Passive smoking and pregnancy outcome in central Poland

1 The present investigation was undertaken to evaluate the effect of environmental tobacco smoke (ETS) on the risk of preterm delivery (PD) and small-for-gestational age (SGA) infants in a female non-smoking population of central Poland. 2 The study group were 1751 women classified as non-smokers in the comprehensive project on 'ocio-economic and environmental risk factors of preterm delivery and small-for-gestational-age babies in cen-tral Poland' conducted on a randomly selected population of 2080 women who gave birth to a child between June 1, 1996 and May 31, 1997. The PD group comprised 95 non-smoking women who delivered before 37 weeks of pregnancy and the SGA group included 111 non-smoking mothers of babies with birthweight below the loth percentile of the standard curves for central Poland. Passive exposure to tobacco smoke was determined based on a structured interview. 3 In the stepwise multiple logistic regression model maternal passive smoke exposure lasting 7 h or more was found to be a significant risk factor for preterm delivery. No significant effect of passive smoking on the risk of SGA was observed. 4 The information about the adverse effects of ETS exposure on pregnancy duration and outcome should be incorporated in the health promotion programmes for women.

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Pregnancy after Bariatric Surgery: A Nested Case-Control Study of Risk Factors for Small for Gestational Age Babies in AURORA

Nutrients ◽

10.3390/nu13051699 ◽

2021 ◽

Vol 13 (5) ◽

pp. 1699

Author(s):

Zainab Akhter ◽

Nicola Heslehurst ◽

Dries Ceulemans ◽

Judith Rankin ◽

Roger Ackroyd ◽

...

Keyword(s):

Bariatric Surgery ◽

Weight Gain ◽

Gestational Age ◽

Small For Gestational Age ◽

Case Control Study ◽

Significant Risk ◽

Significant Risk Factor ◽

Case Control ◽

Institute Of Medicine ◽

Control Study

Bariatric surgery prior to pregnancy is a significant risk factor for small for gestational age (SGA) babies. This case-control study investigated differences between mothers delivering an SGA baby following bariatric surgery, compared to those delivering an appropriate for gestational age (AGA) baby. Out of 129 babies born to mothers in the AURORA cohort study, 25 were SGA (<10th percentile) and 97 were AGA (10th–90th percentile). Higher gestational weight gain (GWG) was significantly associated with decreased odds of SGA (aOR per kg 0.92, 95% CI 0.85–0.99). According to the Institute of Medicine GWG guidelines, 44% of SGA mothers had ‘inadequate’ GWG compared to 17% of AGA mothers. Nearly half of the mothers had ‘excessive’ GWG yet still gave birth to an SGA or AGA baby. Mothers of SGA babies lost more weight following bariatric surgery (45.6 ± 14.4 kg vs. 39.0 ± 17.9 kg). Women who reported receiving nutritional advice following bariatric surgery were significantly less likely to have an SGA baby (aOR 0.15, 95% CI 0.0.4–0.55). Women with a history of bariatric surgery should be provided with specialized support before and during pregnancy to encourage adequate nutritional intake and weight gain to support healthy fetal growth.

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Employment status of pregnant women in Central Poland and the risk of preterm delivery and small-for-gestational-age infants

European Journal of Public Health ◽

10.1093/eurpub/11.1.23 ◽

2001 ◽

Vol 11 (1) ◽

pp. 23-28 ◽

Cited By ~ 16

Author(s):

W Hanke

Keyword(s):

Pregnant Women ◽

Preterm Delivery ◽

Gestational Age ◽

Small For Gestational Age ◽

Employment Status ◽

Central Poland

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AB0372 PREGNANCY OUTCOME IN WOMEN WITH SJÖGREN SYNDROME IS OFTEN COMPLICATED BY PLACENTA INSUFFICIENCY

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.5725 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 1486.2-1486

Author(s):

I. Troester ◽

F. Kollert ◽

A. Zbinden ◽

L. Raio ◽

F. Foerger

Keyword(s):

Pregnancy Outcome ◽

Preterm Delivery ◽

Gestational Age ◽

Small For Gestational Age ◽

Low Dose ◽

Sjögren Syndrome ◽

Sjogren Syndrome ◽

Live Births ◽

Dose Aspirin ◽

Low Dose Aspirin

Background:Chronic inflammatory rheumatic diseases are often associated with a negative effect on pregnancy outcome. Most obstetrical complications are placenta-mediated such as preterm delivery and growths restrictions. In women with Sjögren syndrome, data on placenta- mediated complications are scarce and conflicting (1,2).Objectives:To analyse neonatal outcome in women with Sjögren syndrome with focus on preterm delivery and growth restriction.Methods:We retrospectively analysed 23 pregnancies of 16 patients with Sjögren syndrome that were followed at our centre with regard to pregnancy outcome, medication and disease characteristics. Small for gestational age was defined as birthweight percentile <10th. Preterm delivery was defined as delivery before 37, early term as delivery between 37-39 and term as delivery between 39-42 weeks of gestation.Results:Of 23 pregnancies, one ended in a miscarriage and 22 resulted in live births including one set of twins. Treatment used during pregnancy was hydroxychloroquine (20 pregnancies), prednisone (8), azathioprine (5) and cyclosporine (2). Concomitant treatment with low-dose aspirin was used in 9 pregnancies.Of the 22 live births, 17 were born at early term and 5 at term. There were no preterm deliveries. Median birth weight was 2820g (range 2095-3845g). Nine newborns (40.9%) were small for gestational age (SGA). Maternal treatment during these pregnancies was hydroxychloroquine in all cases and additional low-dose aspirin in three cases. Elevated CRP levels during pregnancy were found in 57% of the cases with SGA outcome. Only one woman with an SGA infant had positive anti-phospholipid antibodies.Regarding delivery mode, most patients had caesarean sections.Conclusion:In our cohort of women with Sjögren syndrome the prevalence of small for gestational age infants was high despite maternal treatment with hydroxychloroquine. Inflammatory markers could help to identify the patients at risk for placental insufficiency, yet prospective studies of larger cohorts are needed.References:[1]Gupta S et al; Sjögren Syndrome and Pregnancy: A literature review. Perm J 2017; 21:16-047[2]De Carolis S et al; The impact of primary Sjögren’s syndrome on pregnancy outcome: Our series and review of the literature. Autoimmun Rev 2014; 13(2):103-7Disclosure of Interests:Isabella Troester: None declared, Florian Kollert Employee of: Novartis, Astrid Zbinden: None declared, Luigi Raio: None declared, Frauke Foerger Grant/research support from: unrestricted grant from UCB, Consultant of: UCB, GSK, Roche, Speakers bureau: UCB, GSK

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Increased risk of low birthweight, infants small for gestational age, and preterm delivery for women with peptic ulcer

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2009.09.029 ◽

2010 ◽

Vol 202 (2) ◽

pp. 164.e1-164.e8 ◽

Cited By ~ 6

Author(s):

Yi-Hua Chen ◽

Herng-Ching Lin ◽

Horng-Yuan Lou

Keyword(s):

Peptic Ulcer ◽

Preterm Delivery ◽

Gestational Age ◽

Small For Gestational Age ◽

Low Birthweight ◽

Increased Risk

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The association between obesity and depression in adults: a meta-review

BJPsych Open ◽

10.1192/bjo.2021.712 ◽

2021 ◽

Vol 7 (S1) ◽

pp. S267-S267

Author(s):

Abdi Malik Musa ◽

Samuele Cortese ◽

Olivia Bloodworth

Keyword(s):

Depressive Disorders ◽

Data Extraction ◽

Significant Risk ◽

Significant Risk Factor ◽

Structured Interview ◽

Future Research ◽

Odds Ratios ◽

Medical File ◽

Depressed Adolescent ◽

Meta Review

AimsObesity and depression are increasing in prevalence and have become key issues in the public health of the modern day. We performed a meta-review to summarise the association between obesity and depression in adults.MethodA systematic literature search was undertaken on MEDLINE, PsychINFO, EMBASE and Web of Science for systematic reviews (SRs) with or without meta-analyses (MA) on the association between obesity and depression in adults (>18 years) published before 18 September 2018. Any approach to define depressive disorders (e.g. via structured interview or code in medical file) was accepted. Likewise, any method to assess obesity was accepted. Screening, data extraction and quality assessment was completed by two reviewers independently, with a third reviewer to arbitrate any disagreement. AMSTAR 2 tool was used to assess the methodological quality and risk of bias of the pertinent SRs/MAs.ResultAfter duplicate removal, we identified 6007 potentially pertinent citations. Following, title, abstract and full-text screening, 10 studies were included in the review; nine SRs with MAs and one SR. A statistically significant association between obesity and depression was reported in all nine SRs with MAs, with odds ratios ranging from 1.18 (95% CI = 1.11-1.26) to 1.57 (95% CI = 1.53-2.01). Increased severity of obesity (body mass index over 40) was associated with a greater odds of becoming depressed. Odds of developing depression were greater for obese females, compared to obese males, but this difference was not statistically significant. Depression was shown to be a significant risk factor for future obesity in all four relevant MAs with odds ratios ranging from 1.18 (95% CI = 1.13-1.23) to 1.40 (95% CI = 1.14-1.71) . Depressed adolescent females had the highest odds of becoming obese, significantly more so than depressed adolescent males and depressed adults. The quality of the included studies were mixed with five scoring moderate quality, three low quality and two critically low quality.ConclusionThe findings suggest a reciprocal association between depression and obesity, which may be modulated by age and gender. Future research should assess the potential effect of obesity and depression severity more carefully while also exploring the underlying mechanisms. These results warrant the investigation of the effect of obesity or depression intervention on the outcomes of the other.FUNDINGThis research received no financial sponsorship.

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Safety of the 2010–11, 2011–12, 2012–13, and 2013–14 seasonal influenza vaccines in pregnancy: Birth defects, spontaneous abortion, preterm delivery, and small for gestational age infants, a study from the cohort arm of VAMPSS

Vaccine ◽

10.1016/j.vaccine.2016.06.054 ◽

2016 ◽

Vol 34 (37) ◽

pp. 4443-4449 ◽

Cited By ~ 32

Author(s):

Christina D. Chambers ◽

Diana L. Johnson ◽

Ronghui Xu ◽

Yunjun J. Luo ◽

Carol Louik ◽

...

Keyword(s):

Preterm Delivery ◽

Spontaneous Abortion ◽

Birth Defects ◽

Gestational Age ◽

Small For Gestational Age ◽

Seasonal Influenza ◽

Influenza Vaccines ◽

In Pregnancy

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Heart Failure in Women With Hypertensive Disorders of Pregnancy

Hypertension ◽

10.1161/hypertensionaha.120.15654 ◽

2020 ◽

Vol 76 (5) ◽

pp. 1506-1513 ◽

Cited By ~ 2

Author(s):

Michael C. Honigberg ◽

Hilde Kristin Refvik Riise ◽

Anne Kjersti Daltveit ◽

Grethe S. Tell ◽

Gerhard Sulo ◽

...

Keyword(s):

Heart Failure ◽

Preterm Delivery ◽

Gestational Age ◽

Small For Gestational Age ◽

Gestational Hypertension ◽

Hazard Ratio ◽

Hypertensive Disorders Of Pregnancy ◽

First Birth ◽

Hypertensive Disorders

Hypertensive disorders of pregnancy (HDP) have been associated with heart failure (HF). It is unknown whether concurrent pregnancy complications (small-for-gestational-age or preterm delivery) or recurrent HDP modify HDP-associated HF risk. In this cohort study, we included Norwegian women with a first birth between 1980 and 2004. Follow-up occurred through 2009. Cox models examined gestational hypertension and preeclampsia in the first pregnancy as predictors of a composite of HF-related hospitalization or HF-related death, with assessment of effect modification by concurrent small-for-gestational-age or preterm delivery. Additional models were stratified by final parity (1 versus ≥2 births) and tested associations with recurrent HDP. Among 508 422 women, 565 experienced incident HF over a median 11.8 years of follow-up. After multivariable adjustment, gestational hypertension in the first birth was not significantly associated with HF (hazard ratio, 1.41 [95% CI, 0.84–2.35], P =0.19), whereas preeclampsia was associated with a hazard ratio of 2.00 (95% CI, 1.50–2.68, P <0.001). Among women with HDP, risks were not modified by concurrent small-for-gestational-age or preterm delivery ( P interaction =0.42). Largest hazards of HF were observed in women whose only lifetime birth was complicated by preeclampsia and women with recurrent preeclampsia. HF risks were similar after excluding women with coronary artery disease. In summary, women with preeclampsia, especially those with one lifetime birth and those with recurrent preeclampsia, experienced increased HF risk compared to women without HDP. Further research is needed to clarify causal mechanisms.

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Impact of the 2017 ACC/AHA Guideline for High Blood Pressure on Evaluating Gestational Hypertension–Associated Risks for Newborns and Mothers

Circulation Research ◽

10.1161/circresaha.119.314682 ◽

2019 ◽

Vol 125 (2) ◽

pp. 184-194 ◽

Cited By ~ 16

Author(s):

Jie Hu ◽

Yuanyuan Li ◽

Bin Zhang ◽

Tongzhang Zheng ◽

Jun Li ◽

...

Keyword(s):

Blood Pressure ◽

Preterm Delivery ◽

High Blood Pressure ◽

Gestational Age ◽

Small For Gestational Age ◽

Gestational Hypertension ◽

Blood Pressure Elevation ◽

Early Term ◽

Term Delivery ◽

The Impact

Rationale: In 2017, the American College of Cardiology (ACC)/American Heart Association (AHA) released a new hypertension guideline for nonpregnant adults, using lower blood pressure values to identify hypertension. However, the impact of this new guideline on the diagnosis of gestational hypertension and the associated maternal and neonatal risks are unknown. Objective: To estimate the impact of adopting the 2017 ACC/AHA guideline on detecting gestational blood pressure elevations and the relationship with maternal and neonatal risk in the perinatal period using a retrospective cohort design. Methods and Results: This study included 16 345 women from China. Systolic and diastolic blood pressures of each woman were measured at up to 22 prenatal care visits across different stages of pregnancy. Logistic and linear regressions were used to estimate associations of blood pressure categories with the risk of preterm delivery, early-term delivery, and small for gestational age, and indicators of maternal liver, renal, and coagulation functions during pregnancy. We identified 4100 (25.1%) women with gestational hypertension using the 2017 ACC/AHA guideline, compared with 4.2% using the former definition. Gestational hypertension, but not elevated blood pressure (subclinical blood pressure elevation), was significantly associated with altered indicators of liver, renal, and coagulation functions during pregnancy for mothers and increased risk of adverse birth outcomes for newborns; adjusted odds ratios (95% CIs) for gestational hypertension stage 2 were 2.23 (1.18–4.24) for preterm delivery, 2.05 (1.67–2.53) for early-term delivery, and 1.43 (1.13–1.81) for small for gestational age. Conclusions: Adopting the 2017 ACC/AHA guideline would result in a substantial increase in the prevalence of gestational hypertension; subclinical blood pressure elevations during late pregnancy were not associated with increased maternal and neonatal risk in this cohort. Therefore, the 2017 ACC/AHA guideline may improve the detection of high blood pressure during pregnancy and the efforts to reduce maternal and neonatal risk. Replications in other populations are required.

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