Impact of medical conditions and medications received during pregnancy on adverse birth outcomes: A hospital-based prospective case-control study.

Q2 Medicine Perspectives in Clinical Research Pub Date : 2023-01-01 Epub Date: 2021-10-23 DOI:10.4103/picr.picr_16_21
Krishna Undela, Parthasarathi Gurumurthy, M S Sujatha
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Abstract

Purpose: In view of the raising rate of adverse birth outcomes (ABOs) across the globe, this study was conducted to assess the impact of medical conditions and medications received during pregnancy on ABOs.

Materials and methods: A prospective case-control study was conducted at the Department of Obstetrics and Gynecology of a tertiary care hospital over a period of 3 years from July 2015 to June 2018. Liveborn and stillborn neonates included in the study were categorized into cases and controls based on the presence or absence of composite ABOs, respectively. Binary logistic regression analysis was used to identify the risk factors for ABOs among medical conditions and medications received by mothers during their current pregnancy.

Results: Among 1214 neonates included in the study, 556 (45.8%) were identified with composite ABOs, the majority were low birth weight (320 [26.4%]) and preterm birth 300 (24.7%). After adjusting for confounding factors, it was identified that hypertension (adjusted odds ratio [aOR] 7.3), oligohydramnios (aOR 3.9), anemia (aOR 3.2), nifedipine (aOR 10.0), nicardipine (aOR 5.3), and magnesium sulfate (aOR 5.3) were the risk factors for overall and specific ABOs like preterm birth and low birth weight. It was also identified that the early detection and management of hypertension with antihypertensives like labetalol and methyldopa can reduce the risk of preterm birth by 93% and 88%, respectively.

Conclusion: Medical conditions such as hypertension, oligohydramnios, and anemia and medications such as nifedipine, nicardipine, and magnesium sulfate during pregnancy were identified as the risk factors for overall and specific ABOs like preterm birth and low birth weight.

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妊娠期间接受的医疗条件和药物对不良分娩结果的影响:一项基于医院的前瞻性病例对照研究。
目的:鉴于全球不良出生结局(ABO)发生率的上升,本研究旨在评估妊娠期间的医疗条件和药物对ABO的影响。材料和方法:2015年7月至2018年6月,在一家三级护理医院妇产科进行了为期3年的前瞻性病例对照研究。纳入研究的活产和死产新生儿分别根据是否存在复合ABO分为病例和对照组。使用二元逻辑回归分析来确定母亲在当前妊娠期间接受的医疗条件和药物中ABO的风险因素。结果:在纳入研究的1214名新生儿中,556名(45.8%)被确定为复合ABO,大多数是低出生体重儿(320名[26.4%])和早产儿300名(24.7%)。在校正混杂因素后,确定为高血压(校正比值比[aOR]7.3)、羊水过少(aOR3.9)、贫血(aOR3.2)、硝苯地平(aOR10.0)、尼卡地平(aOR 5.3),和硫酸镁(aOR 5.3)是早产和低出生体重等总体和特定ABO的危险因素。还发现,使用拉贝洛尔和甲基多巴等抗高血压药物早期发现和治疗高血压可分别将早产风险降低93%和88%。结论:妊娠期间高血压、羊水过少、贫血等疾病以及硝苯地平、尼卡地平和硫酸镁等药物被确定为早产和低出生体重等整体和特定ABO的危险因素。
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来源期刊
Perspectives in Clinical Research
Perspectives in Clinical Research Medicine-Medicine (all)
CiteScore
2.90
自引率
0.00%
发文量
41
审稿时长
36 weeks
期刊介绍: This peer review quarterly journal is positioned to build a learning clinical research community in India. This scientific journal will have a broad coverage of topics across clinical research disciplines including clinical research methodology, research ethics, clinical data management, training, data management, biostatistics, regulatory and will include original articles, reviews, news and views, perspectives, and other interesting sections. PICR will offer all clinical research stakeholders in India – academicians, ethics committees, regulators, and industry professionals -a forum for exchange of ideas, information and opinions.
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