Pediatric admissions that include intensive care: a population-based study.

Background: Pediatric admissions to intensive care outside children's hospitals are generally excluded from registry-based studies. This study compares pediatric admission to specialist pediatric intensive care units (PICU) with pediatric admissions to intensive care units (ICU) in general hospitals in an Australian population.

Methods: We undertook a population-based record linkage cohort study utilizing longitudinally-linked hospital and death data for pediatric hospitalization from New South Wales, Australia, 2010-2013.

Long-term outcomes for large for gestational age infants born at term.

Aim: Large for gestational age (LGA) babies have increased risks for short-term outcomes such as shoulder dystocia, neonatal hypoglycaemia and longer hospital stay. Little is known of long-term health, development and educational outcomes of LGA babies. The aim of this study was to determine the long-term health, mortality, development and educational outcomes for infants born LGA at term.

Cervical cerclage placed before 14 weeks gestation in women with one previous midtrimester loss: A population-based cohort study.

Background: Cervical cerclage is used in an attempt to reduce recurrence risk of preterm birth, but evidence for use is limited.

Aims: To compare pregnancy outcomes among women with a single previous midtrimester delivery when managed with or without a cervical cerclage.

Materials And Methods: Population-based cohort study of all women in New South Wales, Australia with a singleton pregnancy ending in birth/miscarriage ≥14 and <28 weeks, between 2003 and 2011.

Early-onset preeclampsia appears to discourage subsequent pregnancy but the risks may be overestimated.

Background: Early-onset preeclampsia is associated with adverse maternal and perinatal outcomes. For women who consider another pregnancy after one complicated by early-onset preeclampsia, the likelihood of recurrence and the subsequent pregnancy outcome for themselves and their babies are pertinent considerations.

Objectives: The purpose of this study was to determine the subsequent pregnancy rate after a nulliparous pregnancy that was complicated by early-onset preeclampsia and among those who have a subsequent pregnancy, the risk of recurrence by gestational week, and adverse pregnancy outcomes.

Immediate delivery compared with expectant management after preterm pre-labour rupture of the membranes close to term (PPROMT trial): a randomised controlled trial.

Background: Preterm pre-labour ruptured membranes close to term is associated with increased risk of neonatal infection, but immediate delivery is associated with risks of prematurity. The balance of risks is unclear. We aimed to establish whether immediate birth in singleton pregnancies with ruptured membranes close to term reduces neonatal infection without increasing other morbidity.

Increased planned delivery contributes to declining rates of pregnancy hypertension in Australia: a population-based record linkage study.

Objective: Since the 1990s, pregnancy hypertension rates have declined in some countries, but not all. Increasing rates of early planned delivery (before the due date) have been hypothesised as the reason for the decline. The aim of this study was to explore whether early planned delivery can partly explain the declining pregnancy hypertension rates in Australia.

Treatment of vaginal candidiasis for the prevention of preterm birth: a systematic review and meta-analysis.

Background: Recognition that ascending infection leads to preterm birth has led to a number of studies that have evaluated the treatment of vaginal infections in pregnancy to reduce preterm birth rates. However, the role of candidiasis is relatively unexplored. Our aim was to undertake a systematic review and meta-analysis to assess whether treatment of pregnant women with vulvovaginal candidiasis reduces preterm birth rates and other adverse birth outcomes.

Reduced breast milk feeding subsequent to cosmetic breast augmentation surgery.

Objective: To determine the effect of cosmetic breast augmentation on subsequent infant feeding.

Participants, Design And Setting: Population-based record linkage study of women giving birth in New South Wales, January 2006 - December 2011. Birth records were linked longitudinally to maternal hospitalisations up to 11 years before birth.

Association of prelabor cesarean delivery with reduced mortality in twins born near term.

Objective: To examine short-term and longer-term outcomes for twins born at or near term, comparing prelabor cesarean delivery with birth after a trial of labor.

Methods: This study was conducted on a retrospective cohort of twin pregnancies delivered at 36 weeks of gestation or greater from 2000 to 2009. Pregnancies with an antenatal death, lethal anomaly, birth weight discordance 25% or more, or birth weight less than 2,000 g or more than 4,000 g were excluded.

The impact of cosmetic breast implants on breastfeeding: a systematic review and meta-analysis.

Background: Cosmetic breast augmentation (breast implants) is one of the most common plastic surgery procedures worldwide and uptake in high income countries has increased in the last two decades. Women need information about all associated outcomes in order to make an informed decision regarding whether to undergo cosmetic breast surgery. We conducted a systematic review to assess breastfeeding outcomes among women with breast implants compared to women without.

Heart valve prostheses in pregnancy: outcomes for women and their infants.

Background: As the prognosis of women with prosthetic heart valves improves, an increasing number are contemplating and undertaking pregnancy. Accurate knowledge of perinatal outcomes is essential, assisting counseling and guiding care. The aims of this study were to assess outcomes in a contemporary population of women with heart valve prostheses undertaking pregnancy and to compare outcomes for women with mechanical and bioprosthetic prostheses.

Rate of spontaneous onset of labour before planned repeat caesarean section at term.

Background: Guidelines recommend that, in the absence of compelling medical indications (low risk) elective caesarean section should occur after 38 completed weeks gestation. However, implementation of these guidelines will mean some women go into labour before the planned date resulting in an intrapartum caesarean section. The aim of this study was to determine the rate at which low-risk women planned for repeat caesarean section go into spontaneous labour before 39 weeks.

Effects of maternal serum 25-hydroxyvitamin D concentrations in the first trimester on subsequent pregnancy outcomes in an Australian population.

Background: Low serum 25-hydroxyvitamin D [25(OH)D] concentrations during pregnancy have been associated with adverse pregnancy outcomes in a few studies but not in other studies.

Objectives: We assessed the serum 25(OH)D concentration at 10-14 wk of pregnancy and its association with adverse pregnancy outcomes and examined the predictive accuracy.

Design: In this nested case-control study, we measured serum 25(OH)D in 5109 women with singleton pregnancies who were attending first-trimester screening in New South Wales, Australia.

Predicting date of birth and examining the best time to date a pregnancy.

Objective: To compare the estimated date of birth (eDOB) from the last menstrual period (LMP) and ultrasound scans at varying gestations (<7(0), 7(0)-10(6), 11(0)-14(0), 14(1)-19(6), and 20(0)-27(6)weeks) with the actual date of birth (aDOB).

Methods: In a retrospective study, data were analyzed from 18 708 women with spontaneous labor who delivered a single neonate without major anomalies in a local health district in Australia between 2007 and 2011. Data were sourced from a computerized population birth database.

Reducing caesarean section rates--no easy task.

To identify the greatest potential for reducing overall caesarean delivery rates, we used longitudinally linked data for women with consecutive births 2001-2009 to examine the likely impact of hypothetical risk-based scenarios. Among women with a first birth, singleton, vertex-presenting fetus at term, increasing the vaginal birth rate following induction of labour by 20% potentially has greatest impact, with a 12.1% relative decrease in the overall caesarean rate.

Pathways to a rising caesarean section rate: a population-based cohort study.

Objectives: To determine whether the obstetric pathways leading to caesarean section changed from one decade to another. We also aimed to explore how much of the increase in caesarean rate could be attributed to maternal and pregnancy factors including a shift towards delivery in private hospitals.

Design: Population-based record linkage cohort study.

Trends in planned early birth: a population-based study.

Objective: The purpose of this study was to describe trends and outcomes of planned births.

Study Design: Data from linked birth and hospital records for 779,521 singleton births at ≥33 weeks' gestation from 2001-2009 were used to determine trends in planned births (prelabor cesarean section and labor inductions). Adverse outcomes were composite indicators of maternal and neonatal morbidity/death.

Second pregnancy outcomes for women with systemic lupus erythematosus.

Background: Systemic lupus erythematosus (SLE) is associated with adverse pregnancy outcomes overall.

Objective: To examine the outcomes for women with SLE in a pregnancy subsequent to a first birth with an adverse outcome.

Methods: A population-based cohort study was carried out of 794 577 deliveries to 532 612 women giving birth in New South Wales, Australia from 2001 to 2009.