scholarly journals Women treated for epilepsy during pregnancy: outcomes from a nationwide population-based cohort study

2017 ◽  
Vol 96 (7) ◽  
pp. 812-820 ◽  
Author(s):  
Miia Artama ◽  
Jemina Braumann ◽  
Jani Raitanen ◽  
Jukka Uotila ◽  
Mika Gissler ◽  
...  
2018 ◽  
Vol 154 (6) ◽  
pp. S-624
Author(s):  
Han Hee Lee ◽  
Bo-In Lee ◽  
Kang-Moon Lee ◽  
Jin Su Kim ◽  
Jae Myung Park ◽  
...  

2018 ◽  
Vol 154 (1) ◽  
pp. S105
Author(s):  
Han Hee Lee ◽  
Jung Min Bae ◽  
Bo-In Lee ◽  
Kang-Moon Lee ◽  
Jeong Ha Wie ◽  
...  

2019 ◽  
Vol 98 (8) ◽  
pp. 988-996 ◽  
Author(s):  
Michaela Granfors ◽  
Olof Stephansson ◽  
Margit Endler ◽  
Maria Jonsson ◽  
Anna Sandström ◽  
...  

2019 ◽  
Vol 37 (13) ◽  
pp. 1364-1376
Author(s):  
Anura W.G. Ratnasiri ◽  
Lauren Gordon ◽  
Ronald A. Dieckmann ◽  
Henry C. Lee ◽  
Steven S. Parry ◽  
...  

Abstract Objective This study aimed to determine associations between maternal cigarette smoking and adverse birth and maternal outcomes. Study Design This is a 10-year population-based retrospective cohort study including 4,971,896 resident births in California. Pregnancy outcomes of maternal smokers were compared with those of nonsmokers. The outcomes of women who stopped smoking before or during various stages of pregnancy were also investigated. Results Infants of women who smoked during pregnancy were twice as likely to have low birth weight (LBW) and be small for gestational age (SGA), 57% more likely to have very LBW (VLBW) or be a preterm birth (PTB), and 59% more likely to have a very PTB compared with infants of nonsmokers. During the study period, a significant widening of gaps developed in both rates of LBW and PTB and the percentage of SGA between infants of maternal smokers and nonsmokers. Conclusion Smoking during pregnancy is associated with a significantly increased risk of adverse birth and maternal outcomes, and differences in rates of LBW, PTB, and SGA between infants of maternal smokers and nonsmokers increased during this period. Stopping smoking before pregnancy or even during the first trimester significantly decreased the infant risks of LBW, PTB, SGA, and the maternal risk for cesarean delivery.


2017 ◽  
Vol 86 (6) ◽  
pp. 816-824 ◽  
Author(s):  
Shi Chen ◽  
Xiang Zhou ◽  
Huijuan Zhu ◽  
Hongbo Yang ◽  
Fengying Gong ◽  
...  

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 493-493
Author(s):  
Arafat Ul Alam ◽  
Cynthia M. Wu ◽  
Venu Jain ◽  
Haowei Linda Sun

Abstract Introduction: Increasing rate of postpartum hemorrhage (PPH) has been observed between 2003 and 2010 in Canada. Given that bleeding disorders contribute to the risk of PPH, it is important to identify the current trend in PPH in the last decade and assess the impact of inherited bleeding disorders on maternal bleeding and other pregnancy outcomes. Methods: This is a retrospective population-based cohort study using the Alberta Pregnancy Birth Cohort. The creation of this cohort using multiple linked administrative databases has been previously described. Number of deliveries per year in Alberta, Canada was determined by Vital Statistics birth registry from 2010 to 2018 and was linked with Discharge Abstract Database (DAD) to identify cases of PPH and other pregnancy outcomes. PPH was defined as a blood loss of ≥500 ml following vaginal delivery or ≥1000 ml following Caesarean section, or as a diagnosis noted by a health care provider. All diagnoses and procedures were identified by International Classification of Diseases (ICD)-10 codes and Canadian Classification of Interventions (CCI) codes, respectively. Previous validation study of diagnostic code for PPH in DAD showed high sensitivity and specificity. Inherited bleeding disorders including von Willebrand disease, hemophilia carriers, platelet function disorder, and hereditary deficiencies of other coagulation factors were identified by presence of at least two ICD codes. All analyses were restricted to hospitalized deliveries with live births. Temporal trend of PPH rate was assessed by Mann-Kendall test. Univariate logistic regression analyses were used to compute odds of pregnancy outcomes among women with inherited bleeding disorders compared with those without at their index pregnancies during the study period. Results: Between 2010 to 2018, 311,657 women had a total of 452,846 pregnancies with live births. The mean age of the study cohort was 29 years. Most (90%) of them reached term pregnancies. The total number of PPH was 47,602 (10.5 per 100 deliveries). The rate of PPH did not have any significant change from 10.3 in 2010 (95% confidence interval [CI] 10.0-10.6) to 10.8 (95% CI 10.6 -11.1) in 2018 (P for trend =0.28) [Figure 1]. Among 311,657 women, 345 (0.1%) had a diagnosis of inherited bleeding disorders [Table 1]. Women with bleeding disorders were more likely to experience PPH (odds ratio [OR] 1.4; 95% CI 1.1-1.9), antepartum hemorrhage (OR 4.3; 95% CI 2.9-6.4) and had a 3-fold increased risk of undergoing hysterectomy (OR 3.1; 95% CI 1.8-5.2). The bleeding cohort had 3.8 (95% CI: 2.4-6.0) times greater risk of being transfused with blood products. We observed a trend towards higher odds of caesarean delivery in women with bleeding disorders compared with those without (OR 1.2, 95% CI 0.9-1.5), albeit not statistically significant. However, there was no significant difference in prolonged labor, obstetric hematoma, low birth weight baby and induced labour. Conclusion: Despite a rise in the rate of PPH between 2003-2010, we observed no significant change in the rate of PPH in Alberta between 2010-2018. Women with inherited bleeding disorders are at an increased risk of bleeding events during pregnancy and childbirth. Further investigation into quality of care among this patient population is ongoing to identify areas for improvement. Figure 1 Figure 1. Disclosures Wu: BMS-Pfizer: Honoraria, Research Funding; Leo Pharma: Honoraria; Pfizer: Honoraria; Servier: Honoraria; Bayer: Research Funding; Daiichi-Sankyo: Research Funding. Sun: Pfizer: Consultancy; Novo Nordisk: Consultancy; Bayer: Consultancy; Octapharma: Consultancy, Research Funding; Shire: Consultancy.


2021 ◽  
Author(s):  
Rajani Sharma ◽  
Tracey G. Simon ◽  
Olof Stephansson ◽  
Elizabeth C. Verna ◽  
Jean Emond ◽  
...  

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