scholarly journals Group B Streptococcus (GBS) Colonization and Disease among Pregnant Women: A Historical Cohort Study

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
James M. Edwards ◽  
Nora Watson ◽  
Chris Focht ◽  
Clara Wynn ◽  
Christopher A. Todd ◽  
...  
Keyword(s):  
Cohort Study ◽  
Group B Streptococcus ◽  
Perinatal Outcomes ◽  
Chronic Hypertension ◽  
Short Cervix ◽  
Historical Cohort ◽  
Historical Cohort Study ◽  
Increased Risk ◽  
Adverse Pregnancy ◽  
Group B

Background. Maternal GBS colonization is associated with early-onset neonatal sepsis and extensive efforts are directed to preventing this complication. Less is known about maternal risks of GBS colonization. We seek to provide a modern estimate of the incidence and impact of maternal GBS colonization and invasive GBS disease. Methods. A single center historical cohort study of all births between 2003 and 2015 was performed. Data was collected via electronic health record abstraction using an institutional specific tool. Descriptive statistics were performed regarding GBS status. Inferential statistics were performed comparing risk of adverse pregnancy outcomes in cohorts with and without GBS colonization as well as cohorts with GBS colonization and invasive GBS disease. Results. A total of 60,029 deliveries were included for analysis. Overall, 21.6% of the population was GBS colonized and 0.1% had invasive GBS disease. GBS colonization was associated with younger maternal age, Black race, non-Hispanic ethnicity, chronic hypertension, preexisting diabetes, and tobacco use (p<0.01). In the adjusted analyses, there was an increased risk of gestational diabetes (aRR 1.21, 95% CI 1.11-1.32) in colonized pregnancies and a decreased incidence of short cervix (aRR 0.64, 95% CI 0.52-0.79), chorioamnionitis (aRR 0.76, 95% CI 0.66-0.87), wound infection (aRR 0.75, 95% CI 0.64-0.88), and operative delivery (aRR 0.85, 95% CI 0.83-0.88). Conclusions. This modern-day large cohort of all births over a 12-year period demonstrates a GBS colonization rate of 21.6%. This data reflects a need to assess maternal and perinatal outcomes in addition to neonatal GBS sepsis rates to inform decisions regarding the utility of maternal vaccination.

scholarly journals Group B streptococcus (GBS) colonization and disease among pregnant women: a historical cohort study

2017 ◽  
Vol 217 (6) ◽  
pp. 731
Author(s):  
James M. Edwards ◽  
Clara Wynn ◽  
Nora Watson ◽  
Chris Focht ◽  
Christopher A. Todd ◽  
...  
Keyword(s):  
Cohort Study ◽  
Pregnant Women ◽  
Group B Streptococcus ◽  
Historical Cohort ◽  
Historical Cohort Study ◽  
Group B

scholarly journals Effect of maternal obesity on pregnancy outcomes in women delivering singleton babies: a historical cohort study

2019 ◽  
Vol 47 (6) ◽  
pp. 625-630 ◽  
Author(s):  
Iñigo Melchor ◽  
Jorge Burgos ◽  
Ana del Campo ◽  
Amaia Aiartzaguena ◽  
Julieta Gutiérrez ◽  
...  
Keyword(s):  
Cohort Study ◽  
Cesarean Section ◽  
Maternal Obesity ◽  
Perinatal Outcomes ◽  
Normal Weight ◽  
World Health ◽  
Obese Women ◽  
Historical Cohort ◽  
Historical Cohort Study ◽  
Adverse Pregnancy

Abstract Background Obesity in pregnancy is increasing worldwide, reaching epidemic proportions in many countries and frequently creating challenges for obstetricians. We conducted this study to assess the effects of maternal obesity on maternal and perinatal outcomes. Methods A historical cohort study was performed on 16,609 women who delivered singleton babies in a 5-year period (2013–2017). Data were retrieved from the Cruces Perinatal Database (CPD) and only women whose prepregnancy body mass index (BMI) was known were included. Women were categorized according to the World Health Organization (WHO) classification: normal weight (BMI 20–24.9 kg/m2) and obesity (BMI ≥ 30 kg/m2). Obstetric, perinatal and neonatal outcomes were compared, and adjusted odds ratios (aORs) and 95% confidence intervals (95% CIs) were calculated using the normal-weight group as the reference. Results Compared to women of normal weight (n = 9778), obese women (n = 2207) had a higher risk of preeclampsia (aOR 2.199, 95% CI: 1.46–3.29), rectovaginal group B streptococcus colonization (aOR 1.299, 95% CI: 1.14–1.47), induction of labor (aOR 1.593, 95% CI: 1.44–1.75), cesarean section (aOR 2.755, 95% CI: 2.46–3.08), cesarean section in women with a history of cesarean delivery (aOR 1.409, 95% CI: 1.03–1.92), fetal weight ≥4000 g (aOR 2.090, 95% CI: 1.803–2.422) and admission to the neonatal intensive care unit (NICU) (aOR 1.341, 95% CI: 1.12–1.59). No association was found with preterm birth (aOR 0.936, 95% CI: 0.77–1.13), stillbirth (aOR 0.921, 95% CI: 0.41–2.02) or neonatal mortality (aOR 2.205, 95% CI: 0.86–5.62). Conclusion Maternal obesity is associated with a higher risk of adverse pregnancy and perinatal outcomes. Pregnancy in this population of women should be considered and managed as high risk.

Comparison of perinatal outcomes between long-term and short-term use of tocolytic agent: a historical cohort study in a single perinatal hospital

2016 ◽  
Vol 42 (12) ◽  
pp. 1680-1685 ◽  
Author(s):  
Masamitsu Nakamura ◽  
Junichi Hasegawa ◽  
Tatsuya Arakaki ◽  
Shoko Hamada ◽  
Hiroko Takita ◽  
...  
Keyword(s):  
Cohort Study ◽  
Perinatal Outcomes ◽  
Short Term ◽  
Historical Cohort ◽  
Historical Cohort Study ◽  
Tocolytic Agent

The Occurrence of Subsequent Malignancy in Patients Presenting with Deep Vein Thrombosis: Results from a Historical Cohort Study

1998 ◽  
Vol 79 (01) ◽  
pp. 19-22 ◽  
Author(s):  
Raghu Rajan ◽  
Michael Gent ◽  
Jack Hirsh ◽  
William Geerts ◽  
Peter Skingley ◽  
...  
Keyword(s):  
Cohort Study ◽  
Deep Vein Thrombosis ◽  
Venous Thromboembolism ◽  
Oral Anticoagulant Therapy ◽  
Historical Cohort ◽  
Vein Thrombosis ◽  
Historical Cohort Study ◽  
Increased Risk ◽  
Recurrent Venous Thromboembolism ◽  
Deep Vein

SummaryBackground: Several studies have reported that patients who present with idiopathic deep vein thrombosis (DVT) have an increased risk of subsequently developing cancer. A clinical trial had previously been conducted examining the optimal duration of oral anticoagulant therapy following initial heparin treatment in patients with proximal DVT.Methods: A historical cohort study was performed on patients enrolled in the duration of anticoagulant trial. Patients known to have cancer at the time of entry into the trial were excluded. The qualifying DVTs were classified as idiopathic (no known associated risk factors) or secondary without knowledge of subsequent recurrent venous thrombosis or cancer. The patients were then followed for the development of cancer.Results: Thirteen (8.6%) of the 152 patients in the idiopathic cohort subsequently developed cancer compared to eight (7.1%) of 112 patients in the secondary cohort, P = 0.86. Two (5.4%) of 37 patients with recurrent venous thromboembolism and 19 (8.4%) of 227 patients without recurrent thromboembolism developed cancer, P = 0.7.Conclusion: Our study did not detect an increased risk of subsequent cancer in patients presenting with idiopathic DVT compared to secondary DVT; nor did we detect an increased incidence of cancer in patients with recurrent venous thromboembolism. Further studies are required prior to pursuing a policy of aggressive screening for cancer in patients with idiopathic venous thromboembolism.

Long-term outcomes after group B streptococcus infection: a cohort study

2018 ◽  
Vol 104 (2) ◽  
pp. 172-178 ◽  
Author(s):  
Kee Thai Yeo ◽  
Monica Lahra ◽  
Barbara Bajuk ◽  
Lisa Hilder ◽  
Mohamed E Abdel-Latif ◽  
...  
Keyword(s):  
Cohort Study ◽  
Very Low Birth Weight ◽  
Group B Streptococcus ◽  
Population Based ◽  
Long Term Outcomes ◽  
Live Births ◽  
Risk Of Death ◽  
Increased Risk ◽  
Group B

ObjectiveTo describe the risk of death and hospitalisation until adolescence of children after group B streptococcus (GBS) infection during infancy.DesignPopulation-based cohort study.SettingNew South Wales, Australia.PatientsAll registered live births from 2000 to 2011.InterventionsComparison of long-term outcomes in children with the International Statistical Classification of Diseases and Related Health Problems-10th Revision discharge codes corresponding to GBS infections and those without.Main outcome measuresDeath and hospitalisation.ResultsA total of 1206 (0.1%) children (936 (77.6%)≥37 weeks’ gestation) were diagnosed with GBS infection. Over the study period, infection rates decreased from 2.1 (95% CI 1.8 to 2.4) to 0.7 (95% CI 0.5 to 0.9) per 1000 live births. Infants with GBS infection were born at lower gestation (mean 37.6 vs 39.0 weeks), were more likely very low birth weight (<1500 g, OR 9.1(95% CI 7.4 to 11.3)), born premature (OR 3.9(95% CI 3.4 to 4.5)) and have 5 min Apgar scores ≤5 (OR 6.7(95% CI 5.1 to 8.8)). Children with GBS had three times the adjusted odds of death (adjusted OR (AOR) 3.0(95% CI 2.1 to 4.3)) or rehospitalisations (AOR 3.1(95% CI 2.7 to 3.5)). Thirty-six (3.0%) with GBS died, with >50% of deaths occurring <28 days. Children with GBS were hospitalised more frequently (median 2 vs 1), for longer duration (mean 3.7 vs 2.2 days) and were at higher risk for problems with genitourinary (OR 3.1(95% CI 2.8 to 3.5)) and nervous (OR 2.0 (95% CI1.7 to 2.3)) systems.ConclusionsDespite decreasing GBS rates, the risk of poor health outcomes for GBS-infected children remains elevated, especially during the first 5 years. Survivors continue to be at increased risk of death and chronic conditions requiring hospitalisations, such as cerebral palsy and epilepsy.

scholarly journals Full Dilatation Caesarean Section and the Risk of Preterm Delivery in a Subsequent Pregnancy: A Historical Cohort Study

2020 ◽  
Vol 9 (12) ◽  
pp. 3998
Author(s):  
Lauren Jade Ewington ◽  
Siobhan Quenby
Keyword(s):  
Cohort Study ◽  
Reference Group ◽  
Subsequent Pregnancy ◽  
University Hospital ◽  
Interpregnancy Interval ◽  
Spontaneous Preterm Birth ◽  
Historical Cohort ◽  
Historical Cohort Study ◽  
Increased Risk ◽  
Short Interpregnancy Interval

Full dilatation caesarean sections (CS) have increased risk of uterine extensions, which leads to cervical trauma that has been associated with an increased risk of spontaneous preterm birth (sPTB) in a subsequent pregnancy. The aim of this study was to determine if CS at full dilatation increased the risk of sPTB in a subsequent pregnancy in our unit. A historical cohort study was performed on women delivered by emergency CS between 2008–2015 (n = 5808) in a university hospital who had a subsequent pregnancy in this time frame (n = 1557). Women were classified into two exposure groups; those who were 6–9 cm and those fully dilated at index CS. The reference group was CS at 0–5 cm dilated. The primary outcome was sPTB < 37 weeks’ gestation. CS at 6–9 cm or fully dilated did not significantly increase the odds of sPTB in a subsequent pregnancy (aOR 1.64, 95% CI: 0.83–3.28, p = 0.158; aOR 1.86, 95% CI: 0.91–3.83; p = 0.090, respectively). However, a short interpregnancy interval of <1 year significantly increased the odds of sPTB in a subsequent pregnancy (aOR 3.10, 95% CI: 1.71–5.61). This study has found a short interpregnancy interval following a CS conferred a higher risk of sPTB than full dilatation CS. This finding highlights postnatal contraception and increased surveillance of women with short interpregnancy interval post CS as possible interventions to reduce sPTB.

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