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1.
María Ramírez Pineda José Luis Dueñas Díez Carlos Bedoya Bergua Juan Polo Padillo 《Progresos de Obstetricia y Ginecología》2009
Objective
To evaluate the usefulness of fetal fibronectin and cervical length in predicting preterm birth in women with preterm uterine contractions.Material and methods
A prospective study was conducted at the Virgen Macarena Hospital in Seville that included 153 pregnant women with suspected preterm labor and intact membranes. Cervical length was measured by transvaginal sonography and a rapid qualitative fibronectin test was performed in the emergency consultation. Women with a negative fibronectin test and cervical length ≥ 30 mm were not hospitalized or treated with tocolytics or corticosteroids.Results
The mean gestational age at diagnosis was 223,02 ± 19,98 days, and 267,52 ± 14,15 days at delivery. Preterm birth < 37 weeks rate was 23% and 7,4% for deliveries < 35 weeks. There is an association between cervical length < 30 mm and birth < 37 weeks (OR, 3,68; 95% CI, 1,53-8,84), and with delivery in the following 14 days (OR, 3,35; 95% CI, 1,30-21,95). With the association of both tests we gain specificity in predicting preterm birth.Conclusion
Cervical length is the test with higher specificity (E) and negative predictive value (VPN) for the prediction of preterm birth in women with symptomatic contractions. 相似文献2.
A. Moini M. Shiva A. Arabipoor R. Hosseini M. Chehrazi M. Sadeghi 《European journal of obstetrics, gynecology, and reproductive biology》2012
Objective
To compare the obstetric and neonatal outcomes of twin pregnancies conceived by assisted reproduction technology (ART) with spontaneously conceived (SC) twin pregnancies.Study design
A prospective cohort study compared all dichorionic twin pregnancies in nulliparous women following fresh in vitro fertilization/intra-cytoplasmic sperm injection (ICSI) or ICSI cycles at Royan Institute (n = 320) with SC dichorionic twin pregnancies in nulliparous women at Arash Women's hospital (n = 170) from January 2008 to October 2010. These pregnancies were followed-up until hospital discharge following delivery. Obstetric and neonatal outcomes of SC and ART twin pregnancies were compared.Results
Multivariate analysis, adjusted for maternal age and body mass index, revealed that the obstetric outcomes were similar in both groups. However, the risks of very preterm birth [odds ratio (OR) 5.2, 95% confidence interval (CI) 2.1–12.9], extremely low birth weight (OR 2.2, 95% CI 1.0–3.9), admission to a neonatal intensive care unit (OR 2.0, 95% CI 1.2–3.2) and perinatal mortality (OR 2.3, 95% CI 1.2–4.0) were higher in the ART group.Conclusions
The maternal outcomes of ART dichorionic twins were comparable with those of SC twins. However, despite the same obstetric management, the rates of very preterm birth, extremely low birth weight, admission to a neonatal intensive care unit and perinatal mortality were significantly higher in the ART group. 相似文献3.
Xi-Kuan Chen Shi Wu Wen Lu-Ming Sun Qiuying Yang Mark C. Walker Daniel Krewski 《European journal of obstetrics, gynecology, and reproductive biology》2009
Objective
To examine the possible association between oral contraceptive use and adverse birth outcomes.Study design
We conducted a population-based cohort study of pregnant women who used oral contraceptives within 3 months before their last menstrual period. Subjects were divided into three groups, according to the interval (0–30, 31–60, and 61–90 days) between the dispensing date and their last menstrual period. For each exposed subject, 4 subjects without exposure to oral contraceptives were individually matched by infant's year of birth and plurality and by mother's age and parity.Results
Oral contraceptive use within 30 days prior to the last menstrual period was associated with increased risks of very low birth weight (OR: 3.24, 95% CI: 1.18, 8.92), low birth weight (OR: 1.93, 95% CI: 1.17, 3.20), and preterm birth (OR: 1.61, 95% CI: 1.01, 2.55); however, oral contraceptive use 31–90 days prior to the last menstrual period did not increase the risk of low birth weight or preterm birth.Conclusion
Our results indicate the use of oral contraceptives near the time of conception may be associated with an increased risk of low birth weight and preterm birth. 相似文献4.
Andreas Herbst Karin Källén 《European journal of obstetrics, gynecology, and reproductive biology》2007
Objective
To study the association between mode of delivery and neonatal outcome in singleton pregnancy with breech presentation and preterm birth, due to premature labour (PTL) and/or preterm premature rupture of the membranes (pPROM).Design and methods
Information on preterm (gestational week 25–36) singleton births in breech presentation in Sweden during 1990–2002 was obtained from the Swedish Medical Birth Registry and the Swedish Hospital Discharge Registry. The study groups included 1975 caesarean and 699 vaginal deliveries with a diagnosis of PTL or pPROM, without pregnancy complications implying a high risk of fetal compromise. The rates of infant respiratory distress syndrome (IRDS), intraventricular haemorrhage (IVH), low Apgar scores, and neonatal deaths were compared between infants delivered vaginally and by caesarean section. Odds ratios were calculated with adjustment for gestational age, year of birth, maternal age and parity.Results
The risk of neonatal death and the risk of an Apgar score below 5 min postnatally were both lower after caesarean delivery (OR 0.4; 95% CI 0.2–0.7, and OR 0.4; 95% CI 0.3–0.7, respectively), whereas the risk of IRDS was increased (OR 2.1; 95% CI 1.4–3.2). A diagnosis of IRDS was not associated with mortality (OR 0.8; 95% CI 0.5–1.5). IVH was not associated with mode of delivery (OR 1.2; 95% CI 0.5–2.8).Conclusion
The lower neonatal mortality after CS supports a policy of caesarean delivery of the preterm breech. 相似文献5.
Qiongjie Zhou Weiyuan Zhang Huan Xu Huan Liang Yan Ruan Shufeng Zhou Xiaotian Li 《International journal of gynaecology and obstetrics》2014
Objective
To investigate the prevalence of preterm premature rupture of membranes (PPROM) in urban areas in China and examine the associated risk factors.Methods
A population-based, prospective study was undertaken in 14 cities in China between January 1, 2011, and January 31, 2012. Women were recruited at their first prenatal-care visit, when maternal characteristics were recorded. Risk factors were analyzed by one-way analysis of variance.Results
Of 112 439 women included in analyses, 3077 (2.7%) had PPROM. Univariate analysis showed an increased risk of PPROM before 28 weeks of pregnancy in migrant women (odds ratio [OR] 2.25; 95% confidence interval [CI] 1.53–3.30; P < 0.001), in those with a history of recurrent induced abortions (OR 2.75; 95% CI 1.66–4.56; P < 0.001), and in those with a history of preterm birth (OR 3.90; 95% CI 0.77–19.61; P < 0.001). The associations were maintained in multivariate analysis (P < 0.001).Conclusion
Migration as a result of urbanization, high rates of induced abortion, and preterm birth are potential risk factors for PPROM in Chinese women. 相似文献6.
Brettell R Yeh PS Impey LW 《European journal of obstetrics, gynecology, and reproductive biology》2008,141(2):123-126
Objective
To examine possible reasons why a male fetus constitutes a risk factor for preterm delivery.Study design
Retrospective study of deliveries from hospital database in a UK teaching hospital. The population comprised all deliveries >23 weeks over an 11-year period, excluding multiples, terminations and pregnancies with major abnormalities including indeterminate gender. Obstetric variables and outcomes were initially compared in male and female babies for preterm births in different gestation bands, extreme (<28 weeks), severe (29–32 weeks) and moderate (33–36 weeks). For each, the odds ratios with 95% confidence intervals for preterm delivery were calculated. Then, using binary logistic regression with adjusted odds ratios with 95% confidence intervals, putative causal pathways that might explain the male excess were tested.Results
75,725 deliveries occurred, of which 4003 (5.3%) were preterm. Males delivered preterm more frequently (OR 1.13, 95% CI 1.06–1.20). This was due to spontaneous (OR 1.30, 95% CI 1.19–1.42) but not iatrogenic (OR 0.96, 95% CI 0.87–1.05) preterm birth. There was an increased risk of pre eclampsia among preterm females. Although males were larger, and male pregnancies were more frequently nulliparous and affected by some other obstetric complications (abruption, urinary tract infection), these did not account for their increased risk. Any effect of growth restriction could not be properly determined.Conclusions
Being male carries an increased risk of spontaneous but not iatrogenic preterm birth. The reasons behind this remain obscure. 相似文献7.
Eleanor R. Love Jacqueline Crum Sohinee Bhattacharya 《European journal of obstetrics, gynecology, and reproductive biology》2012
Objective
To assess whether maternal hypertension in pregnancy was independently associated with additional support needs in children.Study design
Retrospective cohort study using linkage of birth records of all singleton deliveries occurring in primigravidae between 1995 and 2008 in Aberdeen Maternity and Neonatal Databank with the Support Needs System (SNS) dataset in Grampian. Crude and adjusted odds ratios with 95% confidence intervals of having a record in SNS in the presence of maternal pregnancy induced hypertension were calculated using logistic regression taking account of confounders such as preterm birth and low birth weight.Results
After adjusting for confounding factors, neither pre-eclampsia {Adj OR 0.80 (95% CI 0.60, 1.07)} nor gestational hypertension {Adj OR 1.16 (95% CI 0.99, 1.36)} showed statistically significant associations with additional support needs. An association of pre-eclampsia with cerebral palsy seen on univariate analysis also disappeared on adjusting for confounders {Adj OR 1.26 (95% CI 0.43, 3.68)}. Birth before 32 weeks gestation and birthweight below 1500 g were independently associated with additional support needs in children.Conclusions
While maternal hypertension was not found to be independently associated with special needs in children, very preterm birth and very low birthweight showed an association. 相似文献8.
Krishna Deepti Mogili Hepsy Y. Selliah Achamma Chandy Aleyamma T. Kunjummen Mohan S. Kamath 《Middle East Fertility Society Journal》2018,23(2):93-97
Objective
The purpose of this study was to evaluate whether poor responder women have adverse perinatal outcomes compared to normo responders following assisted reproductive technology (ART).Methods
A retrospective cohort study was conducted in a university level infertility unit between January 2010 to December 2015. Women undergoing fresh IVF cycles were included. Poor responders (≤3 oocytes) and normo responders (4–15 oocytes) were analyzed. Perinatal outcomes such as preterm birth (PTB), low birth weight (LBW), early preterm birth (early PTB) and very low birth weight (very LBW) were recorded.Results
A total of 1386 ART cycles were analyzed. Final analysis included 40 and 318 live births in poor and normo responders respectively. The risk of PTB (30.3% vs. 24.8%; OR 1.32, 95% CI: 0.59–2.9), LBW (33.3% vs. 20.1%; OR 1.99, 95% CI 0.90–4.4), early PTB (3% vs. 2.2%; OR 1.40, 95% CI 0.16–12.4) and very LBW (3% vs. 1.8%: OR 1.72, 95% CI 0.19–15.9) were not significantly different between poor and normo responders. The subgroup analysis within poor responders did not show any significant difference in perinatal outcomes in women aged less and more than 35 years.Conclusion
The current study findings suggest no increased risk of adverse perinatal outcomes in poor responders compared to normo responders following ART. These findings need to be further validated by larger studies. 相似文献9.
Objective
To determine how threatened preterm labor is treated in Spanish hospitals.Material and method
Under the aegis of the Spanish Society of Obstetrics and Gynecology, an Internet questionnaire on basic aspects of the treatment of threatened preterm labor was sent to 41 Spanish hospitals (37 public and four private hospitals).Results
All hospitals use tocolysis in threatened preterm labor before 34th weeks. The most widely used tocolytic agent is atosiban (73,7%), followed by betamimetics (21.9%) and nifedipine (4.9%). Only 7.3% of the hospitals use tocolytics in threatened preterm labor after 34 weeks. All the hospitals use corticosteroids to accelerate lung maturation: 92.7% use betamethasone and 7.3% prefer dexamethasone. In 90% of the hospitals, steroid therapy is not repeated. In multiple pregnancies, the same steroid dose as that used in single pregnancies is administrated in all centers.Conclusions
The most widely used tocolytic agent in Spanish hospitals is atosiban and the preferred corticosteroid is betamethasone. 相似文献10.
Carlos Lozada Nimet CanerLaia Otón Johanna ParraEdda Marimón María Dolores Gómez Roig 《Progresos de Obstetricia y Ginecología》2012
Objective
To determine the rate of preterm births in 2010 at the Sant Joan de Déu University Hospital in Barcelona, and classify them according to the main cause by using a mapping algorithm to establish the main etiological causes of preterm birth.Subjects and methods
All preterm births at less than 37 weeks’ gestation occurring in the Sant Joan de Déu University Hospital in 2010 (n = 396) were reviewed and assigned to a group according to their primary etiology.Results
The preterm birth rate was 9.8%. Inflammatory causes accounted for 36% of all preterm births followed by idiopathic causes (29%). In preterm deliveries of multiple gestations, inflammatory causes accounted for 44%.Conclusions
Inflammatory causes are the main etiology of preterm births and are more common in multiple gestations. 相似文献11.
Tai-Ho Hung T’sang-T’ang Hsieh Liang-Ming Lo Tsung-Hung Chiu Ching-Chang Hsieh Jenn-Jeih Hsu 《International journal of gynaecology and obstetrics》2013
Objective
To determine risk factors and perinatal outcomes associated with small for gestational age (SGA) neonates among healthy pregnant women.Methods
A retrospective cohort study was conducted of 49 945 women who gave birth at Chang Gung Memorial Hospital, Taipei, Taiwan, after 24 weeks of pregnancy. Idiopathic SGA newborns (n = 3398) were characterized by a birth weight below the 10th percentile for mean weight corrected for GA and fetal sex.Results
Risk factors for idiopathic SGA newborns included hypercoiling of the umbilical cord (adjusted odds ratio [aOR], 3.3; 95% confidence interval [CI], 1.6–7.0); prior fetal death (aOR, 2.8; 95% CI, 2.0–3.9); primiparity (aOR, 1.5; 95% CI, 1.4–1.7); adolescent pregnancy (aOR, 1.5; 95% CI, 1.2–2.0), low prepregnancy weight (aOR, 1.6; 95% CI, 1.5–1.8), low prepregnancy body mass index (aOR, 1.1; 95% CI, 1.0–1.3); short stature (aOR, 1.3; 95% CI, 1.1–1.4); and entangled umbilical cord (aOR, 1.1; 95% CI, 1.0–1.3). Idiopathic SGA newborns correlated with increased risk of adverse perinatal outcomes, including fetal death, low Apgar scores, oligohydramnios, placental abruption, and admission to the neonatal intensive care unit.Conclusion
Some risk factors for idiopathic SGA newborns were modifiable, suggesting potential implications for public health. 相似文献12.
Maria do Carmo Leal Ana Paula Esteves-Pereira Marcos Nakamura-Pereira Jacqueline Alves Torres Mariza Theme-Filha Rosa Maria Soares Madeira Domingues Marcos Augusto Bastos Dias Maria Elizabeth Moreira Silvana Granado Gama 《Reproductive health》2016,13(3):127
Background
The rate of preterm birth has been increasing worldwide, including in Brazil. This constitutes a significant public health challenge because of the higher levels of morbidity and mortality and long-term health effects associated with preterm birth. This study describes and quantifies factors affecting spontaneous and provider-initiated preterm birth in Brazil.Methods
Data are from the 2011–2012 “Birth in Brazil” study, which used a national population-based sample of 23,940 women. We analyzed the variables following a three-level hierarchical methodology. For each level, we performed non-conditional multiple logistic regression for both spontaneous and provider-initiated preterm birth.Results
The rate of preterm birth was 11.5 %?, (95 % confidence 10.3 % to 12.9 %) 60.7 % spontaneous - with spontaneous onset of labor or premature preterm rupture of membranes - and 39.3 % provider-initiated, with more than 90 % of the last group being pre-labor cesarean deliveries. Socio-demographic factors associated with spontaneous preterm birth were adolescent pregnancy, low total years of schooling, and inadequate prenatal care. Other risk factors were previous preterm birth (OR 3.74; 95 % CI 2.92–4.79), multiple pregnancy (OR 16.42; 95 % CI 10.56–25.53), abruptio placentae (OR 2.38; 95 % CI 1.27–4.47) and infections (OR 4.89; 95 % CI 1.72–13.88). In contrast, provider-initiated preterm birth was associated with private childbirth healthcare (OR 1.47; 95 % CI 1.09–1.97), advanced-age pregnancy (OR 1.27; 95 % CI 1.01–1.59), two or more prior cesarean deliveries (OR 1.64; 95 % CI 1.19–2.26), multiple pregnancy (OR 20.29; 95 % CI 12.58–32.72) and any maternal or fetal pathology (OR 6.84; 95 % CI 5.56–8.42).Conclusion
The high proportion of provider-initiated preterm birth and its association with prior cesarean deliveries and all of the studied maternal/fetal pathologies suggest that a reduction of this type of prematurity may be possible. The association of spontaneous preterm birth with socially-disadvantaged groups reaffirms that the reduction of social and health inequalities should continue to be a national priority.13.
Alio AP Mbah AK Grunsten RA Salihu HM 《Journal of pediatric and adolescent gynecology》2011,24(6):404-409
Study Objective
We sought to assess the impact of paternal involvement on adverse birth outcomes in teenage mothers.Design
Using vital records data, we generated odds ratios (OR) and 95% confidence intervals (CI) to assess the association between paternal involvement and fetal outcomes in 192,747 teenage mothers. Paternal involvement status was based on presence/absence of paternal first and/or last name on the birth certificate.Setting
Data were obtained from vital records data from singleton births in Florida between 1998 and 2007.Participants
The study population consisted of 192,747 teenage mothers ≤ 20 years old with live single births in the State of Florida.Main Outcome Measures
Low birth weight, very low birth weight, preterm birth, very preterm birth, small for gestational age (SGA), neonatal death, post-neonatal death, and infant death.Results
Risks of SGA (OR = 1.06; 95% CI: 1.03-1.10), low birth weight (OR = 1.19; 95% CI: 1.15-1.23), very low birth weight (OR = 1.53; 95% CI: 1.41-1.67), preterm birth (OR = 1.21; 95% CI: 1.17-1.25), and very preterm birth (OR = 1.49; 95% CI: 1.38-1.62) were elevated for mothers in the father-absent group. When results were stratified by race, black teenagers in the father-absent group had the highest risks of adverse birth outcomes when compared to white teenagers in the father-involved group.Conclusions
Lack of paternal involvement is a risk factor for adverse birth outcomes among teenage mothers; risks are most pronounced among African-American teenagers. Our findings suggest that increased paternal involvement can have a positive impact on birth outcomes for teenage mothers, which may be important for decreasing the racial disparities in infant morbidities. More studies assessing the impact of greater paternal involvement on birth outcomes are needed. 相似文献14.
América Aime Corona Gutiérrez M. Teresa Higueras Sanz Lluís Cabero i Roura 《Progresos de Obstetricia y Ginecología》2008
Objective
To determine whether patients who undergo cesarean section are at higher risk of complications than those who have a vaginal birth and to describe the complications observed.Subjects and methods
We reviewed the clinical records of 1017 patients who gave birth at the Materno- Vall d’Hebron Maternity and Child Hospital in the first trimester of 2007.Results
For a cesarean rate of 22%, the incidence of maternal complication was 18%, while for vaginal birth the incidence was 6% (RR 3.1, 95% CI 2.4-15.1). The most frequent complications were wound infection (7.5%), transfusions (5.3%) and hemorrhage (3.1%); endomyometritis was more common in the group with vaginal births (1.6% vs. 1.3%).Conclusions
Cesarean section is associated with a three times higher risk of complications than vaginal birth. The lower incidence of endomyometritis after cesarean sections may be a consequence of antibiotic prophylaxis, but further studies are required to draw firm conclusions on this topic. 相似文献15.
Benjamin Bar-Oz Myla E. Moretti Radinka Boskovic Lisa O’Brien Gideon Koren 《European journal of obstetrics, gynecology, and reproductive biology》2009
Objective
We conducted a meta-analysis of all published data in order to evaluate the risk for birth defects, stillbirths, preterm births and low birth weight following exposure to quinolones in the first trimester of pregnancy.Study design
Medline, Embase, Scopus, Biological Abstracts and Proquest Thesis Dissertation databases were searched. Other papers and abstracts were located from the retrieved articles’ references, meeting booklets, internet web sites and books on teratology.Results
Five studies met the inclusion criteria. The summary odds ratio for all the included studies was 1.05 (95% CI 0.90–1.22) for major malformations, 2.6 (95% CI 0.36–18.67) for stillbirths, 1.15 (95% CI 0.69–1.91) for preterm births and 0.73 (95% CI 0.30–1.79) for low birth weight. In an additional analysis including only fluoroquinolones (nalidixic acid was removed), the summary odds ratio for major malformations remained non-significant (1.11, 95% CI 0.57–2.15).Conclusions
The use of quinolones during the first trimester of pregnancy does not appear to represent an increased risk for major malformations recognized after birth, stillbirths, preterm births or low birth weight. 相似文献16.
D. Desseauve J. Chantrel A. Fruchart B. Khoshnood G. Brabant P.Y. Ancel D. Subtil 《European journal of obstetrics, gynecology, and reproductive biology》2012
Objectives
Bacterial vaginosis is a risk factor for preterm delivery. Its prevalence and risk factors in Europe are not well known. Our objective was to assess both in early pregnancy.Study design
As part of the PREMEVA randomized controlled trial, this population-based study included 14,193 women screened before 14 weeks’ gestation for bacterial vaginosis in the 160 laboratories of the Nord-Pas-de-Calais region in France. Bacterial vaginosis was defined by a Nugent score ≥ 7. Data were collected about maternal tobacco use, age, education, and history of preterm birth. We estimated the prevalence of bacterial vaginosis and used a multilevel logistic regression model to identify significant risk factors for it.Results
Among the 14,193 women assessed before 14 weeks’ gestation, the prevalence of bacterial vaginosis was 7.1% (95% CI: 6.6–7.5%). In the multivariate analysis, smoking during pregnancy tobacco (adjusted OR: 1.38; 95% CI: 1.19–1.60), maternal age 18–19 years (adjusted OR: 1.40; 95% CI: 1.01–1.93), and educational level (completed only primary school: adjusted OR: 1.77; 95% CI: 1.35–2.31; completed only secondary school: adjusted OR: 1.27; 95% CI: 1.10–1.48) were independent risk factors for bacterial vaginosis. History of preterm delivery was not an independent risk factor of bacterial vaginosis: adjusted OR: 1.15; 95% CI: 0.90–1.47.Conclusion
In a large sample of women in their first trimester of pregnancy in France, the prevalence of bacterial vaginosis was lower than rates reported in other countries, but risk factors were similar: young age, low level of education, and tobacco use during pregnancy. These results should be considered in future strategies to reduce preterm delivery. 相似文献17.
T'sang-T’ang Hsieh Jui-Der Liou Jenn-Jeih Hsu Liang-Ming Lo Szu-Fu Chen Tai-Ho Hung 《European journal of obstetrics, gynecology, and reproductive biology》2010
Objective
To investigate (1) whether there is an increasing trend in the mean maternal age at the birth of the first child and in the group of women giving birth at age 35 or older, and (2) the association between advanced maternal age and adverse perinatal outcomes in an Asian population.Study design
We conducted a retrospective cohort study involving 39,763 Taiwanese women who delivered after 24 weeks of gestation between July 1990 and December 2003. Multivariable logistic regression was used to adjust for potential confounding variables.Results
During the study period, the mean maternal age at the birth of the first child increased from 28.0 to 29.7 years, and the proportion of women giving birth at age 35 or older increased from 11.4% to 19.1%. Compared to women aged 20–34 years, women giving birth at age 35 or older carried a nearly 1.5-fold increased risk for pregnancy complications and a 1.6–2.6-fold increased risk for adverse perinatal outcomes. After adjusting for the confounding effects of maternal characteristics and coexisting pregnancy complications, women aged 35–39 years were at increased risk for operative vaginal delivery (adjusted odds ratio [OR] 1.5, 95% confidence interval [CI] 1.2–1.7) and cesarean delivery (adjusted OR 1.6, 95% CI 1.5–1.7), while women aged 40 years and older were at increased risk for preterm delivery (before 37 weeks of gestation) (adjusted OR 1.7, 95% CI 1.3–2.2), operative vaginal delivery (adjusted OR 3.1, 95% CI 2.0–4.6), and cesarean delivery (adjusted OR 2.6, 95% CI 2.2–3.1). In those women who had a completely uncomplicated pregnancy and a normal vaginal delivery, advanced maternal age was still significantly associated with early preterm delivery (before 34 weeks of gestation), a birth weight <1500 g, low Apgar scores, fetal demise, and neonatal death.Conclusion
In this population of Taiwanese women, there is an increasing trend in the mean maternal age at the birth of the first child. Furthermore, advanced maternal age is independently associated with specific adverse perinatal outcomes. 相似文献18.
Factors associated with maternal near-miss morbidity and mortality in Kowloon Hospital,Suzhou, China
Fang-Rong Shen Ming Liu Xia Zhang Weiwen Yang You-Guo Chen 《International journal of gynaecology and obstetrics》2013
Objective
To investigate factors associated with acute maternal morbidity and mortality in Kowloon Hospital, Suzhou, China.Methods
Data from cases of near-miss and maternal death between January 2008 and December 2012 were reviewed retrospectively. Maternal characteristics and related factors were identified, and multiple regression analysis was used to calculate adjusted odds ratios (aORs) and 95% confidence intervals (CIs).Results
During the study period, there were 18 104 deliveries, 69 near-miss cases, and 3 maternal deaths. Women who had no health insurance (aOR, 4.55; 95% CI, 0.87–21.8), had fewer than 6 prenatal consultations (aOR, 6.76; 95% CI, 0.76–45.8), were part of a migrant population (aOR, 2.34; 95% CI, 0.45–24.9), or delayed seeking healthcare (aOR, 4.76; 95% CI, 0.89–13.6) had a greater risk of near-miss morbidity or death. Admission to intensive care (aOR, 6.75; 95% CI, 0.89–34.6) and blood transfusion within 30 min (aOR, 3.79; 95% CI, 0.65–8.67) were protective factors in disease progression.Conclusion
The factors associated with maternal near-miss morbidity and mortality were closely related to health insurance and socioeconomic status, suggesting that the government should take an active role in the community in preventing morbidity and mortality in pregnancy. 相似文献19.
Sam Ononge Charles Karamagi Clemensia Nakabiito Julius Wandabwa Florence Mirembe Godfrey Z. Rukundo Larissa Jennings 《International journal of gynaecology and obstetrics》2014
Objective
To determine factors associated with an unknown HIV serostatus among pregnant women admitted in labor to Mulago Hospital, Kampala, Uganda.Methods
In total, 665 pregnant women admitted to Mulago Hospital were interviewed about their sociodemographic characteristics, obstetric history, access to prenatal care, fears regarding HIV testing, and knowledge about modes of mother-to-child-transmission (MTCT). Knowledge of the HIV serostatus was assessed by self-report and verified by prenatal card review.Results
The prevalence of unknown HIV serostatus at the time of labor was 27.1%. Factors associated with an unknown HIV serostatus included high parity (odds ratio [OR] 1.9; 95% confidence interval [CI], 1.16–3.14), preterm delivery (OR 2.60; 95% CI, 1.06–6.34), prenatal care at a private clinic (OR 12.87; 95% CI, 5.68–29.14), residence more than 5 km from the nearest prenatal clinic (OR 2.86; 95% CI, 1.18–17.9), high knowledge about MTCT (OR 0.25; 95% CI, 0.07–0.86), and fears related to disclosing the test result to the partner (OR 3.60; 95% CI, 1.84–7.06).Conclusion
The high prevalence of unknown HIV serostatus among women in labor highlights the need to improve accessibility to HIV testing services early during pregnancy to be able to take advantage of antiretroviral therapy. 相似文献20.
Kato O Kawasaki N Bodri D Kuroda T Kawachiya S Kato K Takehara Y 《European journal of obstetrics, gynecology, and reproductive biology》2012,161(1):46-50