Retrospective cohort study of prenatally and postnatally diagnosed coarctation of the aorta (CoA): prenatal diagnosis improve neonatal outcome in severe CoA

Abstract Purpose: To assess whether positive flow cytometry quantification of fetal red blood cells is associated with adverse outcomes in cases of trauma during pregnancy.Methods: A retrospective cohort study, at a single tertiary center between 2013 and 2019. All pregnant women with viable gestation involved in trauma who underwent flow cytometry were included. Flow cytometry was considered positive (≥0.03/≥30 ml). Composite adverse maternal and neonatal outcomes were compared between cases with positive and negative flow cytometry test. Univariate and multivariate logistic regression analysis were performed to assess the role of flow cytometry in predicting adverse outcomes. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were calculated.Results: During the study 1023 women met inclusion and exclusion criteria. The mechanisms of injury were motor vehicle accident in 387 women (38%), falls in 367 (36%), direct abdominal trauma in 353 (35%) and in 14 women (1%) other mechanism of injury. Among the cohort, 119 women (11.6%) had positive flow cytometry (≥0.03/≥30 ml) with median result of 0.03 [0.03-0.04], while 904 women (88.4%) had negative flow cytometry test result (≤0.03/≤30 ml) with median result of 0.01 [0.01-0.02]. Composite adverse outcome occurred in 8% of the women, with no difference in the groups with vs. without positive flow cytometry (4.2% vs. 8.5%; p=0.1). Positive flow cytometry was not associated with any adverse maternal or neonatal outcome. This was confirmed on a multivariate analysis. Conclusions: Flow cytometry result is not related to adverse maternal and fetal/neonatal outcome of women involved in minor trauma during pregnancy. We suggest that flow cytometry should not be routinely assessed in pregnant women involved in minor trauma.

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Growth Abnormalities as a Risk Factor of Adverse Neonatal Outcome in Hypertensive Pregnancies—A Single-Center Retrospective Cohort Study

Children ◽

10.3390/children8060522 ◽

2021 ◽

Vol 8 (6) ◽

pp. 522

Author(s):

Anna Kajdy ◽

Stepan Feduniw ◽

Jan Modzelewski ◽

Dorota Sys ◽

Dagmara Filipecka-Tyczka ◽

...

Keyword(s):

Risk Factor ◽

Cohort Study ◽

Retrospective Cohort Study ◽

Neonatal Death ◽

Retrospective Cohort ◽

Neonatal Outcome ◽

Growth Restriction ◽

Chronic Hypertension ◽

Single Center ◽

Growth Abnormalities

(1) Background: Hypertensive disorders of pregnancy (HDP) include gestational hypertension (GH), chronic hypertension (CH), preeclampsia (PE), and preeclampsia superimposed on chronic hypertension (CH with PE). HDP is associated with several short and long-term perinatal and neonatal complications, such as newborn growth restriction and death. This study aimed to establish the association between HDP, newborn growth abnormalities, and neonatal outcome. (2) Methods: This is a single-center retrospective cohort study of 63651 singleton deliveries. (3) Results: Univariate analysis showed a significantly increased risk of intrauterine and neonatal death associated with maternal hypertension and growth disorders. There were differences between growth charts used, with the highest risk of stillbirth for SGA defined by the Intergrowth chart (OR 17.2) and neonatal death for newborn growth restriction (NGR) based on Intergrowth (OR 19.1). Multivariate analysis showed that NGR is a stronger risk factor of neonatal death than SGA only. (4) Conclusions: HDP is significantly associated with growth abnormalities and is an independent risk factor of adverse outcomes. The presence of newborn growth restriction is strongly associated with the risk of neonatal death. The choice of growth chart has a substantial effect on the percentage of diagnosis of SGA and NGR.

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