Development of a birthweight standard and comparison with currently used standards. What is a 10th centile?

Sousa-Santos, Ricardo; Miguelote, Rui; Cruz‐Correia, Ricardo; Santos, Cristina; Bernardes, João

doi:10.1016/j.ejogrb.2016.09.028

Cited by 21 publications

(10 citation statements)

References 22 publications

(41 reference statements)

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“…Neonatal hypoglycemia was established according to the consensus of the Portuguese Society of Pediatrics – Neonatology Section ( 20 ). Small for gestational age (SGA) and LGA were classified according to Portuguese birthweight charts as a birth weight of less than 10th percentile and greater than 90th percentile for GA, respectively ( 21 ).…”

Section: Methodsmentioning

confidence: 99%

Predictors of metformin monotherapy failure in gestational diabetes mellitus

Silva

Fonseca

Pereira

et al. 2022

Endocrine Connections

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Objective: Metformin has emerged as a safe and effective pharmacological alternative to insulin in gestational diabetes mellitus (GDM), being associated with lower maternal weight gain and hypoglycemia risk. Nevertheless, glycemic control is unaccomplished in a considerable proportion of women only treated with metformin. We aim to determine the metformin monotherapy failure rate in GDM and to identify predictors of its occurrence. Design and Methods: This was a retrospective multicenter study including pregnant women with GDM patients who started metformin as a first line pharmacological treatment (n=2891). A comparative analysis of clinical and analytical data between the group of women treated with metformin monotherapy and those needing combined therapy with insulin was performed. Results: In 685 (23.7%) women with GDM, it was required combined therapy to achieve adequate glycemic control. Higher pregestational BMI (OR 1.039; CI95% 1.008-1.071; p-value=0.013), higher fasting PG levels in OGTT (OR 1.047; CI 95% 1.028-1.066; p-value<0.001) and an earlier GA at metformin introduction (0.839; CI 95% 0.796-0.885, p-value#60;0.001) were independent predictive factors for metformin monotherapy failure. The best predictive cutoff values were a fasting PG in OGTT ≥87 mg/dL and GA at metformin introduction ≤29 weeks. Conclusions: In 685 (23.7%) women it was required combined therapy with insulin to reach glycemic control. Higher pre-gestational BMI, fasting PG levels in OGTT ≥87 mg/dL and introduction of metformin ≤29 weeks of GA were independent predictive factors for metformin monotherapy failure. The early recognition of these characteristics can contribute to the establishment of individualized therapeutic strategies and attain better metabolic control during pregnancy.

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Section: Methodsmentioning

confidence: 99%

Predictors of metformin monotherapy failure in gestational diabetes mellitus

Silva

Fonseca

Pereira

et al. 2022

Endocrine Connections

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“…FGR was defined as a birth weight below the 10th percentile, using the Portuguese population’s curves. 15…”

Section: Methodsmentioning

confidence: 99%

“…FGR was defined as a birth weight below the 10th percentile, using the Portuguese population's curves. 15 Preeclampsia was defined using the American College of Obstetricians and Gynecologists Committee (ACOG) criteria (2020) as a systolic blood pressure ≥140 mmHg and/or a diastolic blood pressure ≥90 mmHg on two occasions at least 4 h apart after 20 weeks of gestation in a woman with previously normal blood pressure and proteinuria (defined as urinary excretion of 300 mg or more in a 24-h urine collection or protein/creatinine ratio ≥0.3 mg/dL or dipstick reading of 2+). Alternatively, in the absence of proteinuria, preeclampsia is defined as new-onset hypertension with the new onset of target organ damage (platelet count less than 100,000 × 10 9 /L, serum creatinine concentration greater than 1.1 mg/dL or doubling of the serum creatinine concentration in the absence of other renal diseases, elevated blood concentrations of liver transaminases to twice the upper limit of normal concentration, severe persistent right upper quadrant or epigastric pain and not accounted for by alternative diagnoses, and pulmonary edema or new-onset headache unresponsive to acetaminophen and not accounted for by alternative diagnoses or visual disturbances).…”

Section: Obstetric and Fetal Outcomesmentioning

confidence: 99%

Systemic lupus erythematosus and pregnancy: A retrospective single-center study of 215 pregnancies from Portugal

Braga

Barros

Faria

et al. 2021

Lupus

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Objective Systemic lupus erythematosus (SLE) is a life-threatening disorder that affects women at reproductive age. We evaluate the clinical impact of pregnancy in a cohort of Portuguese SLE patients and the risk factors associated with maternal and fetal adverse outcomes. Methods A retrospective observational study that included all pregnant women with SLE managed at a Portuguese tertiary hospital, between January 1993 and December 2019. Baseline maternal information was collected, and maternal–fetal and neonatal outcomes were evaluated. Disease activity before and during pregnancy was assessed. Results We included 215 pregnancies from 143 patients. Lupus nephritis was present in 20.0% and antiphospholipid syndrome (APS) in 21.9% of the cases. Preconception consultation was performed in 86.9% of the pregnancies, and 92.5% of the patients had no or low disease activity at conception. During gestation, 79.6% of the patients were under treatment, and hydroxychloroquine (HCQ) was the most commonly used drug (63.7%). Low-dose acetylsalicylic acid (ASA) was prescribed at conception in 87.9% of the patients. The live birth rate was 84.2%. An adverse pregnancy outcome (APO) occurred in 41.4% of the pregnancies. A miscarriage rate of 15.3% and a preterm delivery rate of 15.4% were found. Preeclampsia and fetal growth restriction complicated 13.1% and 14.0% of the gestations, respectively. Neonatal lupus occurred in 7.1% of the newborns, and there were 2 cases of congenital heart block. Significant risk factors for the development of AOP were disease activity at conception, lupus flare, hypocomplementemia, positivity for lupus anticoagulant, and APS. The use of ASA was significantly associated with a reduced incidence of miscarriage. An SLE flare was diagnosed in 16.3% of the cases. We identified as risk factors for lupus flares the presence of active disease at conception, a previous history of lupus nephritis, and the use of chronic medication. HCQ use during pregnancy was associated with a significant reduction of flare incidence during pregnancy and postpartum. Conclusions Pregnancy in an SLE patient is associated with an increased incidence of adverse obstetric outcomes. Good disease control before pregnancy and adequate treatment, especially with HCQ, is crucial to achieving the best obstetric results.

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“…Birth weight was classified using INTERGROWTH-21 st and Birthweight standard for the Portuguese population calculator. 24,25 Continuous variables were expressed as means, standard deviation and range and categorical variables were shown as numbers and percentages. We compared continuous data by using two-tailed Student's t-test, and categorical data by Fisher's exact test.…”

Section: Methodsmentioning

confidence: 99%

One Year of COVID-19 in Pregnancy: A National Wide Collaborative Study

et al. 2022

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Introduction: Even though the risk of COVID-19 in pregnancy may be increased, large-scale studies are needed to better understand the impact of the infection in this population. The aim of this study is to describe obstetric complications and the rate of vertical transmission in pregnant women with SARS-CoV-2 infection.Material and Methods: Detected cases of SARS-CoV-2 infection in pregnancy were registered in Portuguese hospitals by obstetricians. Epidemiological, pregnancy and childbirth data were collected.Results: There were 630 positive cases in 23 Portuguese maternity hospitals, most at term (87.9%) and asymptomatic (62.9%). The most frequent maternal comorbidity was obesity. The rates of preterm birth and small-to-gestational-age were 12.1% and 9.9%, respectively. In the third trimester, 2.9% of pregnant women required respiratory support. There were eight cases (1.5%) of fetal death, including two cases of vertical transmission. There were five cases of postpartum respiratory degradation, but no maternal deaths were recorded. The caesarean section rate was higher in the first than in the second wave (68.5% vs 31.5%). RT-PCR SARS-CoV-2 positivity among newborns was 1.3%.Conclusion: SARS-Cov-2 infection in pregnancy may carry increased risks for both pregnant women and the fetuses. Individualized surveillance and the prophylaxis of this population with vaccination. is recommended in these cases.

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Development of a birthweight standard and comparison with currently used standards. What is a 10th centile?

Cited by 21 publications

References 22 publications

Predictors of metformin monotherapy failure in gestational diabetes mellitus

Predictors of metformin monotherapy failure in gestational diabetes mellitus

Systemic lupus erythematosus and pregnancy: A retrospective single-center study of 215 pregnancies from Portugal

One Year of COVID-19 in Pregnancy: A National Wide Collaborative Study

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