scholarly journals Association of preterm birth and small for gestational age with metabolic outcomes in children and adolescents: A population-based cohort study from Taiwan

2018 ◽  
Vol 59 (2) ◽  
pp. 147-153 ◽  
Author(s):  
Yu-Ting Huang ◽  
Hsiang-Yu Lin ◽  
Chung-Hsing Wang ◽  
Bai-Horng Su ◽  
Che-Chen Lin
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Na Zeng ◽  
Erica Erwin ◽  
Wendy Wen ◽  
Daniel J. Corsi ◽  
Shi Wu Wen ◽  
...  

Abstract Background Racial disparities in adverse perinatal outcomes have been studied in other countries, but little has been done for the Canadian population. In this study, we sought to examine the disparities in adverse perinatal outcomes between Asians and Caucasians in Ontario, Canada. Methods We conducted a population-based retrospective cohort study that included all Asian and Caucasian women who attended a prenatal screening and resulted in a singleton birth in an Ontario hospital (April 1st, 2015-March 31st, 2017). Generalized estimating equation models were used to estimate the independent adjusted relative risks and adjusted risk difference of adverse perinatal outcomes for Asians compared with Caucasians. Results Among 237,293 eligible women, 31% were Asian and 69% were Caucasian. Asians were at an increased risk of gestational diabetes mellitus, placental previa, early preterm birth (< 32 weeks), preterm birth, emergency cesarean section, 3rd and 4th degree perineal tears, low birth weight (< 2500 g, < 1500 g), small-for-gestational-age (<10th percentile, <3rd percentile), neonatal intensive care unit admission, and hyperbilirubinemia requiring treatment, but had lower risks of preeclampsia, macrosomia (birth weight > 4000 g), large-for-gestational-age neonates, 5-min Apgar score < 7, and arterial cord pH ≤7.1, as compared with Caucasians. No difference in risk of elective cesarean section was observed between Asians and Caucasians. Conclusion There are significant differences in several adverse perinatal outcomes between Asians and Caucasians. These differences should be taken into consideration for clinical practices due to the large Asian population in Canada.


BMJ Open ◽  
2018 ◽  
Vol 8 (10) ◽  
pp. e022220 ◽  
Author(s):  
Daphne N McRae ◽  
Patricia A Janssen ◽  
Saraswathi Vedam ◽  
Maureen Mayhew ◽  
Deborah Mpofu ◽  
...  

ObjectiveOur aim was to investigate if antenatal midwifery care was associated with lower odds of small-for-gestational-age (SGA) birth, preterm birth (PTB) or low birth weight (LBW) compared with general practitioner (GP) or obstetrician (OB) models of care for women of low socioeconomic position.SettingThis population-level, retrospective cohort study used province-wide maternity, medical billing and demographic data from British Columbia, Canada.ParticipantsOur study included 57 872 pregnant women, with low socioeconomic position, who: were residents of British Columbia, Canada, carried a singleton fetus, had low to moderate medical/obstetric risk, delivered between 2005 and 2012 and received medical insurance premium assistance.Primary and secondary outcome measuresWe report rates, adjusted ORs (aOR), and 95% CIs for the primary outcome, SGA birth (<the 10th percentile), and secondary outcomes, PTB (<37 weeks’ completed gestation) and LBW (<2500 g).ResultsOur sample included 4705 midwifery patients, 45 114 GP patients and 8053 OB patients. Odds of SGA birth were reduced for patients receiving antenatal midwifery versus GP (aOR 0.71, 95% CI 0.62 to 0.82) or OB care (aOR 0.59, 95% CI 0.50 to 0.69). Odds of PTB were lower for antenatal midwifery versus GP (aOR 0.74, 95% CI 0.63 to 0.86) or OB patients (aOR 0.53, 95% CI 0.45 to 0.62). Odds of LBW were reduced for midwifery versus GP (aOR 0.66, 95% CI 0.53 to 0.82) or OB patients (aOR 0.43, 95% CI 0.34 to 0.54).ConclusionAntenatal midwifery care in British Columbia, Canada, was associated with lower odds of SGA birth, PTB and LBW, for women of low socioeconomic position, compared with physician models of care. Results support the development of policy to ensure antenatal midwifery care is available and accessible for women of low socioeconomic position. Future research is needed to determine the underlying mechanisms linking midwifery care to better birth outcomes for women of low socioeconomic position.


BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e027344
Author(s):  
Yohannes Ejigu ◽  
Jeanette H Magnus ◽  
Johanne Sundby ◽  
Maria C Magnus

ObjectiveThe objective of the study was to compare pregnancy outcomes according to maternal antiretroviral treatment (ART) regimens.DesignA retrospective cohort study.Participants and settingsClinical data was extracted from ART exposed pregnancies of HIV-infected Ethiopian women attending antenatal care follow-up in public health facilities in Addis Ababa between February 2010 and October 2016.OutcomesThe primary outcomes evaluated were preterm birth, low birth weight and small-for-gestational-age.ResultsA total 1663 of pregnancies exposed to ART were included in the analyses. Of these pregnancies, 17% resulted in a preterm birth, 19% in low birth weight and 32% in a small-for-gestational-age baby. Compared with highly active antiretroviral therapy (HAART) initiated during pregnancy, zidovudine monotherapy was less likely to result in preterm birth (adjusted OR 0.35, 95% CI 0.19 to 0.64) and low birth weight (adjusted OR 0.48, 95% CI 0.24 to 0.94). We observed no differential risk of preterm birth, low birth weight and small-for-gestational-age, when comparing women who initiated HAART during pregnancy to women who initiated HAART before conception. The risk for preterm birth was higher in pregnancies exposed to nevirapine-based HAART (adjusted OR 1.44, 95% CI 1.06 to 1.96) compared with pregnancies exposed to efavirenz-based HAART. Comparing nevirapine-based HAART with efavirenz-based HAART indicated no strong evidence of increased risk of low birth weight or small-for-gestational-age.ConclusionsWe observed a higher risk of preterm birth among women who initiated HAART during pregnancy compared with zidovudine monotherapy. Pregnancies exposed to nevirapine-based HAART also had a greater risk of preterm births compared with efavirenz-based HAART.


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