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British Journal of Clinical Pharmacology Sep 2022The objective of this meta-analysis was to determine whether maternal exposure to statins is associated with increased rates of major congenital malformations and other... (Meta-Analysis)
Meta-Analysis Review
AIMS
The objective of this meta-analysis was to determine whether maternal exposure to statins is associated with increased rates of major congenital malformations and other adverse pregnancy outcomes.
METHODS
PubMed/Medline, Web of Science and Reprotox® databases were searched. Cohort and case control studies with prenatal exposure to statins were included.
RESULTS
Analysis of five cohort studies and one case-control study showed no significant increase in rate of major congenital malformations when the exposed group was compared with the control ([OR 1.27; 95% CI 0.80-2.04], [aOR 1.05; 95% CI 0.84-1.31]). A significant increase in heart defect risk was detected in the statin-exposed group when unadjusted ORs were combined (OR 2.47; 95% CI 1.36-4.49). Further analysis of the same outcome by using adjusted ORs showed no significant increase in heart defect risk in the statin-exposed group compared with the controls (aOR 1.24; 95% CI 0.93-1.66). A significantly lower live birth rate (OR 0.60, 95% CI 0.49-0.75) and a higher spontaneous abortion rate (OR 1.36; 95% Cl 1.06-1.75) were detected in the statin-exposed group.
CONCLUSIONS
Gestational statin exposure was not associated with a significant increase in risk of major congenital malformations, heart defects and other adverse pregnancy outcomes, except spontaneous abortion and live birth rate, which may be associated with maternal comorbidity and other unadjusted risk factors. Further research focusing on particular statins is needed to draw more definitive conclusions.
Topics: Abortion, Spontaneous; Case-Control Studies; Female; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Maternal Exposure; Pregnancy; Pregnancy Outcome
PubMed: 35639354
DOI: 10.1111/bcp.15423 -
Acta Haematologica 2015To assess the risk of adverse pregnancy outcomes in patients with acquired and/or congenital thrombophilia factors. (Clinical Trial)
Clinical Trial
OBJECTIVE
To assess the risk of adverse pregnancy outcomes in patients with acquired and/or congenital thrombophilia factors.
PATIENTS AND METHODS
A cohort of 130 women with a history of pregnancy loss and no successful gestation were investigated for the presence of congenital and acquired thrombophilia factors, and then compared with a control group of 130 healthy women who had had at least one successful gestation and no pregnancy loss, and were screened for congenital and acquired thrombophilia factors.
RESULTS
Acquired and congenital thrombophilia factors were found in 30 (23%) patients and in 14 (10.8%) controls (p < 0.015). The presence of ≥1 congenital thrombophilia factor was associated with pregnancy loss with an odds ratio of 2.46 (p = 0.040). Moreover, women who had had >1 early fetal loss had a 2.85-fold risk of being carriers of congenital thrombophilia factors, compared to the controls.
CONCLUSION
Our study showed the increased risk of miscarriage in patients with congenital thrombophilia factors and >1 early fetal loss.
Topics: Abortion, Spontaneous; Adult; Aged; Case-Control Studies; Female; Humans; Male; Middle Aged; Pregnancy; Pregnancy Complications, Hematologic; Pregnancy Outcome; Risk Factors; Thrombophilia
PubMed: 25401392
DOI: 10.1159/000363048 -
Archives of Disease in Childhood. Fetal... Sep 2014
Topics: Female; Fetal Macrosomia; Humans; Male; Pregnancy; Pregnancy Outcome
PubMed: 24948616
DOI: 10.1136/archdischild-2013-305894 -
BMC Pregnancy and Childbirth Jan 2023Pregnancy during adolescence is a major risk factor for adverse pregnancy outcomes. Further, Motherhood during the adolescent period is identified as a major global...
Pregnancy during adolescence is a major risk factor for adverse pregnancy outcomes. Further, Motherhood during the adolescent period is identified as a major global health burden. Considering the widely known importance of the negative impact of adolescent pregnancy, motherhood at an early age, and adverse pregnancy outcomes, this paper aims to provide insight into correlates of teen pregnancy, adolescent motherhood and adverse pregnancy outcome. This study utilizes the data from UDAYA survey conducted in Uttar Pradesh and Bihar. The eligible sample size for the study was 4897 married adolescent girls between the ages of 15 and 19 years. Bivariate analysis with a chi-square test of association and Multivariable logistic regression analysis was performed to fulfill the aim of the study. Our study shows that a major proportion of married adolescents (61%) got pregnant before the age of 20 years and around 42% of all adolescent married women gave birth to a child before reaching the age of 20 years. Adolescents who married before the age of 18 years were 1.79 times more likely to experience pregnancy (OR: 1.79; CI: 1.39-2.30) and 3.21 times more likely to experience motherhood (OR: 3.21; CI: 2.33-4.43). In the present study, women who experienced physical violence were at higher risk for having an adverse pregnancy outcome (OR: 1.41; CI: 1.08-1.84) than those who did not experience physical violence. To conclude, regional and national level efforts focused on improving early marriage, education and empowering women and girls can be beneficial.
Topics: Adolescent; Female; Humans; Pregnancy; Young Adult; Educational Status; India; Parturition; Pregnancy in Adolescence; Pregnancy Outcome; Prevalence
PubMed: 36703105
DOI: 10.1186/s12884-023-05354-6 -
Seminars in Reproductive Medicine Mar 2022The association between adolescent childbearing and adverse maternal and birth outcomes has been well documented. Adverse adolescent pregnancy outcomes are associated... (Review)
Review
The association between adolescent childbearing and adverse maternal and birth outcomes has been well documented. Adverse adolescent pregnancy outcomes are associated with substantial risk of long-term morbidities for the young mother and their newborns. Multiple levels of social disadvantage have been related to adverse pregnancy outcomes among adolescent mothers. Patterns of cumulative social adversity define the most marginalized group of adolescents at the highest risk of experiencing adverse maternal and birth outcomes. Using a social determinants of health (SDOH) framework, we present an overview of the current scientific evidence on the influence of these conditions on adolescent pregnancy outcomes. Multiple SDOH such as residence in remote areas, low educational attainment, low socioeconomic status, and lack of family and community support have been linked with increased risk of adverse pregnancy outcomes among adolescents. Based on the PROGRESS-Plus equity framework, this review highlights some SDOH aspects that perinatal health researchers, clinicians, and policy makers should consider in the context of adolescent pregnancies. There is a need to acknowledge the intersectional nature of multiple SDOH when formulating clinical and societal interventions to address the needs of the most marginalized adolescent in this critical period of life.
Topics: Adolescent; Female; Humans; Infant, Newborn; Pregnancy; Pregnancy Outcome; Pregnancy in Adolescence; Social Determinants of Health
PubMed: 34500474
DOI: 10.1055/s-0041-1735847 -
The Lancet. Psychiatry Oct 2023
Topics: Pregnancy; Female; Humans; Pregnancy Outcome; Mental Health; Mental Disorders; Pregnancy Complications
PubMed: 37591295
DOI: 10.1016/S2215-0366(23)00236-5 -
International Journal of Gynaecology... Feb 2023To explore the potential association of lateral placentation with pregnancy outcome.
OBJECTIVE
To explore the potential association of lateral placentation with pregnancy outcome.
METHODS
The database of a tertiary medical center was searched for women who gave birth to a singleton neonate from 2012 to 2020 for whom placental location was documented during antepartum sonographic examination. Clinical data were compared between patients with a central (anterior/posterior/fundal) or lateral placenta using standard statistics. The primary outcome measure was neonatal birthweight, and secondary outcome measures were pregnancy complications and mode of delivery.
RESULTS
The cohort included 12 306 women: 11 608 (94%) with a central placenta and 698 (5.6%) with a lateral placenta. The lateral placenta group had higher rates (P < 0.05) of prior and current cesarean delivery, assisted delivery, and preterm birth. On multivariate regression analyses, placental location (adjusted odds ratio [aOR], 1.36; 95% confidence interval [CI], 1.11-1.66) and maternal age (aOR, 1.02; 95% CI, 1.01-1.03) were associated with risk of preterm birth. Lateral placenta (aOR, 1.22; 95% CI, 1.02-1.47), maternal age (aOR, 1.07; 95% CI, 1.06-1.08), parity (aOR, 0.32; 95% CI, 0.28-0.35), and prior cesarean delivery (aOR, 12.00; 95% CI, 10.60-13.60) were associated with risk of current cesarean delivery.
CONCLUSION
The findings suggest that lateral placentation may pose a risk of preterm birth and cesarean delivery compared with central placentation.
Topics: Pregnancy; Infant, Newborn; Female; Humans; Placenta; Retrospective Studies; Premature Birth; Pregnancy Outcome; Pregnancy Complications
PubMed: 35749141
DOI: 10.1002/ijgo.14316 -
International Journal of Gynaecology... Feb 2022To assess patterns of non-communicable diseases (NCDs) and pregnancy outcomes of women in a tertiary care hospital. (Observational Study)
Observational Study
OBJECTIVE
To assess patterns of non-communicable diseases (NCDs) and pregnancy outcomes of women in a tertiary care hospital.
METHODS
This was a prospective observational study, conducted over 1 year. All NCDs in women who delivered or aborted were studied. Maternal and neonatal outcomes were noted.
RESULTS
In all, 1003 NCDs occurred in 894 women. Chronic hypertension was the commonest, involving 309 (30.8%) women. Others included cardiovascular (159, 15.9%), neurological (142, 14.2%), endocrine (115, 11.5%), autoimmune (76, 7.6%), chronic kidney (48, 4.8%), and chronic respiratory (43, 4.3%) diseases, psychiatric disorders (38, 3.8%), cancers (20, 2.0%), and chronic liver disease (18, 1.8%). Most (599, 67.0%) were diagnosed before pregnancy and 145 (16.2%), 81 (9.1%), and 69 (7.7%) were diagnosed in the first, second, and third trimesters, respectively. Maternal deaths occurred in 6 (0.7%) women and near miss in 19 (2.1%) women. Only 9 (1.5%) women with NCD diagnosed before pregnancy had maternal near miss or death, compared with 16 (5.4%) diagnosed during pregnancy (P < 0.001). Of live births, 281 (35.3%) were low birth weight, 49 (6.1%) were very low birth weight, and 24 (3.0%) were extremely low birth weight.
CONCLUSION
Chronic hypertension was the commonest NCD, which along with cardiovascular and neurological disorders constituted around 60% of all NCDs. One-third of NCDs were initially diagnosed during pregnancy. Maternal morbidity was lower if NCDs were diagnosed before pregnancy.
Topics: Female; Humans; Infant, Newborn; Live Birth; Maternal Death; Noncommunicable Diseases; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Prospective Studies
PubMed: 33730403
DOI: 10.1002/ijgo.13678 -
Liver Transplantation : Official... Sep 2021
Topics: Female; Fertility; Humans; Liver Transplantation; Living Donors; Pregnancy; Pregnancy Outcome; Tissue Donors
PubMed: 34118122
DOI: 10.1002/lt.26207 -
BMC Pregnancy and Childbirth Apr 2022It is generally beneficial for triplet gestation or high-order multiple pregnancies to operate multifetal pregnancy reduction (MFPR) after assisted reproductive...
BACKGROUND
It is generally beneficial for triplet gestation or high-order multiple pregnancies to operate multifetal pregnancy reduction (MFPR) after assisted reproductive techniques. However, data on pregnancy outcomes is lacking regarding dichorionic triamniotic (DCTA) and trichorionic triplets (TCTA) pregnancy.
METHOD
This research analyzes the difference between 128 DCTA and 179 TCTA pregnancies with or without MFPR after in vitro fertilization/intracytoplasmic sperm injection cycles between January 2015 and June 2020. The subdivided subgroups of the two groups are reduction to singleton, reduction to dichorionic twins, and expectant management groups. We also compare the pregnancy and obstetric outcomes between 2104 dichorionic twins and 122 monochorionic twins.
RESULT
The research subgroups were DCTA to monochorionic singleton pregnancies (n = 76), DCTA to dichorionic twin pregnancies (n = 18), DCTA-expectant management (n = 34), TCTA to monochorionic singleton pregnancies (n = 31), TCTA to dichorionic twin pregnancies (n = 130), and TCTA-expectant management (n = 18). In DCTA-expectant management group, the complete miscarriage rate is dramatically higher, and the survival rate and the rate of take-home babies are lower. However, there was no difference between the rates of complete miscarriages, survival rates, and take-home babies in TCTA-expectant management group. But the complete miscarriage rate of DCTA-expectant management was obviously higher than that of TCTA-expectant management group (29.41 vs. 5.56%, p = 0.044). For obstetric outcomes, MFPR to singleton group had higher gestational week and average birth weight, but lower premature delivery, gestational hypertension rates and low birth weight in both DCTA and TCTA pregnancy groups (all p < 0.05). DCTA to monochorionic singleton had the lowest incidence of gestational diabetes, whereas The subdivided subgroups of TCTA had no significant difference in the incidence of gestational diabetes. Monochorionic twins have higher rates of complete, early, and late miscarriage, premature delivery, and late premature delivery, and lower survival rate (p < 0.05).
CONCLUSION
MFPR could improve gestational week and average birth weight, reducing premature delivery, LBW, and gestational hypertension rates in DCTA and TCTA pregnancies. Monochorionic twins have worse pregnancy and obstetric outcomes. MFPR to singleton is preferable recommended in the pregnancy and obstetric management of complex triplets with monochorionic pair.
Topics: Abortion, Spontaneous; Female; Humans; Pregnancy; Pregnancy Outcome; Pregnancy Reduction, Multifetal; Pregnancy, Triplet; Pregnancy, Twin; Retrospective Studies
PubMed: 35382798
DOI: 10.1186/s12884-022-04617-y