3049 Prenatal care as a protective factor for preterm birth and smoking during pregnancy in nulliparous patients: a propensity score analysis

OBJECTIVES/SPECIFIC AIMS: Preterm birth rates have been rising in the United States, and reducing preterm birth is a high-priority clinical and public health concern. There are no existing strategies to reduce preterm birth in nulliparous individuals. The present study aims to evaluate prenatal care as a protective factor for preterm birth in this population. METHODS/STUDY POPULATION: Missouri birth record data for child birth years 1993-2016 were used to create a sample of 325,088 singleton births to nulliparous women, themselves born in MO 1975-1985. Logistic regressions, stratified by maternal race (White, African-American, Asian, American Indian/Alaskan Native, Other), were used to predict preterm birth (< 37 weeks gestational age) as a function of 1) initiation of prenatal care of by end of first trimester and 2) Adequacy of Prenatal Care Utilization Index, with sociodemographic covariates of child birth year, maternal age, highest educational level, and marital status (four level variable, including married yes/no, and partner named on birth record, yes/no). Subsequent analyses will use this logistic regression to create a propensity score predicting smoking during pregnancy using birth record parental sociodemographic characteristics, stratified by maternal race. Primary analyses will focus on the role of prenatal care in predicting smoking during pregnancy and preterm birth risk within propensity score stratum. Secondary analyses will consider the role of other risk factors, including maternal pre-pregnancy BMI and maternal DUI history, on preterm birth risk. RESULTS/ANTICIPATED RESULTS: Preliminary logistic regressions predicting preterm birth were analyzed, stratified by maternal race. In White mothers, preterm birth prevalence was 8.2%, and risk was significantly increased by maternal age ≤ 15 and ≥ 31, being unmarried, and by receiving no prenatal care, yet unaffected by timing of prenatal care initiation. For African-American mothers, preterm birth prevalence was 11.9%, and risk was significantly increased by being unmarried and both by not initiating prenatal care by end of first trimester and receiving no prenatal care. Preliminary samples were too small for solid inferences for other races. Anticipated results are that after propensity score match, earlier initiation of prenatal care will show modest protective effect on preterm birth, but other characteristics such as maternal cigarette smoking during pregnancy and DUI status will show stronger effects on predicting preterm birth risk. DISCUSSION/SIGNIFICANCE OF IMPACT: By evaluating the role of prenatal care initiation and delivery on preterm birth, this work provides an evidence base for prenatal care schedules and for understanding the interplay of sociodemographics, healthcare delivery, and individual characteristics in the context of preterm birth risk and potentially reduce negative health outcomes.

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Fetal safety of chloroquine and hydroxychloroquine use during pregnancy: a nationwide cohort study

Rheumatology ◽

10.1093/rheumatology/keaa592 ◽

2020 ◽

Author(s):

Niklas Worm Andersson ◽

Lone Skov ◽

Jon Trærup Andersen

Keyword(s):

Cohort Study ◽

Preterm Birth ◽

Birth Defects ◽

First Trimester ◽

Outcome Analysis ◽

Birth Prevalence ◽

Increased Risk ◽

Wide Range ◽

Fetal Safety ◽

In Pregnancy

Abstract Objective The antimalaria 4-aminoquinoline drugs chloroquine and HCQ are used in the treatment of a wide range of CTDs. Data to inform on the safety of their use in pregnancy are limited. Methods In a Danish nationwide cohort study from 1996 through 2016, we identified 4-aminoquinoline–exposed pregnancies from a cohort of 1 240 875 pregnancies to investigate the associated risks of major birth defects, preterm birth, and small size for gestational age (SGA). Distinct study cohorts of propensity-score–matched 4-aminoquinoline-exposed and unexposed pregnancies (in a 1:1 ratio) were established for each outcome analysis. The association with the outcomes was assessed by prevalence odds ratios (ORs) estimated through logistic regression. The associated risks for chloroquine and HCQ were individually assessed through additional analyses. Results A total of 1487 pregnancies exposed to 4-aminoquinolines (1184 chloroquine- and 303 HCQ-exposed) were identified. Among the 983 pregnancies exposed to 4-aminoquinolines in the first trimester, 34 infants (3.5%) were diagnosed with major birth defects as compared with 36 (3.7%) among the matched unexposed pregnancies (prevalence OR, 0.94; 95% CI: 0.59, 1.52). Exposure to 4-aminoquinolines in pregnancy was neither associated with an increased risk of preterm birth (prevalence OR, 0.97; 95% CI: 0.73, 1.28) or SGA (prevalence OR, 1.18; 95% CI: 0.93, 1.50), compared with unexposed pregnancies. No significant associations between exposure to chloroquine or HCQ individually and risk of the outcomes were identified. Conclusion Among pregnancies exposed to 4-aminoquinolines (chloroquine and HCQ), no increased risk of major birth defects, preterm birth, or SGA was identified.

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The role of prenatal care in recurrent preterm birth

European Journal of Obstetrics & Gynecology and Reproductive Biology ◽

10.1016/j.ejogrb.2010.08.011 ◽

2011 ◽

Vol 154 (1) ◽

pp. 40-44 ◽

Cited By ~ 13

Author(s):

Ronit Ratzon ◽

Eyal Sheiner ◽

Ilana Shoham-Vardi

Keyword(s):

Preterm Birth ◽

Prenatal Care

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Role of prenatal care in preterm birth and low birthweight in Portugal

Journal of Public Health ◽

10.1093/oxfordjournals.pubmed.a024513 ◽

1996 ◽

Vol 18 (3) ◽

pp. 321-328 ◽

Cited By ~ 44

Author(s):

H. Barros ◽

M. Tavares ◽

T. Rodrigues

Keyword(s):

Preterm Birth ◽

Prenatal Care ◽

Low Birthweight

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Role of Propensity Score in Developing Decision Trees

PsycEXTRA Dataset ◽

10.1037/e603042010-001 ◽

2010 ◽

Author(s):

Joseph Kang

Keyword(s):

Propensity Score ◽

Decision Trees

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PROGNOSTIC ROLE OF THE COMBINATION OF GENES POLYMORPHISMS OF COAGULATION SYSTEM AND LEVEL CHANGE OF AUTOANTIBODIES TO IMMUNOGLOBULIN FC-FRAGMENT IN THE FIRST TRIMESTER OF PREGNANCY WITH THE FORMATION OF SUBCHORIONIC HEMATOMA

The Journal of scientific articles Health and Education millennium ◽

10.26787/nydha-2226-7425-2017-19-3-38-43 ◽

2017 ◽

Vol 19 (3) ◽

pp. 38-43

Author(s):

M.V. Utrobin ◽

◽

S.Y. Yurev ◽

E.V. Orlova ◽

◽

...

Keyword(s):

First Trimester ◽

Coagulation System ◽

Prognostic Role ◽

Fc Fragment ◽

Level Change ◽

First Trimester Of Pregnancy

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Faculty Opinions recommendation of Predictive value for preterm birth of abnormal vaginal flora, bacterial vaginosis and aerobic vaginitis during the first trimester of pregnancy.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1162475.623996 ◽

2009 ◽

Author(s):

Steven Witkin

Keyword(s):

Preterm Birth ◽

Bacterial Vaginosis ◽

Predictive Value ◽

First Trimester ◽

Vaginal Flora ◽

Aerobic Vaginitis ◽

First Trimester Of Pregnancy ◽

Abnormal Vaginal Flora

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Stories from Ultrasonographic Abyss

Widok. Teorie i Praktyki Kultury Wizualnej - Siła kobiet ◽

10.36854/widok/2016.16.755 ◽

2016 ◽

Author(s):

Matylda Szewczyk

Keyword(s):

Prenatal Care ◽

New Media ◽

Cultural Practices ◽

Prenatal Ultrasound ◽

Cultural Contexts ◽

Media Technologies ◽

Medical Imagery ◽

The Future ◽

Different Cultures

The article presents a reflection on the experience of prenatal ultrasound and on the nature of cultural beings, it creates. It exploits chosen ethnographic and cultural descriptions of prenatal ultrasounds in different cultures, as well as documentary and artistic reflections on medical imagery and new media technologies. It discusses different ways of defining the role of ultrasound in prenatal care and the cultural contexts build around it. Although the prenatal ultrasounds often function in the space of enormous tensions (although they are also supposed to give pleasure), it seems they will accompany us further in the future. It is worthwhile to find some new ways of describing them and to invent new cultural practices to deal with them.

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Role of Serum β-HCG doubling in Diagnosis of Early Pregnancy and its Management Strategy

Current Women s Health Reviews ◽

10.2174/1573404816999200905140919 ◽

2020 ◽

Vol 16 ◽

Author(s):

Divya Mirji ◽

Shubha Rao ◽

Akhila Vasudeva ◽

Roopa P.S

Keyword(s):

Ectopic Pregnancy ◽

Early Pregnancy ◽

Management Strategy ◽

Transvaginal Ultrasound ◽

Expectant Management ◽

First Trimester ◽

Intrauterine Pregnancy ◽

Β Hcg ◽

Pregnancy Of Unknown Location

Background: Pregnancy of unknown location (PUL) is defined as the absence of intrauterine or extrauterine sac and Beta Human Chorionic Gonadotropin levels (β-HCG) above the discriminatory zone of 1500 mIU/ml. It should be noted that PUL is not always an ectopic; however, by measuring the trends of serum β-HCG, we can determine the outcome of a PUL. Objective: This study aims to identify the various trends β-HCG levels in early pregnancy and evaluate the role of β-HCG in the management strategy. Methods: We conducted a prospective observational study of pregnant women suspected with early pregnancy. Cases were classified as having a pregnancy of unknown location (PUL) by transvaginal ultrasound and ß-HCG greater than 1000 mIU/ml. Expectant management was done until there was a definite outcome. All the collected data were analyzed by employing the chi-square test using SPSS version 20. Results: Among 1200 women who had early first trimester scans, 70 women who fulfilled our criteria of PUL and ß-HCG > 1000 mIU/ml were recruited in this study. In our study, the mean age of the participants was 30±5.6yrs, and the overall mean serum ß-HCG was 3030±522 mIU/ml. The most common outcome observed was an ectopic pregnancy, 47% in our study. We also found the rate of failing pregnancy was 27%, and that of intrauterine pregnancy (IUP) was 25%. Overall, in PUL patients diagnosed with ectopic pregnancy, 9% behaved like IUP, and 4% had an atypical trend in their ß-HCG. Those who had an IUP, 11% had a suboptimal increase in ß-HCG. Conclusion: PUL rate in our unit was 6%. Majority of the outcome of PUL was ectopic in our study. Every case of PUL should be managed based on the initial ß-HCG values, clinical assessments and upon the consent of the patient.

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The Loss of Self-Dignity and Anger among Polish Young Adults: The Moderating Role of Religiosity

Religions ◽

10.3390/rel12040284 ◽

2021 ◽

Vol 12 (4) ◽

pp. 284

Author(s):

Wojciech Rodzeń ◽

Małgorzata Maria Kulik ◽

Agnieszka Malinowska ◽

Zdzisław Kroplewski ◽

Małgorzata Szcześniak

Keyword(s):

Protective Factor ◽

Sense Of Self ◽

Early Adulthood ◽

Loss Of Self ◽

Aggression Questionnaire ◽

Meaning System ◽

The Relationship ◽

Moderating Role ◽

Risk Loss

Does the way we think or feel about ourselves have an impact on our anger-based reactions? Is the direction and strength of this relationship direct, or affected by other factors as well? Given that there is a lack of research on the loss of self-dignity and anger, the first aim of the present study consisted in examining whether or not there is a connection between both variables, with particular emphasis on early adulthood. The second purpose was to explore the moderating role of religiosity on the relationship between loss of self-dignity and anger. Methods: Data were gathered from 462 participants aged 18 to 35. The main methods applied were the Questionnaire of Sense of Self-Dignity, Buss–Perry Aggression Questionnaire, and Religious Meaning System Questionnaire. The results show a statistically significant positive correlation between loss of self-dignity and anger, a negative correlation between religiosity and anger, and no significant association between the loss of self-dignity and religiosity. However, all other dimensions of the sense of self-dignity correlated positively with religiosity. Our findings also confirm that the level of anger resulting from the loss of self-dignity is significantly lower as the level of religiosity increases. Such outcomes seem to support the conception that religiosity may act as a protective factor between the risk (loss of self-dignity) and the outcome factor (anger).

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