OP48 The impact of extreme maternal obesity on gestational age at delivery; a national study of births in England

2016 ◽  
Vol 70 (Suppl 1) ◽  
pp. A29.2-A30
Author(s):  
E Slack ◽  
KE Best ◽  
N Heslehurst ◽  
J Rankin
Keyword(s):  
Gestational Age ◽  
Maternal Obesity ◽  
National Study ◽  
Gestational Age At Delivery ◽  
The Impact

The Impact of Gestational Age at Delivery on Urologic Outcomes for the Fetus with Hydronephrosis

2016 ◽  
Vol 35 (6) ◽  
pp. 359-368 ◽  
Author(s):  
Tara Benjamin ◽  
Rhiannon R. Amodeo ◽  
Avinash S. Patil ◽  
Barrett K. Robinson
Keyword(s):  
Gestational Age ◽  
Gestational Age At Delivery ◽  
The Impact

Correlation between Clinical, Placental Histology and Microbiological Findings in Spontaneous Preterm Births

2015 ◽  
Vol 40 (2) ◽  
pp. 141-149 ◽  
Author(s):  
Gali Garmi ◽  
Marina Okopnik ◽  
Yoram Keness ◽  
Noah Zafran ◽  
Elad Berkowitz ◽  
...  
Keyword(s):  
Gestational Age ◽  
Neonatal Outcome ◽  
Preterm Births ◽  
Neonatal Morbidity ◽  
Spontaneous Preterm Birth ◽  
Retrospective Case ◽  
Delivery Methods ◽  
Main Determinant ◽  
Gestational Age At Delivery ◽  
The Impact

Aims: To examine the occurrence of chorioamnionitis and abruption among women who had a spontaneous preterm birth (SPTB), the correlation between clinical and placental findings, and the impact of these complications on neonatal outcome after delivery. Methods: This was a retrospective case-control study conducted between 2008 and 2012 at a single teaching hospital. The study group included all women who had an SPTB (23-36 weeks). Placentas were cultured and underwent histological examination. Results: A total of 478 women were included. The mean gestational age at delivery was 32.6 ± 3.1 weeks. Overall, 260 (54.4%) women had either clinical and/or histological abruption or chorioamnionitis. Clinical chorioamnionitis was diagnosed before birth in 14 (2.9%) women, while histological chorioamnionitis (HCA) in 84 (17.4%). Overall, 38 neonates had infection. Placental cultures were negative in 65.8% (25/38) of these neonates, and in 77.1% (27/38), HCA was ruled out. Logistic regression analysis revealed that neonatal morbidity and mortality were correlated with gestational age at delivery (p = 0.02), not with placental pathology (p = 0.08). Conclusions: Half of the women with PTB had clinical or histological abruption, chorioamnionitis or both. A partial correlation was found between clinical and placental findings. The main determinant of neonatal outcome was gestational age at delivery and not placental findings.

scholarly journals Maternal obesity classes, preterm and post-term birth: a retrospective analysis of 479,864 births in England

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Emma Slack ◽  
Kate E. Best ◽  
Judith Rankin ◽  
Nicola Heslehurst
Keyword(s):  
Preterm Birth ◽  
Retrospective Analysis ◽  
Gestational Age ◽  
Maternal Obesity ◽  
Absolute Risk ◽  
Full Term ◽  
Effect Sizes ◽  
Term Birth ◽  
Gestational Age At Delivery ◽  
Maternal Bmi

Abstract Background Preterm (< 37 weeks gestation) and post–term birth (≥42 weeks gestation) are associated with increased morbidity and mortality for mother and infant. Obesity (body mass index (BMI) ≥30 kg/m2) is increasing in women of reproductive age. Maternal obesity has been associated with adverse pregnancy outcomes including preterm and post–term birth. However, the effect sizes vary according to the subgroups of both maternal BMI and gestational age considered. The aim of this retrospective analysis was to determine the association between maternal obesity classes and gestational age at delivery. Methods A secondary data analysis of 13 maternity units in England with information on 479,864 singleton live births between 1990 and 2007. BMI categories were: underweight (< 18.5 kg/m2), recommended weight (18.5–24.9 kg/m2), overweight (25.0–29.9 kg/m2) and obesity classes I (30.0–34.9 kg/m2), II (35.0–39.9 kg/m2), IIIa (40–49.9 kg/m2) and IIIb (≥50 kg/m2). Gestational age at delivery categories were: Gestational age at delivery (weeks): extreme preterm (20–27), very preterm (28–31), moderately preterm (32–36), early term (37, 38), full term (39–40), late term (41) and post–term (≥42). The adjusted odds of births in each gestational age category (compared to full-term birth), according to maternal BMI categories were estimated using multinomial logistic regression. Missing data were estimated using multiple imputation with chained equations. Results There was a J-shaped association between the absolute risk of extreme, very and moderate preterm birth and BMI category, with the greatest effect size for extreme preterm. The absolute risk of post-term birth increased monotonically as BMI category increased. The largest effect sizes were observed for class IIIb obesity and extreme preterm birth (adjusted OR 2.80, 95% CI 1.31–5.98). Conclusion Women with class IIIb obesity have the greatest risks for inadequate gestational age. Combining obesity classes does not accurately represent risks for many women as it overestimates the risk of all preterm and post-term categories for women with class I obesity, and underestimates the risk for women in all other obesity classes.

scholarly journals Small for Gestational Age Births, Gestational Age, and Labour Outcomes: A Population-Based Study in the US

2021 ◽  
Author(s):  
Justin Brandt ◽  
Cande Ananth (STATS CONSULTS ONLY)
Keyword(s):  
Gestational Age ◽  
Small For Gestational Age ◽  
Caesarean Delivery ◽  
Decomposition Analysis ◽  
Excess Risk ◽  
Cross Sectional ◽  
Increased Risk ◽  
The Us ◽  
Gestational Age At Delivery ◽  
The Impact

Objective: To estimate the causal impact of small for gestational age (SGA) births on caesarean delivery, with and without trial of labour (TOL); and to quantify how much of the association is mediated through gestational age at delivery. Design: Cross-sectional analysis. Setting: Para 2 women who delivered non-anomalous, singleton live births from 22-44 weeks’ gestation in the US (2015-2018). Main outcomes and measures: Caesarean delivery with and without TOL. The exposure was SGA births (sex-specific birthweight <5th and <3rd percentiles for gestational age), and AGA births (10-89th percentile). We performed causal mediation analysis to determine the impact of gestational age at delivery (22-33, 34-36, 37-38, 39-40 and ≥41 weeks) as intermediate. Results: Of the 3,755,798 subjects, compared to AGA (29.6%), caesarean risks were higher for SGA <5th (34.3%) and SGA <3rd (36.4%) percentiles. For SGA <5th percentile, the adjusted excess risk of caesarean delivery without TOL had a “U” shaped association, with increased risk at preterm gestations, nadir at 39-40 weeks, and increased thereafter. The decomposition analysis revealed the driver of this excess risk was SGA births. The risk of caesarean delivery with TOL was highest <34 weeks’ gestation and was primarily an interaction effect. As gestation advanced, SGA births contributed proportionately greater to the risk. Associations were stronger for SGA <3rd percentile. Conclusions: Exposure to SGA drives high rates of prelabour caesareans and contributes to high risks of caesarean deliveries after TOL at >41 weeks gestation; a different mechanism drives high rates of caesareans after TOL at preterm gestations.

scholarly journals Clinical outcomes among pregnant patients with cardiac disease only and those with co-existing pregnancy-associated hypertension

2018 ◽  
Vol 7 (8) ◽  
pp. 3288
Author(s):  
Karishma Gupta ◽  
Arthika Shetty ◽  
Madhva Prasad ◽  
Alka S. Gupta
Keyword(s):  
Heart Disease ◽  
Clinical Outcomes ◽  
Gestational Age ◽  
Cardiac Disease ◽  
Severe Hypertension ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Gestational Age At Delivery ◽  
The Impact ◽  
Control Study

Background: Impact of cardiac disease on pregnancy is significant. Impact of hypertension on pregnancy is also significant. “Does occurrence of hypertension along with cardiac disease worsen the outcomes?” forms the crux of this study. The aim of the present study was to determine the impact of pregnancy-associated hypertension on the clinical outcomes of pregnant patients with cardiac disease.Methods: Retrospective, observational, comparative, case control study of one and half year duration conducted in a tertiary care referral hospital. The various medical and obstetric parameters were studied and compared.Results: Among 143 patients studied, 36 were hypertensive and 107 were non-hypertensive. Non-severe hypertension was seen in 17%, severe hypertension in 4% and eclampsia in 4%. Average age was 26 years and majority were first or second gravida. Valvular heart disease was the most common cardiac disease encountered. Gestational age at delivery, perinatal outcome and occurrence of pulmonary hypertension were all similar in both the hypertensive and non-hypertensive groups.  The most common mode of delivery was vaginal delivery. The cesarean section rate was 29% and was similar among both hypertensive and non-hypertensive groups. Requirement for induction of labor, occurrence of small-for- gestational age among the newborns, intensive care unit admission due to heart failure and maternal death was higher (statistically significant (p<0.05) among the hypertensive group.Conclusions: Presence of hypertension worsens outcomes among pregnant patients with cardiac disease. The coexistence of hypertension and cardiac disease should alert the obstetrician and specialist physician towards a more vigilant management. The findings of this study may help risk stratification (development of pregnancy associated hypertension) while counseling patients with heart disease. 

The impact of maternal obesity on fetal adiposity in the third trimester

2010 ◽  
Vol 95 (Supplement 1) ◽  
pp. Fa25-Fa25
Author(s):  
N. Farah ◽  
M. Kennelly ◽  
V. Donnelly ◽  
B. Stuart ◽  
M. Turner
Keyword(s):  
Maternal Obesity ◽  
Third Trimester ◽  
The Third ◽  
The Impact

scholarly journals EFFECT OF ADVERSE CHILDHOOD EXPERIENCES ON DAILY SUPPORT TO FAMILY AND EMOTIONAL WELL-BEING IN ADULTHOOD

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S235-S235
Author(s):  
Jooyoung Kong ◽  
Yin Liu ◽  
David Almeida
Keyword(s):  
Negative Affect ◽  
Family Relationships ◽  
Emotional Support ◽  
Adverse Childhood Experiences ◽  
Family Members ◽  
Well Being ◽  
National Study ◽  
Childhood Experiences ◽  
Adverse Childhood ◽  
The Impact

Abstract Extensive evidence suggests that adverse childhood experiences (ACEs) can lead to negative health effects across a lifetime. This study examines the impact of ACEs on the frequency of providing daily support (i.e., unpaid assistance, emotional support, and disability-related assistance) to family members and the moderating effects of ACEs in the association between providing daily support to family and daily negative affect. Using the National Study of Daily Experiences II, we analyzed a total of 14,912 daily interviews from 2,022 respondents aged 56 on average. Key results showed that a greater number of ACEs were associated with providing more frequent emotional support to family. We also found the significant interaction effect that adults with more ACEs showed greater negative affect on the days when they provided assistance to family members with disabilities. The findings underscore the long-term negative impact of ACEs on daily well-being in the context of family relationships.

scholarly journals Ovarian Dysgerminoma in Pregnant Women with Viable Fetus: A Rare Case Report

2021 ◽  
pp. 141-146
Author(s):  
Reda Youssef ◽  
Gamal Sayed Ahmed ◽  
Samir Alhyassat ◽  
Sanaa Badr ◽  
Ahmed Sabry ◽  
...  
Keyword(s):  
Gestational Age ◽  
Ovarian Neoplasms ◽  
Imaging Modality ◽  
Reproductive Age ◽  
Diagnostic Challenge ◽  
Short Period ◽  
Ovarian Dysgerminoma ◽  
The Impact ◽  
In Pregnancy

Dysgerminoma is an uncommon malignant tumor arising from the germ cells of the ovary. Its association with pregnancy is extremely rare, with a reported incidence of about 0.2–1 per 100,000 pregnancies. Women in the reproductive age group are more commonly affected. It can be extremely rare to conceive naturally, without assisted reproductive interventions, in cases with ovarian dysgerminoma. If a pregnancy does occur with a concurrent dysgerminoma, it is even more unusual to carry the pregnancy to viability or childbirth without fetal or maternal compromise. We report a case of right ovarian dysgerminoma in a young female with a viable intrauterine pregnancy at 10 weeks, which is rarely diagnosed and managed at this gestational age. Numerous factors played a role in her favorable outcome, including early suspicion by ultrasound and presenting history, surgery, histopathological assessment, imaging, and involvement of the multidisciplinary oncology team. Ovarian neoplasms may rapidly increase in size within a short period with little or no symptoms. This poses a diagnostic challenge for obstetricians and oncologists. Hence, we aimed to evaluate the role of imaging in pregnancy using ultrasound as an imaging modality for both early detection of ovarian neoplasms and for follow-up. In conclusion, patients with ovarian dysgerminoma in pregnancy can have favorable outcomes. Treatment should be individualized on a case-to-case basis, depending on many factors; cancer stage, previous reproductive history, the impact of imaging in staging or follow-up of tumor on the fetus, fetal gestational age, and whether termination of the pregnancy can improve survival or morbidity for the mother.

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