scholarly journals Maternal age and adverse pregnancy outcomes: a population-based register study in Wuhan, China, 2011-2016

2020 ◽  
Author(s):  
Jiangxia Cao ◽  
Bingzheng Zhang ◽  
Yan Liu ◽  
Ting Yu ◽  
Yiming Zhang ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Cesarean Delivery ◽  
Gestational Age ◽  
Pregnancy Outcomes ◽  
Apgar Score ◽  
Maternal Age ◽  
Population Based ◽  
Adverse Pregnancy Outcomes ◽  
Health Management Information System ◽  
Adverse Pregnancy

Abstract Background A trend towards increasing maternal age has been witnessed in China. Evidence from high-income countries has shown that older women have higher risks of various adverse pregnancy outcomes. However, few large, contemporary, population-based studies have adjusted for potential confounders in examining the association between maternal age and adverse pregnancy outcomes in China. Methods Data from the Wuhan Maternal and Child Health Management Information System including all women aged ≥20 years with live singleton pregnancies in 2011-2016 were analyzed. A range of adverse pregnancy outcomes including pregnancy induced hypertension disorder(PIH), gestational diabetes mellitus(GDM), cesarean delivery, postpartum hemorrhage, preterm birth, small-for-gestational age (SGA), large-for-gestational age (LGA), and 5-min Apgar score<7 among women aged 20-24, 30-35 and ≥40 years were compared with women aged 25-29 years using binary logistic regression models, with social-demographic characteristics, pre-pregnancy BMI, parity, and fetal gender adjusted. Subgroup analyses by stratifying on parity were also performed. Results 415,632 women were included during the study period. Among them, 91536(22.0%) were aged 20-24 years, 203687(49.0%) were aged 25-29 years, 89883(21.6%) were aged 30-34 years, 26271(6.3%) were aged 35-39 years, and 4255 (1.0%) were aged ≥40 years. After adjusting for the potential confounders, older maternal age (≥30 years) was associated with higher risks of PIH, GDM, cesarean delivery, preterm birth, LGA, and 5-min Apgar score<7, but not with SGA. Relative to older multiparous women, older nulliparous women were more likely to experience cesarean delivery, preterm birth, and 5-min Apgar score<7. Conclusion Older maternal age is independently associated with various adverse pregnancy outcomes. The risks may occur earlier than the commonly used definition of advanced maternal age, and may also differ by parity. Ensuring age and parity specific clinical counseling, antenatal surveillance, and health interventions may be of great significance to improve older mother’s pregnancy outcomes.

scholarly journals Assessing the relationship between pregravid body mass index and risk of adverse maternal pregnancy and neonatal outcomes: prospective data in Southwest China

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yue Chen ◽  
Ke Wan ◽  
Yunhui Gong ◽  
Xiao Zhang ◽  
Yi Liang ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Cesarean Delivery ◽  
Body Mass ◽  
Gestational Age ◽  
Pregnancy Outcomes ◽  
Maternal Age ◽  
Southwest China ◽  
Adverse Pregnancy Outcomes ◽  
Relative Importance ◽  
Adverse Pregnancy

AbstractThe relevance of pregestational body mass index (BMI) on adverse pregnancy outcomes remained unclear in Southwest China. This study aimed to investigate the overall and age-category specific association between pre-gestational BMI and gestational diabetes mellitus (GDM), preeclampsia, cesarean delivery, preterm delivery, stillbirth, macrosomia, and small-for-gestational age (SGA) or large-for-gestational age (LGA) neonates in Southwest China. Furthermore, it explores the relative importance of influence of pregravid BMI and maternal age on pregnancy outcomes. 51,125 Chinese singleton pregnant women were recruited as study subjects. Multiple logistic regression models were used to examine the influence of pre-pregnancy BMI on adverse pregnancy outcomes. Gradient boosting machine was used to evaluate the relative importance of influence of pregravid BMI and maternal age on pregnancy outcomes. It is found that women who were overweight or obese before pregnancy are at higher risk of adverse pregnancy outcomes except for SGA neonates, while pre-pregnancy underweight is a protective factor for GDM, preeclampsia, cesarean delivery, macrosomia and LGA, but not SGA. Younger mothers are more susceptible to GDM and macrosomia neonates, while older mothers are more prone to preeclampsia. Pre-pregnancy BMI has more influence on various pregnancy outcomes than maternal age. To improve pregnancy outcomes, normal BMI weight as well as relatively young maternal ages are recommended for women in child-bearing age.

scholarly journals Association between neighbourhood deprivation, fetal growth, small-for-gestational age and preterm birth: a population-based prospective cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e049075
Author(s):  
Dionne V Gootjes ◽  
Anke G Posthumus ◽  
Vincent W V Jaddoe ◽  
Eric A P Steegers
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Preterm Birth ◽  
Fetal Growth ◽  
Gestational Age ◽  
Pregnancy Outcomes ◽  
First Trimester ◽  
Adverse Pregnancy Outcomes ◽  
Neighbourhood Deprivation ◽  
Adverse Pregnancy

ObjectiveTo study the associations between neighbourhood deprivation and fetal growth, including growth in the first trimester, and adverse pregnancy outcomes.DesignProspective cohort study.SettingThe Netherlands, Rotterdam.Participants8617 live singleton births from the Generation R cohort study.ExpositionLiving in a deprived neighbourhood.Main outcome measuresFetal growth trajectories of head circumference, weight and length.Secondary outcomes measuresSmall-for-gestational age (SGA) and preterm birth (PTB).ResultsNeighbourhood deprivation was not associated with first trimester growth. However, a higher neighbourhood status score (less deprivation) was associated with increased fetal growth in the second and third trimesters (eg, estimated fetal weight; adjusted regression coefficient 0.04, 95% CI 0.02 to 0.06). Less deprivation was also associated with decreased odds of SGA (adjusted OR 0.91, 95% CI 0.86 to 0.97, p=0.01) and PTB (adjusted OR 0.89, 95% CI 0.82 to 0.96, p=0.01).ConclusionsWe found an association between neighbourhood deprivation and fetal growth in the second and third trimester pregnancy, but not with first trimester growth. Less neighbourhood deprivation is associated with lower odds of adverse pregnancy outcomes. The associations remained after adjustment for individual-level risk factors. This supports the hypothesis that living in a deprived neighbourhood acts as an independent risk factor for fetal growth and adverse pregnancy outcomes, above and beyond individual risk factors.

Risks of Selected Fetal Adverse Pregnancy Outcomes at Advance Maternal Age

2021 ◽  
Vol 15 (8) ◽  
pp. 2468-2471
Author(s):  
Saadia Yasmeen ◽  
Sumayya . ◽  
Javeria Saleem ◽  
Jawairiah Liaqat ◽  
Nadia Pervaiz ◽  
...  
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Pregnancy Outcomes ◽  
Maternal Age ◽  
Advanced Maternal Age ◽  
Adverse Pregnancy Outcomes ◽  
Control Group ◽  
Postpartum Women ◽  
Adverse Pregnancy

Background and Aim: Advanced maternal age pregnancy could be referred to as pregnancy after 35 years or older. The prevalence of postponing pregnancies is increasing day by day worldwide. However, limited evidence was found on advanced maternal age pregnancy association with fetal adverse outcomes. The present study aimed to evaluate the frequency of advanced maternal age selected fetal adverse pregnancy outcomes. Place and Duration: Obstetrics & Gynaecology department of Alkhidmat Hospital Kohat and Qazi Hussain Ahmad Medical Complex, Nowshera for duration of six months from November 2020 to April 2021. Materials and Methods: This single-centered retrospective study was conducted on 220 postpartum women in the study group (≥35 years) and 170 control group postpartum women (20-34 years) who delivered at Obstetrics & Gynaecology department of Alkhidmat Hospital Kohat and Qazi Hussain Ahmad Medical Complex, Nowshera after 28 gestational weeks. Individuals who met the inclusion criteria were enrolled and sampled based on randomized control sampling technique for both control and study groups. Data extraction checklist and pretested questionnaire were used for data collection from the maternal charts. Adverse pregnancy outcome and advanced maternal age was correlated adjusted relative risks and strength with a 95% confidence interval. SPSS version 20 was used for data analysis and considered p-value >0.05 as a statistical standard. Results: The adverse neonatal outcomes include low birth weight, preterm birth, and stillbirth with a prevalence 38 (17.4%), 46 (20.8%), and 31 (14.2%) respectively in the study group. In the control group, the incidence of low birth weight, preterm birth, and stillbirth was 21 (12.6%), 15 (14.6%) and 6 (3.5%) respectively. The stillbirth (ARR=3.16 95% CI (1.29–6.03) and preterm deliveries (ARR=2.71 95% CI (1.79–3.86) risk had significantly higher prevalence compared to control group advanced age pregnancy. Insignificance association was found between low birth weight and advanced maternal age. Conclusion: Stillbirth and preterm birth was the adverse fetal outcome significantly related with advanced maternal age pregnancy. There was no significant association between low birth weight and advanced maternal age. Keywords: Maternal age, Fetal Adverse Pregnancy Outcomes

scholarly journals Association of maternal pre-pregnancy low or increased body mass index with adverse pregnancy outcomes

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jie Tang ◽  
Xinhong Zhu ◽  
Yanbing Chen ◽  
Dongming Huang ◽  
Henning Tiemeier ◽  
...  
Keyword(s):  
Gestational Age ◽  
Pregnancy Outcomes ◽  
Maternal Age ◽  
Caesarean Delivery ◽  
Overweight And Obesity ◽  
Adverse Pregnancy Outcomes ◽  
Healthy Weight ◽  
Birth Injury ◽  
Increased Risk ◽  
Adverse Pregnancy

AbstractThis study investigated the association between pre-pregnancy body mass index (BMI) and adverse pregnancy outcomes among women participated in the National Free Preconception Health Examination Project in Guangdong Province, China, and explored these associations according to maternal age. Pre-pregnancy BMI was classified into underweight (BMI < 18.5 kg/m2), healthy weight (18.5–23.9 kg/m2), overweight (24.0–27.9 kg/m2), and obesity (≥ 28.0 kg/m2) according to Chinese criteria. Outcomes were preterm birth (PTB, delivery before 37 weeks of gestation), large for gestational age (LGA, birthweight above the 90th percentile for gestational age by infants’ sex), small for gestational age (SGA, birthweight below the 10th percentile for gestational age by infants’ sex), primary caesarean delivery, shoulder dystocia or birth injury, and stillbirth. Adjusted incidence risk ratios (aIRR) were calculated for underweight, overweight and obesity, respectively. Compared with healthy weight, underweight was associated with increased risk of PTB (aIRR 1.06, 95%CI 1.04–1.09) and SGA (1.23, 1.22–1.26) but inversely associated with LGA (0.83, 0.82–0.85), primary caesarean delivery (0.88, 0.87–0.90) and stillbirth (0.73, 0.53–0.99). Overweight was associated with increased risk of LGA (1.17, 1.14–1.19), primary caesarean delivery (1.18, 1.16–1.20) and stillbirth (1.44, 1.03–2.06), but inversely associated with SGA (0.92, 0.90–0.95) and shoulder dystocia or birth injury (0.86, 0.79–0.93). Obesity was associated with increased risk of PTB (1.12, 1.05–1.20), LGA (1.32, 1.27–1.37), primary caesarean delivery (1.45, 1.40–1.50), but inversely associated with SGA (0.92, 0.87–0.97). The aIRRs for underweight, overweight and obesity in relation to these adverse pregnancy outcomes ranged from 0.65 to 1.52 according to maternal age. In Chinese population, maternal pre-pregnancy BMI was significantly associated with the risk of adverse pregnancy outcomes and the risk differs according to maternal age. Further investigation is warranted to determine whether and how counselling and interventions for women with low or increased BMI before pregnancy can reduce the risk of adverse pregnancy outcomes.

Has Human Papillomavirus (HPV) Vaccination Prevented Adverse Pregnancy Outcomes? Population-Level Analysis After 8 Years of a National HPV Vaccination Program in Australia

2020 ◽  
Vol 222 (3) ◽  
pp. 499-508
Author(s):  
Susan Yuill ◽  
Sam Egger ◽  
Megan Smith ◽  
Louiza Velentzis ◽  
C David Wrede ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Pregnancy Outcomes ◽  
Maternal Age ◽  
Hpv Vaccination ◽  
Preterm Births ◽  
Population Level ◽  
Adverse Pregnancy Outcomes ◽  
Adverse Pregnancy

Abstract Background Human papillomavirus (HPV) infection, and its sequelae of precancerous cervical lesions and their subsequent treatment, have been linked with an increased risk of adverse pregnancy outcomes. Publicly funded HPV vaccination of female adolescents began in Australia in 2007 with initial catch-up to age 26 years. Methods Using data from the National Perinatal Data Collection we compared rates of preterm births and small-for-gestational-age infants born in Australia 2000–2015. We used generalized linear models, assuming a Poisson distribution and log link function, with single-year categories of infant birth year, maternal age, and age-specific HPV vaccination coverage as independent variables. Results In maternal cohorts with 60%–80% HPV vaccination coverage as achieved in Australia, there was a relative rate reduction of 3.2% (95% confidence interval, 1.1%–5.3%) in preterm births and 9.8% (8.2% to 11.4%) in small-for-gestational-age infants, after adjustment for infant’s birth year and maternal age. Conclusion This analysis provides provisional population-level evidence of a reduction in adverse pregnancy outcomes in cohorts of women offered HPV vaccination. Confounding by smoking or other variables and/or ecological analysis limitations, however, cannot be excluded. These findings indicate potential broader benefits of HPV vaccination than have been documented to date.

scholarly journals A prospective population-based multicentre study on the impact of maternal body mass index on adverse pregnancy outcomes: Focus on normal weight

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257722
Author(s):  
Fieke van Hoorn ◽  
Leon de Wit ◽  
Lenie van Rossem ◽  
Marielle Jambroes ◽  
Floris Groenendaal ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Gestational Age ◽  
Pregnancy Outcomes ◽  
Reference Interval ◽  
Population Based ◽  
Adverse Pregnancy Outcomes ◽  
Maternal Body Mass Index ◽  
Relative Risks ◽  
Composite Endpoints ◽  
Adverse Pregnancy

Background Maternal body mass index (BMI) below or above the reference interval (18.5–24.9 kg/m2) is associated with adverse pregnancy outcomes. Whether BMI exerts an effect within the reference interval is unclear. Therefore, we assessed the association between adverse pregnancy outcomes and BMI, in particular within the reference interval, in a general unselected pregnant population. Methods Data was extracted from a prospective population-based multicentre cohort (Risk Estimation for PrEgnancy Complications to provide Tailored care (RESPECT) study) conducted between December 2012 to January 2014. BMI was studied in categories (I: <18.5, II: 18.5–19.9, III: 20.0–22.9, IV: 23.0–24.9, V: 25.0–27.4, VI: 27.5–29.9, VII: >30.0 kg/m2) and as a continuous variable within the reference interval. Adverse pregnancy outcomes were defined as composite endpoints for maternal, neonatal or any pregnancy complication, and for adverse pregnancy outcomes individually. Linear trends were assessed using linear-by-linear association analysis and (adjusted) relative risks by regression analysis. Results The median BMI of the 3671 included women was 23.2 kg/m2 (IQR 21.1–26.2). Adverse pregnancy outcomes were reported in 1256 (34.2%). Linear associations were observed between BMI categories and all three composite endpoints, and individually for pregnancy-induced hypertension (PIH), preeclampsia, gestational diabetes mellitus (GDM), large-for-gestational-age (LGA) neonates; but not for small-for-gestational-age neonates and preterm birth. Within the reference interval, BMI was associated with the composite maternal endpoint, PIH, GDM and LGA, with adjusted relative risks of 1.15 (95%CI 1.06–1.26), 1.12 (95%CI 1.00–1.26), 1.31 (95%CI 1.11–1.55) and 1.09 (95%CI 1.01–1.17). Conclusions Graded increase in maternal BMI appears to be an indicator of risk for adverse pregnancy outcomes even among women with a BMI within the reference interval. The extent to which BMI directly contributes to the increased risk in this group should be evaluated in order to determine strategies most valuable for promoting safety and long-term health for mothers and their offspring.

scholarly journals Association of Gestational Diabetes Mellitus with Adverse Pregnancy Outcomes and Its Interaction with Maternal Age in Chinese Urban Women

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Xueyin Wang ◽  
Xiaosong Zhang ◽  
Min Zhou ◽  
Juan Juan ◽  
Xu Wang
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Preterm Birth ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Cesarean Delivery ◽  
Pregnancy Outcomes ◽  
Maternal Age ◽  
Urban Women ◽  
Adverse Pregnancy

Background. The prevalence of gestational diabetes mellitus (GDM) has been dramatically increasing worldwide. The aims of this study were to examine associations of GDM with pregnancy outcomes in Chinese urban women and to evaluate the interaction between GDM and other major risk factors for the risk of adverse pregnancy outcomes. Methods. A retrospective analysis included 8844 women who delivered live singletons at ≥28 weeks of gestation between June 2012 and March 2013 among Chinese urban women. Structured questionnaires were used to collect information on demographic characteristics, lifestyle behavior, medical history, and pregnancy outcomes. The diagnosis of GDM was made between 24 and 28 gestational weeks according to the International Association of Diabetes and Pregnancy Study Groups criteria. Logistic regression models were used to assess the association of GDM with pregnancy outcomes and to examine the interaction between GDM and other major risk factors including maternal age, prepregnancy body mass index, and gestational weight gain for the risk of pregnancy outcomes. Results. 13.9% of women were diagnosed with GDM. We found that GDM was associated with higher risk of cesarean delivery ( odds   ratio   OR = 1.69 , 95% CI (confidence interval): 1.48-1.92), preterm birth ( OR = 1.32 , 95% CI: 1.07-1.64), macrosomia ( OR = 1.69 , 95% CI: 1.34-2.13), and large for gestational age (LGA, OR = 1.43 , 95% CI: 1.18-1.73) after adjustment for potential confounders. We also observed the interaction between GDM and maternal age for the risk of cesarean delivery ( P   for   interaction = 0.025 ), and the OR of GDM for cesarean delivery was 1.71 (95% CI: 1.49-1.97) among women aged less than 35 years. Conclusions. GDM was associated with an increased risk of cesarean delivery, preterm birth, macrosomia, and LGA in Chinese urban women, and there was an interaction between GDM and maternal age for the risk of cesarean delivery.

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