The effect of mode of delivery and duration of labour on subsequent pregnancy outcomes: a retrospective cohort study

Abstract The changing family planning policy from One-Child to Two-Child Policy, led to a significant increase in the proportion of pregnancies with variant interpregnancy intervals (IPIs) after previous cesarean section (CS). To examine the relationship between IPI and perinatal outcomes, we conducted a retrospective cohort study of 1854 women having a history of CS and delivered in 2016 at West China Second University Hospital. With an IPI of 24-59 months as the reference, the associations between various IPIs (<24, 60-119, and ≥120 months) and pregnancy outcomes were examined by multivariate logistic regression analysis with multiple models. We found that IPI <24 months significantly increased the risk of anemia in late pregnancy (aOR 2.09, 95% CI 1.21-2.62, p = 0.008). IPI <24 months was associated with a higher risk for incomplete uterine rupture (OR 1.30, 95% CI 1.05-1.61), IPI ≥60 months was related to a lower risk for incomplete uterine rupture (IPI = 60-119 months: OR 0.77, 95% CI 0.62-0.95; IPI ≥120 months, OR 0.59, 95% CI 0.38-1.08), and women with IPI ≥120 months were more likely to develop gestational hypertension (GHP) (p = 0.036) and gestational diabetes mellitus (GDM) (p = 0.001). These effects became nonsignificant after adjusting possible confounders. This study revealed that IPI may combine with other factors to affect GHP, GDM, and uterine rupture in the subsequent pregnancy after previous CS.

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Birth tears after spontaneous and vacuum-assisted births with different vacuum cup systems – a retrospective cohort study

Journal of Perinatal Medicine ◽

10.1515/jpm-2019-0477 ◽

2020 ◽

Vol 48 (6) ◽

pp. 575-581

Author(s):

Martina Kreft ◽

Roland Zimmermann ◽

Nina Kimmich

Keyword(s):

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Care Center ◽

Tertiary Care ◽

Mode Of Delivery ◽

Low Grade ◽

Singleton Pregnancy ◽

Perineal Tear ◽

Vertex Presentation

AbstractObjectivesBirth tears are a common complication of vaginal childbirth. We aimed to evaluate the outcomes of birth tears first by comparing the mode of vaginal birth (VB) and then comparing different vacuum cups in instrumental VBs in order to better advise childbearing women and obstetrical professionals.MethodsIn a retrospective cohort study, we analyzed nulliparous and multiparous women with a singleton pregnancy in vertex presentation at ≥37 + 0 gestational weeks who gave birth vaginally at our tertiary care center between 06/2012 and 12/2016. We compared the distribution of tear types in spontaneous births (SBs) vs. vacuum-assisted VBs. We then compared the tear distribution in the vacuum group when using the Kiwi Omnicup or Bird’s anterior metal cup. Outcome parameters were the incidence and distribution of the different tear types dependent on the mode of delivery and type of vacuum cup.ResultsA total of 4549 SBs and 907 VBs were analyzed. Birth tear distribution differed significantly between the birth modes. In 15.2% of women with an SB an episiotomy was performed vs. 58.5% in women with a VB. Any kind of perineal tear was seen in 45.7% after SB and in 32.7% after VB. High-grade obstetric anal sphincter injuries (OASIS) appeared in 1.1% after SB and in 3.1% after VB. No significant changes in tear distribution were found between the two different VB modes.ConclusionsThere were more episiotomies, vaginal tears and OASIS after VB than after SB. In contrast, there were more low-grade perineal and labial tears after SB. No significant differences were found between different vacuum cup systems, just a slight trend toward different tear patterns.

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Contraceptive Use and Pregnancy Outcomes among Opioid Drug-Using Women: A Retrospective Cohort Study

PLoS ONE ◽

10.1371/journal.pone.0116231 ◽

2015 ◽

Vol 10 (3) ◽

pp. e0116231 ◽

Cited By ~ 14

Author(s):

Charles S. Cornford ◽

Helen J. Close ◽

Roz Bray ◽

Deborah Beere ◽

James M. Mason

Keyword(s):

Cohort Study ◽

Retrospective Cohort Study ◽

Pregnancy Outcomes ◽

Retrospective Cohort ◽

Contraceptive Use

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Associations of serum markers screening for Down's syndrome with pregnancy outcomes: A Chinese retrospective cohort study

Clinica Chimica Acta ◽

10.1016/j.cca.2018.12.001 ◽

2019 ◽

Vol 489 ◽

pp. 130-135 ◽

Cited By ~ 6

Author(s):

Xiaosong Yuan ◽

Wei Long ◽

Jianbing Liu ◽

Bin Zhang ◽

Wenbai Zhou ◽

...

Keyword(s):

Cohort Study ◽

Retrospective Cohort Study ◽

Pregnancy Outcomes ◽

Retrospective Cohort ◽

Down's Syndrome ◽

Down’S Syndrome ◽

Serum Markers

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Impact of Blood Urea Nitrogen and Creatinine Levels on Maternal and Fetal Outcomes of Pregnancy: a Retrospective Cohort Study

10.21203/rs.3.rs-379457/v1 ◽

2021 ◽

Author(s):

Guifang Deng ◽

Lanlan Wu ◽

Yao Liu ◽

Zengyou Liu ◽

Hengying Chen ◽

...

Keyword(s):

Logistic Regression ◽

Cohort Study ◽

Blood Urea Nitrogen ◽

Retrospective Cohort Study ◽

Pregnancy Outcomes ◽

Retrospective Cohort ◽

Fetal Outcomes ◽

Urea Nitrogen ◽

The Third ◽

Fourth Quartile

Abstract Background: Blood urea nitrogen (BUN) and creatinine (SCr) are associated with gestational diabetes mellitus (GDM). However, there were limited data in the literature on the influence of BUN and SCr on maternal and fetal outcomes of pregnancy. We aimed to examine the association of BUN and SCr levels during gestation with the risk of selected adverse pregnancy outcomes.Methods: This retrospective cohort study included 1606 singleton mothers aged 22-44 years. Both BUN and SCr levels were collected and measured during the second (16-18th week), third (28-30th week) trimesters of gestation respectively and followed up pregnancy outcomes. Statistical analysis was used multivariate logistic regression. Results: In the multivariate adjusted logistic regression model, the highest level of SCr in the second trimester increased the risk of PROM by 45% (95% CI, 1.01-2.09). In the third trimester of gestation, compared with those in the lowest quartile, BUN levels in the highest quartile decreased the risk of macrosomia and LGA by 60%(95% CI, 0.20-0.78), 66%(95% CI, 0.21,0.55) , respectively, and increased the risk of SGA by 137%(1.06, 5.31), 186%(1.29,6.34) in the third and fourth quartiles, respectively. The adjusted OR (95%CI) for macrosomia in the fourth quartile was 0.46 (0.24, 0.87), for SGA in the third quartiles was 2.36 (1.10, 5.10), and for LGA in the fourth quartile was 0.61 (0.41,0.91) compared with those in the first quartile of SCr levels. The elevated changes of BUN (> 0.64mmol/L) was the risk factor of SGA (OR: 2.11, 95%CI: 1.03,4.32).Conclusion: Higher BUN and SCr levels during the 28-30th week of gestation even those towards the upper limit of the normal range can act as a warning sign of the impending SGA. Elevated changes of BUN and SCr during pregnancy also associated with the lower birth weight.

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Pregnancy outcome following bacteriuria in pregnancy and the significance of nitrites in urinalysis – a retrospective cohort study

Journal of Perinatal Medicine ◽

10.1515/jpm-2018-0428 ◽

2019 ◽

Vol 47 (6) ◽

pp. 611-618

Author(s):

Eviatar Naamany ◽

Irit Ayalon-Dangur ◽

Eran Hadar ◽

Iftach Sagy ◽

Dafna Yahav ◽

...

Keyword(s):

Cohort Study ◽

Pregnant Women ◽

Retrospective Cohort Study ◽

Pregnancy Outcomes ◽

Retrospective Cohort ◽

Urine Culture ◽

Premature Delivery ◽

Positive Urine Culture ◽

Positive Urine ◽

Adverse Pregnancy

Abstract Background The association between bacteriuria and adverse pregnancy outcomes has been extensively described. The current practice of screening all pregnant women for bacteriuria is challenged by recent studies. We aimed to evaluate pregnancy outcomes among women with a positive urine culture, to assess the significance of positive urinary nitrites in this setting. Methods This was a retrospective cohort study at the emergency department (ED) of the Helen Schneider Hospital for Women, Israel, during 2014–2018. This included all gravida women >18 years old within the 20th week of pregnancy or above, admitted to the ED with diverse complains, who had urinalysis collected and subsequently had a positive urine culture. Clinical and obstetric characteristics were stratified by positive vs. negative nitrites in urinalysis. The primary outcome was premature delivery, and the secondary outcomes were a composite outcome of all recorded pregnancy complications and the significance of urinalysis in predicting urinary tract infection (UTI). Results Overall, 874 pregnant women with a positive urine culture were included. Of them, 721 (79%) patients had a negative nitrite in their urine exam (NNU-group) and 153 (21%) had a positive nitrite in their urine exam (PNU-group). Escherichia coli was the most common pathogen, with significantly higher rates of growth in the PNU-group vs. NNU-group [129 (84.3%) vs. 227 (38.4%), P < 0.001]. Premature delivery was recorded with no association of symptomaticity or nitrite status. Among symptomatic women with classic symptoms of UTI, PNU was significantly associated with decreased risk for major peripartum complications [odds ratio (OR) with 95% confidence interval (CI) of 0.22 (0.05–0.94)]. Conclusion Our findings support that PNU among symptomatic pregnant women with UTI-related symptoms was associated with lower risk of developing major adverse obstetrical outcomes.

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