scholarly journals Low First Trimester Pregnancy-Associated Plasma Protein-A Levels Are Not Associated with an Increased Risk of Intrapartum Fetal Compromise or Adverse Neonatal Outcomes: A Retrospective Cohort Study

2020 ◽  
Vol 9 (4) ◽  
pp. 1108 ◽  
Author(s):  
Jessica M. Turner ◽  
Sailesh Kumar
Keyword(s):  
Cohort Study ◽  
Preterm Birth ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Protein A ◽  
First Trimester ◽  
Neonatal Outcomes ◽  
Increased Risk ◽  
Adverse Neonatal Outcomes ◽  
Fetal Compromise

The aim of this study was to assess if women with a low first trimester maternal pregnancy-associated plasma protein-A (PAPP-A) level are at increased risk of emergency cesarean (EmCS) for intrapartum fetal compromise (IFC) and/or adverse neonatal outcomes. This was a retrospective cohort study performed at Mater Mother’s Hospital, Brisbane, Australia, between 2016 and 2018. All women with a singleton, euploid, non-anomalous fetus with a documented PAPP-A level measured between 10 +0 and 13 +6 weeks gestation during the study period were included. Data were extracted from the institution’s perinatal database and dichotomized according to PAPP-A level (≤0.4 Multiples of Medium (MoM) vs. >0.4 MoM). The primary outcomes were EmCS-IFC and a composite of severe adverse neonatal outcomes (SCNO). Nine thousand sixty-one pregnancies were included, 3.3% with a PAPP-A ≤ 0.4 MoM. Low maternal PAPP-A was not associated with an increased risk of EmCS-IFC (adjusted odds ratio (aOR) 0.77, 95% confidence interval (CI) 0.24–2.46, p = 0.66) or SCNO (aOR 0.65, 95% CI 0.39–1.07, p = 0.09). Low PAPP-A was associated with increased odds of pre-eclampsia, preterm birth and birthweight < 10th centile. In conclusion, low maternal PAPP-A level is not associated with an increased risk of EmCS IFC or adverse neonatal outcomes despite greater odds of low-birthweight infants and preterm birth.

scholarly journals The influence of obesity on perinatal outcomes in pregnancies achieved with assisted reproductive technology: A population-based retrospective cohort study

2016 ◽  
Vol 9 (1) ◽  
pp. 34-39 ◽  
Author(s):  
Amy M Valent ◽  
Eric S Hall ◽  
Emily A DeFranco
Keyword(s):  
Cohort Study ◽  
Assisted Reproductive Technology ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Tertiary Care ◽  
Population Based ◽  
Reproductive Technology ◽  
Neonatal Outcomes ◽  
Increased Risk ◽  
Adverse Neonatal Outcomes

Objective To determine the influence of obesity on neonatal outcomes of pregnancies resulting from assisted reproductive technology. Methods Population-based retrospective cohort study of all non-anomalous, live births in Ohio from 2007 to 2011, comparing differences in the frequency of adverse neonatal outcomes of women who conceived with assisted reproductive technology versus spontaneously conceived pregnancies and stratified by obesity status. Primary outcome was a composite of neonatal morbidities defined as ≥1 of the following: neonatal death, Apgar score of <7 at 5 min, assisted ventilation, neonatal intensive care unit admission, or transport to a tertiary care facility. Results Rates of adverse neonatal outcomes were significantly higher for assisted reproductive technology pregnancies than spontaneously conceived neonates; non-obese 25% versus 8% and obese 27% versus 10%, p < 0.001. Assisted reproductive technology was associated with a similar increased risk for adverse outcomes in both obese (adjusted odds ratio (aOR): 1.33, 95% confidence interval (CI): 1.11–1.59) and non-obese women (aOR: 1.34, 95% CI: 1.18–1.51) even after adjustment for coexisting risk factors. This increased risk was driven by higher preterm births in assisted reproductive technology pregnancies; obese (aOR: 1.06, 95% CI: 0.86–1.31) and non-obese (aOR: 1.15, 95% CI: 1.00–1.32). Discussion Assisted reproductive technology is associated with a higher risk of adverse neonatal outcomes. Obesity does not appear to adversely modify perinatal risks associated with assisted reproductive technology.

scholarly journals Oxygen Saturation Index in Neonates with a Congenital Diaphragmatic Hernia: A Retrospective Cohort Study

Neonatology ◽  
2021 ◽  
pp. 1-8
Author(s):  
Emily J.J. Horn-Oudshoorn ◽  
Marijn J. Vermeulen ◽  
Kelly J. Crossley ◽  
Suzan C.M. Cochius-den Otter ◽  
J. Marco Schnater ◽  
...  
Keyword(s):  
Cohort Study ◽  
Oxygen Saturation ◽  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Saturation Index ◽  
Neonatal Outcomes ◽  
Predictive Values ◽  
Adverse Neonatal Outcomes

<b><i>Introduction:</i></b> The oxygenation index (OI) is a marker for respiratory disease severity and adverse neonatal outcomes. The oxygen saturation index (OSI) is an alternative that allows for continuous noninvasive monitoring, but evidence for clinical use in critically ill neonates is scarce. The aim of this study was to evaluate the OSI as compared to the OI in term neonates with a congenital diaphragmatic hernia (CDH). <b><i>Methods:</i></b> A single-center retrospective cohort study was conducted including all live-born infants with an isolated CDH between June 2017 and December 2020. Paired values of the OI and OSI in the first 24 h after birth were collected. The relation between OI and OSI measurements was assessed, taking into account arterial pH, body temperature, and preductal versus postductal location of oxygen saturation measurement or arterial blood sampling. The predictive values for pulmonary hypertension, need for extracorporeal membrane oxygenation therapy, and survival at discharge were evaluated. <b><i>Results:</i></b> Of 33 subjects included, 398 paired values of the OI (median 5.8 [3.3–17.2]) and OSI (median 7.3 [3.6–14.4]) were collected. The OI and OSI correlated strongly (<i>r</i> = 0.77, <i>p</i> &#x3c; 0.001). The OSI values corresponding to the clinically relevant OI values (10, 15, 20, and 40) were 8.9, 10.9, 12.9, and 20.9, respectively. The predictive values of the OI and OSI were comparable for all adverse neonatal outcomes. No difference was found in the area under the receiver operating characteristic curves for the OI and the OSI for adverse neonatal outcomes. <b><i>Conclusions:</i></b> The OSI could replace the OI in clinical practice in infants with a CDH.

scholarly journals Postpartum maternal codeine therapy and the risk of adverse neonatal outcomes: A retrospective cohort study

2012 ◽  
Vol 50 (5) ◽  
pp. 390-395 ◽  
Author(s):  
David N. Juurlink ◽  
Tara Gomes ◽  
Astrid Guttmann ◽  
Chelsea Hellings ◽  
Marco L. A. Sivilotti ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Neonatal Outcomes ◽  
Adverse Neonatal Outcomes

scholarly journals Association Between Ambient Air Pollutants Exposure and Preterm Birth in Women Who Underwent in vitro Fertilization: A Retrospective Cohort Study From Hangzhou, China

2021 ◽  
Vol 8 ◽  
Author(s):  
Wenming Shi ◽  
Meiyan Jiang ◽  
Lena Kan ◽  
Tiantian Zhang ◽  
Qiong Yu ◽  
...  
Keyword(s):  
Cohort Study ◽  
Preterm Birth ◽  
Retrospective Cohort Study ◽  
Air Pollutants ◽  
Retrospective Cohort ◽  
Oocyte Retrieval ◽  
Ambient Air ◽  
Ambient Air Pollutants ◽  
Increased Risk

Objectives: Exposure to air pollutants has been linked to preterm birth (PTB) after natural conception. However, few studies have explored the effects of air pollution on PTB in patients who underwent in vitro fertilization (IVF). We aimed to investigate the association between ambient air pollutants exposure and PTB risk in IVF patients.Methods: This retrospective cohort study included 2,195 infertile women who underwent IVF treatment from January 2017 and September 2020 in Hangzhou Women's Hospital. Totally 1,005 subjects who underwent a first fresh embryo(s) transfer cycle were analyzed in this study. Residential exposure to ambient six air pollutants (PM2.5, PM10, SO2, NO2, CO, O3) during various periods of the IVF timeline were estimated by satellite remote-sensing and ground measurement. Cox proportional hazards models for discrete time were used to explore the association between pollutants exposure and incident PTB, with adjustment for confounders. Stratified analyses were employed to explore the effect modifiers.Results: The clinical pregnancy and PTB rates were 61.2 and 9.3%, respectively. We found that PM2.5 exposure was significantly associated with an increased risk of PTB during 85 days before oocyte retrieval [period A, adjusted hazard ratio, HR=1.09, 95%CI: 1.02–1.21], gonadotropin start to oocyte retrieval [period B, 1.07 (1.01–1.19)], first trimester of pregnancy [period F, 1.06 (1.01–1.14)], and the entire IVF pregnancy [period I, 1.07 (1.01–1.14)], respectively. An interquartile range increment in PM10 during periods A and B was significantly associated with PTB at 1.15 (1.04–1.36), 1.12 (1.03–1.28), and 1.14 (1.01–1.32) for NO2 during period A. The stratified analysis showed that the associations were stronger for women aged &lt;35 years and those who underwent two embryos transferred.Conclusions: Our study suggests ambient PM2.5, PM10, and NO2 exposure were significantly associated with elevated PTB risk in IVF patients, especially at early stages of IVF cycle and during pregnancy.

scholarly journals Neonatal outcomes after preterm birth by mothers’ health insurance status at birth: a retrospective cohort study

2013 ◽  
Vol 13 (1) ◽  
Author(s):  
Kristjana Einarsdóttir ◽  
Fatima A Haggar ◽  
Amanda T Langridge ◽  
Anthony S Gunnell ◽  
Helen Leonard ◽  
...  
Keyword(s):  
Cohort Study ◽  
Health Insurance ◽  
Preterm Birth ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Neonatal Outcomes ◽  
Insurance Status ◽  
Health Insurance Status

scholarly journals Maternal pregestational glucose level and adverse neonatal outcomes: a population-based retrospective cohort study

2020 ◽  
Author(s):  
Mengyao Zeng ◽  
Yang He ◽  
Min Li ◽  
Liu Yang ◽  
Qianxi Zhu ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Glucose Level ◽  
Retrospective Cohort ◽  
Fasting Glucose ◽  
Neonatal Outcomes ◽  
Very Preterm ◽  
Very Preterm Birth ◽  
Increased Risk ◽  
Adverse Neonatal Outcomes ◽  
One Year

Abstract Background: Women with diabetes or hyperglycemia during the pregnancy have been proved to be at increased risk for adverse outcomes such as primary cesarean section rate and macrosomia. However, a lack of studies have focused on the maternal glucose level prior to the pregnancy and the effect of maternal pregestational hyperglycemia or hypoglycemia on pregnancy outcomes is unclear. Hence, we conducted this study to investigate the association between maternal pregestational fasting blood glucose level and adverse neonatal outcomes.Methods: A retrospective cohort study was conducted in the Chongqing Municipality of China between April 2010 and December 2016. A total of 54365 women with their live birth singletons from all 39 counties of Chongqing who participated in the National Free Preconception Health Examination Project were included. They all took a once fasting glucose testing within one year prior to pregnancy and without a definite diagnosis of diabetes at that point. Our primary outcomes were preterm birth, very preterm birth, macrosomia, large for gestational age (LGA), low birth weight (LBW) and small for gestational age (SGA). Results: Of the 54365 women, 2813 (5.17%) were hypoglycemia, 48400 (89.03%) were normoglycemia, 2582 (4.75%) had impaired fasting glucose (IFG) and 570 (1.05%) were diabetic hyperglycemia. Compared to the normoglycemia group, women with pregestational glucose at the diabetic level had a higher rate of macrosomia (4.16% vs. 6.18%), while impaired fasting glucose group seemed to be associated with decreased risks for preterm birth (7.38% vs. 5.78%), very preterm birth (1.25% vs. 0.74%), LBW (1.18% vs. 0.59%) and SGA (5.92% vs. 4.29%), p<.05 for all. No significant difference was found between hypoglycemia and normoglycemia in the neonatal outcomes. After adjusting for potential confounders, pregestational diabetic hyperglycemia was remained significantly associated with an increased risk for macrosomia (aRR, 1.49; 95%CI, 1.07-2.09). Conclusion: Though without an overt diabetes mellitus, women with once diabetic fasting glucose level during their preconception examinations were still associated with an increased risk for macrosomia. Once fasting glucose within one year before pregnancy might also be considered as an early sign to help the obstetricians to prejudge and control the risk of macrosomia in advance.

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