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BMJ (Clinical Research Ed.) Apr 2024
Topics: Pregnancy; Humans; Female; Pregnancy Outcome; Pregnancy Complications; Risk Factors
PubMed: 38663934
DOI: 10.1136/bmj.q917 -
Drug Safety Nov 2021Pregnancy outcome identification and precise estimates of gestational age (GA) are critical in drug safety studies of pregnant women. Validated pregnancy outcome...
INTRODUCTION
Pregnancy outcome identification and precise estimates of gestational age (GA) are critical in drug safety studies of pregnant women. Validated pregnancy outcome algorithms based on the International Classification of Diseases, Tenth Revision, Clinical Modification/Procedure Coding System (ICD-10-CM/PCS) have not previously been published.
METHODS
We developed algorithms to classify pregnancy outcomes and estimate GA using ICD-10-CM/PCS and service codes on claims in the 2016-2018 IBM MarketScan Explorys Claims-EMR Data Set and compared the results with ob-gyn adjudication of electronic medical records (EMRs). Obstetric services were grouped into episodes using hierarchical and spacing requirements. GA was based on evidence with the highest clinical accuracy. Among pregnancies with obstetric EMRs, 100 full-term live births (FTBs), 100 preterm live births (PTBs), 100 spontaneous abortions (SAs), and 24 stillbirths were selected for review. Physicians adjudicated cases using Global Alignment of Immunization safety Assessment in pregnancy (GAIA) definitions applied to structured EMRs.
RESULTS
The claims-based algorithms identified 34,204 pregnancies, of which 9.9% had obstetric EMRs. Of sampled pregnancies, 92 FTBs, 93 PTBs, 75 SAs, and 24 stillbirths were adjudicated. Among these pregnancies, the percent agreement was 97.8%, 62.4%, 100.0%, and 70.8% for FTBs, PTBs, SAs, and stillbirths, respectively. The percent agreement on GA within 7 and 28 days, respectively, was 85.9% and 100.0% for FTBs, 81.7% and 98.9% for PTBs, 61.3% and 94.7% for SAs, and 66.7% and 79.2% for stillbirths.
CONCLUSIONS
The pregnancy outcome algorithms had high agreement with physician adjudication of EMRs and may inform post-market maternal safety surveillance.
Topics: Abortion, Spontaneous; Algorithms; Electronic Health Records; Female; Gestational Age; Humans; Infant, Newborn; Pregnancy; Pregnancy Outcome; Stillbirth
PubMed: 34591264
DOI: 10.1007/s40264-021-01113-8 -
Reproductive Health Feb 2022Climate change may jeopardize the health of mothers and their offspring. There are few studies on the association between increasing temperature and pregnancy outcomes....
BACKGROUND
Climate change may jeopardize the health of mothers and their offspring. There are few studies on the association between increasing temperature and pregnancy outcomes. The aim of this study was to investigate the relation between Universal Thermal Climate Index (UTCI) and adverse pregnancy outcomes including stillbirth, low birth weight (LBW), preterm labor (PTL), spontaneous abortion (SA), preeclampsia and hypertension in Ahvaz, Iran.
METHODS
Distributed Lag Non-linear Models (DLNM) combined with quasi-Poisson regression were used to research the effect of UTCI on adverse pregnancy outcomes. The effect of time trend, air pollutants (NO, SO and PM), and weekdays were adjusted.
RESULTS
The results showed that the low values of UTCI index (11.6 °C, in lags 0-6, 0-13) caused significant increase in the risk of preterm labor. However, hot thermal stress (high UTCI) significantly increased the risk of stillbirth in lag 0-13. We did not observe any significant relation between UTCI and other pregnancy outcomes in this study.
CONCLUSIONS
It seems like both hot and cold weathers can be associated with adverse pregnancy outcomes.
Topics: Abortion, Spontaneous; Female; Humans; Infant, Newborn; Iran; Pregnancy; Pregnancy Outcome; Stillbirth
PubMed: 35109854
DOI: 10.1186/s12978-022-01344-7 -
Zhonghua Yi Xue Za Zhi May 2016To study the effects of subchorionic hematoma (SCH) on pregnancy outcome. (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To study the effects of subchorionic hematoma (SCH) on pregnancy outcome.
METHODS
We searched publications from January 2000 to July 2015 for cohort and case-control studies evaluating subchorionic hematoma and perinatal outcomes, including spontaneous abortion, premature delivery and delivery mode.
RESULTS
Data of 6 articles analyzed by meta-analysis showed that SCH group had higher rate of spontaneous abortion, while no difference in premature delivery and delivery mode, compared with threatened abortion group.
CONCLUSION
Subchorionic hematoma increases the risk of spontaneous abortion, while premature delivery rate and delivery mode are not affected if the pregnant women can continue the pregnancy.
Topics: Abortion, Spontaneous; Abortion, Threatened; Case-Control Studies; Female; Hematoma; Humans; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Premature Birth
PubMed: 27180760
DOI: 10.3760/cma.j.issn.0376-2491.2016.17.017 -
The Journal of Emergency Medicine Nov 2004
Topics: Abortion, Spontaneous; Female; Humans; Male; Pain; Pregnancy; Pregnancy Outcome
PubMed: 15498631
DOI: 10.1016/j.jemermed.2004.08.004 -
Paediatric and Perinatal Epidemiology Jul 2021
Topics: Birth Intervals; Female; Humans; Pregnancy; Pregnancy Outcome
PubMed: 34184300
DOI: 10.1111/ppe.12797 -
Alimentary Pharmacology & Therapeutics Aug 2021
Topics: Azathioprine; Female; Humans; Mercaptopurine; Pregnancy; Pregnancy Outcome
PubMed: 34236094
DOI: 10.1111/apt.16472 -
African Journal of Reproductive Health Aug 2022
Topics: Pregnancy; Female; Humans; Pregnancy Outcome; Africa South of the Sahara
PubMed: 37585027
DOI: 10.29063/ajrh2022/v26i8.1 -
Radiology May 1997To assess the effect of prognostic factors on the outcome of singleton pregnancies.
PURPOSE
To assess the effect of prognostic factors on the outcome of singleton pregnancies.
MATERIALS AND METHODS
First-trimester ultrasonographic (US) scans that demonstrated a living fetus in 4,156 consecutive singleton pregnancies were studied. The relationship between outcome and maternal age, mode of conception, maternal symptoms, and US findings was evaluated.
RESULTS
Spontaneous abortion occurred in 371 of 4,156 (8.9%) cases. Higher pregnancy-loss rates were associated with older maternal age (P < 10(-5)), assisted mode of conception (P < 10(-8)), maternal symptoms of pain and/or bleeding (P < .001), and abnormal US findings (P < 10(-8)). US abnormalities were more frequent in older women than in younger women (P < 10(-5)) and in assisted conceptions than in natural conceptions (P < 10(-8)). At stepwise logistic regression, with gestational age as a covariate, US abnormalities and maternal symptoms independently affected pregnancy outcome. Maternal age and mode of conception had no further statistically significant effect on pregnancy outcome.
CONCLUSION
The prognosis for older mothers and for those with assisted conception is not statistically significantly different from that for younger mothers and for those with natural conception if maternal symptoms, US findings, and gestational age are the same.
Topics: Abortion, Spontaneous; Adult; Female; Humans; Maternal Age; Pregnancy; Pregnancy Outcome; Reproductive Techniques; Ultrasonography, Prenatal
PubMed: 9114094
DOI: 10.1148/radiology.203.2.9114094 -
American Journal of Primatology Nov 2011Past research has shown that aggressive behaviors can affect female reproductive outcome in nonhuman primate captive breeding programs. In this study, aggressive... (Comparative Study)
Comparative Study
Past research has shown that aggressive behaviors can affect female reproductive outcome in nonhuman primate captive breeding programs. In this study, aggressive behaviors were recorded in a colony of pigtailed macaque monkeys (Macaca nemestrina) and related to pregnancy outcome. For 22 weeks, behavioral data were collected from nine breeding groups, consisting of zero to one male (some males were removed after a cycle of conceptions for husbandry reasons) and four to eight females. Observations included all occurrences of 11 aggressive behaviors during 15 min observation sessions, 1-3 times a week. Mean weekly aggression levels during the study period were determined for each group as well as for each pregnancy. Aggression data were summarized with Principal Components Analyses. Results indicate that pigtailed macaque aggression falls into five distinctive categories: warn, engage, threaten, pursue, and attack. Breeding groups differed in their levels of aggression, even after controlling for group size, presence of a sire, and group stability. Levels of the five aggression categories were found to affect the probability that a pregnancy ended in either a natural birth of a live infant, a clinical intervention producing a live infant, or a nonviable outcome. The predictive value of aggression was significant when clinical interventions were included as possible reproductive outcomes. Behavioral observation of captive groups could identify "risk" conditions affecting pregnancy outcome and the requirement for clinical intervention.
Topics: Aggression; Animals; Female; Macaca nemestrina; Male; Pregnancy; Pregnancy Outcome; Pregnancy, Animal; Principal Component Analysis; Regression Analysis
PubMed: 21898511
DOI: 10.1002/ajp.20984