Recommendations of activity restriction in  high-risk pregnancy scenarios: a Danish national survey

Bendix, Jane M.; Hegaard, Hanne Kristine; Bergholt, Thomas; Langhoff‐Roos, Jens

doi:10.1515/jpm-2013-0347

Cited by 10 publications

(15 citation statements)

References 37 publications

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“… 33 – 37 This is in accordance with a previous study demonstrating that women with poor social support were more often recommended for AOH by health care professionals. 38 …”

Section: Discussionmentioning

confidence: 99%

“… 22 Activity restriction is often prescribed in cases of threatened preterm delivery; however, it is not registered with a specific treatment code in any of the Danish registries. 12 , 38 , 42 Thus, it is not possible to explicitly study the extent of pregnancy-related activity restriction at Danish hospitals within obstetric services. Even though the AOH rate as well as the number of antenatal threatened preterm delivery hospitalizations decreased, many pregnant women still endure activity restriction either during AOHs or at home without a documented beneficial effect of such an intervention.…”

Section: Discussionmentioning

confidence: 99%

“…43 However, in the nonacute phase of an antenatal complication, when close daily observations are indicated, there are options for safe outpatient management using telemonitored medicine. 38 , 44 …”

Section: Discussionmentioning

confidence: 99%

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Changing prevalence and the risk factors for antenatal obstetric hospitalizations in Denmark 2003-2012

Bendix¹,

Hegaard²,

Langhoff‐Roos³

et al. 2016

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PurposePopulation-based studies evaluating the use and extent of antenatal obstetric hospitalizations (AOH) are sparse. The objective of the present study was to describe the prevalence, time trend, and risk factors for AOH in Denmark.Materials and methodsA retrospective national register-based cohort study was conducted that included all pregnancies with delivery after 22 gestational weeks in Denmark from 2003 to 2012. The outcomes were AOH and the diagnoses leading to these hospitalizations. AOH was defined as an antenatal hospitalization for at least 1 day with at least one obstetric International Classification of Diseases-10 diagnosis and admission date more than 3 days before delivery.ResultsThe study included 617,906 pregnancies; 48,366 (7.8%) pregnancies were associated with 64,072 AOH before delivery. The percentage of pregnancies with AOH decreased from 8.6% to 7.1%. The median length of stay decreased from 3 to 2 days, and admission for at least 7 days was almost halved. Threatened preterm delivery was the most frequent diagnostic category for AOH. A decline was seen in all diagnostic categories except maternal diseases. Significant risk factors for AOH were multiple pregnancies, low or high maternal age and body mass index, nulliparity, lower educational levels, unemployment or being outside the workforce, single partner status, and smoking. The relative risk of very preterm delivery before gestational age of 34 weeks was higher in pregnancies with AOH compared with pregnancies without AOH (relative risk 15.2; 95% confidence interval: 14.6–15.8).ConclusionThis study shows a shift toward less use and shorter duration of antenatal hospitalization in Denmark. The most common indication used in pregnancies with AOH was threatened preterm delivery, and more than one-third resulted in very preterm deliveries.

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“… 33 – 37 This is in accordance with a previous study demonstrating that women with poor social support were more often recommended for AOH by health care professionals. 38 …”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Changing prevalence and the risk factors for antenatal obstetric hospitalizations in Denmark 2003-2012

Bendix¹,

Hegaard²,

Langhoff‐Roos³

et al. 2016

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“…A 2015 Danish survey to over 900 providers found that more often activity restriction in high-risk pregnancies was prescribed by midwives or nurse practitioners, which is not consistent with our discovered prescribing habits but comes from the perspective of providers. 13 Significantly, over half of these high-risk women were placed on complete bed rest and more than two-thirds of women were placed on more than one type of activity restriction, which is demonstrated to be interruptive of multiple aspects of life based, as almost half of these women reported an effect on their quality of life. Similarly, a 1998 survey of maternal-fetal medicine and obstetrician/gynecologist providers demonstrated that bed rest was the most commonly prescribed activity restriction.…”

Section: Discussionmentioning

confidence: 99%

The Compliance of Prescribed Activity Restriction in Women at High Risk for Preterm Birth

Bitar

Sciscione²

2020

Am J Perinatol

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Objective Despite lack of evidence to support efficacy, activity restriction is one of the most commonly prescribed interventions used for the prevention of preterm birth. We have a departmental policy against the use of activity restriction but many practitioners still prescribe it in an effort to prevent preterm birth. We sought to evaluate the rate and compliance of women who are prescribed activity restriction during pregnancy to prevent preterm birth. Study Design This was a single-site retrospective questionnaire study at a tertiary care, academic affiliated medical center. Women with a history of preterm delivery or short cervix were included. Once patients were identified, each patient was contacted and administered a questionnaire. We assessed the rates of activity restriction prescription and compliance. Secondary outcomes included details regarding activity restriction and treatment in pregnancy. Continuous variables were compared with t-test and categorical variables with Chi-square test. The value p < 0.05 was considered significant. Results Among the 52 women who responded to the questionnaire, 18 reported being placed on activity restriction by a physician, with 1 self-prescribing activity restriction, giving a rate of our primary outcome of 19 of 52 (36.5%). All women reported compliance with prescribed activity restriction (100%). Gestational age at delivery was not different in women placed on activity restriction. Conclusion This questionnaire suggests that approximately one in three high-risk women were placed on activity restriction during their pregnancy despite a departmental policy against its use. The 100% compliance rate in patients placed on activity restriction is a strong reminder of the impact prescribing patterns of physicians can have on patients. Key Points

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“…Παράλληλα με την βελτιστοποίηση του γλυκαιμικού ελέγχου είναι σημαντικό να υιοθετηθεί ένας υγιεινός τρόπος ζωής ώστε να ελαχιστοποιηθεί ο κίνδυνος επιπλοκών και να ενισχυθεί η υγεία και η καλή ανάπτυξη του εμβρύου. (Bendix et al, 2015).…”

Section: διατροφή και άσκησηunclassified

Προοπτική Κλινική Μελέτη Της Διαβητικής Αμφιβληστροειδοπάθειας Κατά Την Κύηση

Καραφύλογλου¹

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Σκοπός: Η αναζήτηση, καταγραφή και μελέτη της διαβητικής αμφιβληστροειδοπάθειας σε ασθενείς με σακχαρώδη διαβήτη της κύησης.Ασθενείς και μέθοδοι: Εξετάστηκαν προοπτικά 152 γυναίκες πάσχουσες από σακχαρώδη διαβήτη κύησης. Η διάγνωση του διαβήτη έγινε βάσει των κριτηρίων της "International Association of Diabetes in Pregnancy Study Groups". Η εξέταση περιελάμβανε καταγραφή οπτικής οξύτητας με χρήση πινάκων Snellen, εξέταση προσθίων μορίων στην σχισμοειδή λυχνία, βιομικροσκόπηση του αμφιβληστροειδούς μετά από μυδρίαση και οπτική τομογραφία συνοχής. Για την στατιστική ανάλυση επιλέχθηκε το πρόγραμμα SPSS 23.Αποτελέσματα: Σε καμία ασθενή δεν βρέθηκαν βυθοσκοπικές αλλοιώσεις διαβητικής αμφιβληστροειδοπάθειας. Επίσης δεν παρατηρήθηκαν παθολογικά ευρήματα προσθίων μορίων κατά την εξέταση στην σχισμοειδή λυχνία. Το 21,6% των ασθενών παρουσίασαν κάποια διαθλαστική ανωμαλία. Από αυτές το 87,5% είχε μυωπία, το 12,5% υπερμετρωπία και το 37,5% αστιγματισμό.Συμπεράσματα: Οι ασθενείς με σακχαρώδη διαβήτη της κύησης δεν εμφανίζουν οφθαλμολογικά ευρήματα διαβητικής αμφιβληστροειδοπάθειας. Ο σακχαρώδης διαβήτης της κύησης δεν φαίνεται επίσης να επηρεάζει την οπτική οξύτητα και την διαθλαστική ικανότητα των εγκύων.

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Recommendations of activity restriction in high-risk pregnancy scenarios: a Danish national survey

Cited by 10 publications

References 37 publications

Changing prevalence and the risk factors for antenatal obstetric hospitalizations in Denmark 2003-2012

Changing prevalence and the risk factors for antenatal obstetric hospitalizations in Denmark 2003-2012

The Compliance of Prescribed Activity Restriction in Women at High Risk for Preterm Birth

Προοπτική Κλινική Μελέτη Της Διαβητικής Αμφιβληστροειδοπάθειας Κατά Την Κύηση

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