scholarly journals The Burden of Adverse Neonatal Outcome among Antenatal Substance Users in Ethiopia: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 8 ◽  
pp. 2333794X2110196
Author(s):  
Wubet Alebachew Bayih ◽  
Metadel Yibeltal Ayalew ◽  
Melaku Tadege ◽  
Maru Mekie ◽  
Teklehaimanot Kiros ◽  
...  
Keyword(s):  
Neonatal Outcome ◽  
Birth Outcome ◽  
Meta Analysis ◽  
Neonatal Outcomes ◽  
Data Bases ◽  
Substance Users ◽  
Adverse Neonatal Outcome ◽  
Pooled Prevalence ◽  
Adverse Neonatal Outcomes ◽  
International Data

Background. Substances mainly khat, alcohol and cigarette are used during pregnancy in Ethiopia. However, to this date, there is no pooled evidence about the burden of adverse neonatal outcomes among the substance users during pregnancy in the country. Methods. Eligible primary studies were accessed from 4 international data bases (Google Scholar, Science Direct, Scopus, and PubMed). The required data were extracted from these studies and then exported to stata version 14 for analysis. Subgroup analyses were conducted for evidence of heterogeneity. Results. A total of 2298 neonates were included from 7 studies. Among these neonates, 530(23.06%) were those whose mothers used substance during pregnancy (exposed group) whereas 1768 neonates were those whose mothers didn’t use substance during pregnancy (controls group). The pooled prevalence of adverse neonatal outcome among the exposed mothers was 38.32% (95% CI: 29.48%, 47.16%; I2 = 76.3%) whereas it was 16.29% (95% CI: 9.45%, 23.13%) among the controls. Adverse neonatal outcome was most burdensome among cigarette smokers 45.20% (95% CI: 37.68%, 52.73%; I2 = .00%) when compared with khat chewers 34.00% (95% CI: 20.87%, 47.13%) and alcohol drinkers 38.47% (95% CI: 17.96%, 58.98%). Low birth weight 42.00% (95% CI: 18.01%, 65.99%; I2 = 91.8%) was the most common adverse birth outcome. Conclusion. It was found that adverse neonatal outcomes were much more burdensome among antenatal substance users than the controls. Therefore, mothers should be enabled to quit using substance before pregnancy. Besides, strict comprehensive screening of every pregnant mother should be made at antenatal care clinics for early identification and management of antenatal substance use.

Maternal and fetal factors contributing to neonatal outcome in Al-Tibri Medical College and Hospital

2021 ◽  
Vol 15 (1) ◽  
pp. 18-22
Author(s):  
Erum Saboohi ◽  
Nighat Seema ◽  
Abdulah Hadi Hassan
Keyword(s):  
Risk Factors ◽  
Antenatal Care ◽  
Preterm Delivery ◽  
Neonatal Outcome ◽  
Neonatal Outcomes ◽  
P Value ◽  
Medical College ◽  
Adverse Neonatal Outcome ◽  
Adverse Neonatal Outcomes ◽  
Nicu Admission

Background: The study was done to identify the maternal and fetal factors contributing to neonatal outcome and to evaluate the correlation between risk factors and adverse neonatal outcome. Subjects and methods: This prospective observational study was conducted on 126 mothers and their neonates fulfilling the selection criteria at Al-Tibri Medical College and Hospital. A self-designed Performa was used to enter data of subjects. Sick neonates were referred to neonatal intensive care unit for admission and management. The results were analyzed by using SPSS version 22. A p-values <0.05 was considered as significant. Results: Out of 126 enrolled subjects, 81% mothers were multigravidas, 31% were unbooked, 13.5% had gestational comorbidities, 15% were drug addict, 2% were Hepatitis B positive. 22.2% underwent emergency LSCS while 31.7% delivered babies by elective LSCS. Regarding fetal factors contributing to sick babies, IUGR (20%), twin fetuses (15.4%), prematurity (47.7%) were significant. 65 were sick babies. Adverse neonatal outcomes observed were prematurity in 25.4%, IUGR in 11.1%, NICU admission in 33.3%, and neonatal death in 2%. Risk factors associated with adverse neonatal outcomes were positive maternal drug addiction (p-value = 0.028), preterm delivery (p-value<0.001), NICU admission (p-value<0.001) and low birth weight (p-value <0.001). Conclusion: Compromised maternal antenatal care has profound deleterious effect on fetus and neonate. Obstetricians, perinatologists and neonatologists need to work in concord to improve maternal antenatal care hence improving neonatal outcome. In our study adverse neonatal outcome was associated with unbooked cases, delivery by EmLSCS, addicted mother, preterm delivery, LBW and neonates requiring NICU admission.

scholarly journals Neonatal outcomes after neuraminidase inhibitor use during pregnancy: a meta-analysis of cohort studies

2021 ◽  
Author(s):  
Jiangshan Lian ◽  
Munire Adilijiang ◽  
Caihua Chang ◽  
Hai-yin Jiang ◽  
Yongping Zhang
Keyword(s):  
Cohort Studies ◽  
Influenza Infection ◽  
Meta Analysis ◽  
Antiviral Treatment ◽  
Neuraminidase Inhibitor ◽  
Neonatal Outcomes ◽  
Cochrane Library ◽  
Increased Risk ◽  
Adverse Neonatal Outcomes ◽  
Antiviral Medications

AIM: Influenza infection poses a severe threat to pregnant mothers, and antiviral treatment is recommended. However, the safety of neuraminidase-inhibitor antiviral medications during pregnancy has not been well described. METHODS: A systematic review and meta-analysis were performed to evaluate the adverse neonatal outcomes associated with exposure to neuraminidase inhibitors during pregnancy. The PubMed, Embase, and Cochrane Library databases were searched to identify potential studies for inclusion. RESULTS: Nine cohort studies that estimated adverse neonatal outcomes associated with exposure to neuraminidase-inhibitor medication during pregnancy were included. Exposure to a neuraminidase inhibitor during pregnancy was not associated with an increased risk of congenital malformation (odds ratio [OR] 0.9, 95% confidence interval [CI] 0.72–1.12, P = 0.341), low Apgar score (OR 0.96, 95% CI 0.77–1.2, P = 0.733), or preterm birth (OR 0.99, 95% CI 0.89–1.09, P = 0.771) compared with no exposure. However, exposure to a neuraminidase inhibitor was associated with a reduced risk of low birth weight (OR 0.79, 95% CI 0.68–0.92, P = 0.002) and giving birth to a small-for-gestational-age infant (OR 0.78, 95% CI 0.69–0.88, P < 0.001). Further analyses limited to oseltamivir exposure were consistent with the overall results. CONCLUSION: Exposure to neuraminidase-inhibitor medication during pregnancy does not appear to be associated with adverse neonatal outcomes. We recommend further studies to investigate this association, which will help clinicians determine whether to prescribe a neuraminidase inhibitor during pregnancy.

scholarly journals Gastroschisis: Antenatal Sonographic Predictors of Adverse Neonatal Outcome

2014 ◽  
Vol 2014 ◽  
pp. 1-13 ◽  
Author(s):  
Rachael Page ◽  
Zachary Michael Ferraro ◽  
Felipe Moretti ◽  
Karen Fung Kee Fung
Keyword(s):  
Neonatal Outcome ◽  
Adverse Outcomes ◽  
Abdominal Circumference ◽  
Future Research ◽  
Adverse Neonatal Outcome ◽  
Not Otherwise Specified ◽  
Adverse Neonatal Outcomes ◽  
Clinically Significant ◽  
Key Terms ◽  
Bowel Dilatation

Objectives. The aim of this review was to identify clinically significant ultrasound predictors of adverse neonatal outcome in fetal gastroschisis.Methods. A quasi-systematic review was conducted in PubMed and Ovid using the key terms “gastroschisis,” “predictors,” “outcome,” and “ultrasound.”Results. A total of 18 papers were included. The most common sonographic predictors were intra-abdominal bowel dilatation (IABD), intrauterine growth restriction (IUGR), and bowel dilatation not otherwise specified (NOS). Three ultrasound markers were consistently found to be statistically insignificant with respect to predicting adverse outcome including abdominal circumference, stomach herniation and dilatation, and extra-abdominal bowel dilatation (EABD).Conclusions. Gastroschisis is associated with several comorbidities, yet there is much discrepancy in the literature regarding which specific ultrasound markers best predict adverse neonatal outcomes. Future research should include prospective trials with larger sample sizes and use well-defined and consistent definitions of the adverse outcomes investigated with consideration given to IABD.

Is There a Benefit of Antenatal Corticosteroid When Given < 48 Hours Before Delivery?

2021 ◽  
Author(s):  
Yoav Siegler ◽  
Naphtali Justman ◽  
Gal Bachar ◽  
Roy Lauterbach ◽  
Yaniv Zipori ◽  
...  
Keyword(s):  
Primary Outcome ◽  
Neonatal Outcome ◽  
Neonatal Morbidity ◽  
Time Interval ◽  
Outcome Study ◽  
Antenatal Corticosteroid ◽  
Time Intervals ◽  
Corticosteroid Administration ◽  
Adverse Neonatal Outcome ◽  
Adverse Neonatal Outcomes

Abstract Objective We assessed the association between a short Antenatal Corticosteroid Administration-to-Birth Interval and neonatal outcome. Study design: A retrospective study between 2010- 2020. Eligible cases were singleton preterm live-born neonates born between 24 0/7 and 33 6/7 weeks of gestation and were initiated an ACS course of Betamethasone. We divided the first 48 hours following 1st ACS administration to four-time intervals and compared each time interval to those born more than 48 hours following ACS administration. The primary outcome was a composite of adverse neonatal outcome, including neonatal mortality or any major neonatal morbidity. Results A total of 200 women gave birth less than 48 hours from receiving the first betamethasone injection, and 172 women gave birth within 2-7 days (48-168 hours) from ACS administration. Composite adverse neonatal outcome was higher for neonates born less than 12 hours from initial ACS administration compared to neonates born 2-7 days from first betamethasone injection (55.45% vs. 29.07%, OR 3.45 95% CI [2.02-5.89], p.value<0.0001). However, there was no difference in composite adverse neonatal outcomes between neonates born 12-48 hours following ACS administration and those born after 2-7 days. That was also true after adjusting for confounders. Conclusions 12-24 hours following ACS Administration may be sufficient in reducing the same risk of neonatal morbidities as > 48 hours following ACS administration. It may raise the question regarding the utility of the second dose of ACS.

scholarly journals Mild Gestational Diabetes and Adverse Pregnancy Outcome: A Systemic Review and Meta-Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Razieh Bidhendi Yarandi ◽  
Mojtaba Vaismoradi ◽  
Mohammad Hossein Panahi ◽  
Ingjerd Gåre Kymre ◽  
Samira Behboudi-Gandevani
Keyword(s):  
Relative Risk ◽  
Gestational Diabetes ◽  
Diagnostic Criteria ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Meta Analysis ◽  
Neonatal Outcomes ◽  
Adverse Neonatal Outcomes ◽  
Maternal And Neonatal Outcomes ◽  
Adverse Pregnancy

Background and Objectives: Mild gestational diabetes (GDM) refers to the gestational hyperglycemia, which does not fulfill the diagnostic criteria for GDM. The results of studies on adverse pregnancy outcomes among women with mild GDM are controversial. Therefore, the aim of this systematic review and meta-analysis was to investigate the impact of mild GDM on the risk of adverse maternal and neonatal outcomes.Methods: A thorough literature search was performed to retrieve articles that investigated adverse maternal and neonatal outcomes in women with mild GDM in comparison with non-GDM counterparts. All populations were classified to three groups based on their diagnostic criteria for mild GDM. Heterogeneous and non-heterogeneous results were analyzed using the fixed/random effects models. Publication bias was assessed using the Harbord test. DerSimonian and Laird, and inverse variance methods were used to calculate the pooled relative risk of events. Subgroup analysis was performed based on mild GDM diagnostic criteria. Quality and risk of bias assessment were performed using standard questionnaires.Results: Seventeen studies involving 11,623 pregnant women with mild GDM and 53,057 non-GDM counterparts contributed to the meta-analysis. For adverse maternal outcomes, the results of meta-analysis showed that the women with mild GDM had a significantly higher risk of cesarean section (pooled RR: 1.3, 95% CI 1.2–1.5), pregnancy-induced hypertension (pooled RR: 1.4, 95% CI 1.1–1.7), preeclampsia (pooled RR: 1.3, 95% CI 1.1–1.5) and shoulder dystocia (pooled RR: 2.7, 95% CI 1.5–5.1) in comparison with the non-GDM population. For adverse neonatal outcomes, the pooled relative risk of macrosomia (pooled RR = 0.4, 95% CI: 1.1–1.7), large for gestational age (pooled RR = 1.7, 95% CI: 1.3–2.3), hypoglycemia (pooled RR = 1.6, 95% CI: 1.1–2.3), hyperbilirubinemia (pooled RR = 1.1, 95% CI: 1–1.3), 5 min Apgar &lt;7 (pooled RR = 1.6, 95% CI: 1.1–2.4), admission to the neonatal intensive care unit (pooled RR = 1.5, 95% CI: 1.1–2.1), respiratory distress syndrome (pooled RR = 3.2, 95% CI: 1.8–5.5), and preterm birth (pooled RR = 1.4, 95% CI: 1.1–1.7) was significantly increased in the mild GDM women as compared with the non-GDM population. However, the adverse events of small for gestational age and neonatal death were not significantly different between the groups. Analysis of composite maternal and neonatal outcomes revealed that the risk of those adverse outcomes in the women with mild GDM in all classifications were significantly higher than the non-GDM population. Also, the meta-regression showed that the magnitude of those increased risks in both composite maternal and neonatal outcomes was similar.Conclusion: The risks of sever adverse neonatal outcomes including small for gestational age and neonatal mortality are not increased with mild GDM. However, the increased risks of most adverse maternal and neonatal outcomes are observed. The risks have similar magnitudes for all mild GDM diagnostic classifications.

scholarly journals Antenatal magnesium sulphate and adverse neonatal outcomes: A systematic review and meta-analysis

PLoS Medicine ◽  
2019 ◽  
Vol 16 (12) ◽  
pp. e1002988 ◽  
Author(s):  
Emily Shepherd ◽  
Rehana A. Salam ◽  
Deepak Manhas ◽  
Anne Synnes ◽  
Philippa Middleton ◽  
...  
Keyword(s):  
Systematic Review ◽  
Magnesium Sulphate ◽  
Meta Analysis ◽  
Neonatal Outcomes ◽  
Adverse Neonatal Outcomes

scholarly journals Adverse birth outcome and associated factors among diabetic pregnant women in Ethiopia: Systematic review and meta-analysis

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0241811
Author(s):  
Demeke Mesfin Belay ◽  
Wubet Alebachew Bayih ◽  
Abebaw Yeshambel Alemu ◽  
Aklilu Endalamaw Sinshaw ◽  
Demewoz Kefale Mekonen ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Birth Outcomes ◽  
Associated Factors ◽  
Birth Outcome ◽  
Meta Analysis ◽  
Adverse Birth Outcome ◽  
Adverse Birth Outcomes ◽  
Pooled Prevalence ◽  
History Of

Background The magnitude of adverse birth outcome among diabetic pregnant women is high in low-and-middle income countries, like Ethiopia. Precise epidemiological evidence is necessary to plan, evaluate and improve effective preventive measures. This systematic review and meta-analysis is the first to estimate the pooled prevalence of adverse birth outcome and associated factors among diabetic pregnant women in Ethiopia. Methods PubMed, Cochrane Library, Google Scholar, SCOPUS, Web of Science and PsycINFO, and article found in University online repository were accessed. Observational studies such as cross-sectional, case-control and prospective cohort reported using English language was involved. I2 statistic was used to check heterogeneity. Egger’s test and funnel plot were used to measure publication bias. Weighted inverse variance random effects model was also performed. Results Seven studies with 1,225 study participants were retrieved to estimate the pooled prevalence of adverse birth outcome and associated factors. The pooled prevalence of adverse birth outcome among diabetic pregnant women was 5.3% [95% CI; 1.61, 17.41]. Fasting blood glucose level above 100 mg/dl [Adjusted Odds ratio (AOR) = 10.51; 95% Confidence Interval (CI) = 5.90, 15.12], two hour post prandial glucose level above 120 mg/dl [AOR = 8.77; 95% CI = 4.51, 13.03], gestational age <37 completed week [AOR = 9.76; 95% CI = 5.29, 14.23], no ANC follow-up [AOR = 10.78; 95% CI = 6.12, 15.44], history of previous adverse outcomes [AOR = 3.47; 95% CI = 1.04, 5.90], maternal age < 30 years [AOR = 3.47; 95% CI = 1.04, 5.90], and illiteracy [AOR = 2.89; 95% CI = 0.81,4.97)] were associated factors of adverse birth outcome. Conclusions The pooled prevalence of adverse birth outcomes among diabetic pregnant women in Ethiopia was high. Child born from mothers who were illiterate, maternal age < 30 years, gestational age < 37 completed weeks, history of previous adverse birth outcomes and no ANC follow-up increased the risk of adverse birth outcome. Trial registration It is registered in PROSPERO data base: (PROSPERO 2020: CRD42020167734).

scholarly journals Duration of Operative Vaginal Delivery and Adverse Obstetric Outcomes

2019 ◽  
Vol 37 (05) ◽  
pp. 503-510
Author(s):  
Emily S. Miller ◽  
Yinglei Lai ◽  
Jennifer Bailit ◽  
Uma M. Reddy ◽  
Ronald J. Wapner ◽  
...  
Keyword(s):  
Vaginal Delivery ◽  
Study Design ◽  
Neonatal Outcome ◽  
Secondary Analysis ◽  
Perinatal Outcomes ◽  
Obstetric Outcomes ◽  
Adverse Neonatal Outcome ◽  
Operative Vaginal Delivery ◽  
Adverse Neonatal Outcomes ◽  
Observational Cohort

Abstract Objective This study aimed to evaluate whether the number of vacuum pop-offs, the number of forceps pulls, or the duration of operative vaginal delivery (OVD) is associated with adverse maternal and perinatal outcomes. Study Design This is a secondary analysis of a multicenter observational cohort of women who underwent an attempted OVD. Women were stratified by the duration of OVD and the number of pop-offs (vacuum) or pulls (forceps) attempted. Severe perineal lacerations, failed OVD, and a composite adverse neonatal outcome were compared by the duration of OVD and number of pop-offs or pulls. Results Of the 115,502 women in the primary cohort, 5,325 (4.6%) underwent an attempt at OVD: 3,594 (67.5%) with vacuum and 1,731 (32.5%) with forceps. After adjusting for potential confounders, an increasing number of pop-offs was associated with an increased odds of the composite adverse neonatal outcome. However, an increasing duration of vacuum exhibited a stronger association with the composite adverse neonatal outcome. Similarly, the number of forceps pulls was less strongly associated with the composite adverse neonatal outcome compared with the duration of forceps application. Conclusion The duration of OVD may be more associated with adverse neonatal outcomes than the number of pop-offs or pulls.

Neonatal Outcome of Macrosomia

2020 ◽  
Vol 40 (2) ◽  
pp. 114-119
Author(s):  
Subhash Chandra Shah ◽  
Anusmriti Guragain ◽  
Shreejana Pandey ◽  
Ajaya Kumar Dhakal
Keyword(s):  
Maternal Age ◽  
Neonatal Outcome ◽  
Tertiary Care ◽  
Public Health Problem ◽  
Pregnancy Induced Hypertension ◽  
Factors Associated ◽  
Adverse Neonatal Outcome ◽  
Induced Hypertension ◽  
Appropriate For Gestational Age ◽  
Prolonged Hospital

Introduction: Macrosomia is an emerging public health problem, both in the developed as well as in the developing countries. This study was aimed to examine the maternal and neonatal risk factors associated with macrosomia and compare adverse neonatal outcome between appropriate for gestational age (AGA) and macrosomia. Methods: Records of all live singleton AGA and macrosomic babies delivered at a tertiary care teaching hospital in Lalitpur, Nepal, between 14th April 2013 and 13th April 2014 were retrospectively reviewed. Results: Of the 769 deliveries, 684 neonates were eligible of which 93 were born macrosomic with an incidence of 12.1%. We observed the most significant neonatal outcome to be neonatal sepsis (14%; p = 0.005) compared to AGA babies (5.9%). Macrosomia was found to be associated with increasing maternal age and parity (p = 0.007) relative to mothers of AGA babies, most of whom underwent caesarean section (55.9%) whilst the same outcome was fewer for mothers of AGA babies (29.9%). A higher incidence of pregnancy induced hypertension (PIH) as maternal comorbidity (5.4%) was associated with macrosomia contrasted with mothers of AGA babies (4.4%). Conclusion: Macrosomic birth was found to be associated with relatively higher adverse neonatal outcome, warranting prolonged hospital admission than AGA births.

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