scholarly journals Prenatal exposure to antibiotics and wheezing in infancy: a birth cohort study

2015 ◽  
Vol 47 (3) ◽  
pp. 810-817 ◽  
Author(s):  
Maja Popovic ◽  
Franca Rusconi ◽  
Daniela Zugna ◽  
Claudia Galassi ◽  
Franco Merletti ◽  
...  
Keyword(s):  
Birth Cohort ◽  
First Trimester ◽  
Birth Cohort Study ◽  
Confounding Factors ◽  
Antibiotic Exposure ◽  
Third Trimester ◽  
Recurrent Wheezing ◽  
Adjusted Risk ◽  
The Third ◽  
Trimester Exposure

The role of prenatal antibiotic exposure in the development of childhood wheezing is debated. We evaluated whether this association could potentially be explained by confounding factors.Antibiotic use in the first and third trimester of pregnancy, wheezing in children aged ≤18 months and confounding factors were assessed in singletons participating in the NINFEA (Nascita e Infanzia: gli Effetti dell'Ambiente) birth cohort (n=3530 for first-trimester exposure and n=3985 for third-trimester exposure).There was no evidence of an association between antibiotic exposure in the first trimester of pregnancy and ever-wheezing (adjusted risk ratio (RR) 1.02, 95% CI 0.80–1.30) or recurrent wheezing (RR 0.99, 95% CI 0.54–1.82). For the third-trimester exposure, the crude RRs (95% CI) of ever-wheezing and recurrent wheezing were 1.34 (1.10–1.64) and 2.72 (1.80–4.11), respectively, which decreased to 1.12 (0.90–1.39) and 2.09 (1.32–3.29) after adjustment. The RRs of wheezing after genitourinary infections during pregnancy were increased independently of antibiotic treatment.In conclusion, the association between prenatal antibiotic exposure and infant wheezing could be largely explained by confounding factors, in particular respiratory infections during pregnancy. An excess risk of wheezing after antibiotic exposure during the third trimester of pregnancy remains after adjustment.

Antibiotic exposure during pregnancy and childhood asthma: a national birth cohort study investigating timing of exposure and mode of delivery

2021 ◽  
pp. archdischild-2020-319659 ◽  
Author(s):  
Cecilie Skaarup Uldbjerg ◽  
Jessica E Miller ◽  
David Burgner ◽  
Lars Henning Pedersen ◽  
Bodil Hammer Bech
Keyword(s):  
Cohort Study ◽  
Caesarean Section ◽  
Birth Cohort ◽  
Childhood Asthma ◽  
Mode Of Delivery ◽  
First Trimester ◽  
Birth Cohort Study ◽  
Antibiotic Exposure ◽  
Exposure During Pregnancy ◽  
Timing Of Exposure

ObjectiveTo investigate whether antibiotic exposure during pregnancy was associated with childhood asthma and if this relationship was conditional on timing of exposure and mode of delivery.DesignA cohort study using multivariable logistic regression models adjusting for a priori defined confounders. Pregnant women were recruited from 1996 to 2002.SettingThe Danish National Birth Cohort.PatientsOf the 96 832 children in the cohort, 32 651 children were included in the study population.Main outcome measureParent-reported childhood asthma at 11 years.ResultsA total of 5522 (17%) children were born to mothers exposed to antibiotics during pregnancy. In adjusted analyses, children born to exposed mothers had higher odds of asthma (OR 1.14, 95% CI 1.05 to 1.24). There was no association with antibiotic exposure in the first trimester (OR 1.02, 95% CI 0.83 to 1.26), but higher odds were observed for antibiotic exposure in the second to third trimester (OR 1.17, 95% CI 1.06 to 1.28), compared with unexposed children. The overall association between antibiotics during pregnancy and childhood asthma was only observed in vaginally born children (OR 1.17, 95% CI 1.07 to 1.28) but not in caesarean section born children (planned caesarean section: OR 0.95, 95% CI 0.66 to 1.37; caesarean emergency: OR 0.96, 95% CI 0.73 to 1.28). In exposed vaginally born children, the odds for childhood asthma requiring treatment during the preceding year were 34% higher (OR 1.34, 95% CI 1.21 to 1.49), compared with unexposed vaginally born children.ConclusionsAntibiotic exposure in mid-to-late pregnancy is associated with higher odds of childhood asthma in vaginally born children. Mode of delivery may modify the association.

scholarly journals Predictors of Birthweight in Healthy Women Attending A Rural Antenatal Clinic

2005 ◽  
Vol 5 (8) ◽  
pp. 01-19
Author(s):  
Mathule MSL ◽  
Kennedy T ◽  
Gates G ◽  
Maria T Spicer
Keyword(s):  
First Trimester ◽  
Antenatal Clinic ◽  
Antenatal Visit ◽  
Third Trimester ◽  
The Third ◽  
Significant Difference ◽  
Maternal Parity ◽  
The Mean ◽  
Trimester Exposure ◽  
Pregnancy Weight

Birthweight is important to infant survival and the later health of a child. To promote optimum birthweight, in an environment that is vulnerable to seasonal food shortages, it is important to understand the relationship between birthweight and exposure to the hungry season. The objective of this study was to determine seasonal effects on birthweight and examined the ability of maternal and seasonal variables to predict birthweight in this cohort. The study was conducted at Scott Hospital-Morija which services rural communities in Lesotho. Women with normal healthy pregnancies without complications, with a clinic attendance of five or more times, who had full term singleton infants were included. Information including infant’s date of birth, infant’s birthweight and length, monthly maternal weights, and date of first and last antenatal visit were systematically and retrospectively extracted from 477 Antenatal Clinic (ANC) records covering a period of three years from May 1998 to April 2001. There were 252 male infants with mean birthweight of 3169g ± 420 and 225 female infants with mean birthweight of 3297g ± 436. A seasonal pattern was observed with a significant difference (p<0.05) between the mean birthweights in the December and January hungry season (3100g ± 70) and the mean birthweights in March, April, August and September (3310g ± 70). First trimester exposure to the hungry season had a tendency to correlate with birthweight (p<0.10). Third trimester exposure to the hungry season had a significant negative (r = - 0.106, p<0.05) relationship with birthweight. The best predictors of birthweight were maternal parity (p=0.0001), last pregnancy weight (p=0.0001) and exposure to the hungry season in the third trimester (p=0.022) with the first trimester (p=0.056) of pregnancy approaching significance. Thus, length of exposure to the hungry season is important in determining pregnancy outcomes. The regression model including last pregnancy weight, maternal parity and exposure to the hungry season in the third trimester explained 12.2% of the variance in birth weight (p=0.017). Increased surveillance of primigravid women, promoting pregnancy weight gain for optimal infant weight at term and supplementation during the hungry season are recommended.

Physical Activity During Pregnancy and Preterm Birth: Findings From the 2015 Pelotas (Brazil) Birth Cohort Study

2020 ◽  
Vol 17 (11) ◽  
pp. 1065-1074
Author(s):  
Werner de Andrade Müller ◽  
Grégore Iven Mielke ◽  
Inácio Crochemore M. da Silva ◽  
Mariangela F. Silveira ◽  
Marlos Rodrigues Domingues
Keyword(s):  
Physical Activity ◽  
Cohort Study ◽  
Preterm Birth ◽  
Birth Cohort ◽  
Child Outcomes ◽  
Preterm Births ◽  
Birth Cohort Study ◽  
Premature Delivery ◽  
Third Trimester ◽  
The Third

Background: Physical activity (PA) during pregnancy is associated with several benefits in maternal and child outcomes, and its relationship with preterm birth is still conflicting. This study aims to examine the associations between PA during pregnancy and occurrence of preterm birth. Methods: PA was assessed by questionnaire (for each trimester) and accelerometry (second trimester) in women enrolled in a birth cohort study that started during pregnancy and included births that occurred between January 1 and December 31, 2015. Gestational age was based on the last menstrual period and ultrasonography. All deliveries before 37 weeks of gestation were considered preterm births. A Poisson regression model was used to measure associations controlling for potential confounders. Results: PA information was available for 4163 women and 13.8% of births were preterm. A total of 15.8% of women were engaged in PA during pregnancy. Multivariate analysis showed that only PA performed in the third trimester of pregnancy (prevalence ratio = 0.58; 95% confidence interval, 0.36–0.96) was associated with the outcome. Conclusions: PA performed in the third trimester of pregnancy was associated with a protection to preterm birth. Pregnant women should be counseled to engage in PA to lower the risk of premature delivery.

Correlations Between the Values of Maternal Glycemia from the Last Trimester of Pregnancy and Fetal Birth Weight

2013 ◽  
Vol 20 (3) ◽  
pp. 259-265
Author(s):  
Monica Vereş ◽  
Aurel Babeş ◽  
Szidonia Lacziko
Keyword(s):  
First Trimester ◽  
Mean Value ◽  
Fetal Macrosomia ◽  
Entire Group ◽  
Third Trimester ◽  
The Third ◽  
Group I ◽  
Fetal Birth Weight ◽  
First Trimester Of Pregnancy ◽  
The Mean

Abstract Background and aims: Gestational diabetes represents a form of diabetes diagnosed during pregnancy that is not clearly overt diabetes. In the last trimester of gestation the growth of fetoplacental unit takes place, thus maternal hyperglycemia will determine an increased transplacental passage, hyperinsulinemia and fetal macrosomia. The aim of our study was that o analyzing the effect of maternal glycemia from the last trimester of pregnancy over fetal weight. Material and method: We run an observational study on a group of 46 pregnant women taken into evidence from the first trimester of pregnancy, separated in two groups according to blood glucose determined in the third trimester (before birth): group I normoglycemic and group II with hyperglycemia (>92mg/dl). Results: The mean value of third trimester glycemia for the entire group was of 87.13±22.03. The mean value of the glycemia determined in the third trimester of pregnancy was higher in the second group (109.17 mg/dl) in comparison to the first group (74.,21 mg/dl). The ROC curve for third trimester glycemia as fetal macrosomia appreciation test has an AUC of 0.517. Conclusions: Glycemia determined in the last trimester of pregnancy cannot be used alone as the predictive factor for fetal macrosomia.

scholarly journals Infliximab clearance decreases in the second and third trimesters of pregnancy in inflammatory bowel disease

2020 ◽  
pp. 205064062096461
Author(s):  
Ana-Marija Grišić ◽  
Maria Dorn-Rasmussen ◽  
Bella Ungar ◽  
Jørn Brynskov ◽  
Johan F K F Ilvemark ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
First Trimester ◽  
Interquartile Range ◽  
Therapeutic Drug ◽  
Population Pharmacokinetic ◽  
Second Trimester ◽  
Third Trimester ◽  
The Third ◽  
Inflammatory Bowel

Background Infliximab therapy during pregnancy in inflammatory bowel disease is challenged by a dilemma between maintaining adequate maternal disease control while minimizing fetal infliximab exposure. We investigated the effects of pregnancy on infliximab pharmacokinetics. Methods The study population comprised 23 retrospectively identified pregnancies. Patients with inflammatory bowel disease were generally in clinical remission at pregnancy conception (74%) and received steady infliximab maintenance therapy (5 mg/kg q8w n = 17; q6w n = 4; q10w n = 1; 10 mg/kg q8w n = 1). Trough blood samples had been obtained in the same patients prior to pregnancy ( n = 119), the first trimester ( n = 16), second trimester ( n = 18), third trimester ( n = 7), and post-pregnancy ( n = 12). Data were analyzed using nonlinear mixed-effects population pharmacokinetic modelling. Results Dose-normalized infliximab concentrations were significantly higher during the second trimester (median 15 µg/mL/kg, interquartile range 10–21) compared to pre-pregnancy (7, 2–12; p = 0.003), the first trimester (9, 1–12; p = 0.04), or post-pregnancy (6, interquartile range 3–11; p > 0.05) in patients with inflammatory bowel disease. Similar trends were observed in the third trimester (13, 7–36; p > 0.05). A one-compartment model with linear elimination described the pharmacokinetics of infliximab (volume of distribution = 18.2 L; clearance 0.61 L/day). Maternal infliximab exposure was influenced by the second and third trimester of pregnancy and anti-infliximab antibodies, and not by pregnancy-imposed physiological changes in, for example, body weight or albumin. Infliximab clearance decreased significantly during the second and third trimesters by up to 15% as compared to pre- and post-pregnancy and the first trimester. The increased maternal infliximab exposure was weakly associated with lowered clinical disease activity. Pharmacokinetic model simulations of virtual patients indicated the increased maternal infliximab trough concentrations imposed by pregnancy will not completely counteract the decrease in infliximab concentration if therapy is paused in the third trimester. Conclusion Infliximab clearance decreases significantly in the second and third trimesters, leading to increasing maternal infliximab concentrations in any given regimen. Maternal infliximab levels may thus be maintained as constant in a de-intensified regimen by therapeutic drug monitoring guidance in inflammatory bowel disease.

scholarly journals Feasibility of a Birth-cohort In Pakistan: Evidence For Better Lives Study

2021 ◽  
Author(s):  
Yasmeen Anwer ◽  
Fahad Abbasi ◽  
Ariba Dar ◽  
Abdullah Hafeez ◽  
Assad Hafeez ◽  
...  
Keyword(s):  
Mental Health ◽  
Pregnant Women ◽  
Birth Cohort ◽  
Partner Violence ◽  
Postnatal Period ◽  
Practice Change ◽  
Birth Cohort Study ◽  
Third Trimester ◽  
Resource Poor

Abstract BackgroundEvidence for Better Lives Study (EBLS) is an endeavour to establish a global birth cohort with participants from resource poor settings across the globe. It aims to investigate mediators and moderators of child development and wellbeing; it envisages informing policy and practice change to promote child health and wellbeing globally. Pakistan is one of the resource poor settings taking part in this global birth cohort; we report the feasibility of establishing such a birth cohort in Pakistan.MethodFrom March 2019 to July 2019, 153 third trimester pregnant women were identified, using community health worker registers, and approached for baseline demographics and a number of maternal wellbeing, mental health, support related information and stress related biomarkers in a peri-urban area of Islamabad Capital Territory. From October 2019 to December 2019, we re-contacted and followed 121 between 8-24 weeks postnatal period. All interviews were done after consent and data was collected electronically. Results150 (98%) third trimester pregnant women consented and were interviewed, 111 (74%) provided bio-samples and 121 (80.6%) were followed up postnatally. Their mean age and years of schooling was 27.29 (5.18) and 7.77 (4.79) respectively. Majority (82.3%) of the participants were housewives. Nearly a tenth were first time mothers while 63% of women reported current pregnancy to have been unplanned. Overall wellbeing and mental health were reported to be poor (WHO-5 mean scores 49.41 (32.20) & PHQ-9 mean scores 8.23 (7.0)). About 22% of women reported four or more adverse childhood experiences; 12.2% reported intimate partner violence during their current pregnancy. During the postnatal follow up visits, 58% of the women reported breastfeeding their infants. ConclusionThe study demonstrated Pakistan site could identify, approach, interview and follow up women and children postnatally, with a high response rates for both the follow up visits and bio-samples. Thus, a larger scale pregnancy birth cohort study in Pakistan is feasible to conduct.

scholarly journals The Effect of Preserving Pregnancy in Cervical Cancer Diagnosed During Pregnancy: A Retrospective Study

2021 ◽  
Author(s):  
Zuoxi He ◽  
Chuan Xie ◽  
Xiaorong Qi ◽  
Zhengjun Hu ◽  
Yuedong He
Keyword(s):  
Cervical Cancer ◽  
Rare Event ◽  
Oncologic Outcome ◽  
First Trimester ◽  
Second Trimester ◽  
Third Trimester ◽  
Delayed Treatment ◽  
The Third ◽  
Survival Difference ◽  
Estimated Blood Loss

Abstract ObjectiveCervical cancer diagnosed during pregnancy is a rare event, and data regarding efficacy of cancer treatment during pregnancy is limited. This study aimed to assess the safety of continuation of the pregnancy for mother and fetus when concomitantly diagnosed with cervical cancer.MethodsThis study retrospectively analyzed all cervical cancer patients diagnosed while pregnant or immediately postpartum, inclusive from Jan 2010 to June 2019 at our institute. Patient clinical details and follow-up were obtained from hospital records. ResultsThe study comprised 40 patients with clinical cancer stages of ⅠA1 (1/40, 2.5%); ⅠB1 (15/40, 37.5%); IB2 (10/40, 25%); ⅡA (12/40, 30%); and ⅡB (2/40, 5%). There were 38 patients diagnosed during pregnancy, and 2 diagnosed in the postpartum period. Of the 38 patients, 17 were diagnosed in the first trimester, 13 in the second trimester, and 8 in the third trimester. Ten of 38 patients (26.3%) continued their pregnancy after learning of their diagnosis; 7 (70%) in the third trimester and 3 (30%) in the second trimester. The mean time from diagnosis to surgery in the patients who continued their pregnancy was 52.7 days, which was statistically significantly greater than the termination of pregnancy group (52.7 vs 16.3 days, P < 0.01). Notably, there was no survival difference between the 2 groups (100% vs 90.91%, P =0.54), and none of the pregnant women who ultimately died had delayed treatment due to pregnancy. Similarly, the surgical estimated blood loss and operative duration comparing the 2 groups were not significantly different. ConclusionsIn the present study, the gestational age of pregnancy at the time of initial diagnosis of cervical cancer was an important determinant in the disease management. Continuation of the pregnancy when diagnosed with cervical cancer did not affect the oncologic outcome of the mother nor increase either surgical or obstetric complications. Additionally, the use of neoadjuvant chemotherapy did not threaten the health of the fetus. These results may be useful in counseling patients facing the diagnosis of cervical cancer during pregnancy.

scholarly journals The role of triiodothyronine (T3) and T3/free thyroxine (fT4) on glucose metabolism during pregnancy: the Ma’anshan Birth Cohort Study

2021 ◽  
Author(s):  
Beibei Zhu ◽  
Yan Han ◽  
Fen Deng ◽  
Kun Huang ◽  
Shuangqin Yan ◽  
...  
Keyword(s):  
Cohort Study ◽  
Glucose Metabolism ◽  
Birth Cohort ◽  
Goodness Of Fit ◽  
Prediction Models ◽  
First Trimester ◽  
Repeated Measurements ◽  
Free Thyroxine ◽  
Birth Cohort Study ◽  
Goodness Of Fit Test

Objectives: Compared with other thyroid markers, fewer studies explored the associations between triiodothyronine (T3) and T3/free thyroxine (fT4) and glucose abnormality during pregnancy. Thus, we aimed to: (1) examine the associations of T3 and T3/fT4 with glucose metabolism indicators; and (2) evaluate, in the first trimester, the performance of the two markers as predictors of gestational diabetes mellitus (GDM) risk. Methods: Longitudinal data from 2723 individuals, consisting of three repeated measurements of T3 and fT4, from the Man’anshan birth cohort study (MABC), China, were analyzed using a time-specific generalized estimating equation (GEE). The receiver operating characteristic curve (ROC) - area under the curve (AUC) and Hosmer-Lemeshow goodness of fit test were used to assess the discrimination and calibration of prediction models. Results: T3 and T3/fT4 presented stable associations with the level of fasting glucose, glucose at 1h/2h across pregnancy. T3 and T3/fT4 in both the first and second trimesters were positively associated with the risk of GDM, with the larger magnitude of association observed in the second trimester (Odds ratio (OR) = 2.50, 95%CI = 1.95, 3.21 for T3; OR = 1.09, 95%CI = 1.07, 1.12 for T3/fT4). T3 ((AUC) = 0.726, 95%CI = 0.698, 0.754) and T3/fT4 (AUC = 0.724, 95%CI = 0.696, 0.753) in the first trimester could improve the performance of the predicting model; however, the overall performance is not good. Conclusion: Significant and stable associations of T3, T3/fT4 and glucose metabolism indicators were documented. Both T3 and T3/fT4 improve the performance of the GDM predictive model.

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