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Impact of Unintended Pregnancy on Maternal and Neonatal Outcomes.

ABSTRACT: Background:Pregnancy outcomes might be affected by unintended pregnancy such as preeclampsia, preterm birth, cesarean section and low birth weight. The aim of the present study is to assess the association between unintended pregnancy and pregnancy outcomes. Methods:This was a cross-sectional study conducted in 103 hospitals in Tehran, Iran, in July 2015. The data were collected by trained midwives. The interested independent variable was unintended pregnancy and also preeclampsia, weight gain during pregnancy, preterm birth, cesarean section and low birth weight were considered as interested outcomes, and the association of unintended pregnancy and interested outcomes were assessed. Results:Out of 5152 cases, 1021 (19.82%) cases were unintended pregnancy. There was no significant relationship between unintended pregnancy and low birth weight (adjusted OR?0.67, 95% CI 0.403-1.13, P?=?0.138), the risk of preterm birth (adjusted OR?1.15, 95% CI 0.850-1.57, P?=?0.351) and preeclampsia (adjusted OR?1.21, 95% CI 0.846-1.75, P?=?0.289). The results of multiple linear regression model showed that the mean difference between two groups was 0.70 kg, and weight gain mean in unintended pregnant women significantly was lower than unintended pregnant women (mean difference?=?0.70, 95% CI 0.14-1.26 kg, P?=?0.014). Multiple logistic regression showed that after adjusting confounders, there was a significant relationship between unintended pregnancy and cesarean section, and the adjusted odds of cesarean section in unintended pregnant women was 1.32 times of intended pregnant women (95% CI 1.07-1.63, P?=?0.009). Conclusion:We found higher risk of cesarean section and inappropriate weight gain during pregnancy as adverse outcomes of unintended pregnancy in adjusted model.

SUBMITTER: Omani-Samani R

PROVIDER: S-EPMC6430264 | biostudies-literature | 2019 Apr

REPOSITORIES: biostudies-literature

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Impact of Unintended Pregnancy on Maternal and Neonatal Outcomes.

Omani-Samani Reza R Ranjbaran Mehdi M Mohammadi Maryam M Esmailzadeh Arezoo A Sepidarkish Mahdi M Maroufizadeh Saman S Almasi-Hashiani Amir A

Journal of obstetrics and gynaecology of India 20180516 2

<h4>Background</h4>Pregnancy outcomes might be affected by unintended pregnancy such as preeclampsia, preterm birth, cesarean section and low birth weight. The aim of the present study is to assess the association between unintended pregnancy and pregnancy outcomes.<h4>Methods</h4>This was a cross-sectional study conducted in 103 hospitals in Tehran, Iran, in July 2015. The data were collected by trained midwives. The interested independent variable was unintended pregnancy and also preeclampsia ...[more]

PMID: 30956467

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Project description:BackgroundVegetarian diets are becoming increasingly popular in the USA. Limited research has examined the health consequences of vegetarian diets during pregnancy. We comprehensively examined associations of vegetarianism during pregnancy with maternal and neonatal outcomes.MethodsWe used data from the Eunice Kennedy Shriver National Institute of Child Health and Human Development's Fetal Growth Studies-Singletons, a prospective multi-site cohort of 1948 low-risk pregnant women of four races/ethnicities (White, Black, Hispanic, Asian/Pacific Islander) in the USA (2009-2013). Vegetarianism was self-reported and also defined based on dietary patterns measured using a self-administered first-trimester food-frequency questionnaire (full [lacto-ovo and vegan], pesco-, semi- and non-vegetarians). Neonatal outcomes included birthweight and neonatal anthropometric measures, small for gestational age, small for gestational age with neonatal morbidity and preterm delivery. Maternal outcomes included gestational weight gain, gestational diabetes, hypertensive disorders of pregnancy and gestational anaemia.ResultsNinety-nine (6.2%) women self-reported being vegetarian. The diet-based definition identified 32 (2.0%) full vegetarians, 7 (0.6%) pesco-vegetarians and 301 (17.6%) semi-vegetarians. Neonates of diet-based full vegetarians had higher odds of being small for gestational age [adjusted odds ratio (ORadj) = 2.51, 95% confidence interval: 1.01, 6.21], but not of being small for gestational age with a postnatal morbidity. Full vegetarians had marginally increased the odds of inadequate second-trimester gestational weight gain (ORadj = 2.24, 95% confidence interval: 0.95, 5.27).ConclusionVegetarian diets during pregnancy were associated with constitutionally smaller neonatal size, potentially via the mothers' reduced gestational weight gain. Notably, vegetarianism was not associated with small-for-gestational-age-related morbidities or other adverse maternal outcomes.

Project description:BackgroundMaternal dietary habits are contributors of maternal and fetal health; however, available data are heterogeneous and not conclusive.MethodsNutrient intake during pregnancy was assessed in 503 women with uncomplicated pregnancies, using the validated Food Frequency Questionnaire developed by the European Prospective Investigation into Cancer and Nutrition (EPIC-FFQ).ResultsIn all, 68% of women had a normal body mass index at the beginning of pregnancy, and 83% of newborns had an appropriate weight for gestational age. Maternal pre-pregnancy body mass index (BMI), gestational weight gain (GWG), and placental weight were independently correlated with birth weight. GWG was not related to the pre-pregnancy BMI. EPIC-FFQ evaluation showed that 30% of women adhered to the European Food Safety Authority (EFSA) ranges for macronutrient intake. In most pregnant women (98.1%), consumption of water was below recommendations. Comparing women with intakes within EFSA ranges for macronutrients with those who did not, no differences were found in BMI, GWG, and neonatal or placental weight. Neither maternal nor neonatal parameters were associated with the maternal dietary profiles.ConclusionsIn our population, maternal pre-pregnancy BMI, GWG, and placental weight are determinants of birth weight percentile, while no association was found with maternal nutrition. Future studies should explore associations through all infancy.ImpactMaternal anthropometrics and nutrition status may affect offspring birth weight. In 503 healthy women, maternal pre-pregnancy body mass index (BMI), gestational weight gain (GWG), and placental weight were independently correlated to neonatal birth weight. GWG was not related to the pre-pregnancy BMI. In all, 30% of women respected the EFSA ranges for macronutrients. Neither maternal nor neonatal parameters were associated with maternal dietary profiles considered in this study. Maternal pre-pregnancy BMI, GWG, and placental weight are determinants of neonatal birth weight percentile, while a connection with maternal nutrition profiles was not found.

Project description:ImportanceWith the help of medical advances, more women with adult congenital heart disease (ACHD) are becoming pregnant. Adverse maternal, obstetric, and neonatal events occur more frequently in women with ACHD than in the general obstetric population. Adult congenital heart disease is heterogeneous, yet few studies have assessed whether maternal and neonatal outcomes differ across ACHD subtypes.ObjectiveTo assess the association of ACHD and its subtypes with pregnancy, maternal, and neonatal outcomes.Design, setting, and participantsThis cross-sectional study used data from the Discharge Abstract Database, which contains information on all hospitalizations in Canada (except Quebec) from fiscal years 2001-2002 through 2014-2015. Discharge Abstract Database information was linked with maternal and infant hospital records across Canada. All women who gave birth in hospitals during the study period were included in the study. Data were analyzed from December 18, 2017, to March 22, 2019.ExposuresWomen with ACHD were identified using diagnostic and procedural codes. Subtypes of ACHD were classified using the Anatomic and Clinical Classification of Congenital Heart Defects scheme.Main outcomes and measuresPrimary outcomes were defined a priori and included severe maternal morbidity (measured using the Maternal Morbidity Outcomes Indicator), neonatal morbidity and mortality (measured using the Neonatal Adverse Outcomes Indicator), ischemic placental disease, preterm birth, congenital anomalies, and small-for-gestational-age births. Absolute and relative rates of each outcome were calculated overall and by ACHD subtype. Logistic regression using generalized estimating equations assessed crude and adjusted odds ratios (aORs) for each outcome in women with ACHD compared with women without ACHD after adjustment for comorbidities, mode of delivery, and study year.ResultsThe 2114 women with ACHD included in the analysis (mean [SD] age, 29.4 [5.7] years) had significantly higher odds of maternal morbidity (aOR, 2.7; 95% CI, 2.2-3.4) and neonatal morbidity and mortality (aOR, 1.8; 95% CI, 1.6-2.1) compared with women without ACHD (n = 2 682 451). Substantial variation was observed between women with different subtypes of ACHD. For example, the aORs of preterm birth (<37 weeks) varied from 0.4 (95% CI, 0.4-0.5) for women with anomalies of atrioventricular junctions and valves to 4.7 (95% CI, 2.9-7.5) for women with complex anomalies of atrioventricular connections.Conclusions and relevanceThese results suggest that women with different subtypes of ACHD are not uniformly at risk for adverse maternal and neonatal outcomes. Although some women with ACHD can potentially expect healthy pregnancies, it appears that clinical care should be modified to address the heightened risks of certain ACHD subtypes.

Dataset Information

Impact of Unintended Pregnancy on Maternal and Neonatal Outcomes.

Publications

Impact of Unintended Pregnancy on Maternal and Neonatal Outcomes.

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