Impact of adolescent age on maternal and neonatal outcomes in the Born in Bradford cohort

ObjectivesExplore associations between maternal and neonatal outcomes and maternal age, with particular reference to adolescent women.DesignPopulation-based cohort study.SettingMaternity department of a large hospital in Northern England.ParticipantsPrimiparous women delivering a singleton at Bradford Royal Infirmary between March 2007 and December 2010 aged ≤19 years (n=640) or 20–34 years (n=3951). Subgroup analysis was performed using women aged ≤16 years (n=68). Women aged 20–34 years were used as the reference group.Primary outcome measuresMaternal and neonatal outcomes.ResultsThe odds of extremely low birth weight (<1000 g) were significantly higher in the adolescent group (≤19 years) compared with the reference group (adjusted OR (aOR) 4.13, 95% CI 1.41 to 12.11). The odds of very (<32 weeks) and extremely (<28 weeks) preterm delivery were also higher in the adolescent group (aOR 2.12, 95% CI 1.06 to 4.25 and aOR 5.06, 95% CI 1.23 to 20.78, respectively).Women in the adolescent group had lower odds of gestational diabetes (aOR 0.35, 95% CI 0.20 to 0.62), caesarean delivery (aOR 0.53, 95% CI 0.42 to 0.67 and instrumental delivery (aOR 0.53, 95% CI 0.41 to 0.67).ConclusionsThis study identifies important differences in maternal and neonatal outcomes between women by age group. These findings could help in identifying at-risk groups for additional support and tailored interventions to minimise the risk of adverse outcomes for these vulnerable groups. Further work is needed to identify the causal mechanisms linking age with outcomes in adolescent women where significant gaps in the literature exist.

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Association between Adherence with Recommended Antenatal Care in Low-Risk, Uncomplicated Pregnancy, and Maternal and Neonatal Adverse Outcomes: Evidence from Italy

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18010173 ◽

2020 ◽

Vol 18 (1) ◽

pp. 173

Author(s):

Giovanni Corrao ◽

Anna Cantarutti ◽

Anna Locatelli ◽

Gloria Porcu ◽

Luca Merlino ◽

...

Keyword(s):

Antenatal Care ◽

Prevalence Ratio ◽

Population Based ◽

Adverse Outcomes ◽

Low Risk ◽

Neonatal Outcomes ◽

Lombardy Region ◽

Uncomplicated Pregnancy ◽

Maternal And Neonatal Outcomes ◽

Estimate Prevalence

Antenatal care (ANC) aims of monitoring wellbeing of mother and foetus during pregnancy. We validate a set of indicators aimed of measuring the quality of ANC of women on low-risk, uncomplicated pregnancy through their relationship with maternal and neonatal outcomes. We conducted a population-based cohort study including 122,563 deliveries that occurred between 2015 and 2017 in the Lombardy Region, Italy. Promptness and appropriateness of number and timing of gynaecological visits, ultrasounds and laboratory tests were evaluated. We assessed several maternal and neonatal outcomes. Log-binomial regression models were used to estimate prevalence ratio (PR), and corresponding 95% confidence interval (95% CI), for the exposure→outcome association. Compared with women who adhered with recommendations, those who were no adherent had a significant higher prevalence of maternal intensive care units admission (PR: 3.1, 95%CI: 1.2–7.9; and 2.7, 1.1–7.0 respectively for promptness of gynaecological visits, and appropriateness of ultrasound examinations), low Apgar score (1.6, 1.1–1.2; 1.9, 1.3–2.7; and 2.1, 1.5–2.8 respectively for appropriateness and promptness of gynaecological visits, and appropriateness of ultrasound examinations), and low birth weight (1.8, 1.5–2.3 for appropriateness of laboratory test examinations). Benefits for mothers and newborn are expected from improving adherence to guidelines-driven recommendations regarding antenatal care even for low-risk, uncomplicated pregnancies.

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Characteristics and adverse outcomes of Chinese adolescent pregnancies between 2012 and 2019

Scientific Reports ◽

10.1038/s41598-021-92037-x ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Yanxia Xie ◽

Xiaodong Wang ◽

Yi Mu ◽

Zheng Liu ◽

Yanping Wang ◽

...

Keyword(s):

Adolescent Pregnancy ◽

Gestational Age ◽

Rural Areas ◽

Reference Group ◽

Perinatal Outcomes ◽

Severe Anaemia ◽

Adverse Outcomes ◽

Near Miss ◽

Adolescent Women ◽

Adolescent Pregnancies

AbstractWe aimed to describe the characteristics of adolescent pregnancy, determine its effect on adverse maternal and perinatal outcomes and explore whether that association varies with gestational age with the goal of proposing specific recommendations for adolescent health in China. This study included 2,366,559 women aged 10–24 years who had singleton pregnancies between 2012 and 2019 at 438 hospitals. Adolescent pregnancy was defined as younger than 20 years of age. We used multivariable logistic regression to estimate the effects. Women aged 20–24 years served as the reference group in all analyses. The proportion of rural girls with adolescent pregnancies rebounded after 2015 even though common-law marriage in rural areas decreased. Higher risks of eclampsia (adjusted odds ratio (aOR) 1.87, 95% confidence interval (CI) 1.57 ~ 2.23), severe anaemia (aOR 1.18, 95% CI 1.09 ~ 1.28), maternal near miss (MNM; aOR 1.24, 95% CI 1.12 ~ 1.37), and small for gestational age (SGA; aOR 1.30, 95% CI 1.28 ~ 1.33) were observed when gestational age was > 37 weeks. Adolescent pregnancy was independently associated with increased risks of other perinatal outcomes. Further implementation of pregnancy prevention strategies and improved health care interventions are needed to reduce adolescent pregnancies and prevent adverse fertility outcomes among adolescent women in China at a time when adolescent fertility rate is rebounding.

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Maternal and Neonatal Outcomes after Attempted External Cephalic Version among Women with One Previous Cesarean Delivery

American Journal of Perinatology Reports ◽

10.1055/s-0038-1676297 ◽

2018 ◽

Vol 08 (04) ◽

pp. e349-e354 ◽

Cited By ~ 2

Author(s):

Rodney McLaren ◽

Fouad Atallah ◽

Nelli Fisher ◽

Howard Minkoff

Keyword(s):

Cesarean Delivery ◽

Retrospective Cohort ◽

Adverse Outcomes ◽

Neonatal Outcomes ◽

External Cephalic Version ◽

Multivariable Logistic Regression Analysis ◽

Success Rates ◽

Trial Of Labor ◽

Maternal And Neonatal Outcomes ◽

Previous Cesarean

Objective This study was aimed to evaluate success rates of (1) external cephalic version (ECV) among women with one prior cesarean delivery (CD) and (2) maternal and neonatal outcomes after ECV among women with prior CD. Study Design Two linked studies using U.S. Natality Database were performed. First we performed a retrospective cohort comparing ECV success rates of women with prior CD and women without prior CD. Then we compared the outcomes of TOLACs (trial of labor after cesarean delivery) that occurred after ECV with those that occurred without ECV. Multivariable logistic regression analysis was used to estimate adverse outcomes. Results A total of 715 women had ECV after 36 weeks with prior CD and 9,976 had ECV without prior scar. ECV success rate with scar was 80.6% and without scar was 86.4% (p < 0.001). Seven hundred and sixteen women underwent TOLAC after ECV attempt and 234,617 underwent TOLAC without a preceding attempt. Women with preceding version had increased risks of maternal transfusion (1 vs. 0.4%, adjusted OR [odds ratio]: 2.48 [95% CI (confidence interval): 1.17–5.23]), unplanned hysterectomy (0.4 vs. 0.06%, adjusted OR: 6.90 [95% CI: 2.19–21.78]), and low 5-minute Apgar's score (2.5 vs. 1.5%, adjusted OR: 1.76 [95% CI: 1.10–2.82]). Conclusion Women with prior CD may have a decrease in the rate of successful ECV. While the absolute risks are low, ECV appears to increase risks of adverse maternal and neonatal outcomes among women undergoing a trial of labor.

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Rate of teenage pregnancy in Jordan and its impact on maternal and neonatal outcomes

International Journal of Adolescent Medicine and Health ◽

10.1515/ijamh-2017-0075 ◽

2017 ◽

Vol 31 (6) ◽

Cited By ~ 3

Author(s):

Yousef S. Khader ◽

Anwar Batieha ◽

Rana Kareem Al fursan ◽

Rami Al-Hader ◽

Sa’ad S. Hijazi

Keyword(s):

Teenage Pregnancy ◽

Small Sample ◽

Adverse Outcomes ◽

Neonatal Outcomes ◽

National Study ◽

Premature Delivery ◽

Discharge Data ◽

Increased Risk ◽

Maternity Hospitals ◽

Maternal And Neonatal Outcomes

Abstract Objective Research regarding the adverse outcomes of adolescent childbearing has suffered from many limitations such as a small sample size and non-representative samples. This study was conducted to determine the rate of teenage pregnancy among Jordanian adolescents and its associated adverse maternal and neonatal outcomes. Methods The study is a part of a comprehensive national study of perinatal mortality that was conducted between 2011 and 2012 in Jordan. All women who gave birth after 20 weeks of gestation in 18 maternity hospitals in Jordan between 2011 and 2012 were invited to participate in the study. Consenting women were interviewed by the trained midwives in these hospitals using a structured questionnaire prepared for the purpose of this study. Additional information was also collected based on the physical examination by the midwife and the obstetrician at admission and at discharge. Data on the newborn were also collected by the pediatric nurses and the neonatologists in these hospitals. Results The overall rate of teenage pregnancy [95% confidence interval (CI) was 6.2% (5.9%, 6.5%)]. Of the studied maternal and neonatal outcomes, women aged <20 years were more likely to deliver prematurely compared to women aged 20–35 years [odds ratio (OR)=1.5, 95% CI: 1.2, 1.9; p < 0.005)]. However, the two groups of women did not differ significantly in low birth weight delivery (OR = 1.2, 95% CI: 0.9, 1.5; p = 0.167) and neonatal mortality (OR = 1.2, 95% CI: 0.8, 1.3; p = 0.491) in the multivariate analysis. Conclusion Teenage pregnancy was associated with increased risk of premature delivery, apart from the effects of socioeconomic factors.

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Prevalence of Gestational Diabetes Mellitus, Maternal and Neonatal outcomes in a Peripheral Hospital in North India

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20172034 ◽

2017 ◽

Vol 5 (6) ◽

pp. 2343 ◽

Cited By ~ 1

Author(s):

Naiyma Choudhary ◽

Mohd Rasheed ◽

Vivek Aggarwal

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Gestational Hypertension ◽

Adverse Outcomes ◽

Neonatal Outcomes ◽

North India ◽

Peripheral Hospital ◽

Medical Entity ◽

Maternal And Neonatal Outcomes

Background: Gestational diabetes mellitus (GDM) is a well-known medical entity which should be diagnosed at the earliest to prevent adverse maternal and neonatal outcomes due to hyperglycemia.Methods: This study was done in patients attending antenatal OPD in a peripheral hospital in North India. A total of 569 patients diagnosed as GDM were included in the study out of 6321 who attended the antenatal clinic.Results: The prevalence of gestational diabetes mellitus was found to be 9%. Gestational hypertension was seen in 29.35% of patients. The percent of babies who were admitted to NICU was 29.35%.Conclusions: These results stress the need for early detection and treatment of GDM to prevent adverse outcomes.

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Clinical Effects of Form-Based Management of Forceps Delivery under Intelligent Medical Model

Journal of Healthcare Engineering ◽

10.1155/2021/9947255 ◽

2021 ◽

Vol 2021 ◽

pp. 1-8

Author(s):

Siming Xin ◽

Zhizhong Wang ◽

Hua Lai ◽

Lingzhi Liu ◽

Ting Shen ◽

...

Keyword(s):

Success Rate ◽

Medical Model ◽

Adverse Outcomes ◽

Neonatal Outcomes ◽

Control Group ◽

Clinical Effects ◽

Forceps Delivery ◽

Delivery Methods ◽

Maternal And Neonatal Outcomes ◽

The One

Background. Forceps delivery is one of the most important measures to facilitate vaginal delivery. It can reduce the rate of first cesarean delivery. Frustratingly, adverse maternal and neonatal outcomes associated with forceps delivery have been frequently reported in recent years. There are two major reasons: one is that the abilities of doctors and midwives in forceps delivery vary from hospital to hospital and the other one is lack of regulations in the management of forceps delivery. In order to improve the success rate of forceps delivery and reduce the incidence of maternal and neonatal complications, we applied form-based management to forceps delivery under an intelligent medical model. The aim of this work is to explore the clinical effects of form-based management of forceps delivery. Methods. Patients with forceps delivery in Maternal and Child Health Hospital Affiliated to Nanchang University were divided into two groups: form-based patients from January 1, 2019, to December 31, 2020, were selected as the study group, while traditional protocol patients from January 1, 2017, to December 31, 2018, were chosen as the control group. Then, we compared the maternal and neonatal outcomes of these two groups. Results. There were significant differences in the maternal and neonatal adverse outcomes such as rate of postpartum hemorrhage, degree of perineal laceration, and incidence of neonatal facial skin abrasions between the two groups, whereas differences in the incidence of asphyxia and intracranial hemorrhage were not significant. Conclusions. Form-based management could help us assess the security of forceps delivery comprehensively, as it could not only improve the success rate of the one-time forceps traction scheme but also reduce the incidence of maternal and neonatal adverse outcomes effectively.

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Obstetric and Neonatal Outcomes Related To Intrapartum Hydration Strategies in Low-Risk Deliveries: An Observational Study

10.21203/rs.3.rs-776979/v1 ◽

2021 ◽

Author(s):

Ana B. Hernández-López ◽

Cristina Muriel-Miguel ◽

Tirso Pérez-Medina ◽

Aurora Fernández-Cañadas Morillo ◽

Carolina López-Lapeyrere ◽

...

Keyword(s):

Weight Loss ◽

Total Duration ◽

Adverse Outcomes ◽

Low Risk ◽

Neonatal Outcomes ◽

Nulliparous Women ◽

Study Population ◽

Maternal And Neonatal Outcomes ◽

Prolonged Labor ◽

Myometrial Contractility

Abstract Background Effective myometrial contractility is important for successful labor, although little attention has been paid to the effect of managing intrapartum fluid intake. Ineffective myometrial contractility leads to prolonged labor, thus increasing obstetric and neonatal adverse outcomes. The risk of prolonged labor can be reduced by increasing the total volume of fluids administered during labor. Objective To determine the hydration strategies applied in nulliparous women undergoing low risk labor and their association with obstetric and neonatal outcomes. Methods A prospective cohort study was conducted in a Universitary Hospital. The study population included nulliparous women who presented in active labor or induced labor. Sample size was 147. In order to stratify women based on the hydration received, we set as a cut-off point the mean total volume administered per hour (300 ml/h). This enabled to compare obstetric, clinical, and neonatal outcomes in women who had received ≥ 300 mL/h o < 300 mL/h. The primary outcome was total length of labor. Secondary outcomes included maternal and neonatal outcomes. Results The study population comprised 148 nulliparous women, mean (DS) age 32.2 (4.4) years, mean (DS) gestational age of 39.4 (1.41) weeks. At admission, median (IQR) dilation was 2 (1–3) cm. Labor was induced in 65.5% (n = 97). Obstetric and neonatal outcomes were more favorable in women who received a ≥ 300 mL/h volume, with statistically significant median differences in the duration total duration of labor (526 vs 735 min; p < 0.001). Clinically relevant differences were also observed with respect to cesarean delivery (14.3% vs 18.7%), fever (5.5% vs 7.7%), weight loss at 24 hours (–2.3% vs − 3%) and at 48 hours (–5.7% vs − 6.3 %), incidence of weight loss > 7% at 48 hours (28.6% vs 39.8%), breastfeeding (94.6% vs 82.4%). Conclusions Higher fluid volume administered to nulliparous women during low-risk labor is associated with improved obstetric and neonatal outcomes.

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Maternal and neonatal outcomes in pregnancies complicated by maternal obesity

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20190270 ◽

2019 ◽

Vol 8 (2) ◽

pp. 474

Author(s):

Sudha Menon ◽

Sivaprasad K.

Keyword(s):

High Risk ◽

Maternal Obesity ◽

Gestational Hypertension ◽

Tertiary Care ◽

Adverse Outcomes ◽

Neonatal Outcomes ◽

Induction Of Labour ◽

Large For Gestational Age ◽

Obese Women ◽

Maternal And Neonatal Outcomes

Background: Maternal obesity imparts elevated maternal and neo natal adverse outcomes. Aim of the study was to evaluate and analyse the maternal and neonatal outcomes in obese mothers.Methods: This was a prospective case control study in a tertiary care high risk referral center. Antenatal women with first trimester Body mass index (BMI) of more than 30 Kg/m2 constituted the cases and those antenatal women with BMI <25 Kg/m2 formed the controls.Results: Mean age was slightly more (28.6±4.3 years vs 26.3±3.6 years: P<0.0001) in the obese group. Obese women were significantly more likely to have of gestational diabetes (OR 5.2, 95% CI 3.2-8.7 P<0.00001), gestational hypertension (Or 3.5, 95% CI 2.1-5.9 P<0.0001) , induction of labour (OR 2.5, 95% CI 1.8-3.6 P<0.0001), failed induction of labour (OR 2.4, 95% CI 1.3-4.2 P=0.003), Preeclampsia (OR 2.8, 95% CI 1.6-4.9 P=0.0002), Caesarian section (Or 4.0, 95% CI 2.9-5.9 P<0.0001) and Postpartum hemorrhage (OR 4.0,95% CI 1.1-14.3 P=0.034), prolonged hospital stay (OR 12.8, 95% CI 7.7-21.1 P<0.0001) and adverse neonatal outcomes such as low(<7) Apgar (OR 3.2, 95% CI 1.1-10.0 P=0.03), Large for gestational age babies (OR 3.1, 95% Cl 2.1-4.5 P<0.0001) and transfer to new born nursery (OR 3.4, 95% CI 2.3 -5.2 P<0.0001).Conclusions: Maternal obesity in pregnancy is high risk and has many adverse maternal and neonatal outcomes warranting specialized antenatal, intranatal and post-natal care.

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Factors Related to Maternal Adverse Outcomes in Pregnant Women with Cardiac Disease in Low-resource Settings

European Cardiology Review ◽

10.15420/ecr.2020.04 ◽

2020 ◽

Vol 15 ◽

Author(s):

Philippe Amubuomombe Poli ◽

Elkanah Omenge Orang’o ◽

Ann Mwangi ◽

Felix Ayub Barasa

Keyword(s):

Pregnant Women ◽

Cardiac Disease ◽

Premature Death ◽

Adverse Outcomes ◽

Neonatal Outcomes ◽

Low Resource Settings ◽

Neonatal Deaths ◽

Low Resource ◽

Resource Limited ◽

Maternal And Neonatal Outcomes

Background: Cardiac disease is an important life-threatening complication during pregnancy. It is frequently seen in pregnant women living in resource-limited areas and often results in premature death. Aim: The aim of this hospital-based longitudinal study was to identify factors related to adverse maternal and neonatal outcomes in pregnant women with cardiac disease in low-resource settings. Methods: The study enrolled 91 pregnant women with congenital or acquired cardiac disease over a period of 2 years in Kenya. Results: Maternal and early neonatal deaths occurred in 12.2% and 12.6% of cases, respectively. The risk of adverse outcomes was significantly increased in those with pulmonary oedema (OR 11, 95% CI [2.3–52]; p=0.002) and arrhythmias (OR 16.9, 95% CI [2.5–113]; p=0.004). Limited access to care was significantly associated with adverse maternal outcomes (p≤0.001). Conclusion: Many factors contribute to adverse maternal and neonatal outcomes in pregnant women with cardiac disease. Access to comprehensive specialised care may help reduce cardiac-related complications during pregnancy.

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Obstetrical, maternal and neonatal outcomes in pregnancies affected by muscular dystrophy

Journal of Perinatal Medicine ◽

10.1515/jpm-2017-0299 ◽

2018 ◽

Vol 46 (7) ◽

pp. 791-796 ◽

Cited By ~ 2

Author(s):

Adriano Petrangelo ◽

Eman Alshehri ◽

Nicholas Czuzoj-Shulman ◽

Haim A. Abenhaim

Keyword(s):

Cohort Study ◽

Muscular Dystrophy ◽

Large Population ◽

The United States ◽

Population Based ◽

Adverse Outcomes ◽

Neonatal Outcomes ◽

Increased Risk ◽

Maternal And Neonatal Outcomes ◽

Adverse Pregnancy

Abstract Objective: Pregnancies in women affected by a muscular dystrophy are at an increased risk of adverse maternal and neonatal outcomes due to the effect of the disease on the muscular, cardiac and respiratory systems. We sought to evaluate the risk of adverse outcomes within a large population-based cohort study. Methods: We used the data extracted from the Nationwide Inpatient Sample (NIS) to conduct a retrospective population-based cohort study consisting of over 12 million births that occurred in the United States between 1999 and 2013. Births to mothers with muscular dystrophy were identified using the International Classification of Diseases, Ninth Revision (ICD-9) codes and were compared with births to mothers with no maternal muscular dystrophy. Unconditional logistic regression analysis was used to evaluate the adjusted effect of muscular dystrophy on maternal and neonatal outcomes. Results: During the 14-year study period, there was an increasing trend in the incidence of muscular dystrophy, with a cumulative incidence of 7.26 in 100,000 births. Women with muscular dystrophy and their neonates were at a significantly increased risk of adverse pregnancy outcomes: specifically, an increased risk of preeclampsia, preterm premature rupture of membranes, preterm labor, venous thromboembolism, cardiac dysrhythmia, requiring a blood transfusion and giving birth by cesarean section. Neonates born to affected mothers were at a significantly higher risk of being born preterm, with a congenital malformation and suffering intrauterine growth restriction. Conclusion: The risk of several adverse maternal and neonatal outcomes is increased in pregnant women with muscular dystrophy. As such, additional surveillance in order to mitigate the risk of adverse outcomes is warranted in these pregnancies.

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