Predictors of adverse perinatal outcomes in women at 40 weeks or more of pregnancy

Authors

DOI:

https://doi.org/10.15584/ejcem.2023.4.4

Keywords:

adverse perinatal outcomes, doppler velocytometry, placental maturity grading, prolonged pregnancy

Abstract

Introduction and aim. To evaluate the clinical features of women at ≥40 weeks of pregnancy and the utility of obstetric Doppler indices in predicting adverse perinatal outcomes in these pregnancies.

Material and methods. This prospective study was conducted at a single academic medical center between 2020 and 2022. Women aged 18 years and older with no risk factors who were at ≥40 weeks of pregnancy and delivered their babies in our hospital were included in the study. The fetal biometry, placental maturity grading, and doppler velocytometry indices of the pregnant women were evaluated. The cases were divided into two groups according to the development of adverse perinatal outcomes. The relationship between clinical features and adverse perinatal outcomes was evaluated.

Results. Adverse perinatal outcomes developed in 19.6% (42) of the 214 cases. The multiple logistic regression analysis was performed to identify factors affecting perinatal outcomes. Accordingly, a maternal age of ≥35 years (odds ratio [OR]: 1.74, 95% confidence interval [CI]: 1.29–3.96, p=0.038), nulliparity (OR: 1.42, 95% CI: 1.13–4.63, p=0.040), and grade 3 placental calcification (OR: 1.98, 95% CI: 1.11–4.53, p=0.029) were independent predictors of adverse perinatal outcomes.

Conclusion. Care should be taken in terms of adverse perinatal outcomes in the presence of nulliparity, a maternal age of ≥35 years, and grade 3 placental calcification in ≥40 week pregnancies.

Downloads

Download data is not yet available.

References

Middleton P, Shepherd E, Crowther CA. Induction of labour for improving birth outcomes for women at or beyond term. Cochrane Database Syst Rev. 2018;5(5):CD004945. doi: 10.1002/14651858

Kistka ZA, Palomar L, Boslaugh SE, DeBaun MR, DeFranco EA, Muglia LJ. Risk for postterm delivery after previous postterm delivery. Am J Obstet Gynecol. 2007;196:241.e1-241.e6. doi: 10.1016/j.ajog.2006.10.873

Burkitova AM, Polyakova VO, Bolotskikh VM, Kvetnoy IM. Features of the placenta structure in post-term pregnancy. Journal of Obstetrics and Women’s Diseases. 2019;68(6):73-86. doi: 10.17816/JOWD68673-86

Middleton P, Shepherd E, Morris J, Crowther CA, Gomersall JC. Induction of labour at or beyond 37 weeks' gestation. Cochrane Database Syst Rev. 2020;7(7):CD004945. doi: 10.1002/14651858

Kauppinen T, Kantomaa T, Tekay A, Mäkikallio K. Placental and fetal hemodynamics in prolonged pregnancies. Prenat Diagn. 2016;36(7):622-627. doi: 10.1002/pd.4828

Ashwal E, Ali-Gami J, Aviram A, et al. Contribution of Second Trimester Sonographic Placental Morphology to Uterine Artery Doppler in the Prediction of Placenta-Mediated Pregnancy Complications. J Clin Med. 2022;11(22):6759. doi: 10.3390/jcm11226759

Pedroso MA, Palmer KR, Hodges RJ, Costa FDS, Rolnik DL. Uterine Artery Doppler in Screening for Preeclampsia and Fetal Growth Restriction. Rev Bras Ginecol Obstet. 2018;40(5):287-293. doi: 10.1055/s-0038-1660777

Delle Donne RD, Araujo Júnior E, Rolo LC, Bruns RF. Reproducibility of placental maturity grade classification using a dynamic ultrasonography. J Matern Fetal Neonatal Med. 2017;30(8):987-989. doi: 10.1080/14767058.2016.1196661

Galal M, Symonds I, Murray H, Petraglia F, Smith R. Postterm pregnancy. Facts Views Vis Obgyn. 2012;4(3):175-187.

Maged AM, Abdelhafez A, Al Mostafa W, Elsherbiny W. Fetal middle cerebral and umbilical artery Doppler after 40 weeks gestational age. J Matern Fetal Neonatal Med. 2014;27(18):1880-1885. doi: 10.3109/14767058.2014.892068

Practice bulletin no. 145: antepartum fetal surveillance. Obstet Gynecol. 2014;124(1):182-192. doi: 10.1097/01.AOG.0000451759.90082.7b

Maoz O, Wainstock T, Sheiner E, Walfisch A. Immediate perinatal outcomes of postterm deliveries. J Matern Fetal Neonatal Med. 2019;32(11):1847-1852. doi: 10.1080/14767058.2017.1420773

Carroll A, Desforges M, Jones CJP, Heazell AEP. Morphological and functional changes in placentas from prolonged pregnancies. Placenta. 2022;125:29-35. doi: 10.1016/j.placenta.2022.01.009

Dash S, Das B, Panda SR, et al. Perinatal Outcomes in Premature Placental Calcification and the Association of a Color Doppler Study: Report from a Tertiary Care Hospital in Eastern India. Clin Pract. 2021;11(4):841-849. doi: 10.3390/clinpract11040099

Murzakanova G, Räisänen S, Jacobsen AF, Sole KB, Bjarkø L, Laine K. Adverse perinatal outcomes in 665,244 term and post-term deliveries-a Norwegian population-based study. Eur J Obstet Gynecol Reprod Biol. 2020;247:212-218. doi: 10.1016/j.ejogrb.2020.02.028

Seikku L, Gissler M, Andersson S, et al. Asphyxia, Neurologic Morbidity, and Perinatal Mortality in Early-Term and Postterm Birth. Pediatrics. 2016;137(6):e20153334. doi: 10.1542/peds.2015-3334

Chen R, Tedroff K, Villamor E, Lu D, Cnattingius S. Risk of intellectual disability in children born appropriate-for-gestational-age at term or post-term: impact of birth weight for gestational age and gestational age. Eur J Epidemiol. 2020;35(3):273-282. doi: 10.1007/s10654-019-00590-7

Deng K, Huang Y, Wang Y, et al. Prevalence of postterm births and associated maternal risk factors in China: data from over 6 million births at health facilities between 2012 and 2016. Sci Rep. 2019;9(1):273. doi: 10.1038/s41598-018-36290-7

Kortekaas JC, Kazemier BM, Keulen JKJ, et al. Risk of adverse pregnancy outcomes of late- and postterm pregnancies in advanced maternal age: A national cohort study. Acta Obstet Gynecol Scand. 2020;99(8):1022-1030. doi: 10.1111/aogs.13828

Downloads

Published

2023-12-30

How to Cite

Sert, Z. S., Dilmaç, A. E., Alkan, E., & Sert, E. T. (2023). Predictors of adverse perinatal outcomes in women at 40 weeks or more of pregnancy. European Journal of Clinical and Experimental Medicine, 21(4), 711–715. https://doi.org/10.15584/ejcem.2023.4.4

Issue

Section

ORIGINAL PAPERS