scholarly journals OC22.04: Twin actual birthweight discordance and adverse pregnancy outcome: the STORK multiple pregnancy cohort

2012 ◽  
Vol 40 (S1) ◽  
pp. 45-45
Author(s):  
F. D'Antonio ◽  
T. D. Dias ◽  
S. Pescarini ◽  
A. Bhide ◽  
B. Thilaganathan
Keyword(s):  
Pregnancy Outcome ◽  
Adverse Pregnancy Outcome ◽  
Multiple Pregnancy ◽  
Pregnancy Cohort ◽  
Adverse Pregnancy

scholarly journals Study of pregnancy outcome in relation to first trimester body mass index

2019 ◽  
Vol 8 (11) ◽  
pp. 4187
Author(s):  
Prachi Srivastava ◽  
Hema Verma
Keyword(s):  
Body Mass Index ◽  
Pregnancy Outcome ◽  
Body Mass ◽  
Adverse Pregnancy Outcome ◽  
Multiple Pregnancy ◽  
First Trimester ◽  
Large For Gestational Age ◽  
Singleton Pregnancy ◽  
Adverse Pregnancy ◽  
High Bmi

Background: Early pregnancy body mass index (BMI) plays an important role in pregnancy outcome. Women with either low or high BMI have an adverse pregnancy outcome. American college of obstetricians and gynecologists (ACOG) recommends calculation of BMI for all pregnant women at their first visit. This study was conducted to assess maternal and fetal outcome in women based on first trimester BMI.Methods: This was a prospective observational study conducted in Department of Obstetrics and Gynecology of T. S. Misra Medical college and hospital, Lucknow from January 2018 to January 2019. Patients with singleton pregnancy booked in first trimester were included while women with multiple pregnancy, pre-existing medical conditions were excluded from the study. Proper history taking and examination was done, and patients divided into five groups as per guidelines of WHO and National Institute of Health Guidelines. Patients were followed up during entire antenatal period. Any maternal and fetal complications were recorded.Results: Incidence of anemia and intrauterine growth restriction (IUGR) was seen more in underweight patients. Postpartum hemorrhage (PIH), gestational diabetes and macrosomia was associated more with patients who were overweight or obese. There was significantly more incidence of lower (uterine) segment caesarean section (LSCS), instrumental delivery, wound sepsis and PPH in patients with higher BMI. SGA babies were seen more in patients with low BMI while large for gestational age (LGA) babies were seen more in patients with high BMI. More neonatal intensive care unit (NICU) admissions were seen in patients with low or high BMI.Conclusions: Complications during pregnancy and adverse pregnancy and neonatal complication was seen significantly more in patients on either side of BMI (underweight and obese). Hence it can be concluded that BMI of a patient directly affects pregnancy outcome.

scholarly journals POS0737 LOW PRECONCEPTIONAL COMPLEMENT LEVEL IS RELATED WITH ADVERSE OBSTETRIC OUTCOME IN A MULTICENTRIC COHORT OF PREGNANCY IN PATIENTS WITH APS AND APL POSITIVITY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 619.2-620
Author(s):  
D. Lini ◽  
C. Nalli ◽  
L. Andreoli ◽  
F. Crisafulli ◽  
M. Fredi ◽  
...  
Keyword(s):  
Pregnancy Outcome ◽  
Complement Activation ◽  
Pregnancy Complications ◽  
Antiphospholipid Antibodies ◽  
Pregnancy Loss ◽  
Adverse Pregnancy Outcome ◽  
Obstetric Outcome ◽  
Complement Level ◽  
Increased Risk ◽  
Adverse Pregnancy

Background:The role of complement in the antiphospholipid (aPL) related pathology has been widely studied in animal models. Antiphospholipid antibodies can induce fetal loss in experimental animals but mice deficient in specific complement components (C4, C3, C5) appear somehow protected. In addition, in pregnant mice injected with aPL, antibody deposition has been found at decidual level causing focal necrosis, apoptosis and neutrophil infiltrates and supporting aPL pathogenetic potential. On the other hand, human studies did find hypocomplementemia associated to pregnancy complications in patients with obstetric antiphospholipid syndrome (APS). These results, however, are not unanimously confirmed and, in addition, some studies only show increased levels of complement activation products (i.e. Bb) and not decreased levels of C3 and/or C4. A recently study focusing on complement level in early pregnancy and before pregnancy showed a significant correlation with pregnancy complications and loss in a large cohort of primary APS.Objectives:To investigate if the simple detection of low C3 and/or C4 could be considered a risk factor for adverse pregnancy outcome in APS and aPL carriers pregnancies.Methods:We performed a multicentric study including patients from 10 Italian and 1 Russian Centers. Data on pregnancies in women with primary APS (n=434) and asymptomatic carriers with persistently positive aPL but not fulfilling clinical criteria for APS (n=218) were retrospectively collected. Serum C3 and C4 levels were evaluated by nephelometry; hypocomplementemia was defined by local laboratory reference values. Statistical analysis was performed using GraphPad.Results:Preconceptional complement levels and gestational outcome were available for 107 (25%) pregnancies in APS out of 434 and for 196 (90%) pregnancies in aPL carriers women out of 218. In pregnancies with low preconceptional C3 and/or C4, a significantly higher prevalence of pregnancy losses was observed (p=0.019). A subgroup analysis focusing on triple aPL positive patients was also performed. Preconceptional low C3 and/or C4 levels were found to be associated with an increased rate of pregnancy loss (p = 0.027) in this subgroup also. Otherwise, adverse pregnancy outcomes in single or double aPL positive women were not related to preconception complement levels (p = 0.44) (Table 1). Of note, all the pregnancy losses in the triple positive group occurred in patients treated with low dose aspirin and low molecular weight heparin from the time of positive pregnancy test.Conclusion:Our findings confirm that decreased complement levels before pregnancy are associated with increased risk of adverse outcome. This has been seen only in in women with triple aPL positivity, indeed single or double positivity does not show this trend. Complement levels are cheap and easy to be measured therefore they could represent a useful aid to identify patients at increased risk of pregnancy loss. test positivity.References:[1]De Carolis S, et al. Complementemia and obstetric outcome in pregnancy with antiphospholipid syndrome. Lupus (2012) 21:776–8.[2]Kim MY, et al. Complement activation predicts adverse pregnancy outcome in patients with systemic lupus erythematosus and/or antiphospholipid antibodies. Ann Rheum Dis (2018) 77:549–55.[3]Fredi M, et al. Risk Factors for Adverse Maternal and Fetal Outcomes in Women With Confirmed aPL Positivity: Results From a Multicenter Study of 283 Pregnancies. Front Immunol. 2018 May 7;9:864.Triple aPL positivitySingle or double aPL positivityGestational outcomeLow C3/C4 (n=49)Normal C3/C4(n=17)pLow C3/C4 (n=57)Normal C3/C4(n=165)pTerm live birth (>37w)15 (31%)6 (35%)ns34 (60%)110 (67%)nsPreterm live birth (≤37w)22 (45%)11 (65%)ns15 (26%)38 (23%)nsPregnancy losses (abortion and miscarriages)12 (24%)0 (0%)0.0278 (14%) 17 (10%)nsDisclosure of Interests:None declared

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