Ilana Shoham Vardi

Adverse perinatal outcome in teenage pregnancies: is it all due to lack of prenatal care and ethnicity?

Objective: To investigate teenage pregnancy outcomes controlling for lack of prenatal care (LOPC) and ethnicity. Methods: A retrospective population-based cohort study comparing singleton deliveries of nulliparous women classified into two teenage groups: 15–17, 18–19, and a comparison group of 20–24 years was performed. Multiple logistic regressions were used to control for confounders. Results: The study population consisted of 31,985 women, 1,482 15–17 years old, 5,876 18–19 years old and 24,627 20–24 years old. A significant linear association was found between maternal age and perinatal mortality, low birth weight (LBW) and preterm delivery (PTD). Using multivariable logistic regression models, controlling for LOPC and ethnicity, the association between maternal age and perinatal mortality was no longer statistically significant, but both LBW and PTD were significantly associated with young maternal age (>17 years). Conclusion: Teenage pregnancy is a risk factor for LBW and PTD especially for parturient younger than 17.

Attitudes toward the acceptability of reasons for pregnancy termination due to fetal abnormalities among prenatal care providers and consumers in Israel

Current prenatal diagnostic abilities confront parents and health professionals with complicated issues regarding termination of pregnancy (TOP) due to fetal abnormalities. 1. To assess and compare attitudes of consumers (women) and providers (health professionals) of prenatal care regarding TOP due to fetal abnormality. 2. To identify factors related to these attitudes.

Different perceptions and attitudes regarding prenatal testing among service providers and consumers in Israel.

Introduction: The increasing number of prenatal tests for fetal abnormalities calls for a prenatal care policy which will reflect not only medical values, but also the needs and attitudes of the services’ consumers. Objectives: To compare attitudes of prenatal service consumers and providers regarding extent of prenatal testing and to evaluate these attitudes in relation to sociodemographic and professional characteristics. Methods: Women were interviewed by phone 5–8 weeks postpartum (n = 596) using a structured questionnaire. Health professionals (n = 351) completed a parallel questionnaire. Results: Health professionals were significantly more supportive of comprehensive prenatal testing than women (61.1 vs. 34.1%, respectively). In a multivariable analysis, age over 35, Ashkenazi origin and being better informed regarding tests, predicted a preference for comprehensive testing among women. Among health professionals, predictors of that attitude were secularism and a paramedical profession. Conclusions: Providers and consumers of prenatal services differ in their perceptions and opinions. Policy makers should have mechanisms in place to properly represent this diversity.

Recurrence of Preterm Delivery in Women with a Family History of Preterm Delivery

Objective This study aims to evaluate the role of a family history of preterm delivery on the risk of preterm delivery in the next generation. Study Design A retrospective population‐based study was conducted. Perinatal information was gathered from 2,303 familial triads, composed of mothers (F1), daughters (F2), and children (F3). All births occurred in the same regional medical center between the years 1991 and 2013. Statistical analysis using logistic regression was performed to define the risk of F2 delivering a preterm baby (F3) if she was born preterm herself, and then to define the risk of F2 delivering preterm if her mother (F1) gave birth preterm during any of her birthing events. Results The risk for preterm delivery of the F2 parturient was 34% greater if their mother (F1) at any of her births had delivered preterm, controlling for parity, maternal age at delivery, and preeclampsia (adjusted odds ratio: 1.34, 95% confidence interval: −1.01 to 1.77; p = 0.042). Conclusion The family history of preterm delivery is an independent risk factor for preterm delivery. The family history includes the mother as well as one of the mothers sisters (F2 generation) being born preterm.