Prevalence Of Maternal Complications Research Articles

Prevalence of maternal complications and neonatal outcomes at a Midwest academic health center

Introduction: The University of Iowa Hospitals and Clinics (UIHC) serves as the main referral center for Iowa and has seen increased delivery volumes following many hospital closures across the state. Maternal characteristics are also shifting as pre-pregnancy obesity of reproductive-age women is increasing nationally and in Iowa; average maternal age at first delivery has also increased over time. The aim of the current study was to characterize the outcomes of the delivering population at UIHC over a one-year period to better understand the population we serve, as well as compare our population to state and national delivering populations. Methods: This study is a secondary analysis of a pre-existing prospectively gathered database related to COVID-19 in pregnancy. The current study included all pregnant patients who delivered or underwent procedures for a spontaneous or induced second-trimester abortion on the labor and delivery unit at UIHC between May 1, 2020, and April 30, 2021. Demographic and clinical data including maternal characteristics, delivery information, maternal complications, and neonatal outcomes were obtained from the electronic medical record and double entered in a Research Electronic Data Capture (REDCap) database. Continuous and categorical variables were summarized using medians and ranges. Results: The median maternal age among the 2497 delivering patients was 30 (IQR 26, 33). The median pre-delivery body mass index (BMI) was 32 (IQR 28, 37), which included 439 patients (17.6%) with BMI >40 at time of delivery. 1769 (70.8%) patients listed White as their self-defined race and 2275 (91.0%) listed English as their preferred language. 23% had hypertensive disease of pregnancy. The patients delivered a total of 2603 neonates, with 907 (34.8%) born by cesarean section. 18.7% of deliveries were preterm and 16.6% of neonates had low birth weight. Discussion: The delivering population at UIHC has a high rate of obesity and preeclampsia, both of which place patients at higher risk for other obstetric complications. The cesarean section rate was significantly higher than the national rate of 31.8% (p=0.0017). Understanding common complications in our changing population will better equip providers to care for these patients; providing these data also creates a resource for other researchers.

Prevalence of Maternal Complications after Caesarean Section in Women with Abnormal BODY MASS INDEX (BMI)

Objective: To determine the frequency and maternal complications of cesarean section in women with BMI >25 kg/m2.
 Methodology: This descriptive Case series was done at the Gynaecology and Obstetric Unit III, Civil Hospital Karachi for 6 months i.e. May - Nov 2013. Total 164 obese pregnant women who presentedat gestational age >37 weeks, singleton pregnancy with cephalic presentation were included. Data consists of information on demographic items, gestational age, and parity. BMI was calculated by taking weight in kg divided by height in m2. Patients were monitored for progress of labour and mode of delivery was recorded. Maternal complications were identified and noted in pre design proforma.
 Results: Frequency of maternal complications in women with BMI >25 kg/m2 was found in 57.14%women.Induced labour was the commonest i.e. 35.1% women followed by primary post-partum hemorrhage (PPH) 13% and shoulder dystocia was observed in 9.1%.
 Conclusion: The burden of overweight and obesity in pregnant females belong to local population is high. So it is concluded that pre pregnancy normal body weight females with high BMI during pregnancy require special follow-ups and counselling sessions during pregnancy and delivery.

An assessment of the role of socio-economic, maternal and service utilization factors in increasing self-reported maternal complications in India

BackgroundSelf-reported maternal complications are associated with maternal morbidity, deliveries by C-section, postpartum depression, and maternal death. Thus, it is necessary to examine the contribution of socio-demographic and maternal characteristics, as well as service utilization in the rising self-reporting of maternal complications (difficulty with daylight vision, convulsions, swelling of the legs, body or face, heavy vaginal bleeding or high fever) in India. The study aimed at examining the factors that have influenced the increasing prevalence of maternal complications between 2005–06 and 2015–16 in India.MethodsData from the two most recent rounds of the National Family Health Survey, which covered a sample of 36,850 and 190,898 women respectively who delivered in the last five years preceding the survey has been used. Logistic regression analysis was performed to carve out the factors which significantly contributed to maternal complications among women aged 15 – 49 years in India. With the help of the Fairlie decomposition technique, the study quantified the contribution of factors which influenced the changes in maternal complications in the period from 2005–06 to 2015–16.ResultsA significant increase was seen in the prevalence of maternal complications — from 43.6% to 53.7% between the years 2005–06 and 2015–16. About 21% of the increase could be explained by certain maternal, households level factors, service utilization and birth outcomes. For example, service utilization, in which 13% was attributed to the place of delivery and 6% to postnatal care, was the major contributor to the increase in maternal complications from 2005–06 to 2015–16). This was followed by individual-level factors like education (2%), body mass index (4%) and tobacco use,. It was also found that household-level factors like standard of living (-3.7%) and region (-1.4%), and birth weight contributed to the reduction of complications during the period.ConclusionThe increase in the prevalence of maternal complications in India could be attributed mainly attributed to increase in reporting behavior, an outcome of increased utilization of maternal healthcare services, and increase in BMI. However, reduced prevalence of maternal complications can be attributed to the decrease in the prevalence of low-birth-weight babies and tobacco use among women in India.

Traditional medicine utilisation and maternal complications during antenatal care among women in Bulilima, Plumtree, Zimbabwe

BackgroundAs part of the expectation enshrined in the Sustainable Development Goals, countries are expected to ensure maternal health outcomes are improved. It follows that under ideal circumstances, pregnant women should deliver safely without complications, neonatal, and maternal mortality. This paper analyses the relationship between traditional medicine utilisation and maternal complications during antenatal care among women in Bulilima, Plumtree, Zimbabwe.MethodsA quantitative cross-sectional survey was conducted on 185 randomly selected women who responded to a pre-tested semi-structured questionnaire. The Fisher’s Exact Test and the Test of Proportions were used to probe the relationship between traditional medicine utilisation and the prevalence of maternal complications using STATA SE Version 13.ResultsComplications were reported by (51) 29% of the women who were under study. The proportion of women who developed complications was higher in those that did not use traditional medicine as compared to those that used traditional medicine (30 and 26% respectively). In a generalised assessment, women who did not use traditional medicine contributed a significantly higher proportion of complications as compared to those that utilised traditional medicine.ConclusionThis study found a significant relationship between the utilisation of traditional medicines and lesser chances of experiencing maternal complications. Significantly higher prevalence of maternal complications was observed in women who did not use traditional medicine compared to those that did. There is, therefore, a need to investigate further the constituents or active ingredients in this traditional medicine. This study provides a window of opportunity for fully recognising and integrating traditional medicine into Modern Health Systems. It can be argued that traditional medicine utilisation could be a viable alternative to modern medicine, particularly in resource-poor settings where access to modern medicine is seriously constrained.

Operative Deliveries at Full Cervical Dilatation; 'Choosing Between Lesser of Two Evils': A Comparative Study of Morbidities of Vacuum Delivery and Caesarean Section

Introduction: Operative delivery at full cervical dilatation can be either a caesarean section or instrumental deliveries. Instrumental deliveries are well debated options for reducing caesarean section rates but they have their own set of maternal and fetal morbidities. CS at full dilatation of cervix is also demanding due to impacted fetal head. Choice between the two depends on the treating obstetrician. 
 Objective: To assess perinatal morbidities between vacuum delivery and caesarean section at full cervical dilatation. 
 Methodology: This is an observational cross-sectional comparative study done for the duration of one year from January to December 2019. Women undergoing vacuum delivery or caesarean section in full cervical dilatation were compared for maternal and neonatal morbidities. Risk factors associated with these morbidities were also assessed. The morbidities in each group were compared using Pearson's chi square test. Likelihood of morbidities in relation to risk factors was calculated using univariate logistic regression. 
 Results: Prevalence of maternal complications in vacuum delivery was 33.3% (28) and in caesarean was 42.9% (15). Neonatal complications in vacuum delivery was 50% (42) and in caesarean was 48.6% (17). Being a referred case (OR=1.14) and a primigravida (OR=1.45) were risk factors for perinatal morbidities in vacuum delivery. Referred cases (OR=1.52), primigravidas (OR=5.90), head station lower than zero (OR=1.26) and birth weight of more than 3500 gms (OR=2.60) were associated with more number of morbidities in caesarean at full cervical dilatation.
 Conclusion Operative deliveries at full cervical dilatation, either vacuum or CS carry risk of maternal and neonatal morbidities. Obstetrician should make a decision keeping in mind certain risk factors like referred cases, parity, head station, number of pulls, method of delivery of head and fetal weight so that severe morbidities can be prevented.

No difference in perinatal mortality between home and facility delivery in rural Tanzania: a prospective community-based study

Background Facility-based delivery with skilled birth attendants in an enabling environment is recommended for life-saving and for improving maternal and newborn health outcomes. Inconsistent results exist regarding the protective effects of facility delivery on maternal and perinatal mortality in developing countries. The primary objective of this study was to investigate the association between place of delivery and maternal and perinatal mortality. A secondary objective was to examine the association between place of delivery and maternal complications during pregnancy, labor and delivery, and 48 hours postpartum. # Methods This community-based prospective study recruited a cohort of 1719 women in their third trimester of pregnancy through a door-to-door survey in randomly selected wards in rural Geita Northwest Tanzania between September 2016 and December 2017. A total of 1385 eligible mother-infant pairs were followed to seven days post-delivery. Results Half of the women delivered at a health facility (52.23%). A limited number of maternal deaths (n=7) were observed; 3 of these occurred at health facilities. No association was found between place of delivery and perinatal mortality (adjusted odds ratio, aOR=1.60, 95% confidence interval, CI=0.65-3.80). The prevalence of maternal complications during pregnancy, labor and delivery, and 48 hours postpartum were 6.14%, 8.74%, and 12.56%, respectively. A higher proportion of women who delivered at health facilities reported complications during labor and delivery (13.26% vs 3.78%) and 48 hours postnatally (14.78% vs 10.14%) than women who delivered at home. Conclusions Health facility delivery was not associated with reduced perinatal mortality. A higher proportion of women who delivered at health facilities reported complications during labour and delivery. Controlling for maternal complications attenuated the association between place of delivery and perinatal mortality. Many health facilities in rural Geita Tanzania remain ill-equipped to deal with unpredictable complications during childbirth. Improving staff training, access to essential drugs and equipment, and quality care could reduce perinatal mortality.

Maternal complications among tribal women in a tertiary care centre

Back ground: Tribals constitute 1.5% of the total population of Kerala. They live in a deprived condition and are vulnerable to numerous health problems. Eventhough the health indices of Kerala are comparable to many of the developed countries, the condition of tribals are still unsatisfactory. Aim of the study is to identify the maternal complication among tribal women and to analyse the fetomaternal outcome.Methods: This is a retrospective cross sectional study conducted in the Department of Obstetrics and Gynaecology, Government Medical College, Kozhikode during the period 1stJanuary to 31st December 2019.Tribal women admitted with maternal complications were identified from the hospital records and analyzed in detail. Results: 210 patients were included in the study. 93.8% women had received effective antenatal care. Common complications were preterm labour(50.73%), hypertensive disorders (28.57%), anemia (29.5%) and IUGR(29.5%). The average birth weight of the newborn was 2.23 kg. Conclusion: Eventhough majority of the tribal women gets effective antenatal care, prevalence of maternal complications like hypertensive disorders, anaemia, preterm labour and intrauterine growth restriction are more prevalent among them.

Prevalence, Risk Factors, and Fetal and Maternal Outcomes of Hypertensive Disorders of Pregnancy: A Retrospective Study in Western Saudi Arabia.

We sought to estimate the prevalence of hypertensive disorders of pregnancy (HDP) in Saudi Arabia as well as the risk factors of HDP, and maternal and fetal outcomes. We retrospectively evaluated the medical records of 9493 women who delivered at King Abdulaziz University Hospital, a tertiary care center, between January 2015 and June 2017. All cases of HDP were included. We identified 224 pregnant women with HDP in our patient cohort, giving a prevalence of 2.4%. Their mean age was 31.3±6.7 years, with an average gravidity of 4.0 and average parity of 3.0. The most prevalent subtype of HDP was preeclampsia (54.9%) while 29.5% of the women had gestational hypertension, and 8.0% had eclampsia. The prevalence of subtypes of HDP differed significantly with gravidity, and mean age differed significantly with HDP subtype. Personal and family histories of preeclampsia and the presence of diabetes were more prevalent in women with preeclampsia and gestational hypertension; however, only the difference in diabetes prevalence was significant. The overall prevalence of maternal complications was 9.4% and the prevalence of maternal mortality was 1.3%. Multigravid women and women with chronic hypertension were at increased risk of prematurity compared to other pregnant women, but not significantly. The prevalence of HDP was relatively low in our cohort. However, to prevent harmful impacts on both the mother and fetus, screening for this disorder is recommended early in pregnancy.

Severe anaemia during pregnancy in Kisumu District of Kenya: prevalence and risk factors.

Anaemia during pregnancy is an important contributor to maternal mortality and morbidity in Kenya. A prospective study was conducted in Kisumu District, a region characterized by high incidences of maternal and infant mortality, to determine the levels and prevalence of maternal complications. Four health facilities were purposely selected to act as sentinel centres from urban and rural clusters. All the obstetric-related cases were recorded between January and July 1997, and the outcomes of the pregnancies were recorded. Details on the respondents socioeconomic, demographic, biomedical and environment characteristics were also recorded. A total of 1,455 cases were recorded, of which 59 percent experienced obstetric-related complications. Of those with complications, 22 percent were suffering from severe anaemia. Among other things, the study reveals that anaemia prevalence is determined by maternal and environmental factors. These include poor pregnancy care, illness during pregnancy, socioeconomic conditions of the mother and the sanitary conditions of the household. Policy measures aimed at managing anaemia should seek to address all these factors.

Current status of pregnancy in diabetic women. A comparison of pregnancy in IDDM and NIDDM mothers

Pregnancy in diabetic patients was uncommon before 1960 in Japan. It has increased recently and there has been a 3-fold increase since 1971. Only 26% of the cases of diabetic pregnancy had IDDM; the rest of cases had NIDDM. The perinatal mortality of infants decreased from 10.8% in 1971–1975 to 1.1% in 1986–1990, but the incidence of congenital malformations remained at 5.7–8.2% during this period. From 1988 to 1992, we experienced 207 deliveries at the Diabetes Center, Tokyo Women's Medical College. The ratio of IDDM to NIDDM of the mothers was 33:67. The onset of diabetes of pregnant women occurred earlier and the duration of diabetes was longer in IDDM than in NIDDM (mean onset, 17.8 vs. 26.0 years; mean duration, 11.5 vs. 5.6 years). The prevalence of maternal complications was similar between the IDDM and NIDDM mothers. Proliferative retinopathy in NIDDM was often detected for the first time during pregnancy. Major congenital malformations were found in none of the infants of IDDM mothers but in 5.8% of the infants of NIDDM mothers. This is probably related to the poor management of diabetes in NIDDM before pregnancy.