scholarly journals Adverse Birth Outcomes among Nulliparous vs. Multiparous Women

2011 ◽  
Vol 126 (6) ◽  
pp. 797-805 ◽  
Author(s):  
Marie Lynn Miranda ◽  
Sharon E. Edwards ◽  
Evan R. Myers
Keyword(s):  
Birth Outcomes ◽  
Live Birth ◽  
Birth Outcome ◽  
Adverse Outcomes ◽  
Adverse Birth Outcomes ◽  
The North ◽  
Nulliparous Women ◽  
Multiparous Women ◽  
The Difference ◽  
Age Adjusted Rates

Objectives. Previous studies indicate that nulliparous women (i.e., women having no previous births) are at higher risk for adverse birth outcomes than multiparous women (i.e., women having had at least one previous birth). We examined whether part of the difference in adverse outcome rates is attributable to nulliparous women with poor pregnancy outcomes being less likely (through choice or fecundity differences) to have a subsequent live birth within the same time period as nulliparous women without adverse outcomes. Methods. Using deterministic matching, we linked nulliparous women from the North Carolina Detailed Birth Record to subsequent births. We employed statistical and simulation-based analyses to estimate first birth outcome rate differences between nulliparous women who did have a subsequent live birth vs. those who did not. Our Markov simulations focused on preterm birth (PTB). Results. Among nulliparous women who were not linked to a second birth, maternal age-adjusted rates of multiple adverse outcomes were all statistically higher compared with rates for linked women. These results also held in race/ethnicity-specific analyses. Simulations found that the relative risk of PTB associated with a history of PTB was underestimated if some women who would have been at risk for PTB did not experience a second birth. Conclusions. The observed differences in rates of adverse outcomes between nulliparous and multiparous women are partly attributable to higher-risk women not having a subsequent live birth, either by choice or due to fecundity differences.

scholarly journals Parity and the risks of adverse birth outcomes: a retrospective study among Chinese

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Li Lin ◽  
Ciyong Lu ◽  
Weiqing Chen ◽  
Chunrong Li ◽  
Vivian Yawei Guo
Keyword(s):  
Retrospective Study ◽  
Birth Outcomes ◽  
Maternal Age ◽  
Chinese Women ◽  
Complete Information ◽  
Adverse Birth Outcomes ◽  
Combined Effects ◽  
Nulliparous Women ◽  
Multiparous Women ◽  
The Impact

Abstract Background Nulliparity is considered to be a risk factor of preterm birth (PTB), low birth weight (LBW) and small for gestational age (SGA). With the new two-child policy launched in 2016, more Chinese women have delivered their 2nd baby. Yet few studies have assessed the impact of parity on adverse birth outcomes in China. This study aimed to examine the association between parity and risks of PTB, LBW and SGA in a Chinese population. The combined effects of maternal age and parity on adverse birth outcomes were also assessed. Methods This retrospective study included all non-malformed live births born during January 1, 2014 and December 31, 2018 in Chengdu, China. A total of 746,410 eligible live singletons with complete information were included in the analysis. Parity was classified into nulliparity (i.e. has never delivered a newborn before) and multiparity (i.e. has delivered at least one newborn before). Log-binomial regression analyses were applied to evaluate the association between parity and PTB, LBW and SGA. We further divided maternal age into different groups (< 25 years, 25–29 years, 30–34 years and ≥ 35 years) to assess the combined effects of maternal age and parity on adverse birth outcomes. Results Multiparity was associated with reduced risks of PTB (aRR = 0.91, 95% CI: 0.89–0.93), LBW (aRR = 0.74, 95% CI: 0.72–0.77) and SGA (aRR = 0.67, 95% CI: 0.66–0.69) compared with nulliparity. In each age group, we observed that multiparity was associated with lower risks of adverse birth outcomes. Compared to nulliparous women aged between 25 and 29 years, women aged ≥35 years had greater risks of PTB and LBW, regardless of their parity status. In contrast, multiparous women aged ≥35 years (aRR = 0.73, 95% CI: 0.70–0.77) and those aged < 25 years (aRR = 0.88, 95% CI: 0.84–0.93) were at lower risk of SGA compared with nulliparous women aged between 25 and 29 years. Conclusion Multiparity was associated with lower risks of all adverse birth outcomes. Special attention should be paid to nulliparous mothers and those with advanced age during antenatal care, in order to reduce the risks of adverse birth outcomes.

scholarly journals Adverse birth outcomes among women who gave births at Eastern Ethiopian Hospitals: a cross sectional study

2020 ◽  
Author(s):  
Teshale Mulatu Dibisa ◽  
Adera Debela Kebede ◽  
Tilaye Feto Gelano ◽  
Yadeta Dessie Bacha ◽  
Kemal Jemal
Keyword(s):  
Birth Outcomes ◽  
Birth Outcome ◽  
Multiple Pregnancy ◽  
Neonatal Morbidity ◽  
Cross Sectional Study ◽  
Adverse Birth Outcome ◽  
Adverse Birth Outcomes ◽  
Cross Sectional ◽  
Eastern Ethiopia ◽  
History Of

Abstract Background Adverse births outcomes (ABO) such as preterm birth, low birth weight (LBW) and stillbirth are important determining of neonatal morbidity and mortality. It is the major public health problem in low resourced countries. Despite many efforts to reduce neonatal morbidity and mortality, adverse birth outcomes in hospitals has remained high. Therefore, this study aimed to assess the prevalence and factors associated with adverse birth outcomes among women who gave birth at selected public hospitals in Eastern Ethiopia. Methods Facility based cross-sectional study design was conducted in February 2017. Data were collected using a pretested and structured face to face interviewer-administered questionnaire. Binary logistic regression was used to analyze the association between the dependent and independent variables. Results A total of 555 women who give births were involved from four hospitals in Eastern Ethiopia. The prevalence of low birth weight, stillbirth and preterm births were 40(7.2%), 37(6.7%) and 28(5%) respectively. The overall prevalence of adverse birth outcomes was 76(13.7%). Four-ninth 247(44.5%) of mothers had high-risk pregnancies. Hypertension [AOR = 7.25; 95%, CI= (1.71, 30.64)], history of adverse birth outcome [AOR = 12.12; 95%, CI= (6.5, 22.6)], multiple pregnancy [AOR = 6.94; 95%, CI= (2.74, 17.53)] and spontaneous vaginal delivery [AOR = 0.11; 95%, CI= (0.44, 0.16)] were associated with adverse birth outcome. Conclusion In this study adverse birth outcomes were still found as public health problems. Hypertension, history of adverse birth outcome, multiple pregnancy and spontaneous vaginal delivery were significantly associated with ABO. Thus, developing strategies to prevent and treat complications during pregnancy and increasing maternal health utilization at ANC clinics are warranted.

75 Live Birth and Adverse Birth Outcomes in Women With Crohn's Disease Receiving Assisted Reproduction - A 20 Year Nationwide Cohort Study

2016 ◽  
Vol 150 (4) ◽  
pp. S20
Author(s):  
Sonia Friedman ◽  
Pia V. Larsen ◽  
Jens Fedder ◽  
Punyanganie S. De Silva ◽  
Michael D. Larsen ◽  
...  
Keyword(s):  
Cohort Study ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Birth Outcomes ◽  
Assisted Reproduction ◽  
Live Birth ◽  
Adverse Birth Outcomes

scholarly journals The Zambian Preterm Birth Prevention Study (ZAPPS): Cohort characteristics at enrollment

2018 ◽  
Vol 2 ◽  
pp. 25 ◽  
Author(s):  
Marcela C. Castillo ◽  
Nurain M. Fuseini ◽  
Katelyn Rittenhouse ◽  
Joan T. Price ◽  
Bethany L. Freeman ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Birth Outcomes ◽  
Gestational Age ◽  
Clinical Care ◽  
Adverse Outcomes ◽  
Sub Saharan Africa ◽  
Growth Monitoring ◽  
Adverse Birth Outcomes ◽  
Prevention Study ◽  
Background Rate

Background: Sub-Saharan Africa bears a disproportionate burden of preterm birth and other adverse outcomes. Not only is the background rate of preterm birth higher than in North America and Europe, but many facilities lack essential equipment and personnel resources to care for preterm neonates. A better understanding of the demographic, clinical, and biologic underpinnings of preterm birth is urgently needed to plan interventions and inform new discovery.  Methods: The Zambian Preterm Birth Prevention Study (ZAPPS) is a prospective antenatal cohort established at the Women and Newborn Hospital of the University Teaching Hospital (UTH) in Lusaka, Zambia. We recruit pregnant women from the antenatal clinics of district health centers and the UTH for study participation. Women undergo ultrasound examination to determine eligibility by gestational age criteria. Enrolled participants receive routine antenatal and postnatal care, lab testing, midtrimester cervical length measurement, serial fetal growth monitoring and careful assessment of birth outcomes.  Results: Between August 2015 and September 2017, we screened 1784 women, of whom 1450 (81.2%) met inclusion criteria and were enrolled. The median age at enrollment of study participants is 27 years (IQR 23–32). Participants are enrolled at a median gestational age of 16 weeks (IQR 13–18). Among all parous participants (N=866; 64%), 21% (N=182) reported a prior miscarriage, 49% (N=424) reported a prior preterm birth, and 13% (N=116) reported a prior stillbirth. The HIV seroprevalence in our cohort is 24%. Discussion: We have established a large antenatal cohort to characterize the epidemiological and biological determinants of adverse birth outcomes in Lusaka, Zambia. Findings from this cohort will help guide future studies, clinical care, and policy in the prevention and treatment of adverse birth outcomes.

scholarly journals Community-based bilingual doulas for migrant women in labour and birth – findings from a Swedish register-based cohort study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Ulrika Byrskog ◽  
Rhonda Small ◽  
Erica Schytt
Keyword(s):  
Nitrous Oxide ◽  
Pain Relief ◽  
Hospital Stay ◽  
Birth Outcomes ◽  
Well Being ◽  
Adverse Outcomes ◽  
Obstetric Outcomes ◽  
Migrant Women ◽  
Community Based ◽  
Nulliparous Women

Abstract Background Community-based bilingual doula (CBD) services have been established to respond to migrant women’s needs and reduce barriers to high quality maternity care. The aim of this study was to compare birth outcomes for migrant women who received CBD support in labour with birth outcomes for (1) migrant women who experienced usual care without CBD support, and (2) Swedish-born women giving birth during the same time period and at the same hospitals. Methods Register study based on data retrieved from a local CBD register in Gothenburg, the Swedish Medical Birth Register and Statistics Sweden. Birth outcomes for migrant women with CBD support were compared with those of migrant women without CBD support and with Swedish-born women. Associations were investigated using multivariable logistic regression, reported as odds ratios (aORs) with 95% confidence intervals (CI), adjusted for birth year, maternal age, marital status, hypertension, diabetes, BMI, disposable income and education. Results Migrant women with CBD support (n = 880) were more likely to have risk factors for adverse pregnancy outcomes than migrant women not receiving CBD support (n = 16,789) and the Swedish-born women (n = 129,706). In migrant women, CBD support was associated with less use of pain relief in nulliparous women (epidural aOR 0.64, CI 0.50–0.81; bath aOR 0.64, CI 0.42–0.98), and in parous women with increased odds of induction of labour (aOR 1.38, CI 1.08–1.76) and longer hospital stay after birth (aOR 1.19, CI 1.03–1.37). CBD support was not associated with non-instrumental births, perineal injury or low Apgar score. Compared with Swedish-born women, migrant women with CBD used less pain relief (nulliparous women: epidural aOR 0.50, CI 0.39–0.64; nitrous oxide aOR 0.71, CI 0.54–0.92; bath aOR 0.55, CI 0.36–0.85; parous women: nitrous oxide aOR 0.68, CI 0.54–0.84) and nulliparous women with CBD support had increased odds of emergency caesarean section (aOR 1.43, CI 1.05–1.94) and longer hospital stay after birth (aOR 1.31, CI 1.04–1.64). Conclusions CBD support appears to have potential to reduce analgesia use in migrant women with vulnerability to adverse outcomes. Further studies of effects of CBD support on mode of birth and other obstetric outcomes and women’s experiences and well-being are needed.

scholarly journals Adverse Birth Outcomes in Botswana Among Women With Vertically or Horizontally Acquired Human Immunodeficiency Virus

2020 ◽  
Author(s):  
Christina Fennell ◽  
George R Seage ◽  
Rebecca Zash ◽  
Kelesitse Phiri ◽  
Modiegi Diseko ◽  
...  
Keyword(s):  
Birth Outcomes ◽  
Neonatal Death ◽  
Regression Models ◽  
Antiretroviral Treatment ◽  
Birth Outcome ◽  
Adverse Birth Outcomes ◽  
Binomial Regression ◽  
Immunodeficiency Virus ◽  
Risk Ratios ◽  
In Pregnancy

Abstract Background Women with vertically acquired HIV (VHIV) may have a greater risk of adverse birth outcomes than women with horizontally acquired HIV (HHIV). Methods The Tsepamo study performed birth outcomes surveillance at 8 government delivery sites in Botswana from July 2014 through March 2019. Pregnant women diagnosed with HIV before their 11th birthday received VHIV status, and other women had HHIV. Small for gestational age (SGA), preterm delivery (PTD), stillbirth, and neonatal death were compared using χ2 and Fisher’s exact tests. Log-binomial regression models determined risk ratios (RRs). Results VHIV women (n = 402) aged 15–27 years were identified over 4 years of surveillance and compared with HHIV women (n = 8465) of the same age. VHIV women were more likely to use nevirapine (NVP)-based antiretroviral treatment (ART) in pregnancy and to have SGA and very SGA infants, but less likely to have very PTD infants. In unadjusted analyses, VHIV women had a higher risk of any adverse birth outcome combined (RR = 1.21, 95% confidence interval [CI], 1.08–1.36). After adjusting for potential confounders, particularly use of NVP-based regimens, the risk of adverse birth outcomes among VHIV and HHIV women was similar. Conclusions NVP-based ART is a primary and modifiable risk factor for adverse birth outcomes. Updating ART regimens could improve birth outcomes for women with HIV.

441 Live Birth and Adverse Birth Outcomes in Women With Ulcerative Colitis Receiving Assisted Reproduction - A 20 Year Nationwide Cohort Study

2016 ◽  
Vol 150 (4) ◽  
pp. S93
Author(s):  
Bente M. Nørgård ◽  
Pia V. Larsen ◽  
Jens Fedder ◽  
Punyanganie S. De Silva ◽  
Sonia Friedman
Keyword(s):  
Ulcerative Colitis ◽  
Cohort Study ◽  
Birth Outcomes ◽  
Assisted Reproduction ◽  
Live Birth ◽  
Adverse Birth Outcomes

scholarly journals Electronic cigarettes may not be a “safer alternative” of conventional cigarettes during pregnancy: evidence from the nationally representative PRAMS data

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Sooyong Kim ◽  
Sanda Cristina Oancea
Keyword(s):  
Pregnant Women ◽  
Birth Outcomes ◽  
Low Birthweight ◽  
Electronic Cigarettes ◽  
Adverse Outcomes ◽  
Adverse Birth Outcomes ◽  
Third Trimester ◽  
Pregnancy Risk ◽  
The Third ◽  
Shared Risk

Abstract Background Conventional cigarette (CC) smoking is one of the most preventable causes of adverse birth outcomes. Although electronic cigarettes (ECs) are considered to be safer than CCs during pregnancy, the evidence is yet to be presented. This study examines the effects of prenatal EC use on neonatal birth outcomes compared to those of CC smokers and complete tobacco abstainers. Methods Data was extracted from 55,251 pregnant women who participated in the Phase 8 survey of the Pregnancy Risk Assessment Monitoring System between 2016 and 2018. Participants were classified into three groups based on their smoking behaviors in the third trimester: complete tobacco abstinence, exclusive CC smoking, or exclusive EC use. Adverse outcomes included infants being small-for-gestational-age (SGA), having low birthweight (LBW), and being born at preterm. EC users were matched to complete abstainers and CC smokers who share the same baseline characteristics in race/ethnicity, age, educational attainment, income, prenatal care adequacy, and first- and second-trimester CC smoking statuses. The association between EC use and adverse birth outcomes were examined by survey-weighted logistic regression analyses in the matched population. Results Among participants, 1.0% of women reported having used ECs during the third trimester, 60% of which reported using ECs exclusively. Neonates of EC users were significantly more likely to be SGA (OR 1.76; 95% CI 1.04, 2.96), have LBW (OR 1.53; 95% CI 1.06, 2.22), or be born preterm (OR 1.86; 95% CI 1.11, 3.12) compared to tobacco abstainers. However, odds of EC users’ pregnancies resulting in SGA (OR 0.67; 95% CI 0.30, 1.47), LBW (OR 0.71; 95% CI 0.37, 1.37), or preterm birth (OR 1.06; 95% CI 0.46, 2.48) were not significantly lower than those of CC smokers. Conclusions Even after accounting for shared risk factors between prenatal tobacco use and adverse birth outcomes, EC use remains an independent risk factor for neonatal complications and is not a safer alternative to CC smoking during pregnancy. Until further research is completed, all pregnant women are encouraged to abstain from all tobacco products including ECs.

scholarly journals Quantifying Factors Associated With Birth Outcomes and Their Implications on Evaluating the Success of a Maternal Respiratory Syncytial Virus (RSV) Vaccine Program in Kenya

2021 ◽  
Author(s):  
Joyce U. Nyiro ◽  
Elizabeth Bukusi ◽  
Dufton Mwaengo ◽  
David Walumbe ◽  
Amek Nyaguara ◽  
...  
Keyword(s):  
Respiratory Syncytial Virus ◽  
Birth Outcomes ◽  
Birth Outcome ◽  
Home Delivery ◽  
Surveillance Systems ◽  
Adverse Birth Outcomes ◽  
Cross Sectional Survey ◽  
Care Clinic ◽  
Factors Associated ◽  
Syncytial Virus

Abstract BackgroundMaternal immunisation to prevent respiratory syncytial virus (RSV) associated disease among infants is in focus. However, little is known about adverse birth outcomes and associated factors occurring in a setting with high morbidities of malaria, HIV infection and undernutrition. Quantifying these ahead of introduction of a maternal vaccine would assist in assessing an association between RSV vaccination and adverse birth outcomes. MethodsA cross-sectional survey was conducted to collect data on birth outcomes from women residents of the health and demographic surveillance systems (HDSS) of Siaya and Kilifi, Kenya and from the maternity wards of Siaya County referral hospital and Bondo sub-county hospital. Participants of the HDSS sites had pregnancies registered in the years 2017 to 2020 through census rounds and were traced at home for interview. All women had a birth outcome by the time of data collection. Multiple logistic regression was used to determine independent predictors of adverse birth outcomes. Results A total of 2219 women were interviewed. Median age during pregnancy was 27.7yrs (range: 22.7-32.4), 1857 (83.7%) attended antenatal care clinic (ANC), 1,979 (89.2%) delivered at a health facility and 2204 (99.3%) reported they would take up a new maternal vaccine. Adverse birth outcomes occurred in 781 (35%) of pregnancies; 490 (62.7%) were preterm, 247 (31.6%) low birth weight, 189 (24.2%) macrosomia and 42 (5.4%) still births. Predictors of adverse birth outcomes were, eclampsia (AOR 6.86 (1.40-33.60); p=0.017), gestational diabetes (AOR 3.01 (1.24-7.30; p=0.015), and home delivery (AOR 2.48 (1.20-5.13); p=0.014). Being multiparous (AOR 0.52 (0.33-0.81); p=0.004) was protective. Home delivery was significantly associated with older maternal age 40-49 years (p=0.001), multiparous >5 (p=0.001), level of formal education below primary (p=0.001) and Islamic religion (p=0.001). ConclusionsIn this maternal population, about a third of pregnancies have adverse birth outcomes. Recognizing this baseline prevalence will be important in validating safety of a new maternal vaccine. Monitoring of the actual safety outcomes of the maternal RSV vaccine, will require integrated initiatives to mitigate against factors affecting utilization of maternal healthcare services and individual factors associated with adverse birth outcomes.

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