Long-term Neurological Morbidity Of Offspring Research Articles

Ectopic pregnancy: perinatal outcomes of future gestations and long-term neurological morbidity of the offspring.

To evaluate perinatal outcomes and long-term neurological morbidity of offspring to mothers with a history of ectopic pregnancy. In this retrospective study, perinatal outcomes and long-term neurological morbidity of offspring were assessed among mothers with a history of ectopic pregnancy, either medically or surgically treated. The study groups were followed until 18years of age for neurological-related morbidity. For perinatal outcomes, generalized estimated equation (GEE) models were used to control for confounders. A Kaplan-Meier survival curve was used to compare cumulative neurological morbidity incidence and Cox proportional hazards model was conducted to control for confounders. A total of 243,682 mothers were included; 1424 mothers (0.58%) had a previous ectopic pregnancy, of which 25.6% (n = 365) were treated medically, and 74.3% (n = 1059) were treated surgically. Using GEE models, controlling for confounders, both surgically and medically treated ectopic pregnancies were noted as independent risk factors for preterm delivery in the subsequent pregnancies. Maternal history of surgically treated ectopic pregnancy was also independently associated with cesarean delivery. Offspring to mothers with previous ectopic pregnancy had comparable rates of long-term neurological morbidity. In the Cox proportional hazards model, controlling for confounders, being born to a mother with a history of previous ectopic pregnancy was not found to be independently associated with long-term neurological morbidity of offspring. Maternal history of ectopic pregnancy is independently associated with preterm delivery. However, offspring of mothers with a history of ectopic pregnancy are not at an increased risk for long-term neurological morbidity.

687: The association between previous ectopic pregnancy and long-term neurological morbidity of the offspring

Recent studies have demonstrated an association between ectopic pregnancy and preterm delivery in the subsequent pregnancies, though less is known about long-term neurological morbidity of the offspring. The purpose of this study was to examine the association between a history of ectopic pregnancy and long-term neurological morbidity of the offspring in the subsequent pregnancies. A population-based cohort analysis was performed including all singleton deliveries between the years 1991-2014 at a tertiary medical center. The primary exposure was defined as delivering an infant to a mother with a history of previous ectopic pregnancy. The main outcome evaluated was long-term neurological morbidity of the offspring up to the age of 18 years. Neurological morbidity included hospitalizations involving a predefined set of ICD9 codes, as recorded in hospital records. A Kaplan-Meier survival curve was used to compare cumulative neurological morbidity incidence. A cox proportional hazards model was conducted to control for confounders. : During the study period, 242,342 mothers met the inclusion criteria; 1,415 mothers had previous ectopic pregnancy of which 25.7% (n=364) were treated non-surgically, and 74.3% (n=1051) were treated surgically. Long-term neurological morbidity was comparable between groups (Table). Likewise, the Kaplan-Meier survival curve did not demonstrate a significantly higher cumulative incidence of neurological morbidity in offspring of mothers with a history of previous ectopic pregnancy, regardless the choice of treatment (log-rank test p= 0.555, Figure). In the Cox regression model, while controlling for confounders such as maternal age, preterm birth, maternal diabetes mellites, and hypertensive disorders, delivery of a neonate to mother with a history of previous ectopic pregnancy was not found to be independently associated with long-term neurological morbidity of offspring. Offspring of mothers with a history of ectopic pregnancy are not at an increased risk for long-term neurological morbidity.View Large Image Figure ViewerDownload Hi-res image Download (PPT)

453: Long-term neurological morbidity of offspring born to women with systemic lupus erythematosus

453: Long-term neurological morbidity of offspring born to women with systemic lupus erythematosus

852: Maternal epilepsy and long- term neurological morbidity of the offspring

Maternal epilepsy has been associated with adverse short-term perinatal outcome of the offspring. The aim of the present study was to study the possible association between maternal epilepsy and the risk for long-term neurological morbidity of the offspring. A population-based cohort study, comparing long-term neurological morbidity of offspring of mothers with and without epilepsy was conducted. All singleton deliveries between the years 1991-2014 in a tertiary medical center were included. Cases of perinatal mortality, children with congenital malformations or chromosomal abnormalities and pregnancies without prenatal care were excluded from the study. The study groups were followed until 18 years of age for neurological-related morbidity, according to a predefined set of ICD-9 codes associated with hospitalizations of the offspring. A Kaplan-Meier survival curve was used to compare cumulative incidence of long- term neurological morbidity, and a Cox proportional hazards model was constructed to control for confounders. During the study period 242,342 deliveries met the inclusion criteria, of them 0.3% (n=704) were of mothers with epilepsy. Offspring born to mothers with epilepsy had higher rates of long-term neurological morbidity (8.2% vs 3.1%, p<0.001, Table). Likewise, the cumulative incidence of long-term neurological morbidity was higher as compared with those without maternal epilepsy (Kaplan-Meier log rank test P<0.001, Figure). Using a Cox proportional hazards model, controlling for confounders such as maternal age, hypertensive disorders of pregnancy, birth-weight and diabetes mellitus, being born to a mother with epilepsy was found to be an independent risk factor for long-term neurological morbidity of the offspring (adjusted HR 2.74, 95% CI 2.12-3.55; P<0.001). Being born to a mother with epilepsy is independently associated with higher risk for long-term neurological morbidity of the offspring.View Large Image Figure ViewerDownload Hi-res image Download (PPT)