Risk Factor For Perinatal Outcomes Research Articles

Pregnancy, delivery, and neonatal outcomes among women with PCOS and endometriosis: a population database cohort.

PCOS and endometriosis are independent risk factors for perinatal outcomes. Little research has evaluated the concomitant effects of these conditions, nor have studies been conducted on a population database. We sought to identify the pregnancy, delivery, and neonatal outcomes in women with polycystic ovary syndrome (PCOS) and endometriosis vs. PCOS without endometriosis. A retrospective population-based cohort study was performed extracting data using ICD-9 codes from the HCUP-NIS Database from 2004 to 2014. Endometriosis in women with PCOS represented the study group (n = 163), and the remaining PCOS, non-endometriosis patients constituted the reference group (n = 14,719). Subjects were included once per delivery. Demographics were compared using chi-squared tests. Confounding effects in pregnancy outcomes were controlled using binary logistic regression analysis. Concomitant endometriosis and PCOS patients were more likely to be white (88.5% vs.71.0%, p < 0.001), with BMI < 30kg/m2 (87.1% vs.77.8%, p < 0.004) and from lower income quartiles (27.1% vs.17.1%, p < 0.017) when compared to PCOS without endometriosis. Comparing pregnancy complication rates, placental abruption (p < 0.018, aOR 3.01, 95% CI 1.21-7.50), Cesarean section (p < 0.003, aOR 1.75, 95% CI 1.21-2.53), deep venous thromboses (p < 0.002, aOR 74.31, 95% CI 4.57-1209.21), and venous thromboembolic events (p < 0.031, aOR 10.40, 95% CI 1.24-87.37), were increased in the study group compared to the reference group. Women with PCOS and endometriosis were more likely to be white, of lower socioeconomic status, lean, and experience abruptio-placenta, cesarean deliveries, and venous thromboembolisms. Since little was previously known about the combined outcomes of PCOS and endometriosis, it is difficult to counsel patients on risks. Our findings can help clinicians manage pregnant PCOS patients with endometriosis to minimize complications such as abruptio placenta and VTE.

Risk factors & perinatal outcomes of major depression during pregnancy: A population-based study during 2010-2020 in two major cities of Pakistan.

Ever since the world came into being different factors and circumstances contributed in a deteriorating fashion to mental health, and depression is the commonest of mental disturbance and incapability. We aimed to identify the risk factors for perinatal outcomes of maternal depression. Data extracted was from two important cities of Pakistan i.e Islamabad and Karachi, and the numbers are 500,000 and 800,000 respectively. The timeline of the information was from 2010 to 2020 to signify a decade. Women with active pregnancy and depression were included. Chisquare analysis was run to predict which factors had a significant impact on depression. Odds ratio was separately run on the significant factors. Regression analysis was done to describe the relationships between independent variables and each other. The most preferred procedure of delivery was cesarean section in Islamabad and more than 500,000 in Karachi. Low-income women in Karachi had a mean depression score of 12.4 while men with the same socioeconomic class had a score of 23.4. 15.7 females in Islamabad reported medications taken during pregnancy & 34.9 females from major depression group. Mean of 87.9 individuals from Islamabad reported living with husband from no serious depression during pregnancy. In Population of Islamabad, Previous pregnancies and birth weight in comparison with depression is significant having p value 0.00. Maternal age, fetal sex & gestational age are also significant indicators of whether a woman is depressed or not. Apgar scores & violence in relation to depression are significant in Karachi Population having p values of 0.049 and 0.028. Female health and neonatal care should be a serious concern, but unfortunately in spite of progression in the field of medicine the low income or third world countries don't have sufficient awareness and due to that Pakistan still reports high maternal and neonatal mortality rates.

622Low birthweight prediction is not improved by repeated measures of gestational weight: the BOSHI study

Abstract Background Both pre-pregnancy body mass index and total weight gain during pregnancy are known risk factors for perinatal outcomes. However, little is known if repeated measurements of gestational weight gain can be utilized in the prediction of perinatal outcomes. We examined whether repeated measures of gestational weight improve the prediction of low infant birthweight. Methods Using data from the BOSHI study, we developed prediction models with low infant birthweight (&amp;lt;2500 g) as the outcome and gestational weight gain as the exposure of interest. A prediction model (Model 1) using only baseline values (pre-pregnancy body mass index) as the exposure was compared with a model using baseline and the last weight measurement (Model 2) and a model using baseline and trimester-specific measurements (Model 3). Model performance was assessed using c-statistics, Brier scores, and calibration plots. Results Among women who experienced full-term deliveries and had measured weights, the proportion of low infant birthweights was 5%. The c-statistics of Model 1, Model 2, and Model 3 were 0.78, 0.81, and 0.83, respectively. Other assessments were relatively unchanged. The extent of predictive performance improvement depends not only on the exposure-outcome associations but correlations among exposure measurements. Conclusions The inclusion of repeated gestational weight measurements in a model for predicting low infant birthweight only produced a marginal improvement in predictive performance. Key messages The prediction of low infant birthweight is not substantially improved by using repeated measurements of gestational weight.

Interpregnancy weight change and perinatal outcomes: A protocol for a systematic review and meta-analysis.

Background:Growing evidence suggests that interpregnancy weight change (IPWC) is a risk factor for perinatal outcomes, since it may increase the probability of gestational complications including gestational diabetes or cesarean delivery. Additionally, IPWC may affect neonatal outcomes increasing the prevalence of newborns small for gestational age or preterm birth. However, the association between IPWC and perinatal outcomes has not systematically synthesized thus far. This study protocol aims to provide a clear, transparent and standardized procedure for systematically reviewing the association between IPWC and perinatal outcomes.Methods and analysis:This systematic review and meta-analyses protocol is based on the preferred reporting items for systematic review and meta-analysis protocols and the Cochrane Collaboration Handbook. MEDLINE, EMBASE, the Cochrane Library, and Web of Science will be systematically searched from their inception. No limits will be defined by study design, as such different tools to assess risk of bias will be used:(1)a critical appraisal checklist for analytical cross-sectional studies;(2)the Newcastle–Ottawa quality assessment scale for longitudinal studies (including case–control and cohort studies); and(3)Cochrane Collaboration's tool for clinical trials.Odd ratios and their corresponding 95% confidence intervals will be reported to evaluate associations between IPWC and perinatal outcomes.Results:The results of this study will be published in a peer-reviewed journal.Conclusion:This systematic review and meta-analysis will systematically synthesize the evidence regarding the association between IPWC and perinatal outcomes. Data will be extracted from published articles and findings will be published in peer-reviewed journals. Ethical approval and informed consent will not be required due to the nature of the study.Systematic review registration:PROSPERO CRD42018100449.

Gestational diabetes and adiposity are independent risk factors for perinatal outcomes: a population based cohort study in Sweden.

AimsTo evaluate the interaction effects of gestational diabetes (GDM) with obesity on perinatal outcomes.MethodsA population‐based cohort study in Sweden excluding women without pre‐gestational diabetes with a singleton birth between 1998 and 2012. Logistic regression was performed to evaluate the potential independent associations of GDM and BMI with adverse perinatal outcomes as well as their interactions. Main outcome measures were malformations, stillbirths, perinatal mortality, low Apgar score, fetal distress, prematurity and Erb's palsy.ResultsSome 1,294,006 women were included, with a GDM prevalence of 1% (n = 14,833). The rate of overweight/obesity was 67.7% in the GDM‐group and 36.1% in the non‐GDM‐group. No significant interaction existed. Offspring of women with GDM had significantly increased risk of malformations, adjusted odds ratio (aOR) 1.16 (95% confidence intervals 1.06–1.26), prematurity, aOR 1.86 (1.76–1. 98), low Apgar score, aOR 1.36 (1.10–1.70), fetal distress, aOR 1.09 (1.02–1.16) and Erb's palsy aOR 2.26 (1.79–2.86). No risk for stillbirth or perinatal mortality was seen. Offspring of overweight (BMI 25–29.9 kg/m2), obese (BMI 30–34.9 kg/m2) and severely obese women (BMI ≥ 35.0 kg/m2) had significantly increased risks of all outcomes including stillbirth 1.51 (1.40–1.62) to 2.85 (2.52–3.22) and perinatal mortality 1.49 (1.40–1.59) to 2.83 (2.54–3.15).ConclusionsThere is no interaction effect between GDM and BMI for the studied outcomes. Higher BMI and GDM are major independent risk factors for most serious adverse perinatal outcomes. More effective pre‐pregnancy and antenatal interventions are required to prevent serious adverse pregnancy outcomes among women with either GDM or high BMI.

Trends in perinatal mortality and its risk factors in Japan: Analysis of vital registration data, 1979\u20132010

As Japan has achieved one of the lowest perinatal mortality rates (PMR), our study aims to estimate trends in and risk factors for perinatal mortality among singleton births in Japan. We used Japanese vital registration data to assess trends in and risk factors for perinatal outcomes between 1979 and 2010. Birth and death registration data were merged. An autoregressive integrated moving average model was fitted separately by sex to the PMR and the proportion of stillbirths. A multilevel Poisson regression model was used to estimate risk factors for perinatal mortality. Between 1979 and 2010 there were 40,833,957 pregnancies and 355,193 perinatal deaths, the PMR decreased from 18.86 per 1,000 all births to 3.25 per 1,000 all births, and the proportion of stillbirths increased from 83.6% to 92.1%. Key risk factors for perinatal mortality were low or high birth weight, prematurity and post maturity, and being from poorer or unemployed families. A higher proportion of excess perinatal deaths could be averted by effective policies to prevent stillbirths and improved research into their interventions and risk factors. As the cost and challenge of maintaining perinatal mortality gains increases, policies need to be targeted towards higher risk groups and social determinants of health.

Prevalence and differentials of low birth weight in Niamey, Niger.

This study provides population representative data on live births occurring in Niamey, Niger during the period 1980 to 1985. A total of 5097 live births were systematically sampled from maternity registers over the study period. Due to legislation and incentives to register all live births, between 90 and 95 per cent of all live births are represented in this study. The data here suggest that low birth weight (LBW) prevalence may be lower in this urban area than it is in the region as a whole; and that the demographic risk factors are similar to those found in other developing countries. Finally, in many developing countries, maternity coverage of attended births may be quite high, suggesting that record or prospective studies examining trends in LBW and risk factors for perinatal outcomes might be convenient and implemented at very low cost.