scholarly journals Association between the COVID-19 pandemic and the risk for adverse pregnancy outcomes: a cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e047900
Author(s):  
Min Du ◽  
Jie Yang ◽  
Na Han ◽  
Min Liu ◽  
Jue Liu
Keyword(s):  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Time Trends ◽  
Foetal Distress ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Gestational Weight ◽  
Excessive Gestational Weight Gain ◽  
Adverse Pregnancy ◽  
Beijing China

ObjectivesThe secondary impacts of the COVID-19 pandemic on adverse maternal and neonatal outcomes remain unclear. In this study, we aimed to evaluate the association between the COVID-19 pandemic and the risk for adverse pregnancy outcomes.DesignWe conduced retrospective analyses on two cohorts comprising 7699 pregnant women in Beijing, China, and compared pregnancy outcomes between the pre-COVID-2019 cohort (women who delivered from 20 May 2019 to 30 November 2019) and the COVID-2019 cohort (women who delivered from 20 January 2020 to 31 July 2020). The secondary impacts of the COVID-2019 pandemic on pregnancy outcomes were assessed by using multivariate log-binomial regression models, and we used interrupted time-series (ITS) regression analysis to further control the effects of time-trends.SettingOne tertiary-level centre in Beijing, ChinaParticipants7699 pregnant women.ResultsCompared with women in the pre-COVID-19 pandemic group, pregnant women during the COVID-2019 pandemic were more likely to be of advanced age, exhibit insufficient or excessive gestational weight gain and show a family history of chronic disease (all p<0.05). After controlling for other confounding factors, the risk of premature rupture of membranes and foetal distress was increased by 11% (95% CI, 1.04 to 1.18; p<0.01) and 14% (95% CI, 1.01 to 1.29; p<0.05), respectively, during the COVID-2019 pandemic. The association still remained in the ITS analysis after additionally controlling for time-trends (all p<0.01). We uncovered no other associations between the COVID-19 pandemic and other pregnancy outcomes (p>0.05).ConclusionsDuring the COVID-19 pandemic, more women manifested either insufficient or excessive gestational weight gain; and the risk of premature rupture of membranes and foetal distress was also higher during the pandemic.

scholarly journals A Comparative Study on Adverse Pregnancy Outcomes in Pregnant Women with Different Age

2021 ◽  
Vol 31 (1) ◽  
pp. 9-16
Author(s):  
Soudabe Ebrahimi ◽  
◽  
Maryam Niknami ◽  
Fateme Rafat ◽  
Ehsan Kazemnezhad Leili ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Maternal Age ◽  
Age Groups ◽  
Maternal Diabetes ◽  
Neonatal Outcomes ◽  
Age Group ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Adverse Pregnancy

Introduction: Delayed childbearing is increasing. Increased maternal age has been associated with increased risk of pregnancy complications. On the other hand, the adolescent pregnancy has traditionally been considered high-risk, especially in developing countries. Objective: This study aimed to compare the adverse pregnancy outcomes in different age groups of pregnant women. Materials and Methods: The analytical study with cross-sectional design was conducted on 345 pregnant women referred to one of the maternity hospitals in Rasht, Iran in 2018 who were selected by sequential sampling method. They were followed from gestational age >37 weeks until delivery in 3 groups: <19 years, 19-35 years and >35 years. The data collection tool was a two-part researcher-made questionnaire which surveys demographic, fertility, and socioeconomic information and adverse maternal and neonatal outcomes. The collected data were analyzed using descriptive and inferential statistics (Chi-square test, Fisher’s exact test, Kruskal-Wallis test, ANOVA, Bonfrroni test, Spearman correlation test, and multiple linear regression analysis). Results: The highest prevalence of maternal diabetes mellitus (29.7%) and cesarean section (72.46%) were reported in the age group >35 years. The highest frequency of premature rupture of membranes (18.8%) and abnormal fetal presentation (13.8 %) were reported in age groups <19 years and 19-35 years, respectively. Among maternal outcomes, maternal diabetes, abnormal fetal presentation, premature rupture of membranes and delivery by cesarean section were significantly different between three groups (P<0.05). There was a significant difference between maternal age and neonatal outcomes in ages groups <19 years and 19-35 years (P<0.05). Multiple linear regression model showed that the maternal age <19 years was a predictor of adverse neonatal outcomes. The group <19 years reported more adverse outcomes than the age group 19-35 years (β=0.282, 95% CL: 0.002-0.561, P=0.049). Conclusion: All age groups of pregnant women faced some pregnancy outcomes. Due to Iran’s new plan to encourage childbearing, prenatal screening, and receiving more prenatal care, we recommend pregnant women to participate in childbirth preparation training courses.

scholarly journals Objectively Measured Sedentary Behavior and Physical Activity Across 3 Trimesters of Pregnancy: The Monitoring Movement and Health Study

2020 ◽  
pp. 1-8
Author(s):  
Bethany Barone Gibbs ◽  
Melissa A. Jones ◽  
John M. Jakicic ◽  
Arun Jeyabalan ◽  
Kara M. Whitaker ◽  
...  
Keyword(s):  
Physical Activity ◽  
Pregnancy Outcomes ◽  
Second Trimester ◽  
Gestational Weight ◽  
Excessive Gestational Weight Gain ◽  
Intensity Physical Activity ◽  
Steps Per Day ◽  
Vigorous Intensity ◽  
Adverse Pregnancy ◽  
Objectively Measured

Background: Though moderate- to vigorous-intensity physical activity is recommended, limited research exists on sedentary behavior (SED) during pregnancy. Methods: The authors conducted a prospective cohort study to describe objectively measured patterns of SED and activity during each trimester of pregnancy. Women wore thigh- (activPAL3) and waist-mounted (ActiGraph GT3X) activity monitors. SED and activity were compared across trimesters using likelihood ratio tests and described using group-based trajectories. Exploratory analyses associated SED and activity trajectories with adverse pregnancy outcomes and excessive gestational weight gain. Results: Pregnant women (n = 105; mean [SD] age = 31 [5] y; prepregnancy body mass index = 26.2 [6.6] kg/m2) had mean SED of 9.7, 9.5, and 9.5 hours per day (P = .062) across trimesters, respectively. Some activities differed across trimesters: standing (increased, P = .01), stepping (highest in second trimester, P = .04), steps per day (highest in second trimester, P = .008), and moderate- to vigorous-intensity physical activity (decreased, P < .001). Prolonged SED (bouts ≥ 30 min) and bouted moderate- to vigorous-intensity physical activity (≥10 min) were stable (P > .05). In exploratory analyses, higher SED and lower standing, stepping, and steps per day trajectories were associated with increased odds of adverse pregnancy outcomes (P < .05). No trajectories were associated with excessive gestational weight gain. Conclusions: Pregnant women exhibited stable SED of nearly 10 hours per day across pregnancy. Future research evaluating SED across pregnancy and adverse pregnancy outcome risk is warranted.

scholarly journals Lactobacillus iners Is Associated with Vaginal Dysbiosis in Healthy Pregnant Women: A Preliminary Study

2019 ◽  
Vol 2019 ◽  
pp. 1-9
Author(s):  
Nengneng Zheng ◽  
Renyong Guo ◽  
Yinyu Yao ◽  
Meiyuan Jin ◽  
Yiwen Cheng ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Vaginal Microbiota ◽  
Second Trimester ◽  
Premature Rupture Of Membranes ◽  
Third Trimester ◽  
Premature Rupture ◽  
Significant Difference ◽  
Bacterial Marker ◽  
Preliminary Study ◽  
Adverse Pregnancy

Vaginal dysbiosis has been identified to be associated with adverse pregnancy outcomes, such as preterm delivery and premature rupture of membranes. However, the overall structure and composition of vaginal microbiota in different trimesters of the pregnant women has not been fully elucidated. In this study, the physiological changes of the vaginal microbiota in healthy pregnant women were investigated. A total of 83 healthy pregnant participants were enrolled, who are in the first, second, or third pregnancy trimester. Quantitative real-time PCR was used to explore the abundant bacteria in the vaginal microbiota. No significant difference in the abundance of Gardnerella, Atopobium, Megasphaera, Eggerthella, Leptotrichia/Sneathia, or Prevotella was found among different trimesters, except Lactobacillus. Compared with the first pregnancy trimester, the abundance of L. iners decreased in the second and third trimester while the abundance of L. crispatus was increased in the second trimester. Moreover, we also found that vaginal cleanliness is correlated with the present of Lactobacillus, Atopobium, and Prevotella and leukocyte esterase is associated with Lactobacillus, Atopobium, Gardnerella, Eggerthella, Leptotrichia/Sneathia, and Prevotella. For those whose vaginal cleanliness raised or leukocyte esterase became positive, the richness of L. iners increased, while that of L. crispatus decreased significantly. Our present data indicated that the altered vaginal microbiota, mainly Lactobacillus, could be observed among different trimesters of pregnancy and L. iners could be considered as a potential bacterial marker for evaluating vaginal cleanliness and leukocyte esterase.

scholarly journals Association of Pre-Pregnancy Body Mass Index and Gestational Weight Gain with Preterm Delivery in Pregnant Women

2021 ◽  
Author(s):  
Bhavya Baxi ◽  
Jigna Shah
Keyword(s):  
Weight Gain ◽  
Birth Weight ◽  
Pregnant Women ◽  
Gestational Weight Gain ◽  
Pregnancy Outcomes ◽  
Caesarean Delivery ◽  
Junk Food ◽  
Economic Class ◽  
Gestational Weight ◽  
Adverse Pregnancy

The perinatal mortality rate, which is one of the important adverse pregnancy outcome and includes stillbirths and infant death within first week of life is estimated to be nearly 40 deaths per 1,000 pregnancies in Gujarat. Also the infant mortality rates have been estimated to be 50 deaths before age of one year per 1,000 pregnancies. It is stated that children whose mothers are illiterate or belong to low socio-economic class have two and half times more chances to die within 1 year of their birth compared to those whose mothers have completed atleast 10 years of education or belong to high socio-economic class. There are nearly 13% of women who does not receive proper antenatal care and facility during pregnancy. In India, there are nearly half of the women (52%) who possess normal BMI range: rest are either underweight or overweight. Approximately 55% of the women of total population in India are anaemic. These maternal parameters directly affect the children causing 48% of the children to be malnourished and 43% to be underweight. Therefore, it is imperative to examine the association of pre-pregnancy Body Mass Index (BMI) as well as Gestational Weight Gain (GWG) with diverse pregnancy outcomes such as gestational diabetes, gestational hypertension and also with preterm delivery, caesarean delivery, etc. The present study was designed to investigate the prevalence, GWG, various pregnancy outcomes of underweight, overweight or obese pregnant women, and to explore the relationship between pre-pregnancy BMI as well as gestational weight gain during pregnancy and adverse pregnancy outcomes. This is a prospective, multi-centric study involving pregnant women with gestation week ≤20 weeks in Ahmedabad in Gujarat region. Our study observed that out of 226 women enrolled, 44 women (19.47%) were underweight, 137 women (60.62%) were normal, 30 women (13.27%) were overweight and 15 women (6.64%) were obese. The incidence of caesarean delivery (56.92%) was found more in nuclear family as compared to joint family (46.92%). It was found that in women taking no junk food at all, the chances of LBW were 16.39%, which was less as compared to mothers who had junk food. It was also observed that amongst women taking 1 glass milk daily (42.92%), about 55.67% of had normal type of delivery. Amongst women taking 1 fruit daily (57.52%), 53% women had normal delivery. Present study spotted decrease in risk of caesarean delivery with increase in maternal haemoglobin level from 9.0 gm/dl till 12.0 gm/dl. Average weight gain observed in underweight was 12.93 ± 1.90, in normal 12.32 ± 1.71, in overweight 10.23 ± 1.28 and in obese 9.6 ± 1.50. A negative correlation was found between GWG and pre-pregnancy BMI, i.e. as pre-pregnancy BMI increase, the GWG decrease. The incidence of pre-term delivery (9.49%) was much less in normal BMI range. The average infant birth weight observed in underweight women was 2.63 ± 0.47, in normal was 2.9 ± 0.49, in overweight was 2.92 ± 0.56 and in obese was 2.95 ± 0.86. It is observed that highest birth weight is obtained in obese women, which decreases as the maternal BMI range decreases. The incidence of LBW in normal and overweight women was 15.33 and 16.67%, which was low as compared to obese and underweight women. Our study reveals that parameters such as GWG, type of family, intake of milk, fruits and junk food, haemoglobin concentration directly affects the pregnancy outcomes such as term of delivery, type of delivery and infant birth weight.

scholarly journals Pregnancy outcomes in women with excessive gestational weight gain in Dschang health district of Cameroon

2021 ◽  
Vol 7 (4) ◽  
pp. 239
Author(s):  
Skinner Lekelem Nguefack ◽  
Jackson Jr Ndenkeh ◽  
Cavin Bekolo ◽  
Bruno Kenfack
Keyword(s):  
Weight Gain ◽  
Pregnant Women ◽  
Gestational Weight Gain ◽  
Pregnancy Outcomes ◽  
Genital Tract ◽  
Health District ◽  
P Value ◽  
Prolonged Labour ◽  
Gestational Weight ◽  
Excessive Gestational Weight Gain

<p class="abstract"><strong>Background:</strong> Excessive gestational weight gain (EGWG) during pregnancy can lead to adverse outcomes for the mother and/or the new-born. The aim of the study was to determine the prevalence of EGWG as well as its effect on pregnancy outcomes amongst pregnant women at the health district of Dschang in Cameroon.  </p><p class="abstract"><strong>Methods:</strong> This was a cross sectional study conducted from January to June 2019 and targeting all consenting pregnant women in Dschang District Hospital. They were administered a prepared questionnaire followed by their body mass index measurements for times at the beginning and the end of gestation to measure GWG. Logistic regression was used to determine the association of the EGWG to some particular pregnancy outcomes, adjusting for other factors with significance set at 5%.   </p><p class="abstract"><strong>Results:</strong> A total of 400 women were included in this study with a mean age of 27±5years, 59.2% being married and 34.8% still being students. Also it was noted that 24.8% of these women were obese while 25.3% had EGWG. Furthermore, EGWG was independently associated to prolonged labour (aOR=2.4; CI: 1.3-4.6; p value=0.007), genital tract laceration (aOR=2.0; CI: 1.0-3.8; p value=0.036) and foetal macrosomia (aOR=7.3; CI: 3.5-15.2; p value&lt;0.001).</p><p class="abstract"><strong>Conclusions:</strong> The prevalence of EGWG was high and it was associated with prolonged labour, genital tract laceration and foetal macrosomia. There is thus the need to improve the awareness of these women on EGWG as well as a constant follow up all through gestational period so as to regulate their GWG. The above measures will help to reduce occurrence of these complications, and consequently reduce maternal and neonatal mortality.</p><p class="abstract"> </p>

scholarly journals Exploring Pregnancy Outcomes Associated with SARS-CoV-2 Infection

Medicina ◽  
2021 ◽  
Vol 57 (8) ◽  
pp. 796
Author(s):  
Madalina Timircan ◽  
Felix Bratosin ◽  
Iulia Vidican ◽  
Oana Suciu ◽  
Livius Tirnea ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Significant Risk ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Potential Threat ◽  
Apgar Scores ◽  
Obstetrical Outcomes ◽  
Emergency Cesarean

Background and Objectives: The ongoing pandemic proved to be a tremendous challenge to all economic layers, healthcare, and people safety. As more than one year elapsed since the beginning of the COVID-19 pandemic, a multitude of medical studies involving the SARS-CoV-2 virus helped researchers and medical practitioners in understanding the effects it has on all sorts of patients until effective vaccines were finally developed and distributed for mass vaccination. Still, the SARS-CoV-2 and its new variants remain a potential threat towards all categories of patients, including a more delicate group represented by pregnant women. Thus, the current study aims to investigate the potential effects on obstetrical outcomes after a positive SARS-CoV-2 infection. Materials and Methods: This single-center prospective cohort study investigated the pregnancy outcomes in a total of 1039 eligible pregnant women between 30 August 2020 and 30 January 2021. Multiple patient characteristics and obstetrical outcomes were tested and analyzed in a multivariate regression model to establish potential risks determined by a COVID-19-positive pregnancy towards the mother and the newborn. Results: In the study sample, there were 938 pregnancies included without COVID-19 and 101 pregnant women identified with a positive COVID-19 infection. COVID-19 was significantly associated with a 2-fold increase in the risk of premature rupture of membranes and 1.5 times higher risk of preterm birth with emergency c-sections and lower APGAR scores. Also, significantly more newborns were given birth prematurely, with lower APGAR scores after the mothers were infected with SARS-CoV-2. Conclusions: A third-trimester infection with SARS-CoV-2 is a significant risk factor for preterm birth via an emergency cesarean section, a premature rupture of membranes, and a lower APGAR score in newborns, as compared with pregnancies where COVID-19 was not identified.

scholarly journals Association Between Iodine Nutritional Status and Adverse Pregnancy Outcomes in Beijing, China: a Single-Center Cohort Study

2021 ◽  
Author(s):  
Xiaomei Zhang ◽  
Ning Yuan ◽  
Jianbin Sun ◽  
Xin Zhao ◽  
Jing Du ◽  
...  
Keyword(s):  
Nutritional Status ◽  
Pregnant Women ◽  
Iodine Deficiency ◽  
Pregnancy Outcomes ◽  
First Trimester ◽  
Adverse Pregnancy Outcomes ◽  
Single Center ◽  
Iodine Level ◽  
Adverse Pregnancy ◽  
Beijing China

AbstractIodine is an essential trace element for humans and the main raw material for thyroid hormone synthesis. However, the association between iodine nutritional status and adverse pregnancy outcomes in different regions remains controversial. This single-center cohort study was focused on the association between iodine nutritional status and adverse pregnancy outcomes in Beijing, China. We enrolled 726 pregnant women who were registered at the Peking University International Hospital between February 2017 and December 2019. To analyze the association between iodine nutritional status variations and adverse pregnancy outcomes, this study cohort included 390 (53.72%) participants with iodine deficiency, 206 (28.37%) with an adequate iodine level, 103 (14.19%) with a more than adequate iodine level, and 27 (3.72%) with iodine excess, according to the urinary iodine (UI) status of pregnant women. After adjusting for age, body mass index, parity, and history of spontaneous abortion, we identified iodine deficiency as a risk factor for anti-thyroid peroxidase antibody (TPOAb) positivity [odds ratio (OR), 3.646; 95% confidence interval (95% CI), 1.658–8.017], anti-thyroglobulin antibody (TGAb) positivity (OR, 3.109; 95% CI, 1.465–6.599), and thyroid autoimmunity (OR, 2.885; 95% CI, 1.539–5.407). There was a non-linear relationship between UI and the concentrations of TPOAb and TGAb (Pnon-linear < 0.05). Iodine deficiency during the first trimester is a risk factor for thyroid autoantibody positivity. The relationship between UI and the concentrations of TPOAb and TGAb follows a nearly U-shaped curve. Thus, physicians should critically consider the iodine nutritional status of pregnant women during the first trimester. Clinical Trials.gov Identifier: NCT02966405

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