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791: The association between environmental factors and spontaneous (but not induced) preterm delivery
Poster Session V
ajog.org 790 Morbidity and mortality associated with breast cancer diagnosis in pregnancy: a retrospective cohort study
Edward Kent1, Margaret Gorman2, Kaebah Orme-Evans3, Aaron Caughey4 1
Women & Infants Hospital/Brown University, Obstetrics and Gynecology, Providence, RI, 2Virginia Tech Carilion School of Medicine, Obstetrics and Gynecology, Roanoke, VA, 3University of North Carolina, Obstetrics and Gynecology, Chapel Hill, NC, 4Oregon Health & Science University, Obstetrics & Gynecology, Portland, OR
OBJECTIVE: The goal of this study is to identify associated morbidities
and mortality in the neonate and mother when breast cancer is diagnosed during pregnancy. STUDY DESIGN: This is a retrospective cohort study including 2,250,129 pregnant women from the 2005-2008 California Birth Registry of which there were 131 cases of breast cancer diagnosed. Outcomes recorded include preterm delivery, severe preterm delivery (<32wks), intrauterine fetal demise, neonatal death, preterm fetal death, macrosomia, low birth weight, small for gestational age, nulliparous cesarean section, induction of labor, average birth weight, necrotizing enterocolitis, respiratory distress syndrome, intraventricular hemorrhage, jaundice, hypoglycemia, and transient tachypnea of the newborn. Chi squared tests and t-tests were used for statistical analysis. RESULTS: Women diagnosed with breast cancer are more likely to have augmentation of labor with a c-section rate of 42.11% vs. 29.44% and induction of labor of 33.33% vs. 14.27% (p<0.05), additionally their newborns were more likely to be born prematurely (42.11% vs. 8.91%), severely premature (6.14% vs. 1.61%), with low birth weight (25.44% vs. 5.02%), and small for gestational age (19.7% vs. 10.7%). Interestingly, intrauterine fetal demise, neonatal death, and preterm fetal death all combined for a total of one death, which was not of significance. Severe neonatal morbidity such as NEC and IVH were not significant with zero cases, whereas breast cancer was associated with mild neonatal morbidities such as RDS (7.02% vs. 0.86%), jaundice (34.21% vs. 15.26%), hypoglycemia (2.63% vs. 0.75%), and transient tachypnea of the newborn (6.14% vs. 2.07%). CONCLUSION: Breast cancer diagnosed during pregnancy has a significant impact on morbidities associated with preterm birth and augmentation of labor, but has no significant effect on fetal or neonatal severe morbidity or mortality.
791 The association between environmental factors and spontaneous (but not induced) preterm delivery Eli Kabakov2, Eyal Sheiner1, Michael Friger2
1 Soroka University Medical Center, Department of Obstetrics and Gynecology, Be’er Sheva, Israel, 2Ben Gurion University of the Negev, Department of Epidemiology and Health Services Evaluation, Be’er Sheva, Israel
OBJECTIVE: Controversy exists regarding the association between seasonality and outdoor temperature and preterm delivery (PTD). The study was aimed to identify seasonality, temporal variation and the effect of heat stress on the incidence of spontaneous PTD. STUDY DESIGN: A retrospective ecological study was performed including all deliveries during the years 1988 and 2011. Preterm delivery was defined as birth before 37 completed weeks of gestation. A time series database was built which included meteorological factors and the number of spontaneous vs. induced PTDs for each day. Data were analyzed using classical methods of time-series analysis, based on generalized linear models. RESULTS: During the study period, 263,709 deliveries occurred, of which 7.9% were preterm (n¼20,825). A significant annual and seasonal variation was noted in the incidence of PTD (Table). A significant higher incidence of spontaneous PTD was demonstrated during the summer period with an incidence rate ratio (IRR) of 4.1 (95% CI 3.1 -5.5; P<0.001). This trend was not significant for induced PTD (IRR¼1.01, 95% CI 0.7 - 1.4; P¼0.833). A significant linear association was noted between the heat-stress index and the rates of spontaneous (IRR¼1.07, 95% CI 1.05 - 1.10; P<0.001) but not induced PTDs (IRR¼0.99, 95% CI 0.97 - 1.01;P¼0.699). CONCLUSION: Spontaneous PTD is more common during the summer period. Increased outdoor temperature has a significant effect on the incidence of spontaneous (but not on induced) PTD. These findings strengthen the association between environmental factors and spontaneous PTD.
Results of trend-harmonic analysis for daily incidence of preterm deliveries
*Adjusted for trend.
792 EPA- and DHA-rich fish oil supplementation augments maternal and cord blood resolvin pathway markers: a mothers, omega-3, & mental health study secondary analysis
Ellen Mozurkewich1, Matthew Greenwood2, Vivian Romero3, Deborah Berman4, Zora Djuric5, Clifford Qualls6, Karsten Gronert2 1
University of New Mexico, Obstetrics & Gynecology, Albuquerque, NM, University of California Berkeley, Optometry, Berkeley, CA, 3Michigan State University, Obstetrics and Gynecology, Grand Rapids, MI, 4University of Michigan, Obstetrics and Gynecology, Ann Arbor, MI, 5University of Michigan, Family Medicine, Ann Arbor, MI, 6University of New Mexico, Clinical and Translational Sciences Center, Albuquerque, NM 2
OBJECTIVE: Docosahexaenoic acid (DHA) is metabolic precursor to
inflammation-resolving mediators termed resolvins and protections. The presence of an intermediary, 17-HDHA, a DHA-derived resolvin pathway marker (RPM), is presumtive evidence for resolvin and protectin formation in vivo. We performed this study to investigate whether prenatal supplementation with EPA- and DHA-rich fish oil
Supplement to JANUARY 2015 American Journal of Obstetrics & Gynecology
S383
ajog.org 790 Morbidity and mortality associated with breast cancer diagnosis in pregnancy: a retrospective cohort study
Edward Kent1, Margaret Gorman2, Kaebah Orme-Evans3, Aaron Caughey4 1
Women & Infants Hospital/Brown University, Obstetrics and Gynecology, Providence, RI, 2Virginia Tech Carilion School of Medicine, Obstetrics and Gynecology, Roanoke, VA, 3University of North Carolina, Obstetrics and Gynecology, Chapel Hill, NC, 4Oregon Health & Science University, Obstetrics & Gynecology, Portland, OR
OBJECTIVE: The goal of this study is to identify associated morbidities
and mortality in the neonate and mother when breast cancer is diagnosed during pregnancy. STUDY DESIGN: This is a retrospective cohort study including 2,250,129 pregnant women from the 2005-2008 California Birth Registry of which there were 131 cases of breast cancer diagnosed. Outcomes recorded include preterm delivery, severe preterm delivery (<32wks), intrauterine fetal demise, neonatal death, preterm fetal death, macrosomia, low birth weight, small for gestational age, nulliparous cesarean section, induction of labor, average birth weight, necrotizing enterocolitis, respiratory distress syndrome, intraventricular hemorrhage, jaundice, hypoglycemia, and transient tachypnea of the newborn. Chi squared tests and t-tests were used for statistical analysis. RESULTS: Women diagnosed with breast cancer are more likely to have augmentation of labor with a c-section rate of 42.11% vs. 29.44% and induction of labor of 33.33% vs. 14.27% (p<0.05), additionally their newborns were more likely to be born prematurely (42.11% vs. 8.91%), severely premature (6.14% vs. 1.61%), with low birth weight (25.44% vs. 5.02%), and small for gestational age (19.7% vs. 10.7%). Interestingly, intrauterine fetal demise, neonatal death, and preterm fetal death all combined for a total of one death, which was not of significance. Severe neonatal morbidity such as NEC and IVH were not significant with zero cases, whereas breast cancer was associated with mild neonatal morbidities such as RDS (7.02% vs. 0.86%), jaundice (34.21% vs. 15.26%), hypoglycemia (2.63% vs. 0.75%), and transient tachypnea of the newborn (6.14% vs. 2.07%). CONCLUSION: Breast cancer diagnosed during pregnancy has a significant impact on morbidities associated with preterm birth and augmentation of labor, but has no significant effect on fetal or neonatal severe morbidity or mortality.
791 The association between environmental factors and spontaneous (but not induced) preterm delivery Eli Kabakov2, Eyal Sheiner1, Michael Friger2
1 Soroka University Medical Center, Department of Obstetrics and Gynecology, Be’er Sheva, Israel, 2Ben Gurion University of the Negev, Department of Epidemiology and Health Services Evaluation, Be’er Sheva, Israel
OBJECTIVE: Controversy exists regarding the association between seasonality and outdoor temperature and preterm delivery (PTD). The study was aimed to identify seasonality, temporal variation and the effect of heat stress on the incidence of spontaneous PTD. STUDY DESIGN: A retrospective ecological study was performed including all deliveries during the years 1988 and 2011. Preterm delivery was defined as birth before 37 completed weeks of gestation. A time series database was built which included meteorological factors and the number of spontaneous vs. induced PTDs for each day. Data were analyzed using classical methods of time-series analysis, based on generalized linear models. RESULTS: During the study period, 263,709 deliveries occurred, of which 7.9% were preterm (n¼20,825). A significant annual and seasonal variation was noted in the incidence of PTD (Table). A significant higher incidence of spontaneous PTD was demonstrated during the summer period with an incidence rate ratio (IRR) of 4.1 (95% CI 3.1 -5.5; P<0.001). This trend was not significant for induced PTD (IRR¼1.01, 95% CI 0.7 - 1.4; P¼0.833). A significant linear association was noted between the heat-stress index and the rates of spontaneous (IRR¼1.07, 95% CI 1.05 - 1.10; P<0.001) but not induced PTDs (IRR¼0.99, 95% CI 0.97 - 1.01;P¼0.699). CONCLUSION: Spontaneous PTD is more common during the summer period. Increased outdoor temperature has a significant effect on the incidence of spontaneous (but not on induced) PTD. These findings strengthen the association between environmental factors and spontaneous PTD.
Results of trend-harmonic analysis for daily incidence of preterm deliveries
*Adjusted for trend.
792 EPA- and DHA-rich fish oil supplementation augments maternal and cord blood resolvin pathway markers: a mothers, omega-3, & mental health study secondary analysis
Ellen Mozurkewich1, Matthew Greenwood2, Vivian Romero3, Deborah Berman4, Zora Djuric5, Clifford Qualls6, Karsten Gronert2 1
University of New Mexico, Obstetrics & Gynecology, Albuquerque, NM, University of California Berkeley, Optometry, Berkeley, CA, 3Michigan State University, Obstetrics and Gynecology, Grand Rapids, MI, 4University of Michigan, Obstetrics and Gynecology, Ann Arbor, MI, 5University of Michigan, Family Medicine, Ann Arbor, MI, 6University of New Mexico, Clinical and Translational Sciences Center, Albuquerque, NM 2
OBJECTIVE: Docosahexaenoic acid (DHA) is metabolic precursor to
inflammation-resolving mediators termed resolvins and protections. The presence of an intermediary, 17-HDHA, a DHA-derived resolvin pathway marker (RPM), is presumtive evidence for resolvin and protectin formation in vivo. We performed this study to investigate whether prenatal supplementation with EPA- and DHA-rich fish oil
Supplement to JANUARY 2015 American Journal of Obstetrics & Gynecology
S383