scholarly journals Hypertension Before Pregnancy and Infant Outcomes: Secondary Analysis of North Carolina Pregnancy Risks Assessment Monitoring System (PRAMS) Data

2020 ◽  
Author(s):  
Forgive Avorgbedor ◽  
Susan Silva ◽  
James A Blumenthal ◽  
Seonae Yeo ◽  
Elizabeth Merwin ◽  
...  
Keyword(s):  
North Carolina ◽  
Preterm Birth ◽  
Birth Outcomes ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Maternal Age ◽  
Secondary Analysis ◽  
Infant Outcomes ◽  
Race Ethnicity ◽  
Risks Assessment

Abstract Background: Chronic hypertension complicates birth outcomes. This secondary analysis of data from the North Carolina 2009-2011 Pregnancy Risks Assessment Monitoring System (PRAMS) examined factors associated with infant outcomes (preterm birth and small for gestational age) among women with hypertension before pregnancy to determine if the maternal age and race/ethnicity moderated the effect of preexisting hypertension on preterm birth and small for gestational age infants.Methods: We performed logistic regression to determine whether hypertension before pregnancy (HTN, n=292; non-HTN controls, n=2625), maternal age and race/ethnicity (Black vs Non-Black) and their interactions with hypertension before pregnancy predicted preterm birth and small for gestational age infants compared to normotensive women. Results: Results indicated that women with hypertension before pregnancy had significantly higher rates of preterm birth (29.8% vs. 21.3%) and small for gestational infants (23.0% vs. 17.9%) compared to non-HTN controls without adjusting for covariates. HTN had an effect on preterm birth that was independent of other maternal risk factors (aOR= 1.31) after adjusting for covariates . Being Black was associated with a greater likelihood of preterm birth (aOR=1.55). Conclusion: Hypertension before pregnancy is more likely to be associated Black race and with adverse birth outcomes. Black women are especially likely to experience poor birth outcomes. Continuous education to encourage all women and especially women of color and women with chronic illness to access preconception care is needed

scholarly journals Maternal exposure to airborne polychlorinated biphenyls (PCBs) and risk of adverse birth outcomes

2021 ◽  
Author(s):  
Ane Bungum Kofoed ◽  
Laura Deen ◽  
Karin Sørig Hougaard ◽  
Kajsa Ugelvig Petersen ◽  
Harald William Meyer ◽  
...  
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Sex Ratio ◽  
Polychlorinated Biphenyls ◽  
Birth Outcomes ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Maternal Exposure ◽  
Adverse Birth Outcomes ◽  
Secondary Sex Ratio

AbstractHuman health effects of airborne lower-chlorinated polychlorinated biphenyls (LC-PCBs) are largely unexplored. Since PCBs may cross the placenta, maternal exposure could potentially have negative consequences for fetal development. We aimed to determine if exposure to airborne PCB during pregnancy was associated with adverse birth outcomes. In this cohort study, exposed women had lived in PCB contaminated apartments at least one year during the 3.6 years before conception or the entire first trimester of pregnancy. The women and their children were followed for birth outcomes in Danish health registers. Logistic regression was performed to estimate odds ratios (OR) for changes in secondary sex ratio, preterm birth, major congenital malformations, cryptorchidism, and being born small for gestational age. We performed linear regression to estimate difference in birth weight among children of exposed and unexposed mothers. All models were adjusted for maternal age, educational level, ethnicity, and calendar time. We identified 885 exposed pregnancies and 3327 unexposed pregnancies. Relative to unexposed women, exposed women had OR 0.97 (95% CI 0.82, 1.15) for secondary sex ratio, OR 1.13 (95% CI 0.76, 1.67) for preterm birth, OR 1.28 (95% CI 0.81, 2.01) for having a child with major malformations, OR 1.73 (95% CI 1.01, 2.95) for cryptorchidism and OR 1.23 (95% CI 0.88, 1.72) for giving birth to a child born small for gestational age. The difference in birth weight for children of exposed compared to unexposed women was − 32 g (95% CI—79, 14). We observed an increased risk of cryptorchidism among boys after maternal airborne LC-PCB exposure, but due to the proxy measure of exposure, inability to perform dose–response analyses, and the lack of comparable literature, larger cohort studies with direct measures of exposure are needed to investigate the safety of airborne LC-PCB exposure during pregnancy

Preterm birth, low birthweight, and small for gestational age among women with preeclampsia: Does maternal age matter?

2018 ◽  
Vol 13 ◽  
pp. 260-266 ◽  
Author(s):  
Xun Li ◽  
Weishe Zhang ◽  
Jianhua Lin ◽  
Huai Liu ◽  
Zujing Yang ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Maternal Age ◽  
Low Birthweight

scholarly journals Birth outcomes, pregnancy complications, and postpartum mental health after the 2013 Calgary flood: A difference in difference analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0246670
Author(s):  
Erin Hetherington ◽  
Kamala Adhikari ◽  
Lianne Tomfohr-Madsen ◽  
Scott Patten ◽  
Amy Metcalfe
Keyword(s):  
Mental Health ◽  
Preterm Birth ◽  
Birth Outcomes ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Gestational Hypertension ◽  
Difference In Difference ◽  
Postpartum Mental Health ◽  
Nulliparous Women ◽  
The Impact

Background In June 2013, the city of Calgary, Alberta and surrounding areas sustained significant flooding which resulted in large scale evacuations and closure of businesses and schools. Floods can increase stress which may negatively impact perinatal outcomes and mental health, but previous research is inconsistent. The objectives of this study are to examine the impact of the flood on pregnancy health, birth outcomes and postpartum mental health. Methods Linked administrative data from the province of Alberta were used. Outcomes included preterm birth, small for gestational age, a new diagnoses of preeclampsia or gestational hypertension, and a diagnosis of, or drug prescription for, depression or anxiety. Data were analyzed using a quasi-experimental difference in difference design, comparing flooded and non-flooded areas and in affected and unaffected time periods. Multivariable log binomial regression models were used to estimate risk ratios, adjusted for maternal age. Marginal probabilities for the difference in difference term were used to show the potential effect of the flood. Results Participants included 18,266 nulliparous women for the pregnancy outcomes, and 26,956 women with infants for the mental health analysis. There were no effects for preterm birth (DID 0.00, CI: -0.02, 0.02), small for gestational age (DID 0.00, CI: -0.02, 0.02), or new cases of preeclampsia (DID 0.00, CI: -0.01, 0.01). There was a small increase in new cases of gestational hypertension (DID 0.02, CI: 0.01, 0.03) in flood affected areas. There were no differences in postpartum anxiety or depression prescriptions or diagnoses. Conclusion The Calgary 2013 flood was associated with a minor increase in gestational hypertension and not other health outcomes. Universal prenatal care and magnitude of the disaster may have minimized impacts of the flood on pregnant women.

scholarly journals Dengue during pregnancy and live birth outcomes: a cohort of linked data from Brazil

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e023529 ◽  
Author(s):  
Enny S Paixão ◽  
Oona M Campbell ◽  
Maria Gloria Teixeira ◽  
Maria CN Costa ◽  
Katie Harron ◽  
...  
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Birth Outcomes ◽  
Live Birth ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Severe Dengue ◽  
Maternal Risk ◽  
Increased Risk

ObjectivesDengue is the most common viral mosquito-borne disease, and women of reproductive age who live in or travel to endemic areas are at risk. Little is known about the effects of dengue during pregnancy on birth outcomes. The objective of this study is to examine the effect of maternal dengue severity on live birth outcomes.Design and settingWe conducted a population-based cohort study using routinely collected Brazilian data from 2006 to 2012.ParticipatingWe linked birth registration records and dengue registration records to identify women with and without dengue during pregnancy. Using multinomial logistic regression and Firth method, we estimated risk and ORs for preterm birth (<37 weeks’ gestation), low birth weight (<2500 g) and small for gestational age (<10thcentile). We also investigated the effect of time between the onset of the disease and each outcome.ResultsWe included 16 738 000 live births. Dengue haemorrhagic fever was associated with preterm birth (OR=2.4; 95% CI 1.3 to 4.4) and low birth weight (OR=2.1; 95% CI 1.1 to 4.0), but there was no evidence of effect for small for gestational age (OR=2.1; 95% CI 0.4 to 12.2). The magnitude of the effects was higher in the acute disease period.ConclusionThis study showed an increased risk of adverse birth outcomes in women with severe dengue during pregnancy. Medical intervention to mitigate maternal risk during severe acute dengue episodes may improve outcomes for infants born to exposed mothers.

scholarly journals Adverse birth outcomes and their clinical phenotypes in an urban Zambian cohort

2019 ◽  
Vol 3 ◽  
pp. 1533
Author(s):  
Joan T Price ◽  
Bellington Vwalika ◽  
Katelyn J Rittenhouse ◽  
Humphrey Mwape ◽  
Jennifer Winston ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Phase I ◽  
Birth Outcomes ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Sub Saharan Africa ◽  
Age Dating ◽  
Adverse Birth Outcomes ◽  
Short Cervix ◽  
Sub Saharan

Background: Few cohort studies of pregnancy in sub-Saharan Africa use rigorous gestational age dating and clinical phenotyping. As a result, incidence and risk factors of adverse birth outcomes are inadequately characterized. Methods: The Zambian Preterm Birth Prevention Study (ZAPPS) is a prospective observational cohort established to investigate adverse birth outcomes at a referral hospital in urban Lusaka. This report describes ZAPPS phase I, enrolled August 2015 to September 2017. Women were followed through pregnancy and 42 days postpartum. At delivery, study staff assessed neonatal vital status, birthweight, sex, and assigned a delivery phenotype. Primary outcomes were: (1) preterm birth (PTB; delivery <37 weeks), (2) small-for-gestational-age (SGA; <10th percentile weight-for-age at birth), and (3) stillbirth (SB; delivery of an infant without signs of life). Results: ZAPPS phase I enrolled 1450 women with median age 27 years (IQR 23–32). Most participants (68%) were multiparous, of whom 41% reported a prior PTB and 14% reported a prior stillbirth. Twins were present in 3% of pregnancies, 3% of women had short cervix (<25mm), 24% of women were HIV seropositive, and 5% were syphilis seropositive. Of 1216 (84%) retained at delivery, 15% were preterm, 18% small-for-gestational-age, and 4% stillborn. PTB risk was higher with prior PTB (aRR 1.88; 95%CI 1.32–2.68), short cervix (aRR 2.62; 95%CI 1.68–4.09), twins (aRR 5.22; 95%CI 3.67–7.43), and antenatal hypertension (aRR 2.04; 95%CI 1.43–2.91). SGA risk was higher with twins (aRR 2.75; 95%CI 1.81–4.18) and antenatal hypertension (aRR 1.62; 95%CI 1.16–2.26). SB risk was higher with short cervix (aRR 6.42; 95%CI 2.56–16.1). Conclusions: This study confirms high rates of PTB, SGA, and SB among pregnant women in Lusaka, Zambia. Accurate gestational age dating and careful ascertainment of delivery data are critical to understanding the scope of adverse birth outcomes in low-resource settings.

scholarly journals Adverse birth outcomes and their clinical phenotypes in an urban Zambian cohort

2020 ◽  
Vol 3 ◽  
pp. 1533
Author(s):  
Joan T Price ◽  
Bellington Vwalika ◽  
Katelyn J Rittenhouse ◽  
Humphrey Mwape ◽  
Jennifer Winston ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Phase I ◽  
Birth Outcomes ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Sub Saharan Africa ◽  
Age Dating ◽  
Adverse Birth Outcomes ◽  
Short Cervix ◽  
Sub Saharan

Background: Few cohort studies of pregnancy in sub-Saharan Africa use rigorous gestational age dating and clinical phenotyping. As a result, incidence and risk factors of adverse birth outcomes are inadequately characterized. Methods: The Zambian Preterm Birth Prevention Study (ZAPPS) is a prospective observational cohort established to investigate adverse birth outcomes at a referral hospital in urban Lusaka. This report describes ZAPPS phase I, enrolled August 2015 to September 2017. Women were followed through pregnancy and 42 days postpartum. At delivery, study staff assessed neonatal vital status, birthweight, and sex, and assigned a delivery phenotype. Primary outcomes were: (1) preterm birth (PTB; delivery <37 weeks), (2) small-for-gestational-age (SGA; <10th percentile weight-for-age at birth), and (3) stillbirth (SB; delivery of an infant without signs of life). Results: ZAPPS phase I enrolled 1450 women with median age 27 years (IQR 23–32). Most participants (68%) were multiparous, of whom 41% reported a prior PTB and 14% reported a prior stillbirth. Twins were present in 3% of pregnancies, 3% of women had short cervix (<25mm), 24% of women were HIV seropositive, and 5% were syphilis seropositive. Of 1216 (84%) retained at delivery, 15% were preterm, 18% small-for-gestational-age, and 4% stillborn. PTB risk was higher with prior PTB (aRR 1.88; 95%CI 1.32–2.68), short cervix (aRR 2.62; 95%CI 1.68–4.09), twins (aRR 5.22; 95%CI 3.67–7.43), and antenatal hypertension (aRR 2.04; 95%CI 1.43–2.91). SGA risk was higher with twins (aRR 2.75; 95%CI 1.81–4.18) and antenatal hypertension (aRR 1.62; 95%CI 1.16–2.26). SB risk was higher with short cervix (aRR 6.42; 95%CI 2.56–16.1). Conclusions: This study confirms high rates of PTB, SGA, and SB among pregnant women in Lusaka, Zambia. Accurate gestational age dating and careful ascertainment of delivery data are critical to understanding the scope of adverse birth outcomes in low-resource settings.

scholarly journals Occupational exposure to inorganic particles during pregnancy and birth outcomes: a nationwide cohort study in Sweden

BMJ Open ◽  
2019 ◽  
Vol 9 (2) ◽  
pp. e023879 ◽  
Author(s):  
Filip Norlén ◽  
Per Gustavsson ◽  
Pernilla Wiebert ◽  
Lars Rylander ◽  
Maria Albin ◽  
...  
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Birth Outcomes ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Welding Fumes ◽  
High Exposure ◽  
Inorganic Particles ◽  
Increased Risk

ObjectivesThe aim of this study was to investigate if occupational exposure to inorganic particles or welding fumes during pregnancy is associated with negative birth outcomes.DesignA prospective national cohort study.SettingAll single births from 1994 to 2012 in Sweden. Information on birth weight, preterm birth, small for gestational age, smoking habits, nationality, age, occupation, absence from work and education was obtained from nationwide registers. Exposure to inorganic particles (mg/m3) was assessed from a job exposure matrix.ParticipantsThis study included all single births by occupationally active mothers (995 843).Outcome measuresAssociations between occupational exposures and negative birth outcomes in the form of low birth weight, preterm birth and small for gestational age.ResultsMothers who had high exposure to inorganic particles and had less than 50 days (median) of absence from work during pregnancy showed an increased risk of preterm birth (OR 1.18; 95% CI 1.07 to 1.30), low birth weight (OR 1.32; 95% CI 1.18 to 1.48) as well as small for gestational age (OR 1.20; 95% CI 1.04 to 1.39). The increased risks were driven by exposure to iron particles. No increased risks were found in association with exposure to stone and concrete particles. High exposure to welding fumes was associated with an increased risk of low birth weight (OR 1.22; 95% CI 1.02 to 1.45) and preterm birth (OR 1.24; 95% CI 1.07 to 1.42).ConclusionsThe results indicate that pregnant women should not be exposed to high levels of iron particles or welding fumes.

scholarly journals Variation in Birth Outcomes by Mother’s Country of Birth Among Hispanic Women in the United States, 2013

2018 ◽  
Vol 133 (3) ◽  
pp. 318-328 ◽  
Author(s):  
Carla L. DeSisto ◽  
Jill A. McDonald
Keyword(s):  
United States ◽  
Birth Weight ◽  
Preterm Birth ◽  
Birth Outcomes ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Hispanic Women ◽  
The United States ◽  
Country Of Birth ◽  
Foreign Born

Objectives: Despite knowledge that the Hispanic population is growing in the United States and that birth outcomes may vary by maternal country of birth, data on birth outcomes by maternal country of birth among Hispanic women are scant. We compared the rates of 3 birth outcomes for infants born in the United States—preterm birth, low birth weight, and small for gestational age—between foreign-born Hispanic women and US-born Hispanic women, and then we examined these birth outcomes by mother’s country of birth for foreign-born Hispanic women. Methods: Using the 2013 natality file from the National Vital Statistics System of the National Center for Health Statistics, we examined data on the 3 birth outcomes and maternal characteristics by maternal country of birth. We used log binomial models to calculate unadjusted and adjusted relative risks for preterm birth, low birth weight, and small for gestational age for US-born Hispanic women compared with foreign-born Hispanic women. We also compared the relative risk of each adverse birth outcome for foreign-born Hispanic women by country of birth. Results: US-born Hispanic women had higher rates of the 3 birth outcomes than did foreign-born Hispanic women (preterm birth: 8.0% vs 7.0%; low birth weight: 6.1% vs 5.2%; small for gestational age: 9.2% vs 7.9%). These higher rates persisted after adjusting for maternal characteristics. The rates for these 3 birth outcomes varied significantly by country of birth for foreign-born Hispanic women, with Puerto Rican women consistently having the poorest birth outcomes. Conclusions: Our results demonstrated heterogeneity in rates of adverse birth outcomes by country of birth for foreign-born Hispanic women. Presenting rates for foreign-born mothers as a group masks differences by country. To understand possible changes in data on birth outcomes, states should stratify data by maternal country of birth.

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