Women with chronic hypoparathyroidism have low risk of adverse pregnancy outcomes

Author(s):  
Sigridur Björnsdottir ◽  
Bart Clarke ◽  
Outi Mäkitie ◽  
Anna Sandström ◽  
Eleonor Tiblad ◽  
...  

Abstract Objective The aim of this study was to evaluate pregnancy outcome and total number of births in chronic hypoparathyroidism (hypoPT). Patients The Swedish National Patient Register, The Swedish Prescribed Drug Register, Swedish Medical Birth Register and the Total Population Register were used to identify 97 women with chronic hypoPT and 1030 age-matched controls who delivered 139 and 1577 singleton infants, respectively, following diagnosis between 1997 and 2017. Results Women in the chronic hypoPT group had more frequent diabetes (DM) and chronic kidney disease (CKD) compared to women in the control group (p=0.043 and p<0.001, respectively). After adjusting for DM, CKD, maternal age at delivery and calendar year of delivery, chronic hypoPT cases were associated with increased risk of induction of labor (OR 1.82; 95% CI 1.13-2.94) and giving birth to infants with lower birth weight (β-coefficient -188 g; 95% CI -312.2- -63.8) compared to controls. No difference was found in infant length, small for gestational age or head circumference after adjustments. Mean gestational age at delivery after controlling for DM, CKD and pre-eclampsia, was not significantly younger (p=0.119). There was no difference in congenital malformations or perinatal death. There was no difference in the total number of infants born to women with chronic hypoPT and controls (p=0.518). Conclusion The majority of women with chronic hypoPT had normal pregnancy outcomes, and the overall risks appear to be low. Maternal chronic hypoPT, is however, associated with a higher risk of induction of labor and slightly lower infant birth weight.

2021 ◽  
Vol 10 (4) ◽  
pp. 643
Author(s):  
Veronica Giorgione ◽  
Corey Briffa ◽  
Carolina Di Fabrizio ◽  
Rohan Bhate ◽  
Asma Khalil

Twin pregnancies are commonly assessed using singleton growth and birth weight reference charts. This practice has led to a significant number of twins labelled as small for gestational age (SGA), causing unnecessary interventions and increased risk of iatrogenic preterm birth. However, the use of twin-specific charts remains controversial. This study aims to assess whether twin-specific estimated fetal weight (EFW) and birth weight (BW) charts are more predictive of adverse outcomes compared to singleton charts. Centiles of EFW and BW were calculated using previously published singleton and twin charts. Categorical data were compared using Chi-square or McNemar tests. The study included 1740 twin pregnancies, with the following perinatal adverse outcomes recorded: perinatal death, preterm birth <34 weeks, hypertensive disorders of pregnancy (HDP) and admissions to the neonatal unit (NNU). Twin-specific charts identified prenatally and postnatally a smaller proportion of infants as SGA compared to singleton charts. However, twin charts showed a higher percentage of adverse neonatal outcomes in SGA infants than singleton charts. For example, perinatal death (SGA 7.2% vs. appropriate for gestational age (AGA) 2%, p < 0.0001), preterm birth <34 weeks (SGA 42.1% vs. AGA 16.4%, p < 0.0001), HDP (SGA 21.2% vs. AGA 13.5%, p = 0.015) and NNU admissions (SGA 69% vs. AGA 24%, p < 0.0001), when compared to singleton charts (perinatal death: SGA 2% vs. AGA 1%, p = 0.029), preterm birth <34 weeks: (SGA 20.6% vs. AGA 17.4%, p = 0.020), NNU admission: (SGA 34.5% vs. AGA 23.9%, p < 0.000). There was no significant association between HDP and SGA using the singleton charts (p = 0.696). In SGA infants, according to the twin charts, the incidence of abnormal umbilical artery Doppler was significantly more common than in SGA using the singleton chart (27.0% vs. 8.1%, p < 0.001). In conclusion, singleton charts misclassify a large number of twins as at risk of fetal growth restriction. The evidence suggests that the following twin-specific charts could reduce unnecessary medical interventions prenatally and postnatally.


2014 ◽  
Vol 27 (2) ◽  
pp. 191
Author(s):  
Cláudia Andrade ◽  
Joana Santos ◽  
Ana Rita Pinto ◽  
Pedro Manso ◽  
Susana Pereira

<strong>Introduction:</strong> Several studies suggested an association between first trimester biochemical markers (PAPP-A and β- HCG) and infants below 10th percentile. Our goal was to describe this relationship of biochemical markers with small-for- gestational-age fetuses in our population.<br /><strong>Material and Methods:</strong> Retrospective analytic study of 2 035 pregnant women that underwent first-trimester screening in the period between March 2009 and September 2011. Small-for-gestational-age infants below 10th percentile were compared with control group (term newborn with birth weight above 10th percentile). Infants below 3rd percentile and control group were also compared. Multiple and logistic regression analysis were done with PAPP-A, β-HCG (multiples of the expected normal median) and demographic maternal characteristics (ethnicity, weight and smoker status).<br /><strong>Results:</strong> This study demonstrated an independent contribution of PAPP-A, maternal weight and smoker status in predicting small-for-gestational-age infants. For PAPP-A, the odds ratio for small-for-gestational age below 10th and 3rd percentile was 2.41 and 3.41, respectively (p &lt; 0.01). For β-HCG, odds ratio below 10th percentile was 1.70 (p = 0.03) and for birth weight below the 3rd percentile, the odds ratio was 3.22 (p &lt; 0.01).<br /><strong>Conclusions:</strong> Low levels of PAPP-A and β-HCG (values below 5th percentile of the study population) were associated with an increased risk of small-for-gestational-age infants in the pregnant population included in this study.


2016 ◽  
Vol 13 (3) ◽  
pp. 169-176 ◽  
Author(s):  
Rajeeb Thapaliya ◽  
BK Rai ◽  
R Bhandari ◽  
P Rijal ◽  
PP Gupta

Background: Perinatal mortality includes both deaths in the first week of life and fetal deaths (stillbirths). Over 130 million babies are born every year, and more than 10 million infants die before their fifth birthday and almost 8 million before their first birthday.Objectives: To make an effort to find out impact of birth interval on fetal outcomes like, low birth weight (weight less than 2500 grams regardless of gestational age), perinatal death (death within 28 weeks of gestation to 7 days of birth) in subsequent pregnancies.Methods: This was a cross-sectional study conducted in BPKIHS, Dharan in 2011. Patients included were women of second gravida between age group 20 -35 years .The consecutive convenience sampling method was used to collect the data. Study population was divided into three birth interval groups of <18, 18-59,>59 months respectively and fetal outcomes (low birth weight, gestational age, early neonatal death, Apgar score) were compared.Results: Out of included population majority (55.63%) of the women had age range of 20-25 years with the mean age of 25.30. Among the total 168 who were included 20(11.91%) were belongs to birth interval <18 months, 113(67.26%) were found in 18-59 months group and 35(20.83%) were in >59 months group.Conclusion: There was increased risk of preterm and low birth weight and perinatal death in women with birth interval <18 months as compared to women with birth interval 18-59 months and groups >59 months. Health Renaissance 2015;13(3): 169-176


2019 ◽  
Vol 47 (9) ◽  
pp. 4397-4412 ◽  
Author(s):  
Ping Guan ◽  
Fei Tang ◽  
Guoqiang Sun ◽  
Wei Ren

Objective This study aimed to analyze the effects of maternal weight on adverse pregnancy outcomes. Methods Data were retrospectively collected from a hospital in Wuhan, China. A total of 1593 pregnant women with singletons were included. Adverse outcomes during pregnancy, such as small for gestational age (SGA), large for gestational age (LGA), and hypertensive disorders in pregnancy (HDP) were analyzed. Results The risks of low birth weight, SGA, and preterm birth were significantly higher in the inadequate gestational weight gain (GWG) group compared with the adequate GWG group. GWG over the guidelines was related to a higher risk of macrosomia, LGA, cesarean section, and HDP than GWG within the guidelines. The risks of low birth weight (OR = 5.082), SGA (OR = 3.959), preterm birth (OR = 3.422), and gestational diabetes mellitus (OR = 1.784) were significantly higher in women with a normal pre-pregnancy body mass index (BMI) and inadequate GWG compared with women with a normal pre-pregnancy BMI and adequate GWG. The risks of macrosomia (OR = 3.654) and HDP (OR = 1.992) were increased in women with normal pre-pregnancy BMI and excessive GWG. Conclusion Women with an abnormal BMI and inappropriate GWG have an increased risk of adverse maternal and infant outcomes. Weight management during the perinatal period is required.


2019 ◽  
Author(s):  
Xiu xiu Li ◽  
Rui Gao ◽  
Xiaowei Dai ◽  
Hong Liu ◽  
Jinxin Zhang ◽  
...  

Abstract Abstract Objectives Most studies have showed that maternal depression is associated with pregnancy complications. However, there were limited evidences in Chinese population. We examined the associations of the antenatal depression symptoms with pregnancy outcomes, especially for low birth weight. Methods A total of 1377 singleton pregnant women were recruited from Nanshan Maternity & Child Healthcare Hospital of Shenzhen in this prospective cohort study. Depression symptoms were assessed by the Edinburgh postnatal depression scale (EPDS) questionnaire in the second trimester of gestation; cut-points for the indication of antenatal depression were ≥12 scores in this study. Sociodemographic data, life-style and pregnancy outcomes were collected through Shenzhen Maternity & Child Healthcare database. The risks of adverse outcomes in patients with depression were determined by multivariate logistic regression and represented as odds ratios (ORs) and 95% confidence intervals (CIs). Results Of the 1377 subjects, the prevalence of antenatal depression was 19.1%. The EPDS scores were 13.8±2.0 and 6.5±2.9 ( P <0.001) in subjects with and without antenatal depression, respectively. After adjustment for maternal age, education, parity, pre-pregnancy body mass index (BMI), residential area, fetal gender, an EPDS score≥12 (versus. <12) was associated with an increased risk for low birth weight (odds ratio: 2.05, 95% CI: 1.12-4.64), but not for preterm birth, large for gestational age, small for gestational age and macrosomia. Conclusion Pregnant women presenting antenatal depressive symptoms are at elevated risk of low birth weight. Mental health problems of pregnancy should be addressed for the prevention of low birth weight.


2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Qi Sun ◽  
Hongguang Zhang ◽  
Ya Zhang ◽  
Zuoqi Peng ◽  
Jianbo Lu ◽  
...  

Background. The relationship between tuberculosis (TB) and adverse pregnancy outcomes remains unclear. The aim of our study was to investigate whether TB is a risk factor for adverse pregnancy outcomes including premature birth, low birth weight, and stillbirth. Method. We conducted a population-based retrospective cohort study in mainland China. A total of 3,668,004 Chinese women, along with their partners, were included in this study, within the National Free Pre-Pregnancy Checkups Project, during 2015–2018. Propensity score matching was used to balance the two groups (cases: women or partners with TB; controls: women and partners without TB). Multivariable logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Results. Multivariate logistic regression showed that the OR of stillbirth for cases was 1.89 (95% CI: 1.09–3.16), in comparison with the control group. In the subgroup analysis, women whose partner had TB had a higher risk of stillbirth (OR: 2.13, 95% CI: 1.10–3.86) than women whose partner did not have TB. There was no significant difference in adverse pregnancy outcomes, including preterm birth, low birth weight, and stillbirth, between women with and without TB. Conclusions. Women whose partner had TB were more likely to have stillbirth than women whose partners did not have TB.


2020 ◽  
Author(s):  
Xiu xiu Li ◽  
Rui Gao ◽  
Xiaowei Dai ◽  
Hong Liu ◽  
Jinxin Zhang ◽  
...  

Abstract Objectives Most studies have showed that maternal depression is associated with pregnancy complications. However, there were limited evidences in Chinese population. We examined the associations of the antenatal depression symptoms with pregnancy outcomes, especially for low birth weight. Methods A total of 1377 singleton pregnant women were recruited from Nanshan Maternity & Child Healthcare Hospital of Shenzhen in this prospective cohort study. Depression symptoms were assessed by the Edinburgh postnatal depression scale (EPDS) questionnaire in the second trimester of gestation; cut-points for the indication of antenatal depression were ≥12 scores in this study. Sociodemographic data, life-style and pregnancy outcomes were collected through Shenzhen Maternity & Child Healthcare database. The risks of adverse outcomes in patients with depression were determined by multivariate logistic regression and represented as odds ratios (ORs) and 95% confidence intervals (CIs). Results Of the 1377 subjects, the prevalence of antenatal depression was 19.1%. The EPDS scores were 13.8±2.0 and 6.5±2.9 ( P <0.001) in subjects with and without antenatal depression, respectively. After adjustment for maternal age, education, parity, pre-pregnancy body mass index (BMI), residential area, fetal gender, an EPDS score≥12 (versus. <12) was associated with an increased risk for low birth weight (odds ratio: 2.05, 95% CI: 1.12-4.64), but not for preterm birth, large for gestational age, small for gestational age and macrosomia. Conclusion Pregnant women presenting antenatal depressive symptoms are at elevated risk of low birth weight. Mental health problems of pregnancy should be addressed for the prevention of low birth weight.


2019 ◽  
Author(s):  
Xiu xiu Li ◽  
Rui Gao ◽  
Xiaowei Dai ◽  
Hong Liu ◽  
Jinxin Zhang ◽  
...  

Abstract Objectives Most studies have showed that maternal depression is associated with pregnancy complications. However, there were limited evidences in Chinese population. We examined the associations of the antenatal depression symptoms with pregnancy outcomes, especially for low birth weight. Methods A total of 1377 singleton pregnant women were recruited from Nanshan Maternity & Child Healthcare Hospital of Shenzhen in this prospective cohort study. Depression symptoms were assessed by the Edinburgh postnatal depression scale (EPDS) questionnaire in the second trimester of gestation; cut-points for the indication of antenatal depression were ≥12 scores in this study. Sociodemographic data, life-style and pregnancy outcomes were collected through Shenzhen Maternity & Child Healthcare database. The risks of adverse outcomes in patients with depression were determined by multivariate logistic regression and represented as odds ratios (ORs) and 95% confidence intervals (CIs). Results Of the 1377 subjects, the prevalence of antenatal depression was 19.1%. The EPDS scores were 13.8±2.0 and 6.5±2.9 ( P <0.001) in subjects with and without antenatal depression, respectively. After adjustment for maternal age, education, parity, pre-pregnancy body mass index (BMI), residential area, fetal gender, an EPDS score≥12 (versus. <12) was associated with an increased risk for low birth weight (odds ratio: 2.05, 95% CI: 1.12-4.64), but not for preterm birth, large for gestational age, small for gestational age and macrosomia. Conclusion Pregnant women presenting antenatal depressive symptoms are at elevated risk of low birth weight. Mental health problems of pregnancy should be addressed for the prevention of low birth weight.


2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 743.2-743
Author(s):  
I. Redeker ◽  
A. Strangfeld ◽  
U. Marschall ◽  
A. Zink ◽  
X. Baraliakos

Background:In contrast to other rheumatic inflammatory diseases, studies on pregnancy outcomes in axial spondyloarthritis (axSpA) are scarce, despite its onset in early adulthood affecting women in their reproductive years.Objectives:To investigate maternal and infant pregnancy outcomes among women with axSpA compared with population-based controls.Methods:Taking advantage of a large health insurance dataset, comprising the period 2006 – 2018, maternal and infant pregnancy outcomes and delivery outcomes of women with axSpA were assessed and compared with population-based controls (matched by maternal age and calendar year of birth). Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using generalised estimating equation analyses.Results:A total of 611 singleton births among 535 women with axSpA were included in the analysis. The mean age at delivery was 32.5 years. The pharmacological treatment within 12 months prior to and after conception is illustrated in the Figure. Infants of women with axSpA were only slightly more often preterm (5.2% vs 4.7%) and small-for-gestational-age (1.6% vs 1.1%) than infants of matched population-based controls, respectively. Caesarean section was performed in 36% of deliveries among women with axSpA compared with 29.5% in population-based controls, resulting in a significantly increased risk for receiving caesarean section (OR 1.35; 95% CI 1.06-1.73) (Table). The occurrence of pre-eclampsia, preterm birth, and small-for-gestational-age was moderately higher, but not significantly increased, among women with axSpA as compared to population-based controls.Conclusion:Women with axSpA had no significantly increased risks for adverse maternal or infant pregnancy outcomes compared to non-axSpA women. However, a significantly increased risk for receiving caesarean section and a tendency for a higher number of preterm deliveries and of small-for-gestational-age infants was observed in women with axSpA.Table.Prevalences and odds ratios with 95% confidence intervals for adverse pregnancy outcomesPregnancies in women with axSpAN=611Pregnancies in population-based controlsN=611Odds Ratio(95% CI)Preterm birth (< week 37)5.2% (32)4.7% (29)1.11 (0.66, 1.85)Gestational week 28-364.9% (30)4.7% (29)1.03 (0.61, 1.75)Gestational week <280.3% (2)0.2% (1)2.01 (0.18, 22.18)Small for gestational age1.6% (10)1.1% (7)1.43 (0.54, 3.79)Low birth weight (<2500 g)2.8% (17)2.6% (16)1.06 (0.53, 2.13)Exceptionally large baby(birth weight ≥4500 g)1.1% (7)0.2% (1)7.07 (0.87, 57.63)Pre-eclampsia7.5% (46)6.4% (39)1.21 (0.78, 1.90)Assisted vaginal delivery4.3% (26)3.1% (19)1.39 (0.76, 2.56)Caesarean section36.0% (220)29.5% (180)1.35 (1.06, 1.73)axSpA, axial Spondyloarthritis; CI, confidence interval.Acknowledgments:We would like to thank the BARMER Statutory Health Insurance for providing data for this study.Disclosure of Interests:Imke Redeker: None declared, Anja Strangfeld Speakers bureau: AbbVie, BMS, Pfizer, Roche, Sanofi-Aventis, Ursula Marschall: None declared, Angela Zink Speakers bureau: AbbVie, Amgen, BMS, Gilead, Hexal, Janssen, Lilly, MSD, Pfizer, Roche, Sanofi Aventis, UCB, Xenofon Baraliakos Grant/research support from: Grant/research support from: AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB and Werfen, Consultant of: AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB and Werfen, Speakers bureau: AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB and Werfen


2013 ◽  
Vol 17 (9) ◽  
pp. 2071-2080 ◽  
Author(s):  
Kristine Vejrup ◽  
Anne Lise Brantsæter ◽  
Helle K Knutsen ◽  
Per Magnus ◽  
Jan Alexander ◽  
...  

AbstractObjectiveTo examine the association between calculated maternal dietary exposure to Hg in pregnancy and infant birth weight in the Norwegian Mother and Child Cohort Study (MoBa).DesignExposure was calculated with use of a constructed database of Hg in food items and reported dietary intake during pregnancy. Multivariable regression models were used to explore the association between maternal Hg exposure and infant birth weight, and to model associations with small-for-gestational-age offspring.SettingThe study is based on data from MoBa.SubjectsThe study sample consisted of 62 941 women who answered a validated FFQ which covered the habitual diet during the first five months of pregnancy.ResultsMedian exposure to Hg was 0·15 μg/kg body weight per week and the contribution from seafood intake was 88 % of total Hg exposure. Women in the highest quintile compared with the lowest quintile of Hg exposure delivered offspring with 34 g lower birth weight (95 % CI −46 g, −22 g) and had an increased risk of giving birth to small-for-gestational-age offspring, adjusted OR = 1·19 (95 % CI 1·08, 1·30). Although seafood intake was positively associated with increased birth weight, stratified analyses showed negative associations between Hg exposure and birth weight within strata of seafood intake.ConclusionsAlthough seafood intake in pregnancy is positively associated with birth weight, Hg exposure is negatively associated with birth weight. Seafood consumption during pregnancy should not be avoided, but clarification is needed to identify at what level of Hg exposure this risk might exceed the benefits of seafood.


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