Analysis of preterm delivery risk factors - a literature review

Size: px
Start display at page:

Download "Analysis of preterm delivery risk factors - a literature review"

Transcription

1 JOURNAL OF OF PUBLIC HEALTH, NURSING AND AND MEDICAL RESCUE No.4/2013 (9-15) 9 Analysis of preterm delivery risk factors - a literature review (Analiza czynników ryzyka porodu przedwczesnego przegląd piśmiennictwa) M Sulima 1 A,D, M Lewicka 1 E,F, K Wiktor 2 C, H Wiktor 1 C Author Affiliations: Abstract A preterm birth is defined as delivery between pregnancy weeks 22 and 37. It is the case for 6-15% of pregnant women. It constitutes one of the fundamental problems of modern perinatology, as prematurity and low birth weight are the causes of approximately 70% of perinatal mortality.despite considerable progress in medical science in recent years, an increase in the frequency of preterm births has been observed. At the moment, the possibilities of reducing the frequency of preterm births are associated primarily with the identification of risk factors, primary prophylaxis, the intensification of secondary prophylaxis and regionalization of perinatal care. Defining preterm delivery risk factors allows one to identify groups of pregnant women who are at greater risk of premature birth and to apply appropriate preventive measures in time. Key words - premature birth, risk factors, pregnant women. Streszczenie Poród przedwczesny definiowany jest jako poród pomiędzy 22. a 37. tygodniem ciąży i dotyczy 6 15% kobiet ciężarnych. Stanowi jeden z podstawowych problemów współczesnej perinatologii, ponieważ wcześniactwo i mała masa urodzeniowa noworodka warunkują około 70% przypadków śmiertelności okołoporodowej. Mimo postępu w naukach medycznych w ostatnich latach zaobserwowano zwiększenie częstości występowania porodów przedwczesnych. W chwili obecnej możliwości zmniejszenia częstości występowania porodów przedwczesnych związane są przede wszystkim z identyfikacją czynników ryzyka, profilaktyką pierwotną, intensyfikacją profilaktyki wtórnej, oraz regionalizacją opieki okołoporodowej.identyfikacja czynników ryzyka porodu przedwczesnego umożliwia wyodrębnienie grup ciężarnych zwiększonego ryzyka wystąpienia porodu przedwczesnego i wczesne zastosowanie odpowiedniej profilaktyki w tej grupie kobiet ciężarnych. Słowa kluczowe - poród przedwczesny, czynniki ryzyka, kobiety ciężarne. 1. Department of Obstetrics, Gynecology and Obstetrical - Gynecological Nursing, Faculty of Nursing and Health Sciences, Medical University, Lublin. 2. Department of Gynecology and Gynecological Endocrinology, Faculty of Nursing and Health Sciences, Medical University, Lublin; Authors contributions to the article: A. The idea and the planning of the study B. Gathering and listing data C. The data analysis and interpretation D. Writing the article E. Critical review of the article F. Final approval of the article Correspondence to: Magdalena Sulima MD, PhD Department of Obstetrics, Gynecology and Obstetrical - Gynecological Nursing, Faculty of Nursing and Health Sciences, Medical University, Chodźki 6 Str., PL Lublin, Poland, I I. INTRODUCTION n the course of the last 20 years, an increase in the frequency of preterm deliveries was observed across the world [1,2,3,4]. Delivering in the due date is a result of physiologically activated processes of the so-called common pathway, defined as a range of anatomical, physiological, biochemical, immunological, endocrinlogical and clinical occurrences in the organism of the mother or/and the foetus during childbirth. On the other hand, a preterm delivery results from incorrect processes which cause a temporary activation of one or more elements of the common pathway, the final and common element of

2 JOURNAL OF PUBLIC HEALTH, NURSING AND MEDICAL RESCUE No.4/ which is premature end of pregnancy and the birth of a premature baby [4,5,6,7]. Direct causes of preterm delivery are: spontaneous premature systolic function of the uterus muscle (around 50.0% of preterm deliveries), premature leak of amniotic fluid (accounting for around 30.0% of preterm deliveries) and premature completion of pregnancy for medical reasons (around 20% of preterm deliveries) [8]. The risk factors for preterm birth are: history of obstetric abnormalities, sociodemographic factors, intrauterine infections, pregnancy-related irregularities, genetic factors, environmental factors and using stimulants [9,10]. The purpose of this paper is to present a review of literature on the factors influencing premature deliveries. II. THE CHARACTERISTICS OF PRETERM DELIVERY RISK FACTORS One of the main risk factors of preterm delivery is a prior preterm birth in the past [4,11]. It is estimated that after one premature delivery, the risk of another is three times as high. If there have been two preterm births, the risk is six times higher. Furthermore, if there has been a delivery before the pregnancy week 28, the risk of another preterm birth is times as high [12]. Other authors have concluded that a preterm delivery increases the risk of another by 2.5 times, with the risk being inversely proportional to the gestational age at which the previous pregnancy was completed [9]. The study by Karwan- Płońska [13] showed that 48.0% of women who had preterm deliveries had a history of obstetric abnormalities (a miscarriage or preterm birth). Goldenberg et al. [14] observed the following correlation: the more preterm deliveries a woman had, the greater the risk of her having another. These authors also noted that while women who had a spontaneous delivery in the past face increased risk of the reoccurrence of a spontaneous preterm birth, women who gave birth prematurely for medical reasons also are in the risk group of possible premature birth for medical reasons. Similarly, Rouget et al. [15] observed a higher percentage of preterm deliveries in the group who had abnormalities in the past. Sociodemographic factors that increase the risk of premature birth include, among others, the age of the mother, her marital status, education, professional career, nutritional status and stress [16]. Women who are pregnant before they are 18 or after they are 35 years old are also threatened by the risk of premature completion. The increased risk of premature delivery pertaining to very young women is related to the fact that their reproductive organs are not yet fully developed. In the case of women over 35 years of age, the trouble is related to the aging of the vasculature, which leads to higher likelihood of placenta insufficiency. Smith et al. [17] reported that the mother s age below 18 and over 40 increase the risk of preterm completion of pregnancy. The study by Piekarska et al. [16] showed that among women under 18 and over 35, the percentage of preterm birth was significantly the largest. Rouget et al. [15] noted that a large percentage of preterm deliveries pertained to women over 35, yet the age of below 20 was not synonymous with the risk of preterm birth. Anholcer et al. [18], Chazan [19] and Borkowski & Mielniczuk [6] showed that single mothers give preterm births more often. Similar observations were made by Smith et al. [17]. What is more, women with lower education are in the risk group of preterm delivery [17,20]. Preterm birth migh also be related to poor housing conditions. This was pointed to by Etitler et al. [21] and Bucholc & Oleszczuk [22]. The factor that determines delivering prematurely may also be professional career. The multicentre research by Saurel- Cubizolles et al. [23] conducted in European countries showed that remaining in a standing position for over 6 hours, over 42 weekly working hours and no satisfaction with one s work increase the risk of premature births. Similarly, Bonzini et al. [24] concluded that long working hours, shift work system, remaining in standing positions for extended periods of time and being overburdened with work are all related to premature birth. The meta-analysis by Palmer et al. [25] showed that pregnant women who worked over 40 hours a week, remained in a standing position for over 4 hours daily and worked in shifts face an increased risk of preterm delivery. The literature on the subjects also makes references to the correlation between the body weight of pregnant women and the preterm delivery risk. Ehrenberg et al. [26] showed that low pre-pregnancy body weight influences earlier completion of pregnancy. Similar observations were made by Koplan et al. [27] as well as Borkowski & Mielniczuk [6], who showed that the ones to give most premature births were underweight pregnant women. In their study, Hendler et al. [28] showed that the frequency of spontaneous preterm deliveries significantly decreased along with the BMI (with BMI under 19 the frequency of preterm births was 16.6%, BMI between 19 and 24.9% %, BMI between 25 and 29.9% - 8.1%, BMI 30 to %, BMI over %). What is more, Torloni et al. [29] and McDonald et al. [30] reported the decrease in the risk of spontaneous preterm delivery among obese and very obese women. However, a crucial fact is that obese pregnant women are more frequently observed to have: foeti with congenital defects, preeclampsia, hypertension and diabetes, which leads to a premature completion of pregnancy for medical reasons [28,31]. Stress is a widely acknowledged risk factor of premature birth [4,32]. Two mechanisms of the impact of stress on the duration of pregnancy have been defined; namely a direct and indirect one. Direct (physiological) mechanism consists in a

3 JOURNAL OF PUBLIC HEALTH, NURSING AND MEDICAL RESCUE No.4/ stressful situation triggering a specific reaction, activating the structures of nervous, immune and endocrine system. Indirect (behavioural) mechanism causes the pregnant woman to, as a result of stress, engage in various health-related behaviours (diet, stimulants) [33]. As Copper et al. [34] reported, stress doubles the risk of premature delivery. Similarly, Biernacka & Hanke [35], Goldenberg et al. [36], Kramer et al. [37] and Cardwell [38] observed increased risk of premature completion of pregnancy resulting from the stress experienced by the mother. A significant part in the etiopathogenesis of premature births is played by infections. The main reason for premature deliveries is an intrauterine infection, which may be contracted vaginally from peritoneal cavity via Fallopian tubes, haematogenously via placenta or iatrogenically. Infections via ascending tracts are most common, which may lead to premature systolic function of the uterus or rupture of foetal membranes, as a consequence of which a premature birth may occur [39]. Gomez et al. [40] analysed the results of 13 studies on the impact of amniotic fluid on pregnant women threatened by a premature delivery. The results of a bacteriological examination of amniotic fluid were positive in the cases of pregnant women who showed no clinical symptoms of infection during examination. Later on, larger percentages of chorioamnionitis (42.2%), spontaneous rupture of membranes (19.6%) and decreased effectiveness of tocolytic treatment (62.0%) were observed among those women. Reroń et al. [41] quoted Divers and Lilford [42] saying that infections may cause as many as 40.0% of premature deliveries. The occurrence of inflammatory lesions was recorded in 19.0%-74.0% of the placentas from premature births. The study by Ville et al. [43] showed that the inflammation of foetal membranes was the case in 75.0% of the premature deliveries. However, the study by Reroń et al. [41] showed increased percentage of pathogenic bacterial flora in the cervix of the pregnant women threatened by a premature birth with a ruptured amnion in comparison to those whose amnion remained in proper condition. Bacterial vaginosis is a significant independent risk factor of premature births [44]. The study by Mikhov et al. [45] showed 2.5 times as frequent bacterial vaginosis in the group of women who had premature deliveries as in the group of those giving birth in a due date. Other infections which do not affect reproductive organs and still are suggested to shorten the duration of pregnancy are: pyelonephritis, asymptomatic bacteriuria, appendicitis, pneumonia and periodontal diseases [15,36]. Cervical incompetence, placental pathology and systemic diseases suffered by the mother are also among the factors that increase the risk of premature birth. Each change in the length or width of cervix is related to the risk of premature delivery. The causes of cervical incompetence include congenital disorders, cervical trauma and functional disorders. If the cervix of a pregnant woman in her 24 th gestational week is found to be less than 25 mm long during an ultrasound test, the risk of premature pregnancy is increased [4]. Ochędalski [46] reported that if the cervix length is below 10 percentile of the gestational age, the risk of premature completion before pregnancy week 35 is increased 6 times. Bleeding related to placenta praevia or placental abruption signifies a very high risk of premature delivery [47]. A mother s illnesses also affect the course and duration of a pregnancy. Murphy et al. [48] claimed a disease of the mother has an influence on premature birth in 25.0% of cases. Karwan-Płońska [13] studied 392 women whose pregnancies concluded in a premature delivery and showed that there was a connection between preterm birth and a mother s systemic disease such as: heart conditions, hypertension, kidney diseases, gestosis (oedema and proteinuria), anaemia, lung diseases and diabetes. Goldenberg et al. [49] observed more frequent preterm births in women suffering from diabetes and hypertension. Köck et al. [50] showed there was a significant relationship between pregnant women s diabetes and preterm completion of pregnancy. Dennis [51] emphasised a significant risk of shorter pregnancy duration because of preeclampsia, whereas Rouget et al. [15] pointed to asthma, hypertension and diabetes of the mother. Other factors increasing the risk of preterm delivery include oligohydramniosis, polihydramniosis, abdominal surgeries, thyroid diseases and depression [36,52,53]. Factors related to the foetus, such as Intrauterine Growth Restriction (IUGR) and congenital defects also increase the risk of preterm delivery [4]. Multiple pregnancy is also a significant risk factor of preterm delivery. The mechanism of early completion of pregnancy is related to excessive uterus stretching, spontaneous systolic function of the uterus as well as deciding to complete the pregnancy before week 34 [4,54]. Goldenberg et al. [36] reported that 50,0% of twin pregnancies and multiple pregnancies end in premature birth. Similarly, Stock & Norman [55] claimed that the risk of preterm completion in cases of multiple pregnancies is increased. Another crucial problem is the increased preterm delivery risk in cases of implementing assisted reproductive technologies. The risk of preterm delivery in cases of IVF pregnancies is related to more frequent multiple pregnancies and greater risk of obstetric complications such as diabetes, gestational hypertension and urinary tract infections [56]. The study by Perri et al. [57] also showed increased risk of preterm delivery in cases of singleton assisted reproductive technology pregnancies. Marianowski et al. [56] claimed that the percentage of preterm births among IVF pregnancies is comparable to the percentage observed among multiple pregnancies after natural insemination. In the study by Zamłyński et al. [58], preterm

4 JOURNAL OF PUBLIC HEALTH, NURSING AND MEDICAL RESCUE No.4/ deliveries in twin pregnancies were the case in 85,0% of the studied women; the percentage related to natural pregnancies was comparable with that among assisted reproductive technology pregnancies. Preterm birth is a complex condition which occurs as a result of mutual correlation of genes and environmental factors. The result of that correlation is lower or increased risk of preterm delivery [4]. There are many pieces of indirect evidence that genetic factors do impact the pathomechanism of premature delivery. It has been observed that women who were born prematurely are in the risk group of preterm delivery. The lower the gestational age the mother was born in is, the higher the risk. Also, the risk is higher in the cases of women whose sisters delivered prematurely. What is more, preterm deliveries are more common among black women as compared to white women [4,59]. The impact of genetic factors on intrauterine infection-related preterm births has been best explored. Certain inter-individual, qualitative and quantitative differences in the expression of proteins regulating an inflammatory process may contribute to the increase is preterm birth risk (inter-individual differences may stem from, among others, the polymorphism of protein-coding genes). Genetic polymorphism consists in the co-existence of different allelic forms of a given gene in the population [4]. The literature on the subject reports studies on the impact of the polymorphism of both a mother s and a foetus s genes on the risk of preterm delivery. Arbour et al. [60] showed that carrier-state of the polymorphic allele TLR4 gene is related to decreased response to lipopolysaccharide stimulation. The study by Lorenz et al. [61] showed that the foetal carrier-state of this allele increased preterm delivery risk. A lot of attention in literature is paid to the polymorphism of IL-1 (IL-1ra) receptor antagonist-coding gene and its impact on shorter duration of pregnancy. The study by Chaves et al. [62] showed that the carrier-state of allele 2 of this gene (IL1RN*) is related to the increased preterm delivery risk. Kalinka & Bitner [63] observed that when a mother is a carrier of the polymorphic allele 2 of IL-1 (IL1RN*) receptor antagonist-coding gene, the risk of shorter gestation is increased. What is more, that study showed that coincident mother s carrier-state of at least one polymorphic IL-1ra allele and at least one polymorphic IL-6 allele causes further significant increase in the risk of premature birth (the occurrence of gene-gene interaction). Apart from the interaction between two genes, the interaction between genes and environment has also been observed to shorten gestation. Macones et al. [64] showed there is increased risk of preterm birth in case of coincidence of TNF-α gene polymorphism and bacterial vaginosis during pregnancy. Nukui et al. [65] discussed the relation between the existence of polymorphic allele of GSSTT1 glutathione S- transferase-coding gene and the risk of preterm delivery in the case of being exposed to tobacco smoke. Environmental factors penetrating the placenta may also cause a premature delivery [66]. Epidemiological tests point to the possible impact of air pollution on premature pregnancy completion. Gregoraszczuk et al. [67] discussed the role of environmental xenoestrogens as a cause of preterm deliveries. Hanke & Kalinka [68] reported that total suspended dust, nitrogen oxides, carbon monoxide and sulphur monoxide all impact the increase of preterm birth risk. Also stimulants mainly smoking and drinking alcohol have impact on preterm delivery risk. In her study, Karwan-Płońska [13] confirmed that smoking influences the frequency of preterm deliveries. Similarly, Windham et al. [69] showed that mothers who smoked over 10 cigarettes a day delivered before gestation week 35. The risk of premature delivery related to smoking was also confirmed by Burguet et al. (2004) and Resende et al. [70]. Parazzini et al. [71] showed that having more than 2 drinks a day is related to preterm delivery. Albertsen et al. [72] observed that future mothers who had 7 or more drinks a week face 3 times as high a risk of preterm birth as pregnant women who do not drink alcohol. Nevertheless, Rougetet al. [15] saw no connection between smoking or drinking alcohol and the risk of preterm delivery. III. CONCLUSIONS Defining preterm delivery risk factors allows one to identify groups of pregnant women who are at greater risk of premature birth and to apply appropriate preventive measures in time. To what extent one is acquainted with preterm delivery risk factors determines the effectiveness of prophylaxis and treatment. Acquiring knowledge on them may provide new opportunities as far as psychoprophylactic measures are concerned and increase the effectiveness of treatment. IV. REFERENCES [1] Azar ZF, Hakimi P, Ghojazadeh M, Ghatresamani F. Preand post- McDonald cerclage cervical length, width and funneling rate and their association with duration of pregnancy. Pak J Biol Sci; 2011 Apr, 14 (8): [2] Romero R. Vaginal progesterone to reduce the rate of preterm birth and neonatal morbidity: a solution at last. Womens Health; 2011, Sept 7 (5): [3] Drews K, Seremak-Mrozikiewicz A. Poród przedwczesny. W: Diagnostyka biofizyczna i biochemiczna w medycynie perinatalnej. Położnictwo. Tom IV. Bręborowicz G, Wielgoś H (red). Warszawa; Wyd. Lek. PZWL, [4] Kalinka J, Bitner A. Nieprawidłowy czas trwania ciąży. W: Medycyna matczyno-płodowa. Położnictwo. Tom II. Brę-

5 JOURNAL OF PUBLIC HEALTH, NURSING AND MEDICAL RESCUE No.4/ borowicz G, Wielgoś H (red). Warszawa; Wyd. Lek. PZWL, [5] Sawulicka-Oleszczuk H, Oleszczuk J. Organizacyjne możliwości zmniejszenia częstości porodów przedwczesnych. Med Wieku Rozw; 2003, VII, 3,1: [6] Borkowski W, Mielniczuk H. Poród przedwczesny a przyrost masy ciała w ciąży w połączeniu z masą ciała przed ciążą. Prz Epidemiol; 2007, 61: [7] Romero R, Espinoza J, Kusanovic J.P et al. The preterm parturition syndrome. BJOG; 2006, 113, (3): [8] Beck S, Wojdyla D, Say L et al. The worldwide incidence of preterm birth: a systematic review of maternal mortality and morbidity. Bull World Health Organ; 2010, 88 (1): [9] Hamilton SA, Tower CL. Postępowanie w porodzie przedwczesnym. Położ Ginekol Med Rozrodu; 2010, 4 (6): [10] Skoczylas M, Baczyńska M, Chudzik A et al. Późny poród przedwczesny- punkt widzenia położnika. Część I. Perinatol Naonatol Ginek; 2011, 4 (1): [11] Czajkowski K. Diagnostyka porodu przedwczesnego. Perinatol Neonatol Ginek; 2009, 2 (3): [12] Spong CY. Prediction and prevention of recurrent spontaneous preterm birth. Obstet Gynecol; 2007,110: [13] Karwan-Płońska A. Kliniczna analiza porodów przedwczesnych. Nowa Med.; 1999, 6: [14] Goldenberg RL, Andrews WW, Faye-Peterson O et al. The Alabama Preterm Birth Project: placental histology in reccurrent spo-taneous and inicated preterm birth. Am J Obstet Gynecol; 2006, 195 (3): [15] Rouget F, Lebreton J, Kachel P et al. Medical and sociodemographic risk factors for preterm birth in a French Caribbean Population of African Descent. Matern Child Health J; 2012; 26: [16] Piekarska E, Krasomski G, Dominowska J, Tobor E. Ocena wpływu wybranych czynników socjalno-demograficznych na przedwczesne zakończenie ciąży i urodzeniową masę ciała. Perinatol Neonatol Ginek; 2010, 3, (4): [17] Smith LK, Draper ES, Manktelow BN et al. Socioeconomic inequalities In very preterm birth rates. Arch Dis Child Fetal Neonatal; 2007, 92 (1): F11-F14. [18] Anholcer A, Bręborowicz GH, Skręt A et al. Wybrane społeczno-medyczne czynniki ryzyka porodu. Klin Perinatol Ginekol; 2007, 39, (1): [19] Chazan B. Mała masa urodzeniowa- czy poradzimy sobie z tym problemem? Med Wieku Rozw; 2003,1: [20] Rymkiewicz L, Leibschang J, Filipp E, Mazur J. Wiek matki, wykształcenie, jakość opieki położniczej w czasie ciąży, a ryzyko wystąpienia porodu przedwczesnego. Med Wieku Rozw; 2003, 3 (1): [21] Etitler N, Velipasaoglu S, Aktekin M. Risk factors for overall and persistent diarrhoea in infancy in Antalya, Turkey: a cohort study. Public Heath; 2004, 118 (1): [22] Bucholc M, Oleszczuk J. Dochód w rodzinie, zagęszczenie mieszkania a czas trwania ciąży. Prob Hig Epidemiol; 2009, 90 (2): [23] Saurel-Cubizolles MJ, Zeitlin J, Lelong N et al. Employment, working conditions, and preterm birth: results from the Europop case-control survey. J Epidemiol Comm Health; 2004, 58 (5): [24] Bonzini M, Coggon D, Palmer KT. Risk of prematurity, low birthweight and pre-eclampsia in relation to working hours and physical activities: a systematic review. Occup Environ Med; 2007, 64: [25] Palmer KT, Bonzini M, Harris EC et al. Work activities and risk of prematurity, low birth weight and preeclampsia: an updated review with meta-analysis. Occup Environ Med; 2013, 10: [26] Ehrenberg H, Dierker L, Milluzzi C, Mercer BM. Low maternal weight, failure to thrive in pregnancy, and adverse pregnancy outcomes. Am J Obstet Gynecol; 2003, 189 (6): [27] Koplan J, Liverman C, Kraak V. Preventing childhood obesity Heath in the balance. Committee on Prevention of Obesity in Children and Youth. Food and Nutrition Board, Board on Health Promotion and Disease. Washington; National Academy Press, [28] Hendler I, Goldenberg RL, Mercer BM et al. The preterm prediction study: association between maternal body mass index (BMI) and spontaneous preterm birth. Am J Obstet Gynecol; 2005, 192 (3): [29] Torloni M, Betrán A, Daher S et al. Maternal BMI and preterm birth: a systematic review of the literature with metaanalysis. J Matern Fetal Neonatal Med; 2009, 22 (11): [30] McDonald S, Han Z, Mulla S et al. Overweight and obesity in mothers and risk of preterm birth and low birth weight infants: systematic review and meta-analyses. BMJ; 2010; 341: [31] Thangaratinam S, Rogozińska E, Jolly K et al. Interventions to reduce or prevent obesity in pregnant women: a systematic review. Heath Technol Assess; 2012, 16 (31): [32] Catov JM, Abatemarco DJ, Markovic N, Roberts JM. Anxiety and optimism associated with gestational age at birth and fetal growth. Matern Child Health; J 2010, Sep, 14 (5): [33] Dunkel-Schetter C, Gurung R, Lobel M, Wadhwa P. Stress processes in pregnancy and birth: psychological, biological and sociocultural influences. W: Handbook of Health Psychology. Baum A (red). New Jersey; Lawrence Erlbaum, [34] Copper RL, Goldenberg RL, Das A et al. The preterm prediction study: maternal stress is associated with spontaneous preterm birth at less than thirty-five weeks gestation. Am J Obstet Gynecol; 1996, 175 (5): [35] Biernacka JB, Hanke W. Wpływ stresu psychospołecznego w pracy zawodowej i pozazawodowej na przebieg i wynik ciąży. Med Pr; 2006, 57 (3): [36] Goldenberg RL, Culhane JF, Iams JD, Romero R. Epidemiology and causes of preterm birth. Lancet; 2008, 5 (371):

6 JOURNAL OF PUBLIC HEALTH, NURSING AND MEDICAL RESCUE No.4/ [37] Kramer MR, Hogue CJ, Dunlop AL, Menon R. Perceptional stress and racial disparities in preterm birth: an overview. ACTA Obstet Gynecol Scand; 2011, 90: [38] Cardwell MS. Stress: pregnancy considerations. Obstet Gynecol Surv; 2013, 68 (2): [39] Olejek A, Rembielak-Stawecka B. Zapobieganie wcześniactwu. Lekarz; 2004, 12: [40] Gomez R, Ghezzi F, Romero R et al. Premature labor and intra-amniotic infection. Clinical pathophysiology. Clin Perinatol; 1995, 22: [41] Reroń A, Huras H, Szymik M. Białko C-reaktywne w monitorowaniu zagrożenia porodem przedwczesnym. Prz Ginek Położ; 2003; 3, (2): [42] Divers MJ, Lilford RJ. Infection and preterm labour: a metaanalysis. Contemp Rev Obstet Gynecol; 1993, 5: [43] Ville Y. Inflammation and preterm delivery. J Gynecol Obstet Bio Reprod; 2001; 30 (1): [44] Milewicz T, Hejnar J. Jach R et al. Bakteryjna choroba pochwy a ryzyko zagrożenia porodem przedwczesnym. Prz Lek; 2010, 67 (2): [45] Mikhova M, Ivanow S, Nikolov A et al. Cervico-vaginal infections during pregnancy as a risk factor for pretern delivery. Akush Ginekol; 2007, 46 (9): [46] Ochędalski T. Poród przedwczesny- ponadczasowe wyzwanie. Ginek Pol; 2004, 75: [47] Krupa FG, Faltin D, Cecatti JG et al. Predictors of preterm birth. Int J Gynaecol Obstet; 2006, 94: [48] Murphy D, Folie P, McGuire W. Obstetric issues in preterm birth. BMJ; 2004, 2 (329): [49] Goldenberg RL. The management of preterm labor. Obstet Gynecol; 2002, 100 (5): [50] Köck K, Köck F, Klein K. Diabetes mellitus and the risk of preterm birth with regard to the risk of spontaneous preterm birth. J Matern Fetal Neonatal Med; 2010, 23 (9): [51] Dennis AT. Management of pre-eclampsia: issues for anaesthetists. Anaesthesia; 2012, 67: [52] Stagnaro-Green A. Maternal thyroid disease and preterm delivery. J Clin Endocrinol Metab; 2009, 94 (1): [53] Sanchez SE, Puente GC, Atencio G et al. Risk of spontaneous preterm birth in relation to maternal depressive, anxiety, and stress symptoms. J Reprod Med.; 2013, 58 (1-2): [54] Leszczyńska-Gorzelak B, Poniedziałek-Czajkowska E, Oleszczuk J. Czynniki ryzyka przedwczesnego zakończenia ciąży. W: Poród przedwczesny. Bręborowicz G, Paszkowski T (red). Poznań; Ośrodek Wydawnictw Naukowych, [55] Stock S, Norman J. Preterm and term labour in multiple pregnancies. Semin Fetal Neonatal Med; 2010, 15: [56] [56] Marianowski L, Grzechocińska B, Marianowski P. Przedwczesne ukończenie ciąży po leczeniu niepłodności technikami wspomaganego rozrodu. Med Wieku Rozw; 2003, VII, 3 (1): [57] Perri T, Chen R, Yoeli R et al. Are singleton assisted reproductive technology pregnancies at risk of prematurity? J Assist Reprod Genet; 2001, 18: [58] Zamłyński J, Oleś E, Olejek A et al. Powikłania położnicze w ciążach bliźniaczych po rozrodzie wspomaganym oraz po prokreacji naturalnej. Prz Ginek Położ; 2009, 9 (2): [59] Seremak-Mrozikiewicz A, Drews K. Znaczenie czynników genetycznych w etiologii porodu przedwczesnego. Ginekol Pol; 2007,78: [60] Arbour NC, Lorenz E, Schutte BC et al. TLR4 mutations are associated with endotoxin hyporesponsiveness in humans. Nat Genet; 2000, 25 (2): [61] Lorenz E, Hallman M, Martila R et al. Association between the Asp299Gly polymorphisms in the Toll-like receptor 4 and premature birth in the Finnish population. Pediatr Res; 2002, 52 (3): [62] Chaves JH, Babayan A, Bezerra CM et al. Maternal and neonatal interleukin-1 receptor antagonist genotype and pregnancy outcome in a population with a high rate of preterm birth. Am J Reprod Immunol; 2008; 60 (4): [63] Kalinka J, Bitner A. Selected cytokine gene polymorphisms and the risk of preterm delivery in the population of Polish women. Ginek Pol; 2009, 80: [64] Macones GA, Parry S, Elkousy M et al. A polymorphism In the promoter region of TNF and bacterial vaginosis: preliminary evidence of gene-environment interaction in the etiology of spontaneous preterm birth. Am J Obstet Gynecol; 2004, 190 (6): [65] Nukui T, Day RD, Sims CS et al. Maternal/newborn GSTT1 null genotype contributes to risk of preterm, low birthweight infants. Pharmacogenetics; 2004, 14 (9): [66] Rogoszewski M, Szuścik P, Grudzień J, Krzak-Bieńkowska A. Epidemiologa grup ryzyka kobiet ciężarnych według Troszyńskiego ze szczególnym uwzględnieniem czynników ryzyka ciąży mogących zależeć od środowiska. Ginekol Pol; 2001, 72 (12): [67] Gregoraszczuk E, Augustowska K, Ptak A. Ksenoestrogeny środowiskowe jako jednaz przyczyn zaburzeń endokrynnych będących powodem poronień i przedwczesnych porodów. Endokrynol Pol; 2004, 6 (55): [68] Hanke W, Kalinka J. Środowiskowe i zawodowe czynniki ryzyka porodu przedwczesnego. W: Ciąża wysokiego ryzyka. Bręborowicz GH. Poznań; Ośrodek Wydawnictw Naukowych, [69] Windham G, Hopkins B, Ferster L, Swan S. Prenatal active or passive tobacco smoke exposure and the risk of preterm delivery or low birth weight. Epidemiology; 2000, 11: [70] Resende M, Pinto E, Pinto M, Montenegro N. Doenca peridontal, tabaco e parto pre-termo. Acta Med Port; 2011, 24 (S2): [71] Parazzini F, Chatenoud L, Surace M et al. Moderate alcohol drinking and risk of preterm birth. Europ J Clin Nutrition; 2003, 57 (10):

7 JOURNAL OF PUBLIC HEALTH, NURSING AND MEDICAL RESCUE No.4/ [72] Albertsen K, Andersen A, Olsen J, Grønbaek M. Alcohol consumption during pregnancy and the risk of preterm delivery. Am J Epidemiol; 2004, 15, (2):

Pregnancy and Substance Abuse

Pregnancy and Substance Abuse Pregnancy and Substance Abuse Introduction When you are pregnant, you are not just "eating for two." You also breathe and drink for two, so it is important to carefully consider what you put into your

More information

What women can do to optimise their health during pregnancy and that of their baby Claire Roberts

What women can do to optimise their health during pregnancy and that of their baby Claire Roberts Periconception Planning to Protect Pregnancy and Infant Health 2015 What women can do to optimise their health during pregnancy and that of their baby Claire Roberts Pregnancy Complications Preterm Birth

More information

AUSTRALIA AND NEW ZEALAND FACTSHEET

AUSTRALIA AND NEW ZEALAND FACTSHEET AUSTRALIA AND NEW ZEALAND FACTSHEET What is Stillbirth? In Australia and New Zealand, stillbirth is the death of a baby before or during birth, from the 20 th week of pregnancy onwards, or 400 grams birthweight.

More information

Red Flags that should not be ignored

Red Flags that should not be ignored Pregnancy that should not be ignored If a pregnant woman tells you she is experiencing any of the following symptoms during pregnancy, assist her to contact her emergency care professional right away.

More information

SAMPLE. UK Obstetric Surveillance System. Management of Pregnancy following Laparoscopic Adjustable Gastric Band Surgery.

SAMPLE. UK Obstetric Surveillance System. Management of Pregnancy following Laparoscopic Adjustable Gastric Band Surgery. ID Number: UK Obstetric Surveillance System Management of Pregnancy following Laparoscopic Adjustable Gastric Band Surgery Case Definition: Study 04/11 Data Collection Form - Please report any woman delivering

More information

Clinical Policy Title: Home uterine activity monitoring

Clinical Policy Title: Home uterine activity monitoring Clinical Policy Title: Home uterine activity monitoring Clinical Policy Number: 12.01.01 Effective Date: August 19, 2015 Initial Review Date: July 17, 2013 Most Recent Review Date: July 15, 2015 Next Review

More information

Epidemiology 521. Epidemiology of Maternal and Child Health Problems. Winter / Spring, 2010

Epidemiology 521. Epidemiology of Maternal and Child Health Problems. Winter / Spring, 2010 Extended MPH Degree Program School of Public Health Department of Epidemiology University of Washington Epidemiology 521 Epidemiology of Maternal and Child Health Problems Winter / Spring, 2010 Instructor:

More information

Cerebral Palsy An Expensive Enigma

Cerebral Palsy An Expensive Enigma Cerebral Palsy An Expensive Enigma Rhona Mahony National Maternity Hospital A group of permanent disorders of the development of movement and posture, causing activity limitation that are not attributed

More information

Ana M. Viamonte Ros, M.D., M.P.H. State Surgeon General

Ana M. Viamonte Ros, M.D., M.P.H. State Surgeon General Florida Department of Health Division of Disease Control Bureau of Epidemiology Chronic Disease Epidemiology Section Charlie Crist Governor Ana M. Viamonte Ros, M.D., M.P.H. State Surgeon General Florida

More information

South Dakota Task Force to Study Abortion Pierre, South Dakota September 21, 2005

South Dakota Task Force to Study Abortion Pierre, South Dakota September 21, 2005 South Dakota Task Force to Study Abortion Pierre, South Dakota September 21, 2005 Section III. : The review and exposition of the body of medical, psychological, and sociological knowledge that has accumulated

More information

Oregon Birth Outcomes, by Planned Birth Place and Attendant Pursuant to: HB 2380 (2011)

Oregon Birth Outcomes, by Planned Birth Place and Attendant Pursuant to: HB 2380 (2011) Oregon Birth Outcomes, by Birth Place and Attendant Pursuant to: HB 2380 (2011) In 2011, the Oregon Legislature passed House Bill 2380, which required the Oregon Public Health Division to add two questions

More information

BABY PHASES... Whether You Are Pregnant Now Or Just Thinking About It.

BABY PHASES... Whether You Are Pregnant Now Or Just Thinking About It. BABY PHASES... Whether You Are Pregnant Now Or Just Thinking About It. Healthchoice and the Winnie Palmer Hospital for Women & Babies Maternal Education and Breastfeeding Education Center offer an exceptional

More information

Pregnant and Parenting Youth in Foster Care in Washington State: Comparison to Other Teens and Young Women who Gave Birth

Pregnant and Parenting Youth in Foster Care in Washington State: Comparison to Other Teens and Young Women who Gave Birth January 2014 RDA Report 11.202 Olympia, Washington Pregnant and Parenting in Care in Washington State: Comparison to Other and Women who Gave Birth Laurie Cawthon, MD, MPH Barbara Lucenko, PhD Peter Woodcox,

More information

Diagnosis Codes for Pregnancy and Complications of Pregnancy

Diagnosis Codes for Pregnancy and Complications of Pregnancy This list is for informational purposes only and is not a binding or definitive list of covered conditions. It is not a guarantee of coverage; coverage depends on the available benefits and eligibility

More information

The Influence of Infant Health on Adult Chronic Disease

The Influence of Infant Health on Adult Chronic Disease The Influence of Infant Health on Adult Chronic Disease Womb to Tomb Dr Clare MacVicar Introduction Many diseases in adulthood are related to growth patterns during early life Maternal nutrition important

More information

Strategies for the Prevention of Prematurity Progesterone. Cervical Screening, Cerclage, and Pessaries

Strategies for the Prevention of Prematurity Progesterone. Cervical Screening, Cerclage, and Pessaries Strategies for the Prevention of Prematurity Progesterone. Cervical Screening, Cerclage, and Pessaries Thomas J. Garite, M.D. Professor Emeritus, University of CA Irvine Editor Emeritus, American Journal

More information

PERINATAL NUTRITION. Nutrition during pregnancy and lactation. Nutrition during infancy.

PERINATAL NUTRITION. Nutrition during pregnancy and lactation. Nutrition during infancy. PERINATAL NUTRITION Nutrition during pregnancy and lactation Nutrition during infancy. Rama Bhat, MD. Department of Pediatrics, University of Illinois Hospital Chicago, Illinois. Nutrition During Pregnancy

More information

The Clinical Content of Preconception Care: Alcohol, Tobacco, and Illicit Drug Exposures

The Clinical Content of Preconception Care: Alcohol, Tobacco, and Illicit Drug Exposures The Clinical Content of Preconception Care: Alcohol, Tobacco, and Illicit Drug Exposures by R. Louise Floyd, DSN, RN; Brian W. Jack, MD; Robert Cefalo, MD, PhD; Hani Atrash, MD, MPH; Jeanne Mahoney, BSN,

More information

Racial and Ethnic Disparities in Maternal Mortality in the United States

Racial and Ethnic Disparities in Maternal Mortality in the United States Racial and Ethnic Disparities in Maternal Mortality in the United States KYRIAKOS S. MARKIDES, PHD UNIVERSITY OF TEXAS MEDICAL BRANCH GALVESTON, TEXAS PRESENTED AT THE HOWARD TAYLOR INTERNATIONAL SYMPOSIUM

More information

The ABCDE S to Envisioning a Healthy Future. A Guide to Preconception Health

The ABCDE S to Envisioning a Healthy Future. A Guide to Preconception Health The ABCDE S to Envisioning a Healthy Future A Guide to Preconception Health Developing Healthy Lifestyles is Important Because 49% of Pregnancies are Unplanned A woman s health and the health of her infant

More information

Body Mass Index (BMI)

Body Mass Index (BMI) Body Mass Index (BMI) CITY GATE TRAINING CENTRE ALL RIGHTS RESERVED The Body Mass Index (BMI) BMI is a heuristic (experience based) technique in determining healthy body weight considering average body

More information

Preconception Clinical Care for Women Medical Conditions

Preconception Clinical Care for Women Medical Conditions Preconception Clinical Care for Women All women of reproductive age are candidates for preconception care; however, preconception care must be tailored to meet the needs of the individual. Given that preconception

More information

Prince Edward Island Reproductive Care Program Perinatal Database Report 2011

Prince Edward Island Reproductive Care Program Perinatal Database Report 2011 Prince Edward Island Reproductive Care Program Perinatal Database Report 2011 Acknowledgements The PEI Reproductive Care Program is a joint initiative that operates under the direction of a multidisciplinary

More information

Why is prematurity a concern?

Why is prematurity a concern? Prematurity What is prematurity? A baby born before 37 weeks of pregnancy is considered premature. Approximately 12% of all babies are born prematurely. Terms that refer to premature babies are preterm

More information

PREVALENCE OF THYROID DISORDER IN PREGNANCY Dr Vidya A thobbi 1, Dr Sabrina Majeed 2 1

PREVALENCE OF THYROID DISORDER IN PREGNANCY Dr Vidya A thobbi 1, Dr Sabrina Majeed 2 1 PREVALENCE OF THYROID DISORDER IN PREGNANCY Dr Vidya A thobbi, Dr Sabrina Majeed 2 Professor and head, 2 Senior resident Department of OBG, Al Ameen medical college, Vijayapura 58608, Ph no 94484046, 2

More information

Preterm Labor, the Cervix, and Progesterone. The Cervix. The Cervix. Disclosure of Conflict of Interest. 2nd Trimester Cervical Length

Preterm Labor, the Cervix, and Progesterone. The Cervix. The Cervix. Disclosure of Conflict of Interest. 2nd Trimester Cervical Length Disclosure of Conflict of Interest Preterm Labor, the Cervix, and Progesterone John C. Hobbins, M.D. Professor of Obstetrics and Gynecology University of Colorado Health Sciences Center Denver, CO Dr.

More information

3/31/2015. Objectives. Alcohol. Long term effects. Substance abuse increases the risk of: Substance Abuse in Pregnancy

3/31/2015. Objectives. Alcohol. Long term effects. Substance abuse increases the risk of: Substance Abuse in Pregnancy Objectives Substance Abuse in Pregnancy Basics of screening and counseling Minako Watabe, MD Obstetrics and Gynecology Ventura County Medical Center 1) Discuss the risks of alcohol, tobacco, and drug use

More information

A Strategic Plan for Improving Preconception Health and Health Care: Recommendations from the CDC Select Panel on Preconception Care

A Strategic Plan for Improving Preconception Health and Health Care: Recommendations from the CDC Select Panel on Preconception Care 1 A Strategic Plan for Improving Preconception Health and Health Care: Recommendations from the CDC Select Panel on Preconception Care Presentation by Kay A. Johnson, MPH, EdM Research Assistant Professor,

More information

Outcome and future of children born after ART. M. Aboulghar Professor, Cairo University Clinical Director, The Egyptian IVF center

Outcome and future of children born after ART. M. Aboulghar Professor, Cairo University Clinical Director, The Egyptian IVF center Outcome and future of children born after ART M. Aboulghar Professor, Cairo University Clinical Director, The Egyptian IVF center Possible effects on the babies could be from 1. Prematurity and multiple

More information

OET: Listening Part A: Influenza

OET: Listening Part A: Influenza Listening Test Part B Time allowed: 23 minutes In this part, you will hear a talk on critical illnesses due to A/H1N1 influenza in pregnant and postpartum women, given by a medical researcher. You will

More information

Disclosure. Objectives 2/21/2016

Disclosure. Objectives 2/21/2016 Recurrent Pregnancy Loss: The myths, the controversies and the evidence Mamie McLean, MD Assistant Professor Reproductive Endocrinology and Infertility University of Alabama at Birmingham Disclosure I

More information

No. 135 August 2002. The Association of Maternal Smoking with Infant Mortality and Low Birth Weight in North Carolina, 1999

No. 135 August 2002. The Association of Maternal Smoking with Infant Mortality and Low Birth Weight in North Carolina, 1999 SCHS Studies North Carolina Public Health A Special Report Series by the 1908 Mail Service Center, Raleigh, N.C. 27699-1908 www.schs.state.nc.us/schs/ No. 135 August 2002 The Association of Maternal Smoking

More information

35-40% of GBS disease occurs in the elderly or in adults with chronic medical conditions.

35-40% of GBS disease occurs in the elderly or in adults with chronic medical conditions. What is Group B Strep (GBS)? Group B Streptococcus (GBS) is a type of bacteria that is found in the lower intestine of 10-35% of all healthy adults and in the vagina and/or lower intestine of 10-35% of

More information

Alcohol and drugs Be proactive

Alcohol and drugs Be proactive Alcohol and drugs Be proactive PREGNANCY: a critical time to take care of yourself and your future baby Pregnant women must often change certain daily habits and are bombarded with recommendations from

More information

Wendy Martinez, MPH, CPH County of San Diego, Maternal, Child & Adolescent Health

Wendy Martinez, MPH, CPH County of San Diego, Maternal, Child & Adolescent Health Wendy Martinez, MPH, CPH County of San Diego, Maternal, Child & Adolescent Health Describe local trends in birth Identify 3 perinatal health problems Identify 3 leading causes of infant death Age Class

More information

Developing Human Fetus

Developing Human Fetus Period Date LAB. DEVELOPMENT OF A HUMAN FETUS After a human egg is fertilized with human sperm, the most amazing changes happen that allow a baby to develop. This amazing process, called development, normally

More information

Maj Alison Baum. R3, Nellis FMR

Maj Alison Baum. R3, Nellis FMR Maj Alison Baum R3, Nellis FMR What are some of your thoughts about birth plans? http://www.youtube.com/watch?v=hh62v0c xf04 Labor: Pain management wishes Doulas Episiotomy Intermittent fetal monitoring

More information

Lesbian Pregnancy: Donor Insemination

Lesbian Pregnancy: Donor Insemination Lesbian Pregnancy: Donor Insemination (Based on an article originally published in the American Fertility Association 2010 National Fertility and Adoption Directory. Much of this information will also

More information

THE LABOUR ADMISSION CTG An assessment of the test s predictive values, reliability and effect How the test is perceived by practicing midwives

THE LABOUR ADMISSION CTG An assessment of the test s predictive values, reliability and effect How the test is perceived by practicing midwives THE LABOUR ADMISSION CTG An assessment of the test s predictive values, reliability and effect How the test is perceived by practicing midwives Ellen Blix Doctoral thesis at the Nordic School of Public

More information

A8b. Resuscitation of a Term Infant with Meconium Staining. Session Summary. Session Objectives. References

A8b. Resuscitation of a Term Infant with Meconium Staining. Session Summary. Session Objectives. References A8b Resuscitation of a Term Infant with Meconium Staining Karen Wright, PhD, NNP-BC Assistant Professor and Coordinator, Neonatal Nurse Practitioner Program Dept. of Women, Children, and Family Nursing,

More information

Case: 3:14-cv-00870-jdp Document #: 14-9 Filed: 01/07/15 Page 1 of 6 APPENDIX 8

Case: 3:14-cv-00870-jdp Document #: 14-9 Filed: 01/07/15 Page 1 of 6 APPENDIX 8 Case: 3:14-cv-00870-jdp Document #: 14-9 Filed: 01/07/15 Page 1 of 6 APPENDIX 8 Case: 3:14-cv-00870-jdp Document #: 14-9 Filed: 01/07/15 Page 2 of 6 AMERICAN MEDICAL ASSOCIATION Pregnant women will be

More information

CHLAMYDIA SCREENING IN WOMEN

CHLAMYDIA SCREENING IN WOMEN CHLAMYDIA SCREENING IN WOMEN APPLICATIONS OBJECTIVE Purpose of Measure: ELIGIBLE POPULATION Which members are included? STANDARD OF CARE What screening should be done? NCQA ACCEPTED CODES DOCUMENTATION

More information

SWISS SOCIETY OF NEONATOLOGY. Umbilical cord complications in two subsequent pregnancies

SWISS SOCIETY OF NEONATOLOGY. Umbilical cord complications in two subsequent pregnancies SWISS SOCIETY OF NEONATOLOGY Umbilical cord complications in two subsequent pregnancies June 2006 2 Hetzel PG, Godi E, Bührer C, Department of Neonatology (HPG, BC), University Children s Hospital, Basel,

More information

CONFIDENT CODING FOR OB/GYN CONFIDENT CODING FOR OB/GYN

CONFIDENT CODING FOR OB/GYN CONFIDENT CODING FOR OB/GYN Arlene J. Smith, CPC AAPC National Advisory Board 2007-2009 1 So when exactly does the global period start? Unraveling the confusion in antepartum care coding Correct coding for multiple gestations! Vaginal

More information

Methodology for Safety Surveillance of Adverse Events Following Vaccination During Pregnancy

Methodology for Safety Surveillance of Adverse Events Following Vaccination During Pregnancy Methodology for Safety Surveillance of Adverse Events Following Vaccination During Pregnancy C. Jouquelet-Royer September 2012 Fondation Merieux NAME OF PRESENTATION 1 Presentation Outline Background Company

More information

Cardiovascular Disease and Maternal Mortality what do we know and what are the key questions?

Cardiovascular Disease and Maternal Mortality what do we know and what are the key questions? Cardiovascular Disease and Maternal Mortality what do we know and what are the key questions? AFSHAN HAMEED, MD, FACOG, FACC Associate Clinical Professor Maternal Fetal Medicine and Cardiology University

More information

ICD-10 OVERVIEW Coding Guidelines For OB/GYN

ICD-10 OVERVIEW Coding Guidelines For OB/GYN ICD-10 OVERVIEW Coding Guidelines For OB/GYN ICD-10 Chapter 15 Pregnancy, Childbirth and the Puerperium (O00-O9A) Note: Codes from this chapter are for use only on maternal records, NEVER on newborn records.

More information

SAMPLE. UK Obstetric Surveillance System. Management of Pregnancy following Gastric Bypass Surgery Study 02/14. Data Collection Form - CASE

SAMPLE. UK Obstetric Surveillance System. Management of Pregnancy following Gastric Bypass Surgery Study 02/14. Data Collection Form - CASE ID Number: Case Definition: UK Obstetric Surveillance System Management of Pregnancy following Gastric Bypass Surgery Study 02/14 Data Collection Form - Please report any woman delivering on or after 1st

More information

Evidence-Based Practice for Public Health Identified Knowledge Domains of Public Health

Evidence-Based Practice for Public Health Identified Knowledge Domains of Public Health 1 Biostatistics Statistical Methods & Theory Evidence-Based Practice for Public Health Identified Knowledge Domains of Public Health General Public Health Epidemiology Risk Assessment Population-Based

More information

Rural Health Advisory Committee s Rural Obstetric Services Work Group

Rural Health Advisory Committee s Rural Obstetric Services Work Group Rural Health Advisory Committee s Rural Obstetric Services Work Group March 15 th webinar topic: Rural Obstetric Patient and Community Issues Audio: 888-742-5095, conference code 6054760826 Rural Obstetric

More information

Quality of Birth Certificate Data. Daniela Nitcheva, PhD Division of Biostatistics PHSIS

Quality of Birth Certificate Data. Daniela Nitcheva, PhD Division of Biostatistics PHSIS Quality of Birth Certificate Data Daniela Nitcheva, PhD Division of Biostatistics PHSIS Data Quality SC State Law requires that you file the birth certificate within 5 days of a child s birth. Data needs

More information

URINARY TRACT INFECTIONS IN YOUNG WOMEN

URINARY TRACT INFECTIONS IN YOUNG WOMEN URINARY TRACT INFECTIONS IN YOUNG WOMEN Reviewed by Finnish Centre for Health Promotion Publisher: Ylioppilaiden terveydenhoitosäätiö Töölönkatu 37 A 00260 Helsinki Orders: julkaisutilaukset@yths.fi Author:

More information

March of Dimes. FAQ on Drug Use and Pregnancy. November 2006. . [accessed February 2010]

March of Dimes. FAQ on Drug Use and Pregnancy. November 2006. <http://www.marchofdimes.com/14332_1169.asp>. [accessed February 2010] March of Dimes. FAQ on Drug Use and Pregnancy. November 2006. . [accessed February 2010] After delivery, babies who were exposed to amphetamines before birth

More information

Delayed Cord Clamping

Delayed Cord Clamping ICEA Position Paper Delayed Cord Clamping Position The International Childbirth Education Association recognizes that the first minutes after birth are crucial to both mother and newborn. Optimal care

More information

Distortions in Fetal Growth Standards

Distortions in Fetal Growth Standards Pediat. Res. 12: 987-991 (1978) Fetus fetal growth retardation fetal growth standards Distortions in Fetal Growth Standards RICHARD L. NAEYE"" AND JOSEPH B. DIXON Department of Pathology and Research Computing

More information

Major roles of neurocognitive developmental center are as follows:

Major roles of neurocognitive developmental center are as follows: Major roles of neurocognitive developmental center are as follows: 1. Fine developmental assessment of infant and toddler by Bayley Scales of Infant Development 2. Assessment of infant development by age

More information

ABSTRACT LABOR AND DELIVERY

ABSTRACT LABOR AND DELIVERY ABSTRACT POLICY Prior to fetal viability, intentionally undertaking delivery of a fetus is the equivalent of abortion and is not permissible. After fetal viability has been reached, intentionally undertaking

More information

Differentiation between normal and abnormal fetal growth

Differentiation between normal and abnormal fetal growth Differentiation between normal and abnormal fetal growth JASON GARDOSI MD FRCSE FRCOG Director, West Midlands Perinatal Institute, St Chad s Court, 213 Hagley Road, Birmingham B16 9RG, U.K. Tel +44 (0)121

More information

Guidelines for States on Maternity Care In the Essential Health Benefits Package

Guidelines for States on Maternity Care In the Essential Health Benefits Package Guidelines for States on Maternity Care In the Essential Health Benefits Package Section 2707(a) of the Patient Protection and Affordable Care Act (ACA) requires that all new health insurance plans in

More information

Risks and complications of assisted conception

Risks and complications of assisted conception Risks and complications of assisted conception August 005 Richard Kennedy British Fertility Society Factsheet www.fertility.org.uk No medical treatment is entirely free from risk and infertility treatment

More information

49. INFANT MORTALITY RATE. Infant mortality rate is defined as the death of an infant before his or her first birthday.

49. INFANT MORTALITY RATE. Infant mortality rate is defined as the death of an infant before his or her first birthday. 49. INFANT MORTALITY RATE Wing Tam (Alice) Jennifer Cheng Stat 157 course project More Risk in Everyday Life Risk Meter LIKELIHOOD of exposure to hazardous levels Low Medium High Consequences: Severity,

More information

EFFECT OF INCREASED TESTOSTERONE LEVEL ON WOMAN S FERTILITY

EFFECT OF INCREASED TESTOSTERONE LEVEL ON WOMAN S FERTILITY 1 Nada Polyclinic, Po ega, Croatia 2 School of Medicine, University of Zagreb, Zagreb, Croatia Preliminary Communication Received: April 15, 2004 Accepted: June 16, 2004 EFFECT OF INCREASED TESTOSTERONE

More information

PNE 136 Maternal and Child Health Nursing

PNE 136 Maternal and Child Health Nursing Hours Revised: Fall 2015 PNE 136 Maternal and Child Health Nursing Prerequisites: None Course Description: Examines pregnancy, childbirth, postpartum, and newborn care from a family centered approach,

More information

Health for learning: the Care for Child Development package

Health for learning: the Care for Child Development package Health for learning: the Care for Child Development package Charlotte Sigurdson Christiansen, Technical Officer, Chiara Servili, Technical Officer, Tarun Dua, Medical Officer, and Bernadette Daelmans,

More information

Cerebral palsy in children in north-eastern Poland

Cerebral palsy in children in north-eastern Poland ORIGINAL ARTICLE Journal of Pediatric Neurology 2004; 2(2): 79-84 www.jpneurology.org Cerebral palsy in children in north-eastern Poland Wojciech Kułak, Wojciech Sobaniec Department of Pediatric Neurology,

More information

Important facts to remember

Important facts to remember Important facts to remember If you re pregnant or trying to get pregnant, or if you know someone who is, there are several important points to remember: See a healthcare professional regularly. Get plenty

More information

FAMILY PLANNING AND PREGNANCY

FAMILY PLANNING AND PREGNANCY FAMILY PLANNING AND PREGNANCY Decisions about family planning can be difficult and very emotional when one of the prospective parents has a genetic disorder, such as Marfan syndrome. Before making any

More information

Who Is Involved in Your Care?

Who Is Involved in Your Care? Patient Education Page 3 Pregnancy and Giving Birth Who Is Involved in Your Care? Our goal is to surround you and your family with a safe environment for the birth of your baby. We look forward to providing

More information

MATERNAL AND CHILD HEALTH BRIEF #2:

MATERNAL AND CHILD HEALTH BRIEF #2: MATERNAL AND CHILD HEALTH BRIEF #2: OBESITY AMONG CHILDREN AND ADOLESCENTS SEPTEMBER 2012 OBESITY DEFINED Obesity and overweight are typically measured OVERVIEW in terms of Body Mass Index or BMI. BMI

More information

Lecture 12a: Complications of Pregnancy

Lecture 12a: Complications of Pregnancy This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike License. Your use of this material constitutes acceptance of that license and the conditions of use of materials on this

More information

Safety of Antidepressants in Pregnancy and Breastfeeding

Safety of Antidepressants in Pregnancy and Breastfeeding Safety of Antidepressants in Pregnancy and Breastfeeding Exceptional healthcare, personally delivered Background Depression and anxiety disorders are common during pregnancy, affecting nearly one in every

More information

Baby Steps To A Healthy Pregnancy

Baby Steps To A Healthy Pregnancy Preconception Middlesex-London Health Unit 50 King Street, London, ON N6A 5L7 519-663-5317 Published 2015. Copyright of the Middlesex London Health Unit. All rights reserved. Baby Steps To A Healthy Pregnancy

More information

Respiratory Distress Syndrome of the Newborn

Respiratory Distress Syndrome of the Newborn 19 Respiratory Distress Syndrome of the Newborn Respiratory distress syndrome (RDS) of the newborn, also known as hyaline membrane disease, is a breathing disorder of premature babies. In healthy infants,

More information

Obesity Affects Quality of Life

Obesity Affects Quality of Life Obesity Obesity is a serious health epidemic. Obesity is a condition characterized by excessive body fat, genetic and environmental factors. Obesity increases the likelihood of certain diseases and other

More information

Epidemiological Studies on Environmental Stressors from Tobacco to Pesticides

Epidemiological Studies on Environmental Stressors from Tobacco to Pesticides Epidemiological Studies on Environmental Stressors from Tobacco to Pesticides W. Susan Cheng, PhD, MPH Rebecca Carlstrom, MPH Sukaina Hussain, MPH Healthy Lawn Symposium Oct 31, 2014 Two Presentations

More information

Prenatal Stress and Complications

Prenatal Stress and Complications What moms had to say: Prenatal Stress and Complications I think doctors or nurses or whoever should help other pregnant women understand and deal with post-partum blues, cause I'm am still struggling with

More information

Preterm Labour. Signs & Symptoms. Learn about the signs of preterm labour and what to do if it happens.

Preterm Labour. Signs & Symptoms. Learn about the signs of preterm labour and what to do if it happens. An important message for pregnant women, their partners and families Preterm Labour Signs & Symptoms Learn about the signs of preterm labour and what to do if it happens. What is preterm labour? A normal,

More information

SUBJECT: PREVENTION OF PERINATAL GROUP B STREPTOCOCCAL DISEASE

SUBJECT: PREVENTION OF PERINATAL GROUP B STREPTOCOCCAL DISEASE Page: 1 of 9 SUBJECT: PREVENTION OF PERINATAL GROUP B STREPTOCOCCAL DISEASE OVERVIEW This guideline outlines a consistent, evidence-based approach to screening and routine management of Group B Streptococcus

More information

SAMPLE. UK Obstetric Surveillance System. Pregnancy in women with stage 5 Chronic Kidney Disease (chronic renal failure) Study 01/12

SAMPLE. UK Obstetric Surveillance System. Pregnancy in women with stage 5 Chronic Kidney Disease (chronic renal failure) Study 01/12 ID Number: UK Obstetric Surveillance System Pregnancy in women with stage 5 Chronic Kidney Disease (chronic renal failure) Study 01/12 Data Collection Form - Please report any woman delivering on or after

More information

A CLINICAL STUDY OF GESTATIONAL DIABETES MELLITUS IN A TEACHING HOSPITAL IN KERALA Baiju Sam Jacob 1, Girija Devi K 2, V.

A CLINICAL STUDY OF GESTATIONAL DIABETES MELLITUS IN A TEACHING HOSPITAL IN KERALA Baiju Sam Jacob 1, Girija Devi K 2, V. A CLINICAL STUDY OF GESTATIONAL DIABETES MELLITUS IN A TEACHING HOSPITAL IN KERALA Baiju Sam Jacob 1, Girija Devi K 2, V. Baby Paul 3 HOW TO CITE THIS ARTICLE: Baiju Sam Jacob, Girija Devi K, V. Baby Paul.

More information

FAMILY HEALTH SERVICES DIVISION Profiles 2014 OVERVIEW

FAMILY HEALTH SERVICES DIVISION Profiles 2014 OVERVIEW FAMILY HEALTH SERVICES DIVISION Profiles 2014 OVERVIEW Family Health Services Division Overview Data Sources Life Course Perspective and Title V Priorities Population Overview Births Infant Mortality Chapter

More information

Odense Child Cohort (Odense Børnekohorte) a project on children s health

Odense Child Cohort (Odense Børnekohorte) a project on children s health Odense Child Cohort (Odense Børnekohorte) a project on children s health 1 List of contents Odense Child Cohort (Odense Børnekohorte) a project on children s health... 1 List of contents... 2 Project details...

More information

Preventive Services for Pregnancy SERVICE WHAT IS COVERED INTERVALS OF COVERAGE Anemia Screening Screening Annual screening for pregnant women

Preventive Services for Pregnancy SERVICE WHAT IS COVERED INTERVALS OF COVERAGE Anemia Screening Screening Annual screening for pregnant women Preventive Services for Pregnancy SERVICE WHAT IS COVERED INTERVALS OF COVERAGE Anemia Annual screening for pregnant women Bacteriuria For pregnant women at 12-16 weeks gestation or first prenatal visit

More information

Genetic Aspects of Mental Retardation and Developmental Disabilities

Genetic Aspects of Mental Retardation and Developmental Disabilities Prepared by: Chahira Kozma, MD Associate Professor of Pediatrics Medical Director/DCHRP Kozmac@georgetown.edu cck2@gunet.georgetown.edu Genetic Aspects of Mental Retardation and Developmental Disabilities

More information

Crohn's disease and pregnancy.

Crohn's disease and pregnancy. Gut, 1984, 25, 52-56 Crohn's disease and pregnancy. R KHOSLA, C P WILLOUGHBY, AND D P JEWELL From the Gastroenterology Unit, Radcliffe Infirmary, Oxford SUMMARY Infertility and the outcome of pregnancy

More information

Type 1 Diabetes ( Juvenile Diabetes)

Type 1 Diabetes ( Juvenile Diabetes) Type 1 Diabetes W ( Juvenile Diabetes) hat is Type 1 Diabetes? Type 1 diabetes, also known as juvenile-onset diabetes, is one of the three main forms of diabetes affecting millions of people worldwide.

More information

What Does Pregnancy Have to Do With Blood Clots in a Woman s Legs?

What Does Pregnancy Have to Do With Blood Clots in a Woman s Legs? Patient s Guide to Prevention of Blood Clots During Pregnancy: Use of Blood-Thinning A Patient s Guide to Prevention of Blood Clots During Pregnancy: Use of Blood-Thinning Drugs to Prevent Abnormal Blood

More information

Risk Factors for Alcoholism among Taiwanese Aborigines

Risk Factors for Alcoholism among Taiwanese Aborigines Risk Factors for Alcoholism among Taiwanese Aborigines Introduction Like most mental disorders, Alcoholism is a complex disease involving naturenurture interplay (1). The influence from the bio-psycho-social

More information

This notice provides a safe harbor for preventive care benefits allowed to. be provided by a high deductible health plan (HDHP) without satisfying the

This notice provides a safe harbor for preventive care benefits allowed to. be provided by a high deductible health plan (HDHP) without satisfying the Part III - Administrative, Procedural, and Miscellaneous Notice 2004-23 PURPOSE This notice provides a safe harbor for preventive care benefits allowed to be provided by a high deductible health plan (HDHP)

More information

Home Health Agencies. Ante & Postpartum Members

Home Health Agencies. Ante & Postpartum Members FIRST PRIORITY HEALTH /FIRST PRIORITY LIFE INSURANCE COMPANY BLUE CROSS OF NORTHEASTERN PENNSYLVANIA CREDENTIALING CRITERIA FOR OBSTETRIC NURSES IN HOME CARE ADMINISTRATIVE PRACTICE GUIDELINE PROVIDER

More information

Multiple Pregnancy and Birth: Twins, Triplets, and High-order Multiples

Multiple Pregnancy and Birth: Twins, Triplets, and High-order Multiples Multiple Pregnancy and Birth: Twins, Triplets, and High-order Multiples A Guide for Patients PATIENT INFORMATION SERIES Published by the American Society for Reproductive Medicine under the direction of

More information

4/15/2013. Maribeth Inturrisi RN MS CNS CDE Perinatal Diabetes Educator mbturris@comcast.net

4/15/2013. Maribeth Inturrisi RN MS CNS CDE Perinatal Diabetes Educator mbturris@comcast.net Maribeth Inturrisi RN MS CNS CDE Perinatal Diabetes Educator mbturris@comcast.net List the potential complications associated with diabetes during labor. Identify the 2 most important interventions essential

More information

Vaccines in Pregnancy MARK H. SAWYER, MD UCSD SCHOOL OF MEDICINE RADY CHILDREN S HOSPITAL SAN DIEGO

Vaccines in Pregnancy MARK H. SAWYER, MD UCSD SCHOOL OF MEDICINE RADY CHILDREN S HOSPITAL SAN DIEGO Vaccines in Pregnancy MARK H. SAWYER, MD UCSD SCHOOL OF MEDICINE RADY CHILDREN S HOSPITAL SAN DIEGO 1 Objectives List vaccines that should be given either during pregnancy or immediately post-partum in

More information

Substance Abuse During Pregnancy: Moms on Meds. Jennifer Anderson Maddron, M.D LeConte Womens Healthcare Associates

Substance Abuse During Pregnancy: Moms on Meds. Jennifer Anderson Maddron, M.D LeConte Womens Healthcare Associates Substance Abuse During Pregnancy: Moms on Meds Jennifer Anderson Maddron, M.D LeConte Womens Healthcare Associates 2010 National Survey on Drug Use and Health An estimated 4.4% of pregnant women reported

More information

Vaginal or Cesarean Birth:

Vaginal or Cesarean Birth: Vaginal or Cesarean Birth: What Is at Stake for Women and Babies? A Best Evidence Review Executive Summary Contributors Henci Goer Amy Romano, MSN, CNM Carol Sakala, PhD, MSPH 2012, Childbirth Connection

More information

BUTTE COUNTY PUBLIC HEALTH DEPARTMENT POLICY & PROCEDURE

BUTTE COUNTY PUBLIC HEALTH DEPARTMENT POLICY & PROCEDURE BUTTE COUNTY PUBLIC HEALTH DEPARTMENT POLICY & PROCEDURE SUBJECT: Pregnancy Testing and Counseling Protocol P&P # APPROVED BY: EFFECTIVE DATE: Mark Lundberg MD Health Officer REVISION DATE: 2/20/2010 Phyllis

More information

In This Issue: Summer 2012. Tell Us What You Think... 1

In This Issue: Summer 2012. Tell Us What You Think... 1 Summer 2012 Important information from UnitedHealthcare Community Plan for physicians and other health care professionals and facilities serving New Jersey FamilyCare/Medicaid members Physician Satisfaction

More information