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Olukade T, Salama H, Al-Obaidly S, AlQubaisi M, Al-Rifai H. Maternal Body Mass Index and Recommended Gestational Weight Gain in a Middle Eastern Setting. Matern Child Health J 2024; 28:524-531. [PMID: 37955839 PMCID: PMC10914897 DOI: 10.1007/s10995-023-03816-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/23/2023] [Indexed: 11/14/2023]
Abstract
OBJECTIVE Maternal body mass index (BMI) and gestational weight gain (GWG) are modifiable risk factors that influence pregnancy outcomes. We examined the association between the two factors in pregnant women in Qatar with regard to the GWG recommendations by the Institute of Medicine (IOM) in 2009. METHODS We performed a population-based retrospective cohort analysis of 3547 singleton births, using routinely collected data from a Middle Eastern hospital database. RESULTS The mean maternal age was 29.7 ± 5.5 years, prepregnancy BMI was 27.5 ± 5.8 kg/m2, GWG was 9.58 kg ± 6.87 kg and gestational age at birth was 38.5 ± 1.9 weeks. In line with IOM recommendations, we found that higher BMI was correlated with decreased GWG and BMI was significantly associated with GWG even after adjusting for maternal age, parity, and infants' gestational age at birth. Nonetheless, GWG in more than one-third of women who were overweight or obese exceeded the IOM recommendation.
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Affiliation(s)
- Tawa Olukade
- Department of Pediatrics, Hamad Medical Corporation, Doha, Qatar.
| | - Husam Salama
- Neonatal Intensive Care Unit, Hamad Medical Corporation, Doha, Qatar
| | - Sawsan Al-Obaidly
- Department of Obstetrics and Gynecology, Hamad Medical Corporation, Doha, Qatar
| | - Mai AlQubaisi
- Neonatal Intensive Care Unit, Hamad Medical Corporation, Doha, Qatar
| | - Hilal Al-Rifai
- Neonatal Intensive Care Unit, Hamad Medical Corporation, Doha, Qatar
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Minisha F, Khenyab N, Abu Yaqoub S, Al Obaidly S, AlQubaisi M, Salama H, Olukade T, Pallivalappil AR, Al Dewik N, Al Rifai H, Farrell T. Perinatal outcomes in women with class IV obesity compared to women in the normal or overweight body mass index categories: A population-based cohort study in Qatar. Obes Sci Pract 2024; 10:e698. [PMID: 38264000 PMCID: PMC10804329 DOI: 10.1002/osp4.698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Revised: 07/04/2023] [Accepted: 07/07/2023] [Indexed: 01/25/2024] Open
Abstract
Background The prevalence of childhood and adult obesity is rising exponentially worldwide. Class IV obesity (body mass index, BMI ≥50 kg/m2) is associated with a higher risk of adverse perinatal outcomes. This study compared these outcomes between women with class IV obesity and women in the normal or overweight categories during pregnancy. Methods A retrospective cohort study was performed in Qatar, including women having singleton live births beyond 24 weeks of gestation, classified into two class IV obesity and normal/overweight (BMI between 18.5 and 30.0 kg/m2). The outcome measures included the mode of delivery, development of gestational diabetes and hypertension, fetal macrosomia, small for date baby, preterm birth and neonatal morbidity. Adjusted odds ratios (aOR) with 95% confidence intervals (95% CI) were determined using multivariable logistic regression models. Results A total of 247 women with class IV obesity were compared with 6797 normal/overweight women. Adjusted analysis showed that women with class IV obesity had 3.2 times higher odds of cesarean delivery (aOR: 3.19, CI: 2.26-4.50), 3.4 times higher odds of gestational diabetes (aOR: 3.39, CI: 2.55-4.50), 4.2 times higher odds of gestational hypertension (aOR: 4.18, CI: 2.45-7.13) and neonatal morbidity (aOR: 4.27, CI: 3.01-6.05), and 6.5 times higher odds of macrosomia (aOR 6.48, CI 4.22-9.99). Conclusions Class IV obesity is associated with more adverse perinatal outcomes compared with the normal or overweight BMI categories. The study results emphasized the need for specialized antenatal obesity clinics to address the associated risks and reduce complications.
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Affiliation(s)
- Fathima Minisha
- Department of Obstetrics and GynecologyWomen's Wellness and Research CentreHamad Medical CorporationDohaQatar
| | - Najat Khenyab
- Department of Obstetrics and GynecologyWomen's Wellness and Research CentreHamad Medical CorporationDohaQatar
| | - Salwa Abu Yaqoub
- Department of Obstetrics and GynecologyWomen's Wellness and Research CentreHamad Medical CorporationDohaQatar
| | - Sawsan Al Obaidly
- Department of Obstetrics and GynecologyWomen's Wellness and Research CentreHamad Medical CorporationDohaQatar
| | - Mai AlQubaisi
- Department of Pediatrics and NeonatologyWomen's Wellness and Research CentreHamad Medical CorporationDohaQatar
| | - Husam Salama
- Department of Pediatrics and NeonatologyWomen's Wellness and Research CentreHamad Medical CorporationDohaQatar
| | - Tawa Olukade
- Department of PediatricsHamad Medical CorporationDohaQatar
| | | | - Nader Al Dewik
- Department of ResearchWomen's Wellness and Research CentreHamad Medical CorporationDohaQatar
| | - Hilal Al Rifai
- Department of Pediatrics and NeonatologyWomen's Wellness and Research CentreHamad Medical CorporationDohaQatar
- Chief Executive OfficerWomen's Wellness and Research CentreHamad Medical CorporationDohaQatar
| | - Thomas Farrell
- Department of Obstetrics and GynecologyWomen's Wellness and Research CentreHamad Medical CorporationDohaQatar
- Department of ResearchWomen's Wellness and Research CentreHamad Medical CorporationDohaQatar
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Ajmal S, Farrell T, Minisha F, Al Obaidly S, AlQubaisi M, Khenyab N, Ali N, Salama H, Pallivalappil AR, Al Dewik N, Al Rifai H. Maternal and neonatal outcomes associated with multiple repeat cesarean deliveries: A registry-based study from Qatar. Qatar Med J 2024; 2024:3. [PMID: 38264266 PMCID: PMC10801331 DOI: 10.5339/qmj.2024.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 12/27/2023] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND Cesarean delivery (CD) is associated with increased maternal and neonatal morbidity compared to vaginal delivery, particularly in cases classified as emergency procedures or when there are multiple CDs. This retrospective cohort study aims to examine the incidence of maternal and neonatal complications in women with multiple CDs. METHODS This study used data from a national perinatal database obtained from a single tertiary maternity care hospital. Women who delivered a singleton live birth after 24 weeks of gestation by CD were stratified into five groups based on the number of CDs, with the last group having five or more CDs. The women were divided into those with five or more CDs (Group 5) versus those with fewer than five (Groups 1 to 4). The maternal outcomes included intra-operative surgical complications, blood loss, and intensive care unit (ICU) admission. The neonatal outcomes included preterm birth, neonatal ICU (NICU) admission, respiratory distress syndrome (RDS), and perinatal death. RESULTS Of the 6,316 women in the study, 2,608 (41.3%) had a primary CD. 30.3%, 17.5%, and 7.3% of the cohort had their second, third, and fourth CDs, respectively. Women undergoing the 5th CD and above formed the remaining 3.5% (227). Women in Group 5 had the highest risk of suffering a surgical complication (3.1%, p = 0.015) and postpartum hemorrhage (7.5%, p = 0.010). 24% of babies in Group 5 were born preterm (p < 0.001). They also had a 3.5 times higher risk of having a surgical complication (RR = 3.5, 95% CI 1.6-7.6, p = 0.002), a 1.8 times higher risk of developing postpartum hemorrhage (RR = 1.8, 95% CI 1.1-2.9, p = 0.014), a 1.7 times higher risk of delivering between 32-37 weeks of gestation (RR = 1.7, 95% CI 1.3-2.2, p < 0.001), a higher risk of the baby getting admitted to NICU (RR = 1.3, 95% CI 1.0-1.6, p = 0.038), and developing RDS (RR = 1.5, 95% CI 1.2-2.0, p = 0.002) compared to Groups 1-4. The risks of neonatal outcomes such as NICU admission (RR 2.9, 95% CI 2.1-4.0) and RDS (RR 3.5, 95% CI 2.3-5.5) were much higher in elective CDs performed at term compared to preterm births (p < 0.001 for both). CONCLUSION Maternal morbidity significantly increases with the increasing number of CD. The increased risk of RDS and NICU admissions in the neonate with multiple CDs reflects lower gestational age and birthweight in these groups-consideration of preoperative steroids for lung maturation in these women to reduce neonatal morbidity warrants further discussion.
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Affiliation(s)
- Shameena Ajmal
- Department of Obstetrics and Gynecology, Women's Wellness and Research Centre, Hamad Medical Corporation, Doha Qatar.
| | | | - Fathima Minisha
- Department of Obstetrics and Gynecology, Women's Wellness and Research Centre, Hamad Medical Corporation, Doha Qatar.
| | - Sawsan Al Obaidly
- Department of Obstetrics and Gynecology, Women's Wellness and Research Centre, Hamad Medical Corporation, Doha Qatar.
| | - Mai AlQubaisi
- Department of Pediatrics and Neonatology, Women's Wellness and Research Centre, Hamad Medical Corporation, Doha, Qatar
| | - Najat Khenyab
- Department of Obstetrics and Gynecology, Women's Wellness and Research Centre, Hamad Medical Corporation, Doha Qatar.
| | - Najah Ali
- Department of Obstetrics and Gynecology, Women's Wellness and Research Centre, Hamad Medical Corporation, Doha Qatar.
| | - Husam Salama
- Department of Pediatrics and Neonatology, Women's Wellness and Research Centre, Hamad Medical Corporation, Doha, Qatar
| | - Abdul Rouf Pallivalappil
- Department of Research, Women's Wellness and Research Centre, Hamad Medical Corporation, Doha Qatar
| | - Nader Al Dewik
- Department of Research, Women's Wellness and Research Centre, Hamad Medical Corporation, Doha Qatar
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Vazhiyelethil J, Minisha F, Al Obaidly S, AlQubaisi M, Salama H, Ali N, Khenyab N, Mohan S, Pallivalappil AR, Al-Dewik N, Al Rifai H, Farrell T. Impact of bariatric surgery on maternal gestational weight gain and pregnancy outcomes in women with obesity: A population-based cohort study from Qatar. Qatar Med J 2024; 2024:2. [PMID: 38264267 PMCID: PMC10801433 DOI: 10.5339/qmj.2024.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 12/20/2023] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND Bariatric surgery is performed in obese women of reproductive age to help achieve a healthy prepregnancy weight to reduce the complications associated with obesity in pregnancy. However, these procedures can impact maternal nutrition and gestational weight gain (GWG). This study evaluates the maternal and neonatal outcomes in women with prepregnancy bariatric surgery and determines the impact on GWG. METHODS This study included 24 weeks gestation or more pregnancies, with a maternal BMI at delivery of 30 kg/m2 or more. It was categorized into two groups based on whether they had prepregnancy bariatric surgery (exposed) or not (unexposed). The outcomes included gestational diabetes (GDM), gestational hypertension (GHT), mode of delivery, preterm birth (PTB), GWG, birthweight (BW) and customized BW centiles, low birthweight (LBW), congenital anomalies, and admission to the neonatal intensive unit (NICU). Categorization was also done based on the adequacy of GWG (low, adequate, and excess). RESULTS A total of 8,323 women were included in the study, 194 of whom had prepregnancy bariatric surgery. After adjusting for confounders, the exposed group had a mean GWG 1.33 kg higher than the unexposed group (95% CI 0.55-2.13, p = 0.001). The exposed group had higher odds of PTB (aOR 1.78, 95% CI 1.16-2.74, p = 0.008), CD (aOR 6.52, 95% CI 4.28-9.93, p < 0.001), LBW in term babies (aOR 2.60, 95% CI 1.34-5.03, p = 0.005), congenital anomalies (aOR 2.64, 95% CI 1.21-5.77, p = 0.015), low APGAR score (aOR 3.75, 95% CI 1.12-12.5, p = 0.032) and 80.4g lesser birthweight (95% CI -153.0, -5.8; p = 0.034). More women in the low GWG category had LBW babies (28.6% versus 6.7% in the high GWG group, p = 0.033), lowest mean BW and median BW centiles (2775 grams versus 3289 grams in the high GWG group, p = 0.004 and 57.5% versus 74.5% in the high GWG group, p = 0.040, respectively). CONCLUSION The findings of this study highlight differences in perinatal outcomes such as preterm birth, low birth weight, congenital anomalies, cesarean deliveries, and gestational weight gain between post-bariatric women and controls. These insights can help inform the planning and provision of appropriate maternity care to enhance patient safety and outcomes. The results of this study can also guide the counseling of reproductive age-group women who are planning to undergo bariatric surgery.
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Affiliation(s)
- Jesni Vazhiyelethil
- Department of Obstetrics and Gynecology, Women's Wellness and Research Centre, Hamad Medical Corporation, Doha Qatar.
| | - Fathima Minisha
- Department of Obstetrics and Gynecology, Women's Wellness and Research Centre, Hamad Medical Corporation, Doha Qatar.
| | - Sawsan Al Obaidly
- Department of Obstetrics and Gynecology, Women's Wellness and Research Centre, Hamad Medical Corporation, Doha Qatar.
| | - Mai AlQubaisi
- Department of Pediatrics and Neonatology, Women's Wellness and Research Centre, Hamad Medical Corporation, Doha, Qatar
| | - Husam Salama
- Department of Pediatrics and Neonatology, Women's Wellness and Research Centre, Hamad Medical Corporation, Doha, Qatar
| | - Najah Ali
- Department of Obstetrics and Gynecology, Women's Wellness and Research Centre, Hamad Medical Corporation, Doha Qatar.
| | - Najat Khenyab
- Department of Obstetrics and Gynecology, Women's Wellness and Research Centre, Hamad Medical Corporation, Doha Qatar.
| | - Suruchi Mohan
- Department of Obstetrics and Gynecology, Sidra Medicine, Doha Qatar
| | - Abdul Rouf Pallivalappil
- Department of Research, Women's Wellness and Research Centre, Hamad Medical Corporation, Doha Qatar
| | - Nader Al-Dewik
- Department of Research, Women's Wellness and Research Centre, Hamad Medical Corporation, Doha Qatar
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Okwaraji YB, Suárez-Idueta L, Ohuma EO, Bradley E, Yargawa J, Pingray V, Cormick G, Gordon A, Flenady V, Horváth-Puhó E, Sørensen HT, Sakkeus L, Abuladze L, Heidarzadeh M, Khalili N, Yunis KA, Al Bizri A, Karalasingam SD, Jeganathan R, Barranco A, van Dijk AE, Broeders L, Alyafei F, AlQubaisi M, Razaz N, Söderling J, Smith LK, Matthews RJ, Wood R, Monteath K, Pereyra I, Pravia G, Lisonkova S, Wen Q, Lawn JE, Blencowe H. Stillbirths: Contribution of preterm birth and size-for-gestational age for 125.4 million total births from nationwide records in 13 countries, 2000-2020. BJOG 2023. [PMID: 38018284 DOI: 10.1111/1471-0528.17653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 08/07/2023] [Accepted: 08/19/2023] [Indexed: 11/30/2023]
Abstract
OBJECTIVE To examine the contribution of preterm birth and size-for-gestational age in stillbirths using six 'newborn types'. DESIGN Population-based multi-country analyses. SETTING Births collected through routine data systems in 13 countries. SAMPLE 125 419 255 total births from 22+0 to 44+6 weeks' gestation identified from 2000 to 2020. METHODS We included 635 107 stillbirths from 22+0 weeks' gestation from 13 countries. We classified all births, including stillbirths, into six 'newborn types' based on gestational age information (preterm, PT, <37+0 weeks versus term, T, ≥37+0 weeks) and size-for-gestational age defined as small (SGA, <10th centile), appropriate (AGA, 10th-90th centiles) or large (LGA, >90th centile) for gestational age, according to the international newborn size for gestational age and sex INTERGROWTH-21st standards. MAIN OUTCOME MEASURES Distribution of stillbirths, stillbirth rates and rate ratios according to six newborn types. RESULTS 635 107 (0.5%) of the 125 419 255 total births resulted in stillbirth after 22+0 weeks. Most stillbirths (74.3%) were preterm. Around 21.2% were SGA types (PT + SGA [16.2%], PT + AGA [48.3%], T + SGA [5.0%]) and 14.1% were LGA types (PT + LGA [9.9%], T + LGA [4.2%]). The median rate ratio (RR) for stillbirth was highest in PT + SGA babies (RR 81.1, interquartile range [IQR], 68.8-118.8) followed by PT + AGA (RR 25.0, IQR, 20.0-34.3), PT + LGA (RR 25.9, IQR, 13.8-28.7) and T + SGA (RR 5.6, IQR, 5.1-6.0) compared with T + AGA. Stillbirth rate ratios were similar for T + LGA versus T + AGA (RR 0.7, IQR, 0.7-1.1). At the population level, 25% of stillbirths were attributable to small-for-gestational-age. CONCLUSIONS In these high-quality data from high/middle income countries, almost three-quarters of stillbirths were born preterm and a fifth small-for-gestational age, with the highest stillbirth rates associated with the coexistence of preterm and SGA. Further analyses are needed to better understand patterns of gestation-specific risk in these populations, as well as patterns in lower-income contexts, especially those with higher rates of intrapartum stillbirth and SGA.
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Affiliation(s)
- Yemisrach B Okwaraji
- Maternal, Adolescent, Reproductive & Child Health (MARCH) Centre, London School of Hygiene & Tropical Medicine, London, UK
| | | | - Eric O Ohuma
- Maternal, Adolescent, Reproductive & Child Health (MARCH) Centre, London School of Hygiene & Tropical Medicine, London, UK
| | - Ellen Bradley
- Maternal, Adolescent, Reproductive & Child Health (MARCH) Centre, London School of Hygiene & Tropical Medicine, London, UK
| | - Judith Yargawa
- Maternal, Adolescent, Reproductive & Child Health (MARCH) Centre, London School of Hygiene & Tropical Medicine, London, UK
| | - Veronica Pingray
- Institute for Clinical Effectiveness and Health Policy, Ciudad Autónoma de Buenos Aires, Argentina
| | - Gabriela Cormick
- Institute for Clinical Effectiveness and Health Policy, Ciudad Autónoma de Buenos Aires, Argentina
- Centro de Investigaciones en Epidemiología y Salud Pública, National Scientific and Technical Research Council (CONICET), Ciudad Autónoma de Buenos Aires, Argentina
| | - Adrienne Gordon
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Vicki Flenady
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Erzsébet Horváth-Puhó
- Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus N, Denmark
| | - Henrik Toft Sørensen
- Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus N, Denmark
| | - Luule Sakkeus
- School of Governance, Law and Society, Estonian Institute for Population Studies, Tallinn University, Tallinn, Estonia
| | - Liili Abuladze
- School of Governance, Law and Society, Estonian Institute for Population Studies, Tallinn University, Tallinn, Estonia
- Population Research Unit, Väestöliitto, Finland
| | | | - Narjes Khalili
- Department of Community and Family Medicine, Preventive Medicine and Public Health Research Centre, Psychosocial Health Research Institute, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Khalid A Yunis
- Division of Neonatology, Department of Pediatrics and Adolescent Medicine, American University of Beirut, Beirut, Lebanon
| | - Ayah Al Bizri
- Division of Neonatology, Department of Pediatrics and Adolescent Medicine, American University of Beirut, Beirut, Lebanon
| | - Shamala D Karalasingam
- Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Cyberjaya, Cyberjaya, Malaysia
| | - Ravichandran Jeganathan
- Department of Obstetrics & Gynaecology, Malaysia Monash Medical School, Johor Bahru, Malaysia
| | - Arturo Barranco
- Directorate of Health Information, Ministry of Health, Mexico City, Mexico
| | | | | | - Fawzya Alyafei
- Department of Paediatrics, Hamad General Hospital, Doha, Qatar
| | - Mai AlQubaisi
- NICU, Women Wellness and Research Centre, Doha, Qatar
| | - Neda Razaz
- Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institute, Stockholm, Sweden
| | - Jonas Söderling
- Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institute, Stockholm, Sweden
| | - Lucy K Smith
- Department of Population Health Sciences, College of Life Sciences, University of Leicester, Leicester, UK
| | - Ruth J Matthews
- Department of Population Health Sciences, College of Life Sciences, University of Leicester, Leicester, UK
| | - Rachael Wood
- Public Health Scotland, Edinburgh, UK
- Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Kirsten Monteath
- Pregnancy, Birth and Child Health Team, Public Health Scotland, Edinburgh, UK
| | - Isabel Pereyra
- Faculty of Health Sciences, Catholic University of Maule, Curicó, Chile
| | - Gabriella Pravia
- Department of Wellness and Health, Catholic University of Uruguay, Montevideo, Uruguay
| | - Sarka Lisonkova
- Department of Obstetrics & Gynaecology, University of British Columbia, Vancouver, British Columbia, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Qi Wen
- Department of Obstetrics & Gynaecology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Joy E Lawn
- Maternal, Adolescent, Reproductive & Child Health (MARCH) Centre, London School of Hygiene & Tropical Medicine, London, UK
| | - Hannah Blencowe
- Maternal, Adolescent, Reproductive & Child Health (MARCH) Centre, London School of Hygiene & Tropical Medicine, London, UK
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Suárez-Idueta L, Ohuma EO, Chang CJ, Hazel EA, Yargawa J, Okwaraji YB, Bradley E, Gordon A, Sexton J, Lawford HLS, Paixao ES, Falcão IR, Lisonkova S, Wen Q, Velebil P, Jírová J, Horváth-Puhó E, Sørensen HT, Sakkeus L, Abuladze L, Yunis KA, Al Bizri A, Alvarez SL, Broeders L, van Dijk AE, Alyafei F, AlQubaisi M, Razaz N, Söderling J, Smith LK, Matthews RJ, Lowry E, Rowland N, Wood R, Monteath K, Pereyra I, Pravia G, Lawn JE, Blencowe H. Neonatal mortality risk of large-for-gestational-age and macrosomic live births in 15 countries, including 115.6 million nationwide linked records, 2000-2020. BJOG 2023. [PMID: 38012114 DOI: 10.1111/1471-0528.17706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 10/18/2023] [Accepted: 10/20/2023] [Indexed: 11/29/2023]
Abstract
OBJECTIVE We aimed to compare the prevalence and neonatal mortality associated with large for gestational age (LGA) and macrosomia among 115.6 million live births in 15 countries, between 2000 and 2020. DESIGN Population-based, multi-country study. SETTING National healthcare systems. POPULATION Liveborn infants. METHODS We used individual-level data identified for the Vulnerable Newborn Measurement Collaboration. We calculated the prevalence and relative risk (RR) of neonatal mortality among live births born at term + LGA (>90th centile, and also >95th and >97th centiles when the data were available) versus term + appropriate for gestational age (AGA, 10th-90th centiles) and macrosomic (≥4000, ≥4500 and ≥5000 g, regardless of gestational age) versus 2500-3999 g. INTERGROWTH 21st served as the reference population. MAIN OUTCOME MEASURES Prevalence and neonatal mortality risks. RESULTS Large for gestational age was common (median prevalence 18.2%; interquartile range, IQR, 13.5%-22.0%), and overall was associated with a lower neonatal mortality risk compared with AGA (RR 0.83, 95% CI 0.77-0.89). Around one in ten babies were ≥4000 g (median prevalence 9.6% (IQR 6.4%-13.3%), with 1.2% (IQR 0.7%-2.0%) ≥4500 g and with 0.2% (IQR 0.1%-0.2%) ≥5000 g). Overall, macrosomia of ≥4000 g was not associated with increased neonatal mortality risk (RR 0.80, 95% CI 0.69-0.94); however, a higher risk was observed for birthweights of ≥4500 g (RR 1.52, 95% CI 1.10-2.11) and ≥5000 g (RR 4.54, 95% CI 2.58-7.99), compared with birthweights of 2500-3999 g, with the highest risk observed in the first 7 days of life. CONCLUSIONS In this population, birthweight of ≥4500 g was the most useful marker for early mortality risk in big babies and could be used to guide clinical management decisions.
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Affiliation(s)
| | - Eric O Ohuma
- Maternal, Adolescent, Reproductive & Child Health (MARCH) Centre, London School of Hygiene & Tropical Medicine, London, UK
| | - Chia-Jung Chang
- Maternal, Adolescent, Reproductive & Child Health (MARCH) Centre, London School of Hygiene & Tropical Medicine, London, UK
| | - Elizabeth A Hazel
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Judith Yargawa
- Maternal, Adolescent, Reproductive & Child Health (MARCH) Centre, London School of Hygiene & Tropical Medicine, London, UK
| | - Yemisrach B Okwaraji
- Maternal, Adolescent, Reproductive & Child Health (MARCH) Centre, London School of Hygiene & Tropical Medicine, London, UK
| | - Ellen Bradley
- Maternal, Adolescent, Reproductive & Child Health (MARCH) Centre, London School of Hygiene & Tropical Medicine, London, UK
| | - Adrienne Gordon
- Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia
| | - Jessica Sexton
- National Health and Medical Research Council (NHMRC) Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland, Brisbane, Queensland, Australia
| | - Harriet L S Lawford
- National Health and Medical Research Council (NHMRC) Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland, Brisbane, Queensland, Australia
| | - Enny S Paixao
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Center for Data and Knowledge Integration for Health (CIDACS), Instituto Gonçalo Moniz, Fiocruz Bahia, Fundação Oswaldo Cruz, Salvador, Brazil
| | - Ila R Falcão
- Center for Data and Knowledge Integration for Health (CIDACS), Instituto Gonçalo Moniz, Fiocruz Bahia, Fundação Oswaldo Cruz, Salvador, Brazil
| | - Sarka Lisonkova
- Department of Obstetrics & Gynaecology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Qi Wen
- Department of Obstetrics & Gynaecology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Petr Velebil
- Department of Obstetrics and Gynaecology, Institute for the Care of Mother and Child, Prague, Czech Republic
| | - Jitka Jírová
- Department of Data Analysis, Institute of Health Information and Statistics of the Czech Republic, Prague, Czech Republic
| | - Erzsebet Horváth-Puhó
- Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus, Denmark
| | - Henrik T Sørensen
- Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus, Denmark
| | - Luule Sakkeus
- School of Governance, Law and Society, Estonian Institute for Population Studies, Tallinn University, Tallinn, Estonia
| | - Lili Abuladze
- School of Governance, Law and Society, Estonian Institute for Population Studies, Tallinn University, Tallinn, Estonia
| | - Khalid A Yunis
- The National Collaborative Perinatal Neonatal Network (NCPNN) Coordinating Center at the Department of Pediatrics and Adolescent Medicine, American University of Beirut, Beirut, Lebanon
| | - Ayah Al Bizri
- The National Collaborative Perinatal Neonatal Network (NCPNN) Coordinating Center at the Department of Pediatrics and Adolescent Medicine, American University of Beirut, Beirut, Lebanon
| | | | | | | | | | | | - Neda Razaz
- Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Jonas Söderling
- Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Lucy K Smith
- Department of Population Health Sciences, College of Life Sciences, University of Leicester, Leicester, UK
| | - Ruth J Matthews
- Department of Population Health Sciences, College of Life Sciences, University of Leicester, Leicester, UK
| | - Estelle Lowry
- School of Natural and Built Environment, Queen's University Belfast, Belfast, UK
| | - Neil Rowland
- Queen's Management School, Queen's University Belfast, Belfast, UK
| | - Rachael Wood
- Usher Institute, Edinburgh, UK
- Pregnancy, Birth and Child Health Team, Public Health Scotland, Edinburgh, UK
| | - Kirsten Monteath
- Pregnancy, Birth and Child Health Team, Public Health Scotland, Edinburgh, UK
| | - Isabel Pereyra
- Faculty of Health Sciences, Catholic University of Maule, Curicó, Chile
| | - Gabriella Pravia
- Department of Wellness and Health, Catholic University of Uruguay, Montevideo, Uruguay
| | - Joy E Lawn
- Maternal, Adolescent, Reproductive & Child Health (MARCH) Centre, London School of Hygiene & Tropical Medicine, London, UK
| | - Hannah Blencowe
- Maternal, Adolescent, Reproductive & Child Health (MARCH) Centre, London School of Hygiene & Tropical Medicine, London, UK
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7
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Suárez-Idueta L, Yargawa J, Blencowe H, Bradley E, Okwaraji YB, Pingray V, Gibbons L, Gordon A, Warrilow K, Paixao ES, Falcão IR, Lisonkova S, Wen Q, Mardones F, Caulier-Cisterna R, Velebil P, Jírová J, Horváth-Puhó E, Sørensen HT, Sakkeus L, Abuladze L, Gissler M, Heidarzadeh M, Moradi-Lakeh M, Yunis KA, Al Bizri A, Karalasingam SD, Jeganathan R, Barranco A, Broeders L, van Dijk AE, Huicho L, Quezada-Pinedo HG, Cajachagua-Torres KN, Alyafei F, AlQubaisi M, Cho GJ, Kim HY, Razaz N, Söderling J, Smith LK, Kurinczuk J, Lowry E, Rowland N, Wood R, Monteath K, Pereyra I, Pravia G, Ohuma EO, Lawn JE. Vulnerable newborn types: Analysis of population-based registries for 165 million births in 23 countries, 2000-2021. BJOG 2023. [PMID: 37156241 DOI: 10.1111/1471-0528.17505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 04/04/2023] [Indexed: 05/10/2023]
Abstract
OBJECTIVE To examine the prevalence of novel newborn types among 165 million live births in 23 countries from 2000 to 2021. DESIGN Population-based, multi-country analysis. SETTING National data systems in 23 middle- and high-income countries. POPULATION Liveborn infants. METHODS Country teams with high-quality data were invited to be part of the Vulnerable Newborn Measurement Collaboration. We classified live births by six newborn types based on gestational age information (preterm <37 weeks versus term ≥37 weeks) and size for gestational age defined as small (SGA, <10th centile), appropriate (10th-90th centiles), or large (LGA, >90th centile) for gestational age, according to INTERGROWTH-21st standards. We considered small newborn types of any combination of preterm or SGA, and term + LGA was considered large. Time trends were analysed using 3-year moving averages for small and large types. MAIN OUTCOME MEASURES Prevalence of six newborn types. RESULTS We analysed 165 017 419 live births and the median prevalence of small types was 11.7% - highest in Malaysia (26%) and Qatar (15.7%). Overall, 18.1% of newborns were large (term + LGA) and was highest in Estonia 28.8% and Denmark 25.9%. Time trends of small and large infants were relatively stable in most countries. CONCLUSIONS The distribution of newborn types varies across the 23 middle- and high-income countries. Small newborn types were highest in west Asian countries and large types were highest in Europe. To better understand the global patterns of these novel newborn types, more information is needed, especially from low- and middle-income countries.
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Affiliation(s)
| | - Judith Yargawa
- Maternal, Adolescent, Reproductive & Child Health (MARCH) Centre, London School of Hygiene & Tropical Medicine, London, UK
| | - Hannah Blencowe
- Maternal, Adolescent, Reproductive & Child Health (MARCH) Centre, London School of Hygiene & Tropical Medicine, London, UK
| | - Ellen Bradley
- Maternal, Adolescent, Reproductive & Child Health (MARCH) Centre, London School of Hygiene & Tropical Medicine, London, UK
| | - Yemisrach B Okwaraji
- Maternal, Adolescent, Reproductive & Child Health (MARCH) Centre, London School of Hygiene & Tropical Medicine, London, UK
| | - Veronica Pingray
- Department of Mother & Child Health, Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina
| | - Luz Gibbons
- Department of Mother & Child Health, Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina
| | - Adrienne Gordon
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Kara Warrilow
- Centre for Research Excellence in Stillbirth, MRI-UQ, Mater Research Institute, The University of Queensland, Brisbane, Queensland, Australia
| | - Enny S Paixao
- Maternal, Adolescent, Reproductive & Child Health (MARCH) Centre, London School of Hygiene & Tropical Medicine, London, UK
- Centre of Data and Knowledge Integration for Health (CIDACS), Instituto Gonçalo Moniz, Fiocruz Bahia, Fundação Oswaldo Cruz, Salvador, Brazil
| | - Ila Rocha Falcão
- Centre of Data and Knowledge Integration for Health (CIDACS), Instituto Gonçalo Moniz, Fiocruz Bahia, Fundação Oswaldo Cruz, Salvador, Brazil
| | - Sarka Lisonkova
- Department of Obstetrics & Gynaecology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Qi Wen
- Department of Obstetrics & Gynaecology, University of British Columbia, Vancouver, British Columbia, Canada
| | | | | | - Petr Velebil
- Department of Obstetrics and Gynaecology, Institute for the Care of Mother and Child, Prague, Czech Republic
| | - Jitka Jírová
- Department of Data Analysis, Institute of Health Information and Statistics of the Czech Republic, Prague, Czech Republic
| | | | | | - Luule Sakkeus
- School of Governance, Law and Society, Estonian Institute for Population Studies, Tallinn University, Tallinn, Estonia
| | - Lili Abuladze
- School of Governance, Law and Society, Estonian Institute for Population Studies, Tallinn University, Tallinn, Estonia
| | - Mika Gissler
- Department of Knowledge Brokers, THL Finnish Institute for Health and Welfare, Helsinki, Finland
| | | | - Maziar Moradi-Lakeh
- Department of Community Medicine, Preventive Medicine and Public Health Research Centre, Iran University of Medical Sciences, Tehran, Iran
| | - Khalid A Yunis
- Department of Paediatrics and Adolescent Medicine, American University of Beirut, Beirut, Lebanon
| | - Ayah Al Bizri
- Department of Paediatrics and Adolescent Medicine, American University of Beirut, Beirut, Lebanon
| | - Shamala D Karalasingam
- Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Cyberjaya, Cyberjaya, Malaysia
| | - Ravichandran Jeganathan
- Department of Obstetrics & Gynaecology, Hospital Sultanah Aminah, Ministry of Health, Johor Bahru, Malaysia
| | - Arturo Barranco
- Directorate of Health Information, Ministry of Health, Mexico City, Mexico
| | | | | | - Luis Huicho
- Centro de Investigación en Salud Materna e Infantil, Centro de Investigación para el Desarrollo Integral y Sostenible and School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Hugo Guillermo Quezada-Pinedo
- The Generation R Study Group, Department of Paediatrics, Division of Neonatology, Erasmus MC - Sophia Children's Hospital, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Kim Nail Cajachagua-Torres
- The Generation R Study Group, Department of Paediatrics, Division of Neonatology, Erasmus MC - Sophia Children's Hospital, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | | | | | - Geum Joon Cho
- Department of Obstetrics and Gynaecology, Korea University College of Medicine, Seoul, South Korea
| | - Ho Yeon Kim
- Department of Obstetrics and Gynaecology, Korea University College of Medicine, Seoul, South Korea
| | - Neda Razaz
- Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Jonas Söderling
- Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Lucy K Smith
- Department of Health Sciences, College of Life Sciences, University of Leicester, Leicester, UK
| | - Jennifer Kurinczuk
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Estelle Lowry
- School of Natural and Built Environment, Queen's University Belfast, Belfast, UK
| | - Neil Rowland
- Queen's Management School, Queen's University Belfast, Belfast, UK
| | - Rachael Wood
- Public Health Scotland, Edinburgh, UK
- Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Kirsten Monteath
- Department of Maternity and Sexual Health Team, Public Health Scotland, Edinburgh, UK
| | - Isabel Pereyra
- Catholic University of the Maule, Región del Maule, Chile
- Department of Wellness and Health, Catholic University of Uruguay, Montevideo, Uruguay
| | - Gabriella Pravia
- Department of Wellness and Health, Catholic University of Uruguay, Montevideo, Uruguay
| | - Eric O Ohuma
- Maternal, Adolescent, Reproductive & Child Health (MARCH) Centre, London School of Hygiene & Tropical Medicine, London, UK
| | - Joy E Lawn
- Maternal, Adolescent, Reproductive & Child Health (MARCH) Centre, London School of Hygiene & Tropical Medicine, London, UK
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Al-Obaidly S, Salama H, Olukade T, AlQubaisi M, Bayo A, Al Rifai H. Perinatal outcomes of intrahepatic cholestasis of pregnancy from two birth cohorts: A population-based study. Obstet Med 2022; 15:248-252. [PMID: 36523882 PMCID: PMC9745599 DOI: 10.1177/1753495x211058321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 10/07/2021] [Indexed: 12/03/2023] Open
Abstract
Background Intrahepatic cholestasis of pregnancy (ICP) is a complex liver disease with varying incidence worldwide. We compared ICP incidence and pregnancy outcomes with outcomes for normal pregnant controls. Methods We conducted a retrospective data analysis of perinatal registry data for the years 2011 and 2017 to compare the following outcome measures: stillbirths, labour induction, gestational diabetes, pre-eclampsia, antepartum haemorrhage, postpartum haemorrhage, preterm births, low Apgar score, acute neonatal respiratory morbidity, meconium aspiration and in-hospital neonatal death. Results The incidence of ICP was 8 per 1000 births from a total 31,493 singleton births with more cases in 2017 than in 2011. Women with ICP were almost six times more likely to have labour induced including significantly more moderate preterm births (defined as between 32 weeks and 36 weeks and 6 days of gestation)) seen more in 2011 than in 2017. Conclusion Women with ICP showed higher incidence of moderate preterm birth and induced labour but favourable maternal and neonatal outcomes.
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Affiliation(s)
- Sawsan Al-Obaidly
- Obstetrics and Gynecology Department, Women's Wellness and Research
Center, Hamad Medical Corporation, Doha, Qatar
- Weill-Cornell Medicine, Doha, Qatar
| | - Husam Salama
- Neonatal Intensive Care Unit, Department of Critical Care, Hamad Medical Corporation, Doha, Qatar
| | | | - Mai AlQubaisi
- Neonatal Intensive Care Unit, Department of Critical Care, Hamad Medical Corporation, Doha, Qatar
| | - Arabo Bayo
- Obstetrics and Gynecology Department, Women's Wellness and Research
Center, Hamad Medical Corporation, Doha, Qatar
| | - Hilal Al Rifai
- Weill-Cornell Medicine, Doha, Qatar
- Neonatal Intensive Care Unit, Department of Critical Care, Hamad Medical Corporation, Doha, Qatar
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9
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Younes S, Samara M, Salama N, Al-jurf R, Nasrallah G, Al-Obaidly S, Salama H, Olukade T, Hammuda S, Abdoh G, Abdulrouf PV, Farrell T, AlQubaisi M, Al Rifai H, Al-Dewik N. Incidence, risk factors, and feto-maternal outcomes of inappropriate birth weight for gestational age among singleton live births in Qatar: A population-based study. PLoS One 2021; 16:e0258967. [PMID: 34710154 PMCID: PMC8553085 DOI: 10.1371/journal.pone.0258967] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 10/09/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Abnormal fetal growth can be associated with factors during pregnancy and at postpartum. OBJECTIVE In this study, we aimed to assess the incidence, risk factors, and feto-maternal outcomes associated with small-for-gestational age (SGA) and large-for-gestational age (LGA) infants. METHODS We performed a population-based retrospective study on 14,641 singleton live births registered in the PEARL-Peristat Study between April 2017 and March 2018 in Qatar. We estimated the incidence and examined the risk factors and outcomes using univariate and multivariate analysis. RESULTS SGA and LGA incidence rates were 6.0% and 15.6%, respectively. In-hospital mortality among SGA and LGA infants was 2.5% and 0.3%, respectively, while for NICU admission or death in labor room and operation theatre was 28.9% and 14.9% respectively. Preterm babies were more likely to be born SGA (aRR, 2.31; 95% CI, 1.45-3.57) but male infants (aRR, 0.57; 95% CI, 0.4-0.81), those born to parous (aRR 0.66; 95% CI, 0.45-0.93), or overweight (aRR, 0.64; 95% CI, 0.42-0.97) mothers were less likely to be born SGA. On the other hand, males (aRR, 1.82; 95% CI, 1.49-2.19), infants born to parous mothers (aRR 2.16; 95% CI, 1.63-2.82), or to mothers with gestational diabetes mellitus (aRR 1.36; 95% CI, 1.11-1.66), or pre-gestational diabetes mellitus (aRR 2.58; 95% CI, 1.8-3.47) were significantly more likely to be LGA. SGA infants were at high risk of in-hospital mortality (aRR, 226.56; 95% CI, 3.47-318.22), neonatal intensive care unit admission or death in labor room or operation theatre (aRR, 2.14 (1.36-3.22). CONCLUSION Monitoring should be coordinated to alleviate the risks of inappropriate fetal growth and the associated adverse consequences.
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Affiliation(s)
- Salma Younes
- Department of Research, Women’s Wellness and Research Center, Hamad Medical Corporation, Doha, Qatar
| | - Muthanna Samara
- Department of Psychology, Kingston University London, Kingston upon Thames, United Kingdom
| | - Noor Salama
- Health Profession Awareness Program, Health Facilities Development, Hamad Medical Corporation (HMC), Doha, Qatar
- American University in Cairo (AUC), Cairo, Egypt
| | - Rana Al-jurf
- College of Health and Life Science (CHLS), Hamad Bin Khalifa University (HBKU), Doha, Qatar
| | - Gheyath Nasrallah
- Department of Biomedical Science, College of Health Sciences, Member of QU Health, Qatar University, Doha, Qatar
| | - Sawsan Al-Obaidly
- Obstetrics and Gynecology Department, Women’s Wellness and Research Center, Hamad Medical Corporation, Doha, Qatar
| | - Husam Salama
- Department of Pediatrics and Neonatology, Neonatal Intensive Care Unit, Newborn Screening Unit, Women’s Wellness and Research Center, Hamad Medical Corporation, Doha, Qatar
| | - Tawa Olukade
- Department of Pediatrics and Neonatology, Neonatal Intensive Care Unit, Newborn Screening Unit, Women’s Wellness and Research Center, Hamad Medical Corporation, Doha, Qatar
| | - Sara Hammuda
- Department of Psychology, Kingston University London, Kingston upon Thames, United Kingdom
| | - Ghassan Abdoh
- Department of Pediatrics and Neonatology, Neonatal Intensive Care Unit, Newborn Screening Unit, Women’s Wellness and Research Center, Hamad Medical Corporation, Doha, Qatar
| | - Palli Valapila Abdulrouf
- Department of Research, Women’s Wellness and Research Center, Hamad Medical Corporation, Doha, Qatar
- Department of Pharmacy, Women’s Wellness and Research Center, Hamad Medical Corporation, Doha, Qatar
| | - Thomas Farrell
- Department of Research, Women’s Wellness and Research Center, Hamad Medical Corporation, Doha, Qatar
- Obstetrics and Gynecology Department, Women’s Wellness and Research Center, Hamad Medical Corporation, Doha, Qatar
| | - Mai AlQubaisi
- Department of Pediatrics and Neonatology, Neonatal Intensive Care Unit, Newborn Screening Unit, Women’s Wellness and Research Center, Hamad Medical Corporation, Doha, Qatar
| | - Hilal Al Rifai
- Department of Pediatrics and Neonatology, Neonatal Intensive Care Unit, Newborn Screening Unit, Women’s Wellness and Research Center, Hamad Medical Corporation, Doha, Qatar
| | - Nader Al-Dewik
- College of Health and Life Science (CHLS), Hamad Bin Khalifa University (HBKU), Doha, Qatar
- Interim Translational Research Institute (iTRI), Hamad Medical Corporation (HMC), Doha, Qatar
- Faculty of Health and Social Care Sciences, Kingston University, St. George’s University of London, London, United Kingdom
- Department of Pediatrics, Clinical and Metabolic Genetics, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
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10
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Maducolil MK, Al-Obaidly S, Olukade T, Salama H, AlQubaisi M, Al Rifai H. Pre-eclampsia: incidence, determinants, and pregnancy outcomes from maternity hospitals in Qatar: a population-based case-control study. J Matern Fetal Neonatal Med 2021; 35:7831-7839. [PMID: 34112060 DOI: 10.1080/14767058.2021.1937983] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND We aimed to study the maternal characteristics and obstetric and neonatal outcomes in pregnant mothers with pre-eclampsia (PE) compared to normotensive. METHODS This was a population-based retrospective data analysis. Data were obtained from the PEARL-Peristat Study perinatal registry (Perinatal Neonatal Outcomes Research Study in the Arabian Gulf) Qatar. The birth periods ranged from January to December 2017 in the main Women's Hospital (now named Women's Wellness Research Center) and March to December 2017 in other hospitals. This study examined 19762 singleton births at 24 weeks of gestation and above. This analysis included only 19,194 births with complete data in the registry database at the time of this analysis, divided into normotensive women (n = 18,735) and women with PE (n = 459) excluding women with gestational hypertension and chronic hypertension without superimposed PE(n = 568). We compared the maternal characteristics of mothers with PE with normotensive mothers and studied the obstetric and neonatal outcomes including cesarean section, stillbirths, prematurity, fetal growth restriction and postpartum hemorrhage (PPH). RESULTS The prevalence of hypertensive disorders among the 19,762 singleton pregnancies was 1027/19,762 (5.1%). The incidence of pre-eclampsia was 459/19,762 (2.3%) while gestational (341/19,762 (1.7%) and chronic hypertension 219/19,762 (1.1%)). A history of PE or eclampsia in past pregnancies was reported in 12.9% vs 0.9% p < .001 of PE vs normotensive women, respectively. After adjusting for significant maternal risk factors using multivariate logistic regression anlaysis, it was noted that PE was significantly associated with a higher odds for cesarean section (odds ratio (OR), 2.67 (95% CI, 2.19-3.25); p < .001), acute maternal morbidity (OR, 16.42 (95% CI, 5.58-48.30); p < .001), still births (OR, 3.27 (95% CI, 1.56-6.83); p < .001), preterm births (OR, 8.67 (95% CI, 7.05-10.65); p < .001), NICU admissions (OR, 4.41 (95% CI, 3.61-5.38); p < .001) and low birth weight (OR, 7.93 (95% CI, 6.43-9.29); p < .001). CONCLUSION Women with pre-eclampsia when compared to the normotensive women, they are older, nulliparous, diabetic and obese with an increased risk of preterm birth and cesarean deliveries. It was noted that PE was significantly associated with acute maternal morbidity, still births, cesarean section and preterm births. By taking preventive measures, prompt delivery and appropriate care we can reduce the risks associated with it or prolong the pregnancy to a gestational period which is considered safe for the neonatal survival. Therefore it's imperative to be aware of the population-based risk factors and its mode of presentation in order to give a timely appropriate care and to prevent severe maternal and fetal morbidities and mortalities.
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Affiliation(s)
| | | | - Tawa Olukade
- Women's Wellness and Research Center, Doha, Qatar
| | - Husam Salama
- Women's Wellness and Research Center, Doha, Qatar
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11
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Younes S, Samara M, Al-Jurf R, Nasrallah G, Al-Obaidly S, Salama H, Olukade T, Hammuda S, Ismail MA, Abdoh G, Abdulrouf PV, Farrell T, AlQubaisi M, Al Rifai H, Al-Dewik N. Incidence, Risk Factors, and Outcomes of Preterm and Early Term Births: A Population-Based Register Study. Int J Environ Res Public Health 2021; 18:5865. [PMID: 34072575 PMCID: PMC8197791 DOI: 10.3390/ijerph18115865] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 05/16/2021] [Accepted: 05/25/2021] [Indexed: 11/16/2022]
Abstract
Preterm birth (PTB) and early term birth (ETB) are associated with high risks of perinatal mortality and morbidity. While extreme to very PTBs have been extensively studied, studies on infants born at later stages of pregnancy, particularly late PTBs and ETBs, are lacking. In this study, we aimed to assess the incidence, risk factors, and feto-maternal outcomes of PTB and ETB births in Qatar. We examined 15,865 singleton live births using 12-month retrospective registry data from the PEARL-Peristat Study. PTB and ETB incidence rates were 8.8% and 33.7%, respectively. PTB and ETB in-hospital mortality rates were 16.9% and 0.2%, respectively. Advanced maternal age, pre-gestational diabetes mellitus (PGDM), assisted pregnancies, and preterm history independently predicted both PTB and ETB, whereas chromosomal and congenital abnormalities were found to be independent predictors of PTB but not ETB. All groups of PTB and ETB were significantly associated with low birth weight (LBW), large for gestational age (LGA) births, caesarean delivery, and neonatal intensive care unit (NICU)/or death of neonate in labor room (LR)/operation theatre (OT). On the other hand, all or some groups of PTB were significantly associated with small for gestational age (SGA) births, Apgar < 7 at 1 and 5 min and in-hospital mortality. The findings of this study may serve as a basis for taking better clinical decisions with accurate assessment of risk factors, complications, and predictions of PTB and ETB.
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Affiliation(s)
- Salma Younes
- Department of Research, Women’s Wellness and Research Center, Hamad Medical Corporation, Doha 3050, Qatar; (S.Y.); (M.A.I.); (P.V.A.); (T.F.)
| | - Muthanna Samara
- Department of Psychology, Kingston University London, Kingston upon Thames, London KT1 2EE, UK; (M.S.); (S.H.)
| | - Rana Al-Jurf
- Department of Biomedical Science, College of Health Sciences, Member of QU Health, Qatar University, Doha 2713, Qatar; (R.A.-J.); (G.N.)
| | - Gheyath Nasrallah
- Department of Biomedical Science, College of Health Sciences, Member of QU Health, Qatar University, Doha 2713, Qatar; (R.A.-J.); (G.N.)
| | - Sawsan Al-Obaidly
- Obstetrics and Gynecology Department, Women’s Wellness and Research Center, Hamad Medical Corporation, Doha 3050, Qatar;
| | - Husam Salama
- Department of Pediatrics and Neonatology, Neonatal Intensive Care Unit, Newborn Screening Unit, Women’s Wellness and Research Center, Hamad Medical Corporation, Doha 3050, Qatar; (H.S.); (T.O.); (G.A.); (M.A.); (H.A.R.)
| | - Tawa Olukade
- Department of Pediatrics and Neonatology, Neonatal Intensive Care Unit, Newborn Screening Unit, Women’s Wellness and Research Center, Hamad Medical Corporation, Doha 3050, Qatar; (H.S.); (T.O.); (G.A.); (M.A.); (H.A.R.)
| | - Sara Hammuda
- Department of Psychology, Kingston University London, Kingston upon Thames, London KT1 2EE, UK; (M.S.); (S.H.)
| | - Mohamed A. Ismail
- Department of Research, Women’s Wellness and Research Center, Hamad Medical Corporation, Doha 3050, Qatar; (S.Y.); (M.A.I.); (P.V.A.); (T.F.)
| | - Ghassan Abdoh
- Department of Pediatrics and Neonatology, Neonatal Intensive Care Unit, Newborn Screening Unit, Women’s Wellness and Research Center, Hamad Medical Corporation, Doha 3050, Qatar; (H.S.); (T.O.); (G.A.); (M.A.); (H.A.R.)
| | - Palli Valapila Abdulrouf
- Department of Research, Women’s Wellness and Research Center, Hamad Medical Corporation, Doha 3050, Qatar; (S.Y.); (M.A.I.); (P.V.A.); (T.F.)
- Department of Pharmacy, Women’s Wellness and Research Center, Hamad Medical Corporation, Doha 3050, Qatar
| | - Thomas Farrell
- Department of Research, Women’s Wellness and Research Center, Hamad Medical Corporation, Doha 3050, Qatar; (S.Y.); (M.A.I.); (P.V.A.); (T.F.)
- Obstetrics and Gynecology Department, Women’s Wellness and Research Center, Hamad Medical Corporation, Doha 3050, Qatar;
| | - Mai AlQubaisi
- Department of Pediatrics and Neonatology, Neonatal Intensive Care Unit, Newborn Screening Unit, Women’s Wellness and Research Center, Hamad Medical Corporation, Doha 3050, Qatar; (H.S.); (T.O.); (G.A.); (M.A.); (H.A.R.)
| | - Hilal Al Rifai
- Department of Pediatrics and Neonatology, Neonatal Intensive Care Unit, Newborn Screening Unit, Women’s Wellness and Research Center, Hamad Medical Corporation, Doha 3050, Qatar; (H.S.); (T.O.); (G.A.); (M.A.); (H.A.R.)
| | - Nader Al-Dewik
- Department of Research, Women’s Wellness and Research Center, Hamad Medical Corporation, Doha 3050, Qatar; (S.Y.); (M.A.I.); (P.V.A.); (T.F.)
- Department of Biomedical Science, College of Health Sciences, Member of QU Health, Qatar University, Doha 2713, Qatar; (R.A.-J.); (G.N.)
- Interim Translational Research Institute (iTRI), Hamad Medical Corporation (HMC), Doha 3050, Qatar
- Faculty of Health and Social Care Sciences, Kingston University, St. George’s University of London, London KT1 2EE, UK
- Clinical and Metabolic Genetics, Department of Pediatrics, Hamad General Hospital, Hamad Medical Corporation, Doha 3050, Qatar
- College of Health and Life Science (CHLS), Hamad Bin Khalifa University (HBKU), Doha 34110, Qatar
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Maducolil MK, Al-Obaidly S, Olukade T, Salama H, AlQubaisi M, Al Rifai H. Maternal characteristics and pregnancy outcomes of women with chronic hypertension: a population-based study. J Perinat Med 2020; 48:139-143. [PMID: 31860472 DOI: 10.1515/jpm-2019-0293] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 11/21/2019] [Indexed: 11/15/2022]
Abstract
Background We aimed to study the maternal characteristics and obstetric and neonatal outcomes in pregnant mothers with chronic hypertension (CHTN) compared to non-CHTN. Methods The study was a population-based cohort study, and a PEARL-Peristat Study (PPS) for the year of 2017. There were 20,210 total births including 19,762 singleton and 448 multiple births. We excluded multiple gestations from the analysis as they differ in fetal growth, duration of gestation and have a higher rate of obstetric and neonatal complications. We compared the maternal characteristics of mothers with pre-existing HTN with non-hypertensive mothers and studied the obstetric and neonatal outcomes including cesarean section, stillbirths, prematurity, macrosomia and postpartum hemorrhage (PPH). Results We identified 223 births of mothers with essential HTN. The overall prevalence of CHTN in our population was 1.1% (223/20,210). In regard to maternal characteristics, women with CHTN were at or above 35 years of age at the time of delivery 58.9% compared to non-CHTN women 18.7%, P-value <0.001. Pre-existing diabetes was found more in women with CHTN 15.1% compared to non-CHTN women 1.9%, P-value <0.001; while obesity was found in 64% of women with CHTN compared to 32.5% in non-CHTN women, P-value <0.001. Preterm birth was noted in 26% compared to 8% in CHTN compared to non-CHTN women, respectively, P-value <0.001. The rate of stillbirth was similar between the two groups, 0.9% compared to 0.6% in CHTN compared to non-CHTN women, respectively, P-value 0.369. Conclusion Hypertensive mothers have multiple other comorbidities. When compared to the general population, they are older, parous, diabetic and obese with an increased risk of preterm birth and cesarean deliveries. Lifestyle modification, extensive pre-conceptional counseling and multidisciplinary antenatal care are required for such a high-risk group.
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Affiliation(s)
- Mariam K Maducolil
- Women's Wellness and Research Center, Hamad Medical Corporation, Doha, Qatar
| | - Sawsan Al-Obaidly
- Women's Wellness and Research Center, Hamad Medical Corporation, Doha, Qatar
| | - Tawa Olukade
- Women's Wellness and Research Center, Hamad Medical Corporation, Doha, Qatar
| | - Husam Salama
- Women's Wellness and Research Center, Hamad Medical Corporation, Doha, Qatar
| | - Mai AlQubaisi
- Women's Wellness and Research Center, Hamad Medical Corporation, Doha, Qatar
| | - Hilal Al Rifai
- Women's Wellness and Research Center, Hamad Medical Corporation, Doha, Qatar
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