scholarly journals Maternal Lipid Profile During Early Pregnancy and Pregnancy Complications and Outcomes: The ABCD Study

2012 ◽  
Vol 97 (11) ◽  
pp. 3917-3925 ◽  
Author(s):  
Tanja G. M. Vrijkotte ◽  
Náthalie Krukziener ◽  
Barbara A. Hutten ◽  
Karlijn C. Vollebregt ◽  
Manon van Eijsden ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Lipid Profile ◽  
Total Cholesterol ◽  
Outcome Measures ◽  
Early Pregnancy ◽  
Pregnancy Outcomes ◽  
Pregnancy Complications ◽  
Adverse Pregnancy Outcomes ◽  
Child Loss ◽  
Adverse Pregnancy

Context: Elevated lipid levels during late pregnancy are associated with complications and adverse outcome for both mother and newborn. However, it is inconclusive whether a disturbed lipid profile during early pregnancy has similar negative associations. Objective: Our objective was to investigate whether nonfasting maternal total cholesterol and triglyceride levels during early pregnancy are associated with six major adverse pregnancy outcomes. Methods: Data were derived from the Amsterdam Born Children and Their Development (ABCD) cohort study. Random blood samples of nonfasting total cholesterol and triglyceride levels were determined during early gestation (median = 13, interquartile range = 12–14 wk). Outcome measures were pregnancy-induced hypertension (PIH), preeclampsia, preterm birth, small/large for gestational age (SGA/LGA), and child loss. Only nondiabetic women with singleton deliveries were included; the baseline sample consisted of 4008 women. Analysis for PIH and preeclampsia were performed in nulliparous women only (n = 2037). Results: Mean (sd) triglyceride and total cholesterol levels were 1.33 (0.55) and 4.98 (0.87) mmol/liter, respectively. The incidence of pregnancy complications and perinatal outcomes were as follows: PIH, 4.9%; preeclampsia, 3.7%; preterm birth, 5.3%; SGA, 9.3%; LGA, 9.3%; and child loss, 1.4%. After adjustments, every unit increase in triglycerides was linearly associated with an increased risk of PIH [odds ratio (OR) = 1.60, P = 0.021], preeclampsia (OR = 1.69, P = 0.018), LGA (OR = 1.48, P < 0.001), and induced preterm delivery (OR = 1.69, P = 0.006). No associations were found for SGA or child loss. Total cholesterol was not associated with any of the outcome measures. Conclusions: Elevated maternal triglyceride levels measured during early pregnancy are associated with pregnancy complications and adverse pregnancy outcomes. These results suggest that future lifestyle programs in women of reproductive age with a focus on lowering triglyceride levels (i.e. diet, weight reduction, and physical activity) may help to prevent hypertensive complications during pregnancy and adverse birth outcomes.

scholarly journals The Impact of Gestational Weight Gain on the Risks of Adverse Maternal and Infant Outcomes among Normal BMI Women with High Triglyceride Levels during Early Pregnancy

Nutrients ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 3454
Author(s):  
Xia-Fei Jiang ◽  
Hui Wang ◽  
Dan-Dan Wu ◽  
Jian-Lin Zhang ◽  
Ling Gao ◽  
...  
Keyword(s):  
Weight Gain ◽  
Preterm Birth ◽  
Gestational Diabetes ◽  
Early Pregnancy ◽  
Pregnancy Outcomes ◽  
Gestational Hypertension ◽  
Adverse Pregnancy Outcomes ◽  
Gestational Weight ◽  
Adverse Pregnancy ◽  
The Impact

A high maternal triglyceride (mTG) level during early pregnancy is linked to adverse pregnancy outcomes, but the use of specific interventions has been met with limited success. A retrospective cohort study was designed to investigate the impact of gestational weight gain (GWG) on the relationship between high levels of mTG and adverse pregnancy outcomes in normal early pregnancy body mass index (BMI) women. The patients included 39,665 women with normal BMI who had a singleton pregnancy and underwent serum lipids screening during early pregnancy. The main outcomes were adverse pregnancy outcomes, including gestational hypertension, preeclampsia, gestational diabetes, cesarean delivery, preterm birth, and large or small size for gestational age (LGA or SGA) at birth. As a result, the high mTG (≥2.05mM) group had increased risks for gestational hypertension ((Adjusted odds ratio (AOR), 1.80; 95% CI, 1.46 to 2.24)), preeclampsia (1.70; 1.38 to 2.11), gestational diabetes (2.50; 2.26 to 2.76), cesarean delivery (1.22; 1.13 to 1.32), preterm birth (1.42, 1.21 to 1.66), and LGA (1.49, 1.33 to 1.68) compared to the low mTG group, after adjustment for potential confounding factors. Additionally, the risks of any adverse outcome were higher in each GWG subgroup among women with high mTG than those in the low mTG group. High mTG augmented risks of gestational hypertension, preeclampsia, preterm birth, and LGA among women with 50th or greater percentile of GWG. Interestingly, among women who gained less than the 50th percentile of GWG subgroups, there was no relationship between high mTG level and risks for those pregnancy outcomes when compared to low mTG women. Therefore, weight control and staying below 50th centile of the suggested GWG according to gestational age can diminish the increased risks of adverse pregnancy outcomes caused by high mTG during early pregnancy.

scholarly journals Early-pregnancy intermediate hyperglycaemia and adverse pregnancy outcomes among women without gestational diabetes

2021 ◽  
Author(s):  
Yunzhen Ye ◽  
Yu Xiong ◽  
Qiongjie Zhou ◽  
Xirong Xiao ◽  
Xiaotian Li
Keyword(s):  
Preterm Birth ◽  
Caesarean Section ◽  
Gestational Diabetes ◽  
Early Pregnancy ◽  
Pregnancy Outcomes ◽  
Adverse Pregnancy Outcomes ◽  
Large For Gestational Age ◽  
Oral Glucose ◽  
Increased Risk ◽  
Adverse Pregnancy

Abstract Aims Universal early-pregnancy screening for overt diabetes reveals intermediate hyperglycaemia [fasting plasma glucose (FPG) (5.1–6.9 mM)]. We evaluated the association between early-pregnancy intermediate hyperglycaemia and adverse pregnancy outcomes among women without gestational diabetes. Methods This retrospective cohort study, conducted at the Obstetrics and Gynaecology Hospital, Shanghai, China, from 2013-2017. All singleton pregnancies with FPG≤6.9mM in early pregnancy and receiving 75-g oral glucose tolerance test (OGTT) were included. Women with pre-pregnancy diabetes were excluded. Subjects with normal OGTT were analysed. Pregnancy outcomes for FPG<5.1 mM and intermediate hyperglycaemia were evaluated. The primary outcomes were large for gestational age (LGA) and primary caesarean section. Multivariate logistic regressions were conducted. Significance was defined as P<0.05. Results Totally, 24479 deliveries were included, of which 23450 (95.8%) had normal OGTTs later in pregnancy (NGT). There were 807 (3.4%) women had FPG=5.1–6.9 mM in early pregnancy. Compared to the NGT group with FPG<5.1 mM in early pregnancy (N=20692), the intermediate hyperglycaemia NGT group (N=693) had a higher age and BMI, and significantly higher rates of LGA, primary caesarean section, preterm birth, preeclampsia and neonatal distress. The rates of primary caesarean section (AOR 1.24, 95% CI 1.05–1.45), preterm birth (AOR 1.75, 95% CI 1.29–2.36) and neonatal distress (adjusted OR 3.29, 95% CI 1.57–6.89) remained significantly higher after adjustments for maternal age, BMI and other potential confounding factors. Conclusions Women with intermediate hyperglycaemia in early pregnancy are at an increased risk for adverse maternal-foetal outcomes, even with normal future OGTTs.

Association between Thiopurines Use and Pregnancy Outcomes in Female Patients with Inflammatory Bowel Disease: A Meta-analysis

2020 ◽  
Vol 26 ◽  
Author(s):  
Yang Zhang ◽  
Dandan Li ◽  
Heng Guo ◽  
Weina Wang ◽  
Xingang Li ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Preterm Birth ◽  
Spontaneous Abortion ◽  
Bowel Disease ◽  
Pregnancy Outcomes ◽  
Congenital Malformations ◽  
Meta Analysis ◽  
Adverse Pregnancy Outcomes ◽  
Inflammatory Bowel ◽  
Adverse Pregnancy

Background: Conflicting data exist regarding the influence of thiopurines exposure on adverse pregnancy outcomes in female patients with inflammatory bowel disease (IBD). Objective: The aim of this study was to provide an up-to-date and comprehensive assessment of the safety of thiopurines in pregnant IBD women. Methods: All relevant articles reporting pregnancy outcomes in women with IBD received thiopurines during pregnancy were identified from the databases (PubMed, Embase, Cochrane Library, and ClinicalTrials.gov) with the publication data up to April 2020. Data of included studies were extracted to calculate the relative risk (RR) of multiple pregnancy outcomes: congenital malformations, low birth weight (LBW), preterm birth, small for gestational age (SGA), and spontaneous abortion. The meta-analysis was performed using the random-effects model. Results: Eight studies matched with the inclusion criteria and a total of 1201 pregnant IBD women who used thiopurines and 4189 controls comprised of women with IBD received drugs other than thiopurines during pregnancy were included. Statistical analysis results demonstrated that the risk of preterm birth was significantly increased in the thiopurine-exposed group when compared to IBD controls (RR, 1.34; 95% CI, 1.00-1.79; p=0.049; I 2 =41%), while no statistically significant difference was observed in the incidence of other adverse pregnancy outcomes. Conclusion: Thiopurines’ use in women with IBD during pregnancy is not associated with congenital malformations, LBW, SGA, or spontaneous abortion, but appears to have an association with an increased risk of preterm birth.

scholarly journals Interpregnancy Body Mass Index Changes: Distribution and Impact on Adverse Pregnancy Outcomes in the Subsequent Pregnancy

2018 ◽  
Vol 36 (05) ◽  
pp. 517-521 ◽  
Author(s):  
Whitney Bender ◽  
Adi Hirshberg ◽  
Lisa Levine
Keyword(s):  
Body Mass Index ◽  
Preterm Birth ◽  
Body Mass ◽  
Pregnancy Outcomes ◽  
Subsequent Pregnancy ◽  
Adverse Pregnancy Outcomes ◽  
Increased Risk ◽  
History Of ◽  
Index Changes ◽  
Adverse Pregnancy

Objective To examine the change in body mass index (BMI) categories between pregnancies and its effect on adverse pregnancy outcomes. Study Design We performed a retrospective cohort study of women with two consecutive deliveries from 2005 to 2010. Analysis was limited to women with BMI recorded at <24 weeks for both pregnancies. Standard BMI categories were used. Adverse pregnancy outcomes included preterm birth at <37 weeks, intrauterine growth restriction (IUGR), pregnancy-related hypertension, and gestational diabetes mellitus (GDM). Women with increased BMI category between pregnancies were compared with those who remained in the same BMI category. Results In total, 537 women were included, of whom 125 (23%) increased BMI category. There was no association between increase in BMI category and risk of preterm birth, IUGR, or pregnancy-related hypertension. Women who increased BMI category had an increased odds of GDM compared with women who remained in the same BMI category (6.4 vs. 2.2%; p = 0.018). The increased risk remained after controlling for age, history of GDM, and starting BMI (adjusted odds ratio: 8.2; 95% confidence interval: 2.1–32.7; p = 0.003). Conclusion Almost one-quarter of women increased BMI categories between pregnancies. This modifiable risk factor has a significant impact on the risk of GDM.

scholarly journals Association between neighbourhood deprivation, fetal growth, small-for-gestational age and preterm birth: a population-based prospective cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e049075
Author(s):  
Dionne V Gootjes ◽  
Anke G Posthumus ◽  
Vincent W V Jaddoe ◽  
Eric A P Steegers
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Preterm Birth ◽  
Fetal Growth ◽  
Gestational Age ◽  
Pregnancy Outcomes ◽  
First Trimester ◽  
Adverse Pregnancy Outcomes ◽  
Neighbourhood Deprivation ◽  
Adverse Pregnancy

ObjectiveTo study the associations between neighbourhood deprivation and fetal growth, including growth in the first trimester, and adverse pregnancy outcomes.DesignProspective cohort study.SettingThe Netherlands, Rotterdam.Participants8617 live singleton births from the Generation R cohort study.ExpositionLiving in a deprived neighbourhood.Main outcome measuresFetal growth trajectories of head circumference, weight and length.Secondary outcomes measuresSmall-for-gestational age (SGA) and preterm birth (PTB).ResultsNeighbourhood deprivation was not associated with first trimester growth. However, a higher neighbourhood status score (less deprivation) was associated with increased fetal growth in the second and third trimesters (eg, estimated fetal weight; adjusted regression coefficient 0.04, 95% CI 0.02 to 0.06). Less deprivation was also associated with decreased odds of SGA (adjusted OR 0.91, 95% CI 0.86 to 0.97, p=0.01) and PTB (adjusted OR 0.89, 95% CI 0.82 to 0.96, p=0.01).ConclusionsWe found an association between neighbourhood deprivation and fetal growth in the second and third trimester pregnancy, but not with first trimester growth. Less neighbourhood deprivation is associated with lower odds of adverse pregnancy outcomes. The associations remained after adjustment for individual-level risk factors. This supports the hypothesis that living in a deprived neighbourhood acts as an independent risk factor for fetal growth and adverse pregnancy outcomes, above and beyond individual risk factors.

scholarly journals Joint Modeling of Singleton Preterm Birth and Perinatal Death Using Birth Registry Cohort Data in Northern Tanzania

2021 ◽  
Vol 9 ◽  
Author(s):  
Innocent B. Mboya ◽  
Michael J. Mahande ◽  
Joseph Obure ◽  
Henry G. Mwambi
Keyword(s):  
Preterm Birth ◽  
Pregnancy Outcomes ◽  
Perinatal Death ◽  
Substantial Reduction ◽  
Adverse Pregnancy Outcomes ◽  
Birth Registry ◽  
Cohort Data ◽  
Northern Tanzania ◽  
Management Of Complications ◽  
Adverse Pregnancy

Understanding independent and joint predictors of adverse pregnancy outcomes is essential to inform interventions toward achieving sustainable development goals. We aimed to determine the joint predictors of preterm birth and perinatal death among singleton births in northern Tanzania based on cohort data from the Kilimanjaro Christian Medical Center (KCMC) zonal referral hospital birth registry between 2000 and 2017. We determined the joint predictors of preterm birth and perinatal death using the random-effects models to account for the correlation between these outcomes. The joint predictors of higher preterm birth and perinatal death risk were inadequate (&lt;4) antenatal care (ANC) visits, referred for delivery, experiencing pre-eclampsia/eclampsia, postpartum hemorrhage, low birth weight, abruption placenta, and breech presentation. Younger maternal age (15–24 years), premature rupture of membranes, placenta previa, and male children had higher odds of preterm birth but a lessened likelihood of perinatal death. These findings suggest ANC is a critical entry point for delivering the recommended interventions to pregnant women, especially those at high risk of experiencing adverse pregnancy outcomes. Improved management of complications during pregnancy and childbirth and the postnatal period may eventually lead to a substantial reduction of adverse perinatal outcomes and improving maternal and child health.

Risks of Selected Fetal Adverse Pregnancy Outcomes at Advance Maternal Age

2021 ◽  
Vol 15 (8) ◽  
pp. 2468-2471
Author(s):  
Saadia Yasmeen ◽  
Sumayya . ◽  
Javeria Saleem ◽  
Jawairiah Liaqat ◽  
Nadia Pervaiz ◽  
...  
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Pregnancy Outcomes ◽  
Maternal Age ◽  
Advanced Maternal Age ◽  
Adverse Pregnancy Outcomes ◽  
Control Group ◽  
Postpartum Women ◽  
Adverse Pregnancy

Background and Aim: Advanced maternal age pregnancy could be referred to as pregnancy after 35 years or older. The prevalence of postponing pregnancies is increasing day by day worldwide. However, limited evidence was found on advanced maternal age pregnancy association with fetal adverse outcomes. The present study aimed to evaluate the frequency of advanced maternal age selected fetal adverse pregnancy outcomes. Place and Duration: Obstetrics & Gynaecology department of Alkhidmat Hospital Kohat and Qazi Hussain Ahmad Medical Complex, Nowshera for duration of six months from November 2020 to April 2021. Materials and Methods: This single-centered retrospective study was conducted on 220 postpartum women in the study group (≥35 years) and 170 control group postpartum women (20-34 years) who delivered at Obstetrics & Gynaecology department of Alkhidmat Hospital Kohat and Qazi Hussain Ahmad Medical Complex, Nowshera after 28 gestational weeks. Individuals who met the inclusion criteria were enrolled and sampled based on randomized control sampling technique for both control and study groups. Data extraction checklist and pretested questionnaire were used for data collection from the maternal charts. Adverse pregnancy outcome and advanced maternal age was correlated adjusted relative risks and strength with a 95% confidence interval. SPSS version 20 was used for data analysis and considered p-value >0.05 as a statistical standard. Results: The adverse neonatal outcomes include low birth weight, preterm birth, and stillbirth with a prevalence 38 (17.4%), 46 (20.8%), and 31 (14.2%) respectively in the study group. In the control group, the incidence of low birth weight, preterm birth, and stillbirth was 21 (12.6%), 15 (14.6%) and 6 (3.5%) respectively. The stillbirth (ARR=3.16 95% CI (1.29–6.03) and preterm deliveries (ARR=2.71 95% CI (1.79–3.86) risk had significantly higher prevalence compared to control group advanced age pregnancy. Insignificance association was found between low birth weight and advanced maternal age. Conclusion: Stillbirth and preterm birth was the adverse fetal outcome significantly related with advanced maternal age pregnancy. There was no significant association between low birth weight and advanced maternal age. Keywords: Maternal age, Fetal Adverse Pregnancy Outcomes

scholarly journals Effectiveness of Prenatal Vitamin D Deficiency Screening and Treatment Program: A Stratified Randomized Field Trial

2018 ◽  
Vol 103 (8) ◽  
pp. 2936-2948 ◽  
Author(s):  
Maryam Rostami ◽  
Fahimeh Ramezani Tehrani ◽  
Masoumeh Simbar ◽  
Razieh Bidhendi Yarandi ◽  
Sonia Minooee ◽  
...  
Keyword(s):  
Vitamin D ◽  
Pregnant Women ◽  
Treatment Program ◽  
Pregnancy Outcomes ◽  
Pregnancy Complications ◽  
Screening Program ◽  
Adverse Pregnancy Outcomes ◽  
Adverse Outcomes ◽  
Adverse Pregnancy ◽  
Screening Site

Abstract Context Despite evidence on the association between hypovitaminosis D and adverse pregnancy outcomes and the positive impact of vitamin D supplementation, no evidence exists supporting a universal screening program in pregnancy as part of routine prenatal care. Objective We sought to determine the effectiveness of a prenatal screening program on optimizing 25-hydroxyvitamin D [25(OH)D] levels and preventing pregnancy complications. Also, to identify a safe regimen, we compared several regimens in a subgroup of vitamin D–deficient pregnant women. Design Two cities of Masjed-Soleyman and Shushtar from Khuzestan province, Iran, were selected as the screening and nonscreening arms, respectively. Within the screening arm, a randomized controlled trial was conducted on 800 pregnant women. Setting Health centers of Masjed-Soleyman and Shushtar cities. Patients or Participants Pregnant women aged 18 to 40 years. Intervention Women with moderate [25(OH)D, 10 to 20 ng/mL] and severe [25(OH)D, &lt;10 ng/mL] deficiency were randomly divided into four subgroups and received vitamin D3 (D3) until delivery. Main Outcome Measure Maternal concentration of 25(OH)D at delivery and rate of pregnancy complications Results After supplementation, only 2% of the women in the nonscreening site met the sufficiency level (&gt;20 ng/mL) vs 53% of the women in the screening site. Adverse pregnancy outcomes, including preeclampsia, gestational diabetes mellitus, and preterm delivery, were decreased by 60%, 50%, and 40%, respectively, in the screening site. A D3 injection in addition to monthly 50,000 IU maintenance therapy contributed the most to achievement of sufficient levels at delivery. Conclusions A prenatal vitamin D screening and treatment program is an effective approach in detecting deficient women, improving 25(OH)D levels, and decreasing pregnancy adverse outcomes.

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