scholarly journals Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study: Associations of maternal A1C and glucose with pregnancy outcomes

Diabetes Care ◽  
2012 ◽  
Vol 35 (3) ◽  
pp. 574-580 ◽  
Author(s):  
L. P. Lowe ◽  
B. E. Metzger ◽  
A. R. Dyer ◽  
J. Lowe ◽  
D. R. McCance ◽  
...  
Keyword(s):  
Pregnancy Outcome ◽  
Pregnancy Outcomes ◽  
Adverse Pregnancy Outcome ◽  
Adverse Pregnancy

Neonatal outcome in pregnant patients with antiphospholipid syndrome

2015 ◽  
Vol 43 (6) ◽  
Author(s):  
Katarina Jeremic ◽  
Aleksandar Stefanovic ◽  
Jelena Dotlic ◽  
Jelena Stojnic ◽  
Sasa Kadija ◽  
...  
Keyword(s):  
Risk Factors ◽  
Respiratory Distress Syndrome ◽  
Pregnancy Outcome ◽  
Pregnancy Outcomes ◽  
Distress Syndrome ◽  
Adverse Pregnancy Outcome ◽  
Perinatal Asphyxia ◽  
Premature Delivery ◽  
Control Group ◽  
Adverse Pregnancy

AbstractThe study aim was to evaluate pregnancy outcomes in patients with antiphospholipid syndrome (APS) and to determine which clinical parameters present risk factors for adverse pregnancy outcomes in these patients.The study included 55 patients with APS treated at the Clinic for Ob/Gyn, Clinical Center of Serbia, from 2006 to 2012. The control group consisted of 55 healthy pregnant women. Data regarding previous pregnancies and conception method were registered. Immunological and laboratory tests were performed. Pregnancy outcomes, including miscarriage, intrauterine fetal death, hypertensive disorders, diabetes mellitus, phlebothrombosis, fetal growth restriction, premature delivery, delivery method, perinatal asphyxia, respiratory distress syndrome, intraventricular hemorrhage, and necrotizing enterocolitis were followed.The premature delivery rate in APS patients was 31.8%, and pregnancy loss was 18.2%. Significantly more patients with APS had thrombocytopenia, pregnancy losses, intrauterine growth restriction, and perinatal asphyxia compared with the control group. More miscarriages, preterm delivery, lower birth weight, preeclampsia, and IgM anticardiolipin antibody levels significantly correlated with adverse pregnancy outcomes. Although rare, respiratory distress syndrome can also worsen neonatal health status. According to ROC analysis, previous miscarriages correctly explained 66.3% of adverse pregnancy outcome cases. We generated four equations of adverse pregnancy outcome risk factors.The most important prognostic factor for pregnancy outcome in APS patients is the number of previous miscarriages. Using appropriate current therapeutic protocol can enable live birth of a healthy newborn in most cases.

Abstract P176: Associations of Gestational Lipids and Apolipoproteins With Pregnancy Outcomes: The Hyperglycemia and Adverse Pregnancy Outcome Study

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Amanda M Perak ◽  
Alan Kuang ◽  
Nicola Lancki ◽  
Darwin R Labarthe ◽  
Svati H Shah ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Pregnancy Outcome ◽  
Gestational Age ◽  
Pregnancy Outcomes ◽  
Adverse Pregnancy Outcome ◽  
Late Pregnancy ◽  
Large For Gestational Age ◽  
Obstetric Outcomes ◽  
Outcome Study ◽  
Adverse Pregnancy

Introduction: Gestational hyperlipidemia has traditionally been considered physiologic and benign, but the significance of inter-individual variation in lipid levels for maternal-fetal health are poorly understood. We examined associations of gestational lipids and apolipoproteins with adverse obstetric and neonatal outcomes. Methods: Data from the Hyperglycemia and Adverse Pregnancy Outcome Study were analyzed, including 1,813 mother-child dyads from 9 field centers in 6 countries: US (25%), Barbados (24%), UK (20%), China (16%), Thailand (8%), and Canada (7%). Fasting lipids and apolipoproteins were directly measured at a mean of 28 (range 23-34) weeks’ gestation. Cord blood was collected at delivery, neonatal anthropometrics were measured within 72 hours, and medical records were abstracted for obstetric outcomes. Logistic regression was utilized to test associations of lipids and apolipoproteins (per +1 SD; log-transformed if skewed) with pregnancy outcomes, adjusted for center, demographics, and maternal covariates such as BMI, blood pressure, and glycemia. Results: See Table for lipid and apolipoprotein levels in pregnant mothers. In fully adjusted models ( Table ), 1 SD higher log-triglycerides (i.e., ~2.7-fold higher triglyceride level) in late pregnancy was significantly associated with higher odds for preeclampsia (OR 1.53 [95% CI, 1.15-2.05]), large for gestational age infant (1.42 [1.21-1.67]), and infant insulin sensitivity <10 th percentile (1.25 [1.03-1.50]), but not with unplanned primary cesarean section or infant sum of skinfolds >90 th percentile. There were no significant associations of maternal HDL-C, LDL-C, or log-ApoB/A1 ratio with any outcome. Conclusion: Triglyceride levels in the latter half of pregnancy were uniquely associated with both maternal risks (preeclampsia) and neonatal risks (large for gestational age and insulin resistance), even after adjustment for maternal BMI, blood pressure, and glycemia.

scholarly journals Applying deep learning for adverse pregnancy outcome detection with pre-pregnancy health data

2018 ◽  
Vol 189 ◽  
pp. 10014 ◽  
Author(s):  
Yu Mu ◽  
Kai Feng ◽  
Ying Yang ◽  
Jingyuan Wang
Keyword(s):  
Deep Learning ◽  
Pregnancy Outcome ◽  
Pregnancy Outcomes ◽  
Learning Algorithm ◽  
Adverse Pregnancy Outcome ◽  
Health Data ◽  
Adverse Pregnancy Outcomes ◽  
Deep Learning Algorithm ◽  
Adverse Pregnancy

Adverse pregnancy outcomes can bring enormous losses to both families and the society. Thus, pregnancy outcome prediction stays a crucial research topic as it may help reducing birth defect and improving the quality of population. However, recent advances in adverse pregnancy outcome detection are driven by data collected after mothers having been pregnant. In this situation, if a bad pregnancy outcome is diagnosed, the parents will suffer both physically and emotionally. In this paper, we develop a deep learning algorithm which is able to detect and classify adverse pregnancy outcomes before parents getting pregnant. We train a multi-layer neural network by using a dataset of 75542 couples’ multidimension pre-pregnancy health data. Our model outperforms some of algorithms in accuracy, recall and F1 score.

scholarly journals The Hyperglycemia and Adverse Pregnancy Outcome Study: Associations of GDM and obesity with pregnancy outcomes

Diabetes Care ◽  
2012 ◽  
Vol 35 (4) ◽  
pp. 780-786 ◽  
Author(s):  
P. M. Catalano ◽  
H. D. McIntyre ◽  
J. K. Cruickshank ◽  
D. R. McCance ◽  
A. R. Dyer ◽  
...  
Keyword(s):  
Pregnancy Outcome ◽  
Pregnancy Outcomes ◽  
Adverse Pregnancy Outcome ◽  
Outcome Study ◽  
Adverse Pregnancy

scholarly journals Reproductive Concerns Among Female Leukemia and Lymphoma Survivors with the History of Adverse Pregnancy Outcomes after Cancer Treatment

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 5893-5893
Author(s):  
Ksenya Shliakhtsitsava ◽  
Emily Myers ◽  
Irene Su
Keyword(s):  
Pregnancy Outcome ◽  
Pregnancy Outcomes ◽  
Adverse Pregnancy Outcome ◽  
Adverse Pregnancy Outcomes ◽  
The Future ◽  
Reproductive Concerns ◽  
History Of ◽  
Adverse Pregnancy ◽  
After Cancer ◽  
Lymphoma Survivors

Abstract Introduction Due to advances in cancer treatment the majority of young adults diagnosed with leukemia or lymphoma become long-term survivors. These individuals have been shown to have higher pregnancy risks as a result of cancer and treatment exposure. Adverse pregnancy outcomes including miscarriage and premature delivery may impact survivor's reproductive concerns after cancer. We hypothesized that reproductive-aged female leukemia and lymphoma survivors who experienced miscarriage or premature birth after cancer would have higher reproductive concerns as compared to female leukemia and lymphoma survivors who did not have an adverse pregnancy outcome after cancer. Methods This is a retrospective cohort study of young adult female leukemia and lymphoma survivors with at least one pregnancy after cancer, who are participants of the Reproductive Window study. Study participants were recruited between March 2015 and December 2017 from population-based cancer registries (California and Texas), physician and advocacy group referrals. Eligible women were age 18 to 40 at enrollment, age 15-35 at cancer diagnosis, and had at least one ovary. Enrolled participants answered a questionnaire on pregnancy outcomes and reproductive concerns using the Reproductive Concerns After Cancer (RCAC) Scale. The exposure was adverse pregnancy outcome (miscarriage or premature birth). The outcomes were RCAC subscales measuring concerns regarding becoming pregnant in the future and personal and offspring health. Subscale scores were dichotomized at 3, with >3 indicating moderate to severe reproductive concerns. Logistic regression models were used to test the association between an adverse pregnancy outcome (miscarriage or preterm birth) and RCAC subscales of interest, while adjusting for confounding Results 76 participants, mean age 34.3±3.9 years and mean years since cancer diagnosis 12.0± 5.8 years were included. The majority of participants were white (80%), completed college (72%) and were partnered (87%). Thirty eight percent of participants reported an adverse pregnancy outcome after cancer (18% miscarriage, 21% premature delivery). Thirty-two percent reported moderate to severe concerns about becoming pregnant in the future, 60% regarding offspring health, and 46% over personal health. History of miscarriage after cancer, but not preterm birth, was associated with higher concerns about becoming pregnant. In a multivariable model that adjusted for Hispanic ethnicity, current age, and live birth after cancer, participants who experienced a miscarriage after cancer were more likely to have moderate to high concerns about becoming pregnant in the future (adjusted OR 4.1, 95% CI 1.05-15.5, p=0.042) compared to participants with no history of miscarriage. Neither adverse pregnancy outcomes was associated with concerns about offspring or personal health. Conclusions In the cohort of young adult female leukemia and lymphoma survivors, experiencing a miscarriage after cancer was associated with higher concerns regarding becoming pregnant in the future. Additional research is needed to determine whether interventions such as preconception counseling with consideration of prior cancer treatments may help manage these concerns and improve pregnancy outcomes. Disclosures No relevant conflicts of interest to declare.

scholarly journals Effects of sanitation practices on adverse pregnancy outcomes in India: a conducive finding from recent Indian demographic health survey

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Ratna Patel ◽  
Ajay Gupta ◽  
Shekhar Chauhan ◽  
Dhananjay W. Bansod
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Pregnancy Outcome ◽  
Health Survey ◽  
Pregnancy Outcomes ◽  
Adverse Pregnancy Outcome ◽  
Wealth Index ◽  
Adverse Pregnancy Outcomes ◽  
Adverse Outcomes ◽  
Adverse Pregnancy

Abstract Background Several risk factors predisposing women and their live-borns to adverse outcomes during pregnancy have been documented. Little is known about sanitation being a factor contributing to adverse pregnancy outcomes in India. The role of sanitation in adverse pregnancy outcomes remains largely unexplored in the Indian context. This study is an attempt to bring the focus on sanitation as a factor in adverse pregnancy outcome. Along with the sanitation factors, few confounder variables have also been studied in order to understand the adverse pregnancy outcomes. Methods The study is based on the fourth round of National Family Health Survey (NFHS-IV) covering 26,972 married women in the age-group 15–49. The study variables include the mother’s age, Body Mass Index (BMI), education, anemia, and Antenatal care (ANC) visits during their last pregnancy. The household level variable includes place of residence, religion, caste, wealth index, access to toilet, type of toilet, availability of water within toilet premises, and facility of hand wash near the toilet. Children study variables include Low Birth Weight (LBW), the order of birth (Parity), and the death of the children of the women in the last 5 years. The target variable Adverse Pregnancy Outcome (APO) was constructed using children born with low birth weight or died during the last pregnancy. Results We calculated both adjusted as well as unadjusted odds ratios for a better understanding of the association between sanitation and adverse pregnancy outcomes. Findings from the study showed that women who did not have access to a toilet within the house had a higher risk of adverse pregnancy outcome. In the multivariable model, no association was observed for adverse pregnancy outcome among women who did not have access to toilet and women who used shared toilet. Teenage (15–19 years), uneducated, underweight and anemic mothers were more likely to face APO as compare to other mothers in similar characteristics group. Conclusions Our findings contribute to the decidedly less available literature on maternal sanitation behaviour and adverse pregnancy outcomes. Our results support that sanitation is a very significant aspect for women who are about to deliver a baby as there was an association between sanitation and adverse pregnancy outcome. Education on sanitation practices is the need of the hour as much as it needs to follow.

522. THE ASSOCIATION OF FOLATE PATHWAY ENZYME POLYMORPHISMS AND PREGNANCY OUTCOME

2009 ◽  
Vol 21 (9) ◽  
pp. 121 ◽  
Author(s):  
D. L. F. Furness ◽  
G. A. Dekker ◽  
C. D. McCormack ◽  
R. C. Nowak ◽  
S. D. Thompson ◽  
...  
Keyword(s):  
Vitamin B12 ◽  
Pregnancy Outcome ◽  
Pregnancy Outcomes ◽  
Carbon Metabolism ◽  
Adverse Pregnancy Outcome ◽  
Placental Weight ◽  
Genotype Frequencies ◽  
Adverse Pregnancy ◽  
One Carbon Metabolism ◽  
Chi Square Analysis

The folate, vitamin B12 and vitamin B6 (one-carbon) metabolic pathway is essential for the synthesis of precursors used in DNA synthesis, repair, and methylation. We hypothesise that single nucleotide polymorphisms in genes encoding enzymes in this pathway can disrupt these processes leading to adverse pregnancy outcomes. We investigated associations of six candidate polymorphisms in five genes related to one-carbon metabolism with risk for adverse pregnancy outcome in 586 nulliparous Caucasian couples with normal fertility. Chi-square analysis was used to compare genotype frequencies with pregnancy outcomes. Pregnancies were classified as healthy (n=261), preeclampsia (PE, n=38), gestational hypertension (GHT, n=32), small-for-gestational-age (SGA, n=60) and PE+SGA (n=22). Associations between maternal, paternal and neonatal genotypes with customised birthweight centiles and placental weight were determined using ANOVA with SIDAK post-hoc analyses. The maternal MTR 2756 G allele was associated with decreased placental weight (–87g, P=0.040). Both paternal and neonatal MTR 2756 G alleles were associated with lower birthweight (–12%, P=0.028 and –10%, P=0.039) while the latter was also associated with PE+SGA (P <0.000). Neonatal MTRR GG genotype was associated with GHT and PE with SGA (P=0.033, P=0.011). Neonatal MTHFD1 GG genotype was twice as frequent in PE and GHT (P=0.037; P=0.019) while neonatal TCN2 GG genotype doubled in SGA (P=0.042) compared with healthy pregnancies. Our findings indicate that genetic variation in multiple one-carbon metabolism genes may influence risk of adverse pregnancy outcome. MTR with cofactor vitamin-B12, catalyses the methylation of homocysteine to methionine. Formation of methionine through this pathway is important for synthesis of phospholipids, proteins, myelin, DNA, RNA and S-adenosyl methionine. TCN2 encodes the vitamin-B12 transport protein and MTHFD1 catalyses the conversion of one-carbon derivatives of tetrahydrofolate, which are substrates for methionine, thymine and purine synthesis and are important for healthy placental and fetal development. Larger studies are needed to further examine gene/gene and gene/diet interactions in this pathway.

scholarly journals Treatment and pregnancy outcomes of pregnant women exposed to second-line anti-tuberculosis drugs in South Africa

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Idah Mokhele ◽  
Nelly Jinga ◽  
Rebecca Berhanu ◽  
Thandi Dlamini ◽  
Lawrence Long ◽  
...  
Keyword(s):  
South Africa ◽  
Pregnant Women ◽  
Pregnancy Outcome ◽  
Pregnancy Outcomes ◽  
Adverse Pregnancy Outcome ◽  
Adverse Pregnancy Outcomes ◽  
Close Monitoring ◽  
Second Line ◽  
Tb Treatment ◽  
Adverse Pregnancy

Abstract Background Multi-drug resistant and rifampicin-resistant tuberculosis (MDR/RR-TB) in pregnant women is a cause for concern globally; few data have described the safety of second-line anti-TB medications during pregnancy. We aim to describe TB treatment and pregnancy outcomes among pregnant women receiving second-line anti-tuberculosis treatment for MDR/RR-TB in Johannesburg, South Africa. Methods We conducted a retrospective record review of pregnant women (≥ 18 years) who received treatment for MDR/RR-TB between 01/2010–08/2016 at three outpatient treatment sites in Johannesburg, South Africa. Demographic, treatment and pregnancy outcome data were collected from available medical records. Preterm birth (< 37 weeks), and miscarriage were categorized as adverse pregnancy outcomes. Results Out of 720 women of child-bearing age who received MDR/RR-TB treatment at the three study sites, 35 (4.4%) pregnancies were identified. Overall, 68.7% (24/35) were HIV infected, 83.3% (20/24) were on antiretroviral therapy (ART). Most women, 88.6% (31/35), were pregnant at the time of MDR/RR-TB diagnosis and four women became pregnant during treatment. Pregnancy outcomes were available for 20/35 (57.1%) women, which included 15 live births (11 occurred prior to 37 weeks), 1 neonatal death, 1 miscarriage and 3 pregnancy terminations. Overall, 13/20 (65.0%) women with known pregnancy outcomes had an adverse pregnancy outcome. Of the 28 women with known TB treatment outcomes 17 (60.7%) completed treatment successfully (4 were cured and 13 completed treatment), 3 (10.7%) died and 8 (28.6%) were lost-to-follow-up. Conclusions Pregnant women with MDR/RR-TB suffer from high rates of adverse pregnancy outcomes and about 60% achieve a successful TB treatment outcome. These vulnerable patients require close monitoring and coordinated obstetric, HIV and TB care.

scholarly journals Association of Implementation of a Comprehensive Preconception-to-Pregnancy Management Plan With Pregnancy Outcomes Among Chinese Pregnant Women With Type 1 Diabetes: The CARNATION Study

2021 ◽  
Author(s):  
Xueying Zheng ◽  
Daizhi Yang ◽  
Sihui Luo ◽  
Jinhua Yan ◽  
Xiaohui Guo ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Pregnancy Outcome ◽  
Pregnancy Outcomes ◽  
Prospective Cohort ◽  
Retrospective Cohort ◽  
Adverse Pregnancy Outcome ◽  
Management Plan ◽  
Comprehensive Management ◽  
Adverse Pregnancy

<b>Objective </b>To investigate the effect on pregnancy outcome of integrating a comprehensive management plan for type 1 diabetic (T1D) patients into the WHO universal maternal care infrastructure. <p><b> </b></p> <p><b>Research Design and Methods </b>A comprehensive preconception-to-pregnancy management plan for women with T1D was implemented in 11 centers from eight Chinese cities during 2015–2017. Sequential eligible pregnant women (n=133 out of 137 initially enrolled) with T1D and singleton pregnancies attending these management centers formed the prospective cohort. The main outcome was severe adverse pregnancy outcome comprising maternal mortality, neonatal death, congenital malformation(s), miscarriage in the second trimester and stillbirth. We compared pregnancy outcomes in this prospective cohort with two control groups with the same inclusion and exclusion criteria: a retrospective cohort (n=153) of all eligible pregnant women with T1D attending the same management centers during 2012–2014 and a comparison cohort (n=116) of all eligible pregnant women with T1D receiving routine care during 2015–2017 in 11 different centers from seven cities. </p> <p><b> </b></p> <p><b>Results </b>The rate of severe adverse pregnancy outcome was lower in the prospective cohort (6.02%) than in either the retrospective cohort (18.30%, adjusted odds ratio[aOR]=0.31, 95% CI 0.13–0.74) or the contemporaneous comparison cohort (25.00%, aOR=0.22, 95% CI 0.09–0.52).</p> <p><b> </b></p> <p><b>Conclusion </b>The substantial improvements in the prospective cohort are evidence of a potentially clinically important effect of the comprehensive management plan on pregnancy outcomes among Chinese pregnant women with pregestational T1D. This supports the development of similar approaches in other countries.</p>

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