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Prospective study of time to pregnancy and adverse birth outcomes.

ABSTRACT: To investigate the association between time to pregnancy (TTP) and adverse birth outcomes.Prospective cohort study.Not applicable.A total of 3,521 singletons born to women aged 18-40 years at cohort entry.None.Selected birth outcomes, including preterm birth (PTB, <37 weeks' gestation), low birth weight (<2,500 g), small for gestational age, large for gestational age, and placental disorders, ascertained from the Danish Medical Birth Registry and Danish National Registry of Patients. Risk ratios (RRs) and 95% confidence intervals (CIs) were estimated using log-binomial regression, with adjustment for potential confounders and fertility treatment.Multivariable RRs for PTB in relation to TTP of 3-5, 6-11, and ?12 vs. <3 cycles were 1.59 (95% CI 0.94-2.69), 0.85 (95% CI 0.48-1.50), and 1.57 (95% CI 0.93-2.65). The association was slightly stronger for spontaneous PTB (TTP ?12 vs. <3 cycles: RR 1.69, 95% CI 0.84-3.42) than for medically indicated PTB (RR 1.39, 95% CI 0.62-3.12). Longer TTPs (?12 cycles) were associated with increased risks of low birth weight (RR 1.80, 95% CI 0.97-3.35), cesarean delivery (RR 1.64, 95% CI 1.27-2.12), placental disorders (RR 2.21, 95% CI 1.07-4.56), ischemic placental disease (RR 1.56, 95% CI 0.99-2.44), pre-eclampsia (RR 1.45, 95% CI 0.79-2.65), and postpartum hemorrhage (RR 1.58, CI 1.14-2.19), and decreased risks of macrosomia (?4,500 g; RR 0.63, 95% CI 0.35-1.13) and large for gestational age (RR 0.76, 95% CI 0.58-1.00). Longer TTP showed little association with small for gestational age.In a prospective cohort study of Danish pregnancy planners, delayed conception was a marker for adverse birth outcomes, after accounting for fertility treatment.

SUBMITTER: Wise LA

PROVIDER: S-EPMC4394049 | biostudies-literature | 2015 Apr

REPOSITORIES: biostudies-literature

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Prospective study of time to pregnancy and adverse birth outcomes.

Wise Lauren A LA Mikkelsen Ellen M EM Sørensen Henrik Toft HT Rothman Kenneth J KJ Hahn Kristen A KA Riis Anders H AH Hatch Elizabeth E EE

Fertility and sterility 20150220 4

<h4>Objective</h4>To investigate the association between time to pregnancy (TTP) and adverse birth outcomes.<h4>Design</h4>Prospective cohort study.<h4>Setting</h4>Not applicable.<h4>Patient(s)</h4>A total of 3,521 singletons born to women aged 18-40 years at cohort entry.<h4>Intervention(s)</h4>None.<h4>Main outcome measure(s)</h4>Selected birth outcomes, including preterm birth (PTB, <37 weeks' gestation), low birth weight (<2,500 g), small for gestational age, large for gestational age, and p ...[more]

PMID: 25707334

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Project description:BackgroundAdolescent pregnancy is considered a major contributor to maternal and child morbidity and mortality, the greatest concern of developing countries and an important public health issue globally. Adolescents are responsible for eleven percent of births worldwide and they face several pregnancy and childbirth related complications. However, in low-income countries like Ethiopia, there are limited researches conducted to investigate outcomes of adolescent pregnancy. Therefore, this study was conducted to assess the adverse maternal outcomes of adolescent pregnancy in Northwest Ethiopia.MethodsA prospective cohort study was conducted in 12 health facilities from seven districts in East Gojjam zone, Northwest Ethiopia. A total of 418 adolescents (15-19 years old) and 836 adult women (20-34 years old) who attended randomly selected health facilities in East Gojjam zone were included. Data were collected starting from admission to the maternity ward for labor and delivery, and postnatal depression was measured at six weeks' postpartum period using the Edinburgh Postnatal Depression Scale. Generalized estimating equations (GEE) was used to account for the within subject correlation and assess the effect of different known factors that could influence the outcome of this study.ResultsA lower percentage of adolescent (58.4%) than adult (71.2%) women had their first antenatal care booking before 16 weeks of gestation. After adjusting for different confounding factors, the adverse outcome that was significantly associated with adolescent pregnancy was postpartum depression (AOR: 2.29; 95% CI, 1.42, 3.7, p-value = 0.001). Assisted vaginal delivery (AOR: 0.44; 95% CI, 0.23, 0.86, p-value 0.016) and cesarean section (AOR: 0.43; 95% CI, 0.19, 0.97, p-value = 0.042) were significantly lower among adolescent women.ConclusionsAdolescent pregnancy is associated with higher odds of postpartum depression, and lower odds to undergo cesarean section and assisted vaginal delivery than adult women. Perinatal care services should be more adolescent-friendly to ensure early diagnosis and treatment of postpartum depression. School and community-based awareness programs regarding use of contraception to prevent unwanted adolescent pregnancy, early antenatal care booking and adverse pregnancy outcomes of adolescent pregnancy and provision of psychosocial support are recommended.

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Prospective study of time to pregnancy and adverse birth outcomes.

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Prospective study of time to pregnancy and adverse birth outcomes.

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