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Obesity-related maternal complications during the COVID-19 pandemic COVID-19 大流行期间与肥胖有关的产妇并发症

IF 0.7 Q3 Medicine

Obstetric Medicine

Pub Date : 2024-02-11 DOI: 10.1177/1753495x241229773

I. Sgayer, Tomer Yehuda Fishman, L. Lowenstein, M. Wolf

To compare gestational weight gain (GWG) during pregnancy and obesity-related maternal morbidity between three months of the first year of the COVID-19 pandemic and three months of the previous year. A retrospective comparative study was conducted in a tertiary university-affiliated hospital. GWG, obesity rates and pregnancy complications were compared between the time periods. Among women with class I obesity, GWG was higher during the pandemic ( n = 1071) than the previous year ( n = 1194): 11.16 vs. 8.69 kg, p = 0.04. Women during the pandemic compared to the previous year were less likely to be diagnosed with gestational diabetes (odds ratio [OR] = 0.66, 95% confidence interval [CI] 0.47–0.91, p = 0.01) or hypertensive disorders of pregnancy (OR = 0.63, 95% CI 0.35–1.0, p = 0.05) after adjustment for parity, mode of conception and advanced maternal age. Gestational weight gain increased during the pandemic, yet rates of obesity-related complications were notably fewer. This is likely attributed to decreased detection consequent to limited antenatal care.

目的：比较 COVID-19 大流行第一年的三个月与前一年的三个月之间孕期妊娠体重增加（GWG）与肥胖相关的孕产妇发病率。一项回顾性比较研究在一所大学附属三级医院进行。比较了不同时期的 GWG、肥胖率和妊娠并发症。在一级肥胖症妇女中，大流行期间的 GWG（n = 1071）高于前一年（n = 1194）：11.16 对 8.69 千克，P = 0.04。与前一年相比，大流行期间的妇女被诊断为妊娠糖尿病（几率比 [OR] = 0.66，95% 置信区间 [CI]：0.47-0.91，P = 0.01）或妊娠高血压疾病（OR = 0.63，95% CI：0.35-1.0，P = 0.05）的几率较低，这是在调整了准妈妈人数、受孕方式和高龄产妇年龄之后得出的结论。妊娠期体重增加在大流行期间有所增加，但与肥胖相关的并发症发生率却明显较低。这可能是由于产前护理有限导致发现率下降。

引用次数: 0

Obesity-related maternal complications during the COVID-19 pandemic COVID-19 大流行期间与肥胖有关的产妇并发症

IF 0.7 Q3 Medicine

Obstetric Medicine

Pub Date : 2024-02-11 DOI: 10.1177/1753495x241229773

I. Sgayer, Tomer Yehuda Fishman, L. Lowenstein, M. Wolf

To compare gestational weight gain (GWG) during pregnancy and obesity-related maternal morbidity between three months of the first year of the COVID-19 pandemic and three months of the previous year. A retrospective comparative study was conducted in a tertiary university-affiliated hospital. GWG, obesity rates and pregnancy complications were compared between the time periods. Among women with class I obesity, GWG was higher during the pandemic ( n = 1071) than the previous year ( n = 1194): 11.16 vs. 8.69 kg, p = 0.04. Women during the pandemic compared to the previous year were less likely to be diagnosed with gestational diabetes (odds ratio [OR] = 0.66, 95% confidence interval [CI] 0.47–0.91, p = 0.01) or hypertensive disorders of pregnancy (OR = 0.63, 95% CI 0.35–1.0, p = 0.05) after adjustment for parity, mode of conception and advanced maternal age. Gestational weight gain increased during the pandemic, yet rates of obesity-related complications were notably fewer. This is likely attributed to decreased detection consequent to limited antenatal care.

目的：比较 COVID-19 大流行第一年的三个月与前一年的三个月之间孕期妊娠体重增加（GWG）与肥胖相关的孕产妇发病率。一项回顾性比较研究在一所大学附属三级医院进行。比较了不同时期的 GWG、肥胖率和妊娠并发症。在一级肥胖症妇女中，大流行期间的 GWG（n = 1071）高于前一年（n = 1194）：11.16 对 8.69 千克，P = 0.04。与前一年相比，大流行期间的妇女被诊断为妊娠糖尿病（几率比 [OR] = 0.66，95% 置信区间 [CI]：0.47-0.91，P = 0.01）或妊娠高血压疾病（OR = 0.63，95% CI：0.35-1.0，P = 0.05）的几率较低，这是在调整了准妈妈人数、受孕方式和高龄产妇年龄之后得出的结论。妊娠期体重增加在大流行期间有所增加，但与肥胖相关的并发症发生率却明显较低。这可能是由于产前护理有限导致发现率下降。

引用次数: 0

Influence of aspirin on obstetric outcomes in women with pre-gestational diabetes mellitus: a South-Western Sydney cohort study 阿司匹林对妊娠前糖尿病妇女产科结果的影响：悉尼西南部队列研究

IF 0.7 Q3 Medicine

Obstetric Medicine

Pub Date : 2024-02-06 DOI: 10.1177/1753495x241230719

A. Jeyaruban, R. Shanmugalingam, Pamela Wu, Rena Cao, Vincent W Wong, Tang Wong, Jeff Flack, Angela Makris

To investigate the effect of aspirin on obstetric outcomes in women with pre-gestational diabetes mellitus (PGDM). Retrospective audit of pregnant women with PGDM from two centres in South-Western Sydney was conducted. Women were categorised into the aspirin group (prescribed aspirin before 16 weeks, gestation) and non-aspirin group (not prescribed aspirin or prescribed aspirin at or after 16 weeks, gestation). The outcomes examined were pre-eclampsia, pre-term delivery and birthweight percentile. Of 494 women, 52 (10.5%) were in the aspirin group. Pre-eclampsia developed in 57 (12.0%) women. There was no association between aspirin use and pre-eclampsia (8 (15.4%) vs 49 (11.1%), P = 0.2). Aspirin use was not associated with difference in birthweight percentile and rate of pre-term deliveries when adjusted for maternal age, gravidity and other comorbidities. There was no difference in the rates of pre-eclampsia, pre-term delivery, or birthweight percentile between women with PGDM in aspirin group compared to women in non-aspirin group.

研究阿司匹林对妊娠前期糖尿病（PGDM）孕妇产科结果的影响。对悉尼西南部两个中心的妊娠前期糖尿病孕妇进行了回顾性审计。妇女被分为阿司匹林组（妊娠 16 周前处方阿司匹林）和非阿司匹林组（未处方阿司匹林或妊娠 16 周或之后处方阿司匹林）。研究结果包括先兆子痫、早产和出生体重百分位数。在 494 名妇女中，阿司匹林组有 52 人（10.5%）。有 57 名妇女（12.0%）出现先兆子痫。使用阿司匹林与先兆子痫之间没有关联（8（15.4%）对 49（11.1%），P = 0.2）。在对产妇年龄、孕酮和其他合并症进行调整后，阿司匹林的使用与出生体重百分位数和早产率的差异无关。与非阿司匹林组相比，阿司匹林组 PGDM 孕妇的先兆子痫发生率、早产率或出生体重百分位数没有差异。

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Abstracts presented at the Society of Obstetric Medicine of Australia and New Zealand (SOMANZ) 2023 Annual meeting in Adelaide, Australia, 6-8 Oct 2023 澳大利亚和新西兰产科医学会（SOMANZ）2023 年年会摘要，2023 年 10 月 6-8 日，澳大利亚阿德莱德

IF 0.7 Q3 Medicine

Obstetric Medicine

Pub Date : 2024-02-06 DOI: 10.1177/1753495x231222541

引用次数: 0

Abstracts presented at the Society of Obstetric Medicine of Australia and New Zealand (SOMANZ) 2023 Annual meeting in Adelaide, Australia, 6-8 Oct 2023 澳大利亚和新西兰产科医学会（SOMANZ）2023 年年会摘要，2023 年 10 月 6-8 日，澳大利亚阿德莱德

IF 0.7 Q3 Medicine

Obstetric Medicine

Pub Date : 2024-02-06 DOI: 10.1177/1753495x231222541

引用次数: 0

Influence of aspirin on obstetric outcomes in women with pre-gestational diabetes mellitus: a South-Western Sydney cohort study 阿司匹林对妊娠前糖尿病妇女产科结果的影响：悉尼西南部队列研究

IF 0.7 Q3 Medicine

Obstetric Medicine

Pub Date : 2024-02-06 DOI: 10.1177/1753495x241230719

A. Jeyaruban, R. Shanmugalingam, Pamela Wu, Rena Cao, Vincent W Wong, Tang Wong, Jeff Flack, Angela Makris

To investigate the effect of aspirin on obstetric outcomes in women with pre-gestational diabetes mellitus (PGDM). Retrospective audit of pregnant women with PGDM from two centres in South-Western Sydney was conducted. Women were categorised into the aspirin group (prescribed aspirin before 16 weeks, gestation) and non-aspirin group (not prescribed aspirin or prescribed aspirin at or after 16 weeks, gestation). The outcomes examined were pre-eclampsia, pre-term delivery and birthweight percentile. Of 494 women, 52 (10.5%) were in the aspirin group. Pre-eclampsia developed in 57 (12.0%) women. There was no association between aspirin use and pre-eclampsia (8 (15.4%) vs 49 (11.1%), P = 0.2). Aspirin use was not associated with difference in birthweight percentile and rate of pre-term deliveries when adjusted for maternal age, gravidity and other comorbidities. There was no difference in the rates of pre-eclampsia, pre-term delivery, or birthweight percentile between women with PGDM in aspirin group compared to women in non-aspirin group.

研究阿司匹林对妊娠前期糖尿病（PGDM）孕妇产科结果的影响。对悉尼西南部两个中心的妊娠前期糖尿病孕妇进行了回顾性审计。妇女被分为阿司匹林组（妊娠 16 周前处方阿司匹林）和非阿司匹林组（未处方阿司匹林或妊娠 16 周或之后处方阿司匹林）。研究结果包括先兆子痫、早产和出生体重百分位数。在 494 名妇女中，阿司匹林组有 52 人（10.5%）。有 57 名妇女（12.0%）出现先兆子痫。使用阿司匹林与先兆子痫之间没有关联（8（15.4%）对 49（11.1%），P = 0.2）。在对产妇年龄、孕酮和其他合并症进行调整后，阿司匹林的使用与出生体重百分位数和早产率的差异无关。与非阿司匹林组相比，阿司匹林组 PGDM 孕妇的先兆子痫发生率、早产率或出生体重百分位数没有差异。

引用次数: 0

Markedly elevated liver enzymes in pregnancy: A 10-year review of cases in a tertiary maternal hospital in Brisbane, Australia 妊娠期肝酶明显升高：澳大利亚布里斯班一家三级妇产医院的 10 年病例回顾

IF 0.7 Q3 Medicine

Obstetric Medicine

Pub Date : 2024-01-30 DOI: 10.1177/1753495x231226339

A. Morton

Abnormalities of liver function are common during pregnancy. This retrospective study examined the incidence, aetiology and adequacy of investigation of pregnant women with markedly elevated aspartate aminotransferase and/or alanine transaminase levels (more than 10-fold of the upper limit of normal) over a ten-year period at a tertiary referral maternity hospital in Brisbane, Australia. Three hundred and twenty-three women were found to have markedly elevated liver enzymes, representing 0.56% of pregnancies with known delivery outcomes. Two hundred and sixty-four cases (82%) were due to pregnancy-specific causes. No cause was identified in 12 women (3.8%) despite investigation. No adverse maternal, fetal or neonatal outcome occurred in these pregnancies where no cause was identified for markedly elevated liver enzymes. A further six women (1.9%) did not have comprehensive investigation into underlying aetiologies of elevated liver enzymes.

妊娠期肝功能异常很常见。这项回顾性研究调查了澳大利亚布里斯班一家三级转诊妇产医院十年间天门冬氨酸氨基转移酶和/或丙氨酸转氨酶水平明显升高（超过正常值上限的 10 倍）孕妇的发病率、病因和调查的充分性。有 323 名孕妇被发现肝酶明显升高，占已知分娩结果孕妇的 0.56%。其中 264 例（82%）是由妊娠特定原因引起的。有 12 名孕妇（3.8%）在接受调查后仍未找到原因。在这些未找到肝酶明显升高原因的孕妇中，没有出现不良的母体、胎儿或新生儿结局。另有 6 名妇女（1.9%）没有对肝酶升高的潜在病因进行全面调查。

引用次数: 0

Interest and barriers to research in obstetric haematology – findings from a national survey in the United Kingdom 产科血液学研究的兴趣和障碍--英国全国调查的结果

IF 0.7 Q3 Medicine

Obstetric Medicine

Pub Date : 2023-12-21 DOI: 10.1177/1753495x231219296

Lara N. Roberts, Michael Bryan, J. Daru, Beverley J. Hunt, Sajida Kazi, Will Lester, Bethan Myers, Sue Pavord, Mari Thomas, Clare Tower, Gillian Swallow

In 2021, the steering committee members of British Society of Haematology Obstetric Haematology Special Interest Group noted difficulties in opening research studies. This led to the development of a survey to further evaluate this issue. An electronic survey was distributed to all members of the British Society of Haematology Obstetric Haematology Special Interest Group and to relevant specialty leads of the National Institute for Health and Care Research Clinical Research Network for further dissemination within these networks. Responses were received from 65 participants (73% consultant grade); mainly haematologists (52%) or obstetricians (39%). Less than a third of participants reported dedicated time for research in their job plan, with only five participants reporting no challenges in opening research studies in obstetric haematology. The survey confirmed significant interest in obstetric haematology research, with barriers to participation. We propose further actions to facilitate increased research.

2021 年，英国血液学会产科血液学特别兴趣小组指导委员会成员注意到在开展研究方面存在困难。为此，他们开展了一项调查，以进一步评估这一问题。我们向英国血液学会产科血液学专业兴趣小组的所有成员以及国家健康与护理研究所临床研究网络的相关专业负责人分发了一份电子调查表，以便在这些网络中进一步传播。共收到 65 位参与者（73% 为顾问级别）的回复，其中主要是血液科医生（52%）或产科医生（39%）。不到三分之一的参与者表示在他们的工作计划中专门安排了研究时间，只有五位参与者表示在开展产科血液学研究方面没有遇到困难。调查证实了人们对产科血液学研究的浓厚兴趣，但也存在参与障碍。我们建议采取进一步行动，促进研究的增加。

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Pregnancy in a woman with extreme short stature and low body weight secondary to a collagen VI-related muscular dystrophy 一名因胶原蛋白 VI 型肌肉萎缩症而导致身材极度矮小和体重过轻的妇女怀孕了

IF 0.7 Q3 Medicine

Obstetric Medicine

Pub Date : 2023-12-21 DOI: 10.1177/1753495x231219298

Joseph O’Sullivan, Hifsa Mahmood, Ruth A Curry, Charlotte J Frise

Pregnancy poses significant physiological demands, and women of extreme short stature may be particularly at risk of complications. Described here are two pregnancies in a woman who was 130 cm tall with a body mass index of 12 kg/m2 and the maternal and neonatal outcomes. The challenges encountered in the care of our patient included cardiorespiratory compromise, management of medication dosing, management of delivery and bleeding risk.

怀孕对孕妇的生理要求很高，身材极度矮小的妇女尤其容易出现并发症。本文介绍了一位身高 130 厘米、体重指数为 12 千克/平方米的妇女的两次妊娠以及孕产妇和新生儿的结局。我们在护理病人时遇到的挑战包括心肺功能受损、药物剂量管理、分娩管理和出血风险。

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Pregnancy, childbirth and neonatal outcomes of women with rare inherited coagulation disorders. 罕见遗传性凝血障碍妇女的妊娠、分娩和新生儿结局

IF 0.7 Q3 Medicine

Obstetric Medicine

Pub Date : 2023-12-01 Epub Date: 2023-01-18 DOI: 10.1177/1753495X221148813

Lucy Jane McCann, Erin Scullion, Lauren Doy, Etienne Ciantar

Background: We aimed to describe the characteristics and the pregnancy outcomes of women with rare inherited coagulation factor disorders managed at a tertiary obstetric-haematology unit in the United Kingdom.

Methods: A retrospective service evaluation was conducted using routinely collected medical records. Descriptive analyses were applied to investigate pregnancy, childbirth and neonatal management and outcomes.

Results: Overall, 20 patients with rare inherited coagulation disorders were included who birthed 30 live infants from 29 pregnancies. Regarding maternal bleeding outcomes, 3% experienced antepartum haemorrhage, 38% of pregnancies experienced primary post-partum haemorrhage, and none experienced secondary post-partum haemorrhage. Five (17%) neonates had cranial ultrasound scans for imaging to investigate for a neonatal haemorrhage, which were all normal.

Conclusions: Although women with rare inherited coagulation disorders may be more susceptible to complications in pregnancy, within this cohort there was no evidence that the condition led to increased morbidity or mortality when best practices were observed.

我们的目的是描述在英国三级产科血液科管理的罕见遗传性凝血因子疾病妇女的特征和妊娠结局。利用常规收集的医疗记录进行回顾性服务评价。描述性分析应用于调查妊娠、分娩和新生儿管理和结局。总的来说，包括20例罕见的遗传性凝血障碍患者，他们从29次怀孕中生下了30个活婴。关于产妇出血结局，3%的孕妇出现产前出血，38%的孕妇出现原发性产后出血，没有人出现继发性产后出血。5例(17%)新生儿颅脑超声扫描影像学检查新生儿出血，均为正常。虽然患有罕见遗传性凝血障碍的妇女在妊娠期可能更容易出现并发症，但在本队列中，没有证据表明在观察到最佳做法时，这种情况会导致发病率或死亡率增加。

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引用次数: 0