The Impact of Response to Iron Therapy on Maternal and Neonatal Outcomes among Pregnant Women with Anemia

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.

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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

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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.

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The impact of cross-border IVF on maternal and neonatal outcomes in multiple pregnancies: Experience from a UK fetal medicine service

European Journal of Obstetrics & Gynecology and Reproductive Biology ◽

10.1016/j.ejogrb.2019.04.030 ◽

2019 ◽

Vol 238 ◽

pp. 63-67 ◽

Cited By ~ 1

Author(s):

Raj Jaspal ◽

Thomas Prior ◽

Jane Denton ◽

Rehan Salim ◽

Jayanta Banerjee ◽

...

Keyword(s):

Neonatal Outcomes ◽

Multiple Pregnancies ◽

Fetal Medicine ◽

Cross Border ◽

Medicine Service ◽

Maternal And Neonatal Outcomes ◽

The Impact

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A Review of the Impact of Obstetric Anesthesia on Maternal and Neonatal Outcomes

Obstetric Anesthesia Digest ◽

10.1097/01.aoa.0000557645.89263.b7 ◽

2019 ◽

Vol 39 (2) ◽

pp. 65

Author(s):

G. Lim ◽

F.L. Facco ◽

N. Nathan ◽

J.H. Waters ◽

C.A. Wong ◽

...

Keyword(s):

Obstetric Anesthesia ◽

Neonatal Outcomes ◽

Maternal And Neonatal Outcomes ◽

The Impact

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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.

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