Previous mode of delivery affects subsequent pregnancy outcomes: a Chinese birth register study

AbstractIn this case control study, long-term gynecological, reproductive and sexual outcomes after uterine artery embolization (UAE) for postpartum hemorrhage (PPH) were evaluated. The study was performed in a single referral hospital for PPH in Lausanne from 2003 to 2013. Each woman whose delivery was complicated by PPH and treated by UAE was included, and compared to a control group of women whose delivery was uncomplicated. Cases were matched by maternal age, parity, ethnicity, year and mode of delivery, birth weight and gestational age in a 1–3 ratio. A total of 77 patients treated by UAE for PPH were identified in our obstetrical database. Among them, 63 were included and compared to 189 matched patients (no PPH). The mean interval time between UAE and this study was 8.1 years. Time to menstrual cycle recovery after delivery (3.9 vs 5.6 months, p = 0.66), spotting (7.9% vs 7.2%, p = 0.49), dysmenorrhea (25.4% vs 22.2%, p = 0.60) and amenorrhea (14.3% vs 12.2%, p = 0.66) were similar between the two groups. There was no difference in the FSFI score between the groups (23.2 ± 0.6 vs 23.8 ± 0.4; p = 0.41). However, the interval time to subsequent pregnancy was longer for patients after UAE than the control group (35 vs 18 months, p = 0.002). In case of pregnancy desire, the success rate was lower after UAE compared to controls (55% vs 93.5%, p < 0.001). The rate of PPH was higher in those with previous PPH (6.6% vs 36.4%, p = 0.010). Patients treated by UAE for PPH did not report higher rates of gynecological symptoms or sexual dysfunction compared to patients with uneventful deliveries. The inter-pregnancy interval was increased and the success rate was reduced. In subsequent pregnancies, a higher rate of PPH was observed in those that underwent UAE.

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Gestational diabetes mellitus: Beliefs, emotions and treatment compliance: A Pakistani Cohort.

The Professional Medical Journal ◽

10.29309/tpmj/2021.28.03.5629 ◽

2021 ◽

Vol 28 (03) ◽

pp. 361-365

Author(s):

Maryam Zulfiqar ◽

Muhammad Imran Hasan Khan ◽

Salman Shakeel ◽

Usama Azhar

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Mode Of Delivery ◽

Treatment Compliance ◽

Subsequent Pregnancy ◽

Medical Institute ◽

Lifestyle Modifications ◽

Diabetes Clinic ◽

Adverse Pregnancy

To find out the factors regarding patient’s beliefs and concerns about Gestational Diabetes and its treatment. Study Design: Purposive Sampling. Setting: Diabetes Clinic & Antenatal Clinic of Lahore General Hospital/ Post Graduate Medical Institute/ Ameer ud Din Medical College, Lahore. Period: July 2019 to December 2019. Material & Methods: 46 females who were 24-38 weeks pregnant and having gestational diabetes mellitus, type1 diabetes mellitus or having type 2 diabetes mellitus first diagnosed during pregnancy were enrolled. Data was collected by an interview based questionnaire, analyzed using SPSS version 23, and 95% confidence interval was used as test of significance. Results: The mean age was 27±9 years. 20% of the participants were Illiterate 80% were literate. GDM in the all three trimesters was 45.6%, 39% and15% respectively. 30.5% were hypertensive and 100% adopted lifestyle modifications, 89% were using insulin and 10.8% were taking metformin. 33% had history of instruments delivery and 36% had adverse pregnancy or perinatal outcomes. Regarding patients belief’s, 10% believed in diet control, 26% were not comfortable with lab and physician’s counselling, 38% were in state of denial, 26% were unaware of screening, 70% were frightened of unexpected diagnosis and consequences. 18% were concerned of target organs damage, 16% were concerned of mode of delivery, 25% regarding subsequent pregnancy, 53% were concerned about insulin treatment and its duration and 33% were keen to know about adverse pregnancy outcomes. Conclusions: Educational status is not known to influence gestational diabetes mellitus, Major concern of patient with GDM was her health and surroundings, treatment options, adverse effect on baby and subsequent pregnancies outcomes.

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

American Journal of Perinatology ◽

10.1055/s-0038-1670634 ◽

2018 ◽

Vol 36 (05) ◽

pp. 517-521 ◽

Cited By ~ 3

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.

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Factors affecting embryo transfer and subsequent pregnancy outcomes in in vitro fertilization.

Fertility and Sterility ◽

10.1016/s0015-0282(01)02654-1 ◽

2001 ◽

Vol 76 (3) ◽

pp. S219

Author(s):

M.J Heard ◽

R.B Lathi ◽

J.E Buster ◽

P Cisneros ◽

P Casson ◽

...

Keyword(s):

In Vitro Fertilization ◽

Embryo Transfer ◽

Pregnancy Outcomes ◽

Subsequent Pregnancy ◽

Vitro Fertilization ◽

Factors Affecting

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Changes in pregnancy outcomes during the COVID-19 lockdown in Iran

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-04050-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Fahimeh Ranjbar ◽

Leila Allahqoli ◽

Soheila Ahmadi ◽

Robab Mousavi ◽

Maryam Gharacheh ◽

...

Keyword(s):

Health Care ◽

Birth Weight ◽

Low Birth Weight ◽

Pregnant Women ◽

Pregnancy Outcomes ◽

Health Care Services ◽

Mode Of Delivery ◽

Preterm Births ◽

Future Health ◽

Significant Difference

Abstract Background The Covid-19 pandemic response is influencing maternal and neonatal health care services especially in developing countries. However, the indirect effects of Covid-19 on pregnancy outcomes remain unknown. The aim of the present study was to compare pregnancy outcomes before and after the beginning of the Covid-19 pandemic in Iran. Methods We performed a retrospective analysis of the medical records of 2,503 pregnant women with singleton pregnancies, admitted to the maternity department of a women’s hospital in Tehran, Iran, during the pre-Covid-19 pandemic (February 19 to April 19, 2019) and the intra-Covid- 19 pandemic (February 19 to April 19, 2020) period. Results We included 2,503 women admitted to the hospital; 1,287 (51.4 %) were admitted before the Covid-19 lockdown and 1,216 (48.6 %) during the Covid-19 lockdown. There were no significant differences in stillbirth rates (p = 0.584) or pregnancy complications (including preeclampsia, pregnancy-induced hypertension and gestational diabetes) (p = 0.115) between pregnant women in the pre- and intra-pandemic periods. However, decreases in preterm births (p = 0.001), and low birth weight (p = 0.005) were observed in the pandemic period compared to the pre-pandemic period. No significant difference in the mode of delivery, and no maternal deaths were observed during the two time periods. Conclusions In our study we observed a decrease in preterm births and low birth weight, no change in stillbirths, and a rise in the admission rates of mothers to the ICU during the initial Covid-19 lockdown period compared to pre-Covid-19 lockdown period. Further research will be needed to devise plan for immediate post-pandemic care and future health care crises.

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