scholarly journals Thyroid Hormone Changes in Early Pregnancy Along With the COVID-19 Pandemic

2020 ◽  
Vol 11 ◽  
Author(s):  
Ting-Ting Lin ◽  
Chen Zhang ◽  
Han-Qiu Zhang ◽  
Yu Wang ◽  
Lei Chen ◽  
...  
Keyword(s):  
Thyroid Hormone ◽  
Pregnant Women ◽  
Early Pregnancy ◽  
Pregnancy Outcomes ◽  
First Trimester ◽  
Thyroid Peroxidase ◽  
Free Triiodothyronine ◽  
Increased Risk ◽  
Group 2 ◽  
Group 1

PurposeCOVID-19 (Coronavirus Disease 2019) was first reported in December 2019 and quickly swept across China and around the world. Levels of anxiety and depression were increased among pregnant women during this infectious pandemic. Thyroid function is altered during stressful experiences, and any abnormality during early pregnancy may significantly affect fetal development and pregnancy outcomes. This study aimed to determine whether the COVID-19 pandemic induces thyroid hormone changes in early pregnant women.MethodsThis study comprised two groups of pregnant women in Shanghai in their first trimester – those pregnant women before the COVID-19 outbreak from January 20, 2019, to March 31, 2019 (Group 1) and those pregnant during the COVID-19 outbreak from January 20, 2020, to March 31, 2020 (Group 2). All women were included if they had early pregnancy thyrotropin (TSH), free triiodothyronine (FT3), free thyroxine (FT4), total triiodothyronine (TT3), and total thyroxine (TT4) concentrations, thyroid peroxidase (TPO) antibody or thyroglobulin antibody (TgAb) available and did not have a history of thyroid diseases or received thyroid treatment before or during pregnancy. We used propensity score matching to form a cohort in which patients had similar baseline characteristics.ResultsAmong 3338 eligible pregnant women, 727 women in Group 1 and 727 in Group 2 had similar propensity scores and were included in the analyses. Pregnant women in Group 2 had significantly higher FT3 (5.7 vs. 5.2 pmol/L, P<0.001) and lower FT4 (12.8 vs. 13.2 pmol/L, P<0.001) concentrations compared with those in Group 1. Pregnant women in Group 2 were more likely to develop isolated hypothyroxinemia (11.6% vs. 6.9%, OR, 1.75 [95% CI, 1.20–2.53], P=0.003) than those in Group 1 but had a significantly lower risk of TgAb positivity (12.0% vs. 19.0%, OR, 0.58 [95% CI, 0.43–0.78], P<0.001).ConclusionPregnant women in their first trimester in Shanghai during the COVID-19 outbreak were at an increased risk of having higher FT3 concentrations, lower FT4 concentrations, and isolated hypothyroxinemia. The association between thyroid hormones, pregnancy outcomes, and the COVID-19 outbreak should be explored further.

A prospective study of early-pregnancy thyroid markers, lipid species, and risk of gestational diabetes mellitus

2021 ◽  
Author(s):  
Yi Wang ◽  
Fengjiang Sun ◽  
Ping Wu ◽  
Yichao Huang ◽  
Yi Ye ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Early Pregnancy ◽  
Maternal Serum ◽  
Thyroid Peroxidase ◽  
Free Triiodothyronine ◽  
Composite Effect ◽  
Lipid Species ◽  
Increased Risk

Abstract Context While the associations between thyroid markers and gestational diabetes mellitus (GDM) have been extensively studied, the results are inconclusive and the mechanisms remain unclear. Objective We aimed to investigate the prospective associations of thyroid markers in early gestation with GDM risk, and examine the mediating effects through lipid species. Methods This study included 6068 pregnant women from the Tongji-Shuangliu Birth Cohort. Maternal serum thyroid markers (free triiodothyronine (fT3), free thyroxine (fT4), thyroid-stimulating hormone, thyroid peroxidase antibody, and thyroglobulin antibody) were measured before 15 weeks. Deiodinase activity was assessed by fT3/fT4 ratio. Plasma lipidome were quantified in a subset of 883 participants. Results Mean age of the participants was 26.6 ± 3.7 years, and mean gestational age was 10.3 ± 2.0 weeks. Higher levels of fT4 were associated with a decreased risk of GDM (OR=0.73 comparing the extreme quartiles; 95% CI 0.54, 0.98, Ptrend =0.043), while higher fT3/fT4 ratio was associated with an increased risk of GDM (OR=1.43 comparing the extreme quartiles; 95% CI 1.06, 1.93, Ptrend =0.010) after adjusting for potential confounders. Multiple linear regression suggested that fT3/fT4 ratio was positively associated with alkylphosphatidylcholine 36:1, phosphatidylethanolamine plasmalogen 38:6, diacylglyceride 18:0/18:1, sphingomyelin 34:1, and phosphatidylcholine 40:7 (false discovery rate adjusted P<0.05). Mediation analysis indicated 67.9% of the association between fT3/fT4 ratio and GDM might be mediated through the composite effect of these lipids. Conclusions Lower concentration of serum fT4 or higher fT3/fT4 ratio in early pregnancy was associated with an increased risk of GDM. The association of fT3/fT4 ratio with GDM was largely mediated by specific lipid species.

scholarly journals P–384 First trimester pregnancy outcomes after confirmed SARS-CoV–2 infection in the community; a nationwide prospective longitudinal study of 10,000 pregnant women from the COVID–19 pandemic

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
N Balachandren ◽  
M Davies ◽  
J Hall ◽  
D Mavrelos ◽  
E Yasmin
Keyword(s):  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
First Trimester ◽  
Severe Illness ◽  
Healthy Controls ◽  
Household Contacts ◽  
Increased Risk ◽  
Early Miscarriage ◽  
Study Participants ◽  
Prospective Longitudinal

Abstract Study question Are pregnant women in the community with confirmed diagnosis of SARS-CoV–2 infection, at increased risk of an early miscarriage? Summary answer Women diagnosed with COVID–19 in their first trimester were not at increased risk of an early miscarriage. What is known already: In the earliest stages of the pandemic, the Human Fertilisation and Embryology Authority and the European Society of Human Reproduction and Embryology, independently advised against starting assisted reproductive treatments. At the time of this recommendation, among other reasons, there were concerns about the complications of SARS-CoV–2 during pregnancy and the potential for vertical transmission. We now having growing evidence that pregnant women are at an increased risk of severe illness along with higher rates of preterm births in those with severe acute respiratory syndrome. However, data on the impact of community infections of SARS-CoV–2 in early pregnancy has been sparse. Study design, size, duration This is an online survey study undertaken in the UK between May and November 2020. Pregnant women at any stage in their pregnancy were invited to participate in the study. Study participants were asked to complete online surveys at the end of each trimester. 10, 430 women were recruited to take part in the study. Participants/materials, setting, methods: We analysed pregnancy outcomes from women who were under 13 weeks gestation at the time of registration. We compared miscarriage rates among women with a confirmed diagnosis of SARS-CoV–2 infection to healthy controls. Those in the control group had not been diagnosed with or had symptoms of SARS-CoV–2 infection nor did they have any household contacts that were diagnosed with or had symptoms of SARS-CoV–2 infection. Main results and the role of chance 10, 430 pregnant women were recruited to participate in the study. 2934 were under 13 weeks gestation at the time of registration. The median age was 32.6 [IQR 29.8–35.6]. The median gestational age at registration was 8 weeks [IQR [6–10]. 246 women reported a miscarriage before 13 weeks of gestation. The overall miscarriage rate before 13 weeks of gestation was 8.4% (95% CI 7.3%–9.4%). 68 women reported a confirmed diagnosis of SARS-CoV–2 infection in their first trimester. The overall rate of confirmed SARS-CoV–2 infections in the first trimester was 2.3% (95% CI 1.8–2.9%). 3/68 (4.4%) were asymptomatic. Among those reporting symptoms, the commonest symptoms were fatigue (82%), headache (69%) and loss of smell/taste (69%). Only 38% of those with a confirmed diagnosis reported a fever. None of the 68 women with confirmed diagnosis of SARS-CoV–2 infection were hospitalised. The rate of miscarriage before 13 weeks of gestation in women who were diagnosed with SARS-CoV–2 infections was not significantly higher compared to healthy controls (11.8% versus 9.3%, p = 0.35). A further 35 women had household contacts with confirmed SARS-CoV–2 infection although they themselves had not been diagnosed. No miscarriages were reported in this group. Limitations, reasons for caution None of the 68 patients diagnosed with SARS-CoV–2 were hospitalised. We do not know whether the rate of miscarriage among hospitalised women with SARS-CoV–2 infection is the same as those with community infections. Wider implications of the findings: The overall rate of miscarriage during the pandemic was not higher than rates occurring outside of the pandemic. The rate of miscarriage among women diagnosed with SARS-CoV–2 infection was not significantly higher compared to healthy controls. This data can be used to counsel women planning a pregnancy during this pandemic Trial registration number Not applicable

O-234 Using serum metabolomics to identify biomarkers of viable early, intrauterine pregnancy: an untargeted 1H NMR-based approach

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
C Hill ◽  
M Phelan ◽  
A Horne ◽  
K Gemzell-Danielsson ◽  
N Tempest ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Pregnancy Outcome ◽  
1H Nmr ◽  
Early Pregnancy ◽  
Pregnancy Outcomes ◽  
Hydatidiform Mole ◽  
First Trimester ◽  
Intrauterine Pregnancy ◽  
Ectopic Pregnancies ◽  
Twin Pregnancies

Abstract Study question Which metabolites are associated with a viable intrauterine pregnancy (VIUP) when compared to other early pregnancy outcomes (failed intrauterine and ectopic pregnancies)? Summary answer Serum levels of four metabolites (phenylalanine, alanine, glutamate and glutamine) were significantly altered in VIUPs compared to other early pregnancy outcomes. What is known already Around 10% of all intrauterine pregnancies are lost in the first trimester. A further 1-2% of pregnancies are located outside the endometrial cavity; these ectopic pregnancies are the leading cause of maternal mortality in the first trimester of gestation. Early miscarriages may also cause significant morbidity when bleeding or infection occurs. The symptoms of miscarriages and ectopic pregnancy are often similar (pain and bleeding), however, such symptoms are also common in VIUPs. To date, no biomarkers have been identified to differentiate VIUPs from non-viable and ectopic pregnancies. Study design, size, duration This is a prospective cohort study that included 332 pregnant women at less than ten weeks of gestation, who attended the early pregnancy assessment unit (EPAU) at Liverpool Women’s Hospital with pain and/or bleeding. Participants/materials, setting, methods Blood samples were collected from the 332 pregnant women prior to final clinical diagnosis of pregnancy outcome. Serum samples were subjected to NMR metabolomics profiling (14 spectra that did not meet the recommended minimum reporting standards were removed from subsequent analysis). 1D 1H-NMR spectra were acquired at 37 °C on a 700 MHz spectrometer. Relative metabolite abundances underwent statistical analysis using MetaboAnalyst 5.0 (p-value FDR adjusted). Main results and the role of chance Final pregnancy outcomes were as follows: one hydatidiform mole (0.3%), 48 ectopic pregnancies (14.4%), three pregnancies of unknown location (PULs, 0.9%), 78 failed pregnancies of unknown location (FPULs, 23.4%), 47 miscarriages (14.1%), two vanishing twin pregnancies (0.6%) and 153 VIUPs (45.8%). Due to small sample numbers, the hydatidiform mole, PULs and vanishing twin pregnancies were excluded from further analysis. To compare VIUPs to other pregnancy outcomes, ectopic pregnancies, FPULs and miscarriages were grouped together. Univariate analysis of serum metabolite concentrations identified four metabolites (phenylalanine, alanine, glutamate and glutamine) as significantly different in VIUPs compared to other pregnancy outcomes. Multivariate partial least squared discriminant analysis provided only weak correlation between the serum metabolome and pregnancy outcome. In summary, we have identified differences in the metabolome of women with VIUPs compared to other common pregnancy outcomes, which may provide diagnostic utility. Limitations, reasons for caution In this study, women with VIUPs presented with pain and/or bleeding. The presence of symptoms may influence the metabolome of this group versus VIUPs without symptoms, thus limiting the translation of our findings. Furthermore, environmental factors were not controlled (e.g. fasting status), making it likely that cohort heterogeneity was enhanced. Wider implications of the findings This study identifies a metabolite profile associated with VIUPs. These findings may be useful in the development of a diagnostic test to confirm VIUPs and thus exclude potentially life-threatening pregnancy outcomes. Such a test would be invaluable in clinical emergencies. Trial registration number NA

scholarly journals Impact of Endometriomas and Deep Infiltrating Endometriosis on Pregnancy Outcomes and on First and Second Trimester Markers of Impaired Placentation

Medicina ◽  
2019 ◽  
Vol 55 (9) ◽  
pp. 550
Author(s):  
Carolina Scala ◽  
Umberto Leone Roberti Maggiore ◽  
Fabio Barra ◽  
Matteo Tantari ◽  
Simone Ferrero
Keyword(s):  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Demographic Data ◽  
Perinatal Outcomes ◽  
First Trimester ◽  
Deep Infiltrating Endometriosis ◽  
Deep Endometriosis ◽  
Birth Prevalence ◽  
Increased Risk ◽  
Significant Difference

Background and objective: Previous studies did not draw a definitive conclusion about the influence of the role of deep endometriosis (DE) and ovarian endometrioma (OE) as risk factor for developing adverse perinatal outcomes in patients affected by endometriosis. This study aimed to investigate if adverse fetal and maternal outcomes, and in particular the incidence of small for gestational age (SGA) infants, are different in pregnant women with OE versus pregnant women with DE without OE. Material and methods: This study was based on a retrospective analysis of a database collected prospectively. The population included in the study was divided into three groups: patients with OE, patients with DE without concomitant OE, and patients without endometriosis (controls). The controls were matched on the basis of age and parity. Demographic data at baseline and pregnancy outcomes were recorded. Results: There was no statistically significant difference in first trimester levels of PAPP-A, first and mid-pregnancy trimester mean Uterine Artery Doppler pulsatile index, estimated fetal weight centile, and SGA fetuses’ prevalence for patients with OE, and those with DE without OE in comparison to health women; moreover, there was no statistically significant difference with regard to SGA birth prevalence, prevalence of preeclampsia, and five-minute Apgar score between these three groups. Conclusions: The specific presence of OE or DE in pregnant women does not seem to be associated with an increased risk of delivering an SGA infant. These data seem to suggest that patients with endometriosis should be treated in pregnancy as the general population, thus not needing a closer monitoring.

scholarly journals A role of comprehensive cervix assessment in the first trimester of pregnancy for predicting preterm delivery

2020 ◽  
Vol 14 (2) ◽  
pp. 174-181
Author(s):  
V. G. Volkov ◽  
O. V. Chursina
Keyword(s):  
Pregnant Women ◽  
First Trimester ◽  
Diagnostic Value ◽  
Singleton Pregnancy ◽  
Group 4 ◽  
First Trimester Of Pregnancy ◽  
Group 3 ◽  
Group 2 ◽  
Delivery Term ◽  
Group 1

Aim: to improve efficacy of predicting preterm labor in the first trimester of pregnancy by combining diverse parameters of cervical ultrasound examination.Materials and methods. A prospective cohort study of 1517 women with uncomplicated pregnancy was performed. Inclusion criteria were: females underwent cervicometry at 11–14 weeks of gestation, singleton pregnancy, revealing no complaints at the onset of examination. All women were subdivided into four groups: Group 1 – 27 pregnant women with shortened cervix (less than 30 mm); Group 2 – 24 pregnant women without cervical gland area (СGA); Group 3 – 30 pregnant women with two risk factors (shortened cervix less than 30 mm and lacked СGA); Group 4 (control) consisted of 1436 pregnant women with cervix length exceeding 30 mm and presence of СGA.Results. Average delivery term in Group 1 was 35.7 weeks (95 % CI = 34.7–36.8), in Group 2 – 34.7 weeks (95 % CI = 33.59–35.0), in Group 3 – 33.23 weeks (95 % CI = 31.6–34.8), in Group 4 (control) – 38.11 weeks (95 % CI = 38.06–38.17). A significant moderate correlation (Rxy = 0.534) between shortened cervix, absence of СGA and delivery term was found (p < 0.001). A regression model consisting of cervical length and presence of СGA was simulated based upon 50.8 % factors underlying probability of preterm birth, revealing 42.6 % sensitivity, 99.1 % specificity, and 96.6 % overall diagnostic value. The area under the ROC curve was 0.902 ± 0.022 (95 % CI = 0.860–0.945). The data obtained reflect diverse biochemical changes such as collagen decomposition, altered glucosamine level and fluid amount within cervical tissues. Such processes result in shortened, softened and expanded (matured) cervix. Uncovering markers for preterm cervical maturation underlies a logical strategy to predict miscarriage.Conclusion. Untrasound cervical measurement in the first trimester of pregnancy allows for revealing valuable miscarriage predictors (shortened cervix and absence of GI). Risk assessment by combining diverse ultrasound cervix parameters would allow to improve overall predictive efficacy.

scholarly journals Prediction and management model of preterm birth

2019 ◽  
Vol 74 (4) ◽  
pp. 221-228 ◽  
Author(s):  
Yuriy A. Semenov ◽  
Valentina F. Dolgushina ◽  
Marina G. Moskvicheva ◽  
Vasiliy S. Chulkov
Keyword(s):  
Preterm Birth ◽  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Predictive Value ◽  
Diagnostic Value ◽  
Adverse Pregnancy Outcomes ◽  
History Of ◽  
Group 2 ◽  
Adverse Pregnancy ◽  
Group 1

Background: It seems relevant to study the contribution of socio-demographic, somatic and obstetric-gynecological factors in the implementation of preterm birth. Aims: Assessment of the prognostic significance of socio-demographic, obstetric-gynecological and somatic factors in the prediction of preterm birth and associated adverse pregnancy outcomes with subsequent validation of the prognostic model. Materials and methods: Cohort study with a mixed cohort. A retrospective assessment of socio-demographic factors, harmful habits, obstetric and gynecological pathology, somatic diseases, course and outcomes of pregnancy was carried out with the assessment of the status of newborns in 1246 women with subsequent construction of a predictive model of preterm birth and adverse outcomes of pregnancy using Regression with Optimal Scaling and its prospective validation in 100 women. Results: The most significant predictors, that increase the chance of preterm birth and adverse pregnancy outcomes, were history of premature birth, irregular monitoring during pregnancy, history of pelvic inflammatory disease, smoking, obesity, the onset of sexual activity up to 16 years, cardiovascular and endocrine diseases. Intellectual job reduced the chance of preterm birth and adverse pregnancy outcomes This multivariate predictive model has a diagnostic value. The score of risk factors 25 points had a sensitivity of 73%, a specificity of 71%, the area under the ROC curve (AUC) 0.76 (good quality), p0.001. After stratification of high-risk groups by maternal and perinatal pathology the following list of diagnostic and therapeutic measures is introduced and actively implemented in antenatal clinics. To stratificate this model, we prospectively analyze the course and pregnancy outcomes of 100 women divided into 2 groups: group 1 ― 50 women with preterm delivery, group 2 ― 50 women with term delivery. A total score of 25 and above had 44% of women in group 1 and only 10% of women in group 2 (sensitivity 81.4%, specificity 61.6%, positive predictive value 44%, negative predictive value 90%, positive likelihood ratio 2.2 [1.53.0], negative likelihood ratio 0.3 [0.130.68]). Conclusions: We have proposed a model for predicting preterm birth and delivery and perinatal losses using the available characteristics of pregnant women from early pregnancy with moderate indicators of diagnostic value. Further validation of the model in the general population of pregnant women is required.

scholarly journals The importance of visceral fat mass in obese pregnant women and relation with pregnancy outcomes

2013 ◽  
Vol 7 (1) ◽  
pp. 22-25 ◽  
Author(s):  
Jyoti Balani ◽  
Steve Hyer ◽  
Antoinette Johnson ◽  
Hassan Shehata
Keyword(s):  
Gestational Diabetes ◽  
Pregnant Women ◽  
Body Fat ◽  
Fat Mass ◽  
Visceral Fat ◽  
Pregnancy Outcomes ◽  
Central Obesity ◽  
Percentage Body Fat ◽  
Increased Risk ◽  
Group 1

Background Maternal obesity is a well established risk factor for gestational diabetes but it is not known if the pattern of maternal fat distribution predicts adverse pregnancy outcomes. Methods Body composition was assessed by bioimpedance using Inbody 720® in 302 consecutive obese pregnant women attending a weight management clinic. The relation of visceral fat mass and total percentage body fat with the development of gestational diabetes and perinatal outcomes was evaluated. Results Women developing gestational diabetes (Group 1; n = 72) were older, had higher body mass indices and greater central obesity (waist:hip ratio, visceral fat mass) compared with those remaining normoglycaemic. Visceral fat mass, but not percentage body fat, correlated with fasting glucose in all patients ( r = 0.2, p < 0.001) and particularly those in Group 1 ( r = 0.35, p = 0.002). Visceral fat mass, but not percentage body fat, also correlated strongly with glycaemia, particularly in Group 1 ( r = 0.47, p < 0.0001). Visceral fat mass also showed a weak but significant correlation with baby weight ( r = 0.17, p = 0.01). Discussion Central obesity, as assessed by early pregnancy waist:hip ratio and particularly by visceral fat mass, is a predictor of gestational diabetes in addition to classical risk factors and may help identify those obese patients at increased risk of complications.

scholarly journals How does subchorionic hematoma in the first trimester affect pregnancy outcomes?

2021 ◽  
Author(s):  
Taner Günay ◽  
Oğuz Yardımcı
Keyword(s):  
Pregnant Women ◽  
Preterm Delivery ◽  
Early Pregnancy ◽  
Pregnancy Outcomes ◽  
Vaginal Bleeding ◽  
Pregnancy Loss ◽  
Placental Abruption ◽  
First Trimester ◽  
Early Pregnancy Loss ◽  
Adverse Pregnancy

IntroductionSubchorionic hematoma (SCH) in pregnancy has been associated with increased risk of adverse pregnancy outcomes. We aimed to investigate the association of SCH with adverse pregnancy outcomes in pregnant women in relation to size of hematoma and control subjects.Material and methodsThis study included 178 pregnant women with sonographically detected SCH in the 1st trimester, and 350 pregnant controls without SCH. Data on maternal age, smoking status, gestational week at diagnosis, location of SCH, medications before diagnosis, gestational week at delivery, delivery route and pregnancy outcomes (first trimester vaginal bleeding, pre-eclampsia, gestational diabetes, intrauterine growth restriction (IUGR), placental abruption, preterm delivery < 37 weeks, early pregnancy loss and intrauterine death) were retrieved retrospectively from hospital records. Pregnant women with SCH were divided into 3 groups according to the size of hematoma including small SCH (SCH-I group, n = 47), medium- size SCH (SCH-II group, n = 110) and large SCH (SCH-III group, n = 21) groups.ResultsSubchorionic hematoma was associated with significantly lower gestational age at delivery (p < 0.001) and higher rate of first trimester bleeding (p < 0.001) compared with the control group, regardless of the size of the hematoma. Placental abruption (p = 0.002) and early pregnancy loss (p < 0.001) were significantly more common in SCH-II and -III groups than in the control group. SCH-III group was associated with a significantly higher rate of < 37 gestational weeks at delivery (p < 0.001), first trimester vaginal bleeding (p < 0.001), early pregnancy loss (p < 0.001), IUGR (p = 0.003) and preterm delivery (p < 0.001) compared to both lesser size hematoma and control groups.ConclusionsIn conclusion, our findings suggest that large SCH might indicate an increased risk of adverse pregnancy outcomes such as 1st trimester vaginal bleeding, early pregnancy loss, IUGR, placental abruption or preterm delivery. These findings are important to guide the patients with SCH for detailed clinical evaluation.

Pregnancy outcomes in unselected singleton pregnant women with an increased risk of first-trimester Down's syndrome

2004 ◽  
Vol 83 (12) ◽  
pp. 1130-1134 ◽  
Author(s):  
Silvia So-Aei Liu ◽  
Fa-Kung Lee ◽  
Jia-Ling Lee ◽  
Ming-Song Tsai ◽  
Mei-Leng Cheong ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Down's Syndrome ◽  
Down’S Syndrome ◽  
First Trimester ◽  
Increased Risk

scholarly journals Impact of maternal mental health problems on perinatal outcomes for the infant

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
L F Christensen ◽  
S Heuckendorff ◽  
K Fonager ◽  
C Overgaard
Keyword(s):  
Mental Health ◽  
Pregnant Women ◽  
Mental Health Problems ◽  
Maternal Mental Health ◽  
Perinatal Outcomes ◽  
Health Problems ◽  
Increased Risk ◽  
Adverse Perinatal Outcomes ◽  
Group 2 ◽  
Group 1

Abstract Background Mounting evidence suggests that mental health problems in pregnant women may negatively affect the intra- and extrauterine health and development of the child. This is especially of concern as the prevalence of mental health problems in pregnant women is high and believed to be increasing. We set out to quantify the effect of maternal mental health status on the risk of adverse perinatal outcomes for the infant. Methods We undertook a nationwide register-based cohort study including children born alive in Denmark between 2000 and 2016. The exposed cohort was children born to mothers with mental health problems in the two years prior to childbirth that had been cared for in primary care settings only (Group 1, minor problems, n = 71 759) or had required psychiatric intervention (Group 2, moderate-severe problems, n = 41 099). All non-exposed children served as comparison group (n = 908 268). We calculated risk ratios (RRs) with 95% confidence intervals (CI) for each perinatal outcome of interest. Results Infants in Group 1 as well as Group 2 were at higher risk of neonatal death than infants born to unaffected mothers, although for Group 2 the trend was non-significant (Group 1: adjusted RR (aRR) 1.34, 95% CI 1.17-1.52; Group 2: aRR 1.11, 95% CI 0.94-1.32). Both exposure groups were furthermore at significantly increased risk of 5-minute Apgar scores &lt;7 (Group 1: aRR 1.27, 95% CI 1.17-1.37; Group 2: aRR 1.52, 95% CI 0.94-1.32) and &lt;4 (Group 1: aRR 1.26, 95% CI 1.10-1.44; Group 2: aRR 1.28, 95% CI 1.08-1.52) and of hospital admission in the neonatal period (Group 1: aRR 1.22, 95% CI 1.19-1.24; Group 2: 1.29, 95% CI 1.26-1.32), paralleled by a significantly higher risk of preterm birth and several neonatal morbidities. Conclusions Infants born to mothers with moderate-severe as well as minor mental health problems were at increased risk of multiple adverse perinatal outcomes, thus calling for effective preventive strategies to improve outcomes in both groups.

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