scholarly journals FRI0306 WOMEN WITH AXIAL SPONDYLOARTHRITIS HAVE COMPARABLE RATES OF COMPLICATIONS IN PREGNANCY TO WOMEN IN THE GENERAL POPULATION BUT MORE CAESAREAN DELIVERIES: RESULTS FROM NATIONWIDE CLAIMS DATA

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 743.2-743
Author(s):  
I. Redeker ◽  
A. Strangfeld ◽  
U. Marschall ◽  
A. Zink ◽  
X. Baraliakos
Keyword(s):  
Birth Weight ◽  
Caesarean Section ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Pregnancy Outcomes ◽  
Axial Spondyloarthritis ◽  
Population Based ◽  
Research Support ◽  
Increased Risk ◽  
Gestational Week

Background:In contrast to other rheumatic inflammatory diseases, studies on pregnancy outcomes in axial spondyloarthritis (axSpA) are scarce, despite its onset in early adulthood affecting women in their reproductive years.Objectives:To investigate maternal and infant pregnancy outcomes among women with axSpA compared with population-based controls.Methods:Taking advantage of a large health insurance dataset, comprising the period 2006 – 2018, maternal and infant pregnancy outcomes and delivery outcomes of women with axSpA were assessed and compared with population-based controls (matched by maternal age and calendar year of birth). Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using generalised estimating equation analyses.Results:A total of 611 singleton births among 535 women with axSpA were included in the analysis. The mean age at delivery was 32.5 years. The pharmacological treatment within 12 months prior to and after conception is illustrated in the Figure. Infants of women with axSpA were only slightly more often preterm (5.2% vs 4.7%) and small-for-gestational-age (1.6% vs 1.1%) than infants of matched population-based controls, respectively. Caesarean section was performed in 36% of deliveries among women with axSpA compared with 29.5% in population-based controls, resulting in a significantly increased risk for receiving caesarean section (OR 1.35; 95% CI 1.06-1.73) (Table). The occurrence of pre-eclampsia, preterm birth, and small-for-gestational-age was moderately higher, but not significantly increased, among women with axSpA as compared to population-based controls.Conclusion:Women with axSpA had no significantly increased risks for adverse maternal or infant pregnancy outcomes compared to non-axSpA women. However, a significantly increased risk for receiving caesarean section and a tendency for a higher number of preterm deliveries and of small-for-gestational-age infants was observed in women with axSpA.Table.Prevalences and odds ratios with 95% confidence intervals for adverse pregnancy outcomesPregnancies in women with axSpAN=611Pregnancies in population-based controlsN=611Odds Ratio(95% CI)Preterm birth (< week 37)5.2% (32)4.7% (29)1.11 (0.66, 1.85)Gestational week 28-364.9% (30)4.7% (29)1.03 (0.61, 1.75)Gestational week <280.3% (2)0.2% (1)2.01 (0.18, 22.18)Small for gestational age1.6% (10)1.1% (7)1.43 (0.54, 3.79)Low birth weight (<2500 g)2.8% (17)2.6% (16)1.06 (0.53, 2.13)Exceptionally large baby(birth weight ≥4500 g)1.1% (7)0.2% (1)7.07 (0.87, 57.63)Pre-eclampsia7.5% (46)6.4% (39)1.21 (0.78, 1.90)Assisted vaginal delivery4.3% (26)3.1% (19)1.39 (0.76, 2.56)Caesarean section36.0% (220)29.5% (180)1.35 (1.06, 1.73)axSpA, axial Spondyloarthritis; CI, confidence interval.Acknowledgments:We would like to thank the BARMER Statutory Health Insurance for providing data for this study.Disclosure of Interests:Imke Redeker: None declared, Anja Strangfeld Speakers bureau: AbbVie, BMS, Pfizer, Roche, Sanofi-Aventis, Ursula Marschall: None declared, Angela Zink Speakers bureau: AbbVie, Amgen, BMS, Gilead, Hexal, Janssen, Lilly, MSD, Pfizer, Roche, Sanofi Aventis, UCB, Xenofon Baraliakos Grant/research support from: Grant/research support from: AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB and Werfen, Consultant of: AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB and Werfen, Speakers bureau: AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB and Werfen

scholarly journals FRI0305 FERTILITY AND PREGNANCY OUTCOMES IN WOMEN WITH SPONDYLOARTHRITIS: A SYSTEMATIC REVIEW AND META-ANALYSIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 742.2-743
Author(s):  
S. Hamroun ◽  
A. Hamroun ◽  
J. J. Bigna ◽  
E. Allado ◽  
F. Förger ◽  
...  
Keyword(s):  
Systematic Review ◽  
Caesarean Section ◽  
Disease Activity ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Pregnancy Outcomes ◽  
Meta Analysis ◽  
Research Support ◽  
Increased Risk ◽  
The Impact

Background:Women with spondyloarthritis (SpA) are often affected by the disease during their reproductive years1. However, little is known about the impact of the disease and its treatments on fertility and pregnancy outcomes, as well as the effect of pregnancy itself on disease activity2.Objectives:The aim of the study was to determine the effects of spondyloarthritis on fertility and pregnancy outcomes in women with SpA.Methods:We searched Pubmed, Embase, and Web of Science until 1 November 2019, without any language restriction. All studies assessing fertility, pregnancy outcomes and disease activity during pregnancy in women with spondyloarthritis (axial SpA (axSpA) but also peripheral SpA, including psoriatic arthritis (PsA)) were eligible. The heterogeneity between studies was quantified (I2), and multiple meta-regressions were carried out to identify potential sources of heterogeneity. In case I2was < 50%, a random-effects model was used to pool the available data. Prevalence of events was described as percentages. The odds ratio (OR) and corresponding 95% confidence interval (CI) were used to assess the associations between the disease and the pregnancy outcomes.Results:Within 4397 eligible studies, 21 articles fulfilling the selection criteria were included in the review, assessing overall 3306 patients (2578 with axSpA and 728 with PsA) and 4104 pregnancies compared to 42248 healthy controls (in 11 studies with a control group). Among the included studies, the risk of bias was evaluated as high, moderate and low in respectively 12, 1 and 8 studies. Regarding pregnancy outcomes, several studies report an increased risk of preterm birth, small for gestational age (pooled OR 2,05, [1,09-3,89],I2=5,8% in axSpA) and caesarean section (pooled OR 1,77 [1,45-2,17],I2=27,5% in axSpA and pooled OR 1,47 [1,22-1,76],I2=0,0% in PsA), without any other unfavourable pregnancy outcome (miscarriage, stillbirth, gestational diabetes or preeclampsia). Further analysis found a significant higher risk for elective caesarean (pooled OR 2,64, [1,92-3,62],I2=0,0% in axSpA and pooled OR 1,47, [1,15-1,88],I2=0,0% in PsA), without increased risk for emergency caesarean. There was no substantial heterogeneity in the majority of meta-analyses.Conclusion:Although based on observational data, this work is to our knowledge, the first systematic review and meta-analysis concerned with this subject. SpA and PsA seem to be associated with an increased risk of preterm birth, small for gestational age and elective caesarean section. The analysis of the impact of pregnancy on disease activity in this setting is currently ongoing.References:[1]Van den Brandt S. Arthritis Res Ther 2017;19(1):64.[2]Ursin K. Rheumatology. 201;57(6):1064-1071.Fig. 1.Association between caesarean section and axSpAFig. 2.Association between small for gestational age and axSpADisclosure of Interests:SABRINA HAMROUN: None declared, Aghilès Hamroun: None declared, Jean Joël Bigna: None declared, Edem Allado: None declared, Frauke Förger Grant/research support from: Unrestricted grant from UCB, Consultant of: UCB, GSK, Roche, Speakers bureau: UCB, GSK, Anna Moltó Grant/research support from: Pfizer, UCB, Consultant of: Abbvie, BMS, MSD, Novartis, Pfizer, UCB

scholarly journals Preconception Hemoglobin Concentration and Risk of Low Birth Weight and Small-for-Gestational-Age: A Large Prospective Cohort Study in China

Nutrients ◽  
2022 ◽  
Vol 14 (2) ◽  
pp. 271
Author(s):  
Xiaojing Liu ◽  
Hang An ◽  
Nan Li ◽  
Zhiwen Li ◽  
Yali Zhang ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Prospective Cohort ◽  
Large Population ◽  
Hemoglobin Concentration ◽  
Population Based ◽  
Increased Risk ◽  
The Impact

Less is known about the impact of maternal preconception anemia on birth outcomes. We aimed to examine associations between preconception hemoglobin (Hb) concentrations with risk of low birth weight (LBW) and small-for-gestational-age (SGA). This study was from a large population-based prospective cohort in China and included 124,725 women with singleton live births delivered at gestational ages of 28–45 weeks who were registered before pregnancy. Maternal Hb concentrations were measured during registration, and other health-related information was recorded prospectively. Logistic regression was used to evaluate the associations between preconception Hb concentrations with risk of LBW and SGA, adjusting for potential confounders. The results showed women with preconception anemia accounted for 22.28%. The incidences of LBW/SGA were 2.37%/6.30% among anemic women, and 2.01%/5.48% among non-anemic women, respectively. Preconception mild anemia increased by 17% (95% confidence interval (CI): 1.06, 1.28) and 14% (95% CI: 1.07, 1.21) the risk for LBW and SGA, while moderate-to-severe anemia had no significant association with LBW and SGA. Compared with the 120–129 g/L group, a U-shaped association was observed between preconception Hb concentrations with LBW and SGA. In conclusion, not only maternal anemia but also elevated Hb concentrations before pregnancy contribute to an increased risk of LBW and SGA.

scholarly journals Perinatal Outcomes of Small for Gestational Age in Twin Pregnancies: Twin vs. Singleton Charts

2021 ◽  
Vol 10 (4) ◽  
pp. 643
Author(s):  
Veronica Giorgione ◽  
Corey Briffa ◽  
Carolina Di Fabrizio ◽  
Rohan Bhate ◽  
Asma Khalil
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Perinatal Death ◽  
Perinatal Outcomes ◽  
Adverse Outcomes ◽  
Chi Square ◽  
Increased Risk ◽  
Twin Pregnancies

Twin pregnancies are commonly assessed using singleton growth and birth weight reference charts. This practice has led to a significant number of twins labelled as small for gestational age (SGA), causing unnecessary interventions and increased risk of iatrogenic preterm birth. However, the use of twin-specific charts remains controversial. This study aims to assess whether twin-specific estimated fetal weight (EFW) and birth weight (BW) charts are more predictive of adverse outcomes compared to singleton charts. Centiles of EFW and BW were calculated using previously published singleton and twin charts. Categorical data were compared using Chi-square or McNemar tests. The study included 1740 twin pregnancies, with the following perinatal adverse outcomes recorded: perinatal death, preterm birth <34 weeks, hypertensive disorders of pregnancy (HDP) and admissions to the neonatal unit (NNU). Twin-specific charts identified prenatally and postnatally a smaller proportion of infants as SGA compared to singleton charts. However, twin charts showed a higher percentage of adverse neonatal outcomes in SGA infants than singleton charts. For example, perinatal death (SGA 7.2% vs. appropriate for gestational age (AGA) 2%, p < 0.0001), preterm birth <34 weeks (SGA 42.1% vs. AGA 16.4%, p < 0.0001), HDP (SGA 21.2% vs. AGA 13.5%, p = 0.015) and NNU admissions (SGA 69% vs. AGA 24%, p < 0.0001), when compared to singleton charts (perinatal death: SGA 2% vs. AGA 1%, p = 0.029), preterm birth <34 weeks: (SGA 20.6% vs. AGA 17.4%, p = 0.020), NNU admission: (SGA 34.5% vs. AGA 23.9%, p < 0.000). There was no significant association between HDP and SGA using the singleton charts (p = 0.696). In SGA infants, according to the twin charts, the incidence of abnormal umbilical artery Doppler was significantly more common than in SGA using the singleton chart (27.0% vs. 8.1%, p < 0.001). In conclusion, singleton charts misclassify a large number of twins as at risk of fetal growth restriction. The evidence suggests that the following twin-specific charts could reduce unnecessary medical interventions prenatally and postnatally.

scholarly journals Maternal smoking behaviour across the first two pregnancies and small for gestational age birth: Analysis of the SLOPE (Studying Lifecourse Obesity PrEdictors) population-based cohort in the South of England

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0260134
Author(s):  
Elizabeth J. Taylor ◽  
Pia Doh ◽  
Nida Ziauddeen ◽  
Keith M. Godfrey ◽  
Ann Berrington ◽  
...  
Keyword(s):  
Gestational Age ◽  
Small For Gestational Age ◽  
Maternal Smoking ◽  
Population Based ◽  
Smoking Behaviour ◽  
Adverse Birth Outcomes ◽  
Full Sample ◽  
Healthcare Data ◽  
Increased Risk ◽  
Never Smokers

Maternal smoking is established to cause adverse birth outcomes, but evidence considering maternal smoking change across successive pregnancies is sparse. We examined the association between self-reported maternal smoking during and between the first two pregnancies with the odds of small for gestational age (SGA) birth (<10th percentile) in the second infant. Records for the first two pregnancies for 16791 women within the SLOPE (Studying Lifecourse Obesity PrEdictors) study were analysed. This is a population-based cohort of prospectively collected anonymised antenatal and birth healthcare data (2003–2018) in Hampshire, UK. Logistic regression was used to relate maternal smoking change to the odds of SGA birth in the second infant. In the full sample, compared to never smokers, mothers smoking at the start of the first pregnancy had higher odds of SGA birth in the second pregnancy even where they stopped smoking before the first antenatal appointment for the second pregnancy (adjusted odds ratio (aOR) 1.50 [95% confidence interval 1.10, 2.03]). If a mother was not a smoker at the first antenatal appointment for either her first or her second pregnancy, but smoked later in her first pregnancy or between pregnancies, there was no evidence of increased risk of SGA birth in the second pregnancy compared to never smokers. A mother who smoked ten or more cigarettes a day at the start of both of her first two pregnancies had the highest odds of SGA birth (3.54 [2.55, 4.92]). Women who were not smoking at the start of the first pregnancy but who subsequently resumed/began smoking and smoked at the start of their second pregnancy, also had higher odds (2.11 [1.51, 2.95]) than never smokers. Smoking in the first pregnancy was associated with SGA birth in the second pregnancy, even if the mother quit by the confirmation of her second pregnancy.

scholarly journals Gestational Weight Gain and Pregnancy Outcomes among Nulliparous Women

2019 ◽  
Author(s):  
Annie M. Dude ◽  
William Grobman ◽  
David Haas ◽  
Brian M. Mercer ◽  
Samuel Parry ◽  
...  
Keyword(s):  
Weight Gain ◽  
Birth Weight ◽  
Gestational Weight Gain ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Pregnancy Outcomes ◽  
Large For Gestational Age ◽  
Gestational Weight ◽  
Excessive Gestational Weight Gain ◽  
Hypertensive Disorders

Abstract Objective To determine the association between total gestational weight gain and perinatal outcomes. Study Design Data from the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-To-Be (NuMoM2b) study were used. Total gestational weight gain was categorized as inadequate, adequate, or excessive based on the 2009 Institute of Medicine guidelines. Outcomes examined included hypertensive disorders of pregnancy, mode of delivery, shoulder dystocia, large for gestational age or small for-gestational age birth weight, and neonatal intensive care unit admission. Results Among 8,628 women, 1,666 (19.3%) had inadequate, 2,945 (34.1%) had adequate, and 4,017 (46.6%) had excessive gestational weight gain. Excessive gestational weight gain was associated with higher odds of hypertensive disorders (adjusted odds ratio [aOR] = 2.05, 95% confidence interval [CI]: 1.78–2.36) Cesarean delivery (aOR = 1.24, 95% CI: 1.09–1.41), and large for gestational age birth weight (aOR = 1.49, 95% CI: 1.23–1.80), but lower odds of small for gestational age birth weight (aOR = 0.59, 95% CI: 0.50–0.71). Conversely, inadequate gestational weight gain was associated with lower odds of hypertensive disorders (aOR = 0.75, 95% CI: 0.62–0.92), Cesarean delivery (aOR = 0.77, 95% CI: 0.65–0.92), and a large for gestational age birth weight (aOR = 0.72, 95% CI: 0.55–0.94), but higher odds of having a small for gestational age birth weight (aOR = 1.64, 95% CI: 1.37–1.96). Conclusion Both excessive and inadequate gestational weight gain are associated with adverse maternal and neonatal outcomes.

scholarly journals Dengue during pregnancy and live birth outcomes: a cohort of linked data from Brazil

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e023529 ◽  
Author(s):  
Enny S Paixão ◽  
Oona M Campbell ◽  
Maria Gloria Teixeira ◽  
Maria CN Costa ◽  
Katie Harron ◽  
...  
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Birth Outcomes ◽  
Live Birth ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Severe Dengue ◽  
Maternal Risk ◽  
Increased Risk

ObjectivesDengue is the most common viral mosquito-borne disease, and women of reproductive age who live in or travel to endemic areas are at risk. Little is known about the effects of dengue during pregnancy on birth outcomes. The objective of this study is to examine the effect of maternal dengue severity on live birth outcomes.Design and settingWe conducted a population-based cohort study using routinely collected Brazilian data from 2006 to 2012.ParticipatingWe linked birth registration records and dengue registration records to identify women with and without dengue during pregnancy. Using multinomial logistic regression and Firth method, we estimated risk and ORs for preterm birth (<37 weeks’ gestation), low birth weight (<2500 g) and small for gestational age (<10thcentile). We also investigated the effect of time between the onset of the disease and each outcome.ResultsWe included 16 738 000 live births. Dengue haemorrhagic fever was associated with preterm birth (OR=2.4; 95% CI 1.3 to 4.4) and low birth weight (OR=2.1; 95% CI 1.1 to 4.0), but there was no evidence of effect for small for gestational age (OR=2.1; 95% CI 0.4 to 12.2). The magnitude of the effects was higher in the acute disease period.ConclusionThis study showed an increased risk of adverse birth outcomes in women with severe dengue during pregnancy. Medical intervention to mitigate maternal risk during severe acute dengue episodes may improve outcomes for infants born to exposed mothers.

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.

Women with chronic hypoparathyroidism have low risk of adverse pregnancy outcomes

2021 ◽  
Author(s):  
Sigridur Björnsdottir ◽  
Bart Clarke ◽  
Outi Mäkitie ◽  
Anna Sandström ◽  
Eleonor Tiblad ◽  
...  
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Pregnancy Outcomes ◽  
Perinatal Death ◽  
Induction Of Labor ◽  
Control Group ◽  
Drug Register ◽  
Increased Risk ◽  
Infant Birth ◽  
Chronic Hypoparathyroidism

Abstract Objective The aim of this study was to evaluate pregnancy outcome and total number of births in chronic hypoparathyroidism (hypoPT). Patients The Swedish National Patient Register, The Swedish Prescribed Drug Register, Swedish Medical Birth Register and the Total Population Register were used to identify 97 women with chronic hypoPT and 1030 age-matched controls who delivered 139 and 1577 singleton infants, respectively, following diagnosis between 1997 and 2017. Results Women in the chronic hypoPT group had more frequent diabetes (DM) and chronic kidney disease (CKD) compared to women in the control group (p=0.043 and p&lt;0.001, respectively). After adjusting for DM, CKD, maternal age at delivery and calendar year of delivery, chronic hypoPT cases were associated with increased risk of induction of labor (OR 1.82; 95% CI 1.13-2.94) and giving birth to infants with lower birth weight (β-coefficient -188 g; 95% CI -312.2- -63.8) compared to controls. No difference was found in infant length, small for gestational age or head circumference after adjustments. Mean gestational age at delivery after controlling for DM, CKD and pre-eclampsia, was not significantly younger (p=0.119). There was no difference in congenital malformations or perinatal death. There was no difference in the total number of infants born to women with chronic hypoPT and controls (p=0.518). Conclusion The majority of women with chronic hypoPT had normal pregnancy outcomes, and the overall risks appear to be low. Maternal chronic hypoPT, is however, associated with a higher risk of induction of labor and slightly lower infant birth weight.

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