Adverse perinatal outcomes of chlamydia infections: an ongoing challenge

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Yael Eliner ◽  
Moti Gulersen ◽  
Amos Grunebaum ◽  
Erez Lenchner ◽  
Liron Bar-El ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Neonatal Intensive Care ◽  
Low Birthweight ◽  
Perinatal Outcomes ◽  
The United States ◽  
Chlamydia Infection ◽  
Suspected Sepsis ◽  
Bonferroni Adjustment ◽  
Neonatal Ventilation ◽  
Adverse Perinatal Outcomes

Abstract Objectives Chlamydia trachomatis is one of the most common sexually transmitted diseases in the world, but there are limited data on its impact on perinatal outcomes. Our objective was to investigate the association between chlamydia infections and adverse perinatal outcomes. Methods This is a retrospective analysis of the United States Centers for Disease Control and Prevention natality live birth database for the years 2016–2019. The rates of adverse perinatal outcomes were compared between patients with a chlamydia infection during pregnancy and patients without such infection, using Pearson’s chi-square test with the Bonferroni adjustment. A multivariate logistic regression was then used to adjust outcomes for potential confounders. Results Chlamydia infections were associated with small, but statistically significant, increased odds of preterm birth (<37 weeks), early preterm birth (<32 weeks), low birthweight (<2,500 g), congenital anomalies, low 5-min Apgar score (<7), neonatal intensive care unit admission, immediate neonatal ventilation, prolonged (>6 h) neonatal ventilation, and neonatal antibiotic treatment for suspected sepsis. Conclusions Chlamydia infections during pregnancy are associated with adverse perinatal outcomes. These results call for increased education regarding the potential risks of pregnancies with a chlamydia infection, as well as for increased antenatal surveillance and post-natal pediatric assessment in these pregnancies.

scholarly journals Comparison of adverse perinatal outcomes between Asians and Caucasians: a population-based retrospective cohort study in Ontario

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Na Zeng ◽  
Erica Erwin ◽  
Wendy Wen ◽  
Daniel J. Corsi ◽  
Shi Wu Wen ◽  
...  
Keyword(s):  
Cohort Study ◽  
Birth Weight ◽  
Preterm Birth ◽  
Cesarean Section ◽  
Gestational Age ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Perinatal Outcomes ◽  
Population Based ◽  
Adverse Perinatal Outcomes

Abstract Background Racial disparities in adverse perinatal outcomes have been studied in other countries, but little has been done for the Canadian population. In this study, we sought to examine the disparities in adverse perinatal outcomes between Asians and Caucasians in Ontario, Canada. Methods We conducted a population-based retrospective cohort study that included all Asian and Caucasian women who attended a prenatal screening and resulted in a singleton birth in an Ontario hospital (April 1st, 2015-March 31st, 2017). Generalized estimating equation models were used to estimate the independent adjusted relative risks and adjusted risk difference of adverse perinatal outcomes for Asians compared with Caucasians. Results Among 237,293 eligible women, 31% were Asian and 69% were Caucasian. Asians were at an increased risk of gestational diabetes mellitus, placental previa, early preterm birth (< 32 weeks), preterm birth, emergency cesarean section, 3rd and 4th degree perineal tears, low birth weight (< 2500 g, < 1500 g), small-for-gestational-age (<10th percentile, <3rd percentile), neonatal intensive care unit admission, and hyperbilirubinemia requiring treatment, but had lower risks of preeclampsia, macrosomia (birth weight > 4000 g), large-for-gestational-age neonates, 5-min Apgar score < 7, and arterial cord pH ≤7.1, as compared with Caucasians. No difference in risk of elective cesarean section was observed between Asians and Caucasians. Conclusion There are significant differences in several adverse perinatal outcomes between Asians and Caucasians. These differences should be taken into consideration for clinical practices due to the large Asian population in Canada.

scholarly journals Effect of antibiotics on inflammatory marker (IL-6) and perinatal outcomes in women with preterm premature rupture of membranes

2018 ◽  
Vol 7 (10) ◽  
pp. 4068
Author(s):  
Ashima Arora ◽  
Ratna Biswas ◽  
Bhawna Dubey ◽  
Binita Goswami ◽  
Sonal Saxena
Keyword(s):  
Neonatal Sepsis ◽  
Neonatal Intensive Care ◽  
Inflammatory Marker ◽  
Perinatal Outcomes ◽  
Admission Rate ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Preterm Premature Rupture ◽  
Adverse Perinatal Outcomes ◽  
High Level

Background: The aim is to study the effect of antibiotics on inflammatory marker (IL-6) and perinatal outcomes in women with preterm premature rupture of membranes (PPROM).Methods: 60 women with PPROM at 28–34 weeks of gestation were enrolled in the study. All the women were given antibiotics as per hospital protocol and were subjected to blood sampling for Interleukin -6(IL-6) at admission, delivery and umbilical cord blood. IL-6 levels were assessed for associations with adverse perinatal outcomes and the effect of antibiotic treatment on IL-6 and perinatal outcomes were studied. The data were analyzed using t test and χ2 test.Results: Increased level of IL-6 was associated with chorioamnionitis and neonatal sepsis (p<0.001). High level of IL-6 led to early delivery and complete course of antibiotics suppressed IL-6 (p<0.001) and clinical chorioamnionitis in women with PROM. Full course of antibiotics also decreased the admission rate of babies to neonatal intensive care unit and suppressed respiratory distress syndrome, neonatal sepsis.Conclusions: Increased level of IL-6 is seen in women with chorioamnionitis and neonatal sepsis. Antibiotics suppress the IL-6 levels, chorioamnionitis and neonatal sepsis.

Parental age difference and adverse perinatal outcomes in the United States

2002 ◽  
Vol 16 (4) ◽  
pp. 320-327 ◽  
Author(s):  
Wendy L. Kinzler ◽  
Cande V. Ananth ◽  
John C. Smulian ◽  
Anthony M. Vintzileos
Keyword(s):  
United States ◽  
Perinatal Outcomes ◽  
The United States ◽  
Age Difference ◽  
Parental Age ◽  
Adverse Perinatal Outcomes

scholarly journals Exploring Innovations in Human Milk Analysis in the Neonatal Intensive Care Unit: A Survey of the United States

2021 ◽  
Vol 8 ◽  
Author(s):  
Stacey R. Ramey ◽  
Stephanie Merlino Barr ◽  
Katie A. Moore ◽  
Sharon Groh-Wargo
Keyword(s):  
United States ◽  
Intensive Care ◽  
Human Milk ◽  
Clinical Setting ◽  
Neonatal Intensive Care ◽  
Low Birthweight ◽  
The United States ◽  
Future Research ◽  
Milk Analysis ◽  
The Us

Introduction: Human milk (HM) is the ideal enteral feeding for nearly all infants and offers unique benefits to the very low birthweight (VLBW) infant population. It is a challenge to meet the high nutrient requirements of VLBW infants due to the known variability of HM composition. Human milk analysis (HMA) assesses the composition of HM and allows for individualized fortification. Due to recent U.S. Food and Drug Administration (FDA) approval, it has relatively recent availability for clinical use in the US.Aim: To identify current practices of HMA and individualized fortification in neonatal intensive care units (NICUs) across the United States (US) and to inform future translational research efforts implementing this nutrition management method.Methods: An institutional review board (IRB) approved survey was created and collected data on the following subjects such as NICU demographics, feeding practices, HM usage, HM fortification practices, and HMA practices. It was distributed from 10/30–12/21/2020 via online pediatric nutrition groups and listservs selected to reach the intended audience of NICU dietitians and other clinical staff. Each response was assessed prior to inclusion, and descriptive analysis was performed.Results: About 225 survey responses were recorded during the survey period with 119 entries included in the analysis. This represented 36 states and Washington D.C., primarily from level III and IV NICUs. HMA was reported in 11.8% of responding NICUs. The most commonly owned technology for HMA is the Creamatocrit Plus TM (EKF Diagnostics), followed by the HM Analyzer by Miris (Uppsala, Sweden). In NICUs practicing HMA, 84.6% are doing so clinically.Discussion: Feeding guidelines and fortification of HM remain standard of care, and interest in HMA was common in this survey. Despite the interest, very few NICUs are performing HMA and individualized fortification. Barriers identified include determining who should receive individualized fortification and how often, collecting a representative sample, and the cost and personnel required.Conclusions: Human milk analysis and individualized fortification are emerging practices within NICUs in the US. Few are using it in the clinical setting with large variation in execution among respondents and many logistical concerns regarding implementation. Future research may be beneficial to evaluate how practices change as HMA and individualized fortification gain popularity and become more commonly used in the clinical setting.

scholarly journals Benefits of not smoking during pregnancy for Australian Aboriginal and Torres Strait Islander women and their babies: a retrospective cohort study using linked data

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e032763 ◽  
Author(s):  
Carol McInerney ◽  
Ibinabo Ibiebele ◽  
Jane B Ford ◽  
Deborah Randall ◽  
Jonathan M Morris ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Lower Risk ◽  
Perinatal Death ◽  
Perinatal Outcomes ◽  
Smoking During Pregnancy ◽  
Relative Risks ◽  
South Wales ◽  
Adverse Perinatal Outcomes

ObjectivesTo provide evidence for targeted smoking cessation policy, the aim of this study was to compare pregnancy outcomes of Aboriginal mothers who reported not smoking during pregnancy with Aboriginal mothers who reported smoking during pregnancy.DesignPopulation based retrospective cohort study using linked data.SettingNew South Wales, the most populous Australian state.Population18 154 singleton babies born to 13 477 Aboriginal mothers between 2010 and 2014 were identified from routinely collected New South Wales datasets. Aboriginality was determined from birth records and from four linked datasets through an Enhanced Reporting of Aboriginality algorithm.ExposureNot smoking at any time during pregnancy.Main outcome measuresUnadjusted and adjusted relative risks (aRR) and 95% CIs from modified Poisson regression were used to examine associations between not smoking during pregnancy and maternal and perinatal outcomes including severe morbidity, inter-hospital transfer, perinatal death, preterm birth and small-for-gestational age. Population attributable fractions (PAFs) were calculated using adjusted relative risks.ResultsCompared with babies born to mothers who smoked during pregnancy, babies born to non-smoking mothers had a lower risk of all adverse perinatal outcomes including perinatal death (aRR=0.58, 95% CI 0.44 to 0.76), preterm birth (aRR=0.58, 95% CI 0.53 to 0.64) and small-for-gestational age (aRR=0.35, 95% CI 0.32 to 0.39). PAFs (%) were 27% for perinatal death, 26% for preterm birth and 48% for small-for-gestational-age. Compared with women who smoked during pregnancy (n=8919), those who did not smoke (n=9235) had a lower risk of being transferred to another hospital (aRR=0.76, 95% CI 0.66 to 0.89).ConclusionsBabies born to women who did not smoke during pregnancy had a lower risk of adverse perinatal outcomes. Rates of adverse outcomes among Aboriginal non-smokers were similar to those among the general population. These results quantify the proportion of adverse perinatal outcomes due to smoking and highlight why effective smoking cessation programme are urgently required for this population.

Adverse Perinatal Outcomes Among Interracial Couples in the United States

2005 ◽  
Vol 106 (1) ◽  
pp. 81-88 ◽  
Author(s):  
Darios Getahun ◽  
Cande V. Ananth ◽  
Nandini Selvam ◽  
Kitaw Demissie
Keyword(s):  
United States ◽  
Perinatal Outcomes ◽  
The United States ◽  
Interracial Couples ◽  
Adverse Perinatal Outcomes

scholarly journals 631Benefits of not smoking during pregnancy for Aboriginal women and their babies

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Siranda Torvaldsen ◽  
Ibinabo Ibiebele ◽  
Jane Ford ◽  
Deborah Randall ◽  
Jonathan Morris ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Lower Risk ◽  
Perinatal Death ◽  
Perinatal Outcomes ◽  
Smoking During Pregnancy ◽  
Relative Risks ◽  
Aboriginal Women ◽  
Adverse Perinatal Outcomes

Abstract Background To provide evidence for targeted smoking cessation policy, the aim of this study was to compare pregnancy outcomes of Aboriginal mothers who reported not smoking during pregnancy with those who reported smoking. Methods This population-based retrospective cohort study used linked data from routinely collected datasets. Not smoking during pregnancy was the exposure of interest among all New South Wales Aboriginal women who became mothers of singleton babies in 2010–2014. Unadjusted and adjusted relative risks (aRR) and 95%CIs from modified Poisson regression were used to examine associations between not smoking during pregnancy and maternal and perinatal outcomes including severe morbidity, inter-hospital transfer, perinatal death, preterm birth and small-for-gestational age. Population attributable fractions (PAFs) were calculated using adjusted relative risks. Results Compared with babies born to mothers who smoked during pregnancy, babies born to non-smoking mothers had a lower risk of all adverse perinatal outcomes including perinatal death (aRR=0.58, 95%CI 0.44–0.76), preterm birth (aRR=0.58, 95%CI 0.53–0.64) and small-for-gestational age (aRR=0.35, 95%CI 0.32–0.39). PAFs(%) were 27% for perinatal death, 26% for preterm birth and 48% for small-for-gestational-age. Compared with women who smoked during pregnancy (n = 8,919), those who did not smoke (n = 9,235) had a lower risk of being transferred to another hospital (aRR=0.76, 95%CI 0.66–0.89). Conclusions Babies born to women who did not smoke had much lower risks of all adverse perinatal outcomes. Key messages Between a quarter and a half of adverse perinatal outcomes in this population could potentially be prevented by an effective smoking cessation program.

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