G555 The maternal and neonatal microbiota correlates of preterm birth and adverse neonatal outcomes

Abstract Background: This study compares subsequent birth outcomes in migrant women who had already had a child before arriving in Norway with those in migrant women whose first birth occurred in Norway. The aim of this study was to investigate the associations between country of first birth and adverse neonatal outcomes (very preterm birth, moderately preterm birth, post-term birth, small for gestational age, large for gestational age, low Apgar score, stillbirth and neonatal death) in parous migrant and Norwegian-born women. Methods: National population-based study including second and subsequent singleton births in Norway from 1990-2016. Data were retrieved from the Medical Birth Registry of Norway and Statistics Norway. Neonatal outcomes were compared between births to: 1) migrant women with a first birth before immigration to Norway (n=30,062) versus those with a first birth after immigration (n=66,006), and 2) Norwegian-born women with a first birth outside Norway (n=6,205) versus those with a first birth in Norway (n=514,799). Associations were estimated as crude and adjusted odds ratios (aORs) with 95% confidence intervals (CIs) using multiple logistic regression. Results: Migrant women with a first birth before immigrating to Norway had increased odds of adverse outcomes in subsequent births relative to those with a first birth after immigration: very preterm birth (22-31 gestational weeks (gwks); aOR=1.27; CI 1.09-1.48), moderately preterm birth (32-36 gwks; aOR=1.10; CI 1.02-1.18), post-term birth (≥42 gwks; aOR=1.19; CI 1.11-1.27), low Apgar score (<7 at 5 minutes; aOR=1.27; CI 1.16-1.39) and stillbirth (aOR=1.29; CI 1.05-1.58). Similar results were found in the sample of births to Norwegian-born women. Conclusions: The increased odds of adverse neonatal outcomes for migrant and Norwegian-born women who had their first births outside Norway should serve as a reminder of the importance of taking a careful obstetric history in these parous women to ensure appropriate care for their subsequent pregnancies and births in Norway. Keywords: immigration, parous women, neonatal outcomes, obstetric history, predictor

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329: Antenatal corticosteroids and adverse neonatal outcomes in preterm birth in the United States

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2019.11.345 ◽

2020 ◽

Vol 222 (1) ◽

pp. S222-S223

Author(s):

Moti Gulersen ◽

Amos Grunebaum ◽

Eran Bornstein ◽

Erez Lenchner ◽

Frank A. Chervenak

Keyword(s):

United States ◽

Preterm Birth ◽

The United States ◽

Neonatal Outcomes ◽

Antenatal Corticosteroids ◽

Adverse Neonatal Outcomes

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The depletion of regulatory T cells in late gestation increases the susceptibility for LPS-induced preterm birth and causes adverse neonatal outcomes

Journal of Reproductive Immunology ◽

10.1016/j.jri.2016.04.129 ◽

2016 ◽

Vol 115 ◽

pp. 42-43

Author(s):

M. Arenas-Hernandez ◽

R. Romero ◽

A. Balancio ◽

T.N. Mial ◽

S.S. Hassan ◽

...

Keyword(s):

T Cells ◽

Preterm Birth ◽

Regulatory T Cells ◽

Late Gestation ◽

Neonatal Outcomes ◽

Adverse Neonatal Outcomes

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Cholestasis after very preterm birth was associated with adverse neonatal outcomes but no significant long‐term liver disease: A population‐based study

Acta Paediatrica ◽

10.1111/apa.15408 ◽

2020 ◽

Vol 110 (1) ◽

pp. 141-148

Author(s):

Jonas Teng ◽

Kajsa Bohlin ◽

Antal Nemeth ◽

Björn Fischler

Keyword(s):

Liver Disease ◽

Preterm Birth ◽

Population Based ◽

Neonatal Outcomes ◽

Population Based Study ◽

Very Preterm ◽

Very Preterm Birth ◽

Adverse Neonatal Outcomes

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A220 A COMPREHENSIVE SYSTEMATIC REVIEW AND META-ANALYSIS OF THE RISK OF ADVERSE NEONATAL OUTCOME IN INFLAMMATORY BOWEL DISEASE AND PREGNANCY

Journal of the Canadian Association of Gastroenterology ◽

10.1093/jcag/gwz047.219 ◽

2020 ◽

Vol 3 (Supplement_1) ◽

pp. 94-95

Author(s):

K Leung ◽

P Tandon ◽

V Govardhanam ◽

C Maxwell ◽

V Huang

Keyword(s):

Risk Factors ◽

Inflammatory Bowel Disease ◽

Preterm Birth ◽

Bowel Disease ◽

Neonatal Outcomes ◽

Healthy Controls ◽

Increased Risk ◽

Adverse Neonatal Outcomes ◽

Inflammatory Bowel ◽

Active Disease

Abstract Background Inflammatory bowel disease (IBD) often affects women in their child-bearing years. These women may be at an increased risk of adverse neonatal outcomes. Aims The aim of this study was to evaluate the risk of these outcomes in this population of patients, with an emphasis of determining risk factors for development of these conditions. Methods Medline, Embase, and Cochrane library were searched through to May 2019 for studies reporting adverse neonatal outcomes in IBD patients. Weighted odds ratios (OR) with 95% confidence intervals (CI) were calculated to assess the risk of these outcomes in patients with IBD compared to healthy controls, with risk factors such as disease activity and medication exposure also being assessed. Results Sixty studies were included (8194 pregnancies with inflammatory bowel disease and 3253 healthy pregnancies). Compared to healthy controls, patients with inflammatory bowel disease were more likely to deliver infants with low birth weight (LBW) (OR 2.78, 95% CI 1.16–6.66) and infants who were admitted to the neonatal intensive care unit (NICU) (OR 3.33, 95% CI 1.83–6.05). Patients with Crohn’s disease had an increased risk of infants born with congenital anomalies (OR 3.03, 95% CI, 1.43–6.42), whereas patients with ulcerative colitis had an increased risk of preterm delivery (OR 2.68, 95% CI, 1.12–6.43). Active disease increased the risk of preterm birth (OR 2.06, 95% CI 1.21–3.51), LBW (OR 2.96, 95% CI 1.54–5.70), and small for gestation age (OR 2.62, 95% CI 1.18–5.83) compared to disease in remission. Tumor necrosis factor antagonists was associated with increased risk of NICU admission (OR 2.42, 95% CI 1.31–4.45) and LBW (OR 1.54, 95% CI, 1.01–2.35). Conclusions Patients with inflammatory bowel disease are at an increased risk of developing adverse neonatal outcomes such as preterm birth, LBW, congenital anomalies, and NICU admissions. Patients with clinically active disease and those exposed to anti-TNF therapy may be at higher risk of developing these adverse outcomes. The findings of this study are important to communicate to patients and healthcare providers alike. Furthermore, this information may help to mitigate these risks through collaborative specialized care during pregnancy in order to reduce the overall morbidity and mortality for both mother and baby. Funding Agencies None

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Mathematical Modeling of the Biomarker Milieu to Characterize Preterm Birth and Predict Adverse Neonatal Outcomes

American Journal of Reproductive Immunology ◽

10.1111/aji.12502 ◽

2016 ◽

Vol 75 (5) ◽

pp. 594-601 ◽

Cited By ~ 14

Author(s):

Christina N. Cordeiro ◽

Yulia Savva ◽

Dhananjay Vaidya ◽

Cynthia H. Argani ◽

Xiumei Hong ◽

...

Keyword(s):

Mathematical Modeling ◽

Preterm Birth ◽

Neonatal Outcomes ◽

Adverse Neonatal Outcomes

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560: Late preterm birth: adverse neonatal outcomes are increased after iatrogenic preterm birth compared with spontaneous preterm birth

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2009.10.425 ◽

2009 ◽

Vol 201 (6) ◽

pp. S208

Author(s):

Jeff M. Denney ◽

Michael Varner ◽

Bradley Yoder ◽

Robert Silver

Keyword(s):

Preterm Birth ◽

Neonatal Outcomes ◽

Late Preterm ◽

Spontaneous Preterm Birth ◽

Late Preterm Birth ◽

Adverse Neonatal Outcomes

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Using Non-inferiority Margins to Define Optimal Gestational Weight Gain Ranges Based on Reducing the Risk of Occurrence of Adverse Neonatal Outcomes

Current Developments in Nutrition ◽

10.1093/cdn/nzab046_025 ◽

2021 ◽

Vol 5 (Supplement_2) ◽

pp. 728-728

Author(s):

Thais Carrilho ◽

Jennifer Hutcheon ◽

Kathleen Rasmussen ◽

Dayana Farias ◽

Michael Reichenheim ◽

...

Keyword(s):

Weight Gain ◽

Preterm Birth ◽

Gestational Weight Gain ◽

Gestational Age ◽

National Research Council ◽

Neonatal Outcomes ◽

Composite Outcome ◽

Gestational Weight ◽

Adverse Neonatal Outcomes ◽

Z Scores

Abstract Objectives To identify optimal gestational weight gain (GWG) ranges to prevent adverse neonatal outcomes based on the new Brazilian GWG charts. Methods Data from 9,294 women from the Brazilian Maternal and Child Nutrition Consortium and Birth in Brazil study were used. Women aged ≥18 years, free of hypertensive disorders, diabetes in pregnancy, or diseases affecting GWG, were selected. Total GWG was calculated as last measured prenatal weight minus self-reported pre-pregnancy weight. Total GWG was standardized to gestational age-specific z scores according to the Brazilian GWG charts. A composite outcome was defined as the occurrence of any of small-for-gestational-age birth (SGA, birthweight < 10th percentile), large-for-gestational-age birth (LGA > 90th percentile) according to INTERGROWTH-21st charts, or preterm birth (birth < 37 weeks). We weighted each outcome in a composite index using previously-published weights to account for its relative seriousness. Logistic and Poisson regressions were performed with GWG z scores as exposure and independent outcomes and the composite outcome, respectively. Models were adjusted for maternal age, education, pre-pregnancy BMI, and smoking during pregnancy. GWG ranges associated with the lowest risk of the composite outcome were identified using the non-inferiority margins approach (20%). Results The median total GWG was 12.5 kg (IQR 9–16), and 6.2% of the neonates were SGA, 16.6% LGA, and 10.5% were preterm. Higher GWG z scores were associated with an increase in LGA probabilities and preterm birth compared with neonates born with appropriate weight and ≥37 weeks, respectively. Lower z scores were associated with an increase in SGA probability. The non-inferiority margins analysis showed that to prevent the occurrence of these adverse outcomes, women with underweight, normal-weight, overweight, or obesity should gain between 6.5–14.1 kg, 6.4–13.8 kg, 2.2–12.1 kg, and –2.2–8.9 kg, respectively. Conclusions Total GWG ranges associated with lower risk of adverse neonatal outcomes were identified using non-inferiority margins. The next step must incorporate maternal outcomes in this analysis. Funding Sources Brazilian National Research Council, Brazilian Ministry of Health, Bill and Melinda Gates Foundation.

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