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  • Original Article

    Maternal Factors Associated with Low Birth Weight in Term Neonates: A Case-controlled Study

    Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(8):444-449

    Summary

    Original Article

    Maternal Factors Associated with Low Birth Weight in Term Neonates: A Case-controlled Study

    Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(8):444-449

    DOI 10.1055/s-0038-1667341

    Views1

    Abstract

    Objective

    To identify maternal factors associated with the presence of low birth weight in term neonates.

    Methods

    Matched hospital-based case-controlled study performed in a high complexity institution located in the city of Neiva, Colombia. The study included women with term gestation and singleton live fetuses. Patients with prior diseases, coming from other regions, with pregnancy resulting from assisted reproduction, or with a diagnosis of fetal abnormality or aneuploidy were excluded. Low birth weight was the dependent variable, and the independent variables that were analyzed were maternal sociodemographic and clinical characteristics. Adjusted and non-adjusted odds ratios (aOR and OR) together with the 95% confidence intervals (95% CI) were reported.

    Results

    The study included 270 participants (90 cases and 180 controls). Controlling for maternal age, educational level, socioeconomic and civil status, social security and the presence of maternal disease during gestation, it was found that weight gain (aOR 0.77, 95% CI 0.70-0.85) and the absence of prenatal care (aOR 8.20, 95% CI 3.22-20.87) were among the factors associated with low birth weight.

    Conclusions

    The absence of weight gain and of prenatal care are factors associated with the presence of low birth weight in term neonates and should be considered in clinical practice.

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  • Review Article

    Expectant Versus Interventionist Care in the Management of Severe Preeclampsia Remote from Term: A Systematic Review

    Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(8):627-637

    Summary

    Review Article

    Expectant Versus Interventionist Care in the Management of Severe Preeclampsia Remote from Term: A Systematic Review

    Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(8):627-637

    DOI 10.1055/s-0041-1733999

    Views5

    Abstract

    Objective

    To compare the effects of expectant versus interventionist care in the management of pregnant women with severe preeclampsia remote from term.

    Data sources

    An electronic search was conducted in the Medical Literature Analysis and Retrieval System Online (MEDLINE), Excerpta Medica Database (EMBASE), Cochrane Central Register of Controlled Trials (CENTRAL), Latin American and Caribbean Health Sciences Literature (LILACS, for its Spanish acronym), World Health Organization’s International Clinical Trials Registry Platform (WHO-ICTRP), and Open- Grey databases. The International Federation of Gynecology and Obstetrics (FIGO, for its French acronym), Royal College of Obstetricians and Gynaecologists (RCOG), American College of Obstetricians and Gynecologists (ACOG), and Colombian Journal of Obstetrics and Gynecology (CJOG) websites were searched for conference proceedings, without language restrictions, up to March 25, 2020.

    Selection of studies

    Randomized clinical trials (RCTs), and non-randomized controlled studies (NRSs) were included. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach was used to evaluate the quality of the evidence.

    Data collection

    Studies were independently assessed for inclusion criteria, data extraction, and risk of bias. Disagreements were resolved by consensus.

    Data synthesis

    Four RCTs and six NRS were included. Low-quality evidence from the RCTs showed that expectant care may result in a lower incidence of appearance, pulse, grimace, activity, and respiration (Apgar) scores<7 at 5 minutes (risk ratio [RR]: 0.48; 95% confidence interval [95%CI]: 0.23%to 0.99) and a higher average birth weight (mean difference [MD]: 254.7 g; 95%CI: 98.5 g to 410.9 g). Very low quality evidence from the NRSs suggested that expectant care might decrease the rates of neonatal death (RR: 0.42; 95%CI 0.22 to 0.80), hyalinemembrane disease (RR: 0.59; 95%CI: 0.40 to 0.87), and admission to neonatal care (RR: 0.73; 95%CI: 0.54 to 0.99). Nomaternal or fetal differences were found for other perinatal outcomes.

    Conclusion

    Compared with interventionist management, expectant care may improve neonatal outcomes without increasing maternal morbidity and mortality.

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    Expectant Versus Interventionist Care in the Management of Severe Preeclampsia Remote from Term: A Systematic Review

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