scholarly journals Association Between Adverse Pregnancy Outcomes and Preceding Risk Factors: an Analytical Cross-Sectional Study

2021 ◽  
Author(s):  
Prakash Prabhakarrao Doke ◽  
Sonali Hemant Palkar ◽  
Jayashree Sachin Gothankar ◽  
Archana Vasantrao Patil ◽  
Amruta Paresh Chutke ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pregnancy Outcomes ◽  
Significant Risk ◽  
Tobacco Consumption ◽  
Adverse Pregnancy Outcomes ◽  
Adverse Outcomes ◽  
Mountainous Area ◽  
Cross Sectional ◽  
Heavy Work ◽  
Adverse Pregnancy

Abstract Background: The health of women during the preconception phase though critical, is a comparatively ignored part in her life cycle. The presence of health risks is judged as hazardous to the wellbeing of women and their forthcoming progeny. The study aimed to estimate the prevalence of various pregnancy outcomes and assess the association between various risk factors and adverse outcomes. Methods: It was a population-based cross-sectional analytical study. The study was carried out in Nashik District, having a large mountainous area. It included two randomly selected blocks, one tribal and one nontribal, in which interventions were planned in the later stage. For comparison, two adjacent blocks, one tribal and one nontribal, were also included. All women who had a pregnancy outcome in the preceding 12 months (01 April 2017 to 31 March 2018) were interviewed. Trained Accredited Social Health Activists under the direct supervision of Auxiliary Nurse Midwives and Medical Officers conducted the survey. Multivariate analysis was carried out to find the adjusted risk ratio of having a particular adverse outcome because of the specified potential risk factors.Results: A total of 9,307 women participated in the study. The prevalence of adverse pregnancy outcomes was abortion 4.1%; stillbirth 1.6%; preterm birth 4.1%; LBW 11.2%; congenital physical defect 2.6%. Prevalence of consanguineous marriage, heavy work during the last six months of pregnancy, pre-existing illness, tobacco consumption, direct exposure to pesticides and domestic violence during pregnancy was 17.6%; 16.9%; 2.2%; 5.6%; 2.3%; and 0.8%, respectively. Risk factors that were significantly associated with abortion include existing illness at the time of conception and performing heavy work in the last six months of pregnancy. Consanguinity, tobacco consumption during pregnancy and pre-existing illness were identified as risk factors for stillbirth. Significant risk factors of LBW were heavy work in the last six months of pregnancy, pre-existing illness and residence in a tribal area. Conclusion: The survey showed that risk factors differentially affect outcomes of pregnancy. Preconception and antenatal care should include counselling about consanguineous marriages, identifying and managing a pre-existing illness, avoiding tobacco consumption in the prenatal and natal period, and avoiding heavy work during pregnancy.

scholarly journals Association between adverse pregnancy outcomes and preceding risk factors: a cross-sectional study from Nashik District, India

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Prakash Prabhakarrao Doke ◽  
Sonali Hemant Palkar ◽  
Jayashree Sachin Gothankar ◽  
Archana Vasantrao Patil ◽  
Amruta Paresh Chutke ◽  
...  
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Pregnancy Outcomes ◽  
Tobacco Consumption ◽  
Adverse Pregnancy Outcomes ◽  
Cross Sectional ◽  
Parental Consanguinity ◽  
Heavy Work ◽  
Adverse Pregnancy

Abstract Background The preconception phase of women’s life cycle is critical but comparatively ignored. The presence of health risks is judged as hazardous to the wellbeing of women and their offspring. This study aimed to estimate the prevalence of various pregnancy outcomes and assess the association between certain risk factors and adverse outcomes. Methods As a part of a preconception care intervention project, a baseline survey was conducted in four blocks of Nashik District, India. In this population-based cross-sectional analytical study, we compared cases in the study group (randomly selected one tribal and one non-tribal block) with those of the control group (one tribal and one non-tribal block). A comparison was also made between the tribal and non-tribal blocks in each group. All women who had a pregnancy outcome in the preceding 12 months (01 April 2017 to 31 March 2018) were interviewed. Trained Accredited Social Health Activists conducted the survey under the direct supervision of Auxiliary Nurse Midwives and Medical Officers. Multivariate analysis was carried out to find the adjusted prevalence ratio of having a particular adverse outcome because of the prespecified potential risk factors. Results A total of 9307 women participated in the study. The prevalence of adverse pregnancy outcomes was as follows: abortion in 4.1%, stillbirth in 1.7%, preterm birth in 4.1%, low birth weight in 13.2%, and congenital physical defect in 2.8%. Prevalence of parental consanguinity, pre-existing maternal illness at conception, heavy work during the last six months of pregnancy, tobacco consumption, alcohol consumption, direct exposure to pesticides and domestic violence during pregnancy was 18.5, 2.2, 18.7, 5.6, 0.5, 2.3, and 0.8% respectively. Risk factors associated with abortion included pre-existing illness and heavy work in the last six months of the pregnancy. Consanguinity, tobacco consumption during pregnancy and pre-existing illness were identified as risk factors for stillbirth. Significant risk factors of low birth weight were heavy work in the last six months of pregnancy, pre-existing illness and residence in a tribal area. Conclusion There is a need to emphasize on maternal behaviour, including tobacco consumption, and heavy work during pregnancy, as well as on parental consanguinity and pre-existing maternal illnesses, in order to achieve the best possible pregnancy outcomes.

scholarly journals Assessing the relationship between adverse pregnancy outcomes and area-level deprivation in Wales 2014–2019: a national population-based cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e052330
Author(s):  
Heather Brown ◽  
Amrita Jesurasa ◽  
Clare Bambra ◽  
Judith Rankin ◽  
Amy McNaughton ◽  
...  
Keyword(s):  
Risk Factors ◽  
Caesarean Section ◽  
Pregnancy Outcomes ◽  
Emergency Caesarean Section ◽  
Adverse Pregnancy Outcomes ◽  
Perineal Tear ◽  
Cross Sectional ◽  
Individual Level ◽  
Adverse Pregnancy ◽  
The Relationship

ObjectivesThe aim of this study was to assess the relationship between deciles of area-level deprivation and seven adverse pregnancy outcomes in Wales.DesignCross-sectional analysis.Setting64 699 live births in Wales from 31 March 2014 to 16 September 2019.Primary outcome variableWe examined each of the following seven adverse pregnancy outcomes: (1) small for gestational age (SGA); (2) large for gestational age; (3) preterm birth; (4) third-degree or fourth-degree perineal tear; (5) major postpartum haemorrhage (MPPH); (6) a lower Apgar score at 5 min and (7) emergency caesarean section.ResultsThere was no significant association between increasing aggregate measures of area-level deprivation and the adverse pregnancy outcomes we studied. Women living in an area with greater access to services are more likely to have a baby that is SGA (1.27, 95% CI 1.11 to 1.49), have a greater likelihood of a perineal tear (1.74, 95% CI 1.15 to 2.61), are significantly less likely to have MPPH (0.79, 95% CI 0.64 to 0.96), have a baby with an Apgar score of 0.26 higher (95% CI 0.22 to 0.29) and are significantly less likely to have an emergency caesarean section (0.81, 95% CI 0.73 to 0.88). Women living in areas with higher employment (0.26, 95% CI 0.19 to 0.36) and better health (0.26, 95% CI 0.19 to 0.35) were less likely to experience perineal tear.ConclusionsThere was no clear social-spatial gradient in area-level deprivation and adverse pregnancy outcomes. We found a stronger association for individual-level behavioural risk factors than area-level factors. These findings support the benefits that accessible and holistic person-centred care may bring through addressing individual behavioural risk factors. There is a need for improved data completeness and further individual-level data on risk factors such as employment and income to better understand the role which may be played by population-level policies and their pathways to affecting outcomes.

scholarly journals Association between neighbourhood deprivation, fetal growth, small-for-gestational age and preterm birth: a population-based prospective cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e049075
Author(s):  
Dionne V Gootjes ◽  
Anke G Posthumus ◽  
Vincent W V Jaddoe ◽  
Eric A P Steegers
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Preterm Birth ◽  
Fetal Growth ◽  
Gestational Age ◽  
Pregnancy Outcomes ◽  
First Trimester ◽  
Adverse Pregnancy Outcomes ◽  
Neighbourhood Deprivation ◽  
Adverse Pregnancy

ObjectiveTo study the associations between neighbourhood deprivation and fetal growth, including growth in the first trimester, and adverse pregnancy outcomes.DesignProspective cohort study.SettingThe Netherlands, Rotterdam.Participants8617 live singleton births from the Generation R cohort study.ExpositionLiving in a deprived neighbourhood.Main outcome measuresFetal growth trajectories of head circumference, weight and length.Secondary outcomes measuresSmall-for-gestational age (SGA) and preterm birth (PTB).ResultsNeighbourhood deprivation was not associated with first trimester growth. However, a higher neighbourhood status score (less deprivation) was associated with increased fetal growth in the second and third trimesters (eg, estimated fetal weight; adjusted regression coefficient 0.04, 95% CI 0.02 to 0.06). Less deprivation was also associated with decreased odds of SGA (adjusted OR 0.91, 95% CI 0.86 to 0.97, p=0.01) and PTB (adjusted OR 0.89, 95% CI 0.82 to 0.96, p=0.01).ConclusionsWe found an association between neighbourhood deprivation and fetal growth in the second and third trimester pregnancy, but not with first trimester growth. Less neighbourhood deprivation is associated with lower odds of adverse pregnancy outcomes. The associations remained after adjustment for individual-level risk factors. This supports the hypothesis that living in a deprived neighbourhood acts as an independent risk factor for fetal growth and adverse pregnancy outcomes, above and beyond individual risk factors.

Abstract 376: Adverse Pregnancy Outcomes and Cardiovascular Risks Multi-disciplinary Awareness Project

2020 ◽  
Vol 13 (Suppl_1) ◽  
Author(s):  
Venkata Sai Gogineni ◽  
Ki Park ◽  
Denise Manfrini ◽  
Robert Egerman ◽  
Sharon Aroda ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pregnancy Outcomes ◽  
Descriptive Analysis ◽  
Primary Objective ◽  
Adverse Pregnancy Outcomes ◽  
Cardiovascular Risks ◽  
Cvd Risk ◽  
Adverse Pregnancy ◽  
Traditional Risk Factors

Background: Cardiovascular disease (CVD) remains the number one cause of death amongst women. There has been much effort put forth over the past decade in reducing both the incidence and prevalence of this disease burden through screening and treating the traditional risk factors. Recent guidelines have shown that adverse pregnancy outcomes (APOs), including pre-eclampsia (PEC), gestational diabetes mellitus (GDM) and pre-term birth (PTB) have been associated with future maternal CVD risk. Much of the current literature focuses almost exclusively on PEC. Our investigation is more comprehensive, covering not only these other APOs but assessing whether providers of multiple specialties in our community are aware of the APO to CVD risk association. The primary objective of this study was to investigate if there exist any knowledge gaps regarding the progression from APO to CVD and if this knowledge varies by specialty. Methods: An anonymous voluntary survey through REDCap© was sent to providers in the fields of Internal medicine (IM, 21%), Family medicine (FM, 26%), Obstetrics-Gynecology (Ob-Gyn, 23%) and Cardiology (30%) who have been in practice for greater than five years in our local Gainesville community. This project was registered as a QI project and descriptive analysis was used to examine the responses. Results: A total of 53 providers responded to the survey. Despite having the majority of patients being women, Ob-Gyn was the least likely amongst all specialties to routinely screen for CV risk factors. However, when addressed, they were the most likely to ask about APOs. Cardiologists, despite declaring to be aware of the association between APOs and CV risk, were least likely to ask about APOs. All specialties recognized PEC and GDM as APOs linked to long-term maternal CV risk but failed to associate PTB as an APO. The majority of providers amongst IM, FM, and Cardiology did not ask about APOs and lacked the knowledge of how often to appropriately screen for secondary risk factors associated with APOs. Additionally, these providers outright admitted that they are not familiar with the current AHA and/or ACOG guidelines for screening and follow-up. Conclusion: Descriptive statistical analysis of our data suggests that there exists a notable knowledge gap between all four specialties investigated in our survey. Education concerning the link between APOs and future maternal CV risk is needed amongst all specialties, especially amongst the providers in Cardiology, IM, and FM. Targeted efforts at our institution to improve awareness of all APOs, their associated secondary risk factors, and appropriate screening is required in all specialties to help reduce CVD morbidity and mortality.

scholarly journals Impact of Wildfire Smoke on Adverse Pregnancy Outcomes in Colorado, 2007–2015

2019 ◽  
Vol 16 (19) ◽  
pp. 3720 ◽  
Author(s):  
Mona Abdo ◽  
Isabella Ward ◽  
Katelyn O’Dell ◽  
Bonne Ford ◽  
Jeffrey Pierce ◽  
...  
Keyword(s):  
Birth Weight ◽  
Pregnancy Outcomes ◽  
Gestational Hypertension ◽  
Adverse Pregnancy Outcomes ◽  
Adverse Outcomes ◽  
Wildfire Smoke ◽  
Secondary Outcomes ◽  
Adverse Pregnancy ◽  
The Impact ◽  
Zip Code

Colorado is regularly impacted by long-range transport of wildfire smoke from upwind regions. This smoke is a major source of ambient PM2.5. Maternal exposure to total PM2.5 during pregnancy has been linked to decreased birth weight and other adverse outcomes, although the impact of wildfire smoke contribution has only recently been investigated. The objective of this study was to estimate associations between adverse pregnancy outcomes and ambient wildfire smoke PM2.5. Wildfire smoke PM2.5 exposures were estimated using a previously published method incorporating ground-based monitors and remote sensing data. Logistic regression models stratified by ZIP code and mixed models with random intercept by ZIP code were used to test for associations. The primary outcomes of interest were preterm birth and birth weight. Secondary outcomes included gestational hypertension, gestational diabetes, neonatal intensive care unit admission, assisted ventilation, small for gestational age, and low birth weight. Exposure to wildfire smoke PM2.5 over the full gestation and during the second trimester were positively associated with pre-term birth (OR = 1.076 (μg/m3)−1 [95% CI = 1.016, 1.139; p = 0.013] and 1.132 (μg/m3)−1 [95% CI = 1.088, 1.178]; p < 0.0001, respectively), while exposure during the first trimester was associated with decreased birth weight (−5.7 g/(μg/m3) [95% CI: −11.1, −0.4; p = 0.036]). Secondary outcomes were mixed.

scholarly journals Semiconductor Work and Adverse Pregnancy Outcomes Associated with Male Workers: A Retrospective Cohort Study

2019 ◽  
Vol 63 (8) ◽  
pp. 870-880
Author(s):  
Kyung-Hwa Choi ◽  
Hyunjoo Kim ◽  
Myoung-Hee Kim ◽  
Ho-Jang Kwon
Keyword(s):  
Pregnancy Outcomes ◽  
Semiconductor Manufacturing ◽  
Retrospective Cohort ◽  
Reproductive Toxicity ◽  
Adverse Pregnancy Outcomes ◽  
Adverse Outcomes ◽  
Office Workers ◽  
Adverse Pregnancy ◽  
Male Workers ◽  
Semiconductor Production

Abstract Objectives A hazardous work environment in semiconductor factories is a threat to the workers’ health. Semiconductor manufacturing characteristically requires young workers, and reproductive toxicity is an important issue. Studies investigating reproductive toxicity among individuals working in the semiconductor manufacturing industry have primarily focused on outcomes in women. Information on the reproductive health of male semiconductor factory workers is limited. This study aimed to evaluate the association between workplace exposures among male workers in a Korean semiconductor company and adverse pregnancy outcomes. Methods Based on the data from the 2015 Semiconductor Health Survey (SHS), which evaluated the workplace exposures, pregnancy outcomes, and general health of 21 969 employees of the semiconductor industry in South Korea, we included 3868 male workers with 7504 pregnancy outcomes identified by self-reports for this retrospective cohort study. Data regarding the pregnancy outcomes, order of pregnancy, and the years of the outcomes were collected via the SHS questionnaire. Adverse pregnancy outcomes were defined as preterm labor, spontaneous abortion, and stillbirth. Workplace exposures were classified as fabrication, assembly, others, lab, and office work (reference group). A generalized estimating equations model including repeated events of individuals and producing relative risk (RR) and 95% confidence interval (CI) was used to estimate the association between workplace exposure and adverse pregnancy outcomes. Analyses were adjusted for work location, spouse’s employment in semiconductor production work, educational level, marital status, risky alcohol drinking, smoking status, body mass index, order of pregnancy, and age and year of pregnancy outcome, which were based on a priori decisions. Results The adjusted risk for adverse outcomes was higher [RR (95% CI): 1.47 (1.04, 2.07)] among assembly process workers compared with the office workers. Adjusted risks for adverse outcomes among workers in assembly and fabrication, whose spouses also worked in semiconductor production, were 1.60 (95% CI: 1.04, 2.46) and 1.74 (95% CI: 1.18, 2.57) times higher, respectively, compared with the office workers with spouses not working in semiconductor production. Conclusions Based on these findings, semiconductor work might be considered a risk factor for reproductive toxicity among male workers, especially for those whose spouses have the same job.

Studies Assessing Risk of Treatments for Diabetes Mellitus and Adverse Pregnancy Outcomes Should Control for Known Risk Factors

2012 ◽  
Vol 14 (12) ◽  
pp. 1183-1184 ◽  
Author(s):  
E. Edson-Heredia ◽  
R.D. Rohwer ◽  
M. Wong ◽  
P. Wang ◽  
A. Vambergue ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Pregnancy Outcomes ◽  
Adverse Pregnancy Outcomes ◽  
Adverse Pregnancy

scholarly journals Traditional practices and adverse pregnancy outcomes in migrant women

2016 ◽  
Vol 10 (1) ◽  
pp. 45-46
Author(s):  
Adam Morton
Keyword(s):  
Health Professionals ◽  
Pregnancy Outcomes ◽  
Cultural Practices ◽  
Adverse Pregnancy Outcomes ◽  
Adverse Outcomes ◽  
Traditional Practices ◽  
Migrant Women ◽  
Adverse Pregnancy

Traditional practices during pregnancy may lead to adverse outcomes in migrant women. Very little is known regarding the efficacy or safety of many cultural practices during pregnancy, and research is required to address this deficiency in knowledge. Greater awareness of traditional practices by health professionals may result in improved pregnancy outcomes in migrant women.

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