Birth Outcomes in a Prospective Pregnancy–Birth Cohort Study of Environmental Risk Factors in Kuwait: The TRACER Study

AlSeaidan, Mohammad; Wotayan, Rihab Al; Christophi, Christopher; Al-Makhseed, Massouma; Awad, Yara Abu; Nassan, Feiby L.; Ahmed, Ayah; Abraham, Smitha; Boley, Robert Bruce; James‐Todd, Tamarra; Wright, Rosalind J.; Dockery, Douglas W.; Behbehani, Kazem

doi:10.1111/ppe.12296

Cited by 13 publications

(12 citation statements)

References 36 publications

(37 reference statements)

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“…Similarly the rates of LBW (5.5%) were below the global estimate of 16% in 2013 [66] and the regional average for the EMR (19.3%) [67]. The observed rate of SGA (6.7%) is in agreement with that reported recently from a birth cohort in Kuwait (7.4%) [68], while the rate of macrosomia (4.3%) was within the range described for both developing (0.5–14.9%) and developed countries (5–20%) [68–70]. As for LGA, its prevalence (24.6%) was similar to that reported from a recent study in Kuwait [68], while being higher than estimates reported from Italy and China (5.3–10.6%) [71, 72].…”

Section: Discussionsupporting

confidence: 83%

Pre-pregnancy BMI, gestational weight gain and birth outcomes in Lebanon and Qatar: Results of the MINA cohort

et al. 2019

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Accumulating evidence has highlighted the role of maternal nutritional status on fetal development, birth outcomes and child health. The Mother and Infant Nutritional Assessment (MINA) cohort is a 3-year follow-up study of pregnant women and their children in Qatar and Lebanon. This study reports on the characteristics and determinants of pre-pregnancy BMI and Gestational Weight Gain (GWG) of MINA particiants, as well as birth outcomes. A total of 272 pregnant women were recruited during their first trimester from primary healthcare centers as well as private clinics in Beirut (n = 194) and Doha (n = 147). During the first visit, data collection included pre-pregnancy weight, sociodemographic and lifestyle characteristics. The weight before delivery and neonatal outcomes were extracted from the medical records. GWG was calculated as the difference between weight before delivery and pre-pregnancy weight and was classified into insufficient, adequate, and excessive, as per the IOM criteria. Overall, 42.1% of women had a pre-pregnancy BMI≥25 Kg/m 2 (58% in Qatar vs 30.8% in Lebanon, p<0.001). Only 30.2% of women had adequate GWG, while 25.7% and 44.1% of women had insufficient and excessive GWG, respectively. In the cohort 68.7% of infants had a weight adequate-for-gestational age (AGA), 6.7% were SGA and 24.6% were LGA. The proportions of LGA were higher with greater GWG (p<0.05). After adjustment, Qatari women were 3 times more likely to be overweight or obese before pregnancy while a higher education level was associated with significantly lower odds of pre-pregnancy BMI≥25 Kg/m 2 . Pre-pregnancy BMI≥25 Kg/m 2 and regular breakfast consumption were predictors of excessive GWG (OR: 3.20, CI: 1.48–6.91; OR: 2.84, CI: 1.15–7.02, respectively). The high prevalence of pre-pregnancy overweight and excessive GWG among MINA participants underscores the need for culture-specific intervention programs to promote healthy body weight in women of childbearing age, and prevent excessive weight gain during pregnancy.

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Section: Discussionsupporting

confidence: 83%

Pre-pregnancy BMI, gestational weight gain and birth outcomes in Lebanon and Qatar: Results of the MINA cohort

et al. 2019

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“…The stillbirth rate (SBR) of 46.2 per 100 births (95% CI:32.7-59.3) found in our study is higher than the data reported by hospital -based study in 2005 [5] and the data collected from a sub-national household survey conducted in six rural districts of four Yemeni provinces in 2008-2009 [17]. It is also higher than SBR in other EMR countries such as Kuwait [18], Palestine [19] and Pakistan [20]. Our study was a community-based study within households in Yemen, and the burden of stillbirths can be expected to be much higher at home than the hospital setting.…”

Section: Discussioncontrasting

confidence: 81%

Maternal, Foetal and Service-Related Risk Factors for Stillbirths During Conflict Situation, Yemen, 2015-2016

Al-Shahethi¹,

Zaki

Serouri

et al. 2020

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Background: Stillbirth is a silent traumatic canker which is a major concern of various individuals, health institutions and the country as a whole. Stillbirth remains a Global major problem responsible for nearly three million deaths.Study objectives: To estimate the stillbirth rate (SBR) in Sana’a, Yemen and to identify potential risk factors for stillbirth.Methods: A community-based prospective cohort study was carried out between 8/2015 and 12/2016. Nine-hundred and eighty pregnant women were identified for the outcome of their pregnancy. We employed binomial regression together with generalised linear models.Results: The study included 952 pregnant women with 44 stillbirths. The stillbirth rate was 46.2 per 1000 and 45.2 per 1000. In multivariable analysis teenage mothers’ age at first childbirth (< 20 years) (RR 3.70), women with anemia (RR=2.23), smoking snuff (RR = 4.27), prolonged labour (> 24 hours) (RR = 2.02), prolonged rupture of membranes (≥ 24 hours) (RR = 2.22), foetal malposition (RR = 4.60), low birth weight (RR = 14.90) and foetal gestational age (weeks) (RR = 5.60) were significant factors associated with increased risk of stillbirths. Conclusions: This study identiﬁed many risk factors of stillbirth that are amenable to intervention. Encouraging women to deliver at health facilities, providing better management of obstetrical complications, proper antenatal care, and prompt referral services are essential for reduction of stillbirths in Yemen.

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“…Summary of the reviewed 81 published cohort studies according to the measured six exposure and two outcome domainsSociodemographic exposuresMaternal age was a common measured sociodemographic exposure studied in 18 cohort studies. Advanced maternal age was associated with GDM, CS, and preterm delivery[51,53,58,92,111,113]. Primary education or less was independently associated with 69% lower likelihood of exclusive breastfeeding at 6 months (aOR, 0.31; 95% CI, 0.11-0.88)[58] (see Additional file 3:Table S2).…”

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confidence: 99%

“…,43-50, 56, 57, 62-72, 79, 80, 82-98, 105-112], followed by eight (9.9%) in Kuwait[20,21,24,41,51,73,81,99], seven (8.6%) in each of Qatar[42,52,53,60,61,74,113] and the UAE[58, 59, 75-77, 100, 101], six (7.4%) in Oman…”

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confidence: 99%

Maternal and birth cohort studies in the Gulf Cooperation Council countries: a systematic review and meta-analysis

et al. 2020

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Background: We systematically reviewed and chronicled exposures and outcomes measured in the maternal and birth cohort studies in the Gulf Cooperation Council (GCC) countries and quantitatively summarized the weighted effect estimates between maternal obesity and (1) cesarean section (CS) and (2) fetal macrosomia. Methods: We searched MEDLINE-PubMed, Embase, Cochrane Library, Scopus, and Web of Science electronic databases up to 30 June 2019. We considered all maternal and birth cohort studies conducted in the six GCC countries (Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and United Arab Emirates (UAE)). We categorized cohort studies on the basis of the exposure(s) (anthropometric, environmental, medical, maternal/reproductive, perinatal, or socioeconomic) and outcome(s) (maternal or birth) being measured. Adjusted weighted effect estimates, in the form of relative risks, between maternal obesity and CS and fetal macrosomia were generated using a randomeffects model. Results: Of 3502 citations, 81 published cohort studies were included. One cohort study was in Bahrain, eight in Kuwait, seven in Qatar, six in Oman, 52 in Saudi Arabia, and seven in the UAE. Majority of the exposures studied were maternal/reproductive (65.2%) or medical (39.5%). Birth and maternal outcomes were reported in 82.7% and in 74.1% of the cohort studies, respectively. In Saudi Arabia, babies born to obese women were at a higher risk of macrosomia (adjusted relative risk (aRR), 1.15; 95% confidence interval (CI), 1.10-1.20; I 2 = 50%) or cesarean section (aRR, 1.21; 95% CI, 1.15-1.26; I 2 = 62.0%). Several cohort studies were only descriptive without reporting the magnitude of the effect estimate between the assessed exposures and outcomes. Conclusions: Cohort studies in the GCC have predominantly focused on reproductive and medical exposures. Obese pregnant women are at an increased risk of undergoing CS delivery or macrosomic births. Longer-term studies that explore a wider range of environmental and biological exposures and outcomes relevant to the GCC region are needed. Systematic review registration: PROSPERO CRD42017068910

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Birth Outcomes in a Prospective Pregnancy–Birth Cohort Study of Environmental Risk Factors in Kuwait: The TRACER Study

Cited by 13 publications

References 36 publications

Pre-pregnancy BMI, gestational weight gain and birth outcomes in Lebanon and Qatar: Results of the MINA cohort

Pre-pregnancy BMI, gestational weight gain and birth outcomes in Lebanon and Qatar: Results of the MINA cohort

Maternal, Foetal and Service-Related Risk Factors for Stillbirths During Conflict Situation, Yemen, 2015-2016

Maternal and birth cohort studies in the Gulf Cooperation Council countries: a systematic review and meta-analysis

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