المؤلفون: Husby, Anne Engtrø, Simpson, Melanie Rae, Dalbye, Rebecka, Larsen, Marit, Vanky, Eszter, Løvvik, Tone Shetelig

المصدر: Acta Obstetricia et Gynecologica Scandinavica; Jun2024, Vol. 103 Issue 6, p1092-1100, 9p

مصطلحات موضوعية: POLYCYSTIC ovary syndrome, CHILDBIRTH, PREMATURE labor, PREGNANCY complications, PREGNANCY outcomes, LABOR complications (Obstetrics)

مصطلحات جغرافية: ICELAND, NORWAY, SWEDEN

مستخلص: Introduction: Women with polycystic ovary syndrome (PCOS) have more pregnancy complications like gestational diabetes, hypertension, and preterm labor than other women. Metformin has been used in an attempt to improve pregnancy outcomes. Our study aims to explore childbirth experiences in women with PCOS compared with a reference population. It also explores the potential influence of metformin, obesity, pregnancy complications, and the duration and mode of birth on childbirth experiences. Material and methods: This study is a cohort study combining data from two randomized trials conducted in Norway, Sweden and Iceland. The PregMet2 study (ClinicalTrials.gov, NCT01587378) investigated the use of metformin vs. placebo in pregnant women with PCOS. The Labour Progression Study (ClinicalTrials.gov, NCT02221427) compared the WHO partograph to Zhang's guidelines for progression of labor and were used as the reference population. A total of 365 women with PCOS and 3604 reference women were included. Both studies used the Childbirth Experience Questionnaire (CEQ). Main outcome measures were total CEQ score and four domain scores. The CEQ scores were compared using Mann–Whitney U test for women in Robson group 1 with PCOS (n = 131) and reference women (n = 3604). CEQ scores were also compared between metformin‐treated (n = 180) and placebo‐treated (n = 185) women with PCOS, and for different subgroups of women with PCOS. Results: There was no difference in total CEQ score between women with PCOS and reference women—Wilcoxon–Mann–Whitney (WMW)‐odds 0.96 (95% confidence interval [CI] 0.78–1.17). We detected no difference in CEQ scores between the metformin‐ and placebo‐treated women with PCOS (WMW‐odds 1.13, 95% CI 0.89–1.43). Complications in pregnancy did not affect CEQ (WMW‐odds 1, 95% CI 0.76–1.31). Higher body mass index (WMW‐odds 0.75, 95% CI 0.58–0.96), longer duration of labor (WMW‐odds 0.69, 95% CI 0.49–0.96), and cesarean section (WMW‐odds 0.29, 95% CI 0.2–0.42) were associated with lower CEQ scores in women with PCOS. Conclusions: Women with PCOS experience childbirth similarly to the reference women. Metformin did not influence childbirth experience in women with PCOS, neither did pregnancy complications. Obesity, long duration of labor or cesarean section had a negative impact on childbirth experience. [ABSTRACT FROM AUTHOR]

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المؤلفون: Abuduxike, Gulifeiya, Cali, Sanda, Vaizoğlu, Songül Acar, Aşut, Özen, Çavuş, Mahmut, Olgu, Musa, Çavuş, Simay Naime, Arkut, Meryem, Idehen, Blessing Oluwaseun, Almezghwi, Heyam Abdalla Saleh, Asswayeh, Hana Muftah Ali, Abawu, Janet James, Hossain, Mohammad Jayed, Almawali, Nusaiba AbdulMunaem

المصدر: Maternal & Child Health Journal; Apr2024, Vol. 28 Issue 4, p667-678, 12p

مصطلحات موضوعية: CESAREAN section, RISK assessment, PUBLIC hospitals, DELIVERY (Obstetrics), VAGINA, CYPRIOTS, SCIENTIFIC observation, PREMATURE infants, RETROSPECTIVE studies, DESCRIPTIVE statistics, CHI-squared test, AGE distribution, BIRTH rate, RESEARCH methodology, MEDICAL records, ACQUISITION of data, DATA quality, COMPARATIVE studies, DATA analysis software, TURKISH Cypriots, PREGNANCY complications, CHILDBIRTH, FETAL presentation, PREMATURE labor

مصطلحات جغرافية: ISLANDS of the Mediterranean

مستخلص: Objective: We aimed to understand the utilization of the mode of delivery and related risk factors. Further aimed to apply the Robson classification system to evaluate the data quality and analyze the CS rates in subgroups. Methods: We conducted a retrospective descriptive study by reviewing the medical records of all women who delivered at the State Hospital in 2019. A proforma was developed for extracting data from patient records. All women with six obstetric parameters were categorized into Robson groups to determine the absolute and relative contributions of each group to the overall CS rate. Results: Of 797 deliveries, 401 (50.2%) were CSs. Being older, being Turkish Cypriot, having preterm births, previous CS, multiple fetuses, and having breech or transverse fetal presentations were related to having higher risks of CS. The most common medical indication for CSs (52.3%) was a history of previous CSs. Robson Group 5 contributed the most (50.7%) to the overall CS rate, with the highest absolute contribution of 21.8%. Group 10 and Group 8 were the second and third highest contributors to the overall CS rate, with relative contributions of 25.3% and 9.0%, respectively. Conclusions: Findings revealed the substandard quality of obstetric data and a noticeably high overall CS rate. The top priority should be given to improving the quality of medical records. It underscored the necessity of implementing the Robson classification system as a standard clinical practice to enhance data quality, which helps to effectively evaluate and monitor the CS rates in obstetric populations. Significance: Caesarean section rates are increasing worldwide, and the Robson Classification System is recommended by the WHO to evaluate and monitor the CS rates. This study is the first to use Robson classifications and revealed high CS rates in specific subgroups of the obstetric population. The inadequate, substandard data quality highlighted the areas that urgently needed improvement in clinical practices at the largest state hospital. The study lays the foundation for further nationwide studies and demonstrates the importance of the Robson classification system. Specific recommendations were provided to the hospital management for improving the quality of the obstetric data and monitoring CS rates. [ABSTRACT FROM AUTHOR]

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المؤلفون: Suarez, Anna, Yakupova, Vera

المصدر: BMC Pregnancy & Childbirth; 3/11/2024, Vol. 24 Issue 1, p1-11, 11p

مصطلحات موضوعية: CHILD abuse, CHILDBIRTH, PREMATURE labor, RUSSIANS, PREGNANCY complications

مستخلص: Background: A substantial number of women who subsequently become pregnant and give birth have a history of physical, sexual, and/or child abuse. This study investigated the associations of these types of traumas and their cumulative effect with childbirth experiences, namely, mode of birth, maternal and child complications during pregnancy/childbirth, preterm birth, medical procedures, and obstetric violence during labour. Methods: A group of Russian women (n = 2,575) who gave birth within the previous 12 months, completed a web-based survey, where they provided demographic information, details about their childbirth experiences, and a history of trauma. Results: Women with any type of past abuse were at higher risk for maternal complications during pregnancy/childbirth (exp(β) < 0.73, p < 0.010 for all). More specific to the type of trauma were associations of physical abuse with caesarean birth, child abuse with complications during pregnancy/childbirth for the baby, and physical and child abuse with obstetric violence (exp(β) < 0.54, p < 0.022 for all). There was a cumulative effect of trauma for all the outcomes except for medical procedures during childbirth and preterm birth. Conclusion: This study provides insights into potential different individual effects of physical, sexual, and/or child abuse as well as their cumulative impact on the childbirth experiences. The robust findings about maternal complications during pregnancy/childbirth and obstetric violence highlight the importance of trauma-informed care, supportive policies, and interventions to create safe and empowering birthing environments that prioritise patient autonomy, dignity, and respectful communication. [ABSTRACT FROM AUTHOR]

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المؤلفون: Gruber, Teresa Mira, Ortlieb, Laura, Henrich, Wolfgang, Mechsner, Sylvia

المصدر: Journal of Clinical Medicine; Jan2024, Vol. 13 Issue 2, p414, 11p

مصطلحات موضوعية: PREGNANCY complications, CHILDBIRTH, PLACENTA praevia, PREMATURE labor, MATERNAL age, ENDOMETRIOSIS, PELVIC pain

مستخلص: Women with endometriosis (EM), particularly the manifestations of adenomyosis (AM) and deep infiltrating endometriosis (DIE), suffer from pain and sterility. DIE also appears with several specific obstetric complications. To determine the risk profile, we designed a retrospective case–control study. Primary outcomes were defined as the risk of preterm birth and caesarean delivery (CD). Primiparous singleton pregnancies in women with DIE were compared with controls without EM. We matched for mode of conception and maternal age. A total of 41 women diagnosed with DIE and 164 controls were recruited. A total of 92.7% of the cases were also diagnosed with AM. Preterm birth occurred in 12.2% of cases and in 6.7% of controls. The difference was not statistically significant (OR: 1.932; 95% CI: 0.632–5.907). The rate of CD was similar in both groups. Remarkably, placental implantation disorders in the form of placenta praevia were eight times more frequent in women with DIE (9.8%) than in controls (1.2%, OR: 8.757; 95% CI: 1.545–49.614). Neonatal outcome was similar in both groups. Four out of fourteen cases reported abdominal wall endometriosis after CD. Women with DIE/AM and with placenta praevia are at risk of bleeding complications. After CD, they can develop abdominal wall EM. We therefore suggest evaluating the birth mode in each woman with DIE/AM. [ABSTRACT FROM AUTHOR]

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المؤلفون: Orimoloye, Helen T., He, Di, Li, Tong, Janzen, Carla, Barjaktarevic, Igor, Wang, Xuexia, Hansen, Johnni, Heck, Julia E.

المصدر: PLoS ONE; 1/2/2024, Vol. 19 Issue 1, p1-14, 14p

مصطلحات موضوعية: PREGNANCY complications, TRYPSIN inhibitors, LOW birth weight, CHILDBIRTH, POISSON regression, DELIVERY (Obstetrics), PREMATURE labor

مصطلحات جغرافية: DENMARK

مستخلص: Background: Alpha-1 antitrypsin deficiency (AATD) is related to developing lung and liver disease, but no large-scale studies examine its association with birth outcomes. Objective: We investigated the risk of pregnancy complications and adverse birth outcomes in mothers and children with AATD. Methods: Using a large cohort data of Danish mothers and children with AATD from 1973 to 2013 (n = 2,027,229), with 559 cases (305 mothers and 254 children). We conducted Poisson regression to examine associations between alpha-1 antitrypsin deficiency, adverse birth outcomes, and pregnancy complications in mothers and children. Results: AATD was related to term low birth weight [<2500g; Risk Ratio(RR) = 2.04, 95% confidence interval (CI): 1.50–2.79], lowest quartile of abdominal circumference at birth in children of non-smoking mothers (RR = 1.55, 95% CI: 1.14–2.11), delivery via Cesarean-section (RR = 1.59, 95% CI: 1.05–2.40), preterm birth (RR = 1.54, 95% CI: 1.19–2.00) and preeclampsia (RR = 2.64, 95% CI: 1.76–3.94). Conclusions: This emphasizes the need for mothers with AATD to be monitored closely during pregnancy to reduce the risk of adverse birth outcomes. Routine screening for alpha-1 antitrypsin in pregnancy may be considered among mothers with a pulmonary and liver disease history. [ABSTRACT FROM AUTHOR]

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المؤلفون: Yim, Gyeyoon^1,2 (AUTHOR), Roberts, Andrea² (AUTHOR), Wypij, David^3,4,5 (AUTHOR), Kioumourtzoglou, Marianthi-Anna⁶ (AUTHOR), Weisskopf, Marc G^1,2 (AUTHOR) mweissko@hsph.harvard.edu

المصدر: International Journal of Epidemiology. Dec2021, Vol. 50 Issue 6, p1886-1896. 11p.

مصطلحات موضوعية: *LOW birth weight, *PREMATURE labor, *CHILDBIRTH, *PREGNANCY complications, *PREGNANCY

مستخلص: Background: Diethylstilbestrol (DES) is an endocrine-disrupting pharmaceutical prescribed to pregnant women to prevent pregnancy complications between the 1940s and 1970s. Although DES has been shown in animal studies to have multigenerational effects, only two studies have investigated potential multigenerational effects in humans on preterm birth (PTB), and none on low birthweight (LBW)-major determinants of later life health.Methods: Nurses' Health Study (NHS) II participants (G1; born 1946-64) reported their mothers' (G0) use of DES while pregnant with them. We used cluster-weighted generalized estimating equations to estimate odds ratios (OR) and 95% confidence intervals (CI) for risk of LBW and PTB among the grandchildren by grandmother use of DES. G1 birthweight and gestational age were considered to explore confounding by indication.Results: Among 54 334 G0-G1/grandmother-mother pairs, 973 (1.8%) G0 used DES during pregnancy with G1. Of the 128 275 G2 children, 4369 (3.4%) were LBW and 7976 (6.2%) premature. Grandmother (G0) use of DES during pregnancy was associated with an increased risk of G2 LBW [adjusted OR (aOR) = 3.09; 95% CI: 2.57, 3.72], that was reduced when restricted to term births (aOR = 1.59; 95% CI: 1.08, 2.36). The aOR for PTB was 2.88 (95% CI: 2.46, 3.37). Results were essentially unchanged when G1 birthweight and gestational age were included in the model, as well as after adjusting for other potential intermediate variables, such as G2 pregnancy-related factors.Conclusions: Grandmother use of DES during pregnancy is associated with an increased risk of LBW, predominantly through an increased risk of PTB. Results when considering G1 birth outcomes suggest this does not result from confounding by indication. [ABSTRACT FROM AUTHOR]

المؤلفون: Garti, Isabella^1,2 Isabella.garti@cdu.edu.au, Donkor, Elorm³, Musah, Nafisatu⁴, Appiah, Evans Osei², Gyekye, Sandra², Menlah, Awube^1,2, Akuoko, Cynthia Pomaa^5,6

المصدر: BMC Pregnancy & Childbirth. 5/20/2021, Vol. 21 Issue 1, p1-9. 9p.

مصطلحات موضوعية: *PREMATURE labor, *DELIVERY (Obstetrics), *CHILDBIRTH, *MATERNAL health, *PREGNANCY complications

مستخلص: Background: Preterm delivery is the birth of a baby before 37 weeks of gestation. This global phenomenon is a critical issue of concern especially in developing countries that are resource-constrained when it comes to the management of preterm babies. Complications associated with prematurity contribute significantly to under-five mortality and are linked with feelings of despair, grief, and anxiety among mothers.Methods: This was a qualitative descriptive study in an urban setting in the Greater Accra region of Ghana. Eleven mothers whose babies had been discharged from the neonatal intensive care unit in a major hospital and resided in Accra were interviewed in their homes using a semi-structured interview guide. Data were audiotaped, transcribed verbatim, and analyzed inductively by content analysis.Results: All the mothers had formal education and the mean maternal age was 27.9 years. The majority of the mothers were multiparous. The gestational age at birth ranged from 32 to 34 weeks and the average birth weight of their babies was 1.61 kg. Four major themes emerged which included: Around the clock care; mothers' self-perceptions and attitudes of significant others; mothers' health and wellbeing; and support. Most of the mothers experienced physical exhaustion from the extra demands involved with care, had negative emotions, and unmet social needs.Conclusions: The findings indicate that home management of preterm babies poses multiple stressors and is associated with poor psychological and physical wellbeing among mothers. Hence, the need for extensive education and identification of other social support systems to augment facility-based care for mothers and their preterm babies. [ABSTRACT FROM AUTHOR]

المؤلفون: Martinez-Perez, Oscar¹ Oscarmartinezgine@gmail.com, Prats Rodriguez, Pilar², Muner Hernandez, Marta³, Encinas Pardilla, Maria Begoña¹, Perez Perez, Noelia⁴, Vila Hernandez, Maria Rosa⁵, Villalba Yarza, Ana⁶, Nieto Velasco, Olga⁷, Del Barrio Fernandez, Pablo Guillermo⁸, Forcen Acebal, Laura⁹, Orizales Lago, Carmen Maria¹⁰, Martinez Varea, Alicia¹¹, Muñoz Abellana, Begoña¹², Suarez Arana, Maria¹³, Fuentes Ricoy, Laura¹⁴, Martinez Diago, Clara¹⁵, Janeiro Freire, Maria Jesus¹⁶, Alférez Alvarez-Mallo, Macarena¹⁷, Casanova Pedraz, Cristina¹⁸, Alomar Mateu, Onofre¹⁹

المصدر: BMC Pregnancy & Childbirth. 4/1/2021, Vol. 21 Issue 1, p1-11. 11p.

مصطلحات موضوعية: *COVID-19 pandemic, *PREMATURE labor, *DELIVERY (Obstetrics), *CHILDBIRTH, *PREGNANCY complications

مستخلص: Background: To determine whether severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, the cause of COVID-19 disease) exposure in pregnancy, compared to non-exposure, is associated with infection-related obstetric morbidity.Methods: We conducted a multicentre prospective study in pregnancy based on a universal antenatal screening program for SARS-CoV-2 infection. Throughout Spain 45 hospitals tested all women at admission on delivery ward using polymerase-chain-reaction (PCR) for COVID-19 since late March 2020. The cohort of positive mothers and the concurrent sample of negative mothers was followed up until 6-weeks post-partum. Multivariable logistic regression analysis, adjusting for known confounding variables, determined the adjusted odds ratio (aOR) with 95% confidence intervals (95% CI) of the association of SARS-CoV-2 infection and obstetric outcomes.Main Outcome Measures: Preterm delivery (primary), premature rupture of membranes and neonatal intensive care unit admissions.Results: Among 1009 screened pregnancies, 246 were SARS-CoV-2 positive. Compared to negative mothers (763 cases), SARS-CoV-2 infection increased the odds of preterm birth (34 vs 51, 13.8% vs 6.7%, aOR 2.12, 95% CI 1.32-3.36, p = 0.002); iatrogenic preterm delivery was more frequent in infected women (4.9% vs 1.3%, p = 0.001), while the occurrence of spontaneous preterm deliveries was statistically similar (6.1% vs 4.7%). An increased risk of premature rupture of membranes at term (39 vs 75, 15.8% vs 9.8%, aOR 1.70, 95% CI 1.11-2.57, p = 0.013) and neonatal intensive care unit admissions (23 vs 18, 9.3% vs 2.4%, aOR 4.62, 95% CI 2.43-8.94, p <  0.001) was also observed in positive mothers.Conclusion: This prospective multicentre study demonstrated that pregnant women infected with SARS-CoV-2 have more infection-related obstetric morbidity. This hypothesis merits evaluation of a causal association in further research. [ABSTRACT FROM AUTHOR]

المؤلفون: Vigod, Simone N.^1,2,3 (AUTHOR) simone.vigod@wchospital.ca, Fung, Kinwah³ (AUTHOR), Amartey, Abigail³ (AUTHOR), Bartsch, Emily² (AUTHOR), Felemban, Reema² (AUTHOR), Saunders, Natasha^2,3,4 (AUTHOR), Guttmann, Astrid^2,3,4 (AUTHOR), Chiu, Maria^2,3 (AUTHOR), Barker, Lucy C.^1,2,3 (AUTHOR), Kurdyak, Paul^2,3,5 (AUTHOR), Brown, Hilary K.^1,2,3 (AUTHOR)

المصدر: Social Psychiatry & Psychiatric Epidemiology. May2020, Vol. 55 Issue 5, p561-570. 10p.

مصطلحات موضوعية: *MATERNALLY acquired immunity, *PREMATURE labor, *PREGNANCY complications, *ASPHYXIA neonatorum, *GENERALIZED estimating equations, *SCHIZOPHRENIA, *CHILDBIRTH

مصطلحات جغرافية: ONTARIO

مستخلص: Purpose: Maternal schizophrenia is associated with adverse birth outcomes, but the reasons for this remain unclear. In a population-based cohort of infants born to women with schizophrenia, we determined the occurrence of key perinatal outcomes and explored whether factors identifiable in our datasets explained any elevated risk.Methods: Using population-level health administrative data linked to clinical birth-registry data in Ontario, Canada (2006-2011), we examined the relative risk (RR) of preterm birth (< 37 weeks), small for gestational age (SGA), and Apgar scores < 8 in infants of women with schizophrenia (n = 4279) versus infants of unaffected women (n = 286,147). Generalized estimating equations determined whether reproductive history, maternal health conditions, pregnancy exposures, and complications explained elevated RRs.Results: Among infants of women with schizophrenia, risk was higher for prematurity (11.4% vs. 6.9%, aRR 1.64, 95% CI 1.51-1.79), SGA (3.5% vs. 2.5%, aRR 1.40, 95% CI 1.20-1.64), and Apgar score < 8 at 1 (19.0% vs. 12.8%, aRR 1.49, 95% CI 1.40-1.59) and 5 min (5.6% vs. 3.0%, aRR 1.90, 95% CI 1.68-2.16). Smoking, fourfold more common among women with schizophrenia, was the variable that explained the greatest proportion of the elevated aRR for prematurity (9.9%), SGA (28.7%), and Apgar < 8 at 1 and 5 min (9.8%, 5.6%). Illicit substance use, certain reproductive history variables, and pregnancy complications also contributed to the elevated aRR for preterm birth.Conclusions: Elevated risks of preterm birth, SGA, and low Apgar scores in infants of women with schizophrenia are partly explained by potentially modifiable factors such as smoking and illicit drug use, suggesting opportunities for targeted intervention. [ABSTRACT FROM AUTHOR]

المؤلفون: Pradhan, Dinesh¹ (AUTHOR) dinesh.bhutan@gmail.com, Nishizawa, Yoriko¹ (AUTHOR), Chhetri, Hari P² (AUTHOR)

المصدر: Journal of Tropical Pediatrics. Apr2020, Vol. 66 Issue 2, p163-170. 8p.

مصطلحات موضوعية: *PREMATURE labor, *PREMATURE infants, *NEONATAL mortality, *CHILDBIRTH, *BIRTH rate, *PUBLIC hospitals, *CESAREAN section, *RESEARCH, *NEONATAL intensive care, *NEONATAL diseases, *RESEARCH methodology, *NEONATAL intensive care units, *FETAL growth retardation, *DISEASES, *EVALUATION research, *MEDICAL cooperation, *COMPARATIVE studies, *PREGNANCY complications, *MEDICAL referrals, *DISEASE prevalence, *INFANT mortality, *SMALL for gestational age

مصطلحات جغرافية: BHUTAN

مستخلص: Introduction: Preterm birth-related complications are the leading cause of under-5 mortality globally. Bhutan does not have a reliable preterm birth rate or data regarding outcome of preterm babies.Aim: To determine the preterm birth rate at the Jigme Dorji Wangchuck National Referral Hospital (JDWNRH) in Thimphu, Bhutan, and assess their outcomes.Methods: All live preterm births at JDWNRH from 1 January 2017 to 31 December 2017 were followed from birth till hospital discharge. Maternal demographic data, pregnancy details and delivery details were collected. Morbidity and mortality information as well as discharge outcome were collected on babies admitted to neonatal intensive care unit (NICU).Results: Preterm birth rate among live births was 6.4%. Most mothers were younger than 30 years, housewives and had secondary education. Pregnancy registration rate and adequacy of antenatal visits were high. Most preterm births were singleton and the predominant mode of delivery was cesarean section. More than half of the births were initiated spontaneously, and the male:female ratio was 1.2:1. Most babies were late preterm and low birth weight. Half of them required NICU admission. Overall mortality rate was 11% and 21.6% for admitted preterm neonates. Preterm small-for-gestational-age neonates, and those born after provider-initiated preterm birth had significantly increased risk of mortality. Most preterm neonates were discharged without complications. The rate of extrauterine growth restriction was high.Conclusion: This is the first study on the prevalence of preterm births and their outcomes in the largest tertiary-care hospital in Bhutan. [ABSTRACT FROM AUTHOR]