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Hu Y, Song X, Xu L, Zhou Z. High-intensity Focused Ultrasound is a Better Choice for Women with Fertility Desire: A Systematic Review and Meta-analysis of the Comparison between High-intensity Focused Ultrasound and Laparoscopic Treatment of Uterine Fibroids. Gynecol Minim Invasive Ther 2024; 13:79-89. [PMID: 38911304 PMCID: PMC11192288 DOI: 10.4103/gmit.gmit_23_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 08/17/2023] [Accepted: 08/18/2023] [Indexed: 06/25/2024] Open
Abstract
High-intensity focused ultrasound (HIFU) is commonly used to treat uterine fibroids and adenomyosis, but there is no evidence using metadata to compare fertility outcomes between conventional laparoscopic procedures and HIFU. The purpose of this study analysis is that evidence-based fertility outcomes may provide better treatment options for clinicians and patients considering fertility. The literature on fertility data for HIFU surgery versus laparoscopic myomectomy was searched in seven English language databases from January 1, 2010, to November 23, 2022. A total of 1375 articles were received in the literature, 14 of which were selected. We found that women who underwent HIFU surgery had higher rates of spontaneous pregnancy, higher rates of spontaneous delivery, and higher rates of full-term delivery but may have higher rates of miscarriage or postpartum complications than women who underwent laparoscopic myomectomy. Looking forward to future studies, it is hoped that the literature will examine endometrial differences in women who undergo HIFU and laparoscopic myomectomy to demonstrate the ability of endometrial repair. The location of fibroids in the sample should also be counted to allow for attribution statistics on the cause of miscarriage.
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Affiliation(s)
- Ying Hu
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, China
- Department of Surgery, Hangzhou Women’s Hospital (Hangzhou Maternity and Child Health Care Hospital), Hangzhou, China
| | - Xiaohong Song
- Department of Obstetrics and Gynecology, Hangzhou Women’s Hospital, Hangzhou, China
| | - Linjun Xu
- Department of Surgery, Hangzhou Women’s Hospital (Hangzhou Maternity and Child Health Care Hospital), Hangzhou, China
| | - Zhenfeng Zhou
- Department of Anesthesiology, Hangzhou Women’s Hospital, Hangzhou, China
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Etil T, Opio B, Odur B, Lwanga C, Atuhaire L. Risk factors associated with preterm birth among mothers delivered at Lira Regional Referral Hospital. BMC Pregnancy Childbirth 2023; 23:814. [PMID: 37996791 PMCID: PMC10666300 DOI: 10.1186/s12884-023-06120-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 11/10/2023] [Indexed: 11/25/2023] Open
Abstract
BACKGROUND The World Health Organization (WHO) defines Preterm Birth (PTB) as "a live birth taking place before the expected 37 weeks of gestation". Annually, approximately 15 million infants are born prematurely, constituting significantly to infant mortality during the initial four weeks of life, responsible for 40% of deaths among children under the age of five. Evidently, preterm deliveries have contributed to 46% of admissions to the neonatal intensive care unit (NICU) at Lira Regional Referral Hospital (LRRH) over the past three years. Paradoxically, while the prevalence of preterm births remains high, there is a lack of documented information regarding the underlying risk factors. Consequently, the primary objective of this study was to assess the potential risk factors associated with preterm birth at LRRH. METHODS An analytical cross-sectional research was undertaken at LRRH, employing a quantitative methodology. The study utilized secondary data obtained from a total of 590 comprehensive maternal medical records, of deliveries that occurred at the facility between April 2020 and July 2021. The collected data underwent analysis using STATA version 17 software. To identify predictors of preterm birth, a Logistic regression model was applied, yielding adjusted odds ratios (AOR) alongside 95% confidence intervals (CI). The significance level was set at p < 0.05 to establish statistical significance. Furthermore, assessments for multicollinearity and model fitness were conducted using the Variance Inflation Factor (VIF) and linktest, respectively. RESULTS The prevalence of preterm delivery among mothers who gave birth at LRRH stood at 35.8%. The outcomes of logistic regression analysis revealed that maternal employment status had a statistically significant association with preterm birth (AOR = 0.657, p = 0.037, 95%CI: 0.443-0.975); having a baby with low birth weight (AOR = 0.228, p < 0.001, 95% CI: 0.099-0.527) and experiencing preeclampsia (AOR = 0.142, p < 0.001, 95% CI: 0.088-0.229) were also identified as significant predictors of preterm birth in the study. CONCLUSIONS AND RECOMMENDATIONS The occurrence of preterm delivery is significantly higher (35.8%) among mothers who gave birth at LRRH when compared to the national average (13.6%). The prevalence of preterm birth among mothers was linked to factors such as employment status, delivery of low birth weight infants, and the presence of preeclampsia. Consequently, the research proposes a set of recommendations. Firstly, the Ministry of Health (MoH) should evaluate the present state of readiness within the healthcare system to effectively handle cases of preterm birth both within medical facilities and the community. Secondly, the Ministry of Gender, Labour, and Social Development should leverage Labor Officers to implement and uphold the regulations stipulated in the Employment Act and Labor Laws.
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Affiliation(s)
- Tom Etil
- School of Statistics and Planning, Makerere University, Kampala, Uganda.
| | - Bosco Opio
- School of Statistics and Planning, Makerere University, Kampala, Uganda
| | - Bernard Odur
- School of Statistics and Planning, Makerere University, Kampala, Uganda
| | | | - Leonard Atuhaire
- School of Statistics and Planning, Makerere University, Kampala, Uganda
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Teixeira B, Cardoso M, Dias CC, Pereira-da-Silva L, E Silva D. Eating Habits During Pregnancy of Women Giving Birth Very Prematurely: An Exploratory Analysis. ACTA MEDICA PORT 2023. [PMID: 36877956 DOI: 10.20344/amp.18419] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 12/14/2022] [Indexed: 03/08/2023]
Abstract
INTRODUCTION Preterm birth is increasing worldwide, representing a major cause of death and long-term loss of human potential among survivors. Some morbidities during pregnancy are well-known risk factors for preterm labor, but it is not yet known whether deviations from adequate dietary patterns are associated with preterm delivery. Diet may be an important modulator of chronic inflammation, and pro-inflammatory diets during pregnancy were reported to be associated with preterm birth. The aim of this study was to assess the food consumption during pregnancy of Portuguese women giving birth very prematurely and the association between the food consumption and the major maternal morbidities during pregnancy related with preterm delivery. MATERIAL AND METHODS A single-center cross-sectional observational study including consecutive Portuguese women giving birth before 33 weeks of gestation was conducted. Recall of eating habits during pregnancy was obtained within the first week after delivery, using a semi quantitative food frequency questionnaire validated for Portuguese pregnant women. RESULTS Sixty women with a median age of 36.0 years were included. Of these, 35% were obese or overweight at the beginning of pregnancy, 41.7% and 25.0% gained excessive or insufficient weight during pregnancy, respectively. Pregnancy-induced hypertension was present in 21.7% of cases, gestational diabetes in 18.3%, chronic hypertension in 6.7%, and type 2 diabetes mellitus in 5.0%. Pregnancy-induced hypertension was significantly associated with increased daily consumption of pastry products (31.2 vs 10.0 g, p = 0.022), fast food (39.6 vs 29.7 g, p = 0.028), bread (90.0 vs 50.0 g, p = 0.005), pasta, rice and potatoes (225.7 vs 154.3 g, p = 0.012). In a multivariate analysis, only bread consumption maintained a significant, albeit weak, association (OR = 1.021; 1.003 - 1.038, p = 0.022). CONCLUSION Pregnancy-induced hypertension was associated with increased consumption of pastry products, fast food, bread, pasta, rice, and potatoes, although only bread consumption had a weak but statistically significant association with pregnancy-induced hypertension in a multivariate analysis.
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Affiliation(s)
- Beatriz Teixeira
- Faculdade de Ciências da Nutrição e Alimentação. Universidade do Porto. Porto; EPIUnit - Instituto de Saúde Pública. Universidade do Porto. Porto; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR). Porto. Portugal
| | - Manuela Cardoso
- Nutrition Unit. Maternidade Dr. Alfredo da Costa. Centro Hospitalar Universitário de Lisboa Central. Lisbon. Portugal
| | - Claúdia Camila Dias
- Knowledge Management Unit and Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS). Porto; CINTESIS @RISE - Health Research Network. Faculdade de Medicina. Universidade do Porto. Porto. Portugal
| | - Luís Pereira-da-Silva
- Medicine of Woman, Childhood and Adolescence. NOVA Medical School
- Faculdade de Ciências Médicas. Lisbon; Nutrition Group. CHRC - Comprehensive Health Research Centre. NOVA Medical School
- Faculdade de Ciências Médicas. Lisbon; Neonatal Intensive Care Unit. Hospital Dona Estefânia. Centro Hospitalar Universitário de Lisboa Central. Lisbon. Portugal
| | - Diana E Silva
- Faculdade de Ciências da Nutrição e Alimentação. Universidade do Porto. Porto; Pediatric Nutrition Unit. Centro Materno Infantil. Centro Hospitalar Universitário São João. Porto; Center for Health Technology and Services Research - CINTESIS. Porto. Portugal
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Mohapatra V, Saraogi S, Misra S. Demographic Profile, Etiology, and Perinatal Outcome Associated With Preterm Birth in a Tertiary Hospital of Eastern India: A Retrospective Study. Cureus 2022; 14:e26066. [PMID: 35865435 PMCID: PMC9293265 DOI: 10.7759/cureus.26066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/18/2022] [Indexed: 11/13/2022] Open
Abstract
Background Preterm birth (PB), defined as birth occurring at less than 37 weeks of gestation, is a leading cause of perinatal mortality and morbidity in the world. Objectives This study aimed to evaluate the socio-demographic characteristics and etiological factors associated with preterm birth and consequent adverse perinatal outcomes retrospectively at a tertiary care hospital. Methods A single-centre retrospective observational study was conducted in the department of Obstetrics & Gynaecology, Fakir Mohan Medical College & Hospital, Balasore, Odisha, India, from April 2019 to March 2020. Data were retrieved from the antenatal ward admission register, case files, theatre records, and neonatal care unit records and reviewed. Descriptive statistics were used to describe data. Chi-square test and student's t-test were used to find significance of difference between variables. Results The incidence of preterm birth in the study population was 5.52%. The mean gestational age of preterm deliveries was 34.39 ± 1.92 weeks. The bulk of the women hailed from a rural background and belonged to the lower socioeconomic strata. About 47.29% of the women were nulliparous and spontaneous preterm birth was noted in 70.40%. Premature rupture of membranes (PROM), anaemia, intrauterine growth restriction (IUGR), preeclampsia, and eclampsia were the most common adverse pregnancy conditions prevalent in these women. Preterm deliveries comprised 31.21% of all neonatal intensive care unit (NICU) admissions. Respiratory distress syndrome, birth asphyxia, neonatal sepsis, and jaundice were the most common complications. Neonatal death occurred in 51 (9.21%) preterm infants with birth asphyxia being the commonest cause of such deaths. Maternal factors and adverse neonatal outcome variables were compared between the spontaneous and iatrogenic/medically indicated preterm birth groups. Preeclampsia, IUGR, and cesarean section were more significantly associated with the iatrogenic group. Conclusion Our study provides a general overview of the associated etiological factors and perinatal health concerns associated with preterm birth in a rural/semi-urban setting in Eastern India. The findings might provide essential data for taking steps toward the prevention and management of preterm birth from a developing country's perspective.
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Affiliation(s)
- Vandana Mohapatra
- Department of Obstetrics and Gynaecology, Fakir Mohan Medical College & Hospital, Balasore, IND
| | - Sujata Saraogi
- Department of Paediatrics, Fakir Mohan Medical College & Hospital, Balasore, IND
| | - Sujata Misra
- Department of Obstetrics and Gynaecology, Fakir Mohan Medical College & Hospital, Balasore, IND
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Zhang YJ, Zhu Y, Zhu L, Lu CQ, Chen C, Yuan L. Prevalence of preterm birth and risk factors associated with it at different gestational ages: A multicenter retrospective survey in China. Saudi Med J 2022; 43:599-609. [PMID: 35675930 PMCID: PMC9389891 DOI: 10.15537/smj.2022.43.6.20220210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 05/11/2022] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES To investigate the prevalence of preterm birth (PTB) and the risk factors for different gestational age subgroups of preterm birth in China. METHODS We carried out a descriptive cross-sectional study encompassing all singleton live births (24+0 to 41+6 weeks) with completed data in 23 provinces in China from 2010 to 2017 during investigation period. We compared both the preterm group (24+0 to 36+6 weeks) and preterm subgroups (<32 weeks, 32+0 to 33+6 weeks, and 34+0 t0 36+6 weeks) with the term group (37+0 to 41+6 weeks). We collected information on maternal and fetal characteristics from medical records. Logistic regression was use. RESULTS The prevalence of PTB was 7.4% (15,833/215,254) in singleton births. After adjusting for maternal age, parity, and potential risk factors in univariate analysis, the high-risk factors for PTB at <32 weeks were placental abruption (aOR=41.52; 95% CI, 25.89-66.58), placenta previa (aOR=40.04; 95% CI, 32.00-50.09), chorioamnionitis (aOR=11.06; 95% CI, 8.738-14.02), and hypertension disorders in pregnancy (HDP) (aOR=3.564; 95% CI, 2.930-4.335). Intrahepatic cholestasis of pregnancy (ICP) was significantly associated with PTB at 34-36 weeks (aOR=5.763; 95% CI, 5.049-6.577), particularly with spontaneous PTB (aOR=10.04; 95% CI, 8.79-11.47). Gestational diabetes mellitus (GDM) was significantly associated with PTB at 34-36 weeks only (aOR=1.156; 95% CI, 1.054-1.267). CONCLUSION Placental abruption, placenta previa, chorioamnionitis, and HDP were more predictive of early PTB; GDM and ICP were more predictive of late PTB.
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Affiliation(s)
- Yi-Jie Zhang
- From the Department of Neonatology (Zhang, Zhu Y, Zhu L, Chen, Yuan), Children’s Hospital of Fudan University, from the Division of Neonatology (Lu), Gynecology and Obstetrics Hospital of Fudan University; and from the Key Laboratory of Neonatal Diseases (Chen), National Health Commission, Shanghai, China.
| | - Yan Zhu
- From the Department of Neonatology (Zhang, Zhu Y, Zhu L, Chen, Yuan), Children’s Hospital of Fudan University, from the Division of Neonatology (Lu), Gynecology and Obstetrics Hospital of Fudan University; and from the Key Laboratory of Neonatal Diseases (Chen), National Health Commission, Shanghai, China.
| | - Li Zhu
- From the Department of Neonatology (Zhang, Zhu Y, Zhu L, Chen, Yuan), Children’s Hospital of Fudan University, from the Division of Neonatology (Lu), Gynecology and Obstetrics Hospital of Fudan University; and from the Key Laboratory of Neonatal Diseases (Chen), National Health Commission, Shanghai, China.
| | - Cheng-Qiu Lu
- From the Department of Neonatology (Zhang, Zhu Y, Zhu L, Chen, Yuan), Children’s Hospital of Fudan University, from the Division of Neonatology (Lu), Gynecology and Obstetrics Hospital of Fudan University; and from the Key Laboratory of Neonatal Diseases (Chen), National Health Commission, Shanghai, China.
| | - Chao Chen
- From the Department of Neonatology (Zhang, Zhu Y, Zhu L, Chen, Yuan), Children’s Hospital of Fudan University, from the Division of Neonatology (Lu), Gynecology and Obstetrics Hospital of Fudan University; and from the Key Laboratory of Neonatal Diseases (Chen), National Health Commission, Shanghai, China.
| | - Lin Yuan
- From the Department of Neonatology (Zhang, Zhu Y, Zhu L, Chen, Yuan), Children’s Hospital of Fudan University, from the Division of Neonatology (Lu), Gynecology and Obstetrics Hospital of Fudan University; and from the Key Laboratory of Neonatal Diseases (Chen), National Health Commission, Shanghai, China.
- Address correspondence and reprint request to: Dr. Lin Yuan, Department of Neonatology, Children’s Hospital of Fudan University, Shanghai, China. E-mail: ORCID ID: https://orcid.org/0000-0003-3540-7428
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Lopes MLB, Barbosa RDM, Fernandes MAC. Unsupervised Learning Applied to the Stratification of Preterm Birth Risk in Brazil with Socioeconomic Data. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095596. [PMID: 35564992 PMCID: PMC9102534 DOI: 10.3390/ijerph19095596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 04/26/2022] [Accepted: 04/27/2022] [Indexed: 11/16/2022]
Abstract
Preterm birth (PTB) is a phenomenon that brings risks and challenges for the survival of the newborn child. Despite many advances in research, not all the causes of PTB are already clear. It is understood that PTB risk is multi-factorial and can also be associated with socioeconomic factors. Thereby, this article seeks to use unsupervised learning techniques to stratify PTB risk in Brazil using only socioeconomic data. Through the use of datasets made publicly available by the Federal Government of Brazil, a new dataset was generated with municipality-level socioeconomic data and a PTB occurrence rate. This dataset was processed using various unsupervised learning techniques, such as k-means, principal component analysis (PCA), and density-based spatial clustering of applications with noise (DBSCAN). After validation, four clusters with high levels of PTB occurrence were discovered, as well as three with low levels. The clusters with high PTB were comprised mostly of municipalities with lower levels of education, worse quality of public services-such as basic sanitation and garbage collection-and a less white population. The regional distribution of the clusters was also observed, with clusters of high PTB located mostly in the North and Northeast regions of Brazil. The results indicate a positive influence of the quality of life and the offer of public services on the reduction in PTB risk.
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Affiliation(s)
- Márcio L B Lopes
- Laboratory of Machine Learning and Intelligent Instrumentation, Federal University of Rio Grande do Norte, Natal 59078-970, Brazil
| | - Raquel de M Barbosa
- Department of Pharmacy and Pharmaceutical Technology, University of Granada, 18071 Granada, Spain
| | - Marcelo A C Fernandes
- Department of Computer Engineering and Automation, Federal University of Rio Grande do Norte, Natal 59078-970, Brazil
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Tavoli Z, Tajdar A, Kheiltash A, Rabie M. Determination of risk factors and cumulative effects of the maternal and neonatal risk factors in relation to preterm labor. J Family Med Prim Care 2021; 10:1747-1753. [PMID: 34123923 PMCID: PMC8144790 DOI: 10.4103/jfmpc.jfmpc_1118_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 09/09/2020] [Accepted: 12/20/2020] [Indexed: 11/04/2022] Open
Abstract
Background Preterm labor is the leading cause of neonatal morbidity and mortality this study aimed to determine single and combined effects of all risk factors in relation to preterm labor. Methods This was a case-control study that included patients from a teaching hospital affiliated to Tehran University of Medical Sciences. Women who came to this hospital for delivery were divided into two groups: 200 in preterm delivery (before 37 weeks) and 195 in term delivery (after 37 weeks). Results In all 409 pregnant women were delivered. 217 were preterm (group A) and 192 were term (group B). The mean age of mothers in group A was 30.04 ± 5.74 and the mean age of mothers in group B was 27.28 ± 5.90 (P < 0.001). The risk of preterm labor was 4.22 higher in mother with any risk factor before or during pregnancy (P < 0.001), it was 3.67 higher in mother with complication of pregnancy (P < 0.001) and it was 3.40 higher in neonate with any complication (P = 0.002) compared to mother without any risk factors. For each mother, we calculated risk score for preterm labor by counting the number of risk factors. The risk of preterm labor was significantly higher in mother with risk factors compared to those without any risk factors (P for trend = 0. 002). Mother with two risk factors had a 5.60 (P = 0.01) and mother with three or more risk factors had a 23.48 (P = 0. 001) times higher risk for preterm labor than those who did not have any risk factors. Conclusion The screening and identification of mothers with risk factors for preterm delivery can increasing mother's attention and participation to better manage of these condition to have more safe pregnancy period.
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Affiliation(s)
- Zahra Tavoli
- Department of Obstetrics and Gynecology, Ziaeian Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Tajdar
- Department of Family Medicine, Ziaeian Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Azita Kheiltash
- Department of Community Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Rabie
- Department of Obstetrics and Gynecology, Arash Women Hospital, Tehran University of Medical Sciences, Tehran, Iran
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