scholarly journals Causal effects on low Apgar at 5-min and stillbirth in a malaria maternal–fetal health outcome investigation: a large perinatal surveillance study in the Brazilian Amazon

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Julio Abel Seijas-Chávez ◽  
Melissa S. Nolan ◽  
Mary K. Lynn ◽  
Maria José Francalino da Rocha ◽  
Muana da Costa Araújo ◽  
...  

Abstract Background Malaria elimination in Brazil poses several challenges, including the control of Plasmodium falciparum foci and the hidden burden of Plasmodium vivax in pregnancy. Maternal malaria and fetal health outcomes were investigated with a perinatal surveillance study in the municipality of Cruzeiro do Sul, Acre state, Brazilian Amazon. The research questions are: what are the causal effects of low birth weight on low Apgar at 5-min and of perinatal anaemia on stillbirth? Methods From November 2018 to October 2019, pregnant women of ≥ 22 weeks or puerperal mothers, who delivered at the referral maternity hospital (Juruá Women and Children’s Hospital), were recruited to participate in a malaria surveillance study. Clinical information was obtained from a questionnaire and abstracted from medical reports. Haemoglobin level and presence of malarial parasites were tested by haematology counter and light microscopy, respectively. Low Apgar at 5-min and stillbirth were the outcomes analysed in function of clinical data and epidemiologic risk factors for maternal malaria infection using both a model of additive and independent effects and a causal model with control of confounders and use of mediation. Results In total, 202 (7.2%; N = 2807) women had malaria during pregnancy. Nearly half of malaria infections during pregnancy (n = 94) were P. falciparum. A total of 27 women (1.03%; N = 2632) had perinatal malaria (19 P. vivax and 8 P. falciparum). Perinatal anaemia was demonstrated in 1144 women (41.2%; N = 2779) and low birth weight occurred in 212 newborns (3.1%; N = 2807). A total of 75 newborns (2.7%; N = 2807) had low (< 7) Apgar scores at 5-min., and stillbirth occurred in 23 instances (30.7%; n = 75). Low birth weight resulted in 7.1 higher odds of low Apgar at 5-min (OR = 7.05, 95% CI 3.86–12.88, p < 0.001) modulated by living in rural conditions, malaria during pregnancy, perinatal malaria, and perinatal anaemia. Stillbirth was associated with perinatal anaemia (OR = 2.56, 95% CI 1.02–6.42, p = 0.0444) modulated by living in rural conditions, falciparum malaria during pregnancy, perinatal malaria, and perinatal fever. Conclusions While Brazil continues its path towards malaria elimination, the population still faces major structural problems, including substandard living conditions. Here malaria infections on pregnant women were observed having indirect effects on fetal outcomes, contributing to low Apgar at 5-min and stillbirth. Finally, the utility of employing multiple statistical analysis methods to validate consistent trends is vital to ensure optimal public health intervention designs.

PLoS ONE ◽  
2015 ◽  
Vol 10 (12) ◽  
pp. e0144399 ◽  
Author(s):  
Camila Bôtto-Menezes ◽  
Mônica Caroline Silva dos Santos ◽  
Janicéia Lopes Simplício ◽  
Jandira Menezes de Medeiros ◽  
Kelly Cristina Barroso Gomes ◽  
...  

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Anna Dow ◽  
Dumbani Kayira ◽  
Michael G. Hudgens ◽  
Annelies Van Rie ◽  
Caroline C. King ◽  
...  

Background. Limited data exist on cotrimoxazole prophylactic treatment (CPT) in pregnant women, including protection against malaria versus standard intermittent preventive therapy with sulfadoxine-pyrimethamine (IPTp).Methods. Using observational data we examined the effect of CPT in HIV-infected pregnant women on malaria during pregnancy, low birth weight and preterm birth using proportional hazards, logistic, and log binomial regression, respectively. We used linear regression to assess effect of CPT on CD4 count.Results. Data from 468 CPT-exposed and 768 CPT-unexposed women were analyzed. CPT was associated with protection against malaria versus IPTp (hazard ratio: 0.35, 95% Confidence Interval (CI): 0.20, 0.60). After adjustment for time period this effect was not statistically significant (adjusted hazard ratio: 0.66, 95% CI: 0.28, 1.52). Among women receiving and not receiving CPT, rates of low birth weight (7.1% versus 7.6%) and preterm birth (23.5% versus 23.6%) were similar. CPT was associated with lower CD4 counts 24 weeks postpartum in women receiving (−77.6 cells/μL, 95% CI: −125.2, −30.1) and not receiving antiretrovirals (−33.7 cells/μL, 95% CI: −58.6, −8.8).Conclusions. Compared to IPTp, CPT provided comparable protection against malaria in HIV-infected pregnant women and against preterm birth or low birth weight. Possible implications of CPT-associated lower CD4 postpartum warrant further examination.


2020 ◽  
Vol 16 ◽  
Author(s):  
Reza Omani-Samani ◽  
Saman Maroufizadeh ◽  
Nafise Saedi ◽  
Nasim Shokouhi ◽  
Arezoo Esmailzadeh ◽  
...  

Background: Advanced maternal age is an important predictor for maternal and neonatal outcomes such as maternal mortality, low birth weight, stillbirth, preterm birth, cesarean section and preeclampsia. Objective: To determine the association of advanced maternal age and adverse maternal and neonatal outcomes in Iranian pregnant women. Methods: In this hospital-based cross-sectional study, 5117 pregnant women from 103 hospitals in Tehran, Iran, were participated in the study in 2015. The required data were gathered from hospitals which equipped to the department of obstetrics and gynecology. Advanced maternal age was considered as an independent variable and unwanted pregnancy, preeclampsia, preterm birth, cesarean section and low birth weight were considered as interested outcomes. Results: In our study, the prevalence of advanced maternal age was 12.08%. Advanced maternal age was significantly associated with higher risk of unwanted pregnancy (OR: 1.39, 95% CI: 1.12-1.73), preterm birth (OR: 1.75, 95% CI: 1.28- 2.39) and cesarean section (OR: 1.34, 95% CI: 1.03-1.74). In our study, there was no significant relationship between advanced maternal age and preeclampsia but this relationship could be clinically important (OR: 1.48, 95% CI: 0.99-2.20, P=0.052), and there is no significant relationship between advanced maternal age and low birth weight (OR: 1.08, 95% CI: 0.67-1.74, P=0.736). Conclusion: Advanced maternal age is associated with higher risk of unintended pregnancy, preterm birth and cesarean section but our findings did not support advanced maternal age as a risk factor associated with low birth weight.


2019 ◽  
Vol 15 (2) ◽  
pp. 143-149 ◽  
Author(s):  
Harpriya Kaur ◽  
Delf Schmidt-Grimminger ◽  
Baojiang Chen ◽  
K.M. Monirul Islam ◽  
Steven W. Remmenga ◽  
...  

Background: Pregnancy may increase the risk of Human Papillomavirus (HPV) infection because of pregnancy induced immune suppression. The objective of this study was to use a large population-based dataset to estimate the prevalence of HPV infection and its association with adverse outcomes among pregnant women. Methods: We analyzed Pregnancy Risk Monitoring System data from 2004-2011 (N=26,085) to estimate the self-reported HPV infection. Survey logistic procedures were used to examine the relationship between HPV infection and adverse perinatal outcomes. Results: Approximately 1.4% of women were estimated to have HPV infection during their pregnancy. The prevalence of adverse outcomes in this sample was preterm birth (8.4%), preeclampsia (7.5%), low birth weight (6.3%) and premature rupture of membranes (2.8%). Compared to women without HPV infection, HPV infection positive women were much more likely to have had other infections such as chlamydia (9.23% vs. 2.12%, p-value <.0001), Group B Strep (21.7% vs. 10.04%, p-value <.0001), and herpes (7.17% vs. 1.07%, p-value <.0001). After adjusting for other risk factors including other infections, HPV infection was significantly associated with low birth weight (OR: 1.94, 95% CI: 1.14-3.30). Conclusion: The study indicated a potential association between HPV infection and low birth weight. Because pregnant women with HPV infection are at higher risk of other infections, future research may focus on the roles of co-infection in the development of adverse perinatal effects.


2021 ◽  
Vol 7 (1) ◽  
pp. 117-126
Author(s):  
Amanda Luky Ernawati ◽  
Tri Joko ◽  
Suhartono

Background: Low birth weight (LBW) is one of the causes of infants death. One of the factors that is proven to be associated with  LBW incidence is pesticide exposure to pregnant women. The high number of female farmers in the agricultural sector will increase the risk of pesticide exposure in pregnant women. Objectives: This study aims to describe how pesticide exposure can be a risk factor for the incidence of LBW. Research method: This study is a systematic study that used meta-synthesis aggregation approach. The search for articles focused on articles that examined the risk factors for pesticide exposure on the incidence of LBW in pregnant women which was conducted on the online databases of Science Direct, Scopus, PubMed, Springer, Google Scholar, and Garuda Portal. The criteria for the articles used were national observational journals indexed at least 4 and indexed international journals published in 2010-2020. Result: There were 8 articles that match to the criteria and research topic. Factors that were proven to increase the risk of LBW incidence in pregnant women were agricultural activities related to pesticide, participation in agricultural activities, completeness of PPE, storage of pesticide, duration of exposure to pesticide, frequency of exposure to pesticide, amount of pesticide mixture, and types of pesticide used. Conclusion: Pesticide exposure to pregnant women causes the accumulation of pesticide residues in the body, thus reducing the formation of thyroid hormones and IGF-1 which can cause LBW.   Keywords: low birth weight; pesticide exposure; pregnant women


2009 ◽  
Vol 37 (6) ◽  
pp. 527-533 ◽  
Author(s):  
Simone S. Cruz ◽  
Maria da Concei����o N. Costa ◽  
Isaac S. Gomes-Filho ◽  
Edson J. C. Rezende ◽  
Maur��cio L. Barreto ◽  
...  

2020 ◽  
Vol 3 (2) ◽  
pp. 499-507
Author(s):  
Sulistiani Sulistiani

Based on the data from WHO in 2015, incident of low birth weight in Indonesia is still high. As many as 15,5% of babies born in Malang district. in 2018, total babies born were 38.421 and 1261 babies were born with low birth weight (BPS Kab. Malang). Meanwhile in puskesmas dau, there were 30 babies birth with low birth weight. Factors that can influence LBW include maternal weight before pregnancy, maternal weight during pregnancy, arm circumference, alcohol consumption, cigarette use, symptoms of depression or anxiety and eating pattern. This study is a descriptive study with a linear regression analysis design multiple analysis to analyze physical, psychological, and dietary factors in tribulan III pregnant women against LBW events at Puskesmas Dau. Samples were taken by simple random sampling method with a total of 175 pregnant women. The result shows that these three factors had a significant influence on LBW events with a t-count of 2,200 physical condition factors, a t-count of 8,165 psychologic factors, and a t-count of 3,612 eating conditions. Based on the result of this study, it can conclude that there is significant effect between physical factor, psychological factor and eating pattern to low birth weight event in Puskesmas Dau. The conclusion of this study shows that psychological factors that have the most significant influence on LBW events when compared with other factors. Suggestions that can be given from researcher to Puskesmas Dau are to maintain and improve services to psychological conditions by always involving families in solving problems so that low birth weight will decrease


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