scholarly journals Influence of Body Mass Index on Gestation and Delivery in Nulliparous Women: A Cohort Study

2019 ◽  
Vol 16 (11) ◽  
pp. 2015 ◽  
Author(s):  
Noemí Rodríguez-Mesa ◽  
Paula Robles-Benayas ◽  
Yolanda Rodríguez-López ◽  
Eva María Pérez-Fernández ◽  
Ana Isabel Cobo-Cuenca
Keyword(s):  
Cesarean Section ◽  
Maternal Age ◽  
Obese Women ◽  
Nulliparous Women ◽  
Newborn Weight ◽  
Pregnancy And Delivery ◽  
Student’S T ◽  
Type Of Delivery ◽  
Fetal Position ◽  
Student’S T Test

Aims: To assess the influence of obesity on pregnancy and delivery in pregnant nulliparous women. Methods: A cohort, longitudinal, retrospective study was conducted in Spain with 710 women, of which 109 were obese (BMI > 30) and 601 were normoweight (BMI < 25). Consecutive nonrandom sampling. Variables: maternal age, BMI, gestational age, fetal position, start of labor, dilation and expulsion times, type of delivery and newborn weight and height. Results: The dilation time in obese women (309.81 ± 150.42 min) was longer than that in normoweight women (281.18 ± 136.90 min) (p = 0.05, Student’s t-test). A higher fetal weight was more likely to lead to longer dilation time (OR = 0.43, 95% CI 0.010–0.075, p < 0.001) and expulsion time (OR = 0.027, 95% CI 0.015–0.039, p < 0.001). A higher maternal age was more likely to lead to a longer expulsion time (OR = 2.054, 95% CI 1.17–2.99, p < 0.001). Obese women were more likely to have gestational diabetes [relative risk (RR) = 3.612, 95% CI 2.102–6.207, p < 0.001], preeclampsia (RR = 5.514, 95% CI 1.128–26.96, p = 0.05), induced birth (RR = 1.26, 95% CI 1.06–1.50, p = 0.017) and cesarean section (RR = 2.16, 95% CI 1.11–4.20, p = 0.022) than normoweight women. Conclusion: Obesity is associated with increased complications during pregnancy, an increased incidence of a cesarean section and induced birth but it has no significant effect on the delivery time.

The Effect of Epidural Analgesia Alone and in Association With Other Variables on the Risk of Cesarean Section

2017 ◽  
Vol 19 (4) ◽  
pp. 393-398 ◽  
Author(s):  
Antonio Herrera-Gómez ◽  
Elvira De Luna-Bertos ◽  
Javier Ramos-Torrecillas ◽  
Francisco Manuel Ocaña-Peinado ◽  
Olga García-Martínez ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Epidural Analgesia ◽  
Cesarean Delivery ◽  
Maternal Age ◽  
Well Being ◽  
Labor Pain ◽  
Cesarean Deliveries ◽  
Increased Risk ◽  
Newborn Weight ◽  
Fetal Position

Introduction: Epidural analgesia (EA) is the most widespread pharmacologic method of labor pain relief. There remains disagreement, however, regarding its adverse effects. The objective of this study was to determine the effect of EA administration on the risk of cesarean delivery and its causes (e.g., stalled labor, risk of loss of fetal well-being, among others) and the degree to which this effect may be modulated by mother-, newborn-, and labor-related variables. Method: A retrospective cohort observational study was conducted including all deliveries in a Spanish public hospital between March 2010 and March 2013 ( N = 2,450; EA = 562, non-EA = 1,888). Results: Risk of a cesarean section was significantly increased by EA administration (odds ratio [ OR] = 2.673; p < .0001). The percentage of cesarean deliveries due to the risk of loss of fetal well-being was significantly higher in the EA (47.8%) versus non-EA group (27.5%; OR = 1.739; p = 0.0012,). The EA-associated risk of cesarean section was not significantly modified as a function of maternal age or parity, fetal position, newborn weight, weeks of gestation, or sedation administration alone. However, these variables in combination may increase the risk. We present multivariate models for each group that account for these variables, allowing for estimation of the risk of a cesarean delivery if EA is administered. Conclusion: EA is associated with an increased risk of cesarean delivery. Other variables in combination (maternal age or parity, fetal position, newborn weight, weeks of gestation, or sedation administration) may increase this risk.

scholarly journals Prelabor cesarean section: the role of advanced maternal age and associated factors

2021 ◽  
Vol 55 ◽  
pp. 9
Author(s):  
Katrini Guidolini Martinelli ◽  
Silvana Granado Nogueira da Gama ◽  
André Henrique do Vale de Almeida ◽  
Marcos Nakamura-Pereira ◽  
Edson Theodoro dos Santos Neto
Keyword(s):  
Cesarean Section ◽  
Public Service ◽  
Maternal Age ◽  
Age Groups ◽  
Advanced Maternal Age ◽  
Public And Private ◽  
Clinical Criteria ◽  
The Public ◽  
Factors Associated ◽  
Nulliparous Women

OBJECTIVE to evaluate whether advanced maternal age (AMA) is associated with prelabor cesarean section and to identify the factors associated with prelabor cesarean section in AMA women, according to the mode of type of labor financing (private or public). METHODS Based on the Birth in Brazil survey, the research was conducted on representative sample of mothers for the country (Brazil), regions, type of hospital and location (capital or not), in 2011/2012. This study included 15,071 women from two age groups: 20–29 years and ≥ 35 years. The information was collected from interviews with puerperal woman, prenatal cards, and medical records of mothers and newborns. Multiple logistic regression modelling was used to verify the association between prelabor cesarean section and maternal, prenatal and childbirth characteristics, according to the mode of financing. RESULTS Our results showed a higher use of prelabor cesarean section for AMA (≥ 35 years) women in the public service (OR = 1.63; 95%CI 1.38–1.94) and in the private service (OR = 1.44; 95%CI 1.13–1.83), compared with women aged 20–29 years. In the adjusted model, we recorded three factors associated with the prelabor cesarean section in AMA women in both, public and private sectors: the same professional in prenatal care and childbirth (OR = 4.97 and OR = 4.66); nulliparity (OR = 6.17 and OR = 10.08), and multiparity with previous cesarean section (from OR = 5.73 to OR = 32.29). The presence of obstetric risk (OR = 1.94; 95%CI .44–2.62) also contributed to the occurrence of prelabor cesarean section in women who gave birth in the public service. CONCLUSIONS AMA was an independent risk factor for prelabor cesarean in public and private services. In the public, prelabor cesarean in AMA was more influenced by clinical criteria. Higher chance of prelabor cesarean section in nulliparous women increases the chance of cesarean section in multiparous women, as we showed in this study, which increases the risk of anomalous placental implantation.

scholarly journals Obesity in pregnant women: a 20-year analysis of the German experience

2021 ◽  
Author(s):  
Alexander Strauss ◽  
Niels Rochow ◽  
Mirjam Kunze ◽  
Volker Hesse ◽  
Joachim W. Dudenhausen ◽  
...  
Keyword(s):  
Body Weight ◽  
Maternal Age ◽  
Federal State ◽  
Obese Women ◽  
Maternal Weight ◽  
Maternal Body ◽  
Continuous Increase ◽  
Pregnancy And Delivery ◽  
Mother’S Age ◽  
Maternal Bmi

Abstract Background/objective To investigate the longitudinal development of maternal body weight and analyze the influence of obesity on obstetrics during more than two decades in Germany. Subjects/methods Data collected from the Federal state of Schleswig-Holstein (German Perinatal Survey) were analyzed with regard to the dynamics of maternal anthropometric variables (body weight, BMI) between 1995–7 and 2004–17. In total 335,511 mothers substantiated the presented study-collective. The statistical analysis was performed using IBM SPSS Statistics for Windows, Version 26.0. Armonk, NY. Results Maternal BMI advanced significantly over the study period. Among a rise in mean periconceptional body weight (67.6–72.0 kg), the segment of obese women increased disproportionately (in average 9.4–19.2%). Despite the observed trend to late giving birth (mean maternal age 1995: 29.3 vs. 30.7 years in 2017), it was not advanced maternal age but parity that influenced the continuous increase in maternal weight (mean maternal body weight 1995–7: primi- bi-, multiparae 67.4, 68.3 and 69.0 kg vs. 2004–17: primi- bi-, multiparae 70.0, 71.5 and 73.2 kg respectively). Conclusion Obesity is a major problem on health issues in obstetrics. Advancing maternal BMI, increasing mother’s age and derived prenatal risks considerably complicate pregnancy and delivery. It has to be emphasized that its consequences do not end with delivery or childbed, but represent a livelong burden to the mother and their offspring. Hence, multimodal strategies to reduce/control periconceptional body weight are mandatory.

Term Labor Induction and Cesarean Delivery Risk among Obese Women with and without Comorbidities

2020 ◽  
Author(s):  
Kimberly B. Glazer ◽  
Valery A. Danilack ◽  
Alison E. Field ◽  
Erika F. Werner ◽  
David A. Savitz
Keyword(s):  
Cesarean Delivery ◽  
Vaginal Delivery ◽  
Maternal Age ◽  
Expectant Management ◽  
Labor Induction ◽  
Induction Of Labor ◽  
Low Risk ◽  
Obese Women ◽  
Adjusted Risk ◽  
Nulliparous Women

Objective Findings of the recent ARRIVE (A Randomized Trial of Induction Versus Expectant Management) trial, showing reduced cesarean risk with elective labor induction among low-risk nulliparous women at 39 weeks' gestation, have the potential to change interventional delivery practices but require examination in wider populations. The aim of this study was to identify whether term induction of labor was associated with reduced cesarean delivery risk among women with obesity, evaluating several maternal characteristics associated with obesity, induction, and cesarean risk. Study Design We studied administrative records for 66,280 singleton, term births to women with a body mass index ≥30, without a prior cesarean delivery, in New York City from 2008 to 2013. We examined elective inductions in 39 and 40 weeks' gestation and calculated adjusted risk ratios for cesarean delivery risk, stratified by parity and maternal age. We additionally evaluated medically indicated inductions at 37 to 40 weeks among women with obesity and diabetic or hypertensive disorders, comorbidities that are strongly associated with obesity. Results Elective induction of labor was associated with a 25% (95% confidence interval: 19–30%) lower adjusted risk of cesarean delivery as compared with expectant management at 39 weeks of gestation and no change in risk at 40 weeks. Patterns were similar when stratified by parity and maternal age. Risk reductions in week 39 were largest among women with a prior vaginal delivery. Women with comorbidities had reduced cesarean risk with early term induction and in 39 weeks. Conclusion Labor induction at 39 weeks was consistently associated with reduced risk of cesarean delivery among women with obesity regardless of parity, age, or comorbidity status. Cesarean delivery findings from induction trials at 39 weeks among low-risk nulliparous women may generalize more broadly across the U.S. obstetric population, with potentially larger benefit among women with a prior vaginal delivery. Key Points

Advanced Maternal Age and Adverse Maternal and Neonatal Outcomes in Pregnant Women

2020 ◽  
Vol 16 ◽  
Author(s):  
Reza Omani-Samani ◽  
Saman Maroufizadeh ◽  
Nafise Saedi ◽  
Nasim Shokouhi ◽  
Arezoo Esmailzadeh ◽  
...  
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Cesarean Section ◽  
Pregnant Women ◽  
Maternal Age ◽  
Unwanted Pregnancy ◽  
Advanced Maternal Age ◽  
Neonatal Outcomes ◽  
Maternal And Neonatal Outcomes

Background: Advanced maternal age is an important predictor for maternal and neonatal outcomes such as maternal mortality, low birth weight, stillbirth, preterm birth, cesarean section and preeclampsia. Objective: To determine the association of advanced maternal age and adverse maternal and neonatal outcomes in Iranian pregnant women. Methods: In this hospital-based cross-sectional study, 5117 pregnant women from 103 hospitals in Tehran, Iran, were participated in the study in 2015. The required data were gathered from hospitals which equipped to the department of obstetrics and gynecology. Advanced maternal age was considered as an independent variable and unwanted pregnancy, preeclampsia, preterm birth, cesarean section and low birth weight were considered as interested outcomes. Results: In our study, the prevalence of advanced maternal age was 12.08%. Advanced maternal age was significantly associated with higher risk of unwanted pregnancy (OR: 1.39, 95% CI: 1.12-1.73), preterm birth (OR: 1.75, 95% CI: 1.28- 2.39) and cesarean section (OR: 1.34, 95% CI: 1.03-1.74). In our study, there was no significant relationship between advanced maternal age and preeclampsia but this relationship could be clinically important (OR: 1.48, 95% CI: 0.99-2.20, P=0.052), and there is no significant relationship between advanced maternal age and low birth weight (OR: 1.08, 95% CI: 0.67-1.74, P=0.736). Conclusion: Advanced maternal age is associated with higher risk of unintended pregnancy, preterm birth and cesarean section but our findings did not support advanced maternal age as a risk factor associated with low birth weight.

Serosal and cutaneous recordings of gastric myoelectrical activity in patients with gastroparesis

1994 ◽  
Vol 266 (1) ◽  
pp. G90-G98 ◽  
Author(s):  
J. D. Chen ◽  
B. D. Schirmer ◽  
R. W. McCallum
Keyword(s):  
Electrical Stimulation ◽  
Slow Wave ◽  
Test Meal ◽  
Frequency Change ◽  
Fasting State ◽  
Gastric Myoelectrical Activity ◽  
Myoelectrical Activity ◽  
Gastric Slow Wave ◽  
Student’S T ◽  
Student’S T Test

The aims of this study were to 1) investigate gastric myoelectrical activity in patients with gastroparesis, 2) validate the cutaneous electrogastrogram (EGG) in tracking the frequency change of the gastric slow wave, and 3) investigate the effect of electrical stimulation on gastric myoelectrical activity. Gastric myoelectrical activity was recorded in 12 patients with documented gastroparesis using serosal electrodes for > 200 min in each subject. All recordings were made at least 4 days after surgery. Each session consisted of a 30-min recording in the fasting state and a 30-min recording after a test meal. The test meal (liquid or mixed) was selected according to patient's tolerance. Electrical stimulation was performed in three subjects via the serosal electrodes at a frequency of 3 cycles/min. Gastric myoelectrical activity was recorded using serosal electrodes in each session. The serosal recording showed slow waves of 2.5 to 4.0 cycles/min in all 12 subjects. Absence of spikes was noted in 11 of the 12 subjects. The simultaneous serosal and cutaneous recording of gastric myoelectrical activity showed that the frequency of the EGG was exactly the same as that of the serosal recording. Liquid meals resulted in a significant decrease in slow-wave frequency (Student's t test, P = 0.006), and the EGG accurately reflected this change. Electrical stimulation had no effect on the frequency of the gastric slow wave and did not induce spikes.(ABSTRACT TRUNCATED AT 250 WORDS)

The Effect of Changes in Dialysate Volume on Glucose and Urea Equilibration

1994 ◽  
Vol 14 (3) ◽  
pp. 236-239 ◽  
Author(s):  
Edward C. Kohaut ◽  
F. Bryson Waldo ◽  
Mark R. Benfield
Keyword(s):  
Renal Failure ◽  
Chronic Renal Failure ◽  
Prospective Study ◽  
Body Surface ◽  
Patient Population ◽  
Different Ages ◽  
Student’S T ◽  
A Prospective Study ◽  
Dialysate Volume ◽  
Student’S T Test

Objectives To determine the effect of changing dialysate volume on urea and glucoseequilibration curves and to determine, if dialysate volume is prescribed on the basis of body surface area, whether equilibration curves will be consistent in patients of different sizes and ages. Design A prospective study wherein children with acute or chronic renal failure had peritoneal equilibration studies done with dwell volumes of 30 mL/kg, 40 mL/kg, and 1200 mL/m2. Patient Population Twenty-two children: 7 under 3 years of age; 8 between 3 and 10 years of age; 7 older than 10 years of age. Statistics Student's t-test. Results Urea and glucose equilibrated rapidly at dwell volumes of 30 mL/kg, slower at dwell volumes of 40 mL/kg, and slowest at dwell volumes of 1200 mL/m2. Equilibration curves were similar in children of different ages when dialysate volumes of 1200 mL/m2 were infused. Conclusion Dialysate volumes of 1200 mL/m2 should be used when equilibration studies are being done to compare individuals of different ages and sizes.

scholarly journals Development and Validation of 2-Azaspiro [4,5] Decan-3-One (Impurity A) in Gabapentin Determination Method Using qNMR Spectroscopy

Molecules ◽  
2021 ◽  
Vol 26 (6) ◽  
pp. 1656
Author(s):  
Nataliya E. Kuz’mina ◽  
Sergey V. Moiseev ◽  
Mikhail D. Khorolskiy ◽  
Anna I. Lutceva
Keyword(s):  
Test Procedure ◽  
Active Pharmaceutical Ingredient ◽  
Test Methods ◽  
Intermediate Precision ◽  
Coefficients Of Variation ◽  
Validation Parameters ◽  
Limit Of Quantitation ◽  
Student’S T ◽  
Development And Validation ◽  
Student’S T Test

The authors developed a 1H qNMR test procedure for identification and quantification of impurity A present in gabapentin active pharmaceutical ingredient (API) and gabapentin products. The validation studies helped to determine the limit of quantitation and assess linearity, accuracy, repeatability, intermediate precision, specificity, and robustness of the procedure. Spike-and-recovery assays were used to calculate standard deviations, coefficients of variation, confidence intervals, bias, Fisher’s F test, and Student’s t-test for assay results. The obtained statistical values satisfy the acceptance criteria for the validation parameters. The authors compared the results of impurity A quantification in gabapentin APIs and capsules by using the 1H qNMR and HPLC test methods.

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