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Sample records for adverse pregnancy outcome

  1. Adverse Reproductive Outcomes Associated With Teenage Pregnancy

    OpenAIRE

    Yadav, Siddhartha; Choudhary, Dilip; Narayan, K.C.; Mandal, Rajesh Kumar; Sharma, Achyut; Chauhan, Siddharth Singh; Agrawal, Pawan

    2008-01-01

    Introduction It is debated whether teenage pregnancy is associated with an adverse reproductive outcome. This study assessed the reproductive outcomes in teenage pregnancy in Nepal, a developing setting. Methods A hospital based retrospective cohort study of 4,101 deliveries to compare the outcomes between teenage and non-teenage pregnancies. Results Pregnancy in teenagers was associated with significantly increased risk (P

  2. The influence of thyroid disorders on adverse pregnancy outcomes

    NARCIS (Netherlands)

    R. Vissenberg

    2016-01-01

    This thesis explores the association between thyroid disorders and adverse pregnancy outcomes, the underlying pathophysiology and treatment possibilities. The association between thyroid disorders and adverse pregnancy outcomes is investigated in a systematic review and two retrospective cohort stud

  3. Periodontal treatment for preventing adverse pregnancy outcomes

    DEFF Research Database (Denmark)

    Schwendicke, Falk; Karimbux, Nadeem; Allareddy, Veerasathpurush;

    2015-01-01

    OBJECTIVES: Periodontal treatment might reduce adverse pregnancy outcomes. The efficacy of periodontal treatment to prevent preterm birth, low birth weight, and perinatal mortality was evaluated using meta-analysis and trial sequential analysis. METHODS: An existing systematic review was updated...... assess risk of random errors. RESULTS: Thirteen randomized clinical trials evaluating 6283 pregnant women were meta-analyzed. Four and nine trials had low and high risk of bias, respectively. Overall, periodontal treatment had no significant effect on preterm birth (odds ratio [95% confidence interval] 0.......79 [0.57-1.10]) or low birth weight (0.69 [0.43-1.13]). Trial sequential analysis demonstrated that futility was not reached for any of the outcomes. For populations with moderate occurrence (<20%) of preterm birth or low birth weight, periodontal treatment was not efficacious for any of the outcomes...

  4. First-Trimester Fasting Hyperglycemia and Adverse Pregnancy Outcomes

    OpenAIRE

    Riskin-Mashiah, Shlomit; Younes, Grace; Damti, Amit; Auslender, Ron

    2009-01-01

    OBJECTIVE The Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study found strong associations between higher levels of maternal glucose at 24–32 weeks, within what is currently considered normoglycemia and adverse pregnancy outcomes. Our aim was to evaluate the associations between first-trimester fasting plasma glucose level and adverse pregnancy outcomes. RESEARCH DESIGN AND METHODS Charts of all patients who delivered at our hospital between June 2001 and June 2006 were reviewed. Only s...

  5. Maternal Periodontitis, Preeclampsia and Adverse Pregnancy Outcomes

    Directory of Open Access Journals (Sweden)

    Pourandokht Afshari

    2013-07-01

    Full Text Available Background and Aim: Preeclampsia is a considerable problem of pregnancy. Endothelial dysfunction and placental hypoxia are the current hypothesis of preeclampsia. Chronic inflammation, including periodontitis may provoke systemic maternal and placental pro-inflammatory endothelial dysfunction, which represent a significant risk factor for diseases of vascular origin. So this study was carried out to evaluate the possible relationship between periodontitis and preeclampsia. Methods: A total of 360 pregnant women were included, corresponding to 180 pregnant women with mild or sever periodotitis in one group and 180 pregnant women with periodontal health in the other group. Periodontitis was determined by the sum of all pockets with pocket probing depth (PPD ≥4mm and bleeding on probing. periodontal health was defined as the absence of PPD≥ 4mm. Then two groups evaluated to determine the presence of preeclampsia. After delivery, Child weight at birth and gestational age was also evaluated. Chi square and t test analysis were used to analyze the data. Results: There was statistically significant difference between two groups in presence of preeclampsia (p=0.003. Women who had a worse periodontal condition were at higher risk for preeclampsia. In addition, birth weight and gestational age was statistically lower in the case group than the control group (p < 0.001. Conclusion: The results indicate that the presence and severity of peridontitis increase the risk for occurrence of preeclampsia and adverse pregnancy outcomes.

  6. Organ-specific systemic lupus erythematosus activity during pregnancy is associated with adverse pregnancy outcomes.

    Science.gov (United States)

    Tedeschi, Sara K; Guan, Hongshu; Fine, Alexander; Costenbader, Karen H; Bermas, Bonnie

    2016-07-01

    Systemic lupus erythematosus (SLE) is a disease of reproductive-age women, and thus questions regarding how disease influences pregnancy outcomes arise. We investigated whether five specific types of SLE activity during the 6 months before conception or during pregnancy (nephritis, cytopenias, skin disease, arthritis, serositis) were associated with adverse pregnancy outcomes. We performed a retrospective cohort study of pregnancy outcomes among women with SLE at the Brigham and Women's Hospital Lupus Center. Adverse pregnancy outcomes included pre-eclampsia, pre-term delivery, elective termination due to SLE, spontaneous miscarriage at weeks 12-20, and stillbirth. SLE and obstetric history, laboratories, and medications were obtained from electronic medical records. Generalized linear mixed models adjusting for potential confounders were used to identify predictors of any adverse pregnancy outcome. Most pregnancies resulted in a live term delivery (76.5 %). After adjustment for Hispanic ethnicity, prior adverse pregnancy outcome and medication use 6 months before conception, nephritis during pregnancy (odds ratio (OR) 3.6, 95 % confidence interval (CI) 1.0-12.8), cytopenias during pregnancy (OR 3.9, 95 % CI 1.3-11.4), and serositis during pregnancy (OR 5.9, 95 % CI 1.0-34.0) were significantly associated with adverse pregnancy outcome. Specific types of SLE disease activity during pregnancy were related to adverse pregnancy outcome. Nephritis, cytopenias, and serositis carried a higher risk of adverse pregnancy outcome, suggesting that these abnormalities should be carefully monitored during pregnancy. PMID:27166627

  7. Polyhydramnios as a Predictor of Adverse Pregnancy Outcomes

    OpenAIRE

    Ilham Moosa Hamdi; Kaukab Tashfeen

    2013-01-01

    Objectives: This study aimed to ascertain the frequency of polyhydramnios in singleton pregnancies, to determine the associated risk factors, and assess the adverse maternal and perinatal outcomes. Methods: A retrospective cohort study of all singleton pregnancies complicated with polyhydramnios after 28 weeks of gestation was carried out in Nizwa Hospital’s Obstetrics & Gynecology Department, Oman, from January 2002 to December 2007. Of 25,979 pregnant women reviewed, 477 were found to have ...

  8. Population-based investigations to study the association of cardiovascular polymorphisms and adverse pregnancy outcome

    DEFF Research Database (Denmark)

    Lykke, Jacob Alexander; Langhoff-Roos, Jens; Young, Bradford;

    2007-01-01

    Adverse pregnancy outcome refers to placenta-mediated complications that may share a common etiopathogenesis in some cases. Unraveling associations between prothrombotic genetic predispositions and these pregnancy disorders, namely recurrent fetal loss, stillbirth, severe preeclampsia, intrauterine...... study focuses on pro-thrombotic and cardiovascular genetic polymorphisms in a nested-case control study comparing pregnancies with and without an adverse pregnancy outcome in the index pregnancy. This study will be adequately powered to determine the relationship between adverse pregnancy outcome and...

  9. Adverse Pregnancy Outcomes and Cardiovascular Risk Factor Management

    OpenAIRE

    Mehta, Puja K.; Minissian, Margo; Merz, C. Noel Bairey

    2015-01-01

    Cardiovascular disease (CVD) is the leading health threat to American women. In addition to established risk factors for hypertension, hyperlipidemia, diabetes, smoking, and obesity, adverse pregnancy outcomes (APOs) including pre-eclampsia, eclampsia, and gestational diabetes are now recognized as factors that increase a woman’s risk for future CVD. CVD risk factor burden is disproportionately higher in those of low socioeconomic status and in ethnic/racial minority women. Since younger wome...

  10. β-Blocker treatment during pregnancy and adverse pregnancy outcomes

    DEFF Research Database (Denmark)

    Petersen, Kasper Meidahl; Jimenez-Solem, Espen; Andersen, Jon Traerup; Petersen, Morten; Brødbæk, Kasper; Køber, Lars; Torp-Pedersen, Christian; Poulsen, Henrik Enghusen

    2012-01-01

    To investigate the association between exposure to β-blockers during pregnancy and the risk of being born small for gestational age (SGA), preterm birth and perinatal mortality in a nationwide cohort.......To investigate the association between exposure to β-blockers during pregnancy and the risk of being born small for gestational age (SGA), preterm birth and perinatal mortality in a nationwide cohort....

  11. The relationship between salivary bacterial flora and adverse pregnancy outcomes

    Directory of Open Access Journals (Sweden)

    Sadeghi R

    2011-04-01

    Full Text Available "n 800x600 Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman","serif";} Background: Many studies have shown that periodontal pathogens are emerging as a risk factor for preterm delivery and low birth weight, but there are few studies about the relationship between other oral bacteria and pregnancy outcomes. The aim of the present study was to determine the relationship between salivary bacteria and pregnancy outcomes."n"nMethods: This cohort study was performed on 300 pregnant women who were recruited from the prenatal clinic of Zeynab Hospital in Tehran during 2009-2010. The patients' demographic and pregnancy data were recorded. Using samplers, saliva samples were collected about one hour after breakfast. Microbial evaluation was performed by counting the bacteria based on their shape and the Gram reaction. The studied bacteria were composed of gram-positive and negative cocci, gram-positive and negative bacilli, spirilla, spirochetes, yeasts, fusiform bacteria and actinomycetes."n"nResults: The data on the bacteriological profile and pregnancy outcome of 243 out of the 300 eligible participants of the study were completed. Five cases (2% had intra uterine fetal death (IUFD while 238 (98% delivered live infants. There was a significant statistical relationship between the mean of gram-negative cocci and IUFD (P=0.04. 10 cases (4.1% of 243, experienced adverse delivery outcomes and 233 cases (95% had normal delivery. The adverse pregnancy outcomes had a significant relationship with the presence of spirochetes in saliva (P<0.05 but this relationship was not

  12. Adverse pregnancy outcomes and subsequent risk of cardiovascular disease in women with systemic lupus erythematosus

    OpenAIRE

    Lin, Pin; Rhew, Elisa; Ness, Roberta B.; PEACEMAN, Alan; Dyer, Alan; McPherson, David; Kondos, George T.; Edmundowicz, Daniel; Sutton-Tyrrell, Kim; Thompson, Trina; Ramsey-Goldman, Rosalind

    2014-01-01

    Background/objective Patients with systemic lupus erythematosus (SLE) are at increased risk for adverse pregnancy outcomes and cardiovascular disease (CVD). The objective of this exploratory study was to investigate the association between a history of adverse pregnancy outcomes and subsequent risk of subclinical CVD assessed by imaging studies and verified clinical CVD events in 129 women with SLE. Methods The occurrence of adverse pregnancy outcomes, specifically pre-eclampsia, preterm birt...

  13. Pre-existing diabetes mellitus and adverse pregnancy outcomes

    Directory of Open Access Journals (Sweden)

    Wahabi Hayfaa A

    2012-09-01

    Full Text Available Abstract Background Pregnancies complicated by pre-existing diabetes mellitus (PDM are associated with a high rate of adverse outcomes, including an increased miscarriage rate, preterm delivery, preeclampsia, perinatal mortality and congenital malformations; compared to the background population. The objectives of this study are to determine the prevalence of PDM and to investigate the maternal and the neonatal outcomes of women with PDM. Methods This is a retrospective cohort study for women who delivered in King Khalid University Hospital (KKUH during the period of January 1st to the 31st of December 2008. The pregnancy outcomes of the women with PDM were compared to the outcomes of all non-diabetic women who delivered during the same study period. Results A total of 3157 deliveries met the inclusion criteria. Out of the study population 116 (3.7% women had PDM. There were 66 (57% women with type 1 diabetes mellitus (T1DM and 50 (43% women with type 2 diabetes mellitus (T2DM. Compared to non-diabetic women those with PDM were significantly older, of higher parity, and they had more previous miscarriages. Women with PDM were more likely to be delivered by emergency cesarean section (C/S, OR 2.67, 95% confidence intervals (CI (1.63-4.32, P P P P = 0.002. They more frequently have APGAR scores P 0.057 and more likely to be delivered at P 0.003. The stillbirth rate was 2.6 times more among the women with PDM; however the difference did not reach statistical significance, P 0.084. Conclusion PDM is associated with increased risk for C/S delivery, macrosomia, stillbirth, preterm delivery and low APGAR scores at 5 min.

  14. Spousal Military Deployment During Pregnancy and Adverse Birth Outcomes.

    Science.gov (United States)

    Spieker, Amy; Schiff, Melissa A; Davis, Beth E

    2016-03-01

    Pregnant women with a military-deployed spouse have increased risk of depression and self-reported stress. In nonmilitary populations, depression and stress during pregnancy are associated with adverse birth outcomes. This study assesses the association between a spouse's military deployment and adverse birth outcomes. We conducted a retrospective cohort study at a large military medicine center in the Northwest and evaluated records of singleton deliveries to dependent Army spouses from September 2001 to September 2011. We used logistic regression to estimate relative risks and 95% confidence intervals (CI) of the associations between deployment and low birth weight (<2,500 g), preterm delivery (<37 weeks), small for gestational age (SGA, <10 percentile for gestational age), and cesarean delivery. We identified 10,536 births; 1,364 (12.9%) spouses were deployed at delivery. No associations were observed in the overall population. Among women with two or more children, we observed an 81% increased risk of SGA (95% CI 1.18-2.79). Women 30 to 34 years old had an 82% (95% CI 1.06-3.14) increased risk of low birth weight and an 84% increased risk of SGA (95% CI 1.13-2.98). Deployment's effects vary by maternal age and the number of children in the household. These findings may inform programs and practitioners to best serve women with military-deployed spouses. PMID:26926749

  15. Polyhydramnios as a Predictor of Adverse Pregnancy Outcomes

    Directory of Open Access Journals (Sweden)

    Ilham Moosa Hamdi

    2013-02-01

    Full Text Available Objectives: This study aimed to ascertain the frequency of polyhydramnios in singleton pregnancies, to determine the associated risk factors, and assess the adverse maternal and perinatal outcomes. Methods: A retrospective cohort study of all singleton pregnancies complicated with polyhydramnios after 28 weeks of gestation was carried out in Nizwa Hospital’s Obstetrics & Gynecology Department, Oman, from January 2002 to December 2007. Of 25,979 pregnant women reviewed, 477 were found to have polyhydramnios. The control group consisted of 900 pregnant women. Cases of polyhydramnios were diagnosed as mild, moderate, or severe based on their highest amniotic fluid index. Cases were compared with controls in terms of demographic data; prevalence of diabetes, macrosomia, or Caesarean deliveries; frequency of fetal anomalies, and perinatal mortality rate. Results:Polyhydramnios was diagnosed in 1.8% of pregnancies. It was mild in 382 (80%, moderate in 84 (17.6%, and severe in 12 (2.4%. A total of 72 (15.3 % cases of polyhydramnios were complicated by diabetes (gestational or established diabetes mellitus as compared to 10% of the control group and 39 (8.1% neonates had congenital anomalies.Polyhydramnios was associated with advanced maternal age; 58 (12.2% of subjects were over 40 years old. The perinatal mortality rate with polyhydramnios was 42 per 1,000 births compared to 14 per 1000 births in the control group. Conclusion: These data demonstrate that polyhydramnios is associated with an increased risk of adverseperinatal outcomes, and there is a significant positive relation with maternal age, diabetes, fetal anomalies, and fetal macrosomia.

  16. Residential exposure to traffic emissions and adverse pregnancy outcomes

    OpenAIRE

    Pereira, Gavin; Nassar, Natasha; Bower, Carol; Weinstein, Philip; Cook, Angus

    2010-01-01

    Motor vehicle traffic emissions are the single largest contributor to ambient air pollution in many developed countries and it has been suggested that these emissions can affect outcomes of pregnancy. An individual’s exposure experience is greatly influenced by where they live as emission concentrations are much higher closer to roads. A systematic review was conducted using the MOOSE guidelines in order to synthesise studies published 1989-2009 which investigated pregnancy outcomes in relat...

  17. Risk of adverse pregnancy outcome in women exposed to livestock

    DEFF Research Database (Denmark)

    Nielsen, Stine Yde; Henriksen, T B; Hjøllund, Niels Henrik Ingvar; Mølbak, Kare; Andersen, Annett Dalbøge

    2013-01-01

    outcome in women with self-reported occupational or domestic contact with livestock compared to pregnant women without such contact. The Danish National Birth Cohort collected information on pregnancy outcome from 100 418 pregnant women (1996-2002) from which three study populations with occupational and...

  18. Population-based investigations to study the association of cardiovascular polymorphisms and adverse pregnancy outcome

    DEFF Research Database (Denmark)

    Lykke, Jacob Alexander; Langhoff-Roos, Jens; Young, Bradford;

    2007-01-01

    Adverse pregnancy outcome refers to placenta-mediated complications that may share a common etiopathogenesis in some cases. Unraveling associations between prothrombotic genetic predispositions and these pregnancy disorders, namely recurrent fetal loss, stillbirth, severe preeclampsia, intrauteri...... pro-thrombotic and cardiovascular genetic polymorphisms. These studies are urgently needed to accurately assess the linkage between family history, presence of adverse pregnancy outcome, and long-term cardiovascular risk....... growth restriction, and placental abruption, requires rigorous epidemiological studies involving large cohorts of patients with sufficient numbers of the adverse pregnancy outcomes in question. Such is the case with the Denmark National Birth Cohort, which was initiated in 1996 and followed pregnant...

  19. Maternal obesity in early pregnancy and risk of adverse outcomes.

    Directory of Open Access Journals (Sweden)

    Inmaculada Bautista-Castaño

    Full Text Available OBJECTIVES: To assess the role of the health consequences of maternal overweight and obesity at the start of pregnancy on gestational pathologies, delivery and newborn characteristics. METHODS: A cohort of pregnant women (n = 6.558 having delivered at the Maternal & Child University Hospital of Gran Canaria (HUMIGC in 2008 has been studied. Outcomes were compared using multivariate analyses controlling for confounding variables. RESULTS: Compared to normoweight, overweight and obese women have greater risks of gestational diabetes mellitus (RR = 2.13 (95% CI: 1.52-2.98 and (RR = 2.85 (95% CI: 2.01-4.04, gestational hypertension (RR = 2.01 (95% CI: 1.27-3.19 and (RR = 4.79 (95% CI: 3.13-7.32 and preeclampsia (RR = 3.16 (95% CI: 1.12-8.91 and (RR = 8.80 (95% CI: 3.46-22.40. Obese women have also more frequently oligodramnios (RR = 2.02 (95% CI: 1.25-3.27, polyhydramnios. (RR = 1.76 (95% CI: 1.03-2.99, tearing (RR = 1.24 (95% CI: 1.05-1.46 and a lower risk of induced deliveries (RR = 0.83 (95% CI: 0.72-0.95. Both groups have more frequently caesarean section (RR = 1.36 (95% CI: 1.14-1.63 and (RR = 1.84 (95% CI: 1.53-2.22 and manual placenta extraction (RR = 1.65 (95% CI: 1.28-2.11 and (RR = 1.77 (95% CI: 1.35-2.33. Newborns from overweight and obese women have higher weight (p<0.001 and a greater risk of being macrosomic (RR = 2.00 (95% CI: 1.56-2.56 and (RR = 2.74 (95% CI: 2.12-3.54. Finally, neonates from obese mother have a higher risk of being admitted to special care units (RR = 1.34 (95% CI: 1.01-1.77. Apgar 1 min was significantly higher in newborns from normoweight mothers: 8.65 (95% CI: 8.62-8.69 than from overweight: 8.56 (95% CI: 8.50-8.61 or obese mothers: 8.48 (95% CI: 8.41-8.54. CONCLUSION: Obesity and overweight status at the beginning of pregnancy increase the adverse outcomes of the pregnancy. It is important to promote the normalization of bodyweight in those

  20. Early Gestational Weight Gain Rate and Adverse Pregnancy Outcomes in Korean Women.

    Directory of Open Access Journals (Sweden)

    Eun-Hee Cho

    Full Text Available During pregnancy, many women gain excessive weight, which is related to adverse maternal and neonatal outcomes. In this study, we evaluated whether rate of gestational weight gain (RGWG in early, mid, and late pregnancy is strongly associated with adverse pregnancy outcomes. A retrospective chart review of 2,789 pregnant Korean women was performed. Weights were recorded at the first clinic visit, during the screening test for fetal anomaly, and during the 50g oral glucose challenge test and delivery, to represent early, mid, and late pregnancy, respectively. A multivariate logistic regression analysis was performed to examine the relationship between RGWG and adverse pregnancy outcomes. At early pregnancy, the RGWG was significantly associated with high risk of developing gestational diabetes mellitus (GDM, pregnancy-induced hypertension (PIH, large for gestational age (LGA infants, macrosomia, and primary cesarean section (P-CS. The RGWG of mid pregnancy was not significantly associated with any adverse pregnancy outcomes. The RGWG at late pregnancy was significantly associated with a lower risk of developing GDM, preterm birth and P-CS, but with a higher risk of developing LGA infants and macrosomia. When the subjects were divided into three groups (Underweight, Normal, and Obese, based on pre-pregnancy body mass index (BMI, the relationship between early RGWG and adverse pregnancy outcomes was significantly different across the three BMI groups. At early pregnancy, RGWG was not significantly associated to adverse pregnancy outcomes for subjects in the Underweight group. In the Normal group, however, early RGWG was significantly associated with GDM, PIH, LGA infants, macrosomia, P-CS, and small for gestational weight (SGA infants, whereas early RGWG was significantly associated with only a high risk of PIH in the Obese group. The results of our study suggest that early RGWG is significantly associated with various adverse pregnancy outcomes

  1. Retinal artery and vein thrombotic occlusion during pregnancy: markers for familial thrombophilia and adverse pregnancy outcomes

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    Kurtz WS

    2016-05-01

    pregnancy may be a marker for familial or acquired thrombophilia, which confers increased thrombotic risk to the mother and pregnancy, associated with spontaneous abortion or eclampsia. OVO during pregnancy, particularly when coupled with antecedent adverse pregnancy outcomes, should prompt urgent thrombophilia evaluation and institution of thromboprophylaxis to prevent adverse maternal and fetal–placental thrombotic events. Keywords: thrombophilia, ocular thrombosis, retinal vascular occlusion, CRVO, BRAO, pregnancy, miscarriage, fetal loss, ocular vascular occlusion, pre-eclampsia, eclampsia

  2. Adverse pregnancy outcomes after exposure to methylphenidate or atomoxetine during pregnancy

    Directory of Open Access Journals (Sweden)

    Bro SP

    2015-01-01

    Full Text Available Søren Pauli Bro,1 Maiken Ina Siegismund Kjaersgaard,2 Erik Thorlund Parner,2 Merete Juul Sørensen,3 Jørn Olsen,4 Bodil Hammer Bech,4 Lars Henning Pedersen,4,5 Jakob Christensen,6,7 Mogens Vestergaard11Research Unit and Section for General Practice, Department of Public Health, 2Section for Biostatistics, Department of Public Health, Aarhus University, 3Regional Center for Child and Adolescent Psychiatry, Aarhus University Hospital, 4Section for Epidemiology, Department of Public Health, 5Department of Clinical Medicine – Obstetrics and Gynecology, Aarhus University, 6Department of Clinical Pharmacology, 7Department of Neurology, Aarhus University Hospital, Aarhus, DenmarkObjective: To determine if prenatal exposure to methylphenidate (MPH or atomoxetine (ATX increases the risk of adverse pregnancy outcomes in women with attention deficit/hyperactivity disorder (ADHD.Materials and methods: This was a population-based cohort study of all pregnancies in Denmark from 1997 to 2008. Information on use of ADHD medication, ADHD diagnosis, and pregnancy outcomes was obtained from nationwide registers.Results: We identified 989,932 pregnancies, in which 186 (0.02% women used MPH/ATX and 275 (0.03% women had been diagnosed with ADHD but who did not take MPH/ATX. Our reference pregnancies had no exposure to MPH/ATX and no ADHD diagnosis. Exposure to MPH/ATX was associated with an increased risk of spontaneous abortion (SA; ie, death of an embryo or fetus in the first 22 weeks of gestation (adjusted relative risk [aRR] 1.55, 95% confidence interval [CI] 1.03–2.36. The risk of SA was also increased in pregnancies where the mother had ADHD but did not use MPH/ATX (aRR 1.56, 95% CI 1.11–2.20. The aRR of Apgar scores <10 was increased among exposed women (aRR 2.06, 95% CI 1.11–3.82 but not among unexposed women with ADHD (aRR 0.99, 95% CI 0.48–2.05.Conclusion: MPH/ATX was associated with a higher risk of SA, but our study indicated that it may at

  3. Adverse Perinatal Outcome in Subsequent Pregnancy after Stillbirth by Placental Vascular Disorders.

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    Francesca Monari

    Full Text Available To evaluate outcome in the pregnancy following a stillbirth (SB by a placental vascular disorders.A prospective, observational, multicenter study was conducted in woman with a history of stillbirth (> 22 weeks between 2005 and June 2013, in 3 Italian University Hospitals. Causes of SB were previously identified after extensive investigations. Pregnant women were enrolled within the first trimester. The main outcome was "adverse neonatal outcome", including perinatal death, fetal growth restriction, early preterm birth <33+6 weeks, hypoxic-ischemic encephalopathy, intracranial hemorrhage or respiratory distress.Out of 364 index pregnancies, 320 women (87.9% had a subsequent pregnancy during the study period. Forty-seven had an early pregnancy loss. Out of 273 babies, 67 (24.5% had an adverse perinatal outcome, including 1 SB and 1 early neonatal death (3.7/1000. Women who had a SB related to placental vascular disorders (39.6%, were at higher risk of an adverse neonatal outcome compared with women whose SB was unexplained or resulted from other causes (Adj. OR = 2.1, 95%CI: 1.2-3.8. Moreover, also obesity independently predicts an adverse perinatal outcome (Adj OR = 2.1, 95%CI: 1.1-4.3.When previous SB is related to placental vascular disorders there is a high risk for adverse neonatal outcomes in the subsequent pregnancy. Maternal obesity is an additional risk factor.

  4. Adverse pregnancy outcome in a petrochemical polluted area in Taiwan.

    Science.gov (United States)

    Lin, M C; Yu, H S; Tsai, S S; Cheng, B H; Hsu, T Y; Wu, T N; Yang, C Y

    2001-08-24

    The petrochemical industry is the main source of industrial air pollution in Taiwan. Reported here are the results from an ongoing study of outdoor air pollution and the health of individuals living in a community in close proximity to petrochemical industrial complexes. The prevalences of term low birth weight (LBW) in the petrochemical municipality and control municipality were 3.22%, and 1.84%, respectively. After controlling for several possible confounders (including maternal age, season, marital status, maternal education, and infant sex), the adjusted odds ratio was 1.767 (1.002-3.116) for term LBW in the petrochemical municipality. Data provide further support for the hypothesis that air pollution can affect the outcome of pregnancy. PMID:11549116

  5. Predicting adverse obstetric outcome after early pregnancy events and complications: a review

    DEFF Research Database (Denmark)

    van Oppenraaij, R H F; Jauniaux, E; Christiansen, O B;

    2009-01-01

    BACKGROUND The aim was to evaluate the impact of early pregnancy events and complications as predictors of adverse obstetric outcome. METHODS We conducted a literature review on the impact of first trimester complications in previous and index pregnancies using Medline and Cochrane databases......) after two or more miscarriages, the risk of placenta praevia, premature preterm rupture of membranes, VPTD and low birthweight (LBW) after recurrent miscarriage and the risk of VPTD after two or more termination of pregnancy. Clinically relevant associations of adverse obstetric outcome in the ongoing...... hyperemesis gravidarum. CONCLUSIONS Data from our literature review indicate, by finding significant associations, that specific early pregnancy events and complications are predictors for subsequent adverse obstetric and perinatal outcome. Though, some of these associations are based on limited or small...

  6. Asthma exacerbations during pregnancy: incidence and association with adverse pregnancy outcomes

    OpenAIRE

    Murphy, V E; Clifton, V.L.; Gibson, P G

    2006-01-01

    Exacerbations of asthma during pregnancy represent a significant clinical problem and may be related to poor pregnancy outcomes. A systematic review of the literature was conducted for publications related to exacerbations during pregnancy. Four studies with a control group (no asthma) and two groups of women with asthma (exacerbation, no exacerbation) were included in meta‐analyses using fixed effects models. During pregnancy, exacerbations of asthma which require medical intervention occur ...

  7. Maternal pre-pregnancy BMI and adverse pregnancy outcomes among Chinese women: Results from the C-ABCS.

    Science.gov (United States)

    Ding, X-X; Xu, S-J; Hao, J-H; Huang, K; Su, P-Y; Tao, F-B

    2016-04-01

    The aim of this study was to investigate associations between pre-pregnancy body mass index (BMI) and adverse pregnancy outcomes among Chinese pregnant women. A prospective population-based cohort study was performed using data collected as part of the China-Anhui Birth Cohort Study or C-ABCS. A total of 13,121 pregnant women who received the first prenatal visit were enrolled from November 2008 to October 2010. Logistic regression analysis was used to calculate associations between pre-pregnancy BMI and pregnancy outcomes. Results indicated that the increased pre-pregnancy BMI was associated with a number of adverse pregnancy outcomes such as hypertensive disorder (adjusted relative risk (ARR) 2.3, 95% confidence interval [CI] 1.5-3.6), gestational diabetes (ARR 3.5, 95% CI 2.3-5.2), caesarean delivery (ARR 2.0, 95% CI 1.6-2.4), and medically indicated preterm delivery (ARR 1.8, 95% CI 1.1-2.9). Women with pre-pregnancy BMI above the normal range pose an increased risk of adverse pregnancy outcomes. PMID:26492517

  8. Adverse Pregnancy Outcomes: Opportunity for Analysis of Biospecimens and Co-development of Prognostics | NCI Technology Transfer Center | TTC

    Science.gov (United States)

    The Eunice Kennedy Shriver National Institute of Child Health and Human Development’s Pregnancy and Perinatology Branch seeks partners interested in collaborative research to: (i) evaluate data and samples taken from women for potential biomarkers indicative for adverse pregnancy outcomes and (ii) co-develop diagnostic kits useful as predictors of adverse pregnancy outcomes.

  9. Risk of Adverse Pregnancy Outcomes among Women Practicing Poor Sanitation in Rural India: A Population-Based Prospective Cohort Study.

    OpenAIRE

    Padhi, Bijaya K.; Baker, Kelly K.; Ambarish Dutta; Oliver Cumming; Freeman, Matthew C.; Radhanatha Satpathy; Das, Bhabani S.; Pinaki Panigrahi

    2015-01-01

    Editors' Summary Background Pregnancy is usually a happy time for women and their families. But, for some women, pregnancy ends unhappily. Some women lose their baby during early pregnancy (spontaneous abortion or miscarriage) or during late pregnancy (stillbirth). Others have their baby earlier than expected (preterm birth) or have a baby with low birth weight, two outcomes that adversely affect the baby’s survival and long-term health. The burden of adverse pregnancy outcomes (low birth wei...

  10. Risk of Adverse Pregnancy Outcomes among Women Practicing Poor Sanitation in Rural India: A Population-Based Prospective Cohort Study

    OpenAIRE

    Padhi, BK; Baker, KK; Dutta, A; Cumming, O.; Freeman, MC; Satpathy, R; Das, BS; Panigrahi, P

    2015-01-01

    Editors' Summary Background Pregnancy is usually a happy time for women and their families. But, for some women, pregnancy ends unhappily. Some women lose their baby during early pregnancy (spontaneous abortion or miscarriage) or during late pregnancy (stillbirth). Others have their baby earlier than expected (preterm birth) or have a baby with low birth weight, two outcomes that adversely affect the baby’s survival and long-term health. The burden of adverse pregnancy outcomes (low birth wei...

  11. Medical abortion and the risk of subsequent adverse pregnancy outcomes

    DEFF Research Database (Denmark)

    Virk, Jasveer; Zhang, Jun; Olsen, Jørn

    2007-01-01

    identified all women living in Denmark who had undergone an abortion for nonmedical reasons between 1999 and 2004 and obtained information regarding subsequent pregnancies from national registries. Risks of ectopic pregnancy, spontaneous abortion, preterm birth (at <37 weeks of gestation), and low birth...... weight (<2500 g) in the first subsequent pregnancy in women who had had a first-trimester medical abortion were compared with risks in women who had had a first-trimester surgical abortion. RESULTS: Among 11,814 pregnancies in women who had had a previous first-trimester medical abortion (2710 women) or...... pregnancies, gestational age at abortion, parity, cohabitation status, and urban or nonurban residence, medical abortion was not associated with a significantly increased risk of ectopic pregnancy (relative risk, 1.04; 95% confidence interval [CI], 0.76 to 1.41), spontaneous abortion (relative risk, 0.87; 95...

  12. Association of gestational weight gain and pre-pregnancy body mass index with adverse pregnancy outcome

    International Nuclear Information System (INIS)

    Objective: To determine the association between gestation weight gain (GWG) and adverse pregnancy outcome in a Pakistani population. Study Design: Analytical study. Place and Duration of Study: The Aga Khan University, Karachi, from February 2003 to 2007. Methodology: This study used secondary data of 4,735 women from a large cohort study on fetal growth. Pre-pregnancy BMI was categorized according to the recommendations from the institute of medicine (IOM, 2009) and gestation weight gain (GWG) was noted. Chi-square test was used to find the association of GWG and pre-pregnancy BMI with low birth, large for gestational age (LGA), and caesarean section. Logistic regression analysis was weight (LBW), preterm delivery performed to control for confounders like age, parity, working status and ethnicity. Results: The prevalence of LBW decreased with increasing BMI. GWG of the population was noted as 8.5 kg. LBW was omen below the age of 19 were twice more likely to have LBW than observed to have an inverse relationship with GWG. W above 35 years of age. Weight gain above the recommended range were twice more likely to have large for dates. Overweight women were 1.5 times more likely to deliver preterm whereas obese women were 1.4 times more likely to undergo caesarean section than women with normal BMI. Conclusion: The optimal weight gain was estimated to be 8.5 kg to prevent low birth weight in our population. Obese women are more likely to have LGA, caesarean sections and pre-term deliveries. (author)

  13. Adverse pregnancy and neonatal outcomes in polycystic ovary syndrome women

    Directory of Open Access Journals (Sweden)

    Roshan Nikbakht

    2016-02-01

    Full Text Available Background: Polycystic ovary syndrome (PCOS is the most common endocrine disorders in reproductive age women. These women confer with complications of pregnancy such as gestational diabetes, pregnancy-induced hypertension, preeclampsia and neonatal complications such as small for gestational diabetes (SGA are more prevalence in women with PCOS. The aim of this study was to evaluate the incidence of complications associated with PCOS in pregnant women. Methods: This was an observational and prospective study which recruited 205 pregnant women with PCOS from Imam Khomeini Hospital, Ahvaz Jundishapur University of Medical Sciences (AJUMS between 2013 and 2014. Inclusion criteria were women with PCOS and gestational age over 20 weeks. The demographic and clinical variables including mother's age, body mass index (BMI and conditions of pregnancy including pregnancy-induced hypertension, preeclampsia, gestational diabetes and overt diabetes and neonatal complications such as preterm labor (PTL, SGA and intrauterine fetal death (IUFD were recorded. Results: The prevalence of hypertension disorders, preeclampsia, gestational diabetes and overt diabetes were observed in 44 (21.5%, 18 (8.8%, 29 (14% and 22 (11% patients, respectively. The history of familial diabetes was shown in 28 patients (13.6%. In addition, the history of pregnancy induced hypertension was reported in 25 patients (12.1%. Only 6 patients (2.9% had history of gestational diabetes. Among neonatal complications due to PCOS, SGA with 15.3% and then PTL with 12.6% had highest prevalence. IUFD was shown only in 2 patients. Conclusion: Pregnant women with PCOS are at the higher risk for pregnancy and neonatal complications. Specifically, these women should be evaluated for pregnancy induced hypertension during pregnancy than others.

  14. Adverse pregnancy outcomes in rural Maharashtra, India (2008–09: a retrospective cohort study

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    Doke Prakash

    2012-07-01

    Full Text Available Abstract Background The study was carried out to record adverse pregnancy outcomes and to obtain information about sex ratio at birth in rural especially tribal areas in the State of Maharashtra, India. Although the tribal population is considered vulnerable to innumerable adversities, regretfully information about pregnancy wastage among them is not available. About 10% population of the state is tribal. The study of sex ratio at birth was planned as the overall sex ratio and child sex ratio had declined in the state. Methods The cohort of antenatal cases registered in rural areas of Maharashtra in the calendar year 2008 was followed up to study the pregnancy outcomes. A retrospective study was carried out from October 2009 to August 2010. The outcomes of all the registered antenatal cases were recorded by the Auxiliary Nurse Midwives. The summary sheets were obtained by Block Medical Officers. The data was entered at the block level by trained data entry operators in specially designed web-based software. Adverse pregnancy outcome was categorized in two groups abortions and stillbirths. Results About 1.1 million registered pregnancies were followed up. In the state 5.34% registered pregnancies ended in abortions. In tribal PHCs the relative risk of spontaneous abortion and induced abortion was 0.91and 0.38 respectively. It was also revealed that about 1.55% pregnancies culminated in stillbirth. The relative risk of stillbirths in tribal PHCs was 1.33. The sex ratio at birth in the state was 850. The ratio was 883 in the tribal PHCs. Correlation was observed between sex ratio at birth and induced abortion rate. Conclusions The study indicates that women from tribal PHCs are exposed to higher risk of adverse pregnancy outcome in the form of stillbirths. In non-tribal areas high induced abortion rate and poor sex ratio at birth is observed. These two indicators are correlated. The correlation may be explained by the unscrupulous practice of sex

  15. Maternal Snoring May Predict Adverse Pregnancy Outcomes: A Cohort Study in China.

    Directory of Open Access Journals (Sweden)

    Xing Ge

    Full Text Available To examine the prevalence of snoring during pregnancy and its effects on key pregnancy outcomes.Pregnant women were consecutively recruited in their first trimester. Habitual snoring was screened by using a questionnaire in the 1st and 3rd trimester, respectively. According to the time of snoring, participants were divided into pregnancy onset snorers, chronic snorers and non-snorers. Logistic regressions were performed to examine the associations between snoring and pregnancy outcomes.Of 3 079 pregnant women, 16.6% were habitual snorers, with 11.7% were pregnancy onset snorers and 4.9% were chronic snorers. After adjusting for potential confounders, chronic snorers were independently associated with gestational diabetes mellitus (GDM (RR 1.66, 95%CI 1.09-2.53. Both pregnancy onset and chronic snorers were independently associated with placental adhesion (RR 1.96, 95%CI 1.17-3.27, and RR 2.33, 95%CI 1.22-4.46, respectively. Pregnancy onset snorers were at higher risk of caesarean delivery (RR 1.37, 95%CI 1.09-1.73 and having macrosomia (RR 1.54, 95%CI 1.05-2.27 and large for gestational age (LGA (RR 1.71, 95%CI 1.31-2.24 infants. In addition, being overweight or obese before pregnancy plays an important role in mediating snoring and adverse pregnancy outcomes.Maternal snoring may increase the risk of adverse pregnancy outcomes, and being overweight or obese before pregnancy with snoring is remarkable for researchers. Further studies are still needed to confirm our results.

  16. TLR-9 Activation Coupled To IL-10 Deficiency Induces Adverse Pregnancy Outcomes

    OpenAIRE

    Thaxton, Jessica E.; Romero, Roberto; Sharma, Surendra

    2009-01-01

    Pregnancy outcome is severely compromised by intrauterine infections and inflammation. Although the pregnant uterine microenvironment is replete with innate immune cells and Toll-like receptor (TLR) expression, the mechanisms that facilitate adverse effects of their activation are largely unknown. Here we mimic the activation of TLR-9 with its pathogenic ligand hypomethylated CpG, and demonstrate that IL-10 proficiency protects against CpG-induced pregnancy complications. We show that fetal r...

  17. Association between gaseous ambient air pollutants and adverse pregnancy outcomes in Vancouver, Canada.

    OpenAIRE

    Liu, Shiliang; Krewski, Daniel; Shi, Yuanli; Chen, Yue; Richard T. Burnett

    2003-01-01

    The association between ambient air pollution and adverse health effects, such as emergency room visits, hospitalizations, and mortality from respiratory and cardiovascular diseases, has been studied extensively in many countries, including Canada. Recently, studies conducted in China, the Czech Republic, and the United States have related ambient air pollution to adverse pregnancy outcomes. In this study, we examined association between preterm birth, low birth weight, and intrauterine growt...

  18. Blood rheology at term in normal pregnancy and in patients with adverse outcome events.

    Science.gov (United States)

    von Tempelhoff, Georg-Friedrich; Velten, Eva; Yilmaz, Asli; Hommel, Gerhard; Heilmann, Lothar; Koscielny, Jürgen

    2009-01-01

    Plasma volume expansion of more than 1.5 l and sustainable activation of the hemostatic system that results in a steady rise of the fibrinogen/fibrin turnover are contemporary physiological events during normal pregnancy. In contrast, adverse outcome of pregnancy i.e. pre-eclampsia commonly coincide with hemo concentration and over activation of blood coagulation both of which alter blood rheology. On the basis of 4,985 consecutively recorded singleton pregnancies values range of blood rheological parameters in women with normal and complicated outcome of pregnancy at the time of their delivery were compared. Plasma viscosity (pv) was determined using KSPV 1 Fresenius and RBC aggregation (stasis: E0 and low shear: E1) using MA1-Aggregometer; Myrenne. Seventy-nine point four percent (n=3,959) had normal pregnancy outcome and 1,026 with adverse outcome of pregnancy had pre-eclampsia (8.4%; n=423), had newborn with a birth-weight < 2,500 g (9.5%; n=473), had early-birth before week 37 (9.3%; n=464), and/or were diagnosed with intra uterine growth retardation (IUGR) (5.0%; n=250). In women with normal pregnancy outcome mean (+/-SD) of pv was 1.31+/-0.09 mPa s, of E0 was 21.6+/-5.3, and of E1 was 38.4+/-7.9 while in women with adverse outcome means for rheological parameters were statistically significantly different i.e. pv: 1.32+/-0.08 mPa s; p=0.006, E0: 22.1+/-5.5; p=0.002 and E1: 39.5+/-8.5; p=0.0006. Subgroup analysis revealed statistical significant lower pv in women who either had pre term delivery or a low birth-weight child (p<0.005) as compared to women who had normal pregnancy outcome while patients with pre-eclampsia had markedly higher low shear and stasis RBC aggregation (p<0.0001). None of the rheological results at term were correlated with either maternal age (r<0.04), BMI (r<0.09), maternal weight gain until delivery (r<0.04), or fetal outcome such as APGAR-score (r<0.09) art. pH in the umbilical cord (-0.05

  19. Cancer incidence and adverse pregnancy outcome in registered nurses potentially exposed to antineoplastic drugs

    OpenAIRE

    Le Nhu D; Teschke Kay; Chow Yat; Lorenzi Maria; Beking Kris; Spinelli John J; Ratner Pamela A; Gallagher Richard P; Dimich-Ward Helen

    2010-01-01

    Abstract Background To determine the relationships of potential occupational exposure to antineoplastic drugs with cancer incidence and adverse pregnancy outcomes in a historical prospective cohort study of female registered nurses (RNs) from British Columbia, Canada (BC). Methods Female RNs registered with a professional regulatory body for at least one year between 1974 and 2000 formed the cohort (n = 56,213). The identifier file was linked to Canadian cancer registries. An RN offspring coh...

  20. Excess risk of adverse pregnancy outcomes in women with porphyria: a population-based cohort study

    OpenAIRE

    Tollånes, Mette Christophersen; Aarsand, Aasne Karine; Sandberg, Sverre

    2010-01-01

    The porphyrias comprise a heterogeneous group of rare, primarily hereditary, metabolic diseases caused by a partial deficiency in one of the eight enzymes involved in the heme biosynthesis. Our aim was to assess whether acute or cutaneous porphyria has been associated with excess risks of adverse pregnancy outcomes. A population-based cohort study was designed by record linkage between the Norwegian Porphyria Register, covering 70% of all known porphyria patients in Norway, and the Medical Bi...

  1. Under-attending free antenatal care is associated with adverse pregnancy outcomes

    Directory of Open Access Journals (Sweden)

    Heinonen Seppo

    2007-09-01

    Full Text Available Abstract Background Most pertinent studies of inadequate antenatal care concentrate on the risk profile of women booking late or not booking at all to antenatal care. The objective of this study was to assess the outcome of pregnancies when free and easily accessible antenatal care has been either totally lacking or low in number of visits. Methods This is a hospital register based cohort study of pregnancies treated in Kuopio University Hospital, Finland, in 1989 – 2001. Pregnancy outcomes of women having low numbers (1–5 of antenatal care visits (n = 207 and no antenatal care visits (n = 270 were compared with women having 6–18 antenatal visits (n = 23137. Main outcome measures were: Low birth weight, fetal death, neonatal death. Adverse pregnancy outcomes were controlled for confounding factors (adjusted odds ratios, OR: s in multiple logistic regression models. Results Of the analyzed pregnant population, 1.0% had no antenatal care visits and 0.77% had 1–5 visits. Under- or non-attendance associated with social and health behavioral risk factors: unmarried status, lower educational level, young maternal age, smoking and alcohol use. Chorio-amnionitis or placental abruptions were more common complications of pregnancies of women avoiding antenatal care, and pregnancy outcome was impaired. After logistic regression analyses, controlling for confounding, there were significantly more low birth weight infants in under- and non-attenders (OR:s with 95% CI:s: 9.18 (6.65–12.68 and 5.46 (3.90–7.65, respectively more fetal deaths (OR:s 12.05 (5.95–24.40 and 5.19 (2.04–13.22, respectively and more neonatal deaths (OR:s 10.03 (3.85–26.13 and 8.66 (3.59–20.86, respectively. Conclusion Even when birth takes place in hospital, non- or under-attendance at antenatal care carries a substantially elevated risk of severe adverse pregnancy outcome. Underlying adverse health behavior and possible abuse indicate close surveillance of the

  2. Experiences of violence before and during pregnancy and adverse pregnancy outcomes: An analysis of the Canadian Maternity Experiences Survey

    OpenAIRE

    Heaman Maureen I; O'Campo Patricia J; Urquia Marcelo L; Janssen Patricia A; Thiessen Kellie R

    2011-01-01

    Abstract Background Abuse and violence against women constitute a global public health problem and are particularly important among women of reproductive age. The literature is not conclusive regarding the impact of violence against pregnant women on adverse pregnancy outcomes, such as preterm birth, small for gestational age and postpartum depression. Most studies have been conducted on relatively small samples of high-risk women. Our objective was to investigate what dimensions of violence ...

  3. UTERINE ARTERY DOPPLER STUDY FOR PREDICTION OF ADVERSE OUTCOME IN HIGH RISK PREGNANCY

    Directory of Open Access Journals (Sweden)

    Gunjan

    2015-07-01

    Full Text Available AIM : To detect abnormal waveforms in uterine artery in pregnancies at risk between 20 to 24 weeks of gestation and to measure Resistance index (RI and systolic/diastolic ratio(S/D of these waveforms in study population and to study correlation of Doppler dat a with adverse pregnancy outcome. METHODS : This is a prospective study included Doppler analysis of uterine artery waveforms in 107 normotensive women with singleton pregnancy between 20 to24 weeks of period of gestation who were considered to be at increa sed risk of developing pregnancy complications. Women with Multiple gestation, with congenital anomaly of fetus, chronic hypertension, renal disease, cardiac disease, Diabetes Mellitus were excluded from the study. Bilateral uterine artery Doppler was done and Parameters studied were S/D ratio and RI in uterine artery. Early diastolic notch in uterine artery was watched for. The flow velocity waveforms considered abnormal if there was an early diastolic notch in uterine artery in either right or left uterin e artery was watched for abnormal pregnancy outcomes considered are Gestational hypertension, Pre - eclampsia IUGR, Abruptio placentae, IUD and preterm deliveries. RESULTS : minimum women were aged 21 – 25 year with minimum of 18 years and maximum of 36 years, 28% were primigravidae while 72% were multigravidae mean gestational age of which scan was done was 22 wks 1 day (20 - 24 minimum gestational age at time of delivery was 28 wks of gestation 70% women were delivered vaginally and 30% LSCS. 7% women developed Gestational Hypertension, 5% developed Preeclampsia, 8% neonates with IUGR, 3% developed Placental Abruption while 4% had IUD and 8% had Preterm deliveries. CONCLUSION : Abnormal uterine artery Doppler studies in second trimester have been associated with subsequent adverse pregnancy out comes including Preeclampsia IUGR and perinatal mortality. Doppler velocimetry is a primary tool for fetomaternal surveillance in high

  4. Population-based study of smoking behaviour throughout pregnancy and adverse perinatal outcomes.

    LENUS (Irish Health Repository)

    Murphy, Deirdre J

    2013-09-01

    There has been limited research addressing whether behavioural change in relation to smoking is maintained throughout pregnancy and the effect on perinatal outcomes. A cohort study addressed lifestyle behaviours of 907 women who booked for antenatal care and delivered in a large urban teaching hospital in 2010-2011. Adverse perinatal outcomes were compared for "non-smokers", "ex-smokers" and "current smokers". Of the 907 women, 270 (30%) reported smoking in the six months prior to pregnancy, and of those 160 (59%) had stopped smoking and 110 (41%) continued to smoke at the time of the first antenatal visit. There was virtually no change in smoking behaviour between the first antenatal visit and the third trimester of pregnancy. Factors associated with continuing to smoke included unplanned pregnancy (OR 1.9; 95% CI 1.3, 2.9), alcohol use (OR 3.4; 95% CI 2.1, 6.0) and previous illicit drug use (OR 3.6; 95% CI 2.1, 6.0). Ex-smokers had similar perinatal outcomes to non-smokers. Current smoking was associated with an average reduction in birth weight of 191 g (95% CI -294, -88) and an increased incidence of intrauterine growth restriction (24% versus 13%, adjusted OR 1.39 (95% CI 1.06, 1.84). Public Health campaigns emphasise the health benefits of quitting smoking in pregnancy. The greatest success appears to be pre-pregnancy and during the first trimester where women are largely self-motivated to quit.

  5. Adverse pregnancy outcomes in offspring of fathers working in biomedical research laboratories

    DEFF Research Database (Denmark)

    Magnusson, Linda L; Bodin, Lennart; Wennborg, Helena

    2006-01-01

    BACKGROUND: Laboratory work may constitute a possible health hazard for workers as well as for their offspring, and involves a wide range of exposures, such as organic solvents, carcinogenic agents, ionizing radiation, and/or microbiological agents. Adverse pregnancy outcomes in the offspring of...... significant increased ORs concerning birth weight and/or gestational age, but work specifically with radioactive isotopes gave OR 1.8 (CI 1.0-3.2) for high birth weight and a relative risk of 1.2 (CI 1.0-1.4) for sex ratio (male/female). CONCLUSIONS: There was no clear association between periconceptional...

  6. Paternal occupational exposure to radiofrequency electromagnetic fields and risk of adverse pregnancy outcome

    International Nuclear Information System (INIS)

    Background:During the last decades, public concern that radiofrequency radiation (RFR) may be related to adverse reproductive outcomes has been emerging. Our objective was to assess associations between paternal occupational exposure to RFR and adverse pregnancy outcomes including birth defects using population-based data from Norway.Methods:Data on reproductive outcomes derived from the Medical Birth Registry of Norway were linked with data on paternal occupation derived from the general population censuses. An expert panel categorized occupations according to exposure. Using logistic regression, we analyzed 24 categories of birth defects as well as other adverse outcomes.Results:In the offspring of fathers most likely to have been exposed, increased risk was observed for preterm birth (odds ratio (OR): 1.08, 95% confidence interval (CI): 1.03, 1.15). In this group we also observed a decreased risk of cleft lip (OR: 0.63, 95% CI: 0.41, 0.97). In the medium exposed group, we observed increased risk for a category of ,other defects' (OR: 2.40, 95% CI: 1.22, 4.70), and a decreased risk for a category of ,other syndromes' (OR: 0.75, 95% CI: 0.56, 0.99) and upper gastrointestinal defects (OR: 0.61, 95% CI: 0.40, 0.93).Conclusion:The study is partly reassuring for occupationally exposed fathers

  7. Similar adverse pregnancy outcome in native and nonnative dutch women with pregestational type 2 diabetes: a multicentre retrospective study

    OpenAIRE

    Rutgert Bianchi; Bartelink, Anton K M; Geelhoed-Duijvestijn, Petronella H. L. M.; Willy Visser; Manon C. J. Schreuder; Faas, Marijke M; Sluiter, Wim J.; Visser, Gerard H. A.; Sharon Moerman; Marieke Hellinga; van den Berg, Paul P.; Links, Thera P.; Bart Groen; de Valk, Harold W.

    2013-01-01

    Objective. To assess the incidence of adverse pregnancy outcome in native and nonnative Dutch women with pregestational type 2 diabetes (T2D) in a multicenter study in The Netherlands. Methods. Maternal characteristics and pregnancy outcome were retrospectively reviewed and the influence of ethnicity on outcome was evaluated using independent t-test, Mann-Whitney U-test, and chi-square test. Results. 272 pregnant women (80 native and 192 non-native Dutch) with pregestational T2D were included...

  8. Diagnostic evaluation of uterine artery Doppler sonography for the prediction of adverse pregnancy outcomes

    Directory of Open Access Journals (Sweden)

    Mojgan Barati

    2014-01-01

    Full Text Available Background : Increased impedance to flow in the uterine arteries assessed by value of the Doppler is associated with adverse pregnancy outcomes, especially pre-eclampsia. We investigated the predictive value of a uterine artery Doppler in the identification of adverse pregnancy outcomes such as ′pre-eclampsia′ and ′small fetus for gestational age′ (SGA. Materials and Methods: Three hundred and seventy-nine women, with singleton pregnancy, between 18 and 40 years of age, without risk factors, randomly underwent Doppler interrogation of the uterine arteries, between 16-22 weeks of gestation. Those who had a mean pulsatility index (PI of >1.45 were considered to have an abnormal result, and were evaluated and compared with those who had normal results for adverse pregnancy outcomes, including pre-eclampsia and small for gestational age. The relationship between the variables was assessed with the use of the chi-square test. Results : There were 17 cases (4.5% of abnormal uterine artery Doppler results and 15 of them (88.2% developed pre-eclampsia and four cases (23.5% had neonates small for gestational age. For predicting pre-eclampsia, the mean uterine artery PI had to be >1.45, had to have a specificity of 95.5% (95% CI, 70-92%, a sensitivity of 79% (95% CI, 43-82%, a negative predictive value (NPV of 98.9% (95% CI, 72-96%, and a positive predictive value (PPV of 88.2% (95% CI, 68-98%. In the case of ′small for gestational age′ it had to have a specificity of 96.5% (95% CI, 42-68%, a sensitivity of 57% (95% CI, 53-76%, an NPV of 99.2% (95% CI, 70-92%, and a PPV of 23.5% (95% CI, 30-72%. Conclusion : Uterine artery Doppler evaluation at 16-22 weeks of gestation might be an appropriate tool for identifying pregnancies that may be at an increased risk for development of pre-eclampsia and small fetus for gestational age.

  9. Maternal serum disintegrin and metalloprotease protein-12 in early pregnancy as a potential marker of adverse pregnancy outcomes.

    Directory of Open Access Journals (Sweden)

    Jiexia Yang

    Full Text Available OBJECTIVES: The aim of this study was to determine whether the concentration of disintegrin and metalloprotease protein12 (ADAM12 in first trimester maternal serum can be used as a marker for first-trimester complete spontaneous abortions, missed abortions, ectopic pregnancies and hydatidiform moles. METHODS: The maternal serum concentrations of ADAM12 were measured in the range of 5-9+6 weeks of gestation using an automated AutoDelfia immunoassay platform in 9 cases of complete spontaneous abortion, 27 cases of missed abortions, 56 cases of ectopic pregnancies, 12 cases of hydatidiform moles, and 100 controls. Logistic regression analysis was used to determine significant factors for predicting adverse pregnancy outcomes in early pregnancy. Screening performance was assessed using receiver operating characteristic curves. RESULTS: Two hundred and four women were enrolled in the study. In the control group, the level of ADAM12 increased with gestational age. The median ADAM12 levels in the spontaneous abortion (0.430 MoM, ectopic pregnancy (0.460 MoM and hydatidiform mole (0.037 MoM groups were lower than that in the control group, while the median ADAM12 level in the missed abortion group (1.062 MoM was not significant from the controls (1.002 MoM. Logistic regression analysis demonstrated that the level of ADAM12 in maternal serum facilitated the detection of ectopic pregnancies (OR = 0.909; 95% CI = 0.841 ∼ 0.982 and complete spontaneous abortion (OR = 0.863; 95% CI = 0.787 ∼ 0.946. CONCLUSIONS: In complete spontaneous abortion and ectopic pregnancy, ADAM12 maintained at low levels in early pregnancies, and there were significant differences compared to normal pregnancies. ADAM12 is a promising marker for the diagnosis of complete spontaneous abortion and ectopic pregnancy in symptomatic women, and under certain conditions, ADAM12 can diagnose ectopic pregnancy and spontaneous abortion before an ultrasonographic detection of the

  10. Serotonin Reuptake Inhibitors in Pregnancy: Can Genes Help Us in Predicting Neonatal Adverse Outcome?

    Directory of Open Access Journals (Sweden)

    Valentina Giudici

    2014-01-01

    Full Text Available Lots has been written on use of SSRI during pregnancy and possible short and long term negative outcomes on neonates. the literature so far has described a various field of peripartum illness related to SSRI exposure during foetal life, such as increased incidence of low birth weight, respiratory distress, persistent pulmonary hypertension, poor feeding, and neurobehavioural disease. We know that different degrees of outcomes are possible, and not all the newborns exposed to SSRIs during pregnancy definitely will develop a negative outcome. So far, still little is known about the possible etiologic mechanism that could not only explain the adverse neonatal effects but also the degree of clinical involvement and presentation in the early period after birth. Pharmacogenetics and moreover pharmacogenomics, the study of specific genetic variations and their effect on drug response, are not widespread. This review describes possible relationship between SSRIs pharmacogenetics and different neonatal outcomes and summarizes the current pharmacogenetic inquiries in relation to maternal-foetal environment.

  11. First trimester screening using ultrasound and serum markers in Panamanians : f0 actors associated with adverse pregnancy outcomes

    Directory of Open Access Journals (Sweden)

    Tania T Herrera

    2014-01-01

    Full Text Available Background: There is no published data on the association between serum biochemical and ultrasonographic markers and adverse pregnancy outcomes. Therefore, the aim of this study was to determine the factors associated with perinatal outcomes in singleton pregnancies using ultrasound and maternal serum markers during the first trimester in Panamanians. Materials and Methods: This was a prospective observational study of 468 first trimester singleton pregnancies conducted over a 7-year period. All women attending a prenatal screening clinic during the study period were informed of the study and the option to participate. Two maternal serum markers, free β-human chorionic gonadotropin (β-hCG and pregnancy associated plasma protein-A (PAPP-A, and four fetal ultrasound markers, nuchal translucency thickness, nasal bone, flow across the tricuspid valve, and flow in the ductus venosus (DV, were measured by certified maternal fetal medicine specialists. Adverse outcomes included miscarriage, major structural defects, genetic disorders, and major fetal cardiac defects. Results: A total of 454 (97% pregnancies were unaffected. Median maternal age was 31.5 years (range: 18-50. Maternal age was significantly greater in cases of adverse outcome (P = 0.007. The number of adverse outcomes associated with an absent or hypoplastic nasal bone, tricuspid valve regurgitation, and abnormal flow in the DV were significantly greater relative to unaffected pregnancies (Ps < 0.001. No differences were found in fetal crown-rump length or maternal serum levels of β-hCG or PAPP-A. Conclusion: Abnormal ultrasound markers are associated with adverse outcomes. Women with normal ultrasound and serum markers should be reassured of low risk of adverse pregnancy outcomes.

  12. Missing paternal demographics: A novel indicator for identifying high risk population of adverse pregnancy outcomes

    Directory of Open Access Journals (Sweden)

    Wen Shi

    2004-11-01

    Full Text Available Abstract Background One of every 6 United Status birth certificates contains no information on fathers. There might be important differences in the pregnancy outcomes between mothers with versus those without partner information. The object of this study was to assess whether and to what extent outcomes in pregnant women who did not have partner information differ from those who had. Methods We carried out a population-based retrospective cohort study based on the registry data in the United States for the period of 1995–1997, which was a matched multiple birth file (only twins were included in the current analysis. We divided the study subjects into three groups according to the availability of partner information: available, partly missing, and totally missing. We compared the distribution of maternal characteristics, maternal morbidity, labor and delivery complications, obstetric interventions, preterm birth, fetal growth restriction, low birth weight, congenital anomalies, fetal death, neonatal death, post-neonatal death, and neonatal morbidity among three study groups. Results There were 304466 twins included in our study. Mothers whose partner's information was partly missing and (especially totally missing tended to be younger, of black race, unmarried, with less education, smoking cigarette during pregnancy, and with inadequate prenatal care. The rates of preterm birth, fetal growth restriction, low birth weight, Apgar score Conclusions Mothers whose partner's information was partly and (especially totally missing are at higher risk of adverse pregnant outcomes, and clinicians and public health workers should be alerted to this important social factor.

  13. Retinal artery and vein thrombotic occlusion during pregnancy: markers for familial thrombophilia and adverse pregnancy outcomes

    OpenAIRE

    Kurtz WS; Glueck CJ; Hutchins RK; Sisk RA; Wang P

    2016-01-01

    Will S Kurtz,1 Charles J Glueck,1 Robert K Hutchins,2,3 Robert A Sisk,2,3 Ping Wang1 1Cholesterol, Metabolism, and Thrombosis Center, Jewish Hospital of Cincinnati, 2Cincinnati Eye Institute, 3Department of Ophthalmology, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA Background: Ocular vascular occlusion (OVO), first diagnosed during or immediately after giving birth, often reflects superposition of the physiologic thrombophilia of pregnancy on previously undiagnosed u...

  14. Prevalence of Adverse Pregnancy Outcomes, by Maternal Diabetes Status at First and Second Deliveries, Massachusetts, 1998–2007

    OpenAIRE

    Kim, Shin Y.; Kotelchuck, Milton; Wilson, Hoyt G.; Diop, Hafsatou; Shapiro-Mendoza, Carrie K.; England, Lucinda J.

    2015-01-01

    Introduction: Understanding patterns of diabetes prevalence and diabetes-related complications across pregnancies could inform chronic disease prevention efforts. We examined adverse birth outcomes by diabetes status among women with sequential, live singleton deliveries. Methods: We used data from the 1998–2007 Massachusetts Pregnancy to Early Life Longitudinal Data System, a population-based cohort of deliveries. We restricted the sample to sets of parity 1 and 2 deliveries. We created 8 di...

  15. Prevalence of Adverse Pregnancy Outcomes, by Maternal Diabetes Status at First and Second Deliveries, Massachusetts, 1998–2007

    OpenAIRE

    Kim, Shin Y.; Kotelchuck, Milton; Wilson, Hoyt G.; Diop, Hafsatou; Shapiro-Mendoza, Carrie K.; England, Lucinda J.

    2015-01-01

    Introduction Understanding patterns of diabetes prevalence and diabetes-related complications across pregnancies could inform chronic disease prevention efforts. We examined adverse birth outcomes by diabetes status among women with sequential, live singleton deliveries. Methods We used data from the 1998–2007 Massachusetts Pregnancy to Early Life Longitudinal Data System, a population-based cohort of deliveries. We restricted the sample to sets of parity 1 and 2 deliveries. We created 8 diab...

  16. Advanced maternal age and adverse pregnancy outcome: evidence from a large contemporary cohort.

    Directory of Open Access Journals (Sweden)

    Louise C Kenny

    Full Text Available BACKGROUND: Recent decades have witnessed an increase in mean maternal age at childbirth in most high-resourced countries. Advanced maternal age has been associated with several adverse maternal and perinatal outcomes. Although there are many studies on this topic, data from large contemporary population-based cohorts that controls for demographic variables known to influence perinatal outcomes is limited. METHODS: We performed a population-based cohort study using data on all singleton births in 2004-2008 from the North Western Perinatal Survey based at The University of Manchester, UK. We compared pregnancy outcomes in women aged 30-34, 35-39 and ≥40 years with women aged 20-29 years using log-linear binomial regression. Models were adjusted for parity, ethnicity, social deprivation score and body mass index. RESULTS: The final study cohort consisted of 215,344 births; 122,307 mothers (54.19% were aged 20-29 years, 62,371(27.63% were aged 30-34 years, 33,966(15.05% were aged 35-39 years and 7,066(3.13% were aged ≥40 years. Women aged 40+ at delivery were at increased risk of stillbirth (RR = 1.83, [95% CI 1.37-2.43], pre-term (RR = 1.25, [95% CI: 1.14-1.36] and very pre-term birth (RR = 1.29, [95% CI:1.08-1.55], Macrosomia (RR = 1.31, [95% CI: 1.12-1.54], extremely large for gestational age (RR = 1.40, [95% CI: 1.25-1.58] and Caesarean delivery (RR = 1.83, [95% CI: 1.77-1.90]. CONCLUSIONS: Advanced maternal age is associated with a range of adverse pregnancy outcomes. These risks are independent of parity and remain after adjusting for the ameliorating effects of higher socioeconomic status. The data from this large contemporary cohort will be of interest to healthcare providers and women and will facilitate evidence based counselling of older expectant mothers.

  17. Socioeconomic disparities in ectopic pregnancy: predictors of adverse outcomes from Illinois hospital-based care, 2000-2006.

    Science.gov (United States)

    Stulberg, Debra B; Zhang, James X; Lindau, Stacy Tessler

    2011-02-01

    This study aimed to identify the incidence of adverse outcomes from ectopic pregnancy hospital care in Illinois (2000-2006), and assess patient, neighborhood, hospital and time factors associated with these outcomes. Discharge data from Illinois hospitals were retrospectively analyzed and ectopic pregnancies were identified using DRG and ICD-9 diagnosis codes. The primary outcome was any complication identified by ICD-9 procedure codes. Secondary outcomes were length of stay and discharge status. Residential zip codes were linked to 2000 U.S. Census data to identify patients' neighborhood demographics. Logistic regression was used to identify risk factors for adverse outcomes. Independent variables were insurance status, age, co-morbidities, neighborhood demographics, hospital type, hospital ectopic pregnancy service volume, and year of discharge. Of 13,007 ectopic pregnancy hospitalizations, 7.4% involved at least one complication identified by procedure codes. Hospitalizations covered by Medicare (for women with chronic disabilities) were more likely than those with other source or without insurance to result in surgical sterilization (OR 4.7, P = 0.012). Hospitalization longer than 2 days was more likely with Medicaid (OR 1.46, P hospitals (OR 1.21, P hospitals, private hospitals had lower rates of complications (OR 0.39, P hospitalization longer than 2 days (OR 0.57, P hospitalizations became shorter (OR 0.53, P hospitals, were more likely to experience adverse outcomes. PMID:20177756

  18. Adverse pregnancy outcome in women with mild glucose intolerance: is there a clinically meaningful threshold value for glucose?

    DEFF Research Database (Denmark)

    Jensen, Dorte; Lauridsen, Lars Korsholm; Ovesen, Per Glud; Beck-Nielsen, Henning; Mølsted-Pedersen, Lars; Damm, Peter

    2008-01-01

    The diagnostic criteria of gestational diabetes mellitus (GDM) have been based on the risk of future maternal diabetes rather than the short-term risk of mother and infant. Our aim was to illustrate the relation between various adverse pregnancy outcomes and maternal glucose levels in women with...

  19. Crown-rump length discordance in the first trimester: a predictor of adverse outcome in twin pregnancies?

    DEFF Research Database (Denmark)

    Johansen, Mathias; Oldenburg, A.; Rosthøj, Susanne;

    2014-01-01

    OBJECTIVES: To evaluate the usefulness of first-trimester crown-rump length (CRL) discordance in predicting adverse outcome in twin pregnancies. METHODS: This retrospective study included a large cohort retrieved from local ultrasound databases at 14 obstetric departments in Denmark, comprising a...

  20. Impact of Coastal Pollution on Childhood Disabilities and Adverse Pregnancy Outcomes: The Case of Bangladesh

    Directory of Open Access Journals (Sweden)

    Juma Rahman

    2012-07-01

    Full Text Available Objective: The objective of this review was to explore the situation of coastal water pollution and its impact on child health and pregnancy outcomes in Bangladesh. Background: Globally coastal pollution is of greater significance than inland’s for its huge resources and contribution to livelihood. As a result it has been a source of increased Global Burden of Disease by means of consumption of seafood, involvement in risky jobs, and exposure to water related disastrous events. Almost sixty percent of the world’s population is at risk of costal contamination and developing countries like Bangladesh, geographically located at the tip of the Bay of Bengal, are facing significant challenges by this form of pollution. Method: This study was based on a critical review of published literature and unpublished documents from 1972 to 2011 retrieved from databases of scientific publications, from public-access search engines, reports from government, international organizations, and non-government agencies, and personal communications. Discussion: Huge noxious pollutants including heavy metals, oil spill and redionucleotides were found in the Bay of Bengal, those have enormous adverse impacts on child health and pregnancy outcomes. This review focuses on children and pregnant women because of their vulnerable physiological conditions to the impacts of environmental factors. The physiological systems of children and fetuses are developing fast and usually are sensitive to disruptions induced by environmental pollutants and exposures in utero increase the risk of future toxic insults. Conclusion: The coastal zone of Bangladesh is one of the vulnerable zones in the world which is predicted to disappear due to climate change impacts. This areas face huge weather-related disasters due to continuous changing coastal-configuration and man-made pollutions. However, these observations are indecisive due to limitations of supportive evidence. Therefore, further

  1. Adverse pregnancy outcome in rats following exposure to a Salacia reticulata (Celastraceae) root extract

    OpenAIRE

    Ratnasooriya W.D.; Jayakody J.R.A.C.; Premakumara G.A.S.

    2003-01-01

    The root extract of Salacia reticulata Wight (family: Celastraceae) is used in Sri Lanka by traditional practitioners as a herbal therapy for glycemic control even during pregnancy. It is recognized that some clinically used antidiabetic drugs have harmful effects on pregnancy but the effects of the S. reticulata root extract on reproductive outcome is unknown and deserves examination. We determined the effects of the S. reticulata root extract on the reproductive outcome of Wistar rats (250-...

  2. Periodontal Treatment for Preventing Adverse Pregnancy Outcomes: A Meta- and Trial Sequential Analysis

    Science.gov (United States)

    Schwendicke, Falk; Karimbux, Nadeem; Allareddy, Veerasathpurush; Gluud, Christian

    2015-01-01

    Objectives Periodontal treatment might reduce adverse pregnancy outcomes. The efficacy of periodontal treatment to prevent preterm birth, low birth weight, and perinatal mortality was evaluated using meta-analysis and trial sequential analysis. Methods An existing systematic review was updated and meta-analyses performed. Risk of bias, heterogeneity, and publication bias were evaluated, and meta-regression performed. Subgroup analysis was used to compare different studies with low and high risk of bias and different populations, i.e., risk groups. Trial sequential analysis was used to assess risk of random errors. Results Thirteen randomized clinical trials evaluating 6283 pregnant women were meta-analyzed. Four and nine trials had low and high risk of bias, respectively. Overall, periodontal treatment had no significant effect on preterm birth (odds ratio [95% confidence interval] 0.79 [0.57-1.10]) or low birth weight (0.69 [0.43-1.13]). Trial sequential analysis demonstrated that futility was not reached for any of the outcomes. For populations with moderate occurrence (<20%) of preterm birth or low birth weight, periodontal treatment was not efficacious for any of the outcomes, and trial sequential analyses indicated that further trials might be futile. For populations with high occurrence (≥20%) of preterm birth and low birth weight, periodontal treatment seemed to reduce the risk of preterm birth (0.42 [0.24-0.73]) and low birth weight (0.32 [0.15-0.67]), but trial sequential analyses showed that firm evidence was not reached. Periodontal treatment did not significantly affect perinatal mortality, and firm evidence was not reached. Risk of bias, but not publication bias or patients’ age modified the effect estimates. Conclusions Providing periodontal treatment to pregnant women could potentially reduce the risks of perinatal outcomes, especially in mothers with high risks. Conclusive evidence could not be reached due to risks of bias, risks of random

  3. Human cytomegalovirus-induces cytokine changes in the placenta with implications for adverse pregnancy outcomes.

    Directory of Open Access Journals (Sweden)

    Stuart T Hamilton

    Full Text Available Human cytomegalovirus (CMV infection of the developing fetus can result in adverse pregnancy outcomes including death in utero. Fetal injury results from direct viral cytopathic damage to the CMV-infected fetus, although evidence suggests CMV placental infection may indirectly cause injury to the fetus, possibly via immune dysregulation with placental dysfunction. This study investigated the effects of CMV infection on expression of the chemokine MCP-1 (CCL2 and cytokine TNF-α in placentae from naturally infected stillborn babies, and compared these changes with those found in placental villous explant histocultures acutely infected with CMV ex vivo. Tissue cytokine protein levels were assessed using quantitative immunohistochemistry. CMV-infected placentae from stillborn babies had significantly elevated MCP-1 and TNF-α levels compared with uninfected placentae (p = 0.001 and p = 0.007, which was not observed in placentae infected with other microorganisms (p = 0.62 and p = 0.71 (n = 7 per group. Modelling acute clinical infection using ex vivo placental explant histocultures showed infection with CMV laboratory strain AD169 (0.2 pfu/ml caused significantly elevated expression of MCP-1 and TNF-α compared with uninfected explants (p = 0.0003 and p<0.0001 (n = 25 per group. Explant infection with wild-type Merlin at a tenfold lower multiplicity of infection (0.02 pfu/ml, caused a significant positive correlation between increased explant infection and upregulation of MCP-1 and TNF-α expression (p = 0.0001 and p = 0.017. Cytokine dysregulation has been associated with adverse outcomes of pregnancy, and can negatively affect placental development and function. These novel findings demonstrate CMV infection modulates the placental immune environment in vivo and in a multicellular ex vivo model, suggesting CMV-induced cytokine modulation as a potential initiator and/or exacerbator of placental and fetal injury.

  4. Ondansetron in pregnancy and risk of adverse fetal outcomes in the United States.

    Science.gov (United States)

    Fejzo, Marlena S; MacGibbon, Kimber W; Mullin, Patrick M

    2016-07-01

    This is an analysis of fetal outcome in pregnancies exposed to ondansetron to treat Hyperemesis Gravidarum (HG). In this retrospective cohort study, U.S. data on outcome were collected on 1070 pregnancies exposed to ondansetron and compared to outcomes in two control groups: 771 pregnancies in women with a history of HG with no ondansetron exposure and 1555 pregnancies with neither a history of HG nor ondansetron exposure. Ventricular septal defects were reported in 2/952 of infants in the HG/Ondansetron-exposure group and 4/1286 in the No HG/No Ondansetron-exposure group. Cleft palate was reported in 1/952 live births in the HG/Ondansetron and 2/1286 in the No HG/No Ondansetron-exposure groups. Women with a history of HG who took ondansetron reported less miscarriages and terminations, and higher live birth rates. The overall results do not support evidence of teratogenicity of ondansetron. PMID:27151373

  5. The Effects of Chewing Betel Nut with Tobacco and Pre-pregnancy Obesity on Adverse Birth Outcomes Among Palauan Women.

    Science.gov (United States)

    Berger, Katherine E; Masterson, James; Mascardo, Joy; Grapa, Jayvee; Appanaitis, Inger; Temengil, Everlynn; Watson, Berry Moon; Cash, Haley L

    2016-08-01

    The small Pacific Island nation of Palau has alarmingly high rates of betel nut with tobacco use and obesity among the entire population including pregnant women. This study aimed to determine the effects of betel nut with tobacco use and pre-pregnancy obesity on adverse birth outcomes. This study used retrospective cohort data on 1171 Palauan women who gave birth in Belau National Hospital in Meyuns, Republic of Palau between 2007 and 2013. The exposures of interest were pre-pregnancy obesity and reported betel nut with tobacco use during pregnancy. The primary outcomes measured were preterm birth and low birth weight among full-term infants. A significantly increased risk for low birth weight among full-term infants was demonstrated among those women who chewed betel nut with tobacco during pregnancy when other known risk factors were controlled for. Additionally, pre-pregnancy obesity was associated with a significantly increased risk for preterm birth when other known risk factors were controlled for. Both betel nut with tobacco use and pre-pregnancy obesity were associated with higher risks for adverse birth outcomes. These findings should be used to drive public health efforts in Palau, as well as in other Pacific Island nations where these studies are currently lacking. PMID:26994610

  6. Study of correlation between placental morphology and adverse perinatal outcome in different conditions affecting pregnancy

    Directory of Open Access Journals (Sweden)

    Manik Sirpurkar

    2015-08-01

    Conclusions: These conditions also affect the perinatal outcome. Placental parameters are also altered along with foetal parameters like foetal weight. So the diagnosis of such risk factors in pregnancies during antenatal period will improve the outcome. [Int J Reprod Contracept Obstet Gynecol 2015; 4(4.000: 1165-1168

  7. Adverse pregnancy outcome in rats following exposure to a Salacia reticulata (Celastraceae root extract

    Directory of Open Access Journals (Sweden)

    Ratnasooriya W.D.

    2003-01-01

    Full Text Available The root extract of Salacia reticulata Wight (family: Celastraceae is used in Sri Lanka by traditional practitioners as a herbal therapy for glycemic control even during pregnancy. It is recognized that some clinically used antidiabetic drugs have harmful effects on pregnancy but the effects of the S. reticulata root extract on reproductive outcome is unknown and deserves examination. We determined the effects of the S. reticulata root extract on the reproductive outcome of Wistar rats (250-260 g when administered orally (10 g/kg during early (days 1-7 and mid- (days 7-14 pregnancy. The root extract significantly (P<0.05 enhanced post-implantation losses (control vs treatment: early pregnancy, 4.7 ± 2.4 vs 49.3 ± 13%; mid-pregnancy, 4.7 ± 2.4 vs 41.7 ± 16.1%. Gestational length was unaltered but the pups born had a low birth weight (P<0.05 (early pregnancy, 6.8 ± 0.1 vs 5.3 ± 0.1 g; mid-pregnancy, 6.8 ± 0.1 vs 5.0 ± 0.1 g and low birth index (P<0.05 (early pregnancy, 95.2 ± 2.4 vs 50.7 ± 12.9%; mid-pregnancy, 95.2 ± 2.4 vs 58.3 ± 16.1%, fetal survival ratio (P<0.05 (early pregnancy, 95.2 ± 2.4 vs 50.7 ± 12.9; mid-pregnancy, 95.2 ± 2.4 vs 58.3 ± 16.1, and viability index (P<0.05 (early pregnancy, 94.9 ± 2.6 vs 49.5 ± 12.5%; mid-pregnancy, 94.9 ± 2.6 vs 57.1 ± 16.1%. However, the root extract was non-teratogenic. We conclude that the S. reticulata root extract can be hazardous to successful pregnancy in women and should not be used in pregnancy complicated by diabetes.

  8. Experiences of violence before and during pregnancy and adverse pregnancy outcomes: An analysis of the Canadian Maternity Experiences Survey

    Directory of Open Access Journals (Sweden)

    Heaman Maureen I

    2011-06-01

    Full Text Available Abstract Background Abuse and violence against women constitute a global public health problem and are particularly important among women of reproductive age. The literature is not conclusive regarding the impact of violence against pregnant women on adverse pregnancy outcomes, such as preterm birth, small for gestational age and postpartum depression. Most studies have been conducted on relatively small samples of high-risk women. Our objective was to investigate what dimensions of violence against pregnant women were associated with preterm birth, small for gestational age and postpartum depression in a nationally representative sample of Canadian women. Methods We analysed data of the Maternity Experiences Survey, a nationally representative survey of Canadian women giving birth in 2006. The comprehensive questionnaire included a 19-item section to collect information on different dimensions of abuse and violence, such as type, frequency, timing and perpetrator of violence. The survey design is a stratified simple random sample from the 2006 Canadian Census sampling frame. Participants were 6,421 biological mothers (78% response rate 15 years and older who gave birth to a singleton live birth and lived with their infant at the time of the survey. Logistic regression was used to compute Odds Ratios. Survey weights were used to obtain point estimates and 95% confidence intervals were obtained with the jacknife method of variance estimation. Covariate control was informed by use of directed acyclic graphs. Results No statistically significant associations were found for preterm birth or small for gestational age, after adjustment. Most dimensions of violence were associated with postpartum depression, particularly the combination of threats and physical violence starting before and continuing during pregnancy (Adjusted Odds Ratio = 4.1, 95% confidence interval: 1.9, 8.9 and perpetrated by the partner (4.3: 2.1, 8.7. Conclusions Our findings

  9. The role of lupus nephritis in development of adverse maternal and fetal outcomes during pregnancy

    OpenAIRE

    Alimohammad Fatemi; Reyhaneh Motamedi Fard; Zahra Sayedbonakdar; Ziba Farajzadegan; Mina Saber

    2013-01-01

    Background: We aimed to investigate the relationship of lupus nephritis (LN) with fetal and maternal outcomes of pregnant patients with systemic lupus erythematosus (SLE). Methods: In a retrospective study, profiles of pregnant women with SLE were selected. Before pregnancy and at the end of first, second and third trimesters, SLE disease activity index-2K was assessed. Clinical and laboratory evaluations were carried out regularly. Maternal and fetal outcomes were recorded. Assessments o...

  10. APCR, factor V gene known and novel SNPs and adverse pregnancy outcomes in an Irish cohort of pregnant women

    LENUS (Irish Health Repository)

    Sedano-Balbas, Sara

    2010-03-10

    Abstract Background Activated Protein C Resistance (APCR), a poor anticoagulant response of APC in haemostasis, is the commonest heritable thrombophilia. Adverse outcomes during pregnancy have been linked to APCR. This study determined the frequency of APCR, factor V gene known and novel SNPs and adverse outcomes in a group of pregnant women. Methods Blood samples collected from 907 pregnant women were tested using the Coatest® Classic and Modified functional haematological tests to establish the frequency of APCR. PCR-Restriction Enzyme Analysis (PCR-REA), PCR-DNA probe hybridisation analysis and DNA sequencing were used for molecular screening of known mutations in the factor V gene in subjects determined to have APCR based on the Coatest® Classic and\\/or Modified functional haematological tests. Glycosylase Mediated Polymorphism Detection (GMPD), a SNP screening technique and DNA sequencing, were used to identify SNPs in the factor V gene of 5 APCR subjects. Results Sixteen percent of the study group had an APCR phenotype. Factor V Leiden (FVL), FV Cambridge, and haplotype (H) R2 alleles were identified in this group. Thirty-three SNPs; 9 silent SNPs and 24 missense SNPs, of which 20 SNPs were novel, were identified in the 5 APCR subjects. Adverse pregnancy outcomes were found at a frequency of 35% in the group with APCR based on Classic Coatest® test only and at 45% in the group with APCR based on the Modified Coatest® test. Forty-eight percent of subjects with FVL had adverse outcomes while in the group of subjects with no FVL, adverse outcomes occurred at a frequency of 37%. Conclusions Known mutations and novel SNPs in the factor V gene were identified in the study cohort determined to have APCR in pregnancy. Further studies are required to investigate the contribution of these novel SNPs to the APCR phenotype. Adverse outcomes including early pregnancy loss (EPL), preeclampsia (PET) and intrauterine growth restriction (IGUR) were not significantly more

  11. Women with Intellectual Disability at Risk of Adverse Pregnancy and Birth Outcomes

    Science.gov (United States)

    Mcconnell, D.; Mayes, R.; Llewellyn, G.

    2008-01-01

    Background: An increasing number of women with intellectual disability (ID) have children. Cross-sectional, clinical population data suggest that these women face an increased risk of delivering preterm and/or low birthweight babies. The aim of this study was to explore the prevalence of poor pregnancy and birth outcomes in women with ID and/or…

  12. Association between vitamin D insufficiency and adverse pregnancy outcome: global comparisons

    Directory of Open Access Journals (Sweden)

    Bener A

    2013-09-01

    Full Text Available Abdulbari Bener,1,2 Abdulla OAA Al-Hamaq,3 Najah M Saleh4 1Department of Medical Statistics and Epidemiology, Hamad General Hospital, Doha, Qatar; 2Institute of Population Health, University of Manchester, Manchester, UK; 3Qatar Diabetic Association, Doha, Qatar; 4Department of Obstetrics and Gynecology, Women's Hospital, Doha, Qatar Background: Vitamin D insufficiency has been associated with a number of adverse pregnancy outcomes, and has been recognized as a public health concern. Aim: The objective of this study was to determine the impact of vitamin D deficiency on maternal complications like gestational diabetes mellitus (GDM, anemia, iron deficiency, and preeclampsia among pregnant women. Subjects and methods: This was a cohort study undertaken at antenatal clinics at the Women's Hospital of Hamad Medical Corporation in Doha. A total of 2,487 Arab pregnant women above 24 weeks' gestation with any maternal complication were approached, and 1,873 women (75.3% consented to participate in the study. Data on sociodemographic and clinical characteristics by interview and biochemistry parameters were retrieved from medical records. Multivariate logistic regression analysis was performed to determine the associated risk factors. Results: Of the studied pregnant women, nearly half of them had vitamin D deficiency (48.4%. Younger women below 30 years old (43.2%, P = 0.032, housewives (65.3%, P = 0.008, and those on low monthly household incomes (QR5,000–9,999 (49.2%, P = 0.03 were significantly more likely to have lower vitamin D compared with those who had sufficient vitamin D levels. Exposure to sunlight (63.4%, P = 0.05, daily physical activity (64.4%, P = 0.05, and vitamin D supplement intake (89.7%, P < 0.001 were significantly lower in deficient pregnant women. In the study sample of pregnant women, 13.9% had GDM, 11.5% had anemia, 8.6% had iron deficiency, and 6.9% had preeclampsia. Severe vitamin D deficiency was significantly higher in

  13. Circulating angiogenic factors and risk of adverse maternal and perinatal outcomes in twin pregnancies with suspected preeclampsia.

    Science.gov (United States)

    Rana, Sarosh; Hacker, Michele R; Modest, Anna Merport; Salahuddin, Saira; Lim, Kee-Hak; Verlohren, Stefan; Perschel, Frank H; Karumanchi, S Ananth

    2012-08-01

    To evaluate whether angiogenic factor levels correlate with preeclampsia-related adverse maternal and perinatal outcomes in women with twin pregnancy, we studied 79 women with suspected preeclampsia in the 3rd trimester. Antiangiogenic soluble fms-like tyrosine kinase-1 (sFlt-1) and proangiogenic placental growth factor (PlGF) were measured at presentation on an automated platform. An adverse outcome was defined as hemolysis, elevated liver enzymes, and low platelets syndrome; disseminated intravascular coagulation; abruption; pulmonary edema; cerebral hemorrhage; maternal, fetal, and neonatal death; eclampsia; acute renal failure; small for gestational age; and indicated delivery. All outcomes were ascertained 2 weeks after initial evaluation. Comparing the 52 women (65.8%) who experienced an adverse outcome with the 27 women (34.2%) without an adverse outcome, the median sFlt-1 was elevated (11461.5 pg/mL [8794.0-14847.5] versus 7495.0 pg/mL [3498.0-10482.0; P=0.0004]), PlGF was reduced (162.5 pg/mL [98.0-226.5] versus 224.0 pg/mL [156.0-449.0]; P=0.005), and sFlt-1/PlGF ratio was elevated (74.2 [43.5-110.5] versus 36.2 [7.1-71.3]; P=0.0005). Among those presenting preeclampsia, the sFlt-1/PlGF ratio at the time of initial evaluation is associated with subsequent adverse maternal and perinatal outcomes. These findings are similar to those in singleton pregnancies and may implicate common pathogenic pathways. PMID:22753210

  14. Adolescence as risk factor for adverse pregnancy outcome in Central Africa--a cross-sectional study.

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    Florian Kurth

    Full Text Available BACKGROUND: Sub-Saharan Africa has the highest rates of maternal and neonatal mortality worldwide. Young maternal age at delivery has been proposed as risk factor for adverse pregnancy outcome, yet there is insufficient data from Sub-Saharan Africa. The present study aimed to investigate the influence of maternal adolescence on pregnancy outcomes in the Central African country Gabon. METHODOLOGY AND PRINCIPAL FINDINGS: Data on maternal age, parity, birth weight, gestational age, maternal Plasmodium falciparum infection, use of bednets, and intake of intermittent preventive treatment of malaria in pregnancy were collected in a cross-sectional survey in 775 women giving birth in three mother-child health centers in Gabon. Adolescent women (≤16 years of age had a significantly increased risk to deliver a baby with low birth weight in univariable analysis (22.8%, 13/57, vs. 9.3%, 67/718, OR: 2.9, 95% CI: 1.5-5.6 and young maternal age showed a statistically significant association with the risk for low birth weight in multivariable regression analysis after correction for established risk factors (OR: 2.7; 95% CI: 1.1-6.5. In further analysis adolescent women were shown to attend significantly less antenatal care visits than adult mothers (3.3±1.9 versus 4.4±1.9 mean visits, p<0.01, n = 356 and this difference accounted at least for part of the excess risk for low birth weight in adolescents. CONCLUSION: Our data demonstrate the importance of adolescent age as risk factor for adverse pregnancy outcome. Antenatal care programs specifically tailored for the needs of adolescents may be necessary to improve the frequency of antenatal care visits and pregnancy outcomes in this risk group in Central Africa.

  15. Women's perception of risks of adverse fetal pregnancy outcomes: a large-scale multinational survey

    OpenAIRE

    Petersen, Irene; McCrea, Rachel; Lupattelli, Angela; Nordeng, Hedvig Marie Egeland

    2015-01-01

    Objective To determine pregnant women and new mothers’ perception of risks in pregnancy. Design, settings and participants This was a large-scale multinational survey including 9113 pregnant women and new mothers from 18 countries in Europe, North America and Australia. Main outcomes Risk perception scores (0–10) for harmful effects to the fetus were derived for: (1) medicines (over-the-counter medicine and prescribed medicine), (2) food substances (eggs and blue veined chee...

  16. Cancer incidence and adverse pregnancy outcome in registered nurses potentially exposed to antineoplastic drugs

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    Le Nhu D

    2010-09-01

    Full Text Available Abstract Background To determine the relationships of potential occupational exposure to antineoplastic drugs with cancer incidence and adverse pregnancy outcomes in a historical prospective cohort study of female registered nurses (RNs from British Columbia, Canada (BC. Methods Female RNs registered with a professional regulatory body for at least one year between 1974 and 2000 formed the cohort (n = 56,213. The identifier file was linked to Canadian cancer registries. An RN offspring cohort from 1986 was created by linkages with the BC Birth and Health Status Registries. Exposure was assessed by work history in oncology or cancer agencies (method 1 and by estimating weighted duration of exposure developed from a survey of pharmacists and nursing unit administrators of all provincial hospitals and treatment centers and the work history of the nurses (method 2. Relative risks (RR were calculated using Poisson regression for cancer incidence and odds ratios (OR were calculated for congenital anomaly, stillbirth, low birth weight, and prematurity incidence, with 95% confidence intervals. Results In comparison with other female RNs, method 1 revealed that RNs who ever worked in a cancer center or in an oncology nursing unit had an increased risk of breast cancer (RR = 1.83; 95% CI = 1.03 - 3.23, 12 cases and their offspring were at risk for congenital anomalies of the eye (OR = 3.46, 95% CI = 1.08 - 11.14, 3 cases. Method 2 revealed that RNs classified as having the highest weighted durations of exposure to antineoplastic drugs had an excess risk of cancer of the rectum (RR = 1.87, 95% CI = 1.07 - 3.29, 14 cases. No statistically significant increased risks of leukemia, other cancers, stillbirth, low birth weight, prematurity, or other congenital anomalies in the RNs' offspring were noted. Conclusions Female RNs having had potential exposure to antineoplastic drugs were not found to have an excess risk of leukemia, stillbirth, or congenital

  17. Recent immigration and adverse pregnancy outcomes in an urban setting in Spain.

    Science.gov (United States)

    Garcia-Subirats, Irene; Pérez, Glòria; Rodríguez-Sanz, Maica; Salvador, Joaquín; Jané, Mireia

    2011-07-01

    To describe social and economic inequalities in non-fatal pregnancy outcomes (low birth weight, preterm birth and small for gestational age births) in the neighbourhoods of the city of Barcelona (Spain), according to maternal age and maternal country of origin, between 1991 and 2005. A cross-sectional ecological study was carried out using the 38 neighbourhoods of Barcelona as the unit of analysis. The study population comprises the 192,921 live births to resident women aged 12-49 residing from 1991 to 2005. Information was gathered from births registry. Prevalence of low birth-weight, preterm birth and small for gestational age, was calculated for each of the 38 neighbourhoods of mothers' residence, stratifying results by maternal age and country of origin. The indicator of neighbourhood socio-economic level was the unemployment rate. Quartile maps along with Spearman correlation coefficients and linear regression were performed between indicators. The present study reports socio-economic inequalities in pregnancy outcomes among neighbourhoods in Barcelona (Spain): the more disadvantaged neighbourhoods have worse pregnancy outcomes (low birth weight, preterm birth and small for gestational age births) in all women age groups. These inequalities do not exist among immigrant women, and some groups of foreign mothers even have lower rates of low birth weight, preterm birth, and small for gestational age births than autochthonous women. The existing inequalities suggest that policy efforts to reduce these inequalities are not entirely successful and should focus on improving pregnancy and delivery care in less privileged women in a country with universal access to health care. PMID:20440546

  18. Background rates of adverse pregnancy outcomes for assessing the safety of maternal vaccine trials in sub-Saharan Africa.

    Directory of Open Access Journals (Sweden)

    Lauren A V Orenstein

    Full Text Available BACKGROUND: Maternal immunization has gained traction as a strategy to diminish maternal and young infant mortality attributable to infectious diseases. Background rates of adverse pregnancy outcomes are crucial to interpret results of clinical trials in Sub-Saharan Africa. METHODS: We developed a mathematical model that calculates a clinical trial's expected number of neonatal and maternal deaths at an interim safety assessment based on the person-time observed during different risk windows. This model was compared to crude multiplication of the maternal mortality ratio and neonatal mortality rate by the number of live births. Systematic reviews of severe acute maternal morbidity (SAMM, low birth weight (LBW, prematurity, and major congenital malformations (MCM in Sub-Saharan African countries were also performed. FINDINGS: Accounting for the person-time observed during different risk periods yields lower, more conservative estimates of expected maternal and neonatal deaths, particularly at an interim safety evaluation soon after a large number of deliveries. Median incidence of SAMM in 16 reports was 40.7 (IQR: 10.6-73.3 per 1,000 total births, and the most common causes were hemorrhage (34%, dystocia (22%, and severe hypertensive disorders of pregnancy (22%. Proportions of liveborn infants who were LBW (median 13.3%, IQR: 9.9-16.4 or premature (median 15.4%, IQR: 10.6-19.1 were similar across geographic region, study design, and institutional setting. The median incidence of MCM per 1,000 live births was 14.4 (IQR: 5.5-17.6, with the musculoskeletal system comprising 30%. INTERPRETATION: Some clinical trials assessing whether maternal immunization can improve pregnancy and young infant outcomes in the developing world have made ethics-based decisions not to use a pure placebo control. Consequently, reliable background rates of adverse pregnancy outcomes are necessary to distinguish between vaccine benefits and safety concerns. Local studies

  19. ATLANTIC-DIP: raised maternal body mass index (BMI) adversely affects maternal and foetal outcomes in glucose tolerant women classified using International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria

    LENUS (Irish Health Repository)

    Dennedy, MC

    2011-09-15

    Background and aims: Raised maternal body mass index (BMI), in association with hyperglycaemia is associated with adverse pregnancy outcome. Whether BMI has an independent effect on adverse pregnancy outcome is not clear. We aimed to investigate the effects of raised maternal BMI on pregnancy outcome in glucose tolerant women, classified using the IADPSG criteria.\\r\

  20. Contribution of overweight and obesity to the occurrence of adverse pregnancy outcomes in a multi-ethnic cohort : population attributive fractions for Amsterdam

    NARCIS (Netherlands)

    Djelantik, A. A. A. M. J.; Kunst, A. E.; van der Wal, M. F.; Smit, H. A.; Vrijkotte, T. G. M.

    2012-01-01

    Objective To estimate the contribution of pre-pregnancy excessive weight to the occurrence of adverse pregnancy outcomes and to detect the differences in these contributions between different ethnic groups. Design Prospective multi-ethnic community-based cohort study. Setting The prevalence of exces

  1. Regulation of Calcitriol Biosynthesis and Activity: Focus on Gestational Vitamin D Deficiency and Adverse Pregnancy Outcomes

    Directory of Open Access Journals (Sweden)

    Andrea Olmos-Ortiz

    2015-01-01

    Full Text Available Vitamin D has garnered a great deal of attention in recent years due to a global prevalence of vitamin D deficiency associated with an increased risk of a variety of human diseases. Specifically, hypovitaminosis D in pregnant women is highly common and has important implications for the mother and lifelong health of the child, since it has been linked to maternal and child infections, small-for-gestational age, preterm delivery, preeclampsia, gestational diabetes, as well as imprinting on the infant for life chronic diseases. Therefore, factors that regulate vitamin D metabolism are of main importance, especially during pregnancy. The hormonal form and most active metabolite of vitamin D is calcitriol. This hormone mediates its biological effects through a specific nuclear receptor, which is found in many tissues including the placenta. Calcitriol synthesis and degradation depend on the expression and activity of CYP27B1 and CYP24A1 cytochromes, respectively, for which regulation is tissue specific. Among the factors that modify these cytochromes expression and/or activity are calcitriol itself, parathyroid hormone, fibroblast growth factor 23, cytokines, calcium and phosphate. This review provides a current overview on the regulation of vitamin D metabolism, focusing on vitamin D deficiency during gestation and its impact on pregnancy outcomes.

  2. Fetal growth and adverse birth outcomes in women receiving prescriptions for acetaminophen during pregnancy

    DEFF Research Database (Denmark)

    Thulstrup, Ane Marie; Sørensen, Henrik Toft; Nielsen, Gunnar Lauge;

    1999-01-01

    We studied the association between acetaminophen exposure during pregnancy and the prevalence of congenital abnormalities and fetal growth. Our study included 123 women who had received a prescription of acetaminophen during pregnancy and/or 30 days before conception and 13,329 controls who did n...

  3. Research progress of environmental factors of adverse pregnancy outcomes%不良妊娠结局的环境因素研究进展

    Institute of Scientific and Technical Information of China (English)

    姜波玲; 卢媛

    2013-01-01

    妊娠不良结局的相关因素很多,这些危险因素影响着孕妇的健康,增加不良妊娠结局风险,包括早产、低出生体重、出生缺陷等。导致妊娠不良结局的原因目前主要分为母体、胎儿、环境三方面。研究环境因素与不良妊娠结局的关系,减少孕妇高危环境暴露,提前采取干预措施,可避免不良妊娠结局的发生。该文就不良妊娠结局的环境因素研究进展进行综述。%There are many related risk factors of adverse pregnancy outcomes , which affect the health of pregnant women and lead to the increase of adverse pregnancy outcomes , including preterm delivery, low birth weight, birth defects, etc.The causes of adverse pregnancy outcomes are mainly from the aspects of parent , fetus and environment .Studying on the relationship between environmental factors and adverse pregnancy outcomes of pregnant women , reducing environment exposure of pregnant women and taking preventive measures beforehand can avoid adverse pregnancy outcomes .This article gave an overview of research progress on environmental factors in adverse pregnancy outcome .

  4. Malaria infection, poor nutrition and indoor air pollution mediate socioeconomic differences in adverse pregnancy outcomes in Cape Coast, Ghana.

    Directory of Open Access Journals (Sweden)

    Adeladza K Amegah

    Full Text Available BACKGROUND: The epidemiological evidence linking socioeconomic deprivation with adverse pregnancy outcomes has been conflicting mainly due to poor measurement of socioeconomic status (SES. Studies have also failed to evaluate the plausible pathways through which socioeconomic disadvantage impacts on pregnancy outcomes. We investigated the importance of maternal SES as determinant of birth weight and gestational duration in an urban area and evaluated main causal pathways for the influence of SES. METHODS: A population-based cross-sectional study was conducted among 559 mothers accessing postnatal services at the four main health facilities in Cape Coast, Ghana in 2011. Information on socioeconomic characteristics of the mothers was collected in a structured questionnaire. RESULTS: In multivariate linear regression adjusting for maternal age, parity and gender of newborn, low SES resulted in 292 g (95% CI: 440-145 reduction in birth weight. Important SES-related determinants were neighborhood poverty (221 g; 95% CI: 355-87, low education (187 g; 95% CI: 355-20, studentship during pregnancy (291 g; 95% CI: 506-76 and low income (147 g; 95% CI: 277-17. In causal pathway analysis, malaria infection (6-20%, poor nutrition (2-51% and indoor air pollution (10-62% mediated substantial proportions of the observed effects of socioeconomic deprivation on birth weight. Generalized linear models adjusting for confounders indicated a 218% (RR: 3.18; 95% CI: 1.41-7.21 risk increase of LBW and 83% (RR: 1.83; 95% CI: 1.31-2.56 of PTB among low income mothers. Low and middle SES was associated with 357% (RR: 4.57; 95% CI: 1.67-12.49 and 278% (RR: 3.78; 95% CI: 1.39-10.27 increased risk of LBW respectively. Malaria infection, poor nutrition and indoor air pollution respectively mediated 10-21%, 16-44% and 31-52% of the observed effects of socioeconomic disadvantage on LBW risk. CONCLUSION: We provide evidence of the effects of socioeconomic deprivation

  5. The joint effect of vaginal Ureaplasma urealyticum and bacterial vaginosis on adverse pregnancy outcomes

    DEFF Research Database (Denmark)

    Vogel, Ida; Thorsen, Poul; Hogan, Vijaya K.; Schieve, Laura A.; Jacobsson, Bo; Ferre, Cynthia D.

    2006-01-01

    Objective. To examine associations of vaginal Ureaplasma urealyticum (UU) and bacterial vaginosis (BV) with preterm delivery (PTD), small for gestational age (SGA), and low birth weight (LBW). Material and methods. A population-based, prospective cohort study of 2,927 pregnancies. After exclusion...

  6. Reported estimates of adverse pregnancy outcomes among women with and without syphilis: a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Jiabi Qin

    Full Text Available To estimate probability of adverse pregnancy outcomes (APOs among women with and without syphilis through a systematic review of published literatures.Chinese and English literatures were searched for studies assessing pregnancy outcomes in the presence of maternal syphilis through August 2013. The prevalence estimates were summarized and analyzed by meta-analysis. Fifty-four literatures involving 11398 syphilitic women and 43342 non-syphilitic women were included from 4187 records initially found. Among untreated mothers with syphilis, pooled estimates were 76.8% for all APOs, 36.0% for congenital syphilis, 23.2% for preterm, 23.4% for low birth weight, 26.4% for stillbirth or fetal loss, 14.9% for miscarriage and 16.2% for neonatal deaths. Among syphilitic mother receiving treatment only in the late trimester (>28 weeks, pooled estimates were 64.4% for APOs, 40.6% for congenital syphilis, 17.6% for preterm, 12.4% for low birth weight, and 21.3% for stillbirth or fetal loss. Among syphilitic mothers with high titers (≥1∶8, pooled estimates were 42.8% for all APOs, 25.8% for congenital syphilis, 15.1% for preterm, 9.4% for low birth weight, 14.6% for stillbirth or fetal loss and 16.0% for neonatal deaths. Among non-syphilitic mothers, the pooled estimates were 13.7% for all APOs, 7.2% for preterm birth, 4.5% for low birth weight, 3.7% for stillbirth or fetal loss, 2.3% for miscarriage and 2.0% for neonatal death. Begg's rank correlation test indicated little evidence of publication bias (P>0.10. Substantial heterogeneity was found across studies in the estimates of all adverse outcomes for both women with syphilis (I2 = 93.9%; P<0.0001 and women without syphilis (I2 = 94.8%; P<0.0001.Syphilis continues to be an important cause of substantial perinatal morbidity and mortality, which reminds that policy-makers charged with resource allocation that the elimination of mother-to-child transmission of syphilis is a public health priority.

  7. High Prevalence of Vitamin D Deficiency and Adverse Pregnancy Outcomes in Yazd, a Central Province of Iran

    OpenAIRE

    Pirdehghan, Azar; Vakili, Mahmood; Dehghan, Reyhane; Zare, Fatemeh

    2016-01-01

    Background: There is a growing concern about the high prevalence of vitamin D deficiency and its relationship with variety of diseases worldwide. The objective of this study was to determine the prevalence of vitamin D deficiency and its relationship with pregnancy adverse effects in Yazd. Methods: This was a cross sectional study conducted among 200 nulliparous women from October 2013 to April 2014. Data containing socio-demographic and personal details, vitamin D level, pregnancy complicati...

  8. Adverse outcomes of pregnancy in HIV-positive women in the era of HAART: a perspective from an outer London centre in the UK

    Directory of Open Access Journals (Sweden)

    P Thayaparan

    2012-11-01

    Full Text Available Background: Increasing number of women with HIV are choosing to become pregnant as there is dramatic reduction in the risk of vertical transmission. However, management of HIV in pregnancy still poses a variety of challenges and adverse pregnancy outcomes are still common. We aimed to explore the factors associated with adverse outcomes of pregnancy in our HIV cohort. Methods: It is a retrospective case note review of all the women attended our unit and had HIV care from 2008–2011. A total of 87 women were followed up. Three women had two pregnancies during the study period. Data collected from Genitourinary Medicine and maternity records were analysed using SPSS program. Results: Mean age was 34 yrs ranging from 20–43 yrs. Majority (91% were of African origin; 67% had HIV subtype C; 26% resistant to one or more class of HIV drugs; 55% had a nadir CD4 fewer than 350; 44% diagnosed at an antenatal setting and 62% were planned pregnancies. Prior to the current pregnancy, these women had 121 children: 5% of the children have HIV and 33% not tested for HIV. Of the partners, 38% have HIV and 73% were aware of their partner's HIV status. None of the children born during the study period were infected with HIV; mean birth weight was 2789 g; there were 3 sets of twins; one still birth and one child died soon after birth. Around 46% were on anti-retroviral therapy (ART during conception, 6% had miscarriages and 16% had emergency caesarean sections. At delivery, viral load was detectable in 23%, mainly due to poor adherence (11% and late presentation (9%. 38% of the women experienced an obstetric complication, premature labour 9%; premature rupture of membranes and gestational diabetes both accounted to 4% whilst 3% had post-partum haemorrhage. On ART during conception and late HIV diagnosis that is nadir CD4, less than 350 cells were significantly associated (P<0.05 with having a foetal complication such as prematurity 8%, low birth weight 7% or

  9. Elevated antiphospholipid antibody titers and adverse pregnancy outcomes: analysis of a population-based hospital dataset

    Directory of Open Access Journals (Sweden)

    Nuwayhid Bahij S

    2009-03-01

    Full Text Available Abstract Background The primary objective of this study was to determine if elevated antiphospholipid antibody titers were correlated with the presence of preeclampsia/eclampsia, systemic lupus erythematosus (SLE, placental insufficiency, and a prolonged length of stay (PLOS, in women who delivered throughout Florida, USA. Methods Cross-sectional analyses were conducted using a statewide hospital database. Prevalence odds ratios (OR were calculated to quantify the association between elevated antiphospholipid antibody titers and four outcomes in 141,286 women who delivered in Florida in 2001. The possibility that the relationship between elevated antiphospholipid antibody titers and the outcomes of preeclampsia/eclampsia, placental insufficiency, and PLOS, may have been modified by the presence of SLE was evaluated in a multiple logistic regression model by creating a composite interaction term. Results Women with elevated antiphospholipid antibody titers (n = 88 were older, more likely to be of white race and not on Medicaid than women who did not have elevated antiphospholipid antibody titers. Women who had elevated antiphospholipid antibody titers had an increased adjusted odds ratio for preeclampsia and eclampsia, (OR = 2.93 p = 0.0015, SLE (OR = 61.24 p Conclusion This exploratory epidemiologic investigation found moderate to very strong associations between elevated antiphospholipid antibody titers and four important outcomes in a large sample of women.

  10. Changes in androgens and insulin sensitivity indexes throughout pregnancy in women with polycystic ovary syndrome (PCOS): relationships with adverse outcomes

    OpenAIRE

    Falbo Angela; Rocca Morena; Russo Tiziana; D'Ettore Antonietta; Tolino Achille; Zullo Fulvio; Orio Francesco; Palomba Stefano

    2010-01-01

    Abstract Background Given the high rate of pregnancy and perinatal complications recently observed in patients with polycystic ovary syndrome (PCOS) and the lack of data on the serum variations in androgens and insulin sensitivity indexes in pregnant women with PCOS, the current study was aimed to assess these changes and their potential effect on pregnancy outcomes in a population of women with PCOS. Methods Forty-five pregnant patients with ovulatory PCOS (PCOS group) and other 42 healthy p...

  11. Use of antihypertensive medications in pregnancy and the risk of adverse perinatal outcomes: McMaster Outcome Study of Hypertension In Pregnancy 2 (MOS HIP 2

    Directory of Open Access Journals (Sweden)

    Vermeulen Marian J

    2001-11-01

    Full Text Available Abstract Background Uncertainty remains about the potential harmful effects of antihypertensive therapy on the developing fetus, especially for beta-blockers (βb. Methods We prospectively enrolled all singleton women with a blood pressure ≥ 140/90 mm Hg during pregnancy. The main analysis included 1948 women with all forms of hypertension and compared the use of βb drugs, non-βb drugs or a combination of both, to no treatment. The primary study outcome was a composite of the diseases of prematurity, need for assisted ventilation for greater than 1 day, or perinatal death. A sub-group analysis evaluated the four treatment options among 583 singleton women with chronic hypertension before 20 weeks gestation. Results In the main analysis, no association was observed between βb use and the primary composite outcome [adjusted odds ratio (OR 1.4, 95% CI 0.9–2.2], while an association was seen with non-βb therapy (OR 5.0, 95% CI 2.6–9.6 and combination therapy (OR 2.9, 95% CI 1.8–4.7. In the sub-group of 583 women with hypertension before 20 weeks, use of a non-βb drug (OR 4.9, 95% CI 1.7–14.2 or combination therapy (OR 2.9. 95% CI 1.1–7.7 was significantly associated with the primary composite outcome, while βb monotherapy was not (OR 1.4, 95% CI 0.6–3.4. Conclusions Maternal use of antihypertensive medications other than βbs was associated with both major perinatal morbidity and mortality, while βb monotherapy was not. The combined use of βb and non-βb medications demonstrated the strongest association. Before definitive conclusions can be drawn, a large multicentre randomized controlled trial is needed to address the issues of both maternal efficacy and fetal safety with the use of one or more antihypertensive agents in pregnancy.

  12. Periodontal disease as a risk factor for adverse pregnancy outcomes: a systematic review and meta-analysis of case-control studies.

    Science.gov (United States)

    Corbella, Stefano; Taschieri, Silvio; Francetti, Luca; De Siena, Francesca; Del Fabbro, Massimo

    2012-07-01

    Periodontal disease is a highly prevalent group of illnesses of microbial etiology, whose consequence is a severe breakdown of tooth-supporting structures. A link between periodontal infection and several systemic conditions, among which adverse pregnancy outcomes, has been suggested in the recent years. The aim of this review based on case-control studies was to evaluate if periodontal disease could be considered as a risk factor for preterm birth, low birth-weight and preterm low birth-weight. An electronic search (via Pubmed) was performed for case-control studies investigating the relationship between periodontal disease and adverse pregnancy outcomes. From the initially retrieved 417 articles, 17 case-control studies, accounting for a total of 10,148 patients, were included in the review and in the meta-analysis. The estimated odds ratio was 1.78 (CI 95%: 1.58, 2.01) for preterm birth, 1.82 (CI 95%: 1.51, 1.20) for low birth-weight and 3.00 (CI 95%: 1.93, 4.68) for preterm low birth-weight. Despite the results of the analysis of pooled data suggested a link between periodontal diseases and adverse pregnancy outcomes, the presence of important confounders, whose effect could not be addressed, prevents a validation of the meta-analysis outcomes. Further more accurate investigations based on individual data analysis could give a better insight into the topic of the present review. PMID:21739194

  13. Antenatal interventions for preventing the transmission of cytomegalovirus (CMV) from the mother to fetus during pregnancy and adverse outcomes in the congenitally infected infant.

    LENUS (Irish Health Repository)

    McCarthy, Fergus P

    2012-01-31

    BACKGROUND: Cytomegalovirus (CMV) is a herpesvirus and the most common cause of congenital infection in developed countries. Congenital CMV infection can have devastating consequences to the fetus. The high incidence and the serious morbidity associated with congenital CMV infection emphasise the need for effective interventions to prevent the antenatal transmission of CMV infection. OBJECTIVES: The aim of this review was to assess the benefits and harms of interventions used during pregnancy to prevent mother to fetus transmission of CMV infection. SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth Group\\'s Trials Register (31 December 2010). SELECTION CRITERIA: All randomised controlled trials (RCTs) and quasi RCTs investigating antenatal interventions for preventing the transmission of CMV from the mother to fetus during pregnancy and adverse outcomes in the congenitally infected infant. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed studies for inclusion. MAIN RESULTS: We identified six studies from the search. None of these studies met the pre-defined criteria for inclusion in this review. AUTHORS\\' CONCLUSIONS: To date, no RCTs are available that examine antenatal interventions for preventing the transmission of CMV from the infected mother to fetus during pregnancy and adverse outcomes in the congenitally infected infant. Further research is needed to assess the efficacy of interventions aimed at preventing the transmission of CMV from the mother to fetus during pregnancy including a long-term follow-up of exposed infants and a cost effective analysis.

  14. Physical violence against pregnant women by an intimate partner, and adverse pregnancy outcomes in Mazandaran Province, Iran

    Directory of Open Access Journals (Sweden)

    Fatemeh Abdollahi

    2015-01-01

    Full Text Available Background and Aim: Violence against women during pregnancy is linked to poor outcome of pregnancy, which is reported to have widespread in Iran. The aim of this study was to determine the prevalence of physical violence against women by an intimate partner during pregnancy, and to assess the impact of this physical violence on pregnancy outcomes. Materials and Methods: A prospective cohort study was conducted on the characteristics of pregnant women in urban areas and related violence. The modified standard World Health Organization Domestic Violence Questionnaire was used to classify pregnant women and domestic violence. A total of 1461 pregnant women were selected using cluster sampling. The association between sociodemographic with intimate partner violence (IPV and IPV with pregnancy outcomes was determined using logistic regression. Results: Of these, 206 (14.1% (confidence interval = 12.3-15.9 reported physical IPV during pregnancy. The adjusted odds ratio for IPV in illiterate women or those with primary level of education (0.001, secondary level education (0.003, and in low income households (0.0001 were significantly higher than in those women with university level education and in higher income households. After adjusting for suspected confounding factors, the women with a history of violence by partners had 1.9 fold risk of premature rupture of membranes, and a 2.9 fold risk of low birth weight compared to women who did not experience any violence from their partners. Conclusion: The results of this research indicated that the prevalence of IPV was high among pregnant women. Therefore, it is necessary to emphasize the screening of pregnant women at Primary Health Centers to prevent physical abuse.

  15. Salmonella enterica serovar Enteritidis enterocolitis during late stages of gestation induces an adverse pregnancy outcome in the murine model.

    Directory of Open Access Journals (Sweden)

    Mariángeles Noto Llana

    Full Text Available Foodborne diseases caused by Salmonella enterica serovar Enteritidis (S. Enteritidis are a significant health problem. Pregnancy, state of immunological tolerance, is a predisposing condition for the development of infections with intracellular pathogens. Salmonella species can cause pregnancy complications such as chorioamnionitis, transplacental fetal infection, pre term labor, abortions, neonatal and maternal septicemia. However, the specific mechanisms by which Salmonella infections trigger these alterations are not clear. In the present work, using a self-limiting enterocolitis murine model, we show that the ingestion of a low dose of S. Enteritidis at late stages of pregnancy (day 15 of gestation is sufficient to induce massive maternal infection. We found that Salmonella infection leads to 40% of pre term delivery, 33% of abortion and fetal growth restriction. Placental dysfunction during S. Enteritidis enterocolitis was confirmed through cellular infiltration and hypoxia markers (MPO activity and COX-1 and COX-2 expression, respectively. Apoptosis in placental tissue due to Salmonella infection was also evident at day 18 of gestation when investigated by morphometric procedure, DNA fragmentation and Fas/FasL expression. Also, the expression of IFN-γ, TNF-α, IL-17 and IL-10 was up regulated in response to Salmonella not only in placenta, but also in amniotic fluid and maternal serum. Altogether, our results demonstrate that S. Enteritidis enterocolitis during late stages of gestation causes detrimental effect on pregnancy outcome.

  16. Pregnancy Outcomes and Appropriate Timing of Pregnancy in 183 pregnancies in Korean Patients with SLE

    OpenAIRE

    Ko, Hyun Sun; Ahn, Hyun Young; Jang, Dong Gyu; Choi, Sae-Kyung; Park, Yong-Gyu; Park, In Yang; Lee, Guisera; Park, Sung-Hwan; Shin, Jong Chul

    2011-01-01

    This study was undertaken to investigate the pregnancy outcomes in patients with systemic lupus erythematosus (SLE) and the appropriate timing of pregnancy. We performed a retrospective evaluation of 183 pregnancies with SLE at Catholic University Medical Center during the 13-year period from 1998 to 2010. Pregnancy outcomes were compared according to SLE characteristics. The predictive value of the different cut-off points of the stable period before conception on adverse pregnancy outcomes ...

  17. Pregnancy outcome following spontaneous abortions

    Directory of Open Access Journals (Sweden)

    Swati Agrawal

    2015-12-01

    Conclusions: Previous history of spontaneous abortion is associated with adverse pregnancy outcome. There is increased risk of abortion, preterm delivery, need for caesarean sections and fetal loss in cases of previous spontaneous abortions. These complications and fetal loss can be reduced by booking the patients and giving due antenatal care. [Int J Reprod Contracept Obstet Gynecol 2015; 4(6.000: 1891-1893

  18. Adverse pregnancy outcomes with assisted reproductive technology in non-obese women with polycystic ovary syndrome: a case-control study

    OpenAIRE

    Han, Ae Ra; Kim, Hye Ok; Cha, Sun Wha; Park, Chan Woo; Kim, Jin Yeong; Yang, Kwang Moon; Song, In Ok; Koong, Mi Kyoung; Kang, Inn Soo

    2011-01-01

    Objective To investigate adverse pregnancy outcomes in non-obese women with polycystic ovary syndrome (PCOS) compared with obese-PCOS and control groups. Methods Women with PCOS who underwent assisted reproductive technology (ART) from August, 2003 to December, 2007, were considered. A total of 336 women with PCOS were included in the study group and 1,003 infertile women who had tubal factor as an indication for ART were collected as controls. They were divided into four groups: a non-obese ...

  19. Sociobiological variables and pregnancy outcome.

    Science.gov (United States)

    Tambyrajia, R L; Mongelli, M

    2000-07-01

    Recent advances are beginning to shed light on the mechanisms whereby adverse psychosocial factors can influence pregnancy outcome. High levels of maternal stress have been linked to endocrine disturbances, which in turn increases the risk of preterm labor considerably. These observations have been supported by experimental animal models. Birth weight is subject to considerable ethnic variation, and on its own is a nonspecific indicator of pregnancy outcome. The benefits of social and psychological intervention have been best documented in the intrapartum situation, whereas antenatal intervention is most likely to be of benefit when focused on improving socioeconomic conditions and access to healthcare providers. PMID:10884539

  20. Maternal alcohol intake up to and during pregnancy and risk of adverse birth outcomes: evidence from a British cohort

    OpenAIRE

    Nykjaer, C; Alwan, NA; Greenwood, DC; Simpson, NAB; Hay, AWM; White, KLM; Cade, JE

    2013-01-01

    Background High maternal alcohol consumption has been linked to adverse birth outcomes such as small for gestational age and preterm birth, which in turn have been linked to increased risk of development of cardiovascular diseases and type 2 diabetes in adulthood. The UK Department of Health (DH) recommends that pregnant women and those trying to conceive should avoid alcohol and never drink more than 1GÇô2 units once or twice a week. This study aimed to investigate the association between al...

  1. The association of season and temperature with adverse pregnancy outcome in two German states, a time-series analysis.

    Directory of Open Access Journals (Sweden)

    Jennyfer Wolf

    Full Text Available BACKGROUND: A seasonality of low birth weight (LBW and preterm birth (PTB has been described for most regions and there is evidence that this pattern is caused by ambient outdoor temperature. However, the association as such, the direction of effect and the critical time of exposure remain controversial. METHODS: Logistic, time-series regression was performed on nearly 300,000 births from two German states to study the association between season and daily mean temperature and changes in daily proportions of term LBW (tLBW or PTB. Analyses were adjusted for time-varying factors. Temperature exposures were examined during different periods of pregnancy. RESULTS: Weak evidence for an association between season of conception, season of birth or ambient outdoor temperature and tLBW or PTB was found. Results of analyses of temperature were not consistent between the two states. Different sources of bias which would have artificially led to stronger findings were detected and are described. CONCLUSIONS: No clear evidence for an association between season of conception, season of birth or temperature and tLBW or PTB was found. In the study of pregnancy outcome different sources of bias can be identified which can potentially explain heterogeneous findings of the past.

  2. The Meta-analysis for relationship between pre-pregnancy obesity and adverse pregnancy outcomes%中国妇女孕前肥胖与不良妊娠结局关系的Meta 分析

    Institute of Scientific and Technical Information of China (English)

    赵亚娟; 陈双郧

    2011-01-01

    Objective To investigate the correlation between pre-pregnancy obesity and adverse pregnancy outcomes. Methods The literature on the relationship between pre-pregnancy obesity and adverse pregnancy outcomes published in China Journal Net database from 1980 to 2010 were searched and collected , and a comprehensive quantitative analysis for which was carried out by RevMan 4.2. 10 version. Results There was 24 studies about the relationship between pre-pregnancy overweight or obesity and pregnancy outcome. Since significant heterogeneity were found in these studies by heterogeneity test ,random effects model was used for quantitative analysis of integrated comprehensive . The results showed that pre-pregnancy overweight or obesity had increased the risk of macrosomia , gestational diabetes mellitus and hypertensive disorders in pregnancy , the OR were 3.08 ( 95% CI: 2. 58-3. 69 ) , 2. 64 ( 95% C/: 2. 24-3. 13 ) , 2.54(95% CI: 2.11-3.05). Conclusions The risk of macrosomia, gestational diabetes mellitus and hypertensive disorders in pregnancy is significantly higher in pre -pregnancy obesity women than normal weight.%目的 探讨孕前肥胖与不良妊娠结局的关系.方法 检索中国期刊网及万方数据库1980 年至2010 年有关孕前肥胖与妊娠结局关系的研究,并采用RevMan 4.2.10 版本对此进行了定量综合分析.结果 经检索筛选后纳入的有关孕前或者体重超标与妊娠结局关系的文章24 篇,经异质性检验,分别采用固定效应模型或随机效应模型进行定量综合分析综合.结果 表明孕前超重及肥胖增加巨大儿、妊娠期糖尿病及妊娠期高血压疾病发生风险,OR 值依次为3.08(95% CI:2.58 ~3.69)、2.64(95% CI:2.24 ~3.13)、2.54(95% CI:2.11 ~3.05).结论 孕前肥胖者发生妊娠期高血压、糖代谢异常及巨大儿的风险明显高于正常体重妇女.

  3. 不良妊娠结局现状及其影响因素分析%Current status of adverse pregnancy outcomes and their influencing factors

    Institute of Scientific and Technical Information of China (English)

    李媛媛; 张海鲲; 李忠良; 张成元

    2014-01-01

    目的:了解不良妊娠结局的现状并探讨其主要影响因素。方法随机抽取山东省潍坊市2家医院2012年5月至2013年5月期间就诊的孕产妇共计698人,通过查阅产妇病例、新生儿出生记录、现场询问和随访获得产妇和新生儿父亲的一般情况、孕期及分娩情况等资料,应用多因素Logistic回归分析筛选妊娠结局的主要影响因素。结果不良妊娠结局的发生率为15.09%;产妇营养状况好为妊娠结局的保护性因素(OR=2.28,95%CI:1.47~3.54,P<0.05);而高龄产妇、有长期服药史、产妇异常孕产史、妊娠合并症、细菌或病毒性感染、有害因素接触史、羊水异常、胎盘异常等8个因素为妊娠结局的危险因素(均P<0.05)。结论鼓励育龄妇女在最佳生育年龄段生育;注意孕期营养均衡;减少农药等有害因素的接触;加强孕期及分娩时的健康监护工作,特别是注意预防感染和妊娠合并症,防止胎盘异常和羊水异常等。%Objective To investigate the current status of adverse pregnancy outcomes and their major influencing factors .Methods Totally 698 pregnant women visiting hospital were randomly selected from 2 hospitals in Shandong Weifang from May 2012 to May 2013.The general situation of newborns ’ mother and father , pregnancy and delivery data were obtained through maternal clinical records , birth records, on-the-spot inquiry and follow-up.Multiple logistic regression analysis was conducted to screen the major influencing factors of pregnancy outcomes .Results The incidence of adverse pregnancy outcomes was 15.09%.Good maternal nutritional status was protective factor of pregnancy outcomes (OR=2.28, 95%CI:1.47-3.54, P<0.05).Risk factors included advanced maternal age , long-term medication history , maternal history of abnormal pregnancy , pregnancy complications , bacterial or viral infection , history of exposure to harmful

  4. Jaundice during pregnancy: maternal and fetal outcome

    Directory of Open Access Journals (Sweden)

    Jayanthi Krishnamoorthy

    2016-08-01

    Conclusions: Jaundice in pregnancy has adverse fetomaternal outcome. Improvement in health awareness, education and regular antenatal checkups, early referrals result in early diagnosis and treatment of jaundice during pregnancy thus reducing maternal and fetal mortality and morbidity. [Int J Reprod Contracept Obstet Gynecol 2016; 5(8.000: 2541-2545

  5. METERNAL ANTHROPOMETRY DETEMINES PREGNANCY OUTCOME

    Directory of Open Access Journals (Sweden)

    Rupa L

    2015-07-01

    Full Text Available Placenta is a transient vital organ of pregnancy and one of the most sensitive determinants of birth weight and pregnancy complications. Placental morphology and pregnancy outcome are influenced by maternal genetic, socio - economic and psychological make - up , and nutritional status in childhood and thereafter. Variation in these factors will lead to adverse pregnancy outcome. Hence, the study assessed the influence of maternal anthropometry: weight and, height on placental morphometry: weight, volume and surf ace area, and birth weight. MATERIALS AND METHOD : The study was conducted on 391 placentae of singleton newborn from a teaching hospital of North Karnataka, India. Data was collected from August 2012 to January 2013 by using standard operating procedures i n a pre - designed and pre - tested proforma. Maternal anthropometry cumulative distribution is described with figures. Analysis of variance is used to study the differences in means of placental morphometry in different groups of maternal anthropometry. RESUL TS : The Means and standard deviations of placental morphometry; weight, volume, surface area and thickness were 440 ± 100gm, 386 ±101 ml, 230 ±50 cm sq , and 2.1±0.4cm respectively . Mean and standard deviations of b irth weight and were 2700 ±500 gm. Maternal pre - pregnancy weight followed moderately normal distribution with mean 48.4 and SD 8.9 kg. Mean birth weight ( p<0.001 and placental morphometry [weight ( p<0.001 , volume ( p<0.001 and surface area ( p<0.05 ] increased consistently with the increasing mater nal pre - pregnancy weight. Gestational weight gain was significantly related with birth weight ( p<0.01 however, placental morphometry did not exhibit any significant difference with weight gain. Maternal height followed moderately normal distribution with mean maternal height 153.9 cm with SD of 6.7. Means of birth weight ( p<0.05 increased consistently with the increasing maternal height, however, placental

  6. Reverse Engineering Adverse Outcome Pathways

    Energy Technology Data Exchange (ETDEWEB)

    Perkins, Edward; Chipman, J.K.; Edwards, Stephen; Habib, Tanwir; Falciani, Francesco; Taylor, Ronald C.; Van Aggelen, Graham; Vulpe, Chris; Antczak, Philipp; Loguinov, Alexandre

    2011-01-30

    The toxicological effects of many stressors are mediated through unknown, or poorly characterized, mechanisms of action. We describe the application of reverse engineering complex interaction networks from high dimensional omics data (gene, protein, metabolic, signaling) to characterize adverse outcome pathways (AOPs) for chemicals that disrupt the hypothalamus-pituitary-gonadal endocrine axis in fathead minnows. Gene expression changes in fathead minnow ovaries in response to 7 different chemicals, over different times, doses, and in vivo versus in vitro conditions were captured in a large data set of 868 arrays. We examined potential AOPs of the antiandrogen flutamide using two mutual information theory methods, ARACNE and CLR to infer gene regulatory networks and potential adverse outcome pathways. Representative networks from these studies were used to predict a network path from stressor to adverse outcome as a candidate AOP. The relationship of individual chemicals to an adverse outcome can be determined by following perturbations through the network in response to chemical treatment leading to the nodes associated with the adverse outcome. Identification of candidate pathways allows for formation of testable hypotheses about key biologic processes, biomarkers or alternative endpoints, which could be used to monitor an adverse outcome pathway. Finally, we identify the unique challenges facing the application of this approach in ecotoxicology, and attempt to provide a road map for the utilization of these tools. Key Words: mechanism of action, toxicology, microarray, network inference

  7. Effect of pre-pregnancy body mass index on adverse pregnancy outcomes%孕前肥胖与妊娠不良结局的相关性探讨

    Institute of Scientific and Technical Information of China (English)

    钟利若; 张立军; 陈淑芳

    2016-01-01

    目的:探讨孕前肥胖与妊娠不良结局的相关性。方法选取单胎、足月、无妊娠合并症及并发症的498例初产妇作为研究对象,根据孕前体质量指数(BMI)不同分为4组:低体重组(BMI 0.05),而超重组和肥胖组的子痫前期、妊娠期糖尿病、妊娠高血压、胎膜早破、产后出血、剖宫产、新生儿死亡和巨大胎儿的发生率均明显高于对照组和正常体质量组,组间比较差异具有统计学意义( P 0. 05). While in the overweight and obese groups,preeclampsia,gestational diabetes,pregnancy - induced hypertension,prema-ture rupture of membranes,postpartum hemorrhage,cesarean section,macrosomia and neonatal death was significantly higher than the incidence of low - weight group,normal weight group,the difference between the groups was statistically significant( P < 0. 05). Conclusion Overweight and obesity before pregnancy has an adverse effect on pregnancy outcome,we should pay particular attention to the low level of education of preg-nant women weight control management. By pre - pregnancy body mass index of control,can effectively improve pregnancy outcomes,ensure ma-ternal and child health.

  8. A national study of the association between traffic-related air pollution and adverse pregnancy outcomes in Canada, 1999-2008.

    Science.gov (United States)

    Stieb, David M; Chen, Li; Hystad, Perry; Beckerman, Bernardo S; Jerrett, Michael; Tjepkema, Michael; Crouse, Daniel L; Omariba, D Walter; Peters, Paul A; van Donkelaar, Aaron; Martin, Randall V; Burnett, Richard T; Liu, Shiliang; Smith-Doiron, Marc; Dugandzic, Rose M

    2016-07-01

    Numerous studies have examined the association of air pollution with preterm birth and birth weight outcomes. Traffic-related air pollution has also increasingly been identified as an important contributor to adverse health effects of air pollution. We employed a national nitrogen dioxide (NO2) exposure model to examine the association between NO2 and pregnancy outcomes in Canada between 1999 and 2008. National models for NO2 (and particulate matter of median aerodynamic diameter land use variables and, for NO2, deterministic gradients relative to road traffic sources. Generalized estimating equations were used to examine associations with preterm birth, term low birth weight (LBW), small for gestational age (SGA) and term birth weight, adjusting for covariates including infant sex, gestational age, maternal age and marital status, parity, urban/rural place of residence, maternal place of birth, season, year of birth and neighbourhood socioeconomic status and per cent visible minority. Associations were reduced considerably after adjustment for individual covariates and neighbourhood per cent visible minority, but remained significant for SGA (odds ratio 1.04, 95%CI 1.02-1.06 per 20ppb NO2) and term birth weight (16.2g reduction, 95% CI 13.6-18.8g per 20ppb NO2). Associations with NO2 were of greater magnitude in a sensitivity analysis using monthly monitoring data, and among births to mothers born in Canada, and in neighbourhoods with higher incomes and a lower proportion of visible minorities. In two pollutant models, associations with NO2 were less sensitive to adjustment for PM2.5 than vice versa, and there was consistent evidence of a dose-response relationship for NO2 but not PM2.5. In this study of approximately 2.5 million Canadian births between 1999 and 2008, we found significant associations of NO2 with SGA and term birth weight which remained significant after adjustment for PM2.5, suggesting that traffic may be a particularly important source with

  9. Lupus anticoagulant is the main predictor of adverse pregnancy outcomes in aPL-positive patients: validation of PROMISSE study results

    OpenAIRE

    Yelnik, Cecile M; Laskin, Carl A.; Porter, T. Flint; Branch, D Ware; Buyon, Jill P.; Guerra, Marta M; Lockshin, Michael D; Petri, Michelle; Merrill, Joan T; Sammaritano, Lisa R; Kim, Mimi Y; Salmon, Jane E.

    2016-01-01

    Objective We previously reported that lupus anticoagulant (LAC) is the main predictor of poor pregnancy outcome in antiphospholipid antibody (aPL)-positive patients. We sought to confirm this finding in an independent group of patients who were subsequently recruited into the PROMISSE study. Methods The PROMISSE study is a multicentre, prospective, observational study of pregnancy outcomes in women with aPL and/or systemic lupus erythematosus (SLE) that enrolled patients from 2003 to 2015. Al...

  10. Ethno-Specific Risk Factors for Adverse Pregnancy Outcomes: Findings from the Born in Bradford Cohort Study.

    Science.gov (United States)

    Stacey, Tomasina; Prady, Stephanie; Haith-Cooper, Melanie; Downe, Soo; Simpson, Nigel; Pickett, Kate

    2016-07-01

    Objectives Preterm birth (PTB) and small for gestational age (SGA) are major causes of perinatal mortality and morbidity. Previous studies indicated a range of risk factors associated with these poor outcomes, including maternal psychosocial and economic wellbeing. This paper will explore a range of psycho-social and economic factors in an ethnically diverse population. Methods The UK's Born in Bradford cohort study recruited pregnant women attending a routine antenatal appointment at 26-28 weeks' gestation at the Bradford Royal Infirmary (2007-2010). This analysis includes 9680 women with singleton live births who completed the baseline questionnaire. Data regarding maternal socio-demographic and mental health were recorded. Outcome data were collected prospectively, and analysed using multivariate regression models. The primary outcomes measured were: PTB (order to develop appropriate targeted preventative strategies to improve perinatal outcome in disadvantaged groups, a greater understanding of ethno-specific risk factors is required. PMID:26983444

  11. Placental origins of adverse pregnancy outcomes: potential molecular targets: an Executive Workshop Summary of the Eunice Kennedy Shriver National Institute of Child Health and Human Development.

    Science.gov (United States)

    Ilekis, John V; Tsilou, Ekaterini; Fisher, Susan; Abrahams, Vikki M; Soares, Michael J; Cross, James C; Zamudio, Stacy; Illsley, Nicholas P; Myatt, Leslie; Colvis, Christine; Costantine, Maged M; Haas, David M; Sadovsky, Yoel; Weiner, Carl; Rytting, Erik; Bidwell, Gene

    2016-07-01

    Although much progress is being made in understanding the molecular pathways in the placenta that are involved in the pathophysiology of pregnancy-related disorders, a significant gap exists in the utilization of this information for the development of new drug therapies to improve pregnancy outcome. On March 5-6, 2015, the Eunice Kennedy Shriver National Institute of Child Health and Human Development of the National Institutes of Health sponsored a 2-day workshop titled Placental Origins of Adverse Pregnancy Outcomes: Potential Molecular Targets to begin to address this gap. Particular emphasis was given to the identification of important molecular pathways that could serve as drug targets and the advantages and disadvantages of targeting these particular pathways. This article is a summary of the proceedings of that workshop. A broad number of topics were covered that ranged from basic placental biology to clinical trials. This included research in the basic biology of placentation, such as trophoblast migration and spiral artery remodeling, and trophoblast sensing and response to infectious and noninfectious agents. Research findings in these areas will be critical for the formulation of the development of future treatments and the development of therapies for the prevention of a number of pregnancy disorders of placental origin that include preeclampsia, fetal growth restriction, and uterine inflammation. Research was also presented that summarized ongoing clinical efforts in the United States and in Europe that has tested novel interventions for preeclampsia and fetal growth restriction, including agents such as oral arginine supplementation, sildenafil, pravastatin, gene therapy with virally delivered vascular endothelial growth factor, and oxygen supplementation therapy. Strategies were also proposed to improve fetal growth by the enhancement of nutrient transport to the fetus by modulation of their placental transporters and the targeting of placental

  12. 孕前体质量指数与妊娠不良结局的相关性研究%Study on effect of pre-pregnancy body mass index on adverse outcome of pregnancy

    Institute of Scientific and Technical Information of China (English)

    王小绒

    2014-01-01

    目的:探讨孕前体质量指数(BMI)与妊娠不良结局相关性。方法收集4614例分娩的孕妇临床资料,根据孕前 BMI 不同将其分为低体质量组、正常体质量组、超重组和肥胖组,比较各组的子痫前期、妊娠期糖尿病、剖宫产、新生儿死亡、妊娠高血压、巨大胎儿、胎膜早破、耐糖量异常、产后出血等妊娠不良结局的发病率。结果低体质量组占13.5%,正常体质量组占70.5%,超重组占13.4%和肥胖组占2.6%。随着孕前 BMI 的增大,妊娠期的不良结局的风险也越来越大。除新生儿死亡以外,在其他妊娠不良结局中超重组和肥胖组的发病率要明显要高于正常体质量组,差异具有统计学意义( P ﹤0.05)。低体质量组的产后出血、耐糖量异常、新生儿死亡、剖宫产、妊娠期糖尿病的发病率与正常体质量组相比无明显的差异( P ﹥0.05),而子痫前期、妊娠高血压、巨大胎儿、胎膜早破的发生率明显低于正常体质量组,差异具有统计学意义( P ﹤0.05)。结论孕妇的孕前 BMI 对妊娠不良结局有较大的影响,加强对孕妇的孕前 BMI 控制,可以减少母婴并发症。%Objective To explore the significance of pre - pregnancy body mass index(BMI)in adverse outcome of pregnancy. Methods A total of 4 614 nulliparous. women selected on population - based cohort were categorized into 4 groups,pre - eclampsia,emergency caesare-an,gestational diabetes,postpartum haemorrhage,and other adverse pregnancy outcomes were compared among them by univariate and multivari-ate analyses. Results They were classified by pre - pregnancy BMI,625 women as underweight(13. 5% ),3 253 as normal(70. 5% ),617 as overweight(13. 4% ),and 119 as obese(2. 6% ). The risk of adverse pregnancy outcome had been increased with the increase of pre - pregnancy BMI( P ﹤ 0. 05). The risks for gestational hypertension,pre - eclampsia

  13. 孕前体质量指数与妊娠不良结局的相关性研究%Study on effect of pre-pregnancy body mass index on adverse outcome of pregnancy

    Institute of Scientific and Technical Information of China (English)

    王小绒

    2014-01-01

    Objective To explore the significance of pre - pregnancy body mass index(BMI)in adverse outcome of pregnancy. Methods A total of 4 614 nulliparous. women selected on population - based cohort were categorized into 4 groups,pre - eclampsia,emergency caesare-an,gestational diabetes,postpartum haemorrhage,and other adverse pregnancy outcomes were compared among them by univariate and multivari-ate analyses. Results They were classified by pre - pregnancy BMI,625 women as underweight(13. 5% ),3 253 as normal(70. 5% ),617 as overweight(13. 4% ),and 119 as obese(2. 6% ). The risk of adverse pregnancy outcome had been increased with the increase of pre - pregnancy BMI( P ﹤ 0. 05). The risks for gestational hypertension,pre - eclampsia,gestational diabetes,and preterm premature rupture of membranes were higher for those with overweight or obese before pregnancy( P ﹤ 0. 05). There was no significant difference existed between underweight and normal body weight in the occurrence of postpartum hemorrhage,gestational impaired glucose tolerance,cesarean delivery,gestational diabetes mellitus and mortality of infants. There was significant difference between underweight and normal weight in pre - eclampsia,preterm premature rupture of membranes,hypertension and macrosomia. Conclusion High pre - pregnancy body mass index is associated with increased risk of ad-verse outcome of pregnancy,hence pre - pregnancy body mass index should be properly managed.%目的:探讨孕前体质量指数(BMI)与妊娠不良结局相关性。方法收集4614例分娩的孕妇临床资料,根据孕前 BMI 不同将其分为低体质量组、正常体质量组、超重组和肥胖组,比较各组的子痫前期、妊娠期糖尿病、剖宫产、新生儿死亡、妊娠高血压、巨大胎儿、胎膜早破、耐糖量异常、产后出血等妊娠不良结局的发病率。结果低体质量组占13.5%,正常体质量组占70.5%,超重组占13.4%和肥胖组占2.6%

  14. Resistance Exercise in Pregnancy and Outcome.

    Science.gov (United States)

    Barakat, Ruben; Perales, Maria

    2016-09-01

    As the health benefits of exercise are increasingly recognized, the traditional advice to rest during pregnancy has changed toward a more healthy and active pregnancy, therefore different forms of exercise have been integrated into the life of the pregnant woman. Although the benefits of using a combination of resistance and aerobic exercises are not yet determined, studies about resistance and strengthen training programs are few although no adverse outcomes were reported. PMID:27388962

  15. The adverse effects of hypothyroidism and hyperthyroidism during pregnancy

    Directory of Open Access Journals (Sweden)

    Mahnaz Boroumand Rezazadeh

    2015-06-01

    Full Text Available Due to the important role of thyroid disorders on reproductive health of the women of childbearing age, pregnancy outcome, fetal health, and neurodevelopment of the infant, providing comprehensive assessment of the treatments used for preventing hyperthyroidism and hypothyroidism seems to be essential. Therefore, evaluating the efficacy of different treatments of the thyroid disorders would be beneficial in better managing and controlling the disease during pregnancy. Hypothyroidism (a deficiency of thyroid hormone is a common thyroid disorder, which might increase the incidence rate of miscarriage, pre-eclampsia, placental abruption, and preterm delivery. Hyperthyroidism, which is not a common disorder during the pregnancy not only leads to similar adverse effects as hypothyroidism but also can result in stillbirth and intrauterine growth restriction. Levothyroxine is the preferred treatment of hypothyroidism and the only drug therapy recommended for treating hyperthyroidism during pregnancy. In this study, we aimed to briefly review the adverse effects of hyperthyroidism and hypothyroidism during pregnancy and review the effects of recent suggested treatments for controlling thyroid disorders on pregnancy outcomes.

  16. Pregnancy Outcomes and Appropriate Timing of Pregnancy in 183 pregnancies in Korean Patients with SLE

    Directory of Open Access Journals (Sweden)

    Hyun Sun Ko, Hyun Young Ahn, Dong Gyu Jang, Sae-Kyung Choi, Yong-Gyu Park, In Yang Park, Guisera Lee, Sung-Hwan Park, Jong Chul Shin

    2011-01-01

    Full Text Available This study was undertaken to investigate the pregnancy outcomes in patients with systemic lupus erythematosus (SLE and the appropriate timing of pregnancy. We performed a retrospective evaluation of 183 pregnancies with SLE at Catholic University Medical Center during the 13-year period from 1998 to 2010. Pregnancy outcomes were compared according to SLE characteristics. The predictive value of the different cut-off points of the stable period before conception on adverse pregnancy outcomes was calculated by ROC (Receiver operating characteristics curve analysis. In multivariate analysis, the presence of antiphospholipid antibodies (aPLs increased the risk of pregnancy loss (p<0.0001 and premature birth (p=0.0040. Active disease at conception increased the risk of premature birth (p< 0.0001 and complications (IUGR, PIH, or both (p= 0.0078. The other predictor of complications was found to be lupus flare (p=0.0252. At a cut-off level of stable period of 4 months before conception, sensitivity and specificity were 70.8% and 53.2%, 71.4% and 61.5%, and 63.6 % and 59.8 %, respectively on reducing pregnancy loss, premature birth, and complications. Pregnancies with aPLs, active disease at conception and SLE flares are at a higher risk of adverse outcomes. It is essential that disease activity remains stable at least 4 months before conception, for favorable pregnancy outcomes.

  17. Maternal BMI Associations with Maternal and Cord Blood Vitamin D Levels in a North American Subset of Hyperglycemia and Adverse Pregnancy Outcome (HAPO Study Participants.

    Directory of Open Access Journals (Sweden)

    Jami L Josefson

    Full Text Available Obesity in pregnancy may be associated with reduced placental transfer of 25-hydroxyvitamin D (25-OHD. The objective of this study was to examine associations between maternal BMI and maternal and cord blood levels of 25-OHD in full term neonates born to a single racial cohort residing at similar latitude. Secondary objectives were to examine associations between maternal glucose tolerance with maternal levels of 25-OHD and the relationship between cord blood 25-OHD levels and neonatal size.This study was conducted among participants of the Hyperglycemia and Adverse Pregnancy Outcomes (HAPO Study meeting the following criteria: residing at latitudes 41-43°, maternal white race, and gestational age 39-41 weeks. Healthy pregnant women underwent measures of height, weight, and a 75-g fasting oral glucose tolerance test (OGTT at approximately 28 weeks gestation. Maternal and cord blood sera were analyzed for total 25-OHD by HPLC tandem mass spectrometry. Statistical analyses included ANOVA and linear regression models.Maternal and cord blood (N = 360 mean levels (sd of 25-OHD were 37.2 (11.2 and 23.4 (9.2 ng/ml, respectively, and these levels were significantly different among the 3 field centers (ANOVA p< 0.001. Maternal serum 25-OHD was lower by 0.40 ng/ml for BMI higher by 1 kg/m2 (p<0.001 in an adjusted model. Maternal fasting plasma glucose, insulin sensitivity, and presence of GDM were not associated with maternal serum 25-OHD level when adjusted for maternal BMI. Cord blood 25-OHD was lower by 0.26 ng/ml for maternal BMI higher by 1 kg/m2 (p<0.004. With adjustment for maternal age, field center, birth season and maternal serum 25-OHD, the association of cord blood 25-OHD with maternal BMI was attenuated. Neither birth weight nor neonatal adiposity was significantly associated with cord blood 25-OHD levels.These results suggest that maternal levels of 25-OHD are associated with maternal BMI. The results also suggest that interpretation of

  18. Genome-wide association study of preeclampsia detects novel maternal single nucleotide polymorphisms and copy-number variants in subsets of the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study cohort

    OpenAIRE

    Zhao, Linlu; Bracken, Michael B; DeWan, Andrew T

    2013-01-01

    A genome-wide association study was undertaken to identify maternal single nucleotide polymorphisms (SNPs) and copy-number variants (CNVs) associated with preeclampsia. Case-control analysis was performed on 1070 Afro-Caribbean (n=21 cases and 1049 controls) and 723 Hispanic (n=62 cases and 661 controls) mothers and 1257 mothers of European ancestry (n=50 cases and 1207 controls) from the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study. European ancestry subjects were genotyped on Il...

  19. Syphilis in pregnancy in Tanzania. II. The effectiveness of antenatal syphilis screening and single-dose benzathine penicillin treatment for the prevention of adverse pregnancy outcomes

    OpenAIRE

    Watson-Jones, D.; Gumodoka, B; H. Weiss; Changalucha, J; Todd, J.; Mugeye, K; Buvé, A; Kanga, Z; Ndeki, L; Rusizoka, M.; Ross, D.; Marealle, J.; Balira, R; Mabey, D; Hayes, R

    2002-01-01

    Treatment for maternal syphilis with single-dose benzathine penicillin (2.4 million units intramuscularly) is being implemented in many parts of sub-Saharan Africa. To examine the effectiveness of this regimen, a prospective cohort of 1688 pregnant women was recruited in Tanzania. Birth outcomes were compared among women treated for high-titer (n=133; rapid plasma reagin [RPR] titer > or = 1:8 and Treponema pallidum hemagglutination assay [TPHA]/fluorescent treponemal antibody [FTA] positive)...

  20. The Impact of Body Mass Index on Pregnancy Outcome

    OpenAIRE

    Hamideh Pakniat; Fatemeh mohammadi; Fatemeh Ranjkesh

    2015-01-01

    Background & aim: Pre-pregnancy obesity is considered as a significant predictor for neonatal and maternal morbidity and mortality. Several studies have indicated conflicting associations between body mass index (BMI) and pregnancy outcomes. This study aimed to evaluate the effects of pre-pregnancy BMI on adverse pregnancy outcomes. Methods:Thiscohort study was conducted from 2010 to 2013 in Qazvin province, Iran. BMI was measured in a total of 1376 pregnant women before their 12th week of pr...

  1. Survey on Risk Factors for Adverse Pregnancy Outcomes in Patients with Gestational Diabetes Mellitus%妊娠糖尿病患者相关不良妊娠结局危险因素调查

    Institute of Scientific and Technical Information of China (English)

    王霞

    2015-01-01

    Objective To diagnoses the risk factors for adverse pregnancy outcomes in patients with gestational diabetes melitus.Methods 200 patients with gestational diabetes melitus in our hospital from May 2014 to May 2015 were selected , 100 cases were adverse pregnancy among them and another 100 cases were normal labor. Adverse pregnancy outcome risk factors were analysised. Results Adverse pregnancy risk factors including pregnant women over 35 years of age, low education, medication, unexpected pregnancy, etc. after analysis and discovery, among the factors, the greatest risk factor was the history of accidental pregnancy and the history of polution of the environment. Conclusion Influence factors of adverse pregnancy outcome of patients with gestational diabetes melitus were more, it should pay attention to the history of accidents and polution of the environment and the history of the contact population particularly,in order to ensure delivery safety.%目的 对妊娠糖尿病患者相关不良妊娠结局的危险因素进行调查分析.方法 选取我院在2014年5月~2015年5月接收的200例妊娠糖尿病患者,其中100例不良妊娠,另外100例正常分娩.对不良妊娠结局危险因素分析.结果 经过分析发现,不良妊娠危险因素包括:孕妇35岁以上、学历低、用药、意外妊娠等等,其中在多因素分析中,意外妊娠史和污染环境接触史为最大危险因素.结论 妊娠糖尿病患者不良妊娠结局影响因素比较多,尤其要注重意外妊娠史和有污染环境接触史的人群,确保分娩安全.

  2. Pregnancy outcomes amongst thalassemia traits

    OpenAIRE

    Hanprasertpong, Tharangrut; Kor-anantakul, Ounjai; Leetanaporn, Roengsak; Suntharasaj, Thitima; Suwanrath, Chitkasaem; Pruksanusak, Ninlapa; Pranpanus, Savitree

    2013-01-01

    Objective To compare the pregnancy outcome between pregnancies affected and not affected by thalassemia trait. Methods A retrospective case–control cohort study was conducted on singleton pregnant women who attended antenatal care and delivered at Songklanagarind Hospital. All of the participating thalassemia trait pregnant women were diagnosed based on hemoglobin typing and/or DNA analysis. A ratio of around 1–1 was used to compare their pregnancy outcomes with normal pregnant women. Results...

  3. Outcome of teenage pregnancy.

    Directory of Open Access Journals (Sweden)

    Bhalerao A

    1990-07-01

    Full Text Available Two hundred consecutive cases up to 19 years of age admitted for confinement at The Nowrosjee Wadia Maternity Hospital, Bombay, were studied. Out of these 200 girls, 6 were unmarried, 51 were anaemic, 20 had toxaemia of pregnancy. Six girls (43% in the age group 15-17 years delivered prematurely as compared to only 26 girls (14% in the age group of 17-19 years. This difference is statistically significant. Also, only, 4 girls (29% in the age group of 15-17 years had full term normal delivery as compared to 113 girls (61% in the age group of 17-19 years signifying that the outcome of pregnancy becomes worst in girls below the age of 17 years. Ten babies (71% of mothers in the age group of 15-17 years were LBW as compared to 75 babies (44% of mothers in the age group of 17-19 years signifying that the incidence of LBW babies is inversely proportional to maternal age. Teenage pregnant girls needed more attention for prevention and treatment of preeclampsia eclampsia, anaemia, prematurity and LBW.

  4. Early pregnancy vitamin D status and risk for adverse maternal and infant outcomes in a bi-ethnic cohort: the Behaviors Affecting Baby and You (B.A.B.Y.) Study.

    Science.gov (United States)

    Nobles, Carrie J; Markenson, Glenn; Chasan-Taber, Lisa

    2015-12-28

    Vitamin D deficiency is common during pregnancy and higher in Hispanic as compared with non-Hispanic white women. However, the association between vitamin D deficiency and adverse pregnancy outcomes remains unclear and may vary across ethnic groups, in part because of genetic variation in the metabolism of vitamin D. Few studies have included Hispanic women. Therefore, we investigated this association among 237 participants in the Behaviors Affecting Baby and You Study, a randomised trial of an exercise intervention among ethnically diverse prenatal care patients in Massachusetts. Baseline serum 25-hydroxyvitamin D (25(OH)D) was measured at 15·2 (sd 4·7) weeks' gestation. Information on adverse pregnancy outcomes was abstracted from medical records. Mean 25(OH)D was 30·4 (sd 12·0) ng/ml; 53·2 % of participants had insufficient (Hispanic ethnicity, women with insufficient and deficient vitamin D had infants with birth weights 139·74 (se 69·16) g (P=0·045) and 175·52 (se 89·45) g (P=0·051) lower compared with women with sufficient vitamin D levels (≥30 ng/ml). Each 1 ng/ml increase in 25(OH)D was associated with an increased risk for gestational diabetes mellitus among Hispanic women only (relative risk 1·07; 95 % CI 1·03, 1·11) in multivariable analysis. We did not observe statistically significant associations between maternal vitamin D status and other pregnancy outcomes. Our findings provide further support for an adverse impact of vitamin D deficiency on birth weight in Hispanic women. PMID:26507186

  5. Adverse obstetric outcome for the vanishing twin syndrome.

    Science.gov (United States)

    Almog, Benny; Levin, Ishai; Wagman, Israel; Kapustiansky, Rita; Lessing, Joseph B; Amit, Ami; Azem, Foad

    2010-02-01

    The aim was to compare obstetric outcomes of IVF singleton pregnancies diagnosed with vanishing twin (VT) syndrome with those pregnancies originating as singleton pregnancies and with twin pregnancies. In this case control study, 57 patients diagnosed with VT syndrome were matched and compared with 171 singleton controls and 171 twin controls. Mean gestational age was 35.1+/-3.7 versus 38.2+/-2.6 weeks (P=0.001) for patients and singleton controls respectively. Birth weights were 2834.4+/-821.2 versus 3036+/-489.3g (P=0.02), proportion of low birth weight (< 2500 g) was 33.3 versus 11.7% (P=0.0001) and very low birth weight (< 1500 g) 3.5 versus 0.6% for patients and singleton controls respectively. The proportion of deliveries before 28 weeks of gestation was 7.0 versus 1.2% (P=0.01) for patients and singleton controls respectively. When comparing the study group to twin control pregnancies, a similar gestational age at delivery (35 weeks) and rate of preterm birth (23%) were found. In conclusion, pregnancies diagnosed with the VT syndrome after IVF carry a higher rate of adverse obstetric outcomes in terms of preterm deliveries and lower birth weight, compared with IVF pregnancies that were originally singleton. Additionally, significant similarities were observed in the obstetrics outcome of vanishing twin pregnancies and twin pregnancies. PMID:20113963

  6. Pregnancy Outcome in Women with Threatened Miscarriage: a Year Study

    OpenAIRE

    El-Sammani, Mohamed El-Khatem; Al-Sheeha, Muneera Al-Alaziz; Aitallah, Abdou Saeed; Jabin Khan, Farhat; Ahmed, Salah Roshdy

    2012-01-01

    Introduction: Patients with threatened miscarriage associated with adverse pregnancy outcomes because of associated pregnancy and labor complications. Objectives: To evaluate the effect of threatened miscarriage on early and late pregnancy outcome. Methods: A retrospective case–controlled study was performed on 89 women with threatened miscarriage (study group) at Maternity and Children Hospital Buraidah, KSA from January 2010 to December 2010. They were matched for age and parity to 45 cases...

  7. Outcome of Teenage Pregnancy in the Niger Delta of Nigeria

    OpenAIRE

    Ayuba, Ibrahim Isa; Gani, Owoeye

    2012-01-01

    Background Young maternal age at delivery has been proposed as risk factor for adverse pregnancy outcome, it occurs in all races, faiths, socioeconomic statuses, and regions. Teenage pregnancy can have serious physical consequences and teenage mothers are likely to be unmarried, poor and remain uneducated. The objective of the study was to evaluate risk factors associated with teenage pregnancy and compare the obstetric and fetal outcome to older parturient. Methods This is a retrospective st...

  8. Doppler prediction of adverse perinatal outcome in intrauterine growth restriction

    Directory of Open Access Journals (Sweden)

    Nina Mahale

    2015-02-01

    Full Text Available Background: Objective of current study was to determine and compare the diagnostic performance of Doppler ultrasonography of the fetal Middle Cerebral Artery (MCA and Umbilical Artery (UA for prediction of adverse perinatal outcome in suspected intrauterine growth restriction (IUGR. Methods: Fifty singleton pregnancies in third trimester of pregnancy with suspected intrauterine growth restriction were examined with Doppler ultrasonography of fetal MCA and UA. Results: Twenty patients of the fifty included patients had at least one major or minor adverse outcome. Major adverse outcome included perinatal deaths which included both intrauterine deaths and early neonatal deaths, hypoxic ischemic encephalopathy, intraventricular hemorrhage, periventricular leukomalacia, pulmonary hemorrhage, necrotizing enterocolitis and septicemia. Minor outcomes included cesarean section for fetal distress, Apgar score below 7 at 5 minutes and admission to Neonatal Intensive Care Unit (NICU for treatment. MCA PI is the most sensitive(90% index in predicting any adverse perinatal outcome i.e. including both major and minor outcomes, Positive Predictive Value (PPV and specificity being greatest for MCA/UA PI (96.6%, 93.7%. For the major adverse outcome most sensitive (86.6% most specific (91.4% and with highest PPV (81.2% and NPV (94.1%, is MCA/UA PI. Ratio of MCA/UAPI is more sensitive (90% than PI of both the arteries alone for overall prediction of adverse perinatal outcome. Conclusions: Thus we conclude that the Doppler studies of the multiple vessels in the fetoplacental unit can help in the monitoring of the compromised fetus and can help us predicting neonatal morbidity. This may be helpful in determining the optimal time of deliveries in pregnancies complicated by IUGR. [Int J Reprod Contracept Obstet Gynecol 2015; 4(1.000: 119-130

  9. Maternal Serum Screening Markers and Adverse Outcome: A New Perspective

    Directory of Open Access Journals (Sweden)

    David Krantz

    2014-07-01

    Full Text Available There have been a number of studies evaluating the association of aneuploidy serum markers with adverse pregnancy outcome. More recently, the development of potential treatments for these adverse outcomes as well as the introduction of cell-free fetal DNA (cffDNA screening for aneuploidy necessitates a re-evaluation of the benefit of serum markers in the identification of adverse outcomes. Analysis of the literature indicates that the serum markers tend to perform better in identifying pregnancies at risk for the more severe but less frequent form of individual pregnancy complications rather than the more frequent but milder forms of the condition. As a result, studies which evaluate the association of biomarkers with a broad definition of a given condition may underestimate the ability of such markers to identify pregnancies that are destined to develop the more severe form of the condition. Consideration of general population screening using cffDNA solely must be weighed against the fact that traditional screening using serum markers enables detection of severe pregnancy complications, not detectable with cffDNA, of which many may be amenable to treatment options.

  10. The epidemiology of disasters and adverse reproductive outcomes: lessons learned.

    Science.gov (United States)

    Cordero, J F

    1993-07-01

    A disaster has been defined as a disruption of human ecology that exceeds the capacity of the community to function normally. Little is known about the adverse effects of natural disasters on reproductive outcomes. Important lessons can be derived from several disasters caused by human factors, such as the Minamata Bay disaster. Adverse reproductive outcomes include infertility, early pregnancy loss, stillbirths, congenital malformations, and serious developmental disabilities such as cerebral palsy and mental retardation. Recent disasters like the Chernobyl and Bhopal explosions have provided important lessons on the need for accurate and sound information about the risk of prenatal exposures for adverse reproductive outcomes. To study questions of adverse reproductive outcomes and disasters requires a well-planned approach. It should include early development of surveillance for adverse reproductive outcomes, analytic studies on the risk of disasters from direct and indirect effects, sensitive methods to measure early pregnancy loss, and long-term follow-up programs to assess outcomes such as developmental disabilities. PMID:8243383

  11. Impact of antiretroviral therapy on pregnancy outcomes

    Directory of Open Access Journals (Sweden)

    C D Aniji

    2013-12-01

    Full Text Available Background.The majority of HIV-positive women in South Africa are of reproductive age, and pregnancies among women using antiretroviral therapy (ART are common. However, there are mixed data regarding the impact of ART on pregnancy outcomes.Objective. To examine the impact of ART on pregnancy outcome according to the timing of initiation of treatment.Methods. A retrospective cohort study was conducted among women delivering at a tertiary hospital from 1 October 2008 to 31 March 2009.Results. A total of 245 mothers were receiving ART: 76 mothers (31% started ART pre-conception and 169 mothers (69% started ART after the first trimester. No significant differences were observed in the rates of preterm delivery and low birth weight (LBW between the pre- and post-conception groups (21% v. 24% and 21% v. 25%, respectively.Conclusion. In this cohort of women receiving ART in pregnancy, timing of ART initiation did not have any adverse effect on the measured pregnancy outcomes such as preterm delivery and LBW.

  12. Early pregnancy azathioprine use and pregnancy outcomes.

    LENUS (Irish Health Repository)

    Cleary, Brian J

    2012-02-01

    BACKGROUND: Azathioprine (AZA) is used during pregnancy by women with inflammatory bowel disease (IBD), other autoimmune disorders, malignancy, and organ transplantation. Previous studies have demonstrated potential risks. METHODS: The Swedish Medical Birth Register was used to identify 476 women who reported the use of AZA in early pregnancy. The effect of AZA exposure on pregnancy outcomes was studied after adjustment for maternal characteristics that could act as confounders. RESULTS: The most common indication for AZA use was IBD. The rate of congenital malformations was 6.2% in the AZA group and 4.7% among all infants born (adjusted OR: 1.41, 95% CI: 0.98-2.04). An association between early pregnancy AZA exposure and ventricular\\/atrial septal defects was found (adjusted OR: 3.18, 95% CI: 1.45-6.04). Exposed infants were also more likely to be preterm, to weigh <2500 gm, and to be small for gestational age compared to all infants born. This effect remained for preterm birth and low birth weight when infants of women with IBD but without AZA exposure were used as a comparison group. A trend toward an increased risk of congenital malformations was found among infants of women with IBD using AZA compared to women with IBD not using AZA (adjusted OR: 1.42, 95% CI: 0.93-2.18). CONCLUSIONS: Infants exposed to AZA in early pregnancy may be at a moderately increased risk of congenital malformations, specifically ventricular\\/atrial septal defects. There is also an increased risk of growth restriction and preterm delivery. These associations may be confounded by the severity of maternal illness.

  13. International Collaboration on Air Pollution and Pregnancy Outcomes (ICAPPO).

    OpenAIRE

    Woodruff, Tracey J.; Parker, Jennifer D.; Kate Adams; Bell, Michelle L.; Ulrike Gehring; Svetlana Glinianaia; Eun-Hee Ha; Bin Jalaludin; Rémy Slama

    2010-01-01

    Reviews find a likely adverse effect of air pollution on perinatal outcomes, but variation of findings hinders the ability to incorporate the research into policy. The International Collaboration on Air Pollution and Pregnancy Outcomes (ICAPPO) was formed to better understand relationships between air pollution and adverse birth outcomes through standardized parallel analyses in datasets from different countries. A planning group with 10 members from 6 countries was formed to coordinate the p...

  14. Pregnancy Outcomes in Pregnant Women with Subchorionic Hematoma

    OpenAIRE

    Victoria V. Barinova; Anna V. Kovaleva; Maria P. Dmitrieva

    2015-01-01

    Background: The role of subchorionic hematoma (SCH) in the first trimester of pregnancy remains open for discussion. Some authors claim that SCH does not affect the pregnancy; others have found that it is a serious risk factor for adverse pregnancy outcome. The objective of the present study was to explore the outcomes of pregnancy in patients with SCH diagnosed in the first trimester. Methods and Results: The study involved 194 pregnant women who were in terms of 6 to12 weeks: 115 women w...

  15. Obstetric and perinatal outcome of multiple pregnancy

    International Nuclear Information System (INIS)

    To determine the obstetric and perinatal outcome in multiple pregnancies at a teaching hospital. The analysis included data on all women between 20 and 35 years of age with 24 completed weeks gestation having multiple pregnancies during the study period after applying the exclusion criteria. The data retrieved from the hospital-based maternal health medical records included demographic details, complications of pregnancy, and maternal and neonatal outcomes. The data was expressed as frequencies, percentages, mean and standard deviation. Normal distribution of continuous variables was determined by Shapiro Wilk test. The differences in the mean birth weight of the first and second twin were compared by student's t-test considering a p-value less than 0.05 as statistically significant. There were a total of 161 multiple pregnancies with the overall incidence of 37.1 per 1,000 births (3.2%) during the study period. One hundred and twenty two cases had the inclusion criteria applicable. There were 9 triplets among these of whom seven were received as intrauterine death and the other two were lost to follow-up. The four leading maternal adverse outcomes were anemia (74.6%), preterm delivery (31%), pregnancy - induced hypertension (30%) and preterm premature rupture of membranes (26.2%). Median gestational age at delivery was 37 weeks. Most common route of delivery was caesarean section (53.3%). Most common neonatal complication was low birth weight. Prematurity was the most common cause of neonatal death. Multiple pregnancy have high maternal and neonatal complications, especially preterm delivery that increases risk of significant neonatal morbidity and mortality. (author)

  16. Experiences of counselling on physical activity during pregnancy Gestational diabetes mellitus : screening and pregnancy outcomes

    OpenAIRE

    Lindqvist, Maria

    2016-01-01

    Background Overweight and obesity are global health problems with several adverse health effects that threaten public health. In Sweden, almost four of ten pregnant women are overweight or obese, conditions that are associated with adverse pregnancy outcomes, including gestational diabetes mellitus (GDM), a metabolic disorder that complicates pregnancy. Globally, physical inactivity is the fourth leading risk factor for mortality. The recommendation for physical activity (i.e., ≥150 minutes/w...

  17. Serum copeptin and pregnancy outcome in preeclampsia

    Directory of Open Access Journals (Sweden)

    Kehinde Sola Akinlade

    2015-01-01

    Full Text Available Background: A number of biochemical predictors of preeclampsia have been reported, but little is known about their possible relationship with maternal and fetal outcomes. This study determined serum copeptin in pregnant women with preeclampsia and assessed its relationship with pregnancy outcomes. Materials and Methods: Thirty women with severe preeclampsia (SP, 30 with mild preeclampsia (MP, and 30 with uncomplicated pregnancy were enrolled into this study. Serum copeptin, creatinine, and liver function were determined using enzyme-linked immunosorbent assay and colorimetry as appropriate. Pregnancy outcomes, both maternal and fetal, were taken using standard methods. Results: Copeptin was significantly elevated in preeclampsia subjects compared with controls and in SP compared with MP. Assessing the diagnostic property of copeptin for preeclampsia, the area under the curve for copeptin was 0.99. Nine (30% and 3 (10% of SP and MP, respectively had abruptio placenta while 6 (20%, 2 (6.7%, and 1 (3.3% still births were recorded in SP, MP, and controls, respectively. Neonates of mothers with preeclampsia had significantly lower birth weight, infant length, ponderal index, and head circumference compared with neonates of the controls. Copeptin had a significant inverse relationship with birth weight, ponderal index, head circumference, Apgar score, and infant length in neonates of mothers with preeclampsia. Conclusion: Serum copeptin level in the third trimester could predict preeclampsia and its elevation is associated with adverse perinatal outcome.

  18. Collateral Adverse Outcomes After Lumbar Spine Surgery.

    Science.gov (United States)

    Daniels, Alan H; Gundle, Kenneth; Hart, Robert A

    2016-01-01

    Collateral adverse outcomes are the expected or unavoidable results of a procedure that is performed in a standard manner and typically experienced by the patient. Collateral adverse outcomes do not result from errors, nor are they rare. Collateral adverse outcomes occur as the direct result of a surgical procedure and must be accepted as a trade-off to attain the intended benefits of the surgical procedure. As such, collateral adverse outcomes do not fit into the traditional definition of a complication or adverse event. Examples of collateral adverse outcomes after lumbar spine arthrodesis include lumbar stiffness, postoperative psychological stress, postoperative pain, peri-incisional numbness, paraspinal muscle denervation, and adjacent-level degeneration. Ideally, a comparison of interventions for the treatment of a clinical condition should include information on both the negative consequences (expected and unexpected) and potential benefits of the treatment options. The objective evaluation and reporting of collateral adverse outcomes will provide surgeons with a more complete picture of invasive interventions and, thus, the improved ability to assess alternative treatment options. PMID:27049197

  19. RACIAL RESIDENTIAL SEGREGATION AND ADVERSE BIRTH OUTCOMES

    Science.gov (United States)

    INTRODUCTION. The disparity between black and white women's adverse birth outcomes has been subject to much investigation, yet the factors underlying its persistence remain elusive, which has encouraged research on neighborhood-level influences, including racial residential segr...

  20. Brucellosis in pregnancy: clinical aspects and obstetric outcomes

    Directory of Open Access Journals (Sweden)

    Gustavo Vilchez

    2015-09-01

    Conclusions: This is the largest series of brucellosis in pregnancy reported in the literature. Brucella presents adverse obstetric outcomes including fetal and maternal/neonatal death. Cases with unexplained spontaneous abortion should be investigated for brucellosis. Prompt treatment is paramount to decrease the devastating outcomes.

  1. 不良妊娠结局孕妇血清学指标的判别分析%Discriminant analysis on serological indexes of pregnant women with adverse pregnancy outcome

    Institute of Scientific and Technical Information of China (English)

    袁晖; 王宏; 官勇; 欧阳淑媛; 吴晓霞; 文华轩; 谢建生

    2012-01-01

    Objective: To establish the model to predict the adverse pregnancy outcomes of pregnant women by detecting the serological indexes. Methods: A retrospective investigation method was used to gradually discriminate the serological indexes of 118 pregnant women with adverse pregnancy outcome who were found with high risks of Down's syndrome and neural tube defect in Shenzhen region from 2008 to 2010, then corresponding discriminant model was established. Results: Among 118 pregnant women, 61 women were diagnosed as adverse pregnancy outcome definitely during follow - up. The effect of discrimination was the best after including maternal age and alpha feto-prolein level into discriminant model in gradual discriminant analysis; retrospective discriminant analysis showed that 17 pregnant women were discriminated erroneously , the total erroneous discrimination rate was 14. 4% , the total accurate rate was 85. 6% ; cross validation showed that 18 pregnant women were discriminated erroneously , the total erroneous discrimination rate was 15. 3% , the total accurate rate was 84.1%. The sensitivity and specificity of discriminant model were 83. 3% and 90.0% , respectively. Conclusion: Establishing discriminant model by serological indexes of pregnant women is helpful to improve the accuracy of prediction of adverse pregnancy outcome in high risk pregnant women and guide clinical diagnosis.%目的:通过孕妇血清学指标建立不良妊娠结局的预测模型.方法:采用回顾性调查的方法,对2008年~2010年深圳地区唐氏综合征筛查神经管缺陷高风险118例孕妇不良妊娠结局的血清学指标进行逐步判别,建立相应的判别模型.结果:118例中,随访确诊61例不良妊娠.逐步判别分析将孕妇年龄及甲胎蛋白水平纳入判别模型后判别效果最好;回顾性误判分析显示有17例发生误判,总误判率为14.4%,总准确率为85.6%;而交叉核实法显示有18例发生误判,总误判率为15.3

  2. VIOLENT CRIME EXPOSURE CLASSIFICATION AND ADVERSE BIRTH OUTCOMES: A GEOGRAPHICALLY-DEFINED COHORT STUDY

    Science.gov (United States)

    BackgroundArea-level socioeconomic disparities have long been associated with adverse pregnancy outcomes. Crime is an important element of the neighborhood environment inadequately investigated in the public health literature. Using geocoded linked birth, crime and cens...

  3. Correlation Between Blood Glucose Levels in Patients with Gestational Diabetes and Adverse Pregnancy Outcomes%妊娠期糖尿病患者血糖水平与不良妊娠结局的相关性探讨

    Institute of Scientific and Technical Information of China (English)

    区润玲

    2014-01-01

    目的:比较妊娠期糖尿病患者血糖水平与临床不良妊娠结局之间的相关性。方法 GDM患者共60例列入血糖水平异常组,同期血糖正常的健康孕产妇60例列入血糖水平正常组,记录两组患者分娩情况,筛查不良妊娠结局。结果血糖水平异常组孕产妇出现羊水过多、妊高征、剖宫产和产后出血的比例极明显高于血糖水平正常组孕产妇,血糖水平异常组围产儿发生胎儿窘迫、巨大儿、新生儿低血糖和新生儿窒息的比例极明显高于血糖水平正常组围产儿,数据间比较差异具有统计学意义(P<0.01)。结论 GDM患者的高血糖水平促进了不良妊娠结局的增加,加大母婴危险性,应对患者积极进行综合治疗与护理,强调患者的主观能动性,督促和鼓励患者有效控制和改善血糖水平。%Objective To explore the correlation between blood glucose levels in patients with gestational diabetes and adverse pregnancy outcomes. Methods 60 GDM patients were selected as the abnormal blood sugar levels group, while another 60 parturients with normal blood glucose at the same period were selected as the normal blood sugar levels group. The primary outcome was a record of the childbirth of the two groups, in which the adverse pregnancy outcomes were screened. Results Polyhydramnios, pregnancy-induced hypertension syndrome, cesarean delivery, and postpartum hemorrhage in the abnormal maternal glucose levels group were significantly higher than those of the normal blood sugar levels group. The incidence of fetal distress, macrosomia, neonatal hypoglycemia and neonatal asphyxia of the abnormal blood glucose levels group was significantly higher than that of the normal blood sugar levels group (P <0.01). Conclusions The high blood sugar level in the GDM patients increases the incidence of adverse pregnancy outcomes as well as the risk for mothers and children. Positive comprehensive treatment and care

  4. Genome-wide association study of preeclampsia detects novel maternal single nucleotide polymorphisms and copy-number variants in subsets of the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study cohort

    Science.gov (United States)

    Zhao, Linlu; Bracken, Michael B.; DeWan, Andrew T.

    2013-01-01

    Summary A genome-wide association study was undertaken to identify maternal single nucleotide polymorphisms (SNPs) and copy-number variants (CNVs) associated with preeclampsia. Case-control analysis was performed on 1070 Afro-Caribbean (n=21 cases and 1049 controls) and 723 Hispanic (n=62 cases and 661 controls) mothers and 1257 mothers of European ancestry (n=50 cases and 1207 controls) from the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study. European ancestry subjects were genotyped on Illumina Human610-Quad and Afro-Caribbean and Hispanic subjects were genotyped on Illumina Human1M-Duo BeadChip microarrays. Genome-wide SNP data were analyzed using PLINK. CNVs were called using three detection algorithms (GNOSIS, PennCNV, and QuantiSNP), merged using CNVision, and then screened using stringent criteria. SNP and CNV findings were compared to those of the Study of Pregnancy Hypertension in Iowa (SOPHIA), an independent preeclampsia case-control dataset of Caucasian mothers (n=177 cases and 116 controls). A list of top SNPs were identified for each of the HAPO ethnic groups, but none reached Bonferroni-corrected significance. Novel candidate CNVs showing enrichment among preeclampsia cases were also identified in each of the three ethnic groups. Several variants were suggestively replicated in SOPHIA. The discovered SNPs and copy-number variable regions present interesting candidate genetic variants for preeclampsia that warrant further replication and investigation. PMID:23551011

  5. Relation between time to pregnancy and pregnancy outcome

    Directory of Open Access Journals (Sweden)

    Hatave Ghasemi Tehrani

    2014-01-01

    Full Text Available Background: Studies have shown significant correlation between time to pregnancy (TTP and pregnancy  outcomes. But  understanding of these mechanisms may not be facilitated. The aim of this study was to determine the relation between TTP and pregnancy outcome. Materials and Methods: This study was a case cohort study that was done in Shahid Beheshti Educational Hospital during 2006-2007. Women aged 18-35 years, who had only one pregnancy without using any contraception method before pregnancy and delivered their first child, were enrolled in this study. Thus, 801 women were selected and followed up for pregnancy outcome and TTP until the end of pregnancy. All the participants filled in a special questionnaire. Finally the collected data were entered into computer and analyzed by SPSS ver. 20 software. Results: The frequency distribution of TTP-based pregnancy outcome showed that TTP >48 weeks was higher in normal delivery than in abnormal delivery (5.6% vs. 19.4%. According to Chi-square test, the frequency distribution of pregnancy outcome was related to TTP (P < 0.001. Conclusion: According to the results of this study, there is a significant relationship between TTP and pregnancy outcome, and TTP may lead to unwanted complications such as ectopic pregnancy, preterm labor, and abortion. Thus, all women with a long time of contraception, especially in the rural areas, mast be controlled.

  6. Outcome of Subsequent Pregnancies in Familial Molar Pregnancy

    OpenAIRE

    Masoumeh Fallahian; Forough Foroughi; Mohammad Vasei; Shahrzad Tavana; Maryam Ghanbary; Maryam Monajemzadeh; Anahita Tavana

    2013-01-01

    Familial recurrent molar pregnancy is an exceedingly rare condition, in which complete hydatidiform moles are mostly diploid but biparental in origin and the outcome of subsequent pregnancies is likely to be a hydatidiform mole or other type of reproductive loss. We previously reported a case of familial molar pregnancy (family K) comprising five affected members (four sisters and one of their cousins) each with at least one hydatidiform mole (HM). In addition to the molar pregnancies, these ...

  7. Maternal Testosterone Levels are Associated with C-Peptide Levels in the Mexican American Subset of the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study Cohort

    OpenAIRE

    Ackerman, C. M.; Lowe, L. P.; Dyer, A R; Hayes, M G; Metzger, B E; Lowe, W. L.; Urbanek, M

    2013-01-01

    Altered sex hormone levels are thought to play an important role in adult-onset diseases including obesity, cardiovascular disease, and diabetes. They contribute to these complex diseases through changes in their availability, which is influenced, in part, by binding proteins. Insulin resistance, which is characteristic of these diseases, along with increased insulin secretion, is a physiologic change that occurs normally during pregnancy. To determine the relationship between insulin resista...

  8. Systematic review on adverse birth outcomes of climate change

    Directory of Open Access Journals (Sweden)

    Parinaz Poursafa

    2015-01-01

    Full Text Available Background: Climate change and global warming have significant effects on human health. This systematic review presents the effects of the climate changes on pregnancy outcomes. Materials and Methods: The search process was conducted in electronic databases including ISI Web of Knowledge, PubMed, Scopus, and Google Scholar using key words of "environmental temperature" "pregnancy" "low birth weight (LBW" "pregnancy outcome," "climate change," "preterm birth (PTB," and a combination of them. We did not consider any time limitation; English-language papers were included. The related papers were selected in three phases. After quality assessment, two reviewers extracted the data while the third reviewer checked their extracted data. Finally, 15 related articles were selected and included in the current study. Results: Approximately all studies have reported a significant relationship between exposure variable and intended outcomes including eclampsia, preeclampsia, cataract, LBW, PTB, hypertension, sex ratio and length of pregnancy. According to conducted studies, decrease in birth weight is more possible in cold months. Increase in temperature was followed by increase in PTB rate. According to most of the studies, eclampsia and preeclampsia were more prevalent in cold and humid seasons. Two spectrums of heat extent, different seasons of the year, sunlight intensity and season of fertilization were associated with higher rates of PTB, hypertension, eclampsia, preeclampsia, and cataract. Conclusion: Climate change has unfavorable effects on eclampsia, preeclampsia, PTB, and cataract. The findings of this review confirm the crucial importance of the adverse health effects of climate change especially in the perinatal period.

  9. Interventions during pregnancy and labor and obstetric outcome

    OpenAIRE

    Thorsell, Malin

    2011-01-01

    Objectives: The overall objective with the present thesis was to assess pregnancy and delivery associated risk factors for adverse pregnancy outcomes. Specific aims were : 1) to analyze the association between fetal size at the time of dating ultrasound and the risk of preterm delivery, small for gestational age birth (SGA), and macrosomia and to evaluate if the timing of ultrasound, i.e. before 14 weeks of gestation or after 16 weeks, affected this association, 2) to assess the risk of emerg...

  10. Pregnancy outcomes associated with viral hepatitis.

    Science.gov (United States)

    Reddick, K L B; Jhaveri, R; Gandhi, M; James, A H; Swamy, G K

    2011-07-01

    The aim of this study was to examine the contribution of hepatitis B virus (HBV) and hepatitis C virus (HCV) to pregnancy-related complications including gestational diabetes mellitus (GDM), preterm birth (PTB), intrauterine growth restriction (IUGR), pre-eclampsia, antepartum haemorrhage and cholestasis. The Nationwide Inpatient Sample was queried for all pregnancy-related discharges, pregnancy complications and viral hepatitis from 1995 to 2005. Logistic regression was used to examine the association between HBV, HCV, HBV + HCV and pregnancy-related complications including GDM, PTB, IUGR, pre-eclampsia, antepartum haemorrhage, cholestasis and caesarean delivery. Model covariates included maternal age, race, insurance status, substance use and medical complications including liver complication, hypertension, HIV, anaemia, thrombocytopenia and sexually transmitted infections. Of 297 664 pregnant women data available for analysis, 1446 had a coded diagnosis of HBV, HCV or both. High-risk behaviours, such as smoking, alcohol and substance use were higher in women with either HBV or HCV. Women with HBV had an increased risk for PTB (aOR 1.65, CI [1.3, 2.0]) but a decreased risk for caesarean delivery (aOR 0.686, CI [0.53, 0.88]). Individuals with HCV had an increased risk for GDM (aOR 1.6, CI [1.0, 2.6]). Individuals with both HBV and HCV co-infection had an increased risk for antepartum haemorrhage (aOR 2.82, CI [1.1, 7.2]). There was no association of viral hepatitis with IUGR or pre-eclampsia. Women with hepatitis have an increased risk for complications during pregnancy. Research to determine the efficacy and cost-effectiveness of counselling patients about potential risks for adverse outcomes is warranted. PMID:21692952

  11. 孕中期异常甲胎蛋白与不良妊娠结局的相关性%The association between second - trimester maternal serum abnormal alpha - fetoprotein and adverse pregnancy outcome

    Institute of Scientific and Technical Information of China (English)

    吴满武; 俞信忠; 杨志浩; 张涛; 罗婷婷

    2012-01-01

    目的 探讨孕中期甲胎蛋白(AFP)与不良妊娠结局的相关性,为妊娠管理提供建议.方法 对孕中期14 008例孕妇进行唐氏筛查.研究组:①AFP MoM>2.0孕妇338例.②AFP MoM<0.5孕妇224例.依据AFP MoM值不同分组.对照组:AFP MoM值都在正常范围内的孕妇318例.回顾分析妊娠结局资料.结果 ①AFP MoM>2.0的孕妇发生出生缺陷(ρ<0.01)的机会明显比正常孕妇高.②AFP MoM> 3.5的孕妇发生出生缺陷(P<0.001)和早产(P<0.05)的机会明显比正常孕妇高.③AFP MoM> 5.0的孕妇发生出生缺陷(P<0.001)、早产(P<0.01)和胎儿窘迫(P<0.05)的机会明显比正常孕妇高.④AFP MoM<0.5和<0.25的孕妇均未发现与不良妊娠结局相关.结论 异常水平的标志物除了能够提供开放性神经管缺损风险外,还能提供不良妊娠结局的风险信息,而这些信息对产前遗传咨询和妊娠管理是非常重要.%Objective; Aim of this study is to determine the association between risk of adverse pregnancy outcome and abnormal maternal serum alpha - fetoprotein in second trimester screening. Abnormal levels of maternal serum markers provide information which is important for counseling and pregnancy management. Methods: A total of 14 008 pregnant women underwent maternal serum Down' s syndrome screening. Study groups include:①338 cases were found to have a serum AFP of > 2.0 multiples of the median ( MoM). ②cases serum were found to have a serum AFP 2.0 MoM have higher occurrence of birth defects (P 3. 5 MoM have higher occurrence of birth defects ( P 5.0 MoM have higher occurrence of birth defects (P < 0. 001) and preterm labor ( P < 0. 01) and fetal stress ( P < 0. 05). ④Pregnant women with a serum AFP of < 0. 5 M < 0. 25 MoM were found to have no association with adverse outcomes. Conclusion: Abnormal levels of maternal serum markers can provide risk information of adverse outcomes in addition to the risks for open neural tube defects

  12. Eating for Two in Pregnancy: Health outcomes in pregnant women and their children

    OpenAIRE

    Tielemans, Myrte

    2016-01-01

    textabstractAdverse pregnancy and birth outcomes such as pre-eclampsia and preterm birth are prevalent worldwide and are important causes of maternal and perinatal mortality and morbidity. To reduce the occurrence of these adverse outcomes, risk factors should be identified that could be modified in pregnancy. Such modifiable risk factors may be maternal nutrition and gestational weight gain. However, not all aspects of maternal diet during pregnancy have been studied in relation with pregnan...

  13. Fetomaternal outcome in triplet pregnancy

    International Nuclear Information System (INIS)

    To determine maternal outcome as antenatal and postnatal complications and neonatal outcome as birth weight, morbidity and mortality in triplet gestation. All the patients with triplet pregnancy beyond 28 weeks gestation, who delivered at the study place during above period were included in the study. The primary outcome measures were frequency of maternal complications and neonatal birth, weight and morbidity. Secondary outcome measures included the frequency of assisted conception in the studied cohart. Eighteen women had triplet pregnancy beyond 28 weeks. Nine were booked, 6 non-booked and 3 of them were referred. Mean duration of gestation was 237.8 days (33.8 weeks). The antenatal complications were preterm delivery in 50%, hypertension in 50%, anemia in 44.4% and obstetric cholestasis in 5.6%. Eight patients (44.4%) suffered postpartum hemorrhage. One patient had peripartum hysterectomy and later expired in intensive care unit after three weeks. Maternal mortality ratio was 5.6%. Fifty five percent women had induction of ovulation with Clomiphene, while none had In Vitro Fertilization (IVF) or Intracytoplasmic Insemination (ICSI) or received gonadotrophins. Fifteen sets of triplets were delivered abdominally. Mean birth weights of 1st, 2nd and 3rd triplet were 1651, 1640 and 1443 grams respectively. Five sets of triplets (27.8%) had more than 25% discordance for birth weight. The mean Apgar scores of the babies at 1 and 10 minutes after birth were 6.0 and 8.0, 5.6 and 7.5; and 5.2 and 7.0 respectively. Of the 54 infants, 18 required Neonatal Intensive Care Unit (NICU) admission and 14 were admitted in nursery. Two died shortly after birth. Total perinatal mortalities were 13 including 4 cases of intra-uterine demise. Three babies suffered from jaundice, 7 had sepsis and 8 had respiratory distress syndrome. Triplet gestation had a high rate of fetomaternal complications. Majority had history of assisted conception. (author)

  14. Relationship between pre-pregnancy BMI and adverse birth outcomes%孕前体质指数与4种不良妊娠结局关系

    Institute of Scientific and Technical Information of China (English)

    楚舟; 陶芳标; 郝加虎; 宫相君; 徐蓉; 孙露; 刘芳

    2012-01-01

    Objective To assess the relationships between pre-pregnancy body mass index(BMI) and the 4 adverse biith outcomes, including small for gestational age (SGA ) , large for gestational age (LOA ) , low birth weight (LBW), and macrosomia. Methods Subjects were 12 355 pregnant women who had joined in the Anhui Birth Defects and Child Development Cohort Study and delivered between October 2008 and October 2010. The relationships between pre-pregnancy BMI and SGA,LGA,LBW and macrosomia were evaluated by Chi-square analysis and non-conditional logistic regression. Results The average pre-pregnancy BMI for the pregnant women was 20. 19(2.348 kg/m2). Based on the pre-pregnancy BMI,2 834 women were classified as underweight 22.9% ),8 745 as normal (70. 8% ), and 776 as overweight or obese (6.3% ). After adjusted for confounding factors such as age,registered residence, and pregnant times, we figured out the relationship between pre-pregnancy BMI and the gestational age group and the birth weight group. Pregnant underweight increased the risk of SGA(odds ratio[OR] =1.320,95% confidence interval[ CI: 1.068-1. 631] ,pre-pregnant overweight and obesity increased the risks of LGA(OR = 1. 758,95% CIA. 503 -2.056)and macrosomia(OR = 1. 870,95%CI:1. 540 -2.271). Conclusion High or low pre-pregnancy BMI could effect birth outcomes.%目的 探讨孕前体质指数(BMI)与4种不良妊娠结局(小于胎龄儿、大于胎龄儿、低出生体重儿、巨大儿)的关系.方法 以2008年10月-2010年10月在安徽省8个地市的妇幼保健机构孕早期建卡并随访到分娩记录的12 355名孕妇为对象,采用x2检验和非条件Logistic回归分析模型,分析孕前BMI与4种不良妊娠结局的关系.结果 孕妇孕前BMI均数为(20.19±2.348)kg/m2,过低2834人(22.9%),正常8745人(70.8%),超重及肥胖776人(6.3%);调整年龄、户籍地、孕次等混杂因素后,对孕前BMI与胎龄儿组和体重儿组分别进行关联性分析,结果显示,孕前BMI过

  15. Poor pregnancy outcome in women with type 2 diabetes

    DEFF Research Database (Denmark)

    Clausen, Tine D; Mathiesen, Elisabeth; Ekbom, Pia; Hellmuth, Ellinor; Mandrup-Poulsen, Thomas; Damm, Peter

    2005-01-01

    diabetes compared with women with type 1 diabetes. Multivariate logistic regression analysis in the pooled group of pregnancies with pregestational diabetes from 1996 to 2001 showed that high HbA(1c) at admission and type 2 diabetes were independently associated with a serious adverse fetal outcome...

  16. PERINATAL OUTCOME IN SEVERE ANAEMIA COMPLICATING PREGNANCY

    Directory of Open Access Journals (Sweden)

    Nirmala Devi

    2015-06-01

    Full Text Available BACKGROUND: Anaemia is the commonest global public health problem and especially harmful when the pregnancy is complicated by anaemia. Women in reproductive age group are more vulnerable for iron deficiency anaemia with an estimated prevalence of around 70 to 80% in pregnant women. MATERIAL AND METHODS: The aim of the study was to analyse the foetal outcome in the hospitalised pregnant women with severe anaemia. This is a prospective study carried out at maternity ward of Government G eneral H ospital, Kurnool of Andhra Pradesh, India over a period of one year from October 2007 to September 2008. RESULTS: Total of 9731 deliveries occurred during the study period, 282 (2.89 % were severely anaemic at the time of delivery. Majority of the women w ere of 20 - 24 years age (68.4% with second gravidas 37.5%, term gestation 52.1%, preterm deliveries 47.9%, lower socio - economic status 87.6% and Unbooked cases 67.4% and low birth weight in 53.2% cases, intra uterine growth retardation and intra uterine foetal death contributes to 12.8% and 16.7% cases respectively. A total of 36 (12.8% neonates required admission in neonatal intensive care unit and 16(5.7% of them died. CONCLUSION: Severe anaemia during pregnancy has adverse perinatal outcome in the fo rm of low birth weight, preterm birth, intrauterine growth retardation and intrauterine death. Regular iron supplementation during the antenatal period, management of anaemia and improving the nutritional status of the mother will improve the adverse neona tal outcome and decreases perinatal morbidity and mortality.

  17. Maternal and neonatal outcomes in pregnancies complicated by gestational diabetes

    DEFF Research Database (Denmark)

    Ovesen, Per Glud; Jensen, Dorte Møller; Damm, Peter;

    2015-01-01

    OBJECTIVE: To estimate the association between gestational diabetes mellitus (GDM) and adverse pregnancy and neonatal outcomes in Denmark. METHODS: A population-based cohort study including all singleton pregnancies in Denmark from 2004 to 2010 (n = 403 092). Maternal complications during pregnancy...... and delivery and fetal complications were classified according to the International Classification of Diseases 10th Revision. RESULTS: The final study population consisted of 398 623 women. Of these, 9014 (2.3%) had GDM. Data were adjusted for maternal age, parity, smoking, gestational age, birth...

  18. Successful outcome in preeclamptic rudimentary horn pregnancy.

    Science.gov (United States)

    Sinha, Ruchi; Sachan, Shikha; Khanna, Anuradha

    2011-01-01

    Unicornuate uterus with rudimentary horn is an uncommon type of mullerian duct malformation associated with various gynecological and obstetrical complications. Rudimentary horn pregnancy is a rare entity and the majority have rupture of gravid horn leading to maternal and fetal morbidity and mortality. A case of rudimentary horn pregnancy at 32 weeks and 6 days with pregnancy induced hypertension is reported where proper management results in successful pregnancy outcome. PMID:24591959

  19. 浙江省2013-2014年梅毒孕产妇不良妊娠结局分析%Adverse pregnancy outcomes among women with syphilis in Zhejiang province, 2013-2014

    Institute of Scientific and Technical Information of China (English)

    张晓辉; 邱丽倩; 陈丹青; 郭利芳; 阮黎明

    2016-01-01

    Objective To investigate the incidence of adverse pregnancy outcomes among women with syphilis in Zhejiang province during 2013-2014,and to explore the influence of anti⁃syphilis treatment on pregnancy outcomes. Methods A retrospective study was carried out according to the Information Management System for preventing mother⁃to⁃child transmission(PMTCT)of syphilis in Zhejiang province during 2013-2014. The incidence of adverse pregnancy outcomes was compared between women with syphilis and general women without syphilis, between treated and untreated women with syphilis, as well as between women with syphilis receiving and not receiving standard anti⁃syphilis treatment. The effects of anti⁃syphilis treatment and standard anti⁃syphilis treatment on pregnancy outcomes were analyzed. Results Data were collected from 3 985 women with syphilis and their children. Of these women, 12 had a stillbirth, and 3 973 a live birth. Totally, 3 210(80.55%)women received anti⁃syphilis treatment, 967(30.12%, 967/3 210) women received substandard treatment, and 775(19.45%)did not receive anti⁃syphilis treatment. Of the 3 985 fetuses or neonates born to women with syphilis, 45(1.13%)had abnormal clinical symptoms/signs. The incidence rates of low birth weight and early neonatal death were 7.00%(279/3 985) and 1.13%(45/3 985) respectively in fetuses or neonates born to women with syphilis, both significantly higher than those in fetuses or neonates born to general women without syphilis (3.18%[26 092/819494] and 0.13%[1 029/819 494], respectively, both P < 0.01). Among 775 untreated women with syphilis, the incidence rates of premature birth, low birth weight, early neonatal death, congenital syphilis and abnormal neonatal symptoms/signs were 15.61%(121/775), 10.84%(84/775), 2.45%(19/775), 3.48%(27/775)and 2.84%(22/775)respectively, all significantly higher than those in 3 210 women receiving anti⁃syphilis therapy (8.26%, 6.07%, 0.81%, 0.81% and 1.03%,respectively

  20. Pregnancy outcome in inflammatory bowel disease

    DEFF Research Database (Denmark)

    Bortoli, A; Pedersen, N; Duricova, D; D'Inca, R; Gionchetti, P; Panelli, M R; Ardizzone, S; Sanroman, A L; Gisbert, J P; Arena, I; Riegler, G; Marrollo, M; Valpiani, D; Corbellini, A; Segato, S; Castiglione, F; Munkholm, P

    2011-01-01

    Inflammatory bowel disease (IBD) frequently affects women during their reproductive years. Pregnancy outcome in women with IBD is well described, particularly in retrospective studies.......Inflammatory bowel disease (IBD) frequently affects women during their reproductive years. Pregnancy outcome in women with IBD is well described, particularly in retrospective studies....

  1. Prenatal Diagnosis and Pregnancy Outcome Analysis of Polyhydramnios.

    Science.gov (United States)

    Liu, Li-Ling; Pang, Li-Hong; Deng, Bi-Ye

    2016-01-01

    The aim of the study was to investigate the etiology and pregnancy outcomes in mothers with polyhydramnios through prenatal diagnosis and pregnancy outcome analysis of pregnant women with polyhydramnios. One hundred and thirty women were enrolled. Fifty pregnant women with polyhydramnios were categorized as the case group, and 80 pregnant women with normal amniotic fluid were categorized as the control group. The causes of polyhydramnios and the pregnancy outcomes were analyzed. Two cases had chromosomal abnormalities, seven had severe α-thalassemia, 15 had fetal anomalies, four had maternal-fetal diseases and 22 had unexplained idiopathic polyhydramnios. Significantly, higher occurrences of cesarean section, preterm birth, fetal anomaly, fetal distress, fetal macrosomia and female fetuses occurred in patients with polyhydramnios than in patients without polyhydramnios. Polyhydramnios is associated with a higher occurrence of adverse perinatal outcomes. Intensive monitoring of the maternal-fetal condition and prenatal diagnosis is important in patients with polyhydramnios. PMID:26720631

  2. Influence of medical treatment, smoking and disease activity on pregnancy outcomes in Crohn's disease

    DEFF Research Database (Denmark)

    Julsgaard, Mette; Nørgaard, Mette; Hvas, Christian Lodberg;

    2014-01-01

    Objective. Little is known about predictors for adverse pregnancy outcomes among women with Crohn’s disease (CD). In this population-based study, we examined pregnancy outcomes in CD stratified by medical treatment and smoking status while accounting for disease activity. Methods. In two Danish...... adverse pregnancy outcomes by different predictors. Results. Among 105 (80%) respondents, 55 (52%) reported taking medication during pregnancy. The majority (95%) were in disease remission. The children’s mean birth weight did not differ by maternal medical treatment. As expected, smoking was a predictor...

  3. Prevalence of maternal near miss and adverse pregnancy outcomes in Zhejiang province%浙江省危重孕产妇监测及其结局分析

    Institute of Scientific and Technical Information of China (English)

    马袁英; 戴红燕; 邱丽倩; 徐键; 邱灵

    2014-01-01

    目的 通过浙江省危重孕产妇监测系统掌握危重孕产妇发生水平及不良妊娠结局情况.方法 通过横断面调查选取2012至2013年浙江省危重孕产妇监测医院入院的所有危重孕产妇,网络直报危重孕产妇个案表,包括孕产妇的个人信息,妊娠合并症和并发症,危重孕产妇抢救措施和抢救过程,孕产妇及围产儿的不良结局发生情况.结果 共监测孕产妇161 660,共收集危重孕产妇826例,危重孕产妇的发病率5.6‰,危重孕产妇中妊娠期高血压疾病排首位,164例占19.9%;第2位是子宫收缩乏力,162例占19.6%;第3位为前置胎盘,146例占17.7%.危重孕产妇严重孕产结局中,子宫切除139例,子宫切除率16.8%.围产儿死亡81例,围产儿死亡率为10.4%,早产279例,早产出生率39.9%.结论 危重孕产妇监测有利于掌握危重孕产妇发生的流行病学情况,督促医疗机构改善产科质量,降低危重孕产妇发生率,早产儿出生率和围产儿死亡率.%Objective To explore the prevalence of maternal near miss (MNM) and adverse pregnancy outcomes in Zhejiang province by MNM surveillance system.Methods A cross-sectional study was conducted during 2012 and 2013.All MNM cases were recruited from the MNM surveillance system.The information was reported by direct network report system,including personal information,obstetric complications,maternal rescue measures,rescue process and severe maternal and perinatal outcomes.Results A total of 826 MNM patients were recruited.The MNM rate was 5.6 cases/1 000 live births (LB).Maternal gestational hypertension was the most common disease among MNM,accounting for 19.9% (n =164).The second prevalent one was insufficient uterine contraction,accounting for 19.6% (n =162).Placenta previa was the third one accounting for 17.7% (n =146).Among adverse pregnancy outcomes,139 cases underwent hysterectomy (n =139,16.8%).There were 81 perinatal deaths with a perinatal

  4. Frequency of hepatitis C in pregnancy and pregnancy outcome

    International Nuclear Information System (INIS)

    Objective: To determine the frequency of HCV infections in pregnant women, to find out the risk factors of HCV infection in pregnant women and to compare pregnancy outcome of the sero-positive women with sero-negative women. Design: Case-control study. Place and Duration of Study: Shifa International Hospital, Islamabad, from June 2001 to May 2002. Patients and Methods: Study was conducted on 947 booked pregnant women who were screened for HCV antibodies during antenatal consultation and were admitted for delivery in labor room. At the time of admission in labor ward, medical records of all patients were reviewed for anti HCV antibody testing and the presence of risk factors for HCV infection. Previous vaginal deliveries with episiotomy, previous surgeries, blood transfusions, and D and C for abortion or dysfunctional uterine bleeding were taken as independent variables. The obstetric outcome variables studied were: completed weeks of gestation by mother, birth weight and apgar score of newborns. The risk factors under study and the outcome variables were compared among HCV positive and negative women through a case-control study and measures of association calculated. Results: The proportion of HCV sero-positively among pregnant woman in our study was 3.27%. Among all the risk factors under study, previous surgery was found to have a significant association with HCV positive status of women (p=0.001). Other variables did not have significant association with HCV positive status in our study. There was no statistical difference in the mean birth weight of newborns (p=0.94), mean Apgar score of newborns (p=0.73) and mean gestational period among HCV positive cases and controls (p=0.47). Conclusion: Prevalence of hepatitis C in pregnant women was 3.27%. Past history of surgical procedures was the most important factor for transmission of hepatitis C virus infection. No adverse effect on pregnancy outcome was observed in terms of gestational age, Apgar score and baby

  5. Pregnancy and Birth Outcomes among Women with Idiopathic Thrombocytopenic Purpura

    Directory of Open Access Journals (Sweden)

    Diego F. Wyszynski

    2016-01-01

    Full Text Available Objective. To examine pregnancy and birth outcomes among women with idiopathic thrombocytopenic purpura (ITP or chronic ITP (cITP diagnosed before or during pregnancy. Methods. A linkage of mothers and babies within a large US health insurance database that combines enrollment data, pharmacy claims, and medical claims was carried out to identify pregnancies in women with ITP or cITP. Outcomes included preterm birth, elective and spontaneous loss, and major congenital anomalies. Results. Results suggest that women diagnosed with ITP or cITP prior to their estimated date of conception may be at higher risk for stillbirth, fetal loss, and premature delivery. Among 446 pregnancies in women with ITP, 346 resulted in live births. Women with cITP experienced more adverse outcomes than those with a pregnancy-related diagnosis of ITP. Although 7.8% of all live births had major congenital anomalies, the majority were isolated heart defects. Among deliveries in women with cITP, 15.2% of live births were preterm. Conclusions. The results of this study provide further evidence that cause and duration of maternal ITP are important determinants of the outcomes of pregnancy.

  6. Maternal Dietary Patterns and Pregnancy Outcome

    Directory of Open Access Journals (Sweden)

    Xuyang Chen

    2016-06-01

    Full Text Available Maternal nutritional status during pregnancy will affect the outcomes for the mother and the baby. Many analyses of the relationship between diet and outcome are often based on a single or a few food items or nutrients. However, foods are not consumed in isolation and dietary patterns can be used to assess the whole diet consumed. The use of dietary pattern analysis to understand nutritional intake and pregnancy outcome is becoming more and more popular. Many published studies have showed the association between maternal dietary patterns and pregnancy outcome. This review examined articles about the relationship between maternal dietary patterns and pregnancy outcome. As a modifiable factor, dietary patterns may be more applicable to clinical and pregnant health interventions.

  7. The Impact of Body Mass Index on Pregnancy Outcome

    Directory of Open Access Journals (Sweden)

    Hamideh Pakniat

    2015-04-01

    Full Text Available Background & aim: Pre-pregnancy obesity is considered as a significant predictor for neonatal and maternal morbidity and mortality. Several studies have indicated conflicting associations between body mass index (BMI and pregnancy outcomes. This study aimed to evaluate the effects of pre-pregnancy BMI on adverse pregnancy outcomes. Methods:Thiscohort study was conducted from 2010 to 2013 in Qazvin province, Iran. BMI was measured in a total of 1376 pregnant women before their 12th week of pregnancy. The subjects were followed-up until the termination of their pregnancy and childbirth. Data collection was performed through checklists prepared by the researchers, which consisted of three parts: demographic features, obstetric history, and subsequent pregnancy outcome. For data analysis, Chi-square, ANOVA and Mann-Whitney tests were performed, using SPSS version 16. In addition, adjusted odds ratio (OR and 95% confidence interval (CI were measured. Results: The risk of preeclampsia (OR: 5.36, CI: 2.505-11.49, gestational diabetes mellitus (OR: 5.092, CI: 1.67-15.46, cesarean section (OR: 1.959, CI: 1.37-2.79, and large for gestational age (OR: 4.735, CI: 1.402-15.98 was higher in overweight (25≤BMI≤29.9 kg/m2 and obese groups (BMI>30 kg/m2, compared to women with below-normal and average weight. Conclusion: Pre-pregnancy obesity is strongly associated with certain pregnancy complications and perinatal conditions. Therefore, these complications implicate the need for pre-pregnancy counseling and weight loss in this group of women.

  8. Adverse blood transfusion outcomes: establishing causation.

    Science.gov (United States)

    Isbister, James P; Shander, Aryeh; Spahn, Donat R; Erhard, Jochen; Farmer, Shannon L; Hofmann, Axel

    2011-04-01

    The transfusion of allogeneic red blood cells (RBCs) and other blood components is ingrained in modern medical practice. The rationale for administering transfusions is based on key assumptions that efficacy is established and risks are acceptable and minimized. Despite the cliché that, "the blood supply is safer than ever," data about risks and lack of efficacy of RBC transfusions in several clinical settings have steadily accumulated. Frequentist statisticians and clinicians demand evidence from randomized clinical trials (RCTs); however, causation for the recognized serious hazards of allogeneic transfusion has never been established in this manner. On the other hand, the preponderance of evidence implicating RBC transfusions in adverse clinical outcomes related to immunomodulation and the storage lesion comes from observational studies, and a broad and critical analysis to evaluate causation is overdue. It is suggested in several circumstances that this cannot wait for the design, execution, and conduct of rigorous RCTs. We begin by examining the nature and definition of causation with relevant examples from transfusion medicine. Deductive deterministic methods may be applied to most of the well-accepted and understood serious hazards of transfusion, with modified Koch's postulates being fulfilled in most circumstances. On the other hand, when several possible interacting risk factors exist and RBC transfusions are associated with adverse clinical outcomes, establishing causation requires inferential probabilistic methodology. In the latter circumstances, the case for RBC transfusions being causal for adverse clinical outcomes can be strengthened by applying modified Bradford Hill criteria to the plethora of existing observational studies. This being the case, a greater precautionary approach to RBC transfusion is necessary and equipoise that justifying RCTs may become problematic. PMID:21345639

  9. Fathers' occupation and pregnancy outcome

    International Nuclear Information System (INIS)

    Findings from a survey of 56,067 women in Montreal on maternal occupation and pregnancy outcome have been reported. Paternal occupation recorded in the same survey was analysed for spontaneous abortion in 24 occupational groups retaining the six main sectors of maternal occupation and allowing, by means of logistic regression, for seven potentially confounding variables. In only one of the 24 fathers' occupational groups was there a statistically significant excess of spontaneous abortions-mechanics, repairers, and certain assemblers (O/E = 1.10, 90% CI = 1.02-1.20); subdivision of this group suggested that this excess was mainly attributable to the large group of motor vehicle mechanics (O/E = 1.17). No significant excess of known chromosomally determined defects was found in any of the 24 occupational groups. An association of developmental defects was found with food and beverage processing (18 defects observed compared with 8.02 expected; p < 0.05); however, there was no specificity in type of food, beverage, or congenital defect, and no obvious explanatory mechanism. (author)

  10. Subsequent pregnancy outcome after previous foetal death

    NARCIS (Netherlands)

    Nijkamp, J. W.; Korteweg, F. J.; Holm, J. P.; Timmer, A.; Erwich, J. J. H. M.; van Pampus, M. G.

    2013-01-01

    Objective: A history of foetal death is a risk factor for complications and foetal death in subsequent pregnancies as most previous risk factors remain present and an underlying cause of death may recur. The purpose of this study was to evaluate subsequent pregnancy outcome after foetal death and to

  11. Waist circumference in the prediction of obesity-related adverse pregnancy outcomes Circunferência da cintura na predição de desfechos adversos da gestação relacionados à obesidade

    Directory of Open Access Journals (Sweden)

    Eliana M. D. R. Wendland

    2007-02-01

    Full Text Available The aim of this study is to evaluate the diagnostic properties of waist circumference in the prediction of obesity-related gestational outcomes. Pregnant women 20 years or older were consecutively enrolled in six Brazilian State capitals from 1991 to 1995. Weight, height, and waist circumference were measured and an oral glucose tolerance test was performed. Patients were followed through childbirth by chart review. Diagnostic performance for the different outcomes, as measured by area under the receiver operating characteristic (ROC curve, was estimated through logistic regression. Areas under the ROC curve (95%CI for waist circumference were 0.621(0.589-0.652 for gestational diabetes, 0.640 (0.588-0.692 for preeclampsia, and 0.645(0.617-0.673 for macrosomia. These areas were similar to those for BMI (p > 0.05. A waist circumference of 82cm jointly maximized sensitivity (63% and specificity (57%. Cutoff points of 23kg/m² for pre-pregnancy BMI and 26kg/m² for BMI at enrollment produced similar diagnostic properties. In conclusion, waist circumference predicts obesity-related adverse pregnancy outcomes at least as well as BMI.O objetivo deste estudo é avaliar as propriedades diagnósticas da circunferência da cintura na predição de desfechos adversos da gestação relacionados à obesidade. Gestantes com 20 ou mais anos de idade, foram arroladas consecutivamente, entre 20 e 28 semanas de gestação, em seis capitais do Brasil, entre 1991 e 1995. Peso, altura e circunferência da cintura foram aferidos e um teste de tolerância à glicose foi realizado. As pacientes foram acompanhadas até o parto através de revisão de prontuários. Propriedades diagnósticas para os diferentes desfechos, mensurados através da área sob a curva Receiver Operator Charactheristic (ROC, foram estimadas por regressão logística. Áreas (IC95% sob as curvas ROC para a cintura foram 0,621 (0,589-0,652 para diabetes gestacional, 0,640 (0,588-0,692 para pr

  12. 祥云县已婚育龄夫妇不良妊娠结局相关因素病例对照研究%A case -control study of related factors of adverse pregnancy outcome among the married couples at childbearing age in Xiangyun county

    Institute of Scientific and Technical Information of China (English)

    宗琳芳; 周梅; 叶汉风; 袁彦玲; 龚晓洁; 李根瑞

    2012-01-01

    目的:探讨已婚育龄夫妇不良妊娠结局发生的危险因素,为制定干预措施、实现优生优育提供依据.方法:随机选取67例不良妊娠结局已婚育龄夫妇,按照1∶1配对的原则选取67例正常妊娠结局的已婚育龄夫妇作对照,调查可能对两组已婚育龄夫妇不良妊娠结局有影响的相关因素,采用SPSS软件对所有调查因素进行单因素与多因素Logistic回归分析.结果:经Logistic回归模型进行单因素分析,有统计学意义的危险因素有已婚育龄夫妇的年龄(女:OR值=0.585,男:OR值=0.536)、受教育年限(女:OR值=2.982,男:OR值=2.811)、已婚育龄妇女是否曾经怀孕过(包括曾经非意愿流产、早产、不良妊娠结局以及正常分娩等,OR值=2.210)、丈夫的体重指数(OR值=0.370)、丈夫是否吸烟(OR值=11.400)以及丈夫现在是否戒烟(OR值=0.098).经Logistic回归模型进行多因素分析,有统计学意义的危险因素有丈夫是否吸烟(OR值=8.313)、丈夫是否戒烟(OR值=0.082).结论:已婚育龄夫妇的年龄、受教育年限、已婚育龄妇女是否曾经怀孕过(包括曾经非意愿流产、早产、不良妊娠结局以及正常分娩等)、丈夫的体重指数等均为不良妊娠结局的危险因素,并且再次证实了吸烟对不良妊娠结局的影响.劝阻丈夫吸烟、减少育龄妇女被动吸烟、控制婚育年龄、避免高龄妊娠、合理饮食以避免过重和肥胖均能够减少不良妊娠结局的发生.%Objective: To explore the risk factors of adverse pregnancy outcome among the married couples at childbearing age, provide a basis for making interventional measures and realizing prepotency. Methods: Sixty - seven married cases at childbearing age with adverse pregnancy outcome were selected randomly, then 67 married cases at childbearing age with normal pregnancy outcome were selected as control group according to 1: 1 matched principle. The related effect factors of adverse

  13. Racial Disparities in Economic and Clinical Outcomes of Pregnancy Among Medicaid Recipients

    OpenAIRE

    Zhang, Shun; Cardarelli, Kathryn; Shim, Ruth; Ye, Jiali; Booker, Karla L.; Rust, George

    2013-01-01

    To explore racial-ethnic disparities in adverse pregnancy outcomes among Medicaid recipients, and to estimate excess Medicaid costs associated with the disparities. Cross-sectional study of adverse pregnancy outcomes and Medicaid payments using data from Medicaid Analytic eXtract files on all Medicaid enrollees in fourteen southern states. Compared to other racial and ethnic groups, African American women tended to be younger, more likely to have a Cesarean section, to stay longer in the hosp...

  14. Teenage childbearing : pregnancy outcomes and long-term consequences for the mothers

    OpenAIRE

    Otterblad Olausson, Petra

    2000-01-01

    The purposes of the thesis were to study effects of low maternal age on adverse pregnancy outcomes, predictors of teenage childbearing, and long-term effects of teenage motherhood on the women's social situation later in life and risk of premature death. The effects of low maternal age at first birth on risks of adverse pregnancy outcomes, primarily preterm birth and infant mortality, were studied in three population-based cohort studies. We used the Swedish Medical Birt...

  15. Maternal obesity and its adverse impact on labor outcome

    Directory of Open Access Journals (Sweden)

    Inas Mahmoud Hamdy

    2011-10-01

    Full Text Available Objective: to study the impact of maternal obesity on the outcome of labour. Setting: Al zahraa University hospital.Design: prospective randomized control study.Patients: a total of (80 pregnant women were included in this study from April 2009 to March 2010. Patients and Methods:According to the BMI the patients were classified into two groups. Group (I: (Control Group:Included (30 patients with (body mass index (BMI ranging from 20 to 25 kg/m2.Group (II: (Obese Group: Included (50 patients with (BMI ranging from 25 to 30kg/m2. Each patient were subjected to full clinical examination (General Abdominal and pelvic U/S pelviabdominal examination that is to confirm the inclusion and exclusion criteria of the study. Results : A significant differences was noticed between 2 groups as regard the BMI. The current study showed significant difference in cases subjected to induction of labour with p-value 0.05.No significant diff. were noticed between the 2 groups as regard the cases with Apgar score < 7 at 5 minutes with p-value 0.06. A positive correlation coefficient between the BMI (25-29, (29-33 kg/m2 with the case of induction of labour, failure to progress 1st stage, shoulder dystoca, cesarean section and fetal low Apgar score. While a negative correlation was recorded between the BMI of the control group and all the adverse outcomes. Conclusion:Obesity of the gravid women is a sensitive predictor of the adverse outcome during pregnancy, labour, and post partum. Researches are needed into effective, applicable and acceptable community -based program for obese women planning a pregnancy.

  16. Neighborhood conditions are associated with maternal health behaviors and pregnancy outcomes.

    Science.gov (United States)

    Vinikoor-Imler, L C; Messer, L C; Evenson, K R; Laraia, B A

    2011-11-01

    Women residing in neighborhoods of low socioeconomic status are more likely to experience adverse reproductive outcomes; however, few studies explore which specific neighborhood features are associated with poor maternal health behaviors and pregnancy outcomes. Based upon our conceptual model, directly observed street-level data from four North Carolina US counties were used to create five neighborhood indices: physical incivilities (neighborhood degradation), social spaces (public space for socializing), walkability (walkable neighborhoods), borders (property boundaries), and arterial features (traffic safety). Singleton birth records (2001-2005) were obtained from the North Carolina State Center for Vital Statistics and maternal health behavior information (smoking, inadequate or excessive weight gain) and pregnancy outcomes (pregnancy-induced hypertension/pre-eclampsia, low birthweight, preterm birth) were abstracted. Race-stratified random effect models were used to estimate associations between neighborhood indices and women's reproductive behaviors and outcomes. In adjusted models, higher amounts of physical incivilities were positively associated with maternal smoking and inadequate weight gain, while walkability was associated with lower odds of these maternal health behaviors. Social spaces were also associated with inadequate weight gain during pregnancy. Among pregnancy outcomes, high levels of physical incivilities were consistently associated with all adverse pregnancy outcomes, and high levels of walkability were inversely associated with pregnancy-induced hypertension and preterm birth for Non-Hispanic white women only. None of the indices were associated with adverse birth outcomes for Non-Hispanic black women. In conclusion, certain neighborhood conditions were associated with maternal health behaviors and pregnancy outcomes. PMID:21920650

  17. Pregnancy Outcomes in Pregnant Women with Subchorionic Hematoma

    Directory of Open Access Journals (Sweden)

    Victoria V. Barinova

    2015-09-01

    Full Text Available Background: The role of subchorionic hematoma (SCH in the first trimester of pregnancy remains open for discussion. Some authors claim that SCH does not affect the pregnancy; others have found that it is a serious risk factor for adverse pregnancy outcome. The objective of the present study was to explore the outcomes of pregnancy in patients with SCH diagnosed in the first trimester. Methods and Results: The study involved 194 pregnant women who were in terms of 6 to12 weeks: 115 women with SCH (Group 1 and 79 apparently healthy pregnant women (Group 2. A missed miscarriage was observed in 27/23% women of Group 1 and in 4/5% of Group 2 (P<0.05, recurrent threat of miscarriage in 27/23% and in 4/5%, recurrent bleeding in 14/12% and 2/3%, and the short cervix syndrome in 22/19% and 5/6% women, respectively. Conclusion: The results of our study show that the presence of SCH adversely affects the first half of pregnancy, leading to recurrent threatened abortion, recurrent threat of miscarriage, missed miscarriage until 12 weeks of gestation, and the short cervix syndrome.

  18. Pregnancy Outcome in Systemic Lupus Erythematosus (SLE) is Improving: Results from a Case Control Study and Literature Review

    OpenAIRE

    Yan Yuen, Sai; Krizova, Adriana; Ouimet, Janine M; Pope, Janet E

    2008-01-01

    Objectives For women who suffer from systemic lupus erythematosus (SLE), pregnancy can be a concern, placing the mother and fetus at risk. Our objectives were to assess the risk of adverse pregnancy outcome, disease flares, fertility rate, and co-morbidities in SLE women compared to healthy controls. We also systematically reviewed the literature available on pregnancy outcome in SLE to compare our results to other published data. Our hypothesis was that pregnancy outcome in SLE is improving ...

  19. Racial disparities in economic and clinical outcomes of pregnancy among Medicaid recipients.

    Science.gov (United States)

    Zhang, Shun; Cardarelli, Kathryn; Shim, Ruth; Ye, Jiali; Booker, Karla L; Rust, George

    2013-10-01

    To explore racial-ethnic disparities in adverse pregnancy outcomes among Medicaid recipients, and to estimate excess Medicaid costs associated with the disparities. Cross-sectional study of adverse pregnancy outcomes and Medicaid payments using data from Medicaid Analytic eXtract files on all Medicaid enrollees in fourteen southern states. Compared to other racial and ethnic groups, African American women tended to be younger, more likely to have a Cesarean section, to stay longer in the hospital and to incur higher Medicaid costs. African-American women were also more likely to experience preeclampsia, placental abruption, preterm birth, small birth size for gestational age, and fetal death/stillbirth. Eliminating racial disparities in adverse pregnancy outcomes (not counting infant costs), could generate Medicaid cost savings of $114 to $214 million per year in these 14 states. Despite having the same insurance coverage and meeting the same poverty guidelines for Medicaid eligibility, African American women have a higher rate of adverse pregnancy outcomes than White or Hispanic women. Racial disparities in adverse pregnancy outcomes not only represent potentially preventable human suffering, but also avoidable economic costs. There is a significant financial return-on-investment opportunity tied to eliminating racial disparities in birth outcomes. With the Affordable Care Act expansion of Medicaid coverage for the year 2014, Medicaid could be powerful public health tool for improving pregnancy outcomes. PMID:23065298

  20. Association between gestational diabetes mellitus and adverse pregnancy outcomes%妊娠期糖尿病血糖水平与不良妊娠结局的关系

    Institute of Scientific and Technical Information of China (English)

    张克群

    2011-01-01

    Objective To explore the significance of controlling blood sugar level on reducing the perinatal complications of gestational diabetes mellitus( GDM ) and adverse pregnancy outcomes. Methods Group A was 80 pregnant women with GDM, whose blood sugar was well controlled ( fasting blood glucose < 5.8mmol/L and/or 2h postprandial blood glucose < 6.7mmol/L ). Group B included 39 GDM pregnant women whose blood sugar was not well controlled ( fasting blood glucose ≥5.8mmol/L and/or 2h postprandial blood glucose ≥6.7mmol/L ). Group C was 80 normal pregnant women. Maternal and perinatal complications were compared among the above three groups. Results In group A the prevalence of hypertensive disorders in pregnancy ( HDIP ), preterm birth, cesarean section delivered,postpartum hemorrhage, macrosomia, fetal distress was significantly lower than that in group B(X2 was 6.75, 8.48, 7.85, 5.04, 10.22 and 11.12 respectively, all P < 0.05 ). Compared with group C, the prevalence rate of polyhydramnios in group A was higher(x2= 4.24,P < 0.05 ). Compared with that in group C, the prevalence rate of HDIP, polyhydramnios, preterm birth, cesarean section, postpartum hemorrhage, macrosomia, fetal growth restriction, fetal distress in group B was notably higher(x2 was in the range of 7.08 ~ 17.52, all P < 0.05 ). Conclusion Strengthening the management of GDM and controlling blood sugar of pregnant women with GDM can effectively reduce the complications and adverse pregnancy outcomes.%目的 探讨有效控制血糖水平对减少妊娠期糖尿病母儿并发症及不良妊娠结局的重要意义.方法 对血糖得到有效控制(空腹血糖<5.8mmol/L和/或餐后2小时血糖<6.7mmol/L)的妊娠期糖尿病孕妇80例(A组)与血糖控制不满意(空腹血糖≥5.8mmol/L和/或餐后2小时血糖≥6.7mmol/L)的妊娠期糖尿病孕妇39例(B组)和正常孕妇80例(C组)的孕、产及产褥期相关并发症及胎儿、新生儿并

  1. Pregnancy Outcomes and Surgical Management of Pregnancy Complicated By Appendicitis: Obstetrician View

    Directory of Open Access Journals (Sweden)

    Deniz Şimşek

    2015-08-01

    Full Text Available Objective: To evaluate the pregnancy outcomes of patients who underwent appendectomy during pregnancy. Materials and Methods: Patients who underwent appendectomy between years 2010 and 2014 were retrospectively evaluated. All patients’ pregnancy outcomes were followed-up by using university registry system and telephone interview. Patients were evaluated regarding age, gestational age, clinical and laboratory examinations, imaging studies, mean time interval between emergency department and operation, mean operative time, pregnancy outcome and pathologic results of the appendix. Results: Thirty-nine patients were included in the study. Sixteen of 39 patients were in the first, 15 of them in the second and 8 of them were in the third trimester of the pregnancy. Three patients underwent laparoscopic appendectomy and the rest underwent laparotomy. In pathologic evaluation of the appendix, seven patients (17% had normal appendix, 4 patients had perforated appendix, one patient had neuro-endocrine tumor and rest of the patients had appendicitis. Two missed abortion occurred after operation, rest of the patients had live birth. Six of them were preterm and 31 had term birth. Twelve patients delivered through vaginal birth and the rest via caesarean section. Twenty patients were in the first half of the pregnancy (group 1 and 19 patients were in the second half of the pregnancy (group 2. There were no significant differences between the groups in operation time and mean time interval between emergency administration and operation. Conclusion: Delayed operation and negative appendectomy can cause adverse pregnancy outcomes. Expectant management in suspected cases may decrease negative appendectomy rates but can also lead to perforation. Computed tomography and MRI ought to be considered if ultrasonography is inconclusive. Tocolytic regimens can be administered to prevent threatened preterm labor. Obstetric indications were valid for delivery mode.

  2. Pregnancy outcomes following the use of thiocolchicoside.

    Science.gov (United States)

    Ozturk, Zeynep; Olmez, Ercument; Gurpinar, Tugba; Vural, Kamil

    2016-04-01

    Thiocolchicoside is a commonly used muscle relaxant in orthopedic, rheumatologic or musculoskeletal disorders to treat painful muscle spasms. It is contraindicated in pregnancy and lactation. There is no previously published experience with thiocolchicoside exposure during pregnancy. In this observational study, we collected and evaluated 18 pregnancy outcomes of the women referred to our prenatal consultation service for thiocolchicoside exposure between 2007-2012, and offspring were followed up until 2 years of age. There were 16 live births, 1 spontaneous abortion and 1 elective termination of pregnancy. No major birth defect was observed. The mothers and their babies were free of perinatal complications. No growth or developmental abnormalities were found during follow-up period. Our findings add information on inadvertent use of thiocolchicoside in pregnancy. Further large prospective cohort studies are required to investigate this issue. PMID:26876142

  3. Caffeine Use Affects Pregnancy Outcome

    Science.gov (United States)

    Diego, Miguel; Field, Tiffany; Hernandez-Reif, Maria; Vera, Yanexy; Gil, Karla; Gonzalez-Garcia, Adolfo

    2008-01-01

    A sample of 750 women were interviewed during pregnancy on their depression and anxiety symptoms, substance use and demographic variables. A subsample was seen again at the neonatal stage (n = 152), and their infants were observed for sleep-wake behavior. Symptoms of depression and anxiety were related to caffeine use. Mothers who consumed more…

  4. Pregnancy and neonatal outcomes in Indigenous Australians with diabetes in pregnancy

    Science.gov (United States)

    Duong, Victor; Davis, Bronwyn; Falhammar, Henrik

    2015-01-01

    AIM: To perform a systematic review of reported neonatal and pregnancy outcomes of Indigenous Australians with diabetes in pregnancy (DIP). METHODS: Electronic searches of PubMed and Web of Science were carried out. Articles were selected if they contained original data on DIP outcomes in Indigenous Australians. There were no specific exclusion criteria. RESULTS: A total of eight articles, predominantly from Queensland and Western Australia were identified once inclusion criteria were applied. Birth data from midwifery registries or paper charts encompassing years 1985-2008 were used. A total of 465591 pregnant women with and without DIP were included in the eight studies, with 1363 being Indigenous women with DIP. Indigenous Australians experienced increased rates of many known adverse outcomes of DIP including: macrosomia, caesarean section, congenital deformities, low birth weight, hypoglycaemia, and neonatal trauma. There were regional differences among Indigenous Australians, particularly regional/remote vs metropolitan populations where the regional/remote data showed worse outcomes. Two of the articles did not note a difference between Aboriginals and Caucasians in the rates of measured adverse outcome. Studies varied significantly in size, measured outcomes, and subsequent analysis. CONCLUSION: The health disparities between Indigenous Australians and non-Indigenous Australians are further evidenced by poorer outcomes in DIP. This has broader implications for Indigenous health in general. PMID:26131329

  5. Pregnancy Outcomes After a Maternity Intervention for Stressful Emotions (PROMISES) : A Randomised Controlled Trial

    NARCIS (Netherlands)

    Burger, Huibert; Bockting, Claudi L H; Beijers, Chantal; Verbeek, Tjitte; Stant, A Dennis; Ormel, Johan; Stolk, Ronald P; de Jonge, Peter; van Pampus, Mariëlle G; Meijer, Judith

    2015-01-01

    There is ample evidence from observational prospective studies that maternal depression or anxiety during pregnancy is a risk factor for adverse psychosocial outcomes in the offspring. However, to date no previous study has demonstrated that treatment of depressive or anxious symptoms in pregnancy a

  6. EVALUATION OF PREGNANCY OUTCOME IN HEART DISEASE COMPLICATING PREGNANCY

    Directory of Open Access Journals (Sweden)

    Mahalakshmi

    2016-05-01

    Full Text Available OBJECTIVES To evaluate the maternal and foetal outcome in pregnancies complicated by heart disease. METHODS A retrospective evaluation of 62 pregnant cardiac patients, who were managed in a tertiary care centre over a period of one year (January 2015 to December 2015, regarding the incidence, aetiology of cardiac disease, obstetric and cardiac complications, maternal and foetal outcome. RESULTS The incidence of heart disease in pregnancy in the present study is 0.9%. Rheumatic heart disease (Mitral stenosis is still the predominant cause (44 cases, 71% of heart disease in pregnancy followed by congenital heart disease (11 cases, 17.7%. In miscellaneous group, peripartum cardiomyopathy (9 cases, 14.5% is the leading cause. Maternal and foetal outcome was poor in NYHA functional class III and IV. Most of the women delivered vaginally (33 cases, 51.6%, spontaneous in onset and at term gestation. However, 12 cases (37.5% delivered prematurely; 30.7% of cases had cardiac complications during the present study. Maternal mortality was high (11.3%. There were 7 cases of maternal death. All of these patients were in NYHA class III and IV, unbooked, presenting for the first time and with the complications. CONCLUSION The study concludes pregnancy in women with heart disease not only poses a risk of maternal mortality and also morbidity due to heart failure, stroke and cardiac arrhythmias and foetus is also affected with prematurity, Intrauterine Growth Restriction (IUGR and risk of perinatal mortality.

  7. Population Attributable Risk Fractions of Maternal Overweight and Obesity for Adverse Perinatal Outcomes.

    Science.gov (United States)

    MacInnis, Natasha; Woolcott, Christy G; McDonald, Sarah; Kuhle, Stefan

    2016-01-01

    The objective of the current study was to determine the proportion of adverse perinatal outcomes that could be potentially prevented if maternal obesity were to be reduced or eliminated (population attributable risk fractions, PARF); and the number needed to treat (NNT) of overweight or obese women to prevent one case of adverse perinatal outcome. Data from the Atlee Perinatal Database on 66,689 singleton infants born in Nova Scotia, Canada, between 2004 and 2014, and their mothers were used. Multivariable-adjusted PARFs and NNTs of maternal pre-pregnancy weight status were determined for various perinatal outcomes under three scenarios: If all overweight and obese women were to i) become normal weight before pregnancy; ii) shift down one weight class; or iii) lose 10% of their body weight, significant relative reductions would be seen for gestational diabetes mellitus (GDM, 57/33/15%), hypertensive disorders of pregnancy (HDP, 26/16/6%), caesarean section (CS, 18/10/3%), and large for gestational age births (LGA, 24/14/3%). The NNT were lowest for the outcomes GDM, induction of labour, CS, and LGA, where they ranged from 13 to 73. The study suggests that a substantial proportion of adverse perinatal outcomes may be preventable through reductions in maternal pre-pregnancy weight. PMID:26961675

  8. Assessing risk factors for adverse birth outcomes and early childhood respiratory illness: an examination of supplement initiation and participation in Special Supplemental Nutrition Program for Women, Infants and Children during pregnancy

    OpenAIRE

    Alfonso, Vivian

    2015-01-01

    In the United States, rate of preterm birth peaked in 2006 and little progress has been made to date despite ambitious Healthy People 2020 goals. Infants born premature are at higher risk of death and disability, including psychological conditions, learning difficulties and medical disabilities, than term newborns. Additionally, adverse birth outcomes are associated with asthma, the leading cause of chronic childhood illness and disability. According to the ‘Barker hypothesis’, intrauterin...

  9. Pregnancy outcome in Norway after Chernobyl

    International Nuclear Information System (INIS)

    Pregnancy outcome has been studied in terms of legal abortions, early spontaneous abortions and total number of pregnancies (in an ad hoc study covering 6 counties) as well as various perinatal health problems (on the basis of routinely recorded data for epidemiological surveillance from the Medical Birth Registry of Norway). Apparently, no effects were observed in terms of an increased occurrence of legal abortions, while spontaneous abortions increased from 2.4% of all pregnancies during the last 12 months before the accident to 3% after the accident. At the same time, the total number of pregnancies somewhat decreased. Based on monthly measurements in each municipality of external and internal (food-based) doses, dose-response associations were assessed for a number of perinatal health problems. No associations were observed

  10. Risk for Gestational Diabetes Mellitus and Adverse Birth Outcomes in Chinese Women with Polycystic Ovary Syndrome

    OpenAIRE

    Qing Xiao; Yong-Yi Cui; Jine Lu; Guo-Zheng Zhang; Fang-Ling Zeng

    2016-01-01

    Objective. To examine the association of polycystic ovary syndrome (PCOS) in early pregnancy with gestational diabetes mellitus (GDM) and adverse birth outcomes. Methods. In this retrospective cohort study including 2389 pregnant women, the medical records of 352 women diagnosed with PCOS were evaluated. Outcomes included GDM, preterm birth, low birth weight, macrosomia, and being small and large for gestational age. Multivariable logistic regression models were used to examine the associatio...

  11. Fetomaternal Outcome with Hepatitis E in Pregnancy

    International Nuclear Information System (INIS)

    Objective: To assess the maternal morbidity and mortality and fetal outcome with hepatitis E (HEV) in pregnancy. Study Design: Cross-sectional study. Place and Duration of Study: Liaquat National Hospital, Karachi, from May 2008 to April 2010. Methodology: Thirty patients admitted at Gynae Ward with serologically proven HEV in pregnancy were included in the study. All these patients were followed during their hospital stay with liver function tests and coagulation profile. Maternal morbidity and mortality and fetal outcome were recorded. Results: Maximum maternal morbidities were noted in patients who presented in 3rd trimester, both clinically and derangement of haematological and biochemical tests. Out of 30 patients, 08 patients expired with maternal mortality rate of 29.3% and rest were discharged safely. Perinatal mortality rate was 30.3 per 1000 live births. Conclusion: Hepatitis E runs a fulminant course during pregnancy with very high mortality rate especially during third trimester and postpartum period. (author)

  12. The Maternal Microbiome and Pregnancy Outcomes that Impact Infant Health: A Review

    OpenAIRE

    Dunlop, Anne L.; Mulle, Jennifer G.; Ferranti, Erin P.; Edwards, Sara; Dunn, Alexis B.; Corwin, Elizabeth J

    2015-01-01

    The maternal microbiome is recognized as a key determinant of a range of important maternal and child health outcomes, and together with perinatal factors influences the infant microbiome. This manuscript provides a summary review of research investigating: (1) the role of the maternal microbiome in pregnancy outcomes known to adversely influence neonatal and infant health, including preterm birth, cardiometabolic complications of pregnancy such as preeclampsia and gestational diabetes, and e...

  13. Hemoglobin Concentration and Pregnancy Outcomes: A Systematic Review and Meta-Analysis

    OpenAIRE

    Mark McEvoy; Chusak Okascharoen; Ammarin Thakkinstian; John Attia; Boonying Siribumrungwong; Bunyarit Sukrat; Chumpon Wilasrusmee

    2013-01-01

    Objective. To conduct a systematic review and meta-analysis of hemoglobin effect on the pregnancy outcomes. Methods. We searched MEDLINE and SCOPUS from January 1, 1990 to April 10, 2011. Observational studies addressing association between hemoglobin and adverse pregnancy outcomes were selected. Two reviewers independently extracted data. A mixed logistic regression was applied to assess the effects of hemoglobin on preterm birth, low birth weight, and small for gestational age. Results. Sev...

  14. Excessive folic acid intake and relation to adverse health outcome.

    Science.gov (United States)

    Selhub, Jacob; Rosenberg, Irwin H

    2016-07-01

    The recent increase in the intake of folic acid by the general public through fortified foods and supplements, has raised safety concern based on early reports of adverse health outcome in elderly with low B12 status who took high doses of folic acid. These safety concerns are contrary to the 2015 WHO statement that "high folic acid intake has not reliably been shown to be associated with negative healeffects". In the folic acid post-fortification era, we have shown that in elderly participants in NHANES 1999-2002, high plasma folate level is associated with exacerbation of both clinical (anemia and cognitive impairment) and biochemical (high MMA and high Hcy plasma levels) signs of vitamin B12 deficiency. Adverse clinical outcomes in association with high folate intake were also seen among elderly with low plasma B12 levels from the Framingham Original Cohort and in a study from Australia which combined three elderly cohorts. Relation between high folate and adverse biochemical outcomes were also seen in the Sacramento Area Latino Study on Aging (High Hcy, high MMA and lower TC2) and at an outpatient clinic at Yale University where high folate is associated with higher MMA in the elderly but not in the young. Potential detrimental effects of high folic acid intake may not be limited to the elderly nor to those with B12 deficiency. A study from India linked maternal high RBC folate to increased insulin resistance in offspring. Our study suggested that excessive folic acid intake is associated with lower natural killer cells activity in elderly women. In a recent study we found that the risk for unilateral retinoblastoma in offspring is 4 fold higher in women that are homozygotes for the 19 bp deletion in the DHFR gene and took folic acid supplement during pregnancy. In the elderly this polymorphism is associated with lower memory and executive scores, both being significantly worse in those with high plasma folate. These and other data strongly imply that

  15. A randomized controlled trial of pre-conception treatment for periodontal disease to improve periodontal status during pregnancy and birth outcomes

    OpenAIRE

    Jiang, Hong; Xiong, Xu; Su, Yi; Zhang, Yiming; Wu, Hongqiao; Jiang, Zhijun; Qian, Xu

    2013-01-01

    Background Evidence has suggested that periodontal disease is associated with an increased risk of various adverse pregnancy and birth outcomes. However, several large clinical randomized controlled trials failed to demonstrate periodontal therapy during pregnancy reduced the incidence of adverse pregnancy and birth outcomes. It has been suggested that the pre-conception period may be an optimal period for periodontal disease treatment rather than during pregnancy. To date, no randomized cont...

  16. Adverse reproductive outcomes among female veterinarians

    International Nuclear Information System (INIS)

    Because female veterinarians are exposed to several known reproductive hazards, the authors conducted a reproductive survey of all female graduates of a US veterinary school (n = 537) and law school (comparison group, n = 794). Analysis was confined to pregnancies completed after the second year of professional school and from 1966 to 1986. Based on one randomly chosen eligible pregnancy per woman (veterinarians, n = 176; lawyers, n = 229), spontaneous abortion rates, adjusted for elective abortions, were 13.3% for the veterinarians and 15.1% for the lawyers; these did not differ significantly. A Cox life table regression model controlling for age, smoking, alcohol use, and prior spontaneous abortion also showed no significant difference in spontaneous abortion rates between the two populations. Using all pregnancies, veterinarians who reported performing five or more radiographic examinations per week had a marginally elevated risk of spontaneous abortion, but the statistical significance disappeared when analysis was limited to one random pregnancy per woman. For one random eligible birth per woman, the mean birth weight did not differ significantly between the veterinarians and lawyers, even after controlling for possible confounders in regression analyses. A higher rate of reportable birth defects was observed among the veterinarians than among the lawyers (relative risk = 4.2, 95% confidence interval 1.2-15.1), but this unexpected result must be considered hypothesis-generating. The authors did not find an overall increased risk for spontaneous abortion or low birth weight infants among veterinarians compared with lawyers, but veterinarians who reported performing five or more radiographic examinations per week may have been at increased risk for spontaneous abortion

  17. Explaining racial disparities in adverse birth outcomes: unique sources of stress for Black American women.

    Science.gov (United States)

    Rosenthal, Lisa; Lobel, Marci

    2011-03-01

    The infant mortality rate for Black Americans in the US is more than twice the rate for White Americans, with similar racial disparities existing in rates of low birthweight and preterm delivery. Survivors of these adverse birth outcomes have poorer development and health in infancy, childhood, and adulthood. Increasingly, evidence suggests that maternal stress is an important risk factor for adverse birth outcomes. We offer a novel perspective on racial disparities in birth outcomes suggesting that Black American women are subject to unique sources of stress throughout their lives and particularly during pregnancy based on their multiple identities as women, Black, and pregnant. We draw on interdisciplinary work to examine three unique sources of stress for Black American women that elevate their risk for adverse birth outcomes: 1) abuses of Black American women by the medical system and issues of power in obstetrics that disadvantage Black American women; 2) contradictory societal pressures exerted on Black American women about whether they should have children; and 3) historical and contemporary stereotypes about Black American women related to sexuality and motherhood. We discuss implications of this analysis, including applications to research and intervention. Developing a better understanding of the experience of Black American women during pregnancy and throughout their lives offers insight into ways to reduce racial disparities in adverse birth outcomes and their lifelong consequences. PMID:21345565

  18. Occupational exposure to pesticides and pregnancy outcomes in gardeners and farmers

    DEFF Research Database (Denmark)

    Zhu, Jin Liang; Hjollund, Niels H; Andersen, Anne-Marie Nybo;

    2006-01-01

    OBJECTIVE: We conducted a follow-up study to examine whether exposure to pesticides during pregnancy had an adverse effect on pregnancy outcomes among Danish gardeners and farmers. METHODS: Using data from the National Birth Cohort in Denmark, we identified 226 pregnancies of gardeners and 214...... regression was applied to analyze late fetal loss and congenital malformations, and logistic regression was used to analyze preterm birth and small for gestational age. RESULTS: There were no significant differences in the studied pregnancy outcomes between gardeners or farmers and all other workers, except...... for an increased risk of very preterm birth for gardeners and a favorable birth weight for farmers. With the exception of biologic approach used in gardening, neither work activities nor exposure to pesticides showed a significant increased risk of adverse birth outcomes among gardeners or farmers. CONCLUSIONS...

  19. Pregnancy outcome in women with polycystic ovary syndrome

    OpenAIRE

    Nivedhitha V. S.; Sankareswari R.

    2015-01-01

    Background: To compare the pregnancy outcome in polycystic ovary syndrome (PCOS) women with normal women and to study the incidence of pregnancy complications like spontaneous abortions, preterm labour, gestational diabetes, gestational hypertension, preeclampsia, pregnancy and neonatal outcome in women with PCOS. Methods: Prospective comparative study done on 160 pregnant women to compare the pregnancy outcome in PCOS and normal women. All patients were subjected to detailed history, gen...

  20. Development of a Screening Tool for Predicting Adverse Outcomes of Gestational Diabetes Mellitus

    Science.gov (United States)

    Park, Jee Soo; Kim, Deok Won; Kwon, Ja-Young; Park, Yong Won; Kim, Young Han; Cho, Hee Young

    2016-01-01

    Abstract Gestational diabetes mellitus (GDM) is a common disease in pregnancy causing maternal and fetal complications. To prevent these adverse outcomes, optimal screening and diagnostic criteria must be adequate, timely, and efficient. This study suggests a novel approach that is practical, efficient, and patient- and clinician-friendly in predicting adverse outcomes of GDM. The authors conducted a retrospective cohort study via medical record review of patients admitted between March 2001 and April 2013 at the Severance Hospital, Seoul, South Korea. Patients diagnosed by a conventional 2-step method were evaluated according to the presence of adverse outcomes (neonatal hypoglycemia, hyperbilirubinemia, and hyperinsulinemia; admission to the neonatal intensive care unit; large for gestational age; gestational insulin therapy; and gestational hypertension). Of 802 women who had an abnormal 50-g, 1-hour glucose challenge test, 306 were diagnosed with GDM and 496 did not have GDM (false-positive group). In the GDM group, 218 women (71.2%) had adverse outcomes. In contrast, 240 women (48.4%) in the false-positive group had adverse outcomes. Women with adverse outcomes had a significantly higher body mass index (BMI) at entry (P = 0.03) and fasting blood glucose (FBG) (P = 0.03). Our logistic regression model derived from 2 variables, BMI at entry and FBG, predicted GDM adverse outcome with an area under the curve of 0.642, accuracy of 61.3%, sensitivity of 57.2%, and specificity of 66.9% compared with the conventional 2-step method with an area under the curve of 0.610, accuracy of 59.1%, sensitivity of 47.6%, and specificity of 74.4%. Our model performed better in predicting GDM adverse outcomes than the conventional 2-step method using only BMI at entry and FBG. Moreover, our model represents a practical, inexpensive, efficient, reproducible, easy, and patient- and clinician-friendly approach. PMID:26735528

  1. Pregnancy outcome in patients with fibroid

    Directory of Open Access Journals (Sweden)

    Antima Kirtikumar Maliwad

    2014-06-01

    Full Text Available Background: Fibroids are benign smooth muscle cell tumour of the uterus. In some patients of pregnancy associated with fibroid, it does not affect the outcome of pregnancy. On the other hand, various complications have been reported. Objective of current study was to assess the prevalence and obstetric complications of fibroid during pregnancy and it management. Methods: This was a prospective study. The study was conducted at tertiary care centre, obstertrics and gynecology department over a period of nine months September 2013 to May 2014. Total 17 pregnant patients with >3 cm fibroid were included in the study. They were followed during antenatal period. Maternal age, parity, size of fibroid, complications during pregnancy, labour, and delivery, mode of delivery and indications of cesarean section were noted. Results: Incidence of fibroid during pregnancy was 0.4%. Out of 17 patients, majority 9 (52.9% were between 26-30 years of age group, majority 7 (41.1% were diagnosed between 21-28 weeks and 14 (82.3% were multigravidas. Normal vaginal delivery occurred in 3 (20%, while 12 (80% delivered by cesarean section. There were 8 (47% patients who had no complication whereas 9 (52.9% had some complication. Pain was present in 7 (41.1%. PROM and preterm labour was present in 3 (17.6% and 2 (11.7% respectively. Abortion and IUD occurred in 2 (11.7% and in 1 (5.8% respectively. LBW and IUGR was present in 5 (29.4% and 3 (17.6% respectively. PPH was present in 6 (35.2%. Antenatal myomectomy performed in 1 (5.8% and myomectomy at cesarean section performed in 2 (11.7%. Blood transfusion was given to 8 (47% patients. Conclusions: Pregnant patients who have fibroids are to be carefully screened in the antenatal period, so as to have a regular follow up. The wide spread use of ultrasonography has facilitated diagnosis and management of fibroids in pregnancy. The site and size of fibroid is very important to predict its effect on the pregnancy. In

  2. Perinatal Outcomes in Advanced Age Pregnancies

    Directory of Open Access Journals (Sweden)

    Ertuğrul Yılmaz

    2016-06-01

    Full Text Available Objective: The aim of this study is to evaluate the impact of advanced maternal age on pregnancy outcomes Methods: A retrospective analysis of 951 birth registry records of Zeynep Kamil Hospital, were analyzed between Janu­ary 2003 and December 2007. Study group was made up of women ≥40 years old and control group was made up of women younger than 40 years. Results: Mean maternal age was 41.48 years in the study group and 26.41 years in the control group. Mean gesta­tional age at the time of delivery is 37.73 weeks in study group and 38.10 weeks in the control group. There was no statistical difference in terms of preterm delivery, multiple pregnancy, fetal anomaly, IUGR, superimpose preeclampsia oligohidramnios, presentation anomaly and placenta previa rates between the study and control groups. Incidence of preeclampsia (p=0.041, Chronic hypertension (p=0.001, GDM (p= 0.003,is found to be higher in study group. Cesar­ean birth rate is higher (p<0.05 and hospitalization time is longer in study group (p=0.001. 1st minute and 5th minute APGAR scores of the study group (6.99±2, 8.27±2 was lower than the 1st minute and 5th Minutes APGAR scores of the control group (7.38±1.6, 8.58±1.7. Neonatal intensive care unit administration rate is seen also higher in study group (p<0.01. Conclusion: Advanced maternal age was related to increased pregnancy complications and poor perinatal outcome. Preeclampsia, GDM, chronic hypertension is seen more common in advanced age pregnancies. Neonatal intensive care administration is higher and APGAR scores are lower; cesarean delivery was performed more common, and hospitaliza­tion time was longer in advanced age pregnancies. J Clin Exp Invest 2016; 7 (2: 157-162

  3. Associations between maternal lipid profile and pregnancy complications and perinatal outcomes: a population-based study from China

    OpenAIRE

    Jin, Wen-Yuan; Lin, Sheng-Liang; Hou, Ruo-Lin; Chen, Xiao-Yang; Han, Ting; Jin, Yan; Tang, Li; Zhu, Zhi-wei; Zhao, Zheng-yan

    2016-01-01

    Background Dyslipidemia in pregnancy are associated with gestational diabetes mellitus (GDM), preeclampsia, preterm birth and other adverse outcomes, which has been extensively studied in western countries. However, similar studies have rarely been conducted in Asian countries. Our study was aimed at investigating the associations between maternal dyslipidemia and adverse pregnancy outcomes among Chinese population. Methods Data were derived from 934 pairs of non-diabetic mothers and neonates...

  4. Ambient air pollution and adverse birth outcomes: a natural experiment study

    OpenAIRE

    Huang, Cheng; Nichols, Catherine; Liu, Yang; Zhang, Yunping; Liu, Xiaohong; Gao, Suhong; Li, Zhiwen; Ren, Aiguo

    2015-01-01

    Background Radical regulations to improve air quality, including traffic control, were implemented prior to and during the 2008 Beijing Olympic Games. Consequently, ambient concentrations of nitrogen dioxide (NO2) and particular matter 10 micrometers or less (PM10), were reduced in a distinct and short window of time, which presented a natural experiment for testing the relationships between maternal exposure to PM10 and NO2 during pregnancy and adverse birth outcomes. Methods We estimated th...

  5. A Systematic Review and Meta-Analysis of Pregnancy Outcomes in Patients with Systemic Lupus Erythematosus and Lupus Nephritis

    OpenAIRE

    Smyth, Andrew; Oliveira, Guilherme H.M.; Lahr, Brian D.; Bailey, Kent R; Norby, Suzanne M.; Garovic, Vesna D.

    2010-01-01

    Background and objectives: Studies of the impact of systemic lupus erythematosus (SLE) and its pregnancy complications have yielded conflicting results. Major limitations of these studies relate to their small numbers of patients and retrospective designs. The aim of this study was to perform a systematic literature review of pregnancy outcomes in women with SLE and a meta-analysis of the association of lupus nephritis with adverse pregnancy outcomes.

  6. The effects of maternal body mass index on pregnancy outcome.

    LENUS (Irish Health Repository)

    Khashan, A S

    2012-01-31

    The increasing prevalence of obesity is presenting a critical challenge to healthcare services. We examined the effect of Body Mass Index in early pregnancy on adverse pregnancy outcome. We performed a population register-based cohort study using data from the North Western Perinatal survey (N = 99,403 babies born during 2004-2006), based at The University of Manchester, UK. The main outcome measures were Caesarean section delivery, preterm birth, neonatal death, stillbirth, Macrosomia, small for gestational age and large for gestational age. The risk of preterm birth was reduced by almost 10% in overweight (RR = 0.89, [95% CI: 0.83, 0.95]) and obese women (RR = 0.90, [95% CI: 0.84, 0.97]) and was increased in underweight women (RR = 1.33, [95% CI: 1.16, 1.53]). Overweight (RR = 1.17, [95% CI: 1.09, 1.25]), obese (RR = 1.35, [95% CI: 1.25, 1.45]) and morbidly obese (RR = 1.24, [95% CI: 1.02, 1.52]) women had an elevated risk of post-term birth compared to normal women. The risk of fetal macrosomia and operative delivery increased with BMI such that morbidly obese women were at greatest risk of both (RR of macrosomia = 4.78 [95% CI: 3.86, 5.92] and RR of Caesarean section = 1.66 [95% CI: 1.61, 1.71] and a RR of emergency Caesarean section = 1.59 [95% CI: 1.45, 1.75]). Excessive leanness and obesity are associated with different adverse pregnancy outcomes with major maternal and fetal complications. Overweight and obese women have a higher risk of macrosomia and Caesarean delivery and lower risk of preterm delivery. The mechanism underlying this association is unclear and is worthy of further investigation.

  7. Outcomes in type 1 diabetic pregnancies

    DEFF Research Database (Denmark)

    Jensen, Dorte Møller; Damm, Peter; Moelsted-Pedersen, Lars; Ovesen, Per; Westergaard, Jes Grabow; Møller, Margrethe; Beck-Nielsen, Henning

    2004-01-01

    OBJECTIVE: The aim of this study was to compare pregnancy outcomes in type 1 diabetic pregnancies with the background population. RESEARCH DESIGN AND METHODS: This nationwide prospective multicenter study took place in eight Danish centers treating pregnant women with type 1 diabetes during 1993......-1999. A total of 990 women with 1,218 pregnancies and delivery after 24 weeks (n=1,215) or early termination due to severe congenital malformations (n=3) were included. Data were collected prospectively by one to three caregivers in each center and reported to a central registry. RESULTS: The perinatal...... mortality rate was 3.1% in type 1 diabetic pregnancies compared with 0.75% in the background population (RR 4.1 [95% CI 2.9-5.6]), and the stillbirth rate was 2.1% compared with 0.45 (4.7 [3.2-7.0]). The congenital malformation rate was 5.0% in the study population and 2.8% (1.7 [1.3-2.2]) in the background...

  8. Pivmecillinam and adverse birth and neonatal outcomes: a population-based cohort study.

    Science.gov (United States)

    Vinther Skriver, Mette; Nørgaard, Mette; Pedersen, Lars; Carl Schønheyder, Henrik; Sørensen, Henrik Toft

    2004-01-01

    A previous study unexpectedly showed an increased, statistically imprecise, risk of low Apgar score in children of women redeeming prescriptions for pivmecillinam in late pregnancy. To improve statistical precision we extended the previous dataset with data for 5 more y, and in addition added more neonatal outcomes. We thus examined the risk of adverse birth and neonatal outcomes among pregnant users of pivmecillinam based on population-based registries in North Jutland County, Denmark. We included 63,659 women with a live birth, or stillbirth after the 28th week of gestation. 2031 had redeemed prescriptions for pivmecillinam any time during pregnancy, 559 in the first trimester and 371 within 28 d before delivery. Adjusted odds ratios were: birth defects 0.83 (95% confidence interval (95% CI) 0.53-1.32) for exposure during first trimester, preterm delivery 0.96 (95% CI 0.79-1.18) and low birth weight 0.79 (95% CI 0.52-1.20) for exposure any time during pregnancy, and stillbirth 1.19 (95% CI 0.30-4.80), low Apgar score 1.17 (95% CI 0.37-3.66), hypoglycaemia 1.03 (95% CI 0.53-2.00), and respiratory distress syndrome 0.79 (95% CI 0.38-1.68) for exposure within 28 d before delivery. Use of pivmecillinam during pregnancy did not appear to increase the risk of adverse birth and neonatal outcomes; however, statistical precision is still low. PMID:15513399

  9. Pregnancy outcomes in women with heart disease

    Institute of Scientific and Technical Information of China (English)

    LIU Hua; XU Ji-wen; ZHAO Xu-dong; YE Tai-yang; LIN Jian-hua; LIN Qi-de

    2010-01-01

    Background As the Shanghai Obstetrical Cardiology Intensive Care Center, our hospital has accumulated a large number of clinical data of pregnant women with heart disease. This paper is a retrospective analysis of 1142 pregnancies in women with heart disease so as to evaluate the maternal and fetal outcomes of these patients.Methods A retrospective analysis was carried out for pregnancies in 1142 women with heart disease who delivered in Shanghai Obstetrical Cardiology Intensive Care Center between 1993 and 2007.Results In this study, main heart diseases in pregnancy were arrhythmia (n=359, 31.4%), congenital heart disease (CHD; n=291,25.5%), and myocarditis and its sequelae (n=284, 24.9%); based on the functional classification criteria of New York Heart Association (NYHA), more than half (n=678, 59.4%) of patients were classified NYHA Class Ⅰ; pregnant women in NHYA Class Ⅰ-Ⅱ (n=951, 83.3%) commonly had arrhythmia, myocarditis and its sequelae, while those in NHYA Class Ⅲ-Ⅳ (n=191, 16.7%) mainly had CHD, rheumatic heart disease (RHD), cardiopathy induced by hypertensive disorders complicating pregnancy, and peripartum cardiomyopathy (PPCM). Cardiac failure occurred in 97 (8.5%)patients, and 8 (0.7%) maternal deaths and 12 (1.1%) perinatal deaths were reported in this study. Compared with those in NHYA Class Ⅰ-Ⅱ, women in NHYA Class Ⅲ-Ⅳ had a significantly lower gestational age at birth (P <0.05), lower birth weight (P <0.01), and higher incidence of preterm delivery, small for gestational age and perinatal death (P <0.01). The incidence of cardiac failure in pregnant women with cardiopathy induced by hypertensive disorders complicating pregnancy and PPCM was relatively high, with a rate of 80% and 52.2%, respectively. After cardiac operation, 131(90.3%) women were in classified NHYA Class Ⅰ-Ⅱ and 14 (9.7%) in NHYA Class Ⅲ-Ⅳ.Conclusions Arrhythmia is the type of heart disease that has a highest incidence in patients with heart

  10. Risk Assessment of Adverse Birth Outcomes in Relation to Maternal Age.

    Directory of Open Access Journals (Sweden)

    Yi-Hao Weng

    Full Text Available Although a number of studies have investigated correlations of maternal age with birth outcomes, an extensive assessment using age as a continuous variable is lacking. In the current study, we estimated age-specific risks of adverse birth outcomes in childbearing women.National population-based data containing maternal and neonatal information were derived from the Health Promotion Administration, Taiwan. A composite adverse birth outcome was defined as at least anyone of stillbirth, preterm birth, low birth weight, macrosomia, neonatal death, congenital anomaly, and small for gestational age (SGA. Singletons were further analyzed for outcomes of live birth in relation to each year of maternal age. A log-binomial model was used to adjust for possible confounders of maternal and neonatal factors.In total, 2,123,751 births between 2001 and 2010 were utilized in the analysis. The risk of a composite adverse birth outcome was significantly higher at extreme maternal ages. In specific, risks of stillbirth, neonatal death, preterm birth, congenital anomaly, and low birth weight were higher at the extremes of maternal age. Furthermore, risk of macrosomia rose proportionally with an increasing maternal age. In contrast, risk of SGA declined proportionally with an increasing maternal age. The log-binomial model showed greater risks at the maternal ages of 30 years for a composite adverse birth outcome.Infants born to teenagers and women at advanced age possess greater risks for stillbirth, preterm birth, neonatal death, congenital anomaly, and low birth weight. Pregnancies at advanced age carry an additional risk for macrosomia, while teenage pregnancies carry an additional risk for SGA. The data suggest that the optimal maternal ages to minimize adverse birth outcomes are 26∼30 years.

  11. Pregnancy outcome after use of cranberry in pregnancy – the Norwegian mother and child cohort study

    OpenAIRE

    Heitmann, Kristine; Nordeng, Hedvig; Holst, Lone

    2013-01-01

    Background Cranberry is one of the most commonly used herbs during pregnancy. The herb has been used traditionally against urinary tract infections. No studies are found that specifically address the risk of malformations after use of cranberry during pregnancy. The aim of the study was to investigate the safety of cranberry use during pregnancy, including any effects on congenital malformations and selected pregnancy outcomes. ...

  12. MORTALITY AS AN ADVERSE OUTCOME OF SARCOPENIA

    OpenAIRE

    ARANGO-LOPERA, V.E.; Arroyo, P.; GUTIERREZ-ROBLEDO, L.M.; PEREZ-ZEPEDA, M.U.; Cesari, M.

    2013-01-01

    Sarcopenia has an important impact in elderly. Recently the European Working Group on Sarcopenia in Older People (EWGSOP) defined sarcopenia as the loss of muscle mass plus low muscle strength or low physical performance. Lack of clinical sounding outcomes (ie external validity), is one of the flaws of this algorithm. The aim of our study was to determine the association of sarcopenia and mortality in a group of Mexican elderly. A total of 345 elderly were recruited in Mexico City, and follow...

  13. IMPACT OF VITAMIN D ON PREGNANCY AND PREGNANCY OUTCOME

    Directory of Open Access Journals (Sweden)

    Bellad Girija

    2015-06-01

    Full Text Available Vitamin D is required throughout life. It is necessary for the formation of bone, but also likely plays an important role in several other physiological systems and it prevents several degenerative diseases and anticancer agent. Its use may well prevent several degenerative diseases, and it may also play a role as an anticancer agent. 84% of pregnant women in Northern India have suboptimal vitamin D levels. Vitamin D deficiency during pregnancy can significantly impact pregnancy and fetal outcome. A high prevalence of physiologically significant hypovitaminosis D and its magnitude are now recognized in pregnant and breast feeding women and infants. Despite abundant sunlight, UV drenched Indians remain vitamin D deficient because of highly pigmented skin and inadequate direct sunlight exposure, either due to a cultural tendency or due to liberal use of sunscreen. In India, rickets and hypocalcaemia seizures due to vitamin D deficiency in exclusively breastfed young infants have been reported. Vitamin D in breast milk relates to mothers' vitamin D intake, skin pigmentation and sunlight exposure. Vitamin D is thought to have a role in asthma exacerbations. Repletion of vitamin D through supplementation ensures adequate maternal vitamin D stores for prenatal and postnatal period and hence, helps prevent infant rickets. A maternal daily intake of vitamin D 4000 IU/day increased the antirachitic activity of milk by nearly 100 IU/L.

  14. Obstetric outcomes of booked teenage pregnancies at University of Calabar Teaching Hospital, Nigeria

    OpenAIRE

    Ago BU; Abeshi S; Njoku C; TU Agan; Ekabua J

    2012-01-01

    Boniface Uji Ago, Sylvester Abeshi, Charles Njoku, Thomas Udagbor Agan, John EkabuaDepartment of Obstetrics and Gynaecology, University of Calabar Teaching Hospital, Calabar, NigeriaBackground: Teenage pregnancy is high-risk and associated with complications due to adverse physiological, anatomical, and socioeconomic factors. The purpose of this study was to determine the patterns and obstetric outcomes of booked teenage pregnancies at the University of Calabar Teaching Hospital (UCTH) in Nig...

  15. The association between social economic status during pregnancy and the adverse birth outcomes in Chinese women%妇女孕期社会经济状态与新生儿体重的关系

    Institute of Scientific and Technical Information of China (English)

    卢福泉; 陈鹤; 裴丽君; 郑晓瑛

    2012-01-01

    目的:分析妇女孕期的社会经济状态与不良妊娠结局关系,为筛查可能生育不良体重儿的高风险孕妇提供依据.方法:利用2002年中国居民营养与健康调查数据,根据妊娠结局以及孕妇年龄、社会经济状态、体力活动模式和营养补充情况建立8个研究模型,以多元logistic回归分析4159例乳母样本.结果:低出生体重儿和巨大儿的发生率分别为5.8%和11.4%.通过建立不同模型对比分析发现,生活在中小城市、小学及以下教育程度、低收入、步行出行方式的妇女生育低出生体重儿风险更高;小学及以下教育程度、轻体力活动、自行车或公交车出行、服用碘制剂的妇女生育巨大儿的风险更高.结论:社会经济状态处于劣势的妇女生育异常体重新生儿的风险更高,应有针对性地筛查风险人群.%Objective; To investigate the association of socioeconomic status of pregnant women with the adverse birth outcomes in Chinese women to provide the evidence for the screening of the pregnant women at high risk of adverse birth outcomes. Methods: Based on Chinese Nutrition and Health Survey 2002, a multiple Logistic regression was conducted to examine the associations between the three main series of categorical independent variables ( socioeconomic status, physical activity, and nutrition supplement) and the two dependent variables (low birth weight and macrosomia). Results; The incidences of low birth weight and macrosomia in the studied women were 5.8% and 11.4% , respectively. Pregnant women living in a middle/small town, with lower education, lower income, and with walking as a main way of transportation, had a higher possibility of producing low - birth - weight babies, and those with lower education, lighter intensity of physical activity, and with bike or public transportation as main transportation way, had a higher possibility of producing macrosomia babies. Conclusion; The socioeco

  16. Pregnancy outcomes with thyroxine replacement for subclinical hypothyroidism: Role of thyroid autoimmunity

    Directory of Open Access Journals (Sweden)

    Muthukrishnan Jayaraman

    2013-01-01

    Full Text Available Objective: To study pregnancy outcomes in relation to thyroid peroxidase antibody (TPOAb status with optimum thyroxine replacement for subclinical hypothyroidism. Materials and Methods: Ninety-eight women with subclinical hypothyroidism were followed up until the end of their pregnancy. TPO antibody status was performed for 59 women (positive 20, negative 39. Levothyroxine was supplemented to maintain TSH between 0.3-3 mIU/l in all patients, irrespective of TPOAb status. Pregnancy outcomes were noted as pregnancy-induced hypertension (PIH, antepartum or postpartum hemorrhage, preterm delivery, and spontaneous abortion. Outcomes were compared between 3 groups as per TPO antibody status (positive, negative, and undetermined, which were matched for age and gestational period. Results: Thyroid autoimmunity was noted in 34% of women screened for TPO antibody. A total of 11 adverse pregnancy outcomes were recorded (4 spontaneous abortions, 4 preterm deliveries, 3 PIH with no significant difference between the groups. Conclusion: Adverse pregnancy outcomes were not different in the 3 groups with adequate thyroxine replacement for pregnant women with subclinical hypothyroidism targeting TSH in euthyroid range, irrespective of thyroid autoimmunity status.

  17. Nutritional status of pregnant women: prevalence and associated pregnancy outcomes

    Directory of Open Access Journals (Sweden)

    Nucci Luciana Bertoldi

    2001-01-01

    Full Text Available INTRODUCTION: Although obesity is well recognized as a current public health problem, its prevalence and impact among pregnant women have been less investigated in Brazil. The objective of the study was to evaluate the impact of pre-obesity and obesity among pregnant women, describing its prevalence and risk factors, and their association with adverse pregnancy outcomes. METHODS: A cohort of 5,564 pregnant women, aged 20 years or more, enrolled at aproximately 20 to 28 weeks of pregnancy, seen in prenatal public clinics of six state capitals in Brazil were followed up, between 1991 and 1995. Prepregnancy weight, age, educational level and parity were obtained from a standard questionnaire. Height was measured in duplicate and the interviewer assigned the skin color. Nutritional status was defined using body mass index (BMI, according to World Health Organization (WHO criteria. Odds ratios and 95% confidence interval were calculated using logistic regression. RESULTS: Age-adjusted prevalences (and 95% CI based on prepregnancy weight were: underweight 5.7% (5.1%-6.3%, overweight 19.2% (18.1%-20.3%, and obesity 5.5% (4.9%-6.2%. Obesity was more frequently observed in older black women, with a lower educational level and multiparous. Obese women had higher frequencies of gestational diabetes, macrosomia, hypertensive disorders, and lower risk of microsomia. CONCLUSIONS: Overweight nutritional status (obesity and pre-obesity was seen in 25% of adult pregnant women and it was associated with increased risk for several adverse pregnancy outcomes, such as gestational diabetes and pre-eclampsia.

  18. Psychosocial job strain and risk of adverse birth outcomes

    DEFF Research Database (Denmark)

    Larsen, Ann Dyreborg; Hannerz, Harald; Juhl, Mette;

    2013-01-01

    A number of studies examined the effects of prenatal stress on birth outcomes with diverging and inconclusive results. We aimed to examine if working with high job strain during pregnancy measured in week 16 was associated with risk of giving birth to a child born preterm or small/large for...

  19. Evaluate the correlation of early intervening treatment and adverse pregnancy outcomes in gestational diabetes mellitus%妊娠期糖尿病的早期干预对母婴预后的影响

    Institute of Scientific and Technical Information of China (English)

    黄艳萍; 黄宝琴

    2013-01-01

    目的 探讨妊娠期糖尿病(GDM)的早期干预对母婴预后的影响.方法 选择143例GDM孕妇,将其中经早期干预、血糖控制满意的75例GDM孕妇作为GDM治疗组;余下68例血糖控制不满意或未行干预的GDM孕妇作为阳性对照组,另选择130名正常孕妇作为阴性对照组.比较3组孕妇的妊娠并发症及围生儿并发症发生率.结果 3组孕妇的妊娠期高血压疾病、羊水过多、胎膜早破、胎儿窘迫发生率及剖宫产率比较差异均有统计学意义(P均<0.01).其中阳性对照组的妊娠期高血压疾病、羊水过多、胎膜早破、胎儿窘迫、早产儿、新生儿低血糖、巨大儿、新生儿窒息发生率和剖宫产率均高于GDM治疗组(P<0.01或0.05);除早产儿发生率外,GDM治疗组各项妊娠及围生儿并发症发生率及剖宫产率与阴性对照组比较差异均无统计学意义(P均>0.05).结论 早期筛查发现GDM,并及早给予有效干预是降低母婴并发症、改善母婴预后的重要措施.%Objective To evaluate the effect of early intervention on gestational diabetes mellitus (GDM) for outcomes of maternal and fetal.Methods 143 cases of pregnant women with GDM were included.75 cases with satisfactory blood glucose control by early intervention were selected as GDM treatment group.Another 68 pregnant women with glucose poorly controlled undertaking or untreated were selected as positive control group.Then 130 normal pregnant women were selected as negative control group.The maternal and fetal complications of pregnant women among three groups were compared.Results There were statistically significant differences (P < 0.01) of the incidences of hypertensive disorders in pregnancy,polyhydramnios,premature rupture of membranes,fetal distress and cesarean section rate in three groups.The incidences of hypertensive disorders in pregnancy,polyhydramnios,premature rupture of membranes,fetal distress,preterm children

  20. Improving maternal nutrition for better pregnancy outcomes.

    Science.gov (United States)

    Nnam, N M

    2015-11-01

    Much has been learned during the past several decades about the role of maternal nutrition in the outcome of pregnancy. While the bulk of the data is derived from animal models, human observations are gradually accumulating. There is need to improve maternal nutrition because of the high neonatal mortality rate especially in developing countries. The author used a conceptual framework which took both primary and secondary factors into account when interpreting study findings. Nutrition plays a vital role in reducing some of the health risks associated with pregnancy such as risk of fetal and infant mortality, intra-uterine growth retardation, low birth weight and premature births, decreased birth defects, cretinism, poor brain development and risk of infection. Adequate nutrition is essential for a woman throughout her life cycle to ensure proper development and prepare the reproductive life of the woman. Pregnant women require varied diets and increased nutrient intake to cope with the extra needs during pregnancy. Use of dietary supplements and fortified foods should be encouraged for pregnant women to ensure adequate supply of nutrients for both mother and foetus. The author concludes that nutrition education should be a core component of Mother and Child Health Clinics and every opportunity should be utilised to give nutrition education on appropriate diets for pregnant women. PMID:26264457

  1. Pregnancy outcome in women with prosthetic heart valves.

    Science.gov (United States)

    Hall, D R; Olivier, J; Rossouw, G J; Grové, D; Doubell, A F

    2001-03-01

    The pregnancy outcome of 59 pregnancies in 38 women with prosthetic heart valves, managed at a tertiary referral centre from 1989-98 were reviewed. Ten women underwent valve replacement during pregnancy. The main outcome measures were major maternal complications and perinatal outcome. The maternal mortality rate for pregnancies following valve replacement surgery was 6.1%, with a 21% pregnancy loss before viability and a perinatal loss of 8%. Major morbidity in this group was as follows: haemorrhage 29.8%, cardiac failure 12.8%, thromboembolism 8.5%, infective endocarditis 6.4% and valve thrombosis 4.3%. No maternal mortality occurred among those who underwent valve replacement during pregnancy but their perinatal loss was 25%. We conclude that although maternal mortality and morbidity rates in women with prosthetic heart valves who became pregnant were high, the perinatal outcome was good except for women who underwent valve replacement during pregnancy who experienced a high perinatal loss rate. PMID:12521884

  2. Reproductive outcomes in rural Vietnam. Perspectives and experiences by pregnant women and health care professionals on pregnancy promotion and maternal health care.

    OpenAIRE

    Graner, Sophie

    2010-01-01

    Background Reproductive health and health events associated with pregnancy including induced abortions are among the most important factors for the health of fertile women. Adverse outcomes have an impact on women’s reproductive health and their overall health as well as the health of their offspring. Pregnancy and child bearing take place within a cultural context. Risk factors for adverse pregnancy outcomes depend on factors both associated with the individual woman as well as contextual fa...

  3. Lifestyle interventions for overweight and obese pregnant women to improve pregnancy outcome: systematic review and meta-analysis

    OpenAIRE

    Oteng-Ntim Eugene; Varma Rajesh; Croker Helen; Poston Lucilla; Doyle Pat

    2012-01-01

    Abstract Background Overweight and obesity pose a big challenge to pregnancy as they are associated with adverse maternal and perinatal outcome. Evidence of lifestyle intervention resulting in improved pregnancy outcome is conflicting. Hence the objective of this study is to determine the efficacy of antenatal dietary, activity, behaviour or lifestyle interventions in overweight and obese pregnant women to improve maternal and perinatal outcomes. Methods A systematic review and meta-analyses ...

  4. Pregnancy Outcome of Women With Gestational Diabetes in a Tertiary Level Hospital of North India

    Science.gov (United States)

    Saxena, Pikee; Tyagi, Swati; Prakash, Anupam; Nigam, Aruna; Trivedi, Shubha Sagar

    2011-01-01

    Background: Women with gestational diabetes mellitus (GDM) pose an important public health problem because diabetes not only affects the maternal and fetal outcome, but these women and their fetuses are also at an increased risk of developing diabetes and related complications later in their life. Objectives: The study was conducted to determine the maternal and fetal outcomes of 50 diabetic vs 50 normoglycemic pregnancies. Materials and Methods: This was a retrospective analytical record-based study conducted in a tertiary level hospital. Detailed information regarding maternal, fetal, and labor outcome parameters was recorded in a prestructured proforma and compared in normoglycemic and diabetic pregnancies. Results: Patients with obesity, history of diabetes in the family, spontaneous abortions, and gestational diabetes in previous pregnancies had a greater incidence of GDM in current pregnancy (P<0.05 for all). Hypertension, polyhydramnios, macrosomia, fetopelvic disproportion, and cesarean sections were more (P<0.001) among diabetic pregnancies. Congenital anomalies, polycythemia, hypocalcemia, and hyperbilirubinemia were also observed to be more (P<0.05) in neonates born to diabetics, suggesting an adverse effect of hyperglycemia in utero. Conclusion: Diabetes during pregnancy is associated with higher maternal and fetal morbidity. Therefore, early screening, detection, close monitoring, and intervention is essential to reduce maternal and fetal short- and long-term adverse effects, especially in high-risk groups. Pregnancy provides an opportunity to the clinician to control the disease process and inculcate healthy lifestyle practices in these patients. PMID:21976796

  5. Pregnancy outcome of women with gestational diabetes in a tertiary level hospital of North India

    Directory of Open Access Journals (Sweden)

    Pikee Saxena

    2011-01-01

    Full Text Available Background: Women with gestational diabetes mellitus (GDM pose an important public health problem because diabetes not only affects the maternal and fetal outcome, but these women and their fetuses are also at an increased risk of developing diabetes and related complications later in their life. Objectives: The study was conducted to determine the maternal and fetal outcomes of 50 diabetic vs 50 normoglycemic pregnancies. Materials and Methods: This was a retrospective analytical record-based study conducted in a tertiary level hospital. Detailed information regarding maternal, fetal, and labor outcome parameters was recorded in a prestructured proforma and compared in normoglycemic and diabetic pregnancies. Results: Patients with obesity, history of diabetes in the family, spontaneous abortions, and gestational diabetes in previous pregnancies had a greater incidence of GDM in current pregnancy (P<0.05 for all. Hypertension, polyhydramnios, macrosomia, fetopelvic disproportion, and cesarean sections were more (P<0.001 among diabetic pregnancies. Congenital anomalies, polycythemia, hypocalcemia, and hyperbilirubinemia were also observed to be more (P<0.05 in neonates born to diabetics, suggesting an adverse effect of hyperglycemia in utero. Conclusion: Diabetes during pregnancy is associated with higher maternal and fetal morbidity. Therefore, early screening, detection, close monitoring, and intervention is essential to reduce maternal and fetal short- and long-term adverse effects, especially in high-risk groups. Pregnancy provides an opportunity to the clinician to control the disease process and inculcate healthy lifestyle practices in these patients.

  6. Pre-pregnancy high-risk factors at first antenatal visit: how predictive are these of pregnancy outcomes?

    Directory of Open Access Journals (Sweden)

    Tandu-Umba B

    2014-12-01

    Full Text Available Barthélémy Tandu-Umba, Muela Andy Mbangama, Kitenge Marc Brunel Kamongola , Tchawou Armel Georges Kamgang, Mawamfumu Perthus Kivuidi, Munene Sam Kasonga, Meke Irène Kambashi, Kabasele Oscar Kapuku, Bituemi Jackson Kondoli, Kibundila Rolly Kikuni, Kuzungu Simon KasikilaDepartment of Obstetrics and Gynecology, University Clinics of Kinshasa, Kinshasa, Democratic Republic of Congo Objective: To determine relationships between pre-pregnancy risk factors at first antenatal visit booking and pregnancy outcomes.Study design: This was a multicenter, cross-sectional study involving women admitted for singleton delivery from July 1 until October 31 (3 months, 2013, at nine major maternity clinics in Kinshasa, Democratic Republic of Congo. All women were checked for hereditary, community, and personal medical/surgical risk situations and mother/infant problems in previous pregnancies. Maternal and perinatal complications related to current/just-terminated pregnancy were analyzed according to pre-pregnancy risk factors in order to establish their prediction concerning maternal and perinatal complications related to current/just-terminated pregnancy (odds ratios. Results are given with 95% confidence intervals, and P<0.05 was considered significant.Results: The study sample comprised 2,086 women. Primiparity (36.5%, single relationship status (26.4%, and maternal age ≥35 years (18.3% were the most important non-pathologic risk factors, while arterial hypertension in family (34.3%, previous miscarriage (33.2%, overweight/obesity (21.9%, diabetes in family (21.1%, previous cesarean section (15.7%, previous postpartum hemorrhage (13.1%, low birth weight (10%, previous macrosomia (10%, and previous premature rupture of membranes (6.2% predominated among pathologic risk factors. Major adverse outcomes recurred in some women, with recurrence rates of 21/37 (57%, 111/208 (53%, 74/208 (36%, 191/598 (32%, 132/466 (28%, 24/130 (18%, and 4/65 (6% for prematurity

  7. Systemic lupus erythematosus: strategies to improve pregnancy outcomes.

    Science.gov (United States)

    Yamamoto, Yuriko; Aoki, Shigeru

    2016-01-01

    Systemic lupus erythematosus (SLE) is a chronic autoimmune inflammatory disease with a high prevalence in females of childbearing age. Thus, reproduction in SLE patients is a major concern for clinicians. In the past, SLE patients were advised to defer pregnancy because of poor pregnancy outcomes and fear of SLE flares during pregnancy. Investigations to date show that maternal and fetal risks are higher in females with SLE than in the general population. However, with appropriate management of the disease, sufferers may have a relatively uncomplicated pregnancy course. Factors such as appropriate preconception counseling and medication adjustment, strict disease control prior to pregnancy, intensive surveillance during and after pregnancy by both the obstetrician and rheumatologist, and appropriate interventions when necessary play a key role. This review describes the strategies to improve pregnancy outcomes in SLE patients at different time points in the reproduction cycle (preconception, during pregnancy, and postpartum period) and also details the neonatal concerns. PMID:27468250

  8. Obstetric and Perinatal Outcomes in Type 1 Diabetic Pregnancies

    OpenAIRE

    Persson, Martina; Norman, Mikael; Hanson, Ulf

    2009-01-01

    OBJECTIVE To perform comparative analyses of obstetric and perinatal outcomes between type 1 diabetic pregnancies and the general obstetric population in Sweden between 1991 and 2003. RESEARCH DESIGN AND METHODS This was a population-based study. Data were obtained from the Medical Birth Registry, covering >98% of all pregnancies in Sweden. A total of 5,089 type 1 diabetic pregnancies and 1,260,207 control pregnancies were included. Odds ratios (ORs) were adjusted for group differences in mat...

  9. Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study: Common Genetic Variants in GCK and TCF7L2 Are Associated With Fasting and Postchallenge Glucose Levels in Pregnancy and With the New Consensus Definition of Gestational Diabetes Mellitus From the International Association of Diabetes and Pregnancy Study Groups

    OpenAIRE

    Freathy, Rachel M; Hayes, M. Geoffrey; Urbanek, Margrit; Lowe, Lynn P.; Lee, Hoon; Ackerman, Christine; Frayling, Timothy M; Cox, Nancy J.; Dunger, David B.; Dyer, Alan R; Hattersley, Andrew T; Metzger, Boyd E.; Lowe, William L.; ,

    2010-01-01

    OBJECTIVE Common genetic variants in GCK and TCF7L2 are associated with higher fasting glucose and type 2 diabetes in nonpregnant populations. However, their associations with glucose levels from oral glucose tolerance tests (OGTTs) in pregnancy have not been assessed in a large sample. We hypothesized that these variants are associated with quantitative measures of glycemia in pregnancy. RESEARCH DESIGN AND METHODS We analyzed the associations between variants rs1799884 (GCK) and rs7903146 (...

  10. Analysis of prescribing pattern of antihypertensive drugs during pregnancy and neonatal outcome in a tertiary care centre

    OpenAIRE

    Soundarya Yamakanamardi; Anuradha HV; Sujani BK; Shivamurthy MC

    2016-01-01

    Background: Hypertensive disorders are the most common medical complications of pregnancy with an incidence of 2-8%. Maternal hypertension, even of the mild to moderate category, can lead to adverse perinatal outcomes like low birth weight, prematurity, stillbirth and intrauterine growth retardation. Though hypertension occurs up to 8% of pregnancies, yet information on the safety of antihypertensive medication use during pregnancy is limited. The objective of this study was to analyse the pr...

  11. Prenatal Depression and Adverse Birth Outcomes: An Updated Systematic Review

    OpenAIRE

    Accortt, EE; Cheadle, ACD; Dunkel Schetter, C

    2015-01-01

    © 2014 Springer Science+Business Media New York Complications related to preterm birth (PTB) and low birth weight (LBW) are leading causes of infant morbidity and mortality. Prenatal depression is a hypothesized psychosocial risk factor for both birth outcomes. The purpose of this systematic review was to examine evidence published between 1977 and 2013 on prenatal depression and risks of these primary adverse birth outcomes. A systematic search of the PUBMED and PsycINFO databases was conduc...

  12. Proteomics for Adverse Outcome Pathway Discovery using Human Kidney Cells?

    Science.gov (United States)

    An Adverse Outcome Pathway (AOP) is a conceptual framework that applies molecular-based data for use in risk assessment and regulatory decision support. AOP development is based on effects data of chemicals on biological processes (i.e., molecular initiating events, key intermedi...

  13. Variation in outcomes in trials reporting effects of diet and lifestyle based intervention on pregnancy outcomes: a systematic review.

    Science.gov (United States)

    Rogozinska, E; Fen, Y; Molyneaux, E; Khan, K S; Thangaratinam, S

    2014-07-01

    Obesity is a growing threat to women of childbearing age. Increased maternal weight or excessive weight gain in pregnancy is associated with adverse pregnancy outcomes. Interventions based on diet and physical activity minimise gestational weight gain with varied effect on a number of clinical outcomes. There is no consensus amongst the trialists on the core outcomes that need to be reported to inform the clinical care of pregnant women. The aim of this systematic review is to evaluate variation in the type and quality of outcomes reported in systematic reviews and randomised controlled trials on diet and lifestyle interventions on maternal and fetal outcomes. We will assess the correlation between the type of outcome, the quality of the studies and journal impact factor. We searched the major databases from the inception to October 2013 without language restrictions. We used current recommendations for quality of outcome reporting using a 6-point scale. The quality assessment of systematic reviews and RCTs was performed using the AMSTAR and Jadad scoring systems. Additionally we obtained journals' impact factor in the year of publication. We calculated Spearman rank coefficient to assess the correlation between the type of outcome, and study quality. An overview of outcome reporting will show the current attitude of the researchers towards outcomes of importance when conducting trials on diet and lifestyle management in pregnancy. If our abstract is accepted, we will provide the details of the results. PMID:26104628

  14. Pregnancy outcome after use of cranberry in pregnancy - the Norwegian mother and child cohort study

    OpenAIRE

    Heitmann, Kristine; Nordeng, Hedvig; Holst, Lone

    2013-01-01

    Background: Cranberry is one of the most commonly used herbs during pregnancy. The herb has been used traditionally against urinary tract infections. No studies are found that specifically address the risk of malformations after use of cranberry during pregnancy. The aim of the study was to investigate the safety of cranberry use during pregnancy, including any effects on congenital malformations and selected pregnancy outcomes.Methods: The study is based on data from The Norwe...

  15. Association of Maternal Body Mass Index with Adverse Maternal and Prenatal Outcomes

    Directory of Open Access Journals (Sweden)

    Rahele Alijahan

    2013-09-01

    Full Text Available Background: The present study aimed to determine association between abnormal maternal body mass index and adverse maternal/prenatal outcomesMaterials and Methods: In this descriptive-correlation study 8270 pregnant women referred to rural and urban health centers of Ardabil district (from Mar 2009 to Dec 2010 were studied. Data were collected from prenatal healthcare records using a self designed questionnaire. Women with twin pregnancy, less than 18 and above 35 of age, and women with systemic or chronic disease were excluded from the study. The variables examined in this study include, demographic information (e.g. age, social and economy status, and literacy, present pregnancy information (e.g. parity, hemoglobin level, gestational diabetes, preeclampsia and prenatal information (e.g. preterm delivery, low birth weight, and congenital malformation. Data were analyzed through Kruscal wallis, chi-square, and logistic regression tests using SPSS-16.Results: Eight point two, 25 and 15.4% pregnant of women were underweight, overweight, and obese, respectively. Obese women were at increased risk for macrosomia (OR=1.820, CI: 1.345-2.447, p=0.001, unwanted pregnancy (OR= 1.436, CI: 1.198-1.720, p=0.001, pregnancy induced hypertension (OR= 1.633, CI: 1.072-2.486, p=0.022, preeclampsia (OR= 4.666, CI: 2.353-9.2550, p=0.001, and still birth (OR= 2.602, CI: 1.306-5.184, p=0.007. However, the risk of low birth weight delivery in underweight women were 1.6 times higher than the normal cases (OR= 1.674, CI: 0962-2.912, p=0.068.Conclusion: Considering high prevalence of abnormal maternal body mass index and its associated adverse maternal and prenatal outcomes; consultation before pregnancy is recommended in order to achieve normal body mass index and reduce the relevant complications.

  16. The assessment of pregnancy outcome in farmer women and bousewiues in Gilan

    OpenAIRE

    F.Shirinkam

    2000-01-01

    SummaryBackground and purpose : The effect of physical activity of pregnant women on the pregnancy outcome has been studied previously. There are several reports about adverse affects of maternal work on the fetus in the medical literature.This study was designed to assess the pregnancy outcome in farmer women in comparison with howsewives in Gilan.Materials and Methods : This case – control study was performed on 230 farmer women with a singleton alive fetus who reached 20th week of gestatio...

  17. Risk factors for and perinatal outcomes of major depression during pregnancy

    DEFF Research Database (Denmark)

    Räisänen, Sari; Lehto, Soili M; Nielsen, Henriette Svarre;

    2014-01-01

    history of depression prior to pregnancy. After history of depression, the second strongest associated factor for major depression was fear of childbirth, with a 2.6-fold (adjusted OR (aOR=2.63, 95% CI 2.39 to 2.89) increased prevalence. The risk profile of major depression also included adolescent or......OBJECTIVES: To identify risk factors for and the consequences (several adverse perinatal outcomes) of physician-diagnosed major depression during pregnancy treated in specialised healthcare. DESIGN: A population-based cross-sectional study. SETTING: Data were gathered from Finnish health registers...... for 1996-2010. PARTICIPANTS: All singleton births (n=511,938) for 2002-2010 in Finland. PRIMARY OUTCOME MEASURES: Prevalence, risk factors and consequences of major depression during pregnancy. RESULTS: Among 511,938 women, 0.8% experienced major depression during pregnancy, of which 46.9% had a...

  18. Effect of maternal body mass index on pregnancy outcome and newborn weight

    Directory of Open Access Journals (Sweden)

    Yazdani Shahla

    2012-01-01

    Full Text Available Abstract Background Maternal obesity has been associated with adverse pregnancy outcomes, such as pre-eclampsia, eclampsia, pre- and post-term delivery, induction of labor, macrosomia, increased rate of caesarean section, and post-partum hemorrhage. The objective of this study was to determine the effect of maternal Body Mass Index (BMI on pregnancy outcomes. Methods 1000 pregnant women were enrolled in the study. In order to explore the relationship between maternal first trimester Body Mass Index and pregnancy outcomes, participants were categorized into five groups based on their first trimester Body Mass Index. The data were analyzed using Pearson Chi-square tests in SPSS 18. Differences were considered significant if p Results Women with an above-normal Body Mass Index had a higher incidence of pre-eclampsia, induction of labor, caesarean section, pre-term labor, and macrosomia than women with a normal Body Mass Index (controls. There was no significant difference in the incidence of post-term delivery between the control group and other groups. Conclusion Increased BMI increases the incidence of induction of labor, caesarean section, pre-term labor and macrosomia. The BMI of women in the first trimester of pregnancy is associated with the risk of adverse pregnancy outcome.

  19. Occupational exposure to pesticides and pregnancy outcomes in gardeners and farmers: a study within the Danish National Birth Cohort

    DEFF Research Database (Denmark)

    Zhu, Jin Liang; Hjøllund, Niels Henrik Ingvar; Andersen, AM;

    2006-01-01

    regression was applied to analyze late fetal loss and congenital malformations, and logistic regression was used to analyze preterm birth and small for gestational age. RESULTS: There were no significant differences in the studied pregnancy outcomes between gardeners or farmers and all other workers, except......OBJECTIVE: We conducted a follow-up study to examine whether exposure to pesticides during pregnancy had an adverse effect on pregnancy outcomes among Danish gardeners and farmers. METHODS: Using data from the National Birth Cohort in Denmark, we identified 226 pregnancies of gardeners and 214...... pregnancies of farmers during 1997 through 2003. Work activities and exposure to pesticides were reported in an interview (around 16 weeks of gestation). Totally, 62,164 other workers in the cohort served as a reference group. Pregnancy outcomes were obtained by linkage to the national registers. Cox...

  20. Maternal Thyroid Hypofunction and Pregnancy Outcome

    Science.gov (United States)

    Cleary-Goldman, Jane; Malone, Fergal D.; Lambert-Messerlian, Geralyn; Sullivan, Lisa; Canick, Jacob; Porter, T. Flint; Luthy, David; Gross, Susan; Bianchi, Diana W.; D’Alton, Mary E.

    2016-01-01

    OBJECTIVE To estimate whether maternal thyroid hypofunction is associated with complications. METHODS A total of 10,990 patients had first- and second-trimester serum assayed for thyroid-stimulating hormone (TSH), free thyroxine (freeT4), and antithyroglobulin and antithyroid peroxidase antibodies. Thyroid hypofunction was defined as 1) subclinical hypothyroidism: TSH levels above the 97.5th percentile and free T4 between the 2.5th and 97.5th percentiles or 2) hypothyroxinemia: TSH between the 2.5th and 97.5th percentiles and free T4 below the 2.5th percentile. Adverse outcomes were evaluated. Patients with thyroid hypofunction were compared with euthyroid patients (TSH and free T4 between the 2.5th and 97.5th percentiles). Patients with and without antibodies were compared. Multivariable logistic regression analysis adjusted for confounders was used. RESULTS Subclinical hypothyroidism was documented in 2.2% (240 of 10,990) in the first and 2.2% (243 of 10,990) in the second trimester. Hypothyroxinemia was documented in 2.1% (232 of 10,990) in the first and 2.3% (247 of 10,990) in the second trimester. Subclinical hypothyroidism was not associated with adverse outcomes. In the first trimester, hypothyroxinemia was associated with preterm labor (adjusted odds ratio [aOR] 1.62; 95% confidence interval [CI] 1.00–2.62) and macrosomia (aOR 1.97; 95% CI 1.37–2.83). In the second trimester, it was associated with gestational diabetes (aOR 1.7; 95% CI 1.02–2.84). Fifteen percent (1,585 of 10,990) in the first and 14% (1,491 of 10,990) in the second trimester had antithyroid antibodies. When both antibodies were positive in either trimester, there was an increased risk for preterm premature rupture of membranes (P = .002 and Pthyroid hypofunction is not associated with a consistent pattern of adverse outcomes. LEVEL OF EVIDENCE: II PMID:18591312

  1. OBSTETRICS AND PSYCHOSOCIAL OUTCOME OF TEENAGE PREGNANCY

    OpenAIRE

    Seetesh; Lopamudra B

    2013-01-01

    Teenage pregnancy is defined as pregnancies which occur in a female below the age of 20 i.e. when the pregnancy ends. A female can become pregnant as early as two weeks before menarche, although rare, but usually occurs after menarche. In healthy, well - nourished girls, menarche normally takes place around the ages 12 or 13. A number of personal and social factors are responsible for the onset of biological fertility in a teenage. Teenage pregnanc y rates ...

  2. Obstetric outcomes of booked teenage pregnancies at University of Calabar Teaching Hospital, Nigeria

    Directory of Open Access Journals (Sweden)

    Ago BU

    2012-10-01

    Full Text Available Boniface Uji Ago, Sylvester Abeshi, Charles Njoku, Thomas Udagbor Agan, John EkabuaDepartment of Obstetrics and Gynaecology, University of Calabar Teaching Hospital, Calabar, NigeriaBackground: Teenage pregnancy is high-risk and associated with complications due to adverse physiological, anatomical, and socioeconomic factors. The purpose of this study was to determine the patterns and obstetric outcomes of booked teenage pregnancies at the University of Calabar Teaching Hospital (UCTH in Nigeria.Methods: A retrospective comparative analysis of teenage pregnancies and mature mothers at UCTH was carried out from January 2011 to December 2011. A total of 82 teenage pregnancies and 72 mature pregnancies were compared.Results: There were 145 teenage deliveries from a total of 2313 deliveries, ie, 6.3% of total deliveries. There was no statistically significant difference in the mode of delivery (cesarean section, spontaneous vaginal delivery, instrumental delivery between the groups of mothers. There was also no difference in risk of complications, including obstructed labor, retained placenta, uterine atony, pre-eclampsia/eclampsia, and antepartum hemorrhage. However, teenage mothers had more perineal lacerations (P = 0.02 and more preterm labor (P = 0.05, and delivered more low-birth-weight babies (P = 0.02.Conclusion: Supervised teenage pregnancy may not be as hazardous as previously thought.Keywords: teenage pregnancy, booked pregnancy, obstetric outcome

  3. Pregnancy outcome following gestational exposure to azithromycin

    Directory of Open Access Journals (Sweden)

    Woodland C Cindy

    2006-05-01

    Full Text Available Abstract Background Azithromycin is an azalide antibiotic with an extensive range of indications and has become a common treatment option due to its convenient dosing regimen and therapeutic advantages. Human studies addressing gestational use of azithromycin have primarily focused on antibiotic efficacy rather than fetal safety. Our primary objective was to evaluate the possibility of teratogenic risk following gestational exposure to azithromycin. Methods There were 3 groups of pregnant women enrolled in our study: 1 women who took azithromycin. 2 women exposed to non-teratogenic antibiotics for similar indications, and 3 women exposed to non-teratogenic agents. They were matched for gestational age at time of call, maternal age, cigarette and alcohol consumption. Rates of major malformations and other endpoints of interest were compared among the three groups. Results Pregnancy outcome of 123 women in each group was ascertained. There were no statistically significant differences among the three groups in the rates of major malformations; 3.4% (exposed versus 2.3% (disease matched and 3.4% (non teratogen or any other endpoints that were examined. In the azithromycin group, 88 (71.6% women took the drug during the first trimester Conclusion Results suggest that gestational exposure to azithromycin is not associated with an increase in the rate of major malformations above the baseline of 1–3%. Our data adds to previous research showing that macrolide antibiotics, as a group, are generally safe in pregnancy and provides an evidence-based option for health professionals caring for populations with chlamydia.

  4. Risk for Gestational Diabetes Mellitus and Adverse Birth Outcomes in Chinese Women with Polycystic Ovary Syndrome

    Science.gov (United States)

    Xiao, Qing; Cui, Yong-Yi; Lu, Jine; Zhang, Guo-Zheng

    2016-01-01

    Objective. To examine the association of polycystic ovary syndrome (PCOS) in early pregnancy with gestational diabetes mellitus (GDM) and adverse birth outcomes. Methods. In this retrospective cohort study including 2389 pregnant women, the medical records of 352 women diagnosed with PCOS were evaluated. Outcomes included GDM, preterm birth, low birth weight, macrosomia, and being small and large for gestational age. Multivariable logistic regression models were used to examine the association of the risk for GDM and adverse birth outcomes with PCOS after adjusting for confounders. Results. Women previously diagnosed with PCOS had a higher risk of GDM (adjusted odds ratio [OR] 1.55, 95% confidence interval [CI]: 1.14–2.09). A strong association was seen between PCOS and preterm birth (adjusted OR 1.69, 95% CI: 1.08–2.67). On stratified analysis, the adjusted OR for GDM among women with PCOS undergoing assisted reproductive technology was 1.44 (95% CI: 1.03–1.92) and among women with PCOS who conceived spontaneously was 1.60 (1.18–2.15). No increased risk for other adverse birth outcomes was observed. Conclusions. Women with PCOS were more likely to experience GDM and preterm birth. PMID:27066074

  5. Risk for Gestational Diabetes Mellitus and Adverse Birth Outcomes in Chinese Women with Polycystic Ovary Syndrome

    Directory of Open Access Journals (Sweden)

    Qing Xiao

    2016-01-01

    Full Text Available Objective. To examine the association of polycystic ovary syndrome (PCOS in early pregnancy with gestational diabetes mellitus (GDM and adverse birth outcomes. Methods. In this retrospective cohort study including 2389 pregnant women, the medical records of 352 women diagnosed with PCOS were evaluated. Outcomes included GDM, preterm birth, low birth weight, macrosomia, and being small and large for gestational age. Multivariable logistic regression models were used to examine the association of the risk for GDM and adverse birth outcomes with PCOS after adjusting for confounders. Results. Women previously diagnosed with PCOS had a higher risk of GDM (adjusted odds ratio [OR] 1.55, 95% confidence interval [CI]: 1.14–2.09. A strong association was seen between PCOS and preterm birth (adjusted OR 1.69, 95% CI: 1.08–2.67. On stratified analysis, the adjusted OR for GDM among women with PCOS undergoing assisted reproductive technology was 1.44 (95% CI: 1.03–1.92 and among women with PCOS who conceived spontaneously was 1.60 (1.18–2.15. No increased risk for other adverse birth outcomes was observed. Conclusions. Women with PCOS were more likely to experience GDM and preterm birth.

  6. Accelerating Adverse Outcome Pathway (AOP) development via computationally predicted AOP networks

    Science.gov (United States)

    The Adverse Outcome Pathway (AOP) framework is increasingly being adopted as a tool for organizing and summarizing the mechanistic information connecting molecular perturbations by environmental stressors with adverse outcomes relevant for ecological and human health outcomes. Ho...

  7. Diabetes Mellitus and Pregnancy: Influence of Maternal and Fetal Factors on Pregnancy Outcomes

    OpenAIRE

    Al-Agha, Rany

    2010-01-01

    Pregnancy in women with pre-gestational type 1 diabetes mellitus (TI DM) is associated with increased rates of fetal morbidity and mortality. Little data exists on pregnancy outcomes in patients with TI DM pregnancy in Ireland. In this thesis I present the results of one large audit and 9 smaller studies of 600 women with T1 DM attending at the combined diabetes-obstetric antenatal clinics from 1995-2006 in Dublin. Outcomes of pregnancy in patients with TlDM are compared with 142,498 c...

  8. Canadian Pregnancy Outcomes in Rheumatoid Arthritis and Systemic Lupus Erythematosus

    OpenAIRE

    Cheryl Barnabe; Faris, Peter D; Hude Quan

    2011-01-01

    Objective. To describe obstetrical and neonatal outcomes in Canadian women with rheumatoid arthritis (RA) or systemic lupus erythematosus (SLE). Methods. An administrative database of hospitalizations for neonatal delivery (1998–2009) from Calgary, Alberta was searched to identify women with RA (38 pregnancies) or SLE (95 pregnancies), and women from the general population matched on maternal age and year of delivery (150 and 375 pregnancies, resp.). Conditional logistic regression was used t...

  9. Antenatal psychosocial risk factors associated with adverse postpartum family outcomes.

    OpenAIRE

    Wilson, L. M.; Reid, A. J.; Midmer, D. K.; Biringer, A; Carroll, J C; Stewart, D.E.

    1996-01-01

    OBJECTIVE: To determine the strength of the association between antenatal psychosocial risk factors and adverse postpartum outcomes in the family, such as assault of women by their partner, child abuse, postpartum depression, marital dysfunction and physical illness. DATA SOURCES: MEDLINE, Cinahl, Famli, Psych Abstracts and the Oxford Database of Perinatal Trials were searched from relevant articles published from Jan. 1, 1980, to Dec. 31, 1993, with the use of MeSH terms "depression, involut...

  10. Pregnancy outcome in women with polycystic ovary syndrome

    Directory of Open Access Journals (Sweden)

    Nivedhitha V. S.

    2015-08-01

    Full Text Available Background: To compare the pregnancy outcome in polycystic ovary syndrome (PCOS women with normal women and to study the incidence of pregnancy complications like spontaneous abortions, preterm labour, gestational diabetes, gestational hypertension, preeclampsia, pregnancy and neonatal outcome in women with PCOS. Methods: Prospective comparative study done on 160 pregnant women to compare the pregnancy outcome in PCOS and normal women. All patients were subjected to detailed history, general and obstetric examination, antenatal investigations, routine dating scan, glucose challenge test at 24 to 28 weeks in study and control groups, blood pressure recording and urine for proteinuria after 20 weeks to evaluate preeclampsia. After delivery, birth weight and apgar score at 1 and 5 minutes are recorded. Body mass index is calculated and pregnancy outcome studied and compared. Results: Out of 80 pregnancies with PCOS, 8 had spontaneous abortions, 11 Gestational diabetes mellitus (GDM, 9 gestational hypertension, 5 preeclampsia and 3 had preterm labour. GDM is 3 times, Spontaneous Abortion is 4.33 times, gestational hypertension is 3.25 times and neonatal intensive care unit (NICU admission is 3.25 times more in PCOD women. Conclusions: Pregnancy complications like spontaneous abortions, gestational diabetes, gestational hypertension and neonatal complications requiring NICU admissions are significantly higher in pregnant women with PCOD. Pregnant women with PCOD may become a high risk pregnancy at any time. Hence proper antenatal care is mandatory to prevent and treat the complications. [Int J Reprod Contracept Obstet Gynecol 2015; 4(4.000: 1169-1175

  11. Analysis of pregnancy and infant health outcomes among women in the National Smallpox Vaccine in Pregnancy Registry who received Anthrax Vaccine Adsorbed.

    Science.gov (United States)

    Conlin, Ava Marie S; Bukowinski, Anna T; Gumbs, Gia R

    2015-08-26

    The National Smallpox Vaccine in Pregnancy Registry (NSVIPR) actively follows women inadvertently vaccinated with smallpox vaccine during or shortly before pregnancy to evaluate their reproductive health outcomes. Approximately 65% of NSVIPR participants also inadvertently received Anthrax Vaccine Adsorbed (AVA) while pregnant, providing a ready opportunity to evaluate pregnancy and infant health outcomes among these women. AVA-exposed pregnancies were ascertained using NSVIPR and electronic healthcare data. Rates of pregnancy loss and infant health outcomes, including major birth defects, were compared between AVA-exposed and AVA-unexposed pregnancies. Analyses included AVA-exposed and AVA-unexposed pregnant women who also received smallpox vaccine 28 days prior to or during pregnancy. Rates of adverse outcomes among the AVA-exposed group were similar to or lower than expected when compared with published reference rates and the AVA-unexposed population. The findings provide reassurance of the safety of AVA when inadvertently received by a relatively young and healthy population during pregnancy. PMID:26049005

  12. Maternal body mass index in outcome of pregnancy

    Directory of Open Access Journals (Sweden)

    G. Sharmila

    2016-08-01

    Conclusions: Maternal BMI shows strong associations with pregnancy complications and outcome. Both maternal and fetal complications are increased. [Int J Reprod Contracept Obstet Gynecol 2016; 5(8.000: 2652-2656

  13. Exacerbations of asthma during pregnancy: Impact on pregnancy complications and outcome.

    Science.gov (United States)

    Ali, Z; Hansen, A V; Ulrik, C S

    2016-05-01

    Asthma is common among pregnant women, and the incidence of asthma exacerbations during pregnancy is high. This literature review provides an overview of the impact of exacerbations of asthma during pregnancy on pregnancy-related complications. The majority of published retrospective studies reveal that asthma exacerbations during pregnancy increase the risk of pre-eclampsia, gestational diabetes, placental abruption and placenta praevia. Furthermore, these women also have higher risk for breech presentation, haemorrhage, pulmonary embolism, caesarean delivery, maternal admission to the intensive care unit and longer postpartum hospital stay. Asthma has been associated with increased risk of intrauterine growth retardation, small-for-gestational age, low birth weight, infant hypoglycaemia and preterm birth, but more recent prospective studies have not revealed significant associations with regard to these outcomes. In conclusion, asthma exacerbations during pregnancy are associated with complications of pregnancy, labour and delivery. Prevention of exacerbations is essential to reduce the risk of complications and poor outcome. PMID:26467747

  14. Relationship between glycated hemoglobin levels and adverse pregnancy outcomes in puerperas with gestational diabetes mellitus%妊娠期糖尿病患者糖化血红蛋白水平与不良妊娠结局的关系

    Institute of Scientific and Technical Information of China (English)

    王海霞

    2015-01-01

    目的:探究确诊妊娠期糖尿病的患者血清糖化血红蛋白(HbA1c)水平与不良妊娠结局的关系。方法以2013年11月~2014年12月中山市东凤人民医院(以下简称“我院”)妇产科收治的80例确诊妊娠期糖尿病的患者为研究组,选取我院同期非妊娠期糖尿病的正常孕妇80例为对照组,对研究组进行严格血糖控制,并对患者进行追踪研究至终止妊娠。检测研究组患者的HbA1c水平,比较不同HbA1c水平患者早产、羊水过多、巨大儿及胎儿宫内窘迫等发生情况。结果研究组早产、羊水过多、巨大儿及胎儿宫内窘迫发生率均高于对照组,差异均有统计学意义(P6.0%~6.5%、>6.5%~7.0%、>7.0%)而显著增加,不同HbA1c水平患者其不良妊娠结局的发生率比较,差异均有统计学意义(P0.05),且胎膜早破发生率随HbA1c水平升高无明显增加(P>0.05)。结论HbA1c是妊娠期糖尿病的重要临床评价指标,临床应加强HbA1c的检测以便更好地预判妊娠结局,确保母婴平安。%Objective To study the relationship between glycated hemoglobin (HbA1c) levels in gestational diabetes mel-litus (GDM) and obstetric adverse pregnancy outcomes. Methods 80 cases who were diagnosed with GDM in Depart-ment of Obstetrics and Gynecology of Dongfeng People's Hospital of Zhongshan City (“our hospital”for short) from Novem-ber 2013 to December 2014 were treated as study group, and another 80 pregnant women without GDM during the same period admitted in our hospital were chosen as control group. Study group was on glycemic control strictly, and then all cases were followed up until the termination of pregnancy. HbA1c of pregnant women in the study group were detected, the incidence of obstetric adverse symptoms (premature birth, polyhydramnios, fetal distress, macrosomia and premature rupture of membrane) of pregnant women with different levels of HbA1c was compared. Results The inci-dence of

  15. Adverse Effects in the Pharmacologic Management of Bipolar Disorder During Pregnancy.

    Science.gov (United States)

    Hogan, Charlotte S; Freeman, Marlene P

    2016-09-01

    Management of bipolar disorder during pregnancy often involves medications with potential adverse effects, including risks to the mother and fetus. Although some specifics are known, many medications continue to have incompletely characterized reproductive safety profiles. Women with bipolar disorder who are planning pregnancy face challenging decisions about their treatment; careful risk-benefit discussions are necessary. With the goal of further informing these discussions, this article reviews the data currently available regarding medication safety in the management of bipolar disorder during pregnancy, with specific attention to lithium, valproic acid, lamotrigine, carbamazepine, and antipsychotic medications. PMID:27514299

  16. COMPLICATIONS AND OUTCOMES OF PREGNANCY IN GESTATIONAL DIABETES MELLITUS

    OpenAIRE

    I A Bondar'; A S Malysheva

    2015-01-01

    The aim of the study was to analyze the complications and examine the outcomes of pregnancy in women with compensated gestational diabetes mellitus.We studied outcomes and complications of pregnancy in 50 pregnant women with gestational diabetes mellitus, the effects of gestational diabetes on the fetus.The average age of pregnant women was (33.7 ± 5.7) years. The incidence of gestoses and placental insufficiency in compensated gestational diabetes mellitus was 84%, polyhydramnios – 36%, the ...

  17. A RARE INTERESTING CASE OF SPONTANEOUS HETEROTOPIC PREGNANCY OPERATED FOR ECTOPIC PREGNANCY AND CONSERVATION OF INTRAUTERINE PREGNANCY TO FULL TERM WITH GOOD FETOMATERNAL OUTCOME

    Directory of Open Access Journals (Sweden)

    Pradnya

    2015-07-01

    Full Text Available A rare case of heterotopic pregnancy was diagnosed at earlier gestation in which salpingectomy was performed for ectopic pregnancy and intra uterine pregnancy was continued till term with good feto maternal outcome.

  18. Anencephaly: Do the Pregnancy and Maternal Characteristics Impact the Pregnancy Outcome?

    OpenAIRE

    Isabela Nelly Machado; Sílvia Dante Martinez; Ricardo Barini

    2012-01-01

    Objective. To describe the characteristics of obstetric and perinatal outcome of a group of pregnancies complicated by an anencephalic fetus. Methods. Observational study including anencephalic fetuses, divided into groups according to the evolution of pregnancy: elective termination of pregnancy ETP; stillbirths (SBs); live births (LBs), and loss of follow-up. After a univariate description of the sample, some variables were compared using statistical tests. Results. 180 anencephalic fetuses...

  19. Trauma during pregnancy in a Nigerian setting: Patterns of presentation and pregnancy outcome

    OpenAIRE

    Njoku, Omoke I; Joannes, Umeora O U; Christian, Madubueze C; Azubike, Onyebuchi K

    2013-01-01

    Context: Trauma is an important health concern during pregnancy in developing nations though it is under-reported. Aims: The aim of this study was to determine the patterns of presentation and feto- maternal outcomes of trauma during pregnancy in a Nigerian setting. Settings and Design: A hospital-based retrospective analysis of database of entire patient population who presented in Ebonyi State University Teaching Hospital, Abakaliki, with trauma during pregnancy. Materials and Methods: The ...

  20. Maternal Diabetes in Pregnancy: Early and Long-Term Outcomes on the Offspring and the Concept of “Metabolic Memory”

    OpenAIRE

    Kabirou Moutairou; Akadiri Yessoufou

    2011-01-01

    The adverse outcomes on the offspring from maternal diabetes in pregnancy are substantially documented. In this paper, we report main knowledge on impacts of maternal diabetes on early and long-term health of the offspring, with specific comments on maternal obesity. The main adverse outcome on progenies from pregnancy complicated with maternal diabetes appears to be macrosomia, as it is commonly known that intrauterine exposure to hyperglycemia increases the risk and programs the offspring t...

  1. Pregnancy and pregnancy outcome in hepatitis C type 1b.

    LENUS (Irish Health Repository)

    Jabeen, T

    2012-02-03

    A large cohort of rhesus-negative women in Ireland were inadvertently infected with hepatitis C virus following exposure to contaminated anti-D immunoglobulin in 1977-8. This major iatrogenic episode was discovered in 1994. We studied 36 women who had been infected after their first pregnancy, and compared them to an age- and parity-matched control group of rhesus-positive women. The presence of hepatitis C antibody was confirmed in all 36 by enzyme-linked immunosorbent assay and by recombinant immunoblot assay, while 26 (72%) of the cohort were HCV-RNA-positive (type 1b) on PCR testing. In the 20 years post-infection, all members of the study group had at least one pregnancy, and mean parity was 3.5. They had a total of 100 pregnancies and 85 of these went to term. There were four premature births, one being a twin pregnancy, and 11 spontaneous miscarriages. One miscarriage occurred in the pregnancy following HCV infection. There were two neonatal deaths due to severe congenital abnormalities in the PCR-positive women. Of the children born to HCV-RNA positive mothers, only one (2.3%) tested positive for the virus. Significant portal fibrosis on liver biopsy was confined to HCV-RNA-positive mothers apart from one single exception in the antibody-positive HCV-RNA-negative group. Comparison with the control group showed no increase in spontaneous miscarriage rate, and no significant difference in obstetric complications; birth weights were similar for the two groups.

  2. The effect of iodine supplementation in pregnancy on early childhood neurodevelopment and clinical outcomes: results of an aborted randomised placebo-controlled trial

    OpenAIRE

    Zhou, Shao J.; Sheila A. Skeaff; Ryan, Philip; Doyle, Lex W; Anderson, Peter J.; Kornman, Louise; McPhee, Andrew J; Yelland, Lisa N; Makrides, Maria

    2015-01-01

    Background Concern that mild iodine deficiency in pregnancy may adversely affect neurodevelopment of offspring has led to recommendations for iodine supplementation in the absence of evidence from randomised controlled trials. The primary objective of the study was to investigate the effect of iodine supplementation during pregnancy on childhood neurodevelopment. Secondary outcomes included pregnancy outcomes, maternal thyroid function and general health. Methods Women with a singleton pregna...

  3. Does the minor trauma during pregnancy have any effect on perinatal outcome?

    Directory of Open Access Journals (Sweden)

    Neslihan Yerebasmaz

    2015-12-01

    Full Text Available Objective: Women having major trauma during pregnancy are at increased risk for both maternal and fetal morbidity. However, the association between minor trauma and adverse perinatal outcomes is still unknown. Therefore, we aimed to analyze the incidence of minor trauma in pregnancy and effect on the outcomes of pregnancy. Methods: The data of patients, who were admitted to the emergency service of Etlik Zübeyde Hanım Women’s Health Training and Research Hospital between January 2013 and December 2014, were evaluated. A total of 283 patients (0.3%, who had minor trauma during pregnancy, were included in the study. Demographic and obstetric data were analyzed with descriptive statistics. Additionally, antenatal complications and pregnancy outcomes were evaluated in 188 patients, who were followed during pregnancy and delivered their babies at our hospital Results: During the study period, of 105,727 women who were admitted to the emergency service of our hospital, 283 (0.3% had minor trauma during pregnancy. The causes of minor trauma, in order of frequency, included home accidents (81.3%, domestic violence (9.9% and traffic accidents (8.8%. Preterm delivery has been the most frequently antenatal complication observed in these patients (15.4%. Conclusion: Home accidents and domestic violence are the most common causes of minor trauma during pregnancy, and the patients are particularly at risk during the second trimester. The patients must be cautioned regarding the risk of preterm delivery and advised to attend regular pregnancy follow-up visits due to the fact that these patients have a higher risk of preterm delivery.

  4. The effects of maternal exercise on early pregnancy outcome.

    Science.gov (United States)

    Clapp, J F

    1989-12-01

    This study was designed to test the hypothesis that vigorous aerobic exercise during both the periconceptional period and early pregnancy increases the incidence of abnormal early pregnancy outcome. Exercise performance was prospectively monitored before and during pregnancy in 47 recreational runners, 40 aerobic dancers, and 28 physically active, fit controls. Pregnancy was diagnosed by an early test for beta-subunit human chorionic gonadotropin and viability was confirmed by ultrasonography at 40 days' conceptional age. Spontaneous abortion occurred in 19% of the pregnancies. The incidence was 17% in the runners, 18% in the aerobic dancers, and 25% in the controls. At term, one congenital abnormality was detected in each of the three groups. Late pregnancy events, potentially related to abnormalities of placentation, were limited to two cases of mild pregnancy-induced hypertension. We conclude that, in physically fit women, continuation of these types of aerobic activity at intensities between 50% and 85% of maximum during the periconceptional period and early pregnancy does not appreciably alter early pregnancy outcome. PMID:2603898

  5. Teenage pregnancy outcomes in a rural area of South India: A prospective study

    Directory of Open Access Journals (Sweden)

    Chandrika R Doddihal

    2015-07-01

    Full Text Available Context: Teenage pregnancy is dangerous for the mother, child and the community, and teenage girls are twice as likely to die of pregnancy and childbirth related complications as opposed to older women. Aims: (1 To know the outcomes of teenage pregnancies. (2 To study the sociodemographic profile of teenage pregnancies. Study Design: A longitudinal study. Study Setting: Vantamuri Primary Health Centre-Rural field practice area of Jawaharlal Nehru Medical College Belgaum. Materials and Methods: A total of 144 teenage pregnant women, aged between 15 and 19 years were selected and information on sociodemographic variables, and pregnancy outcome was recorded in 3 visits. Statistical Analysis: Percentages and Ratios, Chi-square test to find an association between various study variables. Results: In the current study majority, 66.0% participants were of 18-19 years age, 90.3% adolescents were housewives and 53.5% had studied high school and beyond. The mean age of marriage was 16 years, and 79.2% of them were primigravidae. Traditional practice (68.8% was the commonest reason for early marriage, and family pressure (46.5% was the often cited reason for early pregnancy. Live births were noted in 93.1% teenagers, stillbirths and abortions were present in 4.8% and 2.1% teens respectively. Age and previous pregnancies affected the outcome. Conclusion: The mean age of participants was 17.8 years, and that of marriage was 16 years and this occurrence of pregnancy in teenage leads to adverse outcomes. Thus, periodic Information, Education and Communication activities have to be held, and child marriage act has to be strictly enforced to improve their health.

  6. Borderline gestational diabetes mellitus and pregnancy outcomes

    Directory of Open Access Journals (Sweden)

    Crowther Caroline A

    2008-07-01

    Full Text Available Abstract Background The impact of borderline gestational diabetes mellitus (BGDM, defined as a positive oral glucose challenge test (OGCT and normal oral glucose tolerance test (OGTT, on maternal and infant health is unclear. We assessed maternal and infant health outcomes in women with BGDM and compared these to women who had a normal OGCT screen for gestational diabetes. Methods We compared demographic, obstetric and neonatal outcomes between women participating in the Australian Collaborative Trial of Supplements with antioxidants Vitamin C and Vitamin E to pregnant women for the prevention of pre-eclampsia (ACTS who had BGDM and who screened negative on OGCT. Results Women who had BGDM were older (mean difference 1.3 years, [95% confidence interval (CI 0.3, 2.2], p = 0.01 and more likely to be obese (27.1% vs 14.1%, relative risk (RR 1.92, [95% CI 1.41, 2.62], p Infants born to BGDM mothers were more likely to be born preterm (10.7% vs 6.4%, RR 1.68, [95% CI 1.00, 2.80], p = 0.05, have macrosomia (birthweight ≥4.5 kg (4.3% vs 1.7%, RR 2.53, [95% CI 1.06, 6.03], p = 0.04, be admitted to the neonatal intensive care unit (NICU (6.5% vs 3.0%, RR 2.18, [95% CI 1.09, 4.36], p = 0.03 or the neonatal nursery (40.3% vs 28.4%, RR 1.42, [95% CI 1.14, 1.76], p = 0.002, and have a longer hospital stay (p = 0.001. More infants in the BGDM group had Sarnat stage 2 or 3 neonatal encephalopathy (12.9% vs 7.8%, RR 1.65, [95% CI 1.04, 2.63], p = 0.03. Conclusion Women with BGDM and their infants had an increased risk of adverse health outcomes compared with women with a negative OGCT. Intervention strategies to reduce the risks for these women and their infants need evaluation. Trial registration Current Controlled Trials ISRCTN00416244

  7. OBSTETRICS AND PSYCHOSOCIAL OUTCOME OF TEENAGE PREGNANCY

    Directory of Open Access Journals (Sweden)

    Seetesh

    2013-11-01

    Full Text Available Teenage pregnancy is defined as pregnancies which occur in a female below the age of 20 i.e. when the pregnancy ends. A female can become pregnant as early as two weeks before menarche, although rare, but usually occurs after menarche. In healthy, well - nourished girls, menarche normally takes place around the ages 12 or 13. A number of personal and social factors are responsible for the onset of biological fertility in a teenage. Teenage pregnanc y rates vary between countries because of differences in socio - economic status, traditional culture of early marriage, besides levels of sexual activity, general sex education provided and access to affordable contraceptive options. Worldwide, teenage preg nancy rates range from 143 per 1000 in some sub - Saharan African countries to 2.9 per 1000 in South Korea. ( 1(2 The World Health Organization estimates that the risk of death following pregnancy is twice as great for women between 15 and 19 years than for those between the ages of 20 and 24. The maternal mortality rate can be up to five times higher for girls aged between 10 and 14 than for women of about twenty years of age. Illegal abortion also holds many risks for teenage girls in areas such as sub - Saha ran Africa (3 In our country teenage marriages does take place and pregnancy usually occur after marriage, despite a law against early marriage. Teenage pregnancy is considered to be high - risk due to many reasons because during this period a woman is physio logically and psychologically as well not mature. Their body itself is in growing stage. So to support the growth of the foetus exposes them to additional challenges. Complications of pregnancy result in the deaths of an estimated 70,000 teen girls in deve loping countries each year. Complications they develop can be grouped into medical, obstetrical, psychological and social. This chapter will highlight obstetrical, psychological and social impact of the teenage pregnancy

  8. Diabetic pregnancy outcome in Malta the outcome of non-gestational diabetic pregnancies in the Maltese Islands

    OpenAIRE

    Savona-Ventura, Charles; Chircop, Marcelle; Ellul, Alan; Azzopardi, Joseph; Janulova, Lina

    2004-01-01

    Diabetes in pregnancy is generally associated with a higher morbidity and mortality for both the mother and child. Objective: The study aims to assess the outcome indicators of diabetic pregnant women and compare these to the remaining obstetric population. Research Design and Methods: Women diagnosed as suffering from diabetes prior to their pregnancy were identified (n = 44) and their outcome indicators were compared to the parameters of the women with a presumed normal carbohydrate metabol...

  9. RISK FACTOR PROFILES OF ADVERSE NEUROMOTOR OUTCOME IN INFANTS

    Directory of Open Access Journals (Sweden)

    Farin SOLEIMANI

    2011-02-01

    Full Text Available ObjectiveAssessment of risk predictors for adverse neurodevelopmental outcome at 1 year of age in term and near-term infants.Material & MethodsThis case-control study was a representative sample of infants from different health-care centers of north and east of Tehran. The association betweenrisk factors and delayed motor development (developmental quotient below 70 indicating a significant delay was analyzed using correlating risk factors;including the perinatal and neonatal data to the developmental status. The case group consisted of 143 infants whose DQ score was less than 70 and thecontrol group consisted of 140 infants who had a DQ score of more than 70.ResultsNeonatal seizures, Apgar score less than 3 after 5 minutes of birth (OR = 2.87 [95% CI; 1.68, 4.92], low birth weight (OR = 5.86 [95% CI; 3.07, 11.18], pretermdelivery (OR =6.17 [95% CI; 3.04, 12.52], Premature rupture of membranes (PROM>24 hours (OR = 6.18[95% CI; 2.07, 18.51] and hyperbilirubinemialeading to phototherapy or exchange transfusion (OR =3.75 [95% CI; 2.12, 6.65] were associated with an increased risk for neuromotor delay on developmentalexamination at 1 year.ConclusionThis study identified distinct risk factors for an adverse outcome in infants. In this environment, perinatal risk predictors are most important.Keywords: Neurodevelopmental outcome, perinatal period, infant, risk factor.

  10. Violent crime exposure classification and adverse birth outcomes: a geographically-defined cohort study

    Directory of Open Access Journals (Sweden)

    Herring Amy

    2006-05-01

    Full Text Available Abstract Background Area-level socioeconomic disparities have long been associated with adverse pregnancy outcomes. Crime is an important element of the neighborhood environment inadequately investigated in the reproductive and public health literature. When crime has been used in research, it has been variably defined, resulting in non-comparable associations across studies. Methods Using geocoded linked birth record, crime and census data in multilevel models, this paper explored the relevance of four spatial violent crime exposures: two proximal violent crime categorizations (count of violent crime within a one-half mile radius of maternal residence and distance from maternal residence to nearest violent crime and two area-level crime categorizations (count of violent crimes within a block group and block group rate of violent crimes for adverse birth events among women in living in the city of Raleigh NC crime report area in 1999–2001. Models were adjusted for maternal age and education and area-level deprivation. Results In black and white non-Hispanic race-stratified models, crime characterized as a proximal exposure was not able to distinguish between women experiencing adverse and women experiencing normal birth outcomes. Violent crime characterized as a neighborhood attribute was positively associated with preterm birth and low birth weight among non-Hispanic white and black women. No statistically significant interaction between area-deprivation and violent crime category was observed. Conclusion Crime is variably categorized in the literature, with little rationale provided for crime type or categorization employed. This research represents the first time multiple crime categorizations have been directly compared in association with health outcomes. Finding an effect of area-level violent crime suggests crime may best be characterized as a neighborhood attribute with important implication for adverse birth outcomes.

  11. Chemical respiratory allergy: Reverse engineering an adverse outcome pathway

    International Nuclear Information System (INIS)

    Allergic sensitisation of the respiratory tract by chemicals is associated with rhinitis and asthma and remains an important occupational health issue. Although less than 80 chemicals have been confirmed as respiratory allergens the adverse health effects can be serious, and in rare instances can be fatal, and there are, in addition, related socioeconomic issues. The challenges that chemical respiratory allergy pose for toxicologists are substantial. No validated methods are available for hazard identification and characterisation, and this is due in large part to the fact that there remains considerable uncertainty and debate about the mechanisms through which sensitisation of the respiratory tract is acquired. Despite that uncertainty, there is a need to establish some common understanding of the key events and processes that are involved in respiratory sensitisation to chemicals and that might in turn provide the foundations for novel approaches to safety assessment. In recent years the concept of adverse outcome pathways (AOP) has gained some considerable interest among the toxicology community as a basis for outlining the key steps leading to an adverse health outcome, while also providing a framework for focusing future research, and for developing alternative paradigms for hazard characterisation. Here we explore application of the same general principles to an examination of the induction by chemicals of respiratory sensitisation. In this instance, however, we have chosen to adopt a reverse engineering approach and to model a possible AOP for chemical respiratory allergy working backwards from the elicitation of adverse health effects to the cellular and molecular mechanisms that are implicated in the acquisition of sensitisation

  12. Perfluorinated compounds in umbilical cord blood and adverse birth outcomes.

    Directory of Open Access Journals (Sweden)

    Mei-Huei Chen

    Full Text Available BACKGROUND: Previous animal studies have shown that perfluorinated compounds (PFCs have adverse impacts on birth outcomes, but the results have been inconclusive in humans. We investigated associations between prenatal exposure to perfluorooctanoic acid (PFOA, perfluorooctyl sulfonate (PFOS, perfluorononanoic acid (PFNA, and perfluoroundecanoic acid (PFUA and birth outcomes. METHODS: In total, 429 mother-infant pairs were recruited from the Taiwan Birth Panel Study (TBPS. Demographic data were obtained by interviewing mothers using a structured questionnaire and birth outcomes were extracted from medical records. Cord blood was collected for PFOA, PFOS, PFNA, and PFUA analysis by ultra-high-performance liquid chromatography/tandem mass spectrometry. RESULTS: The geometric mean (standard deviation levels of PFOA, PFOS, PFNA, and PFUA in cord blood plasma were 1.84 (2.23, 5.94 (1.95, 2.36(4.74, and 10.26 (3.07 ng/mL, respectively. Only PFOS levels were found to be inversely associated with gestational age, birth weight, and head circumference [per ln unit: adjusted β (95% confidence interval, CI = -0.37 (-0.60, -0.13 wks, -110.2 (-176.0, -44.5 gm and -0.25 (-0.46, -0.05 cm]. Additionally, the odds ratio of preterm birth, low birth weight, and small for gestational age increased with PFOS exposure [per ln unit: adjusted odds ratio (OR (95%CI = 2.45 (1.47, 4.08, 2.61(0.85, 8.03 and 2.27 (1.25, 4.15]. When PFOS levels were divided into quartiles, a dose-response relation was observed. However, PFOA, PFNA, and PFUA were not observed to have any convincing impact on birth outcomes. CONCLUSIONS: An adverse dose-dependent association was observed between prenatal PFOS exposure and birth outcomes. However, no associations were found for the other examined PFCs.

  13. STUDY OF OBSTETRIC COMPLICATIONS & OUTCOME OF TWIN PREGNANCY

    Directory of Open Access Journals (Sweden)

    Swati

    2014-10-01

    Full Text Available : INTRODUCTION: Twin pregnancy is a rare phenomenon and significantly related to increased maternal & fetal morbidity and mortality as compared to singleton pregnancy. It is important that every physician must know the complications related to twin pregnancy and how to manage these complications. DESIGN: Prospective observational study AIMS AND OBJECTIVE: (1 To study incidence of various obstetric complications in twin pregnancy (2 To study outcome of twin pregnancy in terms of average duration of gestation, mode of delivery & neonatal outcome. METHODS: 59 Patients with sonographically confirmed twin pregnancy attending ante-natal care outpatient department (ANC OPD & labor room at a tertiary care hospital in our Unit in specified period of 18 months as mentioned above were enrolled in this study and followed till delivery and thereafter in the neonatal period. RESULTS: In this study twin pregnancies were slightly more in multigravida. The rate of preterm delivery was 77.9%.PIH & Anaemia was more common in primigravida. Monochorionic twins had more complications than dichorionic twins. NICU admission rate in this study was 23.6%, perinatal mortality rate was 16.9% and neonatal mortality rate was 12.2%. CONCLUSION: Twinning in pregnancy is a high risk factor which can cause various maternal as well fetal complications. Prompt ANC care and timely intervention is required to avoid these complications.

  14. RISK FACTOR PROFILES OF ADVERSE NEUROMOTOR OUTCOME IN INFANTS

    Directory of Open Access Journals (Sweden)

    Farin Soleimani MD

    2010-12-01

    Full Text Available ObjectiveAssessment of risk predictors for adverse neurodevelopmental outcome at 1 year of age in term and near-term infants.Material & MethodsThis case-control study was a representative sample of infants from different health-care centers of north and east of Tehran. The association betweenrisk factors and delayed motor development (developmental quotient below 70 indicating a significant delay was analyzed using correlating risk factors;including the perinatal and neonatal data to the developmental status. The case group consisted of 143 infants whose DQ score was less than 70 and thecontrol group consisted of 140 infants who had a DQ score of more than 70.ResultsNeonatal seizures, Apgar score less than 3 after 5 minutes of birth (OR = 2.87 [95% CI; 1.68, 4.92], low birth weight (OR = 5.86 [95% CI; 3.07, 11.18], pretermdelivery (OR =6.17 [95% CI; 3.04, 12.52], Premature rupture of membranes (PROM>24 hours (OR = 6.18[95% CI; 2.07, 18.51] and hyperbilirubinemialeading to phototherapy or exchange transfusion (OR =3.75 [95% CI; 2.12, 6.65] were associated with an increased risk for neuromotor delay on developmentalexamination at 1 year.ConclusionThis study identified distinct risk factors for an adverse outcome in infants. In this environment, perinatal risk predictors are most important.

  15. Atlantic Diabetes in Pregnancy (DIP): the prevalence and outcomes of gestational diabetes mellitus using new diagnostic criteria.

    LENUS (Irish Health Repository)

    O'Sullivan, E P

    2012-01-31

    AIMS\\/HYPOTHESIS: New diagnostic criteria for gestational diabetes mellitus (GDM) have recently been published. We wished to evaluate what impact these new criteria would have on GDM prevalence and outcomes in a predominantly European population. METHODS: The Atlantic Diabetes In Pregnancy (DIP) programme performed screening for GDM in 5,500 women with an oral glucose tolerance test at 24-28 weeks. GDM was defined according to the new International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria and compared with previous WHO criteria; maternal and neonatal adverse outcomes were prospectively recorded. RESULTS: Of the participants, 12.4% and 9.4% were diagnosed with GDM using IADPSG and WHO criteria, respectively. IADPSG GDM pregnancies were associated with a statistically significant increased incidence of adverse maternal outcomes (gestational hypertension, polyhydramnios and Caesarean section) and neonatal outcomes (prematurity, large for gestational age, neonatal unit admission, neonatal hypoglycaemia and respiratory distress). The odds ratio for the development of these adverse outcomes remained significant after adjustment for maternal age, body mass index and non-European ethnicity. Those women who were classified as having normal glucose tolerance by WHO criteria but as having GDM by IADPSG criteria also had significant adverse pregnancy outcomes. CONCLUSIONS\\/INTERPRETATION: GDM prevalence is higher when using newer IADPSG, compared with WHO, criteria, and these women and their offspring experience significant adverse pregnancy outcomes. Higher rates of GDM pose a challenge to healthcare systems, but improved screening provides an opportunity to attempt to reduce the associated morbidity for mother and child.

  16. Neurocysticercosis in pregnancy: maternal and fetal outcomes.

    Science.gov (United States)

    D'Cruz, Rebecca F; Ng, Sher M; Dassan, Pooja

    2016-07-01

    Neurocysticercosis (NCC) is a parasitic infection with the larvae of Taenia solium from contaminated pork. It is a leading cause of seizures in the developing world. Symptoms may be secondary to live or degenerating cysts, or previous infection causing calcification or gliosis. Diagnosis is based on clinical presentation, radiological confirmation of intracranial lesions and immunological testing. Management involves symptom control with antiepileptics and antiparasitic agents. Few cases have been described of maternal NCC during pregnancy. We describe a 25-year-old female presenting to a London hospital with secondary generalized seizures. MRI of the brain confirmed a calcified lesion in the right parietal lobe, and she gave a corroborative history of NCC during her childhood in India. She was stabilized initially on antiepileptics, but during her pregnancy presented with breakthrough seizures and radiological evidence of NCC reactivation. She was managed symptomatically with antiepileptics and completed the pregnancy to term with no fetal complications. PMID:27471595

  17. Successful Pregnancy Outcome In Maternal Crigler Najjar Syndrome Type II

    Directory of Open Access Journals (Sweden)

    Shakuntala PN

    2012-10-01

    Full Text Available Estimated incidence of Crigler-Najjar syndrome(CNS is 1 case per 1,000,000 births(1 million. The overall prevalence of CN syndrome is unknown, with only several hundred people reported to have this disease. It is interestingly very rare to encounter a pregnant adult women with congenital jaundice. Pregnancy in CN type II patients is a diagnostic and a therapeutic challenge because of the high risk of bilirubin encephalopathy with serious neurological damage as life-threatening complications for the fetus. To date 8 pregnancy outcome have been reported from 5 women and we report the6 woman with a successful 9 th pregnancy outcome. We have discussed detail history, presentation and management during pregnancy and care of the new born.

  18. Systemic lupus erythematosus: strategies to improve pregnancy outcomes

    OpenAIRE

    Yamamoto Y; Aoki S

    2016-01-01

    Yuriko Yamamoto, Shigeru Aoki Perinatal Center for Maternity and Neonate, Yokohama City University Medical Center, Yokohama, Kanagawa Prefecture, Japan Abstract: Systemic lupus erythematosus (SLE) is a chronic autoimmune inflammatory disease with a high prevalence in females of childbearing age. Thus, reproduction in SLE patients is a major concern for clinicians. In the past, SLE patients were advised to defer pregnancy because of poor pregnancy outcomes and fear of SLE flares during pregn...

  19. Autoimmune diseases in pregnancy: maternal and fetal outcomes

    OpenAIRE

    Pavithra M. Vengetesh; Shripad Hebbar; Lavanya Rai

    2015-01-01

    Background: The aim of this study was to assess the impact of autoimmune connective tissue disorders on the outcomes of pregnancy and the influence of treatment on pregnancy. Methods: Thirty-seven antenatal patients with autoimmune connective tissue diseases, comprising of Systemic Lupus Erythematosus (SLE), primary antiphospholipid antibody syndrome (APS), Mixed Connective Tissue Diseases (MCTD), ankylosing spondylitis and Takayasu arteritis were analysed. Results: Multigravidas con...

  20. Clinical characteristics and outcome of cancer diagnosed during pregnancy

    Science.gov (United States)

    Shim, Min Hee; Mok, Chi-Won; Chang, Kylie Hae-Jin; Sung, Ji-Hee; Oh, Soo-young; Roh, Cheong-Rae; Kim, Jong-Hwa

    2016-01-01

    Objective The aim of this study is to describe the clinical characteristics and outcome of cancer diagnosed during pregnancy. Methods This is a retrospective cohort study of women who were diagnosed with cancer during pregnancy at a tertiary academic hospital between 1995 and 2013. Maternal characteristics, gestational age at diagnosis, and type, stage, symptoms and signs of cancer for each patient were retrieved from the medical records. The cancer treatment, pregnancy management and the subsequent perinatal and maternal outcomes for each cancer were assessed. Results A total of 87 women were diagnosed with cancer during pregnancy (172.6 cases per 100,000 deliveries). The most common cancer was breast cancer (n=20), followed by gastrointestinal (n=17), hematologic (n=13), thyroid (n=11), central nervous system (n=7), cervical (n=7), ovarian (n=5), lung (n=3), and other cancers (n=4). Eighteen (20.7%) patients terminated their pregnancies. In the 69 (79.3%) patients who maintained their pregnancies, one patient miscarried and 34 patients delivered preterm. Of the preterm babies, 24 (70.6%) were admitted to the neonatal intensive care unit and 3 (8.8%) of those expired. The maternal mortality rate was 31.0%, with highest rate seen with lung cancers (66.7%), followed by gastrointestinal (50.0%), central nervous system (50.0%), hematologic (30.8%), breast (25.0%), ovarian (20.0%) cervical (14.3%), and thyroid cancers (0%). Conclusion The clinical characteristics and outcome of cancer during pregnancy were highly variable depending on the type of cancer. However, timely diagnosis and appropriate management of cancer during pregnancy may improve both maternal and neonatal outcome. PMID:26866029

  1. Water aerobics in pregnancy: cardiovascular response, labor and neonatal outcomes

    OpenAIRE

    Braga Angelica F; Cecatti Jose G; Pereira Rosa I; Baciuk Erica P; Cavalcante Sergio R

    2008-01-01

    Abstract Background To evaluate the association between water aerobics, maternal cardiovascular capacity during pregnancy, labor and neonatal outcomes. Methods A randomized, controlled clinical trial was carried out in which 34 pregnant women were allocated to a water aerobics group and 37 to a control group. All women were submitted to submaximal ergometric tests on a treadmill at 19, 25 and 35 weeks of pregnancy and were followed up until delivery. Oxygen consumption (VO2 max), cardiac outp...

  2. Mood stabilisers and pregnancy outcomes: a review

    Directory of Open Access Journals (Sweden)

    Costoloni, Giulia

    2014-10-01

    Full Text Available The purpose of this review is to give useful information to guide clinicians when treating pregnant women affected by bipolar disorder. This review focuses on mood stabilizers including lithium, sodium valproate, carbamazepine, oxcarbazepine, gabapentin, lamotrigine and topiramate. Data have been extracted from a MEDLINE search. Data from prospective, retrospective and case-control studies as well as systematic reviews, meta-analysis and data from Pregnancy Registry were included. Major congenital malformations as well as specific malformations were reported for each drug. Preliminary findings seem to identify lamotrigine as one of the safest antiepileptic drugs to be used in pregnancy. Teratogenity risk of topiramate is still largely unknown and there are not enough studies to draw even preliminary conclusions. Preliminary studies failed to report an increased risk for major congenital malformations among gabapentin or oxcarbazepine exposed pregnancies. Even if raising less concern when compared to valproate, carbamazepine should be avoided for its documented teratogenity risk. Valproate seems to be the worst considering major congenital malformations, specific malformations as well as its detrimental effects on neurodevelopment. On the other hand, lithium might be considered a good option when treating pregnant women affected by bipolar disorder. Given the limited research on mood stabilizers in pregnancy, clinicians need to be very careful when treating child bearing age women. Clinicians have to balance the potential teratogenity risk against that of untreated mental illness considering individual circumstances such as severity of illness and risk of relapse.

  3. [Mood stabilisers and pregnancy outcomes - a review].

    Science.gov (United States)

    Costoloni, Giulia; Pierantozzi, Elisa; Goracci, Arianna; Bolognesi, Simone; Fagiolini, Andrea

    2014-01-01

    The purpose of this review is to give useful information to guide clinicians when treating pregnant women affected by bipolar disorder. This review focuses on mood stabilizers including lithium, sodium valproate, carbamazepine, oxcarbazepine, gabapentin, lamotrigine and topiramate. Data have been extracted from a MEDLINE search. Data from prospective, retrospective and case-control studies as well as systematic reviews, meta-analysis and data from Pregnancy Registry were included. Major congenital malformations as well as specific malformations were reported for each drug. Preliminary findings seem to identify lamotrigine as one ofthe safest antiepileptic drugs to be used in pregnancy. Teratogenity risk oftopiramate is still largely unknown and there are not enough studies to draw even preliminary conclusions. Preliminary studies failed to report an increased risk for major congenital malformations among gabapentin or.oxcarbazepine exposed pregnancies. Even if raising less concern when compared to valproate, carbamazepine should be avoided for its documented teratogenity risk. Valproate seems to be the worst considering major congenital malformations, specific malformations as,well as its detrimental effects on neurodevelopment. On the other hand, lithium might be considered a good option when treating pregnant women affected by bipolar disorder. Given the limited research on mood stabilizers in pregnancy, clinicians need to be very careful when treating child bearing age women. Clinicians have to balance the potential teratogenityrisk against that of untreated mental illness considering individual circumstances such as severity of illness and risk of relapse. PMID:25639010

  4. Pregnancy Outcome In Women with the Polycystic Ovarian Syndrome

    OpenAIRE

    Amita Gupta, Kapila Raina, Tania Kalkkar, Yudhishter Veer

    2009-01-01

    The aim of the study is to compare the pregnancy outcome, especially the prevalence of gestationaldiabetes mellitus in a group of patients with PCOS, with a group of healthy weight matched women.Retrospectively we evaluated the pregnancies of 56 women with PCOS some of who had been treatedfor infertility. These were compared with a group of 56 age and weight matched controls. Incidence ofPregnancy induced hypertension in cases of PCOS was 14.2 % (8/56) , gestational diabetes was 14.2% (8/56) ...

  5. Autoimmune diseases in pregnancy: maternal and fetal outcomes

    Directory of Open Access Journals (Sweden)

    Pavithra M. Vengetesh

    2015-02-01

    Full Text Available Background: The aim of this study was to assess the impact of autoimmune connective tissue disorders on the outcomes of pregnancy and the influence of treatment on pregnancy. Methods: Thirty-seven antenatal patients with autoimmune connective tissue diseases, comprising of Systemic Lupus Erythematosus (SLE, primary antiphospholipid antibody syndrome (APS, Mixed Connective Tissue Diseases (MCTD, ankylosing spondylitis and Takayasu arteritis were analysed. Results: Multigravidas constituted 89.4% and were associated with bad obstetric history. Before diagnosis and treatment, serious maternal complications of eclampsia and thromboembolism were observed in patients with SLE and APS. The live birth rates were 9% and 2.4% respectively in patients with SLE and APS. With appropriate treatment- aspirin, heparin and immunosuppressant, the live birth rates were raised to 70% in SLE and 100% in APS patients. Investigation for autoimmune disease in recurrent pregnancy loss is important. A rare association between MCTD and congenital anomaly - Rhizomelic chondrodysplasia punctata was observed. Preeclampsia, gestational diabetes, fetal growth restriction and preterm labour were the common complications noted. Conclusions: Active disease at onset of pregnancy, presence of Anti-ds DNA antibodies and secondary APS were strong predictors of poor pregnancy outcomes among patients with SLE. Vigilant monitoring during pregnancy is required for favourable outcomes. [Int J Reprod Contracept Obstet Gynecol 2015; 4(1.000: 9-14

  6. The relationship between the neighbourhood environment and adverse birth outcomes.

    Science.gov (United States)

    Farley, Thomas A; Mason, Karen; Rice, Janet; Habel, Joanna D; Scribner, Richard; Cohen, Deborah A

    2006-05-01

    Intrauterine growth retardation and preterm birth are more frequent in African-American women and women of lower socio-economic status, but the reasons for these disparities are not fully understood. The physical and social environments in which these women live may contribute to these disparities. We conducted a multilevel study to explore whether conditions of mothers' neighbourhood of residence contribute to adverse birth outcomes independent of individual-level determinants. We analysed data from 105 111 births in 1015 census tracts in Louisiana during 1997-98, merging it with data from other existing sources on neighbourhood socio-economic status, neighbourhood physical deterioration, and neighbourhood density of retail outlets selling tobacco, alcohol and foods. After controlling for individual-level sociodemographic factors, tract-level median household income was positively associated with both birthweight-for-gestational-age and gestational age at birth. Neighbourhood physical deterioration was associated with these birth outcomes in ecological analyses but only inconsistently associated with them after controlling for individual-level factors. Neither gestational age nor birthweight-for-gestational-age was associated with the neighbourhood density of alcohol outlets, tobacco outlets, fast-food restaurants or grocery supermarkets. We conclude that measures of neighbourhood economic conditions are associated with both fetal growth and the length of gestation independent of individual-level factors, but that readily available measures of neighbourhood retail outlets are not. Additional studies are needed to better understand the nature of environmental influences on birth outcomes. PMID:16629693

  7. Associação entre o estado nutricional pré-gestacional e a predição do risco de intercorrências gestacionais Association between pre-gestational nutritional status and prediction of the risk of adverse pregnancy outcome

    Directory of Open Access Journals (Sweden)

    Patricia de Carvalho Padilha

    2007-10-01

    (OR and a 95% confidence interval (95%CI. RESULTS: frequency of pre-gestational weight deviation (low weight, overweight and obesity was 31.6%. Considering the pre-gestational nutritional status, overweight and obese women presented a lower weight gain than eutrophic and low-weight women (p<0.05. Women with pre-gestational obesity presented a higher risk of developing hypertensive disordens of pregnancy (OR=6.3; 95%CI=1.9-20.5 and those with low pre-gestational weight were more likely to give birth to low birth weigh infants (OR=7.1; 95%CI=1.9-27.5. There was no evidence of the association between pre-gestational nutritional status and the development of anemia, vitamin A deficiency and gestational diabetes. The mean weight gain among overweight and obese pregnant women was significantly lower when compared to eutrophic and low-weight pregnant women (p=0.002, p=0.049, p=0.002, p=0.009. CONCLUSIONS: the high number of women with pre-gestational weight deviation reinforces the importance of a nutritional guidance that favors a good nutritional state and reduces the risks of maternal and newborn adverse outcomes.

  8. Substance use during pregnancy and postnatal outcomes

    DEFF Research Database (Denmark)

    Irner, Tina Birk; Teasdale, Thomas William; Tine, Nielsen;

    2012-01-01

    pregnancy, as well as their background, and to examine the effect substance use has on gestational age, birth weight, and the development of neonatal abstinence syndrome at birth. A sample of 161 pregnant women and their 163 newborn children were included. The results indicate that the children whose...... mothers continued to use substances throughout their pregnancies were born at a lower gestational age (Chi-Square = 15.1(2), P < .01); children exposed to poly-substances in utero were more affected than those exposed to only alcohol and those with no substance exposure. The same children were more...... vulnerable to the development of neonatal abstinence syndrome at birth (Chi-Square = 51.7(2), P < .001). Newborns who were exposed primarily to alcohol in utero were at a significant risk of being born with low birth weight (Chi-Square = 8.8(2), P < .05) compared with those exposed to other types of...

  9. Geographic Distribution of Healthy Resources and Adverse Pregnancy Outcomes.

    Science.gov (United States)

    Young, Christopher; Laurent, Olivier; Chung, Judith H; Wu, Jun

    2016-08-01

    Objective To determine the risk of gestational diabetes (GDM) and preeclampsia associated with various community resources. Methods An ecological study was performed in Los Angeles and Orange counties in California. Fast food restaurants, supermarkets, grocery stores, gyms, health clubs and green space were identified using Google © Maps Extractor and through the Southern California Association of Government. California Birth Certificate data was used to identify cases of GDM and preeclampsia. Unadjusted and adjusted risk ratios were calculated using negative binomial regression. Results There were 9692 cases of GDM and 6288 cases of preeclampsia corresponding to incidences of 2.5 and 1.4 % respectively. The adjusted risk of GDM was reduced in zip codes with greater concentration of grocery stores [relative risk (RR) 0.95, 95 % confidence interval (CI) 0.92-0.99] and supermarkets (RR 0.94, 95 % CI 0.90-0.98). There were no significant relationships between preeclampsia and the concentration of fast food restaurants, grocery store, supermarkets or the amount of green space. Conclusion The distribution of community resources has a significant association with the risk of developing GDM but not preeclampsia. PMID:26994606

  10. Poverty in childhood and adverse health outcomes in adulthood.

    Science.gov (United States)

    Raphael, Dennis

    2011-05-01

    The experience of poverty during childhood is a potent predictor of a variety of adverse health outcomes during middle and late adulthood. Children who live in poverty are more likely as adults than their peers to develop and die earlier from a range of diseases. These effects are especially strong for cardiovascular disease and type II diabetes. Most disturbingly, these effects appear in large part to be biologically embedded such that later improved life circumstances have only a modest ameliorative effect. Considering these findings and the relatively high rates of child poverty in nations such as Canada, UK, and USA, those concerned with improving the health of citizens should focus their attention on advocating for public policy that will reduce the incidence of child poverty. PMID:21398059

  11. Relationship between Daily Physical Activity During Last Month of Pregnancy and Pregnancy Outcome

    OpenAIRE

    Koushkie Jahromi, M; Namavar Jahromi, B; Hojjati, S.

    2011-01-01

    Background Previous researchers have evaluated the influence of physical exercise or physical activity on pregnancy outcome, but the influence of daily physical activities in details including energy expenditure, biomechanical load and exercise before and during pregnancy have remained unclear. This study evaluates the relationship between daily physical activities as a biomechanical load and energy expenditure and physical exercise during household activities with birth weight, type of deliv...

  12. The effect of trombophilia on pregnancy outcome and IVF success.

    Science.gov (United States)

    Goldstajn, Marina Sprem; Kovacević, Daria

    2014-12-01

    Thrombophilia is a group of inherited and acquired coagulation disorders often associated with an increased risk of thrombosis. Over the last decade, inherited thrombophilia is often referred as a possible cause of recurrent miscarriages and in vitro fertilisation (IVF) failure. However, many studies in this area still give conflicting results, so the goal of our study was to determine the effect of thrombophilia on pregnancy outcome and success of IVF. The study included 38 patients with proven gene mutation for thrombophilia and 53patients without mutations. The studied parameters were age, duration of infertility, dose of gonadotropins, duration of stimulation, number of embryo transfer (ET), number of oocytes retrieved, the number of days to ET and the outcome in terms of delivery (full term or premature), ectopic pregnancy or abortion. There was no significant difference between two groups in the number of procedures performed, the number of twin pregnancies, abortions, twin miscarriages, ectopic pregnancies, births and the etiology of infertility. A statistically significant difference was found in the number of pregnancies (p=0.018) and in duration of infertility which was signifi- cantly longer in the group with thrombophilia (pIVF failure has not been proven. Therefore, we strongly recommend the prophylactic use of low molecular weight heparin during pregnancy and screening for the most common mutations in our population, particularly in patients with a history of IVF failure and those with a long duration of infertility. PMID:25842749

  13. Maternal and fetal Outcome of pregnancies complicated by ovarian tumor

    International Nuclear Information System (INIS)

    Introduction: Ovarian tumors when occur, endanger two lives, mother and that of fetus. It becomes a therapeutic challenge to evaluate the necessity of immediate intervention for maternal indication versus delaying therapy for fetal indication. Majority of these cysts are benign and usually are functional cysts, dermoid or cyst adenomas. 2-5% of adnexal masses during pregnancy are true malignant neoplasms. Ovarian cancer being the second most frequent gynaecological cancer complicating pregnancy has an average estimated incidence of 1 in 2500 deliveries. Keeping in view all that, a study was conducted in Fatima Memorial Hospital to see maternal and fetal outcome of pregnancies complicated by ovarian tumors. Objective: To determine the maternal and fetal outcome of pregnancies complicated by ovarian tumors. Study Design: Case series descriptive study. Setting: The study was conducted in obstetrics and gynaecology department of Fatima Memorial Hospital, Lahore. Duration of Study: This study was conducted for one year. Subjects and Method: All 14500 pregnant ladies, who visited antenatal clinic and emergency of Fatima Memorial Hospital Lahore for one year, were considered to sort out pregnancies complicated by a co-existent ovarian mass of > 5 cm. Results: Of all 36 patients, included in current study, 24 had surgical and 12 had conservative management. Obstetric out-come revealed one preterm delivery after conservative management. Surgical intervention resulted in two abortions, two pre-term and twenty term deliveries. In both groups, the ratio of abdominal and vaginal delivery was 1:2 respectively. Fetal outcome revealed only one preterm and one IUGR infant in conservative group while surgically managed group revealed two preterm infants, two IUGR and one infant with septicemia. Conclusion: Surgical intervention is a reasonable approach to deal with cases of ovarian tumors with pregnancy, but conservative management may also have comparable obstetric outcome provided

  14. Maternal nutritional status predicts adverse birth outcomes among HIV-infected rural Ugandan women receiving combination antiretroviral therapy.

    Directory of Open Access Journals (Sweden)

    Sera Young

    Full Text Available Maternal nutritional status is an important predictor of birth outcomes, yet little is known about the nutritional status of HIV-infected pregnant women treated with combination antiretroviral therapy (cART. We therefore examined the relationship between maternal BMI at study enrollment, gestational weight gain (GWG, and hemoglobin concentration (Hb among 166 women initiating cART in rural Uganda.Prospective cohort.HIV-infected, ART-naïve pregnant women were enrolled between 12 and 28 weeks gestation and treated with a protease inhibitor or non-nucleoside reverse transcriptase inhibitor-based combination regimen. Nutritional status was assessed monthly. Neonatal anthropometry was examined at birth. Outcomes were evaluated using multivariate analysis.Mean GWG was 0.17 kg/week, 14.6% of women experienced weight loss during pregnancy, and 44.9% were anemic. Adverse fetal outcomes included low birth weight (LBW (19.6%, preterm delivery (17.7%, fetal death (3.9%, stunting (21.1%, small-for-gestational age (15.1%, and head-sparing growth restriction (26%. No infants were HIV-infected. Gaining <0.1 kg/week was associated with LBW, preterm delivery, and a composite adverse obstetric/fetal outcome. Maternal weight at 7 months gestation predicted LBW. For each g/dL higher mean Hb, the odds of small-for-gestational age decreased by 52%.In our cohort of HIV-infected women initiating cART during pregnancy, grossly inadequate GWG was common. Infants whose mothers gained <0.1 kg/week were at increased risk for LBW, preterm delivery, and composite adverse birth outcomes. cART by itself may not be sufficient for decreasing the burden of adverse birth outcomes among HIV-infected women.Clinicaltrials.gov NCT00993031.

  15. Impact of Different Treatment Approaches on Pregnancy Outcomes in 99 Women Treated for Hodgkin Lymphoma

    Energy Technology Data Exchange (ETDEWEB)

    De Sanctis, Vitaliana, E-mail: vitaliana.desanctis@uniroma1.it [Department of Radiotherapy, University ' Sapienza' , Rome (Italy); Filippone, Francesco Romeo [Department of Radiotherapy, University ' Sapienza' , Rome (Italy); Alfo, Marco [Statistics, Probability and Applied Statistics, University ' Sapienza' , Rome (Italy); Muni, Roberta [Department of Radiotherapy, University ' Sapienza' , Rome (Italy); Cavalieri, Elena; Pulsoni, Alessandro; Annechini, Giorgia [Department of Hematology, University ' Sapienza' , Rome (Italy); Valeriani, Maurizio; Osti, Mattia Falchetto; Minniti, Giuseppe; Enrici, Riccardo Maurizi [Department of Radiotherapy, University ' Sapienza' , Rome (Italy)

    2012-11-01

    Purpose: The aim of this study was to evaluate the pregnancy outcomes in women with Hodgkin lymphoma (HL) diagnosis, treated between 1972 and 1999 at Department of Radiotherapy and Hematology of University 'Sapienza' of Roma. Methods and Materials: We retrospectively studied 99 female patients that conceived after treatment for HL. Fifty-nine (59%) were treated with chemotherapy and radiotherapy, 32 (32%) with radiotherapy alone as supradiaphragmatic or as infradiaphragmatic and 8 (8%) patients with chemotherapy alone. Results: Ninety-nine patients reported 145 pregnancies. We observed 132 deliveries (2 of them twin births) after a median of 55 months (range, 14-278 months) from the end of therapy. Twelve women (12%) experienced 13 miscarriages after a median of 50 months (range, 13-120) from the end of therapy. We recorded 9/132 (7%) premature births and 3/134 babies (2%) were underweight at the time of birth. We recorded 2 cases of congenital malformations. No statistical differences were recorded when adverse pregnancy outcomes were analyzed with respect to chemotherapy alone, radiotherapy alone, or combined therapy. Conclusions: No significant associations between pregnancy outcomes and therapeutic approaches were found. In particular, the infradiaphragmatic radiotherapy showed no statistical association with miscarriages, premature birth, and low birth weight at term when compared with other therapeutic approaches.

  16. Impact of Different Treatment Approaches on Pregnancy Outcomes in 99 Women Treated for Hodgkin Lymphoma

    International Nuclear Information System (INIS)

    Purpose: The aim of this study was to evaluate the pregnancy outcomes in women with Hodgkin lymphoma (HL) diagnosis, treated between 1972 and 1999 at Department of Radiotherapy and Hematology of University “Sapienza” of Roma. Methods and Materials: We retrospectively studied 99 female patients that conceived after treatment for HL. Fifty-nine (59%) were treated with chemotherapy and radiotherapy, 32 (32%) with radiotherapy alone as supradiaphragmatic or as infradiaphragmatic and 8 (8%) patients with chemotherapy alone. Results: Ninety-nine patients reported 145 pregnancies. We observed 132 deliveries (2 of them twin births) after a median of 55 months (range, 14–278 months) from the end of therapy. Twelve women (12%) experienced 13 miscarriages after a median of 50 months (range, 13–120) from the end of therapy. We recorded 9/132 (7%) premature births and 3/134 babies (2%) were underweight at the time of birth. We recorded 2 cases of congenital malformations. No statistical differences were recorded when adverse pregnancy outcomes were analyzed with respect to chemotherapy alone, radiotherapy alone, or combined therapy. Conclusions: No significant associations between pregnancy outcomes and therapeutic approaches were found. In particular, the infradiaphragmatic radiotherapy showed no statistical association with miscarriages, premature birth, and low birth weight at term when compared with other therapeutic approaches.

  17. "PREVALENCE, MATERNAL COMPLICATIONS AND BIRTH OUTCOME OF PHYSICAL, SEXUAL AND EMOTIONAL DOMESTIC VIOLENCE DURING PREGNANCY"

    Directory of Open Access Journals (Sweden)

    M. Faramarzi

    2005-05-01

    Full Text Available The prevalence of physical violence during pregnancy varies widely in different societies. To assess the incidence of self-reported physical, emotional and sexual violence in pregnancy and describe the association with maternal complication and birth outcomes, 3275 women who gave birth to live-born infants from October 2002 to November 2003 were assessed for self-reported violence in postpartum units of Obstetrics Department of Babol university of Medical Sciences. Outcome data included maternal antenatal hospitalizations, labor and delivery complications and low birth weights and preterm births. Odds ratios and 95% confidence intervals were calculated to measure the association between violence, maternal morbidity and birth outcomes. The prevalence of physical, sexual and emotional domestic violence was respectively 9.1%, 30.8% and 19.2%. Compared with those not reporting physical, sexual and emotional violence, women who did were more likely to deliver by cesarean and to have abnormal progress of labor, premature rupture of membranes, low birth weight, preterm birth and any hospitalization before delivery. Prevalence of physical, emotional or sexual violence during pregnancy was high and was associated with adverse fetal and maternal conditions. These findings support routine screening for physical, emotional and sexual violence in pregnancy and postpartum period to prevent consequences of domestic violence.

  18. Pregnancy outcome and prepregnancy body mass index in 2459 glucose-tolerant Danish women

    DEFF Research Database (Denmark)

    Jensen, Dorte Møller; Damm, Peter; Sørensen, Bente;

    2003-01-01

    OBJECTIVE: This study was undertaken to investigate the relationship between pregnancy outcome and prepregnancy overweight or obesity in women with a normal glucose tolerance test. STUDY DESIGN: A historical cohort study of 2459 pregnant women systematically examined for gestational diabetes was.......0-29.9 kg/m(2)) and obese women (BMI >or= 30.0 kg/m(2)) compared with women who were of normal weight (BMI 18.5-24.9 kg/m(2)). The frequencies of shoulder dystocia, preterm delivery, and infant morbidity other than macrosomia were not significantly associated with maternal BMI. CONCLUSION: Prepregnancy...... overweight and obesity is associated with adverse pregnancy outcome in glucose-tolerant women....

  19. Early-onset preeclampsia : Constitutional factors and consequences for future pregnancy outcome and cardiovascular health

    OpenAIRE

    van Rijn, B.B.

    2008-01-01

    In this thesis, maternal constitutional factors related to long-term cardiovascular health and subsequent pregnancy outcome in women with early-onset preeclampsia is addressed. Aims of the thesis: To evaluate subsequent pregnancy outcome in women with a first pregnancy complicated by early-onset preeclampsia and to study risk factors for recurrence of preeclampsia and preterm delivery; To evaluate subsequent pregnancy outcome in women with a first pregnancy complicated by intrauterine growth ...

  20. Pregnancy outcomes among African–American patients with systemic lupus erythematosus compared with controls

    OpenAIRE

    Barnado, April; Wheless, Lee; Meyer, Anna K; Gilkeson, Gary S.; Kamen, Diane L.

    2014-01-01

    Objective In a study of Gullah African–Americans, we compared pregnancy outcomes before and after systemic lupus erythematosus (SLE) diagnosis to controls to test whether there is a predisease state that negativelyaffects pregnancy outcomes. Design Cases and controls reporting at least one pregnancy were included. Controls were all Gullah African-American females. We collected demographic, socioeconomic and pregnancy data. We modelled pregnancy outcome associations with case status using mult...

  1. The outcome of Gestational Diabetic pregnancies in the Maltese Islands

    OpenAIRE

    Savona-Ventura, Charles; Chircop, Marcelle; Ellul, Alan; Azzopardi, Joseph; Janulova, Lina

    2004-01-01

    Gestational diabetes is generally associated with a higher morbidity and mortality for both the mother and child. Aims: The study aims to assess the outcome indicators of women suffering gestational diabetes and compare these to the remaining obstetric population. Research Design and Methods: Outcome indicators of women diagnosed during pregnancy as suffering from diabetes (GDM (defined as a 2-hour post-load blood glucose of >=8.6 mmol/l) n=297) were compared to the parameters of women with a...

  2. Relationship of Perfluorooctanoic Acid Exposure to Pregnancy Outcome Based on Birth Records in the Mid-Ohio Valley

    OpenAIRE

    Savitz, David A.; Stein, Cheryl R.; Elston, Beth; Wellenius, Gregory A; Bartell, Scott M; Shin, Hyeong-Moo; Vieira, Veronica M; Fletcher, Tony

    2012-01-01

    Background: Perfluorooctanoic acid (PFOA) is a potential cause of adverse pregnancy outcomes, but previous studies have been limited by low exposures and small study size. Objectives: Using birth certificate information, we examined the relation between estimated PFOA exposure and birth outcomes in an area of West Virginia and Ohio whose drinking water was contaminated by a chemical plant. Methods: Births in the study area from 1990 through 2004 were examined to generate case groups of stillb...

  3. Prenatal lignan exposures, pregnancy urine estrogen profiles and birth outcomes

    International Nuclear Information System (INIS)

    During pregnancy, human exposure to endogenous estrogens and xenoestrogens (such as lignans) may comprehensively impact the gestational maintenance and fetal growth. We measured the concentrations of 5 lignans and the profile of 13 estrogen metabolites (EMs) in the urine samples of 328 pregnant women and examined their associations with birth outcomes. We found significantly positive associations between gestational age and urinary matairesinol (MAT), enterodiol (END) and enterolactone (ENL), as well as 16-hydroxylation pathway EMs. There were consistently positive relationships between END and the 16-hydroxylation pathway EMs. The positive relationships of MAT, END and ENL exposures with the length of gestation were mainly in the low exposure strata of the levels of these EMs. This study reveals that MAT, END and ENL as well as 16-hydroxylation pathway EMs are associated with birth outcomes, and that there are interactive relationships between lignans and 16-hydroxylation pathway EMs with birth outcomes. - Highlights: • We examined relations between prenatal lignan exposures and birth outcomes. • We examined relations between pregnancy urine estrogen profiles and birth outcomes. • MAT, END and ENL are associated with birth outcomes. • 16-hydroxylation pathway EMs are associated with birth outcomes. • There are interactive relationships between ligans and EMs with birth outcomes. - Prenatal lignan exposures and EM levels were interactively related to birth outcomes

  4. Delaying childbearing: effect of age on fecundity and outcome of pregnancy.

    Science.gov (United States)

    van Noord-Zaadstra, B M; Looman, C W; Alsbach, H; Habbema, J D; te Velde, E R; Karbaat, J

    1991-06-01

    This study examined the age of the start of the fall (critical age) in fecundity, the probability of a pregnancy leading to a healthy baby taking into account the age of the women, and, by combining all of the results, the determination of the age-dependent probability of getting a healthy baby. 2 fertility clinics serving a large part of the Netherlands provided the 751 women who fulfilled the selection criteria. In this cohort study of all women who entered a donor insemination program, those who fulfilled the selection criteria were married to azoospermic husbands, were nulliparous, and never received donor insemination previously. Main outcome measures studied were the number of cycles prior to a pregnancy (positive pregnancy result) or the cessation of treatment and the result of the pregnancy (successful outcome). Of 751 women, 555 became pregnant and 461 had healthy babies. The drop in fecundity was estimated to begin at around age 31 (critical age); after 12 cycles, the probability of pregnancy in a woman age 31 was 0.54 compared with 0.74 in a woman age 20-31. After 24 cycles, this difference had decreased (probability of conception 0.75 in women 31 and 0.85 in women age 20-31). The probability of having a healthy baby also decreased, by 3.5% a year after the age of 30. Combining both of these age effects, the chance of a woman age 35 having a healthy baby was about 1.2 that of a woman age 25. After the age of 31, the probability of conception falls rapidly; however, this can be compensated for partly by continuing insemination for more cycles. In addition, the probability of an adverse pregnancy outcome begins to increase at about the same age. PMID:2059713

  5. Clinical audit of foetomaternal outcome in pregnancies with fibroid uterus

    International Nuclear Information System (INIS)

    Background: Leiomyoma, myoma, leiomyoma or fibroids are synonymous terms. They may be present in as many as 1 in 5 women over age 35 years. If pregnancy is associated with fibroids, it leads to multiple complications. Objectives of this study were to evaluate the maternal and foetal outcome in women having pregnancy with fibroids in uterus and the complications associated with fibroids during the pregnancy. Methods: This descriptive study was conducted in the Department of Obstetrics and Gynaecology, Ayub Teaching Hospital Abbottabad from March 2009 to March 2010. Data were collected on proforma regarding demographic variables, obstetrical history, mode of delivery, maternal outcome, maternal complications, and foetal outcome. Mean and standard deviation was calculated for age, period of gestation, and obstetrical history. Frequency and percentages was calculated for booking status, maternal outcome, maternal complications and foetal outcome. Results: Thirty patients were included in this study who had pregnancy with fibroid. Normal delivery was achieved in 14 (46.66%) patients. Eight (26.67%) patients had caesarean section and eight (26.67%) had miscarriages. Seven (23.33%) patients had no complications while 8 (26.67%) had miscarriages, 8 (26.67%) had postpartum haemorrhage, 10 (33.33%) had preterm delivery, and 3 patients had ante-partum haemorrhage. Two (10%) patients had premature rupture off membranes and 1 patient (3.33%) had pain abdomen and technical difficulty during caesarean section. There were 12 (40%) healthy babies. Five (16.67%) babies delivered with morbidity but recovered. There were 4 (13.33%) intrauterine deaths and one early neonatal death. Conclusion: Fibroid in pregnancy, especially multiple intramural fibroids and fibroids larger than 10 Cm, cause miscarriage and preterm labour. (author)

  6. Perinatal outcome in singleton pregnancies complicated with preeclampsia and eclampsia in Ecuador.

    Science.gov (United States)

    Phoa, K Y N; Chedraui, P; Pérez-López, F R; Wendte, J F; Ghiabi, S; Vrijkotte, T; Pinto, P

    2016-07-01

    Preeclampsia in Ecuador is an understudied subject since available epidemiological data are scarce. The aim of this study was to describe perinatal outcomes among singleton pregnancies complicated with preeclampsia and eclampsia in a sample of low-income Ecuadorian women. Pregnant women complicated with preeclampsia (mild and severe) and eclampsia (defined according to criteria of the ACOG) delivering at the Enrique C. Sotomayor Obstetrics and Gynecology Hospital, Guayaquil, Ecuador were surveyed with a structured questionnaire containing maternal (socio-demographic) and neonatal data. Perinatal outcomes were compared according to severity of clinical presentation. A total of 163 women with preeclampsia [mild (23.9%), severe (68.7%) and eclampsia (7.4%)] were surveyed. Perinatal mortality and stillbirth rate was similar among studied groups (mild vs. severe preeclampsia/eclampsia cases). However, severe cases displayed higher rates of adverse perinatal outcomes: lower birth Apgar scores, more preterm births, and more low birth weight and small for gestational age infants. Caesarean-section rate and the number of admissions to intensive or intermediate neonatal care were higher in severe cases. A similar trend was found when analysis excluded preterm gestations. In conclusion, in this specific low-income Ecuadorian population perinatal outcome was adverse in pregnancies complicated with severe preeclampsia/eclampsia. PMID:26790539

  7. Mental health in early pregnancy is associated with pregnancy outcome in women with pregestational diabetes

    DEFF Research Database (Denmark)

    Callesen, N F; Secher, A L; Cramon, P;

    2015-01-01

    AIM: To explore the role of early pregnancy health-related quality of life, anxiety, depression and locus of control for pregnancy outcome in women with pregestational diabetes. METHODS: This was a cohort study of 148 pregnant women with pregestational diabetes (118 with Type 1 diabetes and 30 with...... deliveries. Depression symptoms (Hospital Anxiety and Depression Scale depression score ≥ 8) were more frequent in women with preterm vs. term deliveries (seven (25%) vs. six women (5%); P = 0.003), while levels of anxiety and locus of control were similar in these two groups. No difference in early...... pregnancy scores for health-related quality of life, anxiety, depression and locus of control were seen in women delivering large or appropriate for gestational age infants. CONCLUSIONS: Poor mental quality of life and the presence of depressive symptoms in early pregnancy were associated with preterm...

  8. Drinking water and pregnancy outcome in central North Carolina: source, amount, and trihalomethane levels.

    Science.gov (United States)

    Savitz, D A; Andrews, K W; Pastore, L M

    1995-06-01

    In spite of the recognition of potentially toxic chemicals in chlorinated drinking water, few studies have evaluated reproductive health consequences of such exposure. Using data from a case-control study of miscarriage, preterm delivery, and low birth weight in central North Carolina, we evaluated risk associated with water source, amount, and trihalomethane (THM) concentration. Water source was not related to any of those pregnancy outcomes, but an increasing amount of ingested water was associated with decreased risks of all three outcomes (odds ratios around 1.5 for 0 glasses per day relative to 1-3 glasses per day, falling to 0.8 for 4+ glasses per day). THM concentration and dose (concentration x amount) were not related to pregnancy outcome, with the possible exception of an increased risk of miscarriage in the highest sextile of THM concentration (adjusted odds ratio = 2.8, 95% confidence interval = 1.1-2.7), which was not part of an overall dose-response gradient. These data do not indicate a strong association between chlorination by-products and adverse pregnancy outcome, but given the limited quality of our exposure assessment and the increased miscarriage risk in the highest exposure group, more refined evaluation is warranted. PMID:7556013

  9. Comparison of normal and abnormal cardiotocography with pregnancy outcomes and early neonatal outcomes.

    Science.gov (United States)

    Sultana, Jobaida; Chowdhury, T A; Begum, Kohinoor; Khan, Manir Hossain

    2009-01-01

    Cardiotocography (CTG) is the most commonly used test for antepartum and intrapartum foetal surveillance in the majority hospitals of developed countries. The purpose of this study was to compare the pregnancy outcome and early neonatal outcome among the normal and abnormal CTG groups. In this prospective study, fifty consecutive normal and fifty consecutive abnormal CTG were collected within one hour before delivery from patients who have singleton pregnancy with gestational age >or=32 weeks and having obstetric or medical indication for CTG. In this study, the measure of pregnancy outcomes were mode of delivery, indications of caesarean section, percentage requiring caesarean section for foetal distress, oligohydramnios, meconium stained liquor, small placenta and cord around the neck. Early neonatal outcomes included apgar score, birth weight, admission into neonatal intensive care unit (NICU), duration of stay in NICU and perinatal mortality. There were significant differences between the two groups regarding pregnancy outcomes and early neonatal outcomes. So, CTG is an important test to assess the foetal condition in both antepartum and intrapartum period. The sensitivity of CTG was 87%, specificity was 66%, positive predictive value was 54% and negative predictive value was 92% in the prediction of abnormal outcomes. So, normal CTG is more predictive of normal outcomes than abnormal CTG regarding abnormal outcomes. PMID:19377417

  10. Pregnancy outcome after liver transplantation: a single-center experience of 71 pregnancies in 45 recipients.

    Science.gov (United States)

    Christopher, Vimala; Al-Chalabi, Thawab; Richardson, Paul D; Muiesan, Paolo; Rela, Mohammed; Heaton, Nigel D; O'Grady, John G; Heneghan, Michael A

    2006-07-01

    Infertility is common in women with end-stage liver disease. Successful liver transplant (LT), however, can restore childbearing potential. Controversy exists regarding the most appropriate immunosuppressive regimen and timing of conception following LT. We report the outcomes of a review of all pregnancies occurring following LT at King's College Hospital, London, from 1988 to 2004. Seventy-one pregnancies were recorded in 45 women. Tacrolimus (60%) and cyclosporin A (38%) were the predominant primary immunosuppressive agents used. Median age at conception was 29 years (range, 19-42), with a median time from LT to conception of 40 months (range, 1-111). There were 50 live births, and no maternal or fetal deaths related to pregnancy. There were no graft losses. Median gestation was 37 weeks (range, 24-42) with a median birth weight of 2,690 g (range, 554-4,260). Caesarean section was performed in 40% of pregnancies. Complications included pregnancy-induced hypertension in 20%, preeclampsia in 13%, acute cellular rejection in 17%, and renal impairment in 11%. There was no statistically significant difference in complication rates observed between immunosuppressive groups. Pregnancies occurring within 1-year posttransplant had an increased incidence of prematurity, low birth weight, and acute cellular rejection compared to those occurring later than 1 year. In conclusion, this study confirms that favorable outcomes of pregnancy post-LT can be expected for the majority of patients. However, delaying pregnancy until after 1-year post-LT is advisable, since doing so maybe associated with a lower risk of prematurity. PMID:16799943

  11. Pregnancy and Birth Outcomes Among Primiparae at Very Advanced Maternal Age: At What Price?

    Science.gov (United States)

    Ben-David, Alon; Glasser, Saralee; Schiff, Eyal; Zahav, Aliza Segev; Boyko, Valentina; Lerner-Geva, Liat

    2016-04-01

    Objectives In light of the potential physical and emotional costs to both woman and child, this study was conducted to assess pregnancy complications and birth outcomes in primiparae at very advanced maternal age (VAMA, aged ≥45) compared to younger primiparae. Methods Retrospective cohort study comparing 222 VAMA primiparae and a reference group of 222 primiparae aged 30-35, delivering at Sheba Medical Center from 2008 through 2013.Results VAMA primiparae were more likely than younger primiparae to be single, to have chronic health conditions, and higher rates of gestational diabetes mellitus (GDM), gestational-hypertension (GHTN) and preeclampsia-eclampsia. VAMA primiparae conceived mostly by oocyte donation. They were more likely to be hospitalized during pregnancy, to deliver preterm and by cesarean birth. Infants of VAMA primiparae were at greater risk for low birthweight and Neonatal Intensive Care Unit admission. There were no differences in outcomes between VAMA primiparae with or without preexisting chronic conditions, or between those aged 45-49 and ≥50. In multivariable analysis VAMA was an independent risk factor for GDM, GHTN and preeclamsia-eclampsia, with adjusted odds ratio of 2.38 (95 % CI 1.32, 4.29), 5.80 (95 % CI 2.66, 12.64) and 2.45 (95 % CI 1.03, 5.85); respectively. The effect of age disappeared in multiple pregnancies. Conclusions Primiparity at VAMA holds a significant risk for adverse pregnancy and birth outcomes. The absence of chronic medical conditions or the use of a young oocyte donor does not improve these outcomes. Multiple pregnancies hold additional risk and may diminish the effect of age. Primiparity at an earlier age should be encouraged. PMID:26686195

  12. Risk factors for and perinatal outcomes of major depression during pregnancy: a population-based analysis during 2002–2010 in Finland

    OpenAIRE

    Räisänen, Sari; Lehto, Soili M; Nielsen, Henriette Svarre; Gissler, Mika; Kramer, Michael R.; Heinonen, Seppo

    2014-01-01

    Objectives To identify risk factors for and the consequences (several adverse perinatal outcomes) of physician-diagnosed major depression during pregnancy treated in specialised healthcare. Design A population-based cross-sectional study. Setting Data were gathered from Finnish health registers for 1996–2010. Participants All singleton births (n=511 938) for 2002–2010 in Finland. Primary outcome measures Prevalence, risk factors and consequences of major depression during pregnancy. Results A...

  13. Management and outcome of prolonged pregnancies in Shariati university hospital

    Directory of Open Access Journals (Sweden)

    Eslamian L.

    2008-06-01

    Full Text Available Background: There is dearth of reports from Iran regarding the prevalence of postterm pregnancy and its complications. The present study was conducted to evaluate the prevalence, management and outcome of prolonged pregnancies.Methods: This cross-sectional study included data from the hospital records of all women referred to Shariati Hospital, Tehran, from 2001 to 2002 with pregnancies of more than 40 weeks in duration. Pregnancies ≥40-42 weeks were considered postdate and those more than 42 weeks postterm pregnancy. The data compiled from the hospital records were subjected to t, χ2 and Mann-Whitney U tests.Results: Of the 1500 deliveries in this hospital, 98 patients were included in this study, 66.3% of whom were nullipara and 33.7% multipara. The prevalence of postterm pregnancy was estimated to be 3.3%. Cervix dilation of 2 cm or less on admission occurred in 65 women (73.3%. The mean Bishop score was 4.31. Of the 62 fetuses that underwent assessment tests, 54 (87.1% were normal. The median time between the last test and induction of labor was 2.1 days, and 2.6 days for cesarean deliveries, which was not a significant difference (P=0.6. Cervical ripening with misoprostrol was performed in 36 cases (36.7% and was successful in 18 cases. In this group, the median time for cervical ripening in multiparas was significantly less than nulliparas (4 vs. 7 hrs, P=0.004. Women not subjected to cervical ripening had a higher cesarean rate than those who did undergo cervical ripening (74.7% vs. 66.1%, although this difference was not significant (P=0.9. Vaginal and cesarean delivery rates showed no significant difference between cases that underwent induction with oxytocin and those subjected to cervical ripening with misoprostol (P=0.9. The mean Apgar score was 9.5, with all scores above 6. There were no cases of neonatal hypoglycemia, hypocalcemia, NICU admission or prenatal death. The mean nursery stay was 1.84 days with a range of 1-8 days

  14. The pregnancy outcome in patients with minor β-thalassemia

    OpenAIRE

    Mehran Karimi; Jamileh Jahanbakhsh; Alamtaj Samsami; Sedigheh Amooee

    2011-01-01

    Background: β-thalassemia is the most common hereditary disease in Iran and more than 2 million carriers of the β-thalassemia mutant gene are living in this country.Objective: To determine pregnancy outcome of women with β-thalassemia minor.Materials and Methods: In this retrospective, case-control study in two universities affiliated hospitals in Shiraz, all pregnancies occurred between 2006 and 2008 were included. Patients were divided in two groups regarding the presence of β-thalassemia m...

  15. Increasing Number and Proportion of Adverse Obstetrical Outcomes among Women Living with HIV in the Ottawa Area: A 20-Year Clinical Case Series

    Science.gov (United States)

    Buchan, Sarah; Spaans, Johanna N.; Balfour, Louise

    2016-01-01

    Background. The prevalence and associated risks with adverse obstetrical outcomes among women living with HIV are not well measured. The objective of this study was to longitudinally investigate the prevalence and correlates of adverse obstetrical outcomes among women with HIV. Methods. This 20-year (1990–2010) clinical case series assessed the prevalence of adverse obstetrical outcomes among pregnant women with HIV receiving care at The Ottawa Hospital (TOH). General estimating equation modeling was used to identify factors independently associated with adverse obstetrical outcomes, while controlling for year of childbirth clustering. Results. At TOH, there were 127 deliveries among 94 women (1990–2010): 22 preterm births, 9 births with low birth weight, 12 births small for gestational age, and 4 stillbirths. Per year, the odds of adverse obstetrical outcomes increased by 15% (OR: 1.15, 95% CI: 1.03–1.30). Psychiatric illness (AOR: 2.64, 95% CI: 1.12–6.24), teen pregnancy (AOR: 3.35, 95% CI: 1.04–1.46), and recent immigrant status (AOR: 7.24, 95% CI: 1.30–40.28) were the strongest correlates of adverse obstetrical outcomes. Conclusions. The increasing number and proportion of adverse obstetrical outcomes among pregnant women with HIV over the past 20 years highlight the need for social supports and maternal and child health interventions, especially among adolescents, new immigrants, and those with a history of mental illness. PMID:27528877

  16. The neonatal outcome in twin versus triplet and quadruplet pregnancies

    Directory of Open Access Journals (Sweden)

    Fatemeh Nasseri

    2009-02-01

    Full Text Available

    • BACKGROUND: To assess the risk of neonatal mortality and morbidity in twin, triplet and quadruplet pregnancies.
    • METHODS: In a retrospective study, the neonatal outcome of all twin, triplet and quadruplet gestations delivered from October 2001 to September 2006 was reviewed. The neonatal outcome of triples and quadruplets was compared with a matched group of twins for gestational age.
    • RESULTS: During a 5-year period, 511 sets of twin pregnancies, 42 sets of triplet and 5 sets of quadruplet pregnancies were studied. The mean of gestational age for twins, triplets and quadruplets were 33.92 ± 3.5 weeks, 30.92 ± 3.8 weeks and 31.60 ± 2.0 weeks, respectively, (P = 0.0001. Triplets and quadruplets weighed less than twins, (P = 0.0001. Neonatal mortality was 13.5% for twins, 26.8% for triplets and 30% for quadruplets. In vitro fertilization, use of ovulation induction agents, and cesarean delivery in the women with triplet and quadruplet were significantly higher than in those with twin pregnancies, (P = 0.0001. The mean age of mothers with triplets and quadruplets was significantly higher than with twins (P = 0.026. There was not a significant difference in respiratory and non-respiratory short outcomes between triplets, quadruplets and twins when matched for gestational age. Apgar score at 1 and 5 minutes was significantly lower in triplets and quadruplets than twins. There was no influence of birth order on neonatal mortality of triplet pregnancy. Neonatal mortality of triplet births was significantly decreased over the 5 years of the study period.
    • CONCLUSIONS: Triplets and quadruplets have a similar neonatal outcome as twins when matched for gestational age. There is no influence of birth on the neonatal mortality of triplet pregnancy. It appears that outcome is mainly dependent on gestational age.
    • KEYWORDS: Neonatal

    • Poor Pregnancy Outcomes among Adolescents in South Nyanza Region of Kenya

      OpenAIRE

      Magadi, Monica

      2004-01-01

      In this paper, we examine factors associated with poor pregnancy outcomes among teenagers in South Nyanza region of Kenya. The analysis is based on a recent WHO funded study on Adolescent safe motherhood in the region, which involved a survey of 1247 adolescents aged 12-19 and in-depth interviews with 39 of the adolescents who had experienced very early pregnancies or a pregnancy wastage. The indicators of poor pregnancy outcomes analysed include pregnancy wastage and premature delivery. A s...

    • A study of neonatal and maternal outcomes of asthma during pregnancy

      Directory of Open Access Journals (Sweden)

      Babu Lal Meena

      2013-02-01

      Full Text Available Background: Asthma is a common problem all around the world with variable prevalence ranging from 1%–18% in different age and geographical distribution. There are proximately 300 million affected individuals. There are growing prevalence and morbidity, due to asthma associated with pregnancy. The course of asthma in pregnancy is unpredictable. Methods: 2400 consecutive pregnant women attending the antenatal clinic of S.P. Medical College and AG of Hospitals, Bikaner, were screened using asthma questionnaire translated in Hindi based on the questionnaire developed for International Union against Tuberculosis and Lung Disease. 52 patients diagnosed as asthma were subjected for PFT and classified according to clinical severity as per GINA guidelines, 2006. All subjects were followed till delivery and postpartum charts reviewed to see neonate and maternal outcome. Results: The prevalence of asthma during pregnancy was 2.1%, among them, 25 (48.1% were categorized as having intermittent asthma, 6 (11.5% with mild persistent asthma, 10 (19.2% with moderate persistent asthma and 11 (21.2% having severe persistent asthma. During the course of pregnancy, 36% had no change in the symptomatology, while (32.5% experienced improvement and (32.5% of worsening of asthma. 22 (42.31% women were newly diagnosed during our study. There was no significant adverse maternal and fetal outcome in asthmatic group compared to control. Conclusions: Asthma is an under diagnosed and under treated disorder, especially during pregnancy and overall morbidity of asthma among women & neonates does not change during pregnancy. [Int J Res Med Sci 2013; 1(1.000: 23-27

    • Use of mouth rinse during pregnancy to improve birth and neonatal outcomes: a randomized controlled trial

      OpenAIRE

      Jiang, Hong; Xiong, Xu; BUEKENS, PIERRE; Su, Yi; Qian, Xu

      2015-01-01

      Background Poor oral health, such as periodontal (gum) disease, has been found to be associated with an increased risk of adverse pregnancy outcomes including preterm birth, low birth weight, and neonatal and infant mortality, especially in low-and middle-income countries. However, there is little or no access to preventive dental care in most low-and middle-income countries. We propose to develop and test a “Mouth Rinse Intervention” among pregnant women to prevent the progression of periodo...

    • Age of transfused blood is not associated with increased postoperative adverse outcome after cardiac surgery.

      LENUS (Irish Health Repository)

      McKenny, M

      2011-05-01

      This study investigated the hypothesis that storage age of transfused red blood cells (RBCs) is associated with adverse outcome after cardiac surgery, and examined association between volume of RBC transfusions and outcome after cardiac surgery.

  1. Gestational diabetes and pregnancy outcomes - a systematic review of the World Health Organization (WHO and the International Association of Diabetes in Pregnancy Study Groups (IADPSG diagnostic criteria

    Directory of Open Access Journals (Sweden)

    Wendland Eliana M

    2012-03-01

    Full Text Available Abstract Background Two criteria based on a 2 h 75 g OGTT are being used for the diagnosis of gestational diabetes (GDM, those recommended over the years by the World Health Organization (WHO, and those recently recommended by the International Association for Diabetes in Pregnancy Study Group (IADPSG, the latter generated in the HAPO study and based on pregnancy outcomes. Our aim is to systematically review the evidence for the associations between GDM (according to these criteria and adverse outcomes. Methods We searched relevant studies in MEDLINE, EMBASE, LILACS, the Cochrane Library, CINHAL, WHO-Afro library, IMSEAR, EMCAT, IMEMR and WPRIM. We included cohort studies permitting the evaluation of GDM diagnosed by WHO and or IADPSG criteria against adverse maternal and perinatal outcomes in untreated women. Only studies with universal application of a 75 g OGTT were included. Relative risks (RRs and their 95% confidence intervals (CI were obtained for each study. We combined study results using a random-effects model. Inconsistency across studies was defined by an inconsistency index (I2 > 50%. Results Data were extracted from eight studies, totaling 44,829 women. Greater risk of adverse outcomes was observed for both diagnostic criteria. When using the WHO criteria, consistent associations were seen for macrosomia (RR = 1.81; 95%CI 1.47-2.22; p 2 ≥ 73%. Magnitudes of RRs and their 95%CIs were 1.73 (1.28-2.35; p = 0.001 for large for gestational age; 1.71 (1.38-2.13; p Conclusions The WHO and the IADPSG criteria for GDM identified women at a small increased risk for adverse pregnancy outcomes. Associations were of similar magnitude for both criteria. However, high inconsistency was seen for those with the IADPSG criteria. Full evaluation of the latter in settings other than HAPO requires additional studies.

  2. PREGNANCY OUTCOME IN WOMEN OF ADVANCED MATERNAL AGE

    Directory of Open Access Journals (Sweden)

    Rajmohan Laxmy*, Vinayachandran S, Guhan Beena and Sumangala Devi D

    2013-09-01

    Full Text Available To study the incidence and general outcome of pregnancy in advanced maternal age attending IMCH for delivery from July 1st 2008 to June 30th 2009. To compare the pregnancy outcome of gravitas of AMA and the younger counter parts with special reference to incidence of pregnancy morbidities like GDM, hypertension, abnormal placentation, incidence of LSCS and other instrumental delivers, preterm deliveries and neonatal outcome and maternal mortality. A prospective study of all women of advanced maternal age (>35 yrs admitted for delivery in Institute of Maternal and Child Health (IMCH during a period of one year. The study design is Prospective cohort study and it was conducted in Institute of Maternal and Child Health, Calicut, a Tertiary referral center catering to around 16000-18000 deliveries per year, with 508 beds. The duration of study period is one year, July 1st 2008 to June 30th 2009. Data was collected by interviewing subjects, their relatives, attending doctors and reviewing their records. The sample size is 286 women admitted to IMCH labour room above 35 years of age and 300 controls belonging to 20-25 years age group admitted to labour room for delivery. From the study results our conclusions are Incidence of Pregnancy in advanced maternal age is 1.78% in 2009. Treatment for infertility, Bad obstetric history, Hypertensive disorders of pregnancy, Gestational diabetes, Preterm delivery, Intrauterine growth restriction, Foetal distress, Still births, Cesarian section rate, and Co morbidities like leiomyomas and maternal mortality rates were more and statistically significant in Advanced maternal age compared to the younger counter parts.

  3. Acute promyelocytic leukemia during pregnancy: a systematic analysis of outcome.

    Science.gov (United States)

    Verma, Vivek; Giri, Smith; Manandhar, Samyak; Pathak, Ranjan; Bhatt, Vijaya Raj

    2016-03-01

    The outcomes of acute promyelocytic leukemia (APL) in pregnancy are largely unknown. The MEDLINE database was systematically searched to obtain 43 articles with 71 patients with new-onset APL during pregnancy. Induction therapy included various regimens of all-trans retinoic acid (ATRA), cytarabine, and anthracycline and resulted in a complete remission rate of 93%. Obstetric and fetal complications included pre-term deliveries (46%), spontaneous/therapeutic abortion/intrauterine death (33.3%) and other neonatal complications (25.9%). Mothers diagnosed in the first trimester were more likely to experience obstetric (p < 0.01) and fetal (p < 0.01) complications. To our knowledge, this is the largest systematic review of APL in pregnancy. The vast majority of APL patients in pregnancy may achieve remission with initial induction therapy. APL or its therapy in pregnancy, however, is associated with a high risk of fetal and obstetrical complications. The results of our study may help in patient counseling and informed decision-making. PMID:26110880

  4. ATLANTIC DIP: the impact of obesity on pregnancy outcome in glucose-tolerant women.

    LENUS (Irish Health Repository)

    Owens, Lisa A

    2010-03-01

    OBJECTIVE A prospective study of the impact of obesity on pregnancy outcome in glucose-tolerant women. RESEARCH DESIGN AND METHODS The Irish Atlantic Diabetes in Pregnancy network advocates universal screening for gestational diabetes. Women with normoglycemia and a recorded booking BMI were included. Maternal and infant outcomes correlated with booking BMI are reported. RESULTS A total of 2,329 women fulfilled the criteria. Caesarean deliveries increased in overweight (OW) (odds ratio 1.57 [95% CI 1.24-1.98]) and obese (OB) (2.65 [2.03-3.46]) women. Hypertensive disorders increased in OW (2.30 [1.55-3.40]) and OB (3.29 [2.14-5.05]) women. Reported miscarriages increased in OB (1.4 [1.11-1.77]) women. Mean birth weight was 3.46 kg in normal BMI (NBMI), 3.54 kg in OW, and 3.62 kg in OB (P < 0.01) mothers. Macrosomia occurred in 15.5, 21.4, and 27.8% of babies of NBMI, OW, and OB mothers, respectively (P < 0.01). Shoulder dystocia occur in 4% (>4 kg) compared with 0.2% (<4 kg) babies (P < 0.01). Congenital malformation risk increased for OB (2.47 [1.09-5.60]) women. CONCLUSIONS OW and OB glucose-tolerant women have greater adverse pregnancy outcomes.

  5. A STUDY OF FOETAL AND MATERNAL OUTCOME IN PREGNANCIES WITH IUGR WITH DERANGED DOPPLER

    Directory of Open Access Journals (Sweden)

    Prajakta Shirish

    2016-02-01

    Full Text Available OBJECTIVE The objective of this study was to study the foetal and maternal outcomes in pregnancies with IUGR and deranged Doppler. And to study the effect of deranged blood flow velocimetry in management of growth restricted pregnancies. METHODS This was a prospective study of 96 antenatal women booked at KEM. Hospital Pune during year 2011-2012 between 28-40 wks. of gestation and ultrasonography estimated foetal weight or abdominal circumference 10 days. Total 32 babies had various complications. In the present study, out of 96 study population 9 were stillborn, 11 were Neonatal death, 78 foetuses required NICU care while 32 had complications. Therefore, perinatal mortality is 20(20.8% and morbidity is 76(79.2 %. CONCLUSION The Doppler pattern follow a longitudinal trend with early changes in the Umbilical artery followed by Middle Cerebral artery and other peripheral arteries. Venous changes follow the arterial pattern and occur in severely compromised foetus and predicts poor perinatal outcome. Compared to other methods of foetal monitoring Doppler has proved to be more sensitive in detecting foetal compromise as early and aids in the appropriate timing of delivery. Doppler indices from the foetal circulation can reliability predict adverse perinatal outcome in high risk pregnancy such as intrauterine growth restriction.

  6. Pregnancy outcome in undiagnosed gestational diabetes

    International Nuclear Information System (INIS)

    Objective: To investigate the outcomes of macrosomia and compare the risk factors associated with neonatal and maternal complications between mothers with gestational diabetes (GDM) and Non-GDM mothers, and determine whether it is important to screen for GDM before birth. Methodology: We sampled the venous blood of the mothers of 120 macrosomic neonates in the was based on a HbA1c>5.9%. Results: Twenty-three (19%) mothers had an HgbA1c>5.9%. Maternal and neonatal complications mother's age, parity, and BMI, other risk factors for the development of GDM didn't differ significantly between the two groups. Conclusions: The frequency of neonatal and maternal complications associated with the birth macrosonic neonates are significantly different between GDM and non-GDM mothers. Hence, of the universal screening of pregnant women for GDM is not recommended. (author)

  7. Pregnancy Outcomes in Women of Advanced Age

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    Mehrnaz Valadan

    2011-06-01

    Full Text Available Objective: The aim of this study was to investigate prenatal and obstetrical outcome in mothers aged 40years or older.Materials and methods: A prospective comparative study was conducted for the women aged 40 yearsand over who delivered at 20 week's gestation or beyond from January 2004 to December 2005 at fourHospitals of Tehran University of Medical Sciences. For comparison, a control group of patients whowere 20-29 years of age was considered.Results: There were statistically significant increases in the rates of gestational diabetes, preeclampsia,caesarean section, breech presentation and stillbirth in women 40 years of age or older.Conclusion: There is a need to offer older women special counseling both before and after conception sothat they become informed of the increased risks involved.

  8. Pregnancy Outcome In Women with the Polycystic Ovarian Syndrome

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    Amita Gupta, Kapila Raina, Tania Kalkkar, Yudhishter Veer

    2009-04-01

    Full Text Available The aim of the study is to compare the pregnancy outcome, especially the prevalence of gestationaldiabetes mellitus in a group of patients with PCOS, with a group of healthy weight matched women.Retrospectively we evaluated the pregnancies of 56 women with PCOS some of who had been treatedfor infertility. These were compared with a group of 56 age and weight matched controls. Incidence ofPregnancy induced hypertension in cases of PCOS was 14.2 % (8/56 , gestational diabetes was 14.2% (8/56 IHCP 10.7% (6/56 as compared of age and weight matched controls is with the incidence ofPIH was 7.10% (4/56, GDM 3.5% (2/56 IHCP 7% (4/56.The differences in the incidence of GDM &PIH in two groups was not significant. The outcome of pregnancy in controls & the test groups were notsignificant, though numerically found to be heigher.Thereby, suggesting PCOS must be screened forcomorbid conditions like PIH, GDM &IHCP.

  9. The pregnancy outcome in patients with minor β-thalassemia

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    Mehran Karimi

    2011-01-01

    Full Text Available Background: β-thalassemia is the most common hereditary disease in Iran and more than 2 million carriers of the β-thalassemia mutant gene are living in this country.Objective: To determine pregnancy outcome of women with β-thalassemia minor.Materials and Methods: In this retrospective, case-control study in two universities affiliated hospitals in Shiraz, all pregnancies occurred between 2006 and 2008 were included. Patients were divided in two groups regarding the presence of β-thalassemia minor. Patients in case and control groups were matched according to maternal age, gestational age and number of previous pregnancies. Cesarean delivery, hypertensive disorders, gestational diabetes mellitus, premature rupture of membranes and preterm labor were recorded in each group and were compared using the χ2 or Fisher exact tests. Results: Overall 510 β-thalassemia minor subjects and 512 healthy controls were studied. Cases with β-thalassemia minor had significantly higher prevalence of oligohydramnios (p<0.001 and cesarean section delivery (p=0.001. There was no significant difference regarding Apgar score in 1st (p=0.65 and 5th minute (p=0.25, IUGR (p=0.073, gestational diabetes mellitus (DM (p=0.443 and preeclampsia (p=0.116 between two study groups. Conclusion: β-thalassemia minor does not significantly influence the pregnancy outcome in the negative way.

  10. COMPLICATIONS AND OUTCOMES OF PREGNANCY IN GESTATIONAL DIABETES MELLITUS

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    I. A. Bondar

    2014-01-01

    Full Text Available The aim of the study was to analyze the complications and examine the outcomes of pregnancy in women with compensated gestational diabetes mellitus.We studied outcomes and complications of pregnancy in 50 pregnant women with gestational diabetes mellitus, the effects of gestational diabetes on the fetus.The average age of pregnant women was (33.7 ± 5.7 years. The incidence of gestoses and placental insufficiency in compensated gestational diabetes mellitus was 84%, polyhydramnios – 36%, the fetus fetopathy – 48% of cases. Births in period occurred in 96% of cases, the frequency of fetal malformations consistent with population-based indicators.Gestational diabetes mellitus affects the development of gestosis and fetoplacental insufficiency, even when the compensation of carbohydrate metabolism after the diagnosis of gestational diabetes mellitus.

  11. Pregnancy Complications and Neonatal Outcomes in Multiple Pregnancies: A Comparison between Assisted Reproductive Techniques and Spontaneous Conception

    OpenAIRE

    Mahbod Kaveh; Mahsa Ghajarzadeh; Fatemeh Davari Tanha; Fatemeh Nayeri; Zahra Keramati; Mamak Shariat; Azadeh Ghaheri

    2015-01-01

    Background: This study compared neonatal outcome and maternal complications in multiple pregnancies after assisted reproductive technologies (ART) to spontaneous pregnancies. Materials and Methods: In this cross-sectional study, we reviewed medical records of 190 multiple pregnancies and births conceived by ART or spontaneous conceptions between 2004 and 2009 in Women Hospital. Obstetric history and outcomes were recorded and compared between these two groups. SPSS version 1...

  12. Comparison of gestational weight gain-related pregnancy outcomes in American primiparous and multiparous women

    DEFF Research Database (Denmark)

    Lan-Pidhainy, Xiaomiao; Nohr, Ellen A; Rasmussen, Kathleen M

    2013-01-01

    BACKGROUND: In Danish data, the tradeoffs between mother and infant in the risks of adverse pregnancy outcomes were reached at lower gestational weight gain (GWG) among multiparous than among primiparous women. It is unknown whether the same difference exists among American women. OBJECTIVE: The....... Their self-reported GWG was divided into 4 categories (≤10, >10 to <15, 15 to <20, and ≥20 kg). GWG-specific absolute adjusted risks for emergency cesarean delivery, birth of a small-for-gestational-age (SGA) or large-for-gestational-age (LGA) infant, and postpartum weight retention at 6 mo were...... estimated by multiple logistic regression analyses for women in 3 categories of prepregnancy body mass index. RESULTS: Primiparous women gained more weight during pregnancy than did multiparous women (mean ± SD: 15.9 ± 6.9 compared with 13.5 ± 6.2 kg; P < 0.0001). The absolute adjusted risk of postpartum...

  13. Outcomes in hypertensive disorders of pregnancy in the North Indian population

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    Sachan R

    2013-03-01

    Full Text Available Rekha Sachan,1 Munna Lal Patel,2 Pushpalata Sachan,3 Amrita Gaurav,1 Meenakshi Singh,1 Bhumika Bansal11Department of Obstetrics and Gynecology, 2Department of Medicine, 3Department of Physiology, King George's Medical University, Lucknow, Uttar Pradesh, IndiaIntroduction: Hypertensive disorders complicating pregnancy seriously endanger the safety of the mother and fetus during pregnancy. Very few studies have explored hypertensive disorders of pregnancy in India, even though this disease has been associated with adverse maternal and perinatal outcomes. This study aimed to analyze the disease pattern and risk factors associated with the disorder and assess the maternal and fetal outcomes in cases of hypertensive disorders of pregnancy.Subjects and methods: This case-control study was carried out over 1 year from 2011 to 2012 at the Department of Obstetrics and Gynecology, King George's Medical University, Lucknow, Uttar Pradesh, India. A total of 149 patients were enrolled in the study. As seven were lost to follow-up, analysis was carried out on 142 cases. Patients were further classified according to the National High Blood Pressure Education Program Working Group (2000 as having mild preeclampsia (65 cases, severe preeclampsia (32 cases, or eclampsia (45 cases. Thirty-one healthy pregnant non-hypertensive women were enrolled into the study as controls.Results: The most common manifestation was edema, seen in 90% of cases. Proteinuria was also relatively common, 26.76% of patients with proteinuria of ≥300 mg/24 hours, 47.88% with proteinuria of ≥2 g/24 hours, and 25.35% with a urinary protein excretion of 3–5 g/24 hours. Central nervous system involvement was observed in 42.2% of cases, elevated bilirubin levels in 47.0%, visual symptoms in 6.4%, vaginal bleeding in 11.3%, and HELLP (hemolysis, elevated liver enzymes, and low platelet count syndrome was reported in 2.80%. Maternal deaths occurred in 2.8% of cases, all of which were from

  14. Periodontal intervention effects on pregnancy outcomes in women with preeclampsia.

    OpenAIRE

    Julián A. Herrera; Santiago Vélez Medina; Rodolfo Molano; Virna Medina; Javier E. Botero; Beatriz Parra; Adolfo Contreras

    2009-01-01

    Objective: To determine the efficacy of periodontal intervention on pregnancy outcome in mild preeclamptic women. Methods: A sample of 60 pregnant women with mild preeclampsia (blood pressure levels 300 mg/l in 24 hours urine) from the Hospital Universitario del Valle (Cali, Colombia) was included to the study. Preeclamptic women were randomized in two groups, one with periodontal intervention (PIG, N=28) and another in which the periodontal intervention was pra...

  15. Periodontal intervention effects on pregnancy outcomes in women with preeclampsia

    OpenAIRE

    Julián A. Herrera M; Santiago Vélez-Medina; Rodolfo Molano; Virna Medina; Javier E. Botero; Beatriz Parra; Adolfo Contreras

    2009-01-01

    Objective: To determine the efficacy of periodontal intervention on pregnancy outcome in mild preeclamptic women.Methods: A sample of 60 pregnant women with mild preeclampsia (blood pressure levels 300 mg/l in 24 hours urine) from the Hospital Universitario del Valle (Cali, Colombia) was included to the study. Preeclamptic women were randomized in two groups, one with periodontal intervention (PIG, N=28) and another in which the periodontal intervention was practiced after childbirth (NPIG, N...

  16. Myasthenia gravis and pregnancy: clinical implications and neonatal outcome

    OpenAIRE

    Estanol Bruno; Salinas Vicente; Hernández-Ronquillo Lizbeth; Téllez-Zenteno José F; da Silva Orlando

    2004-01-01

    Abstract Background The myasthenia gravis is twice as common in women as in men and frequently affects young women in the second and third decades of life, overlapping with the childbearing years. Generally, during pregnancy in one third of patients the disease exacerbates, whereas in two thirds it remains clinically unchanged. Complete remission can occur in some patients. Methods To describe the clinical course, delivery and neonatal outcome of 18 pregnant women with the diagnosis of myasth...

  17. Intimate Partner Violence During Pregnancy: Maternal and Neonatal Outcomes

    OpenAIRE

    Alhusen, Jeanne L.; Ray, Ellen; Sharps, Phyllis; Bullock, Linda

    2015-01-01

    The effects of intimate partner violence (IPV) on maternal and neonatal outcomes are multifaceted and largely preventable. During pregnancy, there are many opportunities within the current health care system for screening and early intervention during routine prenatal care or during episodic care in a hospital setting. This article describes the effects of IPV on maternal health (e.g., insufficient or inconsistent prenatal care, poor nutrition, inadequate weight gain, substance use, increased...

  18. The adverse outcome pathway (AOP) for chemical binding to tubulin in oocytes leading to aneuploid offspring.

    Science.gov (United States)

    Marchetti, Francesco; Massarotti, Alberto; Yauk, Carole L; Pacchierotti, Francesca; Russo, Antonella

    2016-03-01

    The Organisation for Economic Co-operation and Development (OECD) has launched the Adverse Outcome Pathway (AOP) Programme to advance knowledge of pathways of toxicity and improve the use of mechanistic information in risk assessment. An AOP links a molecular initiating event (MIE) to an adverse outcome (AO) through intermediate key events (KE). Here, we present the scientific evidence in support of an AOP whereby chemicals that bind to tubulin cause microtubule depolymerization resulting in spindle disorganization followed by altered chromosome alignment and segregation and the generation of aneuploidy in female germ cells, ultimately leading to aneuploidy in the offspring. Aneuploidy, an abnormal number of chromosomes that is not an exact multiple of the haploid number, is a well-known cause of human disease and represents a major cause of infertility, pregnancy failure, and serious genetic disorders in the offspring. Among chemicals that induce aneuploidy in female germ cells, a large majority impairs microtubule dynamics and spindle function. Colchicine, a prototypical chemical that binds to tubulin and causes microtubule depolymerization, is used here to illustrate the AOP. This AOP is specific to female germ cells exposed during the periovulation period. Although the majority of the data come from rodent studies, the available evidence suggests that the MIE and KEs are conserved across species and would occur in human oocytes. The development of AOPs related to mutagenicity in germ cells is expected to aid the identification of potential hazards to germ cell genomic integrity and support regulatory efforts to protect population health. Environ. Mol. Mutagen. 57:87-113, 2016. © 2015 Her Majesty the Queen in Right of Canada. PMID:26581746

  19. Why do singletons conceived after assisted reproduction technology have adverse perinatal outcome?

    DEFF Research Database (Denmark)

    Pinborg, A; Wennerholm, U B; Romundstad, L B; Loft, A; Aittomaki, K; Söderström-Anttila, V; Nygren, K G; Hazekamp, J; Bergh, C

    2013-01-01

    Assisted reproduction technology (ART) is used worldwide, at increasing rates, and data show that some adverse outcomes occur more frequently than following spontaneous conception (SC). Possible explanatory factors for the well-known adverse perinatal outcome in ART singletons were evaluated....

  20. Impact of obesity on pregnancy outcome in different ethnic groups: calculating population attributable fractions.

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    Eugene Oteng-Ntim

    Full Text Available OBJECTIVES: To quantify the proportion of adverse pregnancy outcome attributable to maternal obesity. DESIGN: Cross sectional analysis of routine obstetric dataset. SETTING: Guy's and St Thomas's NHS Foundation Trust (GSTFT. POPULATION: 23,668 women who had singleton deliveries at GSTFT between 2004 and 2008. METHODS: Logistic regression was used to estimate the association between BMI and outcome in different ethnic groups. Adjusted odds ratios, and the proportions of obese women, were used to calculate population attributable risk fractions (PAFs. MAIN OUTCOME MEASURES: (I MATERNAL OUTCOMES: diabetes, type of delivery, post-partum haemorrhage, and preterm delivery. (ii Perinatal outcomes: macrosomia, low birth weight, admission to neonatal intensive care/special care baby unit, and perinatal death. RESULTS: The prevalence of maternal obesity was 14%. Increasing BMI was independently associated with increasing risk of adverse obstetric and neonatal outcome. At the individual level, the effect of obesity on diabetes was highest in Asian women compared to white women (p for interaction = 0.03. Calculation of population attributable risk fractions demonstrated that one third of diabetes cases and one in six Caesarean sections could be avoided in this population if all obese women were of normal BMI. At the population level, the contribution of obesity to diabetes was highest for Black women (42%, and lowest for oriental women (8%. Seven percent of neonatal macrosomia in all the population, and 13% in Black mothers, were attributable to obesity. CONCLUSIONS: Preventing obesity prior to pregnancy will substantially reduce the burden of obstetric and neonatal morbidity in this population. This reduction will be higher in Black women.

  1. Fetal volume measurements with three dimensional ultrasound in the first trimester of pregnancy, related to pregnancy outcome, a prospective cohort study

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    Smeets Nicol AC

    2012-05-01

    Full Text Available Abstract Background First trimester growth restriction is associated with an increased risk of adverse birth outcomes (preterm birth, low birth weight and small for gestational age at birth. The differences between normal and abnormal growth in early pregnancy are small if the fetal size is measured by the crown-rump-length. Three-dimensional ultrasound volume measurements might give more information about fetal development than two-dimensional ultrasound measurements. Detection of the fetus with a small fetal volume might result in earlier detection of high risk pregnancies and a better selection of high risk pregnancies. Methods A prospective cohort study, performed at the Máxima Medical Centre, in Eindhoven-Veldhoven, the Netherlands. During the routine first trimester scan with nuchal translucency measurement 500 fetal volumes will be obtained. The gestational age is based on the first day of the last menstrual period in a regular menstrual cycle and by the crown-rump-length. The acquired datasets are collected and stored on a hard disk for offline processing and volume calculation. The investigator who performs the volume measurements is blinded for the results of the first trimester scan. The manual mode will be used to outline the Region Of Interest, the fetal head and rump, in all cross sections. The fetal volumes are calculated with a rotational step of 9°. First, the relation between fetal volume and gestational age, for a set of participants with normal pregnancies (training set, will be assessed. This model will then be used to determine expected values of fetal volume for a normal pregnancy, which will be referred to as expected normal values. Secondly, for a new set of participants with normal pregnancies and a set of participants with complicated pregnancies (together defined as validation set, the observed fetal volumes (FVobserved are compared with their expected normal values (FVexpected and expressed as a percentage of the

  2. The Effect of Ramadan Fasting on Outcome of Pregnancy

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    Vahid Ziaee

    2010-06-01

    Full Text Available Objective:Pregnancy is a physiological condition that its concurrence with fasting introduces some controversies about condition of mother and fetus. This study was conducted to evaluate the effect of fasting on pregnancy outcome.Methods:The historical cohort paradigm of this study was conducted on referrals of one of the Tehran's hospitals in 2004. All pregnant women at one of the trimesters in holy month of Ramadan were included in the study. The women were divided into non-fasting, 1-10 days fasting, 11-20 days fasting, and 21-30 days fasting. For statistical analysis of data, covariance analysis and SPSS package was used.Findings:In this study, 189 cases were evaluated and their mean age, weight, and body mass index (BMI were 25.9 years, 61.7 kg, and 23.9 kg/m2 respectively. The mean for number of days on fasting was 13 days and 66 cases (34.9% had not been on fasting. In addition, there was no significant difference between BMI at the beginning of pregnancy, mother's age, number of pregnancies, and a history of abortion in different groups. Meanwhile, there was also no significant difference between means of weight, height, and head circumference of infants with number of days on fasting. Furthermore, there was no significant difference between pregnancy outcome parameters and fasting at different trimesters.Conclusion:According to these findings, in healthy women with appropriate nutrition, Islamic fasting has no inappropriate effect on intrauterine growth and birth-time indices. Meanwhile, relative risk of low weight birth was 1.5 times in mothers on fasting at first trimester as compared to non-fasting mothers

  3. Myasthenia gravis and pregnancy: clinical implications and neonatal outcome

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    Estanol Bruno

    2004-11-01

    Full Text Available Abstract Background The myasthenia gravis is twice as common in women as in men and frequently affects young women in the second and third decades of life, overlapping with the childbearing years. Generally, during pregnancy in one third of patients the disease exacerbates, whereas in two thirds it remains clinically unchanged. Complete remission can occur in some patients. Methods To describe the clinical course, delivery and neonatal outcome of 18 pregnant women with the diagnosis of myasthenia gravis. Retrospective chart review of pregnant patients with myasthenia gravis, followed at the National Institute of Perinatology in Mexico City over an 8-year period. Data was abstracted from the medical records on the clinical course during pregnancy, delivery and neonatal outcome. Results From January 1, 1996 to December 31, 2003 18 patients with myasthenia gravis were identified and included in the study. The mean ± SD maternal age was 27.4 ± 4.0 years. During pregnancy 2 women (11% had an improvement in the clinical symptoms of myasthenia gravis, 7 women (39% had clinical worsening of the condition of 9 other patients (50% remained clinically unchanged. Nine patients delivered vaginally, 8 delivered by cesarean section and 1 pregnancy ended in fetal loss. Seventeen infants were born at mean ± SD gestational age of 37.5 ± 3.0 weeks and a mean birth weight of 2710 ± 73 g. Only one infant presented with transient neonatal myasthenia gravis. No congenital anomalies were identified in any of the newborns. Conclusions The clinical course of myasthenia gravis during pregnancy is variable, with a significant proportion of patients experiencing worsening of the clinical symptoms. However, neonatal transient myasthenia was uncommon in our patient population.

  4. Early pregnancy B vitamin status, one carbon metabolism, pregnancy outcome and child development.

    Science.gov (United States)

    Solé-Navais, Pol; Cavallé-Busquets, Pere; Fernandez-Ballart, Joan D; Murphy, Michelle M

    2016-07-01

    Periconception supplementation with folic acid is recommended until 12 gestational weeks to prevent neural tube defects. Doses of folic acid contained in supplements and timing and length of use during pregnancy vary. The effects of status in periconception and pregnancy folate, cobalamin, betaine and their interactions on one carbon metabolism (1C), as well as the global effect of 1C on foetal growth and pregnancy outcome, are reviewed. Results from prospective studies are reviewed. Cessation of folic acid supplement use after the first trimester is associated with a sharp drop in plasma folate status and enhanced conversion of betaine to dimethylglycine. Dimethylglycine production is also higher in mothers with low folate status than in those with normal-high folate status. The effects of high doses of folic acid on one carbon metabolism in mothers with low early pregnancy cobalamin status and on foetal growth are also reviewed. Several studies report that moderately elevated early pregnancy fasting plasma total homocysteine (tHcy) is inversely associated with birth weight and a predictor of intrauterine growth retardation. There is also evidence for increased risk of preterm birth when maternal folate status is low. PMID:26700149

  5. Previous Adverse Infant Outcomes as Predictors of Preconception Care Use: An Analysis of the 2010 and 2012 Los Angeles Mommy and Baby (LAMB) Surveys.

    Science.gov (United States)

    Batra, Priya; Higgins, Chandra; Chao, Shin M

    2016-06-01

    Objectives This study aimed to understand the impact of a previous adverse infant outcome (AIO) on use of preconception care prior to a subsequent pregnancy. Methods Responses from the 2010 and 2012 Los Angeles Mommy and Baby Surveys were analyzed. Weighted multivariate logistic regression was employed to identify significant associations between having had a previous AIO (preterm delivery, low birth weight infant, stillbirth, or major birth defect) and receipt of preconception care prior to the most recent pregnancy. Select patient-level covariates were included: chronic disease, age, education level, race/ethnicity, country of birth, insurance status prior to pregnancy and pregnancy intent. Adjustment for missing responses was performed using multiple chained imputation. Results After controlling for covariates, having had a previous AIO was associated with an increased odds of having utilized preconception care in the most recent pregnancy (OR 1.237, p = 0.040). Per the final regression model, a woman reporting a previous AIO and an intended subsequent pregnancy had a 42.4 % likelihood of having used preconception care. Of these women, only 28.8 % reported doing so because of concern regarding a previous birth complication. Discussion Women reporting a previous AIO were more likely to have used preconception care in a subsequent pregnancy. The prevalence of preconception care utilization remained low overall. Pregnancy intent emerged as a strong secondary predictor; any concerted strategy to improve access to preconception care must include initiatives to help ensure that pregnancies are planned. PMID:26679708

  6. Pregnancy after diabetes obesity surgery (PADOS): Incidence and outcomes.

    Science.gov (United States)

    Whyte, M; Pring, C; Cooke, D; Hart, K; McGowan, B M; Subramanian, D; Shawe, J

    2014-07-01

    Half of all bariatric surgical procedures are in women of childbearing age but it remains unclear whether surgery is suitable for women who subsequently conceive: specifically the relative risks and benefits of potential nutrient deficiencies versus weight reduction. We will present data collected from Clinical Practice Research Databases on the maternal and fetal outcomes of pregnancies complicated either by obesity or previous bariatric surgery (BS). Two groups, matched to obese controls for BMI pre-BS and post-BS (at the time of ante-natal booking) will be compared. In this way, the effect of BS on pregnancy outcomes may be examined, independent of its effect on weight. A sub-group of women with antecedent Type 2 diabetes (T2DM) will allow for investigation of the additional impact and persistence of this co-morbidity. This builds upon pilot data collected from a retrospective cohort of women (18-45years) undergoing laparoscopic roux-en-Y (RYGB) surgery over a 24-month period (n=218). After exclusions and loss to follow up, data from 111 patients were analysed; 81 (73%) had conceived prior to RYGB, 20 (18%) became pregnant post RYGB and a further 22 patients (20%) were trying to conceive at the time of data collection. Three women had T2DM which resolved post BS. A suggestion of greater miscarriage risk prior to surgery in this sub-group will be confirmed as more women are recruited. Pregnancy is a frequent desire/occurrence after BS. This database study will advance understanding of the maternal and fetal outcomes of such pregnancies and inform antenatal care. PMID:26104634

  7. The Chernobyl accident - did it affect pregnancy outcomes in Norway?

    International Nuclear Information System (INIS)

    The outcome of pregnancies in the county of Soer-Troendelag in Norway, during the 27 months preceding and 21 months after the Chernobyl accident has been analysed on the basis of time of conception. The analysis showed a significant decrease in the number of conceptions during the three months immediately after the accident (April - June 1986). This finding can be interpreted to mean fewer ''planned'' conceptions. The Chernobyl accident did not seem to have had any impact on the proportion of conceptions ending as spontaneous abortions or ectopic pregnancies. There was a significant drop in the proportion of pregnancies ending as induced abortions during the year after the accident compared with the year before. However, due to some variation during this year, it is difficult to draw any definite conclusions concerning the impact of the accident on induced abortions in this county. The proportion of pregnancies ending as births increased significantly during the year after the Chernobyl accident compared with the year before. 22 refs., 1 tab

  8. Factors predicting the outcome of acute renal failure in pregnancy

    International Nuclear Information System (INIS)

    To determine the factors predicting renal outcome in patients developing acute renal failure in pregnancy. Study Design: Descriptive cohort study. Place and Duration of Study: Study was conducted at Nephrology Unit of Sindh Institute of Urology and Transplantation, Karachi, from October 2006 to March 2007. Methodology: Patients with acute renal failure due to complications of pregnancy, with normal size of both the kidneys on ultrasound were enrolled, and followed for a period of 60 days or until recovery of renal function. Patient's age and parity, presence of antenatal care, type of complication of pregnancy, foetal outcome and duration of oliguria were compared between patients who remained dialysis dependent and those who recovered renal function. Chi-square/Fisher's exact test and student's t-test, were used for determining the association of categorical and continuous variables with dialysis dependency. Results: The mean age was 29 +- 6 years. Most patients came from rural areas of interior Sindh. Sixty eight percent did not have antenatal checkups. Antepartum haemorrhage (p=0.002) and prolonged duration of oliguria (35 +- 15.7 days, p= < 0.001) were associated with dialysis dependency, which was observed in 50% of the study group. Conclusion: Ante-partum haemorrhage and prolonged oliguria were strong predictors of irreversible renal failure. This highlights the need for early recognition and referral, and the importance of trained birth attendants and antenatal care. (author)

  9. Impact of oxidative stress on pregnancy outcome in albino rats

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    R.S. Al-Naemi

    2012-01-01

    Full Text Available Accumulative reports documented that oxidative stress is implicated in many human and animal diseases. However, the reports concerning the effect of oxidative stress on pregnancy outcome are limited and scarce. The objective of this study was to determine the impact of oxidative stress on pregnancy outcome and to assess the antioxidant effect of vitamin C and E on oxidative stress parameters in blood and placental tissue samples in experimental pregnant animals model exposed to oxidative stress. Wister Albino rats were used in this work to investigate the effects of oxidative stress exposure (addition of H2O2 to the drinking water on pregnancy outcome. Rats were divided into 5 groups, as follows: Group I (included 7 normal pregnant rats which served as control group. Group II (exposed to 1 % H2O2 included 7 pregnant rats, the rats were allowed to become pregnant and received (1% H2O2 in drinking water from day 7th till the day 19th of pregnancy. Group III (exposed to 3% H2O2 included 8 pregnant rats. Same as group 2, but the rats were exposed to a higher concentration of H2O2 (3% in drinking water. Group IV (included 8 pregnant rats. Pregnant rats received vitamins C and E without induction of oxidative stress. Group V (included 8 pregnant rats.induction of oxidative stress by 1% H2O2 with vitamins supplementation in the pregnant rats. Serum total antioxidants capacity (TAC, serum and placental tissue oxidative stress biomarker; 8-iso prostaglandin F2α (8-Isoprostane were measured using specific ELISA kits. Also placental tissues of pregnant rats were isolated and put directly in 10% formalin prepared for histopathological examination. Results revealed a significant decrease in the median values of the body weight and total serum antioxidants capacity (TAC in groups II and III of rats compared with the control group. A significant higher median value of TAC obtained in the groups IV and V when compared with the control group. Significant higher

  10. Integration of umbilical venous and arterial Doppler flow parameters for prediction of adverse perinatal outcome

    Directory of Open Access Journals (Sweden)

    Hebbar Shripad

    2015-01-01

    Full Text Available Background: Quantification of umbilical vein (UV blood flow rate and umbilical artery Doppler indices might be valuable in assessing fetuses at increased risk of perinatal complications as they receive their supply of oxygen and nutrients through this vessel. Previous studies have indicated that UV blood volume flow rate to umbilical artery pulsatility index (UAPI ratio (venous arterial index [VAI] evaluates both venous and arterial arm of fetal umbilical circulation and hence, can be adopted as a screening tool in management of high risk pregnancy. Objectives: To compare umbilical VAI with adverse perinatal outcome and also to evaluate its efficacy with other flow indices in determining perinatal outcome. Materials and Methods: Various Doppler indices such as normalized blood flow rate in UV (nUV, ml/kg estimated fetal weight/min, VAI (nUV/UAPI, umbilical artery resistance index (RI, UAPI, and systolic diastolic ratio were determined in 103 pregnant women within 2 weeks of the delivery. A risk score was devised using APGAR at 5 min, birth weight, preterm delivery, fetal distress, Neonatal Intensive Care Unit (NICU care, and perinatal death and this score was correlated with antenatal Doppler findings. Results: Subjects with low VAI were found to have a greater association with intrauterine growth restricted fetuses (28.5% and low liquor (35.7%, preterm deliveries (46.4%, lower mean birth weight (2.25 kg, higher NICU admission rates (32.1%. The unfavorable score was noticed in 25.2% of the neonates. They had lower VAI (156 vs. 241, UV diameter (6.2 mm vs. 7.8 mm, UV velocity (16.2 vs. 17.8, nUV (163.7 vs. 206.4, and higher PI (1.3 vs. 0.9. A cut-off of VAI of 105 ml/kg/min had sensitivity of 86.7% and a specificity of 93.5% for predicting poor perinatal outcome. Conclusion: VAI with a cut-off of 105 ml/kg/min can be used as an additional tool along with the other conventional Doppler indices in order to predict adverse fetal outcome.

  11. Depression screening and patient outcomes in pregnancy or postpartum : A systematic review

    NARCIS (Netherlands)

    Thombs, Brett D.; Arthurs, Erin; Coronado-Montoya, Stephanie; Roseman, Michelle; Delisle, Vanessa C.; Leavens, Allison; Levis, Brooke; Azoulay, Laurent; Smith, Cheri; Ciofani, Luisa; Coyne, James C.; Feeley, Nancy; Gilbody, Simon; Schinazi, Joy; Stewart, Donna E.; Zelkowitz, Phyllis

    2014-01-01

    Objective: Clinical practice guidelines disagree on whether health care professionals should screen women for depression during pregnancy or postpartum. The objective of this systematic review was to determine whether depression screening improves depression outcomes among women during pregnancy or

  12. 妊娠中期血清学三联筛查指标异常对孕妇发生不良妊娠结局的预测价值%Predictive value of abnormal second-trimester maternal serum triple screening markers for adverse pregnancy outcomes

    Institute of Scientific and Technical Information of China (English)

    胡祝明; 刘祥印; 李琳琳; 贾春澍; 李德军; 刘睿智

    2014-01-01

    孕妇的预产年龄、体质量和血清学三联筛查指标MoM值分别进行比较,差异均有统计学意义(P<0.01).(4)不良妊娠结局组孕妇血清学AFP MoM值>2.0、F-β-hCG MoM值>2.0、uE3 MoM值<0.5的发生率分别为7.95%(19/239)、23.85%(57/239)和4.18%(10/239);仅有两项指标MoM值异常的发生率为5.02%(12/239)、三联指标MoM值均异常的发生率为0.84%(2/239);健康孕妇组孕妇三联指标中仅有两项指标MoM值异常的发生率为0.14%(11/7 760)、三联指标MoM值均为异常的发生率为0.两组孕妇血清学三联筛查各指标MoM值异常发生率比较,差异均有统计学意义(P<0.01).结论 孕中期孕妇血清学三联筛查指标异常与不良妊娠结局发生有一定的相关性,孕中期血清学三联筛查对21三体、18三体和ONTD的检出有较高的实用价值.%Objective To investigate the predictive value of abnormal multiples of the median (MoM) of second trimester maternal serum triple screening (STMSTS) markers for adverse pregnancy outcomes.Methods 16 000 singleton pregnancies at 15+0 to 20+6 weeks' gestation who underwent STMSTS between July 2010 and January 2013 in the First Hospital of Jilin University were recruited.Maternal serum AFP,free β-hCG (F-β-hCG) and unconjugated estriol (uE3) levels were measured using time-resolved fluoroimmunoassay,and then convened to MoM.LifeCycle 3.2 software was used to calculate risk,and a risk value greater than 1 in 270 or 1 in 350 was considered as high risk for trisomy 21 syndrome (Down syndrome,DS) and trisomy 18 syndrome (Edwards syndrome,ES),respectively.MoM of AFP more than 2.5was considered high risk for open neural tube defect (ONTD).Amniocentesis and karyotyping,ultrasound screening were advised for high risk women.AFP,F-β-hCG higher than 2.0 MoM or uE3 lower than 0.5MoM was considered as abnormal,respectively.The MoM of STMSTS marker between women with adverse pregnancy outcome and with normal outcome was

  13. Obstetric outcome with low molecular weight heparin therapy during pregnancy.

    LENUS (Irish Health Repository)

    Donnelly, J

    2012-01-01

    This was a prospective study of women attending a combined haematology\\/obstetric antenatal clinic in the National Maternity Hospital (2002-2008). Obstetric outcome in mothers treated with low molecular weight heparin (LMWH) was compared to the general obstetric population of 2006. There were 133 pregnancies in 105 women. 85 (63.9%) received prophylactic LMWH and 38 (28.6%) received therapeutic LMWH in pregnancy. 10 (7.5%) received postpartum prophylaxis only. The perinatal mortality rate was 7.6\\/1000 births. 14 (11.3%) women delivered preterm which is significantly higher than the hospital population rate (5.7%, p<0.05). Despite significantly higher labour induction rates (50% vs 29.2% p<0.01), there was no difference in CS rates compared to the general hospital population (15.4% vs 18.9%, NS). If carefully managed, these high-risk women can achieve similar vaginal delivery rates as the general obstetric population.

  14. The Risk Factors and Pregnancy Outcomes of 48 Cases of Heterotopic Pregnancy from a Single Center.

    Science.gov (United States)

    Jeon, Ji Hyun; Hwang, Yu Im; Shin, Im Hee; Park, Chan Woo; Yang, Kwang Moon; Kim, Hye Ok

    2016-07-01

    The purpose of this study was to investigate risk factors that are associated with heterotopic pregnancy (HP) following in vitro fertilization (IVF)-embryo transfer (ET) and to demonstrate the outcomes of HP after the surgical treatment of ectopic pregnancies. Forty-eight patients from a single center, who were diagnosed with HP between 1998 and 2012 were included. All of the patients had received infertility treatments, such as Clomid with timed coitus (n = 1, 2.1%), superovulation with intrauterine insemination (n = 7, 14.6%), fresh non-donor IVF-ET (n = 33, 68.8%), and frozen-thawed cycles (n = 7, 14.6%). Eighty-four additional patients were randomly selected as controls from the IVF registry database. HP was diagnosed at 7.5 ± 1.2 weeks (range 5.4-10.3) gestational age. In six cases (12.5%), the diagnosis was made three weeks after the patients underwent treatment for abortion. There were significant differences in the history of ectopic pregnancy (22.5% vs. 3.6%, P = 0.002). There were no significant differences in either group between the rates of first trimester intrauterine fetal loss (15.0% vs. 13.1%) or live birth (80.0% vs. 84.1%) after the surgical treatment for ectopic pregnancy. The risk factors for HP include a history of ectopic pregnancy (OR 7.191 [1.591-32.513], P = 0.010), abortion (OR 3.948 [1.574-9.902], P = 0.003), and ovarian hyperstimulation syndrome (OHSS) (OR 10.773 [2.415-48.060], P = 0.002). In patients undergoing IVF-ET, history of ectopic pregnancy, abortion, and OHSS may be risk factors for HP as compared to the control group of other IVF patients. The surgical treatment of HP does not appear to affect the rates of first trimester fetal loss or live birth. PMID:27366008

  15. Relationship Between Maternal Behavior During Pregnancy, Birth Outcome, and Early Childhood Development: An Exploratory Study

    OpenAIRE

    Li, Kai; Poirier, Dale J.

    2003-01-01

    This study examines the relationship between maternal behavior during pregnancy, birth outcomes, and early childhood development. Specifically, in the context of four measures of maternal behavior during pregnancy (maternal smoking, drinking, prenatal care, and maternal weight gain), three measures of birth outcome (gestational age, birth length, and birth weight), and 32 exogenous covariates observed during pregnancy, we investigate the importance of maternal choices during pregnancy and bir...

  16. Management of Adenomyosis in Subfertile Women and Pregnancy Outcome

    Directory of Open Access Journals (Sweden)

    Fathia E. Al Jama

    2011-05-01

    Full Text Available Objectives: To assess the outcome of treatment with only gonadotropin releasing hormone agonists (Gn-RHa versus combined conservative surgery and Gn-RHa therapy in the management of sub-fertile patients with symptomatic uterine adenomyosis.Methods: A retrospective study of the two treatment modalities allocated to 40 sub-fertile patients with pathology-proven adenomyosis over a period of eight years was undertaken at the Obstetrics and Gynecology department, King Fahad Hospital, Dammam University, Saudi Arabia. Twenty-two patients (Group A were treated with Gn-RHa alone, and 18 patients (Group B received combined conservative surgery with Gn-RHa therapy. After completion of six courses of Gn-RHa injections, there was a 3-year follow up period for all patients. Treatment outcome included relief of symptoms, pregnancy rate and successful deliveries, which were compared between the two groups.Results: The patients in group A were younger in age, had lower CA-125 levels and shorter infertile years than Group B. Three (13.6% spontaneous pregnancies resulted upto 18 months of stopping Gn-RHa in group A, while 8 (44.4% pregnancies resulted upto 36 months in group B patients, which was statistically significant (p=0.0393. Term delivery occurred normally in one (4.5% Group A patient, while 6 (33.3% patients in Group B had cesarean section at term (p=0.0328.Conclusion: Combined conservative surgery and Gn-RHa may provide effective symptom relief, better reproductive performance in subfertile patients with uterine adenomyosis and longer period of pregnancy prospects after treatment than patients who recieved Gn-RHa alone. Due to the nature of this study, a well conducted randomized trial is needed in the future to assess the benefits of the two treatment modalities.

  17. Neonatal outcome in pregnancies complicated with pregestational diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Ćetković Aleksandar

    2007-01-01

    Full Text Available Background/Aim. Pregestational diabetes mellitus (PGDM represents glucose intolerance that begins before pregnancy and is followed by the increased risk of neonatal and maternal complications. The aim of this study was to establish neonatal outcome in pregnancies with pregestational diabetes mellitus and the factors that had influence on it. Methods. This study included 27 pregnant women with insulin-dependant PGDM hospitalized during 2004 in the Institute for Obstretics and Gynecology, Clinical Center of Serbia, Belgrade. The control group consisted of 2 292 healthy pregnant women presented to the Institute within 2004. Results. Twenty-three (85% infants of the women with PGDM had complications in comparison with 356 (15.5% infants of the women in the control group, that was statistically significant difference (p < 0.001. Macrosomia was present in 8 (29.6% and birth injuries in 6 (22.2% infants of women with PGDM that was statistically significant difference (p < 0.001 in comparisom with the women in the control group who had 194 (8.5% infants with macrosomia and 156 (6.8% infants with birth injuries. The women with PGDM had 3 (11.1% neonatal deaths and 3 (11.1% infants were born with congenital malformations in comparison with the women in the control group without these complications. We established statisticaly significant correlation (p < 0.001 between glicoregulation before and during pregnancy in the women with PGDM and neonatal outcome. Conclusion. The incidence of neonatal morbidity and mortality in the women with PGDM was significantely more frequent as compared with the normal population. Achieving optimal maternal glucose levels in women with PGDM both preconceptionally and during pregnancy is associated with significant reduction of neonatal complications.

  18. Obstetrical APS: is there a place for hydroxychloroquine to improve the pregnancy outcome?

    Science.gov (United States)

    Mekinian, Arsene; Costedoat-Chalumeau, Nathalie; Masseau, Agathe; Tincani, Angela; De Caroli, Sara; Alijotas-Reig, Jaume; Ruffatti, Amelia; Ambrozic, Ales; Botta, Angela; Le Guern, Véronique; Fritsch-Stork, Ruth; Nicaise-Roland, Pascale; Carbonne, Bruno; Carbillon, Lionel; Fain, Olivier

    2015-01-01

    The use of the conventional APS treatment (the combination of low-dose aspirin and LMWH) dramatically improved the obstetrical prognosis in primary obstetrical APS (OAPS). The persistence of adverse pregnancy outcome raises the need to find other drugs to improve obstetrical outcome. Hydroxychloroquine is widely used in patients with various autoimmune diseases, particularly SLE. Antimalarials have many anti-inflammatory, anti-aggregant and immune-regulatory properties: they inhibit phospholipase activity, stabilize lysosomal membranes, block the production of several pro-inflammatory cytokines and, in addition, impair complement-dependent antigen-antibody reactions. There is ample evidence of protective effects of hydroxychloroquine in OAPS similar to the situation in SLE arising from in vitro studies of pathophysiological working mechanism of hydroxychloroquine. However, the clinical data on the use of hydroxychloroquine in primary APS are lacking and prospective studies are necessary. PMID:25179813

  19. Anxiety disorders before birth and self-perceived distress during pregnancy: Associations with maternal depression and obstetric, neonatal and early childhood outcomes

    OpenAIRE

    Martini, Julia; Knappe, Susanne; Beesdo-Baum, Katja; Lieb, Roselind; Wittchen, Hans-Ulrich

    2013-01-01

    Background: Maternal perinatal mental health has been shown to be associated with adverse consequences for the mother and the child. However, studies considering the effect of DSM-IV anxiety disorders beyond maternal self-perceived distress during pregnancy and its timing are lacking. Aims: To examine the role of maternal anxiety disorders with an onset before birth and self-perceived distress during pregnancy for unfavourable maternal, obstetric, neonatal and childhood outcomes. Stud...

  20. Ectopic Pregnancy In Previously Infertile Women Subsequent Pregnancy Outcome After Laparoscopic Management

    Directory of Open Access Journals (Sweden)

    Siddhartha Chatterjee

    2009-05-01

    Full Text Available Ectopic tubal pregnancy (ETP is a major event in a woman's reproductive life particularly if it happens after treatment of infertility. It complicates infertility treatment and must be recognized early to simplify the treatment strategy, which must always be directed towards optimizing subsequent fertility. All the treatment trials and the Cochrane database meta-analysis show that medical treatment with methotrexate, preferably multi-dose, is equivalent in efficacy to conservative treatment with laparoscopy in the populations studied. The prolonged follow up and repeated estimation of costly beta subunit of human chorionic gonadotropin (hCG hormone required in medical treatment become inconvenient for patients in this country. Hence people here prefer onetime surgical treatment with short stay in hospital. Occurring during infertility treatment, it marks a reproductive failure, which always results in psychological setback. Amongst 1119 patients conceived after treatment of infertilities in a five year period between ‘02 & ’07 sixty-eight ETP were detected. More than 50% of them resulted in intrauterine pregnancy (IUP spontaneously or after ovulation induction within a period of one to one & half year following the occurrence of ETP. Regardless of the treatment strategy, a successful outcome requires a subsequent ongoing IUP, the ultimate goal of fertility treatment. Nonetheless ETP resulting from fertility treatment is a specific entity, and better knowledge of it should help to improve diagnosis and prognosis, simplify treatment, and optimize subsequent pregnancy outcome.

  1. Successful outcome of pregnancy in uncorrected tetralogy of fallot

    Directory of Open Access Journals (Sweden)

    Kashika Gupta

    2014-06-01

    Full Text Available Tetralogy Of Fallot (TOF is the most common cyanotic congenital heart disease. Most commonly, it is detected in the first year of life and it is rare for patients with the disease to reach adulthood without corrective surgery. Pregnancy in patients with uncorrected TOF is rare and is associated with high morbidity and mortality rates. This is due to increased maternal hypoxemia and cyanosis because of fall in systemic vascular resistance and rise in cardiac output which exacerbates the right to left shunt. Its management poses a challenge to the clinician because of the rarity of its occurrence and the paucity of literature. 22 year old woman, G3A2 with uncorrected TOF presented at 36 weeks gestation to the emergency room with breathlessness on routine daily activities (NYHA III and severe fetal growth restriction. The patient had higher hemoglobin and hematocrit levels and lower platelet count. Oxygen saturation was low. Pregnancy was terminated by caesarean section under spinal anesthesia. Post caesarean patient had a febrile course and falling oxygen saturation (nadir 45.4% which was intensively managed in consultation with cardiologist and physicians. She was discharged along with her baby in satisfactory condition on post-operative day twelve. Uncorrected TOF in pregnancy poses a therapeutic dilemma to the obstetrician, cardiologist and anesthetist. Intensive multidisciplinary management is essential to optimize the fetomaternal prognosis. With adequate care, good outcome can be achieved. [Int J Reprod Contracept Obstet Gynecol 2014; 3(3.000: 799-802

  2. The effect of endometrial thickness on the day of hCG administration on pregnancy outcome in the first fresh IVF/ICSI cycle.

    Science.gov (United States)

    Fang, Rui; Cai, Liyi; Xiong, Fang; Chen, Jie; Yang, Weimin; Zhao, Xin

    2016-06-01

    The aim of this study was to investigate the effect of endometrial thickness (EMT) on human chorionic gonadotropin (hCG) day on in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) outcome. A retrospective study was conducted on the clinical data of 756 patients in their first fresh IVF/ICSI cycle at the Wuxi Maternity and Child Health Hospital. Compared with the pregnancy failure group, the clinical pregnancy group had more transferable embryos and good-quality embryos and had a thicker endometrium (p  14 mm). Group1 had significantly lower clinical pregnancy, embryo implantation and live birth rates compared with group 2 and 3 (p IVF/ICSI cycle. A higher clinical pregnancy rate could be achieved when EMT ≥ 8 mm, and no adverse pregnancy outcome was observed when EMT > 14 mm. PMID:26743235

  3. Limited Depressive and Anxiety Symptoms Late in Pregnancy Are Not Related to Neonatal Outcomes

    Directory of Open Access Journals (Sweden)

    Varela

    2015-09-01

    Full Text Available Background Prior studies have reported inconsistent findings regarding the link between antenatal depressive and anxiety symptomatology, with neonatal outcomes. Objectives The aim of the present study was to assess the possible association of prenatal depressive and anxiety symptoms, in the third trimester of pregnancy, with perinatal outcomes (birth weight of the newborn, Apgar score and the newborn’s admission in neonatal intensive care unit in a sample of pregnant women, in Greece. Patients and Methods A total of 117 women from Athens, during the 32nd to 35th week of pregnancy, participated in the study. Demographic and obstetric history data, as well as neonatal outcomes, were recorded. Three self-administered psychometric scales (Beck depression inventory (BDI, Edinburg postnatal depression scale (EPDS and beck anxiety inventory (BAI were used to evaluate in detail the prenatal depressive and anxiety symptoms. Descriptive statistics, Spearman’s Rho coefficients, Mann-Whitney U and Kruskal-Wallis testes were applied to analyze the data. Results On the basis of BDI, 81.1% of the sample showed minimal, 15.4% mild, 2.6% moderate and 0.9% severe depressive symptoms, respectively. Furthermore, 80.3% of the participants, scored on EPDS below the cut-off point for a likely diagnosis of depression. According to BAI scale, 43.6% showed minimal, 42.7% women mild, 10.3% moderate and 3.4% severe anxiety symptoms. No statistically significant correlations were found between depressive and anxiety symptoms and neonatal outcomes (birth weight, Apgar score and admission in neonatal intensive care unit. Conclusions Limited levels of prenatal depressive and anxiety symptoms do not seem to be associated with neonatal outcomes. In clinical practice, pregnant women, who suffer from low levels of prenatal depressive and anxiety symptoms, may be reassured, in respect of the adverse outcomes of these mood symptoms on the neonate.

  4. Group Prenatal Care Results in Medicaid Savings with Better Outcomes: A Propensity Score Analysis of CenteringPregnancy Participation in South Carolina.

    Science.gov (United States)

    Gareau, Sarah; Lòpez-De Fede, Ana; Loudermilk, Brandon L; Cummings, Tammy H; Hardin, James W; Picklesimer, Amy H; Crouch, Elizabeth; Covington-Kolb, Sarah

    2016-07-01

    Objectives This study was undertaken to determine the cost savings of prevention of adverse birth outcomes for Medicaid women participating in the CenteringPregnancy group prenatal care program at a pilot program in South Carolina. Methods A retrospective five-year cohort study of Medicaid women was assessed for differences in birth outcomes among women involved in CenteringPregnancy group prenatal care (n = 1262) and those receiving individual prenatal care (n = 5066). The study outcomes examined were premature birth and the related outcomes of low birthweight (LBW) and neonatal intensive care unit (NICU) visits. Because women were not assigned to the CenteringPregnancy group, a propensity score analysis ensured that the inference of the estimated difference in birth outcomes between the treatment groups was adjusted for nonrandom assignment based on age, race, Clinical Risk Group, and plan type. A series of generalized linear models were run to estimate the difference between the proportions of individuals with adverse birth outcomes, or the risk differences, for CenteringPregnancy group prenatal care participation. Estimated risk differences, the coefficient on the CenteringPregnancy group indicator variable from identity-link binomial variance generalized linear models, were then used to calculate potential cost savings due to participation in the CenteringPregnancy group. Results This study estimated that CenteringPregnancy participation reduced the risk of premature birth (36 %, P NICU stay (28 %, P < 0.05, $27,249). After considering the state investment of $1.7 million, there was an estimated return on investment of nearly $2.3 million. Conclusions Cost savings were achieved with better outcomes due to the participation in CenteringPregnancy among low-risk Medicaid beneficiaries. PMID:26979611

  5. Pregnancy complications of physicians.

    OpenAIRE

    Katz, V L; Miller, N H; Bowes, W A

    1988-01-01

    Studies indicate an increased risk of adverse late pregnancy events, such as preterm labor and preterm delivery, for practicing physicians. These adverse pregnancy outcomes also occur among pregnant women who work long hours with high levels of psychological stress, a mechanism most likely related to catecholamine and posturally mediated alterations in uterine blood flow. Further evaluation and research into the epidemiology of physicians' pregnancies are needed because of the increasing numb...

  6. Pregnancy Outcomes of In Vitro Fertilization with or without Ovarian Hyperstimulation Syndrome: A Retrospective Cohort Study in Chinese Patients

    Institute of Scientific and Technical Information of China (English)

    Xuan Jiang; Cheng-Yan Deng; Zheng-Yi Sun; Wei-Lin Chen; Han-Bi Wang; Yuan-Zheng Zhou; Li Jin

    2015-01-01

    Background: The effect of ovarian hyperstimulation syndrome (OHSS) on pregnancy outcomes of in vitro fertilization (IVF) patients is still ambiguous.This study aimed to analyze pregnancy outcomes of IVF with or without OHSS in Chinese patients.Methods: A retrospective cohort study was undertaken to compare pregnancy outcomes between 190 women with OHSS and 197 women without OHSS.We examined the rates of clinical pregnancy, multiple pregnancies, miscarriage, live birth, preterm delivery, preterm birth before 34 weeks' gestation, cesarean delivery, low birth weight (LBW), and small-for-gestational age (SGA) between the two groups.Odds ratios (ORs) and 95% confidence intervals (CIs) of measure of clinical pregnancy were also analyzed.Results: The clinical pregnancy rate of OHSS patients was significantly higher than that of non-OHSS patients (91.8% vs.43.5%, P < 0.001).After controlling for drug protocol and causes of infertility, the adjusted ORs of moderate OHSS and severe/critical OHSS for clinical pregnancy were 4.65 (95% CI, 1.86-11.61) and 5.83 (95% CI, 3.45-9.86), respectively.There were no significant differences in rates of multiple pregnancy (4.0% vs.3.7%) and miscarriage (16.1% vs.17.5%) between the two groups.With regard to ongoing clinical pregnancy, we also found no significant differences in the rates of live birth (82.1% vs.78.8%), preterm delivery (20.9% vs.17.5%), preterm birth before 34 weeks' gestation (8.6% vs.7.9%), cesarean delivery (84.9% vs.66.3%), LBW (30.2% vs.23.5%), and SGA (21.9% vs.17.6%) between the two groups.Conclusion: OHSS, which occurs in the luteal phase or early pregnancy in IVF patients and represents abnormal transient hemodynamics, does not exert any obviously adverse effect on the subsequent pregnancy.

  7. G-CSF Intrauterine for Thin Endometrium, and Pregnancy Outcome

    Directory of Open Access Journals (Sweden)

    Ensieh Tehraninejad

    2015-10-01

    Full Text Available Objective:To evaluate effects ofG-CSF on a cancelled ART cycle due to thin endometrium.Materials and methods:In a nonrandomized clinical trial from January 2011 to January 2013 in two tertiary university based hospitals fifteen patients undergoing embryo transfer and with the history of cycle cancellation due to thin endometrium were studied. Intrauterine infusion of G-CSF was done on the day of oocyte pick-up or 5 days before embryo transfer. The primary outcome to be measured was an endometrium thickened to at least 6 mm and the secondary outcome was clinical pregnancy rate and consequently take-home baby. All previous cycles were considered as control for each patient.Results:The G-CSF was infused at the day of oocyte retrieval or 5 days before embryo transfer. The endometrial thickness reached from3.593±0.251 mm to 7.120±0.84 mm. The mean age, gravidity, parity, and FSH were 35.13± 9.531 years,3, 1 and32.78± 31.10 mIU/ml, respectively. The clinical pregnancy rate was 20%, and there was one missed abortion, a mother death at 34 weeks, and a preterm labor at 30 weeks due to PROM.Conclusion:G-CSF may increase endometrial thickness in the small group of patients who had no choice except cycle cancellation or surrogacy.

  8. PREGNANCY AND ITS OUTCOME IN WOMEN WITH MALFORMED UTERUS

    Institute of Scientific and Technical Information of China (English)

    马水清; 边旭明; 郎景和

    2002-01-01

    Objective. To analyze the clinical characteristics of fertility and pregnancy in women with congenital uterine malformations and explore optimal treatments to improve the prognosis.Methods. A retrospective study was conducted on the fertility and obstetric outcome in 153 patients with uterine malformations treated in our hospital from January 1984 to December 1998. Twenty - seven cases with other kinds of genital and/or urinary anomalies but with normal uterus during the same period were enrolled as the control group.Results. The infertility rate was 26.6% (34/128), the miscarriage rate 44.3% (86/194), premature birth rate 9.3% (18/194), abnormal fetal presentation rate 28.4% (29/102), the cesarean section rate 61.8% (63/102), and the perinatal mortality rate 11.8% (12/102).Conclusion. Women with congenital uterine malformation usually have higher incidence of infertility and complications during pregnancy and delivery. Bicornuate and septate uterus can be associated with poor obstetric outcome.

  9. Femoral and Inguinal Hernia : How to Minimize Adverse Outcomes Following Repair

    OpenAIRE

    Dahlstrand, Ursula

    2011-01-01

    Groin hernia is common, and each year 200 repairs per 100 000 adult inhabitants are performed in Sweden. Groin hernias are either inguinal or femoral (2-4%). Elective repair is not associated with an excess mortality, but adverse outcomes include recurrence and long-term pain. Emergency procedures have a 4% mortality rate with an increased risk for bowel resection and postoperative complications. The aim of this thesis was to identify risk factors for adverse outcomes and to propose measures ...

  10. No association between anxiety and depression and adverse clinical outcome among patients with cardiovascular disease

    DEFF Research Database (Denmark)

    Kornerup, Henriette; Zwisler, Ann-Dorthe Olsen; Prescott, Eva

    2011-01-01

    Anxiety and depression have been linked to adverse prognostic outcome in patients with cardiovascular disease (CVD) with mixed results. The timing of anxiety and depression measurement has received little attention so far.......Anxiety and depression have been linked to adverse prognostic outcome in patients with cardiovascular disease (CVD) with mixed results. The timing of anxiety and depression measurement has received little attention so far....

  11. Insulin resistance, adiponectin and adverse outcomes following elective cardiac surgery: a prospective follow-up study

    OpenAIRE

    Hjortdal Vibeke E; Christensen Thomas D; Andersen Niels H; Gjedsted Jakob; Hansen Troels K; Mikkelsen Martin M; Johnsen Søren P

    2010-01-01

    Abstract Background Insulin resistance and adiponectin are markers of cardio-metabolic disease and associated with adverse cardiovascular outcomes. The present study examined whether preoperative insulin resistance or adiponectin were associated with short- and long-term adverse outcomes in non-diabetic patients undergoing elective cardiac surgery. Methods In a prospective study, we assessed insulin resistance and adiponectin levels from preoperative fasting blood samples in 836 patients unde...

  12. Adverse reproduction outcomes among employees working in biomedical research laboratories

    DEFF Research Database (Denmark)

    Wennborg, H.; Bonde, Jens Peter; Stenbeck, M.;

    2002-01-01

    Objectives The aim of the study was to investigate reproductive outcomes such as birthweight, preterm births, and postterm births among women working in research laboratories while pregnant. Methods Female university personnel were identified from a source cohort of Swedish laboratory employees...

  13. Cord around neck in singleton term pregnancies and its outcome

    International Nuclear Information System (INIS)

    To enlist the complications with nuchal cord in singleton term pregnancies and to determine maternal and fetal outcome in singleton term pregnancies. Design: Descriptive study. Place and duration of study: The study was carried out at Gynaecology and Obstetric department Combined Military Hospital Quetta from Nov 2007 to May 2008. Patients and methods: One hundred women irrespective of parity with healthy, singleton term pregnancy and cephalic presentation, labouring or not labouring, were selected from outpatient department. A total of 41 patients were booked with Doppler ultrasound done in antenatal period. Other 59 were poorly booked and diagnosed with cord around neck by clinical criteria e.g. high head at term, fetal distress, meconium discharge, slow progress in labour leading to prolonged labour. All patients signed well informed written proforma regarding study and its outcome. Vigilant feto maternal monitoring was done during labour. All events during labour were mentioned in proformas which were attached with patients case notes. Data was interperated in term of frequency and percentages. Results: Complications with cord around neck found were still birth 3%, fetal distress 15%, intrauterine death 1%. Prolonged labour was seen in 14%, Meconium discharge in 5%, and high presenting part was found in 11% of cases. Maternal outcome were elective caesarean section in 6%, emergency caesarean-section in 32%, spontaneous vaginal delivery in 54% and instrumental vaginal delivery in 8% of the cases. Different fetal outcomes seen were intrauterine death, stillbirth in 1%, and 3% patients respectively. Regarding neonatal outcome, 31% stayed in neonatal intensive care unit (NICU) for less than 48 hours, 69% stayed in NICU for more than 48 hours out of which 4% had early neonatal deaths (ENND). Fifty nine percent patients detected and suspected during labour were with, high head, slow progress in labour, decreased fetal movements, intra partum fetal distress, meconium

  14. Occupational Risks and Pregnancy and Infant Health Outcomes in Florida Farmworkers

    Directory of Open Access Journals (Sweden)

    Jennifer Runkle

    2014-08-01

    Full Text Available The agricultural industry has some of the highest incidence rates and numbers of occupational injuries and illnesses in the United States. Injuries and illnesses in agriculture result from accidents, falls, excessive heat, repetitive motion and adverse pesticide exposure. Women working in agriculture are exposed to the same hazards and risks as their male counterparts, but can face additional adverse impacts on their reproductive health. Yet, few occupational risk assessment studies have considered the reproductive health of female farmworkers. The objective of this community-based participatory research study was to conduct a retrospective, cross-sectional survey to collect information on workplace conditions and behaviors and maternal, pregnancy and infant health outcomes among a sample of female nursery and fernery farmworkers in Central Florida. Survey results showed that nursery workers were more likely to report health symptoms during their pregnancy than fernery workers. We also observed a self-reported increased risk of respiratory illness in the first year of life for infants whose mothers worked in ferneries. Our findings confirm that agricultural work presents potential reproductive hazards for women of childbearing age.

  15. Pregnancy and fetal outcomes after exposure to mefloquine in the pre- and periconception period and during pregnancy

    OpenAIRE

    Schlagenhauf, Patricia; Blumentals, William A.; Suter, Pia; Regep, Loredana; Vital-Durand, Gabriel; Schaerer, Martin T; Boutros, Margarita Suarez; Rhein, Hans-Georg; Adamcova, Miriam

    2012-01-01

    Background: Pregnant women who travel to malarious areas and their clinicians need data on the safety of malaria chemoprophylaxis. Methods: The effect of exposure to mefloquine on pregnancy and offspring outcomes was evaluated using the F. Hoffmann-La Roche global drug safety database for the time frame 31 January 1986 through 26 October 2010. We investigated pregnancy and fetal outcomes in maternal, paternal, and both-parent exposure cases with a focus on congenital malformations and feta...

  16. Pregnancy and Fetal Outcomes After Exposure to Mefloquine in the Pre- and Periconception Period and During Pregnancy

    OpenAIRE

    Schlagenhauf, Patricia; Blumentals, William A.; Suter, Pia; Regep, Loredana; Vital-Durand, Gabriel; Schaerer, Martin T; Boutros, Margarita Suarez; Rhein, Hans-Georg; Adamcova, Miriam

    2012-01-01

    Background.  Pregnant women who travel to malarious areas and their clinicians need data on the safety of malaria chemoprophylaxis. Methods.  The effect of exposure to mefloquine on pregnancy and offspring outcomes was evaluated using the F. Hoffmann–La Roche global drug safety database for the time frame 31 January 1986 through 26 October 2010. We investigated pregnancy and fetal outcomes in maternal, paternal, and both-parent exposure cases with a focus on congenital malformations and fetal...

  17. Prevalence, Risk Factors and Outcomes of Velamentous and Marginal Cord Insertions: A Population-Based Study of 634,741 Pregnancies

    OpenAIRE

    Ebbing, Cathrine; Kiserud, Torvid; Johnsen, Synnøve Lian; Albrechtsen, Susanne; Rasmussen, Svein

    2013-01-01

    Objectives To determine the prevalence of, and risk factors for anomalous insertions of the umbilical cord, and the risk for adverse outcomes of these pregnancies. Design Population-based registry study. Setting Medical Birth Registry of Norway 1999–2009. Population All births (gestational age >16 weeks to

  18. Study of obstetric and fetal outcome of twin pregnancy in a tertiary care centre

    Directory of Open Access Journals (Sweden)

    Gurpreet Kaur Nandmer

    2015-12-01

    Conclusions: Twin pregnancies are high risk pregnancies with more maternal and fetal complications. The use of antenatal care services, identification and anticipation of complications, intrapartum management and good NICU facilities will help to improve maternal and neonatal outcome in twin pregnancies. [Int J Reprod Contracept Obstet Gynecol 2015; 4(6.000: 1789-1792

  19. Effectiveness of Home Visits in Pregnancy as a Public Health Measure to Improve Birth Outcomes.

    Directory of Open Access Journals (Sweden)

    Kayoko Ichikawa

    Full Text Available Birth outcomes, such as preterm birth, low birth weight (LBW, and small for gestational age (SGA, are crucial indicators of child development and health.To evaluate whether home visits from public health nurses for high-risk pregnant women prevent adverse birth outcomes.In this quasi-experimental cohort study in Kyoto city, Japan, high-risk pregnant women were defined as teenage girls (range 14-19 years old, women with a twin pregnancy, women who registered their pregnancy late, had a physical or mental illness, were of single marital status, non-Japanese women who were not fluent in Japanese, or elderly primiparas. We collected data from all high-risk pregnant women at pregnancy registration interviews held at a public health centers between 1 July 2011 and 30 June 2012, as well as birth outcomes when delivered from the Maternal and Child Health Handbook (N = 964, which is a record of prenatal check-ups, delivery, child development and vaccinations. Of these women, 622 women were selected based on the home-visit program propensity score-matched sample (pair of N = 311 and included in the analysis. Data were analyzed between January and June 2014.In the propensity score-matched sample, women who received the home-visit program had lower odds of preterm birth (odds ratio [OR], 0.62; 95% confidence interval [CI], 0.39 to 0.98 and showed a 0.55-week difference in gestational age (95% CI: 0.18 to 0.92 compared to the matched controlled sample. Although the program did not prevent LBW and SGA, children born to mothers who received the program showed an increase in birth weight by 107.8 g (95% CI: 27.0 to 188.5.Home visits by public health nurses for high-risk pregnant women in Japan might be effective in preventing preterm birth, but not SGA.

  20. Water aerobics in pregnancy: cardiovascular response, labor and neonatal outcomes

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    Braga Angelica F

    2008-11-01

    Full Text Available Abstract Background To evaluate the association between water aerobics, maternal cardiovascular capacity during pregnancy, labor and neonatal outcomes. Methods A randomized, controlled clinical trial was carried out in which 34 pregnant women were allocated to a water aerobics group and 37 to a control group. All women were submitted to submaximal ergometric tests on a treadmill at 19, 25 and 35 weeks of pregnancy and were followed up until delivery. Oxygen consumption (VO2 max, cardiac output (CO, physical fitness, skin temperature, data on labor and delivery, and neonate outcomes were evaluated. Frequency distributions of the baseline variables of both groups were initially performed and then analysis of the outcomes was carried out. Categorical data were compared using the chi-square test, and numerical using Student's t or Mann-Whitney tests. Wilk's Lambda or Friedman's analysis of repeat measurements were applied for comparison of physical capacity, cardiovascular outcomes and maternal temperature. Results VO2 max and physical fitness were higher in both groups in the second trimester, returning to basal levels in the third trimester. In both groups, CO increased as pregnancy progressed and peak exercise temperature was higher than resting temperature, increasing further after five minutes of recovery and remaining at this level until 15 minutes after exercise completion. There was no difference between the two groups regarding duration (457.9 ± SD 249.6 vs 428.9 ± SD 203.2 minutes or type of delivery. Labor analgesia was requested by significantly fewer women in the water aerobics group (27% vs 65%; RR = 0.42 95%CI 0.23–0.77. Neonatal results were similar in both groups. Conclusion The regular practice of moderate water aerobics by sedentary and low risk pregnant women was not detrimental to the health of the mother or the child. There was no influence on maternal cardiovascular capacity, duration of labor or type of delivery; however

  1. Associations of the pre-pregnancy BMI and gestational BMI gain with pregnancy outcomes in Chinese women with gestational diabetes mellitus

    OpenAIRE

    Sun, Dongmei; Li, Feifei; Zhang, Ya; Xu, Xianming

    2014-01-01

    Background: Pre-pregnancy body mass index (BMI) and weight change in women with gestational diabetes mellitus (GDM) during pregnancy likely have an effect on pregnancy outcome. However, limited clinical evidence is available to support the correlation. Aims: To investigate the relationship of pre-pregnancy BMI and gestational BMI gains and their effect on pregnancy outcome among Chinese women with GDM. Materials and Methods: Data were collected from 1418 pregnant patients with GDM who receive...

  2. Waiting time to pregnancy and pregnancy outcome among Danish workers in the textile, clothing, and footwear industries.

    Science.gov (United States)

    Schaumburg, I; Boldsen, J L

    1992-06-01

    The relationship between time from planned to achieved pregnancy and pregnancy outcome has been studied in a group of 18,658 workers in the textile, clothing and footwear industries. Information on pregnancy outcome and delay in conception in the period 1979-84 was collected by self administered questionnaires in 1985. The response rate was 70.3%. During the study period there had been 5,171 live births and 708 spontaneous abortions. Information on delay in conception was collected in broad categories. The data were analysed by means of a newly developed statistical parametric model in order to collect all possible information from the highly grouped data. Median waiting time before a pregnancy which ended in spontaneous abortion was 1.68 times longer than median waiting time before a pregnancy leading to a live birth. There seems to be a correlation between the length of the waiting time and abortion. PMID:1496329

  3. Adverse obstetric and perinatal outcomes following treatment of adolescent and young adult cancer: a population-based cohort study.

    Directory of Open Access Journals (Sweden)

    Fatima A Haggar

    Full Text Available OBJECTIVE: To investigate obstetric and perinatal outcomes among female survivors of adolescent and young adult (AYA cancers and their offspring. METHODS: Using multivariate analysis of statewide linked data, outcomes of all first completed pregnancies (n = 1894 in female survivors of AYA cancer diagnosed in Western Australia during the period 1982-2007 were compared with those among females with no cancer history. Comparison pregnancies were matched by maternal age-group, parity and year of delivery. RESULTS: Compared with the non-cancer group, female survivors of AYA cancer had an increased risk of threatened abortion (adjusted relative risk 2.09, 95% confidence interval 1.51-2.74, gestational diabetes (2.65, 2.08-3.57, pre-eclampsia (1.32, 1.04-1.87, post-partum hemorrhage (2.83, 1.92-4.67, cesarean delivery (2.62, 2.22-3.04, and maternal postpartum hospitalization>5 days (3.01, 1.72-5.58, but no excess risk of threatened preterm delivery, antepartum hemorrhage, premature rupture of membranes, failure of labor to progress or retained placenta. Their offspring had an increased risk of premature birth (<37 weeks: 1.68, 1.21-2.08, low birth weight (<2500 g: 1.51, 1.23-2.12, fetal growth restriction (3.27, 2.45-4.56, and neonatal distress indicated by low Apgar score (<7 at 1 minute (2.83, 2.28-3.56, need for resuscitation (1.66, 1.27-2.19 or special care nursery admission (1.44, 1.13-1.78. Congenital abnormalities and perinatal deaths (intrauterine or ≤7 days of birth were not increased among offspring of survivors. CONCLUSION: Female survivors of AYA cancer have moderate excess risks of adverse obstetric and perinatal outcomes arising from subsequent pregnancies that may require additional surveillance or intervention.

  4. Risk of infection and adverse outcomes among pregnant working women in selected occupational groups: A study in the Danish National Birth Cohort

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    Llopis-González Agustín

    2010-11-01

    Full Text Available Abstract Background Exposure to infectious pathogens is a frequent occupational hazard for women who work with patients, children, animals or animal products. The purpose of the present study is to investigate if women working in occupations where exposure to infections agents is common have a high risk of infections and adverse pregnancy outcomes. Methods We used data from the Danish National Birth Cohort, a population-based cohort study and studied the risk of Infection and adverse outcomes in pregnant women working with patients, with children, with food products or with animals. The regression analysis were adjusted for the following covariates: maternal age, parity, history of miscarriage, socio-occupational status, pre-pregnancy body mass index, smoking habit, alcohol consumption. Results Pregnant women who worked with patients or children or food products had an excess risk of sick leave during pregnancy for more than three days. Most of negative reproductive outcomes were not increased in these occupations but the prevalence of congenital anomalies (CAs was slightly higher in children of women who worked with patients. The prevalence of small for gestational age infants was higher among women who worked with food products. There was no association between occupation infections during pregnancy and the risk of reproductive failures in the exposed groups. However, the prevalence of CAs was slightly higher among children of women who suffered some infection during pregnancy but the numbers were small. Conclusion Despite preventive strategies, working in specific jobs during pregnancy may impose a higher risk of infections, and working in some of these occupations may impose a slightly higher risk of CAs in their offspring. Most other reproductive failures were not increased in these occupations.

  5. Zika Found in 9 U.S. Pregnancies, Outcomes Often Severe: CDC

    Science.gov (United States)

    ... nlm.nih.gov/medlineplus/news/fullstory_157505.html Zika Found in 9 U.S. Pregnancies, Outcomes Often Severe: ... among U.S. women who were infected with the Zika virus have resulted in tragic outcomes, federal health ...

  6. Teenage pregnancy outcomes in a rural area of South India: A prospective study

    OpenAIRE

    Chandrika R Doddihal; Sangappa M Katti; Mallapur, Maheshwar D.

    2015-01-01

    Context: Teenage pregnancy is dangerous for the mother, child and the community, and teenage girls are twice as likely to die of pregnancy and childbirth related complications as opposed to older women. Aims: (1) To know the outcomes of teenage pregnancies. (2) To study the sociodemographic profile of teenage pregnancies. Study Design: A longitudinal study. Study Setting: Vantamuri Primary Health Centre-Rural field practice area of Jawaharlal Nehru Medical College Belgaum. Materials and Metho...

  7. Theoretical Framework to Extend Adverse Outcome Pathways to Include Pharmacokinetic Considerations

    Science.gov (United States)

    Adverse Outcome Pathways (AOPs) have generated intense interest for their utility in linking known population outcomes to a molecular initiating event (MIE) that can be quantified using in vitro methods. While there are tens of thousands of chemicals in commercial use, biology h...

  8. Testing the association between psychosocial job strain and adverse birth outcomes--design and methods

    DEFF Research Database (Denmark)

    Larsen, Ann D; Hannerz, Harald; Obel, Carsten;

    2011-01-01

    A number of studies have examined the effects of prenatal exposure to stress on birth outcomes but few have specifically focused on psychosocial job strain. In the present protocol, we aim to examine if work characterised by high demands and low control, during pregnancy, is associated with the...... risk of giving birth to a child born preterm or small for gestational age....

  9. Intervillous macrophage migration inhibitory factor is associated with adverse birth outcomes in a study population in Central India.

    Directory of Open Access Journals (Sweden)

    Puspendra P Singh

    Full Text Available Macrophage migration inhibitory factor (MIF is a pluripotent factor produced by a variety of cells. It plays an important biological role in the regulation of pregnancy and has been shown to influence malaria pathogenesis. In this study, the levels of MIF in the peripheral, cord and placental intervillous blood (IVB plasma collected from women residing in a malaria endemic region of Central India was determined and its association with malaria in pregnancy and birth outcomes was investigated. MIF levels were significantly different in IVB, peripheral, and cord plasma, with IVB plasma having the highest MIF levels and peripheral plasma having the lowest. Placental malaria positive women had significantly higher IVB plasma MIF levels than placental malaria negative women, but this relationship was not seen in peripheral or cord plasma MIF levels. In addition, the odds of stillbirth and low birth weight deliveries for the uppermost placental MIF quartile (irrespective of placental malaria status was significantly higher than that of the lowest placental MIF quartile, supporting the hypothesis that elevated concentrations of placental MIF may be associated with an increased risk of adverse birth outcome.

  10. RISK FACTORS OF HIV-1 VERTICAL TRANSMISSION (VT AND THE INFLUENCE OF ANTIRETROVIRAL THERAPY (ART IN PREGNANCY OUTCOME

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    Maria F.M. Barral

    2014-04-01

    Full Text Available In the absence of intervention, the rate of vertical transmission of HIV can range from 15-45%. With the inclusion of antiretroviral drugs during pregnancy and the choice of delivery route this amounts to less than 2%. However ARV use during pregnancy has generated several questions regarding the adverse effects of the gestational and neonatal outcome. This study aims to analyze the risk factors for vertical transmission of HIV-1 seropositive pregnant women living in Rio Grande and the influence of the use of ARVs in pregnancy outcome. Among the 262 pregnant women studied the rate of vertical transmission of HIV was found to be 3.8%. Regarding the VT, there was a lower risk of transmission when antiretroviral drugs were used and prenatal care was conducted at the referral service. However, the use of ART did not influence the outcome of pregnancy. However, initiation of prenatal care after the first trimester had an influence on low birth weight, as well as performance of less than six visits increased the risk of prematurity. Therefore, the risk factors analyzed in this study appear to be related to the realization of inadequate pre-natal and maternal behavior.

  11. An update on diabetic women obstetrical outcomes linked to preconception and pregnancy glycemic profile: a systematic literature review.

    Science.gov (United States)

    Gizzo, Salvatore; Patrelli, Tito Silvio; Rossanese, Marta; Noventa, Marco; Berretta, Roberto; Di Gangi, Stefania; Bertin, Martina; Gangemi, Michele; Nardelli, Giovanni Battista

    2013-01-01

    Women with type 2 diabetes were less likely to have diabetes related complications than women with type 1. Women with type 1 diabetes had a high prepregnancy care and showed a worse glycemic control than women with type 2 both in the preconception period and during pregnancy. Obstetrical outcomes showed that preeclampsia and stillbirth rate is almost doubled in type 1 patients while perinatal deaths and SGA importantly increased in type 2 diabetes. In modern obstetrical care it is mandatory to maintain glucose levels as close to normal as possible particularly in diabetic population. HbA1C no higher than 6% before pregnancy and during the first trimester seems to decrease the risk of adverse obstetrical outcomes. Both the preconceptional counseling and glycemic profile optimization represent a fundamental step to improve pregnancy outcomes in women with preexisting diabetes. A systematic approach to family planning and the availability of preconception care for all diabetic women who desire pregnancy could be an essential step for diabetic management program. PMID:24319351

  12. Gestational diabetes mellitus and iron supplement; effects on pregnancy outcome.

    Directory of Open Access Journals (Sweden)

    Pouya Javadian

    2014-05-01

    Full Text Available The possible effect of iron supplementation has been investigated in the normal population and patients with gestational diabetes mellitus (GDM. In this study, we survey the risk factors of GDM in pregnant women in contrast with normoglycemic patients in a case control study in patients using iron supplement. This case control study conducted on 52 pregnant women with GDM (25 women with type Al and 27 women with Type A2 of GDM. The control group randomly selected 50 normoglycemic women. Venous blood sampling was done between 24 and 28 weeks of pregnancy for measuring of ferritin, lipoproteins, uric acid and malondialdehyde serum levels. Under study variables including age, gestational age, weight and BMI were gathered. All the women were followed up until the time of delivery and pregnancy outcome were gathered. The serum ferritin levels in GDM group was 31.22+15.44, which is significantly higher than 24.76+8.94, in the control group with (P=0.012. Plasma hemogulobin in the control group was 12.2+0.1 compared to 12.9+0.1 in GDM group which was significantly lower (P=0.005. Triglycerides was significantly higher in GDM group in contrast with the control group, 275.08+143.17 and 192.30+92.13 (P=0.001, respectively. Finally, our findings indicate the concentration of serum ferritin levels was significantly higher in The GDM group.

  13. Pregnancy outcome and prepregnancy body mass index in 2459 glucose-tolerant Danish women

    DEFF Research Database (Denmark)

    Jensen, Dorte; Damm, Peter; Sørensen, Bente;

    2003-01-01

    This study was undertaken to investigate the relationship between pregnancy outcome and prepregnancy overweight or obesity in women with a normal glucose tolerance test.......This study was undertaken to investigate the relationship between pregnancy outcome and prepregnancy overweight or obesity in women with a normal glucose tolerance test....

  14. Factors influencing fertility outcome after ectopic pregnancy: a descriptive observational study

    Directory of Open Access Journals (Sweden)

    Veena KS

    2015-06-01

    Conclusions: Subfertility, tubal pathology and age will influence on future fertility outcome following ectopic pregnancy. Radical or conservative surgery does not have influence on future pregnancy outcome. [Int J Reprod Contracept Obstet Gynecol 2015; 4(3.000: 820-823

  15. Pregnancy Outcomes of In Vitro Fertilization with or without Ovarian Hyperstimulation Syndrome: A Retrospective Cohort Study in Chinese Patients

    OpenAIRE

    Xuan Jiang; Cheng-Yan Deng; Zheng-Yi Sun; Wei-Lin Chen; Han-Bi Wang; Yuan-Zheng Zhou; Li Jin

    2015-01-01

    Background: The effect of ovarian hyperstimulation syndrome (OHSS) on pregnancy outcomes of in vitro fertilization (IVF) patients is still ambiguous. This study aimed to analyze pregnancy outcomes of IVF with or without OHSS in Chinese patients. Methods: A retrospective cohort study was undertaken to compare pregnancy outcomes between 190 women with OHSS and 197 women without OHSS. We examined the rates of clinical pregnancy, multiple pregnancies, miscarriage, live birth, preterm delivery,...

  16. Pregnancy outcomes of anti-hypertensives for women with chronic hypertension: a population-based study.

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    Chen-Yi Su

    Full Text Available BACKGROUND: The impact of anti-hypertensive treatment on fetus was unclear, and hence, remains controversial. We set out in this study to estimate the prevalence of adverse pregnancy outcomes, including low birth weight, preterm delivery and small for gestational age amongst women with chronic hypertension, and to determine whether the use of anti-hypertensive drugs increases the risk of such adverse pregnancy outcomes. METHODOLOGY/PRINCIPAL FINDINGS: A total of 2,727 hypertension mothers and 8,181 matched controls were identified from the population-based cohort. These hypertension women were divided into seven sub-groups according to different types of prescribed anti-hypertensive drugs. Multivariable logistic regressions were conducted to estimate the risk of low birth weight, preterm birth and small for gestational age. Increased risk of low birth weight (OR = 2.29, 95% CI = 1.95-2.68, preterm birth (OR = 2.18, 95% CI = 1.89-2.52 and small for gestational age (OR = 1.62, 95% CI = 1.45-1.81 were all discernible within the hypertension group after adjusting for potential confounding factors. The increased ORs were found to differ with different types of anti-hypertensive drugs. Women who received vasodilators were associated with the highest risk of low birth weight (OR = 2.96, 95% CI = 2.06-4.26, preterm birth (OR = 2.92 95% CI = 2.06-4.15 and small for gestational age (OR = 2.12, 95% CI = 1.60-2.82. CONCLUSIONS/SIGNIFICANCE: This finding is important for practitioners, because it indicates the need for caution while considering the administration of anti-hypertensive drugs to pregnant women. These observations require confirmation in further studies that can better adjust for the severity of the underlying HTN.

  17. The Effects of Passive Smoking on Pregnancy Outcome, Hajar Hospital, Shahrekord

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    M Delaram

    2007-07-01

    Full Text Available Introduction : Adverse health effects of exposure to environmental tobacco smoke (ETS among non-smokers have been studied occasionally in developing countries. The aim of this study was to determine the effects of exposure to ETS on outcome in pregnancy Methods: In this descriptive and analytical study 600 non-smoking women delivering a singleton live baby were studied in delivery room in Hajar hospital in Shahrekord . A pre-designed structured questionnaire was used to record the details of exposure to ETS . Mother and infants outcomes were compared among those who were exposed to ETS vis-à-vis not exposed . We used spss software for analysis of data . Unpaired Student t-test was used for the comparison of continuous variables and Fisher’s Exact test was used for categorical variables. Multiple logistic regression analysis was performed after including all variables found to have significant differences on univariate analysis. Results: Of the 600 women studied 236 (39.3% were exposed to ETS. In these mothers there was a significantly higher incidence of pre-term birth (15.2% versus 7.9% , P = 0.001 and small-for-gestation babies (15.4% versus 6.8% , P= 0.0001 as compared to unexposed mothers. The mean birth weight of the babies born to the mothers exposed to ETS was 139 g less than that of babies in the unexposed group (3094.49 ±402 g versus 3233.99 ±443 g respectively, P= 0.001. The incidence of anemia was higher in exposed than unexposed mothers (P= 0.005 . The multiple logistic regression analyses showed that ETS exposure during pregnancy was significantly associated with a higher risk of small-for-gestation babies . Conclusion: Exposure to ETS during pregnancy is associated with higher risk of having a small-for-gestation baby.

  18. Use of Tamoxifen Before and During Pregnancy

    OpenAIRE

    Braems, Geert; Denys, Hannelore; De Wever, Olivier; Cocquyt, Veronique; Van den Broecke, Rudy

    2011-01-01

    The outcomes of pregnancies in women taking tamoxifen before conception and during pregnancy are reviewed. Because of potential confounding, a causal relationship between treatment with tamoxifen and adverse pregnancy outcome cannot be established. However, the high frequency of severe congenital abnormalities indicates that reliable birth control during tamoxifen therapy is mandatory.

  19. Pregnancy Outcomes of In Vitro Fertilization with or without Ovarian Hyperstimulation Syndrome: A Retrospective Cohort Study in Chinese Patients

    Directory of Open Access Journals (Sweden)

    Xuan Jiang

    2015-01-01

    Conclusion: OHSS, which occurs in the luteal phase or early pregnancy in IVF patients and represents abnormal transient hemodynamics, does not exert any obviously adverse effect on the subsequent pregnancy.

  20. Diet matters, particularly in pregnancy – Results from MoBa studies of maternal diet and pregnancy outcomes

    Directory of Open Access Journals (Sweden)

    Anne Lise Brantsæter

    2014-12-01

    Full Text Available Awareness that maternal diet may influence the outcome of pregnancy as well as the long-term health of mother and child has increased in recent years. A new food frequency questionnaire (FFQ was developed and validated specifically for the Norwegian Mother and Child Cohort Study (MoBa. The MoBa FFQ is a semi-quantitative tool which covers the average intake of food, beverages and dietary supplements during the first 4 to 5 months of pregnancy. It includes questions about intakes of 255 foods and dishes and was used from 2002 onwards. Data assessed by the MoBa FFQ is available for 87,700 pregnancies. Numerous sub-studies have examined associations between dietary factors and health outcomes in MoBa. The aim of this paper is to summarize the results from 19 studies of maternal diet and pregnancy outcomes, which is the complete collection of studies based on the MoBa FFQ and published before September 2014. The overall research question is whether maternal diet – from single substances to dietary patterns – matters for pregnancy outcome. The pregnancy outcomes studied till now include birth size measures, infants being small and large for gestational age, pregnancy duration, preterm delivery, preeclampsia, as well as maternal gestational weight gain and postpartum weight retention. As a whole, the results from these studies corroborate that the current dietary recommendations to pregnant women are sound and that maternal diet during pregnancy is likely to contribute to reduce the risk of pregnancy complications including preterm birth, preeclampsia, and reduced foetal growth. The results provide supporting evidence for recommending pregnant women to consume vegetables, fruit, whole grain, fish, dairy, and water regularly and lower the intake of sugar sweetened beverages, processed meat products and salty snacks. The results showing negative impact of even low levels of environmental contaminants support the precautionary advice on consumption

  1. Late childbearing and changing risks of adverse birth outcomes in Korea.

    Science.gov (United States)

    Cho, Youngtae; Hummer, Robert A; Choi, Yoon-Jung; Jung, Sung Won

    2011-05-01

    This study aimed to examine whether the relative importance of maternal age as a correlate of adverse birth outcomes has changed and to investigate if social inequalities in birth outcomes have widened during the past decade when the marriage and fertility related social environment has undergone tremendous change in Korea. Probabilities of adverse birth outcomes (prematurity and intrauterine growth retardation [IUGR]) were estimated with multinomial logistic regression models, utilizing the Korean birth registration data of 1995 and 2005. The main effects of maternal age and parental socioeconomic characteristics were compared between two study years, net of infant sex, birth order, and plurality. The association between maternal age and adverse birth outcomes, relative to the maternal and parental social characteristics, has clearly diminished between 1995 and 2005. During this period, differences in prematurity and IUGR by maternal age have also diminished, while those by parental social characteristics, particularly maternal education, have substantially widened. The intensified overall socioeconomic polarization since the economic crisis of the late 1990s is most likely responsible for the increased social inequality in adverse birth outcomes in Korea. A massive structural change in macro-economic conditions and culture during the study period may have modified the relationship between maternal age and birth outcomes. PMID:20432060

  2. Obstetric outcomes of monochorionic pregnancies conceived following assisted reproductive technology: A retrospective study

    Directory of Open Access Journals (Sweden)

    Mariano Mascarenhas

    2014-01-01

    Full Text Available Objectives : The overwhelming numbers of twins following assisted reproductive technology (ART are dichorionic twins, but monochorionic twins account for around 0.9% of post ART pregnancies. The data for post ART-monochorionic pregnancy outcomes are scarce due to the rarity of this condition. Hence, we evaluated the obstetric outcomes of monochorionic and dichorionic pregnancies conceived on ART. Settings : University teaching hospital. Study Design : A case-control study of monochorionic diamniotic (MCDA and dichorionic diamniotic (DCDA pregnancies conceived following ART treatment. Charts of all women who conceived following ART from 2008 to 2013 were screened. Among them, the monochorionic twins diagnosed in the first trimester were included and their obstetric outcome was followed-up. For comparison, an equal number of dichorionic twin pregnancies from age and body mass index matched mothers was selected. Results : The baseline clinical characteristics were similar between the two groups. MCDA group had a higher miscarriage rate (50% than the DCDA group (10%, with three seconds trimester miscarriages in the MCDA group. The live birth rates were lower in the MCDA versus DCDA group (40% vs. 90%. Among triplet pregnancies with a monochorionic component, the live birth rate was only 25%. Conclusions : Monochorionic pregnancies following ART have poorer obstetric outcomes when compared to dichorionic pregnancies. For monochorionic pregnancies following ART, intensive antenatal surveillance at a tertiary level obstetric and neonatal center may help optimize the outcome.

  3. PLACENTAL LOCATION AT SECOND TRIMESTER AND PREGNANCY OUTCOMES

    Directory of Open Access Journals (Sweden)

    Seadati N

    2013-04-01

    Full Text Available The aimed of this study was to find association between location of placental at second trimester and pregnancy outcomes. It was a descriptive -analytic epidemiological study which has performed on 250 pregnant women by simple random sampling in Razi hospital and Imam Khomeini hospital during July 2011 – October 2012 in Ahvaz city, Iran. Placental location was determined by sonography at 18 - 22 weeks of gestation, and it was classified to high / low category and anterior / posterior category. In this study has been assessed placental location with incidence of preeclampsia, intrauterine growth restriction and preterm birth. The incidence of preeclampsia and intrauterine growth restriction was 5.6%, 1.6% respectively, these parameters were not associated with placental location (p=0.84, p=0.69. The incidence of preterm birth was 7.2% and it was associated with low placental location (p=0.01.There was no significant difference between anterior and posterior placenta in all of outcomes. Low placental location was associated with increased risk of preterm labor and preterm delivery.

  4. THE OUTCOME OF PREGNANCY IN PATIENTS WITH THREATENED ABORTION

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    Prathap

    2015-10-01

    Full Text Available OBJECTIVE: To assess the Outcome of pregnancy in patients with threatened abortion. METHODS: A Prospective observational study was done on 106 pregnant women with threatened abortion. Out comes in the form of antenatal complications, mode of delivery and postnatal co mplications were noted. Analysis of the data was done using SPSS version 13. RESULTS: In the study of 106 patients 18% had spontaneous abortion. Pre - labour rupture of membranes were seen in 20% of patients and 21% had preterm labour. Threatened abortion di d not affect mode of delivery. PPROM, preterm births were more in women presenting with first trimester bleeding; PIH, PROM, and postpartum complications were more in women presenting beyond 20 weeks gestation though statistically not significant. 13.2% of women had heavy bleeding at admission out of which 50% aborted subsequently – significantly higher than the light bleeding group. CONCLUSION: The overall maternal and perinatal outcome in women with threatened abortion is suboptimal. Women with heavy blee ding are more likely to abort than women with light bleeding. Among the prognostic factors, only the amount of bleeding had significant prognostic accuracy

  5. The adverse influence of pregnancy upon sulphation: a clue to the pathogenesis of intrahepatic cholestasis of pregnancy?

    Science.gov (United States)

    Davies, M H; Ngong, J M; Yucesoy, M; Acharya, S K; Mills, C O; Weaver, J B; Waring, R H; Elias, E

    1994-12-01

    Sulphation of oestrogens and monohydroxy bile acids is important in attenuating their cholestatic potential. Thus, impairment of sulphation could lead to retention of cholestatic compounds and precipitate intrahepatic cholestasis in susceptible individuals. We tested the hypothesis that such a mechanism may be involved in the pathogenesis of intrahepatic cholestasis of pregnancy. In vivo and in vitro assessment of sulphation capacity was performed in patients with cholestasis of pregnancy, compared with control females on and off the oestrogen-containing oral contraceptive pill and control individuals during normal pregnancy and post partum, to assess the influence of high oestrogen states upon this metabolic pathway. During in vivo studies utilising paracetamol as a metabolic probe, the proportion of paracetamol sulphate and sulphate: glucuronide ratio were decreased in those with elevated oestrogens, whether the rise in oestrogens was endogenous, in pregnancy (paracetamol sulphate p < 0.05; paracetamol sulphate:glucuronide ratio p < 0.01), or exogenous, with the contraceptive pill (paracetamol sulphate p = 0.2; paracetamol sulphate:glucuronide ratio p < 0.001). In vitro, platelet sulphotransferase activity was measured, utilising phenol as substrate. Sulphotransferase activity decreased during pregnancy compared with repeat measurements post partum (p < 0.005) and compared with non-pregnant individuals (p < 0.05). In conclusion, we have shown that elevated oestrogens are associated with significant impairment in sulphation capacity. An imbalance of sulphation with glucuronidation provoked by high circulating oestrogen levels may be contributory in the pathogenesis of cholestasis of pregnancy. PMID:7699239

  6. Gestational diabetes mellitus: study of prevalence using criteria of diabetes in pregnancy study group in India and its impact on maternal and fetal outcome in a rural tertiary institute

    OpenAIRE

    Neelam Swaroop; Rajani Rawat; Pavika Lal; Naresh Pal; Kalpana Kumari; Priya Sharma

    2015-01-01

    Background: Gestational diabetes mellitus ((GDM) is defined as carbohydrate intolerance of varying degree of severity with onset or first recognition during pregnancy. GDM is associated with adverse fetomaternal outcome. Its early detection and management is essential for better perinatal outcome. The objective of the study was to assess the prevalence of gestational diabetes mellitus among pregnant women of western U.P. using diabetes in pregnancy study group in India (DIPSI) criteria and fu...

  7. Pregnancy rate and outcome in Swedish women with Turner syndrome.

    Science.gov (United States)

    Bryman, Inger; Sylvén, Lisskulla; Berntorp, Kerstin; Innala, Eva; Bergström, Ingrid; Hanson, Charles; Oxholm, Marianne; Landin-Wilhelmsen, Kerstin

    2011-06-30

    Pregnancies occurred in 57 (12%) of 482 Swedish women with Turner syndrome with a liveborn rate of 54% in 124 pregnancies. Spontaneous pregnancies occurred in 40%, mainly in women with 45,X/46,XX mosaicism, and oocyte donation in 53% where miscarriages were less frequent, odds ratio = 0.43 (95% confidence interval 0.17-1.04). PMID:21256486

  8. 妊娠期外阴阴道假丝酵母菌病症状与妊娠结局分析%Vulva Vagina Candida Disease Symptoms During Pregnancy and Pregnancy Outcome Analysis

    Institute of Scientific and Technical Information of China (English)

    莫培培

    2014-01-01

    目的:研究妊娠期外阴阴道假丝酵母菌病(VVC)症状与妊娠结局的关系。方法选取我院收集的136例妊娠>35 w患者阴道分泌物假丝酵母菌涂片阳性诊断VVC,其中有症状者60例作为观察组,无症状者76例作为对照组。观察两组妊娠结局及不良妊娠结局情况。结果观察组胎膜早破、产褥感染和剖宫产率与对照组比较差异有统计学意义(0.05)。结论妊娠期有症状VVC可致胎膜早破、剖宫产率等不良妊娠结局增高,早期诊断和治疗十分必要。%Objective To study the pregnancy vulva vagina candida disease symptoms and the relationship between pregnancy outcome (VVC). Methods Selected our hospital's col ection of 136 patients older than 35 weeks pregnancy vaginal candida smear positive diagnosis of VVC, including symptoms in 60 patients as observation group, asymptomatic 76 cases as control group. Observation two groups of pregnancy outcome and adverse pregnancy outcomes. Results The observation group of premature rupture of membranes, puerperal infection and cesarean section rate compared with control group dif erence was statistical y significant ( 0.05). Conclusion Symptomatic VVC during pregnancy can cause premature rupture of membranes, cesarean section rate increased and other adverse pregnancy outcomes, early diagnosis and treatment is necessary.

  9. Perinatal outcomes of Southeast Asians with pregnancies complicated by gestational diabetes mellitus or preeclampsia.

    Science.gov (United States)

    Cripe, Swee May; O'Brien, William; Gelaye, Bizu; Williams, Michelle A

    2012-10-01

    To examine risks for adverse perinatal outcomes among Southeast Asian women with pregnancies complicated by gestational diabetes mellitus (GDM) or preeclampsia. Perinatal outcomes of singleton births of Cambodian (3,489), Laotian (2,038), Vietnamese (11,605), Japanese (3,083) and non-Hispanic White women (33,088) were analyzed using Washington state linked birth certificate and hospitalization discharge records (1993-2006). Both Cambodian (aOR = 1.68) and Laotian (aOR = 1.71) women with GDM had increased odds of macrosomia when compared with Japanese women with GDM. Southeast Asian women with GDM had reduced odds of macrosomia when compared with White women. Southeast Asian women with preeclampsia had increased odds for preterm delivery when compared with Japanese and White women with preeclampsia. Research is needed to understand why Southeast Asian women with GDM are more likely to have better perinatal outcomes when compared with White women. Vigilant monitoring and culturally sensitive care for Southeast Asian women with preeclampsia is needed. PMID:22002706

  10. CT and MR imaging findings of systemic complications occurring during pregnancy and puerperal period, adversely affected by natural changes

    OpenAIRE

    Yuki Himoto; Aki Kido; Yusaku Moribata; Toshihide Yamaoka; Ryosuke Okumura; Kaori Togashi

    2015-01-01

    Dynamic physiological and anatomical changes for delivery may adversely induce various specific non-obstetric complications during pregnancy and puerperal period. These complications can be fatal to both the mother and the fetus, thus a precise and early diagnosis ensued by an early treatment is essential. Along with ultrasonography, computed tomography (CT) and magnetic resonance imaging (MRI) have assumed an increasing role in the diagnosis. This article aims to discuss the pathophysiolo...

  11. Sleep disordered breathing in pregnancy

    Directory of Open Access Journals (Sweden)

    Bilgay Izci Balserak

    2015-12-01

    Sleep disordered breathing (SDB is very common during pregnancy, and is most likely explained by hormonal, physiological and physical changes. Maternal obesity, one of the major risk factors for SDB, together with physiological changes in pregnancy may predispose women to develop SDB. SDB has been associated with poor maternal and fetal outcomes. Thus, early identification, diagnosis and treatment of SDB are important in pregnancy. This article reviews the pregnancy-related changes affecting the severity of SDB, the epidemiology and the risk factors of SDB in pregnancy, the association of SDB with adverse pregnancy outcomes, and screening and management options specific for this population.

  12. Pathways of neighbourhood-level socio-economic determinants of adverse birth outcomes

    OpenAIRE

    Meng, Gang; Thompson, Mary E.; Hall, G Brent

    2013-01-01

    Background Although socio-economic factors have been identified as one of the most important groups of neighbourhood-level risks affecting birth outcomes, uncertainties still exist concerning the pathways through which they are transferred to individual risk factors. This poses a challenge for setting priorities and developing appropriate community-oriented public health interventions and planning guidelines to reduce the level of adverse birth outcomes. Method This study examines potential d...

  13. "Maternal and neonatal outcome in teenage pregnancy in Tehran Valiasr Hospital "

    Directory of Open Access Journals (Sweden)

    "Nili F

    2002-05-01

    Full Text Available Among 2357 prenant women at Tehran Valiasr hospital, 99 women under 18 years with their 102 neonates were evaluated retrospectively during Aprill 1999 to April 2000. frequency of adolescent pregnancy was detected in 41.5 per 1000 live birth 7 (7.1% of mothers had preeclampisa, 7 thyroidal diseases, 3 valvular heart diseases, 2 urinary tract infections and 20.3% of women had prolonged rupture of membrane (more than 24 hrs. the route of delivery in 21.2% of women was cesarean section. 32% of neonates were low birth weight and the gestational age in 38.2% of neonates was lower than 37 weeks. Intrauterine growth retardiation was detected in 11.8% of patients 38.2% of babies were admitted into neonatal care unit. Perinatal resuscitation and ventilator care were needed in 9.8% and 3.9% of neonates respectively. Nonatal mortality occurred in 6.9% of patients. Compared with total deliveries the frequency of variables was higher than could be expected except for cesarean section. Our adolescent pregnancy rate is lower than worldwide range but rates for prematurity and low birth weight are the same as other reports from developed and developing countries. Frequency of cesarean section was lower than expected range in this group as in developed countries.With respect to higher rates for rheumatic heart disease, premature labor, prolonged rupture o membrane and low birth weight, it seems that lower socioeconomic factors may result in these adverse outcomes.Higher neonatal ICU admissions, artificial ventilation and resuscitation in adolescent pregnancies suggest that confinement in hospitals with level III nurseries is advisable in these high risk group

  14. The role of eating disorders for pregnancy, neonatal outcome and the child's early development

    OpenAIRE

    Koubaa, Saloua

    2013-01-01

    Little is known about the impact of eating disorders (ED) on pregnancy, infant growth and cognitive development. Preliminary reports indicate increased complications during pregnancy and lower birth weight in children of mothers with ED. There is need of prospective long-term follow-up of growth and cognitive development of the children of these mothers. Aims: To study the impact of ED on pregnancy and neonatal outcomes, maternal adjustment, and infant growth and cognitive development c...

  15. Perinatal Outcome of Monochorionic in Comparison to Dichorionic
Twin Pregnancies

    OpenAIRE

    Nihal Al Riyami; Asmaa Al-Rusheidi; Murtadha Al-Khabori

    2013-01-01

    Objective: The aim of this study is to compare the neonatal outcomes of monochorionic and dichorionic twin pregnancies.Methods: A retrospective cohort study involving 51 twin pregnancies followed and delivered at Sultan Qaboos University Hospital was conducted between January 2006 and December 2011.Result: Thirty six (71%) pregnancies were dichorionic diamniotic (DCDA), 14 (27%) were monochorionic diamniotic (MCDA), and one (2%) was monochorionic monoamniotic (MCMA). The antepartum complicati...

  16. Thyroid Function in Pregnancy and Its Influences on Maternal and Fetal Outcomes

    OpenAIRE

    Saki, Forough; Dabbaghmanesh, Mohammad Hossein; Ghaemi, Seyede Zahra; Forouhari, Sedighe; Ranjbar Omrani, Gholamhossein; Bakhshayeshkaram, Marzieh

    2014-01-01

    Background: Maternal thyroid function alters during pregnancy. Inadequate adaptation to these changes results in thyroid dysfunction and pregnancy complications. Objectives: This prospective study aimed to evaluate the prevalence of thyroid diseases in pregnancy and its outcomes in south of Iran. Materials and Methods: This prospective study was conducted on 600 healthy singleton pregnant women who aged 18 to 35 years old at 15 to 28 weeks of gestation. We investigated the prevalence of thyro...

  17. The Assessment of Diet Quality and Its Effects on Health Outcomes Pre-pregnancy and during Pregnancy.

    Science.gov (United States)

    Martin, Julie C; Zhou, Shao J; Flynn, Angela C; Malek, Lenka; Greco, Rebecca; Moran, Lisa

    2016-03-01

    Overweight and obesity pre pregnancy or during pregnancy is associated with an increased risk for maternal obstetric and fetal complications. Diet is one modifiable risk factor that women may be motivated to improve. General healthy eating guidelines, micronutrient sufficiency and macronutrient quantity and quality are important nutrition considerations pre and during pregnancy. With regards to specific nutrients, health authorities have recommendations for folate and/or iodine supplementation; but not consistently for iron and omega-3 despite evidence for their association with health outcomes. There are modest additional requirements for energy and protein, but not fat or carbohydrate, in mid-late pregnancy. Diet indices and dietary pattern analysis are additional tools or methodologies used to assess diet quality. These tools have been used to determine dietary intakes and patterns and their association with pregnancy complications and birth outcomes pre or during pregnancy. Women who may unnecessarily resist foods due to fear of food contamination from listeriosis and methylmercury may limit their diet quality and a balanced approached is required. Dietary intake may also vary according to certain population characteristics. Additional support for women who are younger, less educated, overweight and obese, from socially disadvantaged areas, smokers and those who unnecessarily avoid healthy foods, is required to achieve a higher quality diet and optimal lifestyle peri conception. PMID:26886241

  18. Effect of multiple micronutrient supplementation during pregnancy on maternal and birth outcomes

    Directory of Open Access Journals (Sweden)

    Yakoob Mohammad

    2011-04-01

    Full Text Available Abstract Objectives/background Given the widespread prevalence of micronutrient deficiencies in developing countries, supplementation with multiple micronutrients rather than iron-folate alone, could be of potential benefit to the mother and the fetus. These benefits could relate to prevention of maternal complications and reduction in other adverse pregnancy outcomes such as small-for-gestational age (SGA births, low birth weight, stillbirths, perinatal and neonatal mortality. This review evaluates the evidence of the impact of multiple micronutrient supplements during pregnancy, in comparison with standard iron-folate supplements, on specific maternal and pregnancy outcomes of relevance to the Lives Saved Tool (LiST. Data sources/review methods A systematic review of randomized controlled trials was conducted. Search engines used were PubMed, the Cochrane Library, the WHO regional databases and hand search of bibliographies. A standardized data abstraction and Child Health Epidemiology Reference (CHERG adaptation of the Grading of Recommendations Assessment, Development and Evaluation (GRADE technique were used for data abstraction and overall quality of evidence. Meta-analyses were performed to calculate summary estimates of utility to the LiST model for the specified outcome of incidence of SGA births. We also evaluated the potential impact of multiple micronutrients on neonatal mortality according to the proportion of deliveries occurring in facilities (using a threshold of 60% to indicate functionality of health systems for skilled births. Results We included 17 studies for detailed data abstraction. There was no significant benefit of multiple micronutrients as compared to iron folate on maternal anemia in third trimester [Relative risk (RR = 1.03; 95% confidence interval (CI: 0.87 – 1.22 (random model]. Our analysis, however, showed a significant reduction in SGA by 9% [RR = 0.91; 95% CI: 0.86 – 0.96 (fixed model]. In the fixed model

  19. Studying Biology to Understand Risk: Dosimetry Models and Quantitative Adverse Outcome Pathways

    Science.gov (United States)

    Confidence in the quantitative prediction of risk is increased when the prediction is based to as great an extent as possible on the relevant biological factors that constitute the pathway from exposure to adverse outcome. With the first examples now over 40 years old, physiologi...

  20. Risk factors for adverse outcome in preterm infants with periventricular hemorrhagic infarction

    NARCIS (Netherlands)

    Roze, Elise; Kerstjens, Jorien M.; Maathuis, Carel G. B.; ter Horst, Hendrik J.; Bos, Arend F.

    2008-01-01

    OBJECTIVE. Our objective was to identify risk factors that were associated with mortality and adverse neurologic outcome at 18 months of age in preterm infants with periventricular hemorrhagic infarction. METHODS. This was a retrospective cohort study of all preterm infants who were <37 weeks' gesta

  1. Adverse Outcomes to Early Middle Age Linked With Childhood Residential Mobility

    DEFF Research Database (Denmark)

    Webb, Roger T; Pedersen, Carsten B; Mok, Pearl L H

    2016-01-01

    vigilance is indicated for relocated adolescents and their families, with a view to preventing longer-term adverse outcomes in this population among all socioeconomic groups. Risk management will require close cooperation among multiple public agencies, particularly child, adolescent, and adult mental...

  2. Mechanisms underlying the associations of maternal age with adverse perinatal outcomes

    DEFF Research Database (Denmark)

    Lawlor, Debbie A; Mortensen, Laust; Andersen, Anne-Marie Nybo

    2011-01-01

    The mechanisms underlying the association between maternal age (both young and older maternal age) and adverse perinatal outcomes are unclear. Methods We examined the association of maternal age at first birth with preterm birth (<37 weeks gestation) and small for gestational age (SGA) in a cohor...

  3. Effect of environmental exposure to Cadmium on pregnancy outcome

    Directory of Open Access Journals (Sweden)

    F. Ramezanzadeh

    2010-04-01

    Full Text Available "n "n "nBackgrounds andObjectives:The objective of the present study was to evaluate the potential effect of environmental exposure to toxic metal (cadmium on pregnancy outcome and fetal growth."nMaterials and Methods: 330 normal pregnant women were randomly selected from vali-e-asr hospital, from July 2003 through Feb. 2005. Cadmium was measured in umbilical cord blood and mother whole blood of postpartum women without occupational exposure to metals in Tehran, Iran, using inductively coupled plasma mass spectrometry"nResult: Whole blood cadmium and cord blood cadmium ranged from 0/00 to 6/30 μg/L ,respectivly. in the group higher level of maternal blood cadmium (> 0.40 μg/L 1cm decrease was seen in neonatal birth height. (p = 0.007 There was a significant association between cadmium exposure and birth weight.Mann-whitney test showed that, maternal blood cadmium level, was significantly negatively associated with neonatal birth weight (z = -1.83, P < 0.06."nConclusion: It was concluded that environmental exposure to cadmium significantly reduces neonatal birth height.

  4. Live and Non-Live Pregnancy Outcomes among Women with Depression and Anxiety: A Population-Based Study

    OpenAIRE

    Ban, Lu; Tata, Laila J.; West, Joe; Fiaschi, Linda; Gibson, Jack E

    2012-01-01

    Background Women taking antidepressant or anti-anxiety medications during early pregnancy have high risks of non-live pregnancy outcomes, although the contribution of the underlying illnesses to these risks remains unclear. We examined the impacts of antenatal depression and anxiety and of commonly prescribed treatments on the risks of non-live pregnancy outcomes. Methods We identified all pregnancies and their outcome (live birth, perinatal death, miscarriage or termination) among women aged...

  5. Embryonic Heart Rate correlation with pregnancy outcome in women with first trimester bleeding

    Directory of Open Access Journals (Sweden)

    Naemat Mohamed H.ELDin Shiry

    2011-10-01

    Full Text Available Objective : To assess the correlation between fetal heart rate and the fate of pregnancy in women with first trimester bleeding. Methods : This prospective observational study included 281 consecutive women with first trimester bleeding and Singleton pregnancies. The embryonic heart rate measured at the time of first trans-vaginal scan as per protocol in our university hospital for the evaluation of pregnancy. The heart rate was classified as slow if it was fewer than 110 beats per minute. The primary outcome measure is the occurrence of spontaneous early pregnancy loss prior to 12 weeks. Other outcome measures included the occurrence of late pregnancy loss (prior to 24 weeks, gestational age at birth, and fetal weight at birth. Results : Embryonic heart rate at less than 110 bpm was associated with a high likelihood of pregnancy loss. The sensitivity, specificity, positive and negative predictive value, and accuracy were 43.1%, 86%, 40.7%, 87.2%, and 78.2%, respectively. The OR (95% CI of first-trimester pregnancy. Conclusion: embryonic heart rate can be an independent predictor of the outcome of pregnancy in women with intrauterine pregnancy complaining of first trimester bleeding.

  6. Women's ponderal history in relation with birthweight and pregnancy outcomes

    OpenAIRE

    Diouf, Ibrahima

    2011-01-01

    Birthweight is strongly and positively related to maternal preconceptional weight as well as with weight gain during pregnancy. Therefore, it would be expected that the increase in maternal weight before pregnancy, and weight gain during pregnancy, would be associated with an increase in birthweight in France. Animal models suggested that maternal weight changes in the periconceptional period can be considered as indicators of maternal energy balance and nutritional status, and may be involve...

  7. Associations of prenatal exposure to five chlorophenols with adverse birth outcomes.

    Science.gov (United States)

    Guo, Jianqiu; Wu, Chunhua; Lv, Shenliang; Lu, Dasheng; Feng, Chao; Qi, Xiaojuan; Liang, Weijiu; Chang, Xiuli; Xu, Hao; Wang, Guoquan; Zhou, Zhijun

    2016-07-01

    Exposures to chlorophenols (CPs) have been linked with adverse health effects on wildlife and humans. This study aimed to evaluate prenatal exposure to five CP compounds using maternal urinary concentrations during pregnancy and the potential associations with birth outcomes of their infants at birth. A total of 1100 mother-newborn pairs were recruited during June 2009 to January 2010 in an agricultural region, China. Urinary concentrations of five CPs from dichlorophenol (DCP) to pentachlorophenol (PCP), namely, 2,5-DCP, 2,4-DCP, 2,4,5-trichlorophenol (2,4,5-TCP), 2,4,6-TCP and PCP, were measured using large-volume-injection gas chromatography-tandem mass spectrometry (LVI-GC-MS-MS), and associations between CP levels and weight, length as well as head circumference at birth were examined. Median urinary creatinine-adjusted concentrations of 2,5-DCP, 2,4-DCP, 2,4,5-TCP, 2,4,6-TCP and PCP were 3.34 μg/g, 1.03 μg/g, < LOD, 1.78 μg/g and 0.39 μg/g creatinine, respectively. We found lower birth weight 30 g [95% confidence interval (CI): -57, -3; p = 0.03] for per SD increase in log10-transformed concentrations of 2,4,6-TCP and lower birth weight 37 g (95% CI: -64, -10; p = 0.04) for PCP, respectively. Similarly, head circumference decrease in associations with creatinine-corrected 2,4,6-TCP and PCP concentrations were also achieved. Considering sex difference, the associations of lower birth weight were only found among male neonates, while head circumference was associated with 2,4-DCP and 2,5-DCP only found among female neonates. This study showed significant negative associations between CPs exposure and reduction in neonatal anthropometric measures. The biological mechanisms concerning CPs exposure on fetal growth deserved further investigations. PMID:27131805

  8. Circulating angiogenic factors and urinary prolactin as predictors of adverse outcomes in women with preeclampsia.

    Science.gov (United States)

    Leaños-Miranda, Alfredo; Campos-Galicia, Inova; Ramírez-Valenzuela, Karla Leticia; Chinolla-Arellano, Zarela Lizbeth; Isordia-Salas, Irma

    2013-05-01

    Preeclampsia is characterized by an imbalance in angiogenic factors. Urinary prolactin (PRL) levels and its antiangiogenic PRL fragments have been associated with disease severity. In this study, we assessed whether these biomarkers are associated with an increased risk of adverse maternal and perinatal outcomes in preeclamptic women. We studied 501 women with preeclampsia attended at a tertiary care hospital. Serum concentrations of soluble fms-like tyrosine kinase-1 (sFlt-1), placental growth factor (PlGF), and soluble endoglin (sEng), as well as urinary PRL levels, were measured by enzymed-linked immunosorbent assay. Antiangiogenic PRL fragments were determined by immunoblotting. The risk for any adverse maternal outcome and for having a small-for-gestational-age infant was higher among women with sFlt-1/PlGF ratios, sEng, and urinary PRL level values in the highest quartile (odds ratios ≥ 2.7), compared with the lowest quartile. Both urinary PRL levels and the presence of antiangiogenic PRL fragments were more closely associated with the risk of specific adverse maternal outcomes (placental abruption, hepatic hematoma or rupture, acute renal failure, pulmonary edema, maternal death, and need for endotracheal intubation, positive inotropic drug support, and hemodialysis; odds ratios ≥ 5.7 and ≥ 4.7, respectively) than either sFlt-1/PlGF ratio or sEng alone. We concluded that in preeclamptic women at the time of initial evaluation, sFlt-1/PlGF ratio and sEng are associated with increased risk of combined adverse maternal outcomes. However, urinary PRL concentrations and its antiangiogenic fragments appear to be better predictors of an adverse maternal outcome and may be useful for risk stratification in preeclampsia. PMID:23460287

  9. Frequency of adverse outcomes of acute myocardial infarction in patients with stress hyperglycem)a

    International Nuclear Information System (INIS)

    Objective: To determine the frequency of in-hospital adverse outcomes of acute myocardial infarction in patients with stress hyperglycemia. Methodology: This was a descriptive cross sectional study conducted from August 2010 to January 2011 in Cardiology department, Lady Reading Hospital, Peshawar. Patients of age 25-70 years, of either gender, non-diabetic with acute myocardial infarction with stress hyperglycemia were included. Random blood sugar >144 mg/dl was taken as stress hyperglycemia for patients at presentation of acute myocardial infarction. Patients were monitored for electrical complications such as atrial fibrillation, ventricular tachycardia, ventricular fibrillation and complete heart block and mechanical complications such as cardiac pulmonary edema and cardiogenic shock during hospital stay. The statistical analysis was performed using the statistical package for social sciences (SPSS Ver. 15.0). Results: A total of 341 patients having acute myocardial infarction with stress hyperglycemia were studied. The mean age was 56.35 +- 9.748 (95% CI 57.39 - 55.31). Male were 58.1% (n=198). The frequency of various major in-hospital electrical adverse outcomes of acute myocardial infarction with stress hyperglycemia were atrial fibrillation (AF) 15.8%, ventricular tachycardia (VT) 11.7%, ventricular fibrillation (VF) 10.9% and complete heart block (CHB) 6.7%, while mechanical adverse outcomes were cardiac pulmonary edema (CPE) 7.9% and cardiogenic shock (CS) 11.7%. Conclusion: Stress hyperglycemia has adverse impact on outcomes of patients presenting with acute myocardial infarction. Among electrical and mechanical complications of acute myocardial infarction in patients with stress hyperglycemia, the two most frequent in-hospital adverse outcomes were atrial fibrillation and cardiogenic shock, respectively. (author)

  10. The Alberta Pregnancy Outcomes and Nutrition (APrON) cohort study : rationale and methods

    NARCIS (Netherlands)

    Kaplan, Bonnie J.; Giesbrecht, Gerald F.; Leung, Brenda M. Y.; Field, Catherine J.; Dewey, Deborah; Bell, Rhonda C.; Manca, Donna P.; O'Beirne, Maeve; Johnston, David W.; Pop, Victor J.; Singhal, Nalini; Gagnon, Lisa; Bernier, Francois P.; Eliasziw, Misha; McCargar, Linda J.; Kooistra, Libbe; Farmer, Anna; Cantell, Marja; Goonewardene, Laki; Casey, Linda M.; Letourneau, Nicole; Martin, Jonathan W.

    2014-01-01

    The Alberta Pregnancy Outcomes and Nutrition (APrON) study is an ongoing prospective cohort study that recruits pregnant women early in pregnancy and, as of 2012, is following up their infants to 3 years of age. It has currently enrolled approximately 5000 Canadians (2000 pregnant women, their offsp

  11. Perinatal outcomes after hypertensive disorders in pregnancy in a low resource setting

    NARCIS (Netherlands)

    Browne, J. L.; Vissers, K. M.; Antwi, E.; Srofenyoh, E. K.; Van der Linden, E. L.; Agyepong, I. A.; Grobbee, D. E.; Klipstein-Grobusch, K.

    2015-01-01

    Objective: The objective of this study was to evaluate perinatal outcomes of pregnancies complicated by hypertensive disorders in pregnancy in an urban sub-Saharan African setting. Methods: A prospective cohort study of 1010 women of less than 17 weeks of gestation was conducted at two antenatal cli

  12. Influence of chorionicity on perinatal outcome in a large cohort of Danish twin pregnancies

    DEFF Research Database (Denmark)

    Oldenburg, Anna; Rode, Line; Bødker, Birgit;

    2012-01-01

    Objective To assess outcome in twin pregnancies according to chorionicity. Methods A cohort was retrieved from local ultrasound databases at 14 obstetric departments in Denmark, comprising all twin pregnancies with two live fetuses scanned between weeks 11 to 14 in the period 1 January 2004 to 31...

  13. Reproductive outcomes in adolescents who had a previous birth or an induced abortion compared to adolescents' first pregnancies

    Directory of Open Access Journals (Sweden)

    Wenzlaff Paul

    2008-01-01

    Full Text Available Abstract Background Recently, attention has been focused on subsequent pregnancies among teenage mothers. Previous studies that compared the reproductive outcomes of teenage nulliparae and multiparae often did not consider the adolescents' reproductive histories. Thus, the authors compared the risks for adverse reproductive outcomes of adolescent nulliparae to teenagers who either have had an induced abortion or a previous birth. Methods In this retrospective cohort study we used perinatal data prospectively collected by obstetricians and midwives from 1990–1999 (participation rate 87–98% of all hospitals in Lower Saxony, Germany. From the 9742 eligible births among adolescents, women with multiple births, >1 previous pregnancies, or a previous spontaneous miscarriage were deleted and 8857 women Results In bivariate logistic regression analyses, compared to nulliparous teenagers, adolescents with a previous birth had higher risks for perinatal [OR = 2.08, CI = 1.11,3.89] and neonatal [OR = 4.31, CI = 1.77,10.52] mortality and adolescents with a previous abortion had higher risks for stillbirths [OR = 3.31, CI = 1.01,10.88] and preterm births [OR = 2.21, CI = 1.07,4.58]. After adjusting for maternal nationality, partner status, smoking, prenatal care and pre-pregnancy BMI, adolescents with a previous birth were at higher risk for perinatal [OR = 2.35, CI = 1.14,4.86] and neonatal mortality [OR = 4.70, CI = 1.60,13.81] and adolescents with a previous abortion had a higher risk for very low birthweight infants [OR = 2.74, CI = 1.06,7.09] than nulliparous teenagers. Conclusion The results suggest that teenagers who give birth twice as adolescents have worse outcomes in their second pregnancy compared to those teenagers who are giving birth for the first time. The prevention of the second pregnancy during adolescence is an important public health objective and should be addressed by health care providers who attend the first birth or the abortion

  14. Gestational weight gain, prepregnancy body mass index related to pregnancy outcomes in KAZERUN, FARS, IRAN

    OpenAIRE

    Tabatabaei, Mozhgan

    2011-01-01

    Objective: The aim of this study was to evaluate associations between pregnancy outcomes and prepregnancy body mass index and gestational weight gain among pregnant women who regularly attended health centers of Kazerun, Fars, Iran.

  15. Adverse Outcome Pathway for Embryonic Vascular Disruption and Alternative Methods to Identify Chemical Vascular Disruptors During Development

    Science.gov (United States)

    Chemically induced vascular toxicity during embryonic development can result in a wide range of adverse prenatal outcomes. We used information from genetic mouse models linked to phenotypic outcomes and a vascular toxicity knowledge base to construct an embryonic vascular disrupt...

  16. Pregnancy outcomes in Benghazi, Libya, before and during the armed conflict in 2011.

    Science.gov (United States)

    Bodalal, Z; Agnaeber, K; Nagelkerke, N; Stirling, B; Temmerman, M; Degomme, O

    2014-03-01

    Stressful life events experienced by pregnant women may lead to adverse obstetric outcomes. This study in Benghazi compared the rates of preterm, low-birth-weight and caesarean-section births at Al-Jamhouria hospital in the months before and during the armed conflict in Libya in 2011. Data were collected on all women admitted to the delivery ward during February to May 2011 (the months of the most active fighting in the city) (n = 7096), and October to December 2010 (the months immediately before the war) (n = 5935). Compared with the preceding months there was a significant rise during the conflict in the rate of deliveries involving preterm (3.6% versus 2.5%) and low-birth-weight (10.1% versus 8.5%) infants and caesarean sections (26.9% versus 25.3%). Psychosocial stress may have been a factor (among others) in an increase in negative pregnancy outcomes, and obstetric hospitals should be aware of these issues in times of war. PMID:24950075

  17. Spectrum of Maternofetal Outcomes during Dengue Infection in Pregnancy: An Insight

    OpenAIRE

    Swati Sharma; Sandhya Jain; Shalini Rajaram

    2016-01-01

    Dengue is a vector transmitted viral infection; tropical and subtropical countries see outbreaks of dengue each year. There is a paucity of literature on effects of dengue infection on pregnancy outcome and this prompted us to undertake a study for better understanding of pregnancy implications with dengue infection. Pregnant women admitted during the seasonal outbreak of dengue between September 2015 and October 2015 were studied and maternal and fetal outcomes in sixteen NS1Ag positive wome...

  18. "PREVALENCE, MATERNAL COMPLICATIONS AND BIRTH OUTCOME OF PHYSICAL, SEXUAL AND EMOTIONAL DOMESTIC VIOLENCE DURING PREGNANCY"

    OpenAIRE

    M Faramarzi; S. Esmaelzadeh; S. Mosavi

    2005-01-01

    The prevalence of physical violence during pregnancy varies widely in different societies. To assess the incidence of self-reported physical, emotional and sexual violence in pregnancy and describe the association with maternal complication and birth outcomes, 3275 women who gave birth to live-born infants from October 2002 to November 2003 were assessed for self-reported violence in postpartum units of Obstetrics Department of Babol university of Medical Sciences. Outcome data included mater...

  19. Effects of Emergency Cervical Cerclage on Pregnancy Outcome: A Retrospective Study of 158 Cases

    OpenAIRE

    Zhu, Li-Qiong; Chen, Hui; Chen, Li-Bin; Liu, Ying-Lin; Tan, Jian-Ping; Wang, Yun-hui; Zhang, Rui; Zhang, Jian-ping

    2015-01-01

    The aim of this study was to evaluate the effectiveness and safety of emergency cervical cerclage in women with advanced cervical dilatation and bulging of fetal membranes. The study included 158 women who underwent emergency cervical cerclage because of cervix dilatation and protruding membranes in mid-trimester at Sun Yat-sen Memorial Hospital of Sun Yat-sen University. Pregnancy outcomes and pregnancy outcome related to clinical features were analyzed retrospectively. Analysis revealed tha...

  20. ATLANTIC DIP: The Impact of Obesity on Pregnancy Outcome in Glucose-Tolerant Women

    OpenAIRE

    Owens, Lisa A.; O'Sullivan, Eoin P; Kirwan, Breeda; Avalos, Gloria; Gaffney, Geraldine; Dunne, Fidelma; ,

    2010-01-01

    OBJECTIVE A prospective study of the impact of obesity on pregnancy outcome in glucose-tolerant women. RESEARCH DESIGN AND METHODS The Irish Atlantic Diabetes in Pregnancy network advocates universal screening for gestational diabetes. Women with normoglycemia and a recorded booking BMI were included. Maternal and infant outcomes correlated with booking BMI are reported. RESULTS A total of 2,329 women fulfilled the criteria. Caesarean deliveries increased in overweight (OW) (odds ratio 1.57 [...

  1. Exercise Training in Pregnancy for obese women (ETIP): study protocol for a randomised controlled trial

    OpenAIRE

    Vik Torstein; Ingul Charlotte B; Salvesen Kjell; Moholdt Trine T; Oken Emily; Mørkved Siv

    2011-01-01

    Background Both maternal pre-pregnancy obesity and excessive gestational weight gain are increasing in prevalence and associated with a number of adverse pregnancy outcomes for both mother and child. Observational studies regarding physical activity in pregnancy have found reduced weight gain in active mothers, as well as reduced risk of adverse pregnancy outcomes. There is however a lack of high quality, randomized controlled trials on the effects of regular exercise training in pregnancy, ...

  2. Periodontal intervention effects on pregnancy outcomes in women with preeclampsia.

    Directory of Open Access Journals (Sweden)

    Julián A. Herrera

    2009-12-01

    Full Text Available Objective: To determine the efficacy of periodontal intervention on pregnancy outcome in mild preeclamptic women. Methods: A sample of 60 pregnant women with mild preeclampsia (blood pressure levels 300 mg/l in 24 hours urine from the Hospital Universitario del Valle (Cali, Colombia was included to the study. Preeclamptic women were randomized in two groups, one with periodontal intervention (PIG, N=28 and another in which the periodontal intervention was practiced after childbirth (NPIG, N=32. Maternal socio-demographic, medical and periodontal data were obtained. PIG included patients in which supragingival and subgingival cleaning within ultrasonic and manual devices were performed after study inclusion. The progression from mild to severe preeclampsia, eclampsia or HELLP syndrome, the number of days of clinical stability and the percentile of birth-weight adjusted for gestational age were evaluated in both groups. Results: Most of the patients (60% were multigravids. Gestational age at inclusion was 31.8±1.6 weeks. Chronic periodontitis was a frequent finding (61.7%. Social, demographic, medical and periodontal conditions were similar between both groups. Disease progression to severe preeclampsia, eclampsia or HELLP syndrome was also similar (89.2% PIG versus 84.4%, p=0.65 (OR=1.06 IC 95% 0.87-1.29, p=0.65. Days of clinical stability were similar between the groups (median 10 days , range 1-46, PIG versus 12 days, range 1-59, p=0.57 and the percentile of birth weight adjusted with gestational age had no differences between the groups (median percentil 50 range 5-90 PIG versus percentil 55 range 5-95, p=0.73. Conclusion: Periodontal intervention does not seem to harm the health, the severity or alter the frequency on maternal complications in mild preeclampsia subjects.

  3. Periodontal intervention effects on pregnancy outcomes in women with preeclampsia

    Directory of Open Access Journals (Sweden)

    Julián A. Herrera M

    2009-06-01

    Full Text Available Objective: To determine the efficacy of periodontal intervention on pregnancy outcome in mild preeclamptic women.Methods: A sample of 60 pregnant women with mild preeclampsia (blood pressure levels 300 mg/l in 24 hours urine from the Hospital Universitario del Valle (Cali, Colombia was included to the study. Preeclamptic women were randomized in two groups, one with periodontal intervention (PIG, N=28 and another in which the periodontal intervention was practiced after childbirth (NPIG, N=32. Maternal socio-demographic, medical and periodontal data were obtained. PIG included patients in which supragingival and subgingival cleaning within ultrasonic and manual devices were performed after study inclusion. The progression from mild to severe preeclampsia, eclampsia or HELLP syndrome, the number of days of clinical stability and the percentile of birth-weight adjusted for gestational age were evaluated in both groups.Results: Most of the patients (60% were multigravids. Gestational age at inclusion was 31.8±1.6 weeks. Chronic periodontitis was a frequent finding (61.7%. Social, demographic, medical and periodontal conditions were similar between both groups. Disease progression to severe preeclampsia, eclampsia or HELLP syndrome was also similar (89.2% PIG versus 84.4%, p=0.65 (OR=1.06 IC 95% 0.87-1.29, p=0.65. Days of clinical stability were similar between the groups (median 10 days , range 1-46, PIG versus 12 days, range 1-59, p=0.57 and the percentile of birth weight adjusted with gestational age had no differences between the groups (median percentil 50 range 5-90 PIG versus percentil 55 range 5-95, p=0.73.Conclusion: Periodontal intervention does not seem to harm the health, the severity or alter the frequency on maternal complications in mild preeclampsia subjects.

  4. Insulin resistance, adiponectin and adverse outcomes following elective cardiac surgery: a prospective follow-up study

    Directory of Open Access Journals (Sweden)

    Hjortdal Vibeke E

    2010-12-01

    Full Text Available Abstract Background Insulin resistance and adiponectin are markers of cardio-metabolic disease and associated with adverse cardiovascular outcomes. The present study examined whether preoperative insulin resistance or adiponectin were associated with short- and long-term adverse outcomes in non-diabetic patients undergoing elective cardiac surgery. Methods In a prospective study, we assessed insulin resistance and adiponectin levels from preoperative fasting blood samples in 836 patients undergoing cardiac surgery. Population-based medical registries were used for postoperative follow-up. Outcomes included all-cause death, myocardial infarction or percutaneous coronary intervention, stroke, re-exploration, renal failure, and infections. The ability of insulin resistance and adiponectin to predict clinical adverse outcomes was examined using receiver operating characteristics. Results Neither insulin resistance nor adiponectin were statistically significantly associated with 30-day mortality, but adiponectin was associated with an increased 31-365-day mortality (adjusted odds ratio 2.9 [95% confidence interval 1.3-6.4] comparing the upper quartile with the three lower quartiles. Insulin resistance was a poor predictor of adverse outcomes. In contrast, the predictive accuracy of adiponectin (area under curve 0.75 [95% confidence interval 0.65-0.85] was similar to that of the EuroSCORE (area under curve 0.75 [95% confidence interval 0.67-0.83] and a model including adiponectin and the EuroSCORE had an area under curve of 0.78 [95% confidence interval 0.68-0.88] concerning 31-365-day mortality. Conclusions Elevated adiponectin levels, but not insulin resistance, were associated with increased mortality and appear to be a strong predictor of long-term mortality. Additional studies are warranted to further clarify the possible clinical role of adiponectin assessment in cardiac surgery. Trial Registration The Danish Data Protection Agency; reference no

  5. Pregnancy following breast cancer using assisted reproduction and its effect on long-term outcome

    DEFF Research Database (Denmark)

    Goldrat, Oranite; Kroman, Niels; Peccatori, Fedro A; Cordoba, Octavi; Pistilli, Barbara; Lidegaard, Oejvind; Demeestere, Isabelle; Azim, Hatem A

    2015-01-01

    INTRODUCTION AND AIMS: We have previously shown that pregnancy is safe following breast cancer, even in endocrine sensitive disease. Yet infertility remains common following systemic treatment. To date, no study has evaluated the safety of assisted reproductive technology (ART) after breast cancer...... were eligible. Patients were divided into two groups according to whether ART following primary systemic therapy was performed to achieve pregnancy. We evaluated the association between ART use and clinic-pathological characteristics, pregnancy outcome and long-term breast cancer outcome. RESULTS: A...

  6. Does physical activity during pregnancy adversely influence markers of the metabolic syndrome in adult offspring?

    DEFF Research Database (Denmark)

    Danielsen, Inge; Granström, Charlotta; Rytter, Dorte;

    2013-01-01

    It is unknown whether physical activity during pregnancy (PA) has long-term impact on the metabolic profile of the offspring. We investigated associations of PA with markers of the metabolic syndrome (MS) in 20y old offspring.......It is unknown whether physical activity during pregnancy (PA) has long-term impact on the metabolic profile of the offspring. We investigated associations of PA with markers of the metabolic syndrome (MS) in 20y old offspring....

  7. Development of computationally predicted Adverse Outcome Pathway (AOP) networks through data mining and integration of publicly available in vivo, in vitro, phenotype, and biological pathway data

    Science.gov (United States)

    The Adverse Outcome Pathway (AOP) framework is increasingly being adopted as a tool for organizing and summarizing the mechanistic information connecting molecular perturbations by environmental stressors with adverse outcomes relevant for ecological and human health outcomes. Ho...

  8. Effect of balanced protein energy supplementation during pregnancy on birth outcomes

    Directory of Open Access Journals (Sweden)

    Bhutta Zulfiqar A

    2011-04-01

    Full Text Available Abstract Background The nutritional status of the mother prior to and during pregnancy plays a vital role in fetal growth and development, and maternal undernourishment may lead to adverse perinatal outcomes including intrauterine growth restriction (IUGR. Several macronutrient interventions had been proposed for adequate protein and energy supplementation during pregnancy. The objective of this paper was to review the effect of balanced protein energy supplementation during pregnancy on birth outcomes. This paper is a part of a series of reviews undertaken for getting estimates of effectiveness of an intervention for input to Lives Saved Tool (LiST model. Methods A literature search was conducted on PubMed, Cochrane Library and WHO regional data bases to identify randomized trials (RCTs and quasi RCTs that evaluated the impact of balanced protein energy supplementation in pregnancy. Balanced protein energy supplementation was defined as nutritional supplementation during pregnancy in which proteins provided less than 25% of the total energy content. Those studies were excluded in which the main intervention was dietary advice to pregnant women for increase in protein energy intake, high protein supplementation (i.e. supplementation in which protein provides at least 25% of total energy content, isocaloric protein supplementation (where protein replaces an equal quantity of non-protein energy content, or low energy diet to pregnant women who are either overweight or who exhibit high weight gain earlier in gestation. The primary outcomes were incidence of small for gestational age (SGA birth, mean birth weight and neonatal mortality. Quality of evidence was evaluated according to the Child Health Epidemiology Reference group (CHERG adaptation of Grading of Recommendations Assessment, Development and Evaluation (GRADE criteria. Results The final number of studies included in our review was eleven comprising of both RCTs and quasi-RCTs. Our meta

  9. Defining the residual risk of adverse perinatal outcome in growth restricted fetuses with normal umbilical artery blood flow.

    LENUS (Irish Health Repository)

    O'Dwyer, Vicky

    2014-07-25

    To determine the cause of adverse perinatal outcome in fetal growth restriction(FGR) where umbilical artery Doppler(UA) was normal, as identified from the Prospective Observational Trial to Optimize Pediatric Health(PORTO). We compared cases of adverse outcome where UA Doppler was normal and abnormal.

  10. Tobacco smoking during pregnancy and risk of adverse behaviour in offspring

    DEFF Research Database (Denmark)

    Dürr, Dorte Wiwe; Høyer, Birgit Bjerre; Christensen, Line Høgenhof; Pedersen, Henning Sloth; Zinchuk, Andrii; Jönsson, Bo Ag; Lindh, Christian H; Bonde, Jens Peter; Toft, Gunnar

    2015-01-01

    OBJECTIVES: This study examines associations between prenatal exposure to tobacco smoking and adverse behaviour in the offspring. METHODS: We included 1016 pregnant women from Greenland and Ukraine (526 from Greenland and 490 from Ukraine). Serum cotinine measurements were used to identify smoking...... non-significant. CONCLUSIONS: In utero exposure to tobacco smoking was not associated with a significant higher risk of adverse behaviour in the offspring, but elevated risk of adverse behaviour among children prenatally exposed to smoking cannot be excluded....

  11. Pregnancy-Related Group A Streptococcal Infections: Temporal Relationships Between Bacterial Acquisition, Infection Onset, Clinical Findings, and Outcome

    OpenAIRE

    Stephanie M Hamilton; Stevens, Dennis L.; Bryant, Amy E.

    2013-01-01

    The development and outcome of pregnancy-related group A streptococcal infections are dependent upon the stage of pregnancy or puerperium, epidemiologic factors of the patient's home and hospital environments, and virulence of the prevalent pathogens.

  12. Predictors of Adverse Cosmetic Outcome in the RAPID Trial: An Exploratory Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Peterson, David; Truong, Pauline T. [Vancouver Island Centre, British Columbia Cancer Agency, Victoria, British Columbia (Canada); Parpia, Sameer [Ontario Clinical Oncology Group, McMaster University, Hamilton, Ontario (Canada); Olivotto, Ivo A. [Tom Baker Cancer Centre, University of Calgary, Calgary, Alberta (Canada); Berrang, Tanya [Vancouver Island Centre, British Columbia Cancer Agency, Victoria, British Columbia (Canada); Kim, Do-Hoon; Kong, Iwa [Juravinski Cancer Centre at Hamilton Health Sciences, McMaster University, Hamilton, Ontario (Canada); Germain, Isabelle [Centre Hospitalier Universitaire de Québec, Pavillon Hôtel-Dieu de Quebec, Quebec City, Québec (Canada); Nichol, Alan [Vancouver Centre, British Columbia Cancer Agency, Vancouver, British Columbia (Canada); Akra, Mohamed [CancerCare Manitoba, Winnipeg, Manitoba (Canada); Roy, Isabelle [Centre intégré de cancérologie de Laval, Laval, Québec (Canada); Reed, Melanie [Center for the Southern Interior, British Columbia Cancer Agency, Kelowna, British Columbia (Canada); Fyles, Anthony [University Health Network, Princess Margaret Hospital, Toronto, Ontario (Canada); Trotter, Theresa [Tom Baker Cancer Centre, University of Calgary, Calgary, Alberta (Canada); Perera, Francisco [London Regional Cancer Centre, London, Ontario (Canada); Balkwill, Susan [Fraser Valley Centre, British Columbia Cancer Agency, Surrey, British Columbia (Canada); Lavertu, Sophie [Centre Hospitalier de l' Université de Montréal, Hôpital Notre-Dame, Montreal, Québec (Canada); Elliott, Elizabeth [Juravinski Cancer Centre at Hamilton Health Sciences, McMaster University, Hamilton, Ontario (Canada); and others

    2015-04-01

    Purpose: To evaluate factors associated with adverse cosmesis outcome in breast cancer patients randomized to accelerated partial breast irradiation (APBI) using 3-dimensional conformal radiation therapy or whole-breast irradiation in the RAPID (Randomized Trial of Accelerated Partial Breast Irradiation) trial. Methods and Materials: Subjects were trial participants with nurse-assessed global cosmetic scores at baseline and at 3 years. Adverse cosmesis was defined as a score of fair or poor. Cosmetic deterioration was defined as any adverse change in score from baseline to 3 years. The analysis is based on data from the previously reported interim analysis. Logistic regression models were used to assess the association of risk factors for these outcomes among all patients and those treated with APBI only. Results: Clinicopathologic characteristics were similar between subjects randomized to APBI (n=569) or whole-breast irradiation (n=539). For all subjects, factors associated with adverse cosmesis at 3 years were older age, central/inner tumor location, breast infection, smoking, seroma volume, breast volume, and use of APBI; factors associated with cosmetic deterioration were smoking, seroma volume, and use of APBI (P<.05). For APBI subjects, tumor location, smoking, age, and seroma volume were associated with adverse cosmesis (P<.05), and smoking was associated with cosmetic deterioration (P=.02). An independent association between the V95/whole-breast volume ratio and adverse cosmesis (P=.28) or cosmetic deterioration (P=.07) was not detected. On further exploration a V95/whole-breast volume ratio <0.15 was associated with a lower risk of cosmetic deterioration (p=.04), but this accounted for only 11% of patients. Conclusion: In the RAPID trial, a number of patient tumor and treatment-related factors, including the use of APBI, were associated with adverse cosmesis and cosmetic deterioration. For patients treated with APBI alone, the high-dose treatment

  13. Predictors of Adverse Cosmetic Outcome in the RAPID Trial: An Exploratory Analysis

    International Nuclear Information System (INIS)

    Purpose: To evaluate factors associated with adverse cosmesis outcome in breast cancer patients randomized to accelerated partial breast irradiation (APBI) using 3-dimensional conformal radiation therapy or whole-breast irradiation in the RAPID (Randomized Trial of Accelerated Partial Breast Irradiation) trial. Methods and Materials: Subjects were trial participants with nurse-assessed global cosmetic scores at baseline and at 3 years. Adverse cosmesis was defined as a score of fair or poor. Cosmetic deterioration was defined as any adverse change in score from baseline to 3 years. The analysis is based on data from the previously reported interim analysis. Logistic regression models were used to assess the association of risk factors for these outcomes among all patients and those treated with APBI only. Results: Clinicopathologic characteristics were similar between subjects randomized to APBI (n=569) or whole-breast irradiation (n=539). For all subjects, factors associated with adverse cosmesis at 3 years were older age, central/inner tumor location, breast infection, smoking, seroma volume, breast volume, and use of APBI; factors associated with cosmetic deterioration were smoking, seroma volume, and use of APBI (P<.05). For APBI subjects, tumor location, smoking, age, and seroma volume were associated with adverse cosmesis (P<.05), and smoking was associated with cosmetic deterioration (P=.02). An independent association between the V95/whole-breast volume ratio and adverse cosmesis (P=.28) or cosmetic deterioration (P=.07) was not detected. On further exploration a V95/whole-breast volume ratio <0.15 was associated with a lower risk of cosmetic deterioration (p=.04), but this accounted for only 11% of patients. Conclusion: In the RAPID trial, a number of patient tumor and treatment-related factors, including the use of APBI, were associated with adverse cosmesis and cosmetic deterioration. For patients treated with APBI alone, the high-dose treatment

  14. Estimated Pregnancy Rates and Rates of Pregnancy Outcomes for the United States, 1990-2008

    Science.gov (United States)

    ... of decline slowed in the mid-2000s. The teenage pregnancy rate in 2008 was the lowest reported since ... 1708–12. 2000. 24. Kost K, Henshaw S. U.S. teenage pregnancies, births, and abortions, 2008: National trends by age, ...

  15. Blood carbon dioxide levels and adverse outcome in neonatal hypoxic-ischemic encephalopathy.

    LENUS (Irish Health Repository)

    Nadeem, Montasser

    2012-01-31

    We investigated pCO(2) patterns and the relationship between pCO(2) levels and neurodevelopmental outcome in term infants with hypoxic-ischemic encephalopathy. Blood gases during the first 72 hours of life were collected from 52 infants with hypoxic-ischemic encephalopathy. Moderate hypocapnia (pCO(2) <3.3 kPa), severe hypocapnia (pCO(2) <2.6 kPa), and hypercapnia (pCO(2) >6.6 kPa) were correlated to neurodevelopmental outcome at 24 months. Normocapnia was documented in 416\\/551 (75.5%) of samples and was present during the entire 72 hours in only 6 out of 52 infants. Mean (standard deviation) pCO(2) values did not differ between infants with normal and abnormal outcomes: 5.43 (2.4) and 5.41 (2.03), respectively. There was no significant association between moderate hypocapnia, severe hypocapnia, or hypercapnia and adverse outcome (odds ratio [OR] = 1.84, 95% confidence interval [CI] = 0.49 to 6.89; OR = 3.16, CI = 0.14 to 28.45; and OR = 1.07, CI = 0.24 to 5.45, respectively). In conclusion, only one in nine newborns had normocapnia throughout the first 72 hours. Severe hypocapnia was rare and occurred only in ventilated babies. Hypercapnia and hypocapnia in infants with hypoxic-ischemic encephalopathy during the first 72 hours of life were not associated with adverse outcome.

  16. Immune system function, stress, exercise and nutrition profile can affect pregnancy outcome: Lessons from a Mediterranean cohort

    OpenAIRE

    Mparmpakas, D; Goumenou, A; ZACHARIADES, E.; Pados, G; Gidron, Y; Karteris, E

    2013-01-01

    Pregnancy is associated with major physiological and future psychosocial changes, and maternal adaptation to these changes is crucial for normal foetal development. Psychological stress in pregnancy predicts an earlier birth and lower birth weight. Pregnancy-specific stress contributes directly to preterm delivery. The importance of nutrition and exercise during pregnancy with regard to pregnancy outcome has long been acknowledged. This importance has only been further emphasized by the recen...

  17. Interpregnancy interval raise odds of adverse perinatal outcome in high fertility region Mewat, Haryana

    Directory of Open Access Journals (Sweden)

    Anam ul Haq

    2014-06-01

    Methods: Retrospective cross sectional study in which 400 meo women (para 2 to para 5 fulfilling inclusion and exclusion criteria having diverse interpregnancy intervals were selected. Statistical analysis was done using SPSS. We used multivariate logistic regression analysis to assess the risk of adverse perinatal outcome. Results: As compared with infants conceived within a time period of 16 to 48 months after a live birth, infants conceived within 16 months after a live birth had odds ratios of 2.1 (95% CI 1.3 to 3.5 for low birth weight, 2.2 (95% CI 1.3 to 3.8 for preterm birth, and 2.3 (95% CI 1.4 to 3.8 for small size for gestational age; infants conceived more than 48 months after a live birth had odds ratios of 1.88 (95% CI 1.1 to 3.1, 1.96 (95% CI 1.1 to 3.4, and 2.08 (95% CI 1.2 to 3.6 for these three adverse outcomes, respectively; P value <0.05. Conclusions: We came to conclusion that interpregnancy interval of 16 - 48 months is the optimal interval carrying least risk of adverse perinatal outcomes and both short as well as long interpregnancy intervals are significantly associated with birth of preterm, low birth weight and small for gestational age babies. Counselling regarding optimal interpregnancy interval and methods of contraception can go a long way in reducing adverse perinatal outcome. [Int J Reprod Contracept Obstet Gynecol 2014; 3(3.000: 598-603

  18. CT and MR imaging findings of systemic complications occurring during pregnancy and puerperal period, adversely affected by natural changes.

    Science.gov (United States)

    Himoto, Yuki; Kido, Aki; Moribata, Yusaku; Yamaoka, Toshihide; Okumura, Ryosuke; Togashi, Kaori

    2015-01-01

    Dynamic physiological and anatomical changes for delivery may adversely induce various specific non-obstetric complications during pregnancy and puerperal period. These complications can be fatal to both the mother and the fetus, thus a precise and early diagnosis ensued by an early treatment is essential. Along with ultrasonography, computed tomography (CT) and magnetic resonance imaging (MRI) have assumed an increasing role in the diagnosis. This article aims to discuss the pathophysiology of these complications, the indications for CT and MRI, and the imaging findings. PMID:26937442

  19. Testing the association between psychosocial job strain and adverse birth outcomes - design and methods

    OpenAIRE

    Thulstrup Ane M; Obel Carsten; Hannerz Harald; Larsen Ann D; Bonde Jens P; Hougaard Karin S

    2011-01-01

    Abstract Background A number of studies have examined the effects of prenatal exposure to stress on birth outcomes but few have specifically focused on psychosocial job strain. In the present protocol, we aim to examine if work characterised by high demands and low control, during pregnancy, is associated with the risk of giving birth to a child born preterm or small for gestational age. Methods and design We will use the Danish National Birth Cohort where 100.000 children are included at bas...

  20. Unintended Pregnancy and Its Adverse Social and Economic Consequences on Health System: A Narrative Review Article.

    Science.gov (United States)

    Yazdkhasti, Mansureh; Pourreza, Abolghasem; Pirak, Arezoo; Abdi, Fatemeh

    2015-01-01

    Unintended pregnancy is among the most troubling public health problems and a major reproductive health issue worldwide imposing appreciable socioeconomic burden on individuals and society. Governments generally plan to control growth of births (especially wanted births as well as orphans and illegitimate births) imposing extra burden on public funding of the governments which inevitably affects economic efficiency and leads to economic slowdown, too. The present narrative review focuses on socioeconomic impacts of unintended pregnancy from the health system perspective. Follow of Computerized searches of Academic, 53 scientific journals were found in various databases including PubMed, EMBASE, ISI, Iranian databases, IPPE, UNFPA (1985-2013). Original articles, review articles, published books about the purpose of the paper were used. During this search, 20 studies were found which met the inclusion criteria. Unintended pregnancy is one of the most critical challenges facing the public health system that imposes substantial financial and social costs on society. On the other hand, affecting fertility indicators, it causes reduced quality of life and workforce efficiency. Therefore lowering the incidence of intended pregnancies correlates with elevating economic growth, socio-economic development and promoting public health. Regarding recent policy changes in Iran on family planning programs and adopting a new approach in increasing population may place the country at a higher risk of increasing the rate of unintended pregnancy. Hence, all governmental plans and initiatives of public policy must be regulated intelligently and logically aiming to make saving in public spending and reduce healthcare cost inflation. PMID:26060771

  1. Unintended Pregnancy and Its Adverse Social and Economic Consequences on Health System: A Narrative Review Article.

    Directory of Open Access Journals (Sweden)

    Mansureh Yazdkhasti

    2015-01-01

    Full Text Available Unintended pregnancy is among the most troubling public health problems and a major reproductive health issue worldwide imposing appreciable socioeconomic burden on individuals and society. Governments generally plan to control growth of births (especially wanted births as well as orphans and illegitimate births imposing extra burden on public funding of the governments which inevitably affects economic efficiency and leads to economic slowdown, too. The present narrative review focuses on socioeconomic impacts of unintended pregnancy from the health system perspective. Follow of Computerized searches of Academic, 53 scientific journals were found in various databases including PubMed, EMBASE, ISI, Iranian databases, IPPE, UNFPA (1985-2013. Original articles, review articles, published books about the purpose of the paper were used. During this search, 20 studies were found which met the inclusion criteria. Unintended pregnancy is one of the most critical challenges facing the public health system that imposes substantial financial and social costs on society. On the other hand, affecting fertility indicators, it causes reduced quality of life and workforce efficiency. Therefore lowering the incidence of intended pregnancies correlates with elevating economic growth, socio-economic development and promoting public health. Regarding recent policy changes in Iran on family planning programs and adopting a new approach in increasing population may place the country at a higher risk of increasing the rate of unintended pregnancy. Hence, all governmental plans and initiatives of public policy must be regulated intelligently and logically aiming to make saving in public spending and reduce healthcare cost inflation.

  2. Abnormal maternal serum alpha fetoprotein and pregnancy outcome.

    Science.gov (United States)

    Zarzour, S J; Gabert, H A; Diket, A L; St Amant, M; Miller, J M

    1998-01-01

    The objective was to assess the occurrence of miscarriages, low birth weight, and karyotype abnormalities found with low and elevated maternal serum alpha-fetoprotein (MSAFP) among women who had genetic amniocentesis performed. A retrospective study of 2,159 women who had MSAFP analysis prior to amniocentesis was conducted. Pregnancy outcomes were obtained from record review and physicians follow-up. Limits of MSAFP used in analysis were MOM) (lower levels) and >2.0 MOM (upper levels). Autosomal trisomy was found in 1.6% with low, 0.9% normal, and 0.6% with elevated MSAFP values. Sex chromosome abnormalities were present only in patients with normal MSAFP, [45X (n = 6), 47XXY (n = 2), 69XXX]. Of five open neural tube defects, four had elevated MSAFP and one had a normal value. Omphalocele was identified in four patients, two with normal and two with elevated MSAFP. Gastroschisis was found in one low and one elevated MSAFP. Amniotic fluid alpha-fetoprotein (AFAFP) values did not correlate with MSAFP values. Patients with low MSAFP levels had a greater prevalence of abnormal karyotype (19 of 249, prevalence = 0.076) than patients with an elevated MSAFP level (2 or 166, prevalence = 0.012 OR (odds ratio) = 0.20 (P value = 0.024) when unadjusted for maternal age, and OR = 0.09 (P value = 0.001) when adjusted for maternal age. Spontaneous abortion occurred more often in patients with elevated (4 of 166, or 4%) than normal or low (20 of 1948, or 1%) values of MSAFP (odds ratio 4.32, P = 0.020 when adjusted for maternal age). Birth weight below 2,500 g was present less frequently with low or normal MSAFP (136 of 1,760, or 7.7%) than in elevated MSAFP (21 of 144 or 14.6%) (odds ratio 2.04, P = 0.005, unadjusted; and odds ratio = 2.32, P = 0.003, adjusted for maternal age). Female fetuses were present more often with low MSAFP (136 of 249, or 55%) than elevated levels 43% (71 of 164, or 43%; P = 0.024). We conclude that patients undergoing genetic amniocentesis with MSAFP

  3. PRegnancy Outcomes after a Maternity Intervention for Stressful EmotionS (PROMISES: study protocol for a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    de Jonge Peter

    2011-06-01

    Full Text Available Abstract Background There is ample evidence from observational prospective studies that maternal depression or anxiety during pregnancy is a risk factor for adverse psychosocial outcomes in the offspring. However, to date no previous study has demonstrated that treatment of depressive or anxious symptoms in pregnancy actually could prevent psychosocial problems in children. Preventing psychosocial problems in children will eventually bring down the huge public health burden of mental disease. The main objective of this study is to assess the effects of cognitive behavioural therapy in pregnant women with symptoms of anxiety or depression on the child's development as well as behavioural and emotional problems. In addition, we aim to study its effects on the child's development, maternal mental health, and neonatal outcomes, as well as the cost-effectiveness of cognitive behavioural therapy relative to usual care. Methods/design We will include 300 women with at least moderate levels of anxiety or depression at the end of the first trimester of pregnancy. By including 300 women we will be able to demonstrate effect sizes of 0.35 or over on the total problems scale of the child behavioural checklist 1.5-5 with alpha 5% and power (1-beta 80%. Women in the intervention arm are offered 10-14 individual cognitive behavioural therapy sessions, 6-10 sessions during pregnancy and 4-8 sessions after delivery (once a week. Women in the control group receive care as usual. Primary outcome is behavioural/emotional problems at 1.5 years of age as assessed by the total problems scale of the child behaviour checklist 1.5 - 5 years. Secondary outcomes will be mental, psychomotor and behavioural development of the child at age 18 months according to the Bayley scales, maternal anxiety and depression during pregnancy and postpartum, and neonatal outcomes such as birth weight, gestational age and Apgar score, health care consumption and general health status

  4. Pregnancy outcome in women with polycystic ovary syndrome comparing the effects of laparoscopic ovarian drilling and clomiphene citrate stimulation in women pre-treated with metformin: a retrospective study

    OpenAIRE

    Vytiska-Binstorfer Elisabeth; Wirth Stefan; Nouri Kazem; Kurz Christine; Ott Johannes; Huber Johannes C; Mayerhofer Klaus

    2010-01-01

    Abstract Background Ovarian stimulation in women with polycystic ovary syndrome (PCOS) increases the risk for perinatal complications. Ovulation induction by laparoscopic ovarian drilling (LOD) might improve the overall pregnancy outcomes. The aim of our study was to assess the adverse events or effects on pregnancy of LOD and clomiphene citrate (CC) stimulation in patients who received metformin. Methods Setting: Academic research institution. We retrospectively analyzed the courses of 40 sp...

  5. Prolonged PR interval, first-degree heart block and adverse cardiovascular outcomes: a systematic review and meta-analysis

    OpenAIRE

    Kwok, Chun Shing; Muhammad RASHID; Beynon, Rhys; Barker, Diane; Patwala, Ashish; Morley-Davies, Adrian; Satchithananda, Duwarakan; Nolan, James; Myint, Phyo K; Buchan, Iain; Loke, Yoon K.; Mamas, Mamas A.

    2016-01-01

    Objective: First-degree atrioventricular block is frequently encountered in clinical practice and is generally considered a benign process. However, there is emerging evidence that prolonged PR interval may be associated with adverse outcomes. This study aims to determine if prolonged PR interval is associated with adverse cardiovascular outcomes and mortality. Methods: We searched MEDLINE and EMBASE for studies that evaluated clinical outcomes associated with prolonged and normal PR interval...

  6. Maternal employment during pregnancy and birth outcomes: evidence from Danish siblings.

    Science.gov (United States)

    Wüst, Miriam

    2015-06-01

    I use Danish survey and administrative data to examine the impact of maternal employment during pregnancy on birth outcomes. As healthier mothers are more likely to work and health shocks to mothers may impact employment and birth outcomes, I combine two strategies: First, I control extensively for time-varying factors that may correlate with employment and birth outcomes, such as pre-pregnancy family income and maternal occupation, pregnancy-related health shocks, maternal sick listing, and health behaviors (smoking and alcohol consumption). Second, to account for remaining time-invariant heterogeneity between mothers, I compare outcomes of mothers' consecutive children. Mothers who work during the first pregnancy trimester have a lower risk of preterm birth. I find no effect on the probability of having a baby of small size for gestational age. To rule out that health selection of mothers between pregnancies drives the results, I focus on mothers whose change in employment status is likely not to be driven by underlying health (mothers who are students in one of their pregnancies and mothers with closely spaced births). Given generous welfare benefits and strict workplace regulations in Denmark, my findings support a residual explanation, namely, that exclusion from employment may stress mothers in countries with high-female employment rates. PMID:24777685

  7. Maternal nutrition among women from Sub-Saharan Africa, with a focus on Nigeria, and potential implications for pregnancy outcomes among immigrant populations in developed countries.

    LENUS (Irish Health Repository)

    Lindsay, K L

    2012-12-01

    Pregnant women in countries of Sub-Saharan Africa (SSA) are at risk of poor nutritional status and adverse outcomes as a result of poverty, food insecurity, sub-optimal healthcare facilities, frequent infections and frequent pregnancies. Studies from Nigeria, for example, have revealed a high prevalence of both under- and over-nutrition, as well as nutrient deficiencies, including iron, folate, vitamin D and vitamin A. Subsequently, obstetric complications, including hypertension, anaemia, neural tube defects, night-blindness, low birth weight and maternal and perinatal mortality, are common. Migration patterns from SSA to the Western world are on the rise in recent years, with Nigerians now representing the most prevalent immigrant African population in many developed countries. However, the effect of immigration, if any, on the nutritional status and pregnancy outcomes of these women in their host countries has not yet been studied. Consequently, it is unknown to what extent the nutritional deficiencies and pregnancy complications occurring in Nigeria, and other countries of SSA, present in these women post-emigration. This may result in missed opportunities for appropriate antenatal care of a potential high-risk group in pregnancy. The present review discusses the literature regarding nutrition in pregnancy among SSA women, using Nigeria as an example, the common nutrition-related complications that arise and the subsequent obstetric outcomes. The concept of dietary acculturation among immigrant groups is also discussed and deficiencies in the literature regarding studies on the diets of pregnant immigrant women are highlighted.

  8. The Effect of School-Based Health Clinics on Teenage Pregnancy and Parenting Outcomes: An Integrated Literature Review

    Science.gov (United States)

    Strunk, Julie A.

    2008-01-01

    Teenage pregnancy outcomes have become an increasing concern in the United States. Education and support of pregnant teens are critical factors that may determine good or poor pregnancy outcomes. Poor outcomes may include low birth weight, developmental delays, and poor academic performance. Although the number of teenagers experiencing pregnancy…

  9. Prediction of adverse outcomes of acute coronary syndrome using intelligent fusion of triage information with HUMINT

    Science.gov (United States)

    McCullough, Claire L.; Novobilski, Andrew J.; Fesmire, Francis M.

    2006-04-01

    Faculty from the University of Tennessee at Chattanooga and the University of Tennessee College of Medicine, Chattanooga Unit, have used data mining techniques and neural networks to examine a set of fourteen features, data items, and HUMINT assessments for 2,148 emergency room patients with symptoms possibly indicative of Acute Coronary Syndrome. Specifically, the authors have generated Bayesian networks describing linkages and causality in the data, and have compared them with neural networks. The data includes objective information routinely collected during triage and the physician's initial case assessment, a HUMINT appraisal. Both the neural network and the Bayesian network were used to fuse the disparate types of information with the goal of forecasting thirty-day adverse patient outcome. This paper presents details of the methods of data fusion including both the data mining techniques and the neural network. Results are compared using Receiver Operating Characteristic curves describing the outcomes of both methods, both using only objective features and including the subjective physician's assessment. While preliminary, the results of this continuing study are significant both from the perspective of potential use of the intelligent fusion of biomedical informatics to aid the physician in prescribing treatment necessary to prevent serious adverse outcome from ACS and as a model of fusion of objective data with subjective HUMINT assessment. Possible future work includes extension of successfully demonstrated intelligent fusion methods to other medical applications, and use of decision level fusion to combine results from data mining and neural net approaches for even more accurate outcome prediction.

  10. Poor pregnancy outcome after octreotide treatment during pregnancy for familial hyperinsulinemic hypoglycemia

    DEFF Research Database (Denmark)

    Skajaa, Gitte O; Mathiesen, Elisabeth R; Iyore, Elisabeth; Beck-Nielsen, Henning; Jimenez-Solem, Espen; Damm, Peter

    2014-01-01

    BACKGROUND: Late familial hyperinsulinemic hypoglycemia is characterized by recurrent episodes of hypoglycemia and an inappropriate insulinemic response. Treatment with octreotide (somatostatin analogue) reduces the prevalence of clinical significant hypoglycemia and might be beneficial during...... pregnancy. To our knowledge this is the first report of a woman with late familial hyperinsulinemic hypoglycemia experiencing pregnancies with and without octreotide treatment. CASE PRESENTATION: A 35-year-old Caucasian woman known to suffer from late familial hyperinsulinemic hypoglycemia due to a well...... following two pregnancies were terminated on parental request after a chorion villus biopsy revealed the mutation causing late familial hyperinsulinemic hypoglycemia. During the fourth pregnancy, in which the fetus also had the mutation, serial ultrasound examinations showed a small fetus with appropriate...

  11. Consanguinity and Pregnancy Outcome among Rural Pregnant Women of Belgaum District

    Directory of Open Access Journals (Sweden)

    Chandra S Metgud , Vijaya A Naik , Maheshwar D Mallapur

    2012-01-01

    Full Text Available Background: Although unions between close biological relatives are preferred in many parts of South India, there still is a large gap of knowledge of this feature of human kinship structure. So, the present study was conducted to know the prevalence and types of consanguineous marriages and its effect on abortion, stillbirth, mortality and congenital malformation. Methods: The present longitudinal study was carried out in Kinaye Primary Health Centre of district Belgaum. All the pregnant women residing in the study area were included in the study, the number of whom was 1138. Results: The prevalence of consanguinity in our study was found to be 20.3%. Majority (53.2% of the marriages were between first cousins. The prevalence of consanguinity was significantly higher in illiterate couples (p < 0.001 and p 0.004 and in women belonging to Muslim religion (p 0.02. No significant effect of consanguinity was noted on the rate of abortion, stillbirth, mortality and congenital malformation. Conclusion: Consanguinity was higher among illiterate rural couples. Hence efforts should be made to enhance the literacy status through Information, Education and Communication activities. Consanguinity is one of the important contributory factors for adverse pregnancy outcomes. So, it would be advisable to avoid consanguineous unions in families where already a congenital malformed child has been born.

  12. Testing the association between psychosocial job strain and adverse birth outcomes - design and methods

    Directory of Open Access Journals (Sweden)

    Thulstrup Ane M

    2011-04-01

    Full Text Available Abstract Background A number of studies have examined the effects of prenatal exposure to stress on birth outcomes but few have specifically focused on psychosocial job strain. In the present protocol, we aim to examine if work characterised by high demands and low control, during pregnancy, is associated with the risk of giving birth to a child born preterm or small for gestational age. Methods and design We will use the Danish National Birth Cohort where 100.000 children are included at baseline. In the present study 49,340 pregnancies will be included. Multinomial logistic regression will be applied to estimate odds ratios for the outcomes: preterm; full term but small for gestational age; full term but large for gestational age, as a function of job-strain (high strain, active and passive versus low strain. In the analysis we control for maternal age, Body Mass Index, parity, exercise, smoking, alcohol use, coffee consumption, type of work (manual versus non-manual, maternal serious disease and parents' heights as well as gestational age at interview. Discussion The prospective nature of the design and the high number of participants strengthen the study. The large statistical power allows for interpretable results regardless of whether or not the hypotheses are confirmed. This is, however, not a controlled study since all kinds of 'natural' interventions takes place throughout pregnancy (e.g. work absence, medical treatment and job-redesign. The analysis will be performed from a public health perspective. From this perspective, we are not primarily interested in the effect of job strain per se but if there is residual effect of job strain after naturally occurring preventive measures have been taken.

  13. Behavioural change in relation to alcohol exposure in early pregnancy and impact on perinatal outcomes - a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Murphy Deirdre J

    2013-01-01

    Full Text Available Abstract Background There has been limited research addressing whether behavioural change in relation to alcohol exposure in pregnancy results in better perinatal outcomes. Methods A cohort study of 6725 women who booked for antenatal care and delivered in a large urban teaching hospital in 2010–2011. A detailed history of alcohol consumption pre-pregnancy and during early pregnancy was recorded at the first antenatal visit with follow-up of the mother and infant until discharge following birth. Adverse perinatal outcomes were compared for ‘non-drinkers’, ‘ex-drinkers’ and ‘current drinkers’. Results Of the 6017 (90% women who reported alcohol consumption prior to pregnancy 3325 (55% engaged in binge drinking and 266 (4.4% consumed more than 14 units on average per week. At the time of booking 5649 (94% women were ex-drinkers and of the 368 women who continued to drink 338 (92% had a low intake (0–5 units per week, 30 (8% an excess intake (6-20+ units per week and 93 (25% reported at least one episode of binge drinking. Factors associated with continuing to drink in early pregnancy included older maternal age (30–39 years, (OR 1.6; 95% CI 1.3 to 1.8, Irish nationality (OR 3.1; 95% CI 2.2 to 4.3 and smoking (OR 2.6; 95% CI 1.9 to 3.5. Ex-drinkers had similar perinatal outcomes to non-drinkers. Compared to non-drinkers current drinking was associated with an increased risk of intrauterine growth restriction (IUGR (13% versus 19%, crude OR 1.6; 95% CI 1.1 to 2.2, adjusted OR 1.2; 95% CI 0.8 to 1.8. The greatest risk of IUGR was among women who continued to both drink and smoke, (9% versus 32%, crude OR 4.8; 95% CI 3.3 to 7.0, adjusted OR 4.5; 95% CI 3.1 to 6.7. Conclusions Public Health campaigns need to emphasise the potential health gains of abstaining from both alcohol and smoking in pregnancy.

  14. The Violence Proneness Scale of the DUSI-R predicts adverse outcomes associated with substance abuse.

    Science.gov (United States)

    Kirisci, Levent; Tarter, Ralph; Reynolds, Maureen

    2009-01-01

    Accuracy of the Violence Proneness Scale (VPS) of the Drug Use Screening Inventory (DUSI-R) was evaluated in 328 boys for predicting use of illegal drugs, DUI, selling drugs, sexually transmitted disease, car accident while under acute effects of drugs/alcohol, trading drugs for sex, injuries from a fight, and traumatic head injury. Boys were prospectively tracked from age 16 to 19 at which time these outcomes were documented in the interim period. The results demonstrated that the VPS score is a significant predictor of all outcomes. Prediction accuracy ranged between 62%-83%. These findings suggest that the VPS may be useful for identifying youths who are at high risk for using illicit drugs and commonly associated adverse outcomes. PMID:19283571

  15. Incidence and outcome of bleeding before the 20th week of pregnancy: prospective study from general practice.

    OpenAIRE

    EVERETT, C

    1997-01-01

    OBJECTIVE: To estimate the miscarriage rate in a cohort of pregnant women and the final outcome of pregnancy. DESIGN: Two year prospective community study. SETTING: Women registered with four semirural practices at one health centre. SUBJECTS: 626 pregnant women from a population 21448, 5140 of whom were women aged 15-44 years. MAIN OUTCOME MEASURES: Vaginal bleeding and outcome of pregnancy. Results: 76 of the 89 women with an unwanted pregnancy requested a termination. In the 550 ongoing pr...

  16. Impact of spontaneous fibroid expulsion of uterine leiomyoma on pregnancy outcome after uterine arteries embolization

    Directory of Open Access Journals (Sweden)

    Medvediev M.V.

    2015-09-01

    Full Text Available Uterine leiomyoma (UL is common benign tumor of female genitals. Uterine artery embolization (UAE is widely used method of organ-sparing UL treatment. Safe ty of this procedure for future fertility and labor is controversial. We present a case of pregnancy in woman who previously underwent uterine artery embolization. During 12-months’ follow-up period patient periodically noted vaginal di¬scharge. No signs of UL have been found on ultrasound in 12 months of follow-up. Normal pregnancy occurred 1.5 years after UAE procedure which ended in normal labor without complications. Most authors report increased risk of pregnancy complications such as postpartum hemorrhage, preterm delivery, malpresentation after UAE. Our point of view is that a lot of pregnancy complications are possibly associated with persistence of necrotic leiomyoma tissue in uterine wall after UAE. Presented case allowed to draw preliminary conclusions that complete disappearance of UL nodule after UAE could improve pregnancy outcomes.

  17. Associations between Anticholinergic Burden and Adverse Health Outcomes in Parkinson Disease.

    Directory of Open Access Journals (Sweden)

    James A G Crispo

    Full Text Available Elderly adults should avoid medications with anticholinergic effects since they may increase the risk of adverse events, including falls, delirium, and cognitive impairment. However, data on anticholinergic burden are limited in subpopulations, such as individuals with Parkinson disease (PD. The objective of this study was to determine whether anticholinergic burden was associated with adverse outcomes in a PD inpatient population.Using the Cerner Health Facts® database, we retrospectively examined anticholinergic medication use, diagnoses, and hospital revisits within a cohort of 16,302 PD inpatients admitted to a Cerner hospital between 2000 and 2011. Anticholinergic burden was computed using the Anticholinergic Risk Scale (ARS. Primary outcomes were associations between ARS score and diagnosis of fracture and delirium. Secondary outcomes included associations between ARS score and 30-day hospital revisits.Many individuals (57.8% were prescribed non-PD medications with moderate to very strong anticholinergic potential. Individuals with the greatest ARS score (≥ 4 were more likely to be diagnosed with fractures (adjusted odds ratio (AOR: 1.56, 95% CI: 1.29-1.88 and delirium (AOR: 1.61, 95% CI: 1.08-2.40 relative to those with no anticholinergic burden. Similarly, inpatients with the greatest ARS score were more likely to visit the emergency department (adjusted hazard ratio (AHR: 1.32, 95% CI: 1.10-1.58 and be readmitted (AHR: 1.16, 95% CI: 1.01-1.33 within 30-days of discharge.We found a positive association between increased anticholinergic burden and adverse outcomes among individuals with PD. Additional pharmacovigilance studies are needed to better understand risks associated with anticholinergic medication use in PD.

  18. Asymptomatic bacteriuria & obstetric outcome following treatment in early versus late pregnancy in north Indian women

    OpenAIRE

    Jain, Vaishali; Das, Vinita; Agarwal, Anjoo; Pandey, Amita

    2013-01-01

    Background & objectives: Asymptomatic bacteriuria during pregnancy if left untreated, may lead to acute pyelonephritis, preterm labour, low birth weight foetus, etc. Adequate and early treatment reduces the incidence of these obstetric complications. The present study was done to determine presence of asymptomatic bacteriuria (ASB) and obstetric outcome following treatment in early versus late pregnancy. Methods: A prospective cohort study was conducted at a tertiary care teaching hospital of...

  19. High Rate of Severe Fetal Outcomes Associated with Maternal Parvovirus B19 Infection in Pregnancy

    OpenAIRE

    Beigi, Richard H.; Wiesenfeld, Harold C.; Daniel V. Landers; Simhan, Hyagriv N.

    2008-01-01

    Objective. To augment the understanding of parvovirus B19 infection in pregnancy with respect to maternal characteristics and their corresponding fetal outcomes. Study Design. Retrospective case-series of all women referred to Magee-Women_s Hospital with serologically-documented parvovirus B19 infection during pregnancy from 1998–2001. Results. All 25 cases that are available for analysis occurred from January through June. The frequency of cases varied substantially from year to year, with 1...

  20. Influence of exercise mode on pregnancy outcomes: ENHANCED by Mom project

    OpenAIRE

    Moyer, Carmen; Livingston, Jeffrey; Fang, Xiangming; May, Linda E.

    2015-01-01

    Background The extent of the benefits of exercise training during pregnancy on maternal, fetal, and neonatal health outcomes has not been sufficiently addressed. While aerobic exercise training has been determined as safe and efficacious throughout pregnancy, the effects of other training modes on fetal health and development as well as any continued benefits for the neonate, especially with regards to cardiovascular development and function, is largely unknown. In the ENHANCED by Mom study w...

  1. Outcome of pregnancy in patients with inactive systemic lupus erythromatosus and minimal proteinuria

    OpenAIRE

    Alshohaib Saad

    2009-01-01

    Systemic lupus erythematosus (SLE) is a multisystem disease. This study was under-taken to assess the outcome of pregnancies in patients with inactive SLE. We prospectively studied 20 female patients with diagnosis of stable class IV Lupus nephritis followed up at King Abdul Aziz University Hospital, in Jeddah, Saudi Arabia between 1998 and 2008. Before each pregnancy all the patients had their blood pressure, serum creatinine, creatinine clearance, serology for SLE and 24-hour urine protein ...

  2. A prospective clinical study of feto-maternal outcome in pregnancies with abnormal liquor volume

    OpenAIRE

    Rutwa J. Chavda; Hardev B. Saini

    2014-01-01

    Background: Evaluating feto-maternal outcome in pregnancies with abnormal liquor volume. Methods: 200 pregnant subjects between 20 and 42 weeks of gestation, who were clinically suspected to have an abnormal amniotic fluid volume (oligohydramnios or polyhydramnios) were subjected to ultrasonographic (USG) assessment of amniotic fluid index. The subjects were closely monitored during pregnancy, labour and puerperium. Results: Ultrasonically, abnormal liquor volume was confirmed in 90-93...

  3. The effect of body mass index on the outcome of pregnancy in women with recurrent miscarriage

    OpenAIRE

    Winnie Lo; Raj Rai; Aisha Hameed; Brailsford, Susan R.; Al-Ghamdi, Ahlam A.; Lesley Regan

    2012-01-01

    Background: Maternal obesity is associated with menstrual disorders, infertility and sporadic miscarriages. Recurrent miscarriage (RM) affects at least 1% of couples trying to conceive. In over 50% of cases, the cause of the loss of pregnancy remains unexplained. The aim of this study was to determine the relationship between maternal Body Mass Index (BMI) and future outcomes of pregnancy in couples with "unexplained" RM. Methods and Results: All couples referred to the specialist recurrent m...

  4. PREGNANCY OUTCOME OF GESTATIONAL DIABETIC MOTHERS: EXPERIENCE IN A TERTIARY CENTER

    OpenAIRE

    Al-Hakeem, Malak M.

    2006-01-01

    Background: Carbohydrate intolerance is the most common metabolic complication of pregnancy. Gestational Diabetes Mellitus (GDM) poses numerous problems for both mother and fetus. The objectives of this study are to find out the incidence of gestational diabetes mellitus in pregnant women and their pregnancy outcomes. It was also to discover the risk factors for the admission of neonates to the Neonatal Intensive Care Unit (NICU). Design and Patients: A hospital-based prospective study perfor...

  5. Neonatal Outcomes in Twin Pregnancies Delivered Moderately Preterm, Late Preterm and Term

    OpenAIRE

    Refuerzo, Jerrie S.; Momirova, Valerija; Peaceman, Alan M.; Sciscione, Anthony; ROUSE, Dwight J.; CARITIS, Steve N.; Catherine Y. Spong; Varner, Michael W.; Malone, Fergal D.; Iams, Jay D.; Mercer, Brian M.; THORP, John M.; Sorokin, Yoram; CARPENTER, Marshall W.; LO, Julie

    2010-01-01

    We compared neonatal outcomes in twin pregnancies following moderately preterm birth (MPTB), late preterm birth (LPTB) and term birth. A secondary analysis of a multi-center, randomized controlled trial of multiple gestations was conducted. MPTB was defined as delivery between 320/7 and 336/7 weeks and LPTB between 340/7 and 366/7 weeks. Primary outcome was a neonatal outcome composite consisting of one or more of the following: neonatal death, respiratory distress syndrome, early onset cultu...

  6. Maternal and fetal outcomes in rheumatic heart disease in pregnancy

    Directory of Open Access Journals (Sweden)

    Dhivya Sethuraman

    2014-08-01

    Conclusion: The association of the pre pregnancy functional class with the risk of maternal events raises attention to the possibility of reducing these complications in pregnant women with mitral stenosis by means of early interventions aimed at improving their functional class. [Int J Res Med Sci 2014; 2(4.000: 1632-1637

  7. Maternal Diabetes in Pregnancy: Early and Long-Term Outcomes on the Offspring and the Concept of “Metabolic Memory”

    Directory of Open Access Journals (Sweden)

    Akadiri Yessoufou

    2011-01-01

    Full Text Available The adverse outcomes on the offspring from maternal diabetes in pregnancy are substantially documented. In this paper, we report main knowledge on impacts of maternal diabetes on early and long-term health of the offspring, with specific comments on maternal obesity. The main adverse outcome on progenies from pregnancy complicated with maternal diabetes appears to be macrosomia, as it is commonly known that intrauterine exposure to hyperglycemia increases the risk and programs the offspring to develop diabetes and/or obesity at adulthood. This “fetal programming”, due to intrauterine diabetic milieu, is termed as “metabolic memory”. In gestational diabetes as well as in macrosomia, the complications include metabolic abnormalities, degraded antioxidant status, disrupted immune system and potential metabolic syndrome in adult offspring. Furthermore, there is evidence that maternal obesity may also increase the risk of obesity and diabetes in offspring. However, women with GDM possibly exhibit greater macrosomia than obese women. Obesity and diabetes in pregnancy have independent and additive effects on obstetric complications, and both require proper management. Management of gestational diabetes mellitus and maternal obesity is essential for maternal and offspring's good health. Increasing physical activity, preventing gestational weight gain, and having some qualitative nutritional habits may be beneficial during both the pregnancy and offspring's future life.

  8. The 2011 survey on hypertensive disorders of pregnancy (HDP in China: prevalence, risk factors, complications, pregnancy and perinatal outcomes.

    Directory of Open Access Journals (Sweden)

    Chun Ye

    Full Text Available Hypertensive disorders of pregnancy (HDP are a group of medical complications in pregnancy and also a risk factor for severe pregnancy outcomes, but it lacks a large-scale epidemiological investigation in recent years. This survey represents a multicenter cross-sectional retrospective study to estimate the prevalence and analyze the risk factors for HDP among the pregnant women who had referred for delivery between January 1st 2011 and December 31st 2011 in China Mainland. A total of 112,386 pregnant women were investigated from 38 secondary and tertiary specialized or general hospitals randomly selected across the country, of which 5,869 had HDP, accounting for 5.22% of all pregnancies. There were significant differences in the prevalence of HDP between geographical regions, in which the North China showed the highest (7.44% and Central China showed the lowest (1.23%. Of six subtypes of HDP, severe preeclampsia accounted for 39.96%, gestational hypertension for 31.40%, mild preeclampsia for 15.13%, chronic hypertension in pregnancy for 6.00%, preeclampsia superimposed on chronic hypertension for 3.68% and eclampsia for 0.89%. A number of risk factors for HDP were identified, including twin pregnancy, age of >35 years, overweight and obesity, primipara, history of hypertension as well as family history of hypertension and diabetes. The prevalence of pre-term birth, placental abruption and postpartum hemorrhage were significantly higher in women with HDP than those without HDP. The possible risk factors confirmed in this study may be useful for the development of early diagnosis and appropriate treatment of HDP.

  9. Adverse effects of maternal age, weight and smoking during pregnancy in Pleven, Bulgaria

    Directory of Open Access Journals (Sweden)

    Mariela Stefanova Kamburova

    2015-11-01

    Full Text Available Aim: This paper aims to study the relationship between mothers’ age, body mass index (BMI, gestational weight gain (GWG and smoking and the risk for premature birth in Pleven, Bulgaria. Methods: A case-control study was conducted in Pleven in 2007. The study was comprehensive for all premature children (N=58 and representative for full-term infants (N=192, or 10.4% of all of the 1827 full-term children born in 2007 at the University Hospital of Pleven and resident in the city of Pleven. Retrospective data on determinants under study were collected from all the mothers included in this study (N=250. Results: Mothers of premature children were more likely to be above 35 years old (27.6%, with a BMI ≥25 kg/m2 (23.1%, GWG below the recommended value (38.5% and to smoke during pregnancy (37.9%. The odds of being a smoker during pregnancy were five times higher among mothers with low birth weight (LBW newborns compared with their counterparts with normal birth weight newborns (OR=5.1, 95%CI=2.4-10.6. There was a positive association between BMI and LBW in infants whose mothers were overweight (OR=2.1, 95%CI=1.0-4.0. The risk of LBW increased when GWG was less than recommended (OR=1.8, 95%CI=1.0-3.1. Conclusion: Our results indicate that pre-pregnancy BMI ≥25 kg/m2, less than recommended GWG and smoking during pregnancy are risk factors for premature birth in Pleven region. Findings from this study suggest the need for active health and educational actions by health professionals in order to avoid premature births in Bulgaria.

  10. Adverse Geriatric Outcomes Secondary to Polypharmacy in a Mouse Model: The Influence of Aging.

    Science.gov (United States)

    Huizer-Pajkos, Aniko; Kane, Alice E; Howlett, Susan E; Mach, John; Mitchell, Sarah J; de Cabo, Rafael; Le Couteur, David G; Hilmer, Sarah N

    2016-05-01

    We aimed to develop a mouse model of polypharmacy, primarily to establish whether short-term exposure to polypharmacy causes adverse geriatric outcomes. We also investigated whether old age increased susceptibility to any adverse geriatric outcomes of polypharmacy. Young (n= 10) and old (n= 21) male C57BL/6 mice were administered control diet or polypharmacy diet containing therapeutic doses of five commonly used medicines (simvastatin, metoprolol, omeprazole, acetaminophen, and citalopram). Mice were assessed before and after the 2- to 4-week intervention. Over the intervention period, we observed no mortality and no change in food intake, body weight, or serum biochemistry in any age or treatment group. In old mice, polypharmacy caused significant declines in locomotor activity (pre minus postintervention values in control 2 ± 13 counts, polypharmacy 32 ± 7 counts,p< .05) and front paw wire holding impulse (control -2.45 ± 1.02 N s, polypharmacy +1.99 ± 1.19 N s,p< .05), loss of improvement in rotarod latency (control -59 ± 11 s, polypharmacy -1.7 ± 17 s,p< .05), and lowered blood pressure (control -0.2 ± 3 mmHg, polypharmacy 11 ± 4 mmHg,p< .05). In young mice, changes in outcomes over the intervention period did not differ between control and polypharmacy groups. This novel model of polypharmacy is feasible. Even short-term polypharmacy impairs mobility, balance, and strength in old male mice. PMID:25940962

  11. Below knee angioplasty in elderly patients: predictors of major adverse clinical outcomes.

    LENUS (Irish Health Repository)

    Keeling, Aoife N

    2012-02-01

    AIM: To determine predictors of clinical outcome following percutaneous transluminal angioplasty (PTA) in elderly patients with below knee atherosclerotic lesions causing intermittent claudication (IC) or critical limb ischaemia (CLI). MATERIALS AND METHODS: Over 7.5 years, 76 patients (CLI 72%, n = 55) underwent below knee PTA. The composite end-point of interest was major adverse clinical outcome (MACO) of the treated limb at follow-up which was defined as clinical failure, need for subsequent endovascular or surgical revascularization or amputation. Actuarial freedom from MACO was assessed using Kaplan-Meier curves and multivariable Cox proportional hazards regression. RESULTS: IC was improved in 95% at mean 3.4 years (range 0.5-108 months). Successful limb salvage and ulcer healing were seen in 73% with CLI. Most failures were in the CLI group (27% CLI vs. 5% IC), with an amputation rate of 16% for CLI vs. 5% for IC and persistent ulceration in 24% of CLI. Significant independent predictors of MACO were ulceration (hazard ratio 4.02, 95% CI = 1.55-10.38) and family history of atherosclerosis (hazard ratio 2.53, 95% CI = 1.1-5.92). CONCLUSION: Primary below knee PTA is a feasible therapeutic option in this elderly population. Limb ulceration and family history of atherosclerosis may be independent predictors of adverse outcome.

  12. Below knee angioplasty in elderly patients: Predictors of major adverse clinical outcomes

    Energy Technology Data Exchange (ETDEWEB)

    Keeling, Aoife N.; Khalidi, Karim; Leong, Sum [Department of Academic Radiology, Beaumont Hospital, Beaumont Road, Dublin 9 (Ireland); Wang, Tim T. [Department of Biosurgery and Surgical Technology, Imperial College London, St. Mary' s Hospital, London W2 1NY (United Kingdom); Ayyoub, Alaa S.; McGrath, Frank P. [Department of Academic Radiology, Beaumont Hospital, Beaumont Road, Dublin 9 (Ireland); Athanasiou, Thanos [Department of Biosurgery and Surgical Technology, Imperial College London, St. Mary' s Hospital, London W2 1NY (United Kingdom); Lee, Michael J., E-mail: mlee@rcsi.ie [Department of Academic Radiology, Beaumont Hospital, Beaumont Road, Dublin 9 (Ireland)

    2011-03-15

    Aim: To determine predictors of clinical outcome following percutaneous transluminal angioplasty (PTA) in elderly patients with below knee atherosclerotic lesions causing intermittent claudication (IC) or critical limb ischaemia (CLI). Materials and methods: Over 7.5 years, 76 patients (CLI 72%, n = 55) underwent below knee PTA. The composite end-point of interest was major adverse clinical outcome (MACO) of the treated limb at follow-up which was defined as clinical failure, need for subsequent endovascular or surgical revascularization or amputation. Actuarial freedom from MACO was assessed using Kaplan-Meier curves and multivariable Cox proportional hazards regression. Results: IC was improved in 95% at mean 3.4 years (range 0.5-108 months). Successful limb salvage and ulcer healing were seen in 73% with CLI. Most failures were in the CLI group (27% CLI vs. 5% IC), with an amputation rate of 16% for CLI vs. 5% for IC and persistent ulceration in 24% of CLI. Significant independent predictors of MACO were ulceration (hazard ratio 4.02, 95% CI = 1.55-10.38) and family history of atherosclerosis (hazard ratio 2.53, 95% CI = 1.1-5.92). Conclusion: Primary below knee PTA is a feasible therapeutic option in this elderly population. Limb ulceration and family history of atherosclerosis may be independent predictors of adverse outcome.

  13. Below knee angioplasty in elderly patients: Predictors of major adverse clinical outcomes

    International Nuclear Information System (INIS)

    Aim: To determine predictors of clinical outcome following percutaneous transluminal angioplasty (PTA) in elderly patients with below knee atherosclerotic lesions causing intermittent claudication (IC) or critical limb ischaemia (CLI). Materials and methods: Over 7.5 years, 76 patients (CLI 72%, n = 55) underwent below knee PTA. The composite end-point of interest was major adverse clinical outcome (MACO) of the treated limb at follow-up which was defined as clinical failure, need for subsequent endovascular or surgical revascularization or amputation. Actuarial freedom from MACO was assessed using Kaplan-Meier curves and multivariable Cox proportional hazards regression. Results: IC was improved in 95% at mean 3.4 years (range 0.5-108 months). Successful limb salvage and ulcer healing were seen in 73% with CLI. Most failures were in the CLI group (27% CLI vs. 5% IC), with an amputation rate of 16% for CLI vs. 5% for IC and persistent ulceration in 24% of CLI. Significant independent predictors of MACO were ulceration (hazard ratio 4.02, 95% CI = 1.55-10.38) and family history of atherosclerosis (hazard ratio 2.53, 95% CI = 1.1-5.92). Conclusion: Primary below knee PTA is a feasible therapeutic option in this elderly population. Limb ulceration and family history of atherosclerosis may be independent predictors of adverse outcome.

  14. Outcome of pregnancy in patients with inactive systemic lupus erythromatosus and minimal proteinuria

    Directory of Open Access Journals (Sweden)

    Alshohaib Saad

    2009-01-01

    Full Text Available Systemic lupus erythematosus (SLE is a multisystem disease. This study was under-taken to assess the outcome of pregnancies in patients with inactive SLE. We prospectively studied 20 female patients with diagnosis of stable class IV Lupus nephritis followed up at King Abdul Aziz University Hospital, in Jeddah, Saudi Arabia between 1998 and 2008. Before each pregnancy all the patients had their blood pressure, serum creatinine, creatinine clearance, serology for SLE and 24-hour urine protein excretion measured and then repeated at monthly intervals during the pregnancy. Statistical analysis was performed using the Wilcoxon signed-rank test. Despite having negative antinuclear antibody (ANA significant complications were observed during pregnancy. The daily proteinuria during 34-36 weeks′ gestation was significantly higher (P< 0.05 than during 32 weeks. Two patients had abortions one stillbirth and 2 required termination of the pregnancy; one due to severe hypertension, and other due to renal impairment. One patient developed HELLP (hemolysis, elevated liver enzymes, low platelets syndrome. 14 patients had a successful preg-nancy, including 4 requiring a cesarian section. In conclusion, although no clinical evidence of lupus disease activity was demonstrated pre-conception proteinuria significantly increased during pregnancy along with maternal and fetal complications. Pregnant females with diagnosis of SLE need a multidisciplinary care during the pregnancy and post-partum period.

  15. Antenatal Receipt of Sulfadoxine-Pyrimethamine Does Not Exacerbate Pregnancy-Associated Malaria Despite the Expansion of Drug-Resistant Plasmodium falciparum: Clinical Outcomes From the QuEERPAM Study

    OpenAIRE

    Taylor, Steve M.; Antonia, Alejandro L.; Chaluluka, Ebbie; Mwapasa, Victor; Feng, Gaoqian; Molyneux, Malcolm E.; ter Kuile, Feiko O; Meshnick, Steven R.; Rogerson, Stephen J.

    2012-01-01

    Antenatal preventive administration of sulfadoxine-pyrimethamine did not potentiate pregnancy-associated malaria morbidity despite expansion and fixation of drug-resistant malaria parasites. Sulfadoxine-pyrimethamine may be a safe component of malaria prevention programs without causing adverse effects on birth outcomes.

  16. Intervillous Macrophage Migration Inhibitory Factor Is Associated with Adverse Birth Outcomes in a Study Population in Central India

    OpenAIRE

    Singh, Puspendra P.; Lucchi, Naomi W.; Anna Blackstock; Venkatachalam Udhayakumar; Neeru Singh

    2012-01-01

    Macrophage migration inhibitory factor (MIF) is a pluripotent factor produced by a variety of cells. It plays an important biological role in the regulation of pregnancy and has been shown to influence malaria pathogenesis. In this study, the levels of MIF in the peripheral, cord and placental intervillous blood (IVB) plasma collected from women residing in a malaria endemic region of Central India was determined and its association with malaria in pregnancy and birth outcomes was investigate...

  17. Effect of RAAS blockers on adverse clinical outcomes in high CVD risk subjects with atrial fibrillation

    Science.gov (United States)

    Chaugai, Sandip; Sherpa, Lhamo Yanchang; Sepehry, Amir A.; Arima, Hisatomi; Wang, Dao Wen

    2016-01-01

    Abstract Recent studies have demonstrated that atrial fibrillation significantly increases the risk of adverse clinical outcomes in high cardiovascular disease risk subjects. Application of renin–angiotensin–aldosterone system blockers for prevention of recurrence of atrial fibrillation and adverse clinical outcomes in subjects with atrial fibrillation is a theoretically appealing concept. However, results of clinical trials evaluating the effect of renin–angiotensin–aldosterone blockers on adverse clinical outcomes in high cardiovascular disease risk subjects with atrial fibrillation remain inconclusive. A pooled study of 6 randomized controlled trials assessing the efficacy of renin–angiotensin–aldosterone blockers on subjects with atrial fibrillation was performed. A total of 6 randomized controlled trials enrolled a total of 53,510 patients followed for 1 to 5 years. RAAS blockade therapy was associated with 14% reduction in the incidence of heart failure (OR: 0.86, [95%CI: 0.76– 0.97], P=0.018) and 17% reduction in the incidence of CVE (OR: 0.83, [95%CI: 0.70–0.99], P = 0.038). The corresponding decline in absolute risk against heart failure (ARR: 1.4%, [95%CI: 0.2–2.6%], P = 0.018) and CVE (ARR: 3.5%, [95%CI: 0.0–6.9%], P = 0.045) in the AF group was much higher than the non-AF group for heart failure (ARR: 0.4%, [95%CI: 0.0–0.7%], P = 0.057) and CVE (ARR: 1.6%, [95%CI: –0.1% to 3.3%], P = 0.071). No significant effect was noted on all-cause or cardiovascular mortality, stroke, or myocardial infarction. This study suggests that RAAS blockade offers protection against heart failure and cardiovascular events in high cardiovascular disease risk subjects with atrial fibrillation. PMID:27368043

  18. Obstetric outcomes of teenagers and older mothers: ‎experience from Saudi Arabia

    OpenAIRE

    Abdel-Hady El-Gilany; Sabry Hammad

    2012-01-01

    Background: Extremes of maternal age adversely affect pregnancy outcomes. Teenage ‎pregnancy is a public health problem and is known to be associated with adverse pregnancyoutcomes. Advanced maternal age is a risk factor for pregnancy outcome. Saudi Arabia suffers ‎the dual burden of teenage pregnancy and older pregnancy.‎Objectives: To explore the effects of maternal age on pregnancy and its outcome among mothers ‎adequately covered with maternity care. ‎Methods: A retrospective record-bas...

  19. The obese woman with gestational diabetes: effects of body mass index and weight gain in pregnancy on obstetric and glycaemic outcomes

    Science.gov (United States)

    Ip, Flora; Bradford, Jennifer; Hng, Tien-Ming; Hendon, Susan; McLean, Mark

    2012-01-01

    Background Obese women with gestational diabetes mellitus (GDM) represent a high-risk group in pregnancy, although the effects of increasing degrees of obesity and weight gain in pregnancy in this group is poorly defined. Methods We performed a retrospective analysis of 375 singleton pregnancies complicated by maternal obesity and GDM. Women with a body mass index (BMI) of 30–35 kg/m2 were compared with those with a BMI of ≥ 35 kg/m2. Additionally, women were categorized according to weight gain in pregnancy: Group A (0.27 kg/week). Results Obstetric outcomes did not differ between the groups; however, postpartum dysglycaemia was more likely in women with a BMI ≥ 35 kg/m2 (odds ratio [OR] 3.2, 95% confidence interval [CI]: 1.2–8.9). Group B and Group C had higher odds of LGA (OR 3.8, 95% CI: 1.3–11.3; OR 5.0, 95% CI: 2.0–12.1, respectively) compared with Group A. Group C also had a lower risk of SGA (OR 0.4, 95% CI: 0.2–1.0) and a higher risk of postpartum dysglycaemia (OR 6.8, 95% CI: 1.7–26.9) compared with Group A. Conclusion Greater degrees of obesity are associated with higher risk of abnormal metabolic outcomes after pregnancy. Excessive weight gain in pregnancy in obese women increases adverse obstetric and glycaemic outcomes. Our findings suggest that targets for weight gain in pregnancy for obese women should be reduced from current recommendations.

  20. The effect of Porphyromonas gingivalis lipopolysaccharide on pregnancy in the rat

    NARCIS (Netherlands)

    Kunnen, A; van Pampus, M G; Aarnoudse, J G; van der Schans, C P; Abbas, F; Faas, M M

    2014-01-01

    OBJECTIVE: Periodontitis, mostly associated with Porphyromonas gingivalis, has frequently been related to adverse pregnancy outcomes. We therefore investigated whether lipopolysaccharides of P. gingivalis (Pg-LPS) induced pregnancy complications in the rat. METHODS: Experiment 1: pregnant rats (day