THE EFFECT OF DECREASED HEMOGLOBIN LEVELS AT FIRST TRIMESTER ON MATERNAL AND FETAL OUTCOME – A RETROSPECTIVE STUDY

2021 ◽  
pp. 16-18
Author(s):  
Manasa D.R. ◽  
Sadananjali Sadananjali ◽  
Ramkrishna Yadgude
Keyword(s):  
Health Care ◽  
Retrospective Study ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Early Pregnancy ◽  
Pregnancy Outcomes ◽  
Negative Impact ◽  
Post Partum ◽  
Fetal Mortality ◽  
Post Partum Haemorrhage

Background And Objective: Iron deciency anemia, especially during the rst trimester has a more negative impact on both maternal & fetal well being. Commonly associated conditions are post partum haemorrhage, birth asphyxia, preeclampsia, low birth weight, preterm, abortions, still born and many more. Thus the study was aimed to determine the levels of haemoglobin in early pregnancy and effect of pregnancy outcomes at Primary Health Care, Ankalagi, Belagavi. Methodology: A retrospective study was done from 2017 April to May 2020 April for a period of three years at PHC, Ankalagi, Belagavi. Over 718 pregnant women were enrolled. Regular ANC was done. Data was collected on Maternal Age, Body mass Index (BMI), Number of parity and Socio-economic determinants. Other Demographic characteristics included rst trimester haemoglobin levels, gestational age at delivery & mode, birth weight, and pregnancy outcomes were recorded. Hemoglobin levels were estimated by Sahil's hemoglobinometer method. Categorised into four groups a) Normal :more than11g/L b) Mild anemia :9-10.9g/dl c) Moderate anemia (7-8.9g/dl) and d) Severe anemia (<7.0g/dl) Results: Mean age was 18±39 yrs. Nearly 39.75% were anemic in early pregnancy. Mild anemic were 20.75%(149), moderate anemic were18.10%(130)and severe anemic were 0.4%(3)respectively. The pregnancy outcome of low level haemoglobins duing rst trimester showed miscarriage/abortions of about18.79%, LSCS mode of delivery of about 17.02%, low birth weight of about 9.21%, preterm baby of about 2.12%, neonatal admissions of about 2.12%, still born of about 1.06%, and post partum haemorrhage of 1.77% respectively. Conclusion: The above ndings suggests that anemia in rst trimester denitely has negative impact on both maternal &fetal health. Thus adequate iron intake in early trimester (prior to conception) is crucial for healthy pregnancy. It is one of the preventable causes which can decrease the maternal & fetal mortality. Should reinforce the health education from adolescent girls, with regular antenatal check up and active participation of ASHA workers. Mothers should receive appropriate nutritional advice and supplementation at their rst point of contact with health care professionals

scholarly journals Changes in pregnancy outcomes during the COVID-19 lockdown in Iran

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fahimeh Ranjbar ◽  
Leila Allahqoli ◽  
Soheila Ahmadi ◽  
Robab Mousavi ◽  
Maryam Gharacheh ◽  
...  
Keyword(s):  
Health Care ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Health Care Services ◽  
Mode Of Delivery ◽  
Preterm Births ◽  
Future Health ◽  
Significant Difference

Abstract Background The Covid-19 pandemic response is influencing maternal and neonatal health care services especially in developing countries. However, the indirect effects of Covid-19 on pregnancy outcomes remain unknown. The aim of the present study was to compare pregnancy outcomes before and after the beginning of the Covid-19 pandemic in Iran. Methods We performed a retrospective analysis of the medical records of 2,503 pregnant women with singleton pregnancies, admitted to the maternity department of a women’s hospital in Tehran, Iran, during the pre-Covid-19 pandemic (February 19 to April 19, 2019) and the intra-Covid- 19 pandemic (February 19 to April 19, 2020) period. Results We included 2,503 women admitted to the hospital; 1,287 (51.4 %) were admitted before the Covid-19 lockdown and 1,216 (48.6 %) during the Covid-19 lockdown. There were no significant differences in stillbirth rates (p = 0.584) or pregnancy complications (including preeclampsia, pregnancy-induced hypertension and gestational diabetes) (p = 0.115) between pregnant women in the pre- and intra-pandemic periods. However, decreases in preterm births (p = 0.001), and low birth weight (p = 0.005) were observed in the pandemic period compared to the pre-pandemic period. No significant difference in the mode of delivery, and no maternal deaths were observed during the two time periods. Conclusions In our study we observed a decrease in preterm births and low birth weight, no change in stillbirths, and a rise in the admission rates of mothers to the ICU during the initial Covid-19 lockdown period compared to pre-Covid-19 lockdown period. Further research will be needed to devise plan for immediate post-pandemic care and future health care crises.

scholarly journals Folate deficiency in early pregnancy increases the risk of low birth weight: survey of neonates in eastern China

2021 ◽  
Author(s):  
Yisheng Chen ◽  
Chunmei Ying
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Early Pregnancy ◽  
Protective Factor ◽  
Eastern China ◽  
Folate Deficiency ◽  
Serum Folate ◽  
Premature Delivery ◽  
Fetal Mortality ◽  
Mthfr C677t Polymorphism

Abstract Background Low birth weight (LBW) is a major cause of fetal mortality and morbidity. This study aims to assess the relationship between maternal serum folate levels and LBW in early pregnancy in eastern China. Methods We conducted a retrospective study including 124 newborns with LBW (born ≥ 1500g to < 2500 g) and 393 normal birth weight neonates (NBW). The maternal methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism genotyping was performed by the gene chip hybrid method. The concentrations of serum homocysteine (hcy), folate, vitamin B12 and vitamin D were measured before 18 weeks of pregnancy. Multivariable logistic regression model was used to identify the predictors of LBW. Results After controlling the covariates, maternal underweight before pregnancy (AOR = 5.15: 95% CI 2.40, 11.05), folate deficiency in early pregnancy (AOR = 2.06: 95% CI 1.03, 4.09), preeclampsia during pregnancy (AOR = 6.02: 95% CI 2.83, 12.81), and premature delivery (AOR = 23.81: 95% CI 12.90, 43.95) were risk factors for LBW. However, multipara (AOR = 0.53:95% CI 0.31, 0.91) was a protective factor for LBW. Conclusions This study revealed different factors associated with LBW in eastern China. Sufficient folate before 18 weeks of pregnancy is a protective factor for LBW. Serum folate > 32.5 nmol/L can reduce the risk of LBW. Therefore, maternal screening of folate statue in the first trimester of pregnancy could be helpful.

scholarly journals Is routine urine dip stick testing justified in asymptomatic women in early pregnancy?

2020 ◽  
Vol 10 (1) ◽  
pp. 17
Author(s):  
Jonathan Gaughran ◽  
Bethany Chung ◽  
Tom Lyne ◽  
Nuhaat Syedab ◽  
Daniel Fieldb ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Early Pregnancy ◽  
Pregnancy Outcomes ◽  
Diagnostic Yield ◽  
Secondary Outcome ◽  
Term Birth ◽  
The Cost ◽  
Asymptomatic Women ◽  
Culture Positive

Background: Routine urinalysis is commonly performed in early pregnancy units (EPUs) based on historic evidence that bacteriuria is linked to pyelonephritis, pre-term birth, mid trimester loss and low birth weight. Aim was to assess the cost and diagnostic yield of routine urinalysis in asymptomatic women in early pregnancy. A secondary outcome was the birth outcomes for women with proven bacteriuria.Methods: Retrospective review of all urinalysis performed over 12 month period in a tertiary EPU and analysis of pregnancy outcomes in the proven bacteriuria group.Results: 10,490 urinalyses performed at a cost of £40,385.50. 1162 (11%) positive urine dips; 68 (0.6%) nitrite positive. 179 microscopy, culture and sensitivity performed at a cost of £2593.71. Of the 179, 65 were culture positive giving a proven bacteriuria rate of 0.6%. The most common pathogen was E-Coli. There were no recorded episodes of pyelonephritis and no statistical significance in the pre-term birth, mid trimester loss or low birth weight rate in the culture positive versus culture negative group.Conclusions: The cost associated with routine urinalysis is significant and the diagnostic yield is extremely low. We did not identify an association between bacteriuria and adverse pregnancy outcomes. As such, urinalysis should only be performed in symptomatic/ high risk patients presenting to the EPU.

scholarly journals PREVALENCE AND DETERMINANTS OF SEVERE ANAEMIA AMONG ANTENATAL WOMEN ATTENDING A TERTIARY CARE HOSPITAL IN MANIPUR

2020 ◽  
pp. 1-4
Author(s):  
Namoijam Basanti ◽  
Ningthoukhongjam Romita Devi* ◽  
Ningombam Joenna Devi ◽  
Ningthoukhongjam Shugeta Devi ◽  
Shugeta Devi Tutor Community Medicine Thangjam Netajini Devi ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Maternal Mortality ◽  
Pregnant Women ◽  
Post Partum ◽  
Severe Anaemia ◽  
Health Concern ◽  
Care Hospital ◽  
Severe Anemia ◽  
Post Partum Haemorrhage

Introduction: WHO defines anaemia in pregnancy as haemoglobin <11gm/dl and severe anaemia as haemoglobin < 7gm/dl.Anaemia is a major health concern during pregnancy particularly for the developing countries like India. Not many studies have been done so far regarding this health issue in this part of the country.Hence,this study was done to estimate the magnitude of the problem with focus on severe anemia. Objectives: To determine the prevalence of anaemia among pregnant women attending JNIMS Hospital, Manipur and classify the grades of anaemia and determine the factors leading to anaemia and study the outcomes of severely anaemic patients. Materials and methods: A prospective, hospital-based study was conducted in the Department of Obstetrics and Gynaecology,Jawaharlal Nehru Institute of Medical Sciences (JNIMS),Porompat,from August 2017 to April 2019 among pregnant women in second and third trimesters in a 20 months' duration,in a twice weekly survey,recruitment was done on all eligible women attending Obstetrics and Gynecology OPD, JNIMS using a pre-tested semi-structured questionnaire. Haemoglobin was measured using colorimetry method. All the very severely anaemic study-subjects were followed up for any interventions given and the pregnancy outcome until discharged alive or death. Data was analysed by SPSS version 20. Mean, standard deviation, Chi square test etc. were used for analysis. The study was approved by the Institutional ethics committee. Results: The prevalence of anaemia was found to be 30.8%; mild anaemia was found in 288(17.9%), moderate in 124 (7.8%) and severe anaemia was 82 (5.1%). Severe anaemia was found to be significantly associated with age group 34 years and above, Muslim community, rural residence, being illiterate, ANC less than three times, never taken supplemental iron,with increasing gravida and booking ANC visit after 12 weeks.Blood transfusion was given to 62 out of 82 (75.6%) patients and 20 patients (24.3%) received parenteral iron. Six patients (7.3%) had associated preeclampsia, 3 (3.6%) had ante-partum haemorrhage, and 4 (4.8%) had associated post-partum haemorrhage. There were 6 (7.3%) intrauterine deaths,10 preterm deliveries (12.1%),and 7 low birth weight babies (8.5%). There was one maternal mortality with the baby in utero. Conclusion: Almost around a third of the pregnant women suffered from anaemia with a sixth of them having severe anaemia.Three fourths of the pregnant women having severe anaemia received blood transfusion. Severe anemia was associated with pre-eclampsia, ante-partum haemorrhage and post-partum haemorrhage, intra-uterine deaths, preterm deliveries, low birth weight and maternal mortality. Regular antenatal checkups, adequate intake of iron and folic acid tablets and proper age at the time of pregnancy should be encouraged.

scholarly journals Folate Deficiency in Early Pregnancy Increases the Risk of Low Birth Weight: Survey of Neonates in Eastern China

2021 ◽  
Author(s):  
Yisheng Chen ◽  
Chunmei Ying
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Early Pregnancy ◽  
Protective Factor ◽  
Eastern China ◽  
Folate Deficiency ◽  
Serum Folate ◽  
Premature Delivery ◽  
Fetal Mortality ◽  
Mthfr C677t Polymorphism

Abstract Objective: Low birth weight (LBW) is a major cause of fetal mortality and morbidity. This study aims to assess the relationship between maternal serum folate levels and LBW in early pregnancy in eastern China. Methods: We conducted a retrospective study including 124 newborns with LBW (born≥1500g to <2500 g) and 393 normal birth weight neonates (NBW). The maternal methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism genotyping was performed by the gene chip hybrid method. The concentrations of serum homocysteine (hcy), folate, vitamin B12 and vitamin D were measured before 18 weeks of pregnancy. Multivariable logistic regression model was used to identify the predictors of LBW. Results: After controlling the covariates, maternal underweight before pregnancy (AOR = 5.15: 95% CI 2.40, 11.05), folate deficiency in early pregnancy (AOR = 2.06: 95% CI 1.03, 4.09), preeclampsia during pregnancy (AOR = 6.02: 95% CI 2.83, 12.81), and premature delivery (AOR =23.81: 95% CI 12.90, 43.95) were risk factors for LBW. However, multipara (AOR = 0.53:95% CI 0.31, 0.91) was a protective factor for LBW. Conclusions: This study revealed different factors associated with LBW in eastern China. Sufficient folate before 18 weeks of pregnancy is a protective factor for LBW. Serum folate > 32.5 nmol/L can reduce the risk of LBW. Therefore, maternal screening of folate statue in the first trimester of pregnancy could be helpful.

Age-specific risk factors for adverse maternal and neonatal outcomes in Xiamen, China: A population-based retrospective study

2019 ◽  
Author(s):  
Yin-ling Chen ◽  
Li-li Han ◽  
Wei-juan Su ◽  
Fu-ping Lv ◽  
Zheng Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Retrospective Study ◽  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Maternal Age ◽  
Population Based ◽  
Adverse Pregnancy

Abstract Background: Elderly mothers are increasingly in China. We are aims to explore whether association between pregnancy to delivery interval and adverse pregnancy outcomes is affected by maternal age. Methods: A population-based retrospective study was performed in Xiamen, China. Data were derived from the Medical Birth Registry of Xiamen from 2011 to 2018. Multivariable logistic regression was used to conduct multivariable analyses based on adjusting the factors to evaluate the effect of maternal age on pregnancy outcomes. Results: Among 77,859 pregnant women with specific age, gestational diabetes mellitus (GDM) risk were increased for women aged 40 years or older (42.9%; aRR, 3.84 (3.26-4.51); P < 0.001), but not for pregnant women aged less than 25 years (9.2%; aRR, 0.60 (0.54-0.68)). Increased cesarean, preterm birth, large-for-gestational age (LGA), and low birth weight risks were more pronounced for pregnant women aged 40 years or older (66.5%, 8.4%, 26.5%, and 6.7%, respectively; aRR, 3.77 (3.14-4.52), 1.26 (0.90-1.79), 1.31 (1.08-1.60), and 1.10 (0.74-1.65), respectively; all P < 0.001). Risk of Apgar < 7 at 5 minutes were increased for women < 25 years old compared with women 35 to 39 years old (0.2% vs. 0.1%; aRR, 2.05 (0.85-4.93) vs. 0.63 (0.14-2.86)). Conclusion: Advanced maternal age increased risk of adverse pregnancy outcomes. The risk ratio of GDM, cesarean, preterm birth, LGA, and low birth weight is higher, which suggests pregnant women should guard against related risk factors and choose an appropriate mode of production. Furthermore, pregnant women should choose an ideal age for pregnancy to make themselves and child healthy.

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