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  • Author: Tomasz Hadada x
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The influence of selected risk factors on premature birth - statistical research

Abstract

For a very long time, scientists have been interested in preterm births, which are an extremely interesting object of research, and are worth investigating in context of a vast number of new clinical applications. A number of factors may contribute to the early termination of pregnancy, including groups related to the conditions of mother's organism. In this work, it was examined whether environmental, maternal and fetal factors could affect normal time of birth. Variables that were considered to influence the length of prenatal development were categorized as biological, describing the state of mother's health and pregnancy, and those describing the socio-economic status of parents. The research material was subjected to exploratory analysis. For categorized variables, numerical tables were constructed, and for quantitative variables the basic measures of position and variability were presented (mean, minimum, maximum, standard deviation, median, quartile distribution). To analyze the differences in the frequency distributions of the examined variables, the χ2 tests were used. To estimate the duration of the pregnancy of the tested mothers, the survival analysis (the product limit method - Kaplan-Meier method) was applied. The analysis showed a statistically significant effect on the duration of pregnancy and the nature of its course, indicating a shortening of pregnancy in the presence of risk factors (χ2=196,23; df = 4; p<0,001). The course of the curves shows an increase in the frequency of premature delivery in the case of clinically diagnosed risk factors. This will certainly provide a strong basis for improving the care of premature newborns and minimizing the risk for the mother.

Open access
The role of prostaglandins and polymorphisms of A2 phospholipase genes in the occurrence of early uterine contractions during pregnancy

Abstract

This study focused on the role of polymorphisms in prostaglandin expression regulating genes in the occurrence of early uterine contractions during pregnancy. The analyzed genes were: PLA2G4C, encoding calcium independent phospholipase A2, and PLA2G4C, encoding IVD phospholipase A2. It was examined if known reference polymorphisms in these genes (rs1366442, [A/C/T] for PLA2G4C; and rs4924618, [A/T] for PLA2G4D), have any influence on preterm birth. Additionally, other biological, genetic and socio-economic factors were taken into account and analyzed, based on their role in induction of early resolve of pregnancy in the study group. Blood samples were taken from 20 patients. 15 of them gave birth preterm, 5 gave birth at the predicted date of pregnancy resolve. DNA was isolated from the samples, and subjected to PCR, with obtained amplified samples separated using electrophoresis on 1,5% agarose gel. Resulting material was subjected to high-throughput sequencing. Statistical analysis was performed using Statistica 13 software. Analyses have shown that the discussed biological, genetic and societal-economic factors have statistically significant influence on preterm birth. Sequencing results presented the suspected presence of the analyzed SNPs in most women from the studied groups, while not showing their presence in any of the controls. The biological, genetic, and socio-economic factors analyzed have a significant influence on pre-term birth. Presence of SNPs in PLA2G4C and PLA2G4D genes may increase the risk of early resolve of pregnancy. However, as the control and study groups were relatively small, it is suggested to repeat the studies on bigger samples to validate the results.

Open access
Does extreme maternal age still act as a risk factor for adverse perinatal outcome? Evidence from Poland 20 years after the social and economic transformation

Abstract

It was examined whether positive changes in maternal SES and medical facilities in Poland 20 years after social and economic transformation weakened the role of maternal age in shaping perinatal outcome. Data comprised of 2,979 children born in 2000 and 2,992 – born in 2015. To test the differences between the frequency of indicators of adverse perinatal outcome the chi-square test was applied. The influence of maternal age on the perinatal outcome was estimated using Generalized Linear Models (GLMs), with binomial error distribution and the logit link function. The infants survival was examined using survival analysis. Gestational age and birth weight were influenced by mother’s age and the year of survey. Infants of adolescent and older mothers represented the groups with a risk of adverse perinatal outcome: an increase of preterm births and higher risk of having children with LBW in the group of adolescent mothers than in mothers aged >35, infants born SGA and LGA found in both adolescent and adult mothers. GLMs confirmed the impact of maternal age and the year of survey on perinatal outcome. The Cox proportional hazard models showed that the year of survey was the only factor affecting the risk of infants’ death. The impact of maternal age on adverse perinatal outcome can be counterbalanced by positive changes in social and economic standard of living of women, improvement in neonatal medical care and better equipment of hospital wards in 2015 as compared to 2000.

Open access