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1.
BMC Pregnancy Childbirth ; 21(1): 351, 2021 May 03.
Artigo em Inglês | MEDLINE | ID: mdl-33941083

RESUMO

BACKGROUND: Yoga can reduce the risk of preterm delivery, cesarean section (CS), and fetal death. The aim of the present study was to investigate the effects of Yoga on pregnancy, delivery, and neonatal outcomes. METHODS: This was a clinical trial study and using the random sampling without replacement 70 pregnant women entered Hatha Yoga and control groups according to the color of the ball they took from a bag containing two balls (blue or red). The data collection tool was a questionnaire pregnancy, delivery, and neonatal outcomes. The intervention in this study included pregnancy Hatha Yoga exercises that first session of pregnancy Yoga started from the 26th week and samples attended the last session in the 37th week. They exercised Yoga twice a week (each session lasting 75 min) in a Yoga specialized sports club. The control group received the routine prenatal care that all pregnant women receive. RESULTS: The results showed that yoga reduced the induction of labor, the episiotomy rupture, duration of labor, also had a significant effect on normal birth weight and delivery at the appropriate gestational age. There were significant differences between the first and second Apgar scores of the infants. CONCLUSION: The results of the present study showed that Yoga can improve the outcomes of pregnancy and childbirth. They can be used as part of the care protocol along with childbirth preparation classes to reduce the complications of pregnancy and childbirth. TRIAL REGISTRATION: IRCT20180623040197N2 (2019-02-11).


Assuntos
Cesárea/estatística & dados numéricos , Trabalho de Parto Induzido/estatística & dados numéricos , Trabalho de Parto Prematuro/epidemiologia , Resultado da Gravidez , Cuidado Pré-Natal , Ioga , Adolescente , Adulto , Episiotomia/efeitos adversos , Episiotomia/estatística & dados numéricos , Feminino , Humanos , Recém-Nascido , Irã (Geográfico) , Trabalho de Parto Prematuro/prevenção & controle , Paridade , Gravidez , Inquéritos e Questionários , Adulto Jovem
2.
Medicina (Kaunas) ; 57(3)2021 Mar 05.
Artigo em Inglês | MEDLINE | ID: mdl-33807607

RESUMO

Background and Objectives: COVID-19, a disease caused by SARS-CoV-2, is a public health emergency. Data on the effect of the virus on pregnancy are limited. Materials and Methods: We carried out a retrospective descriptive study, in order to evaluate the obstetric results on pregnant women in which SARS-CoV-2 was detected through RT-PCR of the nasopharyngeal swab, at admission to the maternity hospital. Results: From 16 March to 31 July 2020, 12 SARS-CoV-2 positive pregnant women have been hospitalized. Eleven were hospitalized for initiation or induction of labor, corresponding to 0.64% of deliveries in the maternity hospital. One pregnant woman was hospitalized for threatened abortion, culminating in a stillbirth at 20 weeks of gestation. Regarding the severity of the disease, nine women were asymptomatic and three had mild illness (two had associated cough and one headache). Three had relevant environmental exposure and a history of contact with infected persons. None had severe or critical illness due to SARS-CoV-2. There were no maternal deaths. The following gestational complications were observed: one stillbirth, one preterm labor, one preterm prelabor rupture of membranes, and one fetal growth restriction. Four deliveries were eutocic, two vacuum-assisted deliveries and five were cesarean sections. The indications for cesarean section were obstetric. Conclusions: SARS-CoV-2 infection was found in a minority of hospitalized pregnant women in this sample. Most are asymptomatic or have mild illness, from gestational complications to highlight stillbirth and preterm birth. There were no cases of vertical transmission by coronavirus.


Assuntos
/epidemiologia , Complicações Infecciosas na Gravidez/epidemiologia , Adulto , Cesárea , Tosse/fisiopatologia , Feminino , Retardo do Crescimento Fetal/epidemiologia , Ruptura Prematura de Membranas Fetais/epidemiologia , Cefaleia/fisiopatologia , Hospitalização , Maternidades , Humanos , Trabalho de Parto Induzido , Trabalho de Parto Prematuro/epidemiologia , Portugal/epidemiologia , Hemorragia Pós-Parto/epidemiologia , Gravidez , Resultado da Gravidez , Nascimento Prematuro/epidemiologia , Estudos Retrospectivos , Índice de Gravidade de Doença , Natimorto/epidemiologia , Vácuo-Extração
3.
Reprod Health ; 18(1): 56, 2021 Mar 04.
Artigo em Inglês | MEDLINE | ID: mdl-33663555

RESUMO

BACKGROUND: Uganda has one of the highest adolescent pregnancy rates in sub-Saharan Africa. We compared the risk of adverse birth outcomes between adolescents (age 12-19 years) and mothers (age 20-34 years) in four urban hospitals. METHODS: Maternal demographics, HIV status, and birth outcomes of all live births, stillbirths, and spontaneous abortions delivered from August 2015 to December 2018 were extracted from a hospital-based birth defects surveillance database. Differences in the distributions of maternal and infant characteristics by maternal age groups were tested with Pearson's chi-square. Adjusted odds ratios (aORs) and 95% confidence intervals (CI) were calculated using logistic regression to compare the prevalence of adverse birth outcomes among adolescents to mothers 20-34 years. RESULTS: A total of 100,189 births were analyzed, with 11.1% among adolescent mothers and 89.0% among older mothers. Adolescent mothers had an increased risk of preterm delivery (aOR: 1.14; CI 1.06-1.23), low birth weight (aOR: 1.46; CI 1.34-1.59), and early neonatal deaths (aOR: 1.58; CI 1.23-2.02). Newborns of adolescent mothers had an increased risk of major external birth defects (aOR: 1.33; CI 1.02-1.76), specifically, gastroschisis (aOR: 3.20; CI 1.12-9.13) compared to mothers 20-34 years. The difference between the prevalence of gastroschisis among adolescent mothers (7.3 per 10,000 births; 95% CI 3.7-14.3) was statistically significant when compared to mothers 20-34 years (1.6 per 10,000 births; 95% CI 0.9-2.6). CONCLUSIONS: This study found that adolescent mothers had an increased risk for several adverse birth outcomes compared to mothers 20-34 years, similar to findings in the region and globally. Interventions are needed to improve birth outcomes in this vulnerable population.


Assuntos
Anormalidades Congênitas/epidemiologia , Gastrosquise/epidemiologia , Trabalho de Parto Prematuro/epidemiologia , Morte Perinatal , Resultado da Gravidez/epidemiologia , Adolescente , Adulto , Fatores Etários , Cesárea , Criança , Feminino , Hospitais , Humanos , Lactente , Recém-Nascido de Baixo Peso , Recém-Nascido , Recém-Nascido Prematuro , Idade Materna , Mães , Gravidez , Gravidez na Adolescência , Prevalência , Uganda/epidemiologia , Adulto Jovem
4.
Int J Gynaecol Obstet ; 153(3): 449-456, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33638200

RESUMO

OBJECTIVE: To determine the maternal and neonatal outcomes of pregnant women with COVID-19 infection. METHODS: A cohort study was conducted on 56 pregnant women with COVID-19 and 94 healthy pregnant women during the COVID-19 epidemic in Iran. Two groups were followed until childbirth. Demographic and obstetric information, clinical symptoms, laboratory and radiographic findings of the patients, and maternal and neonatal outcomes of the two groups were gathered by a checklist. Data were analyzed using SPSS version 16. A P value < 0.05 was considered significant. RESULTS: The two groups were similar in terms of maternal age, gravida, parity, and co-morbidities (P > 0.05). The rate of cesarean delivery in the exposed group was higher than that in the control group (P = 0.027; relative risk [RR] =2.23). Pre-eclampsia was seen in 19.8% of the exposed group and 7.4% of the control group (P = 0.037; RR = 2.68). The rate of preterm labor in the exposed group was higher than that in the control group (P = 0.003; RR = 2.70). Fetal distress was seen in 16.1% of the exposed group and 4.3% of the control group (P = 0.016; RR = 3.84). CONCLUSION: Pregnant women with COVID-19 had an increased risk of pre-eclampsia, preterm labor, and cesarean delivery. Their fetal and neonatal outcomes were fetal distress, newborn prematurity, and low Apgar score.


Assuntos
/epidemiologia , Sofrimento Fetal/epidemiologia , Trabalho de Parto Prematuro/epidemiologia , Pré-Eclâmpsia/epidemiologia , Complicações na Gravidez/epidemiologia , Nascimento Prematuro/epidemiologia , Adulto , Índice de Apgar , Cesárea/estatística & dados numéricos , Estudos de Coortes , Feminino , Humanos , Recém-Nascido , Irã (Geográfico)/epidemiologia , Gravidez , Estudos Prospectivos , Adulto Jovem
5.
Environ Res ; 196: 110894, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33609551

RESUMO

BACKGROUND: Previous reports indicate an association between ambient temperature (Ta) and air pollution exposure during pregnancy and preterm birth (PTB). Nevertheless, information regarding the association between environmental factors and specific precursors of spontaneous preterm birth is lacking. We aimed to determine the association between Ta and air pollution during gestation and the precursors of spontaneous preterm parturition, i.e. preterm labor (PTL) and preterm prelabor rupture of membranes (PPROM). METHODS: From 2003 to 2013 there were 84,476 deliveries of singleton gestation that comprised the study cohort. Exposure data during pregnancy included daily measurements of temperature and particulate matter <2.5 µm and <10 µm, PM2.5 and PM10, respectively. Deliveries were grouped into PPROM, PTL and non-spontaneous preterm and term deliveries. Exposure effect was tested in windows of a week and two days prior to admission for delivery and adjusted to gestational age and socio-economic status. Poisson regression models were used for analyses. RESULTS: There is an association of environmental exposure with the precursors of spontaneous preterm parturition; PPROM was more sensitive to Ta fluctuations than PTL. This effect was modified by the ethnicity, Bedouin-Arabs were susceptible to elevated Ta, especially within the last day prior to admission with PPROM (Relative Risk (RR) =1.19 [95% CI, 1.03; 1.37]). Jews, on the other hand, were susceptible to ambient pollutants, two (RR=1.025 [1.010; 1.040]) and one (RR= 1.017 [1.002; 1.033]) days prior to spontaneous PTL with intact membranes resulting in preterm birth. CONCLUSION: High temperature is an independent risk factor for PPROM among Bedouin-Arabs; ambient pollution is an independent risk factor for spontaneous PTL resulting in preterm birth. Thus, the precursors of spontaneous preterm parturition differ in their association with environmental factors.


Assuntos
Ruptura Prematura de Membranas Fetais , Trabalho de Parto Prematuro , Nascimento Prematuro , Feminino , Idade Gestacional , Humanos , Recém-Nascido , Trabalho de Parto Prematuro/induzido quimicamente , Trabalho de Parto Prematuro/epidemiologia , Material Particulado , Gravidez , Nascimento Prematuro/induzido quimicamente , Nascimento Prematuro/epidemiologia
6.
Rev. chil. obstet. ginecol. (En línea) ; 85(supl.1): S59-S66, set. 2020. tab
Artigo em Espanhol | LILACS | ID: biblio-1138649

RESUMO

INTRODUCCIÓN Y OBJETIVO: La pandemia por SARS-CoV-2 afecta a las embarazadas con diferentes manifestaciones clínicas; una de ellas es el parto prematuro. El objetivo del presente estudio es caracterizar a las embarazadas con COVID-19 que tuvieron su parto y determinar la razón de aumento de parto prematuro en este grupo en comparación con aquellas que no presentaban la enfermedad. MÉTODOS: Estudio observacional de cohorte retrospectivo donde se incluyeron pacientes embarazadas entre abril y junio del año 2020 en la Maternidad del Hospital San Juan de Dios. Se seleccionaron aquellas que tuvieron su parto y se evaluaron los datos demográficos y médicos, antecedentes obstétricos, información respecto al parto, antecedentes del recién nacido y características de la enfermedad por COVID-19. RESULTADOS: Entre las pacientes COVID-19 un 16.9% tuvo parto prematuro, alcanzando un OR de 1,79 (0,76-3,84 IC 95%) respecto a aquellas sin la enfermedad que, aunque no significativo, evidencia tendencia. Entre las que cursaron con COVID-19 severo todas tuvieron parto prematuro, con un OR significativo (>= 7.84 IC 95%) en comparación con aquellas con cuadro leve o negativas a COVID-19. Un 10.1% de los recién nacidos de madres COVID-19 requirió reanimación neonatal, mientras que en las negativas fue de un 5.5%. CONCLUSIONES: Entre las pacientes COVID-19 se observo una tendencia a aumento del riesgo de parto prematuro respecto a aquellas sin la enfermedad, siendo significativo el aumento del riesgo en aquellas que cursaban con síntomas y aún más significativo si presentaban enfermedad severa.


INTRODUCTION AND OBJECTIVES: The SARS-CoV-2 pandemic has affected pregnant women with different clinical manifestations, one of them premature labor. The objective of this study is to characterize the pregnant patients with COVID-19 who had their delivery and to determine the risk of preterm delivery in this group compared to those who did not have the disease at the Maternity Department in San Juan de Dios Hospital, and determine what the rate of premature delivery is. METHODS: Retrospective observational cohort study where pregnant patients were included between April and June of 2020 at the Maternity Department in San Juan de Dios Hospital. Patients who had their delivery were selected and demographic and medical data, obstetric history, information regarding delivery, newborn history and characteristics of COVID-19 disease were evaluated. RESULTS: Among COVID-19 positives, a 16.9% had premature labor, reaching a nonsignificant OR 1.79 (0.76-3.84 95% CI) compared to those COVID-19 negative. Among those with severe COVID-19, all had preterm birth, with a significant OR (>=7.84 95% CI) compared to those with mild symptoms or COVID-19 negative. 10.1% of newborns of COVID-19 mothers required neonatal resuscitation, while, in the negative ones it was 5.5%. CONCLUSIONS: Among COVID-19 patients, a trend towards increased risk of preterm birth was observed compared to those without the disease, with the increased risk being significant in those with symptoms and even more significant if they had severe disease.


Assuntos
Humanos , Feminino , Gravidez , Recém-Nascido , Adulto , Pneumonia Viral/complicações , Infecções por Coronavirus/complicações , Trabalho de Parto Prematuro/epidemiologia , Pneumonia Viral/epidemiologia , Complicações Infecciosas na Gravidez , Cesárea/estatística & dados numéricos , Chile , Risco , Análise Multivariada , Estudos de Coortes , Infecções por Coronavirus/epidemiologia , Pandemias , Betacoronavirus , Hospitais , Maternidades/estatística & dados numéricos , Trabalho de Parto Prematuro/etiologia
7.
BMC Infect Dis ; 20(1): 564, 2020 Aug 03.
Artigo em Inglês | MEDLINE | ID: mdl-32746801

RESUMO

BACKGROUND: The recent COVID-19 outbreak in Wuhan, China, has quickly spread throughout the world. In this study, we systematically reviewed the clinical features and outcomes of pregnant women with COVID-19. METHODS: PubMed, Web of Science, EMBASE and MEDLINE were searched from January 1, 2020, to April 16, 2020. Case reports and case series of pregnant women infected with SARS-CoV-2 were included. Two reviewers screened 366 studies and 14 studies were included. Four reviewers independently extracted the features from the studies. We used a random-effects model to analyse the incidence (P) and 95% confidence interval (95% CI). Heterogeneity was assessed using the I2 statistic. RESULTS: The meta-analysis included 236 pregnant women with COVID-19. The results were as follows: positive CT findings (71%; 95% CI, 0.49-0.93), caesarean section (65%; 95% CI, 0.42-0.87), fever (51%; 95% CI, 0.35-0.67), lymphopenia (49%; 95% CI, 0.29-0.70), coexisting disorders (33%; 95% CI, 0.21-0.44), cough (31%; 95% CI, 0.23-0.39), fetal distress (29%; 95% CI, 0.08-0.49), preterm labor (23%; 95% CI, 0.14-0.32), and severe case or death (12%; 95% CI, 0.03-0.20). The subgroup analysis showed that compared with non-pregnant patients, pregnant women with COVID-19 had significantly lower incidences of fever (pregnant women, 51%; non-pregnant patients, 91%; P < 0.00001) and cough (pregnant women, 31%; non-pregnant patients, 67%; P < 0.0001). CONCLUSIONS: The incidences of fever, cough and positive CT findings in pregnant women with COVID-19 are less than those in the normal population with COVID-19, but the rate of preterm labor is higher among pregnant with COVID-19 than among normal pregnant women. There is currently no evidence that COVID-19 can spread through vertical transmission.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Trabalho de Parto Prematuro/epidemiologia , Pneumonia Viral/epidemiologia , Complicações Infecciosas na Gravidez/epidemiologia , Cesárea , China/epidemiologia , Infecções por Coronavirus/diagnóstico por imagem , Infecções por Coronavirus/virologia , Tosse/epidemiologia , Tosse/virologia , Feminino , Febre/epidemiologia , Febre/virologia , Humanos , Incidência , Recém-Nascido , Transmissão Vertical de Doenças Infecciosas , Trabalho de Parto Prematuro/virologia , Pandemias , Pneumonia Viral/diagnóstico por imagem , Pneumonia Viral/virologia , Gravidez , Complicações Infecciosas na Gravidez/diagnóstico por imagem , Complicações Infecciosas na Gravidez/virologia , Estudos Retrospectivos , Tomografia Computadorizada por Raios X
8.
SEMERGEN, Soc. Esp. Med. Rural Gen. (Ed. Impr.) ; 46(supl.1): 47-54, ago. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-192617

RESUMO

En este trabajo se revisan los artículos publicados sobre COVID-19, embarazo y afectación del neonato hasta el 30 de abril de 2020. Se han encontrado un total de 33 publicaciones que se refieren a 553 gestantes y 456 partos. Los síntomas más frecuentes en la embarazada fueron fiebre, tos y disnea. Cerca de tercios de los partos se realizaron por cesárea; el 5,9% de las mujeres requirieron ingreso en la UCI y el 4% requirieron ventilación mecánica. No se produjo ninguna muerte materna. Hubo prematuridad en el 22,3% de los partos y el neonato requirió ingreso en la UCI en el 38,3%. Solo se informó de una muerte neonatal (0,4%) y de 13 casos de COVID-19 neonatal (3,4%). La información disponible no permite asegurar que la transmisión se produjera por vía transplacentaria


Studies published on COVID-19, pregnancy and neonate disease until 30 April 2020 are revised. We found 33 articles including 553 pregnant women and 456 deliveries. The more frequent symptoms in the pregnant women were fever, cough and dyspnoea. About two thirds deliveries were carried out via Caesarean rate; 5.9% women were admitted in the ICU and 4% required mechanic ventilation. No maternal death was reported. Prematurity occurred in 22.3% deliveries and 38.3% neonates required admission in the ICU. Only one neonatal death was reported (0.4%) and 13 neonates (3.4%) suffered COVID-19. The available information does not allow to state whether transmission to neonates occurred transplacentarily


Assuntos
Humanos , Complicações Infecciosas na Gravidez/epidemiologia , Infecções por Coronavirus/epidemiologia , Transmissão Vertical de Doenças Infecciosas , Gestantes , Síndrome Respiratória Aguda Grave/epidemiologia , Vírus da SARS/patogenicidade , Trabalho de Parto Prematuro/epidemiologia
9.
Am J Perinatol ; 37(11): 1077-1083, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32615621

RESUMO

OBJECTIVE: This study aimed to determine the rate of preterm birth (PTB) during hospitalization among women diagnosed with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) between 23 and 37 weeks of gestation and whether this rate differs by gestational age at diagnosis of infection. STUDY DESIGN: Retrospective, cross-sectional study of all women diagnosed with SARS-CoV-2 infection between 23 and 37 weeks of gestation within a large integrated health system from March 13 to April 24, 2020. Cases with severe fetal structural malformations detected prior to infection were excluded. Women were stratified into two groups based on gestational age at diagnosis: early preterm (230/7 to 336/7 weeks) versus late preterm (34 to 366/7 weeks). We compared the rate of PTB during hospitalization with infection between the two groups. Statistical analysis included use of Wilcoxon rank sum and Fisher exact tests, as well as a multivariable logistic regression. Statistical significance was defined as a p-value <0.05. RESULTS: Of the 65 patients included, 36 (53.7%) were diagnosed in the early preterm period and 29 (46.3%) were diagnosed in the late preterm period. Baseline demographics were similar between groups. The rate of PTB during hospitalization with infection was significantly lower among women diagnosed in the early preterm period compared with late preterm (7/36 [19.4%] vs. 18/29 [62%], p-value = 0.001). Of the 25 patients who delivered during hospitalization with infection, the majority were indicated deliveries (64%, 16/25). There were no deliveries <33 weeks of gestation for worsening coronavirus disease 2019 and severity of disease did not alter the likelihood of delivery during hospitalization with SARS-CoV-2 infection (adjusted odds ratio [aOR]: 0.64; 95% confidence interval [CI]: 0.24-1.59). Increased maternal age was associated with a lower likelihood of delivery during hospitalization with SARS-CoV-2 infection (aOR: 0.77; 95% CI: 0.58-0.96), while later gestational age at diagnosis of infection was associated with a higher likelihood of delivery during hospitalization (aOR: 2.9; 95% CI: 1.67-8.09). CONCLUSION: The likelihood of PTB during hospitalization with SARS-CoV-2 infection is significantly lower among women diagnosed in the early preterm period compared with late preterm. Most women with SARS-CoV-2 infection in the early preterm period recovered and were discharged home. The majority of PTB were indicated and not due to spontaneous preterm labor. KEY POINTS: · Preterm delivery is less likely among women diagnosed in the early preterm compared with late preterm.. · Most women infected in the early preterm period recovered and were discharged home undelivered.. · The majority of preterm birth were indicated and not due to spontaneous preterm labor..


Assuntos
Betacoronavirus/isolamento & purificação , Coeficiente de Natalidade , Infecções por Coronavirus , Trabalho de Parto Prematuro/epidemiologia , Pandemias , Pneumonia Viral , Complicações Infecciosas na Gravidez , Adulto , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/fisiopatologia , Infecções por Coronavirus/terapia , Estudos Transversais , Feminino , Idade Gestacional , Hospitalização/estatística & dados numéricos , Humanos , Recém-Nascido , Recém-Nascido Prematuro , Idade Materna , New York/epidemiologia , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Pneumonia Viral/fisiopatologia , Pneumonia Viral/terapia , Gravidez , Complicações Infecciosas na Gravidez/diagnóstico , Complicações Infecciosas na Gravidez/epidemiologia , Complicações Infecciosas na Gravidez/fisiopatologia , Complicações Infecciosas na Gravidez/terapia , Cuidado Pré-Natal/métodos , Fatores de Tempo
10.
Arch Gynecol Obstet ; 302(3): 553-567, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32643040

RESUMO

PURPOSE: To analyze the effect of Chlamydia trachomatis (C. trachomatis) on adverse pregnancy outcomes based on the currently available evidence. METHODS: Multiple databases were comprehensively searched from the available date of inception through December 9, 2019. The effect of C. trachomatis on adverse pregnancy outcomes was assessed using pooled odds rations (ORs) and 95% confidence intervals (CIs). Egger's test was used for publication bias. RESULTS: Fifty studies involving 502,141 participants were identified. C. trachomatis infection was found to be associated with preterm birth in antibody detection [OR (95% CI): 1.571 (1.112-2.220), P = 0.010] and high-quality assessment [OR (95% CI): 1.734 (1.295-2.321), P < 0.001], preterm premature rupture of membranes (PPROM) in culture detection [OR (95% CI): 4.339 (1.806-10.424), P = 0.001] and high-quality assessment [OR (95% CI): 2.822 (1.333-5.973), P = 0.007], stillbirth [OR (95% CI): 1.585 (1.219-2.062), P = 0.001], low-birthweight babies [OR (95% CI): 2.205 (1.137-4.274), P = 0.019], and babies small for gestational age [OR (95% CI): 1.193 (1.091-1.305), P < 0.001]. No publication bias was exhibited in miscarriage (P = 0.170), preterm birth (P = 0.303), PPROM (P = 0.341), stillbirth (P = 0.533), and low-birthweight babies (P = 0.535). CONCLUSIONS: C. trachomatis infection during pregnancy is associated with a higher risk of preterm birth, PPROM, stillbirth, low-birthweight babies, and babies small for gestational age.


Assuntos
Infecções por Chlamydia/epidemiologia , Chlamydia trachomatis/isolamento & purificação , Ruptura Prematura de Membranas Fetais/epidemiologia , Trabalho de Parto Prematuro/epidemiologia , Complicações Infecciosas na Gravidez/epidemiologia , Aborto Espontâneo , Infecções por Chlamydia/diagnóstico , Infecções por Chlamydia/microbiologia , Feminino , Ruptura Prematura de Membranas Fetais/microbiologia , Humanos , Recém-Nascido de Baixo Peso , Recém-Nascido , Recém-Nascido Pequeno para a Idade Gestacional , Gravidez , Complicações Infecciosas na Gravidez/diagnóstico , Complicações Infecciosas na Gravidez/microbiologia , Resultado da Gravidez/epidemiologia , Nascimento Prematuro/epidemiologia , Natimorto
11.
Niger J Clin Pract ; 23(7): 928-933, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32620721

RESUMO

Background: Short inter-pregnancy interval (IPI) is a potential risk factor for adverse pregnancy outcomes. Previous reports from sub-Sahara Africa documented increasing incidence of short IPI but evidence is lacking in its effect on pregnancy outcome. Aim: The study aimed to determine the effect of short IPI on pregnancy outcome in Nigeria. Subjects and Methods: It was a prospective cohort study of 271 pregnant women receiving antenatal care in a tertiary hospital in Nigeria. For every eligible woman with short IPI (<18 months) recruited; a suitable control with IPI ≥18 months was selected. Statistical analysis was both inferential and descriptive using the statistical package for social sciences version 24 (SPSS Inc. Chicago, Illinois, USA) for windows. A P value of less than 0.05 was considered statistically significant. Results: Incidence of maternal anemia was higher in women with short IPI than control (RR: 2.091; 95% CI: 1.4433.031; P < 0.001). Other maternal and perinatal outcome measures including premature rupture of membranes, preterm labor/delivery, pregnancy induced hypertension, third trimester bleeding, postpartum hemorrhage, and inadequate gestational weight gain did not show any significant association with short IPI (P > 0.05). Conclusion: Short IPI is associated with anemia in pregnancy in Nigeria. Public health campaigns for improvement in uptake of family planning services and breastfeeding may help reduce the incidence of short IPI and anemia in low income countries.


Assuntos
Intervalo entre Nascimentos , Resultado da Gravidez , Nascimento Prematuro/epidemiologia , Cuidado Pré-Natal/estatística & dados numéricos , Adulto , Anemia/epidemiologia , Estudos de Coortes , Feminino , Humanos , Hipertensão Induzida pela Gravidez/epidemiologia , Incidência , Recém-Nascido , Nigéria/epidemiologia , Trabalho de Parto Prematuro/epidemiologia , Hemorragia Pós-Parto/epidemiologia , Pobreza , Gravidez , Estudos Prospectivos
12.
Arch Gynecol Obstet ; 302(4): 861-871, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32621250

RESUMO

PURPOSE: Preterm birth (PTB) can be categorised according to aetiology into: spontaneous preterm labour (SPL), preterm prelabour rupture of membranes (PPROM), and iatrogenic (iatro) PTB. Outcomes could differ between these groups, which could be of interest in counselling. We aimed to explore differences between aetiologic groups of PTB in maternal demographics, obstetrical characteristics and management, and neonatal outcomes. METHODS: This is a cohort study (2012-2018) in Ghent University Hospital, Belgium, of deliveries from 24 + 0 to 33 + 6 weeks. We compared perinatal demographics, management, and outcomes between the aetiologic types of PTB. Point and interval estimates for differences between aetiologic types were estimated using a Generalised Estimating Equations approach to handle clustering due to multiple gestations. RESULTS: 813 mothers and 987 neonates were included. Prevalences of different aetiologic types of PTB were similar. Maternal BMI was higher in the iatrogenic group (iatro-SPL: + 1.92 kg/m2, 95% CI 1.02, 2.83; iatro-PPROM: + 2.06 kg/m2, 95% CI 1.15, 2.96). There was an inversed sex ratio (0.82, 95% CI 0.65, 1.03), more growth restriction (iatro-SPL: + 22.60%, 95% CI 17.08, 28.13; iatro-PPROM: + 24.64%, 95% CI 19.44, 29.83), and a higher caesarean section rate in the iatrogenic group (iatro-SPL: + 57.23%, 95% CI 50.32, 64.13, iatro-PPROM: + 56.79%, 95% CI 50.20, 63.38) and more patients received at least one complete course of antenatal corticosteroids (iatro-SPL: + 17.60%, 95% CI 10.60, 24.60, iatro-PPROM: + 10.73%, 95% CI 4.52, 16.94). In all types of PTB, adverse neonatal outcomes had a low prevalence, except for respiratory distress syndrome. A composite of adverse neonatal outcome was more prevalent in the SPL- compared to the PPROM group, and there was less intraventricular haemorrhage in the iatrogenic group. CONCLUSION: Additional to gestational age at birth, the aetiology of PTB is associated with neonatal outcome. More data are needed to enable individualised management and counselling in case of threatened PTB. TRIAL REGISTRATION NUMBER: NCT03405116.


Assuntos
Ruptura Prematura de Membranas Fetais/epidemiologia , Trabalho de Parto Prematuro/epidemiologia , Resultado da Gravidez/epidemiologia , Nascimento Prematuro/etiologia , Síndrome do Desconforto Respiratório do Recém-Nascido/epidemiologia , Bélgica/epidemiologia , Cesárea , Estudos de Coortes , Feminino , Idade Gestacional , Humanos , Recém-Nascido , Mães , Gravidez , Gravidez Múltipla , Nascimento Prematuro/epidemiologia , Prevalência
13.
South Med J ; 113(6): 292-297, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32483639

RESUMO

OBJECTIVE: To assess patient- and hospital-level characteristics associated with opioid use in human immunodeficiency virus (HIV)-positive pregnant women and fetal health outcomes. METHODS: Using the 2002-2014 Nationwide Inpatient Sample database, we analyzed discharge records to describe the rates of opioid use among HIV-positive pregnant women. Logistic regression was used to quantify the magnitude of the association between exposure status and maternal-fetal outcomes. RESULTS: Opioid use was fourfold greater among HIV-positive pregnant women compared with their HIV-negative counterparts (odds ratio 4.0; 95% confidence interval 3.15-5.12). Relatively smaller but significant increases in the early onset of delivery, poor fetal growth, abortive pregnancy, and spontaneous abortion also were observed in association with HIV-positive status and opioid drug use during pregnancy. CONCLUSIONS: An increased risk of negative maternal-fetal complications persists among HIV-positive women who use opioids during pregnancy. Focusing on predisposing factors and monitoring opioid dispensing may mitigate overuse or abuse in this vulnerable population.


Assuntos
Aborto Espontâneo/epidemiologia , Retardo do Crescimento Fetal/epidemiologia , Infecções por HIV/epidemiologia , Transtornos Relacionados ao Uso de Opioides/epidemiologia , Complicações Infecciosas na Gravidez/epidemiologia , Nascimento Prematuro/epidemiologia , Aborto Induzido/estatística & dados numéricos , Adolescente , Adulto , Consumo de Bebidas Alcoólicas/epidemiologia , Estudos de Casos e Controles , Depressão/epidemiologia , Feminino , Humanos , Modelos Logísticos , Pessoa de Meia-Idade , Trabalho de Parto Prematuro/epidemiologia , Gravidez , Complicações na Gravidez/epidemiologia , Sepse/epidemiologia , Uso de Tabaco/epidemiologia , Estados Unidos/epidemiologia , Adulto Jovem
14.
BMC Psychiatry ; 20(1): 250, 2020 05 20.
Artigo em Inglês | MEDLINE | ID: mdl-32434583

RESUMO

BACKGROUND: The mental health of pregnant women, particularly those with elevated risks, has been an issue of global concern. Thus far, few studies have addressed the mental health of pregnant women with threatened preterm labour (TPL). This study investigated the prevalence of self-perceived burden (SPB) among Chinese women hospitalized due to TPL during pregnancy and early postpartum depressive disorders, exploring the effect of SPB and other potential risk factors on the early signs of postpartum depressive disorders. METHODS: A self-reported survey was conducted in the obstetrics department of Anhui Provincial Hospital, China. Women hospitalized with TPL were approached 1 week after delivery. One hundred fifty women were recruited from January 2017 to December 2017. The Self-Perceived Burden Scale (SPBS) and Edinburgh Postnatal Depression Scale (EPDS) were the main measures. Descriptive statistics, Spearman correlations, and a multiple logistic regression were employed for data analysis. RESULTS: SPB and early postpartum depressive disorders were commonly experienced by Chinese women hospitalized with TPL, and SPB was positively and significantly correlated with depressive symptoms. A multiple logistic regression analysis revealed that for the women hospitalized with TPL during pregnancy, the emotional aspect of SPB (OR = 1.42, 95% CI = 1.11-1.83, p = 0.006), age (OR = 1.14, 95% CI = 1.02-1.27, p = 0.023), occupation (OR = 3.48, 95% CI = 1.18-10.20, p = 0.023), the history of scarred uterus (OR = 7.96, 95% CI = 1.49-42.48, p = 0.015), the delivery mode of the present birth (OR = 6.19, 95% CI = 1.72-22.30, p = 0.005), and family support during pregnancy (OR = 0.60, 95% CI = 0.45-0.82, p = 0.001) were significant factors predicting early postpartum depressive symptoms. CONCLUSION: This study indicates that SPB and early postpartum depressive disorders are prevalent mental issues among Chinese women hospitalized with TPL, and that SPB, especially perceived emotional burden, is a strong predictor of early postpartum depressive disorders. Our study suggests the necessity of paying attention to mental health issues, e.g. SPB and postpartum depressive symptoms among hospitalized women with TPL, and providing appropriate interventions at the prenatal stage to prevent adverse consequences.


Assuntos
Depressão/psicologia , Hospitalização/estatística & dados numéricos , Transtornos Mentais/diagnóstico , Transtornos Mentais/psicologia , Complicações na Gravidez/psicologia , Gravidez de Alto Risco/psicologia , Adulto , China , Depressão/diagnóstico , Depressão/etnologia , Depressão Pós-Parto/diagnóstico , Depressão Pós-Parto/etnologia , Feminino , Humanos , Recém-Nascido , Transtornos Mentais/etnologia , Trabalho de Parto Prematuro/epidemiologia , Trabalho de Parto Prematuro/etiologia , Período Pós-Parto , Gravidez , Fatores de Risco
15.
Epidemiol Health ; 42: e2020025, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32422694

RESUMO

OBJECTIVES: The global prevalence of preterm labor is approximately 11.1% of live births. However, preterm labor contributes to 75-80% of neonatal morbidity and mortality. The morbidity experienced by preterm infants may continue to influence their subsequent development, imposing physical, psychological, and economic burdens. Premature rupture of membranes (PROM) is a causal factor that may affect preterm birth. Previous studies have shown an association between PROM and preterm labor, but this association should be investigated in more diverse populations. Therefore, this study was conducted in Cilegon, Indonesia to determine the magnitude of the risk of preterm labor associated with PROM at Cilegon Hospital from July 2014 to December 2015. METHODS: This case-control study used data from patients' medical records. The cases were all mothers who delivered at less than 37 weeks of gestation, while the control population comprised all mothers who delivered at greater or equal to 37 weeks. The data were analyzed using logistic regression. RESULTS: The bivariate analysis yielded an odds ratio (OR) of 2.97 (95% confidence interval [CI], 1.92 to 4.59) before controlling for covariates. The model derived through multiple regression analysis after controlling for education, history of preterm labor, and anemia resulted in an OR of 2.58 (95% CI, 1.68 to 3.98). CONCLUSIONS: Mothers who experience PROM during pregnancy were at a 2.58 times higher risk of preterm labor after controlling for education, history of preterm labor, and anemia.


Assuntos
Ruptura Prematura de Membranas Fetais/epidemiologia , Trabalho de Parto Prematuro/epidemiologia , Estudos de Casos e Controles , Feminino , Humanos , Indonésia/epidemiologia , Gravidez , Fatores de Risco
16.
Clín. investig. ginecol. obstet. (Ed. impr.) ; 47(1): 3-8, ene.-mar. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-187065

RESUMO

Introducción: Las guías clínicas actuales recomiendan el uso del cerclaje de emergencia (CE) como tratamiento de la insuficiencia cervical con exposición de membranas en gestaciones únicas. Sin embargo, el CE en gestación múltiple es tema de controversia dado que no existen ensayos clínicos randomizados que demuestren su eficacia. Algunos estudios retrospectivos sugieren que el CE también podría prolongar la gestación en embarazos múltiples. El objetivo de nuestro estudio es evaluar los resultados de las gestaciones múltiples que se sometieron a un CE en nuestro centro. Materiales y métodos: Se diseñó un estudio retrospectivo que incluyó los CE realizados en gestaciones gemelares en nuestro centro entre 2007-2016. No fueron tributarias de CE gestaciones con malformaciones fetales, monocoriales-monoamnióticas, triple o superior y finalizaciones activas de la gestación. Variables primarias: latencia al parto espontáneo y edad gestacional al parto. Variables secundarias: mortalidad neonatal, ingreso en UCI neonatal, rotura prematura de membranas pretérmino, corioamnionitis y fallo del cerclaje. Resultados. El estudio incluyó 17 pacientes. La edad gestacional mediana (rango intercuartil) al parto fue de 27,1 (24,5-32,3) semanas y la latencia mediana (rango intercuartil) al parto fue de 43 (21-64) días. Hubo 4/17 (23,5%) casos de parto antes de las 24 semanas de gestación y 2/26 (7,7%) de muerte neonatal. Discusión: Estos resultados muestran que la latencia al parto después del CE en gestación múltiple es remarcable, por lo que podría ser considerado como una opción terapéutica. Sin embargo, se requiere evidencia basada en estudios randomizados para hacer una recomendación firme


Introduction: Current guidelines support the use of physical-examination indicated cerclage (PEIC) as a treatment for cervical insufficiency and membrane exposure in single pregnancies. However, PEIC in twin pregnancies is a controversial issue as no data from random clinical trial are available to demonstrate its efficacy. Few studies suggest that PEIC may prolong pregnancy also in twin pregnancies. The aim of this study was to evaluate the results of twin pregnancies that underwent a PEIC in our health centre. Material and methods: A retrospective review was performed on women that underwent a PEIC from 2007-2016 in our centre. Women were not eligible if they were carrying foetuses with major foetal anomalies, more than two foetuses or monochorionic-monoamniotic pregnancies, or three or more foetuses or requesting an elective termination of pregnancy. Primary outcomes: latency to spontaneous delivery and gestational age (GA) at delivery. Secondary outcomes: neonatal mortality and Neonatal Intensive Care Unit admission, preterm premature rupture of membranes (PPROM), chorioamnionitis and cerclage displacement. Results: The study included a total of 17 women. The median (inter-quartile range) gestational age at delivery was 27.1 (24.5-32.3) weeks, and median (inter-quartile range) latency, from cervical cerclage to delivery, was 43 (21-64) days. There were 4/17 (23.5%) cases of delivery before 24 weeks of pregnancy, and 2/26 (7.7%) cases of neonatal death. Discussion: These results suggest that latency to delivery after PEIC in twins is remarkable. Therefore, it could be considered as an optional management. Nevertheless, evidence based on random clinical trial is required to make firm recommendations on its formal use


Assuntos
Humanos , Feminino , Gravidez , Adulto , Cerclagem Cervical/métodos , Gravidez de Gêmeos/fisiologia , Mortalidade Infantil , Fatores de Risco , Amniocentese/métodos , Estudos Retrospectivos , Idade Gestacional , Trabalho de Parto Prematuro/epidemiologia , Ruptura Prematura de Membranas Fetais , Gardnerella vaginalis/isolamento & purificação , Gardnerella vaginalis/efeitos dos fármacos , Klebsiella pneumoniae/efeitos dos fármacos , Klebsiella pneumoniae/isolamento & purificação , Candida albicans/efeitos dos fármacos , Candida albicans/isolamento & purificação
17.
Am J Obstet Gynecol ; 223(2): 204.e1-204.e8, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32067966

RESUMO

OBJECTIVE DATA: The purpose of this study was to conduct a systematic review and meta-analyses of literature regarding the risk of preterm birth in singleton pregnancies after a preterm twin birth. STUDY: We conducted a literature search of Embase, Ovid Medline, and Cochrane from inception until February 28, 2019. Studies that evaluated women with a previous twin birth followed by a singleton birth were included. STUDY APPRAISAL AND SYNTHESIS METHODS: Data were abstracted in duplicate, and summary odds ratios and confidence intervals were calculated with the use of random effects model. Risk of bias was assessed with the use of the Newcastle-Ottawa Scale, and quality of evidence was evaluated with the use of the Grades of Recommendation, Assessment, Development, and Evaluation approach. The primary outcome was a preterm singleton birth (<37 weeks gestational age); secondary outcomes included risk of late preterm birth (34-36+6 weeks gestation), preterm birth between 30 and 33+6 weeks gestation, and preterm birth at <30 weeks gestation. Subanalysis of risk of singleton preterm birth after spontaneous twin birth was also performed. A priori, the protocol was developed and registered with PROSPERO (2016; registration number: CRD42017053382). RESULTS: We included 8 cohort studies at low risk-of-bias met inclusion criteria for the systematic review and 6 for the meta-analysis. Compared with women with previous term twin births, women who had previous preterm (<37 weeks gestation) twin births were at increased odds of preterm singleton birth in subsequent pregnancy (odds ratio, 4.34; 95% confidence interval, 2.83-6.65). Gestational age at birth of previous twin pregnancy was an effect modifier. Compared with previous term twin births, the odd ratios of subsequent preterm singleton birth were 2.13 (95% confidence interval, 1.21-3.74) if twins were born between 34 and 36+6 weeks gestation, 5.18 (95% confidence interval, 2.78-9.64) if twins were born between 30 and 33+6 weeks gestation, and 9.78 (95% confidence interval, 4.99-18.98) if twins were born at <30 weeks gestation. A similar trend was seen for the risk of singleton preterm birth after spontaneous twin preterm birth. CONCLUSION: A history of preterm twin birth is associated with higher odds of subsequent preterm singleton birth. The odds increase with decreasing gestational age of previous twin birth.


Assuntos
Trabalho de Parto Prematuro/epidemiologia , Gravidez de Gêmeos , Nascimento Prematuro/epidemiologia , Feminino , Humanos , Incidência , Gravidez , Risco
18.
Am J Cardiol ; 125(5): 812-819, 2020 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-31902476

RESUMO

Improved treatment of congenital heart defects (CHDs) has resulted in women with CHDs living to childbearing age. However, no US population-based systems exist to estimate pregnancy frequency or complications among women with CHDs. Cases were identified in multiple data sources from 3 surveillance sites: Emory University (EU) whose catchment area included 5 metropolitan Atlanta counties; Massachusetts Department of Public Health (MA) whose catchment area was statewide; and New York State Department of Health (NY) whose catchment area included 11 counties. Cases were categorized into one of 5 mutually exclusive CHD severity groups collapsed to severe versus not severe; specific ICD-9-CM codes were used to capture pregnancy, gestational complications, and nongestational co-morbidities in women, age 11 to 50 years, with a CHD-related ICD-9-CM code. Pregnancy, CHD severity, demographics, gestational complications, co-morbidities, and insurance status were evaluated. ICD-9-CM codes identified 26,655 women with CHDs, of whom 5,672 (21.3%, range: 12.8% in NY to 22.5% in MA) had codes indicating a pregnancy. Over 3 years, age-adjusted proportion pregnancy rates among women with severe CHDs ranged from 10.0% to 24.6%, and 14.2% to 21.7% for women with nonsevere CHDs. Pregnant women with CHDs of any severity, compared with nonpregnant women with CHDs, reported more noncardiovascular co-morbidities. Insurance type varied by site and pregnancy status. These US population-based, multisite estimates of pregnancy among women with CHD indicate a substantial number of women with CHDs may be experiencing pregnancy and complications. In conclusion, given the growing adult population with CHDs, reproductive health of women with CHD is an important public health issue.


Assuntos
Cardiopatias Congênitas/epidemiologia , Complicações Cardiovasculares na Gravidez/epidemiologia , Complicações na Gravidez/epidemiologia , Taxa de Gravidez , Adolescente , Adulto , Anemia/epidemiologia , Arritmias Cardíacas/epidemiologia , Área Programática de Saúde , Criança , Comorbidade , Doença da Artéria Coronariana/epidemiologia , Diabetes Gestacional/epidemiologia , Hipertensão Essencial/epidemiologia , Feminino , Georgia/epidemiologia , Humanos , Hiperêmese Gravídica/epidemiologia , Hiperlipidemias/epidemiologia , Hipertensão Induzida pela Gravidez/epidemiologia , Armazenamento e Recuperação da Informação , Cobertura do Seguro/estatística & dados numéricos , Classificação Internacional de Doenças , Massachusetts/epidemiologia , Medicaid , Pessoas sem Cobertura de Seguro de Saúde , Medicare , Pessoa de Meia-Idade , New York/epidemiologia , Obesidade Materna/epidemiologia , Trabalho de Parto Prematuro/epidemiologia , Gravidez , Complicações Hematológicas na Gravidez/epidemiologia , Complicações Infecciosas na Gravidez/epidemiologia , Acidente Vascular Cerebral/epidemiologia , Trombose/epidemiologia , Estados Unidos/epidemiologia , Adulto Jovem
19.
Women Birth ; 33(6): e535-e542, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31899149

RESUMO

BACKGROUND: Each year thousands of pregnant women experiencing threatened premature labour are transferred considerable distances across Australia to access higher level facilities but only a small proportion of these women go on to actually give birth to a premature baby. Women from regional areas are required to move away from their home, children and support networks because of a perceived risk of birthing in a centre without neonatal intensive care facilities. AIM: This study examines the experience of women undergoing antenatal transfer for threatened premature labour in New South Wales and the Australian Capital Territory who do not give birth during their transfer admission. METHODS: Thirteen semi-structured in-depth interviews were held with women across five tertiary referral sites across New South Wales and the Australian Capital Territory, and analysed until saturation for themes. FINDINGS: Seven urban and six rural women were interviewed. Women and their families were all negatively affected by antenatal transfer. Factors that helped enable a positive experience were; enhanced sense of safety in the tertiary unit, and individual qualities of staff. Factors that contributed to negative experiences were; inadequate and conflicting information, and no involvement or choice in the clinical decision-making process to move to another facility. CONCLUSIONS: Antenatal transfer is an extremely stressful experience for women and their families. The provision of high quality written and verbal information, and the inclusion of women's perception of risk in the clinical decision making process will improve the experience for women and their families in NSW and the ACT.


Assuntos
Centros de Assistência à Gravidez e ao Parto/organização & administração , Trabalho de Parto/psicologia , Trabalho de Parto Prematuro/prevenção & controle , Transferência de Pacientes/estatística & dados numéricos , Gestantes/psicologia , Adulto , Austrália , Feminino , Humanos , Entrevistas como Assunto , New South Wales , Trabalho de Parto Prematuro/epidemiologia , Parto , Planejamento de Assistência ao Paciente , Gravidez , Gestantes/etnologia , Pesquisa Qualitativa , Inquéritos e Questionários , Centros de Atenção Terciária
20.
BMC Pregnancy Childbirth ; 20(1): 38, 2020 Jan 14.
Artigo em Inglês | MEDLINE | ID: mdl-31937269

RESUMO

BACKGROUND: Few studies have investigated whether maternal age and education level modify the association of chronic hepatitis B virus (HBV) infection with preterm labor. We hypothesized that the association of HBV infection with preterm labor is modified by maternal age and education level. METHODS: A retrospective cohort study was conducted on the HBsAg-positive and HBsAg-negative pregnant women delivered from June 2012 to August 2017 at Wuhan Medical Care Center for Women and Children, Wuhan, China. A multivariate regression model was used in this study. RESULTS: This study included 2050 HBsAg-positive pregnant women and 2050 HBsAg negative women. In the stratified analyses, positive HBsAg status was associated with the increased risk of preterm labor in women aged < 30 years, having low educational level, with an odds ratio of 1.65(95% CI 1.07-2.54) and 2.59(95% CI 1.41-4.76), respectively. Breslow-Day test showed that there existed significant differences in the ORs for HBsAg carriage across each stratum of maternal age (p = 0.023), educational level (p = 0.002). After adjusting other co-variables, we observed maternal HBV infection (OR 1.60, 95% CI 1.03-2.49) was still associated with risk of preterm labor in pregnancy women with age < 30. Similarly, the significant association of HBV infection (OR 2.49, 95% CI 1.34-4.63) with preterm labor remained in low educated women. CONCLUSIONS: Our results indicated that HBV infection was associated with high risk of preterm labor, but maternal age and educational level could modify the association between HBV infection and preterm labor.


Assuntos
Escolaridade , Hepatite B Crônica/epidemiologia , Idade Materna , Trabalho de Parto Prematuro/epidemiologia , Complicações Infecciosas na Gravidez/epidemiologia , Adulto , China/epidemiologia , Feminino , Humanos , Modelos Logísticos , Análise Multivariada , Razão de Chances , Gravidez , Estudos Retrospectivos , Adulto Jovem
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