Risk factors for perinatal cardiac complications in pregnancy with pulmonary hypertension

Abstract Background Neonatal respiratory distress syndrome (NRDS) is strongly associated with premature birth, but it can also affect term neonates. Unlike the extent of research in preterm neonates, risk factors associated with incidence and severity of NRDS in term neonates are not well studied. In this study, we examined the association of maternal and neonatal risk factors with the incidence and severity of NRDS in term neonates admitted to Neonatal Intensive Care Unit (NICU) in Cyprus. Methods In a prospective, case-control design we recruited term neonates with NRDS and non-NRDS admitted to the NICU of Archbishop Makarios III hospital, the only neonatal tertiary centre in Cyprus, between April 2017–October 2018. Clinical data were obtained from patients’ files. We used univariate and multivariate logistic and linear regression models to analyse binary and continuous outcomes respectively. Results During the 18-month study period, 134 term neonates admitted to NICU were recruited, 55 (41%) with NRDS diagnosis and 79 with non-NRDS as controls. In multivariate adjusted analysis, male gender (OR: 4.35, 95% CI: 1.03–18.39, p = 0.045) and elective caesarean section (OR: 11.92, 95% CI: 1.80–78.95, p = 0.01) were identified as independent predictors of NRDS. Among neonates with NRDS, early-onset infection tended to be associated with increased administration of surfactant (β:0.75, 95% CI: − 0.02-1.52, p = 0.055). Incidence of pulmonary hypertension or systemic hypotension were associated with longer duration of parenteral nutrition (pulmonary hypertension: 11Vs 5 days, p < 0.001, systemic hypotension: 7 Vs 4 days, p = 0.01) and higher rate of blood transfusion (pulmonary hypertension: 100% Vs 67%, p = 0.045, systemic hypotension: 85% Vs 55%, p = 0.013). Conclusions This study highlights the role of elective caesarean section and male gender as independent risk factors for NRDS in term neonates. Certain therapeutic interventions are associated with complications during the course of disease. These findings can inform the development of evidence-based recommendations for improved perinatal care.

Download Full-text

Systemic sclerosis portends increased risk of conduction and rhythm abnormalities at diagnosis and during disease course: A US population-based cohort

Journal of Scleroderma and Related Disorders ◽

10.1177/23971983211034074 ◽

2021 ◽

pp. 239719832110340

Author(s):

Yasser A Radwan ◽

Reto D Kurmann ◽

Avneek S Sandhu ◽

Edward A El-Am ◽

Cynthia S Crowson ◽

...

Keyword(s):

Risk Factors ◽

Pulmonary Hypertension ◽

Systemic Sclerosis ◽

Confidence Interval ◽

Cumulative Incidence ◽

Disease Onset ◽

Population Based ◽

Hazard Ratio ◽

Conduction Disorders ◽

Increased Risk

Objectives: To study the incidence, risk factors, and outcomes of conduction and rhythm disorders in a population-based cohort of patients with systemic sclerosis versus nonsystemic sclerosis comparators. Methods: An incident cohort of patients with systemic sclerosis (1980–2016) from Olmsted County, MN, was compared to age- and sex-matched nonsystemic sclerosis subjects (1:2). Electrocardiograms, Holter electrocardiograms, and a need for cardiac interventions were reviewed to determine the occurrence of any conduction or rhythm abnormalities. Results: Seventy-eight incident systemic sclerosis cases and 156 comparators were identified (mean age 56 years, 91% female). The prevalence of any conduction disorder before systemic sclerosis diagnosis compared to nonsystemic sclerosis subjects was 15% versus 7% ( p = 0.06), and any rhythm disorder was 18% versus 13% ( p = 0.33). During a median follow-up of 10.5 years in patients with systemic sclerosis and 13.0 years in nonsystemic sclerosis comparators, conduction disorders developed in 25 patients with systemic sclerosis with cumulative incidence of 20.5% (95% confidence interval: 12.4%–34.1%) versus 28 nonsystemic sclerosis patients with cumulative incidence of 10.4% (95% confidence interval: 6.2%–17.4%) (hazard ratio: 2.57; 95% confidence interval: 1.48–4.45), while rhythm disorders developed in 27 patients with systemic sclerosis with cumulative incidence of 27.3% (95% confidence interval: 17.9%–41.6%) versus 43 nonsystemic sclerosis patients with cumulative incidence of 18.0% (95% confidence interval: 12.3%–26.4%) (hazard ratio: 1.62; 95% confidence interval: 1.00–2.64). Age, pulmonary hypertension, and smoking were identified as risk factors. Conclusion: Patients with systemic sclerosis have an increased risk of conduction and rhythm disorders both at disease onset and over time, compared to nonsystemic sclerosis patients. These findings warrant increased vigilance and screening for electrocardiogram abnormalities in systemic sclerosis patients with pulmonary hypertension.

Download Full-text

Recommendations of the AGG (Task Force for Obstetrics, Section Maternal Diseases) on the Management of Maternal Hepatitis B, C and D Infection in Pregnancy

Geburtshilfe und Frauenheilkunde ◽

10.1055/a-1330-7514 ◽

2021 ◽

Vol 81 (04) ◽

pp. 390-397

Author(s):

Maritta Kühnert ◽

Sven Kehl ◽

Ulrich Pecks ◽

Ute Margaretha Schäfer-Graf ◽

Tanja Groten ◽

...

Keyword(s):

Risk Factors ◽

Hepatitis B ◽

Task Force ◽

Clinical Care ◽

Diagnostic Procedures ◽

Routine Clinical Care ◽

Prenatal Counselling ◽

Hepatitis Infection ◽

Birth Planning ◽

In Pregnancy

AbstractThese statements and recommendations should provide appropriate information about maternal and fetal routes of infection, screening, detection of risk factors, diagnostic procedures, treatment, birth planning and peripartum and postpartum management of maternal hepatitis infection and offer pointers for prenatal counselling and routine clinical care on delivery wards.

Download Full-text

Perinatal Anxiety Symptoms: Rates and Risk Factors in Mexican Women

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18010082 ◽

2020 ◽

Vol 18 (1) ◽

pp. 82

Author(s):

Janeth Juarez Padilla ◽

Sandraluz Lara-Cinisomo ◽

Laura Navarrete ◽

Ma. Asunción Lara

Keyword(s):

Risk Factors ◽

Stressful Life Events ◽

Secondary Data ◽

Anxiety Symptoms ◽

Mexican Women ◽

Negative Consequences ◽

Postpartum Anxiety ◽

Perinatal Anxiety ◽

Relevant Risk Factor ◽

In Pregnancy

Anxiety during pregnancy and after childbirth can have negative consequences for a woman and her baby. Despite growing interest in the perinatal mental health of Mexican women living in the U.S., perinatal anxiety symptom (PAS) rates and risk factors have yet to be established for women in Mexico. We sought to determine PAS rates and identify risk factors, including the traditional female role (TFR) in a sample of Mexican women. This secondary data analysis is based on 234 Mexican women who participated in a longitudinal study on perinatal depression in Mexico. Anxiety symptoms were assessed in pregnancy and at six weeks postpartum. Rates were determined through frequencies, and multiple logistics regressions were conducted to identify risk factors in the sample. The PAS rate was 21% in pregnancy and 18% postpartum. Stressful life events and depressive symptoms were associated with a higher probability of PAS. Adherence to TFR increased the probability of prenatal anxiety; lower educational attainment and low social support during pregnancy increased the probability of postpartum anxiety. The PAS rates were within the range reported in the literature. The TFR was only associated with anxiety in gestation, highlighting the role of this culturally relevant risk factor. Culturally responsive early interventions are therefore required.

Download Full-text

Some Risk Factors for Low Birthweight Infants at Manado Hospital

Paediatrica Indonesiana ◽

10.14238/pi35.3-4.1995.94-100 ◽

2018 ◽

Vol 35 (3-4) ◽

pp. 94-100

Author(s):

S. M. Salendu W. ◽

Sutomo Raharjo ◽

Immanuel Mustadjab ◽

Nan Warouw

Keyword(s):

Risk Factors ◽

Maternal Age ◽

Intrauterine Growth Retardation ◽

Maternal Education ◽

Low Birthweight ◽

Term Infants ◽

Intrauterine Growth ◽

Hypertension In Pregnancy ◽

History Of ◽

In Pregnancy

The risk factors of low birthweight infants were assessed in a retrospective study covering 3607 singleton livebirth infants at Manado Hospital from January until December 1993. The analysis confirmed that patterns of risk birthweight hypertension in pregnancy (P<0.01), maternal education (P<0.01), maternal age (P<0.05), and parity (P<0.01), marital status (P<0.01), history of abortion (P<0.05), and parity (P<0.01). Anemia in pregnancy was also associated with birthweight in low birth weight (P<0.05). Asymetric intrauterine growth retardation (Ponderal Index below 2.32) was found both in premature and term infants.

Download Full-text