scholarly journals The Effect of Cotrimoxazole Prophylactic Treatment on Malaria, Birth Outcomes, and Postpartum CD4 Count in HIV-Infected Women

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Anna Dow ◽  
Dumbani Kayira ◽  
Michael G. Hudgens ◽  
Annelies Van Rie ◽  
Caroline C. King ◽  
...  
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Pregnant Women ◽  
Prophylactic Treatment ◽  
Proportional Hazards ◽  
Preventive Therapy ◽  
Hazard Ratio ◽  
Cd4 Count ◽  
Malaria During Pregnancy

Background. Limited data exist on cotrimoxazole prophylactic treatment (CPT) in pregnant women, including protection against malaria versus standard intermittent preventive therapy with sulfadoxine-pyrimethamine (IPTp).Methods. Using observational data we examined the effect of CPT in HIV-infected pregnant women on malaria during pregnancy, low birth weight and preterm birth using proportional hazards, logistic, and log binomial regression, respectively. We used linear regression to assess effect of CPT on CD4 count.Results. Data from 468 CPT-exposed and 768 CPT-unexposed women were analyzed. CPT was associated with protection against malaria versus IPTp (hazard ratio: 0.35, 95% Confidence Interval (CI): 0.20, 0.60). After adjustment for time period this effect was not statistically significant (adjusted hazard ratio: 0.66, 95% CI: 0.28, 1.52). Among women receiving and not receiving CPT, rates of low birth weight (7.1% versus 7.6%) and preterm birth (23.5% versus 23.6%) were similar. CPT was associated with lower CD4 counts 24 weeks postpartum in women receiving (−77.6 cells/μL, 95% CI: −125.2, −30.1) and not receiving antiretrovirals (−33.7 cells/μL, 95% CI: −58.6, −8.8).Conclusions. Compared to IPTp, CPT provided comparable protection against malaria in HIV-infected pregnant women and against preterm birth or low birth weight. Possible implications of CPT-associated lower CD4 postpartum warrant further examination.

Advanced Maternal Age and Adverse Maternal and Neonatal Outcomes in Pregnant Women

2020 ◽  
Vol 16 ◽  
Author(s):  
Reza Omani-Samani ◽  
Saman Maroufizadeh ◽  
Nafise Saedi ◽  
Nasim Shokouhi ◽  
Arezoo Esmailzadeh ◽  
...  
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Cesarean Section ◽  
Pregnant Women ◽  
Maternal Age ◽  
Unwanted Pregnancy ◽  
Advanced Maternal Age ◽  
Neonatal Outcomes ◽  
Maternal And Neonatal Outcomes

Background: Advanced maternal age is an important predictor for maternal and neonatal outcomes such as maternal mortality, low birth weight, stillbirth, preterm birth, cesarean section and preeclampsia. Objective: To determine the association of advanced maternal age and adverse maternal and neonatal outcomes in Iranian pregnant women. Methods: In this hospital-based cross-sectional study, 5117 pregnant women from 103 hospitals in Tehran, Iran, were participated in the study in 2015. The required data were gathered from hospitals which equipped to the department of obstetrics and gynecology. Advanced maternal age was considered as an independent variable and unwanted pregnancy, preeclampsia, preterm birth, cesarean section and low birth weight were considered as interested outcomes. Results: In our study, the prevalence of advanced maternal age was 12.08%. Advanced maternal age was significantly associated with higher risk of unwanted pregnancy (OR: 1.39, 95% CI: 1.12-1.73), preterm birth (OR: 1.75, 95% CI: 1.28- 2.39) and cesarean section (OR: 1.34, 95% CI: 1.03-1.74). In our study, there was no significant relationship between advanced maternal age and preeclampsia but this relationship could be clinically important (OR: 1.48, 95% CI: 0.99-2.20, P=0.052), and there is no significant relationship between advanced maternal age and low birth weight (OR: 1.08, 95% CI: 0.67-1.74, P=0.736). Conclusion: Advanced maternal age is associated with higher risk of unintended pregnancy, preterm birth and cesarean section but our findings did not support advanced maternal age as a risk factor associated with low birth weight.

scholarly journals Effect of per Capita Income on the Relationship between Periodontal Disease during Pregnancy and the Risk of Preterm Birth and Low Birth Weight Newborn. Systematic Review and Meta-Analysis

2020 ◽  
Vol 17 (21) ◽  
pp. 8015
Author(s):  
Carmen Alba Moliner-Sánchez ◽  
José Enrique Iranzo-Cortés ◽  
José Manuel Almerich-Silla ◽  
Carlos Bellot-Arcís ◽  
José Carmelo Ortolá-Siscar ◽  
...  
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Periodontal Disease ◽  
Pregnant Women ◽  
Capita Income ◽  
Meta Analysis ◽  
Income Level ◽  
Per Capita Income ◽  
Per Capita

This work analyzed the available evidence in the scientific literature about the risk of preterm birth and/or giving birth to low birth weight newborns in pregnant women with periodontal disease. A systematic search was carried out in three databases for observational cohort studies that related periodontal disease in pregnant women with the risk of preterm delivery and/or low birth weight, and that gave their results in relative risk (RR) values. Eleven articles were found, meeting the inclusion criteria. Statistically significant values were obtained regarding the risk of preterm birth in pregnant women with periodontitis (RR = 1.67 (1.17–2.38), 95% confidence interval (CI)), and low birth weight (RR = 2.53 (1.61–3.98) 95% CI). When a meta-regression was carried out to relate these results to the income level of each country, statistically significant results were also obtained; on the one hand, for preterm birth, a RR = 1.8 (1.43–2.27) 95% CI was obtained and, on the other hand, for low birth weight, RR = 2.9 (1.98–4.26) 95% CI. A statistically significant association of periodontitis, and the two childbirth complications studied was found, when studying the association between these results and the country’s per capita income level. However, more studies and clinical trials are needed in this regard to confirm the conclusions obtained.

The role of Vitamin D in the prevention of pregnancy complications and childhood diseases in the first year of life

2021 ◽  
Vol 20 (5) ◽  
pp. 114-123
Author(s):  
E.V. Shikh ◽  
◽  
A.A. Makhova ◽  
Zh.M. Sizova ◽  
N.V. Shikh ◽  
...  
Keyword(s):  
Vitamin D ◽  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Pregnant Women ◽  
Pregnancy Complications ◽  
Vitamin D Supplementation ◽  
Childhood Diseases ◽  
Vitamin D Levels ◽  
First Year Of Life

Vitamin D status during pregnancy has an impact on fetal growth and development and plays an important role in the prevention of pregnancy complications. Fetal vitamin D supplementation is completely dependent on maternal status, which explains the high correlation between 25(OH)D concentrations in maternal and umbilical cord blood. Adequate vitamin D supplementation in pregnant women is associated with a decreased risk of preterm birth and low birth weight. Most newborns, regardless of gestational age, have insufficient vitamin D levels. Thus, the problem of Vitamin D supplementation is relevant not only for pregnant women, but also for newborns. Research studies of recent years have aimed at comparing the efficacy of Vitamin D dosing to prevent pregnancy complications. Doses higher than 4000 IU have virtually no effect on the risk of preeclampsia compared with doses of 4000 IU or less. Administration of Vitamin D in doses less than 2000 IU per day reduces the risk of low birth weight, intrauterine or neonatal mortality. Doses higher than 2000 IU have no additional benefit. Recommendations for vitamin D supplementation based on objective pharmacokinetic characteristics should be developed. Key words: pregnancy, vitamin D, doses, preterm birth, gestational diabetes, preeclampsia

scholarly journals PRETERM BIRTH AND FETAL GROWTH RESTRICTION IN HIV-INFECTED BRAZILIAN PREGNANT WOMEN

2015 ◽  
Vol 57 (2) ◽  
pp. 111-120 ◽  
Author(s):  
Helena Lucia Barroso DOS REIS ◽  
Karina da Silva ARAUJO ◽  
Lilian Paula RIBEIRO ◽  
Daniel Ribeiro DA ROCHA ◽  
Drielli Petri ROSATO ◽  
...  
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Hiv Infection ◽  
Pregnant Women ◽  
Fetal Growth ◽  
Low Income ◽  
Fetal Growth Restriction ◽  
Growth Restriction ◽  
Southeastern Brazil

Introduction: Maternal HIV infection and related co-morbidities may have two outstanding consequences to fetal health: mother-to-child transmission (MTCT) and adverse perinatal outcomes. After Brazilian success in reducing MTCT, the attention must now be diverted to the potentially increased risk for preterm birth (PTB) and intrauterine fetal growth restriction (IUGR). Objective: To determine the prevalence of PTB and IUGR in low income, antiretroviral users, publicly assisted, HIV-infected women and to verify its relation to the HIV infection stage. Patients and Methods: Out of 250 deliveries from HIV-infected mothers that delivered at a tertiary public university hospital in the city of Vitória, state of Espírito Santo, Southeastern Brazil, from November 2001 to May 2012, 74 single pregnancies were selected for study, with ultrasound validated gestational age (GA) and data on birth dimensions: fetal weight (FW), birth length (BL), head and abdominal circumferences (HC, AC). The data were extracted from clinical and pathological records, and the outcomes summarized as proportions of preterm birth (PTB, < 37 weeks), low birth weight (LBW, < 2500g) and small (SGA), adequate (AGA) and large (LGA) for GA, defined as having a value below, between or beyond the ±1.28 z/GA score, the usual clinical cut-off to demarcate the 10th and 90th percentiles. Results: PTB was observed in 17.5%, LBW in 20.2% and SGA FW, BL, HC and AC in 16.2%, 19.1%, 13.8%, and 17.4% respectively. The proportions in HIV-only and AIDS cases were: PTB: 5.9 versus 27.5%, LBW: 14.7% versus 25.0%, SGA BW: 17.6% versus 15.0%, BL: 6.0% versus 30.0%, HC: 9.0% versus 17.9%, and AC: 13.3% versus 21.2%; only SGA BL attained a significant difference. Out of 15 cases of LBW, eight (53.3%) were preterm only, four (26.7%) were SGA only, and three (20.0%) were both PTB and SGA cases. A concomitant presence of, at least, two SGA dimensions in the same fetus was frequent. Conclusions: The proportions of preterm birth and low birth weight were higher than the local and Brazilian prevalence and a trend was observed for higher proportions of SGA fetal dimensions than the expected population distribution in this small casuistry of newborn from the HIV-infected, low income, antiretroviral users, and publicly assisted pregnant women. A trend for higher prevalence of PTB, LBW and SGA fetal dimensions was also observed in infants born to mothers with AIDS compared to HIV-infected mothers without AIDS.

scholarly journals Causal effects on low Apgar at 5-min and stillbirth in a malaria maternal–fetal health outcome investigation: a large perinatal surveillance study in the Brazilian Amazon

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Julio Abel Seijas-Chávez ◽  
Melissa S. Nolan ◽  
Mary K. Lynn ◽  
Maria José Francalino da Rocha ◽  
Muana da Costa Araújo ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Pregnant Women ◽  
Malaria Elimination ◽  
Public Health Intervention ◽  
Brazilian Amazon ◽  
Causal Effects ◽  
Surveillance Study ◽  
Fetal Health ◽  
Malaria During Pregnancy

Abstract Background Malaria elimination in Brazil poses several challenges, including the control of Plasmodium falciparum foci and the hidden burden of Plasmodium vivax in pregnancy. Maternal malaria and fetal health outcomes were investigated with a perinatal surveillance study in the municipality of Cruzeiro do Sul, Acre state, Brazilian Amazon. The research questions are: what are the causal effects of low birth weight on low Apgar at 5-min and of perinatal anaemia on stillbirth? Methods From November 2018 to October 2019, pregnant women of ≥ 22 weeks or puerperal mothers, who delivered at the referral maternity hospital (Juruá Women and Children’s Hospital), were recruited to participate in a malaria surveillance study. Clinical information was obtained from a questionnaire and abstracted from medical reports. Haemoglobin level and presence of malarial parasites were tested by haematology counter and light microscopy, respectively. Low Apgar at 5-min and stillbirth were the outcomes analysed in function of clinical data and epidemiologic risk factors for maternal malaria infection using both a model of additive and independent effects and a causal model with control of confounders and use of mediation. Results In total, 202 (7.2%; N = 2807) women had malaria during pregnancy. Nearly half of malaria infections during pregnancy (n = 94) were P. falciparum. A total of 27 women (1.03%; N = 2632) had perinatal malaria (19 P. vivax and 8 P. falciparum). Perinatal anaemia was demonstrated in 1144 women (41.2%; N = 2779) and low birth weight occurred in 212 newborns (3.1%; N = 2807). A total of 75 newborns (2.7%; N = 2807) had low (< 7) Apgar scores at 5-min., and stillbirth occurred in 23 instances (30.7%; n = 75). Low birth weight resulted in 7.1 higher odds of low Apgar at 5-min (OR = 7.05, 95% CI 3.86–12.88, p < 0.001) modulated by living in rural conditions, malaria during pregnancy, perinatal malaria, and perinatal anaemia. Stillbirth was associated with perinatal anaemia (OR = 2.56, 95% CI 1.02–6.42, p = 0.0444) modulated by living in rural conditions, falciparum malaria during pregnancy, perinatal malaria, and perinatal fever. Conclusions While Brazil continues its path towards malaria elimination, the population still faces major structural problems, including substandard living conditions. Here malaria infections on pregnant women were observed having indirect effects on fetal outcomes, contributing to low Apgar at 5-min and stillbirth. Finally, the utility of employing multiple statistical analysis methods to validate consistent trends is vital to ensure optimal public health intervention designs.

scholarly journals Assessment of the diet components of pregnant women as predictors of risk of preterm birth and born baby with low birth weight

2015 ◽  
Vol 86 (4) ◽  
pp. 292-299 ◽  
Author(s):  
Rafał Bobiński ◽  
Monika Mikulska ◽  
Hanna Mojska ◽  
Izabela Ulman-Włodarz ◽  
Patrycja Sodowska
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Pregnant Women ◽  
Born Baby

A Meta-Analysis for Prevalence of Cesarean Section, Preterm Birth, Stillbirth, and Low Birth Weight Deliveries in Infected Pregnant Women with COVID-19

2021 ◽  
Author(s):  
Mojgan Karimi-Zarchi ◽  
David A. Schwartz ◽  
Seyed Alireza Dastgheib ◽  
Reza Bahrami ◽  
Atiyeh Javaheri ◽  
...  
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Cesarean Section ◽  
Pregnant Women ◽  
Meta Analysis ◽  
Asian Women ◽  
Pooled Data ◽  
Stratified Analysis ◽  
Combined Data

Background: The aim of this meta-analysis was to estimate the prevalence of cesarean section (CS), preterm birth, stillbirth, and low birth weight deliveries (LBWD) in pregnant women with SARS-COV-2 infection. Methods: All relevant studies were searched up to 30 February 2021. Results: A total of 47 studies with 5970 infected pregnant women were included. There were 1010 CS, 55 stillbirths, 524 preterm birth, and 82 with LBWD. Pooled data showed that the prevalence of CS, preterm birth, stillbirth, and LBWD among women with SARS-COV-2 infection was 29.6% (95% CI 0.081-0.160), 2.1% (95% CI 0.081-0.160), 11.5% (95% CI 0.081-0.160), and 2.1% (95% CI 0.081-0.160), respectively. Stratified analysis revealed that these pregnancy outcomes among Asian women were higher than Caucasians. Conclusion: Our combined data revealed that the CS prevalence (29.6%) was the highest followed by preterm birth (11.5%), stillbirth (2.1%), and LBWD (2.1%) among women with COVID-19.

scholarly journals Pica in Rural Obstetric Population: An Underestimated Nutritional Mystery

2014 ◽  
Vol 6 (2) ◽  
pp. 71-74
Author(s):  
Bhavna Kumare ◽  
Nikita Vijay
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Pregnant Women ◽  
Gestational Age ◽  
Cross Sectional Study ◽  
Paired Data ◽  
Chi Square ◽  
Cross Sectional ◽  
Obstetric Population

ABSTRACT Objective To determine the prevalence of pica during pregnancy, maternal hemoglobin levels at delivery and the association of pica with low birth weight and preterm birth. Study design A descriptive cross-sectional study. Subjects/setting Two hundred pregnant women aged 18 to 35 years admitted in labor room of Department of Obstetrics and Gynecology, NKPSIMS. Study duration 1 March 2012 to 28 February 2013. Main outcome measures — maternal hemoglobin at delivery, mean birth weight and mean gestational age were compared in pica and no pica group. Statistical analysis Mean, percentage and chi-square test (for paired data). Results Seventeen percent of these pregnant women practiced pica. The most common pica substance that was consumed was chalk (44.1%) and clay (38.2%). Women in pica group had lower hemoglobin levels 8.63 ± 1.12 gm% (mean ± SD) at delivery than women who did not report pica (10.03 ± 0.96 gm%). There was no difference in mean birth weight and gestational age of neonates born to women with pica group and no pica group. Conclusion The findings suggest that pica practices are associated with significantly lower maternal hemoglobin levels at delivery, but are not associated with low birth weight and preterm birth. How to cite this article Kumare B, Somalwar S, Vijay N. Pica in Rural Obstetric Population: An Underestimated Nutritional Mystery. J South Asian Feder Obst Gynae 2014;6(2):71-74.

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