scholarly journals Frequency of Anemia and Obstetric Outcome in Young Primigravida

2018 ◽  
Vol 23 (4) ◽  
pp. 531-535
Author(s):  
Abida Sajid ◽  
Aqsam Sajid
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Pregnancy Outcome ◽  
Preterm Delivery ◽  
Adverse Pregnancy Outcome ◽  
National Level ◽  
Deficiency Anemia ◽  
Major Public Health Problem ◽  
Obstetric Outcome ◽  
Adverse Pregnancy

Pregnancy and childbirth is an event celebrated worldwide. During pregnancy physiological changes and increasing demand causes fall in hemoglobin level leading to anemia and adverse pregnancy outcome especially in young girls. Anemia is a major public health problem. Around 58.27 million women worldwide are anemic during pregnancy 95% of whom live in countries that are developing. To know the frequency of anemia, and obstetric outcome in terms of preterm delivery, low birth weight and rate of caesarean section in young Primigravida. It was a cross sectional study, conducted in the department of Gynae & Obstetric unit 5 King Edward Medical University Lahore during a period of one year from May2013 April 2014. All primigravida young 15-24years with anemia enrolled for the study. Anemia is defined as hemoglobin< 10.5g/dl (WHO Criteria), Iron deficiency Anemia is defined as serum ferritin level less than 12 micro gram per ml and on Red Blood Cell indices, i.e. decrease in MCV, MCH and MCHC, and Microcytic Hypochromic cells in Peripheral Smear. Megaloblastic anemia was labeled when Macrocytic Hypochromic cells seen. Obstetric outcome in terms of Preterm delivery defined as delivery at <37 weeks of gestation (36 +6 weeks) and birth weight <2500g mand a need for operative delivery. Patients fulfilling the selection criteria as per operational definition were included in the study after taking informed consent using non probability consecutive sampling technique. Data was collected on a pre-designed questionnaire. A total of 3855 deliveries during study period in which 1318 were primigravida. Mean age in study group was 15 to 24 years. We observed mild anemia in 46% of woman, moderate anemia in 41% and severe anemia in 13% in young primigravida. Preterm delivery was noted in 25% of the females and low birth weight babies were noted by 33% in teenage and young primigravida. Statistically significant relationship was found between maternal age, education and socio economic status. Anemia in pregnancy nowadays is still a common problem in adolescent and young primigravida and associated with adverse pregnancy outcome. Prompt measure should be taken by the stake holders at local and national level to prevent and treat this problem in order to reduce morbidity and mortality associated with it.

AB0105 CHECKPOINT MOLECULES AND PREGNANCY: ENHANCED SPD-L1 PREDICTS FLARE IN RA PREGNANCY AND POSTPARTUM

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1351.1-1352
Author(s):  
A. L. Stefanski ◽  
K. Eriksson ◽  
A. Zbinden ◽  
P. Villiger ◽  
F. Förger
Keyword(s):  
Birth Weight ◽  
Disease Activity ◽  
Pregnancy Outcome ◽  
Preterm Delivery ◽  
Adverse Pregnancy Outcome ◽  
Healthy Controls ◽  
Serum Samples ◽  
Healthy Pregnancy ◽  
Pregnancy And Postpartum ◽  
Adverse Pregnancy

Background:Rheumatoid arthritis (RA) is a female-predominant autoimmune disease that may affect women in childbearing age, making family planning an important issue for their life. There is a need for better understanding the mechanisms modulating RA in pregnancy and develop prognostic marker regarding adverse pregnancy outcome such as reduced birth weight and preterm delivery. As a crucial organ for peripheral tolerance during pregnancy, the placenta is expressing constitutively programmed cell death ligand 1 (PD-L1), major ligand of the inhibitory receptor PD-1 (Zhang et al, 2015). We hypothesize that the PD-1 pathway plays a central inhibitory role in regulating the course of the disease and pregnancy outcome in RA.Objectives:To investigate the relationship between PD-1 pathway, disease activity during pregnancy/postpartum and pregnancy outcome in RA.Methods:We measured soluble PD-1 and PD-L1 levels by ELISA in serum samples of 27 pregnant RA patients and 25 healthy pregnant controls at different time points during pregnancy and postpartum. As for pregnancy controls, we analyzed serum samples from 28 non-pregnant RA patients and 18 non-pregnant healthy controls. The data was analyzed in correlation with disease activity (measured by DAS28-CRP) and pregnancy outcome (defined as preterm delivery and birth weight). Statistics were calculated by Mann-Whitney U test and Wilcoxon test, correlations by Spearman rank test.Results:In healthy pregnancy, sPD-L1 increases significantly in the 1sttrimester (p = 0,0198) and decreases significantly postpartum (p = 0,0029). sPD-L1 values are higher in non-pregnant RA patients compared to non-pregnant healthy controls (p = 0,047) and there are no significant changes during RA pregnancy. Postpartum sPD-L1 values are significantly higher in RA patients compared to healthy controls (p = 0,0014), Fig. 1. Notably, regarding disease activity, we noticed a significant positive correlation between the overall sPD-L1 values in RA and DAS28-CRP (p= 0.0104), Fig. 2. No significant correlation was seen between sPD-L1, birth weight and preterm delivery. For sPD-1 we focused on 3rdtrimester and postpartum, however, there was no difference between healthy controls and RA patients and no correlation with disease activity or pregnancy outcome.Conclusion:In healthy pregnancy, we observed an increase of sPD-L1, which decreases after delivery. This supports the hypothesis, that PD-1 pathway may be involved in shaping the physiological fetal-maternal tolerance. In RA higher sPD-L1 values are measured already in non-pregnant patients compared to healthy controls and there is no physiological decrease postpartum. Intriguing, sPD-L1 correlates positively with RA disease activity, reflecting a possible functional antagonism towards the inhibitory function of membrane bound PD-L1 molecules. However, the detailed function of sPD-L1 need to be further delineated. Nevertheless, sPD-L1 may have the potential to serve as prognostic marker for flares in RA pregnancy. Regarding the rather rarely observed adverse pregnancy outcome, larger cohorts need to be investigated.References:[1]Zhang YH, Tian M, Tang MX et al. Recent Insight into the Role of the PD-1/PD-L1 Pathway in Feto-Maternal Tolerance and Pregnancy. Am J Reprod Immunol. 2015 Sep;74(3):201-8.Disclosure of Interests:Ana-Luisa Stefanski: None declared, Klara Eriksson: None declared, Astrid Zbinden: None declared, Peter Villiger Consultant of: MSD, Abbvie, Roche, Pfizer, Sanofi, Speakers bureau: Roche, MSD, Pfizer, Frauke Förger Grant/research support from: Unrestricted grant from UCB, Consultant of: UCB, GSK, Roche, Speakers bureau: UCB, GSK

scholarly journals Effects of sanitation practices on adverse pregnancy outcomes in India: a conducive finding from recent Indian demographic health survey

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Ratna Patel ◽  
Ajay Gupta ◽  
Shekhar Chauhan ◽  
Dhananjay W. Bansod
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Pregnancy Outcome ◽  
Health Survey ◽  
Pregnancy Outcomes ◽  
Adverse Pregnancy Outcome ◽  
Wealth Index ◽  
Adverse Pregnancy Outcomes ◽  
Adverse Outcomes ◽  
Adverse Pregnancy

Abstract Background Several risk factors predisposing women and their live-borns to adverse outcomes during pregnancy have been documented. Little is known about sanitation being a factor contributing to adverse pregnancy outcomes in India. The role of sanitation in adverse pregnancy outcomes remains largely unexplored in the Indian context. This study is an attempt to bring the focus on sanitation as a factor in adverse pregnancy outcome. Along with the sanitation factors, few confounder variables have also been studied in order to understand the adverse pregnancy outcomes. Methods The study is based on the fourth round of National Family Health Survey (NFHS-IV) covering 26,972 married women in the age-group 15–49. The study variables include the mother’s age, Body Mass Index (BMI), education, anemia, and Antenatal care (ANC) visits during their last pregnancy. The household level variable includes place of residence, religion, caste, wealth index, access to toilet, type of toilet, availability of water within toilet premises, and facility of hand wash near the toilet. Children study variables include Low Birth Weight (LBW), the order of birth (Parity), and the death of the children of the women in the last 5 years. The target variable Adverse Pregnancy Outcome (APO) was constructed using children born with low birth weight or died during the last pregnancy. Results We calculated both adjusted as well as unadjusted odds ratios for a better understanding of the association between sanitation and adverse pregnancy outcomes. Findings from the study showed that women who did not have access to a toilet within the house had a higher risk of adverse pregnancy outcome. In the multivariable model, no association was observed for adverse pregnancy outcome among women who did not have access to toilet and women who used shared toilet. Teenage (15–19 years), uneducated, underweight and anemic mothers were more likely to face APO as compare to other mothers in similar characteristics group. Conclusions Our findings contribute to the decidedly less available literature on maternal sanitation behaviour and adverse pregnancy outcomes. Our results support that sanitation is a very significant aspect for women who are about to deliver a baby as there was an association between sanitation and adverse pregnancy outcome. Education on sanitation practices is the need of the hour as much as it needs to follow.

scholarly journals POS0737 LOW PRECONCEPTIONAL COMPLEMENT LEVEL IS RELATED WITH ADVERSE OBSTETRIC OUTCOME IN A MULTICENTRIC COHORT OF PREGNANCY IN PATIENTS WITH APS AND APL POSITIVITY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 619.2-620
Author(s):  
D. Lini ◽  
C. Nalli ◽  
L. Andreoli ◽  
F. Crisafulli ◽  
M. Fredi ◽  
...  
Keyword(s):  
Pregnancy Outcome ◽  
Complement Activation ◽  
Pregnancy Complications ◽  
Antiphospholipid Antibodies ◽  
Pregnancy Loss ◽  
Adverse Pregnancy Outcome ◽  
Obstetric Outcome ◽  
Complement Level ◽  
Increased Risk ◽  
Adverse Pregnancy

Background:The role of complement in the antiphospholipid (aPL) related pathology has been widely studied in animal models. Antiphospholipid antibodies can induce fetal loss in experimental animals but mice deficient in specific complement components (C4, C3, C5) appear somehow protected. In addition, in pregnant mice injected with aPL, antibody deposition has been found at decidual level causing focal necrosis, apoptosis and neutrophil infiltrates and supporting aPL pathogenetic potential. On the other hand, human studies did find hypocomplementemia associated to pregnancy complications in patients with obstetric antiphospholipid syndrome (APS). These results, however, are not unanimously confirmed and, in addition, some studies only show increased levels of complement activation products (i.e. Bb) and not decreased levels of C3 and/or C4. A recently study focusing on complement level in early pregnancy and before pregnancy showed a significant correlation with pregnancy complications and loss in a large cohort of primary APS.Objectives:To investigate if the simple detection of low C3 and/or C4 could be considered a risk factor for adverse pregnancy outcome in APS and aPL carriers pregnancies.Methods:We performed a multicentric study including patients from 10 Italian and 1 Russian Centers. Data on pregnancies in women with primary APS (n=434) and asymptomatic carriers with persistently positive aPL but not fulfilling clinical criteria for APS (n=218) were retrospectively collected. Serum C3 and C4 levels were evaluated by nephelometry; hypocomplementemia was defined by local laboratory reference values. Statistical analysis was performed using GraphPad.Results:Preconceptional complement levels and gestational outcome were available for 107 (25%) pregnancies in APS out of 434 and for 196 (90%) pregnancies in aPL carriers women out of 218. In pregnancies with low preconceptional C3 and/or C4, a significantly higher prevalence of pregnancy losses was observed (p=0.019). A subgroup analysis focusing on triple aPL positive patients was also performed. Preconceptional low C3 and/or C4 levels were found to be associated with an increased rate of pregnancy loss (p = 0.027) in this subgroup also. Otherwise, adverse pregnancy outcomes in single or double aPL positive women were not related to preconception complement levels (p = 0.44) (Table 1). Of note, all the pregnancy losses in the triple positive group occurred in patients treated with low dose aspirin and low molecular weight heparin from the time of positive pregnancy test.Conclusion:Our findings confirm that decreased complement levels before pregnancy are associated with increased risk of adverse outcome. This has been seen only in in women with triple aPL positivity, indeed single or double positivity does not show this trend. Complement levels are cheap and easy to be measured therefore they could represent a useful aid to identify patients at increased risk of pregnancy loss. test positivity.References:[1]De Carolis S, et al. Complementemia and obstetric outcome in pregnancy with antiphospholipid syndrome. Lupus (2012) 21:776–8.[2]Kim MY, et al. Complement activation predicts adverse pregnancy outcome in patients with systemic lupus erythematosus and/or antiphospholipid antibodies. Ann Rheum Dis (2018) 77:549–55.[3]Fredi M, et al. Risk Factors for Adverse Maternal and Fetal Outcomes in Women With Confirmed aPL Positivity: Results From a Multicenter Study of 283 Pregnancies. Front Immunol. 2018 May 7;9:864.Triple aPL positivitySingle or double aPL positivityGestational outcomeLow C3/C4 (n=49)Normal C3/C4(n=17)pLow C3/C4 (n=57)Normal C3/C4(n=165)pTerm live birth (>37w)15 (31%)6 (35%)ns34 (60%)110 (67%)nsPreterm live birth (≤37w)22 (45%)11 (65%)ns15 (26%)38 (23%)nsPregnancy losses (abortion and miscarriages)12 (24%)0 (0%)0.0278 (14%) 17 (10%)nsDisclosure of Interests:None declared

scholarly journals Pregnancy outcome in isolated oligohydramnios diagnosed in third trimester

2021 ◽  
Vol 10 (5) ◽  
pp. 1914
Author(s):  
Pratibha Singh ◽  
Vibha Rani Pipal ◽  
Dharmendra Kumar Pipal ◽  
Navdeep Kaur Ghuman ◽  
Garima Yadav ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Amniotic Fluid ◽  
Pregnancy Outcome ◽  
Preterm Delivery ◽  
Neonatal Outcome ◽  
Low Risk ◽  
Control Group ◽  
P Value ◽  
Third Trimester

Background: The aim of this study was to compare the outcomes of pregnancies complicated by isolated oligohydramnios with the low risk pregnancies with normal amniotic fluid volume.Methods: The present study is a retrospective cohort study of singleton pregnancies diagnosed with Isolated oligohydramnios (AFI≤5) in their third trimester (N=35). Pregnancy outcome was compared with a matched control group of low risk pregnancies with amniotic fluid volume >5 (N=30).Results: The overall incidence of Isolated oligohydramnios was 0.7-0.8%. In oligohydramnios group, significant association were found in null-parity (60% vs 23.33%, p-value<0.005), Fetal growth retardation (25.71% vs 0% p-value<0.02), preterm delivery (22.85% vs 3.33%, p-value 0.025), rate of Induction of labor (40% vs 10%) and cesarean rate for non-reassuring fetal heart rate (20% vs 3.33%, p-value<0.001). Likewise, the incidence of low birth weight was (54.28% vs 13.33%, p-value<0.001) and NICU admissions was (20% vs 0%, p-value<0.01), but there was no difference in Apgar score finding. NICU stay was of short duration and all babies discharged in stable condition, there were no stillbirth or early neonatal death in both groups.Conclusions: Isolated oligohydramnios has an adverse influence on pregnancy and neonatal outcome in the form of FGR, preterm delivery, increased rate of Induction and cesarean section. Despite the high incidence of low birth weight and NICU admissions, the overall early neonatal outcome was similar to the other low risk pregnancies.

MYOMA PLACENTA RELATIONSHIP & PREGNANCY OUTCOME

2021 ◽  
pp. 3-4
Author(s):  
Savita Chandra
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Pregnancy Outcome ◽  
P Value ◽  
Obstetric Outcome ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Antepartum Haemorrhage

During the two years study period, 8557 deliveries took place, of which 114 were pregnancies with myoma giving the incidence as 1.33%. 12 of the 114 pregnancies ended in abortion, i.e.10.5%. The myoma placenta relationship and the obstetric outcome was analyzed in the remaining 102 pregnancies which continued beyond 22 weeks. Of these, 41.2% had complications. Premature rupture of membranes was the commonest complication seen in 22.5%. No case of preeclampsia or antepartum haemorrhage occurred in the 'no contact' category. Amongst the cases where the placenta was either in contact or superimposed on the broid, 85.5% -87.5% developed one or more complication. The myoma placenta relationship was found to be statistically signicant, p value <0.001. 39.3% were caesarean deliveries. Overall 37.25% were low birth weight neonates. There were two stillbirths, both in the superimposed category.

scholarly journals Value of PI of uterine artery at 23-24 weeks in the prediction of adverse pregnancy outcome

2017 ◽  
Vol 6 (12) ◽  
pp. 5435
Author(s):  
Anshu Dhar ◽  
Indu Kaul
Keyword(s):  
Pregnancy Outcome ◽  
Preterm Delivery ◽  
Uterine Artery ◽  
Adverse Pregnancy Outcome ◽  
Color Doppler ◽  
Subsequent Development ◽  
Adverse Outcomes ◽  
Intrauterine Death ◽  
Increased Risk ◽  
Adverse Pregnancy

Background: Increased resistance in uteroplacental circulation is associated with pregnancy complications. The aim of this study was to determine the role of uterine artery PI at 23-24 weeks gestation in predicting adverse pregnancy outcomes.Methods: 200 singleton pregnancies were prospectively examined with color Doppler to determine the PI of uterine artery at 23-24 weeks and study its correlation with subsequent development of adverse maternal and fetal outcomes defined as any or the combination of preeclampsia, intrauterine growth restriction (IUGR), intrauterine death (IUD), preterm delivery and placental abruption.Results: There were 13 cases (6.5%) with abnormal uterine artery Doppler results and 8 (61.5%) of them developed preeclampsia, out of these 8, 1 had IUGR as well and 3 had iatrogenic preterm delivery due to severe preeclampsia. 2 (15.4%) out of 13 had only IUGR. The pregnancies with adverse outcomes had significantly higher mean PI than those with normal outcomes (1.2±0.3 versus 0.857±0.179; p <0.001). The sensitivity, specificity, PPV and NPV of PI ≥95th percentile in the prediction of adverse pregnancy outcome was 35.71%, 98.26%, 76.92% and 90.37% respectively. The birth weight in higher mean PI group was significantly lower than in pregnancies with PI <95th percentile (2.33±0.49 kg versus 2.86±0.48 kg; p <001). No cases of spontaneous preterm labor, IUD or abruption were present in higher mean PI group.Conclusions: Increased uterine artery PI at 23-24 weeks of pregnancy is associated with an increased risk of adverse pregnancy outcomes. 

scholarly journals Birth Weight Ratio as an Alternative to Birth Weight Percentile to Express Infant Weight in Research and Clinical Practice: A Nationwide Cohort Study

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Bart Jan Voskamp ◽  
Brenda M. Kazemier ◽  
Ewoud Schuit ◽  
Ben Willem J. Mol ◽  
Maarten Buimer ◽  
...  
Keyword(s):  
Cohort Study ◽  
Birth Weight ◽  
Pregnancy Outcome ◽  
Perinatal Death ◽  
Adverse Pregnancy Outcome ◽  
Weight Ratio ◽  
Discriminative Ability ◽  
Birth Weight Percentile ◽  
Adverse Pregnancy ◽  
Weight Percentile

Objective. To compare birth weight ratio and birth weight percentile to express infant weight when assessing pregnancy outcome.Study Design. We performed a national cohort study. Birth weight ratio was calculated as the observed birth weight divided by the median birth weight for gestational age. The discriminative ability of birth weight ratio and birth weight percentile to identify infants at risk of perinatal death (fetal death and neonatal death) or adverse pregnancy outcome (perinatal death + severe neonatal morbidity) was compared using the area under the curve. Outcomes were expressed stratified by gestational age at delivery separate for birth weight ratio and birth weight percentile.Results. We studied 1,299,244 pregnant women, with an overall perinatal death rate of 0.62%. Birth weight ratio and birth weight percentile have equivalent overall discriminative performance for perinatal death and adverse perinatal outcome. In late preterm infants (33+0–36+6weeks), birth weight ratio has better discriminative ability than birth weight percentile for perinatal death (0.68 versus 0.63,P  0.01) or adverse pregnancy outcome (0.67 versus 0.60,P<0.001).Conclusion. Birth weight ratio is a potentially valuable instrument to identify infants at risk of perinatal death and adverse pregnancy outcome and provides several advantages for use in research and clinical practice. Moreover, it allows comparison of groups with different average birth weights.

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