Maternal morbidity associated with early preterm birth in low-risk singleton pregnancies

Abstract Objective: To compare adverse outcomes between: 1) pregnant women with thyrotoxicosis and low risk pregnancies, 2) pregnant women with thyrotoxicosis requiring no anti-thyroid drug (ATD) and low risk pregnancies, and 3) those treated with methimazole (MMI) and propylthiouracil (PTU)Methods: The medical records of singleton pregnancies with thyrotoxicosis were comprehensively reviewed. Low-risk pregnancies matched for age and parity were randomly recruited as controls. The obstetric outcomes were compared between both groups, and the outcomes of various subgroups of the study group were also compared.Results: A total of 408 pregnant women with thyrotoxicosis were recruited. Compared with the controls, the women of the study group had significantly higher rates of low birth weight (LBW) (23.7% vs 17.7%; p:0.036), preterm birth (19.3% vs 12.3%; p:0.007), preeclampsia (8.5% vs 4.4%; p: 0.019) and cesarean section (21.5% vs 16.0%; p:0.046). In the study group (thyrotoxicosis), 67, 127, and 158 patients were treated with MMI, PTU and no anti-thyroid drug (ATD), respectively. All obstetric outcomes were comparable between the women treated with PTU and those with MMI, and between the controlled and uncontrolled groups. However, women who needed ATD had significantly higher rates of LBW and preterm birth than those without medications.Conclusions: Thyrotoxicosis, whether treated or not needing ATDs, was significantly associated with an increased risk of adverse pregnancy outcomes. Also, active disease, indicated by the need for ATD significantly increased the risk of such adverse outcomes, whereas the patients treated with MMI or PTU had comparable adverse outcomes.

Download Full-text

Coronavirus disease 2019 in pregnancy was associated with maternal morbidity and preterm birth

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2021.01.007 ◽

2021 ◽

Author(s):

Rasha A. Al-Lami ◽

Ali M. Alrammahi ◽

Ammar M.A. Algburi

Keyword(s):

Preterm Birth ◽

Maternal Morbidity ◽

In Pregnancy

Download Full-text

Relationship between vaginal group B streptococcus colonization in the early stage of pregnancy and preterm birth: a retrospective cohort study

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-03624-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Sho Tano ◽

Takuji Ueno ◽

Michinori Mayama ◽

Takuma Yamada ◽

Takehiko Takeda ◽

...

Keyword(s):

Cohort Study ◽

Preterm Birth ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Early Stage ◽

Group B Streptococcus ◽

Multivariable Logistic Regression Analysis ◽

Simple Method ◽

Group B ◽

Singleton Pregnancies

Abstract Background Although infection and inflammation within the genital tract during pregnancy is considered a major risk factor for spontaneous preterm birth (PTB), there are few studies on association between vaginal microorganisms in the early stage of pregnancy and PTB. The aim of this study was to investigate relationship between vaginal Group B streptococcus (GBS) colonization, a leading cause of infection during pregnancy, in the early stage of pregnancy and PTB. Methods This single-center, retrospective cohort study utilized data from 2009 to 2017 obtained at TOYOTA Memorial Hospital. Women with singleton pregnancies who underwent vaginal culture around 14 weeks of gestation during their routine prenatal check-up were included. Vaginal sampling for Gram staining and culture was performed regardless of symptoms. GBS colonization was defined as positive for GBS latex agglutination assay. Statistical analysis was performed to determine the factors associated with PTB. Results Overall 1079 singleton pregnancies were included. GBS (5.7%) and Candida albicans (5.5%) were the most frequently observed microorganisms. The incidence of PTB (before 34 and before 37 weeks of gestation) were significantly higher in the GBS-positive group than in the GBS-negative group (6.6% vs 0.5%, p = 0.001 and 9.8% vs 4.3%, p = 0.047). Our multivariable logistic regression analysis revealed that GBS colonization was a factor associated with PTB before 34 and before 37 weeks of gestation (Odds ratio [OR] 15.17; 95% confidence interval [CI] 3.73–61.74), and OR 2.42; 95%CI 1.01–5.91, respectively). Conclusions The present study found that vaginal GBS colonization in the early stage of pregnancy was associated with PTB. Our study indicates that patients at a high risk for PTB can be extracted by a simple method using conventional culture method.

Download Full-text

Routine second trimester cervical length screening in low risk women identified women at risk of a ‘very’ preterm birth but did not reduce the preterm birth rate: a randomised study from India

Journal of Obstetrics and Gynaecology ◽

10.1080/01443615.2017.1419461 ◽

2018 ◽

Vol 38 (6) ◽

pp. 789-795 ◽

Cited By ~ 3

Author(s):

Siddhidatri Mishra ◽

Rashmi Bagga ◽

Jasvinder Kalra ◽

Vanita Jain ◽

Sourabh Dutta

Keyword(s):

Preterm Birth ◽

Birth Rate ◽

Cervical Length ◽

Low Risk ◽

Second Trimester ◽

Randomised Study ◽

Very Preterm ◽

Very Preterm Birth ◽

Preterm Birth Rate ◽

Low Risk Women

Download Full-text

The Preterm Prediction Study: Can low-risk women destined for spontaneous preterm birth be identified?

American Journal of Obstetrics and Gynecology ◽

10.1067/mob.2001.111248 ◽

2001 ◽

Vol 184 (4) ◽

pp. 652-655 ◽

Cited By ~ 94

Author(s):

J.D. Iams ◽

R.L. Goldenberg ◽

B.M. Mercer ◽

A.H. Moawad ◽

P.J. Meis ◽

...

Keyword(s):

Preterm Birth ◽

Low Risk ◽

Spontaneous Preterm Birth ◽

Low Risk Women

Download Full-text

Higher Dose Docosahexaenoic Acid Supplementation During Pregnancy and Early Preterm Birth: A Randomised, Double-Blind, Adaptive-Design Superiority Trial

SSRN Electronic Journal ◽

10.2139/ssrn.3835731 ◽

2021 ◽

Author(s):

Susan E. Carlson ◽

Byron J. Gajewski ◽

Christina J. Valentine ◽

Elizabeth H. Kerling ◽

Carl P. Weiner ◽

...

Keyword(s):

Preterm Birth ◽

Docosahexaenoic Acid ◽

Adaptive Design ◽

Double Blind ◽

Acid Supplementation ◽

Blind Adaptive ◽

Superiority Trial ◽

Early Preterm Birth

Download Full-text

Fish consumption prior to pregnancy and pregnancy outcomes in the National Birth Defects Prevention Study, 1997–2011

Public Health Nutrition ◽

10.1017/s1368980018002641 ◽

2018 ◽

Vol 22 (2) ◽

pp. 336-343

Author(s):

Renata H Benjamin ◽

Laura E Mitchell ◽

Mark A Canfield ◽

Adrienne T Hoyt ◽

Dejian Lai ◽

...

Keyword(s):

Preterm Birth ◽

Birth Defects ◽

Pregnancy Outcomes ◽

Fish Consumption ◽

Large Population ◽

Population Based ◽

Prevention Study ◽

Preparation Methods ◽

The Usa ◽

Early Preterm Birth

AbstractObjectiveTo evaluate the relationships between maternal fish consumption and pregnancy outcomes in a large, population-based sample of women in the USA.DesignWe collected average fish consumption prior to pregnancy using a modified version of the semi-quantitative Willett FFQ. We estimated adjusted OR (aOR) and 95 % CI for associations between different levels of fish consumption and preterm birth (<37 weeks), early preterm birth (<32 and <35 weeks) and small-for-gestational-age infants (SGA; <10th percentile).SettingThe National Birth Defects Prevention Study (NBDPS).SubjectsControl mother–infant pairs with estimated delivery dates between 1997 and 2011 (n 10 919).ResultsNo significant associations were observed between fish consumption and preterm birth or early preterm birth (aOR = 0·7–1·0 and 0·7–0·9, respectively). The odds of having an SGA infant were elevated (aOR = 2·1; 95 % CI 1·2, 3·4) among women with daily fish consumption compared with women consuming fish less than once per month. No associations were observed between other levels of fish consumption and SGA (aOR = 0·8–1·0).ConclusionsHigh intake of fish was associated with twofold higher odds of having an SGA infant, while moderate fish consumption prior to pregnancy was not associated with preterm or SGA. Our study, like many other studies in this area, lacked information regarding preparation methods and the specific types of fish consumed. Future studies should incorporate information on nutrient and contaminant contents, preparation methods and biomarkers to assess these relationships.

Download Full-text