Incidence, risk factors, and feto-maternal outcomes of inappropriate birth weight for gestational age among singleton live births in Qatar : a population-based study

Background Abnormal fetal growth can be associated with factors during pregnancy and at postpartum. Objective In this study, we aimed to assess the incidence, risk factors, and feto-maternal outcomes associated with small-for-gestational age (SGA) and large-for-gestational age (LGA) infants. Methods We performed a population-based retrospective study on 14,641 singleton live births registered in the PEARL-Peristat Study between April 2017 and March 2018 in Qatar. We estimated the incidence and examined the risk factors and outcomes using univariate and multivariate analysis. Results SGA and LGA incidence rates were 6.0% and 15.6%, respectively. In-hospital mortality among SGA and LGA infants was 2.5% and 0.3%, respectively, while for NICU admission or death in labor room and operation theatre was 28.9% and 14.9% respectively. Preterm babies were more likely to be born SGA (aRR, 2.31; 95% CI, 1.45–3.57) but male infants (aRR, 0.57; 95% CI, 0.4–0.81), those born to parous (aRR 0.66; 95% CI, 0.45–0.93), or overweight (aRR, 0.64; 95% CI, 0.42–0.97) mothers were less likely to be born SGA. On the other hand, males (aRR, 1.82; 95% CI, 1.49–2.19), infants born to parous mothers (aRR 2.16; 95% CI, 1.63–2.82), or to mothers with gestational diabetes mellitus (aRR 1.36; 95% CI, 1.11–1.66), or pre-gestational diabetes mellitus (aRR 2.58; 95% CI, 1.8–3.47) were significantly more likely to be LGA. SGA infants were at high risk of in-hospital mortality (aRR, 226.56; 95% CI, 3.47–318.22), neonatal intensive care unit admission or death in labor room or operation theatre (aRR, 2.14 (1.36–3.22). Conclusion Monitoring should be coordinated to alleviate the risks of inappropriate fetal growth and the associated adverse consequences.The PEARL-Peristat study was funded by Qatar National Research Fund (Grant no NPRP 6-238-3-059) and was sponsored by the Medical Research Centre, Hamad Medical Corporation. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript

Incidence, Risk Factors, and Outcomes of Preterm and Early Term Births: A Population-Based Register Study

Preterm birth (PTB) and early term birth (ETB) are associated with high risks of perinatal mortality and morbidity. While extreme to very PTBs have been extensively studied, studies on infants born at later stages of pregnancy, particularly late PTBs and ETBs, are lacking. In this study, we aimed to assess the incidence, risk factors, and feto-maternal outcomes of PTB and ETB births in Qatar. We examined 15,865 singleton live births using 12-month retrospective registry data from the PEARL-Peristat Study. PTB and ETB incidence rates were 8.8% and 33.7%, respectively. PTB and ETB in-hospital mortality rates were 16.9% and 0.2%, respectively. Advanced maternal age, pre-gestational diabetes mellitus (PGDM), assisted pregnancies, and preterm history independently predicted both PTB and ETB, whereas chromosomal and congenital abnormalities were found to be independent predictors of PTB but not ETB. All groups of PTB and ETB were significantly associated with low birth weight (LBW), large for gestational age (LGA) births, caesarean delivery, and neonatal intensive care unit (NICU)/or death of neonate in labor room (LR)/operation theatre (OT). On the other hand, all or some groups of PTB were significantly associated with small for gestational age (SGA) births, Apgar <7 at 1 and 5 minutes and in-hospital mortality. The findings of this study may serve as a basis for taking better clinical decisions with accurate assessment of risk factors, complications, and predictions of PTB and ETB.The study was approved by the Hamad Medical Corporation Institutional Review Board, with a waiver of consent. It was funded by Qatar National Research Fund (Grant no NPRP 6-238-3-059) and was sponsored by the Medical Research Centre, Hamad Medical Corporation. The authors want to thank their respective institutions for their continued support. The publication of this article is funded by the Qatar National Library, Doha, Qatar

Prevalence, predictors, and outcomes of major congenital anomalies : a population-based register study

Congenital anomalies (CAs) are a leading cause of morbidity and mortality in early life. We aimed to assess the incidence, risk factors, and outcomes of major CAs in the State of Qatar. A population-based retrospective data analysis of registry data retrieved from the Perinatal Neonatal Outcomes Research Study in the Arabian Gulf (PEARL-Peristat Study) between April 2017 and March 2018. The sample included 25,204 newborn records, which were audited between April 2017 and March 2018, of which 25,073 live births were identified and included in the study. Maternal risk factors and neonatal outcomes were assessed for association with specific CAs, including chromosomal/genetic, central nervous system (CNS), cardiovascular system (CVS), facial, renal, multiple congenital anomalies (MCAs) using univariate and multivariate analyses. The incidence of any CA among live births was 1.3% (n = 332). The most common CAs were CVS (n = 117; 35%), MCAs (n = 69, 21%), chromosomal/genetic (51; 15%), renal (n = 39; 12%), CNS (n = 20; 6%), facial (14, 4%), and other (GIT, Resp, Urogenital, Skeletal) (n = 22, 7%) anomalies. Multivariable regression analysis showed that multiple pregnancies, parity ≥ 1, maternal BMI, and demographic factors (mother’s age and ethnicity, and infant’s gender) were associated with various specific CAs. In-hospital mortality rate due to CAs was estimated to be 15.4%. CAs were significantly associated with high rates of caesarean deliveries (aOR 1.51; 95% CI 1.04–2.19), Apgar < 7 at 1 min (aOR 5.44; 95% CI 3.10–9.55), Apgar < 7 at 5 min (aOR 17.26; 95% CI 6.31–47.18), in-hospital mortality (aOR 76.16; 37.96–152.8), admission to neonatal intensive care unit (NICU) or perinatal death of neonate in labor room (LR)/operation theatre (OT) (aOR 34.03; 95% CI 20.51–56.46), prematurity (aOR 4.17; 95% CI 2.75–6.32), and low birth weight (aOR 5.88; 95% CI 3.92–8.82) before and after adjustment for the significant risk factors. This is the first study to assess the incidence, maternal risk factors, and neonatal outcomes associated with CAs in the state of Qatar. Therefore, a specialized congenital anomaly data registry is needed to identify risk factors and outcomes. In addition, counselling of mothers and their families may help to identify specific needs for pregnant women and their babies.Open Access funding provided by the Qatar National Library. The PEARL-Peristat study was funded by Qatar National Research Fund (Grant no NPRP 6-238-3-059) and was sponsored by the Medical Research Centre, Hamad Medical Corporation.Scopu

Perinatal outcomes in women with class IV obesity compared to women in the normal or overweight body mass index categories: A population‐based cohort study in Qatar

Abstract Background The prevalence of childhood and adult obesity is rising exponentially worldwide. Class IV obesity (body mass index, BMI ≥50 kg/m2) is associated with a higher risk of adverse perinatal outcomes. This study compared these outcomes between women with class IV obesity and women in the normal or overweight categories during pregnancy. Methods A retrospective cohort study was performed in Qatar, including women having singleton live births beyond 24 weeks of gestation, classified into two class IV obesity and normal/overweight (BMI between 18.5 and 30.0 kg/m2). The outcome measures included the mode of delivery, development of gestational diabetes and hypertension, fetal macrosomia, small for date baby, preterm birth and neonatal morbidity. Adjusted odds ratios (aOR) with 95% confidence intervals (95% CI) were determined using multivariable logistic regression models. Results A total of 247 women with class IV obesity were compared with 6797 normal/overweight women. Adjusted analysis showed that women with class IV obesity had 3.2 times higher odds of cesarean delivery (aOR: 3.19, CI: 2.26–4.50), 3.4 times higher odds of gestational diabetes (aOR: 3.39, CI: 2.55–4.50), 4.2 times higher odds of gestational hypertension (aOR: 4.18, CI: 2.45–7.13) and neonatal morbidity (aOR: 4.27, CI: 3.01–6.05), and 6.5 times higher odds of macrosomia (aOR 6.48, CI 4.22–9.99). Conclusions Class IV obesity is associated with more adverse perinatal outcomes compared with the normal or overweight BMI categories. The study results emphasized the need for specialized antenatal obesity clinics to address the associated risks and reduce complications

Maternal and Neonatal Outcomes Post Bariatric Surgery: A Population-Based Study

Objectives  This study had two primary objectives. First, to evaluate the incidence, risk factors, and maternal and neonatal outcomes among pregnant women post-BS (the exposed group). Second, to evaluate these outcomes among pregnant women without a history of BS, these include women who are obese, overweight, and with normal weight (non-exposed groups). Design This population-based study was conducted using 12-month retrospective registry data from the PEARL-Peristat Study at the Women's Wellness and Research Center (WWRC) in Qatar. Methods: We examined 6,212 parturient women and their offspring. Participants were classified into exposed (post-BS) (N=315) and non-exposed (N=5897). Statistical analysis was conducted using SPSS 28 software. We analyzed the risk factors and outcomes using univariate and multivariable regression. Results were reported as odds ratios (cOR) and adjusted aOR with 95% confidence intervals (CI), while incidences were reported as percentages. P value was regarded as significant at Results Qatari, advanced maternal age, Parity >1, diabetes, and hypertension were found to be significant risk factors for women with post-BS. In addition, women in the post-BS group were found to be significantly more likely to have a cesarean delivery (37.5% vs. 24%, aOR=1.59, CI 1.18-2.14), preterm babies (10% vs. 7%, aOR=1.66, CI 1.06-2.59), and stillbirth (1.6% vs. 0.4%, aOR=4.53, CI 1.33-15.50) compared to the normal weight women group. Moreover, post-BS women had a higher risk of low-birth-weight neonates than obese (15% vs. 8%, aOR= 1.77, CI 1.153-2.73), overweight (15% vs. 7%, aOR=1.63, CI:1.09-2.43), and normal weight (15% vs. 8%, aOR=1.838, CI 1.23-2.75) women. Finally, women in the post-BS group were more likely to have low-birth weight neonates ( In contrast, post-BS had a lower risk of gestational diabetes than obese (19% vs. 40%, aOR=0.39, CI: 0.29-0.54) overweight (19% vs. 32%, aOR= 0.57, CI 0.42-0.79) women. Similarly, compared to the overweight group, post-BS had a lower incidence and risk of assisted birth (4% vs. 9%, aOR=0.46, CI 0.21-0.99). On the other hand, obesity significantly increased the risk of gestational diabetes, cesarean deliveries, and labor induction in comparison to the other groups. Conclusion  Pregnancies with post-BS should be considered a high-risk group for some outcomes and should be monitored closely. These findings may guide the future clinical decisions of antenatal and postnatal follow-up for post-BS women. </p