Differences in the pregnancy gestation period and mean birth weights in infants born to Indian, Pakistani, Bangladeshi and white British mothers in Luton, UK: a retrospective analysis of routinely collected data

The Incidence and Outcomes of Late-Term Pregnancy

BACKGROUND

Little is known about the outcomes of late-term pregnancy. In this study, we aim to assess the incidence and adverse prenatal outcomes associated with late-term pregnancy.

METHODS

We retrospectively assessed all singleton pregnant mothers who gave birth at Khalij-e-Fars Hospital in Bandar Abbas, Iran, between January 2020 and 2022. All preterm and post-term deliveries were excluded. Mothers were divided into two groups: late-term mothers (41 0/7-41 6/7 weeks of gestation) and term mothers (37 0/7-40 6/7 weeks of gestation). Demographic factors, obstetric factors, maternal comorbidities, and prenatal outcomes were extracted from the electronic data of each mother. The incidence of late-term births was calculated. The chi-squared test was used to compare differences between the groups. Logistic regression models were used to assess the association of prenatal outcome with late-term pregnancy.

RESULTS

There were 8,888 singleton deliveries during the study period, and 1,269 preterm and post-term pregnancies were ruled out. Of the 7,619 deliveries, 309 (4.1%) were late-term, while 7,310 (95.9%) were term. There were no sociodemographic differences between term and late-term mothers. The late-term group had a higher prevalence of primiparous mothers, and the term group had a higher prevalence of diabetes. Late-term mothers had a higher risk of macrosomia (adjusted odds ratio (aOR): 2.24 (95% confidence interval (CI): 1.34-3.01)), meconium amniotic fluid (aOR: 2.32 (95% CI: 1.59-3.14)), and fetal distress (aOR: 2.38 (95% CI: 1.54-2.79)). When compared to term pregnancy, the risk of low birth weight (LBW) was lower in late-term pregnancy (aOR: 0.69 (95% CI: 0.36-0.81)).

CONCLUSIONS

Late-term pregnancy was found to be more likely to be associated with macrosomia, meconium amniotic fluid, and fetal distress, but serious maternal and neonatal adverse events were comparable to term pregnancy.

Analysis of routinely collected data: Determining associations of maternal risk factors and infant outcomes with gestational diabetes, in Pakistani, Indian, Bangladeshi and white British pregnant women in Luton, England

OBJECTIVE

This study aims to compare the prevalence of gestational diabetes in Indian, Pakistani, Bangladeshi and British women in Luton, England and further examine associations in maternal risk factors (age BMI, smoking status and birth outcome), with gestational diabetes, with maternal ethnicity.

DESIGN

A retrospective analysis using routinely collected secondary data from Ciconia Maternity information System (CMiS), between 2008 and 2013. The ethnicity of women recorded as Indian, Pakistani, Bangladeshi and white British, residing in [removed] were included in the study. The outcomes for n=15,211 cases were analysed using adjusted standardised residuals, Pearson Chi-square, frequencies and percentages of women with gestational diabetes.

RESULTS

The prevalence of gestational diabetes was significantly higher in the sample of Bangladeshi (2.1%) and Pakistani (1.4%) compared to Indian (1%) and white British (0.4%) women. Of the women diagnosed with gestational diabetes, 48.7% of the women diagnosed with gestational diabetes in this cohort were Pakistani, compared with 28.3% of Bangladeshi, 6.6% of Indian and 16.4% of white British (χ2= 84.57 df=6, p<0.001). A number of significant Pearson Chi-square associations were found between Pakistani women diagnosed with gestational diabetes and BMI over 30kg/m² (χ²= 43.1 df=4, p<0.001) and an early gestational age at delivery (24-37 weeks) (χ2= 4.084 df=1, p=0.043).

CONCLUSIONS

There are important differences in the prevalence rates of gestational diabetes which varied by maternal ethnicity. Of the women who had GDM, 48.7% were Pakistani, compared with 28.3% Bangladeshi, 16.4% white British and 6.6% Indian. It is essential policy makers and service providers target GDM screening and associated interventions and future research seeks to understand the reasons behind these differences.

Ethnic differences in singleton preterm birth in England and Wales, 2006-12: Analysis of national routinely collected data

BACKGROUND

Data recorded at birth and death registration in England and Wales have been routinely linked with data recorded at birth notification since 2006. These provide scope for detailed analyses on ethnic differences in preterm birth (PTB).

OBJECTIVES

We aimed to investigate ethnic differences in PTB and degree of prematurity in England and Wales, taking into account maternal sociodemographic characteristics and to further explore the contribution of mother's country of birth to these ethnic differences in PTB.

METHODS

We analysed PTB and degree of prematurity by ethnic group, using routinely collected and linked data for all singleton live births in England and Wales, 2006-2012. Logistic regression was used to adjust for mother's age, marital status/registration type, area deprivation and mother's country of birth.

RESULTS

In the 4 634 932 births analysed, all minority ethnic groups except 'Other White' had significantly higher odds of PTB compared with White British babies (ORs between 1.04-1.25); highest odds were in Black Caribbean, Indian, Bangladeshi and Pakistani groups. Ethnic differences in PTB tended to be greater at earlier gestational ages. In all ethnic groups, odds of PTB were lower for babies whose mothers were born outside the UK.

CONCLUSIONS

In England and Wales, Black Caribbean, Indian, Bangladeshi, Pakistani and Black African babies all have significantly increased odds of being born preterm compared with White British babies. Bangladeshis apart, these groups are particularly at risk of extremely PTB. In all ethnic groups, the odds of PTB are lower for babies whose mothers were born outside the UK. These ethnic differences do not appear to be wholly explained by area deprivation or other sociodemographic characteristics.

Understanding the consumption of folic acid during preconception, among Pakistani, Bangladeshi and white British mothers in Luton, UK: a qualitative study

Background

To review the similarities and differences in Pakistani, Bangladeshi and White British mothers health beliefs (attitudes, knowledge and perceptions) and health behaviour regarding their consumption of folic acid pre-conception, to reduce the risk of neural tube defects.

Methods

Our study used a descriptive qualitative research approach, implementing face-to-face focus group discussions with Pakistani, Bangladeshi or White British mothers (normal birth outcomes and mothers with poor birth outcomes) and semi-structured interviews or focus groups with service providers using semi-structured topic guides. This method is well suited for under researched areas where in-depth information is sought.

There were three sample groups:

Pakistani, Bangladeshi and White British mothers with normal birth outcomes (delivery after 37 weeks of gestation, in the preceding 6 to 24 months, weighing 2500 g and living within a specified postcode area in Luton, UK).

Pakistani Bangladeshi and white British bereaved mothers who had suffered a perinatal mortality (preceding 6 to 24 months, residing within a specificied postcode area).

Healthcare professionals working on the local maternity care pathway (i.e. services providing preconception, antenatal, antepartum and postpartum care).

Transcribed discussions were analysed using the Framework Analysis approach.

Results

The majority of mothers in this sample did not understand the benefits or optimal time to take folic acid pre-conception. Conversely, healthcare professionals believed the majority of women did consume folic acid, prior to conception.

Conclusions

There is a need to increase public health awareness of the optimal time and subsequent benefits for taking folic acid, to prevent neural tube defects.

Electronic supplementary material

The online version of this article (10.1186/s12884-018-1884-0) contains supplementary material, which is available to authorized users.