scholarly journals Birth Weight Ratio as an Alternative to Birth Weight Percentile to Express Infant Weight in Research and Clinical Practice: A Nationwide Cohort Study

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Bart Jan Voskamp ◽  
Brenda M. Kazemier ◽  
Ewoud Schuit ◽  
Ben Willem J. Mol ◽  
Maarten Buimer ◽  
...  
Keyword(s):  
Cohort Study ◽  
Birth Weight ◽  
Pregnancy Outcome ◽  
Perinatal Death ◽  
Adverse Pregnancy Outcome ◽  
Weight Ratio ◽  
Discriminative Ability ◽  
Birth Weight Percentile ◽  
Adverse Pregnancy ◽  
Weight Percentile

Objective. To compare birth weight ratio and birth weight percentile to express infant weight when assessing pregnancy outcome.Study Design. We performed a national cohort study. Birth weight ratio was calculated as the observed birth weight divided by the median birth weight for gestational age. The discriminative ability of birth weight ratio and birth weight percentile to identify infants at risk of perinatal death (fetal death and neonatal death) or adverse pregnancy outcome (perinatal death + severe neonatal morbidity) was compared using the area under the curve. Outcomes were expressed stratified by gestational age at delivery separate for birth weight ratio and birth weight percentile.Results. We studied 1,299,244 pregnant women, with an overall perinatal death rate of 0.62%. Birth weight ratio and birth weight percentile have equivalent overall discriminative performance for perinatal death and adverse perinatal outcome. In late preterm infants (33+0–36+6weeks), birth weight ratio has better discriminative ability than birth weight percentile for perinatal death (0.68 versus 0.63,P  0.01) or adverse pregnancy outcome (0.67 versus 0.60,P<0.001).Conclusion. Birth weight ratio is a potentially valuable instrument to identify infants at risk of perinatal death and adverse pregnancy outcome and provides several advantages for use in research and clinical practice. Moreover, it allows comparison of groups with different average birth weights.

AB0105 CHECKPOINT MOLECULES AND PREGNANCY: ENHANCED SPD-L1 PREDICTS FLARE IN RA PREGNANCY AND POSTPARTUM

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1351.1-1352
Author(s):  
A. L. Stefanski ◽  
K. Eriksson ◽  
A. Zbinden ◽  
P. Villiger ◽  
F. Förger
Keyword(s):  
Birth Weight ◽  
Disease Activity ◽  
Pregnancy Outcome ◽  
Preterm Delivery ◽  
Adverse Pregnancy Outcome ◽  
Healthy Controls ◽  
Serum Samples ◽  
Healthy Pregnancy ◽  
Pregnancy And Postpartum ◽  
Adverse Pregnancy

Background:Rheumatoid arthritis (RA) is a female-predominant autoimmune disease that may affect women in childbearing age, making family planning an important issue for their life. There is a need for better understanding the mechanisms modulating RA in pregnancy and develop prognostic marker regarding adverse pregnancy outcome such as reduced birth weight and preterm delivery. As a crucial organ for peripheral tolerance during pregnancy, the placenta is expressing constitutively programmed cell death ligand 1 (PD-L1), major ligand of the inhibitory receptor PD-1 (Zhang et al, 2015). We hypothesize that the PD-1 pathway plays a central inhibitory role in regulating the course of the disease and pregnancy outcome in RA.Objectives:To investigate the relationship between PD-1 pathway, disease activity during pregnancy/postpartum and pregnancy outcome in RA.Methods:We measured soluble PD-1 and PD-L1 levels by ELISA in serum samples of 27 pregnant RA patients and 25 healthy pregnant controls at different time points during pregnancy and postpartum. As for pregnancy controls, we analyzed serum samples from 28 non-pregnant RA patients and 18 non-pregnant healthy controls. The data was analyzed in correlation with disease activity (measured by DAS28-CRP) and pregnancy outcome (defined as preterm delivery and birth weight). Statistics were calculated by Mann-Whitney U test and Wilcoxon test, correlations by Spearman rank test.Results:In healthy pregnancy, sPD-L1 increases significantly in the 1sttrimester (p = 0,0198) and decreases significantly postpartum (p = 0,0029). sPD-L1 values are higher in non-pregnant RA patients compared to non-pregnant healthy controls (p = 0,047) and there are no significant changes during RA pregnancy. Postpartum sPD-L1 values are significantly higher in RA patients compared to healthy controls (p = 0,0014), Fig. 1. Notably, regarding disease activity, we noticed a significant positive correlation between the overall sPD-L1 values in RA and DAS28-CRP (p= 0.0104), Fig. 2. No significant correlation was seen between sPD-L1, birth weight and preterm delivery. For sPD-1 we focused on 3rdtrimester and postpartum, however, there was no difference between healthy controls and RA patients and no correlation with disease activity or pregnancy outcome.Conclusion:In healthy pregnancy, we observed an increase of sPD-L1, which decreases after delivery. This supports the hypothesis, that PD-1 pathway may be involved in shaping the physiological fetal-maternal tolerance. In RA higher sPD-L1 values are measured already in non-pregnant patients compared to healthy controls and there is no physiological decrease postpartum. Intriguing, sPD-L1 correlates positively with RA disease activity, reflecting a possible functional antagonism towards the inhibitory function of membrane bound PD-L1 molecules. However, the detailed function of sPD-L1 need to be further delineated. Nevertheless, sPD-L1 may have the potential to serve as prognostic marker for flares in RA pregnancy. Regarding the rather rarely observed adverse pregnancy outcome, larger cohorts need to be investigated.References:[1]Zhang YH, Tian M, Tang MX et al. Recent Insight into the Role of the PD-1/PD-L1 Pathway in Feto-Maternal Tolerance and Pregnancy. Am J Reprod Immunol. 2015 Sep;74(3):201-8.Disclosure of Interests:Ana-Luisa Stefanski: None declared, Klara Eriksson: None declared, Astrid Zbinden: None declared, Peter Villiger Consultant of: MSD, Abbvie, Roche, Pfizer, Sanofi, Speakers bureau: Roche, MSD, Pfizer, Frauke Förger Grant/research support from: Unrestricted grant from UCB, Consultant of: UCB, GSK, Roche, Speakers bureau: UCB, GSK

Treatment of 139 Pregnancies in Antiphospholipid-positive Women Not Fulfilling Criteria for Antiphospholipid Syndrome: A Retrospective Study

2013 ◽  
Vol 40 (4) ◽  
pp. 425-429 ◽  
Author(s):  
Teresa Del Ross ◽  
Amelia Ruffatti ◽  
Maria Serena Visentin ◽  
Marta Tonello ◽  
Antonia Calligaro ◽  
...  
Keyword(s):  
Birth Weight ◽  
Pregnancy Outcome ◽  
Gestational Age ◽  
Pregnancy Loss ◽  
Antiphospholipid Antibody ◽  
Birth Weight Percentile ◽  
Antibody Profile ◽  
Gestational Age At Birth ◽  
Age At Birth ◽  
Weight Percentile

Objective.The effect of low-dose aspirin (LDA) on pregnancy outcome in antiphospholipid (aPL)-positive women not fulfilling the criteria for antiphospholipid antibody syndrome (APS) was evaluated retrospectively.Methods.We evaluated 139 pregnancies of 114 aPL-positive women not fulfilling the Sydney classification criteria for definite APS (104 treated with LDA, 35 untreated). Inclusion criteria consisted of (1) any titer of aPL and no previous pregnancy or no pregnancy losses (defined as aPL carriers); (2) any titer of aPL and 1 or 2 pregnancy losses before the 10th gestational week. No women had previous thrombosis. The rate of pregnancy loss, gestational age at delivery, and birth weight percentile were compared in the treated and untreated patients. Associations between clinical and laboratory characteristics and pregnancy outcomes were investigated.Results.The rate of pregnancy loss was low in both treated and untreated groups (7.7% vs 2.9%, respectively). There were no statistically significant differences in the rate of pregnancy loss, gestational age at birth, or birth weight percentile in the treated and untreated groups. There were significant associations between gestational age at birth ≤ 34th week and positivity for lupus anticoagulant (p = 0.025) and anti-ß2-glycoprotein I IgG antibodies at titers > 99th (p = 0.016).Conclusion.LDA treatment does not appear to improve pregnancy outcome in low-risk women not fulfilling the criteria for APS. Because antibody profile seems to influence pregnancy outcome, further studies of patients stratified according to their antibody profile are warranted.

scholarly journals Effects of sanitation practices on adverse pregnancy outcomes in India: a conducive finding from recent Indian demographic health survey

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Ratna Patel ◽  
Ajay Gupta ◽  
Shekhar Chauhan ◽  
Dhananjay W. Bansod
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Pregnancy Outcome ◽  
Health Survey ◽  
Pregnancy Outcomes ◽  
Adverse Pregnancy Outcome ◽  
Wealth Index ◽  
Adverse Pregnancy Outcomes ◽  
Adverse Outcomes ◽  
Adverse Pregnancy

Abstract Background Several risk factors predisposing women and their live-borns to adverse outcomes during pregnancy have been documented. Little is known about sanitation being a factor contributing to adverse pregnancy outcomes in India. The role of sanitation in adverse pregnancy outcomes remains largely unexplored in the Indian context. This study is an attempt to bring the focus on sanitation as a factor in adverse pregnancy outcome. Along with the sanitation factors, few confounder variables have also been studied in order to understand the adverse pregnancy outcomes. Methods The study is based on the fourth round of National Family Health Survey (NFHS-IV) covering 26,972 married women in the age-group 15–49. The study variables include the mother’s age, Body Mass Index (BMI), education, anemia, and Antenatal care (ANC) visits during their last pregnancy. The household level variable includes place of residence, religion, caste, wealth index, access to toilet, type of toilet, availability of water within toilet premises, and facility of hand wash near the toilet. Children study variables include Low Birth Weight (LBW), the order of birth (Parity), and the death of the children of the women in the last 5 years. The target variable Adverse Pregnancy Outcome (APO) was constructed using children born with low birth weight or died during the last pregnancy. Results We calculated both adjusted as well as unadjusted odds ratios for a better understanding of the association between sanitation and adverse pregnancy outcomes. Findings from the study showed that women who did not have access to a toilet within the house had a higher risk of adverse pregnancy outcome. In the multivariable model, no association was observed for adverse pregnancy outcome among women who did not have access to toilet and women who used shared toilet. Teenage (15–19 years), uneducated, underweight and anemic mothers were more likely to face APO as compare to other mothers in similar characteristics group. Conclusions Our findings contribute to the decidedly less available literature on maternal sanitation behaviour and adverse pregnancy outcomes. Our results support that sanitation is a very significant aspect for women who are about to deliver a baby as there was an association between sanitation and adverse pregnancy outcome. Education on sanitation practices is the need of the hour as much as it needs to follow.

Maternal age and adverse pregnancy outcome: a cohort study

2013 ◽  
Vol 42 (6) ◽  
pp. 634-643 ◽  
Author(s):  
A. Khalil ◽  
A. Syngelaki ◽  
N. Maiz ◽  
Y. Zinevich ◽  
K. H. Nicolaides
Keyword(s):  
Cohort Study ◽  
Pregnancy Outcome ◽  
Maternal Age ◽  
Adverse Pregnancy Outcome ◽  
Adverse Pregnancy

scholarly journals Frequency of Anemia and Obstetric Outcome in Young Primigravida

2018 ◽  
Vol 23 (4) ◽  
pp. 531-535
Author(s):  
Abida Sajid ◽  
Aqsam Sajid
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Pregnancy Outcome ◽  
Preterm Delivery ◽  
Adverse Pregnancy Outcome ◽  
National Level ◽  
Deficiency Anemia ◽  
Major Public Health Problem ◽  
Obstetric Outcome ◽  
Adverse Pregnancy

Pregnancy and childbirth is an event celebrated worldwide. During pregnancy physiological changes and increasing demand causes fall in hemoglobin level leading to anemia and adverse pregnancy outcome especially in young girls. Anemia is a major public health problem. Around 58.27 million women worldwide are anemic during pregnancy 95% of whom live in countries that are developing. To know the frequency of anemia, and obstetric outcome in terms of preterm delivery, low birth weight and rate of caesarean section in young Primigravida. It was a cross sectional study, conducted in the department of Gynae & Obstetric unit 5 King Edward Medical University Lahore during a period of one year from May2013 April 2014. All primigravida young 15-24years with anemia enrolled for the study. Anemia is defined as hemoglobin< 10.5g/dl (WHO Criteria), Iron deficiency Anemia is defined as serum ferritin level less than 12 micro gram per ml and on Red Blood Cell indices, i.e. decrease in MCV, MCH and MCHC, and Microcytic Hypochromic cells in Peripheral Smear. Megaloblastic anemia was labeled when Macrocytic Hypochromic cells seen. Obstetric outcome in terms of Preterm delivery defined as delivery at <37 weeks of gestation (36 +6 weeks) and birth weight <2500g mand a need for operative delivery. Patients fulfilling the selection criteria as per operational definition were included in the study after taking informed consent using non probability consecutive sampling technique. Data was collected on a pre-designed questionnaire. A total of 3855 deliveries during study period in which 1318 were primigravida. Mean age in study group was 15 to 24 years. We observed mild anemia in 46% of woman, moderate anemia in 41% and severe anemia in 13% in young primigravida. Preterm delivery was noted in 25% of the females and low birth weight babies were noted by 33% in teenage and young primigravida. Statistically significant relationship was found between maternal age, education and socio economic status. Anemia in pregnancy nowadays is still a common problem in adolescent and young primigravida and associated with adverse pregnancy outcome. Prompt measure should be taken by the stake holders at local and national level to prevent and treat this problem in order to reduce morbidity and mortality associated with it.

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