scholarly journals Associations Between Maternal Thyroid Function in Pregnancy and Obstetric and Perinatal Outcomes

2019 ◽  
Vol 105 (5) ◽  
pp. e2015-e2023 ◽  
Author(s):  
Sun Y Lee ◽  
Howard J Cabral ◽  
Ann Aschengrau ◽  
Elizabeth N Pearce
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Confidence Interval ◽  
Gestational Hypertension ◽  
Medical Center ◽  
Academic Medical Center ◽  
Fetal Loss ◽  
Perinatal Outcomes ◽  
Tsh Levels ◽  
In Pregnancy

Abstract Context The effects of maternal subclinical hypothyroidism on pregnancy outcomes are not clear. Objective We aimed to assess potential associations between maternal thyrotropin (thyroid-stimulating hormone [TSH]) levels in pregnancy and obstetric and perinatal outcomes. Design Retrospective cohort study. Setting Tertiary academic medical center. Patients Women aged ≥18 years with a singleton gestation and no known thyroid disease seen for prenatal care at Boston Medical Center from January 1, 2003 through May 22, 2014, and their fetuses and infants were included. Main Outcome Measures Risk ratios of adverse obstetric and perinatal outcomes. Results A total of 8,413 pregnant women (mean age 29.1 years, 15% white, 60% black, 13% Hispanic) and their fetuses and infants (mean gestational age at birth 38.5 weeks, 52% male, mean birth weight 3.2 kg) were included in the analyses. The median (interquartile range) TSH level was 1.06(0.62–1.60) mIU/L, and 130 women (1.6%) had TSH > 4 mIU/L. Maternal TSH levels > 4 mIU/L were associated with increased risks of prematurity (risk ratio [RR] 2.17 [95% confidence interval 1.15–4.07] P = .016) and neonatal respiratory distress syndrome (RDS) (RR 2.83 [95% confidence interval 1.02–7.86] P = .046) compared to TSH levels ≤ 4 mIU/L. Although not statistically significant, TSH levels > 4 mIU/L were also associated with increased RRs for fetal loss, preeclampsia/eclampsia, and low birth weight. TSH levels > 4 mIU/L were not associated with preterm labor, placental abruption, cesarean section, gestational hypertension or diabetes, or neonatal intensive care unit admission. Conclusion Maternal serum TSH concentration > 4 mIU/L in pregnancy was associated with approximately 2-fold increased risks of prematurity and RDS in offspring. Elevated TSH was also associated with statistically non-significant increases in the risk of fetal loss, preeclampsia/eclampsia, and low birth weight.

scholarly journals Pregnancy and Delivery with Cardiac Disease in Dr. Soetomo Hospital 2018

2021 ◽  
Vol 2 (2) ◽  
pp. 61-66
Author(s):  
Ana Puji Rahayu ◽  
Khanisyah Erza Gumilar
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Cardiac Disease ◽  
Perinatal Outcome ◽  
Perinatal Outcomes ◽  
Number Of Patients ◽  
Pregnancy And Delivery ◽  
Maternal And Neonatal Outcomes ◽  
In Pregnancy

Background: Cardiac disease is one of the non obstetric problems causing mortality both in pregnancy and labor due to the complications. Preventions for the complications have not been implemented, thus the number of patients which have cardiac disease with complications and perinatal outcome with low birth weight is still high. Objective : To identify maternal and neonatal outcome of pregnant women with cardiac disease in dr. Soetomo Surabaya hospital in 2018. Method: Descriptive retrospective study using medical records in dr. Soetomo Surabaya hospital 2018. Result: We found 1433 pregnancy cases with 51 (3,6 %) patients were having cardiac disease and included in this research. The most common maternal complication was pulmonary hypertension 16 cases. A dead case was found 1 case (1,9 %) with eissenmenger syndrome. We found the perinatal outcome of 30 babies (58.8%) born with a weight of 2500 gram and under. There are 7 patients with cardiac disease that have been corrected (13,7%). Among those 7 patients, 6 had a perinatal outcome with a birth weight of more than 2500 gram. Conclusion : Most pregnant patients with cardiac disease in dr. Soetomo Surabaya hospital 2018 are already having some complications with perinatal outcomes of low birth weight. Therefore, management of cardiac disease in pregnancy to prevent complications by means of preconception counseling, good antenatal care, and appropriate referrels are still needed to improve the quality of maternal and neonatal outcomes.

Cardiac Disease in Pregnancy: Maternal and Perinatal Outcomes in RSUP Dr. Mohammad Hoesin Palembang

2021 ◽  
Vol 6 (2) ◽  
pp. 1380-1392
Author(s):  
Ni Made Dyah Gayatri ◽  
Peby Maulina Lestari ◽  
Abarham Martadiansyah ◽  
Rizky Agustria ◽  
Muwarni Emasrissa Latifah
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Cardiac Failure ◽  
Cardiac Disease ◽  
Perinatal Asphyxia ◽  
Hypertensive Heart Disease ◽  
Perinatal Outcomes ◽  
Peripartum Cardiomyopathy ◽  
Age Group ◽  
In Pregnancy

Background: Impaired maternal and uteroplacental perfusion can occur in pregnancy with cardiac disease leading to maternal and perinatal mortality and morbidity due to increased cardiac load and ventricular dysfunction. This research aims to determine maternal and perinatal outcomes of pregnancies with cardiac disease. Method: This research was a descriptive observational study conducted by a total sampling method and a cross-sectional design. This research used medical records of pregnant women with cardiac disease who gave birth in RSUP Dr. Mohammad Hoesin Palembang in January 2018-December 2020 as study samples. Result: Among 68 pregnancies with cardiac disease, there were 4 cases (0.87%) found in 2018, 37 cases (2.47%) found in 2019, and 27 cases (1.48%) found in 2020. The highest distribution of pregnancies with cardiac disease was found at 64.7% in the range of 20-35 years old age group; 57.4% in the multiparity group; 38.2% in the range of ≥34 – <37 weeks gestational age group; 86.8% in the high school educational level group; 66.2% in the high-risk cardiac functional status group; 54.4% in the peripartum cardiomyopathy group; and 36.8% with preeclampsia/eclampsia as a comorbid. In this study, maternal outcomes found were maternal mortality at 11.8%; cardiac failure at 70.6%; arrhythmia at 1.5%; and stroke at 1.5%, while perinatal outcomes found were prematurity at 60.3%; low birth weight at 64.4%; IUGR at 37.0%; IUFD at 1.4%; stillbirth at 6.8%; neonatal death at 9.6%; and perinatal asphyxia at 42.5%. Conclusion: The prevalence rate of pregnancies with cardiac disease in RSUP Dr. Mohammad Hoesin Palembang was 0.87% in 2018, 2.47% in 2019, and 1.48% in 2020. The most common maternal outcome in this study was cardiac failure, with most in the peripartum cardiomyopathy group, while the most common perinatal outcome was low birth weight, with most in the hypertensive heart disease group.

HPV Prevalence and its Association with Perinatal Outcomes among Singleton Mothers: Analysis of Pregnancy Risk Assessment and Monitoring System (PRAMS) Data, 2004-2011

2019 ◽  
Vol 15 (2) ◽  
pp. 143-149 ◽  
Author(s):  
Harpriya Kaur ◽  
Delf Schmidt-Grimminger ◽  
Baojiang Chen ◽  
K.M. Monirul Islam ◽  
Steven W. Remmenga ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Pregnant Women ◽  
Monitoring System ◽  
Large Population ◽  
Perinatal Outcomes ◽  
Hpv Infection ◽  
Adverse Outcomes ◽  
P Value ◽  
Pregnancy Risk

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.

Hepatitis B Vaccination of Low Birth Weight Infants in Washington State

2020 ◽  
Author(s):  
Katarina Ost ◽  
Natalia V. Oster ◽  
Elizabeth N. Jacobson ◽  
M. Patricia deHart ◽  
Janet A. Englund ◽  
...  
Keyword(s):  
Birth Weight ◽  
Hepatitis B ◽  
Low Birth Weight ◽  
Academic Medical Center ◽  
Washington State ◽  
Hepatitis B Vaccination ◽  
High Risk Population ◽  
Low Birth Weight Infants ◽  
Birth Dose ◽  
Birth Hospitalization

Objective The U.S. Advisory Committee on Immunization Practices (ACIP) recommends that infants born weighing less than 2,000 g receive the hepatitis B (HepB) vaccine at hospital discharge or 30 days of age. This study aimed to assess timely HepB vaccination among low birth weight infants. We hypothesized that many of these vulnerable infants would fail to receive their HepB birth dose on time. Study Design This retrospective cohort study included Washington State infants born weighing less than 2,000 g at an academic medical center between 2008 and 2013. Data were abstracted from electronic health records and linked to vaccine data from the Washington State Immunization Information System. Multivariable logistic regression was used to examine the associations between sociodemographic, clinical, and visit characteristics and HepB vaccination by birth hospitalization discharge or 30 days of age. Results Among 976 study infants, 58.4% received their HepB vaccine by birth hospitalization discharge or 30 days of age. Infants had higher odds of timely HepB vaccination if they were Hispanic (adjusted odds ratio [AOR] = 1.80, 95% confidence interval [CI]: 1.10–2.95) or non-Hispanic black (AOR = 2.28, 95% CI: 1.36–3.80) versus non-Hispanic white or if they were hospitalized 14 days or longer versus less than 14 days (AOR = 2.43, 95% CI: 1.66–3.54). Infants had lower odds of timely HepB vaccination if they were born before 34 weeks versus on or after 34 weeks of gestational age (AOR = 0.41, 95% CI: 0.27–0.63) or if they had an estimated household income less than $50,845 versus 50,845 or greater (AOR = 0.64, 95% CI: 0.48–0.86). Conclusion Many infants born weighing less than 2,000 g did not receive their first HepB birth dose according to ACIP recommendations. Strategies are needed to improve timely HepB vaccination in this high-risk population. Key Points

scholarly journals Pregnancy Outcome after Cerclage for Cervical Incompetence at a Private Hospital of Dhaka

2017 ◽  
Vol 12 (2) ◽  
pp. 78-81
Author(s):  
Shafeya Khanam ◽  
Maliha Rashid ◽  
Ayesha Siddika Purobi ◽  
Zebunnessa Parvin ◽  
Sanjoy Kumar Das ◽  
...  
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Fetal Loss ◽  
Cervical Dilatation ◽  
Cervical Insufficiency ◽  
Miscarriage Rate ◽  
Cervical Cerclage ◽  
Cervical Incompetence ◽  
Obstetric Population

Miscarriage, particularly recurrent mid-trimester miscarriage is a distressful condition. This form of miscarriage and preterm birth appear to have some etiologies. An important etiology is cervical incompetence that describes a disorder in which painless cervical dilatation leads to recurrent second trimester pregnancy losses. Every year more than 10 million preterm birth occurs and more than 1 million baby die from this common complication of pregnancy. The incidence of true cervical insufficiency is estimated at less than 1% of the obstetric population. In the index pregnancy, findings indicative of possible cervical insufficiency include cervical funneling, cervical shortening, and overt cervical dilatation. The main objective of the study was to explore the benefit from cervical cerclage in pregnant women with cervical incompetence. This is a retrospective observational study conducted over a period of twelve months. All cases delivered in Central Hospital were assisted by consultant obstetricians, in which 16(61.5%) out of 26 cases were delivered by caesarean section. Miscarriage rate was 11.53%. Out of the caesarean deliveries 2(12.5%) were at term and 14(87.5%) were at preterm. In this study 3(21.42%) babies born at 32nd and 33rd weeks, 6(42.85%) at 34th week and 2(14.28%) were at 35th week. There was no fetal loss. Extreme low birth weight was only one, 7(43.75%) of the babies had normal body weight for the area of study, 8 babies (50%) had low birth weight. The cervical cerclage procedure therefore should be available more widely to benefit those patients with proven or strongly suspected cervical incompetence.Faridpur Med. Coll. J. Jul 2017;12(2): 78-81

scholarly journals Late-Onset Enterobacter cloacae Sepsis in Very-Low-Birth-Weight Neonates: Experience in a Medical Center

2009 ◽  
Vol 50 (1) ◽  
pp. 3-7 ◽  
Author(s):  
Hsiao-Neng Chen ◽  
Meng-Luen Lee ◽  
Wai-Kit Yu ◽  
Yue-Wen Lin ◽  
Lon-Yen Tsao
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Very Low Birth Weight ◽  
Late Onset ◽  
Medical Center ◽  
Enterobacter Cloacae

Placental massive perivillous fibrinoid deposition is associated with adverse pregnancy outcomes: a clinicopathological study of 12 cases

2016 ◽  
Vol 5 (1) ◽  
pp. 35-39
Author(s):  
Maili Qi ◽  
Kenneth Tou En Chang ◽  
Derrick Wen Quan Lian ◽  
Chong Kiat Khoo ◽  
Kok Hian Tan
Keyword(s):  
Pregnancy Outcomes ◽  
Gestational Hypertension ◽  
Local Population ◽  
Fetal Loss ◽  
Perinatal Outcomes ◽  
First Trimester ◽  
Adverse Outcomes ◽  
Special Focus ◽  
Adverse Perinatal Outcomes ◽  
Adverse Pregnancy

Abstract Introduction: Massive perivillous fibrinoid deposition (MPFD) is a very rare placental condition characterized by abnormally extensive fibrinoid deposition in the placental villous parenchyma. The aim of this study is to document clinical and pathological features with special focus on pregnancy outcomes of this condition in consecutive cases of MPFD in our local population. Methods: This is a retrospective clinico-pathological study of cases affected by MPFD over the period January 2010–July 2014 in our hospital. We document clinical features (including perinatal outcome and subsequent pregnancies) and placental pathological characteristics. Results: Twelve cases of MPFD were identified among 3640 placentas (0.33%). There was no identified recurrence. The affected infants had adverse outcomes, including intrauterine growth restriction (IUGR) (75%), preterm birth (58.3%), and fetal loss (25%). A high frequency of reduced PAPP-A in the first trimester (25%), and concurrent gestational hypertension or pre-eclampsia (25%) was noted. Conclusion: MPFD is associated with adverse perinatal outcomes. Further research to better understand its pathogenesis and to improve clinical diagnosis and management is warranted.

Fundus Pigmentation in Retinopathy of Prematurity

PEDIATRICS ◽  
1996 ◽  
Vol 97 (3) ◽  
pp. 343-348 ◽  
Author(s):  
Tova Monos ◽  
Shirley D. Rosen ◽  
Michael Karplus ◽  
Yuval Yassur
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Confidence Interval ◽  
Retinopathy Of Prematurity ◽  
Protective Factor ◽  
Very Low Birth Weight ◽  
Ophthalmological Examination ◽  
Dark Pigmentation ◽  
Prospective Study Design ◽  
Fundus Pigmentation

Objective. A prospective study design was used to investigate the association between different degrees of fundus pigmentation and the incidence of retinopathy of prematurity (ROP) among very low birth weight infants in a large neonatal intensive care unit. Methods. The study group consisted of 161 infants weighing 1500 g or less at birth and included all infants born from 1988 to 1990 who survived at least 10 weeks. Presence or lack of any acute stage ROP was determined by weekly ophthalmological examination from the age of 4 weeks. The degree of fundus pigmentation was recorded for each infant during the first examination. Results. Infants with dark fundus pigmentation were found to be at half the risk of developing ROP as compared with the infants having light/medium fundus pigmentation (relative risk 0.5;95% confidence interval = 0.2-1.1). When controlling for birth weight, gestational age, length of oxygen therapy, and ethnic group in multivariate analysis, dark pigmentation was an independent and statistically significant protective factor (odds ratio = 0.09, 95% confidence interval = 0.02-0.6). None of the infants with Stage III ROP or higher had dark pigmentation. Conclusion. We speculate that large amounts of melanin in the retinal pigment epithelium or choroid may protect the dark-pigmented very low birth weight infant from developing ROP.

scholarly journals Association between Interleukin-6 Levels and Perioperative Fatigue in Gastric Adenocarcinoma Patients

2019 ◽  
Vol 8 (4) ◽  
pp. 543 ◽  
Author(s):  
Jin-Ming Wu ◽  
Hui-Ting Yang ◽  
Te-Wei Ho ◽  
Shiow-Ching Shun ◽  
Ming-Tsan Lin
Keyword(s):  
Confidence Interval ◽  
Gastric Adenocarcinoma ◽  
Cancer Cachexia ◽  
Medical Center ◽  
Academic Medical Center ◽  
Gastric Surgery ◽  
Time Points ◽  
Cell Counts ◽  
Cytokine Levels ◽  
The Mean

Background: Gastric adenocarcinoma (GA), one of the most common gastrointestinal cancers worldwide, is often accompanied by cancer cachexia in the advanced stage owing to malnutrition and cancer-related symptoms. Although resection is the most effective curative procedure for GA patients, it may cause perioperative fatigue, worsening the extent of cancer cachexia. Although the relationship between cytokines and cancer fatigue has been evaluated, it is unclear which cytokines are associated with fatigue in GA patients. Therefore, this study aimed to investigate whether the changes in cytokine levels were associated with the perioperative changes in fatigue amongst GA patients. Methods: We included GA patients undergoing gastric surgery in a single academic medical center between June 2017 and December 2018. Fatigue-related questionnaires, serum cytokine levels (interferon-gamma, interleukin (IL)-1, IL-2, IL-5, IL-6, IL-12 p70, tumor necrosis factor-alpha, and granulocyte-macrophage colony-stimulating factor), and biochemistry profiles (albumin, prealbumin, C-reactive protein, and white blood cell counts) were assessed at three time points (preoperative day 0 (POD 0), post-operative day 1 (POD 1), and postoperative day 7 (POD 7)). We used the Brief Fatigue Inventory-Taiwan Form to assess the extent of fatigue. The change in fatigue scores among the three time points, as an independent variable, was adjusted for clinicopathologic characteristics, malnutrition risk, and cancer stages. Results: A total of 34 patients were included for analysis, including 12 female and 22 male patients. The mean age was 68.9 years. The mean score for fatigue on POD 0, POD 1, and POD 7 was 1.7, 6.2, and 3.6, respectively, with significant differences among the three time points (P < 0.001). Among the cytokines, only IL-6 was significantly elevated from POD 0 to POD 1. In the regression model, the change in IL-6 levels between POD 0 and POD 1 (coefficients = 0.01 for every 1 pg/mL increment; 95% confidence interval: 0.01–0.02; P = 0.037) and high malnutrition risk (coefficients = 2.80; 95% confidence interval: 1.45–3.52; P = 0.041) were significantly associated with changes in fatigue scores. Conclusions: The perioperative changes in plasma IL-6 levels are positively associated with changes in the fatigue scores of GA patients undergoing gastric surgery. Targeting the IL-6 signaling cascade or new fatigue-targeting medications may attenuate perioperative fatigue, and further clinical studies should be designed to validate this hypothesis.

scholarly journals Severe anemia and adverse pregnancy outcome in a tertiary care hospital in North India

2018 ◽  
Vol 7 (2) ◽  
pp. 483
Author(s):  
Premlata Yadav
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Peripheral Blood ◽  
Tertiary Care ◽  
Significant Risk ◽  
North India ◽  
Deficiency Anemia ◽  
Care Hospital ◽  
Severe Anemia ◽  
In Pregnancy

Background: Anaemia is commonest medical disorder in pregnancy with 88% prevalence in India mainly due to ignorance, poverty and gender bias. 40-60% of maternal deaths in developing countries. According to the recent standard laid down by WHO anemia is present when the hemoglobin (Hb) concentration in the peripheral blood is less than 11 gm/dl. The most common cause of anemia in pregnancy is iron deficiency. Anemia is diagnosed by estimating the hemoglobin concentration and examining a peripheral blood smear for the characteristic red blood cell changes. The aim of the study was to determine the association between severe anemia, maternal and perinatal complications.Methods: Case control study was done in department of Obstetrics and Gynecology, Rajendra Institute of Medical Sciences Ranchi, India from February 2016 to July 2016. 100 pregnant women, admitted for delivery and having severe anemia were studied and compared with 100 non-anaemic women of similar demographic features. Maternal and perinatal complications were observed. Pearson, chi-square and Fischer exact tests were used to calculate significance of results.Results: Of the severely anaemic mothers, 36% babies were low birth weight (p=0.042) and 20% were small for gestational age (p = 0.026), as compared to 18% and 10% of controls, respectively.Conclusions: Severe maternal anemia carries significant risk of hemorrhage and infection in the mother. It is also associated with preterm birth, low birth weight.

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