Comparison of obstetric outcomes of pregnant women with isolated proteinuria according to proteinuria severity

Good maternal nutrition is key to optimal maternal and foetal health. A poor-quality diet is often associated with obesity, and the prevalence and severity of maternal obesity has increased significantly in recent years. This study observed dietary intakes in pregnant women living with obesity and assessed the quality of their diet. In total, 140 women with a singleton pregnancy, aged > 18 years and BMI ≥ 35 kg/m2, were recruited from antenatal clinics, weighed and completed food diaries at 16-, 28- and 36-weeks’ gestation. Clinical data were recorded directly from the women’s medical records. Nutrient intake was determined using ‘MicrodietTM’, then compared to Dietary Reference Values (DRVs). Energy intakes were comparable with DRVs, but intakes of sugar and saturated fatty acids were significantly higher. Intake of fibre and several key micronutrients (Iron, Iodine, Folate and Vitamin D) were significantly low. Several adverse obstetric outcomes were higher than the general obstetric population. Women with obesity, often considered ‘over nourished’, may have diets deficient in essential micronutrients, often associated with poor obstetric outcomes. To address the intergenerational transmission of poor health via poor diets warrants a multi-disciplinary approach focusing away from ‘dieting’ onto positive messages, emphasising key nutrients required for good maternal and foetal health.

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The relation between second-trimester placental elasticity and poor obstetric outcomes in low-risk pregnancies

Journal of Perinatal Medicine ◽

10.1515/jpm-2020-0464 ◽

2020 ◽

Vol 0 (0) ◽

Author(s):

Murat Akbas ◽

Faik Mumtaz Koyuncu ◽

Burcu Artunç-Ülkümen ◽

Gökce Akbas

Keyword(s):

Birth Weight ◽

Pregnant Women ◽

Value Added ◽

Shear Wave Elastography ◽

Multiple Regression Model ◽

Low Risk ◽

Obstetric Outcomes ◽

Second Trimester ◽

The Mean ◽

Random Measurements

AbstractObjectivesIncreased placental stiffness is associated with various pathological conditions. Our objective was to evaluate the relation between the second-trimester placental elasticity value in low-risk pregnant women and poor obstetric outcomes.MethodsA total of 143 pregnant women were enrolled. Placental elasticity values were measured using the transabdominal point shear wave elastography method. 10 random measurements were obtained from different areas of the placenta. The mean was accepted as the mean placental elasticity value. Logistic regression analyses were performed to identify independent variables associated with obstetric outcomes.ResultsSecond-trimester placental elasticity value was significantly and positively associated with the poor obstetric outcomes (p=0.038). We could predict a poor outcome with 69.2% sensitivity and 60.7% specificity if we defined the placental elasticity cut-off as 3.19 kPa. Furthermore, in the multiple regression model, the placental elasticity value added significantly to the prediction of birth weight (p=0.043).ConclusionsOur results showed that the pregnancies with a stiffer placenta in the second trimester were associated with an increased likelihood of exhibiting poor obstetric outcomes. Also, placental elasticity was independently associated with birth weight.

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The presence of lupus nephritis additionally increases the risk of preeclampsia among pregnant women with systemic lupus erythematosus

Lupus ◽

10.1177/09612033211004716 ◽

2021 ◽

pp. 096120332110047

Author(s):

Katarina Bremme ◽

Sonja Honkanen ◽

Iva Gunnarsson ◽

Roza Chaireti

Keyword(s):

Caesarean Section ◽

Lupus Nephritis ◽

Pregnant Women ◽

Lupus Erythematosus ◽

Premature Birth ◽

Renal Involvement ◽

Significant Risk ◽

Obstetric Outcomes ◽

Increased Risk ◽

Renal Lupus

Introduction Pregnant women with systematic lupus erythematosus (SLE) have an increased risk of obstetric complications, such as preeclampsia and premature births. Previous studies have suggested that renal involvement could further increase the risk for adverse obstetric outcomes. Aims: The aim of this study was to compare the obstetric outcomes in a Swedish cohort of patients with SLE with and without lupus nephritis (LN). Patients and methods The study was conducted as a retrospective observational study on 103 women with SLE, who gave birth at the Karolinska University Hospital between the years 2000-2017. Thirty-five women had previous or active LN and 68 women had non-renal lupus. Data was collected from digital medical records. The outcomes that were analysed included infants born small for gestational age (SGA), premature birth, preeclampsia, SLE- or nephritis flare and caesarean section. Results Women with LN, both with previous and with renal flare during pregnancy suffered from pre-eclampsia more often compared to women with non-renal lupus (25.7% vs 2.9%, p = 0.001) and this complication was associated with premature birth (p = 0.021) and caesarean section (p = 0.035). Conclusions Lupus nephritis is a significant risk factor for adverse obstetric outcomes in women with SLE, including preeclampsia. Those patients could benefit from more frequent antenatal controls and more vigorous follow-up.

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COVID-19: Uncertainties from Conception to Birth

Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics ◽

10.1055/s-0040-1721856 ◽

2021 ◽

Vol 43 (01) ◽

pp. 054-060

Author(s):

Bruno Ramalho de Carvalho ◽

Karina de Sá Adami ◽

Walusa Assad Gonçalves-Ferri ◽

Marise Samama ◽

Rui Alberto Ferriani ◽

...

Keyword(s):

Pregnant Women ◽

Present Article ◽

Vertical Transmission ◽

Scientific Information ◽

Obstetric Outcomes ◽

Reproductive Events ◽

The Impact ◽

Initial Impressions ◽

Quality Evidence

AbstractScientific information on the impact of the new coronavirus (SARS-CoV-2) on the health of pregnant women, fetuses and newborns is considered of limited confidence, lacking good-quality evidence, and drawing biased conclusions. As a matter of fact, the initial impressions that the evolution of COVID-19 was no different between pregnant and non-pregnant women, and that SARS-CoV-2 was not vertically transmitted, are confronted by the documentation of worsening of the disease during pregnancy, poor obstetric outcomes, and the possibility of vertical transmission. The present article aims to compile the data available on the association of COVID-19 and reproductive events, from conception to birth.

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Multidisciplinary Unit Improves Pregnancy Outcomes in Women with Rheumatic Diseases and Hereditary Thrombophilias: An Observational Study

Journal of Clinical Medicine ◽

10.3390/jcm10071487 ◽

2021 ◽

Vol 10 (7) ◽

pp. 1487

Author(s):

Isabel Añón-Oñate ◽

Rafael Cáliz-Cáliz ◽

Carmen Rosa-Garrido ◽

María José Pérez-Galán ◽

Susana Quirosa-Flores ◽

...

Keyword(s):

High Risk ◽

Observational Study ◽

Medical Care ◽

Pregnant Women ◽

Rheumatic Diseases ◽

Absolute Risk ◽

University Hospital ◽

Obstetric Outcomes ◽

Number Needed To Treat ◽

Foetal Death

Rheumatic diseases (RD) and hereditary thrombophilias (HT) can be associated with high-risk pregnancies. This study describes obstetric outcomes after receiving medical care at a multidisciplinary consultation (MC) and compares adverse neonatal outcomes (ANOs) before and after medical care at an MC. This study is a retrospective observational study among pregnant women with RD and HT treated at an MC of a university hospital (southern Spain) from 2012 to 2018. Absolute risk reduction (ARR) and number needed to treat (NNT) were calculated. A total of 198 pregnancies were registered in 143 women (112 with RD, 31 with HT), with 191 (96.5%) pregnancies without ANOs and seven (3.5%) pregnancies with some ANOs (five miscarriages and two foetal deaths). Results previous to the MC showed 60.8% of women had more than one miscarriage, with 4.2% experiencing foetal death. MC reduced the ANO rate by AAR = 60.1% (95%CI: 51.6−68.7%). The NNT to avoid one miscarriage was 1.74 (95%CI: 1.5–2.1) and to avoid one foetal death NNT = 35.75 (95CI%: 15.2–90.9). A total of 84.8% of newborns and 93.2% of women did not experience any complication. As a conclusion, the follow-up of RD or HT pregnant women in the MC drastically reduced the risk of ANOs in this population with a previous high risk.

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Cohort profile: the Chinese Pregnant Women Cohort Study and Offspring Follow-up (CPWCSaOF)

BMJ Open ◽

10.1136/bmjopen-2020-044933 ◽

2021 ◽

Vol 11 (3) ◽

pp. e044933

Author(s):

Tianchen Lyu ◽

Yunli Chen ◽

Yongle Zhan ◽

Yingjie Shi ◽

Hexin Yue ◽

...

Keyword(s):

Cohort Study ◽

Pregnant Women ◽

First Trimester ◽

Health Problems ◽

Environmental Data ◽

Geographical Information ◽

Obstetric Outcomes ◽

Factors Affecting ◽

Link Type

PurposeA multicentre prospective cohort study, known as the Chinese Pregnant Women Cohort Study (CPWCS), was established in 2017 to collect exposure data during pregnancy (except environmental exposure) and analyse the relationship between lifestyle during pregnancy and obstetric outcomes. Data about mothers and their children’s life and health as well as children’s laboratory testing will be collected during the offspring follow-up of CPWCS, which will enable us to further investigate the longitudinal relationship between exposure in different periods (during pregnancy and childhood) and children’s development.Participants9193 pregnant women in 24 hospitals in China who were in their first trimester (5–13 weeks gestational age) from 25 July 2017 to 26 November 2018 were included in CPWCS by convenience sampling. Five hospitals in China which participated in CPWCS with good cooperation will be selected as the sample source for the Chinese Pregnant Women Cohort Study (Offspring Follow-up) (CPWCS-OF).Findings to dateSome factors affecting pregnancy outcomes and health problems during pregnancy have been discovered through data analysis. The details are discussed in the ‘Findings to date’ section.Future plansInfants and children and their mothers who meet the criteria will be enrolled in the study and will be followed up every 2 years. The longitudinal relationship between exposure (questionnaire data, physical examination and biospecimens, medical records, and objective environmental data collected through geographical information system and remote sensing technology) in different periods (during pregnancy and childhood) and children’s health (such as sleeping problem, oral health, bowel health and allergy-related health problems) will be analysed.Trail registration numberCPWCS was registered with ClinicalTrials.gov on 18 January 2018: NCT03403543. CPWCS-OF was registered with ClinicalTrials.gov on 24 June 2020: NCT04444791.

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Author Correction: Obstetric outcomes in pregnant women with and without depression: population-based comparison

Scientific Reports ◽

10.1038/s41598-018-35248-z ◽

2018 ◽

Vol 8 (1) ◽

Cited By ~ 1

Author(s):

Hui-Chun Huang ◽

Fung-Chang Sung ◽

Pei-Chun Chen ◽

Cherry Yin-Yi Chang ◽

Chih-Hsin Muo ◽

...

Keyword(s):

Pregnant Women ◽

Population Based ◽

Obstetric Outcomes

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Heparin Use in Pregnant Women Diagnosed With Thrombophilia: Obstetric Outcomes

10.35248/2090-7214.19.16.331 ◽

2019 ◽

Vol 16 (4) ◽

Cited By ~ 1

Author(s):

Julio Rezende de Andrade ◽

Marina Valadao Camargos ◽

Mateus Figueiredo de Rezende Reis ◽

Ricardo Augusto Barcelos Maciel ◽

Tamara Teixeira Mello ◽

...

Keyword(s):

Pregnant Women ◽

Obstetric Outcomes

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Obstetric outcomes of women referred for delivery to a tertiary hospital in northern Tanzania– a descriptive retrospective study based on a hospital birth registry

10.21203/rs.2.24072/v1 ◽

2020 ◽

Author(s):

Carolyn Lissu ◽

Helena Volgsten ◽

Festu Mazuguni ◽

Eusebious Maro

Keyword(s):

Retrospective Study ◽

Pregnant Women ◽

Tertiary Hospital ◽

Health Facilities ◽

Obstetric Outcomes ◽

Birth Registry ◽

Maternal Deaths ◽

Hospital Birth ◽

Northern Tanzania ◽

Lower Health

Abstract Background: Maternal mortality remains a great challenge in a low-income country like Tanzania, despite global and national efforts to improve women’s reproductive health. Timeliness and appropriateness of referral from a lower- to higher-level health facility comprise an important factor for the obstetrics outcome for pregnant women. This study aimed to determine the obstetric outcomes, such as maternal deaths, of women referred to KCMC, a tertiary hospital in northern Tanzania. Methods: A descriptive retrospective study based on a hospital birth registry was conducted, using consecutive stored data on pregnant women referred while in labor and managed at the KCMC tertiary hospital in northern Tanzania between the years 2000 and 2015. All referred pregnant women whose labor status information was missing during admission were excluded from the study. Results: During the study period, a total of 53662 deliveries were managed at KCMC. Among these, 6066 women were referred from lower health facilities, with 4193 (69.2%) of them being referred while in labor. The main reason for referral was poor progress of labor (31.0%), followed by prolonged labor (27.1%) and obstructed labor (19.5%). For 1859 (44.6%) women, delivery was by caesarean section. A total of 292 maternal deaths occurred between 2000 and 2015. Of these, almost a quarter (22.6%) occurred in women referred from other health facilities while in labor. Conclusions: Most of the maternal complications during labor and delivery were prevalent among women referred from lower health facilities. This underscores the need to strengthen lower health facilities’ ability to detect complications in timely manner and provide effective emergency obstetric care, as well as to refer women to higher-level facility.

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An Analysis of 38 Pregnant Women With COVID-19, Their Newborn Infants, and Maternal-Fetal Transmission of SARS-CoV-2: Maternal Coronavirus Infections and Pregnancy Outcomes

Archives of Pathology & Laboratory Medicine ◽

10.5858/arpa.2020-0901-sa ◽

2020 ◽

Vol 144 (7) ◽

pp. 799-805 ◽

Cited By ~ 241

Author(s):

David A. Schwartz

Keyword(s):

Pregnant Women ◽

Pregnancy Outcomes ◽

Viral Infections ◽

Clinical Laboratory ◽

Newborn Infants ◽

Public Health Problem ◽

Obstetric Outcomes ◽

Maternal Fetal Transmission ◽

Novel Coronavirus ◽

Coronavirus Infections

The emergence of a novel coronavirus, termed SARS-CoV-2, and the potentially life-threatening respiratory disease that it can produce, COVID-19, has rapidly spread across the globe, creating a massive public health problem. Previous epidemics of many emerging viral infections have typically resulted in poor obstetric outcomes including maternal morbidity and mortality, maternal-fetal transmission of the virus, and perinatal infections and death. This article reviews the effects of 2 previous coronavirus infections—severe acute respiratory syndrome (SARS) caused by SARS-CoV and Middle East respiratory syndrome (MERS) caused by MERS-CoV—on pregnancy outcomes. In addition, it analyzes literature describing 38 pregnant women with COVID-19 and their newborns in China to assess the effects of SARS-CoV-2 on the mothers and infants, including clinical, laboratory, and virologic data, and the transmissibility of the virus from mother to fetus. This analysis reveals that unlike coronavirus infections of pregnant women caused by SARS and MERS, in these 38 pregnant women COVID-19 did not lead to maternal deaths. Importantly, and similar to pregnancies with SARS and MERS, there were no confirmed cases of intrauterine transmission of SARS-CoV-2 from mothers with COVID-19 to their fetuses. All neonatal specimens tested, including placentas in some cases, were negative by RT-PCR for SARS-CoV-2. At this point in the global pandemic of COVID-19 infection there is no evidence that SARS-CoV-2 undergoes intrauterine or transplacental transmission from infected pregnant women to their fetuses. Analysis of additional cases is necessary to determine if this remains true.

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