Recurrent Risk of Adverse Pregnancy Outcome
Section snippets
Gestational diabetes
GDM is glucose intolerance with onset or first recognition during pregnancy. Between 2% and 5% of all pregnancies are complicated by GDM. Current thinking is that GDM and Type 2 diabetes are the same disease. The two diseases share common risk factors and both are characterized by insulin resistance [1], [2], [3], [4].
The recurrence rate of GDM is between 35% and 75%. Risk factors for recurrence include high prepregnancy body mass index (BMI), birth weight greater than or equal to 4 kg in
Preterm delivery
Preterm delivery is delivery occurring before 37 weeks gestation. Very early preterm delivery (<34 weeks) is associated with significant neonatal morbidity and mortality [12].
The incidence of preterm delivery is estimated between 7% and 12% of all deliveries. One third of all preterm births occur before 34 weeks [13], [14]. The cause of preterm delivery is multifactorial and medical and social factors overlap.
Stillbirth
Stillbirth is defined as the birth of a nonliving fetus after 20 weeks gestation. If gestational age is unknown a birth weight of 500 g or more constitutes a stillbirth.
The rate of stillbirth in the United States is approximately 6.4 per 1000 births [31], [32]. Thirty percent of stillbirths can be attributed to abnormalities of the placenta, umbilical cord, or fetal membranes. Ten percent are caused by underlying maternal disease. Twenty-five percent are from fetal causes, such as aneuploidy,
Preeclampsia
Preeclampsia affects between 5% and 7% of all pregnancies and is responsible for 7% to 15% of maternal mortality [43], [44]. Neonatal outcomes are directly related to iatrogenic prematurity, although uteroplacental insufficiency may also be associated with the disease.
The cause of preeclampsia is unknown. It is unique to human pregnancy and the only known cure is cessation of pregnancy, although temporizing measures are often undertaken. The rate of recurrence is cited between 0% and 60% [45],
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Request and fulfillment of postpartum tubal ligation in patients after high-risk pregnancy
2017, ContraceptionCitation Excerpt :The consequences of subsequent undesired pregnancies may be even more grave for women who have had prior high-risk pregnancies due to medical or obstetric factors. For women with prior obstetric problems such as gestational diabetes or preeclampsia, recurrence risks range from 35% to 75% and from 7% to 65%, respectively, putting them at increased risk for maternal and fetal morbidity and mortality [7,8]. Similarly, those with preexisting medical conditions such as hypertension or thrombophilia also face risks of maternal and fetal complications during subsequent pregnancies.
Placental expression of VEGF is increased in pregnancies with hydatidiform mole: Possible association with developing very early onset preeclampsia
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The role of prenatal care in recurrent preterm birth
2011, European Journal of Obstetrics and Gynecology and Reproductive BiologyCitation Excerpt :Rising rates of preterm delivery worldwide and the failure of prevention programs are a growing concern in contemporary obstetrics [1–3] as preterm delivery continues to be a major risk factor for neonatal morbidity and mortality [3–8].
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