Browsing by Author "Senevirathne, R. de A."

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Effect of energy expenditure on pregnancy outcome: a cohort study
(College of Community Physicians of Sri Lanka, 2008) Abeysena, C.; Jayawardana, P.; Senevirathne, R. de A.
OBJECTIVE: To determine the trimester specific effect of energy expenditure on pregnancy outcome. STUDY DESIGN: A population based prospective cohort study was carried out in two Medical Officer of Health areas in the Gampaha District from May 2001 to April 2002. Eight hundred and seventy five pregnant women were recruited on or before 16 weeks of gestation. Daily energy expenditure was assessed based on the activities re-sorted at home by housewives and both at home and at work by working mothers indicated in the three day activity record on two occasions during second (n=371) and third (n=271) trimesters. Information on potential confounding factors was gathered on average at 12th 28th and 36th weeks of gestation. There were no statistically significant difference between responders and non-responders in terms of socio-economic characteris-tics. Multiple logistic regression was applied and the results are expressed as odds ratios (OR) and 95% confidence intervals (95%CI). RESULTS: Energy expenditure >2550 kcal/day during second trimester was a risk factor for maternal complications [OR 6.30; 95%CI: 1.8, 21.9]. During third trimester it was a protective factor [OR 0.29; 95%CI: 0.09, 0.96] for small for gestational age defined as <5 centile. Energy expenditure had no association with low birth weight or preterm birth either in second or third trimesters. CONCLUSION: High energy expenditure was a risk factor for maternal complications and a protective factor against the birth of a small for gestational age infant in uncomplicated pregnancies.
Effect of psychosocial stress and physical activity on low birth weight: a cohort study
(Wiley-Blackwell Pub. Asia, 2010) Abeysena, C.; Jayawardana, P.; Senevirathne, R. de A.
AIM: To determine the effect of physical activity and psychosocial stress on low birthweight (LBW). METHODS: A prospective study was carried out in a district of Sri Lanka between May 2001 and April 2002. A total of 885 pregnant mothers were recruited at < or = 16 weeks of gestation and followed up until partus. Trimester-specific exposure statuses along with potential confounding factors were gathered on average at the 12th, 28th, and 36th weeks of gestation. Physical activities were assessed by inquiring about the duration of specific postures adopted per day by housewives during each trimester at home and both at home and during working hours for those who were engaged in paid employment. Psychosocial stress was assessed using the Modified Life Events Inventory and the General Health Questionnaire 30. LBW was defined as a birthweight of less than 2500 g. Multiple logistic regression analysis was applied for controlling confounders and the results were expressed as adjusted odds ratios (OR) and 95% confidence intervals (95%CI). RESULTS: Standing > 2.5 h/day (OR 2.26; 95%CI 1.10, 4.69) during the second trimester and sleeping 8 h or less/day (OR 2.84; 95%CI 1.49, 5.40) either during the second, third or both trimesters together, an increase in maternal age in years (OR 0.92; 95%CI 0.87, 0.98), and body mass index < 19.8 kg/m(2) (OR 2.2; 95%CI 1.17, 4.22) had a statistically significant association with LBW. Psychosocial stress was not associated with LBW.CONCLUSIONS: Standing > 2.5 h/day and sleeping < or = 8 h/day were risk factors for LBW, whereas psychosocial stress was not
Effect of psychosocial stress and physical activity on preterm birth: a cohort study
(Wiley-Blackwell Pub. Asia, 2010) Abeysena, C.; Jayawardana, P.; Senevirathne, R. de A.
AIM: To determine trimester-specific effects of risk factors for preterm birth (PTB). METHODS: A prospective study was carried out in a district of Sri Lanka. A total of 885 pregnant mothers were recruited at equal to or less than 16 weeks of gestation and followed up until partus. Trimester-specific exposure statuses and potential confounding factors were gathered on average at the 12th, 28th, and 36th weeks of gestation. Physical activities were assessed by obtaining information about the duration of specific postures adopted per day by housewives during each trimester at home and both at home and during working hours for those who were engaged in paid employment. Psychosocial stress was assessed using the Modified Life Events Inventory and the General Health Questionnaire 30. Multiple logistic regression analysis was applied and the results were expressed as adjusted odds ratios (OR) and 95% confidence intervals (95%CI). RESULTS: Standing equal to or less than 2.5 h/day during the first or second or both trimesters (OR 1.83, 95%CI 1.03, 3.25), maternal age of <25 years (OR 1.73, 95%CI 1.02, 2.95), education up to primary school level (OR 3.30, 95%CI 1.3, 8.36) and past history of low birthweight (OR 2.52, 95%CI 1.16, 5.48) were risk factors for PTB. Psychosocial stress was not found to be a risk factor for PTB. CONCLUSIONS: Standing equal to or less than 2.5 h/day during the early trimesters was a risk factor for PTB among uncomplicated pregnancies. Further studies are recommended to assess the trimester-specific effect of psychosocial stress on PTB.
Maternal haemoglobin level at booking visit and its effect on adverse pregnancy outcome
(Wiley-Blackwell, 2010) Abeysena, C.; Jayawardana, P.; Senevirathne, R. de A.
AIMS: To determine the effect of maternal haemoglobin levels at booking visit on pregnancy outcome. METHODS: A prospective study was carried out at two Medical Officer of Health areas in a district in Sri Lanka, including 817 pregnant mothers who were followed up until delivery. Maternal haemoglobin level was measured according to specified standard protocols. The reliability and the accuracy of haemoglobin measurements were assessed and were found to be satisfactory. Pregnancy outcome was defined in terms of miscarriage, maternal morbidities, preterm birth (PTB), low birth weight (LBW) and small for gestational age (SGA) infants. Potential confounding factors for each pregnancy outcome were also assessed. Multiple logistic regression was applied and the results were expressed as odds ratios (OR) and 95% confidence intervals (95% CI). RESULTS: The prevalence of anaemia (Hb < 11 g/dL) was 7.1% (95% CI 5.4-8.9%). Anaemia during pregnancy was not significantly associated with any of the pregnancy outcomes studied. Reference range for haemoglobin measurements among mothers with normal pregnancy outcome was 10.4-13.9 g/dL. Haemoglobin level of >13.9 g/dL had a significant adverse association with maternal morbidities (OR 3.0; 95% CI 1.03-8.90) and LBW (OR 3.95; 95% CI 1.30-12.0) compared with the reference range. CONCLUSIONS: Although anaemia during pregnancy was not adversely associated with any of the pregnancy outcomes, Hb level of >13.9 g/dL was adversely associated with maternal morbidities and LBW.
Maternal sleep deprivation is a risk factor for small for gestational age: a cohort study
(Wiley-Blackwell, 2009) Abeysena, C.; Jayawardana, P.; Senevirathne, R. de A.
AIMS: To determine trimester-specific risk factors for small-for-gestational-age (SGA) infants. METHODS: A population-based prospective cohort study was conducted in Sri Lanka from May 2001 to April 2002. Pregnant women were recruited on or before 16 weeks of gestation and followed up until delivery. The sample size was 690. Trimester-specific exposure status and potential confounding factors were gathered on average at 12th, 28th and 36th weeks of gestation. SGA was assessed using customised birth centile charts. Multiple logistic regression was applied, and the results were expressed as odds ratios (OR) and 95% confidence intervals (95%CI). RESULTS: The risk factors for SGA less than 5th centile were shift work and exposure to physical and chemical hazards during 2nd and 3rd trimesters (OR 4.20, 95%CI 1.10-16.0), sleeping for less than or equal to 8 h during 2nd or 3rd or both trimesters (OR 2.23, 95%CI 1.08-4.59), walking for less than or equal to 2.5 h per day (OR 2.66, 95%CI 1.12-6.31) and alcohol consumption during the 3rd trimester (OR 14.5, 95%CI 2.23-94.7). Poor weekly gestational weight gain was significantly associated with both SGA < 10th and < 5th centiles. None of the other factors became significant for SGA < 10th centile. CONCLUSIONS: Risk factors for SGA less than 5th centile were sleep deprivation and shift work and exposure to physical and chemical hazards during 2nd and 3rd trimesters, less walking hours and alcohol consumption during 3rd trimester. Poor weekly gestational weight gain may be considered as a predictor of delivering an SGA infant.
Risk factors for spontaneous abortion
(College of Community Physicians of Sri Lanka, 2009) Abeysena, C.; Jayawardana, P.; Senevirathne, R. de A.
OBJECTIVE: To determine the risk factors for spontaneous abortion. STUDY DESIGN: A prospective cohort study was carried out in Sri Lanka ITom May 2001 to April 2002 determine the risk factors for spontaneous abortion. Eight hundred and twenty pregnant mothers were recruited on or before 16 weeks of gesta¬tion and followed up until delivery. Socio-demographic, occupational exposures, psychosocial stress and physical activity in terms of posture during pregnancy were assessed. Logistic regression analysis was applied and results were expressed as odds ratios (OR) and 95% confidence intervals (95%CI). RESULTS: Maternal age of> 35 years was a risk factor [OR 2.98; 95%CI: 1.07,8.26] and walking> 2.5 hours/day was a protec¬tive factor [OR 0.31; 95%CI: 0.11, 0.92] for second trimester spontaneous abortions after controlling for confounding factors. Occupational exposures, psychosocial stress, alcohol consumption or exposure to passive cigarette smoke during pregnancy were not observed to have an association. CONCLUSIONS: Maternal age of>35 years was and less walking hours/day were risk factors for spontaneous abortion