Impact of Improved Biomass and Liquid Petroleum Gas Stoves on Birth Outcomes in Rural Nepal: Results of 2 Randomized Trials

Abstract Background Nausea and vomiting are experienced by a majority of pregnant women worldwide. Previous studies have yielded conflicting results regarding their impact on birth outcomes and few studies have examined this relationship in settings with limited resources. We aimed to determine the effect of nausea, vomiting and poor appetite during pregnancy on birth outcomes in rural Nepal. Methods Observational cohort study using data collected in two randomized, community-based trials to assess the effect of influenza immunization during pregnancy on reproductive and respiratory outcomes among pregnant women and their offspring. Pregnant women in Sarlahi District, Nepal were recruited from 2011 to 2013. Exposure was defined as nausea, vomiting or poor appetite at any point during pregnancy and by trimester; symptoms were recorded monthly throughout pregnancy. Adverse outcomes were low birth weight (LBW), preterm birth and small for gestational age (SGA). Adjusted relative risks (aRR) with 95% CIs are reported from Poisson regressions with robust variance. Results Among 3,623 pregnant women, the cumulative incidence of nausea, vomiting or poor appetite was 49.5% (n = 1793) throughout pregnancy and 60.6% (n = 731) in the first trimester. Significantly higher aRRs of LBW and SGA were observed among women experiencing symptoms during pregnancy as compared to symptom free women (LBW: aRR 1.20; 95% CI 1.05 1.28; SGA: aRR 1.16; 95% CI 1.05 1.28). Symptoms in the first trimester were not significantly associated with any of the outcomes. In the second trimester, we observed significantly higher aRRs for LBW and SGA (LBW: aRR 1.17; 95% CI 1.01 1.36; SGA: aRR 1.16; 95% CI 1.05 1.29) and a significantly lower aRR for preterm birth (aRR 0.75; 95% CI 0.59 0.96). In the third trimester, we observed significantly higher aRRs for LBW and SGA (LBW: aRR 1.20; 95% CI 1.01 1.43; SGA: aRR 1.14; 95% CI 1.01 1.29). Conclusions Symptoms of nausea, vomiting or poor appetite during pregnancy are associated with LBW, SGA and preterm birth in a setting with limited resources, especially beyond the first trimester. Trial registration Prospectively registered at ClinicalTrials.gov on Dec 17, 2009 (NCT01034254).

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Impact of maternal vaccination timing and influenza virus circulation on birth outcomes in rural Nepal

International Journal of Gynecology & Obstetrics ◽

10.1002/ijgo.12341 ◽

2017 ◽

Vol 140 (1) ◽

pp. 65-72 ◽

Cited By ~ 5

Author(s):

Naoko Kozuki ◽

Joanne Katz ◽

Janet A. Englund ◽

Mark C. Steinhoff ◽

Subarna K. Khatry ◽

...

Keyword(s):

Influenza Virus ◽

Birth Outcomes ◽

Maternal Vaccination ◽

Rural Nepal

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Economic assessment of a women's group intervention to improve birth outcomes in rural Nepal

The Lancet ◽

10.1016/s0140-6736(05)67758-6 ◽

2005 ◽

Vol 366 (9500) ◽

pp. 1882-1884 ◽

Cited By ~ 59

Author(s):

Josephine Borghi ◽

Bidur Thapa ◽

David Osrin ◽

Stephen Jan ◽

Joanna Morrison ◽

...

Keyword(s):

Birth Outcomes ◽

Group Intervention ◽

Economic Assessment ◽

Rural Nepal

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Nausea, vomiting and poor appetite during pregnancy and adverse birth outcomes in rural Nepal: an observational cohort study

10.21203/rs.2.15484/v3 ◽

2020 ◽

Author(s):

Amanda Regodón Wallin ◽

James M Tielsch ◽

Subarna K Khatry ◽

Luke C Mullany ◽

Janet A Englund ◽

...

Keyword(s):

Cohort Study ◽

Preterm Birth ◽

Pregnant Women ◽

Birth Outcomes ◽

First Trimester ◽

Observational Cohort Study ◽

Limited Resources ◽

Poor Appetite ◽

Observational Cohort ◽

Rural Nepal

Abstract Background Nausea and vomiting are experienced by a majority of pregnant women worldwide. Previous studies have yielded conflicting results regarding their impact on birth outcomes and few studies have examined this relationship in settings with limited resources. We aimed to determine the effect of nausea, vomiting and poor appetite during pregnancy on birth outcomes in rural Nepal.Methods Observational cohort study using data collected in two randomized, community-based trials to assess the effect of influenza immunization during pregnancy on reproductive and respiratory outcomes among pregnant women and their offspring. Pregnant women in Sarlahi District, Nepal were recruited from 2011-2013. Exposure was defined as nausea, vomiting or poor appetite at any point during pregnancy and by trimester; symptoms were recorded monthly throughout pregnancy. Adverse outcomes were low birth weight (LBW), preterm birth and small for gestational age (SGA). Adjusted relative risks (aRR) with 95% CIs is reported from Poisson regressions with robust variance.Results Among 3,623 pregnant women, the cumulative incidence of nausea, vomiting or poor appetite was 49.5% (n=1793) throughout pregnancy and 60.6% (n=731) in the first trimester. Significantly higher aRRs of LBW and SGA were observed among women experiencing symptoms during pregnancy as compared to symptom free women (LBW: aRR 1.20; 95% CI 1.05 1.28; SGA: aRR 1.16; 95% CI 1.05 1.28). Symptoms in the first trimester were not significantly associated with any of the outcomes. In the second trimester, we observed significantly higher aRRs for LBW and SGA (LBW: aRR 1.17; 95% CI 1.01 1.36; SGA: aRR 1.16; 95% CI 1.05 1.29) and a significantly lower aRR for preterm birth (aRR 0.75; 95% CI 0.59 0.96). In the third trimester, we observed significantly higher aRRs for LBW and SGA (LBW: aRR 1.20; 95% CI 1.01 1.43; SGA: aRR 1.14; 95% CI 1.01 1.29).Conclusions Symptoms of nausea, vomiting or poor appetite during pregnancy are associated with LBW, SGA and preterm birth in a setting with limited resources, especially beyond the first trimester.Trial registration Prospectively registered at ClinicalTrials.gov on Dec 17, 2009 (NCT01034254)

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Nausea, vomiting and poor appetite during pregnancy and adverse birth outcomes in rural Nepal: an observational cohort study

10.21203/rs.2.15484/v2 ◽

2020 ◽

Author(s):

Amanda Regodón Wallin ◽

James M Tielsch ◽

Subarna K Khatry ◽

Luke C Mullany ◽

Janet A Englund ◽

...

Keyword(s):

Cohort Study ◽

Preterm Birth ◽

Pregnant Women ◽

Birth Outcomes ◽

First Trimester ◽

Observational Cohort Study ◽

Limited Resources ◽

Poor Appetite ◽

Observational Cohort ◽

Rural Nepal

Abstract Background Nausea and vomiting are experienced by a majority of pregnant women worldwide. Previous studies have yielded conflicting results regarding their impact on birth outcomes and few studies have examined this relationship in settings with limited resources. We aimed to determine the effect of nausea, vomiting and poor appetite during pregnancy on birth outcomes in rural Nepal.Methods Observational cohort study using data collected in two randomized, community-based trials to assess the effect of influenza immunization during pregnancy on reproductive and respiratory outcomes among pregnant women and their offspring. Pregnant women in Sarlahi District, Nepal were recruited from 2011-2013. Exposure was defined as nausea, vomiting or poor appetite at any point during pregnancy and by trimester; symptoms were recorded monthly throughout pregnancy. Adverse outcomes were low birth weight (LBW), preterm birth and small for gestational age (SGA). Adjusted relative risks (aRR) with 95% CIs is reported from Poisson regressions with robust variance.Results Among 3,623 pregnant women, the cumulative incidence of nausea, vomiting or poor appetite was 49.5% (n=1793) throughout pregnancy and 60.6% (n=731) in the first trimester. Significantly higher aRRs of LBW and SGA were observed among women experiencing symptoms during pregnancy as compared to symptom free women (LBW: aRR 1.20; 95% CI 1.05 1.28; SGA: aRR 1.16; 95% CI 1.05 1.28). Symptoms in the first trimester were not significantly associated with any of the outcomes. In the second trimester, we observed significantly higher aRRs for LBW and SGA (LBW: aRR 1.17; 95% CI 1.01 1.36; SGA: aRR 1.16; 95% CI 1.05 1.29) and a significantly lower aRR for preterm birth (aRR 0.75; 95% CI 0.59 0.96). In the third trimester, we observed significantly higher aRRs for LBW and SGA (LBW: aRR 1.20; 95% CI 1.01 1.43; SGA: aRR 1.14; 95% CI 1.01 1.29).Conclusions Symptoms of nausea, vomiting or poor appetite during pregnancy are associated with LBW, SGA and preterm birth in a setting with limited resources, especially beyond the first trimester.Trial registration ClinicalTrials.gov number (NCT01034254)

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Impact of Timing of Influenza Vaccination in Pregnancy on Transplacental Antibody Transfer, Influenza Incidence, and Birth Outcomes: A Randomized Trial in Rural Nepal

Clinical Infectious Diseases ◽

10.1093/cid/ciy090 ◽

2018 ◽

Vol 67 (3) ◽

pp. 334-340 ◽

Cited By ~ 14

Author(s):

Joanne Katz ◽

Janet A Englund ◽

Mark C Steinhoff ◽

Subarna K Khatry ◽

Laxman Shrestha ◽

...

Keyword(s):

Influenza Vaccination ◽

Randomized Trial ◽

Birth Outcomes ◽

Rural Nepal ◽

In Pregnancy

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Nausea, vomiting and poor appetite during pregnancy and adverse birth outcomes in rural Nepal: an observational cohort study

10.21203/rs.2.15484/v1 ◽

2019 ◽

Author(s):

Amanda Regodón Wallin ◽

James M Tielsch ◽

Subarna K Khatry ◽

Luke C Mullany ◽

Janet A Englund ◽

...

Keyword(s):

Preterm Birth ◽

Pregnant Women ◽

Birth Outcomes ◽

First Trimester ◽

Observational Cohort Study ◽

Limited Resources ◽

Adverse Birth Outcomes ◽

Poor Appetite ◽

Observational Cohort ◽

Rural Nepal

Abstract Background: Nausea and vomiting are experienced by a majority of pregnant women worldwide. Previous studies have yielded conflicting results regarding their impact on birth outcomes and few studies have examined this relationship in settings with limited resources. We aimed to determine the effect of nausea, vomiting and poor appetite (NVP) during pregnancy on birth outcomes in rural Nepal. Methods: Observational cohort study using data collected in two randomized, community-based trials to assess the effect of influenza immunization during pregnancy on reproductive and respiratory outcomes among pregnant women and their offspring. Pregnant women in Sarlahi District, Nepal were recruited from 2011-2013. Symptoms of NVP were recorded monthly throughout pregnancy; exposure was defined as NVP at any point during pregnancy and by trimester. Adverse outcomes were low birth weight (LBW), preterm birth, and small for gestational age (SGA). Adjusted relative risk (RR) with 95% CIs is reported from Poisson regressions with robust variance. Results: Among 3,623 pregnant women, the prevalence of NVP was 49.5% (n=1793) any time during pregnancy and 60.6% (n=731) in the first trimester. Significantly higher RRs of LBW and SGA were observed among women experiencing symptoms during pregnancy as compared to symptom free women (LBW: aRR 1.20; 95% CI 1.05 1.28; SGA: aRR 1.16; 95% CI 1.05 1.28). Symptoms in the first trimester were not significantly associated with any of the outcomes. In the second trimester, we observed significantly higher RRs for LBW and SGA (LBW: aRR 1.17; 95% CI 1.01 1.36; SGA: aRR 1.16; 95% CI 1.05 1.29) and a significantly lower RR for preterm birth (aRR 0.75; 95% CI 0.59 0.96). In the third trimester, we observed significantly higher RRs for LBW and SGA (LBW: aRR 1.20; 95% CI 1.01 1.43; SGA: aRR 1.14; 95% CI 1.01 1.29). Conclusions: NVP during pregnancy is associated with birth outcomes in a setting with limited resources, especially beyond the first trimester. Trial registration: ClinicalTrials.gov number (NCT01034254) Keywords: Nausea and vomiting in pregnancy, adverse birth outcomes, pregnancy, birthweight, low birth weight, small for gestational age, preterm birth, Nepal

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1365: Admission for Nephrolithiasis in Pregnancy and Risk of Adverse Birth Outcomes

The Journal of Urology ◽

10.1016/s0022-5347(18)31579-9 ◽

2007 ◽

Vol 177 (4S) ◽

pp. 450-450

Author(s):

Mia A. Swartz ◽

Mona T. Lydon-Rochelle ◽

David Simon ◽

Jonathan L. Wright ◽

Michael P. Porter

Keyword(s):

Birth Outcomes ◽

Adverse Birth Outcomes ◽

In Pregnancy

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