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Sample records for high risk pregnancy

  1. High-Risk Pregnancy

    Science.gov (United States)

    ... NICHD Research Information Clinical Trials Resources and Publications High-Risk Pregnancy: Condition Information Skip sharing on social media links Share this: Page Content A high-risk pregnancy refers to anything that puts the ...

  2. [Detecting high risk pregnancy].

    Science.gov (United States)

    Doret, Muriel; Gaucherand, Pascal

    2009-12-20

    Antenatal care is aiming to reduce maternal land foetal mortality and morbidity. Maternal and foetal mortality can be due to different causes. Their knowledge allows identifying pregnancy (high risk pregnancy) with factors associated with an increased risk for maternal and/or foetal mortality and serious morbidity. Identification of high risk pregnancies and initiation of appropriate treatment and/or surveillance should improve maternal and/or foetal outcome. New risk factors are continuously described thanks to improvement in antenatal care and development in biology and cytopathology, increasing complexity in identifying high risk pregnancies. Level of risk can change all over the pregnancy. Ideally, it should be evaluated prior to the pregnancy and at each antenatal visit. Clinical examination is able to screen for intra-uterin growth restriction, pre-eclampsia, threatened for preterm labour; ultrasounds help in the diagnosis of foetal morphological anomalies, foetal chromosomal anomalies, placenta praevia and abnormal foetal growth; biological exams are used to screen for pre-eclampsia, gestational diabetes, trisomy 21 (for which screening method just changed), rhesus immunisation, seroconversion for toxoplasmosis or rubeola, unknown infectious disease (syphilis, hepatitis B, VIH). During pregnancy, most of the preventive strategies have to be initiated during the first trimester or even before conception. Prevention for neural-tube defects, neonatal hypocalcemia and listeriosis should be performed for all women. On the opposite, some measures are concerning only women with risk factors such as prevention for toxoplasmosis, rhesus immunization (which recently changed), tobacco complications and pre-eclampsia and intra-uterine growth factor restriction.

  3. High risk pregnancy

    Directory of Open Access Journals (Sweden)

    Bernardita Donoso Bernales

    2012-06-01

    Full Text Available It is estimated that roughly 20% of pregnancies fall into the high risk category, which in turn are responsible for over 80% of perinatal adverse outcome. Modern obstetrics has been very successful in reducing maternal morbidity and mortality. It has focused mainly on fetal and neonatal aspects, and on identifying the subgroup of pregnant women that need greater surveillance and care because of clearly identifiable risk factors. The article describes the preconceptional advice, its components and recommendations for its implementation, as well as its role in maternal and perinatal risk assessment. These interventions attempt to reduce the rates of maternal and perinatal mortality.

  4. Psychological implications of high-risk pregnancy.

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    Cumberbatch, Carla-Joy; Birndorf, Catherine; Dresner, Nehama

    2005-01-01

    The psychological adjustments of "normal" pregnancy are complex, and those of high-risk pregnancy are even more pronounced and severe. A pregnancy may be determined to be at high risk because of obstetric factors in previous pregnancies or the present one; more general medical factors, such as preexisting or emergent disease (often, diabetes); and conditions that are, themselves, psychosocial: anxiety disorders (GAD, OCD, panic disorder, PTSD), mood disorders, and schizophrenia, all of which are a background for a disturbed pregnancy and might complicate a pregnancy denominated high risk for some other reason. This paper discusses these concepts and, in addition, includes sections on pregnancy in adolescence, in the developmentally disabled, and in the situation of chemical dependence (substance abuse).

  5. High-risk pregnancy and the rheumatologist.

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    Soh, May Ching; Nelson-Piercy, Catherine

    2015-04-01

    Rheumatologists are increasingly involved in the care of young women who, in the age of biologic therapy, are now gaining control of their rheumatic diseases and attempting pregnancy. With careful planning, most women with rheumatic diseases have successful pregnancies. This article focuses specifically on the highest-risk pregnancies and controversial areas. We discuss the women at risk of complications, the types of maternal and fetal complications, the treatments that can be used in pregnancy (and breastfeeding) and longer-term outcomes that could affect the mother. SLE, RA, ANCA-associated vasculitides, large vessel vasculitis (e.g. Takayasu's) and other CTDs (e.g. scleroderma) are among the conditions covered. The evidence and controversies regarding the recommendations for the use of biologics in pregnancy are discussed. The role of the rheumatologist in pregnancy planning and caring for the pregnant and post-partum woman as part of the multidisciplinary team is discussed.

  6. Economic evaluation studies of obstetric interventions in high risk pregnancies

    NARCIS (Netherlands)

    Vijgen, S.M.C.

    2013-01-01

    In this thesis we performed comparative costs and cost-effectiveness analyses for several clinical dilemmas in high risk pregnancies or deliveries, and explored practical and methodological issues in such research and to discuss the context of evidence-based policy making in relation to complex dile

  7. Special features of high-risk pregnancies as factors in development of mental distress: a review

    Directory of Open Access Journals (Sweden)

    Paula Borba Rodrigues

    Full Text Available Abstract Introduction: Approximately 22% of all pregnant women are classified as having high-risk pregnancies, which may involve feelings of vulnerability because of having a high-risk pregnancy, resulting in greater exposure to stressful feelings. Objective: To review aspects of high-risk pregnancy that can have a negative impact on the these women's mental health status. Method: Original articles were identified by conducting searches of the PubMed/MEDLINE, LILACS and SciELO databases, followed by a manual search of references to select articles and additional bibliographic material. Articles from the last 22 years were included in the review (1992-2014. Results: Fifteen articles were found that specifically studied high-risk pregnancies and mental health outcomes. Women with high-risk pregnancies exhibited a significantly higher level of stress and reported negative emotions as they dealt with stress and had worse emotional status than women with normal pregnancies. Researchers found that hospitalized pregnant women had higher levels of anxiety than non-hospitalized women. Studies of women going through normal and high-risk pregnancies show that women with normal pregnancies had good self-perceived quality of life. Conclusion: Special features of high-risk pregnancies could be factors in development of mental distress, in addition to psychological and social factors. Therefore, only a biopsychosocial research study would be able to identify the factors that can affect the quality of mental health during high-risk pregnancy.

  8. Recommendations of activity restriction in high-risk pregnancy scenarios

    DEFF Research Database (Denmark)

    Bendix, Jane; Hegaard, Hanne Kristine; Bergholt, Thomas;

    2015-01-01

    obstetricians and midwives prescribe activity restriction in most high-risk pregnancies. The degree of activity restriction and the presumed effect vary between clinicians. This may reflect different attitudes and lack of guidelines based on clinical studies of a possible benefit of activity restriction....... to the obstetricians, the midwives also reported that they expected the recommendation to be more effective. Most midwives and obstetricians reported that they thought strict activity restriction was associated with severe or moderate adverse effect, and recommended antithrombotic prophylaxis. Conclusions: Danish......Abstract Aims: To describe specific recommendations of activity restriction, place of care, expected beneficial and adverse effects, and recommended antithrombotic prophylaxis in nine clinical scenarios. Methods: A national survey. All members of the Danish Society of Obstetrics and Gynaecology...

  9. [Maternal metabolic diseases related to pre-pregnancy overweight and obesity in mexican women with high risk pregnancy].

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    Hernández-Higareda, Salvador; Pérez-Pérez, Omar-Alejandro; Balderas-Peña, Luz-Ma-Adriana; Martínez-Herrera, Brenda-Eugenia; Salcedo-Rocha, Ana-Leticia; Ramírez-Conchas, Rosa-Emilia

    Pre-pregnancy obesity has been proposed as a risk factor related to gestational diabetes and hypertensive disorders during pregnancy. Identify pregnancy related diseases associated with pre-pregnancy obesity as a risk factor ina high risk preganancy patient population. 600 patients whose pre-pregnancy obesity had been assessed as a high risk factor were included in the study. The means, standard deviation, median, interquartile intervals, Pearson and Spearman correlation and logistic regression to estimate risk with the odds ratio and 95% confidence intervals were calculated. The mean pre-pregnancy body mass index was 29.59 ± 6.42 kg/m(2). The mean for recommended pregnancy weight gain was 2.31 ± 1.03 kg, but the mean of real weight gain was 8.91 ± 6.84 kg. A significant correlation between pre-pregnancy obesity and family history of diabetes mellitus (p=0.000), systemic hypertension (p=0.003), cardiac diseases (p=0.000), dyslipidemia (p=0.000) and obesity (p=0.000) was identified. Pre-pregnancy obesity was identified as a risk factor for the development of gestational diabetes (OR: 1.95; IC95%: 1.39 to 2.76; p=0.000) in this kind of patient. 75% of high risk pregnancy women in a high specialty hospital in West Mexico are overweight or obese when they become pregnant. These are risk factors in the development of gestational diabetes. Copyright © 2016 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.

  10. Importance of Pre-pregnancy Counseling in Iran: Results from the High Risk Pregnancy Survey 2012

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    Mohammad Eslami

    2013-01-01

    Full Text Available Background To identify the prevalence of behavioural (Pre-pregnancy, obstetrical and medical risks of pregnancy in Iranian women. Methods A total of 2993 postpartum women who delivered in 23 randomly selected hospitals of six provinces were enrolled in this nationwide cross-sectional study. A structured questionnaire was completed based on interviewees’ self-reports and medical record data, consisting of socio-demographic characteristics, behavioural, obstetrical and medical risks, before and during pregnancy. Results Less than 6.0% had no health insurance and 5.0% had no prenatal visit before labour. Unintended pregnancy was reported by 27.5% of women. Waterpipe and/or cigarette smoking was reported by 7.1% of them and 0.9% abused opiates during pregnancy. Physical abuse by husband in the year before pregnancy occurred in 7.5% of participants. The rate of cesarean section was 50.4%. Preterm birth, low birth weight, and stillbirth were seen in 6.8, 7.7, and 1.2% of deliveries respectively. The most frequent medical risk factors were urinary tract infection (32.5%, anemia (21.6%, and thyroid disease (4.1%. Conclusion More effort should be devoted by health policymakers to the establishment of a preconception counselling (health education and risk assessment and surveillance system; although obstetrical and medical risks should not be neglected too.

  11. High-Risk Cardiac Disease in Pregnancy Part II

    NARCIS (Netherlands)

    Elkayam, Uri; Goland, Sorel; Pieper, Petronella G.; Silverside, Candice K.

    2016-01-01

    Heart disease continues to be the leading cause of nonobstetric maternal morbidity and mortality. Early diagnosis and appropriate care can lead to prevention of complications and improvement of pregnancy outcome. This paper continues the review and provides recommendations for the approach to high-r

  12. Unintended pregnancy and perinatal depression trajectories in low-income, high-risk Hispanic immigrants.

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    Christensen, Anna L; Stuart, Elizabeth A; Perry, Deborah F; Le, Huynh-Nhu

    2011-09-01

    Perinatal depression is a prevalent and detrimental condition. Determining modifiable factors associated with it would identify opportunities for prevention. This paper: 1) identifies depressive symptom trajectories and heterogeneity in those trajectories during pregnancy through the first-year postpartum, and 2) examines the association between unintended pregnancy and depressive symptoms. Depressive symptoms (BDI-II) were collected from low-income Hispanic immigrants (n=215) five times from early pregnancy to 12-months postpartum. The sample was at high-risk for perinatal depression and recruited from two prenatal care settings. Growth mixture modeling (GMM) was used to identify distinct trajectories of depressive symptoms over the perinatal period. Multinomial logistic regression was then conducted to examine the association between unintended pregnancy (reported at baseline) and the depression trajectory patterns. Three distinct trajectory patterns of depressive symptoms were identified: high during pregnancy, but low postpartum ("Pregnancy High": 9.8%); borderline during pregnancy, with a postpartum increase ("Postpartum High": 10.2%); and low throughout pregnancy and postpartum ("Perinatal Low": 80.0%). Unintended pregnancy was not associated with the "Pregnancy High" pattern, but was associated with a marginally significant nearly four fold increase in risk of the "Postpartum High" pattern in depressive symptoms (RRR=3.95, ppregnancies during prenatal care must be educated of their increased risk, even if they do not exhibit antenatal depressive symptoms. Routine depression screening should occur postpartum, and referral to culturally appropriate treatment should follow positive screening results.

  13. [Systematization of high-risk pregnancy care: a strategy for teaching obstetric nursing].

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    Praça, N de S

    1994-04-01

    The present study describes a teaching experience using high risk pregnancy nursing care systematization with patients of a maternity. It also shows the students opinion of the use of such methodology.

  14. Correlation between high-risk pregnancy and developmental delay in children aged 4–60 months

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    Saba Amiri

    2012-09-01

    Full Text Available Background: The future development of children is considered more than ever now due to the advances in medical knowledge and thus the increase in survival rates of high-risk infants. This study investigated the correlation between high-risk pregnancy and developmental delay in children aged 4–60 months. Methods: This descriptive study was conducted on 401 mothers and their children (4–60 months who visited health service centers affiliated to Isfahan University of Medical Sciences, Iran, in 2011. Sampling was carried out in several stages, and the Ages and Stage Questionnaire was completed by the participants. Data were analyzed with SPSS 18 software and independent t-test; Mann-Whitney and logistic-regression tests were used. Results: The average age of children in the low-risk pregnancy group was 22±16 months, and that in the high-risk pregnancy group was 18.9±14.8 months. The majority of children were female (53.1%. The prevalence of high-risk pregnancies was 80.5%, and the prevalence of developmental delay was 18.7%. Multiple pregnancies, low birth weight, habitual abortions, maternal medical disorders in pregnancy, and gestational diabetes had significant correlations with developmental delay in children (P<0.04. In the logistic model, male gender, low birth weight, family marriage, and maternal medical disorders during pregnancy showed significant correlations with developmental delay in children (P<0.05. Additionally, abnormal body mass index (BMI and social and economic status showed probability values close to the significance level (P = 0.05, whereas other high-risk pregnancy variables had no correlation with developmental delay in children. A correlation between high-risk pregnancy and developmental delay (P = 0.002 and fine motor delay was observed (P = 0.02, but no correlation was observed between high-risk pregnancy and other developmental domains. Conclusion: This study showed that some high-risk pregnancy variables had a

  15. [Predictive tools of preterm birth in asymptomatic high-risk pregnancy].

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    Blanc, J; Bretelle, F

    2016-12-01

    Describe tools designed to predict preterm birth in asymptomatic high-risk pregnancy and determine their predictive value. The PubMed database, the Cochrane Library and the recommendations from the French and foreign obstetrical societies or colleges have been consulted. Obstetric history particularly spontaneous preterm birth identifies a population at risk for preterm birth for the current pregnancy (LE3). This risk is related to the number of prior preterm birth and is even higher than the term of the prior event is more premature and that the event concerns the last pregnancy (LE3). The literature data are insufficient to recommend systematic cervical examination at each prenatal visit in asymptomatic high-risk pregnancy (multiple pregnancy, uterine malformations, history of spontaneous preterm birth, excisional cervical procedure or at least two voluntary first trimester abortion) (professional consensus). Regular recording of uterine activity and home visits for asymptomatic high-risk pregnancy did not predict nor reduce the risk of preterm birth (LE2) and are not recommended (grade B). In asymptomatic high-risk pregnancy, ultrasonographic measurement of cervical length estimates the risk of preterm birth (LE2). Shorter is the cervical length higher is the risk of preterm birth (LE3). In asymptomatic patient with prior preterm birth, ultrasonographic measurement of cervical length estimates the risk of preterm birth (LE2). The strategy of ultrasound indicated cerclage are discussed in dedicated chapter. The measurement of cervical length by transvaginal ultrasonography in asymptomatic pregnancy with uterine malformation, a history of cervical treatment, at least two voluntary abortions or having a multiple pregnancy would estimate the risk of preterm birth (LE3). A shortening of more than 10% of the cervical length at 3-week interval is associated with an increased risk of preterm birth (LE3). Systematic detection of fetal fibronectin is not recommended in

  16. Sexual Orientation and Risk of Pregnancy Among New York City High-School Students.

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    Lindley, Lisa L; Walsemann, Katrina M

    2015-07-01

    We examined associations between sexual orientation and pregnancy risk among sexually experienced New York City high-school students. We analyzed data from 2005, 2007, and 2009 New York City Youth Risk Behavior Surveys. We excluded students who had never engaged in sexual intercourse, only had same-gender sexual partners, or had missing data on variables of interest, resulting in a final sample of 4892 female and 4811 male students. We employed multivariable logistic regression to examine pregnancy risk by sexual orientation, measured as self-reported sexual identity and gender of sexual partners, with adjustment for demographics and sexual behaviors. We stratified analyses by gender. Overall, 14.3% of female and 10.8% of male students had experienced a pregnancy. Students who identified as gay, lesbian, or bisexual or reported both male and female sexual partners had higher odds of pregnancy than heterosexual students or students who only had opposite-gender sexual partners. Sexual behaviors accounted for higher odds of pregnancy among female, but only partially accounted for higher odds of pregnancy involvement among male, sexual-minority students. Sexual orientation should be considered in future adolescent pregnancy-prevention efforts, including the design of pregnancy-prevention interventions.

  17. Risk perception and choice of place of birth in women with high risk pregnancies: A qualitative study.

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    Lee, Suzanne; Ayers, Susan; Holden, Des

    2016-07-01

    Objective To examine the perception of risk among a group of women with high risk pregnancies who were either planning to give birth in hospital, or at home despite medical advice to the contrary. The intention was to consider differences and similarities between the groups to examine how perception of risk relates to choice of place of birth. Design Qualitative study using semi-structured interviews. Setting Maternity department in a hospital in South East England. Participants Twenty-six women with high risk pregnancies, at least 32 weeks pregnant. Half were planning hospital births and half homebirths. Measurements and findings Semi-structured interviews to investigate women's understanding and assessment of risk. Results were analysed using thematic analysis. Five themes emerged: understanding of situation; judgement of risk; reassuring factors; impact of risk; and coping with risk. Women from both groups had some understanding of the implications of their medical/obstetric conditions. They displayed concerns about their babies' wellbeing. Women planning homebirths assessed their risks as lower and expressed less concerns than women planning hospital births. Women planning hospital births more frequently described following professional advice. Key conclusions Risk perception is individual and subjective. Women with high risk pregnancies who plan to give birth at home perceive risk differently to women who plan hospital births. Implications for practice Healthcare professionals working with women with high risk pregnancies should be aware of the potential for differences in definitions and perceptions of risk within this group.

  18. Validation of the High-Risk Pregnancy Stress Scale in a sample of hospitalized Greek high-risk pregnant women.

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    Gourounti, Kleanthi; Karpathiotaki, Natassa; Karapanou, Vassiliki; Antzaklis, Panos; Daskalakis, Georgios

    2016-01-01

    The aim of the authors in this study was to determine the psychometric properties of the Greek adaptation of the High-Risk Pregnancy Stress Scale (HRPSS) in a sample of high-risk hospitalized pregnant women. The sample consisted of 133 high-risk pregnant women with gestational age from 9 to 37 weeks. Data were collected between February and June of 2014. HRPSS was "forward-backward" translated from English to Greek. Principal axis factoring with promax rotation was used to test the factor structure of the HRPSS. Measures of state anxiety (STAI) and depressive symptoms (EPDS) were used to assess the convergent validity of the HRPSS. Exploratory factor analysis suggested three factors: concerns of pregnancy, movement restriction, and isolation and restriction of external activities. Construct validity was confirmed by computing correlations between the HRPSS and constructions of anxiety and depressive symptoms. Internal consistency reliability was satisfactory (α = 0.813). The original factor structure of the HRPSS was only partly replicated. The results of the exploratory factor analysis suggested that a three-factor solution instead of a two-factor solution would be the most adequate. The HRPSS is an appropriate measure for assessing the levels of concerns regarding pregnancy outcome, movement restriction, isolation, and external activity restrictions in Greek high-risk pregnant women.

  19. High risk pregnancies and factors associated with neonatal death

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    Marcela de Oliveira Demitto

    Full Text Available Abstract OBJECTIVE To identify the factors associated with intra-hospital neonatal mortality based on the individual characteristics of at-risk pregnant mothers, delivery and newborns. METHOD This was a cross-sectional epidemiological study of live newborns delivered by women attended at the high-risk outpatient unit of a philanthropic hospital in Maringá, Paraná, Brazil between September 2012 and September 2013. RESULTS Six hundred and eighty-eight women participated in the study. The neonatal mortality coefficient found was 17.7/1,000 live births, most in the early neonatal phase. Premature labor, fetal malformation and multiple gestations were associated with neonatal death. Premature, very low birth weight newborns and those with an Apgar score of less than seven, five minutes after birth were at high risk of death. CONCLUSION Identifying risk factors can help plan actions to consolidate the perinatal network. Specific programs should be incentivized in other countries, in the search for significant perinatal results such as reducing neonatal mortality.

  20. Impact of having a high-risk pregnancy on future postpartum contraceptive method choice.

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    Kiykac Altinbas, Sadiman; Bayoglu Tekin, Yesim; Dilbaz, Berna; Kilic, Selim; Khalil, Susan S; Kandemir, Omer

    2014-12-01

    To compare the knowledge and preference of preconceptional contraception to future postpartum contraceptive method choice in high-risk pregnancies. Does a high-risk pregnancy condition affect future postpartum contraceptive method choice? Women hospitalised at the High Risk Pregnancy unit of a tertiary research and training hospital were asked to complete a self-reported questionnaire that included demographic characteristics, presence of unintended pregnancy, contraceptive method of choice before the current pregnancy, plans for contraceptive use following delivery and requests for any contraceptive counselling in the postpartum period. A total of 655 pregnant women were recruited. The mean age, gravidity and parity of the women were 27.48 ± 6.25 years, 2.81 ± 2.15 and 1.40 ± 1.77, respectively. High-risk pregnancy indications included 207 (31.6%) maternal, 396 (60.5%) foetal and 52 (7.9%) uterine factors. All postpartum contraceptive choices except for combined oral contraceptives (COCs) usage were significantly different from preconceptional contraceptive preferences (pcontraceptive choices. While the leading contraceptive method in the postpartum period was long-acting reversible contraceptive methods (non-hormonal copper intrauterine device Cu-IUD, the levonorgestrel-releasing intrauterine system (LNG-IUS) (40%), the least preferred method was COCs use (5.2%) and preference of COCs use showed no difference between the preconceptional and postpartum periods (p=0.202). Overall 73.7% of the women wanted to receive contraceptive counselling before their discharge. A high-risk pregnancy condition may change the opinion and preference of contraceptive use, and also seems to affect the awareness of family planning methods. Copyright © 2014 Australian College of Midwives. All rights reserved.

  1. High-Risk Cardiac Disease in Pregnancy Part I

    NARCIS (Netherlands)

    Elkayam, Uri; Goland, Sorel; Pieper, Petronella G.; Silverside, Candice K.

    2016-01-01

    The incidence of pregnancy in women with cardiovascular disease is rising, primarily due to the increased number of women with congenital heart disease reaching childbearing age and the changing demographics associated with advancing maternal age. Although most cardiac conditions are well tolerated

  2. High-Risk Cardiac Disease in Pregnancy Part I

    NARCIS (Netherlands)

    Elkayam, Uri; Goland, Sorel; Pieper, Petronella G.; Silverside, Candice K.

    2016-01-01

    The incidence of pregnancy in women with cardiovascular disease is rising, primarily due to the increased number of women with congenital heart disease reaching childbearing age and the changing demographics associated with advancing maternal age. Although most cardiac conditions are well tolerated

  3. High-Risk Cardiac Disease in Pregnancy Part II

    NARCIS (Netherlands)

    Elkayam, Uri; Goland, Sorel; Pieper, Petronella G.; Silverside, Candice K.

    2016-01-01

    Heart disease continues to be the leading cause of nonobstetric maternal morbidity and mortality. Early diagnosis and appropriate care can lead to prevention of complications and improvement of pregnancy outcome. This paper continues the review and provides recommendations for the approach to

  4. High risk pregnancies and factors associated with neonatal death.

    Science.gov (United States)

    Demitto, Marcela de Oliveira; Gravena, Angela Andréia França; Dell'Agnolo, Cátia Millene; Antunes, Marcos Benatti; Pelloso, Sandra Marisa

    2017-04-03

    To identify the factors associated with intra-hospital neonatal mortality based on the individual characteristics of at-risk pregnant mothers, delivery and newborns. This was a cross-sectional epidemiological study of live newborns delivered by women attended at the high-risk outpatient unit of a philanthropic hospital in Maringá, Paraná, Brazil between September 2012 and September 2013. Six hundred and eighty-eight women participated in the study. The neonatal mortality coefficient found was 17.7/1,000 live births, most in the early neonatal phase. Premature labor, fetal malformation and multiple gestations were associated with neonatal death. Premature, very low birth weight newborns and those with an Apgar score of less than seven, five minutes after birth were at high risk of death. Identifying risk factors can help plan actions to consolidate the perinatal network. Specific programs should be incentivized in other countries, in the search for significant perinatal results such as reducing neonatal mortality. Identificar os fatores associados à mortalidade neonatal intra-hospitalar com base nas características individuais de gestantes de risco, do parto e do recém-nascido. Estudo epidemiológico do tipo transversal, realizado com crianças nascidas vivas de partos hospitalares de mulheres acompanhadas pelo ambulatório de alto risco de um hospital filantrópico de Maringá, Paraná, Brasil, no período de setembro de 2012 a setembro de 2013.RESULTADOS Fizeram parte da pesquisa 688 mulheres. O coeficiente de mortalidade neonatal foi de 17,7 óbitos/1.000 nascidos vivos, sendo sua maioria no período neonatal precoce. Trabalho de parto prematuro, malformação fetal e gestação múltipla foram as intercorrências associadas ao óbito neonatal. Recém-nascidos prematuros, com muito baixo peso ao nascer e Índice de Apgar menor que sete no quinto minuto de vida apresentaram risco elevado de morte. A identificação de fatores de risco pode auxiliar no

  5. Successful Non-fluoroscopic Radiofrequency Ablation of Incessant Atrial Tachycardia in a High Risk Twin Pregnancy.

    Science.gov (United States)

    Zuberi, Zia; Silberbauer, John; Murgatroyd, Francis

    2014-01-01

    We describe a patient presenting with incessant ectopic atrial tachycardia during a high risk twin pregnancy. Tachycardia was resistant to escalating doses of beta-blockade with digoxin. Because of increasing left ventricular dysfunction early in the third trimester, catheter ablation was performed successfully at 30 weeks gestation. Electro-anatomic mapping permitted the entire procedure to be conducted without the use of ionizing radiation. The pregnancy proceeded to successful delivery near term and after three years the patient remains recurrence free with normal left ventricular function, off all medication.

  6. Fluorescence polarization of amniotic fluid to assess fetal lung maturity in high risk pregnancies

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    Tadeu Gantus Simão Stefano

    2006-06-01

    Full Text Available Objective: To assess the accuracy, sensitivity, specificity, and thepositive and negative predictive values of amniotic fluidfluorescence polarization for neonatal respiratory distresssyndrome in high risk pregnancies. Methods: A prospectivedescriptive study of 54 patients with high risk pregnancies. Fetallung maturity was assessed using amniotic fluid florescencepolarization obtained by amniocentesis up to 72 hours beforedelivery. Respiratory distress syndrome, stratified by gestationalage at birth, was the primary outcome analyzed. Amniotic fluidfluorescence polarization values equal to or over 50 mg/g (indicatingfetal lung maturity were considered as negative results. Results:The mean gestational age at birth was 35 weeks (SD 2.0.Respiratory distress syndrome was seen in 14 newborns(24%. Amniotic fluid fluorescence polarization had high sensitivity(86% and specificity (81%, with 14% false-negative and 19% falsepositiveresults. The positive predictive value was 60% and thenegative predictive value was 94%. The area under the ROC curveindicated the 50 mg/g albumin/surfactant ratio as the best cutoffpoint (85% sensitivity and 81% specificity. Conclusion: A negativevalue in amniotic fluid fluorescence polarization (results equal toor over 50 mg/g confirms lung maturity which translates into avery low risk of a newborn developing respiratory distresssyndrome in high risk pregnancies.

  7. Risk of adverse pregnancy and perinatal outcomes after high technology infertility treatment: a comprehensive systematic review.

    Science.gov (United States)

    Palomba, Stefano; Homburg, Roy; Santagni, Susanna; La Sala, Giovanni Battista; Orvieto, Raoul

    2016-11-04

    In the literature, there is growing evidence that subfertile patients who conceived after infertility treatments have an increased risk of pregnancy and perinatal complications and this is particularly true for patients who conceived through use of high technology infertility treatments. Moreover, high technology infertility treatments include many concomitant clinical and biological risk factors. This review aims to summarize in a systematic fashion the current evidence regarding the relative effect of the different procedures for high technology infertility treatments on the risk of adverse pregnancy and perinatal outcome. A literature search up to August 2016 was performed in IBSS, SocINDEX, Institute for Scientific Information, PubMed, Web of Science and Google Scholar and an evidence-based hierarchy was used to determine which articles to include and analyze. Data on prepregnancy maternal factors, low technology interventions, specific procedures for male factor, ovarian tissue/ovary and uterus transplantation, and chromosomal abnormalities and malformations of the offspring were excluded. The available evidences were analyzed assessing the level and the quality of evidence according to the Oxford Centre for Evidence-Based Medicine guidelines and the Grading of Recommendations Assessment, Development, and Evaluation system, respectively. Current review highlights that every single procedure of high technology infertility treatments can play a crucial role in increasing the risk of pregnancy and perinatal complications. Due to the suboptimal level and quality of the current evidence, further well-designed studies are needed.

  8. Efficacy and safety of once daily low molecular weight heparin (tinzaparin sodium) in high risk pregnancy.

    LENUS (Irish Health Repository)

    Ní Ainle, Fionnuala

    2008-10-01

    Low molecular weight heparin (LMWH) is widely regarded as the anticoagulant treatment of choice for the prevention and treatment of venous thromboembolism during pregnancy. However, previous studies have demonstrated that the pharmacokinetic profiles of LMWH vary significantly with increasing gestation. Consequently, it remains unclear whether LMWH regimens recommended for use in nonpregnant individuals can be safely extrapolated to pregnant women. The aims of this study were to assess the safety and the efficacy of tinzaparin sodium (Innohep) administered only once daily during pregnancy. A systematic retrospective review identified a cohort of 37 high-risk pregnancies which had been managed using tinzaparin 175 IU\\/kg once daily. In 26 cases, the index pregnancy had been complicated by development of an acute venous thromboembolism (17 deep vein thrombosis and nine pulmonary embolism). For each individual, case notes were examined and data extracted using a predetermined questionnaire. No episodes of recurrent venous thromboembolism were identified amongst this cohort of pregnancies managed using once daily LMWH administration. However, two unusual thrombotic complications were observed, including a parietal infarct in one patient, and a postpartum cerebral venous thrombosis in another. Once daily tinzaparin was well tolerated, with no cases of heparin-induced thrombocytopaenia, symptomatic osteoporosis, or foetal malformations. Tinzaparin dose modification based upon peak anti-Xa levels occurred in 45% of the cases examined. The present study is the largest study to have examined the clinical efficacy of once daily LMWH for use in pregnant women at high risk of venous thromboembolism. Our data support the safety and efficacy of antenatal tinzaparin at a dose of 175 IU\\/kg. In order to determine whether this once daily regimen provides equivalent (or indeed greater) thromboprophylaxis to twice daily LMWH regimens during pregnancy will require highly powered

  9. Foot length measurements of newborns of high and low risk pregnancies

    Directory of Open Access Journals (Sweden)

    Ana Karina Marques Salge

    Full Text Available Abstract OBJECTIVE Comparing foot length measurements of newborns in high and low risk pregnancies at a public hospital in Goiânia, GO, Brazil. METHOD A cross-sectional study carried out between April, 2013 and May, 2015, with a sample consisting of 180 newborns; 106 infants of women from high-risk pregnancies and 74 of women from low-risk pregnancies. Data were descriptively analyzed. Foot length measurement was performed using a stiff transparent plastic ruler, graduated in millimeters. The length of both feet was measured from the tip of the hallux (big toe to the end of the heel. RESULTS A statistically significant relationship was found between the foot length and newborn’s weight, between the cephalic and thoracic perimeters in the high-risk group and between the cephalic perimeter in the control group. CONCLUSION There is a need for creating cut-off points to identify newborns with intrauterine growth disorders using foot length.

  10. Pregnancy - health risks

    Science.gov (United States)

    ... provider before trying to get pregnant. Seeing a prenatal provider before trying to get pregnant or early in the pregnancy can help prevent, or detect and control health risks to the mother and unborn baby ...

  11. 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

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

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    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

  13. Is intensive care the only answer for high risk pregnancies in developing nations?

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    Bajwa Sukhwinder

    2010-01-01

    Full Text Available Background : Management of high risk obstetric patients. Aim : The present study was conducted to evaluate the primary causes of the admission of obstetric patients to Intensive Care Unit (ICU, the presence of co-morbid diseases, outcome of such patients, their survival rate as well as the factors which contribute to the maternal mortality. Settings and Design : A retrospective study was conducted in the Department of Obstetrics and Gynaecology and Anaesthesiology/ICU of our Institute. Materials and Methods : Sixty-one obstetric patients, who were admitted to ICU between 20 December 2006 and 31 January 2010, were evaluated for various factors responsible for their admission as well as their outcome. Statistical Analysis : At the end of study, the data were arranged systematically and subjected to statistical analysis using nonparametric tests and P value <0.05 was considered significant. Results : Majority of the 61 patients admitted in ICU were referred from the peripheral health centers, smaller nursing homes/hospitals and some even without proper primary care and mainly comprising uneducated and rural population. Hemorrhage, pregnancy induced hypertension, cardiac diseases, respiratory insufficiency and sepsis were the main causes for admission. A total of 18 patients among 61 died during their ICU stay in the hospital. Conclusions : In the developing countries, high risk pregnancy should be managed at peripheral centers with proper facilities, antenatal visits and timely referral. The intensive care help should be reserved for very high risk pregnancies with co-morbid diseases.

  14. Hyperbaric index in the primary prevention of hypertensive complications in high-risk pregnancy.

    Science.gov (United States)

    Otero González, Alfonso; Uribe Moya, Silvia; Arenas Moncaleano, Ivan Gilberto; Borrajo Prol, María Paz; García García, María Jesús; López Sánchez, Luis

    2015-01-01

    Preeclampsia (PE) is a major cause of fetal morbidity and mortality. In the Western World, PE affects 2-7% of pregnancies and is responsible for 50,000 deaths annually. Early detection is a priority as it can change the clinical course, but there are no biomarkers or instrumental methods with high sensitivity and specificity. Only the hyperbaric index has a sensitivity and specificity of 99% for early identification of pregnant women at risk of developing PE, but its use is not widespread. To assess the usefulness of the hyperbaric index in the primary prevention of hypertensive pregnancy complications in a public healthcare area. This is a retrospective study of pregnancies that occurred in our area during the period 2007-2012 (N=11,784). The diagnosis was established by the hyperbaric index and pregnant women at risk were treated with ASA at night. In pregnant patients referred to the nephrology clinic (38.2%), diagnosed as high-risk for PE, and treated with 100mg ASA/night (from week 17), the incidence of PE episodes was reduced by 96.94. Copyright © 2015 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.

  15. High risk of pregnancy-related venous thromboembolism in women with multiple thrombophilic defects

    NARCIS (Netherlands)

    Folkeringa, Nienke; Leendert, Jan; Brouwer, P.; Korteweg, Fleurisca J.; Veeger, Nic J. G. M.; Erwich, Jan Jaap H. M.; van der Meer, Jan

    2007-01-01

    Pregnancy is associated with an increased risk of venous thromboembolism, which probably varies according to the presence of single or multiple thrombophilic defects. This retrospective family cohort study assessed the risk of venous thromboembolism during pregnancy and puerperium, and the contribut

  16. Risk of tuberculosis during pregnancy in Mongolia, a high incidence setting with low HIV prevalence.

    Science.gov (United States)

    Rendell, N L; Batjargal, N; Jadambaa, N; Dobler, C C

    2016-12-01

    To investigate the epidemiology and the relative risk of tuberculosis (TB) in pregnant women in Mongolia, a high TB incidence setting with a low rate of human immunodeficiency virus co-infection, where active case finding for TB in pregnancy is implemented. We retrospectively collected data on pregnant women diagnosed with TB during 2013. Data were collected through doctors at central TB dispensaries who extracted the relevant information from patients' clinical records. The overall incidence of TB among pregnant women was 228 (95%CI 187276) per 100000 person-years, resulting in an incidence rate ratio of 1.31 (95%CI 1.081.59) in pregnant women compared to the general population. Twelve per cent of the pregnant women with TB chose to have an abortion. In this study, pregnant women had a 1.3-fold higher risk of developing TB than the general population. Based on a moderately increased risk of TB during pregnancy in our study and the potential for adverse health outcomes, TB screening among pregnant women can currently be justified, but the cost-effectiveness of this intervention remains unclear. Patients and doctors need to be educated about the safety of standard TB treatment in pregnancy to reduce the rate of abortions.

  17. The development of parents-infant relationship in high-risk pregnancies and preterm birth

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    Camilla Pisoni

    2014-06-01

    Full Text Available The theory of human attachment, developed in 1951 by John Bowlby, has been widely applied across psychological, medical and social disciplines, especially in the context of developmental psychology; more recently it has been studied in the obstetric and neonatal fields. Numerous studies suggest that attachment patterns have an impact on the social, cognitive and emotional development of the off-spring, and are also believed to influence the individual’s psychosocial trajectories across the lifespan. Starting from empirical study of attachment, the psychological analysis of the experience of pregnancy allowed to introduce the concept of prenatal attachment, considered as the earlier internalized representation of the fetus that both parents acquire and elaborate during pregnancy. Recent studies have attempted to investigate how prenatal attachment develops in conditions of hazard, as for example in women hospitalized for a high-risk pregnancy or preterm birth. Literature showed that these clinical conditions may represent risk factors that, along with psychological distress and lack of familiar and social support, may adversely affect the mother-child relationship, with consequences on the psycosocial development of the off-spring. During pregnancy, medical team should assess mothers’ distress and attachment, perform procedures to positively develop attachment, and direct parents with low attachment scores to receive a professional, specific counseling. In the premature birth context, it is important to closely support mother-infant contact and to decrease maternal stress in every possible way during hospitalization and after discharge. Promotion of psychological wellbeing and attachment during pregnancy and after birth may serve as a crucial opportunity of improving maternal health practices, perinatal health and neonatal outcomes. Proceedings of the 10th International Workshop on Neonatology · Cagliari (Italy · October 22nd-25th, 2014

  18. [Can we decrease cesarean rate at a university hospital treating high risk pregnancies?].

    Science.gov (United States)

    Lembrouck, C; Mottet, N; Bourtembourg, A; Ramanah, R; Riethmuller, D

    2016-06-01

    To determine which clinical practice changes were responsible for a decrease in cesarean rate from 19.2% in 2003 to 15.5% in 2012 at our university hospital treating high risk pregnancies, while verifying the absence of any increase in neonatal morbidity and death. A descriptive retrospective study was undertaken at our labour ward including all patients delivering in 2003 and in 2012. Maternal, obstetrical and neonatal characteristics of the two populations were compared. Cesarean rates were analysed following : (1) Robson classification, (2) some maternal and obstetrical characteristics, and (3) indications for cesarean. Mean age, BMI and rate of scarred uterus significantly increased in 2012. The two populations remained comparable in terms of other criteria studied. The main cause responsible for decrease in cesarean rate was breech presentations (pdecreased our elective cesarean rate by more than 3% without increasing cesarean sections during labour, showing a rise in successful vaginal delivery trials. The impact of in utero transfers on the global rate of cesarean is highly significant since the latter has been divided by half in 10 years in this population considered to be of high risk for cesareans. These significant decreases reflect our experience in allowing vaginal deliveries in breech presentations, and also a better selection of patients for labour induction. Furthermore, it should be noted that increasing vaginal delivery trials in various obstetrical situations participated in this decrease. We clearly found that some indications for elective cesarean can be avoided, such as multiple pregnancies and scarred uterus, thus showing the importance of restricting the first indication for cesarean. Finally, the decrease in cesarean rate had no negative effect on neonatal outcome. Decreasing cesarean rate is possible in a university hospital treating high risk pregnancies. It requires daily obstetrical case by case critical analysis, allowing wide

  19. Association between immunoreactivity to Anisakis spp. antigens and high-risk pregnancy.

    Science.gov (United States)

    Figueiredo, Israel; Vericimo, Mauricio; Terra, Luciana; Ferreira, Taylane; São Clemente, Sergio Carmona; Teixeira, Gerlinde

    2015-12-01

    Numerous factors contribute to perinatal risk, many of which remain undefined. This study sought to determine the frequency of fish intake in postpartum women, and to establish a relationship between the rates of immunoreactivity for antigens from Anisakis spp. and high-risk pregnancy. In this prospective noninterventional study, a structured questionnaire was administered and serum was collected from postpartum women at two perinatal centers (a high-risk birth unit [HRBU] and a low-risk birth unit [LRBU]) in the Niteroi municipality of Brazil. Anisakis species-specific IgG and IgE were measured by ELISA. The chisquared test was performed, and odds ratios (ORs) with their 95% confidence intervals were estimated. The t-test or Mann-Whitney test was applied to continuous, normally distributed variables. In total, 309 women (170 from HRBU, 139 from LRBU) between 24.8 and 26.7 years old with a median of 6 to 8 prenatal visits were enrolled. Women in the two units exhibited differences in some variables, including prenatal care (p = 0.01), maternal and fetal risk (p = 0.00; OR = 6.17), and gestational age (p = 0.00), but no differences in fish consumption (p = 0.29), frequency of fish intake (p = 0.40), allergic symptoms (p = 0.51), or frequency of anti-Anisakis reactivity (p = 0.22). Logistic regression analysis revealed that only age was independently associated with postpartum anti-Anisakis reactivity. This study confirmed a low prevalence of fish intake and suggested that Anisakis spp. had no impact on high-risk pregnancies among this postpartum study population.

  20. High risk pregnancy referrals adequacy in the Basic Health Services of Sobral, Ceará, Brazil

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    José Juvenal Linhares

    2009-03-01

    Full Text Available Objective: To describe the appropriateness of referrals of high-risk pregnancies in the basic healthcare network of Sobral, in Ceará, Brazil. Methods: A descriptive quantitative study. The medical files of 173 pregnant patients referred to the high-risk outpatient clinic of Centro de Especialidades Médicas of Sobral, during the period from July 2006 to April 2007, were analyzed. Variables analyzed were correctness of the referrals, professionals who made them, causes and origins of the referrals, and age bracket of the patients referred. The referrals were divided into “appropriate” and “inappropriate”, according to the classification of risk established by the technical manual of the Ministry of Health. Rresults: Of the 173 cases, 102 (59% were considered appropriate/correct, and 71 (41% referrals were considered inappropriate/incorrect. The referrals were divided according to the professional class of the referring individuals: physicians or nurses. Of the 173 referrals, 49 (28.3% were made by physicians, and 124 (71.7% by nurses. Of the 49 patients referred by physicians, 39 (79.6% were considered correct. Of the 124 referrals made by nurses, 63 (50.8% were considered incorrect, revealing a significant difference between the groups (p < 0.00001. The most common causes of referrals of pregnant patients were hypertensive syndromes (23.6%, physiological modifications of pregnancy (22.6%, prolonged pregnancy (15.1%, and diabetes (12.3%. Cconclusions: There was a low rate of appropriate/correct referrals. There is a need for training in the basic healthcare network for quality prenatal care, with special emphasis on referring nurses.

  1. Pregnancy in Sickle Cell Disease Is a Very High-Risk Situation: An Observational Study

    Science.gov (United States)

    Elenga, Narcisse; Adeline, Aurélie; Balcaen, John; Vaz, Tania; Calvez, Mélanie; Terraz, Anne; Accrombessi, Laetitia; Carles, Gabriel

    2016-01-01

    Sickle cell disease is a serious genetic disorder affecting 1/235 births in French Guiana. This study aimed to describe the follow-up of pregnancies among sickle cell disease patients in Cayenne Hospital, in order to highlight the most reported complications. 62 records of pregnancies were analyzed among 44 females with sickle cell disease, between 2007 and 2013. Our results were compared to those of studies conducted in Brazil and Guadeloupe. There were 61 monofetal pregnancies and 2 twin pregnancies, 27 pregnancies among women with SS phenotype, 30 SC pregnancies, and five S-beta pregnancies. The study showed that the follow-up of patients was variable, but no maternal death was found. We also noted that the main maternofetal complications of pregnancies were anemia (36.5%), infection (31.7%), vasoocclusive crisis (20.6%), preeclampsia (17.5%), premature birth (11.1%), intrauterine growth retardation (15.9%), abnormal fetal heart rate (14.3%), and intrauterine fetal death (4.8%). Pregnancies were more at risk among women with SS phenotype. Pregnancy in sickle cell disease patients requires a supported multidisciplinary team including the primary care physician, the obstetrician, and the Integrated Center for Sickle Cell Disease. PMID:27403164

  2. Pregnancy in Sickle Cell Disease Is a Very High-Risk Situation: An Observational Study

    Directory of Open Access Journals (Sweden)

    Narcisse Elenga

    2016-01-01

    Full Text Available Sickle cell disease is a serious genetic disorder affecting 1/235 births in French Guiana. This study aimed to describe the follow-up of pregnancies among sickle cell disease patients in Cayenne Hospital, in order to highlight the most reported complications. 62 records of pregnancies were analyzed among 44 females with sickle cell disease, between 2007 and 2013. Our results were compared to those of studies conducted in Brazil and Guadeloupe. There were 61 monofetal pregnancies and 2 twin pregnancies, 27 pregnancies among women with SS phenotype, 30 SC pregnancies, and five S-beta pregnancies. The study showed that the follow-up of patients was variable, but no maternal death was found. We also noted that the main maternofetal complications of pregnancies were anemia (36.5%, infection (31.7%, vasoocclusive crisis (20.6%, preeclampsia (17.5%, premature birth (11.1%, intrauterine growth retardation (15.9%, abnormal fetal heart rate (14.3%, and intrauterine fetal death (4.8%. Pregnancies were more at risk among women with SS phenotype. Pregnancy in sickle cell disease patients requires a supported multidisciplinary team including the primary care physician, the obstetrician, and the Integrated Center for Sickle Cell Disease.

  3. Early induction of labor in high-risk intrahepatic cholestasis of pregnancy: what are the costs?

    Science.gov (United States)

    Friberg, Anne Katrine; Zingmark, Vera; Lyndrup, Jens

    2016-10-01

    Induction of labor among pregnant women with high levels of total bile acid (TBA) is common among clinicians. We examined, if women with intrahepatic cholestasis of pregnancy (ICP) and TBA ≥ 40 μmol/l have a higher risk of maternal-fetal complications, when labor is induced at 37 weeks of gestation, compared with induction of labor at term in women with low-risk ICP. Retrospective cohort study of 16,185 women delivering at Roskilde University Hospital in the period 2006-2011. Women with high-risk ICP (TBA ≥ 40 μmol/l) had labor induced at 37 weeks of gestation; women with low-risk ICP (TBA < 40 μmol/l) at term. Mode of delivery, duration of induction procedures, highest level of TBA and alanine aminotransferase (ALT) and for the neonates: Apgar scores at 5 min, umbilical cord pHs and SBEs, NICU admissions and birthweights. The incidences of ICP was 1.2 % (95 % CI 1.05-1.39 %) altogether and for high-risk ICP 0.4 % (95 % CI 0.27-0.46 %). No difference was found in mode of delivery, length of induction of labor nor in neonatal outcomes, except for an expected difference in birthweight. In high-risk ICP, ALT was not raised in 10.3 % (95 % CI 2.5-18.2 %). Early induction of labor at 37 weeks of gestation seems justified in high-risk ICP, as, except for abbreviating gestational age by 9 days with 296 g smaller babies, induction of labor was not followed by detectable maternal-fetal disadvantages and is favored by an expected major reduction in ICP stillbirth risk.

  4. COMPARISION OF VIBROACOUSTIC STIMULATION TEST & NON ST RESS TEST IN HIGH RISK PREGNANCIES

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    Puneeta Kaur

    2015-06-01

    Full Text Available INTRODUCTION : S everal studies show that fetal sleeping periods can lead to falsely non - reactive test , therefore increasing the risk of unnecessary obstetric intervention. Attempt to arouse the fetus while in sleeping state or in rest activity cycle includ e a change in maternal position , physical activity , maternal glucose ingestion , sound stimulation , light stimulation and manual fetal manipulation. H owever the only stimuli that have consistently evoked response in normal fetus are acoustic and vibrotactil e ones. AIMS & OBJECTIVES: 1. To compare and evaluate the role of non - stress test and vibro acoustic stimulation test on the perinatal outcome. 2. To evaluate vibro acoustic stimulation test as a screening test for early intrapartum fetal monitoring. MATERIAL AND METHODS : This study was done at department of OBGY , NIMS , hospital J aipur. It included 100 women with high risk pregnancies above 34 weeks of gestation. Fetal monitor was used for non - stress test , and acoustic stimulator by teksonic instrumen t with sound pressure 80 - 85 db for vibro acoustic stimulation test. I t is a cross sectional study. OBSERVATION & RESULTS: High risk pregnant women showed ( 75% 75 cases positive test which included ( R eactive nst with reactive vast and also with reactive va st over non - reactive nst out of which 62 cases (82.6% were with favourable perinatal outcome and 13cases ( 17.3% with unfavourable perinatal outcome. CONCLUSION: Result showed that in the high risk pregnancies after vibroacoustic stimulation test were si gnificantly associated with favourable perinatal outcome. KEYWORDS: V ibroacoustic stimulation test as adjunct to non - stress test for antepartum fetal well - being .

  5. ROLE OF DOPPLER IN PRED ICTION OF PERINATAL OUTCOME: A COMPARATIVE STUDY OF DOPPLER INDICES IN LOW RISK AND HIGH RISK PREGNANCIES

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    Uma

    2015-09-01

    Full Text Available AIMS AND OBJECTIVES: to evaluate Doppler abnormalities in low risk and high risk pregnancies and to determine their relation to the outcome of pregnancy . METHODS: A total of 60 no. of pregnant women without any known risk factors are included in the low risk group and 60 no. of pregnant women with pre - eclampsia or gestational hypertension or intra uterine growth restriction, are included in the high risk group. Doppler evaluation done at term and the outcome is noted in terms of mode of delivery and perinatal complications in both the groups. RESULTS: Forty percent of high risk pregnant women and 1.6 percent of low risk pregnant women are found to be associated with abnormal Doppler results. Abnormal UA - PI , in association with high risk pregnancy is significantly associated wit h abnormal mode of delivery (P - 0.0005 and perinatal complications (P - 0.0009. Abnormal MCA - PI and abnormal MCA - PI/UA - PI ratio of <1.1 are associated with perinatal complications with highest significance (P - <0.0001. High risk pregnancy with normal Doppl er results, also had perinatal complications with slightly lower significance (0.0011. CONCLUSION: There is definite association of Doppler abnormalities with high risk pregnancy. Low risk pregnancy is almost never associated with Doppler abnormalities an d it is not necessary to perform Doppler to all women. Of all the Doppler indices, the ratio of MCA - PI/ UA - PI appears to be the best predictor of poor outcome. Normal Doppler results in association with high risk pregnancy cannot ensure uncomplicated outco me.

  6. [Influence of maternal nutritional status, weight gain and energy intake on fetal growth in high-risk pregnancies].

    Science.gov (United States)

    Nomura, Roseli Mieko Yamamoto; Paiva, Letícia Vieira; Costa, Verbênia Nunes; Liao, Adolfo Wenjaw; Zugaib, Marcelo

    2012-03-01

    To analyze the influence of maternal nutritional status, weight gain and energy consumption on fetal growth in high-risk pregnancies. A prospective study from August 2009 to August 2010 with the following inclusion criteria: puerperae up to the 5th postpartum day; high-risk singleton pregnancies (characterized by medical or obstetrical complications during pregnancy); live fetus at labor onset; delivery at the institution; maternal weight measured on the day of delivery, and presence of medical and/or obstetrical complications characterizing pregnancy as high-risk. Nutritional status was assessed by pregestational body mass index and body mass index in late pregnancy, and the patients were classified as: underweight, adequate, overweight and obese. A food frequency questionnaire was applied to evaluate energy consumption. We investigated maternal weight gain, delivery data and perinatal outcomes, as well as fetal growth based on the occurrence of small for gestational age and large for gestational age neonates. We included 374 women who were divided into three study groups according to newborn birth weight: adequate for gestational age (270 cases, 72.2%), small for gestational age (91 cases, 24.3%), and large for gestational age (13 cases, 3.5%). Univaried analysis showed that women with small for gestational age neonates had a significantly lower mean pregestational body mass index (23.5 kg/m², ppregnancy (27.7 kg/m², ppregnancy (25.3%, ppregnancy (34.3 kg/m², ppregnancy (53.8%, ppregnancy (OR=0.9; CI95% 0.8-0.9, ppregnancy (OR=3.6; 95%CI 1.1-11.7, p=0.04). The maternal nutritional status at the end of pregnancy in high-risk pregnancies is independently associated with fetal growth, the body mass index during late pregnancy is a protective factor against small for gestational age neonates, and maternal obesity is a risk factor for large for gestational age neonates.

  7. Rates of fetal polydrug exposures in methadone-maintained pregnancies from a high-risk population.

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    Kaitlyn Delano

    Full Text Available Methadone maintenance treatment (MMT is the standard of care during pregnancy for opioid-dependency, showing efficacy in improving prenatal care and reducing risk of relapse. By design, however, MMT is only intended to prevent withdrawal thus facilitating cognitive behavioural interventions. In order to maximize the benefits of MMT, it is essential that methadone is both properly prescribed and that additional addiction treatment is concurrently administered. This study aims to determine the effectiveness of MMT engagement in high-risk pregnant women in reducing polydrug use by objective laboratory examination of neonatal meconium.Over a 29-month period, the Motherisk Laboratory at the Hospital for Sick Children in Toronto analyzed meconium samples as per request by social services and hospitals for drugs of abuse.Of the 904 meconium samples received, 273 were tested for methadone with 164 positive and 109 negative for methadone. Almost half of the methadone positive samples (46.34% were also positive for at least one other opioid compound, which did not differ statistically from the methadone-negative control samples (46.79%; Chi square test, p=0.94. No differences were found between the methadone positive and negative groups in rates of concurrent amphetamines, cocaine, cannabis, and alcohol use indicating a similar risk of polydrug use between pregnant women taking or not taking methadone in this population.The high rates of additional opioid and other drug use in the MMT group, suggest that MMT is failing this population of patients. It is possible that methadone doses during pregnancy are not appropriately adjusted for changes in pharmacokinetic parameters (e.g. blood volume, renal function during the second and third trimesters. This may result in sub-therapeutic dosing creating withdrawal symptoms leading to additional substance use. Alternatively, these results may be demonstrating a substantial lack in delivery of addiction support

  8. Aspirin versus Placebo in Pregnancies at High Risk for Preterm Preeclampsia.

    Science.gov (United States)

    Rolnik, Daniel L; Wright, David; Poon, Liona C; O'Gorman, Neil; Syngelaki, Argyro; de Paco Matallana, Catalina; Akolekar, Ranjit; Cicero, Simona; Janga, Deepa; Singh, Mandeep; Molina, Francisca S; Persico, Nicola; Jani, Jacques C; Plasencia, Walter; Papaioannou, George; Tenenbaum-Gavish, Kinneret; Meiri, Hamutal; Gizurarson, Sveinbjorn; Maclagan, Kate; Nicolaides, Kypros H

    2017-08-17

    Preterm preeclampsia is an important cause of maternal and perinatal death and complications. It is uncertain whether the intake of low-dose aspirin during pregnancy reduces the risk of preterm preeclampsia. In this multicenter, double-blind, placebo-controlled trial, we randomly assigned 1776 women with singleton pregnancies who were at high risk for preterm preeclampsia to receive aspirin, at a dose of 150 mg per day, or placebo from 11 to 14 weeks of gestation until 36 weeks of gestation. The primary outcome was delivery with preeclampsia before 37 weeks of gestation. The analysis was performed according to the intention-to-treat principle. A total of 152 women withdrew consent during the trial, and 4 were lost to follow up, which left 798 participants in the aspirin group and 822 in the placebo group. Preterm preeclampsia occurred in 13 participants (1.6%) in the aspirin group, as compared with 35 (4.3%) in the placebo group (odds ratio in the aspirin group, 0.38; 95% confidence interval, 0.20 to 0.74; P=0.004). Results were materially unchanged in a sensitivity analysis that took into account participants who had withdrawn or were lost to follow-up. Adherence was good, with a reported intake of 85% or more of the required number of tablets in 79.9% of the participants. There were no significant between-group differences in the incidence of neonatal adverse outcomes or other adverse events. Treatment with low-dose aspirin in women at high risk for preterm preeclampsia resulted in a lower incidence of this diagnosis than placebo. (Funded by the European Union Seventh Framework Program and the Fetal Medicine Foundation; EudraCT number, 2013-003778-29 ; Current Controlled Trials number, ISRCTN13633058 .).

  9. Rates of fetal polydrug exposures in methadone-maintained pregnancies from a high-risk population.

    Science.gov (United States)

    Delano, Kaitlyn; Gareri, Joey; Koren, Gideon

    2013-01-01

    Methadone maintenance treatment (MMT) is the standard of care during pregnancy for opioid-dependency, showing efficacy in improving prenatal care and reducing risk of relapse. By design, however, MMT is only intended to prevent withdrawal thus facilitating cognitive behavioural interventions. In order to maximize the benefits of MMT, it is essential that methadone is both properly prescribed and that additional addiction treatment is concurrently administered. This study aims to determine the effectiveness of MMT engagement in high-risk pregnant women in reducing polydrug use by objective laboratory examination of neonatal meconium. Over a 29-month period, the Motherisk Laboratory at the Hospital for Sick Children in Toronto analyzed meconium samples as per request by social services and hospitals for drugs of abuse. Of the 904 meconium samples received, 273 were tested for methadone with 164 positive and 109 negative for methadone. Almost half of the methadone positive samples (46.34%) were also positive for at least one other opioid compound, which did not differ statistically from the methadone-negative control samples (46.79%; Chi square test, p=0.94). No differences were found between the methadone positive and negative groups in rates of concurrent amphetamines, cocaine, cannabis, and alcohol use indicating a similar risk of polydrug use between pregnant women taking or not taking methadone in this population. The high rates of additional opioid and other drug use in the MMT group, suggest that MMT is failing this population of patients. It is possible that methadone doses during pregnancy are not appropriately adjusted for changes in pharmacokinetic parameters (e.g. blood volume, renal function) during the second and third trimesters. This may result in sub-therapeutic dosing creating withdrawal symptoms leading to additional substance use. Alternatively, these results may be demonstrating a substantial lack in delivery of addiction support services in this

  10. Pregnancy-specific stress, preterm birth, and gestational age among high-risk young women.

    Science.gov (United States)

    Cole-Lewis, Heather J; Kershaw, Trace S; Earnshaw, Valerie A; Yonkers, Kimberly Ann; Lin, Haiqun; Ickovics, Jeannette R

    2014-09-01

    There is evidence that pregnancy-specific stress is associated with preterm birth. The purpose of this study is to examine the association between change in pregnancy-specific stress over the course of pregnancy and birth outcomes (i.e., preterm birth and gestational age) in an understudied but vulnerable group using a theoretically derived model. Multivariate linear and logistic regression techniques were used to examine the association between pregnancy-specific stress (measured in second and third trimester) and length of gestation (i.e., preterm birth and gestational age) among a sample of 920 Black and/or Latina adolescent and young women. Second trimester pregnancy-specific stress was not associated with preterm birth or gestational age. Third trimester pregnancy-specific stress was associated with preterm birth but not with gestational age. Change in pregnancy-specific stress between second and third trimester was significantly associated with increased likelihood of preterm delivery and shortened gestational age, even after controlling for important biological, behavioral, psychological, interpersonal, and sociocultural risk factors. Findings emphasize the importance of measuring pregnancy-specific stress across pregnancy, as the longitudinal change from second to third trimester was significantly associated with length of gestation measured both as a dichotomous variable (preterm birth) and a continuous variable (gestational age). Furthermore, this is the first study to observe the association of pregnancy-specific stress with length of gestation in this understudied population-unique in age, race, and ethnicity. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

  11. Role of fetal monitoring in high risk pregnancy by fetal electrocardiogram

    Directory of Open Access Journals (Sweden)

    Somya Girish Goyal

    2014-08-01

    Full Text Available Background: Non-stress test is an external monitoring of fetal heart rate by electrocardiograph. Although intermittent auscultation of fetal heart rate is equivalent to continuous electronic fetal monitoring in detecting fetal compromise1 but continuous electronic fetal monitoring is indicated in high risk patients women whose foetuses are at high risk for neonatal encephalopathy or cerebral palsy.2 Objective of current study was to study the efficacy and diagnostic value of non-stress Test for surveillance and its usefulness to detect fetal distress at early stage which help to decide further management in mode of delivery. Methods: Design: prospective study. NST was done in 50 high risk patients for minimum of 20 minutes and in patients with non-reactive non stress test it was continued for 40 minutes. Maternal age, parity, complications during labour, and delivery, mode of delivery, indications of caesarean section and perinatal outcome were noted. Results: Out of total 50 cases studied patient delivered vaginally were 24 and Caesarean was done in 26 cases. Most LSCS were performed due to PIH (35% and related complications like IUGR, eclampsia (10%, fetal distress, previous caesarean pregnancy, IUGR, oligohydraminos and meconium stained liquor. 52% patients were delivered by caesarean and 48% by normal delivery. Conclusions: Routine use of electronic fetal heart monitoring helped in reduction of neonatal morbidity and mortality with increased rate of caesarean section. [Int J Reprod Contracept Obstet Gynecol 2014; 3(4.000: 893-897

  12. Retinol and α-Tocopherol in the Breast Milk of Women after a High-Risk Pregnancy

    Science.gov (United States)

    Sámano, Reyna; Martínez-Rojano, Hugo; Hernández, Rosa M.; Ramírez, Cristina; Flores Quijano, María E.; Espíndola-Polis, José M.; Veruete, Daniela

    2017-01-01

    Background: There is scant information about whether, after a high-risk pregnancy, breast milk provides enough vitamins for assuring satisfactory bodily reserves in newborns. Objective: To comparatively evaluate, in women with high-risk and normal pregnancy, the concentration of retinol and α-tocopherol in breast milk. Methods: This cross-sectional, analytical study was evaluated with reverse-phase high-performance liquid chromatography (HPLC). Informed consent was signed by 95 mothers with a high-risk pregnancy and 32 mothers with a normal pregnancy. From the mothers with a high-risk pregnancy were obtained: 23 samples of colostrum, 24 of transitional milk, and 48 of mature milk. From the normal pregnancy group, 32 mature milk samples were collected. Pregestational Body Mass Index (BMI) and the gestational weight gain were noted. Models of logistic regression were constructed to identify the variables related to a low concentration of either retinol or α-tocopherol in breast milk. Results: The concentration of retinol and α-tocopherol in mature milk was 60 (interquartile range (IQR), 41–90) and 276 (103–450) μg/dL, respectively, for the high-risk pregnancy group, and 76 (65–91) and 673 (454–866) µg/dL, respectively, for the normal pregnancy group (p = 0.001). The concentration of retinol and α-tocopherol was similar in the subgroups of mothers with different disorders during gestation. A clear correlation was found between a greater pregestational weight and a lower concentration of retinol (Rho = –0.280, p = 0.006), and between α-tocopherol and retinol in all cases (Rho = 0.463, p = 0.001). Among women having a high-risk pregnancy, those delivering prematurely rather than carrying their pregnancy to term had a reduced concentration of retinol (54 (37–78) vs. 70 (49–106) µg/dL; p = 0.002) and a tendency to a lower concentration of α-tocopherol in breast milk (185 (75–410) vs. 339 (160–500) µg/dL; p = 0.053). Compared to mothers with a

  13. Retinol and α-Tocopherol in the Breast Milk of Women after a High-Risk Pregnancy

    Directory of Open Access Journals (Sweden)

    Reyna Sámano

    2017-01-01

    Full Text Available Background: There is scant information about whether, after a high-risk pregnancy, breast milk provides enough vitamins for assuring satisfactory bodily reserves in newborns. Objective: To comparatively evaluate, in women with high-risk and normal pregnancy, the concentration of retinol and α-tocopherol in breast milk. Methods: This cross-sectional, analytical study was evaluated with reverse-phase high-performance liquid chromatography (HPLC. Informed consent was signed by 95 mothers with a high-risk pregnancy and 32 mothers with a normal pregnancy. From the mothers with a high-risk pregnancy were obtained: 23 samples of colostrum, 24 of transitional milk, and 48 of mature milk. From the normal pregnancy group, 32 mature milk samples were collected. Pregestational Body Mass Index (BMI and the gestational weight gain were noted. Models of logistic regression were constructed to identify the variables related to a low concentration of either retinol or α-tocopherol in breast milk. Results: The concentration of retinol and α-tocopherol in mature milk was 60 (interquartile range (IQR, 41–90 and 276 (103–450 μg/dL, respectively, for the high-risk pregnancy group, and 76 (65–91 and 673 (454–866 µg/dL, respectively, for the normal pregnancy group (p = 0.001. The concentration of retinol and α-tocopherol was similar in the subgroups of mothers with different disorders during gestation. A clear correlation was found between a greater pregestational weight and a lower concentration of retinol (Rho = –0.280, p = 0.006, and between α-tocopherol and retinol in all cases (Rho = 0.463, p = 0.001. Among women having a high-risk pregnancy, those delivering prematurely rather than carrying their pregnancy to term had a reduced concentration of retinol (54 (37–78 vs. 70 (49–106 µg/dL; p = 0.002 and a tendency to a lower concentration of α-tocopherol in breast milk (185 (75–410 vs. 339 (160–500 µg/dL; p = 0.053. Compared to mothers with

  14. Incidence of anti-Toxoplasma antibodies in women with high-risk pregnancy and habitual abortions.

    Science.gov (United States)

    Galván Ramírez, M L; Soto Mancilla, J L; Velasco Castrejón, O; Pérez Medina, R

    1995-01-01

    Toxoplasmosis is a zoonosis caused by Toxoplasma gondii, an obligate intracellular parasite. In pregnant women on the worldwide scale, there are seroprevalences from 7% to 51.3% and in women with abnormal pregnancies and abortions the seroprevalences vary from 17.5% to 52.3%. In Mexico, seropositivity has been found to vary from 18.2% to 44.8% in women with abnormal deliveries or abortions. This study's aim was to determine the incidence of IgG and IgM anti-Toxoplasma antibodies in women at the Gineco-Obstetrics Hospital of the Western Medical Center of the Mexican Social Security Institute. Three hundred and fifty women with high-risk pregnancies were studied, and 122 (34.9%) were found to be IgG seropositive and 76 (20.7%) were IgM positive. In one group of women with habitual abortions there were 48 (44.9%) with the presence of IgG antibodies and 33 (33.3%) were IgM seropositive. Seropositivity was analyzed according to age, occupation, socio-economic level, eating raw or poorly cooked meat, and living with cats.

  15. Apheresis in high risk antiphospholipid syndrome pregnancy and autoimmune congenital heart block.

    Science.gov (United States)

    Ruffatti, Amelia; Favaro, Maria; Brucato, Antonio; Ramoni, Veronique; Facchinetti, Myriam; Tonello, Marta; Del Ross, Teresa; Calligaro, Antonia; Hoxha, Ariela; Grava, Chiara; De Silvestro, Giustina

    2015-12-01

    In the first part a prospective cohort study was reported to evaluate the efficacy and safety of a treatment protocol including plasma exchange (PE) or PE plus intravenous immunoglobulins (IVIG) or immunoadsorption (IA) plus IVIG administered in addition to conventional therapy to 22 pregnant women with high-risk APS. The results indicate that PE or IA treatments administered along with IVIG and conventional antithrombotic therapy could be a valuable and safe therapeutic option in pregnant APS women with triple antiphospholipid antibody positivity along with a history of thrombosis and/or one or more severe pregnancy complications. In the second part the efficacy and safety of PE combined with IVIG and steroids were evaluated for the treatment of 10 patients with autoimmune congenital heart block (CHB) by comparing maternal features, pregnancy outcome and side effects with those of 24 CHB patients treated with steroids only. The patients treated with the combined therapy showed a statistically significant regression of 2nd degree blocks, an increase in heart rate at birth and a significantly lower prevalence of pacing in the first year of life. Moreover, no side effects were observed except for a few steroid-related events. If these results are confirmed by large-scale studies, the apheretic procedures could lead to improved outcomes in the treatment of these devastating diseases.

  16. Incidence of anti-toxoplasma antibodies in women with high-risk pregnancy and habitual abortions

    Directory of Open Access Journals (Sweden)

    Maria de la Luz Galvan Ramirez

    1995-12-01

    Full Text Available Toxoplasmosis is a zoonosis caused by Toxoplasma gondii, an obligate intracellular parasite. In pregnant women on the worldwide scale, there are seroprevalences from 7% to 51.3% and in women with abnormal pregnancies and abortions the seroprevalences vary from 17.5% to 52.3%. In Mexico, seropositivity has been found to vary from 18.2% to 44.8% in women with abnormal deliveries or abortions. This study's aim was to determine the incidence oflgG and IgM anti-Toxoplasma antibodies in women at the Gineco-Obstetrics Hospital of the Western Medical Center of the Mexican Social Security Institute. Three hundred and fifty women with high-risk pregnancies were studied, and 122 (34.9% were found to be IgG seropositive and 76 (20.7% were IgM positive. In one group of women with habitual abortions there were 48 (44.9% with the preseiwe of IgG antibodies and 33 (33-3% were IgM seropositive. Seropositivity was analyzed according to age, occupation, socio-economic level, eating raw or poorly cooked meat, and living with cats.

  17. Persistent high TRAb values during pregnancy predict increased risk of neonatal hyperthyroidism following radioiodine therapy for refractory hyperthyroidism.

    Science.gov (United States)

    Hamada, Noboru; Momotani, Naoko; Ishikawa, Naofumi; Yoshimura Noh, Jaeduk; Okamoto, Yasuyuki; Konishi, Toshiaki; Ito, Koichi; Ito, Kunihiko

    2011-01-01

    Serum levels of TSH receptor antibody (TRAb) often increase after radioiodine treatment for Graves' disease, and high-serum levels of maternal TRAb in late pregnancy indicate a risk of neonatal hyperthyroidism. The aim of this retrospective study is to investigate the characteristics of Graves' women who had a history of radioiodine treatment for intractable Graves' disease, and whose neonates suffered from hyperthyroidism. The subjects of this study were 45 patients with Graves' disease who became pregnant during the period from 1988 to 1998 after receiving radioiodine treatment at Ito Hospital. 25 of the 45 subjects had had a relapse of hyperthyroidism after surgical treatment for Graves' disease. 19 pregnancies were excluded because of artificial or spontaneous abortion. In the remaining 44 pregnancies of 35 patients, neonatal hyperthyroidism developed in 5 (11.3%) pregnancies of 4 patients. Serum levels of TRAb at delivery were higher in patients whose neonates suffered from hyperthyroidism (NH mother) than those of patients who delivered normal infants (N mother). Furthermore, serum levels of TRAb in NH mother did not change during pregnancy, although those of 4 patients of N mother, in which serum levels of TRAb before radioiodine treatment were as high as in NH mother, decreased significantly during pregnancy. In conclusion, women who delivered neonates with hyperthyroidism following radioiodine treatment seem to have very severe and intractable Graves' disease. Persistent high TRAb values during pregnancy observed in those patients may be a cause of neonatal hyperthyroidism.

  18. Effect of antioxidants on amelioration of high-risk factors inducing hypertensive disorders in pregnancy

    Institute of Scientific and Technical Information of China (English)

    LIN Jian-hua; YANG Yi-ke; LIU Hua; LIN Qi-de; ZHANG Wei-yuan

    2010-01-01

    Background This is a prospective clinical study based on a large sample gathered from multiple centers in China,subordinating to 10th Five-Year Plan of National Science & Technology Progression. We analyzed the high-risk factors inducing hypertensive disorders in pregnancy (HDP) and estimated the potential effect of anti-oxidants administration,including vitamin C (VC), vitamin E (VE) and Salvia Miltiorrhiza L (SML), a Chinese herb medicine, in amelioration of the high-risk factors in pregnancy.Methods From April 2005 to July 2006, 4814 pregnant women from 24 national wide cooperative hospitals were involved in this prospective research. The participants were randomly divided into two groups: 1607 cases were in anti-oxidants group with administration of vitamins and SML; 3207 cases were in control group without any medicine given. Every participant was under monitoring for the morbidity of HDP and the high-risk factors were investigated in HDP cases in each group.Results (1)The morbidity of HDP was 3.55% in anti-oxidants group vs. 4.18% in control group. No statistical difference existed between the two groups (P>0.05). (2) In anti-oxidants group, the HDP morbidities among three subgroups: VC +VE + SML, VC + VE and SML only, were 5.51%, 3.05% and 5% respectively. It showed no statistical difference among three remedies (P>0.05). (3) The related index of factors affecting HDP showed in intensity sequence as follows: family HDP history > profession > education level > age > body weight. The incidence of HDP in normal population was 3.51%,and the incidence of HDP in high-risk pregnant women (family HDP history, heavy physical labor, low education level (middle school and below), age >40, body mass index ≥24) was 5.84%, which was obviously higher than that in normal population (P <0.01). In anti-oxidants group, the probability of HDP in women with high-risk factors was 3.81%, which was obviously lower than that in control group with high-risk factors at 7.14% (P<0

  19. High risk of neonatal complications in children of mothers with gestational diabetes mellitus in their first pregnancy

    DEFF Research Database (Denmark)

    Wielandt, Hanne; Schønemann-Rigel, Helena; Blunck, Charlotte H.;

    2015-01-01

    intensive care unit. Conclusion: The present study supports the notion of high-risk pregnancy among GDM patients. Compared with nulliparous in general, the offspring were more likely to be delivered by emergency CS. Despite the prophylactic pro­ced­ures, one in six had neonatal hypoglycaemia....

  20. Effects of relaxation on depression levels in women with high-risk pregnancies: a randomised clinical trial

    Directory of Open Access Journals (Sweden)

    Wanda Scherrer de Araújo

    Full Text Available ABSTRACT Objective: to analyse the effects of relaxation as a nursing intervention on the depression levels of hospitalised women with high-risk pregnancies. Methods: a randomised clinical trial realised in a reference centre for high-risk pregnancies. The sample consisted of 50 women with high-risk pregnancies (25 in the control group and 25 in the intervention group. The Benson relaxation technique was applied to the intervention group for five days. Control variables were collected using a predesigned form, and the signs and symptoms of depression were evaluated using the Edinburgh Postnatal Depression Scale (EPDS. The Statistical Package for Social Sciences (SPSS, version 20.0, was used with a significance level of 5%. The Wilcoxon and paired t-tests were used to evaluate depression levels between two timepoints. Using categorical data, the McNemar test was used to analyse differences in depression severity before and after the intervention. Results: depression levels decreased in the intervention group five days after the relaxation technique was applied (4.5 ± 3, p<0.05 compared with the levels at the first timepoint (10.3±5.9. Conclusion: as a nursing intervention, relaxation was effective in decreasing the symptoms of depression in hospitalised women with high-risk pregnancies.

  1. Are teenage pregnancies at high risk? A comparison study in a developing country.

    Science.gov (United States)

    Sagili, Haritha; Pramya, N; Prabhu, Karthiga; Mascarenhas, Mariano; Reddi Rani, P

    2012-03-01

    The aim of this study was to compare obstetric and perinatal outcome in teenage and non-teenage pregnancies. We analyzed retrospective data of 15,498 pregnant patients who delivered from March 2008 to April 2009 in Jawaharlal Institute of Postgraduate Medical Education and Research, a referral tertiary care and teaching hospital in Pondicherry, South India. Girls aged ≤ 19 years were compared with pregnancy outcomes in women aged > 19 years who delivered in the same hospital during the study period. A total of 620 teenage pregnancies were compared with 14,878 non-teenage women. The obstetric and perinatal outcome was compared in the study and control groups using t test with Yates correction. We calculated Odds ratio (OR), 95% confidence intervals(CI) and p values; p teenage pregnancy in the study was 4%. A signicant proportion of teenage mothers were in their first pregnancies and their mean age was 18.04 years. Our study showed a significantly higher incidence of anaemia, past dates, premature rupture of membranes (PROM), normal vaginal delivery, episiotomy, low birth weight, and a significantly lower incidence of caesarean sections/perineal tears in teenage mothers compared to other mothers. In contrast, the incidence of hypertension, intrauterine growth restriction of fetus, pre-term labour and postpartum haemorrhage were similar in both the groups. The data in our study should throw more light on the current thinking of the obstetrical problems facing teenage mothers, in which some of our results support and others refute several long held beliefs about the risks in teenage pregnancy. Early booking, adequate antenatal care and delivery by trained people should improve the obstetric and perinatal outcome in teenage pregnancies, which is still an unresolved problem inspite of various government programmes in developing countries.

  2. Smoking, HIV, and risk of pregnancy loss.

    Science.gov (United States)

    Westreich, Daniel; Cates, Jordan; Cohen, Mardge; Weber, Kathleen M; Seidman, Dominika; Cropsey, Karen; Wright, Rodney; Milam, Joel; Young, Mary A; Mehta, C Christina; Gustafson, Deborah R; Golub, Elizabeth T; Fischl, Margaret A; Adimora, Adaora A

    2017-02-20

    Cigarette smoking during pregnancy increases risks of poor pregnancy outcomes including miscarriage and stillbirth (pregnancy loss), but the effect of smoking on pregnancy loss among HIV-infected women has not been explored. Here, investigated the impact of smoking on risk of pregnancy loss among HIV-positive and HIV-negative women, and estimated the potential impact of realistic smoking cessation interventions on risk of pregnancy loss among HIV-positive women. We analyzed pregnancy outcomes in HIV-positive and HIV-negative participants in the Women's Interagency HIV Study between 1994 and 2014. We estimated effects of current smoking at or immediately before pregnancy on pregnancy loss; we controlled for confounding using regression approaches, and estimated potential impact of realistic smoking cessation interventions using a semiparametric g-formula approach. Analysis examined 1033 pregnancies among 659 women. The effect of smoking on pregnancy loss differed dramatically by HIV status: adjusted for confounding, the risk difference comparing current smokers to current nonsmokers was 19.2% (95% confidence limit 10.9-27.5%) in HIV-positive women and 9.7% (95% confidence limit 0.0-19.4%) in HIV-negative women. These results were robust to sensitivity analyses. We estimated that we would need to offer a realistic smoking cessation intervention to 36 women to prevent one pregnancy loss. Smoking is a highly prevalent exposure with important consequences for pregnancy in HIV-positive pregnant women in the United States, even in the presence of potent highly active antiretroviral therapy. This evidence supports greater efforts to promote smoking cessation interventions among HIV-positive women, especially those who desire to become pregnant.

  3. Smoking, HIV, and risk of pregnancy loss

    Science.gov (United States)

    Westreich, Daniel; Cates, Jordan; Cohen, Mardge; Weber, Kathleen M.; Seidman, Dominika; Cropsey, Karen; Wright, Rodney; Milam, Joel; Young, Mary A.; Mehta, C. Christina; Gustafson, Deborah R.; Golub, Elizabeth T.; Fischl, Margaret A.; Adimora, Adaora A.

    2017-01-01

    Objective: Cigarette smoking during pregnancy increases risks of poor pregnancy outcomes including miscarriage and stillbirth (pregnancy loss), but the effect of smoking on pregnancy loss among HIV-infected women has not been explored. Here, investigated the impact of smoking on risk of pregnancy loss among HIV-positive and HIV-negative women, and estimated the potential impact of realistic smoking cessation interventions on risk of pregnancy loss among HIV-positive women. Design: We analyzed pregnancy outcomes in HIV-positive and HIV-negative participants in the Women's Interagency HIV Study between 1994 and 2014. Methods: We estimated effects of current smoking at or immediately before pregnancy on pregnancy loss; we controlled for confounding using regression approaches, and estimated potential impact of realistic smoking cessation interventions using a semiparametric g-formula approach. Results: Analysis examined 1033 pregnancies among 659 women. The effect of smoking on pregnancy loss differed dramatically by HIV status: adjusted for confounding, the risk difference comparing current smokers to current nonsmokers was 19.2% (95% confidence limit 10.9–27.5%) in HIV-positive women and 9.7% (95% confidence limit 0.0–19.4%) in HIV-negative women. These results were robust to sensitivity analyses. We estimated that we would need to offer a realistic smoking cessation intervention to 36 women to prevent one pregnancy loss. Conclusion: Smoking is a highly prevalent exposure with important consequences for pregnancy in HIV-positive pregnant women in the United States, even in the presence of potent highly active antiretroviral therapy. This evidence supports greater efforts to promote smoking cessation interventions among HIV-positive women, especially those who desire to become pregnant. PMID:27902507

  4. The Risk of Preeclampsia According to High Thyroid Function in Pregnancy Differs by hCG Concentration.

    Science.gov (United States)

    Korevaar, Tim I M; Steegers, Eric A P; Chaker, Layal; Medici, Marco; Jaddoe, Vincent W V; Visser, Theo J; de Rijke, Yolanda B; Peeters, Robin P

    2016-12-01

    During pregnancy, there is an increased demand for thyroid hormone. The pregnancy hormone human chorionic gonadotropin (hCG) is an important physiological stimulator of thyroid function. Already high-normal maternal free T4 concentrations are associated with a higher risk of preeclampsia. The objective of the investigation was to study our hypothesis that hCG concentrations can distinguish a physiological form of high thyroid function from a more pathological form of high thyroid function and that the risk of preeclampsia would differ accordingly. TSH, free T4, hCG, or thyroperoxidase antibody concentrations were determined in pregnant women participating in a population-based prospective cohort study. The study was conducted in the general community. A nonselected sample of 5146 pregnant women participated in the study. There were no interventions. Preeclampsia was measured. Women with high hCG-associated high thyroid function did not have a higher risk of preeclampsia than women with normal thyroid function. In contrast, women with low hCG and high thyroid function had a 3.4- to 11.1-fold higher risk of preeclampsia. These risk estimates were amplified in women with a high body mass index. Women with a low hCG and suppressed TSH (hCG was not associated with preeclampsia, and results remained similar after exclusion of thyroperoxidase antibody-positive women. This study suggests that, in contrast to women with a high hCG associated high thyroid function, women with low hCG and high thyroid function during pregnancy are at a higher risk of developing preeclampsia. The additional measurement of hCG may therefore help to distinguish a more pathological form of high thyroid function and women at a high risk of preeclampsia.

  5. High risk of neonatal complications in children of mothers with gestational diabetes mellitus in their first pregnancy

    DEFF Research Database (Denmark)

    Wielandt, Hanne Benedicte; Schønemann-Rigel, Helena; Holst, Charlotte Blunck

    2015-01-01

    intensive care unit. CONCLUSION: The present study supports the notion of high-risk pregnancy among GDM patients. Compared with nulliparous in general, the offspring were more likely to be delivered by emergency CS. Despite the prophylactic procedures, one in six had neonatal hypoglycaemia.......INTRODUCTION: THE study presents the neonatal outcome from a cohort of women with gestational diabetes mellitus (GDM) in their first pregnancy. METHODS: During a five-year period (2009-2013), a prospective follow-up study was performed at the Department of Gynaecology and Obstetrics, Lillebaelt...

  6. Role of cardiotocography in high risk pregnancy and its correlation with increase cesarean section rate

    Directory of Open Access Journals (Sweden)

    Manisha Gupta

    2016-12-01

    Full Text Available Background: FHR monitoring plays the most important role in management of labouring patient when incidence of fetal hypoxia and progressive asphyxia increases. Now a day’s cardiotocography (CTG become a popular method for monitoring of fetal wellbeing and it is assisting the obstetrician in making the decision on the mode of delivery to improve perinatal outcome. The aim of the study was to assess the effect of cardiotocography on perinatal outcome and its correlation with caesarean section rate. Methods: In this prospective observational study 201 gravid women with high risk pregnancy in first stage of labour were taken. Result was assessed in the form of Apgar score at five minute, NICU admission, perinatal mortality and mode of delivery. Statistical analysis is done by using Chi square test and p<0.05 is considered as statistically significant. Results: Perinatal morbidity in the form of NICU admission is higher in nonreactive group as compare to reactive group (75.7% v/s 22.8%. Cesarean section rate for fetal distress were higher in nonreactive group (87.8% in comparison to reactive group (20.5%. So this study suggest that there is significant difference in mode of delivery with increasing chances of caesarean section in cases belong to non-reactive traces (p<0.001. Conclusions: Admission test is non-invasive and the best screening test to evaluate the fetal health and to predict the perinatal outcome but it also associated with increase caesarean section rate.

  7. Comparison of Phenylephrine and Ephedrine in Treatment of Spinal-Induced Hypotension in High-Risk Pregnancies: A Narrative Review.

    Science.gov (United States)

    Dusitkasem, Sasima; Herndon, Blair H; Somjit, Monsicha; Stahl, David L; Bitticker, Emily; Coffman, John C

    2017-01-01

    To compare maternal and fetal effects of intravenous phenylephrine and ephedrine administration during spinal anesthesia for cesarean delivery in high-risk pregnancies. An extensive literature search was conducted using the US National Library of Medicine, MEDLINE search engine, Cochrane review, and Google Scholar using search terms "ephedrine and phenylephrine," "preterm and term and spinal hypotension," "preeclampsia and healthy parturients," or "multiple and singleton gestation and vasopressor." Society of Obstetric Anesthesia and Perinatology meeting abstracts for the past 4 years were also searched for relevant studies. Both phenylephrine and ephedrine can be safely used to counteract hypotension after spinal anesthesia in patients with uteroplacental insufficiency, pregnancy-induced hypertension, and in non-elective cesarean deliveries. Vasopressor requirements before delivery in high-risk cesarean sections are reduced compared to healthy parturients. Among the articles reviewed, there were no statistically significant differences in umbilical arterial pH, umbilical venous pH, incidence of fetal acidosis, Apgar scores, or maternal hypotension when comparing maternal phenylephrine and ephedrine use. From the limited existing data, phenylephrine and ephedrine are both appropriate selections for treating or preventing hypotension induced by neuraxial blockade in high-risk pregnancies. There is no clear evidence that either medication is more effective at maintaining maternal blood pressure or has a superior safety profile in this setting. Further investigations are required to determine the efficacy, ideal dosing regimens, and overall safety of phenylephrine and ephedrine administration in high-risk obstetric patients, especially in the presence uteroplacental insufficiency.

  8. High maternal serum ferritin in early pregnancy and risk of spontaneous preterm birth.

    Science.gov (United States)

    Khambalia, Amina Z; Collins, Clare E; Roberts, Christine L; Morris, Jonathan M; Powell, Katie L; Tasevski, Vitomir; Nassar, Natasha

    2015-08-14

    Previous studies have reported inconsistent associations between maternal serum ferritin concentrations and the risk of spontaneous preterm birth (sPTB). The aim of the present study was to examine the association between Fe biomarkers, including serum ferritin concentrations, and the risk of total ( 75th percentile ( ≥ 43 μg/l) (OR 1.49, 95% CI 1.06, 2.10) and >90th percentile ( ≥ 68 μg/l) (OR 1.92, 95% CI 1.25, 2.96). Increased odds of early and moderate-to-late sPTB were associated with ferritin levels >90th percentile (OR 2.50, 95% CI 1.32, 4.73) and >75th percentile (OR 1.56, 95% CI 1.03, 2.37), respectively. No association was found between the risk of sPTB and elevated sTfR levels or Fe deficiency. In conclusion, elevated maternal serum ferritin levels in early pregnancy are associated with an increased risk of sPTB from 34 weeks of gestation. The usefulness of early pregnancy ferritin levels in identifying women at risk of sPTB warrants further investigation.

  9. Randomised clinical trials of fish oil supplementation in high risk pregnancies. Fish Oil Trials In Pregnancy (FOTIP) Team

    DEFF Research Database (Denmark)

    Olsen, S F; Secher, N J; Tabor, A;

    2000-01-01

    To test the postulated preventive effects of dietary n-3 fatty acids on pre-term delivery, intrauterine growth retardation, and pregnancy induced hypertension.......To test the postulated preventive effects of dietary n-3 fatty acids on pre-term delivery, intrauterine growth retardation, and pregnancy induced hypertension....

  10. Incidence of anti-toxoplasma antibodies in women with high-risk pregnancy and habitual abortions

    Directory of Open Access Journals (Sweden)

    Maria de la Luz Galvan Ramirez

    1995-12-01

    Full Text Available Toxoplasmosis is a zoonosis caused by Toxoplasma gondii, an obligate intracellular parasite. In pregnant women on the worldwide scale, there are seroprevalences from 7% to 51.3% and in women with abnormal pregnancies and abortions the seroprevalences vary from 17.5% to 52.3%. In Mexico, seropositivity has been found to vary from 18.2% to 44.8% in women with abnormal deliveries or abortions. This study's aim was to determine the incidence oflgG and IgM anti-Toxoplasma antibodies in women at the Gineco-Obstetrics Hospital of the Western Medical Center of the Mexican Social Security Institute. Three hundred and fifty women with high-risk pregnancies were studied, and 122 (34.9% were found to be IgG seropositive and 76 (20.7% were IgM positive. In one group of women with habitual abortions there were 48 (44.9% with the preseiwe of IgG antibodies and 33 (33-3% were IgM seropositive. Seropositivity was analyzed according to age, occupation, socio-economic level, eating raw or poorly cooked meat, and living with cats.La toxoplasmosis es una zoonosis causada por Toxoplasma gondii , parãsito intracellular obligado, en mujeres embarazadas a nivel mundial existen seroprevalencias del 7% al 51.3% y mujeres con embarazos anormales y aborto varian desde 17.5% al 52.3%. En México se ha referido seropositividad del 18.2% al 44.8% en mujeres con partos anormales 6 abortos. El propósito de este trabajo consistió en determinar la frecuencia de anticuerpos antitoxoplasma IgG e IgM en mujeres del Hospital de Gineco Obstetrícia del Centro Médico de Occidente del Instituto Mexicano del Seguro Social. Se estudiaron 350 mujeres con embarazo de alto riesgo encontrando 122 (34.9% seropositivas a IgG y 76 (20.7% a IgM, y en un grupo de 105 mujeres con aborto habitual resultando 48 (44.9% con presencia de anticuerpos IgG y 33 (33-3% a IgM. Se analizó la seropositividad con la edad, ocupación, nivel socioeconómicoa, ingesta de came cruda 6 mal cocida y conviveticia

  11. Health Management's analysis of high-risk pregnancies%高危妊娠的健康管理分析

    Institute of Scientific and Technical Information of China (English)

    葛芳

    2013-01-01

    Objective:To investigate the effect of high-risk pregnancy management casualty rate in reducing maternal and child mortality rates and other aspects of disability. Methods:A retrospective analysis of July 2010 to July 2013 in our hospital admissions of 328 patients undergoing high-risk pregnancy health management results. Results:The cause of high-risk pregnancy with history of cesarean section, apposition, pregnancy hypertension in the top three, respectively, 47.2%, 25.6%, 14.3%;patient as cesarean delivery, birth, breech midwifery the top three, respectively, 46.9%, 27.4%, 17.6%;13 cases of miscarriage, stil birth seven cases, six cases of malformation. Delivery failure rate was 7.9%, the success rate was 92.0%childbirth. Conclusion:The high-risk pregnancy health management incentives for effective analysis of high-risk pregnancy, the effect of improving the delivery of health care and have a positive effect, can effectively protect the health and safety of mothers and newborns.%目的:了解高危妊娠管理在降低孕妇死伤率和儿童致残致死率等方面的效果。方法:回顾性分析2010年7月到2013年7月在我院接诊的328名高危妊娠患者接受健康管理的效果。结果:引发高危妊娠的原因以剖宫产史、胎位不正、妊娠合并高血压位列前三,分别达到47.2%、25.6%、14.3%;患者分娩情况为剖宫产、顺产、臀位助产位列前三,分别达到46.9%、27.4%、17.6%;流产13例、死胎7例、畸形6例。分娩失败率为7.9%,分娩成功率为92.0%。结论:高危妊娠健康管理对于有效分析高危妊娠诱因,提高健康护理与分娩效果有积极作用,可以有效保障产妇和新生儿的生命健康安全。

  12. When no choice of embryos exists, the multiple pregnancy risk is still high.

    LENUS (Irish Health Repository)

    Wong, V V

    2012-10-01

    Multiple pregnancies arising from assisted reproduction are known to be associated with increased medical, psychological, economical and social risks. If only two embryos develop after culture, how should the couple be counselled in relation to the risk of multiple pregnancy? We performed a retrospective review of all IVF\\/ICSI treatments performed between 1 January 2005 and 31 December 2007, that resulted in double embryos transfer (DET). We identified 623 cycles with a fortuitous DET (Group I) and 635 cycles with an elective DET (Group II). Group II were significantly more likely to have twins when compared with Group I, irrespective of age. Twin rates in Group I were higher in IVF compared with ICSI; 33.3% vs 16.6% in < 35 years old and 16.2% vs 7.6% in 35-40 years old. Therefore, single embryo transfer should be considered for IVF patients below 35 years old, even if only two good quality embryos are available.

  13. Pregnancy Diet High in Refined Grains Could Increase Child Obesity Risk By Age 7, NIH Study Suggests

    Science.gov (United States)

    ... News Releases Media Advisory Wednesday, June 7, 2017 Pregnancy diet high in refined grains could increase child obesity ... during pregnancy, affects about 5 percent of all pregnancies in the United ... studies have linked diets high in refined grains — such as white rice — ...

  14. Comparison of Outcome of Normal and High-Risk Pregnancies Based Upon Cerebroplacental Ratio Assessed by Doppler Studies.

    Science.gov (United States)

    Kant, Anita; Seth, Namrata; Rastogi, Deepti

    2017-06-01

    To evaluate the cerebroplacental ratio which is the ratio of pulsatility index of fetal middle cerebral and umbilical arteries, in normal and high-risk pregnancies during 30-36 weeks of gestation. In this study, we included 70 patients, who were scanned for Doppler parameters of Middle cerebral artery and Umbilical artery pulsatility index ratio of fetus, between 30 and 36 weeks, and then were followed till delivery. Thirty-five patients with normal pregnancy and 35 patients with high-risk pregnancy were included. Perinatal outcome was evaluated in relation to indices ratio. There was cerebroplacental ratio of <1.00 in eight cases of the study group in comparison with the control group in which there is no case of <1.00 value. It was associated with poor perinatal outcome in terms of need for lower segment cesarean section for fetal distress, Apgar <8 at 5 min, and admission to nursery. Cerebroplacental ratio is highly sensitive in diagnosing hemodynamically compromised fetuses and very useful for the prediction of adverse perinatal outcome in these fetuses.

  15. Smoking, HIV, and risk of pregnancy loss

    OpenAIRE

    Westreich, Daniel; Cates, Jordan; Cohen, Mardge; Weber, Kathleen M.; Seidman, Dominika; Cropsey, Karen; Wright, Rodney; Milam, Joel; Young, Mary A.; Mehta, C. Christina; Gustafson, Deborah R.; Golub, Elizabeth T.; Margaret A Fischl; Adimora, Adaora A.

    2017-01-01

    Objective: Cigarette smoking during pregnancy increases risks of poor pregnancy outcomes including miscarriage and stillbirth (pregnancy loss), but the effect of smoking on pregnancy loss among HIV-infected women has not been explored. Here, investigated the impact of smoking on risk of pregnancy loss among HIV-positive and HIV-negative women, and estimated the potential impact of realistic smoking cessation interventions on risk of pregnancy loss among HIV-positive women. Design: We analyzed...

  16. 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.

  17. Reducing the Risks of Teenage Pregnancy.

    Science.gov (United States)

    Mitchell, M. Faith

    1984-01-01

    Reviews the medical and social risks of teenage pregnancy and describes two successful programs dealing with pregnancy and parenting: the St. Paul Maternal and Infant Care Project in Minnesota and the Teenage Pregnancy and Parenting Project in San Francisco. (SK)

  18. Reducing the Risks of Teenage Pregnancy.

    Science.gov (United States)

    Mitchell, M. Faith

    1984-01-01

    Reviews the medical and social risks of teenage pregnancy and describes two successful programs dealing with pregnancy and parenting: the St. Paul Maternal and Infant Care Project in Minnesota and the Teenage Pregnancy and Parenting Project in San Francisco. (SK)

  19. Absorbing and transferring risk: assessing the impact of a statewide high-risk-pregnancy telemedical program on VLBW maternal transports

    Directory of Open Access Journals (Sweden)

    Norton Jonathan D

    2006-04-01

    Full Text Available Abstract Background Prior research has shown that resources have an impact on birth outcomes. In this paper we ask how combinations of telemedical and hospital-level resources impact transports of mothers expecting very low birth weight (VLBW babies in Arkansas. Methods Using de-identified birth certificate data from the Arkansas Department of Health, data were gathered on transports of women carrying VLBW babies for two six-month periods: a period just before the start of ANGELS (12/02-05/03, a telemedical outreach program for high-risk pregnancies, and a period after the program had been running for six months (12/03-05/04. For each maternal transport, the following information was recorded: maternal race-ethnicity, maternal age, and the birth weight of the infant. Logistic regression was used to assess the relationship between the predictors (telemedicine, hospital level, maternal characteristics and the probability of a transport. Results Having a telemedical site available increases the probability of a mother carrying a VLBW baby being transported to a level III facility either before or during birth. Having at least a level II nursery also increases the chance of a maternal transport. Where both level II nurseries and telemedical access are available, the odds of VLBW maternal transports are only modestly increased in comparison to the case where neither is present. At the individual level, Hispanic mothers were less likely to be transported than other mothers, and teenaged mothers were more likely to be transported than those 18 and over. A mother's being Black or being over 35 did not have an impact on the odds of being transported to a level III facility. Conclusion Combinations of resources have an impact on physician decisions regarding VLBW transports and are interpretable in terms of the capacity to diagnose and absorb risk. We suggest a collegial review of transport patterns and birth outcomes from areas with different levels of

  20. Risk factors of teenage pregnancy

    Directory of Open Access Journals (Sweden)

    Maria Siettou

    2011-01-01

    Full Text Available Teenage pregnancy is a worldwide medical and social issue, associated with many physical, psychological and social consequences and can result in birth, miscarriage or abortion. Aim: The aim of the present study is to find those risk factors that contribute to teenage pregnancy. Results: In U.S.A., according to data from Unicef, the birth rate among teenagers touches the 52.1% and it is four times higher, than the corresponding rate recorded in the countries of Western Europe. The United Kingdom has the highest rate of teenage pregnancy in Europe and in contrast to the decline in the rate of teenage pregnancy, recorded in the remaining countries of Western Europe, this figure has remained relatively stable, especially in adolescents aged 16 years and below. In Greece, according to National Statistics Office, in 2007, we had 3.129 births by teenagers under 18, with 75 births by teenagers under 15. The main factors contributing to the incidence of teenage pregnancy are socioeconomic factors, the family, the education and the sexual behavior of teenagers. Conclusions.It is necessary the state, through the health services and the education programs, to provide modern sex education in schools, as well as programs of prevention and health education in primary health care. The cooperation of these authorities is essential, to better address the extent and consequences of teenage pregnancy.

  1. THE RATE OF THE PREVALENCE OF HIGH-RISK PREGNANCIES AND THE RESULTS ON PREGNANT MOTHERS AND THE EFFECT ON PARAMETERS AFTER THE BIRTH

    Directory of Open Access Journals (Sweden)

    Sam Firozi

    2012-10-01

    Full Text Available Pregnancy causes large physiologic changes in most body systems and these changes may lead to ease or harden examining some events. The purpose of this study is to define the rate of risk in pregnant women and the results in mother and fetus and also to define the risk rate of pregnancy in pregnant women and its effect on parameters after birth in patients of Educational and Medical center of Gorgan, Dezyani. This case - control study was performed in Educational and Medical Center Dezyany, of Golestan University of Medical Sciences in 1390. In this study, 1266 pregnant women were enrolled of which 804 cases (63.5% according to the criteria for scoring in the questionnaire with a score greater than or equal to 7 were considered as high risk pregnancies (case group, 462 patients (36.5% were considered as low-risk pregnancies (control group. Parameters after the birth and pregnancy results such as delivery type, infant difficulties, mother health after labor were compared and analyzed by T-test and ANOVA in both groups. About the history of infertility almost 80% of the people who had a 2-year history of infertility were in high-risk group and the difference was significant. (P = 0.02 About the history of abortion also almost 90% of the people who had a 2-year history of abortion were in high-risk group and the difference was significant. (P<0.05 Post-term infant was found in 77 cases that were entirely in high-risk group. This difference was statistically significant (P<0.05. According to results and comparing them to other studies we can conclude that pregnant mothers who have pregnancy difficulties history such as history of abortion or infertility, visits during pregnancy should be paid attention and warn them about the risk of not being visited and timely pursuits.

  2. Pregnancy weight gain and breast cancer risk

    Directory of Open Access Journals (Sweden)

    Hemminki Elina

    2004-10-01

    Full Text Available Abstract Background Elevated pregnancy estrogen levels are associated with increased risk of developing breast cancer in mothers. We studied whether pregnancy weight gain that has been linked to high circulating estrogen levels, affects a mother's breast cancer risk. Methods Our cohort consisted of women who were pregnant between 1954–1963 in Helsinki, Finland, 2,089 of which were eligible for the study. Pregnancy data were collected from patient records of maternity centers. 123 subsequent breast cancer cases were identified through a record linkage to the Finnish Cancer Registry, and the mean age at diagnosis was 56 years (range 35 – 74. A sample of 979 women (123 cases, 856 controls from the cohort was linked to the Hospital Inpatient Registry to obtain information on the women's stay in hospitals. Results Mothers in the upper tertile of pregnancy weight gain (>15 kg had a 1.62-fold (95% CI 1.03–2.53 higher breast cancer risk than mothers who gained the recommended amount (the middle tertile, mean: 12.9 kg, range 11–15 kg, after adjusting for mother's age at menarche, age at first birth, age at index pregnancy, parity at the index birth, and body mass index (BMI before the index pregnancy. In a separate nested case-control study (n = 65 cases and 431 controls, adjustment for BMI at the time of breast cancer diagnosis did not modify the findings. Conclusions Our study suggests that high pregnancy weight gain increases later breast cancer risk, independently from body weight at the time of diagnosis.

  3. What Is the Risk for a Second Ectopic Pregnancy?

    Science.gov (United States)

    ... Old What Is the Risk for a Second Ectopic Pregnancy? KidsHealth > For Parents > What Is the Risk for ... TOPIC Medical Care During Pregnancy Pregnancy & Newborn Center Pregnancy Precautions: FAQs Ectopic Pregnancy Contact Us Print Resources Send to a ...

  4. High Blood Pressure in Pregnancy

    Science.gov (United States)

    ... of the baby. Controlling your blood pressure during pregnancy and getting regular prenatal care are important for ... your baby. Treatments for high blood pressure in pregnancy may include close monitoring of the baby, lifestyle ...

  5. 469 Cases of High-risk Pregnancy Monitoring Analysis and Management%469例高危妊娠监测分析及管理探讨

    Institute of Scientific and Technical Information of China (English)

    龚洪春

    2015-01-01

    ObjectiveTo analyze the risk factors for high-risk pregnancies, improving maternal system management quality, reduce the incidence of high-risk pregnancy, effective protection of safe motherhood.Methods From January 1, 2009 to December 31, 2011, 469 cases of perinatal risk factors for high-risk pregnancy care clinics management analysis and discussion.Results The occurrence rate of 55.05% high-risk pregnancy, the top ifve risk factors are: weight≥70 kg, fetal abnormalities, unexplained antepartum hemorrhage, hypertensive disorders in pregnancy, pregnant women with anemia.Conclusion Through a series of interventions in high-risk pregnancy, timely screening, tracking and standardize management, to effectively control the maternal and perinatal mortality.%目的:分析高危妊娠的高危因素,提高孕产妇系统管理质量,降低高危妊娠的发生率,有效保障母婴安全。方法对我所2009年1月1日~2011年12月31日围产期保健门诊管理的469例高危妊娠的高危因素进行分析和探讨。结果高危妊娠的发生率为55.05%,高危因素的前五位依次是:体重≥70 kg、胎位异常、产前出血原因不明、妊娠期高血压疾病、妊娠合并贫血。结论通过高危妊娠的一系列干预措施,及时筛选、追踪等规范管理,从而有效地控制孕产妇和围产儿死亡率。

  6. Governance of innovation and appropriateness of hospitalization for high-risk pregnancy: the TOCOMAT system.

    Science.gov (United States)

    Tagliaferri, Salvatore; Ippolito, Adelaide; Cuccaro, Patrizia; Annunziata, Maria Laura; Campanile, Marta; Di Lieto, Andrea

    2013-07-01

    Over the last 30 years, a great increase in the application of technologies in public health, with an undisputed impact on both the effectiveness of performance and the investment and management costs, has occurred. This evidence has induced the development of assessment tools to clarify the relationships among resources, outputs, and outcomes of technological innovations. This analysis was developed in order to examine the use of a telematic system for reporting remotely transmitted cardiotocographic traces, specifically (1) its impact on the health organization and on the appropriateness of the care setting used and (2) the efficiency of its adoption in a regional network. We adopted a case-control study on patients' medical records during the first 4 months of 2009, 2010, and 2011 and a cost analysis of resources used for the creation of a computerized telecardiotocography network connecting eight peripheral areas to the operations center. The case-control study showed a reduction in the average hospital stay days for high-risk patients (1.32) and for low-risk patient (1.7) with a total of cost savings of €89,628 for high-risk patients and €170,170 for low-risk patients. The cost savings of the regional network was €20,769.04. The adoption of a remote transmission system of cardiotocography provided a managerial and economic advantage in the reduction of inappropriate admissions for prepartum symptoms and an improvement in the admission indicators (hospital stay days).

  7. Alcohol intake in pregnancy increases the child's risk of atopic dermatitis. the COPSAC prospective birth cohort study of a high risk population.

    Directory of Open Access Journals (Sweden)

    Charlotte Giwercman Carson

    Full Text Available BACKGROUND: Atopic dermatitis has increased four-fold over the recent decades in developed countries, indicating that changes in environmental factors associated with lifestyle may play an important role in this epidemic. It has been proposed that alcohol consumption may be one contributing risk factor in this development. OBJECTIVE: To analyze the impact of alcohol intake during pregnancy on the development of atopic dermatitis during the first 7 years of life. METHOD: The COPSAC cohort is a prospective, longitudinal, birth cohort study of 411 children born to mothers with a history of asthma, followed up for 7 years with scheduled visits every 6 months as well as visits for acute exacerbations of atopic dermatitis. Risk of atopic dermatitis from any alcohol consumption during pregnancy was analyzed as time-to-diagnosis and adjusted for known risk factors. RESULTS: 177 of 411 children developed atopic dermatitis before age 7 years. We found a significant effect of alcohol intake during pregnancy on atopic dermatitis development (HR 1.44, 95% CI 1.05-1.99 p=0.024. This conclusion was unaffected after adjustment for smoking, mother's education and mother's atopic dermatitis. LIMITATIONS: The selection of a high-risk cohort, with all mothers suffering from asthma, and all children having a gestational age above 35 weeks with no congenital abnormality, systemic illness, or history of mechanical ventilation or lower airway infection. CONCLUSION: Alcohol intake by pregnant women with a history of asthma, is significantly associated with an increased risk for the child for developing atopic dermatitis during the first 7 years of life.

  8. Monitoring of high-risk pregnancies using E3 and HPL

    Energy Technology Data Exchange (ETDEWEB)

    Bieglmayer, Ch.; Spona, J.

    1981-01-01

    Routine determinations of HPL and E3 together with other clinical and laboratory checks offer usable information on the state of pregnancy and assist the doctor in taking decisions on the use of therapeutical measures. The anamnesis, the presence of placental insufficiency of EPH-gestosis are important indications for monitoring the pregnancy using HPL and E3. A commercial RIA apparatus (Centria 2) allowing the determination of HPL in a mere hour was compared with our established laboratory method. In 140 determinations, the correlation was r=0.75. Considering its capacity and method, the instrument seems to be more suitable for a small specialized laboratory.

  9. Prenatal risk indicators of a prolonged pregnancy

    DEFF Research Database (Denmark)

    Olesen, Annette Wind; Westergaard, Jes Grabow; Olsen, Jørn

    2006-01-01

    BACKGROUND: Few prenatal risk factors of prolonged pregnancy, a pregnancy of 42 weeks or more, are known. The objective was to examine whether sociodemographic, reproductive, toxicologic, or medical health conditions were associated with the risk of prolonged pregnancy. METHODS: Data from the Dan...

  10. A PROSPECTIVE TRIAL OF THE FETAL BIOPHYSICAL PROFILE VERSUS MODIFIED BIOPHYSICAL PROFILE IN THE MANAGEMENT OF HIGH RISK PREGNANCIES

    Directory of Open Access Journals (Sweden)

    A. Jamal

    2007-07-01

    Full Text Available "nThe original biophysical profile is time consuming and costly. This study was performed to compare diagnostic value of the original fetal biophysical profile to the modified biophysical profile. Patients were selected from high risk pregnancies referred for fetal assessment and were randomly assigned to two groups. The measures of outcomes were perinatal mortality, Cesarean section for abnormal test, meconium-stained amniotic fluid and 5-minute Apgar score < 7. Diagnostic values of tests were assessed in terms of the incidence of abnormal outcome. In addition comparisons between the positive and negative predictive values of each of these tests as well as the sensitivity and specificity of the tests were reviewed. A total of 200 patients were entered into the study; 104 pregnancies were managed by the original biophysical profile and 96 pregnancies by the modified biophysical profile. There were 30 abnormal (31.3% in modified biophysical profile and 24 (23.1% abnormal tests in original one. There was significant difference in the incidence of meconium passage between two groups. Cesarean section for abnormal tests was 27 of 30 abnormal test (90% in modified and 22 of 24 (91.6% in original profile that was similar in both groups. There was not significant difference in Apgar score < 7 between two groups. We did not find significant difference with comparison of the sensitivity, specificity and negative predictive value of two tests for all measures of outcome except the positive predictive value of meconium passage. Original biophysical profile is more costly and time consuming than modified one.

  11. Correlation of doppler studies at 34 weeks of gestation with perinatal outcome in high risk pregnancies

    Directory of Open Access Journals (Sweden)

    Apoorva Reddy

    2015-12-01

    Results: Uterine artery S/D abnormality was seen in 32.5% of high risk cases were as abnormal umbilical artery S/D was seen in 25% and abnormal Pulsatility Index (PI in 15% cases. Middle cerebral artery flow was abnormal in only 17.5% cases. Abnormality in the uterine artery flow correlated well with the incidence of preterm delivery (69.2%, need for cesarean section (53.8% and length of Neonatal intensive care unit(NICU stay >48 hours (69.23%. Abnormal umbilical artery flow was associated with a significant increase in the incidence of preterm delivery(75%, small for gestational age babies(93.75% and length of NICU stay >48 hours (93.75%. There was no significant correlation seen with isolated abnormal middle cerebral artery flow. Conclusions: Both uterine and umbilical artery Doppler velocities correlate well with the perinatal outcome but abnormal uterine artery Doppler predicts adverse neonatal outcome better than the fetal vessels as it discriminates fetuses at risk because of abnormal placental vascularisation from those who are at risk due to other causes. [Int J Reprod Contracept Obstet Gynecol 2015; 4(6.000: 1894-1899

  12. The meaning of the Occupational Therapy activities in the hospitalization context of high risk pregnancy

    Directory of Open Access Journals (Sweden)

    Laís Abdala Martins

    2014-09-01

    Full Text Available Objective: The present study aimed to describe and interpret the meaning and realization of activities directed to motherhood during occupational therapy treatment with hospitalized high-risk pregnant women. Methods: An interpretative qualitative study carried out with forty-five high-risk pregnant women under treatment at the University Hospital of the Federal University of Parana - UFPR. Data from a total of 90 interviews, conducted with all hospitalized pregnant women who agreed to participate in the study, were collected and submitted to content analysis. Results: In the study of the two sets of categories obtained, many analysis units emerged. In the category related to hospitalization, 14 units were found: anxiety, loneliness, boredom, and worry for the baby were among the main ones. In the category related to therapeutic process, 9 units were highlighted: satisfaction, relaxation, and family proximity were among the most often mentioned. Conclusions: Hospitalization is a stressful life event and influences the emotional state of pregnant women. The process of realization of therapeutic occupational activities directed to motherhood allowed the rescue of being active, being able to live and revive positive and natural experiences of the gestational process, allowing the reframing of hospitalization.

  13. High-risk pregnancy in a woman with Marfan syndrome, a bicuspid aortic valve, and a dilated aortic sinus

    DEFF Research Database (Denmark)

    Groth, Kristian Ambjørn; Greisen, Jacob Raben; Nielsen, Birgitte Bruun;

    2015-01-01

    A 29-year-old woman with Marfan syndrome, a bicuspid aortic valve, and a dilated aortic sinus (5.2 cm) presented herself in clinic 14 weeks pregnant. She was advised to discontinue the pregnancy due to risk of dissection; however, she decided to continue. She was treated with labetalol (300 mg...

  14. Clinical application of Medical Resonance Therapy Music in high-risk pregnancies.

    Science.gov (United States)

    Sidorenko, V N

    2000-01-01

    Music is an ancient method for healing. In the year 550 B.C., Pythagoras from Greece developed a concept for the use of music in medicine, esteeming music higher than many other medical treatments. The Medical Resonance Therapy Music (MRT-Music) of the German classical composer and musicologist Peter Huebner is built on this concept of Pythagorean music medicine. Its therapeutic effect may be best explained by the natural phenomenon of resonance between the harmony laws of the microcosm of music and the biological laws of the body. Results received after application of MRT-Music indicate multiple positive effects on the organism of pregnant women both with a healthy pregnancy as with a pathologic one, reducing the rate of premature births very effectively. Furthermore, MRT-Music came out to be an effective method in the complex therapy of late gestoses and a nearly irreplaceable method for preoperative preparation of pregnant woman for caesarean section. It demonstrated a powerful anti-stress effect and allowed to reduce the amount of administered pain-killers to pregnant women by the factor 1.5 to 2.0, thus reducing the negative pharmacological load to the foetus. It furthermore reduced labour time and shortened hospital stay. It helped to create optimal conditions for the course of pregnancy and heightened pain sensitivity threshold by means of improving the functional, hormonal, and psycho-emotional conditions of pregnant and lying-in women. Thus, the labour process became more natural, the delivery non-traumatic, and motherhood more happy and safe.

  15. Incidence and risk factors for exacerbations of asthma during pregnancy

    Directory of Open Access Journals (Sweden)

    Ali Z

    2013-05-01

    Full Text Available Zarqa Ali, Charlotte Suppli UlrikDepartment of Pulmonary Medicine, Hvidovre Hospital and University of Copenhagen, Copenhagen, DenmarkBackground: Asthma is one of the most common chronic diseases among pregnant women. Acute exacerbations of asthma during pregnancy have an unfavorable impact on pregnancy outcome. This review provides an overview of current knowledge of incidence, mechanisms, and risk factors for acute exacerbations of asthma during pregnancy.Methods: A narrative literature review was carried out using the PubMed database.Results: During pregnancy, up to 6% of women with asthma are hospitalized for an acute exacerbation. The maternal immune system is characterized by a very high T-helper-2:T-helper-1 cytokine ratio during pregnancy and thereby provides an environment essential for fetal survival but one that may aggravate asthma. Cells of the innate immune system such as monocytes and neutrophils are also increased during pregnancy, and this too can exacerbate maternal asthma. Severe or difficult-to-control asthma appears to be the major risk factor for exacerbations during pregnancy, but studies also suggest that nonadherence with controller medication and viral infections are important triggers of exacerbations during pregnancy. So far, inconsistent findings have been reported regarding the effect of fetal sex on exacerbations during pregnancy. Other risk factors for exacerbation during pregnancy include obesity, ethnicity, and reflux, whereas atopy does not appear to be a risk factor.Discussion: The incidence of asthma exacerbations during pregnancy is disturbingly high. Severe asthma – better described as difficult-to-control asthma – nonadherence with controller therapy, viral infections, obesity, and ethnicity are likely to be important risk factors for exacerbations of asthma during pregnancy, whereas inconsistent findings have been reported with regard to the importance of sex of the fetus.Keywords: acute exacerbations

  16. Maternal and foetal outcome after epidural labour analgesia in high-risk pregnancies

    Directory of Open Access Journals (Sweden)

    Sukhen Samanta

    2016-01-01

    Full Text Available Background and Aims: Low concentration local anaesthetic improves uteroplacental blood flow in antenatal period and during labour in preeclampsia. We compared neonatal outcome after epidural ropivacaine plus fentanyl with intramuscular tramadol analgesia during labour in high-risk parturients with intrauterine growth restriction of mixed aetiology. Methods: Forty-eight parturients with sonographic evidence of foetal weight <1.5 kg were enrolled in this non-randomized, double-blinded prospective study. The epidural (E group received 0.15% ropivacaine 10 ml with 30 μg fentanyl incremental bolus followed by 7–15 ml 0.1% ropivacaine with 2 μg/ml fentanyl in continuous infusion titrated until visual analogue scale was three. Tramadol (T group received intramuscular tramadol 1 mg/kg as bolus as well as maintenance 4–6 hourly. Neonatal outcomes were measured with cord blood base deficit, pH, ionised calcium, sugar and Apgar score after delivery. Maternal satisfaction was also assessed by four point subjective score. Results: Baseline maternal demographics and neonatal birth weight were comparable. Neonatal cord blood pH, base deficit, sugar, and ionised calcium levels were significantly improved in the epidural group in comparison to the tramadol group. Maternal satisfaction (P = 0.0001 regarding labour analgesia in epidural group was expressed as excellent by 48%, good by 52% whereas it was fair in 75% and poor in 25% in the tramadol group. Better haemodynamic and pain scores were reported in the epidural group. Conclusion: Epidural labour analgesia with low concentration local anaesthetic is associated with less neonatal cord blood acidaemia, better sugar and ionised calcium levels. The analgesic efficacy and maternal satisfaction are also better with epidural labour analgesia.

  17. Effects of relaxation on depression levels in women with high-risk pregnancies: a randomised clinical trial.

    Science.gov (United States)

    Araújo, Wanda Scherrer de; Romero, Walckiria Garcia; Zandonade, Eliana; Amorim, Maria Helena Costa

    2016-09-09

    to analyse the effects of relaxation as a nursing intervention on the depression levels of hospitalised women with high-risk pregnancies. a randomised clinical trial realised in a reference centre for high-risk pregnancies. The sample consisted of 50 women with high-risk pregnancies (25 in the control group and 25 in the intervention group). The Benson relaxation technique was applied to the intervention group for five days. Control variables were collected using a predesigned form, and the signs and symptoms of depression were evaluated using the Edinburgh Postnatal Depression Scale (EPDS). The Statistical Package for Social Sciences (SPSS), version 20.0, was used with a significance level of 5%. The Wilcoxon and paired t-tests were used to evaluate depression levels between two timepoints. Using categorical data, the McNemar test was used to analyse differences in depression severity before and after the intervention. depression levels decreased in the intervention group five days after the relaxation technique was applied (4.5 ± 3, pSocial Sciences (SPSS), versão 20.0, foi utilizado com nível de significância de 5%. Os testes de Wilcoxon e t pareado foram utilizados para avaliar os níveis de depressão entre os dois momentos. Em relação aos dados categóricos, foi utilizado o teste de McNemar para analisar diferenças na gravidade da depressão antes e depois da intervenção. os níveis de depressão diminuíram no grupo intervenção cinco dias após a aplicação da técnica de relaxamento (4.5±3, pCiencias Sociales (SPSS, del inglés Statistical Package for Social Sciences), versión 20.0, se usó con un nivel de significación del 5%. La prueba de Wilcoxon y la prueba de t de Student pareada se usaron para evaluar los niveles de depresión entre dos puntos en el tiempo. Usando datos categóricos, la prueba de McNemar se usó para analizar diferencias en la severidad de la depresión antes y después de la intervención. los niveles de depresi

  18. Maternal Adjustment and Infant Outcome in Medically Defined High-Risk Pregnancy.

    Science.gov (United States)

    Levy-Shiff, Rachel; Lerman, Maya; Har-Even, Dov; Hod, Moshe

    2002-01-01

    Explored relation of biological and psychosocial risk factors to infant development among pregnant women who had pregestational diabetes, gestational diabetes, or were nondiabetic. Found that infants of diabetic mothers scored lower on the Bayley Scales at 1 year and revealed fewer positive and more negative behaviors than infants of nondiabetic…

  19. Data collection on risk factors in pregnancy

    NARCIS (Netherlands)

    Zetstra-van der Woude, Alethea Priscilla

    2016-01-01

    This thesis aims to investigate the different methods of data collection of risk factors in pregnancy. Several observational epidemiologic study designs were used to assess associations between risk factors and negative birth outcomes. We especially looked at the use of folic acid around pregnancy a

  20. Application research on programmable management of high-risk pregnancy%高危妊娠程序化管理的应用研究

    Institute of Scientific and Technical Information of China (English)

    王素君; 王慧敏; 房笑丽

    2009-01-01

    Objective: To explore the programmable management models of high-risk pregnancy, increase the screening rate and intervention rate of high-risk pregnancy, thus reduce the mortality of pregnant and lying-in women, neonates and children under-five years old. Methods: The network of high-risk pregnancy management was established and screening criteria of high-risk pregnancy was instituted, the procedure of high-risk pregnancy nmnagement was perfected. Results: There was significant difference in detection rate of high-risk pregnancy, the amount of health care, maternal mortality, neonatal mortality and the percentage of neonatal mortality accounting for children mortality under five years old before and after programmable management of high-risk pregnancy (P <0. 05) . By Fisher's Ex-act test, there was significant difference in maternal mortality between Ningyang County after programmable management and the other identi-cal cities, the other cities in Shandong province; In 2006, there was significant difference in maternal mortality between Ningyang County and the other rural areas. Conclusion: After the implementation of high-risk pregnancy programmable management, the maternal and child health care services have uninterrupted improved, and screening rate of high-risk pregnancy has increased year by year, a significant reduc-tion in maternal mortality, neonatal mortality, the percentage of neonatal mortality accounting for children mortality under five years old is in decline.%目的:探讨高危妊娠的程序化管理模式,提高高危妊娠筛出率和干预率,以降低孕产妇、新生儿及5岁以下儿童的死亡率.方法:建立高危妊娠组织管理网络、制定高危妊娠筛查的评分标准、完善高危妊娠管理的工作流程.应用SPSS12.0统计软件,经Chi-Square Test分析,了解高危妊娠的程序化管理实施前后3年的高危孕产妇筛出率、孕产妇保健数、孕产妇死亡率、新生儿死亡率等情况.结果:高危

  1. Coronary angiography of pregnancy-associated coronary artery dissection: a high-risk procedure.

    Science.gov (United States)

    Martins, Raphaël Pedro; Leurent, Guillaume; Corbineau, Hervé; Fouquet, Olivier; Seconda, Sébastien; Baruteau, Alban E; Moreau, Olivier; Le Breton, Hervé; Bedossa, Marc

    2010-01-01

    Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndrome occurring predominantly in young women without any cardiovascular risk factors, especially during the peripartum and early postpartum period. Here, we report a case of a 28-year-old pregnant woman who was found to have an isolated distal SCAD of the left anterior descending artery (LAD). Coronary angiography was complicated by extensive LAD and circumflex arteries dissection, requiring an emergency coronary artery bypass grafting associated with ventricular assist device implantation and underlying the extreme fragility of coronary arteries in pregnant women.

  2. Consumption of medicines in high-risk pregnancy: evaluation of determinants related to the use of prescription drugs and self-medication

    Directory of Open Access Journals (Sweden)

    Danielle Dayse Araújo

    2013-09-01

    Full Text Available The use of drugs during pregnancy still represents a challenge for medicine, since the majority of drugs cross the placental barrier with a potential to cause several congenital problems to the fetus, and most of them have not been clinically tested in pregnant patients. At the same time, the medicalization phenomenon, self-medication, and lack of patient information about the misuse of medicines are additional problems. Thus, the aim of this study was to evaluate the pattern of medicine consumption in high-risk pregnancies and the determinants related to this consumption pattern. In order to do so, a cross-sectional descriptive study was performed with puerperal women who had a history of high-risk pregnancy. Statistically significant associations were found between self-medication and fewer prenatal visits, and cigarette use during pregnancy and a higher number of children. According to these data, the vulnerability of this population to the risks of drug use is evident, demonstrating a gap that requires urgent interventions in health-care education.

  3. Postpartum diagnosis demonstrates a high risk for metastasis and merits an expanded definition of pregnancy-associated breast cancer.

    Science.gov (United States)

    Callihan, Eryn B; Gao, Dexiang; Jindal, Sonali; Lyons, Traci R; Manthey, Elizabeth; Edgerton, Susan; Urquhart, Alexander; Schedin, Pepper; Borges, Virginia F

    2013-04-01

    Previous studies report conflicting data on outcomes of pregnancy-associated breast cancer (PABC). Our aim was to examine the effect of a postpartum diagnosis on maternal prognosis in a young women's breast cancer cohort. We conducted a retrospective cohort study of women age ≤45 years, diagnosed with breast cancer (n = 619) during 1981-2011 at the University of Colorado Hospital and The Shaw Cancer Center in Edwards, CO. Breast cancer cases were grouped according to time between giving birth and diagnosis: nulliparous (n = 125), pregnant (n = 24), 5-cancer during the first five-years postpartum confers poorer maternal prognoses after adjustment for biologic subtype, stage, and year of diagnosis. We propose that the definition of PABC should include cases diagnosed up to at least five-years postpartum to better delineate the increased risk imparted by a postpartum diagnosis. Based on emerging preclinical and epidemiologic data, we propose that pregnant and postpartum cases be researched as distinct subsets of PABC to clarify the risk imparted by pregnancy and the events subsequent to pregnancy, such as breast involution, on breast cancer. Further, we highlight the importance of postpartum breast cancer as an area for further research to reduce the increased metastatic potential and mortality of PABC.

  4. Correlation Between Biophysical Profile and Middle Cerebral/Umbilical Artery Resistance Index Ratio in the Assessment of Prenatal Outcome in High Risk Pregnancies

    Directory of Open Access Journals (Sweden)

    Nazanin Eshraghi

    2009-01-01

    Full Text Available  Introduction: Antenatal fetal surveillance tests have led to a significant decrease in perinatal mortality and morbidity rates, especially in high risk pregnancies (e.g placenta previa, intrauterine growth retardation. But there is no concurrence on the best and accurate modality yet. The aim of this study is to evaluate the accuracy of antenatal assessment with biophysical profile and Doppler sonography (cerebral and umbilical artery regarding fetal acidosis and asphyxia. "nMaterials and Methods: This is a cross-sectional study on fetuses of seventy women with a 28-42 week singleton pregnancy who had hypertension (pre eclampsia, diabetes mellitus or intra uterine growth retardation and were admitted as high risk pregnancies to AL-Zahra hospital. The study population routinely underwent sonographic evaluation of cerebral and umbilical arteries and a biophysical profile twice a week until the end of pregnancy. "nResults: Infants who had a lower score of biophysical profile, had a lower umbilical PH and a negative base deficit. Fetuses with a lower MCA/Umb. A RI had a higher base deficit and acidosis (measured from umbilical blood after birth. Apgar on minute 5 was higher in infants with a history of higher profile score as well as a higher MCA/Umb. A. RI ratio. On the other hand; there was no significant correlation between MCA RI and umbilical PH. Correlation between Umb. A. RI and umbilical PH was not significant either. "nConclusion: Biophysical profile and assessment of the umbilical and cerebral arteries are valuable modalities for predicting the fetal condition and the outcome in high risk pregnancies. MCA/Umb. A RI Index ratio is a better indicator compared to its components.

  5. Influence of Perinatal Depression on Labor-Associated Fear and Emotional Attachment to the Child in High-Risk Pregnancies and the First Days After Delivery.

    Science.gov (United States)

    Koss, Joanna; Bidzan, Mariola; Smutek, Jerzy; Bidzan, Leszek

    2016-03-29

    The aim of this study was to analyze the influence of the level of perinatal depression on the labor-associated fear and emotional attachment of children born to women during high-risk pregnancies and in the first days after delivery. 133 women aged between 16 and 45 years took part in the study. The first group included 63 pregnant women (mean age=28.59, SD=5.578) with a high-risk pregnancy (of maternal origin, for example, cardiologic disorders and diabetes). The second group included 70 women (mean age=27.94, SD=5.164) who were in the first days post-partum. Research methods included: Analysis of medical documentation; Clinical interview; the Edinburgh Postnatal Depression Scale (EPDS); the Questionnaire of Labor-Associated Anxiety (KLP), the Maternal-Fetal Attachment Scale (MFAS). Women after delivery displayed a higher level of concern for the child's health and life when compared to the high-risk pregnancy group. The results indicated the appearance of a postnatal fear, the level of which is connected with the perception of the role of the mother. This fear is lower in women prior to childbirth than it is after. There has also been noted a statistically significant relationship between the appearance of depression and attachment to the child. Those women with depression show less attachment to their child than is the case for those who do not suffer from depression. The appearance of a high level of depression amongst women from the high-risk pregnancy group during the first days post childbirth was accompanied by perinatal depression and a weaker attachment to the child.

  6. 流动人口早中孕期高危妊娠相关因素分析%Analysis of the high-risk pregnancy factors of the floating population with early and middle pregnancy

    Institute of Scientific and Technical Information of China (English)

    孙惠敏; 邬姝阳

    2012-01-01

    Objective It is essential and difficult to manage the high -risk pregnancy among the floating population in mater -nal systematic management. The aim of this study is to provide references for formulating health care for the high -risk gravida among the floating population, their high-risk pregnancy factors in early and middle stage were analyzed . Methods The data of high-risk gravi-da in early and middle stage pregnancy among the floating population from October 1 , 2008 to March 30, 2012 were retrospectively analyzed. Results The cases of high-risk gravida in early and middle stage pregnancy among the floating population were 746 and the times of higlnisk pregnancy factors were 924. The top five factors were : multiple artificial abortion (53.22%), weight =70 kg or <40 kg (19.03% ) , gynecological history of genital surgery (13. 94% ) , scar uterus (9. 52% ) , and pregnancy associated with ovarian ne -oplasms or uterine fibroids (7.64%). The spontaneous delivery rate of high -risk gravida (43.57%) was lower than that of normal gravida(51. 93% ) (P <0. 001 ) in the corresponding period. Conclusion Risk factors of high-risk pregnancy for floating population women mainly include multiple artificial abortion , weight (=70 kg or <40kg) , gynecological history of genital surgery , scar uterus and pregnancy associated with ovarian neoplasms or uterine fibroids .%目的 流动人口孕妇的高危妊娠管理是孕产妇系统管理的重点和难点.文中分析流动人口早中孕期高危妊娠因素,为制定流动人口高危孕妇保健措施提供参考依据.方法 对2008年10月1日至2012年3月30日南京市玄武区流动人口早中孕期高危妊娠孕妇的资料进行回顾性分析.结果 746例流动人口早中孕期高危孕妇,出现高危妊娠因素924例次,排前5位的因素依次为:多次人流史(53.22%)、体重≥70kg或<40kg(19.03%)、妇科生殖器手术史(13.94%)、瘢痕子宫(9.52%)、妊娠合并卵巢肿瘤或子宫肌瘤(7

  7. [Hereditary thrombophilia and pregnancy: thrombotic risk and pregnancy outcome].

    Science.gov (United States)

    Fonseca, Ana Glória

    2012-01-01

    Thromboembolic disease and obstetric complications related to ischemia of the placenta are currently the major causes of maternal mortality and morbidity. Thrombophilia been implicated in their aetiology and the magnitude of the risk depends on the type of thrombophilia. As the evidence is still unclear and controversial, questions about the clinical management of pregnant women with thrombophilia are a daily issue. We aim to review, bearing in mind the consensus and controversies, the impact of inherited thrombophilia in the risk of thrombosis related to pregnancy and of obstetric complications. Moreover, the diagnostic, preventive and therapeutic approach during pregnancy and puerperium, including the role of antithrombotic pharmacopoeia available, will be discussed.

  8. Pregnancy risks associated with obesity.

    Science.gov (United States)

    Mission, John F; Marshall, Nicole E; Caughey, Aaron B

    2015-06-01

    Obesity has increased dramatically in the United States over the last several decades, with approximately 40% of pregnant women now considered overweight or obese. Obesity has been shown to be associated with numerous poor pregnancy outcomes, including increased rates of preeclampsia, gestational diabetes, fetal macrosomia, stillbirth, postterm pregnancy, and increased rates of cesarean delivery. Many of these complications have been found to increase even further with increasing body mass index in a dose-response fashion. In this review, the association of obesity with maternal, fetal, and pregnancy outcomes is discussed as are the recommendations for caring for the obese gravida.

  9. More Folic Acid in Pregnancy May Protect Kids from High Blood Pressure

    Science.gov (United States)

    ... Folic Acid in Pregnancy May Protect Kids From High Blood Pressure If mothers have heart disease risk factors, nutrient ... levels during pregnancy may reduce the risk of high blood pressure in children if their mothers have heart disease ...

  10. 1568例高危妊娠的健康管理分析%Management analysis of 1 568 cases of high-risk pregnancy

    Institute of Scientific and Technical Information of China (English)

    胡蓉

    2011-01-01

    Objective: To explore the methods of high-risk pregnant management, in order to offer the scientific basis to improve the interfering measures of high-risk pregnant.Methods: To analyze the 1 568 cases of high-risk pregnant women in our hospital from January 2005 to December 2009.Results: The percentage of high-risk pregnancy was 24.18%, five types of the high-risk pregnancy were scar uterus, fetal position, old maternal, diabetes, anemia.The highest rate of highrisk pregnant was in the pregnant women with the age above 35 years old.Conclusion: The high-risk pregnant women should be carried in special nanagement, timely follow-up and appropriate interventions, to reduce the perinatal children's death.%目的:探讨高危妊娠的健康管理方法,为制定相关干预措施提供科学依据.方法:对我院2005年1月-2009年12月登记的1568例高危妊娠的管理情况及相关因素进行回顾性分析.结果:高危妊娠的发生率为24.18%,妊娠高危因素的前5位的是瘢痕子宫、胎位不正、高龄孕妇、妊娠期糖尿病、贫血,年龄≥35岁的孕妇高危妊娠发生率最高.结论:对高危孕妇进行管理、及时追踪,并给予相应的干预措施,可以降低孕产妇围生儿死亡率.

  11. 高危妊娠产妇高危因素分析与治疗%Analysis of the High-risk Factors of High-risk Pregnancy and the Corre-sponding Treatment

    Institute of Scientific and Technical Information of China (English)

    黄雅; 朱丽仙; 钟洁; 杨楠

    2016-01-01

    目的 分析高位妊娠产妇危险因素及其临床治疗措施,以确保孕妇与围生儿的生命安全. 方法 回顾性随机选取2014年1月—2015年6月该院收治的320例高危妊娠产妇为研究对象,将其设为观察组,同期选取320例正常产妇设为对照组,对比并分析两组产妇的引导助产分娩率、胎儿死亡率、剖宫产率. 结果 观察组阴道助产分娩率、剖宫产率、胎儿死亡率分别为9.06%(29/320)、58.13%(186/320)、8.13%(26/320),对照组阴道助产分娩率、剖宫产率、胎儿死亡率分别为3.44%(11/320)、30.63%(98/320)、1.56%(5/320),组间对比差异有统计学意义(P3次、贫血等.结论 妊娠期加强孕前健康教育,加强高危产妇危险因素监控,对提高产妇及围生儿生命安全,减少高位妊娠发生率具有重要作用.%Objective To analyze the risk factors of high-risk pregnancy and the corresponding clinical treatment in order to ensure the safety of pregnant women and the perinatal infants. Methods 320 puerperants with high-risk pregnancy admit-ted in our hospital from January 2014 to June 2015 were selected as the subjects of observation group. And other 320 nor-mal puerperants were selected as the control group. The rate of delivery with midwifery guide, fetal mortality and cesarean section rate of the two groups were compared and analyzed. Results The assisted vaginal delivery rate, cesarean section rate, fetal mortality was 9.06% (29/320), 58.13% (186/320), 8.13% (26/320), respectively in the observation group, and 3.44% (11/320), 30.63% (98/320), 1.56% (5/320), respectively in the control group with statistically significant differences between the two groups (P<0.05). Compared with the control group, the risk factors of the observation group were abnormal fetal position, macrosomia, prolonged pregnancy, preterm birth, premature rupture of fetal membranes, fetal distress, more than 3 times of abortion, anemia and so on. Conclusion Strengthening the

  12. [Early pregnancy risk: development and validation of a predictive instrument].

    Science.gov (United States)

    Burrows, R; Rosales, M E; Díaz, M; Muzzo, S

    1994-06-01

    An early pregnancy risk scale, with scores ranging from 11 to 66 points from lower to higher risk, was constructed using variables associated with teenager's pregnancy. This scale was applied to 3000 female teenagers, coming from Metropolitan Santiago public schools. The sample was divided in three risk groups: group A (high risk) with scores equal or over 35 points, group B (low risk) with scores equal or below 20 points and group B (intermediate risk) with scores between 20.1 and 34.9 points. These girls were followed during 2 years. During this period, 84 girls became pregnant, 24 of 184 (13%) in group A, 60 of 2332 (2.6%) in group C and none of 307 in group B. There were 104 school desertions in group A and 37 in group B. To study associations and analyze risk, the sample was divided in two risk groups: high, with scores over 27 and low, with scores below 27. There was a high association between pregnancy risk score and the occurrence of pregnancy (RR 5.25 p school desertion (RR 3.32 p School desertion was predicted with a 74% sensitivity and 56% specificity. The importance variable weighing using multiple regression models, to improve the predictor's sensitivity and specificity, is discussed.

  13. Identification of Behavioral Risk Factors During Pregnancy

    OpenAIRE

    Ruţa Florina; Tarcea Monica; Stere Victoria; Abram Zoltan; Avram Călin

    2015-01-01

    Exposure to smoking during pregnancy is known to be one of the main modifiable risk factors, which threatens maternal and child health. Along with this factor, are not to be neglected also other risk factors belonging to lifestyle sphere, such as alcohol, sedentary, irregular daily meal serving plan, lack of knowledge.

  14. Who Is at Increased Risk of Health Problems during Pregnancy?

    Science.gov (United States)

    ... is at increased risk of health problems during pregnancy? Skip sharing on social media links Share this: Page Content Some women are at increased risk for health problems during pregnancy. Important risk factors include the following: Overweight and ...

  15. Short inter-pregnancy intervals, parity, excessive pregnancy weight gain and risk of maternal obesity.

    Science.gov (United States)

    Davis, Esa M; Babineau, Denise C; Wang, Xuelei; Zyzanski, Stephen; Abrams, Barbara; Bodnar, Lisa M; Horwitz, Ralph I

    2014-04-01

    To investigate the relationship among parity, length of the inter-pregnancy intervals and excessive pregnancy weight gain in the first pregnancy and the risk of obesity. Using a prospective cohort study of 3,422 non-obese, non-pregnant US women aged 14-22 years at baseline, adjusted Cox models were used to estimate the association among parity, inter-pregnancy intervals, and excessive pregnancy weight gain in the first pregnancy and the relative hazard rate (HR) of obesity. Compared to nulliparous women, primiparous women with excessive pregnancy weight gain in the first pregnancy had a HR of obesity of 1.79 (95% CI 1.40, 2.29); no significant difference was seen between primiparous without excessive pregnancy weight gain in the first pregnancy and nulliparous women. Among women with the same pregnancy weight gain in the first pregnancy and the same number of inter-pregnancy intervals (12 and 18 months or ≥18 months), the HR of obesity increased 2.43-fold (95% CI 1.21, 4.89; p = 0.01) for every additional inter-pregnancy interval of pregnancy intervals. Among women with the same parity and inter-pregnancy interval pattern, women with excessive pregnancy weight gain in the first pregnancy had an HR of obesity 2.41 times higher (95% CI 1.81, 3.21; p obesity risk unless the primiparous women had excessive pregnancy weight gain in the first pregnancy, then their risk of obesity was greater. Multiparous women with the same excessive pregnancy weight gain in the first pregnancy and at least one additional short inter-pregnancy interval had a significant risk of obesity after childbirth. Perinatal interventions that prevent excessive pregnancy weight gain in the first pregnancy or lengthen the inter-pregnancy interval are necessary for reducing maternal obesity.

  16. Risco de suicídio em gestantes de alto risco: um estudo exploratório Risk of suicide in high risk pregnancy: an exploratory study

    Directory of Open Access Journals (Sweden)

    Gláucia Rosana Guerra Benute

    2011-10-01

    sugerem a importância da prevenção e diagnóstico precoce do risco para suicídio, pois ocasionar a própria morte é uma tentativa de mudar de uma esfera para outra à força, buscando solução para o que parece impossível.OBJECTIVE: To identify the risk of suicidal behavior in high-risk pregnant women at a public hospital in São Paulo. METHODS: We conducted a semi-structured interview with each of the participants (n = 268 through a previously prepared questionnaire. Risk of suicidal behavior was assessed by the Portuguese version of PRIME-MD. RESULTS: The mean age of patients was 29 years (SD = 0.507 and gestation period was 30 weeks (SD = 0.556. Of the total sample, specific risk of suicide was found in 5% (n = 14. Of these, 85% have a stable relationship (married or cohabitating, the pregnancy was planned in 50% of cases, and 71% have no religion or professional activities. The correlation of risk of suicide with data from marital status, planned birth, age, education, professional practice, risk of prematurity, and religion showed that having a religion is statistically significant (p = 0.012. There were no positive associations for any of the other selected variables when compared with the risk of suicide. By correlating the risk of suicide with other characteristic symptoms of major depression, there was statistical significance in the sample with regard to insomnia or hypersomnia (p = 0.003, fatigue or loss of energy (p = 0.001, decreased or increased appetite (p = 0.005, less interest in daily activities (p = 0.000, depressed mood (p = 0.000, feelings of worthlessness or guilt (p = 0.000, decreased concentration (p = 0.002, and agitation or psychomotor retardation (p = 0.002. CONCLUSION: We found that religion can be a protective factor against suicidal behavior. Besides providing a social support network needed by women during pregnancy, religion supports belief in life after death and in a loving God, giving purpose to life and self esteem and providing

  17. Adolescent pregnancy outcomes and risk factors in Malaysia.

    Science.gov (United States)

    Omar, Khairani; Hasim, Suriati; Muhammad, Noor Azimah; Jaffar, Aida; Hashim, Syahnaz Mohd; Siraj, Harlina Halizah

    2010-12-01

    To assess the outcomes and risk factors of adolescent pregnancies in 2 major hospitals in Malaysia. We conducted a case-control study of pregnant girls aged 10 through 19 years. The controls were women aged 20 through 35 years who did not become pregnant in their adolescence. Cases and controls were matched for parity and place of delivery. Data were collected from questionnaires and the hospitals' medical records. The study included 102 cases and 102 controls. There were significant associations between adolescent pregnancy and low education level, low socioeconomic status, being raised by a single parent, not engaging in extracurricular school activities, engaging in unsupervised activities with peers after school, and substance abuse (PAdolescent pregnancies are high-risk pregnancies. Better sexual health strategies are required to address the associated complications. Copyright © 2010 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  18. ANALYSIS OF RISK FACTORS ECTOPIC PREGNANCY

    Directory of Open Access Journals (Sweden)

    Budi Santoso

    2017-04-01

    Full Text Available Introduction: Ectopic pregnancy is a pregnancy with extrauterine implantation. This situation is gynecologic emergency that contributes to maternal mortality. Therefore, early recognition, based on identification of the causes of ectopic pregnancy risk factors, is needed. Methods: The design descriptive observational. The samples were pregnant women who had ectopic pregnancy at Maternity Room, Emergency Unit, Dr. Soetomo Hospital, Surabaya, from 1 July 2008 to 1 July 2010. Sampling technique was total sampling using medical records. Result: Patients with ectopic pregnancy were 99 individuals out of 2090 pregnant women who searched for treatment in Dr. Soetomo Hospital. However, only 29 patients were accompanied with traceable risk factors. Discussion:. Most ectopic pregnancies were in the age group of 26-30 years, comprising 32 patients (32.32%, then in age groups of 31–35 years as many as 25 patients (25.25%, 18 patients in age group 21–25 years (18.18%, 17 patients in age group 36–40 years (17.17%, 4 patients in age group 41 years and more (4.04%, and the least was in age group of 16–20 years with 3 patients (3.03%. A total of 12 patients with ectopic pregnancy (41.38% had experience of abortion and 6 patients (20.69% each in groups of patients with ectopic pregnancy who used family planning, in those who used family planning as well as ectopic pregnancy patients with history of surgery. There were 2 patients (6.90% of the group of patients ectopic pregnancy who had history of surgery and history of abortion. The incidence rate of ectopic pregnancy was 4.73%, mostly in the second gravidity (34.34%, whereas the nulliparous have the highest prevalence of 39.39%. Acquired risk factors, i.e. history of operations was 10.34%, patients with family planning 20.69%, patients with history of abortion 41.38%, patients with history of abortion and operation 6.90% patients with family and history of abortion was 20.69%.

  19. [Risks of intrahepatic cholestasis of pregnancy].

    Science.gov (United States)

    Bolier, A Ruth; Jebbink, Jiska M; van der Post, Joris A M; Oude Elferink, Ronald P J; Beuers, Ulrich

    2014-01-01

    Intrahepatic cholestasis of pregnancy (ICP) is defined as pruritus during pregnancy in the absence of primary skin lesions, combined with an increase in serum total bile salts and/or abnormal serum liver tests. This article provides an insight into the diagnostic and therapeutic considerations by presenting two cases. ICP usually presents around 34 weeks of gestation, but can be present early in pregnancy as described in a 32-year-old patient pregnant after in-vitro fertilization. DNA analysis showed a mutation in the ABCB4 gene, causing MDR3 deficiency. Ursodeoxycholic acid treatment seems to alleviate maternal pruritus and possibly reduces perinatal risks related to the severe form of ICP, defined as fasted serum bile salt levels of ≥ 40 μmol/l at any point during the pregnancy. Short-term rifampicin treatment can be considered in patients with persistent pruritus. Induction of labour is advised only after 37 weeks of gestation in patients with severe ICP.

  20. Outdoor Activity and High Altitude Exposure During Pregnancy: A Survey of 459 Pregnancies.

    Science.gov (United States)

    Keyes, Linda E; Hackett, Peter H; Luks, Andrew M

    2016-06-01

    To evaluate whether women engage in outdoor activities and high altitude travel during pregnancy; the health care advice received regarding high altitude during pregnancy; and the association between high altitude exposure and self-reported pregnancy complications. An online survey of women with at least 1 pregnancy distributed on websites and e-mail lists targeting mothers and/or mountain activities. Outcome measures were outdoor activities during pregnancy, high altitude (>2440 m) exposure during pregnancy, and pregnancy and perinatal complications. Hiking, running, and swimming were the most common activities performed during pregnancy. Women traveled to high altitude in over half of the pregnancies (244/459), and most did not receive counseling regarding altitude (355, 77%), although a small proportion (14, 3%) were told not to go above 2440 m. Rates of miscarriage and most other complications were similar between pregnancies with and without travel above 2440 m. Pregnancies with high altitude exposure were more likely to have preterm labor (odds ratio [OR] 2.3; 95% CI 0.97-5.4; P = .05). Babies born to women who went to high altitude during pregnancy were more likely to need oxygen at birth (OR 2.34; 95% CI 1.04-5.26; P < .05) but had similar rates of neonatal intensive care unit admission (P = not significant). Our results suggest pregnant women who are active in outdoor sports and travel to high altitude have a low rate of complications. Given the limitations of our data, further research is necessary on the risks associated with high altitude travel and physical activity and how these apply to the general population. Copyright © 2016 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.

  1. Effect of supplementation during pregnancy with L-arginine and antioxidant vitamins in medical food on pre-eclampsia in high risk population: randomised controlled trial.

    Science.gov (United States)

    Vadillo-Ortega, Felipe; Perichart-Perera, Otilia; Espino, Salvador; Avila-Vergara, Marco Antonio; Ibarra, Isabel; Ahued, Roberto; Godines, Myrna; Parry, Samuel; Macones, George; Strauss, Jerome F

    2011-05-19

    To test the hypothesis that a relative deficiency in L-arginine, the substrate for synthesis of the vasodilatory gas nitric oxide, may be associated with the development of pre-eclampsia in a population at high risk. Randomised, blinded, placebo controlled clinical trial. Tertiary public hospital in Mexico City. Pregnant women with a history of a previous pregnancy complicated by pre-eclampsia, or pre-eclampsia in a first degree relative, and deemed to be at increased risk of recurrence of the disease were studied from week 14-32 of gestation and followed until delivery. Supplementation with a medical food-bars containing L-arginine plus antioxidant vitamins, antioxidant vitamins alone, or placebo-during pregnancy. Development of pre-eclampsia/eclampsia. 222 women were allocated to the placebo group, 228 received L-arginine plus antioxidant vitamins, and 222 received antioxidant vitamins alone. Women had 4-8 prenatal visits while receiving the bars. The incidence of pre-eclampsia was reduced significantly (χ(2) = 19.41; P vitamins compared with placebo (absolute risk reduction 0.17 (95% confidence interval 0.12 to 0.21). Antioxidant vitamins alone showed an observed benefit, but this effect was not statistically significant compared with placebo (χ(2) = 3.76; P = 0.052; absolute risk reduction 0.07, 0.005 to 0.15). L-arginine plus antioxidant vitamins compared with antioxidant vitamins alone resulted in a significant effect (P = 0.004; absolute risk reduction 0.09, 0.05 to 0.14). Supplementation during pregnancy with a medical food containing L-arginine and antioxidant vitamins reduced the incidence of pre-eclampsia in a population at high risk of the condition. Antioxidant vitamins alone did not have a protective effect for prevention of pre-eclampsia. Supplementation with L-arginine plus antioxidant vitamins needs to be evaluated in a low risk population to determine the generalisability of the protective effect, and the relative contributions of L-arginine and

  2. High consumption of peanuts or tree nuts by non-allergic mothers around the time of pregnancy reduces the risk of nut allergy in the child.

    Science.gov (United States)

    Allen, Katrina J; Koplin, Jennifer J

    2015-04-01

    Implications for practice and research: Peanut or tree nut avoidance during pregnancy is not recommended for non-allergic mothers. Maternal nut consumption does not appear to increase the risk of nut allergy in offspring and may even be protective. Further research is required to clarify the role of maternal nut consumption during pregnancy and lactation; research should consider potential differential effects of the genetic risk of peanut allergy in children.

  3. Risk of hypertensive disorders in pregnancies following assisted reproductive technology

    DEFF Research Database (Denmark)

    Opdahl, S; Henningsen, A A; Tiitinen, A

    2015-01-01

    STUDY QUESTION: Is the risk of hypertensive disorders in pregnancies conceived following specific assisted reproductive technology (ART) procedures different from the risk in spontaneously conceived (SC) pregnancies? SUMMARY ANSWER: ART pregnancies had a higher risk of hypertensive disorders......, in particular following cryopreservation, with the highest risk seen in twin pregnancies following frozen-thawed cycles. WHAT IS KNOWN ALREADY: The risk of hypertensive disorders is higher in ART pregnancies than in SC pregnancies. The increased risk may be partly explained by multiple pregnancies...... twin pregnancies (46 674). We used logistic regression to estimate adjusted odds ratios and risk differences for hypertensive disorders in pregnancies following IVF, ICSI and fresh or frozen-thawed cycles. We also compared fresh and frozen-thawed cycles within mothers who had conceived following both...

  4. Creatine supplementation during pregnancy: summary of experimental studies suggesting a treatment to improve fetal and neonatal morbidity and reduce mortality in high-risk human pregnancy.

    Science.gov (United States)

    Dickinson, Hayley; Ellery, Stacey; Ireland, Zoe; LaRosa, Domenic; Snow, Rodney; Walker, David W

    2014-04-27

    While the use of creatine in human pregnancy is yet to be fully evaluated, its long-term use in healthy adults appears to be safe, and its well documented neuroprotective properties have recently been extended by demonstrations that creatine improves cognitive function in normal and elderly people, and motor skills in sleep-deprived subjects. Creatine has many actions likely to benefit the fetus and newborn, because pregnancy is a state of heightened metabolic activity, and the placenta is a key source of free radicals of oxygen and nitrogen. The multiple benefits of supplementary creatine arise from the fact that the creatine-phosphocreatine [PCr] system has physiologically important roles that include maintenance of intracellular ATP and acid-base balance, post-ischaemic recovery of protein synthesis, cerebral vasodilation, antioxidant actions, and stabilisation of lipid membranes. In the brain, creatine not only reduces lipid peroxidation and improves cerebral perfusion, its interaction with the benzodiazepine site of the GABAA receptor is likely to counteract the effects of glutamate excitotoxicity - actions that may protect the preterm and term fetal brain from the effects of birth hypoxia. In this review we discuss the development of creatine synthesis during fetal life, the transfer of creatine from mother to fetus, and propose that creatine supplementation during pregnancy may have benefits for the fetus and neonate whenever oxidative stress or feto-placental hypoxia arise, as in cases of fetal growth restriction, premature birth, or when parturition is delayed or complicated by oxygen deprivation of the newborn.

  5. Exercise in Pregnancy: First Trimester Risks

    DEFF Research Database (Denmark)

    Hegaard, Hanne K.; Ersbøll, Anne S; Damm, Peter

    2016-01-01

    in the first trimester and the risk of miscarriage. A systematic review based on the EMBASE and PUBMED databases was conducted and 5 studies assessing the association between early pregnancy exercise and miscarriage were identified. Diverging findings were reported making no clear conclusion possible. New...

  6. What Are the Factors That Put a Pregnancy at Risk?

    Science.gov (United States)

    ... Resources and Publications What are the factors that put a pregnancy at risk? Skip sharing on social ... hearing problems. 7 Cigarette smoking. Smoking during pregnancy puts the fetus at risk for preterm birth, certain ...

  7. Sexual Risk Behavior: HIV, STD, & Teen Pregnancy Prevention

    Science.gov (United States)

    ... Glance Project Connect Sexual Health STD Teen Pregnancy Sexual Risk Behaviors: HIV, STD, & Teen Pregnancy Prevention Recommend ... Tweet Share Compartir Many young people engage in sexual risk behaviors that can result in unintended health ...

  8. Prevalence and risk factors of asymptomatic bacteriuria in pregnancy1

    Directory of Open Access Journals (Sweden)

    Ghafarnezhad M

    2000-07-01

    Full Text Available Asymptomatic bacteriuria is prevalent during pregnancy. It can lead to pyelonephritis, premature pregnancy and low birth weight. In this prospective study, to determine prevalence and risk factors of asymptomatic bacteriuria, 205 consecutive pregnant women who visited our prenatal care clinic in Mirza-Koochakkhan Hospital and had no urinary symptom were entered. Patients data were recorded using a questionnaire and urine samples were obtained for urinalysis and urine culture. We analysed data by using fisher exact and chi-squared test. 14 cases had positive urine culture (6.8%. Significant correlation was seen between asymptomatic bacteriuria and age, parity, past history of kidney stone, pyelonephritis, urinary tract infection, preterm delivery and pyuria pvalue <0.05. We suggest routine urine culture in first visit of high risk and 16th week of low risk pregnancies.

  9. Prevalence and risk factors of asymptomatic bacteriuria in pregnancy

    Directory of Open Access Journals (Sweden)

    Ghafarnezhad M

    2001-07-01

    Full Text Available Asymptomatic bacteriuria is prevalent during pregnancy. It can lead to pyelonephritis, premature pregnancy and low birth weight. In this prospective study, to determine prevalence and risk factors of asymptomatic bacteriuria, 205 consecutive pregnant women who visited our prenatal care clinic in Mirza-Koochakkhan Hospital and had no urinary symptom were entered. Patients data were recorded using a questionnaire and urine samples were obtained for urinalysis and urine culture. We analysed data by using fisher exact and chi-squared test. 14 cases had positive urine culture (6.8%. Significant correlation was seen between asymptomatic bacteriuria and age, parity, past history of kidney stone, pyelonephritis, urinary tract infection, preterm delivery and pyuria pvalue <0.05. We suggest routine urine culture in first visit of high risk and 16th week of low risk pregnancies.

  10. Young Adult Outcomes Associated with Teen Pregnancy Among High-Risk Girls in an RCT of Multidimensional Treatment Foster Care.

    Science.gov (United States)

    Leve, Leslie D; Kerr, David C R; Harold, Gordon T

    2013-09-01

    Teen pregnancy is associated with a host of deleterious outcomes for girls such as drug use and poor parenting. Thus, reducing teen pregnancy rates could improve long-term developmental outcomes for girls, improving adjustment during young adulthood. Based on the positive effects of Multidimensional Treatment Foster Care (MTFC) relative to group care (GC) in a study of adolescent girls-significantly fewer pregnancies reported in the 2-year follow-up for MTFC girls-the present study followed this sample into young adulthood (approximately 7 years postbaseline) to examine the effects of adolescent pregnancy on young adult substance use and pregnancy-related outcomes. All participants were randomly assigned to MTFC (n = 81) or GC (n = 85) as adolescents as part of two RCTs. Results from logistic regression analyses indicated that becoming pregnant during the 2-year follow-up was significantly related to illicit drug use, miscarriage from a new pregnancy, and child welfare involvement at 7 years postbaseline. In addition, baseline marijuana use predicted marijuana use at 7 years postbaseline.

  11. 产前检查对高危妊娠的重要性%Importance of antenatal examination on high - risk pregnancy

    Institute of Scientific and Technical Information of China (English)

    徐冬梅; 党秋红; 孙利环

    2012-01-01

    目的 探讨产前检查对高危妊娠的重要性,加强孕期保健,减少高危产妇母婴并发症及降低死亡率.方法 回顾分析2009年4月-2010年3月在我院住院分娩的2000例孕产妇资料,选择其中高危妊娠患者200例(无产前检查)作为病例组.并选取无高危因素,无妊娠合并症及并发症的正常健康孕妇200例(产前检查次数≥5次)作为对照组,比较两组的围产期母婴情况.结果 对照组妊高症、妊娠期贫血、产后出血、早产及过期妊娠、早产儿、新生儿窒息、低体重、先天畸形发生率均比病例组明显降低.有显著差异(P<0.05).结论 产前检查是孕产妇系统保健中一项非常重要的措施,而高危妊娠系统检测是产前检查的核心内容,其目的不只是降低孕产妇死亡率和围产儿死亡率,还要减少伤残儿出生,提高人口健康素质.%Objective To investigate the importance of antenatal examination on high - risk pregnancy,to strengthen prenatal care, reduce maternal complications and infant mortality. Methods Retrospective analysis of April 2009— March 2010 in our hospital 2000 inpatient delivery maternal material, choose highrisk pregnancy patients 200 cases (no antenatal examination) as the treatment group. And selected no risk factors,no pregnancy complications and complications of normal healthy pregnant women in 200 cases ( antenatal examination times ≥5 times) as control group, compared with perinatal mother - to - child situation of two groups. Results The control group PIH, gestational anemia, postpartum hemorrhage,premature pregnancy,premature and expired,neonatal asphyxia,low weight,congenital malformation rates were significantly lower than those the treatment group. A significant difference (P < 0. 05 ). Conclusions Antenatal examination is an important measures in maternal care system,but the high - risk pregnancy systefn detection is the core content of antenatal examination, the purpose of

  12. Pregnancy and the risk of autoimmune disease.

    Directory of Open Access Journals (Sweden)

    Ali S Khashan

    Full Text Available Autoimmune diseases (AID predominantly affect women of reproductive age. While basic molecular studies have implicated persisting fetal cells in the mother in some AID, supportive epidemiological evidence is limited. We investigated the effect of vaginal delivery, caesarean section (CS and induced abortion on the risk of subsequent maternal AID. Using the Danish Civil Registration System (CRS we identified women who were born between 1960 and 1992. We performed data linkage between the CRS other Danish national registers to identify women who had a pregnancy and those who developed AID. Women were categorised into 4 groups; nulligravida (control group, women who had 1st child by vaginal delivery, whose 1st delivery was by CS and who had abortions. Log-linear Poisson regression with person-years was used for data analysis adjusting for several potential confounders. There were 1,035,639 women aged >14 years and 25,570 developed AID: 43.4% nulligravida, 44.3% had their first pregnancy delivered vaginally, 7.6% CS and 4.1% abortions. The risk of AID was significantly higher in the 1st year after vaginal delivery (RR = 1.1[1.0, 1.2] and CS (RR = 1.3[1.1, 1.5] but significantly lower in the 1st year following abortion (RR = 0.7[0.6, 0.9]. These results suggest an association between pregnancy and the risk of subsequent maternal AID. Increased risks of AID after CS may be explained by amplified fetal cell traffic at delivery, while decreased risks after abortion may be due to the transfer of more primitive fetal stem cells. The increased risk of AID in the first year after delivery may also be related to greater testing during pregnancy.

  13. Pregnancy and the risk of autoimmune disease.

    LENUS (Irish Health Repository)

    Khashan, Ali S

    2012-01-31

    Autoimmune diseases (AID) predominantly affect women of reproductive age. While basic molecular studies have implicated persisting fetal cells in the mother in some AID, supportive epidemiological evidence is limited. We investigated the effect of vaginal delivery, caesarean section (CS) and induced abortion on the risk of subsequent maternal AID. Using the Danish Civil Registration System (CRS) we identified women who were born between 1960 and 1992. We performed data linkage between the CRS other Danish national registers to identify women who had a pregnancy and those who developed AID. Women were categorised into 4 groups; nulligravida (control group), women who had 1st child by vaginal delivery, whose 1st delivery was by CS and who had abortions. Log-linear Poisson regression with person-years was used for data analysis adjusting for several potential confounders. There were 1,035,639 women aged >14 years and 25,570 developed AID: 43.4% nulligravida, 44.3% had their first pregnancy delivered vaginally, 7.6% CS and 4.1% abortions. The risk of AID was significantly higher in the 1st year after vaginal delivery (RR = 1.1[1.0, 1.2]) and CS (RR = 1.3[1.1, 1.5]) but significantly lower in the 1st year following abortion (RR = 0.7[0.6, 0.9]). These results suggest an association between pregnancy and the risk of subsequent maternal AID. Increased risks of AID after CS may be explained by amplified fetal cell traffic at delivery, while decreased risks after abortion may be due to the transfer of more primitive fetal stem cells. The increased risk of AID in the first year after delivery may also be related to greater testing during pregnancy.

  14. Screening pregnant women for group B streptococcus infection between 30 and 32 weeks of pregnancy in a population at high risk for premature birth.

    Science.gov (United States)

    Horváth, Boldizsar; Grasselly, Magdolna; Bödecs, Tamás; Boncz, Imre; Bódis, József

    2013-07-01

    To assess the benefits of a chemoprophylaxis program based on screening women for group B streptococcus (GBS) infection between 30 and 32 weeks of pregnancy in a population with a high rate of premature births. From 1995 to 2011, 24 950 women were screened for GBS infection between 30 and 32 weeks of pregnancy at Markusovszky Teaching Hospital, Szombathely, Hungary. Those who tested positive, and those who tested negative but were at risk of infecting their newborns, underwent intrapartum prophylaxis. Neonatal outcomes were compared with those of a historical cohort that underwent no screening or treatment, and with those published in CDC/ACOG guidelines recommending screening closer to term. There were 63 infected newborns (0.2%) in the study cohort, and 1 of 8 with sepsis died. There were 149 infected newborns (0.7%) in the historical cohort, and 29 of 31 with sepsis died. Screening women early in a population with a high rate of premature births may simplify preterm labor management. It results, however, in a higher incidence of early onset neonatal GBS disease than when screening is done closer to term. Copyright © 2013 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  15. Pregnancy Risk among Black, White, and Hispanic Teen Girls in New York City Public Schools

    OpenAIRE

    Waddell, Elizabeth Needham; Orr, Mark G.; Sackoff, Judith; Santelli, John S.

    2010-01-01

    Disparities in teen pregnancy rates are explained by different rates of sexual activity and contraceptive use. Identifying other components of risk such as race/ethnicity and neighborhood can inform strategies for teen pregnancy prevention. Data from the 2005 and 2007 New York City Youth Risk Behavior Surveys were used to model demographic differences in odds of recent sexual activity and birth control use among black, white, and Hispanic public high school girls. Overall pregnancy risk was c...

  16. Teenage Pregnancy

    Science.gov (United States)

    ... plan to get pregnant, but many do. Teen pregnancies carry extra health risks to both the mother ... later on. They have a higher risk for pregnancy-related high blood pressure and its complications. Risks ...

  17. Pregnancy-associated breast cancer and increased risk of pregnancy-associated recurrence: a case report

    OpenAIRE

    Schnabel Freya; Billig Jessica; Cimeno Arielle; Chun Jennifer

    2012-01-01

    Abstract Introduction Pregnancy-associated breast cancer refers to breast cancer diagnosed during pregnancy, lactation, or within twelve months postpartum. Recent studies suggest that, when matched for age and stage, the prognosis of pregnancy-associated breast cancer is comparable to non-pregnancy-associated breast cancer. However, the risk for breast cancer recurrence associated with subsequent pregnancies in this population is not clear. Case presentation We describe the case of a Caucasia...

  18. High risk of neonatal complications in children of mothers with gestational diabetes mellitus in their first pregnancy

    DEFF Research Database (Denmark)

    Wielandt, Hanne; Schønemann-Rigel, Helena; Blunck, Charlotte H.;

    2015-01-01

    Introduction: The study presents the neonatal outcome from a cohort of women with gestational diabetes mellitus (GDM) in their first pregnancy. Methods: During a five-year period (2009-2013), a prospective follow-up study was performed at the Department of Gynaecology and Obstetrics, Lillebaelt...

  19. Placenta previa with early opening of the uterine isthmus is associated with high risk of bleeding during pregnancy, and massive haemorrhage during caesarean delivery.

    Science.gov (United States)

    Goto, M; Hasegawa, J; Arakaki, T; Takita, H; Oba, T; Nakamura, M; Sekizawa, A

    2016-06-01

    To demonstrate the relationship between the timing of opening of the uterine isthmus and bleeding during pregnancy and caesarean section in patients with placenta previa. A prospective observational study was conducted at a single perinatal centre. All patients with placenta previa, diagnosed between 20 and 22 weeks of gestation, who were followed up at the study hospital and underwent caesarean section were enrolled. The condition of the uterine isthmus was examined every 2 weeks. The timing (in gestational weeks) of complete opening of the uterine isthmus was determined. Patients were divided into two groups: patients in whom the uterine isthmus opened before 25 weeks of gestation (EO-previa), and patients in whom the uterine isthmus opened after 25 weeks of gestation (LO-previa). The frequency of bleeding during pregnancy and the amount of intra-operative bleeding were compared between the two groups. Forty-four cases of EO-previa and 55 cases of LO-previa were analysed. Complete placenta previa at delivery was observed more frequently in the EO-previa group than in the LO-previa group (88.6% vs 47.3%, pprevia group (48%) than in the LO-previa group (25%) (p=0.021). The frequency of massive haemorrage (>2500ml) during caesarean section was higher in the EO-previa group than in the LO-previa group (25% vs 9%, p=0.033). Placenta previa was associated with a high risk of bleeding leading to emergency caesarean section during pregnancy, and massive haemorrhage during caesarean section in patients in whom the uterine isthmus opened before 25 weeks of gestation. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  20. Mothers' pre-pregnancy BMI and weight gain during pregnancy and risk of breast cancer in daughters.

    Science.gov (United States)

    Wilson, Kathryn M; Willett, Walter C; Michels, Karin B

    2011-11-01

    Previous studies have established that higher birthweight is associated with increased risk of breast cancer. However, the mechanisms underlying this association remain unclear. We explored whether maternal pregnancy weight gain and pre-pregnancy body mass index (BMI), which influence birthweight, are associated with risk of breast cancer in offspring. The Nurses' Mothers case-control study of breast cancer was nested in the Nurses' Health Study I and II cohorts. Mothers of 814 nurses with and 1,809 nurses without breast cancer completed questionnaires with information on pre-pregnancy height and weight, pregnancy weight gain, and other aspects of their pregnancies with the nurse daughters. We calculated odds ratios for breast cancer using conditional logistic regression. Mean pregnancy weight gain was 23 lb, and average pre-pregnancy BMI was 21 kg/m². Mothers' weight gain during pregnancy was not associated with the daughters' risk of breast cancer. Compared to women whose mothers gained 20-29 lb, women whose mothers gained less than 10 lb had a relative risk of 0.92 (95% confidence interval [CI]: 0.62-1.36), adjusting for the age of the nurses. Women whose mothers gained 40 or more pounds had a relative risk of 0.82 (95% CI: 0.55-1.23). Mothers' pre-pregnancy BMI was not associated with the daughters' risk of breast cancer. Women whose mothers had a pre-pregnancy BMI of 30 or more had a relative risk of 0.77 (95% CI: 0.34-1.74) compared to those with BMI less than 20. Additional adjustment for prenatal factors or for nurses' characteristics later in life had no effect on the results. The association between birthweight and breast cancer risk is likely due to factors independent of mothers' weight gain during pregnancy or pre-pregnancy BMI. Because BMIs and pregnancy weight gains were lower in this population than today, we cannot rule out associations for very high pre-pregnancy BMIs or pregnancy weight gains.

  1. Fish Oil During Pregnancy May Cut Kids' Asthma Risk

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_162796.html Fish Oil During Pregnancy May Cut Kids' Asthma Risk ... Dec. 29, 2016 (HealthDay News) -- Women who take fish oil during their third trimester of pregnancy might ...

  2. Análise Computadorizada da Cardiotocografia Anteparto em Gestações de Alto Risco Computerized Antepartum Cardiotocography Analysis in High Risk Pregnancies

    Directory of Open Access Journals (Sweden)

    Roseli Mieko Yamamoto Nomura

    2002-01-01

    Full Text Available Objetivos: analisar a freqüência dos resultados das cardiotocografias computadorizadas realizadas em gestantes de alto risco e relacionar o critério proposto pelo sistema com os resultados perinatais. Métodos: estudamos prospectivamente 233 gestantes de alto risco que realizaram 485 cardiotocografias computadorizadas. Foram excluídos casos de anomalias fetais e os exames com perda de sinal superior a 20% (proporção de episódios de 3,75 milissegundos do traçado onde não se constata intervalo de pulso por perda de captação dos sinais de batimentos cardíacos fetais. Para estudo da associação da cardiotocografia com os resultados perinatais, analisou-se o último exame realizado na semana anterior ao parto (71 casos, excluindo-se casos com diagnóstico de diástole zero ou reversa na dopplervelocimetria das artérias umbilicais. Resultados: após a exclusão de 33 exames com perda de sinal superior a 20%, constatou-se que 404 cardiotocografias foram caracterizadas como normais (83,3%. Quanto à duração do exame, em 62,1% foi de até 20 minutos e em 79,0% de até 30 minutos. A análise das correlações com os resultados perinatais demonstrou associação significativa (pPurpose: to study computerized cardiotocography performed in high-risk pregnancies, analyze the results, and correlate the criteria to perinatal results. Patients and Methods: two hundred and thirty-three high-risk pregnancies were studied prospectively, performing a total of 485 computerized cardiotocographies. The exclusion criteria included fetal anomalies and signal loss over 20% (proportion of 3.75-millisecond periods in which there were no valid pulse intervals. The perinatal results of 71 pregnancies were correlated to the last cardiotocography, performed at least seven days before birth, excluding patients with absent or reversed end diastolic velocities in the umbilical arteries. Results: thirty-three examinations with signal loss over 20% were excluded. The

  3. Risk of inflammatory bowel disease according to self-rated health, pregnancy course, and pregnancy complications

    DEFF Research Database (Denmark)

    Harpsøe, Maria C; Jørgensen, Kristian Tore; Frisch, Morten;

    2013-01-01

    Poor self-rated health (SRH) has been connected to immunological changes, and pregnancy complications have been suggested in the etiology of autoimmune diseases including inflammatory bowel disease (IBD). We evaluated the impact of self-rated pre-pregnancy health and pregnancy course, hyperemesis......, gestational hypertension, and preeclampsia on risk of IBD....

  4. Pregnancy-related characteristics and breast cancer risk.

    Science.gov (United States)

    Brasky, Theodore M; Li, Yanli; Jaworowicz, David J; Potischman, Nancy; Ambrosone, Christine B; Hutson, Alan D; Nie, Jing; Shields, Peter G; Trevisan, Maurizio; Rudra, Carole B; Edge, Stephen B; Freudenheim, Jo L

    2013-09-01

    Breast tissues undergo extensive physiologic changes during pregnancy, which may affect breast carcinogenesis. Gestational hypertension, preeclampsia/eclampsia, gestational diabetes, pregnancy weight gain, and nausea and vomiting (N&V) during pregnancy may be indicative of altered hormonal and metabolic profiles and could impact breast cancer risk. Here, we examined associations between these characteristics of a woman's pregnancy and her subsequent breast cancer risk. Participants were parous women that were recruited to a population-based case-control study (Western New York Exposures and Breast Cancer Study). Cases (n = 960), aged 35-79 years, had incident, primary, histologically confirmed breast cancer. Controls (n = 1,852) were randomly selected from motor vehicle records (pregnancy experiences. Multivariable-adjusted logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). N&V during pregnancy was inversely associated with breast cancer risk. Relative to those who never experienced N&V, ever experiencing N&V was associated with decreased risk (OR 0.69, 95% CI 0.56-0.84) as were increased N&V severity (p trend pregnancies (p trend pregnancies. Associations were stronger for more recent pregnancies (breast cancer subtype including estrogen receptor and HER2 expression status. Other pregnancy characteristics examined were not associated with risk. We observed strong inverse associations between pregnancy N&V and breast cancer risk. Replication of these findings and exploration of underlying mechanisms could provide important insight into breast cancer etiology and prevention.

  5. Pregnancy loss and risk of ischaemic stroke and myocardial infarction

    NARCIS (Netherlands)

    Maino, Alberto; Siegerink, Bob; Algra, Ale|info:eu-repo/dai/nl/07483472X; Martinelli, Ida; Peyvandi, Flora; Rosendaal, Frits R.

    2016-01-01

    We investigated whether pregnancy loss increases the risk of arterial thrombosis in young women. Women (age 18–50 years) with ischaemic stroke (IS) or myocardial infarction (MI) and at least one pregnancy were compared for pregnancy loss in a control group. Odds ratios (OR) with 95% confidence inter

  6. Incidence and risk factors for exacerbations of asthma during pregnancy

    DEFF Research Database (Denmark)

    Ali, Zarqa; Ulrik, Charlotte Suppli

    2013-01-01

    Asthma is one of the most common chronic diseases among pregnant women. Acute exacerbations of asthma during pregnancy have an unfavorable impact on pregnancy outcome. This review provides an overview of current knowledge of incidence, mechanisms, and risk factors for acute exacerbations of asthma...... during pregnancy....

  7. Pregnancy-associated breast cancer and increased risk of pregnancy-associated recurrence: a case report

    Directory of Open Access Journals (Sweden)

    Schnabel Freya

    2012-06-01

    Full Text Available Abstract Introduction Pregnancy-associated breast cancer refers to breast cancer diagnosed during pregnancy, lactation, or within twelve months postpartum. Recent studies suggest that, when matched for age and stage, the prognosis of pregnancy-associated breast cancer is comparable to non-pregnancy-associated breast cancer. However, the risk for breast cancer recurrence associated with subsequent pregnancies in this population is not clear. Case presentation We describe the case of a Caucasian woman who was initially treated for pregnancy-associated breast cancer at age 23, three months after the birth of her third child. She underwent a total mastectomy with axillary node dissection, followed by chemotherapy and hormonal therapy. Ten years later, when the patient was 24 weeks pregnant with her fourth child, she presented with an ipsilateral chest wall recurrence of breast cancer. To the best of our knowledge, this represents the first reported case of a pregnancy-associated recurrence in a patient previously treated for pregnancy-associated breast cancer. Conclusion The case described here is the first report of a second occurrence of pregnancy-associated breast cancer. This case raises the possibility that pregnancy may represent a unique trigger for breast malignancy in a specific cohort of women. Although there is data showing no increase in the risk of recurrence for women who become pregnant after breast cancer treatment, pregnancy-associated breast cancer may be a distinct clinical category where subsequent pregnancies after treatment may confer an increased risk of recurrent disease.

  8. Inter-Pregnancy Weight Change and the Risk of Recurrent Pregnancy Complications.

    Directory of Open Access Journals (Sweden)

    Jacqueline M Wallace

    Full Text Available Women with specific adverse pregnancy outcomes in their first pregnancy may be receptive to inter-pregnancy weight management guidance aimed at preventing these complications reoccurring in subsequent pregnancies. Thus the association between inter-pregnancy weight change and the risk of recurrent pregnancy complications at the second pregnancy was investigated in a retrospective cohort study of 24,520 women with their first-ever and second consecutive deliveries in Aberdeen using logistic regression. Compared with women who were weight stable, weight loss (>2BMI units between pregnancies was associated with an increased risk of recurrent small for gestational age (SGA birth and elective Cesarean-section, and was protective against recurrent pre-eclampsia, placental oversize and large for gestational age (LGA birth. Conversely weight gain (>2BMI units between pregnancies increased the risk of recurrent gestational hypertension, placental oversize and LGA birth and was protective against recurrent low placental weight and SGA birth. The relationships between weight gain, and placental and birth weight extremes were evident only in women with a healthy weight at first pregnancy (BMI<25units, while that between weight gain and the increased risk of recurrent gestational hypertension was largely independent of first pregnancy BMI. No relationship was detected between inter-pregnancy weight change and the risk of recurrent spontaneous preterm delivery, labour induction, instrumental delivery, emergency Cesarean-section or postpartum hemorrhage. Therefor inter-pregnancy weight change impacts the risk of recurrent hypertensive disorders, SGA and LGA birth and women with a prior history of these specific conditions may benefit from targeted nutritional advice to either lose or gain weight after their first pregnancy.

  9. Delivery Analysis of 660 Cases of Maternal High-risk Pregnancy%660例高危妊娠孕产妇住院分娩情况分析

    Institute of Scientific and Technical Information of China (English)

    谢小红

    2009-01-01

    Objective to analyze of high-risk maternal risk factors and delivery situation. Methods 1980 cases in January 2004 to December 2004 delivery at hospital of maternal were retrospectivly analyzed,maternal high-risk pregnancy 660 cases,the occurrence rate was 33.3%. Results The high-risk pregnant women 505 cases of cesarean section,cesarean section rate of the total number of hospital deliveries accounted for 25.5 percent, accounting for high-risk pregnancy maternal 76.5%. 23 eases of postpartum hemorrhage, accounting for the high-risk pregnant women of 3.74%. 4 eases of hysterectomy,accounting for the high-risk pregnant women of 6‰. 15 cases of perinatal death,accounting for the high-risk pregnant women of 24.8‰ ,the total number of hospital deliveries 7.6%~. Conclusion The need to strengthen high-risk pregnancy management,and strict three-tier referral system,at least to reduce the occurrence of high-risk pregnancy to improve pregnancy outcome,reducing maternal and perinatal mortality.%目的 分析高危孕产妇的高危因素及分娩情况.方法 回顾性分析2004年1~12月住院分娩1980例孕产妇,其中高危妊娠孕产妇660例,发生率为33.3%.结果 高危孕产妇剖宫产505例,剖宫产率占住院分娩总数的25.5%,占高危妊娠产妇的76.5%;产后出血23例,占高危孕产妇的3.74%;子宫切除4例,占高危孕产妇的6‰;围产儿死亡15例,占高危孕产妇的24.8‰,占总住院分娩总数的7.6‰.结论 加强高危妊娠管理,严格三级转诊制度,最低限度地减少高危妊娠的发生,改善妊娠结局,降低孕产妇和围产儿的死亡率.

  10. Pregnancy at 65, risks and complications

    Directory of Open Access Journals (Sweden)

    Shailja Verma

    2016-01-01

    Full Text Available A 65-year-old postmenopausal pregnant woman was referred with antepartum hemorrhage at 29 weeks of gestation. Postadmission diagnosed with chronic hypertension, gestational diabetes mellitus, valvular heart disease, and placenta previa. Her pregnancy was terminated by cesarean delivery at 32 weeks as she had a bout of bleeding per vaginum. Most of the placenta was adherent with no plane of cleavage; therefore, cesarean hysterectomy was performed. Baby birth weight was 1650 g and was shifted to nursery for observation and mother needed Intensive Care Unit care postcesarean. On the 15th day, both healthy mother and baby were discharged. Although pregnancy is possible in postmenopausal women with hormone support but the incidence of complications remain very high. It raises a need for developing well-laid guidelines for performing in vitro fertilization in older age group women.

  11. Pregnancy

    DEFF Research Database (Denmark)

    Palmer, Keith T; Bonzini, Matteo; Bonde, Jens Peter Ellekilde

    2013-01-01

    Most pregnant women are exposed to some physical activity at work. This Concise Guidance is aimed at doctors advising healthy women with uncomplicated singleton pregnancies about the risks arising from five common workplace exposures (prolonged working hours, shift work, lifting, standing and heavy...... on pregnancy. Moreover, moderate physical exercise is thought to be healthy in pregnancy and most pregnant women undertake some physical work at home. The guidelines provide risk estimates and advice on counselling....

  12. Pre-conception counselling in primary care: Prevalence of risk factors among couples contemplating pregnancy

    NARCIS (Netherlands)

    Pal van der-Bruin, K.M. de; Cessie, S. le; Elsinga, J.; Jong de-Potjer, L.C.; Haeringen, A. van; Knuistingh Neven, A.; Verloove-Vanhorick, S.P.; Assendelft, P.

    2008-01-01

    The outcome of pregnancy can be influenced by several risk factors. Women who are informed about these risks during pre-conception counselling (PCC) have an opportunity to take preventive measures in time. Several studies have shown that high-risk populations have a high prevalence of such risk

  13. Pre-conception counselling in primary care: Prevalence of risk factors among couples contemplating pregnancy

    NARCIS (Netherlands)

    Pal van der-Bruin, K.M. de; Cessie, S. le; Elsinga, J.; Jong de-Potjer, L.C.; Haeringen, A. van; Knuistingh Neven, A.; Verloove-Vanhorick, S.P.; Assendelft, P.

    2008-01-01

    The outcome of pregnancy can be influenced by several risk factors. Women who are informed about these risks during pre-conception counselling (PCC) have an opportunity to take preventive measures in time. Several studies have shown that high-risk populations have a high prevalence of such risk fact

  14. Association between polycystic ovary syndrome and the risk of pregnancy complications

    Science.gov (United States)

    Yu, Hai-Feng; Chen, Hong-Su; Rao, Da-Pang; Gong, Jian

    2016-01-01

    Abstract Background: Polycystic ovary syndrome (PCOS) is inconsistently associated with increased risk of adverse pregnancy outcomes. The purpose of this meta-analysis was to summarize the evidence regarding the strength of the association between pregnancy in women with PCOS and pregnancy complications. Methods: We systematically searched PubMed, EmBase, and the Cochrane Library to identify observational studies up to January 2016. The primary focus was pregnancy outcomes, including gestational diabetes mellitus (GDM), preeclampsia, pregnancy-induced hypertension (PIH), preterm delivery, cesarean delivery, oligohydramnios, and polyhydramnios. Effect estimates were pooled using the random-effects model. The analysis was further stratified by factors that could affect these associations. Results: We included 40 observational studies that reported data on a total of 17,816 pregnancies with PCOS and 123,756 pregnancies without PCOS. Overall, PCOS in pregnancy was associated with greater risk of GDM, preeclampsia, PIH, preterm delivery, cesarean delivery, miscarriage, hypoglycemia, and perinatal death. However, PCOS in pregnancy had little or no effect on oligohydramnios, polyhydramnios, large-for-gestational age (LGA), small-for-gestational-age (SGA), fetal growth restriction (FGR), preterm premature membrane rupture, fasting blood glucose (FBG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglyceride, total cholesterol, congenital malformation, macrosomia, and respiratory distress syndrome. Subgroup analysis suggested that these associations might be influenced by study design and pre-BMI. Conclusion: PCOS in pregnancy is associated with a significantly increased risk of adverse pregnancy, fetal, and neonatal outcomes. PMID:28002314

  15. Risk of post-pregnancy hypertension in women with a history of hypertensive disorders of pregnancy

    DEFF Research Database (Denmark)

    Behrens, Ida; Basit, Saima; Melbye, Mads

    2017-01-01

    Objectives To determine how soon after delivery the risk of post-pregnancy hypertension increases in women with hypertensive disorders of pregnancy and how the risk evolves over time.Design Nationwide register based cohort study.Setting Denmark.Populations 482 972 primiparous women with a first l...

  16. First pregnancy characteristics, postmenopausal breast density, and salivary sex hormone levels in a population at high risk for breast cancer

    Directory of Open Access Journals (Sweden)

    Mary Mockus

    2015-06-01

    Conclusions and general significance: While reproductive characteristics, in particular parity, generally demonstrated independent associations with postmenopausal breast density and E, P and DHEA levels, T levels showed concordant inverse associations with age-at-first birth and breast density. These findings suggest that reproductive effects and later life salivary sex steroid hormone levels may have independent effects on later life breast density and cancer risk.

  17. Pregnancy loss and later risk of atherosclerotic disease

    DEFF Research Database (Denmark)

    Ranthe, Mattis Flyvholm; Andersen, Elisabeth Anne Wreford; Wohlfahrt, Jan;

    2013-01-01

    Pregnancy losses and atherosclerotic disease may be etiologically linked through underlying pathology. We examined whether miscarriage and stillbirth increase later risk of myocardial infarction, cerebral infarction, and renovascular hypertension.......Pregnancy losses and atherosclerotic disease may be etiologically linked through underlying pathology. We examined whether miscarriage and stillbirth increase later risk of myocardial infarction, cerebral infarction, and renovascular hypertension....

  18. Cytokines and the Risk of Preterm Delivery in Twin Pregnancies

    DEFF Research Database (Denmark)

    Rode, Line; Klein, Katharina; Larsen, Helle

    2012-01-01

    To estimate the association between cytokine levels in twin pregnancies and risk of spontaneous preterm delivery, including the effect of progesterone treatment.......To estimate the association between cytokine levels in twin pregnancies and risk of spontaneous preterm delivery, including the effect of progesterone treatment....

  19. Maternal smoking during pregnancy and risk of stillbirth

    DEFF Research Database (Denmark)

    Bjørnholt, Sarah M; Leite, Mimmi; Albieri, Vanna

    2016-01-01

    INTRODUCTION: Maternal smoking during pregnancy has been associated with an increased risk of stillbirth. Only a few studies have been conducted to determine whether smoking affects the risk of antepartum and intrapartum stillbirth differently or whether smoking cessation in early pregnancy reduc...

  20. High Blood Pressure and Pregnancy

    Science.gov (United States)

    ... fewer nutrients. This can lead to slow growth, low birth weight or preterm birth. Prematurity can lead to ... previous pregnancy, your doctor might recommend a daily low-dose aspirin — between 60 and 81 milligrams — beginning late in your first trimester. Your health care provider ...

  1. Overview on application of clinical abortion on high-risk early uterine pregnancy%高危早期宫内妊娠临床流产方法应用综述

    Institute of Scientific and Technical Information of China (English)

    袁照

    2011-01-01

    介绍了高危早期妊娠流产的概念、因素及目前几种终止高危早期宫内妊娠的临床流产方法,对各种方法的优缺点进行分析对比.并提出加强对高危流产手术的管理和重视、针对不同因素的高危早期妊娠选择合适的流产方法,是减少并发症发生、确保受术者安全的关键.%To study the concept and effect factors of high-risk early uterine pregnancy and introduce several clinical abortion methods at present of stopping high-risk early uterine pregnancy.The merits and demerits among these ways were compared and analyzed.Enhancing the management to highrisk abortion operation,paying enough attention to high-risk abortion operation,and choosing proper abortion ways according to the different factors of high-risk early uterine pregnancy are the key points to reduce the occurrence of complication and guarantee the safety of the patients who receive the abortion operation.

  2. Obesity in Early Pregnancy May Raise Child's Risk of Epilepsy

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_164428.html Obesity in Early Pregnancy May Raise Child's Risk of ... researchers said. "This means more severe grades of obesity correspond to increasingly higher risk," said study co- ...

  3. Postural balance and the risk of falling during pregnancy.

    Science.gov (United States)

    Cakmak, Bulent; Ribeiro, Ana Paula; Inanir, Ahmet

    2016-01-01

    Pregnancy is a physiological process and many changes occur in a woman's body during pregnancy. These changes occur in all systems to varying degrees, including the cardiovascular, respiratory, genitourinary, and musculoskeletal systems. The hormonal, anatomical, and physiological changes occurring during pregnancy result in weight gain, decreased abdominal muscle strength and neuromuscular control, increased ligamentous laxity, and spinal lordosis. These alterations shift the centre of gravity of the body, altering the postural balance and increasing the risk of falls. Falls during pregnancy can cause maternal and foetal complications, such as maternal bone fractures, head injuries, internal haemorrhage, abruption placenta, rupture of the uterus and membranes, and occasionally maternal death or intrauterine foetal demise. Preventative strategies, such as physical exercise and the use of maternity support belts, can increase postural stability and reduce the risk of falls during pregnancy. This article reviews studies that have investigated changes in postural balance and risk of falling during pregnancy.

  4. Adolescent substance use and unplanned pregnancy: strategies for risk reduction.

    Science.gov (United States)

    Connery, Hilary Smith; Albright, Brittany B; Rodolico, John M

    2014-06-01

    Substance use among adolescents increases the risk of unplanned pregnancies, which then increases the risk of fetal exposure to addictive, teratogenic substances. Specific interventions are necessary to target pregnancy planning and contraception among reproductive-age substance users. Screening for substance use using the CRAFFT is recommended in all health care settings treating adolescent patients. Screening for tobacco and nicotine use is also recommended along with the provision of smoking cessation interventions. Using motivational interviewing style and strategies is recommended to engage adolescents in discussions related to reducing substance use, risky sexual behavior, and probability of unplanned pregnancy or late-detection pregnancy.

  5. Moderate alcohol intake during pregnancy and risk of fetal death

    DEFF Research Database (Denmark)

    Andersen, Anne-Marie Nybo; Andersen, Per Kragh; Olsen, Jørn

    2012-01-01

    Controversies still exist regarding the existence of a 'safe' level of alcohol intake during pregnancy. The aim of this study was to assess the risk of fetal death (spontaneous abortion and stillbirth) according to maternal alcohol consumption in a large Danish pregnancy cohort.......Controversies still exist regarding the existence of a 'safe' level of alcohol intake during pregnancy. The aim of this study was to assess the risk of fetal death (spontaneous abortion and stillbirth) according to maternal alcohol consumption in a large Danish pregnancy cohort....

  6. Dermatoses of Pregnancy - Clues to Diagnosis, Fetal Risk and Therapy

    Science.gov (United States)

    2011-01-01

    The specific dermatoses of pregnancy represent a heterogeneous group of pruritic skin diseases that have been recently reclassified and include pemphigoid (herpes) gestationis, polymorphic eruption of pregnancy (syn. pruritic urticarial papules and plaques of pregnancy), intrahepatic cholestasis of pregnancy, and atopic eruption of pregnancy. They are associated with severe pruritus that should never be neglected in pregnancy but always lead to an exact work-up of the patient. Clinical characteristics, in particular timing of onset, morphology and localization of skin lesions are crucial for diagnosis which, in case of pemphigoid gestationis and intrahepatic cholestasis of pregnancy, will be confirmed by specific immunofluorescence and laboratory findings. While polymorphic and atopic eruptions of pregnancy are distressing only to the mother because of pruritus, pemphigoid gestationis may be associated with prematurity and small-for-date babies and intrahepatic cholestasis of pregnancy poses an increased risk for fetal distress, prematurity, and stillbirth. Corticosteroids and antihistamines control pemphigoid gestationis, polymorphic and atopic eruptions of pregnancy; intrahepatic cholestasis of pregnancy, in contrast, should be treated with ursodeoxycholic acid. This review will focus on the new classification of pregnancy dermatoses, discuss them in detail, and present a practical algorithm to facilitate the management of the pregnant patient with skin lesions. PMID:21909194

  7. Low back pain during pregnancy in Iranian women: Prevalence and risk factors.

    Science.gov (United States)

    Ansari, Noureddin Nakhostin; Hasson, Scott; Naghdi, Soofia; Keyhani, Sousan; Jalaie, Shohreh

    2010-01-01

    Low back pain (LBP) is a common and often disabling condition that deserves attention. Although LBP during pregnancy is a common clinical problem, only one study was found documenting prevalence of LBP during pregnancy in Iran. No investigation evaluated the diagnostic value of possible risk factors. The aims of the present, cross-sectional study were 1) to ascertain the prevalence of LBP of Iranian women during pregnancy and compare to other ethnic/cultural groups and 2) identify risk factors associated with LBP during pregnancy in Iranian women. One hundred three women were interviewed in the obstetric ward of a university hospital within 48 hours after giving birth. Possible risk factor associations were studied by using nonparametric tests, and sensitivity, specificity, positive and negative predictive, and likelihood ratio values were calculated for the interview questions about previous low back pain, LBP during menstruation, and trauma during pregnancy. The prevalence of LBP during pregnancy was found to be 57.3%, which is similar to most other countries. Pain onset was most frequently reported in the third trimester of pregnancy (40.7%) and was often reported to be in the low back area (71.2%). Almost half of the patients reported their pain as being moderate (44.1%). The logistic regression model demonstrated that the LBP during menstruation predicts a high risk for LBP during the current pregnancy. The study showed that LBP during menstruation and previous LBP may be useful tests for ruling out and ruling in LBP during pregnancy, respectively.

  8. Clinical investigation of risk factors in ectopic pregnancy

    Directory of Open Access Journals (Sweden)

    Ling-yun HU

    2013-05-01

    Full Text Available Objective  To discuss the relative and independent risk factors in ectopic pregnancy. Methods  The clinical data of 870 patients with ectopic pregnancy, admitted from 2005 to 2012, were retrospectively analyzed, with 800 cases of normal pregnancy serving as control. Monofactorial correlation analysis was used to analyze the related risk factor, and logistic regression analysis was used to analyze the independent risk factor. Results  Pelvic adhesion, previous operation, cesarean section delivery, number of pregnancy, artificial abortion, medical abortion, in vitrofertilization and embryo replacement (IVF-ER, and placement of intrauterine device (IUD are the risk factors of ectopic pregnancy, pelvic adhesion, artificial abortion, operation, number of pregnancies and IUD are the independent risk factors, and pelvic adhesion is the major risk factor. Conclusion  Avoidance of unexpected pregnancy as possible, reduction of the number of artificial abortion, prevention and treatment of genital duct inflammation, and standardization of pelvic operation may reduce the incidence of ectopic pregnancy.

  9. Pregnancy and the risk of autoimmune disease: An exploration.

    LENUS (Irish Health Repository)

    2012-01-31

    Fetal microchimerism is the study of persisting fetal cells in the mother years after pregnancy and the purported implications for her health and longevity. Due to the association between pregnancy and autoimmune disease (AID), and the preponderance of these diseases in women, laboratory studies have for years attempted to link microchimeric fetal cells with the onset of AID after pregnancy. This new study gave us the opportunity to examine for the first time if this theory could be proven clinically in a large cohort of women. By examining whether different types of delivery affected the onset of AID, we also aimed to indirectly relate this finding to fetal microchimerism. The results did suggest an association between pregnancy and the risk of subsequent maternal AID, with increased risks noted after caesarean section (CS) and decreased risks after abortion. This is the first epidemiological study on the risk of AID following pregnancy.

  10. Pregnancy and the risk of autoimmune disease: An exploration.

    Science.gov (United States)

    O'Donoghue, Keelin

    2011-07-01

    Fetal microchimerism is the study of persisting fetal cells in the mother years after pregnancy and the purported implications for her health and longevity. Due to the association between pregnancy and autoimmune disease (AID), and the preponderance of these diseases in women, laboratory studies have for years attempted to link microchimeric fetal cells with the onset of AID after pregnancy. This new study gave us the opportunity to examine for the first time if this theory could be proven clinically in a large cohort of women. By examining whether different types of delivery affected the onset of AID, we also aimed to indirectly relate this finding to fetal microchimerism. The results did suggest an association between pregnancy and the risk of subsequent maternal AID, with increased risks noted after caesarean section (CS) and decreased risks after abortion. This is the first epidemiological study on the risk of AID following pregnancy.

  11. Survey of high-risk pregnancy maternal depression and related factors%高危妊娠孕产妇抑郁情况及相关因素分析

    Institute of Scientific and Technical Information of China (English)

    张滢

    2014-01-01

    目的:分析影响高危妊娠孕产妇抑郁情况及相关社会心理因素。方法选择200例孕32~36周孕产妇为研究对象。100名诊断为高危妊娠,为高危妊娠组,100名妊娠期无异常,为对照组。分别在入组时、产前1周、产后1周,产后42d采用抑郁自评量表评价孕产妇抑郁症状发生率,在产后1周和产后42d采用爱丁堡产后抑郁量表评价产妇产后抑郁发生率,并分析高危产妇产后抑郁的相关因素。结果产前1周高危妊娠组存在抑郁情绪发生率显著高于对照组(P<0.01)。高危妊娠组产前1周SDS评分与产后42d的EPDS具有相关性,对照组产前1周SDS评分与产后1周EPDS评分具有相关性(P<0.05)。待产准备、担心分娩安全为影响高危妊娠孕产妇抑郁的相关因素(P<0.05)。结论产前1周高危妊娠组存在抑郁情绪发生率较高,待产准备、担心分娩安全为影响高危妊娠孕产妇抑郁的相关因素。%Objective To analyze high-risk pregnancy maternal depression and related factors. Methods 200 cases with 32 to 36 weeks gestational maternal were selected for studying. 100 cases were diagnosed high-risk pregnancy as high-risk pregnancy group, and 100 cases without exception as the control group. The incidences of maternal depressive symptoms were evaluated using the self-rating depression scale at enrolled in study, the prenatal one week, one week postpartum, and postpartum 42 days. The incidences of postpartum depression were evaluated using the Edinburgh Postnatal Depression Scale in one week postpartum and postnatal 42 days, and related factors of high-risk pregnancy maternal depression were analyzed. Results Depression of high-risk pregnancy group incidence at prenatal one week was significantly higher than control group(P<0.01). High-risk pregnancy group prenatal one week SDS scores were correlated with postpartum 42 days of EPDS, and control group prenatal one week SDS

  12. ICP围产儿不良结局的高危因素分析%High risk factors for adverse outcomes of perinatal infants of intrahepatic cholestasis pregnancy

    Institute of Scientific and Technical Information of China (English)

    刘翠; 王勇; 楼方

    2015-01-01

    Objective To discuss the high risk factors for adverse outcomes of perinatal infants in intrahepatic cholestasis of pregnancy ( ICP) . Methods The ICP cases were collected from Affiliated Hospital of Chengdu University. The relationship between obstetric factors and adverse outcomes of perinatal infants was retrospectively analyzed with the data of 522 cases of ICP. Results Univariate analysis showed that the time of onset earlier than 34 gestational week, high TBA, high ALT, high TBIL, high DBIL, and complicated hypertension were statistically significant (χ2 value was 35. 079, 15. 140, 12. 155, 6. 142, 9. 988 and 12. 604, respectively, all P <0. 05). Logistic regression analysis indicated that time of onset earlier than 34 gestational week, high TBA and complicated hypertension were high risk factors for adverse outcomes of ICP perinatal infants (OR value was 2. 922, 1. 770 and 1. 861, respectively, all P<0. 05). Conclusion TBA≥40μmol/L, time of onset earlier than 34 gestational week and complicated high hypertension are risk factors for adverse outcomes of ICP perinatal infants.%目的:探讨妊娠期肝内胆汁淤积症( ICP)围产儿不良结局的高危因素。方法收集在成都大学附属医院住院分娩的ICP病例。回顾性分析522例ICP病例的产科因素与围产儿不良结局之间的关系。结果单因素分析发现发病时间≤孕34周、高总胆汁酸( TBA)、高谷丙转氨酶( ALT)、高总胆红素( TBIL)、高直接胆红素( DBIL)、合并高血压对围产儿不良结局均有统计学差异(χ2值分别为35.079、15.140、12.155、6.142、9.988、12.604,均P<0.05);经Logistic回归分析发现ICP的发病时间≤孕34周、高TBA、合并高血压系ICP围产儿不良结局的高危因素,其OR值分别为2.922、1.770、1.861,均P<0.05。结论 TBA≥40μmol/L、发病时间≤孕34周、合并高血压系ICP围产儿不良结局的高危因素。

  13. Teen Pregnancy : Are Pregnancies following an Elective Termination Associated with Increased Risk for Adverse Perinatal Outcomes?

    NARCIS (Netherlands)

    van Veen, Teelkien R.; Haeri, Sina; Baker, Arthur M.

    2015-01-01

    Study Objective: The authors sought to determine whether pregnancies in adolescents following an abortion of pregnancy is associated with an elevated risk for adverse perinatal outcomes. Methods: In a cohort study of all adolescent (younger than 18 years) deliveries over a 4-year period at 1 institu

  14. Teen Pregnancy : Are Pregnancies following an Elective Termination Associated with Increased Risk for Adverse Perinatal Outcomes?

    NARCIS (Netherlands)

    van Veen, Teelkien R.; Haeri, Sina; Baker, Arthur M.

    2015-01-01

    Study Objective: The authors sought to determine whether pregnancies in adolescents following an abortion of pregnancy is associated with an elevated risk for adverse perinatal outcomes. Methods: In a cohort study of all adolescent (younger than 18 years) deliveries over a 4-year period at 1

  15. Contraceptive Use Among Nonpregnant and Postpartum Women at Risk for Unintended Pregnancy, and Female High School Students, in the Context of Zika Preparedness - United States, 2011-2013 and 2015.

    Science.gov (United States)

    Boulet, Sheree L; D'Angelo, Denise V; Morrow, Brian; Zapata, Lauren; Berry-Bibee, Erin; Rivera, Maria; Ellington, Sascha; Romero, Lisa; Lathrop, Eva; Frey, Meghan; Williams, Tanya; Goldberg, Howard; Warner, Lee; Harrison, Leslie; Cox, Shanna; Pazol, Karen; Barfield, Wanda; Jamieson, Denise J; Honein, Margaret A; Kroelinger, Charlan D

    2016-08-05

    Zika virus infection during pregnancy can cause congenital microcephaly and brain abnormalities (1,2). Since 2015, Zika virus has been spreading through much of the World Health Organization's Region of the Americas, including U.S. territories. Zika virus is spread through the bite of Aedes aegypti or Aedes albopictus mosquitoes, by sex with an infected partner, or from a pregnant woman to her fetus during pregnancy.* CDC estimates that 41 states are in the potential range of Aedes aegypti or Aedes albopictus mosquitoes (3), and on July 29, 2016, the Florida Department of Health identified an area in one neighborhood of Miami where Zika virus infections in multiple persons are being spread by bites of local mosquitoes. These are the first known cases of local mosquito-borne Zika virus transmission in the continental United States.(†) CDC prevention efforts include mosquito surveillance and control, targeted education about Zika virus and condom use to prevent sexual transmission, and guidance for providers on contraceptive counseling to reduce unintended pregnancy. To estimate the prevalence of contraceptive use among nonpregnant and postpartum women at risk for unintended pregnancy and sexually active female high school students living in the 41 states where mosquito-borne transmission might be possible, CDC used 2011-2013 and 2015 survey data from four state-based surveillance systems: the Behavioral Risk Factor Surveillance System (BRFSS, 2011-2013), which surveys adult women; the Pregnancy Risk Assessment Monitoring System (PRAMS, 2013) and the Maternal and Infant Health Assessment (MIHA, 2013), which surveys women with a recent live birth; and the Youth Risk Behavior Survey (YRBS, 2015), which surveys students in grades 9-12. CDC defines an unintended pregnancy as one that is either unwanted (i.e., the pregnancy occurred when no children, or no more children, were desired) or mistimed (i.e., the pregnancy occurred earlier than desired). The proportion of

  16. Risk factors of systemic lupus erythematosus flares during pregnancy.

    Science.gov (United States)

    Jara, Luis J; Medina, Gabriela; Cruz-Dominguez, Pilar; Navarro, Carmen; Vera-Lastra, Olga; Saavedra, Miguel A

    2014-12-01

    This review examines the risk factors for the development of systemic lupus erythematosus (SLE) flares during pregnancy. In preconception, anti-DNA, hypocomplementemia, previous thrombosis, triple antiphospholipid (aPL) antibody positivity, active lupus nephritis and discontinuation of medications such as hydroxychloroquine and azathioprine are factors associated with pregnancy failure. During pregnancy, SLE flares are associated with aPL antibodies, synergic changes of pregnancy on Th1 and TH2 cytokines, other cytokines and chemokines that interact with hormones such as estrogen and prolactin that amplify the inflammatory effect. From the clinical point of view, SLE activity at pregnancy onset, thrombocytopenia, lupus nephritis, arterial hypertension, aPL syndromes, preeclampsia is associated with lupus flares and fetal complications. In puerperium, the risk factors of flares are similar to pregnancy. Hyperactivity of immune system, autoantibodies, hyperprolactinemia, active lupus nephritis, decrease in TH2 cytokines with increase in TH1 cytokines probably participate in SLE flare. The SLE flares during pregnancy make the difference between an uncomplicated pregnancy and pregnancy with maternal and fetal complications. Therefore, the knowledge of risk factors leads the best treatment strategies to reduce flares and fetal complications in SLE patients.

  17. [Hypothyroidism during pregnancy risks the child's neurocognitive development. New guidelines and remaining knowledge gaps].

    Science.gov (United States)

    Skalkidou, Alkistis; Bixo, Marie; Sköldebrand Sparre, Ann-Charlotte; Strandell, Annika; Lindén Hirschberg, Angelica; Filipsson Nyström, Helena

    2016-02-05

    Thyroid abnormalities are common during pregnancy and can affect pregnancy outcome. In 2012, the working group for endocrinology was assigned by SFOG to develop evidence based guidelines for their management. There is high quality evidence that untreated clinical hypothyroidism increases the risk of pregnancy and fetal complications. Subclinical hypothyroidism is associated with pregnancy complications. The presence of TPO-antibodies is linked to miscarriage and premature birth. It is uncertain whether subclinical hypothyroidism/maternal TPO-antibodies adversely affect the child's neurocognitive development. Reference intervals for TSH among pregnant women in Sweden need to be established.

  18. Randomized Controlled Trial Investigating the Effects of a Low-Glycemic Index Diet on Pregnancy Outcomes in Women at High Risk of Gestational Diabetes Mellitus: The GI Baby 3 Study.

    Science.gov (United States)

    Markovic, Tania P; Muirhead, Ros; Overs, Shannon; Ross, Glynis P; Louie, Jimmy Chun Yu; Kizirian, Nathalie; Denyer, Gareth; Petocz, Peter; Hyett, Jon; Brand-Miller, Jennie C

    2016-01-01

    Dietary interventions can improve pregnancy outcomes in women with gestational diabetes mellitus (GDM). We compared the effect of a low-glycemic index (GI) versus a conventional high-fiber (HF) diet on pregnancy outcomes, birth weight z score, and maternal metabolic profile in women at high risk of GDM. One hundred thirty-nine women [mean (SD) age 34.7 (0.4) years and prepregnancy BMI 25.2 (0.5) kg/m(2)] were randomly assigned to a low-GI (LGI) diet (n = 72; target GI ∼50) or a high-fiber, moderate-GI (HF) diet (n = 67; target GI ∼60) at 14-20 weeks' gestation. Diet was assessed by 3-day food records and infant body composition by air-displacement plethysmography, and pregnancy outcomes were assessed from medical records. The LGI group achieved a lower GI than the HF group [mean (SD) 50 (5) vs. 58 (5); P diet and a healthy diet produce similar pregnancy outcomes. © 2016 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

  19. Screening and triage of intrauterine growth restriction (IUGR in general population and high risk pregnancies: a systematic review with a focus on reduction of IUGR related stillbirths

    Directory of Open Access Journals (Sweden)

    Siddiqui Saad

    2011-04-01

    Full Text Available Abstract Background There is a strong association between stillbirth and fetal growth restriction. Early detection and management of IUGR can lead to reduce related morbidity and mortality. In this paper we have reviewed effectiveness of fetal movement monitoring and Doppler velocimetry for the detection and surveillance of high risk pregnancies and the effect of this on prevention of stillbirths. We have also reviewed effect of maternal body mass index (BMI screening, symphysial-fundal height measurement and targeted ultrasound in detection and triage of IUGR in the community. Methods We systematically reviewed all published literature to identify studies related to our interventions. We searched PubMed, Cochrane Library, and all World Health Organization Regional Databases and included publications in any language. Quality of available evidence was assessed using GRADE criteria. Recommendations were made for the Lives Saved Tool (LiST based on rules developed by the Child Health Epidemiology Group. Given the paucity of evidence related to the effect of detection and management of IUGR on stillbirths, we undertook Delphi based evaluation from experts in the field. Results There was insufficient evidence to recommend against or in favor of routine use of fetal movement monitoring for fetal well being. (1 Detection and triage of IUGR with the help of (1a maternal BMI screening, (1b symphysial-fundal height measurement and (1c targeted ultrasound can be an effective method of reducing IUGR related perinatal morbidity and mortality. Pooled results from sixteen studies shows that Doppler velocimetry of umbilical and fetal arteries in ‘high risk’ pregnancies, coupled with the appropriate intervention, can reduce perinatal mortality by 29 % [RR 0.71, 95 % CI 0.52-0.98]. Pooled results for impact on stillbirth showed a reduction of 35 % [RR 0.65, 95 % CI 0.41-1.04]; however, the results did not reach the conventional limits of statistical

  20. Teenage pregnancy: a psychopathological risk for mothers and babies?

    Science.gov (United States)

    Goossens, Gwendoline; Kadji, Caroline; Delvenne, Veronique

    2015-09-01

    Teen pregnancy remains a public health problem of varying importance in developing and developed countries. There are risks and consequences for teen parents and the child on the medical and socioeconomic level. We conducted a literature search on multiple databases, focusing on the risk and the consequences of teen pregnancy and childbearing. We used different combined keywords as teen pregnancy, teen mother, teenage parents, teenage childbearing, teenage mother depression. Our search included different type of journals to have access on different views (medical, psychological, epidemiologic). The teen mothers are more at risk for postnatal depression, school dropout and bad socioeconomic status. The babies and children are more at risk for prematurity and low birthweight and later for developmental delays and behavior disorders. Pregnancy in adolescence should be supported in an interdisciplinary way (gynecologist, psychologist, child psychiatrist, midwives, pediatrician). We need further studies that allow targeting patients most at risk and personalizing maximum support.

  1. Risk Factors For Ectopic Pregnancy : A Case Control Study

    Directory of Open Access Journals (Sweden)

    Deshmukh J.S

    1999-01-01

    Full Text Available Research question: Which are the risk factors for ectopic pregnancy . Objective: To study the strength of association between hypothesised risk factors and ectopic pregnancy. Study design: Unmatched case- control study. Setting: Government Medical College, Hospital, Nagpur. Participants: 133 cases of ectopic pregnancy and equal number of controls (non pregnant women admitted to study hospital. Study variables : Pelvic inflammatory diseases, sexually transmitted diseases, IUD use at conception , past use of IUD, prior ectopic pregnancy, OC pills use at the time of conception, past use of OC pills, induced abortion, spontaneous abortion, infertility and pelvic and abdominal surgery. Statistical analysis: Odds ratios & their 95% CI, Pearson’s chi square test, unconditional logistic regression analysis and population attributable risk proportion. Results : Use of IUD at conception, prior ectopic pregnancy , pelvic inflammatory disease, sexually transmitted diseases, infertility, OC pills use at the time of conception, past use of IUD and induced abortion were found to be significantly associated with ectopic pregnancy. Conclusion: Identification of these risk factors for etopic pregnancy shall help in early detection and appropriate management in an individual case and it may help in devising a comprehensive preventive strategy for ectopic pregnancy

  2. Hypertension in Pregnancy and Future Cardiovascular Event Risk in Siblings.

    Science.gov (United States)

    Weissgerber, Tracey L; Turner, Stephen T; Mosley, Thomas H; Kardia, Sharon L R; Hanis, Craig L; Milic, Natasa M; Garovic, Vesna D

    2016-03-01

    Hypertension in pregnancy is a risk factor for future hypertension and cardiovascular disease. This may reflect an underlying familial predisposition or persistent damage caused by the hypertensive pregnancy. We sought to isolate the effect of hypertension in pregnancy by comparing the risk of hypertension and cardiovascular disease in women who had hypertension in pregnancy and their sisters who did not using the dataset from the Genetic Epidemiology Network of Arteriopathy study, which examined the genetics of hypertension in white, black, and Hispanic siblings. This analysis included all sibships with at least one parous woman and at least one other sibling. After gathering demographic and pregnancy data, BP and serum analytes were measured. Disease-free survival was examined using Kaplan-Meier curves and Cox proportional hazards regression. Compared with their sisters who did not have hypertension in pregnancy, women who had hypertension in pregnancy were more likely to develop new onset hypertension later in life, after adjusting for body mass index and diabetes (hazard ratio 1.75, 95% confidence interval 1.27-2.42). A sibling history of hypertension in pregnancy was also associated with an increased risk of hypertension in brothers and unaffected sisters, whereas an increased risk of cardiovascular events was observed in brothers only. These results suggest familial factors contribute to the increased risk of future hypertension in women who had hypertension in pregnancy. Further studies are needed to clarify the potential role of nonfamilial factors. Furthermore, a sibling history of hypertension in pregnancy may be a novel familial risk factor for future hypertension.

  3. Pregnancy after kidney transplantation: high rates of maternal complications

    Directory of Open Access Journals (Sweden)

    Cristina Candido

    Full Text Available Abstract Introduction: Women regain fertility a few time after renal transplantation. However, viability of pregnancy and maternal complications are still unclear. Objective: To describe the outcomes of pregnancies in kidney transplanted patients, focusing on maternal complications. Methods: Retrospective study of pregnancies in kidney transplanted patients between 2004 and 2014, followed up 12 months after delivery. Each pregnancy was considered an event. Results: There were 53 pregnancies in 36 patients. Mean age was 28 ± 5years. Pregnancy occurred 4.4 ± 3.0 years post-transplant. Immunosuppression before conception was tacrolimus, azathioprine, and prednisone in 74% of the cases. There were 15% miscarriages in the 1st trimester and 8% in 2nd trimester. In 41% of the cases, it was necessary to induce labor. From all births, 22% were premature and 17% very premature. There were 5% stillbirths and 5% of neonatal deaths. De novo proteinuria occurred in 60%, urinary tract infection in 23%, preeclampsia in 11%, acute rejection in 6%, and graft loss in 2% of the cases. It was observed a significant increase in creatinine at preconception comparing to 3rd trimester and follow-up (1.17 vs. 1.46 vs. 1.59 mg/dL, p < 0.001. Conclusion: Although the sample is limited, the number of miscarriages was higher than in the general population, with high rates of maternal complications. Sustained increase of creatinine suggests increased risk of graft loss in long-term.

  4. A meta-analysis of risk of pregnancy loss and caffeine and coffee consumption during pregnancy.

    Science.gov (United States)

    Li, Ji; Zhao, Hong; Song, Ju-Min; Zhang, Jing; Tang, Yin-Lan; Xin, Chang-Mao

    2015-08-01

    Previous reports of the relationship between pregnancy loss and caffeine/coffee consumption have been inconsistent. To evaluate the association between pregnancy loss and caffeine and coffee consumption. PubMed was searched for reports published before September 2014, with the keywords "caffeine," "coffee," "beverage," "miscarriage," "spontaneous abortion," and "fetal loss." Case-control and cohort studies were included when they had been reported in English, the exposure of interest was caffeine/coffee consumption during pregnancy, the outcome of interest was spontaneous abortion or fetal death, and multivariate-adjusted odds ratios (ORs) or risk ratios were provided or could be calculated. Data were extracted and combined ORs calculated. Overall, 26 studies were included (20 of caffeine and eight of coffee). After adjustment for heterogeneity, caffeine consumption was associated with an increased risk of pregnancy loss (OR 1.32, 95% confidence interval [CI] 1.24-1.40), as was coffee consumption (OR 1.11, 95% CI 1.02-1.21). A dose-response analysis suggested that risk of pregnancy loss rose by 19% for every increase in caffeine intake of 150 mg/day and by 8% for every increase in coffee intake of two cups per day. Consumption of caffeine and coffee during pregnancy seems to increase the risk of pregnancy loss. Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  5. Alcohol intake in pregnancy increases the child's risk of atopic dermatitis. the COPSAC prospective birth cohort study of a high risk population

    DEFF Research Database (Denmark)

    Carson, Charlotte Giwercman; Halkjaer, Liselotte Brydensholt; Jensen, Signe Marie

    2012-01-01

    Atopic dermatitis has increased four-fold over the recent decades in developed countries, indicating that changes in environmental factors associated with lifestyle may play an important role in this epidemic. It has been proposed that alcohol consumption may be one contributing risk factor...

  6. Physical activity, sedentary behavior and risk of hypertensive disorders of pregnancy in Hispanic women.

    Science.gov (United States)

    Chasan-Taber, Lisa; Silveira, Marushka; Pekow, Penelope; Braun, Barry; Manson, JoAnn E; Solomon, Caren G; Markenson, Glenn

    2015-02-01

    Prior studies of the association between physical activity and hypertensive disorders of pregnancy have been conflicting; the majority focused on leisure-time activity only, did not use physical activity questionnaires validated for pregnancy, and were conducted in primarily non-Hispanic white populations. We prospectively evaluated this association among 1240 Hispanic women in Proyecto Buena Salud. The Pregnancy Physical Activity Questionnaire, validated for use in pregnancy, was used to assess pre- and early pregnancy sports/exercise, household/caregiving, occupational and transportation activity. Diagnoses of hypertensive disorders of pregnancy were based on medical record abstraction and confirmed by the study obstetrician. A total of 49 women (4.0%) were diagnosed with a hypertensive disorder of pregnancy, including 32 women (2.6%) with pre-eclampsia. In age-adjusted analyses, high levels of early pregnancy household/caregiving activity were associated with reduced risk of total hypertensive disorders (OR = 0.4, 95% CI 0.1-0.9) and pre-eclampsia (OR = 0.3, 95% CI 0.1-0.9) relative to low levels; however, these findings were no longer statistically significant in multivariable models. Pre-pregnancy activity and pattern of activity from pre- to early-pregnancy were not significantly associated with risk. Finally, sedentary behavior was not significantly associated with hypertensive disorders. Findings from this prospective study of Hispanic women were consistent with those of prior prospective cohorts indicating that physical activity prior to and during early pregnancy does not significantly reduce risk of hypertensive disorders of pregnancy.

  7. Assessment of risk factors that influence pregnancy outcomes in ...

    African Journals Online (AJOL)

    Keywords: Pregnancy outcome, low birth weight, Apgar score, maternal age, Tanzania ... (2006) reported that, several risk factors influence neonatal mortality. ..... which is the lowest cut off point for the classification of normal blood pressure.

  8. Prospective risk of stillbirth and neonatal complications in twin pregnancies

    DEFF Research Database (Denmark)

    Cheong-See, Fiona; Schuit, Ewoud; Arroyo-Manzano, David

    2016-01-01

    OBJECTIVE: To determine the risks of stillbirth and neonatal complications by gestational age in uncomplicated monochorionic and dichorionic twin pregnancies. DESIGN: Systematic review and meta-analysis. DATA SOURCES: Medline, Embase, and Cochrane databases (until December 2015). REVIEW METHODS: ...

  9. Increased risk of ventral hernia recurrence after pregnancy

    DEFF Research Database (Denmark)

    Oma, Erling; Jensen, Kristian K.; Jorgensen, Lars N.

    2017-01-01

    Background: Female patients of reproductive age constitute a substantial portion of patients undergoing ventral hernia repair, however the impact of pregnancy on the risk of recurrence is scarcely documented. The aim of the study was to evaluate if pregnancy following ventral hernia repair...... was associated with an increased risk of recurrence. Methods: This nationwide cohort study included all female patients of reproductive age registered in the Danish Ventral Hernia Database with ventral hernia repair between 2007 and 2013. The primary outcome was ventral hernia recurrence. Multivariable extended...... of pregnancy on the risk of recurrence is scarcely documented. In this cohort study based on nationwide Danish registries, we found that pregnancy after ventral hernia repair was independently associated with an increased risk of ventral hernia recurrence....

  10. Acetaminophen During Pregnancy May Up Risk of ADHD in Kids

    Science.gov (United States)

    ... html Acetaminophen During Pregnancy May Up Risk of ADHD in Kids But only association found, and researchers ... their child will develop behavioral problems such as attention-deficit/hyperactivity disorder (ADHD), a new study suggests. Acetaminophen is generally ...

  11. Unwanted Pregnancy and Its Risk Factors Among Pregnant Women in Tehran, Iran

    Directory of Open Access Journals (Sweden)

    Nourollahpour Shiadeh

    2016-02-01

    Full Text Available Background Unwanted pregnancies remain a main public health problem worldwide. In Iran, comparative studies on the risk factors of unwanted pregnancies and their effects on maternal health are rare. Objectives This study was conducted to determine the risk factors of unwanted pregnancies and their impact on maternal behavior during pregnancy. Patients and Methods This case-control study was carried out on 240 pregnant women who referred to the healthcare centers of Shahid Beheshti University of Medical Science for receiving routine prenatal care. Of the 240 women, 120 had unwanted pregnancies (case and 120 had wanted pregnancies (control. Data collection was performed using a researcher-made questionnaire. The data were analyzed using chi-square tests, Fisher’s exact tests, t-tests, Mann Whitney U tests, odds ratios, and logistic regression analysis. Results Compared to women with wanted pregnancies, those with unwanted pregnancies were more employed (23.3% vs. 12.5%, P = 0.006, had lower education levels (P = 0.016, had lower incomes (P = 0.009, had more children (1.30 ± 1.08 vs. 0.53 ± 0.67, P = 0.001, and had more traditional marriages (15% vs. 3.3%, P = 0.002. Also, women with unwanted pregnancies had significantly lower tendencies to do prenatal care (P = 0.002, had a higher tendency to abortion (P = 0.001, had higher previous abortion attempts (P = 0.001, and had higher levels of unhealthy behaviors (P = 0.017 compared to those with wanted pregnancies. Conclusions Lower education and socioeconomic status, longer marriage duration, being employed, and unwilling of spouse were among the risk factors of unwanted pregnancies. These women are at high risk for unhealthy behaviors and have a higher tendency to abortion that consequently threatens their health.

  12. Hypertensive diseases in pregnancy and breast cancer risk

    OpenAIRE

    Opdahl, S.; Romundstad, P R; Alsaker, M D K; Vatten, L. J.

    2012-01-01

    Background: Hypertensive diseases in pregnancy may be associated with a reduced risk of breast cancer. Most previous studies are small and have shown conflicting results. Methods: In a cohort of 919 712 women who gave their first birth between 1967 and 2008, with linkage of information from two national registries, we assessed whether women with pregnancy hypertensive diseases are at reduced breast cancer risk. We used Cox regression to estimate hazard ratios (HRs) with 95% confidence interva...

  13. Avaliação da maturidade pulmonar fetal em gestações de alto risco Prenatal diagnosis of fetal lung maturity in high-risk pregnancies

    Directory of Open Access Journals (Sweden)

    Wladimir Taborda

    1998-07-01

    in 121 consecutive high-risk gestations at the São Paulo Hospital from January 1990 to January 1995. Delivery occurred within 3 days of fetal lung maturation testing. This is a prospective study in which the sensitivity, specificity, positive (PPV and negative predictive value (NPV of all the tests were determined. Neonatal respiratory outcome and amniocentesis results were stratified by gestational age for comparison. The distribution of the studied population according to maternal pathology was diabetes mellitus (48, hypertensive disorders (41, Rh isoimmunization (14 and miscellaneous (18. Respiratory distress (RD was present in 33 infants (27.2%, mainly in the diabetic group. There was no false negative using lung profile (all patients and foam stability tests among hypertensive pregnancies (specificity 100%, but there were about 20% to 50% false positives in the other tests. Overall, all four tests had a low PPV: 23% for foam test, 51% for L/S ratio, 63% for PG, 61% for lung profile, and high NPV: 92% for foam test, 88% for L/S ratio, 89% for PG and 100% for lung profile. All tests had less accuracy in the diabetic pregnant women. This study shows that the presence of PG and L/S ratio > 1.7 in the amniotic fluid of high-risk pregnancies confirms maturity with a very low risk to develop RD and that the foam stability test was useful as a first-line test to predict the absence of surfactant-deficient respiratory distress syndrome, particularly in hypertensive pregnant women.

  14. Systematic review of sexual risk among pregnant and mothering teens in the USA: pregnancy as an opportunity for integrated prevention of STD and repeat pregnancy.

    Science.gov (United States)

    Meade, Christina S; Ickovics, Jeannette R

    2005-02-01

    Behaviors that lead to teen pregnancy also place young women at risk for STDs and repeat pregnancy. Compared to the broad literature on adolescent sexual risk behavior, our understanding of sexual risk in pregnant/mothering teens lags far behind. Primary objectives of this systematic review (1981-2003) of pregnant/mothering teens were to: (1) document rates of STD, repeat pregnancy, condom use, and contraception; (2) identify correlates of these biological and behavioral outcomes; (3) review sexual risk reduction interventions; and (4) discuss directions for future research and implications for clinical care. Fifty-one studies met inclusion criteria. Rates of STD and repeat pregnancy were high, with the majority of teens engaging in unprotected sex during and after pregnancy. An Ecological Model of Sexual Risk, based on Bronfenbrenner's (1989) Ecological Systems Theory, was proposed to organize findings on correlates of sexual risk. Improvements in research, including integration of outcomes and risk factors, stronger methodologies, and standardized assessments, are essential. Results suggest that teen pregnancy is a marker for future sexual risk behavior and adverse outcomes, and that pregnant/mothering teens need hybrid interventions promoting dual use of condoms and hormonal contraception. Pregnancy may provide a critical "window of opportunity" for sexual risk reduction.

  15. Risk factors of thrombocytopenia in pregnancy

    Directory of Open Access Journals (Sweden)

    Ayisha Begam

    2017-01-01

    Conclusions: Thrombocytopenia should be evaluated by making a practice of routinely checking the platelet count and peripheral smear in early pregnancy and also in third trimester to enable early diagnosis since most cases may be asymptomatic.

  16. Maternal smoking in pregnancy and risk for congenital malformations

    DEFF Research Database (Denmark)

    Leite, Mimmi; Albieri, Vanna; Kjaer, Susanne K.

    2014-01-01

    OBJECTIVE: To examine the association between maternal smoking during pregnancy and risk for congenital malformations. DESIGN: Population-based prospective cohort study. SETTING: Denmark. POPULATION: A total of 838 265 singleton liveborn babies delivered in Denmark between 1997 and 2010 and regis....... Future smoking cessation programs should focus on this adverse health aspect in order to encourage more women to quit smoking before or in early pregnancy.......OBJECTIVE: To examine the association between maternal smoking during pregnancy and risk for congenital malformations. DESIGN: Population-based prospective cohort study. SETTING: Denmark. POPULATION: A total of 838 265 singleton liveborn babies delivered in Denmark between 1997 and 2010...... and registered in the Danish Medical Birth Register containing detailed information on smoking during pregnancy and congenital malformations. METHODS: Associations [odds ratios (OR) with 95% CI] between maternal smoking and risk for various groups of congenital malformations, investigated using the generalized...

  17. Pregnancies After the Diagnosis of Mild Gestational Diabetes Mellitus and Risk of Cardiometabolic Disorders.

    Science.gov (United States)

    Varner, Michael W; Rice, Madeline Murguia; Landon, Mark B; Casey, Brian M; Reddy, Uma M; Wapner, Ronald J; Rouse, Dwight J; Tita, Alan T N; Thorp, John M; Chien, Edward K; Saade, George R; Peaceman, Alan M; Blackwell, Sean C; Vandorsten, J Peter

    2017-02-01

    To assess the association of subsequent pregnancy with subsequent metabolic syndrome and type II diabetes mellitus after a pregnancy complicated by mild gestational diabetes mellitus (GDM). We conducted a prospective observational follow-up study of women with mild GDM randomized from 2002 to 2007 to usual care or dietary intervention and glucose self-monitoring. Women were evaluated 5-10 years after the parent study. Participants were grouped according to the number of subsequent pregnancies (group A, none [reference]; group B, one; group C, two or greater). Serum triglycerides, glucose tolerance, high-density lipoprotein cholesterol, blood pressure, and waist circumference were assessed. Metabolic syndrome was diagnosed by American Heart Association and National Heart Lung and Blood Institute criteria. Multivariable regression was used to estimate adjusted relative risks (RRs) and 95% confidence intervals (CIs). Of 905 eligible women from the original trial, 483 agreed to participate, 426 of whom were included in this analysis. Groups A, B, and C consisted of 212, 143, and 71 women, respectively. Of women with subsequent pregnancies, 32% (69/214) had another pregnancy complicated with GDM. No difference between groups was observed for metabolic syndrome (group A, 34%; group B, 33%; group C, 30%). Subsequent pregnancies were associated with diabetes mellitus outside of pregnancy (group A, 5.2%; group B, 10.5%, RR 2.62, 95% CI 1.16-5.91; group C, 11.3%, RR 2.83, 95% CI 1.06-7.59), and if complicated with GDM (no subsequent GDM pregnancy, RR 1.99, 95% CI 0.82-4.84; subsequent GDM pregnancy, RR 3.75, 95% CI 1.60-8.82). In women with prior mild GDM, subsequent pregnancies did not increase the frequency of metabolic syndrome, but subsequent pregnancies with GDM increased the risk of diabetes mellitus outside of pregnancy.

  18. Understanding Pregnancy and Birth Issues

    Science.gov (United States)

    ... Navigation Bar Home Current Issue Past Issues Understanding Pregnancy and Birth Issues Past Issues / Winter 2008 Table ... turn Javascript on. What is a High-Risk Pregnancy? All pregnancies involve a certain degree of risk ...

  19. Sequential screening for psychosocial and behavioural risk during pregnancy in a population of urban African Americans.

    Science.gov (United States)

    Kiely, M; Gantz, M G; El-Khorazaty, M N; El-Mohandes, A A E

    2013-10-01

    Screening for psychosocial and behavioural risks, such as depression, intimate partner violence, and smoking, during pregnancy is considered to be state of the art in prenatal care. This prospective longitudinal analysis examines the added benefit of repeated screening, compared with a single screening, in identifying such risks during pregnancy. Data were collected as part of a randomised controlled trial to address intimate partner violence, depression, smoking, and environmental tobacco smoke exposure in African American women. Prenatal care sites in the District of Columbia serving mainly women of minority background. A cohort of 1044 African American pregnant women in the District of Columbia. Mothers were classified by their initial response (acknowledgement of risks), and these data were updated during pregnancy. Risks were considered new if they were not previously reported. Standard hypothesis tests and logistic regression were used to predict the acknowledgment of any new risk(s) during pregnancy. New risks: psychosocial variables to understand what factors might help identify the acknowledgement of additional risk(s). Repeated screening identified more mothers acknowledging risk over time. Reported smoking increased by 11%, environmental tobacco smoke exposure increased by 19%, intimate partner violence increased by 9%, and depression increased by 20%. The psychosocial variables collected at the baseline that were entered into the logistic regression model included relationship status, education, Medicaid, illicit drug use, and alcohol use during pregnancy. Among these, only education less than high school was associated with the acknowledgement of new risk in the bivariate analyses, and significantly predicted the identification of new risks (OR 1.39, 95% CI 1.01-1.90). It is difficult to predict early on who will acknowledge new risks over the course of pregnancy, and thus all women should be screened repeatedly to allow for the identification of risks

  20. 常州市育龄妇女对高危妊娠认知行为分析%Knowledge and Practice survey of Reproductive Women on High-risk Pregnancy in Changzhou City

    Institute of Scientific and Technical Information of China (English)

    张雅英; 郝模; 蒋健; 白鸽; 吕军; 陈莉; 虞斌; 钱琴玉; 王秋伟

    2012-01-01

    目的:了解常州市育龄妇女对高危妊娠危险因素的知识掌握水平和行为现状,为建立针对育龄妇女的高危妊娠管理模式提供依据.方法:围绕育龄妇女的健康和需要,现场调查常州市8个社区的育龄妇女.结果:常州市育龄妇女对于妊娠危险因素知识的掌握程度良好(总合格率达到76.82%),而对于妊娠危险的主动就医程度仍偏低(合格率为53.64%),育龄妇女目前获取知识的主要来源为医院健康宣传栏/宣传手册、电视书刊网络和医务人员指导.结论:常州市在针对育龄妇女的高危妊娠管理中,要从以重点人群为主的管理策略拓展到全人群,建立多元化健康传播格局,最终形成供需双方联动的管理模式.%Objective:Provide evidence for prevention interventions of reproductive women on high-risk pregnancy. Methods: Knowledge and practice field survey of reproductive women on high-risk pregnancy in 8 communities of Changzhou City, and analysis of its impact factor. Results: Reproductive women had a good mastery of knowledge on high risk pregnancy with the total qualified rate 76.82%, while the initiative seeking treatment willing of reproductive women was at low level with the total qualified rate 53.64%. Currently, the main sources of high risk pregnancy knowledge were from hospital health promotion bar / brochures, television, books, networks and medical staffs. Conclusion: Changzhou should make full use of hospitals and doctors, positively carry out the long-term health education activities, increase the risk awareness of reproductive women, and promote their health behavior change.

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

    DEFF Research Database (Denmark)

    Virk, Jasveer; Zhang, Jun; Olsen, Jørn

    2007-01-01

    BACKGROUND: The long-term safety of surgical abortion in the first trimester is well established. Despite the increasing use of medical abortion (abortion by means of medication), limited information is available regarding the effects of this procedure on subsequent pregnancies. METHODS: We...... 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 ... weight (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...

  2. Obesity in pregnancy: addressing risks to improve outcomes.

    Science.gov (United States)

    Kriebs, Jan M

    2014-01-01

    The rapidly increasing rates of obesity among women of childbearing age, not only in the United States but also across the globe, contribute to increased risks during pregnancy and childbirth. Overweight and obesity are quantified by body mass index (BMI) for clinical purposes. In 2010, 31.9% of U.S. women aged 20 to 39 years met the definition of obesity, a BMI of 30 kg/m or greater. Across the life span, obesity is associated with increased risks of hypertension, cardiovascular disease, diabetes, sleep apnea, and other diseases. During pregnancy, increasing levels of prepregnancy BMI are associated with increases in both maternal and fetal/neonatal risks. This article reviews current knowledge about obesity in pregnancy and health risks related to increased maternal BMI, addresses weight stigma as a barrier to care and interventions that have evidence of benefit, and discusses the development of policies and guidelines to improve care.

  3. Pregnancy and Thoracic Aortic Disease: Managing the Risks.

    Science.gov (United States)

    Wanga, Shaynah; Silversides, Candice; Dore, Annie; de Waard, Vivian; Mulder, Barbara

    2016-01-01

    The most common aortopathies in women of childbearing age are bicuspid aortic valve, coarctation of the aorta, Marfan syndrome, Ehlers-Danlos syndrome, Loeys-Dietz syndrome, SMAD3 aortopathy, Turner syndrome, and familial thoracic aneurysm and dissection. The hemodynamic and hormonal changes of pregnancy increase the risk of progressive dilatation or dissection of the aorta in these women. The presence of hypertension increases the risk further. Therefore, appropriate preconception counselling is advised. For women who become pregnant, serial follow-up by a specialized multidisciplinary team throughout pregnancy and postpartum period is required. In this review we discuss risk assessment and management strategies for women with aortopathies.

  4. Binge drinking in pregnancy and risk of fetal death

    DEFF Research Database (Denmark)

    Strandberg-Larsen, Katrine; Nielsen, Naja Rod; Grønbaek, Morten;

    2008-01-01

    episodes was related to the risk of early (at or before 12 completed weeks) or late (13-21 completed weeks) spontaneous abortion. However, three or more binge episodes showed an adjusted hazard ratio of 1.56 (95% confidence interval 1.01-2.40) for stillbirth (22 or more completed weeks) relative...... pregnancy is associated with an increased risk of stillbirth, but neither frequency nor timing of binge drinking was associated with an increased risk of spontaneous abortion in clinically recognized pregnancies....

  5. Risk factors for unplanned pregnancy among young women in Tanzania

    OpenAIRE

    Calvert, Clara; Baisley, Kathy; Aoife M Doyle; Maganja, Kaballa; Changalucha, John; Watson-Jones, Deborah; Hayes, Richard J; Ross, David A

    2013-01-01

    Background With effective contraceptives available, unplanned pregnancies are preventable and educational interventions have been cited as a promising platform to increase contraceptive use through improving knowledge. However, results from trials of educational interventions have been disappointing. In order to effectively target future interventions, this study aimed to identify risk factors for unplanned pregnancy among young women in Mwanza, Tanzania. Methods Data were analysed from the M...

  6. Pregnancy

    DEFF Research Database (Denmark)

    Palmer, Keith T; Bonzini, Matteo; Bonde, Jens Peter Ellekilde;

    2013-01-01

    Most pregnant women are exposed to some physical activity at work. This Concise Guidance is aimed at doctors advising healthy women with uncomplicated singleton pregnancies about the risks arising from five common workplace exposures (prolonged working hours, shift work, lifting, standing and heavy...... physical workload). The adverse outcomes considered are: miscarriage, preterm delivery, small for gestational age, low birth weight, pre-eclampsia and gestational hypertension. Systematic review of the literature indicates that these exposures are unlikely to carry much of an increased risk for any...... on pregnancy. Moreover, moderate physical exercise is thought to be healthy in pregnancy and most pregnant women undertake some physical work at home. The guidelines provide risk estimates and advice on counselling....

  7. Sexual risk behavior and pregnancy in detained adolescent females: a study in Dutch detention centers

    Directory of Open Access Journals (Sweden)

    Jansen Lucres MC

    2007-06-01

    Full Text Available Abstract Background The purpose of this study was to investigate the lifetime prevalence of teenage pregnancy in the histories of detained adolescent females and to examine the relationship between teenage pregnancy on the one hand and mental health and sexuality related characteristics on the other. Methods Of 256 admitted detained adolescent females aged 12–18 years, a representative sample (N = 212, 83% was examined in the first month of detention. Instruments included a semi-structured interview, standardized questionnaires and file information on pregnancy, sexuality related characteristics (sexual risk behavior, multiple sex partners, sexual trauma, lack of assertiveness in sexual issues and early maturity and mental health characteristics (conduct disorder, alcohol and drug use disorder and suicidality. Results Approximately 20% of the participants reported having been pregnant (before detention, although none had actually given birth. Sexuality related characteristics were more prevalent in the pregnancy group, while this was not so for the mental health characteristics. Age at assessment, early maturity, sexual risk behavior, and suicidality turned out to be the best predictors for pregnancy. Conclusion The lifetime prevalence of pregnancy in detained adolescent females is high and is associated with both sexuality related risk factors and mental health related risk factors. Therefore, prevention and intervention programs targeting sexual risk behavior and mental health are warranted during detention.

  8. Sexual risk behavior and pregnancy in detained adolescent females: a study in Dutch detention centers

    Science.gov (United States)

    Hamerlynck, Sannie MJJ; Cohen-Kettenis, Peggy T; Vermeiren, Robert; Jansen, Lucres MC; Bezemer, Pieter D; Doreleijers, Theo AH

    2007-01-01

    Background The purpose of this study was to investigate the lifetime prevalence of teenage pregnancy in the histories of detained adolescent females and to examine the relationship between teenage pregnancy on the one hand and mental health and sexuality related characteristics on the other. Methods Of 256 admitted detained adolescent females aged 12–18 years, a representative sample (N = 212, 83%) was examined in the first month of detention. Instruments included a semi-structured interview, standardized questionnaires and file information on pregnancy, sexuality related characteristics (sexual risk behavior, multiple sex partners, sexual trauma, lack of assertiveness in sexual issues and early maturity) and mental health characteristics (conduct disorder, alcohol and drug use disorder and suicidality). Results Approximately 20% of the participants reported having been pregnant (before detention), although none had actually given birth. Sexuality related characteristics were more prevalent in the pregnancy group, while this was not so for the mental health characteristics. Age at assessment, early maturity, sexual risk behavior, and suicidality turned out to be the best predictors for pregnancy. Conclusion The lifetime prevalence of pregnancy in detained adolescent females is high and is associated with both sexuality related risk factors and mental health related risk factors. Therefore, prevention and intervention programs targeting sexual risk behavior and mental health are warranted during detention. PMID:17683633

  9. 北京市大兴区202例重症高危妊娠孕产妇危险因素分析及管理对策%High risk factors and management measures on 202 cases of maternal high-risk pregnancy in Daxing district of Beijing

    Institute of Scientific and Technical Information of China (English)

    李砚颖

    2016-01-01

    Objective To analyze the high risk factors of maternal high-risk pregnancy of Daxing district in Beijing, in order to provide the basis for scientific and effective management. Methods A total of 202 maternal high-risk pregnancys from October 2014 to September 2015 in 20 district health stations,10 midwifery institutions of obstetric outpatient service in Daxing District were selected,which were screening and management according to the ﹤Classification Standard of Maternal Risk Factors in Beijing City ﹥ and ﹤ Job Specification of Management of High Risk Pregnant Women in Beijing Daxing District﹥. The classification was according to the city,the other region of the country,the maternal age,register time,pregnancy history, time of onset,reporting to the department,outcome,times of prenatal examination were calculated,the risk factors and differ-ent pregnancy outcome were calculated. Results Among 202 maternal high-risk pregnancy,nonlocal census register was 116 cases,accounted for 55. 50%. Less than or equal to 18 years old of childbirth of pregnant and lying in women in the field of household registration accounted for 0. 99%,which was higher than the residence registration of the municipality;maternal age in the field of household registration accounted for 7. 42%,which was higher than the residence registration of the municipality of 4. 46%;then pregnant multiparous pregnant women in the field of household registration accounted for 34. 65%,which was higher than the residence registration of the municipality of 18. 32%;early pregnancy built nonlocal census register representing 22. 77%,which was lower than the residence registration of the municipality of 35. 64%;estate examination times 8 times in the field of household registration accounted for 2. 48% and higher than that of the city residence,times of prenatal examination more than 12 times nonlocal census register accounted for 17. 33%,which was lower than the city of 26. 73%. 202 severe high risk

  10. Is adolescent pregnancy a risk factor for low birth weight?

    Directory of Open Access Journals (Sweden)

    Alzira Maria D'avila Nery Guimarães

    2013-02-01

    Full Text Available OBJECTIVE: The objective of this study was to evaluate whether adolescent pregnancy is a risk factor for low birth weight (LBW babies. METHODS: This was a cross-sectional study of mothers and their newborns from a birth cohort in Aracaju, Northeastern Brazil. Data were collected consecutively from March to July 2005. Information collected included socioeconomic, biological and reproductive aspects of the mothers, using a standardized questionnaire. The impact of early pregnancy on birth weight was evaluated by multiple logistic regression. RESULTS: We studied 4,746 pairs of mothers and their babies. Of these, 20.6% were adolescents (< 20 years of age. Adolescent mothers had worse socioeconomic and reproductive conditions and perinatal outcomes when compared to other age groups. Having no prenatal care and smoking during pregnancy were the risk factors associated with low birth weight. Adolescent pregnancy, when linked to marital status "without partner", was associated with an increased proportion of low birth weight babies. CONCLUSIONS: Adolescence was a risk factor for LBW only for mothers without partners. Smoking during pregnancy and lack of prenatal care were considered to be independent risk factors for LBW.

  11. Maternal infection in pregnancy and risk of asthma in offspring.

    Science.gov (United States)

    Collier, Charlene H; Risnes, Kari; Norwitz, Errol R; Bracken, Michael B; Illuzzi, Jessica L

    2013-12-01

    This study estimates the effect of maternal infections during pregnancy on childhood asthma. One-thousand four-hundred and twenty-eight pregnant women were prospectively followed using structured interviews and chart review until their child's 6th year of life. Infections were identified from outpatient and hospital visits. Childhood asthma was defined as physician diagnosis with symptoms at age six. Adjusted odds ratios were calculated from multivariable logistic regression models. Six-hundred and thirty-five women experienced an infection during pregnancy. Among antepartum infections, maternal urinary tract infections were significantly associated with childhood asthma (aOR 1.60, 95 % CI 1.12-2.29). Chorioamnionitis and maternal group beta streptococcus colonization were not significantly associated with an increased risk in childhood asthma. This study found an increased risk of asthma in children of women diagnosed with urinary tract infections during pregnancy, while other maternal infections did not increase the risk.

  12. Sleep Disorder Diagnosis During Pregnancy and Risk of Preterm Birth.

    Science.gov (United States)

    Felder, Jennifer N; Baer, Rebecca J; Rand, Larry; Jelliffe-Pawlowski, Laura L; Prather, Aric A

    2017-09-01

    To test the hypothesis that sleep disorder diagnosis would be associated with increased risk of preterm birth and to examine risk by gestational age, preterm birth type, and specific sleep disorder (insomnia, sleep apnea, movement disorder, and other). In this observational study, participants were from a cohort of nearly 3 million women in California between 2007 and 2012. Inclusion criteria were women with singleton neonates liveborn between 20 and 44 weeks of gestation without chromosomal abnormalities or major structural birth defects linked to a hospital discharge database maintained by the California Office of Statewide Health Planning and Development and without mental illness during pregnancy. Sleep disorder was defined based on International Classification of Diseases, 9th Revision, Clinical Modification diagnostic code (n=2,265). Propensity score matching was used to select a referent population at a one-to-one ratio. Odds of preterm birth were examined by gestational age (less than 34 weeks, 34-36 weeks, and less than 37 weeks of gestation) and type (spontaneous, indicated). Prevalence of preterm birth (before 37 weeks of gestation) was 10.9% in the referent group compared with 14.6% among women with a recorded sleep disorder diagnosis. Compared with the referent group, odds (95% CI, P value, percentage) of preterm birth were 1.3 (1.0-1.7, P=.023, 14.1%) for insomnia and 1.5 (1.2-1.8, Ppreterm birth type. Odds of preterm birth were not significantly increased for sleep-related movement disorders or other sleep disorders. Insomnia and sleep apnea were associated with significantly increased risk of preterm birth. Considering the high prevalence of sleep disorders during pregnancy and availability of evidence-based nonpharmacologic interventions, current findings suggest that screening for severe presentations would be prudent.

  13. Is high consumption of fatty fish during pregnancy a risk factor for fetal growth retardation? A study of 44,824 Danish pregnant women.

    Science.gov (United States)

    Halldorsson, Th I; Meltzer, H M; Thorsdottir, I; Knudsen, V; Olsen, S F

    2007-09-15

    The authors examined the relation between fish consumption during pregnancy and fetal growth among 44,824 women from the Danish National Birth Cohort (1996-2002). They evaluated the associations between consumption of total fish, fatty fish, and lean fish in midpregnancy and birth weight, birth length, and head circumference among singleton full-term infants. Fish consumption was ascertained by food frequency questionnaire. The birth of infants classified below the 10th percentile for gestational age and gender was significantly increased among women who consumed more than 60 g of fish per day, as compared with women who consumed 5 g or less per day. Adjusted odds ratios were 1.24 (95% confidence interval (CI): 1.03, 1.49) for birth weight and 1.21 (95% CI: 1.01, 1.43) for head circumference. The adjusted odds ratio was borderline significant for birth length (odds ratio = 1.20, 95% CI: 1.00, 1.45). These increases in risk were followed by small decreases in average values for these growth measures. Furthermore, the inverse association for total fish consumption could be explained by consumption of fatty fish, while no association was found for lean fish. These results indicate that consumption of fatty fish, a known route of exposure to persistent organic pollutants, could be associated with reduced fetal growth.

  14. Risk factors for venous thromboembolism during pregnancy

    DEFF Research Database (Denmark)

    Jensen, Thomas Bo; Gerds, Thomas Alexander; Grøn, Randi;

    2013-01-01

    Pregnant women are at an increased risk of venous thromboembolism (VTE). Risk factors for VTE among pregnant women are not sufficiently investigated.......Pregnant women are at an increased risk of venous thromboembolism (VTE). Risk factors for VTE among pregnant women are not sufficiently investigated....

  15. Alcohol consumption during pregnancy and the risk of preterm delivery

    DEFF Research Database (Denmark)

    Albertsen, Katrine; Andersen, Anne-Marie Nybo; Olsen, Jørn;

    2004-01-01

    The authors evaluated the association between amount and type of alcohol consumed during pregnancy and the risk of preterm delivery and whether the relation differs among very (... of alcohol, no increased risk of preterm delivery was found. Among women who consumed seven or more drinks per week, the relative risk of very preterm delivery was 3.26 (95% confidence interval: 0.80, 13.24) compared with that of nondrinkers. There were no differences in the associations between type...

  16. Malformation risks of antiepileptic drug monotherapies in pregnancy: updated results from the UK and Ireland Epilepsy and Pregnancy Registers.

    LENUS (Irish Health Repository)

    Campbell, E

    2014-09-01

    Antiepileptic drug (AED) exposure during pregnancy increases the risk of major congenital malformations (MCMs). The magnitude of this risk varies by AED exposure. Here we provide updated results from the UK Epilepsy and Pregnancy Register of the risk of MCMs after monotherapy exposure to valproate, carbamazepine and lamotrigine.

  17. Pregnancy Risk among Black, White, and Hispanic Teen Girls in New York City Public Schools

    Science.gov (United States)

    Orr, Mark G.; Sackoff, Judith; Santelli, John S.

    2010-01-01

    Disparities in teen pregnancy rates are explained by different rates of sexual activity and contraceptive use. Identifying other components of risk such as race/ethnicity and neighborhood can inform strategies for teen pregnancy prevention. Data from the 2005 and 2007 New York City Youth Risk Behavior Surveys were used to model demographic differences in odds of recent sexual activity and birth control use among black, white, and Hispanic public high school girls. Overall pregnancy risk was calculated using pregnancy risk index (PRI) methodology, which estimates probability of pregnancy based on current sexual activity and birth control method at last intercourse. Factors of race/ethnicity, grade level, age, borough, and school neighborhood were assessed. Whites reported lower rates of current sexual activity (23.4%) than blacks (35.4%) or Hispanics (32.7%), and had lower predicted pregnancy risk (PRI = 5.4% vs. 9.0% and 10.5%, respectively). Among sexually active females, hormonal contraception use rates were low in all groups (11.6% among whites, 7.8% among blacks, and 7.5% among Hispanics). Compared to white teens, much of the difference in PRI was attributable to poorer contraceptive use (19% among blacks and 50% among Hispanics). Significant differences in contraceptive use were also observed by school neighborhood after adjusting for age group and race/ethnicity. Interventions to reduce teen pregnancy among diverse populations should include messages promoting delayed sexual activity, condom use and use of highly effective birth control methods. Access to long-acting contraceptive methods must be expanded for all sexually active high school students. PMID:20383750

  18. Truancy and teenage pregnancy in English adolescent girls: can we identify those at risk?

    Science.gov (United States)

    Zhou, Yin; Puradiredja, Dewi Ismajani; Abel, Gary

    2016-06-01

    Truancy has been linked to risky sexual behaviours in teenagers. However, no studies in England have examined the association between truancy and teenage pregnancy, and the use of truancy as a marker of teenagers at risk of pregnancy. Using logistic regression, we investigated the association between truancy at age 15 and the likelihood of teenage pregnancy by age 19 among 3837 female teenagers who participated in the Longitudinal Study of Young People of England. We calculated the areas under the ROC curves of four models to determine how useful truancy would be as a marker of future teenage pregnancy. Truancy showed a dose-response association with teenage pregnancy after adjusting for ethnicity, educational intentions at age 16, parental socioeconomic status and family composition ('several days at a time' versus 'none', odds ratio 3.48 95% confidence interval 1.90-6.36, P teenage pregnancy among English adolescent girls. However, the discriminatory powers of models were low, suggesting that interventions addressing the whole population, rather than targeting high-risk individuals, might be more effective in reducing teenage pregnancy rates. © The Author 2015. Published by Oxford University Press on behalf of Faculty of Public Health.

  19. Alcohol consumption during pregnancy and the risk of preterm delivery

    DEFF Research Database (Denmark)

    Albertsen, Katrine; Andersen, Anne-Marie Nybo; Olsen, Jørn;

    2004-01-01

    The authors evaluated the association between amount and type of alcohol consumed during pregnancy and the risk of preterm delivery and whether the relation differs among very (preterm delivery. The study is based on data of 40......,892 pregnant women included in the first part of the Danish National Birth Cohort. The women completed a computer-assisted telephone interview between December 12, 1997, and December 31, 2000, and delivered a liveborn singleton. Of these women, 1,880 gave birth preterm. Compared with those who abstained during...... pregnancy, the relative risks for preterm delivery among women who consumed from four to less than seven drinks and seven or more drinks per week during pregnancy were 1.15 (95% confidence interval: 0.84, 1.57) and 1.77 (95% confidence interval: 0.94, 3.31), respectively. Below these intake levels...

  20. Alcohol consumption during pregnancy and the risk of preterm delivery

    DEFF Research Database (Denmark)

    Albertsen, Katrine; Andersen, Anne-Marie Nybo; Olsen, Jørn

    2004-01-01

    The authors evaluated the association between amount and type of alcohol consumed during pregnancy and the risk of preterm delivery and whether the relation differs among very (preterm delivery. The study is based on data of 40......,892 pregnant women included in the first part of the Danish National Birth Cohort. The women completed a computer-assisted telephone interview between December 12, 1997, and December 31, 2000, and delivered a liveborn singleton. Of these women, 1,880 gave birth preterm. Compared with those who abstained during...... pregnancy, the relative risks for preterm delivery among women who consumed from four to less than seven drinks and seven or more drinks per week during pregnancy were 1.15 (95% confidence interval: 0.84, 1.57) and 1.77 (95% confidence interval: 0.94, 3.31), respectively. Below these intake levels...

  1. 分析心理护理干预对于高危妊娠产妇的影响%Analysis of effect of psychological nursing intervention for high-risk pregnancy lying-in woman

    Institute of Scientific and Technical Information of China (English)

    王玉兰

    2015-01-01

    目的:分析心理护理干预对高危妊娠产妇的影响。方法:资料随机选取2012年9月~2013年9月我院收治的高危妊娠产妇82例,分为研究组和对照组,给予对照组产妇常规护理,研究组则在对照组的护理基础上实施心理护理干预,并对2组临床资料进行回顾性分析。结果:经实施心理护理干预之后,研究组护理满意度是97.56%,明显优于对照组护理的满意度87.80%,比较均有差异具有统计学意义( P<0.05)。结论:通过对高危妊娠产妇实施心理护理干预后,可以减少产妇忧郁、焦躁等负面情绪,降低高危影响的因素,且还可以使产妇身心得以健康发展,值得在临床中广泛推广应用。%Objective:To analyze of the effect of psychological nursing intervention for high-risk pregnancy lying-in woman.Meth-ods:data of randomly selected from September 2012 to September 2013 of our hospital 82 cases of high-risk pregnancy lying-in woman was divided into research group and the control group, and to give control group routine nursing care, maternal team, on the other hand, in the control group based on nursing, psychological nursing intervention and the two groups of clinical data were retrospectively analyzed. Results:after the implementation of psychological nursing intervention, the team of nursing satisfaction was 97.56%, significantly better than control group 87.80%of nursing satisfaction, comparison were statistically significant difference (P <0.05).Conclusion:based on the high-risk pregnancy after maternal psychological nursing intervention could reduce maternal depression, anxiety and other negative emotions, reduce the high risk factors, and could also make maternal body and mind healthy development, might be worth to be widely ap-plied in clinical.

  2. Teenage Pregnancy among Latinas: Examining Risk and Protective Factors

    Science.gov (United States)

    Dogan-Ates, Aysun; Carrion-Basham, Carla Y.

    2007-01-01

    This study investigated the role of three groups of risk and protective factors (e.g., individual, family, and extrafamilial) that are associated with teen pregnancy. Two groups of Latina adolescents (aged 15 to 19), nonpregnant/ nonparenting (NP; N = 48) and pregnant/parenting (P; N = 46), completed a demographic survey, an adolescent profile…

  3. Contraceptive use and risk of unintended pregnancy in California.

    Science.gov (United States)

    Foster, Diana G; Bley, Julia; Mikanda, John; Induni, Marta; Arons, Abigail; Baumrind, Nikki; Darney, Philip D; Stewart, Felicia

    2004-07-01

    California is home to more than one out of eight American women of reproductive age. Because California has a large, diverse and growing population, national statistics do not necessarily describe the reproductive health of California women. This article presents risk for pregnancy and sexually transmitted infections among women in California based on the California Women's Health Survey. Over 8900 women of reproductive age who participated in this survey between 1998 and 2001 provide estimates of access to care and use of family-planning methods in the state. We find that 49% of the female population aged 18-44 in California is at risk of unintended pregnancy. Nine percent (9%) of women at risk of an unintended pregnancy are not using any method of contraception, primarily for method-related reasons, such as a concern about side effects or a dislike of available contraceptive methods. Among women at risk for unintended pregnancy, we find disparities by race/ethnicity and education in use of contraceptive methods.

  4. Weight-Loss Surgery May Lower Risk of Pregnancy Complications

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_161748.html Weight-Loss Surgery May Lower Risk of Pregnancy Complications Women ... Oct. 28, 2016 (HealthDay News) -- Women who undergo weight-loss surgery gain major benefits when it comes to ...

  5. Pregnancy-induced changes in breast cancer risk.

    Science.gov (United States)

    Russo, Irma H; Russo, Jose

    2011-09-01

    Breast cancer is the malignant disease most frequently diagnosed in women of all races and nationalities. Since the 1970s the worldwide incidence of this disease has increased 30-40% in postmenopausal women, in whom, paradoxically, the risk of developing breast cancer is significantly reduced by an early first full term pregnancy (FTP) as compared to nulliparous and late parous women. Although the cause of breast cancer is not known, the mechanisms mediating the protection conferred by an early FTP have been identified to reside in the breast itself, and to be modulated by endogenous and environmental exposures that might negatively affect this organ during specific windows in its development that extend from prenatal life until the first pregnancy. Soon after conception the embryo initiates the production of human chorionic gonadotropin (hCG), the glycoprotein hormone that is diagnostic of pregnancy. HCG in conjunction with ovarian steroid hormones primes the hypothalamic neuroendocrine system for maintaining the pregnancy. Higher levels of hCG during the first trimester of pregnancy have been associated with a reduction in maternal breast cancer incidence after age 50. In preclinical studies it has been demonstrated that both FTP and hCG treatment of virgin rats prevent the development of chemically-induced mammary tumors, a phenomenon mediated by the differentiation of the mammary gland epithelial cells prior to carcinogen exposure. Complete differentiation proceeds through complex morphological, physiological and molecular changes that occur during pregnancy and lactation, that ultimately result in increased DNA repair capabilities of the mammary epithelium, activation of genes controlling differentiation and programmed cell death and imprinting in the breast epithelium a specific and permanent genomic signature of pregnancy. This signature is indicative of a reduced breast cancer risk and serves as a molecular biomarker of differentiation for evaluating the

  6. 妊娠期高血压疾病发病的高危因素研究%Study on the High Risk Factors of Pathogenesis of Hypertensive Disorder Complicating Pregnancy

    Institute of Scientific and Technical Information of China (English)

    方明; 何元芬; 章庆华

    2014-01-01

    目的:调查分析妊娠期高血压疾病发病的高危因素。方法:选取2010年1月~2013年4月本院的968例孕妇为研究对象,将其妊娠期高血压疾病发病率进行统计,并将其中不同年龄段、孕次、流产史、吸烟史、高血压家族史、心理评估结果及叶酸应用者的发生率进行比较,并以Logistic回归分析妊娠期高血压疾病的危险因素。结果:年龄≥35岁、孕次≥2次、有流产史、吸烟史、高血压家族史、Zung自评量表阳性及未早期应用叶酸者的妊娠期高血压疾病发病率均高于其他患者,且上述因素均为妊娠期高血压疾病发病的危险因素,P均<0.05,均有显著性差异。结论:年龄、孕次、流产史、吸烟史、高血压家族史、心理评估及叶酸应用情况均是对妊娠期高血压疾病发病有影响的因素,可根据此危险因素给予患者针对性干预。%Objective:To investigate and analyze the high risk factors of pathogenesis of hypertensive disorder complicating pregnancy.Methods:968 pregnant women in our hospital from January 2010 to April 2013 were selected as research object,then the hypertensive disorder complicating pregnancy rate of all the pregnant women was analyzed,and the rate of pregnant women with different ages,gravidity times,abortion history,smoking history,hypertension family history,psychological assessment results and folic acid application were compared,and the risk factors of pathogenesis of hypertensive disorder complicating pregnancy were analyzed with Logistic regression.Results:The hypertensive disorder complicating pregnancy rate of pregnant women with ≥35 years old,gravidity times≥2 times,abortion history,smoking history,hypertension family history,positive Zung checklist and without early folic acid application were all higher than those of others,and those factors were all the risk factors of pathogenesis of hypertensive disorder complicating pregnancy,all P<0.05,there were

  7. Pre-conception counselling in primary care: prevalence of risk factors among couples contemplating pregnancy.

    Science.gov (United States)

    van der Pal-de Bruin, Karin M; le Cessie, Saskia; Elsinga, Joyce; de Jong-Potjer, Lieke C; van Haeringen, Arie; Neven, Arie Knuistingh; Verloove-Vanhorick, S Pauline; Assendelft, Pim

    2008-05-01

    The outcome of pregnancy can be influenced by several risk factors. Women who are informed about these risks during pre-conception counselling (PCC) have an opportunity to take preventive measures in time. Several studies have shown that high-risk populations have a high prevalence of such risk factors. However, prevalence in the general population, which is assumed to be low risk, is largely unknown. We therefore provided a systematic programme of PCC for the general population and studied the prevalence of risk factors using the risk-assessment questionnaire which was part of the PCC. None of the couples reported no risk factors at all and only 2% of the couples reported risk factors for which written information was considered to be sufficient. Therefore, 98% of all couples reported one or more risk factors for which at least personal counselling by a general practitioner (GP) was indicated. Many of these factors were related to an unhealthy lifestyle. Women with a low level of education reported more risk factors than women with a high level of education. There is a great need for PCC as shown by the fact that almost all couples reported risk factors for which personal counselling was indicated. Pre-conception counselling may reduce the risk of adverse pregnancy outcome by enabling couples to avoid these risks. PCC can be provided by GPs, who have the necessary medical knowledge and background information to counsel couples who wish to have a baby.

  8. High-risk Pregnancy, Maternal Mental Problems Maternal Separation and Nursing Intervention Measures%母婴分离的高危妊娠产妇心理问题分析及护理干预对策

    Institute of Scientific and Technical Information of China (English)

    王燕

    2016-01-01

    目的:以调研的方式对处于母婴分离状态的高危妊娠产妇心理问题进行分析,以此为基础探讨护理干预对纠正该类产妇心理状态的正面意义。方法于2015年1月—6月,经便利抽样采集90例该院妇产科母婴分离的高危妊娠产妇纳入研究视野。于剖宫产术后1 d分别采用焦虑自评量表(SAS)和抑郁自评量表(SDS)评估产后焦虑和抑郁状况。随机分为研究组和对照组,对照组给予常规护理,研究组接受整体性护理,再次评价产妇心理状况,并记录护理满意率、母乳喂养率。结果新生儿出生孕周短、妊娠合并症及产妇人格特征等是母婴分离的高危妊娠产妇心理问题的独立因素。护理后7 d,研究组SAS、SDS分值分别为(36.04±9.03)、(44.96±10.21)分,对照组分别为(41.32±7.45)、(49.33±7.62)分,对比差异具有统计学意义(P﹤0.05)。结论母婴分离作为应激源会使高危妊娠产妇产生不良的应激反应,对此类产妇给予针对性的护理干预可降低其心理应激反应,提高母乳喂养率。%Objective Research-way high-risk pregnancy maternal mental problems in maternal separation state is analyzed as a basis to explore nursing intervention to correct such maternal mental state of positive significance. Methods In January 2015 to June 2015, by a convenience sample collected 90 cases of high-risk pregnancy, maternal hospital maternity maternal separation into research perspective. In cesarean section 1d were self-rating anxiety scale (SAS) and Self-Rating Depression Scale (SDS) to assess postpartum anxiety and depression status. Randomly divided into study group and the control group, the control group received routine care, research group received holistic nursing, maternal mental health evaluation again, and record the care satisfaction rate, rate of breastfeeding. Results Short gestational age birth, pregnancy complications and maternal personality traits and other factors

  9. Supplemental folic acid in pregnancy and maternal cancer risk

    OpenAIRE

    Mortensen, Jan Helge Seglem; Øyen, Nina; Fomina, Tatiana; Melbye, Mads; Tretli, Steinar; Vollset, Stein Emil; Bjørge, Tone

    2015-01-01

    Background: There is evidence that increased intake of folate protects against the development of several types of cancer. Some studies have, however, raised concern about the safety of folate in relation to cancer risk. Here we examined the risk of maternal cancer after intake of supplemental folic acid in pregnancy. Methods: This is a population-based cohort study comprising 429,004 women with data from the Medical Birth Registry of Norway, the Cancer Registry of Norway, and other nation...

  10. Pregnancy disorders and cardiovascular disease risk

    NARCIS (Netherlands)

    Heida, K.Y.

    2016-01-01

    Cardiovascular disease is the most important cause of death in women in the Netherlands. Early identification of women at increased risk of cardiovascular disease and subsequent detection and treatment of risk factors contributes to the reduction of cardiovascular disease morbidity and mortality. A

  11. Pregnancy disorders and cardiovascular disease risk

    NARCIS (Netherlands)

    Heida, KY

    2016-01-01

    Cardiovascular disease is the most important cause of death in women in the Netherlands. Early identification of women at increased risk of cardiovascular disease and subsequent detection and treatment of risk factors contributes to the reduction of cardiovascular disease morbidity and mortality. A

  12. 妊娠高危因素监测及管理模式转变探讨%Exploration on monitoring and management mode transformation for pregnancy high risk factors

    Institute of Scientific and Technical Information of China (English)

    潘凯斯

    2014-01-01

    Objective To commit a transformation of monitoring and management mode for pregnancy high risk factors.We expanded the high risk pregnancy supervision net to community hospitals and village committees including all childbearing-aged women who wanted to have a baby as subjects,and manage basic diseases and high risks actively.We supervised and urged the high risky pregnant women to receive antenatal care regularly.Methods We took the pregnant women who received antenatal care in the high risk pregnancy management area of our hospital from June 2010 to September 2011 as the control group.We took the pregnant women who received antenatal care in the same area from November 2011 to January 2013 as the observation group,following the expansion of high risk pregnancy supervision net to community hospitals and village committees.We performed retrospective analysis for the high risk pregnancy management of the two groups.Results The rate of high risk pregnancy,rate of regular antenatal care record establishment,rate of early record establishment,rate of regular antenatal care,rate of in-hospital delivery,and rate of postpartum follow-up visit in the observation group were all higher than those of control group.The rate of cesarean section,rate of postpartum hemorrhage,rate of preterm birth,rate of disabled newborns,and rate of neonate death in the observation group were all lower than those of control group (P < 0.05).Conclusion This management mode transformation greatly raises the rate of regular antenatal care record establishment,rate of early record establishment,rate of regular antenatal care,rate of in-hospital delivery,and rate of postpartum follow-up visit.Further more,the rate of cesarean section,rate of postpartum hemorrhage,rate of preterm birth,rate of disabled newborns,and rate of neonate death are greatly decreased,and pregnancy outcomes are greatly improved.%目的 转变妊娠高危因素监测及管理模式,将高危妊娠监测网络延伸至社区

  13. Post-term pregnancy is an independent risk factor for neonatal morbidity even in low-risk singleton pregnancies.

    Science.gov (United States)

    Linder, Nehama; Hiersch, Liran; Fridman, Elana; Klinger, Gil; Lubin, Daniel; Kouadio, Franck; Melamed, Nir

    2017-07-01

    To determine the independent association of post-term pregnancy with neonatal outcome in low-risk newborns. Retrospective cohort. Tertiary university-affiliated medical centre. All newborns of low-risk singleton pregnancies born at 39+0 to 44+0 weeks' gestation over a 5-year period. multiple gestation, maternal hypertensive disorder, diabetes or cholestasis, placental abruption or intrapartum fever (>38°C), small for gestational age (post-term (≥42+0 weeks), late term (41+0 to 41+6 weeks) and full term (39+0 to 40+6 weeks). Of the 23 524 eligible neonates, 747 (3.2%) were born post-term, 4632 (19.7%) late term and 18 145 (77.1%) full term. Women in the post-term group versus the late-term group had a significantly higher rate of caesarean section (8.9% vs 5.6%, poperative vaginal delivery (9.6% vs 7.4%, p=0.024). Post-term pregnancy versus full-term pregnancy was associated with an increased risk of NICU admission (OR 2.0, 95% CI 1.4 to 2.8), respiratory morbidity (OR 2.2, 95% CI 1.3 to 3.8) and infectious morbidity (OR 1.88, 95% CI 1.32 to 2.69). Post-term pregnancy versus late-term pregnancy was similarly associated with an increased risk of NICU admission (OR 2.0, 95% CI 1.4 to 2.9), respiratory morbidity (OR 2.7, 95% CI 1.5 to 5.0) and infectious morbidity (OR 1.8, 95% CI 1.2 to 2.7) and with hypoglycaemia (OR 2.6, 95% CI 1.2 to 5.4). Post-term delivery was not associated with neonatal mortality. Post-term pregnancy is an independent risk factor for neonatal morbidity even in low-risk singleton pregnancies. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  14. Severe intrahepatic cholestasis of pregnancy is a risk factor for preeclampsia in singleton and twin pregnancies.

    Science.gov (United States)

    Raz, Yael; Lavie, Anat; Vered, Yaffa; Goldiner, Ilana; Skornick-Rapaport, Avital; Landsberg Asher, Ysca; Maslovitz, Sharon; Levin, Ishai; Lessing, Joseph B; Kuperminc, Michael J; Rimon, Eli

    2015-09-01

    Intrahepatic cholestasis of pregnancy (ICP) is known to be associated with fetal complications. It recently was suggested to be associated possibly with preeclampsia (PET) as well. The objective of this study was to investigate that possibility. The study group included 78 women (54 singleton and 24 twin pregnancies) who had been diagnosed with ICP based on clinical presentation, elevated liver enzymes, and elevated total bile acids (>10 μmol/L). Disease severity was based on total bile acids levels as being severe (>40 μmol/L), moderate (20-40 μmol/L), or mild (10-20 μmol/L). The course of disease was reviewed carefully in each case. The control groups were comprised of apparently healthy women with singleton (n = 200) and twin (n = 100) pregnancies that were drawn randomly from a computerized registry of all the deliveries in our institution during the study period. The total incidence of PET was significantly higher for the patients with ICP who had singleton and twin pregnancies compared with the control groups (singletons: 7.4% vs 1.5%; P pregnancies compared with control subjects. Severe ICP, but not mild ICP, was a major risk factor for PET among women with either singleton or twin pregnancies. The timing of the initial presentation of ICP had no effect on PET incidence rates. Preeclampsia occurred usually 2-4 weeks after the diagnosis of ICP, and proteinuria preceded elevated blood pressure in all cases. Moreover, the total bile acid levels among 33 women who were diagnosed as having PET, but not ICP, were within normal range. ICP increases the incidence of PET; severe disease was a major risk factor for preeclampsia. Therefore, we strongly suggest including routine evaluation for preeclampsia in the treatment of women with moderate and severe ICP. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Physical activity before and during pregnancy and risk of abnormal glucose tolerance among Hispanic women.

    Science.gov (United States)

    Chasan-Taber, L; Silveira, M; Lynch, K E; Pekow, P; Braun, B; Manson, J E; Solomon, C G; Markenson, G

    2014-02-01

    Women diagnosed with abnormal glucose tolerance and gestational diabetes mellitus are at increased risk for subsequent type 2 diabetes, with higher risks in Hispanic women. Studies suggest that physical activity may be associated with a reduced risk of these disorders; however, studies in Hispanic women are sparse. We prospectively evaluated this association among 1241 Hispanic participants in Proyecto Buena Salud. The Pregnancy Physical Activity Questionnaire was used to assess pre, early, and mid pregnancy physical activity. Medical records were abstracted for pregnancy outcomes. A total of 175 women (14.1%) were diagnosed with abnormal glucose tolerance and 57 women (4.6%) were diagnosed with gestational diabetes. Increasing age and body mass index were strongly and positively associated with risk of gestational diabetes. We did not observe statistically significant associations between total physical activity or meeting exercise guidelines and risk. However, after adjusting for age, BMI, gestational weight gain, and other important risk factors, women in the top quartile of moderate-intensity activity in early pregnancy had a decreased risk of abnormal glucose tolerance (odds ratio=0.48, 95% Confidence Interval 0.27-0.88, Ptrend=0.03) as compared to those in the lowest quartile. Similarly, women with the highest levels of occupational activity in early pregnancy had a decreased risk of abnormal glucose tolerance (odds ratio=0.48, 95% Confidence Interval 0.28-0.85, Ptrend=0.02) as compared to women who were unemployed. In this Hispanic population, total physical activity and meeting exercise guidelines were not associated with risk. However, high levels of moderate-intensity and occupational activity were associated with risk reduction. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  16. 剖宫产术后瘢痕处妊娠的高危因素探讨%Study on high risk factors of pregnancy at the scar after cesarean section

    Institute of Scientific and Technical Information of China (English)

    刘小媚; 袁秀英; 刘燕燕

    2014-01-01

    目的:探讨剖宫产术后瘢痕处妊娠的高危因素,提高诊断水平。方法剖宫产手术史且合并瘢痕处妊娠的患者34例纳入瘢痕妊娠组,同期在我院接受剖宫产手术但未合并瘢痕处妊娠的产妇34例,纳入对照组。比较两组的手术指征、人工流产次数、手术医院级别等。结果两组的产程延长例次、胎儿宫内窘迫例次、产科合并症例次、剖宫产次数及反复宫腔操作例次比较,差异均有统计学意义。两组接受最近一次剖宫产手术的医院级别、人工流产平均次数比较,差异有统计学意义。 Logistic回归分析结果显示,产程延长、胎儿窘迫、产科合并症、反复宫腔操作、剖宫产2次以上均是影响瘢痕处妊娠的高危因素。结论产程延长、胎儿窘迫、产科合并症、剖宫产次数、反复宫腔操作均是影响瘢痕处妊娠的高危因素。%Objective To explore the high risk factors of pregnancy at the scar after cesarean section ,and improve the diagnostic level. Methods A total of 34 patients of cesarean section operation with scar pregnancy were arranged in scar pregnancy group,in the same period,34 patients who received cesarean operation but not with scar pregnancy were arranged in the control group. Results The production process extension number,fetal distress number,obstetric com-plications number,fetal breech number,repeated uterine cavity operation number ,comparison difference had statistics significance. Recent cesarean operation of hospital level , the average number of artificial abortion of two groups had statistical significance differences. The results of logistic regression analysis display, prolonged labor, fetal distress, obstetric complications, recurrentuterine cavity operation, cesarean section 2 above are all risk factors influencing the scar pregnancy. Conclusion Prolonged labor, fetal distress, obstetric complications, breech presentation,recurrent u

  17. 个体化营养管理对妊娠高血压疾病高风险孕妇围生期结局的影响%Influence of individualized nutritional management on the perinatal outcomes of the pregnancies in pregnancy hypertensive disorders high-risk

    Institute of Scientific and Technical Information of China (English)

    侯湘平; 吴仕元; 袁劲进; 康昭海; 熊静

    2012-01-01

    目的 探讨个体化的营养管理对妊娠高血压疾病高风险孕妇围生期结局的影响.方法 选择2011年1月~2012年2月在我院规范产前检查且经妊娠高血压疾病风险筛查为高风险孕妇157例,按照孕妇意愿进行营养管理67例(观察组),按常规孕期保健但未进行营养管理90例(对照组),比较两组孕妇妊娠结局及围生儿结局.结果观察组孕妇妊娠高血压疾病、妊娠期糖尿病、妊娠期贫血、胎膜早破发生率明显低于对照组(P < 0.05),早产、胎儿窘迫,观察组新生儿窒息发生率低于对照组,差异有统计学意义(P < 0.05),观察组剖宫产分娩低于对照组(P < 0.05).结论 个体化的孕期营养管理能改善妊娠高血压疾病高风险孕妇的围生期结局,值得推广.%Objective To study the influence of individualized nutritional management to the perinatal outcomes of pregnancy hypertensive disorders in high-risk pregnancies. Methods 157 cases of the pregnancies in pregnancy hypertensive disorders high-riskare selected, who was regulated prenatal diagnosis in our hospital from January 2011 to February 2012; in accordance with the wishes pregnant woman had 67 cases to be given nutrition manage as the study group, the rest of the 90 cases which not routine prenatal diagnosis as the control group; pregnancy outcome and perinatal of two groups outcome were compared. Results The incidence of hypertension, gestational diabetes, anemia in pregnancy, premature rupture of membranes in study group were significantly lower than that of the control group (P < 0.05), the incidence of premature birth, fetal distress, neonatal asphyxia in study group were significantly lower than that of the control group (P < 0.05), the rate of cesarean in study group was significantly lower than that of the control group (P < 0.05). Conclusion The individualized nutritional management during pregnancy can improve perinatal outcomes of the high-risk pregnant women with

  18. Teens' risk of AIDS, unintended pregnancies examined.

    Science.gov (United States)

    Scommegna, P

    1996-08-01

    Approximately 1.6 billion of the world's population are 10-24 years old. About 15 million women aged 15-19 years give birth annually, more than 10% of all births worldwide. The proportion of teen births to unwed mothers has risen by 50% in the US since 1980, and by almost 70% in Kenya during the 1980s. Approximately 2 million adolescent women in developing countries have illegal, unsafe abortions each year, with at least 10% of all abortions worldwide occurring among women ages 15-19. Since the start of the HIV/AIDS pandemic, at least 12 million young people have been infected with HIV. In fact, about half of all HIV infections worldwide have occurred in young people under age 25. HIV is spreading rapidly among young women aged 15-24 such that in many countries women account for 40% of all new HIV infections. Several new reports from the Population Reference Bureau, the US Census Bureau, and the International Center for Research on Women offer data on how the world's youth are exposed to unintended pregnancies, unsafe abortions, and sexually transmitted diseases. Maternal and infant mortality among adolescent mothers and their children, coercion to have sex, and the growing proportion of school-aged youth worldwide enrolled in secondary schools are discussed.

  19. Clusters of Factors Identify A High Prevalence of Pregnancy Involvement Among US Adolescent Males.

    Science.gov (United States)

    Lau, May; Lin, Hua; Flores, Glenn

    2015-08-01

    The study purpose was to use recursive partitioning analysis (RPA) to identify factors that, when clustered, are associated with a high prevalence of pregnancy involvement among US adolescent males. The National Survey of Family Growth is a nationally representative survey of individuals 15-44 years old. RPA was done for the 2002 and 2006-2010 cycles to identify factors which, when combined, identify adolescent males with the highest prevalence of pregnancy involvement. Pregnancy-involvement prevalence among adolescent males was 6 %. Two clusters of adolescent males have the highest pregnancy-involvement prevalence, at 84-87 %. In RPA, the highest pregnancy-involvement prevalence (87 %) was seen in adolescent males who ever HIV tested, had >4 lifetime sexual partners, reported less than an almost certain chance of feeling less physical pleasure with condom use, had an educational attainment of 4 lifetime sexual partners, reported less than an almost certain chance of feeling less physical pleasure with condom use, had an educational attainment ≥11th grade, were >17 years old, and had their first contraceptive education ≥10th grade, had a pregnancy-involvement prevalence of 84 %. Pregnancy-prevention efforts among adolescent males who have been involved in a pregnancy may need to target risk factors identified in clusters with the highest pregnancy prevalence to prevent subsequent pregnancies in these adolescent males and improve their future outcomes.

  20. Depression during pregnancy: Prevalence and obstetric risk factors among pregnant women attending a tertiary care hospital in Navi Mumbai

    Directory of Open Access Journals (Sweden)

    Shaunak Ajinkya

    2013-01-01

    Full Text Available Context: Depression affects about 20% of women during their lifetime, with pregnancy being a period of high vulnerability. Prevalence of depression during pregnancy ranges from 4% to 20%. Several risk factors predispose to depression during pregnancy including obstetric factors. Depression during pregnancy is not only the strongest risk factor for post-natal depression but also leads to adverse obstetric outcomes. Aims: To study the prevalence of depression during pregnancy and its associated obstetric risk factors among pregnant women attending routine antenatal checkup. Settings and Design: Cross-sectional observational survey done at the outpatient department (OPD of the department of obstetrics of a tertiary care hospital in Navi Mumbai. Materials and Methods: One hundred and eighty-five pregnant women were randomly administered the Beck Depression Inventory (BDI for detecting depression. Additional socio-demographic and obstetric history was recorded and analyzed. Results: Prevalence of depression during pregnancy was found to be 9.18% based upon BDI, and it was significantly associated with several obstetric risk factors like gravidity (P = 0.0092, unplanned pregnancy (P = 0.001, history of abortions (P = 0.0001, and a history of obstetric complications, both present (P = 0.0001 and past (P = 0.0001. Conclusions: Depression during pregnancy is prevalent among pregnant women in Navi-Mumbai, and several obstetric risk factors were associated to depression during pregnancy. Future research in this area is needed, which will clearly elucidate the potential long-term impact of depression during pregnancy and associated obstetric risk factors so as to help health professionals identify vulnerable groups for early detection, diagnosis, and providing effective interventions for depression during pregnancy.

  1. Maternal diet quality before pregnancy and risk of childhood leukaemia.

    Science.gov (United States)

    Singer, Amanda W; Carmichael, Suzan L; Selvin, Steve; Fu, Cecilia; Block, Gladys; Metayer, Catherine

    2016-10-01

    Previous studies on maternal nutrition and childhood leukaemia risk have focused on the role of specific nutrients such as folate and have not considered broader measures of diet quality, which may better capture intake of diverse nutrients known to impact fetal development. We examined the relationship between maternal diet quality before pregnancy, as summarised by a diet quality index, and risk of childhood acute lymphoblastic leukaemia (ALL) and acute myeloid leukaemia (AML) in a case-control study in California. Dietary intake in the year before pregnancy was assessed using FFQ in 681 ALL cases, 103 AML cases and 1076 matched controls. Conditional logistic regression was used to estimate OR and 95 % CI for diet quality continuous score and quartiles (Q1-Q4). Higher maternal diet quality score was associated with reduced risk of ALL (OR 0·66; 95 % CI 0·47, 0·93 for Q4 v. Q1) and possibly AML (OR 0·42; 95 % CI 0·15, 1·15 for Q4 v. Q1). No single index component appeared to account for the association. The association of maternal diet quality with risk of ALL was stronger in children diagnosed under the age of 5 years and in children of women who did not report using vitamin supplements before pregnancy. These findings suggest that the joint effects of many dietary components may be important in influencing childhood leukaemia risk.

  2. A Dual-Focus Motivational Intervention to Reduce the Risk of Alcohol-Exposed Pregnancy

    Science.gov (United States)

    Velasquez, Mary M.; Ingersoll, Karen S.; Sobell, Mark B.; Floyd, R. Louise; Sobell, Linda Carter; von Sternberg, Kirk

    2010-01-01

    Project CHOICES developed an integrated behavioral intervention for prevention of prenatal alcohol exposure in women at high risk for alcohol-exposed pregnancies. Settings included primary care, university-hospital based obstetrical/gynecology practices, an urban jail, substance abuse treatment settings, and a media-recruited sample in three large…

  3. Uterine prolapse in pregnancy: risk factors, complications and management.

    Science.gov (United States)

    Tsikouras, Panagiotis; Dafopoulos, Alexandros; Vrachnis, Nikolaos; Iliodromiti, Zoe; Bouchlariotou, Sofia; Pinidis, Petros; Tsagias, Nikolaos; Liberis, Vasileios; Galazios, Georgios; Von Tempelhoff, Georg Friedrich

    2014-02-01

    Presentation of uterine prolapse is a rare event in a pregnant woman, which can be pre-existent or else manifest in the course of pregnancy. Complications resulting from prolapse of the uterus in pregnancy vary from minor cervical infection to spontaneous abortion, and include preterm labor and maternal and fetal mortality as well as acute urinary retention and urinary tract infection. Moreover, affected women may be at particular risk of dystocia during labor that could necessitate emergency intervention for delivery. Recommendations regarding the management of this infrequent but potentially harmful condition are scarce and outdated. This review will examine the causative factors of uterine prolapse and the antepartum, intrapartum and puerperal complications that may arise from this condition as well as therapeutic options available to the obstetrician. While early recognition and appropriate prenatal management of uterine prolapse during pregnancy is imperative, implementation of conservative treatment modalities throughout pregnancy, these applied in accordance with the severity of the uterus prolapse and the patient's preference, may be sufficient to achieve uneventful pregnancy and normal, spontaneous delivery.

  4. Evaluation of Relaxin Blood Profiles of Horses as A Means of Assessing Placental Function in High-Risk Pregnancies And Responsiveness to Therapeutic Strategies

    Science.gov (United States)

    Placental insufficiency is regarded as the primary factor contributing to late-term abortion and perinatal death of foals. Often when problems associated with late-term pregnancy in the horse are manifest the condition is well-advanced and therapeutic intervention may not be effective in rescuing th...

  5. Evaluation of Systemic Relaxin Blood Profiles in Horses as A Means of Assessing Placental Function in High-Risk Pregnancies and Responsiveness to Therapeutic Strategies

    Science.gov (United States)

    Placental insufficiency is regarded as the primary factor contributing to late-term abortion and perinatal death of foals. Often when problems associated with late-term pregnancy in the horse are manifest the condition is well-advanced and therapeutic intervention may not be effective in rescuing th...

  6. Is high consumption of fatty fish during pregnancy a risk factor for fetal growth retardation? A study of 44,824 Danish pregnant women

    DEFF Research Database (Denmark)

    Halldorsson, Th I; Meltzer, H M; Thorsdottir, I;

    2007-01-01

    The authors examined the relation between fish consumption during pregnancy and fetal growth among 44,824 women from the Danish National Birth Cohort (1996-2002). They evaluated the associations between consumption of total fish, fatty fish, and lean fish in midpregnancy and birth weight, birth l...

  7. Good outcome of teenage pregnancies in high-quality maternity care.

    Science.gov (United States)

    Raatikainen, Kaisa; Heiskanen, Nonna; Verkasalo, Pia K; Heinonen, Seppo

    2006-04-01

    Teenage pregnancies have been associated with fetal growth restriction, low birth weight, preterm birth and neonatal mortality. These could be due to biological immaturity, lifestyle factors or inadequate attendance to maternity care. The objective of this study was to assess the relationship between young age of the mother and pregnancy risk factors and adverse pregnancy outcome in conditions of high-quality maternity care used by almost the entire pregnant population. We analysed a population-based database of 26,967 singleton pregnancies during 1989-2001. Only 185 of these mothers were under 18 years old. Data were collected using a self-administered questionnaire at 20 weeks of pregnancy and clinical records of pregnancy, delivery and newborn child. The information covered maternal risk factors, pregnancy characteristics and obstetric outcomes. Odds ratios (ORs) for adverse pregnancy outcomes in teenage compared with older mothers were obtained from multiple logistic regression models. Teenage mothers smoked, were unemployed and had anaemia or chorioamnionitis more often than older mothers. On the other hand, they were overweight and had maternal diabetes less often than adults. Teenage mothers had as many instrumented deliveries (OR 0.70; 95% confidence interval 0.39-1.27) but fewer Caesarean sections (0.62; 0.39-0.97) than adults. We found no evidence for increased risk of preterm delivery, fetal growth restriction, low birth weight, or fetal or perinatal death in teenage mothers. These results suggest that increased risks for adverse pregnancy outcomes in teenage pregnancies can most probably be overcome by means of high-quality maternity care with complete coverage.

  8. Medication exposure in pregnancy risk evaluation program: the prevalence of asthma medication use during pregnancy.

    Science.gov (United States)

    Hansen, Craig; Joski, Peter; Freiman, Heather; Andrade, Susan; Toh, Sengwee; Dublin, Sascha; Cheetham, Craig; Cooper, William; Pawloski, Pamala; Li, De-Kun; Beaton, Sarah; Kaplan, Sigal; Scott, Pamela; Hammad, Tarek; Davis, Robert

    2013-11-01

    Asthma is one of the most common chronic diseases in women of reproductive age, occurring in up to 8 % of pregnancies. The objective of this study is to assess the prevalence of asthma medication use during pregnancy in a large diverse cohort. We identified women aged 15-45 years who delivered a live born infant between 2001 and 2007 across 11 U.S. health plans within the Medication Exposure in Pregnancy Risk Evaluation Program (MEPREP). Using health plans' administrative and claims data, and birth certificate data, we identified deliveries for which women filled asthma medications from 90 days before pregnancy through delivery. Prevalence (%) was calculated for asthma diagnosis and medication dispensing. There were 586,276 infants from 575,632 eligible deliveries in the MEPREP cohort. Asthma prevalence among mothers was 6.7 %, increasing from 5.5 % in 2001 to 7.8 % in 2007. A total of 9.7 % (n = 55,914) of women were dispensed asthma medications during pregnancy. The overall prevalence of maintenance-only medication, rescue-only medication, and combined maintenance and rescue medication was 0.6, 6.7, and 2.4 % respectively. The prevalence of maintenance-only use doubled during the study period from 0.4 to 0.8 %, while rescue-only use decreased from 7.4 to 5.8 %. In this large population-based pregnancy cohort, the prevalence of asthma diagnoses increased over time. The dispensing of maintenance-only medication increased over time, while rescue-only medication dispensing decreased over time.

  9. Follow-up analysis on pregnancy outcome with high risk of Down' s syndrome%唐氏筛查高危孕产妇妊娠结局随访分析

    Institute of Scientific and Technical Information of China (English)

    钟赋真; 闫学明; 赵银珠; 孟超

    2011-01-01

    To investigate the relation between high risk of Down' s syndrome and birth defect by studying the pregnancy outcome with high risk of Down' s syndrome and ultrasound screening in Xicheng district of Beijing, and to improve secondary prevention of birth defect. Methods From October 1 st of 2008 to September 30th of 2009, 466 cases with high risk of Down' s syndrome were randomly selected from Gynecological Hospitals in Xicheng district of Beijing and followed up by the way of case extraction and telephone. Results There were statistical differences among groups of different ages in screening Down' s syndrome ( X2 = 22.396, P = 0.001 ). Of 466 pregnant women with high risk of Down' s syndrome, there were 67 abnormal deliveries ( 14.4% ), including 42 cases with birth defects.Among 42 cases with birth defects, 19 were found to be abnormal before delivery by ultrasound screening, 14 by amniocentesis in screening Down' s syndrome, 4 both by ultrasound screening and Down' s syndrome screening, but 3 were not found either by Down' s syndrome screening or by ultrasound screening. Conclusion Trisomy 21 high risk is related with pregnant women' s age, and high risk of Down's syndrome is associated with abnormal pregnancy outcome and birth defects. Down' s syndrome screening and ultrasound screening could complement each other in detecting pregnancy outcome and birth defect.%目的 了解北京市西城区唐氏高危人群妊娠结局、超声筛查等情况,了解经唐氏高危者与出生缺陷的关系,完善出生缺陷的二级预防.方法 对2008年10月1日-2009年9月30日间北京市西城区产科医院随机抽取466名唐氏筛查高危患者,对每例孕产妇妊娠结局通过病案室调取病历及电话进行随访.结果 ①不同年龄组中唐氏高危筛查有明显统计学意义(χ2=22.396,P=0.001);②466例唐氏筛查高危孕妇,妊娠结局异常67例(14.4%),其中出生缺陷42例;③42例出生缺陷中,19例由超声筛查发现,14

  10. Early pregnancy vitamin D status and risk of preeclampsia.

    Science.gov (United States)

    Mirzakhani, Hooman; Litonjua, Augusto A; McElrath, Thomas F; O'Connor, George; Lee-Parritz, Aviva; Iverson, Ronald; Macones, George; Strunk, Robert C; Bacharier, Leonard B; Zeiger, Robert; Hollis, Bruce W; Handy, Diane E; Sharma, Amitabh; Laranjo, Nancy; Carey, Vincent; Qiu, Weilliang; Santolini, Marc; Liu, Shikang; Chhabra, Divya; Enquobahrie, Daniel A; Williams, Michelle A; Loscalzo, Joseph; Weiss, Scott T

    2016-12-01

    Low vitamin D status in pregnancy was proposed as a risk factor of preeclampsia. We assessed the effect of vitamin D supplementation (4,400 vs. 400 IU/day), initiated early in pregnancy (10-18 weeks), on the development of preeclampsia. The effects of serum vitamin D (25-hydroxyvitamin D [25OHD]) levels on preeclampsia incidence at trial entry and in the third trimester (32-38 weeks) were studied. We also conducted a nested case-control study of 157 women to investigate peripheral blood vitamin D-associated gene expression profiles at 10 to 18 weeks in 47 participants who developed preeclampsia. Of 881 women randomized, outcome data were available for 816, with 67 (8.2%) developing preeclampsia. There was no significant difference between treatment (N = 408) or control (N = 408) groups in the incidence of preeclampsia (8.08% vs. 8.33%, respectively; relative risk: 0.97; 95% CI, 0.61-1.53). However, in a cohort analysis and after adjustment for confounders, a significant effect of sufficient vitamin D status (25OHD ≥30 ng/ml) was observed in both early and late pregnancy compared with insufficient levels (25OHD preeclampsia (FDR preeclampsia incidence in the intention-to-treat paradigm. However, vitamin D levels of 30 ng/ml or higher at trial entry and in late pregnancy were associated with a lower risk of preeclampsia. Differentially expressed vitamin D-associated transcriptomes implicated the emergence of an early pregnancy, distinctive immune response in women who went on to develop preeclampsia. ClinicalTrials.gov NCT00920621. Quebec Breast Cancer Foundation and Genome Canada Innovation Network. This trial was funded by the National Heart, Lung, and Blood Institute. For details see Acknowledgments.

  11. Hypertensive Disorders of Pregnancy - A Life-Long Risk?!

    Science.gov (United States)

    Schausberger, C E; Jacobs, V R; Bogner, G; Wolfrum-Ristau, P; Fischer, T

    2013-01-01

    Background: Arterial hypertension is one of the most important causes of cardiovascular diseases, and the latter are responsible for almost half of the deaths in the industrialised nations. Hypertensive disorders of pregnancy constitute one of the most frequent causes of feto-maternal morbidity and mortality; on the other hand the occurrence of a hypertensive disorder of pregnancy represents a risk for the later development of hypertension and the cardiovascular risks resulting therefrom. The aim of this article is to demonstrate the association of hypertensive disorders of pregnancy with consecutive cardiovascular diseases. Materials and Methods: Specific selective literature research. Results: After the occurrence of a hypertensive disorder of pregnancy the relative risks for hypertension are 3.7 (2.70-5.05), for ischaemic heart disease 2.2 (1.86-2.52), for cerebral insult 1.8 (1.45-2.27) and for mortality resulting from cardiovascular causes 1.5 (1.05-2.14) and are thus significant. According to a recent study 56 % of internal specialists and 23 % of gynecologists do not know about the association of preeclampsia with ischemic heart disease, 48 % and 38 % respectively are not aware of the link with stroke and 79 % and 77 % respectively are not aware of the association with a reduced life expectancy after preeclampsia. The presence of hypertension is not known by many of the patients, merely 28-38 % receive an appropriate therapy. Conclusion: Adequate follow-up after hypertensive disorders of pregnancy and the early recognition of and therapy for hypertension represent the cornerstones in the prevention of late cardiovascular sequelae. General practitioners, specialist for internal medicine and gynaecologists have a special responsibility with regard to the reduction of later complications.

  12. Application Research on High Risk Pregnancy Management in the Scarred Uterus Vaginal Delivery%高危妊娠管理在瘢痕子宫阴道分娩中的应用研究

    Institute of Scientific and Technical Information of China (English)

    王玉华

    2016-01-01

    Objective To study the application of high risk pregnancy management in the scarred uterus vaginal delivery. Methods 168 cases of pregnant women with scarred uterus admitted in our hospital from August 2012 to November 2015 were selected and randomly divided into two groups with 84 cases in each, the control group were given routine nursing, the observation group were given high-risk pregnancy management, and the delivery method, delivery outcome, perinatal weight and length of stay were compared between the two groups. Results After the high-risk pregnancy management, the vaginal trial production rate, success rate of trial production and vaginal birth rate in the observation group were obviously higher than those in the control group, and the differences had statistical significance, P<0.05, the bleeding volumes after postpar-tum 2h and 24h in the observation group were obviously lower than those in the control group, and the differences had sta-tistical significance, P<0.05;the birth weight of newborns in the observation group was obviously lower than that in the con-trol group, and the length of stay was lower than that in the control group, and the difference had statistical significance, P<0.05. Conclusion The high-risk pregnancy management can change the delivery method of pregnant women, improve the delivery outcome of pregnant women with scarred uterus and reduce the postpartum bleeding volume.%目的:探讨高危妊娠管理在瘢痕子宫阴道分娩中的应用。方法选取2012年8月-2015年11月该院接收的168例瘢痕子宫孕妇,随机分组,各84例,对照组给予常规护理,观察组给予高危妊娠管理,比较两组产妇分娩方式、分娩结局、围生儿体重、住院时间。结果高危妊娠管理后观察组阴道试产率、试产成功率、阴道分娩率均显著高于对照组,差异有统计学意义(P<0.05);观察组产后2 h出血量、24 h出血量均显著低于对照组

  13. Risk Psychosocial Factors to School Dropout and Early Teenage Pregnancy

    Directory of Open Access Journals (Sweden)

    Fabián Antonio Dávila Ramírez

    2016-01-01

    Full Text Available To explore the frequency and weight that psychosocial risk factors predispose to outcomes of early pregnancy and scholar dropout, a descriptive review was conducted. Materials and Meth­ods: A search and review of the results reported by observational studies in the PubMed data­base indexed from July 27, 2010 until July 25, 2013 was performed, restricting the search to studies in humans, Spanish or English written, not made in countries in Africa or Asia. Search was widened to LILACS database for the years 2006 to 2013 for Latinamerican countries. For inclusion, all case-control studies comparing different types of interventions and psychosocial risk factors in adolescents were eligible. Results: The review suggests violence experienced dur­ing adolescence, sexual abuse, belonging to a low socioeconomic status, low self-esteem, eating behavior disorders, smoking, alcoholism and drug addiction, mental disorders, early initiation of sex, poor family ties, lack of access to information, and resources for family planning as main psychosocial factors related to early pregnancy and scholar dropout in adolescents. Conclusions: Both risk factors associated with pregnancy and scholar dropout were described, and interven­tions targeting the described risk factors could potentially contribute to the reduction of these outcomes were described.

  14. Uterine Spiral Artery Remodeling: The Role of Uterine Natural Killer Cells and Extravillous Trophoblasts in Normal and High-Risk Human Pregnancies.

    Science.gov (United States)

    Tessier, Daniel R; Yockell-Lelièvre, Julien; Gruslin, Andrée

    2015-07-01

    The process of uterine spiral artery remodeling in the first trimester of human pregnancy is an essential part of establishing adequate blood perfusion of the placenta that will allow optimal nutrient/waste exchange to meet fetal demands during later development. Key regulators of spiral artery remodeling are the uterine natural killer cells and the invasive extravillous trophoblasts. The functions of these cells as well as regulation of their activation states and temporal regulation of their localization within the uterine tissue are beginning to be known. In this review, we discuss the roles of these two cell lineages in arterial remodeling events, their interaction/influence on one another and the outcomes of altered temporal, and spatial regulation of these cells in pregnancy complications. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  15. Can prematurity risk in twin pregnancies after in vitro fertilization be predicted? A retrospective study

    Directory of Open Access Journals (Sweden)

    Barad David

    2009-01-01

    Full Text Available Abstract Background Assisted reproduction (ART contributes to world-wide increases of twin pregnancies, in turn raising prematurity risks. Whether characteristics of ART cycles, resulting in twin gestations, can predict prematurity risks was the subject of this study. Methods One-hundred-and-six women, ages 20 to 39 years, with consecutive dichorionic-diamniotic (DC/DA twin gestations were retrospectively investigated. All pregnancies investigated followed fresh ART cycles, with use of autologous gamets, and were delivered at a university-based high-risk, maternal-fetal medicine unit. Only premature deliveries (i.e., <37.0 weeks gestational age, with viable neonate(s of ≥ 500 grams, were considered for analysis. Results After 1.8 +/- 1.2 ART cycles, 11.0 +/- 5.4 oocytes were retrieved and 2.4 +/- 0.9 embryos transferred in 106 women aged 31.6 +/- 4.2 years. Indications for ART treatment were male factor in 51.9%, female infertility in 27.4% and combined infertility in 20.8%. Though maternal age significantly influenced prematurity risk (p < 0.05, paternal age, maternal body mass index, indications for fertility treatment, number of previous ART attempts, oocytes retrieved or embryos transferred, as well as stimulation protocols and previous ART pregnancies, were not associated with gestational duration in twin pregnancies. Summary Except for female age, baseline and ART cycle characteristics do not allow for prediction of prematurity risk in dichorionic twin gestations after assisted reproduction.

  16. Use of tramadol in early pregnancy and congenital malformation risk.

    Science.gov (United States)

    Källén, Bengt; Reis, Margareta

    2015-12-01

    Only few studies exist regarding the risk of a teratogenic effect of tramadol when used in early pregnancy. Using the Swedish Medical Birth Register, women (deliveries in 1997-2013) who had reported the use of tramadol in early pregnancy were identified. Maternal characteristics and concomitant drug use were analyzed. Among 1,682,846 women (1,797,678 infants), 1751 (1776 infants) had used tramadol, 96 of the infants had a congenital malformation and 70 of them were relatively severe. The adjusted odds ratio for a relatively severe malformation was 1.33 (95% CI 1.05-1.70). The odds ratios for cardiovascular defects (1.56, 95% CI 1.04-2.29) and for pes equinovarus (3.63, 95% CI 1.61-6.89) were significantly increased. The study suggests a teratogenic effect of tramadol but the risk increase is moderate. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. Cardiovascular risk factors in women who had hypertensive disorders late in pregnancy: a cohort study.

    Science.gov (United States)

    Hermes, Wietske; Franx, Arie; van Pampus, Maria G; Bloemenkamp, Kitty W M; Bots, Michiel L; van der Post, Joris A; Porath, Martina; Ponjee, Gabrielle A E; Tamsma, Jouke T; Mol, Ben Willem J; de Groot, Christianne J M

    2013-06-01

    The purpose of this study was to determine cardiovascular risk factors in women with a history of hypertensive pregnancy disorders at term (HTP) 2.5 years after pregnancy. In a multicenter cohort study in The Netherlands from June 2008 through November 2010, cardiovascular risk factors were compared between women with a history of HTP (HTP cohort, n = 306) and women with a history of normotensive pregnancies at term (NTP cohort, n = 99). HTP women had participated in a randomized, longitudinal trial assessing the effectiveness of induction of labor in women with hypertensive pregnancy disorders at term. All women were assessed 2.5 years after pregnancy for blood pressure, anthropometrics, glucose, glycosylated hemoglobin, insulin, homeostatic model assessment score, total cholesterol, high-density lipoprotein cholesterol, triglycerides, high-sensitivity C-reactive protein, and microalbumin and metabolic syndrome. After a mean follow-up period of 2.5 years, hypertension (HTP, 34%; NTP, 1%; P HTP, 25%; NTP, 5%; P HTP women compared with NTP women. HTP women had significantly higher systolic and diastolic blood pressure, higher body mass index, and higher waist circumference. Glucose, glycosylated hemoglobin, insulin, homeostatic model assessment score, total cholesterol, triglycerides, and high-sensitivity C-reactive protein levels were significantly higher and high-density lipoprotein cholesterol was significantly lower in HTP women. In women with a history of HTP, hypertension and metabolic syndrome are more common, and they have higher levels of biochemical cardiovascular risk factors 2.5 years after pregnancy. Copyright © 2013 Mosby, Inc. All rights reserved.

  18. Contraceptive use and risk of unintended pregnancy in California

    OpenAIRE

    Foster, Diana; Bley, Julia; Mikanda, John; Induni, Marta; Arons, Abigail; Baumrind, Nikki; Darney, Philip D; Stewart, Felicia

    2004-01-01

    Abstract California is home to more than one out of eight American women of reproductive age. Because California has a large, diverse and growing population, national statistics do not necessarily describe the reproductive health of California women. This article presents risk for pregnancy and sexually transmitted infections among women in California based on the California Women’s Health Survey. Over 8900 women of reproductive age who participated in this survey between 1998 and 2001 pr...

  19. Risk management of seasonal influenza during pregnancy: current perspectives

    Science.gov (United States)

    Yudin, Mark H

    2014-01-01

    Influenza poses unique risks to pregnant women, who are particularly susceptible to morbidity and mortality. Historically, pregnant women have been overrepresented among patients with severe illness and complications from influenza, and have been more likely to require hospitalization and intensive care unit admission. An increased risk of adverse outcomes is also present for fetuses/neonates born to women affected by influenza during pregnancy. These risks to mothers and babies have been observed during both nonpandemic and pandemic influenza seasons. During the H1N1 influenza pandemic of 2009–2010, pregnant women were more likely to be hospitalized or admitted to intensive care units, and were at higher risk of death compared to nonpregnant adults. Vaccination remains the most effective intervention to prevent severe illness, and antiviral medications are an important adjunct to ameliorate disease when it occurs. Unfortunately, despite national guidelines recommending universal vaccination for women who are pregnant during influenza season, actual vaccination rates do not achieve desired targets among pregnant women. Pregnant women are also sometimes reluctant to use antiviral medications during pregnancy. Some of the barriers to use of vaccines and medications during pregnancy are a lack of knowledge of recommendations and of safety data. By improving knowledge and understanding of influenza and vaccination recommendations, vaccine acceptance rates among pregnant women can be improved. Currently, the appropriate use of vaccination and antiviral medications is the best line of defense against influenza and its sequelae among pregnant women, and strategies to increase acceptance are crucial. This article will review the importance of influenza in pregnancy, and discuss vaccination and antiviral medications for pregnant women. PMID:25114593

  20. The Effect of Early Intervention of High Risk Factors on Pregnancy Outcomes in Gestational Diabetes Mellitus%高危因素早期干预对妊娠期糖尿病妊娠结局的影响

    Institute of Scientific and Technical Information of China (English)

    张亚伟; 赵淑霞

    2014-01-01

    目的:早期干预具有妊娠期糖尿病(GDM)高危因素的孕产妇,观察其妊娠结局。方法对2010年5月至2013年3月我院产科建档的具有妊娠期糖尿病高危因素的孕妇随机分为研究组(726例)和对照组(708例),采用前瞻性随机对照研究方法,针对妊娠期糖尿病高危因素进行早期干预,观察两组妊娠结局。结果对照组的剖宫产、妊娠期高血压疾病、产后出血、羊水过多、巨大儿的发生率高于研究组(P<0.05);而胎膜早破、羊水过少、GDM、早产、低出生体质量儿、胎儿畸形、胎儿窘迫及新生儿窒息的发生率两组无统计学差异(P>0.05)。结论妊娠期糖尿病严重危害母亲及胎儿的健康,对具有妊娠期糖尿病高危因素的孕妇进行早期干预,可有效减少妊娠期糖尿病引起的母婴并发症的发生。%Objective Early intervention with gestational diabetes mellitus(GDM)risk factors for maternal, observes its pregnancy outcome. Methods The pregnant women with high risk factors of gestational diabetes mellitus documented in our hospital obstetric from May 2010 to March 2013 were randomly divided into study group(726)and control group(708). Prospective randomized comparison study methods are used, perform early intervention against the gestational diabetes-risk factors, and observe two groups of pregnancy outcomes. Results The incidence rate of Cesarean section, hypertensive disorders in pregnancy, postpartum bleeding, polyhydramnios of the control group is higher than that of macrosomia research group(P0.05).Conclusion Diabetes seriously endangers the health of the mother and fetus during pregnancy. With early intervention of high risk factors of gestational diabetes mellitus pregnant women, the incidence of maternal and neonatal complications of gestational diabetes can be effectively reduced.

  1. Risk and Benefit of Drug Use During Pregnancy

    Directory of Open Access Journals (Sweden)

    2005-07-01

    Full Text Available Environmental teratogenic factors (e.g. alcohol are preventable. We focus our analysis on human teratogenic drugs which are not used frequently during pregnancy. The previous human teratogenic studies had serious methodological problems, e.g. the first trimester concept is outdated because environmental teratogens cannot induce congenital abnormalities in the first month of gestation. In addition, teratogens usually cause specific congenital abnormalities or syndromes. Finally, the importance of chemical structures, administrative routes and reasons for treatment at the evaluation of medicinal products was not considered. On the other hand, in the so-called case-control epidemiological studies in general recall bias was not limited. These biases explain that the teratogenic risk of drugs is exaggerated, while the benefit of medicine use during pregnancy is underestimated. Thus, a better balance is needed between the risk and benefit of drug treatments during pregnancy. Of course, we have to do our best to reduce the risk of teratogenic drugs as much as possible, however, it is worth stressing the preventive effect of drugs for maternal diseases (e.g. diabetes mellitus and hyperthermia related congenital abnormalities.

  2. Risk Factors for Hyperglycaemia in Pregnancy in Tamil Nadu, India.

    Directory of Open Access Journals (Sweden)

    Karoline Kragelund Nielsen

    Full Text Available Hyperglycaemia in pregnancy (HIP, i.e. gestational diabetes mellitus (GDM and diabetes in pregnancy (DIP, increases the risk of various short- and long-term adverse outcomes. However, much remains to be understood about the role of different risk factors in development of HIP.The aims of this observational study were to examine the role of potential risk factors for HIP, and to investigate whether any single or accumulated risk factor(s could be used to predict HIP among women attending GDM screening at three centres in urban, semi-urban and rural Tamil Nadu, India.Pregnant women underwent a 75 g oral glucose tolerance test. Data on potential risk factors was collected and analysed using logistical regression analysis. Receiver operating characteristic (ROC curves, sensitivity, specificity and predictive values were calculated for significant risk factors and a risk factor scoring variable was constructed.HIP was prevalent in 18.9% of the study population (16.3% GDM; 2.6% DIP. Increasing age and BMI as well as having a mother only or both parents with diabetes were significant independent risk factors for HIP. Among women attending the rural health centre a doubling of income corresponded to an 80% increased risk of HIP (OR 1.80, 95%CI 1.10-2.93; p = 0.019, whereas it was not significantly associated with HIP among women attending the other health centres. The performance of the individual risk factors and the constructed scoring variable differed substantially between the three health centres, but none of them were good enough to discriminate between those with and without HIP.The findings highlight the importance of socio-economic circumstances and intergenerational risk transmission in the occurrence of HIP as well as the need for universal screening.

  3. RISK FACTORS IN PREGNANCY AND THEIR RELATION TO BIRTH WEIGHT

    Directory of Open Access Journals (Sweden)

    F. Azordegan

    1989-06-01

    Full Text Available In 17 hospitals, 13123 new births were born during 1989 in Tehran. Some well-trained personnel observed the events, filling the required questionnaires, interviewing, and collecting necessary information. Among them 730 newborns was low birth weight (less than 2500 grams which was considered as cases. Immediately after each case was born, two normal newborn were randomly selected as controls. So at the end of data collection, a total of 1460 births were considered controls. In a case-control study the effect of some risk factors during pregnancy of mothers on birth weight and death rate of newborn during first 4 weeks of their life were fully investigated. Some of the findings are as follows: The past history of miscarriages will decrease the birth weight of the newborn and thereby will increase the death rate in the first 28 days of their life. In this respect the difference between case and control was highly significant. Other variables like past history of premature birth, chronic diseases, hemorrhage and severe vomiting showed the same results.

  4. Social discrimination, stress, and risk of unintended pregnancy among young women.

    Science.gov (United States)

    Hall, Kelli Stidham; Kusunoki, Yasamin; Gatny, Heather; Barber, Jennifer

    2015-03-01

    Prior research linking young women's mental health to family planning outcomes has often failed to consider their social circumstances and the intersecting biosocial mechanisms that shape stress and depression as well as reproductive outcomes during adolescence and young adulthood. We extend our previous work to investigate relationships between social discrimination, stress and depression symptoms, and unintended pregnancy among adolescent and young adult women. Data were drawn from 794 women aged 18-20 years in a longitudinal cohort study. Baseline and weekly surveys assessed psychosocial information including discrimination (Everyday Discrimination Scale), stress (Perceived Stress Scale), depression (Center for Epidemiologic Studies-Depression Scale), and reproductive outcomes. Multilevel, mixed-effects logistic regression and discrete-time hazard models estimated associations between discrimination, mental health, and pregnancy. Baron and Kenny's method was used to test mediation effects of stress and depression on discrimination and pregnancy. The mean discrimination score was 19/45 points; 20% reported moderate/high discrimination. Discrimination scores were higher among women with stress and depression symptoms versus those without symptoms (21 vs. 18 points for both, p Pregnancy rates (14% overall) were higher among women with moderate/high (23%) versus low (11%) discrimination (p stress (adjusted relative risk ratio, [aRR], 2.2; 95% confidence interval [CI], 1.4-3.4), depression (aRR, 2.4; CI, 1.5-3.7), and subsequent pregnancy (aRR, 1.8; CI, 1.1-3.0). Stress and depression symptoms did not mediate discrimination's effect on pregnancy. Discrimination was associated with an increased risk of mental health symptoms and unintended pregnancy among these young women. The interactive social and biological influences on reproductive outcomes during adolescence and young adulthood warrant further study. Copyright © 2015 Society for Adolescent Health and Medicine

  5. Pregnancy after bariatric surgery - a review of benefits and risks

    DEFF Research Database (Denmark)

    Kjær, Mette Karie Mandrup; Nilas, Lisbeth

    2013-01-01

    Background. When other weight loss attempts have failed, bariatric surgery offers a successful alternative against obesity. Since operations are performed during women´s reproductive years, the number of pregnant women with prior bariatric surgery is increasing. Bariatric surgery results in restr......Background. When other weight loss attempts have failed, bariatric surgery offers a successful alternative against obesity. Since operations are performed during women´s reproductive years, the number of pregnant women with prior bariatric surgery is increasing. Bariatric surgery results...... in restriction of food intake and/or malabsorption leading to weight loss, but may induce a risk for malnutrition and pregnancy complications. Method. Systematically conducted review addressing pregnancy after bariatric surgery using the PubMed and Cochrane databases. Main Outcome Measures. Birthweight......, gestational age, birth defects, preeclampsia, gestational diabetes mellitus, and mode of delivery. Results. We included 17 articles in English, comparing pregnancies in women with prior bariatric surgery to pregnancies in a control group without this. There was considerable heterogeneity in study design...

  6. Progesterone elevation does not compromise pregnancy rates in high responders

    DEFF Research Database (Denmark)

    Griesinger, Georg; Mannaerts, Bernadette; Andersen, Claus Yding

    2013-01-01

    To compare the impact of elevated P during the late follicular phase on the chance of pregnancy in low, normal, and high responders.......To compare the impact of elevated P during the late follicular phase on the chance of pregnancy in low, normal, and high responders....

  7. Maternal high-dose folic acid during pregnancy and asthma medication in the offspring

    NARCIS (Netherlands)

    Zetstra-van der Woude, Priscilla A.; De Walle, Hermien E. K.; Hoek, Annemieke; Bos, H. Jens; Boezen, H. Marike; Koppelman, Gerhard H.; de Jong-van den Berg, Lolkje T. W.; Scholtens, Salome

    2014-01-01

    Purpose Low-dose folic acid supplementation (0.5 mg) taken during pregnancy has been associated with an increased risk for childhood asthma. The effect of high-dose folic acid (5 mg) advised to women at risk for having a child with neural tube defect has not been assessed so far. Our aim was to inve

  8. Risk of Adverse Pregnancy Outcome After Paternal Exposure to Methotrexate Within 90 Days Before Pregnancy

    DEFF Research Database (Denmark)

    Eck, Lasse Karlsen; Jensen, Thomas Bo; Mastrogiannis, Dimitrios

    2017-01-01

    group and no increased risk of preterm birth (adjusted OR 1.31, 95% CI 0.66-2.59) among the children from exposed fathers. CONCLUSION: We found no association between paternal exposure to methotrexate within 90 days before pregnancy and congenital malformations, stillbirths, or preterm birth. Available......OBJECTIVE: To study the association between paternal exposure to methotrexate within the 90-day period before pregnancy and congenital malformations and stillbirth in the offspring. METHODS: We conducted a nationwide register study. Our cohort consisted of all live births in Denmark between 1997...... and 2011 identified from the Medical Birth Registry. Methotrexate-exposed fathers were identified from the National Prescription Registry. From the national Hospital Registry we identified paternity, live births, and stillbirths as well as discharge diagnoses on congenital malformations. RESULTS: We...

  9. Truancy and teenage pregnancy in English adolescent girls: can we identify those at risk?

    National Research Council Canada - National Science Library

    Zhou, Yin; Puradiredja, Dewi Ismajani; Abel, Gary

    2016-01-01

    Truancy has been linked to risky sexual behaviours in teenagers. However, no studies in England have examined the association between truancy and teenage pregnancy, and the use of truancy as a marker of teenagers at risk of pregnancy...

  10. Effect of high parity on occurrence of anemia in pregnancy: a cohort study

    Directory of Open Access Journals (Sweden)

    Cabral Howard J

    2011-01-01

    Full Text Available Abstract Background Studies that explore the controversial association between parity and anaemia-in-pregnancy (AIP were often hampered by not distinguishing incident cases caused by pregnancy from prevalent cases complicated by pregnancy. The authors' aim in conducting this study was to overcome this methodological concern. Methods A retrospective cohort study was conducted in Oman on 1939 pregnancies among 479 parous female participants with available pregnancy records in a community trial. We collected information from participants, the community trial, and health records of each pregnancy. Throughout the follow-up period, we enumerated 684 AIP cases of which 289 (42.2% were incident cases. High parity (HP, ≥ 5 pregnancies accounted for 48.7% of total pregnancies. Two sets of regression analyses were conducted: the first restricted to incident cases only, and the second inclusive of all cases. The relation with parity as a dichotomy and as multiple categories was examined for each set; multi-level logistic regression (MLLR was employed to produce adjusted models. Results In the fully adjusted MLLR models that were restricted to incident cases, women with HP pregnancies had a higher risk of AIP compared to those who had had fewer pregnancies (Risk Ratio, RR = 2.92; 95% CI 2.02, 4.59; the AIP risk increased in a dose-response fashion over multiple categories of parity. In the fully adjusted MLLR models that included all cases, the association disappeared (RR = 1.11; 95% CI 0.91, 1.18 and the dose-response pattern flattened. Conclusions This study shows the importance of specifying which cases of AIP are incident and provides supportive evidence for a causal relation between parity and occurrence of incidental AIP.

  11. PP112. Prediction of preeclampsia based on clinical risk factors: A prospective high-risk cohort study : 18th World Congress of the International Society for the Study of Hypertension in Pregnancy, 9-12 July 2012, Geneva, Switzerland

    NARCIS (Netherlands)

    Wong, T.Y.; Groen, H.; Faas, M.M.; van Pampus, M.G.

    2012-01-01

    Introduction Early recognition of preeclampsia (PE) is crucial for better obstetric care. Clinical risk factors are easier to identify than biochemical markers and may be useful in the prediction of PE. Objectives To evaluate which risk factors provide the best prediction for PE in a group at high-r

  12. Folic Acid Supplementation in Pregnancy and the Risk of Pre-Eclampsia-A Cohort Study.

    Science.gov (United States)

    Wen, Shi Wu; Guo, Yanfang; Rodger, Marc; White, Ruth Rennicks; Yang, Qiuying; Smith, Graeme N; Perkins, Sherry L; Walker, Mark C

    2016-01-01

    This prospective cohort study designed to assess the effect of folic acid supplementation in pregnancy on the risk of preeclampsia (PE) took place in Ottawa, ON and Kingston, ON, Canada, from September 1, 2002 to August 31, 2008. Pregnant women, less than 20 weeks gestational age were recruited and delivered in the Ottawa region and the Kingston General Hospital. Demographic characteristics of the study participants and the patterns of supplementation of folic acid were described and occurrence of PE between women with folic acid supplementation during pregnancy and women without were compared. Multiple logistic regression was used in the estimation of the independent effect of supplementation of folic acid. Additional analyses assessing the effect of low RBC and serum folate and dose-response relationship were performed. Analyses were performed in all study participants, and then in high risk and low risk sub-groups, respectively. A total of 7,669 participants were included in the final analysis. Ninety five percent of the study participants were taking folic acid supplementation in early second trimester. The rate of PE was lower in the supplementation group than in the no supplementation group, and the difference was statistically significant in high risk women. Similar patterns of associations were observed in analysis by RBC and serum folate levels and in dose-response analysis. Folic acid supplementation in pregnancy may reduce PE risk in pregnant women, especially in those women with increased risk of developing PE.

  13. Risk-Taking Behavior for HIV Acquisition during Pregnancy in Porto Alegre, Brazil

    Directory of Open Access Journals (Sweden)

    Nava Yeganeh

    2012-01-01

    Full Text Available Recent studies suggest that acquisition of HIV-1 infection during pregnancy and breastfeeding is associated with a high risk of HIV mother-to-child transmission. This study evaluates risk factors associated with HIV acquisition during pregnancy in women delivering at a large metropolitan medical facility located in the south of Brazil. From February to August 2009, our group conducted a cross-sectional study assessing women’s risk for HIV acquisition by administering an oral survey to peripartum women. Of 2465 participants, 42% (n=1046 knew that partner had been tested for HIV. During pregnancy, 82% (n=2022 of participants never used condoms; yet 97% (n=2399 practiced vaginal sex. Multivariate logistic regression analysis showed that patients with more years of education, in a relationship for more than 1 year, and who knew their own HIV status were more likely to know their partners' HIV status (P<0.05. Those who were in relationship for more than 1 year and were married/living together were more likely to be comfortable discussing HIV testing with partners (P<0.05. In conclusion, women in Brazil are at risk of HIV-infection during pregnancy as they remain sexually active, often do not know their sexual partner’s HIV status, and have minimal condom use.

  14. Severe stress following bereavement during pregnancy and risk of pregnancy loss: results from a population-based cohort study.

    Science.gov (United States)

    Plana-Ripoll, Oleguer; Parner, Erik; Olsen, Jørn; Li, Jiong

    2016-05-01

    Previous findings on the association between stress during pregnancy and pregnancy loss are inconsistent. We aimed to estimate this association using a large prospective cohort. This population-based study included all 1 303 660 clinically recognised pregnancies in Denmark between 1995 and 2008. We categorised women as exposed to severe stress if they lost a child, sibling or parent during pregnancy. Cox Proportional Hazards models were used to study the association between exposure and rate of fetal death, starting with the follow-up on the day of completion of week 4 of pregnancy. In an attempt to control for unknown potential confounders, we also designed a pregnancy-matched analysis in which each woman had her own baseline risk of pregnancy loss and controls therefore for genetic and time-stable environmental factors. A total of 146 031 pregnancies ended in clinically recognised fetal loss (11.2%) and a total of 10 808 (0.8%) women were categorised as exposed. The overall risk of pregnancy loss was similar in the exposed and unexposed (aHR=1.05, 95% CI 0.95 to 1.15). Results from the pregnancy-matched analysis (performed in 423 women) showed stronger and significant associations (aHR=1.83, 95% CI 1.49 to 2.25). All the analyses indicated a stronger effect of bereavement when the mother lost a child or when the death was unexpected. Our main results suggested no strong association between severe stress during pregnancy and risk of pregnancy loss. Results from the pregnancy-matched analyses considered information from a selected and small group of women for whom there may exist a stronger association between stress during pregnancy and pregnancy loss. The fact that an unexpected death or the loss of a child had a stronger effect in both analyses may indicate that severe stressful situations increase the risk of pregnancy loss. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  15. RISK FACTOR EPIDEMIOLOGY OF ECTOPIC PREGNANCY AND SUCCESS OF NONSURGICAL MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Vijayan C.P

    2016-10-01

    Full Text Available BACKGROUND Ectopic pregnancies are increasing in number and proportions. Real increase and better detection methods are contributing for this rise. All the cases diagnosed now are not surgical emergencies. Medical management and expectant line of management are possible. Revised clinical guidelines are there for the selection of cases for nonsurgical management. Knowledge about the risk factors is good for prophylaxis and to have a high suspicion about ectopic pregnancy in high-risk individuals. Knowing the success rate is absolutely essential for counselling before starting the therapy. Aim of the study- 1. To study the risk factor profile of ectopic pregnancies and to compare them with the old data of the study setting. 2. To follow up the cases receiving nonsurgical treatment and to assess the success rate. MATERIALS AND METHODS Study Setting- Department of Obstetrics and Gynaecology, Government Medical College, Kottayam. It is a tertiary care centre with 1500 beds and catering for the population of five districts of Kerala. Study Design- Observational Study Study Period- This study was completed by eighteen months from April 2014 to September 2015. RESULTS 219 cases of ectopic pregnancies were diagnosed during the study period. The ratio of this number with the total number of deliveries during that period is 3.48% and this is three times higher than that of the ratio twenty years ago (1.23%. Risk factor profile is also showing changes over this period. 15.1% had medical treatment and 11% had expectant line of therapy. Success rates are 87.87% and 95.65%, respectively. CONCLUSIONS Incidence and detection of ectopic pregnancies are increasing and the risk factor profile is changing. In properly selected cases, the success of nonsurgical management is excellent.

  16. [Pregnancy and labor activity: is there really risk?].

    Science.gov (United States)

    Rosales-Aujang, Enrique

    2010-11-01

    In the last decades the participation of women in the family economy has increased causing in theory a higher risk for reproduction. To investigate whether labor negatively influences the course and culmination of pregnancy in women workers. Descriptive and comparative cross-sectional survey made in the Hospital General de Zona núm. 2, of the Instituto Mexicano del Seguro Social, in Aguascalientes city (Mexico), which included 154 working patients and a control group of 154 not working patients selected by pairs. The study period was from 1 February to 31 March 2010. The following variables were analyzed: age, marital status, education degree, occupation, pregnancy number, queries, weight increase, obstetric complications, obstetric event, family planning method after the obstetric event; sex, weight and gestational age of the newborn, years of labor and weekly hours labored. There are significant differences in favor of working women according to the background; while in progress and resolution of pregnancy there is virtually no difference. Work does not imply an increased obstetric complication or neonatal morbidity risk.

  17. Fetal Hemodynamic Parameters in Low Risk Pregnancies: Doppler Velocimetry of Uterine, Umbilical, and Middle Cerebral Artery

    Directory of Open Access Journals (Sweden)

    C. O. Figueira

    2016-01-01

    Full Text Available Objective. To elaborate curves of longitudinal reference intervals of pulsatility index (PI and systolic velocity (SV for uterine (UtA, umbilical (UA, and middle cerebral arteries (MCA, in low risk pregnancies. Methods. Doppler velocimetric measurements of PI and SV from 63 low risk pregnant women between 16 and 41 weeks of gestational age. Means (±SD for intervals of gestational age and percentiles 5, 50, and 95 were calculated for each parameter. The Intraclass Correlation Coefficients (ICC were also estimated for assessing intra- and intervariability of measurements. Results. Mean PI of UtA showed decreasing values during pregnancy, but no regular pattern was identified for mean SV. For UA, PI decreased and SV increased along gestation. MCA presented PI increasing values until 32–35 weeks. SV showed higher levels with increasing gestation. High ICC values indicated good reproducibility. Conclusions. Reference intervals for the assessment of SV and PI of UtA, UA, and MCA were established. These reference intervals showed how a normal pregnancy is expected to progress regarding these Doppler velocimetric parameters and are useful to follow high risk pregnancies. The comparison between results using different curves may provide insights about the best patterns to be used.

  18. Drugs for treatment of very high blood pressure during pregnancy.

    Science.gov (United States)

    Duley, Lelia; Meher, Shireen; Jones, Leanne

    2013-07-31

    Very high blood pressure during pregnancy poses a serious threat to women and their babies. The aim of antihypertensive therapy is to lower blood pressure quickly but safety, to avoid complications. Antihypertensive drugs lower blood pressure but their comparative effectiveness and safety, and impact on other substantive outcomes is uncertain. To compare different antihypertensive drugs for very high blood pressure during pregnancy. We searched the Cochrane Pregnancy and Childbirth Group Trials Register (9 January 2013). Studies were randomised trials. Participants were women with severe hypertension during pregnancy. Interventions were comparisons of one antihypertensive drug with another. Two review authors independently assessed trials for inclusion and assessed trial quality. Two review authors extracted data and checked them for accuracy. Thirty-five trials (3573 women) with 15 comparisons were included. Women allocated calcium channel blockers were less likely to have persistent high blood pressure compared to those allocated hydralazine (six trials, 313 women; 8% versus 22%; risk ratio (RR) 0.37, 95% confidence interval (CI) 0.21 to 0.66). Ketanserin was associated with more persistent high blood pressure than hydralazine (three trials, 180 women; 27% versus 6%; RR 4.79, 95% CI 1.95 to 11.73), but fewer side-effects (three trials, 120 women; RR 0.32, 95% CI 0.19 to 0.53) and a lower risk of HELLP (haemolysis, elevated liver enzymes and lowered platelets) syndrome (one trial, 44 women; RR 0.20, 95% CI 0.05 to 0.81).Labetalol was associated with a lower risk of hypotension compared to diazoxide (one trial 90 women; RR 0.06, 95% CI 0.00 to 0.99) and a lower risk of caesarean section (RR 0.43, 95% CI 0.18 to 1.02), although both were borderline for statistical significance.Both nimodipine and magnesium sulphate were associated with a high incidence of persistent high blood pressure, but this risk was lower for nimodipine compared to magnesium sulphate (one trial

  19. Risk of Ectopic Pregnancy in Women With Inflammatory Bowel Disease

    DEFF Research Database (Denmark)

    de Silva, Punyanganie S; Hansen, Helene H; Wehberg, Sonja

    2017-01-01

    BACKGROUND & AIMS: Few data are available on adverse events of pregnancy in women with inflammatory bowel diseases (IBDs), such as ectopic pregnancy. We assessed the risk of an ectopic pregnancy in pregnancies of women in Denmark with IBD compared with those without IBD over a 22-year period. We...... also examined the disease-specific risks of ectopic pregnancies in pregnancies of women with ulcerative colitis (UC) or Crohn's disease (CD) who underwent IBD-related surgical procedures. METHODS: We performed a retrospective study of all women of child-bearing age (ages, 15-50 y) registered...... in the Danish National Patient Registry with at least 1 pregnancy during the period from January 1994 through December 2015. We collected data on all women with an ectopic pregnancy, hydatiform mole, miscarriages (spontaneous and other abortions, including abnormal pregnancy products, missed abortion...

  20. Immunosuppression under pregnancy and risks under viral infections

    Directory of Open Access Journals (Sweden)

    O. I. Kiselev

    2013-12-01

    Full Text Available The paper is devoted to studying the mechanisms of combined immunosuppression in pregnant women with influenza infection to develop arrangements for controlling these processes and for decreasing mortality from this infection. In this connection the author is dwelling on the following problems: – How are the fetus immune privilege and tolerance development provided? – What mechanisms do underlie the functional immunosuppresion under pregnancy? – Why are the infections especially dangerous for pregnant women? – Is there the code of the immune system control, and do viruses use this code? The paper deals with the problem of influence of endogenic viruses, which have penetrated the human genome more than 25 million years ago, on the great number of risks of development of various kinds of human pathologies: from infertility to pregnancy diseases; from development of malignant tumors to system pathology and autoimmune diseases.

  1. Management of metastatic thyroid cancer in pregnancy: risk and uncertainty

    Directory of Open Access Journals (Sweden)

    Christopher W Rowe

    2016-12-01

    Full Text Available Metastatic thyroid cancer is an uncommon condition to be present at the time of pregnancy, but presents a challenging paradigm of care. Clinicians must balance the competing interests of long-term maternal health, best achieved by iatrogenic hyperthyroidism, regular radioiodine therapy and avoidance of dietary iodine, against the priority to care for the developing foetus, with inevitable compromise. Additionally, epidemiological and cellular data support the role of oestrogen as a growth factor for benign and malignant thyrocytes, although communicating the magnitude of this risk to patients and caregivers, as well as the uncertain impact of any pregnancy on long-term prognosis, remains challenging. Evidence to support treatment decisions in this uncommon situation is presented in the context of a case of a pregnant teenager with known metastatic papillary thyroid cancer and recent radioiodine therapy.

  2. Cardiovascular risk, lipids and pregnancy: preeclampsia and the risk of later life cardiovascular disease.

    Science.gov (United States)

    Charlton, Francesca; Tooher, Jane; Rye, Kerry-Anne; Hennessy, Annemarie

    2014-03-01

    It has been widely thought that the effects of hypertension in pregnancy reversed after delivery and hypertension values returned to their pre-pregnancy level as it was seen as a disease of short duration in otherwise healthy young women. However, recent studies have demonstrated that the principal underlying abnormality, endothelial dysfunction, remains in women who had preeclampsia and that it is this damage that increases the risk of developing cardiovascular disease (CVD) in later life. The contributions of hypertension and dyslipidaemia before and during the pregnancy are also important and contribute to future risk. Serum lipids are complex and change dramatically in pregnancy. In general there is an increase in most plasma lipid components, notably triglycerides, total cholesterol and the major particles of HDL and LDL. Aberrations or exaggerations in this shift (i.e. decrease HDL and a greater increase in LDL) are associated with poor outcomes of pregnancy such as preeclampsia. Long term cardiovascular disease is influenced by preeclampsia and in part potentially by the lipid changes which escalate late in disease. Whether we can influence the risk of preeclampsia by controlling cardiovascular risk factors preceding or during preeclampsia, or cardiovascular disease after preeclampsia is yet to be determined. Ultimately, strategies to control lipid concentrations will only be viable when we understand the safety to the mother at the time of the pregnancy, and to the foetus both immediately and in the very long term. Strategies to control blood pressure are well established in the non-pregnant population, and previous preeclampsia and gestational hypertension should be considered in any cardiovascular risk profile. Whether control of blood pressure in the pregnancy per se is of any longer term benefit is also yet to be determined.

  3. Depression during pregnancy: rates, risks and consequences--Motherisk Update 2008.

    Science.gov (United States)

    Marcus, Sheila M

    2009-01-01

    Affective illness is common in women, and the puerperium is a time of particular vulnerability. Gender differences in the expression of affective disorders have been attributed to the impact of hormonal influence, socialization, and genetics. Dramatic fluctuations in gonadal hormones that occur following childbirth, influences the increased incidence of mood disorders during this time. Numerous tools including the Edinburgh Postpartum Depression Scale can be used to screen for depression during pregnancy and postpartum. While screening tools may assist with appropriately identifying women who should be further assessed, their use alone does not significantly increase treatment seeking in women, even when their providers are notified about risk. Many studies demonstrate that only a small number (18%) of women who meet criteria for major depressive disorder seek treatment during pregnancy and postpartum. Additionally, common symptoms of depression (sleep, energy and appetite change) may be misinterpreted as normative experiences of pregnancy.Treatment engagement is important as untreated depression during pregnancy may have unfavorable outcomes for both women and children. Complications of pregnancy associated with depression include: inadequate weight gain,under utilization of prenatal care, increased substance use, and premature birth. Human studies demonstrate that perceived life-event stress, as well as depression and anxiety predicted lower birth weight, decreased Apgar scores, and smaller head circumference, and small for gestational age babies. Postpartum depression (PPD) is a common clinical disorder occurring in 15% of deliveries,making it one of the most frequent conditions to complicate pregnancy. Risk factors include past personal or family history of depression, sing marital status, poor health functioning, lower SES, and alcohol use. Women who have a prior history of postpartum depression, particularly with features of bipolarity or psychosis may be at

  4. The value of MR angiography in predicting the risk of torsion of a pelvic spleen during pregnancy

    Energy Technology Data Exchange (ETDEWEB)

    Karantanas, A.H. [Department of CT-MRI, Larissa General Hospital (Greece); Stagianis, K.D. [Department of Obstetrics and Gynecology, University Hospital, Larissa (Greece)

    2002-02-01

    A case of an enlarged pelvic spleen, studied with MRI and MR angiography (MRA), is presented in a 32-year-old female wishing to become pregnant. An ectopic located spleen may be complicated by an acute abdomen due to torsion of the splenic vascular pedicle, resulting in splenic infarction. Displacement of the spleen and splenic pedicle during pregnancy may further increase the risk of torsion. Urgent splenectomy during pregnancy is associated with a high fetal and maternal mortality and morbidity. On the other hand, elective splenectomy of a pelvic spleen before pregnancy can result in adhesion formation, compromising the patient's fertility. The abilities of MRI and MRA in predicting the risk of these life-threatening complications during pregnancy are discussed, in order to evaluate the benefit-risk ratio of surgical treatment by splenectomy of splenopexia. (orig.)

  5. Study on the occurrence and factors of hypoxemia in patients with high risk pregnancy%高危妊娠患者术后并发低氧血症发生因素的研究与探讨

    Institute of Scientific and Technical Information of China (English)

    刘世舜; 李锐; 王冬梅

    2015-01-01

    目的:本文主要是为了探讨和分析高危妊娠患者术后并发低氧血症的发生因素。方法选择2014年1月~2014年7月我院产科接收的50例产妇的临床资料作为研究对象,所有的产妇都为高危妊娠,接受了相应的剖宫产手术,对孕妇的临床治疗以及PaO2值进行比较、观察和记录。结果50例产妇中出现低氧血症的共有10例,占总人数的20%,其中包括轻度低氧血症7例、中度低氧血症2例以及重度低氧血症1例。手术之后无低氧血症的产妇前后PaO2对比差异较为明显。单因素结果显示患者的体重、年龄、剖宫产手术之间、吸烟与产次与高危妊产妇的术后并发低氧血症存在显著的关系。通过Logistic回归分析产妇的体重、年龄、吸烟是高危妊娠产妇术后出现低氧血症较为独立的一种危险因素。所有产妇在接受机械通气治疗之后,都产生了一定的效果,显效率和有效率分别为92%和100%。结论高危妊娠产妇很容易出现术后低氧血症的现象,其发生率与年龄、是否吸烟以及体重有关,作为其独立危险因素需要对相关因素进行重视,还要引导患者积极接受机械通气治疗。%Objective The purpose of this paper is to investigate and analyze the high risk pregnancy patients complicated with postoperative hypoxemia factors. Methods Select 2014 January to 2015 January in our hospital 50 cases of maternal obstetric accept pregnancy clinical data as the research object, all women are high risk pregnancy, accept the corresponding cesarean operation, the clinical treatment for pregnant women and PaO2 values were compared, to observe and record. Results 50 cases of maternal hypoxemia occurred in a total of 10 cases, the total number of 20%, including 7 cases of mild hypoxemia, 2 cases of moderate hypoxemia and 1 cases of severe hypoxemia. After the operation without hypoxemia after cesarean section before and after PaO2

  6. Periodontal therapy and risk for adverse pregnancy outcomes.

    Science.gov (United States)

    Oliveira, Alcione Maria Soares Dutra; de Oliveira, Peterson Antonio Dutra; Cota, Luís Otávio Miranda; Magalhães, Claúdia Silami; Moreira, Allyson Nogueira; Costa, Fernando Oliveira

    2011-10-01

    Periodontitis has been associated with adverse pregnancy outcomes. Results from intervention studies are few and controversial. The present study assessed the effects of non-surgical periodontal treatment in the occurrence of adverse pregnancy outcomes. Two hundred forty-six eligible women were randomly divided into two groups: periodontitis intervention (n = 122; undergoing non-surgical treatment during gestation) and periodontitis control (n = 124; not treated during gestation). Univariate analysis was performed and estimates of relative risk were reported. Data from 225 women were analyzed. No differences for preterm birth (p = 0.721), low birth weight (p = 0.198), and preterm low birth weight (p = 0.732) rates were observed. Relative risk estimates for preterm birth, low birth weight, and preterm low birth weight in the periodontitis intervention group were 0.915 (95% CI 0.561-1.493), 0.735 (95% CI 0.459-1.179), and 0.927 (0.601-1.431), respectively. Non-surgical periodontal treatment during the second semester of gestation did not reduce the risk for preterm birth, low birth weight, and preterm low birth weight.

  7. Alcohol and Pregnancy: Why Take the Risk? PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2016-02-02

    This public service announcement is based on the February 2016 CDC Vital Signs report. More than three million women in the U.S. are at risk for exposing their developing baby to alcohol. Drinking alcohol during pregnancy can cause physical, behavioral, and intellectual disabilities that can affect a child’s whole life. Learn what can be done to keep developing babies healthy.  Created: 2/2/2016 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 2/2/2016.

  8. Antidepressant exposure in pregnancy and risk of autism spectrum disorders

    Directory of Open Access Journals (Sweden)

    Sørensen MJ

    2013-11-01

    Full Text Available Merete Juul Sørensen,1 Therese Koops Grønborg,2 Jakob Christensen,3,4 Erik Thorlund Parner,2 Mogens Vestergaard,5,6 Diana Schendel,7 Lars Henning Pedersen8,9 1Regional Centre of Child and Adolescent Psychiatry, Aarhus University Hospital, Risskov, Denmark; 2Department of Public Health, Section of Biostatistics, Aarhus University, Aarhus, Denmark; 3Department of Neurology, Aarhus University Hospital, Aarhus, Denmark; 4Department of Clinical Pharmacology, 5Department of Public Health, Section of General Practice, 6Research unit for General Practice, Aarhus University, Aarhus, Denmark; 7Centers for Disease Control and Prevention, Atlanta, GA, USA; 8Danish Epidemiological Science Centre, Institute of Public Health, 9Department of Obstetrics and Gynecology, Institute of Clinical Medicine, Aarhus University, Aarhus, Denmark Background: Both the use of antidepressant medication during pregnancy and the prevalence of autism spectrum disorder have increased during recent years. A causal link has recently been suggested, but the association may be confounded by the underlying indication for antidepressant use. We investigated the association between maternal use of antidepressant medication in pregnancy and autism, controlling for potential confounding factors. Methods: We identified all children born alive in Denmark 1996–2006 (n=668,468 and their parents in the Danish Civil Registration System. We obtained information on the mother's prescriptions filled during pregnancy from the Danish National Prescription Registry, and on diagnoses of autism spectrum disorders in the children and diagnoses of psychiatric disorders in the parents from the Danish Psychiatric Central Register. In a cohort analysis, we estimated hazard ratios of autism spectrum disorders in children exposed to antidepressant medication during pregnancy compared with children who were not exposed, using Cox proportional hazards regression analysis. Furthermore, we estimated the risk

  9. Smoking and Pregnancy — A Review on the First Major Environmental Risk Factor of the Unborn

    Directory of Open Access Journals (Sweden)

    Mathias Mund

    2013-11-01

    Full Text Available Smoking cigarettes throughout pregnancy is one of the single most important avoidable causes of adverse pregnancy outcomes and it represents the first major environmental risk of the unborn. If compared with other risk factors in the perinatal period, exposure to tobacco smoke is considered to be amongst the most harmful and it is associated with high rates of long and short term morbidity and mortality for mother and child. A variety of adverse pregnancy outcomes are linked with cigarette consumption before and during pregnancy. Maternal prenatal cigarette smoke disturbs the equilibrium among the oxidant and antioxidant system, has negative impact on the genetic and cellular level of both mother and fetus and causes a large quantity of diseases in the unborn child. These smoking-induced damages for the unborn offspring manifest themselves at various times in life and for most only a very limited range of causal treatment exists. Education, support and assistance are of high importance to decrease maternal and fetal morbidity and mortality, as there are few other avoidable factors which influence a child’s health that profoundly throughout its life. It is imperative that smoking control should be seen as a public health priority.

  10. Adverse pregnancy outcomes and cardiovascular risk factor management.

    Science.gov (United States)

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

    2015-06-01

    Cardiovascular disease (CVD) is the leading health threat to American women. In addition to establish 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 women often use their obstetrician/gynecologist as their primary health provider, this is an opportune time to diagnose and treat CVD risk factors early. Embedding preventive care providers such as nurse practitioners or physician assistants within OB/GYN practices can be considered, with referral to family medicine or internist for ongoing risk assessment and management. The American Heart Association (AHA)/American Stroke Association (ASA) stroke prevention guidelines tailored to women recommend that women with a history of pre-eclampsia can be evaluated for hypertension and other CVD risk factors within 6 months to 1-year post-partum. Given the burden and impact of CVD on women in our society, the entire medical community must work to establish feasible practice and referral patterns for assessment and treatment of CVD risk factors.

  11. Associated Behavioral Risks in a Group of Women During Pregnancy from Mures District

    Directory of Open Access Journals (Sweden)

    Florina Ruţa

    2015-09-01

    Full Text Available Background. It is well-known that the exposure during pregnancy to lifestyle risk factors can affect thehealth both for the mother and the fetus. There are many risk factors for pregnancy, including: smoking, alcohol consumption, sedentary pattern, irregular daily meal serving plan, lack of knowledge regarding health prevention. The main objective of our study was to assess the practices, knowledge and attitudes towards lifestyle risk behaviors during pregnancy in a group of women from Tirgu-Mures area.

  12. Hypofibrinogenemia and the α-Fibrinogen Thr312Ala Polymorphism may be Risk Factors for Early Pregnancy Loss.

    Science.gov (United States)

    Kamimoto, Yuki; Wada, Hideo; Ikejiri, Makoto; Nakatani, Kaname; Sugiyama, Takashi; Osato, Kazuhiro; Murabayashi, Nao; Habe, Koji; Mizutani, Hitoshi; Matsumoto, Takeshi; Ohishi, Kohshi; Ikeda, Tomoaki

    2017-01-01

    We analyzed a cohort of 36 females with pregnancy loss. In addition to 11 patients with antiphospholipid antibody syndrome and 2 patients with congenital antithrombin (AT) or protein C deficiency, we identified 5 patients with low fibrinogen levels (median 110 mg/dL) prior to 10 weeks of gestation. Four of these 5 patients underwent a fibrinogen gene analysis, and all 4 were found to be heterozygotes for the α-fibrinogen (FGA) Thr321Ala polymorphism. One female without hypofibrinogenemia with a history of 8 pregnancy losses was found to be homozygous for the same polymorphism, and she also showed hypercoagulability without thrombosis. In conclusion, there was a relatively high frequency of pregnancy loss in the setting of hypofibrinogenemia and/or the FGA Thr312Ala polymorphism, and this may be an important risk factor for pregnancy loss and a hypercoagulable state in later pregnancy.

  13. Pregnancy and inflammatory bowel diseases: Current perspectives, risks and patient management

    Institute of Scientific and Technical Information of China (English)

    Pegah; Hosseini-Carroll; Monica; Mutyala; Abhishek; Seth; Shaheen; Nageeb; Demiana; Soliman; Moheb; Boktor; Ankur; Sheth; Jonathon; Chapman; James; Morris; Paul; Jordan; Kenneth; Manas; Felix; Becker; Jonathan; Steven; Alexander

    2015-01-01

    Inflammatory bowel diseases(IBD) are chronic idiopathic inflammatory conditions characterized by relapsing and remitting episodes of inflammation which can affect several different regions of the gastrointestinal tract, but also shows extra-intestinal manifestations. IBD is most frequently diagnosed during peak female reproductive years, with 25% of women with IBD conceiving after their diagnosis. While IBD therapy has improved dramatically with enhanced surveillance and more abundant and powerful treatment options, IBD disease can have important effects on pregnancy and presents several challenges for maintaining optimal outcomes for mothers with IBD and the developing fetus/neonate. Women with IBD, the medical team treating them(both gastroenterologists and obstetricians/gynecologists) must often make highly complicated choices regarding conception, pregnancy, and post-natal care(particularly breastfeeding) related to their choice of treatment options at different phases of pregnancy as well as post-partum. This current review discusses current concerns and recommendations for pregnancy duringIBD and is intended for gastroenterologists, general practitioners and IBD patients intending to become,(or already) pregnant, and their families. We have addressed patterns of IBD inheritance, effects of IBD on fertility and conception(in both men and women), the effects of IBD disease activity on maintenance of pregnancy and outcomes, risks of diagnostic procedures during pregnancy and potential risks and complications associated with different classes of IBD therapeutics. We also have evaluated the clinical experience using "top-down" care with biologics, which is currently the standard care at our institution. Post-partum care and breastfeeding recommendations are also addressed.

  14. Drug safety in pregnancy: utopia or achievable prospect? Risk information, risk research and advocacy in Teratology Information Services.

    Science.gov (United States)

    Schaefer, Christof

    2011-03-01

    Even though from preclinical testing to drug risk labeling, the situation with drugs in pregnancy has improved substantially since the thalidomide scandal, there is still an increasing need to provide healthcare professionals and patients with updated individualized risk information for clinical decision making. For the majority of drugs, clinical experience is still insufficient with respect to their safety in pregnancy. There is often uncertainty in how to interpret the available scientific data. Based on 20 years of experience with Teratology Information Services (TIS) cooperating in the European Network of Teratology Information Services (ENTIS) methods of risk interpretation, follow-up of exposed pregnancies through the consultation process and their evaluation is discussed. Vitamin K antagonists, isotretinoin and angiotensin (AT) II-receptor-antagonists are presented as examples of misinterpretation of drug risks and subjects of research based on observational clinical data recorded in TIS. As many TIS are poorly funded, advocacy is necessary by establishing contacts with decision makers in health politics and administration, informing them of the high return in terms of health outcomes and cost savings provided by TIS as reference institutions in clinical teratology.

  15. 产前护理需求及护理干预对高危妊娠孕妇的效果评价%Effect evaluation of prenatal care needs and study on nursing intervention on high risk pregnancy

    Institute of Scientific and Technical Information of China (English)

    杜丽芳

    2014-01-01

    目的:探讨高危妊娠孕妇的产前护理需求以及采用护理干预方案的临床效果。方法:2013年7月-2014年6月收治高危妊娠孕妇100例,首先通过问卷调查的方式了解护理需求;然后将其随机分为对照组(50例)和观察组(50例)。对照组采用常规护理方案,观察组在对照组的基础上进行护理干预。观察两组患者的护理效果。结果:在高危妊娠孕妇中,对胎儿发育情况的护理需求最高(72.0%);对社会支持的需求最低(4.0%)。观察组的T-AI指标和S-AI指标明显低于对照组,护理满意率明显高于对照组,差异具有统计学意义(P<0.05)。结论:了解高危妊娠孕妇的产前护理需求,并有针对性地实施护理干预,能够提高患者的护理满意度,改善身心状况,提高患者的生存质量,值得临床推广。%Objective:To explore the prenatal care needs of high risk pregnancy and the clinical effect of the nursing intervention program.Methods:100 cases of high-risk pregnant women were selected from July 2013 to June 2014.Care needs were investigated by questionnaire.Then they were randomly divided into the control group(50 cases) and the observation group(50 cases).The control group were given conventional nursing,and the observation group were given nursing intervention on the basis of the control group.We observed the effect of nursing care.Results:In the high-risk pregnant women,nursing demand for fetal development was the highest(72%);the demand for social support was the lowest(4%).In the observation group,T-AI index and S-AI index was significantly lower than the control group;nursing satisfaction rate was significantly higher than that in the control group;the difference was statistically significant(P<0.05). Conclusion:Understanding the prenatal care needs of high risk pregnancy and the implementation of targeted nursing intervention can improve the patients' satisfaction to nursing care

  16. Application of Prenatal Care Needs and Intervention in the High-risk Pregnancy%高危妊娠孕妇中产前护理需求及干预措施分析

    Institute of Scientific and Technical Information of China (English)

    胡俊妹

    2015-01-01

    Objective To explore the prenatal nursing demands of high risk pregnant women and the effect of the intervention of nursing.Methods Forty cases of high risk pregnancy were selected from September 2014 to December 2014 and investigated the care demands by the questionnaire. Cases were divided into two groups including control group(20 cases)and observation group(20 cases). Conventional nursing were given to control group, and the observation group were given the nursing intervention on the basis of control group. Observing the effect of nursing care.Results The highest of nursing needs in the high risk pregnant women was the knowledge of high risk pregnancy(92.5%),the lowest was the demand of social support. In the observation group,T-AI index and S-AI index was significantly lower than the control group. The satisfaction of the nursing care showed that the observation group was significantly higher than the control group. All the differences were statistically significant (P﹤0.05).Conclusion Meeting the needs of pregnant women and the implementation of targeted intervention of nursing can significantly improve the satisfaction of patients and the quality of patients.%目的:了解高危妊娠孕妇对于产前护理的需求并对其进行的护理干预结果进行总结分析。方法选取我院与2014年9~12月间收治的40例高危妊娠孕妇,对其发放调查问卷来进行护理需求的相关调查并统计结果,并随机分为观察组和对照组。其中对照组行常规护理方法,对观察组则在行对照组相同的常规护理的基础上施加护理干预,观察两组患者的临床效果及患者的满意程度。结果在本例高危妊娠孕妇中,高危妊娠常识(92.5%)相关护理是孕妇最为关心的护理需求;而社会支持系统的需求(15.0%)则较低。用S-AI及T-AI评分的方式对患者进行评估,观察组相比对照组,两项分值降低,组间差异具有统计学意义(P﹤0.05

  17. Duo test and aneuploidy detection in women under 35 years of age with high-risk pregnancy at the Hospital General de México

    Directory of Open Access Journals (Sweden)

    J.M. Valdés-Miranda

    2017-04-01

    Results: Only five duo tests were positive: three showed risk of trisomy 18 and one of Turner syndrome, they all corroborated with the cytogenetic study; the fifth showed a risk of Down's syndrome, however it was a chromosomally normal product. Three patients with a negative duo test cytogenetically detected with karyotypes with structural abnormalities, which were: deletion of the short arm of chromosome 18 [46,XY, del(18(p11], Robertsonian translocation between chromosome 13 and 14 [45,XY, rob(13:14] and a chromosome derived from X [46,X, der(X]. The duo test is a very useful tool for the diagnosis of numerical chromosome abnormalities, but not for detecting structural chromosome aberrations. However, it is essential to perform amniocentesis to definitively rule out chromosomal aberrations in products of conception.

  18. Risk screening, emergency care, and lay concepts of complications during pregnancy in Chiapas, Mexico.

    Science.gov (United States)

    Tinoco-Ojanguren, Rolando; Glantz, Namino M; Martinez-Hernandez, Imelda; Ovando-Meza, Ismael

    2008-03-01

    Maternal morbidity and mortality are widespread in Chiapas, Mexico's southernmost state, as in many developing regions. Globally, the utility of three approaches to addressing such problems has been debated: (a) obstetric risk screening (i.e. screening women for risk during pregnancy and channeling those at risk to preventive care); (b) emergency obstetric care (i.e. identifying complications during pregnancy or birth and providing prompt effective treatment); and (c) combined risk screening and emergency care. Unaddressed to date in peer-reviewed journals are the lay perceptions of complications and risk that precede and incite the quest for obstetric care in Mexico. High incidence of maternal mortality in Chiapas, exacerbated by the predominantly rural, highly indigenous, geographically dispersed, and economically marginalized nature of the state's southern Border Region, prompted us to conduct 45 open-ended interviews with a convenience sample of women and their close relative/s, including indigenous and non-indigenous informants in urban and rural areas of four municipalities in this region. Interviews suggest that none of the three approaches is effective in this context, and we detail reasons why each approach has fallen short. Specific obstacles identified include that (1) many women do not access adequate prenatal screening care on a regular basis; (2) emergency obstetric care in this region is severely circumscribed; and (3) lay notions of pregnancy-related risk and complications contrast with official clinical criteria, such that neither clinical nor extra-clinical prenatal monitoring encompasses the entire range of physical and social risk factors and danger signs. Findings reported here center on a rich description of the latter: lay versus clinical criteria for risk of antepartum complication.

  19. Cardiovascular risk estimation in women with a history of hypertensive pregnancy disorders at term: a longitudinal follow-up study.

    Science.gov (United States)

    Hermes, Wietske; Tamsma, Jouke T; Grootendorst, Diana C; Franx, Arie; van der Post, Joris; van Pampus, Maria G; Bloemenkamp, Kitty Wm; Porath, Martina; Mol, Ben W; de Groot, Christianne J M

    2013-06-04

    Cardiovascular disease is associated with major morbidity and mortality in women in the Western world. Prediction of an individual cardiovascular disease risk in young women is difficult. It is known that women with hypertensive pregnancy complications have an increased risk for developing cardiovascular disease in later life and pregnancy might be used as a cardiovascular stress test to identify women who are at high risk for cardiovascular disease. In this study we assess the possibility of long term cardiovascular risk prediction in women with a history of hypertensive pregnancy disorders at term. In a longitudinal follow-up study, between June 2008 and November 2010, 300 women with a history of hypertensive pregnancy disorders at term (HTP cohort) and 94 women with a history of normotensive pregnancies at term (NTP cohort) were included. From the cardiovascular risk status that was known two years after index pregnancy we calculated individual (extrapolated) 10-and 30-year cardiovascular event risks using four different risk prediction models including the Framingham risk score, the SCORE score and the Reynolds risk score. Continuous data were analyzed using the Student's T test and Mann-Whitney U test and categorical data by the Chi-squared test. A poisson regression analysis was performed to calculate the incidence risk ratios and corresponding 95% confidence intervals for the different cardiovascular risk estimation categories. After a mean follow-up of 2.5 years, HTP women had significantly higher mean (SD) extrapolated 10-year cardiovascular event risks (HTP 7.2% (3.7); NTP 4.4% (1.9) (pHTP 11% (7.6); NTP 7.3% (3.5) (p<.001, IRR 2.7, 95% CI 1.6 to 4.5)) as compared to NTP women calculated by the Framingham risk scores. The SCORE score and the Reynolds risk score showed similar significant results. Women with a history of gestational hypertension or preeclampsia at term have higher predicted (extrapolated) 10-year and 30-year cardiovascular event risks as

  20. Management of glaucoma in pregnancy: risks or choices, a dilemma?

    Directory of Open Access Journals (Sweden)

    Harinder Singh Sethi

    2016-12-01

    Full Text Available The treatment of glaucoma in and around pregnancy offers the unique challenge of balancing the risk of vision loss to the mother as against the potential harm to the fetus or newborn. Most anti-glaucoma drugs (i.e. beta-blockers, prostaglandin analogues, carbonic anhydrase inhibitors topical and systemic, cholinergics, anticholinesterases, and apraclonidine are considered category C agents and ophthalmologists are usually limited to treating patients with the category B drugs of brimonidine and dipivefrin. Brimonidine is generally the preferred first-line drug in the first, second and early third trimester. Late in the third trimester, brimonidine should be discontinued because it can induce central nervous system depression in newborns wherein topical carbonic anhydrase inhibitors may be the optimal choice. Glaucoma surgery can be performed with caution in second and third trimester if the patients have a strong indication for the procedure. However, anesthetics, sedative agents, and antimetabolites still have potential risk for the fetus. Argon laser trabeculoplasty (ALT or selective laser trabeculoplasty (SLT is an alternative treatment that can be performed in all trimesters. Carbonic anhydrase inhibitors and β-blockers are certified by the American Academy of Pediatrics for use during nursing. However, low doses of these medications should be considered when used in the breast feeding period. Optimum treatment for glaucoma in pregnancy must not be withheld so as to prevent any further deterioration in progressive vision loss and quality of life.

  1. Management of glaucoma in pregnancy: risks or choices, a dilemma?

    Science.gov (United States)

    Sethi, Harinder Singh; Naik, Mayuresh; Gupta, Vishnu Swarup

    2016-01-01

    The treatment of glaucoma in and around pregnancy offers the unique challenge of balancing the risk of vision loss to the mother as against the potential harm to the fetus or newborn. Most anti-glaucoma drugs (i.e. beta-blockers, prostaglandin analogues, carbonic anhydrase inhibitors topical and systemic, cholinergics, anticholinesterases, and apraclonidine) are considered category C agents and ophthalmologists are usually limited to treating patients with the category B drugs of brimonidine and dipivefrin. Brimonidine is generally the preferred first-line drug in the first, second and early third trimester. Late in the third trimester, brimonidine should be discontinued because it can induce central nervous system depression in newborns wherein topical carbonic anhydrase inhibitors may be the optimal choice. Glaucoma surgery can be performed with caution in second and third trimester if the patients have a strong indication for the procedure. However, anesthetics, sedative agents, and antimetabolites still have potential risk for the fetus. Argon laser trabeculoplasty (ALT) or selective laser trabeculoplasty (SLT) is an alternative treatment that can be performed in all trimesters. Carbonic anhydrase inhibitors and β-blockers are certified by the American Academy of Pediatrics for use during nursing. However, low doses of these medications should be considered when used in the breast feeding period. Optimum treatment for glaucoma in pregnancy must not be withheld so as to prevent any further deterioration in progressive vision loss and quality of life.

  2. Evaluation of gestational diabetes mellitus risk factors using abdominal subcutaneous fat thickness for early pregnancy in the US imaging

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Chang Soo; Kim, Jung Hoon [Dept. of Radiological Science, College of Health Sciences, Catholic University of Pusan, Busan (Korea, Republic of); Yang, Sung Hee [Dept. of Radiology, Ilsin Christian Hospital, Busan (Korea, Republic of)

    2017-03-15

    The purpose of this study was to investigate the relationship between abdominal subcutaneous fat thickness(ASFT) and maternal gestational diabetes mellitus(GDM) measured by ultrasound at period of pregnancy. We compared maternal age, pre-pregnancy body mass index, and weight gain during pregnancy in 286 pregnant women who were diagnosed with early pregnancy ASFT and high GDM screening test(50 g OGTT) of more than 140 mg/dL. ROC curve analysis was used to determine the cut-off value of ASFT for GDM prediction. Maternal age and weight gain during pregnancy were not related to GDM in the mid-trimester and pre-pregnancy body mass index and early pregnancy ASFT were significantly different between normal and GDM high risk groups. The cut-off value of ASFT for GDM prediction was 2.23 cm(AUC 0.913. Sensitivity 76.19%, Specificity 93.72%). ASFT measured by ultrasound in early pregnancy was useful as an important index for predicting mid-trimester GDM prediction. Therefore, ASFT can be used as an auxiliary diagnostic index for early recognition of GDM.

  3. Association between polycystic ovary syndrome and the risk of pregnancy complications: A PRISMA-compliant systematic review and meta-analysis.

    Science.gov (United States)

    Yu, Hai-Feng; Chen, Hong-Su; Rao, Da-Pang; Gong, Jian

    2016-12-01

    Polycystic ovary syndrome (PCOS) is inconsistently associated with increased risk of adverse pregnancy outcomes. The purpose of this meta-analysis was to summarize the evidence regarding the strength of the association between pregnancy in women with PCOS and pregnancy complications. We systematically searched PubMed, EmBase, and the Cochrane Library to identify observational studies up to January 2016. The primary focus was pregnancy outcomes, including gestational diabetes mellitus (GDM), preeclampsia, pregnancy-induced hypertension (PIH), preterm delivery, cesarean delivery, oligohydramnios, and polyhydramnios. Effect estimates were pooled using the random-effects model. The analysis was further stratified by factors that could affect these associations. We included 40 observational studies that reported data on a total of 17,816 pregnancies with PCOS and 123,756 pregnancies without PCOS. Overall, PCOS in pregnancy was associated with greater risk of GDM, preeclampsia, PIH, preterm delivery, cesarean delivery, miscarriage, hypoglycemia, and perinatal death. However, PCOS in pregnancy had little or no effect on oligohydramnios, polyhydramnios, large-for-gestational age (LGA), small-for-gestational-age (SGA), fetal growth restriction (FGR), preterm premature membrane rupture, fasting blood glucose (FBG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglyceride, total cholesterol, congenital malformation, macrosomia, and respiratory distress syndrome. Subgroup analysis suggested that these associations might be influenced by study design and pre-BMI. PCOS in pregnancy is associated with a significantly increased risk of adverse pregnancy, fetal, and neonatal outcomes.

  4. Risk of ectopic pregnancy following day-5 embryo transfer compared with day-3 transfer.

    Science.gov (United States)

    Smith, Laura P; Oskowitz, Selwyn P; Dodge, Laura E; Hacker, Michele R

    2013-10-01

    The incidence of ectopic pregnancy after IVF is increased approximately 2.5-5-fold compared with natural conceptions; however, the aetiology for this increased risk remains unclear. One proposed practice change to decrease the incidence of ectopic pregnancy is blastocyst embryo transfer on day 5 rather than cleavage-stage embryo transfer on day 3. A retrospective cohort study was conducted to compare the risk of ectopic pregnancy following fresh day-5 embryo transfer with day-3 embryo transfer among women who underwent IVF and achieved pregnancy from 1998 to 2011. There were 13,654 eligible pregnancies; 277 were ectopic. The incidence of ectopic pregnancy was 2.1% among day-3 pregnancies and 1.6% among day-5 pregnancies. The adjusted risk ratio for ectopic pregnancy from day-5 compared with day-3 transfer was 0.71 (95% confidence interval 0.46-1.10). Although this analysis included 13,654 cycles, with a two-sided significance level of 0.05, it had only 21.9% power to detect a difference between the low incidence of ectopic pregnancy among both day-3 and day-5 transfers. In conclusion, this study was not able to demonstrate a difference in the risk of ectopic pregnancy among day-3 compared with day-5 transfers.

  5. Intrahepatic cholestasis of pregnancy: A risk factor for cancer, autoimmune and cardiovascular diseases?

    Science.gov (United States)

    Erlinger, Serge

    2016-04-01

    The authors show, in an elegant population-based study, a significant association between intrahepatic cholestasis of pregnancy and liver and biliary cancer. This association is most probably related to the high frequency of hepatitis C and gallstone disease in women with intrahepatic cholestasis of pregnancy, both being risk factors for liver and biliary cancer. In addition, the study clearly shows an increased risk of diabetes mellitus and autoimmune diseases, such as thyroid diseases, psoriasis, autoimmune arthropathies and Crohn's disease, and a small increase in cardiovascular diseases. In practice, a follow-up of liver function tests 6-12 weeks after delivery is strongly recommended to detect a possible associated liver disease. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  6. Analysis of Psychological State and Influencing Factors of High Risk Pregnancies before Cesarean Section%高危妊娠孕妇剖宫产术前心理状况及影响因素分析

    Institute of Scientific and Technical Information of China (English)

    谭晓艳; 郭伟航; 汪爱梅

    2011-01-01

    Objective To discuss preoperative psychological state and influencing factors of high risk pregnancies and provide reference for nursing intervention. Methods 458 patients were investigated with Self-Rating Anxiety Scale, Self-Rating Depression Scale, Social Support Scale, Life Events Scale, Trait Coping Style Questionnaire (TCSQ) and Eysenck Personality Questionnaire. The analysis went to preoperative psychological state and the influence of preoperative indexes on anxiety and depression. Results The incidence of anxiety and depression were 31.9% and 332% respectively. Multiple stepwise regression analysis indicated familyrelated problems and N scale score were risk factors of depression, while social support was the protective factor. Family-related problems were the risk factors of anxiety, while solving of these problems and social support are protective ones. Conclusion Measures particularly supports from family and society which are significant to the improvement of preoperative psychological state of high risk pregnancies should be taken.%目的 探讨高危妊娠孕妇术前心理状况及影响因素,为护理干预提供依据.方法 2008年1月-2010年3月住院的高危妊娠孕妇458例,于住院第1天采用焦虑自评量表、抑郁自评量表、社会支持评定量表、生活事件量表、应对方式问卷及艾森克人格问卷进行调查,分析高危妊娠孕妇术前心理状况及术前各指标对抑郁和焦虑水平的影响.结果 本组高危妊娠孕妇术前抑郁、焦虑症状发生率分别为31.9%和33.2%;多元逐步回归分析表明,家庭有关问题、N量表分是影响抑郁水平的危险因素,社会支持则是其保护因素;家庭有关问题是影响焦虑水平的危险因素,而解决问题和社会支持则是其保护因素.结论 高危妊娠孕妇术前心理状况不容乐观,应从多方面着手,提高家庭和社会支持,改善高危妊娠孕妇心理健康状况.

  7. Does pregnancy increase the risk of ART-induced hepatotoxicity among HIV-positive women?

    Directory of Open Access Journals (Sweden)

    Susie Huntington

    2014-11-01

    Full Text Available Introduction: High rates of hepatotoxicity have been observed among HIV-positive pregnant women using antiretroviral therapy (ART. However, the extent to which pregnancy affects the risk of ART-induced hepatotoxicity is unclear since studies in this area have generated conflicting results. Material and Methods: Combined data from the UK Collaborative HIV Cohort (UK CHIC study and the UK and Ireland National Study of HIV in Pregnancy and Childhood (NSHPC were used. Alanine aminotransferase (ALT data were assessed according to the Division of AIDS toxicity guidelines to identify factors associated with liver enzyme elevation (LEE (grade 1–4. Women starting ART in 2000–11 aged 16–49 years were included irrespective of pregnancy status at ART start. Cox proportional hazards were used to assess the associations between fixed (ethnicity, exposure group, HBV/HCV co-infection, prior ART use, and age, year, pregnancy status, viral load and CD4 count at ART start and time-dependent covariates (pregnancy status, age, year, CD4 count, viral load, duration on ART and the risk of LEE. Results: Of the 3426 women included, one-quarter (25.0%, n=857 were pregnant during follow-up and 14.4% (n=492 started ART during pregnancy. The rate of LEE was 15/100 person-years (PY during pregnancy and 6.1/100 PY outside pregnancy. The risk of LEE was increased during pregnancy (adjusted hazard ratio (aHR 1.61 [1.26–2.06], p<0.001, including in secondary analysis excluding 493 women pregnant when starting ART. Other factors independently associated with LEE were lower CD4 count (<250 cells/mm3 vs. 251–350 cells/mm3 aHR 1.25 [1.02–1.54], p=0.03, HBV/HCV co-infection (aHR 1.94 [1.58–2.39], p<0.001, HIV acquired via injecting drug use (aHR 1.61 [1.15–2.24], p=0.01 vs. heterosexually and calendar year (aHR 1.05 [1.02–1.08], p<0.001 per one year increase. Three ART drugs were associated with increased risk of LEE (efavirenz aHR 1.27 [1.06–1.50], p-value 0

  8. Cause analysis and prevention of postpartum hemorrhage of high risk pregnancy women%高危妊娠产妇产后出血原因分析及预防

    Institute of Scientific and Technical Information of China (English)

    杨东群

    2015-01-01

    group) according to preventive methods,with 500 in each.High risk factors,blood loss of 2h and 24h after delivery and causes of hemorrhage of high risk pregnant women in the control group and the observation group were observed.ResultsPortions of hypertension during pregnancy of high risk pregnant women in the control group and the observation group were both the highest.x2=5.158、5.236,P0.05.Blood loss of 2h and 24h after delivery of high risk pregnant women in the observation group was both lower than that of the control group.t=68.06、14.46,P0.05.Hemorrhage, uterine atony,injury of soft birth canal,placental problem and coagulation disorders of 1000 high risk pregnant women all had significant positive correlations.r=0.125、0.110、0.068、0.046,P<0.05. The difference had statistical significance.Conclusion Pregnant women should strengthen prenatal examination. Especially for high risk pregnant women,hemabate injection has great significance for reducing postpartum hemorrhage and improving pregnancy outcome quality of pregnant women.

  9. Risk of pre-eclampsia in first and subsequent pregnancies: prospective cohort study

    OpenAIRE

    2009-01-01

    Objective: To investigate whether pre-eclampsia is more common in first pregnancies solely because fewer affected women, who presumably have a higher risk of recurrence, go on to have subsequent pregnancies. Design: Prospective cohort study. Setting: Swedish Medical Birth Register. Participants: 763 795 primiparous mothers who had their first births in Sweden, 1987-2004. Main outcome measures: Pre-eclampsia. Results: The risk of pre-eclampsia was 4.1% in the first pregnancy and 1.7% in later ...

  10. 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

    age, low or unspecified socioeconomic status (SES), single marital status, smoking, prior pregnancy terminations, anaemia and gestational diabetes regardless of a history of depression. Outcomes of pregnancies were worse among women with major depression than without. The contribution of smoking...... during pregnancy was found to be rare. The strongest risk factor was history of depression prior to pregnancy. Other associated factors were fear of childbirth, low SES, lack of social support and unhealthy reproductive behaviour such as smoking. Outcomes of pregnancies were worse among women with major...... 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 history...

  11. Gravidez de alto risco: o desejo e a programação de uma gestação Embarazo de alto riesgo: el deseo y la programación de una gestación Desiring and planning pregnancy: experience of women who had high risk pregnancy

    Directory of Open Access Journals (Sweden)

    Viviani Guilherme Dourado

    2007-03-01

    ón programada y deseada" y "Gestación no programada y no deseada". CONCLUSIÓN: Frente a las ideas centrales identificadas fue evidenciada la carencia de educación en salud, en especial con relación a la salud reproductiva.OBJECTIVES: To verify the event of pregancy, and to describe women's planning and desire of having a child. METHODS: This study used a descriptive, exploratory qualitative design. The sample consisted of 12 women from a well respect prenatal service who had a high risk pregnancy. Data were collected through semi-structured interviews. RESULTS: The main central themes have emerged: Desired but not planned pregnancy and associated to either to non-use or incorrect use of contraceptive methods; Desired but not planned pregnancy associated with religious beliefs; Desired planned pregnancy; and, Not desired nor planned pregnancy. CONCLUSIONS: Prior to identification of the main central ideas, it was observed the need of health education, specifically related to the reproductive health.

  12. 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

  13. Women referred for occupational risk assessment in pregnancy have no increased risk of adverse obstetric outcomes

    DEFF Research Database (Denmark)

    Bidstrup, Signe Brøker; Kaerlev, Linda; Thulstrup, Ane Marie

    2015-01-01

    pregnant women referred to two Danish clinics of occupational medicine (Copenhagen and Aarhus) from 1984 to 2010 were compared with the referred women's 1,077 non-referred pregnancy outcomes and with the pregnancy outcomes of 345,467 gainfully employed women from the same geographical areas and time period....... Logistic regression was used to calculate odds ratios (OR) with 95% confidence intervals (CI). Calculations were adjusted for the mother's age at delivery, parity, ethnicity, socioeconomic status, smoking, and in supplementary analyses for year of birth. RESULTS: Referred women gave birth to children....../or that the occupational risk assessment and counselling of pregnant women are preventing these selected adverse pregnancy outcomes. FUNDING: The Research Unit at Department of Occupational and Environmental Medicine at Bispebjerg Hospital supported the study financially. TRIAL REGISTRATION: not relevant. The study...

  14. Does Father Absence Place Daughters at Special Risk for Early Sexual Activity and Teenage Pregnancy?

    Science.gov (United States)

    Ellis, Bruce J.; Bates, John E.; Dodge, Kenneth A.; Fergusson, David M.; Horwood, L. John; Pettit, Gregory S.; Woodward, Lianne

    2003-01-01

    Longitudinal studies in two countries investigated impact of father absence on girls' early sexual activity (ESA) and teenage pregnancy. Findings indicated that greater exposure to father absence strongly related to elevated ESA and adolescent pregnancy risk. Elevated risk was not explained (U.S. sample) or only partly explained (New Zealand…

  15. Risk assessment during pregnancy and labor: optimal fetal growth and monitoring of contractions

    NARCIS (Netherlands)

    Vasak, B

    2016-01-01

    This thesis focuses on risk assessment during pregnancy and labor. Part 1 of this thesis describes risk assessment during pregnancy concentrating on fetal growth in relation to perinatal morbidity, perinatal mortality and implications for maternal health. Perinatal mortality related to fetal growth

  16. Does Father Absence Place Daughters at Special Risk for Early Sexual Activity and Teenage Pregnancy?

    Science.gov (United States)

    Ellis, Bruce J.; Bates, John E.; Dodge, Kenneth A.; Fergusson, David M.; Horwood, L. John; Pettit, Gregory S.; Woodward, Lianne

    2003-01-01

    Longitudinal studies in two countries investigated impact of father absence on girls' early sexual activity (ESA) and teenage pregnancy. Findings indicated that greater exposure to father absence strongly related to elevated ESA and adolescent pregnancy risk. Elevated risk was not explained (U.S. sample) or only partly explained (New Zealand…

  17. Prospective Risk of Stillbirth and Neonatal Complications in Twin Pregnancies : Systematic Review and Meta-analysis

    NARCIS (Netherlands)

    Cheong-See, Fiona; Schuit, Ewoud; Arroyo-Manzano, David; Khalil, Asma; Barrett, Jon; Joseph, K. S.; Asztalos, Elizabeth; Hack, Karien; Lewi, Liesbeth; Lim, Arianne; Liem, Sophie; Norman, Jane E.; Morrison, John; Combs, C. Andrew; Garite, Thomas J.; Maurel, Kimberly; Serra, Vicente; Perales, Alfredo; Rode, Line; Worda, Katharina; Nassar, Anwar; Aboulghar, Mona; Rouse, Dwight; Thom, Elizabeth; Breathnach, Fionnuala; Nakayama, Soichiro; Russo, Francesca Maria; Robinson, Julian N.; Dodd, Jodie M.; Newman, Roger B.; Bhattacharya, Sohinee; Tang, Selphee; Mol, Ben Willem J; Zamora, Javier; Thilaganathan, Basky; Thangaratinam, Shakila

    2017-01-01

    Twin pregnancies are at increased risk of stillbirth. Uncomplicated twin pregnancies are commonly delivered earlier to prevent stillbirth; however, there is a risk of neonatal complications associated with being born prior to 39 weeks’ gestation. The optimal gestational age for delivery in twin

  18. Automatic Classification of Structured Product Labels for Pregnancy Risk Drug Categories, a Machine Learning Approach.

    Science.gov (United States)

    Rodriguez, Laritza M; Fushman, Dina Demner

    2015-01-01

    With regular expressions and manual review, 18,342 FDA-approved drug product labels were processed to determine if the five standard pregnancy drug risk categories were mentioned in the label. After excluding 81 drugs with multiple-risk categories, 83% of the labels had a risk category within the text and 17% labels did not. We trained a Sequential Minimal Optimization algorithm on the labels containing pregnancy risk information segmented into standard document sections. For the evaluation of the classifier on the testing set, we used the Micromedex drug risk categories. The precautions section had the best performance for assigning drug risk categories, achieving Accuracy 0.79, Precision 0.66, Recall 0.64 and F1 measure 0.65. Missing pregnancy risk categories could be suggested using machine learning algorithms trained on the existing publicly available pregnancy risk information.

  19. Excess Pre-Pregnancy Weight May Slightly Raise Baby's Cerebral Palsy Risk

    Science.gov (United States)

    ... Excess Pre-Pregnancy Weight May Slightly Raise Baby's Cerebral Palsy Risk But, study found overall odds remain quite ... slight increased risk of having a baby with cerebral palsy, a new study suggests. After reviewing data from ...

  20. Preeclampsia and hypertensive disease in pregnancy: their contributions to cardiovascular risk.

    Science.gov (United States)

    Valdiviezo, Carolina; Garovic, Vesna D; Ouyang, Pamela

    2012-03-01

    More women than men die each year of cardiovascular disease, which remains the leading cause of death in the United States. Sex-specific factors, including pregnancy-related disorders, should be considered when assessing cardiovascular (CV) risk in women. Hypertensive disorders of pregnancy have been associated with CV risk later in life and may identify women in whom earlier primary prevention may reduce their risk. This article reviews the physiologic changes in blood pressure during pregnancy, current definitions of hypertensive diseases of pregnancy and preeclampsia, and postulated pathophysiologic mechanisms leading to preeclampsia that might contribute to later CV risk. Also summarized are studies providing evidence on the association between hypertensive diseases of pregnancy and future CV risk.

  1. Antidepressant medication and the risk of pregnancy-induced hypertension

    NARCIS (Netherlands)

    Ter Heijne, Loes F.; Zakiyah, Neily; Bos, Jens H.J.; Hak, Eelko; Schuiling-Veninga, Catharina C.M.

    2016-01-01

    Background: Increased activity of the sympatic nervous system could possibly cause pregnancy-induced hypertension (PIH). Previous studies have suggested that antidepressants could contribute to this increased activity. Objectives: To examine whether the use of antidepressants during pregnancy

  2. Pregnancy outcomes following the administration of high doses of dexamethasone in early pregnancy.

    Science.gov (United States)

    Namdar Ahmadabad, Hasan; Kayvan Jafari, Sabah; Nezafat Firizi, Maryam; Abbaspour, Ali Reza; Ghafoori Gharib, Fahime; Ghobadi, Yusef; Gholizadeh, Samira

    2016-03-01

    In the present study, we aimed to evaluate the effects of high doses of dexamethasone (DEX) in early pregnancy on pregnancy outcomes. Pregnant BALB/c mice were treated with high-dose DEX in the experimental group or saline in the control group on gestational days (GDs) 0.5 to 4.5. Pregnant mice were sacrificed on GDs 7.5, 13.5, or 18.5 and their peripheral blood, placentas, fetuses, and uterine tissue were collected. Decidual and placenta cell supernatants were examined to evaluate the effect of DEX on the proliferation of mononuclear cells, the quantity of uterine macrophages and uterine natural killer (uNK) cells, and levels of progesterone and 17β-estradiol, as determined by an 3-(4,5-dimethylthiazole-2-yl)-2,5-diphenyltetrazolium bromide assay, immunohistochemistry, and enzyme-linked immunosorbent assay, respectively. We also were measured fetal and placental growth parameters on GD 18.5. We found that high doses of DEX were associated with an increased abortion rate, enhancement of the immunosuppressive effect of the decidua, alterations in placental growth parameters, decreased progesterone and 17β-estradiol levels, and a reduced frequency of macrophages and uNK cells. Our data suggest that the high-dose administration of DEX during early pregnancy negatively affected pregnancy outcomes.

  3. Risk factors for helminth, malaria, and HIV infection in pregnancy in Entebbe, Uganda.

    Directory of Open Access Journals (Sweden)

    Patrick William Woodburn

    2009-06-01

    Full Text Available Infections during pregnancy may have serious consequences for both mother and baby. Assessment of risk factors for infections informs planning of interventions and analysis of the impact of infections on health outcomes.To describe risk factors for helminths, malaria and HIV in pregnant Ugandan women before intervention in a trial of de-worming in pregnancy.The trial recruited 2,507 pregnant women between April 2003 and November 2005. Participants were interviewed and blood and stool samples obtained; location of residence at enrolment was mapped. Demographic, socioeconomic, behavioral and other risk factors were modelled using logistic regression.There was a high prevalence of helminth, malaria and HIV infection, as previously reported. All helminths and malaria parasitemia were more common in younger women, and education was protective against every infection. Place of birth and/or tribe affected all helminths in a pattern consistent with the geographical distribution of helminth infections in Uganda. Four different geohelminths (hookworm, Trichuris, Ascaris and Trichostrongylus showed a downwards trend in prevalence during the enrolment period. There was a negative association between hookworm and HIV, and between hookworm and low CD4 count among HIV-positive women. Locally, high prevalence of schistosomiasis and HIV occurred in lakeshore communities.Interventions for helminths, malaria and HIV need to target young women both in and out of school. Antenatal interventions for malaria and HIV infection must continue to be promoted. Women originating from a high risk area for a helminth infection remain at high risk after migration to a lower-risk area, and vice versa, but overall, geohelminths seem to be becoming less common in this population. High risk populations, such as fishing communities, require directed effort against schistosomiasis and HIV infection.

  4. Psychosocial distress during pregnancy and the risk of infantile colic: a follow-up study

    DEFF Research Database (Denmark)

    Søndergaard, Charlotte; Olsen, J.; Friis-Hasché, Erik;

    2003-01-01

    AIM: To examine the association between psychosocial exposures during pregnancy and the risk of infantile colic. METHODS: The study included 378 infants and was conducted as a substudy of the Danish National Birth Cohort from 1997 to 1999, with prenatal data collected twice during pregnancy. A di....... Whether or not this relationship is causal requires further investigations.......AIM: To examine the association between psychosocial exposures during pregnancy and the risk of infantile colic. METHODS: The study included 378 infants and was conducted as a substudy of the Danish National Birth Cohort from 1997 to 1999, with prenatal data collected twice during pregnancy...

  5. Women referred for occupational risk assessment in pregnancy have no increased risk of adverse obstetric outcomes

    DEFF Research Database (Denmark)

    Bidstrup, Signe Brøker; Kaerlev, Linda; Thulstrup, Ane Marie;

    2015-01-01

    INTRODUCTION: Our aim was to study the association between pregnant women's referral status for occupational risk assessment, and their risk of preterm delivery (... pregnant women referred to two Danish clinics of occupational medicine (Copenhagen and Aarhus) from 1984 to 2010 were compared with the referred women's 1,077 non-referred pregnancy outcomes and with the pregnancy outcomes of 345,467 gainfully employed women from the same geographical areas and time period....... Logistic regression was used to calculate odds ratios (OR) with 95% confidence intervals (CI). Calculations were adjusted for the mother's age at delivery, parity, ethnicity, socioeconomic status, smoking, and in supplementary analyses for year of birth. RESULTS: Referred women gave birth to children...

  6. Depression during pregnancy in women with a medical disorder: risk factors and perinatal outcomes

    Directory of Open Access Journals (Sweden)

    Gláucia Rosana Guerra Benute

    2010-01-01

    Full Text Available BACKGROUND: Approximately one-fifth of women present depression during pregnancy and puerperium, and almost 13% of pregnant women experience a major depressive disorder. OBJECTIVE: The aim of this study was to identify risk factors for depression among pregnant women with a medical disorder and to evaluate the influence of depression on perinatal outcomes. METHODS: Three hundred and twenty-six pregnant women with a medical disorder were interviewed. A semistructured interview was conducted for each participant using a questionnaire that had been developed previously. Major depression was diagnosed using the Portuguese version of the Primary Care Evaluation of Mental Disorders (PRIME-MD. The medical records of the participants were thoroughly reviewed to evaluate the perinatal results. RESULTS: Major depressive disorder was diagnosed in 29 cases (9.0%. The prevalence of major depression was as follows: 7.1% for preeclampsia or chronic hypertension, 12.1% for cardiac disorder, 7.1% for diabetes mellitus, 6.3% for maternal anemia, 8.3% for collagenosis and 12.5% for a high risk of premature delivery. An univariate analysis showed a significant positive correlation between an average household income below minimum wage and a PRIME-MD diagnosis of major depression. A multiple regression analysis identified unplanned pregnancy as an independent predictor of major depression (86.2% in the group with a diagnosis of major depression by PRIME-MD vs. 68.4% in the group without major depression. A comparison between women who presented major depression and those who did not revealed no significant differences in the perinatal results (i.e., preterm delivery, birth weight and low Apgar scores. CONCLUSION: In the present study, unplanned pregnancy in women with a medical disorder was identified as a risk factor for major depression during gestation. Major depression during pregnancy in women with a medical disorder should be routinely investigated using

  7. The Application of Remifentanil-Propofol in Obstetric General Anesthesia of High Risk Pregnancy Cesarean Section%高危妊娠剖宫产全身麻醉中瑞芬太尼和异丙酚的应用

    Institute of Scientific and Technical Information of China (English)

    蔡昀夏; 曾葵; 黄蔚; 陈筱静

    2011-01-01

    Ob|ective:To study the effect of remifentanil-propofol on neonatus and mothers with high risk pregnancy in obstetric general anesthesia. Methods:46 women with high risk pregnancy who had cesarean section were divided into group I (epidural anesthesia, n = 24) and group Ⅱ (general anesthesia with remifentanil and propofol, n=22). The changes of systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate(HR) were observed five times: before, at the beginning of (after the tracheal cannu-la) and 20 minutes in the operation, fetal delivery and at the end of the operation . Apgar scores at 1, 5, 10 minutes after baby delivery, the frequency of the the newborns'tracheal cannula,pH, PaCO2 and PaO2 of umbilical artery, the operation time, blood loss, and the time of baby delivery from the beginning of the operation were compared between the two groups. Results:There were no significant differences in HR, DBP, operative duration .blood loss,the time of baby delivery, Apgar scores of the newborns,the frequency of the the newborns'tracheal cannula,umbilical arterial blood gas (P > 0. 05). The SBP in group I was markedly lower than that in group Ⅱ at the beginning of operation (after the tracheal cannula) ( P < 0. 05). The incidences of left heart failure andhy of mothers during anesthesia and operation in group I were higher than those in group Ⅱ(P<0.05)). Conclusions:Remifentanil-propofol in anesthesia of High-risk pregnancy is a safe, stable, quick palinesthesia. And there is no obviously side effects on the neonates if the drug-taken time and dosage are well controlled.%目的:应用瑞芬太尼和异丙酚对高危妊娠患者剖宫产施行全身麻醉,观察其对新生儿和母体的影响.方法:高危妊娠施行剖宫产患者46例,分成Ⅰ组(硬膜外麻醉)及Ⅱ组(瑞芬太尼和异丙酚全身麻醉).记录术前、手术开始时(即气管插管后时刻)、胎儿娩出时、术中20分钟时及术毕母体的收缩压(SBP)、舒张

  8. Reduced levels of maternal progesterone during pregnancy increase the risk for allergic airway diseases in females only.

    Science.gov (United States)

    Hartwig, Isabel R V; Bruenahl, Christian A; Ramisch, Katherina; Keil, Thomas; Inman, Mark; Arck, Petra C; Pincus, Maike

    2014-10-01

    Observational as well as experimental studies support that prenatal challenges seemed to be associated with an increased risk for allergic airway diseases in the offspring. However, insights into biomarkers involved in mediating this risk are largely elusive. We here aimed to test the association between endogenous and exogenous factors documented in pregnant women, including psychosocial, endocrine, and life style parameters, and the risk for allergic airway diseases in the children later in life. We further pursued to functionally test identified factors in a mouse model of an allergic airway response. In a prospectively designed pregnancy cohort (n = 409 families), women were recruited between the 4th and 12th week of pregnancy. To investigate an association between exposures during pregnancy and the incidence of allergic airway disease in children between 3 and 5 years of age, multiple logistic regression analyses were applied. Further, in prenatally stressed adult offspring of BALB/c-mated BALB/c female mice, asthma was experimentally induced by ovalbumin (OVA) sensitization. In addition to the prenatal stress challenge, some pregnant females were treated with the progesterone derivative dihydrodydrogesterone (DHD). In humans, we observed that high levels of maternal progesterone in early human pregnancies were associated with a decreased risk for an allergic airway disease (asthma or allergic rhinitis) in daughters (adjusted OR 0.92; 95% confidence interval [CI] 0.84 to 1.00) but not sons (aOR 1.02, 95% CI 0.94-1.10). In mice, prenatal DHD supplementation of stress-challenged dams attenuated prenatal stress-induced airway hyperresponsiveness exclusively in female offspring. Reduced levels of maternal progesterone during pregnancy-which can result from high stress perception-increase the risk for allergic airway diseases in females but not in males. Key messages: Lower maternal progesterone during pregnancy increases the risk for allergic airway disease

  9. Frequency of fetal macrosomia and the associated risk factors in pregnancies without gestational diabetes mellitus.

    Science.gov (United States)

    Usta, Akin; Usta, Ceyda Sancakli; Yildiz, Ayla; Ozcaglayan, Ruhsen; Dalkiran, Eylem Sen; Savkli, Aydin; Taskiran, Meryem

    2017-01-01

    There has been an increased incidence of macrosomic newborns in the world and most of the macrosomic newborns are born from non-GDM pregnant women. The objective of this study was to determine the frequency and the associated risk factors of fetal macrosomia in non-GDM pregnant women. A total 4246 consequtive pregnant women who had no GDM was included the study population. Data was collected from hospital database of Balikesir State Hospital between January 2014 and January 2015. Statistical analysis was carried out using the independent samples t-test and chi-squared test. Logistic regression analysis was used to determine the relationships between associated risk factors and the presence of fetal macrosomia. In this analysis, fetal macrosomia was taken as the dependent variable and associated risk factors were taken as independent variables. Results are shown as odds ratios (ORs) (95% CI) in the logistic regression analysis. 366 of the 4246 pregnant women were diagnosed with fetal macrosomia (8.6%). Compared the control women, a statistically significant correlation between fetal macrosomia and pre-pregnancy body mass index (BMI), gestational weight gain (GWG), parity, advanced maternal age, and male fetal sex was found. Maternal BMI, and GWG were the two risk factors most strongly associated with macrosomia. The prevalance of fetal macrosomia is rising among Turkish women. High pre-pregnancy BMI and GWG represent main modifiable risk factors for macrosomia and need more attention from health care providers.

  10. Annexin A5 Promoter Haplotype M2 Is Not a Risk Factor for Recurrent Pregnancy Loss in Northern Europe

    DEFF Research Database (Denmark)

    Nagirnaja, Liina; Nõmmemees, Diana; Rull, Kristiina;

    2015-01-01

    factor in early pregnancy success because: i) no RPL disease risk was associated with the haplotype in two clinically well-characterized RPL case-control study samples, ii) high prevalence of the haplotype among fertile controls and world-wide populations is inconsistent with the previously proposed......INTRODUCTION: Annexin A5 is an essential component of placental integrity that may potentially mediate susceptibility to phenotypes of compromised pregnancy. A promoter haplotype termed M2 of the coding gene ANXA5 has been implicated in various pregnancy complications such as preeclampsia...... and recurrent pregnancy loss (RPL), however with inconclusive results. STUDY SUBJECTS AND METHODS: A retrospective case-control study combining resequencing and restriction fragment length polymorphism (RFLP) analysis was undertaken in 313 women with unexplained RPL and 214 fertile women from Estonia...

  11. 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.

  12. Predicting the Risk of Macrosomia at Mid-Pregnancy Among Non-Diabetics: A Retrospective Cohort Study.

    Science.gov (United States)

    Jeffers, Elizabeth; Dodds, Linda; Allen, Victoria; Woolcott, Christy

    2017-08-02

    To identify factors known in mid-pregnancy to be associated with risk of macrosomia (≥4000 g) among non-diabetic women and to develop a risk score to allow early identification of women at high risk. Data were obtained from a population-based perinatal database and a hospital laboratory database in Nova Scotia, Canada. The study included singleton live births born to non-diabetic women between 1998 and 2005. Logistic regression was used to identify risk factors significantly associated with macrosomia. Risk scoring systems were developed for nulliparous and parous women separately and validated using the C-statistic. Of the 23 857 mother-infant pairs included in the study, 16.7% of the infants were macrosomic. In nulliparous women, seven risk factors were identified, of which pre-pregnancy weight ≥90 kg with an OR of 4.8 (95% CI: 3.9 to 6.0) contributed a greater number of points to the risk score. The resulting risk score corresponded to a range of estimated risk of 0.2% to 47.0% and had a C-statistic of 0.70. In parous women, the most points were assigned to women with a previous large birth (OR: 3.7; 95% CI: 3.2-4.0) and a pre-pregnancy weight ≥90 kg (OR: 3.8; 95% CI: 3.1-4.7). The resulting risk score corresponded to a range of estimated risk of 0.4% to 88.0% and had a C-statistic of 0.75. Macrosomia risk can be estimated by a simple calculation based on a woman's risk factor profile at mid-pregnancy. Copyright © 2017 Society of Obstetricians and Gynaecologists of Canada. Published by Elsevier Inc. All rights reserved.

  13. Dietary Patterns during Pregnancy Are Associated with Risk of Gestational Diabetes Mellitus.

    Science.gov (United States)

    Shin, Dayeon; Lee, Kyung Won; Song, Won O

    2015-11-12

    Maternal dietary patterns before and during pregnancy play important roles in the development of gestational diabetes mellitus (GDM). We aimed to identify dietary patterns during pregnancy that are associated with GDM risk in pregnant U.S. women. From a 24 h dietary recall of 253 pregnant women (16-41 years) included in the National Health and Nutrition Examination Survey (NHANES) 2003-2012, food items were aggregated into 28 food groups based on Food Patterns Equivalents Database. Three dietary patterns were identified by reduced rank regression with responses including prepregnancy body mass index (BMI), dietary fiber, and ratio of poly- and monounsaturated fatty acids to saturated fatty acid: "high refined grains, fats, oils and fruit juice", "high nuts, seeds, fat and soybean; low milk and cheese", and "high added sugar and organ meats; low fruits, vegetables and seafood". GDM was diagnosed using fasting plasma glucose levels ≥5.1 mmol/L for gestation education, family poverty income ratio, marital status, prepregnancy BMI, gestational weight gain, energy intake, physical activity, and log-transformed C-reactive protein (CRP). All statistical analyses accounted for the appropriate survey design and sample weights of the NHANES. Of 249 pregnant women, 34 pregnant women (14%) had GDM. Multivariable AOR (95% CIs) of GDM for comparisons between the highest vs. lowest tertiles were 4.9 (1.4-17.0) for "high refined grains, fats, oils and fruit juice" pattern, 7.5 (1.8-32.3) for "high nuts, seeds, fat and soybean; low milk and cheese" pattern, and 22.3 (3.9-127.4) for "high added sugar and organ meats; low fruits, vegetables and seafood" pattern after controlling for maternal sociodemographic variables, prepregnancy BMI, gestational weight gain, energy intake and log-transformed CRP. These findings suggest that dietary patterns during pregnancy are associated with risk of GDM after controlling for potential confounders. The observed connection between a high

  14. Dietary Patterns during Pregnancy Are Associated with Risk of Gestational Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    Dayeon Shin

    2015-11-01

    Full Text Available Maternal dietary patterns before and during pregnancy play important roles in the development of gestational diabetes mellitus (GDM. We aimed to identify dietary patterns during pregnancy that are associated with GDM risk in pregnant U.S. women. From a 24 h dietary recall of 253 pregnant women (16–41 years included in the National Health and Nutrition Examination Survey (NHANES 2003–2012, food items were aggregated into 28 food groups based on Food Patterns Equivalents Database. Three dietary patterns were identified by reduced rank regression with responses including prepregnancy body mass index (BMI, dietary fiber, and ratio of poly- and monounsaturated fatty acids to saturated fatty acid: “high refined grains, fats, oils and fruit juice”, “high nuts, seeds, fat and soybean; low milk and cheese”, and “high added sugar and organ meats; low fruits, vegetables and seafood”. GDM was diagnosed using fasting plasma glucose levels ≥5.1 mmol/L for gestation <24 weeks. Multivariable logistic regression models were used to estimate adjusted odds ratio (AOR and 95% confidence intervals (CIs for GDM, after controlling for maternal age, race/ethnicity, education, family poverty income ratio, marital status, prepregnancy BMI, gestational weight gain, energy intake, physical activity, and log-transformed C-reactive protein (CRP. All statistical analyses accounted for the appropriate survey design and sample weights of the NHANES. Of 249 pregnant women, 34 pregnant women (14% had GDM. Multivariable AOR (95% CIs of GDM for comparisons between the highest vs. lowest tertiles were 4.9 (1.4–17.0 for “high refined grains, fats, oils and fruit juice” pattern, 7.5 (1.8–32.3 for “high nuts, seeds, fat and soybean; low milk and cheese” pattern, and 22.3 (3.9–127.4 for “high added sugar and organ meats; low fruits, vegetables and seafood” pattern after controlling for maternal sociodemographic variables, prepregnancy BMI, gestational

  15. Maternal coffee consumption during pregnancy and risk of childhood acute leukemia: a metaanalysis.

    Science.gov (United States)

    Cheng, Jian; Su, Hong; Zhu, Rui; Wang, Xu; Peng, Meiling; Song, Jian; Fan, Dongdong

    2014-02-01

    This study was undertaken to explore the association between maternal coffee consumption during pregnancy and childhood acute leukemia (AL). The PubMed database was used to search studies up to May 5, 2013, and the lists of references of retrieved articles were also screened to identify additional relevant studies. Studies were included if they reported the odds ratio and corresponding 95% confidence interval (CI) of childhood AL, including childhood acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML), with respect to maternal coffee consumption during pregnancy. Compared with non/lowest drinkers, the combined odds ratio regarding the relationship of maternal coffee consumption during pregnancy and childhood AL was 1.22 (95% CI, 1.04-1.43) for ever drinkers, 1.16 (95% CI, 1.00-1.34) for low to moderate-level drinkers, and 1.72 (95% CI, 1.37-2.16) for high-level drinkers. When analysis was conducted by subtypes of childhood AL, maternal coffee consumption (high-level drinkers vs non/lowest drinkers) was statistically significantly associated with childhood ALL (1.65; 95% CI, 1.28-2.12) and childhood AML (1.58; 95% CI, 1.20-2.08). We observed the linear dose-response relationship of coffee consumption and childhood AL (P for nonlinearity = .68), including childhood ALL and childhood AML; with increased coffee consumption, the risk of childhood AL increased. The findings of the metaanalysis suggest that maternal coffee consumption during pregnancy may increase the risk of childhood AL. Because of limited studies, further prospective studies are urgently needed to explore the adverse effect of coffee consumption on childhood AL. Copyright © 2014 Mosby, Inc. All rights reserved.

  16. Mechanism and preclinical prevention of increased breast cancer risk caused by pregnancy.

    Science.gov (United States)

    Haricharan, Svasti; Dong, Jie; Hein, Sarah; Reddy, Jay P; Du, Zhijun; Toneff, Michael; Holloway, Kimberly; Hilsenbeck, Susan G; Huang, Shixia; Atkinson, Rachel; Woodward, Wendy; Jindal, Sonali; Borges, Virginia F; Gutierrez, Carolina; Zhang, Hong; Schedin, Pepper J; Osborne, C Kent; Tweardy, David J; Li, Yi

    2013-12-31

    While a first pregnancy before age 22 lowers breast cancer risk, a pregnancy after age 35 significantly increases life-long breast cancer risk. Pregnancy causes several changes to the normal breast that raise barriers to transformation, but how pregnancy can also increase cancer risk remains unclear. We show in mice that pregnancy has different effects on the few early lesions that have already developed in the otherwise normal breast-it causes apoptosis evasion and accelerated progression to cancer. The apoptosis evasion is due to the normally tightly controlled STAT5 signaling going astray-these precancerous cells activate STAT5 in response to pregnancy/lactation hormones and maintain STAT5 activation even during involution, thus preventing the apoptosis normally initiated by oncoprotein and involution. Short-term anti-STAT5 treatment of lactation-completed mice bearing early lesions eliminates the increased risk after a pregnancy. This chemoprevention strategy has important implications for preventing increased human breast cancer risk caused by pregnancy. DOI: http://dx.doi.org/10.7554/eLife.00996.001.

  17. High Lifetime Pregnancy and Low Contraceptive Usage Among Sex Workers Who Use Drugs- An Unmet Reproductive Health Need

    Directory of Open Access Journals (Sweden)

    Alexson Debbie

    2011-08-01

    Full Text Available Abstract Background The objective of this study was to describe levels of pregnancy and contraceptive usage among a cohort of street-based female sex workers (FSWs in Vancouver. Methods The study sample was obtained from a community-based prospective cohort study (2006-2008 of 211 women in street-based sex work who use drugs, 176 of whom had reported at least one prior pregnancy. Descriptive statistics were used to estimate lifetime pregnancy prevalence, pregnancy outcomes (miscarriage, abortion, adoption, child apprehension, child custody, and contraceptive usage. In secondary analyses, associations between contraceptive usage, individual and interpersonal risk factors and high number of lifetime pregnancies (defined as greater than the sample mean of 4 were examined. Results Among our sample, 84% reported a prior pregnancy, with a mean of 4 lifetime pregnancies (median = 3; IQR: 2-5. The median age of women reporting 5+ pregnancies was 38 years old [interquartile range (IQR: 25.0-39.0] compared to 34 years [IQR: 25.0-39.0] among women reporting 4 or fewer prior pregnancies. 45% were Caucasian and 47% were of Aboriginal ancestry. We observed high rates of previous abortion (median = 1;IQR:1-3, apprehension (median = 2; IQR:1-4 and adoption (median = 1; IQR:1-2 among FSWs who reported prior pregnancy. The use of hormonal and insertive contraceptives was limited. In bivariate analysis, tubal ligation (OR = 2.49; [95%CI = 1.14-5.45], and permanent contraceptives (e.g., tubal ligation and hysterectomy (OR = 2.76; [95%CI = 1.36-5.59] were both significantly associated with having five or more pregnancies. Conclusion These findings demonstrate high levels of unwanted pregnancy in the context of low utilization of effective contraceptives and suggest a need to improve the accessibility and utilization of reproductive health services, including family planning, which are appropriately targeted and tailored for FSWs in Vancouver.

  18. Exposure to topical chloramphenicol during pregnancy and the risk of congenital malformations

    DEFF Research Database (Denmark)

    Thomseth, Vilde; Cejvanovic, Vanja; Jimenez-Solem, Espen

    2015-01-01

    malformations (adjusted odds ratio = 1.06, 95% CI 0.91-1.22) or specific major malformations. The number of redeemed prescriptions decreased significantly during pregnancy as compared to before and after pregnancy (p dispensing...... of chloramphenicol eye drops or eye ointment in the first trimester of pregnancy and major congenital malformations. This is in accordance with a previous study analysing the risk of systemic chloramphenicol....

  19. Women referred for occupational risk assessment in pregnancy have no increased risk of adverse obstetric outcomes

    DEFF Research Database (Denmark)

    Bidstrup, Signe Brøker; Kaerlev, Linda; Thulstrup, Ane Marie

    2015-01-01

    /or that the occupational risk assessment and counselling of pregnant women are preventing these selected adverse pregnancy outcomes. FUNDING: The Research Unit at Department of Occupational and Environmental Medicine at Bispebjerg Hospital supported the study financially. TRIAL REGISTRATION: not relevant. The study......INTRODUCTION: Our aim was to study the association between pregnant women's referral status for occupational risk assessment, and their risk of preterm delivery (....72-1.17). CONCLUSION: The women who are referred for occupational risk assessment at two large occupational university departments are not at an increased risk of preterm birth or of delivering low birth weight children. This may reflect that reproductive hazards in Danish workplaces are limited and...

  20. Pregnancy incidence and risk factors among women participating in vaginal microbicide trials for HIV prevention: systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Alfred Musekiwa

    Full Text Available INTRODUCTION: Pregnancy is contraindicated in vaginal microbicide trials for the prevention of HIV infection in women due to the unknown maternal and fetal safety of the microbicides. Women who become pregnant are taken off the microbicide during pregnancy period but this result in reduction of the power of the trials. Strategies to reduce the pregnancy rates require an understanding of the incidence and associated risk factors of pregnancy in microbicide trials. This systematic review estimates the overall incidence rate of pregnancy in microbicide trials and describes the associated risk factors. METHODS: A comprehensive literature search was carried out to identify eligible studies from electronic databases and other sources. Two review authors independently selected studies and extracted relevant data from included studies. Meta-analysis of incidence rates of pregnancy was carried out and risk factors of pregnancy were reported narratively. RESULTS: Fifteen studies reporting data from 10 microbicide trials (N=27,384 participants were included. A total of 4,107 participants (15.0% fell pregnant and a meta-analysis of incidence rates of pregnancy from 8 microbicide trials (N=25,551 yielded an overall incidence rate of 23.37 (95%CI: 17.78 to 28.96 pregnancies per 100 woman-years. However, significant heterogeneity was detected. Hormonal injectable, intra-uterine device (IUD or implants or sterilization, older age, more years of education and condom use were associated with lower pregnancy. On the other hand, living with a man, history of pregnancy, self and partner desire for future baby, oral contraceptive use, increased number of unprotected sexual acts and inconsistent use of condoms were associated with higher pregnancy. CONCLUSIONS: The incidence rate of pregnancy in microbicide trials is high and strategies for its reduction are urgently required in order to improve the sample size and power of these trials.

  1. The risk of unintended pregnancy among young women with mental health symptoms

    Science.gov (United States)

    Kusunoki, Yasamin; Gatny, Heather; Barber, Jennifer

    2013-01-01

    Depression and stress have been linked with poor contraceptive behavior, but whether existing mental health symptoms influence women's subsequent risk of unintended pregnancy is unclear. We prospectively examined the effect of depression and stress symptoms on young women's pregnancy risk over one year. We used panel data from a longitudinal study of 992 U.S. women ages 18-20 years who reported a strong desire to avoid pregnancy. Weekly journal surveys measured relationship, contraceptive use and pregnancy outcomes. We examined 27,572 journal surveys from 940 women over the first study year. Our outcome was self-reported pregnancy. At baseline, we assessed moderate/severe depression (CESD-5) and stress (PSS-4) symptoms. We estimated the effect of baseline mental health symptoms on pregnancy risk with discrete-time, mixed-effects, proportional hazard models using logistic regression. At baseline, 24% and 23% of women reported moderate/severe depression and stress symptoms, respectively. Ten percent of young women not intending pregnancy became pregnant during the study. Rates of pregnancy were higher among women with baseline depression (14% vs. 9%, p=0.04) and stress (15% vs. 9%, p=0.03) compared to women without symptoms. In multivariable models, the risk of pregnancy was 1.6 times higher among women with stress symptoms compared to those without stress (aRR 1.6, CI 1.1,2.7). Women with co-occurring stress and depression symptoms had over twice the risk of pregnancy (aRR 2.1, CI 1.1,3.8) compared to those without symptoms. Among women without a prior pregnancy, having co-occurring stress and depression symptoms was the strongest predictor of subsequent pregnancy (aRR 2.3, CI 1.2,4.3), while stress alone was the strongest predictor among women with a prior pregnancy (aRR 3.0, CI 1.1,8.8). Depression symptoms were not independently associated with young women's pregnancy risk. In conclusion, stress, and especially co-occurring stress and depression symptoms

  2. Hypertension in pregnancy is a risk factor for microalbuminuria later in life.

    Science.gov (United States)

    Kattah, Andrea G; Asad, Reem; Scantlebury, Dawn C; Bailey, Kent R; Wiste, Heather J; Hunt, Steven C; Mosley, Thomas H; Kardia, Sharon L R; Turner, Stephen T; Garovic, Vesna D

    2013-09-01

    The authors aimed to compare renal function by estimated glomerular filtration rate and albuminuria in 3 groups of women: nulliparous women, women with a history of normotensive pregnancies, and women with a history of at least one hypertensive pregnancy. Women who participated in the second Family Blood Pressure Program Study visit (2000-2004) and had serum creatinine and urine albumin measurements (n=3015) were categorized as having had no pregnancy lasting >6 months (n=341), having had only normotensive pregnancies (n=2199), or having had at least 1 pregnancy with hypertension (n=475) based on a standardized questionnaire. Women who reported having had at least one pregnancy with hypertension were significantly more likely to be hypertensive (75.6% vs 59.4%, Ppregnancies. There was a significantly greater risk of microalbuminuria (urine albumin-creatinine ratio >25 mg/g) in those who reported at least one pregnancy with hypertension (odds ratio, 1.37; confidence interval, 1.02-1.85; P=.04) than in those with normotensive pregnancies, after adjusting for risk factors for chronic kidney and cardiovascular disease. Hypertension in pregnancy is associated with an increased risk of future microalbuminuria.

  3. Pregnancy as a risk factor for undertreatment after bariatric surgery.

    Science.gov (United States)

    Jacquemyn, Yves; Meesters, Johanna

    2014-01-09

    A pregnant woman presented at the emergency department with severe nausea and vomiting at 20 weeks of gestational age; she was known with gastric banding. Advanced imaging studies were avoided of fear to harm the fetus. The patient continued to vomit and at 23 weeks intrauterine fetal death was noted. The symptoms did not resolve after delivery and CT scan demonstrated slippage of the gastric band over the pylorus resulting in a high digestive obstruction as the cause of hyperemesis and finally resulting necrosis of the vasa brevia. The gastric band was laparoscopically removed along with the necrotic tissue. Avoidance of radiological and endoscopic investigations of fear to harm the pregnancy resulted in complications and possibly in fetal death.

  4. Maternal-Fetal Cancer Risk Assessment of Ochratoxin A during Pregnancy

    Directory of Open Access Journals (Sweden)

    Chit Shing Jackson Woo

    2016-03-01

    Full Text Available Increasing evidence has demonstrated that in utero exposure to environmental chemicals may interfere with fetal development and increase the risk of disease and cancer development later in life. Ochratoxin A (OTA has been proven to induce diverse toxic effects including teratogenicity, carcinogenicity, immunotoxicity and potential endocrine disruption. Due to the continuous and widespread occurrence of OTA as a potential contaminant of staple foods, there is increasing concern of in utero exposure of fetus to this mycotoxin. In this study, maternal-fetal risk assessment of OTA during pregnancy was conducted using the benchmark dose approach for genotoxic carcinogens. The daily intake of OTA for Egyptian pregnant women was estimated based on their serum OTA level using the refined Klaassen equation for pregnancy. Fetal exposure level was also estimated based on the maternal data. Comparison between the estimated daily exposure and the negligible cancer risk intake (NCRI, and the calculation of margin of exposure (MOE implicated that OTA exposure from dietary intake would be of low health concern for this general subpopulation of Egyptian women. This subpopulation of pregnant women was generally estimated not to be in high-risk for toxicity induced by OTA.

  5. Cadmium levels in a North Carolina cohort: Identifying risk factors for elevated levels during pregnancy.

    Science.gov (United States)

    Edwards, Sharon E; Maxson, Pamela; Miranda, Marie Lynn; Fry, Rebecca C

    2015-01-01

    The objectives of this study were to examine cadmium (Cd) levels and relationships to demographics in an observational, prospective pregnancy cohort study in Durham County, North Carolina. Multivariable models were used to compare blood Cd levels across demographic characteristics. The relative risk of having a blood Cd level that exceeds the US national median (0.32 μg/l) was estimated. Overall, >60% of the women had an elevated (>0.32 μg/l) blood Cd level. Controlling for confounding variables, smoking was associated with 21% (95% CI: 15-28%) increased risk for an elevated blood Cd level. High Cd levels were also observed in non-smokers and motivated smoking status-stratified models. Race, age, education, relationship status, insurance status and cotinine level were not associated with risk of elevated Cd levels among smokers; however, older age and higher cotinine levels were associated with elevated Cd levels among non-smokers. Taken together, more than half of pregnant women in this cohort had elevated blood Cd levels. Additionally, among non-smokers, 53% of the women had elevated levels of Cd, highlighting other potential sources of exposure. This study expands on the limited data describing Cd levels in pregnant populations and highlights the importance of understanding Cd exposures among non-smokers. Given the latent health risks of both smoking and Cd exposure, this study further highlights the need to biomonitor for exposure to toxic metals during pregnancy among all women of child-bearing age.

  6. Maternal-Fetal Cancer Risk Assessment of Ochratoxin A during Pregnancy.

    Science.gov (United States)

    Woo, Chit Shing Jackson; El-Nezami, Hani

    2016-03-23

    Increasing evidence has demonstrated that in utero exposure to environmental chemicals may interfere with fetal development and increase the risk of disease and cancer development later in life. Ochratoxin A (OTA) has been proven to induce diverse toxic effects including teratogenicity, carcinogenicity, immunotoxicity and potential endocrine disruption. Due to the continuous and widespread occurrence of OTA as a potential contaminant of staple foods, there is increasing concern of in utero exposure of fetus to this mycotoxin. In this study, maternal-fetal risk assessment of OTA during pregnancy was conducted using the benchmark dose approach for genotoxic carcinogens. The daily intake of OTA for Egyptian pregnant women was estimated based on their serum OTA level using the refined Klaassen equation for pregnancy. Fetal exposure level was also estimated based on the maternal data. Comparison between the estimated daily exposure and the negligible cancer risk intake (NCRI), and the calculation of margin of exposure (MOE) implicated that OTA exposure from dietary intake would be of low health concern for this general subpopulation of Egyptian women. This subpopulation of pregnant women was generally estimated not to be in high-risk for toxicity induced by OTA.

  7. Maternal-Fetal Cancer Risk Assessment of Ochratoxin A during Pregnancy

    Science.gov (United States)

    Woo, Chit Shing Jackson; El-Nezami, Hani

    2016-01-01

    Increasing evidence has demonstrated that in utero exposure to environmental chemicals may interfere with fetal development and increase the risk of disease and cancer development later in life. Ochratoxin A (OTA) has been proven to induce diverse toxic effects including teratogenicity, carcinogenicity, immunotoxicity and potential endocrine disruption. Due to the continuous and widespread occurrence of OTA as a potential contaminant of staple foods, there is increasing concern of in utero exposure of fetus to this mycotoxin. In this study, maternal-fetal risk assessment of OTA during pregnancy was conducted using the benchmark dose approach for genotoxic carcinogens. The daily intake of OTA for Egyptian pregnant women was estimated based on their serum OTA level using the refined Klaassen equation for pregnancy. Fetal exposure level was also estimated based on the maternal data. Comparison between the estimated daily exposure and the negligible cancer risk intake (NCRI), and the calculation of margin of exposure (MOE) implicated that OTA exposure from dietary intake would be of low health concern for this general subpopulation of Egyptian women. This subpopulation of pregnant women was generally estimated not to be in high-risk for toxicity induced by OTA. PMID:27023600

  8. Effect of maternal stress during pregnancy on the risk for preterm birth.

    Science.gov (United States)

    Lilliecreutz, Caroline; Larén, Johanna; Sydsjö, Gunilla; Josefsson, Ann

    2016-01-15

    Preterm birth defined as birth prior to 37 weeks of gestation is caused by different risk factors and implies an increased risk for disease and early death for the child. The aim of the study was to investigate the effect of maternal stress during pregnancy on the risk of preterm birth. A case-control study that included 340 women; 168 women who gave birth preterm and 172 women who gave birth at term. Data were manually extracted from standardized medical records. If the medical record contained a psychiatric diagnosis or a self-reported stressor e.g., depression or anxiety the woman was considered to have been exposed to stress during pregnancy. Adjusted odds ratio (AOR) was used to calculate the attributable risk (AR) of maternal stress during pregnancy on preterm birth, both for the women exposed to stress during pregnancy (AR1 = (AOR-1)/AOR) and for the whole study population (AR2 = AR1*case fraction). Maternal stress during pregnancy was more common among women who gave birth preterm compared to women who gave birth at term (p stress during pregnancy 54% gave birth preterm with stress as an attributable risk factor. Among all of the women the percentage was 23%. Stress seems to increase the risk of preterm birth. It is of great importance to identify and possibly alleviate the exposure to stress during pregnancy and by doing so try to decrease the preterm birth rate.

  9. Análise dos Testes de Vitalidade Fetal e dos Resultados Perinatais em Gestações de Alto Risco com Oligoidrâmnio Analysis of Fetal Well-being and Perinatal Outcome in the High-risk Pregnancies Complicated by Oligohydramnios

    Directory of Open Access Journals (Sweden)

    Roseli Mieko Yamamoto Nomura

    2002-07-01

    Full Text Available Objetivos: analisar, em gestações de alto risco com diagnóstico de oligoidrâmnio, os resultados dos testes de avaliação da vitalidade fetal e os resultados perinatais. Métodos: foram selecionadas retrospectivamente 572 gestações de alto risco com diagnóstico de oligoidrâmnio, caracterizado por ILA inferior ou igual a 5,0 cm. Destas, 220 apresentavam diagnóstico de oligoidrâmnio grave (ILA Purpose: to evaluate, in the high-risk pregnancies with oligohydramnios, the assessment tools for fetal well-being and perinatal results. Methods: five hundred seventy-two high-risk pregnancies were retrospectively analyzed. All of them presented with oligohydramnios established by AFI <=5.0 cm. Severe oligohydramnios was detected in 220 cases (AFI<=3,0 cm. The fetal well-being tests included: antepartum cardiotocography, biophysical profile score (BPS and dopplervelocimetry of umbilical and middle cerebral arteries. Multiple gestation, fetal anomalies and premature rupture of membrane cases were excluded. Results: severe oligohydramnios was significantlly associated with abnormal and suspected cardiotocography results (23.2%, abnormal biophysical profile score (10.5%, abnormal results of middle cerebral artery dopplervelocimetry (54.5%, small for gestational age infants (32.7% and meconial amniotic fluid (27.9% when compared to pregnancies with AFI between 3.1 and 5.0 cm. This group presented: abnormal or suspected cardiotocography results (13.9%, abnormal biophysical profile score (4.3%, abnormal results of middle cerebral artery dopplervelocimetry (33.9%, small for gestational age infants (21.0% and meconial amniotic fluid (16.8%. Conclusion: the oligohydramnios severity in high-risk pregnancies allows to discriminate the cases that are related to adverse perinatal outcome.

  10. If You Do Not Ask, They Will Not Tell: Evaluating Pregnancy Risk in Young Women in Pediatric Hospitals.

    Science.gov (United States)

    Coles, Mandy S; Lau, May; Akers, Aletha Y

    2016-03-01

    Adolescents experience some of the highest rates of unintended pregnancy among women of all reproductive age groups. And despite the fact that adolescents often receive care in pediatric hospital settings, evaluation of pregnancy risk is inconsistent. Pregnancy risk assessments can identify opportunities to deliver reproductive health services, allow earlier pregnancy diagnoses, and reduce morbidity and mortality for medically complex adolescent patients and their pregnancies. In this commentary we discuss some of the challenges and potential solutions to performing pregnancy risk assessments in pediatric hospital settings.

  11. Maternal Pre-Pregnancy Obesity and Risk for Inattention and Negative Emotionality in Children

    Science.gov (United States)

    Rodriguez, Alina

    2010-01-01

    Objective: This study aimed to replicate and extend previous work showing an association between maternal pre-pregnancy adiposity and risk for attention deficit hyperactivity disorder (ADHD) symptoms in children. Methods: A Swedish population-based prospective pregnancy-offspring cohort was followed up when children were 5 years old (N = 1,714).…

  12. Air pollution, blood pressure, and the risk of hypertensive complications during pregnancy: The generation r study

    NARCIS (Netherlands)

    Hooven, E.H. van den; Kluizenaar, Y. de; Pierik, F.H.; Hofman, A.; Ratingen, S.W. van; Zandveld, P.Y.J.; MacKenbach, J.P.; Steegers, E.A.P.; Miedema, H.M.E.; Jaddoe, V.W.V.

    2011-01-01

    Exposure to air pollution is associated with elevated blood pressure and cardiovascular disease. We assessed the associations of exposure to particulate matter (PM10) and nitrogen dioxide (NO2) levels with blood pressure measured in each trimester of pregnancy and the risks of pregnancy-induced hype

  13. Cardiovascular risk factors in women who had hypertensive disorders late in pregnancy : a cohort study

    NARCIS (Netherlands)

    Hermes, Wietske; Franx, Arie; van Pampus, Maria G.; Bloemenkamp, Kitty W. M.; Bots, Michiel L.; van der Post, Joris A.; Porath, Martina; Ponjee, Gabrielle A. E.; Tamsma, Jouke T.; Mol, Ben Willem J.; de Groot, Christianne J. M.

    2013-01-01

    OBJECTIVE: The purpose of this study was to determine cardiovascular risk factors in women with a history of hypertensive pregnancy disorders at term (HTP) 2.5 years after pregnancy. STUDY DESIGN: In a multicenter cohort study in The Netherlands from June 2008 through November 2010, cardiovascular r

  14. Air pollution, blood pressure, and the risk of hypertensive complications during pregnancy: The generation r study

    NARCIS (Netherlands)

    Hooven, E.H. van den; Kluizenaar, Y. de; Pierik, F.H.; Hofman, A.; Ratingen, S.W. van; Zandveld, P.Y.J.; MacKenbach, J.P.; Steegers, E.A.P.; Miedema, H.M.E.; Jaddoe, V.W.V.

    2011-01-01

    Exposure to air pollution is associated with elevated blood pressure and cardiovascular disease. We assessed the associations of exposure to particulate matter (PM10) and nitrogen dioxide (NO2) levels with blood pressure measured in each trimester of pregnancy and the risks of pregnancy-induced

  15. Clarithromycin in early pregnancy and the risk of miscarriage and malformation

    DEFF Research Database (Denmark)

    Andersen, Jon Thor Trærup; Petersen, Morten; Jimenez-Solem, Espen

    2013-01-01

    The antibiotic clarithromycin has been associated with fetal loss in animals and a study has found a doubling in the frequency of miscarriages among women using clarithromycin in pregnancy. The aim of the study was to investigate whether clarithromycin use in early pregnancy was associated...... with an increased risk for miscarriages and major malformations....

  16. Biochemical Cardiovascular Risk Factors After Hypertensive Pregnancy Disorders: A Systematic Review and Meta-analysis

    NARCIS (Netherlands)

    Hermes, W.; Ket, J.C.; Pampus, M.G. van; Franx, A.; Veenendaal, M.V.; Kolster, C.; Tamsma, J.T.; Bloemenkamp, K.W.; Ponjee, G.; Hout, E. van der; Ten Horn, H.; Loix, S.; Mol, B.W.; Groot, C.J. de

    2012-01-01

    The objective of this study was to perform a systematic review and meta-analysis of studies assessing biochemical cardiovascular risk factors in women with previous hypertensive pregnancy disorders and women with previous normotensive pregnancies. Data were collected from PubMed and EMBASE (from inc

  17. Biochemical Cardiovascular Risk Factors After Hypertensive Pregnancy Disorders : A Systematic Review and Meta-analysis

    NARCIS (Netherlands)

    Hermes, Wietske; Ket, Johannes C. F.; van Pampus, Maria G.; Franx, Arie; Veenendaal, Marjolein V. E.; Kolster, Clara; Tamsma, Jouke T.; Bloemenkamp, Kitty W. M.; Ponjee, Gabrielle; van der Hout, Evelien; ten Horn, Hilde; Loix, Stephanie; Mol, Ben Willem; de Groot, Christianne J. M.

    2012-01-01

    The objective of this study was to perform a systematic review and meta-analysis of studies assessing biochemical cardiovascular risk factors in women with previous hypertensive pregnancy disorders and women with previous normotensive pregnancies. Data were collected from PubMed and EMBASE (from inc

  18. Lamotrigine use in pregnancy and risk of orofacial cleft, an update of eurocat lamotrigine study

    NARCIS (Netherlands)

    Wang, Hao; Loane, Maria; Garne, Ester; Morris, Joan; Nelen, Vera; Khoshnood, Babak; Rißmann, Anke; Wiesel, Awi; O'Mahony, Mary; Pierini, Anna; Calzolari, Elisa; Gatt, Miriam; Bakker, Marian; Addor, Marie-Claude; Tucker, David; Klungsoyr, Kari; Latos-Bielenska, Anna; Mejnartowicz, Jan P.; Kallen, Karin; Barisic, Ingeborg; Verellen-Dumoulin, Christine; Doray, Bérénice; Arriola, Larraitz; Wellesley, Diana; Neville, Amanda; De Jong-Van Den Berg, Lolkje T.W.; Dolk, Helen

    2014-01-01

    Background: Lamotrigine (LTG) is increasingly used during pregnancy. A FDA warning was issued for an association of LTG exposure and increased risk of orofacial clefts (OCs), based on data from the North American Antiepileptic Drug Pregnancy Registry (Holmes, 2006; Holmes et al., 2008). The signal

  19. Sequential screening for psychosocial and behavioural risk during pregnancy in a population of urban African Americans

    National Research Council Canada - National Science Library

    Kiely, M; Gantz, MG; El‐Khorazaty, MN; El‐Mohandes, AAE

    2013-01-01

    ... to be state of the art in peri‐ and prenatal care. The exposure to risks considered in this study (depression, intimate partner violence [IPV], smoking, and environmental tobacco smoke exposure [ETSE]) have all been causally associated with poor pregnancy outcomes. Depression during pregnancy is common, with rates ranging between 10 and 30%. D...

  20. Young women's education and behavioural risk trajectories: clarifying their association with unintended-pregnancy resolution.

    Science.gov (United States)

    Gomez-Scott, Jessica; Cooney, Teresa M

    2014-06-01

    In the USA, most pregnancies occurring to teenage women are unplanned, making both the decisions regarding their resolution and the consequences of those decisions important topics of inquiry. Substantial debate surrounds the potential consequences for young women of either carrying an unintended pregnancy to term or voluntarily terminating it. The present study utilises data from The US National Longitudinal Study of Adolescent Health prospectively to examine the predictors of pregnancy resolution decisions in terms of young women's educational goals and their engagement in risk behaviours. Additionally, the long-term consequences of these decisions for education and risk-taking behaviours are identified. Results indicate that young women with strong educational goals have a greater likelihood of terminating an unintended pregnancy than those with low aspirations, and that pregnancy termination predicts higher educational attainment compared to motherhood. Risk behaviours did not predict pregnancy-resolution decisions, but young women who became mothers reported lower rates of subsequent substance use and fewer sexual partners post-pregnancy than those who terminated the pregnancy or who had never been pregnant. Motherhood appears to be a catalyst for lifestyle change among young women, limiting substance use and sexual partnering, in contrast to abortion, which appears to allow adolescents to continue risk-taking trajectories.

  1. A case-control study to evaluate risk factors for ectopic pregnancy

    Directory of Open Access Journals (Sweden)

    Sangita Khedar

    2016-08-01

    Conclusions: Increase awareness and knowledge of risk factors will help obstetricians to suspect and diagnose ectopic pregnancy early and accurately and enable them to plan medical treatment. Surgical treatment will be reserved for ruptured ectopic pregnancy and haemodynamically unstable patients. [Int J Reprod Contracept Obstet Gynecol 2016; 5(8.000: 2828-2835

  2. Classification of discordant fetal growth may contribute to risk stratification in monochorionic twin pregnancies

    NARCIS (Netherlands)

    van Gemert, MJC; Vandenbussche, FPHA; Schaap, AHP; Zondervan, HA; Nikkels, PGJ; van Wijngaarden, WJ; van Zalen-Sprock, RM; Sollie-Szarynska, KM; Stoutenbeek, PH

    2000-01-01

    Objectives To determine whether classification of discordant growth between fetal twins allows risk stratification in monochorionic twin pregnancies. Methods In 12 twin-to-twin transfusion syndrome (TTTS) pregnancies and 12 cases that were suspected of developing the syndrome, fetal growth was deter

  3. Cardiovascular risk factors in women who had hypertensive disorders late in pregnancy : a cohort study

    NARCIS (Netherlands)

    Hermes, Wietske; Franx, Arie; van Pampus, Maria G.; Bloemenkamp, Kitty W. M.; Bots, Michiel L.; van der Post, Joris A.; Porath, Martina; Ponjee, Gabrielle A. E.; Tamsma, Jouke T.; Mol, Ben Willem J.; de Groot, Christianne J. M.

    2013-01-01

    OBJECTIVE: The purpose of this study was to determine cardiovascular risk factors in women with a history of hypertensive pregnancy disorders at term (HTP) 2.5 years after pregnancy. STUDY DESIGN: In a multicenter cohort study in The Netherlands from June 2008 through November 2010, cardiovascular r

  4. Risk of postpartum urinary incontinence associated with pregnancy and mode of delivery

    DEFF Research Database (Denmark)

    Foldspang, Anders; Hvidman, Lone; Mommsen, Søren

    2004-01-01

    Aim.  The aim was to estimate the postpartum urinary incontinence (PP UI) impact of precursory UI during pregnancy (PR UI) and delivery performed by cesarean section (CS) vs. vaginal childbirth (VC). Methods.  Among the members of two population samples, in total 8610 women aged 20–59 years, 1232...... of the high frequency of VC, more than seven out of 10 cases of UI following the first childbirth, however, seemed to be attributable to VC. The present data did not lend significant support to the assumption that the PP UI risk is also lowered after a subsequent delivery by CS....

  5. From infancy to pregnancy: birth weight, body mass index, and the risk of gestational diabetes.

    Science.gov (United States)

    Lagerros, Ylva Trolle; Cnattingius, Sven; Granath, Fredrik; Hanson, Ulf; Wikström, Anna-Karin

    2012-10-01

    Obesity is a risk factor for gestational diabetes, whereas the role of the mother's birth weight is more uncertain. We aimed to investigate the combined effect of mothers' birth-weight-for-gestational-age and early pregnancy Body Mass Index (BMI) in relation to risk of gestational diabetes. Between 1973 and 2006, we identified a cohort of 323,083 women included in the Swedish Medical Birth Register both as infants and as mothers. Main exposures were mothers' birth-weight-for-gestational-age (categorized into five groups according to deviation from national mean birth weight) and early pregnancy BMI (classified according to WHO). Rates of gestational diabetes increased with adult BMI, independently of birth-weight-for-gestational-age. However, compared to women with appropriate birth-weight-for-gestational-age [appropriate-for-gestational age (AGA); -1 to +1 SD] and BMI (born small-for-gestational-age [small for gestational age (SGA); born large-for-gestational-age [large-for-gestational-age (LGA); >2SD], and OR = 10.4 (95 % CI 8.4-13.0) if born AGA. Risk of gestational diabetes is not only increased among obese women, but also among women born SGA and LGA. Severely obese women born with a low or a high birth-weight-for-gestational-age seem more vulnerable to the development of gestational diabetes compared to normal weight women. Normal pre-pregnancy BMI diminishes the increased risk birth size may confer in terms of gestational diabetes. Therefore, the importance of keeping a healthy weight cannot be overemphasized.

  6. Risk of subsequent pregnancy in women with a history of peripartum cardiomyopathy.

    Science.gov (United States)

    Elkayam, Uri

    2014-10-14

    Peripartum cardiomyopathy (PPCM) is a pregnancy-associated myocardial disease with marked left ventricular systolic dysfunction. Although this condition can lead to major complications, including severe heart failure, arrhythmias, thromboembolic events, and death, the majority of women with this condition demonstrate a complete or partial recovery. Many of these women desire to become pregnant again and are concerned regarding the safety of additional pregnancies. The purpose of this paper is to review the available information related to subsequent pregnancies in women with a history of PPCM in an attempt to reach conclusions regarding the risk of such pregnancies in this group of patients.

  7. [Interconnection between assisted reproductive technologies, pregnancy complications and risk of birth defects].

    Science.gov (United States)

    Grabar', V V

    2014-02-01

    The aim of the article was to investigate the relationship between pregnancy complications, infertility and assisted reproductive technologies (ART). The study was conducted on 1331 couples with complicated reproductive history. It is found that miscarriage and other complications of pregnancy depend rather on the etiopathogenesis of infertility than on the technique of ART. The highest frequency of complications of pregnancy was diagnosed in women with endocrine disorders. In case of congenital malformations in the fetus the frequency of birth defects was 3.6% after in vitro fertilization (IVF) and 1.8% in case of spontaneous pregnancy. It was found an increased risk of birth defects in singleton boys conceived by IVF.

  8. Effect of repeated OGTT examinations in prenatal diagnosis and pregnancy outcome of high risk pregnant women%多次OGTT检查对高危孕妇产前诊断及母婴结局的影响

    Institute of Scientific and Technical Information of China (English)

    贺彤; 陈琳; 李青

    2014-01-01

    目的:研究行多次OGTT检查对高危孕妇产前诊断妊娠期糖尿病的临床应用价值,并探讨母婴结局。方法简单随机选择2012年8~11月于湖南省妇幼保健院产科门诊行产前捡查的62例高危孕妇(观察组),分别于孕24~28周及32~35周进行75 g口服葡萄糖量试验检查。选择同期未按照医嘱及时复查的高危孕妇39例为对照组,观察高危孕妇二次筛查妊娠期糖尿病的检出率及两组孕妇胎盘异常或早产、新生儿Apgar评分和住院时间。结果高危孕妇二次葡萄糖筛查的检出率为16.13%(10/62),明显高于首次葡萄糖筛查的检出率4.84%(3/62),差异有统计学意义(P<0.05)。观察组新生儿Apgar评分为(8.89±0.06)分,高于对照组的(8.25±0.04)分,差异有统计学意义(P<0.05);观察组产妇和婴儿平均住院时间为(6.12±0.08) d,低于对照组的(8.61±0.17) d,差异也有统计学意义(P<0.05)。结论对高危孕妇增加二次葡萄糖筛查可以提高妊娠期糖尿病的检出率,为患者的早期诊断和治疗提供更合适的依据,明显改善母婴结局,适合临床推广应用。%Objective To study the clinical value of repeated OGTTs in prenatal diagnosis of gestational dia-betes in high-risk pregnant women and explore the pregnancy outcome. Methods Sixty-two cases of high-risk preg-nant women were selected in Department of obstetrics of Maternal and Child Health Hospital of Hunan Province from Aug. 2012 to Nov. 2012 (the observation group). They were carried oral glucose tolerance tests at 24~28 weeks and 32~35 weeks. Thirty-nine high-risk pregnant women, which did not follow the doctors' instruction to repeat the test, were selected during the same period as the control group. The detection rate of gestational diabetes in high risk preg-nant women after twice screening was observed, and compare the placental abnormality, premature delivery, neonatal Apgar score and hospitalization time of two

  9. Coffee consumption during pregnancy and the risk of hyperkinetic disorder and ADHD: a prospective cohort study

    DEFF Research Database (Denmark)

    Linnet, Karen Markussen; Wisborg, Kirsten; Secher, Niels Jørgen

    2008-01-01

    Aim: Based on hypotheses from experimental studies, we studied the association between intrauterine exposure to coffee and the risk of clinically verified hyperkinetic disorder and attention-deficit hyperactivity disorder (ADHD). Methods: A cohort study with prospectively collected data from...... 88 children with hyperkinetic disorder and ADHD. Information about coffee consumption during pregnancy was obtained at 16 weeks of gestation from self-administrated questionnaires. Potential confounding factors were evaluated using Cox regression analyses. Results: We found that intrauterine exposure...... to 10 or more cups of coffee per day was associated with a threefold increased risk of hyperkinetic disorder and ADHD. After adjustments for a number of confounding factors, the risk decreased and became statistically insignificant (RR 2.3, 95% CI 0.9-5.9). Conclusion: Prenatal exposure to high levels...

  10. Use of psychotropic medications during pregnancy: perception of teratogenic risk among physicians in two Latin American countries

    Directory of Open Access Journals (Sweden)

    Amaury Cantilino

    2014-05-01

    Full Text Available Objective: Pregnant women and their health care professionals commonly believe that use of medications during pregnancy may be harmful to the unborn fetus. The objective of this study was to evaluate the risk perception of psychotropic drug use in pregnancy among physicians in different medical specialties. Method: This was a convenience survey conducted at outpatient clinics in the cities of Recife, Brazil, and La Plata, Bahía Blanca, and Buenos Aires, Argentina. Physicians who agreed to participate were asked to rate their perception of teratogenic risk among different classes of drugs, which included antidepressants, antipsychotics, anticonvulsants, and benzodiazepines. Results: Two hundred and thirty-eight physicians completed the survey (response rate, 98%. These included psychiatrists, obstetricians, neurologists, cardiologists, gastroenterologists, and general practitioners. Among different specialties, a minority of psychiatrists perceived psychotropic drugs to be highly teratogenic (antidepressants, 12.5%; antipsychotics, 15%; benzodiazepines, 25% as compared with other specialties (p < 0.003 for each drug class. There was no difference in perceived risk of antiepileptic drugs among specialties, including psychiatrists. Conclusion: The risk associated with use of psychotropic drugs in pregnancy was overestimated by physicians of all medical specialties, except psychiatry. All physicians should be aware of the safety/risk of psychotropic agents in pregnancy, as they may be required to give advice and/or prescribe these drugs to pregnant women.

  11. Clinical risk factors for gestational hypertensive disorders in pregnant women at high risk for developing preeclampsia

    NARCIS (Netherlands)

    Wong, Tsz Y.; Groen, Henk; Faas, Marijke M.; van Pampus, Maria G.

    2013-01-01

    Objectives: To evaluate clinical risk factors for the development of gestational hypertensive disorders in a group of pregnant women at high risk for developing preeclampsia. Secondly we evaluated the incidence and recurrence rate of preeclampsia and pregnancy-induced hypertension. Study design: A

  12. Clinical risk factors for gestational hypertensive disorders in pregnant women at high risk for developing preeclampsia

    NARCIS (Netherlands)

    Wong, Tsz Y.; Groen, Henk; Faas, Marijke M.; van Pampus, Maria G.

    2013-01-01

    Objectives: To evaluate clinical risk factors for the development of gestational hypertensive disorders in a group of pregnant women at high risk for developing preeclampsia. Secondly we evaluated the incidence and recurrence rate of preeclampsia and pregnancy-induced hypertension. Study design: A p

  13. Ectopic pregnancy: a comprehensive analysis of risk factors and management

    Directory of Open Access Journals (Sweden)

    Dinesh Pal Yadav

    2016-08-01

    Conclusions: Ectopic pregnancy is a life-threatening condition occurring in women all over the world. As the incidence of ectopic pregnancy increases, ways and means have to be found to reduce the associated morbidity and mortality and to preserve future fertility. [Int J Reprod Contracept Obstet Gynecol 2016; 5(8.000: 2723-2727

  14. Risk factors and birth outcomes of anaemia in early pregnancy in a nulliparous cohort.

    Directory of Open Access Journals (Sweden)

    Gwinyai Masukume

    Full Text Available Anaemia in pregnancy is a major public health and economic problem worldwide, that contributes to both maternal and fetal morbidity and mortality.The aim of the study was to calculate the prevalence of anaemia in early pregnancy in a cohort of 'low risk' women participating in a large international multicentre prospective study (n = 5 609, to identify the modifiable risk factors for anaemia in pregnancy in this cohort, and to compare the birth outcomes between pregnancies with and without anaemia in early gestation.The study is an analysis of data that were collected prospectively during the Screening for Pregnancy Endpoints study. Anaemia was defined according to the World Health Organization's definition of anaemia in pregnancy (haemoglobin < 11g/dL. Binary logistic regression with adjustment for potential confounders (country, maternal age, having a marital partner, ethnic origin, years of schooling, and having paid work was the main method of analysis.The hallmark findings were the low prevalence of anaemia (2.2%, that having no marital partner was an independent risk factor for having anaemia (OR 1.34, 95% CI 1.01-1.78, and that there was no statistically significant effect of anaemia on adverse pregnancy outcomes (small for gestational age, pre-tem birth, mode of delivery, low birth weight, APGAR score < 7 at one and five minutes. Adverse pregnancy outcomes were however more common in those with anaemia than in those without.In this low risk healthy pregnant population we found a low anaemia rate. The absence of a marital partner was a non-modifiable factor, albeit one which may reflect a variety of confounding factors, that should be considered for addition to anaemia's conceptual framework of determinants. Although not statistically significant, clinically, a trend towards a higher risk of adverse pregnancy outcomes was observed in women that were anaemic in early pregnancy.

  15. Association Between Hypertensive Disorders of Pregnancy and Later Risk of Cardiomyopathy

    DEFF Research Database (Denmark)

    Behrens, Ida; Basit, Saima; Lykke, Jacob Alexander

    2016-01-01

    disorder of pregnancy. During follow-up, 1577 women (mean age, 48.5 years at cardiomyopathy diagnosis; 2.6% with multiple pregnancies) developed cardiomyopathy. Compared with women with normotensive pregnancies (18,211,603 person-years of follow-up; n = 1408 cardiomyopathy events, 7.7/100,000 person......-years [95% CI, 7.3-8.2]), women with a history of hypertensive disorders of pregnancy had significantly increased rates of cardiomyopathy (in 173,062 person-years of follow-up among women with severe preeclampsia, n = 27 cardiomyopathy events; 15.6/100,000 person-years [95% CI, 10.7-22.7]; adjusted hazard......IMPORTANCE: Women with hypertensive disorders of pregnancy, preeclampsia in particular, have an increased risk of cardiomyopathy during the peripartum period. Whether hypertensive disorders of pregnancy are also associated with cardiomyopathy later in life is unknown. OBJECTIVE: To determine...

  16. E1. Risk of chronic hypertension in women with a history of hypertensive disorders of pregnancy - a nationwide cohort study

    DEFF Research Database (Denmark)

    Behrens, I; Basit, S; Melbye, M;

    2016-01-01

    BACKGROUND: Women with a history of hypertensive disorders of pregnancy (HDP) are known to have an increased risk of hypertension years after their pregnancy. However, how soon after an affected pregnancy the risk of hypertension increases and how/whether this risk evolves over time, is unclear....... METHOD: Using national health register data, we identified all women giving birth in Denmark from 1978 to 2011. Cox regression analysis was used to compare the rates of incident post-pregnancy hypertension requiring treatment with medication after pregnancy in women with and without a history of HDP......, by the number of years since pregnancy. FINDINGS: In the first 3 years after a woman's latest pregnancy, rates of chronic hypertension were 4- to 9-fold higher in women with an HDP in that pregnancy than in women with a normotensive pregnancy. The difference in rates between the two groups declined...

  17. Impact of maternal anti retroviral drugs during pregnancy on risk of ...

    African Journals Online (AJOL)

    Preterm birth and low birth weight contribute significantly to perinatal morbidity and mortality. ... Others demonstrated no effect on risk of prematurity while others ... Other associated factors were immunosuppression, multiple pregnancies and ...

  18. MATERNAL RISK FACTORS IN HYPERTENSIVE´S SYNDROMES OF PREGNANCY: A REVIEW

    Directory of Open Access Journals (Sweden)

    R. C. Bortoli

    2014-07-01

    Full Text Available The Hypertensive´s syndrome in pregnancy, represent the major cause of maternal and fetal morbidity and mortality in the country. That are so many risk factors for you unleashment and it can happen before pregnancy or arise in your course. Thus, the present study aimed to analyze the bibliographic production around the maternal risk factors associated with Hypertensive´s syndromes in pregnancy. Were analyzed 09 articles from national and international journals obtained through the LILACS database, between 2001 to 2010. Between the maternal risk factors for the development of Hypertensive´s syndrome in pregnancy were appointed chronic hypertension, preeclampsia, and gestational hypertension and prior gestational hypertension. The family history of hypertension, overweight and obesity; the tobaccoism; low socioeconomic status, stress / emotional conflicts and improper prenatal care. Emphasize the importance of early identification and intervention of risk factors in the prenatal, seeking a better maternal and fetal prognosis.

  19. Healthy Pre-Pregnancy Diet and Exercise May Reduce Risk of Gestational Diabetes

    Science.gov (United States)

    ... Resources Interviews & Selected Staff Profiles Multimedia Healthy Pre-Pregnancy Diet and Exercise May Reduce Risk of Gestational Diabetes Skip sharing on social media links Share this: Page Content ​NICHD Studies May ...

  20. Gestational diabetes and hypertensive disorders of pregnancy as vascular risk signals: an overview and grading of the evidence.

    Science.gov (United States)

    Nerenberg, Kara; Daskalopoulou, Stella S; Dasgupta, Kaberi

    2014-07-01

    The occurrence of common pregnancy-related medical disorders identifies women at high risk of developing future vascular disease. Systematic reviews of cohort studies demonstrate that gestational diabetes confers a 7-fold risk increase for type 2 diabetes, and preeclampsia confers a 1.8-fold risk increase for type 2 diabetes and 3.4-fold risk increase for hypertension. Gestational diabetes and hypertensive disorders of pregnancy (HDP) increase the risk of premature vascular disease, but the 2-fold risk increase associated with preeclampsia is only partially explained by the development of traditional vascular risk factors. Despite the compelling evidence for gestational diabetes and HDP as vascular risk indicators, there are no published Canadian vascular prevention guidelines that recognize these postpartum women. In contrast, the 2011 American Heart Association guidelines on cardiovascular disease in women include gestational diabetes and HDP in their vascular risk assessment. Studies indicate that the importance surveillance of vascular risk factors in these women after pregnancy is underappreciated by the women themselves and their physicians. Although a prudent diet and physically active lifestyle were demonstrated to reduce diabetes risk in women with a gestational diabetes history in the American Diabetes Prevention Program trial, adoption of these health behaviours is low; qualitative studies confirm a need for tailored strategies that address barriers and provide social support. Further research is also needed on approaches to reduce vascular risk in women with a history of gestational diabetes and HDP. Otherwise, an early window of opportunity for chronic disease prevention in young, high-risk women will be missed.

  1. [The socio-cultural and eating aspects of women experiencing risk pregnancies].

    Science.gov (United States)

    Sámano, Reyna Sámano; Martínez, Estela Godinez; Pérez, Irma Romero; Miranda, Georgina Sánchez; Polis, José Manuel Espíndola; Courtois, Mayra Lilia Chávez

    2014-05-01

    To promote a healthy diet, the dietary guidance should consider socio-cultural factors as they influence both the food standards and preferences of each population. The aim of this study was to describe the socio-cultural contexts of pregnancy and feeding in the domestic arena, using a qualitative approach. In-depth interviews were conducted using the data saturation technique with six women experiencing high-risk pregnancy. The interviews were transcribed and analyzed in accordance with the Bardin method and the IT Atlas program. The following aspects were identified: uncertainty due to unplanned pregnancy and limited partner support; a few dietary changes to improve health; perception of bad and good feeding habits, although it did not comply with the characteristics of a good diet; omission of fruit and vegetable group from dinner. The people in charge of preparing and serving food were not always the pregnant woman; food products perceived as being harmful were consumed and beneficial products were rarely consumed. This highlighted the need to train professionals to consider the socio-cultural context when providing dietary guidance.

  2. Work-related maternal risk factors and the risk of pregnancy induced hypertension and preeclampsia during pregnancy. The Generation R Study.

    Directory of Open Access Journals (Sweden)

    Jaap Jan Nugteren

    Full Text Available OBJECTIVE: To study the associations between physically demanding work and occupational exposure to chemicals and hypertensive disorders during pregnancy within a large birth cohort study, the Generation R Study. METHODS: Associations between occupational characteristics and hypertensive disorders during pregnancy were studied in 4465 pregnant woman participating in a population-based prospective cohort study from early pregnancy onwards in the Netherlands (2002-2006. Mothers who filled out a questionnaire during mid-pregnancy (response 77% of enrolment, were included if they conducted paid employment, had a spontaneously conceived singleton live born pregnancy, and did not suffer from pre-existing hypertension (n = 4465. Questions on physical demanding work were obtained from the Dutch Musculoskeletal Questionnaire and concerned questions on manually handling loads of 25 kg or more, long periods of standing or walking, night shifts, and working hours. To assess occupational exposure to chemicals, job titles and task descriptions were linked to a job-exposure-matrix (JEM, an expert judgment on exposure to chemicals at the workplace. Information on hypertensive disorders during pregnancy was obtained from medical records. RESULTS: We observed no consistent associations between any of the work related risk factors, such as long periods of standing or walking, heavy lifting, night shifts, and working hours, nor exposure to chemicals with hypertensive disorders during pregnancy. CONCLUSION: This prospective birth cohort study suggests that there is no association of hypertensive disorders during pregnancy with physically demanding work or exposure to chemicals. However, the low prevalence of PIH and PE, combined with the low prevalence of occupational risk factors limit the power for inference and larger studies are needed to corroborate or refute these findings.

  3. Women's Knowledge, Attitudes and Behavior about Maternal Risk Factors in Pregnancy.

    Directory of Open Access Journals (Sweden)

    Giuseppe Esposito

    Full Text Available The aims of this study were to assess the levels of knowledge, attitudes and behaviors of women about the main maternal risk factors in pregnancy and to identify the factors linked to the main outcomes of interest.A cross-sectional survey was conducted in 513 pregnant women randomly selected from the gynecological ambulatory services of five hospitals located in Naples, Italy.Only 42% of women correctly knew all the main maternal risk factors in pregnancy (alcohol, smoking, passive smoking and obesity. Only 21.7% of women were very worried about causing harm to the fetus or child with their risk behaviors, and 22.3% of women reported smoking during pregnancy. Approximately one-third of women (28.9% reported regularly drinking alcohol before pregnancy and 74.8% of these women reported stopping drinking alcohol during pregnancy. However, only 27.3% of women who were drinking alcohol during pregnancy had the intention of stopping. Only 43.7% of women indicated that during ambulatory gynecological examinations they received information from physicians about the possible damage resulting from all the main risk factors in pregnancy (alcohol, smoking, passive smoking and obesity.The results indicate that pregnant women lack knowledge regarding the main maternal risk factors. Pregnant women claim to receive little information during gynecological examinations and, therefore, some continue to smoke and drink alcohol during pregnancy. Our results suggest an urgent need for the design of interventions to improve women's levels of knowledge and to promote appropriate behavior in relation to the major risk factors in pregnancy.

  4. Validation of self-reported maternal and infant health indicators in the Pregnancy Risk Assessment Monitoring System.

    Science.gov (United States)

    Dietz, Patricia; Bombard, Jennifer; Mulready-Ward, Candace; Gauthier, John; Sackoff, Judith; Brozicevic, Peggy; Gambatese, Melissa; Nyland-Funke, Michael; England, Lucinda; Harrison, Leslie; Taylor, Allan

    2014-12-01

    To assess the validity of self-reported maternal and infant health indicators reported by mothers an average of 4 months after delivery. Three validity measures-sensitivity, specificity and positive predictive value (PPV)-were calculated for pregnancy history, pregnancy complications, health care utilization, and infant health indicators self-reported on the Pregnancy Risk Assessment Monitoring System (PRAMS) questionnaire by a representative sample of mothers delivering live births in New York City (NYC) (n = 603) and Vermont (n = 664) in 2009. Data abstracted from hospital records served as gold standards. All data were weighted to be representative of women delivering live births in NYC or Vermont during the study period. Most PRAMS indicators had >90 % specificity. Indicators with >90 % sensitivity and PPV for both sites included prior live birth, any diabetes, and Medicaid insurance at delivery, and for Vermont only, infant admission to the NICU and breastfeeding in the hospital. Indicators with poor sensitivity and PPV (urinary tract infection or kidney infection, and for NYC only, preterm labor, prior low-birth-weight birth, and prior preterm birth. For Vermont only, receipt of an HIV test during pregnancy had poor sensitivity and PPV. Mothers accurately reported information on prior live births and Medicaid insurance at delivery; however, mothers' recall of certain pregnancy complications and pregnancy history was poor. These findings could be used to prioritize data collection of indicators with high validity.

  5. Clinical observation of corboprost in preventing postpartum hemorrhage of caserean in high risk pregnancy%卡孕栓预防高危妊娠剖宫产出血的临床观察

    Institute of Scientific and Technical Information of China (English)

    杨晓丽; 吴素醒

    2012-01-01

    目的 观察卡孕栓联合缩宫素Oxytocin预防高危妊娠剖宫产术中术后出血的疗效.方法 选择2008年9月至2010年6月在禹州市人民医院行剖宫产发生产后出血的高危妊娠产妇90例,其中前置胎盘16例,巨大儿38例,羊水过多24例,双胎12例,随机分为两组:观察组(卡孕栓+缩宫素)45例和对照组(缩宫素)45例.观察组于胎头娩出后由助手给予卡孕栓1 mg舌下含化,缩宫素20 IU宫体注射,20 IU静脉注射,滴速80滴/min;对照组在胎儿娩出后向宫体肌层注入缩宫素20 IU,静脉滴注缩宫素20 IU,滴速80滴/min.比较两组剖宫产术产妇术中、术后2h、术后24h的出血量.结果 观察组术中、术后2h及术后24h出血量明显少于对照组,产后出血的发生率低,差异有统计学意义(P<0.05).结论 卡孕栓联合缩宫素促进产后子宫收缩作用强于单用缩宫素,能明显减少高危妊娠剖宫产术中术后的出血量,且用药简单,安全可靠,值得推广.%Objective To observe the efficacy of corboprost combined with oxytocin on preventing hemorrhage during and after cesarean section in high risk pregnancy.Methods Ninety high risk patients hospitalized for cesarean section with probability of postpartum hemorrhage in our hospital from September 2008 to June 2010 were choosed including 16 case of placenta previa,38 case of macrosomia,24 case of polyhydramnios,and 12 case of twins.They were randomly divided into two groups:45 case in the observation group recieued corboprost plus oxytocin,and 45 case in the control group recleued oxytocin.In observation group,after the delivery of the fetus head,corboprost 1 mg sublingual administration,oxytocin 20 IU uterus body injection,and 20 IU intravenous injection at dripping speed 80 drops/minute was incidence.In control group,after the delivery of fetus,oxytocin 20 IU uterus myometrium injection,and 20 IU intravenous injection at dripping speed 80 drops/minute was giuen.The bleeding volumes

  6. Smoking during pregnancy and the risk for hyperkinetic disorder in offspring

    DEFF Research Database (Denmark)

    Linnet, KM; Wisborg, K; Obel, C

    2005-01-01

    newborn characteristics, socioeconomic status, and family history of psychiatric illnesses, were evaluated by conditional logistic regression analyses. Results. Women who smoked during pregnancy had a 3-fold increased risk for having offspring with hyperkinetic disorder compared with nonsmokers......Objective. Maternal smoking during pregnancy may increase the risk for behavioral disorders. The aim of this study was to investigate the association between smoking during pregnancy and hyperkinetic and attention-deficit/hyperactivity disorder in the offspring in a large population-based study...... completed gestation), and Apgar scores smoked...

  7. Prevalence and risk of Down syndrome in monozygotic and dizygotic multiple pregnancies in Europe: implications for prenatal screening

    DEFF Research Database (Denmark)

    Boyle, B; Morris, J K; McConkey, R

    2014-01-01

    OBJECTIVE: To determine risk of Down syndrome (DS) in multiple relative to singleton pregnancies, and compare prenatal diagnosis rates and pregnancy outcome. DESIGN: Population-based prevalence study based on EUROCAT congenital anomaly registries. SETTING: Eight European countries. POPULATION: 14...

  8. Hypertension in Pregnancy and Offspring Cardiovascular Risk in Young Adulthood: Prospective and Sibling Studies in the HUNT Study (Nord-Trøndelag Health Study) in Norway.

    Science.gov (United States)

    Alsnes, Ingvild V; Vatten, Lars J; Fraser, Abigail; Bjørngaard, Johan Håkon; Rich-Edwards, Janet; Romundstad, Pål R; Åsvold, Bjørn O

    2017-04-01

    Women with hypertensive disorders in pregnancy are at increased lifetime risk for cardiovascular disease. We examined the offspring's cardiovascular risk profile in young adulthood and their siblings' cardiovascular risk profile. From the HUNT study (Nord-Trøndelag Health Study) in Norway, 15 778 participants (mean age: 29 years), including 210 sibling groups, were linked to information from the Medical Birth Registry of Norway. Blood pressure, anthropometry, serum lipids, and C-reactive protein were assessed. Seven hundred and six participants were born after exposure to maternal hypertension in pregnancy: 336 mothers had gestational hypertension, 343 had term preeclampsia, and 27 had preterm preeclampsia. Offspring whose mothers had hypertension in pregnancy had 2.7 (95% confidence interval, 1.8-3.5) mm Hg higher systolic blood pressure, 1.5 (0.9-2.1) mm Hg higher diastolic blood pressure, 0.66 (0.31-1.01) kg/m(2) higher body mass index, and 1.49 (0.65-2.33) cm wider waist circumference, compared with offspring of normotensive pregnancies. Similar differences were observed for gestational hypertension and term preeclampsia. Term preeclampsia was also associated with higher concentrations of non-high-density lipoprotein cholesterol (0.14 mmol/L, 0.03-0.25) and triglycerides (0.13 mmol/L, 0.06-0.21). Siblings born after a normotensive pregnancy had nearly identical risk factor levels as siblings born after maternal hypertension. Offspring born after maternal hypertension in pregnancy have a more adverse cardiovascular risk profile in young adulthood than offspring of normotensive pregnancies. Their siblings, born after a normotensive pregnancy, have a similar risk profile, suggesting that shared genes or lifestyle may account for the association, rather than an intrauterine effect. All children of mothers who have experienced hypertension in pregnancy may be at increased lifetime risk of cardiovascular disease.

  9. Treatment of bacterial vaginosis in pregnancy in order to reduce the risk of spontaneous preterm delivery - a clinical recommendation.

    Science.gov (United States)

    Haahr, Thor; Ersbøll, Anne S; Karlsen, Mona A; Svare, Jens; Sneider, Kirstine; Hee, Lene; Weile, Louise K; Ziobrowska-Bech, Agnes; Østergaard, Claus; Jensen, Jørgen S; Helmig, Rikke B; Uldbjerg, Niels

    2016-08-01

    Bacterial vaginosis (BV) is characterized by a dysbiosis of the vaginal microbiota with a depletion of Lactobacillus spp. In pregnancy, prevalence's between 7 and 30% have been reported depending on the study population and the definition. BV may be associated with an increased risk of spontaneous preterm delivery (sPTD). However, it is controversial whether or not BV-positive pregnant women will benefit from treatment to reduce the risk of sPTD. We could not identify any good-quality guideline addressing this issue. Consequently we aimed to produce this clinical recommendation based on GRADE. Systematic literature searches were conducted in the following databases: Guidelines International Network: G-I-N, Medline, Embase, The Cochrane Database of Systematic Reviews, Web of Science and http://www.clinicaltrials.gov from 1999 to 3 October 2014. Hence, nine guidelines, 34 reviews, 18 randomized controlled trials and 12 observational studies were included. The GRADE quality of evidence was consistently low or very low, primarily because none of the risk ratios (RR) for the risk of sPTD at treatment with metronidazole, RR was 1.11 (95% CI 0.93-1.34) in low-risk pregnancies and 0.96 (95% CI 0.78-1.18) in high risk pregnancies. Concerning treatment with clindamycin at any gestational age, the RR was 0.87 (95% CI 0.73-1.05). This systematic review gives a strong recommendation against treatment with metronidazole and a weak recommendation against treatment with clindamycin to reduce the sPTD rate in both high-risk and low-risk pregnancies with BV. © 2016 Nordic Federation of Societies of Obstetrics and Gynecology.

  10. Pre-pregnancy risk assessment and counselling of the cardiac patient

    NARCIS (Netherlands)

    Pieper, P. G.

    2011-01-01

    Pregnant women with heart disease often have an increased risk of maternal cardiovascular and offspring complications. The magnitude of these risks varies depending on the type and severity of the underlying disease. Therefore risk assessment should be performed before pregnancy. This can be accompl

  11. Overweight in epilepsy as a risk factor for pregnancy and delivery complications.

    Science.gov (United States)

    Kolstad, Eivind; Veiby, Gyri; Gilhus, Nils Erik; Bjørk, Marte

    2016-11-01

    when pregnancy is planned. These women should be regarded as a high-risk group. Wiley Periodicals, Inc. © 2016 International League Against Epilepsy.

  12. Fish consumption in pregnancy and fetal risks of methylmercury toxicity

    OpenAIRE

    2010-01-01

    QUESTION Because I practise in a rural area with a large number of lakes, I have patients planning pregnancy who consume relatively large amounts of fish harvested by their families. What should be my advice to them?

  13. Women with Epilepsy: Drug Risks and Safety During Pregnancy

    Science.gov (United States)

    ... birth defects. There is weak evidence that taking folic acid before pregnancy will help women with epilepsy in particular. Keep in mind that taking folic acid before you become pregnant will not harm your ...

  14. Elevated Corticotropin-Releasing Hormone in Human Pregnancy Increases the Risk of Postpartum Depressive Symptoms

    Science.gov (United States)

    Yim, Ilona S.; Glynn, Laura M.; Schetter, Christine Dunkel; Hobel, Calvin J.; Chicz-DeMet, Aleksandra; Sandman, Curt A.

    2009-01-01

    Context Postpartum depression (PPD) is common and has serious implications for the mother and her newborn. A possible link between placental corticotropin-releasing hormone (pCRH) and PPD incidence has been discussed, but there is a lack of empirical evidence. Objective To determine whether accelerated pCRH increases throughout pregnancy are associated with PPD symptoms. Design Pregnant women were recruited into this longitudinal cohort study. Blood samples were obtained at 15, 19, 25, 31 and 37 weeks gestational age (GA) for assessment of pCRH, cortisol and ACTH. Depressive symptoms were assessed with a standardized questionnaire at the last four pregnancy visits and postpartum. Setting Subjects were recruited from two Southern California Medical Centers, and visits were conducted in university research laboratories. Participants 100 adult women with a singleton pregnancy. Main Outcome Measure PPD symptoms were assessed 8.7 weeks (SD = 2.94 wks) after delivery with the Edinburgh Postnatal Depression Scale. Results Sixteen women developed PPD symptoms. At 25 weeks GA, pCRH was a strong predictor of PPD symptoms (R2 = .21, β = .46, p < .001), an effect that remained significant after controlling for prenatal depressive symptoms. No significant associations were found for cortisol and ACTH. Receiver Operating Characteristic curve analyses revealed that pCRH at 25 weeks GA is a useful diagnostic test (area under the curve = .78, p = .001). Sensitivity (.75) and specificity (.74) at the ideal cut-off point (56.86 pg/ml pCRH) were high. Growth curve analyses indicated that pCRH trajectories in women with PPD symptoms are significantly accelerated between 23 and 26 weeks GA. Conclusion There is a critical period in mid-pregnancy during which pCRH is a sensitive and specific early diagnostic test for PPD symptoms. If replicated, these results have implications for identification and treatment of pregnant women at risk of PPD. PMID:19188538

  15. Stressful life events during pregnancy as risk factors for developing autistic disorder in children

    Directory of Open Access Journals (Sweden)

    Salman Abdi

    2016-12-01

    Full Text Available Introduction: This study aimed to examine the role of prenatal stressful events in mothers of children and adolescents with autistic disorder (AD. Methods: This case-control study was conducted in 2014. A total number of 115 children and adolescents with AD were selected by convenience method from the autism rehabilitation centers in Tabriz, Iran. Moreover, 112 typically developing (TD children and adolescents were selected from public schools using a random clustering method. Two groups were matched in terms of mother's and child's age and mother's educational level. The Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS semi-structured diagnostic interview was used to evaluate the presence of psychiatric disorders. The diagnosis of AD was made based on the DSM-IV criteria during separate diagnostic interviews by two child and adolescent psychiatrists. The life stressful events’ inventory was used to assess the presence of stressful events during pregnancy. Results: According to Fisher's exact test, the frequency of stressful life events including failure to achieve life goals, high debt, frequent marital conflict, conflict with spouse's family, changes in sleeping habits, and sexual difficulties in the mothers of AD children during pregnancy was significantly higher than the mothers of TD children. Also, mothers of AD children reported significantly higher frequency for the positive stressful life events including the major job progress, starting or finishing education, change of education, location, and summer vacation during pregnancy. Conclusion: Some stressful life events in mothers during pregnancy may be considered as risk factors for developing AD in their children. Further researches are needed to establish the results of this study.

  16. [Doppler flowmetric fetal indices in low-risk pregnancies].

    Science.gov (United States)

    Romero Gutiérrez, G; Ponce de León, A L; Ramos Palma, S

    1999-10-01

    In order to measure the umbilical resistance and pulsatility Doppler indexes 60 pregnant women with low risk pregnancies were studied in a descriptive, observational and prospective study carried out at the Hospital de Gineco-Pediatria numero 48 del Instituto Mexicano del Seguro Social. Umbilical Doppler measurements were done of the fetal umbilical cord from the week 30 at the 40 of gestation. We carried out a total of 337 measurements and 178 (52.8%) corresponded to the resistance index and 159 (47.2%) to the pulsatility index. The average of the resistance index was 0.64 with a range average (average plus two standard deviations was 0.48-0.79) and the pulsatility index had an average value of 0.94 with an average range of 0.58-1.30. The percentil values of the resistance index were 0.52, 0.66 and 0.79 respectively in the percentil 5, 50 and 95 whereas the percentil values of the pulsatility index were 0.64, 0.94 and 1.28 respectively in the percentil 5, 50 and 95. The analysis of variance with the Bonferroni test for multiple comparisons showed that our found indexes can be applied from the week 31 to the 40 of gestation. Our findings are in according to reported by other authors and it should be kept in mind that the concept of normality of the Doppler velocimetry indexes is strictly statistical and that only its judicious use will offer the benefit to our pregnant patients to obtain products under good conditions of health.

  17. Change of pulsatility index of the fetal middle cerebral artery after auditory stimulation in no risk pregnancies and in pregnancies with gestational hypertension.

    Science.gov (United States)

    Plesinac, Snezana; Jankovic, Svetlana; Plecas, Darko; Antonovic, Olga; Adamovic, Tatijana; Sovilj, Mirjana

    2013-01-01

    An aim was to determine the degree and the mode of variation of PI of middle cerebral artery in no risk pregnancies and in pregnancies with gestational hypertension, after the constant sound stimuli. Study included 343 patients divided in two groups. Group 1: low risk pregnancies and group 2: gestational hypertension. Ultrasound prenatal auditory screening was performed after the 27th week of gestation. The percentage of fetuses with increase of cerebral blood flow was slightly higher in the pregnancies with hypertension. An average change of PI of median cerebral artery was higher in this group.

  18. Mode of conception of triplets and high order multiple pregnancies.

    LENUS (Irish Health Repository)

    Basit, I

    2012-03-01

    A retrospective audit was performed of all high order multiple pregnancies (HOMPs) delivered in three maternity hospitals in Dublin between 1999 and 2008. The mode of conception for each pregnancy was established with a view to determining means of reducing their incidence. A total of 101 HOMPs occurred, 93 triplet, 7 quadruplet and 1 quintuplet. Information regarding the mode of conception was available for 78 (81%) pregnancies. Twenty eight (27.7%) were spontaneous, 34 (33.7%) followedlVF\\/ICSI\\/FET treatment (in-vitro fertilisation, intracytoplasmic sperm injection, frozen embryo transfer), 16 (15.8%) resulted from Clomiphene Citrate treatment and 6 (6%) followed ovulation induction with gonadotrophins. Triplet and HOMPs are a major cause of maternal, feta land neonatal morbidity. Many are iatrogenic, arising from fertility treatments including Clomiphene. Reducing the numbers of embryos transferred will address IVF\\/ICSI\\/FET-related multiple pregnancy rates and this is currently happening in Ireland. Clomiphene and gonadotrophins should only be prescribed when appropriate resources are available to monitor patients adequately.

  19. Maternal fish consumption during pregnancy and risk of early childhood asthma.

    Science.gov (United States)

    Salam, Muhammad T; Li, Yu-Fen; Langholz, Bryan; Gilliland, Frank D

    2005-01-01

    Maternal fish consumption during pregnancy may affect children's asthma risk by modulating early-life immune development. Type of fish intake may be important because of differences in fatty acid content. To test this hypothesis, we conducted a nested case-control study, selecting subjects from the Children's Health Study, a population-based study of school-aged children in southern California. Cases had physician-diagnosed asthma and controls were asthma-free by age 5 years. Mothers or guardians provided information on fish consumption during pregnancy in telephone interviews. We computed odds ratio (OR) and 95% confidence interval (CI) by using conditional logistic regression models that accounted for the sampling. In children born to mothers with a history of asthma, the OR of asthma was 0.20 (95% CI = 0.06-0.65) when mothers ate oily fish at least monthly during pregnancy compared with no consumption (p(trend) = 0.006). Maternal oily fish consumption during pregnancy did not benefit children of non-asthmatic mothers. In contrast, fish stick (a source of trans-fats) consumption during pregnancy increased asthma risk in children (OR = 2.04; 95% CI = 1.18-3.51). Our results suggest that maternal oily fish intake during pregnancy may protect offspring from asthma; however, eating fish sticks during pregnancy may increase asthma risk in children.

  20. Elective amniocentesis in low-risk pregnancies: decision making in the era of information and uncertainty.

    Science.gov (United States)

    Lesser, Y; Rabinowitz, J

    2001-04-01

    Rational choice theory was applied to explain women's use of amniocentesis. Variables included knowledge about prenatal diagnostics, attitudes, and emotional preferences. Using structured instruments at 9 to 14 and at 29 to 34 weeks' gestation, we interviewed 232 Israeli women who had low-risk pregnancies. Women who had elective amniocentesis (n = 39) were more knowledgeable about prenatal diagnostics, risks of invasive procedures, and probability of fetal abnormality in high maternal age; had fewer children; and had less favorable attitudes toward parenthood than those who had medically indicated amniocentesis (n = 57) and those who did not have amniocentesis (n = 136). The use and possible overuse of amniocentesis were associated with having more information about prenatal diagnostics and definite emotional preferences.

  1. Pregnancy Intentions and Teenage Pregnancy Among Latinas: A Mediation Analysis

    Science.gov (United States)

    Rocca, Corinne H.; Doherty, Irene; Padian, Nancy S.; Hubbard, Alan E.; Minnis, Alexandra M.

    2010-01-01

    CONTEXT The extent to which pregnancy intentions mediate the relationship between individual, familial and cultural characteristics and adolescent pregnancy is not well understood. The role of intentions may be particularly important among Latina teenagers, whose attitudes toward pregnancy are more favorable than those of other groups and whose pregnancy rates are high. METHODS Prospective, time-varying data from 2001–2004 were used to investigate whether two measures of pregnancy intentions, wantedness and happiness, mediated associations between risk factors and pregnancy among 213 Latina adolescents in San Francisco. Participants were tested for pregnancy and interviewed about pregnancy intentions, partnerships, family characteristics and activities every six months for two years. Associations and mediation were examined using logistic regression. RESULTS Neither pregnancy intention variable mediated relationships between participant characteristics and pregnancy. After adjustment for other measures, wantedness was strongly associated with pregnancy (odds ratio, 2.6), while happiness was not. Having a strong family orientation was associated with happiness (3.7) but unrelated to pregnancy. Low sexual relationship power with a main partner was associated with an elevated risk of pregnancy (3.3). If the pregnancy intentions of all participants were changed to definitely not wanting pregnancy, the estimated decline in pregnancy risk would be 16%. CONCLUSIONS Pregnancy intentions were important not as mediators but rather as independent risk factors for pregnancy. Differences in pregnancy rates between groups of Latinas may be less a function of intentional choice than of situational factors. Interventions and research should focus on identifying and targeting factors that hinder effective contraceptive use among teenagers who want to avoid pregnancy. PMID:20887287

  2. Pregnancy intentions and teenage pregnancy among Latinas: a mediation analysis.

    Science.gov (United States)

    Rocca, Corinne H; Doherty, Irene; Padian, Nancy S; Hubbard, Alan E; Minnis, Alexandra M

    2010-09-01

    The extent to which pregnancy intentions mediate the relationship between individual, familial and cultural characteristics and adolescent pregnancy is not well understood. The role of intentions may be particularly important among Latina teenagers, whose attitudes toward pregnancy are more favorable than those of other groups and whose pregnancy rates are high. Prospective, time-varying data from 2001-2004 were used to investigate whether two measures of pregnancy intentions, wantedness and happiness, mediated associations between risk factors and pregnancy among 213 Latina adolescents in San Francisco. Participants were tested for pregnancy and interviewed about pregnancy intentions, partnerships, family characteristics and activities every six months for two years. Associations and mediation were examined using logistic regression. Neither pregnancy intention variable mediated relationships between participant characteristics and pregnancy. After adjustment for other measures, wantedness was strongly associated with pregnancy (odds ratio, 2.6), while happiness was not. Having a strong family orientation was associated with happiness (3.7) but unrelated to pregnancy. Low power in a sexual relationship with a main partner was associated with an elevated risk of pregnancy (3.3). If the pregnancy intentions of all participants were changed to definitely not wanting pregnancy, the estimated decline in pregnancy risk would be 16%. Pregnancy intentions were important not as mediators but rather as independent risk factors for pregnancy. Differences in pregnancy rates between groups of Latinas may be less a function of intentional choice than of situational factors. Interventions and research should focus on identifying and targeting factors that hinder effective contraceptive use among teenagers who want to avoid pregnancy. Copyright © 2010 by the Guttmacher Institute.

  3. Maternal dyslipidemia during pregnancy may increase the risk of preterm birth: A meta-analysis

    Directory of Open Access Journals (Sweden)

    Shuying Jiang

    2017-02-01

    Full Text Available Epidemiological studies have reported an inconsistent relationship between maternal lipid levels and preterm birth (PTB. We performed this meta-analysis to evaluate the association between maternal dyslipidemia and PTB. Overall, three nested case-control studies and eight cohort studies were eligible. Effect estimates [odds ratio(OR/relative risk] were pooled using a fixed-effects or a random-effects model. Subgroup and metaregression analyses were conducted to evaluate the sources of heterogeneity. Eleven studies involving 13,025 pregnant women were included. Compared with pregnant women with normal lipid levels, the women with elevated levels of lipids had an increased risk of PTB, and the pooled OR was 1.68 [95% confidence interval (CI: 1.25–2.26]; meanwhile, women with lower levels of lipids also had a trend of an increased risk of PTB (OR=1.52, 95% CI=0.60–3.82. The pooled ORs for elevated levels of total cholesterol, triglycerides, low density lipoprotein-cholesterol, and lower levels of high density lipoprotein-cholesterol were 1.71 (95% CI: 1.05–2.79, 1.55 (95% CI: 1.13–2.12, 1.19 (95% CI: 0.95–1.48, and 1.33 (95% CI: 1.14–1.56, respectively. The present meta-analysis found that maternal dyslipidemia during pregnancy, either the elevated total cholesterol or triglycerides, was associated with an increased risk of PTB. These findings indicate that a normal level of maternal lipid during pregnancy may reduce the risk of PTB.

  4. Risk of Ectopic Pregnancy in Women With Inflammatory Bowel Disease: A 22-Year Nationwide Cohort Study.

    Science.gov (United States)

    de Silva, Punyanganie S; Hansen, Helene H; Wehberg, Sonja; Friedman, Sonia; Nørgård, Bente M

    2017-07-08

    Few data are available on adverse events of pregnancy in women with inflammatory bowel diseases (IBD), such as ectopic pregnancy. We assessed the risk of ectopic pregnancy in pregnancies of women in Denmark with IBD compared with those without IBD over a 22-year period. We also examined the disease-specific risks of ectopic pregnancies in pregnancies of women with ulcerative colitis (UC) or Crohn's disease (CD) who underwent IBD-related surgical procedures. We performed a retrospective study of all women of child-bearing age (ages, 15-50 y) registered in the Danish National Patient Registry with at least 1 pregnancy during the period from January 1994 through December 31, 2015. We collected data on all women with an ectopic pregnancy, hydatidiform mole, miscarriages (spontaneous and other abortions, including abnormal pregnancy products, missed abortion, and pregnancy without a fetus), induced abortions, and births in women with and without IBD. Our study population included 7548 pregnancies in women with UC, 6731 pregnancies in women with CD, and 1,832,732 pregnancies in women without IBD. We controlled for multiple covariates, including pelvic and abdominal surgery. Women with CD had a greater risk of ectopic pregnancy, per pregnancy, than women without IBD (odds ratio [OR], 1.23; 95% confidence interval [CI], 1.01-1.49), whereas women with UC did not (OR, 0.98; 95% CI, 0.80-1.20). In pregnancies of women with CD and UC who underwent IBD-related surgery before pregnancy, there was a nonsignificant increase in risk of ectopic pregnancy compared with pregnancies in women with IBD who did not have surgery (OR, 1.49; 95% CI, 0.91-2.44 for CD, and OR, 1.17; 95% CI, 0.54-2.52 for UC). We found a statistically significant increased risk of ectopic pregnancy in pregnancies of women with CD compared with pregnancies of women without IBD. Surgery for IBD before pregnancy increased the risk of ectopic pregnancy, although this increase was not statistically significant

  5. Low risk of adverse obstetrical and perinatal outcome in pregnancies complicated by asthma

    DEFF Research Database (Denmark)

    Ali, Zarqa; Nilas, Lisbeth; Ulrik, Charlotte Suppli

    2016-01-01

    BACKGROUND: Asthma in pregnancy have been associated with an increased risk of pregnancy complications. Our aim was to estimate incidence and describe risk factors for adverse obstetrical and perinatal outcomes in pregnant women with asthma. METHODS: Women enrolled in the Management of Asthma......, although women with asthma had a statistically significant higher risk of pre-eclampsia (5% vs. 3%, ORadj 1.60, 95% CI 1.07-2.38; p = 0.02) and small for gestational age neonates (SGA) (ORadj 1.30, 95% CI 1.10-1.54; p ... with a higher risk of SGA (60% vs 53%, ORadj. 1.30, 95% CI 1.10-1.54; p pre-eclampsia (ORadj 3.33 95% CI 0.96-11.65, p = 0.06) compared to pregnancies without any exacerbations. CONCLUSION: The overall risk...

  6. Substance use and the risk for sexual intercourse with and without a history of teenage pregnancy among adolescent females.

    Science.gov (United States)

    Cavazos-Rehg, Patricia A; Krauss, Melissa J; Spitznagel, Edward L; Schootman, Mario; Cottler, Linda B; Bierut, Laura Jean

    2011-03-01

    The present study examined the associations between initiation and intensity of substance use and with sexual experience with and without a history of teenage pregnancy. Participants were high school females (weighted n = 3,451) who participated in the 1999-2003 Youth Risk Behavior Surveillance System, a cross-sectional, nationally representative survey. Multinomial multivariable logistic regression was used to assess the likelihood of being sexually experienced (but never pregnant) and teenage pregnancy (reference group: never had sexual intercourse) as a function of age at substance use initiation (i.e., age 12 or younger, 13-14 years of age, and age 15 or older) and intensity of substance use (i.e., nonuser, experimental/ new or nondaily, nonexperimental/daily user) for alcohol, cigarettes, and marijuana, while controlling for race/ethnicity, metropolitan location, symptoms of depression, and illegal drug availability at school. A major finding of our study is that substance use behaviors across each substance (alcohol, cigarettes, and marijuana) independently contributed to an increased risk in sexual intercourse experience with and without a history of teenage pregnancy (vs. nonsexually experienced females). A dose-response relationship was also observed between an increased likelihood of a teenage pregnancy and marijuana behaviors. Furthermore, the risk for teenage pregnancy was compounded for daily cigarette smokers who initiated use at age 12 or younger. Screening substance use behaviors can help to identify girls who may benefit from pregnancy prevention strategies. Targeting cigarette and marijuana behaviors as early as age 12 or younger may provide an added benefit. Prevention strategies should also consider the role of race above and beyond substance use behaviors.

  7. A COMPARATIVE STUDY OF PERINATAL OUTCOME IN LOW RISK PREGNANCIES WITH CTG MONITORING AND INTERMITTENT AUSCULTATION

    Directory of Open Access Journals (Sweden)

    Velimala Ratna

    2015-12-01

    Full Text Available EFM was introduced into widespread clinical practice in the 1970s to 1980s on the premise that it would facilitate early detection of abnormal FHR patterns thought to be associated with hypoxia thus allowing earlier intervention to prevent foetal neurological damage and/or death. There is a lack of evidence of benefit supporting the use of the admission CTG in low-risk pregnancy. In this study we the aim to evaluate the effects of Cardiotocograph Foetal Monitoring on perinatal outcome in low risk Obstetric population and determine the cost effective and reliable method of fetal monitoring that is applicable to low-risk population. METHODOLOGY A prospective randomized study conducted on 200 low risk pregnant women in labour divided into 2 groups of 100 each. Group A includes those monitored with admission CTG and Group B includes those monitored with intermittent auscultation (IA. OBSERVATION AND RESULTS The demographic features, parity and gestational age in both the groups were comparable; 10 out of the 100 in CTG group had meconium stained liquor whereas 15 of them had meconium in IA group; 71% of the patients in CTG group had normal delivery, whereas it was 84% in IA group. Incidence of LSCS was 23% in CTG group as against 9% in IA group. A ‘P’ value of 0.02, RR of 2 5 for operative deliveries in CTG group was observed which was significant. Incidence of AVD was 6% in CTG group and 7% in IA group with a p value of <0.05, which is statistically significant. The incidence of MSL, APGAR scores at 1, 5 and 10 minutes and NICU admissions were comparable in both the groups. There was no significant difference in babies with low APGAR <7 at 5 min and NICU admissions in both the groups. In our study the sensitivity of CTG was 63.63%, specificity 80.35%, positive predictive value 33.3%, negative predictive value 94.93%. The low sensitivity and high false positives led to the intervention in delivery and increase in operative delivery with no

  8. Comparison of three prenatal risk scores in a series of low-risk pregnancies.

    Science.gov (United States)

    Kelly, R B; Acheson, L S; Zyzanski, S J

    1988-01-01

    Three prepartum obstetrical risk-scoring methods (Goodwin, Halliday, Hobel) were retrospectively applied to a consecutive series of 795 singleton pregnancies. The study population was low risk overall, with a perinatal mortality rate of 11 per 1000 and a primary cesarean section rate of 9.7%. The predictive ability of the scores was tested for individual outcomes as well as for a "combined measure" designed to group outcomes of clinical interest. Outcome variables examined included labor arrests, need for augmentation of labor, fetal heartrate abnormalities during labor, selection of or transfer to a more intensive level of care, indicated forceps delivery, cesarean section, resuscitation, Apgar scores, permanent injury, and perinatal deaths. Along with expected differences in sensitivity and specificity, there were differences among the three scores in performance as measured by positive and negative predictive value. Goodwin's system performed somewhat better overall. All three systems performed better in multiparous than in primiparous patients, but primiparas experienced more adverse outcomes.

  9. Pregnancy

    Science.gov (United States)

    ... occur between 34 and 36 weeks—these are late-preterm births. 5 Infants born in the 37th and 38th ... NICHD News and Spotlights Common tests for preterm birth not useful for ... in treating mildly low thyroid function in pregnancy, NIH Network study finds ...

  10. Risk Factors and Health Profiles of Recent Migrant Women Who Experienced Violence Associated with Pregnancy

    Science.gov (United States)

    Gagnon, Anita J.; Merry, Lisa A.; Dennis, Cindy-Lee

    2012-01-01

    Abstract Background Violence associated with pregnancy is a major public health concern, but little is known about it in recent migrant women. This study looked at (1) risk factors for violence associated with pregnancy among newly arrived migrant women in Canada and (2) if those who experienced violence associated with pregnancy had a different health profile or use of healthcare services for themselves or their infants during pregnancy and up to 4 months postpartum compared to other childbearing migrant women. Methods Pregnant migrant women in Canada social support and report more depression, anxiety, somatization, and posttraumatic stress disorder (PTSD) on standardized tests. No differences were found in the health status of the infants of women who experienced violence compared to those who did not. Conclusions Clinicians should sensitively ask recent migrant women (asylum seekers, refugees, and nonrefugee immigrants) about violence associated with pregnancy and appropriately assess, treat, and refer them. PMID:22900928

  11. Risk of ectopic pregnancy lowest with transfer of single frozen blastocyst.

    Science.gov (United States)

    Li, Z; Sullivan, E A; Chapman, M; Farquhar, C; Wang, Y A

    2015-09-01

    What type of transferred embryo is associated with a lower rate of ectopic pregnancy? The lowest risk of ectopic pregnancy was associated with the transfer of blastocyst, frozen and single embryo compared with cleavage stage, fresh and multiple embryos. Ectopic pregnancy is a recognized complication following assisted reproductive technology (ART) treatment. It has been estimated that the rate of ectopic pregnancy is doubled in pregnancies following ART treatment compared with spontaneous pregnancies. However, it was not clear whether the excess rate of ectopic pregnancy following ART treatment is related to the underlying demographic factors of women undergoing ART treatment, the number of embryos transferred or the developmental stage of the embryo. A population-based cohort study of pregnancies following autologous treatment cycles between January 2009 and December 2011 were obtained from the Australian and New Zealand Assisted Reproduction Technology Database (ANZARD). The ANZARD collects ART treatment information and clinical outcomes annually from all fertility centres in Australia and New Zealand. Between 2009 and 2011, a total of 44 102 pregnancies were included in the analysis. The rate of ectopic pregnancy was compared by demographic and ART treatment factors. Generalized linear regression of Poisson distribution was used to estimate the likelihood of ectopic pregnancy. Odds ratios, adjusted odds ratios (AOR) and 95% confidence intervals (CI) were calculated. The overall rate of ectopic pregnancy was 1.4% for women following ART treatment in Australia and New Zealand. Pregnancies following single embryo transfers had 1.2% ectopic pregnancies, significantly lower than double embryo transfers (1.8%) (P ectopic pregnancy rate was 1.9% for pregnancies from transfers of fresh cleavage embryo, followed by transfers of frozen cleavage embryo (1.7%), transfers of fresh blastocyst (1.3%), and transfers of frozen blastocyst (0.8%). Compared with fresh blastocyst

  12. Use of antidepressants during pregnancy and the risk of pregnancy-induced hypertension

    NARCIS (Netherlands)

    Van Loveren, Fianne MAM; Boekema, Monique; Hak, Eelko; Bos, Jens HJ; Aarnoudse, Jan G; Schuiling-Veninga, Catharina CM

    2014-01-01

    Background: Pregnancy-induced hypertension (PIH) is possibly caused by an increased activity of the sympatic nervous system. Previous studies have suggested that inhibition of the re-uptake of serotonin and norepinephrine by selective serotonin re-uptake inhibitors (SSRIs) and tricyclic

  13. Use of antidepressants during pregnancy and the risk of pregnancy-induced hypertension

    NARCIS (Netherlands)

    Van Loveren, Fianne MAM; Boekema, Monique; Hak, Eelko; Bos, Jens HJ; Aarnoudse, Jan G; Schuiling-Veninga, Catharina CM

    2014-01-01

    Background: Pregnancy-induced hypertension (PIH) is possibly caused by an increased activity of the sympatic nervous system. Previous studies have suggested that inhibition of the re-uptake of serotonin and norepinephrine by selective serotonin re-uptake inhibitors (SSRIs) and tricyclic antidepressa

  14. Pregnancy-associated breast cancer in women from Shanghai: risk and prognosis.

    Science.gov (United States)

    Strasser-Weippl, Kathrin; Ramchandani, Ritesh; Fan, Lei; Li, Junjie; Hurlbert, Marc; Finkelstein, Dianne; Shao, Zhi-Ming; Goss, Paul E

    2015-01-01

    Breast cancer (BC) has been associated with pregnancy if diagnosed within 5-10 years after delivery (pregnancy-associated BC, PABC). PABC carries a poor prognosis compared to sporadic BC in Western populations. Data are limited regarding PABC in Asian populations, where longer periods of breastfeeding, higher birth rates and a lower median age of BC at diagnosis have been noted, all of which are known to influence prognosis. We used two datasets of women treated for early BC in Shanghai 1990-2012 (n = 10,161 and n = 7,411). For the analysis of BC risk after pregnancy we compared the distribution of pregnancy in our dataset to that in Shanghai using age-specific fertility rates. For disease-free survival (DFS) evaluation, we restricted our data to women ≤45 years. Women pregnancy compared to women who had not been pregnant in the previous 5 years. In women aged 20-24 the relative risk (RR) was 3.33 (P = 0.012), and for women aged 25-29 the RR was 1.76 (P = 0.0074). For women >30, the RR was decreased. Patients with PABC had a higher risk of recurrence or death (hazard ratio (HR) for DFS 1.72, P = 0.019) compared to women with non-PABC by univariable analysis. Age was eliminated from the multivariable model by backward selection, resulting in tumor stage (3 versus 1, HR 3.08, P pregnancy (HR 1.62, P pregnancy in the previous 5 years was associated with a 62 % increased risk of recurrence. We show that recent full-term pregnancy significantly elevates BC risk in women <30 in Shanghai, and that women diagnosed with PABC have a particularly adverse prognosis. Health care providers and women in Asian populations should be made aware of these results.

  15. Changes in Cosmetics Use during Pregnancy and Risk Perception by Women.

    Science.gov (United States)

    Marie, Cécile; Cabut, Sophie; Vendittelli, Françoise; Sauvant-Rochat, Marie-Pierre

    2016-03-30

    Cosmetic products contain various chemical substances that may be potential carcinogen and endocrine disruptors. Women's changes in cosmetics use during pregnancy and their risk perception of these products have not been extensively investigated. The main objective of this study was to describe the proportion of pregnant women changing cosmetics use and the proportion of non-pregnant women intending to do so if they became pregnant. The secondary objectives were to compare, among the pregnant women, the proportions of those using cosmetics before and during pregnancy, and to describe among pregnant and non-pregnant women, the risk perception of these products. A cross-sectional study was carried out in a gynaecology clinic and four community pharmacies. One hundred and twenty-eight women (60 non-pregnant and 68 pregnant women) replied to a self-administered questionnaire. Cosmetics use was identified for 28 products. The results showed that few women intended to change or had changed cosmetics use during pregnancy. Nail polish was used by fewer pregnant women compared to the period before pregnancy (p cosmetics use as a risk during pregnancy and 65% would have appreciated advice about these products. Our findings indicate that all perinatal health professionals should be ready to advise women about the benefits and risks of using cosmetics during pregnancy.

  16. Changes in Cosmetics Use during Pregnancy and Risk Perception by Women

    Science.gov (United States)

    Marie, Cécile; Cabut, Sophie; Vendittelli, Françoise; Sauvant-Rochat, Marie-Pierre

    2016-01-01

    Cosmetic products contain various chemical substances that may be potential carcinogen and endocrine disruptors. Women’s changes in cosmetics use during pregnancy and their risk perception of these products have not been extensively investigated. The main objective of this study was to describe the proportion of pregnant women changing cosmetics use and the proportion of non-pregnant women intending to do so if they became pregnant. The secondary objectives were to compare, among the pregnant women, the proportions of those using cosmetics before and during pregnancy, and to describe among pregnant and non-pregnant women, the risk perception of these products. A cross-sectional study was carried out in a gynaecology clinic and four community pharmacies. One hundred and twenty-eight women (60 non-pregnant and 68 pregnant women) replied to a self-administered questionnaire. Cosmetics use was identified for 28 products. The results showed that few women intended to change or had changed cosmetics use during pregnancy. Nail polish was used by fewer pregnant women compared to the period before pregnancy (p < 0.05). Fifty-five percent of the women considered cosmetics use as a risk during pregnancy and 65% would have appreciated advice about these products. Our findings indicate that all perinatal health professionals should be ready to advise women about the benefits and risks of using cosmetics during pregnancy. PMID:27043593

  17. Preeclampsia and Stroke: Risks during and after Pregnancy

    OpenAIRE

    2011-01-01

    Preeclampsia and stroke are significantly related, both pathologically and temporally (across the life span) in women. Cerebrovascular events can complicate preeclampsia, and can also manifest later in life. A history of preeclampsia is associated with long-term risk for hypertension, stroke, and heart disease. Cerebrovascular complications occur in only a small proportion of women with severe preeclampsia, but with high morbidity and mortality. Endothelial dysfunction and impaired cerebral ...

  18. Prepregnancy contraceptive use among teens with unintended pregnancies resulting in live births - Pregnancy Risk Assessment Monitoring System (PRAMS), 2004-2008.

    Science.gov (United States)

    2012-01-20

    Approximately 400,000 teens aged 15-19 years give birth every year in the United States (1), and the teen birth rate remains the highest in the developed world. Teen childbearing is a public health concern because teen mothers are more likely to experience negative social outcomes, including school dropout. In addition, infants of teen mothers are more likely to be low birth weight and have lower academic achievement, and daughters of teen mothers are more likely to become teen mothers themselves. To learn why teens wishing to avoid pregnancy become pregnant, CDC analyzed data from the 2004-2008 Pregnancy Risk Assessment Monitoring System (PRAMS). This report describes estimated rates of self-reported prepregnancy contraceptive use among white, black, and Hispanic teen females aged 15-19 years with unintended pregnancies resulting in live births. Approximately one half (50.1%) of these teens were not using any method of birth control when they got pregnant, and of these, nearly one third (31.4%) believed they could not get pregnant at the time; 21.0% used a highly effective contraceptive method (although less than 1% used one of the most effective methods, such as an intrauterine device [IUD]); 24.2% used the moderately effective method of condoms; and 5.1% used the least effective methods, such as rhythm and withdrawal. To decrease teen birth rates, efforts are needed to reduce or delay the onset of sexual activity, provide factual information about the conditions under which pregnancy can occur, increase teens' motivation and negotiation skills for pregnancy prevention, improve access to contraceptives, and encourage use of more effective contraceptive methods.

  19. Vitamin D status in early pregnancy and risk of preeclampsia

    Science.gov (United States)

    Achkar, Madonna; Dodds, Linda; Giguère, Yves; Forest, Jean-Claude; Armson, B. Anthony; Woolcott, Christy; Agellon, Sherry; Spencer, Anne; Weiler, Hope A.

    2016-01-01

    OBJECTIVE We sought to examine the association between maternal serum 25-hydroxyvitamin D (25[OH]D) concentration in early pregnancy and the subsequent diagnosis of preeclampsia (PE). STUDY DESIGN This was a nested case-control study from 2 prospective Canadian cohorts conducted in Quebec City, Quebec, and Halifax, Nova Scotia, from 2002 through 2010. Participants were pregnant women (n=169 cases with PE and 1975 controls). Maternal serum was drawn child-bearing age should be explored as a strategy for reducing PE and for promoting a healthier pregnancy. PMID:25446694

  20. Further evidence for periodontal disease as a risk indicator for adverse pregnancy outcomes.

    Science.gov (United States)

    Turton, Mervyn; Africa, Charlene W J

    2017-06-01

    Although there is increasing evidence to suggest an association between periodontal disease and adverse pregnancy outcomes, the issue remains controversial. This study tested the hypothesis that periodontal disease is a risk indicator for preterm delivery of low-birthweight infants. The study sample comprised 443 pregnant women with a mean (± standard deviation) age of 24.13 (±5.30) years. At first visit, maternal oral health status was assessed by the measurement of probing pocket depth and clinical attachment loss, and periodontal status was graded as absent, mild, moderate or severe. An association was sought between pregnancy outcomes and maternal periodontal status. While controlling for other factors, significant associations were found between pregnancy outcomes and maternal periodontal index scores. This study provides further evidence that periodontal disease is a risk indicator for adverse pregnancy outcomes. © 2016 FDI World Dental Federation.

  1. Pre-pregnancy weight and the risk of stillbirth and neonatal death

    DEFF Research Database (Denmark)

    Kristensen, J; Vestergaard, M; Wisborg, K

    2005-01-01

    OBJECTIVE: To evaluate the association between maternal pre-pregnancy body mass index (BMI) and the risk of stillbirth and neonatal death and to study the causes of death among the children. DESIGN: Cohort study of pregnant women receiving routine antenatal care in Aarhus, Denmark. SETTING: Aarhus...... University Hospital, Denmark, 1989-1996. POPULATION: A total of 24,505 singleton pregnancies (112 stillbirths, 75 neonatal deaths) were included in the analyses. METHODS: Information on maternal pre-pregnancy weight, height, lifestyle factors and obstetric risk factors were obtained from self......-administered questionnaires and hospital files. We classified the population according to pre-pregnancy BMI as underweight (BMI neonatal death and causes of death...

  2. Vitamin D status during pregnancy and the risk of subsequent postpartum depression

    DEFF Research Database (Denmark)

    Nielsen, Nina Odgaard; Strøm, Marin; Boyd, Heather A.

    of postpartum depression (PPD). The objective of the study was thus to determine whether low vitamin D status during pregnancy was associated with postpartum depression. In a case-control study nested in the Danish National Birth Cohort, we measured late pregnancy serum concentrations of 25[OH]D3 in 605 women......Epidemiological studies have provided evidence of an association between vitamin D insufficiency and depression and other mood disorders, and a role for vitamin D in various brain functions has been suggested. We hypothesized that low vitamin D status during pregnancy might increase the risk....... In a post-hoc analysis among women with sufficient vitamin D (≥50 nmol/L), we observed a significant positive association between vitamin D concentrations and PPD. Our results did not support an association between low maternal vitamin D concentrations during pregnancy and risk of PPD. Instead, an increased...

  3. Sex of the first-born and risk of preterm birth in the subsequent pregnancy

    DEFF Research Database (Denmark)

    Mortensen, Laust H; Nielsen, Henriette Svarre; Cnattingius, Sven

    2011-01-01

    BACKGROUND: Recent data suggest that the chance of successfully maintaining a pregnancy may be influenced by the sex of previously born children. We explored a possible relation between sex of the first-born infant and the risk of preterm birth in the second pregnancy. METHODS: Using data from...... the National Medical Birth Registries in Denmark 1980-2004 and Sweden 1980-2001, we selected all women whose first and second births were singleton and who had information on sex of first-born infant and gestational age for the second (Denmark, n = 393,686; Sweden, n = 603,282). Cox proportional hazards...... regression analysis was used to estimate the hazard ratio of preterm birth in the second pregnancy according to the sex of the first-born infant. RESULTS: Compared with women whose first baby was a girl, women with boys had an increased risk of preterm birth in a second pregnancy (hazard ratio = 1.10 [95...

  4. Autotaxin activity has a high accuracy to diagnose intrahepatic cholestasis of pregnancy.

    Science.gov (United States)

    Kremer, Andreas E; Bolier, Ruth; Dixon, Peter H; Geenes, Victoria; Chambers, Jenny; Tolenaars, Dagmar; Ris-Stalpers, Carrie; Kaess, Bernhard M; Rust, Christian; van der Post, Joris A; Williamson, Catherine; Beuers, Ulrich; Oude Elferink, Ronald P J

    2015-04-01

    Intrahepatic cholestasis of pregnancy (ICP) is defined by pruritus, elevated total fasting serum bile salts (TBS) and transaminases, and an increased risk of adverse fetal outcome. An accurate diagnostic marker is needed. Increased serum autotaxin correlates with cholestasis-associated pruritus. We aimed at unraveling the diagnostic accuracy of autotaxin in ICP. Serum samples and placental tissue were collected from 44 women with uncomplicated pregnancies and 105 with pruritus and/or elevated serum transaminases. Autotaxin serum levels were quantified enzymatically and by Western blotting, autotaxin gene expression by quantitative PCR. Serum autotaxin was increased in ICP (mean ± SD: 43.5 ± 18.2 nmol ml(-1)min(-1), n=55, ppregnancy (16.8 ± 6.7 nmol ml(-1)min(-1), n=33), pre-eclampsia complicated by HELLP-syndrome (16.8 ± 8.9 nmol ml(-1)min(-1), n=17), and pregnant controls (19.6 ± 5.7 nmol ml(-1)min(-1), n=44). Longitudinal analysis during pregnancy revealed a marked rise in serum autotaxin with onset of ICP-related pruritus. Serum autotaxin was increased in women taking oral contraceptives. Increased serum autotaxin during ICP was not associated with increased autotaxin mRNA in placenta. With a cut-off value of 27.0 nmol ml(-1)min(-1), autotaxin had an excellent sensitivity and specificity in distinguishing ICP from other pruritic disorders or pre-eclampsia/HELLP-syndrome. Serum autotaxin displayed no circadian rhythm and was not influenced by food intake. Increased serum autotaxin activity represents a highly sensitive, specific and robust diagnostic marker of ICP, distinguishing ICP from other pruritic disorders of pregnancy and pregnancy-related liver diseases. Pregnancy and oral contraception increase serum autotaxin to a much lesser extent than ICP. Copyright © 2014 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

  5. Ectopic Pregnancy risk factors among the patients referred to Shariati hospital in Bandarabbas

    Directory of Open Access Journals (Sweden)

    Minoo Rajaee

    2011-08-01

    Full Text Available Background: Ectopic pregnancy (EP is the most common cause of death related to pregnancy during the first trimester and its' incidence is increasing. Knowledge about the risk factors of EP can be helpful in diagnosis and also in prevention of EP, because some of these risk factors are preventable. The aim of this study is to assess the EP patients and the prevalence of EP risk factors among them in Bandarabbas.Methods: Eighty two patients with EP referred to Shariati hospital in Bandarabbas in 2009 were included in our descriptive study. Study was conducted using a questionnaire about demographic characteristics, EP risk factors, and information about treatment and duration of hospital stay. Data was collected using interview with patients by educated personnel and patients' records during hospitalization. After data collection we analysed the data using SPSS 17.0 software using descriptive statistics (Mean, Standard Deviation, and frequency.Results: Mean age of the participants was 27.46±5.98. Sixty four (78% patients were households and 18(22% were employees. Sixteen (19.5% had low socioeconomic status, 62(75.6% had intermediate socioeconomic status and 4 (4.9% had high socioeconomic status.Twenty one (25.6% of patients were using withdrawal method for contraception at the time of conception. Condom, Oral Contraceptive Pills (OCP, DMPA, and IUD was reported in 7 (8.5%, 13 (15.9%, 8 (9.8%, and 2 (2.4% respectively. Other 31 (37.8% patients weren’t using any method for contraception. Six (7.3% patients had previous history of EP. Also 4 (4.9% had history of previous EP in their near family members. One (1.2% patient was undergone surgery for Tubal Ligation (TL.Four (4.9% patient were using tobacco. EP location was in fallopian tube in 62 (75.6% and in other places in 20 (24.4% of patients. Thirty four (41.5% received drug therapy, 35 (42.7% undergone surgery and 13 (15.9% received both drug and surgery treatment. Mean duration of hospital

  6. Fever in pregnancy and risk of fetal death: a cohort study

    DEFF Research Database (Denmark)

    Andersen, Anne-Marie Nybo; Vastrup, Pernille; Wohlfart, Jan

    2002-01-01

    BACKGROUND: Hyperthermia acts as a teratogen in some animals where it can induce resorption of the fetus and fetal death. Fever during pregnancy, especially in the period of embryogenesis, is also suspected as being a risk factor for fetal death in human beings. We did a large cohort study...... in Denmark to investigate this possibility. METHODS: We interviewed 24040 women who were recruited in the first half of pregnancy to the Danish National Birth Cohort Study, and obtained information on the number of fever incidents during the first 16 weeks of pregnancy. For each fever episode, the highest...

  7. Vitamin D Status during Pregnancy and the Risk of Subsequent Postpartum Depression

    DEFF Research Database (Denmark)

    Nielsen, Nina O; Strøm, Marin; Boyd, Heather A

    2013-01-01

    of postpartum depression (PPD). The objective of the study was thus to determine whether low vitamin D status during pregnancy was associated with postpartum depression. In a case-control study nested in the Danish National Birth Cohort, we measured late pregnancy serum concentrations of 25[OH]D3 in 605 women......Epidemiological studies have provided evidence of an association between vitamin D insufficiency and depression and other mood disorders, and a role for vitamin D in various brain functions has been suggested. We hypothesized that low vitamin D status during pregnancy might increase the risk...

  8. Runaway and pregnant: risk factors associated with pregnancy in a national sample of runaway/homeless female adolescents.

    Science.gov (United States)

    Thompson, Sanna J; Bender, Kimberly A; Lewis, Carol M; Watkins, Rita

    2008-08-01

    Homeless youth are at particularly high risk for teen pregnancy; research indicates as many as 20% of homeless young women become pregnant. These pregnant and homeless teens lack financial resources and adequate health care, resulting in increased risk for low-birth-weight babies and high infant mortality. This study investigated individual and family-level predictors of teen pregnancy among a national sample of runaway/homeless youth in order to better understand the needs of this vulnerable population. Data from the Runaway/Homeless Youth Management Information System (RHY MIS) provided a national sample of youth seeking services at crisis shelters. A sub-sample of pregnant females and a random sub-sample (matched by age) of nonpregnant females comprised the study sample (N = 951). Chi-square and t tests identified differences between pregnant and nonpregnant runaway females; maximum likelihood logistic regression identified individual and family-level predictors of teen pregnancy. Teen pregnancy was associated with being an ethnic minority, dropping out of school, being away from home for longer periods of time, having a sexually transmitted disease, and feeling abandoned by one's family. Family factors, such as living in a single parent household and experiencing emotional abuse by one's mother, increased the odds of a teen being pregnant. The complex problems associated with pregnant runaway/homeless teens create challenges for short-term shelter services. Suggestions are made for extending shelter services to include referrals and coordination with teen parenting programs and other systems of care.

  9. Effects of maternal pregnancy intention, depressive symptoms and social support on risk of low birth weight: a prospective study from southwestern Ethiopia.

    Directory of Open Access Journals (Sweden)

    Yohannes Dibaba Wado

    Full Text Available BACKGROUND: Low birth weight (LBW is the principal risk factor for neonatal and infant mortality in developing countries. This study examines the effects of unwanted pregnancy, prenatal depression and social support on the risk of low birth weight in rural southwestern Ethiopia. We hypothesized that unwanted pregnancy and prenatal depression increase the risk of low birth weight, while social support mediates this association. METHODS: Data for the study comes from a prospective study in which women were followed from pregnancy through to delivery. Six hundred twenty two women were followed and 537 birth weights were measured within 72 hours. Multivariable log binomial regression was used to model the risk of low birth weight. RESULTS: The mean birth weight was 2989 grams (SD ± 504 grams, and the incidence of LBW was 17.88%. The mean birth weight of babies after unwanted pregnancy was 114 g lower compared to births from intended pregnancy. Similarly, mean birth weight for babies among women with symptoms of antenatal depression was 116 grams lower. Results of unadjusted log-binomial regression showed that unwanted pregnancy, prenatal depression and social support were associated with LBW. The relationship between antenatal depressive symptoms and LBW was mediated by the presence of social support, while the association between LBW and unwanted pregnancy remained after multivariable adjustment. CONCLUSION: The incidence of low birth weight is high in the study area. Poverty, nonuse of antenatal care, low social support and unwanted pregnancy contribute to this high incidence of low birth weight. Hence, identifying women's pregnancy intention during antenatal care visits, and providing appropriate counseling and social support will help improve birth outcomes.

  10. Loop electrosurgical excision of the cervix and risk for spontaneous preterm delivery in twin pregnancies

    DEFF Research Database (Denmark)

    Noehr, Bugge; Jensen, Allan; Frederiksen, Kirsten;

    2009-01-01

    OBJECTIVE: To investigate the association between three cervical procedures (biopsy with no treatment, ablation, and loop electrosurgical excision procedure [LEEP]) and subsequent spontaneous preterm delivery in twin pregnancies using population-based data from various nationwide registries...... spontaneously preterm (32.7%). Preterm delivery was defined as gestational age between 21 weeks and 37 weeks. Logistic regression analyses were used to evaluate the association between cervical procedures and preterm delivery. RESULTS: Twin pregnancies subsequent to LEEP had a significantly increased risk...... preterm groups. We found no increase in risk of preterm delivery subsequent to biopsy without treatment or ablation. CONCLUSION: Our study showed an overall significant increase in risk of preterm delivery in twin pregnancies subsequent to LEEP treatment, even after adjustment for several potential risk...

  11. Pre-pregnancy weight and the risk of stillbirth and neonatal death

    DEFF Research Database (Denmark)

    Kristensen, J; Vestergaard, M; Wisborg, K

    2005-01-01

    OBJECTIVE: To evaluate the association between maternal pre-pregnancy body mass index (BMI) and the risk of stillbirth and neonatal death and to study the causes of death among the children. DESIGN: Cohort study of pregnant women receiving routine antenatal care in Aarhus, Denmark. SETTING: Aarhus...... University Hospital, Denmark, 1989-1996. POPULATION: A total of 24,505 singleton pregnancies (112 stillbirths, 75 neonatal deaths) were included in the analyses. METHODS: Information on maternal pre-pregnancy weight, height, lifestyle factors and obstetric risk factors were obtained from self....... RESULTS: Maternal obesity was associated with a more than doubled risk of stillbirth (odds ratio = 2.8, 95% confidence interval [CI]: 1.5-5.3) and neonatal death (odds ratio = 2.6, 95% CI: 1.2-5.8) compared with women of normal weight. No statistically significantly increased risk of stillbirth...

  12. Family history and risk of pregnancy-associated breast cancer (PABC).

    Science.gov (United States)

    Johansson, Anna L V; Andersson, Therese M-L; Hsieh, Chung-Cheng; Cnattingius, Sven; Dickman, Paul W; Lambe, Mats

    2015-05-01

    The risk of breast cancer is at least two-fold increased in young women with a family history of breast cancer. Pregnancy has a dual effect on breast cancer risk; a short-term increase followed by a long-term protection. We investigated if the risk of breast cancer during and within 10 years following pregnancy is affected by a family history of breast cancer. We followed a cohort of women aged 15-44 years between 1963 and 2009 identified in Swedish population-based registers. Family history was defined as having a mother or sister with breast cancer. We estimated incidence rate ratios of breast cancer during pregnancy and time intervals up to 10 years post-delivery, with a focus on pregnancy-associated breast cancer (PABC), defined as breast cancer during pregnancy or within 2 years post-delivery. In 3,452,506 women, there were 15,548 cases of breast cancer (1208 were PABC). Compared to nulliparous women, the risk of breast cancer was decreased during pregnancy, similar during first year and increased during second year post-delivery. The pattern was similar in women with or without family history of breast cancer. A peak in risk was observed 5-6 years following the first birth regardless of family history. After a second birth, this peak was only present in women with a family history. Our results indicate that women with a family history of breast cancer do not have a different breast cancer risk during and within 10 years following pregnancy compared to women without a family history.

  13. Psychosocial and physical work environment, and risk of pelvic pain in pregnancy

    DEFF Research Database (Denmark)

    Juhl, Mette; Andersen, Per Kragh; Olsen, Jørn;

    2005-01-01

    night shift) had odds ratios for pelvic pain in pregnancy of 1.76 (95% confidence intervals 1.04 to 2.96) and 1.65 (1.22 to 2.24), respectively, compared with women with day work. Physically strenuous work was associated with an almost 50% increased risk of pelvic pain in pregnancy (1.47; 1.17 to 1...

  14. Maternal diet modulates the risk for neural tube defects in a mouse model of diabetic pregnancy

    OpenAIRE

    Kappen, Claudia; Kruger, Claudia; Macgowan, Jacalyn; Salbaum, J. Michael

    2010-01-01

    Pregnancies complicated by maternal diabetes have long been known to carry a higher risk for congenital malformations, such as neural tube defects. Using the FVB inbred mouse strain and the Streptozotocin-induced diabetes model, we tested whether the incidence of neural tube defects in diabetic pregnancies can be modulated by maternal diet. In a comparison of two commercial mouse diets, which are considered nutritionally replete, we found that maternal consumption of the unfavorable diet was ...

  15. Geographic access to family planning facilities and the risk of unintended and teenage pregnancy.

    Science.gov (United States)

    Goodman, David C; Klerman, Lorraine V; Johnson, Kay A; Chang, Chiang-Hua; Marth, Nancy

    2007-03-01

    This study tested the hypotheses that greater geographic access to family planning facilities is associated with lower rates of unintended and teenage pregnancies. State Pregnancy Risk Assessment Monitoring System (PRAMS) and natality files in four states were used to locate unintended and teenage births, respectively. Geographic availability was measured by cohort travel time to the nearest family planning facility, the presence of a family planning facility in a ZIP area, and the supply of primary care physicians and obstetric-gynecologists. 83% of the PRAMS cohort and 80% of teenagers lived within 15 min or less of a facility and virtually none lived more than 30 min. Adjusted odds ratios did not demonstrate a statistically significant trend to a higher risk of unintended pregnancies with longer travel time. Similarly there was no association with unintended pregnancy and the presence of a family planning facility within the ZIP area of maternal residence, or with the supply of physicians capable of providing family planning services. Both crude and adjusted relative rates of teenage pregnancies were significantly lower with further distance from family planning sites and with the absence of a facility in the ZIP area of residence. In adjusted models, the supply of obstetricians-gynecologists and primary care physicians was not significantly associated with decreased teen pregnancies. This study found no relationship between greater geographic availability of family planning facilities and a risk of unintended pregnancies. Greater geographic availability of family planning services was associated with a higher risk of teenage pregnancy, although these results may be confounded by facilities locating in areas with greater family planning needs.

  16. PROTEINURIA - A RISK FACTOR FOR PREGNANCY-RELATED RENAL-FUNCTION DECLINE IN PRIMARY GLOMERULAR-DISEASE

    NARCIS (Netherlands)

    HEMMELDER, MH; DEZEEUW, D; FIDLER, [No Value; DEJONG, PE

    1995-01-01

    Pregnancy may be followed by a postpartum acceleration of renal function loss in patients with renal disease. We retrospectively analyzed the effects of pregnancy on progressive renal function decline, and the risk factors for an acceleration, in a group of 19 renal disease patients with 30 pregnanc

  17. Vascular related pregnancy complications: genetics and remote cardiovascular risk

    NARCIS (Netherlands)

    A.L. Berends (Anne)

    2008-01-01

    textabstractPreeclampsia and intrauterine growth restriction (IUGR) are common vascular related pregnancy syndromes of unknown cause. Both preeclampsia and IUGR are responsible for a significant maternal and perinatal morbidity and mortality worldwide. Preeclampsia affects approximately 2.5-3.0% of

  18. Risking the Future. Adolescent Sexuality, Pregnancy, and Childbearing. Volume I.

    Science.gov (United States)

    Hayes, Cheryl D., Ed.

    This book examines in detail the complex, controversial problem of teenage pregnancy in the United States. Compiled by a panel of distinguished experts, it is a comprehensive review of data on such issues as sex education in the schools, contraception, abortion, adoption, prenatal and pediatric care, child support enforcement, and Aid to Families…

  19. Risking the Future. Adolescent Sexuality, Pregnancy, and Childbearing. Volume I.

    Science.gov (United States)

    Hayes, Cheryl D., Ed.

    This book examines in detail the complex, controversial problem of teenage pregnancy in the United States. Compiled by a panel of distinguished experts, it is a comprehensive review of data on such issues as sex education in the schools, contraception, abortion, adoption, prenatal and pediatric care, child support enforcement, and Aid to Families…

  20. Alcohol drinking pattern during pregnancy and risk of infant mortality

    DEFF Research Database (Denmark)

    Strandberg-Larsen, Katrine; Grønboek, Morten; Andersen, Anne-Marie Nybo;

    2009-01-01

    The safety of small amounts of alcohol drinking and occasional binge-level drinking during pregnancy remains unsettled. We examined the association of maternal average alcohol intake and binge drinking (>or=5 drinks per sitting) with infant mortality, both in the neonatal and postneonatal period....

  1. Parental Attitudes about Teenage Pregnancy: Impact on Sexual Risk Behaviour of African-American Youth

    Science.gov (United States)

    Annang, Lucy; Lian, Brad; Fletcher, Faith E.; Jackson, Dawnyéa

    2014-01-01

    African-American youth suffer disproportionately from sexual risk consequences including unintended pregnancy and sexually transmitted infections. Parents educating young people about sex may be one approach to reduce sexual risk behaviour among this population. The purpose of this study was to determine young people's perceptions of parents'…

  2. Prevention of cardiovascular risk in women who had hypertension during pregnancy after 36 weeks gestation

    NARCIS (Netherlands)

    van Kesteren, Floortje; Visser, Sanne; Hermes, Wietske; Franx, Arie; van Pampus, Maria G.; Poppel, Mireille N. M.; Tamsma, Jouke T.; Mol, Ben W.; de Groot, Christianne J.

    2015-01-01

    Objective: To analyse preventive interventions of women with cardiovascular risk factors postpartum. Methods: 3.5 years postpartum, women with history of hypertension in pregnancy were invited for a questionnaire, 1 year after a cardiovascular risk assessment. Results: Two hundred and fifty-seven wo

  3. Occupational Exposure During Pregnancy and the Risk of Atopic Dermatitis in the Offspring

    DEFF Research Database (Denmark)

    Christensen, Berit Hvass; Schlünssen, Vivi; Thulstrup, Ane Marie

    2015-01-01

    of the maternal exposure groups were associated with a changed risk of AD in the offspring. Conclusions: Our results do not suggest maternal exposure during pregnancy to be a significant risk factor for AD in the offspring. Exposure of pregnant women employed in the healthcare sector to e.g. antibiotics, latex...

  4. Parental Attitudes about Teenage Pregnancy: Impact on Sexual Risk Behaviour of African-American Youth

    Science.gov (United States)

    Annang, Lucy; Lian, Brad; Fletcher, Faith E.; Jackson, Dawnyéa

    2014-01-01

    African-American youth suffer disproportionately from sexual risk consequences including unintended pregnancy and sexually transmitted infections. Parents educating young people about sex may be one approach to reduce sexual risk behaviour among this population. The purpose of this study was to determine young people's perceptions of parents'…

  5. The risk of pregnancy-related venous thromboembolism in women who are homozygous for factor V Leiden

    NARCIS (Netherlands)

    Middeldorp, S; Libourel, EJ; Hamulyak, K; van der Meer, J; Buller, HR

    The risk of venous thromboembolism (VTE) is increased in pregnancy and during the post-partum period, The absolute risk for pregnancy-related VTE in heterozygous women with the factor V Leiden mutation is approximately 2%, but studies on this risk for homozygous women show conflicting results. In a

  6. Core state preconception health indicators - pregnancy risk assessment monitoring system and behavioral risk factor surveillance system, 2009.

    Science.gov (United States)

    Robbins, Cheryl L; Zapata, Lauren B; Farr, Sherry L; Kroelinger, Charlan D; Morrow, Brian; Ahluwalia, Indu; D'Angelo, Denise V; Barradas, Danielle; Cox, Shanna; Goodman, David; Williams, Letitia; Grigorescu, Violanda; Barfield, Wanda D

    2014-04-25

    Promoting preconception health can potentially improve women's health and pregnancy outcomes. Evidence-based interventions exist to reduce many maternal behaviors and chronic conditions that are associated with adverse pregnancy outcomes such as tobacco use, alcohol use, inadequate folic acid intake, obesity, hypertension, and diabetes. The 2006 national recommendations to improve preconception health included monitoring improvements in preconception health by maximizing public health surveillance (CDC. Recommendations to improve preconception health and health care-United States: a report of the CDC/ATSDR Preconception Care Work Group and the Select Panel on Preconception Care. MMWR 2006;55[No. RR-6]). 2009 for 38 indicators; 2008 for one indicator. DESCRIPTION OF SURVEILLANCE SYSTEMS: The Pregnancy Risk Assessment Monitoring System (PRAMS) is an ongoing state- and population-based surveillance system designed to monitor selected self-reported maternal behaviors, conditions, and experiences that occur shortly before, during, and after pregnancy among women who deliver live-born infants. The Behavioral Risk Factor Surveillance System (BRFSS) is an ongoing state-based telephone survey of noninstitutionalized adults aged ≥18 years in the United States that collects state-level data on health-related risk behaviors, chronic conditions, and preventive health services. This surveillance summary includes PRAMS data from 29 reporting areas (n = 40,388 respondents) and BRFSS data from 51 reporting areas (n = 62,875 respondents) for nonpregnant women of reproductive age (aged 18-44 years). To establish a comprehensive, nationally recognized set of indicators to be used for monitoring, evaluation, and response, a volunteer group of policy and program leaders and epidemiologists identified 45 core state preconception health indicators, of which 41 rely on PRAMS or BRFSS as data sources. This report includes 39 of the 41 core state preconception health indicators for which

  7. Physical activity from menarche to first pregnancy and risk of breast cancer

    Science.gov (United States)

    Liu, Ying; Tobias, Deirdre K.; Sturgeon, Kathleen M.; Rosner, Bernard; Malik, Vasanti; Cespedes, Elizabeth; Joshi, Amit D.; Eliassen, A. Heather; Colditz, Graham A.

    2017-01-01

    Breast tissue is particularly susceptible to exposures between menarche and first pregnancy, and a longer interval between these reproductive events is associated with elevated breast cancer risk. Physical activity during this time period may offset breast cancer risk, particularly for those at highest risk with longer menarche-to-first-pregnancy intervals. We used data from 65,576 parous women in the Nurses’ Health Study II free of cancer in 1989 (baseline) and recalled their leisure-time physical activity at ages 12–34 in 1997. Current activity was collected at baseline and over follow-up. Relative risks (RRs) were estimated using multivariable Cox proportional hazards regression models. Between 1989 and 2011, 2,069 invasive breast cancer cases were identified. Total recreational activity between menarche and first pregnancy was not significantly associated with the risk of breast cancer. However, physical activity between menarche and first pregnancy was associated with significantly lower breast cancer risk among women in the highest category of a menarche-to first-pregnancy interval (≥20 years; RR for the highest versus the lowest quartile = 0.73, 95% confidence interval = 0.55–0.97; Ptrend = 0.045; Pinteraction = 0.048). This was not observed in women with a shorter interval. Physical activity between menarche and first pregnancy was associated with a lower risk of breast cancer among women with at least 20 years between these reproductive events. This may provide a modifiable factor that women can intervene on to mitigate their breast cancer risk associated with a longer interval. PMID:27130486

  8. Physical activity from menarche to first pregnancy and risk of breast cancer.

    Science.gov (United States)

    Liu, Ying; Tobias, Deirdre K; Sturgeon, Kathleen M; Rosner, Bernard; Malik, Vasanti; Cespedes, Elizabeth; Joshi, Amit D; Eliassen, A Heather; Colditz, Graham A

    2016-09-15

    Breast tissue is particularly susceptible to exposures between menarche and first pregnancy, and a longer interval between these reproductive events is associated with elevated breast cancer risk. Physical activity during this time period may offset breast cancer risk, particularly for those at highest risk with longer menarche-to-first-pregnancy intervals. We used data from 65,576 parous women in the Nurses' Health Study II free of cancer in 1989 (baseline) and recalled their leisure-time physical activity at ages 12-34 in 1997. Current activity was collected at baseline and over follow-up. Relative risks (RRs) were estimated using multivariable Cox proportional hazards regression models. Between 1989 and 2011, 2,069 invasive breast cancer cases were identified. Total recreational activity between menarche and first pregnancy was not significantly associated with the risk of breast cancer. However, physical activity between menarche and first pregnancy was associated with significantly lower breast cancer risk among women in the highest category of a menarche-to first-pregnancy interval (≥20 years; RR for the highest versus the lowest quartile = 0.73, 95% confidence interval = 0.55-0.97; Ptrend  = 0.045; Pinteraction  = 0.048). This was not observed in women with a shorter interval. Physical activity between menarche and first pregnancy was associated with a lower risk of breast cancer among women with at least 20 years between these reproductive events. This may provide a modifiable factor that women can intervene on to mitigate their breast cancer risk associated with a longer interval.

  9. Does Infection During Pregnancy Outside of the Time of Delivery Increase the Risk of Cerebral Palsy?

    Science.gov (United States)

    Brookfield, Kathleen F; Osmundson, Sarah S; Caughey, Aaron B; Snowden, Jonathan M

    2017-02-01

    Objective We sought to evaluate whether maternal antepartum infection (excluding chorioamnionitis) is associated with cerebral palsy (CP). Study Design This is a secondary analysis from a multicenter trial in women at risk of preterm delivery who received antenatal magnesium sulfate versus placebo. We compared the risk of CP in the children of women who had evidence of antepartum infection over the course of pregnancy to those women who had no evidence of antepartum infection during pregnancy. Results Within a cohort of 2,251 women who met our inclusion criteria, 1,350 women had no history of infection in pregnancy and 801 women had a history of some type of antepartum infection during pregnancy. The incidence of CP was similar between the two groups (4.9 vs 5.0%; p = 0.917). After adjustment for maternal and obstetric confounders, we observed no significantly increased risk of CP among infants born to women with evidence of antepartum infection; (adjusted relative risk [aRR], 1.09 (0.72, 1.66); p = 0.68). Conclusion Compared with women with no evidence of antepartum infection during pregnancy, those women with infections excluding chorioamnionitis may not be at an increased risk of delivering an infant with CP. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  10. Retinol-Binding Protein 4 and Lipids Prospectively Measured During Early to Mid-Pregnancy in Relation to Preeclampsia and Preterm Birth Risk.

    Science.gov (United States)

    Mendola, Pauline; Ghassabian, Akhgar; Mills, James L; Zhang, Cuilin; Tsai, Michael Y; Liu, Aiyi; Yeung, Edwina H

    2017-06-01

    Maternal retinol-binding protein 4 (RBP4) and lipids may relate to preeclampsia and preterm birth risk but longitudinal data are lacking. This study examines these biomarkers longitudinally during pregnancy in relation to preeclampsia and preterm birth risk. Maternal serum samples from the Calcium for Preeclampsia Prevention (CPEP) trial were analyzed at baseline: average 15 gestational weeks; mid-pregnancy: average 27 weeks; and at >34 weeks. We measured RBP4, total cholesterol, high-density lipoprotein, low-density lipoprotein, triglycerides and lipoprotein (a) (Lp(a)). Cross-sectional logistic regression analyses estimated the odds ratio (OR) and 95% confidence intervals (CI) for preterm preeclampsia (n = 63), term preeclampsia (n = 104), and preterm delivery (n = 160) associated with RBP4 and lipids at baseline and mid-pregnancy compared with controls (n = 136). Longitudinal trajectories across pregnancy were assessed using mixed linear models with fixed effects. Adjusted models included clinical and demographic factors. RBP4 concentrations at baseline and mid-pregnancy were associated with a 4- to 8-fold increase in preterm preeclampsia risk but were not associated with term preeclampsia. RBP4 measured mid-pregnancy was also associated with preterm birth (OR = 6.67, 95% CI: 1.65, 26.84). Higher triglyceride concentrations in mid-pregnancy were associated with a 2- to 4-fold increased risk for both preeclampsia and preterm birth. Longitudinal models demonstrate that both preterm preeclampsia and preterm birth cases had elevated RBP4 throughout gestation. Elevated RBP4 is detectable early in pregnancy and its strong relation with preterm preeclampsia merits further investigation and confirmation to evaluate its potential use as a predictor, particularly among high-risk women.

  11. Risk of Ectopic Pregnancy Associated With Assisted Reproductive Technology in the United States, 2001–2011

    Science.gov (United States)

    Perkins, Kiran M.; Boulet, Sheree L.; Kissin, Dmitry M.; Jamieson, Denise J.

    2015-01-01

    OBJECTIVE To assess national trends in ectopic pregnancy incidence among assisted reproductive technology users and identify risk factors associated with ectopic pregnancy. METHODS We identified 553,577 pregnancies reported to the National ART Surveillance System between 2001 and 2011. Of those, 9,480 were ectopic, of which 485 were heterotopic. As a result of small numbers, ectopic and heterotopic pregnancies were combined for analysis. We assessed temporal trends in annual ectopic pregnancy rates using Poisson regression. We used log-binomial regression models with generalized estimating equations for correlated outcomes within clinics to calculate unadjusted and adjusted risk ratios for the association between ectopic pregnancy and selected patient characteristics and treatment factors. RESULTS The rate of ectopic pregnancy declined from 2.0% (n5735, 95% confidence interval [CI] 1.9–2.2) in 2001 to 1.6% (n=968, 95% CI 1.5–1.7) in 2011 (P for trend ,.001). The ectopic pregnancy rate ranged from 2.0% (n=7,469, 95% CI 1.9–2.0) for fresh, nondonor cycles to 1.0% (n=641, 95% CI 0.9–1.1) for fresh, donor cycles. Among fresh, nondonor cycles, the rate of ectopic pregnancy was 1.6% (95% CI 1.4–1.7) when one embryo was transferred compared with 1.7% (95% CI 1.7–1.8), 2.2% (95% CI 2.1–2.3), and 2.5% (95% CI 2.4–2.6) when two, three, or four or more embryos were transferred, respectively (adjusted risk ratios 1.11, 95% CI 0.94–0.30; 1.33, 95% CI 1.12–1.56; and 1.49, 95% CI 1.25–1.78). CONCLUSION Ectopic pregnancy incidence after assisted reproductive technology has decreased over time, but factors such as multiple embryo transfer increase the risk of ectopic pregnancy. PMID:25560107

  12. Characterization of the Risks of Adverse Outcomes Following Rubella Infection in Pregnancy.

    Science.gov (United States)

    Thompson, Kimberly M; Simons, Emily A; Badizadegan, Kamran; Reef, Susan E; Cooper, Louis Z

    2016-07-01

    Although most infections with the rubella virus result in relatively minor sequelae, rubella infection in early pregnancy may lead to severe adverse outcomes for the fetus. First recognized in 1941, congenital rubella syndrome (CRS) can manifest with a diverse range of symptoms, including congenital cataracts, glaucoma, and cardiac defects, as well as hearing and intellectual disability. The gestational age of the fetus at the time of the maternal rubella infection impacts the probability and severity of outcomes, with infection in early pregnancy increasing the risks of spontaneous termination (miscarriage), fetal death (stillbirth), birth defects, and reduced survival for live-born infants. Rubella vaccination continues to change the epidemiology of rubella and CRS globally, but no models currently exist to evaluate the economic benefits of rubella management. This systematic review provides an overall assessment of the weight of the evidence for the outcomes associated with rubella infections in the first 20 weeks of pregnancy. We identified, evaluated, and graded 31 studies (all from developed countries) that reported on the pregnancy outcomes of at least 30 maternal rubella infections. We used the available evidence to estimate the increased risks of spontaneous termination, fetal death, infant death, and CRS as a function of the timing of rubella infection in pregnancy and decisions about induced termination. These data support the characterization of the disability-adjusted life years for outcomes associated with rubella infection in pregnancy. We find significant impacts associated with maternal rubella infections in early pregnancy, which economic analyses will miss if they only focus on live births of CRS cases. Our estimates of fetal loss from increased induced terminations due to maternal rubella infections provide context that may help to explain the relatively low numbers of observed CRS cases per year despite potentially large burdens of disease. Our

  13. High incidence of unplanned pregnancy after antiretroviral therapy initiation: findings from a prospective cohort study in South Africa.

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    Sheree R Schwartz

    Full Text Available Increased fertility rates in HIV-infected women receiving antiretroviral therapy (ART have been attributed to improved immunological function; it is unknown to what extent the rise in pregnancy rates is due to unintended pregnancies.Non-pregnant women ages 18-35 from four public-sector ART clinics in Johannesburg, South Africa, were enrolled into a prospective cohort and followed from August 2009-March 2011. Fertility intentions, contraception and pregnancy status were measured longitudinally at participants' routine ART clinic visits.Of the 850 women enrolled, 822 (97% had at least one follow-up visit and contributed 745.2 person-years (PY at-risk for incident pregnancy. Overall, 170 pregnancies were detected in 161 women (incidence rate [IR]: 21.6/100 PY [95% confidence interval (CI: 18.5-25.2]. Of the 170 pregnancies, 105 (62% were unplanned. Unmet need for contraception was 50% higher in women initiating ART in the past year as compared to women on ART>1 year (prevalence ratio 1.5 [95% CI: 1.1-2.0]; by two years post-ART initiation, nearly one quarter of women had at least one unplanned pregnancy. Cumulative incidence of pregnancy was equally high among recent ART initiators and ART experienced participants: 23.9% [95% CI: 16.4-34.1], 15.9% [12.0-20.8], and 21.0% [16.8-26.1] for women on ART 0-1 yr, >1 yr-2 yrs, and >2 yrs respectively (log-rank, p = 0.54. Eight hormonal contraceptive failures were detected [IR: 4.4 [95% CI: 2.2-8.9], 7/8 among women using injectable methods. Overall 47% (80/170 of pregnancies were not carried to term.Rates of unintended pregnancies among women on ART are high, including women recently initiating ART with lower CD4 counts and higher viral loads. A substantial burden of pregnancy loss was observed. Integration of contraceptive services and counselling into ART care is necessary to reduce maternal and child health risks related to mistimed and unwanted pregnancies. Further research into injectable

  14. Common mental disorders increase pre-eclampsia/ eclampsia risks in pregnancy

    Directory of Open Access Journals (Sweden)

    Y. Wibowo

    2013-04-01

    Full Text Available Introduction Pre-eclampsia is a multisystem complication that occurs after 20 weeks of pregnancy and can cause considerable maternal and fetal morbidity and mortality. Mental health is influenced by social support, and emotional distress during pregnancy may cause pre-ecclampsia/ecclampsia (PE/E. The objective of this study was to determine the association of social support and common mental disorders (CMD with PE/E in pregnant women. Methods This study was a matched case-control study. Cases were pregnant women who had been diagnosed with PE/E. Controls were those with normal pregnancies or not diagnosed as PE/E. Instruments social support questionnaire-6 (SSQ-6 was used to measure social support and self-reporting questionnaire 20 (SRQ-20 items for measuring CMD. Conditional logistic regression was used to estimate matched odds ratios (ORs and 95% confidence intervals (95% CI. Results Low social support was not directly associated with PE/E. Compared with women with high social support, those with low social support had a 26-fold increased risk of CMD (+ (OR=26.4, 95% CI: 10.67 to 77.20, p=0.001. Several variables significantly associated with PE/E were CMD (+ (OR=6.11, 95% CI: 2.99 to 14.07, p=0.001, low family income (OR=2.93, 95% CI: 1.56 to 5.82, p=0.001, history of chronic hypertension (+ (OR=7.67, 95% CI: 2.32 to 39.89, p=0.001, history of PE/E (+ (p=0.001, and history of hereditary PE/E (+ (OR=6, 95% CI: 1.34 to 55.20, p=0.013. Conclusion Low social support was not directly associated with PE/E but was associated with CMD. To prevent CMD in pregnant women, there is a need for social support from the family.

  15. A Meta-Analysis of Maternal Smoking during Pregnancy and Autism Spectrum Disorder Risk in Offspring

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    Shiming Tang

    2015-08-01

    Full Text Available The association between maternal smoking during pregnancy and autism spectrum disorder (ASD risk in offspring has been investigated in several studies, but the evidence is not conclusive. We, therefore, conducted this meta-analysis to explore whether an association exists between maternal smoking during pregnancy and ASD risk in offspring. We searched PubMed, Embase, Web of Science, and the Cochrane Library for studies of maternal smoking during pregnancy and ASD risk in offspring up to 10 June 2015. The random-effects model was used to combine results from individual studies. 15 observational studies (6 cohort studies and 9 case-control studies, with 17,890 ASD cases and 1,810,258 participants were included for analysis. The pooled odds ratio (OR was 1.02 (95% confidence interval (CI: 0.93–1.13 comparing mothers who smoked during pregnancy with those who did not. Subgroup and sensitivity analysis suggested the overall result of this analysis was robust. Results from this meta-analysis indicate that maternal smoking during pregnancy is not associated with ASD risk in offspring. Further well-designed cohort studies are needed to confirm the present findings.

  16. Does topical isotretinoin exposure during pregnancy increase the risk of congenital malformations?

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    İsmail Yılmaz

    2015-06-01

    Full Text Available A 34-year-old patient learned that she was 7 weeks pregnant while she was using topical isotretinoin + erythromycin gel for acne treatment and referred to Izmir Katip Celebi University Teratology Information Service for information regarding the risk of teratogenicity. Systemic use of isotretinoin is well-known for its teratogenic effects and case reports suggesting possible teratogenic effects regarding topical exposure to retinoids in pregnancy exist in the literature. However, findings reported in four prospective controlled studies do not suggest an increased congenital malformation risk in case of inadvertent exposure during pregnancy. This manuscript aims to give a summary and evaluation of available data for counseling pregnant patients regarding the possible teratogenic risk of inadvertent topical isotretinoin exposure during pregnancy. It also aims to emphasize the importance of increasing communication between pregnant patients, clinicians and teratology information services for the benefit of mother and unborn.

  17. Risk factors for bacterial vaginosis in pregnancy: a population-based study on Danish women

    DEFF Research Database (Denmark)

    Thorsen, Poul; Vogel, Ida; Molsted, Kirsten

    2006-01-01

    Background. No larger population-based study of bacterial vaginosis in pregnancy has previously been available. The objective of this study was to examine risk factors for bacterial vaginosis in pregnancy. Design. From a prospective population-based cohort of 3,596 eligible pregnant women, 2......, and sociodemographic factors) were computed. Results. At enrolment, bacterial vaginosis was diagnosed in 13.7% of Danish pregnant women. Significant risk factors for bacterial vaginosis were: daily coitus (adjusted relative risk 2.09 [1.43-3.04]), being single (1.76 [1.21-2.56]), smoking more than 10 cigarettes daily...... at conception (1.59 [1.29-1.93]), previous genital infection with Chlamydia trachomatis or Neisseria gonorrhoeae (1.39 [1.07-1.79]), and consuming 2 or more drinks per week (1.33 [1.02-1.74]) after control for confounding factors. Conclusion. In pregnancy, women who have daily coitus, are single, smokers...

  18. Risk and Benefit of Drug Use During Pregnancy

    OpenAIRE

    Bánhidy, Ferenc; Lowry, R. Brian; Czeizel, Andrew E.

    2005-01-01

    Environmental teratogenic factors (e.g. alcohol) are preventable. We focus our analysis on human teratogenic drugs which are not used frequently during pregnancy. The previous human teratogenic studies had serious methodological problems, e.g. the first trimester concept is outdated because environmental teratogens cannot induce congenital abnormalities in the first month of gestation. In addition, teratogens usually cause specific congenital abnormalities or syndromes. Finally, the importanc...

  19. Treatment of recurrent pregnancy loss by Levothyroxine in women with high Anti-TPO antibody

    OpenAIRE

    Abbas Aflatoonian; Tahere Jahaninejad; Fatemeh Mohsenifar; Mohammad Hosein Mosaddegh; Nasrin Ghasemi

    2012-01-01

    Background: Recurrent pregnancy loss (RPL) is defined as two or more consecutive pregnancy losses before twenty weeks of gestation. It is caused by a variety of genetics and non-genetics factors. Thyroid autoimmunity could associate with pregnancy loss. Objective: To investigate the effectiveness of Levothyroxine in treatment of RPL in women with high auto-thyroid antibodies. Materials and Methods: In this observational cross sectional study, 900 women who had a history of recurrent pregnancy...

  20. Risks to the fetus from diagnostic imaging during pregnancy: review and proposal of a clinical protocol

    Energy Technology Data Exchange (ETDEWEB)

    Gomes, Mafalda; Matias, Alexandra [University of Porto, Faculty of Medicine, Porto (Portugal); Macedo, Filipe [SMIC, Porto (Portugal)

    2015-12-15

    Every day, medical practitioners face the dilemma of exposing pregnant or possibly pregnant patients to radiation from diagnostic examinations. Both doctors and patients often have questions about the risks of radiation. The most vulnerable period is between the 8th and 15th weeks of gestation. Deterministic effects like pregnancy loss, congenital malformations, growth retardation and neurobehavioral abnormalities have threshold doses above 100-200 mGy. The risk is considered negligible at 50 mGy and in reality no diagnostic examination exceeds this limit. The risk of carcinogenesis is slightly higher than in the general population. Intravenous iodinated contrast is discouraged, except in highly selected patients. Considering all the possible noxious effects of radiation exposure, measures to diminish radiation are essential and affect the fetal outcome. Nonionizing procedures should be considered whenever possible and every radiology center should have its own data analysis on fetal radiation exposure. In this review, we analyze existing literature on fetal risks due to radiation exposure, producing a clinical protocol to guide safe radiation use in a clinical setting. (orig.)

  1. Study on the psychological state and its influencing factors of high-risk pregnancy mothers after being separated from their newborns%母婴分离高危妊娠产妇心理状况及影响因素研究

    Institute of Scientific and Technical Information of China (English)

    张晶; 刘纯艳

    2009-01-01

    目的 调查母婴分离高危妊娠产妇的心理状况;探讨心理状况的影响因素.方法 采用非实验设计的描述性研究方法,应用和进行调查. 结果母婴分离高危妊娠产妇的焦虑明显高于常模,产后抑郁的发生率为57.9%;新生儿出生孕周、特质焦虑、是否有妊娠合并症或并发症是产妇心理状况的独立影响因素.结论 母婴分离高危妊娠产妇的心理状况应受到重视,需针对影响因素制订相应的护理措施,以提高其心理健康水平.%Objective To investigate the psychological state of high-risk pregnancy mothers af-ter being separated from their newborns and discuss the influencing factors of psychological state. Methods Nonexperimental descriptive study was used in this study. The investigation adopted state-trait anxiety inventory (STA-Ⅰ) and Edinburgh postnatal depression scale (EPDS). Results The moth-ers' anxiety score was significantly higher than normal women in China, and postnatal depression inci- dence rate was 57.9%. Mothers' psychological state was correlated with gestational age of new-borns, trait anxiety and pregnancy complications. Conclusions The psychological state of high- risk pregnancy mothers after being separated from their newborns should be paid more attention to, and cor-related nursing methods should be taken to improve their mental health.

  2. Maternal exposure to floricultural work during pregnancy, PON1 Q192R polymorphisms and the risk of low birth weight

    Energy Technology Data Exchange (ETDEWEB)

    Moreno-Banda, G.; Blanco-Munoz, J. [Population Health Research Center, National Institute of Public Health, Avenida Universidad 655, Colonia Santa Maria Ahuacatitlan, 62508 Cuernavaca, Morelos (Mexico); Lacasana, M., E-mail: marina.lacasana.easp@juntadeandalucia.es [Andalusian School of Public Health, Campus Universitario de la Cartuja, Cuesta del Observatorio, 4, 18080 Granada (Spain); CIBER of Epidemiology and Public Health (CIBERESP) (Spain); Rothenberg, S.J. [Population Health Research Center, National Institute of Public Health, Avenida Universidad 655, Colonia Santa Maria Ahuacatitlan, 62508 Cuernavaca, Morelos (Mexico); Center of Research and Advanced Studies, National Institute Polytechnic, Department of Toxicology, Av, Instituto Politecnico Nacional No. 2508, Col. San Pedro Zacatenco, Deleg. Gustavo A. Madero, 07360 Mexico, D.F. (Mexico); Aguilar-Garduno, C. [Andalusian School of Public Health, Campus Universitario de la Cartuja, Cuesta del Observatorio, 4, 18080 Granada (Spain); Andalusian Observatory of Environmental Health, Campus Universitario de la Cartuja, Cuesta del Observatorio, 4, 18080 Granada (Spain); Gamboa, R. [Department of Physiology, National Institute of Cardiology ' Ignacio Chavez' , Juan Badiano 4, Section XVI, 14080, Mexico DF (Mexico); Perez-Mendez, O. [Department of Molecular Biology and cardiovascular Diseases Genomic and Proteomic, National Institute of Cardiology ' Ignacio Chavez' , Juan Badiano 4, Section XVI, 14080, Mexico DF (Mexico)

    2009-10-15

    Background: Although there is evidence from animal studies of impaired reproductive function by exposure to organophosphates (OP), the effects on birth weight have not been sufficiently evaluated in epidemiological studies. Paraoxonase (PON1) detoxifies organophosphates by cleavage of active oxons. Some PON1 gene polymorphisms could reduce the enzyme activity and increase susceptibility to OP toxicity. Objective: To assess the association between maternal exposure to floriculture during pregnancy and the risk of low birth weight (< 2500 g) in their offspring, as well as to evaluate the interaction between this exposure and maternal genotype for PON1 Q192R polymorphisms. Materials and methods: A cross sectional study was carried out in two Mexican states (States of Mexico and Morelos) with high frequencies of greenhouse activity. We interviewed and collected blood samples from 264 females (floriculturists or partners of floricultural workers) who became pregnant during the 10 years prior to the interview. The questionnaire measured socioeconomic characteristics, tobacco and alcohol consumption, diseases and occupational and reproductive history. We also applied a food frequency questionnaire. Information was obtained pertaining to 467 pregnancies. DNA was extracted from white cells, and PON1 genotype was determined by Restriction Fragment Length Polymorphism for Q192R polymorphisms. Results were analyzed with generalized estimating equations models. Results: After adjusting for potential confounders, we detected a statistically significant interaction between maternal exposure to flower growing work during pregnancy and PON1 Q192R polymorphisms on risk of low birth weight. The risk of having a baby with LBW is nearly six times higher if a mother is a floriculture worker during pregnancy and has PON1 192RR genotype (OR 5.93, 95% CI 1.28, 27.5). Conclusion: These results suggest that the interaction between maternal floriculture work during pregnancy and 192RR PON1

  3. Does unemployment in family affect pregnancy outcome in conditions of high quality maternity care?

    Directory of Open Access Journals (Sweden)

    Heinonen Seppo

    2006-02-01

    Full Text Available Abstract Background The influence of unemployment in the family on pregnancy outcome is controversial. Only a few studies have involved investigation of the effect of unemployment of the father on pregnancy. The objective of this study was to assess the effects of unemployment of one or both parents on obstetric outcome in conditions of free antenatal care attended by the entire pregnant population. Methods The data of 24 939 pregnancies included maternal risk factors, pregnancy characteristics and outcome, and was based on a self administered questionnaire at 20 weeks of pregnancy and on clinical records. Results Unemployment was associated with adolescent maternal age, unmarried status and overweight, anemia, smoking, alcohol consumption and prior pregnancy terminations. Multivariate logistic regression analysis indicated that after controlling for these maternal risk factors small differences only were found in pregnancy outcomes between unemployed and employed families. Unemployed women had significantly more often small-for-gestational-age (SGA infants, at an OR of 1.26 (95% CI: 1.12 – 1.42 whereas, in families where both parents were unemployed, the risk of SGA was even higher at an OR of 1.43 (95% CI: 1.18 – 1.73. Otherwise, pregnancy outcome was comparable in the groups studied. Conclusion Free antenatal care was unable to fully overcome the adverse pregnancy outcomes associated with unemployment, SGA risk being highest when both parents are unemployed.

  4. Main Risk Factors for Ectopic Pregnancy: A Case-Control Study in A Sample of Iranian Women

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    Shayesteh Parashi

    2014-07-01

    Full Text Available Background: Although the risk factors of ectopic pregnancy have been determined in previous studies, the main risk factors of ectopic pregnancy are different in various countries due to different cultural and social characteristics. Determination of main risk factors of ectopic pregnancy leads to a rapid diagnosis and an improvement in strategies for its prevention. The purpose of this study was to determine the main risk factors of ectopic pregnancy in a sample of Iranian women. Materials and Methods: We designed a case-control study to include 150 cases and 300 controls and to compare them by the following factors: socio-demographic characteristics, contraceptive methods, prior tubal surgery, tubal pathology, prior ectopic pregnancy, prior caesarean section, prior abortion, prior infertility, and prior abdominal/pelvic surgery. Results: The case and control groups were significantly similar in term of education and parity. There was an association between ectopic pregnancy and age which was disappeared after controlling for the main risk factors (adjusted OR=2.45, 95% CI: 0.86-6.97. There was no statistically significant relation between ectopic pregnancy and prior tubal surgery, tubal pathology, prior abortion, prior infertility, assisted reproductive technology, and oral contraceptive method (p>0.05. However, there was a significant association between prior ectopic pregnancy, prior tubal ligation, use of intrauterine device, and prior abdominal/pelvic surgery with ectopic pregnancy (p<0.05. The risk of ectopic pregnancy increased with the use of intrauterine device and tubal ligation, whereas decreased with use of oral contraception. Conclusion: This study identified prior ectopic pregnancy, prior tubal ligation, use of intrauterine device, and prior pelvic/abdominal surgery as the main risk factors for ectopic pregnancy in a sample of Iranian women. Our findings can be useful for early diagnosis of ectopic pregnancy and for improvement in

  5. Pregnancy is not a risk factor for gallstone disease: Results of a randomly selected population sample

    Institute of Scientific and Technical Information of China (English)

    Thomas Walcher; Bernhard Otto Boehm; Wolfgang Kratzer; Mark Martin Haenle; Martina Kron; Birgit Hay; Richard Andrew Mason; Alexa Friederike Alice von Schmiesing; Armin Imhof; Wolfgang Koenig; Peter Kern

    2005-01-01

    AIM: To investigate the prevalence, risk factors, and selection of the study population for cholecystolithiasis in an urban population in Germany, in relation to our own findings and to the results in the international literature.METHODS: A total of 2 147 persons (1 111 females,age 42.8±12.7 years; 1 036 males, age 42.3±13.1 years)participating in an investigation on the prevalence of Echinococcus multilocularis were studied for risk factors and prevalence of gallbladder stone disease.Risk factors were assessed by means of a standardized interview and calculation of body mass index (BMI). A diagnostic ultrasound examination of the gallbladder was performed. Data were analyzed by multiple logistic regression, using the SAS statistical software package.RESULTS: Gallbladder stones were detected in 171study participants (8.0%, n = 2 147). Risk factors for the development of gallbladder stone disease included age, sex, BMI, and positive family history. In a separate analysis of female study participants, pregnancy (yes/no)and number of pregnancies did not exert any influence.CONCLUSION: Findings of the present study confirm that age, female sex, BMI, and positive family history are risk factors for the development of gallbladder stone disease. Pregnancy and the number of pregnancies,however, could not be shown to be risk factors. There seem to be no differences in the respective prevalence for gallbladder stone disease in urban and rural populations.

  6. Gluten consumption during late pregnancy and risk of celiac disease in the offspring: the TEDDY birth cohort.

    Science.gov (United States)

    Uusitalo, Ulla; Lee, Hye-Seung; Aronsson, Carin Andrén; Yang, Jimin; Virtanen, Suvi M; Norris, Jill; Agardh, Daniel

    2015-11-01

    Maternal diet during pregnancy has been proposed to increase the risk of autoimmune diseases. The objective was to investigate the association between maternal consumption of gluten-containing foods during late pregnancy and subsequent risk of celiac disease in the offspring. Genetically susceptible children prospectively followed from birth were screened annually for tissue transglutaminase autoantibodies (tTGAs). Children testing persistently positive for tTGAs were further evaluated for celiac disease. Diagnosis of celiac disease was confirmed by intestinal biopsy or was considered likely if the mean tTGA concentration was >100 units in 2 consecutive samples. A questionnaire on the mother's diet in late pregnancy was completed by 3-4.5 mo postpartum. Mothers were divided into 3 groups based on the tertiles of their consumption of gluten-containing foods (servings/d). The association between maternal gluten-containing food consumption and the risk of celiac disease was studied by using a time-to-event analysis. At the time of analysis, 359 (5%) of the 6546 children developed celiac disease. Compared with the middle category of maternal gluten-containing food consumption (servings/d), low (HR: 0.87; 95% CI: 0.67, 1.13; P = 0.296) and high (HR: 0.84; 95% CI: 0.65, 1.09; P = 0.202) consumption was not associated with risk of celiac disease in the child after adjustment for country, human leukocyte antigen genotype, family history of celiac disease, maternal education, and sex of the child. Median maternal daily consumption frequency of gluten-containing foods was higher (P celiac disease. The frequency of gluten-containing food consumption during late pregnancy is not associated with risk of celiac disease in the offspring. © 2015 American Society for Nutrition.

  7. Gluten consumption during late pregnancy and risk of celiac disease in the offspring: the TEDDY birth cohort12

    Science.gov (United States)

    Uusitalo, Ulla; Lee, Hye-Seung; Aronsson, Carin Andrén; Yang, Jimin; Virtanen, Suvi M; Norris, Jill; Agardh, Daniel

    2015-01-01

    Background: Maternal diet during pregnancy has been proposed to increase the risk of autoimmune diseases. Objective: The objective was to investigate the association between maternal consumption of gluten-containing foods during late pregnancy and subsequent risk of celiac disease in the offspring. Design: Genetically susceptible children prospectively followed from birth were screened annually for tissue transglutaminase autoantibodies (tTGAs). Children testing persistently positive for tTGAs were further evaluated for celiac disease. Diagnosis of celiac disease was confirmed by intestinal biopsy or was considered likely if the mean tTGA concentration was >100 units in 2 consecutive samples. A questionnaire on the mother’s diet in late pregnancy was completed by 3–4.5 mo postpartum. Mothers were divided into 3 groups based on the tertiles of their consumption of gluten-containing foods (servings/d). The association between maternal gluten-containing food consumption and the risk of celiac disease was studied by using a time-to-event analysis. Results: At the time of analysis, 359 (5%) of the 6546 children developed celiac disease. Compared with the middle category of maternal gluten-containing food consumption (servings/d), low (HR: 0.87; 95% CI: 0.67, 1.13; P = 0.296) and high (HR: 0.84; 95% CI: 0.65, 1.09; P = 0.202) consumption was not associated with risk of celiac disease in the child after adjustment for country, human leukocyte antigen genotype, family history of celiac disease, maternal education, and sex of the child. Median maternal daily consumption frequency of gluten-containing foods was higher (P celiac disease. Conclusion: The frequency of gluten-containing food consumption during late pregnancy is not associated with risk of celiac disease in the offspring. PMID:26447157

  8. Is thrombophilia a risk factor for placenta-mediated pregnancy complications?

    DEFF Research Database (Denmark)

    Hoffmann, Elise; Hedlund, Elisabeth; Perin, Trine

    2012-01-01

    PURPOSE: To determine if thrombophilia is a risk factor for placenta-mediated pregnancy complications (PMPC) (i.e., preeclampsia, intrauterine growth restriction (IUGR), placental abruption, intrauterine fetal death and recurrent pregnancy loss). METHODS: A 5-year retrospective cohort study....... Ongoing pregnancies in women with an antecedent PMPC with thrombophilia were compared with the pregnancies in similar women without thrombophilia. The main outcome measures were mean birth weight deviations, corrected for gestational age, and recurrence of PMPC. Low-molecular-weight heparin (LMWH......) was employed for thromboprophylaxis only. Mann-Whitney's, Fisher's and Chi-square tests were employed for comparison. RESULTS: PMPC recurred in 10/43 (23 %) in the thrombophilia group and in 7/41 (17 %) in the non-thrombophilia group, P

  9. Sexual Health Outcomes at 24 Months for a Clinic-Linked Intervention to Prevent Pregnancy Risk Behaviors

    Science.gov (United States)

    Sieving, Renee E.; McRee, Annie-Laurie; McMorris, Barbara J.; Beckman, Kara J.; Pettingell, Sandra L.; Bearinger, Linda H.; Garwick, Ann W.; Oliphant, Jennifer A.; Plowman, Shari; Resnick, Michael D.; Secor-Turner, Molly

    2015-01-01

    Importance Preventing early pregnancy among vulnerable adolescents requires innovative and sustained approaches. Prime Time, a youth development intervention, aims to reduce pregnancy risk among adolescent girls seeking clinic services who are at high risk for pregnancy. Objective To evaluate sexual risk behaviors and related outcomes with a 24-month postbaseline survey, 6 months after the conclusion of the Prime Time intervention. Design Randomized controlled trial. Setting Community and school-based primary care clinics. Participants Of 253 sexually active 13- to 17-year-old girls meeting specified risk criteria, 236 (93.3%) completed the 24-month follow-up survey. Intervention Offered during an 18-month period, Prime Time includes case management and youth leadership programs. Main Outcome Measures Self-reported consistency of condom, hormonal, and dual-method contraceptive use with most recent male sex partner and number of male sex partners in the past 6 months. Results At 24-month follow-up, the intervention group reported significantly more consistent use of condoms, hormonal contraception, and dual-method contraception than the control group. Intervention participants also reported improvements in family connectedness and self-efficacy to refuse unwanted sex, and reductions in the perceived importance of having sex. No between-group differences were found in the number of recent male sex partners. Conclusions and Relevance This study contributes to what has been a dearth of evidence regarding youth development interventions offered through clinic settings, where access to high-risk adolescents is plentiful but few efforts have emphasized a dual approach of strengthening sexual and nonsexual protective factors while addressing risk. Findings suggest that health services grounded in a youth development framework can lead to long-term reductions in sexual risk among vulnerable youth. PMID:23440337

  10. Incident HIV during pregnancy and postpartum and risk of mother-to-child HIV transmission: a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Alison L Drake

    2014-02-01

    associations and sources of heterogeneity. CONCLUSIONS: Pregnancy and the postpartum period are times of persistent HIV risk, at rates similar to "high risk" cohorts. MTCT risk was elevated among women with incident infections. Detection and prevention of incident HIV in pregnancy/postpartum should be prioritized, and is critical to decrease MTCT.

  11. Risk factors for venous thromboembolism in 1.3 million pregnancies: a nationwide prospective cohort.

    Directory of Open Access Journals (Sweden)

    Rie Adser Virkus

    Full Text Available OBJECTIVE: To quantify risk factors for venous thromboembolism during pregnancy and the puerperal period. DESIGN: In a nationwide prospective cohort study we followed pregnant and puerperal women in Denmark from 1995 to 2009 for venous thromboembolism. Information on risk factors and confounders was retrieved from national registries. The diagnosis of venous thromboembolism was confirmed through medical charts. We calculated adjusted incidence rates per 10,000 women years and used Poisson regression to estimate effects during pregnancy and the puerperal period. RESULTS: We studied 1,297,037 pregnancies and related puerperal periods, during which there were 748 venous thromboembolisms. The incidence rate for venous thromboembolism during a pregnancy with and without hospitalization for hyperemesis was 15.2/10,000 yr and 6.3/10,000 yr, respectively, (adjusted rate ratio: 2.5 (95%-confidence interval; 1.4-4.5. The incidence rate among women with multiple pregnancies was 18.2/10,000 yr and 6.3/10,000 yr in singletons (adjusted rate ratio: 2.8 (1.9-4.2. Increased risk was found with hospitalization during pregnancy or the puerperal period with incidence rates of 42.1/10.000 and 54.7/10.000, respectively, (rate ratios: 12.2 (8.7-17 and 5.9 (4.0-8.8. Women hospitalized with infections during pregnancy had incidence rates of 25.9/10,000 yr and 29.3/10,000 yr during pregnancy and the puerperal period, respectively, and of 62.7/10,000 yr if hospitalized with infection in the puerperal period. Puerperal venous thromboembolism was associated with hospitalization for preeclampsia and intrauterine growth restriction/fetal death with incidence rates of 45.8/10,000 yr and 18.3/10,000 yr, respectively (rate ratio: 5.0 (3.1-7.8 and 1.9 (0.9-4.4. Additionally puerperal venous thromboembolism was associated with obesity, elective and acute caesarean sections and major postpartum bleeding with incidence rates of 25.5/10,000 yr, 23.2/10,000 yr, 34.0/10,000 yr and 20

  12. Pregnancy during Adolescence and Associated Risks: An 8-Year Hospital-Based Cohort Study (2007–2014) in Romania, the Country with the Highest Rate of Teenage Pregnancy in Europe

    Science.gov (United States)

    Socolov, Demetra-Gabriela; Carauleanu, Alexandru; Ilea, Ciprian; Blidaru, Iolanda; Boiculese, Lucian; Socolov, Razvan-Vladimir

    2017-01-01

    Aim. To determine pregnancy and delivery outcomes among teenagers. Materials and Methods. An 8-year retrospective comparative hospital-based cohort study is analysing singleton pregnancy comorbidities and delivery parameters of a teenage group under the age of 20 compared with a young adult group 20–24 years of age in a university hospital. Results. Teenage is a risk factor for preterm birth teenagers than in adults (0.75 [0.70–0.80]). The following comorbidities are risk factors for teenage pregnancy (risk ratio [CI 95%]): anaemia (1.13 [1.10–1.17]), low urinary tract infection (1.10 [1.03–1.18]), pediculosis (2.42 [1.90–3.00]), anogenital condyloma (1.50 [1.04–2.17]), and trichomoniasis (1.74 [1.12–2.68]). The risks for hepatitis B and hepatitis C, premature rupture of membranes, and placenta praevia were lower compared with those in the young adult group, respectively, 0.43 (0.26–0.71), 0.90 (0.85–0.96), and 0.29 (0.20–0.41), while the risk for gestational diabetes and preeclampsia were the same in both groups. Conclusion. Considering the high risks for teenage pregnancy, this information should be provided to pregnant adolescent women and their caregivers. PMID:28133615

  13. Pregnancy dur