BJOG : an international journal of obstetrics and gynaecology
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Multicenter Study Comparative Study
Advanced maternal age and pregnancy outcomes: a multicountry assessment.
To assess the association between advanced maternal age (AMA) and adverse pregnancy outcomes. ⋯ Advanced maternal age predisposes women to adverse pregnancy outcomes. The findings of this study would facilitate antenatal counselling and management of women in this age category.
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To describe the mode and timing of delivery of twin pregnancies at ≥34 weeks of gestation and their association with perinatal outcomes. ⋯ The prelabour caesarean delivery rate among twins varied largely between countries, probably as a result of overuse of caesarean delivery in wealthier countries and limited access to caesarean delivery in low-income countries. Prelabour delivery may be beneficial when the first twin is nonvertex. International guidelines for optimal twin delivery methods are needed.
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To assess the incidence of hypertensive disorders of pregnancy and related severe complications, identify other associated factors and compare maternal and perinatal outcomes in women with and without these conditions. ⋯ The analysis of this large database provides estimates of the global distribution of the incidence of hypertensive disorders of pregnancy. The information on the most frequent complications related to pre-eclampsia and eclampsia could be of interest to inform policies for health systems organisation.
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Multicenter Study
Development of criteria for identifying neonatal near-miss cases: analysis of two WHO multicountry cross-sectional studies.
To develop and test markers of neonatal severe morbidity for the identification of neonatal near-miss cases. ⋯ Newborn infants presenting selected markers of severity and surviving the first neonatal week could be considered as neonatal near-miss cases. This definition and criteria may be seen as a basis for future applications of the near-miss concept in neonatal health. These tools can be used to inform policy makers on how best to apply scarce resources for improving the quality of care and reducing neonatal mortality.