Association Of Maternal Risk Factors Research Articles

Association of Maternal Risk Factors with the Prevalence of Caesarean Section Deliveries: A Cross-Sectional Study.

In the last few years, there has been a gradually increasing rate of caesarean section deliveries worldwide that negatively affects both mothers' and children's health. The present survey intended to explore the relations of common maternal risk factors with the prevalence of caesarean sections. This is a cross-sectional study including 5182 healthy mothers from geographically diverse regions of Greece, which has applied relevant inclusion and exclusion criteria. An elevated 56.4% incidence of caesarean sections was noted. The prevalence of caesarean section deliveries was estimated to be 51.5% in private hospitals and 48.5% in public hospitals. Maternal age, pre-pregnancy overweight/obesity, excess gestational weight gain, preterm birth, financial status, smoking habits, and private type of birth hospital were considerably associated with a high probability of caesarean section, regardless of several confounders. In conclusion, caesarean section rates are constantly increasing, and various maternal risk factors additively elevate its incidence, which additionally enhances the likelihood of postpartum complications for both the mothers and their infants. Public health procedures and approaches are strongly recommended to notify future mothers of the potential risk factors that may result in adverse pregnancy outcomes of caesarean section delivery, highlighting its use only for emergency medical reasons and also promoting healthier nutritional and lifestyle habits that may reduce the increasing prevalence of caesarean section deliveries.

Association of maternal risk factors with infant maltreatment: an administrative data cohort study

ObjectiveWe aimed to evaluate the risk of infant maltreatment associated with commonly used criteria for home visiting programmes: young maternal age, maternal adversity (homelessness, substance abuse, intimate partner violence), newcomer...

Association of maternal risk factors with fetal aneuploidy and the accuracy of prenatal aneuploidy screening: a correlation analysis based on 12,186 karyotype reports

BackgroundNIPT is becoming increasingly important as its use becomes more widespread in China. More details are urgently needed on the correlation between maternal risk factors and fetal aneuploidy, and how these factors affect the accuracy of prenatal aneuploidy screening.MethodsInformation on the pregnant women was collected, including maternal age, gestational age, specific medical history and results of prenatal aneuploidy screening. Additionally, the OR, validity and predictive value were also calculated.ResultsA total of 12,186 analysable karyotype reports were collected with 372 (3.05%) fetal aneuploidies, including 161 (1.32%) T21, 81 (0.66%) T18, 41 (0.34%) T13 and 89 (0.73%) SCAs. The OR was highest for maternal age less than 20 years (6.65), followed by over 40 years (3.59) and 35–39 years (2.48). T13 (16.95) and T18 (9.40) were more frequent in the over-40 group (P < 0.01); T13 (3.62/5.76) and SCAs (2.49/3.95) in the 35–39 group (P < 0.01). Cases with a history of fetal malformation had the highest OR (35.94), followed by RSA (13.08): the former was more likely to have T13 (50.65) (P < 0.01) and the latter more likely to have T18 (20.50) (P < 0.01). The sensitivity of primary screening was 73.24% and the NPV was 98.23%. The TPR for NIPT was 100.00% and the respective PPVs for T21, T18, T13 and SCAs were 89.92, 69.77, 53.49 and 43.24%, respectively. The accuracy of NIPT increased with increasing gestational age (0.81). In contrast, the accuracy of NIPT decreased with maternal age (1.12) and IVF-ET history (4.15).Conclusions①Pregnant patients with maternal age below 20 years had higher risk of aneuploidy, especially in T13; ②A history of fetal malformations is more risky than RSA, with the former more likely to have T13 and the latter more likely to have T18; ③Primary screening essentially achieves the goal of identifying a normal karyotype, and NIPT can accurately screen for fetal aneuploidy; ④A number of maternal risk factors may influence the accuracy of NIPT diagnosis, including older age, premature testing, or a history of IVF-ET. In conclusion, this study provides a reliable theoretical basis for optimizing prenatal aneuploidy screening strategies and improving population quality.

Association of Maternal Risk Factors with Birth Weight of Newborn in a Tertiary Level Hospital in Dhaka City

Background: Lowbirthweight(LBW)contributes substantially to neonatal, infant, and childhood mortality and morbidity. Several maternal factors contribute to the incidence of LBW, majority of which are biologically and socially interrelated, are modifiable; making LBW a potentially preventable condition. Objective: To evaluate the association of maternal risk factors with birth weight of newborn. Methods: This hospital-based cross-sectional comparative study was conducted in Mugda medical college, Dhaka, a government health center of Bangladesh, from January 2019 to 30 June 2019. A total of 180 recently delivered pregnant mother were included in this study and categorized into two groups: Group A- 90 mother who had given birth of low birth weight baby, and Group B- another 90 mother who delivered normal birth weight baby.Face-to-face interviews using a structured questionnaire and a review of medical records were carried out. Statistical analyses of the results were obtained by using window-based computer software devised with SPSS version 23. Results: Highest percentage of patients from both group A and B were belonged to 20 - 34 years of age (62.2% and 81.1% respectively) and para £3 (76.7% and 88.8% respectively) with significant odds ratio for delivering low birth weight baby at advanced maternal age (³35 years) (OR=2.14, p value 0.037) and high parity (para &gt;3) (OR=2.44, p value 0.03).Majority mothers from group A had hypertension (58.9%) whereas 90% mothers from group B were normotensive with significant odds ratio (OR= 12.89, p value &lt;0.001) as risk factor for predicting low birth weight baby. Multivariate logistic regression analysis revealed that gestational hypertension was the most powerful independent risk factor (OR= 12.72, p value &lt;0.001) for delivering LBW baby compared to age ³35 years (OR= 0.757, p value .717) and parity &gt;3 (OR= 2.66, p value 0.257). Conclusion: Gestational hypertension, advanced maternal age and high parity are the significant risk factors for delivering LBW baby. However, further larger multicenter study is recommended. Bangladesh Med Res Counc Bull 2021; 47(1): 50-56

Maternal Predictors of Disparate Outcomes in Children With Single Ventricle Congenital Heart Disease.

BackgroundSignificant variability in morbidity and mortality persists for children with functionally single ventricle congenital heart disease (SV‐CHD) despite standardization in medical and surgical care. We hypothesized that maternal health factors may be associated with an increased risk of poor outcomes in children with SV‐CHD.Methods and ResultsThis retrospective, observational, cohort study included term maternal‐infant pairs with a diagnosis of SV‐CHD who underwent surgical palliation from 2006 to 2015 at Primary Children's Hospital. Pairs lacking maternal variables of interest or infant follow‐up data were excluded. The association of maternal risk factors of abnormal pre‐pregnancy body mass index, abnormal gestational weight gain (<7 or >20 kg), hypertensive disorders, and gestational diabetes mellitus with death/transplant and hemodynamics were analyzed using regression models. Of 190 infants, 135 (71%) maternal‐infant dyads had complete data for inclusion. Death or transplant occurred in 48 infants (36%) during an average follow‐up of 2.2 years (0.1–11.7 years). Abnormal gestational weight gain was associated with an increased risk of death and/or transplant in logistic regression (odds ratio, 3.22; 95% CI, 1.32–7.86; P=0.01), but not Cox regression (hazard ratio, 1.9; 95% CI, 1.0–3.7; P=0.055). Mean pulmonary artery pressures were higher in the setting of abnormal gestational weight gain (16.5±2.9 versus 14.7±3.0 mm Hg; P<0.001), and abnormal pre‐pregnancy body mass index (15.7±3.5 versus 14.2±2.1 mm Hg; P<0.001) in the systemic right ventricle group.ConclusionsAbnormal gestational weight gain (excessive or inadequate) is a novel risk factor for worse outcomes in SV‐CHD. The fetoplacental environment may alter the trajectory of vascular development to impact outcomes in infants with SV‐CHD.

Association of maternal risk factors with the recent rise of neural tube defects in Canada.

We sought to assess the recent trend in NTD prevalence at birth in the post-folic acid food fortification era and to identify the maternal risk factors associated with that trend. We carried out a population-based study of all livebirths and stillbirths (including late pregnancy terminations) delivered in hospitals in Canada (excluding Quebec) from 2004 to 2015 (n=3439330). We examined NTD birth prevalence by year, multiple pregnancy, maternal age, parity, pregestational diabetes, chronic illness, and problematic substance use. Poisson regression was used to quantify the association between spina bifida and cranial defects and maternal characteristics and other risk factors. We identified 1517 non-chromosomal NTDs, yielding a birth prevalence of 4.4 per 10000 total births. NTD prevalence rose from 3.6 in 2004 to 4.6 per 10000 in 2015 (Ptrend =0.03). Among NTD subtypes, only spina bifida showed a temporal increase (Ptrend =0.03). Birth prevalence of spina bifida was higher among younger mothers, those with type 2 diabetes (rate ratio (RR) 3.74, 95% confidence interval (CI) 2.21, 6.35), chronic illness (RR 3.16, 95% CI 1.97, 5.07), and problematic substance use (RR 1.88, 95% CI 1.31, 2.71). Adjusting for risk factors attenuated the significant temporal trend in spina bifida (unadjusted average annual prevalence ratio (aAAPR) 1.016, 95% CI 1.001, 1.032; adjusted AAPR 1.014, 95% CI 0.998, 1.029). Increases in the frequency of maternal risk factors such as pregestational diabetes mellitus, substance use, and chronic illness may be partly responsible for the recent rise in NTDs, particularly spina bifida.

Maternal Risk Factors Associated with Low Birth Weight in Indonesia

Background: Low birth weight (LBW) is a major risk factor for death and disease in the fetus and newborn infant. However, the study about LBW and maternal risk factors involved in Indonesia is still limited. Objective: The present study attempted to examine the association of maternal risk factors including mother’s age, mother and husband education, mother and husband occupation and wealth, ANC visit, desired pregnancy and obstetric complication toward the occurrence of low birth weight infant across region and family wealthy. Methods: This study employed the data from the national survey of Indonesia Demographic and Health Survey (IDHS). The latest births from married women who gave birth within 2 years (2011 and 2012) preceding the IDHS were considered as sample selection. It was approximately 15,126 respondents. The predicted risks of low birth weight were estimated using multilevel logistic analysis. Results: Data were collected on 15,126 pregnant women who reported 10.2% were with LBW infants. When using the multilevel logistic analysis, the factors associated with LBW were maternal delivery-baby age, mother’s education, antenatal care and pregnancy complication at significant levels of 0.01. Conclusion: The prevalence of preterm infants in this study was quite high. Factors affecting LBW were maternal age, maternal education, ANC visits and pregnancy complication. The ANC visit of pregnant women is a potential and feasible activity to reduce the incidence of LBW.

The association of maternal risk factors to macrosomia in rural areas of Haryana, India: a community based study

Background: Macrosomia affects 1-10% of all pregnancies. The macrosomia is reportedly associated with neonatal morbidity, neonatal injury, maternal injury and cesarean delivery. The present study was aimed at finding out prevalence and assessing association of maternal risk factors with macrosomia.Methods: This community based retrospective and cross-sectional study was carried out in 23 rural sub-centres of block Beri, district Jhajjar (Haryana, India) among 920 mothers. A predesigned pretested semistructured questionnaire was used to collect information. Univariate analysis along with logistic regression analysis was performed.Results: The prevalence of macrosomia among live births was 1.3% (n=12). In the present study, mothers from upper and upper middle socio-economic status had six times higher odds of delivering a large baby. Diabetic mothers had seventeen times higher incidence of macrosomia as compared to non-diabetic mothers. Mothers who consumed full course of iron folic acid (IFA) tablets during antenatal period had 24% lesser chances of macrosomia in live births as compared to mothers who did not consume the full course.Conclusions: The findings of the present study emphasize that incidence of macrosomia can be reduced by strengthening antenatal monitoring, prevention of complications, early diagnosis and appropriate and adequate management of treatable risk factors in mothers.

A study to assess the association of maternal factors and the outcome of pregnancy among mothers delivering in a tertiary care hospital in Haryana, India

Background: Low birth weight is a major cause of infant mortality and is considered as a sensitive index of the nation’s health and development. World Health Organization (WHO) defines low birth weight (LBW) as weight at birth of less than 2,500 grams (up to and including 2499 grams) irrespective of the gestational age. LBW is the leading cause of neonatal and postnatal deaths and as such it remains a worldwide issue and one of the most important public health problems, particularly in developing countries. The objectives of the study were to study the outcome of pregnancy whether normal, low birth weight, or still-birth, and to study the association of maternal risk factors- haemoglobin level, diabetes mellitus, hypertension and outcome of pregnancy. Methods: It was a cross sectional study carried out among the pregnant females delivering in MM Institute of Medical Sciences and Research, Mullana, Haryana, India from January 2010 to December 2010. A total of 500 cases were interviewed for the study purpose by systematic random sampling, using a semi structured pretested questionnaire. Data was analyzed using SPSS17 software. Results: Outcomes of pregnancy recorded were 28.8% low birth weight, 5.4% stillbirth and 65.8% normal birth weight. The mean birth weight was recorded as 2.556±0.411kgs. The incidence of LBW was maximum (54.3%) among the mothers who did not seek ANC while it was minimum (12.7%) in the ones who had sought ANC for more than 3 times. 57.6% mothers were anaemic and severe anaemia in 1.4% contributed towards more number of stillbirths and LBW infants (57.14% and 42.86% respectively). 4.2% mothers were found to be suffering from pregnancy induced hypertension (PIH). 69.41% of the mothers with any infection had delivered a low birth weight baby and 4.70% had a stillborn baby . Conclusions: The present study confirms birth weight as an important determinant of neonatal and post-neonatal outcomes.

Preventing intellectual disability during pregnancy: what are the potentially high yield targets?

To identify risk factors among children with unknown cause intellectual disability (ID) and to estimate the population-attributable risk (PAR) associated with these factors. This was a retrospective cohort study of maternal and child pairs born between 2004 and 2010 in South Carolina, and information was obtained from Medicaid billing records, birth certificates, and other administrative data. The data included 123,922 children and logistic generalized estimating equations (GEE) regression models were used to estimate the association of maternal risk factors and ID. We estimated models with and without birth weight as a covariate, since low birth weight is known to be a mediator of the association between some risk factors and ID in children. The prevalence of ID in the children was 3.85% and the associations between risk factors and ID were similar for female and male children. We found that the odds of having ID were increased if a child's mother had a diagnosis of major depression; for male children, the odds ratio (OR) was 1.34 (95% confidence interval [CI] 1.14-1.59, PAR 2.17%); and for females, the OR was 1.59 (95% CI 1.30-1.95, PAR 4.70%). The odds of having ID were also increased for children of women with bipolar disorder (males - OR 1.95, 95% CI 1.53-2.48, PAR 2.85%; females - OR 1.63, 95% CI 1.20-2.22, PAR 2.05%). Major maternal depression and bipolar disorder were each significantly associated with the odds of ID in children, each accounting for approximately 2-5% of the PAR, when controlling for covariates.

Bacteriological profile and antibiotic susceptibility pattern of neonatal septicemia in a tertiary care hospital of Tripura

Background:Sepsis is the commonest cause of neonatal mortality and is influenced by the quality of intrauterine life, host and environmental factors. The present study was undertaken to identify the aetiological agents causing neonatal septicemia and analyze the antibiotic susceptibility pattern, so as to guide the Pediatrician in formulating an empirical antibiotic policy against the predominant pathogens in this geographical area of North East India. Methods:On clinical suspicion of septicemia, atleast two sets of test for blood culture were performed and such neonates included in the study. Antimicrobial Susceptibility Testing was subsequently performed following Kirby Bauer Disc Diffusion method. The data obtained from culture proven septicemia was analyzed. Results:Blood culture was positive in 41.1% clinically suspected cases of septicemia. Early Onset Septicemia was confirmed in 73(57.5%) and Late Onset Septicemia in 54(42.5%) neonates. The Gram Positive organisms (51.1%) predominated over Gram negative organisms (48.9%). Staphylococcus aureus (34.6%) was the most predominant isolate followed by Klebsiellapneumoniae (24.4%). The antibiotic sensitivity pattern of the gram positive blood culture isolates indicates that all isolates were sensitive to Vancomycin. The Cephalosporins, Clindamycin and Amikacin were found significantly sensitive to Staphylococcus aureus(95.5%). All Gram negative isolates were sensitive to Imipenem followed by Piperacillin-tazobactum and Amikacin. Conclusion:Amikacin along with a third generation Cephalosporin like Cefotaxime were chosen to be the first line regimen for treatment of cases of septicemia in our setting. The predominant isolate of Staphylococcus aureus along with significant association of maternal risk factors indicates the possibility of cross infection in NICU from index case, for which emphasis need to be laid on Hospital infection control strategies. Keywords: Neonatal septicemia, Aetiology, Risk fact

Association of maternal risk factors with large for gestational age fetuses in Indian population

Colorectal cancer is the fourth leading cause of cancer death worldwide. The objective of this study was to determine the knowledge of colorectal cancer among the general population in Malaysia. A cross-sectional study was conducted among the general population in Shah Alam, Selangor, Malaysia. A total number of 300 subjects participate in this study. The mean age of the study participants was 31.38±11.07. The majority of the participants were female, less than 50 years of age, Malay, single and with no history of colorectal cancer (56.7%, 90.3%, 71.0%, 59.0% and 83.3%; respectively). Regarding the eating habits, 60.3% eat vegetables regularly, 45.0% eat green salad regularly, 29.3% took supplements regularly, 55.7% eat fruits regularly, 64.7% eat meat regularly, 46.3% eat fast food regularly and only 29.0% drink sufficient amount of water regularly. For lifestyle, 43.3% of the participants reported that they exercise regularly. Univariate analysis showed that sex, marital status, smoking cigarettes and shisha were significantly influence the knowledge of colorectal cancer (P=0.006, P=0.022, p<0.001, P<0.001; respectively). Multiple linear regression identified smoking and family history of colorectal cancer significantly associated with knowledge about colorectal cancer prevention (p<0.001, p=0.044; respectively). Conclusions: The population survey showed low awareness of colorectal cancer. Therefore importance of continuing public education, particularly about the link between lifestyle behaviors and colorectal cancer is urgently needed.

Association of maternal risk factors with early childhood caries in schoolchildren of Moradabad, India

Children who have caries in their primary teeth in infancy or toddlerhood tend to develop dental caries in their permanent dentition. Although risk indicators are helpful in identifying groups at risk, they give little information about the causes of difference in caries experience. To identify the association between maternal risk factors and early childhood caries among 3- to 5-year-old schoolchildren of Moradabad City, Uttar Pradesh, India. A total of 150 child-mother pairs participated in the study. The maternal risk factors were assessed by a pretested questionnaire. After obtaining the consent, the mothers and their children were clinically examined for dental caries using Radike criteria (1968). Saliva was collected from all the participating mothers for assessing the Streptococcus mutans level. Significant differences were found in mothers' caries activity, high level of S. mutans, educational level, socioeconomic status, frequency of maternal sugar consumption, and their child's caries experience (P < 0.001). Differences between children's situations in these underlying factors play out as consequential disparities in both their health and the health care they receive.