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maternal outcomes 45 years

Thomas Schmitz, Corinne Alberti, Moreno Ursino, Olivier Baud, Camille Aupiais
BACKGROUND: Although antenatal betamethasone is recommended worldwide for women at risk of preterm delivery, concerns persist regarding the long-term effects associated with this treatment. Indeed, adverse events, mainly dose-related, have been reported. The current recommended dose of antenatal betamethasone directly derives from sheep experiments performed in the late 60's and has not been challenged in 45 years. Therefore, randomized trials evaluating novel dose regimens are urgently needed...
February 12, 2019: BMC Pregnancy and Childbirth
Joemer C Maravilla, Kim S Betts, Rosa Alati
OBJECTIVE: To evaluate the risk of adverse maternal outcomes among adolescents experiencing a repeat pregnancy in the Philippines. METHODS: Data were analyzed from four waves (1998-2013) of a cross-sectional nationally representative survey. We included 2518 non-nulliparous and non-pregnant women aged 15-44 years with an interpregnancy interval (IPI) of 24 months or less. Multivariate logistic regression was used to measure the association of repeat pregnancy with adverse maternal outcomes by age group (11-19, 20-24, and 25-45 years), accounting for clustering within each respondent...
February 1, 2019: International Journal of Gynaecology and Obstetrics
Liv Guro Engen Hanem, Øyvind Salvesen, Petur B Juliusson, Sven M Carlsen, Marit Cecilie Fonn Nossum, Marte Øye Vaage, Rønnaug Ødegård, Eszter Vanky
BACKGROUND: Metformin is increasingly used to treat gestational diabetes and type 2 diabetes in pregnancy, and in attempts to improve pregnancy outcomes in polycystic ovary syndrome and obesity. It passes across the placenta with possible long-term consequences for the offspring. We previously explored the effect of metformin, given to women with polycystic ovary syndrome during pregnancy, on children's growth up to 4 years of age. In this 5-10 year follow-up, we examined the cardiometabolic risk factors in these children...
January 28, 2019: Lancet Child & Adolescent Health
Kai-Ti Tseng, Chun-Chih Peng, Jui-Hsing Chang, Chyong-Hsin Hsu, Chia-Ying Lin, Wai-Tim Jim, Hung-Yang Chang
The association between advanced maternal age and neonatal outcomes remains controversial. This study attempted to determine the short-term and long-term outcomes of very low birth weight (VLBW, <1500 g) preterm infants, born to mothers of advanced age (≥35 years).In this retrospective cohort study, VLBW infants were divided into the advanced maternal age group and comparison group. We compared the pregnancy complications, demographic factors, short-term morbidities, and neurodevelopmental outcomes using the Bayley Scales of Infant Development-Third Edition, at 24 months of corrected age between the 2 groups...
February 2019: Medicine (Baltimore)
N L Kozlovskaya, Yu V Korotchaeva, E M Shifman, L A Bobrova
AIM: Analysis of clinical manifestations, course and outcomes of obstetric aHUS. MATERIALS AND METHODS: 45 patients with aHUS development during pregnancy or immediately after childbirth were observed between 2011 and 2017, age from 16 to 42 years. RESULTS: All patients had AKI (serum creatinine 521,5±388,0 µmol/l, oliguria or anuria that required initiation of hemodialysis). 93.3% pts had extrarenal manifestations of TMA with the development of multiple organ failure (MOF)...
June 20, 2018: Terapevticheskiĭ Arkhiv
Alexander J Butwick, Jason Bentley, Cynthia A Wong, Jonathan M Snowden, Eric Sun, Nan Guo
Importance: Neuraxial labor analgesia is recognized as the most effective method of providing pain relief during labor. Little is known about variation in the rates of neuraxial analgesia across US states. Identifying the presence and extent of variation may provide insights into practice variation and may indicate where access to neuraxial analgesia is inadequate. Objective: To test the hypothesis that variation exists in neuraxial labor analgesia use among US states...
December 7, 2018: JAMA network open
Jose Paulo Pereira, Karin Nielsen-Saines, Jeffrey Sperling, Melanie M Maykin, Luana Damasceno, Renan Fonseca Cardozo, Helena Abreu Valle, Beatriz Ribeiro Torres Dutra, Helder Dotta Gama, Kristina Adachi, Andrea A Zin, Irena Tsui, Zilton Vasconcelos, Patricia Brasil, Maria E Moreira, Stephanie L Gaw
Importance: Congenital Zika virus infection causes a spectrum of adverse birth outcomes, including severe birth defects of the central nervous system. The association of prenatal ultrasonographic findings with adverse neonatal outcomes, beyond structural anomalies such as microcephaly, has not been described to date. Objective: To determine whether prenatal ultrasonographic examination results are associated with abnormal neonatal outcomes in Zika virus-affected pregnancies...
December 7, 2018: JAMA network open
Josephine Funck Bilsteen, David Taylor-Robinson, Klaus Børch, Katrine Strandberg-Larsen, Anne-Marie Nybo Andersen
Importance: The poor health outcomes associated with preterm birth are well established. However, it is less clear how small variations in gestational age, even within the term range, are associated with long-term opportunities and well-being, as measured by socioeconomic outcomes in adulthood. Objective: To examine the association of gestational age at birth with educational achievement, income, and primary source of income in adulthood. Design, Setting, and Participants: This Danish population-based, register-based cohort study examined all live-born singletons born in Denmark from 1982 to 1986 without congenital anomalies and who lived in Denmark at age 28 years...
December 7, 2018: JAMA network open
Sayoko Ogura, Jun Suzuki, Hiromichi Suzuki
Hypertensive disorders of pregnancy (HDP) represent a frequent disorder among pregnancies. Women with severe hypertension in pregnancy are at increased risk of maternal complications and require antihypertensive drug therapy. This study aimed to systematically review randomized control trials of antihypertensive drug(s) treating non-severe hypertension during pregnancy to estimate the effectiveness and safety of this intervention. On May 8, 2018, we searched PubMed, Cochrane Library, and Ichu-Shi with no restriction on publication year...
January 9, 2019: Hypertension Research: Official Journal of the Japanese Society of Hypertension
Kyung Don Yoo, Hajeong Lee, Yaerim Kim, Sehoon Park, Joong Shin Park, Joon Seok Hong, Chang Wook Jeong, Hyeon Hoe Kim, Jung Pyo Lee, Dong Ki Kim, Kook-Hwan Oh, Kwon Wook Joo, Yon Su Kim
Background: Woman kidney donors face obstetric complication risks after kidney donation, such as gestational hypertension and preeclampsia. Studies on childbirth-related complications among Asian women donors are scarce. Methods: This retrospective cohort study included woman donors aged 45 years or younger at the time of kidney donation in a single tertiary hospital between 1985 and 2014. Pregnancy associated complications were investigated using medical records and telephone questionnaires for 426 pregnancies among 225 donors...
December 2018: Kidney Research and Clinical Practice
Su Mon Latt, Allison Milner, Anne Kavanagh
BACKGROUND: Unsafe abortion is one of the commonest causes of maternal mortality. Abortion-related maternal deaths are higher in countries with the most restrictive abortion laws. We assess whether maternal mortality varies within and between countries over time according to the flexibility of abortion laws (the number of reasons a woman can have an abortion). METHOD: We conducted an ecological study to assess the association between abortion laws and maternal mortality in 162 countries between 1985 and 2013...
January 5, 2019: BMC Women's Health
Luca Cegolon, Oona Campbell, Salvatore Alberico, Marcella Montico, Giuseppe Mastrangelo, Lorenzo Monasta, Luca Ronfani, Fabio Barbone
BACKGROUND: Lengths of hospital stay (LoS) after childbirth that are too long have a number of health, social and economic drawbacks. For this reason, in several high-income countries LoS has been reduced over the past decades and early discharge (ED) is increasingly applied to low-risk mothers and newborns. METHODS: We conducted a population-based study investigating LoS after chilbirth across all 12 maternity centres of Friuli Venezia-Giulia (FVG), North-Eastern Italy, using a database capturing all registered births in the region from 2005 to 2015 (11 years)...
2019: PloS One
Olivia Magwood, Victoire Kpadé, Kednapa Thavorn, Sandy Oliver, Alain D Mayhew, Kevin Pottie
Home-based records (HBRs) may improve the health of pregnant women, new mothers and their children, and support health care systems. We assessed the effectiveness of HBRs on maternal, newborn and child health reporting, care seeking and self-care practice, mortality, morbidity and women's empowerment in low-, middle- and high-income countries. We conducted a systematic search in MEDLINE, EMBASE, CENTRAL, Health Systems Evidence, CINAHL, HTA database, NHS EED, and DARE from 1950 to 2017. We also searched the WHO, CDC, ECDC, JICA and UNAIDS...
2019: PloS One
Snorri Einarsson, Christina Bergh, Linda Kluge, Ann Thurin-Kjellberg
INTRODUCTION: Large observational studies have shown that obstetric and perinatal outcomes are negatively affected in obese women. In contrast, a recent Dutch randomized trial of infertile women and lifestyle weight intervention found no difference between the weight intervention group and the control group in obstetric or neonatal outcomes. We have recently published a large Nordic randomized trial where obese women scheduled for in vitro fertilization (IVF) treatment went through an intensive weight intervention treatment prior to IVF...
December 30, 2018: Acta Obstetricia et Gynecologica Scandinavica
Stine Bernitz, Rebecka Dalbye, Jun Zhang, Torbjørn M Eggebø, Kathrine F Frøslie, Inge Christoffer Olsen, Ellen Blix, Pål Øian
BACKGROUND: There is an ongoing debate concerning which guidelines and monitoring tools are most beneficial for assessing labour progression, to help prevent use of intrapartum caesarean section (ICS). The WHO partograph has been used for decades with the assumption of a linear labour progression; however, in 2010, Zhang introduced a new guideline suggesting a more dynamic labour progression. We aimed to investigate whether the frequency of ICS use differed when adhering to the WHO partograph versus Zhang's guideline for labour progression...
December 20, 2018: Lancet
Ernani B da Rosa, Daniélle B Silveira, Jamile D Correia, Carolina G Grapiglia, Samir A G de Moraes, Mauricio R Nunes, Tatiana D Zen, Ceres A Oliveira, Elisa P E Correia, Cristiane T Alcay, Marli L Lisboa, Andre C da Cunha, Paulo R G Zen, Rafael F M Rosa
Several countries, as Brazil, have public policies for periconceptional folic acid supplementation (FAS) in order to prevent unfavorable outcomes. Our aim was to evaluate the FAS situation in a public reference hospital from Southern Brazil. This study included all mothers who had children born at the Hospital Materno Infantil Presidente Vargas, RS, Brazil, in a 1-year period. Data collection was conducted through interviews with application of a clinical protocol and analysis of the patients' records. FAS was defined as the use of folic acid in any period of the periconceptional period, irrespective of the duration and amount...
December 19, 2018: American Journal of Medical Genetics. Part A
Margo S Harrison, Sharon Scarbro, Elizabeth Juarez-Colunga, Andrea Jimenez-Zambrano, Saskia Bunge-Montes, Guillermo A Bolaños, Molly Lamb, Edwin J Asturias, Stephen Berman, Gretchen Heinrichs
Purpose To evaluate trends and factors associated with mode of delivery in the rural Southwest Trifinio region of Guatemala. Description We conducted a retrospective analysis of self-reported antepartum factors and postpartum outcomes recorded in a quality improvement database among 430 women enrolled in a home-based maternal healthcare program between June 1, 2015 and August 1, 2017. Assessment Over the study period, the rates of cesarean delivery (CD) increased (from 30 to 45%) and rates of vaginal delivery (VD) decreased (70-55%) while facility-based delivery attendance remained stable around 70%...
December 12, 2018: Maternal and Child Health Journal
Alyaa AlRefai, James Drake, Abhaya V Kulkarni, Kristin L Connor, Patrick Shannon, Ants Toi, David Chitayat, Susan Blaser, Paige T Church, Nimrah Abbasi, Greg Ryan, Tim Van Mieghem
OBJECTIVE: Fetal myelomeningocele (fMMC) surgery improves infant outcomes when compared with postnatal surgery. Surgical selection criteria and the option of pregnancy termination, however, limit the number of cases that are eligible for prenatal surgery. We aimed to quantify what proportion of cases could ultimately benefit from fetal therapy. METHODS: We retrospectively reviewed all cases of fMMC referred to a large tertiary care center over a 10-year period and assessed their eligibility for fetal surgery, pregnancy termination rates, and actual uptake of the surgery...
December 10, 2018: Prenatal Diagnosis
Mohammad Rifat Haider, Mohammad Masudur Rahman, Md Moinuddin, Ahmed Ehsanur Rahman, Shakil Ahmed, M Mahmud Khan
BACKGROUND: Cesarean Section (CS) delivery has been increasing rapidly worldwide and Bangladesh is no exception. In Bangladesh, the CS rate has increased from about 3% in 2000 to about 24% in 2014. This study examines trend in CS in Bangladesh over the last fifteen years and implications of this increasing CS rates on health care expenditures. METHODS: Birth data from Bangladesh Demographic and Health Survey (BDHS) for the years 2000-2014 have been used for the trend analysis and 2010 Bangladesh Maternal Mortality Survey (BMMS) data were used for estimating health care expenditure associated with CS...
2018: PloS One
John N Chang, Everett F Magann, Sarah A Novotny, Chad E Cooley, C Heath Gauss, Marc R Parrish, John C Morrison
OBJECTIVE: To compare pregnancy outcomes in women with sickle cell disease from recent deliveries with a similar group delivered earlier. METHODS: During a 12-year period (2005-2016), data from pregnant women with hemoglobin SS or SC were collected from three university medical centers and compared with earlier studies (1979-2003) involving similar patients. The primary endpoints were maternal complications during pregnancy and newborn outcomes. RESULTS: There were 278 patients in the control group (1979-2003) compared with 150 patients in the study group (2005-2016)...
December 2018: Southern Medical Journal
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