Complications and adverse outcomes in pregnancy and childbirth among women who conceived by assisted reproductive technologies: a nationwide birth cohort study of Japan environment and children’s study

Nagata, Chie; Yang, Limin; Yamamoto‐Hanada, Kiwako; Mezawa, Hidetoshi; Ayabe, Tadayuki; Ishizuka, Kazue; Konishi, Mizuho; Ohya, Yukihiro; Saito, Hirohisa; Sago, Haruhiko

doi:10.1186/s12884-019-2213-y

Cited by 59 publications

(45 citation statements)

References 31 publications

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“…Increasing prevalence of AMA pregnancy in the country may thus further aggravate the state of maternal and child health by increasing the numbers of pregnant women or newborns in need of effective obstetrics counselling or management. Furthermore, the lack of widespread availability of assisted reproductive technology in the country unlike what obtained in more developed countries [10][11] may further increase demand for obstetric management of complications arising from AMA pregnancy in the country.…”

Section: Discussionmentioning

confidence: 99%

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Analysis of individual-level and community-level effects on advanced maternal age pregnancy in Nigeria

Solanke

Oduyoye

Oni

2020

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Background: Advanced Maternal Age (AMA) pregnancy refers to pregnancy in women aged 35 years or older at the time of delivery. Existing studies have been more concerned with the obstetrics implication of AMA pregnancy. The associated social factors such as the individual and community level factors have remained largely unexplored particularly in population-based studies. This study examines the individual and community level factors associated with AMA pregnancy in Nigeria.Methods: Data were extracted from the 2018 Nigeria Demographic and Health Survey. A weighted sample of 13,105 women was analysed. The outcome variable was AMA pregnancy. The explanatory variables were individual characteristics (age, marital status, media exposure, current contraceptive use, period spent schooling, female autonomy, remarriage and income group) and community characteristics (proportion who delayed marriage in community, community level of female higher education, proportion of female in professional occupation in community, proportion of divorced or separated women in community, proportion of women in commuter marriage, type of community and geo-political zone of residence). Three mixed-effects multilevel logistic regression models were estimated. Results: Findings reveal 10.9% prevalence of AMA pregnancy in Nigeria. While the odds of AMA pregnancy were lower among women in very advanced (AOR=0.592, p<0.001; 95% CI: 0.509-0.688) and extremely advanced (AOR=0.290, p<0.001; 95% CI: 0.239-0.353) (AOR=1.794, p<0.001; 95% CI: 1.580-2.008) age groups, the odds were higher among women who had high exposure to mass media (AOR=1.794, p<0.001; 95% CI: 1.580-2.008), long schooling period (AOR=2.680, p<0.001; 95% CI: 2.058-3.488), remarried (AOR=2.269, p<0.001; 95% CI: 1.915-2.688) and from richest households (AOR=1.271, p<0.05; 95% CI: 1.098-1.472). The values of the Intra-Class Correlation (ICC) across the three fitted models reveal significant effects of the community characteristics on the odds of AMA pregnancy.Conclusion: Individual and community characteristics have important effects on AMA pregnancy. Health planners and authorities in the country should include AMA pregnancy as one of the priority areas of women’s health and safe motherhood strategies in addition to raising awareness of the obstetrics implication of AMA pregnancy through community-based public health education programme.

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Section: Discussionmentioning

confidence: 99%

“…Also, the widespread availability of assisted reproduction technology in more developed countries has also enhanced the high prevalence of AMA pregnancy across Europe and North America [1,[10][11]. In sub-Saharan Africa particularly in Nigeria, the rising pro le of AMA pregnancy may be linked to two developments.…”

Section: Introductionmentioning

confidence: 99%

Analysis of individual-level and community-level effects on advanced maternal age pregnancy in Nigeria

Solanke

Oduyoye

Oni

2020

Preprint

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“…The change in delivery volume is consistent with the results in this study. A growing number of women are conceiving with assisted reproductive technology (ART), giving rise to a signi cantly increased risk of perinatal complications, blood transfusion, and ICU hospitalization [24]. Therefore, we strive to check at the source, pour attention into high-risk pregnant women, and provide the correct advice on the timing of pregnancy again, health care, and precautions during pregnancy.…”

Section: Discussionmentioning

confidence: 99%

Incidence, risk factors, and causes of maternal near-miss admitted to the intensive care unit in Yangzhou, China: A 5-year retrospective study

Chen¹,

Shi²,

Zhu³

et al. 2020

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BackgroundThe maternal near-miss (MNM) criterion formulated by the WHO can dynamically evaluate the obstetric quality and maternal health in medical institutions. The study aims to explore the incidence, risk factors, and causes of MNM cases admitted to the intensive care unit (ICU) within 5 years.MethodsThis study is a retrospective study. The data of MNM admitted to the ICU comes from the medical records of Subei People's Hospital in Yangzhou from 2015 to 2019. The study subjects meet at least one World Health Organization (WHO) criterion of MNM. The MNM who had not been admitted to the ICU in the same year served as the control group. We use descriptive analysis, Chi-Square test and Fisher’s exact test for data analysis.Results151 women met the WHO criteria of MNM and there was one maternal death in 2016. The average maternal near-miss rate（MNMR）for ICU admission was 3.5 per 1,000LBs, and the average MNM morbidity was 0.36%. The average maternal mortality ratio (MMR) was 5 per 100,000LBs. The 5-year research period witnessed moderate growth in MNM admitted to the ICU. The region, referral, gravidity, prenatal examination, and mode of delivery were significantly related to the MNM admitted to the ICU(p<0.05). Concerning neonatal characteristics, there is a significant difference in preterm birth rate and low Apgar scores at 1 min and 5 min(p<0.05). The direct obstetric causes were the primary cause of MNM, regardless of the ICU admission. The leading direct obstetric causes of MNM admitted to the ICU were obstetric hemorrhage diseases(38.8%)，following hypertension diseases(18.8%), while the leading indirect obstetric cause of MNM admitted to the ICU was heart-related diseases (7.2%). MNM for the ICU admission were mostly postpartum (96.9%), who underwent multiple interventions.ConclusionsICU is one of the most important endpoints of MNM management. In the context of "universal two-child", medical institutions should strengthen multidisciplinary joint treatment. In the future, it needs to be expanded to multi-center research to determine the criteria for MNM admitted to the ICU.

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“…Singletons 98.1 [17] 100 2) Analyzed 18/23 post-onset vaginal deliveries due to missing data (no response).…”

Section: Number Of Fetusesmentioning

confidence: 99%

Pregnancy in GNE Myopathy Patients: A Nationwide Repository Survey in Japan

Yoshioka

Miyasaka

Okubo

et al. 2020

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Background: GNE myopathy is an autosomal recessive adult-onset distal myopathy. While a few case reports have described the progression of GNE myopathy during pregnancy, none have examined progression after delivery or obstetric complications. Objective: This study aimed to reveal maternal complications, newborn complications, and the impact of pregnancy on disease progression in GNE myopathy patients. Methods: We conducted a questionnaire survey on pregnancy, delivery, and newborns involving female GNE myopathy patients who are currently registered in a national registry in Japan.Results: The response rate for the questionnaire survey was 60.0% (72/120). Of the 72 respondents, 44 (61.1%) had pregnancy experience (average, 1.8 pregnancies; 53 pregnancies before onset and 28 after onset). The incidence of threatened abortion was 26.9% among post-onset pregnancies, which was higher compared to those of the general Japanese population (p=0.03). No other maternal or infant complications were commonly observed. Over 80% were unaware of changes in disease progression during pregnancy or after delivery, while 19.0% experienced disease exacerbation within a year after delivery. Six patients developed myopathy within a year after delivery, while none developed myopathy during pregnancy.Conclusions: There were no serious maternal or newborn complications, and subjective progression did not differ during or after delivery in the majority of GNE myopathy patients. However, our findings suggest the importance of considering the possibility of threatened abortion and disease progression after delivery.

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Complications and adverse outcomes in pregnancy and childbirth among women who conceived by assisted reproductive technologies: a nationwide birth cohort study of Japan environment and children’s study

Cited by 59 publications

References 31 publications

Analysis of individual-level and community-level effects on advanced maternal age pregnancy in Nigeria

Analysis of individual-level and community-level effects on advanced maternal age pregnancy in Nigeria

Incidence, risk factors, and causes of maternal near-miss admitted to the intensive care unit in Yangzhou, China: A 5-year retrospective study

Pregnancy in GNE Myopathy Patients: A Nationwide Repository Survey in Japan

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