1
|
Hung TH, Hsu TY, Hsu J, Ou CY, Liu PH, Lo LM, Shaw SW, Wan GH. Influence of gestational hypertension and maternal air pollutant exposure on birth outcomes. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2024; 31:42264-42276. [PMID: 38865044 DOI: 10.1007/s11356-024-33944-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 06/04/2024] [Indexed: 06/13/2024]
Abstract
The relationship between exposure to air pollutants and fetal growth outcomes has shown inconsistency, and only a limited number of studies have explored the impact of air pollution on gestational hypertension and birth outcomes. This study aimed to evaluate how maternal exposure to air pollutants and blood pressure could influence fetal birth outcomes. A total of 55 women with gestational hypertension and 131 healthy pregnant women were enrolled in this study. Data pertaining to personal characteristics, prenatal examinations, outdoor air pollutant exposure, and fetal birth outcomes were collected. The study revealed that fetal birth weight and abdominal circumference exhibited a significant reduction among women with gestational hypertension compared to healthy pregnant women, even after adjustments for body mass index, gestational age, and exposure to air pollutants had been made. Moreover, maternal exposure to outdoor air pollutants displayed a notable correlation with decreased birth length of fetuses. Consequently, the study concluded that maternal blood pressure and exposure to outdoor air pollutants during pregnancy potentially stand as pivotal factors influencing fetal birth outcomes.
Collapse
Affiliation(s)
- Tai-Ho Hung
- Department of Obstetrics and Gynecology, Taipei Chang Gung Memorial Hospital, Taipei, Taiwan
- Department of Obstetrics and Gynecology, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan
- Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Te-Yao Hsu
- Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Jie Hsu
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chia-Yu Ou
- Department of Obstetrics, Po-Jen Hospital, Kaohsiung, Taiwan
| | - Pi-Hua Liu
- Clinical Informatics and Medical Statistics Research Center, Chang Gung University, Taoyuan, Taiwan
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Liang-Ming Lo
- Department of Obstetrics and Gynecology, Taipei Chang Gung Memorial Hospital, Taipei, Taiwan
| | - Steven W Shaw
- Department of Obstetrics and Gynecology, Taipei Chang Gung Memorial Hospital, Taipei, Taiwan
- Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Gwo-Hwa Wan
- Department of Obstetrics and Gynecology, Taipei Chang Gung Memorial Hospital, Taipei, Taiwan.
- Department of Respiratory Therapy, College of Medicine, Chang Gung University, 259, Wen-Hwa 1st Road, Kwei-Shan, Taoyuan, 333, Taiwan.
- Department of Respiratory Care, Chang Gung University of Science and Technology, Chiayi, Taiwan.
- Center for Environmental Sustainability and Human Health, Ming Chi University of Technology, Taishan, New Taipei, Taiwan.
| |
Collapse
|
2
|
Pavlidou E, Papadopoulou SK, Alexatou O, Tsourouflis G, Antasouras G, Louka A, Chatziprodromidou IP, Mentzelou M, Sampani A, Chrysafi M, Apostolou T, Dakanalis A, Papadopoulou VG, Giaginis C. Association of Gestational Hypertension with Sociodemographic and Anthropometric Factors, Perinatal Outcomes, Breastfeeding Practices, and Mediterranean Diet Adherence: A Cross-Sectional Study. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:2103. [PMID: 38138206 PMCID: PMC10744616 DOI: 10.3390/medicina59122103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 11/23/2023] [Accepted: 11/29/2023] [Indexed: 12/24/2023]
Abstract
Background and Objectives: Gestational hypertension has been associated with several pregnancy short-term and long-term complications, affecting both the mother and her infant's health. The present study aims to assess the potential association of gestational hypertension with sociodemographic and anthropometry factors, perinatal outcomes, breastfeeding habits, and Mediterranean diet (MD) compliance. Materials and Methods: This is a cross-sectional study conducted on 5271 mothers that was carried out after delivery. The anthropometry characteristics and perinatal outcomes were retrieved from the mothers' medical records. Sociodemographic characteristics, MD adherence, and breastfeeding habits were assessed via one-to-one interviews of the assigned women with qualified staff. Results: Maternal older age, being employed, family history of gestational hypertension, overweight/obesity before gestation, and abnormal gestational weight gain (GWG) independently increased the risk of developing gestational hypertension. Moreover, gestational hypertension was independently related with a greater incidence of abnormal childbirth body weight and preterm birth, not exclusively breastfeeding, and lower levels of MD adherence. Conclusions: This study highlights the importance of informing future mothers about the risk factors of gestational hypertension, underlining also that a healthy lifestyle, which simultaneously includes a healthy nutritional pattern such as MD, may decrease the risk of developing gestational hypertension and the subsequent pregnancy complications.
Collapse
Affiliation(s)
- Eleni Pavlidou
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Myrina, Lemnos, Greece; (E.P.); (O.A.); (G.A.); (A.L.); (M.M.); (M.C.)
| | - Sousana K. Papadopoulou
- Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece; (S.K.P.); (V.G.P.)
| | - Olga Alexatou
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Myrina, Lemnos, Greece; (E.P.); (O.A.); (G.A.); (A.L.); (M.M.); (M.C.)
| | - Gerasimos Tsourouflis
- Second Department of Propedeutic Surgery, Medical School, University of Athens, 11527 Athens, Greece;
| | - Georgios Antasouras
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Myrina, Lemnos, Greece; (E.P.); (O.A.); (G.A.); (A.L.); (M.M.); (M.C.)
| | - Aikaterini Louka
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Myrina, Lemnos, Greece; (E.P.); (O.A.); (G.A.); (A.L.); (M.M.); (M.C.)
| | | | - Maria Mentzelou
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Myrina, Lemnos, Greece; (E.P.); (O.A.); (G.A.); (A.L.); (M.M.); (M.C.)
| | - Anastasia Sampani
- First Department of Pathology, Medical School, University of Athens, 11527 Athens, Greece;
| | - Maria Chrysafi
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Myrina, Lemnos, Greece; (E.P.); (O.A.); (G.A.); (A.L.); (M.M.); (M.C.)
| | - Thomas Apostolou
- Department of Physiotherapy, Faculty of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece;
| | - Antonios Dakanalis
- School of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy;
- Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza, Italy
| | - Vasiliki G. Papadopoulou
- Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece; (S.K.P.); (V.G.P.)
| | - Constantinos Giaginis
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Myrina, Lemnos, Greece; (E.P.); (O.A.); (G.A.); (A.L.); (M.M.); (M.C.)
| |
Collapse
|
3
|
Nabil F, Gharib AA, Gadelrab NA, Osman HM. Preoperative lignocaine nebulisation for attenuation of the pressor response of laryngoscopy and tracheal intubation in patients with severe preeclampsia undergoing caesarean section delivery: A randomised double-blind controlled trial. Indian J Anaesth 2023; 67:515-522. [PMID: 37476442 PMCID: PMC10355362 DOI: 10.4103/ija.ija_898_22] [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: 11/06/2022] [Revised: 03/25/2023] [Accepted: 03/26/2023] [Indexed: 07/22/2023] Open
Abstract
Background and Aims Following induction of general anaesthesia, direct laryngoscopy and endotracheal intubation usually cause tachycardia and hypertension due to increased sympathetic activity. This response is generally exaggerated in hypertensive patients. This study aimed to evaluate the effectiveness of preoperative lignocaine nebulisation in attenuating the pressor response to laryngoscopy and endotracheal intubation in patients with severe preeclampsia undergoing caesarean delivery. Methods After ethical approval, we conducted this randomised, double-blind study, which included 110 patients with severe preeclampsia who underwent caesarean delivery under general anaesthesia. These patients were randomly allocated into two groups to receive either preoperative nebulisation of lignocaine 2% in a dose of 4.5 mg/kg (not exceeding 400 mg) in the lignocaine group or nebulisation of an equivalent volume of 0.9% NaCl in the saline group. The primary objective was the systolic blood pressure after tracheal intubation. The secondary objectives included heart rate, maternal serum cortisol and blood glucose levels, grade of cough during emergence, postoperative sore throat and hoarseness of voice, neonatal Apgar score and umbilical blood gas. Results The systolic blood pressure was significantly lower in the lignocaine group compared to the saline group at 1, 3 and 5 min after endotracheal intubation and after delivery of the foetus (P = 0.001, 0.003, 0.002 and 0.019, respectively). Similarly, the heart rate was significantly lower in the lignocaine group versus saline group at 1 and 3 min after endotracheal intubation (P = 0.041 and 0.042, respectively). Conclusion Preoperative lignocaine nebulisation in a dose of 4.5 mg/kg effectively attenuated the pressor response to laryngoscopy and endotracheal intubation in patients with severe preeclampsia undergoing caesarean delivery.
Collapse
Affiliation(s)
- Fatma Nabil
- Department of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Alaa Ahmed Gharib
- Department of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Nawal Abdelaziz Gadelrab
- Department of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Hany M. Osman
- Department of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine, Assiut University, Assiut, Egypt
| |
Collapse
|
4
|
Ueno K, Kojima J, Suzuki K, Kuwahara A, Higuchi Y, Tanaka A, Utsunomiya T, Mio Y, Nishi H, Yoshimura Y, Irahara M, Kuji N. Anthropometric measurements of term singletons at 6 years of age born from fresh and frozen embryo transfer: A multicenter prospective study in Japan. Reprod Med Biol 2023; 22:e12506. [PMID: 36789271 PMCID: PMC9909382 DOI: 10.1002/rmb2.12506] [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: 05/01/2022] [Revised: 12/07/2022] [Accepted: 01/18/2023] [Indexed: 02/11/2023] Open
Abstract
Purpose The purpose of this study is to compare anthropometric measurements between term singletons conceived via fresh embryo transfer (FreET) and frozen embryo transfer (FET) and those born via natural conception (NC) or fertility treatments milder than assisted reproductive technology (non-ART) at 6 years of age. Methods A total of 8149 children were enrolled, and questionnaires about anthropometric measures (weight, height, BMI) were addressed to parents, when the children were 1.5, 3, and 6 years of age. A total of 3299 term singletons were enrolled at birth: 533, 476, 916, and 1374 in the NC, non-ART, FreET, and FET groups, respectively. Results A total of 1635 term singletons (290, 176, 467, and 702 in the NC, non-ART, FreET, and FET groups respectively) were enrolled until 6 years of age (follow-up rate, approximately 50%). When non-ART group was used as control, the FreET children were 1.0 cm taller than the non-ART children at 6 years of age, after adjusting for confounding factors. However, no differences were observed in the anthropometric data among the non-ART, ART, and NC children at 6 years of age. Conclusion At 6 years of age, term singletons were taller in the FreET group than in the non-ART group, after adjusting for confounders.
Collapse
Affiliation(s)
- Keiko Ueno
- Department of Obstetrics and GynecologyTokyo Medical UniversityTokyoJapan
| | - Junya Kojima
- Department of Obstetrics and GynecologyTokyo Medical UniversityTokyoJapan
| | - Kohta Suzuki
- Department of Health and Psychosocial MedicineAichi Medical University School of MedicineNagakuteAichiJapan
| | - Akira Kuwahara
- Department of Obstetrics and Gynecology, Institute of Biomedical SciencesTokushima University Graduate SchoolTokushima‐shiTokushimaJapan
| | | | - Atsushi Tanaka
- Saint Mother Obstetrics and Gynecology Clinic and Institute for Assisted Reproductive TechnologiesKitakyushu‐shiFukuokaJapan
| | | | | | - Hirotaka Nishi
- Department of Obstetrics and GynecologyTokyo Medical UniversityTokyoJapan
| | - Yasunori Yoshimura
- Department of Obstetrics and GynecologyKeio University School of MedicineTokyoJapan
| | - Minoru Irahara
- Department of Obstetrics and Gynecology, Institute of Biomedical SciencesTokushima University Graduate SchoolTokushima‐shiTokushimaJapan
| | - Naoaki Kuji
- Department of Obstetrics and GynecologyTokyo Medical UniversityTokyoJapan
| |
Collapse
|
5
|
Yang W, Braun JM, Vuong AM, Percy Z, Xu Y, Xie C, Deka R, Calafat AM, Ospina M, Burris HH, Yolton K, Cecil KM, Lanphear BP, Chen A. Associations of gestational exposure to organophosphate esters with gestational age and neonatal anthropometric measures: The HOME study. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2023; 316:120516. [PMID: 36341822 PMCID: PMC9884151 DOI: 10.1016/j.envpol.2022.120516] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 10/19/2022] [Accepted: 10/21/2022] [Indexed: 06/16/2023]
Abstract
Organophosphate esters (OPEs) are developmental toxicants in experimental studies of animals, but limited evidence is available in humans. We included 340 mother-infant pairs in the Health Outcomes and Measures of the Environment (HOME) Study (Cincinnati, Ohio, USA) for the analysis. We evaluated gestational exposure to OPEs with gestation age at birth and newborn anthropometric measures. We quantified four OPE urinary metabolites at 16 weeks and 26 weeks of gestation. We extracted gestational age at birth, newborn weight, length, and head circumference from the chart review. We calculated z-scores for these anthropometric measures and the ponderal index. We used multiple informant models to examine the associations between repeated OPE measurements and the outcomes. We used modified Poisson regression to estimate the association of gestational exposure to OPEs with preterm birth. We also explored effect modification by infant sex and the potential mediation effect by the highest maternal blood pressure and glucose levels. We found that bis(2-chloroethyl) phosphate (BCEP) at 16 weeks and diphenyl phosphate at 26 weeks of pregnancy were positively associated with gestational age and inversely associated with preterm birth. In female newborns, BCEP at 16 weeks was inversely related to birth weight and length z-scores. In male newborns, we observed negative associations of 26-week di-n-butyl phosphate with the ponderal index at birth. No mediation by the highest maternal blood pressure or glucose levels during pregnancy was identified. In this cohort, gestational exposure to some OPEs was associated with gestational age, preterm birth, and neonatal anthropometric measures. Certain associations tended to be window- and infant sex-specific.
Collapse
Affiliation(s)
- Weili Yang
- Department of Environmental and Public Health Sciences, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
| | - Joseph M Braun
- Department of Epidemiology, Brown University, Providence, RI, USA
| | - Ann M Vuong
- Department of Epidemiology and Biostatistics, University of Nevada Las Vegas, Las Vegas, NV, USA
| | - Zana Percy
- Department of Environmental and Public Health Sciences, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Yingying Xu
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Changchun Xie
- Department of Environmental and Public Health Sciences, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Ranjan Deka
- Department of Environmental and Public Health Sciences, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Antonia M Calafat
- National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Maria Ospina
- National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Heather H Burris
- Division of Neonatology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA; Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Kimberly Yolton
- Department of Environmental and Public Health Sciences, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Kim M Cecil
- Department of Environmental and Public Health Sciences, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Department of Radiology, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Bruce P Lanphear
- Child and Family Research Institute, BC Children's Hospital, Vancouver, BC, Canada; Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Aimin Chen
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| |
Collapse
|
6
|
Asefa F, Cummins A, Dessie Y, Foureur M, Hayen A. Influence of gestational weight gain on baby's birth weight in Addis Ababa, Central Ethiopia: a follow-up study. BMJ Open 2022; 12:e055660. [PMID: 35701046 PMCID: PMC9198685 DOI: 10.1136/bmjopen-2021-055660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 06/01/2022] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Gestational weight gain (GWG) is an important indicator of fetal well-being during pregnancy. Inadequate or excessive GWG could have undesirable effects on birth weight. However, information regarding the influence of GWG on birth weight is lacking from the Ethiopian setting. OBJECTIVE This study aimed to determine the influence of GWG and other maternal-related factors on birth weight in Addis Ababa, Ethiopia. DESIGN AND METHODS A cohort of pregnant women who received the first antenatal care before or at 16 weeks of gestation in health centres in Addis Ababa were followed from 10 January 2019 to 25 September 2019. Data were collected using a structured questionnaire and medical record reviews. We conducted a multivariable linear regression analysis to determine the independent effect of gestational weight on birth weight. RESULTS Of the 395 women enrolled in the study, the participants' pregnancy outcome was available for 329 (83.3%). The mean birth weight was 3130 (SD, 509) g. The proportion of low birth weight (<2500 g) was 7.5% (95% CI 4.8% to 11.0%). Babies born to underweight women were 150.9 g (95% CI 5.8 to 308.6 g, p=0.049) lighter than babies born to normal-weight women. Similarly, babies whose mothers gained inadequate weight were 248 g (95% CI 112.8 to 383.6 g, p<0.001) lighter than those who gained adequate weight. Moreover, babies whose mothers had a previous history of abortion or miscarriages or developed gestational hypertension in the current pregnancy were 147.2 g (95% CI 3.2 to 291.3 g, p=0.045) and 310.7 g (95% CI 62.7 to 552.8 g, p=0.012) lighter, respectively, compared with those whose mothers had not. CONCLUSIONS Prepregnancy weight, GWG, having had a previous history of abortion or miscarriages, and developing gestational hypertension during a current pregnancy were independently associated with birth weight. Pregnancy-related weight management should be actively promoted through intensive counseling during routine antenatal care contacts.
Collapse
Affiliation(s)
- Fekede Asefa
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Oromia, Ethiopia
- Centre for Midwifery, Child and Family Health, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Allison Cummins
- Centre for Midwifery, Child and Family Health, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Yadeta Dessie
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Oromia, Ethiopia
| | - Maralyn Foureur
- Centre for Midwifery, Child and Family Health, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
- Hunter New England Health, Nursing and Midwifery Research Centre, University of Newcastle, Newcastle, NSW, Australia
| | - Andrew Hayen
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| |
Collapse
|
7
|
Prevalence and Factors Associated with Low Birth Weight and Preterm Delivery in the Ho Municipality of Ghana. ADVANCES IN PUBLIC HEALTH 2022. [DOI: 10.1155/2022/3955869] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Background. Low birth weight and preterm delivery are birth outcomes that can predict newborns’ survival, development, and long-term health outcomes. This study assessed the prevalence and factors associated with low birth weight and preterm delivery in the Ho Municipality of Ghana. Methods. This retrospective, cross-sectional study analysed data from 680 birth records between October and December 2018. Univariate and multivariate logistic regression models predicted low birth weight and preterm delivery factors. Results. The prevalence of low birth weight and preterm delivery was 12.9% and 14.1%, respectively. Increasing maternal age (AOR: 0.52; 95% CI: 0.28–0.98), multiparity (AOR: 0.54; 95% CI: 0.30–0.94) and increasing doses of sulphadoxine-pyrimethamine (AOR: 0.43; 95% CI: 0.22–0.84) significantly reduced the odds of low birth weight. However, caesarean section (AOR: 1.94; 95% CI: 0.1.16–3.27) and hypertension (AOR: 2.06; 95% CI: 1.27–03.33) significantly increased the likelihood of low birth weight. An increasing number of antenatal care visits (AOR: 0.38; 95% CI: 0.18–0.80) and doses of sulphadoxine-pyrimethamine (AOR: 0.43; 95% CI: 0.19–0.97) were significantly associated with decreased odds of preterm delivery, while caesarean section increased the odds of preterm delivery by two folds (AOR: 2.14; 95% CI: 1.15–3.99). Conclusion. This study shows that maternal age, parity, number of antenatal care visits, hypertension, SP/IPTp, and caesarean section were independently associated with low birth weight and preterm delivery. Education and interventions should be prioritised as vitally important on these factors to reduce the risk and complications associated with these birth outcomes.
Collapse
|
8
|
Wu W, Zhang B, Li D, Yan M, Deng Q, Kang Y, Du J, Gao X, Yan H. Development and validation of nomogram for prediction of low birth weight: a large-scale cross-sectional study in northwest China. J Matern Fetal Neonatal Med 2021; 35:7562-7570. [PMID: 34304668 DOI: 10.1080/14767058.2021.1956457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Birth weight is closely related to infant survival and future health, growth and development. In developing countries, the incidence of low birth weight is twice as high as in developed countries. Due to the low economic and medical level in northwest China, the problem of low birth weight needs to be solved urgently. METHODS We developed the predictive model based on data sets from a cross-sectional study conducted in northwest China, and data were collected from August 2013 to November 2013. A total of 27,233 patients were included in the study. Least Absolute Shrinkage and Selection Operator (LASSO) regression was used to select the optimal predictive characteristics among risk factors. The selected characteristics in the LASSO regression were used in multivariate logistic regression to build the prediction model. C-index and calibration plot were used to evaluate the degree of discrimination and calibration of the model. The decision curve is used to evaluate the net benefit rate of the application of the predictive tool. Bootstrapping validation was used for internal validation. RESULTS Nomogram included gestational age, the sex of the attendance, the mother's education level, antenatal care, the mother's occupation, pregnancy-induced hypertension, family income, exposure to pesticides and nutritional supplements. The C-index of the predicted nomogram was 0.698(95% confidence interval: 0.671-0.725), C-index of internal verification was 0.694, indicating that the model had a good identification ability. Calibration plot showed that the model had good calibration. Decision curve indicated that patients with a threshold probability of low birth weight between 1% and 71% would benefit more from using the prediction tool. CONCLUSION The use of this predictive model will contribute to clinicians and pregnant women to make personalized predictions easily and quickly so that early lifestyle detection and medical intervention can be undertaken by physicians and patients.
Collapse
Affiliation(s)
- Wentao Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Binyan Zhang
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Daning Li
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Miaojia Yan
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Qiwei Deng
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Yijun Kang
- Department of Epidemiology and Health Statistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Jiaoyang Du
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Xiangyu Gao
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Hong Yan
- Department of Epidemiology and Health Statistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China
| |
Collapse
|
9
|
Czubilińska-Łada J, Gliwińska A, Świȩtochowska E, Nowak-Borzȩcka L, Sadownik B, Behrendt J, Szczepańska M. The influence of gestational hypertension on cord blood adiponectin levels: a case-controlled study. Ther Adv Endocrinol Metab 2021; 12:20420188211058582. [PMID: 35154636 PMCID: PMC8832286 DOI: 10.1177/20420188211058582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 10/19/2021] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Gestational hypertension is one of the most common complications of pregnancy and childbirth worldwide and may be associated with metabolic disorders. Adiponectin is an adipocyte-specific plasma protein with insulin-sensitizing, vascular-protective, anti-inflammatory properties, and its role in metabolic disorders in prenatal and postnatal development in neonates remains unclear. The primary purpose of this study was to determine whether gestational hypertension is a condition lowering cord blood adiponectin level. Next, we have evaluated whether cord blood adiponectin level correlates with selected anthropometric parameters in neonates. MATERIAL AND METHODS The case-control study included 89 newborns divided into two groups: 30 neonates in the study group whose mothers were diagnosed with gestational hypertension and 59 healthy neonates born from normotensive pregnancies. Adiponectin determinations were performed in both groups, and neonatal anthropometric measurements and perinatal data were collected. RESULTS There was no statistically significant difference (p = 0.27) between adiponectin concentration in cord blood of newborns from the study group [median (Q1-Q3) 9.86 μg/ml (8.16-13.26 μg/ml)] compared with the control group [median (Q1-Q3) 10.65 μg/ml (8.69-14.29 μg/ml)]. No statistically significant correlations were observed between adiponectin level and gestational age, body weight, body length, and chest circumference. A significant correlation was observed between adiponectin level and head circumference among newborns in the control group and among the entire population of newborns included in the study. CONCLUSION No significant influence of gestational hypertension on cord blood adiponectin levels or their correlation with neonatal anthropometric measurements was observed.
Collapse
Affiliation(s)
| | - Aleksandra Gliwińska
- Department of Paediatric Nephrology with
Dialysis Division for Children, Independent Public Clinical Hospital No. 1,
Zabrze, Poland
| | - Elżbieta Świȩtochowska
- Department of Medical and Molecular Biology,
Faculty of Medical Sciences in Zabrze, Medical University of Silesia in
Katowice, Katowice, Poland
| | | | - Beata Sadownik
- Department of Neonatology, Multi-Specialist
Hospital, Gliwice, Poland
| | - Jakub Behrendt
- Department of Neonatology Intensive Care,
Faculty of Medical Sciences in Zabrze, Medical University of Silesia in
Katowice, Katowice, Poland
| | - Maria Szczepańska
- Department of Paediatrics, Faculty of Medical
Sciences in Zabrze, Medical University of Silesia in Katowice, Katowice,
Poland
| |
Collapse
|
10
|
Yoon SW, Choi GJ, Seong HK, Lee MJ, Kang H. Pharmacological strategies to prevent haemodynamic changes after intubation in parturient women with hypertensive disorders of pregnancy: A network meta-analysis. Int J Med Sci 2021; 18:1039-1050. [PMID: 33456362 PMCID: PMC7807187 DOI: 10.7150/ijms.54002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 12/22/2020] [Indexed: 01/14/2023] Open
Abstract
Objective : This network meta-analysis (NMA) aimed to determine the relative efficacy and safety of pharmacological strategies used to mitigate haemodynamic instability by intubation for general anaesthesia in hypertensive parturient women undergoing caesarean section. Methods : We considered randomised controlled studies comparing the effects of pharmacological strategies used to alleviate haemodynamic instability during intubation in parturient women with hypertensive disorders of pregnancy. The primary endpoints were maximum blood pressure and heart rate after intubation, and secondary endpoints were the Apgar scores at 1 and 5 min. NMA allowed us to combine direct and indirect comparisons between strategies. Results : Twelve studies evaluating nine pharmacological strategies in 619 patients were included. According to the surface under the cumulative ranking curve, the maximal mean arterial pressure was lowest for high-dose remifentanil (99.4%) followed by nitroglycerin (73.6%) and labetalol (60.9%). The maximal heart rate was lowest for labetalol (99.9%) followed by high dose of remifentanil (81.2%) and fentanyl (61.6%). Apgar score at 1 min was higher with low-dose than with high-dose remifentanil (mean difference, 0.726; 95% confidence interval, 0.056 to 1.396; I2=0.0%). Conclusions : High-dose remifentanil produces minimum blood pressure changes, while labetalol is most effective in maintaining normal heart rate in parturient women with hypertensive disorders of pregnancy during caesarean section under general anaesthesia.
Collapse
Affiliation(s)
- Sang Won Yoon
- Department of Anaesthesiology and Pain Medicine, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Geun Joo Choi
- Department of Anaesthesiology and Pain Medicine, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Hee-Kyeong Seong
- Department of Anaesthesiology and Pain Medicine, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Myeong Jong Lee
- Department of Anaesthesiology and Pain Medicine, Konkuk University Medical School, Chungju, Republic of Korea
| | - Hyun Kang
- Department of Anaesthesiology and Pain Medicine, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| |
Collapse
|
11
|
Maternal exposure to low-to-medium altitude and birth outcomes: evidence from a population-based study in Chinese newborns. J Dev Orig Health Dis 2020; 12:443-451. [PMID: 32662389 DOI: 10.1017/s204017442000063x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Despite high altitude was implicated in adverse birth outcomes, there remained a paucity of evidence on low-to-medium altitude effect. This study aimed to explore the association of low-to-medium altitude with birth outcomes. A population-based cross-sectional survey was performed using a stratified multistage random sampling method among women with their infants born during 2010-2013 in Northwestern China. Altitude was determined in meters based on the village or community of the mother's living areas. Birth outcomes involved birth weight, gestational age, and small for gestational age (SGA). Generalized linear models were fitted to investigate the association of altitude with birth outcomes. Moreover, the dose-response relationship between altitude and birth outcomes was evaluated with a restricted cubic spline function. A total of 27 801 women with their infants were included. After adjusting for potential confounders, every 100-m increase in the altitude was associated with reduced birth weight by 6.4 (95% CI -8.1, -4.6) g, the slight increase of gestational age by 0.015 (95% CI 0.010, 0.020) week, and an increased risk of SGA birth (odds ratio 1.03, 95% CI 1.02, 1.04). Moreover, there was an inversely linear relationship between altitude and birth weight (P for overall < 0.001 and P for nonlinear = 0.312), and a positive linear relationship between altitude and SGA (P for overall < 0.001 and P for nonlinear = 0.194). However, a nonlinear relationship was observed between altitude and gestational age (P for overall < 0.001 and P for nonlinear = 0.010). The present results suggest that low-to-medium altitude is possibly associated with adverse birth outcomes.
Collapse
|
12
|
Hu J, Li Y, Zhang B, Zheng T, Li J, Peng Y, Zhou A, Buka SL, Liu S, Zhang Y, Shi K, Xia W, Rexrode KM, Xu S. Impact of the 2017 ACC/AHA Guideline for High Blood Pressure on Evaluating Gestational Hypertension–Associated Risks for Newborns and Mothers. Circ Res 2019; 125:184-194. [DOI: 10.1161/circresaha.119.314682] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Rationale:
In 2017, the American College of Cardiology (ACC)/American Heart Association (AHA) released a new hypertension guideline for nonpregnant adults, using lower blood pressure values to identify hypertension. However, the impact of this new guideline on the diagnosis of gestational hypertension and the associated maternal and neonatal risks are unknown.
Objective:
To estimate the impact of adopting the 2017 ACC/AHA guideline on detecting gestational blood pressure elevations and the relationship with maternal and neonatal risk in the perinatal period using a retrospective cohort design.
Methods and Results:
This study included 16 345 women from China. Systolic and diastolic blood pressures of each woman were measured at up to 22 prenatal care visits across different stages of pregnancy. Logistic and linear regressions were used to estimate associations of blood pressure categories with the risk of preterm delivery, early-term delivery, and small for gestational age, and indicators of maternal liver, renal, and coagulation functions during pregnancy. We identified 4100 (25.1%) women with gestational hypertension using the 2017 ACC/AHA guideline, compared with 4.2% using the former definition. Gestational hypertension, but not elevated blood pressure (subclinical blood pressure elevation), was significantly associated with altered indicators of liver, renal, and coagulation functions during pregnancy for mothers and increased risk of adverse birth outcomes for newborns; adjusted odds ratios (95% CIs) for gestational hypertension stage 2 were 2.23 (1.18–4.24) for preterm delivery, 2.05 (1.67–2.53) for early-term delivery, and 1.43 (1.13–1.81) for small for gestational age.
Conclusions:
Adopting the 2017 ACC/AHA guideline would result in a substantial increase in the prevalence of gestational hypertension; subclinical blood pressure elevations during late pregnancy were not associated with increased maternal and neonatal risk in this cohort. Therefore, the 2017 ACC/AHA guideline may improve the detection of high blood pressure during pregnancy and the efforts to reduce maternal and neonatal risk. Replications in other populations are required.
Collapse
Affiliation(s)
- Jie Hu
- From the Key Laboratory of Environment and Health (HUST), Ministry of Education and Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China (J.H., Y.L., J.L., Y.P., W.X., S.X.)
- Department of Epidemiology, Brown University School of Public Health, Providence, RI (J.H., T.Z., S.L.B., S.L., K.S.)
- Division of Women’s Health, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA (J.H., K.M.R.)
| | - Yuanyuan Li
- From the Key Laboratory of Environment and Health (HUST), Ministry of Education and Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China (J.H., Y.L., J.L., Y.P., W.X., S.X.)
| | - Bin Zhang
- Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China (B.Z., A.Z., Y.Z.)
| | - Tongzhang Zheng
- Department of Epidemiology, Brown University School of Public Health, Providence, RI (J.H., T.Z., S.L.B., S.L., K.S.)
| | - Jun Li
- From the Key Laboratory of Environment and Health (HUST), Ministry of Education and Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China (J.H., Y.L., J.L., Y.P., W.X., S.X.)
- Department of Nutrition (J.L.), Harvard T.H. Chan School of Public Health, Boston, MA
- Department of Epidemiology (J.L.), Harvard T.H. Chan School of Public Health, Boston, MA
| | - Yang Peng
- From the Key Laboratory of Environment and Health (HUST), Ministry of Education and Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China (J.H., Y.L., J.L., Y.P., W.X., S.X.)
| | - Aifen Zhou
- Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China (B.Z., A.Z., Y.Z.)
| | - Stephen L. Buka
- Department of Epidemiology, Brown University School of Public Health, Providence, RI (J.H., T.Z., S.L.B., S.L., K.S.)
| | - Simin Liu
- Department of Epidemiology, Brown University School of Public Health, Providence, RI (J.H., T.Z., S.L.B., S.L., K.S.)
- Division of Endocrinology, Department of Medicine, Warren Alpert Medical School of Brown University, Providence, RI (S.L.)
| | - Yiming Zhang
- Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China (B.Z., A.Z., Y.Z.)
| | - Kunchong Shi
- Department of Epidemiology, Brown University School of Public Health, Providence, RI (J.H., T.Z., S.L.B., S.L., K.S.)
| | - Wei Xia
- From the Key Laboratory of Environment and Health (HUST), Ministry of Education and Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China (J.H., Y.L., J.L., Y.P., W.X., S.X.)
| | - Kathryn M. Rexrode
- Division of Women’s Health, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA (J.H., K.M.R.)
| | - Shunqing Xu
- From the Key Laboratory of Environment and Health (HUST), Ministry of Education and Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China (J.H., Y.L., J.L., Y.P., W.X., S.X.)
| |
Collapse
|
13
|
Singleton fetal growth kinetics depend on the mode of conception. Fertil Steril 2019; 110:1109-1117.e2. [PMID: 30396555 DOI: 10.1016/j.fertnstert.2018.06.030] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 05/25/2018] [Accepted: 06/20/2018] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To study the impact of in vitro fertilization, with or without intracytoplasmic sperm injection (IVF/ICSI), frozen-embryo transfer (FET), and intrauterine insemination (IUI) on fetal growth kinetics throughout pregnancy and to compare the different modes of conception. DESIGN Retrospective cohort study. SETTING University. PATIENT(S) A total of 560 singleton pregnancies were included (96 IVF, 210 ICSI, 121 FET, and 133 IUI). INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) We compared crown-rump length (CRL) at the first trimester (T1: 11-13 weeks of gestation [WG] + 6 days), estimated fetal weight (EFW) at the second (T2: 21-23 WG + 6 days) and third (T3: 31-33 WG + 6 days) trimesters, and birth weight (BW) z-scores with those in the reference curves (Papageorghiou for T1, and Ego M2 for T2, T3, and birth). Multivariate analyses were performed. RESULT(S) For T1, the CRL was longer than the reference curve whatever the assisted reproductive technique (ART). For T2, EFW was significantly greater for all groups compared with the reference curve, and for T3 only FET singletons had a greater EFW. ICSI, IVF, and IUI singletons had a significantly lower BW compared with reference curves. For all ART fetuses, growth kinetics differed from T2. Only FET fetuses maintained their significantly above-reference growth values. The proportion of fetuses for which at least one period of growth loss was observed from T2 to birth was higher after IVF, ICSI, and IUI than after FET. CONCLUSION(S) For the first time, we have highlighted that fetal growth kinetics differed from T2 depending on the ART protocols used. They could have an impact on trophoblastic invasiveness and might lead to long-term health effects.
Collapse
|