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Marti DT, Bratosin F, Rosca O, Folescu R, Citu C, Ratiu A, Popa ZL. Impact of Genital Infections and Antibiotic Use on Incidence of Preterm Birth: A Retrospective Observational Study. Antibiotics (Basel) 2024; 13:240. [PMID: 38534675 DOI: 10.3390/antibiotics13030240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 03/02/2024] [Accepted: 03/05/2024] [Indexed: 03/28/2024] Open
Abstract
This study investigates the complex interplay among genital infections, antibiotic usage, and preterm birth. This study aims to identify common genital pathogens associated with preterm births, assess the impact of various antibiotic treatments on pregnancy outcomes, and understand antibiotic resistance patterns among these pathogens. This study included 71 pregnant women who experienced preterm birth and 94 women with genital infections who delivered at term. Various maternal characteristics, medical history, signs and symptoms, gestational weight, gestational age, type of birth, vaginal pH, Nugent scores, and vaginal flora were analyzed. Antibiotic resistance patterns of isolated microorganisms were also examined. The prevalence of sexually transmitted diseases (STDs) and genital herpes was significantly higher in the preterm group. Preterm births were associated with fever, pelvic pain, vaginal spotting, and fatigue. Vaginal pH levels and Nugent scores were significantly higher in the preterm group, indicating disturbed vaginal flora. The presence of Extended-Spectrum Beta-Lactamases (ESBLs) was a particularly strong risk factor, increasing by more than four times the odds of preterm birth (OR = 4.45, p = 0.001). Vancomycin-Resistant Enterococci (VRE) presence was another critical factor, with a four-fold increase in the odds of preterm birth (OR = 4.01, p = 0.034). The overall presence of Multidrug-Resistant (MDR) organisms significantly increased the odds of preterm birth (OR = 3.73, p = 0.001). Specific pathogens like Chlamydia trachomatis (OR = 3.12, p = 0.020) and Mycoplasma hominis (OR = 3.64, p = 0.006) were also identified as significant risk factors. Ureaplasma urealyticum also showed a significantly higher risk of preterm birth (OR = 2.76, p = 0.009). This study highlights the importance of screening for and treating genital infections during pregnancy, especially STDs and genital herpes, as they can significantly increase the risk of preterm birth. Additionally, the presence of specific microorganisms and antibiotic resistance patterns plays an essential role in preterm birth risk. Early detection and targeted antibiotic treatment may help mitigate this risk and improve pregnancy outcomes.
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Affiliation(s)
- Daniela Teodora Marti
- Clinical Analysis Laboratory, Emergency Clinical Hospital of Arad County, 310037 Arad, Romania
- Department of Biology and Life Sciences, Vasile Goldis University of Medicine, 310048 Arad, Romania
| | - Felix Bratosin
- Department of Infectious Diseases, "Victor Babes" University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania
- Doctoral School, "Victor Babes" University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania
- Methodological and Infectious Diseases Research Center, Department of Infectious Diseases, "Victor Babes" University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania
| | - Ovidiu Rosca
- Department of Infectious Diseases, "Victor Babes" University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania
- Doctoral School, "Victor Babes" University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania
- Methodological and Infectious Diseases Research Center, Department of Infectious Diseases, "Victor Babes" University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania
| | - Roxana Folescu
- Department of Family Medicine, "Victor Babes" University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania
| | - Cosmin Citu
- Department of Obstetrics and Gynecology, "Victor Babes" University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania
| | - Adrian Ratiu
- Department of Obstetrics and Gynecology, "Victor Babes" University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania
| | - Zoran Laurentiu Popa
- Department of Obstetrics and Gynecology, "Victor Babes" University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania
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Elmaraghy AM, Shaaban SMA, Elsokkary MS, Elshazly ISMA. Uterocervical angle versus cervical length in the prediction of spontaneous preterm birth in women with history of spontaneous preterm birth: a prospective observational study. BMC Pregnancy Childbirth 2023; 23:658. [PMID: 37704977 PMCID: PMC10500866 DOI: 10.1186/s12884-023-05977-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 09/05/2023] [Indexed: 09/15/2023] Open
Abstract
BACKGROUND Preterm delivery is a leading cause of neonatal mortality and morbidity. History of spontaneous preterm birth is the greatest risk factor for another preterm delivery. So, every effort should be made to prevent the recurrence of preterm delivery in this vulnerable group. This study aimed to evaluate the predictive ability of the anterior uterocervical angle and cervical length in preterm birth. PATIENTS AND METHODS This was a prospective cohort study that included 70 patients with a history of spontaneous preterm birth. Ultrasound measurements of cervical length and anterior uterocervical angle were set to be measured for each patient at three visits; first between 16 0/7 and 24 0/7 weeks, second between 24 1/7 and 32 0/7 weeks, and the third was between 32 1/7 and 36 6/7 weeks. The correlation between both measures and the prediction of preterm birth among study participants was the primary outcome of the study. Neonatal outcome among the study patients was a secondary measure of outcome. RESULTS The incidence of preterm birth among study participants was 31.41%. Cervical length and uterocervical angle showed progressive decrease and increase respectively throughout pregnancy. At the 2nd visit, the two measures were significantly different between those who delivered at term and those with preterm delivery with the cervical length being significantly shorter in the preterm arm (3.0 ± 0.49 versus 3.38 ± 0.36, p < 0.001) and uterocervical angle being significantly bigger among the same arm (110.1 ± 18.48 versus 84.42 ± 12.24, p < 0.001). A uterocervical angle > 89.8° at the second visit predicted preterm birth with 81.8% sensitivity and 70.8% specificity while cervical length ≤ 3.22 cm at the second visit predicted preterm birth with 68.1% sensitivity and 62.5% specificity. Multivariant logistic regression analysis showed that uterocervical angle > 89.8° at the second visit increased the odds ratio for preterm birth by 9. CONCLUSION Uterocervical angle can be a useful ultrasound marker for the prediction of preterm birth among high risk patients. A cutoff value of 89.8° can be used as a threshold above which prophylactic measures such as cervical cerclage or progesterone therapy can be provided. TRIAL REGISTRATION NCT05632003 (First posted date: 30/11/2022).
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Affiliation(s)
- Ahmed Mohammed Elmaraghy
- Department of Obstetrics and Gynecology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
| | | | - Mohammed Salah Elsokkary
- Department of Obstetrics and Gynecology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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Fry-Hilderbrand K, Chen YP, Howard A. Automated assessment of infant motor development to predict infant age: The determination of objective metrics of spontaneous kicking. WEARABLE TECHNOLOGIES 2022; 3:e29. [PMID: 38486904 PMCID: PMC10936260 DOI: 10.1017/wtc.2022.25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 09/12/2022] [Accepted: 10/01/2022] [Indexed: 03/17/2024]
Abstract
Though early intervention can improve outcomes for children with motor disabilities, delays in diagnosis can impact the success of intervention programs. Prior work indicates that spontaneous kicking patterns can be used to model typical infant motor development to assist in the early detection of motor delays. However, abnormalities in spontaneous movements are not well defined or readily observable through traditional functional assessments. In this research, a method is introduced for the early detection of delays through the assessment of spontaneous kicking data gathered using a wearable sensing suit. We present formulations of kinematic features identified in the clinical space, identify which features are significant predictors of infant age, and establish normative values. Finally, we offer an analysis of preterm (PT) infant data compared to normative values derived from term infants. Term and PT infants ranging in age from 1 to 10 months were studied. We found that frequency, duration, acceleration, inter-joint coordination, and maximum joint excursion metrics had a significant correlation with age. From these features, models of typical kicking development were created using data from term, typically developing infants. When compared to normative trends, PT infants display differing developmental trends.
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Affiliation(s)
- Katelyn Fry-Hilderbrand
- Institute for Robotics and Intelligent Machines, Georgia Institute of Technology, 85 5th St. NW, Atlanta, GA30308, USA
| | - Yu-Ping Chen
- Department of Physical Therapy, Georgia State University, 140 Decatur St., Atlanta, GA30303, USA
| | - Ayanna Howard
- College of Engineering, The Ohio State University, 2070 Neil Ave., Columbus, OH43210, USA
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Omar AI, Mohamed AD, Farah MG, Mahad IA, Mohamed SA, Dimbil AH, Mohamud NS, Abshir FA, Abdulkadir UA. Maternal Risk Factors Associated with Preterm Births among Pregnant Women in Mogadishu, Somalia. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9101518. [PMID: 36291454 PMCID: PMC9600974 DOI: 10.3390/children9101518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 09/24/2022] [Accepted: 10/01/2022] [Indexed: 11/06/2022]
Abstract
Background: Premature birth impacts millions of newborns annually. Sixty percent of the world’s preterm births occur in Sub-Saharan Africa and South Asia. Somalia’s premature birth rates and maternal risk factors are poorly studied; hence, this study aims to identify maternal risk factors related to premature births in Mogadishu, Somalia. Methods: This unmatched case-control study was conducted at four maternity hospitals in Mogadishu, Somalia. The cases were newborns with gestational ages of less than 37 weeks; controls were newborns with gestational ages of 37 to 42 weeks. All were live singletons. Cross-tabulation and binary logistic regression were used to analyze the data; a p-value of 0.05 was deemed statistically significant. Result: Of the total of 499 newborns, 70 were cases, and 429 were controls. Adequate prenatal care, maternal urine analysis, tetanus toxoid (TT) vaccination, hemoglobin (Hb) measurement, ultrasound monitoring, intake of iron + folic acid (IFA) supplement, blood pressure (BP) measurement during the current pregnancy, as well as partograph usage during labor all significantly decreased risk of having premature births. A prior history of preterm delivery and preeclampsia, obstetric complications, and female genital mutilation (FGM) significantly increased the risk of preterm births. Conclusion: The utilization of antenatal care services, use of a partograph, obstetric complications, and prior history of premature birth and preeclampsia had a substantial effect on preterm birth rates. This study identifies female genital mutilation (FGM) as a previously unidentified risk factor for preterm birth that needs additional investigation.
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Affiliation(s)
- Abdifetah Ibrahim Omar
- Faculty of Medicine and Health Sciences, Jamhuriya University of Science and Technology, Mogadishu 2526, Somalia
- Advance Medical Research Unit, Jamhuriya Research Center, Jamhuriya University of Science and Technology, Mogadishu 2526, Somalia
- Correspondence: ; Tel.: +252-618684545
| | - Amina Dahir Mohamed
- Faculty of Medicine and Health Sciences, Jamhuriya University of Science and Technology, Mogadishu 2526, Somalia
| | - Mohamed Garad Farah
- Faculty of Medicine and Health Sciences, Jamhuriya University of Science and Technology, Mogadishu 2526, Somalia
| | - Ismail Abukar Mahad
- Faculty of Medicine and Health Sciences, Jamhuriya University of Science and Technology, Mogadishu 2526, Somalia
| | - Suban Abdullahi Mohamed
- Faculty of Medicine and Health Sciences, Jamhuriya University of Science and Technology, Mogadishu 2526, Somalia
| | - Abyan Hassan Dimbil
- Faculty of Medicine and Health Sciences, Jamhuriya University of Science and Technology, Mogadishu 2526, Somalia
| | - Nadifo Salad Mohamud
- Faculty of Medicine and Health Sciences, Jamhuriya University of Science and Technology, Mogadishu 2526, Somalia
| | - Fowziya Ahmed Abshir
- Faculty of Medicine and Health Sciences, Jamhuriya University of Science and Technology, Mogadishu 2526, Somalia
| | - Umayma Abdinasir Abdulkadir
- Faculty of Medicine and Health Sciences, Jamhuriya University of Science and Technology, Mogadishu 2526, Somalia
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Relationships between Maternal Gene Polymorphisms in One Carbon Metabolism and Adverse Pregnancy Outcomes: A Prospective Mother and Child Cohort Study in China. Nutrients 2022; 14:nu14102108. [PMID: 35631247 PMCID: PMC9146434 DOI: 10.3390/nu14102108] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 05/11/2022] [Accepted: 05/13/2022] [Indexed: 11/16/2022] Open
Abstract
Background: To investigate relationships between five single nucleotide polymorphisms (SNP) in four maternal genes involved in one carbon metabolism and adverse pregnancy outcomes, including preterm birth (PTB), low birth weight (LBW), and small-for-gestational-age (SGA). Methods: This was a prospective mother and child cohort study in Wuqiang, China. Pregnant women (n = 939) were recruited from Jun 2016 to Oct 2018. Pregnancy outcomes (PTB, LBW, and SGA) were extracted from medical records and other information including age at childbearing, maternal education level, gravidity, parity, pre-pregnancy weight and height was collected by using a structured questionnaire. The maternal serum folate concentration was measured by using Abbott Architect i2000SR chemiluminescence analyzer in the first prenatal care visit. DNA genotyping of methylenetetrahydrofolate reductase (MTHFR) C677T and A1298C, methionine synthase reductase (MTRR) A66G, methionine synthase (MTR) A2756G, and thymidylate synthetase (TYMS) rs3819102 was processed by Sequenom MassARRAY iPLEX Platform. Univariate and multivariate logistics regression analysis were used to test the relationships between 5 SNPs and PTB, LBW, SGA. Results: Totally, 849 dyads of women and infants were included in the analysis. The prevalence of PTD, LBW, and SGA were 3.76%, 1.58%, and 5.31% respectively. The homozygote frequencies of MTHFR C677T, MTHFR A1298C, MTRR A66G, MTR A2756G, and TYMS rs3819102 were 44.2%, 1.4%, 6.7%, 1.3%, and 3.2%, and the alt allele frequencies were 66.1%, 10.8%, 24.9%, 10.5%, and 20.5% respectively. The average serum folate concentration was 11.95 ng/mL and the folate deficiency rate was 0.47%. There were no significant associations between MTHFR C677T, MTHFR A1298C, MTRR A66G, MTR A2756G, TYMS rs3819102 alleles and PTD, LBW, SGA (p > 0.05). Conclusions: In the population with adequate folate status and low prevalence of adverse pregnancy outcomes, MTHFR C677T, MTHFR A1298C, MTRR A66G, MTR A2756G, TYMS rs3819102 alleles may not be related to PTD, LBW, and SGA.
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Jena BH, Biks GA, Gete YK, Gelaye KA. Effects of inter-pregnancy intervals on preterm birth, low birth weight and perinatal deaths in urban South Ethiopia: a prospective cohort study. Matern Health Neonatol Perinatol 2022; 8:3. [PMID: 35545779 PMCID: PMC9092840 DOI: 10.1186/s40748-022-00138-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 05/05/2022] [Indexed: 11/18/2022] Open
Abstract
Background Preterm birth, low birth weight and perinatal deaths are common adverse perinatal outcomes that are linked with each other, and a public health problems contributing to neonatal mortality, especially in developing countries. Although more than half of women in Ethiopia become pregnant within a short interval after the preceding childbirth, whether the short intervals increase the risk of adverse perinatal outcomes or not is understudied. We, therefore, aimed to assess the effects of inter-pregnancy intervals (IPIs) on the adverse perinatal outcomes. Methods A community-based prospective cohort study was conducted among 2578 pregnant women in urban South Ethiopia. Pregnant women with IPIs < 24 months (IPIs < 18 and 18–23 months) were exposed groups, and those with IPI 24–60 months were the unexposed group. A multilevel analysis (mixed-effects) was done to estimate the effect of IPIs on preterm birth and low birth weight, and a generalized linear model for a binary outcome (fixed-effect) was done for perinatal deaths, using a 95% confidence level. Results In this study, IPI < 18 months found to increase the risk of preterm birth (Adjusted Relative Risk (ARR) = 1.35, 95% CI: 1.02, 1.78), term low birth weight (ARR = 2.20, 95% CI: 1.35, 3.58) and perinatal deaths (ARR = 3.83, 95% CI: 1.90, 7.71) than 24–60 months. The results suggest that, about 9% of preterm birth, 21% of term low birth weight and 41% of perinatal deaths in the study population were attributed to IPI < 18 months. These could be prevented with the removal of the IPI < 18 months in the study population. IPI 18–23 months has shown no effect on the three adverse perinatal outcomes. Conclusion This study has shown that, IPI under 18 months has a higher risk of adverse perinatal outcomes than IPI 24–60 months. Due attention should still be given for spacing pregnancies. Supplementary Information The online version contains supplementary material available at 10.1186/s40748-022-00138-w.
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Affiliation(s)
- Belayneh Hamdela Jena
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia. .,Department of Public Health, College of Medicine and Health Sciences, Wachemo University, Hossana, Ethiopia.
| | - Gashaw Andargie Biks
- Department of Health System and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Yigzaw Kebede Gete
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Kassahun Alemu Gelaye
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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