scholarly journals Taking the plunge: Water immersion for labour and birth amongst women with moderate obstetric risk factors: A prospective cohort study

2021 ◽  
Author(s):  
Emma Seed ◽  
Lauren Kearney ◽  
Edward Weaver ◽  
Rachael Nugent
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Outcome Measures ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Water Immersion ◽  
Perinatal Outcomes ◽  
Neonatal Morbidity ◽  
Significant Difference ◽  
Mode Of Birth

Objective: This study investigated maternal and fetal outcomes following warm water immersion (WWI) and/or waterbirth compared with land birth for women with moderate obstetric risk factors. Design: Prospective cohort study. Setting: Maternity hospital, Australia, 2019-2020 Population: 1665 participants, some with ‘risk factors’ for adverse perinatal outcomes requiring continuous electronic fetal monitoring (CEFM) during labour. Method: Multivariate logistical regressions were used to determine the odds of neonatal and maternal outcome measures between three groups: waterbirth, WWI and land birth Main outcome measures: Neonatal morbidity and mortality, including neonatal unit admission (NNU). Maternal clinical outcome measures, including mode of birth, perineal injury, postpartum haemorrhage, length of labour and morbidity. Results: NNU admissions for a suspected infectious condition were significantly higher in the land birth group (p=0.035). After accounting for labour duration, epidural use, previous birth mode, and labour onset, no significant difference was detected between land births and WWI/water births in the odds of NNU admission (p=0.200). No babies were admitted to NNU with signs of water inhalation or drowning. Women birthing on land had a higher mean blood loss (p=0.036) and were more likely to be febrile (2% v 0%; p=0.007); Obstetric anal sphincter injury was similar between groups. Pharmacological analgesia use was lower in the WB/WWI group (p<0.001). There was 1 cord avulsion in the waterbirth group (0.41%). Mode of birth was similar between groups (p=0.697). Conclusion: Despite moderate obstetric risk factors such as oxytocin administration and induction of labour; maternal and neonatal outcomes were similar between groups.

scholarly journals Epidemiological correlates with communicable viral co-infections of hepatitis B and hepatitis C and non-communicable diabetes among HIV ART naïve rural patients of Kanchipuram district: a prospective cohort study

2018 ◽  
Vol 5 (8) ◽  
pp. 3283
Author(s):  
A. Kasthuri ◽  
K. Mohana Krishnan ◽  
S. K. Amsavathani
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Hepatitis C ◽  
Hepatitis B ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Diabetic Patients ◽  
Increased Risk ◽  
Significant Difference ◽  
Onset Of Diabetes

Background: The objectives of the study were to study the epidemiological correlates of ART Naïve HIV cases; to study the incidence of co–infections among them; to find the incidence of onset of diabetes among them. Concomitant infection of hepatitis B virus, hepatitis C virus viruses leads to higher frequency of carrier state and severe manifestations of the disease in HIV patients. There is general agreement that the traditional risk factors for DM (increasing age, minority race, obesity) are still responsible for most of the increased risk in the HIV infected population.Methods: This study was designed as a prospective cohort study and was done at the Meenakshi Medical College & Research institute, an academic and Tertiary medical centre in Kanchipuram, Tamil Nadu, South India. The study duration was from June 2004 to June 2010. SPSS 13 was used in the calculation of chi-square and percentages.Results: Among 207 participants, mean age is 36.04 and the SD is 10.895. There is significant difference between the incidence of viral co-infections like hepatitis B and hepatitis C (p<0.001). There is significant difference between the incidence of onset of diabetes (p<0.001). The HbsAg and HCV co infection was comparatively lower than the urban population. Among the 50 HIV reactive, non diabetic patients without risk factors, only one found to be Diabetic and another found to be Pre diabetic after 6 months follow-up.Conclusions: The cost of treatment escalates, when PLHA is co-infected either with viral infections or diabetes, and also their quality of life becomes poor. So, monitoring of CD4 and CD8 should be done as a routine and screening and early treatment should be made mandatory. 

scholarly journals Anemia during different trimesters of pregnancy and hypertensive disorders are associated with adverse maternal and perinatal outcomes in Bekwai Municipality, Ghana: protocol for a prospective cohort study.

2019 ◽  
Author(s):  
Kwabena Acheampong ◽  
Xiongfeng Pan ◽  
Aizhong Liu
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Cohort Study ◽  
Birth Outcomes ◽  
Prospective Cohort Study ◽  
Logistic Regression Analysis ◽  
Prospective Cohort ◽  
Perinatal Outcomes ◽  
Baseline Characteristics

Abstract Background: Data examining whether anemia during different trimesters of pregnancy affects maternal and birth outcomes is lacking. Studies typically look at associations between risk factors and anemia or anemia and birth outcomes but have limited information as to whether birth outcomes differ with different trimesters of anemia. The main objective of this study is to determine whether anemia during different trimesters of pregnancy and hypertension disorders is associated with adverse maternal and perinatal outcomes in Ghana.Methods: This will be a primary analysis of data from a hospital-based prospective cohort study in four selected hospitals in the Bekwai Municipality, Ghana from February 2020 to August 2020. All singleton pregnancy at less than 20 weeks to women with at least one hemoglobin measure during pregnancy will be included. The risk of maternal and perinatal outcomes will be measured. Descriptive statistics will be used to describe the baseline characteristics of our cohort. Baseline characteristics of the two groups will be compared using Pearson Chi-square (χ2) test for categorical variables; the independent t-test and Mann–Whitney U test for parametric and nonparametric continuous variables, respectively. The risk associated with anemia and maternal and perinatal outcomes, using the history of anemia (Hb<11g/dL) in different trimesters will be calculated by logistic regression analysis, conditional on the baseline covariates. Possible confounding variables will be identified from background data, obstetric risk factors, and health behaviors. Multivariate analysis of significant effects (p<0.05) will be based on multiple logistic regression analysis. Confidence intervals will be evaluated at 95%. Data will be coded and examined using the SPSS program IBM version 20.Discussion: The better understanding of whether anemia during different trimesters of pregnancy and hypertension disorders is associated with adverse maternal and perinatal outcomes in Bekwai Municipality of Ghana. This study will establish targets for early intervention and identify risk factors to save and improve the lives of pregnant women and inborn by developing solutions that promote the quality and accountability of health services for the most vulnerable. These findings will be served as a policy document to governments in designing effective programs to curb the increasing prevalence of anemia and its associated health consequences.

scholarly journals Maternal and Perinatal Outcomes in Childbirths with Meconium Stained Amniotic Fluid in a Low-resource Setting: A Prospective Cohort Study

2019 ◽  
pp. 1-11
Author(s):  
Gregory E. Halle-Ekane ◽  
Phyllis N. Fon ◽  
Paul N. Koki ◽  
Alexis A. Tazinya ◽  
Rodrigue Ekollo ◽  
...  
Keyword(s):  
Cohort Study ◽  
Amniotic Fluid ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Neonatal Intensive Care ◽  
Perinatal Death ◽  
Perinatal Outcomes ◽  
Neonatal Morbidity ◽  
Resource Setting ◽  
Meconium Stained Amniotic Fluid

Meconium stained amniotic fluid (MSAF) can be associated with a high maternal and perinatal mortality. There is paucity of data on maternal and fetal outcomes of MSAF in Cameroon. Aim: The study was to determine the maternal and perinatal outcomes in patients with MSAF. Study Design: Prospective cohort study. Place and Duration of Study: The study carried out in the Limbe Regional Hospital maternity, Cameroon from 10th January 2017 to 20th April 2017. Methodology:  Fifty- two mothers who had MSAF and their neonates, were matched with controls (without MSAF) in a 1:1 ratio after matching for: age, gestational age, parity and body mass index. Risk ratio (RR) of MSAF on the various perinatal outcomes were calculated by multivariate logistic regression with MSAF (-) being the reference. Data was analyzed with Epi Info 7. Results: Two hundred and three deliveries were conducted during the study period with fifty-two with MSAF enrolled in the study. The proportion of participants with MSAF was 19.1%. Parturients who had thick MSAF were 3 times more likely to have caesarean sections (RR: 3.2, 95% CI= 1.1 - 10.2, p = 0.04). Two (3.9%) parturients with chorioamnionitis had MSAF. The neonatal complications were: non- reassuring fetal heart rate (RR=4.4, 95%CI: 1.1-16.8, p=0.02), neonatal sepsis (RR=3.7, 95%CI: 1.4-9.8, p=0.01) and neonatal intensive care unit admissions (RR=2.9, 95%CI: 1.2-6.9, p=0.02), were associated with MSAF. Two (3.9%) had meconium aspiration syndrome on clinical examination. No maternal death was recorded. However, a perinatal death occurred in a parturient with MSAF. Conclusion: The proportion of parturients with MSAF was high. MSAF was associated with increased maternal and neonatal morbidity.  We recommend larger and robust cohort studies to further refine our findings.

scholarly journals Clinical and Epidemiological aspects of SARS-CoV-2 infection among pregnant and postpartum women in Mozambique: a prospective cohort study

2021 ◽  
Author(s):  
Charles M'poca Charles ◽  
Nafissa Bique Osman ◽  
Domingos Arijama ◽  
Benjamim Matingane ◽  
Tomás Sitoé ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Statistical Significance ◽  
Perinatal Outcomes ◽  
P Value ◽  
Postpartum Women ◽  
Increased Risk ◽  
Significant Difference ◽  
Obstetric Population

Abstract Background Although there is a significant increase of evidence regarding the prevalence and impact of COVID-19 on maternal and perinatal outcomes, data on the effects of the pandemic on the obstetric population in sub-Saharan African countries are still scarce. Therefore, the study aims were to assess the prevalence and impact of COVID-19 on maternal and neonatal outcomes in the obstetric population at Central Hospital of Maputo (HCM), Mozambique. Methods Prospective cohort study conducted at teaching and referral maternity, HCM, from 20 October 2020 to 22 July 2021. We collected maternal and perinatal outcomes up to six weeks postpartum of eligible women (pregnant and postpartum women - up to the 14th day postpartum) screened for COVID-19 (individual test for symptomatic participants and pool testing for asymptomatic). The primary outcome was maternal death, SARS and UCI admission. We estimated the COVID-19 prevalence and the unadjusted RR (95% CI) for maternal and perinatal outcomes. We used the chi-square or Fisher's exact test to compare qualitative variables (two-sided p-value < 0.05 for statistical significance). Results We included 239 participants. The overall prevalence of COVID-19 was 9.2% (22/239) and in the symptomatic group was 32.4 % (11/34). About 48% of the participants with COVID-19 were asymptomatic. Moreover, the most frequent symptoms were dyspnoea (33.3%), cough (28.6%), anosmia (23.8%), and fever (19%). Not having a partner, being pregnant, and consuming alcohol were vulnerability factors for SARS-CoV-2 infection. COVID-19 among pregnant and postpartum women was associated with an increased risk of adverse maternal outcome, foetal death (RR = 4.0 [1.19–13.48]) and abortion/stillbirth 12.0 [7.7–18.7]). Conversely, we did not observe a significant difference in the primary outcomes between exposed and non-exposed groups. Conclusion The prevalence of COVID-19 in the obstetric population is higher than in the general population, and most pregnant and postpartum women with COVID-19 infection are asymptomatic. Being pregnant, not having a partner and alcohol consumption were factors of greatest vulnerability to SARS-COV-2 infection. Data suggest that pregnant women with COVID-19 may have a higher risk of adverse gestational outcomes, reinforcing the need for universal testing and monitoring of this population group. However, more prospective and robust studies are needed to assess these outcomes.

scholarly journals Prospective cohort study of water immersion for labour and birth compared with standard care in an Irish maternity setting

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e038080
Author(s):  
Paula L Barry ◽  
Lean E McMahon ◽  
Ruth AM Banks ◽  
Ann M Fergus ◽  
Deirdre J Murphy
Keyword(s):  
Cohort Study ◽  
Birth Outcomes ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Standard Care ◽  
Water Immersion ◽  
Low Risk ◽  
Perineal Tears ◽  
Significant Difference ◽  
Low Risk Women

ObjectiveTo examine the birth outcomes for women and babies following water immersion for labour only, or for labour and birth.DesignProspective cohort study.SettingMaternity hospital, Ireland, 2016–2019.ParticipantsA cohort of 190 low-risk women who used water immersion; 100 gave birth in water and 90 laboured only in water. A control group of 190 low-risk women who received standard care.MethodsLogistic regression analyses examined associations between water immersion and birth outcomes adjusting for confounders. A validated Childbirth Experience Questionnaire was completed.Main outcome measuresPerineal tears, obstetric anal sphincter injuries (OASI), postpartum haemorrhage (PPH), neonatal unit admissions (NNU), breastfeeding and birth experiences.ResultsCompared with standard care, women who chose water immersion had no significant difference in perineal tears (71.4% vs 71.4%, adj OR 0.83; 95% CI 0.49 to 1.39) or in OASI (3.3% vs 3.8%, adj OR 0.91; 0.26–2.97). Women who chose water immersion were more likely to have a PPH ≥500 mL (10.5% vs 3.7%, adj OR 2.60; 95% CI 1.03 to 6.57), and to exclusively breastfeed at discharge (71.1% vs 45.8%, adj OR 2.59; 95% CI 1.66 to 4.05). There was no significant difference in NNU admissions (3.7% vs 3.2%, adj OR 1.06; 95% CI 0.33 to 3.42). Women who gave birth in water were no more likely than women who used water for labour only to require perineal suturing (64% vs 80.5%, adj OR 0.63; 95% CI 0.30 to 1.33), to experience OASI (3.0% vs 3.7%, adj OR 1.41; 95% CI 0.23 to 8.79) or PPH (8.0% vs 13.3%, adj OR 0.73; 95% CI 0.26 to 2.09). Women using water immersion reported more positive memories than women receiving standard care (p<0.01).ConclusionsWomen choosing water immersion for labour or birth were no more likely to experience adverse birth outcomes than women receiving standard care and rated their birth experiences more highly.

The Natural Course and Risk Factors for Progression of Diabetic Retinopathy-KNDP Prospective Cohort Study

Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 1571-P
Author(s):  
HYUN UK MOON ◽  
JA YOUNG JEON ◽  
SOOJIN LEE ◽  
SEUNG JIN HAN ◽  
HAE JIN KIM ◽  
...  
Keyword(s):  
Risk Factors ◽  
Diabetic Retinopathy ◽  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Natural Course

scholarly journals Prenatal Sociodemographic Factors Predicting Maltreatment of Children up to 3 Years Old: A Prospective Cohort Study Using Administrative Data in Japan

2021 ◽  
Vol 18 (5) ◽  
pp. 2505
Author(s):  
Aya Isumi ◽  
Kunihiko Takahashi ◽  
Takeo Fujiwara
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Child Maltreatment ◽  
Survey Data ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Characteristic Curve ◽  
Risk Scores ◽  
Prenatal Risk ◽  
Prenatal Risk Factors

Identifying risk factors from pregnancy is essential for preventing child maltreatment. However, few studies have explored prenatal risk factors assessed at pregnancy registration. This study aimed to identify prenatal risk factors for child maltreatment during the first three years of life using population-level survey data from pregnancy notification forms. This prospective cohort study targeted all mothers and their infants enrolled for a 3- to 4-month-old health check between October 2013 and February 2014 in five municipalities in Aichi Prefecture, Japan, and followed them until the child turned 3 years old. Administrative records of registration with Regional Councils for Children Requiring Care (RCCRC), which is suggestive of child maltreatment cases, were linked with survey data from pregnancy notification forms registered at municipalities (n = 893). Exact logistic regression was used for analysis. A total of 11 children (1.2%) were registered with RCCRC by 3 years of age. Unmarried marital status, history of artificial abortion, and smoking during pregnancy were significantly associated with child maltreatment. Prenatal risk scores calculated as the sum of these prenatal risk factors, ranging from 0 to 7, showed high predictive power (area under receiver operating characteristic curve 0.805; 95% confidence interval (CI), 0.660–0.950) at a cut-off score of 2 (sensitivity = 72.7%, specificity = 83.2%). These findings suggest that variables from pregnancy notification forms may be predictors of the risk for child maltreatment by the age of three.

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