585 Pregnancy Outcomes in Women With Dilated Cardiomyopathy Gene Variants: A Retrospective Cohort Study

Abstract Background: Blood urea nitrogen (BUN) and creatinine (SCr) are associated with gestational diabetes mellitus (GDM). However, there were limited data in the literature on the influence of BUN and SCr on maternal and fetal outcomes of pregnancy. We aimed to examine the association of BUN and SCr levels during gestation with the risk of selected adverse pregnancy outcomes.Methods: This retrospective cohort study included 1606 singleton mothers aged 22-44 years. Both BUN and SCr levels were collected and measured during the second (16-18th week), third (28-30th week) trimesters of gestation respectively and followed up pregnancy outcomes. Statistical analysis was used multivariate logistic regression. Results: In the multivariate adjusted logistic regression model, the highest level of SCr in the second trimester increased the risk of PROM by 45% (95% CI, 1.01-2.09). In the third trimester of gestation, compared with those in the lowest quartile, BUN levels in the highest quartile decreased the risk of macrosomia and LGA by 60%(95% CI, 0.20-0.78), 66%(95% CI, 0.21,0.55) , respectively, and increased the risk of SGA by 137%(1.06, 5.31), 186%(1.29,6.34) in the third and fourth quartiles, respectively. The adjusted OR (95%CI) for macrosomia in the fourth quartile was 0.46 (0.24, 0.87), for SGA in the third quartiles was 2.36 (1.10, 5.10), and for LGA in the fourth quartile was 0.61 (0.41,0.91) compared with those in the first quartile of SCr levels. The elevated changes of BUN (> 0.64mmol/L) was the risk factor of SGA (OR: 2.11, 95%CI: 1.03,4.32).Conclusion: Higher BUN and SCr levels during the 28-30th week of gestation even those towards the upper limit of the normal range can act as a warning sign of the impending SGA. Elevated changes of BUN and SCr during pregnancy also associated with the lower birth weight.

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Pregnancy outcome following bacteriuria in pregnancy and the significance of nitrites in urinalysis – a retrospective cohort study

Journal of Perinatal Medicine ◽

10.1515/jpm-2018-0428 ◽

2019 ◽

Vol 47 (6) ◽

pp. 611-618

Author(s):

Eviatar Naamany ◽

Irit Ayalon-Dangur ◽

Eran Hadar ◽

Iftach Sagy ◽

Dafna Yahav ◽

...

Keyword(s):

Cohort Study ◽

Pregnant Women ◽

Retrospective Cohort Study ◽

Pregnancy Outcomes ◽

Retrospective Cohort ◽

Urine Culture ◽

Premature Delivery ◽

Positive Urine Culture ◽

Positive Urine ◽

Adverse Pregnancy

Abstract Background The association between bacteriuria and adverse pregnancy outcomes has been extensively described. The current practice of screening all pregnant women for bacteriuria is challenged by recent studies. We aimed to evaluate pregnancy outcomes among women with a positive urine culture, to assess the significance of positive urinary nitrites in this setting. Methods This was a retrospective cohort study at the emergency department (ED) of the Helen Schneider Hospital for Women, Israel, during 2014–2018. This included all gravida women >18 years old within the 20th week of pregnancy or above, admitted to the ED with diverse complains, who had urinalysis collected and subsequently had a positive urine culture. Clinical and obstetric characteristics were stratified by positive vs. negative nitrites in urinalysis. The primary outcome was premature delivery, and the secondary outcomes were a composite outcome of all recorded pregnancy complications and the significance of urinalysis in predicting urinary tract infection (UTI). Results Overall, 874 pregnant women with a positive urine culture were included. Of them, 721 (79%) patients had a negative nitrite in their urine exam (NNU-group) and 153 (21%) had a positive nitrite in their urine exam (PNU-group). Escherichia coli was the most common pathogen, with significantly higher rates of growth in the PNU-group vs. NNU-group [129 (84.3%) vs. 227 (38.4%), P < 0.001]. Premature delivery was recorded with no association of symptomaticity or nitrite status. Among symptomatic women with classic symptoms of UTI, PNU was significantly associated with decreased risk for major peripartum complications [odds ratio (OR) with 95% confidence interval (CI) of 0.22 (0.05–0.94)]. Conclusion Our findings support that PNU among symptomatic pregnant women with UTI-related symptoms was associated with lower risk of developing major adverse obstetrical outcomes.

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