scholarly journals The Influence of Maternal BMI on Adverse Pregnancy Outcomes in Older Women

Nutrients ◽  
2020 ◽  
Vol 12 (9) ◽  
pp. 2838 ◽  
Author(s):  
Małgorzata Lewandowska ◽  
Stefan Sajdak ◽  
Barbara Więckowska ◽  
Nevena Manevska ◽  
Jan Lubiński
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Cesarean Section ◽  
Older Women ◽  
Pregnancy Outcomes ◽  
Adverse Pregnancy Outcomes ◽  
Older Age ◽  
Odds Ratios ◽  
Age Related ◽  
Adverse Pregnancy

As mothers age, the risk of adverse pregnancy outcomes may increase, but the results so far are controversial and several issues remain unknown, such as the impact of maternal weight on the effects associated with older age. In a prospective cohort of 912 Polish women with singleton pregnancies (recruited in 2015–2016), we assessed the pregnancy outcomes depending on the mother’s age (18–24, 25–29, 30–34, 35–39, and ≥40 years). Women aged ≥35 years (vs. <35 years) were assessed in terms of body mass index (BMI). Multidimensional logistic regression was used to calculate the odds ratios (with 95% confidence intervals) of the pregnancy results. The risk profiles (using the Lowess method) were applied to determine the threshold risk. We found that both the youngest and the oldest group members displayed higher adjusted odds ratios of preeclampsia (PE), intrauterine growth restriction (IUGR), and preterm birth <37th week (U-shaped risk). In the remaining cases, the age ≥40 years, compared to the youngest age 18–24 years, was associated with a higher adjusted risk of gestational hypertension (GH) (AOR = 5.76, p = 0.034), gestational diabetes mellitus GDM-1 (AOR = 7.06, p = 0.016), cesarean section (AOR = 6.97, p <0.001), and low birth weight LBW (AOR = 15.73, p = 0.033) as well as macrosomia >4000 g (AOR = 8.95, p = 0.048). We found that older age ≥35 years (vs. <35 years) was associated with higher adjusted odds ratios of all the pregnancy outcomes investigated. In obese women, these adverse older age related results were found to be more intense in GH study, as well as (though weaker) in birth <37th week study, small-for-gestational age birth weight (SGA), LBW, large-for-gestational age birth weight (LGA), and macrosomia. In overweight women, these adverse older age related results were found to be more intense in preterm birth study, as well as (though weaker) in SGA and LBW. In underweight women, adverse pregnancy outcomes related to older age were more intense in a study of cesarean section. At the same time, underweight was associated with reversal of some negative effects of older age (we found lower odds ratios of GDM-1 diabetes). The maternal threshold age above which the risk of GH, PE, GDM, caesarean section, and preterm birth increased was 33–34 years (lower than the threshold of 35 years assumed in the literature), and the threshold risk of IUGR, LBW, SGA, LGA, and macrosomia was 36–37 years. Main conclusions: Older maternal age was associated with a higher chance of all kinds of obstetric complications. Older women should particularly avoid obesity and overweight.

Risks of Selected Fetal Adverse Pregnancy Outcomes at Advance Maternal Age

2021 ◽  
Vol 15 (8) ◽  
pp. 2468-2471
Author(s):  
Saadia Yasmeen ◽  
Sumayya . ◽  
Javeria Saleem ◽  
Jawairiah Liaqat ◽  
Nadia Pervaiz ◽  
...  
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Pregnancy Outcomes ◽  
Maternal Age ◽  
Advanced Maternal Age ◽  
Adverse Pregnancy Outcomes ◽  
Control Group ◽  
Postpartum Women ◽  
Adverse Pregnancy

Background and Aim: Advanced maternal age pregnancy could be referred to as pregnancy after 35 years or older. The prevalence of postponing pregnancies is increasing day by day worldwide. However, limited evidence was found on advanced maternal age pregnancy association with fetal adverse outcomes. The present study aimed to evaluate the frequency of advanced maternal age selected fetal adverse pregnancy outcomes. Place and Duration: Obstetrics & Gynaecology department of Alkhidmat Hospital Kohat and Qazi Hussain Ahmad Medical Complex, Nowshera for duration of six months from November 2020 to April 2021. Materials and Methods: This single-centered retrospective study was conducted on 220 postpartum women in the study group (≥35 years) and 170 control group postpartum women (20-34 years) who delivered at Obstetrics & Gynaecology department of Alkhidmat Hospital Kohat and Qazi Hussain Ahmad Medical Complex, Nowshera after 28 gestational weeks. Individuals who met the inclusion criteria were enrolled and sampled based on randomized control sampling technique for both control and study groups. Data extraction checklist and pretested questionnaire were used for data collection from the maternal charts. Adverse pregnancy outcome and advanced maternal age was correlated adjusted relative risks and strength with a 95% confidence interval. SPSS version 20 was used for data analysis and considered p-value >0.05 as a statistical standard. Results: The adverse neonatal outcomes include low birth weight, preterm birth, and stillbirth with a prevalence 38 (17.4%), 46 (20.8%), and 31 (14.2%) respectively in the study group. In the control group, the incidence of low birth weight, preterm birth, and stillbirth was 21 (12.6%), 15 (14.6%) and 6 (3.5%) respectively. The stillbirth (ARR=3.16 95% CI (1.29–6.03) and preterm deliveries (ARR=2.71 95% CI (1.79–3.86) risk had significantly higher prevalence compared to control group advanced age pregnancy. Insignificance association was found between low birth weight and advanced maternal age. Conclusion: Stillbirth and preterm birth was the adverse fetal outcome significantly related with advanced maternal age pregnancy. There was no significant association between low birth weight and advanced maternal age. Keywords: Maternal age, Fetal Adverse Pregnancy Outcomes

scholarly journals Socioeconomic inequalities and adverse pregnancy outcomes in the UK and Republic of Ireland: a systematic review and meta-analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e042753
Author(s):  
Katie Thomson ◽  
Malcolm Moffat ◽  
Oluwatomi Arisa ◽  
Amrita Jesurasa ◽  
Catherine Richmond ◽  
...  
Keyword(s):  
Systematic Review ◽  
Birth Weight ◽  
Preterm Birth ◽  
Pregnancy Outcomes ◽  
Meta Analysis ◽  
Adverse Pregnancy Outcomes ◽  
Individual Level ◽  
Healthy Pregnancy ◽  
Adverse Pregnancy ◽  
The Uk

ObjectiveThere has been an unprecedented rise in infant mortality associated with deprivation in recent years in the United Kingdom (UK) and Republic of Ireland. A healthy pregnancy can have significant impacts on the life chances of children. The objective of this review was to understand the association between individual-level and household-level measures of socioeconomic status and adverse pregnancy outcomes.DesignSystematic review and meta-analysis.Data sourcesNine databases were searched (Medline, Embase, Scopus, ASSIA, CINAHL, PsycINFO, BNI, MIDRIS and Google Scholar) for articles published between 1999 and August 2019. Grey literature searches were also assessed.Study selection criteriaStudies reporting associations between individual-level or household socioeconomic factors on pregnancy outcomes in the UK or Ireland.ResultsAmong the 82 353 search results, 53 821 titles were identified and 35 unique studies met the eligibility criteria. Outcomes reported were neonatal, perinatal and maternal mortality, preterm birth, birth weight and mode of delivery. Pooled effect sizes were calculated using random-effects meta-analysis. There were significantly increased odds of women from lower levels of occupation/social classes compared with the highest level having stillbirth (OR 1.40, 95% CI 1.23 to 1.59, I298.62%), neonatal mortality (OR 1.39, 95% CI 1.22 to 1.57, I297.09%), perinatal mortality (OR 1.39, 95% CI 1.23 to 1.57, I298.69%), preterm birth (OR 1.41, 95% CI 1.33 to 1.50, I270.97%) and low birth weight (OR 1.40, 95% CI 1.19 to 1.61, I299.85%). Limitations relate to available data, unmeasured confounders and the small number of studies for some outcomes.ConclusionsThis review identified consistent evidence that lower occupational status, especially manual occupations and unemployment, were significantly associated with increased risk of multiple adverse pregnancy outcomes. Strategies to improve pregnancy outcomes should incorporate approaches that address wider determinants of health to provide women and families with the best chances of having a healthy pregnancy and baby and to decrease pregnancy-related health inequalities in the general population.PROSPERO registration numberPROSPERO CRD42019140893.

Intrauterine Growth Restriction, Low Birth Weight, and Preterm Birth: Adverse Pregnancy Outcomes and Their Association With Maternal Periodontitis

2007 ◽  
Vol 78 (12) ◽  
pp. 2266-2276 ◽  
Author(s):  
Fernanda Mafra Siqueira ◽  
Luís Otávio Miranda Cota ◽  
José Eustáquio Costa ◽  
João Paulo Amaral Haddad ◽  
Ângela Maria Quintão Lana ◽  
...  
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Pregnancy Outcomes ◽  
Intrauterine Growth Restriction ◽  
Adverse Pregnancy Outcomes ◽  
Growth Restriction ◽  
Intrauterine Growth ◽  
Adverse Pregnancy

scholarly journals Periodontal disease and adverse pregnancy outcomes

2017 ◽  
Vol 14 (1) ◽  
Author(s):  
Johana Delgado ◽  
Lilian Gómez ◽  
Viviana González ◽  
Beatriz Ramírez ◽  
Juliana Vivas
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Periodontal Disease ◽  
Pregnancy Outcomes ◽  
Clinical Manifestations ◽  
Human Case ◽  
Case Control ◽  
Adverse Pregnancy Outcomes ◽  
Periodontal Pathogens ◽  
Adverse Pregnancy

Summary: The aim of this bibliographic revision is to show the existing relationshipbetween periodontal disease and some adverse pregnancy outcomes such as preeclampsia, pre-laborrupture of membranes, fetal growth restriction, preterm birth and low birth weight; by taking inaccount some aspects of the periodontal disease like clinical manifestations during pregnancy,microbiological findings, and the different results found in animal and human case-control studies.Key words: Periodontitis. Pregnancy. Preeclampsia. Periodontal pathogens. Inflammatoryreactions.

scholarly journals Association between antenatal care visits and adverse pregnancy outcomes: a retrospective cross-sectional study among Ghanaian women

2021 ◽  
Author(s):  
ALHASSAN SIBDOW ABUKARI ◽  
Shamsudeen Mohammed ◽  
Ibrahim Yakubu ◽  
Waliu Jawula Salisu ◽  
Yakubu H. Yakubu
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Adolescent Mothers ◽  
Pregnancy Outcomes ◽  
Adverse Pregnancy Outcomes ◽  
Older Mothers ◽  
Adverse Pregnancy ◽  
Ghanaian Women ◽  
Antenatal Visits

Abstract Background The study aimed to determine the association between antenatal visits and adverse pregnancy outcomes among Ghanaian women in the North East Region.Methods We analysed data on the birth records of 2907 women who delivered at Baptist Medical Centre between January 2018 to December 2018. Binary logistic regression was used to assess the association between antenatal visits and four adverse pregnancy outcomes – preterm birth, low birth weight, small-for-gestational-age, and stillbirth. Results Our analysis showed that ANC attendance offered some protection against preterm birth, low birth weight, small-for-gestational-age, and stillbirth in the study sample, albeit with variations in the protective effect depending on the number of visits attended. An increase in the number of ANC visits was associated with a decrease in the occurrence of the adverse pregnancy outcomes, except for low birth weight where the protective effect was observed only after four ANC visits. Adolescent mothers attended the least number of ANC visits during the study period. Our analysis suggests that the effect of ANC attendance on preterm birth and low birth weight differed depending on the age of the mother. Among mothers who never attended any ANC visits, adolescent mothers and older mothers had higher odds of low birth weight compared to mothers aged 20-30years. Surprisingly, the odds of preterm birth among the mothers who never attended any ANC visits was lower in adolescent mothers and older mothers compared to mothers aged 20-30years. For mothers who attended four or more ANC visits, the odds of low birth weight were higher in adolescent mothers and lower in older mothers compared to mothers aged 20-30years. However, the odds of preterm birth among the mothers who attended more than four ANC visits was higher in adolescent mothers and older mothers compared to mothers aged 20-30years. Conclusion The findings highlight the importance of ANC in preventing adverse pregnancy outcomes and the need for every pregnant woman to initiate and ensure adequate ANC contacts. The results also highlight the need to prioritise adolescents and older pregnant women for ANC.

scholarly journals A várandós nő parodontalis egészségi állapota és a terhességi komplikációk közötti kapcsolat

2018 ◽  
Vol 159 (25) ◽  
pp. 999-1007
Author(s):  
István Gera
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Periodontal Disease ◽  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Clinical Studies ◽  
Adverse Pregnancy Outcomes ◽  
Periodontal Therapy ◽  
Adverse Pregnancy

Abstract: Data from epidemiological and clinical studies published in the past two decades indicate certain association between periodontal disease and increased risk for preterm birth or low birth weight. Although the strength of those observed associations is weak, periodontitis today is considered as one of the potentially modifiable risk factors for adverse pregnancy outcomes. The aims of the publication are to summarize the epidemiological and clinical evidence for the impact of periodontal disease on adverse pregnancy outcomes and to make an attempt to overview the potential biological mechanism behind this association. The majority of epidemiological and clinical studies found certain negative effect of poor maternal periodontal condition on the incidence of low birth weight, preterm birth, pre-eclampsy, restricted foetal growth or even stillbirth. Two possible biological pathways have so far been identified: 1) the direct dissemination of the periodontal pathogens or their toxic by-products which reach the foetal-placental unit, and 2) an indirect mechanism when the circulating systemic inflammatory mediators induced by the periodontal inflammation can provoke secondary inflammation and foetal damage in the amnion. The periodontal therapy applied during the second or third trimesters has not been proven to reduce the incidence of any adverse pregnancy outcomes in pregnant women. A much more prophylaxis-oriented approach in periodontal treatment is needed. The adequate periodontal therapy should be completed before the conception to provide benefit to the pregnant women and also the new born baby. Orv Hetil. 2018; 159(25): 999–1007.

Association between Thiopurines Use and Pregnancy Outcomes in Female Patients with Inflammatory Bowel Disease: A Meta-analysis

2020 ◽  
Vol 26 ◽  
Author(s):  
Yang Zhang ◽  
Dandan Li ◽  
Heng Guo ◽  
Weina Wang ◽  
Xingang Li ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Preterm Birth ◽  
Spontaneous Abortion ◽  
Bowel Disease ◽  
Pregnancy Outcomes ◽  
Congenital Malformations ◽  
Meta Analysis ◽  
Adverse Pregnancy Outcomes ◽  
Inflammatory Bowel ◽  
Adverse Pregnancy

Background: Conflicting data exist regarding the influence of thiopurines exposure on adverse pregnancy outcomes in female patients with inflammatory bowel disease (IBD). Objective: The aim of this study was to provide an up-to-date and comprehensive assessment of the safety of thiopurines in pregnant IBD women. Methods: All relevant articles reporting pregnancy outcomes in women with IBD received thiopurines during pregnancy were identified from the databases (PubMed, Embase, Cochrane Library, and ClinicalTrials.gov) with the publication data up to April 2020. Data of included studies were extracted to calculate the relative risk (RR) of multiple pregnancy outcomes: congenital malformations, low birth weight (LBW), preterm birth, small for gestational age (SGA), and spontaneous abortion. The meta-analysis was performed using the random-effects model. Results: Eight studies matched with the inclusion criteria and a total of 1201 pregnant IBD women who used thiopurines and 4189 controls comprised of women with IBD received drugs other than thiopurines during pregnancy were included. Statistical analysis results demonstrated that the risk of preterm birth was significantly increased in the thiopurine-exposed group when compared to IBD controls (RR, 1.34; 95% CI, 1.00-1.79; p=0.049; I 2 =41%), while no statistically significant difference was observed in the incidence of other adverse pregnancy outcomes. Conclusion: Thiopurines’ use in women with IBD during pregnancy is not associated with congenital malformations, LBW, SGA, or spontaneous abortion, but appears to have an association with an increased risk of preterm birth.

scholarly journals Maternal obesity influences birth weight more than gestational diabetes

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Eman M Alfadhli
Keyword(s):  
Birth Weight ◽  
Gestational Diabetes ◽  
Pregnancy Outcomes ◽  
Maternal Obesity ◽  
Reference Group ◽  
Adverse Pregnancy Outcomes ◽  
Antenatal Visit ◽  
Oral Glucose ◽  
The Mean ◽  
Adverse Pregnancy

Abstract Background Maternal obesity and gestational diabetes (GDM) are commonly encountered during pregnancy. Both conditions are independently associated with unfavorable pregnancy consequences. The objective of this study was to compare the effects of obesity and GDM on birth weight, macrosomia, and other adverse pregnancy outcomes. Methods This cohort study involved 531 women with a singleton pregnancy attending the Maternity and Children’s Hospital, Medina, Saudi Arabia, between June 2014 and June 2015. Participants underwent a 75-g oral glucose tolerance test between 24 and 28 weeks. The International Association of Diabetes and Pregnancy Study Groups criteria were used for GDM diagnosis. BMI was assessed at the first antenatal visit, and obesity was defined as a BMI ≥30.0 kg/m2. All women were followed up until delivery. Women were divided into 4 groups: non-GDM nonobese (reference group), GDM nonobese, obese non-GDM, and obese GDM. Clinical characteristics and adverse pregnancy outcomes were compared. Results The mean age and BMI of the participants were 30.5 years and 29.3 kg/m2, respectively. GDM was diagnosed in 50.2% of the participants, and obesity was diagnosed in 47.8% of the participants. Obese women with GDM were the oldest and heaviest among all women. The mean birth weight increased in order among the four groups; it was highest in the infants in the obese GDM group, followed by those in the obese non-GDM, GDM nonobese and reference groups. Obesity and GDM alone or in combination were associated with higher rates of macrosomia and cesarean deliveries than the reference group. Neonatal intensive care unit (NICU) admission was higher in infants in the GDM nonobese and obese GDM groups. The frequency of low Apgar score was significantly higher in infants in the obese GDM group than in infants in the reference group. Conclusions Maternal obesity seems to influence birth weight more than GDM, while GDM is associated with a greater risk of admission to the NICU. The combination of both conditions is associated with the greatest risk of adverse pregnancy outcomes.

scholarly journals Factors associated with sub-microscopic placental malaria and its association with adverse pregnancy outcomes among HIV-negative women in Dar es Salaam, Tanzania: a cohort study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Aneth Vedastus Kalinjuma ◽  
Anne Marie Darling ◽  
Ferdinand M. Mugusi ◽  
Ajibola Ibraheem Abioye ◽  
Fredros O. Okumu ◽  
...  
Keyword(s):  
Birth Weight ◽  
Pregnancy Outcomes ◽  
Malaria Infection ◽  
Placental Malaria ◽  
Adverse Pregnancy Outcomes ◽  
Placental Infection ◽  
Factors Associated ◽  
Adverse Pregnancy ◽  
Prevention Methods ◽  
Dna Pcr

Abstract Background Malaria infection during pregnancy has negative health consequences for both mothers and offspring. Sub-microscopic malaria infection during pregnancy is common in most African countries. We sought to identify factors associated with sub-microscopic placental malaria, and its association with adverse pregnancy outcomes among HIV-negative pregnant women in Dar es Salaam, Tanzania. Methods We recruited a cohort of pregnant women during their first trimester and assessed for the occurrence of placental malaria and pregnancy outcomes. The follow-up was done monthly from recruitment until delivery. Histopathology placental malaria positive results were defined as the presence of malaria pigment or parasitized erythrocytes on the slide (histology-positive (HP)), and the sub-microscopic placental infection was defined as positive Plasmodium falciparum DNA by polymerase chain reaction (DNA PCR) amplification in a negative histopathology test. Adverse pregnancy outcomes investigated included low birth weight (birth weight below 2.5 kg), prematurity (live birth below 37 weeks), and small-for-gestational-age (SGA) (live born with a birth weight below 10th percentile for gestational age and sex). Weighted baseline category logit, log-binomial, and log-Poisson models were used to assess factors associated with placental malaria, and its association with adverse pregnancy outcomes. Results Among 1115 women who had histopathology and DNA PCR performed, 93 (8%) had HP placental infection, and 136 (12%) had the sub-microscopic placental infection. The risk of sub-microscopic placental malaria was greater in women who did not use mosquito prevention methods such as bed nets, fumigation, or mosquito coils (odds ratio (OR) = 1.75; 95% confidence interval (CI): 1.05–2.92; P = 0.03) and in women who were anemic (OR = 1.59; 95% CI: 1.20–2.11; P = 0.001). Women who were underweight had reduced odds of sub-microscopic placental malaria infection (OR = 0.33; 95% CI: 0.17–0.62; P = 0.001). Women who were overweight/obese had 1.48 times higher the odds of HP placental malaria compared to normal weight (OR = 1.48; 95% CI: 1.03–2.11; P = 0.03). HP placental malaria infection was associated with an increased risk of SGA births (RR = 1.30, 95% CI: 0.98–1.72, P = 0.07). In contrast, the sub-microscopic infection was associated with a reduced risk of SGA births (RR = 0.61, 95% CI: 0.43–0.88, P = 0.01). Placental malaria was not associated with low birth weight or prematurity. Conclusion Malaria prevention methods and maternal nutrition status during early pregnancy were important predictors of sub-microscopic placental malaria. More research is needed to understand sub-microscopic placental malaria and the possible mechanisms mediating the association between placental malaria and SGA.

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