Falling Third-Trimester Insulin Requirements and Adverse Pregnancy Outcomes

SummaryThe conclusions of studies to date which evaluate a possible association between factor V Leiden and adverse pregnancy outcome have been conflicting. This study was undertaken to further investigate this association. Our objective was to evaluate the association between adverse pregnancy outcomes and maternal factor V Leiden genotype by meta-analysis. Inclusion criteria were: (a) cohort or case control design; (b) outcomes clearly defined as one of the following: first or second/ third trimester miscarriage or intrauterine death, preeclampsia, fetal growth retardation, or placental abruption; (c) both the case and control mothers tested for the factor V Leiden mutation; (d) sufficient data for calculation of an odds ratio. Both fixed and random effect models were used to pool results and heterogeneity and publication bias were checked. For first trimester fetal loss, the pooled odds ratio was heterogeneous (p=0.06) and no dose-response curve could be found. For second/third trimester fetal loss, there was a consistent and graded increase in risk: the odds ratio was 2.4 (95% CI 1.1-5.2) for isolated (non-recurrent) third trimester fetal loss, rising to 10.7 (95% CI 4.0-28.5) for those with 2 or more second/third trimester fetal losses. FactorV Leiden is associated with a 2.9 fold (95% CI 2.0-4.3) increased risk of severe preeclampsia, and a 4.8 fold (95% CI 2.4-9.4) increased risk of fetal growth retardation. These results support factor V Leiden testing for women with recurrent fetal loss in the second/third trimester. Women with only 1 event may also warrant testing if the fetal loss occurred in the third trimester. Conversely, in those women known to have the factor V Leiden mutation, monitoring for adverse pregnancy outcomes is warranted; whether this means increased vigilance or anti-coagulant prophylaxis is still contentious.

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Does antibiotic prophylaxis during the second and third trimester prevent adverse pregnancy outcomes and morbidity?

Cochrane Clinical Answers ◽

10.1002/cca.711 ◽

2016 ◽

Keyword(s):

Antibiotic Prophylaxis ◽

Pregnancy Outcomes ◽

Adverse Pregnancy Outcomes ◽

Third Trimester ◽

Adverse Pregnancy

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Faculty Opinions recommendation of Antibiotic prophylaxis during the second and third trimester to reduce adverse pregnancy outcomes and morbidity.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.725326153.793503744 ◽

2015 ◽

Author(s):

Steven Witkin

Keyword(s):

Antibiotic Prophylaxis ◽

Pregnancy Outcomes ◽

Adverse Pregnancy Outcomes ◽

Third Trimester ◽

Adverse Pregnancy

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Falling Insulin Requirements and Adverse Pregnancy Outcomes in Women With Pre-pregnancy Diabetes [10D]

Obstetrics and Gynecology ◽

10.1097/01.aog.0000663536.28562.95 ◽

2020 ◽

Vol 135 ◽

pp. 41S

Author(s):

Marina Vainder ◽

Navneet Natt ◽

Rohan D. DʼSouza ◽

Ambreen Syeda ◽

Nicholas Mitsakakis

Keyword(s):

Pregnancy Outcomes ◽

Adverse Pregnancy Outcomes ◽

Insulin Requirements ◽

Adverse Pregnancy

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Non-Surgical Treatment of Periodontal Disease in a Pregnant Caucasian Women Population: Adverse Pregnancy Outcomes of a Randomized Clinical Trial

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16193638 ◽

2019 ◽

Vol 16 (19) ◽

pp. 3638

Author(s):

Leticia Caneiro-Queija ◽

Jose López-Carral ◽

Pablo Martin-Lancharro ◽

Jacobo Limeres-Posse ◽

Pedro Diz-Dios ◽

...

Keyword(s):

Clinical Trial ◽

Surgical Treatment ◽

Pregnancy Outcomes ◽

Test Group ◽

Adverse Pregnancy Outcomes ◽

Periodontal Treatment ◽

Third Trimester ◽

Caucasian Women ◽

Adverse Pregnancy ◽

Non Surgical Treatment

Aim: To analyze if non-surgical treatment of periodontitis in a pregnant Caucasian women population can reduce adverse pregnancy outcomes. Methods and results: A parallel randomized clinical trial was designed and approved by the Ethical Committee of Sanitary Area Santiago-Lugo, Spain (registration number: 2016/451). Forty patients with periodontitis stage II grade B were randomly allocated to receive either comprehensive non-surgical periodontal therapy (test group; n = 20) or professional tooth cleaning (control group; n = 20) before 24 gestational weeks. Randomization was computer-generated by the statistic program Epidat v.4.1 and allocation was performed using sealed opaque envelopes. Clinical measurements and peripheral blood samples for biochemical variables were collected at baseline, in the middle of second trimester before non-surgical treatment, and in the third trimester. Microbiological samples were collected in the second and third trimester. A statistically significant reduction was verified in all clinical and microbiological parameters after periodontal treatment in the test group. No significant differences were observed for the rest of the variables, including preterm birth and/or low birth weight. No adverse events related to periodontal treatment were reported. Conclusions: Non-surgical periodontal treatment in Caucasian patients with periodontitis stage II grade B did not significantly reduce the risk of adverse pregnancy outcomes.

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High Hemoglobin Level is a Risk Factor for Maternal and Fetal Outcomes of Pregnancy in Chinese Women: A Retrospective Cohort Study

10.21203/rs.3.rs-793648/v1 ◽

2021 ◽

Author(s):

Lanlan Wu ◽

Ruifang Sun ◽

Yao Liu ◽

Zengyou Liu ◽

Hengying Chen ◽

...

Keyword(s):

Pregnancy Outcomes ◽

Chinese Women ◽

Adverse Pregnancy Outcomes ◽

Multivariate Logistic Regression ◽

Third Trimester ◽

Low Birth Weight Infants ◽

The Third ◽

Increased Risk ◽

Adverse Pregnancy ◽

Multivariable Adjustment

Abstract Background To examine the association of hemoglobin (Hb) levels during gestation with the risk of selected adverse pregnancy outcomes in Chinese women. Methods A total of 1911 singleton mothers were included. Hb levels were measured during the second (16-18th weeks) and third (28-30th weeks) trimesters of pregnancy, and pregnancy outcomes were followed. Statistical analysis was performed using multivariate logistic regression. Results After multivariable adjustment, Hb levels > 130 g/L in the second trimester increased the risk of low-birth-weight infants (LBW) (odds ratio [OR], 2.54; 95% confidence interval [CI], 1.12–5.77). In the third trimester of gestation, compared with women whose Hb levels between 110–119 g/L, women with Hb levels > 130 g/L had an increased risk of LBW (OR, 2.17; 95% CI, 1.05–4.48) and small-for-gestational-age infants (SGA) (OR, 1.98; 95% CI, 1.04–3.78). In addition, maternal Hb levels of < 110 g/L or > 130 g/L at the second week that were restored vs not restored in the third trimester decreased the risk of preterm birth (PTB) by 80% (95% CI, 0.07–0.58) and 86% (95% CI, 0.03–0.84), respectively. Conclusion Maternal Hb > 130 g/L was associated with increased risk of adverse pregnancy outcomes. Reduction of PTB risk was observed with correction of Hb level during the third trimester.

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Rate of gestational weight gain and adverse pregnancy outcomes in rural nulliparous women: a prospective cohort analysis from China

British Journal Of Nutrition ◽

10.1017/s0007114519001247 ◽

2019 ◽

Vol 122 (03) ◽

pp. 352-359 ◽

Cited By ~ 1

Author(s):

Yubo Zhou ◽

Hongtian Li ◽

Yali Zhang ◽

Le Zhang ◽

Jufen Liu ◽

...

Keyword(s):

Weight Gain ◽

Preterm Birth ◽

Gestational Weight Gain ◽

Infant Death ◽

Pregnancy Outcomes ◽

Adverse Pregnancy Outcomes ◽

Third Trimester ◽

Gestational Weight ◽

Nulliparous Women ◽

Adverse Pregnancy

AbstractBoth inadequate and excessive gestational weight gain (GWG) have been shown to increase the risk of adverse pregnancy outcomes, but the risk profiles of GWG rate are unclear. We aimed to examine the associations between GWG rate in the second/third trimester and a spectrum of pregnancy outcomes. This study consisted of 14 219 Chinese rural nulliparous women who participated in a randomised controlled trial of prenatal micronutrient supplementation during 2006–2009. The outcomes included stillbirth, neonatal and infant death, preterm birth, macrosomia, low birth weight (LBW) and large and small for gestational age (LGA and SGA, respectively). GWG rate was divided into quintiles within each BMI category. Compared with women in the middle quintile, those in the lowest quintile had higher risks of neonatal death (adjusted OR 2·27; 95 % CI 1·03, 5·02), infant death (adjusted OR 1·85; 95 % CI 1·02, 3·37) and early preterm birth (adjusted OR 2·33; 95 % CI 1·13, 4·77), while those in the highest quintile had higher risks of overall preterm birth (adjusted OR 1·28; 95 % CI 1·04, 1·59), late preterm birth (adjusted OR 1·25; 95 % CI 1·00, 1·56), LBW (adjusted OR 1·48; 95 % CI 1·02, 2·15), macrosomia (adjusted OR 1·89; 95 % CI 1·46, 2·45) and LGA (adjusted OR 1·56; 95 % CI 1·31, 1·85). In conclusion, very low and very high GWG rates in the second/third trimester appear to be associated with adverse pregnancy outcomes in Chinese nulliparous women, indicating that an appropriate GWG rate during pregnancy is necessary for neonatal health.

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