Parity and pregnancy outcomes

Bai, Jun; Wong, Felix; Bauman, Adrian; Mohsin, Mohammed

doi:10.1067/mob.2002.119639

Cited by 261 publications

(252 citation statements)

References 12 publications

Supporting

Mentioning

208

Contrasting

Unclassified

Order By: Relevance

“…Muitos estudos referem que a idade interfere na mortalidade materna; as mulheres acima de 35 anos são consideradas como de alto risco, porém alguns autores ressaltam que a idade deve ser associada a outros fatores como as condições socioeconômicas e qualidade dos serviços para gestação de risco. [2][3][4][5]15,16 Estudo realizado por LANG e KING (2008) nos Estados Unidos identificou pequenos progressos na redução da RMM desde 1982 no país. Explicações para a estagnação das taxas, segundo os autores, incluem as gestações mais tardias, o potencial de complicações associadas à idade reprodutiva avançada (particularmente acima de 35 anos) e a multiparidade.…”

Section: Discussionunclassified

“…A literatura refere que as hemorragias são complicações freqüentes entre as multíparas. [2][3][4] Os óbitos maternos devido ao aborto, com proporção duas vezes superior à das mulheres com até duas gestações, poderiam ter sido evitados em parte pela inclusão, em programas de planejamento familiar mais efetivos, das mulheres que não desejavam mais engravidar, atendendo a suas necessidades particulares e identificando as dificuldades na utilização e na adaptação aos métodos contraceptivos. A garantia ao aborto seguro e ao tratamento adequado das suas complicações também se mostra indispensável.…”

Section: Discussionunclassified

“…Alguns autores consideram a baixa primiparidade como de maior risco, outros a multiparidade, e ainda outros não atribuem efeitos que, por si só, expliquem o aumento do risco de morte materna pelo aumento da paridade. [2][3][4][5] Estudo americano publicado em 2005 e que realizou ampla revisão da literatura sobre este tema, refere como incerta a associação entre multiparidade (número de partos > 5) e resultados adversos na gestação. Segundo os autores, os achados que associam alta paridade e resultados maternos e fetais não são consistentes; enquanto a literatura mais antiga tende a sugerir que multiparidade é um fator de risco negativo para o nascimento, a literatura mais recente não sustenta esses achados.…”

Section: Introductionunclassified

“…No entanto, alguns estudos concluem que estes efeitos desfavoráveis estariam relacionados à idade avançada na gestação e/ou às condições socioeconômicas mais desvantajosas apresentadas normalmente pelas mulheres com alta paridade. [2][3][4][5] A oferta de serviços de planejamento familiar é destacada neste sentido como estratégi-ca para a redução da mortalidade materna, contribuindo inicialmente para reduzir o número absoluto de gestações, para aumentar o intervalo entre as gestações e evitar as gestações nas faixas etárias de maior risco. No entanto, já se evidenciou em muitos países que apenas o processo de controle da fecundidade apresenta impacto limitado na redução da mortalidade materna.…”

Section: Introductionunclassified

See 3 more Smart Citations

Vidas arriscadas: uma reflexão sobre a relação entre o número de gestações e mortalidade materna

Soares

Schor

Tavares

2008

J. Hum. Growth Dev.

View full text Add to dashboard Cite

2008Vidas arriscadas: uma reflexão sobre a relação entre o número de gestações e mortalidade materna Revista Brasileira de Crescimento e Desenvolvimento Humano, São Paulo, v. 18, n. 3, p. 254-263, dez. 2008 http://producao.usp.br/handle/BDPI/14320 (206) was of multigestas (gesta > 5), the maternal death relative risk was six times higher than for the women with to two gestations, and the profiles sociodemographic and the reproductive one were more unfavorable for that group of women. Incomplete schooling, equal age or above 30 years and less than four prenatal medical consultations presented association with the most greatest number of gestations. The deaths proportion by indirect obstetric causes, hemorrhages and abortion was bigger between the multigestas and around 90% of the deaths of this group was considered avoidable. It concluded that monitoring of the multigestas with advanced age and in social disadvantage, as well as effective actions of family planning, and obstetric service qualified for high risk gestation are measures that can contribute for reduction of the maternal mortality in Paraná.

show abstract

Section: Discussionunclassified

Section: Introductionunclassified

See 2 more Smart Citations

Vidas arriscadas: uma reflexão sobre a relação entre o número de gestações e mortalidade materna

Soares

Schor

Tavares

2008

J. Hum. Growth Dev.

View full text Add to dashboard Cite

show abstract

“…Scholars argue that analyses of birth outcomes and child development by parity suffer from bias in that women who deliver, for instance, five children fundamentally differ from women who deliver two children [28][29][30]. Selection into higher parity may arise from a complex set of biological and behavioural characteristics that could covary with hCG and confound our tests [31].…”

Section: (B) Variablesmentioning

confidence: 99%

A test of maternal human chorionic gonadotropin during pregnancy as an adaptive filter of human gestations

et al. 2012

View full text Add to dashboard Cite

The risk of abnormalities and morbidity among live births increases with advanced maternal age. Explanations for this elevated morbidity invoke several maternal mechanisms. The relaxed filter stringency (RFS) hypothesis asserts that mothers, nearing the end of their reproductive lifespan, reduce the stringency of a screen of offspring quality in utero based on life-history traits of parity and interbirth interval (IBI). A separate line of research implicates human chorionic gonadotropin (hCG) during pregnancy as a signal of offspring quality. We test the RFS hypothesis directly by examining whether the difference in gestational hCG across consecutive live births varies positively with the mother's number of previous live births but inversely with her most recent IBI. We applied multivariable regression methods to a unique dataset of gestational hCG for over 500 000 live births from 2002 to 2007. The difference in gestational hCG across mothers' consecutive live births varies positively with both mothers' parity and IBI. These associations remain similar among older mothers (35þ years). Findings support the RFS hypothesis for the parity expectation but not for the IBI expectation. Further evidence for the RFS hypothesis among contemporary human gestations would have to invoke screening mechanisms other than hCG.

show abstract

Mode of Obstetric Delivery in Kidney and Liver Transplant Recipients and Associated Maternal, Neonatal, and Graft Morbidity During 5 Decades of Clinical Practice

et al. 2021

View full text Add to dashboard Cite

IMPORTANCERates of cesarean delivery (CD) are increased among transplant recipients. There is a need to define the indications for CD and associated outcomes among transplant recipients to determine the safest mode of obstetric delivery. OBJECTIVE To evaluate the association of mode of obstetrical delivery with maternal and neonatal morbidity among pregnant women who have received a kidney or liver transplant. DESIGN, SETTING, AND PARTICIPANTS This registry-based retrospective cohort study used data from the Transplant Pregnancy Registry International, which has recruited participants since 1991 from 289 diverse academic and community settings, mainly in North America. Eligible participants were recipients of a kidney or liver transplant who were aged 18 years or older at the time of a live birth at or later than 20 weeks' gestational age and who delivered between 1968 and 2019. The data were analyzed from April 30, 2020, to April 16, 2021. EXPOSURES Scheduled CD, a trial of labor resulting in CD (TOL-CD), or a TOL resulting in vaginal delivery (TOL-VD). MAIN OUTCOMES AND MEASURESThe primary outcomes were severe maternal morbidity and neonatal composite morbidity. Multivariate regression was conducted to calculate odds ratios (ORs) or β values and 95% CIs with adjustment for differences in maternal comorbidities and gestational age at delivery. Nonmedical indications for CD are those not associated with decreased morbidity or mortality in the obstetric literature. RESULTSThis study included 1865 women, of whom 1435 were kidney transplant recipients and 430 were liver transplant recipients. The age range of the participants was 18 to 48 years; the median body mass index among the participants was in the normal range, and the median transplant-toconception interval was more than 2 years. Compared with a scheduled CD, a TOL was not associated with increased severe maternal morbidity among kidney transplant recipients (TOL-CD: adjusted odds ratio [aOR], 1.80 [95% CI, 0.77-4.22]; TOL-VD: aOR, 1.22 [95% CI, 0.57-2.62]) (for liver transplant recipients, the numbers were too small for multivariate modeling). In the adjusted model, a TOL was associated with a decrease in neonatal composite morbidity among kidney transplant recipients who underwent TOL-CD (aOR, 0.52; 95% CI, 0.32-0.82) and TOL-VD (aOR, 0.36; 95% CI, 0.24-0.53) and liver transplant recipients who underwent TOL-VD (aOR, 0.41; 95% CI, 0.19-0.87) but not for TOL-CD (aOR, 0.58; 95% CI, 0.21-1.61). The main factors associated with CD after labor were placental abruption (aOR, 12.96; 95% CI, 2.85-59.07) and pregestational diabetes (aOR 5.44; 95% CI,). The rate of CD was 51.6% (741 of 1435) among kidney transplant recipients and (continued) Key Points Question Are there differences in maternal and neonatal morbidity associated with the mode of obstetrical delivery among kidney and liver transplant recipients? Findings In this cohort study of 1865 women, including 1435 kidney and 430 liver transplant recipients, a trial of labor was not associated with severe ...

show abstract

Parity and pregnancy outcomes

Cited by 261 publications

References 12 publications

Vidas arriscadas: uma reflexão sobre a relação entre o número de gestações e mortalidade materna

Vidas arriscadas: uma reflexão sobre a relação entre o número de gestações e mortalidade materna

A test of maternal human chorionic gonadotropin during pregnancy as an adaptive filter of human gestations

Mode of Obstetric Delivery in Kidney and Liver Transplant Recipients and Associated Maternal, Neonatal, and Graft Morbidity During 5 Decades of Clinical Practice

Contact Info

Product

Resources

About