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Preeclampsia is a multisystem disorder that affects pregnant women. Preeclampsia and its complications are the leading causes of maternal and perinatal morbidity and mortality in developing countries. Studies conducted in Ethiopia have primarily concentrated on preeclampsia's trends and prevalence rather than its obstetrical and perinatal consequences. Thus, this study aimed to determine the risk of adverse obstetric and perinatal outcomes among women with preeclampsia at Woldia Comprehensive Specialized Hospital, Northeast Ethiopia. A retrospective cohort study was conducted among 140 preeclamptic women and 280 normotensive women who gave birth at Woldia Comprehensive Specialized Hospital between 30 December 2020 and 29 December 2022. Maternal records were retrieved using data-extraction tools. The data were entered into EpiData version 4.6.0.6 and analyzed using SPSS version 26. Binary and multivariable logistic regression models were used to test the associations between independent and outcome variables. The adjusted odds ratio (OR) with a 95% confidence interval (CI) and -values <0.05 were used to measure the strength of the association and declare the level of statistical significance. The odds of at least one adverse obstetric outcome among preeclamptic women were 2.25 times higher than those among normotensive women [AOR: 2.25, 95% CI: (1.06, 4.77)]. In addition, babies born to preeclamptic women were at a higher risk of perinatal death [AOR: 2.90, 95% CI: (1.10, 8.17)], low birth weight [AOR: 3.11, 95% CI: (1.43, 6.7)], birth asphyxia [AOR: 2.53, 95% CI: (1.15, 5.5)], and preterm birth [AOR: 2.21, 95% CI: (1.02, 4.8)] than babies born to normotensive women. More adverse obstetric and perinatal outcomes were observed in women with preeclampsia than those in normotensive women. This study highlights the significantly elevated level of at least one adverse obstetric outcome associated with preeclampsia, low hemoglobin level, and rural residents. Moreover, perinatal death, low birth weight, asphyxia, and preterm birth were significantly associated with preeclampsia.

Background Due to the advancement of modern societies, the proportion of women who delay childbearing until or beyond 30 years has dramatically increased in the last three decades and has been linked with adverse maternal-neonatal outcomes. Objective To determine the trend in delayed childbearing and its negative impact on pregnancy outcomes. Material and methods A tertiary hospital-based retrospective study was conducted in Wuhan University Renmin Hospital, Hubei Province, China, during the years 2011–2019. The joinpoint regression analysis was used to find a trend in the delayed childbearing and the multiple binary logistic regression model was used to estimate the association between maternal age and pregnancy outcomes. Results Between 2011 and 2019, the trend in advanced maternal age (AMA ≥35 years) increased by 75% [AAPC 7.5% (95% CI: − 10.3, 28.9)]. Based on maternal education and occupation, trend in AMA increased by 130% [AAPC 11.8% (95% CI: 1.1, 23.7)] in women of higher education level, and 112.5% [AAPC 10.1% (95% CI: 9.4, 10.9)] in women of professional services. After adjusting for confounding factors, AMA was significantly associated with increased risk of gestational hypertension (aOR 1.5; 95% CI: 1.2, 2.1), preeclampsia (aOR 1.6; 95% CI: 1.4, 1.9), sever preeclampsia (aOR 1.7; 95% CI: 1.1, 2.6), placenta previa (aOR 1.8; 95% CI: 1.5, 2.2), gestational diabetes mellitus (aOR 2.5; 95% CI: 2.3, 2.9), preterm births (aOR 1.6; 95% CI: 1.4, 1.7), perinatal mortality (aOR 1.8; 95% CI: 1.3, 2.3), and low birth weight (aOR 1.3; 95% CI: 1.2, 1.4) compared with women aged < 30 years. Conclusion Our findings show a marked increase in delayed childbearing and its negative association with pregnancy outcomes.

Pregnancy at advanced maternal age (age >35 years old) is considered a risk factor for adverse maternal and perinatal outcomes. Yet, pregnancies of advanced maternal age have become more prevalent over the last few decades. Possible maternal complications of pregnancy at age 35 or older include increased risk of spontaneous miscarriage, preterm labor, gestational diabetes mellitus, pre-eclampsia, stillbirth, chromosomal abnormalities, and cesarean delivery. Possible adverse fetal outcomes include infants small for gestational age and intrauterine growth restrictions, low Apgar score, admission to neonatal intensive care units, and an autism spectrum disorder. This paper aims to present an up-to-date review of the literature, summarizing the most current studies and implications for the management of pregnancy of advanced maternal age. Keywords: advanced maternal age, adverse maternal outcome, adverse perinatal outcome

Background Advanced maternal age generally denotes age after 35 years during the time of delivery. Despite the fact that being pregnant at any reproductive age is not risk-free, older gravidity usually culminates with adverse outcomes both to the mother and fetus or neonate. This study aimed to determine the association of adverse obstetrical and perinatal outcomes with advanced maternal age pregnancy. The study was conducted in Ayder comprehensive specialized hospital, north Ethiopia, from 2015 to 2017. Methods chart review comparative cross-sectional study was employed. Data were retrieved from medical charts of 752 pregnant mothers (376 each for both the study;> 35-year-old and reference group;20-34 year old). Data was collected using a pretested and structured checklist using systematic sampling and data was entered & analyzed using SPSS version 20. Binary and multivariable logistic regression was run to determine the association of independent variables with dependent variables. Results This study revealed that advanced maternal age pregnancy was significantly associated with pregnancy induced hypertension [AOR 4.15, 95% CI (2.272–7.575), p  <  0.001], ante partum hemorrhage [AOR 2.54, 95% CI (1.32–4.91), P  = 0.005] & cesarean delivery [AOR 2.722, 95% CI (1.777–4.170), p  <  0.001]. Furthermore, advanced maternal age pregnancy was also increasingly associated with adverse perinatal outcomes like preterm delivery [AOR 3.622, 95% CI (1.469–8.930), p  = 0.005], low birth weight [ AOR 3.137, 95% CI (1.324–7.433), p  = 0.009], perinatal death [AOR 2.54, 95% CI (1.141–5.635), p  = 0.022] and low fifth minute APGAR score [AOR 7.507, 95% CI (3.134–17.98), p <  0.001]. Notwithstanding this, maternal age was not found to be associated with amniotic fluid disturbances, premature rupture of membranes and post-term pregnancy. Conclusions Advanced maternal age is markedly linked with adverse obstetrical and perinatal outcomes. Therefore, it is better for health care providers to counsel couples, who seek to have a child in their later ages, about the risks of advanced maternal age pregnancy. In addition, health care workers need to emphasize on how to improve advanced age mothers’ health through the utilization of contraception to reduce pregnancy in this age group.

Introduction Therapeutic rest refers to the usage of medication to relieve pain in women in the latent phase of labor. Very few data are available to evaluate the safety and effect of its use. The objectives of this study were to compare perinatal and labor outcomes in women who were seeking hospital care during the latent phase of labor and who were treated either with or without therapeutic rest. Material and methods Retrospective cohort study with inclusion of nulliparous singleton pregnant women in the latent phase of labor presenting at the labor ward at Aarhus University Hospital, Denmark from May 13, 2018 to June 1, 2021. We identified two groups: women who were treated with therapeutic rest and women who were not. The primary outcomes were neonatal admission and neonatal resuscitation. Secondary outcomes included use of cardiotocography during labor, nonreactive fetal heart rate, meconium‐stained amniotic fluid, pediatric delivery room assistance, umbilical cord arterial pH and standard base excess, Apgar score at 5 minutes, interventions during labor and mode of delivery. Results In our sample of 800 women in the latent phase of labor, 414 women (52%) were treated with therapeutic rest and 386 women (48%) were not. The most frequently used (n = 206) medication for therapeutic rest was a combination of paracetamol, triazolam and codeine. We found no significant difference in neonatal admission (9.2% vs 6.5%, adjusted odds ratio [aOR] 1.2, 95% confidence interval [CI] 0.4–3.1) or neonatal resuscitation (2.4% vs 3.1%, aOR 0.7, 95% CI 0.1–4.0) between women treated with or without therapeutic rest. There were no differences between the two groups in other perinatal adverse outcomes, interventions during labor or mode of delivery. Conclusions This study found no significant association between therapeutic rest and neonatal admission or resuscitation. Our findings indicate that therapeutic rest is a safe method for managing the latent phase of labor concerning neonatal health and does not increase the risk of labor complications. A retrospective cohort study aiming to evaluate perinatal and labor outcomes in nulliparous women who were treated with therapeutic rest during the latent phase of labor compared with women who were not. There was no significant difference in neonatal admission or resuscitation, in other perinatal adverse outcomes, interventions during labor or mode of delivery between the two groups.

Background The prevalence of pregnancy-induced hypertension in Ethiopia ranges from 2.2 to 18.3%. However, so far little is known about the adverse perinatal outcomes of pregnancy-induced hypertension in Tigray regional state, Ethiopia. Therefore, the objective of this study was to assess the effect of pregnancy-induced hypertension on adverse perinatal outcomes in Tigray Regional State, Ethiopia. Methods a prospective cohort study was conducted on a total sample of 782 pregnant women attending antenatal care in hospitals of Tigray regional state, Ethiopia. Pregnant mothers diagnosed with PIH during the data collection period in the selected hospitals were included as exposed group and normotensive women were also enrolled as a control group. This study addresses women diagnosed with preeclampsia, eclampsia and gestational hypertension between 28 and 35 weeks of gestation. Data were collected using an interviewer-administered questionnaire and review of their medical records from February 2018, to February 2019. The adverse perinatal outcome event includes low birth weight, birth asphyxia, small for gestational age, preterm delivery, admission to neonatal intensive care unit and perinatal death. A modified Poisson regression model with robust standard errors was used to analyze relative risk. Results In this study, the overall incidence of adverse perinatal outcome was higher among women with pregnancy-induced hypertension than normotensive women (66.4% vs 22.2%). After adjusted for confounders women with pregnancy-induced hypertension were born babies with a higher risk of low birth weight (adjusted RR (95%CI) = 5.1(3.4,7.8)), birth asphyxia (aRR = 2.6(1.9,3.8)), small for gestational age (aRR = 3.3(2.3,4.6)), preterm delivery (aRR = 5.2(3.4,7.9)), stillbirth (aRR = 3.46(1.40,8.54)), admission to neonatal intensive care unit (aRR = 5.1(3.1,8.4)) and perinatal death (aRR = 3.6(1.8,7.4)) compared to normotensive pregnant women. Conclusions Higher incidences of adverse perinatal outcomes occurred among women pregnancy-induced hypertension in Tigray regional state, Ethiopia. Hence, health care providers should strengthen prevention, early diagnosis and prompt management of pregnancy-induced hypertension to reduce adverse perinatal outcomes of pregnancy-induced hypertension.

Since the world’s first in vitro fertilization baby was born in 1978, there have been more than 8 million children conceived through assisted reproductive technologies (ART) worldwide, and a significant proportion of them have reached puberty or young adulthood. Many studies have found that ART increases the risk of adverse perinatal outcomes, including preterm birth, low birth weight, small size for gestational age, perinatal mortality, and congenital anomalies. However, data regarding the long-term outcomes of ART offspring are limited. According to the developmental origins of health and disease theory, adverse environments during early life stages may induce adaptive changes and subsequently result in an increased risk of diseases in later life. Increasing evidence also suggests that ART offspring are predisposed to an increased risk of non-communicable diseases, such as malignancies, asthma, obesity, metabolic syndrome, diabetes, cardiovascular diseases, and neurodevelopmental and psychiatric disorders. In this review, we summarize the risks for long-term health in ART offspring, discuss the underlying mechanisms, including underlying parental infertility, epigenetic alterations, non-physiological hormone levels, and placental dysfunction, and propose potential strategies to optimize the management of ART and health care of parents and children to eliminate the associated risks. Further ongoing follow-up and research are warranted to determine the effects of ART on the long-term health of ART offspring in later life.

Background Pregnancies among mothers of advanced age (≥ 35 years) are inherently associated with poor perinatal outcomes. In this study, we determined the proportion of adverse perinatal outcomes and identified associated factors among pregnant mothers of advanced age who delivered at Kabale Regional Referral Hospital (KRRH) in Southwestern Uganda. Methods We conducted a cross-sectional study at KRRH’s Maternity Ward from March to August 2023. We enrolled post-delivery mothers aged ≥ 35 years. We collected data on socio-demographic, obstetric, and medical characteristics, as well as fetal outcomes, using interviewer-administered structured questionnaires. We defined an adverse perinatal outcome as the occurrence of any of the following complications: early neonatal death, preterm birth, congenital anomalies, macrosomia, low APGAR score, or low birth weight, sustained by the fetus or neonate during pregnancy, delivery, or the immediate post-delivery period before discharge from the hospital. We performed multivariable logistic regression to identify factors associated with adverse perinatal outcomes. Results We enrolled 417 participants, of whom 206 (49.4%) were aged 35–37 years. The majority ( n  = 273; 65.5%) were multiparous (parity ≥ 5). Adverse perinatal outcomes occurred in 8.4% ( n  = 36; 95% CI: 6.1–11.5%) of participants, with early neonatal death being the most common (3.6%), followed by low birth weight (2.4%), congenital anomalies (2.6%), macrosomia (1.4%), low APGAR score (1.4%), and preterm birth (1.2%). Prolonged labor (adjusted odds ratio [aOR] = 3.71, 95% CI: 1.40–9.85) and a history of abortion (aOR = 2.56, 95% CI: 1.17–5.60) were significantly associated with adverse fetal outcomes. Conclusion Approximately 1 out of every 10 advanced-aged mothers surveyed experienced a poor perinatal outcome, with mothers who had prolonged labor or history of abortions having increased odds of the poor perinatal outcomes. We recommend strengthening close monitoring of labour and timely interventions to reduce adverse perinatal outcomes including early neonatal deaths.

The aim of this study was to evaluate the predictive value of the systemic inflammatory index (SII), the systemic inflammatory response index (SIRI), and the aggregate systemic inflammatory index (AISI) in patients diagnosed with preeclampsia (PE) for PE and composite adverse perinatal outcomes (CAPO) in patients with PE. This single-center, retrospective case-control study included pregnant women aged 18-45 years with PE and healthy controls. First- and third-trimester hematological parameters were recorded, and inflammatory indices were calculated. Neonatal intensive care unit (NICU) admission and CAPO were evaluated as clinical outcomes. Receiver operating characteristic (ROC) analysis assessed predictive performance, and multivariable logistic regression was used to adjust for confounding factors. A total of 300 patients (150 with PE and 150 controls) were included. The PE group had significantly higher rates of NICU admission and CAPO (p < 0.05). Several first- and third-trimester inflammatory indices, including NLR, PNR, SII, SIRI, and AISI, were significantly higher in the PE group. ROC analysis demonstrated that multiple indices were associated with the prediction of PE, NICU admission, and CAPO. In multivariable analysis, third-trimester PLR remained an independent predictor of NICU admission, while third-trimester PLR and PMR were identified as independent predictors of CAPO (p < 0.05). For the prediction of PE, only first-trimester NLR and PNR remained independent predictors (p < 0.05). Inflammation-based indices derived from routine blood tests were associated with PE and adverse perinatal outcomes. Inflammation-based indices derived from routine blood tests were associated with PE and adverse perinatal outcomes. Certain indices demonstrated independent predictive value, particularly third-trimester PLR for NICU admission, third-trimester PLR and PMR for CAPO, and first-trimester NLR and PNR for PE. However, these indices should be interpreted in conjunction with clinical variables and considered as supportive markers rather than stand-alone predictors in clinical practice.

Knowledge on longitudinal trajectories of maternal placental growth factor (PlGF) levels, their prenatal factors, and their associations with adverse perinatal outcomes is lacking. We sought to identify PlGF trajectories, examine associations of prenatal factors with these trajectories, and determine whether these trajectories are associated with adverse perinatal outcomes. This retrospective cohort study included 438 pregnant women with multiple PlGF measurements. Group-based trajectory modeling identified distinct PlGF trajectories. Logistic and linear regression examined associations of trajectories with prenatal factors and adverse perinatal outcomes. Three PlGF trajectories were identified. The high (46.6%) and moderate (40.6%) PlGF level trajectories tracked together until the late second trimester, after which the moderate trajectory plateaued and then declined steeply in the third trimester while the high trajectory remained elevated, peaking in the early third trimester before declining gradually. The low PlGF level trajectory (12.8%) maintained the lowest overall levels, rising modestly to an early peak before declining progressively. Uterine fibroids were associated with higher odds of the moderate and low trajectories, as was a history of late adverse obstetric outcomes. Conversely, a history of early pregnancy loss was associated with reduced odds of these trajectories. Additionally, each 1 kg/m increase in pre-pregnancy body mass index (BMI) was associated with higher odds of the low trajectory. Compared with the high trajectory, the low trajectory was associated with increased odds of placental insufficiency, preeclampsia, and preterm delivery, alongside reductions in neonatal birth weight and length. The moderate trajectory was associated with increased odds of preterm delivery before 37 weeks and reduced neonatal birth weight. Maternal PlGF trajectories are shaped by prenatal factors. Both moderate and low trajectories markedly increase the odds of adverse perinatal outcomes, underscoring the potential value of dynamic PlGF monitoring for early risk stratification and identification of high-risk pregnancies.