Maternal and neonatal outcomes among pregnant women with inflammatory myopathies

Background: Advanced maternal age is an important predictor for maternal and neonatal outcomes such as maternal mortality, low birth weight, stillbirth, preterm birth, cesarean section and preeclampsia. Objective: To determine the association of advanced maternal age and adverse maternal and neonatal outcomes in Iranian pregnant women. Methods: In this hospital-based cross-sectional study, 5117 pregnant women from 103 hospitals in Tehran, Iran, were participated in the study in 2015. The required data were gathered from hospitals which equipped to the department of obstetrics and gynecology. Advanced maternal age was considered as an independent variable and unwanted pregnancy, preeclampsia, preterm birth, cesarean section and low birth weight were considered as interested outcomes. Results: In our study, the prevalence of advanced maternal age was 12.08%. Advanced maternal age was significantly associated with higher risk of unwanted pregnancy (OR: 1.39, 95% CI: 1.12-1.73), preterm birth (OR: 1.75, 95% CI: 1.28- 2.39) and cesarean section (OR: 1.34, 95% CI: 1.03-1.74). In our study, there was no significant relationship between advanced maternal age and preeclampsia but this relationship could be clinically important (OR: 1.48, 95% CI: 0.99-2.20, P=0.052), and there is no significant relationship between advanced maternal age and low birth weight (OR: 1.08, 95% CI: 0.67-1.74, P=0.736). Conclusion: Advanced maternal age is associated with higher risk of unintended pregnancy, preterm birth and cesarean section but our findings did not support advanced maternal age as a risk factor associated with low birth weight.

Download Full-text

Clinical Stratification of Pregnant COVID-19 Patients based on Severity: A Single Academic Center Experience

American Journal of Perinatology ◽

10.1055/s-0041-1723761 ◽

2021 ◽

Vol 38 (05) ◽

pp. 515-522

Author(s):

Marissa Berry ◽

Amanda Wang ◽

Shannon M. Clark ◽

Hassan M. Harirah ◽

Sangeeta Jain ◽

...

Keyword(s):

Pregnant Women ◽

Disease Severity ◽

Gestational Age ◽

Laboratory Data ◽

Population Characteristics ◽

Neonatal Outcomes ◽

P Value ◽

Asymptomatic Patients ◽

Increased Risk ◽

Maternal And Neonatal Outcomes

Objective This study aimed to describe baseline characteristics of a cohort of pregnant women infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and determine if these correlate with disease severity and perinatal outcomes. Study Design This was a retrospective cohort trial conducted at the University of Texas Medical Branch Galveston, Texas. All pregnant women presented to our medical center, who were screened and tested positive for SARS-CoV-2 virus, were included. We stratified our study population in three groups: asymptomatic, symptomatic not requiring oxygen therapy, and patients requiring oxygen support to maintain oxygen saturation >94%. Relevant population characteristics, laboratory data, and maternal and neonatal outcomes were abstracted. A p-value <0.05 was considered statistically significant. Results Between March and July 2020, 91 women tested positive for SARS-CoV-2 upon admission to our labor and delivery unit. Among these, 61.5% were asymptomatic, 34.1% were symptomatic, and 4.4% required oxygen support. Our population was mainly Hispanic (80.2%), multiparous (76.9%), obese (70.3%), and with a median age of 27 years. Median gestational age at symptom onset or diagnosis was 36 weeks. Significant differences were found between gestational age and disease severity. Maternal characteristics including age, body mass index (BMI), and presence of comorbid conditions did not appear to influence severity of SARS-CoV-2 infection. Significant laboratory findings associated with increasing disease severity included decreasing hemoglobin and white blood cell count, lymphopenia, and increasing levels of inflammatory markers including CRP, ferritin, and procalcitonin. Maternal and neonatal outcomes did not differ among groups. No SARS-CoV-2 was detected by polymerase chain reaction testing in neonates of mothers with COVID-19. Conclusion Pregnant patients with COVID-19 infection are predominantly asymptomatic. Patients appear to be at increased risk for more severe infection requiring oxygen support later in pregnancy. Key Points

Download Full-text

COVID-19 during pregnancy: an overview of maternal characteristics, clinical symptoms, maternal and neonatal outcomes of 10,996 cases described in 15 countries

Journal of Perinatal Medicine ◽

10.1515/jpm-2020-0364 ◽

2020 ◽

Vol 48 (9) ◽

pp. 900-911 ◽

Cited By ~ 3

Author(s):

Ernesto Antonio Figueiro-Filho ◽

Mark Yudin ◽

Dan Farine

Keyword(s):

General Population ◽

Pregnant Women ◽

Clinical Symptoms ◽

Case Series ◽

Perinatal Outcomes ◽

Neonatal Outcomes ◽

Eligibility Criteria ◽

Maternal Characteristics ◽

Th2 Immune Response ◽

Maternal And Neonatal Outcomes

AbstractThe objective of this review was to identify the most significant studies reporting on COVID-19 during pregnancy and to provide an overview of SARS-CoV-2 infection in pregnant women and perinatal outcomes. Eligibility criteria included all reports, reviews; case series with more than 100 individuals and that reported at least three of the following: maternal characteristics, maternal COVID-19 clinical presentation, pregnancy outcomes, maternal outcomes and/or neonatal/perinatal outcomes. We included eight studies that met the inclusion criteria, representing 10,966 cases distributed in 15 countries around the world until July 20, 2020. The results of our review demonstrate that the maternal characteristics, clinical symptoms, maternal and neonatal outcomes almost 11,000 cases of COVID-19 and pregnancy described in 15 different countries are not worse or different from the general population. We suggest that pregnant women are not more affected by the respiratory complications of COVID-19, when compared to the outcomes described in the general population. We also suggest that the important gestational shift Th1-Th2 immune response, known as a potential contributor to the severity in cases of viral infections during pregnancy, are counter-regulated by the enhanced-pregnancy-induced ACE2-Ang-(1–7) axis. Moreover, the relatively small number of reported cases during pregnancy does not allow us to affirm that COVID-19 is more aggressive during pregnancy. Conversely, we also suggest, that down-regulation of ACE2 receptors induced by SARS-CoV-2 cell entry might have been detrimental in subjects with pre-existing ACE2 deficiency associated with pregnancy. This association might explain the worse perinatal outcomes described in the literature.

Download Full-text

A Population-level Analysis of the Differing Effects of Rheumatoid Arthritis and Spondyloarthritis on Peripartum Outcomes

The Journal of Rheumatology ◽

10.3899/jrheum.181320 ◽

2019 ◽

Vol 47 (2) ◽

pp. 197-203 ◽

Cited By ~ 3

Author(s):

Stephanie O. Keeling ◽

Samantha L. Bowker ◽

Anamaria Savu ◽

Padma Kaul

Keyword(s):

Rheumatoid Arthritis ◽

Pregnant Women ◽

Population Level ◽

Nonsteroidal Antiinflammatory Drugs ◽

Neonatal Outcomes ◽

Hypertensive Disorder ◽

Antiinflammatory Drugs ◽

Hypertensive Disorders ◽

Maternal And Neonatal Outcomes ◽

In Pregnancy

Objective.The effects of rheumatoid arthritis (RA) and spondyloarthritis (SpA) on maternal and neonatal outcomes at a population level have not previously been well compared.Methods.A contemporary pregnancy cohort of 312,081 women and corresponding birth events was assembled for the province of Alberta from the random selection of 1 live birth event per woman. We identified 3 groups: (1) no inflammatory arthritis (no IA, n = 308,989), (2) RA (n = 631), and (3) SpA (n = 2461). We compared maternal and neonatal outcomes, comorbid conditions, and medication use among the 3 groups. Multivariable logistic regression models evaluated the independent association between RA and SpA, relative to no IA, and the outcomes of small for gestation age (SGA) and hypertensive disorders during pregnancy.Results.Pregnant women with RA were significantly more likely to have preterm delivery (13.5%), cesarean delivery (33.9%), hypertensive disorders in pregnancy (10.5%), and SGA babies (15.6%), compared to pregnant women with either SpA or no IA. Nonsteroidal antiinflammatory drugs and corticosteroid use were significantly higher in pregnant women with RA compared to the other groups. Women with RA were significantly more likely to have an SGA baby (OR 1.51, 95% CI 1.21–1.88; p < 0.01), and hypertensive disorder in pregnancy (OR 1.51, 95% CI 1.16–1.97; p < 0.01), compared to women with no IA, while no difference was found between women with SpA and those with no IA.Conclusion.Women with RA have a higher risk of worse maternal and neonatal outcomes, whereas the risk of these events is similar between women with and without SpA.

Download Full-text

Comparison of the maternal and neonatal outcomes of pregnant women whose anemia was not corrected before delivery and pregnant women who were treated with intravenous iron in the third trimester

Archives of Gynecology and Obstetrics ◽

10.1007/s00404-020-05817-7 ◽

2020 ◽

Author(s):

Z. Asli Oskovi-Kaplan ◽

Harun Kilickiran ◽

Gul Nihal Buyuk ◽

Sebnem Ozyer ◽

H. Levent Keskin ◽

...

Keyword(s):

Pregnant Women ◽

Intravenous Iron ◽

Neonatal Outcomes ◽

Third Trimester ◽

The Third ◽

Maternal And Neonatal Outcomes

Download Full-text

1191: Maternal and neonatal outcomes among pregnant women with Hepatitis C in Utah, 2009-2017

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2019.11.1203 ◽

2020 ◽

Vol 222 (1) ◽

pp. S733

Author(s):

Marcela Smid ◽

Nicole Stone ◽

Laurie Baksh ◽

Amelia Prebish ◽

Bree Barbeau

Keyword(s):

Hepatitis C ◽

Pregnant Women ◽

Neonatal Outcomes ◽

Maternal And Neonatal Outcomes

Download Full-text

A Comparison of Buprenorphine + Naloxone to Buprenorphine and Methadone in the Treatment of Opioid Dependence during Pregnancy: Maternal and Neonatal Outcomes

Substance Abuse Research and Treatment ◽

10.4137/sart.s10955 ◽

2013 ◽

Vol 7 ◽

pp. SART.S10955 ◽

Cited By ~ 6

Author(s):

Ingunn O. Lund ◽

Gabriele Fischer ◽

Gabrielle K. Welle-Strand ◽

Kevin E. O'grady ◽

Kimber Debelak ◽

...

Keyword(s):

Pregnant Women ◽

Opioid Dependence ◽

Physical Development ◽

Neonatal Outcomes ◽

Maternal Outcomes ◽

Summary Statistics ◽

Research Methodologies ◽

Maternal And Neonatal Outcomes

Given that buprenorphine + naloxone is prescribed for opioid-dependent pregnant women, it is important to examine the extent to which it differs from buprenorphine alone, methadone, or methadone-assisted withdrawal on neonatal and maternal outcomes. Summary statistics on maternal and neonatal outcomes were collected from 7 previously published studies examining treatment for opioid-dependent pregnant women that represented a range of research methodologies. Outcomes from these studies were compared to the same outcomes for 10 women treated with the combined buprenorphine + naloxone product. There were no significant differences in maternal outcomes for buprenorphine + naloxone compared to buprenorphine, methadone, or methadone-assisted withdrawal. Preliminary findings suggest no significant adverse maternal or neonatal outcomes related to the use of buprenorphine + naloxone for the treatment of opioid dependence during pregnancy. However, further research should examine possible differences between buprenorphine + naloxone and buprenorphine alone or methadone in fetal physical development.

Download Full-text

COVID-19 and Pregnancy Outcome: An Experience in ‘COVID-19 Management Designated’ Tertiary Care Hospital, Rawalpindi, Pakistan

Journal of Rawalpindi Medical College ◽

10.37939/jrmc.v24isupp-1.1453 ◽

2020 ◽

Vol 24 (Supp-1) ◽

pp. 85-91

Author(s):

Shazia Syed ◽

Humera Noreen ◽

Humaira Masood ◽

Ismat Batool ◽

Hina Gul ◽

...

Keyword(s):

Hepatic Encephalopathy ◽

Pregnant Women ◽

Clinical Characteristics ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Neonatal Outcomes ◽

Categorical Variables ◽

Care Hospital ◽

Case Series Study ◽

Maternal And Neonatal Outcomes

Background: The current COVID-19 pandemic has affected almost 17.3 million victims worldwide with mortality of almost 674K. Pregnancy is one of the most susceptible conditions for COVID-19 infection, but limited data is currently available about the clinical characteristics of pregnant women with the disease. Objective; to describe the clinical characteristics, co-morbidities, management, feto-maternal, and neonatal outcome in COVID-19 positive pregnant women. Methodology: A descriptive case series study was conducted in Obs/Gynae dept of Benazir Bhutto Tertiary Care Hospital, Rawalpindi, including all asymptomatic/symptomatic COVID-19 positive pregnant women and clinical suspects (COVID-19 PCR negative women) delivered in our hospital from 01st April 2020 to 31st July 2020. Their medical records were reviewed for clinical characteristics, management, feto-maternal and neonatal outcomes. Continuous variables were expressed in Mean & Range and Categorical variables as number & Percentage. Results: During the study period a total of 17 cases were reviewed. The mean maternal age was 28.94 yrs. Primigravida (07), Multipara (10). Mean gestational age was 37 wks (range; 30-41wks). Presenting symptomatology was varied. Asymptomatic; (29%), COVID-19 specific symptoms; fever & flu (12%), fever&cough (6%), shortness of breath(SOB) alone (6%), fever & SOB(6%) and pregnancy-related manifestations were labour pains (17%), eclampsia(6%), hydrocephalous fetus (6%) and hepatic encephalopathy(6%). The commonest co-morbidity was Hypertensive disorders of pregnancy (24%). Five women (29%) required ICU care. Lower segment caesarean sections(LSCS) (59%), vaginal delivery (41%). Eleven babies delivered with good Apgar score and birth weight. Two were early neonatal deaths (ENND) and 04 were received intra-uterine fetal deaths (IUDs). Fetal demise was associated with strong obstetric risk factors. Out of 13 live-born babies, RT-PCR Covid-19 testing was done in 10 (77%) cases and was negative. One mother was expired due to complications of hepatic encephalopathy, sepsis, and burst abdomen. Conclusion; The clinical course of COVID-19 disease in pregnancy seems to be no different from non-pregnant women. Clinical manifestations are diverse and infection contracted in the third trimester of pregnancy is associated with good feto-maternal and neonatal outcomes.

Download Full-text