To assess pregnancy outcome in women with anaemia during pregnancy.
The study design involved a retrospective chart review of all women registering for prenatal care in the area of Kuopio University Hospital between 1990 and 2000. A haemoglobin concentration below 100g/l was used as a cutoff for anaemia and affected women (N=597) were stratified by the trimester at which anaemia was diagnosed. Multiple regression analysis was used to compare obstetric outcomes in the study groups and in non-anaemic women (N=22,202).
The frequency of anaemia was 2.6%, with 0.3% occurring in the first trimester. After controlling for confounding factors, anaemia detected in the first trimester was associated with low-birth-weight infants (OR=3.14, 95% CI: 1.35-7.28) whereas the mid- and third-trimester anaemia groups showed no significantly different outcomes when compared with the non-anaemic women. First trimester anaemia was not significantly associated with small birth weight for gestational age (OR=0.98, 95% CI: 0.41-2.17) or with premature delivery
Epidemiologic data were analyzed for a total of 2,693 infants with esophageal atresia registered in nine congenital malformation registries around the world. The average recorded prevalence at birth was 2.6 per 10,000 births, with a significant variability among programs--and sometimes within a program--and a maximum prevalence of above 3 per 10,000 births. Clusters of infants with esophageal atresia were observed but may be random. An increasing rate was seen during the period 1965 to 1975 (Norway, South America, Sweden). The type of esophageal atresia was specified in only 439 cases, but no major differences were seen in the epidemiologic characteristics of infants with the most common type (distal fistula) and infants with other types. There was an excess of low birth weight and preterm birth, and infants with esophageal atresia had a birth weight 500 to 1,000 g less than normal infants in each gestational week. There was an excess of twins, apparently mainly or exclusively due to monozygotic twinning, but in only two pairs did both twins have esophageal atresia. There was no effect seen of maternal age, but low parity, irrespective of maternal age, was associated with an increased risk for esophageal atresia. Infant survival varied among programs and depended heavily on associated malformations. Among 1,107 sibs born before the proband and 385 born after the proband, only 25 (1.7%) had a serious malformation; three had esophageal atresia. In 57.3% of the infants with esophageal atresia, no other malformations were present, in 36.4% other major malformations were recorded, and in 6.3% there were chromosomal anomalies. The malformations present associated with esophageal atresia were analyzed: a large proportion entered the constellation sometimes called "caudal mesoderm spectrum of malformations": VATER, Potter, and caudal regression sequences.
With few exceptions, the number of births fell steadily in Denmark between the mid-60s and 1983, when 51,087 children were born, the lowest number on record. Since 1984 the number of births has risen and in 1989 about 61,700 children were born. In the period with declining number of births, the number of voluntary abortions fell nearly as much. After the law on permissive abortion went into effect on October 1, 1973, the number of abortions rose rapidly to a maximum of 27,884 in 1975, after which it declined steadily to 19, 919 in 1986 with a weak rise to 21,456 in 1989. Danish statistics on the total number of conceptions showed a steady decrease from 1974 through 1982 but a change to an increase after 1983. A parallel decrease in the fraction of conceptions carried to term also reversed after 1983. In 1973-74 the frequency of conception among women of fertile age was 85/1000; in 1982-83, 63.5; and in 1988-89, nearly 72. Spontaneous abortions rose by 1/3 from 8300 in 1982 to 11,600 in 1989. The sample does not reveal how much of the observed increase is due to increased hospital admission in early miscarriages and how much to a real increase. Age group statistics show that the number of teen pregnancies has fallen about 10% since 1982 while the numbers have risen for all other age groups. The strongest rise has been among the 30-34 year group, where the number of pregnancies has risen 20% since 1982.
To evaluate the association between gestational age at birth and the risk of subsequent development of asthma.
We conducted a retrospective observational hospital-based birth case-control study in a university-based obstetrics and gynecology department in Finland. A total of 44,173 women delivering between 1989 and 2008 were linked with the social insurance register to identify asthma reimbursements for their offspring (n = 2661). Pregnancy factors were recorded during pregnancy. Infants were categorized as moderately preterm (= 32 weeks), late preterm (33-36 weeks), early term (37-38 weeks), term (39-40 weeks), or late term and postterm (= 41 weeks). The main outcome measure was asthma among the infants.
Children born moderately preterm (= 32 weeks gestation) had a significantly increased risk of asthma (aOR, 3.9; 95% CI, 3.2-4.8). The risk of asthma was also increased in those born late preterm (aOR, 1.7; 95% CI, 1.4-2.0) and early term (aOR, 1.2; 95% CI, 1.1-1.4). In contrast, delivery at 41 weeks or later seemed to decrease the risk of asthma (aOR, 0.9; 95% CI, 0.8-1.0). The burden of asthma associated with preterm birth was associated mainly with early term infants, in whom 108 extra cases of asthma were observed.
Even though the individual risk of asthma was inversely correlated with gestational age at birth, the overall burden brought about by delivery before term was associated with late preterm and early term deliveries. Furthermore, delivery after term was protective against asthma.
The objective of this study is to determine the risk of adverse pregnancy outcomes resulting from a true umbilical knot. We analyzed 288 singleton pregnancies with a true umbilical knot among the women who gave birth at Kuopio University Hospital from January 1990 to December 1999. Logistic regression analysis was used to compare pregnancy outcomes of the affected cases with those of the general obstetric population (n = 23,027). The incidence of true knot was 1.25% and it was associated with advanced maternal age, multiparity, previous miscarriages, obesity, prolonged gravidity, male fetus, long cord, and maternal anemia. The women having a fetus with a cord knot underwent cesarean delivery less frequently than unaffected controls. Fetal death and low Apgar score at 1 min occurred significantly more frequently in the study group than in the general obstetric population, the adjusted odds ratios being 3.93 (95% CI, 1.41-11.0) and 1.73 (95% CI, 1.10-2.72), respectively. Otherwise, the pregnancy outcome measures were comparable in the two groups. Fetuses with true umbilical knots are at a four-fold increased risk of stillbirth, but little can be done to prevent fetal deaths during pregnancy. Surviving fetuses with true knots are likely to suffer temporary distress during delivery, but affected newborns recover soon after birth. Thus, monitored vaginal delivery appears to be a safe option for fetuses with true knots.
Preterm birth, defined as birth occurring before 37 weeks gestation, is one of the most significant contributors to neonatal mortality and morbidity, with long-term adverse consequences for health, and cognitive outcome.
The aim of the present study was to identify risk factors of preterm birth (=36+6 weeks gestation) among singleton births and to quantify the contribution of risk factors to socioeconomic disparities in preterm birth.
A retrospective population-based case-control study using data derived from the Finnish Medical Birth Register. A total population of singleton births in Finland from 1987-2010 (n?=?1,390,742) was reviewed.
Among all singleton births (n?=?1,390,742), 4.6% (n?=?63,340) were preterm (
Cites: Am J Obstet Gynecol. 1999 Nov;181(5 Pt 1):1216-2110561648
Cites: Matern Child Health J. 2013 Nov;17(9):1689-70023135625
Cites: Am J Obstet Gynecol. 2000 Nov;183(5):1094-911084547
Cites: Am J Public Health. 2001 Feb;91(2):284-611211639