scholarly journals Younger Age in Adolescent Pregnancies Is Associated with Higher Risk of Adverse Outcomes

2021 ◽  
Vol 18 (16) ◽  
pp. 8514
Author(s):  
Maria de la Calle ◽  
Jose L. Bartha ◽  
Cristina M. Lopez ◽  
Miriam Turiel ◽  
Nuria Martinez ◽  
...  
Keyword(s):  
Maternal Age ◽  
Clinical History ◽  
Developed Countries ◽  
Adverse Outcomes ◽  
Young Adolescents ◽  
Maternal Complications ◽  
Breastfeeding Intention ◽  
Labor Complications ◽  
Fetal Complications ◽  
Adolescent Pregnancies

Adolescent pregnancy remains a health issue worldwide also in developed countries, since it has been associated with adverse maternal and neonatal outcomes. Some data suggest that very young adolescents have higher risk, likely due to immaturity. Therefore, we aimed to assess the influence of maternal age on complications during gestation and labor in pregnant women between 13 and 19 years of age. In particular, we evaluated the possible association between maternal age and obstetric, fetal and labor complications. This is a retrospective, observational and exploratory study conducted at Hospital Universitario La Paz (HULP, Madrid, Spain). The clinical history of 279 women who delivered between 2013 and 2018 was analyzed. Maternal age and the presence of maternal, fetal and labor complications, as well as risk of postpartum depression and breastfeeding intention, were recorded. General regression models were used to analyze the contribution of maternal age on each complication. The percentage of adolescent pregnancies at HULP between 2013 and 2018 was 0.9%. The risk of all the maternal complications analyzed decreased significantly with every year of age of the mother (hyperemesis, lower back pain, anemia, gestational diabetes mellitus, and threat of premature labor and premature rupture of membranes). Every year of maternal age decreased 0.8-fold [0.8; 0.9] the prevalence of fetal complications and also reduced the risk of C-section, postpartum hemorrhage and obstetrical hysterectomy. Furthermore, higher maternal age increased 1.1-fold [1.0; 1.2] the breastfeeding intention. In conclusion, young adolescents are at higher risk of complications during pregnancy and labor.

Case Series: Seventeen Year Institutional Review of Placental Chorangiomas

2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S98-S98
Author(s):  
A Kousar ◽  
K Takeda ◽  
A Rizvi ◽  
A Sutton ◽  
K Geisinger
Keyword(s):  
Gestational Hypertension ◽  
Medical Center ◽  
Case Series ◽  
Adverse Outcomes ◽  
Lesion Detection ◽  
Maternal Complications ◽  
Ultrasound Monitoring ◽  
Institutional Review ◽  
Fetal Complications ◽  
Prenatal Imaging

Abstract Introduction/Objective Chorangioma is a rare tumor occurring in less than 0.5 - 1% of all pregnancies. Small chorangiomas (< 4cm) are mostly asymptomatic and incidental. Large chorangiomas (> 4 cm) may be associated with various fetal complications and complicated pregnancies. The aim of our study is to assess the ultrasound detection rate of these lesions. Methods A retrospective study of chorangioma cases seen at Vidant Medical Center between 2003 to 2019 was conducted. Size of the lesion, detection on prenatal imaging, gestational weeks at delivery, maternal age and pregnancy related fetal and maternal complications were analyzed. Results A total of 25761 placentas were examined from 2003 to 2019 in Vidant Medical Center. Out of these only thirty-nine cases (0.15%) of chorangioma were found. 41% of these women were above 30 years of age. 36 patients were non-Hispanic. 92.3 % (36 cases) of these lesions were less than 4cm and 7.6 %(3 cases) were above 4 cm, with only one recent case of 7.0 cm in greatest dimension. 92% of the total patients presented with complicated pregnancies. Preeclampsia, preterm delivery, gestational hypertension and intrauterine growth retardation were among the most common complications observed. 3 patients presented with oligohydramnios. Interestingly, none of the lesions were detected on prenatal ultrasound. Conclusion Large chorangiomas(>4 cm) are rare but are known to be associated with adverse fetal outcomes. Our seventeen year institutional review shows the largest chorangioma to be 7 cm in greatest dimension. Regular ultrasound monitoring is required to pick up these benign lesions early and prevent adverse outcomes. A retrospective review is needed to determine why the lesions in our study were not detected radiographically.

scholarly journals Women Aged over 40 with Twin Pregnancies Have a Higher Risk of Adverse Obstetrical Outcomes

2021 ◽  
Vol 18 (24) ◽  
pp. 13117
Author(s):  
María De la Calle ◽  
Jose L. Bartha ◽  
Laura García ◽  
Marcos J. Cuerva ◽  
David Ramiro-Cortijo
Keyword(s):  
Risk Factor ◽  
Retrospective Cohort ◽  
Maternal Age ◽  
Independent Risk Factor ◽  
Adverse Outcomes ◽  
Obstetric Outcomes ◽  
P Value ◽  
Labor Complications ◽  
Twin Pregnancies ◽  
Over 40 Years

Maternal age is related to a higher risk of adverse maternal, fetal, and neonatal outcomes in twin pregnancies. However, whether this increase in adverse outcomes is due solely to age or due to risk factors that are more common in women over 40 remains unknown. The aim of this study is to assess if maternal age over 40 years old is an independent risk factor for obstetric adverse outcomes in dichorionic diamniotic twin gestations. In this single-center retrospective cohort study, we compared the obstetric outcomes of women with dichorionic diamniotic twin pregnancies below and over 40 years of age. A twin pregnancy cohort enrolled between 2013 and 2019 was included in the study. Maternal, fetal, and labor complications were recorded. A total of 510 women were analyzed in two groups: 266 women below 40 years old and 244 women over 40 years old. Maternal age over 40 increased the odds of maternal (aOR = 1.9 (1.3; 2.9); p-value = 0.002), fetal (aOR = 1.8 (1.0; 3.0); p-value = 0.037), and labor complications (aOR = 2.5 (1.3; 4.6); p-value = 0.004). Maternal age over 40 years was the most important factor increasing the odds of having a caesarean section (C-section). Over 40 years old was an independent risk factor for complications in dichorionic diamniotic twin pregnancies.

scholarly journals Characteristics and adverse outcomes of Chinese adolescent pregnancies between 2012 and 2019

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yanxia Xie ◽  
Xiaodong Wang ◽  
Yi Mu ◽  
Zheng Liu ◽  
Yanping Wang ◽  
...  
Keyword(s):  
Adolescent Pregnancy ◽  
Gestational Age ◽  
Rural Areas ◽  
Reference Group ◽  
Perinatal Outcomes ◽  
Severe Anaemia ◽  
Adverse Outcomes ◽  
Near Miss ◽  
Adolescent Women ◽  
Adolescent Pregnancies

AbstractWe aimed to describe the characteristics of adolescent pregnancy, determine its effect on adverse maternal and perinatal outcomes and explore whether that association varies with gestational age with the goal of proposing specific recommendations for adolescent health in China. This study included 2,366,559 women aged 10–24 years who had singleton pregnancies between 2012 and 2019 at 438 hospitals. Adolescent pregnancy was defined as younger than 20 years of age. We used multivariable logistic regression to estimate the effects. Women aged 20–24 years served as the reference group in all analyses. The proportion of rural girls with adolescent pregnancies rebounded after 2015 even though common-law marriage in rural areas decreased. Higher risks of eclampsia (adjusted odds ratio (aOR) 1.87, 95% confidence interval (CI) 1.57 ~ 2.23), severe anaemia (aOR 1.18, 95% CI 1.09 ~ 1.28), maternal near miss (MNM; aOR 1.24, 95% CI 1.12 ~ 1.37), and small for gestational age (SGA; aOR 1.30, 95% CI 1.28 ~ 1.33) were observed when gestational age was > 37 weeks. Adolescent pregnancy was independently associated with increased risks of other perinatal outcomes. Further implementation of pregnancy prevention strategies and improved health care interventions are needed to reduce adolescent pregnancies and prevent adverse fertility outcomes among adolescent women in China at a time when adolescent fertility rate is rebounding.

scholarly journals Consequences of antepartum hemorrhage and its maternal and perinatal outcome

2019 ◽  
Vol 8 (4) ◽  
pp. 1480
Author(s):  
Himang Jharaik ◽  
Bishan Dhiman ◽  
S. K. Verma ◽  
Aditi Sharma
Keyword(s):  
Perinatal Outcome ◽  
Placenta Previa ◽  
Developed Countries ◽  
Perinatal Morbidity ◽  
Antepartum Haemorrhage ◽  
High Risk Factors ◽  
Fetal Complications ◽  
Life Threatening ◽  
One Year ◽  
Life Threatening Event

Background: Antepartum haemorrhage, a life-threatening event, is defined as bleeding per vaginum occurring after the fetus has reached the period of viability, considered to be 20 weeks in developed countries and 28 weeks in countries with low resource settings. We evaluated the consequences of antepartum haemorrhage, their maternal and perinatal outcome so as to outline the proper management of patient in order to improve both maternal and perinatal morbidity and mortality.Methods: This one-year prospective study totaled 133 cases of APH fulfilling the inclusion criteria were studied. Data was recorded on the MS excel sheet for further analysis and processing.Results: Total 6693 deliveries were conducted out of which 133 presented as APH and incidence of APH was found out to be 1.98%. Placenta previa was most common. APH was commonly associated with multigravida and most cases were in age group of 26-30 years. Most of the PP and abruption cases were admitted at 34-37 weeks and 31-33 weeks respectively. High risk factors included previous LSCS and D and C, hypertension, multiple pregnancies and malpresentations. Most of the patients underwent preterm LSCS. Most fetal complications were due to prematurity. 58.6% patients were transfused blood. Overall perinatal mortality was 20.1% and maternal mortality was zero.Conclusions: Early diagnoses, timely referrals and transfusion facilities along with trained team of doctors with well-equipped ICU facility goes a long way in avoiding APH related maternak and fetal complications.

scholarly journals Maternal age at first cesarean delivery related to adverse pregnancy outcomes in a second cesarean delivery: a multicenter, historical, cross-sectional cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shilei Bi ◽  
Lizi Zhang ◽  
Jingsi Chen ◽  
Minshan Huang ◽  
Lijun Huang ◽  
...  
Keyword(s):  
Risk Factor ◽  
Cohort Study ◽  
Cesarean Delivery ◽  
Maternal Age ◽  
Reference Group ◽  
Multivariate Logistic Regression Analysis ◽  
Advanced Maternal Age ◽  
Adverse Outcomes ◽  
Cross Sectional ◽  
Singleton Pregnancies

Abstract Background To determine the effects of maternal age at first cesarean on maternal complications and adverse outcomes of pregnancy with the second cesarean. Methods This was a multicenter, historical, cross-sectional cohort study involving singleton pregnancies ≥28 gestational weeks, with a history of 1 cesarean delivery, and who underwent a second cesarean between January and December 2017 at 11 public tertiary hospitals in 7 provinces of China. We analyzed the effects of maternal age at first cesarean on adverse outcomes of pregnancy in the second cesarean using multivariate logistic regression analysis. Results The study consisted of 10,206 singleton pregnancies. Women were at first cesarean between 18 and 24, 25–29, 30–34, and ≥ 35 years of age; and numbered 2711, 5524, 1751, and 220 cases, respectively. Maternal age between 18 and 24 years at first cesarean increased the risk of placenta accreta spectrum (aOR, 1.499; 95% CI, 1.12–2.01), placenta previa (aOR, 1.349; 95% CI, 1.07–1.70), intrahepatic cholestasis of pregnancy (aOR, 1.947; 95% CI, 1.24–3.07), postpartum hemorrhage (aOR, 1.505; 95% CI, 1.05–2.16), and blood transfusion (aOR, 1.517; 95% CI, 1.21–1.91) in the second cesarean compared with the reference group (aged 25–29 years). In addition, maternal age ≥ 35 years at first cesarean was a risk factor for premature rupture of membranes (aOR, 1.556; 95% CI, 1.08–2.24), placental abruption (aOR, 6.464, 95% CI, 1.33–31.51), uterine rupture (aOR, 7.952; 95% CI, 1.43–44.10), puerperal infection (aOR, 6.864; 95% CI, 1.95–24.22), neonatal mild asphyxia (aOR, 4.339; 95% CI, 1.53–12.32), severe asphyxia (aOR, 18.439; 95% CI, 1.54–220.95), and admission to a neonatal intensive care unit (aOR, 2.825; 95% CI, 1.54–5.17) compared with the reference group (aged 25–29 years). Conclusions Maternal age between 18 and 24 years or advanced maternal age at first cesarean was an independent risk factor for adverse maternal outcomes with the second cesarean. Advanced maternal age at the first cesarean specifically increased adverse neonatal outcomes with the second. Therefore, decisions as to whether to perform a first cesarean at a young or advanced maternal age must be critically evaluated.

330. Association between maternal age and adverse outcomes in pre-eclampsia

2018 ◽  
Vol 13 ◽  
pp. S43
Author(s):  
Ugochinyere Vivian Ukah ◽  
Beth Payne ◽  
Jennifer Hutcheon ◽  
Laura Magee ◽  
Peter von Dadelszen
Keyword(s):  
Maternal Age ◽  
Adverse Outcomes

scholarly journals Re: Maternal age and risk for adverse outcomes

2019 ◽  
Vol 220 (2) ◽  
pp. 210-211 ◽  
Author(s):  
Jonathan M. Snowden ◽  
Mark A. Klebanoff
Keyword(s):  
Maternal Age ◽  
Adverse Outcomes

Postponing Motherhood: a Demographic and Contemporary Issue

2021 ◽  
Vol 17 ◽  
Author(s):  
Patrícia Félix Nazaré ◽  
Ana Sofia Fernandes Pais ◽  
Margarida Figueiredo-Dias
Keyword(s):  
Fertility Preservation ◽  
Maternal Age ◽  
Developed Countries ◽  
Public Health Issue ◽  
Chromosomal Anomalies ◽  
Labor Conditions ◽  
Mesh Terms ◽  
Age Related ◽  
Pubmed Database ◽  
The Postponement

Background: During the last decades, the postponement of motherhood became a reality in developed countries, leading to inevitable medical consequences, both maternal and fetal. Fertility preservation techniques constitute a matter of discussion in the context of voluntary delay of pregnancy. Objective: This study aims to analyse the causes, to address the maternal and fetal consequences and to explore solutions to this problem, namely the applicability of fertility preservation techniques. Methods: Bibliographic search of studies published between 2008 and 2020 was conducted in the PubMed database using the MeSH terms "fertility preservation" and "maternal age", among others. Results: The reasons that lead to the postponement of motherhood are the difficulty in establishing stable relationships, the expansion of differentiated education and demanding labor conditions, the diffusion of contraceptive methods, economic insecurity, ideational changes and the lack of information about this issue. The increased infertility, fetal death, chromosomal anomalies, multiple pregnancies, preterm birth and increased caesarean sections are the medical consequences associated. The review of social policies and the provision of information about fertility constitute possible solutions to this phenomenon. Fertility preservation techniques, especially oocyte cryopreservation, appear as an option but cannot totally compensate the age-related fertility decline. Conclusion: Advanced maternal age is a Public Health issue essentially explained by a set of interconnected social factors, involving considerable risks for maternal and fetal health. Fertility preservation techniques, although promising, may contribute to the perpetuation of this reality.

scholarly journals Rising rates of second stage caesarean section and its impact on maternal outcome

2018 ◽  
Vol 7 (7) ◽  
pp. 2681
Author(s):  
Shanmugapriya Kumaresan ◽  
Malarvizhi Loganathan
Keyword(s):  
Caesarean Section ◽  
Caesarean Section Rate ◽  
Adverse Outcomes ◽  
Cesarean Sections ◽  
Maternal Complications ◽  
College Hospital ◽  
Second Stage Of Labor ◽  
Medical College ◽  
Second Stage ◽  
Second Stage Of Labour

Background: There is an alarming rise in caesarean section leading to increased adverse outcomes for both the mother and fetus when compared with vaginal delivery. With this increasing caesarean section rate, there is a concerning increase in the rate of second stage caesarean section. This study highlights includes the rate of caesarean deliveries in the second stage of labour, the indications for delivery and the associated maternal morbidity in this cohort of women.  Methods: This was a prospective cohort review of all women with a singleton, cephalic fetus at term delivered by caesarean section in the second stage of labor between July, 2016 and December 31, 2017 at government medical college hospital Dharmapuri. The main outcome measures were second stage caesarean section, indications and its maternal morbidity.Results: 250 women underwent caesarean delivery in the advanced labor. Among the 250 patient’s majority of them were in the age group of 21-30 yrs. about 76% of the patients were primigravidae and only the remaining 24% were multigravida. The commonest indications for doing caesarean section in the second stage of labor was cephalo pelvic disproportion and non-reassuring fetal heart rate patterns. The difficult task was delivery of the deeply engaged head, the increased likelihood of intraoperative and post-operative complications.Conclusions: Cesarean sections done in second stage of labor are associated with several intra-operative maternal complications and morbidity.

scholarly journals Pregnancy with previous caesarean section: an overview of adverse fetomaternal sequelae

2018 ◽  
Vol 7 (5) ◽  
pp. 1817 ◽  
Author(s):  
Joyita Bhowmik ◽  
Amit Kyal ◽  
Indrani Das ◽  
Vidhika Berwal ◽  
Pijush Kanti Das ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Cesarean Section ◽  
Previous History ◽  
Successful Outcome ◽  
Maternal Complications ◽  
Cross Sectional ◽  
Medical College ◽  
Increased Risk ◽  
Fetal Complications ◽  
History Of

Background: The Caesarean section epidemic is a reason for immediate concern and deserves serious international attention. The purpose of this study was to evaluate adverse maternal and fetal complications associated with pregnancies with history of previous caesarean section.Methods: A cross-sectional, observational study carried out over a period of 1 year from 1st June 2016 to 31st July 2017 in Medical College Kolkata. 200 antenatal patients with previous history of 1 or more caesarean sections were included. In all cases thorough history, complete physical and obstetrical examination, routine and case specific investigations were carried out and patients were followed till delivery and for 7 days thereafter. All adverse maternal and fetal complications were noted.Results: Out of 200 women, 30 candidates were tried for VBAC, of them 20 (66.66%) had successful outcome. Most common antenatal complication was APH (5.5%) due to placenta praevia followed by scar dehiscence. There were 12 cases (6.66%) of PPH and 6 cases (3.33%) of scar dehiscence in the study group. 3 cases required urgent hysterectomy due to placenta accreta. 42 out of 196 babies required management in SNCU immediately or later after birth.Conclusions: Women with a prior cesarean are at increased risk for repeat cesarean section. Vigilance with respect to indication at primary cesarean delivery, proper counselling for trial of labor and proper antepartum and intrapartum monitoring of patients are key to reducing the cesarean section rates and maternal complications.

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