The Association Between Number of Repeat Cesarean Deliveries and Adverse Outcomes among Low‐Risk Pregnancies

2022 ◽  
Author(s):  
Sami Backley ◽  
Han‐Yang Chen ◽  
Baha M. Sibai ◽  
Suneet P. Chauhan ◽  
Michal Fishel Bartal
Keyword(s):  
Adverse Outcomes ◽  
Low Risk ◽  
Cesarean Deliveries

scholarly journals POS0719 ADVERSE OUTCOMES AND REHOSPITALIZATION AFTER DELIVERY AMONG WOMEN WITH SYSTEMIC LUPUS ERYTHEMATOSUS OR RHEUMATOID ARTHRITIS AND THEIR INFANTS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 609.1-609
Author(s):  
J. Sabo ◽  
N. Singh ◽  
D. A. Crane ◽  
D. R. Doody ◽  
M. A. Schiff ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Systemic Lupus Erythematosus ◽  
Hospital Discharge ◽  
Birth Outcomes ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Lupus Erythematosus ◽  
Adverse Outcomes ◽  
Systemic Lupus ◽  
Cesarean Deliveries

Background:Women with rheumatoid arthritis (RA) or systemic lupus erythematosus (SLE) have greater risk of adverse obstetric and birth outcomes than women without these conditions. Infant outcomes are less well-studied. It is unknown whether re-hospitalization after delivery occurs more often for affected mothers and their infants.Objectives:We compared obstetric outcomes among women with and without RA or SLE, and birth outcomes among their infants. Maternal and infant rehospitalizations <2 years of delivery were also compared.Methods:This population-based cohort study used linked birth-hospital discharge data from Washington State for 1987-2014. International Classification of Disease 9th revision (ICD9) codes identified all women with RA (ICD9 714.X, 725.X) and SLE (ICD9 710, 710.0, 710.1) in the hospital discharge record at delivery, and a 10:1 comparison group of women without these codes. Analyses were restricted to singleton live births (1,223 RA; 1,354 SLE). Poisson regression with robust standard errors estimated relative risks (RR) and 95% confidence intervals (CI) for selected outcomes, accounting for delivery year, maternal age, and parity.Results:Many adverse outcomes were more common among RA and SLE cases than among comparison women. Preeclampsia occurred more often during pregnancies of women with RA (RR 1.42, 95% CI 1.17-1.71) or SLE (RR 2.33, 95% CI 2.01-2.70), as did preterm rupture of membranes (PROM, RR 2.85, 95% CI 2.20-3.72 for RA; RR 3.28, 95% CI 2.54-4.23 for SLE). Cesarean deliveries were more common among nulliparous women in both groups (RR 1.32, 95% CI 1.18-1.48 for both conditions). Infants of women with RA or SLE were more likely to weigh <2500 g (RR 2.08, 95% CI 1.72-2.52 for RA; RR 4.88, 95% CI 4.27-5.58 for SLE), be small for gestational age (RR 1.25, 95% CI 1.07-2.50; RR 2.30; 2.04-2.59, respectively), delivered at <32 weeks gestation (RR 1.83, 95% CI 1.13-2.97; RR 5.13, 95% CI 3.75-7.01, respectively), and require neonatal intensive care unit admission (NICU, RR 1.89, 95% CI 1.56-2.30; RR 2.71, 95% CI 2.25-3.28, respectively). Infants of women with SLE were more likely to have a malformation (RR 1.46, 95% CI 1.21-1.75) or die within 2 years (RR 2.11, 95% CI 1.21-3.67). Rehospitalization levels among both women with RA (RR 2.22; 1.62-3.04) and SLE (RR 2.78, 95% CI 2.15-3.59) were greatest <6 months of delivery and declined over time. Infants of women with SLE had increased rehospitalization <6 months (RR 1.64, 95% CI 1.36-1.98).Conclusion:Consistent with prior literature, we found women with RA or SLE experienced many adverse outcomes. In our data, these included preeclampsia, PROM, and cesarean deliveries, with increased risks more notable among women with SLE. Infants of women with either condition were more likely to weigh <2500g, be <32 weeks gestation, small for gestational age, and require NICU admission than infants of comparison women. Only infants of women with SLE had increased malformations. Maternal rehospitalization after delivery was more common in both groups; most marked at <6 months. Infant rehospitalizations were increased in both cohorts to a lesser extent. Close follow-up during this time period is crucial to minimize adverse outcomes.Disclosure of Interests:Julianna Sabo: None declared, Namrata Singh: None declared, Deborah A. Crane: None declared, David R. Doody: None declared, Melissa A. Schiff: None declared, Beth A. Mueller Shareholder of: Household owns shares in AstraZeneca

scholarly journals Association between Adherence with Recommended Antenatal Care in Low-Risk, Uncomplicated Pregnancy, and Maternal and Neonatal Adverse Outcomes: Evidence from Italy

2020 ◽  
Vol 18 (1) ◽  
pp. 173
Author(s):  
Giovanni Corrao ◽  
Anna Cantarutti ◽  
Anna Locatelli ◽  
Gloria Porcu ◽  
Luca Merlino ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Prevalence Ratio ◽  
Population Based ◽  
Adverse Outcomes ◽  
Low Risk ◽  
Neonatal Outcomes ◽  
Lombardy Region ◽  
Uncomplicated Pregnancy ◽  
Maternal And Neonatal Outcomes ◽  
Estimate Prevalence

Antenatal care (ANC) aims of monitoring wellbeing of mother and foetus during pregnancy. We validate a set of indicators aimed of measuring the quality of ANC of women on low-risk, uncomplicated pregnancy through their relationship with maternal and neonatal outcomes. We conducted a population-based cohort study including 122,563 deliveries that occurred between 2015 and 2017 in the Lombardy Region, Italy. Promptness and appropriateness of number and timing of gynaecological visits, ultrasounds and laboratory tests were evaluated. We assessed several maternal and neonatal outcomes. Log-binomial regression models were used to estimate prevalence ratio (PR), and corresponding 95% confidence interval (95% CI), for the exposure→outcome association. Compared with women who adhered with recommendations, those who were no adherent had a significant higher prevalence of maternal intensive care units admission (PR: 3.1, 95%CI: 1.2–7.9; and 2.7, 1.1–7.0 respectively for promptness of gynaecological visits, and appropriateness of ultrasound examinations), low Apgar score (1.6, 1.1–1.2; 1.9, 1.3–2.7; and 2.1, 1.5–2.8 respectively for appropriateness and promptness of gynaecological visits, and appropriateness of ultrasound examinations), and low birth weight (1.8, 1.5–2.3 for appropriateness of laboratory test examinations). Benefits for mothers and newborn are expected from improving adherence to guidelines-driven recommendations regarding antenatal care even for low-risk, uncomplicated pregnancies.

Association of Time of Delivery With Composite Adverse Outcomes in Low-Risk Pregnancies

2020 ◽  
Vol 135 (3) ◽  
pp. 527-534
Author(s):  
Stephen M. Wagner ◽  
Han-Yang Chen ◽  
Megha Gupta ◽  
Suneet P. Chauhan
Keyword(s):  
Adverse Outcomes ◽  
Low Risk

402: Adverse outcomes of low risk pregnancies in the united states

2015 ◽  
Vol 212 (1) ◽  
pp. S208-S209
Author(s):  
Valery Danilack ◽  
Anthony Nunes ◽  
Maureen Phipps
Keyword(s):  
United States ◽  
The United States ◽  
Adverse Outcomes ◽  
Low Risk

scholarly journals Timing of Delivery and Adverse Outcomes in Term Singleton Repeat Cesarean Deliveries

2014 ◽  
Vol 34 (2) ◽  
pp. 86
Author(s):  
G. Chiossi ◽  
Y. Lai ◽  
M.B. Landon ◽  
C.Y. Spong ◽  
D.J. Rouse ◽  
...  
Keyword(s):  
Adverse Outcomes ◽  
Cesarean Deliveries

Knowledge of the Birth Process Among Undergraduates: Impact of Screening of a Documentary Featuring Natural Childbirth in Low-Risk Pregnancies

2012 ◽  
Vol 2 (1) ◽  
pp. 20-28 ◽  
Author(s):  
Katherine F. Kavanagh ◽  
Stephanie M. Joyce ◽  
Jennifer Nicklas ◽  
Joy V. Nolte ◽  
Lauren G. Morgan ◽  
...  
Keyword(s):  
United States ◽  
Panel Discussion ◽  
The United States ◽  
Low Risk ◽  
Birth Process ◽  
Natural Childbirth ◽  
Cesarean Deliveries ◽  
Risk Pregnancy ◽  
Delivery Options ◽  
The Impact

PURPOSE: Little is known about knowledge of birthing practices, among young adults in the United States; specifically, knowledge regarding the impact of these practices on mothers and newborn. Therefore, the purpose was to assess U.S. undergraduates’ knowledge regarding risks of cesarean deliveries (medically indicated or not), before and after viewing a documentary featuring unmedicated vaginal birth in low-risk pregnancy and subsequent expert panel discussion.STUDY DESIGN: Uncontrolled before/after study.MAJOR FINDINGS: Of the 225 attendees, 206 completed the pretest (91.5%) and 163 completed the posttest (72.4%). Of the 206 completing the pretest, 152 identified as undergraduates, and 123 (80%) of these 152 completed the posttest. Results indicate exposure to the documentary and expert discussion panel resulted in significant increases in knowledge of risks of cesarean deliveries, regardless of gender. In addition, witnessing or viewing birth in the media was significantly associated, at posttest, with greater increases in knowledge of some risks.MAIN CONCLUSION: These findings are important in light of the increasing trend in cesarean deliveries in the United States. Educating this population and providing credible information on delivery options should be informed by further research into these domains.

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