scholarly journals EP03.04: Clustering of risk factors and preterm delivery at the first prenatal visit

2018 ◽  
Vol 52 ◽  
pp. 200-201
Author(s):  
Y. Tai ◽  
C. Lee
Keyword(s):  
Risk Factors ◽  
Preterm Delivery ◽  
Prenatal Visit ◽  
Clustering Of Risk Factors

Risk factors for very preterm delivery out of a level III maternity unit: The EPIPAGE‐2 cohort study

2021 ◽  
Author(s):  
Thomas Desplanches ◽  
Andrei S. Morgan ◽  
Peter Jones ◽  
Caroline Diguisto ◽  
Jennifer Zeitlin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Preterm Delivery ◽  
Maternity Unit ◽  
Very Preterm

Impact of smoking and fetal gender on preterm delivery

2020 ◽  
pp. 1-6
Author(s):  
Veronika Günther ◽  
Ibrahim Alkatout ◽  
Alexandra Stein ◽  
Nicolai Maass ◽  
Alexander Strauss ◽  
...  
Keyword(s):  
Risk Factors ◽  
Preterm Birth ◽  
Preterm Delivery ◽  
Preterm Infants ◽  
Preterm Births ◽  
World Health ◽  
Smoking During Pregnancy ◽  
Fetal Gender ◽  
Extremely Preterm ◽  
Heavy Smokers

Abstract According to the World Health Organization, smoking is the most important risk factor for adverse pregnancy outcomes in industrialized nations. We aimed to establish how fetal gender and smoking interact with regard to perinatal outcomes, especially preterm delivery. Data from 220,339 singleton pregnancies, obtained from the German Perinatal Survey in Schleswig-Holstein and registered between 2004 and 2017 were analyzed in regard to smoking behavior, fetal gender, and preterm delivery. The rate of preterm births was directly proportional to the women’s consumption of nicotine. The rate of preterm deliveries was 6.8% among nonsmokers, and 13.2% in women who were very heavy smokers (≥22 cigarettes/day). Very heavy smoking (≥22 cigarettes/day) had a marked impact on extremely preterm births (<28 weeks of gestation) and very preterm births (28–31 weeks of gestation). Preterm births increased by 1.2% from heavy smokers to very heavy smokers; the differences between the other groups ranged between 0.1% and 0.4%. Fetal gender also had an impact on preterm birth: male infants were predominant in nearly all groups of women who delivered preterm infants. Smoking during pregnancy and male gender are both risk factors for preterm delivery. Fetal gender should be given greater attention as one of the several risk factors of preterm birth. Due to the high rate of morbidity among preterm infants and enormous costs for the healthcare system, women should be encouraged to cease or at least reduce smoking during pregnancy.

scholarly journals Clustering of Risk Factors With Smoking Habits Among Adults, Sousse, Tunisia

2013 ◽  
Vol 10 ◽  
Author(s):  
Jihene Maatoug ◽  
Imed Harrabi ◽  
Sonia Hmad ◽  
Mylene Belkacem ◽  
Mustafa al’Absi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Smoking Habits ◽  
Clustering Of Risk Factors

scholarly journals A Novel Nomogram for Predicting the Risk of Premature Delivery Based on the Thyroid Function in Pregnant Women

2022 ◽  
Vol 12 ◽  
Author(s):  
Yu Meng ◽  
Jing Lin ◽  
Jianxia Fan
Keyword(s):  
Risk Factors ◽  
Pregnant Women ◽  
Preterm Delivery ◽  
Thyroid Function ◽  
Premature Delivery ◽  
Multivariable Logistic Regression Analysis ◽  
Decision Curve Analysis ◽  
Cutoff Values ◽  
Lemeshow Test ◽  
Maternal Thyroid

BackgroundMaternal thyroid dysfunction and autoantibodies were associated with preterm delivery. However, recommendations for cutoff values of thyroperoxidase antibody (TPOAb) positivity and thyroid-stimulating homone (TSH) associated with premature delivery are lacking.ObjectiveTo identify the pregnancy-specific cutoff values for TPOAb positivity and TSH associated with preterm delivery. To develop a nomogram for the risk prediction of premature delivery based on maternal thyroid function in singleton pregnant women without pre-pregnancy complications.MethodsThis study included data from the International Peace Maternity and Child Care Health Hospital (IPMCH) in Shanghai, China, between January 2013 and December 2016. Added data between September 2019 and November 2019 as the test cohort. Youden’s index calculated the pregnancy-specific cutoff values for TPOAb positivity and TSH concentration. Univariate and multivariable logistic regression analysis were used to screen the risk factors of premature delivery. The nomogram was developed according to the regression coefficient of relevant variables. Discrimination and calibration of the model were assessed using the C-index, Hosmer-Lemeshow test, calibration curve and decision curve analysis.Results45,467 pregnant women were divided into the training and validation cohorts according to the ratio of 7: 3. The testing cohort included 727 participants. The pregnancy-specific cutoff values associated with the risk of premature delivery during the first trimester were 5.14 IU/mL for TPOAb positivity and 1.33 mU/L for TSH concentration. Multivariable logistic regression analysis showed that maternal age, history of premature delivery, elevated TSH concentration and TPOAb positivity in the early pregnancy, preeclampsia and gestational diabetes mellitus were risk factors of premature delivery. The C-index was 0.62 of the nomogram. Hosmer-Lemeshow test showed that the Chi-square value was 2.64 (P = 0.955 &gt; 0.05). Decision curve analysis showed a positive net benefit. The calibration curves of three cohorts were shown to be in good agreement.ConclusionsWe identified the pregnancy-specific cutoff values for TPOAb positivity and TSH concentration associated with preterm delivery in singleton pregnant women without pre-pregnancy complications. We developed a nomogram to predict the occurrence of premature delivery based on thyroid function and other risk factors as a clinical decision-making tool.

scholarly journals Risk Factors for Neonatal Bronchopulmonary Dysplasia in Extremely Preterm Premature Rupture of Membranes: A Retrospective Study

2020 ◽  
Author(s):  
Eishin Nakamura ◽  
Shigetaka Matsunaga ◽  
Yoshihisa Ono ◽  
Yasushi Takai ◽  
Hiroyuki Seki
Keyword(s):  
Risk Factors ◽  
Preterm Delivery ◽  
Bronchopulmonary Dysplasia ◽  
Roc Curve ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Preterm Premature Rupture ◽  
Extremely Preterm ◽  
Gestational Week ◽  
The Mean

Abstract Background: Determination of the optimal timing for termination of pregnancy in cases of preterm premature rupture of membranes (pPROM) during the extremely preterm period is still difficult. Bronchopulmonary dysplasia (BPD) is a major disease widely taken into account when determining the prognosis of respiratory disorders in a neonate. Many aspects of this disease remain unclear. With the aim of further improving the prognosis of neonates born to mothers with pPROM, this study examined cases who were diagnosed with pPROM before 28 weeks of gestation. The study analysed risk factors for neonatal BPD. Methods: This study included 73 subjects with singleton pregnancy, diagnosed with pPROM during the gestational period from 22 weeks and 0 days to 27 weeks and 6 days. The following factors were retrospectively examined: the gestational week at which pPROM was diagnosed, the gestational week at which delivery occurred, the period for which the volume of amniotic fluid was maintained, and neonatal BPD as a complication. Receiver operating characteristic (ROC) curve analyses were conducted to analyse the relationship of the onset of BPD with the duration of oligohydramnios and the gestational weeks of delivery. Results: The mean gestational week at which a diagnosis of amniorrhexis was made was 24.5±1.9 weeks (mean±SD), and that at which delivery occurred was 27.0±3.0 weeks. Fifty-seven cases (78.1%) were diagnosed with oligohydramnios, the mean duration of which was 17.4±20.5 days. The mean birth weight of neonates was 1000±455 g, of which 49 (67.1%) were diagnosed with BPD following birth. No neonates died in this study. The ROC curve indicated that the cut-off values for the duration of oligohydramnios and gestational age at delivery were 4 days and 24.1 weeks, respectively. Multivariate analysis indicated that the duration of oligohydramnios for more than 4 days before delivery and preterm delivery at less than 24.1 weeks were risk factors for the onset of BPD. Conclusion: Our findings suggest that duration of oligohydramnios for more than 4 days before delivery and preterm delivery less than 24.1 weeks are risk factors for BPD in cases who are diagnosed with pPROM before 28 weeks of gestation.

scholarly journals Patterns of Cardiovascular Risk Factors in the Years Before Pregnancy in Nulliparous Women With and Without Preterm Birth and Small‐for‐Gestational‐Age Delivery

2021 ◽  
Author(s):  
Ravi Retnakaran ◽  
Baiju R. Shah
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Cardiovascular Risk ◽  
Preterm Delivery ◽  
Alanine Aminotransferase ◽  
Fasting Glucose ◽  
Glycosylated Hemoglobin ◽  
Density Lipoprotein ◽  
Nulliparous Women ◽  
Over Time

Background Women with either preterm or small‐for‐gestational‐age (SGA) delivery have an elevated lifetime risk of cardiovascular disease that has been attributed to the accrual of vascular risk factors over time. We sought to determine whether an adverse cardiovascular risk factor profile develops in the years before pregnancies complicated by preterm delivery or SGA. Methods and Results Using administrative databases, we identified all 156 278 nulliparous women in Ontario, Canada, who had singleton pregnancies between January 2011 and December 2018 and ≥2 measurements of the following analytes between January 2008 and the start of pregnancy: glycosylated hemoglobin, glucose, lipids, and alanine aminotransferase. There were 11 078 women with preterm delivery and 19 367 with SGA. The 2 most recent pregravid tests were performed at median 0.6 (interquartile range, 0.3–1.4) and 1.9 (interquartile range, 1.1–3.3) years before pregnancy, respectively. Women with preterm delivery had higher pregravid glycosylated hemoglobin, glucose, low‐density lipoprotein cholesterol, triglycerides, and alanine aminotransferase, and lower high‐density lipoprotein cholesterol, than those without preterm delivery. In contrast, women with SGA had lower pregravid fasting glucose, random glucose, and triglycerides than those without SGA. In the years before pregnancy, women with preterm delivery had higher annual increases than their peers in glycosylated hemoglobin (0.7‐times higher), triglycerides (7.9‐times higher), and alanine aminotransferase (2.2‐times higher). During this time, fasting glucose increased in women who developed preterm delivery but decreased in their peers. Conclusions An adverse cardiovascular risk factor profile evolves over time in the years before pregnancy complicated by preterm delivery, but does not necessarily precede SGA.

Delinquency and the Pediatrician

1988 ◽  
Vol 9 (8) ◽  
pp. 249-257
Author(s):  
Alan D. Woolf
Keyword(s):  
Risk Factors ◽  
Health Assessment ◽  
Health Problems ◽  
Double Jeopardy ◽  
Dental Pathology ◽  
The Family ◽  
Complete Health ◽  
Clustering Of Risk Factors ◽  
Hearing Difficulties

Adolescents may be predisposed to delinquency by a double-jeopardy situation of clustering of risk factors in physical health (eg, perinatal or nervous system trauma, naurodevelopmental or cognitive dysfunction, neglected health problems) and the environment (eg, poverty, disordered family dynamics, poor education). Pediatricians must be attentive to neglected or previously undiscovered health problems in this population, such as overlooked cosmetic or congential defects, nutritional problems, substance abuse, vision and hearing difficulties, dental pathology, and sex-related conditions and diseases. Delinquents, especially during the transition into detention, are at particular risk for injuries, depression, and suicidal behavior. The complete health assessment of the delinquent should include a neurodevelopmental, cognitive, and educational progress assessment. This will facilitate implementation of an appropriate individualized remediation program. The pediatrician, in the dual role of health care provider for the family and child advocate in the community, can accomplish much toward the primary, secondary, and tertiary prevention of delinquency.

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