Association of maternal psoriasis and small for gestational age or preterm birth: A nationwide matched cohort study in 69 080 singleton infants

2022 ◽  
Author(s):  
Cæcilie B. Johansen ◽  
Alexander Egeberg ◽  
Espen Jimenez‐Solem ◽  
Lone Skov ◽  
Simon F. Thomsen
Keyword(s):  
Cohort Study ◽  
Preterm Birth ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Matched Cohort ◽  
Matched Cohort Study

scholarly journals Reduced prevalence of small-for-gestational-age and preterm birth for women of low socioeconomic position: a population-based cohort study comparing antenatal midwifery and physician models of care

BMJ Open ◽  
2018 ◽  
Vol 8 (10) ◽  
pp. e022220 ◽  
Author(s):  
Daphne N McRae ◽  
Patricia A Janssen ◽  
Saraswathi Vedam ◽  
Maureen Mayhew ◽  
Deborah Mpofu ◽  
...  
Keyword(s):  
British Columbia ◽  
Cohort Study ◽  
Preterm Birth ◽  
Gestational Age ◽  
Socioeconomic Position ◽  
Small For Gestational Age ◽  
Models Of Care ◽  
Midwifery Care ◽  
Low Socioeconomic ◽  
Lower Odds

ObjectiveOur aim was to investigate if antenatal midwifery care was associated with lower odds of small-for-gestational-age (SGA) birth, preterm birth (PTB) or low birth weight (LBW) compared with general practitioner (GP) or obstetrician (OB) models of care for women of low socioeconomic position.SettingThis population-level, retrospective cohort study used province-wide maternity, medical billing and demographic data from British Columbia, Canada.ParticipantsOur study included 57 872 pregnant women, with low socioeconomic position, who: were residents of British Columbia, Canada, carried a singleton fetus, had low to moderate medical/obstetric risk, delivered between 2005 and 2012 and received medical insurance premium assistance.Primary and secondary outcome measuresWe report rates, adjusted ORs (aOR), and 95% CIs for the primary outcome, SGA birth (<the 10th percentile), and secondary outcomes, PTB (<37 weeks’ completed gestation) and LBW (<2500 g).ResultsOur sample included 4705 midwifery patients, 45 114 GP patients and 8053 OB patients. Odds of SGA birth were reduced for patients receiving antenatal midwifery versus GP (aOR 0.71, 95% CI 0.62 to 0.82) or OB care (aOR 0.59, 95% CI 0.50 to 0.69). Odds of PTB were lower for antenatal midwifery versus GP (aOR 0.74, 95% CI 0.63 to 0.86) or OB patients (aOR 0.53, 95% CI 0.45 to 0.62). Odds of LBW were reduced for midwifery versus GP (aOR 0.66, 95% CI 0.53 to 0.82) or OB patients (aOR 0.43, 95% CI 0.34 to 0.54).ConclusionAntenatal midwifery care in British Columbia, Canada, was associated with lower odds of SGA birth, PTB and LBW, for women of low socioeconomic position, compared with physician models of care. Results support the development of policy to ensure antenatal midwifery care is available and accessible for women of low socioeconomic position. Future research is needed to determine the underlying mechanisms linking midwifery care to better birth outcomes for women of low socioeconomic position.

scholarly journals Pregnancy outcome among HIV-infected women on different antiretroviral therapies in Ethiopia: a cohort study

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e027344
Author(s):  
Yohannes Ejigu ◽  
Jeanette H Magnus ◽  
Johanne Sundby ◽  
Maria C Magnus
Keyword(s):  
Cohort Study ◽  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Highly Active Antiretroviral Therapy ◽  
Addis Ababa ◽  
Zidovudine Monotherapy ◽  
Increased Risk

ObjectiveThe objective of the study was to compare pregnancy outcomes according to maternal antiretroviral treatment (ART) regimens.DesignA retrospective cohort study.Participants and settingsClinical data was extracted from ART exposed pregnancies of HIV-infected Ethiopian women attending antenatal care follow-up in public health facilities in Addis Ababa between February 2010 and October 2016.OutcomesThe primary outcomes evaluated were preterm birth, low birth weight and small-for-gestational-age.ResultsA total 1663 of pregnancies exposed to ART were included in the analyses. Of these pregnancies, 17% resulted in a preterm birth, 19% in low birth weight and 32% in a small-for-gestational-age baby. Compared with highly active antiretroviral therapy (HAART) initiated during pregnancy, zidovudine monotherapy was less likely to result in preterm birth (adjusted OR 0.35, 95% CI 0.19 to 0.64) and low birth weight (adjusted OR 0.48, 95% CI 0.24 to 0.94). We observed no differential risk of preterm birth, low birth weight and small-for-gestational-age, when comparing women who initiated HAART during pregnancy to women who initiated HAART before conception. The risk for preterm birth was higher in pregnancies exposed to nevirapine-based HAART (adjusted OR 1.44, 95% CI 1.06 to 1.96) compared with pregnancies exposed to efavirenz-based HAART. Comparing nevirapine-based HAART with efavirenz-based HAART indicated no strong evidence of increased risk of low birth weight or small-for-gestational-age.ConclusionsWe observed a higher risk of preterm birth among women who initiated HAART during pregnancy compared with zidovudine monotherapy. Pregnancies exposed to nevirapine-based HAART also had a greater risk of preterm births compared with efavirenz-based HAART.

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