scholarly journals Pregnancy, delivery and neonatal outcomes among women living with Down syndrome. A matched cohort study, taken from a population database.

2022 ◽  
Author(s):  
Abdullah Alnoman ◽  
Ahmad Badeghiesh ◽  
Haitham Baghlaf ◽  
Magdalena Peeva ◽  
MH Dahan
Keyword(s):  
Down Syndrome ◽  
Pregnant Women ◽  
Health Care Cost ◽  
Neonatal Outcomes ◽  
Premature Delivery ◽  
Control Group ◽  
P Value ◽  
Nationwide Inpatient Sample Database ◽  
Increased Risk ◽  
Adverse Neonatal Outcomes

Objectives: Women with Down syndrome (DS) suffer from several health issues, however, their fecundity is not affected. Despite that, there are no studies in the literature to address pregnancy, delivery, or neonatal outcomes among women with DS. Design: We conducted a retrospective study using the Health Care Cost and Utilization Project-Nationwide Inpatient Sample Database over 11 years from 2004 to 2014. Methods: A delivery cohort was created using ICD-9 codes. ICD-9 code 758.0 was used to extract the cases of maternal DS. Pregnant women with DS (study group) were matched based on age and health insurance type to women without DS (control) at a ratio of 1:4. A multivariant logistic regression model was used to adjust for statistically significant variables (P-value < 0.5). Results: There were a total of 9,096,788 deliveries during the study period. Of those, 185 pregnant women were found to have DS. The matched control group was 740. Maternal pregnancy risks mostly did not differ between those with and without DS including pregnancy-induced PIH, gestational diabetes, preeclampsia, PPROM, chorioamnionitis, cesarean section, operative vaginal delivery, or blood transfusion (P >0.05, all). However, they were at extremely increased risk of delivering prematurely (aOR 3.86, 95% CI 1.25-11.93), and to have adverse neonatal outcomes such as small for gestational age (aOR 13.13, 95% CI 2.20-78.41), intrauterine fetal demise (aOR 20.97, 95% CI 1.86-237.02), and congenital anomalies (aOR 9.59, 95% CI 1.47-62.72). Conclusion: Women with DS should be counseled about their increased risk of premature delivery and adverse neonatal outcomes.

scholarly journals Clinical Stratification of Pregnant COVID-19 Patients based on Severity: A Single Academic Center Experience

2021 ◽  
Vol 38 (05) ◽  
pp. 515-522
Author(s):  
Marissa Berry ◽  
Amanda Wang ◽  
Shannon M. Clark ◽  
Hassan M. Harirah ◽  
Sangeeta Jain ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Disease Severity ◽  
Gestational Age ◽  
Laboratory Data ◽  
Population Characteristics ◽  
Neonatal Outcomes ◽  
P Value ◽  
Asymptomatic Patients ◽  
Increased Risk ◽  
Maternal And Neonatal Outcomes

Objective This study aimed to describe baseline characteristics of a cohort of pregnant women infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and determine if these correlate with disease severity and perinatal outcomes. Study Design This was a retrospective cohort trial conducted at the University of Texas Medical Branch Galveston, Texas. All pregnant women presented to our medical center, who were screened and tested positive for SARS-CoV-2 virus, were included. We stratified our study population in three groups: asymptomatic, symptomatic not requiring oxygen therapy, and patients requiring oxygen support to maintain oxygen saturation >94%. Relevant population characteristics, laboratory data, and maternal and neonatal outcomes were abstracted. A p-value <0.05 was considered statistically significant. Results Between March and July 2020, 91 women tested positive for SARS-CoV-2 upon admission to our labor and delivery unit. Among these, 61.5% were asymptomatic, 34.1% were symptomatic, and 4.4% required oxygen support. Our population was mainly Hispanic (80.2%), multiparous (76.9%), obese (70.3%), and with a median age of 27 years. Median gestational age at symptom onset or diagnosis was 36 weeks. Significant differences were found between gestational age and disease severity. Maternal characteristics including age, body mass index (BMI), and presence of comorbid conditions did not appear to influence severity of SARS-CoV-2 infection. Significant laboratory findings associated with increasing disease severity included decreasing hemoglobin and white blood cell count, lymphopenia, and increasing levels of inflammatory markers including CRP, ferritin, and procalcitonin. Maternal and neonatal outcomes did not differ among groups. No SARS-CoV-2 was detected by polymerase chain reaction testing in neonates of mothers with COVID-19. Conclusion Pregnant patients with COVID-19 infection are predominantly asymptomatic. Patients appear to be at increased risk for more severe infection requiring oxygen support later in pregnancy. Key Points

scholarly journals Pregnancy outcomes in women with a hemoglobinopathy trait: a multicenter, retrospective study

2021 ◽  
Author(s):  
Jan Kasparek ◽  
Tilo Burkhardt ◽  
Irene Hoesli ◽  
Gabriela Amstad Bencaiova
Keyword(s):  
Pregnant Women ◽  
Neonatal Outcomes ◽  
University Hospital ◽  
Control Group ◽  
Maternal Outcomes ◽  
Adverse Neonatal Outcomes ◽  
Maternal And Neonatal Outcomes ◽  
Clinical Records ◽  
The University ◽  
Fetal Acidosis

Abstract Purpose To determine the risk of adverse maternal and neonatal outcomes in pregnant women with a hemoglobinopathy trait. Materials and methods Retrospective cohort study was conducted to compare adverse maternal and neonatal outcomes between pregnant women with a hemoglobinopathy trait (study group; n = 172), and without a hemoglobinopathy trait (control group; n = 360). The medical data were extracted from clinical records of pregnant women attending antenatal care and delivering at the University Hospital Basel or University Hospital Zurich between 2015 and 2018. Results A total of 172 pregnant women with a hemoglobinopathy trait and 360 controls were recruited. Apart from fetal acidosis, the groups did not differ significantly in any variables of adverse neonatal outcomes. Whereas, among the maternal outcomes the rate of abortion, gestational diabetes mellitus, bacteriuria or urinary tract infection, intrahepatic cholestasis, abnormal placentation and anemia postpartum were significantly increased in women with a hemoglobinopathy trait. Conclusion In our study, a hemoglobinopathy trait increased the risk of adverse maternal outcomes but did not increase adverse neonatal outcomes.

scholarly journals Reproductive and neonatal outcomes in women with unicornuate uterus: a population-based study

2021 ◽  
Vol 12 (5) ◽  
pp. 344-350
Author(s):  
Ahmad Badeghiesh ◽  
Angelos G Vilos ◽  
Haitham Baghlaf ◽  
Jana Abi Rafeh ◽  
Nabigah Alzawawi ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Preterm Delivery ◽  
Health Care Cost ◽  
Gestational Hypertension ◽  
Neonatal Outcomes ◽  
Baseline Risk ◽  
Multivariate Logistic Regression Model ◽  
P Value ◽  
Unicornuate Uterus ◽  
Nationwide Inpatient Sample Database

Objective: To investigate reproductive and neonatal outcomes in women with unicornuate uterus. Study design: Data from the Health Care Cost and Utilization Project-Nationwide Inpatient Sample database were extracted from 2010 through 2014 to create a delivery cohort using ICD-9 codes. Code 752.33 was used to identify cases with unicornuate uterus and reproductive outcomes were compared to pregnancies without unicornuate uterus. A multivariate logistic regression model was used to adjust for statistically significant variables (P-value<0.05). Results: Among 3,850,226 deliveries during the study period, 802 women had unicornuate uterus. Patient with unicornuate uterus were more likely to be older (P<0.001), have thyroid disease (P<0.001), previous Caesarean section (P<0.001), and to have had in-vitro fertilization (IVF) (P<0.001). The risk of gestational diabetes, pregnancy induced hypertension, gestational hypertension and preeclampsia were significantly greater in the unicornuate uterus group relative to controls, after controlling for baseline risk factors; aOR 1.32 [95% CI 1.03–1.71], aOR 1.46 [95% CI 1.16–1.85], aOR 1.16 [95% CI 1.22-2.28] and aOR 1.70 [95% CI 1.24-2.32], respectively. Also, the rates of preterm delivery, preterm premature rupture of membranes and caesarean section were higher in the unicornuate uterus group compared to controls after controlling for confounding factors, aOR 3.83 (95% CI 3.19–4.6), aOR 5.11 (95% CI 3.73–7.14) and aOR 11.38 (95% CI 9.16–14.14) respectively. At birth, 11.1% and 2.6% of neonates were small for gestational age in the unicornuate uterus and the control groups, respectively, aOR 4.90, (95% CI 3.87-6.21). Conclusion: Women with unicornuate uterus are at higher risk for pregnancy complications, preterm delivery and having small for gestation age neonates. Women with known unicornuate uterus may benefit from increased surveillance to prevent and/or decrease maternal and neonate morbidity and mortality.

scholarly journals ANEMIC PATIENTS

2015 ◽  
Vol 22 (12) ◽  
pp. 1550-1554
Author(s):  
Tayyaba Majeed ◽  
Rabia Adnan ◽  
Zahid Mahmood ◽  
Ishrat Majeed ◽  
Kanwal Saba ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Pregnant Women ◽  
Iron Deficiency Anemia ◽  
Preterm Labor ◽  
Deficiency Anemia ◽  
Control Group ◽  
P Value ◽  
Increased Risk ◽  
Study Setting ◽  
Control Study

Pregnant women are particularly considered to be the most vulnerable groupbecause of the additional demands that are made on maternal stores during pregnancy. Theiron deficiency anemia is the most common nutritional deficiency problems in females and isresponsible of high maternal death rate in our society. Objectives: To determine the relationshipof frequency and severity of iron deficiency anemia to preterm labor and eventual perinatalout come in anemic patients. Study Design: It was a case control study. Study Setting: InObstetrics and Gynecology Unit-III, Sir Ganga Ram hospital, Lahore from July 2012 to June2013. Methodology: The study was conducted on 200 patients (100 cases and 100 controls)were studied. Cases were patients admitted in labor room with preterm labor and Controlswere females in labor at term at. Convenience sampling was done. On admission relevanthistory taking examination and investigation were done. The data was collected on a Performa.Results: There were 50 patients with anemia amongst the patients with preterm labor. In thecontrol group, 40 patients were suffering from anemia. In the patients with preterm labor themean hemoglobin was 9.83 grams/deciliter. In the control group the mean hemoglobin was10.3gm/dl. (Pregnant women having hemoglobin <10gm/dl are considered to be anemic). Theodds ratio was calculated to be 3.4 and P value was <0.05. Conclusions: Iron deficiencyanemia was associated with increased risk for low birth weight, preterm delivery, and perinatalmortality. The frequency of iron-deficiency anemia was seen in both groups of pregnant women.

scholarly journals Can Oral Anaerobic Bacteria cause Adverse Pregnancy Outcomes?/ Дали Оралните Анаеробни Бактерии Можат Да Доведат До Лоши Опстетрички Исходи?

PRILOZI ◽  
2015 ◽  
Vol 36 (1) ◽  
pp. 137-143 ◽  
Author(s):  
Irena Andonova ◽  
Vasil Iliev ◽  
Nikica Živković ◽  
Edita Sušič ◽  
Ivana Bego ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Pregnancy Outcome ◽  
Low Birthweight ◽  
Adverse Pregnancy Outcome ◽  
Premature Delivery ◽  
Control Group ◽  
Case Group ◽  
Periodontal Pathogens ◽  
Increased Risk ◽  
Adverse Pregnancy

Abstract Aim: Maternal periodontal infection has been recognized as a risk factor for premature and low birthweight infants. It is suspected that pathogens causing periodontal disease may translocate to the amniotic cavity and so contribute to triggering an adverse pregnancy outcome. The aim of this study was to evaluate whether the presence of specific periodontal pathogens may influence the incidence of preterm labor and premature birth. Material and Methods: This study was designed as a hospital-based case-control study. A total of 70 pregnant women, aged 18-40 with single live pregnancy were recruited from the Departement of Gynecolgy and Obstetrics at a General hospital in Sibenik, Croatia, between March 2013 to March 2014. The case group: 30 pregnant women who were hospitalised with signs of premature labor. Control group: 40 patients with normal pregnancy post-delivery up to 48 hrs, who had given birth at term, and the baby had a weight of more than 2500 gr. These women had undergone microbiological examination at the time of recruitment, microbial samples, paper point subgingival swabs were obtained in both groups and processed by anaerobic culturing. Standard procedures were used for culture and identification of bacteria. Information was collected on demographics, health behaviors, and obstetric and systemic diseases that may have influence the premature delivery. Results: The levels of periodontal pathogens tended to be higher in the premature (case group) labor compared to the term deliveries (control group). Levels of Porphyromonas gingivalis, Fuscobacterium nucleatum, Actinomyces actinomycetecomitans were statistically significantly higher in premature births as compared to term deliveries, adjusting for baseline levels. The joint effects of red and orange microbial clusters were significantly higher in the premature group compared to the term group. Conclusions: The study shows a significant association betwen periodontal anaerobic infection and adverse pregnancy outcome. High levels of periodontal pathogens during pregnancy are associated with an increased risk for preterm delivery. Further studies elucidating the role of the microbial load and maternal immune response as related to pregnancy outcome seem merited.

scholarly journals The Effect of Yoga Relaxation on Anxiety Levels among Pregnant Women

2019 ◽  
Vol 8 (2) ◽  
pp. 86 ◽  
Author(s):  
Shinta Novelia ◽  
Tantri Wenny Sitanggang ◽  
AFNITA Lutfiyanti
Keyword(s):  
Pregnant Women ◽  
Rating Scale ◽  
Premature Delivery ◽  
Control Group ◽  
Third Trimester ◽  
Maternal Mood ◽  
Mood Symptoms ◽  
Increased Risk ◽  
Anxiety Levels ◽  
And Control

Background: Self-reported maternal mood symptoms during pregnancy have been related to poor birth outcomes, including low birth weight, increased risk of premature delivery, and preeclampsia in the mother. A non-pharmacology method is needed to overcome mood symptoms such as anxiety during pregnancy.Purpose: This research aimed to evaluate the effect of yoga relaxation on anxiety levels among pregnant women at third trimester.Methods: A quasy experimental design has been conducted with using 30 pregnant women at third trimester who were equally divided into two group (experimental and control). The levels of anxiety were measured using Hamilton Anxiety Rating Scale (HARS). Data were analyzed using descriptive and inferential statistic.Results: The results showed that there was a difference of anxiety levels before and after intervention within experiment group (t= 7.56, p= .005) and there was a difference of anxiety levels after the intervention between experiment and control group (t=-9.289, p= .005).Conclusion: Yoga relaxation has an effect on reducing anxiety levels among pregnant women at third trimester. It is expected that pregnant women more digging knowledge on how to deal with the anxiety disorder as practice the yoga relaxation during pregnancy.  

scholarly journals Obstetrical management of cancer in pregnancy and risk of adverse pregnancy and neonatal outcomes: a nationwide cohort study

2021 ◽  
Author(s):  
Iben Greiber ◽  
Jakob Viuff ◽  
Lene Mellemkjær ◽  
Cristel Hjortshøj ◽  
Ojvind Lidegaard ◽  
...  
Keyword(s):  
Cohort Study ◽  
Elective Caesarean Section ◽  
Neonatal Outcomes ◽  
Control Group ◽  
Increased Risk ◽  
Cancer In Pregnancy ◽  
Adverse Neonatal Outcomes ◽  
Adverse Pregnancy ◽  
Obstetrical Management ◽  
In Pregnancy

Objectives. To investigate the obstetrical management of cancer in pregnancy and to determine adverse pregnancy and neonatal outcomes. Design. A register-based nationwide historical prospective cohort study. Setting and population. We assessed all pregnancies (N = 4,071,848) in Denmark from 1 January 1973 to 31 December 2018. Methods. We linked data on maternal cancer, obstetrical, and neonatal outcomes. Exposure was defined as pregnancies exposed to maternal cancer (n = 1,068). The control group comprised pregnancies without cancer. The groups were compared using logistic regression analysis and adjusted for potential confounders. Main outcome Measures. The primary outcome was the iatrogenic termination of the pregnancy (induced abortions/labor induction or elective caesarean section). Secondary outcomes were adverse neonatal outcomes. Results. More women with cancer in pregnancy, as compared to the control group, experienced first-trimester induced abortion; adjusted odds ratio (aOR) 3.7 (95% CI 2.8─4.7), second-trimester abortion; aOR 9.0 (6.4─12.6), iatrogenic preterm delivery; aOR 10.9 (8.1─14.7), and iatrogenic delivery below 32 gestational weeks; aOR 16.5 (8.5─32.2). Neonates born to mothers with cancer in pregnancy had a higher risk of respiratory distress syndrome; aOR 1.5 (1.2─2.0), but not of low birth weight; aOR 0.6 (0.4─0.8), admission to neonatal intensive care unit more than seven days; aOR 1.4 (1.1─1.9), neonatal infection; aOR 0.9 (0.5─1.5) nor neonatal mortality; aOR1.3 (0.6─2.6). Conclusion. Cancer in pregnancy implies an increased risk of iatrogenic termination of pregnancy and iatrogenic premature birth. Neonates born to mothers with cancer in pregnancy had no increased risk of severe adverse neonatal outcomes.

Pathological features of the sequence in pregnant women with delayed fetal growth

2019 ◽  
pp. 50-54
Author(s):  
V.O. Golyanovskiy ◽  
◽  
Ye.O. Didyk ◽  
Keyword(s):  
Pregnant Women ◽  
Intrauterine Growth Restriction ◽  
Normal Development ◽  
Intrauterine Infection ◽  
Normal Pregnancy ◽  
Growth Restriction ◽  
Control Group ◽  
Intrauterine Growth ◽  
Increased Risk ◽  
Infection And Inflammation

Pregnant women with intrauterine growth restriction (IUGR) have an increased risk of adverse perinatal and long-term complications compared with the birth of children with normal body weight. Thus, IUGR is one of the main challenges for the global health system, especially in poor and developing countries. Morpho-functional studies of the placentas help in determining the causes of IUGR, and therefore, timely prevent complications in pregnant women with IUGR. The objective: The purpose of this study is to investigate various morphometric and pathomorphological changes in the placenta, including inflammatory, in cases of IUGR, and to establish a correlation of these results with the etiology and complications for the fetus. Materials and methods. In the current study, 54 placentas of the fetuses with IUGR (the main group) were compared with 50 placentas of the fetuses with normal development (control group). The criteria for the inclusion of IUGR were gestational age more than 30 weeks and all fetuses with a weight less than 10th percentile for this period of pregnancy. The placenta material was studied pathomorphologically with laboratory screening for infection and inflammation. Similarly, the results were determined for placentas of the fetuses with normal development compared to placentas with IUGR. Results. The placenta study showed the presence of calcification in the case of IUGR, as well as in the case of prolonged pregnancy. However, calcification of the placenta in the case of IUGR was more progressive compared with placenta in the normal pregnancy. In addition, the presence of intrauterine infection and inflammation was observed, which could also lead to an adverse outcome for the further progression of pregnancy with IUGR. Conclusion. A comparative macro- and microscopic pathomorphological study of the placentas in the two groups has shown a significant increase in the pathological changes in all the anatomical structures of the fetuses with IUGR. Key words: Intrauterine growth restriction (IUGR), fetal weight, pathomorphological changes of the placenta.

Optimisation of tactics of conducting pregnancy and labours at women after auxiliary reproductive technologies

2016 ◽  
pp. 160-164
Author(s):  
D.N. Maslo ◽  
Keyword(s):  
Pregnant Women ◽  
Resistance Index ◽  
First Trimester ◽  
Reproductive Technologies ◽  
Premature Delivery ◽  
Control Group ◽  
Uterine Arteries ◽  
Placental Dysfunction ◽  
Placental Blood ◽  
Two Stages

The objective: frequency decrease perinatal pathologies at women after ART on the basis of studying clinical-ehografical, endocrinological, biochemical, dopplerometrical, cardiotokografical and morphological researches, and also improvement of algorithm of diagnostic and treatment-and-prophylactic actions. Patients and methods. The work basis is made spent by us from 2012 on 2015 by complex inspection of 300 pregnant women from which 250 were after ART and 50 – firstlabours which pragnency without ART, and also their newborns. For the decision of an object in view of research spent to two stages. At 1 stage spent prosperctive research which included 150 pregnant women: з them 100 women pregnancy at which has come out ART (1 group) and 50 healthy women (control group). At 2 stage spent prospective randomization in which result of patients after ART have divided on two equal groups by therapy principle: 2 basic group - 75 pregnant women after ART at which used the algorithm improved by us; 3 group of comparison - 75 pregnant women after ART which have been spent on the standard treatment-and-prophylactic actions. Results. The results suggest that women after using ART is a high frequency of reproductive losses in the first trimester (10.0%), 3.0% of spontaneous abortion from 16 to 22 weeks, and 3.0% "early" premature delivery (22 to 28 weeks of pregnancy). The frequency of violations of the functional state of placenta in women after using IVF is 63.0%, which is the main cause of high levels of perinatal losses (40.0 ‰), and delivery by cesarean section (96.0%). Placental dysfunction in women after using ART characterized by retrohorialnyh hematoma (21.0%); size mismatch fruit (30.0%) and hypertonicity of the uterus (73.0%) against changes in fruit-placental blood flow - increased resistance index in umbilical artery and increased vascular resistance in the uterine arteries. Endocrinological and biochemical changes in placental dysfunction in women after using IVF starting from 28 weeks of pregnancy and are in significant reduction in progesterone, placental b1-microglobulin, B2-microglobulin of fertility and trophic в-glycoprotein. Conclusion. The received results: use of the algorithm of diagnostic and treatment-and-prophylactic actions improved by us allows to lower frequency of spontaneous interruption of pregnancy till 22 weeks – from 13.0% to 5.7%; «early» premature birth – from 3.0% to 1.0%; placentary dysfunction from 63.0% to 40.6%; cesarean sections – from 96.0% to 56.5%, and also perinatal losses – from 40.0‰ to 16.2‰. Key words: pregnancy, childbirth, auxiliary reproductive technologies.

scholarly journals Neurodevelopment in Children Exposed to Zika Virus: What Are the Consequences for Children Who Do Not Present with Microcephaly at Birth?

Viruses ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 1427
Author(s):  
Paula Sobral da Silva ◽  
Sophie Eickmann ◽  
Ricardo Ximenes ◽  
Celina Martelli ◽  
Elizabeth Brickley ◽  
...  
Keyword(s):  
Neurological Examination ◽  
Zika Virus ◽  
Control Group ◽  
P Value ◽  
Zikv Infection ◽  
Clinical Neurological Examination ◽  
Cognitive Delay ◽  
Increased Risk ◽  
Neurodevelopmental Impairment ◽  
The Impact

The relation of Zika virus (ZIKV) with microcephaly is well established. However, knowledge is lacking on later developmental outcomes in children with evidence of maternal ZIKV infection during pregnancy born without microcephaly. The objective of this analysis is to investigate the impact of prenatal exposure to ZIKV on neuropsychomotor development in children without microcephaly. We evaluated 274 children including 235 ZIKV exposed and 39 controls using the Bayley-III Scales of Infant and Toddler Development (BSIDIII) and neurological examination. We observed a difference in cognition with a borderline p-value (p = 0.052): 9.4% of exposed children and none of the unexposed control group had mild to moderate delays. The prevalence of delays in the language and motor domains did not differ significantly between ZIKV-exposed and unexposed children (language: 12.3% versus 12.8%; motor: 4.7% versus 2.6%). Notably, neurological examination results were predictive of neurodevelopmental delays in the BSIDIII assessments for exposed children: 46.7% of children with abnormalities on clinical neurological examination presented with delay in contrast to 17.8% among exposed children without apparent neurological abnormalities (p = 0.001). Overall, our findings suggest that relative to their unexposed peers, ZIKV-exposed children without microcephaly are not at considerably increased risk of neurodevelopmental impairment in the first 42 months of life, although a small group of children demonstrated higher frequencies of cognitive delay. It is important to highlight that in the group of exposed children, an abnormal neuroclinical examination may be a predictor of developmental delay. The article contributes to practical guidance and advances our knowledge about congenital Zika.

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