Maternal Physical Characteristics Research Articles

Reasons for performing episiotomy during ectopic deliveries: An integrative literature review

The labor process is a crucial phase in a pregnant woman's life. However, it is often perceived as a frightening experience due to routine procedures carried out without her consent and the potential for traumatic experiences that can have long-lasting effects. Nursing, particularly midwifery, is responsible for providing support and care that upholds the dignity of women. This integrative literature review aims to identify and analyze the reasons health professionals identify for the practice of episiotomy in ectopic births and the situations in which it would be appropriate to perform it. The results of this review may help identify gaps in practice and guide the improvement of the quality of obstetric care. Eight articles were selected for analysis after a detailed review of 200. The review revealed that health professionals perform episiotomies for various reasons related to the fetus, the pregnant/parent, the health professional, and the birth. The most common reasons given by the participants were physical damage and maternal physical characteristics. Results provide a better understanding of practice gaps, enlighten the need to improve knowledge and evidence-based care practices, and encourage health professionals to examine their practices.

Association between adolescent pregnancy and adverse birth outcomes, a multicenter cross sectional Japanese study

We aimed to clarify how maternal physical characteristics explains the association between adolescent pregnancy and adverse birth outcomes, focusing on their height. We used a national multicenter-based delivery registry among 30,831 women under age 25 years with a singleton pregnancy between 2005 and 2011. Adolescent pregnancy was defined as younger than 20 years of age, and categorized into “junior adolescent” (aged ≤15 years) and “senior adolescent” (aged 16–19 years). We used multivariate Poisson regression and mediation analysis to assess the extent to which maternal height explained the association between adolescent pregnancy and risk of adverse birth outcomes. Risks for preterm birth [(adjusted risk ratio (aRR) 1.17, 95% confidence interval (95% CI), 1.08–1.27], low birthweight (aRR 1.08, 95% CI, 1.01–1.15), and low Apgar score (aRR 1.41 95%CI, 1.15–1.73) were significantly higher among adolescent women compared to women of 20–24 years of age. The mediation effect of maternal height on these outcomes were moderate for low birthweight (45.5%) and preterm birth (10.5%), and smaller for low Apgar score (6.6%). In all analyses, we did not detect significant differences between junior adolescent and senior adolescent. Adolescent women have higher risk of adverse birth outcomes. This association is partially mediated by shorter maternal height.

Maternal Factors Predicting Cognitive and Behavioral Characteristics of Children with Fetal Alcohol Spectrum Disorders

To provide an analysis of multiple predictors of cognitive and behavioral traits for children with fetal alcohol spectrum disorders (FASDs). Multivariate correlation techniques were used with maternal and child data from epidemiologic studies in a community in South Africa. Data on 561 first-grade children with fetal alcohol syndrome (FAS), partial FAS (PFAS), and not FASD and their mothers were analyzed by grouping 19 maternal variables into categories (physical, demographic, childbearing, and drinking) and used in structural equation models (SEMs) to assess correlates of child intelligence (verbal and nonverbal) and behavior. A first SEM using only 7 maternal alcohol use variables to predict cognitive/behavioral traits was statistically significant (B = 3.10, p < .05) but explained only 17.3% of the variance. The second model incorporated multiple maternal variables and was statistically significant explaining 55.3% of the variance. Significantly correlated with low intelligence and problem behavior were demographic (B = 3.83, p < .05) (low maternal education, low socioeconomic status [SES], and rural residence) and maternal physical characteristics (B = 2.70, p < .05) (short stature, small head circumference, and low weight). Childbearing history and alcohol use composites were not statistically significant in the final complex model and were overpowered by SES and maternal physical traits. Although other analytic techniques have amply demonstrated the negative effects of maternal drinking on intelligence and behavior, this highly controlled analysis of multiple maternal influences reveals that maternal demographics and physical traits make a significant enabling or disabling contribution to child functioning in FASD.

Maternal risk factors predicting child physical characteristics and dysmorphology in fetal alcohol syndrome and partial fetal alcohol syndrome

BackgroundPrevious research in South Africa revealed very high rates of fetal alcohol syndrome (FAS), of 46–89 per 1000 among young children. Maternal and child data from studies in this community summarize the multiple predictors of FAS and partial fetal alcohol syndrome (PFAS). MethodSequential regression was employed to examine influences on child physical characteristics and dysmorphology from four categories of maternal traits: physical, demographic, childbearing, and drinking. Then, a structural equation model (SEM) was constructed to predict influences on child physical characteristics. ResultsIndividual sequential regressions revealed that maternal drinking measures were the most powerful predictors of a child's physical anomalies (R2=.30, p<.001), followed by maternal demographics (R2=.24, p<.001), maternal physical characteristics (R2=.15, p<.001), and childbearing variables (R2=.06, p<.001). The SEM utilized both individual variables and the four composite categories of maternal traits to predict a set of child physical characteristics, including a total dysmorphology score. As predicted, drinking behavior is a relatively strong predictor of child physical characteristics (β=0.61, p<.001), even when all other maternal risk variables are included; higher levels of drinking predict child physical anomalies. ConclusionsOverall, the SEM model explains 62% of the variance in child physical anomalies. As expected, drinking variables explain the most variance. But this highly controlled estimation of multiple effects also reveals a significant contribution played by maternal demographics and, to a lesser degree, maternal physical and childbearing variables.

Risk Factors and Outcomes Associated With First-Trimester Fetal Growth Restriction

ABSTRACT Exposure of the fetus to an adverse environment may result in developmental adaptations that lead to fetal growth restriction. It has been suggested that fetal growth restriction may increase the risk of metabolic and cardiovascular diseases and other adverse outcomes in adulthood. Previous studies have shown that first trimester fetal growth restriction increased the risks of low birth weight and small size for gestational age. The effects of maternal lifestyle habits and physical characteristics on first trimester growth and postnatal outcomes are not known. This population-based prospective cohort study investigated the associations of first trimester growth restriction with adverse birth outcomes and postnatal outcomes in early childhood. The effect of several maternal physical characteristics and lifestyle habits on postnatal outcomes was also investigated. A self-administered questionnaire was completed by the mothers at enrollment. First trimester fetal growth in singleton mothers was assessed sonographically by measuring fetal crown rump length between the gestational age of 10 weeks 0 days and 13 weeks 6 days, and then performing follow-up growth scans in the second and third trimesters. The primary birth outcomes examined were preterm birth, low birth weight, and small size for gestational age at birth. Postnatal outcomes were studied up to the age of 2 years. Multivariate analysis showed that maternal age was positively associated with fetal crown rump length; the difference was 0.79 mm (95% confidence interval [CI]: 0.41–1.18) per 1 standard deviation (4.68 maternal years of age) increase. Both diastolic blood pressure and the hematocrit were negatively associated with first trimester crown to rump growth (shorter length) (differences, −0.40 mm; 95% CI: −0.74 to −0.06, and −0.52 mm; 95% CI: −0.90 to −0.14 per standard deviation increase, respectively). Mothers who smoked and did not use folic acid supplements had shorter crown rump lengths than nonsmoking mothers who used folic acid supplements; the difference was 3.84 mm; 95% CI: −5.71 to −1.98. In comparison to normal first trimester growth, restricted first trimester growth was associated with increased risks of prematurity (4.0% vs. 7.2%; adjusted odds ratio [OR]: 2.12; 95% CI: 1.24–3.61), small size for the gestational age at birth (4.0% vs.10.6%; OR: 2.64; 95% CI: 1.64–4.25), and low birth weight (3.5% vs. 7.5%; OR: 2.42; 95% CI: 1.41–4.16). Over the first 2 years of postnatal growth, each standard deviation decrease in first trimester fetal crown rump length was associated with an accelerated growth rate in weight and height; the increase in the standard deviation score was 0.139 per 2 years; 95% CI: 0.097 to 0.181. These findings demonstrate that first trimester fetal growth is independently associated with a number of maternal physical characteristics and lifestyle habits. Early fetal growth restriction is also associated with an increased risk of adverse birth outcomes and accelerated growth rates in early childhood.

Early fetal growth: concepts and pitfalls

Early fetal growth: concepts and pitfalls

Risk Factors and Outcomes Associated With First-Trimester Fetal Growth Restriction

Adverse environmental exposures lead to developmental adaptations in fetal life. The influences of maternal physical characteristics and lifestyle habits on first-trimester fetal adaptations and the postnatal consequences are not known. To determine the risk factors and outcomes associated with first-trimester growth restriction. Prospective evaluation of the associations of maternal physical characteristics and lifestyle habits with first-trimester fetal crown to rump length in 1631 mothers with a known and reliable first day of their last menstrual period and a regular menstrual cycle. Subsequently, we assessed the associations of first-trimester fetal growth restriction with the risks of adverse birth outcomes and postnatal growth acceleration until the age of 2 years. The study was based in Rotterdam, The Netherlands. Mothers were enrolled between 2001 and 2005. First-trimester fetal growth was measured as fetal crown to rump length by ultrasound between the gestational age of 10 weeks 0 days and 13 weeks 6 days. Main birth outcomes were preterm birth (gestational age <37 weeks), low birth weight (<2500 g), and small size for gestational age (lowest fifth birth centile). Postnatal growth was measured until the age of 2 years. In the multivariate analysis, maternal age was positively associated with first-trimester fetal crown to rump length (difference per maternal year of age, 0.79 mm; 95% confidence interval [CI], 0.41 to 1.18 per standard deviation score increase). Higher diastolic blood pressure and higher hematocrit levels were associated with a shorter crown to rump length (differences, -0.40 mm; 95% CI, -0.74 to -0.06 and -0.52 mm; 95% CI, -0.90 to -0.14 per standard deviation increase, respectively). Compared with mothers who were nonsmokers and optimal users of folic acid supplements, those who both smoked and did not use folic acid supplements had shorter fetal crown to rump lengths (difference, -3.84 mm; 95% CI, -5.71 to -1.98). Compared with normal first-trimester fetal growth, first-trimester growth restriction was associated with increased risks of preterm birth (4.0% vs 7.2%; adjusted odds ratio [OR], 2.12; 95% CI, 1.24 to 3.61), low birth weight (3.5% vs 7.5%; adjusted OR, 2.42; 95% CI, 1.41 to 4.16), and small size for gestational age at birth (4.0% vs 10.6%; adjusted OR, 2.64; 95% CI, 1.64 to 4.25). Each standard deviation decrease in first-trimester fetal crown to rump length was associated with a postnatal growth acceleration until the age of 2 years (standard deviation score increase, 0.139 per 2 years; 95% CI, 0.097 to 0.181). Maternal physical characteristics and lifestyle habits were independently associated with early fetal growth. First-trimester fetal growth restriction was associated with an increased risk of adverse birth outcomes and growth acceleration in early childhood.