scholarly journals Associations between periconceptional lifestyle behaviours and adverse pregnancy outcomes

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Veronique Y.F. Maas ◽  
Marjolein Poels ◽  
Marije Lamain-de Ruiter ◽  
Anneke Kwee ◽  
Mireille N. Bekker ◽  
...  
Keyword(s):  
Folic Acid ◽  
Pregnancy Outcomes ◽  
Adverse Pregnancy Outcome ◽  
First Trimester ◽  
Adverse Pregnancy Outcomes ◽  
Adverse Outcomes ◽  
Normal Body Mass Index ◽  
Lifestyle Behaviours ◽  
Folic Acid Supplements ◽  
Adverse Pregnancy

Abstract Background While the potential adverse outcomes of prenatal exposure to unhealthy lifestyle are widely evidenced, little is known about these exposures in the periconception period. We investigated the associations between lifestyle behaviours and adverse pregnancy outcomes with a unique distinction between preconceptional- and prenatal lifestyle behaviours. Methods A secondary analysis took place within a prospective multicentre cohort study in the Netherlands, including 3,684 pregnant women. Baseline characteristics and preconceptional and first trimester lifestyle behaviours were assessed through a self-administered questionnaire in the first trimester. Adverse pregnancy outcomes (hypertensive disorders in pregnancy (HDP), small for gestational age (SGA), gestational diabetes (GDM) and spontaneous preterm birth (sPTB)) were reported by healthcare professionals. Data were collected between 2012 and 2014 and analysed using multivariate logistic regression. Results Women who are overweight, and especially obese, have the highest odds of developing any adverse pregnancy outcome (adjusted odds ratio (aOR) 1.61 (95 % Confidence Interval (CI) 1.31–1.99) and aOR 2.85 (95 %CI 2.20–3.68), respectively), particularly HDP and GDM. Women who prenatally continued smoking attained higher odds for SGA (aOR 1.91 (95 %CI 1.05–1.15)) compared to the reference group, but these odds decreased when women prenatally quit smoking (aOR 1.14 (95 %CI 0.59–2.21)). Women who did not use folic acid supplements tended to have a higher odds of developing adverse pregnancy outcomes (aOR 1.28 (95 %CI 0.97–1.69)), while women who prenatally started folic acid supplements did not (aOR 1.01 (95 %CI 0.82–1.25)). Conclusions Our results indicate that smoking cessation, having a normal body mass index (BMI) and initiating folic acid supplements preconceptionally may decrease the risk of adverse pregnancy outcomes. Therefore, intervening as early as the preconception period could benefit the health of future generations.

Placental Growth Factor and Adverse Obstetric Outcomes in a Mixed-Risk Cohort of Women Screened for Preeclampsia in the First Trimester of Pregnancy

2021 ◽  
pp. 1-9
Author(s):  
Charlotte Kvist Ekelund ◽  
Line Rode ◽  
Ann Tabor ◽  
Jon Hyett ◽  
Andrew McLennan
Keyword(s):  
Growth Factor ◽  
Pregnancy Outcomes ◽  
Gestational Hypertension ◽  
Adverse Pregnancy Outcome ◽  
First Trimester ◽  
Placental Growth Factor ◽  
Adverse Pregnancy Outcomes ◽  
Adverse Outcomes ◽  
Obstetric Outcomes ◽  
Adverse Pregnancy

<b><i>Objective:</i></b> The study aimed to investigate the association between placental growth factor (PlGF) and adverse obstetric outcomes in a mixed-risk cohort of pregnant women screened for preeclampsia (PE) in the first trimester. <b><i>Methods:</i></b> We included women with singleton pregnancies screened for PE between April 2014 and September 2016. Outcome data were retrieved from the New South Wales Perinatal Data Collection (NSW PDC) by linkage to the prenatal cohort. Adverse outcomes were defined as spontaneous preterm birth (sPTB) before 37-week gestation, birth weight (BW) below the 3rd centile, PE, gestational hypertension (GH), stillbirth, and neonatal death. <b><i>Results:</i></b> The cohort consisted of 11,758 women. PlGF multiple of the median (MoM) was significantly associated with maternal sociodemographic characteristics (particularly smoking status and parity) and all biomarkers used in the PE first trimester screening model (notably pregnancy-associated plasma protein A MoM and uterine artery pulsatility index [PI] MoM). Low levels of PlGF (&#x3c;0.3 MoM and &#x3c;0.5 MoM) were independently associated with sPTB, low BW, PE, GH, and a composite adverse pregnancy outcome score, with odds ratios between 1.81 and 4.44 on multivariable logistic regression analyses. <b><i>Conclusions:</i></b> Low PlGF MoM levels are independently associated with PE and a range of other adverse pregnancy outcomes. Inclusion of PlGF should be considered in future models screening for adverse pregnancy outcomes in the first trimester.

scholarly journals Does the Thyroid-Stimulating Hormone Measured Concurrently With First Trimester Biochemical Screening Tests Predict Adverse Pregnancy Outcomes Occurring After 20 Weeks Gestation?

2014 ◽  
Vol 99 (12) ◽  
pp. E2668-E2672 ◽  
Author(s):  
Gregory S. Y. Ong ◽  
Narelle C. Hadlow ◽  
Suzanne J. Brown ◽  
Ee Mun Lim ◽  
John P. Walsh
Keyword(s):  
Thyroid Function ◽  
Pregnancy Outcomes ◽  
First Trimester ◽  
Adverse Pregnancy Outcomes ◽  
Adverse Outcomes ◽  
First Trimester Screening ◽  
Free T4 ◽  
Trimester Screening ◽  
Secondary Outcomes ◽  
Adverse Pregnancy

Context: Maternal hypothyroidism in early pregnancy is associated with adverse outcomes, but not consistently across studies. First trimester screening for chromosomal anomalies is routine in many centers and provides an opportunity to test thyroid function. Objective: To determine if thyroid function tests performed with first trimester screening predicts adverse pregnancy outcomes. Design, Participants and Setting: A cohort study of 2411 women in Western Australia with singleton pregnancies attending first trimester screening between 9 and 14 weeks gestation. Outcome Measures: We evaluated the association between TSH, free T4, free T3, thyroid antibodies, free beta human chorionic gonadotrophin (β-hCG) and pregnancy associated plasma protein A (PAPP-A) with a composite of adverse pregnancy events as the primary outcome. Secondary outcomes included placenta previa, placental abruption, pre-eclampsia, pregnancy loss after 20 weeks gestation, threatened preterm labor, preterm birth, small size for gestational age, neonatal death, and birth defects. Results: TSH exceeded the 97.5th percentile for the first trimester (2.15 mU/L) in 133 (5.5%) women, including 22 (1%) with TSH above the nonpregnant reference range (4 mU/L) and 5 (0.2%) above 10 mU/L. Adverse outcomes occurred in 327 women (15%). TSH and free T4 did not differ significantly between women with or without adverse pregnancy events. On the multivariate analysis, neither maternal TSH &gt;2.15 mU/L nor TSH as a continuous variable predicted primary or secondary outcomes. Conclusion: Testing maternal TSH as part of first trimester screening does not predict adverse pregnancy outcomes. This may be because in the community setting, mainly mild abnormalities in thyroid function are detected.

scholarly journals Effects of sanitation practices on adverse pregnancy outcomes in India: a conducive finding from recent Indian demographic health survey

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Ratna Patel ◽  
Ajay Gupta ◽  
Shekhar Chauhan ◽  
Dhananjay W. Bansod
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Pregnancy Outcome ◽  
Health Survey ◽  
Pregnancy Outcomes ◽  
Adverse Pregnancy Outcome ◽  
Wealth Index ◽  
Adverse Pregnancy Outcomes ◽  
Adverse Outcomes ◽  
Adverse Pregnancy

Abstract Background Several risk factors predisposing women and their live-borns to adverse outcomes during pregnancy have been documented. Little is known about sanitation being a factor contributing to adverse pregnancy outcomes in India. The role of sanitation in adverse pregnancy outcomes remains largely unexplored in the Indian context. This study is an attempt to bring the focus on sanitation as a factor in adverse pregnancy outcome. Along with the sanitation factors, few confounder variables have also been studied in order to understand the adverse pregnancy outcomes. Methods The study is based on the fourth round of National Family Health Survey (NFHS-IV) covering 26,972 married women in the age-group 15–49. The study variables include the mother’s age, Body Mass Index (BMI), education, anemia, and Antenatal care (ANC) visits during their last pregnancy. The household level variable includes place of residence, religion, caste, wealth index, access to toilet, type of toilet, availability of water within toilet premises, and facility of hand wash near the toilet. Children study variables include Low Birth Weight (LBW), the order of birth (Parity), and the death of the children of the women in the last 5 years. The target variable Adverse Pregnancy Outcome (APO) was constructed using children born with low birth weight or died during the last pregnancy. Results We calculated both adjusted as well as unadjusted odds ratios for a better understanding of the association between sanitation and adverse pregnancy outcomes. Findings from the study showed that women who did not have access to a toilet within the house had a higher risk of adverse pregnancy outcome. In the multivariable model, no association was observed for adverse pregnancy outcome among women who did not have access to toilet and women who used shared toilet. Teenage (15–19 years), uneducated, underweight and anemic mothers were more likely to face APO as compare to other mothers in similar characteristics group. Conclusions Our findings contribute to the decidedly less available literature on maternal sanitation behaviour and adverse pregnancy outcomes. Our results support that sanitation is a very significant aspect for women who are about to deliver a baby as there was an association between sanitation and adverse pregnancy outcome. Education on sanitation practices is the need of the hour as much as it needs to follow.

scholarly journals Associations Between Periconceptional Lifestyle Behaviour Change and Adverse Pregnancy Outcomes

2021 ◽  
Author(s):  
Veronique Y.F. Maas ◽  
Marjolein Poels ◽  
Marije Lamain-de Ruiter ◽  
Anneke Kwee ◽  
Mireille N. Bekker ◽  
...  
Keyword(s):  
Folic Acid ◽  
Behaviour Change ◽  
Pregnancy Outcomes ◽  
Adverse Pregnancy Outcome ◽  
Adverse Pregnancy Outcomes ◽  
Obese Women ◽  
Spontaneous Preterm Birth ◽  
Unhealthy Lifestyle ◽  
Lifestyle Behaviour ◽  
Adverse Pregnancy

Abstract Background While the effect of prenatal exposure to unhealthy lifestyle is widely evidenced, little is known about these exposures in the periconception period. We investigated associations between periconceptional lifestyle behaviour change and adverse pregnancy outcomes. Methods A retrospective secondary analysis took place within a prospective multicentre cohort study in the Netherlands, including 3,684 pregnant women. Baseline characteristics and preconceptional and first-trimester lifestyle behaviours were assessed through a self-administered questionnaire. Adverse pregnancy outcomes (hypertensive disorders in pregnancy (HDP), small for gestational age (SGA), gestational diabetes (GDM) and spontaneous preterm birth (sPTB)) were reported by healthcare professionals. Data were collected between December 2012 - January 2014 and analysed between August - December 2019, using multivariate logistic regression. Results Overweight, and especially obese women, have the highest odds of developing any adverse pregnancy outcome (adjusted odds ratio (aOR) 1.61 (95%CI 1.31–1.99) and aOR 2.85 (95%CI 2.20–3.68), respectively), particularly HDP and GDM. Women who prenatally quit smoking had a lower odds of SGA (aOR 1.14 (95%CI 0.59–2.21)), while women who continued smoking attained higher odds (aOR 1.91 (95%CI 1.05–1.15)). Women who did not use folic acid tended to have a higher odds of developing adverse pregnancy outcomes (aOR 1.28 (95%CI 0.97–1.69)), while women who prenatally started folic acid did not (aOR 1.01 (95%CI 0.82–1.25)). Conclusions Our results indicate that smoking cessation, having a lower BMI and initiating folic acid supplements preconceptionally may decrease the risk of adverse pregnancy outcomes. Therefore, intervening as early as the preconception period could benefit the health of future generations.

scholarly journals Prediction of adverse pregnancy outcomes by extreme values of first trimester screening markers

2017 ◽  
Vol 10 (3) ◽  
pp. 132-137 ◽  
Author(s):  
Marina S Gomes ◽  
Mariana Carlos-Alves ◽  
Vera Trocado ◽  
Diana Arteiro ◽  
Paula Pinheiro
Keyword(s):  
Pregnancy Outcomes ◽  
Extreme Values ◽  
Protein A ◽  
First Trimester ◽  
Adverse Pregnancy Outcomes ◽  
Adverse Outcomes ◽  
Increased Risk ◽  
Trimester Screening ◽  
Adverse Pregnancy ◽  
Β Hcg

Background To determine the association between extreme values of first trimester markers and adverse pregnancy outcomes. Methods A retrospective cohort study of 916 women who underwent first-trimester combined screening during 2015 was performed. Extreme values of NT, pregnancy-associated plasma protein-A (PAPP-A) and free β-hCG, and their association with adverse pregnancy outcomes were analyzed. Results Low PAPP-A (<10th percentile) was associated with an increased risk for preeclampsia (adjusted odds ratio (AOR) 4.13), fetal growth restriction (AOR 3.94) and abruptio placentae (AOR 52.63). Abnormally low or high free β-hCG, high PAPP-A or increased NT was not associated with an increased risk for adverse outcomes. Discussion PAPP-A <10th percentile could be associated with an increased risk for adverse outcomes. However, the majority of patients with these events do not have abnormal PAPP-A and few patients with PAPP-A <10th percentile will have an adverse outcome.

Chronic histiocytic intervillositis (CHI): an under-recognised condition with potential serious sequelae in pregnancy

2021 ◽  
Vol 14 (4) ◽  
pp. e241637
Author(s):  
Ai Xin Lee ◽  
Brian Run Yi Tan ◽  
Chye Lee Kho ◽  
Kim Teng Tan
Keyword(s):  
Pregnancy Outcomes ◽  
Adverse Pregnancy Outcome ◽  
Well Being ◽  
First Trimester ◽  
Interesting Case ◽  
Adverse Pregnancy Outcomes ◽  
Optimal Management ◽  
Recurrence Rates ◽  
Adverse Pregnancy ◽  
The Impact

Chronic histiocytic intervillositis (CHI) is a rare placental disorder associated with adverse pregnancy outcomes and high recurrence rates in subsequent pregnancies. We discuss a case of CHI diagnosed incidentally in a young primigravida who presented with a first trimester miscarriage. CHI is usually diagnosed after an adverse pregnancy outcome by microscopic placental histopathology. Currently, CHI is a poorly understood condition by clinicians in many aspects, including its aetiology and subsequent management of patients in their future pregnancies. This is due to the lack of awareness and underdiagnosis of CHI among general pathologists and obstetricians. The authors would like to highlight this interesting case to encourage more research on CHI to understand its pathophysiology and optimal management better. Clinicians should also focus on providing holistic care to this group of patients by considering the impact of adverse pregnancy outcomes on their emotional well-being.

scholarly journals Ultrasound Assessment of Twin Reversed Arterial Perfusion Sequence for the Prediction of Adverse Pregnancy Outcomes in the First Trimester

2021 ◽  
Author(s):  
Ying Tang ◽  
Yan Zeng ◽  
Taizhu Yang ◽  
Pan Yang ◽  
Shan Bao ◽  
...  
Keyword(s):  
Gestational Age ◽  
Pregnancy Outcomes ◽  
First Trimester ◽  
Adverse Pregnancy Outcomes ◽  
University Hospital ◽  
Intrauterine Death ◽  
Crown Rump Length ◽  
Arterial Perfusion ◽  
Adverse Pregnancy ◽  
Twin Reversed Arterial Perfusion

Abstract ObjectivesTo investigate twin reversed arterial perfusion (TRAP) sequence for the prediction of TRAP-related adverse pregnancy outcomes at the gestational age of 11-14 weeks. MethodsPregnant women in the first trimester diagnosed with TRAP were recruited at West China Second University Hospital from January 2015 to June 2018. Systematic screening for the pump twin’s crown-rump length (CRL) and acardiac twin’s upper pole-rump length (URL) was conducted using ultrasonic detection. The (CRL-URL)/CRL and URL/CRL ratios were used to assess the pregnancy outcomes for the pump twin. ResultsTwenty-one pregnant women aged 21–39 years with a gestation of 11-14 weeks were recruited. TRAP was diagnosed on average (± standard deviation [SD]) at pregnancy week 13.1 ± 0.18. The pump twins’ mean (± SD) CRL was 6.65 ± 1.1 cm. The incidence of intrauterine death for the pump twins was 19.0% (n=4), the miscarriage rate was 14.3% (n=3), and the live birth rate was 66.7% (n=14). The (CRL-URL)/CRL ratios between the non-survival (intrauterine death and miscarriage) and survival groups significantly differed (0.33 ± 0.08 vs. 0.58 ± 0.08, p < 0.05). Similarly, the URL/CRL ratios between the non-survival and survival groups significantly differed (0.67 ± 0.08 vs. 0.42 ± 0.08, p < 0.05). ConclusionsThe (CRL-URL)/CRL and URL/CRL ratios were valuable indicators for determining pregnancy outcomes of pump twins with TRAP at an early gestational age.

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

BMJ Open ◽  
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.

Placental massive perivillous fibrinoid deposition is associated with adverse pregnancy outcomes: a clinicopathological study of 12 cases

2016 ◽  
Vol 5 (1) ◽  
pp. 35-39
Author(s):  
Maili Qi ◽  
Kenneth Tou En Chang ◽  
Derrick Wen Quan Lian ◽  
Chong Kiat Khoo ◽  
Kok Hian Tan
Keyword(s):  
Pregnancy Outcomes ◽  
Gestational Hypertension ◽  
Local Population ◽  
Fetal Loss ◽  
Perinatal Outcomes ◽  
First Trimester ◽  
Adverse Outcomes ◽  
Special Focus ◽  
Adverse Perinatal Outcomes ◽  
Adverse Pregnancy

Abstract Introduction: Massive perivillous fibrinoid deposition (MPFD) is a very rare placental condition characterized by abnormally extensive fibrinoid deposition in the placental villous parenchyma. The aim of this study is to document clinical and pathological features with special focus on pregnancy outcomes of this condition in consecutive cases of MPFD in our local population. Methods: This is a retrospective clinico-pathological study of cases affected by MPFD over the period January 2010–July 2014 in our hospital. We document clinical features (including perinatal outcome and subsequent pregnancies) and placental pathological characteristics. Results: Twelve cases of MPFD were identified among 3640 placentas (0.33%). There was no identified recurrence. The affected infants had adverse outcomes, including intrauterine growth restriction (IUGR) (75%), preterm birth (58.3%), and fetal loss (25%). A high frequency of reduced PAPP-A in the first trimester (25%), and concurrent gestational hypertension or pre-eclampsia (25%) was noted. Conclusion: MPFD is associated with adverse perinatal outcomes. Further research to better understand its pathogenesis and to improve clinical diagnosis and management is warranted.

Sign in / Sign up

Export Citation Format

Share Document