1
|
Agarwal R, Agrawal R. Exploring Risk Factors and Perinatal Outcomes of Preterm Birth in a Tertiary Care Hospital: A Comprehensive Analysis. Cureus 2024; 16:e53673. [PMID: 38455809 PMCID: PMC10918306 DOI: 10.7759/cureus.53673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/06/2024] [Indexed: 03/09/2024] Open
Abstract
Background Preterm birth before 37 weeks of gestation is a global public health challenge, particularly in India, where the prevalence varies regionally. Understanding risk factors, such as maternal age and complications like hypertensive disorders, is vital. India's diverse healthcare landscape and regional disparities further complicate this issue. Preterm infants face increased mortality and morbidity risks like respiratory distress and intraventricular hemorrhage. This study in a tertiary care hospital aimed to analyze risk factors, assess perinatal outcomes, and contribute to the understanding of preterm birth in this complex context, providing valuable insights for maternal and child health strategies. Methods This retrospective cohort study was conducted at the Venkateshwara Institute of Medical Science, Rajabpur, over one year, extracting data from electronic health records. The study aimed to analyze risk factors associated with preterm delivery and assess perinatal outcomes. The study included diverse pregnancies, both singleton and multiple gestations, and employed sample size calculations to ensure statistical validity. Trained medical personnel collected extensive data on maternal characteristics, obstetric history, antenatal care, perinatal outcomes, and mode of delivery. Statistical analysis, utilizing SPSS (IBM, Chicago, USA), involved descriptive statistics, comparative analysis, chi-square tests, t-tests, Mann-Whitney U tests, and multivariate logistic regression models. Findings with a p-value <0.05 were considered significant. Results The study included 2042 deliveries, with a preterm birth prevalence of 14.2%. Multiparous women had higher preterm birth rates than primigravida (72.92% vs. 27.08%). Maternal age, history of preterm delivery, hypertensive disorders, inadequate antenatal care compliance, previous cesarean section, multiple gestations, antepartum hemorrhage (APH), polyhydramnios, oligohydramnios, and premature rupture of membranes (PROM) were significantly associated with preterm birth. Apgar scores at one minute and five minutes, neonatal complications, and mortality rates were notably worse among preterm births. Vaginal delivery rates were significantly lower in the preterm group (36.3%) compared to full-term deliveries (48.8%), with a higher rate of emergency cesarean sections (19.7% vs. 10.8%). Conclusion This study provides valuable insights into the risk factors and perinatal outcomes of preterm delivery at a tertiary care hospital, with precise values illustrating the extent of associations. The findings such as history of preterm delivery, hypertensive disorders, and inadequate antenatal care compliance as the most commonly associated conditions with preterm birth and management of such associated conditions may help reduce the rate of premature birth.
Collapse
Affiliation(s)
- Ritika Agarwal
- Obstetrics and Gynaecology, Venkateshwara Institute of Medical Science, Gajraula, IND
| | - Rajni Agrawal
- Obstetrics and Gynaecology, Venkateshwara Institute of Medical Science, Gajraula, IND
| |
Collapse
|
2
|
Shazly SA, Ahmed IA, Radwan AA, Abd-Elkariem AY, El-Dien NB, Ragab EY, Abouzeid MH, Shams AH, Ali AK, Hemdan HN, Hemdan MN, Nassr AA, AbdelHafez FF, Eltaweel NA, Ghoniem K, El Saman AM, Ali MK, Thompson AC. Middle-East OBGYN Graduate Education (MOGGE) Foundation Practice Guidelines: Prelabor rupture of membranes; Practice guideline No. 01-O-19. J Glob Health 2021; 10:010325. [PMID: 32257148 PMCID: PMC7125938 DOI: 10.7189/jogh.10.010325] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Affiliation(s)
- Sherif A Shazly
- Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota, USA
| | - Islam A Ahmed
- Department of Obstetrics and Gynecology, Assiut School of Medicine, Assiut, Egypt
| | - Ahmad A Radwan
- Department of Obstetrics and Gynecology, Assiut School of Medicine, Assiut, Egypt
| | - Ahmed Y Abd-Elkariem
- Department of Obstetrics and Gynecology, Assiut School of Medicine, Assiut, Egypt
| | | | - Esraa Y Ragab
- Department of Obstetrics and Gynecology, Assiut School of Medicine, Assiut, Egypt
| | - Mostafa H Abouzeid
- Department of Obstetrics and Gynecology, Assiut School of Medicine, Assiut, Egypt
| | | | - Ahmed K Ali
- Department of Obstetrics and Gynecology, Assiut School of Medicine, Assiut, Egypt
| | - Heba N Hemdan
- Department of Obstetrics and Gynecology, Assiut School of Medicine, Assiut, Egypt
| | - Menna N Hemdan
- Department of Obstetrics and Gynecology, Assiut School of Medicine, Assiut, Egypt
| | - Ahmed A Nassr
- Department of Obstetrics & Gynecology, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas, USA
| | - Faten F AbdelHafez
- Department of Obstetrics and Gynecology, Assiut School of Medicine, Assiut, Egypt
| | | | - Khaled Ghoniem
- Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota, USA
| | - Ali M El Saman
- Department of Obstetrics and Gynecology, Assiut School of Medicine, Assiut, Egypt
| | - Mohamed K Ali
- Department of Obstetrics and Gynecology, Assiut School of Medicine, Assiut, Egypt
| | - Angela C Thompson
- Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota, USA
| | | |
Collapse
|
3
|
Kumar S, Hash CT, Thirunavukkarasu N, Singh G, Rajaram V, Rathore A, Senapathy S, Mahendrakar MD, Yadav RS, Srivastava RK. Mapping Quantitative Trait Loci Controlling High Iron and Zinc Content in Self and Open Pollinated Grains of Pearl Millet [ Pennisetum glaucum (L.) R. Br.]. FRONTIERS IN PLANT SCIENCE 2016; 7:1636. [PMID: 27933068 PMCID: PMC5120122 DOI: 10.3389/fpls.2016.01636] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Accepted: 10/17/2016] [Indexed: 05/05/2023]
Abstract
Pearl millet is a multipurpose grain/fodder crop of the semi-arid tropics, feeding many of the world's poorest and most undernourished people. Genetic variation among adapted pearl millet inbreds and hybrids suggests it will be possible to improve grain micronutrient concentrations by selective breeding. Using 305 loci, a linkage map was constructed to map QTLs for grain iron [Fe] and zinc [Zn] using replicated samples of 106 pearl millet RILs (F6) derived from ICMB 841-P3 × 863B-P2. The grains of the RIL population were evaluated for Fe and Zn content using atomic absorption spectrophotometer. Grain mineral concentrations ranged from 28.4 to 124.0 ppm for Fe and 28.7 to 119.8 ppm for Zn. Similarly, grain Fe and Zn in open pollinated seeds ranged between 22.4-77.4 and 21.9-73.7 ppm, respectively. Mapping with 305 (96 SSRs; 208 DArT) markers detected seven linkage groups covering 1749 cM (Haldane) with an average intermarker distance of 5.73 cM. On the basis of two environment phenotypic data, two co-localized QTLs for Fe and Zn content on linkage group (LG) 3 were identified by composite interval mapping (CIM). Fe QTL explained 19% phenotypic variation, whereas the Zn QTL explained 36% phenotypic variation. Likewise for open pollinated seeds, the QTL analysis led to the identification of two QTLs for grain Fe content on LG3 and 5, and two QTLs for grain Zn content on LG3 and 7. The total phenotypic variance for Fe and Zn QTLs in open pollinated seeds was 16 and 42%, respectively. Analysis of QTL × QTL and QTL × QTL × environment interactions indicated no major epistasis.
Collapse
Affiliation(s)
- Sushil Kumar
- Plant Biotechnology Centre, Swami Keshwanand Rajasthan Agricultural UniversityBikaner, India; International Crops Research Institute for the Semi-Arid TropicsPatancheru, India; Centre of Excellence in Agricultural Biotechnology, Anand Agricultural UniversityAnand, India
| | - Charles T Hash
- International Crops Research Institute for the Semi-Arid Tropics Niamey, Niger
| | | | - Govind Singh
- Plant Biotechnology Centre, Swami Keshwanand Rajasthan Agricultural University Bikaner, India
| | - Vengaldas Rajaram
- International Crops Research Institute for the Semi-Arid Tropics Patancheru, India
| | - Abhishek Rathore
- International Crops Research Institute for the Semi-Arid Tropics Patancheru, India
| | | | - Mahesh D Mahendrakar
- International Crops Research Institute for the Semi-Arid Tropics Patancheru, India
| | - Rattan S Yadav
- Crop Genetics, Genomics and Breeding Division, Aberystwyth University Aberystwyth, UK
| | - Rakesh K Srivastava
- International Crops Research Institute for the Semi-Arid Tropics Patancheru, India
| |
Collapse
|
4
|
Abstract
Confusion in terminology and non-standardized definitions can arguably be classified as the most important characteristics that lead to disparate study findings. While such situations abound in all of perinatal epidemiology, the study of "periviable birth" is a classic case in point. The most common term used to describe periviable birth has been extremely low birthweight (ELBW), often defined as newborns with birthweight below 1000g; yet, we identified 11 other descriptors for periviable birth. Due to the multitude of definitions, the reported incidence of periviable births varies from 0.03% to 1.9% (a relative difference of 7025%). Antecedent risk factors for periviable birth, though geographically heterogeneous, include nulliparity and multiple gestations, each accounting for one-third and one-fourth of all periviable births, respectively. Spontaneous preterm labor precedes 34% of these deliveries and premature rupture of membranes in 25%. The pregnancy was complicated by hypertensive disease in 21% and bleeding and chorioamnionitis in 18% each. Over 50% of these births are cesarean deliveries. Six clinical interventions before delivery that may improve outcomes include transfer of patient to a tertiary center, administration of antenatal corticosteroids, tocolytics, or antibiotics after premature rupture of membranes, assessment of fetal well-being with electronic fetal heart rate monitoring, and willingness to perform a cesarean delivery after the limit of viability is reached. While there is an accessible predictive model for mortality and long-term morbidities for newborns delivered at 22-25 weeks with weights of 400-1000g, it is hampered by the need to know the birthweight. In addition to reaching a consensus regarding what birthweight-gestational age thresholds determine a periviable birth, the acute need to optimize neonatal outcomes remains a paramount target worthy of future research, and efforts to advance obstetrical medicine are needed to minimize the likelihood of its occurrence.
Collapse
Affiliation(s)
- Suneet P Chauhan
- Department of Obstetrics and Gynecology, Eastern Virginia Medical School, 845 Fairfax Ave, Suite 544, Norfolk, VA 23507.
| | | |
Collapse
|
5
|
Mokuolu OA, Suleiman BM, Adesiyun OO, Adeniyi A. Prevalence and determinants of pre-term deliveries in the University of Ilorin Teaching Hospital, Ilorin, Nigeria. Pediatr Rep 2010; 2:e3. [PMID: 21589839 PMCID: PMC3094003 DOI: 10.4081/pr.2010.e3] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2009] [Revised: 02/01/2010] [Accepted: 02/04/2010] [Indexed: 11/23/2022] Open
Abstract
In Nigeria, over 900,000 children under the age of five years die every year. Early neonatal death is responsible for a little over 20% of these deaths. Prematurity remains a significant cause of these early neonatal deaths. In some series, it is reported to be responsible for 60-70% of these deaths. This study aimed to determine the prevalence and determinants of pre-term deliveries at the University of Ilorin Teaching Hospital, Ilorin. This was a prospective cohort study conducted over a 9-month period at the University of Ilorin Teaching Hospital. Records of deliveries and data on maternal socio-biological and antenatal variables were collected during this period in order to determine the prevalence and determinants of pre-term deliveries. Out of the 2,489 deliveries that took place over a 9-month period, there were 293 pre-terms, giving a pre-term delivery rate of 120 per 1,000 deliveries. Of the total deliveries, 1,522 singleton deliveries that satisfied inclusion criteria were recruited; 185 of them were pre-term deliveries giving a case:control ratio of 1:7. Significant determinants of pre-term delivery identified were previous pre-term delivery (P=0.001; OR=3.55; 95% CI=1.71-7.30), antepartum hemorrhage (P=0.000; OR=8.95; 95%CI=4.06-19.78), premature rupture of the membranes (P=0.000; OR=6.48; 95%CI=4.33-9.67), maternal urinary tract infection (P=0.006; OR=5.89; 95%CI=1.16-27.57), pregnancy induced hypertension (P=0.007; OR=3.23; 95%CI=2.09-4.99), type of labor (P=0.000; OR=6.44; 95%CI=4.42-9.38) and booking status (P=0.000; OR=4.67; 95%CI=3.33-6.56). The prevalence of pre-term delivery was 120 per 1,000 live births. Factors significantly associated with pre-term delivery were low socio-economic class, previous pre-term delivery, antepartum hemorrhage, premature rupture of fetal membranes, urinary tract infection, pregnancy induced hypertension, induced labor, and booking elsewhere outside the teaching hospital.
Collapse
Affiliation(s)
- Olugbenga A. Mokuolu
- Neonatal Intensive Care Unit, Department of Paediatrics, University of Ilorin Teaching Hospital, Ilorin, Nigeria
| | - BM Suleiman
- Department of Paediatrics, Federal Medical Centre, Katsina, Nigeria
| | - OO Adesiyun
- Neonatal Intensive Care Unit, Department of Paediatrics, University of Ilorin Teaching Hospital, Ilorin, Nigeria
| | - A Adeniyi
- Neonatal Intensive Care Unit, Department of Paediatrics, University of Ilorin Teaching Hospital, Ilorin, Nigeria
| |
Collapse
|