52 research outputs found
Rates of maternal complications of pregnancy are increased with asthma: a ten-year analysis
No full textAbstract F-043 for Poster session: Epidemiology (Friday, 3/23/2012, 9:00 AM - 11:00 AM)Nicolette A Hodyl, Wendy Scheil, Vicki L Clifto
Maternal asthma is a significant contributor to neonatal morbidity
No full textAbstract S-115 for Poster Session: Epidemiology (Friday, 3/23/2012, 9:00 AM - 11:00 AM)Nicolette A Hodyl, Wendy Scheil, Michael J Stark, Vicki L Clifto
Seasonality of hypertensive disorders of pregnancy - A South Australian population study
No full textAvailable online 11 April 2018Abstract not availablePetra E. Verburg, Gus A. Dekker, Graeme Tucker, Wendy Scheil, Jan Jaap H.M. Erwich, Claire T. Robert
A retrospective cohort review of intrahepatic cholestasis of pregnancy in a South Australian population
No full textAbstract not availableJessica A Marathe, Wei How Lim, Michael P Metz, Wendy Scheil, Gustaaf A Dekker, William M Hagu
The association between increasing maternal age at first birth and decreased rates of spontaneous vaginal birth in South Australia from 1991 to 2009
No full textArticle first published online: 8 FEB 2014BACKGROUND: Caesarean section rates in Australia rose over the period 1999-2009, as did maternal age at first birth. The contribution of the rise of maternal age to the rise in caesarean sections remains unclear. AIMS: To estimate the effect of increasing maternal age on the incidence of emergency caesarean section or instrumental delivery in term singleton first births in South Australia. METHODS: We undertook a population-based study of 117 981 term singleton first births, which followed labour during the period 1991-2009, using data from the South Australian Perinatal Statistics Collection. The main outcome measures were deliveries other than spontaneous vaginal births (SVB) (emergency caesarean section or instrumental birth) and emergency caesarean section alone. Logistic regression analysis was performed. RESULTS: Increasing maternal age at first birth was found to be associated with delivery other than SVB and emergency caesarean section. The adjusted odds of delivery other than SVB increased multiplicatively by approximately 1.49 (95% CI, 1.47-1.51) per five-year rise in maternal age, and the odds of emergency caesarean section increased multiplicatively by approximately 1.39 (95% CI, 1.37-1.42) per five-year rise. Although there are likely to be many reasons for the effect, increases in maternal age at first birth made a contribution in up to 75% of the observed increase in delivery other than SVB from 44.0% to 49.6% over the study period. CONCLUSIONS: Rising maternal age at first birth appeared to contribute to a large proportion of the increase in deliveries other than SVB in South Australia.Peter Baghurst, Stephen Robson, Georgia Antoniou, Wendy Scheil and Robert Bryc
Perinatal outcomes following maternal asthma and cigarette smoking during pregnancy
No full textPublished online before print July 30, 2013Does cigarette smoking in pregnancy explain the increased risk of adverse perinatal outcomes that occur with maternal asthma or does it compound the effect? Using population based birth records, a retrospective analysis was conducted of all singleton pregnancies in South Australia over 10 years (1999–2008; n=172 305), examining maternal asthma, cigarette smoking and quantity of smoking to estimate odds ratios. Compared with nonasthmatic females who did not smoke during pregnancy, both asthmatic females who smoked and those who did not smoke during pregnancy had a significantly increased risk of gestational diabetes, antepartum haemorrhage, polyhydramnios, premature rupture of membranes, emergency Caesarean section, and the child being small for gestational age and having congenital abnormalities. These associations suggest that asthma, independently of maternal smoking, increases the risk of these adverse perinatal outcomes. Maternal smoking was itself associated with an increased risk of a number of poor neonatal outcomes, with a dose–response relationship observed. Notably, maternal asthma combined with cigarette smoking significantly increased the risk of preterm birth and urinary tract infections to a greater degree than with either exposure alone. Maternal asthma and cigarette smoking during pregnancy are both independently associated with adverse perinatal outcomes and, combined, compound the risk of preterm birth and urinary tract infections.Nicolette A. Hodyl, Michael J. Stark, Wendy Scheil, Luke E. Grzeskowiak and Vicki L. Clifto
Pregnancy outcomes for nulliparous women of advanced maternal age in South Australia, 1998-2008
No full textBACKGROUND: Child bearing in the later reproductive years has become increasingly common in Australia with potential implications for clinical practice. AIM: To examine pregnancy outcomes for nulliparous women of advanced maternal age with singleton pregnancies. METHODS: A retrospective population-based cohort study was conducted to compare the pregnancy outcomes for women aged 35–39 years and >40 years with women aged 25–29 years, analysing 34 695 records from the South Australian Perinatal Database between 1998 and 2008. RESULTS: Pre-existing hypertension [relative risks (RR) 1.98 and 2.94 for women aged 35–39 years and >40 years, respectively], placenta praevia (RR 2.88 and 3.68), suspected intrauterine growth restriction (RR 1.33 and 1.77) and gestational diabetes (RR 1.97 and 2.53) increased with age. Women of advanced maternal age were more likely to have not laboured prior to birth (RR 2.19 and 3.28), be induced (RR 1.12 and 1.27) and have a breech presentation (RR 1.57 and 1.60). The likelihood of fetal distress increased with advancing maternal age (RR 1.15 and 1.24). Regression analyses revealed women of advanced maternal age were significantly more likely to have small for gestational age infants [adjusted odds ratios (AOR) 1.26 and 1.50], preterm birth (AOR 1.26 and 1.43), elective caesarean [relative risk ratios (RRR) 2.55 and 4.52], emergency caesarean (RRR 1.59 and 2.21) and experience a perinatal death (RRR 1.94 and 2.18). CONCLUSIONS: The likelihood of pre-existing medical conditions, obstetric complications, adverse labour and birth outcomes and complications increased with advancing maternal age. Advanced maternal age was also independently associated with selected adverse pregnancy and infant outcomes.Isobel Ludford, Wendy Scheil, Graeme Tucker and Rosalie Grivel
The impact of Aboriginal status, cigarette smoking and smoking cessation on perinatal outcomes in South Australia
No full textObjective: To assess the impact of Aboriginal status, active cigarette smoking and smoking cessation during pregnancy on perinatal outcomes. Design: Retrospective cohort study from 1 January 1999 to 31 December 2008. Setting: All singleton births in South Australia. Participants: Population-based birth records of pregnancies to Aboriginal women (n = 4245) and non-Aboriginal women (n = 167 746). Main outcome measures: Adjusted odds ratios (aORs) and 95% CIs for adverse maternal and neonatal outcomes according to Aboriginal status and maternal smoking in pregnancy. Results: Active cigarette smoking during pregnancy was associated with an increased risk of adverse perinatal outcomes, including premature labour (Aboriginal, 1-10 cigarettes per day: aOR, 1.69; 95% CI, 1.28-2.23; non-Aboriginal, 1-10 cigarettes per day: aOR, 1.46; 95% CI, 1.34-1.58), preterm birth (Aboriginal, 1-10 cigarettes per day: aOR, 1.40; 95% CI, 1.14-1.73; non-Aboriginal, 1-10 cigarettes per day: aOR, 1.48; 95% CI, 1.39-1.57), intrauterine growth restriction (Aboriginal, 1-10 cigarettes per day: aOR, 2.33; 95% CI, 1.77-3.08; non-Aboriginal, 1-10 cigarettes per day: aOR, 2.65; 95% CI, 2.48-2.83) and small for gestational age (Aboriginal, 1-10 cigarettes per day: aOR, 2.49; 95% CI, 2.06-3.00; non- Aboriginal, 1-10 cigarettes per day: aOR, 2.29; 95% CI, 2.20-2.40). For both Aboriginal and non-Aboriginal women who smoked 11 or more cigarettes per day the aOR for these outcomes increased. Smoking cessation in the fi rst trimester reduced these risks to levels comparable with non-smokers. The risk of each adverse outcome was greater in Aboriginal than non-Aboriginal women for all smoking categories; however, interactions between Aboriginal status and smoking were not signifi cant, indicating an equal contribution of smoking to poor outcomes in both populations. Conclusions: Smoking cessation or reduction during pregnancy would signifi cantly improve outcomes in both Aboriginal and non-Aboriginal women. This should be made a clear priority to improve pregnancy outcomes for all women.Nicolette A Hodyl, Luke E Grzeskowiak, Michael J Stark, Wendy Scheil, Vicki L Clifto
Anaemia of pregnancy, perinatal outcomes and children's developmental vulnerability: a whole-of-population study
No full textBACKGROUND: There is limited longitudinal data from high-income countries on the sequelae of anaemia during pregnancy. The aim of this study is to examine whether anaemia of pregnancy is associated with adverse perinatal outcomes and with children's developmental vulnerability. METHODS: We conducted a population-based study to link routinely collected government administrative data that involved all live births in the state of South Australia 1999-2005 (n = 124 061) and a subset for whom developmental data were collected during a national census of children attending their first year of school in 2009 (n = 13 654). Perinatal outcomes were recorded by midwives using a validated, standardised form. Development was recorded by schoolteachers using the Australian Early Development Index (AEDI). Children in the lowest 10% of AEDI scores are indicative of developmental vulnerability. RESULTS: There were 8764/124 061 (7.1%) cases of anaemia. After adjustment for a range of potentially confounding factors, anaemia of pregnancy was associated with a higher risk of fetal distress [incident rate ratio (IRR) 1.20 [95% CI 1.13, 1.27]] and preterm birth <37 weeks gestation (IRR 1.23 [1.15, 1.31]), slightly higher birthweight [14 g (2, 26)] and newborns were less likely to require resuscitation (IRR 0.94 [0.91, 0.097]). Anaemia of pregnancy was not associated with children's developmental vulnerability after adjustment for maternal, obstetric and sociodemographic covariables, either in complete case analyses (n = 11 949) or after imputation for missing data (n = 13 654). CONCLUSIONS: Anaemia of pregnancy is associated with perinatal complications but not with children's developmental vulnerability at school entry.Lisa G. Smithers, Angela Gialamas, Wendy Scheil, Sally Brinkman, John W. Lync
Increase in late diagnosed developmental dysplasia of the hip in South Australia: risk factors, proposed solutions
No full textObjectives: To review evidence for the increased incidence of late diagnosed developmental dysplasia of the hip (DDH) in South Australia; to identify perinatal risk factors associated with late DDH in babies born between 2003 and 2009 in SA. Design: Linkage study of data collected prospectively by the South Australian Birth Defects Register (SABDR) and the Pregnancy Outcome Statistics Unit (SA Department of Health), supplemented by medical records review. Participants: All children born 2003–2009 in whom DDH was diagnosed between 3 months and 5 years of age and notified to the SABDR (data inclusion range, 2003–2014). Children with teratological hip dislocations and other major congenital abnormalities were excluded. Main outcome measures: Uni- and multivariable analyses were performed to identify perinatal risk factors for late diagnosed DDH. Results: The incidence of late diagnosed DDH in babies born 2003–2009 was 0.77 per 1000 live births, contrasting with the figure of 0.22 per 1000 live births during 1988–2003. Significant perinatal risk factors were birth in a rural hospital (v metropolitan public hospital: odds ratio [OR], 2.47; CI, 1.37–4.46; P = 0.003), and being the second child (v being the first-born: OR, 1.69; CI, 1.08–2.66; P = 0.023). Breech presentation was highly significant as a protective factor when compared with cephalic presentation (OR, 0.25; CI, 0.12–0.54; P < 0.001). Conclusions: The incidence of late DDH has increased in SA despite an ongoing clinical screening program. Increased awareness, education, and avoidance of inappropriate lower limb swaddling are necessary to reverse this trend.Kathrin Studer, Nicole Williams, Georgia Antoniou, Catherine Gibson, Heather Scott, Wendy K Scheil, Bruce K Foster, Peter J Cund
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