scholarly journals 1332Endometriosis, assisted reproductive technology and adverse pregnancy outcomes: a population based data linkage study

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Ibinabo Ibiebele ◽  
Tanya Nippita ◽  
Rodney Baber ◽  
Siranda Torvaldsen
Keyword(s):  
Preterm Birth ◽  
Assisted Reproductive Technology ◽  
Pregnancy Outcomes ◽  
Data Linkage ◽  
Reproductive Technology ◽  
Linkage Study ◽  
Adverse Pregnancy Outcomes ◽  
Placenta Praevia ◽  
Antepartum Haemorrhage ◽  
Adverse Pregnancy

Abstract Background Endometriosis is a chronic inflammatory disease characterised by endometrial tissue outside the uterus – pain and infertility are common symptoms. There is a paucity of data on the association between endometriosis and adverse pregnancy outcomes where the contribution of assisted reproductive technology (ART) use is also considered. This study will examine the association between endometriosis, with and without ART use, on adverse pregnancy outcomes. Methods Population data linkage study of all female NSW residents aged 15-45 years with a singleton birth in 2006-2015. Pregnancies were classified into 4 groups based on endometriosis diagnosis (yes/no) and ART use (yes/no). Multinomial logistic regression was used to estimate the odds of adverse pregnancy outcomes with 99% confidence intervals, adjusting for maternal and pregnancy factors. Outcomes assessed included placenta praevia, antepartum haemorrhage, planned birth (induction of labour or caesarean section) and preterm birth. Results Of 889,101 eligible pregnancies, women with endometriosis were more likely to be older while women who used ART were more likely to be nulliparous, birth in a private hospital and less likely to smoke. Adjusted odds ratios for selected study outcomes are outlined below. Conclusions Endometriosis is associated with increased odds of preterm birth, placenta praevia, antepartum haemorrhage and planned birth. In general, the odds of adverse pregnancy outcomes associated with endometriosis were further increased with ART use. Key messages These findings suggest that women with endometriosis, especially those who achieved pregnancy via ART use, represent a high risk obstetric population requiring appropriate surveillance and management.

Assisted Reproductive Technology and Placenta-Mediated Adverse Pregnancy Outcomes

2009 ◽  
Vol 114 (4) ◽  
pp. 818-824 ◽  
Author(s):  
Lu-Ming Sun ◽  
Mark C. Walker ◽  
Hui-Ling Cao ◽  
Qiuying Yang ◽  
Tao Duan ◽  
...  
Keyword(s):  
Assisted Reproductive Technology ◽  
Pregnancy Outcomes ◽  
Reproductive Technology ◽  
Adverse Pregnancy Outcomes ◽  
Adverse Pregnancy

scholarly journals Obstetric Outcome After Surgical Treatment of Endometriosis: A Review of the Literature

2021 ◽  
Vol 3 ◽  
Author(s):  
Samantha S. Mooney ◽  
Vanessa Ross ◽  
Catharyn Stern ◽  
Peter A. W. Rogers ◽  
Martin Healey
Keyword(s):  
Preterm Birth ◽  
Surgical Treatment ◽  
Pregnancy Outcomes ◽  
Gestational Hypertension ◽  
Adverse Pregnancy Outcomes ◽  
Placenta Praevia ◽  
Obstetric Outcomes ◽  
Obstetric Outcome ◽  
Adverse Pregnancy ◽  
The Impact

A diagnosis of endometriosis is associated with increased risks of adverse pregnancy outcomes including placenta praevia and preterm birth. Some studies have also suggested associations with gestational hypertension, foetal growth restriction, gestational diabetes, perinatal death, and obstetric haemorrhage. This review aims to assess the impact of pre-pregnancy surgical treatment of endometriosis on future obstetric outcomes. A search of the Medline, Embase and PubMed electronic databases was performed to identify studies reporting pre-pregnancy surgery for endometriosis and subsequent pregnancy outcome compared to controls with unresected endometriosis. Three studies met the inclusion criteria. The studies were heterogenous in design, definition of study groups and outcome measures. All three studies were judged at critical risk of bias. Pre-pregnancy excision of endometriosis was associated with an increased risk of caesarean section in one of two studies, OR 1.72 (95% CI 1.59–1.86) and OR 1.79 (95% CI 0.69–4.64). Placenta praevia rates were also increased in one of two studies OR 2.83 (95% CI 0.56–12.31) and OR 2.04 (95% CI 1.66–2.52). One study found increased risks of preterm birth, small for gestational age, gestational hypertension, and antepartum and postpartum haemorrhage (all p < 0.05) with pre-pregnancy excision of endometriosis. There is insufficient evidence examining the role of pre-pregnancy endometriosis surgery in ameliorating adverse pregnancy outcomes, and thus reliable conclusions cannot be drawn. Prospectively designed studies are needed to assess the relationship between surgical treatments for endometriosis and obstetric outcome and examine potential confounders such as comorbid adenomyosis and infertility.

Infertility, Assisted Reproductive Technology, and Adverse Pregnancy Outcomes

2007 ◽  
Vol 109 (4) ◽  
pp. 967-977 ◽  
Author(s):  
Uma M. Reddy ◽  
Ronald J. Wapner ◽  
Robert W. Rebar ◽  
Richard J. Tasca
Keyword(s):  
Assisted Reproductive Technology ◽  
Pregnancy Outcomes ◽  
Reproductive Technology ◽  
Adverse Pregnancy Outcomes ◽  
Adverse Pregnancy

Association between Thiopurines Use and Pregnancy Outcomes in Female Patients with Inflammatory Bowel Disease: A Meta-analysis

2020 ◽  
Vol 26 ◽  
Author(s):  
Yang Zhang ◽  
Dandan Li ◽  
Heng Guo ◽  
Weina Wang ◽  
Xingang Li ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Preterm Birth ◽  
Spontaneous Abortion ◽  
Bowel Disease ◽  
Pregnancy Outcomes ◽  
Congenital Malformations ◽  
Meta Analysis ◽  
Adverse Pregnancy Outcomes ◽  
Inflammatory Bowel ◽  
Adverse Pregnancy

Background: Conflicting data exist regarding the influence of thiopurines exposure on adverse pregnancy outcomes in female patients with inflammatory bowel disease (IBD). Objective: The aim of this study was to provide an up-to-date and comprehensive assessment of the safety of thiopurines in pregnant IBD women. Methods: All relevant articles reporting pregnancy outcomes in women with IBD received thiopurines during pregnancy were identified from the databases (PubMed, Embase, Cochrane Library, and ClinicalTrials.gov) with the publication data up to April 2020. Data of included studies were extracted to calculate the relative risk (RR) of multiple pregnancy outcomes: congenital malformations, low birth weight (LBW), preterm birth, small for gestational age (SGA), and spontaneous abortion. The meta-analysis was performed using the random-effects model. Results: Eight studies matched with the inclusion criteria and a total of 1201 pregnant IBD women who used thiopurines and 4189 controls comprised of women with IBD received drugs other than thiopurines during pregnancy were included. Statistical analysis results demonstrated that the risk of preterm birth was significantly increased in the thiopurine-exposed group when compared to IBD controls (RR, 1.34; 95% CI, 1.00-1.79; p=0.049; I 2 =41%), while no statistically significant difference was observed in the incidence of other adverse pregnancy outcomes. Conclusion: Thiopurines’ use in women with IBD during pregnancy is not associated with congenital malformations, LBW, SGA, or spontaneous abortion, but appears to have an association with an increased risk of preterm birth.

scholarly journals Interpregnancy Body Mass Index Changes: Distribution and Impact on Adverse Pregnancy Outcomes in the Subsequent Pregnancy

2018 ◽  
Vol 36 (05) ◽  
pp. 517-521 ◽  
Author(s):  
Whitney Bender ◽  
Adi Hirshberg ◽  
Lisa Levine
Keyword(s):  
Body Mass Index ◽  
Preterm Birth ◽  
Body Mass ◽  
Pregnancy Outcomes ◽  
Subsequent Pregnancy ◽  
Adverse Pregnancy Outcomes ◽  
Increased Risk ◽  
History Of ◽  
Index Changes ◽  
Adverse Pregnancy

Objective To examine the change in body mass index (BMI) categories between pregnancies and its effect on adverse pregnancy outcomes. Study Design We performed a retrospective cohort study of women with two consecutive deliveries from 2005 to 2010. Analysis was limited to women with BMI recorded at <24 weeks for both pregnancies. Standard BMI categories were used. Adverse pregnancy outcomes included preterm birth at <37 weeks, intrauterine growth restriction (IUGR), pregnancy-related hypertension, and gestational diabetes mellitus (GDM). Women with increased BMI category between pregnancies were compared with those who remained in the same BMI category. Results In total, 537 women were included, of whom 125 (23%) increased BMI category. There was no association between increase in BMI category and risk of preterm birth, IUGR, or pregnancy-related hypertension. Women who increased BMI category had an increased odds of GDM compared with women who remained in the same BMI category (6.4 vs. 2.2%; p = 0.018). The increased risk remained after controlling for age, history of GDM, and starting BMI (adjusted odds ratio: 8.2; 95% confidence interval: 2.1–32.7; p = 0.003). Conclusion Almost one-quarter of women increased BMI categories between pregnancies. This modifiable risk factor has a significant impact on the risk of GDM.

scholarly journals Association between neighbourhood deprivation, fetal growth, small-for-gestational age and preterm birth: a population-based prospective cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e049075
Author(s):  
Dionne V Gootjes ◽  
Anke G Posthumus ◽  
Vincent W V Jaddoe ◽  
Eric A P Steegers
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Preterm Birth ◽  
Fetal Growth ◽  
Gestational Age ◽  
Pregnancy Outcomes ◽  
First Trimester ◽  
Adverse Pregnancy Outcomes ◽  
Neighbourhood Deprivation ◽  
Adverse Pregnancy

ObjectiveTo study the associations between neighbourhood deprivation and fetal growth, including growth in the first trimester, and adverse pregnancy outcomes.DesignProspective cohort study.SettingThe Netherlands, Rotterdam.Participants8617 live singleton births from the Generation R cohort study.ExpositionLiving in a deprived neighbourhood.Main outcome measuresFetal growth trajectories of head circumference, weight and length.Secondary outcomes measuresSmall-for-gestational age (SGA) and preterm birth (PTB).ResultsNeighbourhood deprivation was not associated with first trimester growth. However, a higher neighbourhood status score (less deprivation) was associated with increased fetal growth in the second and third trimesters (eg, estimated fetal weight; adjusted regression coefficient 0.04, 95% CI 0.02 to 0.06). Less deprivation was also associated with decreased odds of SGA (adjusted OR 0.91, 95% CI 0.86 to 0.97, p=0.01) and PTB (adjusted OR 0.89, 95% CI 0.82 to 0.96, p=0.01).ConclusionsWe found an association between neighbourhood deprivation and fetal growth in the second and third trimester pregnancy, but not with first trimester growth. Less neighbourhood deprivation is associated with lower odds of adverse pregnancy outcomes. The associations remained after adjustment for individual-level risk factors. This supports the hypothesis that living in a deprived neighbourhood acts as an independent risk factor for fetal growth and adverse pregnancy outcomes, above and beyond individual risk factors.

scholarly journals Joint Modeling of Singleton Preterm Birth and Perinatal Death Using Birth Registry Cohort Data in Northern Tanzania

2021 ◽  
Vol 9 ◽  
Author(s):  
Innocent B. Mboya ◽  
Michael J. Mahande ◽  
Joseph Obure ◽  
Henry G. Mwambi
Keyword(s):  
Preterm Birth ◽  
Pregnancy Outcomes ◽  
Perinatal Death ◽  
Substantial Reduction ◽  
Adverse Pregnancy Outcomes ◽  
Birth Registry ◽  
Cohort Data ◽  
Northern Tanzania ◽  
Management Of Complications ◽  
Adverse Pregnancy

Understanding independent and joint predictors of adverse pregnancy outcomes is essential to inform interventions toward achieving sustainable development goals. We aimed to determine the joint predictors of preterm birth and perinatal death among singleton births in northern Tanzania based on cohort data from the Kilimanjaro Christian Medical Center (KCMC) zonal referral hospital birth registry between 2000 and 2017. We determined the joint predictors of preterm birth and perinatal death using the random-effects models to account for the correlation between these outcomes. The joint predictors of higher preterm birth and perinatal death risk were inadequate (&lt;4) antenatal care (ANC) visits, referred for delivery, experiencing pre-eclampsia/eclampsia, postpartum hemorrhage, low birth weight, abruption placenta, and breech presentation. Younger maternal age (15–24 years), premature rupture of membranes, placenta previa, and male children had higher odds of preterm birth but a lessened likelihood of perinatal death. These findings suggest ANC is a critical entry point for delivering the recommended interventions to pregnant women, especially those at high risk of experiencing adverse pregnancy outcomes. Improved management of complications during pregnancy and childbirth and the postnatal period may eventually lead to a substantial reduction of adverse perinatal outcomes and improving maternal and child health.

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