scholarly journals A Comparative Study on Adverse Pregnancy Outcomes in Pregnant Women with Different Age

2021 ◽  
Vol 31 (1) ◽  
pp. 9-16
Author(s):  
Soudabe Ebrahimi ◽  
◽  
Maryam Niknami ◽  
Fateme Rafat ◽  
Ehsan Kazemnezhad Leili ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Maternal Age ◽  
Age Groups ◽  
Maternal Diabetes ◽  
Neonatal Outcomes ◽  
Age Group ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Adverse Pregnancy

Introduction: Delayed childbearing is increasing. Increased maternal age has been associated with increased risk of pregnancy complications. On the other hand, the adolescent pregnancy has traditionally been considered high-risk, especially in developing countries. Objective: This study aimed to compare the adverse pregnancy outcomes in different age groups of pregnant women. Materials and Methods: The analytical study with cross-sectional design was conducted on 345 pregnant women referred to one of the maternity hospitals in Rasht, Iran in 2018 who were selected by sequential sampling method. They were followed from gestational age >37 weeks until delivery in 3 groups: <19 years, 19-35 years and >35 years. The data collection tool was a two-part researcher-made questionnaire which surveys demographic, fertility, and socioeconomic information and adverse maternal and neonatal outcomes. The collected data were analyzed using descriptive and inferential statistics (Chi-square test, Fisher’s exact test, Kruskal-Wallis test, ANOVA, Bonfrroni test, Spearman correlation test, and multiple linear regression analysis). Results: The highest prevalence of maternal diabetes mellitus (29.7%) and cesarean section (72.46%) were reported in the age group >35 years. The highest frequency of premature rupture of membranes (18.8%) and abnormal fetal presentation (13.8 %) were reported in age groups <19 years and 19-35 years, respectively. Among maternal outcomes, maternal diabetes, abnormal fetal presentation, premature rupture of membranes and delivery by cesarean section were significantly different between three groups (P<0.05). There was a significant difference between maternal age and neonatal outcomes in ages groups <19 years and 19-35 years (P<0.05). Multiple linear regression model showed that the maternal age <19 years was a predictor of adverse neonatal outcomes. The group <19 years reported more adverse outcomes than the age group 19-35 years (β=0.282, 95% CL: 0.002-0.561, P=0.049). Conclusion: All age groups of pregnant women faced some pregnancy outcomes. Due to Iran’s new plan to encourage childbearing, prenatal screening, and receiving more prenatal care, we recommend pregnant women to participate in childbirth preparation training courses.

scholarly journals Association between the COVID-19 pandemic and the risk for adverse pregnancy outcomes: a cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e047900
Author(s):  
Min Du ◽  
Jie Yang ◽  
Na Han ◽  
Min Liu ◽  
Jue Liu
Keyword(s):  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Time Trends ◽  
Foetal Distress ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Gestational Weight ◽  
Excessive Gestational Weight Gain ◽  
Adverse Pregnancy ◽  
Beijing China

ObjectivesThe secondary impacts of the COVID-19 pandemic on adverse maternal and neonatal outcomes remain unclear. In this study, we aimed to evaluate the association between the COVID-19 pandemic and the risk for adverse pregnancy outcomes.DesignWe conduced retrospective analyses on two cohorts comprising 7699 pregnant women in Beijing, China, and compared pregnancy outcomes between the pre-COVID-2019 cohort (women who delivered from 20 May 2019 to 30 November 2019) and the COVID-2019 cohort (women who delivered from 20 January 2020 to 31 July 2020). The secondary impacts of the COVID-2019 pandemic on pregnancy outcomes were assessed by using multivariate log-binomial regression models, and we used interrupted time-series (ITS) regression analysis to further control the effects of time-trends.SettingOne tertiary-level centre in Beijing, ChinaParticipants7699 pregnant women.ResultsCompared with women in the pre-COVID-19 pandemic group, pregnant women during the COVID-2019 pandemic were more likely to be of advanced age, exhibit insufficient or excessive gestational weight gain and show a family history of chronic disease (all p<0.05). After controlling for other confounding factors, the risk of premature rupture of membranes and foetal distress was increased by 11% (95% CI, 1.04 to 1.18; p<0.01) and 14% (95% CI, 1.01 to 1.29; p<0.05), respectively, during the COVID-2019 pandemic. The association still remained in the ITS analysis after additionally controlling for time-trends (all p<0.01). We uncovered no other associations between the COVID-19 pandemic and other pregnancy outcomes (p>0.05).ConclusionsDuring the COVID-19 pandemic, more women manifested either insufficient or excessive gestational weight gain; and the risk of premature rupture of membranes and foetal distress was also higher during the pandemic.

scholarly journals The implications for advanced maternal age on pregnancy complications and adverse neonatal outcomes

2021 ◽  
Vol 29 (3) ◽  
pp. 200-209
Author(s):  
Zeynep Gedik Özköse ◽  
Süleyman Cemil Oğlak
Keyword(s):  
Birth Weight ◽  
Cesarean Section ◽  
Pregnancy Outcomes ◽  
Maternal Age ◽  
Advanced Maternal Age ◽  
Neonatal Outcomes ◽  
Apgar Scores ◽  
Adverse Neonatal Outcomes ◽  
Adverse Pregnancy ◽  
Nicu Admission

Objective This study aimed to determine the effect of advanced maternal age (AMA) on maternal and neonatal outcomes in pregnant women aged ≥35 years compared with patients aged 30–34 years. Also, we aimed to analyze the risk estimates of potential confounders to identify whether these variables contributed to the development of adverse pregnancy outcomes or not. Methods This retrospective cohort study included 2284 pregnant women aged ≥35 years at the time of delivery who was delivered in a tertiary referral hospital from January 1, 2016, to December 31, 2020. We further classified these women into two subgroups: 35–39 years as early AMA (EAMA), and ≥40 years as very AMA (VAMA). Pregnancy complications and adverse neonatal outcomes were recorded. Results Compared to younger women, pregnant AMA women had significantly higher risks of complicated pregnancies, including a higher risk of gestational diabetes mellitus (GDM, p<0.001), polyhydramnios (p<0.001), cesarean section (p<0.001), stillbirths (p<0.001), major fetal abnormality (p<0.001), preterm delivery (p<0.001), lower birth weight (p<0.001), lower 5-minute Apgar scores (p<0.001), lower umbilical artery blood pH values (p<0.001), neonatal intensive care unit (NICU) admission (p<0.001), and length of NICU stay (p<0.001). Conclusion We found a strong and significant association between VAMA and adverse pregnancy outcomes, including an increased risk of GDM, polyhydramnios, cesarean section, and adverse neonatal outcomes, including a higher risk of stillbirths, preterm delivery, lower birth weight, lower 5-minute Apgar scores, and NICU admission.

scholarly journals COVID-19 and Adverse Pregnancy Outcome: A Systematic Review of 104 Cases

2020 ◽  
Vol 9 (11) ◽  
pp. 3441
Author(s):  
Ramy Abou Ghayda ◽  
Han Li ◽  
Keum Hwa Lee ◽  
Hee Won Lee ◽  
Sung Hwi Hong ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Adverse Pregnancy Outcome ◽  
Mode Of Delivery ◽  
Maternal Mortality Ratio ◽  
Case Series ◽  
Neonatal Outcomes ◽  
Treatment Modalities ◽  
Adverse Pregnancy

(1) Background: Until now, several reports about pregnant women with confirmed coronavirus disease 2019 (COVID-19) have been published. However, there are no comprehensive systematic reviews collecting all case series studies on data regarding adverse pregnancy outcomes, especially association with treatment modalities. (2) Objective: We aimed to synthesize the most up-to-date and relevant available evidence on the outcomes of pregnant women with laboratory-confirmed infection with COVID-19. (3) Methods: PubMed, Scopus, MEDLINE, Google scholar, and Embase were explored for studies and papers regarding pregnant women with COVID-19, including obstetrical, perinatal, and neonatal outcomes and complications published from 1 January 2020 to 4 May 2020. Systematic review and search of the published literature was done using the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA). (4) Results: In total, 11 case series studies comprising 104 pregnant women with COVID-19 were included in our review. Fever (58.6%) and cough (30.7%) were the most common symptoms. Other symptoms included dyspnea (14.4%), chest discomfort (3.9%), sputum production (1.0%), sore throat (2.9%), and nasal obstruction (1.0%). Fifty-two patients (50.0%) eventually demonstrated abnormal chest CT, and of those with ground glass opacity (GGO), 23 (22.1%) were bilateral and 10 (9.6%) were unilateral. The most common treatment for COVID-19 was administration of antibiotics (25.9%) followed by antivirals (17.3%). Cesarean section was the mode of delivery for half of the women (50.0%), although no information was available for 28.8% of the cases. Regarding obstetrical and neonatal outcomes, fetal distress (13.5%), pre-labor rupture of membranes (9.6%), prematurity (8.7%), fetal death (4.8%), and abortion (2.9%) were reported. There are no positive results of neonatal infection by RT-PCR. (5) Conclusions: Although we have found that pregnancy with COVID-19 has significantly higher maternal mortality ratio compared to that of pregnancy without the disease, the evidence is too weak to state that COVID-19 results in poorer maternal outcome due to multiple factors. The number of COVID-19 pregnancy outcomes was not large enough to draw a conclusion and long-term outcomes are yet to be determined as the pandemic is still unfolding. Active and intensive follow-up is needed in order to provide robust data for future studies.

scholarly journals Lactobacillus iners Is Associated with Vaginal Dysbiosis in Healthy Pregnant Women: A Preliminary Study

2019 ◽  
Vol 2019 ◽  
pp. 1-9
Author(s):  
Nengneng Zheng ◽  
Renyong Guo ◽  
Yinyu Yao ◽  
Meiyuan Jin ◽  
Yiwen Cheng ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Vaginal Microbiota ◽  
Second Trimester ◽  
Premature Rupture Of Membranes ◽  
Third Trimester ◽  
Premature Rupture ◽  
Significant Difference ◽  
Bacterial Marker ◽  
Preliminary Study ◽  
Adverse Pregnancy

Vaginal dysbiosis has been identified to be associated with adverse pregnancy outcomes, such as preterm delivery and premature rupture of membranes. However, the overall structure and composition of vaginal microbiota in different trimesters of the pregnant women has not been fully elucidated. In this study, the physiological changes of the vaginal microbiota in healthy pregnant women were investigated. A total of 83 healthy pregnant participants were enrolled, who are in the first, second, or third pregnancy trimester. Quantitative real-time PCR was used to explore the abundant bacteria in the vaginal microbiota. No significant difference in the abundance of Gardnerella, Atopobium, Megasphaera, Eggerthella, Leptotrichia/Sneathia, or Prevotella was found among different trimesters, except Lactobacillus. Compared with the first pregnancy trimester, the abundance of L. iners decreased in the second and third trimester while the abundance of L. crispatus was increased in the second trimester. Moreover, we also found that vaginal cleanliness is correlated with the present of Lactobacillus, Atopobium, and Prevotella and leukocyte esterase is associated with Lactobacillus, Atopobium, Gardnerella, Eggerthella, Leptotrichia/Sneathia, and Prevotella. For those whose vaginal cleanliness raised or leukocyte esterase became positive, the richness of L. iners increased, while that of L. crispatus decreased significantly. Our present data indicated that the altered vaginal microbiota, mainly Lactobacillus, could be observed among different trimesters of pregnancy and L. iners could be considered as a potential bacterial marker for evaluating vaginal cleanliness and leukocyte esterase.

scholarly journals Chlamydia trachomatis Screening and Treatment in Pregnancy to Reduce Adverse Pregnancy and Neonatal Outcomes: A Review

2021 ◽  
Vol 9 ◽  
Author(s):  
Kristina N. Adachi ◽  
Karin Nielsen-Saines ◽  
Jeffrey D. Klausner
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Adverse Outcomes ◽  
Neonatal Outcomes ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Middle Income ◽  
Infant Outcomes ◽  
Adverse Pregnancy

Chlamydial trachomatis infection has been associated with adverse pregnancy and neonatal outcomes such as premature rupture of membranes, preterm birth, low birth weight, conjunctivitis, and pneumonia in infants. This review evaluates existing literature to determine potential benefits of antenatal screening and treatment of C. trachomatis in preventing adverse outcomes. A literature search revealed 1824 studies with 156 full-text articles reviewed. Fifteen studies were selected after fulfilling inclusion criteria. Eight studies focused on chlamydial screening and treatment to prevent adverse pregnancy outcomes such as premature rupture of membranes, preterm birth, low birth weight, growth restriction leading to small for gestational age infants, and neonatal death. Seven studies focused on the effects of chlamydial screening and treatment on adverse infant outcomes such as chlamydial infection including positive mucosal cultures, pneumonia, and conjunctivitis. Given the heterogeneity of those studies, this focused review was exclusively qualitative in nature. When viewed collectively, 13 of 15 studies provided some degree of support that antenatal chlamydial screening and treatment interventions may lead to decreased adverse pregnancy and infant outcomes. However, notable limitations of these individual studies also highlight the need for further, updated research in this area, particularly from low and middle-income settings.

scholarly journals Risk of Selected Fetal Adverse Pregnancy Outcomes at Advanced Maternal Age: A Retrospective Cohort Study in Debre Markos Referral Hospital, Northwest Ethiopia

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Bikila Tefera Debelo ◽  
Melaku Hunie Asratie ◽  
Abayneh Aklilu Solomon
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Pregnancy Outcomes ◽  
Maternal Age ◽  
Advanced Maternal Age ◽  
Referral Hospital ◽  
Age Group ◽  
Debre Markos ◽  
Adverse Pregnancy

Introduction. Pregnancy at an advanced maternal age is defined as pregnancy at 35 years or older. Today, women postpone pregnancy due to different socioeconomic and personal reasons. However, there was limited evidence on fetal adverse outcomes’ association with pregnancy at an advanced maternal age in Ethiopia and particularly in the study area. This study was aimed at assessing the effect of pregnancy at an advanced age on selected neonatal adverse pregnancy outcomes in Debre Markos Referral Hospital, Ethiopia, 2019. Methods. Institution-based retrospective cohort study was conducted on 303 exposed (35 years and older) and 604 nonexposed (20–34 years old) immediate postpartum women who delivered at Debre Markos Referral Hospital after 28 weeks of gestation. All exposed women who fulfilled the inclusion criteria were sampled, and systematic random sampling was employed for those in the nonexposed group. The data were collected from 1st of July to 30th of December, 2019, by face-to-face interview and extraction from maternal chart using a structured questionnaire and data extraction checklist, respectively. Binary logistic regression (bivariate and multivariable) model was fitted, and wealth index was analyzed by principal component analysis. Adjusted relative risk with respect to 95% confidence interval was employed for the strength and directions of association between advanced maternal age and selected adverse pregnancy outcomes, respectively. P -value of <0.05 was used to declare statistical significance. Results. The incidence of adverse neonatal outcomes including stillbirth, preterm birth, and low birth weight in the advanced maternal age group was 13.2%, 19.8%, and 16.5%, respectively. The incidence of stillbirth, preterm birth, and low birth weight in the nonexposed group was 3.1%, 8.4%, and 12.4%, respectively. The advanced maternal age group had three times the risk of stillbirth compared with the nonexposed group (ARR = 3.14 95% CI (1.30–7.00)). The advanced maternal age group had 2.66 times the risk of delivering preterm fetus (ARR = 2.66 95% CI (1.81–3.77)) compared with the younger counterparts. Low birth weight was not significantly associated with pregnancy at an advanced maternal age. Conclusion. Fetal adverse outcomes including stillbirth and preterm birth were significantly associated with pregnancy at an advanced maternal age.

Abnormal umbilical cord insertions in singleton deliveries: placental histology and neonatal outcomes

2021 ◽  
pp. jclinpath-2020-207342
Author(s):  
Sivlia Visentin ◽  
Ambrogio P Londero ◽  
Luisa Santoro ◽  
Sara Pizzi ◽  
Matteo Andolfatto ◽  
...  
Keyword(s):  
Clinical Information ◽  
Neonatal Outcomes ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Fetal Demise ◽  
Gestational Age At Delivery ◽  
Adverse Neonatal Outcomes ◽  
Microscopic Features ◽  
Adverse Pregnancy ◽  
Singleton Pregnancies

AimsThis study aimed to identify any microscopic features associated with abnormal (membranous/velamentous or marginal) placental cord insertions and to analyse their adverse neonatal outcomes.MethodsWe retrospectively analysed the records—including pathological findings, clinical information and pregnancy outcomes—for 1060 singleton pregnancies, involving newborn delivered after 24 weeks of gestation.ResultsMarginal cord insertions were identified in 26.60% of cases and membranous cord insertions in 2.64%. Subchorionic vessel thrombus was more prevalent in marginal or membranous insertions (0.97%) than in normal cord insertions (0.27%) (p=0.129). Intervillous thrombi (13.73% vs 8.41%, p<0.05) and chorioamnionitis (8.53% vs 5.48%, p=0.089) were more prevalent in normal cord insertions. Premature rupture of membranes was significantly more commonly associated with abnormal (marginal 15.25% and membranous 17.86%) than with normal (9.87%) insertions (p<0.05). Pre-eclampsia was more common in the group with membranous cord insertions (7.14%) than in the other groups (marginal 0.35%; normal 0.80%) (p<0.05). Marginal and membranous placental cord insertions were associated with earlier gestational age at delivery and smaller fetuses than in the group with normal insertions. Intrauterine fetal demise, cardiac malformations and pregestational diabetes were also more common among cases of abnormal cord insertions.ConclusionsSubchorionic vessel thrombus and adverse pregnancy-related outcomes were more prevalent in cases of marginal/membranous cord insertion than for normal insertions.

scholarly journals Exploring Pregnancy Outcomes Associated with SARS-CoV-2 Infection

Medicina ◽  
2021 ◽  
Vol 57 (8) ◽  
pp. 796
Author(s):  
Madalina Timircan ◽  
Felix Bratosin ◽  
Iulia Vidican ◽  
Oana Suciu ◽  
Livius Tirnea ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Significant Risk ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Potential Threat ◽  
Apgar Scores ◽  
Obstetrical Outcomes ◽  
Emergency Cesarean

Background and Objectives: The ongoing pandemic proved to be a tremendous challenge to all economic layers, healthcare, and people safety. As more than one year elapsed since the beginning of the COVID-19 pandemic, a multitude of medical studies involving the SARS-CoV-2 virus helped researchers and medical practitioners in understanding the effects it has on all sorts of patients until effective vaccines were finally developed and distributed for mass vaccination. Still, the SARS-CoV-2 and its new variants remain a potential threat towards all categories of patients, including a more delicate group represented by pregnant women. Thus, the current study aims to investigate the potential effects on obstetrical outcomes after a positive SARS-CoV-2 infection. Materials and Methods: This single-center prospective cohort study investigated the pregnancy outcomes in a total of 1039 eligible pregnant women between 30 August 2020 and 30 January 2021. Multiple patient characteristics and obstetrical outcomes were tested and analyzed in a multivariate regression model to establish potential risks determined by a COVID-19-positive pregnancy towards the mother and the newborn. Results: In the study sample, there were 938 pregnancies included without COVID-19 and 101 pregnant women identified with a positive COVID-19 infection. COVID-19 was significantly associated with a 2-fold increase in the risk of premature rupture of membranes and 1.5 times higher risk of preterm birth with emergency c-sections and lower APGAR scores. Also, significantly more newborns were given birth prematurely, with lower APGAR scores after the mothers were infected with SARS-CoV-2. Conclusions: A third-trimester infection with SARS-CoV-2 is a significant risk factor for preterm birth via an emergency cesarean section, a premature rupture of membranes, and a lower APGAR score in newborns, as compared with pregnancies where COVID-19 was not identified.

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