scholarly journals Effect of advanced maternal age on pregnancy outcome - A retrospective cohort study

2021 ◽  
Vol 8 (3) ◽  
pp. 377-382
Keyword(s):  
Cohort Study ◽  
Gestational Diabetes ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Maternal Age ◽  
Gestational Hypertension ◽  
Preterm Labour ◽  
Advanced Maternal Age ◽  
Maternal Complications ◽  
Fetal Outcomes

To determine the risks of pregnancy and to study the adverse maternal and fetal outcomes of pregnancy in advanced maternal age.This study was a retrospective cohort study. Which was conducted in the Department of Obstetrics and Gynaecology, Government Medical College, Kozhikode. Data were collected from Department Medical Records Library. Data consisted of study group with maternal age above 35 years and control group with age less than 35 years. Cases beyond 28 weeks of gestation, both primiparous and multiparous patients were included. Minimum 262 patients were included in each group. Gestational age, presentation, mode of delivery, indications for caesarean, maternal complications and fetal outcomes were analysed. Statistical analysis was done by SPSS16.0 statistical software. In this study statistically significant difference in maternal complications like incidence of gestational diabetes, gestational hypertension and preterm labour were observed in advanced maternal age women.Increasing incidence of maternal complications both obstetric and medical were observed in the advanced age mothers (AMA). There was a significant increase in preterm labour, increased caesarean delivery, PROM, PPROM, gestational hypertension, gestational diabetes, VLBW babies, intrauterine death in these elderly mothers. Due to the increase and advances of infertility treatments has made it common for mothers to become pregnant even at late forties.

Obstetric outcomes of pregnancy complicated by urolithiasis: a retrospective cohort study

2021 ◽  
Vol 49 (1) ◽  
pp. 54-59
Author(s):  
Emily K. Clennon ◽  
Bharti Garg ◽  
Brian D. Duty ◽  
Aaron B. Caughey
Keyword(s):  
Cohort Study ◽  
Gestational Diabetes ◽  
Preterm Delivery ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Gestational Hypertension ◽  
Neonatal Abstinence Syndrome ◽  
Obstetric Outcomes ◽  
Abstinence Syndrome ◽  
Increased Risk

AbstractObjectivesEvaluate the association between urolithiasis during pregnancy and obstetric outcomes outside the context of urological intervention.MethodsWe conducted a retrospective cohort study of singleton, non-anomalous gestations delivered at 23–42 weeks in California from 2007 to 2011. Maternal outcomes (preterm delivery [early (<32 weeks) and late (<37 weeks)], preeclampsia, gestational diabetes, cesarean deliveries, urinary tract infection [UTI] at delivery, chorioamnionitis, endomyometritis, and maternal sepsis) and newborn outcomes (seizure, respiratory distress syndrome, hypoglycemia, jaundice, and neonatal abstinence syndrome [NAS]) were compared using χ2-tests and multivariable logistic regression.ResultsA total of 2,013,767 pregnancies met inclusion criteria, of which 5,734 (0.28%) were complicated by urolithiasis. Stone disease during pregnancy was associated with 30% greater odds of each early (aOR 1.30; 95% CI 1.19–1.43) and late (aOR 1.29; 95% CI 1.18–1.41) preterm delivery. Cesarean delivery, UTI at delivery, gestational hypertension, gestational diabetes, preeclampsia, and sepsis were all significantly positively associated with urolithiasis. Odds of NAS (aOR 2.11; 95% CI 1.27–3.51) and jaundice were significantly greater in the neonates of stone-forming patients (aOR 1.08; 95% CI 1.01–1.16).ConclusionsUrolithiasis during pregnancy was associated with 30% greater odds of preterm delivery and increased risk of myriad metabolic, hypertensive, and infectious disorders of gestation. Neonates born to stone-forming patients were more than twice as likely to develop neonatal abstinence syndrome but did not have significantly greater odds of complications of prematurity.

scholarly journals Safe threshold of capillary blood glucose for predicting early future neonatal hypoglycaemia in babies born to mothers with gestational diabetes mellitus, an observational, retrospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Esther H. G. Park ◽  
Frances O’Brien ◽  
Fiona Seabrook ◽  
Jane Elizabeth Hirst
Keyword(s):  
Diabetes Mellitus ◽  
Cohort Study ◽  
Blood Glucose ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Capillary Blood ◽  
Capillary Blood Glucose ◽  
Neonatal Hypoglycaemia

Abstract Background There is increasing pressure to get women and babies home rapidly after birth. Babies born to mothers with gestational diabetes mellitus (GDM) currently get 24-h inpatient monitoring. We investigated whether a low-risk group of babies born to mothers with GDM could be defined for shorter inpatient hypoglycaemia monitoring. Methods Observational, retrospective cohort study conducted in a tertiary maternity hospital in 2018. Singleton, term babies born to women with GDM and no other risk factors for hypoglycaemia, were included. Capillary blood glucose (BG) testing and clinical observations for signs of hypoglycaemia during the first 24-h after birth. BG was checked in all babies before the second feed. Subsequent testing occurred if the first result was < 2.0 mmol/L, or clinical suspicion developed for hypoglycaemia. Neonatal hypoglycaemia, defined as either capillary or venous glucose ≤ 2.0 mmol/L and/or clinical signs of neonatal hypoglycaemia requiring oral or intravenous dextrose (lethargy, abnormal feeding behaviour or seizures). Results Fifteen of 106 babies developed hypoglycaemia within the first 24-h. Maternal and neonatal characteristics were not predictive. All babies with hypoglycaemia had an initial capillary BG ≤ 2.6 mmol/L (Area under the ROC curve (AUC) 0.96, 95% Confidence Interval (CI) 0.91–1.0). This result was validated on a further 65 babies, of whom 10 developed hypoglycaemia, in the first 24-h of life. Conclusion Using the 2.6 mmol/L threshold, extended monitoring as an inpatient could have been avoided for 60% of babies in this study. Whilst prospective validation is needed, this approach could help tailor postnatal care plans for babies born to mothers with GDM.

scholarly journals “INTERGROWTH21st vs customized fetal growth curves in the assessment of the neonatal nutritional status: a retrospective cohort study of gestational diabetes”

2019 ◽  
Author(s):  
Juan Jesus Fernández Alba ◽  
Estefania Soto Pazos ◽  
Rocio Moreno Cortes ◽  
Angel Vilar Sanchez ◽  
Carmen Gonzalez Macias ◽  
...  
Keyword(s):  
Cohort Study ◽  
Gestational Diabetes ◽  
Nutritional Status ◽  
Positive Predictive Value ◽  
Pregnant Women ◽  
Fetal Growth ◽  
Retrospective Cohort Study ◽  
Predictive Value ◽  
Retrospective Cohort ◽  
Growth Curves

Abstract Background Gestational diabetes mellitus is associated with increased incidence of adverse perinatal outcomes including newborns large for gestational age, macrosomia, preeclampsia, polihydramnios, stillbirth, and neonatal morbidity. Thus, fetal growth should be monitored by ultrasound to limit fetal overnutrition, and thereby, its clinical consequence, macrosomia. However, it is not clear which reference curve to use to define the limits of normality. Our aim is to determine which method, INTERGROWTH21st or customized curves, better identifies the nutritional status of newborns of diabetic mothers.Methods This retrospective cohort study compared the risk of malnutrition in SGA newborns and the risk of overnutrition in LGA newborns using INTERGROWTH21st and customized birth weight references in gestational diabetes. Additionally, to determine the ability of both methods in the identification of neonatal malnutrition and overnutrition, we calculate sensitivity, specificity, positive predictive value, negative predictive value and likelihood ratios.Results 231 pregnant women with GDM were included in the study. The rate of SGA indentified by INTERGROWTH21st was 4.7% vs 10.7% identified by the customized curves. The rate of LGA identified by INTERGROWT21st was 25.6% vs 13.2% identified by the customized method. Newborns identified as SGA by the customized method showed a higher risk of malnutrition than those identified as SGA by INTERGROWTH21st.(RR 4.24 vs 2.5). LGA newborns according to the customized method also showed a higher risk of overnutrition than those classified as LGA according to INTERGROWTH21st. (RR 5.26 vs 3.57). In addition, the positive predictive value of the customized method was superior to that of INTERGROWTH21st in the identification of malnutrition (32% vs 27.27%), severe malnutrition (22.73% vs 20%), overnutrition (51.61% vs 32.20%) and severe overnutrition (28.57% vs 14.89%).Conclusions In pregnant women with GDM, the ability of customized fetal growth curves to identify the newborns with alterations in nutritional status exceeds that of INTERGROWTH21st.

scholarly journals Impact of Blood Urea Nitrogen and Creatinine Levels on Maternal and Fetal Outcomes of Pregnancy: a Retrospective Cohort Study

2021 ◽  
Author(s):  
Guifang Deng ◽  
Lanlan Wu ◽  
Yao Liu ◽  
Zengyou Liu ◽  
Hengying Chen ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Cohort Study ◽  
Blood Urea Nitrogen ◽  
Retrospective Cohort Study ◽  
Pregnancy Outcomes ◽  
Retrospective Cohort ◽  
Fetal Outcomes ◽  
Urea Nitrogen ◽  
The Third ◽  
Fourth Quartile

Abstract Background: Blood urea nitrogen (BUN) and creatinine (SCr) are associated with gestational diabetes mellitus (GDM). However, there were limited data in the literature on the influence of BUN and SCr on maternal and fetal outcomes of pregnancy. We aimed to examine the association of BUN and SCr levels during gestation with the risk of selected adverse pregnancy outcomes.Methods: This retrospective cohort study included 1606 singleton mothers aged 22-44 years. Both BUN and SCr levels were collected and measured during the second (16-18th week), third (28-30th week) trimesters of gestation respectively and followed up pregnancy outcomes. Statistical analysis was used multivariate logistic regression. Results: In the multivariate adjusted logistic regression model, the highest level of SCr in the second trimester increased the risk of PROM by 45% (95% CI, 1.01-2.09). In the third trimester of gestation, compared with those in the lowest quartile, BUN levels in the highest quartile decreased the risk of macrosomia and LGA by 60%(95% CI, 0.20-0.78), 66%(95% CI, 0.21,0.55) , respectively, and increased the risk of SGA by 137%(1.06, 5.31), 186%(1.29,6.34) in the third and fourth quartiles, respectively. The adjusted OR (95%CI) for macrosomia in the fourth quartile was 0.46 (0.24, 0.87), for SGA in the third quartiles was 2.36 (1.10, 5.10), and for LGA in the fourth quartile was 0.61 (0.41,0.91) compared with those in the first quartile of SCr levels. The elevated changes of BUN (> 0.64mmol/L) was the risk factor of SGA (OR: 2.11, 95%CI: 1.03,4.32).Conclusion: Higher BUN and SCr levels during the 28-30th week of gestation even those towards the upper limit of the normal range can act as a warning sign of the impending SGA. Elevated changes of BUN and SCr during pregnancy also associated with the lower birth weight.

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