scholarly journals The adverse maternal and perinatal outcomes of adolescent pregnancy: a cross sectional study in Hebei, China

2020 ◽  
Author(s):  
Ting Zhang ◽  
Huien Wang ◽  
Xinling Wang ◽  
Yue Yang ◽  
Yingkui Zhang ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Pregnant Women ◽  
Adolescent Pregnancy ◽  
Pregnancy Outcomes ◽  
Neonatal Death ◽  
Perinatal Outcomes ◽  
Hebei Province ◽  
Adolescent Group ◽  
Adolescent Women ◽  
Adverse Pregnancy

Abstract Background The adverse pregnancy outcomes caused by teenage pregnancy are major public health problems with significant social impact, especially in developing countries. While China is the most populous country in the world, and 8.5% of the women aged 10-50 years are adolescent women, we aimed to analyze the adverse maternal and perinatal outcomes of the adolescent pregnant women in Hebei Province, China.Methods There were 238,598 singleton pregnant women aged 10-34 years from January 1, 2013 to December 31, 2017 in the database of Hebei Province Maternal Near Miss Surveillance System (HBMNMSS). The 238,598 pregnant women were divided into two groups: adolescent group (aged 10-19 years) and adult group (aged 20-34 years), the adolescent group was divided into two subgroups (aged 10-17 years, aged 18-19 years). The information that was collected included sociodemographic characteristics, obstetric history, place and mode of delivery, pregnancy outcome, complications during pregnancy. We compared the risk of adverse pregnancy outcomes between the two groups and two subgroups using univariate and multivariate Logistic regression. Results Compared with women aged 20-34 years, women aged 10-19 years had lower risk of cesarean delivery [adjusted risk ratio (aRR): 0.75, 95% confidence interval (CI): 0.70-0.80], gestational diabetes mellitus (GDM) (aRR: 0.55, 95% CI: 0.41-0.73). The women aged 10-19 years had higher risk of preterm birth (aRR: 1.76, 95% CI: 1.54-2.01), small for gestational age (SGA) (aRR: 1.19, 95% CI: 1.08-1.30), stillbirth (aRR: 2.58, 95% CI: 1.83-3.62), neonatal death (aRR: 2.63, 95% CI: 1.60-4.32). The adolescent women aged 10-17 years had significantly higher risk of stillbirth (aRR: 4.83, 95% CI: 2.86-8.14) and neonatal death (aRR: 6.35, 95% CI: 3.16-12.77) compared with the women aged 20-34 years, but there was no association with the risk of incidence of GDM (aRR: 1.03, 95% CI: 0.63-1.68) and SGA (aRR: 1.11, 95% CI: 0.89-1.39). Conclusions The adolescent pregnancy was related to adverse perinatal (fetal and neonatal) outcomes, such as preterm birth, stillbirth and neonatal death, especially in younger adolescent pregnancies (aged 10-17 years).

scholarly journals The adverse maternal and perinatal outcomes of adolescent pregnancy: a cross sectional study in Hebei, China

2020 ◽  
Author(s):  
Ting Zhang ◽  
Huien Wang ◽  
Xinling Wang ◽  
Yue Yang ◽  
Yingkui Zhang ◽  
...  
Keyword(s):  
Adolescent Pregnancy ◽  
Preterm Delivery ◽  
Pregnancy Outcomes ◽  
Neonatal Death ◽  
Perinatal Outcomes ◽  
Hebei Province ◽  
Adult Group ◽  
Adolescent Group ◽  
Adolescent Women ◽  
Adverse Pregnancy

Abstract Background The adverse pregnancy outcomes caused by teenage pregnancy are major public health problems with significant social impact. While China is the most populous country in the world, and 8.5% of the women aged 10-50 years are adolescent women, we aimed to analyze the adverse maternal and perinatal outcomes of the adolescent pregnancy in Hebei Province, China. Methods There were 238,598 singleton pregnant women aged 10-34 years from January 1, 2013 to December 31, 2017 in the database of Hebei Province Maternal Near Miss Surveillance System (HBMNMSS). The 238,598 pregnant women were divided into two groups: adolescent group ( aged 10-19 years) and adult group (aged 20-34 years). The adolescent group was divided into two subgroups (aged 10-17 years, aged 18-19 years), the adult group was divided into two subgroups (aged 20-24 years, aged 25-34 years). We compared the risk of adverse pregnancy outcomes using univariate and multivariate logistic regression. We also made a stratified analysis of nulliparous and multiparous adolescent pregnancy. Results Compared with women aged 20-34 years, women aged 10-19 years had lower risk of cesarean delivery [adjusted risk ratio (aRR): 0.75, 95% confidence interval (CI): 0.70-0.80], gestational diabetes mellitus (GDM) (aRR: 0.55, 95%CI: 0.41-0.73). Women aged 10-19 years had higher risk of preterm delivery (aRR: 1.76, 95%CI: 1.54-2.01), small for gestational age (SGA) (aRR: 1.19, 95%CI: 1.08-1.30), stillbirth (aRR: 2.58, 95%CI: 1.83-3.62), neonatal death (aRR: 2.63, 95%CI: 1.60-4.32). The adolescent women aged 10-17 years had significantly higher risk of stillbirth (aRR: 5.69, 95%CI: 3.36-9.65) and neonatal death (aRR: 7.57, 95%CI: 3.74-15.33) compared with the women aged 25-34 years. Younger adults (20-24 years) also had higher risks of preterm delivery (aRR: 1.26, 95%CI: 1.20-1.32), stillbirth (aRR: 1.45, 95%CI: 1.23-1.72), and neonatal death (aRR: 1.51, 95%CI: 1.21-1.90) compared with women aged 25-34 years. The structural equation model showed that preterm delivery and cesarean delivery had an indirect effect on neonatal death in adolescent pregnancy. Conclusions The adolescent pregnancy was related to adverse perinatal (fetal and neonatal) outcomes, such as preterm delivery, stillbirth and neonatal death, especially in younger adolescent pregnancies.

scholarly journals The adverse maternal and perinatal outcomes of adolescent pregnancy: a cross sectional study in Hebei, China

2020 ◽  
Author(s):  
Ting Zhang ◽  
Huien Wang ◽  
Xinling Wang ◽  
Yue Yang ◽  
Yingkui Zhang ◽  
...  
Keyword(s):  
Adolescent Pregnancy ◽  
Preterm Delivery ◽  
Pregnancy Outcomes ◽  
Neonatal Death ◽  
Perinatal Outcomes ◽  
Hebei Province ◽  
Adult Group ◽  
Adolescent Group ◽  
Adolescent Women ◽  
Adverse Pregnancy

Abstract Background: The adverse pregnancy outcomes caused by teenage pregnancy are major public health problems with significant social impact. While China is the most populous country in the world, and 8.5% of the women aged 10-50 years are adolescent women, we aimed to analyze the adverse maternal and perinatal outcomes of the adolescent pregnancy in Hebei Province, China.Methods: There were 238,598 singleton pregnant women aged 10-34 years from January 1, 2013 to December 31, 2017 in the database of Hebei Province Maternal Near Miss Surveillance System (HBMNMSS). The 238,598 pregnant women were divided into two groups: adolescent group (aged 10-19 years) and adult group (aged 20-34 years). The adolescent group was divided into two subgroups (aged 10-17 years, aged 18-19 years), the adult group was divided into two subgroups (aged 20-24 years, aged 25-34 years). We compared the risk of adverse pregnancy outcomes using univariate and multivariate logistic regression. We also made a stratified analysis of nulliparous and multiparous adolescent pregnancy. Results: Compared with women aged 20-34 years, women aged 10-19 years had lower risk of cesarean delivery [adjusted risk ratio (aRR): 0.75, 95% confidence interval (CI): 0.70-0.80], gestational diabetes mellitus (GDM) (aRR: 0.55, 95%CI: 0.41-0.73). Women aged 10-19 years had higher risk of preterm delivery (aRR: 1.76, 95%CI: 1.54-2.01), small for gestational age (SGA) (aRR: 1.19, 95%CI: 1.08-1.30), stillbirth (aRR: 2.58, 95%CI: 1.83-3.62), neonatal death (aRR: 2.63, 95%CI: 1.60-4.32). The adolescent women aged 10-17 years had significantly higher risk of stillbirth (aRR: 5.69, 95%CI: 3.36-9.65) and neonatal death (aRR: 7.57, 95%CI: 3.74-15.33) compared with the women aged 25-34 years. Younger adults (20-24 years) also had higher risks of preterm delivery (aRR: 1.26, 95%CI: 1.20-1.32), stillbirth (aRR: 1.45, 95%CI: 1.23-1.72), and neonatal death (aRR: 1.51, 95%CI: 1.21-1.90) compared with women aged 25-34 years. The structural equation model showed that preterm delivery and cesarean delivery had an indirect effect on neonatal death in adolescent pregnancy.Conclusions: The adolescent pregnancy was related to adverse perinatal (fetal and neonatal) outcomes, such as preterm delivery, stillbirth and neonatal death, especially in younger adolescent pregnancies.

scholarly journals Maternal Pre-Pregnancy Obesity Combined With Abnormal Glucose Metabolism Further Increases Adverse Pregnancy Outcomes in Chinese Pregnant Women

2022 ◽  
Vol 12 ◽  
Author(s):  
Mei-Fang Li ◽  
Jiang-Feng Ke ◽  
Li Ma ◽  
Jun-Wei Wang ◽  
Zhi-Hui Zhang ◽  
...  
Keyword(s):  
Glucose Metabolism ◽  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Perinatal Outcomes ◽  
Adverse Pregnancy Outcomes ◽  
Control Group ◽  
Abnormal Glucose Metabolism ◽  
Induced Hypertension ◽  
Adverse Perinatal Outcomes ◽  
Adverse Pregnancy

AimsOur aim was to evaluate the separate and combined effects of maternal pre-pregnancy obesity and gestational abnormal glucose metabolism (GAGM) on adverse perinatal outcomes.MethodsA total of 2,796 Chinese pregnant women with singleton delivery were studied, including 257 women with pre-pregnancy obesity alone, 604 with GAGM alone, 190 with both two conditions, and 1,745 with neither pre-pregnancy obesity nor GAGM as control group. The prevalence and risks of adverse pregnancy outcomes were compared among the four groups.ResultsCompared with the normal group, pregnant women with maternal pre-pregnancy obesity alone, GAGM alone, and both two conditions faced significantly increased risks of pregnancy-induced hypertension (PIH) (odds ratio (OR) 4.045, [95% confidence interval (CI) 2.286–7.156]; 1.993 [1.171–3.393]; 8.495 [4.982–14.485]), preeclampsia (2.649 [1.224–5.735]; 2.129 [1.128–4.017]; 4.643 [2.217–9.727]), cesarean delivery (1.589 [1.212–2.083]; 1.328 [1.095–1.611]; 2.627 [1.908–3.617]), preterm delivery (1.899 [1.205–2.993]; 1.358 [0.937–1.968]; 2.301 [1.423–3.720]), macrosomia (2.449 [1.517–3.954]; 1.966 [1.356–2.851]; 4.576 [2.895–7.233]), and total adverse maternal outcomes (1.762 [1.331–2.332]; 1.365 [1.122–1.659]; 3.228 [2.272–4.587]) and neonatal outcomes (1.951 [1.361–2.798]; 1.547 [1.170–2.046]; 3.557 [2.471–5.122]). Most importantly, there were no obvious risk differences in adverse pregnancy outcomes between maternal pre-pregnancy obesity and GAGM group except PIH, but pregnant women with both obesity and GAGM exhibited dramatically higher risks of adverse pregnancy outcomes than those with each condition alone.ConclusionsMaternal pre-pregnancy obesity and GAGM were independently associated with increased risks of adverse pregnancy outcomes. The combination of pre-pregnancy obesity and GAGM further worsens adverse pregnancy outcomes compared with each condition alone.

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.

Mobile phone application use in pregnant women: does it make a difference? Usage and perinatal outcomes in China (Preprint)

2021 ◽  
Author(s):  
Puhong Zhang ◽  
Huan Chen ◽  
Jie Shang ◽  
Jun Ge ◽  
Huichen Zhang ◽  
...  
Keyword(s):  
Child Health ◽  
Pregnant Women ◽  
Maternal And Child Health ◽  
Pregnancy Outcomes ◽  
Adverse Pregnancy Outcome ◽  
Perinatal Outcomes ◽  
Northern China ◽  
Mobile Phone Application ◽  
Adverse Pregnancy ◽  
And Child Health

BACKGROUND Maternal and child health (MCH) related mobile applications (apps) are becoming increasingly popular amongst pregnant women, however, few have demonstrated they lead to improvements in pregnancy outcomes. OBJECTIVE This study aimed to investigate the use of MCH apps amongst pregnant women and explore associations with pregnancy outcomes in China. METHODS A retrospective study was conducted in six maternal and child health hospitals in Northern China. Women who delivered a singleton baby greater than 28 weeks gestation in the study hospitals were sequentially recruited from postnatal wards during October 2017 to January 2018. Information was collected on self-reported MCH app use during their pregnancy, with clinical outcomes. Women were categorized as non-users of MCH apps, and users (further divided into intermittent users and continuous users). The primary outcome was a composite adverse pregnancy outcome (CAPO) comprising preterm birth, birth weight <2500 grams, birth defects, stillbirth and neonatal asphyxia. The association between app use and CAPO was explored using multivariable logistic analysis. RESULTS The 1850 participants reported using 127 different MCH apps during pregnancy. App use frequency was reported as never, 457 (24.7%); intermittent 876 (47.4%); and continuous 517 (27.9%). Amongst app users, the most common reasons for app use were for health education (100.0%), self-monitoring (54.2%) and antenatal appointment reminders (43.2%). Non-users were older, with fewer years of education, lower incomes, and higher parity (P<0.01). No association was found between “any app” use and the CAPO (6.8% in non-users compared to 6.3% in any users, OR 0.77, 95% CI: 0.48-1.25). CONCLUSIONS Women in China access a large number of different MCH apps, with social disparities in access and frequency of use. “Any app” use was not found associated with improved pregnancy outcomes, highlighting the needs for rigorous development and testing of apps before recommendation for use in clinical settings.

Pregnancy outcomes in women with significant valve disease: a systematic review and meta-analysis

Heart ◽  
2020 ◽  
Vol 106 (7) ◽  
pp. 512-519 ◽  
Author(s):  
Robin Alexandra Ducas ◽  
David A Javier ◽  
Rohan D’Souza ◽  
Candice K Silversides ◽  
Wendy Tsang
Keyword(s):  
Systematic Review ◽  
Heart Disease ◽  
Preterm Birth ◽  
Pregnant Women ◽  
Pulmonary Oedema ◽  
Pregnancy Outcomes ◽  
Neonatal Death ◽  
Meta Analysis ◽  
Mortality Rates ◽  
Fetal Outcomes

ObjectiveTo perform a systematic review and meta-analysis of maternal/fetal outcomes in pregnant women with moderate/severe native valvular heart disease (VHD) from medium/higher Human Development Index (HDI) countries.MethodsOvidSP platform databases were searched (1985-January 2019) to identify studies reporting pregnancy outcomes in women with moderate/severe VHD. The primary maternal outcome was maternal mortality. The primary fetal/neonatal outcome was stillbirth and neonatal death. Pooled incidences and 95% confidence intervals (CI) of maternal/fetal outcomes could only be calculated from studies involving mitral stenosis (MS) or aortic stenosis (AS).ResultsTwelve studies on 646 pregnancies were included. Pregnant women with severe MS had mortality rates of 3% (95% CI, 0% to 6%), pulmonary oedema 37% (23%–51%) and new/recurrent arrhythmias 16% (1%–25%). Their stillbirth, neonatal death and preterm birth rates were 4% (1%–7%), 2% (0%–4%), and 18% (7%–29%), respectively. Women with moderate MS had mortality rates of 1%(0%–2%), pulmonary oedema 18% (2%–33%), new/recurrent arrhythmias 5% (1%–9%), stillbirth 2% (1%–4%) and preterm birth 10%(2%–17%).Pregnant women with severe AS had a risk of mortality of 2% (0%–5%), pulmonary oedema 9% (2%–15%), and new/recurrent arrhythmias 4% (0%–7%). Their stillbirth, neonatal death and preterm birth rates were 2% (0%–5%), 3% (0%–6%) and 14%(4%–24%), respectively. No maternal/neonatal deaths were reported in moderate AS, however women experienced pulmonary oedema (8%; 0%–20%), new/recurrent arrhythmias (2%; 0%–5%), and preterm birth (13%; 6%–20%).ConclusionsWomen with moderate/severe MS and AS are at risk for adverse maternal and fetal/neonatal outcomes. They should receive preconception counseling and pregnancy care by teams with pregnancy and heart disease experience.

scholarly journals Does Aerobic Vaginitis Have Adverse Pregnancy Outcomes? Prospective Observational Study

2020 ◽  
Vol 2020 ◽  
pp. 1-6 ◽  
Author(s):  
Mahmoud F. Hassan ◽  
Nancy M. A. Rund ◽  
Osama El-Tohamy ◽  
Mahmoud Moussa ◽  
Yahia Z. Ali ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Prospective Observational Study ◽  
Late Pregnancy ◽  
Neonatal Outcomes ◽  
Aerobic Vaginitis ◽  
Neonatal Icu ◽  
Maternal And Neonatal Outcomes ◽  
Adverse Pregnancy

Background. Aerobic vaginitis (AV) is an aberration within the balanced vaginal microbiota. Only few reports have documented the adverse pregnancy outcomes related to AV. Nonetheless, the exact role of AV in pregnancy and the potential benefit of its screening need further study. Our goal was to evaluate the association between aerobic vaginitis (AV) in late pregnancy and maternal and neonatal outcomes. Methods. In this prospective observational study, a total of 600 singleton pregnant women with intact fetal membranes at a gestational age of 34-36 weeks were recruited (one hundred women with AV and 500 pregnant women without AV). The study protocol excluded patients with other forms of vaginal infection. Pregnancy outcomes were traced and documented. The primary outcome was the association between AV and preterm labor. The current study compared the maternal and neonatal outcomes among pregnant women with and without AV in unadjusted and adjusted analyses with the odds ratio (OR) and 95% confidence interval (CI) reported. Results. There was an association between AV and with preterm birth (adjusted OR 3.06, 95% CI 1.58-5.95) and prelabor rupture of membranes (adjusted OR 6.17, 95% CI 3.24-11.7). For neonatal outcomes, AV was associated with a higher incidence of neonatal ICU admission (adjusted OR 2.19, 95% CI 1.1-4.34). Severe forms of AV significantly increased the incidence of PTB (p=0.0014) and PROM (p=0.0094) when compared to less severe forms of AV. Conclusion. AV is common in late pregnancy and is linked to a diversity of adversative pregnancy outcomes including preterm birth, PROM, and neonatal ICU admission. Moreover, the incidence of PTB and PROM might further increase with the severity of AV. Clinicians should pay more consideration to vaginal microbiota assessment during pregnancy.

scholarly journals Prediction and management model of preterm birth

2019 ◽  
Vol 74 (4) ◽  
pp. 221-228 ◽  
Author(s):  
Yuriy A. Semenov ◽  
Valentina F. Dolgushina ◽  
Marina G. Moskvicheva ◽  
Vasiliy S. Chulkov
Keyword(s):  
Preterm Birth ◽  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Predictive Value ◽  
Diagnostic Value ◽  
Adverse Pregnancy Outcomes ◽  
History Of ◽  
Group 2 ◽  
Adverse Pregnancy ◽  
Group 1

Background: It seems relevant to study the contribution of socio-demographic, somatic and obstetric-gynecological factors in the implementation of preterm birth. Aims: Assessment of the prognostic significance of socio-demographic, obstetric-gynecological and somatic factors in the prediction of preterm birth and associated adverse pregnancy outcomes with subsequent validation of the prognostic model. Materials and methods: Cohort study with a mixed cohort. A retrospective assessment of socio-demographic factors, harmful habits, obstetric and gynecological pathology, somatic diseases, course and outcomes of pregnancy was carried out with the assessment of the status of newborns in 1246 women with subsequent construction of a predictive model of preterm birth and adverse outcomes of pregnancy using Regression with Optimal Scaling and its prospective validation in 100 women. Results: The most significant predictors, that increase the chance of preterm birth and adverse pregnancy outcomes, were history of premature birth, irregular monitoring during pregnancy, history of pelvic inflammatory disease, smoking, obesity, the onset of sexual activity up to 16 years, cardiovascular and endocrine diseases. Intellectual job reduced the chance of preterm birth and adverse pregnancy outcomes This multivariate predictive model has a diagnostic value. The score of risk factors 25 points had a sensitivity of 73%, a specificity of 71%, the area under the ROC curve (AUC) 0.76 (good quality), p0.001. After stratification of high-risk groups by maternal and perinatal pathology the following list of diagnostic and therapeutic measures is introduced and actively implemented in antenatal clinics. To stratificate this model, we prospectively analyze the course and pregnancy outcomes of 100 women divided into 2 groups: group 1 ― 50 women with preterm delivery, group 2 ― 50 women with term delivery. A total score of 25 and above had 44% of women in group 1 and only 10% of women in group 2 (sensitivity 81.4%, specificity 61.6%, positive predictive value 44%, negative predictive value 90%, positive likelihood ratio 2.2 [1.53.0], negative likelihood ratio 0.3 [0.130.68]). Conclusions: We have proposed a model for predicting preterm birth and delivery and perinatal losses using the available characteristics of pregnant women from early pregnancy with moderate indicators of diagnostic value. Further validation of the model in the general population of pregnant women is required.

scholarly journals Pregnancy outcomes among women with thyrotoxicosis a retrospective cohort study

2021 ◽  
Author(s):  
Panwad Harn-a-morn ◽  
Prapai Dejkhamron ◽  
Theera Tongsong ◽  
Suchaya Luewan
Keyword(s):  
Preterm Birth ◽  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Adverse Outcomes ◽  
Low Risk ◽  
Obstetric Outcomes ◽  
Study Group ◽  
Increased Risk ◽  
Adverse Pregnancy ◽  
Singleton Pregnancies

Abstract Objective: To compare adverse outcomes between: 1) pregnant women with thyrotoxicosis and low risk pregnancies, 2) pregnant women with thyrotoxicosis requiring no anti-thyroid drug (ATD) and low risk pregnancies, and 3) those treated with methimazole (MMI) and propylthiouracil (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, and the outcomes of various subgroups of the study group were also compared.Results: A total of 408 pregnant women with thyrotoxicosis were recruited. Compared with the controls, the women of the study 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 study group (thyrotoxicosis), 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.

scholarly journals Gestational Weight Gain During the Second and Third Trimesters and Adverse Pregnancy Outcomes, Results From a Prospective Pregnancy Cohort in Urban Tanzania

2021 ◽  
Author(s):  
Jiaxi Yang ◽  
Molin Wang ◽  
Deirdre K. Tobias ◽  
Janet W. Rich-Edwards ◽  
Anne Marie Darling ◽  
...  
Keyword(s):  
Weight Gain ◽  
Preterm Birth ◽  
Pregnant Women ◽  
Gestational Weight Gain ◽  
Early Pregnancy ◽  
Gestational Age ◽  
Pregnancy Outcomes ◽  
Gestational Weight ◽  
Pregnancy Cohort ◽  
Adverse Pregnancy

Abstract Background Appropriate gestational weight gain (GWG) is important for optimal pregnancy outcomes. This study prospectively evaluated the associations between GWG during the second and third trimesters of pregnancy and adverse pregnancy outcomes in an urban Tanzanian pregnancy cohort. Methods We used data from a randomized clinical trial conducted among pregnant women recruited by 27 weeks of gestation in Dar es Salaam, Tanzania (N = 1,230). Women’s gestational weight was measured at baseline and at monthly antenatal visits. Weekly GWG rate during the second and third trimesters was calculated and characterized as inadequate, adequate, or excessive, in conjunction with measured or imputed early-pregnancy BMI status according to the 2009 Institute of Medicine (IOM) GWG guidelines. We used multivariable Poisson regression with a sandwich variance estimator to calculate risk ratios (RR) for associations of GWG with low birth weight, preterm birth, small for gestational age (SGA), and large for gestational age (LGA). Degree of appropriate GWG defined using additional metrics (i.e., percentage of adequacy, z-score) and potential effect modification by maternal BMI were additionally evaluated. Results According to the IOM guidelines, 517 (42.0%), 270 (22.0%), and 443 (36.0%) women were characterized as having inadequate, adequate, and excessive GWG, respectively. Overall, compared to women with adequate GWG, women with inadequate GWG had a lower risk of LGA births (RR=0.54, 95% CI: 0.36 - 0.80) and a higher risk of SGA births (RR=1.32, 95% CI: 0.95 - 1.81). ­­Women with inadequate GWG as defined by percentage of GWG adequacy had a higher risk of LBW (OR=1.93, 95% CI: 1.03 - 3.63). In stratified analyses by early-pregnancy BMI, excessive GWG among women with normal BMI was associated with a higher risk of preterm birth (RR=1.59, 95% CI: 1.03 - 2.44). Conclusions A comparatively high percentage of excessive GWG was observed among healthy pregnant women in Tanzania. Both inadequate and excessive GWGs were associated with elevated risks of poor pregnancy outcomes. Future studies among diverse SSA populations are warranted to confirm our findings, and clinical recommendations on optimal GWG should be developed to promote healthy GWG in SSA settings. Trial registration This trial was registered as “Prenatal Iron Supplements: Safety and Efficacy in Tanzania” (NCT01119612; http://clinicaltrials.gov/show/NCT01119612).

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