Oseltamivir use in pregnancy: Risk of birth defects, preterm delivery, and small for gestational age infants

2019 ◽  
Vol 111 (19) ◽  
pp. 1487-1493 ◽  
Author(s):  
Christina D. Chambers ◽  
Diana Johnson ◽  
Ronghui Xu ◽  
Yunjun Luo ◽  
Kenneth L. Jones ◽  
...  
Keyword(s):  
Preterm Delivery ◽  
Birth Defects ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Pregnancy Risk ◽  
In Pregnancy

scholarly journals Impact of Marriage on Birth Outcomes: Pregnancy Risk Assessment Monitoring System, 2012–2014

2019 ◽  
Vol 86 (2-3) ◽  
pp. 225-230
Author(s):  
Jennifer J. Barr ◽  
Lindsey Marugg
Keyword(s):  
Risk Assessment ◽  
Intensive Care ◽  
Preterm Delivery ◽  
Birth Outcomes ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Pregnancy Outcomes ◽  
Lower Risk ◽  
Neonatal Intensive Care ◽  
Pregnancy Risk

Marriage has been associated with improved pregnancy outcomes. However, as Americans become increasingly accepting of pregnancy and childbearing outside of marriage, many believe the father can support the mother without the parents being married. Some question whether the present normalization of childbearing outside of marriage will negate the protective effect of marriage on pregnancy outcomes. Data from the Centers for Disease Control and Prevention Pregnancy Risk Assessment Monitoring System were used to obtain data from a sample of 138,118 live singleton deliveries from 2012 to 2014. Odds ratios were compared between married and unmarried mothers for outcomes of preterm delivery, a small for gestational age infant, neonatal intensive care unit admission, vaginal delivery, and breastfeeding initiation. Logistic regression analyses were used to adjust for maternal age, maternal and paternal race, maternal medical comorbidities, maternal smoking status, and receipt of Medicaid. Adjusted odds ratios (AOR) showed married women had a lower risk of preterm delivery (AOR = .877, 95% confidence interval [CI; .811–.948]), a small for gestational age baby (AOR = .838, 95% CI [.726–.967]), and a neonatal intensive care admission (AOR = .808, 95% CI [.754–.866]). Women who were married were more likely to have a vaginal delivery (AOR = 1.144, 95% CI [1.085–1.211]) and to initiate breastfeeding (AOR = 1.601, 95% CI [1.490–1.719]). These data demonstrate that despite a normalization in society of childbearing outside of marriage, there continues to be an association of marriage with improved birth outcomes. Summary: Marriage is associated with a lower risk of preterm delivery, small for gestational age infants, and neonatal intensive care unit admission. These differences persist even after correcting for potentially confounding socioeconomic factors.

scholarly journals AB0372 PREGNANCY OUTCOME IN WOMEN WITH SJÖGREN SYNDROME IS OFTEN COMPLICATED BY PLACENTA INSUFFICIENCY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1486.2-1486
Author(s):  
I. Troester ◽  
F. Kollert ◽  
A. Zbinden ◽  
L. Raio ◽  
F. Foerger
Keyword(s):  
Pregnancy Outcome ◽  
Preterm Delivery ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Low Dose ◽  
Sjögren Syndrome ◽  
Sjogren Syndrome ◽  
Live Births ◽  
Dose Aspirin ◽  
Low Dose Aspirin

Background:Chronic inflammatory rheumatic diseases are often associated with a negative effect on pregnancy outcome. Most obstetrical complications are placenta-mediated such as preterm delivery and growths restrictions. In women with Sjögren syndrome, data on placenta- mediated complications are scarce and conflicting (1,2).Objectives:To analyse neonatal outcome in women with Sjögren syndrome with focus on preterm delivery and growth restriction.Methods:We retrospectively analysed 23 pregnancies of 16 patients with Sjögren syndrome that were followed at our centre with regard to pregnancy outcome, medication and disease characteristics. Small for gestational age was defined as birthweight percentile <10th. Preterm delivery was defined as delivery before 37, early term as delivery between 37-39 and term as delivery between 39-42 weeks of gestation.Results:Of 23 pregnancies, one ended in a miscarriage and 22 resulted in live births including one set of twins. Treatment used during pregnancy was hydroxychloroquine (20 pregnancies), prednisone (8), azathioprine (5) and cyclosporine (2). Concomitant treatment with low-dose aspirin was used in 9 pregnancies.Of the 22 live births, 17 were born at early term and 5 at term. There were no preterm deliveries. Median birth weight was 2820g (range 2095-3845g). Nine newborns (40.9%) were small for gestational age (SGA). Maternal treatment during these pregnancies was hydroxychloroquine in all cases and additional low-dose aspirin in three cases. Elevated CRP levels during pregnancy were found in 57% of the cases with SGA outcome. Only one woman with an SGA infant had positive anti-phospholipid antibodies.Regarding delivery mode, most patients had caesarean sections.Conclusion:In our cohort of women with Sjögren syndrome the prevalence of small for gestational age infants was high despite maternal treatment with hydroxychloroquine. Inflammatory markers could help to identify the patients at risk for placental insufficiency, yet prospective studies of larger cohorts are needed.References:[1]Gupta S et al; Sjögren Syndrome and Pregnancy: A literature review. Perm J 2017; 21:16-047[2]De Carolis S et al; The impact of primary Sjögren’s syndrome on pregnancy outcome: Our series and review of the literature. Autoimmun Rev 2014; 13(2):103-7Disclosure of Interests:Isabella Troester: None declared, Florian Kollert Employee of: Novartis, Astrid Zbinden: None declared, Luigi Raio: None declared, Frauke Foerger Grant/research support from: unrestricted grant from UCB, Consultant of: UCB, GSK, Roche, Speakers bureau: UCB, GSK

scholarly journals Heart Failure in Women With Hypertensive Disorders of Pregnancy

Hypertension ◽  
2020 ◽  
Vol 76 (5) ◽  
pp. 1506-1513 ◽  
Author(s):  
Michael C. Honigberg ◽  
Hilde Kristin Refvik Riise ◽  
Anne Kjersti Daltveit ◽  
Grethe S. Tell ◽  
Gerhard Sulo ◽  
...  
Keyword(s):  
Heart Failure ◽  
Preterm Delivery ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Gestational Hypertension ◽  
Hazard Ratio ◽  
Hypertensive Disorders Of Pregnancy ◽  
First Birth ◽  
Hypertensive Disorders

Hypertensive disorders of pregnancy (HDP) have been associated with heart failure (HF). It is unknown whether concurrent pregnancy complications (small-for-gestational-age or preterm delivery) or recurrent HDP modify HDP-associated HF risk. In this cohort study, we included Norwegian women with a first birth between 1980 and 2004. Follow-up occurred through 2009. Cox models examined gestational hypertension and preeclampsia in the first pregnancy as predictors of a composite of HF-related hospitalization or HF-related death, with assessment of effect modification by concurrent small-for-gestational-age or preterm delivery. Additional models were stratified by final parity (1 versus ≥2 births) and tested associations with recurrent HDP. Among 508 422 women, 565 experienced incident HF over a median 11.8 years of follow-up. After multivariable adjustment, gestational hypertension in the first birth was not significantly associated with HF (hazard ratio, 1.41 [95% CI, 0.84–2.35], P =0.19), whereas preeclampsia was associated with a hazard ratio of 2.00 (95% CI, 1.50–2.68, P <0.001). Among women with HDP, risks were not modified by concurrent small-for-gestational-age or preterm delivery ( P interaction =0.42). Largest hazards of HF were observed in women whose only lifetime birth was complicated by preeclampsia and women with recurrent preeclampsia. HF risks were similar after excluding women with coronary artery disease. In summary, women with preeclampsia, especially those with one lifetime birth and those with recurrent preeclampsia, experienced increased HF risk compared to women without HDP. Further research is needed to clarify causal mechanisms.

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