scholarly journals Association between Birth Plan Use and Maternal and Neonatal Outcomes in Southern Spain: A Case-Control Study

Author(s):  
Pedro Hidalgo-Lopezosa ◽  
Ana María Cubero-Luna ◽  
Andrea Jiménez-Ruz ◽  
María Hidalgo-Maestre ◽  
María Aurora Rodríguez-Borrego ◽  
...  

Background: Birth plans are used for pregnant women to express their wishes and expectations about childbirth. The aim of this study was to compare obstetric and neonatal outcomes between women with and without birth plans. Methods: A multicentre, retrospective case–control study at tertiary hospitals in southern Spain between 2009 and 2013 was conducted. A total of 457 pregnant women were included, 178 with and 279 without birth plans. Women with low-risk gestation, at full-term and having been in labour were included. Sociodemographic, obstetric and neonatal variables were analysed and comparisons were established. Results: Women with birth plans were older, more educated and more commonly primiparous. Caesarean sections were less common in primiparous women with birth plans (18% vs. 29%, p = 0.027); however, no significant differences were found in instrumented births, 3rd–4th-degree tears or episiotomy rates. Newborns of primiparous women with birth plans obtained better results on 1 min Apgar scores, umbilical cord pH and advanced neonatal resuscitation. No significant differences were found on 5 min Apgar scores or other variables for multiparous women. Conclusions: Birth plans were related to less intervention, a more natural process of birth and better outcomes for mothers and newborns. Birth plans can improve the welfare of the mother and newborn, leading to birth in a more natural way.

2019 ◽  
Vol 2019 ◽  
pp. 1-8
Author(s):  
Joshua Kaduma ◽  
Jeremiah Seni ◽  
Clotilda Chuma ◽  
Richard Kirita ◽  
Fridolin Mujuni ◽  
...  

Urinary tract infection (UTI) and preeclampsia are common among pregnant women and are associated with adverse maternal-fetal and neonatal outcomes. Despite this, limited information exists on the association between UTIs and preeclampsia in Tanzania to guide specific management and thereby averting the adverse outcomes. A 1:2 matched case-control study (by age and gravidity) involving 131 pregnant women with preeclampsia (cases) and 262 without preeclampsia (controls) was conducted. Sociodemographic and clinical information was collected using a questionnaire. Midstream urine samples were collected during admission for culture and antimicrobial susceptibility testing (AST). Out of 393 pregnant women enrolled, 110 (28.0%), 95% CI: 23.8%-32.7%, had significant bacteriuria [cases: 50.4% (66/131) and control: 16.8% (44/262)]. Pregnant women with preeclampsia had 7.7 odds of having significant bacteriuria than those without preeclampsia [OR=7.7, 95% CI (4.11-14.49); p-value <0.001]. Escherichia coli, 50 (45.5%), and Klebsiella spp., 25 (23.6%), predominated, and resistance to gentamicin, ceftriaxone, and piperacillin-tazobactam ranged from 9.0% to 29.0% in these dominant species. Extended spectrum beta lactamases (ESBL) production in Escherichia coli and Klebsiella spp. was 18.0% (9/50) and 15.4% (4/26), respectively. Routine urine culture and AST among pregnant women with preeclampsia should be introduced in the antenatal clinics to ensure prompt management. Delineation of maternal-fetal and neonatal outcomes among pregnant women with preeclampsia and UTIs would be of interest in future studies.


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

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


Author(s):  
Emine Öztürk ◽  
Şükrü Yıldız

Objective: The aim of this study was to determine whether pregnant women who developed maternal hypoglycemia during the 75 g Oral Glucose Test (OGT) were at an increased risk for adverse obstetric and neonatal outcomes. Methods: This case-control study was conducted from computer-based medical records of women who delivered in a tertiary center between January 2015 and December 2018. OGT had been performed with 75 gr glucose for gestational diabetes screening at 24-28 weeks of gestation. The pregnants with 1st-hour blood glucose levels less than 90 mg/dl (low GT) were matched with normoglycemic patients according to age, body mass index (BMI), gravida and gestational weeks. Obstetric and neonatal outcomes were assessed. Results: Of the 1249 pregnant women included in the study, 62 (4.9%) were in the Low GT group. Admission to the neonatal intensive care unit (NICU) showed a rate of 3.48 increase in the Low GT group (95% confidence interval: 1.05-11.47, p=0.04). There was no difference between the two groups in the other obstetric and neonatal parameters such as: preeclampsia, preterm delivery, birth weight, and weight gained during pregnancy and the 5-minute Apgar scores adjusted for gestational age (SGA) of the fetus. Conclusion: Low 75 g OGT results are significantly associated with increased risk of neonatal intensive care unit (NICU) admissions.


Author(s):  
Patrícia Alves ◽  
Maria Filipa Malheiro ◽  
João Cavaco Gomes ◽  
Tiago Ferraz ◽  
Nuno Montenegro

Abstract Objective The present study aims to understand to what extent obesity is related to adverse maternal, obstetrical, and neonatal outcomes in a Portuguese obstetrical population. Methods A retrospective case-control study was conducted at the Department of Obstetrics of a differentiated perinatal care facility. The study compared 1,183 obese pregnant women with 5,399 normal or underweight pregnant women for the occurrence of gestational diabetes, hypertensive pregnancy disorders, and preterm birth. Mode of delivery, birthweight, and neonatal intensive care unit (ICU) admissions were also evaluated. Mean blood glucose values were evaluated and compared between groups, in the first and second trimesters of pregnancy. Only singleton pregnancies were considered. Results The prevalence of obesity was 13.6%. Obese pregnant women were significantly more likely to have cesarean sections (adjusted odds ratio [aOR] 2.0, p < 0.001), gestational diabetes (aOR 2.14, p < 0.001), hypertensive pregnancy disorders (aOR 3.43, p < 0.001), and large-for-gestational age or macrosomic infants (aOR 2.13, p < 0.001), and less likely to have small-for-gestational age newborns (aOR 0.51, p < 0.009). No significant differences were found in terms of preterm births, fetal/neonatal deaths, low birthweight newborns, and neonatal ICU admissions among cases and controls. Maternal obesity was significantly associated with higher mean blood glucose levels, in the first and second trimesters of pregnancy. Conclusion Obesity is associated with increased risks of adverse pregnancy and neonatal outcomes. These risks seem to increase progressively with increasing body mass index (BMI) class. Female obesity should be considered a major public health issue and has consequences on maternal-fetal health.


2020 ◽  
Vol 25 (1) ◽  
Author(s):  
Ingrid Reiter-Owona ◽  
Harald Hlobil ◽  
Martin Enders ◽  
Ute Klarmann-Schulz ◽  
Barbara Gruetzmacher ◽  
...  

Abstract Background Dosing recommendations for the treatment of pregnancy-acquired toxoplasmosis are empirical and widely based on experimental data. There are no pharmacological data on pregnant women with acute Toxoplasma gondii infection under treatment with pyrimethamine (PY) and sulfadiazine (SA) and our study intends to tighten this gap. Methods In this retrospective case–control study, we included 89 pregnant women with primary Toxoplasma infection (PT) treated with PY (50 mg first dose, then 25 mg/day), SA (50 mg/kg of body weight/day), and folinic acid (10–15 mg per week). These were compared to a group of 17 women with acute ocular toxoplasmosis (OT) treated with an initial PY dose of 75 mg, thereafter 25 mg twice a day but on the same SA and folinic acid regimen. The exact interval between drug intake and blood sampling and co-medication had not been recorded. Plasma levels of PY and SA were determined 14 ± 4 days after treatment initiation using liquid chromatography–mass spectrometry and compared using the Mann–Whitney U test at a p < 0.05 level. Results In 23 PT patients (26%), SA levels were below 20 mg/l. Fifteen of these 23 patients (17% of all patients) in parallel presented with PY levels below 700 µg/l. Both drug concentrations differed remarkably between individuals and groups (PY: PT median 810 µg/l, 95% CI for the median [745; 917] vs. OT 1230 µg/l [780; 1890], p = 0.006; SA: PT 46.2 mg/l [39.9; 54.4] vs. OT 70.4 mg/l [52.4; 89], p = 0.015) despite an identical SA dosing scheme. Conclusions SA plasma concentrations were found in the median 34% lower in pregnant women with PT compared to OT patients and fell below a lower reference value of 50 mg/l in a substantial portion of PT patients. The interindividual variability of plasma concentrations in combination with systematically lower drug levels and possibly a lower compliance in pregnant women may thus account for a still not yet supportable transmission risk. Systematic drug-level testing in PT under PY/SA treatment deserves to be considered.


Author(s):  
Na Li ◽  
Lefei Han ◽  
Min Peng ◽  
Yuxia Lv ◽  
Yin Ouyang ◽  
...  

AbstractBackgroundThe ongoing epidemics of coronavirus disease 2019 (COVID-19) have caused serious concerns about its potential adverse effects on pregnancy. There are limited data on maternal and neonatal outcomes of pregnant women with COVID-19 pneumonia.MethodsWe conducted a case-control study to compare clinical characteristics, maternal and neonatal outcomes of pregnant women with and without COVID-19 pneumonia.ResultsDuring January 24 to February 29, 2020, there were sixteen pregnant women with confirmed COVID-19 pneumonia and eighteen suspected cases who were admitted to labor in the third trimester. Two had vaginal delivery and the rest took cesarean section. Few patients presented respiratory symptoms (fever and cough) on admission, but most had typical chest CT images of COVID-19 pneumonia. Compared to the controls, COVID-19 pneumonia patients had lower counts of white blood cells (WBC), neutrophils, C-reactive protein (CRP), and alanine aminotransferase (ALT) on admission. Increased levels of WBC, neutrophils, eosinophils, and CRP were found in postpartum blood tests of pneumonia patients. There were three (18.8%) and two (10.5%) of the mothers with confirmed or suspected COVID-19 pneumonia had preterm delivery due to maternal complications, which were significantly higher than the control group. None experienced respiratory failure during hospital stay. COVID-19 infection was not found in the newborns and none developed severe neonatal complications.ConclusionSevere maternal and neonatal complications were not observed in pregnant women with COVID-19 pneumonia who had vaginal delivery or caesarean section. Mild respiratory symptoms of pregnant women with COVID-19 pneumonia highlight the need of effective screening on admission.


2011 ◽  
Vol 2 (3) ◽  
pp. 109-113
Author(s):  
Tarakeswari Surapaneni ◽  
Manisha Dudlani

ABSTRACT Aim To determine associations of advanced paternal age with fetal growth and adverse neonatal outcomes. Methods A hospital-based unmatched case-control study with random selection of controls. Fetal growth was determined by serial ultrasound measurements and growth was classified at birth by a neonatalogist based on the Lubchenco charts. Advanced paternal age was explored using two cutoffs (35 and 40 years). Likelihood ratios, unadjusted and adjusted odds ratios and the 95% confidence intervals around point estimates are presented. Results The study covered 218 pregnant women that included 137 (63.72%) pregnant women who delivered a live AGA/LGA baby and 78 (36.28%) pregnant women who delivered a live small for gestational age baby and 45 (20.64%) fathers with advanced paternal age based on a cutoff of ≥ 40 years and 73 (33.49%) fathers with advanced paternal age based on a age cutoff ≥ 35 years. Although advanced paternal age (both ≥ 35 and ≥ 40 years) was protective for small for gestational age babies in a bivariate analysis, the association was not significant in a multivariate regression model that adjusted for maternal age, parity, diabetes and gestational age at delivery. Advanced paternal age (both ≥ 35 and ≥ 40 years) did not show a clinically meaningful positive or negative likelihood ratio with other adverse neonatal outcomes. Conclusion Paternal age does not seem to be associated with fetal growth or adverse neonatal outcomes; however, a prospective cohort study is necessary to provide further evidence after controlling for potential confounders.


2021 ◽  
Vol 20 (1) ◽  
pp. 53-60
Author(s):  
Lijun Li ◽  
Zhen Sun ◽  
Shasha Liu ◽  
Hongyan Cui

Purpose: Sestrin2, a metabolic regulator with antioxidant activity, might have some certain predictability for the occurrence and severity of pre-eclampsia (PE). The purpose of this work was to explore the levels of serum Sestrin2 and PlGF in pregnant women with PE and their correlation with the severity index of the disease.Methods:This was a retrospective case-control study of pregnant women with PE who planned to give birth in our hospital from 05/2017 to 05/2019. Pearson correlation was used to analyze Sestrin2 and PlGF levels with PE severity. Receiver operating characteristic (ROC) curves were used to evaluate the predictive value of Sestrin2 and PlGF for PE.Results: There were 52 women in the control group, 46 in the mild PE group, and 36 in the severe PE group. As the severity of PE increased, the median levels of Sestrin2 increased (8.1, 9.8, and 11.8 ng/ml), and the levels of PlGF decreased (156, 117, and 67 pg/ml) in the three groups of women (all P<0.05).The levels of Sestrin2 and PlGF were strongly correlated with mean arterial pressure,proteinuria, newborn birth weight and gestational weeks at delivery (all P<0.001). Sestrin2 and PlGF had high efficiency of diagnosing PE (cut-off: 8.90 ng/ml, Area Under Curve [AUC]=0.979; cut-off: 122.50 pg/ml, AUC=0.963). Additionally, Sestrin2 and PlGF showed high value of severity prediction (cut-off: 11.15 ng/ml, AUC=0.857; cut-off: 68.50 pg/ml, AUC=0.837).Conclusion: Sestrin2 and PlGF are correlated with the severity of PE. Both Sestrin2 and PlGF had high value for PE diagnosis and severity prediction. Keywords: pre-eclampsia; Sestrin2; placental growth factor; oxidative stress; severity 


Sign in / Sign up

Export Citation Format

Share Document