Fetal Risk Factors Research Articles

Maternal and fetal risk factors for congenital anomalies of the kidney and urinary tract: a birth cohort study in urban China

Maternal and fetal risk factors for congenital anomalies of the kidney and urinary tract: a birth cohort study in urban China

Prominent themes in shoulder dystocia research: A bibliometric and document-based analysis.

This study aims to comprehensively examine the academic development of shoulder dystocia (SD) through bibliometric and document analysis and to identify topics that can guide future research. In this study, performance, co-citation, co-word, and document analyses were used as bibliometric analysis techniques. The study identified 3 main themes in terms of the intellectual structure of Shoulder Dystocia (SD): "Management of SD, Risk Factors and Associated Complications," "Clinical Practices, Birth Abnormalities and Effects of Complications," and "Impact of Education, Clinical Maneuvers and Fetal Health Outcomes." Co-occurrence analysis identified 4 significant themes: "Management and Clinical Practice of SD," "Fetal Macrosomia and Risk Factors," "Obstetric Maneuvers and Brachial Plexus Injury," and "Clinical Trends and Risks in SD." Additionally, ten consolidated themes were identified as a result of thematic coding analysis. Shoulder dystocia remains a critical component of obstetric practice. Themes such as training and simulation, risk factors, and technical and management approaches are consistently emphasized. Technological advances and studies on how machine learning techniques can be used effectively in this field reflect innovative approaches in the scientific literature. This analysis confirms that shoulder dystocia is a complex topic requiring a multidisciplinary approach and that research in this field is constantly evolving.

A Review of Fetal Development in Pregnancies with Maternal Type 2 Diabetes Mellitus (T2DM)-Associated Hypothalamic-Pituitary-Adrenal (HPA) Axis Dysregulation: Possible Links to Pregestational Prediabetes.

Research has identified fetal risk factors for adult diseases, forming the basis for the Developmental Origins of Health and Disease (DOHaD) hypothesis. DOHaD suggests that maternal insults during pregnancy cause structural and functional changes in fetal organs, increasing the risk of chronic diseases like type 2 diabetes mellitus (T2DM) in adulthood. It is proposed that altered maternal physiology, such as increased glucocorticoid (GC) levels associated with a dysregulated hypothalamic-pituitary-adrenal (HPA) axis in maternal stress and T2DM during pregnancy, exposes the fetus to excess GC. Prenatal glucocorticoid exposure reduces fetal growth and programs the fetal HPA axis, permanently altering its activity into adulthood. This programmed HPA axis is linked to increased risks of hypertension, cardiovascular diseases, and mental disorders in adulthood. With the global rise in T2DM, particularly among young adults of reproductive age, it is crucial to prevent its onset. T2DM is often preceded by a prediabetic state, a condition that does not show any symptoms, causing many to unknowingly progress to T2DM. Studying prediabetes is essential, as it is a reversible stage that may help prevent T2DM-related pregnancy complications. The existing literature focuses on HPA axis dysregulation in T2DM pregnancies and its link to fetal programming. However, the effects of prediabetes on HPA axis function, specifically glucocorticoid in pregnancy and fetal outcomes, are not well understood. This review consolidates research on T2DM during pregnancy, its impact on fetal programming via the HPA axis, and possible links with pregestational prediabetes.

Fetal single ventricle journey to first postnatal procedure: a multicentre UK cohort study

ObjectivesUK single ventricle (SV) palliation outcomes after first postnatal procedure (FPP) are well documented. However, survival determinants from fetal diagnosis to FPP are lacking. To better inform parental-fetal counselling, we...

Potential Risk Factors for Predicting Fetal Shoulder Dystocia

Objective: The aim of this study was to assess maternal, obstetric, and fetal risk factors, as well as shoulder dystocia (SD) maneuvers and perinatal outcomes, in the management of SD. Materials and Methods: This descriptive retrospective cross-sectional study analyzed 66 documented patient cases of SD from a pool of 36 390 singleton vaginal deliveries. This review was based on hospital deliveries that occurred between 2017 and 2022. In addition, 201 control cases were selected from a computer-assisted randomization program, which were based pregnancy, delivery, fetal, and newborn outcome data. Regression analysis was used to elucidate the relationship between SD and associated risk factors. Results: The SD group exhibited a significantly higher mean age ( P < .05) compared with control group. Notably, the abdominal circumference (AC) measurement (sensitivity = 81.8% and specificity = 91.0%) and birth weight (sensitivity = 62.4% and specificity = 91.5%) emerged as the most significant risk factors for SD. Conclusion: These retrospective findings may suggest that aside from birth weight and AC measurements, other risk factors for SD demonstrate low sensitivity. This work also underscored the unpredictable nature of this obstetric complication.

MATERNAL- AND FETAL-RISK FACTORS ASSOCIATED WITH LATEPRETERM AND EARLY TERM NEONATECOMPARED TO FULL TERM NEONATE BIRTH IN GARISSA COUNTY

Despite late preterm neonates (LPN) and early term neonates (ETN) constitutingmajority of preterm births globally, the risk factors associated with these preterm births, in Garissa County are largely unexplored. This study aimed to identify maternal and fetal risk factors associated with LPN and ETN births relative to their full-term counterpartsin Garissa County. The study was conducted at Garissa County Referral Hospital. A prospective cohort studythat employed convenience sampling to enroll mother-neonate pairs. Data were collected using pretested and validated questionnaires and analyzed using STATA version 17. Multinomial logistic regression analysis was performed to determine Relative Risk Ratio. The P-value was generated at α=0.05 and P<0.05 was considered statistically significant. related risk factors associated with birth of LPN, ETN and FTN were maternal age (P=0.042), occupation (P=0.024), ethnicity (P=0.021), religion (P=0.016) and absence of previous abortion/still birth/premature deliveries (P=0.015). Birth weight was associated with LPN (P<0.001), while FTN had higher likelihood of delayed initiation of breastfeeding (P=0.038) but were less likely to have feeding difficulties compared to LPN and ETN (P=0.012). A comparison of fit model with the complete set of predictors with an intercept-only, or null modelrevealed that P-values for maternal (P=0.0175) and fetal (P<0.001) related risk factors were less than Fisher’s value of 0.05, hence the null hypothesis was rejected. - and fetal-related risk factors associated with LPNs and ETNsare distinct from those of FTNs.

The Implications of Socioeconomic Status by ZIP Code on Maternal-Fetal Morbidity and Mortality in San Antonio, Texas.

Introduction Over the past 20 years, the number of pregnancy-related fatalities in the United States has been on the rise. Increases in maternal and fetal mortality have been attributed to low socioeconomic status (SES). This raises the question of whether all geographical locations are proportionally affected by this upward trend in pregnancy-related fatalities. San Antonio is one of the largest cities in the United States and is known for its economic segregation. This study aims to compare the maternal and fetal health outcomes of mothers from diverse socioeconomic backgrounds in San Antonio, Texas. Methods To analyze the relationship between pregnancy-related mortality rates and SES in San Antonio, Texas, the International Classification of Diseases (ICD)-10 codes for maternal and fetal demise and their associated risk factors were identified. The ICD-10 codes were used to compare the health outcomes of pregnant women from the highest SES ZIP Code (78255, median income $124,397) to women from the lowest SES ZIP Code (78207, median income $25,415) using the Texas Inpatient Public Use Data File for 2016, which contains information on 93-97% of all hospital discharges in San Antonio, Texas. Results Notably, pregnant women from the high SES ZIP Code were admitted to the hospital from clinics or a physician's office (68.8%), while pregnant women from the low SES ZIP Code were admitted to the hospital from non-healthcare facilities like home or workplace (62.5%). In addition, a greater percentage of patients from the low SES ZIP Code were Black (4.3% vs 1.3%) or Hispanic (88.5% vs 35.1%). Compared to women from the high SES ZIP Code, women from the low SES ZIP Code experienced more fetal deaths and a higher prevalence of maternal and fetal risk factors such as obesity (47.6% vs 32.5%), asthma (1.7% vs 1.3%), hypertension (0.8% vs 0%), substance abuse (0.5% vs 0%), diabetes mellitus (9.8% vs 7.8%), preeclampsia (7.7% vs 2.6%), and multiple C-sections (35.5% vs 28.6%). Finally, fetal mortality rates were higher in the low SES ZIP Code (1.1% vs 0%). Although there were no statistically significant maternal or fetal mortality differences between the ZIP Codes, the trend suggests that women's health outcomes in San Antonio are not equitable. Discussion Analysis reveals disproportionate health outcomes for women in south San Antonio. Further investigation is warranted to better understand the role social and medical factors play in these results. Investigating the relationship between SES and pregnancy-related mortality can help to better inform healthcare providers and identify ways to improve women's health outcomes in San Antonio, Texas.

Umbilical Vascular Thromboembolism: High-Risk Factors, Diagnosis, Management, and Pregnancy Outcomes: A Scoping Review.

Umbilical vascular thromboembolism is a rare condition that can lead to serious consequences such as fetal hypoxia, fetal growth restriction, and even stillbirth. However, there is currently a lack of research on the pathology, pathogenesis, clinical management, and prognosis of this condition. Therefore, the purpose of this article is to analyze this condition's high-risk factors, clinical characteristics, pregnancy management, and discuss its corresponding pregnancy outcomes. Databases such as PubMed are searched using the relevant keywords of umbilical vascular thromboembolism in worldwide. And related information is analyzed such as maternal risk factors, fetal risk factors, umbilical cord and placental risk factors, and pregnancy outcomes. The literature search yields 113 articles, 64 of which meet the inclusion criteria for umbilical vascular thromboembolism. There are 4 retrospective cohort studies and 8 case series, the rest are all case reports. A total of 262 cases of umbilical vascular thromboembolism are found. The most common maternal complications and fetal related risk factors are diabetes (25 cases, 9.5%) and stillbirths (106 cases, 40.5%), respectively. Among these 262 cases, 98 (37.4%) cases are found by prenatal ultrasound to have umbilical vascular thromboembolism and the fetus is in a viable state with complete clinical information. In addition, considering the effectiveness and safety of low molecular weight heparin in thromboembolic conditions, twenty-four patients of umbilical artery thromboembolism attempted to use low molecular weight heparin during observation. Maternal diabetes was the highest risk factor for this condition. When umbilical artery thromboembolism occurs, the incidence of stillbirth increases. Premature patients with this condition can continue their pregnancy under close external monitoring. However, due to the small sample size, further research is needed.

Preterm Birth: Screening and Prediction.

Preterm birth (PTB) affects approximately 10% of births globally each year and is the most significant direct cause of neonatal death and of long-term disability worldwide. Early identification of women at high risk of PTB is important, given the availability of evidence-based, effective screening modalities, which facilitate decision-making on preventative strategies, particularly transvaginal sonographic cervical length (CL) measurement. There is growing evidence that combining CL with quantitative fetal fibronectin (qfFN) and maternal risk factors in the extensively peer-reviewed and validated QUanititative Innovation in Predicting Preterm birth (QUiPP) application can aid both the triage of patients who present as emergencies with symptoms of preterm labor and high-risk asymptomatic women attending PTB surveillance clinics. The QUiPP app risk of delivery thus supports shared decision-making with patients on the need for increased outpatient surveillance, in-patient treatment for preterm labor or simply reassurance for those unlikely to deliver preterm. Effective triage of patients at preterm gestations is an obstetric clinical priority as correctly timed administration of antenatal corticosteroids will maximise their neonatal benefits. This review explores the predictive capacity of existing predictive tests for PTB in both singleton and multiple pregnancies, including the QUiPP app v.2. and discusses promising new research areas, which aim to predict PTB through cervical stiffness and elastography measurements, metabolomics, extracellular vesicles and artificial intelligence.

Potential risk factors for fetal loss due to umbilical cord torsion in the mare

Equine pregnancy failure can occur throughout gestation with etiologies varying by region. In Europe, umbilical cord torsion (UCT) has been reported to account for up to 52% of abortions and stillbirths. Little is known about what causes excessive twisting of the umbilical cord (UC), and up till now, only the length of the UC has been identified as a risk factor for UCT. The aim of the present study was to determine the association of potential maternal and fetal risk factors with UCT and umbilical cord length (UCL). A retrospective cohort study was performed on aborted or prematurely delivered stillborn fetuses submitted for necropsy, and a follow-up questionnaire survey was sent to mare owners to obtain additional anamnestic data. In total 72 cases were included in the study. Multivariable regression analyses were performed to evaluate the risk factors (mare size, period of gestation, gestational length, parity, previous abortion, UCL, maternal age at abortion and fetal sex) association with UCT and UCL, and Wilcoxon rank sum test tested pairwise differences in UCL for the risk factors mare size, period of gestation and cause of abortion. Abortion caused by UCT (UCTA) was diagnosed in 37 cases, and these had shorter gestational length (8.1 ± 0.3 months) compared to fetuses lost to other causes (8.9 ± 0.2 months) (p = 0.002). UCTAs accounted for the highest prevalence of abortions in the mid gestational period (113–227 days) (14/21, 67%) compared to the late period (228–314 days) (22/50, 44%) (p = 0.05). The cause of abortion was associated with period of gestation (p = 0.009) and UCL (p = 0.002), and fetuses aborted as a consequence of UCT had longer UCs (98.84 ± 5.14 cm) compared to abortions due to other causes (67.2 ± 4.9 cm). Mares in the mid period of gestation had 7.9 times the odds of UCTA compared to the late period (CI: 1.93, 32.2), and UCL was associated with increased odds of UCTA (OR: 1.05, CI: 1.02, 1.07). UCL was associated with mare size (p = 0.012), period of gestation (p = 0.002) and cause of abortion (p = 0.001). In conclusion, UCTA was significantly associated with UCL and gestational length. The prevalence of UCTA was not influenced by mare size, but pony fetuses from UCTAs had significantly shorter UCs compared to horse fetuses. UCs longer than 54 cm may predispose ponies for UCTA. No other maternal or fetal risk factors were found to be associated with the cause of abortion.

FIGO good practice recommendations for induced or spontaneous labor at term: Prep-for-Labor triage to minimize risks and maximize favorable outcomes.

The goal of induced or spontaneous labor is childbirth by vaginal delivery. Delivery after 37 weeks is desirable and associated with favorable maternal and newborn outcomes. Delivery facilities should have suitable staff and resources on site for antenatal services and delivery care. FIGO's Prep-for-Labor triage method provides rapid diagnostic tools that help define patients as high or low risk to determine whether transfer to a higher-level center is needed. There is often a disconnect between a facility's designation and its ability to achieve safe deliveries. For preplanned labor induction, the designated clinical facility must have the right set-up and prenatal records available to achieve a successful outcome. However, this is often not the case if a patient arrives in labor or needs an induction and the facility has limited patient information and resources, thus requiring rapid management decisions. The practical guidance checklist in this article defines maternal and/or fetal risk factors and delineates approaches and safe practices for labor induction and management, including when antenatal information is limited to maximize safe delivery practices. Guidelines on using the Bishop score (>6 or <6) to manage labor are presented. Evidence supporting successful safe labor induction at 41-42 weeks of gestation in low-risk cases is described. This practice will increase the rate of spontaneous labor and delivery, minimizing intervention and thereby diverting limited clinical resources to those patients in need. In the right setting, this could lead to around 80% of women delivering spontaneously, which remains a desired goal.

Seroprevalence, Risk Factors and Maternal-Fetal Outcomes of Toxoplasma gondii in Pregnant Women from WHO Eastern Mediterranean Region: Systematic Review and Meta-Analysis.

The protozoan parasite Toxoplasma gondii may cause serious illness in the immunocompromised. The Toxoplasma gondii seropositive prevalence in pregnant women in WHO Eastern Mediterranean Region countries is inconsistent in the literature and it is associated with outcomes that have not be fully elucidated, hence the need for a better understanding of the pooled seroprevalence and associated maternal and fetal outcomes. The objective was to conduct a systematic literature review and determine the pooled prevalence of WHO Eastern Mediterranean Regional countries' pregnant women's seroprevalence of Toxoplasma gondii and the maternal-fetal outcomes. This quantitative study examined WHO Eastern Mediterranean countries' maternal-fetal outcomes and Toxoplasma gondii prevalence in pregnant women. The targeted population was pregnant women, while the primary outcome was seropositivity of Toxoplasma gondii, while other outcomes such as maternal and fetal associations and risk factors were determined PubMed, SCOPUS, MEDLINE, and Index Medicus for the Eastern Mediterranean Region (IMEMR) databases were searched up until 30 January 2023. The search terms used were "Toxoplasma gondii" OR "Toxoplasma infection" AND "Pregnant woman" or pregnan* OR Antenatal OR Prenatal OR Gravidity OR Parturition OR Maternal AND WHO Eastern Mediterranean Region). OpenMeta-Analyst and Jamovi were used to analyze the generated data. In total, 95 of 2947 articles meeting the inclusion criteria examined Toxoplasma gondii prevalence in pregnant women from WHO Eastern Mediterranean countries. The pooled prevalence of Toxoplasma gondii in pregnant women was 36.5% (95%CI: 32.6-40.4) with a median value of 35.64%, range values of 1.38-75.30%, with 99.61% heterogeneity. The pooled seroprevalence of IgG of Toxoplasma gondii was 33.5% (95%CI: 29.8-37.2) with a median value of 33.51%, and a range values of 1.38-69.92%; the pooled seroprevalence of IgM was 3.6% (95%CI: 3.1-4.1)) with a median value of 3.62 and range values of 0.20-17.47%, while cases of pooled seroprevalence of both IgG and IgM positivity was 3.0% (95%CI: 1.9-4.4) with a median value of 2.05 and a range values of 0.05-16.62%. Of the Toxoplasma gondii seropositive women, 1281/3389 (34.8%) 174/1765 (32.9%), 1311/3101 (43.7%), and 715/1683 (40.8%) of them had contact with cats, drank unprocessed milk, ate raw or undercooked meat and ate unwashed raw vegetables, respectively. The maternal-fetal outcomes associated with Toxoplasma gondii seropositivity were a history of abortions, miscarriage, stillbirth, intrauterine fetal death, and premature birth, which were found in 868/2990 (32.5%), 112/300 (36.1%), 111/375 (25.7%), 3/157 (1.9%) and 96/362 (20.1%) of women who tested positive for Toxoplasma gondii antibodies. The study found a high proportion of Toxoplasma gondii seroprevalence in pregnant women in the WHO Eastern Mediterranean Region, which may be linked to poor outcomes for mothers and their babies. Thus, pregnant women require monitoring and comprehensive prevention strategies for Toxoplasma gondii infection.

MATERNAL AND FETAL FACTORS ASSOCIATED WITH MISOPROSTOL USE IN MUBENDE REGIONAL REFERRAL HOSPITAL, UGANDA

There are numerous obstetric uses for misoprostol. It mimics the normal labour process by causing the uterus to contract strongly and by softening and dilating the cervix. This action makes it a uterotonic. The maternal uses include cervical ripening, initiating labour, treating incomplete abortions, preventing and treating postpartum haemorrhage, and causing abortions. This study sought to identify maternal and foetal risk factors related to misoprostol use among mothers who gave birth at the regional referral hospital in Mubende.&#x0D; A mixed method analytical cross-sectional design was used with mothers, their infants, and healthcare professionals. 385 respondents made up the sample. Interviews, observation, and the review of documents were used to gather the data.&#x0D; 12.4% of mothers had ever used misoprostol. In comparison to mothers who lived in rural areas, urban mothers were two times more likely to have a positive history of misoprostol usage (COR=1.843, 95% CI (0.903-3.763)). Mothers with a parity of 2–4 had a 0.5x lower likelihood of using misoprostol [COR=0.514, 95% CI (0.166–1.595)]. Better APGAR scores of 4-7 (4 times) and 8-10 (2 times) in newborns were associated with a higher likelihood of a positive history of misoprostol use.&#x0D; In conclusion, misoprostol use poses dangers to both the mother and the foetus, necessitating careful observance.

Elective cesarean section versus induced vaginal delivery: Do any differences in terms of neonatal respiratory morbidities exist?

Background/Aim: Transient tachypnea of the newborn (TTN) is mostly a benign and self-limiting common physiological disorder. Certain factors, such as elective cesarean section (CS) not preceded by spontaneous labor, delivery before 39 gestational weeks, and perinatal asphyxia, interfere with the fetal–neonatal transition. In our study, we aimed to review the results of hospitalized newborns who receive a diagnosis of TTN and investigate the possible relationship between the implementation of labor induction and the occurrence of this disorder. Methods: This study used a case-control study design. We scanned the hospital records of 156 term newborns hospitalized between January 2017 and January 2018 who received a diagnosis of TTN and who did not have any additional fetal and/or maternal risk factors. Demographic features, mode of delivery, and implementation of labor induction in vaginal deliveries were recorded and compared to the data from 150 healthy term infants. Infants were then split into two groups according to their type of labor induction, and a separate subgroup analysis was performed in terms of the risk of TTN development. Results: The incidence of TTN was 2.9% in vaginal deliveries and 8.5% in CSs. Differences between groups regarding gestational age, birth weights, gender, elective induction in vaginal deliveries, interventions in the delivery room, and types of intervention were found (P&lt;0.05). The risk of developing TTN was 2.5 times higher in the induction group compared to those who did not receive induction but still developed TTN (P&lt;0.001). Also, the risk was significantly higher in the induction group compared to those who did not receive induction and did not develop TTN (P&lt;0.001). After applying a logistic regression analysis, labor induction (odds ratio: 1.005; 95% confidence interval: 1.003–1.008, P&lt;0.001) was found to be an independent significant risk factor for developing TTN. Conclusions: This study indicates that infants born via electively induced vaginal delivery had significantly higher rates of TTN. Therefore, elective labor induction can be added as a new risk factor for TTN development. In our opinion, labor induction without valid medical and obstetric indications should be avoided due to maternal and fetal complications.

The Success of a New Protocol for Early Diagnosis and Management of Congenital Atrioventricular Block: A Follow-up Study of 15 Fetuses from November 2007 to August 2022

Background: Congenital atrioventricular heart block (CAVB) is a relatively rare condition that can lead to long-term complications. Early diagnosis and management of CAVB is currently the ideal goal, particularly in high-risk pregnancies. Methods: The Fetal Heart Center at Kurdistan University serves as the primary referral center for pregnant mothers residing in the western region of Iran. Fifteen fetuses with CAVB were admitted between November 2007 and August 2022. They were referred for one or more of the following reasons: Fetal bradycardia or arrhythmia, abnormal ultrasound findings, and previous maternal or fetal risk factors. After obtaining a complete medical history, we conducted fetal echocardiography and ordered testing for maternal Lo/Ra autoantibodies. Our therapeutic approach was based on the type of atrioventricular block (AVB), serum titer of Lo/Ra antibodies, and specific risk factors associated with each type of AVB. Consequently, we used a combination of different medications, including dexamethasone, Hydroxychloroquine (HCQ), IVIG, beta-agonists, and inotropes. Results: We admitted 15 fetuses with CAVB, including seven females (47%) and eight males (53%). Most of our cases had positive tests for Lo and Ra autoantibodies, with varying degrees of AVB. A previous fetal death was common in our case series, accounting for 47% of cases. Moderate and high antibody titers were present in 80% of our cases. Mild bradycardia was a relatively common finding in our cases of first and second-degree atrioventricular block (AVB), occurring in 33% of patients. All of the above-mentioned findings, commonly referred to as major risk factors, were used for either early evaluation or therapeutic goals. No cases with first-degree AVB developed a higher grade of AVB after our therapeutic approach. One fetus with second-degree AVB developed CCHB, and another with mixed second/third-degree AVB reverted to second-degree AVB with the use of appropriate medications. Conclusions: Our therapeutic approach for the current cases yielded satisfactory results. Subsequently, we attempted to develop a rudimentary approach for early managing and treating fetuses with various types of CAVB. We are looking forward to future multicenter studies.

Maternal Hydration with Intravenous Versus Oral Therapy in the Correction of Isolated Oligohydramnios in the third Trimester of Pregnancy

Objective: To compare the effectiveness of oral hydration versus intravenous hydration therapy in correcting amniotic fluid volume in women presenting with isolated oligohydramnios in the third trimester.&#x0D; Methodology: A randomized controlled study was conducted at the Department of Obstetrics &amp; Gynaecology, Pakistan Institute of Medical Sciences, Islamabad, over six months from March 2021 to September 2021. One hundred and twenty-six patients were enrolled, with 63 in each group. Patients with AFI &lt; 5 cm in the third trimester, singleton pregnancies, and no associated maternal or fetal risk factors were included. Demographic data, AFI at baseline, and hydration details were collected. Patients were divided into two groups: one received oral rehydration solution (ORS) every 30 minutes, and the other received intravenous (IV) lactated Ringers solution over one week. APGAR scores at 1 &amp; 5 minutes were compared between the two study groups using independent samples t-test. P value ≤0.05 was taken as significant.&#x0D; Results: Both groups were comparable in terms of demographic parameters and pre-intervention water intake. AFI increased significantly in both groups compared to baseline at various intervals and persisted even one week after the completion of the study. Urine specific gravity decreased significantly after one week in both groups. Birthweight and Apgar scores at 1 and 5 minutes were comparable in both groups.&#x0D; Conclusion: Both oral and intravenous hydration significantly increased amniotic fluid volume and were equally effective in correcting isolated oligohydramnios in the third trimester. Oral hydration is a non-invasive, cost-effective, and convenient alternative to intravenous hydration, offering potential benefits for pregnant women without the need for hospital admission or IV lines.

Pre-gestational diabetes and the risk of congenital heart defects in the offspring: A French nationwide study

To compare the frequencies and types of congenital heart defects for infants of women without and with pre-gestational diabetes, type 1 and type 2 diabetes (T1DM, T2DM) and to identify risk factors. All live births between 2012 and 2020 were screened for maternal diabetes and infant congenital heart defects using the French Medical Information System Program in Medicine, Surgery and Obstetrics database (PMSI-MCO). Incidences of these defects were estimated, and a logistic model evaluated maternal and fetal prognostic risk factors. Overall, 6,038,703 mothers did not have pre-gestational diabetes (no-diabetes), 23,147 had T1DM, and 14,401 had T2DM. The incidence of infant congenital disease was 6.2% for the no-diabetes group, 8.0%, for women with T1DM, and 8.4% for women with T2DM (P < 0.001); for congenital heart defects, incidences were respectively 0.8%, 3.0% and 2.7% (P < 0.001). In comparison with the no-diabetes group, the odds ratios (95%CI) of coronary heart defects were 2.07 (1.91;2.24) (P < 0.001) for women with T1DM and 2.20 (1.99;2.44) (P < 0.001) for women with T2DM, with no difference between T1DM and T2DM (P=0.336). cesarian section, small and large for gestational age, and prematurity were also associated with an increased risk of congenital heart defects. In this study we observed higher incidences of congenital heart defects in infants of women with pre-gestational diabetes compared to women without pre-gestational diabetes, with no difference between women with T1DM or T2DM. These data call for intensifying preconception care and justify systematic cardiac echography in selected fetuses.

Prevalence and Risk Factors of Obstructed Labor Among Pregnant Women at Selected Public Hospitals in Mogadishu- Somalia: Multi-Centered Case-Control Study

Obstructed labor (OL) is a typical reason for maternal morbidity and mortality in sub-Saharan Africa and Southeast Asia. A retrospective case-control study was conducted to determine the prevalence and risk factors of obstructed labor among pregnant women at selected public hospitals in Mogadishu-Somalia. Methods: a retrospective case-control study was conducted to ascertain risk factors of obstructed labor among pregnant women at selected public hospitals in Mogadishu- Somalia, from 1^stJuly 2020 to 30^thDecember 2020. The study site was one of the selected public hospitals in Mogadishu- Somalia, including Banadir, SOS, Madina Daynile, and Demartino public hospitals. The Maternal Sociodemographic factors, clinical factors, and complications associated with obstructed labor were obtained from selected public and clinical data. These variables were coded numerically and computerized using statistical analysis software called statistical package for social science (SPSS) version 24). <i>Results</i>: 143 out of 960 patients were obstructed Labor prevalence of 14.8%; according to age group, 22% were 15–19 years, over 47.2% were married, had educational levels (25.52%), and patients were illiterate. The majority (89.5%) of the patients were rural dwellers with (80.2%) who came from a distance between 30-59Km. Being nulliparous (first pregnancy) was the leading cause for the patients in obstructed labor (27.27%) of all the cases group. This was followed by being referred with Obstructed Labor (OL) (72.0%) and referred from Private health facilities alone, forming about (65.0%). The fetal risk factors observed in this study were Cephalo-pelvic disproportion, with a reported (71.1%), and fetal malpresentation, with (23.8%). The dominant maternal complication type reported in this study was ruptured uterus (43.3%) among obstructed labor. The most typical fetal complication was birth Asphyxia (40.5%), although there was a significant association between demographics, Obstetrical risk factors, and the developing obstructed labor. Conclusion: This study showed a high prevalence of obstructed labor, and sociodemographic attributes and obstetrical factors are causal factors to its development. The results of this study make it clear that the Ministry of Health and other healthcare stakeholders must seek to scale up present facility-based interventions to improve maternal outcomes and lessen the effects and incidences of obstructed labor.

Early teenage pregnancy (12 to 14 years) in Solidaridad, Q. Roo. México

Introduction. As of 2019, adolescent girls aged 15-19 in low- and middle-income countries had approximately 21 million pregnancies each year, of which approximately 50% were unintended and resulted in 12 million births. Material and method. Retrospective, cross-sectional, descriptive and observational study on the prevalence of pregnancies in adolescents between 10 and 14 years of age in the municipality of Solidaridad, Q. Roo México, during a five-year period (2018 to 2022) by reviewing the clinical records of all early adolescent pregnant women. Descriptive statistics of central tendency and dispersion were used for analysis. Results. During the study period, 14 cases of early pregnant adolescents (10 to 14 years old) were found out of a total of 629 pregnancies in early and late adolescents between 10 and 19 years old, distributed as follows: 2018=4; 2019=9, 2020=1. Discussion. Despite efforts to reduce the incidence of teenage pregnancy, including preventing child marriage, keeping girls in education and improving access to contraception, adolescent girls continue to get pregnant and few developing countries adequately prioritize their care. An insight into adolescent pregnancy experiences will help identify whether context-specific services meet their needs, whether they require additional support, and how to optimize their pregnancy experience. Conclusions. We found only two factors as Maternal Risk Factors: 1) RF&lt;17 years and 2) lack of birth control. As Fetal Risk Factors three cases at birth by cesarean section. Regarding the other maternal-fetal risk factors, they did not appear in the patients of this age group. It appears that early adolescent mothers can have low-risk pregnancies at this hospital from a biological but not a sociological point of view.

Maternal, Fetal and Service-Related Risk Factors for Stillbirths During Conflict Situation, Yemen, 2015-2016

Background: Stillbirth is a silent traumatic canker, which is a major concern to individuals, health institutions countries worldwide and continues to be a major global problem responsible for nearly three million deaths each year. To estimate the stillbirth rate (SBR) and to identify the potential risk factors for stillbirth. Subjects and Method: A community-based prospective cohort study was undertaken between August 2015 and December 2016 in which 980 pregnant women in Sana’a city of Yemen were identified. A multi-stage cluster sampling was used to select participants from community households. The independent variables were socio-demographic, prenatal and past obstetric, special habit, birth and fetal. The dependent variable was stillbirth. The data collection of this study used a questionnaire. Binomial regression together with generalized linear models, were employed in this study. Results: The results identified that the stillbirth rate (SBR) was presently between 46.2 per 1000 and 45.2 per 1000 cases. The multivariable analysis identified teenage mothers aged &lt; 20 years, with their first childbirth, had a (aOR= 3.70; 95% CI= 1.76 to 7.76; p&lt;0.001) women with anemia (aOR = 2.23; 95% CI= 1.67 to 2.98; p&lt;0.001), smoking snuff (aOR = 4.27; 95% CI= 1.17 to 15.55; p= 0.028), prolonged labor (&gt; 24 hours) (aOR= 2.02; 95% CI= 1.38 to 2.96; p&lt; 0.001), prolonged rupture of membranes (≥ 24 hours) (aOR= 2.22; 95% CI= 1.66 to 2.98; p&lt;0.001), fetal malposition (aOR= 4.60; 95% CI= 2.97 to 7.12; p&lt;0.001), low birth weight (aOR= 14.90; 95% CI= 4.30 to 51.75; p&lt;0.001) and fetal gestational age (in weeks) (aOR = 5.60; 95% CI= 2.52 to 12.41; p&lt;0.001). These factors were associated with an increased risk of stillbirths. Conclusion: This study is encouraging pregnant women to deliver at health facilities, providing better management of obstetrical complications, proper antenatal care, and prompt referral services are essential for the reduction of stillbirths in Yemen. Keywords: stillbirth, risk factors, community-based study, cohort study, Sana’a city, Yemen Correspondence: Ahmed H. Al-Shahethi. National Center for Epidemiology and Diseases Surveillance, Ministry of Public Health and Population, Yemen. P.O. box: 299. Fax: +9671564720. Phone: +967771922712. Email: alshahethi71@yahoo.com, ahmedhamood71@gmail.com.