Multiple Pregnancy and Oligoamnios as Risk Factors for Refractory Hypoxemia in Very Premature Newborns

Aim. Risk based screening for developmental dysplasia of the hip (DDH) with ultrasound is common. However, risk factors vary from one country to the other since data are insufficient to give clear recommendations. We aimed to evaluate the risk factors for developmental dysplasia of the hip (DDH). Methods. In this retrospective case-control study, the health records of all children, who were followed up between 2004 and 2014 at a well-child unit, were investigated for the diagnosis of DDH in Turkey. Of 9758 children, 57 children were found to have abnormal ultrasonographic findings (according to Graf classification) and these constituted the case group. As the control group, healthy 228 children who matched the case children in birth months were selected. Two groups were compared for the risk factors. Results. A total of 19516 hips of 9758 children were examined for DDH. 97 hips of 57 children were found to have abnormal ultrasonographic findings. When the two groups were compared, breech presentation, multiple pregnancy, and torticollis were identified as risk factors. The female sex was also found to have a significantly high prevalence among the children in the case group. Limited hip abduction, positive Ortolani, and Barlow signs were important clinical findings in the case group. Conclusion. According to our findings, breech presentation, female sex, torticollis, and multiple pregnancy were found to be the risk factors of this disorder. Infants with these risk factors should be investigated carefully for DDH.

Download Full-text

Vasa praevia: Should we routinely screen high-risk women for this rare but serious condition?

Ultrasound ◽

10.1177/1742271x17747137 ◽

2018 ◽

Vol 26 (2) ◽

pp. 127-131

Author(s):

Victoria McQueen ◽

Michelle Speed ◽

Susan Rutter ◽

Thomas Gray

Keyword(s):

Risk Factors ◽

Transvaginal Ultrasound ◽

Elective Caesarean Section ◽

Survival Rates ◽

Multiple Pregnancy ◽

Placental Tissue ◽

Rare Condition ◽

Cost Effective ◽

Fetal Survival ◽

Vasa Praevia

Vasa praevia is described as the unprotected fetal vessels traversing through the placental membranes over the cervical os, below the fetal presenting part and unprotected by placental tissue or the umbilical cord. It is often not detected antenatally and presents with painless bleeding and rapid fetal compromise after spontaneous or artificial rupture of the membranes, which causes trauma to these vessels. It is a rare condition affecting one in 2500 pregnancies and has a reported perinatal mortality rate of up to 60%. More than 80% of cases of vasa praevia have at least one risk factor for the condition and it has been shown that identification of vasa praevia antenatally results in fetal survival rates of up to 97%. Risk factors include placenta praevia, velamentous cord insertion, bi-lobed placenta, succenturiate lobe, assisted reproduction and multiple pregnancy. Screening for vasa praevia with transvaginal ultrasound has been shown to be sensitive and cost effective when used in a targeted population where risk factors are present. Here, we present the antenatal assessment and management of a case of vasa praevia detected during the routine 20-week anatomy scan of a healthy primigravida, which resulted in elective caesarean section delivery of a healthy baby at 36 weeks' gestation. The pathophysiology of vasa praevia is discussed and the methods and role of screening for this rare but serious condition are appraised.

Download Full-text

Risk factors related to childbirth in El Salvador

ALERTA Revista Científica del Instituto Nacional de Salud ◽

10.5377/alerta.v2i2.7922 ◽

2019 ◽

Vol 2 (2) ◽

pp. 144-152

Author(s):

Fátima Larisa Chavarría Rodríguez

Keyword(s):

Public Health ◽

Risk Factors ◽

Preterm Birth ◽

El Salvador ◽

Multiple Pregnancy ◽

Public Health Problem ◽

Clinical History ◽

Cross Sectional ◽

History Of ◽

Prevalence Ratios

Introduction. Preterm birth is a public health problem, considered a high risk factor for morbidity, disability and neonatal mortality. Objective. Characterize risk factors related to preterm birth in El Salvador. Methodology. Analytical cross-sectional study of risk factors related to preterm birth, in women who received childbirth care in the national public health system, during 2017. Data was obtained from the Perinatal Information System. 44 891 cases were analyzed. Qualitative variables were analyzed through absolute values and frequencies, and the quantitative variables, through absolute values, frequency and central tendency measures, using the Statistical Package for the Social Science (SPSS) version 24 program. The analysis of relation of variables, was performed with the Epidat version 3.1 program, through the calculation of prevalence ratios (PR) and the calculation of Odds Ratio (OR), both analysis with a 95% confidence interval and a value of p <0.05. Results. 9.5% of the deliveries attended were preterm. The risk analysis through the calculation of prevalence ratios showed that women with a multiple pregnancy were 14 times more likely to have a preterm birth. Preterm birth was 4.7 times more frequent in women with a clinical history of diabetes mellitus and 2.4 times more frequent, with a history of high blood pressure. Conclusions. Women who have a multiple pregnancy and pregnant women with a clinical history of chronic diseases, and an obstetric history of preeclampsia, are more likely to have a preterm birth. Likewise, obesity and inadequate age for pregnancy, mainly women over 35 years, are also related to preterm birth.

Download Full-text

Analysis of antenatal risk factors in multiple pregnancies

Bukovinian Medical Herald ◽

10.24061/2413-0737.xviii.2.70.2014.107 ◽

2014 ◽

Vol 18 (2 (70)) ◽

Author(s):

О. V. Kravchenko

Keyword(s):

Risk Factors ◽

Pregnant Women ◽

Preterm Labor ◽

Multiple Pregnancy ◽

Maternity Hospital ◽

Age Group ◽

Multiple Pregnancies ◽

Population Index ◽

Average Population

We examined 42 pregnant women with twins who gave birth in 2013 in the clinical maternity hospital № 2 of Chernivtsi. It was established that multiple pregnancy is more common in multipara women of age group 25-30 years (52,3 %). The course of pregnancy with twins is aggravated in 78,5 %, which is much higher than the average population index. Dichorionic diamniotic twins dominated (57,1 %) in the structure of multiple pregnancy. The preterm labor with dichorionic diamniotic twins occur 3 times less frequently (23,6 %) than in monochorionic diamniotic multiple pregnancies (75,4 %).

Download Full-text

Serum chloride and sodium concentration as a predictor of acute kidney injury in premature newborns

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh161124090t ◽

2017 ◽

Vol 145 (7-8) ◽

pp. 340-345

Author(s):

Drazenka Todorovic ◽

Vesna Stojanovic ◽

Aleksandra Doronjski

Keyword(s):

Risk Factors ◽

Acute Kidney Injury ◽

Gestational Age ◽

Neonatal Intensive Care ◽

Significant Risk ◽

Kidney Injury ◽

Significant Risk Factor ◽

Sodium Concentration ◽

Premature Newborns ◽

Serum Chloride

Introduction/Objective. Hyperchloremia is often registered in adults? studies after administration with 0.9% sodium chloride, which contributes to the development of acute kidney injury (AKI) as it leads to vasoconstriction of renal blood vessels. The aim of this study was to determine the correlation of sodium and chloride imbalance with the development of AKI, with consideration of other risk factors for this disorder. Methods. This retrospective study included 146 randomly selected preterm infants hospitalized at the Neonatal Intensive Care Unit from 2008 to 2015. Results. Among the patients registered for the study, 23.97% developed AKI, and they were of a significantly lower gestational age (26.3 ? 2.8 weeks vs. 31.7 ? 2.90 weeks, p < 0.05); birth weight (971.31 ? 412.1 g vs. 1,753.3 ? 750.3 g, p < 0.05); Apgar score in the first (3.2 ? 1.7 vs. 5.7 ? 2.4, p < 0.05) and fifth minute (5.3 ? 1.7 vs. 7.1 ? 1.8, p < 0.05) of life compared to those without AKI. The neonates with AKI had significantly higher maximum chloremia (Clmax: 114.1 ? 8.4 vs. 111.7 ? 4.6, p = 0.029) and maximum natremia (Namax: 147.9 ? 8.8 vs. 142.9 ? 4, p < 0.05). Each of these parameters is (independently) a statistically significant risk factor for the development of AKI, and gestational age is the strongest (OR = 1 / 0.643 = 1.55; 95% CI 1.24?1.94). Mortality in neonates with AKI was higher than in neonates without AKI (19.4% vs. 92.7%, p < 0.05). Conclusion. Hyperchloremia and hypernatremia are more common in the premature newborns with AKI compared to the premature newborns without AKI. Higher maximum sodium and chloride values are independent risk factors for AKI.

Download Full-text

Factores de riesgo asociados al parto pre término en el hospital nacional Guillermo Almenara Irigoyen de enero a junio del 2010.

Revista ECIPeru ◽

10.33017/reveciperu2011.0036/ ◽

2019 ◽

pp. 143-149

Keyword(s):

Risk Factors ◽

Preterm Birth ◽

Pregnant Women ◽

Preterm Delivery ◽

Multiple Pregnancy ◽

Premature Rupture Of Membranes ◽

Premature Rupture ◽

National Hospital ◽

Factors Associated ◽

Factores De Riesgo

Factores de riesgo asociados al parto pre término en el hospital nacional Guillermo Almenara Irigoyen de enero a junio del 2010. Risk factors associated with preterm delivery in the Guillermo Almenara Irigoyen National Hospital from January to June 2010 Lizbeth Estefanía Díaz Polo Universidad de San Martin de Porres. Lima 12 DOI: https://doi.org/10.33017/RevECIPeru2011.0036/ RESUMEN El parto pre término ocurre entre las 22 y antes de las 37 semanas. Su etiología es multifactorial y es causa principal de morbilidad y mortalidad perinatal. El objetivo fue determinar los factores de riesgo asociados al parto pre término en gestantes del Hospital Nacional Guillermo Almenara Irigoyen de Enero a Junio del 2010. Se realizó un estudio retrospectivo, caso - control y descriptivo. Las historias clínicas de pacientes casos y controles, fueron revisadas y registradas en fichas y se procesaron con el SPSS versión 15. Los resultados fueron 81 pacientes con diagnóstico de parto pre término, con significancia estadística en las siguientes variables: ausencia de atención prenatal (OR 3.07, P>0.05), pre eclampsia (OR 20.86, P>0.001), ruptura prematura de membranas (OR 4.03, P>0.005), embarazo múltiple (OR 5.64, P>0.01), corioamnionitis (OR 2.02, P>0.1), lugar de nacimiento: sierra (OR 3.88, P>0.05) y nivel socioeconómico D-E (OR12.73, P>0.05). Se evidencio que gestantes más pobres y con menor nivel educativo presentan mayor incidencia de parto pre término [1] [2] [3]. Que el 21% de los partos pre término, estuvo asociado a la ruptura prematura de membranas (OR 4.03) dato que se encuentra dentro del rango de incidencia, ya que Aagaard-Tillery [4] (2005) señala una incidencia de la ruptura prematura de membrana pre término entre 30 y 40% y Fabián (2008) observó 11.67% de ruptura prematura de membranas [5]. Las gestantes con pre eclampsia tuvieron un riesgo 20 veces más de presentar parto pre término. El 34.6% con parto pre término presentó pre eclampsia, de ellas el 42.8% fue pre eclampsia severa, 25% leve y 32.14% síndrome de HELLP; dato similar al observado por Salviz en su estudio en el Hospital Cayetano Heredia, donde encontró un 30 % de parto pre término en pacientes con pre eclampsia; si bien es conocido que la pre eclampsia afecta del 3 al 5% de las gestaciones, no existen estudios sobre la incidencia de la pre eclampsia en el parto pre término [6]. Se concluye que el principal factor de riesgo asociado al parto pre término fue la pre eclampsia. Haber nacido en la sierra, pertenecer a nivel socioeconómico D-E, ausencia de atención prenatal, ruptura prematura de membranas, coriomanionitis y embarazo múltiple fueron también significativos. Descriptores: factores de riesgo, parto pre término, parto a término, pre eclampsia. ABSTRACT Preterm birth occurs between 22 and before 37 weeks. Its etiology is multifactorial and is a major cause of perinatal morbidity and mortality. The objective was to determine the risk factors associated with preterm delivery in pregnant women Guillermo Almenara Irigoyen National Hospital from January to June 2010. We performed a retrospective case - control and descriptive. The case histories of patients and controls were reviewed and recorded in chips and processed with SPSS version 15. The results were 81 patients diagnosed with preterm birth, with statistical significance in the following variables: absence of prenatal care (OR 3.07, P> 0.05), pre-eclampsia (OR 20.86, P <0.001), premature rupture of membranes (OR 4.03, P> 0,005), multiple pregnancy (OR 5.64, P> 0.01), chorioamnionitis (OR 2.02, P> 0.1), place of birth: saw (OR 3.88, P> 0.05) and socioeconomic status (OR12.73, P> 0.05). It was evident that more poor pregnant women with less education have a higher incidence of preterm delivery [1] [2] [3]. That 21% of preterm births was associated with premature rupture of membranes (OR 4.03) data that is within the range of incidence, as Aagaard-Tillery [4] (2005) noted an incidence of premature rupture preterm membrane between 30 and 40% and Fabian (2008) observed 11.67% of premature rupture of membranes [5]. Pregnant women with preeclampsia had a 20 times higher risk of preterm birth present. 34.6% presented with preterm birth pre-eclampsia, of which 42.8% was severe preeclampsia, 25% and 32.14% mild HELLP syndrome; data Salviz similar to that observed in their study in the Cayetano Heredia Hospital, where he found a 30 % of preterm birth in patients with preeclampsia, although it is known that pre-eclampsia affects 3 to 5% of pregnancies, no studies on the incidence of preeclampsia in preterm labor [6]. We conclude that the main risk factor associated with preterm delivery was preeclampsia. Being born in the mountains, belong to socioeconomic status, lack of prenatal care, premature rupture of membranes, coriomanionitis and multiple pregnancy were also significant. Keywords: risk factors, preterm delivery, term delivery, pre-eclampsia.

Download Full-text

Maternal risk factors associated with preterm birth after IVF/ICSI

10.21203/rs.3.rs-963053/v1 ◽

2021 ◽

Author(s):

Jian Li ◽

Jinhua Shen ◽

Xiaoli Zhang ◽

Yangqin Peng ◽

Qin Zhang ◽

...

Keyword(s):

Risk Factors ◽

Preterm Birth ◽

Placenta Previa ◽

Multiple Pregnancy ◽

Multivariate Logistic Regression Analysis ◽

Maternal Risk ◽

Increased Risk ◽

Gestational Week ◽

Independent Risk Factors ◽

Early Preterm Birth

Abstract In vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI).is associated with an increased risk of preterm (33rd - 37th gestational week), and early preterm birth (20th - 32nd gestational week). The underlying general and procedure related risk factors are not well understood so far. 4,328 infertile women undergoing IVF/ICSI were entered into this study. The study population was divided into three groups: a) early preterm birth group (n=66), b) preterm birth group (n=675 ) and c) full-term birth group (n=3653). Odds for preterm birth were calculated by stepwise multivariate logistic regression analysis. We identified seven independent risk factors for preterm birth and four independent risk factors for early preterm birth. Older (>39) or younger (<25) maternal age (OR:1.504, 95%CI: 1.108-2.042,P=0.009; OR: 2.125, 95%CI: 1.049-4.304,P=0.036, respectively), multiple pregnancy (OR: 9.780, 95%CI: 8.014-11.935,P<0.001; OR: 8.588, 95%CI: 4.866-15.157,P<0.001, respectively), placenta previa (OR: 14.954, 95%CI: 8.053-27.767,P<0.001; OR: 16.479, 95%CI: 4.381-61.976,P<0.001, respectively), and embryo reduction (OR: 3.547, 95%CI: 1.736-7.249,P=0.001; OR: 7.145, 95%CI: 1.990-25.663,P=0.003, respectively) were associated with preterm birth and early preterm birth, whereas gestational hypertension (OR: 2.494, 95%CI: 1.770-3.514,P<0.001), elevated triglycerides (OR: 1.120, 95%CI: 1.011-1.240,P=0.030) and shorter activated partial thromboplastin time (OR: 0.967, 95%CI: 0.949-0.985,P<0.001) were associated only with preterm birth. In conclusion, preterm and early preterm birth risk factors in patients undergoing assisted IVF/ICSI are in general similar to those in natural pregnancy. The lack of some associations in the early preterm group was most likely due to the lower number of early preterm birth cases. Only embryo reduction represents an IVF/ICSI specific risk factor.

Download Full-text

The Incidence and Risk Factors of Brain Injury in Multiple Pregnancy Preterm Infants

Pediatric Research ◽

10.1038/pr.2011.376 ◽

2011 ◽

Vol 70 ◽

pp. 151-151

Author(s):

X L Bai ◽

Y H Cao

Keyword(s):

Risk Factors ◽

Brain Injury ◽

Preterm Infants ◽

Multiple Pregnancy

Download Full-text

Preterm Birth: A Prominent Risk Factor for Low Apgar Scores

BioMed Research International ◽

10.1155/2015/978079 ◽

2015 ◽

Vol 2015 ◽

pp. 1-8 ◽

Cited By ~ 3

Author(s):

Maria Svenvik ◽

Lars Brudin ◽

Marie Blomberg

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Preterm Birth ◽

Tertiary Care ◽

Multiple Pregnancy ◽

Apgar Scores ◽

Significant Difference ◽

Gestational Week ◽

Using Data ◽

Predictive Risk

Objective.To determine predictive risk factors for Apgar scores < 7 at 5 minutes at two hospitals providing tertiary care and secondary care, respectively.Methods.A retrospective registry cohort study of 21126 births (2006–2010) using data from digital medical records. Risk factors were analyzed by logistic regression analyses.Results. AS5min⁡<7was multivariately associated with the following: preterm birth; gestational week 32 + 0–36 + 6,OR=3.9(95% CI 2.9–5.3); week 28 + 0–31 + 6,OR=8(5–12); week < 28 + 0,OR=15(8–29); postterm birth,OR=2.0(1.7–2.3); multiple pregnancy,OR=3.53(1.79–6.96); previous cesarean section,OR=3.67(2.31–5.81); BMI 25–29,OR=1.30(1.09–1.55);BMI≥30 OR=1.70(1.20–2.41); nonnormal CTG at admission,OR=1.98(1.48–2.66). ≥1-para was associated with a decreased risk forAS5min⁡<7,OR=0.34(0.25–0.47). In the univariate logistic regression analysisAS5min⁡<7was associated with tertiary level care,OR=1.48(1.17–1.87); however, in the multivariate analysis there was no significant difference.Conclusion.A number of partially preventable risk factors were identified, preterm birth being the most evident. Further, no significant difference between the two hospital levels regarding the risk for low Apgar scores was detected.

Download Full-text