Anaemia and iron deficiency in pregnancy and adverse perinatal outcomes in Southern India

Objective To determine if women who newly met criteria for stage 1 hypertension in early pregnancy were at increased risk for adverse perinatal outcomes compared with normotensive women. Study Design We conducted a retrospective cohort study of women who had prenatal care at a single institution and subsequently delivered a live infant between December 2017 and August 2019. Women with a singleton gestation who had at least two prenatal visits prior to 20 weeks of gestation were included. We excluded women with known chronic hypertension or other major maternal illness. Two groups were identified: (1) women newly diagnosed with stage 1 hypertension before 20 weeks of gestation (blood pressure [BP] 130–139/80–89 on at least two occasions) and (2) women with no known history of hypertension and normal BP (<130/80 mm Hg) before 20 weeks of gestation. The primary outcome was any hypertensive disorder of pregnancy; secondary outcomes were indicated preterm birth and small for gestational age. Generalized linear models were used to compare risk of adverse outcomes between the groups. Results Of the 1,630 women included in the analysis, 1,443 women were normotensive prior to 20 weeks of gestation and 187 women (11.5%) identified with stage 1 hypertension. Women with stage 1 hypertension were at significantly increased risk for any hypertensive disorder of pregnancy (adjusted risk ratio [aRR]: 1.86, 95% confidence interval [CI]: 1.12–3.04) and indicated preterm birth (aRR: 1.83, 95% CI: 1.12–3.02). Black women and obese women with stage 1 hypertension were at increased for hypertensive disorder of pregnancy compared with white women and nonobese women, respectively (aRR: 1.32, 95% CI: 1.11–1.57; aRR: 1.69, 95% CI: 1.39–2.06). Conclusion These results provide insight about the prevalence of stage 1 hypertension and inform future guidelines for diagnosis and management of hypertension in pregnancy. Future research is needed to assess potential interventions to mitigate risk. Key Points

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Mild gestational hyperglycaemia as a risk factor for metabolic syndrome in pregnancy and adverse perinatal outcomes

Diabetes/Metabolism Research and Reviews ◽

10.1002/dmrr.815 ◽

2008 ◽

Vol 24 (4) ◽

pp. 324-330 ◽

Cited By ~ 31

Author(s):

Carlos Antonio Negrato ◽

Lois Jovanovic ◽

Marcos Antonio Tambascia ◽

Iracema de Mattos Paranhos Calderon ◽

Bruno Geloneze ◽

...

Keyword(s):

Metabolic Syndrome ◽

Risk Factor ◽

Perinatal Outcomes ◽

Adverse Perinatal Outcomes ◽

In Pregnancy

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The use of intravenous iron in pregnancy: for whom and when? A survey of Australian and New Zealand obstetricians

BMC Pregnancy and Childbirth ◽

10.1186/s12884-020-03363-3 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Sarah Smith-Wade ◽

Giselle Kidson-Gerber ◽

Antonia Shand ◽

Luke Grzeskowiak ◽

Amanda Henry

Keyword(s):

New Zealand ◽

Iron Deficiency ◽

Online Survey ◽

Controlled Trial ◽

Perinatal Outcomes ◽

Intravenous Iron ◽

Line Treatment ◽

Second Line ◽

First Line ◽

In Pregnancy

Abstract Background Iron deficiency anaemia in pregnancy (IDAP) affects 11–18% of Australian pregnancies and is associated with adverse perinatal outcomes. National prescribing data suggests the use of intravenous iron in pregnancy is increasingly common. This study aimed to: 1) Establish the current patterns of intravenous iron use by Fellows of the Royal Australian and New Zealand College of Obstetricians (FRANZCOG) when treating iron deficiency and IDAP including immediately postpartum and; 2) Assess FRANZCOG opinions regarding potential trial of intravenous iron for first-line treatment of IDAP. Methods An online survey of RANZCOG Fellows practicing obstetrics was distributed in September 2018. Results were analysed descriptively and responses compared by clinician demographics using Chi-squared testing. Results Of 484 respondents (21% of FRANZCOG), 457 were currently practicing obstetrics. Most prescribed intravenous iron in pregnancy (96%) and/or postpartum (85%). Most intravenous iron was prescribed for IDAP (98%) rather than iron deficiency without anaemia (53%), and for IDAP most commonly second-line to failed oral iron supplementation and first-line in special circumstances (59%). Intravenous iron prescribing was associated with shorter time since FRANZCOG completion (p = 0.01), public hospital practice (p = 0.008) and higher hospital birth numbers (p = 0.01). Most respondents (90%) would consider a randomised controlled trial of first-line intravenous iron for IDAP, although views on appropriate thresholds differed. Conclusions Almost all respondents prescribed intravenous iron for IDAP, and while mostly used for second-line treatment over half sometimes used it first-line. With accelerating intravenous iron use, further research is required into its optimal use in pregnancy, recognizing important clinical outcomes and cost effectiveness.

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Midgut volvulus secondary to congenital malrotation in pregnancy

BMJ Case Reports ◽

10.1136/bcr-2020-234664 ◽

2020 ◽

Vol 13 (5) ◽

pp. e234664 ◽

Cited By ~ 1

Author(s):

Eelyn Chong ◽

David S Liu ◽

Vishnupriya Rajagopal ◽

Neil Strugnell

Keyword(s):

Perinatal Outcomes ◽

First Trimester ◽

Small Bowel Resection ◽

Emergency Laparotomy ◽

Midgut Volvulus ◽

Threatening Condition ◽

Life Threatening ◽

Uncommon Condition ◽

Adverse Perinatal Outcomes ◽

In Pregnancy

Midgut volvulus complicating congenital malrotation is a rare but life-threatening condition that can occur in pregnancy. We present a case of intestinal infarction resulting from midgut volvulus in a healthy 32-week pregnant woman who underwent emergency laparotomy and small bowel resection in the setting of fetal death in utero. This case highlights several challenging issues in diagnosing and managing this uncommon condition which leads to increased adverse perinatal outcomes. Prompt investigation and definitive surgical treatment are required when pregnant women present with bilious vomiting and new-onset abdominal or back pain especially beyond the first trimester.

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The Impact of Subclinical Hypothyroidism on Adverse Perinatal Outcomes and the Role of Thyroid Screening in Pregnancy

Frontiers in Endocrinology ◽

10.3389/fendo.2019.00522 ◽

2019 ◽

Vol 10 ◽

Cited By ~ 4

Author(s):

Mei-Qin Wu ◽

Jin Liu ◽

Ya-Qian Wang ◽

Ying Yang ◽

Chong-Huai Yan ◽

...

Keyword(s):

Subclinical Hypothyroidism ◽

Perinatal Outcomes ◽

Thyroid Screening ◽

Adverse Perinatal Outcomes ◽

The Impact ◽

In Pregnancy

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Asthma in Pregnancy: Pathophysiology, Diagnosis, Whole-Course Management, and Medication Safety

Canadian Respiratory Journal ◽

10.1155/2020/9046842 ◽

2020 ◽

Vol 2020 ◽

pp. 1-10

Author(s):

Huijie Wang ◽

Na Li ◽

Huaqiong Huang

Keyword(s):

Health Care ◽

Medication Safety ◽

Control Level ◽

Perinatal Outcomes ◽

Health Care Practitioner ◽

Disease Assessment ◽

Physiological Changes ◽

Drug Compliance ◽

Adverse Perinatal Outcomes ◽

In Pregnancy

Asthma in pregnancy is a health issue of great concern. Physiological changes and drug compliance during pregnancy can affect asthma control in varying degrees, and the control level of asthma and the side effects of asthma medications are closely related to the adverse perinatal outcomes of mother and fetus. This article provides an update on the available literature regarding the alleviating or aggravating mechanism of asthma in pregnancy, diagnosis, disease assessment, and systematic management, to provide a new guidance for physician, obstetric joint doctor, and health care practitioner.

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