PP.02 Effect of Method and Gestational Age at Termination of Pregnancy on Future Obstetric and Perinatal Outcomes: A Retrospective Cohort Study

Abstract Background Racial disparities in adverse perinatal outcomes have been studied in other countries, but little has been done for the Canadian population. In this study, we sought to examine the disparities in adverse perinatal outcomes between Asians and Caucasians in Ontario, Canada. Methods We conducted a population-based retrospective cohort study that included all Asian and Caucasian women who attended a prenatal screening and resulted in a singleton birth in an Ontario hospital (April 1st, 2015-March 31st, 2017). Generalized estimating equation models were used to estimate the independent adjusted relative risks and adjusted risk difference of adverse perinatal outcomes for Asians compared with Caucasians. Results Among 237,293 eligible women, 31% were Asian and 69% were Caucasian. Asians were at an increased risk of gestational diabetes mellitus, placental previa, early preterm birth (< 32 weeks), preterm birth, emergency cesarean section, 3rd and 4th degree perineal tears, low birth weight (< 2500 g, < 1500 g), small-for-gestational-age (<10th percentile, <3rd percentile), neonatal intensive care unit admission, and hyperbilirubinemia requiring treatment, but had lower risks of preeclampsia, macrosomia (birth weight > 4000 g), large-for-gestational-age neonates, 5-min Apgar score < 7, and arterial cord pH ≤7.1, as compared with Caucasians. No difference in risk of elective cesarean section was observed between Asians and Caucasians. Conclusion There are significant differences in several adverse perinatal outcomes between Asians and Caucasians. These differences should be taken into consideration for clinical practices due to the large Asian population in Canada.

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Outcomes in emergency versus elective cases of placenta accreta spectrum disorder managed by caesarean-hysterectomy within a dedicated multidisciplinary care team: retrospective cohort study.

10.22541/au.163253036.69537467/v1 ◽

2021 ◽

Author(s):

Homero Flores Mendoza ◽

Anjana Chandran ◽

Carlos Hernandez-Nieto ◽

Ally Murji ◽

Lisa Allen ◽

...

Keyword(s):

Cohort Study ◽

Gestational Age ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Placenta Accreta ◽

Perinatal Outcomes ◽

Elective Delivery ◽

Gestational Age At Delivery ◽

Placenta Accreta Spectrum ◽

Caesarean Hysterectomy

Objective: Compare maternal and perinatal outcomes between emergency and elective caesarean-hysterectomy for placenta accreta spectrum (PAS) disorders managed by a multidisciplinary team. Design and setting: Single-centre retrospective cohort study Population: 125 cases of antenatally suspected and pathologically confirmed PAS disorder. Methods: Maternal and perinatal outcomes were analyzed. Multivariate logistic regression was used to test associations, adjusting for potential confounders. Survival curves exploring risk factors for emergency delivery were sought. Main Outcome Measures: Maternal outcomes including hemorrhagic morbidity, operative complications. Perinatal outcomes included gestational age at delivery, birthweight, Apgar scores and perinatal death. Results: 25 (20%) and 100 (80%) patients had emergency and elective delivery, respectively. Emergency delivery had a higher estimated blood loss (median IQR 2772 [2256.75] vs. 1561.19 [1152.95], p<0.001), with a higher rate of coagulopathy (40 vs. 6%; p<0.001) and bladder injury (44 vs. 13%; p<0.001). Emergency delivery was associated with increased rates of blood transfusion (aOR 4.9, CI95% 1.3-17.5, p=0.01), coagulopathy (aOR 16.4, CI95% 2.6-101.4, p=0.002) and urinary tract injury (aOR 6.96, CI95% 1.5-30.7, p=0.01). Gestational age at delivery was lower in the emergency group (mean SD 35.19 [2.77] vs. 31.55 [4.75], p=0.001), no difference in perinatal mortality was found (aOR 0.01, CI95% <0.001-17.5, p=0.53). A sonographically short cervix and/or history of APH had an increased cumulative risk of emergency delivery with advancing gestational age. Conclusions: Patients with PAS disorders managed in a tertiary centre by a multidisciplinary team requiring emergency delivery have increased maternal morbidity and poorer perinatal outcomes than those with elective delivery.

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Oocyte exposure to supraphysiological estradiol during ovarian stimulation increased the risk of adverse perinatal outcomes after frozen-thawed embryo transfer: a retrospective cohort study

Journal of Developmental Origins of Health and Disease ◽

10.1017/s2040174419000679 ◽

2019 ◽

Vol 11 (4) ◽

pp. 392-402 ◽

Cited By ~ 1

Author(s):

Chen-Chi Duan ◽

Cheng Li ◽

Yi-Chen He ◽

Jing-Jing Xu ◽

Chao-Yi Shi ◽

...

Keyword(s):

Cohort Study ◽

Embryo Transfer ◽

Gestational Age ◽

Retrospective Cohort Study ◽

Ovarian Stimulation ◽

Retrospective Cohort ◽

Perinatal Outcomes ◽

Large For Gestational Age ◽

Lower Percentage ◽

Adverse Perinatal Outcomes

AbstractMaternal supraphysiological estradiol (E2) environment during pregnancy leads to adverse perinatal outcomes. However, the influence of oocyte exposure to high E2 levels on perinatal outcomes remains unknown. Thus, a retrospective cohort study was conducted to explore the effect of high E2 level induced by controlled ovarian stimulation (COH) on further outcomes after frozen embryo transfer (FET). The study included all FET cycles (n = 10,581) between 2014 and 2017. All cycles were categorized into three groups according to the E2 level on the day of the human Chorionic Gonadotropin trigger. Odds ratios (ORs) and their confidence intervals (CIs) were calculated to evaluate the association between E2 level during COH and pregnancy outcomes and subsequent neonatal outcomes. From our findings, higher E2 level was associated with lower percentage of chemical pregnancy, clinical pregnancy, ongoing pregnancy, and live birth as well as increased frequency of early miscarriage. Preterm births were more common among singletons in women with higher E2 level during COH (aOR1 = 1.93, 95% CI: 1.22–3.06; aOR2 = 2.05, 95% CI: 1.33–3.06). Incidence of small for gestational age (SGA) was more common in both singletons (aOR1 = 2.01, 95% CI: 1.30–3.11; aOR2 = 2.51, 95% CI: 1.69–3.74) and multiples (aOR1 = 1.58, 95% CI: 1.03–2.45; aOR2 = 1.99, 95% CI: 1.05–3.84) among women with relatively higher E2 level. No association was found between high E2 level during COH and the percentage of macrosomia or large for gestational age. In summary, oocyte exposure to high E2 level during COH should be brought to our attention, since the pregnancy rate decreasing and the risk of preterm birth and SGA increasing following FET.

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130 Maternal and perinatal outcomes according to gestational age of diagnosis of preeclampsia: A retrospective cohort study

Pregnancy Hypertension ◽

10.1016/j.preghy.2016.08.212 ◽

2016 ◽

Vol 6 (3) ◽

pp. 244

Author(s):

Melania Maria Ramos Amorim ◽

Leila katz ◽

Taíse da Nóbrega Veras ◽

Rafael Dayves Medeiros de Queiroz ◽

Marcone Nunes Dos Santos ◽

...

Keyword(s):

Cohort Study ◽

Gestational Age ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Perinatal Outcomes ◽

Age Of Diagnosis

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Early-Onset Thrombocytopenia in Small-for-Gestational-Age Neonates: A Retrospective Cohort Study

American Journal of Perinatology ◽

10.1055/s-0036-1592382 ◽

2016 ◽

Vol 33 (S 01) ◽

Author(s):

S. Fustolo-Gunnink ◽

R. Vlug ◽

V. Smits-Wintjens ◽

E. Heckman ◽

A. Te Pas ◽

...

Keyword(s):

Cohort Study ◽

Gestational Age ◽

Small For Gestational Age ◽

Retrospective Cohort Study ◽

Early Onset ◽

Retrospective Cohort

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Morbidity in Late Preterm Birth: A Retrospective Cohort Study Assessing the Role of Immaturity versus Antecedent Factors

Neonatology ◽

10.1159/000515089 ◽

2021 ◽

pp. 1-8

Author(s):

Melissa Lorenzo ◽

Megan Laupacis ◽

Wilma M. Hopman ◽

Imtiaz Ahmad ◽

Faiza Khurshid

Keyword(s):

Cohort Study ◽

Preterm Birth ◽

Preterm Delivery ◽

Gestational Age ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Late Preterm ◽

Multiple Gestation ◽

Late Preterm Birth ◽

Apnea Of Prematurity

Introduction: Late preterm infants (LPIs) are infants born between 340/7 and 366/7 weeks gestation. Morbidities in these infants are commonly considered a result of prematurity; however, some research has suggested immaturity may not be the sole cause of morbidities. We hypothesize that antecedents leading to late preterm birth are associated with different patterns of morbidities and that morbidities are the result of gestational age superimposed by the underlying etiologies of preterm delivery. Methods: This is a retrospective cohort study of late preterm neonates born at a single tertiary care center. We examined neonatal morbidities including apnea of prematurity, hyperbilirubinemia, hypoglycemia, and the requirement for continuous positive airway pressure (CPAP). Multivariable logistic regression analysis was performed to estimate the risk of each morbidity associated with 3 categorized antecedents of delivery, that is, spontaneous preterm labor, preterm premature rupture of membranes (PPROM), and medically indicated birth. We calculated the predictive probability of each antecedent resulting in individual morbidity across gestational ages. Results: 279 LPIs were included in the study. Decreasing gestational age was associated with significantly increased risk of apnea of prematurity, hyperbilirubinemia, and requirement of CPAP. In our cohort, the risk of hypoglycemia increased with gestational age, with the greatest incidence at 360−6 weeks. There was no significant association of risk of selected morbidities and the antecedents of late preterm delivery, with or without adjustment for gestational age, multiple gestation, small for gestational age (SGA), antenatal steroids, and delivery method. Discussion and Conclusion: This study found no difference in morbidity risk related to 3 common antecedents of preterm birth in LPIs. Our research suggests that immaturity is the primary factor in determining adverse outcomes, intensified by factors resulting in prematurity.

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