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Adverse Perinatal Outcome in Subsequent Pregnancy after Stillbirth by Placental Vascular Disorders

OBJECTIVE: To evaluate outcome in the pregnancy following a stillbirth (SB) by a placental vascular disorders. STUDY DESIGN: A prospective, observational, multicenter study was conducted in woman with a history of stillbirth (> 22 weeks) between 2005 and June 2013, in 3 Italian University Hospita...

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Autores principales: Monari, Francesca, Pedrielli, Giulia, Vergani, Patrizia, Pozzi, Elisa, Mecacci, Federico, Serena, Caterina, Neri, Isabella, Facchinetti, Fabio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4881909/
https://www.ncbi.nlm.nih.gov/pubmed/27228078
http://dx.doi.org/10.1371/journal.pone.0155761
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author Monari, Francesca
Pedrielli, Giulia
Vergani, Patrizia
Pozzi, Elisa
Mecacci, Federico
Serena, Caterina
Neri, Isabella
Facchinetti, Fabio
author_facet Monari, Francesca
Pedrielli, Giulia
Vergani, Patrizia
Pozzi, Elisa
Mecacci, Federico
Serena, Caterina
Neri, Isabella
Facchinetti, Fabio
author_sort Monari, Francesca
collection PubMed
description OBJECTIVE: To evaluate outcome in the pregnancy following a stillbirth (SB) by a placental vascular disorders. STUDY DESIGN: A prospective, observational, multicenter study was conducted in woman with a history of stillbirth (> 22 weeks) between 2005 and June 2013, in 3 Italian University Hospitals. Causes of SB were previously identified after extensive investigations. Pregnant women were enrolled within the first trimester. The main outcome was “adverse neonatal outcome”, including perinatal death, fetal growth restriction, early preterm birth <33+6 weeks, hypoxic-ischemic encephalopathy, intracranial hemorrhage or respiratory distress. RESULTS: Out of 364 index pregnancies, 320 women (87.9%) had a subsequent pregnancy during the study period. Forty-seven had an early pregnancy loss. Out of 273 babies, 67 (24.5%) had an adverse perinatal outcome, including 1 SB and 1 early neonatal death (3.7/1000). Women who had a SB related to placental vascular disorders (39.6%), were at higher risk of an adverse neonatal outcome compared with women whose SB was unexplained or resulted from other causes (Adj. OR = 2.1, 95%CI: 1.2–3.8). Moreover, also obesity independently predicts an adverse perinatal outcome (Adj OR = 2.1, 95%CI: 1.1–4.3). CONCLUSION: When previous SB is related to placental vascular disorders there is a high risk for adverse neonatal outcomes in the subsequent pregnancy. Maternal obesity is an additional risk factor.
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spelling pubmed-48819092016-06-10 Adverse Perinatal Outcome in Subsequent Pregnancy after Stillbirth by Placental Vascular Disorders Monari, Francesca Pedrielli, Giulia Vergani, Patrizia Pozzi, Elisa Mecacci, Federico Serena, Caterina Neri, Isabella Facchinetti, Fabio PLoS One Research Article OBJECTIVE: To evaluate outcome in the pregnancy following a stillbirth (SB) by a placental vascular disorders. STUDY DESIGN: A prospective, observational, multicenter study was conducted in woman with a history of stillbirth (> 22 weeks) between 2005 and June 2013, in 3 Italian University Hospitals. Causes of SB were previously identified after extensive investigations. Pregnant women were enrolled within the first trimester. The main outcome was “adverse neonatal outcome”, including perinatal death, fetal growth restriction, early preterm birth <33+6 weeks, hypoxic-ischemic encephalopathy, intracranial hemorrhage or respiratory distress. RESULTS: Out of 364 index pregnancies, 320 women (87.9%) had a subsequent pregnancy during the study period. Forty-seven had an early pregnancy loss. Out of 273 babies, 67 (24.5%) had an adverse perinatal outcome, including 1 SB and 1 early neonatal death (3.7/1000). Women who had a SB related to placental vascular disorders (39.6%), were at higher risk of an adverse neonatal outcome compared with women whose SB was unexplained or resulted from other causes (Adj. OR = 2.1, 95%CI: 1.2–3.8). Moreover, also obesity independently predicts an adverse perinatal outcome (Adj OR = 2.1, 95%CI: 1.1–4.3). CONCLUSION: When previous SB is related to placental vascular disorders there is a high risk for adverse neonatal outcomes in the subsequent pregnancy. Maternal obesity is an additional risk factor. Public Library of Science 2016-05-26 /pmc/articles/PMC4881909/ /pubmed/27228078 http://dx.doi.org/10.1371/journal.pone.0155761 Text en © 2016 Monari et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Monari, Francesca
Pedrielli, Giulia
Vergani, Patrizia
Pozzi, Elisa
Mecacci, Federico
Serena, Caterina
Neri, Isabella
Facchinetti, Fabio
Adverse Perinatal Outcome in Subsequent Pregnancy after Stillbirth by Placental Vascular Disorders
title Adverse Perinatal Outcome in Subsequent Pregnancy after Stillbirth by Placental Vascular Disorders
title_full Adverse Perinatal Outcome in Subsequent Pregnancy after Stillbirth by Placental Vascular Disorders
title_fullStr Adverse Perinatal Outcome in Subsequent Pregnancy after Stillbirth by Placental Vascular Disorders
title_full_unstemmed Adverse Perinatal Outcome in Subsequent Pregnancy after Stillbirth by Placental Vascular Disorders
title_short Adverse Perinatal Outcome in Subsequent Pregnancy after Stillbirth by Placental Vascular Disorders
title_sort adverse perinatal outcome in subsequent pregnancy after stillbirth by placental vascular disorders
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4881909/
https://www.ncbi.nlm.nih.gov/pubmed/27228078
http://dx.doi.org/10.1371/journal.pone.0155761
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