186: Electronic cigarette use in pregnancy is not associated with low birth weight or preterm delivery

This study aimed to illustrate and account for immortal time bias in pregnancy observational investigations, using the relationship between late use of antibiotics and risk of preterm birth as an example. We conducted a population-based cohort study including 549,082 deliveries between 2007 and 2017 in Lombardy, Italy. We evaluated the risk of preterm births, low birth weight, small for gestational age, and low Apgar score associated with antibiotic dispensing during the third trimester of pregnancy. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CI) of the outcomes, considering the use of antibiotics as time-fixed (with biased classification of exposure person-time) and time-varying (with proper classification of exposure person-time) exposure. There were 23,638 (4.3%) premature deliveries. There was no association between time-fixed exposure to antibiotics and preterm delivery (adjusted HR 0.96; 95% CI 0.92 to 1.01) but an increased risk of preterm birth when time-varying exposure to antibiotics was considered (1.27; 1.21 to 1.34). The same trend was found for low birth weight and low Apgar score. Immortal time bias is a common and sneaky trap in observational studies involving exposure in late pregnancy. This bias could be easily avoided with suitable design and analysis.

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Comparison of Perinatal Outcome (Low Birth Weight, Preterm Delivery) in Women with <6 Month Versus 12-17 Months of IBI

10.53350/pjmhs2115102742 ◽

2021 ◽

Vol 15 (10) ◽

pp. 2742-2745

Author(s):

Andleeb Arshad ◽

Misbah Kausar Javaid ◽

Abida Rehman

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Preterm Delivery ◽

Perinatal Outcome ◽

Short Interval ◽

Singleton Pregnancy ◽

Optimal Interval ◽

Low Birth Weight Babies ◽

Group B ◽

Inter Pregnancy Interval

Objectives: To compare the perinatal outcome (low birth weight, preterm delivery) in women with <6 month versus 12-17 months of interpregnancy birth interval. Material and methods: This Cohort study was conducted at Department of Obstetrics and Gynecology, Lahore General Hospital Lahore from March 2020 to September 2020. Total 420 patients with age range 18-40 years, singleton pregnancy, women with previous live birth, parity 1-4 and Gestational age > 28 weeks assessed on LMP were selected for this study. Patients were divided into two groups (A & B) according to their inter-pregnancy interval i.e. <6 months group labelled as A group and 12-17 months group labelled as B group. All patients in both groups will be followed till delivery and the perinatal outcome i.e. preterm delivery (birth occurred before completion of 37 weeks of gestation) and low birth weight (those babies whose weight less than 2.5 Kg at the time of birth) were noted. Results: The mean age of women in group A was 26.73 ± 6.56 years and in group B was 26.73 ± 6.56 years. The perinatal outcome was preterm delivery in 189 (90.0%) and low birth weight babies in 143 (68.10%) women of <6 months while in 12-17 months interpregnancy interval, it was noted in 111 (52.86%) and 102 (48.57%) women respectively Conclusion: Our study concluded that appropriate inter pregnancy interval could reduce the rate of preterm delivery and low birth weight babies and optimal interval associated with the lowest risk of adverse perinatal outcome was 12-17 months. Keywords: Birth spacing, short interval, preterm delivery, low birth weight.

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Neonatal Outcome Among Adolescent and Adult Pregnancy in a Tertiary Care Center of Nepal

Journal of Nepalgunj Medical College ◽

10.3126/jngmc.v14i2.21541 ◽

2018 ◽

Vol 14 (2) ◽

pp. 56-59

Author(s):

Jyoti Adhikari ◽

Shristi Kharel ◽

Lalita Bahl ◽

Deepal Poudel ◽

Rajesh K.C.

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Preterm Delivery ◽

Adolescent Mothers ◽

Neonatal Outcome ◽

Birth Asphyxia ◽

Adolescent Mother ◽

P Value ◽

The Common ◽

Mother Group

Background: Teenage pregnancy is a common public health problem worldwide which is detrimental to the health of mother and child and has long been considered a high-risk situation. The risk of low birth weight (LBW) and preterm delivery is particularly high among teenagers.Methods: A comparative study was conducted in Nepalgunj Medical College Teaching Hospital, Kohalpur during the period of July 2015 to June 2016. The study was carried out to compare the immediate neonatal outcome and morbidity pattern in neonates of 50 adolescent and 50 adult mothers.Results: In the present study, 84% belonged to adolescent mother group (17-19 years) whereas 50% belonged to adult mother group (20-23 years). Illiteracy was seen more in adolescent mothers (62%) and most were from rural areas (68%). The common immediate neonatal outcome found in adolescent and adult mothers were preterm delivery (96% vs. 52%; p value 0.001), low birth weight (LBW) (70% vs. 38%; p value 0.001). The common neonatal morbidities seen significantly high in neonates of adolescent mothers, viz: Neonatal sepsis (NNS)(54% vs. 20% p value <0.02), apnea (30% vs. 14% P value <0.02), neonatal jaundice(NNJ)(44% vs. 30% p value <0.01) while the other morbidities found were birth asphyxia (20% vs. 14%; p value <0.1), Respiratory distress syndrome (RDS) (36% vs. 24% p value<0.1), anemia (16% vs. 8%; p value <0.1), seizure (10% vs. 8%; p value <0.1), meconium aspiration syndrome (MAS) (6% vs. 18%; p value<0.1) and intrauterine growth retardation(IUGR)(22% vs. 20%; p value <0.5). Similarly mortality was found to be more in neonates of adolescent mothers (14% vs. 8%; p value <0.1).Conclusion: Adolescent pregnant mothers are at risk of having poor neonatal outcome and morbidities like NNS, NNJ, RDS, apnea, IUGR, birth asphyxia, anemia and seizure. JNGMC, Vol. 14 No. 2 December 2016, Page: 56-59

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Preterm Delivery and Low Birth Weight Among Neonates Conceived With Intracytoplasmic Sperm Injection Compared With Conventional In Vitro Fertilization

Obstetrics and Gynecology ◽

10.1097/aog.0000000000002423 ◽

2018 ◽

Vol 131 (2) ◽

pp. 262-268 ◽

Cited By ~ 1

Author(s):

Sanaz Keyhan ◽

Tracy Truong ◽

Yi-Ju Li ◽

Tia Jackson-Bey ◽

Jennifer L. Eaton

Keyword(s):

Birth Weight ◽

In Vitro Fertilization ◽

Low Birth Weight ◽

Preterm Delivery ◽

Intracytoplasmic Sperm Injection ◽

Vitro Fertilization

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Pregnancies achieved after fresh and frozen IVF cycles with a thinner endometrium are at higher risk for preterm delivery and low birth weight

Fertility and Sterility ◽

10.1016/j.fertnstert.2018.02.071 ◽

2018 ◽

Vol 109 (3) ◽

pp. e37

Author(s):

Melissa Martinez ◽

Hayley Eichlin ◽

Thomas Molinaro ◽

Paul Bergh

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Preterm Delivery

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Paternal age and the risk of low birth weight and preterm delivery: a Finnish register-based study

Journal of Epidemiology & Community Health ◽

10.1136/jech-2017-210170 ◽

2018 ◽

Vol 72 (12) ◽

pp. 1104-1109 ◽

Cited By ~ 6

Author(s):

Alice Goisis ◽

Hanna Remes ◽

Kieron Barclay ◽

Pekka Martikainen ◽

Mikko Myrskylä

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Preterm Delivery ◽

Birth Outcomes ◽

Conclusive Evidence ◽

Paternal Age ◽

Adverse Birth Outcomes ◽

Maternal Characteristics ◽

Parental Characteristics ◽

Increased Risk

BackgroundBased on existing studies, there is no conclusive evidence as to whether and why paternal age matters for birth outcomes.MethodsWe used Finnish population registers on 106 652 children born 1987–2000. We first document the unadjusted association between paternal age and the risk of low birth weight (LBW; <2500 g) and preterm birth (<37 weeks’ gestation). Second, we investigate whether the unadjusted association is attenuated on adjustment for child’s, maternal and parental socioeconomic characteristics. Third, by adopting a within-family design which involves comparing children born to the same father at different ages, we additionally adjust for unobserved parental characteristics shared between siblings.ResultsThe unadjusted results show that being born to a father aged 40+, as opposed to a father aged 30–34, is associated with an increased risk of LBW of 0.96% (95% CI 0.5% to 1.3%) and to a younger father (<25) with a 1% (95% CI 0.6% to 1.3%) increased risk. The increased risk at younger paternal ages is halved on adjustment for the child’s characteristics and fully attenuated on adjustment for child/parental characteristics. The increased risk at paternal ages 40+ is partially attenuated on adjustment for maternal characteristics (β=0.62%; 95% CI 0.13% to 1.1%). Adjustment for unobserved parental characteristics shared by siblings further attenuates the 40+ coefficient (β=0.4%; 95% CI −0.5% to −1.2%). Results for preterm delivery are similar.ConclusionsThe results underscore the importance of considering paternal age as a potential risk factor for adverse birth outcomes and of expanding research on its role and the mechanisms linking it to birth outcomes.

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Severe anemia and adverse pregnancy outcome in a tertiary care hospital in North India

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20180159 ◽

2018 ◽

Vol 7 (2) ◽

pp. 483

Author(s):

Premlata Yadav

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Peripheral Blood ◽

Tertiary Care ◽

Significant Risk ◽

North India ◽

Deficiency Anemia ◽

Care Hospital ◽

Severe Anemia ◽

In Pregnancy

Background: Anaemia is commonest medical disorder in pregnancy with 88% prevalence in India mainly due to ignorance, poverty and gender bias. 40-60% of maternal deaths in developing countries. According to the recent standard laid down by WHO anemia is present when the hemoglobin (Hb) concentration in the peripheral blood is less than 11 gm/dl. The most common cause of anemia in pregnancy is iron deficiency. Anemia is diagnosed by estimating the hemoglobin concentration and examining a peripheral blood smear for the characteristic red blood cell changes. The aim of the study was to determine the association between severe anemia, maternal and perinatal complications.Methods: Case control study was done in department of Obstetrics and Gynecology, Rajendra Institute of Medical Sciences Ranchi, India from February 2016 to July 2016. 100 pregnant women, admitted for delivery and having severe anemia were studied and compared with 100 non-anaemic women of similar demographic features. Maternal and perinatal complications were observed. Pearson, chi-square and Fischer exact tests were used to calculate significance of results.Results: Of the severely anaemic mothers, 36% babies were low birth weight (p=0.042) and 20% were small for gestational age (p = 0.026), as compared to 18% and 10% of controls, respectively.Conclusions: Severe maternal anemia carries significant risk of hemorrhage and infection in the mother. It is also associated with preterm birth, low birth weight.

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Polymorphisms of haemostasis genes as risk factors for preterm delivery

Thrombosis and Haemostasis ◽

10.1160/th04-10-0653 ◽

2005 ◽

Vol 94 (07) ◽

pp. 88-92 ◽

Cited By ~ 19

Author(s):

Christoph Härtel ◽

Sören von Otte ◽

Julia Koch ◽

Peter Ahrens ◽

Evelyn Kattner ◽

...

Keyword(s):

Risk Factors ◽

Birth Weight ◽

Preterm Birth ◽

Low Birth Weight ◽

Preterm Delivery ◽

Factor Xiii ◽

Very Low Birth Weight ◽

Factor V Leiden ◽

Factor Vii ◽

Factor V

SummaryClinical trials evaluating the potential benefit of anticoagulant treatment in pregnant women with inherited thrombophilia are based on the observation that a genetic predisposition to thrombosis is associated with frequent abortions and preterm birth. It was the aim of our study to delineate the impact of genetic polymorphisms with prothrombotic and antithrombotic effects on the occurrence of preterm birth in a large cohort of very-low-birth-weight (VLBW)-infants and their mothers. We examined the factor V Leiden and the prothrombin G20210A mutation, the factor VII 121del/ins and the factor XIII Val34Leu polymorphism in preterm very-low-birth-weight (VLBW, n=593) and term-born-infants (n=278) and their mothers (n=785).The primary outcome was preterm vs. term birth. From all polymorphisms tested, the maternal factor VII-121del/ins polymorphism (26.2 vs. 17.6 %; p=0.009) and the infant’s factor VII-121del/ins polymorphism (29.0 vs. 20.0 %; p=0.009) were more frequent in singletonVLBW and their mothers compared to term infants and their mothers. Furthermore, the frequency of the factor XIII-Val34Leu polymorphism was significantly lower in singleton VLBW than in term infant controls (5.1 vs. 9.6%, p=0.025). In a multivariate regression analysis, previous preterm delivery (OR=3.8, 95% CI: 1.7–8.4), the maternal carrier status of the factor-VII-121del/ins polymorphism (OR=1.7, 95% CI: 1.12–2.5, p=0.007) and the lower frequency of infant’s factor-XIII-Val34Leu polymorphism (OR=0.53; 95% CI: 0.29–0.96; p=0.038) were found to be independently associated with preterm delivery. InVLBW mothers with pathological CTG as cause of preterm delivery, the frequency of factor V Leiden mutation was significantly increased compared to VLBW mothers without pathological CTG (14.1 vs. 6.1%, p=0.01).The investigated haemostasis gene polymorphisms have a much lower impact on subsequent preterm delivery than known risk factors such as previous preterm birth. The reported association of the factor-VII-121del/ins polymorphism on preterm delivery and its clinical relevance needs to be further elucidated.

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