Age-specific risk factors for adverse maternal and neonatal outcomes in Xiamen, China: A population-based retrospective study

2019 ◽  
Author(s):  
Yin-ling Chen ◽  
Li-li Han ◽  
Wei-juan Su ◽  
Fu-ping Lv ◽  
Zheng Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Retrospective Study ◽  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Maternal Age ◽  
Population Based ◽  
Adverse Pregnancy

Abstract Background: Elderly mothers are increasingly in China. We are aims to explore whether association between pregnancy to delivery interval and adverse pregnancy outcomes is affected by maternal age. Methods: A population-based retrospective study was performed in Xiamen, China. Data were derived from the Medical Birth Registry of Xiamen from 2011 to 2018. Multivariable logistic regression was used to conduct multivariable analyses based on adjusting the factors to evaluate the effect of maternal age on pregnancy outcomes. Results: Among 77,859 pregnant women with specific age, gestational diabetes mellitus (GDM) risk were increased for women aged 40 years or older (42.9%; aRR, 3.84 (3.26-4.51); P < 0.001), but not for pregnant women aged less than 25 years (9.2%; aRR, 0.60 (0.54-0.68)). Increased cesarean, preterm birth, large-for-gestational age (LGA), and low birth weight risks were more pronounced for pregnant women aged 40 years or older (66.5%, 8.4%, 26.5%, and 6.7%, respectively; aRR, 3.77 (3.14-4.52), 1.26 (0.90-1.79), 1.31 (1.08-1.60), and 1.10 (0.74-1.65), respectively; all P < 0.001). Risk of Apgar < 7 at 5 minutes were increased for women < 25 years old compared with women 35 to 39 years old (0.2% vs. 0.1%; aRR, 2.05 (0.85-4.93) vs. 0.63 (0.14-2.86)). Conclusion: Advanced maternal age increased risk of adverse pregnancy outcomes. The risk ratio of GDM, cesarean, preterm birth, LGA, and low birth weight is higher, which suggests pregnant women should guard against related risk factors and choose an appropriate mode of production. Furthermore, pregnant women should choose an ideal age for pregnancy to make themselves and child healthy.

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 Risk of Selected Fetal Adverse Pregnancy Outcomes at Advanced Maternal Age: A Retrospective Cohort Study in Debre Markos Referral Hospital, Northwest Ethiopia

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Bikila Tefera Debelo ◽  
Melaku Hunie Asratie ◽  
Abayneh Aklilu Solomon
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Pregnancy Outcomes ◽  
Maternal Age ◽  
Advanced Maternal Age ◽  
Referral Hospital ◽  
Age Group ◽  
Debre Markos ◽  
Adverse Pregnancy

Introduction. Pregnancy at an advanced maternal age is defined as pregnancy at 35 years or older. Today, women postpone pregnancy due to different socioeconomic and personal reasons. However, there was limited evidence on fetal adverse outcomes’ association with pregnancy at an advanced maternal age in Ethiopia and particularly in the study area. This study was aimed at assessing the effect of pregnancy at an advanced age on selected neonatal adverse pregnancy outcomes in Debre Markos Referral Hospital, Ethiopia, 2019. Methods. Institution-based retrospective cohort study was conducted on 303 exposed (35 years and older) and 604 nonexposed (20–34 years old) immediate postpartum women who delivered at Debre Markos Referral Hospital after 28 weeks of gestation. All exposed women who fulfilled the inclusion criteria were sampled, and systematic random sampling was employed for those in the nonexposed group. The data were collected from 1st of July to 30th of December, 2019, by face-to-face interview and extraction from maternal chart using a structured questionnaire and data extraction checklist, respectively. Binary logistic regression (bivariate and multivariable) model was fitted, and wealth index was analyzed by principal component analysis. Adjusted relative risk with respect to 95% confidence interval was employed for the strength and directions of association between advanced maternal age and selected adverse pregnancy outcomes, respectively. P -value of <0.05 was used to declare statistical significance. Results. The incidence of adverse neonatal outcomes including stillbirth, preterm birth, and low birth weight in the advanced maternal age group was 13.2%, 19.8%, and 16.5%, respectively. The incidence of stillbirth, preterm birth, and low birth weight in the nonexposed group was 3.1%, 8.4%, and 12.4%, respectively. The advanced maternal age group had three times the risk of stillbirth compared with the nonexposed group (ARR = 3.14 95% CI (1.30–7.00)). The advanced maternal age group had 2.66 times the risk of delivering preterm fetus (ARR = 2.66 95% CI (1.81–3.77)) compared with the younger counterparts. Low birth weight was not significantly associated with pregnancy at an advanced maternal age. Conclusion. Fetal adverse outcomes including stillbirth and preterm birth were significantly associated with pregnancy at an advanced maternal age.

scholarly journals A várandós nő parodontalis egészségi állapota és a terhességi komplikációk közötti kapcsolat

2018 ◽  
Vol 159 (25) ◽  
pp. 999-1007
Author(s):  
István Gera
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Periodontal Disease ◽  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Clinical Studies ◽  
Adverse Pregnancy Outcomes ◽  
Periodontal Therapy ◽  
Adverse Pregnancy

Abstract: Data from epidemiological and clinical studies published in the past two decades indicate certain association between periodontal disease and increased risk for preterm birth or low birth weight. Although the strength of those observed associations is weak, periodontitis today is considered as one of the potentially modifiable risk factors for adverse pregnancy outcomes. The aims of the publication are to summarize the epidemiological and clinical evidence for the impact of periodontal disease on adverse pregnancy outcomes and to make an attempt to overview the potential biological mechanism behind this association. The majority of epidemiological and clinical studies found certain negative effect of poor maternal periodontal condition on the incidence of low birth weight, preterm birth, pre-eclampsy, restricted foetal growth or even stillbirth. Two possible biological pathways have so far been identified: 1) the direct dissemination of the periodontal pathogens or their toxic by-products which reach the foetal-placental unit, and 2) an indirect mechanism when the circulating systemic inflammatory mediators induced by the periodontal inflammation can provoke secondary inflammation and foetal damage in the amnion. The periodontal therapy applied during the second or third trimesters has not been proven to reduce the incidence of any adverse pregnancy outcomes in pregnant women. A much more prophylaxis-oriented approach in periodontal treatment is needed. The adequate periodontal therapy should be completed before the conception to provide benefit to the pregnant women and also the new born baby. Orv Hetil. 2018; 159(25): 999–1007.

scholarly journals Pregnancy Outcomes among Women with Graves’ Hyperthyroidism: A Retrospective Cohort Study

2021 ◽  
Vol 10 (19) ◽  
pp. 4495
Author(s):  
Panwad Harn-a-morn ◽  
Prapai Dejkhamron ◽  
Theera Tongsong ◽  
Suchaya Luewan
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Adverse Outcomes ◽  
Low Risk ◽  
Obstetric Outcomes ◽  
Increased Risk ◽  
Adverse Pregnancy

Objective: The primary objectives of this study are to compare the rates of preterm birth; fetal growth restriction and low birth weight between the following groups: (1) pregnant women treated for thyrotoxicosis and low-risk pregnancies; (2) between pregnant women with thyrotoxicosis with no need of medication and low-risk pregnancies; and (3) between those treated with MMI and PTU. Methods: The medical records of singleton pregnancies with thyrotoxicosis were comprehensively reviewed. Low-risk pregnancies matched for age and parity were randomly recruited as controls. The obstetric outcomes were compared between both groups; the outcomes of various subgroups of the thyrotoxicosis group were also compared. Results: A total of 408 pregnant women with thyrotoxicosis were recruited. Compared with the controls; the women of the thyrotoxicosis group had significantly higher rates of low birth weight (LBW) (23.7% vs. 17.7%; p: 0.036), preterm birth (19.3% vs. 12.3%; p: 0.007), preeclampsia (8.5% vs. 4.4%; p: 0.019) and cesarean section (21.5% vs. 16.0%; p: 0.046). In the thyrotoxicosis group; 67; 127; and 158 patients were treated with MMI; PTU and no anti-thyroid drug (ATD), respectively. All obstetric outcomes were comparable between the women treated with PTU and those with MMI; and between the controlled and uncontrolled groups. However, women who needed ATD had significantly higher rates of LBW and preterm birth than those without medications. Conclusions: Thyrotoxicosis, whether treated or not needing ATDs, was significantly associated with an increased risk of adverse pregnancy outcomes. Also, active disease, indicated by the need for ATD significantly increased the risk of such adverse outcomes; whereas the patients treated with MMI or PTU had comparable adverse outcomes.

Advanced Maternal Age and Adverse Maternal and Neonatal Outcomes in Pregnant Women

2020 ◽  
Vol 16 ◽  
Author(s):  
Reza Omani-Samani ◽  
Saman Maroufizadeh ◽  
Nafise Saedi ◽  
Nasim Shokouhi ◽  
Arezoo Esmailzadeh ◽  
...  
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Cesarean Section ◽  
Pregnant Women ◽  
Maternal Age ◽  
Unwanted Pregnancy ◽  
Advanced Maternal Age ◽  
Neonatal Outcomes ◽  
Maternal And Neonatal Outcomes

Background: Advanced maternal age is an important predictor for maternal and neonatal outcomes such as maternal mortality, low birth weight, stillbirth, preterm birth, cesarean section and preeclampsia. Objective: To determine the association of advanced maternal age and adverse maternal and neonatal outcomes in Iranian pregnant women. Methods: In this hospital-based cross-sectional study, 5117 pregnant women from 103 hospitals in Tehran, Iran, were participated in the study in 2015. The required data were gathered from hospitals which equipped to the department of obstetrics and gynecology. Advanced maternal age was considered as an independent variable and unwanted pregnancy, preeclampsia, preterm birth, cesarean section and low birth weight were considered as interested outcomes. Results: In our study, the prevalence of advanced maternal age was 12.08%. Advanced maternal age was significantly associated with higher risk of unwanted pregnancy (OR: 1.39, 95% CI: 1.12-1.73), preterm birth (OR: 1.75, 95% CI: 1.28- 2.39) and cesarean section (OR: 1.34, 95% CI: 1.03-1.74). In our study, there was no significant relationship between advanced maternal age and preeclampsia but this relationship could be clinically important (OR: 1.48, 95% CI: 0.99-2.20, P=0.052), and there is no significant relationship between advanced maternal age and low birth weight (OR: 1.08, 95% CI: 0.67-1.74, P=0.736). Conclusion: Advanced maternal age is associated with higher risk of unintended pregnancy, preterm birth and cesarean section but our findings did not support advanced maternal age as a risk factor associated with low birth weight.

scholarly journals Adverse pregnancy outcomes in women with diabetes-related microvascular disease and risks of disease progression in pregnancy: A systematic review and meta-analysis

PLoS Medicine ◽  
2021 ◽  
Vol 18 (11) ◽  
pp. e1003856
Author(s):  
Sophie Relph ◽  
Trusha Patel ◽  
Louisa Delaney ◽  
Soha Sobhy ◽  
Shakila Thangaratinam
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Preterm Birth ◽  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Meta Analysis ◽  
Microvascular Disease ◽  
Adverse Pregnancy ◽  
In Pregnancy

Background The rise in the global prevalence of diabetes, particularly among younger people, has led to an increase in the number of pregnant women with preexisting diabetes, many of whom have diabetes-related microvascular complications. We aimed to estimate the magnitude of the risks of adverse pregnancy outcomes or disease progression in this population. Methods and findings We undertook a systematic review and meta-analysis on maternal and perinatal complications in women with type 1 or 2 diabetic microvascular disease and the risk factors for worsening of microvascular disease in pregnancy using a prospective protocol (PROSPERO CRD42017076647). We searched major databases (January 1990 to July 2021) for relevant cohort studies. Study quality was assessed using the Newcastle–Ottawa Scale. We summarized the findings as odds ratios (ORs) with 95% confidence intervals (CIs) using random effects meta-analysis. We included 56 cohort studies involving 12,819 pregnant women with diabetes; 40 from Europe and 9 from North America. Pregnant women with diabetic nephropathy were at greater risk of preeclampsia (OR 10.76, CI 6.43 to 17.99, p < 0.001), early (<34 weeks) (OR 6.90, 95% CI 3.38 to 14.06, p < 0.001) and any preterm birth (OR 4.48, CI 3.40 to 5.92, p < 0.001), and cesarean section (OR 3.04, CI 1.24 to 7.47, p = 0.015); their babies were at increased risk of perinatal death (OR 2.26, CI 1.07 to 4.75, p = 0.032), congenital abnormality (OR 2.71, CI 1.58 to 4.66, p < 0.001), small for gestational age (OR 16.89, CI 7.07 to 40.37, p < 0.001), and admission to neonatal unit (OR 2.59, CI 1.72 to 3.90, p < 0.001) than those without nephropathy. Diabetic retinopathy was associated with any preterm birth (OR 1.67, CI 1.27 to 2.20, p < 0.001) and preeclampsia (OR 2.20, CI 1.57 to 3.10, p < 0.001) but not other complications. The risks of onset or worsening of retinopathy were increased in women who were nulliparous (OR 1.75, 95% CI 1.28 to 2.40, p < 0.001), smokers (OR 2.31, 95% CI 1.25 to 4.27, p = 0.008), with existing proliferative disease (OR 2.12, 95% CI 1.11 to 4.04, p = 0.022), and longer duration of diabetes (weighted mean difference: 4.51 years, 95% CI 2.26 to 6.76, p < 0.001) than those without the risk factors. The main limitations of this analysis are the heterogeneity of definition of retinopathy and nephropathy and the inclusion of women both with type 1 and type 2 diabetes. Conclusions In pregnant women with diabetes, presence of nephropathy and/or retinopathy appear to further increase the risks of maternal complications.

scholarly journals Maternal urinary levels of trichloroacetic acid and association with adverse pregnancy outcomes

2019 ◽  
Vol 17 (6) ◽  
pp. 884-895 ◽  
Author(s):  
Funanani Mashau ◽  
Esper Jacobeth Ncube ◽  
Kuku Voyi
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Premature Birth ◽  
Trichloroacetic Acid ◽  
Adverse Pregnancy Outcomes ◽  
Potential Health ◽  
Increased Risk ◽  
Adverse Pregnancy

Abstract The current study aimed to determine the association between trichloroacetic acid (TCAA) levels and adverse pregnancy outcomes among third-trimester pregnant women who were exposed to chlorinated drinking water. A total of 205 pregnant women who participated in the disinfection by-products exposure and adverse pregnancy outcome study in South Africa were randomly asked to participate in this study by providing their morning urine sample voids. Samples were analysed for urinary creatinine and TCAA. Furthermore, participants gave individual data using a structured questionnaire. The mean (median) concentration of creatinine-adjusted urinary TCAA was 2.34 (1.95) μg/g creatinine. Elevated levels of creatinine-adjusted TCAA concentrations showed an increased risk of premature birth, small for gestational age (SGA) and low birth weight. There was no significant statistical correlation observed between creatinine-adjusted TCAA concentrations and the total volume of cold water ingested among the study population. No statistically significant association was observed between creatinine-adjusted urinary TCAA and premature birth, SGA and low birth weight newborns among the study subjects. However, the urinary TCAA concentrations identified in this study suggest potential health risks towards women and foetus. Therefore, further studies are warranted to prevent further adverse pregnancy outcomes.

scholarly journals Maternal age and adverse pregnancy outcomes: a population-based register study in Wuhan, China, 2011-2016

2020 ◽  
Author(s):  
Jiangxia Cao ◽  
Bingzheng Zhang ◽  
Yan Liu ◽  
Ting Yu ◽  
Yiming Zhang ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Cesarean Delivery ◽  
Gestational Age ◽  
Pregnancy Outcomes ◽  
Apgar Score ◽  
Maternal Age ◽  
Population Based ◽  
Adverse Pregnancy Outcomes ◽  
Health Management Information System ◽  
Adverse Pregnancy

Abstract Background A trend towards increasing maternal age has been witnessed in China. Evidence from high-income countries has shown that older women have higher risks of various adverse pregnancy outcomes. However, few large, contemporary, population-based studies have adjusted for potential confounders in examining the association between maternal age and adverse pregnancy outcomes in China. Methods Data from the Wuhan Maternal and Child Health Management Information System including all women aged ≥20 years with live singleton pregnancies in 2011-2016 were analyzed. A range of adverse pregnancy outcomes including pregnancy induced hypertension disorder(PIH), gestational diabetes mellitus(GDM), cesarean delivery, postpartum hemorrhage, preterm birth, small-for-gestational age (SGA), large-for-gestational age (LGA), and 5-min Apgar score<7 among women aged 20-24, 30-35 and ≥40 years were compared with women aged 25-29 years using binary logistic regression models, with social-demographic characteristics, pre-pregnancy BMI, parity, and fetal gender adjusted. Subgroup analyses by stratifying on parity were also performed. Results 415,632 women were included during the study period. Among them, 91536(22.0%) were aged 20-24 years, 203687(49.0%) were aged 25-29 years, 89883(21.6%) were aged 30-34 years, 26271(6.3%) were aged 35-39 years, and 4255 (1.0%) were aged ≥40 years. After adjusting for the potential confounders, older maternal age (≥30 years) was associated with higher risks of PIH, GDM, cesarean delivery, preterm birth, LGA, and 5-min Apgar score<7, but not with SGA. Relative to older multiparous women, older nulliparous women were more likely to experience cesarean delivery, preterm birth, and 5-min Apgar score<7. Conclusion Older maternal age is independently associated with various adverse pregnancy outcomes. The risks may occur earlier than the commonly used definition of advanced maternal age, and may also differ by parity. Ensuring age and parity specific clinical counseling, antenatal surveillance, and health interventions may be of great significance to improve older mother’s pregnancy outcomes.

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