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Waist circumference in the prediction of obesity-related adverse pregnancy outcomes; Circunferência da cintura na predição de desfechos adversos da gestação relacionados à obesidade

Wendland, Eliana Marcia da Ros; Duncan, Bruce Bartholow; Mengue, Sotero Serrate; Nucci, Luciana Bertoldi; Schmidt, Maria Inês
Fonte: Universidade Federal do Rio Grande do Sul Publicador: Universidade Federal do Rio Grande do Sul
Tipo: Artigo de Revista Científica Formato: application/pdf
POR
Relevância na Pesquisa
76.16%
O objetivo deste estudo é avaliar as propriedades diagnósticas da circunferência da cintura na predição de desfechos adversos da gestação relacionados à obesidade. Gestantes com 20 ou mais anos de idade, foram arroladas consecutivamente, entre 20 e 28 semanas de gestação, em seis capitais do Brasil, entre 1991 e 1995. Peso, altura e circunferência da cintura foram aferidos e um teste de tolerância à glicose foi realizado. As pacientes foram acompanhadas até o parto através de revisão de prontuários. Propriedades diagnósticas para os diferentes desfechos, mensurados através da área sob a curva Receiver Operator Charactheristic (ROC), foram estimadas por regressão logística. Áreas (IC95%) sob as curvas ROC para a cintura foram 0,621 (0,589-0,652) para diabetes gestacional, 0,640 (0,588- 0,692) para pré-eclâmpsia e 0,645 (0,617-0,673) para macrossomia. Estas áreas foram similares às encontradas para o IMC (p > 0,05). A cintura de 82cm apresentou máximas sensibilidade (63%) e especificidade (57%). Um ponto de corte de 23kg/m2 para o IMC prégestacional e de 26kg/m2 para o IMC no arrolamento produziu propriedades diagnósticas semelhantes. A medida da circunferência da cintura prediz complicações como diabete gestacional...

The impact of prior preeclampsia on the risk of superimposed preeclampsia and other adverse pregnancy outcomes in patients with chronic hypertension

Sibai, Baha M.; Koch, Matthew A.; Freire, Salvio; Pinto e Silva, Joao Luiz; Rudge, Marilza Vieira Cunha; Martins-Costa, Sergio; Moore, Janet; Santos, Cleide de Barros; Cecatti, Jose Guilherme; Costa, Roberto; Ramos, Jose Geraldo; Moss, Nancy; Spinnato, Jo
Fonte: Mosby-elsevier Publicador: Mosby-elsevier
Tipo: Artigo de Revista Científica Formato: 6
ENG
Relevância na Pesquisa
76.13%
OBJECTIVE: We sought to compare the rates of superimposed preeclampsia and adverse outcomes in women with chronic hypertension with or without prior preeclampsia.STUDY DESIGN: We conducted secondary analysis of 369 women with chronic hypertension (104 with prior preeclampsia) enrolled at 12-19 weeks as part of a multisite trial of antioxidants to prevent preeclampsia (no reduction was found). Outcome measures were rates of superimposed preeclampsia and other adverse perinatal outcomes.RESULTS: Prepregnancy body mass index, blood pressure, and smoking status at enrollment were similar between groups. The rates of superimposed preeclampsia (17.3% vs 17.7%), abruptio placentae (1.0% vs 3.1%), perinatal death (6.7% vs 8.7%), and small for gestational age (18.4% vs 14.3%) were similar between groups, but preterm delivery <37 weeks was higher in the prior preeclampsia group (36.9% vs 27.1%; adjusted risk ratio, 1.46; 95% confidence interval, 1.05-2.03; P = .032).CONCLUSION: In women with chronic hypertension, a history of preeclampsia does not increase the rate of superimposed preeclampsia, but is associated with an increased rate of delivery at <37 weeks.

Periodontal infection and adverse pregnancy outcomes: a systematic review of epidemiological studies

Vettore,Mario Vianna; Lamarca,Gabriela de Almeida; Leão,Anna Thereza Thomé; Thomaz,Filipe Brand; Sheiham,Aubrey; Leal,Maria do Carmo
Fonte: Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz Publicador: Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/10/2006 EN
Relevância na Pesquisa
76.35%
The objective of this systematic review was to evaluate analytical studies on periodontal disease as a possible risk factor for adverse pregnancy outcomes. A literature search of the MEDLINE, SciELO, and LILACS bibliographic databases and CAPES thesis database was conducted up to December 2005, covering epidemiological studies of periodontal disease and adverse pregnancy outcomes. Of the 964 papers identified, 36 analytical studies met the inclusion criteria. Twenty-six epidemiological studies reported associations between periodontal disease and adverse pregnancy outcomes. There was a clear heterogeneity between studies concerning measurement of periodontal disease and selection of type of adverse pregnancy outcome. Therefore no meta-analysis was performed. Most studies did not control for confounders, thus raising serious doubts about their conclusions. The methodological limitations of most studies did not allow conclusions concerning the effects of periodontal disease on adverse pregnancy outcomes. Larger and methodologically rigorous analytical studies using reliable outcomes and exposure measures are recommended.

Waist circumference in the prediction of obesity-related adverse pregnancy outcomes

Wendland,Eliana M. D. R.; Duncan,Bruce Bartholow; Mengue,Sotero Serrate; Nucci,Luciana Bertoldi; Schmidt,Maria Inês
Fonte: Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz Publicador: Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/02/2007 EN
Relevância na Pesquisa
76.16%
The aim of this study is to evaluate the diagnostic properties of waist circumference in the prediction of obesity-related gestational outcomes. Pregnant women 20 years or older were consecutively enrolled in six Brazilian State capitals from 1991 to 1995. Weight, height, and waist circumference were measured and an oral glucose tolerance test was performed. Patients were followed through childbirth by chart review. Diagnostic performance for the different outcomes, as measured by area under the receiver operating characteristic (ROC) curve, was estimated through logistic regression. Areas under the ROC curve (95%CI) for waist circumference were 0.621(0.589-0.652) for gestational diabetes, 0.640 (0.588-0.692) for preeclampsia, and 0.645(0.617-0.673) for macrosomia. These areas were similar to those for BMI (p > 0.05). A waist circumference of 82cm jointly maximized sensitivity (63%) and specificity (57%). Cutoff points of 23kg/m² for pre-pregnancy BMI and 26kg/m² for BMI at enrollment produced similar diagnostic properties. In conclusion, waist circumference predicts obesity-related adverse pregnancy outcomes at least as well as BMI.

Quality of life, depression and anxiety among pregnant women with previous adverse pregnancy outcomes

Couto,Evelyn Regina; Couto,Egle; Vian,Bruna; Gregório,Zoraide; Nomura,Marcelo Luis; Zaccaria,Renata; Passini Junior,Renato
Fonte: Associação Paulista de Medicina - APM Publicador: Associação Paulista de Medicina - APM
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/07/2009 EN
Relevância na Pesquisa
76.2%
CONTEXT AND OBJECTIVE: Previous adverse pregnancy outcomes (recurrent spontaneous abortion, fetal death, preterm birth or early neonatal death) can affect the quality of life of pregnant women. The objective of this study was to compare the quality of life and the prevalence of symptoms of anxiety and depression among pregnant women with and without these antecedents. DESIGN AND SETTING: An analytical cross-sectional study was performed in four settings (two high-risk and two low-risk prenatal clinics) in the city of Campinas, São Paulo, Brazil. METHODS: A total of 240 women were interviewed by a single investigator between the 18th and 24th weeks of gestation: 120 women with prior adverse pregnancy outcomes (group 1) and 120 women with no such history (group 2), matched according to their numbers of living children. Sociodemographic variables were collected and two questionnaires were used: the Short Form-36 quality-of-life questionnaire and the Depression and Anxiety Scale. RESULTS: The women in group 1 had lower scores in all the items on the quality-of-life questionnaire. Depression and anxiety were more frequent in group 1 (P < 0.0001). An inverse correlation was found between the Short Form-36 domains and anxiety and depression. CONCLUSIONS: Women with histories of recurrent spontaneous abortion...

How Disturbed Sleep May Be a Risk Factor for Adverse Pregnancy Outcomes A Hypothesis

Okun, Michele L.; Roberts, James M.; Marsland, Anna L.; Hall, Martica
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /04/2009 EN
Relevância na Pesquisa
66.31%
Adverse pregnancy outcomes associated with significant maternal and infant morbidity are on the rise in Western society despite advances of medical technology. Current risk factors are insufficient to identify women at greatest risk of developing an adverse outcome. An attempt to identify novel contributors to increased risk is warranted. Sleep disturbances are frequent during pregnancy, yet are often dismissed as irrelevant. Emerging evidence indicates that sleep disturbances are associated with poor health outcomes, including cardiovascular disease. Disturbed sleep is also linked with an increased inflammatory response. Increased inflammation is proposed as a key biological pathway through which chronic disease and adverse pregnancy outcomes develop. In this paper, we propose a model and a testable hypothesis of how disturbed sleep in the first 20 weeks of pregnancy could contribute to adverse pregnancy outcomes such as preeclampsia, intrauterine growth restriction, and preterm birth via increased inflammation.

Neighborhood Inequalities in Adverse Pregnancy Outcomes in an Urban Setting in Spain: A Multilevel Approach

Garcia-Subirats, Irene; Pérez, Glòria; Rodríguez-Sanz, Maica; Muñoz, Dolores Ruiz; Salvador, Joaquín
Fonte: Springer US Publicador: Springer US
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
66.3%
The aim of the present study was to describe socioeconomic inequalities in low birth weight (LBW), premature birth (PM) and small size for gestational age at birth (SGA) between 2000 and 2005 in Barcelona, Spain, jointly evaluating the effect of mother’s country of origin, and neighborhood of residence socioeconomic level measured using unemployment and educational level. We performed a cross-sectional study of births to mothers aged 12–49 years who were residents in the city of Barcelona in 2000–2005, analyzing adverse pregnancy outcomes (n = 61,676). Weighted multilevel logistic regression models were fitted with individual data on level 1 and neighborhood data on level 2, to obtain adjusted odds ratios (aOR) with 95% confidence intervals and residual variance. Individually, pregnancy outcomes are more favorable in births to older mothers and to mothers from Maghrib and Central and South America than from developed countries (including Spain) or from other developing countries. After adjusting for individual variables, poor pregnancy outcomes were associated with poor neighborhoods (more unemployment was associated to LBW: aOR = 1.56; PM aOR = 1.51; SGA aOR = 1.66). The same trend was observed for associations with illiteracy rate. The present study shows that there are socioeconomic inequalities in adverse pregnancy outcomes in the city of Barcelona. One of the main challenges in perinatal health continues to be the reduction of adverse pregnancy outcomes in the city.

Maternal weight change before pregnancy in relation to birthweight and risks of adverse pregnancy outcomes

Diouf, Ibrahima; Charles, Marie Aline; Thiebaugeorges, Olivier; Forhan, Anne; Kaminski, Monique; Heude, Barbara
Fonte: Kluwer Academic Publishers Publicador: Kluwer Academic Publishers
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
66.29%
Maternal weight change before pregnancy can be considered an indicator of maternal energy balance and nutritional status before conception, and may be involved in early life programming. We aimed to investigate the association of maternal Weight Change Before Pregnancy (WCBP) with fetal growth and adverse pregnancy outcomes. Data are from the French EDEN mother-child cohort of 1756 mother-child pairs; information on mother’s weight at 20 years, weight just before pregnancy, fetal anthropometry at second and third trimesters, infant’s birthweight and pregnancy complications were recorded. The average annual WCBP between 20 years and start of pregnancy (in kg/year) was categorized as: “Weight Loss” (n=320), “Moderate weight gain” (n=721) and “High weight gain” (n=715). The associations of WCBP with fetal and newborn characteristics and with adverse pregnancy outcomes were analyzed, adjusting for maternal and pregnancy characteristics, including the mother’s prepregnancy BMI. Interactions between WCBP and prepregnancy BMI were tested. Birthweight and estimated fetal weight in the third trimester increased significantly with increasing WCBP in mothers with BMI <25kg/m2. In these mothers, weight loss before pregnancy was associated with a higher risk of newborns small for gestational age (SGA). Whatever the prepregnancy BMI...

Fetal exposure to herpesviruses may be associated with pregnancy-induced hypertensive disorders and preterm birth in a Caucasian population

Gibson, C.; Goldwater, P.; MacLennan, A.; Haan, E.; Priest, K.; Dekker, G.
Fonte: Blackwell Publishing Ltd Publicador: Blackwell Publishing Ltd
Tipo: Artigo de Revista Científica
Publicado em //2008 EN
Relevância na Pesquisa
76.17%
OBJECTIVE: To investigate the role of fetal viral infection in the development of a range of adverse pregnancy outcomes (APOs), including pregnancy-induced hypertensive disorders (PIHD), antepartum haemorrhage (APH), birthweight <10th percentile (small for gestational age, SGA) and preterm birth (PTB). DESIGN: Population-based case-control study. SETTING: Laboratory-based study. POPULATION: The newborn screening cards of 717 adverse pregnancy cases and 609 controls. METHODS: Newborn screening cards were tested for RNA from enteroviruses and DNA from herpesviruses using polymerase chain reaction (PCR). The herpesviruses were detected using two PCRs, one detecting nucleic acids from herpes simplex virus (HSV)-1, HSV-2, Epstein-Barr virus (EBV), cytomegalovirus (CMV) and human herpesvirus (HHV)-8, hereafter designated Herpes PCR group A viruses, and the other detecting nucleic acids from varicella-zoster virus (VZV), HHV-6 and HHV-7, hereafter designated Herpes PCR group B viruses. MAIN OUTCOME MEASURE: Odds ratios and 95% CIs for specific APOs. RESULTS: For both term and PTBs, the risk of developing PIHD was increased in the presence of DNA from Herpes PCR group B viruses (OR 3.57, 95% CI 1.10-11.70), CMV (OR 3.89, 95% CI 1.67-9.06)...

The risk of adverse pregnancy outcomes in women who are overweight or obese

Athukorala, C.; Rumbold, A.; Willson, K.; Crowther, C.
Fonte: BioMed Central Ltd. Publicador: BioMed Central Ltd.
Tipo: Artigo de Revista Científica
Publicado em //2010 EN
Relevância na Pesquisa
76.23%
Background: The prevalence of obesity amongst women bearing children in Australia is rising and has important implications for obstetric care. The aim of this study was to assess the prevalence and impact of mothers being overweight and obese in early to mid-pregnancy on maternal, peripartum and neonatal outcomes. Methods: A secondary analysis was performed on data collected from nulliparous women with a singleton pregnancy enrolled in the Australian Collaborative Trial of Supplements with antioxidants Vitamin C and Vitamin E to pregnant women for the prevention of pre-eclampsia (ACTS). Women were categorized into three groups according to their body mass index (BMI): normal (BMI 18.5-24.9 kg/m2); overweight (BMI 25-29.9 kg/m2) and; obese (BMI 30-34.9 kg/m2). Obstetric and perinatal outcomes were compared by univariate and multivariate analyses. Results: Of the 1661 women included, 43% were overweight or obese. Obese women were at increased risk of pre-eclampsia (relative risk (RR) 2.99 [95% confidence intervals (CI) 1.88, 4.73], p < 0.0001) and gestational diabetes (RR 2.10 [95%CI 1.17, 3.79], p = 0.01) compared with women with a normal BMI. Obese and overweight women were more likely to be induced and require a caesarean section compared with women of normal BMI (induction - RR 1.33 [95%CI 1.13...

Fetal MBL2 haplotypes combined with viral exposure are associated with adverse pregnancy outcomes

Gibson, C.; MacLennan, A.; Haan, E.; Priest, K.; Dekker, G.
Fonte: Taylor & Francis Ltd Publicador: Taylor & Francis Ltd
Tipo: Artigo de Revista Científica
Publicado em //2011 EN
Relevância na Pesquisa
76.27%
Objective. To investigate the roles of inherited polymorphisms in the MBL2 gene and exposure to viral infection in the development of a range of adverse pregnancy outcomes, including birthweight <10th percentile (small-for-gestational age, SGA), antepartum hemorrhage (APH), pregnancy-induced hypertensive disorders (PIHD), and preterm birth (PTB). Methods. This was a case–control study using DNA from newborn screening cards of 717 cases (babies with at least one of the adverse pregnancy outcomes listed above) and 609 controls, to screen for six polymorphisms within the MBL2 gene. These combine to create haplotypes with high (HYPA), intermediate (LYQA, LYPA), low (LXPA), and defective (HYPD, LYQC, LYPB) circulating MBL2 levels. Results. Significant associations were found between variant MBL2 haplotypes and SGA (LYPA <32 weeks OR 5.37, 95% CI 1.50–17.27), antepartum hemorrhage (LYPA <37 weeks OR 2.29, 95% CI 1.25–4.18), and PIHD (LYQC <32 weeks (OR 17.89, 95% CI 2.20–139.57). Evidence of exposure to infection increased the effect of these associations, (SGA OR 17.00, 95% CI 1.03–252.48; APH OR 5.67, 95% CI 1.73–18.84; PIHD OR 23.80, 95% CI 1.08–1414.76), while no evidence of exposure to infection demonstrated no associations. PTB was significantly associated with the defective HYPD haplotype with evidence of exposure to infection (OR 6.14...

The vascular endothelial growth factor family in adverse pregnancy outcomes

Andraweera, P.; Dekker, G.; Roberts, C.
Fonte: Oxford Univ Press Publicador: Oxford Univ Press
Tipo: Artigo de Revista Científica
Publicado em //2012 EN
Relevância na Pesquisa
76.13%
BACKGROUND Pre-eclampsia, small-for-gestational-age infants, preterm birth and recurrent miscarriage complicate a significant number of pregnancies. The vascular endothelial growth factor (VEGF) family of angiogenic growth factors is implicated in the pathophysiology of these complications. We aimed to elucidate the role of these angiogenic factors in placentation and to evaluate the predictive value of their protein concentrations and genetic variations in pregnancy complications. METHODS We performed a systematic search of PubMed, and retrieved original articles. The search included a combination of terms such as VEGF-A, placental growth factor (PlGF), kinase insert domain receptor, fms-like-tyrosine-kinase receptor 1, soluble fms-like-tyrosine-kinase receptor 1, pre-eclampsia, small-for-gestational-age infants, preterm birth, recurrent miscarriage, placenta, prediction and polymorphisms. RESULTS This review summarizes the current knowledge of the roles of the VEGF family in early placentation and of the abnormalities in maternal plasma and placental expression of angiogenic proteins in adverse pregnancy outcomes compared with normal pregnancy. PlGF and sFLT-1 in combination with other clinical and biochemical markers in late first or second trimester appear to predict early-onset pre-eclampsia with a high sensitivity and specificity. However...

Association between weight gain during pregnancy and pregnancy outcomes after dietary and lifestyle interventions: a meta-analysis

Ruifrok, A.E.; Van Poppel, M.N.M.; Van Wely, M.; Rogozińska, E.; Khan, K.S.; De Groot, C.J.M.; Thangaratinam, S.; Mol, B.W.
Fonte: Thieme Publishing Publicador: Thieme Publishing
Tipo: Artigo de Revista Científica
Publicado em //2014 EN
Relevância na Pesquisa
76.3%
OBJECTIVES: Lifestyle interventions in obese pregnant women reduce adverse maternal outcomes of pregnancy. However, the association between weight change due to interventions and the actual reduction in complications is unknown. The objective of this study was to determine the association between gestational weight gain (GWG) and the rate of pregnancy complications. STUDY DESIGN: The authors included randomized controlled trials (RCTs) assessing the effect of lifestyle interventions during pregnancy on GWG and adverse maternal and fetal outcomes. For each outcome they assessed the association between GWG and the risk of adverse pregnancy outcomes. RESULTS: They analyzed data of 23 RCTs (4,990 women). Increased GWG was associated with a nonsignificant increase in the incidence of preeclampsia (PE) (0.2% per gained kg, 95% confidence interval [CI] 0.5 to 0.9%, p > 0.05), gestational diabetes (GDM) (0.3% per gained kg, 95% CI -0.5 to 1.0%, p > 0.05), and induction of labor (IOL) (1.5% per gained kg, 95% CI -0.9 to 3.9%, p > 0.05). CONCLUSIONS: Reduction in GWG due to lifestyle interventions in pregnancy had statistically nonsignificant effects on lowering the incidence of PE, GDM, and IOL. Possibly, the beneficial effect of lifestyle interventions on pregnancy outcomes is due to an effect independent of the reduction of GWG.; A.E. Ruifrok...

Pregnancy loss managed by cervical dilatation and curettage increases the risk of spontaneous preterm birth

McCarthy, F.; Khashan, A.; North, R.; Rahma, M.; Walker, J.; Baker, P.; Dekker, G.; Poston, L.; McCowan, L.; O'Donoghue, K.; Kenny, L.
Fonte: Oxford Univ Press Publicador: Oxford Univ Press
Tipo: Artigo de Revista Científica
Publicado em //2013 EN
Relevância na Pesquisa
76.23%
STUDY QUESTION Do women with a previous miscarriage or termination of pregnancy have an increased risk of spontaneous preterm birth and is this related to previous cervical dilatation and curettage? SUMMARY ANSWER A single previous pregnancy loss (termination or miscarriage) managed by cervical dilatation and curettage is associated with a greater risk of SpPTB. WHAT IS KNOWN ALREADY Miscarriage affects ∼20% of pregnancies and as many as a further 20% of pregnancies undergo termination. STUDY DESIGN, SIZE, DURATION We utilized data from 5575 healthy nulliparous women with singleton pregnancies recruited to the Screening for Pregnancy Endpoints (SCOPE) study, a prospective cohort study performed between November 2004 and January 2011. PARTICIPANTS/MATERIALS, SETTING, METHODS The primary outcome was spontaneous preterm birth (defined as spontaneous preterm labour or preterm premature rupture of membranes (PPROM) resulting in preterm birth <37 weeks' gestation). Secondary outcomes included PPROM, small for gestational age, birthweight, pre-eclampsia and placental abruption. MAIN RESULTS AND THE ROLE OF CHANCE Women with previous pregnancy loss (miscarriage or termination) were compared with those with no previous pregnancy loss. There were 4331 (78%) women who had no previous pregnancy loss...

Associations between fetal inherited thrombophilia and adverse pregnancy outcomes

Gibson, C.; MacLennan, A.; Janssen, N.; Kist, W.; Hague, W.; Haan, E.; Goldwater, P.; Priest, K.; Dekker, G.
Fonte: Mosby Inc Publicador: Mosby Inc
Tipo: Artigo de Revista Científica
Publicado em //2006 EN
Relevância na Pesquisa
96.26%
Objective: The purpose of this study was to investigate associations between fetal inherited thrombophilia and adverse pregnancy outcomes, including pregnancy-induced hypertensive disorders (PIHD), antepartum hemorrhage (APH), small-for-gestational age <10th percentile (SGA), and preterm birth (PTB). Study design: Seven hundred and seventeen cases and 609 controls were genotyped for Factor V Leiden (FVL, G1691A), Prothrombin gene mutation (PGM, G20210A), and Methylenetetrahydrofolate reductase (MTHFR) C677T and MTHFR A1298C using DNA from newborn screening cards. Results: For babies born <28 weeks' gestation, PGM was associated with an increased risk of SGA (OR 6.40, 95%CI 1.66-24.71) and APH with SGA (OR 6.35, 95%CI 1.63-24.75). Homozygous MTHFR A1298C was associated with an increased risk of SGA for babies born 28-31 weeks gestation (OR 4.00, 95%CI 1.04-15.37), and with APH and SGA for babies born <32 weeks' gestation (OR 3.57, 95%CI 1.09-11.66). Homozygous MTHFR C677T was associated with a reduced risk of PTB and SGA (OR 0.52, 95%CI 0.28-0.96) for babies born 32 to 36 weeks' gestation. Homozygous FVL decreased the risk of PTB <32 weeks' gestation (OR 0.55, 95%CI 0.31-0.98). Conclusion: Fetal thrombophilic polymorphisms may be related to adverse pregnancy outcomes...

Periodontal treatment during pregnancy decreases the rate of adverse pregnancy outcome: a controlled clinical trial

SANT'ANA, Adriana Campos Passanezi; CAMPOS, Marinele R. de; PASSANEZI, Selma Campos; REZENDE, Maria Lúcia Rubo de; GREGHI, Sebastião Luiz Aguiar; PASSANEZI, Euloir
Fonte: Faculdade De Odontologia De Bauru - USP Publicador: Faculdade De Odontologia De Bauru - USP
Tipo: Artigo de Revista Científica
ENG
Relevância na Pesquisa
66.36%
OBJECTIVES: The aim of this study was to evaluate the effects of non-surgical treatment of periodontal disease during the second trimester of gestation on adverse pregnancy outcomes. MATERIAL AND METHODS: Pregnant patients during the 1st and 2nd trimesters at antenatal care in a Public Health Center were divided into 2 groups: NIG - "no intervention" (n=17) or IG- "intervention" (n=16). IG patients were submitted to a non-surgical periodontal treatment performed by a single periodontist consisting of scaling and root planning (SRP), professional prophylaxis (PROPH) and oral hygiene instruction (OHI). NIG received PROPH and OHI during pregnancy and were referred for treatment after delivery. Periodontal evaluation was performed by a single trained examiner, blinded to periodontal treatment, according to probing depth (PD), clinical attachment level (CAL), plaque index (PI) and sulcular bleeding index (SBI) at baseline and 35 gestational weeks-28 days post-partum. Primary adverse pregnancy outcomes were preterm birth (<37 weeks), low birth weight (<2.5 kg), late abortion (14-24 weeks) or abortion (<14 weeks). The results obtained were statistically evaluated according to OR, unpaired t test and paired t test at 5% signifcance level. RESULTS: No signifcant differences were observed between groups at baseline examination. Periodontal treatment resulted in stabilization of CAL and PI (p>0.05) at IG and worsening of all periodontal parameters at NIG (p<0.0001)...

Early Gestational Weight Gain Rate and Adverse Pregnancy Outcomes in Korean Women

Cho, Eun-Hee; Hur, Junguk; Lee, Kyung-Ju
Fonte: Public Library of Science Publicador: Public Library of Science
Tipo: Artigo de Revista Científica
Publicado em 14/10/2015 EN
Relevância na Pesquisa
66.45%
During pregnancy, many women gain excessive weight, which is related to adverse maternal and neonatal outcomes. In this study, we evaluated whether rate of gestational weight gain (RGWG) in early, mid, and late pregnancy is strongly associated with adverse pregnancy outcomes. A retrospective chart review of 2,789 pregnant Korean women was performed. Weights were recorded at the first clinic visit, during the screening test for fetal anomaly, and during the 50g oral glucose challenge test and delivery, to represent early, mid, and late pregnancy, respectively. A multivariate logistic regression analysis was performed to examine the relationship between RGWG and adverse pregnancy outcomes. At early pregnancy, the RGWG was significantly associated with high risk of developing gestational diabetes mellitus (GDM), pregnancy-induced hypertension (PIH), large for gestational age (LGA) infants, macrosomia, and primary cesarean section (P-CS). The RGWG of mid pregnancy was not significantly associated with any adverse pregnancy outcomes. The RGWG at late pregnancy was significantly associated with a lower risk of developing GDM, preterm birth and P-CS, but with a higher risk of developing LGA infants and macrosomia. When the subjects were divided into three groups (Underweight...

Periodontal treatment during pregnancy decreases the rate of adverse pregnancy outcome: a controlled clinical trial

Sant'Ana,Adriana Campos Passanezi; Campos,Marinele R. de; Passanezi,Selma Campos; Rezende,Maria Lúcia Rubo de; Greghi,Sebastião Luiz Aguiar; Passanezi,Euloir
Fonte: Faculdade De Odontologia De Bauru - USP Publicador: Faculdade De Odontologia De Bauru - USP
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/04/2011 EN
Relevância na Pesquisa
66.36%
OBJECTIVES: The aim of this study was to evaluate the effects of non-surgical treatment of periodontal disease during the second trimester of gestation on adverse pregnancy outcomes. MATERIAL AND METHODS: Pregnant patients during the 1st and 2nd trimesters at antenatal care in a Public Health Center were divided into 2 groups: NIG - "no intervention" (n=17) or IG- "intervention" (n=16). IG patients were submitted to a non-surgical periodontal treatment performed by a single periodontist consisting of scaling and root planning (SRP), professional prophylaxis (PROPH) and oral hygiene instruction (OHI). NIG received PROPH and OHI during pregnancy and were referred for treatment after delivery. Periodontal evaluation was performed by a single trained examiner, blinded to periodontal treatment, according to probing depth (PD), clinical attachment level (CAL), plaque index (PI) and sulcular bleeding index (SBI) at baseline and 35 gestational weeks-28 days post-partum. Primary adverse pregnancy outcomes were preterm birth (<37 weeks), low birth weight (<2.5 kg), late abortion (14-24 weeks) or abortion (<14 weeks). The results obtained were statistically evaluated according to OR, unpaired t test and paired t test at 5% signifcance level. RESULTS: No signifcant differences were observed between groups at baseline examination. Periodontal treatment resulted in stabilization of CAL and PI (p>0.05) at IG and worsening of all periodontal parameters at NIG (p<0.0001)...

Periodontal infection and adverse pregnancy outcomes: a systematic review of epidemiological studies

Vettore,Mario Vianna; Lamarca,Gabriela de Almeida; Leão,Anna Thereza Thomé; Thomaz,Filipe Brand; Sheiham,Aubrey; Leal,Maria do Carmo
Fonte: Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz Publicador: Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/10/2006 EN
Relevância na Pesquisa
76.35%
The objective of this systematic review was to evaluate analytical studies on periodontal disease as a possible risk factor for adverse pregnancy outcomes. A literature search of the MEDLINE, SciELO, and LILACS bibliographic databases and CAPES thesis database was conducted up to December 2005, covering epidemiological studies of periodontal disease and adverse pregnancy outcomes. Of the 964 papers identified, 36 analytical studies met the inclusion criteria. Twenty-six epidemiological studies reported associations between periodontal disease and adverse pregnancy outcomes. There was a clear heterogeneity between studies concerning measurement of periodontal disease and selection of type of adverse pregnancy outcome. Therefore no meta-analysis was performed. Most studies did not control for confounders, thus raising serious doubts about their conclusions. The methodological limitations of most studies did not allow conclusions concerning the effects of periodontal disease on adverse pregnancy outcomes. Larger and methodologically rigorous analytical studies using reliable outcomes and exposure measures are recommended.

Waist circumference in the prediction of obesity-related adverse pregnancy outcomes

Wendland,Eliana M. D. R.; Duncan,Bruce Bartholow; Mengue,Sotero Serrate; Nucci,Luciana Bertoldi; Schmidt,Maria Inês
Fonte: Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz Publicador: Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/02/2007 EN
Relevância na Pesquisa
76.16%
The aim of this study is to evaluate the diagnostic properties of waist circumference in the prediction of obesity-related gestational outcomes. Pregnant women 20 years or older were consecutively enrolled in six Brazilian State capitals from 1991 to 1995. Weight, height, and waist circumference were measured and an oral glucose tolerance test was performed. Patients were followed through childbirth by chart review. Diagnostic performance for the different outcomes, as measured by area under the receiver operating characteristic (ROC) curve, was estimated through logistic regression. Areas under the ROC curve (95%CI) for waist circumference were 0.621(0.589-0.652) for gestational diabetes, 0.640 (0.588-0.692) for preeclampsia, and 0.645(0.617-0.673) for macrosomia. These areas were similar to those for BMI (p > 0.05). A waist circumference of 82cm jointly maximized sensitivity (63%) and specificity (57%). Cutoff points of 23kg/m² for pre-pregnancy BMI and 26kg/m² for BMI at enrollment produced similar diagnostic properties. In conclusion, waist circumference predicts obesity-related adverse pregnancy outcomes at least as well as BMI.