The Effect of Different Treatment Regimens and Multiple Risk Factors on Adverse Pregnancy Outcomes among Syphilis-Seropositive Women in Guangzhou: A Retrospective Cohort Study

Background. To eliminate mother-to-child transmission of syphilis, the Chinese government recommends a treatment regimen that slightly differs from the World Health Organization- (WHO-) recommended treatment. However, little is known about their difference in efficacy. This study is aimed at comparing the effect of China-recommended and WHO-recommend treatment regimens on adverse pregnancy outcomes (APOs) and at examining associated risk factors of APOs among syphilis-seropositive women. Methods. Using the syphilis registry data, we retrospectively collected data from 4488 syphilis-infected pregnant women in Guangzhou during 2011-2018. Multivariate analyses were used to investigate the association between treatment regimens and APOs (ectopic pregnancy, spontaneous abortion, stillbirth, preterm birth or low birth weight, newborn smaller than gestational age, congenital syphilis, and infant death) and the association between risk factors and APOs. Results. Of 3474 participants, 27.3% had at least one APO. Compared to those receiving WHO-recommended treatment, women who received China-recommended treatment were less likely to have APOs (odds ratio (OR) 0.47, 95% confidence interval (CI) 0.38-0.57), whereas those who received no treatment had 1.6 times higher odds of experiencing APOs. One common risk factor across different APOs was high levels of log2-transformed toluidine red unheated serum test (TRUST) titers before treatment (OR 1.14, 95% CI 1.10-1.19). China-recommended treatment was effective in reducing APOs for those with TRUST≥1:8 (OR 0.21, 95% CI 0.14-0.29) and those with TRUST<1:8 (OR 0.62, 95% CI 0.50-0.77). Conclusions. Syphilis-seropositive women receiving China-recommended treatment had lower odds of APOs, especially when TRUST titers before treatment were high. Findings can be used to guide health professionals to reduce APOs among syphilis-infected mothers and promote nationwide use of China-recommended treatment.

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Risk Factors for Congenital Syphilis and Adverse Pregnancy Outcomes in Offspring of Women With Syphilis in Shenzhen, China

Sexually Transmitted Diseases ◽

10.1097/olq.0000000000000062 ◽

2014 ◽

Vol 41 (1) ◽

pp. 13-23 ◽

Cited By ~ 26

Author(s):

Jia-Bi Qin ◽

Tie-Jian Feng ◽

Tu-Bao Yang ◽

Fu-Chang Hong ◽

Li-Na Lan ◽

...

Keyword(s):

Risk Factors ◽

Pregnancy Outcomes ◽

Congenital Syphilis ◽

Adverse Pregnancy Outcomes ◽

Adverse Pregnancy

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A Strategic Program for Risk Assessment and Intervention to Mitigate Environmental Stressor-Related Adverse Pregnancy Outcomes in the Indian Population

Frontiers in Reproductive Health ◽

10.3389/frph.2021.673118 ◽

2021 ◽

Vol 3 ◽

Author(s):

Divyanu Jain ◽

Ajay K. Jain ◽

Gerlinde A. S. Metz ◽

Nina Ballanyi ◽

Abha Sood ◽

...

Keyword(s):

Risk Assessment ◽

At Risk ◽

Pregnancy Outcomes ◽

Local Level ◽

Adverse Pregnancy Outcomes ◽

Environmental Stressors ◽

World Health ◽

Strategic Program ◽

Adverse Pregnancy ◽

Health Organization

The Problem: Global environmental stressors of human health include, but are not limited to, conflict, migration, war, natural disasters, climate change, pollution, trauma, and pandemics. In combination with other factors, these stressors influence physical and mental as well as reproductive health. Maternal stress is a known factor for adverse pregnancy outcomes such as preterm birth (PTB); however, environmental stressors are less well-understood in this context and the problem is relatively under-researched. According to the WHO, major Indian cities including New Delhi are among the world's 20 most polluted cities. It is known that maternal exposure to environmental pollution increases the risk of premature births and other adverse pregnancy outcomes which is evident in this population.Response to the Problem: Considering the seriousness of this problem, an international and interdisciplinary group of researchers, physicians, and organizations dedicated to the welfare of women at risk of adverse pregnancy outcomes launched an international program named Optimal Pregnancy Environment Risk Assessment (OPERA). The program aims to discover and disseminate inexpensive, accessible tools to diagnose women at risk for PTB and other adverse pregnancy outcomes due to risky environmental factors as early as possible and to promote effective interventions to mitigate these risks. OPERA has been supported by the Worldwide Universities Network, World Health Organization (WHO) and March of Dimes USA.Addressing the Problem: This review article addresses the influence of environmental stressors on maternal-fetal health focusing on India as a model population and describes the role of OPERA in helping local practitioners by sharing with them the latest risk prediction and mitigation tools. The consequences of these environmental stressors can be partially mitigated by experience-based interventions that build resilience and break the cycle of inter- and-transgenerational transmission. The shared knowledge and experience from this collaboration are intended to guide and facilitate efforts at the local level in India and other LMIC to develop strategies appropriate for the jurisdiction for improving pregnancy outcomes in vulnerable populations.

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Association between neighbourhood deprivation, fetal growth, small-for-gestational age and preterm birth: a population-based prospective cohort study

BMJ Open ◽

10.1136/bmjopen-2021-049075 ◽

2021 ◽

Vol 11 (11) ◽

pp. e049075

Author(s):

Dionne V Gootjes ◽

Anke G Posthumus ◽

Vincent W V Jaddoe ◽

Eric A P Steegers

Keyword(s):

Risk Factors ◽

Cohort Study ◽

Preterm Birth ◽

Fetal Growth ◽

Gestational Age ◽

Pregnancy Outcomes ◽

First Trimester ◽

Adverse Pregnancy Outcomes ◽

Neighbourhood Deprivation ◽

Adverse Pregnancy

ObjectiveTo study the associations between neighbourhood deprivation and fetal growth, including growth in the first trimester, and adverse pregnancy outcomes.DesignProspective cohort study.SettingThe Netherlands, Rotterdam.Participants8617 live singleton births from the Generation R cohort study.ExpositionLiving in a deprived neighbourhood.Main outcome measuresFetal growth trajectories of head circumference, weight and length.Secondary outcomes measuresSmall-for-gestational age (SGA) and preterm birth (PTB).ResultsNeighbourhood deprivation was not associated with first trimester growth. However, a higher neighbourhood status score (less deprivation) was associated with increased fetal growth in the second and third trimesters (eg, estimated fetal weight; adjusted regression coefficient 0.04, 95% CI 0.02 to 0.06). Less deprivation was also associated with decreased odds of SGA (adjusted OR 0.91, 95% CI 0.86 to 0.97, p=0.01) and PTB (adjusted OR 0.89, 95% CI 0.82 to 0.96, p=0.01).ConclusionsWe found an association between neighbourhood deprivation and fetal growth in the second and third trimester pregnancy, but not with first trimester growth. Less neighbourhood deprivation is associated with lower odds of adverse pregnancy outcomes. The associations remained after adjustment for individual-level risk factors. This supports the hypothesis that living in a deprived neighbourhood acts as an independent risk factor for fetal growth and adverse pregnancy outcomes, above and beyond individual risk factors.

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PTSD Symptoms and Risk Factors During the COVID-19 Disease Pandemic in Iran

Iranian Journal of Psychiatry and Clinical Psychology ◽

10.32598/ijpcp.26.3367.1 ◽

2020 ◽

Vol 26 (3 Special Issue on COVID-19) ◽

pp. 394-399

Author(s):

Seyyed Mohammad Hossein Javadi ◽

◽

Roya Marsa ◽

Fahimeh Rahmani ◽

◽

...

Keyword(s):

Risk Factors ◽

World Health Organization ◽

World Health ◽

Chinese Government ◽

Ptsd Symptoms ◽

The World ◽

Health Organization

In December 2019, the Chinese government alerted the world to a dangerous virus that spread rapidly in communities. In fact, another acute respiratory syndrome occurred in Wuhan, China, and then spread rapidly to other parts of the world. The World Health Organization (WHO) refers to this virus as nCoV-2019, where n stands for “new” and CoV stands for “coronavirus”. In general, the virus (COVID-19) is similar to acute respiratory syndrome (MERS-CoV), but they are by no means identical

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Abstract 376: Adverse Pregnancy Outcomes and Cardiovascular Risks Multi-disciplinary Awareness Project

Circulation Cardiovascular Quality and Outcomes ◽

10.1161/hcq.13.suppl_1.376 ◽

2020 ◽

Vol 13 (Suppl_1) ◽

Author(s):

Venkata Sai Gogineni ◽

Ki Park ◽

Denise Manfrini ◽

Robert Egerman ◽

Sharon Aroda ◽

...

Keyword(s):

Risk Factors ◽

Pregnancy Outcomes ◽

Descriptive Analysis ◽

Primary Objective ◽

Adverse Pregnancy Outcomes ◽

Cardiovascular Risks ◽

Cvd Risk ◽

Adverse Pregnancy ◽

Traditional Risk Factors

Background: Cardiovascular disease (CVD) remains the number one cause of death amongst women. There has been much effort put forth over the past decade in reducing both the incidence and prevalence of this disease burden through screening and treating the traditional risk factors. Recent guidelines have shown that adverse pregnancy outcomes (APOs), including pre-eclampsia (PEC), gestational diabetes mellitus (GDM) and pre-term birth (PTB) have been associated with future maternal CVD risk. Much of the current literature focuses almost exclusively on PEC. Our investigation is more comprehensive, covering not only these other APOs but assessing whether providers of multiple specialties in our community are aware of the APO to CVD risk association. The primary objective of this study was to investigate if there exist any knowledge gaps regarding the progression from APO to CVD and if this knowledge varies by specialty. Methods: An anonymous voluntary survey through REDCap© was sent to providers in the fields of Internal medicine (IM, 21%), Family medicine (FM, 26%), Obstetrics-Gynecology (Ob-Gyn, 23%) and Cardiology (30%) who have been in practice for greater than five years in our local Gainesville community. This project was registered as a QI project and descriptive analysis was used to examine the responses. Results: A total of 53 providers responded to the survey. Despite having the majority of patients being women, Ob-Gyn was the least likely amongst all specialties to routinely screen for CV risk factors. However, when addressed, they were the most likely to ask about APOs. Cardiologists, despite declaring to be aware of the association between APOs and CV risk, were least likely to ask about APOs. All specialties recognized PEC and GDM as APOs linked to long-term maternal CV risk but failed to associate PTB as an APO. The majority of providers amongst IM, FM, and Cardiology did not ask about APOs and lacked the knowledge of how often to appropriately screen for secondary risk factors associated with APOs. Additionally, these providers outright admitted that they are not familiar with the current AHA and/or ACOG guidelines for screening and follow-up. Conclusion: Descriptive statistical analysis of our data suggests that there exists a notable knowledge gap between all four specialties investigated in our survey. Education concerning the link between APOs and future maternal CV risk is needed amongst all specialties, especially amongst the providers in Cardiology, IM, and FM. Targeted efforts at our institution to improve awareness of all APOs, their associated secondary risk factors, and appropriate screening is required in all specialties to help reduce CVD morbidity and mortality.

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Synthesized prevention and control of one decade for mother-to-child transmission of syphilis and determinants associated with congenital syphilis and adverse pregnancy outcomes in Shenzhen, South China

European Journal of Clinical Microbiology & Infectious Diseases ◽

10.1007/s10096-014-2186-8 ◽

2014 ◽

Vol 33 (12) ◽

pp. 2183-2198 ◽

Cited By ~ 10

Author(s):

J.-B. Qin ◽

T.-J. Feng ◽

T.-B. Yang ◽

F.-C. Hong ◽

L.-N. Lan ◽

...

Keyword(s):

South China ◽

Pregnancy Outcomes ◽

Prevention And Control ◽

Congenital Syphilis ◽

Adverse Pregnancy Outcomes ◽

Mother To Child Transmission ◽

Child Transmission ◽

Adverse Pregnancy ◽

And Control ◽

Mother To Child

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Nutritional status of pregnant women: prevalence and associated pregnancy outcomes

Revista de Saúde Pública ◽

10.1590/s0034-89102001000600002 ◽

2001 ◽

Vol 35 (6) ◽

pp. 502-507 ◽

Cited By ~ 74

Author(s):

Luciana Bertoldi Nucci ◽

Maria Inês Schmidt ◽

Bruce Bartholow Duncan ◽

Sandra Costa Fuchs ◽

Eni Teresinha Fleck ◽

...

Keyword(s):

Gestational Diabetes ◽

Nutritional Status ◽

Pregnant Women ◽

Pregnancy Outcomes ◽

Educational Level ◽

Adverse Pregnancy Outcomes ◽

World Health ◽

Prepregnancy Weight ◽

Adverse Pregnancy ◽

The Impact

INTRODUCTION: Although obesity is well recognized as a current public health problem, its prevalence and impact among pregnant women have been less investigated in Brazil. The objective of the study was to evaluate the impact of pre-obesity and obesity among pregnant women, describing its prevalence and risk factors, and their association with adverse pregnancy outcomes. METHODS: A cohort of 5,564 pregnant women, aged 20 years or more, enrolled at aproximately 20 to 28 weeks of pregnancy, seen in prenatal public clinics of six state capitals in Brazil were followed up, between 1991 and 1995. Prepregnancy weight, age, educational level and parity were obtained from a standard questionnaire. Height was measured in duplicate and the interviewer assigned the skin color. Nutritional status was defined using body mass index (BMI), according to World Health Organization (WHO) criteria. Odds ratios and 95% confidence interval were calculated using logistic regression. RESULTS: Age-adjusted prevalences (and 95% CI) based on prepregnancy weight were: underweight 5.7% (5.1%-6.3%), overweight 19.2% (18.1%-20.3%), and obesity 5.5% (4.9%-6.2%). Obesity was more frequently observed in older black women, with a lower educational level and multiparous. Obese women had higher frequencies of gestational diabetes, macrosomia, hypertensive disorders, and lower risk of microsomia. CONCLUSIONS: Overweight nutritional status (obesity and pre-obesity) was seen in 25% of adult pregnant women and it was associated with increased risk for several adverse pregnancy outcomes, such as gestational diabetes and pre-eclampsia.

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