scholarly journals Maternal Characteristics and Temporal Trends in Birth Outcomes: Comparison between Spanish and Migrant Mothers

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Carlos Varea ◽  
Cristina Bernis ◽  
Antonio González González
Keyword(s):  
Birth Weight ◽  
Caesarean Section ◽  
Low Birth Weight ◽  
Birth Outcomes ◽  
Common Factor ◽  
Mode Of Delivery ◽  
Temporal Trends ◽  
Medical Intervention ◽  
Future Research ◽  
Reproductive Pattern

Low birth weight and preterm babies have been increasing in Spain since 1980, coinciding with important changes in the social and demographic structure of childbearing populations—including the contribution of a 25% of foreign mothers—and with increasing medical intervention in births. This study, based on 5,990,613 births, compares the temporary trends in reproductive patterns and birth outcomes in Spanish and foreign mothers during the period 1996–2009 and evaluates for the years 2007 to 2009 the relative contribution of mother's origin and Caesarean section to birth weight variability. Foreign mothers maintain their own reproductive pattern, whereas negative birth outcomes increase in all groups. Results from logistic regression analysis show that besides late maternity and primiparity also Caesarean section increases the risk for low birth weight. The reduction in Caesarean section rates between 2007 and 2009 might explain the reduction of low birth weight detected. A change of tendency simultaneously appears in most maternal and newborn characteristics, and in the mode of delivery in all ethnic groups since 2008. Coincidence in the timing of the change of trends points to a common factor. We suggest that the current world financial crisis could be this common cause, a hypothesis to be contrasted in future research.

scholarly journals Pregnancy-associated cancers and birth outcomes in children: a Danish and Swedish population-based register study

BMJ Open ◽  
2018 ◽  
Vol 8 (12) ◽  
pp. e022946 ◽  
Author(s):  
Natalie C Momen ◽  
Linn Håkonsen Arendt ◽  
Andreas Ernst ◽  
Jørn Olsen ◽  
Jiong Li ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Birth Weight ◽  
Caesarean Section ◽  
Low Birth Weight ◽  
Birth Outcomes ◽  
Gestational Age ◽  
Apgar Score ◽  
Population Based ◽  
Register Study ◽  
Adverse Birth Outcomes

ObjectivesThis study aims to estimate the association between pregnancy-associated maternal cancers, diagnosed both prenatally and postnatally, and birth outcomes.DesignPopulation-based register study.SettingNational registers of Denmark and Sweden.ParticipantsA total of 5 523 365 children born in Denmark (1977–2008) and Sweden (1973–2006).Primary and secondary outcome measures: gestational age, birth weight, size for gestational age, Apgar score, caesarean section and sex were the outcomes of interest. ORs and relative risk ratios (RRR) with 95% CIs were estimated using logistic regression and multinomial logistic regression, respectively.ResultsIn this study, 2% of children were born to mothers with a diagnosis of cancer. Children whose mothers received a prenatal cancer diagnosis had higher risk of being born preterm (RRR: 1.77, 95% CI 1.64 to 1.90); low birth weight (RRR 1.84, 95% CI 1.69 to 2.01); low Apgar score (OR 1.36, 95% CI 1.20 to 1.56); and by caesarean section (OR: 1.69, 95% CI 1.59 to 1.80). Associations moved towards the null for analyses using postnatal diagnoses, but preterm birth (RRR: 1.13, 95% CI 1.09 to 1.17) and low birth weight (RRR: 1.14, 95% CI 1.09 to 1.18) remained statistically significant, while risk of caesarean section became so (OR: 0.95, 95% CI 0.91 to 0.98). Additionally, statistical significance was reached for large for gestational age (RRR: 1.06, 95% CI 1.01 to 1.11), high birth weight (RRR: 1.04, 95% CI 1.01 to 1.06) and caesarean section (OR: 0.95, 95% CI 0.91 to 0.98).ConclusionsResults suggest an association between pregnancy-associated cancers and adverse birth outcomes in the offspring. While this is strongest for prenatally diagnosed cancers, some smaller associations exist for postnatally diagnosed cancers, indicating that cancer itself could affect fetal development, or that cancer and adverse birth outcomes share risk factors. Future studies on maternal cancer during pregnancy should consider including some postnatal years in their exposure window.

scholarly journals Comparative study of early neonatal outcome in low birth weight babies in hypertensive disorders complicating pregnancies with the mode of delivery

2021 ◽  
Vol 8 (3) ◽  
pp. 339-345
Author(s):  
Sivajyothi Pilli ◽  
Kavitha Bakshi
Keyword(s):  
Birth Weight ◽  
Caesarean Section ◽  
Low Birth Weight ◽  
Vaginal Delivery ◽  
Caesarean Delivery ◽  
Neonatal Outcome ◽  
Mode Of Delivery ◽  
Survival Advantage ◽  
Hypertensive Disorders ◽  
Significant Difference

Pregnancy induced Hypertension (PIH) is strongly associated with intrauterine fetal growth restriction (IUGR), low birth weight (LBW) and admission to NICU. PIH is not by itself an indication for caesarean delivery. However, the incidence of caesarean is high because of the development of complications in mother and the need to deliver prematurely. To compare the immediate morbidity and survival advantage of LBW vertex presenting babies with the mode of delivery in hypertensive disorders complicating pregnancies. This was a comparative cross-sectional study done on women admitted to the labour ward during the study period with PIH delivering a baby through either a vaginal delivery or a caesarean section with a birthweight of <2.5kgs. A detailed history taking and clinical examination was done. Babies were followed up for one week following delivery to note down the early neonatal outcome. In this study, over all there was no statistically significant difference in neonatal outcome in both vaginal delivery and caesarean section groups. However, there was slight increased incidence of prematurity (68% vs 64%), Birth Asphyxia (14% vs 8%), Sepsis (8% vs 6%), IVH (6% vs 2%) and Hyperbilirubinemia (16% vs 14%) in vaginal delivery group. While, RDS (20% vs 14%) and NEC (4% vs 2%) had higher incidence in caesarean delivery group. Overall, prematurity and IUGR resulting in LBW, contributed to these neonatal complications. Caesarean delivery offers no short-term survival advantage compared with vaginal delivery for LBW vertex presenting foetuses in PIH patients. Neonatal outcomes are not worsened by spontaneous or induced vaginal delivery in women with hypertension with good control and also decreases morbidity due to caesarean section to the mother.

scholarly journals Pregnancy outcome and delivery in Spanish and migrant women: an ecological approach

2013 ◽  
Vol 76 (2) ◽  
pp. 129-150 ◽  
Author(s):  
Cristina Bernis ◽  
Carlos Varea
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Ethnic Differences ◽  
Gestational Age ◽  
Birth Outcome ◽  
Descriptive Analysis ◽  
Mode Of Delivery ◽  
Medical Intervention ◽  
Secular Trends ◽  
Ethnic Variability

Abstract For most of our history as a species, maternal constraint was the main environmental factor affecting biological status at birth. However, the great increase in medical intervention in the20th Century coincided first with an extraordinary reduction in perinatal mortality and later with an increase in preterm and low birth-weight babies. Herein, we analyze these temporary trends in neonate biology in Spain, according to early viability (1980-2010) and ethnic variability (1996-2010). The aim of this study is to evaluate the interaction between maternal and medical environmental constraints affecting the biology of birth and to understand the observed ethnic differences and secular trends. All single births in Spain between 1980 and 2010 are included. Following descriptive analysis, logistic regression analysis was applied to evaluate the effect of secular trends, mode of delivery and mother’s origin on birth outcome after adjustment for other maternal bio-cultural factors. Results highlighted that mean birth weight decreased and prematurity increased in still births, live births and deaths before one day. In regard to ethnic differences, while there were no secular trends in weight by gestational age in the Spanish newborns, there was an increase among the newborns of foreign mothers. Spanish mothers experienced an increasing and higher frequency of low birth weight, while foreigners had an increasing and higher frequency of prematurity. Both groups, however, shared temporal reduction in gestational age, and although this was less marked in foreigners, it suggests a common trend related to medical care and increasing obstetric interventions

scholarly journals Mass incarceration and public health: the association between black jail incarceration and adverse birth outcomes among black women in Louisiana

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Lauren Dyer ◽  
Rachel Hardeman ◽  
Dovile Vilda ◽  
Katherine Theall ◽  
Maeve Wallace
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Black Women ◽  
Low Birth Weight ◽  
Racial Disparities ◽  
Population Health ◽  
Birth Outcomes ◽  
Mass Incarceration ◽  
Interquartile Range ◽  
Adverse Birth Outcomes

Abstract Background A growing body of evidence is beginning to highlight how mass incarceration shapes inequalities in population health. Non-Hispanic blacks are disproportionately affected by incarceration and criminal law enforcement, an enduring legacy of a racially-biased criminal justice system with broad health implications for black families and communities. Louisiana has consistently maintained one of the highest rates of black incarceration in the nation. Concurrently, large racial disparities in population health persist. Methods We conducted a cross-sectional analysis of all births among non-Hispanic black women in Louisiana in 2014 to identify associations between parish-level (county equivalent) prevalence of jail incarceration within the black population and adverse birth outcomes (N = 23,954). We fit a log-Poisson model with generalized estimating equations to approximate the relative risk of preterm birth and low birth weight associated with an interquartile range increase in incarceration, controlling for confounders. In sensitivity analyses, we additionally adjusted for the parish-level index crime prevalence and analyzed regression models wherein white incarceration was used to predict the risk of adverse birth outcomes in order to quantify the degree to which mass incarceration may harm health above and beyond living in a high crime area. Results There was a significant 3% higher risk of preterm birth among black women associated with an interquartile range increase in the parish-level incarceration prevalence of black individuals, independent of other factors. Adjusting for the prevalence of index crimes did not substantively change the results of the models. Conclusion Due to the positive significant associations between the prevalence of black individuals incarcerated in Louisiana jails and estimated risk of preterm birth, mass incarceration may be an underlying cause of the persistent inequities in reproductive health outcomes experienced by black women in Louisiana. Not only are there economic and social impacts stemming from mass incarceration, but there may also be implications for population health and health inequities, including the persistence of racial disparities in preterm birth and low birth weight.

scholarly journals Characterizing dynamics of serum creatinine and creatinine clearance in extremely low birth weight neonates during the first 6 weeks of life

2020 ◽  
Author(s):  
Tamara van Donge ◽  
Karel Allegaert ◽  
Verena Gotta ◽  
Anne Smits ◽  
Elena Levtchenko ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Serum Creatinine ◽  
Creatinine Clearance ◽  
Mode Of Delivery ◽  
Extremely Low Birth Weight ◽  
Reference Ranges ◽  
Mixed Effect ◽  
Postnatal Maturation ◽  
Elbw Neonates

Abstract Background Characterizing the dynamics of serum creatinine concentrations (Scr) and associated creatinine clearance (CLcr) as a measure of kidney function in extremely low birth weight (≤ 1000 g; ELBW) neonates remains challenging. Methods We performed a retrospective study that included longitudinal Scr (enzymatic assay) data from 148 ELBW neonates up to 6 weeks after birth. Change of Scr and inter-individual variability was characterized with nonlinear mixed-effect modeling. Key covariates such as gestational age (GA), mode of delivery (MOD), and treatment with ibuprofen or inotropic agents were investigated. Results A total of 2814 Scr concentrations were analyzed. GA was associated with Scr at birth (higher with advancing GA), and GA and MOD showed an association with postnatal maturation of CLcr (faster clearance increase with advancing GA and after C-section). Small CLcr decrease (≤ 5%) was quantified during ibuprofen treatment. For a GA of 27 weeks, mean Scr (estimated CLcr) at birth was 0.61 mg/dl (0.23 ml/min), increasing to 0.87 mg/dl (0.27 ml/min) at day three, and decreasing to 0.36 mg/dl (0.67 ml/min) at day 42 after birth. Conclusions We report the first mathematical model able to characterize Scr and CLcr in ELBW neonates during the first 6 weeks of life in a quantitative manner as a function of GA, MOD, and ibuprofen treatment. This model allows the derivation of GA-adjusted reference ranges for ELBW neonates and provides a rationale for normative Scr concentrations, and as such will help clinicians to further optimize monitoring and treatment decisions in this vulnerable patient population.

scholarly journals Changes in pregnancy outcomes during the COVID-19 lockdown in Iran

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fahimeh Ranjbar ◽  
Leila Allahqoli ◽  
Soheila Ahmadi ◽  
Robab Mousavi ◽  
Maryam Gharacheh ◽  
...  
Keyword(s):  
Health Care ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Health Care Services ◽  
Mode Of Delivery ◽  
Preterm Births ◽  
Future Health ◽  
Significant Difference

Abstract Background The Covid-19 pandemic response is influencing maternal and neonatal health care services especially in developing countries. However, the indirect effects of Covid-19 on pregnancy outcomes remain unknown. The aim of the present study was to compare pregnancy outcomes before and after the beginning of the Covid-19 pandemic in Iran. Methods We performed a retrospective analysis of the medical records of 2,503 pregnant women with singleton pregnancies, admitted to the maternity department of a women’s hospital in Tehran, Iran, during the pre-Covid-19 pandemic (February 19 to April 19, 2019) and the intra-Covid- 19 pandemic (February 19 to April 19, 2020) period. Results We included 2,503 women admitted to the hospital; 1,287 (51.4 %) were admitted before the Covid-19 lockdown and 1,216 (48.6 %) during the Covid-19 lockdown. There were no significant differences in stillbirth rates (p = 0.584) or pregnancy complications (including preeclampsia, pregnancy-induced hypertension and gestational diabetes) (p = 0.115) between pregnant women in the pre- and intra-pandemic periods. However, decreases in preterm births (p = 0.001), and low birth weight (p = 0.005) were observed in the pandemic period compared to the pre-pandemic period. No significant difference in the mode of delivery, and no maternal deaths were observed during the two time periods. Conclusions In our study we observed a decrease in preterm births and low birth weight, no change in stillbirths, and a rise in the admission rates of mothers to the ICU during the initial Covid-19 lockdown period compared to pre-Covid-19 lockdown period. Further research will be needed to devise plan for immediate post-pandemic care and future health care crises.

scholarly journals Mode of delivery and other risk factors for Escherichia coli infections in very low birth weight infants

2014 ◽  
Vol 14 (1) ◽  
Author(s):  
Agnieszka Chmielarczyk ◽  
Jadwiga Wójkowska-Mach ◽  
Dorota Romaniszyn ◽  
Paweł Adamski ◽  
Ewa Helwich ◽  
...  
Keyword(s):  
Risk Factors ◽  
Escherichia Coli ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Very Low Birth Weight ◽  
Mode Of Delivery ◽  
Low Birth Weight Infants

Regional Birth Outcomes after the 2011 Great East Japan Earthquake and Tsunami in Miyagi Prefecture

2018 ◽  
Vol 33 (2) ◽  
pp. 215-219 ◽  
Author(s):  
Junichi Sugawara ◽  
Noriyuki Iwama ◽  
Tetsuro Hoshiai ◽  
Hideki Tokunaga ◽  
Hidekazu Nishigori ◽  
...  
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Risk Analysis ◽  
Birth Outcomes ◽  
Birth Rate ◽  
Great East Japan Earthquake ◽  
Miyagi Prefecture ◽  
Preterm Birth Rate ◽  
Regional Risk Analysis

AbstractObjectivesThis study was aimed to analyze post-disaster birth outcomes in coastal and inland regions of Miyagi Prefecture, Japan.MethodsPrimary data sets were compiled from birth records of obstetric facilities and 12,808 patients were analyzed for baseline birth outcomes by region. Regional risk analysis of the low-birth-weight rate and premature birth rate were conducted using multi-level logistic regression analysis.ResultsFrom overall baseline birth outcomes, a preterm birth rate was 4.6% and low-birth-weight rate was 8.8%. Regional analysis revealed that a preterm birth rate was 3.2% (coastal) and 5.0% (inland), respectively, and the rate of low birth weight was 6.5% in the coastal and 8.5% in the inland region. In the risk analysis of low-birth-weight rate and preterm birth rate, the risk in the coastal region could not be considered any higher than in the inland region (adjusted odds ratio 0.91 [0.73-1.14] and 0.85 [0.46-1.59], respectively).ConclusionsThe incidence of preterm birth and low birth weight were not adversely affected by the disaster. Early transfer and intensive medical intervention may have led to those findings. Further survey will be necessary to determine the long-term effects in both mothers and children.SugawaraJ, IwamaN, HoshiaiT, TokunagaH, NishigoriH, MetokiH, OkamuraK, YaegashiN. Regional birth outcomes after the 2011 Great East Japan Earthquake and tsunami in Miyagi Prefecture. Prehosp Disaster Med. 2018;33(2):215–219.

scholarly journals Paternal age and the risk of low birth weight and preterm delivery: a Finnish register-based study

2018 ◽  
Vol 72 (12) ◽  
pp. 1104-1109 ◽  
Author(s):  
Alice Goisis ◽  
Hanna Remes ◽  
Kieron Barclay ◽  
Pekka Martikainen ◽  
Mikko Myrskylä
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Preterm Delivery ◽  
Birth Outcomes ◽  
Conclusive Evidence ◽  
Paternal Age ◽  
Adverse Birth Outcomes ◽  
Maternal Characteristics ◽  
Parental Characteristics ◽  
Increased Risk

BackgroundBased on existing studies, there is no conclusive evidence as to whether and why paternal age matters for birth outcomes.MethodsWe used Finnish population registers on 106 652 children born 1987–2000. We first document the unadjusted association between paternal age and the risk of low birth weight (LBW; <2500 g) and preterm birth (<37 weeks’ gestation). Second, we investigate whether the unadjusted association is attenuated on adjustment for child’s, maternal and parental socioeconomic characteristics. Third, by adopting a within-family design which involves comparing children born to the same father at different ages, we additionally adjust for unobserved parental characteristics shared between siblings.ResultsThe unadjusted results show that being born to a father aged 40+, as opposed to a father aged 30–34, is associated with an increased risk of LBW of 0.96% (95% CI 0.5% to 1.3%) and to a younger father (<25) with a 1% (95% CI 0.6% to 1.3%) increased risk. The increased risk at younger paternal ages is halved on adjustment for the child’s characteristics and fully attenuated on adjustment for child/parental characteristics. The increased risk at paternal ages 40+ is partially attenuated on adjustment for maternal characteristics (β=0.62%; 95% CI 0.13% to 1.1%). Adjustment for unobserved parental characteristics shared by siblings further attenuates the 40+ coefficient (β=0.4%; 95% CI −0.5% to −1.2%). Results for preterm delivery are similar.ConclusionsThe results underscore the importance of considering paternal age as a potential risk factor for adverse birth outcomes and of expanding research on its role and the mechanisms linking it to birth outcomes.

Association of US state policy orientation with adverse birth outcomes: a longitudinal analysis

2021 ◽  
pp. jech-2020-214858
Author(s):  
Alicia R Riley ◽  
Daniel Collin ◽  
Jacob M Grumbach ◽  
Jacqueline M Torres ◽  
Rita Hamad
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Birth Outcomes ◽  
State Policy ◽  
Fixed Effects ◽  
State Policies ◽  
Adverse Birth Outcomes ◽  
Lower Odds ◽  
Policy Orientation

BackgroundThe current US context is marked by extreme right–left partisanship, which means that state policies tend to bundle together and are not experienced in isolation. While prior work has leveraged abrupt shifts in single policies to examine the effects of state policy on birth outcomes, we examined a holistic measure that captures political polarisation.MethodsData were drawn from national birth certificates for 2003–2017 (N=56 770 470). Outcomes included preterm birth, low birth weight, small-for-gestational age and other perinatal health measures. The primary exposure was a composite index of right–left state policy orientation, generated from historical data on 135 state policies. Multivariable regressions were used to estimate the association between state policy orientation and each outcome, adjusting for relevant covariates.ResultsCompared with infants born in states with right-leaning policy orientations, those born in left-leaning states had lower odds of adverse birth outcomes (eg, low birth weight: OR 0.95 (0.93, 0.97), preterm birth: OR 0.94 (0.92, 0.95)). Subgroup analyses revealed stronger associations for US-born and White mothers. With the inclusion of state fixed effects, left-leaning policy orientation was no longer associated with lower odds of adverse birth outcomes. Models were otherwise robust to alternative specifications.ConclusionWhile left-leaning state policy orientation has protective associations with a range of birth outcomes, the associations may be explained by stable characteristics of states, at least during the study period. Future studies should examine state policy orientation in association with other health outcomes and study periods.

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