Correcting haemoglobin cut-offs to define anaemia in high-altitude pregnant women in Peru reduces adverse perinatal outcomes

Pregnant women who are infected with SARS-CoV-2 are at an increased risk of adverse perinatal outcomes. With this study, we aimed to better understand the relationship between maternal infection and perinatal outcomes, especially preterm births, and the underlying medical and interventionist factors. This was a prospective observational study carried out in 78 centers (Spanish Obstetric Emergency Group) with a cohort of 1347 SARS-CoV-2 PCR-positive pregnant women registered consecutively between 26 February and 5 November 2020, and a concurrent sample of PCR-negative mothers. The patients’ information was collected from their medical records, and the association of SARS-CoV-2 and perinatal outcomes was evaluated by univariable and multivariate analyses. The data from 1347 SARS-CoV-2-positive pregnancies were compared with those from 1607 SARS-CoV-2-negative pregnancies. Differences were observed between both groups in premature rupture of membranes (15.5% vs. 11.1%, p < 0.001); venous thrombotic events (1.5% vs. 0.2%, p < 0.001); and severe pre-eclampsia incidence (40.6 vs. 15.6%, p = 0.001), which could have been overestimated in the infected cohort due to the shared analytical signs between this hypertensive disorder and COVID-19. In addition, more preterm deliveries were observed in infected patients (11.1% vs. 5.8%, p < 0.001) mainly due to an increase in iatrogenic preterm births. The prematurity in SARS-CoV-2-affected pregnancies results from a predisposition to end the pregnancy because of maternal disease (pneumonia and pre-eclampsia, with or without COVID-19 symptoms).

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Fetal movement counting is associated with the reduction of delayed maternal reaction after perceiving decreased fetal movements: a prospective study

Scientific Reports ◽

10.1038/s41598-021-90240-4 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Shigeki Koshida ◽

Shinsuke Tokoro ◽

Daisuke Katsura ◽

Shunichiro Tsuji ◽

Takashi Murakami ◽

...

Keyword(s):

Pregnant Women ◽

Maternal Behavior ◽

Multivariable Analysis ◽

Perinatal Outcomes ◽

Fetal Movement ◽

Post Intervention ◽

Fetal Movements ◽

Adverse Perinatal Outcomes ◽

The Impact ◽

Maternal Reaction

AbstractMaternal perception of decreased fetal movement is associated with adverse perinatal outcomes. Although there have been several studies on interventions related to the fetal movements count, most focused on adverse perinatal outcomes, and little is known about the impact of the fetal movement count on maternal behavior after the perception of decreased fetal movement. We investigated the impact of the daily fetal movement count on maternal behavior after the perception of decreased fetal movement and on the stillbirth rate in this prospective population-based study. Pregnant women in Shiga prefecture of Japan were asked to count the time of 10 fetal movements from 34 weeks of gestation. We analyzed 101 stillbirths after the intervention compared to 121 stillbirths before the intervention. In multivariable analysis, maternal delayed visit to a health care provider after the perception of decreased fetal movement significantly reduced after the intervention (aOR 0.31, 95% CI 0.11–0.83). Our regional stillbirth rates in the pre-intervention and post-intervention periods were 3.06 and 2.70 per 1000 births, respectively. Informing pregnant women about the fetal movement count was associated with a reduction in delayed maternal reaction after the perception of decreased fetal movement, which might reduce stillbirths.

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Diagnostic utility of protein excretion in 24-hour urine and the protein to creatinine ratio for adverse perinatal outcomes and time of delivery

Perinatal Journal ◽

10.2399/prn.21.0293015 ◽

2021 ◽

Vol 29 (3) ◽

pp. 255-265

Author(s):

İbrahim Ömeroğlu ◽

Didem Dereli Akdeniz ◽

Hakan Gölbaşı ◽

Ceren Gölbaşı ◽

Atalay Ekin

Keyword(s):

Pregnant Women ◽

Latency Period ◽

Perinatal Outcomes ◽

Urinary Protein ◽

Neonatal Outcomes ◽

Protein Loss ◽

Spot Urine ◽

Protein Levels ◽

Adverse Perinatal Outcomes ◽

Diagnosis Of Hypertension

Objective Our study aimed to evaluate the perinatal and neonatal outcomes of hypertensive pregnant women with or without proteinuria. We compared the predictivity of spot urinary protein to creatinine (P/C) ratio and 24-hour protein excretions on outcomes. Methods We retrospectively enrolled 230 pregnant women with a new diagnosis of hypertension between 20 and 37 weeks of gestation. We divided the patients into two groups according to the protein level determined by 24-hour urine collection and P/C ratio. The presence and level of proteinuria, its relationship with the P/C ratio, and the relationship between these findings and perinatal outcomes were evaluated. Results Gestational age at delivery weeks and latency period (duration between diagnosis of hypertension and delivery) were significantly earlier in pregnant women with ≥300 mg/24-h and P/C ratio ≥0.3. Adverse neonatal outcomes were significant in patients with proteinuria ≥300 mg/24-hour and P/C ratio ≥0.3. Urinary protein levels in 24-hour urine were significantly higher in pregnant women with P/C ratio ≥0.3 and a significantly positive correlation was found between 24-h proteinuria and P/C (r=0.382, p<0.001). Conclusion Our study demonstrated that a protein loss of ≥300 mg in 24-h and a P/C ratio in spot urine ≥0.3 in hypertensive pregnant women is associated with adverse perinatal outcomes. Furthermore, we have identified that proteinuria ≥300 mg/day and spot urine P/C ratio ≥0.3 in hypertensive pregnant women make them prone to early delivery risk.

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Placental elasticity assessment by point shear wave elastography in pregnancies with intrauterine growth restriction

Journal of Perinatal Medicine ◽

10.1515/jpm-2019-0238 ◽

2019 ◽

Vol 47 (8) ◽

pp. 841-846 ◽

Cited By ~ 6

Author(s):

Murat Akbas ◽

Faik M. Koyuncu ◽

Burcu Artunç-Ulkumen

Keyword(s):

Pregnant Women ◽

Shear Wave ◽

Intrauterine Growth Restriction ◽

Perinatal Outcomes ◽

Shear Wave Elastography ◽

Growth Restriction ◽

Intrauterine Growth ◽

The Mean ◽

Adverse Perinatal Outcomes ◽

Doppler Indices

Abstract Background Placental elasticity varies in different diseases. Our objective was to evaluate placental elasticity using point shear wave elastography (pSWE) in pregnancies with intrauterine growth restriction (IUGR). Methods A total of 66 pregnant women with IUGR and 81 healthy pregnant women were enrolled. Placental elasticity was measured using the transabdominal pSWE method. Ten measurements were made, and the mean was accepted as the mean placental elasticity value in each case. The results for IUGR pregnancies and controls were compared. Results The mean pSWE values were significantly higher in pregnancies with IUGR, which means that women with IUGR have stiffer placentas (P < 0.001). Furthermore, the pSWE values were significantly and positively correlated with Doppler indices and adverse perinatal outcomes. Conclusion The pregnancies with IUGR had stiffer placentas than the healthy controls. The utilization of pSWE for placental elasticity may be useful in the diagnosis and management of IUGR as a supplement to the existing ultrasonography methods.

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Maternal-fetal Transmission and Adverse Perinatal Outcomes in Pregnant Women Infected With Zika Virus

Obstetric Anesthesia Digest ◽

10.1097/01.aoa.0000557676.45720.85 ◽

2019 ◽

Vol 39 (2) ◽

pp. 89-90

Author(s):

L. Pomar ◽

M. Vouga ◽

V. Lambert ◽

C. Pomar ◽

N. Hcini ◽

...

Keyword(s):

Pregnant Women ◽

Zika Virus ◽

Perinatal Outcomes ◽

Adverse Perinatal Outcomes ◽

Maternal Fetal Transmission

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Effect of asthma exacerbation during pregnancy in women with asthma: a population-based cohort study

European Respiratory Journal ◽

10.1183/13993003.01335-2019 ◽

2019 ◽

Vol 55 (2) ◽

pp. 1901335 ◽

Cited By ~ 3

Author(s):

Kawsari Abdullah ◽

Jingqin Zhu ◽

Andrea Gershon ◽

Sharon Dell ◽

Teresa To

Keyword(s):

Early Childhood ◽

Cohort Study ◽

Health Outcomes ◽

Pregnant Women ◽

Pregnancy Complications ◽

Asthma Exacerbation ◽

Perinatal Outcomes ◽

Respiratory Disorders ◽

Physician Visits ◽

Adverse Perinatal Outcomes

The association between asthma exacerbation during pregnancy and adverse maternal and child health outcomes have not been investigated appropriately. Our objective was to determine the short- and long-term intergenerational effect of asthma exacerbation in pregnant women with asthma.A population cohort study was conducted using data from the Ontario asthma surveillance system and population-level health administrative data. Asthma exacerbation in pregnant women with asthma was defined as at least one of the following criteria: at least five physician visits, or one emergency department visit or one hospital admission for asthma during pregnancy. Pregnancy complications, adverse perinatal outcomes and early childhood respiratory disorders were identified using International Classification of Disease codes (9th and 10th revisions).The cohort consisted of 103 424 singleton pregnancies in women with asthma. Asthma exacerbation in pregnant women with asthma was associated with higher odds of pre-eclampsia (OR 1.30, 95% CI 1.12–1.51) and pregnancy-induced hypertension (OR 1.17, 95% CI 1.02–1.33); babies had higher odds of low birthweight (OR 1.14, 95% CI 1.00–1.31), preterm birth (OR 1.14, 95% CI 1.01–1.29) and congenital malformations (OR 1.21, 95% CI 1.05–1.39). Children born to women with asthma exacerbation during pregnancy had elevated risk of asthma (OR 1.23, 95% CI 1.13–1.33) and pneumonia (OR 1.12, 95% CI 1.03–1.22) during the first 5 years of life.Asthma exacerbation during pregnancy in women with asthma showed increased risk of pregnancy complications, adverse perinatal outcomes and early childhood respiratory disorders in their children, indicating that appropriate asthma management may reduce the risk of adverse health outcomes.

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Social deprivation and adverse perinatal outcomes among Western and non-Western pregnant women in a Dutch urban population

Social Science & Medicine ◽

10.1016/j.socscimed.2013.02.008 ◽

2013 ◽

Vol 83 ◽

pp. 42-49 ◽

Cited By ~ 32

Author(s):

Jashvant Poeran ◽

Arno F.G. Maas ◽

Erwin Birnie ◽

Semiha Denktas ◽

Eric A.P. Steegers ◽

...

Keyword(s):

Pregnant Women ◽

Urban Population ◽

Social Deprivation ◽

Perinatal Outcomes ◽

Adverse Perinatal Outcomes

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Machine learning from fetal flow waveforms to predict adverse perinatal outcomes: a study protocol

Gates Open Research ◽

10.12688/gatesopenres.12796.1 ◽

2018 ◽

Vol 2 ◽

pp. 8

Author(s):

Zahra Hoodbhoy ◽

Babar Hasan ◽

Fyezah Jehan ◽

Bart Bijnens ◽

Devyani Chowdhury

Keyword(s):

Machine Learning ◽

Pregnant Women ◽

Perinatal Outcomes ◽

Fetal Ultrasound ◽

Eligibility Criteria ◽

Early Neonatal Mortality ◽

Increased Risk ◽

Machine Learning Approach ◽

Adverse Perinatal Outcomes ◽

Flow Waveforms

Background: In Pakistan, stillbirth rates and early neonatal mortality rates are amongst the highest in the world. The aim of this study is to provide proof of concept for using a computational model of fetal haemodynamics, combined with machine learning. This model will be based on Doppler patterns of the fetal cardiovascular, cerebral and placental flows with the goal to identify those fetuses at increased risk of adverse perinatal outcomes such as stillbirth, perinatal mortality and other neonatal morbidities. Methods: This will be prospective one group cohort study which will be conducted in Ibrahim Hyderi, a peri-urban settlement in south east of Karachi. The eligibility criteria include pregnant women between 22-34 weeks who reside in the study area. Once enrolled, in addition to the performing fetal ultrasound to obtain Dopplers, data on socio-demographic, maternal anthropometry, haemoglobin and cardiotocography will be obtained on the pregnant women. Discussion: The machine learning approach for predicting adverse perinatal outcomes obtained from the current study will be validated in a larger population at the next stage. The data will allow for early interventions to improve perinatal outcomes.

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Maternal Pre-Pregnancy Obesity Combined With Abnormal Glucose Metabolism Further Increases Adverse Pregnancy Outcomes in Chinese Pregnant Women

Frontiers in Endocrinology ◽

10.3389/fendo.2021.754406 ◽

2022 ◽

Vol 12 ◽

Author(s):

Mei-Fang Li ◽

Jiang-Feng Ke ◽

Li Ma ◽

Jun-Wei Wang ◽

Zhi-Hui Zhang ◽

...

Keyword(s):

Glucose Metabolism ◽

Pregnant Women ◽

Pregnancy Outcomes ◽

Perinatal Outcomes ◽

Adverse Pregnancy Outcomes ◽

Control Group ◽

Abnormal Glucose Metabolism ◽

Induced Hypertension ◽

Adverse Perinatal Outcomes ◽

Adverse Pregnancy

AimsOur aim was to evaluate the separate and combined effects of maternal pre-pregnancy obesity and gestational abnormal glucose metabolism (GAGM) on adverse perinatal outcomes.MethodsA total of 2,796 Chinese pregnant women with singleton delivery were studied, including 257 women with pre-pregnancy obesity alone, 604 with GAGM alone, 190 with both two conditions, and 1,745 with neither pre-pregnancy obesity nor GAGM as control group. The prevalence and risks of adverse pregnancy outcomes were compared among the four groups.ResultsCompared with the normal group, pregnant women with maternal pre-pregnancy obesity alone, GAGM alone, and both two conditions faced significantly increased risks of pregnancy-induced hypertension (PIH) (odds ratio (OR) 4.045, [95% confidence interval (CI) 2.286–7.156]; 1.993 [1.171–3.393]; 8.495 [4.982–14.485]), preeclampsia (2.649 [1.224–5.735]; 2.129 [1.128–4.017]; 4.643 [2.217–9.727]), cesarean delivery (1.589 [1.212–2.083]; 1.328 [1.095–1.611]; 2.627 [1.908–3.617]), preterm delivery (1.899 [1.205–2.993]; 1.358 [0.937–1.968]; 2.301 [1.423–3.720]), macrosomia (2.449 [1.517–3.954]; 1.966 [1.356–2.851]; 4.576 [2.895–7.233]), and total adverse maternal outcomes (1.762 [1.331–2.332]; 1.365 [1.122–1.659]; 3.228 [2.272–4.587]) and neonatal outcomes (1.951 [1.361–2.798]; 1.547 [1.170–2.046]; 3.557 [2.471–5.122]). Most importantly, there were no obvious risk differences in adverse pregnancy outcomes between maternal pre-pregnancy obesity and GAGM group except PIH, but pregnant women with both obesity and GAGM exhibited dramatically higher risks of adverse pregnancy outcomes than those with each condition alone.ConclusionsMaternal pre-pregnancy obesity and GAGM were independently associated with increased risks of adverse pregnancy outcomes. The combination of pre-pregnancy obesity and GAGM further worsens adverse pregnancy outcomes compared with each condition alone.

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Oxidative stress in pregnant women with diabetes mellitus

Diabetes Mellitus ◽

10.14341/dm8669 ◽

2018 ◽

Vol 20 (6) ◽

pp. 461-471 ◽

Cited By ~ 1

Author(s):

Roman V. Kapustin ◽

Olga N. Arzhanova ◽

Alena V. Tiselko

Keyword(s):

Oxidative Stress ◽

Diabetes Mellitus ◽

Pregnant Women ◽

Asymmetric Dimethylarginine ◽

Malonic Dialdehyde ◽

Perinatal Outcomes ◽

Abnormal Development ◽

Different Types ◽

Anti Oxidant ◽

Adverse Perinatal Outcomes

Oxidative stress (OS) plays an important role in embryo development, implantation, placentation, fetal development and labour. Diabetes mellitus (DM) is associated with an increase in OS processes. However, the expression of OS biomarkers in pregnant women with DM remains unclear. Based on a literature review, the features of the pro- and anti-oxidant systems of pregnant women with different types of DM have been established. Pregnancy in patients with DM has been shown to be characterised by an activation of OS processes. This leads to an overexpression of free radicals (peroxynitrite), toxic derivatives (malonic dialdehyde, 8-isoprostane) and specific enzymes (asymmetric dimethylarginine, catalase) and a decrease in the synthesis of antioxidants (superoxide dismutase, glutathione peroxidase and uric acid). The modified expression of these biomarkers is observed both in the blood and the placenta of pregnant women. These disorders can cause an unfavourable course of pregnancy, abnormal development of the placenta and development of adverse perinatal outcomes in pregnant women with DM. Nevertheless, given the inconsistency of data obtained, further scientific studies are needed to clarify this issue.

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