scholarly journals Stillbirth and neonatal mortality in a subsequent pregnancy following stillbirth: a population-based cohort study

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Janna W. Nijkamp ◽  
Anita C. J. Ravelli ◽  
Henk Groen ◽  
Jan Jaap H. M. Erwich ◽  
Ben Willem J. Mol
Keyword(s):  
Cohort Study ◽  
Gestational Age ◽  
Perinatal Outcome ◽  
Neonatal Death ◽  
Fetal Death ◽  
Subsequent Pregnancy ◽  
Early Gestation ◽  
Risk Of Recurrence ◽  
History Of ◽  
Obstetrical Management

Abstract Background A history of stillbirth is a risk factor for recurrent fetal death in a subsequent pregnancy. Reported risks of recurrent fetal death are often not stratified by gestational age. In subsequent pregnancies increased rates of medical interventions are reported without evidence of perinatal benefit. The aim of this study was to estimate gestational-age specific risks of recurrent stillbirth and to evaluate the effect of obstetrical management on perinatal outcome after previous stillbirth. Methods A retrospective cohort study in the Netherlands was designed that included 252.827 women with two consecutive singleton pregnancies (1st and 2nd delivery) between 1999 and 2007. Data was obtained from the national Perinatal Registry and analyzed for pregnancy outcomes. Fetal deaths associated with a congenital anomaly were excluded. The primary outcome was the occurrence of stillbirth in the second pregnancy stratified by gestational age. Secondary outcome was the influence of obstetrical management on perinatal outcome in a subsequent pregnancy. Results Of 252.827 first pregnancies, 2.058 pregnancies ended in a stillbirth (8.1 per 1000). After adjusting for confounding factors, women with a prior stillbirth have a two-fold higher risk of recurrence (aOR 1.96, 95% CI 1.07–3.60) compared to women with a live birth in their first pregnancy. The highest risk of recurrence occurred in the group of women with a stillbirth in early gestation between 22 and 28 weeks of gestation (a OR 2.25, 95% CI 0.62–8.15), while after 32 weeks the risk decreased. The risk of neonatal death after 34 weeks of gestation is higher in women with a history of stillbirth (aOR 6.48, 95% CI 2.61–16.1) and the risk of neonatal death increases with expectant obstetric management (aOR 10.0, 95% CI 2.43–41.1). Conclusions A history of stillbirth remains an important risk for recurrent stillbirth especially in early gestation (22–28 weeks). Women with a previous stillbirth should be counselled for elective induction in the subsequent pregnancy at 37–38 weeks of gestation to decrease the risk of perinatal death.

scholarly journals Population based cohort study of fetal deaths, and neonatal and perinatal mortality at term within a Somali diaspora

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Stephen Contag ◽  
Rahel Nardos ◽  
Irina A. Buhimschi ◽  
Jennifer Almanza
Keyword(s):  
Cohort Study ◽  
Black Women ◽  
Perinatal Mortality ◽  
Gestational Age ◽  
Neonatal Death ◽  
Fetal Death ◽  
Hispanic Women ◽  
Place Of Birth ◽  
Death Rates ◽  
Somali Women

Abstract Background Somali women deliver at greater gestational age with limited information on the associated perinatal mortality. Our objective is to compare perinatal mortality among Somali women with the population rates. Methods This is a retrospective cohort study from all births that occurred in Minnesota between 2011 and 2017. Information was obtained from certificates of birth, and neonatal and fetal death. Data was abstracted from 470,550 non-anomalous births ≥37 and ≤ 42 weeks of gestation. The study population included U.S. born White, U.S. born Black, women born in Somalia or self-identified as Somali, and women who identified as Hispanic regardless of place of birth (377,426). We excluded births < 37 weeks and > 42 weeks, > 1 fetus, age < 18 or > 45 years, or women of other ethnicities. The exposure was documented ethnicity or place of birth, and the outcomes were live birth, fetal death, neonatal death prior to 28 days, and perinatal mortality rates. These were calculated using binomial proportions with 95% confidence intervals and compared using odds ratios adjusted (aOR) for diabetes, hypertension and maternal body mass index. Results The aOR [95%CI] for stillbirth rate in the Somali cohort was greater than for U.S. born White (2.05 [1.49–2.83]) and Hispanic women (1.90 [1.30–2.79]), but similar to U.S. born Black women (0.88 [0.57–1.34]). Neonatal death rates were greater than for U.S. born White (1.84 [1.36–2.48], U.S. born Black women (1.47 [1.04–2.06]) and Hispanic women (1.47 [1.05–2.06]). This did not change after analysis was restricted to those with spontaneous onset of labor. When analyzed by week, at 42 weeks Somali aOR for neonatal death was the same as for U.S. born White women, but compared against U.S. born Black and Hispanic women, was significantly lower. Conclusions The later mean gestational age at delivery among women of Somali ethnicity is associated with greater overall risk for stillbirth and neonatal death rates at term, except compared against U.S. born Black women with whom stillbirth rates were not different. At 42 weeks, Somali neonatal mortality decreased and was comparable to that of the U.S. born White population and was lower than that of the other minorities.

scholarly journals Pregnancy outcome in women with previous preeclampsia versus women normotensive in previous pregnancy

2018 ◽  
Vol 7 (12) ◽  
pp. 5045
Author(s):  
Jayshree Mulik ◽  
Snehalata Suresh
Keyword(s):  
Pregnancy Outcome ◽  
Perinatal Outcome ◽  
Tertiary Care ◽  
Subsequent Pregnancy ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Previous Pregnancy ◽  
Index Pregnancy ◽  
History Of ◽  
Adverse Pregnancy

Background: Women with history of preeclampsia have reportedly higher risk of development of preeclampsia in subsequent pregnancies, along with other adverse pregnancy outcomes. Authors aimed to study the incidence of recurrent preeclampsia and compare the pregnancy outcome in women with history of preeclampsia in previous pregnancy with those who were normotensive in previous pregnancy and further compare outcomes in women with recurrent preeclampsia between their previous and index pregnancy.Methods: Pregnancy outcome was studied in women with preeclampsia in previous pregnancy (cases) and compared with women normotensive in previous pregnancy (controls). Further analysis of cases was done by dividing them into subgroups: those with recurrent preeclampsia in index pregnancy (A1) and those normotensive in index pregnancy despite being pre-eclamptic in previous pregnancy (A2). Total 100 cases and 100 controls were enrolled in the study, which was conducted at present tertiary care centre from January 2012 to June 2013.Results: Out of total 200 participants (100 cases, 100 controls) enrolled in the study; 58 out of 100 cases had recurrent preeclampsia and remaining 42 remained normo-tensive in index pregnancy. Among 100 controls, 93 were normotensive in index pregnancy.Conclusions: Women with history of preeclampsia in previous pregnancy had adverse maternal and perinatal outcome in subsequent pregnancy when compared to the women who were normotensive in the previous pregnancy. But when compared with their own previous preeclamptic pregnancy, they had better pregnancy outcome with good perinatal outcome in their index pregnancy. 

Incidences of Feto-Fetal Transfusion Syndrome and Perinatal Outcomes in Triplet Gestations with Monochorionic Placentation

2016 ◽  
Vol 40 (3) ◽  
pp. 181-186 ◽  
Author(s):  
Yuka Sato ◽  
Keisuke Ishii ◽  
Tae Yokouchi ◽  
Takeshi Murakoshi ◽  
Kenji Kiyoshi ◽  
...  
Keyword(s):  
Cohort Study ◽  
Neonatal Death ◽  
Intraventricular Hemorrhage ◽  
Retrospective Cohort ◽  
Fetal Death ◽  
Periventricular Leukomalacia ◽  
Neurological Complication ◽  
Perinatal Outcomes ◽  
Grade 3 ◽  
Poor Outcomes

Introduction: This study aimed to determine the incidences of feto-fetal transfusion syndrome (FFTS) and perinatal outcomes in triplet gestations with monochorionic placentation. Materials and Methods: In this retrospective cohort study, we evaluated the incidences of FFTS and perinatal outcomes at 28 days of age in cases of triplet gestations with monochorionic placentation who visited our centers before 16 weeks of gestation and delivered over a period of 11 years. Results: In 41 triplet gestations (17 monochorionic triamniotic, 22 dichorionic triamniotic, 1 dichorionic diamniotic, and 1 monochorionic monoamniotic), the incidence of FFTS was 17.1%, and the median gestational age at FFTS diagnosis was 19 weeks. In 123 triplets, the incidences of fetal death and neonatal death at 28 days of age were 8.1 and 0.9%, respectively. None of the surviving infants had grade 3 or 4 intraventricular hemorrhage, while cystic periventricular leukomalacia occurred in 6 of 113 infants (5.3%). The incidence of poor outcomes (death or any major neurological complication at 28 days of age) was 13.8%. Discussion: Seventeen percent of triplet pregnancies with monochorionic placentation developed FFTS, and 14% had a poor outcome. Therefore, triplet gestations with monochorionic placentation should be followed carefully.

scholarly journals Infant Mortality and the Risk of Small Size for Gestational Age in the Subsequent Pregnancy: A Retrospective Cohort Study

2012 ◽  
Vol 17 (6) ◽  
pp. 1044-1051 ◽  
Author(s):  
Hamisu M. Salihu ◽  
Euna M. August ◽  
Cara de la Cruz ◽  
Mulubrhan F. Mogos ◽  
Hanna Weldeselasse ◽  
...  
Keyword(s):  
Cohort Study ◽  
Infant Mortality ◽  
Gestational Age ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Subsequent Pregnancy

Perinatal Outcomes in Women with a History of Recurrent Pregnancy Loss

2020 ◽  
Vol 38 (01) ◽  
pp. 010-015
Author(s):  
Elizabeth B. Ausbeck ◽  
Christina Blanchard ◽  
Alan T. Tita ◽  
Jeff M. Szychowski ◽  
Lorie Harper
Keyword(s):  
Gestational Diabetes ◽  
Gestational Age ◽  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Perinatal Death ◽  
Perinatal Outcomes ◽  
Subsequent Pregnancy ◽  
Gestational Age At Delivery ◽  
History Of ◽  
Nicu Admission

Objective This study aimed to evaluate perinatal outcomes in women with a history of recurrent pregnancy loss. Study Design Retrospective cohort study of singleton and nonanomalous gestations at ≥ 20 weeks who delivered at our academic institution. The exposed group was defined as women with a history of ≥ 2 consecutive spontaneous abortions (SABs) at < 12 weeks. These women were compared with women with a history of ≤ 1 SAB at < 12 weeks. The primary outcome was preterm birth (PTB) at < 37 weeks. Secondary outcomes included gestational age at delivery, gestational diabetes, small for gestational age birth weight, hypertensive diseases of pregnancy, fetal demise, cesarean delivery, and a composite of neonatal complications (5-minute Apgar score < 5, perinatal death, and NICU admission). Multivariable logistic regression was performed to adjust for confounders. Results Of 17,670 women included, 235 (1.3%) had a history of ≥ 2 consecutive SABs. Compared with women with a history of ≤ 1 SAB, women with ≥ 2 consecutive SABs were not more likely to have a PTB (19.6 vs. 14.0%, p = 0.01, adjusted odds ratios (AOR): 0.91, 95% confidence interval [CI]: 0.62–1.33). However, they were more likely to deliver at an earlier mean gestational age (37.8 ± 3.4 vs. 38.6 ± 2.9 weeks, p < 0.01) and to have gestational diabetes (12.3 vs. 6.6%, p < 0.01, AOR: 1.69, 95% CI: 1.10–2.59). Other outcomes were similar between the two groups. Conclusion A history of ≥ 2 consecutive SABs was not associated with an increased incidence of PTB but may be associated with gestational diabetes in a subsequent pregnancy. Key Points

Imaging-Based Risk Stratification for Recurrence Risk in Women with a History of Peripartum Cardiomyopathy

2021 ◽  
Author(s):  
Marwan Ma'ayeh ◽  
Jeremy A. Slivnick ◽  
Monique E. McKiever ◽  
Zachary D. Garrett ◽  
Woobeen Lim ◽  
...  
Keyword(s):  
Global Longitudinal Strain ◽  
Recurrence Risk ◽  
Left Ventricular ◽  
Subsequent Pregnancy ◽  
Peripartum Cardiomyopathy ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Risk Of Recurrence ◽  
Key Points ◽  
History Of

Objective Peripartum cardiomyopathy (PPCM) affects 1:1,000 U.S. pregnancies, and while many recover from the disease, the risk of recurrence in subsequent pregnancy (SSP) is high. This study aims to evaluate the utility of left ventricular ejection fraction (LVEF) and global longitudinal strain (GLS) to predict the risk of recurrence of PPCM in SSP. Study Design We retrospectively evaluated outcomes in women with a history of PPCM and SSP at a large-volume cardioobstetrics program (2008–2019). Results There were 18 women who had incident PPCM and pursued SSP. Of 24 pregnancies in these women, 8 (33%) were complicated by the development of recurrent PPCM. LVEF ≥ 52% or GLS ≤ −16 was associated with a low risk of recurrent PPCM. Conclusion Approximately one-third of women with PPCM developed recurrent PPCM in SSP. LVEF and GLS on prepregnancy echocardiography may predict the risk of recurrence. Additional studies evaluating risk for recurrence are required to better understand which women are the safest to consider SSP. Key Points

Amniocentesis Complications in Yazd Baghaeipour Polyclinic: A Cross-Sectional Study

2020 ◽  
Author(s):  
Nasim Shirgholami ◽  
Fatemeh Abdi ◽  
Mahta Mazaheri ◽  
Razieh Sadat Tabatabaee
Keyword(s):  
Gestational Age ◽  
Fetal Death ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Second Stage ◽  
History Of ◽  
The Mean ◽  
Pass Through ◽  
Type Of Delivery

Background: Amniocentesis, like other invasive methods, has complications such as abortion, premature rupture - second pregnancy and at 29 weeks of membranes, infection, bleeding, etc. Here, we aimed to study the complications of amniocentesis in pregnant women. Methods: This descriptive cross-sectional study was included 409 women with positive first and second stage screening or required amniocentesis referred to Baghaeipour Clinic in 2017. Data was collected by a pre-prepared questionnaire. Results: The mean age of the patients and gestational age was 33.49 ± 6.51 years and 17.39 ± 1.36  weeks, respectively. 132 patients (32.2%) had a history of abortion. Regarding the frequency of needle passage through the placenta, the results showed that in 369 people (90.2%) the needle did not pass through the placenta and in 40 people (9.8%). The needle has passed through the pair. Regarding the frequency distribution of amniocentesis complications, fetal death in (2.4%), bleeding in (2.2%) and PROM (1.7%) were observed in patients and no case of infection and abortion was observed. In terms of age, gestational age, gestational number, placental location, needle passage, aspirated fluid color, history of abortion and type of delivery, there were no significant differences. Conclusion: In this study the most common complication of amniocentesis was fetal death (2.4%), followed by bleeding and Spotting (2.2%), PROM (1.7%), infection and abortion, respectively.

scholarly journals The Risk of Preterm Birth in Women with Three Consecutive Deliveries—The Effect of Number and Type of Prior Preterm Births

2020 ◽  
Vol 9 (12) ◽  
pp. 3933
Author(s):  
Liran Hiersch ◽  
Yael Pasternak ◽  
Nir Melamed ◽  
Moshe Meshulam ◽  
Reut Shashar ◽  
...  
Keyword(s):  
Cohort Study ◽  
Preterm Birth ◽  
Gestational Age ◽  
Retrospective Cohort ◽  
Primary Outcome ◽  
Medical Center ◽  
Preterm Births ◽  
Inclusion Criteria ◽  
The Third ◽  
History Of

Background: We aimed to explore the association of the number, order, gestational age and type of prior PTB and the risk of preterm birth (PTB) in the third delivery in women who had three consecutive singleton deliveries. Methods: A retrospective cohort study of all women who had three consecutive singleton births at a single medical center over a 20-year period (1994–2013). The primary outcome was PTB (<37 weeks) in the third delivery. Results: 4472 women met inclusion criteria. The rate of PTB in the third delivery was 4.9%. In the adjusted analysis, the risk of PTB was 3.5% in women with no prior PTBs; 10.9% in women with prior one PTB only in the first pregnancy; 16.2% in women with prior one PTB only in the second pregnancy; and 56.5% in women with prior two PTBs. A similar trend was observed when the outcome of interest was spontaneous PTB and when the exposure was limited to prior spontaneous or indicated PTB. Conclusions: In women with a history of PTB, the risk of recurrent PTB in subsequent pregnancies is related to the number and order of prior PTBs. These factors should be taken into account when stratifying the risk of PTB.

scholarly journals Fetal and Perinatal Outcome Following First and Second Trimester COVID-19 Infection: Evidence from a Prospective Cohort Study

2021 ◽  
Vol 10 (10) ◽  
pp. 2152
Author(s):  
Hadar Rosen ◽  
Yossi Bart ◽  
Rita Zlatkin ◽  
Liat Ben-Sira ◽  
Dafna Ben Bashat ◽  
...  
Keyword(s):  
Cohort Study ◽  
Vertical Transmission ◽  
Prospective Cohort Study ◽  
Gestational Age ◽  
Prospective Cohort ◽  
Perinatal Outcomes ◽  
Neonatal Outcomes ◽  
Second Trimester ◽  
Early Gestation ◽  
The Mean

A novel coronavirus termed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a new strain of coronavirus causing coronavirus disease 2019 (COVID-19) disease, which emerged as a global pandemic. Data regarding the implications of COVID-19 disease at early gestation on fetal and obstetric outcomes is scarce. Thus, our aim was to investigate the effect of first and second trimester maternal COVID-19 disease on fetal and perinatal outcomes. This was a prospective cohort study of pregnant women with a laboratory-proven SARS-COV-2 infection contracted prior to 26 weeks gestation. Women were followed at a single tertiary medical center by serial sonographic examinations every 4–6 weeks to assess fetal well-being, growth, placental function, anatomic evaluation and signs of fetal infection. Amniocentesis was offered to assess amniotic fluid SARS-COV-2-PCR (polymerase chain reaction) and fetal brain magnetic resonance imaging (MRI) was offered at 30–32 weeks gestation. Demographic, obstetric and neonatal data were collected from history intake, medical charts or by telephone survey. Perinatal outcomes were compared between women infected at first vs. second trimester. 55 women with documented COVID-19 disease at early gestation were included and followed at our center. The mean maternal age was 29.6 ± 6.2 years and the mean gestational age at viral infection was 14.2 ± 6.7 weeks with 28 (51%) women infected at the first trimester and 27 (49%) at the second trimester. All patients but one experienced asymptomatic to mild symptoms. Of 22 patients who underwent amniocentesis, none had evidence of vertical transmission. None of the fetuses exhibited signs of central nervous system (CNS) disease, growth restriction and placental dysfunction on serial ultrasound examinations and fetal MRI. Pregnancies resulted in perinatal survival of 100% to date with mean gestational age at delivery of 38.6 ± 3.0 weeks and preterm birth <37 weeks rate of 3.4%. The mean birthweight was 3260 ± 411 g with no cases of small for gestational age infants. The obstetric and neonatal outcomes were similar among first vs. second trimester infection groups. We conclude SARS-CoV-2 infection at early gestation was not associated with vertical transmission and resulted in favorable obstetric and neonatal outcomes.

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