Maternal and perinatal outcomes after implementation of a more active management in late- and postterm pregnancies in Sweden: A population-based cohort study
PLoS Medicine,
Год журнала:
2025,
Номер
22(1), С. e1004504 - e1004504
Опубликована: Янв. 16, 2025
Background
The
risk
of
perinatal
death
and
severe
neonatal
morbidity
increases
gradually
after
41
weeks
pregnancy.
We
evaluated
maternal
outcomes
a
national
shift
from
expectancy
induction
at
42
+0
to
more
active
management
late-term
pregnancies
in
Sweden
offering
or
an
individual
plan
aiming
birth
labour
no
later
than
weeks.
Methods
findings
Women
with
singleton
pregnancy
lasting
fetus
cephalic
presentation
(
N
=
150,370)
were
included
nationwide,
register-based
cohort
study.
Elective
cesarean
sections
excluded.
Outcomes
during
period
1,
January
2017
December
2019
(before
the
shift)
versus
2,
2020
October
2023
(after
analysed.
For
comparison,
39
40
+6
358,548)
also
studied.
Primary
were:
First,
peri/neonatal
(stillbirth
before
28
days);
second,
composite
adverse
outcome
(peri/neonatal
death,
Apgar
score
<4
5
min,
hypoxic
ischemic
encephalopathy
grades
1–3,
meconium
aspiration
syndrome,
trauma,
admission
intensive
care
unit
(NICU)
≥4
third,
excluding
NICU;
fourth,
emergency
section.
Secondary
components
primary
outcomes.
Relative
risks
(RRs)
95%
confidence
intervals
(CIs)
for
binary
2
1
computed
using
modified
Poisson
regression
analyses
adjustments
age,
parity,
body
mass
index
(BMI),
smoking,
educational
level.
Induction
rates
among
increased
33.7%
52.4%
2.
Mean
(standard
deviation)
gestational
age
decreased
290.7
(2.9)
days
289.6
(2.3)
days.
Infants
born
lower
compared
infants
1;
0.9/1,000
1.7/1,000
(adjusted
RR
0.52;
CI
[0.38,
0.69];
p
<
0.001),
they
had
having
outcome,
both
including
(50.5/1,000
53.9/1,000,
adjusted
0.92;
[0.88,
0.96];
0.001)
NICU
(18.5/1,000
22.5/1,000,
0.79;
[0.74,
0.85];
0.001).
section
rate
10.5%
11.9%
1.07;
[1.04,
1.10];
births
was
0.86
(95%
[0.72,
1.02]).
One
limitation
study
is
that
we
data
on
what
extent
monitoring
fetal
health
performed.
Conclusions
A
associated
decrease
deaths,
Increased
observed.
advancing
towards
should
be
given
balanced
information
benefits
expectant
until
offered
surveillance
order
mortality.
Язык: Английский
Impacts of COVID-19 on mothers’ and newborns’ health outcomes in regional Canada: A cross-sectional analysis
Heliyon,
Год журнала:
2024,
Номер
10(14), С. e34165 - e34165
Опубликована: Июль 1, 2024
BackgroundCOVID-19
infection
and
pandemic-related
stressors
(e.g.,
socioeconomic
challenges,
isolation)
resulted
in
significant
concerns
for
the
health
of
mothers
their
newborns
during
perinatal
period.
Therefore,
primary
objective
this
study
was
to
compare
outcomes
pregnant
one
year
prior
into
pandemic
period
Alberta,
Canada.
Secondary
objectives
included
investigating:
1)
predictors
admission
neonatal
intensive
care
units
(NICU)
NICU-admitted
newborn
between
two
time
periods;
2)
hospital
utilization
3)
following
with
COVID-19.MethodsThis
analytical
cross-sectional
used
a
large
administrative
dataset
(n
=
32,107)
obtained
from
provincial
regional
hospitals
homebirths
Canada,
April
15,
2019,
14,
2021.
Descriptive
statistics
characterized
samples.
Chi-squares
two-sample
t-tests
statistically
compared
Multivariable
logistic
regression
identified
predictor
variables.ResultsGeneral
characteristics,
pregnancy
labor
complications,
infant
were
similar
periods.
Preterm
birth
low
birthweight
predicted
NICU
admission.
During
pandemic,
prevalence
visits
rehospitalization
after
discharge
decreased
all
infants
neonates.
The
odds
revisits
higher
among
COVID-19
at
birth.ConclusionsMost
findings
are
contextualized
on
(rather
than
infection)
briefly
other
countries.
Hospitals
Alberta
appeared
adapt
well
since
conditions
comparable
periods
or
few
observable
impacts.
Further
investigation
is
required
determine
causal
reasons
changes
greater
pandemic-born
infants.
Язык: Английский
Effect of COVID-19 lockdown on maternity care and maternal outcome in the Netherlands: a national quasi-experimental study
Public Health,
Год журнала:
2024,
Номер
235, С. 15 - 25
Опубликована: Июль 20, 2024
The
COVID-19
pandemic
and
associated
lockdowns
disrupted
health
care
worldwide.
High-income
countries
observed
a
decrease
in
preterm
births
during
lockdowns,
but
maternal
pregnancy-related
outcomes
were
also
likely
affected.
This
study
investigates
the
effect
of
first
lockdown
(March-June
2020)
on
provision
maternity
Netherlands.
Язык: Английский
Healthcare Provider Narratives of the Impacts of the COVID-19 Pandemic on Pregnant and Parenting Youth in Canada: A Qualitative Study
International Journal of Environmental Research and Public Health,
Год журнала:
2024,
Номер
21(11), С. 1419 - 1419
Опубликована: Окт. 26, 2024
The
COVID-19
pandemic
led
to
significant
challenges
for
healthcare
providers
working
with
pregnant
and
parenting
youth.
However,
the
impacts
of
on
this
population
services
from
perspective
are
not
well
documented
in
Canada.
We
examined
narratives
experiences
regarding
these
explored
service
provision.
Using
a
qualitative
interpretative
description
(ID)
approach,
we
recruited
25
health
Alberta,
Ontario,
British
Columbia
individual
interviews.
Our
analysis
resulted
three
themes:
complexities
provision
during
COVID-19,
providers’
accounts
youth,
leveraging
into
opportunities
Participants
described
influence
policies
distancing
measures
accessibility
services,
availability
resources
personnel,
well-being
their
clients.
They
also
reported
increased
mental
issues,
isolation,
exacerbation
inequities
within
population.
Providers
highlighted
role
telemedicine
ensuring
some
degree
continuity
care.
Additionally,
they
commented
adaptations
address
evolving
needs
findings
underline
need
resilient
adaptable
system
that
can
better
support
vulnerable
populations
crises.
Язык: Английский