Maternal Hepatitis B Infection Burden, Comorbidity and Pregnancy Outcome in a Low-Income Population on the Myanmar-Thailand Border: A Retrospective Cohort Study

Objectives. Hepatitis B virus (HBV) was believed to have minimal impact on pregnancy outcomes apart from the risk of perinatal transmission. In more recent years, there have been reports of adverse associations, most consistently preterm birth (PTB), but this is in the context of high rates of caesarean section. The aim of this study was to explore the association of HBV on pregnancy outcomes in marginalized, low-income populations on the Myanmar-Thailand border. Methods. HBsAg positive (+) point of care rapid detection tests results were confirmed by immunoassays. Women with a confirmed HBsAg status, HIV- and syphilis-negative at first antenatal care screening, singleton fetus and known pregnancy outcome (Aug-2012 to Dec-2016) were included. Logistic regression analysis was used to evaluate associations between HBV group (controls HBsAg negative, HBsAg+/HBeAg-, or HBsAg+/HBeAg+) and pregnancy outcome and comorbidity. Results. Most women were tested, 15,046/15,114 (99.6%) for HBV. The inclusion criteria were not met for 4,089/15,046 (27.2%) women due mainly to unavailability of pregnancy outcome and nonconfirmation of HBsAg+. In evaluable women 687/11,025 (6.2%) were HBsAg+, with 476/11,025 (4.3%) HBsAg+/HBeAg- and 211/11,025 (1.9%) were HBsAg+/HBeAg+. The caesarean section rate was low at 522/8,963 (5.8%). No significant associations were observed between pregnancy comorbidities or adverse pregnancy outcomes and HBV status. Conclusions. The results highlight the disease burden of HBV in women on the Myanmar-Thailand border and support original reports of a lack of significant associations with HBsAg+ irrespective of HBeAg status, for comorbidity, and pregnancy outcomes in deliveries supervised by skilled birth attendants.

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Hepatitis B Virus Infection in Pregnancy: Immunological Response, Natural Course and Pregnancy Outcomes

Journal of Clinical Medicine ◽

10.3390/jcm10132926 ◽

2021 ◽

Vol 10 (13) ◽

pp. 2926

Author(s):

Sirinart Sirilert ◽

Theera Tongsong

Keyword(s):

Hepatitis B Virus ◽

Hepatitis B ◽

Pregnancy Outcomes ◽

Natural Course ◽

Hbv Infection ◽

Chronic Hbv Infection ◽

B Virus ◽

Chronic Hbv ◽

Adverse Pregnancy ◽

The Impact

This review aimed to provide an update on the impact of pregnancy on the natural course of hepatitis B virus (HBV) infection and also on the impact of HBV infection on adverse pregnancy outcomes, including mother-to-child transmission (MTCT). For the literature review, original research articles, review articles, and guidelines were narratively reviewed and comprehensively validated. The databases of PubMed, EMBASE, and CINAHL were carefully searched for articles in English on topics related to HBV infection, pregnancy, and vertical transmission from 1960 to May 2021. Immunological changes during pregnancy such as suppression of Th1 response and induction of Th2 immunity lead to an impaired immune reaction to HBV and stimulate viral activity along with the reduction of CD8 T cells to escape immune detection. The impact of pregnancy on the natural course of chronic HBV infection seems to be minimal, while pregnancy can increase morbidity and mortality in the case of advanced HBV hepatitis or cirrhosis. Importantly, hepatitis flare or alanine aminotransferase (ALT) flare can occur during pregnancy and is more common during the postpartum period due to the interaction between HBV and the immune response. Interestingly, the impact of HBV infection on adverse pregnancy outcomes is more serious than ever thought. Updated evidence indicates that pregnancies with chronic HBV infection increase the risk of preterm birth and gestational diabetes, especially in cases of positive hepatitis e antigen (HBeAg).

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Validity of a point-of-care viral load test for hepatitis B in a low-income setting

Journal of Virological Methods ◽

10.1016/j.jviromet.2020.114057 ◽

2021 ◽

Vol 289 ◽

pp. 114057

Author(s):

Gezahegn Mekonnen Woldemedihn ◽

Corina Silvia Rueegg ◽

Hailemichael Desalegn ◽

Hanna Aberra ◽

Nega Berhe ◽

...

Keyword(s):

Viral Load ◽

Hepatitis B ◽

Low Income ◽

Point Of Care ◽

Load Test ◽

Viral Load Test ◽

Low Income Setting

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Neonatal outcome in pregnant patients with antiphospholipid syndrome

Journal of Perinatal Medicine ◽

10.1515/jpm-2014-0118 ◽

2015 ◽

Vol 43 (6) ◽

Cited By ~ 13

Author(s):

Katarina Jeremic ◽

Aleksandar Stefanovic ◽

Jelena Dotlic ◽

Jelena Stojnic ◽

Sasa Kadija ◽

...

Keyword(s):

Risk Factors ◽

Respiratory Distress Syndrome ◽

Pregnancy Outcome ◽

Pregnancy Outcomes ◽

Distress Syndrome ◽

Adverse Pregnancy Outcome ◽

Perinatal Asphyxia ◽

Premature Delivery ◽

Control Group ◽

Adverse Pregnancy

AbstractThe study aim was to evaluate pregnancy outcomes in patients with antiphospholipid syndrome (APS) and to determine which clinical parameters present risk factors for adverse pregnancy outcomes in these patients.The study included 55 patients with APS treated at the Clinic for Ob/Gyn, Clinical Center of Serbia, from 2006 to 2012. The control group consisted of 55 healthy pregnant women. Data regarding previous pregnancies and conception method were registered. Immunological and laboratory tests were performed. Pregnancy outcomes, including miscarriage, intrauterine fetal death, hypertensive disorders, diabetes mellitus, phlebothrombosis, fetal growth restriction, premature delivery, delivery method, perinatal asphyxia, respiratory distress syndrome, intraventricular hemorrhage, and necrotizing enterocolitis were followed.The premature delivery rate in APS patients was 31.8%, and pregnancy loss was 18.2%. Significantly more patients with APS had thrombocytopenia, pregnancy losses, intrauterine growth restriction, and perinatal asphyxia compared with the control group. More miscarriages, preterm delivery, lower birth weight, preeclampsia, and IgM anticardiolipin antibody levels significantly correlated with adverse pregnancy outcomes. Although rare, respiratory distress syndrome can also worsen neonatal health status. According to ROC analysis, previous miscarriages correctly explained 66.3% of adverse pregnancy outcome cases. We generated four equations of adverse pregnancy outcome risk factors.The most important prognostic factor for pregnancy outcome in APS patients is the number of previous miscarriages. Using appropriate current therapeutic protocol can enable live birth of a healthy newborn in most cases.

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Outcome of induced labour in pregnancies at 41 weeks gestation and over in Saudi Arabia

Eastern Mediterranean Health Journal ◽

10.26719/2003.9.3.316 ◽

2021 ◽

Vol 9 (3) ◽

pp. 316-323

Author(s):

A. A. Sobande ◽

H. M. Al Bar

Keyword(s):

Clinical Trial ◽

Saudi Arabia ◽

Cohort Study ◽

Caesarean Section ◽

Antenatal Care ◽

Pregnancy Outcomes ◽

Caesarean Section Rate ◽

Military Hospital ◽

Perinatal Morbidity ◽

Perinatal Complications

A retrospective, descriptive cohort study was conducted at King Faisal Military Hospital, Saudi Arabia, to compare pregnancy outcomes in patients induced with prostagl and in E2 from 41 weeks gestation. A total of 450 women whose antenatal care and delivery were conducted at the hospital during 1995-99 were studied. The main outcome measures used were caesarean section rate and perinatal morbidity and mortality. In otherwise normal pregnancies, the caesarean section rate was not significantly increased when induction of labour was carried out at 41 weeks gestation compared with >/=42 weeks. Although more perinatal complications occurred when induction was carried out at 42 weeks, the results were not statistically significant. A large prospective clinical trial is indicated

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FIRST TRIMESTER MATERNAL BMI AND PREGNANCY OUTCOME AT DMCH, LAHERIASARAI, BIHAR

10.36106/ijsr/6930378 ◽

2020 ◽

pp. 79-81

Author(s):

Supriya Kumari ◽

Surya Narayan ◽

Kumudini Jha ◽

Debarshi Jana

Keyword(s):

Pregnancy Outcome ◽

Pregnancy Outcomes ◽

First Trimester ◽

Normal Weight ◽

Obese Women ◽

Family History Of Diabetes ◽

Medical College ◽

Asian Indian Women ◽

Adverse Pregnancy ◽

Maternal Bmi

Aim: The aim of the study was to find out relationship of maternal BMI to pregnancy outcome. Methodology: The study carried out in Department of Obstetrics and Gynaecology, Darbhanga Medical College and Hospital, Laheriasarai, Bihar from February 2019 to January 2020 and pregnancy outcomes were analyzed in relation BMI recorded in first trimester of primigravida. Results: Mean age of pregnant women was 26.2 years. At first booking obese women were significantlyolder (28.0 years) than others. Family history of diabetes was significantly higher among obese women (8.25%) compared to others. Rates of cesarean sections were higher in obese compared to others. The macrosomia rates were higher in obese compared to other group. The preeclampsia (1.89%), were significantly higher in obese women than others. Conclusions: Obese women were at a high risk of developing adverse pregnancy outcomes in terms ofgestational diabetes, macrosomia, preeclampsia more of ceasarean section. Normal weight women have low risk for cesarean section and macrosomia. These results highlight the need for preconception counseling, especially for obese and overweight and have beneficial outcomes in Asian Indian women.

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Abstract P176: Associations of Gestational Lipids and Apolipoproteins With Pregnancy Outcomes: The Hyperglycemia and Adverse Pregnancy Outcome Study

Circulation ◽

10.1161/circ.141.suppl_1.p176 ◽

2020 ◽

Vol 141 (Suppl_1) ◽

Author(s):

Amanda M Perak ◽

Alan Kuang ◽

Nicola Lancki ◽

Darwin R Labarthe ◽

Svati H Shah ◽

...

Keyword(s):

Blood Pressure ◽

Pregnancy Outcome ◽

Gestational Age ◽

Pregnancy Outcomes ◽

Adverse Pregnancy Outcome ◽

Late Pregnancy ◽

Large For Gestational Age ◽

Obstetric Outcomes ◽

Outcome Study ◽

Adverse Pregnancy

Introduction: Gestational hyperlipidemia has traditionally been considered physiologic and benign, but the significance of inter-individual variation in lipid levels for maternal-fetal health are poorly understood. We examined associations of gestational lipids and apolipoproteins with adverse obstetric and neonatal outcomes. Methods: Data from the Hyperglycemia and Adverse Pregnancy Outcome Study were analyzed, including 1,813 mother-child dyads from 9 field centers in 6 countries: US (25%), Barbados (24%), UK (20%), China (16%), Thailand (8%), and Canada (7%). Fasting lipids and apolipoproteins were directly measured at a mean of 28 (range 23-34) weeks’ gestation. Cord blood was collected at delivery, neonatal anthropometrics were measured within 72 hours, and medical records were abstracted for obstetric outcomes. Logistic regression was utilized to test associations of lipids and apolipoproteins (per +1 SD; log-transformed if skewed) with pregnancy outcomes, adjusted for center, demographics, and maternal covariates such as BMI, blood pressure, and glycemia. Results: See Table for lipid and apolipoprotein levels in pregnant mothers. In fully adjusted models ( Table ), 1 SD higher log-triglycerides (i.e., ~2.7-fold higher triglyceride level) in late pregnancy was significantly associated with higher odds for preeclampsia (OR 1.53 [95% CI, 1.15-2.05]), large for gestational age infant (1.42 [1.21-1.67]), and infant insulin sensitivity <10 th percentile (1.25 [1.03-1.50]), but not with unplanned primary cesarean section or infant sum of skinfolds >90 th percentile. There were no significant associations of maternal HDL-C, LDL-C, or log-ApoB/A1 ratio with any outcome. Conclusion: Triglyceride levels in the latter half of pregnancy were uniquely associated with both maternal risks (preeclampsia) and neonatal risks (large for gestational age and insulin resistance), even after adjustment for maternal BMI, blood pressure, and glycemia.

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Gestational weight gain and adverse pregnancy outcomes: a prospective cohort study

BMJ Open ◽

10.1136/bmjopen-2020-038187 ◽

2020 ◽

Vol 10 (9) ◽

pp. e038187

Author(s):

Yuelin Wu ◽

Sheng Wan ◽

Shengyi Gu ◽

Zhengqian Mou ◽

Lingling Dong ◽

...

Keyword(s):

Cohort Study ◽

Weight Gain ◽

Caesarean Section ◽

Gestational Age ◽

Pregnancy Outcomes ◽

Late Pregnancy ◽

Adverse Pregnancy Outcomes ◽

Gestational Weight ◽

Maternal And Neonatal Outcomes ◽

Adverse Pregnancy

ObjectiveTo assess the associations of gestational weight gain (GWG) in early and late pregnancy with subsequent risks of adverse pregnancy outcomes in Chinese women.DesignProspective cohort study.SettingShanghai, China.ParticipantsWe studied 2630 nulliparous singleton pregnant women with complete data on weight gain in early (≤17 weeks of gestation) and late (>17 weeks) pregnancy in the Shanghai Birth Cohort.MethodsGWG was standardised into z-scores by gestational age and categorised as low (z-score <−1), normal (−1 to +1) and high (>1). The adjusted relative risks (aRRs) and 95%CIs were estimated through log-binomial regression models. Interaction effects between GWG and some other adjustment factors were tested, further stratified analyses were performed separately where interaction terms were significant.Outcome measuresAdverse maternal and neonatal outcomes.ResultsIndependent from GWG in late pregnancy, higher GWG in early pregnancy was associated with higher risks of gestational diabetes mellitus (aRR: 1.66; 95% CI: 1.11 to 2.48), caesarean section (aRR: 1.21; 95% CI: 1.05 to 1.39) and prolonged hospitalisation (aRR: 1.56; 95% CI: 1.03 to 2.38). Higher GWG in late pregnancy was independently associated with higher risks of caesarean section (aRR: 1.24; 95% CI: 1.09 to 1.41), large for gestational age (aRR: 2.01; 95% CI: 1.50 to 2.7) and macrosomia (aRR: 1.90; 95% CI: 1.30 to 2.78). In addition, the risk of gestational hypertension increased significantly with increased total GWG (aRR: 1.78; 95% CI: 1.14 to 2.76). The effects of GWG in late pregnancy on maternal and neonatal outcomes were significantly different between the women bearing a female and the women bearing male fetus.ConclusionThe GWG associations with adverse pregnancy outcomes differ at early and late pregnancy, and there may be effect modification by fetal sex in the association of GWG in late pregnancy with some pregnancy outcomes.

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Applying deep learning for adverse pregnancy outcome detection with pre-pregnancy health data

MATEC Web of Conferences ◽

10.1051/matecconf/201818910014 ◽

2018 ◽

Vol 189 ◽

pp. 10014 ◽

Cited By ~ 2

Author(s):

Yu Mu ◽

Kai Feng ◽

Ying Yang ◽

Jingyuan Wang

Keyword(s):

Deep Learning ◽

Pregnancy Outcome ◽

Pregnancy Outcomes ◽

Learning Algorithm ◽

Adverse Pregnancy Outcome ◽

Health Data ◽

Adverse Pregnancy Outcomes ◽

Deep Learning Algorithm ◽

Adverse Pregnancy

Adverse pregnancy outcomes can bring enormous losses to both families and the society. Thus, pregnancy outcome prediction stays a crucial research topic as it may help reducing birth defect and improving the quality of population. However, recent advances in adverse pregnancy outcome detection are driven by data collected after mothers having been pregnant. In this situation, if a bad pregnancy outcome is diagnosed, the parents will suffer both physically and emotionally. In this paper, we develop a deep learning algorithm which is able to detect and classify adverse pregnancy outcomes before parents getting pregnant. We train a multi-layer neural network by using a dataset of 75542 couples’ multidimension pre-pregnancy health data. Our model outperforms some of algorithms in accuracy, recall and F1 score.

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Pregnancy outcome in working women with work place stress

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20172631 ◽

2017 ◽

Vol 6 (7) ◽

pp. 2891

Author(s):

Kusuma Naik M. V. ◽

Vedavathy Nayak ◽

Renuka Ramaiah ◽

. Praneetha

Keyword(s):

Physical Activity ◽

Pregnancy Outcome ◽

Pregnancy Outcomes ◽

Social Stress ◽

Significant Risk ◽

Working Women ◽

Work Conditions ◽

Stress Index ◽

Work Place ◽

Adverse Pregnancy

Background: The employment rate of mothers has increased worldwide in recent years. So, there is concern about possible effects of work related risk factors and pregnancy outcome in working women. As a growing percentage of women work outside home before, during, and after pregnancy in most countries and its related occupational factors deserve to be studied in relation to pregnancy outcomes. To identify the effect of work place stress, on pregnancy and perinatal outcome.Methods: 100 pregnant working women, who were visiting the antenatal care unit and labour room taken into study. They were interviewed using predesigned questionnaire, Physical activity questionnaire, Workplace Stress Survey. Statistical analysis performed using SPSS version 21.Results: Mean age was 27yrs, with hrs of working/wk of 47hrs, 41 women studied were working in garment factories,46% of them had complications during their antenatal period, 56% of them were primigravidas. Among studied working conditions, working more than 40 hours/ week was significantly associated with high rates of preterm delivery (12%) and Small for gestational age (SGA) (22%) was significantly increased with high work stress.Conclusions: Among the studied, work conditions for working women working more than 40 hours/week, social stress index were found to be a significant risk factor for adverse pregnancy outcomes. General practice physical activity (GPPA) 80% of both active and moderately active women had some problems. In work place stress survey (WSS), 100% of women encountering problems at work place had problems during their pregnancy, 72% of women who handled stress moderately had problems. Therefore, as long as the health of the pregnant woman permits her to continue work during pregnancy that is not stressful or overloading for her, no adverse effect on pregnancy outcomes is expected.

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