scholarly journals Is there an Increased Risk for Unfavorable Obstetric Outcomes in Women with Endometriosis? An Evaluation of Evidences

2020 ◽  
Vol 42 (04) ◽  
pp. 200-210
Author(s):  
Giuliana Annicchino ◽  
Helena Malvezzi ◽  
Carla de Azevedo Piccinato ◽  
Sérgio Podgaec
Keyword(s):  
Systematic Review ◽  
Preterm Birth ◽  
Placenta Previa ◽  
Albert Einstein ◽  
Sao Paulo ◽  
Obstetric Outcomes ◽  
São Paulo ◽  
Review Of The Literature ◽  
Increased Risk ◽  
Evidence Quality

Abstract Objective The present study is a systematic review of the literature to assess whether the presence of endometriosis determines or contributes to adverse obstetric outcomes. Data Sources The present work was carried out at the Hospital Israelita Albert Einstein, São Paulo, state of São Paulo, Brazil, in accordance to the PRISMA methodology for systematic reviews. A review of the literature was performed using PubMed, Web of Science and Scopus databases. The keywords used were: pregnancy outcome, pregnancy complications, obstetrical complications, obstetrics, obstetric outcomes and endometriosis. The survey was further completed by a manually executed review of cross-referenced articles, which was last performed on November 30, 2018. Selection of studies The survey disclosed a total of 2,468 articles, published from May 1946 to October 2017. A total of 18 studies were selected to be further classified according to their quality and relevance. Data Collection The Newcastle–Ottawa Quality Assessment Scale was used for classification. Five studies of greater impact and superior evidence quality and 13 studies of moderate evidence quality were selected. We analyzed the studies for the characteristics of their patients plus how endometriosis was diagnosed and their respective obstetric outcomes taking into account their statistical relevance. Data Synthesis Analyses of the higher impact and better quality studies have shown high incidence of preterm birth and placenta previa in patients with endometriosis. Conclusion Placenta previa and preterm birth are the most statistically significant outcomes related to endometriosis, as indicated by our systematic review. The present information is useful to alert obstetricians and patients about possible unfavorable obstetric outcomes.

scholarly journals BRAZILIAN SOCIETY OF HEPATOLOGY UPDATED RECOMMENDATIONS FOR DIAGNOSIS AND TREATMENT OF HEPATOCELLULAR CARCINOMA

2020 ◽  
Vol 57 (suppl 1) ◽  
pp. 1-20 ◽  
Author(s):  
Aline Lopes CHAGAS ◽  
Angelo Alves de MATTOS ◽  
Flair José CARRILHO ◽  
Paulo Lisboa BITTENCOURT ◽  
Denise Cerqueira Paranaguá VEZOZZO ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Systematic Review ◽  
Sao Paulo ◽  
Diagnosis And Treatment ◽  
Governing Board ◽  
São Paulo ◽  
Review Of The Literature ◽  
Final Version ◽  
Brazilian Society ◽  
Related Mortality

ABSTRACT Hepatocellular carcinoma (HCC) is one of the leading causes of cancer-related mortality worldwide. The Brazilian Society of Hepatology (SBH) published in 2015 its first recommendations about the management of HCC. Since then, new data have emerged in the literature, prompting the governing board of SBH to sponsor a single-topic meeting in August 2018 in São Paulo. All the invited experts were asked to make a systematic review of the literature reviewing the management of HCC in subjects with cirrhosis. After the meeting, all panelists gathered together for the discussion of the topics and the elaboration of updated recommendations. The text was subsequently submitted for suggestions and approval of all members of the Brazilian Society of Hepatology through its homepage. The present manuscript is the final version of the reviewed manuscript containing the recommendations of SBH.

scholarly journals Endometriosis and Risk of Adverse Pregnancy Outcome: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 10 (4) ◽  
pp. 667
Author(s):  
Kjerstine Breintoft ◽  
Regitze Pinnerup ◽  
Tine Brink Henriksen ◽  
Dorte Rytter ◽  
Niels Uldbjerg ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Cesarean Section ◽  
Placental Abruption ◽  
Gestational Hypertension ◽  
Adverse Pregnancy Outcome ◽  
Placenta Previa ◽  
Meta Analysis ◽  
Increased Risk ◽  
Spontaneous Hemoperitoneum ◽  
In Pregnancy

Background: This systematic review and meta-analysis summarizes the evidence for the association between endometriosis and adverse pregnancy outcome, including gestational hypertension, pre-eclampsia, low birth weight, and small for gestational age, preterm birth, placenta previa, placental abruption, cesarean section, stillbirth, postpartum hemorrhage, spontaneous hemoperitoneum in pregnancy, and spontaneous bowel perforation in pregnancy. Methods: We performed the literature review in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA), by searches in PubMed and EMBASE, until 1 November 2020 (PROSPERO ID CRD42020213999). We included peer-reviewed observational cohort studies and case-control studies and scored them according to the Newcastle–Ottawa Scale, to assess the risk of bias and confounding. Results: 39 studies were included. Women with endometriosis had an increased risk of gestational hypertension, pre-eclampsia, preterm birth, placenta previa, placental abruption, cesarean section, and stillbirth, compared to women without endometriosis. These results remained unchanged in sub-analyses, including studies on spontaneous pregnancies only. Spontaneous hemoperitoneum in pregnancy and bowel perforation seemed to be associated with endometriosis; however, the studies were few and did not meet the inclusion criteria. Conclusions: The literature shows that endometriosis is associated with an increased risk of gestational hypertension, pre-eclampsia, preterm birth, placenta previa, placental abruption, cesarean section, and stillbirth.

scholarly journals Relationship between preterm birth and air pollution in Santos, Sao Paulo, Brazil

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M E L Brandao ◽  
B A L F Braga ◽  
M L C Martins ◽  
P L A A Pereira
Keyword(s):  
Air Pollution ◽  
Preterm Birth ◽  
Air Pollutants ◽  
First Trimester ◽  
Sao Paulo ◽  
São Paulo ◽  
Air Humidity ◽  
Relative Air Humidity ◽  
The Impact ◽  
Fourth Quartile

Abstract Santos is a seaboard Brazilian city recognized by its port activity where the road and rail infrastructure along with the large transportation operation, displays an important factor to contribute with all kinds of toxic and air pollutants. Recent studies have suggested associations between air pollution and various birth outcomes. Pollutant gases such as NOx, O3 and particulate matter PM2,5, PM10 have been cited as factors involved in such outcomes. The present study aims to assess the relationship between atmospheric pollutants and perinatal outcomes in the city of Santos from Jan. 2012 to Dec. 2015. Cross-sectional study that analyzed 10.319 singleton births in an area set with 2 km radius of the monitoring stations. Birth weight and information on mother and pregnancy were obtained at the Brazilian “Born Alive National Information System”. Daily records of air pollutants (PM10, PM2.5, NO2 and O3), temperature and relative air humidity, for the study period, were obtained from São Paulo State Environmental Agency (CETESB). Associations between preterm birth and air pollutants mean levels at each gestational trimester were investigated using multiple logistic regression model controlled by the variables: infant sex, type of delivery, maternal education. prenatal care, and number of previous live births, temperature and relative air humidity. NO2 e PM2,5 was not associated with preterm birth. O3 was significantly associated in the first trimester in the fourth quartile (OR = 1,47 CI 95% 1,05; 2,07). PM10 was significantly associated in the first trimester for the fourth quartile (OR = 1,28 CI 95% 1,00; 1,64), second trimester for the second quartile (OR = 1,37 CI 95% 1,07; 1,77). Conclusions the results shows evidence that maternal exposure to air pollution especially during the first trimester of pregnancy may contribute to preterm birth. Further actions are needed towards controlling air pollution are strongly recommended for promoting early-life health. Key messages This is the first research of this kind that was made in Santos. It brings important evidence of the impact in the life of the population, especially those whose is not even born yet. It can be used as a resource to guide public policies in health, especially the guidelines that dictate the concentration of air pollutants and air quality.

scholarly journals Association between Caffeine Consumption in Pregnancy and Low Birth Weight and Preterm Birth in the birth Cohort of Ribeirão Preto

2018 ◽  
Vol 40 (12) ◽  
pp. 749-756 ◽  
Author(s):  
Fernanda Vitti ◽  
Carlos Grandi ◽  
Ricardo Cavalli ◽  
Vanda Simões ◽  
Rosângela Batista ◽  
...  
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Birth Cohort ◽  
Skin Color ◽  
Sao Paulo ◽  
Caffeine Intake ◽  
São Paulo ◽  
Caffeine Consumption ◽  
Coffee Intake

Objective To describe caffeine consumption during pregnancy and its association with low birth weight (LBW) and preterm birth in the birth cohort of Ribeirão Preto, state of São Paulo, Brazil, in 2010. Methods Cohort study, with descriptive and analytical approach. Data included 7,607 women and their newborns in Ribeirão Preto, state of São Paulo, Brazil. The women answered standardized questionnaires about reproductive health, prenatal care, life habits, sociodemographic conditions, and information about coffee intake. The independent variable was high caffeine consumption (≥300 mg/day) from coffee during pregnancy, and the dependent variables were LBW (birth weight < 2,500 g) and preterm birth (< 37 weeks of gestational age). Four adjusted polytomous logistic regression models, relative risk (RR) and 95% confidence interval (CI) were fitted: biological and sociodemographic conditions; obstetric history; current gestational conditions; and all variables included in the previous models. Results A total of 4,908 (64.5%) mothers consumed caffeine, 143 (2.9%) of whom reported high consumption. High caffeine intake was significantly associated with reduced education and with the occupation of the head of the family, nonwhite skin color, not having a partner, higher parity, previous abortion and preterm birth, urinary tract infection, threatened abortion, alcohol consumption and smoking. No association was found between high caffeine consumption and LBW or preterm birth in both unadjusted (RR = 1.45; 95% CI: 0.91–2.32; and RR = 1.16; 95% CI: 0.77–1.75, respectively) and adjusted analyses (RR = 1.42; 95% CI: 0.85–2.38; and RR = 1.03; 95% CI: 0.65–1.63, respectively). Conclusion In this cohort, high caffeine intake was lower than in other studies and no association with LBW or preterm birth was found.

scholarly journals Association between maternal sleep duration and quality, and the risk of preterm birth: a systematic review and meta-analysis of observational studies

2020 ◽  
Author(s):  
ling wang ◽  
Feng Jin
Keyword(s):  
Systematic Review ◽  
Preterm Birth ◽  
Sleep Quality ◽  
Sleep Duration ◽  
Meta Analysis ◽  
Controlled Study ◽  
Poor Sleep ◽  
Poor Sleep Quality ◽  
Increased Risk ◽  
Study Heterogeneity

Abstract Background : To assess the association of sleep duration and quality with the risk of preterm birth. Methods : Relevant studies were retrieved from the PubMed and Web of Science databases up to September 30, 2018. The reference lists of the retrieved articles were reviewed. Random effects models were applied to estimate summarized relative risks (RRs) and 95% confidence intervals (CIs). Results : Ten identified studies (nine cohort studies and one case-controlled study) examined the associations of sleep duration and quality with the risk of preterm birth. As compared with women with the longest sleep duration, the summary RR was 1.23 (95% CI = 1.01–1.50) for women with the shortest sleep duration, with moderate between-study heterogeneity ( I 2 = 57.4%). Additionally, as compared with women with good sleep quality, the summary RR was 1.54 (95% CI = 1.18–2.01) for women with poor sleep quality (Pittsburgh Sleep Quality Index > 5), with high between-study heterogeneity ( I 2 = 76.7%). Funnel plots as well as the Egger’s and Begg’s tests revealed no evidence of publication bias. Conclusions : This systematic review and meta-analysis revealed that short sleep duration and poor sleep quality may be associated with an increased risk of preterm birth. Further subgroup analyses are warranted to test the robustness of these findings as well as to identify potential sources of heterogeneity.

Maternal BMI and preterm birth: A systematic review of the literature with meta-analysis

2009 ◽  
pp. 1-14 ◽  
Author(s):  
Maria Regina Torloni ◽  
Ana Pilar Betran ◽  
Silvia Daher ◽  
Mariana Widmer ◽  
Siobhan Dolan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Preterm Birth ◽  
Meta Analysis ◽  
Review Of The Literature ◽  
Maternal Bmi

Geographical clusters and social risk factors for suicide in the city of São Paulo, 2006–2015: An ecologic study

2020 ◽  
Vol 66 (5) ◽  
pp. 460-468
Author(s):  
Daniel Hideki Bando ◽  
Ligia Vizeu Barrozo ◽  
Fernando Madalena Volpe
Keyword(s):  
Risk Factors ◽  
Suicide Rate ◽  
Religious Affiliation ◽  
Sao Paulo ◽  
São Paulo ◽  
Multiple Model ◽  
Increased Risk ◽  
The Mean ◽  
Risk Factors For Suicide ◽  
Geographical Clusters

Background: To identify geographical clusters of suicide in São Paulo, Brazil (2006–2015) and to verify the associations of suicide with sociocultural characteristics of its 96 districts. Methods: Spatial scan test was used to detect the geographical clusters. Correlation and multiple regression techniques were used to estimate the association of socioeconomic and cultural variables with suicide. Results: The mean suicide rate was 4.8/100,000. Three clusters were identified which are as follows: one of increased risk in downtown and two of decreased risk in the South and in the Southeast. The mean suicide rate of the high-risk clustered districts (7.99/100,000) presented significantly higher average incomes per household, higher proportion of formally educated, of no religious affiliation, of recent migrants, of all-times migrants and lower proportion of married. The multiple model selected two independent risk factors – people with no religious affiliation (β = 0.182) and of recent migrants (β = 0.278) – and two protective factors – the proportion of married (β = –0.185) and of total migrants (β = –0.075), which jointly explained 58.4% of the variance. Conclusion: Durkheimian social and cultural risk factors for suicide were confirmed. Compared to a previous study period (1996–2005), suicide rates and geographical clusters remained relatively stable in the subsequent decade (2006–2015).

Placental malperfusion as a possible mechanism of preterm birth in patients with Müllerian anomalies

2017 ◽  
Vol 45 (1) ◽  
Author(s):  
Jovana Lekovich ◽  
Joshua Stewart ◽  
Sarah Anderson ◽  
Erin Niemasik ◽  
Nigel Pereira ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Gestational Age ◽  
Placenta Previa ◽  
Preterm Births ◽  
Mullerian Anomalies ◽  
Müllerian Anomalies ◽  
Increased Risk ◽  
Uterine Anomalies ◽  
Gestational Age At Delivery ◽  
Term Births

AbstractObjective:Müllerian anomalies are associated with increased risk of miscarriage, intrauterine growth restriction (IUGR) and preterm birth. While a commonly implicated cause is restricted expansion of endometrial cavity, alternatively it could be due to abnormal placentation. We sought to examine clinical and histopathologic factors associated with preterm delivery in women with Müllerian anomalies.Study design:One hundred and eleven singleton pregnancies in 85 women were analyzed retrospectively. There were 42 pregnancies with bicornaute, 24 with unicornuate, 24 with septate, 19 with didelphys and one each with arcuate and T-shaped uterus. Primary outcomes included gestational age at delivery, placental histopathology, placenta previa and accreta.Results:Twenty-eight (25.2%) of pregnancies were delivered prior to term. Of those, only 14 (50%) were due to preterm labor or preterm premature rupture of membranes (PPROM). Histological evidence of placental malperfusion was present in 22% of all pregnancies and those delivered at an earlier median gestational age [34 (IQR 31–37) vs. 37 weeks (IQR 34–39); P=0.001]. Malperfusion was more common in preterm than in full term births (46% vs. 14%; P=0.04). Conversely, inflammation was not more common in preterm compared to term deliveries (17.9% vs. 16.9%; P=0.89). Five pregnancies had placenta previa, three of which were complicated by accreta.Conclusion:Placental malperfusion, rather than inflammation, was more commonly associated with preterm births in women with uterine anomalies.

IMPACT OF MATERNAL AGE ON BIRTH OUTCOMES: A POPULATION-BASED STUDY OF PRIMIPAROUS BRAZILIAN WOMEN IN THE CITY OF SÃO PAULO

2005 ◽  
Vol 38 (4) ◽  
pp. 523-535 ◽  
Author(s):  
CARLA JORGE MACHADO
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Maternal Age ◽  
Sao Paulo ◽  
Outcome Variable ◽  
Delivery Mode ◽  
São Paulo ◽  
Apgar Scores ◽  
The City

The aim of this study is to analyse the impact of maternal age at first birth on low birth weight, preterm birth and low Apgar scores at one minute and at five minutes among live births delivered to primiparous Brazilian women in the city of São Paulo. Analyses were based on 73,820 birth records from the 1998 birth cohort. Logistic regression was used to assess the association between maternal age and each outcome variable, controlling for the following risk factors: delivery mode, plurality, sex, maternal education, number of prior losses, prenatal care, race, parity and community development. Maternal ages below 20 and above 30 years were significantly associated with the risks of low birth weight and preterm birth, but no association was found between maternal ages and Apgar score, with the exception that ages 15–19 reduced the odds of a low one-minute score. Even though this result seems to be inconsistent, low birth weight, preterm birth and low Apgar scores measure different dimensions of newborn well-being, and the association of each measure with maternal age is expected to diverge.

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