RESUMO
OBJECTIVE: To assess the impact of being small for gestational age (SGA) on very preterm mortality and morbidity rates by using different birthweight percentile thresholds and whether these effects differ by the cause of the preterm birth. STUDY DESIGN: The study included singletons and twins alive at onset of labor between 24 and 31 weeks of gestation without congenital anomalies from the Models of Organising Access to Intensive Care for very preterm births very preterm cohort in 10 European regions in 2003 (n = 4525). Outcomes were mortality, intraventricular hemorrhage grade III and IV, cystic periventricular leukomalacia, and bronchopulmonary dysplasia (BPD). Birthweight percentiles in 6 classes were analyzed by pregnancy complication. RESULTS: The mortality rate was higher for infants with birthweights <25th percentile when compared with the 50th to 74th percentile (adjusted odds ratio, 3.98 [95% CI, 2.79-5.67] for <10th; adjusted odds ratio, 2.15 [95% CI, 1.54-3.00] for 10th-24th). BPD declined continuously with increasing birthweight. There was no association for periventricular leukomalacia or intraventricular hemorrhage. Seventy-five percent of infants with birthweights <10th percentile were from pregnancies complicated by hypertension or indicated deliveries associated with growth restriction. However, stratifying for pregnancy complications yielded similar risk patterns. CONCLUSIONS: A 25th percentile cutoff point was a means of identifying infants at higher risk of death and a continuous measure better described risks of BPD. Lower birthweights were associated with poor outcomes regardless of pregnancy complications.
Assuntos
Retardo do Crescimento Fetal/epidemiologia , Doenças do Prematuro/epidemiologia , Recém-Nascido Prematuro , Recém-Nascido Pequeno para a Idade Gestacional , Feminino , Humanos , Recém-Nascido , Doenças do Prematuro/mortalidade , MasculinoRESUMO
A possible association between pregnancy-induced hypertension and new father for the concerned pregnancy has been published. This prospective study explored the association between the duration of sexual cohabitation before conception with the father and pregnancy-induced hypertension (PIH) in primigravid and in multigravid women. During 5 months, 1011 women who consecutively delivered in the Maternity Ward were interviewed. Information about paternity and duration of sexual cohabitation before conception for the current pregnancy was collected. In 48/72 (66.7 percent) of PIH multigravidae, the father of the current pregnancy was different from that of the former, compared to 9/52 (17.3 percent) among chronic hypertensiver women and 152/633 (24.0 percent) in controls (p<0.0001). In primigravid and multigravid PIH women, the duration of sexual cohabitation was significantly shorter than in controls (p<0.0001). The length of sexual cohabitation before conception was correlated with PIH, especially for women with a cohabitation of 0-4 months, association regularly decreasing until 12 months. These results remained after controlling for ethnicity, level of education, maternal age, marital status and gravidity. PIH seems to be a problem of primipaternity (rather than primigravidity). In primipaternity pregnancies, a long duration of sexual cohabitation before conception could be protective against this disorder in women (AU)
Assuntos
Estudo Comparativo , Humanos , Feminino , Gravidez , Hipertensão/etiologia , Paternidade , Complicações Cardiovasculares na Gravidez , Comportamento SexualRESUMO
Some investigations exist in the current literature regarding a possible association between pre-eclampsia (PH-gestosis) and changing paternity in multigravid women. This study explored this relationship in a cohort of pre-eclamptic multigravid women in a Caribbean community. The study population included multigravid women whose infants were admitted to the neonatal department of the University Hospital, Guadeloupe, French West Indies, during a twenty-month time period. Information was collected from the women regarding blood pressure and patterns of paternity for the index and pevious pregnancies. Women with hypertension were classified as chronic hypertensive or PH-gestosis (gestational proteinuric hypertension). The comparison group comprised women without hypertension. In twenty-one of the thirty-four (61.7 per cent) women with PH-gestosis, the father of the index pregnancy was different from the father of the former pregnancy. Among the women with chronic hypertension, 4 of 40 (10 per cent) women had changed partners from the previous pregnancy as compared to 10 of 60 (16.6 per cent) of the women in the comparison group. After simultaneously controlling for maternal age, infant sex, and gravidity, mothers with changing paternity continued to experience gestosis more often. Patterns of changing paternity were found to be significantly correlated with gestosis but not with chronic hypertension or the absence of hypertension (p < 0.001) (AU)
Assuntos
Humanos , Feminino , Gravidez , Recém-Nascido , Pré-Eclâmpsia , Paridade , Paternidade , HipertensãoRESUMO
It is suggested that the observed difference in duration of pregnancy between Blacks and Whites is partly physiological since it is not entirely explained by social inequities alone. This study compare women with well-defined gestational periods seeking attention at the Antoine Beclere Maternity Clinic . Group A consist of French women of European ancestry, Group B, those born in the French Antilles of mixed ancestry, and Group C Black African women with insignificant European admixture. When compared to Group A, within each socio-economic class, group B and C have shorter gestational periods. These differences persist after adjustment for socio-economic variables, so that other explanations should be considered, specifically genetic determinants.(AU)