Effect of maternal chronic disease on obstetric complications in twin pregnancies in a United States cohort.

MedStar author(s):
Citation: Fertility & Sterility. 100(1):142-9.e1-2, 2013 Jul.PMID: 23541402Institution: MedStar Washington Hospital CenterDepartment: Obstetrics and Gynecology, Maternal-Fetal MedicineForm of publication: Journal ArticleMedline article type(s): Journal Article | Multicenter Study | Research Support, N.I.H., Intramural | Twin StudySubject headings: *Delivery, Obstetric | *Pregnancy Complications/di [Diagnosis] | *Pregnancy Complications/ep [Epidemiology] | *Pregnancy, Twin | Adult | Cesarean Section/td [Trends] | Chronic Disease | Cohort Studies | Delivery, Obstetric/td [Trends] | Female | Humans | Pregnancy | Pregnancy, Twin/ph [Physiology] | Premature Birth/di [Diagnosis] | Premature Birth/ep [Epidemiology] | Retrospective Studies | United States/ep [Epidemiology] | Young AdultLocal holdings: Available online from MWHC library: 1997 - present, Available in print through MWHC library:1999-2007ISSN:
  • 0015-0282
Name of journal: Fertility and sterilityAbstract: CONCLUSION(S): Chronic disease was associated with additional risk of earlier delivery and cesarean section after spontaneous labor in a nationwide sample of US twin pregnancies. Published by Elsevier Inc.DESIGN: Multicenter, retrospective, observational study.INTERVENTION(S): None.MAIN OUTCOME MEASURE(S): Gestational age at delivery, gestational hypertension, pre-eclampsia, gestational diabetes, placental abruption, placenta previa, hemorrhage, chorioamnionitis, maternal postpartum fever, premature rupture of membranes, labor onset (spontaneous vs. nonspontaneous), route of delivery, and maternal admission to intensive care unit.OBJECTIVE: To evaluate the effect of maternal chronic disease on obstetric complications among twin pregnancies.PATIENT(S): Twin pregnancies (n = 4,821) delivered >= 23 weeks of gestation and classified by maternal chronic disease (either none or any of the following: asthma, depression, hypertension, diabetes, and heart, thyroid, gastrointestinal or renal disease).RESULT(S): Women with chronic disease delivered earlier (mean gestational length, 34.1 vs. 34.6 weeks) and were less likely to have term birth (risk ratio 0.80; 95% confidence interval 0.70-0.90). Cesarean delivery after spontaneous labor (risk ratio 1.20; 95% confidence interval 1.05-1.37) was also increased with chronic disease. No statistically significant effects were observed for other complications studied. Women who used assisted reproductive technology were more likely to hemorrhage, independent of chronic disease, but other findings were generally similar to the non-assisted reproductive technology sample.SETTING: Clinical centers (19 hospitals).All authors: Laughon SK, Mannisto T, Mendola P, O'Loughlin J, Werder EDigital Object Identifier: Date added to catalog: 2013-09-17
Holdings
Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article Available 23541402

Available online from MWHC library: 1997 - present, Available in print through MWHC library:1999-2007

CONCLUSION(S): Chronic disease was associated with additional risk of earlier delivery and cesarean section after spontaneous labor in a nationwide sample of US twin pregnancies. Published by Elsevier Inc.

DESIGN: Multicenter, retrospective, observational study.

INTERVENTION(S): None.

MAIN OUTCOME MEASURE(S): Gestational age at delivery, gestational hypertension, pre-eclampsia, gestational diabetes, placental abruption, placenta previa, hemorrhage, chorioamnionitis, maternal postpartum fever, premature rupture of membranes, labor onset (spontaneous vs. nonspontaneous), route of delivery, and maternal admission to intensive care unit.

OBJECTIVE: To evaluate the effect of maternal chronic disease on obstetric complications among twin pregnancies.

PATIENT(S): Twin pregnancies (n = 4,821) delivered >= 23 weeks of gestation and classified by maternal chronic disease (either none or any of the following: asthma, depression, hypertension, diabetes, and heart, thyroid, gastrointestinal or renal disease).

RESULT(S): Women with chronic disease delivered earlier (mean gestational length, 34.1 vs. 34.6 weeks) and were less likely to have term birth (risk ratio 0.80; 95% confidence interval 0.70-0.90). Cesarean delivery after spontaneous labor (risk ratio 1.20; 95% confidence interval 1.05-1.37) was also increased with chronic disease. No statistically significant effects were observed for other complications studied. Women who used assisted reproductive technology were more likely to hemorrhage, independent of chronic disease, but other findings were generally similar to the non-assisted reproductive technology sample.

SETTING: Clinical centers (19 hospitals).

English

Powered by Koha