scholarly journals OBSTETRIC OUTCOMES

2011 ◽  
Vol 18 (01) ◽  
pp. 11-17
Author(s):  
FOUZIA YASMEEN ◽  
NABEELA SHAMI ◽  
WASEEM TALIB

Objectives: To compare obstetric outcomes in the pregnancy subsequent to still birth with that following live birth in first pregnancy. Data Source: Medline data base. Study Design: Prospective cohort study. Setting: Ghurki Trust Teaching Hospital Lahore. Materials & Methods: The study included women who delivered a stillbirth between 2005 - 2007(exposed cohort). A group of women with live birth (unexposed cohort) was matched for delivery within the same year, maternal age (+/- 3 years), parity (+/- 1). In 2009, the charts of these women were examined for subsequent pregnancies. Main outcome measures Maternal and neonatal outcomes in the second pregnancy, pre eclampsia, placental abruption, labour induction, instrumental delivery, caesarean delivery, malpresentation, prematurity, low birthweight and stillbirth. Results: The exposed cohort group B (n =50) was at increased risk of preeclampsia (44% versus 28%, p value = 0.001<0.05) and placental abruption (20% versus 2%) and malpresentation (18% versus 4%). labour induction (20% versus 8%) instrumental delivery (16%versus 8%) and emergency caesarean (40%versus 16%); and prematurity (62%versus 26%, p value = 0.001<0.05), low birthweight (86% versus 54%, p value = 0.000<0.05) and stillbirths (6% versus 2%, p value = 0.489>0.05) of the infant as compared with the unexposed cohort group A (n =50). Conclusions: Majority of women with a previous stillbirth have a live birth in the subsequent pregnancy, they are a highrisk group with an increased incidence of adverse maternal and neonatal outcomes.

2021 ◽  
Vol 38 (05) ◽  
pp. 515-522
Author(s):  
Marissa Berry ◽  
Amanda Wang ◽  
Shannon M. Clark ◽  
Hassan M. Harirah ◽  
Sangeeta Jain ◽  
...  

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


Author(s):  
Ximena Camacho ◽  
Alys Havard ◽  
Helga Zoega ◽  
Margaret Wilson ◽  
Tara Gomes ◽  
...  

IntroductionRecent evidence from the USA and Nordic countries suggests a possible association between psychostimulant use during gestation and adverse pregnancy and birth outcomes. Objectives and ApproachWe employed a distributed cohort analysis using linked administrative data for women who gave birth in New South Wales (NSW; Australia) and Ontario (Canada), whereby a common protocol was implemented separately in each jurisdiction. The study population comprised women who were hospitalized for a singleton delivery over an 8 (NSW) and 4 (Ontario) year period, respectively, with the NSW cohort restricted to social security beneficiaries. Psychostimulant exposure was defined as at least one dispensing of methylphenidate, amphetamine, dextroamphetamine or lisdexamfetamine during pregnancy. We examined the risk of maternal and neonatal outcomes among psychostimulant exposed mothers compared with unexposed mothers. ResultsThere were 140,356 eligible deliveries in NSW and 449,499 in Ontario during the respective study periods. Fewer than 1% of these pregnancies were exposed to psychostimulants during gestation, although use was higher in Ontario (0.30% vs 0.11% in NSW). Preliminary unadjusted analyses indicated possible associations between psychostimulant use in pregnancy and higher risks of pre-term birth (relative risk [RR] 1.7, 95% confidence interval [CI] 1.4-2.0 (Ontario); RR 1.8, 95% CI 1.2-2.6 (NSW)) and pre-eclampsia (RR 2.0, 95% CI 1.5-2.6 (Ontario); RR 2.0, 95% CI 1.2-3.5 (NSW)). Similarly, psychostimulant use was associated with higher risks of low birthweight (RR 1.6, 95% CI 1.3-1.9 (Ontario); RR 2.0, 95% CI 1.3-3.0 (NSW)) and admission to neonatal intensive care (RR 2.1, 95% CI 1.9-2.3 (Ontario); RR 1.5, 95% CI 1.1-1.9 (NSW)). Conclusion / ImplicationsUnadjusted analyses indicate an increased risk of adverse maternal and birth outcomes associated with psychostimulant exposure during pregnancy, potentially representing a placental effect. We are currently refining the analyses, employing propensity score methods to adjust for confounding.


2019 ◽  
Vol 33 (22) ◽  
pp. 3775-3783
Author(s):  
Kazuma Onishi ◽  
Hiroyuki Tsuda ◽  
Kazuya Fuma ◽  
Momoko Kuribayashi ◽  
Atsuko Tezuka ◽  
...  

2020 ◽  
Author(s):  
Qiang WEI ◽  
Qin-yan CAO ◽  
Li ZHANG ◽  
Yi XU ◽  
Mei-fan DUAN

Abstract Backgroud: When labour induction should be offered to women at or beyond term is unclear. This work aimed to investigate the effects of the timing of labour induction on maternal and neonatal outcomes in low-risk pregnancies. Methods: This retrospective case-control study involved low-risk primigravid pregnant mothers in whom labour was induced at 40-41+6 weeks at our two hospitals between January and December 2017. According to the gestational age at labour induction, participants were categorized into the study group (40-40+6 weeks, n=284) or to the control group (41-41+6 weeks, n=172), and maternal and neonatal outcomes were compared.Results: The study group showed significantly shorter labour in the first stage (391.8±225.7 vs. 472.0±268.9 min, P=0.006), second stage (65.41±38.66 vs. 53.73±31.58 min, P= 0.008) and total stage (453.0±235.8 vs. 535.7±259.8 min, P=0.005). The two groups showed no significant differences in the methods of labour induction or in the rates of failure of labour induction, of caesarean delivery, of postpartum haemorrhage, or of admission to the neonatal intensive care unit.Conclusions: Our retrospective study suggests that inducing labour at 40-40+6 weeks does not increase the risk of adverse maternal or foetal outcomes, and that it shortens labour. These results suggest that labor induction at 40-40+6 weeks was feasible for low-risk primiparas.Trial registration: The research has been approved by the Ethics Committee of West China Second Hospital of Sichuan University and Chengdu Women and Children's Central Hospital, China. Patients gave written informed consent for their anonymized medical data to be analyzed and published for research purposes.


2020 ◽  
Author(s):  
Giovanna Esposito ◽  
Matteo Franchi ◽  
Michela Dalmartello ◽  
Giovanna Scarfone ◽  
Eva Negri ◽  
...  

Abstract Background: Pregnancy associated cancer (PAC) may lead to adverse obstetric and neonatal outcomes. This study aims to assess the association between PACs and adverse perinatal outcomes [i.e. labor induction, iatrogenic delivery, preterm birth, small for gestational age (SGA) newborn, low Apgar score, major malformations, perinatal mortality] in Lombardy, Northern Italy. Methods: This population-based historic cohort study used the certificate of delivery assistance and the regional healthcare utilization databases of Lombardy Region to identify beneficiaries of National Health Service who delivered between 2008 and 2017. PACs were defined through oncological ICD-9-CM codes reported in the hospital discharge forms. Each woman with PAC was matched to four women randomly selected from those cancer-free (1:4). Log-binomial regression models were fitted to estimate crude and adjusted prevalence ratio (aPR) and the corresponding 95% confidence interval (CI) of each perinatal outcome among PAC and cancer-free women. Results: Out of the 657,968 deliveries, 831 PACs were identified (1.26 per 1000). PAC diagnosed during pregnancy was positively associated with labor induction or planned delivery (aPR=1.80, 95% CI: 1.57-2.07), cesarean section (aPR=1.78, 95% CI: 1.49-2.11) and premature birth (aPR=6.34, 95% CI: 4.59-8.75). No association with obstetric outcomes was found among PAC diagnosed in the post-pregnancy. No association of PAC, neither during pregnancy nor in post-pregnancy was found for SGA (aPR=0.71, 95% CI: 0.36-1.35 and aPR=1.04, 95% CI: 0.78-1.39, respectively), but newborn among PAC women had a lower birth weight (p-value<0.001). Newborns of women with PAC diagnosed during pregnancy had a higher risk of borderline significance of a low Apgar score (aPR=2.65, 95% CI: 0.96-7.33) as compared to cancer-free women. Conclusion: PAC, especially when diagnosed during pregnancy, is associated with iatrogenic preterm delivery, compromising some neonatal heath indicators.


Medicina ◽  
2020 ◽  
Vol 56 (1) ◽  
pp. 32 ◽  
Author(s):  
Tanaka ◽  
Tanaka ◽  
Osato ◽  
Kusaka ◽  
Maegawa ◽  
...  

Background: To evaluate maternal and neonatal outcomes of assisted reproductive technology (ART). Materials and Methods: Pregnant women registered from 2015 through 2017 (n = 6994) at five perinatal centers that managed high-risk pregnancies in Mie, Japan, retrospectively. Rates of preterm birth (<37 gestational weeks), early onset preeclampsia (<34 gestational weeks), late onset preeclampsia (≥34 gestational weeks), low-lying placenta, placenta previa, placenta accreta, placental abruption, atonic bleeding, uterine rupture, and amniotic fluid embolism after ART were evaluated. ART was defined as in vitro fertilization and micro-fertilization. Fisher’s exact test, Mann–Whitney’s U test, and logistic regression analysis were used to analyze the data. Results: Rates of obstetrical complications including low-lying placenta, placenta previa, placenta accreta, and atonic bleeding were increased with ART compared to those with the control. Particularly, ART was associated with a significantly increased rate of placenta accreta (adjusted odds ratio: 7.35, 95% confidence interval (CI): 3.20–16.6) and significantly decreased rate of placental abruption (adjusted odds ratio: 0.24, 95% CI: 0.07–0.61). Conclusions: This study showed that ART may reduce placental abruption and increase placenta previa. There is a possibility that the placenta attaches deeper in the myometrium because of ART.


2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Seyed-Abdolvahab Taghavi ◽  
Solmaz Heidari ◽  
Shayesteh Jahanfar ◽  
Shakiba Amirjani ◽  
Amireh Aji-ramkani ◽  
...  

Abstract Background The purpose of the present study was to evaluate obstetric, maternal, and neonatal outcomes in COVID-19 compared to healthy pregnant women in Iran. Results A case-control study was conducted on 55 COVID-19 as the case and 55 matched control pregnant women in Hormozgan, Iran. Patients were considered to be cases if they had a positive COVID-19 test plus a positive chest X-ray result. Our measures were COVID-19 symptoms, including laboratory evaluations, clinical symptoms, and maternal and neonatal outcomes. The most prevalent symptoms related to COVID-19 were fever (69.09%) and cough (58.18%). Less common symptoms included fatigue, diarrhea, shortness of breath, sore throat, and myalgia. Hydroxychloroquine/chloroquine (58.18%) and antibiotic therapy (45.45%) were the most prevalent management in COVID-19 patients. Based on our findings, maternal and obstetric outcomes—neonatal in case groups—such as mode of delivery, premature rupture of membrane, postpartum hemorrhage, perineal resection rate, neonates’ birth weight, Apgar score, and neonatal asphyxia rate were similar to pregnant women without COVID-19. We observed a higher incidence rate of premature delivery in COVID-19 cases (25 vs. 10%) (p < 0.05). In the present study, we found that women with COVID-19 had a more than twofold increased odds of preterm labor. History of preterm delivery was also associated with high twofold odds of preterm labor. Conclusion We observed a higher incidence rate of premature delivery in COVID-19 cases. Women with COVID-19 had a more than twofold increased odds of preterm labor. Considering prematurity has high morbidity and is regarded as the primary cause of mortality in children under 5 years old, more case-control studies are needed to ascertain the results.


2016 ◽  
Vol 23 (06) ◽  
pp. 727-730
Author(s):  
Quddsia Tanveer ◽  
Anees Fatima

Objectives: To compare the obstetric outcomes in adolescent and adultprimigravida. Study Design: A comparative, cross sectional study. Setting: Gynae unit 3,Jinnah hospital, Lahore. Period: One year from Jan-Dec 2014. Methodology: Study populationwas adolescent primigravida (<19 years) and adult primigravida between the ages 20-29 years,250 in each group who were > 24 weeks of gestation. Obstetric complications were recordedas percentages of anaemia, pre-eclampsia, antepartum hemorrhage, postpartum hemorrhage,gestational diabetes mellitus, preterm delivery, instrumental delivery, cesarean section rate, lowbirth weight, Apgar score <7 at 5 minutes and NNU admission. Data was entered into SPSS 16.Chi square test applied and a p-value of<0.05 was considered significant. Results: The meanage of adolescent group was 18.4+ 0.56 years while it was 24+2.47 years in adult primigravida.The data revealed that the adolescent mothers are at higher risk of certain obstetric risks whencompared to adult primigravida .These include anaemia ( 41.2% VS 17.6%), pregnancy inducedhypertension (14.4% VS 1.6%), preterm delivery (21.6% VS 13.6% ), instrumental delivery (6.4%VS 1.6%), cesarean section rate (24% VS 12%), low birth weight (20.4% VS 8%), Apgar score<7 at 5 minutes (4% VS 2%) and NNU admission (19.2% VS 8%). The risk of antepartumhemorrhage (1.6% VS 1.2%), postpartum hemorrhage (0.8% VS 1.6%), gestational diabetesmellitus (1.2% VS 2%) and malpresentation (1.6% VS 2%) were not different in two groups.Conclusion: Adolescent pregnancy is associated with a higher rates of certain obstetric riskslike anemia, preterm delivery, pregnancy induced hypertension, instrumental delivery, cesareansection and poor neonatal outcome However the risk of antepartum hemorrhage, postpartumhemorrhage and malpresentation is no greater than adult pregnant mothers.


Author(s):  
Sule Ozel ◽  
Selen Yaman ◽  
Hatice Kansu-Celik ◽  
Necati Hancerliogullari ◽  
Nurgul Balci ◽  
...  

Objective The aim of this study was to analyze and compare obstetric and neonatal outcomes between Syrian refugees and ethnic Turkish women. Methods Retrospective, observational study. A total of 576 Syrian refugees and 576 ethnic Turkish women were included in this study, which was conducted between January 2015 and December 2015 at a tertiary maternity training hospital in Ankara, Turkey. The demographic characteristics, obstetric and neonatal outcomes were compared. The primary outcomes were pregnancy outcomes and cesarean rates between the groups Results The mean age was significantly lower in the refugee group (p < 0.001). Mean gravidity, proportion of adolescent pregnancies, proportion of pregnant women aged 12 to 19 years, and number of pregnancies at < 18 years were significantly higher among the refugee women (p < 0.001). Rates of antenatal follow-up, double testing, triple testing, gestational diabetes mellitus (GDM) screening, and iron replacement therapy were significantly lower in the refugee group (p < 0.001). The primary Cesarean section rate was significantly lower in the refugee group (p = 0.034). Pregnancies in the refugee group were more complicated, with higher rates of preterm delivery (< 37 weeks), preterm premature rupture of membranes (PPROM), and low birth weight (< 2,500 g) when compared with the control group (4.2% versus 0.7%, p < 0.001; 1.6% versus 0.2%, p = 0.011; and 12% versus 5.8%, p < 0.001, respectively). Low education level (odds ratio [OR] = 1.7, 95% confidence interval [CI] = 0.5–0.1), and weight gain during pregnancy (OR = 1.7, 95% CI = 0.5–0.1) were found to be significant indicators for preterm birth/PPROM and low birthweight. Conclusion Syrian refugees had increased risks of certain adverse obstetric outcomes, including preterm delivery, PPROM, lower birth weight, and anemia. Several factors may influence these findings; thus, refugee women would benefit from more targeted care during pregnancy and childbirth.


2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Shunji Suzuki

The purpose of this paper was to examine the obstetric and neonatal outcomes of preterm singleton pregnancies complicated by placental abruption following preterm premature rupture of membranes (p-PROM) compared with those without p-PROM. We reviewed the obstetric records of 95 singleton deliveries complicated by placental abruption at 22–36 weeks’ gestation. The incidence of placental abruption in singleton pregnancies with p-PROM was 4.7%, and the crude odds ratio of placental abruption for women following p-PROM was 6.50 (P<0.01). Of the 95 cases of placental abruption in preterm singleton deliveries, 64 cases (67.4%) occurred without p-PROM and 31 cases (32.6%) occurred following p-PROM. The incidence of histological chorioamnionitis stage III in the patients following p-PROM was significantly higher than that in the patients without p-PROM (P=0.02). The rate of emergency Cesarean deliveries associated with nonreassuring fetal status (NRFS) in the patients following p-PROM was significantly lower than that in the patients without p-PROM. However, there were no significant differences in the maternal and neonatal outcomes between the patients with and without p-PROM. Although p-PROM may be one of important risk factors for placental abruption associated with chorioamnionitis, it may not influence the perinatal outcomes in preterm placental abruption.


Sign in / Sign up

Export Citation Format

Share Document