scholarly journals The effect of neighbourhood crime and deprivation on pregnancy outcomes. A quasi-experimental study using routine administrative records

2018 ◽  
Vol 3 (4) ◽  
Author(s):  
Tom Clemens ◽  
Chris Dibben
Keyword(s):  
Pregnancy Outcomes ◽  
Low Birthweight ◽  
Birth Outcome ◽  
Adverse Pregnancy Outcome ◽  
Adverse Outcomes ◽  
Area Deprivation ◽  
Cross Sectional ◽  
Neighbourhood Deprivation ◽  
Quasi Experimental ◽  
Adverse Pregnancy

IntroductionWe know that rates of adverse pregnancy outcome such as low birthweight and preterm births vary both by socio-economic status and across geographical areas. Furthermore, more deprived neighbourhoods show higher rates of adverse outcomes. However, much of the evidence comes from cross-sectional observational studies where causality is difficult to assess. Objectives and ApproachNeighbourhood crime and a resultant increase in maternal stress is a plausible explanation for the deprivation-birth outcome relationship. Without an experiment, isolating this pathway from other confounding effects is challenging. Because many mothers (within the Scottish maternity dataset) experience multiple pregnancies and varying exposure for the same person, we can assume a quasi-experimental allocation to exposure. We model associations as both within mother (comparing exposures between pregnancies to the same mother) and between mother (comparing different people between more and less deprived areas) partitioning the variation and effects accordingly. ResultsWe find that both composite neighbourhood deprivation and neighbourhood crime specifically is associated with reduced birthweight. However, the composite neighbourhood deprivation measure is only significant when modelled as a between mother effect. Neighbourhood crime on the other hand is significantly associated with both between mother and within mother effects (though the latter is reduced compared to the former). These results suggest that much of the observed relationship with deprivation in general is therefore confounded by factors associated with the composition of individuals in these areas rather than an area deprivation effect per se. In contrast, the association with neighbourhood crime can be considered in isolation from the composition of individuals and is therefore likely to be an independent “area” effect. Conclusion/ImplicationsThese results are important because outcomes of pregnancy including birthweight and premature births influence health and social outcomes not just in infancy but across the life course. This study suggests policies targeting neighbourhood crime may help to reduce neighbourhood disparities in pregnancy outcomes and therefore health inequalities in general.

scholarly journals Association Between Adverse Pregnancy Outcomes and Preceding Risk Factors: an Analytical Cross-Sectional Study

2021 ◽  
Author(s):  
Prakash Prabhakarrao Doke ◽  
Sonali Hemant Palkar ◽  
Jayashree Sachin Gothankar ◽  
Archana Vasantrao Patil ◽  
Amruta Paresh Chutke ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pregnancy Outcomes ◽  
Significant Risk ◽  
Tobacco Consumption ◽  
Adverse Pregnancy Outcomes ◽  
Adverse Outcomes ◽  
Mountainous Area ◽  
Cross Sectional ◽  
Heavy Work ◽  
Adverse Pregnancy

Abstract Background: The health of women during the preconception phase though critical, is a comparatively ignored part in her life cycle. The presence of health risks is judged as hazardous to the wellbeing of women and their forthcoming progeny. The study aimed to estimate the prevalence of various pregnancy outcomes and assess the association between various risk factors and adverse outcomes. Methods: It was a population-based cross-sectional analytical study. The study was carried out in Nashik District, having a large mountainous area. It included two randomly selected blocks, one tribal and one nontribal, in which interventions were planned in the later stage. For comparison, two adjacent blocks, one tribal and one nontribal, were also included. All women who had a pregnancy outcome in the preceding 12 months (01 April 2017 to 31 March 2018) were interviewed. Trained Accredited Social Health Activists under the direct supervision of Auxiliary Nurse Midwives and Medical Officers conducted the survey. Multivariate analysis was carried out to find the adjusted risk ratio of having a particular adverse outcome because of the specified potential risk factors.Results: A total of 9,307 women participated in the study. The prevalence of adverse pregnancy outcomes was abortion 4.1%; stillbirth 1.6%; preterm birth 4.1%; LBW 11.2%; congenital physical defect 2.6%. Prevalence of consanguineous marriage, heavy work during the last six months of pregnancy, pre-existing illness, tobacco consumption, direct exposure to pesticides and domestic violence during pregnancy was 17.6%; 16.9%; 2.2%; 5.6%; 2.3%; and 0.8%, respectively. Risk factors that were significantly associated with abortion include existing illness at the time of conception and performing heavy work in the last six months of pregnancy. Consanguinity, tobacco consumption during pregnancy and pre-existing illness were identified as risk factors for stillbirth. Significant risk factors of LBW were heavy work in the last six months of pregnancy, pre-existing illness and residence in a tribal area. Conclusion: The survey showed that risk factors differentially affect outcomes of pregnancy. Preconception and antenatal care should include counselling about consanguineous marriages, identifying and managing a pre-existing illness, avoiding tobacco consumption in the prenatal and natal period, and avoiding heavy work during pregnancy.

scholarly journals Does Multiparity Affect Periodontitis Associated Adverse Pregnancy Outcomes' Awareness?

2021 ◽  
pp. 359-370
Author(s):  
Mohamed Abdelrasoul ◽  
Bashayer Bahamdain ◽  
Raghad Hasanain ◽  
Renad Barayan ◽  
Nada Bugis ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Pregnancy Outcomes ◽  
Adverse Pregnancy Outcome ◽  
Oral Bacteria ◽  
Adverse Pregnancy Outcomes ◽  
University Education ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Validated Questionnaire ◽  
Adverse Pregnancy

Background: Periodontal disease is a very common, undesirable, and neglected bacterial infection causing destruction of the connective tissue and dental bone support. During pregnancy, the oral bacteria could lead to tissue damage and mediate immune response which can impair the development and fetal growth in the placenta that it may be a risk factor for pre-term birth (before 37 weeks of gestation). The goal of this study to measure the knowledge and awareness of women in Jeddah, Saudi Arabia toward the relation between periodontitis and adverse pregnancy outcome. Methodology: A cross-sectional study was done in Jeddah, Saudi Arabia from January 2020 until November 2021. based on a validated questionnaire developed by the authors. A convenience sample size of 966 women, aged 20-50 years, with a confidence level of 95%, and a 5% margin of error was selected. The questionnaire was divided into three main sections: demographics, knowledge and attitude. Results: The study showed a mean score of awareness of 3.801.26 (54.35 ± 17.98%) while the mean score of attitudes was 1.60 ± 0.98 (39.91 ± 24.42%). There was no statistically significant relationship to age group, nationality, or parity, however, scores were significant to university education level. Conclusion: Learning from previous multigravidas did not influence knowledge and awareness towards adverse pregnancy outcomes associated with PD.

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.

Placental Growth Factor and Adverse Obstetric Outcomes in a Mixed-Risk Cohort of Women Screened for Preeclampsia in the First Trimester of Pregnancy

2021 ◽  
pp. 1-9
Author(s):  
Charlotte Kvist Ekelund ◽  
Line Rode ◽  
Ann Tabor ◽  
Jon Hyett ◽  
Andrew McLennan
Keyword(s):  
Growth Factor ◽  
Pregnancy Outcomes ◽  
Gestational Hypertension ◽  
Adverse Pregnancy Outcome ◽  
First Trimester ◽  
Placental Growth Factor ◽  
Adverse Pregnancy Outcomes ◽  
Adverse Outcomes ◽  
Obstetric Outcomes ◽  
Adverse Pregnancy

<b><i>Objective:</i></b> The study aimed to investigate the association between placental growth factor (PlGF) and adverse obstetric outcomes in a mixed-risk cohort of pregnant women screened for preeclampsia (PE) in the first trimester. <b><i>Methods:</i></b> We included women with singleton pregnancies screened for PE between April 2014 and September 2016. Outcome data were retrieved from the New South Wales Perinatal Data Collection (NSW PDC) by linkage to the prenatal cohort. Adverse outcomes were defined as spontaneous preterm birth (sPTB) before 37-week gestation, birth weight (BW) below the 3rd centile, PE, gestational hypertension (GH), stillbirth, and neonatal death. <b><i>Results:</i></b> The cohort consisted of 11,758 women. PlGF multiple of the median (MoM) was significantly associated with maternal sociodemographic characteristics (particularly smoking status and parity) and all biomarkers used in the PE first trimester screening model (notably pregnancy-associated plasma protein A MoM and uterine artery pulsatility index [PI] MoM). Low levels of PlGF (&#x3c;0.3 MoM and &#x3c;0.5 MoM) were independently associated with sPTB, low BW, PE, GH, and a composite adverse pregnancy outcome score, with odds ratios between 1.81 and 4.44 on multivariable logistic regression analyses. <b><i>Conclusions:</i></b> Low PlGF MoM levels are independently associated with PE and a range of other adverse pregnancy outcomes. Inclusion of PlGF should be considered in future models screening for adverse pregnancy outcomes in the first trimester.

scholarly journals Associations between periconceptional lifestyle behaviours and adverse pregnancy outcomes

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Veronique Y.F. Maas ◽  
Marjolein Poels ◽  
Marije Lamain-de Ruiter ◽  
Anneke Kwee ◽  
Mireille N. Bekker ◽  
...  
Keyword(s):  
Folic Acid ◽  
Pregnancy Outcomes ◽  
Adverse Pregnancy Outcome ◽  
First Trimester ◽  
Adverse Pregnancy Outcomes ◽  
Adverse Outcomes ◽  
Normal Body Mass Index ◽  
Lifestyle Behaviours ◽  
Folic Acid Supplements ◽  
Adverse Pregnancy

Abstract Background While the potential adverse outcomes of prenatal exposure to unhealthy lifestyle are widely evidenced, little is known about these exposures in the periconception period. We investigated the associations between lifestyle behaviours and adverse pregnancy outcomes with a unique distinction between preconceptional- and prenatal lifestyle behaviours. Methods A secondary analysis took place within a prospective multicentre cohort study in the Netherlands, including 3,684 pregnant women. Baseline characteristics and preconceptional and first trimester lifestyle behaviours were assessed through a self-administered questionnaire in the first trimester. Adverse pregnancy outcomes (hypertensive disorders in pregnancy (HDP), small for gestational age (SGA), gestational diabetes (GDM) and spontaneous preterm birth (sPTB)) were reported by healthcare professionals. Data were collected between 2012 and 2014 and analysed using multivariate logistic regression. Results Women who are overweight, and especially obese, have the highest odds of developing any adverse pregnancy outcome (adjusted odds ratio (aOR) 1.61 (95 % Confidence Interval (CI) 1.31–1.99) and aOR 2.85 (95 %CI 2.20–3.68), respectively), particularly HDP and GDM. Women who prenatally continued smoking attained higher odds for SGA (aOR 1.91 (95 %CI 1.05–1.15)) compared to the reference group, but these odds decreased when women prenatally quit smoking (aOR 1.14 (95 %CI 0.59–2.21)). Women who did not use folic acid supplements tended to have a higher odds of developing adverse pregnancy outcomes (aOR 1.28 (95 %CI 0.97–1.69)), while women who prenatally started folic acid supplements did not (aOR 1.01 (95 %CI 0.82–1.25)). Conclusions Our results indicate that smoking cessation, having a normal body mass index (BMI) and initiating folic acid supplements preconceptionally may decrease the risk of adverse pregnancy outcomes. Therefore, intervening as early as the preconception period could benefit the health of future generations.

scholarly journals Maternal and perinatal outcomes of asylum seekers and undocumented migrants in Europe: a systematic review

2019 ◽  
Vol 29 (4) ◽  
pp. 714-723 ◽  
Author(s):  
Noor C Gieles ◽  
Julia B Tankink ◽  
Myrthe van Midde ◽  
Johannes Düker ◽  
Peggy van der Lans ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pregnancy Outcomes ◽  
Asylum Seekers ◽  
Low Birthweight ◽  
Grey Literature ◽  
Perinatal Outcomes ◽  
Adverse Outcomes ◽  
Health Determinants ◽  
Undocumented Migrants ◽  
Adverse Pregnancy

Abstract Background Asylum seekers (AS) and undocumented migrants (UM) are at risk of adverse pregnancy outcomes due to adverse health determinants and compromised maternal healthcare access and service quality. Considering recent migratory patterns and the absence of a robust overview, a systematic review was conducted on maternal and perinatal outcomes in AS and UM in Europe. Methods Systematic literature searches were performed in MEDLINE and EMBASE (until 1 May 2017), complemented by a grey literature search (until 1 June 2017). Primary research articles reporting on any maternal or perinatal outcome, published between 2007 and 2017 in English/Dutch were eligible for inclusion. Review protocols were registered on Prospero: CRD42017062375 and CRD42017062477. Due to heterogeneity in study populations and outcomes, results were synthesized narratively. Results Of 4652 peer-reviewed articles and 145 grey literature sources screened, 11 were included from 4 European countries. Several studies reported adverse outcomes including higher maternal mortality (AS), severe acute maternal morbidity (AS), preterm birth (UM) and low birthweight (UM). Risk of bias was generally acceptable, although the limited number and quality of some studies preclude definite conclusions. Conclusion Limited evidence is available on pregnancy outcomes in AS and UM in Europe. The adverse outcomes reported imply that removing barriers to high-quality maternal care should be a priority. More research focussing on migrant subpopulations, considering potential risk factors such as ethnicity and legal status, is needed to guide policy and optimize care.

scholarly journals Knowledge, Attitudes and Practice Behaviour of Midwives Concerning Periodontal Health of Pregnant Patients

2020 ◽  
Vol 17 (7) ◽  
pp. 2246
Author(s):  
Jennifer Gia-linh Nguyen ◽  
Shanika Nanayakkara ◽  
Alexander C. L. Holden
Keyword(s):  
Oral Health ◽  
Pregnancy Outcomes ◽  
Interprofessional Education ◽  
Low Birthweight ◽  
Statistical Tests ◽  
Online Questionnaire ◽  
Periodontal Health ◽  
Cross Sectional ◽  
Adverse Pregnancy ◽  
Gum Disease

Maternal gum disease is associated with adverse pregnancy outcomes such as preterm birth and low birthweight. This study aims to evaluate the knowledge, attitudes and practice behaviour of Australian midwives regarding the periodontal health of pregnant women to inform interprofessional antenatal care. This was an observational, cross-sectional study. We circulated an online questionnaire to Australian midwives from August 2018 to February 2019. Key outcome variables were knowledge, attitudes, and practice behaviours related to oral health. Key predictor variables were years of practice, practice location, and dental history. We summarized responses with frequency tables and assigned tallied scores for analysis using non-parametric statistical tests. 100 responses were analysed, including from rural (n = 23) and urban (n = 77) midwives. Eighty percent of midwives agreed that maternal dental care can positively affect pregnancy outcomes. Fluoridated toothpaste use (19.1%) was incorrectly answered to prevent gum disease more often than psychological stress control (7.9%), a correct answer. Rural midwives demonstrated a significantly higher knowledge score (p = 0.001) and significantly more positive practice behaviours towards oral health (p = 0.014) than urban midwives. Australian midwives have positive attitudes towards antenatal oral health but misunderstand gum disease aetiology and prevention. This study highlights areas to improve interprofessional education for optimal oral health and pregnancy outcomes.

Reproductive health issues in patients with psoriasis (literature review)

2019 ◽  
Vol 1 (7) ◽  
pp. 5-8
Author(s):  
L. S. Kruglova ◽  
A. A. Osina ◽  
A. A. Khotko
Keyword(s):  
Drug Therapy ◽  
Reproductive Health ◽  
Literature Review ◽  
Pregnancy Outcomes ◽  
Adverse Pregnancy Outcome ◽  
Certolizumab Pegol ◽  
Genetically Engineered ◽  
Health Issues ◽  
Degree Of Confidence ◽  
Adverse Pregnancy

Among patients with psoriasis, approximately 50% are women and almost 75 % of them are under the age of 40 years. Thus, most women with psoriasis have childbearing potential. When pregnancy occurs in 22 % of patients, the activity of psoriasis persists, characteristic of the course before pregnancy, in 23 % of women, the course of the disease worsens. The article provides up-to-date data on the management of pregnant patients with psoriasis. To improve pregnancy outcomes in patients with psoriasis, it is important to prevent exacerbation of the disease. The choice of drug therapy in this case is based on an assessment of the ratio of the risk of undesirable effects of the drugs on the developing fetus and the risk of the development of exacerbation of psoriasis, which can cause an adverse pregnancy outcome. Despite the fact that the available clinical experience of using genetically engineered drugs is still limited, with a certain degree of confidence we can say that there is no increase in the risk of adverse pregnancy outcomes associated with therapy with certolizumab pegol.

Neonatal outcome in pregnant patients with antiphospholipid syndrome

2015 ◽  
Vol 43 (6) ◽  
Author(s):  
Katarina Jeremic ◽  
Aleksandar Stefanovic ◽  
Jelena Dotlic ◽  
Jelena Stojnic ◽  
Sasa Kadija ◽  
...  
Keyword(s):  
Risk Factors ◽  
Respiratory Distress Syndrome ◽  
Pregnancy Outcome ◽  
Pregnancy Outcomes ◽  
Distress Syndrome ◽  
Adverse Pregnancy Outcome ◽  
Perinatal Asphyxia ◽  
Premature Delivery ◽  
Control Group ◽  
Adverse Pregnancy

AbstractThe study aim was to evaluate pregnancy outcomes in patients with antiphospholipid syndrome (APS) and to determine which clinical parameters present risk factors for adverse pregnancy outcomes in these patients.The study included 55 patients with APS treated at the Clinic for Ob/Gyn, Clinical Center of Serbia, from 2006 to 2012. The control group consisted of 55 healthy pregnant women. Data regarding previous pregnancies and conception method were registered. Immunological and laboratory tests were performed. Pregnancy outcomes, including miscarriage, intrauterine fetal death, hypertensive disorders, diabetes mellitus, phlebothrombosis, fetal growth restriction, premature delivery, delivery method, perinatal asphyxia, respiratory distress syndrome, intraventricular hemorrhage, and necrotizing enterocolitis were followed.The premature delivery rate in APS patients was 31.8%, and pregnancy loss was 18.2%. Significantly more patients with APS had thrombocytopenia, pregnancy losses, intrauterine growth restriction, and perinatal asphyxia compared with the control group. More miscarriages, preterm delivery, lower birth weight, preeclampsia, and IgM anticardiolipin antibody levels significantly correlated with adverse pregnancy outcomes. Although rare, respiratory distress syndrome can also worsen neonatal health status. According to ROC analysis, previous miscarriages correctly explained 66.3% of adverse pregnancy outcome cases. We generated four equations of adverse pregnancy outcome risk factors.The most important prognostic factor for pregnancy outcome in APS patients is the number of previous miscarriages. Using appropriate current therapeutic protocol can enable live birth of a healthy newborn in most cases.

scholarly journals Dengue in Pregnancy

2019 ◽  
Vol 34 (1) ◽  
pp. 36-42
Author(s):  
Sameena Chowdhury ◽  
Sharmin Abbasi
Keyword(s):  
Adverse Effects ◽  
Dengue Fever ◽  
Pregnancy Outcomes ◽  
Adverse Outcomes ◽  
Severe Dengue ◽  
Management Guideline ◽  
Serious Infection ◽  
Adverse Pregnancy ◽  
Day By Day ◽  
In Pregnancy

Dengue fever during pregnancy is increasing day by day in Bangladesh. The knowledge of adverse effects on mother and neonate remains limited and there are also lack of management guideline in this regard. Mortality rate for severe dengue fever is 0.8–2.5%, and pregnancy should be considered as a coexisting risk factor for serious infection. However, the maternal and fetal outcomes not fully understood. Some review articles on outcomes of neonates born to mother with dengue fever was reported, and demonstrated that preterm birth and low birth weight were the most common adverse pregnancy outcomes; however, dengue fever was not significantly associated with these adverse outcomes, suggesting that symptomatic dengue fever may indicate risk. Other adverse effects such as stillbirth or postpartum hemorrhage (PPH) remain unclear. Therefore, we aimed to brief review of recent management guideline of OGSB about dengue fever in pregnancy. Bangladesh J Obstet Gynaecol, 2019; Vol. 34(1): 36-42

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