Pregnancy Risk Factors Research Articles

The Association Between Placenta-Mediated Diseases of Pregnancy and Postpartum Maternal Cardiovascular Disease Risk Factors: A Systematic Review

The Association Between Placenta-Mediated Diseases of Pregnancy and Postpartum Maternal Cardiovascular Disease Risk Factors: A Systematic Review

Overview of Risk Factors for Ectopic Pregnancy at Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia

Introduction: Ectopic pregnancy is an emergency condition that is the cause of maternal death during the first trimester of pregnancy. Most extrauterine implantations occur in the fallopian tubes. This study aimed to find an overview factor risk of ectopic pregnancy at Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia.
 Methods: This study was a descriptive observational study and used secondary data from medical record data at the medical record installation of Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia. A total of 100 research subjects participated in this study, and the research subjects met the inclusion criteria. The inclusion criteria in this study were patients with ectopic pregnancy disorders who were treated at Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia, over 18 years of age and had complete medical record data. Data analysis was carried out using SPSS software version 25. Univariate analysis was performed to present the distribution frequency data for each variable test.
 Results: The majority of research subjects had an age range of 26-35 years (55%). The most common risk factors in this study were a history of abortion in a previous pregnancy (47%), parity 0 (46%), and abortion occurring in the first pregnancy (35%).
 Conclusion: Maternal age, history of abortion, parity, and gravidity are risk factors that play a role in the incidence of ectopic pregnancy at Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia.

Energy-Adjusted Dietary Inflammatory Index in pregnancy and maternal cardiometabolic health: findings from the ROLO study

Excessive inflammation during pregnancy has been linked to adverse long-term health outcomes for both mothers and their children. One such outcome is maternal cardiometabolic dysfunction. The Energy-Adjusted Dietary Inflammatory Index is a method of scoring the overall inflammatory potential of the diet. Research on how the inflammatory potential of the maternal diet during pregnancy affects maternal cardiometabolic factors is limited. We investigated if the maternal Energy-Adjusted Dietary Inflammatory Index was associated with maternal cardiometabolic factors during pregnancy. This is a secondary analysis of 518 individuals who participated in the ROLO (Randomized cOntrol trial of a LOw glycemic index diet in pregnancy) study. Maternal Energy-Adjusted Dietary Inflammatory Index scores were calculated in early (12-14 weeks' gestation) and late pregnancy (34 weeks' gestation) using data collected from 3-day food diaries. Body mass index, blood pressure, fasting lipid profiles, glucose levels, and HOMA1-IR were obtained in early and late pregnancy. Multiple linear regression examined associations between early-pregnancy Energy-Adjusted Dietary Inflammatory Index and early and late maternal cardiometabolic markers. In addition, the relationship between late-pregnancy Energy-Adjusted Dietary Inflammatory Index and late cardiometabolic factors was explored. Regression models were adjusted for maternal ethnicity, maternal age at delivery, education level, smoking status, and original randomized control trial group allocation. In regression models examining late-pregnancy Energy-Adjusted Dietary Inflammatory Index with late lipids, change in lipid level from early to late pregnancy was also adjusted for. Women's mean (standard deviation) age at delivery was 32.8 (±4.01) years, with median (interquartile range) body mass index of 24.45 (23.34-28.20) kg/m2. Mean (standard deviation) Energy-Adjusted Dietary Inflammatory Index was 0.59 (±1.60) in early pregnancy and 0.67 (±1.59) in late pregnancy. In adjusted linear regression analysis, first-trimester maternal Energy-Adjusted Dietary Inflammatory Index was positively associated with maternal body mass index (B=0.007; 95% confidence interval, 0.003-0.011; P=.001), early-pregnancy cardiometabolic markers including total cholesterol (B=0.155; 95% confidence interval, 0.061-0.249; P=.001), triglycerides (B=0.043; 95% confidence interval, 0.005-0.080; P=.03), low-density lipoproteins (B=0.129; 95% confidence interval, 0.049-0.209; P=.002), and diastolic blood pressure (B=0.538; 95% confidence interval, 0.070-1.006; P=.02), and late-pregnancy cardiometabolic markers including total cholesterol (B=0.127; 95% confidence interval, 0.012-0.243; P=.01) and low-density lipoproteins (B=0.110; 95% confidence interval, 0.010-0.209; P=.03). In the third trimester, Energy-Adjusted Dietary Inflammatory Index was associated with late-pregnancy diastolic blood pressure (B=0.624; 95% confidence interval, 0.103-1.145; P=.02), HOMA1-IR (B=0.030; 95% confidence interval, 0.005-0.054; P=.02), and glucose (B=0.003; 95% confidence interval, 0.003-0.034; P=.03). No associations were observed between third-trimester Energy-Adjusted Dietary Inflammatory Index and late-pregnancy lipid profiles. Maternal diets with a higher Energy-Adjusted Dietary Inflammatory Index, which were low in anti-inflammatory foods and rich in proinflammatory foods, were associated with increased levels of cardiometabolic health risk factors in pregnancy. Promoting dietary intakes that have a lower inflammatory potential may support more favorable maternal cardiometabolic profiles during pregnancy.

The Science of Amniotic Fluid Embolism

With many countries around the world facing aging populations and declining birth rates, governments are encouraging women to have children. However, few countries are really concerned about the effects of pregnancy on women, and society is hiding the risks and symptoms of pregnancy and postpartum complications as if to get more women to have children by hiding these facts. What I believe is that only when women truly understand the process and risk factors of pregnancy can they be prepared to give birth with confidence. People are always afraid of the unknown. This article systematically analyzes the disease with the highest mortality rate during pregnancy, amniotic fluid embolism (AFE). Hopefully, this article will make more people aware of this rare but highly fatal disease. This article introduces various aspects of AFE, the most central part of which should be the analysis of the causes of AFE and the current treatment methods. The author hopes that after reading this article, the reader will be able to eliminate as many questions as possible about AFE.

Laparoscopic treatment of advanced interstitial pregnancy: key steps for a successful management

To describe a conservative laparoscopic treatment of an advanced case of interstitial pregnancy diagnosed in a woman at 14 weeks of gestational age. Video case report with demonstration of diagnostic work-up and laparoscopic management of rare subtypes of ectopic pregnancy SETTING: University tertiary care hospital. A 32-year-old nulliparous woman at 14 weeks of gestational age, presented with moderate abdominal pain. She reported an history of irregular periods however, no risk factor for ectopic pregnancy were identified. HCG levels was 7345 mIU/mL. Transvaginal ultrasound revealed an empty uterine cavity and a complex heterogeneous mass of 6 cm on the left cornual region. Myometrial thickness surrounding the gestational sac was 4 mm. There were several critical strategies for this laparoscopic approach. To reduce intraoperative bleeding, the peritoneum was opened, the ureters were identified, and bulldog clamps were used to temporarily reduce uterine vascularization. An intramyometrial injection of vasopressin was performed. After a first cornuostomy attempt, we had to get on a cornual resection to achieve a complete removal of the ectopic mass. Multilayer uterine suture and anatomical restoration to prevent adhesion was then accomplished. Institutional review board approval was not required for this case report as per our institution's policy; patient consent was obtained for publication of the case. Description of a laparoscopic management of huge interstitial pregnancy RESULTS: The overall operation time was 55 minutes, and the estimated blood loss was 55cl. A successfully conservative treatment was achieved with no short-term complications. Postoperative ultrasound showed a normal uterus and complete regression of hCG was obtained two weeks after surgery. Interstitial ectopic pregnancy presents a high risk of maternal mortality considering that the interstitial part of the tube, because of its thickness, has a great capacity to expand before rupture.

Predictors of Unintended Pregnancy and Sexual Reproductive Health Conditions in Survivors of Violence

The effect of violence on women's sexual reproductive health is of significant importance; this study aimed to study the association between gender-based violence with unintended pregnancy and common sexual reproductive health conditions. The size of the study sample was 102, who were survivors of violence. Direct interviews collected the data, and the researchers used a structured 30-question questionnaire. Results showed that early marriage was significantly associated with unintended pregnancy. The mean of unintended pregnancy for the marriage age group <=18 years was 1.79, which is higher than the mean of the>18 years marriage age group. The t-value is 2.616, and the significance value is 0.010, meaning there are statistically significant differences in unintended pregnancy in favour of the age group <=18 years. Results also indicated the prevalence of unmet needs for contraception in the study sample was 55% among survivors. 26% of women received inadequate antenatal visits primarily due to financial reasons, and almost half (47%) of births were delivered by the Cesarian section; the most popular method is IUD. In conclusion, gender-based violence is a consistent and strong risk factor for unintended pregnancy, especially in the child marriage age group, so it's necessary to overlook sexual reproductive health among survivors of violence as it might be threatened.

MP30-12 HIGHER TESTOSTERONE SERUM LEVELS ARE ASSOCIATED WITH A HIGHER CHILDBIRTH IN PATIENTS TREATED FOR TESTICULAR CANCER

You have accessJournal of UrologyCME1 Apr 2023MP30-12 HIGHER TESTOSTERONE SERUM LEVELS ARE ASSOCIATED WITH A HIGHER CHILDBIRTH IN PATIENTS TREATED FOR TESTICULAR CANCER Cosimo De Nunzio, Riccardo Lombardo, Antonio Nacchia, Giorgio Guarnotta, Aldo Brassetti, Gabriele Tuderti, Antonio Luigi Pastore, Yazan Al Sahli, Giuseppe Simone, Antonio Carbone, and Andrea Tubaro Cosimo De NunzioCosimo De Nunzio More articles by this author , Riccardo LombardoRiccardo Lombardo More articles by this author , Antonio NacchiaAntonio Nacchia More articles by this author , Giorgio GuarnottaGiorgio Guarnotta More articles by this author , Aldo BrassettiAldo Brassetti More articles by this author , Gabriele TudertiGabriele Tuderti More articles by this author , Antonio Luigi PastoreAntonio Luigi Pastore More articles by this author , Yazan Al SahliYazan Al Sahli More articles by this author , Giuseppe SimoneGiuseppe Simone More articles by this author , Antonio CarboneAntonio Carbone More articles by this author , and Andrea TubaroAndrea Tubaro More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003258.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Aim of our study was to assess fertility of patients treated with orchifunicolectomy for testicular cancer. METHODS: A retrospective analysis of patients undergoing orchifunicolectomy for testicular cancer was conducted in three centers from 2000 to 2019. Demographic, clinical and histological characteristics of the patients were recorded. Adjuvant treatments were recorded. Number of pregnancies, number of children, cryopreservation, in vitro fertilization were recorded as well as post-operative testosterone serum level. Risk factors for pregnancy were evaluated. Univariate and multivariate analysis were performed to evaluate factors influencing pregnancy rates. RESULTS: Overall 271 patients were enrolled with a median age of 31 (25/35) years and a median BMI of 25 (23/28 Kg/m2). Overall 187 of 271 (69%) presented a seminoma, 61 of 271 (22%) presented advanced stage (≥pT2), 4 of 271 (1%) presented metastasis, 13 of 271 (5%) underwent lymphadenectomy. 112 of 271 (41%) underwent adjuvant chemotherapy and 35 of 271 (13%) underwent adjuvant radiotherapy. 71 of 271 (26%) patients had at least one child, 165 of 271 (60%) performed cryopreservation, 9 of 271 (3%) performed fertilization in vitro and out of them 8 of 9 (89%) had at least one child. Patients with at least one child presented higher levels of testosterone and performed more often in vitro fertilization (Table). On multivariate analysis testosterone levels (OR=1,94; 95% CI: 1,35-2,80, p=0,001) were associated with a higher probability of having a child after testicular cancer surgery. Table 1. Patients characteristics according to Child status CONCLUSIONS: In our experience, patients undergoing testicular cancer surgery have 25% probability of having a child. Higher testosterone levels increase the probability of having a child in patients treated for testicular cancer. Source of Funding: No one © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e395 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Cosimo De Nunzio More articles by this author Riccardo Lombardo More articles by this author Antonio Nacchia More articles by this author Giorgio Guarnotta More articles by this author Aldo Brassetti More articles by this author Gabriele Tuderti More articles by this author Antonio Luigi Pastore More articles by this author Yazan Al Sahli More articles by this author Giuseppe Simone More articles by this author Antonio Carbone More articles by this author Andrea Tubaro More articles by this author Expand All Advertisement PDF downloadLoading ...

Vaccine intention and hesitancy among Australian women who are currently pregnant or have recently given birth: the Birth in the Time of COVID-19 (BITTOC) national online survey

ObjectiveTo examine the prevalence of COVID-19 vaccination, and factors associated with vaccination intention and hesitancy in pregnant and postnatal women in Australia.Design and settingA national online survey was conducted over...

Management of ectopic pregnancy in a tertiary hospital: a retrospective cohort study.

The goal of this study was to manage the treatment modalities of ectopic pregnancy. This retrospective study included 1,103 women diagnosed and treated for ectopic pregnancy at Kanuni Sultan Suleyman Training and Research Hospital between January 1, 2017, and December 31, 2020. Serial beta-human chorionic gonadotropin (β-Hcg) measurements and transvaginal ultrasound (TV USG) findings were used to establish the diagnosis of an ectopic pregnancy. They were divided into four groups: expectant treatment, single-dose methotrexate, multidose methotrexate, and surgical treatment. All data analyses were performed using SPSS version 24.0. A receiver operating characteristic (ROC) analysis was used to determine the cut-off for change in beta-human chorionic gonadotropin (β-hCG) levels between the first and fourth day. There were significant differences between groups in terms of gestational age and β-hCG changes (p < 0.001). In patients receiving expectant treatment, the decrease in β-hCG values on the fourth day was 35.19%, while patients receiving single-dose methotrexate treatment showed a decrease of 24%. The most common risk factor for ectopic pregnancy was the absence of risk factors. Comparison of the surgical treatment group with the other groups revealed significant differences in terms of the presence of free fluid in the abdomen, the average diameter of the ectopic pregnancy mass, and the presence of fetal cardiac activity. A single dose of methotrexate was effective in patients with β-hCG levels lower than 1,227.5 mIU/ml, with a 68.5% sensitivity and 69.1% specificity. An increase in gestational age also leads to an increase in β-hCG values and the diameter of the ectopic focus. As the diagnosis period progresses, the need for surgical intervention increases.

MANAGEMENT AND PROGNOSIS OF ECTOPIC PREGNANCY AT THE UNIVERSITY HOSPITAL-PR BOCAR SIDI SALL DE KATI

Introduction: Ectopic pregnancy is the implantation and development of the egg outside the uterine cavity. The epidemiological and therapeutic profiles of ectopic pregnancy differ from one country to another and from one health facility to another. This study, which is a first at the University Hospital PrBocarSidySall of Kati, aims to study ectopic pregnancy in the context of our daily practice. Methods and Patients : Our study was retrospective, cross-sectional and descriptive. It took place from January 2014 to December 2019 in the obstetrics gynecology department of theUniversity Hospital PrBocarSidySall of Kati. The data were collected using a survey form and obtained from the patients medical record, the hospitalization register, the delivery register and the registers of surgical reports. Data were analyzed with SPSS version 20.0 software. Results: A total of 99 records were collected during the study period, representing a frequency of 0.53% of emergency visits and 1.88% of deliveries. A history of genital infection was found in 78% of cases. In our series, women with low parity were more numerous with 77.8% of cases. We found more right-sided and ruptured Ectopic pregnancies. The treatment was surgical in 92.2% of cases and the procedure performed was essentially a total salpingectomy. Conclusion : The improvement of the technical platform of our health care facilities and preventive measures against the risk factors of the Ectopic pregnancy could reduce the burden of this pathology.

Risk factors for ectopic pregnancy in a sub-Saharan African country.

Our case-control study aimed at identifying the risk factors (RFs) for ectopic pregnancy (EP), and was carried out between 1st February and 31st May, 2019. Women who had EP were compared to those without EP. Out of 3421 pregnancies, 93 (2.7%) had EP. Independent RFs were previous EP, past history of infertility, first sexual encounter <15 years, past history of chlamydia infection, ≥ 3 sexual partners, use of levonorgestrel based emergency contraceptive pill, and unemployment. Girls should be counselled concerning these RFs and specifically against early sexual intercourse and multiple sexual partnership.

Pregnancy incidence and associated risk factors of dichorionic triamniotic triplet under assisted reproduction: A large sample of clinical data analysis.

Dichorionic triamniotic (DCTA) triplet pregnancies are rare in spontaneous pregnancy. The aim was to characterize the incidence and risk factors of DCTA triplet pregnancies after assisted reproductive technology (ART). A retrospective analysis of 10,289 patients, including 3,429 fresh embryo transfer (ET) cycle and 6,860 frozen ET cycle, was performed from January 2015 to June 2020. The effect of different ART parameters on the incidence of DCTA triplet pregnancies was evaluated by multivariate logistic regression analyses. Among all clinical pregnancies after ART, the incidence of DCTA was 1.24%. 1.22% occurred in the fresh ET cycle, while 1.25% occurred in the frozen ET cycle. The number of ET and cycle type has no effect on the occurrence of DCTA triplet pregnancies (p = 0.987; p = 0.056, respectively). There were significant differences in DCTA triplet pregnancies rate among receiving intracytoplasmic sperm injection (ICSI) and receiving in vitro fertilization (IVF) [1.92% vs. 1.02%, p < 0.001, OR = 0.461, 95% confidence interval (CI) 0.315-0.673], blastocyst transfer (BT) versus cleavage-ET (1.66% vs. 0.57%, P < 0.001, OR = 0.329, 95% CI 0.315-0.673), and maternal age ≥ 35 years versus maternal age < 35 years (1.00% vs. 1.30%, P = 0.040, OR = 1.773, 95% CI 1.025-3.066). Based on the regression analysis of cycle type, DCTA triplet pregnancies rate was higher in maternal age < 35 years than in maternal age ≥ 35 years (1.35% vs. 0.97%, P < 0.001, OR = 5.266, 95% CI 2.184-12.701), BT versus cleavage-ET (1.47% vs. 0.94%; P = 0.006, OR = 0.346, 95% CI 0.163-0.735), and receiving ICSI was higher than receiving IVF (3.82% vs. 0.78%, p < 0.001, OR = 0.085, 95% CI 0.039-0.189) in fresh ET cycle. However, DCTA triplet pregnancies rate did not show difference in maternal age, insemination methods, and number of ET, and only BT was found to be associated with a higher DCTA triplet pregnancies rate in the frozen ET cycle (1.73% vs. 0.30%, p < 0.001, OR = 0.179, 95% CI 0.083-0.389). The prevalence of DCTA triplet pregnancies has increased after ART. Maternal age < 35 years, BT, and receiving ICSI are risk factors for DCTA triplet pregnancies, also in fresh ET cycle. However, in frozen ET cycle, BT is an independent risk factor for increased DCTA triplet pregnancies rate.

Paternal preconception modifiable risk factors for adverse pregnancy and offspring outcomes: a review of contemporary evidence from observational studies

BackgroundThe preconception period represents transgenerational opportunities to optimize modifiable risk factors associated with both short and long-term adverse health outcomes for women, men, and children. As such, preconception care is recommended to couples during this time to enable them to optimise their health in preparation for pregnancy. Historically, preconception research predominately focuses on maternal modifiable risks and health behaviours associated with pregnancy and offspring outcomes; limited attention has been given to inform paternal preconception health risks and outcomes. This systematic review aims to advance paternal preconception research by synthesising the current evidence on modifiable paternal preconception health behaviours and risk factors to identify associations with pregnancy and/or offspring outcomes.MethodsMedline, Embase, Maternity and Infant care, CINAHL, PsycINFO, Scopus, and ISI Proceedings were searched on the 5th of January 2023, a date limit was set [2012–2023] in each database. A Google Scholar search was also conducted identifying all other relevant papers. Studies were included if they were observational, reporting associations of modifiable risk factors in the preconception period among males (e.g., identified as reproductive partners of pregnant women and/or fathers of offspring for which outcomes were reported) with adverse pregnancy and offspring outcomes. Study quality was assessed using the Newcastle–Ottawa Scale. Exposure and outcome heterogeneity precluded meta-analysis, and results were summarised in tables.ResultsThis review identified 56 cohort and nine case control studies. Studies reported on a range of risk factors and/or health behaviours including paternal body composition (n = 25), alcohol intake (n = 6), cannabis use (n = 5), physical activity (n = 2), smoking (n = 20), stress (n = 3) and nutrition (n = 13). Outcomes included fecundability, IVF/ISCI live birth, offspring weight, body composition/BMI, asthma, lung function, leukemia, preterm birth, and behavioural issues. Despite the limited number of studies and substantial heterogeneity in reporting, results of studies assessed as good quality showed that paternal smoking may increase the risk of birth defects and higher paternal BMI was associated with higher offspring birthweight.ConclusionThe current evidence demonstrates a role of paternal preconception health in influencing outcomes related to pregnancy success and offspring health. The evidence is however limited and heterogenous, and further high-quality research is needed to inform clinical preconception care guidelines to support men and couples to prepare for a health pregnancy and child.

Obesity increases the odds of multiple pregnancies: A nationwide register-based cohort study in Finland.

To investigate the effects of increased pre-pregnancy body mass index (BMI, calculated as weight in kilograms divided by the square of height in meters) on the risk of having spontaneous multiple pregnancies using a nationwide register-based study sample. Data from the National Medical Birth Register (MBR) (2004-2018) were used to evaluate the effects of a higher pre-pregnancy BMI on the risk of multiple pregnancies. Lower and higher pre-pregnancy BMI classes, using the WHO classification, were compared with a normal weight class. A logistic regression model was used to assess the primary outcomes. Adjusted odds ratios (aOR) with 95% confidence intervals (CI) between the groups were compared. The model was adjusted by maternal age, maternal height, and maternal smoking status. The odds of multiple pregnancies were higher among women in the overweight group (aOR 1.07, 95% CI 1.02-1.12), obesity class I group (aOR 1.11, 95% CI 1.04-1.18), and obesity class II group (aOR 1.15, 95% CI 1.03-1.28) compared with women in the non-overweight BMI class. Women in the underweight group had lower odds for multiple pregnancies (aOR 0.82, 95% CI 0.73-0.93). The odds of multiple pregnancies slightly increase with pre-pregnancy obesity, and this should be acknowledged as a minor risk factor for multiple pregnancies.

First-trimester prediction of preterm prelabour rupture of membranes incorporating cervical length measurement

ObjectivesTo examine early pregnancy risk factors for preterm prelabour rupture of membranes (PPROM) and develop a predictive model. Study designRetrospective analysis of a cohort of mixed-risk singleton pregnancies screened in the first and second trimesters in three Danish tertiary fetal medicine centres, including a cervical length measurement at 11–14 weeks, at 19–21 weeks and at 23–24 weeks of gestation. Univariable and multivariable logistic regression analyses were employed to identify predictive maternal characteristics, biochemical and sonographic factors. Receiver operating characteristic (ROC) curve analysis was used to determine predictors for the most accurate model. ResultsOf 3477 screened women, 77 (2.2%) had PPROM. Maternal factors predictive of PPROM in univariable analysis were nulliparity (OR 2.0 (95% CI 1.2–3.3)), PAPP-A < 0.5 MoM (OR 2.6 (1.1–6.2)), previous preterm birth (OR 4.2 (1.9–8.9)), previous cervical conization (OR 3.6 (2.0–6.4)) and cervical length ≤ 25 mm on transvaginal imaging (first-trimester OR 15.9 (4.3–59.3)). These factors all remained statistically significant in a multivariable adjusted model with an AUC of 0.72 in the most discriminatory first-trimester model. The detection rate using this model would be approximately 30% at a false-positive rate of 10%. Potential predictors such as bleeding in early pregnancy and pre-existing diabetes mellitus affected very few cases and could not be formally assessed. ConclusionsSeveral maternal characteristics, placental biochemical and sonographic features are predictive of PPROM with moderate discrimination. Larger numbers are required to validate this algorithm and additional biomarkers, not currently used for first-trimester screening, may improve model performance.

A comprehensive methodology report for maternity and perinatal mortality research in the New Zealand Integrated Data Infrastructure.

The highest quality perinatal data in New Zealand is collected and collated by the Perinatal and Maternal Mortality Review Committee (PMMRC) and is made available to a limited number of researchers. Therefore, maternity, and perinatal mortality studies are generally performed on Government-held data. This report offers an alternative approach with in-depth justification for the methodology, while simultaneously improving the understanding of the data sources. A standardised method for creating a comprehensive maternity dataset within the Statistics New Zealand Integrated Data Infrastructure (IDI) was developed and a validation dataset was created to include all births between 2008 and 2017. A close approximation to the PMMRC annual report data was found, with 4.0% over-reporting of perinatal deaths and 0.05% over-reporting of live births in the IDI dataset. Several variables, including important pregnancy risk factors, were validated for use. Limitations to the datasets were explored and additional tables in the IDI were proposed, to include variables on pregnancy complications, ethnicity and country of birth, and socio-economic data. This methodological report describes an opportunity for standardised, high-quality maternity research in New Zealand using the IDI, including a variety of national data sources. Recommendations for further enhancement of these resources have been offered.

Clinical study of ectopic pregnancy in a tertiary care centre in Andhra Pradesh

Background: If not detected early, ectopic pregnancy can result in a gynaecological emergency with significant abdominal bleeding, hypovolemic shock, and maternal death. The main objectives of this study are to find out the incidence of ectopic pregnancy, demographic profile of the women, risk factors and to study the clinical presentation, treatment modalities and outcome in our hospital. Methods: This prospective observational study was conducted in the department of obstetrics and Gynaecology, at a tertiary care centre, Andhra Pradesh from January 2021 to December 2022. A total of 62 cases of ectopic pregnancy were analysed for parameters like demographic characteristics, gravidity, risk factors, clinical presentation, treatment modalities and outcome. Results: The incidence of ectopic pregnancy in present study was 9.7 per thousand deliveries. Majority of cases belonged to age group of 21-25 years (67.7%) and were gravida 3 and above (49.1%). Commonest risk factors identified were tubal ligation (29%) and history of previous abortions (19.3%). The frequent presenting symptoms were abdominal pain (87%) and amenorrhea (38.7%). Most of the patients required surgical management (91.9%), medical management was done in 4 cases and expectant management was done in 1 case. Tubal ectopic pregnancy (87%) is more common. Anaemia was seen in 64.5% of cases that required multiple blood transfusions (72.5%) for resuscitation. There was no maternal mortality in the current study.Conclusions: Ectopic pregnancy is an emergency in which timely intervention will reduce the maternal morbidity and mortality. Clinical presentation varies from case to case and still there is a chance of missing the diagnosis in a small proportion of patients even with the availability of advanced imaging techniques. For early diagnosis a clinician should be aware about the various presentations and associated risk factors of ectopic pregnancy.

Abstract P242: Accuracy of a Self-Report Screening Tool for Identifying Pregnant People With High Sedentary Behavior

Introduction: High levels of sedentary behavior (SB) are emerging as a distinct risk factor in pregnancy for poor maternal-fetal health outcomes. Thigh-worn accelerometry is ideal for quantifying SB but has high cost and participant burden; simple screening questions that could quickly identify those with high SB in clinical or research settings are desirable. We aimed to evaluate the accuracy of self-report screening questions for identifying pregnant participants with high SB. Methods: This secondary analysis used baseline data from the S edentary Behavior Reduction in Pr egnancy In tervention (SPRING) feasibility trial. During eligibility screening, participants in their first trimester met at least one of four study-developed, self-reported criteria that put them at risk for high SB: 1) mostly sitting job ≥ 30 h/week; 2) mostly sitting job &lt;30 h/week and reporting sitting ≥ ½ of non-work time; 3) did not work but reported sitting ≥ ¾ of time; and 4) &lt;6,000 steps/d from a wearable device. Eligible participants then underwent baseline SB assessment using a thigh-worn accelerometer (activPAL3, 7 d x 24 h). The proportion of participants meeting evidence-based definitions for high SB were calculated for each criterion. Definitions of high SB included: SB &gt; 10 h/d (+10h), SB &gt; 66.7% of waking time (+66.7%), and &lt; 6,000 steps per day (low steps). Results: Participants (n=51) enrolled in the study with mean (SD) age=32 (4) years, 82% White, and 84% with a college degree or greater. Of these, n=50 had valid objective SB data at baseline. On average, participants met high SB definitions with mean (SD) SB of 10.5 (1.5) hours per day, 77% (11%) of waking time in SB, and with 5,646 (2,954) steps per day. Among those with a mostly sitting job ≥ 30 h/week (n=33), 66% were above the +10h definition, 71% met the +66.7% definition, and 57% met the low steps definition. For participants with a mostly sitting but &lt;30 h/week job (n=7) and high sitting otherwise, 57% met the +10h definition, 100% met the +66.7% definition, and 71% met the low steps definition. Participants who did not work and reported ¾ time in SB (n=5) met each definition 80% of the time. Participants who reported &lt;6000 steps per day from a wearable (n=3) met all definitions 66.7% of the time. Those below the +10h SB threshold had mean (range) SB of 8.7 (7.5 to 9.4) h/d, those below the +67% SB threshold were sedentary 57.9% (51.1% to 61.3%) of the time, and those above the low steps threshold had 9,478 (6023 to 14,751) steps per day. Conclusions: Screening questions mostly identified participants who were highly sedentary, though approximately one in three did not meet thresholds for objectively-measured high SB. Future research refining screening questions is needed to improve the accuracy of identifying pregnant people with high SB by self-report, who may be at higher risk of adverse pregnancy outcomes.

Gender role beliefs and adolescent pregnancy in Colombia: findings from the 2015 DHS survey

This study investigated the association between gender role beliefs and the prevalence and likelihood of experiencing pregnancy among 8525 young women and girls aged 13–19 years in Colombia. The primary outcome of interest was adolescent pregnancy. Retrospective cross-sectional analysis utilised data from the 2015 Demographic and Health Survey (DHS) in Colombia, which included an add-on questionnaire on gender relations. Our analysis measured both pregnancy prevalence and pregnancy likelihood in relation to gender role beliefs. With one exception, young women who disagreed with traditionally conforming gender roles had a lower prevalence of pregnancy and were less likely to experience pregnancy than those who agreed with them. The highest likelihood of pregnancy prevalence and likelihood was found among those who agreed with statements suggesting male dominance and those who agreed with women’s homemaking responsibilities. The greater the adherence to traditionally conforming gender role beliefs, the higher the likelihood of experiencing pregnancy during adolescence. Girls’ and young women’s adherence to traditional gender role beliefs appeared to be a risk factor for adolescent pregnancy. Our findings support Colombia’s current sex education policies and practices within the framework of gender equity, and evidence the link between gender equity and girls’ and young women’s reproductive health.

Adolescent Pregnancy Outcomes and Risk Factors.

One of the major social and public health problems in the world is adolescent pregnancy. Adolescent pregnancy is strongly associated to less favorable results for both the mother and the newborn. We conducted this research to ascertain the impact of teenage age on neonatal outcomes and also observed the lifestyles of pregnant teenage girls. We conducted a study of 2434 mothers aged ≤19 years (n = 294) or 20-34 years (n = 2140) who gave birth in 2019-2020 at the Department of Gynaecology and Obstetrics of Louis Pasteur University Hospital in Košice. The data on mothers and newborn infants have been reported from the reports on mothers at childbirth. Women between the ages of 20 and 34 served as the reference group. The teenage mothers were more likely to become pregnant if they were unmarried (OR = 14.2; 95% CI = 9.3-21.6; p < 0.001) and had a basic education or lack of education (OR = 16.8; 95% CI = 11.5-24.6; p < 0.001). Additionally, they were more likely to smoke when pregnant (OR = 5.0; 95% CI = 3.8-6.6; p < 0.001). Low birth weight was more common in newborns born to adolescent mothers than in those born to adult mothers (p < 0.001). Our findings showed that infants of teenage mothers often had lower birth weights (-332.6 g, p < 0.001). Adolescent mothers were associated with lower Apgar scores at the first minute (p = 0.003). As compared with the control group, pregnant teenage girls had a greater prevalence of preterm deliveries in our research (p = 0.004). This study finds significant age-related disparities in neonatal outcomes between mothers. These results might be used to identify vulnerable groups who need special assistance and actions to reduce the probability of negative outcomes for such groups.