scholarly journals Maternal and Neonatal Outcomes of Syrian Adolescent Refugees and Local Adolescent Turkish Citizens: A Comparative Study at a Tertiary Care Maternity Hospital in Turkey

Author(s):  
Ceren Golbasi ◽  
Tayfun Vural ◽  
Burak Bayraktar ◽  
Hakan Golbasi ◽  
Alkim Gulsah Sahingoz Yildirim

OBJECTIVE: In this study, we aim to compare the maternal and obstetric outcomes between local adolescent Turkish citizens and adolescent Syrian refugees admitted to a tertiary care center in Turkey. STUDY DESIGN: Between January 2014 and December 2019, a total of 57,049 births were performed in our hospital. The study included a total of 6,021 patients aged 19 years or younger pregnancy who gave birth at our hospital. Of this number, 5,164 (1,792 Syrian adolescent refugee cases and 3,372 local adolescent Turkish cases) were live singleton pregnancies. Our primary aim was to compare the maternal and obstetric outcomes between the two groups. RESULTS: In the pregnant refugee women, the maternal age was younger (p<0.001). Hemoglobin and hematocrit levels are significantly lower in Syrian pregnant women (p<0.001 and p<0.001, respectively). Anemia was significantly higher in Syrian refugee pregnant women (p<0.001). The double screening test and triple screening test were significantly lower in Syrian pregnant women (p<0.001 and p<0.001, respectively). Preterm birth rates and late preterm delivery prevalence (34-37 gestational weeks) were significantly higher in the adolescent Syrian immigrants' compared to the adolescent Turkish locals (p<0.001 and p<0.001, respectively). The average birth weight of the Syrian refugees was lower but the number of low birth weight babies was higher Turkish locals (p=0.010 and p=0.014, respectively). The preterm birth ratio and low birth weight ratio in Syrian adolescents has decreased over the years. CONCLUSION: Syrian adolescent refugees are particularly at risk of early pregnancy, high fertility rate, preterm birth, low birth weight, and anemia. Immigrant women should be provided with fertility, family planning, and training on behavior that protects reproductive health. Syrian pregnant women should be supported to receive services.

2021 ◽  
Vol 10 (19) ◽  
pp. 4495
Author(s):  
Panwad Harn-a-morn ◽  
Prapai Dejkhamron ◽  
Theera Tongsong ◽  
Suchaya Luewan

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.


2020 ◽  
Vol 16 ◽  
Author(s):  
Reza Omani-Samani ◽  
Saman Maroufizadeh ◽  
Nafise Saedi ◽  
Nasim Shokouhi ◽  
Arezoo Esmailzadeh ◽  
...  

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.


2020 ◽  
Vol 32 (2) ◽  
pp. 26-31
Author(s):  
Fatima Zohra ◽  
Md Faruq Alam ◽  
Mekhala Sarkar ◽  
Shahriar Faruque ◽  
Mohammad Waliul Hasnat Sajib

Neurodevelopmental disorders (NDD) are public health burden worldwide. NDD causes disabilities and reduces the quality of life. Perinatal factors like maternal age, stress, maternal physical illnesses, birth complications, preterm birth, low birth weight and neonatal infections are the important risk factors for NDD. The objectives of the study were to determine the proportion of perinatal factors among children with neurodevelopmental disorders attending tertiary care hospitals in Dhaka city. This was a cross-sectional study conducted in outpatient department of National Institute of Mental Health (NIMH), Dhaka and Institute of Paediatric Neurodisorder and Autism (IPNA), Bangabandhu Sheikh Mujib Medical University (BSMMU) from January 2017 to July 2018. Among 115 children with NDD aged 0-17 years satisfying inclusion and exclusion criteria who were conveniently selected as sample. After diagnosing NDD using DSM- 5 criteria by psychiatrists and paediatric neurologists, a semi structured questionnaire was applied by researcher herself that included socio-demographic and perinatal factors as well. Results showed that majority of the respondents (29.6%) were 5-8 years with male predominance (78.3%). The most common perinatal factors were maternal factors like maternal stress (68.7%), maternal physical illness (66.1 %), inadequate food/rest intake (53.9%) and inadequate weight gain during pregnancy (50.4%). Fetal and neonatal factors like birth complication (82.6%), preterm birth (80%), low birth weight (75.6%), neonatal illness (69.6%) and birth asphyxia (61.7%). Most common neonatal illness were pneumonia (30.0 %) followed by neonatal Jaundice (20%). Early identification of possible perinatal factors and providing safe perinatal period can give a positive impact in prevention of NDD in children. Bang J Psychiatry 2018;32(2): 26-31


Author(s):  
Carmen Alba Moliner-Sánchez ◽  
José Enrique Iranzo-Cortés ◽  
José Manuel Almerich-Silla ◽  
Carlos Bellot-Arcís ◽  
José Carmelo Ortolá-Siscar ◽  
...  

This work analyzed the available evidence in the scientific literature about the risk of preterm birth and/or giving birth to low birth weight newborns in pregnant women with periodontal disease. A systematic search was carried out in three databases for observational cohort studies that related periodontal disease in pregnant women with the risk of preterm delivery and/or low birth weight, and that gave their results in relative risk (RR) values. Eleven articles were found, meeting the inclusion criteria. Statistically significant values were obtained regarding the risk of preterm birth in pregnant women with periodontitis (RR = 1.67 (1.17–2.38), 95% confidence interval (CI)), and low birth weight (RR = 2.53 (1.61–3.98) 95% CI). When a meta-regression was carried out to relate these results to the income level of each country, statistically significant results were also obtained; on the one hand, for preterm birth, a RR = 1.8 (1.43–2.27) 95% CI was obtained and, on the other hand, for low birth weight, RR = 2.9 (1.98–4.26) 95% CI. A statistically significant association of periodontitis, and the two childbirth complications studied was found, when studying the association between these results and the country’s per capita income level. However, more studies and clinical trials are needed in this regard to confirm the conclusions obtained.


2021 ◽  
Vol 20 (5) ◽  
pp. 114-123
Author(s):  
E.V. Shikh ◽  
◽  
A.A. Makhova ◽  
Zh.M. Sizova ◽  
N.V. Shikh ◽  
...  

Vitamin D status during pregnancy has an impact on fetal growth and development and plays an important role in the prevention of pregnancy complications. Fetal vitamin D supplementation is completely dependent on maternal status, which explains the high correlation between 25(OH)D concentrations in maternal and umbilical cord blood. Adequate vitamin D supplementation in pregnant women is associated with a decreased risk of preterm birth and low birth weight. Most newborns, regardless of gestational age, have insufficient vitamin D levels. Thus, the problem of Vitamin D supplementation is relevant not only for pregnant women, but also for newborns. Research studies of recent years have aimed at comparing the efficacy of Vitamin D dosing to prevent pregnancy complications. Doses higher than 4000 IU have virtually no effect on the risk of preeclampsia compared with doses of 4000 IU or less. Administration of Vitamin D in doses less than 2000 IU per day reduces the risk of low birth weight, intrauterine or neonatal mortality. Doses higher than 2000 IU have no additional benefit. Recommendations for vitamin D supplementation based on objective pharmacokinetic characteristics should be developed. Key words: pregnancy, vitamin D, doses, preterm birth, gestational diabetes, preeclampsia


2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Anna Dow ◽  
Dumbani Kayira ◽  
Michael G. Hudgens ◽  
Annelies Van Rie ◽  
Caroline C. King ◽  
...  

Background. Limited data exist on cotrimoxazole prophylactic treatment (CPT) in pregnant women, including protection against malaria versus standard intermittent preventive therapy with sulfadoxine-pyrimethamine (IPTp).Methods. Using observational data we examined the effect of CPT in HIV-infected pregnant women on malaria during pregnancy, low birth weight and preterm birth using proportional hazards, logistic, and log binomial regression, respectively. We used linear regression to assess effect of CPT on CD4 count.Results. Data from 468 CPT-exposed and 768 CPT-unexposed women were analyzed. CPT was associated with protection against malaria versus IPTp (hazard ratio: 0.35, 95% Confidence Interval (CI): 0.20, 0.60). After adjustment for time period this effect was not statistically significant (adjusted hazard ratio: 0.66, 95% CI: 0.28, 1.52). Among women receiving and not receiving CPT, rates of low birth weight (7.1% versus 7.6%) and preterm birth (23.5% versus 23.6%) were similar. CPT was associated with lower CD4 counts 24 weeks postpartum in women receiving (−77.6 cells/μL, 95% CI: −125.2, −30.1) and not receiving antiretrovirals (−33.7 cells/μL, 95% CI: −58.6, −8.8).Conclusions. Compared to IPTp, CPT provided comparable protection against malaria in HIV-infected pregnant women and against preterm birth or low birth weight. Possible implications of CPT-associated lower CD4 postpartum warrant further examination.


2015 ◽  
Vol 57 (2) ◽  
pp. 111-120 ◽  
Author(s):  
Helena Lucia Barroso DOS REIS ◽  
Karina da Silva ARAUJO ◽  
Lilian Paula RIBEIRO ◽  
Daniel Ribeiro DA ROCHA ◽  
Drielli Petri ROSATO ◽  
...  

Introduction: Maternal HIV infection and related co-morbidities may have two outstanding consequences to fetal health: mother-to-child transmission (MTCT) and adverse perinatal outcomes. After Brazilian success in reducing MTCT, the attention must now be diverted to the potentially increased risk for preterm birth (PTB) and intrauterine fetal growth restriction (IUGR). Objective: To determine the prevalence of PTB and IUGR in low income, antiretroviral users, publicly assisted, HIV-infected women and to verify its relation to the HIV infection stage. Patients and Methods: Out of 250 deliveries from HIV-infected mothers that delivered at a tertiary public university hospital in the city of Vitória, state of Espírito Santo, Southeastern Brazil, from November 2001 to May 2012, 74 single pregnancies were selected for study, with ultrasound validated gestational age (GA) and data on birth dimensions: fetal weight (FW), birth length (BL), head and abdominal circumferences (HC, AC). The data were extracted from clinical and pathological records, and the outcomes summarized as proportions of preterm birth (PTB, < 37 weeks), low birth weight (LBW, < 2500g) and small (SGA), adequate (AGA) and large (LGA) for GA, defined as having a value below, between or beyond the ±1.28 z/GA score, the usual clinical cut-off to demarcate the 10th and 90th percentiles. Results: PTB was observed in 17.5%, LBW in 20.2% and SGA FW, BL, HC and AC in 16.2%, 19.1%, 13.8%, and 17.4% respectively. The proportions in HIV-only and AIDS cases were: PTB: 5.9 versus 27.5%, LBW: 14.7% versus 25.0%, SGA BW: 17.6% versus 15.0%, BL: 6.0% versus 30.0%, HC: 9.0% versus 17.9%, and AC: 13.3% versus 21.2%; only SGA BL attained a significant difference. Out of 15 cases of LBW, eight (53.3%) were preterm only, four (26.7%) were SGA only, and three (20.0%) were both PTB and SGA cases. A concomitant presence of, at least, two SGA dimensions in the same fetus was frequent. Conclusions: The proportions of preterm birth and low birth weight were higher than the local and Brazilian prevalence and a trend was observed for higher proportions of SGA fetal dimensions than the expected population distribution in this small casuistry of newborn from the HIV-infected, low income, antiretroviral users, and publicly assisted pregnant women. A trend for higher prevalence of PTB, LBW and SGA fetal dimensions was also observed in infants born to mothers with AIDS compared to HIV-infected mothers without AIDS.


2020 ◽  
Vol 7 (48) ◽  
pp. 2815-2819
Author(s):  
Argha Mallya Debbarman ◽  
Ashis Kumar Rakshit ◽  
Jahar Lal Baidya ◽  
Dhruba Prasad Paul

BACKGROUND Lancefield Group-B Streptococcus (GBS) emerged as a significant neonatal pathogen with mortality rates of 15 - 50 % in western countries during 1970s. In India, incidence of invasive neonatal GBS diseases is around 0.17 per 1000 live birth and probably is underestimated. Hence, the study was undertaken to evaluate the vaginal GBS colonization in pregnant women along with the neonatal outcome. METHODS The study was single centered, hospital based observational cross-sectional study done in the dept. of Obstetrics & Gynaecology at Agartala Government Medical College (AGMC), and GBP Hospital for one & half years (Jan’ 16 - June’ 17). 250 Pregnant mothers with 31 to 40 weeks of gestation with singleton pregnancy, delivering either by Caesarean section & Vaginal delivery, were included in this study. They were recruited from obstetrics OPD and casualty of AGMC & GBP Hospital. During 1 st pelvic examination, two low vaginal swabs were taken for Gram Staining, and for determination of ß-hemolytic colony in blood agar. After identification of GBS from genitalia, outcome of neonates in these positive cases were evaluated for up to 28 days after delivery. RESULTS GBS was found in 8.8 % of total women recruited and was more common in multi-gravida. GBS vaginal colonization was significantly associated with low birth weight, and preterm delivery (p value 0.01) which is significant. CONCLUSIONS Prevalence of vaginal GBS colonization is more in pregnant mothers, more in multigravidas & is associated with low-birth-weight neonates and preterm delivery. So, there is a need to formulate guidelines for incorporation of detection of vaginal colonization in multi gravidas to determine its prevalence. KEYWORDS Group-B Streptococcus (GBS), Multigravidas, Colonization, Neonates, Pregnant Women


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