Neurodevelopmental outcomes of singleton large for gestational age infants <29 weeks’ gestation: a retrospective cohort study

AbstractMaternal supraphysiological estradiol (E2) environment during pregnancy leads to adverse perinatal outcomes. However, the influence of oocyte exposure to high E2 levels on perinatal outcomes remains unknown. Thus, a retrospective cohort study was conducted to explore the effect of high E2 level induced by controlled ovarian stimulation (COH) on further outcomes after frozen embryo transfer (FET). The study included all FET cycles (n = 10,581) between 2014 and 2017. All cycles were categorized into three groups according to the E2 level on the day of the human Chorionic Gonadotropin trigger. Odds ratios (ORs) and their confidence intervals (CIs) were calculated to evaluate the association between E2 level during COH and pregnancy outcomes and subsequent neonatal outcomes. From our findings, higher E2 level was associated with lower percentage of chemical pregnancy, clinical pregnancy, ongoing pregnancy, and live birth as well as increased frequency of early miscarriage. Preterm births were more common among singletons in women with higher E2 level during COH (aOR1 = 1.93, 95% CI: 1.22–3.06; aOR2 = 2.05, 95% CI: 1.33–3.06). Incidence of small for gestational age (SGA) was more common in both singletons (aOR1 = 2.01, 95% CI: 1.30–3.11; aOR2 = 2.51, 95% CI: 1.69–3.74) and multiples (aOR1 = 1.58, 95% CI: 1.03–2.45; aOR2 = 1.99, 95% CI: 1.05–3.84) among women with relatively higher E2 level. No association was found between high E2 level during COH and the percentage of macrosomia or large for gestational age. In summary, oocyte exposure to high E2 level during COH should be brought to our attention, since the pregnancy rate decreasing and the risk of preterm birth and SGA increasing following FET.

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A Retrospective Cohort Study of Safety Outcomes in New Zealand Infants Exposed to Tdap Vaccine in Utero

Vaccines ◽

10.3390/vaccines7040147 ◽

2019 ◽

Vol 7 (4) ◽

pp. 147 ◽

Cited By ~ 1

Author(s):

Helen Petousis-Harris ◽

Yannan Jiang ◽

Lennex Yu ◽

Donna Watson ◽

Tony Walls ◽

...

Keyword(s):

Cohort Study ◽

New Zealand ◽

Preterm Birth ◽

Gestational Age ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

National Level ◽

Birth Asphyxia ◽

Large For Gestational Age ◽

The Government

We aimed to evaluate the safety of maternal Tdap; thus, we assessed health events by examining the difference in birth and hospital-related outcomes of infants with and without fetal exposure to Tdap. This was a retrospective cohort study using linked administrative datasets. The study population were all live-born infants in New Zealand (NZ) weighing at least 400 g at delivery and born to women who were eligible for the government funded, national-level vaccination program in 2013. Infants were followed from birth up to one year of age. There were a total of 69,389 eligible infants in the cohort. Of these, 8299 infants were born to 8178 mothers exposed to Tdap (12%), primarily between 28 and 38 weeks gestation as per the national schedule. Among the outcomes, we found a reduced risk for moderate to late preterm birth, low birth weight, small for gestational age, large for gestational age, respiratory distress syndrome, transient tachypnea of newborn, tachycardia or bradycardia, haemolytic diseases, other neonatal jaundice, anaemia, syndrome of infant of mother with gestational diabetes, and hypoglycemia in infants born to vaccinated mothers. There was no association between maternal Tdap, infant Apgar score at 5 min after birth, asphyxia, sepsis or infection, or hypoxic ischemic encephalopathy. Infant exposure to Tdap during pregnancy was associated with a higher mean birthweight (not clinically significant) and higher odds for ankyloglossia and neonatal erythema toxicum diagnoses. There were insufficient observations to allow examination of the effect of Tdap on extreme preterm and very preterm birth, and stillbirth, infant death, or microcephaly. Overall, we found no outcomes of concern associated with the administration of Tdap during pregnancy. NZ Health and Disability Ethics Committee Approval #14/N.T.A/169/AM05.

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Antenatal Magnesium Sulfate Reduced Intestinal Morbidities Requiring Surgery in Preterm Infants With Extremely Low Gestational Age: A Retrospective Cohort Study

10.21203/rs.3.rs-29795/v1 ◽

2020 ◽

Author(s):

Seh Hyun Kim ◽

Yoo-Jin Kim ◽

Seung Hyun Shin ◽

Hannah Cho ◽

Seung Han Shin ◽

...

Keyword(s):

Multivariate Analysis ◽

Cohort Study ◽

Magnesium Sulfate ◽

Preterm Infants ◽

Gestational Age ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Dependent Manner ◽

Neurodevelopmental Outcomes ◽

Surgical Conditions

Abstract Background Antenatal magnesium sulfate is widely used as a tocolytic, for maternal seizures, and for seizure prophylaxis in preeclampsia. Recent studies have suggested that antenatal magnesium sulfate use is associated with favorable neurodevelopmental outcomes in preterm infants. However, there are concerns regarding the neonatal effects of antenatal magnesium sulfate, especially regarding gastrointestinal morbidities. This study aims to explore the effects of antenatal magnesium sulfate on intestinal morbidities requiring surgery in preterm infants.Methods This was a retrospective cohort study of 181 preterm infants who were born at less than 28 weeks of gestational age. Subjects were categorized as infants exposed to antenatal magnesium sulfate and those not exposed to antenatal magnesium sulfate.Results Antenatal magnesium sulfate was associated with a lower incidence of surgical conditions of the intestine (OR 0.393, 95% CI 0.170–0.905). Multivariate analysis showed that the duration of antenatal magnesium sulfate use was associated with surgical conditions of the intestine (adjusted OR 0.766, 95% CI 0.589–0.997). In the < 26 weeks of gestational age subgroup, use of antenatal magnesium sulfate was significantly associated with decreased intestinal morbidities requiring surgery (adjusted OR 0.234, 95% CI 0.060–0.922).Conclusion Antenatal magnesium sulfate use appears to have a protective effect on intestinal morbidities requiring surgery in preterm infants in a duration-dependent manner. Association of antenatal magnesium sulfate use and decreased intestinal morbidities requiring surgery was more distinct in preterm infants < 26 weeks of gestational age.

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Predictors of Large-for-Gestational Age Birth Weight Among Pregnant Women with Type 1 and Type 2 Diabetes: A Retrospective Cohort Study

Canadian Journal of Diabetes ◽

10.1016/j.jcjd.2018.08.047 ◽

2018 ◽

Vol 42 (5) ◽

pp. S15

Author(s):

Lisa D. Alexander ◽

George Tomlinson ◽

Denice S. Feig

Keyword(s):

Type 2 Diabetes ◽

Cohort Study ◽

Birth Weight ◽

Pregnant Women ◽

Gestational Age ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Large For Gestational Age

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Predictors of Large-for-Gestational-Age Birthweight Among Pregnant Women With Type 1 and Type 2 Diabetes: A Retrospective Cohort Study

Canadian Journal of Diabetes ◽

10.1016/j.jcjd.2019.08.015 ◽

2019 ◽

Vol 43 (8) ◽

pp. 560-566

Author(s):

Lisa D. Alexander ◽

George Tomlinson ◽

Denice S. Feig

Keyword(s):

Type 2 Diabetes ◽

Cohort Study ◽

Pregnant Women ◽

Gestational Age ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Large For Gestational Age

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Relationship between weight retention at 6 weeks postpartum and the risk of large-for-gestational age birth in a second pregnancy in China: a retrospective cohort study

BMJ Open ◽

10.1136/bmjopen-2021-049903 ◽

2021 ◽

Vol 11 (8) ◽

pp. e049903

Author(s):

Jing Liu ◽

Guang Song ◽

Ge Zhao ◽

Tao Meng

Keyword(s):

Cohort Study ◽

Gestational Age ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Subsequent Pregnancy ◽

Normal Weight ◽

The Body ◽

Large For Gestational Age ◽

Weight Retention ◽

Gestational Weight

ObjectiveWe aimed to investigate the association between weight retention at 6 weeks postpartum after the first pregnancy and large-for-gestational age (LGA) risk in a subsequent pregnancy.Study designA retrospective cohort study.SettingA tertiary hospital of China.Participants5950 Chinese singleton pregnancies that delivered their second singletons between 28 and 42 weeks of gestation.Outcomes measuresWe calculated the weight retention at 6 weeks postpartum after the first pregnancy (the body mass index (BMI) at 6 weeks after the first birth minus the prepregnant BMI of the first pregnancy) and the gestational weight gain in the second pregnancy. We used the logistic regression to obtain adjusted OR. We determined the relationship between maternal BMI change at 6 weeks after the first pregnancy and LGA risk in the second pregnancy.ResultsRelative to other categories of BMI change at 6 weeks postpartum, women who gained ≥3 kg/m2 compared with the prepregnancy BMI were at increased LGA risk. The stratified analysis showed that LGA risk was increased in the second pregnancy in underweight and normal weight women who gained ≥3 kg/m2 when using remain stable women as the reference group (OR=3.35, 95% CI 1.11 to 10.12 for underweight women; OR=2.23, 95% CI 1.43 to 3.45 for normal weight women) at 6 weeks postpartum. For the women who gained ≥3 kg/m2 at 6 weeks postpartum, LGA risk was increased in normal weight women with an adequate (OR=3.21, 95% CI 1.10 to 9.33) and excessive (OR=2.62, 95% CI 1.02 to 6.76) gestational weight in the second pregnancy when using obese women as the reference.ConclusionPostpartum weight retention at 6 weeks after the first pregnancy provides us a new early window to identify LGA risk in a subsequent pregnancy and allows us to implement primary preventative strategies.

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Pertussis Immunisation in Pregnancy Safety (PIPS) Study: A Retrospective Cohort Study of Safety Outcomes in Infants Exposed to Tdap Vaccine in Utero

10.20944/preprints201907.0210.v1 ◽

2019 ◽

Author(s):

Helen A. Petousis-Harris ◽

Yannan Jiang ◽

Lennox Yu ◽

Donna Watson ◽

Tony Walls ◽

...

Keyword(s):

Cohort Study ◽

Preterm Birth ◽

Gestational Age ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

National Level ◽

Large For Gestational Age ◽

Infant Exposure ◽

The Difference ◽

The Government

We aimed to evaluate the safety of maternal Tdap we assessed health events by examining the difference in birth and hospital-related outcomes of infants with and without fetal exposure to Tdap. This was a retrospective cohort study using linked administrative datasets. The study population were all live-born infants in New Zealand (NZ) weighing at least 400 grams at delivery and born to women who were eligible for the government funded, national-level vaccination program in 2013. Infants were followed from birth up to one year of age. There were a total of 69,389 eligible infants in the cohort. Of these, 8,299 infants were born to 8,178 mothers exposed to Tdap (12%), primarily between 28-38 weeks gestation as per the national schedule. Among the outcomes, we found a reduced risk for moderate to late preterm birth, low birth weight, small for gestational age, large for gestational age, respiratory distress syndrome, transient tachypnea of newborn, tachycardia or bradycardia, haemolytic diseases, other neonatal jaundice, anaemia, syndrome of infant of mother with gestational diabetes, and hypoglycemia in infants born to vaccinated mothers. There was no association between maternal Tdap and stillbirth, infant Apgar score at 5 minutes after birth, microcephaly, asphyxia, sepsis or infection, or hypoxic ischemic encephalopathy. Infant exposure to Tdap during pregnancy was associated with a higher mean birthweight (not clinically significant) and higher odds for ankyloglossia and neonatal erythema toxicum diagnoses. There were insufficient observations to allow examination of the effect of Tdap on extreme preterm and very preterm birth, and infant death. Overall, we found no outcomes of concern associated with the administration of Tdap during pregnancy.

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