Maternal Pre-Pregnancy Obesity Combined With Abnormal Glucose Metabolism Further Increases Adverse Pregnancy Outcomes in Chinese Pregnant Women

AimsOur aim was to evaluate the separate and combined effects of maternal pre-pregnancy obesity and gestational abnormal glucose metabolism (GAGM) on adverse perinatal outcomes.MethodsA total of 2,796 Chinese pregnant women with singleton delivery were studied, including 257 women with pre-pregnancy obesity alone, 604 with GAGM alone, 190 with both two conditions, and 1,745 with neither pre-pregnancy obesity nor GAGM as control group. The prevalence and risks of adverse pregnancy outcomes were compared among the four groups.ResultsCompared with the normal group, pregnant women with maternal pre-pregnancy obesity alone, GAGM alone, and both two conditions faced significantly increased risks of pregnancy-induced hypertension (PIH) (odds ratio (OR) 4.045, [95% confidence interval (CI) 2.286–7.156]; 1.993 [1.171–3.393]; 8.495 [4.982–14.485]), preeclampsia (2.649 [1.224–5.735]; 2.129 [1.128–4.017]; 4.643 [2.217–9.727]), cesarean delivery (1.589 [1.212–2.083]; 1.328 [1.095–1.611]; 2.627 [1.908–3.617]), preterm delivery (1.899 [1.205–2.993]; 1.358 [0.937–1.968]; 2.301 [1.423–3.720]), macrosomia (2.449 [1.517–3.954]; 1.966 [1.356–2.851]; 4.576 [2.895–7.233]), and total adverse maternal outcomes (1.762 [1.331–2.332]; 1.365 [1.122–1.659]; 3.228 [2.272–4.587]) and neonatal outcomes (1.951 [1.361–2.798]; 1.547 [1.170–2.046]; 3.557 [2.471–5.122]). Most importantly, there were no obvious risk differences in adverse pregnancy outcomes between maternal pre-pregnancy obesity and GAGM group except PIH, but pregnant women with both obesity and GAGM exhibited dramatically higher risks of adverse pregnancy outcomes than those with each condition alone.ConclusionsMaternal pre-pregnancy obesity and GAGM were independently associated with increased risks of adverse pregnancy outcomes. The combination of pre-pregnancy obesity and GAGM further worsens adverse pregnancy outcomes compared with each condition alone.

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Pregnancy outcome after exposure to oral contraceptives during the periconceptional period

Human & Experimental Toxicology ◽

10.1177/0960327108092290 ◽

2008 ◽

Vol 27 (4) ◽

pp. 307-313 ◽

Cited By ~ 11

Author(s):

HK Ahn ◽

JS Choi ◽

JY Han ◽

MH Kim ◽

JH Chung ◽

...

Keyword(s):

Pregnant Women ◽

Oral Contraceptives ◽

Gestational Age ◽

Pregnancy Outcomes ◽

Adverse Pregnancy Outcomes ◽

Exposed Group ◽

Large For Gestational Age ◽

Control Group ◽

Periconceptional Period ◽

Adverse Pregnancy

To evaluate whether periconceptional exposure to oral contraceptives (OCs) increased adverse pregnancy outcomes, 136 pregnant women taking OCs within the periconceptional period were identified at the Korean Motherisk Program. Of them, 120 pregnant women accepted to participate in their study and were followed up until completion of the pregnancy. A control group of 240 age- and gravidity-matched pregnant women exposed to non-teratogen drugs for at least 1 month before pregnancy was also included. The median gestational age at delivery was 39.1 (27.0–41.0) weeks in the exposed group and 39.3 (27.4–42.0) weeks in the control group ( P = 0.19). In the exposed group, 7.1% of babies were born with low birth weight versus 2.6% in the control group ( P = 0.068). The number of preterm deliveries or babies born large for gestational age did not differ between the two groups. In the exposed group, the rate of birth defects was 3.2% ( n = 3/99) versus 3.6% ( n = 7/193) in the control group ( P = 1.0). There were 15 women who took high doses of progesterone (emergency contraception) and no adverse fetal outcomes were observed. In conclusion, periconceptional exposure to OCs does not appear to increase the risk for adverse pregnancy outcomes.

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Oral Anaerobic Microflora and Pregnancy Complication

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2021.7601 ◽

2021 ◽

Vol 9 (B) ◽

pp. 1681-1685

Author(s):

Irena Andonova ◽

Vasil Iliev

Keyword(s):

Bacterial Vaginosis ◽

Pregnant Women ◽

Pregnancy Outcomes ◽

Preterm Labor ◽

Bacterial Flora ◽

Anaerobic Bacteria ◽

Adverse Pregnancy Outcomes ◽

Obstetric Outcomes ◽

Control Group ◽

Adverse Pregnancy

Bacterial vaginosis and periodontal diseases share very similar pathogenesis. Each of these diseases occurs when healthy microbiome changes to predominately anaerobic bacterial flora. Bacterial vaginosis is proven factor for adverse pregnancy outcomes. In recent years it has been hypothesized that infection from distant sites of the fetoplacental unit may also elicit an inflammatory response in utero. Aim: The study is designed to determine whether the presence of specific oral anaerobic bacteria in subgingival sulcus of mother increase the risk of adverse obstetric outcomes. Material and Methods: Case-control study. Control group: 50 patients who gave birth to neonate whit normal birth weight at term. Group cases: I group - 40 pregnant women who were hospitalized with signs of preterm labor. II - 20 pregnant women, who have an ultrasound diagnosis of fetal growth retardation. Sub-gingival microbiological paper-point swab was taken in all patients. Results: The total number of isolated oral anaerobic bacteria was statistically significantly higher in the cases group compared to control group p <0.01. In our study, pregnant women who tested positive for Porphyrmonas gingivalis for 6.65 times were more likely to have preterm labor compare with pregnant women with negative oral swabs (95.0% CI: 1.38-32.11 / p <0.05), and for 2,79 times more likely to have fetus with intrauterine growth restriction (95.0% CI: 1.10-7.91 / p <0.05 Conclusions: The study confirmed the hypothesis of a statistically significant association between oral anaerobic infection and adverse pregnancy outcomes. In the future, more studies are needed to investigate the role of the microbial load, maternal immune response, pathophysiological pathway that leads to negative pregnancy outcome.

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Adverse pregnancy outcomes and inherited thrombophilia

Journal of Perinatal Medicine ◽

10.1515/jpm-2017-0059 ◽

2018 ◽

Vol 46 (4) ◽

pp. 411-417 ◽

Cited By ~ 5

Author(s):

Dominik Dłuski ◽

Radzisław Mierzyński ◽

Elżbieta Poniedziałek-Czajkowska ◽

Bożena Leszczyńska-Gorzelak

Keyword(s):

Pregnant Women ◽

Pregnancy Outcomes ◽

Protein C ◽

Antithrombin Iii ◽

Activated Protein C ◽

Protein S ◽

Adverse Pregnancy Outcomes ◽

Control Group ◽

Inherited Thrombophilia ◽

Adverse Pregnancy

Abstract Aim: (1) To evaluate the prevalence of inherited thrombophilia in pregnant women with adverse pregnancy outcomes: intrauterine growth retardation (IUGR), preeclampsia (PE) and placental abruption. (2) To assess the impact of inherited thrombophilia on the nature of obstetric complications. (3) To assess levels of protein S, protein C, antithrombin III and homocysteine in pregnant women with adverse pregnancy outcomes. Subjects and methods: The study comprised 162 pregnant women. The patients were divided into three test groups and one control group. In all 162 patients the following tests were completed: activated protein C resistance (APC-R), the level of free protein S, activity of protein C, antithrombin III and the level of homocysteine. The data were statistically analyzed via χ2 of independence or homogeneity test. Results: In 32 of 162 patients participating in clinical research thrombophilia was diagnosed (10 patients with APC-R, 21 patients with protein S deficiency, one patient with hyperhomocysteinemia): seven patients belonged to the control group and 25 patients had diagnosed adverse pregnancy outcomes (P=0.04). In 32 patients with diagnosed thrombophilia, level of protein S was decreased (P=0.04). Protein S deficiency was diagnosed, when level of protein S was lower than 30% in the second trimester and lower than 24% in the third trimester. The incidence of activated protein C resistance caused by the mutation of factor V Leiden was in six patients (5.9%) with adverse pregnancy outcomes, and in four patients (6.6%) from the control group. Results were not statistically significant. No protein C deficiency was diagnosed (diagnosis: level<60%), but in 50% of patients with thrombophilia level of protein C was over the norm (P=0.02). The level of antithrombin III was often decreased in patients with preeclampsia – (32.4%), then in the other patients – (17.2%) (P=0.04), but no patient was diagnosed with antithrombin III deficiency (diagnosis: level<60%). Conclusions: Tests for thrombophilia should be carried out in women with adverse pregnancy outcomes in their history, who are planning pregnancy, to start anticoagulant prophylaxis. Our study supports the thesis that tests for thrombophilia should be carried out in women with a history of adverse pregnancy outcomes and who are planning a pregnancy to start anticoagulant prophylaxis.

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Weight gain after diagnosis of gestational diabetes mellitus and its association with adverse pregnancy outcomes: a cohort study

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-03690-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Wei Zheng ◽

Wenyu Huang ◽

Cheng Liu ◽

Qi Yan ◽

Li Zhang ◽

...

Keyword(s):

Cesarean Section ◽

Pregnancy Outcomes ◽

Glucose Tolerance Test ◽

Perinatal Outcomes ◽

Tolerance Test ◽

Adverse Pregnancy Outcomes ◽

Neonatal Outcomes ◽

Oral Glucose ◽

Adverse Perinatal Outcomes ◽

Adverse Pregnancy

Abstract Background Gestational diabetes mellitus (GDM) and excessive body weight are two key risk factors for adverse perinatal outcomes. However, it is not clear whether restricted gestational weight gain (GWG) is favorable to reduce the risk for adverse pregnancy and neonatal outcomes in women with GDM. Therefore, this study aimed to assess the association of GWG after an oral glucose tolerance test with maternal and neonatal outcomes. Methods This prospective cohort study assessed the association of GWG after an oral glucose tolerance test (OGTT) with pregnancy and neonatal outcomes in 3126 women with GDM, adjusted for age, pre-pregnancy body mass index, height, gravidity, parity, adverse history of pregnancy, GWG before OGTT, blood glucose level at OGTT and late pregnancy. The outcomes included the prevalence of pregnancy-induced hypertension (PIH) and preeclampsia, large for gestational age (LGA), small for gestational age, macrosomia, low birth weight, preterm birth, and birth by cesarean section. GDM was diagnosed according to the criteria established by the International Association of Diabetes and Pregnancy Study Groups. Results GWG after OGTT was positively associated with risk for overall adverse pregnancy outcomes (adjusted odds ratio [aOR] = 1.72, 95% confidence interval [CI] = 1.50–1.97), LGA (aOR = 1.29, 95%CI = 1.13–1.47), macrosomia (aOR = 1.24, 95%CI = 1.06–1.46) and birth by cesarean section (aOR = 1.91, 95%CI = 1.67–2.19) in women with GDM. Further analyses revealed that a combination of excessive GWG before OGTT and after OGTT increased the risk of PIH and preeclampsia, LGA, macrosomia, and birth by cesarean section compared with adequate GWG throughout pregnancy. In contrast, GWG below the Institute of Medicine guideline after OGTT did not increase the risk of adverse perinatal outcomes despite GWG before OGTT. Conclusion Excessive GWG after OGTT was associated with an elevated risk of adverse pregnancy outcomes, while insufficient GWG after OGTT did not increase the risk of LBW. Restricting GWG after diagnosis of GDM in women with excessive GWG in the first half of pregnancy may be beneficial to prevent PIH and preeclampsia, LGA, macrosomia, and birth by cesarean section.

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Efficacy of normodyne-magnesium sulfate combination treatment on pregnancy-induced hypertension, and its effect on VEGF and Flt-1 levels

Tropical Journal of Pharmaceutical Research ◽

10.4314/tjpr.v20i10.20 ◽

2021 ◽

Vol 20 (10) ◽

pp. 2155-2161

Author(s):

Xiaoyan Diao ◽

Kun Ding ◽

Xuemei Ma

Keyword(s):

Blood Pressure ◽

Pregnant Women ◽

Magnesium Sulfate ◽

Pregnancy Outcomes ◽

Group Treatment ◽

Adverse Pregnancy Outcomes ◽

Pregnancy Induced Hypertension ◽

Induced Hypertension ◽

Adverse Pregnancy ◽

Group B

Purpose: To investigate the efficacy of the combined use of normodyne and magnesium sulfate in the treatment of pregnancy-induced hypertension, and its effect on vascular endothelial growth factor (VEGF) and factor receptor-1 (Flt-1) levels in serum.Methods: A total of 100 patients with pregnancy-induced hypertension attending Maternal and Child Health Hospital of Xinjiang Uygur Autonomous Region, Xinjiang, China, were categorized as Group A, and then further subdivided into control sub-group (who were treated with magnesium sulfate only) and study sub-group (treated with magnesium sulfate plus normodyne). Furthermore, 100 healthy pregnantwomen attending the hospital for prenatal examination during the same period were categorized as Group B. Serum expressions of VEGF and Flt-1 in all patients were determined and compared. The therapeutic effect, adverse reactions, adverse pregnancy outcomes, blood pressure before and after treatment, 24 h proteinuria, and serum expression levels of VEGF and Flt-1 in the study and control groups were determined and compared.Results: Serum VEGF levels in patients with pregnancy-mediated hypertension were significantly lower than those of healthy pregnant women, and Flt-1 was raised in healthy pregnant women (p < 0.05). In the study group, treatment was markedly more effective, and the degree of amelioration of blood pressure, 24 h proteinuria, serum VEGF, and Flt-1 were significantly higher than for control sub-group. There were lower adverse pregnancy outcomes in study sub-group than in control (p < 0.05).Conclusion: The combination of magnesium sulfate and normodyne produces greater clinical efficacy in the treatment of patients with pregnancy-induced hypertension than magnesium sulfate alone, and also shows a high safety profile.

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The association between soy intake and risk of gestational diabetes mellitus: a prospective cohort study

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-04175-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Yan Wang ◽

Biru Luo ◽

Jie Xiang

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Cesarean Section ◽

Gestational Diabetes Mellitus ◽

Pregnant Women ◽

Pregnancy Outcomes ◽

Adverse Pregnancy Outcomes ◽

Control Group ◽

Increased Risk ◽

Adverse Pregnancy

Abstract Background The association between soy intake and adverse pregnancy outcomes remains unclear. The objectives of this study were to investigate the soy consumption of pregnant women in the second trimester and explore the prospective association between soy intake and the risk of adverse pregnancy outcomes. Methods Pregnant women between 13 and 24 weeks of gestation were recruited at a women’s and children’s hospital in southwest China from June to December 2019. Dietary intakes in the middle trimester were assessed by a semi-quantitative food frequency questionnaire. Participants were divided into the insufficient group (< 40 g/day) and the control group (≥40 g/day) according to daily soy consumption. Participants were followed up until delivery. Pregnancy outcomes including gestational diabetes mellitus (GDM), cesarean section, and macrosomia were obtained. Multiple logistic regression was used to analyze the association between soy intake and risk of adverse pregnancy outcomes. Sociodemographic information, histories of diseases, and duration of physical activities were obtained and used for covariate adjustments. Results A total of 224 participants were included in this study, of which identified 36 (16.1%) cases of GDM, and 120 (53.6%) cases of cesarean section. More than half (125, 55.8%) pregnant women consumed less soy than 40 g/day. Daily soy intake less than 40 g was associated with the increased risk of GDM (OR = 2.755 95%CI 1.230-6.174, P = 0.014) and cesarean section (OR = 1.792 95%CI 1.035-3.101, P = 0.037) without adjustment for confounders such as age, pre-pregnancy body mass index, parity, daily intake of vegetables, fruits, seafood and, nuts. After adjusting for these factors, daily soy intake of less than 40 g increased 2.116-fold risk of GDM (95%CI 1.228-7.907, P = 0.017), but not with the significantly increased risk of cesarean section. Conclusion Insufficient soy intake may increase the risk of GDM, suggesting adequate soy intake may have a beneficial role in the prevention of GDM. Trial registration Registration number: ChiCTR1900023721. Date of registration: June 9, 2019.

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Is Indoor Air Pollution From Different Fuel Types Associated With the Anemia Status of Pregnant Women in Ethiopia?

Journal of Primary Care & Community Health ◽

10.1177/21501327211034374 ◽

2021 ◽

Vol 12 ◽

pp. 215013272110343

Author(s):

Sewitemariam Desalegn Andarge ◽

Abriham Sheferaw Areba ◽

Robel Hussen Kabthymer ◽

Miheret Tesfu Legesse ◽

Girum Gebremeskel Kanno

Keyword(s):

Air Pollution ◽

Logistic Regression ◽

Pregnant Women ◽

Indoor Air ◽

Pregnancy Outcomes ◽

Indoor Air Pollution ◽

Adverse Pregnancy Outcomes ◽

Outcome Variable ◽

Multivariable Logistic Regression Analysis ◽

Adverse Pregnancy

Background Indoor air pollution from different fuel types has been linked with different adverse pregnancy outcomes. The study aimed to assess the link between indoor air pollution from different fuel types and anemia during pregnancy in Ethiopia. Method We have used the secondary data from the 2016 Ethiopian Demographic and Health Survey data. The anemia status of the pregnant women was the dichotomous outcome variable and the type of fuel used in the house was classified as high, medium, and low polluting fuels. Logistic regression was employed to determine the association between the exposure and outcome variables. Adjusted Odds Ratio was calculated at 95% Confidence Interval. Result The proportion of anemia in the low, medium, and high polluting fuel type users was 13.6%, 46%, 40.9% respectively. In the multivariable logistic regression analysis, the use of either kerosene or charcoal fuel types (AOR 4.6; 95% CI: 1.41-18.35) and being in the third trimester (AOR 1.72; 95% CI: 1.12-2.64) were significant factors associated with the anemia status of the pregnant women in Ethiopia. Conclusion According to our findings, the application of either kerosene or charcoal was associated with the anemia status during pregnancy in Ethiopia. An urgent intervention is needed to reduce the indoor air pollution that is associated with adverse pregnancy outcomes such as anemia.

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Pregnancy outcomes in women with inflammatory bowel disease following exposure to thiopurines and antitumor necrosis factor drugs

Human & Experimental Toxicology ◽

10.1177/0960327114550882 ◽

2014 ◽

Vol 34 (5) ◽

pp. 445-459 ◽

Cited By ~ 26

Author(s):

S Mozaffari ◽

AH Abdolghaffari ◽

S Nikfar ◽

M Abdollahi

Keyword(s):

Inflammatory Bowel Disease ◽

Pregnant Women ◽

Bowel Disease ◽

Pregnancy Outcomes ◽

Congenital Abnormalities ◽

Meta Analysis ◽

Adverse Pregnancy Outcomes ◽

Inflammatory Bowel ◽

Adverse Pregnancy ◽

Necrosis Factor

Several studies have indicated the harmful effect of flare-up periods in pregnant women with inflammatory bowel disease (IBD) on their newborns. Therefore, an effective and safe medical treatment during pregnancy is of great concern in IBD patients. The aim of this study was to perform a meta-analysis on the outcomes of thiopurines use and a systematic review of antitumor necrosis factor (anti-TNF) drugs used during pregnancy in women with IBD. The results of cohorts evaluating the safety of anti-TNF drugs during pregnancy up to July 2013 were collected and analyzed. In the meta-analysis, a total of 312 pregnant women with IBD who used thiopurines were compared with 1149 controls (women with IBD who were not treated with any medication and women who were exposed to drugs other than thiopurines) to evaluate the drug effect on different pregnancy outcomes, including prematurity, low birth weight, congenital abnormalities, spontaneous abortion, and neonatal adverse outcomes. Results of statistical analysis demonstrated that congenital abnormalities were increased significantly in thiopurine-exposed group in comparison with control group who did not receive any medicine for IBD treatment. The summary odds ratio was 2.95 with 95% confidence interval = 1.03–8.43 ( p = 0.04). We observed no significant differences in occurrence of other adverse pregnancy outcomes between compared groups. The results of cohorts evaluated the safety of anti-TNF drugs during pregnancy demonstrated no increase in occurrence of adverse pregnancy outcomes in comparison with controls except for the significant decrease in gestational age of newborns of drug-exposed mothers in one trial. In conclusion, a benefit–risk ratio should be considered in prescribing or continuing medicinal therapy during pregnancy of IBD patients.

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COVID-19 Quarantine is a Risk Factor for Poor Pregnancy Outcomes in GDM Patients: A Retrospective Study

10.21203/rs.3.rs-836921/v1 ◽

2021 ◽

Author(s):

Qin-Yu Cai ◽

Yin Yang ◽

Ling-Ling Ruan ◽

Dang-Dang Wang ◽

Han-Lin Cui ◽

...

Keyword(s):

Pregnant Women ◽

Electronic Medical Records ◽

Pregnancy Outcomes ◽

Medical Records ◽

Control Group ◽

Second Trimester ◽

Public Health Emergencies ◽

Nuchal Cord ◽

Adverse Pregnancy ◽

Glucose Management

Abstract Aims: This study was to evaluate the effects of the home quarantine on pregnancy outcomes of gestational diabetes mellitus (GDM) patients during the COVID-19 outbreak.Methods: Thecomplete electronic medical records of GDM patients with home quarantine history were collected and classified into the home quarantine group from 24 February 2020 to 24 November 2020. The same period of GDM patients without home quarantine historywas included in the control group from 2018 and 2019.Results: A total of 1358 GDM patients were included in the analysis, including 484 in 2018, 468 in 2019, and 406 in 2020. GDM patients with home quarantine in 2020 had higher glycemic levels and worse pregnancy outcomes than 2018 and 2019, including higher cesarean section rate,lower Apgar scores, and higher incidence of macrosomia and nuchal cord. More importantly, the second trimester of home quarantine had brought a broader impactto pregnant women and fetuses.Conclusion: Home quarantine has aggravated the condition of GDM pregnant women and brought more adverse pregnancy outcomes during the COVID-19 outbreak. Therefore, we suggested that governments and hospitals should strengthen lifestyle guidance, glucose management, and antenatal care for GDM patients with home quarantine during public health emergencies.

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Placental massive perivillous fibrinoid deposition is associated with adverse pregnancy outcomes: a clinicopathological study of 12 cases

Case Reports in Perinatal Medicine ◽

10.1515/crpm-2015-0087 ◽

2016 ◽

Vol 5 (1) ◽

pp. 35-39

Author(s):

Maili Qi ◽

Kenneth Tou En Chang ◽

Derrick Wen Quan Lian ◽

Chong Kiat Khoo ◽

Kok Hian Tan

Keyword(s):

Pregnancy Outcomes ◽

Gestational Hypertension ◽

Local Population ◽

Fetal Loss ◽

Perinatal Outcomes ◽

First Trimester ◽

Adverse Outcomes ◽

Special Focus ◽

Adverse Perinatal Outcomes ◽

Adverse Pregnancy

Abstract Introduction: Massive perivillous fibrinoid deposition (MPFD) is a very rare placental condition characterized by abnormally extensive fibrinoid deposition in the placental villous parenchyma. The aim of this study is to document clinical and pathological features with special focus on pregnancy outcomes of this condition in consecutive cases of MPFD in our local population. Methods: This is a retrospective clinico-pathological study of cases affected by MPFD over the period January 2010–July 2014 in our hospital. We document clinical features (including perinatal outcome and subsequent pregnancies) and placental pathological characteristics. Results: Twelve cases of MPFD were identified among 3640 placentas (0.33%). There was no identified recurrence. The affected infants had adverse outcomes, including intrauterine growth restriction (IUGR) (75%), preterm birth (58.3%), and fetal loss (25%). A high frequency of reduced PAPP-A in the first trimester (25%), and concurrent gestational hypertension or pre-eclampsia (25%) was noted. Conclusion: MPFD is associated with adverse perinatal outcomes. Further research to better understand its pathogenesis and to improve clinical diagnosis and management is warranted.

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