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maternal outcomes 45 years

Margo S Harrison, Sharon Scarbro, Elizabeth Juarez-Colunga, Andrea Jimenez-Zambrano, Saskia Bunge-Montes, Guillermo A Bolaños, Molly Lamb, Edwin J Asturias, Stephen Berman, Gretchen Heinrichs
Purpose To evaluate trends and factors associated with mode of delivery in the rural Southwest Trifinio region of Guatemala. Description We conducted a retrospective analysis of self-reported antepartum factors and postpartum outcomes recorded in a quality improvement database among 430 women enrolled in a home-based maternal healthcare program between June 1, 2015 and August 1, 2017. Assessment Over the study period, the rates of cesarean delivery (CD) increased (from 30 to 45%) and rates of vaginal delivery (VD) decreased (70-55%) while facility-based delivery attendance remained stable around 70%...
December 12, 2018: Maternal and Child Health Journal
Alyaa AlRefai, James Drake, Abhaya V Kulkarni, Kristin L Connor, Patrick Shannon, Ants Toi, David Chitayat, Susan Blaser, Paige T Church, Nimrah Abbasi, Greg Ryan, Tim Van Mieghem
OBJECTIVE: Fetal myelomeningocele (fMMC) surgery improves infant outcomes when compared with postnatal surgery. Surgical selection criteria and the option of pregnancy termination, however, limit the number of cases that are eligible for prenatal surgery. We aimed to quantify what proportion of cases could ultimately benefit from fetal therapy. METHODS: We retrospectively reviewed all cases of fMMC referred to a large tertiary care center over a 10-year period and assessed their eligibility for fetal surgery, pregnancy termination rates, and actual uptake of the surgery...
December 10, 2018: Prenatal Diagnosis
Mohammad Rifat Haider, Mohammad Masudur Rahman, Md Moinuddin, Ahmed Ehsanur Rahman, Shakil Ahmed, M Mahmud Khan
BACKGROUND: Cesarean Section (CS) delivery has been increasing rapidly worldwide and Bangladesh is no exception. In Bangladesh, the CS rate has increased from about 3% in 2000 to about 24% in 2014. This study examines trend in CS in Bangladesh over the last fifteen years and implications of this increasing CS rates on health care expenditures. METHODS: Birth data from Bangladesh Demographic and Health Survey (BDHS) for the years 2000-2014 have been used for the trend analysis and 2010 Bangladesh Maternal Mortality Survey (BMMS) data were used for estimating health care expenditure associated with CS...
2018: PloS One
John N Chang, Everett F Magann, Sarah A Novotny, Chad E Cooley, C Heath Gauss, Marc R Parrish, John C Morrison
OBJECTIVE: To compare pregnancy outcomes in women with sickle cell disease from recent deliveries with a similar group delivered earlier. METHODS: During a 12-year period (2005-2016), data from pregnant women with hemoglobin SS or SC were collected from three university medical centers and compared with earlier studies (1979-2003) involving similar patients. The primary endpoints were maternal complications during pregnancy and newborn outcomes. RESULTS: There were 278 patients in the control group (1979-2003) compared with 150 patients in the study group (2005-2016)...
December 2018: Southern Medical Journal
Raanan Meyer, Raoul Orvieto, Ariel Israel, Aya Mohr-Sasson, Yael Timerman, Tal Gorodesky, Shlomo Toussia-Cohen, Israel Hendler, Michal J Simchen, Ronit Machtinger
BACKGROUND: Pregnancies in the fifth and sixth decades of life have been increasing, but current data are limited regarding the outcomes of twin compared with singleton pregnancies in this age group and to twin pregnancies at younger age. OBJECTIVE: To compare obstetrical and neonatal outcomes of IVF conceived pregnancies, in twin gestations of women who were ≥45 years old at delivery to singletons at similar age and twin gestations at the age of <35 years, and to assess if the complications are mainly influenced by the very advanced maternal age or by the multifetal pregnancy...
November 6, 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Anne E Sved Williams, Chris Yelland, Sharron Hollamby, Maria Wigley, Paul Aylward
OBJECTIVES: Few treatments have been described to treat the population of women with borderline personality structure who present in a dysregulated state with their infants. Therefore, a new treatment program was developed for this target group. METHODS: A total of 45 women, who were identified clinically as meeting full or partial diagnostic criteria for borderline personality disorder (BPD) and having an infant younger than 3 years of age, were offered entry with their infant(s) into specialized dialectical behavior therapy groups, adapted to focus on parenting and the mother-infant relationship...
September 2018: Journal of Psychiatric Practice
Suzanne Ford, Mike O'Driscoll, Anita MacDonald
Introduction: Many women with PKU are well-informed about the risks of maternal PKU but there are several barriers to achieving satisfactory metabolic control before and during pregnancy. Many studies have documented the outcome of maternal PKU infants, but very little has been reported about the experiences of women of reproductive age with PKU, particularly about their psychosexual development, pre-conception, pregnancy and postnatal experience. Methods: In the UK, in a subsection of an online questionnaire conducted by the National Society for PKU (NSPKU) about living with PKU, women aged 18 years and over completed 9 closed questions about their pre-conception, pregnancy and post-natal experiences and an open-ended question on their reproductive health...
December 2018: Molecular Genetics and Metabolism Reports
Roger Smith, Lita Mohapatra, Mandy Hunter, Tiffany-Jane Evans, Christopher Oldmeadow, Elizabeth Holliday, Alexis Hure, John Attia
BACKGROUND: Low birth weight is more common in infants of Indigenous (Aboriginal and/or Torres Strait Islander) than of Caucasian Australian mothers. Controversy exists on whether fetal growth is normally different in different populations. OBJECTIVE: We sought to determine the relationships of birth weight, birth weight centiles and smoking with perinatal outcomes in Indigenous versus non-Indigenous infants to determine if Caucasian growth charts could be applied to Indigenous infants...
November 4, 2018: American Journal of Obstetrics and Gynecology
Yash S Khandwala, Valerie L Baker, Gary M Shaw, David K Stevenson, Ying Lu, Michael L Eisenberg
OBJECTIVE: To evaluate the impact of advanced paternal age on maternal and perinatal outcomes in the United States. DESIGN: Retrospective, population based cohort study. SETTING: US. POPULATION: 40 529 905 documented live births between 2007 and 2016. MAIN OUTCOME MEASURES: Primary perinatal outcomes were gestational age, birth weight, Apgar score at five minutes, admission to a neonatal intensive care unit, need for postpartum antibiotics, and seizures...
October 31, 2018: BMJ: British Medical Journal
Shabnam Peyvandi, Rebecca J Baer, Anita J Moon-Grady, Scott P Oltman, Christina D Chambers, Mary E Norton, Satish Rajagopal, Kelli K Ryckman, Laura L Jelliffe-Pawlowski, Martina A Steurer
Background Racial/ethnic and socioeconomic disparities exist in outcomes for children with congenital heart disease. We sought to determine the influence of race/ethnicity and mediating socioeconomic factors on 1-year outcomes for live-born infants with hypoplastic left heart syndrome and dextro-Transposition of the great arteries. Methods and Results The authors performed a population-based cohort study using the California Office of Statewide Health Planning and Development database. Live-born infants without chromosomal anomalies were included...
October 16, 2018: Journal of the American Heart Association
Sawsan Abdulrahim, Rym El Rafei, Zahraa Beydoun, Ghinwa Y El Hayek, Pascale Nakad, Khalid Yunis
Background: Studies on immigrants revealed an epidemiological paradox whereby low-socioeconomic status (SES) immigrant mothers exhibit favourable birth outcomes compared with native-born mothers. We tested the epidemiological paradox in a context of forced migration, comparing associations of low birthweight (LBW) and maternal SES between Syrian and Lebanese newborns in Lebanon. Methods: We used data from the National Collaborative Perinatal Neonatal Network (NCPNN) of 31 Lebanese hospitals, including 45 442 Lebanese and 4910 Syrian neonates born 2011-13...
October 23, 2018: International Journal of Epidemiology
Donna B Mak, Annette K Regan, Dieu T Vo, Paul V Effler
BACKGROUND: Influenza and pertussis vaccines have been recommended in Australia for women during each pregnancy since 2010 and 2015, respectively. Estimating vaccination coverage and identifying factors affecting uptake are important for improving antenatal immunisation services. METHODS: A random sample of 800 Western Australian women ≥18 years of age who gave birth between 4th April and 4th October 2015 were selected. Of the 454 (57%) who were contactable by telephone, 424 (93%) completed a survey...
October 24, 2018: BMC Pregnancy and Childbirth
Meron Mehari Kifle, Hana Fesehaye Kesete, Hermon Tekeste Gaim, Goitu Seltene Angosom, Michael Berhane Araya
BACKGROUND: In Eritrea, despite high antenatal care (ANC) use, utilization of health facilities for child birth is still low and with marked variations between urban and rural areas. Understanding the reasons behind the poor use of these services in a rural setting is important to design targeted strategies and address the challenge contextually. This study aimed to determine factors that influence women's choice of delivery place in selected rural communities in Eritrea. METHODS: A cross-sectional survey of 309 women aged 15-49 years with a delivery in the last 1-2 years prior to the survey was conducted in a randomly selected villages of Hadish Adi, Serea, Genseba, Kelay Bealtat, Dirko, Mai Leham, Kudo Abour, Adi Koho, and Leayten...
October 22, 2018: Journal of Health, Population, and Nutrition
Roselyter Monchari Riang'a, Anne Kisaka Nangulu, Jacqueline E W Broerse
BACKGROUND: There have been few studies about the basis on which women in developing regions evaluate and choose traditional rather than western maternal care. This qualitative study explores the socio-cultural perceptions of complications associated with pregnancy and childbirth and how these perceptions influence maternal health and care-seeking behaviours in Kenya. METHODS: Kalenjin women (n = 42) aged 18-45 years, who were pregnant or had given birth within the last 12 months, were interviewed...
October 19, 2018: BMC Pregnancy and Childbirth
Mihai Dimitriu, Cringu Antoniu Ionescu, Alexandra Matei, Roxana Viezuina, George Rosu, Corina Ilinca, Mihai Banacu, Liana Ples
RATIONALE: The extent of pregnancy in adolescents and young adults, especially in low and middle-income countries, is a source of increasing concern given its social and economic impact. AIMS AND OBJECTIVE: We hypothesized that there would be correlations between female patients becoming pregnant at a young age and practices such as harmful alcohol misuse, cigarette smoking, and drug use, the use of toxic substances, low educational attainment, and an essential absence of health care seeking about the outcome of adolescent pregnancies...
October 17, 2018: Journal of Evaluation in Clinical Practice
Elizabeth Wall-Wieler, Suzan L Carmichael, Marcelo L Urquia, Can Liu, Anders Hjern
We examined whether women experiencing severe maternal morbidity (SMM) are more likely to be treated for a psychiatric illness or be prescribed psychotropic medications in the postpartum year than mothers who did not experience SMM. We also examine the relationship between SMM and specific mental health-related outcomes, and the relationship between specific SMM diagnoses/procedures and postpartum mental-health-related outcomes. The national registers in Sweden were used to create a population-based matched cohort...
October 17, 2018: Archives of Women's Mental Health
Andrew G Herzog, Hannah B Mandle, Devon B MacEachern
Importance: If unintended pregnancy is common among women with epilepsy and is associated with increased risk of spontaneous fetal loss (SFL), it is important to develop guidelines for safe and effective contraception for this community. Objective: To assess whether planned pregnancy is a determinant of SFL in women with epilepsy. Design, Setting, and Participants: The Epilepsy Birth Control Registry conducted this web-based, retrospective survey between 2010 and 2014...
October 15, 2018: JAMA Neurology
Saeed Baradwan, Abdullah Alyousef, Abdulrhman Turkistani
Background: Iron deficiency anemia (IDA) during pregnancy is a common and preventable disorder. It remains a contributing factor to maternal morbidity and mortality and is associated with high perinatal mortality rates. Objective: To determine the prevalence of IDA and its associated clinical features among pregnant women. Methods: This analytical prospective cohort study included 1,579 pregnant women who attended an antenatal clinic, Women's Specialized Hospital, King Fahad Medical City, Riyadh, Saudi Arabia, between January 2018 and April 2018...
2018: Journal of Blood Medicine
Telmo Henrique Barbosa de Lima, Leila Katz, Samir Buainain Kassar, Melania Maria Amorim
BACKGROUND: To investigate the associations of maternal variables - sociodemographic, obstetrical and maternal near miss (MNM) variables - with neonatal near miss (NNM) using the new concept of NNM formulated by the Centro Latino-Americano de Perinatologia (CLAP) and the corresponding health indicators for NNM. METHODS: An analytical prospective cohort study was performed at maternity hospital for high-risk pregnancy in Northeastern Brazil. Puerperal women whose newborn infants met the selection criteria were subjected to interviews involving pretested questionnaires...
October 12, 2018: BMC Pregnancy and Childbirth
Alison G Cahill, Sindhu K Srinivas, Alan T N Tita, Aaron B Caughey, Holly E Richter, W Thomas Gregory, Jingxia Liu, Candice Woolfolk, David L Weinstein, Amit M Mathur, George A Macones, Methodius G Tuuli
Importance: It is unclear whether the timing of second stage pushing efforts affects spontaneous vaginal delivery rates and reduces morbidities. Objective: To evaluate whether immediate or delayed pushing results in higher rates of spontaneous vaginal delivery and lower rates of maternal and neonatal morbidities. Design, Setting, and Participants: Pragmatic randomized clinical trial of nulliparous women at or beyond 37 weeks' gestation admitted for spontaneous or induced labor with neuraxial analgesia between May 2014 and December 2017 at 6 US medical centers...
October 9, 2018: JAMA: the Journal of the American Medical Association
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