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Sample records for pregnancy study design

  1. Studying time to pregnancy by use of a retrospective design

    DEFF Research Database (Denmark)

    Joffe, Michael; Key, Jane; Best, Nicky

    2005-01-01

    Biologic fertility can be measured using time to pregnancy (TTP). Retrospective designs, although lacking detailed timed information about behavior and exposure, are useful since they have a well-defined target population, often have good response rates, and are simpler and less expensive...... at the beginning of unprotected intercourse. More complete inference is possible if the study design covers the whole population, not just those who achieve a pregnancy....

  2. Etiology and prognosis of pregnancy-related pelvic girdle pain; design of a longitudinal study

    Directory of Open Access Journals (Sweden)

    Kroese Mariëlle EAL

    2005-01-01

    Full Text Available Abstract Background Absence of knowledge of pregnancy-related pelvic girdle pain (PPGP has prompted the start of a large cohort study in the Netherlands. The objective of this study was to investigate the prevalence and incidence of PPGP, to identify risk factors involved in the onset and to determine the prognosis of pregnancy-related pelvic girdle pain. Methods/design 7,526 pregnant women of the southeast of the Netherlands participated in a prospective cohort study. During a 2-year period, they were recruited by midwives and gynecologists at 14 weeks of pregnancy. Participants completed a questionnaire at baseline, at 30 weeks of pregnancy, at 2 weeks after delivery, at 6 months after delivery and at 1 year after delivery. The study uses extensive questionnaires with questions ranging from physical complaints, limitations in activities, restriction in participation, work situation, demographics, lifestyle, pregnancy-related factors and psychosocial factors. Discussion This large-scale prospective cohort study will provide reliable insights in incidence, prevalence and factors related to etiology and prognosis of pregnancy-related pelvic girdle pain.

  3. INNOVATIVE CLOTHING DESIGN FOR WOMEN DURING PREGNANCY

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    POPESCU Georgeta

    2015-05-01

    Full Text Available During pregnancy there is an evident change in the physical appearance of a woman's body. The most evident change is the substantial weight gain, increased abdominal region, torso and hip, and limbs thickening. Physical changes leads to the need of a wardrobe changing, especially in the fourth month of pregnancy. Given these factors the question arises is to identify the transformations of body conformation and ensure a maximum comfort in developing clothing products for this category. Because it is a continuous transformation, the products must be designed to be adjustable and versatile, ensuring their usability for a long period of the pregnancy and even after birth. The paper presents the specific algorithms for body conformations during pregnancy and the patterns designed based on these algorithms with the proper modifications. The principle of designing clothes for pregnant women refers to the introduction of pregnancy-related size changes in the standard method of pattern design. The research was conducted by INCDTP during the initial stage of a project, financed through national founds, consisting in a documentary study on morphologic indicators of women during the pregnancy period, the changes observe and their application in pattern design. Following the principles specific to the product group studied regarding comfort and style, INCDTP specialists have developed and produced a collection of clothing products for women during pregnancy. Key words: Pregnancy, algorithms, proportions, morphological indices, pattern design, clothing, changes

  4. Blood pressure, edema and proteinuria in pregnancy. 3. Study design, population and data characteristics.

    Science.gov (United States)

    Vollman, R F

    1976-01-01

    1. The mean blood pressure runs a curvilinear pattern during the course of pregnancy, with the lowest reading between 20 and 27 weeks of gestation, a continuous rise from 28 to 36 weeks, followed by a plateau. 2. the mean blood pressure in pregnancies without edema and proteinuria are lowest throughout pregnancy. However, the mean blood pressures in pregnancies complicated by edema, proteinuria, or both, are less than 5 mm. Hg higher after 28 weeks of gestation. 3. The mean blood pressures are lower in black gravidas than in white gravidas throughout pregnancy, independent of the presence or absence of edema, proteinuria, or their combinations. 4. The mean blood pressure is related to age and parity. Median-age gravidas (20-34 years) of parity 1-5 have the lowest mean blood pressures overall at any time during gestation. The mean blood pressure of nulliparas, independent of age, is elevated over the mean blood pressure of comparable multiparas. Independent of parity, maternal age systematically affects the mean blood pressure. 5. The standard deviations for the mean diastolic and systolic blood pressures are approximately 9 and 11 mm. Hg, respectively, independent of the weeks of gestation. They are affected very little by the absence or presence of edema or proteinuria, or both. 6. Edema of hands and/or face occurs more often in black gravidas. 7. The overall perinatal mortality rates in pregnancies complicated by edema are not higher than in pregnancies without edema. Perinatal mortality rates in pregnancies with proteinuria, or edema and proteinuria, on the other hand, are approximately double the rates for pregnancies without edema and proteinuria.

  5. Pregnancy as a Window to Future Cardiovascular Health: Design and Implementation of the nuMoM2b Heart Health Study.

    Science.gov (United States)

    Haas, David M; Ehrenthal, Deborah B; Koch, Matthew A; Catov, Janet M; Barnes, Shannon E; Facco, Francesca; Parker, Corette B; Mercer, Brian M; Bairey-Merz, C Noel; Silver, Robert M; Wapner, Ronald J; Simhan, Hyagriv N; Hoffman, Matthew K; Grobman, William A; Greenland, Philip; Wing, Deborah A; Saade, George R; Parry, Samuel; Zee, Phyllis C; Reddy, Uma M; Pemberton, Victoria L; Burwen, Dale R

    2016-03-15

    The National Institute of Child Health and Human Development's Nulliparous Pregnancy Outcomes Study-Monitoring Mothers-to-Be (nuMoM2b) Heart Health Study (HHS) was designed to investigate the relationships between adverse pregnancy outcomes and modifiable risk factors for cardiovascular disease. The ongoing nuMoM2b-HHS, which started in 2013, is a prospective follow-up of the nuMoM2b cohort, which included 10,038 women recruited between 2010 and 2013 from 8 centers across the United States who were initially observed over the course of their first pregnancies. In this report, we detail the design and study procedures of the nuMoM2b-HHS. Women in the pregnancy cohort who consented to be contacted for participation in future studies were approached at 6-month intervals to ascertain health information and to maintain ongoing contact. Two to 5 years after completion of the pregnancy documented in the nuMoM2b, women in the nuMoM2b-HHS were invited to an in-person study visit. During this visit, they completed psychosocial and medical history questionnaires and had clinical measurements and biological specimens obtained. A subcohort of participants who had objective assessments of sleep-disordered breathing during pregnancy were asked to repeat this investigation. This unique prospective observational study includes a large, geographically and ethnically diverse cohort, rich depth of phenotypic information about adverse pregnancy outcomes, and clinical data and biospecimens from early in the index pregnancy onward. Data obtained from this cohort will provide mechanistic and clinical insights into how data on a first pregnancy can provide information about the potential development of subsequent risk factors for cardiovascular disease.

  6. Pregnancy: a demographic study

    OpenAIRE

    Laufer, Linda

    1987-01-01

    A retrospective study of 126 pregnant females, presenting to a chiropractor’s office was made. The average age of the patient was 29.8 years. Their backgrounds were career oriented and for the majority, it was their first pregnancy. The most frequent complaint was lower back pain. The study outlines the necessity for further data on the role of the chiropractic management of the pregnant patient.

  7. Benefits of Incentives for Breastfeeding and Smoking cessation in pregnancy (BIBS): a mixed-methods study to inform trial design.

    Science.gov (United States)

    Morgan, Heather; Hoddinott, Pat; Thomson, Gill; Crossland, Nicola; Farrar, Shelley; Yi, Deokhee; Hislop, Jenni; Moran, Victoria Hall; MacLennan, Graeme; Dombrowski, Stephan U; Rothnie, Kieran; Stewart, Fiona; Bauld, Linda; Ludbrook, Anne; Dykes, Fiona; Sniehotta, Falko F; Tappin, David; Campbell, Marion

    2015-04-01

    Smoking in pregnancy and/or not breastfeeding have considerable negative health outcomes for mother and baby. To understand incentive mechanisms of action for smoking cessation in pregnancy and breastfeeding, develop a taxonomy and identify promising, acceptable and feasible interventions to inform trial design. Evidence syntheses, primary qualitative survey, and discrete choice experiment (DCE) research using multidisciplinary, mixed methods. Two mother-and-baby groups in disadvantaged areas collaborated throughout. UK. The qualitative study included 88 pregnant women/recent mothers/partners, 53 service providers, 24 experts/decision-makers and 63 conference attendees. The surveys included 1144 members of the general public and 497 health professionals. The DCE study included 320 women with a history of smoking. (1) Evidence syntheses: incentive effectiveness (including meta-analysis and effect size estimates), delivery processes, barriers to and facilitators of smoking cessation in pregnancy and/or breastfeeding, scoping review of incentives for lifestyle behaviours; (2) qualitative research: grounded theory to understand incentive mechanisms of action and a framework approach for trial design; (3) survey: multivariable ordered logit models; (4) DCE: conditional logit regression and the log-likelihood ratio test. Out of 1469 smoking cessation and 5408 breastfeeding multicomponent studies identified, 23 smoking cessation and 19 breastfeeding studies were included in the review. Vouchers contingent on biochemically proven smoking cessation in pregnancy were effective, with a relative risk of 2.58 (95% confidence interval 1.63 to 4.07) compared with non-contingent incentives for participation (four studies, 344 participants). Effects continued until 3 months post partum. Inconclusive effects were found for breastfeeding incentives compared with no/smaller incentives (13 studies) but provider commitment contracts for breastfeeding show promise. Intervention intensity

  8. Design options and sources of bias in time-to-pregnancy studies

    DEFF Research Database (Denmark)

    Olsen, Jørn

    1999-01-01

    on fecundity not only has to obtain information on waiting time, but also information on the importance of evaluation results. The use of contraceptive methods, the understanding of family planning, and behavioral changes driven by past reproductive experience are issues of importance for designing...... and interpreting results, as are other sources of bias also....

  9. Study of Women, Infant feeding, and Type 2 diabetes mellitus after GDM pregnancy (SWIFT, a prospective cohort study: methodology and design

    Directory of Open Access Journals (Sweden)

    Gunderson Erica P

    2011-12-01

    Full Text Available Abstract Background Women with history of gestational diabetes mellitus (GDM are at higher risk of developing type 2 diabetes within 5 years after delivery. Evidence that lactation duration influences incident type 2 diabetes after GDM pregnancy is based on one retrospective study reporting a null association. The Study of Women, Infant Feeding and Type 2 Diabetes after GDM pregnancy (SWIFT is a prospective cohort study of postpartum women with recent GDM within the Kaiser Permanente Northern California (KPNC integrated health care system. The primary goal of SWIFT is to assess whether prolonged, intensive lactation as compared to formula feeding reduces the 2-year incidence of type 2 diabetes mellitus among women with GDM. The study also examines whether lactation intensity and duration have persistent favorable effects on blood glucose, insulin resistance, and adiposity during the 2-year postpartum period. This report describes the design and methods implemented for this study to obtain the clinical, biochemical, anthropometric, and behavioral measurements during the recruitment and follow-up phases. Methods SWIFT is a prospective, observational cohort study enrolling and following over 1, 000 postpartum women diagnosed with GDM during pregnancy within KPNC. The study enrolled women at 6-9 weeks postpartum (baseline who had been diagnosed by standard GDM criteria, aged 20-45 years, delivered a singleton, term (greater than or equal to 35 weeks gestation live birth, were not using medications affecting glucose tolerance, and not planning another pregnancy or moving out of the area within the next 2 years. Participants who are free of type 2 diabetes and other serious medical conditions at baseline are screened for type 2 diabetes annually within the first 2 years after delivery. Recruitment began in September 2008 and ends in December 2011. Data are being collected through pregnancy and early postpartum telephone interviews, self

  10. CLINICAL STUDY OF ECTOPIC PREGNANCY

    Directory of Open Access Journals (Sweden)

    Swami

    2015-10-01

    Full Text Available An ectopic pregnancy is one in which fertilized ovum is implanted at the site other than normal uterine cavity.[1] Incidence of ectopic pregnancy is 1:160 deliveries.[2] Clinical presentation is variable from acute to chronic type. Due to its varied clinical presentation ectopic pregnancy poses great diagnostic difficulty both to obstetrician, physician and surgeons.[3] OBJECTIVE: To find out incidence in our study population and to evaluate symptomatically and clinical presentation in these patients. MATERIALS AND METHODS: Retrospective study of 34 ectopic pregnancies admitted and treated in Medical College hospital, Ujjain from 2010 to 2015 are included in the study. RESULTS: The incidence of ectopic pregnancy is more between the age group of 21-30years (73.52% and in Multigravida 64.71%. Infertility and previous tubal surgery are the high risk factors for tubal pregnancy. Pain in abdomen was present in all 34 cases, amenorrhea in 97.05% and bleeding per vagina in 76.47% cases. Syncopal attacks, vomiting were detected in 14.70% cases. Acute ectopic pregnancy was detected in 14.71% and chronic in 85.29% cases. 82.35% cases presented with adnexal mass, 79.41% with cervical motion tenderness, 50% with pallor, 32.35% with abdominal lump and tenderness and 11.76% with fullness in POD. CONCLUSION: Ectopic pregnancy is leading cause of maternal mortality in first trimester. In spite of advanced diagnostic techniques. It poses great diagnostic difficulties due to varied signs and symptoms. Previous tubal surgery pelvic inflammatory disease and infertility are the risk factors of tubal pregnancy.

  11. Design of the New Life(style study: a randomised controlled trial to optimise maternal weight development during pregnancy. [ISRCTN85313483

    Directory of Open Access Journals (Sweden)

    Seidell Jacob C

    2006-06-01

    Full Text Available Abstract Background Preventing excessive weight gain during pregnancy is potentially important in the prevention of overweight and obesity among women of childbearing age. However, few intervention studies aiming at weight management during pregnancy have been performed and most of these interventions were not as successful as expected. In this paper the design of the New Life(style study is described as well as the content of the individually tailored intervention program, which focuses on controlling weight development during pregnancy. Methods The effectiveness of the New Life(style intervention program versus usual care by midwives is evaluated in a randomised controlled trial. Women who expect their first child and visit one of the participating midwifery practices are included. The intervention is standardised in a protocol and executed by trained counsellors with the women who are randomised in the intervention group. During 5 sessions – at 18, 22, 30 and 36 weeks of pregnancy and at 8 weeks postpartum – individual weight gain is discussed in relation to weight gain guidelines for pregnant women of the American Institute of Medicine. Counsellors coach the women to maintain or optimise a healthy lifestyle, in a period of drastic physical and mental changes. Data is collected at 15, 25, 35 weeks of pregnancy and at 6, 26, and 52 weeks after delivery. Primary outcome measures are body weight, BMI, and skinfold thickness. Secondary outcome measures include physical activity, nutrition and blood levels of factors that are associated with energy homeostasis. Discussion Results of the current RCT will improve the knowledge of determinants of weight gain during pregnancy, weight retention after childbirth and of the effectiveness of the intervention program that is described. Caregivers and researchers in the field of health promotion are offered more insight in specific elements of the New Life(style intervention program.

  12. Clinical study of ectopic pregnancy.

    Science.gov (United States)

    Chhabra, S; Aher, K; Jaiswal, M

    1992-01-01

    Ectopic pregnancy remains a leading cause of maternal mortality and accounts for a sizeable proportion of infertility and ectopic recurrence. The possibility that a woman is experiencing an ectopic pregnancy must be considered when evaluating a woman, especially a sterilized woman, who has a possible pregnancy, amenorrhea, abdominal pain, or abnormal bleeding; studies have found that one in six pregnancies occurring after tubal sterilization are ectopic. The authors present a clinical study of 82 cases of ectopic pregnancy admitted to the department of Obstetrics and Gynecology of Mahatma Gandhi Institute of Medical Sciences, Sevagram. Cases of ectopic pregnancy represent 0.99% of total obstetric admissions, of whom 69.51% were diagnosed as such on admission. 40.24% of the women were older than 30 years, while 34.14% were elderly beyond third parity. 70.73% of the women presented before missing their second period. Patients presented with multiple complaints, but the most common was abdominal pain reported by 61.70%. 78.04% were admitted with an acute abdomen, but shock was present in only 7.14% of cases. The main surgical treatment modality was salpingectomy among 59.75%. There was no maternal mortality through postoperative morbidity in the form of paralytic ileus, although fever did occur in some women.

  13. Diabetes in pregnancy among indigenous women in Australia, Canada, New Zealand, and the United States: a method for systematic review of studies with different designs

    Directory of Open Access Journals (Sweden)

    Chamberlain Catherine

    2011-12-01

    Full Text Available Abstract Background Diabetes in pregnancy, which includes gestational diabetes mellitus (GDM and type 2 diabetes mellitus (T2DM, is associated with poor outcomes for both mother and infant during pregnancy, at birth and in the longer term. Recent international guidelines recommend changes to the current GDM screening criteria. While some controversy remains, there appears to be consensus that women at high risk of T2DM, including indigenous women, should be offered screening for GDM early in pregnancy, rather than waiting until 24-28 weeks as is current practice. A range of criteria should be considered before changing screening practice in a population sub-group, including: prevalence, current practice, acceptability and whether adequate treatment pathways and follow-up systems are available. There are also specific issues related to screening in pregnancy and indigenous populations. The evidence that these criteria are met for indigenous populations is yet to be reported. A range of study designs can be considered to generate relevant evidence for these issues, including epidemiological, observational, qualitative, and intervention studies, which are not usually included within a single systematic review. The aim of this paper is to describe the methods we used to systematically review studies of different designs and present the evidence in a pragmatic format for policy discussion. Methods/Design The inclusion criteria will be broad to ensure inclusion of the critical perspectives of indigenous women. Abstracts of the search results will be reviewed by two persons; the full texts of all potentially eligible papers will be reviewed by one person, and 10% will be checked by a second person for validation. Data extraction will be standardised, using existing tools to identify risks for bias in intervention, measurement, qualitative studies and reviews; and adapting criteria for appraising risk for bias in descriptive studies. External validity

  14. Paradox of Modern Pregnancy: A Phenomenological Study of Women's Lived Experiences from Assisted Pregnancy

    Science.gov (United States)

    Ranjbar, Fahimeh; Akhondi, Mohammad-Mehdi; Borimnejad, Leili; Ghaffari, Saeed-Reza; Behboodi-Moghadam, Zahra

    2015-01-01

    The purpose of our study was describing the meaning of pregnancy through Assisted Reproductive Technologies (ARTs). A qualitative design with hermeneutic phenomenology approach was selected to carry out the research. Semistructured in-depth interviews were conducted with 12 women who experienced assisted pregnancy. Three themes emerged from women's experience including finding peace in life, paradoxical feelings, and struggling to realize a dream. We concluded that pregnancy is the beginning of a new and hard struggle for women with fertility problems. The findings of our study resulted in helpful implications for the health care professionals managing assisted pregnancies. PMID:26064687

  15. Paradox of Modern Pregnancy: A Phenomenological Study of Women’s Lived Experiences from Assisted Pregnancy

    Directory of Open Access Journals (Sweden)

    Fahimeh Ranjbar

    2015-01-01

    Full Text Available The purpose of our study was describing the meaning of pregnancy through Assisted Reproductive Technologies (ARTs. A qualitative design with hermeneutic phenomenology approach was selected to carry out the research. Semistructured in-depth interviews were conducted with 12 women who experienced assisted pregnancy. Three themes emerged from women’s experience including finding peace in life, paradoxical feelings, and struggling to realize a dream. We concluded that pregnancy is the beginning of a new and hard struggle for women with fertility problems. The findings of our study resulted in helpful implications for the health care professionals managing assisted pregnancies.

  16. Psychological stress during pregnancy and stillbirth: prospective study

    DEFF Research Database (Denmark)

    Wisborg, K.; Barklin, A.; Hedegaard, M.

    2008-01-01

    ) in the population studied. Compared with women with an intermediate level of psychological stress during pregnancy, women with a high level of stress had 80% increased risk of stillbirth (relative risk = 1.8; 95% CI 1.1-3.2). Adjustment for maternal age, parity, maternal pre-pregnancy body mass index, smoking......OBJECTIVE: To study the association between psychological stress during pregnancy and stillbirth. DESIGN: Prospective follow-up study. SETTING: Aarhus University Hospital, Skejby, Denmark,1989-98. POPULATION: A total of 19 282 singleton pregnancies in women with valid information about...... habits, alcohol and caffeine intake during pregnancy, education and cohabitation failed to change the result. The results remained essentially unchanged after exclusion of preterm deliveries. Exclusion of women with complications during pregnancy such as diabetes, hypertension, vaginal bleeding...

  17. CLINICAL AND EPIDEMIOLOGICAL STUDY OF CUTANEOUS MANIFESTATIONS OF PREGNANCY

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    Sharath Kumar

    2013-10-01

    Full Text Available ABSTRACT: BACKGROUND: Pregnancy is a period of profound immunologic, endocr ine, metabolic and vascular changes which are tolerated by the body for a relatively short time. Almost all pregnant women (90% may develop both physiologic and pathologic changes in the skin, nails, and hair which should be recognized and appropriately m anaged 1 . Moreover, pregnancy modifies the course of a number of pre - existing dermatological conditions. AIMS: To find out the frequency and pattern of skin changes in pregnant women i.e. physiological skin changes, dermatoses modified by pregnancy and spec ific dermatoses of pregnancy . DESIGN: Prospective descriptive study . METHODS AND MATERIAL: A total of 300 pregnant women attending antenatal OPD and those admitted in wards having symptoms related to skin and mucosa, at tertiary care centre between June 20 11 and November 2012 were studied. Patients not willing to give informed consent were only excluded. . Detailed history, clinical examination and relevant investigations were done. RESULTS: In our study age distribution of pregnancy, was in range of 16 - 30 years. Most of the cases belonged to 2 nd and 3 rd trimester (93%. Pigmentary changes were the most common non specific pregnancy dermatosis, seen in almost all cases. Of these linea nigra (87% being the commonest. Overall 54 cases showed specific dermatos es of pregnancy. Of these the most common was prurigo of pregnancy (12% followed by pruritus of pregnancy (4%, PUPPP (2%. Among the other dermatological conditions, scabies (16% was the commonest. Fungal infections were seen in 14%, viral infections in 8% and bacterial infections in 5%. CONCLUSION: Majority of the dermatoses associated with pregnancy were observed in third trimester and among multigravidas. Pigmentary changes was the commonest physiological change observed. Prurigo of pregnancy was the commonest specific dermatosis of pregnancy. There were no cases of dermatoses modified during pregnancy

  18. [Hydronephrosis in pregnancy. Ultrasonographic study].

    Science.gov (United States)

    Croce, P; Signorelli, P; Chiapparini, I; Dedè, A

    1994-04-01

    Hydronephrosis is a common pathology during pregnancy and according to some authors affects between 80 and 90% of women in the third trimester. The right side is most frequently affected. Moreover, there appears to be no relation between parity and hydronephrosis or between previous infections of the urinary tract and hydronephrosis; however its presence, especially if severe, is associated with urinary infections with a frequency which is significantly greater than in patients with a urinary tract within normal limits. There are two pathogenetic hypotheses: one identifies the inhibitory effect of progesterone and prostaglandins on muscular tone and the peristalsis of smooth ureteral muscle, with consequent dilatation and anfractuosity of the excretory tract above the pelvic brim; the other is the mechanical hypothesis based on the possible compression of the ureter caused by the pregnant womb at the level of the pelvic brim at the intersection with the ilial and ovarian vessels. One hypothesis does not exclude the other, but on the contrary they complement each other and give added plausibility to a multifactorial pathogenesis. The study of hydronephrosis in pregnancy has made considerable progress since the introduction of echotomography in image diagnosis, a low-cost method which is easy to use and does not harm the product of conception. Echographs with 3.5 MHz probes were used to carry out a prospective study by examining the kidneys and excretory tract in 370 asymptomatic pregnant women during the first, second and third trimesters of gestation.(ABSTRACT TRUNCATED AT 250 WORDS)

  19. STUDY OF OBSTETRIC COMPLICATIONS & OUTCOME OF TWIN PREGNANCY

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    Swati

    2014-10-01

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

  20. A comparative study of teenage pregnancy.

    Science.gov (United States)

    Mahavarkar, S H; Madhu, C K; Mule, V D

    2008-08-01

    Teenage pregnancy is a global problem and is considered a high-risk group, in spite of conflicting evidence. Our objective was to compare obstetric outcomes of pregnancy in teenagers and older women. This was a retrospective study of case records of pregnancies from August 2000 to July 2001. Girls aged pregnancy outcomes in older women (19-35 years) in the same hospital. The study took place in the Government General Hospital, Sangli, India, a teaching hospital in rural India, with an annual delivery rate of over 3,500. A total of 386 teenage pregnancies were compared with pregnancies in 3,326 older women. Socioeconomic data, age, number of pregnancies, antenatal care and complications, mode of delivery, and neonatal outcomes were considered. The incidence of teenage pregnancy in the study was 10%. A significant proportion of teenage pregnant mothers were in their first pregnancies. The teenage mothers were nearly three times more at risk of developing anaemia (OR = 2.83, 95% CI = 2.2-3.7, p Teenage mothers were twice as likely to develop hypertensive problems in pregnancy (OR = 2.2, 95% CI = 1.5-3.2, p teenage pregnancies are still a common occurrence in rural India in spite of various legislations and government programmes and teenage pregnancy is a risk factor for poor obstetric outcome in rural India. Cultural practices, poor socioeconomic conditions, low literacy rate and lack of awareness of the risks are some of the main contributory factors. Early booking, good care during pregnancy and delivery and proper utilisation of contraceptive services can prevent the incidence and complications in this high-risk group.

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

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    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. Direct-from-patient information on medication use: Protect pregnancy study results

    NARCIS (Netherlands)

    Dreyer, Nancy A.; Mt-Isa, Shahrul; Richardson, Jonathan L.; Laursen, Maja; Zetstra-van der Woude, Priscilla A.; De Jong-Van Den Berg, Lolkje; Jamry-Dziuria, Ana; Thomas, Simon H.L.; Blackburn, Stella C.F.

    2014-01-01

    Background: The PROTECT Pregnancy Study is a non-interventional, prospective study of pregnant women who provide information about medication use and key lifestyle factors at set intervals throughout their pregnancy, and pregnancy outcome. Objectives: This study was designed to pilot new methods of

  3. Maternal pre-pregnancy body mass index and offspring attention deficit hyperactivity disorder: a population-based cohort study using a sibling-comparison design.

    Science.gov (United States)

    Chen, Qi; Sjölander, Arvid; Långström, Niklas; Rodriguez, Alina; Serlachius, Eva; D'Onofrio, Brian M; Lichtenstein, Paul; Larsson, Henrik

    2014-02-01

    High maternal pre-pregnancy body mass index (BMI) is associated with increased risk of offspring attention deficit hyperactivity disorder (ADHD). However, the role of unmeasured familial confounding for this association remains unclear. We conducted a population-based cohort study via linkage of Swedish national and regional registers to investigate maternal pre-pregnancy BMI (underweight: BMI ADHD. We followed 673 632 individuals born in Sweden between 1992 and 2000, with prospectively collected information on maternal pre-pregnancy BMI, until they received an ADHD diagnosis or ADHD medication, death, emigration or 31 December 2009. Hazard ratios (HRs) were estimated by Cox proportional hazards models. Stratified Cox proportional hazards models were applied to data on full siblings to control for unmeasured familial confounding. At the population level, pre-pregnancy overweight/obesity was associated with increased risk of offspring ADHD (HR(overweight) = 1.23, 95% CI = 1.18-1.27, P = 0.01; HR(obesity) = 1.64, 95% CI = 1.57-1.73, P = 0.01), after adjustment for measured covariates. In full sibling comparisons, however, previously observed associations no longer remained (HR(overweight) = 0.98, 95% CI = 0.83-1.16, P = 0.82; HR(obesity) = 1.15, 95% CI = 0.85-1.56, P = 0.38). The results suggested that the association between maternal pre-pregnancy overweight/obesity and offspring ADHD could be ascribed to unmeasured familial confounding.

  4. CenteringPregnancy (CP): A Longitudinal Correlational Study Designed to Evaluate Maternal and Fetal Outcomes After Participation in CP

    Science.gov (United States)

    2014-01-10

    Centering or Traditional Prenatal care here designated as Centering and TPC 1. A second control group, designated as TPC 2 was composed by randomly...be related to Stress, Anxiety, Sense of Control or Depression Scores or perceived support mechanisms. The mechanism by which group prenatal care...model of prenatal care compared to traditional obstetric care. Both methods of prenatal care are commonly used in the US and are used here at WHMC

  5. A Screening Study on Dermatoses in Pregnancy

    Science.gov (United States)

    Tharini, GK

    2017-01-01

    Introduction Pregnancy produces many cutaneous changes, some of which are specifically related to pregnancy (dermatoses of pregnancy), some are modifiable by pregnancy and others that are common are named physiologic. These physiologic skin changes, usually do not impair the health of the mother or the fetus but some of them can be cosmetically significant and of importance to the dermatologist. Aim The present study was undertaken to find out the prevalence of the physiological and pathological skin changes in pregnancy, and to correlate the prevalence of the major cutaneous changes and diseases in relation to different trimesters of pregnancy and with gravidity. Materials and Methods A cross-sectional study was conducted during the period of August 2008 to August 2010. Ethical clearance was sought from Institutional Ethical Committee. Five hundred pregnant women were randomly selected, irrespective of the duration of pregnancy and gravidity. Detailed history and complete dermatological examination was done. Results were tabulated and analysed. Statistical analysis was done by Fisher’s exact test and Chi square test. Results Physiological skin changes were seen in 94.8% of cases, with pigmentary changes being more common (90.8%). Specific dermatoses of pregnancy were observed in 14% of cases with pruritus gravidarum being the most common (10.4%). Prevalence of infection was found to 30.8% with fungal infection being the most common (23.8%). Exacerbations of systemic lupus erythematosus and neurofibromatosis was observed. Pigmentary changes, striae gravidarum and specific dermatoses of pregnancy were observed in statistically significant proportion in primigravidas and during third trimester. Conclusion This study emphasizes that the prevalence of physiological skin changes (94.8%) was much higher than specific dermatoses (14%), stressing the fact that in most instances, the skin problems during pregnancy needs only reassurance. But meticulous observation and

  6. Rationale, design, and method of the Diabetes & Women's Health study – a study of long-term health implications of glucose intolerance in pregnancy and their determinants

    DEFF Research Database (Denmark)

    Zhang, Cuilin; Hu, Frank B; Olsen, Sjurdur F

    2014-01-01

    Women who develop gestational diabetes mellitus or impaired glucose tolerance during pregnancy are at substantially increased risk for type 2 diabetes and comorbidities after pregnancy. Little is known about the role of genetic factors and their interactions with environmental factors in determin...

  7. CLINICAL STUDY OF HEART DISEASE COMPLICATING PREGNANCY

    Directory of Open Access Journals (Sweden)

    Richa

    2014-07-01

    Full Text Available Introduction-Heart disease complicating pregnancy is considered as a high risk situation. Increased cardiac demands during the course of pregnancy potentially increase morbidity and mortality in women with underlying heart disease. AIM: To determine maternal and fetal outcome in women with heart disease complicating pregnancy, To emphasize on proper protocol for managing pregnancy complicated by heart disease, To correlate the time of booking & NYHA grading with maternal & fetal outcome. Risk of adverse outcome is more in rural population as compared to its urban counterpart. METHOD: A prospective clinical study of 25 cases of pregnancy complicated by heart disease, reporting to tertiary care hospital for delivery, was carried out to find out the incidence and maternal and fetal outcome. RESULTS: The incidence of heart disease in pregnancy in the present study was 0.6%. Most of the women (91% belonged to low socioeconomic class in the rural population. Rheumatic heart lesions constituted 77% of the cases. Mitral stenosis was the commonest lesion in 40% of cases. Ten (40% women delivered spontaneously vaginally at term. Cesarean section was performed in 14 cases (56%. There were 5 maternal deaths. There were no perinatal deaths. CONCLUSION: Early diagnosis of heart disease, regular antenatal check-up, institutional delivery, limiting family size can reduce the maternal and perinatal mortality and morbidity associated with heart disease

  8. 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/

  9. Nail alterations during pregnancy: a clinical study.

    Science.gov (United States)

    Erpolat, Seval; Eser, Ayla; Kaygusuz, Ikbal; Balci, Hatice; Kosus, Aydin; Kosus, Nermin

    2016-10-01

    During pregnancy, cutaneous and appendageal alterations manifest and may cause concern in the subject. The nails may be affected by pregnancy. This study investigated the frequency and nature of nail changes occurring during pregnancy in 312 healthy, 18-40-year-old pregnant women in gestation weeks 16-40. After a routine obstetric examination at the obstetrics and gynecology clinic at the study institution, all subjects submitted to an examination of all fingernails and toenails. Only nail alterations that had developed during pregnancy were recorded. Any nail changes that had occurred before the start of gestation were not considered. Data were presented as percentages. The Shapiro-Wilk and chi-squared tests were used to make categorical comparisons. A P-value of nail pathologies were detected in 116 (37.2%) of the 312 subjects. The most commonly found nail change was leukonychia (24.4%). Ingrown toenail (9.0%) and onychoschizia (9.0%) represented the second most common nail changes. Rapid nail growth and subungual hyperkeratosis were observed in 6.7% and 4.2%, respectively, of subjects. When the alterations were evaluated according to gestational age, the most common nail pathology was leukonychia at both 14-28 weeks (16.3%) and 29-42 weeks (27.4%) of pregnancy. Leukonychia, onychoschizia, onycholysis, and brittle nail pathologies were frequently observed at 29-42 weeks of pregnancy (P = 0.047). A large proportion of nail changes that occur during pregnancy are benign and do not require treatment. However, these changes may cause significant cosmetic stress in women.

  10. 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 ...

  11. Pregnancy and liver adenoma management: PALM-study

    Directory of Open Access Journals (Sweden)

    van Aalten Susanna M

    2012-06-01

    Full Text Available Abstract Background Hepatocellular adenoma (HCA in pregnant women requires special considerations because of the risk of hormone induced growth and spontaneous rupture, which may threaten the life of both mother and child. Due to scarcity of cases there is no evidence-based algorithm for the evaluation and management of HCA during pregnancy. Most experts advocate that women with HCA should not get pregnant or advise surgical resection before pregnancy. Whether it is justified to deny a young woman a pregnancy, as the biological behavior may be less threatening than presumed depends on the incidence of HCA growth and the subsequent clinical events during pregnancy. We aim to investigate the management and outcome of HCA during pregnancy and labor based on a prospectively acquired online database in the Netherlands. Methods/design The Pregnancy And Liver adenoma Management (PALM - study is a multicentre prospective study in three cohorts of pregnant patients. In total 50 pregnant patients, ≥ 18 years of age with a radiologically and/or histologically proven diagnosis of HCA will be included in the study. Radiological diagnosis of HCA will be based on contrast enhanced MRI. Lesions at inclusion must not exceed 5 cm. The study group will be compared to a healthy control group of 63 pregnant patients and a group of 63 pregnant patients with diabetes mellitus without HCA. During their pregnancy HCA patients will be closely monitored by means of repetitive ultrasound (US at 14, 20, 26, 32 and 38 weeks of gestation and 6 and 12 weeks postpartum. Both control groups will undergo US of the liver at 14 weeks of gestation to exclude HCA lesions in the liver. All groups will be asked to fill out quality of life related questionnaires. Discussion The study will obtain information about the behaviour of HCA during pregnancy, the clinical consequences for mother and child and the impact of having a HCA during pregnancy on the health related quality

  12. Study of Ocular Changes in Pregnancy

    Directory of Open Access Journals (Sweden)

    O K Radhakrishnan

    2016-03-01

    Full Text Available Introduction: In pregnancy, women undergo a tremendous number of systemic and ocular changes. Physiological changes occur in the cardiovascular, hormonal, metabolic, hematologic and immunologic systems. Hormonal changes are among the most prominent systemic changes in pregnant women with the placenta, maternal endocrine glands and the fetal adrenal glands combining their productivity to make a high-powered hormone factory. Aims: To evaluate the various ocular changes taking place in pregnancy in women with no other co-morbid ocular or systemic diseases and to compare ocular changes in three trimesters of pregnancy with controls of non pregnant women. Materials and Methods: The ocular changes occuring in varying stages of pregnancy in 225 pregnant women were studied and compared with 75 healthy non pregnant women. Results: Age was similar in the pregnant and non pregnant women studied. Headache was significantly more common among pregnant women when compared to non pregnant women. Diplopia was not significantly different between pregnant and non pregnant women. Intraocular pressure was significantly less among the pregnant women as compared to non pregnant women. Occurrence of conjunctival pigmentation was significantly more in pregnant women when compared to non pregnant women. There was no difference in corneal thickness when pregnant and non pregnant women were compared. Krukenberg's spindles were seen more commonly among pregnant women when compared to non pregnant women. Conclusion: Various ocular changes occur during a normal pregnancy. Knowledge of these changes can help to differentiate the physiological changes occurring in a normal pregnancy from ocular manifestation of systemic diseases. [Natl J Med Res 2016; 6(1.000: 1-4

  13. Pre-pregnancy weight status, early pregnancy lipid profile and blood pressure course during pregnancy: The ABCD study.

    Science.gov (United States)

    Oostvogels, Adriëtte J J M; Busschers, Wim B; Spierings, Eline J M; Roseboom, Tessa J; Gademan, Maaike G J; Vrijkotte, Tanja G M

    2017-01-01

    Although pre-pregnancy weight status and early pregnancy lipid profile are known to influence blood pressure course during pregnancy, little is known about how these two factors interact. The association between pre-pregnancy weight status and blood pressure course during pregnancy was assessed in the prospective ABCD study and the role (independent/mediating/moderating) of early pregnancy lipid profile in this association was determined. We included 2500 normal weight (lipids [median (IQR): 13 (12-14) weeks of gestation] and blood pressure during pregnancy [mean (SD) = 10 (2.3)]. Lipids (triglycerides, total cholesterol, apolipoprotein A1, apolipoprotein B and free fatty acids) were divided into tertiles. Multilevel piecewise linear spline models were used to describe the course of systolic and diastolic blood pressure (SBP/DBP) in four time periods during gestation for overweight and normal weight women. Both SBP (5.3 mmHg) and DBP (3.9 mmHg) were higher in overweight compared to normal weight women and this difference remained the same over all four time periods. The difference in SBP and DBP was not mediated or moderated by the lipid profile. Lipid profile had an independent positive effect on both SBP (range 1.3-2.2 mmHg) and DBP (0.8-1.1 mmHg), but did not change blood pressure course. Both pre-pregnancy weight status and early pregnancy lipid profile independently increase blood pressure during pregnancy. Improving pre-pregnancy weight status and early pregnancy lipid profile might result in a healthier blood pressure course during pregnancy.

  14. 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

  15. 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

  16. Acute burn during pregnancy: A retrospective study

    Directory of Open Access Journals (Sweden)

    Ezzatollah Rezaei

    2016-01-01

    Full Text Available Background & aim: The incidence of acute burn injuries in pregnant women is very low. Burn injuries during pregnancy are often associated with a high rate of fetal and maternal mortality and morbidity. In this study, we aimed to review the cases of acute burn during pregnancy and evaluate the outcome of these patients in Mashhad, Iran. Methods:This retrospective study was performed using the medical records of 48 pregnant women with thermal injuries over a 13-year period. Results: The results showed that 8 (16.7%, 27 (56.3%, and 13 (27.1% patients were in the first, second, and third trimesters of pregnancy. Moreover, 14 mothers (29.2% died, 24 (50.0% were discharged without any fetal problems, eight (16.7% had fetal death, 13 (27.1% had abortion, two (4.2% had normal vaginal delivery, and one (2.1% underwent normal caesarean section. Conclusion: The rate ofmaternal survival in the first and second trimesters was higher than the third one. In the third trimester, pregnancy termination is indicated only after fetal maturation.

  17. OUTCOME OF PREGNANCIES COMPLICATED BY THREATENED ABORTION IN THE SECOND TRIMESTER OF PREGNANCY - PROSPECTIVE STUDY

    Directory of Open Access Journals (Sweden)

    Rajeswary

    2015-11-01

    Full Text Available AIM: To compare the outcome of pregnancies complicated by bleeding per vaginum between 14- 20 weeks with those not complicated by bleeding per vaginum before 20 weeks. To evaluate the potential determinants of outcome such as gestational age at bleeding, number of bleeding episodes, extent of placental separation or sub chorionic bleed, incidence of complications as placenta previa, abruptio placenta, development of gestational hypertension and pre eclampsia, intra uterine growth restriction, and neonatal outcomes as birth weight, mode of delivery, neonatal ICU admission, and congenital anomalies. SETTINGS AND DESIGN: This was a prospective, comparative study, for a duration of one year. STUDY POPULATION: Cases- 100 women admitted in IMCH with first episode of bleeding per vaginum between 14- 20 weeks and continuing their pregnancy after 20 weeks. CONTROLS: 200 uncomplicated pregnancies attending antenatal outpatient clinic which were followed up till delivery. EXCLUSION CRITERIA: 1. Women with history of threatened abortion in first trimester were not included in the study. 2. Subjects age more than 35 years. 3. Previous history of abortion. 4. Any significant medical, surgical or gynecological history. RESULTS: When patients who presented with bleeding pv after completion of 1st trimester were analyzed by USS, a significant number of them had evidence of sub chorionic bleed, heavier the bleed, more the likelihood of presence of sub placental hematoma. There was no significant difference in prevalence of development of hypertensive disorders of pregnancy in both study groups. There was no significant rise in ante partum hemorrhage between cases and controls. Incidence of IUGR, PPROM, PRE TERM LABOR was significantly increased in study group. LSCS rate was not significantly different in both groups. In this study, there was no significant difference in incidence of congenital anomalies in both groups. STUDY AREA: Tertiary health center

  18. 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 ...

  19. Suicides after pregnancy in Finland, 1987-94: register linkage study.

    OpenAIRE

    1996-01-01

    OBJECTIVE: To determine rates of suicide associated with pregnancy by the type of pregnancy. DESIGN: Register linkage study. Information on suicides in women of reproductive age was linked with the Finnish birth, abortion, and hospital discharge registers to find out how many women who committed suicide had had a completed pregnancy during her last year of life. SETTING: Nationwide data from Finland. SUBJECTS: Women who committed suicide in 1987-94. RESULTS: There were 73 suicides associated ...

  20. A Study On Maternal Factors And Pregnancy Outcome In Medical College Hospital Of Jhansi City

    Directory of Open Access Journals (Sweden)

    Sandip kumar

    2005-12-01

    Full Text Available Research Question : What are the maternal factors which affect the pregnancy outcome.Objectives : To study the effects of maternal factors on the outcome of pregnancy in terms of pregnancy wastage as abortions or stillbirths and to assess the magnitude of low birth babies.Study Design: Cross-sectional studyStudy Area: maternity wards of department of obstetrics & Gynecology of M.L.B. Medical college.Jhansi (U.P. Participants : 1350 pregnant women, who were admitted in the maternity wards & their new born babies Study variables : Age, parity, education, per capita income, inter pregnancy interval Statistical analysis:Chi-square testResults : Live born babies were 81.48% while pregnancy wastage was 18.52% Among the live born babies 44.36% had normal weight at birth & 55.64% were low birth weight. Out of total pregnancy wastage, 58.80% were terminated as abortions and 41.20% as still births.

  1. Study Counters Link Between Excess Pregnancy Weight and Overweight Kids

    Science.gov (United States)

    ... Study Counters Link Between Excess Pregnancy Weight and Overweight Kids Connection is likely in the genes, researchers ... 24, 2017 (HealthDay News) -- Kids whose moms were overweight during pregnancy have increased odds of being overweight ...

  2. Unintended Pregnancy in Ethiopia: Community Based Cross-Sectional Study

    Directory of Open Access Journals (Sweden)

    Kidest Getu Melese

    2016-01-01

    Full Text Available Introduction. Unintended pregnancy is defined as a pregnancy which is a sum of mistimed pregnancy (pregnancy wanted at a later time and unwanted pregnancy (pregnancy which is not wanted at all. Unintended pregnancy is a global public health problem and its sequels are major causes for maternal and neonatal morbidity and mortality with its effect to maternal metal illness as well. Objective. To determine the prevalence and associated factors of unintended pregnancy in Debre Birhan town, northeast of Ethiopia, in 2014. Method. Community based cross-sectional study and questionnaire developed from Ethiopian demographic health survey 2011. Participants were 690 currently pregnant mothers. Association of unintended pregnancy with factors was measured with bivariate and multivariate logistic regressions. Result. In this study unintended pregnancy is found to be 23.5%. Being formerly married and never married, distance to the nearest health facility >80 minutes, gravidity >5, 1-2 parity, and partner disagreement on desired number of children are the variables significantly associated with unintended pregnancy. Conclusion. Significant proportion of unintended pregnancy is found in the study area. To minimize unintended pregnancy concerned bodies should work on the identified factors, so we can minimize maternal and neonatal morbidity and mortality and keep the health of the family specifically and country in general.

  3. Maternal pre-pregnancy body mass index and offspring attention deficit hyperactivity disorder: a population-based cohort study using a sibling-comparison design

    National Research Council Canada - National Science Library

    Chen, Qi; Sjölander, Arvid; Långström, Niklas; Rodriguez, Alina; Serlachius, Eva; D'Onofrio, Brian M; Lichtenstein, Paul; Larsson, Henrik

    2014-01-01

    ...) in relation to offspring ADHD. We followed 673 632 individuals born in Sweden between 1992 and 2000, with prospectively collected information on maternal pre-pregnancy BMI, until they received an ADHD diagnosis or ADHD medication...

  4. The use of the mHealth program Smarter Pregnancy in preconception care: Rationale, study design and data collection of a randomized controlled trial

    NARCIS (Netherlands)

    van Dijk, M.R. (Matthijs R.); Oostingh, E.C. (Elsje C.); M.P.H. Koster (M. P H); S.P. Willemsen (Sten); J.S.E. Laven (Joop); Steegers-Theunissen, R.P.M. (Régine P.M.)

    2017-01-01

    textabstractBackground: Unhealthy nutrition and lifestyle contribute to the worldwide rising prevalence of non-communicable diseases. This also accounts for the reproductive population, in which unhealthy behavior affects fertility and pregnancy outcome. Maternal smoking, alcohol consumption and ina

  5. The use of the mHealth program Smarter Pregnancy in preconception care: Rationale, study design and data collection of a randomized controlled trial

    NARCIS (Netherlands)

    van Dijk, M.R. (Matthijs R.); Oostingh, E.C. (Elsje C.); M.P.H. Koster (M. P H); S.P. Willemsen (Sten); J.S.E. Laven (Joop); R.P.M. Steegers-Theunissen (Régine)

    2017-01-01

    textabstractBackground: Unhealthy nutrition and lifestyle contribute to the worldwide rising prevalence of non-communicable diseases. This also accounts for the reproductive population, in which unhealthy behavior affects fertility and pregnancy outcome. Maternal smoking, alcohol consumption and ina

  6. The impact of nutritional fatty acids during pregnancy and lactation on early human adipose tissue development. Rationale and design of the INFAT study.

    Science.gov (United States)

    Hauner, H; Vollhardt, C; Schneider, K T M; Zimmermann, A; Schuster, T; Amann-Gassner, U

    2009-01-01

    Recent observational studies suggest that mean birth weight and body fat growth in the first year of life have increased continuously over the last decades. Both elevated birth weight and early fat mass are potential risk factors for childhood obesity. Experimental and limited clinical data suggest that the dietary ratio of n-6 to n-3 fatty acids (FAs) during pregnancy is critical for early adipose tissue growth. The aim of this randomized controlled study is to examine the effect of the supplementation with n-3 long-chain polyunsaturated FAs and reduction in the n-6/n-3 ratio in the diet of pregnant women/breast-feeding mothers on adipose tissue growth in their newborns using various methods for the assessment of body fat mass. Measurement of skinfold thickness in the newborn is the primary outcome parameter. Two hundred and four pregnant women will be recruited before the 15th week of gestation and randomly assigned to either active intervention or an isocaloric control diet. This upcoming study will explore the potential of this dietary approach to limit early adipose tissue growth and may contribute to the development of a new strategy for the primary prevention of childhood obesity. 2009 S. Karger AG, Basel.

  7. Pregnancy Outcomes in Chinese Patients with Systemic Lupus Erythematosus (SLE: A Retrospective Study of 109 Pregnancies.

    Directory of Open Access Journals (Sweden)

    Ming Ku

    Full Text Available Systemic lupus erythematosus (SLE is a multisystem autoimmune disease that primarily affects women during their reproductive years. The interaction between SLE and pregnancy remains debated. The objective of this study was to analyze the fetal and maternal outcomes of Chinese women with SLE. A total of 109 pregnancies in 83 SLE patients from June 2004 to June 2014 at a tertiary university hospital were reviewed retrospectively. Patients' characteristics, clinical and laboratory data during pregnancy were obtained from electronic medical records. After exclusion of elective abortions, the live birth rate was 61.5%. Significantly, APS (antiphospholipid syndrome, disease activity, hypertension, hypocomplementemia, thrombocytopenia, and anemia during pregnancy were more commonly observed in fetal loss pregnancies than in live birth pregnancies. Compared to the 64 women with a history of SLE, 19 women with new-onset lupus during pregnancy had worse pregnancy outcome. Furthermore, the 64 patients with a history of SLE were divided into lupus nephritis group and SLE group (non-renal involvement. We found that the lupus nephritis group had worse maternal outcome than the SLE group. We conclude that new-onset lupus during pregnancy predicts both adverse maternal and fetal outcomes, while a history of lupus nephritis predicts adverse maternal outcomes. It is essential to provide SLE women with progestational counseling and regular multispecialty care during pregnancy.

  8. Pregnancy Outcomes in Chinese Patients with Systemic Lupus Erythematosus (SLE): A Retrospective Study of 109 Pregnancies.

    Science.gov (United States)

    Ku, Ming; Guo, Shuiming; Shang, Weifeng; Li, Qing; Zeng, Rui; Han, Min; Ge, Shuwang; Xu, Gang

    2016-01-01

    Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease that primarily affects women during their reproductive years. The interaction between SLE and pregnancy remains debated. The objective of this study was to analyze the fetal and maternal outcomes of Chinese women with SLE. A total of 109 pregnancies in 83 SLE patients from June 2004 to June 2014 at a tertiary university hospital were reviewed retrospectively. Patients' characteristics, clinical and laboratory data during pregnancy were obtained from electronic medical records. After exclusion of elective abortions, the live birth rate was 61.5%. Significantly, APS (antiphospholipid syndrome), disease activity, hypertension, hypocomplementemia, thrombocytopenia, and anemia during pregnancy were more commonly observed in fetal loss pregnancies than in live birth pregnancies. Compared to the 64 women with a history of SLE, 19 women with new-onset lupus during pregnancy had worse pregnancy outcome. Furthermore, the 64 patients with a history of SLE were divided into lupus nephritis group and SLE group (non-renal involvement). We found that the lupus nephritis group had worse maternal outcome than the SLE group. We conclude that new-onset lupus during pregnancy predicts both adverse maternal and fetal outcomes, while a history of lupus nephritis predicts adverse maternal outcomes. It is essential to provide SLE women with progestational counseling and regular multispecialty care during pregnancy.

  9. CLINICAL STUDY OF LABOUR IN TWIN PREGNANCY

    Directory of Open Access Journals (Sweden)

    Amudha

    2015-07-01

    Full Text Available OBJECTIVES: The objective of the present study is to analyse the incidence of preterm labour, intrapartum complications, incidence of operative delivery both vaginal and cesarean and indications for such interventions. METHODOLOGY: A total of 150 cases of twin pregnancy were analyzed between the period of September 2012 to February 2014. These cases were stud ied with respect to period of gestation at the onset of labour, fetal presentations at the onset of labour, route and mode of delivery, indications in cases of cesarean delivery, intrapartum complications and delivery interval between twins. OBSERVATIONS A ND RESULTS: In the present study there was increased incidence of preterm labour (52.6%, fetal malpresentations (43.3%, operative vaginal delivery (29.5%, cesarean delivery (17.3%. CONCLUSION: In this study it is observed that above mentioned labour ev ents and complications double up in the event of a twin pregnancy. Regular antenatal visits, planned delivery and anticipation and identification of complications will help for better pregnancy outcome.

  10. [Study on pregnancy & embryology in Tibetan medicine].

    Science.gov (United States)

    Hong, W

    1994-01-01

    The author has studied the materials on menstruation, gestational course, embryonic development and hygiene during pregnancy recorded in ancient Tibetan medical literatures, and compared them with that in Han medicine, generally known as TCM. The article points out that Tibetan and Han medicine share some common views in pregnancy and embryology, but, in the aspects of observation and knowledge in menstruation and embryology, Tibetan medicine seems more unique. Tibetan medicine not only recorded foetal shape week by week for 38 weeks, but also presented them in color pictures to illustrate the "fish-tortois-pig" stages in its course of embryonic development which is absent in Han medicine. Tibetan medicine is very creative in its knowledge on pregnant physiology and embryology.

  11. A prospective study of the onset of symptoms of pregnancy.

    Science.gov (United States)

    Sayle, Amy E; Wilcox, Allen J; Weinberg, Clarice R; Baird, Donna D

    2002-07-01

    The objective of this study was to provide prospectively collected data on the onset of pregnancy symptoms. Two hundred twenty-one women attempting pregnancy kept daily records of the occurrence of symptoms of pregnancy. Among 136 women delivering live infants, half began experiencing symptoms by day 36 after their last menstrual period (LMP), and 89% by the end of the eighth week. Onset of symptoms occurred later in pregnancies that went on to miscarry. Among 48 women with biochemically detected pregnancy loss before 6 weeks LMP, symptoms were substantially reduced but not entirely absent. Women who smoked tobacco or marijuana tended to have delayed onset of symptoms. Nearly 90% of women with successful pregnancies experience symptoms within 8 weeks LMP. Even pregnancies lost very early (before 6 weeks) are sometimes symptomatic. The earliest symptoms do not begin until after key stages of embryogenesis, reinforcing the need for women to initiate sound health behaviors before pregnancy is apparent. Published by Elsevier Science Inc.

  12. Clinico-Epidemiological Study Of Factors Associated With Pregnancy Induced Hypertension

    Directory of Open Access Journals (Sweden)

    Amir Ali

    1998-01-01

    Full Text Available Research Question: What are the factors responsible for pregnancy induced hypertension. Objectives: To determine whether maternal, demographic, clinical and socio-economic characteristics are predictive of hypertension associated with pregnancy. Study design: Cross â€" Sectional. Participants: 728 hypertensive pregnant mothers attending the ante-natal clinic and admitted to the inpatient department of obstetric unit. Study Variables: Maternal, demographic and socio-economic characteristics. Outcome variable: Hypertension associated with pregnancy. Statistical analysis: Percentages and proportions. Results: The relative incidence of pregnancy induced hypertension was 71.29%. The critical evaluation of social and demographic characteristics of 519 cases of pregnancy induced hypertension revealed that nulliparous, young women (15-25 years belonging to low socio-economic group with lower literacy status and higher house hold work load are more vulnerable to develop pregnancy induced hypertension. Inadequate diet having low protein, rich carbohydrate and extra salt intake played a crucial role in the development of pregnancy induced hypertension. Conclusions: i since the nulliparous and younger women are vulnerable to develop pregnancy induced hypertension, the age at first pregnancy be reasonably delayed. ii Balanced diet is to be ensured through appropriate nutrition education and within t he resources of the family. iii The heavy household work is to be avoided and adequate rest and sleep be ensured in those who are at risk of developing pregnancy induced hypertension.

  13. Pregnancy in multiple sclerosis: a questionnaire study.

    Directory of Open Access Journals (Sweden)

    Nadja Borisow

    Full Text Available BACKGROUND: Multiple sclerosis (MS preferentially affects females at childbearing age. For this reason patients and treating physicians were frequently confronted with questions concerning family planning, pregnancy and birth. OBJECTIVE: The aim of this study was to evaluate the expertise about pregnancy related topics in multiple sclerosis of neurologists in private practice. METHODS: We developed a survey with 16 multiple choice questions about pregnancy related topics and sent it to neurologists in private practice in Berlin, Germany. RESULTS: 56 completed questionnaires were sent back. 54% of all questions were answered correctly, 21% of the questions were answered with "I don't know". Correct answers were more often given by physicians who treat more than 400 MS patients per year (p = 0.001. Further positive associations were found for assumed relevance of the topic (p = 0.002 and the degree of counseling (p<0.001. CONCLUSION: To provide a comprehensive counseling, MS patients with desire for children should be counseled by physicians with a lot of experience in MS treatment.

  14. Treatment of pregnancy-related pelvic girdle and/or low back pain after delivery design of a randomized clinical trial within a comprehensive prognostic cohort study [ISRCTN08477490

    Directory of Open Access Journals (Sweden)

    Klabbers Aldegonda BA

    2004-12-01

    Full Text Available Abstract Background Pregnancy-related pelvic girdle and/or low back pain is a controversial syndrome because insight in etiology and prognosis is lacking. The controversy relates to factors eliciting pain and some prognostic factors such as the interpretation of pain at the symphysis. Recent research about treatment strategies also reflects those various opinions, in fact suggesting there is professional uncertainty about the optimal approach. Currently, physiotherapists often prescribe a pain-contingent treatment regime of relative rest and avoiding several day-to-day activities. Additionally, treatment more often includes an exercise program to guide rectification of the muscle imbalance and alignment of the pelvic girdle. Effectiveness of those interventions is not proven and the majority of the studies are methodologically flawed. Investigators draw particular attention to biomedical factors but there is growing evidence that important prognostic issues such as biopsychosocial factors appear to be even more important as point of action in a treatment program. Methods/design This pragmatic randomized controlled trial is designed to evaluate the effectiveness of a tailor-made treatment program with respect to biopsychosocial factors in primary care. The effect of the experimental intervention and usual care are evaluated as they are applied in primary health care. The trial is embedded in a cohort study that is designed as a longitudinal, prospective study, which studies prevalence, etiology, severity and prognosis during pregnancy until one year after delivery. The present paper focuses on choices regarding recruitment procedures, in-/exclusion criteria and the development of a well-timed intervention. Discussion This section briefly discusses the actions taken to minimize bias in the design, the proper time-window for the experimental intervention and the contrast between the experimental intervention and usual care.

  15. 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....

  16. Overweight and obesity knowledge prior to pregnancy: a survey study

    Directory of Open Access Journals (Sweden)

    Nitert Marloes

    2011-11-01

    Full Text Available Abstract Background Overweight and obesity are associated with increased risk for pregnancy complications. Knowledge about increased risks in overweight and obese women could contribute to successful prevention strategies and the aim of this study is to assess current levels of knowledge in a pregnant population. Methods Cross sectional survey of 412 consecutive unselected women in early pregnancy in Brisbane, Australia: 255 public women attending their first antenatal clinic visit and 157 women at private maternal fetal medicine clinics undergoing a routine ultrasound evaluation prior to 20 weeks gestation. The cohort was stratified according to pre pregnancy BMI ( Results Over 75% of respondents identified that obese women have an increased risk of overall complications, including gestational diabetes and hypertensive disorders of pregnancy compared to women of normal weight. More than 60% of women asserted that obesity would increase the risk of caesarean section and less than half identified an increased risk of adverse neonatal outcomes. Women were less likely to know about neonatal complications (19.7% did not know about the effect of obesity on these than maternal complications (7.4%. Knowledge was similar amongst women recruited at the public hospital and those recruited whilst attending for an ultrasound scan at a private clinic. For most areas they were also similar between women of lower and higher BMI, but women with BMI Conclusions Many women correctly identify that overweight and obesity increases the overall risk of complications of pregnancy and childbirth. The increased risks of maternal complications associated with being obese are better known than the increased risk of neonatal complications. Maternal education status is a main determinant of the extent of knowledge and this should be considered when designing education campaigns.

  17. A study on dermatoses of pregnancy

    Directory of Open Access Journals (Sweden)

    Neerja Puri

    2013-01-01

    Full Text Available Certain dermatoses are specifically seen in pregnancy or postpartum period. It is therefore important for the clinicians to recognize and treat these cutaneous disorders to minimize maternal and fetal morbidity. The commonest pregnancy related dermatoses was polymorphic eruption of pregnancy seen in 22% patients, prurigo of pregnancy was seen in 7% patients, pemphigoid gestationis was seen in 3% patients, pruritic folliculitis of pregnancy was seen in 2% patients and intrahepatic cholestasis was seen in 1% of patients. It was seen that the skin disorders were commonest in the third trimester (60%, followed by 31% patients in second trimester and 9% patients in first trimester.

  18. Obstetric outcomes of monochorionic pregnancies conceived following assisted reproductive technology: A retrospective study

    Directory of Open Access Journals (Sweden)

    Mariano Mascarenhas

    2014-01-01

    Full Text Available Objectives : The overwhelming numbers of twins following assisted reproductive technology (ART are dichorionic twins, but monochorionic twins account for around 0.9% of post ART pregnancies. The data for post ART-monochorionic pregnancy outcomes are scarce due to the rarity of this condition. Hence, we evaluated the obstetric outcomes of monochorionic and dichorionic pregnancies conceived on ART. Settings : University teaching hospital. Study Design : A case-control study of monochorionic diamniotic (MCDA and dichorionic diamniotic (DCDA pregnancies conceived following ART treatment. Charts of all women who conceived following ART from 2008 to 2013 were screened. Among them, the monochorionic twins diagnosed in the first trimester were included and their obstetric outcome was followed-up. For comparison, an equal number of dichorionic twin pregnancies from age and body mass index matched mothers was selected. Results : The baseline clinical characteristics were similar between the two groups. MCDA group had a higher miscarriage rate (50% than the DCDA group (10%, with three seconds trimester miscarriages in the MCDA group. The live birth rates were lower in the MCDA versus DCDA group (40% vs. 90%. Among triplet pregnancies with a monochorionic component, the live birth rate was only 25%. Conclusions : Monochorionic pregnancies following ART have poorer obstetric outcomes when compared to dichorionic pregnancies. For monochorionic pregnancies following ART, intensive antenatal surveillance at a tertiary level obstetric and neonatal center may help optimize the outcome.

  19. Vaccinations given during pregnancy, 2002-2009: a descriptive study.

    Science.gov (United States)

    Naleway, Allison L; Kurosky, Samantha; Henninger, Michelle L; Gold, Rachel; Nordin, James D; Kharbanda, Elyse O; Irving, Stephanie; Craig Cheetham, T; Nakasato, Cynthia; Glanz, Jason M; Hambidge, Simon J; Davis, Robert L; Klein, Nicola P; McCarthy, Natalie L; Weintraub, Eric

    2014-02-01

    A number of studies have described influenza vaccination coverage during pregnancy but few publications have described rates of other vaccinations. To describe vaccination rates during pregnancy in the Vaccine Safety Datalink (VSD), with particular focus on vaccinations contraindicated during pregnancy. Pregnancies ending in 2002 through 2009 and vaccinations administered during these pregnancies were identified in the VSD. Vaccination rates per 1000 pregnancies during the study period were calculated by vaccine type, recommendation category, pregnancy year, maternal age, and trimester. Analyses were conducted in 2012-2013. In the VSD, 669,695 pregnancies and 141,389 vaccinations were identified. Trivalent inactivated influenza (TIV) was the most commonly administered vaccination (174.1 doses per 1000 pregnancies) and was most often administered during the 2nd and 3rd trimesters. The most common vaccines in the "consider if indicated" category were tetanus-diphtheria (6.1 per 1000) and hepatitis B (3.7 per 1000). Contraindicated vaccination was infrequent, and the majority of these were measles-mumps-rubella (MMR) (1.2 per 1000); varicella (1.0 per 1000); and live-attenuated influenza vaccine (LAIV) (0.3 per 1000). Both "consider if indicated" and contraindicated vaccines were more frequently administered during early pregnancy. TIV was the most commonly administered vaccine. With the exception of TIV, other vaccines were most frequently administered during early pregnancy and among younger women, suggesting that vaccination may occur when the woman and/or provider are unaware of the pregnancy. Contraindicated vaccines were infrequently administered during pregnancy; however, given that some women received contraindicated vaccines later in pregnancy, clearer recommendations and improved provider education may be needed. © 2013 American Journal of Preventive Medicine Published by American Journal of Preventive Medicine All rights reserved.

  20. A study of cardiovascular autonomic function in normal pregnancy

    Directory of Open Access Journals (Sweden)

    Sumana Panja

    2013-04-01

    Full Text Available Objective: The present study was designed to evaluate the physiological responses to noninvasive cardiovascular autonomic function tests in normal pregnancy and compare them with non- pregnant controls. Materials and Methods: The study population comprised of 90 apparently healthy, pregnant women divided equally into three groups based on their period of gestation and 30 otherwise healthy, non-pregnant women as controls. The standard autonomic function tests based on cardiovascular reflexes, including heart rate response tests and blood pressure response tests were performed. Result: It was observed that variability of mean between and within all the population groups and controls was significantly different. Multiple comparison analysis revealed a significantly lower Deep Breathing Difference in pregnant subjects, significant difference in Valsalva Ratio in third trimester group, a significantly lower Postural Tachycardia Index only during last trimester and a significantly higher fall in systolic blood pressure on standing only during 1st trimester. A significantly lower alteration in diastolic blood pressure during isometric handgrip in later trimesters and a significant increase in overall cardiovascular autonomic score between and within all groups were also observed. Conclusion: The observations serve to corroborate that the cardiovascular indices in pregnant women are significantly altered in comparison to non-pregnant women, thus highlighting the importance of cardiovascular monitoring during pregnancy. The study also helped to reaffirm the efficacy of simple cardiovascular reflex tests in research on pregnancy physiology.

  1. The use of the mHealth program Smarter Pregnancy in preconception care: rationale, study design and data collection of a randomized controlled trial.

    Science.gov (United States)

    van Dijk, Matthijs R; Oostingh, Elsje C; Koster, Maria P H; Willemsen, Sten P; Laven, Joop S E; Steegers-Theunissen, Régine P M

    2017-01-26

    Unhealthy nutrition and lifestyle contribute to the worldwide rising prevalence of non-communicable diseases. This also accounts for the reproductive population, in which unhealthy behavior affects fertility and pregnancy outcome. Maternal smoking, alcohol consumption and inadequate folic acid supplement use are strongly associated with fetal complications as small for gestational age, premature birth and congenital malformations. In the Netherlands 83% of the perinatal mortality rate is due to these complications and is relatively high compared to other European countries. In order to reduce this prevalence rate, preconception care should be focused on the promotion of health of prospective parents by identification and intervention on modifiable nutrition and lifestyle risk factors. We developed the personal mHealth program 'Smarter Pregnancy' (Dutch version available on: https://www.slimmerzwanger.nl ) to provide individual coaching and information to improve nutrition and lifestyle during the preconception period in order to improve health of the reproductive population and subsequent generations. Women between 18 and 45 years of age, and trying to conceive are eligible for inclusion in a randomized controlled trial. Participants are allocated either to a general population cohort or a subfertile (IVF/ICSI) population cohort. The intervention group receives personal online coaching based on the identified nutrition and lifestyle risk factors at baseline. Coaching comprises recipes, incentives, additional questions including feedback and text and e-mail messages, with a maximum of three per week. The control group only receives one recipe per week to maintain adherence to the program and prevent drop out. Screening questionnaires are send in both groups at 6, 12, 18, and 24 weeks of the program to monitor the change in the identified risk factors. We expect to demonstrate that the mHealth program 'Smarter Pregnancy' can effectively improve nutrition and

  2. Glycemic control and pregnancy outcomes in patients with diabetes in pregnancy: A retrospective study

    Directory of Open Access Journals (Sweden)

    Badurudeen Mahmood Buhary

    2016-01-01

    Full Text Available Context: Diabetes in pregnancy (DIP is either pregestational or gestational. Aims: To determine the relationship between glycemic control and pregnancy outcomes in a cohort of DIP patients. Settings and Design: In this 12-month retrospective study, a total of 325 Saudi women with DIP who attended the outpatient clinics at a tertiary center Riyadh, Saudi Arabia, were included. Subjects and Methods: The patients were divided into two groups, those with glycated hemoglobin (HbA1c ≤6.5% (48 mmol/mol and those with glycated hemoglobin (HbA1c above 6.5%. The two groups were compared for differences in maternal and fetal outcomes. Statistical Analysis Used: Independent Student's t-test and analysis of variance were performed for comparison of continuous variables and Chi-square test for frequencies. Odds ratio and 95% confidence intervals were calculated using logistic regression. Results: Patients with higher HbA1c were older (P = 0.0077, had significantly higher blood pressure, proteinuria (P < 0.0001, and were multiparous (P = 0.0269. They had significantly shorter gestational periods (P = 0.0002, more preterm labor (P < 0.0001, more perineal tears (P = 0.0406, more miscarriages (P < 0.0001, and more operative deliveries (P < 0.0001. Their babies were significantly of greater weight, had more Neonatal Intensive Care Unit (NICU admissions, hypoglycemia, and macrosomia. Conclusions: Poor glycemic control during pregnancy is associated with adverse maternal and fetal outcomes (shortened gestational period, greater risk of miscarriage, increased likelihood of operative delivery, hypoglycemia, macrosomia, and increased NICU admission. Especially at risk are those with preexisting diabetes, who would benefit from earlier diabetes consultation and tighter glycemic control before conception.

  3. Smoking during pregnancy: Childbirth and Health Study in Primary Care in Iceland

    OpenAIRE

    Erlingsdottir, Asthildur; Sigurdsson, Emil L.; Jonsson, Jon Steinar; Kristjansdottir, Hildur; Sigurdsson, Johann A.

    2014-01-01

    Abstract Objective. To study the prevalence and possible predictors for smoking during pregnancy in Iceland. Design. A cross-sectional study. Setting. Twenty-six primary health care centres in Iceland 2009–2010. Subjects. Women attending antenatal care in the 11th–16th week of pregnancy were invited to participate by convenient consecutive manner, stratified according to residency. A total of 1111 women provided data in this first phase of the cohort study. Main outcome measures. Smoking habi...

  4. The impact of African ethnicity and migration on pregnancy in women living with HIV in the UK: design and methods

    Directory of Open Access Journals (Sweden)

    Tariq Shema

    2012-08-01

    Full Text Available Abstract Background The number of reported pregnancies in women with diagnosed HIV in the UK increased from 80 in 1990 to over 1400 in 2010; the majority were among women born in sub-Saharan Africa. There is a paucity of research on how social adversity impacts upon pregnancy in HIV positive women in the UK; furthermore, little is known about important outcomes such as treatment uptake and return for follow-up after pregnancy. The aim of this study was to examine pregnancy in African women living with HIV in the UK. Methods and design This was a two phase mixed methods study. The first phase involved analysis of data on approximately 12,000 pregnancies occurring between 2000 and 2010 reported to the UK’s National Study of HIV in Pregnancy and Childhood (NSHPC. The second phase was based in London and comprised: (i semi-structured interviews with 23 pregnant African women living with HIV, 4 health care professionals and 2 voluntary sector workers; (ii approximately 90 hours of ethnographic fieldwork in an HIV charity; and (iii approximately 40 hours of ethnographic fieldwork in a Pentecostal church. Discussion We have developed an innovative methodology utilising epidemiological and anthropological methods to explore pregnancy in African women living with HIV in the UK. The data collected in this mixed methods study are currently being analysed and will facilitate the development of appropriate services for this group.

  5. The study of serum calcium and serum magnesium in pregnancy induced hypertension and normal pregnancy

    Directory of Open Access Journals (Sweden)

    Jagannath Pairu

    2015-02-01

    Full Text Available Background: Preeclampsia along with its complications is one of the major causes of maternal and fetal mortality and morbidity. Association of calcium and magnesium with pregnancy induced hypertension is known since decades. Evidence of decreased serum calcium and decreased serum magnesium has been observed in patients with pregnancy induced hypertension and has been implicated in the etiopathogenesis of preeclampsia. Methods: The present study was undertaken in 100 pregnant women. Data for the study was collected from 50 normotensive pregnant women with more than 20 weeks of gestational age (control group and 50 pregnancy induced hypertension patients (study group attending for the antenatal care in department of obstetrics and gynaecology in Vanivilas hospital, Bowring and Lady Curzon hospital attached to Bangalore medical college and research institute. Cases and controls were matched. Serum calcium and serum magnesium levels were estimated by spectrophotometry method. Results: The mean serum calcium is significantly lower in pregnancy induced hypertension group (8.15 +/- 0.37 mg/dl compared to normal pregnancy (9.16 +/- 0.82 mg/dl. The mean serum magnesium is lower in pregnancy induced hypertension group (1.78 +/- 0.70 mEq/L than normal pregnancy (2.08 +/- 0.46 mEq/L which is moderately significant. Conclusions: The serum calcium and serum magnesium levels are decreased in pregnancy induced hypertension patients compared to normotensive normal pregnant women, suggesting the possible role of calcium and magnesium in etiopathophysiology of pregnancy induced hypertension. [Int J Reprod Contracept Obstet Gynecol 2015; 4(1.000: 30-34

  6. Hypertensive disorders in twin pregnancy

    NARCIS (Netherlands)

    J.G. Santema (Job); E. Koppelaar (Elin); H.C.S. Wallenburg (Henk)

    1995-01-01

    textabstractObjective: To compare the incidence and severity of pregnancy-induced hypertensive disorders in twin pregnancy and in singleton gestation. Study design: Case-control study in the setting of a University Hospital. Each pregnancy of a consecutive series of 187 twin pregnancies attending th

  7. Research on vaccines during pregnancy: protocol design and assessment of safety.

    Science.gov (United States)

    Munoz, Flor M; Sheffield, Jeanne S; Beigi, Richard H; Read, Jennifer S; Swamy, Geeta K; Jevaji, Indira; Rasmussen, Sonja A; Edwards, Kathryn M; Fortner, Kimberly B; Patel, Shital M; Spong, Catherine Y; Ault, Kevin; Heine, R Philips; Nesin, Mirjana

    2013-09-13

    The Division of Microbiology and Infectious Diseases at the National Institute of Allergy and Infectious Diseases, National Institutes of Health organized a series of conferences, entitled "Enrolling Pregnant Women in Clinical Trials of Vaccines and Therapeutics", to discuss study design and the assessment of safety in clinical trials conducted in pregnant women. A panel of experts was charged with developing guiding principles for the design of clinical trials and the assessment of safety of vaccines during pregnancy. Definitions and a grading system to evaluate local and systemic reactogenicity, adverse events, and other events associated with pregnancy and delivery were developed. The purpose of this report is to provide investigators interested in vaccine research in pregnancy with a basic set of tools to design and implement maternal immunization studies which may be conducted more efficiently using consistent definitions and grading of adverse events to allow the comparison of safety reports from different trials. These guidelines and safety assessment tools may be modified to meet the needs of each particular protocol based on evidence collected as investigators use them in clinical trials in different settings and share their findings and expertise.

  8. Experiences of pregnancy among Iranian adolescents: A qualitative study

    OpenAIRE

    Dehghan-Nayeri, Nahid; Tajvidi, Mansooreh

    2014-01-01

    Background: Pregnancy rate among Iranian adolescents below 20 years of age is increasing. Pregnancy during adolescence is considered a social issue associated with medical, emotional, and social outcomes for the mother, child, and family. The current research examines the experience of pregnancy among Iranian adolescents. Materials and Methods: The qualitative content analysis method was used. A purposive sample of 14 pregnant adolescents was enrolled in the study. Deep interviews were carrie...

  9. Experiences of pregnancy among Iranian adolescents: A qualitative study

    OpenAIRE

    Dehghan-Nayeri, Nahid; Tajvidi, Mansooreh

    2014-01-01

    Background: Pregnancy rate among Iranian adolescents below 20 years of age is increasing. Pregnancy during adolescence is considered a social issue associated with medical, emotional, and social outcomes for the mother, child, and family. The current research examines the experience of pregnancy among Iranian adolescents. Materials and Methods: The qualitative content analysis method was used. A purposive sample of 14 pregnant adolescents was enrolled in the study. Deep interviews were carrie...

  10. Study of maternal and foetal outcome in multifetal pregnancy

    OpenAIRE

    Pranjal Sanjay Nimbalkar; Amarjeet Bava; Yogeshwar Nandanwar

    2016-01-01

    Background: Development of two or more foetuses simultaneously in the uterus is termed as multifetal pregnancy. Such pregnancies are associated with increased risk for both mother and child, and this risk increases with the number of offspring's. The incidence of multifetal pregnancies in LTMMC hospital, Sion during study period was 1.7%. The overall increase in prevalence of multifetal births is of concern because the corresponding increase in the rate of preterm birth compromises neonatal s...

  11. The current duration design for estimating the time to pregnancy distribution

    DEFF Research Database (Denmark)

    Gasbarra, Dario; Arjas, Elja; Vehtari, Aki

    2015-01-01

    This paper was inspired by the studies of Niels Keiding and co-authors on estimating the waiting time-to-pregnancy (TTP) distribution, and in particular on using the current duration design in that context. In this design, a cross-sectional sample of women is collected from those who are currently...... attempting to become pregnant, and then by recording from each the time she has been attempting. Our aim here is to study the identifiability and the estimation of the waiting time distribution on the basis of current duration data. The main difficulty in this stems from the fact that very short waiting...

  12. Outcome of Multifetal Pregnancy Reduction in Women with a Dichorionic Triamniotic Triplet Pregnancy to a Singleton Pregnancy : A Retrospective Nationwide Cohort Study

    NARCIS (Netherlands)

    Van De Mheen, L.; Everwijn, S. M P; Haak, M. C.; Manten, G. T R; Zondervan, H. A.; Knapen, M. F C M; Engels, M. A J; Erwich, J. J H M; Coumans, A. B.; Van Vugt, J. M G; Bilardo, C. M.; Van Pampus, M. G.; De Groot, C. J M; Mol, B. W J; Pajkrt, E.

    2016-01-01

    Objective: To study the pregnancy outcomes of women with a dichorionic triamniotic triplet pregnancy that was reduced to a singleton pregnancy and to review the literature. Methods: We performed a nationwide retrospective cohort study. We compared time to delivery and perinatal mortality in dichorio

  13. Pregnancy outcome after use of cranberry in pregnancy--the Norwegian Mother and Child Cohort Study.

    Science.gov (United States)

    Heitmann, Kristine; Nordeng, Hedvig; Holst, Lone

    2013-12-07

    Cranberry is one of the most commonly used herbs during pregnancy. The herb has been used traditionally against urinary tract infections. No studies are found that specifically address the risk of malformations after use of cranberry during pregnancy. The aim of the study was to investigate the safety of cranberry use during pregnancy, including any effects on congenital malformations and selected pregnancy outcomes. The study is based on data from The Norwegian Mother and Child Cohort Study including more than 100,000 pregnancies from 1999 to 2008. Information on use of cranberry and socio-demographic factors was retrieved from three self-administered questionnaires completed by the women in pregnancy weeks 17 and 30, and 6 months after birth. Information on pregnancy outcomes was retrieved from the Medical Birth Registry of Norway. Among the 68,522 women in the study, 919 (1.3%) women had used cranberry while pregnant. We did not detect any increased risk of congenital malformations after use of cranberry. Furthermore, the use of cranberry was also not associated with increased risk for stillbirth/neonatal death, low birth weight, small for gestational age, preterm birth, low Apgar score (preterm delivery, low birth weight, small for gestational age, low Apgar score and neonatal infections are reassuring. However, maternal vaginal bleeding should be investigated further before any firm conclusion can be drawn. Treatment guidelines on asymptomatic bacteriuria in pregnancy recommend antimicrobial therapy as the first line treatment. According to our data and the outcomes studied, cranberry does not appear to be a harmful adjunctive self-treatment.

  14. An analytic study on maternal and fetal complications as the pregnancy outcome in teenage pregnancy

    Directory of Open Access Journals (Sweden)

    Vidya A. Thobbi

    2017-01-01

    Full Text Available Background: The aim of the study is to find out the strategies on the maternal and fetal complications as the pregnancy outcome in teenage women. With modernization, teenage pregnancy rate is rapidly declining in developed countries, but it is still high in developing countries like India, and socially backward district like Vijayapur. Hence this prospective study was carried out at Al-Ameen Medical College, Vijayapur, Karnataka. Aims: (1 To find out strategies for prevention of problems of teenage pregnancies. (2 To find out strategies for prevention of perinatal mortality. Methodology: A prospective study of teenage pregnancy was carried out for two years period; all Teen Primigravidae admitted to the labour ward were taken for study. 150 cases of teenage primigravidae of 13yrs to 19yrs were studied. Cases were selected randomly and randomization was attained. Results: Teenage primigravidae who delivered comprised of 29.6% of the total term deliveries to the labour ward. In this study 72% teenage pregnancies were associated with mild to severe complications. The major maternal complications were Sever-Anemia 16%, Hypertensive Disorders of Pregnancy 18.66%, Premature Rupture of Membranes 18.21%, and. Low Birth Weight 20%, Pre-term births 6% and Stillbirths 1.33% was major adverse fetal outcome. Conclusion: Early childbearing is associated with various health risks for both mother and child. Teenage mothers are more likely to experience pregnancy related complications which often lead to raised MMR and adverse fetal outcome. But Teenage pregnancy is still a common occurrence.

  15. Terminating pregnancy for severe hypertension when the fetus is considered non-viable: a retrospective cohort study

    OpenAIRE

    Van Eerden, Leonoor; Van Oostwaard, Miriam F.; Zeeman, Gerda G.; Page-Christiaens, Godelieve C. M.; Pajkrt, Eva; Duvekot, Johannes J.; Vandenbussche, Frank P; Oei, Swan G.; Scheepers, Hubertina C. J.; van Eyck, Jim; Middeldorp, Johanna M; Koenen, Steven V.; de Groot, Christianne J. M.; Bolte, Antoinette C

    2016-01-01

    Objective: To investigate frequency and practise of termination of pregnancy for early-onset hypertensive disorders where the fetus is considered to be non-viable. Study design: Retrospective cohort study in all Dutch tertiary perinatal care centres (n = 10), between January 2000 and January 2014. All women who underwent termination of pregnancy, without fetal surveillance or intention to intervene for fetal reasons, for early-onset hypertensive disorders in pregnancy, were analyzed. Women el...

  16. A RETROSPECTIVE STUDY OF OBSTETRIC OUTCOME IN TEENAGE PREGNANCY AND OLDER PREGNANCIES

    Directory of Open Access Journals (Sweden)

    Anita Valsaladevi

    2017-07-01

    Full Text Available BACKGROUND Younger age pregnancy of the group 18 years to 19 years is characterized by adverse maternal outcomes like anaemia, hypertension, low birth weight babies and intra uterine growth restriction. A comparative retrospective study on the obstetric outcome in teenage mothers and older women was carried out. Data for the study was obtained from a hospital where considerable teenage pregnancy is reported. Evidence obtained in this study regarding antenatal complications and birth weight shows that good antenatal care and support by family and caregivers can bring down the incidence of anaemia and low birth weight babies in teenage pregnancy. The aim of the study is to compare the obstetric outcome of pregnancy in teenagers and older women in a tertiary care hospital. MATERIALS AND METHODS This was a retrospective study conducted in Government Medical College, Manjeri, Malappuram, Kerala, India for a period of three months from March 2017 to May 2017. This is a teaching hospital with annual delivery rate of around 3500. Obstetric outcome of young mothers in the age group 18 -19 years were compared to older women (20-38 years delivering in the same hospital. A total of 843 deliveries were considered, out of which 87 belonged to teenage group. They were compared in terms of social and educational data, age, number of pregnancy, antenatal care, complications, mode of delivery, birth weight, episiotomy and perineal tears. RESULTS The incidence of teenage pregnancy was fairly high. (10.3% Most of them were in their first pregnancy. A significant number of teenage pregnant mothers (72.4% had completed higher secondary education as compared to (27.6% in older women. Contrary to many prior studies, teenage pregnancies showed less anaemia (6.9% versus 12% and lesser incidence of low birth weight babies in comparison to older women. Preterm birth was higher in teenage group (33.1% and incidence of hypertensive disorders and intrauterine growth

  17. 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....

  18. Hypertension in pregnancy: A community-based study

    Directory of Open Access Journals (Sweden)

    Bharti Mehta

    2015-01-01

    Full Text Available Background: Hypertensive disorders during pregnancy occur in women with preexisting primary or secondary chronic hypertension, and in women who develop new-onset hypertension in the second half of pregnancy. The present study was undertaken to study the prevalence and correlates of hypertension in pregnancy in a rural block of Haryana. Materials and Methods: This cross-sectional study was carried out in the all 20 subcenters under Community Health Center (CHC Chiri, Block Lakhanmajra. All the pregnant women registered at the particular subcenter at a point of time of visit were included in the study. Appropriate statistical tests were used for analysis. Results: A total of 931 pregnant women were included in the present study. Prevalence of hypertension in pregnancy was found to be 6.9%. Maternal age ΃25 years, gestational period ͳ20 weeks, history of cesarean section, history of preterm delivery, and history of hypertension in previous pregnancy were found to be significantly associated with prevalence of hypertension in pregnancy. Conclusion: Nearly one in 14 pregnant women in rural areas of Haryana suffers from a hypertensive disorder of pregnancy. Early diagnosis and treatment through regular antenatal checkup is a key factor to prevent hypertensive disorders of pregnancy and its complications.

  19. Parents’ concerns about future pregnancy after stillbirth: a qualitative study

    LENUS (Irish Health Repository)

    Meaney, Sarah

    2016-07-01

    As stillbirth has a devastating impact, it is imperative to understand the importance of clinical and emotional care after stillbirth and how it influences subsequent pregnancies. The aim of the study was to gain insight into the consideration and planning of a subsequent pregnancy by parents in the weeks following stillbirth.

  20. Thrombocytopenia during pregnancy: an institutional based study

    Directory of Open Access Journals (Sweden)

    Rajshree Dayanand Katke

    2014-08-01

    Methods: The study was conducted in this tertiary institute over a period of two years and three months. 103 pregnant patients with a platelet count of or less than 100000/mL were included. The course of pregnancy was studied and the investigation profile was monitored. Results: Out of 103 cases of thrombocytopenia, 73 (70.9% patients had moderate, 30 (29.1% patients had severe thrombocytopenia. In this study 35% cases were primigravidas, 32% cases were gravida 2, 33% cases were gravida 3 to 5. Gestational thrombocytopenia was the most common etiological factor with 30.1% cases, 27.2% cases due to hypertensive disorders, 18.4% cases due to malaria followed by 12.6% cases due to dengue. In the study group the mean gestational age was 33 +/- 5.139, maximum cases belonged to gestational age 30 to and #8805;40. 14 patients (14.1% had still births. 9 patients (8.7% had Neonatal deaths (NNDs. Conclusions: The challenge to the clinician is to weigh the risks of maternal and fetal bleeding complications against the benefits of diagnostic tests and interventions. [Int J Reprod Contracept Obstet Gynecol 2014; 3(4.000: 947-951

  1. Study of Ocular Changes in Pregnancy

    OpenAIRE

    O K Radhakrishnan; Debapriya Datta; Jyoti Yadav; Priti Kumari; Vasundhara Phillips; Nimrita Nagdev

    2016-01-01

    Introduction: In pregnancy, women undergo a tremendous number of systemic and ocular changes. Physiological changes occur in the cardiovascular, hormonal, metabolic, hematologic and immunologic systems. Hormonal changes are among the most prominent systemic changes in pregnant women with the placenta, maternal endocrine glands and the fetal adrenal glands combining their productivity to make a high-powered hormone factory. Aims: To evaluate the various ocular changes taking place in pregnancy...

  2. Study of Ocular Changes in Pregnancy

    OpenAIRE

    O K Radhakrishnan; Debapriya Datta; Jyoti Yadav; Priti Kumari; Vasundhara Phillips; Nimrita Nagdev

    2016-01-01

    Introduction: In pregnancy, women undergo a tremendous number of systemic and ocular changes. Physiological changes occur in the cardiovascular, hormonal, metabolic, hematologic and immunologic systems. Hormonal changes are among the most prominent systemic changes in pregnant women with the placenta, maternal endocrine glands and the fetal adrenal glands combining their productivity to make a high-powered hormone factory. Aims: To evaluate the various ocular changes taking place in pregnancy...

  3. A clinical study of ectopic pregnancy

    Directory of Open Access Journals (Sweden)

    Shanti Sri Asuri

    2016-11-01

    Conclusions: The early diagnosis of an ectopic pregnancy is one of the greatest challenges for a physician. It requires a high index of suspicion to diagnose an ectopic pregnancy. The importance of an early diagnosis lies in the fact that the lady can be offered a conservative line of management which can definitely have a beneficial effect on her reproductive career. [Int J Reprod Contracept Obstet Gynecol 2016; 5(11.000: 3750-3753

  4. The Clinical and Ultrasonic Study of Clinically Suspected Ectopic Pregnancy: Laying Emphasis on 15 proven Ectopic Pregnancies

    Energy Technology Data Exchange (ETDEWEB)

    Byun, Myung Ho; Chung, Yung Sun [Chonnam National University College of Medicine, Gwangju (Korea, Republic of)

    2010-05-15

    Ectopic preganacies are unsuccessful pregnancies that result from implantation of fertilized ovum occurring in an aberrant area. Aside from an emergency case, the early diagnosis of ectopic pregnancy is very difficult particularly in a case with insidious onset and mild clinical manifestations. Early diagnosis not only reduces the danger, but also simplifies the management of ectopic pregnancy. Ultrasonography has been an indispensable diagnostic tool in Obstetrics and Gynecology. In the authors' experience, clinical suspected ectopic pregnancy was one of the common indications for performing ultrasonography. Since Kobayashi at al. reported the appearances of ectopic pregnancy utilizing bistable B-scan ultrasonography, the ultrasonic findings of ectopic pregnancy have been reported by many authors. But, its accuracy and reliability in the diagnosis of ectopic pregnancy are still open to controversy. The authors studied 65 cases of clinically suspected ectopic pregnancy with Picker 80 L gray scale ultrasonography from Aug. 1982 to June. 1983. There were 29 confirmed cases, of which 15 were proved to have ectopic pregnancy and 14 were proved to have diseases other than ectopic pregnancy by surgical and histopathological study or by laparoscopy and follow up study. 29 confirmed cases were reviewed. The results were as follows: 1. Among 15 ectopic pregnancies, there were 12 ampullary pregnancies, 2 isthmic pregnancies and 1 interstitial pregnancy. Among 14 cases of no ectopic pregnancy, there were 5 intrauterine pregnancies, 3 myoma uteri, 2 P.I.D., and 1 case of dermoid cyst, cystic teratoma, H-mole and tubal hematoma due to previous tuball ligation, respectively. 2. The age distribution of ectopic pregnancy was from 22 to 41 years. The common clinical manifestations of ectopic pregnancy were lower abdominal pain (73.3%), vaginal spotting or bleeding (73.3%) and amenorrhea (66.7%). 3. Positive result of urine immunologic pregnancy test was 28.6% in ectopic

  5. The study of HIV and antenatal care integration in pregnancy in Kenya: design, methods, and baseline results of a cluster-randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Janet M Turan

    Full Text Available Despite strong evidence for the effectiveness of anti-retroviral therapy for improving the health of women living with HIV and for the prevention of mother-to-child transmission (PMTCT, HIV persists as a major maternal and child health problem in sub-Saharan Africa. In most settings antenatal care (ANC services and HIV treatment services are offered in separate clinics. Integrating these services may result in better uptake of services, reduction of the time to treatment initiation, better adherence, and reduction of stigma.A prospective cluster randomized controlled trial design was used to evaluate the effects of integrating HIV treatment into ANC clinics at government health facilities in rural Kenya. Twelve facilities were randomized to provide either fully integrated services (ANC, PMTCT, and HIV treatment services all delivered in the ANC clinic or non-integrated services (ANC clinics provided ANC and basic PMTCT services and referred clients to a separate HIV clinic for HIV treatment. During June 2009- March 2011, 1,172 HIV-positive pregnant women were enrolled in the study. The main study outcomes are rates of maternal enrollment in HIV care and treatment, infant HIV testing uptake, and HIV-free infant survival. Baseline results revealed that the intervention and control cohorts were similar with respect to socio-demographics, male partner HIV testing, sero-discordance of the couple, obstetric history, baseline CD4 count, and WHO Stage. Challenges faced while conducting this trial at low-resource rural health facilities included frequent staff turnover, stock-outs of essential supplies, transportation challenges, and changes in national guidelines.This is the first randomized trial of ANC and HIV service integration to be conducted in rural Africa. It is expected that the study will provide critical evidence regarding the implementation and effectiveness of this service delivery strategy, with important implications for programs striving

  6. Hypertensive disorders in twin pregnancy

    OpenAIRE

    Santema, Job; Koppelaar, Elin; Wallenburg, Henk

    1995-01-01

    textabstractObjective: To compare the incidence and severity of pregnancy-induced hypertensive disorders in twin pregnancy and in singleton gestation. Study design: Case-control study in the setting of a University Hospital. Each pregnancy of a consecutive series of 187 twin pregnancies attending the antenatal clinic and booked before a gestational age of 24 weeks was matched for maternal age, parity, and gestational age at delivery with a singleton pregnancy delivered in the same year. Prima...

  7. Prospective Study of Pregnancy and Newborn Outcomes in Mothers with West Nile Illness during Pregnancy

    Science.gov (United States)

    Pridjian, Gabriella; Sirois, Patricia A.; McRae, Scott; Hinckley, Alison F.; Rasmussen, Sonja A.; Kissinger, Patricia; Buekens, Pierre; Hayes, Edward B.; O’Leary, Dan; Kuhn, Stephanie; Swan, Kenneth F.; Xiong, Xu; Wesson, Dawn M.

    2016-01-01

    Background A previous case report of West Nile virus (WNV) illness during pregnancy suggested that WNV could be a cause of congenital defects. We performed a prospective, longitudinal cohort study of pregnant women with WNV illness to increase our knowledge of the effects of WNV illness during pregnancy. Methods Participants were enrolled in 2005 to 2008 from pregnant women with serologically confirmed WNV illness reported to the Centers for Disease Control and Prevention. Comparison was made to WNV-uninfected women, matched on maternal age and enrollment month. Pregnancy and newborn data were collected; cord blood WNV serology was obtained. Pediatric exams and the Bayley Scales of Infant and Toddler Development-Third Edition (Bayley-III) were performed. Results Twenty-eight WNV-infected mothers and 25 WNV-uninfected mothers participated. Maternal demographics were similar except for a higher rate of planned pregnancies, education, and household income in the WNV-uninfected mothers. There were no differences in pregnancy and delivery characteristics except that infected mothers had a higher incidence of febrile illnesses and used more medications. Birth weight, length, head circumference, and rate of congenital malformations were similar in babies born to WNV-infected and -uninfected mothers. Follow-up physical exams were generally normal. The Bayley-III assessments, available for 17 children born to mothers with WNV illness, showed performance at or above age level across domains. Conclusion The risk for adverse pregnancy and newborn outcomes in women experiencing WNV illness in pregnancy appears to be low, but future studies with larger numbers are needed to rule out a small risk. PMID:27223334

  8. Transitions in pregnancy planning in women recruited for a large prospective cohort study.

    Science.gov (United States)

    Luderer, U; Li, T; Fine, J P; Hamman, R F; Stanford, J B; Baker, D

    2017-06-01

    Do the rates at which women transition among different intensities of pregnancy planning vary with age, marital status and race/ethnicity? Rates of transition from low or moderate pregnancy probability groups (PPGs) to higher PPGs vary by age, marital status and race/ethnicity. The design of prospective studies of the effects of pre- and peri-conception exposures on fecundity, pregnancy and children's health is challenging because at any specific time only a small percentage of reproductive age women is attempting to conceive. To our knowledge, there has been no population-based, prospective study that repeatedly assessed pregnancy planning, which included women who were not already planning pregnancy at enrollment and whose ages spanned the female reproductive age range. A longitudinal study was carried out that repeatedly assessed pregnancy probability in 12 916 women for up to 21 months from January 2009 to September 2010. We analyzed data from the National Children's Study Vanguard Study, a pilot study for a large-scale epidemiological birth cohort study of children and their parents. During the Vanguard Study, investigators followed population-based samples of reproductive age women in each of seven geographically dispersed and diverse study locations over time to identify when they sought to become pregnant, providing a unique opportunity to prospectively assess changes in pregnancy planning in a large sample of US women. At study entry and each follow-up contact, which occurred at 1, 3 or 6 month intervals depending on PPG, a questionnaire was used to assess behavior dimensions of pregnancy planning to assign women to low, moderate, high non-tryer and high tryer PPGs. Crude rates of pregnancy increased with higher assigned PPG, validating the utility of the instrument. The initial PPG and probabilities of transitioning from low or moderate PPG to higher PPG or pregnancy varied with age, marital status and race/ethnicity. Women aged 25 to planning behavior in

  9. Pregnancy in Women with Systemic Lupus Erythematosus: A Retrospective Study of 83 Pregnancies at a Single Centre

    Directory of Open Access Journals (Sweden)

    Shanying Chen

    2015-08-01

    Full Text Available Objective: To evaluate the outcome of 80 pregnant women with systemic lupus erythematosus (SLE and explore the risk factors for lupus flare, obstetric complications and fetal loss. Methods: 83 pregnancies in 80 women were divided into three groups. Group A: patients in remission for > 6 months before pregnancy, proteinuria < 0.5 g per day, without renal failure and discontinuation of cytotoxic drugs for > one year; Group B: patients with SLE disease activity in the six months before pregnancy; Group C: patients with new onset SLE during pregnancy. Results: In group A, 76.47% pregnancies achieved full-term deliveries and 80.39% achieved live born infants. In group B and C, the outcome was poor. Among 62 patients (64 pregnancies diagnosed as SLE before pregnancy, SLE flares occurred in 27 (42.19% pregnancies. SLE disease activity in the six months before pregnancy was significantly associated with lupus flare (OR 5.00, 95% CI 1.14–21.87, p = 0.03 and fetal loss. New onset lupus during pregnancy was independently associated with obstetric complications (OR 7.22, 95% CI 2.14–24.38, p = 0.001. Conclusions: The current study confirmed the previous report that SLE should be considered a high risk of pregnancy. If pregnancy is planned after remission for > 6 months, the favorable outcome can be achieved.

  10. Birth outcomes after exposure to mebendazole and pyrvinium during pregnancy - A Danish nationwide cohort study

    DEFF Research Database (Denmark)

    Torp-Pedersen, Arendse; Jimenez-Solem, Espen; Cejvanovic, Vanja;

    2016-01-01

    worldwide. Limited safety data of anthelmintics during pregnancy exists and the purpose of this study was to investigate the association between exposure to mebendazole or pyrvinium during pregnancy and the adverse pregnancy outcomes: congenital malformations, stillbirths, neonatal mortality and small...

  11. Aspirin in pregnancy : clinical and biochemical studies

    NARCIS (Netherlands)

    H.A. Bremer (Henk)

    1994-01-01

    textabstractAspirin, acetylsalicylic acid, is the most frequently consumed drug in pregnancy,47 mostly taken without a prescription because of headache or a minor ailment. 226,277 Numerous preparations containing acetylsalicylic acid are freely available over the counter under a variety of proprieta

  12. Effects of 25OHD concentrations on chances of pregnancy and pregnancy outcomes: a cohort study in healthy Danish women

    DEFF Research Database (Denmark)

    Streym, Súsanna við; Møller, Ulla Kristine; Heickendorff, Lene;

    2012-01-01

    BACKGROUND/OBJECTIVES: Plasma 25-hydroxyvitamin D (P-25OHD) concentrations may affect pregnancy outcomes. To elucidate this further, we studied the effects of pre-conception P-25OHD concentrations on chances for pregnancy as well as the effects of P-25OHD during pregnancy on the risk of miscarriage...... compared with the controls. CONCLUSION: P-25OHD concentrations did not affect fertility or pregnancy outcomes, although low P-25OHD may be associated with an increased risk of late miscarriage......., birth weight and length, Apgar score and head circumference. Moreover, we studied whether pregnancy and breastfeeding patterns affect maternal P-25OHD concentrations. SUBJECTS/METHODS: A total of 153 healthy Caucasian women with pregnancy plans were followed with measurements performed before pregnancy...

  13. Effects of 25OHD concentrations on chances of pregnancy and pregnancy outcomes: a cohort study in healthy Danish women

    DEFF Research Database (Denmark)

    Streym, Súsanna við; Møller, Ulla Kristine; Heickendorff, Lene

    2012-01-01

    BACKGROUND/OBJECTIVES: Plasma 25-hydroxyvitamin D (P-25OHD) concentrations may affect pregnancy outcomes. To elucidate this further, we studied the effects of pre-conception P-25OHD concentrations on chances for pregnancy as well as the effects of P-25OHD during pregnancy on the risk of miscarria...... compared with the controls. CONCLUSION: P-25OHD concentrations did not affect fertility or pregnancy outcomes, although low P-25OHD may be associated with an increased risk of late miscarriage......., birth weight and length, Apgar score and head circumference. Moreover, we studied whether pregnancy and breastfeeding patterns affect maternal P-25OHD concentrations. SUBJECTS/METHODS: A total of 153 healthy Caucasian women with pregnancy plans were followed with measurements performed before pregnancy...

  14. Reproductive Outcomes Following Ectopic Pregnancy: Register-Based Retrospective Cohort Study

    Science.gov (United States)

    Bhattacharya, Sohinee; McLernon, David J; Lee, Amanda J; Bhattacharya, Siladitya

    2012-01-01

    Background We aimed to compare reproductive outcomes following ectopic pregnancy (EP) versus livebirth, miscarriage, or termination in a first pregnancy. Methods And Findings A retrospective cohort study design was used. Scottish national data on all women whose first pregnancy occurred between 1981 and 2000 were linked to records of a subsequent pregnancy. The exposed cohort comprised women with an EP in their first pregnancy. There were three unexposed cohorts: women with livebirth, miscarriage, and termination of their first pregnancies. Any differences in rates of second pregnancy, livebirth, EP, miscarriage, or terminations and complications of a second ongoing pregnancy and delivery were assessed among the different exposure groups. A total of 2,969 women had an initial EP; 667,299 had a livebirth, 39,705 women miscarried, and 78,697 terminated their first pregnancies. Women with an initial EP had an increased chance of another pregnancy within 2 years (adjusted hazard ratio (AHR) 2.76 [95% CI 2.58–2.95]) or after 6 years (AHR 1.57 [95% CI 1.29–1.91]) compared to women with a livebirth. In comparison with women with an initial miscarriage, women who had an EP had a lower chance of a second pregnancy (AHR 0.53 [95% CI 0.50–0.56]). Compared to women with an initial termination, women with an EP had an increased chance of a second pregnancy (AHR 2.38 [95% CI 2.23–2.55]) within 2 years. Women with an initial EP suffered an increased risk of another EP compared to women with a livebirth (AHR 13.0 [95% CI 11.63–16.86]), miscarriage (AHR 6.07 [95% CI 4.83–7.62]), or termination (AHR 12.84 [95% CI 10.07–16.37]). Perinatal complications in a pregnancy following EP were not significantly higher than those in primigravidae or in women with a previous miscarriage or termination. Conclusion Women with an initial EP have a lower chance of conception than those who miscarry but an increased risk of a repeat EP in comparison with all three comparison groups. A

  15. Most Women Stop Drinking After Positive Pregnancy Test, Study Finds

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_164006.html Most Women Stop Drinking After Positive Pregnancy Test, Study Finds Researchers 'pleasantly surprised' by fact that most quickly made the healthy choice To use the ...

  16. Zika Virus Can Damage Fetal Brain Late in Pregnancy: Study

    Science.gov (United States)

    ... https://medlineplus.gov/news/fullstory_161451.html Zika Virus Can Damage Fetal Brain Late in Pregnancy: Study ... WEDNESDAY, Oct. 12, 2016 (HealthDay News) -- The Zika virus may harm a baby's brain even if the ...

  17. Pregnancy Problems More Likely with Baby Boys, Study Suggests

    Science.gov (United States)

    ... 160159.html Pregnancy Problems More Likely With Baby Boys, Study Suggests Gender-related differences seem to start ... are more likely when women are carrying baby boys, new research suggests. After analyzing more than half ...

  18. Iranian Azeri women's perceptions of unintended pregnancy: A qualitative study

    OpenAIRE

    Mohammadi, Easa; Nourizadeh, Roghaiyeh; Simbar, Masoumeh

    2015-01-01

    Background: Many women, throughout their life cycle, experience unintended pregnancy and its subsequent induced abortion. Nonetheless, women's perceptions of this phenomenon – particularly in countries prohibiting elective abortion – are poorly known. The aim of this study was to explore Iranian Azeri women's perceptions of unintended pregnancy. Materials and Methods: This was a conventional content analysis study conducted in Tabriz, Iran. The data were collected through 31 semi-structured i...

  19. Magnesium supplement in pregnancy-induced hypertension. A clinicopathological study

    DEFF Research Database (Denmark)

    Rudnicki, M; Junge, Jette; Frølich, A;

    1990-01-01

    The placenta and the umbilical cord obtained from 18 women with pregnancy-induced hypertension were investigated by light microscopy. The umbilical artery was studied by electron microscopy. 10 placentae and umbilical cords from normal pregnancies served as controls. The study was performed...... fibrosis or intervillous fibrin. Ultrastructurally, the endothelial cells of the umbilical arteries from women with pregnancy-induced hypertension showed a significant increase in the amount of dilated endoplasmic reticulum and basal laminae thickness when all 18 cases were compared with the controls....... There was no significant difference when the magnesium group, the placebo group and the control group were compared separately. The present study suggests that magnesium supplement has a beneficial effect on fetal growth in pregnancy-induced hypertension. With regard to the light and electron microscopic changes we were...

  20. Main Risk Factors for Ectopic Pregnancy: A Case-Control Study in A Sample of Iranian Women

    Science.gov (United States)

    Parashi, Shayesteh; Moukhah, Somayeh; Ashrafi, Mahnaz

    2014-01-01

    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 (pectopic 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 strategies of its prevention through

  1. Main Risk Factors for Ectopic Pregnancy: A Case-Control Study in A Sample of Iranian Women

    Directory of Open Access Journals (Sweden)

    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

  2. Determinants Associated with Pregnancy Complications in Pregnant Women; (Case Study in Abepura, Jayapura City Health Center 2015

    Directory of Open Access Journals (Sweden)

    Rodinda Sihombing

    2016-03-01

    Full Text Available According to the World Health Organization (WHO in 2014, about 800 mothers die worldwide each day from complications related to pregnancy or childbirth. Each year approximately 20,000 women in Indonesia die from causes related to pregnancy and labor. The purpose of this study was to determine the incidence of pregnancy complications determinant in Abepura, Jayapura City Health Center in 2015. This study was an observational study design with "cross-sectional study", which is one type of the analytic study design. The sample in this study is the third trimester pregnant women who visited antenatal at health centers Abepura totaling 155 people using accidental sampling technique. All data in this study were collected through interviews using questionnaires. Analysis of the data in this study include univariate, bivariate (chi square and multivariate (logistic regression. Chi-square test results demonstrated an association iron tablet intake (p = 0.022; RP = 2, maternal age (p = 0.018; RP = 2.6, parity (p = 0.03; RP = 1.9, a history of pregnancy complications (p = 0.0001; RP = 2.9, and a history of birth complications (p = 0.002; RP = 2.6 and the incidence of pregnancy complications. While the history of infectious disease has no relationship with the incidence of pregnancy complications (p = 0.214; RP = 1.4. Multivariate analysis showed that maternal age and previous pregnancy complications are dominant factors on the incidence of pregnancy complications.

  3. Hereditary thrombophilia and recurrent pregnancy loss: a retrospective cohort study of pregnancy outcome and obstetric complications

    DEFF Research Database (Denmark)

    Lund, M; Nielsen, H S; Hviid, T V

    2010-01-01

    The association among hereditary thrombophilia, recurrent pregnancy loss (RPL) and obstetric complications is yet uncertain. The objective of the study was to assess the prognostic value of the factor V Leiden (FVL) and prothrombin (PT) mutations for the subsequent chance of live birth for women...

  4. Hereditary thrombophilia and recurrent pregnancy loss: a retrospective cohort study of pregnancy outcome and obstetric complications

    DEFF Research Database (Denmark)

    Lund, Marie; Nielsen, H S; Hviid, T V

    2010-01-01

    The association among hereditary thrombophilia, recurrent pregnancy loss (RPL) and obstetric complications is yet uncertain. The objective of the study was to assess the prognostic value of the factor V Leiden (FVL) and prothrombin (PT) mutations for the subsequent chance of live birth for women...

  5. Comparison of foetomaternal circulation in normal pregnancies and pregnancy induced hypertension using color Doppler studies.

    Science.gov (United States)

    Gupta, Shikha; Misra, R; Ghosh, U K; Gupta, V; Srivastava, D

    2014-01-01

    The aim of present study was to assess fetomaternal blood flows in normal and abnormal pregnancies using color Doppler indices. Subjects were divided into two groups as: Group A of 25 subjects of normal pregnancy as controls and group B of 25 subjects of pregnancy induced hypertension. All the subjects were lying in the age-group of 25-35 years and having 28 to 34 weeks of gestation; the patients were evaluated by detailed history and were subjected to complete general examination. Blood pressure was taken on two occasions at least 6 hours apart. Systemic examination and obstetrical examination was done in all subjects. All cases were subjected to pathological tests- Haemogram, Test for proteins in urine. Ultrasound assessment of fetal growth was done by measuring BPD (Biparietal diameter), HC (Head circumference), FL (Femur length) and AC (Abdominal circumference): Average gestational age and effective fetal weight was then calculated by ultrasound machine. Color Doppler was used to assess the various Doppler indices indices: Pulsatility index (PI), Resistive index (RI) and Systolic diastolic ratio (S/D ratio) in bilateral uterine, umbilical and middle cerebral arteries and compared to the standard normograms. Percentage of subjects having abnormal Doppler indices were calculated. Assessment of percentage of SGA (small for gestational age) fetuses was done in all the three groups. Decline in mean values of all Doppler indices was found with advancing gestational age in normal pregnancy suggesting decreased vascular resistance and increased blood flow in fetomaternal circulation. In pregnancy induced hypertensives, the mean values of Doppler indices showed a decline as in normal pregnancy but showed an increase (more than 2 S.D. of the mean) for that gestational age in comparison to the control group suggesting increased impedance to blood flow in uteroplacental and fetomaternal circulation. Umbilical artery Doppler indices were found to be the most sensitive

  6. Women's Reported Health Behaviours before and during Pregnancy: A Retrospective Study

    Science.gov (United States)

    Smedley, Jenna; Jancey, Jonine M.; Dhaliwal, Satvinder; Zhao, Yun; Monteiro, Sarojini M. D. R.; Howat, Peter

    2014-01-01

    Objective: This study aimed to determine women's reported health behaviours (physical activity, diet, weight management) before and during pregnancy, and to identify sources of health information. Design: Retrospective study incorporating quantitative (a self-completed survey) and qualitative (one-on-one interviews) methods. Methodology:…

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

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    Doke Prakash

    2012-07-01

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

  8. Ectopic pregnancy in a Caesarean section scar: a case study

    Directory of Open Access Journals (Sweden)

    Piotr Niziurski

    2013-08-01

    Full Text Available Implantation of a pregnancy in a scar after Caesarean section is one of the rarest locations of ectopic pregnancies. A diagnosis and/or treatment which is too late may lead to a uterine rupture, the necessity to remove the uterus and a significant increase in morbidity among mothers. The study presents a diagnostically difficult case of a 29-year-old woman, who was diagnosed with pregnancy in its seventh week, located in a scar after a Caesarean section, with highly increased values of human chorionic gonadotropin (β-HCG concentration in blood serum. The pregnancy was removed and the wound was stitched during laparotomy, without a need to remove the uterus.

  9. A danish national cohort study on neonatal outcome in singleton pregnancies with placenta previa

    DEFF Research Database (Denmark)

    Nørgaard, Lone N; Pinborg, Anja; Lidegaard, Ojvind

    2012-01-01

    Objective. To describe the incidence of placenta previa and to assess neonatal morbidity and mortality in pregnancies with placenta previa after adjustment for previous cesarean section, smoking, multiparity, maternal age and in-vitro fertilization. Design. National cohort study. Setting. Danish ...... score, being transferred to neonatal intensive care and for death.......Objective. To describe the incidence of placenta previa and to assess neonatal morbidity and mortality in pregnancies with placenta previa after adjustment for previous cesarean section, smoking, multiparity, maternal age and in-vitro fertilization. Design. National cohort study. Setting. Danish....... Main outcome measures. Gestational age, birthweight, Apgar score after 5min, stillbirth, neonatal mortality and admittance to neonatal intensive care unit. Results. The incidence of placenta previa in Denmark was 0.54% in 2006. Neonates born after pregnancies with placenta previa had a higher risk...

  10. PREVALENCE OF ADVERSE PREGNANCY OUTCOMES: A COMMUNITY BASED LONGITUDINAL STUDY

    Directory of Open Access Journals (Sweden)

    Vidya

    2015-06-01

    Full Text Available BACKGROUND: In most developed countries, pregnancies are planned, complications are few and outcomes are generally favorable for both mother and infant. But in developing countries, adverse pregnancy outcomes are far more frequent due to various reasons. T he most severe adverse outcome of pregnancy is the death of the mother or her offspring. Over the years maternal and child health programmes are striving to improve the health status of pregnant women and neonates. However, the adverse pregnancy outcomes ( M aternal and N eonatal still remain high. OBJECTIVE: To study the prevalence of adverse pregnancy in the study area. METHODOLOGY: A community based longitudinal study was carried out in the 36 villages of Kaiwara from January 2011 to December 2011. All the antenatal mothers were traced through Anganwadi records maintained at different villages. They were contacted at their residence and the questionnaire was administered in their local language. The questionnaire was administered during three different visi ts to collect information regarding socio - demographic details, pregnancy outcomes. The first visit was made before delivery and subsequently second and third visits were made within 7 days and 42 nd day after delivery respectively. Maternal and child protec tion cards were used to validate the collected information. Statistical analysis was performed using SPSS software version 18.0 RESULTS: The present study revealed that, the proportion of low birth weight in the study area was 31.9% (95% CI=25.74 - 38.06, p reterm birth 20.5% (95% CI=15.28 - 25.72, postnatal complications 5% (95% CI=14.819 - 9.181, abortion 2.1% (95% CI=0.25 - 3.95, maternal death 0.4% (95% CI=0.416 - 1.216 and neonatal death 0.4% (95% CI=0.416 - 1.216. CONCLUSION: The present study revealed that the proportion of adverse pregnancy outcomes was in par with the national average.

  11. Asthma during pregnancy in a population-based study--pregnancy complications and adverse perinatal outcomes.

    Directory of Open Access Journals (Sweden)

    Gustaf Rejnö

    Full Text Available BACKGROUND: Asthma is one of the most common chronic diseases, and prevalence, severity and medication may have an effect on pregnancy. We examined maternal asthma, asthma severity and control in relation to pregnancy complications, labour characteristics and perinatal outcomes. METHODS: We retrieved data on all singleton births from July 1, 2006 to December 31, 2009, and prescribed drugs and physician-diagnosed asthma on the same women from multiple Swedish registers. The associations were estimated with logistic regression. RESULTS: In total, 266 045 women gave birth to 284 214 singletons during the study period. Maternal asthma was noted in 26 586 (9.4% pregnancies. There was an association between maternal asthma and increased risks of pregnancy complications including preeclampsia or eclampsia (adjusted OR 1.15; 95% CI 1.06-1.24 and premature contractions (adj OR 1.52; 95% CI 1.29-1.80. There was also a significant association between maternal asthma and emergency caesarean section (adj OR 1.29; 95% CI 1.23-1.34, low birth weight, and small for gestational age (adj OR 1.23; 95% CI 1.13-1.33. The risk of adverse outcomes such as low birth weight increased with increasing asthma severity. For women with uncontrolled compared to those with controlled asthma the results for adverse outcomes were inconsistent displaying both increased and decreased OR for some outcomes. CONCLUSION: Maternal asthma is associated with a number of serious pregnancy complications and adverse perinatal outcomes. Some complications are even more likely with increased asthma severity. With greater awareness and proper management, outcomes would most likely improve.

  12. Reproducibility of urinary bisphenol A concentrations measured during pregnancy in the Generation R Study

    NARCIS (Netherlands)

    Jusko, T.A.; Shaw, P.A.; Snijder, C.A.; Pierik, F.H.; Koch, H.M.; Hauser, R.; Jaddoe, V.W.V.; Burdorf, A.; Hofman, A.; Tiemeier, H.; Longnecker, M.P.

    2014-01-01

    The potential human health effects of bisphenol A (BPA) exposure are a public health concern. In order to design adequately powered epidemiological studies to address potential health effects, data on the reproducibility of BPA concentration in seri al urine specimens taken during pregnancy are need

  13. Asthma medication prescribing before, during and after pregnancy : A study in seven European regions

    NARCIS (Netherlands)

    Charlton, Rachel A; Pierini, Anna; Klungsøyr, Kari; Neville, Amanda J; Jordan, Susan; Jong-van den Berg, de Lolkje; Thayer, Daniel; Bos, H Jens; Puccini, Aurora; Hansen, Anne V; Gini, Rosa; Engeland, Anders; Nybo Andersen, Anne-Marie; Dolk, Helen; Garne, Ester

    2016-01-01

    OBJECTIVES: To explore utilisation patterns of asthma medication before, during and after pregnancy as recorded in seven European population-based databases. DESIGN: A descriptive drug utilisation study. SETTING: 7 electronic healthcare databases in Denmark, Norway, the Netherlands, Italy (Emilia Ro

  14. Clinical, ultrasonographic, and endocrinological studies on donkey pregnancy.

    Science.gov (United States)

    Crisci, Angelica; Rota, Alessandra; Panzani, Duccio; Sgorbini, Micaela; Ousey, Jennifer C; Camillo, Francesco

    2014-01-15

    Although donkey breeding has gained new interest in the past two decades, knowledge about donkey reproduction is still scarce, particularly on jenny pregnancy. The aim of this study was to describe the ultrasonographic and endocrine profiles of the physiological pregnancy in the jenny. The study was performed on 12 pregnancies of 7 Amiata donkeys from Day 10 after ovulation to delivery. Because three pregnancies, respectively at weeks 42, 44, and 45, were considered pathologic and treated pharmacologically, data collected from 2 weeks before diagnosis to the end of pregnancy were removed from the analysis. Average length of the normal pregnancies was 353.4 ± 13.0 days (range, 339-370 days). Timing, dimensions, and development during the first phases of embryonic growth, evaluated using transrectal ultrasound, were similar to that previously described in jennies and mares: first detection of embryonic vesicle was at 11.8 ± 1.3 days of gestation and diameter was 6.5 ± 1.9 mm, loss of spherical shape occurred at 18.5 ± 1.4 days, and embryo and heart beat were first seen at 22.0 ± 1.1 and 25 ± 1.1 days, respectively. The intrauterine growth in the second half of pregnancy, evaluated using the transrectal and transabdominal approach, also showed strong positive correlations, similar to that reported for the mare. The trends of the combined thickness of the utero-placental unit and the echogenicity of the amniotic and allantoic fluids are examples. The diameters (mm) of fetal chest, eye orbit, and aorta increased throughout pregnancy and were 40.6 ± 2.9, 8.7 ± 1.5, and 3.5 ± 0.7, respectively, at week 13, and 190.9 ± 12.0, 21.4 ± 1.5, and 30.6 ± 1.8 at the last evaluation before parturition. In contrast, heart rate decreased as pregnancy progressed. Regression analyses between these parameters and day of gestation were statistically significant (P < 0.001). All fetuses consistently showed some intrauterine activity. Maternal plasma progestagens and estrone

  15. Experiences of physical activity during pregnancy in Danish nulliparous women with a physically active life before pregnancy. A qualitative study

    DEFF Research Database (Denmark)

    Hegaard, Hanne; Kjaergaard, Hanne; Damm, Peter P;

    2010-01-01

    National guidelines recommend that healthy pregnant women take 30 minutes or more of moderate exercise a day. Most women reduce the level of physical activity during pregnancy but only a few studies of women's experiences of physical activity during pregnancy exist. The aim of the present study w...

  16. Experiences of physical activity during pregnancy in Danish nulliparous women with a physically active life before pregnancy. A qualitative study

    DEFF Research Database (Denmark)

    Hegaard, Hanne Kristine; Kjaergaard, Hanne; Damm, Peter P;

    2010-01-01

    National guidelines recommend that healthy pregnant women take 30 minutes or more of moderate exercise a day. Most women reduce the level of physical activity during pregnancy but only a few studies of women's experiences of physical activity during pregnancy exist. The aim of the present study...

  17. Recurrent pregnancy loss

    DEFF Research Database (Denmark)

    Egerup, P; Kolte, A M; Larsen, E C

    2016-01-01

    STUDY QUESTION: Is there a different prognostic impact for consecutive and non-consecutive early pregnancy losses in women with secondary recurrent pregnancy loss (RPL)? SUMMARY ANSWER: Only consecutive early pregnancy losses after the last birth have a statistically significant negative prognostic...... impact in women with secondary RPL. WHAT IS KNOWN ALREADY: The risk of a new pregnancy loss increases with the number of previous pregnancy losses in patients with RPL. Second trimester losses seem to exhibit a stronger negative impact than early losses. It is unknown whether the sequence of pregnancy...... losses plays a role for the prognosis in patients with a prior birth. STUDY DESIGN, SIZE, DURATION: This retrospective cohort study of pregnancy outcome in patients with unexplained secondary RPL included in three previously published, Danish double-blinded placebo-controlled trials of intravenous...

  18. Magnesium supplement in pregnancy-induced hypertension. A clinicopathological study

    DEFF Research Database (Denmark)

    Rudnicki, M; Junge, Jette; Frølich, A

    1990-01-01

    The placenta and the umbilical cord obtained from 18 women with pregnancy-induced hypertension were investigated by light microscopy. The umbilical artery was studied by electron microscopy. 10 placentae and umbilical cords from normal pregnancies served as controls. The study was performed...... weight and placental weight significantly. Light microscopic study of the placentae and the umbilical cord arteries showed no difference between the three groups concerning the occurrence of infarctions, cytotrophoblastic hyperplasia, vasculo-syncytial membranes, basement membrane thickening, stromal...... fibrosis or intervillous fibrin. Ultrastructurally, the endothelial cells of the umbilical arteries from women with pregnancy-induced hypertension showed a significant increase in the amount of dilated endoplasmic reticulum and basal laminae thickness when all 18 cases were compared with the controls...

  19. Monitoring Levothyroxine Dose during Pregnancy: A Prospective Study

    Directory of Open Access Journals (Sweden)

    Juhi Agarwal

    2011-01-01

    Full Text Available Problem statement: Thyroid dysfunction in pregnant women can influence the outcome for mother and fetus at all stages of pregnancy. As the fetus is entirely dependent on maternal thyroid hormones for its development until about 13 weeks of gestation, it is important to ensure adequate thyroxine substitution in pregnant women during the first trimester. Objective: The aim of this prospective study was to explore whether hypothyroidic pregnant women are adequately levothyroxine (L-T4 substituted in early pregnancy. Approach: During March 2008 to July 2009, 93 pregnant females with thyroid diseases were followed at the outpatient department of INMAS. At the first visit 86 patients were on L-T4 substitution for hypothyroidism. Seven other patients had hyperthyroidism. The patients were regularly followed every 4-8 weeks during pregnancy for dose adjustment. Before each visit serum Free Thyroxine (FT4 and TSH concentrations were determined. Results: Of the 86 patients on thyroxine substitution for hypothyroidism 56 (65.12% had serum TSH values within the reference range at their first TSH test. Thirty (34.9% had TSH values outside the reference range. In 5 patients TSH was 4 increase at the first evaluation during pregnancy was 17.46±30.8µg day1. In the 50 patients who needed to increase L-T4, 26% reached a definitive therapeutic dosage within 12th week of pregnancy, 24% within the 20th week and 50% within the 31st week. Conclusion/Recommendations: In 34.9% of pregnant women on L-T4 substitution for hypothyroidism, serum TSH values were abnormal when first tested and they had increased chances of fetal loss if not treated timely. Thyroid function in pregnant women on thyroxine substitution should be monitored as soon as pregnancy has been confirmed and carefully followed during pregnancy.

  20. Maternal consumption of coffee during pregnancy and stillbirth and infant death in first year of life: prospective study

    DEFF Research Database (Denmark)

    Wisborg, Kirsten; Kesmodel, Ulrik; Bech, Bodil Hammer

    2003-01-01

    Objective To study the association between coffee consumption during pregnancy and the risk of stillbirth and infant death in the first year of life. Design Prospective follow up study. Setting Aarhus University Hospital, Denmark, 1989-96. Participants 18 478 singleton pregnancies in women...... with valid information about coffee consumption during pregnancy. Main outcome measures Stillbirth (delivery of a dead fetus at >28 weeks’ gestation) and infant death (death of a liveborn infant during the first year of life). Results Pregnant women who drank eight or more cups of coffee per day during...... pregnancy had an increased risk of stillbirth compared with women who did not drink coffee (odds ratio=3.0, 95% confidence interval 1.5 to 5.9). After adjustment for smoking habits and alcohol intake during pregnancy, the relative risk of stillbirth decreased slightly. Adjustment for parity, maternal age...

  1. Maternal consumption of coffee during pregnancy and stillbirth and infant death in first year of life: prospective study

    DEFF Research Database (Denmark)

    Wisborg, Kirsten; Kesmodel, Ulrik; Bech, Bodil Hammer

    2003-01-01

    pregnancy had an increased risk of stillbirth compared with women who did not drink coffee (odds ratio=3.0, 95% confidence interval 1.5 to 5.9). After adjustment for smoking habits and alcohol intake during pregnancy, the relative risk of stillbirth decreased slightly. Adjustment for parity, maternal age......Objective To study the association between coffee consumption during pregnancy and the risk of stillbirth and infant death in the first year of life. Design Prospective follow up study. Setting Aarhus University Hospital, Denmark, 1989-96. Participants 18 478 singleton pregnancies in women...... with valid information about coffee consumption during pregnancy. Main outcome measures Stillbirth (delivery of a dead fetus at >28 weeks’ gestation) and infant death (death of a liveborn infant during the first year of life). Results Pregnant women who drank eight or more cups of coffee per day during...

  2. 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...

  3. Jaundice in pregnancy: a clinical study at JSS hospital, Mysore

    OpenAIRE

    Triveni Kondareddy; Krithika KA

    2016-01-01

    Background: Jaundice in pregnancy is an important medical disorder seen more often in developing countries than in developed ones. It could be peculiar to the pregnancy viz., acute fatty liver of pregnancy, recurrent cholestatic jaundice in pregnancy and jaundice complicating toxemia of pregnancy. It can be concurrent with pregnancy such as due to infective pathology like viral hepatitis or due to gallstones or other causes. Jaundice in pregnancy carries a grave prognosis for both the fetus a...

  4. [Study of pregnancies in women with intrauterine devices of copper].

    Science.gov (United States)

    Albert, A; Carrasco, F; Dueñas, J J; Navarro, J

    1983-01-01

    The authors analyze the intrauterine pregnancies observed in women with four different models of copper IUD. The study was made in a period of 54 months on 3216 insertions. The pregnancy index oscillated between 1.22 of the ML Cu-250 and 4.13 of the 7 Cu-200 (balanced percentage). The permanence of the IUD "in situ" in pregnant women increased the incidence of spontaneous abortions. The authors do not observe infections in pregnant women with the IUD, nor do they register malformations in the newborn.

  5. Maternal pre-pregnancy obesity and achievement of infant motor developmental milestones in the Upstate KIDS Study

    OpenAIRE

    Wylie, Amanda; Sundaram, Rajeshwari; Kus, Christopher; Ghassabian, Akhgar; Yeung, Edwina H.

    2015-01-01

    Objective Maternal pre-pregnancy obesity is associated with several poor infant health outcomes; however studies that investigated motor development have been inconsistent. Thus, we examined maternal pre-pregnancy weight status and infants’ gross motor development. Design and Methods Participants consisted of 4,901 mother-infant pairs from the Upstate KIDS study, a longitudinal cohort in New York. Mothers indicated dates when infants achieved each of six gross motor milestones when infants we...

  6. Prevalence of HIV among childbearing women and women having termination of pregnancy: multidisciplinary steering group study.

    Science.gov (United States)

    Goldberg, D. J.; MacKinnon, H.; Smith, R.; Patel, N. B.; Scrimgeour, J. B.; Inglis, J. M.; Peutherer, J. F.; Urquhart, G. E.; Emslie, J. A.; Covell, R. G.

    1992-01-01

    OBJECTIVE--To determine the prevalence of HIV among pregnant women, in particular those whose behaviour or that of their partners put them at "low risk" of infection. DESIGN--Voluntary named or anonymous HIV testing of pregnant women during 21 months (November 1988 to July 1990). SUBJECTS AND SETTING--All women who planned to continue their pregnancy and attended clinics serving the antenatal populations of Edinburgh and Dundee. All women admitted for termination of pregnancy to gynaecology wards serving the pregnant populations of Dundee and outlying rural areas. MAIN OUTCOME MEASURES--Period prevalence of HIV antibody positivity. RESULTS--91% of antenatal clinic attenders and 97% of women having termination of pregnancy agreed to HIV testing on a named or anonymous basis. HIV period prevalences for antenatal clinic attenders and women having termination of pregnancy tested in Dundee were 0.13% and 0.85% respectively, and for antenatal clinic attenders tested in Edinburgh 0.26%. For those at "low risk" rates for antenatal clinic attenders and women having termination of pregnancy in Dundee were 0.11% and 0.13%, and for antenatal clinic attenders in Edinburgh 0.02%. In Dundee HIV prevalence among women having a termination of pregnancy (0.85%) was significantly greater than that among antenatal clinic attenders (0.13%). CONCLUSIONS--HIV infection is undoubtedly occurring among women at "low risk," and it is clear that a policy of selective testing of those at only "high risk" is inadequate for pregnant women living in areas of high prevalence such as Edinburgh and Dundee. Moreover, when studying pregnant populations in such areas there is the need to include those having a termination of pregnancy. PMID:1586820

  7. The Cessation in Pregnancy Incentives Trial (CPIT: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Tappin David M

    2012-07-01

    Full Text Available Abstract Background Seventy percent of women in Scotland have at least one baby, making pregnancy an opportunity to help most young women quit smoking before their own health is irreparably compromised. By quitting during pregnancy their infants will be protected from miscarriage and still birth as well as low birth weight, asthma, attention deficit disorder and adult cardiovascular disease. In the UK, the NICE guidelines: ‘How to stop smoking in pregnancy and following childbirth’ (June 2010 highlighted that little evidence exists in the literature to confirm the efficacy of financial incentives to help pregnant smokers to quit. Its first research recommendation was to determine: Within a UK context, are incentives an acceptable, effective and cost-effective way to help pregnant women who smoke to quit? Design and methods This study is a phase II exploratory individually randomized controlled trial comparing standard care for pregnant smokers with standard care plus the additional offer of financial voucher incentives to engage with specialist cessation services and/or to quit smoking during pregnancy. Participants (n = 600 will be pregnant smokers identified at maternity booking who, when contacted by specialist cessation services, agree to having their details passed to the NHS Smokefree Pregnancy Study Helpline to discuss the trial. The NHS Smokefree Pregnancy Study Helpline will be responsible for telephone consent and follow-up in late pregnancy. The primary outcome will be self reported smoking in late pregnancy verified by cotinine measurement. An economic evaluation will refine cost data collection and assess potential cost-effectiveness while qualitative research interviews with clients and health professionals will assess the level of acceptance of this form of incentive payment. The research questions are: What is the likely therapeutic efficacy? Are incentives potentially cost-effective? Is individual randomization an

  8. Longitudinal study of serum placental GH in 455 normal pregnancies

    DEFF Research Database (Denmark)

    Chellakooty, Marla; Skibsted, Lillian; Skouby, Sven Olaf

    2002-01-01

    Placental GH is thought to be responsible for the rise in maternal IGF-I during pregnancy and is considered to be important for fetal growth. In this prospective longitudinal study of healthy pregnant women, we investigated determinants of placental GH in maternal serum. Serum was obtained from 4...

  9. Impact of Pre-Pregnancy BMI on B Vitamin and Inflammatory Status in Early Pregnancy: An Observational Cohort Study

    Science.gov (United States)

    Bjørke-Monsen, Anne-Lise; Ulvik, Arve; Nilsen, Roy M.; Midttun, Øivind; Roth, Christine; Magnus, Per; Stoltenberg, Camilla; Vollset, Stein Emil; Reichborn-Kjennerud, Ted; Ueland, Per Magne

    2016-01-01

    Maternal nutrition and inflammation have been suggested as mediators in the development of various adverse pregnancy outcomes associated with maternal obesity. We have investigated the relation between pre-pregnancy BMI, B vitamin status, and inflammatory markers in a group of healthy pregnant women. Cobalamin, folate, pyridoxal 5′-phosphate, and riboflavin; and the metabolic markers homocysteine, methylmalonic acid, and 3-hydroxykynurenine/xanthurenic acid ratio (HK/XA); and markers of cellular inflammation, neopterin and kynurenine/tryptophan ratio (KTR) were determined in pregnancy week 18 and related to pre-pregnancy body mass index (BMI), in 2797 women from the Norwegian Mother and Child Cohort Study (MoBa). Pre-pregnancy BMI was inversely related to folate, cobalamin, pyridoxal 5′-phosphate (PLP), and riboflavin (p pregnant. PMID:27916904

  10. Does pre-pregnancy BMI determine blood pressure during pregnancy? : A prospective cohort study

    NARCIS (Netherlands)

    Savitri, Ary I; Zuithoff, Peter; Browne, Joyce L; Amelia, Dwirani; Baharuddin, Mohammad; Grobbee, Diederick E; Uiterwaal, Cuno S P M

    2016-01-01

    OBJECTIVES: To evaluate if pre-pregnancy body mass index (BMI) determines blood pressure throughout pregnancy and to explore the role of gestational weight gain in this association. In addition, the effects of pre-pregnancy BMI and gestational weight gain on the occurrence of gestational hypertensio

  11. Pregnancy in Sickle Cell-Haemoglobin C (SC) Disease, A Retrospective Study of Birth Size and Maternal Weight Gain

    Science.gov (United States)

    Thame, Minerva M.; Singh-Minott, Indira; Osmond, Clive; Melbourne-Chambers, Roxanne H.; Serjeant, Graham R

    2017-01-01

    Objective To assess pregnancy and fetal outcomes in Jamaican subjects with sickle cell-haemoglobin C (SC) disease. Study Design A retrospective chart review over 21 years (1992-2012) of all pregnancies in SC disease and a comparison group matched by gender and date of delivery in mothers with a normal haemoglobin (AA) phenotype at the University Hospital of the West Indies, Jamaica. There were 118 pregnancies in 81 patients with SC disease and 110 pregnancies in 110 in the normal comparison group. Corrections were made for repeat pregnancies from the same mother. Outcome measures included maternal weight at 20, 25, 30, 35 and 38 weeks gestation, maternal pregnancy complications, birth weight, head circumference and crown heel length and were used to analyse possible predictors of birth weight. Results First antenatal visits occurred later in women with SC disease, who also had lower haemoglobin level and lower systolic blood pressure. The prevalence of pregnancy-induced hypertension, pre-eclampsia, ante-partum or postpartum haemorrhage did not differ between genotypes. Maternal weight gain was significantly lower in SC disease and there was a significantly lower birth weight, head circumference, and gestational age. Conclusions Pregnancy in SC disease is generally benign but mothers had lower weight gain and lower birth weight babies, the difference persisting after correction for gestational age. PMID:27235631

  12. MATERNAL AND FETAL OUTCOME IN PREGNANCIES WITH SLE - A PROSPECTIVE STUDY OF 40 CASES

    Directory of Open Access Journals (Sweden)

    Menon Nalini

    2015-03-01

    Full Text Available Pregnancy and child birth in SLE patients can be complicated by disease activity, lupus nephritis, gestational diabetes, hypertensive disorders, intrauterine growth retardation, placental abruption, intrauterine and neonatal death, birth asphyxia, neonatal lupus and maternal mortality. AIMS AND OBJECTIVES : T o find out 1 T he most common complications and their incidence . 2 M aternal and fetal outcome in SLE patients during pregnancies. Study design; Prospective observational study. MATERIALS AND METHODS : Patients are enrolled for the study from pregnant mothers with known as well as newly diagnosed SLE who are attending outpatient department of obstetrics and gynecology department of Institute of maternal and child health, Calicut Government Medical college from 2011 February to 2012 June (18 months . Data collected from available past medical records, interview, physical examination, progress records and laboratory investigations of patients using predesigned profo r ma. RESULTS : Of the total 40 patients enrolled in the study, 45% were in the age group 26 - 30. 25% had one abortion in the past and 2 patients had 3 abortions. 65% had the disease for more than 6 years. Prior to the present pregnancy, 95% patients were in remission. During the present pregnancy 25 % patients had active lupus nephritis and 20% had flare. 25% and 75% patients had gestational diabetes mellitus and hypertensive disorders respectively. The incidence of intra uterine growth retardation was 45%. Placental abruption occurred in 10% pregnancies. The incidence of intrau terine death (25% was higher than that of neonatal deaths (10%. 20% babies had birth asphyxia and the incidence of low birth weight was very high (60%. 10% mothers had flare and 10% babies neonatal lupus. Maternal mortality was 5%. CONCLUSION : The study highlights the increased incidence of complications associated with pregnancies in SLE and thus the need for high quality care for better maternal and

  13. Dengue during Pregnancy: A Study of Thirteen Cases

    Directory of Open Access Journals (Sweden)

    Christiane Fernandes Alvarenga

    2009-01-01

    Full Text Available Problem statement: The principal aim was to evaluate the effects of dengue virus infection by dengue during pregnancy and analyze the histopathology of the placenta. Approach: A retrospective study was conducted with 13 pregnant women with dengue confirmed in the period from January-December 2002, during a widespread dengue type 3 epidemic in Rio de Janeiro. Maternal and newborn data were collected from patient files and medical records during hospitalization for research for identification of dengue IgM antibodies (PanBio, Australia. Virus isolation was performed on all fatal cases and anathomopathological studies and immunohistochemistry of the placenta were carried out in three cases. Results: Among the 13 women, 11 (84, 6% were infected in the third quarter of pregnancy, 6 (54, 5% of which resulting in premature birth and 4 cases (30, 7% were classified as DHF, causing 2 deaths. Intense abdominal pain afflicted 6 patients (46, 2% and 5 newborns presented low weight, however appropriate for the gestacional age. Conclusion: Dengue virus infection in pregnancy increases premature birth risk, especially if the infection occurs in the last quarter of pregnancy.

  14. Costs and effects of screening and treating low risk women with a singleton pregnancy for asymptomatic bacteriuria, the ASB study

    OpenAIRE

    Kazemier Brenda M; Schneeberger Caroline; De Miranda Esteriek; Van Wassenaer Aleid; Bossuyt Patrick M; Vogelvang Tatjana E; Reijnders Frans JL; Delemarre Friso MC; Verhoeven Corine JM; Oudijk Martijn A; van der Ven Jeanine A; Kuiper Petra N; Feiertag Nicolette; Ott Alewijn; de Groot Christianne JM

    2012-01-01

    Abstract Background The prevalence of asymptomatic bacteriuria (ASB) in pregnancy is 2-10% and is associated with both maternal and neonatal adverse outcomes as pyelonephritis and preterm delivery. Antibiotic treatment is reported to decrease these adverse outcomes although the existing evidence is of poor quality. Methods/Design We plan a combined screen and treat study in women with a singleton pregnancy. We will screen women between 16 and 22 weeks of gestation for ASB using the urine dips...

  15. Cutting down: insights from qualitative studies of smoking in pregnancy.

    Science.gov (United States)

    Graham, Hilary; Flemming, Kate; Fox, David; Heirs, Morag; Sowden, Amanda

    2014-05-01

    The adverse effects of smoking in pregnancy are minimised if the mother quits completely in early pregnancy. Smokers are therefore advised to quit abruptly; cutting down is not recommended either as a method of, or alternative to, quitting. However, most pregnant smokers do not quit and cutting down is widely reported. Evidence comes primarily from quantitative studies; qualitative research has contributed little to understandings of cigarette consumption in pregnancy. In consequence, little is known about the place and meaning of cutting down for pregnant smokers. The paper investigates this important dimension of maternal smoking. It explores perceptions and experiences of cutting down among pregnant smokers by examining data from a systematic review of qualitative studies of smoking in pregnancy. The studies were located in high-income countries and published between 1970 and 2012. Twenty-six studies, reported in 29 papers, were included, representing over 640 women. Meta-ethnography guided the analysis and synthesis. Data (participants' accounts and authors' interpretations) were extracted and coded; codes were progressively combined to identify overarching themes ('lines of argument'). Running through the lines of argument was evidence on cutting down; the paper presents and analyses this evidence. The analysis indicates that cutting down figured centrally as both a method of quitting and, for persistent smokers, a method of harm reduction. While pregnant women were aware that official advice was to quit abruptly, cutting down was seen as a positive behaviour change in often-difficult domestic circumstances, and one that health professionals condoned. Our findings suggest that cutting down in pregnancy, as an aid and an alternative to quitting, requires greater recognition if healthcare and tobacco control policies are to be sensitive to the perspectives and circumstances of pregnant smokers.

  16. A longitudinal study of antioxidant status during uncomplicated and hypertensive pregnancies.

    NARCIS (Netherlands)

    Roes, E.M.; Hendriks, J.C.M.; Raijmakers, M.; Steegers-Theunissen, R.P.M.; Groenen, P.; Peters, W.H.M.; Steegers, E.A.P.

    2006-01-01

    BACKGROUND: To study the possible involvement of an (im)balance between oxidants and antioxidants in pre-eclampsia concentrations of intra- and extracellular blood antioxidants in women with uncomplicated and hypertensive pregnancies, they were studied preconceptionally and throughout pregnancy.

  17. Does Pregnancy-Associated Breast Cancer Imply a Worse Prognosis? A Matched Case-Case Study

    Science.gov (United States)

    Dimitrakakis, Constantine; Zagouri, Flora; Tsigginou, Alexandra; Marinopoulos, Spyros; Sergentanis, Theodoros N.; Keramopoulos, Antonis; Zografos, George C.; Ampela, Konstantina; Mpaltas, Dimosthenis; Papadimitriou, Christos; Dimopoulos, Meletios-Athanassios; Antsaklis, Aris

    2013-01-01

    Summary Background Significant controversy exists in the literature regarding the role of pregnancy in the prognosis of breast cancer. We designed a matched case-case study, matching pregnancy-associated breast cancer (PABC) cases with breast cancer cases for stage, age, and year of diagnosis. Patients and Methods 39 consecutive cases of PABC were matched with 39 premenopausal cases of breast cancer. Univariate and multivariate survival analyses followed by adjustment for stage, grade, estrogen receptor status, and age at diagnosis, were performed. Results Regarding overall survival (OS), univariate analysis pointed to longer OS in non-PABC cases vs. PABC cases. Accordingly, a more advanced stage predicted shorter survival. In the multivariate analysis, the independent aggravating effect mediated by pregnancy persisted. Interestingly, a post hoc nested analysis within PABC cases indicated that the 3rd trimester pointed to shorter OS. The aforementioned results on OS were also replicated during the examination of relapse-free survival. Conclusion Implementing a matched case-case design, the present study points to pregnancy as a poor prognostic factor for breast cancer. PMID:24415971

  18. The Alberta Pregnancy Outcomes and Nutrition (APrON) cohort study: rationale and methods.

    Science.gov (United States)

    Kaplan, Bonnie J; Giesbrecht, Gerald F; Leung, Brenda M Y; Field, Catherine J; Dewey, Deborah; Bell, Rhonda C; Manca, Donna P; O'Beirne, Maeve; Johnston, David W; Pop, Victor J; Singhal, Nalini; Gagnon, Lisa; Bernier, Francois P; Eliasziw, Misha; McCargar, Linda J; Kooistra, Libbe; Farmer, Anna; Cantell, Marja; Goonewardene, Laki; Casey, Linda M; Letourneau, Nicole; Martin, Jonathan W

    2014-01-01

    The Alberta Pregnancy Outcomes and Nutrition (APrON) study is an ongoing prospective cohort study that recruits pregnant women early in pregnancy and, as of 2012, is following up their infants to 3 years of age. It has currently enrolled approximately 5000 Canadians (2000 pregnant women, their offspring and many of their partners). The primary aims of the APrON study were to determine the relationships between maternal nutrient intake and status, before, during and after gestation, and (1) maternal mood; (2) birth and obstetric outcomes; and (3) infant neurodevelopment. We have collected comprehensive maternal nutrition, anthropometric, biological and mental health data at multiple points in the pregnancy and the post-partum period, as well as obstetrical, birth, health and neurodevelopmental outcomes of these pregnancies. The study continues to follow the infants through to 36 months of age. The current report describes the study design and methods, and findings of some pilot work. The APrON study is a significant resource with opportunities for collaboration. © 2012 John Wiley & Sons Ltd.

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

    OpenAIRE

    Shi Wu Wen; Yanfang Guo; Marc Rodger; Ruth Rennicks White; Qiuying Yang; 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 occurren...

  20. Port Pirie cohort study: maternal blood lead and pregnancy outcome

    Energy Technology Data Exchange (ETDEWEB)

    McMichael, A.J.; Vimpani, G.V.; Robertson, E.F.; Baghurst, P.A.; Clark, P.D.

    1986-03-01

    During a three-year period, 831 pregnant women in and around Port Pirie, South Australia--a lead smelter community with longstanding lead pollution--were enrolled in a cohort study to examine prospectively the relation between body lead burden and pregnancy outcome. Three-quarters of the enrolled women were residents of the Port Pirie municipality; the other women lived in adjacent towns and countryside. At 14-20 weeks' gestation, the Port Pirie resident women had a mean blood lead concentration of 10.6 micrograms/dl, while the mean in the other (non-Port Pirie) women was 7.6 micrograms/dl. Similar differences were observed in maternal blood samples taken at 30-36 weeks, at delivery, and from the umbilical cord. These blood lead measures, in conjunction with information collected on other risk factors, were then examined in relation to pregnancy outcome. Among 749 pregnancies followed to completion, pre-term delivery was statistically significantly associated, in a dose-response manner, with maternal blood lead concentration at delivery. Mothers of late fetal deaths (stillbirths) had blood lead concentrations at 14-20 weeks' gestation similar to those of all the other women but had lower concentrations at delivery than the other women. Outcomes of pregnancy for which no association with blood lead was detected were spontaneous abortion, low birthweight (for births at term), intrauterine growth retardation, premature rupture of the membranes, and congenital anomalies.

  1. Association between Intimate Partner Violence during Pregnancy and Adverse Pregnancy Outcomes in Vietnam: A Prospective Cohort Study

    Science.gov (United States)

    Van, Toan Ngo; Gammeltoft, Tine; W. Meyrowitsch, Dan; Nguyen Thi Thuy, Hanh; Rasch, Vibeke

    2016-01-01

    Background Violence against pregnant women is an increasing public health concern particularly in low- and middle-income countries. The purpose of this study was to measure the association between intimate partner violence (IPV) during pregnancy and the risk of adverse birth outcomes. Methods Prospective cohort study of 1276 pregnant women in Dong Anh district, Vietnam. Women with gestational age less than 24 weeks were enrolled and interviewed. Repeated interviews were performed at 30–34 weeks gestation to assess experience of IPV during pregnancy and again 48 hours post-delivery to assess the birth outcome including birth weight and gestational age at delivery. Results There was a statistically significant association between exposure to physical violence during pregnancy and preterm birth (PTB) or low birth weight (LBW). After adjustment for age, education, occupation, body mass index (BMI), haemoglobin level, previous adverse pregnancy outcomes, the pregnant women who were exposed to physical violence during pregnancy were five times more likely to have PTB (AOR = 5.5; 95%CI: 2.1–14.1) and were nearly six times more likely to give birth to a child of LBW (AOR = 5.7; 95%CI: 2.2–14.9) as compared to those who were not exposed to physical violence. Conclusion Exposure to IPV during pregnancy increases the risk of PTB and LBW. Case-finding for violence in relation to antenatal care may help protect pregnant women and improve pregnancy outcomes. PMID:27631968

  2. Predictive factors of plasma HIV suppression during pregnancy: a prospective cohort study in Benin.

    Directory of Open Access Journals (Sweden)

    Lise Denoeud-Ndam

    Full Text Available OBJECTIVE: To investigate the factors associated with HIV1 RNA plasma viral load (pVL below 40 copies/mL at the third trimester of pregnancy, as part of prevention of mother-to-child transmission (PMTCT in Benin. DESIGN: Sub study of the PACOME clinical trial of malaria prophylaxis in HIV-infected pregnant women, conducted before and after the implementation of the WHO 2009 revised guidelines for PMTCT. METHODS: HIV-infected women were enrolled in the second trimester of pregnancy. Socio-economic characteristics, HIV history, clinical and biological characteristics were recorded. Malaria prevention and PMTCT involving antiretroviral therapy (ART for mothers and infants were provided. Logistic regression helped identifying factors associated with virologic suppression at the end of pregnancy. RESULTS: Overall 217 third trimester pVLs were available, and 71% showed undetectability. Virologic suppression was more frequent in women enrolled after the change in PMTCT recommendations, advising to start ART at 14 weeks instead of 28 weeks of pregnancy. In multivariate analysis, Fon ethnic group (the predominant ethnic group in the study area, regular job, first and second pregnancy, higher baseline pVL and impaired adherence to ART were negative factors whereas higher weight, higher antenatal care attendance and longer ART duration were favorable factors to achieve virologic suppression. CONCLUSIONS: This study provides more evidence that ART has to be initiated before the last trimester of pregnancy to achieve an undetectable pVL before delivery. In Benin, new recommendations supporting early initiation were well implemented and, together with a high antenatal care attendance, led to high rate of virologic control.

  3. Pregnancy Outcome following Prenatal Diagnosis of Chromosomal Anomaly: A Record Linkage Study of 26,261 Pregnancies

    National Research Council Canada - National Science Library

    Jacobs, Myrthe; Cooper, Sally-Ann; McGowan, Ruth; Nelson, Scott M; Pell, Jill P

    2016-01-01

    ... and terminated with chromosomal anomalies. However, we are unaware of any population studies examining pregnancy terminations after diagnosis of chromosomal anomalies that has included all aneuploidies and the influence of maternal factors...

  4. Effect of intrauterine injection of human chorionic gonadotropin before embryo transfer on pregnancy rate: A prospective randomized study.

    Science.gov (United States)

    Mostajeran, Fatemeh; Godazandeh, Farzaneh; Ahmadi, Sayed Mehdi; Movahedi, Minoo; Jabalamelian, Seyed Abolfazl

    2017-01-01

    Human chorionic gonadotropin (hCG) as the most important factor to controlled implantation is one of the early embryonic signals in primates that is secreted by the embryo before its implantation. This study was designed to assess the effects of intrauterine injection of hCG before the embryo transfer in an in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) cycle on pregnancy rate in infertile patients. This randomized study was done on 100 infertile patients in two groups: intervention group received injection of 700 IU of intrauterine hCG 10 min before embryo transfer and control group did not receive hCG. The pregnancy rate was tested 2 weeks after embryo transfer, and if the pregnancy test was positive, a transvaginal ultrasound was performed 3 weeks later to search for signs of pregnancy, such as the presence of a gestational sac, embryo, and fetal heart rate, and confirmed as successful pregnancy. Pregnancy test was positive in 13 (28.6%) of 46 patients in hCG group and in control group was positive in 6 (12.5%) of 48 patients. The pregnancy rate between hCG group and control group was not significantly different (P = 0.54). The pregnancy rate in hCG group with IVF fertilization was 20.8% and in their controls was 7.4% (P = 0.51). The pregnancy rate in hCG group with ICSI fertilization was 36.4% and in their controls was 19% (P = 0.16). The intrauterine injection of 700 IU of hCG before embryo transfer improved pregnancy rate compared to control group but was not significantly different.

  5. CLINICO PATHOLOGICAL STUDY OF PATTERNS OF ANEMIA DURING PREGNANCY

    Directory of Open Access Journals (Sweden)

    Chamakuri

    2015-10-01

    Full Text Available INTRODUCTION: Anemia is defined as haemoglobin level in the blood below the lower extreme of the normal range for the age and sex of the individual. According to WHO, in developing countries the prevalence of anemia among pregnant women averages 60%, ranging between 35 to 100% among different regions of the world. A hemoglobin concentration below 11.0g/dl or packed cell volume (PCV of less than 33.0% is regarded as anemia during pregnancy by the WHO. It occurs in 40 - 80% of the pregnant women. Iron and folic acid defici encies, malaria, intestinal parasitic infections and hemoglobinopathies are the principal causes of anemia in pregnancy. Predisposing factors include young age, grand multiparity, low socioeconomic status, illiteracy, ignorance and short intervals of pregn ancy. AIM AND OBJECTIVES: 1. To study various patterns of anemia in pregnant women having haemoglobin level < 11 gm%. 2. To determine the most common pattern of anemia in pregnancy based on red cell morphology. MATERIALS AND METHODS: This study is a prospe ctive study over a period of one year from September 2014 to August 2015 in the department of pathology, Andhra medical college, Visakhapatnam . The study was conducted on 120 pregnant women whose haemoglobin level is < 11 gm/dl. All the haemotological parameters & peripheral blood smear stained by Leishman’s stain were evaluated. Complete clinical & obstetric history was recorded. Socioeconomic status was also noted. RESULTS: Out of 120 cases of anemia, we found 47 patie nts (39.1% having dimorphic anemia, 36(30% – microcytic hypochromic anemia, 23(19.1% - normocytic hypochromic anemia, 11(9.16% - sickle cell anemia and 1(0.83% case of pancytopenia. Maximum cases were seen in the age group of 21 - 30 years. 52 cases (43. 3% were primigravida and remaining 68 cases (56.6% were gravida two to four. 20 cases (16.6% were diagnosed in the first trimester, 38 cases (31.6% in the second trimester & 62 cases (51.6s% in the

  6. Impact of Pre-Pregnancy BMI on B Vitamin and Inflammatory Status in Early Pregnancy: An Observational Cohort Study.

    Science.gov (United States)

    Bjørke-Monsen, Anne-Lise; Ulvik, Arve; Nilsen, Roy M; Midttun, Øivind; Roth, Christine; Magnus, Per; Stoltenberg, Camilla; Vollset, Stein Emil; Reichborn-Kjennerud, Ted; Ueland, Per Magne

    2016-11-30

    Maternal nutrition and inflammation have been suggested as mediators in the development of various adverse pregnancy outcomes associated with maternal obesity. We have investigated the relation between pre-pregnancy BMI, B vitamin status, and inflammatory markers in a group of healthy pregnant women. Cobalamin, folate, pyridoxal 5'-phosphate, and riboflavin; and the metabolic markers homocysteine, methylmalonic acid, and 3-hydroxykynurenine/xanthurenic acid ratio (HK/XA); and markers of cellular inflammation, neopterin and kynurenine/tryptophan ratio (KTR) were determined in pregnancy week 18 and related to pre-pregnancy body mass index (BMI), in 2797 women from the Norwegian Mother and Child Cohort Study (MoBa). Pre-pregnancy BMI was inversely related to folate, cobalamin, pyridoxal 5'-phosphate (PLP), and riboflavin (p pregnancy BMI is a risk factor for low B vitamin status and increased cellular inflammation. As an optimal micronutrient status is vital for normal fetal development, the observed lower B vitamin levels may contribute to adverse pregnancy outcomes associated with maternal obesity and B vitamin status should be assessed in women with high BMI before they get pregnant.

  7. Impact of Pre-Pregnancy BMI on B Vitamin and Inflammatory Status in Early Pregnancy: An Observational Cohort Study

    Directory of Open Access Journals (Sweden)

    Anne-Lise Bjørke-Monsen

    2016-11-01

    Full Text Available Maternal nutrition and inflammation have been suggested as mediators in the development of various adverse pregnancy outcomes associated with maternal obesity. We have investigated the relation between pre-pregnancy BMI, B vitamin status, and inflammatory markers in a group of healthy pregnant women. Cobalamin, folate, pyridoxal 5′-phosphate, and riboflavin; and the metabolic markers homocysteine, methylmalonic acid, and 3-hydroxykynurenine/xanthurenic acid ratio (HK/XA; and markers of cellular inflammation, neopterin and kynurenine/tryptophan ratio (KTR were determined in pregnancy week 18 and related to pre-pregnancy body mass index (BMI, in 2797 women from the Norwegian Mother and Child Cohort Study (MoBa. Pre-pregnancy BMI was inversely related to folate, cobalamin, pyridoxal 5′-phosphate (PLP, and riboflavin (p < 0.001, and associated with increased neopterin and KTR levels (p < 0.001. Inflammation seemed to be an independent predictor of low vitamin B6 status, as verified by low PLP and high HK/XA ratio. A high pre-pregnancy BMI is a risk factor for low B vitamin status and increased cellular inflammation. As an optimal micronutrient status is vital for normal fetal development, the observed lower B vitamin levels may contribute to adverse pregnancy outcomes associated with maternal obesity and B vitamin status should be assessed in women with high BMI before they get pregnant.

  8. CALM Pregnancy: results of a pilot study of mindfulness-based cognitive therapy for perinatal anxiety.

    Science.gov (United States)

    Goodman, Janice H; Guarino, Anthony; Chenausky, Kerry; Klein, Lauri; Prager, Joanna; Petersen, Rebecca; Forget, Avery; Freeman, Marlene

    2014-10-01

    Many women experience anxiety during pregnancy with potential negative effects on maternal, birth, and child outcomes. Because of potential risks of fetal exposure to psychotropic medications, efficacious non-pharmacologic approaches are urgently needed. However, no published studies of psychotherapeutic treatments for anxiety in pregnancy exist. Mindfulness-based cognitive therapy (MBCT) may substantially reduce anxiety and co-morbid symptoms in people with anxiety disorders. Coping with Anxiety through Living Mindfully (CALM) Pregnancy is an adaptation of MBCT designed to address anxiety in pregnant women. This study examined the feasibility, acceptability, and clinical outcomes of the CALM Pregnancy intervention in pregnant women anxiety. Twenty-four pregnant women with generalized anxiety disorder (GAD) or prominent symptoms of generalized anxiety participated in an open treatment trial of the CALM Pregnancy group intervention. Psychiatric diagnoses were determined by structured clinical interview, and self-report measures of anxiety, worry, depression, self-compassion, and mindfulness were completed at baseline and post-intervention. Qualitative feedback was elicited via questionnaire. Twenty-three participants completed the intervention with high attendance and good compliance with home practice. Completers showed statistically and clinically significant improvements in anxiety, worry, and depression, and significant increases in self-compassion and mindfulness. Of the 17 participants who met GAD criteria at baseline, only one continued to meet criteria post-intervention. Participants regarded their experience in the intervention to be overwhelmingly positive. MBCT in the form of the CALM Pregnancy intervention holds potential to provide effective, non-pharmacological treatment for pregnant women with anxiety. These promising findings warrant further testing of the intervention with a randomized controlled trial.

  9. Prospective, Controlled, Multicentre Study of Loperimide in Pregnancy

    Directory of Open Access Journals (Sweden)

    A Einarson

    2000-01-01

    Full Text Available BACKGROUND: Loperamide is a synthetic piperidine derivative used for the treatment of both acute and chronic diarrhea. Little is known about its safety and risk in pregnancy. Human data are limited to one surveillance study of Michigan Medicaid patients, with 108 women exposed in the first trimester. In this study there were six major birth defects, three of which were cardiovascular anomalies.

  10. Posture and low back pain during pregnancy - 3D study.

    Science.gov (United States)

    Glinkowski, Wojciech M; Tomasik, Paweł; Walesiak, Katarzyna; Głuszak, Michał; Krawczak, Karolina; Michoński, Jakub; Czyżewska, Anna; Żukowska, Agnieszka; Sitnik, Robert; Wielgoś, Mirosław

    2016-01-01

    Back pain is a common complaint of pregnant women. The posture, curvatures of the spine and the center of gravity changes are considered as the mechanisms leading to pain. The study aimed to assess spinal curvatures and static postural characteristics with three-dimensional surface topography and search for relationships with the occurrence of back pain complaints among pregnant women. The study was conducted from December 2012 to February 2014. Patients referred from University Clinic of Gynecology and Obstetrics were examined outpatient at the Posture Study Unit of Department of Orthopaedics and Traumatology. Sixty-five women at 4-39 weeks of pregnancy were assessed and surveyed with Oswestry Disability Index; posture was evaluated using surface topography. The study confirmed that difficulties in sitting and standing are significant in the third trimester of the pregnancy. The overall tendency for significant lumbar curvature changes in pregnant women was not confirmed. Major changes in sagittal trunk inclination in relation to the plumb line were not observed in the study group. The issue regarding how the pregnancy causes changes in spinal curvature and posture remains open for further studies. Presented method of 3D surface topography can reveal postural changes, but that requires several exams of each subject and strict follow-up of the series of cases.

  11. Chlamydia trachomatis infection during pregnancy associated with preterm delivery: A population-based prospective cohort study

    NARCIS (Netherlands)

    G.I.J.G. Rours (Ingrid); L. Duijts (Liesbeth); H.A. Moll (Henriëtte); L.R. Arends (Lidia); R. de Groot (Ronald); V.W.V. Jaddoe (Vincent); A. Hofman (Albert); R.P.M. Steegers-Theunissen (Régine); J.P. Mackenbach (Johan); A. Ott (Alewijn); H.F. Willemse; E.A.E. van der Zwaan (Elizabeth); R.P.A.J. Verkooijen (Roel); H.A. Verbrugh (Henri)

    2011-01-01

    textabstractChlamydia trachomatis infection is the most prevalent bacterial sexually transmitted infection and may influence pregnancy outcome. This study was conducted to assess the effect of chlamydial infection during pregnancy on premature delivery and birthweight. Pregnant women attending a

  12. Diet matters, particularly in pregnancy – Results from MoBa studies of maternal diet and pregnancy outcomes

    Directory of Open Access Journals (Sweden)

    Anne Lise Brantsæter

    2014-12-01

    Full Text Available Awareness that maternal diet may influence the outcome of pregnancy as well as the long-term health of mother and child has increased in recent years. A new food frequency questionnaire (FFQ was developed and validated specifically for the Norwegian Mother and Child Cohort Study (MoBa. The MoBa FFQ is a semi-quantitative tool which covers the average intake of food, beverages and dietary supplements during the first 4 to 5 months of pregnancy. It includes questions about intakes of 255 foods and dishes and was used from 2002 onwards. Data assessed by the MoBa FFQ is available for 87,700 pregnancies. Numerous sub-studies have examined associations between dietary factors and health outcomes in MoBa. The aim of this paper is to summarize the results from 19 studies of maternal diet and pregnancy outcomes, which is the complete collection of studies based on the MoBa FFQ and published before September 2014. The overall research question is whether maternal diet – from single substances to dietary patterns – matters for pregnancy outcome. The pregnancy outcomes studied till now include birth size measures, infants being small and large for gestational age, pregnancy duration, preterm delivery, preeclampsia, as well as maternal gestational weight gain and postpartum weight retention. As a whole, the results from these studies corroborate that the current dietary recommendations to pregnant women are sound and that maternal diet during pregnancy is likely to contribute to reduce the risk of pregnancy complications including preterm birth, preeclampsia, and reduced foetal growth. The results provide supporting evidence for recommending pregnant women to consume vegetables, fruit, whole grain, fish, dairy, and water regularly and lower the intake of sugar sweetened beverages, processed meat products and salty snacks. The results showing negative impact of even low levels of environmental contaminants support the precautionary advice on consumption

  13. Returning to life, the Lived Experiences of Pregnancy in Women with HIV: A Phenomenological study

    Directory of Open Access Journals (Sweden)

    Z Khalajinia

    2016-08-01

    . Understanding and awareness of all those are necessary for health care providers.The findings of this study emphasize on the need to design and implement comprehensive prevention strategies and interventions tailored to have a good feeling of pregnancy in these women.

  14. Early adolescent pregnancy increases risk of incident HIV infection in the Eastern Cape, South Africa: a longitudinal study

    Directory of Open Access Journals (Sweden)

    Nicola J Christofides

    2014-03-01

    Full Text Available Introduction: Adolescents having unprotected heterosexual intercourse are at risk of HIV infection and unwanted pregnancy. However, there is little evidence to indicate whether pregnancy in early adolescence increases the risk of subsequent HIV infection. In this paper, we tested the hypothesis that adolescent pregnancy (aged 15 or younger increases the risk of incident HIV infection in young South African women. Methods: We assessed 1099 HIV-negative women, aged 15–26 years, who were volunteer participants in a cluster-randomized, controlled HIV prevention trial in the predominantly rural Eastern Cape province of South Africa. All of these young women had at least one additional HIV test over two years of follow-up. Outcomes were HIV incidence rates per 100 person years and HIV incidence rate ratios (IRRs estimated by Poisson multivariate models. Three pregnancy categories were created for the Poisson model: early adolescent pregnancy (a first pregnancy at age 15 years or younger; later adolescent pregnancy (a first pregnancy at age 16 to 19 years; and women who did not report an adolescent pregnancy. Models were adjusted for study design, age, education, time since first sexual experience, socio-economic status, childhood trauma and herpes simplex virus type 2 infection. Results: HIV incidence rates were 6.0 per 100 person years over two years of follow-up. The adjusted IRR was 3.02 (95% CI 1.50–6.09 for a pregnancy occurring at age 15 or younger. Women with pregnancies occurring between 16 and 19 years of age did not have a higher incidence of HIV (IRR 1.08; 95% CI 0.64–1.84. Early adolescent pregnancies were associated with higher partner numbers and a greater age difference with partners. Conclusions: Early adolescent pregnancies increase the incidence of HIV among South African women. The higher risk is associated with sexual risk behaviours such as higher partner numbers and a greater age difference with partners rather than a

  15. Ascorbic acid is lower during pregnancy in diabetic women compared to controls: A prospective study

    DEFF Research Database (Denmark)

    Juhl, B.; Lauszus, Finn; Lykkesfeldt, Jens

    2017-01-01

    Abstract.Few studies have examined how vitamin C status is affected in diabetic pregnancy and no comparison between normal and diabetic pregnancies has been found. This study evaluated vitamin C status prospectively during pregnancy in women with type 1 diabetes mellitus (n=76), in non-diabetic w...

  16. Ascorbic acid is lower during pregnancy in diabetic women compared to controls: A prospective study

    DEFF Research Database (Denmark)

    Juhl, B.; Lauszus, Finn; Lykkesfeldt, Jens

    2016-01-01

    Few studies have examined how vitamin C status is affected in diabetic pregnancy and no comparison between normal and diabetic pregnancies has been found. This study evaluated vitamin C status prospectively during pregnancy in women with type 1 diabetes mellitus (n=76), in non-diabetic women (n=6...

  17. Placental Growth during Normal Pregnancy - A Magnetic Resonance Imaging Study

    DEFF Research Database (Denmark)

    Langhoff, Lasse; Grønbeck, Lene; von Huth, Sebastian

    2017-01-01

    was 640 g (range 500-787 g). All pregnancies were carried to term, resulting in the delivery of healthy infants with good correlation between placental size and birth weight (R = 0.56, p = 0.009). CONCLUSION: Placental growth was measured systematically in a longitudinal study through the second and third......OBJECTIVE: To investigate normal human placental growth longitudinally throughout the second and third trimesters using MRI. METHODS: Twenty normal, first-time singleton pregnancies were scanned 7 times between the 14th and 38th week of gestation, at 4-week intervals, using MRI. Placental volumes...... were measured in both sagittal and transversal slices. All placentas were weighed after delivery to make a comparative study. RESULTS: Sixteen of the 20 women had increasing placental volumes from the 14th to 38th week of gestation. The 6th and 7th scan showed that 4 women had placentas of the same...

  18. A teratological study of aminoglycoside antibiotic treatment during pregnancy.

    Science.gov (United States)

    Czeizel, A E; Rockenbauer, M; Olsen, J; Sørensen, H T

    2000-01-01

    The aim of this study was to investigate the teratogenicity of aminoglycoside antibiotics, such as parenteral gentamicin, streptomycin, tobramycin and oral neomycin, during pregnancy. Pair analysis of cases with congenital abnormalities and matched healthy controls was carried out. The setting was the population-based dataset of the Hungarian Case-Control Surveillance of Congenital Abnormalities, 1980-96. In total, 38,151 pregnant women who had newborn infants without any defects (control group) and 22,865 pregnant women who had foetuses or newborns with congenital abnormalities were included in the study. 38 (0.16%) and 42 (0.11%) pregnant women in the case and control groups, respectively, were treated with the aminoglycosides studied. A teratogenic potential of gentamicin and neomycin was not indicated by a comparison of the occurrence of aminoglycoside antibiotic treatments in the total control group as referent with the figures of different congenital abnormality groups. In addition, the case-control pair analysis during the second-third months of pregnancy did not show a teratogenic risk of gentamicin and neomycin. The conclusion of this study is that treatment with parenteral gentamicin and oral neomycin during pregnancy presents no detectable teratogenic risk to the foetus, when restricted to structural developmental disturbances.

  19. Atypical antipsychotic drugs and pregnancy outcome: a prospective, cohort study.

    Science.gov (United States)

    Habermann, Frank; Fritzsche, Juliane; Fuhlbrück, Frederike; Wacker, Evelin; Allignol, Arthur; Weber-Schoendorfer, Corinna; Meister, Reinhard; Schaefer, Christof

    2013-08-01

    Women of childbearing age are often affected with psychotic disorders, requiring the use of antipsychotic medication during pregnancy. In the present study, we prospectively followed the pregnancies of 561 women exposed to second-generation antipsychotic agents (SGAs; study cohort) and compared these to 284 pregnant women exposed to first-generation antipsychotic agents (FGAs; comparison cohort I) and to 1122 pregnant women using drugs known as not harmful to the unborn (comparison cohort II). Subjects were enrolled through the Institute's consultation service. Major malformation rates of SGA exposed were higher compared to comparison cohort II (adjusted odds ratio, 2.17; 95% confidence interval, 1.20-3.91), possibly reflecting a detection bias concerning atrial and ventricular septal defects. Postnatal disorders occurred significantly more often in infants prenatally exposed to SGAs (15.6%) and FGAs (21.6%) compared to 4.2% of comparison cohort II. Cumulative incidences of elective terminations of pregnancy were significantly higher in both the study cohort (17%) and comparison cohort I (21%) compared to comparison cohort II (3%), whereas the rates of spontaneous abortions did not differ. The numbers of stillbirths and neonatal deaths were within the reference range. Preterm birth and low birth weight were more common in infants exposed to FGAs. To conclude, our findings did not reveal a major teratogenic risk for SGAs, making the better studied drugs of this group a treatment option during pregnancy. Because neonates exposed to SGAs or FGAs in the last gestational week are at higher risk of postnatal disorders, delivery should be planned in clinics with neonatal intensive care units.

  20. [Multicenter study on the use of drugs during pregnancy in Spain (II). Drugs used during pregnancy. Spain DUP workshop].

    Science.gov (United States)

    1991-01-12

    A structured questionnaire administered to the 1,371 participating women was used for data collection on drug use in the multicentric study on Drug Use during Pregnancy in Spain. This paper describes and discusses the pattern of the use of medicines during pregnancy. Only 104 women (7%) stated that they had not taken any drug during their pregnancy, while 627 (45%) had taken 3 or more medicines; 39% of all medicines used were fixed-dose combinations of two or more drugs, the mean number of these taken by the participating women being 8.9. The most frequent reason for taking medicines during pregnancy was vitamin supplementation (823 women, 60%), and out of the 1,119 medicines taken to this end, 443 (30%) contained vitamin A. Other reasons for using medicines were the treatment of anaemia (497, 36%), dispepsia (235, 17%), nausea and/or vomiting (204, 14%), colds, pain, urinary tract infections, headache, and genital infections.

  1. Cigarette smoking during pregnancy in two regions:cross-sectional study

    Institute of Scientific and Technical Information of China (English)

    Marcel Leppe; Josip Culig; Mirela Eric

    2012-01-01

    Objective:To assess the prevalence of cigarette smoking in pregnancy, and the rate of congenital malformations in children at in utero exposure.Methods:The trial was designed as a cross-sectional study to measure exposure of pregnant women to adverse influence of smoking and their health status.The study consists of two arms: one was conducted at fourZagreb maternity hospitals(Croatia) and the other at the same hospitals inNoviSad(Serbia).Results:Data analysis revealed the habit of cigarette smoking during pregnancy in829(11.9%) of6992(6099+893) women.Malformations were found in105(1.5%) fetuses and newborns.Major congenital malformations were present in4(0.6%), minor malformations in73(10.5%) and low birth weight in12(1.7%) newborns.In all these pregnant women smoked until becoming aware of pregnancy or during pregnancy.Tobacco smoking and congenital abnormalities that define the contingency table were not significantly related inZagreb(P=0.385), as well as inNoviSad(P=0.345). Conclusions:The proportion of pregnant women reporting cigarette smoking was quite similar in Zagreb andNoviSad.There is no statistically significant association between cigarette smoking and congenitalmalformations.

  2. Changes in bone mineral density and body composition during pregnancy and postpartum. A controlled cohort study

    DEFF Research Database (Denmark)

    Møller, U K; Við Streym, S; Mosekilde, L

    2012-01-01

    In a controlled cohort study, bone mineral density (BMD) was measured in 153 women pre-pregnancy; during pregnancy; and 0.5, 4, 9, and 19 months postpartum. Seventy-five age-matched controls, without pregnancy plans, were followed in parallel. Pregnancy and breastfeeding cause a reversible bone...... loss, which, initially, is most pronounced at trabecular sites but also involves cortical sites during prolonged breastfeeding. INTRODUCTION: Conflicting results have been reported on effects of pregnancy and breastfeeding on BMD and body composition (BC). In a controlled cohort study, we elucidate...... changes in BMD and BC during and following a pregnancy. METHODS: We measured BMD and BC in 153 women planning pregnancy (n = 92 conceived), once in each trimester during pregnancy and 15, 129, and 280 days postpartum. Moreover, BMD was measured 19 months postpartum (n = 31). Seventy-five age...

  3. A Prospective Study of Villous Capillary Lesions in Complicated Pregnancies

    Directory of Open Access Journals (Sweden)

    Anu Priyadharshini Srinivasan

    2014-01-01

    Full Text Available The vascularity of placental tissue is dependent on various factors of which fetomaternal hypoxia plays a major role. Hypoxia can be of different types and each type influences the vascularity of the villi, especially terminal villi, in its own way. In this study, we attempted to identify villous vascular changes in a group of term placentae from mothers with diseases complicating pregnancy. Chorangiosis was the most frequently identified lesion while chorangioma was found in only 2 cases. There were no cases of chorangiomatosis. A few cases had normal villous vasculature. Maternal diseases have a major role in disrupting the placental vasculogenesis and angiogenesis by creating a hypoxic environment that may affect the fetus adversely. Hence, such conditions need to be identified early in pregnancy and managed appropriately as it is possible to maintain a normal vasculature and prevent neonatal mortality and morbidity if prompt intervention is done.

  4. Cytogenetic studies in couples experiencing repeated pregnancy losses.

    Science.gov (United States)

    De Braekeleer, M; Dao, T N

    1990-07-01

    A computerized database generated from the literature on cytogenetic studies in couples experiencing repeated pregnancy losses has been set up at the University of Quebec at Chicoutimi. At the present time, it contains data on 22,199 couples (44,398 individuals). The statistical analyses showed a relationship between the distribution of the chromosome abnormalities and the number of abortions. An uneven distribution of the chromosomal structural rearrangements according to the sex of the carrier was found (P less than 0.05). Overall, 4.7% of the couples ascertained for two or more spontaneous abortions included one carrier. It also appeared that only translocations (both reciprocal and Robertsonian) and inversions were associated with a higher risk of pregnancy wastage. Therefore, genetic counselling should be offered to these couples and investigations performed on their extended families.

  5. 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......,927 (81.4%) completed the study. Methods. Women were asked to participate in this study at their first prenatal visit at 17 gestational weeks (range 7+/324+/0). Samples from the genital tract were taken at enrolment. Bacterial vaginosis was determined by Amsel's clinical criteria (3 out of 4: pH>/4.......5, homogenous discharge, clue cells, and positive amine test). Data were collected from three questionnaires completed during the second and third trimesters and correlated with the diagnosis of bacterial vaginosis. Crude and adjusted relative risks (reproductive, medical, behavioral, sexual...

  6. Early pregnancy exposure to antihistamines and risk of congenital heart defects : results of two case-control studies

    NARCIS (Netherlands)

    Smedts, Huberdina P. M.; de Jonge, Linda; Bandola, Sarah J. G.; Baardman, Marlies E.; Bakker, Marian K.; Stricker, Bruno H. C.; Steegers-Theunissen, Regine P. M.

    2014-01-01

    UNLABELLED: We aimed to study the association between use of antihistamines in early pregnancy and congenital heart defects (CHD) in the offspring. DESIGN: Two case-control studies. SETTING: HAVEN study, Erasmus MC, University Medical Centre, Rotterdam, and Eurocat Northern Netherlands (NNL), Univer

  7. Lung cancer in pregnancy: Report of nine cases from an international collaborative study

    NARCIS (Netherlands)

    Boussios, S.; Han, S.N.; Fruscio, R.; Halaska, M.J.; Ottevanger, P.B.; Peccatori, F.A.; Koubkova, L.; Pavlidis, N.; Amant, F.

    2013-01-01

    OBJECTIVE: Lung cancer is an uncommon diagnosis during pregnancy. The combination of smoking in young women, increased maternal age during pregnancy, and increasing incidence of lung cancer worldwide may cause an increase of pregnancy associated lung cancer. The aim of this study was to describe all

  8. A retrospective study on ectopic pregnancy: a two year study

    Directory of Open Access Journals (Sweden)

    V. S. Sudha

    2016-12-01

    Conclusions: Early diagnosis, identifying of underlying risk factors and timely intervention in the form of conservative or surgical treatment will help in reducing the morbidity and mortality associated with ectopic pregnancy. [Int J Reprod Contracept Obstet Gynecol 2016; 5(12.000: 4365-4368

  9. A Multicentre Study of Thromboprophylaxis in Pregnancy

    LENUS (Irish Health Repository)

    Crowley, MP

    2017-05-01

    Venous thromboembolism (VTE) is a leading cause of maternal mortality. The risk increases with increasing maternal age, mode of delivery and medical co-morbidities. Thromboprophylaxis with low molecular weight heparin (LMWH) has been shown to be both safe and efficacious. The aim of this study was to prospectively investigate the incidence of maternal risk factors in pregnant women admitted to hospital, to calculate their VTE risk status and to investigate if they were receiving appropriate thromboprophylaxis. All patients admitted to the participating hospitals on the day of investigation were assessed for risk of VTE on the basis of hospital chart review. Five Hundred and forty women were recruited from 16 hospitals. Almost 32% (31.7%) were receiving thromboprophylaxis with LMWH. Just under 80% of patients were on the correct thromboprophylaxis strategy as defined by the RCOG guideline but 49% were under-dosed. The odds of receiving appropriate thromboprophylaxis were significantly increased if the woman was >35 years 0or with parity>3.

  10. Cigarette smoking during pregnancy in two regions:cross-sectional study

    Institute of Scientific and Technical Information of China (English)

    Marcel Leppe; Josip Culig; Mirela Eric

    2012-01-01

    Objective:Smoking in pregnancy is associated with the risk of congenital malformations and functional disorders.The aim of the study was to assess the prevalence of cigarette smoking in pregnancy, and the rate of congenital malformations in children at in utero exposure.Methods:The trial was designed as a cross-sectional study to measure exposure of pregnant women to adverse influence of smoking and their health status.The study consists of two arms: one was conducted at fourZagreb maternity hospitals(Croatia) and the other at the same hospitals inNovi Sad(Serbia).Results:Data analysis revealed the habit of cigarette smoking during pregnancy in829(11.9%) of6992(6099+893) women.Malformations were found in105(1.5%) fetuses and newborns.Major congenital malformations were present in four(0.6%), minor malformations in73 (10.5%) andLBW in12(1.7%) newborns.In all these cases pregnant women smoked until becoming aware of pregnancy or during pregnancy.Tobacco smoking and congenital abnormalities that define the contingency table are not significantly related inZagreb(P=0.385), as well as in NoviSad(P=0.345).Conclusions:The rate of congenital malformations is higher in fetuses and newborns at in utero exposure to maternal cigarette smoking as well as to alcohol consumption and drug abuse than in the general population.The results of the present study did not identify the exact cause of these malformations because of fetal concurrent exposure to multiple teratogenic factors.

  11. Prognosis for patients diagnosed with pregnancy-associated breast cancer: a paired case-control study

    Directory of Open Access Journals (Sweden)

    Wagner Brant Moreira

    Full Text Available CONTEXT AND OBJECTIVE: Previous studies have suggested that the occurrence of pregnancy concomitantly with a diagnosis of breast cancer may affect the evolution of the neoplasia. The present study aimed to compare pregnancy-associated breast cancer (PABC patients with non-pregnant cancer patients (controls in relation to the time taken to diagnose the disease, tumor characteristics and mortality. DESIGN AND SETTING: A retrospective, paired case-control study was conducted at the Hospital da Santa Casa de Misericórdia and Centro de Quimioterapia Antiblástica e Imunoterapia in Belo Horizonte, Brazil. METHODS: The study involved 87 PABC and 252 control patients. The influence of covariables (interval between first symptoms and diagnosis, tumor histology, size of primary tumor, distant metastasis, grade of malignancy, hormone receptor status and axillary lymph node involvement and the pregnancy variable on overall survival was investigated using univariate and multivariate analyses. RESULTS: The median overall survival for PABC patients of 30.1 months (95% confidence interval, CI: 19.4-40.9 months was significantly different (P = 0.005 from that of the control group (53.1 months; 95% CI: 35.1-71.0 months. The cumulative overall survivals after five and ten years were, respectively, 29.7 and 19.2% for PABC patients, and 47.3 and 34.8% for control patients (P = 0.005. Tumor size, grade of malignancy, distant metastasis and pregnancy were independent factors that significantly modified disease prognosis. CONCLUSIONS: Pregnancy was an independent prognostic factor. The overall survival of PABC patients was shorter than that of non-pregnant patients.

  12. Predictive factors for pregnancy after intrauterine insemination: A prospective study of factors affecting outcome

    Directory of Open Access Journals (Sweden)

    Mohan S Kamath

    2010-01-01

    Full Text Available Objective : To determine the predictive factors for pregnancy after controlled ovarian hyperstimulation (COH/intrauterine insemination (IUI. Design : Prospective observational study. Setting : University-level tertiary care center. Patients and Methods : 366 patients undergoing 480 stimulated IUI cycles between November 2007 and December 2008. Interventions : Ovarian stimulation with gonadotrophins was initiated and a single IUI was performed 36 h after triggering ovulation. Main Outcome Measures : The primary outcome measures were clinical pregnancy and live birth rates. Predictive factors evaluated were female age, duration of infertility, indication for IUI, number of preovulatory follicles, luteinizing hormone level on day of trigger and postwash total motile fraction (TMF. Results : The overall clinical pregnancy rate and live birth rate were 8.75% and 5.83%, respectively. Among the predictive factors evaluated, the duration of infertility (5.36 vs. 6.71 years, P = 0.032 and the TMF (between 10 and 20 million, P = 0.002 significantly influenced the clinical pregnancy rate. Conclusion : Our results indicate that COH/IUI is not an effective option in couples with infertility due to a male factor. Prolonged duration of infertility is also associated with decreased success, and should be considered when planning treatment.

  13. A study of neurological disorders during pregnancy and puerperium

    Directory of Open Access Journals (Sweden)

    Gupta S

    2006-01-01

    Full Text Available Objective: To study the clinical profile of patients presenting with primary and secondary neurological disorders during pregnancy and puerperium. Materials and Methods: This study was carried out at the Lady Harding Medical College between February 2004 and January 2005. All patients in pregnancy, postabortal or postpartum period attending to the Lady Harding Medical College between February 2004 and January 2005 and requiring neurological consultation were included in this study. Women with eclampsia were excluded. Results: There were 76 women included in this study (incidence of neurological disorders was 584 per 100,000 deliveries, with 46 cases of primary and 30 of secondary neurological disorders. The former included epilepsy (22, CNS infections (12, cerebrovascular disorders (9 [cerebral venous thrombosis - CVT (5, arterial infarctions (3 and haemorrhage (1], CNS glioma (1, traumatic quadriparesis (1 and acute disseminated encephalomyelitis (1. The latter included hepatic encephalopathy [HE] (28, enteric encephalopathy (1 and critical illness polyneuropathy (1. In patients of epilepsy, the seizures had an equitable distribution in the trimesters and post-partum period, were mainly of generalized type (77.27% and were controlled in the majority (90.9%. No fetal congenital malformations were seen. Tubercular meningitis [TBM] (7, pyogenic meningitis (4 and viral encephalitis (1 were the CNS infections encountered and pregnancy outcome was good in most cases. All cases of CVT presented in the postpartum period with fever and neurological signs following home delivery. Outcomes included recovery (2, residual deficits (1, persisting seizures (1 and death (1. HE affected patients mainly during the latter half of pregnancy or the post-partum period and was associated with 64.3% mortality. Death in HE showed correlation with grade of HE ( P =0.007; Glasgow Coma Scale ( P =0.006; Liver span ( P =0.049; bilirubin ( P =0.005 and retained foetus ( P

  14. [Pregnancy-Associated Breast Cancer: An analytical observational study].

    Science.gov (United States)

    Baulies, Sonia; Cusidó, Maite; Tresserra, Francisco; Rodríguez, Ignacio; Ubeda, Belén; Ara, Carmen; Fábregas, Rafael

    2014-03-04

    Pregnancy-associated breast cancer is defined as breast cancer diagnosed during pregnancy and up to one year postpartum. A retrospective, analytical, observational study comparing 56 cases of breast cancer and pregnancy (PABC) diagnosed 1976-2008 with 73 patients with breast cancer not associated with pregnancy (non-PABC) was performed. Demographic data, prognostic factors, treatment and survival were reviewed and compared. The prevalence of PABC in our center is 8.3/10,000. The highest frequency (62%) appeared during the postpartum period. The stages are higher in PABC, being 31.3% advanced (EIII and EIV) in PABC versus 13.3% in non-PABC (P < .05). Regarding prognostic factors, 27.3% in PABC had a tumoral grade 3 versus 15.8% of non-PABC. Among women with PABC, 33.3% had negative estrogen receptors, 48.7% negative progesterone receptors and 34.5% positive Her2Neu compared with 22.2, 24.1 and 31%, respectively of non-PABC patients. Finally, positive lymph nodes were found in 52.8% of PABC, versus 33.8% non-PABC (P < .05). Overall and disease-free survival rate at 5 years for PABC was 63.7 and 74.2%, respectively. The poorer survival observed is possibly due to the presence of adverse prognostic features such as lymph node metastases, negative hormone receptors, tumoral grade iii, as well as a delay in diagnosis with a higher rate of advanced stages. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  15. Outcome of Adolescent Pregnancy: A Retrospective Cohort Study

    Directory of Open Access Journals (Sweden)

    S Ozdogan

    2015-05-01

    Full Text Available Objective: The aim of this study is to review the sociodemographic characteristics, maternal, natal and postnatal outcomes of adolescent pregnancy. Subjects and method: The records of all adolescent pregnancies (aged 13–19 years delivered at Sisli Hamidiye Etfal Research and Training Hospital, Istanbul, Turkey, over a period of two years were reviewed. Structured survey was conducted with adolescent mothers over the phone. Results: The incidence of adolescent pregnancy was 7.06%; 91.1% of the cases were reported to be married. Consanguineous marriage was found to be 27.6%. Maternal anaemia was detected in 43.1% of cases. Premature birth rate was 6.3%. The rate of Cesarean section was 31.8%. Adolescent mothers were categorized into two groups: 17 years and below and above 17 years. The maternal, natal and postnatal outcomes were not statistically different between the two groups. Conclusions: Health policies should be revised and improved to take the necessary steps for providing adequate health services for adolescents and for improving prenatal, natal and postnatal care of pregnant adolescents.

  16. Maternal iron status in early pregnancy and birth outcomes: insights from the Baby's Vascular health and Iron in Pregnancy study.

    Science.gov (United States)

    Alwan, Nisreen A; Cade, Janet E; McArdle, Harry J; Greenwood, Darren C; Hayes, Helen E; Simpson, Nigel A B

    2015-06-28

    Fe deficiency anaemia during early pregnancy has been linked with low birth weight and preterm birth. However, this evidence comes mostly from studies measuring Hb levels rather than specific measures of Fe deficiency. The present study aimed to examine the association between maternal Fe status during the first trimester of pregnancy, as assessed by serum ferritin, transferrin receptor and their ratio, with size at birth and preterm birth. In the Baby VIP (Baby's Vascular health and Iron in Pregnancy) study, we recruited 362 infants and their mothers after delivery in Leeds, UK. Biomarkers were measured in maternal serum samples previously obtained in the first trimester of pregnancy. The cohort included sixty-four (18 %) small for gestational age (SGA) babies. Thirty-three babies were born preterm (9 %; between 34 and 37 weeks). First trimester maternal Fe depletion was associated with a higher risk of SGA (adjusted OR 2·2, 95 % CI 1·1, 4·1). This relationship was attenuated when including early pregnancy Hb in the model, suggesting it as a mediator (adjusted OR 1·6, 95 % CI 0·8, 3·2). For every 10 g/l increase in maternal Hb level in the first half of pregnancy the risk of SGA was reduced by 30 % (adjusted 95 % CI 0, 40 %); levels below 110 g/l were associated with a 3-fold increase in the risk of SGA (95 % CI 1·0, 9·0). There was no evidence of association between maternal Fe depletion and preterm birth (adjusted OR 1·5, 95 % 0·6, 3·8). The present study shows that depleted Fe stores in early pregnancy are associated with higher risk of SGA.

  17. Association between pregnancy intention and optimal breastfeeding practices in the Philippines: a cross-sectional study1

    Directory of Open Access Journals (Sweden)

    Ulep Valerie Gilbert T

    2012-07-01

    Full Text Available Abstract Background The effect of pregnancy intention on post-natal practices like breastfeeding is still poorly understood in the Philippines. In this light, this study aims to determine the association between pregnancy intention and optimal breastfeeding practices in the Philippines. Methods This is a cross-sectional study design using the 2003 Philippine National Demographic and Health Survey. Logistic regression analysis was used to determine the independent association of pregnancy intention and optimal breastfeeding practices. The study includes 3,044 last-born children aged 6–36 months at the time of survey. Dead children were also included as long as their age of death satisfies the age criterion. Results Children born from mistimed pregnancies are more likely to have late breastfeeding initiation compared to children born from wanted pregnancies (OR = 1.44; 90%CI: 1.17-1.78. However, this occurs only among children belonging to households with low socio-economic status. Among children belonging to households with high socio-economic status, no significant effect of pregnancy intention on breastfeeding initiation was observed. Children born from unwanted pregnancies are less likely to have short breastfeeding duration (OR = 0.60; 90%CI: 0.48-0.76. However, this occurs only among children belonging to households with high socioeconomic status. No significant effect of pregnancy intention on breastfeeding duration was observed among children belonging to households with low socio-economic status. Conclusion The findings of this study suggest that there are different effects of pregnancy intention on the two types of optimal breastfeeding practices examined. With regards to breastfeeding duration, it was found that among infants belonging to high SES, the odds of having short breastfeeding duration is lower among children born from unwanted pregnancies compared to children born from wanted one. Conversely, children belonging to

  18. Effect of dietary factors in pregnancy on risk of pregnancy complications: results from the Norwegian Mother and Child Cohort Study.

    Science.gov (United States)

    Meltzer, Helle Margrete; Brantsæter, Anne Lise; Nilsen, Roy M; Magnus, Per; Alexander, Jan; Haugen, Margareta

    2011-12-01

    There has been a thrilling development , as well as profound changes, in our understanding of the effect of fetal nutrition on the development and health of the child. The Norwegian Mother and Child Cohort Study (MoBa) is an ongoing nationwide population-based pregnancy cohort study that between 1999 and 2008 recruited 90,723 women with 106,981 pregnancies and 108,487 children. The objective of MoBa is to test specific etiologic hypotheses by estimating the association between exposures and diseases with a special focus on disorders that may originate in early life. An important aspect in this regard is maternal diet and nutritional status during pregnancy. Nutritional factors have long been considered to be important determinants of maternal and fetal health, and dietary information is currently being collected in a number of pregnancy cohorts in Europe and the United States. Thus far, pregnancy complications studied in MoBa are preterm birth, preeclampsia, and fetal growth; and the aim of this article is to report results of recently published studies of dietary factors in relation to these outcomes. Numerous studies are planned using MoBa data, and the aim is to add to the knowledge of the interplay between dietary factors, nonnutrients, and toxic dietary substances and epigenetic modulation on fetal development and health later in life.

  19. Designing satisfaction studies

    DEFF Research Database (Denmark)

    Kristensen, Kai; Eskildsen, Jacob Kjær

    2007-01-01

    In the effect sampling method, presentation of researcher, the intro text, the order of questions in the questionnaire along with the number of categories in the rating scale is tested in relation to the design of satisfaction studies. Based on the analyses specific recommendations for designing...... satisfaction studies are given....

  20. Deviant early pregnancy maternal triglyceride levels and increased risk of congenital anomalies : a prospective community-based cohort study

    NARCIS (Netherlands)

    Nederlof, M.; de Walle, H. E. K.; van Poppel, M. N. M.; Vrijkotte, T. G. M.; Gademan, M. G. J.

    ObjectiveThe maternal lipid profile could be of importance in congenital anomaly development. This study therefore investigates whether the maternal lipid profile during early pregnancy is associated with major nonsyndromic congenital anomalies (MNCA). DesignProspective community-based cohort study.

  1. Terminating pregnancy for severe hypertension when the fetus is considered non-viable: a retrospective cohort study

    NARCIS (Netherlands)

    Eerden, L. van; Oostwaard, M.F. Van; Zeeman, G.G.; Page-Christiaens, G.C.; Pajkrt, E.; Duvekot, J.J.; Vandenbussche, F.P.H.A.; Oei, S.G.; Scheepers, H.C.; Eyck, J. van; Middeldorp, J.M.; Koenen, S.V.; Groot, C.J. de; Bolte, A.C.

    2016-01-01

    OBJECTIVE: To investigate frequency and practise of termination of pregnancy for early-onset hypertensive disorders where the fetus is considered to be non-viable. STUDY DESIGN: Retrospective cohort study in all Dutch tertiary perinatal care centres (n=10), between January 2000 and January 2014. All

  2. Anorectal malformations and pregnancy-related disorders : a registry-based case-control study in 17 European regions

    NARCIS (Netherlands)

    Wijers, C. H. W.; van Rooij, I. A. L. M.; Bakker, M. K.; Marcelis, C. L. M.; Addor, M. C.; Barisic, I.; Beres, J.; Bianca, S.; Bianchi, F.; Calzolari, E.; Greenlees, R.; Lelong, N.; Latos-Bielenska, A.; Dias, C. M.; McDonnell, R.; Mullaney, C.; Nelen, V.; O'Mahony, M.; Queisser-Luft, A.; Rankin, J.; Zymak-Zakutnia, N.; de Blaauw, I.; Roeleveld, N.; de Walle, H. E. K.

    2013-01-01

    Objective To identify pregnancy-related risk factors for different manifestations of congenital anorectal malformations (ARMs). Design A population-based case-control study. Setting Seventeen EUROCAT (European Surveillance of Congenital Anomalies) registries, 1980-2008. Population The study populati

  3. Anorectal malformations and pregnancy-related disorders: a registry-based case-control study in 17 European regions

    NARCIS (Netherlands)

    Wijers, C.H.W.; Rooij, I.A.L.M. van; Bakker, M.K.; Marcelis, C.L.M.; Addor, M.C.; Barisic, I.; Beres, J.; Bianca, S.; Bianchi, F.; Calzolari, E.; Greenlees, R.; Lelong, N.; Latos-Bielenska, A.; Dias, C.M.; McDonnell, R.; Mullaney, C.; Nelen, V.; O'Mahony, M.; Queisser-Luft, A.; Rankin, J.; Zymak-Zakutnia, N.; Blaauw, I. de; Roeleveld, N.; Walle, H.E. de

    2013-01-01

    OBJECTIVE: To identify pregnancy-related risk factors for different manifestations of congenital anorectal malformations (ARMs). DESIGN: A population-based case-control study. SETTING: Seventeen EUROCAT (European Surveillance of Congenital Anomalies) registries, 1980-2008. POPULATION: The study popu

  4. Terminating pregnancy for severe hypertension when the fetus is considered non-viable : a retrospective cohort study

    NARCIS (Netherlands)

    Van Eerden, Leonoor; Van Oostwaard, Miriam F.; Zeeman, Gerda G.; Page-Christiaens, Godelieve C. M.; Pajkrt, Eva; Duvekot, Johannes J.; Vandenbussche, Frank P.; Oei, Swan G.; Scheepers, Hubertina C. J.; Van Eyck, Jim; Middeldorp, Johanna M.; Koenen, Steven V.; De Groot, Christianne J. M.; Bolte, Antoinette C.

    2016-01-01

    Objective: To investigate frequency and practise of termination of pregnancy for early-onset hypertensive disorders where the fetus is considered to be non-viable. Study design: Retrospective cohort study in all Dutch tertiary perinatal care centres (n = 10), between January 2000 and January 2014.

  5. Terminating pregnancy for severe hypertension when the fetus is considered non-viable : a retrospective cohort study

    NARCIS (Netherlands)

    Van Eerden, Leonoor; Van Oostwaard, Miriam F.; Zeeman, Gerda G.; Page-Christiaens, Godelieve C M; Pajkrt, Eva; Duvekot, Johannes J.; Vandenbussche, Frank P.; Oei, Swan G.; Scheepers, Hubertina C J; Van Eyck, Jim; Middeldorp, Johanna M.; Koenen, Steven V.; De Groot, Christianne J M; Bolte, Antoinette C.

    2016-01-01

    Objective To investigate frequency and practise of termination of pregnancy for early-onset hypertensive disorders where the fetus is considered to be non-viable. Study design Retrospective cohort study in all Dutch tertiary perinatal care centres (n = 10), between January 2000 and January 2014. All

  6. Risk of vertical transmission of human papillomavirus throughout pregnancy: a prospective study.

    Directory of Open Access Journals (Sweden)

    Seung Mi Lee

    Full Text Available OBJECTIVE: Much controversy still exists about maternal-to-infant transmission of human papillomavirus (HPV infection, specifically about the magnitude of the risk and the route and timing of such vertical transmission. This prospective cohort study examines the risk of vertical transmission of maternal HPV in each trimester of pregnancy. STUDY DESIGN: One hundred fifty three healthy pregnant women were followed longitudinally throughout pregnancy and cervical swabs obtained in each trimester and postpartum for HPV detection. Cord blood, neonatal nasopharyngeal aspirates, and placental biopsies were collected at delivery. DNA isolation, polymerase chain reaction, and hybridization were performed using the GG HPV Genotyping Chip Kit (Goodgene Inc., Seoul, Korea. Detection of HPV in neonates was defined as the presence of HPV DNA in either cord blood or neonatal nasopharyngeal aspirate. RESULTS: HPV DNA was detected in 14%(22/153 of healthy women in the first trimester, 18%(22/124 in the second trimester, and 10%(15/153 in the third trimester; 24%(37/153 were positive for HPV DNA on at least one occasion in pregnancy. At birth, 5.2%(8/153 of neonates were HPV DNA positive. Seven of these eight infants were born to HPV-positive mothers. Placental HPV DNA was positive in 3.3%(5/152 of cases, and all five cases were from mothers with at least one HPV-positive test. Detection of HPV DNA in neonates was associated with detection of HPV in mothers during any of the three trimesters of pregnancy. CONCLUSION: HPV DNA was detected at birth in 5.2%(8/153 of neonates born to healthy women, and was associated with the detection of HPV in mothers during any of the three trimesters of pregnancy.

  7. Maternal Lifestyle and Pregnancy Complications: The Generation R Study

    NARCIS (Netherlands)

    R. Bakker (Rachel)

    2011-01-01

    textabstractAdverse maternal lifestyle habits during pregnancy are important modifiable risk factors for pregnancy complications in Western countries. Most common adverse maternal lifestyle habits include smoking, alcohol consumption, and caffeine consumption. Although not directly lifestyle related

  8. Vitamin D Status during Pregnancy: A Longitudinal Study in Swedish Women from Early Pregnancy to Seven Months Postpartum.

    Science.gov (United States)

    Lundqvist, Anette; Sandström, Herbert; Stenlund, Hans; Johansson, Ingegerd; Hultdin, Johan

    2016-01-01

    Low vitamin D levels during pregnancy may have negative consequences for the health of both the mother and child. Cross-sectional studies in childbearing women suggest that vitamin D levels are low during pregnancy, but few studies have followed the same women during pregnancy and postpartum. The aims of this study were to longitudinally assess vitamin D status during pregnancy and postpartum and identify the factors associated with vitamin D status in pregnant women in northern Sweden. Between September 2006 and March 2009, 184 women were consecutively recruited at five antenatal primary care clinics. Blood was sampled, and dietary intake was estimated using a food frequency questionnaire with 66 food items/food aggregates and questions on the intake of vitamin supplements at gestational weeks 12, 21, and 35, as well as at 12 and 29 weeks after birth. Plasma 25(OH) vitamin D levels were analyzed using liquid chromatography tandem-mass spectrometry. At least one-third of the women had 25(OH) vitamin D levels pregnancy. The levels reverted to the baseline levels after birth. Multivariate analysis showed that gestational and postpartum week, season, dietary intake of vitamin D, and vitamin supplementation were significantly related to plasma levels. There was also an influence of season on the longitudinal concentration patterns. In conclusion, more than one-third of the women studied had low 25(OH) vitamin D levels, and gestational and postpartum week was related to 25(OH) vitamin D levels after adjustment for season and vitamin D intake.

  9. Magnesium supplement in pregnancy-induced hypertension. A clinicopathological study

    DEFF Research Database (Denmark)

    Rudnicki, M; Junge, Jette; Frølich, A;

    1990-01-01

    as a double-blind randomized controlled study in which 11 women were allocated to magnesium and 7 to placebo treatment. The treatment comprised a 48-hour intravenous magnesium/placebo infusion followed by daily oral magnesium/placebo intake until one day after delivery. Magnesium supplement increased birth....... There was no significant difference when the magnesium group, the placebo group and the control group were compared separately. The present study suggests that magnesium supplement has a beneficial effect on fetal growth in pregnancy-induced hypertension. With regard to the light and electron microscopic changes we were...... unable to demonstrate any significant difference between the magnesium, placebo and control groups....

  10. STUDY ON PLATELET INDICES IN PREGNANCY INDUCED HYPERTENSION

    Directory of Open Access Journals (Sweden)

    Rabi a Parveen

    2015-10-01

    Full Text Available INTRODUCTION : Pregnancy induced hypertension includes gestational hypertension, preeclampsia, and eclampsia. In PIH, lower the platelet count, greater are maternal and fetal morbidity and mortality. Recent studies suggest that platele t parameters like platelet indices are most simple and cost effective method for prediction of PIH, way before the appearance of derangements in PT, APTT, TT values so we undertook this study with an aim to see an association between platelet indices and pregnancy induced hypertension. MATERIAL AND METHOD : This was prospective analytical case control study. Study included 125 cases, who were diagnosed as PIH with B.P. > 140/90 mmHg, detected after 20 weeks of pregnancy. Under all aseptic precautions samples were collected randomly in EDTA vials . Samples were analysed for platelet indices . RESULT : Maximum number of cases of Preeclampsia (88.57% & Eclampsia (87.5% were fo und in age group of 21 to 25 . Controls were of same age group i.e. 21 to 25 years. It was observed that platelet count showed gradual decrease in eclampsia (1.44580± 36,210 & pre - e clampsia patients (1.97850± 39,010 as compared to normotensive subjects (2.42620± 40,412. MPV showed gradual increase in eclampsia ( 10.49 ±1.12 & pre - eclampsia ( 9.14 ±0.612 patients as compared to normotensive subjects ( 8.422 ±0.743. PDW value also shows gradual increase in eclampsia ( 18.39 ±2.62 & pre - eclampsia ( 16.29 ±2.34 p atients as compared to normotensive subjects ( 12.09 ±2.53. CONCLUSION : Study showed that platelet indices were important, simple, effortless and cost effective investigations which can be used for early recognition of preventable eclampsia complications.

  11. The Scope of Design Studying

    Institute of Scientific and Technical Information of China (English)

    JIN Yin; Ren Wenying

    2007-01-01

    This article trys to discuss the scope of design studying in two fields.Firstly, design has three meanings: wide design, art design and industrial design.Secondly, design studying has five contents: cultural, philosophical, methodological, produced and marketable trends.

  12. Malaria in pregnancy: ultrasound studies of fetal growth

    NARCIS (Netherlands)

    Rijken, M.J.

    2012-01-01

    Malaria has been a plague for human mankind. Each year roughly 125 million pregnancies are at risk for malaria infection. This thesis demonstrates the detrimental effects of malaria in pregnancy on the mother and the baby. To determine the effects of malaria in pregnancy on birth outcomes, accurate

  13. SSRI use in pregnancy : A study in 6 European databases

    NARCIS (Netherlands)

    Jordan, S.; Charlton, R.A.; Tingay, K.; Thayer, D.S.; Davies, G.I.; Morgan, M.; Tucker, D.; Watkins, A.; Gini, R.; Pierini, A.; Hansen, A.; Garne, E.; Nybo, A.; Puccini, A.; Neville, A.J.; Bos, Jens; De Jong-Van Den Berg, L.T.W.; De Vries, C.S.; Dolk, H.; Petersen, I.; Man, S.

    2015-01-01

    Objective / Background Use of selective serotonin reuptake inhibitors (SSRIs) during pregnancy has been associated with adverse pregnancy outcomes, including congenital heart disease. Objectives: To describe utilisation patterns of SSRIs 1 year before, during and 1 year after pregnancy in primary ca

  14. U.S. teen pregnancy: studies point to new prevention approaches.

    Science.gov (United States)

    1988-01-01

    The US has the highest rate of teenage pregnancy in the developed world, and although there is no consensus on the best solution, promising prevention approaches are being offered. 1 in 10 teenaged girls in the US becomes pregnant each year, and more than 1/2 of these pregnancies end in abortion or miscarriage. In a 1986 survey of US teens aged 12 to 17, 1/3 of the sexually active reported using contraceptives all the time, and 27% said they never used them. 24% of the teens cited embarrassment and fear of parental disapproval as reasons for not using contraceptives, while almost 40% said they did not want to use them. 1/4 reportedly lacked knowledge about contraceptives. A successful approach, which increased contraceptive use among teens and helped reduce adolescent pregnancies, involved a school-based clinic in Minnesota. It provided information about sex and birth control, and referred students to a clinic for contraceptive services. Another effective approach provided a combination of sex education and accessible family planning services in 2 Baltimore schools. It resulted in reduced teenage pregnancy rates and a small decrease in the age at 1st intercourse. Programs designed to encourage postponement of sexual activity, and resistance of peer pressure, as well as efforts to promote responsible decision-making and communication between parents and children, are thought to have potential. The "life options" strategy targets girls with low educational ambitions, who are from poor families since study results indicate a high rate of pregnancy among this group. The approach is to help young people develop values and self-esteem, and work toward realistic goals.

  15. Longitudinal study of serum placental GH in 455 normal pregnancies

    DEFF Research Database (Denmark)

    Chellakooty, Marla; Skibsted, Lillian; Skouby, Sven O

    2002-01-01

    women with normal singleton pregnancies at approximately 19 and 28 wk gestation. Serum placental GH concentrations were measured by a highly specific immunoradiometric assay, and fetal size was measured by ultrasound. Data on birth weight, gender, prepregnancy body mass index (BMI), parity, and smoking.......002). Placental GH at second examination was positively correlated with gestational age (P = 0.002) and negatively correlated with prepregnancy BMI (P = 0.039). Placental GH correlated with fetal weight at approximately 28 wk gestation (P = 0.002) but did not predict birth weight at term. Our study supports...

  16. Perinatal Mortality And Pregnancy Wastage In Ten Punjab Villages During 1991-1996 - A Population Based Study

    Directory of Open Access Journals (Sweden)

    Sachar R.K

    1998-01-01

    Full Text Available Research question: What is the extent of perinatal mortality and pregnancy wastage in rural Punjab and what are risk factors for the same. Objective: To quantify the perinatal; wastage and risk factors including the prevalence of these factors to determine the loss attributable to these factors in ten Punjab villages during the period 1991-1996. Study Design: Case control. Sample Size: 2519 pregnant women with Known outcome of pregnancy. Study Variables: Cause, timing and factors affecting perinatal mortality and pregnancy wastage (viz Wt.<40kg; Ht, <152cm,BMI, <20 illiteracy, birth to conception interval <100wks, Prematurity (Gestation <37 wks. Registered in IIIrd trimester, Registered in IInd Trimester, Home delivery. Outcome variables: Contribution of these factors in perinatal loss and pregnancy wastage. Analysis; Percentages, Odds ratio, confidence interval and population attributable risk%. Results: The perinatal mortality rate was 34.57/1000 and pregnancy wastage was 7.23%. Prematurity was the leading cause of perinatal loss. 31.25% of perinatal deaths took place within 24 hours and 87.5% within 96 hours. In case of perinatal mortality the odds ration were significant (p<0.05 for the following risk factors: weight, height, body mass index, illiteracy, birth to conception interval <1000 weeks, prematurity, registration of pregnancy in IInd trimester, registration of pregnancy in IIIrd trimester, home delivery. In case of pregnancy wastage the odds ratio were significant for the following risk factors: weight, height, body mass index, illiteracy, birth to conception interval <100weeks, prematurity, past history of abortion and low socio-economic status.

  17. Cigarette smoking and waiting time to pregnancy: results of a pilot study.

    Science.gov (United States)

    Zilaitiene, Birute; Dirzauskas, Marius; Preiksa, Romualdas Tomas; Matulevicius, Valentinas

    2007-01-01

    Waiting time to pregnancy is an important characteristic of human reproductive health, which has not been investigated in Lithuania until now. Data on waiting time to pregnancy have been collected from medical records of 111 women admitted to the Department of Obstetrics, Klaipeda Hospital. Seven women in whom pregnancy was the result of infertility treatment were excluded from the analysis, and the rest 104 cases were analyzed. We evaluated waiting time to pregnancy in respect to the age of couples, contraceptive use, cigarette smoking of both partners, and some other features of obstetric history. The mean waiting time to pregnancy in the cohort was 5.21+/-7.03 months. If both partners smoked, the mean waiting time to pregnancy was significantly longer than in nonsmoking couples (7.68+/-9.41 vs. 4.30+/-5.73, Pus to plan and implement a larger-scale study of waiting time to pregnancy in Lithuanian population.

  18. Drug Use before and during Pregnancy in Japan: The Japan Environment and Children’s Study

    Directory of Open Access Journals (Sweden)

    Hidekazu Nishigori

    2017-04-01

    Full Text Available Purpose: To elucidate drug use before and during pregnancy in Japan. Methods: The Japan Environment and Children’s Study (JECS is an ongoing nationwide birth cohort study. We analyzed data from JECS involving cases where drugs were used for 12 months before pregnancy was diagnosed, between the time of diagnosis of pregnancy until week 12 of pregnancy, and after week 12 of pregnancy. Results: We analyzed data from 97,464 pregnant women. The percentages of pregnant women who had taken one or more drugs and supplements before diagnosis of pregnancy, between the time of diagnosis of pregnancy until week 12 of pregnancy, and after week 12 of pregnancy, were 78.4%, 57.1%, and 68.8% respectively. Excluding iron supplements, folic acid, and other vitamins and minerals, the percentages of women taking supplements were 75.3%, 36.0%, and 51.7% at each respective time point. The following drugs and supplements were frequently used for 12 months before pregnancy diagnosis: Commercially available antipyretics, analgesics, and/or medicine for treating common cold (34.7%, antipyretics, analgesics, and/or medicine for treating common colds, which were prescribed in hospitals (29.8%, antimicrobial drugs (14.0%, and anti-allergy drugs (12.5%. The following drugs and supplements were frequently used from the time of pregnancy diagnosis until week 12 of pregnancy, and after week 12 of pregnancy: folic acid (28.9% and 26.2%, antipyretics, analgesics and/or medicines for treating common cold, that were prescribed in hospitals (7.8% and 13.3%, Chinese herbal medicines (6.0% and 9.4%, and uterine relaxants (5.1% and 15.2%. Conclusions: The analysis of a nationwide cohort study showed that a high percentage of Japanese pregnant women were taking medicinal drugs. Further research is required to elucidate the relationship between drug use during pregnancy and birth defects in Japan.

  19. 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.

  20. Effect of maternal age on pregnancy: a retrospective cohort study

    Institute of Scientific and Technical Information of China (English)

    Liu Xiaoli; Zhang Weiyuan

    2014-01-01

    Background In the last few decades,there has been a delay in first-time pregnancies,and the average age of women at the time of delivery has increased in many countries.Advanced maternal age is associated with adverse pregnancy outcomes.This study aimed to determine the present trends and pregnancy outcomes related to maternal age in China.Methods Data were collected from 39 hospitals in mainland of China.All deliveries were performed after 28 completed weeks of gestation and between January 1 and December 31,2011.In total,110 450 of 112 441 cases were included in the study.All enrolled cases were divided into 6 age groups with 5-year intervals.The x2 test or Fisher's exact test and unadjusted binary-Logistic regression were used for statistical analysis.Results The mean age at the time of delivery was 28.18±4.70 years (range,14-52 years).The teenage group (15-19 years) had a higher risk than the 25-29-year old group for anemia (odds ratio (OR),1.4),preeclampsia (OR,1.6),preterm birth (OR,2.1),low birth weight neonates (OR,2.3),and perinatal mortality (OR,3.6).The 35-39-year old group and ≥40-year-old group had a higher risk than the 25-29-year-old group for leiomyoma (OR,4.2 vs.5.8),pregestational diabetes (OR,2.2 vs.3.8),chronic hypertension (OR,4.6 vs.6.5),gestational diabetes (OR,2.6 vs.3.5),preeclampsia (OR,2.5 vs.3.6),premature delivery (OR,1.8 vs.2.4),postpartum hemorrhage (OR,1.5 vs.1.7),placenta previa (OR,2.7 vs.4.0),placental abruption (OR,1.4 vs.2.5),cesarean delivery (OR,2.1 vs.2.5),macrosomia (OR,1.2 vs.1.2),low birth weight neonates (OR,1.6 vs.2.3),and perinatal mortality (OR,1.6 vs.3.7).Conclusion Maternal and neonatal risks are higher during the teenage years and at an advanced maternal age; 20-30 years of age is the lowest risk period for pregnancy and delivery.

  1. Selective serotonin reuptake inhibitor prescribing before, during and after pregnancy : a population-based study in six European regions

    NARCIS (Netherlands)

    Charlton, R. A.; Jordan, S.; Pierini, A.; Garne, E.; Neville, A. J.; Hansen, A. V.; Gini, R.; Thayer, D.; Tingay, K.; Puccini, A.; Bos, H. J.; Andersen, A. M. Nybo; Sinclair, M.; Dolk, H.; de Jong-van den Berg, L. T. W.

    2015-01-01

    ObjectiveTo explore the prescribing patterns of selective serotonin reuptake inhibitors (SSRIs) before, during and after pregnancy in six European population-based databases. DesignDescriptive drug utilisation study. SettingSix electronic healthcare databases in Denmark, the Netherlands, Italy (Emil

  2. Prediction of recurrence of hypertensive disorders of pregnancy between 34 and 37 weeks of gestation: a retrospective cohort study

    NARCIS (Netherlands)

    Oostwaard, M.F. van; Langenveld, J.; Bijloo, R.; Wong, K.M.; Scholten, I.; Loix, S.; Hukkelhoven, C.W.; Vergouwe, Y.; Papatsonis, D.N.; Mol, B.W.; Ganzevoort, W.

    2012-01-01

    OBJECTIVE: To assess the recurrence risk of late-preterm hypertensive disease of pregnancy, and to determine whether potential risk factors are predictive. DESIGN: Retrospective cohort study. SETTING: Three secondary and three tertiary care hospitals in the Netherlands. POPULATION: We identified wom

  3. Leisure time physical exercise during pregnancy and the risk of miscarriage: a study within the Danish National Birth Cohort

    DEFF Research Database (Denmark)

    Madsen, M; Jørgensen, T; Jensen, M L

    2007-01-01

    OBJECTIVE: To examine the association between leisure time physical exercise during pregnancy and the risk of miscarriage. DESIGN: Prospective study with elements of retrospective data collection. SETTING: Denmark 1996-2002. POPULATION: A total of 92,671 pregnant women enrolled in the Danish...

  4. Clinical study of venous thromboembolism during pregnancy and puerperium.

    Science.gov (United States)

    Adachi, T; Hashiguchi, K; Arai, Y; Ohta, H

    2001-01-01

    We encountered 16 cases of venous thromboembolism (VTE) in women during pregnancy and/or puerperium over the past 15 years at our perinatal center, representing 0.14% of all patients who delivered babies. The present study was undertaken to analyze the risk factors, clinical course and outcomes in these 16 cases. The ages of the patients varied from 29 to 39 years. Four women had pulmonary embolism (PE), 3 of which after caesarean section (C/S) at 35 to 40 weeks, and one case after ovarian cystectomy at 13 weeks of gestation. Twelve cases had deep venous thrombosis (DVT), 4 of which during pregnancy, and the remaining 8 cases after C/S. Four patients who had DVT during a normal course of pregnancy had severe thrombophilia: antiphospholipid antibody syndrome, a history of thrombosis and antithrombin (AT) deficiency. They were treated with heparin with or without AT and had healthy babies via successful vaginal deliveries. The common risk factors in 3 cases of PE with C/S was prolonged bed rest due to threatened premature delivery with total placenta previa, uterine myoma and Ehlers-Danlos syndrome. Other risk factors were massive bleeding, and positive lupus anticoagulant. However, the case of the ovarian cystectomy had only one risk factor, which was obesity. This patient died but the remaining patients recovered with treatment. Because of the low incidence of thrombosis in the Japanese population, prophylactic anticoagulant therapy has not routinely been given to patients undergoing obstetrical operations. However, proper management including prophylactic anticoagulant therapy might be considered for risk patients, depending on the risk factors.

  5. Cross-sectional study of nutritional markers in pregnancy

    Directory of Open Access Journals (Sweden)

    Subhadra Sharma

    2016-01-01

    Full Text Available Objectives: To note the value of serum Vitamin B12, folic acid, and ferritin in normal and high-risk pregnancies (HRPs in patients attending antenatal clinic at All India Institute of Medical Sciences (AIIMS. Materials and Methods: This is a cross-sectional study where a total of 282 patients attending Gynaecology Outpatient Department at AIIMS, New Delhi, India were recruited. Among the 282 subjects, 251 were pregnant, and 31 were controls. The serum was tested for serum Vitamin B12, serum folic acid, and serum ferritin levels using Beckman Coulter Access 2 immunoassay. Results: The median value of serum folic acid level in pregnant women was 12 pg/ml with range being 2–20 pg/ml in contrast to 8 pg/ml with range being 3–20 pg/ml in nonpregnant female. This difference was statistically significant. (P = 0.05. There was no significant difference in the median level of serum Vitamin B12 and serum ferritin in pregnant and nonpregnant group. Serum Vitamin B12 level was lower in the third trimester (127 pg/ml than in first trimester (171 pg/ml and the difference is statistically significant (P = 0.03. Serum ferritin levels were also significantly lower in the second trimester (16.4 pg/ml than third trimester (24.55 pg/ml. Although the median serum folic acid level was lower in the first trimester (9.84 pg/ml than in second trimester (10.8 pg/ml and in the third trimester (13.18 pg/ml but the difference was not statistically significant. There was no significant difference in Vitamin B12 level in HRPs (median value 134 pg/ml as compared to low-risk pregnancies (149.5 pg/ml. Conclusion: Serum folic acid levels are significantly higher during pregnancy as compared to nonpregnant state. However, there was no significant difference in the median level of serum Vitamin B12 and serum ferritin in pregnant and nonpregnant group. Serum folic acid level and ferritin level were significantly higher in HRPs compared to low-risk pregnancies.

  6. Anxiety during pregnancy and preeclampsia: a case - control study

    Directory of Open Access Journals (Sweden)

    Masoumeh Kordi

    2017-01-01

    Full Text Available Introduction:  Preeclampsia is the common and dangerous complication of pregnancy with unknown reason. Multiple causes such as depression, psychological and physical stress may be involved in its development. This study was performed to determine the relationship between anxiety during pregnancy and the incidence of preeclampsia. Methods: This case-control study was conducted on 150 pregnant women with preeclampsia and 150 healthy pregnant women referred to health centers and academic hospitals of Mashhad in 2014. The diagnosis of preeclampsia was made by systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg accompanied with urinary protein excretion more than 300 mg per 24 hours. The cutoff point for the presence of anxiety was the score of ≥8; the score of 8-9 was mild anxiety and the score of 20 was very severe anxiety. Data collection tools included the form of demographic characteristics, clinical and laboratory signs of preeclampsia, and depression, anxiety, and stress scale (DASS 21. Data were analyzed using SPSS software (version 16 and independent t-test, Mann-Whitney, Chi-square, and logistic regressions model. P Results: We found significant relationship between anxiety and preeclampsia (P

  7. Physical exercise during pregnancy and fetal growth measures: a study within the Danish National Birth Cohort

    DEFF Research Database (Denmark)

    Juhl, Mette; Olsen, Jørn; Andersen, Per Kragh

    2010-01-01

    OBJECTIVE: The objective of the study was to examine the association between physical exercise during pregnancy and fetal growth measures. STUDY DESIGN: Data on 79,692 liveborn singletons from the Danish National Birth Cohort were collected between 1996 and 2002. Mean differences in birthweight......, length, ponderal index, head and abdominal circumference, and placental weight and hazard ratios of small- and large-for-gestational-age babies were calculated. RESULTS: Our data indicated smaller babies in exercising women compared with nonexercisers, but the differences were small, and only a few were...

  8. 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

  9. 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.

  10. Design and data analysis 1 study design

    Directory of Open Access Journals (Sweden)

    Karthik Suresh

    2012-01-01

    Full Text Available This article is intended to give the reader guidance in evaluating different study designs used in medical research for better scientific quality, reliability and validity of their research. This article explains three main types of study designs with understanding examples. Care and caution with skills and experience needed to design suitable studies and appropriate design coupled with reliable sampling techniques and appropriate statistical analysis, supported by clear objectives with decent communication of the findings, are essential for good research.

  11. Dermatological disorders during pregnancy: a study from tertiary care hospital

    Directory of Open Access Journals (Sweden)

    Krina B. Patel

    2016-05-01

    Results: Out of 131 patients, only 11(8.4% patients presented with pregnancy specific dermatoses while rest 120 (91.6% presented with pregnancy non-specific dermatoses. Among pregnancy non-specific dermatoses, non-infectious conditions were found in 48.1% and 43.5% presented with infectious dermatoses. Most common infectious dermatoses was herpes labialis while most common non-infectious dermatosis was pruritus. Conclusions: Pregnancy specific dermatoses are rare and require vigilant eye to recognize them while wide variety of pregnancy non-specific dermatoses are commonly encountered and require prompt diagnosis and treatment for uneventful pregnancy outcome. [Int J Reprod Contracept Obstet Gynecol 2016; 5(5.000: 1354-1359

  12. Maternal and Live-birth Outcomes of Pregnancies following Assisted Reproductive Technology: A Retrospective Cohort Study

    Science.gov (United States)

    Zhu, Linling; Zhang, Yu; Liu, Yifeng; Zhang, Runjv; Wu, Yiqing; Huang, Yun; Liu, Feng; Li, Meigen; Sun, Saijun; Xing, Lanfeng; Zhu, Yimin; Chen, Yiyi; Xu, Li; Zhou, Liangbi; Huang, Hefeng; Zhang, Dan

    2016-01-01

    This study was carried out to explore associations between assisted reproductive technology (ART) and maternal and neonatal outcomes compared with similar outcomes following spontaneously conceived births. We conducted a retrospective cohort study of pregnancies conceived by ART (N = 2641) during 2006–2014 compared to naturally conceived pregnancies (N = 5282) after matching for maternal age and birth year. Pregnancy complications, perinatal complications and neonatal outcomes of enrolled subjects were investigated and analysed by multivariate logistic regression. We found that pregnancies conceived by in vitro fertilization (IVF) were associated with a significantly increased incidence of gestational diabetes mellitus, gestational hypertension, preeclampsia, intrahepatic cholestasis of pregnancy, placenta previa, placental abruption, preterm premature rupture of membranes, placental adherence, postpartum haemorrhage, polyhydramnios, preterm labour, low birth weight, and small-for-date infant compared with spontaneously conceived births. Pregnancies conceived by intracytoplasmic sperm injection (ICSI) showed similar elevated complications, except some of the difference narrowed or disappeared. Singleton pregnancies or nulliparous pregnancies following ART still exhibited increased maternal and neonatal complications. Therefore, we conclude that pregnancies conceived following ART are at increased risks of antenatal complications, perinatal complications and poor neonatal outcomes, which may result from not only a higher incidence of multiple pregnancy, but also the manipulation involved in ART processes. PMID:27762324

  13. Study of maternal and foetal outcome in multifetal pregnancy

    Directory of Open Access Journals (Sweden)

    Pranjal Sanjay Nimbalkar

    2016-10-01

    Conclusions: Risk of pregnancy related complication in twins is definitely more than singleton pregnancy. Early diagnosis, careful monitoring of foetal wellbeing throughout pregnancy, administration of corticosteroids and tocolytics, regular antenatal checkups, adequate rest and institutional delivery having level 3 neonatal back up facilities can improve maternal and perinatal outcome in these patients. Motivating mothers for feeding and taking proper nutrition will help in preventing health problems in babies. [Int J Reprod Contracept Obstet Gynecol 2016; 5(10.000: 3478-3481

  14. Pregnancy, Childbirth and Midwifery Care among Women with Intellectual Disability in Sweden : Epidemiological and Descriptive Studies

    OpenAIRE

    Höglund, Berit

    2012-01-01

    The overall aim of this thesis was to investigate pregnancy and childbirth in women with intellectual disability (ID), in Sweden, the health of their newborns and midwifery care for these women. Two register studies and two descriptive studies are included. Pregnancy and birth outcomes as well as data on the newborns’ health were examined by linking data from the National Patient Register and the Medical Birth Register (I-II). The women’s experience of pregnancy and delivery was investigated ...

  15. Cancer in pregnancy

    DEFF Research Database (Denmark)

    Han, Sileny N; Kesic, Vesna I; Van Calsteren, Kristel

    2013-01-01

    OBJECTIVE: To evaluate physicians' attitudes and knowledge regarding the treatment possibilities for patients with cancer in pregnancy. STUDY DESIGN: A 30-item questionnaire was mailed electronically to physicians across Europe, who were potentially involved in care of pregnant patients and....../or cancer, using the membership directories of different professional societies. RESULTS: 142 surveys were eligible for analysis. A median of 2 (range 0-100) patients with cancer in pregnancy were treated per center in 2010. The vast majority of respondents (94%) agreed that management of pregnant patients......% of respondents. Univariate logistic regression analysis found a trend that non-academic hospitals prefer termination of pregnancy (odds ratio [OR]=0.68; 95% CI, 0.28-1.63; P=0.39), and also no treatment during pregnancy (OR=0.70; 95% CI, 0.33-1.50; P=0.36). CONCLUSION: Termination of pregnancy, delay of maternal...

  16. A prospective study of Willis-Ekbom disease/restless legs syndrome during and after pregnancy.

    Science.gov (United States)

    Neyal, Abdurrahman; Senel, Gulcin Benbir; Aslan, Rahime; Nalbantoglu, Mecbure; Acikgoz, Serdar; Yilmaz, Nevin; Tumay, Feray Bolukbasi; Neyal, Munife; Karadeniz, Derya

    2015-09-01

    Willis-Ekbom disease/restless legs syndrome (WED/RLS) is the most common sleep-related movement disorder in pregnancy. We designed a prospective longitudinal study to investigate the correlates of WED/RLS during and after pregnancy. A total of 138 pregnant women with WED/RLS and a control group of 251 age-matched pregnant women were enrolled prospectively. A questionnaire was administered during a face-to-face interview at first evaluation during pregnancy and three months after delivery. Among all women in the first trimester, 15.6% were diagnosed with WED/RLS, whereas 32.8% of those in the second trimester and 38.8% of those in the third trimester were diagnosed with WED/RLS (p = 0.032). In regression analysis, later gestational age [p < 0.001; odds ratio (OR) 1.054] and previous history of WED/RLS (p = 0.001; OR 2.795) were positively correlated with the presence of WED/RLS, while ferritin levels (p = 0.001; OR 0.956) were negatively correlated with the presence of WED/RLS. Ferritin levels were also negatively correlated with the International RLS Study Group severity index (p = 0.041). Forty-eight patients (34.8%) experienced WED/RLS symptomatology after delivery. The ferritin levels were lower, and the mean number of pregnancies was higher, in women with residual WED/RLS (p = 0.008). Our survey showed that WED/RLS was more common in the second and third trimesters. Emergence of WED/RLS during the second trimester was strongly associated with residual WED/RLS. Lower ferritin levels were associated with both WED/RLS in pregnancy and residual WED/RLS after delivery. A higher number of pregnancies were also associated with a greater likelihood of having residual WED/RLS after delivery. Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.

  17. Pregnancy hypertensive disease and risk of dementia and cardiovascular disease in women aged 65 years or older: a cohort study

    OpenAIRE

    Nelander, Maria; Cnattingius, S; Åkerud, Helena; Wikström, Johan; Pedersen, N.L.; Wikström, Anna-Karin

    2016-01-01

    OBJECTIVE: The primary aim was to study pregnancy hypertensive disease and subsequent risk of dementia. The second aim was to study if the increased risks of cardiovascular disease (CVD) and stroke after pregnancy hypertensive disease persist in an elderly population. DESIGN: Cohort study. SETTING: Sweden. POPULATION OR SAMPLE: 3232 women 65 years or older (mean 71 years) at inclusion. METHODS: Cox proportional hazards regression analyses were used to calculate risks of dementia, CVD and/or s...

  18. Multiple sclerosis and pregnancy: a single-centre prospective comparative study.

    Science.gov (United States)

    Cuello, J P; Martínez Ginés, M L; Martin Barriga, M L; de Andrés, C

    2017-03-01

    Multiple sclerosis (MS) is a autoimmune disorder which preferentially affects young women of childbearing age. During pregnancy, the annualized relapse rate (AAR) is modified, but pregnancy has no harm effect on the long-term course of the disease. We aimed to study the clinical course of our MS patients during pregnancy, and compare their obstetrics outcomes with a control group of non-MS patients. A single centre prospective observational study was conducted. We assessed the reproductive history, MS history, pregnancy course and new-born outcome of a cohort of MS patients who had had a pregnancy between january 2007 and july 2012. We compared the global outcomes with a control cohort of 58 age-matched healthy pregnancies. Complete data from 35 consecutive women were analyzed, 40 deliveries. Control groups: 58 patients, 60 deliveries. EDSS at pregnancy 0,7. ARR before pregnancy 0,5. During pregnancy 0,3, after pregnancy 0,4. Twelve patients were on disease-modifying drugs (DMD) before pregnancy, 4 prenatal exposure occurs. The comparison between relapse rate and EDSS before, during and after delivery showed no statistically significant difference. In addition, compared to control group, there were also no differences in the obstetric outcomes. In MS cohort, we found a higher incidence of assisted reproductive treatments and lower breastfeeding rate, both statistically significant. Our series confirms that pregnancy has no negative long term impact on the progression of MS and also suggest that there is no additional morbidity in the pregnancy, comparing to the rest of the population. Copyright © 2014 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

  19. A population-based case-control study of the safety of oral anti-tuberculosis drug treatment during pregnancy

    DEFF Research Database (Denmark)

    Czeizel, A.E.; Rockenbauer, M.; Olsen, J.

    2001-01-01

    OBJECTIVE: To study the human teratogenic potential of isoniazid and other anti-tuberculosis drug treatment during pregnancy. DESIGN AND SETTING: Cases from a large population-based dataset at the Hungarian Case-Control Surveillance of Congenital Abnormalities, and controls from the National Birth...... Registry, between 1980 and 1996. Information on all oral anti-tuberculosis drug treatments during pregnancy was medically recorded. STUDY PARTICIPANTS: Women who had newborns or fetuses with congenital abnormalities (case group), and women who had babies with no congenital abnormality (control group). MAIN...... OUTCOME MEASURES: Congenital abnormalities in newborn infants and fetuses diagnosed prenatally during the second and third trimesters, and postnatally from birth to the age of one year. RESULTS: Of 38,151 controls, 29 (0.08%) were exposed to anti-tuberculosis drug treatment during pregnancy...

  20. Differential transferrin expression in placentae from normal and abnormal pregnancies: a pilot study

    Directory of Open Access Journals (Sweden)

    Bukovsky Antonin

    2008-07-01

    Full Text Available Abstract Background The placenta is an important site for iron metabolism in humans. It transfers iron from the mother to the fetus. One of the major iron transport proteins is transferrin, which is a blood plasma protein crucial for iron uptake. Its localization and expression may be one of the markers to distinguish placental dysfunction. Methods In the experimental study we used antibody preparation, mass spectrometric analysis, biochemical and immunocytochemical methods for characterization of transferrin expression on the human choriocarcinoma cell line JAR (JAR cells, placental lysates, and cryostat sections. Newly designed monoclonal antibody TRO-tf-01 to human transferrin was applied on human placentae from normal (n = 3 and abnormal (n = 9 pregnancies. Results Variations of transferrin expression were detected in villous syncytiotrophoblast, which is in direct contact with maternal blood. In placentae from normal pregnancies, the expression of transferrin in the syncytium was significantly lower (p Conclusion These observations suggest that in the case of abnormal pregnancies, the fetus may require higher levels of transferrin in order to prevent iron depletion due to the stress from the placental dysfunction.

  1. Core body temperature and the thermoneutral zone: a longitudinal study of normal human pregnancy.

    Science.gov (United States)

    Hartgill, T W; Bergersen, T K; Pirhonen, J

    2011-04-01

    Using a longitudinal study design, we investigated changes in maternal core temperature and ambient temperatures before and after a localized cooling procedure to the right hand. Fifteen pregnant women participated. The experiments were sequentially performed for 21 month periods on each subject: from the 8th week of gestation to 1 year after delivery on seven separate occasions (gestational weeks 8, 16, 26, 36 and 12, 24, 52 weeks post-partum). The experiments were conducted in a climactic chamber, allowing ambient temperature adjustment to each subjects' thermoneutral zone determined using Doppler ultrasound of the digital artery. Maternal core temperature decreased from 37.1 °C (week 8) towards term, reaching a nadir (36.4 °C) at 12 weeks post-partum (P temperature required to reach the thermoneutral zone changed significantly from 26.5 °C (week 8) falling to its lowest point: 23.0 °C (week 36) (P temperature is highest in the first trimester but falls during pregnancy to a nadir 3 months post-partum. The ambient temperature required to reach the thermoneutral zone was 4 °C lower at 36 weeks of gestation compared with early pregnancy and late post-partum. Human temperature regulation is altered in pregnancy and for at least 3 months post-partum.

  2. Pregnancy Outcome following Prenatal Diagnosis of Chromosomal Anomaly: A Record Linkage Study of 26,261 Pregnancies.

    Science.gov (United States)

    Jacobs, Myrthe; Cooper, Sally-Ann; McGowan, Ruth; Nelson, Scott M; Pell, Jill P

    2016-01-01

    Previous studies have demonstrated the influence of changes in the age at which women give birth, and of developments in prenatal screening and diagnosis on the number of pregnancies diagnosed and terminated with chromosomal anomalies. However, we are unaware of any population studies examining pregnancy terminations after diagnosis of chromosomal anomalies that has included all aneuploidies and the influence of maternal factors. The aims of this study were to examine the association between results of prenatal tests and pregnancy termination, and the proportion of foetuses with and without chromosomal anomalies referred for invasive diagnostic tests over time. Diagnostic information of 26,261 prenatal invasive tests from all genetic service laboratories in Scotland from 2000 to 2011 was linked to Scottish Morbidity Records to obtain details on pregnancy outcome. Binary logistic regression was carried out to test the associations of year and type of diagnosis with pregnancy termination, while controlling for maternal age, neighbourhood deprivation and parity. There were 24,155 (92.0%) with no chromosomal anomalies, 1,483 (5.6%) aneuploidy diagnoses, and 623 (2.4%) diagnoses of anomaly that was not aneuploidy (including translocations and single chromosome deletions). In comparison with negative test results, pregnancies diagnosed with trisomy were most likely to be terminated (adjusted OR 437.40, 95% CI 348.19-549.46) followed by other aneuploid anomalies (adjusted OR 95.94, 95% CI 69.21-133.01). During the study period, fewer pregnancies that were diagnosed with aneuploidy were terminated, including trisomy diagnoses (adjusted OR 0.44, 95% CI 0.26-0.73). Older women were less likely to terminate (OR 0.35, 95% CI 0.28, 0.42), and parity was also an independent predictor of termination. In keeping with previous findings, while the number of invasive diagnostic tests declined, the proportion of abnormal results increased from 6.09% to 10.88%. Systematic advances in

  3. A clinical study of fetomaternal outcome in pregnancy with polyhydramnios

    Directory of Open Access Journals (Sweden)

    Aditi Anil Rajgire

    2016-12-01

    Full Text Available Background: Amniotic fluid not only provides protection to the fetus from traumatic forces, cord compression, and microbial pathogens, but also plays an integral role in the normal development of the fetal musculoskeletal, pulmonary, and gastrointestinal systems. Polyhydramnios, defined as an excessive amount of amniotic fluid, complicates approximately 0.4-3.3% of all pregnancies. Fetal conditions that are associated with polyhydramnios include major congenital anomalies and both the immunologic and non-immunologic forms of hydrops foetalis. Maternal medical conditions are also known to be associated with polyhydramnios and subsequently alter perinatal outcome. So by diagnosing these cases as early as possible, these maternal complications can be prevented and advise proper prenatal counseling in relevant cases. Methods: This study was conducted in obstetrics and gynaecology department at a tertiary care hospital, over the period of from September 2015 to September 2016. Prospective observational study. Results: Polyhydramnios is commoner in primigravida. Causative factor are mainly idiopathic after which the most important is fetal defects. Diabetes is also associated finding with polyhydramnios in 8.3% cases. The occurrence of fetal congenital abnormality was directly proportional to the gestational age of pregnancy. Incidence of congenital abnormality was found to be 1.25 %. Congenital heart disease and cleft lip and cleft palate (3% were the commonest congenital abnormality associated with polyhydramnios followed by anencephaly and spina bifida (3.3%. Conclusions: In our study Idiopathic polyhydramnios was found to be the most common cause of polyhydramnios. A careful study must be done for detection of etiological factors in all cases of polyhydramnios, careful screening, prenatal and antenatal counseling will help to improve the foetal outcome as well as to prevent the maternal complication.

  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. Pregnancy Outcomes after a Mass Vaccination Campaign with an Oral Cholera Vaccine in Guinea: A Retrospective Cohort Study.

    Directory of Open Access Journals (Sweden)

    Lise Grout

    2015-12-01

    retrospective design, we can conclude that if a risk exists, it is very low. Additional prospective studies are warranted to add to the evidence base on OCV use during pregnancy. Pregnant women are particularly vulnerable during cholera episodes and should be included in vaccination campaigns when the risk of cholera is high, such as during outbreaks.

  6. Pregnancy Outcomes after a Mass Vaccination Campaign with an Oral Cholera Vaccine in Guinea: A Retrospective Cohort Study

    Science.gov (United States)

    Grout, Lise; Martinez-Pino, Isabel; Ciglenecki, Iza; Keita, Sakoba; Diallo, Alpha Amadou; Traore, Balla; Delamou, Daloka; Toure, Oumar; Nicholas, Sarala; Rusch, Barbara; Staderini, Nelly; Serafini, Micaela; Grais, Rebecca F.; Luquero, Francisco J.

    2015-01-01

    malformation. Despite the weaknesses of a retrospective design, we can conclude that if a risk exists, it is very low. Additional prospective studies are warranted to add to the evidence base on OCV use during pregnancy. Pregnant women are particularly vulnerable during cholera episodes and should be included in vaccination campaigns when the risk of cholera is high, such as during outbreaks. PMID:26713614

  7. Pregnancy Outcomes after a Mass Vaccination Campaign with an Oral Cholera Vaccine in Guinea: A Retrospective Cohort Study.

    Science.gov (United States)

    Grout, Lise; Martinez-Pino, Isabel; Ciglenecki, Iza; Keita, Sakoba; Diallo, Alpha Amadou; Traore, Balla; Delamou, Daloka; Toure, Oumar; Nicholas, Sarala; Rusch, Barbara; Staderini, Nelly; Serafini, Micaela; Grais, Rebecca F; Luquero, Francisco J

    2015-12-01

    design, we can conclude that if a risk exists, it is very low. Additional prospective studies are warranted to add to the evidence base on OCV use during pregnancy. Pregnant women are particularly vulnerable during cholera episodes and should be included in vaccination campaigns when the risk of cholera is high, such as during outbreaks.

  8. Design and development of a film-based intervention about teenage men and unintended pregnancy: Applying the Medical Research Council framework in practice.

    LENUS (Irish Health Repository)

    Aventin, Aine

    2014-11-15

    Following the UK Medical Research Council\\'s (MRC) guidelines for the development and evaluation of complex interventions, this study aimed to design, develop and optimise an educational intervention about young men and unintended teenage pregnancy based around an interactive film. The process involved identification of the relevant evidence base, development of a theoretical understanding of the phenomenon of unintended teenage pregnancy in relation to young men, and exploratory mixed methods research. The result was an evidence-based, theory-informed, user-endorsed intervention designed to meet the much neglected pregnancy education needs of teenage men and intended to increase both boys\\' and girls\\' intentions to avoid an unplanned pregnancy during adolescence. In prioritising the development phase, this paper addresses a gap in the literature on the processes of research-informed intervention design. It illustrates the application of the MRC guidelines in practice while offering a critique and additional guidance to programme developers on the MRC prescribed processes of developing interventions. Key lessons learned were: (1) know and engage the target population and engage gatekeepers in addressing contextual complexities; (2) know the targeted behaviours and model a process of change; and (3) look beyond development to evaluation and implementation.

  9. Design and development of a film-based intervention about teenage men and unintended pregnancy: applying the Medical Research Council framework in practice.

    Science.gov (United States)

    Aventin, Áine; Lohan, Maria; O'Halloran, Peter; Henderson, Marion

    2015-04-01

    Following the UK Medical Research Council's (MRC) guidelines for the development and evaluation of complex interventions, this study aimed to design, develop and optimise an educational intervention about young men and unintended teenage pregnancy based around an interactive film. The process involved identification of the relevant evidence base, development of a theoretical understanding of the phenomenon of unintended teenage pregnancy in relation to young men, and exploratory mixed methods research. The result was an evidence-based, theory-informed, user-endorsed intervention designed to meet the much neglected pregnancy education needs of teenage men and intended to increase both boys' and girls' intentions to avoid an unplanned pregnancy during adolescence. In prioritising the development phase, this paper addresses a gap in the literature on the processes of research-informed intervention design. It illustrates the application of the MRC guidelines in practice while offering a critique and additional guidance to programme developers on the MRC prescribed processes of developing interventions. Key lessons learned were: (1) know and engage the target population and engage gatekeepers in addressing contextual complexities; (2) know the targeted behaviours and model a process of change; and (3) look beyond development to evaluation and implementation. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  10. Association of severe intrahepatic cholestasis of pregnancy with adverse pregnancy outcomes: a prospective population-based case-control study.

    Science.gov (United States)

    Geenes, Victoria; Chappell, Lucy C; Seed, Paul T; Steer, Philip J; Knight, Marian; Williamson, Catherine

    2014-04-01

    Intrahepatic cholestasis of pregnancy (ICP) is a pregnancy-specific liver disease, characterized by maternal pruritus and raised serum bile acids. Our objectives were to describe the epidemiology and pregnancy complications associated with severe ICP and to test the hypothesis that adverse perinatal outcomes are increased in these women. A prospective population-based case-control study with national coverage was undertaken using the UK Obstetric Surveillance System (UKOSS). Control data for comparison were obtained from women with healthy pregnancy outcome through UKOSS (n = 2,232), St Mary's Maternity Information System (n = 554,319), and Office for National Statistics (n = 668,195). The main outcome measures investigated were preterm delivery, stillbirth, and neonatal unit admission. In all, 713 confirmed cases of severe ICP were identified, giving an estimated incidence of 9.2 per 10,000 maternities. Women with severe ICP and a singleton pregnancy (n = 669) had increased risks of preterm delivery (164/664; 25% versus 144/2200; 6.5%; adjusted odds ratio [OR] 5.39, 95% confidence interval [CI] 4.17 to 6.98), neonatal unit admission (80/654; 12% versus 123/2192; 5.6%; adjusted OR 2.68, 95% CI 1.97 to 3.65), and stillbirth (10/664; 1.5% versus 11/2205; 0.5%; adjusted OR 2.58, 95% CI 1.03 to 6.49) compared to controls. Seven of 10 stillbirths in ICP cases were associated with coexisting pregnancy complications. These differences remained significant against national data. Risks of preterm delivery, meconium-stained amniotic fluid, and stillbirth rose with increasing maternal serum bile acid concentrations. In the largest prospective cohort study in severe ICP to date, we demonstrate significant increased risks of adverse perinatal outcomes, including stillbirth. Our findings support the case for close antenatal monitoring of pregnancies affected by severe ICP. © 2014 The Authors. Hepatology published by Wiley on behalf of the American Association for the Study of

  11. Timing of Pregnancy After Gastric Bypass—a National Register-Based Cohort Study

    DEFF Research Database (Denmark)

    Kjær, Mette Karie Mandrup; Nilas, Lisbeth

    2013-01-01

    Current recommendations suggest postponing pregnancy by at least 1 year after gastric bypass. During the first postoperative year, women are in a catabolic phase with a rapid weight loss which may increase the risk of adverse pregnancy and neonatal outcomes. This study tested the hypothesis...... that the risk of adverse pregnancy and neonatal outcomes is increased in women who conceive during the first year after gastric bypass surgery....

  12. Clinical Aspects of Pregnancy-induced Amelioration of Rheumatoid Arthritis: PARA-study

    OpenAIRE

    Man, Yael

    2009-01-01

    textabstractIn this PhD thesis, embedded in the PARA (Pregnancy-induced Amelioration of Rheumatoid Arthritis) study, several clinical aspects of the spontaneously occurring pregnancy-induced improvement of rheumatoid arthritis (RA) are addressed. An overview is given of inflammatory rheumatic diseases and the current knowledge about their disease courses and treatment options during pregnancy and postpartum. This thesis focuses firstly on the description of tools to objectively measure the di...

  13. Bacteriuria and pregnancy outcome: a prospective hospital-based study in Pakistani women.

    Science.gov (United States)

    Qureshi, R N; Khan, K S; Darr, O; Khattak, N; Farooqui, B J; Rizvi, J H

    1994-01-01

    The prevalence of bacteriuria in Pakistani women and its association with complications of pregnancy was studied. Out of 1579 women, 77 had bacteriuria (4.8%). There was no association of age, gravidity, parity, haemoglobin, pre-eclampsia, mode of delivery, gestational age at delivery, preterm delivery and low birth-weight with presence of bacteriuria. With detection and treatment the pregnancy outcome of women with bacteriuria in pregnancy was the same as that of those without.

  14. Analysis of heart rate variability in pre-eclamptic pregnancy: a study employing frequency domain analysis

    Directory of Open Access Journals (Sweden)

    Gul Ar Navi Khan

    2014-08-01

    Full Text Available Background: Preeclampsia is a disorder characterized by development of hypertension to the extent of 140/90 mmHg or more with proteinuria after 20th weeks of pregnancy in a previously normotensive and non proteinuric woman. Physiologically blood pressure is controlled by Autonomic Nervous System (ANS so study of ANS during pregnancy plays a significant role to extract some vital information which may be helpful to deal with Pregnancy Induced Hypertension (PIH or preeclampsia. The autonomic nervous system and changes in ANS during different pathophysiological conditions could be evaluated with heart rate variability analysis test. The modification in the autonomic control occurs during pregnancy and its evaluation through Heart Rate Variability (HRV analysis is very informative technique now a day but studied little thus the main objective of our project is to compare the maternal HRV changes between normal pregnancy and pre-eclamptic pregnancy. Methods: 48 subjects (33 of normotensive pregnant women i.e., control group and 15 pre-eclamptic pregnant women i.e, study group of more than 20 weeks pregnancy were recruited from the outpatients, antenatal unit and wards of obstetrics and gynaecology department of JNMC, AMU, Aligarh. Physical examination was done and anthropometric measurement like height and weight were taken. BMI was calculated as per Quetlet's index. Urine test was conducted to every pregnant woman for urine albumin and we designated the pregnant women as pre-eclamptic women on the basis of definition. The subject was advised to take complete bed rest in supine position for 15 minutes in a cool and calm environment. The recording of short term HRV was done according to recommendation of the task force on HRV. The data was transferred from Medicaid machine to window based computer with HRV analysis software. Frequency domain analysis of HRV was taken for further statistical analysis. Results: There was no significant difference of

  15. Pregnancy, chimerism and lupus nephritis: a multi-centre study.

    NARCIS (Netherlands)

    Hovinga, I.C. Kremer; Koopmans, M.; Grootscholten, C.; Wal, A.M. van der; Bijl, M. van der; Derksen, R.H.; Voskuyl, A.E.; Heer, E. de; Bruijn, J.A.; Berden, J.H.M.; Bajema, I.M.

    2008-01-01

    Chimerism occurs twice as often in the kidneys of women with lupus nephritis as in normal kidneys and may be involved in the pathogenesis of systemic lupus erythematosus. Pregnancy is considered the most important source of chimerism, but the exact relationship between pregnancy, the persistence of

  16. Pregnancy, chimerism and lupus nephritis : a multi-centre study

    NARCIS (Netherlands)

    Hovinga, I. C. L. Kremer; Koopmans, M.; Grootscholten, C.; van der Wal, A. M.; Bijl, M.; Derksen, R. H. W. M.; Voslcuyl, A. E.; de Heer, E.; Bruijn, J. A.; Berden, J. H. M.; Rajema, I. M.

    2008-01-01

    Chimerism occurs twice as often in the kidneys of women with lupus nephritis as in normal kidneys and may he involved in the pathogenesis of systemic lupus erythematosus. Pregnancy is considered the most important source of chimerism, but the exact relationship between pregnancy, the persistence of

  17. Periodontal infection and adverse pregnancy outcomes: a systematic review of epidemiological studies

    Directory of Open Access Journals (Sweden)

    Vettore Mario Vianna

    2006-01-01

    Full Text Available The objective of this systematic review was to evaluate analytical studies on periodontal disease as a possible risk factor for adverse pregnancy outcomes. A literature search of the MEDLINE, SciELO, and LILACS bibliographic databases and CAPES thesis database was conducted up to December 2005, covering epidemiological studies of periodontal disease and adverse pregnancy outcomes. Of the 964 papers identified, 36 analytical studies met the inclusion criteria. Twenty-six epidemiological studies reported associations between periodontal disease and adverse pregnancy outcomes. There was a clear heterogeneity between studies concerning measurement of periodontal disease and selection of type of adverse pregnancy outcome. Therefore no meta-analysis was performed. Most studies did not control for confounders, thus raising serious doubts about their conclusions. The methodological limitations of most studies did not allow conclusions concerning the effects of periodontal disease on adverse pregnancy outcomes. Larger and methodologically rigorous analytical studies using reliable outcomes and exposure measures are recommended.

  18. Risk factors for teenage pregnancy among sexually active black adolescents in Cape Town. A case control study.

    Science.gov (United States)

    Vundule, C; Maforah, F; Jewkes, R; Jordaan, E

    2001-01-01

    Teenage pregnancy is an important health and social problem in South Africa. So far research on adolescent sexual activity has been almost exclusively descriptive; as a result there is considerable knowledge about practices of adolescents in general and outcomes of their pregnancies, but very limited understanding of factors that place particular adolescents at increased risk of teenage pregnancy. Without this understanding, our ability to intervene effectively to reduce teenage pregnancy rates is limited. To undertake an exploratory study to investigate risk factors for teenage pregnancy among sexually active adolescents in an urban and peri-urban context. The study used a matched case-control design, with 191 cases and 353 age-matched controls from the same school or neighbourhood. Subjects were under 19 years of age and were recruited from township areas of Cape Town. A structured questionnaire was used to obtain information on socio-economic factors, contraceptive knowledge and use, and sexual behaviour. Conditional logistical regression was used to analyse the relationship between teenage pregnancy and the factors investigated. Teenage pregnancy was found to be most strongly associated with having frequent sex (risk ratio (RR) 30.81) without reliable contraceptive protection (RR 24.35), forced sexual initiation (RR 14.42), not owning a television set (RR 10.33), larger household size (RR 2.44), not living in a brick house (RR 5.09), not living with the biological father (RR 3.26), talking openly about sex with a boyfriend (RR 4.72), and perceiving most friends to be pregnant (RR 4.38). The findings suggest associations between the promotion of sexual health among adolescents and broader social development and promotion of gender equality. Although further research is needed, it is likely that important foci for short-term strategies should include developing assertiveness, enhancing decision-making competence, and promoting contraception and condoms as part of

  19. Occupational exposure to endocrine disruptors and time to pregnancy among couples in a large birth cohort study: the Generation R Study

    NARCIS (Netherlands)

    Snijder, C.A.; Brouwers, M.M.; Jaddoe, V.W.; Hofman, A.; Roeleveld, N.; Burdorf, A.

    2011-01-01

    OBJECTIVE: To study the influence of occupational exposure to endocrine disruptors (EDs) on time to pregnancy (TTP). DESIGN: Cross-sectional analysis within a prospective, population-based cohort study. SETTING: Medical center. PATIENT(S): Mothers and fathers who filled out a questionnaire during mi

  20. Multiple sclerosis and pregnancy: what does the patient think? a questionnaire study

    Directory of Open Access Journals (Sweden)

    Moser Andreas

    2010-04-01

    Full Text Available Abstract Background Multiple Sclerosis (MS is primarily a disease of women in their childbearing years. Pregnancy and puerperium have opposite effects on the course of the disease. Nevertheless, no studies have been carried out yet on the level of information among female MS-patients regarding the interaction between MS and pregnancy. Findings Demographic data, clinical features of MS, course of MS during pregnancy and puerperium as well as knowledge concerning MS and pregnancy were evaluated by means of a questionnaire in 154 female MS-patients. The level of information was significantly higher (p Conclusions The findings illustrate a lack of knowledge in female MS-patients concerning the interactions of MS and pregnancy. In order to make their own independent decision based on scientific facts known to date, female MS-patients need to be better informed on issues regarding MS and pregnancy.

  1. Does a history of hypertensive disorders of pregnancy help predict future essential hypertension? Findings from a prospective pregnancy cohort study.

    Science.gov (United States)

    Callaway, L K; Mamun, A; McIntyre, H D; Williams, G M; Najman, J M; Nitert, M D; Lawlor, D A

    2013-05-01

    Hypertensive disorder of pregnancy (HDP) is considered an important determinant in the prediction of future hypertension. The aim of this study is to examine whether HDP improves prediction of future hypertension, over prediction based on established risk factors measured during pregnancy. We used a community based cohort study of 2117 women who received antenatal care at a major hospital in Brisbane between 1981 and 1983 and had blood pressure assessed 21 years after the index pregnancy. Of these 2117 women, 193 (9.0%) experienced HDP and 345 (16.3%) had hypertension at 21 years postpartum. For women with HDP, the odds of being hypertensive at 21 years postpartum were 2.46 (95% CI 1.70, 3.56), adjusted for established risk factors including age, education, race, alcohol, cigarettes, exercise and body mass index. Addition of HDP did not improve the prediction model that included these established risk factors, with the area under the curve of receiver operator (AUROC) increasing from 0.710 to 0.716 (P-value for difference in AUROC=0.185). Our findings suggest that HDP is strongly and independently associated with future hypertension, and women who experience this condition should be counselled regarding lifestyle modification and careful ongoing blood pressure monitoring. However, the development of HDP during pregnancy does not improve our capacity to predict future hypertension, over risk factors identifiable at the time of pregnancy. This suggests that counseling regarding lifestyle modification and ongoing blood pressure monitoring might reasonably be provided to all pregnant and postpartum women with identifiable risk factors for future hypertension.

  2. Narrow intra-individual variation of maternal thyroid function in pregnancy based on a longitudinal study on 132 women

    DEFF Research Database (Denmark)

    Boas, M.; Forman, Julie Lyng; Juul, A.

    2009-01-01

    was the assessment of the intra-individual variation as well as the longitudinal course of thyroid hormones during normal pregnancy and factors that influence the normal reference range for thyroid function. For this purpose, a longitudinal statistical model was applied. DESIGN: In a cohort of 132 pregnant women......BACKGROUND: Adaptive alterations in maternal physiology cause changes in thyroid hormone levels throughout pregnancy, and precise biochemical evaluation is thus highly dependent on gestation-specific reference intervals and expected intra-individual variation. OBJECTIVE: The aim of the study......, serial blood samples were obtained and ultrasound scans were performed throughout pregnancy. METHODS: Serum levels of TSH, free and total thyroxine (T(4)), free and total triiodothyronine (T(3)) as well as autoantibodies against thyroid peroxidase and thyroglobulin were measured in 979 serum samples...

  3. Teenage Pregnancy and Female Educational Underachievement: A Prospective Study of a New Zealand Birth Cohort.

    Science.gov (United States)

    Fergusson, David M.; Woodward, Lianne J.

    2000-01-01

    Study examined the relationship between teenage pregnancy and educational underachievement in a sample of women studied from birth to 21 years. Findings suggest that rates of teenage pregnancy might be elevated among women who leave school early, rather than rates of early school leaving being elevated among women who become pregnant. (Author/JDM)

  4. The Alberta Pregnancy Outcomes and Nutrition (APrON) cohort study : Rationale and methods

    NARCIS (Netherlands)

    Kaplan, B.J.; Giesbrecht, G.F.; Leung, B.M.; Field, C.J.; Dewey, D.; Bell, R.C.; Manca, D.P.; O'Beirne, M.; Johnston, D.W.; Pop, V.J.M.; Singhal, N.; Gagnon, L.; Bernier, F.P.; Eliasziw, M.; McCargar, L.J.; Kooistra, L.; Farmer, A.; Cantell, M.; Goonewardene, L.; Casey, L.M.; Letourneau, N.; Martin, J.W.

    2014-01-01

    The Alberta Pregnancy Outcomes and Nutrition (APrON) study is an ongoing prospective cohort study that recruits pregnant women early in pregnancy and, as of 2012, is following up their infants to 3 years of age. It has currently enrolled approximately 5000 Canadians (2000 pregnant women, their

  5. The Alberta Pregnancy Outcomes and Nutrition (APrON) cohort study : rationale and methods

    NARCIS (Netherlands)

    Kaplan, Bonnie J.; Giesbrecht, Gerald F.; Leung, Brenda M. Y.; Field, Catherine J.; Dewey, Deborah; Bell, Rhonda C.; Manca, Donna P.; O'Beirne, Maeve; Johnston, David W.; Pop, Victor J.; Singhal, Nalini; Gagnon, Lisa; Bernier, Francois P.; Eliasziw, Misha; McCargar, Linda J.; Kooistra, Libbe; Farmer, Anna; Cantell, Marja; Goonewardene, Laki; Casey, Linda M.; Letourneau, Nicole; Martin, Jonathan W.

    The Alberta Pregnancy Outcomes and Nutrition (APrON) study is an ongoing prospective cohort study that recruits pregnant women early in pregnancy and, as of 2012, is following up their infants to 3 years of age. It has currently enrolled approximately 5000 Canadians (2000 pregnant women, their

  6. Teenage Pregnancy and Female Educational Underachievement: A Prospective Study of a New Zealand Birth Cohort.

    Science.gov (United States)

    Fergusson, David M.; Woodward, Lianne J.

    2000-01-01

    Study examined the relationship between teenage pregnancy and educational underachievement in a sample of women studied from birth to 21 years. Findings suggest that rates of teenage pregnancy might be elevated among women who leave school early, rather than rates of early school leaving being elevated among women who become pregnant. (Author/JDM)

  7. The Alberta Pregnancy Outcomes and Nutrition (APrON) cohort study : rationale and methods

    NARCIS (Netherlands)

    Kaplan, Bonnie J.; Giesbrecht, Gerald F.; Leung, Brenda M. Y.; Field, Catherine J.; Dewey, Deborah; Bell, Rhonda C.; Manca, Donna P.; O'Beirne, Maeve; Johnston, David W.; Pop, Victor J.; Singhal, Nalini; Gagnon, Lisa; Bernier, Francois P.; Eliasziw, Misha; McCargar, Linda J.; Kooistra, Libbe; Farmer, Anna; Cantell, Marja; Goonewardene, Laki; Casey, Linda M.; Letourneau, Nicole; Martin, Jonathan W.

    2014-01-01

    The Alberta Pregnancy Outcomes and Nutrition (APrON) study is an ongoing prospective cohort study that recruits pregnant women early in pregnancy and, as of 2012, is following up their infants to 3 years of age. It has currently enrolled approximately 5000 Canadians (2000 pregnant women, their offsp

  8. Outcome of singleton pregnancy following in-vitro fertilization: a prospective study

    Directory of Open Access Journals (Sweden)

    Vipin Kumar

    2016-12-01

    Full Text Available Background: It is observed that any spontaneous pregnancy does not always result in healthy baby and healthy mother. The aim of the study was to study the obstetrical outcome of singleton pregnancies following in vitro fertilization and embryo transfer (IVF-ET. Methods: All cases undergoing IVF-ET at ART Centre were followed up after Day18 (of ET for estimation of serum beta HCG and trans-vaginal ultrasound done on day 21 and 5th week. The selected singleton pregnancies were followed for the various parameters to be studied and the data was statistically analyzed. A resultant 73 patients with single intrauterine gestational sac was followed up. Results: In our study population of 73 post IVF-ET singleton pregnancies, 13.69% underwent first and second trimester abortions. They had increased risk of developing hypertensive disorders in pregnancy. Study also showed increased incidence of gestational diabetes mellitus. Yet another important outcome also included pregnancy with intrauterine growth restriction. Preterm birth was noted in 10 singleton pregnancies. Out of 73 followed up patients one third underwent caesarean delivery and another few underwent instrumental delivery. One in four babies accounted for weight more than 2.5 kgs. Out of followed up 73 cases of singleton IVF-ET pregnancies, 5 cases had congenital anomalies. Most common indication for NICU admission was respiratory distress. The incidence of small for gestational age came out to be significant. Conclusions: Outcome of singleton pregnancy after IVF-ET is associated with adverse pregnancy outcomes. Couples should be made aware that even singleton pregnancies resulting from ART are at increased risk for obstetric complications.

  9. A STUDY OF PLACENTAL WEIGHT AND FETAL OUTCOME IN DIFFERENT GRADES OF PREGNANCY INDUCED HYPERTENSION

    Directory of Open Access Journals (Sweden)

    Raghavendra. A. Y

    2014-10-01

    Full Text Available Introduction and Objectives: Placenta is a feto-maternal organ which is vital for maintaining pregnancy and promoting normal development of the fetus. The weight of the placenta is functionally significant because it is related to villous surface area and to fetal metabolism. Present study has done to record the placental weight and co-relate with the corresponding fetal weight. Materials and Methods: A total of 100 placentae were studied, out of which 50 placentae belong to pregnancy induced hypertension and 50 placentae were of normotensive pregnant mothers. The weight of placenta and weight of fetus were compared between normotensive (Control and hypertensive mothers (Cases. Results: The mean weight of placenta in study group was low as compared to that in the control group. The birth weight of newborn was low with increasing grades of hypertension compared to control groups. The feto- placental weight ratio was higher in case of mild and severe preeclampsia. The incidence of stillbirth was 0.5%, 12.5% and 20% in mild pre-ecampsia, severe preeclampsia and eclampsia respectively. Conclusion: In present study, the birth weight was low with increasing grades of hypertension compared to control groups. The fetal: placental weight ratio was higher in case of mild and severe preeclampsia. The incidence of eclampsia was more common in primigravida where as mild preeclampsia was more common in multigravida. The mean weight of placenta in study group was low compared to control group. Thus study of placental changes in pregnancy induced hypertension may help us to understand patho-physiological mechanisms and design treatment plans for better maternal and foetal outcome. Modern sophisticated techniques like ultrasonography have made it possible to study the necessary placental parameters in utero. This helps in assessing the foetal outcome and management.

  10. The relationship between maternal depression and smoking cessation during pregnancy--a cross-sectional study of pregnant women from 15 European countries.

    Science.gov (United States)

    Smedberg, Janne; Lupattelli, Angela; Mårdby, Ann-Charlotte; Øverland, Simon; Nordeng, Hedvig

    2015-02-01

    Epidemiologic studies have reported an association between depression and continuing smoking during pregnancy. However, differences in study design and methodology challenge study comparability. The purpose of this study was to examine the relationship between maternal depression and continuing smoking among pregnant European women while adjusting for maternal characteristics. This multinational, web-based study evaluated pregnant women in 15 European countries recruited from October 2011 to February 2012. Data on depression status, smoking habits, maternal socio-demographic characteristics, and life-style factors were collected via an anonymous online questionnaire. Associations were estimated with logistic regression. Of 4,295 women included, 1,481 (34.5 %) reported smoking before pregnancy, and 391 (26.4 %) continued smoking during pregnancy whereof 127 (32.5 %) were depressed. The association between depression and continuing smoking during pregnancy were uniform across the European countries (OR 2.02, 95 % CI 1.50-2.71), with about twice the prevalence of continuing smoking among the depressed. There was a strong relationship between continuing smoking in pregnancy and low education level (OR 4.46, 95 % CI 2.72-7.32), which coincided with risky pregnancy behavior such as failure to attend pregnancy/birth preparation courses (OR 1.80, 95 % CI 1.19-2.72) and follow recommended use of folic acid (OR 1.81, 95 % CI 1.23-2.65). Women who perceived the risk for the fetus of continued smoking during pregnancy as higher were the least likely to continue smoking during pregnancy (OR 0.72, 95 % CI 0.68-0.77). This underlines the clustering of risk in some pregnant women, and the results should guide antenatal care of depressed women struggling to quit smoking during pregnancy.

  11. Seven years of teenage pregnancy in an inner London genitourinary medicine service - a retrospective cohort study.

    Science.gov (United States)

    Hegazi, Aseel; Daley, Natalie; Williams, Elizabeth; McLeod, Felicity; Rafiezadeh, Saba; Prime, Katia

    2014-12-01

    Young people attending genitourinary medicine services are at high risk of unplanned pregnancy. We performed a retrospective cohort study to identify characteristics of pregnant teenagers accessing an inner London genitourinary medicine service. There were 481 pregnancies in 458 teenagers with 54 previous pregnancies and 46 previous terminations of pregnancy. The under-18 and under-16 teenage pregnancy rates were 92.1 and 85.8 per 1000 age-matched clinic attendees, respectively. Median age was 17.1 years. 'Black Other' teenagers ('Black British', 'Mixed White-Black Caribbean' and 'Mixed White-Black African') were over-represented, compared to our clinic population, while those of White ethnicity were under-represented. Few pregnancies (1.5%) were planned with the majority (64%) intending terminations of pregnancy. Most teenagers did not use consistent contraception. Two-thirds of patients had attended genitourinary medicine services in the past and sexually transmitted infection prevalence at presentation was high. Effectively targeting the sexual and reproductive health needs of teenage genitourinary medicine clinic attendees may have a significant impact on reducing sexually transmitted infections, unplanned pregnancy and terminations of pregnancy in this group. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  12. Alcohol consumption and binge drinking in early pregnancy. A cross-sectional study with data from the Copenhagen Pregnancy Cohort

    DEFF Research Database (Denmark)

    Iversen, Mette Langeland; Sørensen, Nina Olsén; Broberg, Lotte

    2015-01-01

    pregnancy. The overall proportion of women reporting binge drinking during early pregnancy was 35 % (n = 1,134). The following independent risk factors for binge drinking in early pregnancy were identified: lower degree of planned pregnancy, smoking and alcohol habits before pregnancy ((1 unit/weekly aOR 4......BACKGROUND: Since 2007 the Danish Health and Medicines Authority has advised total alcohol abstinence from the time of trying to conceive and throughout pregnancy. The prevalence of binge drinking among pregnant Danish women has nevertheless been reported to be up to 48 % during early pregnancy...... drinking in early pregnancy among women living in the capital of Denmark. Secondly to identify pre-pregnancy lifestyle and reproductive risk factors associated with binge drinking during early pregnancy. METHODS: Data were collected from September 2012 to August 2013 at the Department of Obstetrics...

  13. Impact of maternal metabolic abnormalities in pregnancy on human milk and subsequent infant metabolic development: methodology and design

    Directory of Open Access Journals (Sweden)

    Hamilton Jill K

    2010-10-01

    Full Text Available Abstract Background Childhood obesity is on the rise and is a major risk factor for type 2 diabetes later in life. Recent evidence indicates that abnormalities that increase risk for diabetes may be initiated early in infancy. Since the offspring of women with diabetes have an increased long-term risk for obesity and type 2 diabetes, the impact of maternal metabolic abnormalities on early nutrition and infant metabolic trajectories is of considerable interest. Human breast milk, the preferred food during infancy, contains not only nutrients but also an array of bioactive substances including metabolic hormones. Nonetheless, only a few studies have reported concentrations of metabolic hormones in human milk specifically from women with metabolic abnormalities. We aim to investigate the impact of maternal metabolic abnormalities in pregnancy on human milk hormones and subsequently on infant development over the first year of life. The objective of this report is to present the methodology and design of this study. Methods/Design The current investigation is a prospective study conducted within ongoing cohort studies of women and their offspring. Pregnant women attending outpatient obstetrics clinics in Toronto, Canada were recruited. Between April 2009 and July 2010, a total of 216 pregnant women underwent a baseline oral glucose tolerance test and provided medical and lifestyle history. Follow-up visits and telephone interviews are conducted and expected to be completed in October 2011. Upon delivery, infant birth anthropometry measurements and human breast milk samples are collected. At 3 and 12 months postpartum, mothers and infants are invited for follow-up assessments. Interim telephone interviews are conducted during the first year of offspring life to characterize infant feeding and supplementation behaviors. Discussion An improved understanding of the link between maternal metabolic abnormalities in pregnancy and early infant nutrition may

  14. Maternal smoking during pregnancy and childhood overweight and fat distribution: The KOALA Birth Cohort Study

    NARCIS (Netherlands)

    Timmermans, S.H.; Mommers, M.; Gubbels, J.S.; Kremers, S.P.J.; Stafleu, A.; Stehouwer, C.D.A.; Prins, M.H.; Penders, J.; Thijs, C.

    2014-01-01

    What is already known about this subject There is an association between maternal smoking during pregnancy and higher body mass index (BMI) and overweight in childhood. What this study adds The association between maternal smoking during pregnancy and childhood overweight develops with age, starting

  15. Clinical Aspects of Pregnancy-induced Amelioration of Rheumatoid Arthritis: PARA-study

    NARCIS (Netherlands)

    Y.A. de Man (Yael)

    2009-01-01

    textabstractIn this PhD thesis, embedded in the PARA (Pregnancy-induced Amelioration of Rheumatoid Arthritis) study, several clinical aspects of the spontaneously occurring pregnancy-induced improvement of rheumatoid arthritis (RA) are addressed. An overview is given of inflammatory rheumatic disea

  16. Peritraumatic dissociation and posttraumatic stress after pregnancy loss: A prospective study.

    NARCIS (Netherlands)

    Engelhard, I.M.; van den Hout, M.; Kindt, M.; Arntz, A.; Schouten, E.

    2003-01-01

    This study examined (1) predictors for peritraumatic dissociation, (2) its relations with acute and chronic symptoms of posttraumatic stress disorder (PTSD), and (3) pathways regarding these relations in response to pregnancy loss. In early pregnancy, about 1,370 women volunteers completed

  17. What we have learned about best practices for recruitment and retention in multicenter pregnancy studies.

    Science.gov (United States)

    Salazar, Ashley; Tolivaisa, Susan; Allard, Donna; Bishop, Tammy S; Bousleiman, Sabine; Clark, Kelly; Dalton, Wendy; Harris, Stacy; Hale, Kathy; Hill, Kim; Johnson, Francee; Mallett, Gail; Moseley, Lisa; Ortiz, Felecia; Willson, Cynthia; Thom, Elizabeth A

    2016-08-01

    For 30 years, the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units (MFMU) Network has had significant impact on clinical practice in obstetrics. The MFMU Network has conducted 50 randomized clinical trials and observational studies designed to improve pregnancy outcomes for mothers and children. Each center has a designated clinical research nurse coordinator who coordinates the day-to-day operations of each trial and leads a research team that is responsible for recruitment and retention of participants. Some of the lessons learned by the nurse coordinators over the past 30 years are described with examples from recent studies. Best practices that we have amassed from our experience are also described.

  18. MRIs Safe During First Months of Pregnancy: Study

    Science.gov (United States)

    ... The researchers also compared women who had an MRI with the contrast agent gadolinium at any point in pregnancy with those who did not have an MRI. There was a slightly higher risk of stillbirth ...

  19. A Prospective Study of Doppler Velocimetry in Pregnancy-induced ...

    African Journals Online (AJOL)

    Mubeen

    Background: Pregnancy-induced hypertension (PIH) remains a great ... predicts most occurrences of early-onset preeclampsia ... the cause of previous caesarean section done, having ... Meconium staining of liquor during labor for which.

  20. Cesarean scar pregnancy

    DEFF Research Database (Denmark)

    Petersen, Kathrine Birch; Hoffmann, Elise; Rifbjerg Larsen, Christian

    2016-01-01

    OBJECTIVE: To study treatment modalities for cesarean scar pregnancies (CSPs), focusing on efficacy and complications in relation to study quality. DESIGN: Systematic review. SETTING: Not applicable. PATIENT(S): A total of 2,037 women with CSP. INTERVENTION(S): Review of MEDLINE, EMBASE, and Coch......OBJECTIVE: To study treatment modalities for cesarean scar pregnancies (CSPs), focusing on efficacy and complications in relation to study quality. DESIGN: Systematic review. SETTING: Not applicable. PATIENT(S): A total of 2,037 women with CSP. INTERVENTION(S): Review of MEDLINE, EMBASE...

  1. A descriptive longitudinal study protocol: recurrence and pregnancy post-repair of obstetric fistula in Guinea.

    Science.gov (United States)

    Delamou, Alexandre; Delvaux, Therese; Beavogui, Abdoul Habib; Levêque, Alain; Zhang, Wei-Hong; De Brouwere, Vincent

    2016-10-10

    Obstetric fistula is a serious medical condition which affects women in low income countries. Despite the progress of research on fistula, there is little data on long term follow-up after surgical repair. The objective of this study is to analyse the factors associated with the recurrence of fistula and the outcomes of pregnancy following fistula repair in Guinea. A descriptive longitudinal study design will be used. The study will include women who underwent fistula repair between 2012 and 2015 at 3 fistula repair sites supported by the Fistula Care Project in Guinea (Kissidougou Prefectoral Hospital, Labé Regional Hospital and Jean Paul II Hospital of Conakry). Participants giving an informed consent after a home visit by the Fistula Counsellors will be interviewed for enrolment at least 3 months after hospital discharge The study enrolment period is January 1, 2012 - June 30, 2015. Participants will be followed-up until June 30, 2016 for a maximum follow up period of 48 months. The sample size is estimated at 364 women. The cumulative incidence rates of fistula recurrence and pregnancy post-repair will be calculated using Kaplan-Meier methods and the risk factor analyses will be performed using adjusted Cox regression. The outcomes of pregnancy will be analysed using proportions, the Pearson's Chi Square (χ2) and a logistic regression with associations reported as risk ratios with 95 % confidence intervals. All analyses will be done using STATA version 13 (STATA Corporation, College Station, TX, USA) with a level of significance set at P < 0.05. This study will contribute to improving the prevention and management of obstetric fistula within the community and support advocacy efforts for the social reintegration of fistula patients into their communities. It will also guide policy makers and strategic planning for fistula programs. ClinicalTrials.gov Identifier: NCT02686957 . Registered 12 February 2016 (Retrospectively registered).

  2. [Contribution to the serologic study of toxoplasmosis in pregnancy].

    Science.gov (United States)

    Passaglia, A; Grassi, R; Bocci, F; Innocenti, S; Avio, C M

    1983-09-01

    Toxoplasma antibodies in five women sera during the pregnancy were detected by direct agglutination and immunofluorescent tests both for IgG and IgM. The presence and the changes of the IgG and IgM titers are related to the abortion and/or foetal pathology. In order to prevent such a risk the authors suggest to test all the women before or early in the pregnancy for toxoplasma antibodies.

  3. Contraception and Unintended Pregnancy among Unmarried Female University Students: A Cross-sectional Study from China.

    Directory of Open Access Journals (Sweden)

    Hongjing Wang

    Full Text Available This study aims to understand the level of contraceptive knowledge and attitudes towards contraception, and then to explore the association between the contraceptive behavior and unintended pregnancy in unmarried female university students in China. A cross-sectional study was conducted of university students in 49 universities across 7 cities in China from September 2007 to January 2008. We distributed 74,800 questionnaires, of which 69,842 were returned. In this paper, the data from 35,383 unmarried female university students were analyzed. The prevalence of sexual intercourse in unmarried female university students was 10.2%. The prevalence of unintended pregnancy in those sexually active female university students, was 31.8%. Among students with pregnancy, 53.5% experienced two or more pregnancies. 28.3% of the students with sexual intercourse reported that they always adopted contraceptive methods, and of those 82.9% chose to use male condoms. The majority (83.9% of students with unintended pregnancy chose to terminate the latest pregnancy by surgical abortion or medical abortion. The contraceptive knowledge level of students who experienced unintended pregnancy was lower than those who did not. In China, about one third of unmarried female students with sexual intercourse experience unintended pregnancy. A variety of contraceptive methods are adopted, but the frequency of contraceptive use is low. Most of unmarried female students who experienced unintended pregnancy would choose to terminate the pregnancy with surgical or medical abortion. University students, especially the ones who have experienced unintended pregnancy, lack contraceptive and reproductive health knowledge.

  4. Perineal Massage in Pregnancy

    Science.gov (United States)

    PERINEAL MASSAGE IN PREGNANCY S HARE W ITH W OMEN PERINEAL MASSAGE IN PREGNANCY What Is My “Perineum”? Your perineum ... research studies. Several studies have found that perineal massage during the last weeks of pregnancy can reduce ...

  5. Study of 50 cases of modern management of ectopic pregnancy

    Directory of Open Access Journals (Sweden)

    Rajita S. Jani

    2014-04-01

    Results: Lower abdominal pain was most common presenting symptom of ectopic pregnancy in 96% cases. The classical triad of symptoms (amenorrhea, abdominal pain and vaginal bleeding was present in only 28% cases. PID contributed 24% cases and previous abortion contributed 28% cases indicating these two as the common risk factors. Ampulla was the commonest site for ectopic pregnancy, in 52% cases. Salpingostomy performed mainly at this site. In 6% cases ectopic pregnancy in infundibulum were treated with fimbrial expression and fimbriectomy. 22% patients were managed medically (methotraxte. These were the cases having unruptured ectopic pregnancy and ectopic mass <4 cm. Laparoscopy was done in 34% cases, in 2 cases it was converted to laparotomy. While open laparotomy was done in 40% cases. Conclusions: Ectopic pregnancy is a treatable problem. Ultrasonography plays central role in the diagnosis and management. Mode of therapy is determined by a combination of clinical symptoms, sonography findings and serum b-HCG values. Surgical management is still a cornerstone of management of ectopic pregnancy. But now scope of medical and laparoscopic management is also there. In recent years laparotomy has been replaced by laparoscopic surgery which is more conservative, minimally invasive and less time consuming which leads to quick recovery. [Int J Reprod Contracept Obstet Gynecol 2014; 3(2.000: 374-379

  6. Spinal posture and pelvic position during pregnancy: a prospective rasterstereographic pilot study.

    Science.gov (United States)

    Betsch, Marcel; Wehrle, Regina; Dor, Larissa; Rapp, Walter; Jungbluth, Pascal; Hakimi, Mohssen; Wild, Michael

    2015-06-01

    Despite the high prevalence of low back pain during pregnancy there is still a lack in the understanding of its aetiology. Changes of the spinal posture due to the anatomical changes of the pregnant body seem to be in part responsible for the back pain. In this pilot study we assessed the potential to accurately measure the spinal posture and pelvic position during pregnancy without any harmful radiation using a spine and surface topography system. Thirteen pregnant women were examined during the second and third trimester of their pregnancy, and postpartum. Twenty female, non-pregnant volunteers comprised the control group. The spinal posture and pelvic position were measured with a radiation-free spine and surface topography system. We found a significant increase in thoracic kyphosis during the course of pregnancy, but no increased lumbar lordosis. The lateral deviation of the spine also decreased significantly. However, we did not measure significant changes of the pelvic position during or after pregnancy. The results of our study show that pregnancy has an effect on the spinal posture, and that spine and surface topography can be used to measure these changes three-dimensionally and without any harmful radiation. In future studies this technique could allow to further evaluate the relationship between posture and low back pain during pregnancy, helping to understand the aetiology of low back pain in pregnancy as well as to identify methods for its prevention and treatment.

  7. Slurry reactor design studies

    Energy Technology Data Exchange (ETDEWEB)

    Fox, J.M.; Degen, B.D.; Cady, G.; Deslate, F.D.; Summers, R.L. (Bechtel Group, Inc., San Francisco, CA (USA)); Akgerman, A. (Texas A and M Univ., College Station, TX (USA)); Smith, J.M. (California Univ., Davis, CA (USA))

    1990-06-01

    The objective of these studies was to perform a realistic evaluation of the relative costs of tublar-fixed-bed and slurry reactors for methanol, mixed alcohols and Fischer-Tropsch syntheses under conditions where they would realistically be expected to operate. The slurry Fischer-Tropsch reactor was, therefore, operated at low H{sub 2}/CO ratio on gas directly from a Shell gasifier. The fixed-bed reactor was operated on 2.0 H{sub 2}/CO ratio gas after adjustment by shift and CO{sub 2} removal. Every attempt was made to give each reactor the benefit of its optimum design condition and correlations were developed to extend the models beyond the range of the experimental pilot plant data. For the methanol design, comparisons were made for a recycle plant with high methanol yield, this being the standard design condition. It is recognized that this is not necessarily the optimum application for the slurry reactor, which is being proposed for a once-through operation, coproducing methanol and power. Consideration is also given to the applicability of the slurry reactor to mixed alcohols, based on conditions provided by Lurgi for an Octamix{trademark} plant using their standard tubular-fixed reactor technology. 7 figs., 26 tabs.

  8. Comparison of Pregnancy Stress Between In Vitro Fertilization/Embryo Transfer and Spontaneous Pregnancy in Women During Early Pregnancy.

    Science.gov (United States)

    Shih, Fen-Fen; Chen, Chung-Hey; Chiao, Chia-Yi; Li, Chi-Rong; Kuo, Pi-Chao; Lai, Te-Jen

    2015-12-01

    Women who undergo in vitro fertilization/embryo transfer (IVF/ET) face complicated psychological stress and negative emotions, which may affect health during pregnancy and the development of the fetus. The current literature does not address the question of whether women who become pregnant spontaneously and women who undergo IVF face similar levels of pregnancy stress. This study investigates the differences in pregnancy stress between women with spontaneous pregnancy and women with IVF/ET pregnancy living in central Taiwan during their first 20 weeks of pregnancy. A prospective, longitudinal design with repeated measures, generalized estimated equations model, Wilks' λ, and Bonferroni test was used. Purposive samples of 163 women who had undergone IVF/ET and of 94 women who had undergone spontaneous pregnancy were enrolled as participants. Pregnancy stress was measured using the Chinese version of the self-administered Pregnancy Stress Scale at the 9th, 12th, and 20th weeks of pregnancy. The psychological stress experienced by IVF participants significantly increased with gestational week during the first 20 weeks of pregnancy (p pregnancy participants. Gestational week was the main factor found to influence stress ratings for "identifying maternal role." "Altering body structure and body function" was the main factor found to influence pregnancy stress (p pregnancy stress during the first 20 weeks of pregnancy (p > .05). The results of this study provide clinical evidence that IVF/ET does not cause more stress for women than spontaneous pregnancy. However, the intensity and trend of stresses differed between these two groups. These findings suggest that nurses should consider method of pregnancy when assessing the risk of stress in expectant mothers for each gestational week and when providing appropriate care and support.

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

    Directory of Open Access Journals (Sweden)

    Xing Ge

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

  10. Seal design alternatives study

    Energy Technology Data Exchange (ETDEWEB)

    Van Sambeek, L.L. [RE/SPEC Inc., Rapid City, SD (US); Luo, D.D.; Lin, M.S.; Ostrowski, W.; Oyenuga, D. [Parsons Brinckerhoff Quade & Douglas, Inc., San Francisco, CA (US)

    1993-06-01

    This report presents the results from a study of various sealing alternatives for the WIPP sealing system. Overall, the sealing system has the purpose of reducing to the extent possible the potential for fluids (either gas or liquid) from entering or leaving the repository. The sealing system is divided into three subsystems: drift and panel seals within the repository horizon, shaft seals in each of the four shafts, and borehole seals. Alternatives to the baseline configuration for the WIPP seal system design included evaluating different geometries and schedules for seal component installations and the use of different materials for seal components. Order-of-magnitude costs for the various alternatives were prepared as part of the study. Firm recommendations are not presented, but the advantages and disadvantages of the alternatives are discussed. Technical information deficiencies are identified and studies are outlined which can provide required information.

  11. HYPERTENSION IN PREGNANCY: A STUDY IN A TEACHING HOSPITAL

    Directory of Open Access Journals (Sweden)

    Shiva

    2016-05-01

    Full Text Available BACKGROUND In pregnant women, hypertension is one of the common causes of mortality and morbidity in Indian women. METHODS We conducted a study on four hundred and sixteen pregnant women consisting of 202 primigravidae, 148 gravidae 2 and 66 multigravidae. We screened these pregnant women for hypertension between January 2015 to July 2015 at Kamineni Institute of Medical Sciences and Fathima Institute of Medical Sciences(FIMS, which are tertiary care hospitals catering most of the rural areas of Hyderabad & Kadapa Districts. RESULT Hypertension was noted in 34 (8.2% of pregnant women. Majority of pregnant women in the study population were primigravidae (48.56%. Nearly 80% of hypertensive pregnant women were primigravidae. 88.24% developed hypertension in III trimester. Complication like preeclampsia was seen in 23.52%. CONCLUSION We conclude that pregnancy-induced hypertension is the common variety of hypertension in pregnant women. It is commonly seen in primigravidae who are exposed to the trophoblastic tissue for the first time.

  12. 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.

  13. Effects of lifestyle intervention in pregnancy and anthropometrics at birth on offspring metabolic profile at 2.8 years - results from the Lifestyle in Pregnancy and Offspring (LiPO) study

    DEFF Research Database (Denmark)

    Tanvig, Mette; Vinter, Christina A; Jørgensen, Jan S

    2014-01-01

    Context: Maternal obesity and gestational weight gain are linked to offspring adverse metabolic profile, and lifestyle intervention during pregnancy in obese women may have long-term positive effect on their children. Furthermore, although the association between birth weight and later metabolic...... outcomes is well established, little is known about the predictive value of abdominal circumference at birth. Objectives: To study: i) effects of lifestyle intervention during pregnancy in obese women on offspring metabolic risk factors and ii) predictive values of birth weight (BW) and birth abdominal...... circumference (BAC). Design: Follow-up of a randomized controlled trial; the Lifestyle in Pregnancy (LiP) study Setting: Odense and Aarhus University Hospitals, Denmark Participants: Offspring of LiP study participants (n=157) and offspring of normal weight mothers (external reference group, ER, n=97...

  14. Physical activity as an aid to smoking cessation during pregnancy (LEAP trial: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Ussher Michael

    2012-10-01

    Full Text Available Abstract Background Many women try to stop smoking in pregnancy but fail. One difficulty is that there is insufficient evidence that medications for smoking cessation are effective and safe in pregnancy and thus many women prefer to avoid these. Physical activity (PA interventions may assist cessation; however, trials examining these interventions have been too small to detect or exclude plausible beneficial effects. The London Exercise And Pregnant smokers (LEAP trial is investigating whether a PA intervention is effective and cost-effective when used for smoking cessation by pregnant women, and will be the largest study of its kind to date. Methods/design The LEAP study is a pragmatic, multi-center, two-arm, randomized, controlled trial that will target pregnant women who smoke at least one cigarette a day (and at least five cigarettes a day before pregnancy, and are between 10 and 24 weeks pregnant. Eligible patients are individually randomized to either usual care (that is, behavioral support for smoking cessation or usual care plus a intervention (entailing supervised exercise on a treadmill plus PA consultations. The primary outcome of the trial is self-reported and biochemically validated continuous abstinence from smoking between a specified quit date and the end of pregnancy. The secondary outcomes, measured at 1 and 4 weeks after the quit date, and at the end of pregnancy and 6 months after childbirth, are PA levels, depression, self-confidence, and cigarette withdrawal symptoms. Smoking status will also be self-reported at 6 months after childbirth. In addition, perinatal measures will be collected, including antenatal complications, duration of labor, mode of delivery, and birth and placental weight. Outcomes will be analyzed on an intention-to-treat basis, and logistic regression models used to compare treatment effects on the primary outcome. Discussion This trial will assess whether a PA intervention is effective when used for

  15. Alcohol consumption during pregnancy and birth outcomes: the Kyushu Okinawa Maternal and Child Health Study.

    Science.gov (United States)

    Miyake, Yoshihiro; Tanaka, Keiko; Okubo, Hitomi; Sasaki, Satoshi; Arakawa, Masashi

    2014-02-20

    A recent meta-analysis showed no relationships between light to moderate alcohol consumption during pregnancy and the risk of low birth weight (LBW), preterm birth (PTB), or small-for-gestational-age (SGA). Here, we present the first epidemiological study on this topic in Japan. Study subjects were 1565 Japanese mothers with singleton pregnancies and the babies born from these pregnancies. Alcohol consumption during pregnancy was assessed using a self-administered diet history questionnaire. Alcohol consumption during pregnancy was classified into three categories (none, < 1 g/day, and ≥ 1 g/day). The mean birth weight of the babies was 3006.3 g. 7.7% were classified as LBW, 4.0% as PTB, and 7.8% as SGA. The range of maternal alcohol consumption during pregnancy was 0.0 to 11.7 g per day: 1356 (86.7%) mothers were abstainers and the 95th percentile value was 0.84 g per day. Compared with abstinence, alcohol consumption of 1.0 g or more per day during pregnancy was significantly associated with an increased risk of PTB with a significant positive linear trend: the adjusted OR for PTB associated with maternal alcohol consumption of 1.0 g or more per day was 2.58 (95% CI: 1.004 - 5.80, P for trend = 0.03). No significant relationships were observed between maternal alcohol consumption during pregnancy and the risk of LBW or SGA, and there was no material association between maternal alcohol consumption during pregnancy and birth weight. This is the first study in Japan to show that maternal alcohol consumption during pregnancy of 1.0 g or more per day was significantly positively associated with the risk of PTB, but not LBW or SGA.

  16. Statistical methods for estimating the probability of spontaneous abortion in observational studies--analyzing pregnancies exposed to coumarin derivatives.

    Science.gov (United States)

    Meister, Reinhard; Schaefer, Christof

    2008-09-01

    Spontaneous abortion rates are of general interest when investigating pregnancy outcome. In most studies observations are left truncated as pregnant women enter with a delay of several weeks after conception. Apart from spontaneous abortion pregnancy may end in induced abortion or live birth. These outcomes are considered as competing events (risks). Although statistical methods for handling this setting are available since more than 10 years, studies on pregnancy outcome after drug exposure usually report crude rates of spontaneous abortions, ignoring left truncation and competing risks. The authors propose simple methods which remove bias inherent to crude rates. The probability of spontaneous abortion is estimated using an event-history based approach for the subdistribution of competing risks that handles left truncation appropriately. Variance estimation enables the construction of approximate confidence intervals and of a simple test-statistic for comparing rates between different cohorts. The proposed methods are applied to a comparative prospective study on the association of spontaneous abortion and exposure to coumarin derivatives. The naive analysis using crude rates gives substantially different results than those based on the proposed methods, with up to a twofold change. Correctly incorporating left truncation into the analysis may increase the variance of the estimators, relative to an ideal sample where all pregnancies are followed from the time of conception. The consequences of such truncation for study design are discussed. Combining corrections for left truncation and competing risks offers a powerful method for analyzing miscarriage risk.

  17. A LONGITUDINAL STUDY OF SERUM URIC ACID LEVEL IN NORMAL PREGNANCY AND PREGNANCY INDUCED HYPERTENSION AMONG PATIENTS ATTENDING ANTENATAL OUTPATIENT DEPARTMENT OF GA UHATI MEDICAL COLLEGE, GUWAHATI

    Directory of Open Access Journals (Sweden)

    Santana

    2015-07-01

    Full Text Available AIMS AND OBJECTIVES: To estimate serum uric acid level in normal pregnancy and pregnancy induced hypertension at different duration as pregnancy advances and to evaluate its place in determining severity of pregnancy induced hypertension. MATERIALS AND METHODS: A longitudinal study was carried out among forty cases of normal pregnancy and forty cases of pregnancy induced hypertension attending antenatal outpatient department of Gauhati Medical College and Hospital. Serum uric acid level was estimated colorimetrically by using Uricase method in the Department of Physiology, Gauhati Medical College. Statistical analysis was carried out applying ANOVA test using IBM SPSS 16. RESULTS: Serum Uric Acid level was found to be significantly higher in study group as compared to control g roup. The mean values of serum uric acid level in study group were 4.07 mg/dl, 4.44 mg/dl and 5.27mg/dl as compared to 3.14mg/dl, 3.11 mg/dl and 3.71 mg/dl in control group at 20 - 24 weeks, 24 - 28 weeks and 32 - 40 weeks of gestation respectively. Also, the leve l of serum uric acid was found to be increased with increasing severity of pregnancy induced hypertension. CONCLUSION: A definite rise in serum uric level was found in cases of pregnancy induced hypertension and its level increases with increasing severity of the disease.

  18. Work-related maternal risk factors and the risk of pregnancy induced hypertension and Preeclampsia during pregnancy. The generation R study

    NARCIS (Netherlands)

    J.J. Nugteren (Jaap); C.A. Snijder (Claudia); A. Hofman (Albert); V.W.V. Jaddoe (Vincent); E.A.P. Steegers (Eric); A. Burdorf (Alex)

    2012-01-01

    textabstractObjective: 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

  19. Work-related maternal risk factors and the risk of pregnancy induced hypertension and Preeclampsia during pregnancy. The generation R study

    NARCIS (Netherlands)

    J.J. Nugteren (Jaap); C.A. Snijder (Claudia); A. Hofman (Albert); V.W.V. Jaddoe (Vincent); E.A.P. Steegers (Eric); A. Burdorf (Alex)

    2012-01-01

    textabstractObjective: 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

  20. Clinical Study on Acute Pancreatitis in Pregnancy in 26 Cases

    Directory of Open Access Journals (Sweden)

    Cheng Qihui

    2012-01-01

    Full Text Available Aim. This paper investigated the pathogenesis and treatment strategies of acute pancreatitis (AP in pregnancy. Methods. We analyzed retrospectively the characteristics, auxiliary diagnosis, treatment strategies, and clinical outcomes of 26 cases of patients with AP in pregnancy. Results. All patients were cured finally. (1 Nine cases of 22 mild acute pancreatitis (MAP patients selected automatic termination of pregnancy because of the unsatisfied therapeutic efficacy or those patients’ requirements. (2 Four cases of all patients were complicated with severe acute pancreatitis (SAP; 2 cases underwent uterine incision delivery while one of them also received cholecystectomy, debridement and drainage of pancreatic necrosis, and percutaneous jejunostomy. One case had a fetal death when complicated with SAP; she had to receive extraction of bile duct stones and drainage of abdominal cavity after induced abortion. The other one case with hyperlipidemic pancreatitis was given induced abortion and hemofiltration. Conclusions. The first choice of MAP in pregnancy is the conventional therapy. Apart from the conventional therapy, we need to terminate pregnancy as early as possible for patients with SAP. Removing biliary calculi and drainage is supposed to be considered for acute biliary pancreatitis. Lowering blood lipids treatment should be applied to hyperlipidemic pancreatitis or given to hemofiltration when necessary.

  1. Medicine and Pregnancy

    Science.gov (United States)

    ... Consumer Information by Audience For Women Medicine and Pregnancy Share Tweet Linkedin Pin it More sharing options ... reporting problems to FDA . Sign Up for a Pregnancy Registry Pregnancy Exposure Registries are research studies that ...

  2. Case study Early psychomotor development of children from triple pregnancy – case study

    Directory of Open Access Journals (Sweden)

    Łucja Bieleninik

    2014-08-01

    Full Text Available The aim of this study was to analyze the specificity and dynamics of psychomotor development in children from triplet pregnancy. The studied group was composed of siblings from triple pregnancy (T1, T2, T3, including two girls and one boy. This longitudinal study comprised three stages: stage I – children aged 25 months, stage II – children aged 29 months, and stage III – children aged 38 months. At each stage, the psychomotor development of children was examined with the Third Edition of Bayley Scales of Infant and Toddler Development (BSID-III and subjectively by their mother. Additionally, medical and nursing documentation was analyzed. Individual psychomotor development of children from triple pregnancy is different with regards to various spheres, and has different rates and dynamics throughout consecutive years. Psychomotor development of children from triple pregnancies is determined by gender and postnatal clinical parameters, i.e. birth weight, head circumference, postnatal morbidity, and prematurity-related conditions.

  3. A prospective-longitudinal study on the association of anxiety disorders prior to pregnancy and pregnancy- and child-related fears.

    Science.gov (United States)

    Martini, Julia; Asselmann, Eva; Einsle, Franziska; Strehle, Jens; Wittchen, Hans-Ulrich

    2016-05-01

    This study aimed to investigate the relation between anxiety disorders prior to pregnancy and specific pregnancy- and child-related fears during pregnancy and after delivery. 306 expectant mothers were interviewed regarding anxiety (and depressive) disorders prior to pregnancy and pregnancy- and child-related fears (e.g. fear of labor pain, fear of infant injury) using the Composite International Diagnostic Interview for Women (CIDI-V). Pregnancy- and child-related fears were particularly pronounced in women with multiple anxiety disorders and women with comorbid anxiety and depressive disorders prior to pregnancy. Further analyses revealed associations between particular anxiety disorders and specific pregnancy- and child-related fears. Results remained stable when considering potential confounders such as maternal age, education, marital status, parity, prior abortion and preterm delivery or low birth weight. Our study suggests that especially women with multiple anxiety and/or comorbid depressive disorders may benefit from early targeted interventions to prevent an escalation of anxiety and fears over the peripartum period. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. Maternal and perinatal complications in triplet compared with twin pregnancy

    NARCIS (Netherlands)

    J.G. Santema (Job); P. Bourdrez (Petra); H.C.S. Wallenburg (Henk)

    1995-01-01

    textabstractObjective: To compare maternal and perinatal complications in triplet and twin pregnancies. Study design: Case-controlled study in the setting of a University Hospital. Each pregnancy of a consecutive series of 40 triplet pregnancies of 20 weeks or more was matched for parity and materna

  5. FUNDUS CHANGES IN PREGNANCY INDUCED HYPERTENSION: A CLINICAL STUDY

    Directory of Open Access Journals (Sweden)

    Rama Bharathi

    2015-01-01

    Full Text Available PURPOSE: To estimate the prevalence of fundus changes in Pregnancy Induced Hypertension (PIH and to find the correlation of the findings with the levels of hypertension and with the severity of the disease. METHODS: This was a hospital based cross section al study conducted over a period of one year from July 2012 to June 2013. 150 patients with diagnosed PIH and admission into wards at King George Hospital, Visakhapatnam, with 36 weeks period of gestation and above, were included in the study. Those with p re - existing hypertension, coexisting diabetes mellitus, severe anaemia, renal disease and ocular diseases like cataract or corneal opacities were excluded from the study. After taking consent and ocular history, anterior segment was evaluated. Pupils were dilated with 0.5% tropicamide eye drops and fundus examination was done with direct ophthalmoscope. Information like age, para, BP etc., was noted down from case sheets. RESULTS: Total number of patients studied was 150.Mean age was 23.06+ 3.03years. 105 ( 70% were primigravidae and 45(30% were multigravidae. Fundus findings were seen in 35 cases (23.33%. 26 (17.33% had Grade I changes, 1 (0.66% had grade II changes, 6 (3.9% had grade III changes 2 (1.3% had serous retinal detachment/grade - IV. The de gree of retinopathy was correlating with the severity of the disease and levels of hypertension. CONCLUSION: The prevalence of fundus changes in PIH is 23.33%. Most of the fundus changes in PIH are underdiagnosed. Timely ophthalmoscopy should be called for in all cases of PIH as it would affect the decision of induction of delivery, thereby preventing other complications.

  6. Maternal smoking during pregnancy and newborn neurobehavior: A pilot study of effects at 10–27 days

    Science.gov (United States)

    Stroud, Laura R.; Paster, Rachel L.; Papandonatos, George D.; Niaura, Raymond; Salisbury, Amy L.; Battle, Cynthia; Lagasse, Linda L.; Lester, Barry

    2010-01-01

    Objective To examine effects of maternal smoking during pregnancy on newborn neurobehavior at 10–27 days. Study design Participants were 56 healthy infants (28 smoking-exposed, 28 unexposed) matched on maternal social class, age, and alcohol use. Maternal smoking during pregnancy was determined by maternal interview and maternal saliva cotinine. Postnatal smoke exposure was quantified by infant saliva cotinine. Infant neurobehavior was assessed through the NICU Network Neurobehavioral Scale. Results Smoking-exposed infants showed greater need for handling and worse self-regulation (p <.05) and trended toward greater excitability and arousal (p <.10) relative to matched, unexposed infants (all moderate effect sizes). In contrast to prior studies of days 0–5, no effects of smoking-exposure on signs of stress/abstinence or muscle tone emerged. In stratified, adjusted analyses, only effects on need for handling remained significant (p<.05, large effect size). Conclusions Effects of maternal smoking during pregnancy at 10–27 days are subtle and consistent with increased need for external intervention and poorer self-regulation. Along with parenting deficits, these effects may represent early precursors for long-term adverse outcomes from maternal smoking during pregnancy. That signs of abstinence shown in prior studies of 0–5 day-old newborns did not emerge in older newborns provides further evidence for the possibility of a withdrawal process in exposed infants. PMID:18990408

  7. 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

  8. Brief intervention to reduce risky drinking in pregnancy: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Wilson Graeme B

    2012-09-01

    Full Text Available Abstract Background Risky drinking in pregnancy by UK women is likely to result in many alcohol-exposed pregnancies. Studies from the USA suggest that brief intervention has promise for alcohol risk reduction in antenatal care. However, further research is needed to establish whether this evidence from the USA is applicable to the UK. This pilot study aims to investigate whether pregnant women can be recruited and retained in a randomized controlled trial of brief intervention aimed at reducing risky drinking in women receiving antenatal care. Methods The trial will rehearse the parallel-group, non-blinded design and procedures of a subsequent definitive trial. Over 8 months, women aged 18 years and over (target number 2,742 attending their booking appointment with a community midwife (n = 31 in north-east England will be screened for alcohol consumption using the consumption questions of the Alcohol Use Disorders Identification Test (AUDIT-C. Those screening positive, without a history of substance use or alcohol dependence, with no pregnancy complication, and able to give informed consent, will be invited to participate in the trial (target number 120. Midwives will be randomized in a 1:1 ratio to deliver either treatment as usual (control or structured brief advice and referral for a 20-minute motivational interviewing session with an alcohol health worker (intervention. As well as demographic and health information, baseline measures will include two 7-day time line follow-back questionnaires and the EuroQoL EQ-5D-3 L questionnaire. Measures will be repeated in telephone follow-ups in the third trimester and at 6 months post-partum, when a questionnaire on use of National Health Service and social care resources will also be completed. Information on pregnancy outcomes and stillbirths will be accessed from central health service records before the follow-ups. Primary outcomes will be rates of eligibility, recruitment, intervention

  9. BWID System Design Study

    Energy Technology Data Exchange (ETDEWEB)

    O' Brien, M.C.; Rudin, M.J.; Morrison, J.L.; Richardson, J.G.

    1991-01-01

    The mission of the Buried Waste Integrated Demonstration (BWID) System Design Study is to identify and evaluate technology process options for the cradle-to-grave remediation of Transuranic (TRU)-Contaminated Waste Pits and Trenches buried at the Idaho National Engineering Laboratory (INEL). Emphasis is placed upon evaluating system configuration options and associated functional and operational requirements for retrieving and treating the buried wastes. A Performance-Based Technology Selection Filter was developed to evaluate the identified remediation systems and their enabling technologies based upon system requirements and quantification of technical Comprehensive Environmental Response, Compensation, and Liability (CERCLA) balancing criteria. Remediation systems will also be evaluated with respect to regulatory and institutional acceptance and cost-effectiveness.

  10. BWID System Design Study

    Energy Technology Data Exchange (ETDEWEB)

    O`Brien, M.C.; Rudin, M.J.; Morrison, J.L.; Richardson, J.G.

    1991-12-31

    The mission of the Buried Waste Integrated Demonstration (BWID) System Design Study is to identify and evaluate technology process options for the cradle-to-grave remediation of Transuranic (TRU)-Contaminated Waste Pits and Trenches buried at the Idaho National Engineering Laboratory (INEL). Emphasis is placed upon evaluating system configuration options and associated functional and operational requirements for retrieving and treating the buried wastes. A Performance-Based Technology Selection Filter was developed to evaluate the identified remediation systems and their enabling technologies based upon system requirements and quantification of technical Comprehensive Environmental Response, Compensation, and Liability (CERCLA) balancing criteria. Remediation systems will also be evaluated with respect to regulatory and institutional acceptance and cost-effectiveness.

  11. Occupational activity during pregnancy based on the Polish Mother and Child Cohort Study

    Directory of Open Access Journals (Sweden)

    Kinga Polańska

    2014-02-01

    Full Text Available Background: In Poland conditions related to or aggravated by the pregnancy, childbirth or the puerperium are one of the most common causes of sickness absence. The aim of the study was to analyze the occupational activity pattern during pregnancy and to evaluate the determinants of pregnancy-related temporary work disability confirmed by medical certificate. Materials and Methods: The presented analysis is based on data collected under the Polish Mother and Child Cohort Study. The study population consisted of 954 women who reported occupational activity during pregnancy. All women participating in the study were interviewed 3 times during pregnancy. Detail information on occupational activity during pregnancy and occupational stress, based on the Subjective Work Characteristics Questionnaire, was collected from all women. Results: The pregnant women had been issued medical certificate of temporary work disability because of conditions related to or aggravated by the pregnancy, childbirth or by the puerperium at 16 week of gestation on average and did not continue their activities until the end of pregnancy. The statistically significant determinants of receiving such medical certificate in the first trimester of pregnancy (≤ 12 weeks of pregnancy comprised poor health condition and complications during pregnancy (OR = 1.4; p = 0.01, lower education (OR = 2.4; p < 0.001, socio-economic status (OR = 9.6; p = 0.03, use of public transport to commute to work (OR = 2.7; p < 0.001, a longer work commute (OR = 1.4; p = 0.008 and a higher level of occupational stress (OR = 3.0; p < 0.01. Waitresses, nurses and saleswomen received medical certificate of temporary work disability in the first trimester of pregnancy more frequently than office workers (OR = 4.2; p = 0.005; OR = 3.3; p = 0.02; OR = 2.3; p < 0.001 respectively. Conclusions: It is crucial to develop the model of cooperation between occupational medicine physicians and gynecologists and a

  12. STUDY OF FACTORS RELATED TO STRESS AMONG WOMEN UNDERGOING TERMINATION OF PREGNANCY (TOP IN A COLLECTIVIST CULTURE

    Directory of Open Access Journals (Sweden)

    Priyanka H

    2016-01-01

    Full Text Available BACKGROUND India is a country where people are dependent on each other for psychological support. Traditional Indian culture follows a collectivist pattern where the woman cares more about her family and society than herself. An unmarried woman who is pregnant poses a problem for both herself and her baby here, where traditional values are held high and pregnancy without marriage is almost always a taboo. AIMS To find the impact of Termination of Pregnancy (TOP on the anxiety and depression levels among pregnant women, correlation with period of gestation and the impact of perceived social support on anxiety and depression levels of these women. SETTING One hundred women who attended the outpatient department of ESICMC- PGIMSR, Bengaluru, India, requesting for Termination of Pregnancy, between August 2011 and December 2014 were studied. DESIGN A Prospective Observational study. METHODS AND MATERIAL Hospital Anxiety and Depression Scale (HADS and Multidimensional Scale of Perceived Social Support (Zimet, 1988 were measured both pre-TOP and Hospital Anxiety and Depression Scale (HADS was measured post TOP in women fulfilling the Inclusion and Exclusion criteria. STATISTICAL ANALYSIS Averages and proportions were calculated for the study and appropriate statistical tests like Wilcoxon Signed Ranks Test and Spearman’s Correlation Coefficient were done using MiniTab version 16. RESULTS 1 There is a reduction of depression and anxiety after Termination of pregnancy (p <0.05 more so among unmarried women with an unwanted pregnancy. 2 The higher the period of gestation, the higher the levels of HADS anxiety levels were observed (p value of <0.05. 3 The lower the social support scores, the higher the levels of HADS anxiety and depression (p value of <0.05. CONCLUSIONS There is a need for larger number of abortion care providers in India with increased contraception awareness and education regarding the need for Termination of Pregnancy in medical

  13. Pregnancy related back pain, is it related to aerobic fitness? A longitudinal cohort study

    Directory of Open Access Journals (Sweden)

    Thorell Eva

    2012-04-01

    Full Text Available Abstract Background Low back pain with onset during pregnancy is common and approximately one out of three women have disabling pain. The pathogenesis of the pain condition is uncertain and there is no information on the role of physical fitness. Whether poorer physical conditioning is a cause or effect of back pain is also disputed and information from prospective studies needed. Methods A cohort of pregnant women, recruited from maternal health care centers in central Sweden, were examined regarding estimated peak oxygen uptake by cycle ergometer test in early pregnancy, reported physical activity prior to pregnancy, basic characteristics, back pain during pregnancy and back pain postpartum. Results Back pain during the current pregnancy was reported by nearly 80% of the women. At the postpartum appointment this prevalence was 40%. No association was displayed between estimated peak oxygen uptake and incidence of back pain during and after pregnancy, adjusted for physical activity, back pain before present pregnancy, previous deliveries, age and weight. A significant inverse association was found between estimated peak oxygen uptake and back pain intensity during pregnancy and a direct association post partum, in a fully adjusted multiple linear regression analysis. Conclusions Estimated peak oxygen uptake and reported physical activity in early pregnancy displayed no influence on the onset of subsequent back pain during or after pregnancy, where the time sequence support the hypothesis that poorer physical deconditioning is not a cause but a consequence of the back pain condition. The mechanism for the attenuating effect of increased oxygen uptake on back pain intensity is uncertain.

  14. Thermionic Reactor Design Studies

    Energy Technology Data Exchange (ETDEWEB)

    Schock, Alfred

    1994-06-01

    During the 1960's and early 70's the author performed extensive design studies, analyses, and tests aimed at thermionic reactor concepts that differed significantly from those pursued by other investigators. Those studies, like most others under Atomic Energy Commission (AEC and DOE) and the National Aeronautics and Space Administration (NASA) sponsorship, were terminated in the early 1970's. Some of this work was previously published, but much of it was never made available in the open literature. U.S. interest in thermionic reactors resumed in the early 80's, and was greatly intensified by reports about Soviet ground and flight tests in the late 80's. This recent interest resulted in renewed U.S. thermionic reactor development programs, primarily under Department of Defense (DOD) and Department of Energy (DOE) sponsorship. Since most current investigators have not had an opportunity to study all of the author's previous work, a review of the highlights of that work may be of value to them. The present paper describes some of the author's conceptual designs and their rationale, and the special analytical techniques developed to analyze their performance. The basic designs, first published in 1963, are based on single-cell converters, either double-ended diodes extending over the full height of the reactor core or single-ended diodes extending over half the core height. In that respect they are similar to the thermionic fuel elements employed in the Topaz-2 reactor subsequently developed in the Soviet Union, copies of which were recently imported by the U.S. As in the Topaz-2 case, electrically heated steady-state performance tests of the converters are possible before fueling. Where the author's concepts differed from the later Topaz-2 design was in the relative location of the emitter and the collector. Placing the fueled emitter on the outside of the cylindrical diodes permits much higher axial conductances to reduce ohmic

  15. 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...

  16. Drug pattern use during pregnancy: a prospective study at tertiary care teaching hospital

    OpenAIRE

    Savitha A.; Sarita H.; Kashinath Gumma

    2016-01-01

    Background: Pregnancy is a normal physiological state. It may be accompanied by some common conditions which may occur normally due to the physiological changes. For these, drug treatment may be necessary. Use of drug is of growing concern due to increased risk of teratogenicity. Hence use of safe drugs during pregnancy should be promoted. This study aims to study and evaluate the pattern of drug use in women attending the antenatal clinic. Methods: A prospective cross sectional study was ...

  17. Data from the PALS (Pregnancy and Lifestyle Study, a Community-Based Study of Lifestyle on Fertility and Reproductive Outcome

    Directory of Open Access Journals (Sweden)

    Judith Helen Ford

    2015-11-01

    Full Text Available In order to assess the possible effects of lifestyle on fertility and pregnancy outcome, the PALS (Pregnancy and Lifestyle study collected extensive data on a broad range of parameters termed ‘lifestyle’ from couples who were planning a natural (non-assisted pregnancy in the coming months. There was no intervention. Participants were recruited over a six year period from 1988 to 1993 in response to extensive promotion in the local media. Male and female partners were interviewed independently and all interviews were conducted prospectively before the couple attempted to conceive. The result of each month of ‘trying’ was recorded and pregnancies were confirmed by urine tests and by ultrasound. The length of gestation of each pregnancy was recorded and pregnancies at term were classified with respect to weight. Multiple pregnancies and/or babies with congenital abnormalities have been excluded from the dataset. The data is stored as an xls file and each variable has a codename. For each of 582 couples there are 355 variables, the codes for which are described in a separate metadata file. The questionnaire based data includes information about households, occupation, chemical exposures at work and home, diet, smoking, alcohol use, hobbies, exercise and health. Recorded observations include monthly pregnancy tests and pregnancy outcomes.

  18. Nutrition, mental health and violence: from pregnancy to postpartum Cohort of women attending primary care units in Southern Brazil - ECCAGE study

    Directory of Open Access Journals (Sweden)

    Nunes Maria A

    2010-08-01

    Full Text Available Abstract Background Woman's nutritional status, before and during pregnancy, is a strong determinant of health outcomes in the mother and newborn. Gestational weight gain and postpartum weight retention increases risk of overweight or obesity in the future and they depend on the pregestational nutritional status and on food consumption and eating behavior during pregnancy. Eating behavior during pregnancy may be the cause or consequence of mood changes during pregnancy, especially depression, which increases likelihood of postpartum depression. In Brazil, a study carried out in the immediate postpartum period found that one in three women experienced some type of violence during pregnancy. Violence and depression are strongly associated and both exposures during pregnancy are associated with increased maternal stress and subsequent harm to the infant. The main objectives of this study are: to identify food intake and eating behaviors patterns; to estimate the prevalence of common mental disorders and the experience of violence during and after pregnancy; and to estimate the association between these exposures and infant's health and development. Methods/Design This is a cohort study of 780 pregnant women receiving care in 18 primary care units in two cities in Southern Brazil. Pregnant women were first evaluated between the 16th and 36th week of pregnancy at a prenatal visit. Follow-up included immediate postpartum assessment and around the fifth month postpartum. Information was obtained on sociodemographic characteristics, living circumstances, food intake, eating behaviors, mental health and exposure to violence, and on infant's development and anthropometrics measurements. Discussion This project will bring relevant information for a better understanding of the relationship between exposures during pregnancy and how they might affect child development, which can be useful for a better planning of health actions aiming to enhance available

  19. 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

  20. Jaundice in pregnancy: a clinical study at JSS hospital, Mysore

    Directory of Open Access Journals (Sweden)

    Triveni Kondareddy

    2016-07-01

    Conclusions: Jaundice and pregnancy is a deadly combination resulting in a very high perinatal as well as maternal morbidity and mortality, and requires an early diagnosis and careful management. [Int J Reprod Contracept Obstet Gynecol 2016; 5(7.000: 2257-2260

  1. A Cross Sectional Study to Assess Socio Economic Complications of Adolescent Pregnancy in a Metropolitan City of Central India.

    Directory of Open Access Journals (Sweden)

    Rachna Dubey, Sanjay Dixit

    2014-01-01

    Full Text Available "Background: Teenage pregnancy is not new to this century which is pregnancy in a female under the age of 20 (when the pregnancy ends. Half of all the teenage births occur in just 7 countries, namely Bangladesh, Brazil, Congo, Ethiopia, Nigeria, India and USA. Present study assessed the prevalence of adolescent pregnancies and correlate with their social background, also to study the possible socio-economic problems specific to pregnant adolescents. Methods: The cross sectional study is conducted at Hukumchand hospital, District hospital and MGM medical college from 1st October 2011 to 1st September 2012. The delivered mothers were visited daily and detailed history was taken in a pre-designed, semi-open pro-forma. Study Group include Adolescent mothers (Study group 14-20 years & Mothers 20-28 years (Control group. Result: 12.05% of the total deliveries were teenage pregnancy. 31.74% were adolescent deliveries out of the total primi-gravida. 77 (43.75% adolescent mothers were found in the age group of 17-19 years. In non-adolescent mothers 68 (38.64% beneficiaries were in 21-23 years. Mean age of delivery in adolescent age was 18.45 years as compared to 22.28 years in control group. Only 41 (11.65% beneficiaries were graduates and above. Most beneficiaries were in the Socio Economic Status Class III and IV. 101 (57.39% adolescent mothers had alcoholic/addict fathers as compared to 54 (30.68% in non-adolescent mothers. Conclusion: Most of adolescent mothers had low education, rural background and belonged to low socioeconomic status with history of both pre and post marital sex discrimination."

  2. Maternal polyunsaturated fatty acid plasma levels during pregnancy and childhood adiposity. The Generation R Study

    Science.gov (United States)

    Vidakovic, Aleksandra Jelena; Gishti, Olta; Voortman, Trudy; Felix, Janine F.; Williams, Michelle A.; Hofman, Albert; Demmelmair, Hans; Koletzko, Berthold; Tiemeier, Henning; Jaddoe, Vincent WV; Gaillard, Romy

    2017-01-01

    Background Maternal polyunsaturated fatty acid (PUFA) levels during pregnancy may have persistent effects on growth and adiposity in the offspring. Suboptimal maternal diet during pregnancy might lead to fetal cardio-metabolic adaptations with persistent consequences in the offspring. Objective We examined the associations of maternal PUFA levels during pregnancy with childhood general and abdominal fat distribution measures. Design In a population-based prospective cohort study among 4,830 mothers and their children, we measured maternal second trimester n-3 and n-6 PUFA plasma levels. At the median age of 6.0 years (95% range, 5.6–7.9), we measured childhood body mass index, fat mass percentage, android/gynoid fat ratio with dual-energy x-ray absorptiometry, and pre-peritoneal abdominal fat area with ultrasound. Analyses were adjusted for maternal and childhood socio-demographic and lifestyle related characteristics. Results We observed that higher maternal total n-3 PUFA levels, and specifically eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA), docosahexaenoic acid (DHA) levels, were associated with lower childhood total body fat percentage and lower android/gynoid fat mass ratio (p-values<0.05), but not with childhood body mass index and abdominal pre-peritoneal fat mass area. Higher maternal total n-6 PUFA levels and specifically dihomo-gamma linolenic acid (DGLA) were associated with a higher childhood total body fat percentage, android/gynoid fat mass ratio and abdominal pre-peritoneal fat mass area (p-values<0.05), but not with childhood body mass index. In line with these findings, a higher maternal n-6/n-3 PUFA ratio was associated with higher childhood total body and abdominal fat mass levels. Conclusions Lower maternal n-3 PUFA levels and higher n-6 PUFA levels during pregnancy are associated with higher total body fat and abdominal fat levels in childhood. Further studies are needed to replicate these observations and to explore the causality

  3. A population-based case-control teratologic study of ampicillin treatment during pregnancy

    DEFF Research Database (Denmark)

    Czeizel, A.E.; Rockenbauer, M.; Sørensen, Henrik Toft

    2001-01-01

    Objective: This was a study of the association between ampicillin treatment during pregnancy and prevalence of different congenital abnormalities. Study Design: The paired analysis of case patients with congenital abnormalities and matched population control subjects was performed in the population......-based Hungarian Case-Control Surveillance of Congenital Abnormalities between 1980 and 1996. Of 38,151 pregnant women who had babies without any defects (population control group), 2632 (6.9%) had been treated with ampicillin. Of 22,865 pregnant women who had offspring with congenital abnormalities (case patients......), 1643 (7.2%) had been treated with ampicillin (crude odds ratio, 1.0; 95% confidence interval, 0.7-1.2). Of 812 mothers who were delivered of babies affected by Down syndrome (patient control subjects), 61 (7.5%) had ampicillin treatment, and these were also compared with the case group. Results...

  4. Conduct Disorder Symptoms and Subsequent Pregnancy, Child-Birth and Abortion: A Population-Based Longitudinal Study of Adolescents

    Science.gov (United States)

    Pedersen, Willy; Mastekaasa, Arne

    2011-01-01

    Research on teenage pregnancy and abortion has primarily focused on socio-economic disadvantage. However, a few studies suggest that risk of unwanted pregnancy is related to conduct disorder symptoms. We examined the relationship between level of conduct disorder symptoms at age 15 and subsequent pregnancy, child-birth and abortion. A…

  5. Conduct Disorder Symptoms and Subsequent Pregnancy, Child-Birth and Abortion: A Population-Based Longitudinal Study of Adolescents

    Science.gov (United States)

    Pedersen, Willy; Mastekaasa, Arne

    2011-01-01

    Research on teenage pregnancy and abortion has primarily focused on socio-economic disadvantage. However, a few studies suggest that risk of unwanted pregnancy is related to conduct disorder symptoms. We examined the relationship between level of conduct disorder symptoms at age 15 and subsequent pregnancy, child-birth and abortion. A…

  6. 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 — ...

  7. Lupus Activity in Pregnancy

    OpenAIRE

    Clowse, Megan E. B.

    2007-01-01

    Pregnancy in a woman with Systemic Lupus Erythematosus (SLE) can be complicated by both lupus activity and pregnancy mishaps. The majority of recent studies demonstrate an increase in lupus activity during pregnancy, perhaps exacerbated by hormonal shifts required to maintain pregnancy. Increased lupus activity, in turn, prompts an elevated risk for poor pregnancy outcomes, including stillbirth, preterm birth, low birth weight, and preeclamspsia. Fortunately, the majority of pregnancies in wo...

  8. Narcolepsy and pregnancy

    DEFF Research Database (Denmark)

    Maurovich-Horvat, Eszter; Kemlink, David; Högl, Birgit

    2013-01-01

    In a retrospective cohort study undertaken in 12 European countries, 249 female narcoleptic patients with cataplexy (n = 216) and without cataplexy (n = 33) completed a self-administrated questionnaire regarding pregnancy and childbirth. The cohort was divided further into patients whose symptoms...... of narcolepsy started before or during pregnancy (308 pregnancies) and those in whom the first symptoms of narcolepsy appeared after delivery (106 pregnancies). Patients with narcolepsy during pregnancy were older during their first pregnancy (P ...

  9. Pregnancy periodontitis and low birth weight: A cohort study in rural Belgaum, India

    Directory of Open Access Journals (Sweden)

    Murthy S

    2012-07-01

    Full Text Available Background: Low birth weight can cause devastating long term medical and economical impacts to the family as whole and much interest prevails in preventing LBW by controlling its potential risk factors. Pregnancy periodontitis, being reported as one of such risk factors, is amenable to prevention, control and cure. Confirmative evidence can bring drastic improvements in birth weight and also health of the mother. This cohort study was an attempt to find if such a relation exists since limited conclusive evidence is available. Objectives: To determine the relation between pregnancy periodontitis and low birth weight of newborn in primigravida women in rural Belgaum. To assess the oral health status of the same primigravida women in rural Belgaum. Materials & Methods: Study Design & Period: A cohort study for 18 months Study location: 3 rural field areas of JNMC (Handiganur, Kinaye and Vantamuri in Belgaum. Study Population: Primigravida women in the 3 villages in their first trimester in January/February 2011 during enrolment and expected to deliver in August/September 2011. Sample Size: 240 (120 in each cohort. Data Collection: After ethical review, a pilot study was conducted on 10% of study population in each village to essentially pre-test the interview schedule. Then screening visit to enrol women based on eligibility criteria was done. Subsequent screening periodontal examination was done by CPI to allocate the women into study (pregnant women with periodontitis and control (pregnant women without periodontitis cohort. Oral health status was also recorded using OHI-S and DMFT indices. Follow up visits consisted of trimester-wise visit to check on periodontal status and a post delivery visit to record term of delivery and LBW. Data was entered in Microsoft Excel 2007 and SPSS (β version 20 and analyzed in in proportions, percentages, Odds Ratio, Relative Risk, Chi-Square test and Logistic Regression Analysis.Results: The total incidence of

  10. Cobalamin status during normal pregnancy and postpartum: a longitudinal study comprising 406 danish women

    DEFF Research Database (Denmark)

    Milman, N; Byg, KE; Bergholt, T

    2006-01-01

    OBJECTIVES: To assess cobalamin (vitamin B(12)) status during normal pregnancy and postpartum in a longitudinal setting. METHODS: This study was performed in 1995-1996. It comprised 406 healthy, pregnant Danish Caucasian women, living in Copenhagen County. Cobalamin status, i.e. plasma (P...... in late pregnancy. The recommendations for periconceptional vitamin B(12) supplementation should be reconsidered.......-) cobalamin, P-methylmalonic acid and P-homocysteine was measured at 18, 32 and 39 wk gestation and 8 wk postpartum during lactation. RESULTS: P-cobalamin showed a gradual, significant decline during pregnancy (P

  11. Physical activity, sedentary behaviour and fetal macrosomia in uncomplicated pregnancies: a prospective cohort study.

    Science.gov (United States)

    Reid, Esther W; McNeill, Jenny A; Alderdice, Fiona A; Tully, Mark A; Holmes, Valerie A

    2014-12-01

    to explore maternal energy balance, incorporating free living physical activity and sedentary behaviour, in uncomplicated pregnancies at risk of macrosomia. a parallel-group cross-sectional analysis was conducted in healthy pregnant women predicted to deliver infants weighing ≥ 4000 g (study group) or macrosomia and energy balance, those women predicted to deliver a macrosomic infant exhibited increased sedentary behaviour and reduced physical activity in the third trimester of pregnancy. Professionals caring for women during pregnancy have an important role in promoting and supporting more active lifestyles amongst women who are predicted to deliver a macrosomic infant given the known associated risks. Copyright © 2014 Elsevier Ltd. All rights reserved.

  12. A prospective observational study of thyroid dysfunctions during pregnancy in a tertiary care hospital

    Directory of Open Access Journals (Sweden)

    Sarojamma Chunchaiah

    2016-11-01

    Conclusions: Our study showed 11.25% prevalence of thyroid dysfunction in pregnant women and commonest dysfunction was hypothyroidism in subclinical form. Adverse pregnancy outcomes were seen in 55.55% woman having thyroid dysfunctions. Absence of risk factor was noted in upto 70% of the cases with thyroid dysfunctions hence the diagnosis will be missed if only high risk cases are screened. Therefore universal screening is recommended early in pregnancy to identify and correct thyroid dysfunctions to prevent the associated adverse pregnancy outcomes. [Int J Reprod Contracept Obstet Gynecol 2016; 5(11.000: 3683-3689

  13. Exploring the barriers of quitting smoking during pregnancy: a systematic review of qualitative studies.

    OpenAIRE

    Ingall, G; Cropley, M.

    2010-01-01

    Smoking during pregnancy is widely known to increase health risks to the foetus, and understanding the quitting process during pregnancy is essential in order to realise national government targets. Qualitative studies have been used in order to gain a greater understanding of the quitting process and the objective of this systematic review was to examine and evaluate qualitative studies that have investigated the psychological and social factors around women attempting to quit smoking during...

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

    Science.gov (United States)

    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.

  15. An inventory of Canadian pregnancy and birth cohort studies: research in progress

    Directory of Open Access Journals (Sweden)

    Joly Marie-Pier

    2012-10-01

    Full Text Available Abstract Background A web-based inventory was developed as a voluntary registry of Canadian pregnancy and birth cohort studies, with the objective to foster collaboration and sharing of research tools among cohort study groups as a means to enrich research in maternal and child health across Canada. Description Information on existing birth cohort studies conducted in Canada exclusively or as part of broader international initiatives was accessed by searching the literature in PubMed and PsychInfo databases. Additional studies were identified by enquiring about the research activities of researchers at Canadian universities or working in affiliated hospitals or research centres or institutes. Of the fifty-eight birth cohort studies initially identified, forty-six were incorporated into the inventory if they were of a retrospective and/or prospective longitudinal design and with a minimum of two phases of data collection, with the first period having occurred before, during, or shortly after pregnancy and had an initial study sample size of a minimum of 200 participants. Information collected from each study was organized into four main categories: basic information, data source and period of collection, exposures, and outcome measures and was coded and entered into an Excel spreadsheet. The information incorporated into the Excel spreadsheet was double checked, completed when necessary, and verified for completeness and accuracy by contacting the principal investigator or research coordinator. All data collected were then uploaded onto the website of the Institute of Human Development Child and Youth Health of the Canadian Institutes of Health Research. Subsequently, the database was updated and developed as an online searchable inventory on the website of the Maternal, Infant, Child and Youth Research Network. Conclusions This inventory is unique, as it represents detailed information assembled for the first time on a large number of Canadian

  16. An inventory of Canadian pregnancy and birth cohort studies: research in progress.

    Science.gov (United States)

    Joly, Marie-Pier; Boivin, Michel; Junker, Anne; Bocking, Alan; Kramer, Michael S; Atkinson, Stephanie A

    2012-10-29

    A web-based inventory was developed as a voluntary registry of Canadian pregnancy and birth cohort studies, with the objective to foster collaboration and sharing of research tools among cohort study groups as a means to enrich research in maternal and child health across Canada. Information on existing birth cohort studies conducted in Canada exclusively or as part of broader international initiatives was accessed by searching the literature in PubMed and PsychInfo databases. Additional studies were identified by enquiring about the research activities of researchers at Canadian universities or working in affiliated hospitals or research centres or institutes. Of the fifty-eight birth cohort studies initially identified, forty-six were incorporated into the inventory if they were of a retrospective and/or prospective longitudinal design and with a minimum of two phases of data collection, with the first period having occurred before, during, or shortly after pregnancy and had an initial study sample size of a minimum of 200 participants.Information collected from each study was organized into four main categories: basic information, data source and period of collection, exposures, and outcome measures and was coded and entered into an Excel spreadsheet. The information incorporated into the Excel spreadsheet was double checked, completed when necessary, and verified for completeness and accuracy by contacting the principal investigator or research coordinator. All data collected were then uploaded onto the website of the Institute of Human Development Child and Youth Health of the Canadian Institutes of Health Research. Subsequently, the database was updated and developed as an online searchable inventory on the website of the Maternal, Infant, Child and Youth Research Network. This inventory is unique, as it represents detailed information assembled for the first time on a large number of Canadian birth cohort studies. Such information provides a valuable

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

    Directory of Open Access Journals (Sweden)

    Smeets Nicol AC

    2012-05-01

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

  18. Multiple Pregnancy

    Science.gov (United States)

    ... Education & Events Advocacy For Patients About ACOG Multiple Pregnancy Home For Patients Search FAQs Multiple Pregnancy Page ... Multiple Pregnancy FAQ188, July 2015 PDF Format Multiple Pregnancy Pregnancy How does multiple pregnancy occur? What are ...

  19. Pregnancy Complications

    Science.gov (United States)

    ... To receive Pregnancy email updates Enter email Submit Pregnancy complications Complications of pregnancy are health problems that ... pregnancy. Expand all | Collapse all Health problems before pregnancy Before pregnancy, make sure to talk to your ...

  20. A clinical study of the skin changes in pregnancy in Kashmir valley of north India: A hospital based study

    Directory of Open Access Journals (Sweden)

    Iffat Hassan

    2015-01-01

    Full Text Available Background: Pregnancy is associated with multiple skin changes, most of which are physiological in nature, being the direct result of expected modifications of the hormonal, vascular, metabolic or immunologic status in pregnant females. Pregnancy however is also associated with certain pruritic eruptions, which not only cause distress to the pregnant female, but may influence the fetal outcome as well. Objective: The objective of this study was to determine the pattern of skin changes associated with pregnancy and to identify the various clinical types of pregnancy specific dermatoses (PSDs. Materials and Methods: The study was a cross sectional study carried out at the out-patient Department of Gynecology and obstetrics of our hospital. A total of 650 pregnant females, irrespective of their parity and gestational age were screened for the presence of any dermatological complaint. Results: The age of the study population ranged from 17 to 39 years (mean age: 24 years. The study population included 272 (42% primigravidae and 378 (58% multigravidae. Physiological skin changes of pregnancy were seen in all patients, out of which linea nigra was the most common change, seen in 520 (80% cases. Specific dermatoses of pregnancy were seen in 32 (4.9% cases, which included (in the decreasing order of frequency prurigo of pregnancy (50% cases, intrahepatic cholestasis of pregnancy (25% cases, polymorphic eruption of pregnancy (22% cases and pemphigus gestationis (3% cases. Conclusion: Skin changes were seen in 100% of pregnant females in this study, the major proportion being formed by physiological skin changes of pregnancy though PSDs were also seen in a significant number.

  1. Studies in Interior Design

    Science.gov (United States)

    Environ Planning Design, 1970

    1970-01-01

    Floor plans and photographs illustrate a description of the Samuel C. Williams Library at Stevens Institute of Technology, Hoboken, N.J. The unusual interior design allows students to take full advantage of the library's resources. (JW)

  2. Studies in Interior Design

    Science.gov (United States)

    Environ Planning Design, 1970

    1970-01-01

    Floor plans and photographs illustrate a description of the Samuel C. Williams Library at Stevens Institute of Technology, Hoboken, N.J. The unusual interior design allows students to take full advantage of the library's resources. (JW)

  3. A study of respiratory rate, tidal volume, inspiratory capacity and inspiratory reserve volume in different trimesters of pregnancy

    Directory of Open Access Journals (Sweden)

    Anita Teli

    2013-01-01

    Full Text Available Background: The anatomical, physiological and biochemical adaptations in pregnancy are profound. Many of these changes begin soon after fertilization and continue throughout the gestation and changes in the respiratory system are part of the same process. However there is insufficient information regarding the changes in respiratory parameters in different trimesters of pregnancy. Aims: The aim of the study was designed to evaluate the pulmonary function tests in 1 st , 2 nd and 3 rd trimesters of pregnancy and compare them with non-pregnant control group. Materials and Methods: A cross-sectional study was carried in 200 healthy women in the age range of 19-35 years. The subjects were distributed in four groups, as control (non-pregnant group and 1 st , 2 nd and 3 rd trimester pregnant groups. Number of subjects in each group was 50. Respiratory parameters in control and study groups were recorded. Statistical Analysis: By ′Z ′ test. Results: There was gradual significant increase in respiratory rate in all trimesters of pregnancy. There was a gradual decrease in tidal volume in 1 st , 2 nd and 3 rd trimesters of pregnancy when compared to non pregnant women. There was significant decrease in Inspiratory Reserve Volume and Inspiratory Capacity. Conclusion: The changes in pulmonary function are attributed to major adaptations in the maternal respiratory system and are influenced by the mechanical pressure of enlarging gravid uterus, elevating the diaphragm and restricting the movements of lungs thus hampering the forceful expiration and also might be due to decline in alveolar Pco 2 caused by hyperventilation which acts as bronchoconstrictor; in addition to sensitization of respiratory center due to progesterone

  4. Antecedents of teenage pregnancy from a 14-year follow-up study using data linkage

    Directory of Open Access Journals (Sweden)

    Stanley Fiona J

    2010-02-01

    Full Text Available Abstract Background Many western nations continue to have high rates of teenage pregnancies and births, which can result in adverse outcomes for both mother and child. This study identified possible antecedents of teenage pregnancy using linked data from administrative sources to create a 14-year follow-up from a cross-sectional survey. Methods Data were drawn from two sources - the 1993 Western Australian Child Health Survey (WACHS, a population-based representative sample of 2,736 children aged 4 to 16 years (1,374 girls; and administrative data relating to all their subsequent births and hospital admissions. We used weighted population estimates to examine differences between rates for teenage pregnancy, motherhood and abortion. We used Cox proportional hazards regression to model risk for teenage pregnancy. Results There were 155 girls aged less than 20 years at the time of their first recorded pregnancy. Teenage pregnancy was significantly associated with: family type; highest school year completed by primary carer; combined carer income; whether the primary carer was a smoker; and whether the girl herself displayed aggressive and delinquent behaviours. An age-interaction analysis on the association with aggressive and delinquent behaviours found that while girls with aggressive and delinquent behaviours who were older at the time of the survey were at highest risk of teenage pregnancy, there was elevated risk for future teenage pregnancy across all ages. Conclusions Our findings suggest that interventions to reduce teenage pregnancy rates could be introduced during primary school years, including those that are focused on the prevention and management of aggressive and delinquent behaviour.

  5. Antecedents of teenage pregnancy from a 14-year follow-up study using data linkage.

    Science.gov (United States)

    Gaudie, Jennifer; Mitrou, Francis; Lawrence, David; Stanley, Fiona J; Silburn, Sven R; Zubrick, Stephen R

    2010-02-11

    Many western nations continue to have high rates of teenage pregnancies and births, which can result in adverse outcomes for both mother and child. This study identified possible antecedents of teenage pregnancy using linked data from administrative sources to create a 14-year follow-up from a cross-sectional survey. Data were drawn from two sources - the 1993 Western Australian Child Health Survey (WACHS), a population-based representative sample of 2,736 children aged 4 to 16 years (1,374 girls); and administrative data relating to all their subsequent births and hospital admissions. We used weighted population estimates to examine differences between rates for teenage pregnancy, motherhood and abortion. We used Cox proportional hazards regression to model risk for teenage pregnancy. There were 155 girls aged less than 20 years at the time of their first recorded pregnancy. Teenage pregnancy was significantly associated with: family type; highest school year completed by primary carer; combined carer income; whether the primary carer was a smoker; and whether the girl herself displayed aggressive and delinquent behaviours. An age-interaction analysis on the association with aggressive and delinquent behaviours found that while girls with aggressive and delinquent behaviours who were older at the time of the survey were at highest risk of teenage pregnancy, there was elevated risk for future teenage pregnancy across all ages. Our findings suggest that interventions to reduce teenage pregnancy rates could be introduced during primary school years, including those that are focused on the prevention and management of aggressive and delinquent behaviour.

  6. Pregnancy outcome in patients with antiphospholipid syndrome after cerebral ischaemic events: an observational study.

    Science.gov (United States)

    Fischer-Betz, R; Specker, C; Brinks, R; Schneider, M

    2012-10-01

    Among the most prominent features associated with antiphospholipid syndrome (APS) are cerebral ischaemic events (CVE). Pregnancy with APS increases the risk of thrombosis, including CVE. This study was undertaken to assess the risk of obstetric complications and recurrence of CVE during pregnancy in women with APS and previous CVE. We prospectively observed 23 pregnancies in 20 women (median age 31 years) with primary (n = 8) or secondary APS (n = 12). Eight patients had transient ischaemic attacks (TIA) and 12 had stroke before pregnancy. All patients received aspirin 100 mg daily in combination with low molecular weight heparin (LMWH) during their pregnancies. The live birth rate was 91.3% (n = 21). Obstetrical complications consisted mainly of preeclampsia (n = 8, 34.8%) and preterm delivery (n = 9, 42.9%). The risk for preeclampsia increased in patients who were positive for multiple antiphospholipid antibodies (aPL) (odds ratio (OR) 3.06 (95% confidence interval (CI) 1.01-9.32)) per positive aPL test (i.e anticardiolipin antibody, anti-ß2-glycoprotein I antibody, lupus anticoagulant) (p 0.049). Three patients experienced recurrent CVE in the context of pregnancy (one during pregnancy, two in the postpartum period). We found an increased, but not significant, risk of a new episode of cerebral ischaemia in patients with pregnancies complicated by preeclampsia (two out of the eight preeclampsia (p 0.15). Despite treatment, there is a significant risk for pregnancy complications in APS patients with previous CVE. Especially in the context of preeclampsia, anticoagulation should be given rigorously to prevent recurrence of CVE.

  7. Thrombophilia and Pregnancy Complications.

    Science.gov (United States)

    Simcox, Louise E; Ormesher, Laura; Tower, Clare; Greer, Ian A

    2015-11-30

    There is a paucity of strong evidence associated with adverse pregnancy outcomes and thrombophilia in pregnancy. These problems include both early (recurrent miscarriage) and late placental vascular-mediated problems (fetal loss, pre-eclampsia, placental abruption and intra-uterine growth restriction). Due to poor quality case-control and cohort study designs, there is often an increase in the relative risk of these complications associated with thrombophilia, particularly recurrent early pregnancy loss, late fetal loss and pre-eclampsia, but the absolute risk remains very small. It appears that low-molecular weight heparin has other benefits on the placental vascular system besides its anticoagulant properties. Its use is in the context of antiphospholipid syndrome and recurrent pregnancy loss and also in women with implantation failure to improve live birth rates. There is currently no role for low-molecular weight heparin to prevent late placental-mediated complications in patients with inherited thrombophilia and this may be due to small patient numbers in the studies involved in summarising the evidence. There is potential for low-molecular weight heparin to improve pregnancy outcomes in women with prior severe vascular complications of pregnancy such as early-onset intra-uterine growth restriction and pre-eclampsia but further high quality randomised controlled trials are required to answer this question.

  8. Thrombophilia and Pregnancy Complications

    Directory of Open Access Journals (Sweden)

    Louise E. Simcox

    2015-11-01

    Full Text Available There is a paucity of strong evidence associated with adverse pregnancy outcomes and thrombophilia in pregnancy. These problems include both early (recurrent miscarriage and late placental vascular-mediated problems (fetal loss, pre-eclampsia, placental abruption and intra-uterine growth restriction. Due to poor quality case-control and cohort study designs, there is often an increase in the relative risk of these complications associated with thrombophilia, particularly recurrent early pregnancy loss, late fetal loss and pre-eclampsia, but the absolute risk remains very small. It appears that low-molecular weight heparin has other benefits on the placental vascular system besides its anticoagulant properties. Its use is in the context of antiphospholipid syndrome and recurrent pregnancy loss and also in women with implantation failure to improve live birth rates. There is currently no role for low-molecular weight heparin to prevent late placental-mediated complications in patients with inherited thrombophilia and this may be due to small patient numbers in the studies involved in summarising the evidence. There is potential for low-molecular weight heparin to improve pregnancy outcomes in women with prior severe vascular complications of pregnancy such as early-onset intra-uterine growth restriction and pre-eclampsia but further high quality randomised controlled trials are required to answer this question.

  9. Operative Complications During Pregnancy After Gastric Bypass—a Register-Based Cohort Study

    DEFF Research Database (Denmark)

    Andreasen, Lisbeth A; Nilas, Lisbeth; Kjær, Mette M

    2014-01-01

    BACKGROUND: Late complications to bariatric surgery during pregnancy have become an area of concern. Expansion of the uterus and the following displacement of the small intestine may increase the risk of internal herniation. We wanted to estimate the risk and consequences of surgical complications...... during pregnancy in a national cohort of women with a history of gastric bypass surgery. METHODS: A national, register-based cohort study of all Danish women with a history of gastric bypass surgery who had given birth from 2004 to 2010 was conducted. Surgical codes registered during pregnancy and until...... the puerperium. CONCLUSIONS: The incidence of internal herniation during pregnancy was 1 % in our study. Internal herniation may be a serious complication in pregnant women, and both the diagnosis and treatment requires handling by experienced obstetrical, radiological, and surgical staff....

  10. [Study on the relationship between prenatal monitoring index in intrahepatic cholestasis of pregnancy and perinatal prognosis].

    Science.gov (United States)

    Lu, Junling; Kuang, Jingxia; Cheng, Xiaolin

    2014-11-01

    To investigate the association between prenatal monitoring index in intrahepatic cholestasis of pregnancy and the perinatal prognosis, as well as the characteristics of perinatal situations. A retrospective study on the clinical data of 88 cases intrahepatic cholestasis of pregnancy and prognosis that were treated in our hospital from Jan. 2011 to Jan. 2014 was carried out. Relationship between prenatal monitoring index in intrahepatic cholestasis of pregnancy and perinatal prognosis, together with the epidemiological features of infants were analyzed. The incidence rates of perinatal meconium stained amniotic fluid, asphyxia neonatorum, premature and fetal distress were significantly higher in the study group than those in the controls, with differences statistically significant (P intrahepatic cholestasis of pregnancy, with most frequently seen as meconium stained amniotic fluid. It was necessary to monitor the level of prenatal CG, ALT, AST, TBIL and TBA in puerperant in predicting the perinatal prognosis.

  11. A STUDY OF DIFFERENT DOSES OF SUBLINGUAL MISOPROSTOL AFTER ORAL MIFEPRISTONE IN MEDICAL TERMINATION OF PREGNANCY

    Directory of Open Access Journals (Sweden)

    Sujatha

    2015-11-01

    Full Text Available BACKGROUND: Though Mifepristone- Misoprostol combination is well established for early pregnancy termination, the optimal Misoprostol dose is still under much debate. AIMS: To compare the efficacy of sublingual 400µg Misoprostol and 800µg Misoprostol after oral 200mg Mifepristone in achieving complete abortion, to study the induction abortion interval, complications and adverse effects seen with both groups. Setting 100 antenatal women requesting for medical termination of pregnancy of upto 63 days of gestation in ESI Medical College and Postgraduate Institute of Medical Sciences and Research, Karnataka in India. Design A Prospective Observational study. METHODS AND MATERIAL: Study population was randomized into 2 groups of 50 patients each. Both groups received 200 mg Mifepristone. Twenty four hours later, Group A received 400µg sublingual Misoprostol and Group B received 800 µg sublingual Misoprostol. OUTCOME MEASURES: The primary outcome analyzed in this study is the efficacy of the two regimens in achieving complete abortion. Secondary outcome measures are Induction to Abortion interval and adverse effects like pain abdomen, nausea, vomiting, diarrhoea, fever and chills. STATISTICAL ANALYSIS USED: Averages and proportions were calculated for the study and appropriate statistical tests like Chi Square Test, Fischer Exact Test and Student T Test were done using MiniTab version 16. RESULTS: Administration of 400µg sublingual Misoprostol 24 hours after 200 mg of Mifepristone has complete medical abortion rates comparable with 800µg sublingual Misoprostol with significantly lesser side effects. CONCLUSIONS: In the present study, administration of 400µg sublingual Misoprostol after 200 mg of Mifepristone has complete medical abortion rates comparable with 800µg sublingual Misoprostol with significantly lesser side effects. However further research with different doses and routes of administration of Misoprostol in required in a larger

  12. Contraception and unwanted pregnancy.

    Science.gov (United States)

    Adler, N E

    1984-01-01

    marriage, 5) immediately following geographical mobility, 6) immediately following a pregnancy, 7) toward the end of the reproductive period, and 8) during menopause. Several researchers investigated the factors which play a role in contraceptive decision making. All the options available to those who experienced unwanted pregnancies entailed some degree of pain. Women who chose abortion, compared to those who had term pregnancies tended to suffer less serious, longterm consequences. Most abortion patients suffered only mild or temporary stress. Abortion patients who had more serious reactions tended to be young, single, Catholid, and socially immature. Individuals who a history of psychological problems, had negative relationships with their mothers, felt ambivalent about the abortion, or felt pressured to have an abortion were also more likely to experience psychological disturbances at some point following abortion. Most studies of unwanted pregnancy were retrospective, correlational, and based on small samples. Many were based on self-selected samples. Several social factors hinder efforts to investigate this sensitive social problem. As a result, intervention strategies, designed to prevent unwanted pregnancy, are frequently based on inadequate research. Efforts must be made to increase research on unwanted pregnancy and to utilize this research to develop effective preventive strategies.

  13. Final results from the Betaseron (interferon β-1b) Pregnancy Registry: a prospective observational study of birth defects and pregnancy-related adverse events

    Science.gov (United States)

    Coyle, P K; Sinclair, S M; Scheuerle, A E; Thorp, J M; Albano, J D; Rametta, M J

    2014-01-01

    Objective Women with multiple sclerosis are often diagnosed and treated during their reproductive years. Limited data are available on the safety of treatment during pregnancy. The Betaseron Pregnancy Registry prospectively monitored women exposed to interferon β-1b (IFNβ-1b) during pregnancy to estimate the rates of birth defects, spontaneous abortions (SABs) and other negative outcomes in this population. Design From 2006 to 2011, this observational registry enrolled women exposed prior to conception or during pregnancy (but prior to or without abnormalities on prenatal screening). Follow-up continued from enrolment through the 4-month paediatric visit. Setting Patients in the USA who met these criteria were enrolled in the registry. Results The registry enrolled 99 pregnant women; 3 were lost to follow-up. The earliest exposure to IFNβ-1b occurred during the first trimester for 95 pregnancies and in the third trimester for 1 pregnancy. There were 99 birth outcomes (3 twins), including 86 (86.9%) live births, 11 (11.1%) SABs and 2 (2%) stillbirths. Birth defects were reported in five (5.1%) cases. Rates of birth defects and SAB were not significantly different from population comparators. No developmental concerns were identified at the 4-month paediatric visit. Conclusions The small sample size limits the ability to draw definitive conclusions; however, there was no pattern to suggest increased negative outcomes with IFNβ-1b. Clinical trials registration number NCT00317564. PMID:24821713

  14. Influence of psychological factors on pregnancy, childbirth and puerperium. A longitudinal study

    OpenAIRE

    Dolores Marín Morales; Mª Ángeles Bullones Rodríguez; Francisco Javier Carmona Monge; Mª Isabel Carretero Abellán; Mª Amparo Moreno Moure; Cecilia Peñacoba Puente

    2008-01-01

    The aim of the present study is to analyze different psychological factors (personality, psychiatric symptoms, pregnancy worries, beliefs about delivery, locus of control, coping styles) and its relation to clinical symptomatology and the presence of complications during pregnancy, quality of life indicators, perception and coping with labour pain, type of delivery, neonatal well-being indicators, delivery satisfaction, maternal bond development and care of the baby and presence of post-partu...

  15. Termination of pregnancy among very preterm births and its impact on very preterm mortality : results from ten European population-based cohorts in the MOSAIC study

    NARCIS (Netherlands)

    Papiernik, E.; Zeitlin, J.; Delmas, D.; Draper, E. S.; Gadzinowski, J.; Kuenzel, W.; Cuttini, M.; Di Lallo, D.; Weber, T.; Kollee, L.; Bekaert, A.; Breart, G.

    2008-01-01

    Objective To study the impact of terminations of pregnancy (TOP) on very preterm mortality in Europe. Design European prospective population-based cohort study. Setting Ten regions from nine European countries participating in the MOSAIC (Models of OrganiSing Access to Intensive Care for very preter

  16. Termination of pregnancy among very preterm births and its impact on very preterm mortality: results from ten European population-based cohorts in the MOSAIC study.

    NARCIS (Netherlands)

    Papiernik, E.; Zeitlin, J.; Delmas, D.; Draper, E.S.; Gadzinowski, J.; Kunzel, W.; Cuttini, M.; Lallo, D. di; Weber, T.; Kollee, L.A.A.; Bekaert, A.; Breart, G.

    2008-01-01

    OBJECTIVE: To study the impact of terminations of pregnancy (TOP) on very preterm mortality in Europe. DESIGN: European prospective population-based cohort study. SETTING: Ten regions from nine European countries participating in the MOSAIC (Models of OrganiSing Access to Intensive Care for very pre

  17. Fetal and perinatal outcomes in type 1 diabetes pregnancy : a randomized study comparing insulin aspart with human insulin in 322 subjects

    NARCIS (Netherlands)

    Hod, Moshe; Damm, Peter; Kaaja, Risto; Visser, Gerard H. A.; Dunne, Fidelma; Demidova, Irina; Hansen, Anne-Sofie Pade; Mersebach, Henriette

    2008-01-01

    OBJECTIVE: The objective of the study was a comparison of insulin aspart (IAsp) with human insulin (HI) in basal-bolus therapy with neutral protamine Hagedorn for fetal and perinatal outcomes of type 1 diabetes in pregnancy. STUDY DESIGN: This was a randomized, parallel, open-label, controlled, mult

  18. 10-Year cardiovascular event risks for women who experienced hypertensive disorders in late pregnancy: the HyRAS study

    Directory of Open Access Journals (Sweden)

    Ponjee Gabrielle

    2010-06-01

    Full Text Available Abstract Background Cardiovascular disease is the cause of death in 32% of women in the Netherlands. Prediction of an individual's risk for cardiovascular disease is difficult, in particular in younger women due to low sensitive and specific tests for these women. 10% to 15% of all pregnancies are complicated by hypertensive disorders, the vast majority of which develop only after 36 weeks of gestation. Preeclampsia and cardiovascular disease in later life show both features of "the metabolic syndrome" and atherosclerosis. Hypertensive disorders in pregnancy and cardiovascular disease may develop by common pathophysiologic pathways initiated by similar vascular risk factors. Vascular damage occurring during preeclampsia or gestational hypertension may contribute to the development of future cardiovascular disease, or is already present before pregnancy. At present clinicians do not systematically aim at the possible cardiovascular consequences in later life after a hypertensive pregnancy disorder at term. However, screening for risk factors after preeclampsia or gestational hypertension at term may give insight into an individual's cardiovascular risk profile. Methods/Design Women with a history of preeclampsia or gestational hypertension will be invited to participate in a cohort study 2 1/2 years after delivery. Participants will be screened for established modifiable cardiovascular risk indicators. The primary outcome is the 10-year cardiovascular event risk. Secondary outcomes include differences in cardiovascular parameters, SNP's in glucose metabolism, and neonatal outcome. Discussion This study will provide evidence on the potential health gains of a modifiable cardiovascular risk factor screening program for women whose pregnancy was complicated by hypertension or preeclampsia. The calculation of individual 10-year cardiovascular event risks will allow identification of those women who will benefit from primary prevention by tailored

  19. CLINICAL STUDY TO EVALUATE THE MATERNAL AND PERINATAL OUTCOME OF PREGNANCIES WITH POLYHYDRAMNIOS

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    Sudha

    2013-10-01

    Full Text Available ABSTRACT: BACKGROUND : Due to active involvement of fetal system in regulation of amn iotic fluid volume, AFI has been identified as indicator of intrauterine fetal status. USG has revolutionized the process of assessment of amniotic fluid thus becoming an integral part of fetal surveillance . Polyhydramnios is an obstetrical condition assoc iated with significant perinatal and maternal morbidity and mortality. In a low resource health facility as India with poor coverage of antenatal care and malnutrition it still becomes more important to screen pregnancies for such high risk factors. AIMS: 1. To study incidence of polyhydramnios. 2. To identify major etiological factors of polyhydramnios. 3. To study perinatal outcome. SETTINGS AND DESIGN: A hospital based cross section study for duration from 1 st May 2009 to 31 st October 2010. MATERIAL & ME THOD: All the cases identified as polyhydramnios according to AFI in four pocket were included in the study. The cases identified as having polyhydramnios but not delivered at the facility were excluded. OBSERVATION: Incidence of polyhydramnios is 0.72% of the total antenatal cases, multiparous ie, 52% more than primiparous cases. Majority were unbooked (77.3% 63% were from rural set up. 76% belonged to low socio economic status. Majority 66% of the cases had their 1 st antenatal visit at term. Increased in cidence of operative delivery was seen in the study. Associated maternal factors found with polyhydramnios were gestation hypertension (8.4%, preeclampsia (2.9%, eclampsia (2.9%, anaemia (11%, twins (8.4%, malpresentation (5%, RH negative factor (3.7 %, and diabetes (1.9%. Fetal complication include prematurity 21.6%, IUFT 20.7%, congenital malformation 21.6%, cord prolapse 3.7%, birth asphyxia 1.9%. Most common congenital anomaly was anencephaly i.e., 11%. CONCLUSION : The study gives us the underst anding of the impact of polyhydramnios on the maternal and fetal outcome. Our study demonstrate s

  20. A study protocol to evaluate the relationship between outdoor air pollution and pregnancy outcomes

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    Selemane Ismael

    2010-10-01

    Full Text Available Abstract Background The present study protocol is designed to assess the relationship between outdoor air pollution and low birth weight and preterm births outcomes performing a semi-ecological analysis. Semi-ecological design studies are widely used to assess effects of air pollution in humans. In this type of analysis, health outcomes and covariates are measured in individuals and exposure assignments are usually based on air quality monitor stations. Therefore, estimating individual exposures are one of the major challenges when investigating these relationships with a semi-ecologic design. Methods/Design Semi-ecologic study consisting of a retrospective cohort study with ecologic assignment of exposure is applied. Health outcomes and covariates are collected at Primary Health Care Center. Data from pregnant registry, clinical record and specific questionnaire administered orally to the mothers of children born in period 2007-2010 in Portuguese Alentejo Litoral region, are collected by the research team. Outdoor air pollution data are collected with a lichen diversity biomonitoring program, and individual pregnancy exposures are assessed with spatial geostatistical simulation, which provides the basis for uncertainty analysis of individual exposures. Awareness of outdoor air pollution uncertainty will improve validity of individual exposures assignments for further statistical analysis with multivariate regression models. Discussion Exposure misclassification is an issue of concern in semi-ecological design. In this study, personal exposures are assigned to each pregnant using geocoded addresses data. A stochastic simulation method is applied to lichen diversity values index measured at biomonitoring survey locations, in order to assess spatial uncertainty of lichen diversity value index at each geocoded address. These methods assume a model for spatial autocorrelation of exposure and provide a distribution of exposures in each study location

  1. Work-related maternal risk factors and the risk of pregnancy induced hypertension and preeclampsia during pregnancy. The Generation R Study.

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    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.

  2. Methodological aspects of the study of dietary patterns during pregnancy and maternal and infant health outcomes. A systematic review.

    Science.gov (United States)

    Sánchez-Villegas, Almudena; Brito, Noe; Doreste-Alonso, Jorge; Nissensohn, Mariela; Henriquez, Patricia; Hermoso, Maria; Berti, Cristiana; Serra Majem, Lluis

    2010-10-01

    The objective of the present study was to systematically review the literature exploring the associations between different dietary patterns obtained from Food Frequency Questionnaires during pregnancy and the development of health-related maternal and infant outcomes in the Framework of the EURRECA Network of Excellence. A systematic search was conducted on Pubmed for literature published up to September 2009. The search strategy resulted in an initial amount of 2048 articles. After applying the selection criteria, seven studies were finally identified. Five articles were based on prospective cohort studies and the other two were case-control studies. The methods used to elaborate the dietary pattern could be classified as hypothesis-oriented (three studies) or empirically-derived (four studies). The different food frequency questionnaires used for diet assessment were self-administered, semi-quantitative and had been previously validated, but just four studies employed questionnaires validated specifically for their use in a pregnant population. The divergent methods used to assess the dietary patterns make it difficult to compare results. However, some resulting recommendations can be applied when dietary patterns during pregnancy are analyzed: to employ a validated food frequency questionnaire designed for use in pregnancy, to consider the special role exerted by mineral and vitamin supplements in this particular population group, to adequately select the time in which dietary data is collected, to adjust the results for life-style and educational characteristics, and in the case of hypothesis-oriented dietary patterns, to correctly choose the components comprising the score.

  3. Experiences of Infertile Women Seeking Assisted Pregnancy in Iran: A Qualitative Study

    Science.gov (United States)

    Ranjbar, Fahimeh; Behboodi-Moghadam, Zahra; Borimnejad, Leili; Ghaffari, Saeed Reza; Akhondi, Mohammad Mehdi

    2015-01-01

    Background: Assisted reproductive technologies (ARTs) are complicated and stressful techniques and the social and cultural norms are major obstacles against their use. Many qualitative studies have been done in the field of women’s experiences of infertility, but less is known about the experiences of infertile women seeking assisted pregnancy. The aim of this study was to understand and describe the experience of women who have used assisted reproductive technologies for their current pregnancy. Methods: This qualitative study was conducted based on a content analysis approach. With purposive sampling, 12 pregnant women who were using ART were recruited from Avicenna Fertility Center in Tehran. Women were selected purposefully and with maximum variation. Interviews were performed after a positive test of pregnancy and women were introduced to researchers in their first visit of pregnancy in the prenatal clinic. Interviews were recorded, transcribed verbatim and analyzed concurrently. Semi-structured interviews were coded, categorized and the themes were also identified. Results: Four main themes were uncovered which included struggle to achieve pregnancy, fear and uncertainty, escape from stigma and the pursuit to achieve husband satisfaction. Conclusion: It is essential for these women to be counseled and prepared by their health care providers after the use of ARTs. Distress can be reduced for infertile women seeking assisted pregnancy when they are prepared for possible failures, empowered to deal with stigma, and have their partners’ involvement in counseling sessions. PMID:27110521

  4. STUDY OF HEMOGLOBIN LEVELS IN PREGNANT WOMEN AND ITS VARIOUS EFFECTS ON PREGNANCY OUTCOME

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    Maneesha

    2014-03-01

    Full Text Available INTRODUCTION: When maternal anemia is diagnosed before mid-pregnancy, it has been associated with an increased risk of preterm delivery. High maternal hemoglobin is associated with fetal growth restriction. Several epidemiologic studies have shown that high fetal hemoglobin is associated with lower birth weight and increased incidence of IUGR and intrauterine death. MATERIAL AND METHODS: It was a prospective observational study. All pregnant women attending antenatal clinic with first visit before 18 weeks of gestation were included in the study. Hemoglobin levels were done on women at the first visit to antenatal clinic and also in the third trimester between 34-36 weeks. Outcome criteria were birth weight of neonate, gestational age at delivery, maternal weight gain in pregnancy, development of PIH, IUGR, IUD and preterm labor. RESULTS: Increased weight gain in pregnancy was associated with increase in mean birth weight r=0.23 (P value 0.672. Increase in the hemoglobin concentration was associated with increase in birth weight r=0.36 (P value 0.49. It was observed that high hemoglobin concentration in pregnancy was associated with more length of gestation but it was not significant r=0.31 (P value 0.50. CONCLUSION: During early pregnancy normal hemoglobin concentrations were associated with higher birth weights. Weight gain in pregnancy was associated with lower hemoglobin concentrations at term and higher birth weights. The best outcomes of pregnancy were observed in women who had normal hemoglobin concentrations at the onset of pregnancy and who became anemic at term, presumably due to physiologic hemodilution.

  5. A cross-sectional, clinical study to evaluate mobility of teeth during pregnancy using periotest

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    Poonam Sujeet Mishra

    2017-01-01

    Full Text Available Background and Objective: Over a century, an increased prevalence of gingival diseases associated with increasing plasma sex steroid hormone levels has been reported. These situations present unique challenges to the oral health-care professional. It is believed that hormonal fluctuations such as those associated with pregnancy, menstruation, and use of hormonal contraceptives lead to an increase in tooth mobility. However, this effect of female sex hormones on periodontal ligament and tooth-supporting alveolar bone has rarely been investigated. Hence, this study was conducted to understand the effect of hormonal changes during pregnancy on tooth mobility. Materials and Methods: Mobility of index teeth 16, 13, 21, 23, 24, 36, 33, 41, 43, and 44 was measured with periotest for fifty pregnant females at first trimester (12th week, second trimester (24th week, and third trimester (35th week. Simplified oral hygiene index, plaque index, Gingival index (GI, and probing depth were also evaluated during the three trimesters of pregnancy for each subject participating in the study. Statistical Analysis: The results of the study were subjected to statistical analysis. Data analysis was done by applying Z-test for comparing difference between two sample means. Results: A small but statistically significant influence on the periotest value was seen during the three trimesters of pregnancy. GI scores significantly increased throughout pregnancy despite no significant change in plaque levels. Conclusion: Pregnancy had a significant influence on tooth mobility. Highest value of tooth mobility was seen in the last month of pregnancy. The maximum severity of gingivitis was also seen during the third trimester of pregnancy.

  6. Pharmacokinetics of chemotherapeutic agents in pregnancy: a preclinical and clinical study.

    NARCIS (Netherlands)

    Calsteren, K. van; Verbesselt, R.; Ottevanger, N.; Halaska, M.; Heyns, L.; Bree, R. de; Bruijn, E. de; Chai, D.; Delforge, M.; Noens, L.; Renard, V.; Witteveen, E.; Rob, L.; Hoon, J. de; Amant, F.

    2010-01-01

    OBJECTIVE: To determine the impact of physiologic changes of pregnancy on pharmacokinetics of chemotherapeutic agents. DESIGN: A preclinical and a clinical case-control trial. SETTING: Institute of Primate Research Nairobi and collaborating hospitals in Belgium, the Netherlands and Czech Republic. P

  7. Pharmacokinetics of chemotherapeutic agents in pregnancy: a preclinical and clinical study.

    NARCIS (Netherlands)

    Calsteren, K. van; Verbesselt, R.; Ottevanger, N.; Halaska, M.; Heyns, L.; Bree, R. de; Bruijn, E. de; Chai, D.; Delforge, M.; Noens, L.; Renard, V.; Witteveen, E.; Rob, L.; Hoon, J. de; Amant, F.

    2010-01-01

    OBJECTIVE: To determine the impact of physiologic changes of pregnancy on pharmacokinetics of chemotherapeutic agents. DESIGN: A preclinical and a clinical case-control trial. SETTING: Institute of Primate Research Nairobi and collaborating hospitals in Belgium, the Netherlands and Czech Republic.

  8. Architecture as Design Study.

    Science.gov (United States)

    Kauppinen, Heta

    1989-01-01

    Explores the use of analogies in architectural design, the importance of Gestalt theory and aesthetic cannons in understanding and being sensitive to architecture. Emphasizes the variation between public and professional appreciation of architecture. Notes that an understanding of architectural process enables students to improve the aesthetic…

  9. Plasma immunoreactive erythropoietin in normal women studied sequentially during and after pregnancy.

    Science.gov (United States)

    Widness, J A; Clemons, G K; Garcia, J F; Schwartz, R

    1984-07-15

    Six healthy, nonanemic women with uncomplicated singleton pregnancies were sequentially studied for plasma immunoreactive erythropoietin levels, hematologic indices, and human placental lactogen. Mean group levels of erythropoietin as well as human placental lactogen were significantly increased (p less than 0.01) after 18 weeks' gestation compared to nonpregnant values (20 to 30 weeks post partum). However, individual responses of erythropoietin during pregnancy were found to be highly variable. There was a direct correlation of both maternal plasma erythropoietin and human placental lactogen with gestational age (p less than 0.001) but no detectable relation of erythropoietin with human placental lactogen levels. We speculate that the increase in erythropoietin levels during pregnancy acts as a trophic stimulus for effecting an increase in maternal red blood cell mass presumably to meet the increased metabolic (oxygen) demands of pregnancy.

  10. Fetal size in mid- and late pregnancy is related to infant alertness: the generation R study.

    Science.gov (United States)

    Henrichs, Jens; Schenk, Jacqueline J; Schmidt, Henk G; Arends, Lidia R; Steegers, Eric A P; Hofman, Albert; Jaddoe, Vincent W V; Verhulst, Frank C; Tiemeier, Henning

    2009-03-01

    The vulnerability for behavioral problems is partly shaped in fetal life. Numerous studies have related indicators of intrauterine growth, for example, birth weight and body size, to behavioral development. We investigated whether fetal size in mid- and late pregnancy is related to infant irritability and alertness. In a population-based birth cohort of 4,255 singleton full-term infants ultrasound measurements of fetal head and abdominal circumference in mid- and late pregnancy were performed. Infant irritability and alertness scores were obtained by the Mother and Baby Scales at 3 months and z-standardized. Multiple linear regression analyses revealed curvilinear associations (inverted J-shape) of measures of fetal size in both mid- and late pregnancy with infant alertness. Fetal size characteristics were not associated with infant irritability. These results suggest that alterations of intrauterine growth affecting infant alertness are already detectable from mid-pregnancy onwards.

  11. Outcomes in type 1 diabetic pregnancies

    DEFF Research Database (Denmark)

    Jensen, Dorte Møller; Damm, Peter; Moelsted-Pedersen, Lars

    2004-01-01

    OBJECTIVE: The aim of this study was to compare pregnancy outcomes in type 1 diabetic pregnancies with the background population. RESEARCH DESIGN AND METHODS: This nationwide prospective multicenter study took place in eight Danish centers treating pregnant women with type 1 diabetes during 1993-...

  12. NEONATAL MORTALITY AND MORBIDITY IN PREGNANCY INDUCED HYPERTENSION: A PROSPECTIVE OBSERVATIONAL STUDY

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    George

    2014-05-01

    Full Text Available BACKGROUND: Pregnancy induced Hypertension (PIH is one of the common complications which contributes to significant maternal and perinatal morbidity and mortality. Effective management improves outcome of both mother and the baby OBJECTIVES: To study the morbidity and mortality in babies born to mothers with pregnancy induced hypertension, assess the reasons for the outcome of the baby and monitor the growth and development till the age of 6 months. METHODS: This study was conducted at Niloufer Institute of Child Health, Hyderabad a teaching institution which caters to high risk obstetric patients and also has a tertiary level NICU care. Study was conducted over a period of 9 months and 100 cases of PIH were included over a period of 3 months and the babies were followed up till the age of 6 months. A structured proforma was designed and analyzed using Epi info for window statistical software. RESULTS: Out of 1461 deliveries, we enrolled 100 PIH cases as per inclusion criteria and studied during 3 months period. Of the study group, 48% were with mild PIH (n=48 and 52% were with severe PIH (n=52. When compared to mild PIH, severe PIH was associated with higher rates of preterm deliveries and it was statistically significant (P 2. In NICU admissions Meconium aspiration syndrome (MAS, Hyaline membrane disease (HMD, Birth asphyxia (BA and sepsis were observed. All the complications were more in severe PIH than mild PIH. After discharge infants were fallowed up till the age of 6 months. Out of 75 babies discharged, 24 cases were lost to follow up and in the remaining 51 babies, 33 were born to mild PIH mothers, 18 were born to severe PIH mothers. CONCLUSION: PIH is one of the major causes of morbidity and mortality in the fetus and newborn. The more severe the PIH, the more adverse is the outcome. Our goal is early detection and prompts Management

  13. Semaphorin 3F expression is reduced in pregnancy complicated by preeclampsia. An observational clinical study

    Science.gov (United States)

    Stallone, Giovanni; Matteo, Maria; Netti, Giuseppe Stefano; Infante, Barbara; Di Lorenzo, Adelaide; Prattichizzo, Clelia; Carlucci, Stefania; Trezza, Federica; Gesualdo, Loreto; Greco, Pantaleo

    2017-01-01

    Background and objective Preeclampsia is a systemic disorder, affecting 2–10% of pregnancies, characterized by a deregulated pro- and anti-angiogenic balance. Semaphorin 3F is an angiogenesis inhibitor. We aimed to investigate whether semaphorin 3F expression is modulated in preeclampsia. Design, setting, participants, and measurements We performed two observational single center cohort studies between March 2013 and August 2014. In the first we enrolled 110 consecutive women, undergoing an elective cesarean section; in the second we included 150 consecutive women undergoing amniocentesis for routine clinical indications at 16–18 week of gestation. Semaphorin 3F concentration was evaluated in maternal peripheral blood, venous umbilical blood and amniotic fluid, along with its placenta protein expression at the time of delivery in the first study group and in the amniotic fluid at 16–18 weeks of gestation in the second study group. Results In the first study 19 patients presented at delivery with preeclampsia. Semaphorin 3F placenta tissue expression was significantly reduced in preeclampsia. In addition, semaphorin 3F level at delivery was significantly lower in serum, amniotic fluid and venous umbilical blood of preeclamptic patients compared with normal pregnant women. In the prospective cohort study 14 women developed preeclampsia. In this setting, semaphorin 3F amniotic level at 16–18 weeks of gestation was reduced in women who subsequently developed preeclampsia compared to women with a normal pregnancy. ROC curve analysis showed that semaphorin 3F amniotic levels could identify women at higher risk of preeclampsia. Conclusions Semaphorin 3F might represent a predictive biomarker of preeclampsia. PMID:28350837

  14. Measuring stress before and during pregnancy: a review of population-based studies of obstetric outcomes.

    Science.gov (United States)

    Witt, Whitney P; Litzelman, Kristin; Cheng, Erika R; Wakeel, Fathima; Barker, Emily S

    2014-01-01

    Mounting evidence from clinic and convenience samples suggests that stress is an important predictor of adverse obstetric outcomes. Using a proposed theoretical framework, this review identified and synthesized the population-based literature on the measurement of stress prior to and during pregnancy in relation to obstetric outcomes. Population-based, peer-reviewed empirical articles that examined stress prior to or during pregnancy in relation to obstetric outcomes were identified in the PubMed and PsycInfo databases. Articles were evaluated to determine the domain(s) of stress (environmental, psychological, and/or biological), period(s) of stress (preconception and/or pregnancy), and strength of the association between stress and obstetric outcomes. Thirteen studies were evaluated. The identified studies were all conducted in developed countries. The majority of studies examined stress only during pregnancy (n = 10); three examined stress during both the preconception and pregnancy periods (n = 3). Most studies examined the environmental domain (e.g. life events) only (n = 9), two studies examined the psychological domain only, and two studies examined both. No study incorporated a biological measure of stress. Environmental stressors before and during pregnancy were associated with worse obstetric outcomes, although some conflicting findings exist. Few population-based studies have examined stress before or during pregnancy in relation to obstetric outcomes. Although considerable variation exists in the measurement of stress across studies, environmental stress increased the risk for poor obstetric outcomes. Additional work using a lifecourse approach is needed to fill the existing gaps in the literature and to develop a more comprehensive understanding of the mechanisms by which stress impacts obstetric outcomes.

  15. The association between pelvic girdle pain and sick leave during pregnancy; a retrospective study of a Norwegian population.

    Science.gov (United States)

    Malmqvist, Stefan; Kjaermann, Inger; Andersen, Knut; Økland, Inger; Larsen, Jan Petter; Brønnick, Kolbjørn

    2015-10-05

    The incidence of pelvic girdle pain (PGP) in pregnancy is wide ranged depending on definition, the utilised diagnostic means, and the design of the studies. PGP during pregnancy has negative effects on activities of daily living and causes long sick leave, which makes it a major public health issue. Our objectives were to explore the frequency of sick leave in pregnancy due to PGP, assess the relationship between different types of pain-related activities of daily living, examine physical workload, type of work in relation to sick leave, and to explore factors that make women less likely to take sick leave for PGP. All women giving birth at the maternity ward of Stavanger University Hospital, Norway, were asked to participate and complete a questionnaire on demographic features, PGP, pain-related activities of daily living, sick leave in general and for PGP, frequency of exercising before and during pregnancy. Drawings of pelvic girdle and low back area were used for the localization of pain. PGP intensity was then rated retrospectively on a numerical rating scale. Non-parametric tests, multinomial logistic regression and sequential linear regression analysis were used in the statistical analysis. PGP is a frequent and major cause of sick leave during pregnancy among Norwegian women, which is also reflected in activities of daily living as measured with scores on all Oswestry disability index items. In the multivariate analysis of factors related to sick leave and PGP we found that work satisfaction, problems with lifting and sleeping, and pain intensity were risk factors for sick leave. In addition, women with longer education, higher work satisfaction and fewer problems with sitting, walking and standing, were less likely to take sick leave in pregnancy, despite the same pain intensity as women being on sick leave. A coping factor in pregnant women with PGP was discovered, most likely dependant on education, associated with work situation and/or work posture

  16. Hepcidin levels are low during pregnancy and increase around delivery in women without iron deficiency - a prospective cohort study

    DEFF Research Database (Denmark)

    Hedengran, Katrine K; Nelson, Dick; Andersen, Malene R;

    2015-01-01

    OBJECTIVE: To investigate hepcidin during pregnancy, delivery and postpartum in women with sufficient iron supplementation. METHODS: Hepcidin was measured using LC-MS spectroscopy in 37 women during pregnancy, delivery and postpartum period in this longitudinal study. RESULTS: Hepcidin was low...... during pregnancy and increased at delivery and postpartum. No correlations with inflammatory markers or iron metabolism were observed during pregnancy; at delivery a correlation with inflammatory markers was observed. CONCLUSION: During pregnancy, in women with sufficient iron supplementation, hepcidin...... is low and does not reflect iron status. During delivery and the postpartum period, hepcidin functions as a marker of inflammation....

  17. Maternal late pregnancy anxiety and stress is associated with children's health: a longitudinal study.

    Science.gov (United States)

    Zijlmans, Maartje A C; Beijers, Roseriet; Riksen-Walraven, Marianne J; de Weerth, Carolina

    2017-07-09

    Maternal prenatal anxiety and stress (PNS) have been positively associated to physical health prob lems in offspring in the first year of life. Whether these associations are transient, persistent, or even progressive over time, is as yet unknown. The goal of this study is to investigate associations between late pregnancy PNS and child health from 18 months to age 6. Mothers were recruited in late pregnancy, and had uncomplicated, singleton pregnancies without physical health problems. Around week 37 of pregnancy, mothers reported on their PNS by means of questionnaires, and provided saliva for determination of circadian cortisol concentrations. Children's illnesses in the preceding year were assessed using maternal reports at 30, 48, 60, and 72 months. Antibiotic use was obtained from medical records between one and six years. Multilevel models (N¼174) showed a positive relation between maternal prenatal general and pregnancy-specific anxiety during late pregnancy and offspring respiratory illnesses and symptoms. Interaction effects with time indicated that more PNS was related to more respiratory illnesses until toddlerhood, but not later in life. Furthermore, maternal prenatal cortisol concentrations were related to child digestive illnesses. A steeper maternal cortisol decline over the day was related to more child digestive illnesses, until around three years of age. Finally, children of mothers who suffered more from daily hassles during pregnancy received more antibiotics between one and six years of age. PNS was not related to general and skin illnesses. Summarizing, this study showed that late pregnancy anxiety and cortisol was associated with children's respiratory and digestive illnesses till the age of 3.0-3.5 years. Additionally, more daily hassles were related to more prescribed antibiotics between one and six years. These findings point in the direction of possible effects of PNS persisting beyond the first year of life and into toddlerhood, but

  18. Effects of unplanned pregnancy on neonatal health in Turkey: a case-control study.

    Science.gov (United States)

    Karaçam, Zekiye; Şen, Emine; Amanak, Keziban

    2010-12-01

    The aim of this study was to investigate effects of unplanned pregnancy on neonatal health. This is a retrospective case-control study and included 314 babies selected with a non-probability method. Data were collected with a questionnaire of descriptive characteristics and neonatal health and Parent Infant Interaction Assessment Scale. A significantly higher rate of the babies born to the women with unplanned pregnancy had meconium in their amniotic fluid (14.6% vs. 7.0%; P = 0.029), needed special care (20.4% vs. 11.5%; P = 0.031) and were kept in the incubators (12.7% vs. 4.5%; P = 0.009). Both the babies born to the women with unplanned pregnancy and the babies born to the women with planned pregnancy were first fed with breast milk (96.8% of the unplanned group; 98.1% of the planned group), but a higher rate of the babies born to the women with unplanned pregnancy had problems with breast-feeding. (19.1% vs. 5.1%; P = 0.000). The babies born to the women with unplanned pregnancy got significantly lower scores on Parent Infant Interaction Assessment Scale (4.86 ± 1.98 in the unplanned group; 8.52 ± 1.43 in the planned group; P = 0.000). We found that a higher rate of the babies born to the women with unplanned pregnancy needed special care, had problems with breast-feeding and negative parent-infant interaction. We recommend that women with unplanned pregnancy should be given priority on prenatal, intrapartum and postpartum care and that measures which protect and promote neonatal health should be taken.

  19. Diclofenac/misoprostol during early pregnancy and the risk of miscarriage: a Danish nationwide cohort study.

    Science.gov (United States)

    Andersen, Jon T; Mastrogiannis, Dimitrios; Andersen, Nadia L; Petersen, Morten; Broedbaek, Kasper; Cejvanovic, Vanja; Nielsen, Torben K; Poulsen, Henrik E; Jimenez-Solem, Espen

    2016-08-01

    Misoprostol can be used in the prevention of gastric ulcer in treatment with diclofenac and is used in rheumatic diseases. Since misoprostol causes contractions of the uterus, it can also be used to induce abortions when administrated vaginally. The aim of the study was to investigate if early pregnancy exposure to oral diclofenac/misoprostol was associated with miscarriage. We conducted a nationwide cohort study identifying all registered pregnancies in Denmark from 1997 to 2011. All births were identified using the Medical Birth Registry, and all records of induced abortion and miscarriage were from the National Hospital Register. Data on drug use were from the National Prescription Register. Cox proportional hazard regression models were used to calculate the hazard of miscarriage in women exposed to diclofenac/misoprostol in early pregnancy. We identified 1,338,824 pregnancies (970,491 births, 142,147 miscarriages, 226,145 induced abortions). One hundred sixty-six were exposed to diclofenac/misoprostol in the early pregnancy of which 28.3 % (47) ended up in a miscarriage compared to 10.6 % among unexposed. The adjusted hazard ratio of having a miscarriage after exposure to diclofenac/misoprostol in the first trimester was 3.6 (CI 95 % 2.6-4.9). We found an increased risk of miscarriage after exposure to diclofenac/misoprostol during the early pregnancy. Women in the fertile age should not be treated with the combination of diclofenac/misoprostol if other options were available.

  20. Prospective study of perinatal outcome in pregnancies with primary antiphospholipid syndrome

    Directory of Open Access Journals (Sweden)

    Ćetković Aleksandar

    2014-01-01

    Full Text Available Background/Aim. Pregnancies complicated with antiphospholipd syndrome are associated with the increased perinatal mortality and morbidity. The aim of this study was to assess perinatal outcome in pregnancies with primary antiphospholipd syndrome. Methods. This prospective study evaluated perinatal outcome in 25 pregnant women with antiphospholipid syndrome. After establishing vital pregnancy all the patients were treated with low-molecularweight heparin and aspirin. The perinatal outcome was measured by rates of miscarriages, preterm deliveries, live births and neonatal complications. Results. Of the 25 pregnancies, 20 (80% resulted in live birth, 3 (12% in spontaneous abortion and 2 (8% were stillbirths. The mean gestational age at delivery was 37.2 ± 1.0 weeks, mean neonatal birth weight was 2,930.4 ± 428.0 g. Prematurity occurs in 4 (20% live births, and there were 4 (20% intrauterine growth restriction with mean birth weight 2,060 ± 210.6 g. Neonatal complications were present in 6 (30% newborns. Adverse perinatal outcome was significantly associated with anticardiolipin IgG antibodies (p < 0.01 and development of hypertension during pregnancy (p < 0.01. Conclusion. Despite a high incidence of adverse perinatal outcomes in pregnancies with primary antiphospholipid syndrome, early treatment with aspirin and low-molecular-weight heparin, combined with meticulous fetomaternal monitoring could be associated with a relatively high probability of favorable perinatal outcome.

  1. A PROSPECTIVE STUDY ON DERMATOSES IN PREGNANCY IN A TERTIARY CARE HOSPITAL OF SOUTHERN ASSAM

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    Vaswatee

    2015-09-01

    Full Text Available Various skin diseases are seen in pregnancy. Some of these diseases occur specifically in pregnancy. Maternal and fetal morbidity and mortality can be decreased by early diagnosis and appropriate treatment of these conditions. A total of 53 pregnant females were found to have dermatological disorders or sexually transmitted diseases during the study period. The commonest pregnancy specific dermatoses in the study was polymorphic eruption of pregnancy (22.64% followed by prurigo of pregnancy (9.43%, pruritic folliculitis of pregnancy (5.66%, pruritus gravidarum (0.01%, impetigo herpetiformis (0.01% and pemphigoid gestationis (0.01%. The commonest dermatological disorder was scabies (13.20% followed by candidiasis (11.32%, dermatophytosis (9.43%, melasma (5.66% and equal number of cases of urticaria (3.7% and acne (3.7%. Among sexually transmitted diseases, commonest disease was genital warts (3.7% followed by single case (0.01% each of syphilis, molluscum contagiosum and one patient was seropositive for HIV.

  2. Thermionic Reactor Design Studies

    Energy Technology Data Exchange (ETDEWEB)

    Schock, Alfred

    1994-08-01

    Paper presented at the 29th IECEC in Monterey, CA in August 1994. The present paper describes some of the author's conceptual designs and their rationale, and the special analytical techniques developed to analyze their (thermionic reactor) performance. The basic designs, first published in 1963, are based on single-cell converters, either double-ended diodes extending over the full height of the reactor core or single-ended diodes extending over half the core height. In that respect they are similar to the thermionic fuel elements employed in the Topaz-2 reactor subsequently developed in the Soviet Union, copies of which were recently imported by the U.S. As in the Topaz-2 case, electrically heated steady-state performance tests of the converters are possible before fueling.

  3. Metformin Treatment in Type 2 Diabetes in Pregnancy: An Active Controlled, Parallel-Group, Randomized, Open Label Study in Patients with Type 2 Diabetes in Pregnancy

    OpenAIRE

    2015-01-01

    Aims. To assess the effect of metformin and to compare it with insulin treatment in patients with type 2 diabetes in pregnancy in terms of perinatal outcome, maternal complications, additional insulin requirement, and treatment acceptability. Methods. In this randomized, open label study, 206 patients with type 2 diabetes in pregnancy who met the eligibility criteria were selected from the antenatal clinics. Insulin was added to metformin treatment when required, to maintain the target glycem...

  4. Pre-Pregnancy BMI, Gestational Weight Gain, and the Risk of Hypertensive Disorders of Pregnancy: A Cohort Study in Wuhan, China.

    Directory of Open Access Journals (Sweden)

    Aifen Zhou

    Full Text Available Hypertensive disorders of pregnancy (HDP are major causes of maternal death worldwide and the risk factors are not fully understood. Few studies have investigated the risk factors for HDP among Chinese women. A cohort study involving 84,656 women was conducted to investigate pre-pregnancy BMI, total gestational weight gain (GWG, and GWG during early pregnancy as risk factors for HDP among Chinese women.The study was conducted between 2011-2013 in Wuhan, China, utilizing data from the Maternal and Children Healthcare Information Tracking System of Wuhan. A total of 84,656 women with a live singleton pregnancy were included. Multiple unconditional logistic regression was conducted to evaluate associations between putative risk factors and HDP.Women who were overweight or obese before pregnancy had an elevated risk of developing HDP (overweight: OR = 2.66, 95% CI = 2.32-3.05; obese: OR = 5.53, 95% CI = 4.28-7.13 compared to their normal weight counterparts. Women with total GWG above the Institute of Medicine (IOM recommendation had an adjusted OR of 1.72 (95% CI = 1.54-1.93 for HDP compared to women who had GWG within the IOM recommendation. Women with gestational BMI gain >10 kg/m2 during pregnancy had an adjusted OR of 3.35 (95% CI = 2.89-3.89 for HDP, compared to women with a gestational BMI gain 600g/wk: adjusted OR = 1.48, 95% CI = 1.19-1.84.The results from this study show that maternal pre-pregnancy BMI, early GWG, and total GWG are positively associated with the risk of HDP. Weight control efforts before and during pregnancy may help to reduce the risk of HDP.

  5. Intake of vitamin C and E in pregnancy and risk of pre-eclampsia: prospective study among 57 346 women

    DEFF Research Database (Denmark)

    Klemmensen, Ak; Tabor, A; Østerdal, M L

    2009-01-01

    of pre-eclampsia. DESIGN: Prospective cohort study. SETTING: The Danish National Birth Cohort; a population-based pregnancy cohort; analyses were based on 57 346 pregnancies. METHODS: Vitamin intake was estimated from a food frequency questionnaire completed in gestational week 25, recording intake from......OBJECTIVE: It has been suggested that vitamin C, alone or in combination with vitamin E, may protect against pre-eclampsia, whereas the safety of high-dose vitamin E supplements has been questioned. We investigated dietary intakes of vitamins C and E to see if they correlated with the incidence...... OUTCOME MEASURES: A small increase in the incidence of severe disease was also seen in the group of women (64, n = 49 373) with a high intake of vitamin E from supplements and dietary sources. RESULTS: The incidence of 'pre-eclampsia (all types)' did not correlate with dietary vitamin C and E intake...

  6. EFFECT OF EARLY PREGNANCY BODY MASS INDEX ON PREGNANCY OUTCOMES IN WOMEN DELIVERING SINGLETON BABIES- AN OBSERVATIONAL STUDY

    Directory of Open Access Journals (Sweden)

    Divya Vishnu

    2017-02-01

    Full Text Available BACKGROUND Maternal overweight/obesity causes many complications during pregnancy and delivery. It can also increase neonatal and infant morbidity and mortality. BMI is an important measure of under/overweight. This observational study examines the correlation between maternal Body Mass Index (BMI with maternal outcome in women. MATERIALS AND METHODS This study was conducted at Department of Obstetrics and Gynaecology, Government Medical College, Kottayam, Kerala, for a period of one year. A sample of 300 pregnant women with intrauterine pregnancy of gestational age <12 weeks at first visit was taken for this study with an age between 18 and 35 years with singleton pregnancy. BMI of these women were calculated and they were classified into two categories (BMI <23 kg/m2 and BMI ≥23 kg/m2 . The Chi-square test was done to find the association of BMI and various maternal outcomes. RESULTS In the sample of 300 pregnant women, 39% were having BMI <23 kg/m2 and 61% were having BMI ≥23 kg/m2 . Pregnant women with BMI ≥23 kg/m2 were found to have significantly increased risk of developing gestational hypertension, gestational diabetes and macrosomia. We found that a significantly increased need of induction and increased risk of developing intrapartum and postpartum complications in those with BMI ≥23 kg/m2 . Our study also found out that an increased incidence of elective as well as emergency caesareans and increased risk of neonatal complications in women whose BMI ≥23 kg/m2 . CONCLUSION Adverse maternal and perinatal outcomes are significantly related to extremes of BMI categories and least complications were seen in normal BMI group. Therefore, it is ideal to reduce the body weight to an optimal level so that the complications, which are attributed to overweight and obesity can be reduced. We recommended future research on the association of BMI and maternal outcomes involving large samples comparable to those done in developed countries.

  7. Changes in weight and health behaviors after pregnancies complicated by gestational diabetes mellitus: the CARDIA study.

    Science.gov (United States)

    Bennett, Wendy L; Liu, Su-Hsun; Yeh, Hsin-Chieh; Nicholson, Wanda K; Gunderson, Erica P; Lewis, Cora E; Clark, Jeanne M

    2013-06-01

    Prepregnancy to postpregnancy change in weight, body mass index (BMI), waist circumference, diet, and physical activity in women with and without gestational diabetes mellitus (GDM) were compared. Using the Coronary Artery Risk Development in Young Adults study, women with at least one pregnancy during 20 years of follow-up (n = 1,488 with 3,125 pregnancies) was identified. Linear regression with generalized estimating equations to compare prepregnancy to postpregnancy changes in health behaviors and anthropometric measurements between 137 GDM pregnancies and 1,637 non-GDM pregnancies, adjusted for parity, age at delivery, outcome measure at the prepregnancy exam, race, education, mode of delivery, and interval between delivery and postpregnancy examination were used. When compared with women without GDM in pregnancy, women with GDM had higher prepregnancy mean weight (158.3 vs. 149.6 lb, P = 0.011) and BMI (26.7 vs. 25.1 kg/m(2) , P = 0.002), but nonsignificantly lower total daily caloric intake and similar levels of physical activity. Both GDM and non-GDM groups had higher average postpartum weight of 7-8 lbs and decreased physical activity on average 1.4 years after pregnancy. Both groups similarly increased total caloric intake but reduced fast food frequency. Prepregnancy to postpregnancy changes in body weight, BMI, waist circumference, physical activity, and diet did not differ between women with and without GDM in pregnancy. Following pregnancy, women with and without GDM increased caloric intake, BMI, and weight and decreased physical activity, but reduced their frequency of eating fast food. Given these trends, postpartum lifestyle interventions, particularly for women with GDM, are needed to reduce obesity and diabetes risk. Copyright © 2013 The Obesity Society.

  8. Individual and familial factors associated with teenage pregnancy: an interview study.

    Science.gov (United States)

    Haldre, Kai; Rahu, Kaja; Rahu, Mati; Karro, Helle

    2009-06-01

    The determinants of teenage sexual health, including pregnancies, can be addressed from social, familial and individual level perspectives. The main objective of this study was to examine whether pregnancy among 18 years old and younger girls were associated with selected individual (age at coitarche, score of sexual health knowledge, dislike of school) and family (mother's education) and family functioning (alcohol abuse in the family, parents' acceptance of sexual relationship) characteristics. An interview survey in two medical institutions in Estonia among 279 18 year old and younger girls, who: (i) used contraception, had been sexually active for at least 6 months and had not pregnancies--(148 girls); (ii) came for termination of pregnancy--abortion group; (iii) planned to deliver and came for prenatal care--delivery group. The last two groups were analysed together as the 'pregnancy group'--131 girls. Multivariate analysis, by means of logistic regression models, was used to explore whether the associations were sustained after adjusting for other variables. Crude odds ratios (ORs), adjusted ORs and their 95% confidence intervals (CIs) were estimated, with girls having no pregnancies as the reference group. Risk factors associated with teenage pregnancy were low score of sexual health knowledge (adjusted ORs 3.07; 95% CIs 1.73-5.46), dislike of school (adjusted ORs 1.96; 95% CIs 1.08-3.54), alcohol abuse by family members (adjusted ORs 2.03; 95% CIs 1.16-3.54). Sexual knowledge of teenagers, their attitude towards school, alcohol abuse in the family are factors associated with teenage pregnancies.

  9. Asthma affects time to pregnancy and fertility: a register-based twin study.

    Science.gov (United States)

    Gade, Elisabeth J; Thomsen, Simon F; Lindenberg, Svend; Kyvik, Kirsten O; Lieberoth, Sofie; Backer, Vibeke

    2014-04-01

    Coexistence of infertility and asthma has been observed clinically. Therefore, we investigated the association between asthma and delayed pregnancy in a nationwide population-based cohort of twins. A cohort of 15 250 twins living in Denmark (aged 12-41 years) participated in a questionnaire study including questions about the presence of asthma and fertility. Differences in time to pregnancy and pregnancy outcome were analysed in subjects with asthma, allergy and in healthy individuals using multiple regression analysis. Asthma was associated with an increased time to pregnancy, the percentage of asthmatics with a time to pregnancy >1 year was 27% versus 21.6% for non-asthmatics (OR (95% CI) 1.31 (1.1-1.6); p=0.009). The association remained significant after adjustment for age, age at menarche, body mass index and socioeconomic status (OR (95% CI) 1.25 (1.0-1.6); p=0.05), and was more pronounced in those >30 years of age (32.2% versus 24.9%, OR (95% CI) 1.44 (1.1-1.9); p=0.04). Untreated asthmatics had a significant increased risk of prolonged time to pregnancy compared to healthy individuals (OR (95% CI) 1.79 (1.20-2.66); p=0.004), while asthmatics receiving any kind of treatment for asthma tended to have a shorter time to pregnancy than untreated asthmatics (OR 1.40; p=0.134). Asthma prolongs time to pregnancy. The negative effect of asthma on fertility increases with age and with disease intensity, indicating that a systemic disease characterised by systemic inflammation also can involve reproductive processes.

  10. 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.

  11. Kaiser Permanente Northern California pregnancy database: Description and proof of concept study.

    Science.gov (United States)

    Zerbo, Ousseny; Chan, Berwick; Goddard, Kristin; Lewis, Ned; Bok, Karin; Klein, Nicola P; Baxter, Roger

    2016-11-04

    We describe the establishment of a dynamic database linking mothers to newborns with the goal of studying vaccine safety in both pregnant women and their children and provide results of a study utilizing this database as a proof of concept. All Kaiser Permanente Northern California (KPNC) live births and their mothers were eligible for inclusion in the pregnancy database. We used the medical record number (MRN), a unique identifier, to retrieve information about events that occurred during the pregnancy and at delivery and linked this same MRN to newborns for post-partum follow up. We conducted a retrospective cohort study to evaluate the association between receipt of tetanus, diphtheria and acellular pertussis (Tdap) vaccine during pregnancy and fever 0-3days after the first dose of diphtheria tetanus and acellular pertussis (DTaP) vaccine in the infant. The study included infants who were born at ⩾37weeks gestation from January 1, 2009 - October 1, 2015 and who received their first DTaP vaccine between 6 and 10weeks of age. We utilized diagnostic codes from inpatient, emergency department, outpatient clinics, and telephone calls. We identified fever using ICD 9 code 780.6, recorded temperature ⩾101 degree Fahrenheit, or parental report. The database contained the starting and ending date of each pregnancy and basic demographic characteristics of mothers and infants. There were 859,699 women and 873,753 children in the database as of January 2016. The proof of concept study included 148,699 infants. In a multivariable logistic regression analysis, Tdap vaccination during pregnancy was not associated with infant fever 0-3daysafter first dose of DTaP (adjusted odds ratio=0.92, 95% CI 0.82-1.04). The KPNC pregnancy database can be used for studies investigating exposure during pregnancy and outcomes in mothers and/or infants, particularly monitoring vaccine safety and effectiveness. Copyright © 2016 Elsevier Ltd. All rights reserved.

  12. 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.

  13. 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

  14. Hormones and cognitive functioning during late pregnancy and postpartum: a longitudinal study.

    Science.gov (United States)

    Henry, Jessica F; Sherwin, Barbara B

    2012-02-01

    This longitudinal study investigated the possible influence of estradiol (E₂), progesterone (P), testosterone (T), cortisol (CORT), and prolactin (PRL) levels on cognitive functioning during late pregnancy and the early postpartum period. The performance of 55 pregnant women on a battery of neuropsychological tests, tested once during the third trimester of pregnancy and once during the early postpartum period, was compared with that of 21 nonpregnant controls matched for age and education. Women in the pregnancy group had significantly lower scores than the controls during both the pre- and postpartum visits on tasks of verbal recall and processing speed. CORT levels were significantly associated, in an inverted-U function, with verbal recall scores at both the pregnancy and at postpartum periods and with spatial abilities at postpartum only. During pregnancy, PRL levels were associated in both a linear and an inverted-U function with scores on tests of paragraph recall and in a linear function with scores on tests of executive function. At postpartum, E₂ and CORT were negatively associated in a linear fashion with attention scores. These findings provide new evidence that fluctuating hormone levels during late pregnancy and early postpartum may modulate selected cognitive abilities.

  15. Maternal smoking during pregnancy and fetal organ growth: a magnetic resonance imaging study.

    Directory of Open Access Journals (Sweden)

    Devasuda Anblagan

    Full Text Available OBJECTIVE: To study whether maternal cigarette smoking during pregnancy is associated with alterations in the growth of fetal lungs, kidneys, liver, brain, and placenta. DESIGN: A case-control study, with operators performing the image analysis blinded. SETTING: Study performed on a research-dedicated magnetic resonance imaging (MRI scanner (1.5 T with participants recruited from a large teaching hospital in the United Kingdom. PARTICIPANTS: A total of 26 pregnant women (13 current smokers, 13 non smokers were recruited; 18 women (10 current smokers, 8 nonsmokers returned for the second scan later in their pregnancy. METHODS: Each fetus was scanned with MRI at 22-27 weeks and 33-38 weeks gestational age (GA. MAIN OUTCOME MEASURES: Images obtained with MRI were used to measure volumes of the fetal brain, kidneys, lungs, liver and overall fetal size, as well as placental volumes. RESULTS: Exposed fetuses showed lower brain volumes, kidney volumes, and total fetal volumes, with this effect being greater at visit 2 than at visit 1 for brain and kidney volumes, and greater at visit 1 than at visit 2 for total fetal volume. Exposed fetuses also demonstrated lower lung volume and placental volume, and this effect was similar at both visits. No difference was found between the exposed and nonexposed fetuses with regards to liver volume. CONCLUSION: Magnetic resonance imaging has been used to show that maternal smoking is associated with reduced growth of fetal brain, lung and kidney; this effect persists even when the volumes are corrected for maternal education, gestational age, and fetal sex. As expected, the fetuses exposed to maternal smoking are smaller in size. Similarly, placental volumes are smaller in smoking versus nonsmoking pregnant women.

  16. Designing verbal autopsy studies

    Directory of Open Access Journals (Sweden)

    Shibuya Kenji

    2010-06-01

    Full Text Available Abstract Background Verbal autopsy analyses are widely used for estimating cause-specific mortality rates (CSMR in the vast majority of the world without high-quality medical death registration. Verbal autopsies -- survey interviews with the caretakers of imminent decedents -- stand in for medical examinations or physical autopsies, which are infeasible or culturally prohibited. Methods and Findings We introduce methods, simulations, and interpretations that can improve the design of automated, data-derived estimates of CSMRs, building on a new approach by King and Lu (2008. Our results generate advice for choosing symptom questions and sample sizes that is easier to satisfy than existing practices. For example, most prior effort has been devoted to searching for symptoms with high sensitivity and specificity, which has rarely if ever succeeded with multiple causes of death. In contrast, our approach makes this search irrelevant because it can produce unbiased estimates even with symptoms that have very low sensitivity and specificity. In addition, the new method is optimized for survey questions caretakers can easily answer rather than questions physicians would ask themselves. We also offer an automated method of weeding out biased symptom questions and advice on how to choose the number of causes of death, symptom questions to ask, and observations to collect, among others. Conclusions With the advice offered here, researchers should be able to design verbal autopsy surveys and conduct analyses with greatly reduced statistical biases and research costs.

  17. Risk of postpartum episodes in women with bipolar disorder after lamotrigine or lithium use during pregnancy: A population-based cohort study.

    Science.gov (United States)

    Wesseloo, Richard; Liu, Xiaoqin; Clark, Crystal T; Kushner, Steven A; Munk-Olsen, Trine; Bergink, Veerle

    2017-08-15

    Women with bipolar disorder are at high risk for relapse/recurrence postpartum. Among all mood stabilizers, lithium has the largest evidence base for efficacy in the peripartum period, but lamotrigine is increasingly prescribed for bipolar spectrum disorders during pregnancy. The aim of this study was to investigate whether lamotrigine use during pregnancy is as effective as lithium in the prevention of severe episodes postpartum. Danish national registries were used to identify pregnancies of women with a diagnosis of bipolar spectrum disorders at the time of conception who used lamotrigine or lithium during pregnancy. We compared the risk of inpatient psychiatric admission within three months postpartum between women who used lamotrigine (N=55) versus lithium (N=59) during pregnancy. A logistic regression model was used to calculate crude and adjusted odds ratios. We did not find a significant difference in the risk of postpartum psychiatric admission between women who used lamotrigine versus lithium during pregnancy (7.3% versus 15.3% respectively, adjusted OR 0.83; 95% CI 0.22-3.14). We adjusted for year of delivery, parity, previous admissions and antidepressant/benzodiazepine use during pregnancy. Other variables did not differ substantially between groups. We used an observational design and therefore patients were not randomized to lamotrigine or lithium. The study has a small sample size. Lamotrigine was not inferior to lithium in the prevention of severe postpartum episodes. Our findings suggest lamotrigine could be a reasonable alternative treatment option for bipolar disorder during pregnancy in patients with vulnerability for depression and may prevent severe episodes postpartum. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. Monitoring of spine curvatures and posture during pregnancy using surface topography – case study and suggestion of method

    Directory of Open Access Journals (Sweden)

    Jakub Michoński

    2016-10-01

    Full Text Available Abstract Background Low back and pelvic pain is one of the most frequently reported disorders in pregnancy, however etiology and pathology of this problem have not been fully determined. The relationship between back pain experienced during pregnancy and posture remains unclear. It is challenging to measure reliably postural and spinal changes at the time of pregnancy, since most imaging studies cannot be used due to the radiation burden. 3D shape measurement, or surface topography (ST, systems designed for posture evaluation could potentially fill this void. A pilot study was conducted to test the potential of monitoring the change of spine curvatures and posture during pregnancy using surface topography. A single case was studied to test the methodology and preliminarily assess the usefulness of the procedure before performing a randomized trial. The apparatus used in this study was metrologically tested and utilized earlier in scoliosis screening. Case presentation The subject was measured using a custom-made structured light illumination scanner with accuracy of 0.2 mm. Measurement was taken every 2 weeks, between 17th and 37th week of pregnancy, 11 measurements in total. From the measurement the thoracic kyphosis and lumbar lordosis angles, and vertical balance angle were extracted automatically. Custom-written software was used for analysis. Oswestry Low Back Pain Disability Questionnaire (ODI was done with every measurement. The values were correctly extracted from the measurement. The results were: 50.9 ± 2.4° for kyphosis angle, 58.1 ± 2.1° for lordosis angle and 4.7 ± 1.7° for vertical balance angle. The registered change was 7.4° in kyphosis angle, 8.4° in lordosis angle and 5.5° in vertical balance angle. The calculated ODI values were between moderate disability and severe disability (22 to 58 %. Conclusions This case study presents that surface topography may be suitable for monitoring of spinal curvature

  19. Maternal pre-pregnancy body mass index explains infant's weight and BMI at 14 months: results from a multi-ethnic birth cohort study

    NARCIS (Netherlands)

    Mesman, I.; Roseboom, T.J.; Bonsel, G.J.; Gemke, R.J.B.J.; van der Wal, M.F.; Vrijkotte, T.G.

    2009-01-01

    Objective: To investigate the association between (self-reported) maternal pre-pregnancy body mass index (pBMI), and child's weight, height and BMI at age 14 months. Design: Prospective multi-ethnic community-based cohort study. Setting: Amsterdam, The Netherlands. Participants: 8266 pregnant women

  20. Perinatal and maternal outcomes by planned place of birth for healthy women with low risk pregnancies: the Birthplace in England national prospective cohort study.

    NARCIS (Netherlands)

    Brocklehurst, P.; Kwee, A.; Birthplace in England Collaborative Group

    2011-01-01

    Objective: To compare perinatal outcomes, maternal outcomes, and interventions in labour by planned place of birth at the start of care in labour for women with low risk pregnancies. Design: Prospective cohort study. Setting: England: all NHS trusts providing intrapartum care at home, all freestandi

  1. Invasive treatment in complicated monochorionic twin pregnancies

    DEFF Research Database (Denmark)

    Sundberg, Karin; Søgaard, Kirsten; Jensen, Lisa Neerup;

    2012-01-01

    Objective. Monochorionic twin pregnancies are associated with increased risk of severe complications. Umbilical cord occlusion (UCO) and fetoscopic selective laser coagulation (FSLC) are used as invasive treatment. The study aim was to document treatment indications and pregnancy outcome where UCO...... and FSLC were used for treating fetal discrepancies and twin-to-twin transfusion syndrome (TTTS). Design. Cohort study of all consecutively treated monochorionic twin pregnancies 2004-2010. Setting. Tertiary care center. Population. One hundred and twenty pregnancies treated by FSLC (55) or UCO (65...

  2. [Clinical practice recommendations for diabetes in pregnancy (Diabetes and Pregnancy Study Group of the Austrian Diabetes Association)].

    Science.gov (United States)

    Kautzky-Willer, Alexandra; Harreiter, Jürgen; Weitgasser, Raimund; Lechleitner, Monika

    2016-04-01

    Twenty-six years ago the St. Vincent Declaration aimed for an achievement of a comparable pregnancy outcome in diabetic and non-diabetic women. However, current surveys clearly show that women with pre-gestational diabetes still feature a much higher risk of perinatal morbidity and even increased mortality. This fact is mostly ascribed to a persistently low rate of pregnancy planning and pre-pregnancy care with optimization of metabolic control prior to conception. In addition, obesity increases worldwide, contributing to a growing number of women with type 2 diabetes at a childbearing age, and a further deterioration in outcome in diabetic women. Development of diabetic embryopathy and fetopathy are known to be related to maternal glycemic control (target: normoglycemia and normal HbA1c, if possible without hypoglycemia). The risk for hypoglycemia is at its greatest in early pregnancy and decreases with the progression of pregnancy due to the hormonal changes leading to a marked increase of insulin resistance. Intensified insulin therapy with multiple daily insulin injections and pump treatment are equally effective in reaching good metabolic control during pregnancy. All women should be experienced in the management of their therapy and on stable glycemic control prior to the conception. In addition, thyroid dysfunction, hypertension as well as the presence of diabetic complications should be excluded before pregnancy or treated adequately in order to decrease the risk for a progression of complications during pregnancy as well as for maternal and fetal morbidity.

  3. A STUDY OF THE OUTCOME OF SUBSEQUENT PREGNANCY FOLLOWING PREVIOUS C ESAREAN SECTION

    Directory of Open Access Journals (Sweden)

    Suman

    2014-02-01

    Full Text Available With the world - wide rising trend of caesarean delivery (CD, modern obstetric practice deals with a new group of mothers carrying reproductive performance upon a scarred uterus with obvious risk in feto - maternal outcome. AIMS: (1 To analyse the maternal & neonatal outcome in post - caesarean pregnancy. (2 To evaluate the factors influencing outcome in such cases. Design : Observational analytical study. MATERIALS & METHODS: The present study was carried out over two years (2010 - 11 taking consecutive 100 p ost - caesarean cases as admitted on my admission days & delivered in BR Singh Hospital. Data collection was done by interview technique along with hospital records. ANALYSIS USED: Percentage analysis was most often done. Categorical variables were compared with chi - square test; P value was calculated with 2012 Graphpad Software. Relative risk (RR & Odd ratio (OR were calculated with 1993 - 2012 Medcalc Software bvba (Version 12.3.0. All statistical tests were evaluated at the 0.05 significance level. RESULT S: Post - caesarean pregnancy rate was 26.02%. Vaginal birth after caesarean (VBAC incidence was 22% whereas VBAC success on trial of labour was 55%. VBAC gave best morbidity outcome (18.18% & 27.27%. But failed VBAC cases result more significant maternal morbidity (RR=3.97, P=0.0037 & NICU admission was also found highest in failed VBAC cases (38.89%. Maternal and neonatal morbidity were significantly high when scar integrity was lost; also significantly co - related with elderly mothers (>35 yrs., un - boo ked cases & non - admitted cases undergone repeat CD. CONCLUSIONS: Post - caesarean cases need meticulous antenatal check - up & mandatory institutional delivery with proper selection of mode of confinement to have a better maternal & neonatal outcome

  4. Physical activity in pregnancy: a qualitative study of the beliefs of overweight and obese pregnant women

    Directory of Open Access Journals (Sweden)

    Rankin Judith

    2010-04-01

    Full Text Available Abstract Background Whilst there has been increasing research interest in interventions which promote physical activity during pregnancy few studies have yielded detailed insights into the views and experiences of overweight and obese pregnant women themselves. The qualitative study described in this paper aimed to: (i explore the views and experiences of overweight and obese pregnant women; and (ii inform interventions which could promote the adoption of physical activity during pregnancy. Methods The study was framed by a combined Subtle Realism and Theory of Planned Behaviour (TPB approach. This enabled us to examine the hypothetical pathway between beliefs and physical activity intentions within the context of day to day life. The study sample for the qualitative study was chosen by stratified, purposive sampling from a previous study of physical activity measurements in pregnancy. Research participants for the current study were recruited on the basis of Body Mass Index (BMI at booking and parity. Semi-structured, in-depth interviews were conducted with 14 overweight and obese pregnant women. Data analysis was undertaken using a Framework Approach and was informed by TPB. Results Healthy eating was often viewed as being of greater importance for the health of mother and baby than participation in physical activity. A commonly cited motivator for maintaining physical activity during pregnancy is an aid to reducing pregnancy-related weight gain. However, participants often described how they would wait until the postnatal period to try and lose weight. A wide range of barriers to physical activity during pregnancy were highlighted including both internal (physical and psychological and external (work, family, time and environmental. The study participants also lacked access to consistent information, advice and support on the benefits of physical activity during pregnancy. Conclusions Interventions to encourage recommended levels of physical

  5. The effects of exercise during pregnancy on the newborn’s brain: study protocol for a randomized controlled trial

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    LeMoyne Elise L

    2012-05-01

    Full Text Available Abstract Background It is generally accepted that an active lifestyle is beneficial for cognition in children, adults and the elderly. Recently, studies using the rat animal model found that the pups of mothers who exercised during pregnancy had increased hippocampal neurogenesis and better memory and learning abilities. The aim of this report is to present the experimental protocol of a study that is designed to verify if an active lifestyle during pregnancy in humans has an impact on the newborn's brain. Methods 60 pregnant women will be included in a randomized controlled study. The experimental group will be asked to exercise a minimum of 20 minutes three times per week, at a minimal intensity of 55% of their maximal aerobic capacity. The control group will not be exercising. The effect of exercise during pregnancy on the newborn's brain will be investigated 8 to 12 days postpartum by means of the mismatch negativity, a neurophysiological brain potential that is associated to auditory sensory memory. We hypothesize that children born to mothers who exercised during their pregnancy will present shorter latencies and larger mismatch negativity amplitudes, indicating more efficient auditory memory processes. Discussion As of September 2011, 17 women have joined the study. Preliminary results show that the experimental group are active 3.1 ± 0.9 days per week while the control group only exercise 0.8 ± 0.6 days per week. The results of this study will present insight on fetal neuroplasticity and will be a valuable tool for health professionals who wish to encourage pregnant women to exercise. Trial registration ClinicalTrials.gov registration: NTC01220778

  6. Adequate weight gain in pregnancy: An analysis of its determinants in a cross-sectional study

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    Popa Alina Delia

    2014-01-01

    Full Text Available Introduction. Prenatal care is considered an important tool for promoting a healthy lifestyle, but has not been studied as a predictor for maternal weight gain during pregnancy, especially in Romania, where evidence about pregnancy and nutrition is scarce. Objective. This study has aimed to explore the relationship between pre-gestational body mass index (BMI, adequacy of prenatal care and weight gain during pregnancy. Methods. We carried a cross-sectional study on a sample of 400 pregnant women admitted at the “Cuza Voda” Obstetrics and Gynecology Hospital in Iasi. Information regarding demographic characteristics, number of prenatal visits, date of the initial hospital record, nutritional education during pregnancy were registered throughout a questionnaire filled out by means of a direct interview. The anthropometric indicators analyzed were the pre-gestational BMI and the pregnancy weight gain. Data on caloric intake were obtained using a food frequency questionnaire. Results. Weight gain within the limits of the Institute of Medicine recommendations was noticed at 44.35% of the women who declared that they received nutritional advice compared to 40.7% of those who did not receive advice regarding diet during pregnancy. Overweight (53.1% and obese women (66.7% had a larger weight gain than those with a normal pre-pregnancy BMI (29.8% (p<0.001. The variables that were identified with an effect on weight gain in this sample of pregnant women were: inadequate prenatal care, pre-gestational BMI and energy intake. Conclusion. Identifying the pre-gestational BMI and diet changes as predictors of weight gain underline the importance of an individualized prenatal care.

  7. Induced abortion, pregnancy loss and intimate partner violence in Tanzania: a population based study

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    Stöckl Heidi

    2012-03-01

    Full Text Available Abstract Background Violence by an intimate partner is increasingly recognized as an important public and reproductive health issue. The aim of this study is to investigate the extent to which physical and/or sexual intimate partner violence is associated with induced abortion and pregnancy loss from other causes and to compare this with other, more commonly recognized explanatory factors. Methods This study analyzes the data of the Tanzania section of the WHO Multi-Country Study on Women's Health and Domestic Violence, a large population-based cross-sectional survey of women of reproductive age in Dar es Salaam and Mbeya, Tanzania, conducted from 2001 to 2002. All women who answered positively to at least one of the questions about specific acts of physical or sexual violence committed by a partner towards her at any point in her life were considered to have experienced intimate partner violence. Associations between self reported induced abortion and pregnancy loss with intimate partner violence were analysed using multiple regression models. Results Lifetime physical and/or sexual intimate partner violence was reported by 41% and 56% of ever partnered, ever pregnant women in Dar es Salaam and Mbeya respectively. Among the ever pregnant, ever partnered women, 23% experienced involuntary pregnancy loss, while 7% reported induced abortion. Even after adjusting for other explanatory factors, women who experienced intimate partner violence were 1.6 (95%CI: 1.06,1.60 times more likely to report an pregnancy loss and 1.9 (95%CI: 1.30,2.89 times more likely to report an induced abortion. Intimate partner violence had a stronger influence on induced abortion and pregnancy loss than women's age, socio-economic status, and number of live born children. Conclusions Intimate partner violence is likely to be an important influence on levels of induced abortion and pregnancy loss in Tanzania. Preventing intimate partner violence may therefore be beneficial

  8. How can formative research inform the design of an iron-folic acid supplementation intervention starting in first trimester of pregnancy in Bangladesh?

    Science.gov (United States)

    Alam, Ashraful; Rasheed, Sabrina; Khan, Nazib U Z; Sharmin, Tamanna; Huda, Tanvir M; Arifeen, Shams E; Dibley, Michael J

    2015-04-12

    The study objective was to understand community preparedness for iron and folic acid (IFA) supplementation early in pregnancy and to inform the design of a large-scale trial of early introduction of IFA supplementation in rural Bangladesh. 66 in-depth interviews (pregnant women, husbands, and older women in the household), 20 key-informant interviews, 3 focus-group discussions (community health workers and adolescent female students), and observation of two community-based clinics were conducted. Most of the women who used IFA tablets during pregnancy reported better health and physical strength after taking them. Women perceived that IFA increased blood volume, leading to foetal nourishment and compensated for blood loss during delivery. However, a culturally informed perceived barrier was the belief that IFA supplementation will increase foetus size, leading to birth complications, hospitalisation, caesarean section and financial burden for the family. Community health workers (CHWs) of BRAC (a non-government organisation) were the main sources of IFA information and supplements, although knowledge of IFA tablets among women's social networks also helped to make it acceptable. Pregnant women felt that they could start taking IFA during the first trimester of pregnancy if advised by the CHWs. Programme managers and healthcare providers expressed concern about starting IFA supplementation early. Our study suggests that introduction of IFA supplementation early in pregnancy is feasible with support from CHWs. Promotion of IFA could benefit from efforts to include culturally sensitive reasons for usage; improvement of the CHW training modules; targeted home visits and counselling; and outreach to standardize messages.

  9. 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

  10. Study design in causal models

    OpenAIRE

    2012-01-01

    The causal assumptions, the study design and the data are the elements required for scientific inference in empirical research. The research is adequately communicated only if all of these elements and their relations are described precisely. Causal models with design describe the study design and the missing data mechanism together with the causal structure and allow the direct application of causal calculus in the estimation of the causal effects. The flow of the study is visualized by orde...

  11. Maternal and fetal outcome in jaundice complicating pregnancy: a prospective study

    OpenAIRE

    Swati Sharma; Rupa Aherwar; Shashikala Jawade

    2016-01-01

    Background: The objective of the study was to study maternal and fetal outcome in pregnancy complicated with jaundice. Methods: 30 antenatal patients with clinical /laboratory evidence of Jaundice were selected for study in period between august 2014 to august 2015. Results: The peak age of incidence in our study was 21-25 years (66.6%) and majority were primigravida (66.6%). All cases were in third trimester of pregnancy, 93.3% were unbooked, 73.3% were term, 60% were of lower socioeco...

  12. Residential traffic exposure and pregnancy-related outcomes: a prospective birth cohort study

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    Hofman Albert

    2009-12-01

    Full Text Available Abstract Background The effects of ambient air pollution on pregnancy outcomes are under debate. Previous studies have used different air pollution exposure assessment methods. The considerable traffic-related intra-urban spatial variation needs to be considered in exposure assessment. Residential proximity to traffic is a proxy for traffic-related exposures that takes into account within-city contrasts. Methods We investigated the association between residential proximity to traffic and various birth and pregnancy outcomes in 7,339 pregnant women and their children participating in a population-based cohort study. Residential proximity to traffic was defined as 1 distance-weighted traffic density in a 150 meter radius, and 2 proximity to a major road. We estimated associations of these exposures with birth weight, and with the risks of preterm birth and small size for gestational age at birth. Additionally, we examined associations with pregnancy-induced hypertension, (preeclampsia, and gestational diabetes. Results There was considerable variation in distance-weighted traffic density. Almost fifteen percent of the participants lived within 50 m of a major road. Residential proximity to traffic was not associated with birth and pregnancy outcomes in the main analysis and in various sensitivity analyses. Conclusions Mothers exposed to residential traffic had no higher risk of adverse birth outcomes or pregnancy complications in this study. Future studies may be refined by taking both temporal and spatial variation in air pollution exposure into account.

  13. Use of cephalosporins during pregnancy and in the presence of congenital abnormalities: a population-based, case-control study

    DEFF Research Database (Denmark)

    Czeizel, A.E.; Rockenbauer, M.; Sørensen, Henrik Toft

    2001-01-01

    Objective: Our purpose was to study the human teratogenic potential of cephalosporin treatment during pregnancy. Study Design: Pair analysis of cases with congenital abnormalities and matched controls without congenital abnormalities was performed. The population-based data set of the Hungarian...... delivered of babies affected with Down syndrome (patient controls). Results: In the case group, 308 (1.35%) pregnant women were treated with cephalosporin. In the population and patient control groups, 440 (1.15%) and 16 (1.97%) pregnant women had similar treatments. The somewhat higher use...

  14. Pregnancy outcomes in liver and cardiothoracic transplant recipients: a UK national cohort study.

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    Olaa Mohamed-Ahmed

    Full Text Available INTRODUCTION: There are an increasing number of reports of pregnancy in transplant recipients but many questions remain regarding the effect of the transplant on pregnancy outcome, the pregnancy on the graft and the medication on the fetus. The majority of studies reporting outcomes in transplant recipients have focused on women with kidney transplants, and have included retrospective, voluntary registries or single centre studies. METHODS: The UK Obstetric Surveillance System (UKOSS was used to prospectively identify all pregnant women with a liver or cardiothoracic transplant in the United Kingdom, between January 2007 and January 2012. Data were collected on demographics, transplant characteristics, immunosuppression regimens, antenatal care, maternal, graft and neonatal outcomes. In an exploratory analysis, we tested for associations between "poor fetal outcome" and medications used before or during pregnancy. RESULTS AND CONCLUSIONS: We report 62 pregnancies in 56 liver transplant recipients and 14 pregnancies in 14 cardiothoracic transplant recipients (including 10 heart, three lung and one heart-lung recipient. Liver transplant recipients, in comparison to cardiothoracic, had similar livebirth rates (92% vs. 87% but better fetal outcomes (median gestational age 38 weeks vs. 35 weeks; median birthweight 2698 g vs. 2365 g, fewer caesarean deliveries (47% vs. 62%, fewer maternal intensive care (ICU admissions (19% vs. 29% and fewer neonatal ICU admissions (25% vs. 54%. Nine women (12% were taking mycophenolate mofetil at conception, which was associated with adverse fetal outcomes. Pregnancy in transplant recipients may have successful outcomes, but complication rates are high, emphasising the role of pre-conception counselling and further research into the long-term effect on maternal and graft survival rates.

  15. Reference ranges and determinants of total hCG levels during pregnancy: the Generation R Study.

    Science.gov (United States)

    Korevaar, Tim I M; Steegers, Eric A P; de Rijke, Yolanda B; Schalekamp-Timmermans, Sarah; Visser, W Edward; Hofman, Albert; Jaddoe, Vincent W V; Tiemeier, Henning; Visser, Theo J; Medici, Marco; Peeters, Robin P

    2015-09-01

    Human chorionic gonadotropin (hCG) is a pregnancy hormone secreted by the placental synctiotrophoblast cell layer that has been linked to fetal growth and various placental, uterine and fetal functions. In order to investigate the effects of hCG on clinical endpoints, knowledge on reference range (RR) methodology and determinants of gestational hCG levels is crucial. Moreover, a better understanding of gestational hCG physiology can improve current screening programs and future clinical management. Serum total hCG levels were determined in 8195 women participating in the Generation R Study. Gestational age specific RRs using 'ultrasound derived gestational age' (US RRs) were calculated and compared with 'last menstrual period derived gestational age' (LMP RRs) and a model-based RR. We also investigated which pregnancy characteristics were associated with hCG levels. Compared to the US RRs, the LMP RRs were lower, most notably for the median and lower limit levels. No considerable differences were found between RRs calculated in the general population or in uncomplicated pregnancies only. Maternal smoking, BMI, parity, ethnicity, fetal gender, placental weight and hyperemesis gravidarum symptoms were associated with total hCG. We provide gestational RRs for total hCG and show that total hCG values and RR cut-offs during pregnancy vary depending on pregnancy dating methodology. This is likely due to the influence of hCG on embryonic growth, suggesting that ultrasound based pregnancy dating might be less reliable in women with high/low hCG levels. Furthermore, we identify different pregnancy characteristics that influence total hCG levels considerably and should therefore be accounted for in clinical studies.

  16. Body Mass Index, Smoking and Hypertensive Disorders during Pregnancy: A Population Based Case-Control Study.

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    Thuridur A Gudnadóttir

    Full Text Available While obesity is an indicated risk factor for hypertensive disorders of pregnancy, smoking during pregnancy has been shown to be inversely associated with the development of preeclampsia and gestational hypertension. The purpose of this study was to investigate the combined effects of high body mass index and smoking on hypertensive disorders during pregnancy. This was a case-control study based on national registers, nested within all pregnancies in Iceland 1989-2004, resulting in birth at the Landspitali University Hospital. Cases (n = 500 were matched 1:2 with women without a hypertensive diagnosis who gave birth in the same year. Body mass index (kg/m2 was based on height and weight at 10-15 weeks of pregnancy. We used logistic regression models to calculate odds ratios and corresponding 95% confidence intervals as measures of association, adjusting for potential confounders and tested for additive and multiplicative interactions of body mass index and smoking. Women's body mass index during early pregnancy was positively associated with each hypertensive outcome. Compared with normal weight women, the multivariable adjusted odds ratio for any hypertensive disorder was 1.8 (95% confidence interval, 1.3-2.3 for overweight women and 3.1 (95% confidence interval, 2.2-4.3 for obese women. The odds ratio for any hypertensive disorder with obesity was 3.9 (95% confidence interval 1.8-8.6 among smokers and 3.0 (95% confidence interval 2.1-4.3 among non-smokers. The effect estimates for hypertensive disorders with high body mass index appeared more pronounced among smokers than non-smokers, although the observed difference was not statistically significant. Our findings may help elucidate the complicated interplay of these lifestyle-related factors with the hypertensive disorders during pregnancy.

  17. Folic acid supplementation before and during pregnancy in the Newborn Epigenetics STudy (NEST

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    Kurtzberg Joanne

    2011-01-01

    Full Text Available Abstract Background Folic acid (FA added to foods during fortification is 70-85% bioavailable compared to 50% of folate occurring naturally in foods. Thus, if FA supplements also are taken during pregnancy, both mother and fetus can be exposed to FA exceeding the Institute of Medicine's recommended tolerable upper limit (TUL of 1,000 micrograms per day (μg/d for adult pregnant women. The primary objective is to estimate the proportion of women taking folic acid (FA doses exceeding the TUL before and during pregnancy, and to identify correlates of high FA use. Methods During 2005-2008, pre-pregnancy and pregnancy-related data on dietary supplementation were obtained by interviewing 539 pregnant women enrolled at two obstetrics-care facilities in Durham County, North Carolina. Results Before pregnancy, 51% of women reported FA supplementation and 66% reported this supplementation during pregnancy. Before pregnancy, 11.9% (95% CI = 9.2%-14.6% of women reported supplementation with FA doses above the TUL of 1,000 μg/day, and a similar proportion reported this intake prenatally. Before pregnancy, Caucasian women were more likely to take FA doses above the TUL (OR = 2.99; 95% = 1.28-7.00, compared to African American women, while women with chronic conditions were less likely to take FA doses above the TUL (OR = 0.48; 95%CI = 0.21-0.97. Compared to African American women, Caucasian women were also more likely to report FA intake in doses exceeding the TUL during pregnancy (OR = 5.09; 95%CI = 2.07-12.49. Conclusions Fifty-one percent of women reported some FA intake before and 66% during pregnancy, respectively, and more than one in ten women took FA supplements in doses that exceeded the TUL. Caucasian women were more likely to report high FA intake. A study is ongoing to identify possible genetic and non-genotoxic effects of these high doses.

  18. Negative histology with surgically treated tubal ectopic pregnancies - A retrospective cohort study.

    Science.gov (United States)

    Farahani, Linda; Sinha, Anjita; Lloyd, Jilly; Islam, Melissa; Ross, Jackie A

    2017-06-01

    To determine the outcome of histological examinations of surgical specimens obtained from treatment of tubal ectopic pregnancy and to correlate with clinical findings, pre-operative ultrasound scans and the type of surgery. A retrospective cohort study of 941 women diagnosed with a tubal ectopic pregnancy in the Early Pregnancy Unit and having surgical treatment at King's College Hospital, London. Clinical and ultrasound data had been entered contemporaneously on our electronic early pregnancy database and hospital clinical records over an 11year period from 2004 to 2014. Demographic data, clinical history, ultrasound scan parameters, type of surgical management and histological diagnosis were recorded. The primary outcome measure was the presence or absence of chorionic villi in the surgical specimen. Data were analysed using Mann Whitney U test for non-parametric data, relative risk for categorical data and binomial logistic regression. A surgical specimen was obtained in 925 cases. Of these, 881/925 (95.2%) were positive for the presence of chorionic villi on histological examination. Patients with negative histology had a lower median gestational age, smaller ectopic pregnancies and lower serum human chorionic gonadotrophin levels. The relative risk of negative histology was significantly higher with a solid ectopic pregnancy on ultrasound (RR1.91, 95% CI 1.07-3.4) and with conservative surgery (RR 3.68, 95% CI 1.25-10.77). The relative risk was significantly lower with the presence of embryonic cardiac activity (RR 0.12, 95% CI 0.02-0.85). Only the serum hCG level was a significant predictor of negative histology on logistic regression analysis (p=0.048). In 39/44 women with negative histology, the human chorionic gonadotrophin level declined after surgery with no further intervention. Five of the 44 required a second surgical procedure as the ectopic pregnancy had been missed at the initial surgery and did not resolve. There is lack of histological

  19. Implementation of repeat HIV testing during pregnancy in Kenya: a qualitative study.

    Science.gov (United States)

    Rogers, Anna Joy; Weke, Elly; Kwena, Zachary; Bukusi, Elizabeth A; Oyaro, Patrick; Cohen, Craig R; Turan, Janet M

    2016-07-11

    Repeat HIV testing in late pregnancy has the potential to decrease rates of mother-to-child transmission of HIV by identifying mothers who seroconvert after having tested negative for HIV in early pregnancy. Despite being national policy in Kenya, the available data suggest that implementation rates are low. We conducted 20 in-depth semi-structured interviews with healthcare providers and managers to explore barriers and enablers to implementation of repeat HIV testing guidelines for pregnant women. Participants were from the Nyanza region of Kenya and were purposively selected to provide variation in socio-demographics and job characteristics. Interview transcripts were coded and analyzed in Dedoose software using a thematic analysis approach. Four themes were identified a priori using Ferlie and Shortell's Framework for Change and additional themes were allowed to emerge from the data. Participants identified barriers and enablers at the client, provider, facility, and health system levels. Key barriers at the client level from the perspective of providers included late initial presentation to antenatal care and low proportions of women completing the recommended four antenatal visits. Barriers to offering repeat HIV testing for providers included heavy workloads, time limitations, and failing to remember to check for retest eligibility. At the facility level, inconsistent volume of clients and lack of space required for confidential HIV retesting were cited as barriers. Finally, at the health system level, there were challenges relating to the HIV test kit supply chain and the design of nationally standardized antenatal patient registers. Enablers to improving the implementation of repeat HIV testing included client dissemination of the benefits of antenatal care through word-of-mouth, provider cooperation and task shifting, and it was suggested that use of an electronic health record system could provide automatic reminders for retest eligibility. This study

  20. Psychosocial Factors Associated with Bulimia Nervosa during Pregnancy: An Internal Validation Study

    Science.gov (United States)

    Watson, Hunna J.; Von Holle, Ann; Knoph, Cecilie; Hamer, Robert M.; Torgersen, Leila; Reichborn-Kjennerud, Ted; Stoltenberg, Camilla; Magnus, Per; Bulik, Cynthia M.

    2014-01-01

    Objective The aim of this paper was to internally validate previously reported relations (1) between psychosocial factors and bulimia nervosa (BN) outcomes during pregnancy. Method This study is based on the Norwegian Mother and Child Cohort Study (MoBa) conducted by the Norwegian Institute of Public Health. Participants were women enrolled during pregnancy (N = 69,030). Internal validity was evaluated by way of bootstrapped parameter estimates using the overall sample and a split sample calibration approach. Results Bootstrap bias estimates were below the problematic threshold, and extend earlier findings(1) by providing support for the validity of the models at the population level of all pregnant women in Norway. Bootstrap risk ratios indicated that prevalence, incidence, and remission of BN during pregnancy were significantly associated with psychosocial factors. The split sample procedure showed that the models developed on the training sample did not predict risks in the validation sample. Discussion This study characterizes associations between psychosocial exposures and BN outcomes among pregnant women in Norway. Women with lifetime and current self-reported psychosocial adversities were at a much higher risk for BN during pregnancy. Psychosocial factors were associated with BN remission during pregnancy, inviting the prospect of enhancing therapeutic interventions. We consider the findings in the context of reproducibility in science. PMID:25346291

  1. Predictive factors for the methotrexate treatment outcome in ectopic pregnancy: A comparative study of 400 cases.

    Science.gov (United States)

    Bonin, Lucie; Pedreiro, Cécile; Moret, Stéphanie; Chene, Gautier; Gaucherand, Pascal; Lamblin, Géry

    2017-01-01

    We sought to evaluate the global success rate of intramuscular methotrexate for the treatment of ectopic pregnancy, identify factors predictive of treatment success or failure, and study methotrexate tolerability in a large patient cohort. For this single-center retrospective observational study, we retrieved the records of all women who had a clinically or echographically confirmed ectopic pregnancy with a Fernandez score ectopic pregnancy. The medical treatment protocol was effective for 314 patients, i.e., an overall success rate of 78.5%. A single methotrexate dose was sufficient for 63.5% of the women and a second dose was successful for 73.2% of the remaining women. The medical treatment success rate fell as initial hCG levels climbed. The main factors associated with methotrexate failure included day (D) 0, D4 and D7 hCG levels, pretherapeutic blood progesterone, hematosalpinx at D0 and pain at D7. Early favorable kinetics of hCG levels was predictive of success. Methotrexate treatment was successful in 90% of women who had D0 hCG ectopic pregnancy was 80.7%. In this study, we showed that an initial hCG value ectopic pregnancy by methotrexate, and hematosalpinx and pretherapeutic blood progesterone >5ng/ml at diagnosis were predictive of its failure. We also confirmed good tolerability for single-dose methotrexate protocols. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  2. A comparison of pregnancy outcomes in Ghanaian women with varying dietary diversity: a prospective cohort study protocol

    Science.gov (United States)

    Saaka, Mahama; Siassi, Fereydoun; Qorbani, Mostafa; Yavari, Parvaneh; Danquah, Ina; Sotoudeh, Gity

    2016-01-01

    Introduction Poor dietary intake during pregnancy can have negative repercussions on the mother and fetus. This study therefore aims to explore the dietary diversity (DD) of pregnant women and its associations with pregnancy outcomes among women in Northern Ghana. The main outcome variables to be measured are gestational weight gain and birth weight. Methods and analysis A prospective cohort study design will be used and 600 pregnant women in their first trimester will be systematically recruited at health facilities and followed until delivery. In three follow-up visits after recruitment, information on sociodemographic and general characteristics, physical activity (International Physical Activity Questionnaire (IPAQ) short form, dietary intake (24-hour food recall), anthropometry and pregnancy outcomes will be collected. DD will be measured three times using the minimum DD-women (MDD-W) indicator and the mean of the three values overall will be used to determine low (<5 food groups) and high (≥5 food groups) DD. Data will be analysed using SPSS. Comparisons between groups (categorical data) will be made using the χ2 test for proportions, and t-tests and ANOVA will be performed on continuous variables. Regression analysis will be used to identify independent outcome predictors while controlling for possible confounding factors. The results may help to identify differences in DD between healthy and unhealthy pregnancy outcomes. Ethics and dissemination The study protocol has been approved by the ethics committee of Tehran University of Medical Sciences and the ethical review committee of the Tamale Teaching Hospital. Written informed consent will be obtained from all subjects. The results will be published in due course. PMID:27655259

  3. Happiness and depression in adolescence after maternal smoking during pregnancy: birth cohort study.

    Science.gov (United States)

    Menezes, Ana Maria Baptista; Murray, Joseph; László, Mitzi; Wehrmeister, Fernando C; Hallal, Pedro C; Gonçalves, Helen; Assunção, Maria Cecilia F; Menezes, Carolina Baptista; Barros, Fernando C

    2013-01-01

    Prenatal cigarette smoke exposure may have adverse psychological effects on offspring. The objective was to assess the association between parental smoking during pregnancy and offspring happiness at age 18, as well as depression. Participants were part of a birth cohort study in Pelotas, Brazil (5,249 participants). Happiness was measured by the Subjective Happiness Scale, a Likert-like scale with four questions generating a score from 1 to 7, with ≥ 6 indicating "happiness". Depression was measured using the Mini International Psychiatric Interview. About one third of mothers reported having smoked during pregnancy and 4.6% reported smoking 20 or more cigarettes a day. The prevalence of happiness was 32.2% (95% CI 30.8; 33.7), depression 6.8% (95% CI 6.1; 7.6), and simultaneous happiness and depression less than 1%. The prevalence of offspring happiness decreased as smoking in pregnancy increased, even after control for confounding variables, showing an OR = 0.79 [95% CI 0.55; 1.13]. The opposite happened to depression; the prevalence of offspring depression increased as smoking in pregnancy increased (happiness after adjustment for confounders, but did no show association with offspring depression. Offspring were less likely to be happy and more likely to be depressed if their mother smoked during pregnancy, and less likely to be happy if their father smoked during mother's pregnancy. Although we can not affirm that this is a "causal pathway", public policies to reduce smoking in pregnancy could improve the health of the offspring in the short and long term.

  4. Abuse against women in pregnancy: a population-based study from Eastern India.

    Science.gov (United States)

    Babu, Bontha V; Kar, Shantanu K

    2012-01-01

    Violence against women is widely recognized as an important public health problem. However, the magnitude of the problem among pregnant women is not well known in several parts of India. Hence, the prevalence and characteristics associated with various forms of domestic violence against women in pregnancy were studied in Eastern India. A population-based cross-sectional sample survey covering married women with a history of at least one full-term pregnancy (n 1525) was carried out in the Orissa, West Bengal and Jharkhand states of India. Interviews were conducted using a pre-piloted structured questionnaire to inquire about physical, psychological and sexual domestic violence. Data on socioeconomic characteristics and behaviours were also collected. The association of independent variables with domestic violence were examined by using logistic regression models. The prevalence of physical, psychological and sexual domestic violence during a recent pregnancy was found to be 7.1%, 30.6% and 10.4% respectively, and the lifetime prevalence during all pregnancies was 8.3%, 33.4% and 12.6% respectively. Urban living, higher maternal age and husbands' alcoholism were the factors associated with domestic violence in pregnancy. Women belonging to lower social groups were less likely to have physical domestic violence. Factors such as higher prevalence of undesirable behaviours like denying adequate rest and diet, demand for more sex, not providing antenatal care and pressure for male child were also associated with domestic violence in pregnancy. Considerable proportions of women experience some type of domestic violence during pregnancy. Health-care providers should be able to recognize and respond to pregnant women's victimization and refer them for appropriate support and care.

  5. Happiness and depression in adolescence after maternal smoking during pregnancy: birth cohort study.

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    Ana Maria Baptista Menezes

    Full Text Available BACKGROUND: Prenatal cigarette smoke exposure may have adverse psychological effects on offspring. The objective was to assess the association between parental smoking during pregnancy and offspring happiness at age 18, as well as depression. METHODOLOGY: Participants were part of a birth cohort study in Pelotas, Brazil (5,249 participants. Happiness was measured by the Subjective Happiness Scale, a Likert-like scale with four questions generating a score from 1 to 7, with ≥ 6 indicating "happiness". Depression was measured using the Mini International Psychiatric Interview. RESULTS: About one third of mothers reported having smoked during pregnancy and 4.6% reported smoking 20 or more cigarettes a day. The prevalence of happiness was 32.2% (95% CI 30.8; 33.7, depression 6.8% (95% CI 6.1; 7.6, and simultaneous happiness and depression less than 1%. The prevalence of offspring happiness decreased as smoking in pregnancy increased, even after control for confounding variables, showing an OR = 0.79 [95% CI 0.55; 1.13]. The opposite happened to depression; the prevalence of offspring depression increased as smoking in pregnancy increased (<20 cigarettes/day OR = 1.38 [95% CI 1.03; 1.84] and ≥ 20 cigarettes/day OR = 2.11[95% CI 1.31; 3.40]. Smoking by the partner was associated with decreased offspring happiness after adjustment for confounders, but did no show association with offspring depression. CONCLUSIONS: Offspring were less likely to be happy and more likely to be depressed if their mother smoked during pregnancy, and less likely to be happy if their father smoked during mother's pregnancy. Although we can not affirm that this is a "causal pathway", public policies to reduce smoking in pregnancy could improve the health of the offspring in the short and long term.

  6. Unplanned pregnancy after ultrasound-guided percutaneous microwave ablation of uterine fibroids: A follow-up study.

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    Bing-song, Zhang; Jing, Zhang; Zhi-Yu, Han; Chang-tao, Xu; Rui-fang, Xu; Xiu-mei, Li; Hui, Liu

    2016-01-06

    A follow-up study was performed with 169 women of childbearing age who underwent ultrasound-guided percutaneous microwave ablation (UPMWA) therapy for symptomatic uterine fibroids in the Chinese PLA General Hospital from June 2007 to December 2014. This study aimed to observe the incidence of unplanned pregnancies in these women after UPMWA treatment in order to evaluate its effect on natural conception. Ten unplanned pregnancies in nine women were occurred. Of the nine patients, six did not want the pregnancy and chose for induced abortion to end the pregnancy at an early stage. Three chose to continue with the pregnancy and gave birth to a healthy term infant delivered by cesarean section (of these three patients, two had been previously diagnosed as infertility). None of the patients had any serious obstetric complications. After UPMWA treatment for uterine fibroids, patients may conceive naturally, the impact of the procedure on fertility and pregnancy outcomes is worthy of further prospective study in larger sample.

  7. Does sequential embryo transfer improve pregnancy rate in patients with repeated implantation failure? A randomized control study

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    Wael A. Ismail Madkour

    2015-12-01

    Full Text Available Background: Repeated failure of in vitro fertilization treatment is frustrating to the patients and their clinicians. Various treatment plans and a change of protocol have been suggested for “low responders”; however, patients who fail treatment repeatedly inspite of good quality embryos pose a special therapeutic challenge. Additional challenge would be imposed on that particular group when the local IVF regulating low does not permit surplus embryo freezing. Objective: To examine whether sequential transfer of embryos on day 3 and on day 5 after ovum pick-up improves IVF/ET success rates in patients with repeated consecutive IVF failures (⩾ 3 trials compared to day 3 alone, with the background that local regulation prohibits embryo freezing. Study design: Randomized controlled study. Women scheduled for IVF/ET with repeated consecutive IVF failures (⩾ 3 trials were randomized to either sequential transfer of embryos on day 3 and on day 5 after ovum pick-up (Group I = 74 or conventional day 3 transfer (Group II = 73 as a control. The primary outcome measures were clinical pregnancy rate and implantation rate. The secondary outcome measures were ongoing pregnancy rate and early pregnancy loss. Results: Baseline and cycle characteristics were comparable in both groups. Clinical pregnancy rate (per embryo transfer was significantly higher in sequential ET group (37. 8% compared to that in day 3 group (21.9% (P value <0.05. Also, implantation rate (per embryos transferred was significantly higher in sequential ET group (17.1% compared to that in control group (10.5% (P value <0.01. Similarly, ongoing pregnancy (per embryo transfer was significantly higher in sequential ET group (33. 8% compared to that in day 3 group (19.2% (P value <0.05. Conclusions: Patients with repeated implantation failures, treatment with the sequential embryo transfer approach had significantly improved pregnancy outcomes compared to regular day 3 transfers

  8. [What determines smoking habits in pregnancy? A qualitative study among pregnant smokers].

    Science.gov (United States)

    Haugland, S; Haug, K; Wold, B

    1995-06-30

    In this article we present results from a qualitative study among 33 pregnant smokers, who took part in an in-depth interview in the 27th-35th weeks of pregnancy. The aim was to obtain insight into pregnant women's own experience of smoking in pregnancy. The pregnant women interviewed were concerned about their smoking habits. In spite of this, they still expressed positive attitudes towards smoking, and many did not experience pregnancy as a favourable time to stop. The study shows that pregnant women still lack important knowledge about the dangers of smoking. Pregnant smokers' attitudes towards scientific facts, and the role cigarettes play in their everyday lives, are considered to be important variables in determining smoking in pregnancy. The pregnant women experienced that their partner and health-personnel played a minor role in changing smoking behaviour. The reasons the women gave for smoking in pregnancy are discussed in the light of current theories on changing health behaviour. Four key questions are proposed which can be used by doctor and midwife to obtain knowledge of pregnant women's perception of the seriousness of smoking and the associated risks, and of the gains and barriers connected with quitting.

  9. Evaluating patient values and preferences for thromboprophylaxis decision making during pregnancy: a study protocol

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    Alonso-Coello Pablo

    2012-05-01

    Full Text Available Abstract Background Pregnant women with prior venous thromboembolism (VTE are at risk of recurrence. Low molecular weight heparin (LWMH reduces the risk of pregnancy-related VTE. LMWH prophylaxis is, however, inconvenient, uncomfortable, costly, medicalizes pregnancy, and may be associated with increased risks of obstetrical bleeding. Further, there is uncertainty in the estimates of both the baseline risk of pregnancy-related recurrent VTE and the effects of antepartum LMWH prophylaxis. The values and treatment preferences of pregnant women, crucial when making recommendations for prophylaxis, are currently unknown. The objective of this study is to address this gap in knowledge. Methods We will perform a multi-center cross-sectional interview study in Canada, USA, Norway and Finland. The study population will consist of 100 women with a history of lower extremity deep vein thrombosis (DVT or pulmonary embolism (PE, and who are either pregnant, planning pregnancy, or may in the future consider pregnancy (women between 18 and 45 years. We will exclude individuals who are on full dose anticoagulation or thromboprophylaxis, who have undergone surgical sterilization, or whose partners have undergone vasectomy. We will determine each participant's willingness to receive LMWH prophylaxis during pregnancy through direct choice exercises based on real life and hypothetical scenarios, preference-elicitation using a visual analog scale (“feeling thermometer”, and a probability trade-off exercise. The primary outcome will be the minimum reduction (threshold in VTE risk at which women change from declining to accepting LMWH prophylaxis. We will explore possible determinants of this choice, including educational attainment, the characteristics of the women’s prior VTE, and prior experience with LMWH. We will determine the utilities that women place on the burden of LMWH prophylaxis, pregnancy-related DVT, pregnancy-related PE and pregnancy

  10. Association between periodontal condition and subgingival microbiota in women during pregnancy: a longitudinal study

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    Priscila Viola BORGO

    2014-12-01

    Full Text Available Objectivo In this study, the gingival conditions and the quantitative detection for Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum, Porphyromonas gingivalis and Prevotella intermedia in pregnant women were determined. Material and Methods Quantitative determinations of periodontal bacteria by using a SyBr green system in women during pregnancy were performed. Women at the 2nd and 3rd trimesters of pregnancy and non-pregnant women were included in this study. A. actinomycetemcomitans was observed in high numbers in women at the 2nd and 3rd trimesters of pregnancy with a significant difference (p<0.05. F. nucleatum and P. intermedia were also observed in high levels. Results and Conclusion Our results show that pregnant women are more susceptible to gingivitis, and the presence of A. actinomycetemcomitans in subgingival biofilm might be taken into account for the treatment of periodontal disease.

  11. Association between periodontal condition and subgingival microbiota in women during pregnancy: a longitudinal study

    Science.gov (United States)

    BORGO, Priscila Viola; RODRIGUES, Viviane Aparecida Arenas; FEITOSA, Alfredo Carlos Rodrigues; XAVIER, Karla Correa Barcelos; AVILA-CAMPOS, Mario Julio

    2014-01-01

    Objectivo In this study, the gingival conditions and the quantitative detection for Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum, Porphyromonas gingivalis and Prevotella intermedia in pregnant women were determined. Material and Methods Quantitative determinations of periodontal bacteria by using a SyBr green system in women during pregnancy were performed. Women at the 2nd and 3rd trimesters of pregnancy and non-pregnant women were included in this study. A. actinomycetemcomitans was observed in high numbers in women at the 2nd and 3rd trimesters of pregnancy with a significant difference (p<0.05). F. nucleatum and P. intermedia were also observed in high levels. Results and Conclusion Our results show that pregnant women are more susceptible to gingivitis, and the presence of A. actinomycetemcomitans in subgingival biofilm might be taken into account for the treatment of periodontal disease. PMID:25591021

  12. Accuracy of erythrogram and serum ferritin for the maternal anemia diagnosis (AMA): a phase 3 diagnostic study on prediction of the therapeutic responsiveness to oral iron in pregnancy

    OpenAIRE

    Bresani, Cristiane Campello; Braga, Maria Cynthia; Felisberto, Daniel Falcão; Tavares-de-Melo, Carlos Eduardo Lopes; Salvi, Debora Bresani; Batista-Filho,Malaquias

    2013-01-01

    Background Pregnancy anemia remains as a public health problem, since the official reports in the 70’s. To guide the treatment of iron-deficiency anemia in pregnancy, the haemoglobin concentration is the most used test in spite of its low accuracy, and serum ferritin is the most reliable test, although its cutoff point remains an issue. Methods/design The aim of this protocol is to verify the accuracy of erythrocyte indices and serum ferritin (studied tests) for the diagnosis of functional ir...

  13. Bone mass in Indian children--relationships to maternal nutritional status and diet during pregnancy: the Pune Maternal Nutrition Study.

    Science.gov (United States)

    Ganpule, A; Yajnik, C S; Fall, C H D; Rao, S; Fisher, D J; Kanade, A; Cooper, C; Naik, S; Joshi, N; Lubree, H; Deshpande, V; Joglekar, C

    2006-08-01

    Bone mass is influenced by genetic and environmental factors. Recent studies have highlighted associations between maternal nutritional status during pregnancy and bone mass in the offspring. We hypothesized that maternal calcium intakes and circulating micronutrients during pregnancy are related to bone mass in Indian children. DESIGN/SETTING/PARTICIPANTS/MAIN OUTCOME MEASURES: Nutritional status was measured at 18 and 28 wk gestation in 797 pregnant rural Indian women. Measurements included anthropometry, dietary intakes (24-h recall and food frequency questionnaire), physical workload (questionnaire), and circulating micronutrients (red cell folate and plasma ferritin, vitamin B12, and vitamin C). Six years postnatally, total body and total spine bone mineral content and bone mineral density (BMD) were measured using dual-energy x-ray absorptiometry (DXA) in the children (n = 698 of 762 live births) and both parents. Both parents' DXA measurements were positively correlated with the equivalent measurements in the children (P pregnancy (milk, milk products, pulses, non-vegetarian foods, green leafy vegetables, fruit) had higher total and spine bone mineral content and BMD, and children of mothers with higher folate status at 28 wk gestation had higher total and spine BMD, independent of parental size and DXA measurements. Modifiable maternal nutritional factors may influence bone health in the offspring. Fathers play a role in determining their child's bone mass, possibly through genetic mechanisms or through shared environment.

  14. Health Care Consumption during Pregnancy in relation to Maternal Body Mass Index: A Swedish Population Based Observational Study

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    Elisabeth S. Lindholm

    2015-01-01

    Full Text Available Objective. To assess whether antenatal health care consumption is associated with maternal body mass index (BMI. Design. A register based observational study. Methods. The Swedish Medical Birth Register, the Maternal Health Care Register, and the Inpatient Register were used to determine antenatal health care consumption according to BMI categories for primiparous women with singleton pregnancies, from 2006 to 2008, n=71,638. Pairwise comparisons among BMI groups are obtained post hoc by Tukey HSD test. Result. Obese women were more often admitted for in-patient care (p<0.001, had longer antenatal hospital stays (p<0.001, and were more often sick-listed by an obstetrician (p<0.001 during their pregnancy, compared to women with normal weight women. Preeclampsia was more than four times as common, hypertension five times as common, and gestational diabetes 11 times as common when comparing in-patient care, obese to normal weight women (p<0.001 for all comparisons. Underweight mothers had longer stay in hospitals (p<0.05 and hydronephrosis and hyperemesis gravidarum were more than twice as common (both p<0.001. Conclusion. Obese and underweight mothers consumed significantly more health care resources and obese women were significantly more often sick-listed during their pregnancy when compared to pregnant women of normal weight.

  15. Costs and effects of screening and treating low risk women with a singleton pregnancy for asymptomatic bacteriuria, the ASB study

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    Kazemier Brenda M

    2012-06-01

    Full Text Available Abstract Background The prevalence of asymptomatic bacteriuria (ASB in pregnancy is 2-10% and is associated with both maternal and neonatal adverse outcomes as pyelonephritis and preterm delivery. Antibiotic treatment is reported to decrease these adverse outcomes although the existing evidence is of poor quality. Methods/Design We plan a combined screen and treat study in women with a singleton pregnancy. We will screen women between 16 and 22 weeks of gestation for ASB using the urine dipslide technique. The dipslide is considered positive when colony concentration ≥105 colony forming units (CFU/mL of a single microorganism or two different colonies but one ≥105 CFU/mL is found, or when Group B Streptococcus bacteriuria is found in any colony concentration. Women with a positive dipslide will be randomly allocated to receive nitrofurantoin or placebo 100 mg twice a day for 5 consecutive days (double blind. Primary outcomes of this trial are maternal pyelonephritis and/or preterm delivery before 34 weeks. Secondary outcomes are neonatal and maternal morbidity, neonatal weight, time to delivery, preterm delivery rate before 32 and 37 weeks, days of admission in neonatal intensive care unit, maternal admission days and costs. Discussion This trial will provide evidence for the benefit and cost-effectiveness of dipslide screening for ASB among low risk women at 16–22 weeks of pregnancy and subsequent nitrofurantoin treatment. Trial registration Dutch trial registry: NTR-3068

  16. Access to Pharmacotherapy Amongst Women with Bipolar Disorder during Pregnancy: a Preliminary Study.

    Science.gov (United States)

    Byatt, Nancy; Cox, Lucille; Moore Simas, Tiffany A; Biebel, Kathleen; Sankaran, Padma; Swartz, Holly A; Weinreb, Linda

    2017-07-11

    Bipolar disorder among pregnant women has deleterious effects on birth and child outcomes and is currently under-detected, not addressed effectively, or exacerbated through inappropriate treatment. The goal of this study was to identify perspectives of pregnant and postpartum women with bipolar disorder on barriers and facilitators to psychiatric treatment during pregnancy. In-depth interviews were conducted with pregnant and postpartum women who scored ≥ 10 on the Edinburgh Postnatal Depression Scale and met DSM-IV criteria for bipolar disorder I, II or not otherwise specified using the Mini International Neuropsychiatric Interview version 5.0. Interviews were transcribed, and resulting data were analyzed using a grounded theory approach to identify barriers and facilitators to bipolar disorder treatment access in pregnancy. Participant identified barriers included perception that psychiatric providers lack training and experience in the treatment of psychiatric illness during pregnancy, are reluctant to treat bipolar disorder among pregnant women, and believe that pharmacotherapy is not needed for psychiatric illness during pregnancy. Facilitators included participants' perception that providers' acknowledge risks associated with untreated or undertreated psychiatric illness during pregnancy and provide psycho-education about the risks, benefits and alternatives to pharmacotherapy. Psychiatric providers are critically important to the treatment of bipolar disorder and need knowledge and skills necessary to provide care during the perinatal period. Advancing psychiatric providers' knowledge/skills may improve access to pharmacotherapy for pregnant women with bipolar disorder.

  17. Vitamin, mineral and iron supplementation in pregnancy: cross-sectional study

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    Eric M.

    2010-04-01

    Full Text Available Aim. To assess the use of vitamin, mineral and iron supplements during pregnancy in Zagreb and Novi Sad. Methods. The study was conducted by use of a structured standardized questionnaire consisting of two parts, i. e. data obtained by maternal interview and hospital records. It is designed as a cross-sectional study in two countries (Croatia and Serbia. The study included 893 pregnant women from Zagreb and 6099 pregnant women from Novi Sad. Results. In Zagreb, pregnant women reported highest utilization of vitamin-mineral supplements (n = 508; 56.9 %, whereas in Novi Sad these supplements ranked third (n = 408; 20.3 %, following tocolytics and iron supplements. There was no statistically significant difference in the prevalence of congenital malformations between neonates at in utero exposure to vitamins, minerals and iron supplements and those without such exposure in either Zagreb or Novi Sad arm, with the exception of iron and calcium supplementation in the Zagreb arm. Conclusions. In spite of certain study limitations, the results obtained pointed to the unreasonable and potentially harmful use of these supplements in pregnant women from Zagreb.

  18. Study of Risk Factors of Perinatal Death in Pregnancy Induced Hypertension (PIH

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    Mehul T Parmar, Harsha M Solanki, Vibha V Gosalia

    2012-01-01

    Full Text Available Background: Hypertensive disorders are common complication occurring during pregnancy responsible for maternal & fetal mortality & morbidity. Though the condition is on decline, still stands a public health problem. Objectives: To determine risk factors of perinatal death in women with pregnancy induced hypertension. Materials & Method: A cross-sectional study was conducted over period of one year in the department of Obstetrics & Gynecology in NHL municipal college, Ahmadabad. A total of 100 pregnant women with PIH were enrolled in the study. A pre-tested structured Performa was prepared & women were interviewed to collect necessary information such as detailed history, clinical examination findings & investigations performed. Results were analyzed using MS Excel & Epi Info. Results: In the present study, 29%, 21% & 50 % were of mild PIH, moderate PIH & severe PIH respectively. The incidence of PIH was found more among teenage pregnancy, among primigravidas, those from low socio-economic status, those with history of PIH in previous pregnancy, having family history of PIH & those who were found obese. Emergency delivery, having diastolic blood pressure > 90 mm Hg, higher degree of proteinuria & low birth weight among PIH cases had an adverse perinatal outcome in terms of higher perinatal death. The findings were statistically significant On Univariate analysis; diastolic blood pressure & degree of proteinuria were found to be significant risk factors responsible for perinatal mortality among PIH women. Conclusion: Pregnancy induced hypertension is a common medical disorder associated with pregnancy. In the present study, PIH cases who delivered in emergency, with raised diastolic blood pressure & more proteinuria & neonate with low birth weight were found risk factors for perinatal death. Fetal morbidity & mortality can be reduced by early recognition & institutional management.

  19. Barriers to and facilitators of smoking cessation in pregnancy and following childbirth: literature review and qualitative study.

    Science.gov (United States)

    Bauld, Linda; Graham, Hilary; Sinclair, Lesley; Flemming, Kate; Naughton, Felix; Ford, Allison; McKell, Jennifer; McCaughan, Dorothy; Hopewell, Sarah; Angus, Kathryn; Eadie, Douglas; Tappin, David

    2017-06-01

    central to cessation in pregnancy at an individual level, and that reflected the findings from the reviews, were perception of risk to baby, self-efficacy, influence of close relationships and smoking as a way of coping with stress. Overall, pregnant smokers were faced with more barriers than facilitators. At an interpersonal level, partners' emotional and practical support, willingness to change smoking behaviour and role of smoking within relationships were important. Across the review and interviews of HPs, education to enhance knowledge and confidence in delivering information about smoking in pregnancy and the centrality of the client relationship, protection of which could be a factor in downplaying risks, were important. HPs acknowledged that they could best assist by providing support and understanding, and access to effective interventions, including an opt-out referral pathway to Stop Smoking Services, routine carbon monoxide screening, behavioural support and access to pharmacotherapy. Additional themes at community, organisational and societal levels were also identified. Limitations include a design grounded in qualitative studies, difficulties recruiting SOs, and local service configurations and recruitment processes that potentially skewed the sample. Perceptions and experiences of barriers to and facilitators of smoking cessation in pregnancy are fluid and context dependent. Effective interventions for smoking cessation in pregnancy should take account of the interplay between the individual, interpersonal and environmental aspects of women's lives. Research focus: removing barriers to support, improving HPs' capacity to offer accurate advice, and exploration of weight concerns and relapse prevention. Interventions focus: financial incentives, self-help and social network interventions. This study is registered as PROSPERO CRD42013004170. The National Institute for Health Research Health Technology Assessment programme.

  20. Pregnancy after treatment of breast cancer--a population-based study on behalf of Danish Breast Cancer Cooperative Group

    DEFF Research Database (Denmark)

    Kroman, N.; Jensen, M.B.; Wohlfahrt, J.;

    2008-01-01

    at diagnosis, tumour size, nodal status, or pregnancy history before diagnosis of breast cancer. Neither spontaneous abortions nor induced abortions subsequent to breast cancer treatment had a negative impact on prognosis. CONCLUSION: In line with our previous study, but based on more than twice the patient...... material, we found no evidence that a pregnancy after treatment of breast cancer has a negative influence the prognosis Udgivelsesdato: 2008......BACKGROUND: Estrogen is an established growth factor in breast cancer and it has been hypothesized that pregnancy associated estrogens may increase the risk of recurrence of breast cancer. In 1997 we published a population-based Danish study indicating no negative prognostic effect of pregnancy...

  1. 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

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

    DEFF Research Database (Denmark)

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

    2007-01-01

    women giving birth from the years 1996 to 2002. In addition, national registers exist which can be linked together. Two studies have been initiated. One is a retrospective cohort study concerning primiparous women, with singleton pregnancy and with no identifiable congenital malformation. The purpose...

  3. Pregnancy outcomes in youth with type 2 diabetes: The TODAY Study experience

    Science.gov (United States)

    We evaluated pregnancy outcomes, maternal and fetal/neonatal, during the Treatment Options for type 2 Diabetes in Adolescents and Youth (TODAY) study. The TODAY study was a randomized controlled trial comparing three treatment options for youth with type 2 diabetes. Informed consent included the req...

  4. Domestic Violence during Pregnancy in an Eastern City of Turkey: A Field Study

    Science.gov (United States)

    Arslantas, Hulya; Adana, Filiz; Ergin, Filiz; Gey, Neriman; Bicer, Nejla; Kiransal, Nilufer

    2012-01-01

    Violence is an increasing and important community health problem that can be seen in any area of human life. Limited studies were found about domestic violence among pregnant women and its relation with social status of women. The aim of this study was to determine the prevalence and types of domestic violence during pregnancy, factors affecting…

  5. SHPPS 2006: School Health Policies and Programs Study--Pregnancy Prevention

    Science.gov (United States)

    Centers for Disease Control and Prevention, 2007

    2007-01-01

    The School Health Policies and Programs Study (SHPPS) is a national survey periodically conducted to assess school health policies and programs at the state, district, school, and classroom levels. This brief reports 2006 study results in the area of pregnancy prevention, covering the following topics: (1) Health Education; and (2) Health Services…

  6. Physical Activity Patterns and Factors Related to Exercise during Pregnancy: A Cross Sectional Study.

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    Simony Lira Nascimento

    Full Text Available To assess the physical activity levels of pregnant women and to examine the characteristics associated with the practice of exercise and the activities of daily living during pregnancy.For this cross-sectional study, 1,279 women were recruited within 72 hours postpartum. They were interviewed about their socio-demographic data and obstetric history and were administered self-report questionnaires about exercise and daily physical activities during pregnancy. Data on the current pregnancy, labor, delivery, and newborn outcomes were collected from participants' medical records. To analyze factors related to the practice of exercise, we used the student t-test, X², and odds ratio (OR, with a corresponding 95% confident interval (CI, followed by a multiple logistic regression. The significance level was 5%.Compared to the pre-pregnancy period, the prevalence of physical activity among participants was lower throughout pregnancy (20.1% (p = 0.01. Half of the women interrupted practicing physical exercise due to pregnancy. The lowest prevalence of exercise was observed in the first (13.6% and third trimesters (13.4%. Less than half of women received exercise guidance during prenatal care meetings (47.4%. Walking was the most commonly reported exercise, followed by water aerobics. Factors positively associated with exercise practice were higher educational level (OR= 1.82; CI 95% 1.28-2.60, primiparity (OR=1.49; CI 95% 1.07-2.07, exercising before pregnancy (OR= 6.45; CI 95% 4.64-8.96, and exercise guidance during prenatal care (OR=2.54; CI 95% 1.80-3.57. Mildly intense exercise and domestic activities were most frequently reported among pregnant women. There were no differences in maternal and perinatal outcomes between active and sedentary pregnant women.The findings indicate that promoting physical activity remains a priority in public health policy, and women of childbearing age, especially those planning a pregnancy, should be encouraged to adopt

  7. Sonographic Evaluation of the Splenic Length in Normal Pregnancy in a Tertiary Hospital in Southern Nigeria: A Pilot Study

    OpenAIRE

    Ugboma, EW; Ugboma, HAA

    2013-01-01

    Background: The spleen is affected by the changes that occur in pregnancy. Ultrasound is the commonest imaging modality used in the evaluation of the abdominal organs in pregnancy; however, there is a paucity of information on the sonographic measurement of the splenic length in normal pregnancy in our environment. Aim: To establish sonographically the range of splenic length in normal pregnant women. Subjects and Methods: A prospective descriptive cross sectional study of the sonographic mea...

  8. Tobacco and alcohol use in pregnancy in France: The role of migrant status: The nationally representative ELFE study

    OpenAIRE

    Melchior, Maria; Chollet, Aude; Glangeaud-Freudenthal, Nine,; Saurel-Cubizolles, Marie-Josèphe; Dufourg, Marie-Noëlle; Van Der Waerden, Judith; Sutter-Dallay, Anne-Laure

    2015-01-01

    International audience; Introduction : Tobacco and alcohol use in pregnancy are modifiable yet frequent risk factors of poor perinatal outcomes. We examined whether characteristics associated with substance use in pregnancy vary between native and migrant women, who often differ in terms of socio-demographic characteristics.Methods : Data come from a nationally representative sample of children born in France in 2011 (ELFE study, n = 18,014). Maternal substance use in pregnancy (tobacco: ≥ 1 ...

  9. The association of factor V leiden and prothrombin gene mutation and placenta-mediated pregnancy complications: a systematic review and meta-analysis of prospective cohort studies.

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    Marc A Rodger

    2010-06-01

    Full Text Available BACKGROUND: Factor V Leiden (FVL and prothrombin gene mutation (PGM are common inherited thrombophilias. Retrospective studies variably suggest a link between maternal FVL/PGM and placenta-mediated pregnancy complications including pregnancy loss, small for gestational age, pre-eclampsia and placental abruption. Prospective cohort studies provide a superior methodologic design but require larger sample sizes to detect important effects. We undertook a systematic review and a meta-analysis of prospective cohort studies to estimate the association of maternal FVL or PGM carrier status and placenta-mediated pregnancy complications. METHODS AND FINDINGS: A comprehensive search strategy was run in Medline and Embase. Inclusion criteria were: (1 prospective cohort design; (2 clearly defined outcomes including one of the following: pregnancy loss, small for gestational age, pre-eclampsia or placental abruption; (3 maternal FVL or PGM carrier status; (4 sufficient data for calculation of odds ratios (ORs. We identified 322 titles, reviewed 30 articles for inclusion and exclusion criteria, and included ten studies in the meta-analysis. The odds of pregnancy loss in women with FVL (absolute risk 4.2% was 52% higher (OR = 1.52, 95% confidence interval [CI] 1.06-2.19 as compared with women without FVL (absolute risk 3.2%. There was no significant association between FVL and pre-eclampsia (OR = 1.23, 95% CI 0.89-1.70 or between FVL and SGA (OR = 1.0, 95% CI 0.80-1.25. PGM was not associated with pre-eclampsia (OR = 1.25, 95% CI 0.79-1.99 or SGA (OR 1.25, 95% CI 0.92-1.70. CONCLUSIONS: Women with FVL appear to be at a small absolute increased risk of late pregnancy loss. Women with FVL and PGM appear not to be at increased risk of pre-eclampsia or birth of SGA infants. Please see later in the article for the Editors' Summary.

  10. Observational cohort study of pregnancy outcome after first-trimester exposure to fluoroquinolones.

    Science.gov (United States)

    Padberg, Stephanie; Wacker, Evelin; Meister, Reinhard; Panse, Mary; Weber-Schoendorfer, Corinna; Oppermann, Marc; Schaefer, Christof

    2014-08-01

    Fluoroquinolones are avoided during pregnancy due to developmental toxicity in animals. The aim of this study was to assess the fetal risk after intrauterine fluoroquinolone exposure. We performed an observational study of a prospectively ascertained cohort of pregnant women exposed to a fluoroquinolone during the first trimester. Pregnancy outcomes were compared to those of a cohort exposed to neither fluoroquinolones nor teratogenic or fetotoxic drugs. The outcomes evaluated were major birth defects (structural abnormalities of medical, surgical, or cosmetic relevance), spontaneous abortion, and elective termination of pregnancy. Pregnancy outcomes of 949 women with fluoroquinolone treatment were compared with those of 3,796 nonexposed controls. Neither the rate of major birth defects (2.4%; adjusted odds ratio [OR(adj)], 0.91; 95% confidence interval [CI], 0.6 to 1.5) nor the risk of spontaneous abortion (adjusted hazard ratio [HR(adj)], 1.01; 95% CI, 0.8 to 1.3) was increased. However, there was a nonsignificant increase in major birth defects after exposure to moxifloxacin (6/93, 6.5%; crude odds ratio [OR(crude)], 2.40; 95% CI, 0.8 to 5.6). Neither a critical exposure time window within the first trimester nor a specific pattern of birth defects was demonstrated for any of the fluoroquinolones. The rate of electively terminated pregnancies was increased among the fluoroquinolone-exposed women (HR(adj), 1.32; 95% CI, 1.03 to 1.7). The gestational ages at delivery and birth weights did not differ between groups. Our study did not detect an increased risk of spontaneous abortion or major birth defects. These reassuring findings support the recommendation to allow fluoroquinolone use in early pregnancy in selected cases. After the use of moxifloxacin, a detailed fetal ultrasound examination should be considered. Copyright © 2014, American Society for Microbiology. All Rights Reserved.

  11. Can insomnia in pregnancy predict postpartum depression? A longitudinal, population-based study.

    Directory of Open Access Journals (Sweden)

    Signe K Dørheim

    Full Text Available BACKGROUND: Insomnia and depression are strongly interrelated. This study aimed to describe changes in sleep across childbirth, and to evaluate whether insomnia in pregnancy is a predictor of postpartum depression. METHODS: A longitudinal, population-based study was conducted among perinatal women giving birth at Akershus University Hospital, Norway. Women received questionnaires in weeks 17 and 32 of pregnancy and eight weeks postpartum. This paper presents data from 2,088 of 4,662 women with complete data for insomnia and depression in week 32 of pregnancy and eight weeks postpartum. Sleep times, wake-up times and average sleep durations were self-reported. The Bergen Insomnia Scale (BIS was used to measure insomnia. The Edinburgh Postnatal Depression Scale (EPDS was used to measure depressive symptoms. RESULTS: After delivery, sleep duration was reduced by 49 minutes (to 6.5 hours, and mean sleep efficiency was reduced from 84% to 75%. However, self-reported insomnia scores (BIS improved from 17.2 to 15.4, and the reported prevalence of insomnia decreased from 61.6% to 53.8%. High EPDS scores and anxiety in pregnancy, fear of delivery, previous depression, primiparity, and higher educational level were risk factors for both postpartum insomnia and depression. Insomnia did not predict postpartum depression in women with no prior history of depression, whereas women who recovered from depression had residual insomnia. LIMITATIONS: Depression and insomnia were not verified by clinical interviews. Women with depressive symptoms were less likely to remain in the study. CONCLUSIONS: Although women slept fewer hours at night after delivery compared to during late pregnancy, and reported more nights with nighttime awakenings, their self-reported insomnia scores improved, and the prevalence of insomnia according to the DSM-IV criteria decreased. Insomnia in pregnancy may be a marker for postpartum recurrence of depression among women with previous

  12. Antiepileptic drugs prescribed in pregnancy and prevalence of major congenital malformations: comparative prevalence studies

    Science.gov (United States)

    Petersen, Irene; Collings, Shuk-Li; McCrea, Rachel L; Nazareth, Irwin; Osborn, David P; Cowen, Phil J; Sammon, Cormac J

    2017-01-01

    Objective The aim of this study was to examine the prevalence of major congenital malformations associated with antiepileptic drug (AED) treatment in pregnancy. Patients and methods Using data from The Health Improvement Network, we identified women who have given live birth and their offspring. Four subgroups were selected based on the AED treatment in early pregnancy, valproate, carbamazepine, lamotrigine and women not receiving AED treatment. We compared the prevalence of major congenital malformations within children of these four groups and estimated prevalence ratios (PRs) using Poisson regression adjusted for maternal age, sex of child, quintiles of Townsend deprivation score and indication for treatment. Results In total, 240,071 women were included in the study. A total of 229 women were prescribed valproate in pregnancy, 357 were prescribed lamotrigine and 334 were prescribed carbamazepine and 239,151 women were not prescribed AEDs. Fifteen out of 229 (6.6%) women prescribed valproate gave birth to a child with a major congenital malformation. The figures for lamotrigine, carbamazepine and women not prescribed AEDs were 2.7%, 3.3% and 2.2%, respectively. The prevalence of major congenital malformation was similar for women prescribed lamotrigine or carbamazepine compared to women with no AED treatment in pregnancy. For women prescribed valproate in polytherapy, the prevalence was fourfold higher. After adjustments, the effect of estimates attenuated, but the prevalence remained two- to threefold higher in women prescribed valproate. Conclusion The results of our study suggest that lamotrigine and carbamazepine are safer treatment options than valproate in pregnancy and should be considered as alternative treatment options for women of childbearing potential and in pregnancy. PMID:28243149

  13. Pregnancy and Antiphospholipid Syndrome.

    Science.gov (United States)

    Schreiber, Karen; Hunt, Beverley J

    2016-10-01

    Antiphospholipid syndrome (APS) is classified as the association of thrombotic events and/or obstetric morbidity in patients persistently positive for antiphospholipid antibodies (aPL). APS is also the most frequently acquired risk factor for a treatable cause of recurrent pregnancy loss and increases the risk of conditions associated with ischemic placental dysfunction, such as stillbirth, intrauterine death, preeclampsia, premature birth, and fetal growth restriction. The use of low-dose aspirin and heparin has improved the pregnancy outcome in obstetric APS and approximately 70% of pregnant women with APS will deliver a viable live infant. However, current management does not prevent all maternal, fetal, and neonatal complications of APS and the current treatment fails in 20 to 30% of APS pregnancies, raising the need to explore other treatments to improve obstetrical outcome. Two clinical studies of retrospective design have suggested that the immunomodulator hydroxychloroquine (HCQ) may play a role in the prevention of pregnancy complications in women with aPL and APS. The randomized controlled multicenter trial of hydroxychloroquine versus placebo during pregnancy in women with antiphospholipid antibodies (HYPATIA) of HCQ versus placebo will provide scientific evidence on the use of HCQ in pregnant women with aPL.

  14. Sexual Problems During Pregnancy and After Delivery Among Women With and Without Anxiety and Depressive Disorders Prior to Pregnancy: A Prospective-Longitudinal Study.

    Science.gov (United States)

    Asselmann, Eva; Hoyer, Jurgen; Wittchen, Hans-Ulrich; Martini, Julia

    2016-01-01

    Few prospective-longitudinal studies have examined the course of sexual problems during pregnancy and after delivery in women with and without anxiety and depressive disorders prior to pregnancy as well as with and without maternal birth injuries. To prospectively investigate associations of anxiety and depressive disorders prior to pregnancy and maternal birth injuries with sexual problems during the peripartum period. The Maternal Anxiety in Relation to Infant Development Study is a prospective-longitudinal study of 306 women enrolled during early pregnancy and repeatedly assessed in seven waves during the peripartum period. Anxiety and depressive disorders prior to pregnancy were assessed in early pregnancy (T1) using the Composite International Diagnostic Interview for Women. Maternal birth injuries were assessed by questionnaire shortly after delivery (T4). Sexual problems during pregnancy (T2) as well as 4 months (T6) and 16 months (T7) postpartum were measured using the German version of the Massachusetts General Hospital Sexual Function Questionnaire. Impairment of sexual interest, arousal, orgasm, lubrication, and overall sexual satisfaction at T2, T6, and T7. Rates of sexual problems generally increased from T2 to T6 and decreased from T6 to T7. Compared with women without anxiety and depressive disorders, those with comorbid anxiety and depressive disorders prior to pregnancy more often specified impairment of overall sexual satisfaction at T2 (odds ratio [OR] = 2.0) and T7 (OR = 2.1). In contrast, sexual problems were not pronounced in those with pure anxiety or pure depressive disorders, and women with pure anxiety disorders often reported even less impairment of sexual interest at T7 (OR = 0.5). Compared with women without birth injury, those with vaginal birth injury more often reported impairment of sexual interest (OR = 1.8) and lubrication (OR = 2.3) at T6. Findings suggest that especially women with comorbid anxiety and depression and vaginal

  15. Metamizol (dipyrone, optalgin) in pregnancy, is it safe? A prospective comparative study.

    Science.gov (United States)

    Bar-Oz, Benjamin; Clementi, Maurizio; Di Giantonio, Elena; Greenberg, Revital; Beer, Monic; Merlob, Paul; Arnon, Judy; Ornoy, Asher; Zimmerman, Deena M; Berkovitch, Matitiahu

    2005-04-01

    To assess the teratogenic effect of metamizol when used during the first trimester of pregnancy. One hundred and eight women who used metamizol during the first trimester of pregnancy were recruited from 4 teratogen information centers in Israel (3) and in Italy (1). The study group was paired for age, smoking habits and alcohol consumption with a comparative group exposed to acetaminophen. Maternal demographics and history, birth weight, gestational age at delivery, rate of live births, spontaneous abortions and fetal distress were comparable in both groups. The rate of major malformations in the metamizol group (3%) did not differ significantly from the rate in the comparative group (2%) (P = 0.57, relative risk = 1.55, 95% confidence interval 0.26-9.05). Our data may suggest that exposure to metamizol during the first trimester of pregnancy is probably not associated with a significantly increased risk for malformations or spontaneous abortions.

  16. Healthcare databases in Europe for studying medicine use and safety during pregnancy

    DEFF Research Database (Denmark)

    Charlton, Rachel A; Neville, Amanda J; Jordan, Sue

    2014-01-01

    PURPOSE: The aim of this study was to describe a number of electronic healthcare databases in Europe in terms of the population covered, the source of the data captured and the availability of data on key variables required for evaluating medicine use and medicine safety during pregnancy. METHODS......: A sample of electronic healthcare databases that captured pregnancies and prescription data was selected on the basis of contacts within the EUROCAT network. For each participating database, a database inventory was completed. RESULTS: Eight databases were included, and the total population covered was 25...... million. All databases recorded live births, seven captured stillbirths and five had full data available on spontaneous pregnancy losses and induced terminations. In six databases, data were usually available to determine the date of the woman's last menstrual period, whereas in the remainder, algorithms...

  17. Cobalamin status during normal pregnancy and postpartum: a longitudinal study comprising 406 danish women

    DEFF Research Database (Denmark)

    Milman, N; Byg, KE; Bergholt, T;

    2006-01-01

    OBJECTIVES: To assess cobalamin (vitamin B(12)) status during normal pregnancy and postpartum in a longitudinal setting. METHODS: This study was performed in 1995-1996. It comprised 406 healthy, pregnant Danish Caucasian women, living in Copenhagen County. Cobalamin status, i.e. plasma (P......-) cobalamin, P-methylmalonic acid and P-homocysteine was measured at 18, 32 and 39 wk gestation and 8 wk postpartum during lactation. RESULTS: P-cobalamin showed a gradual, significant decline during pregnancy (P ... and 8 wk postpartum median values were 225, 172, 161 and 319 pmol/L, respectively. P-methylmalonic displayed a gradual, significant increase during pregnancy as well as postpartum (P homocysteine demonstrated...

  18. Study of Continuance Rate and Related Causes of Discontinuance of Pregnancy Prevention Methods among Women in Yazd

    Directory of Open Access Journals (Sweden)

    H Fallahzadeh

    2008-04-01

    Full Text Available Introduction: From maturity to menopause, women are worried about pregnancy. Abstinence from sex or use of pregnancy prevention methods are choices for them. As abstinence is impossible, the only remaining choice is use of pregnancy prevention methods. Effective control of pregnancy is really essential for the health of mother and infant and also control of unplanned increase in population. Regarding the importance of continuance rate of pregnancy prevention methods (OCP, IUD, Condom &DMPA & the reasons for their disruption, this study was carried out with the aim of determining the continuance rate and reasons for discontinuance of pregnancy prevention methods in Yazd women. Methods: This was a cross-sectional study. Six urban health care centers of Yazd were selected as study clusters and information of 15-49 year old women using the pregnancy prevention methods (OCP, IUD, Condom& injection was collected via a questionnaire. The data collected was analyzed by Coplan- Mayer statistic method and variance analysis test. Results: Pregnancy prevention methods were most prevalent in the 25-34 years old age group (57%. Mean duration of pregnancy prevention method usage was 27.98 months using Caplan-mayer method with a median of 24 months. 86.3% for 6 months, 72.8% for 12 months, 62.5% for 18 months, 47.9% for 24 months, 39.9% for 30 months and 37% for 37 months had used four certain methods of pregnancy prevention (OCP, IUD, Condom and Injection. The reasons of discontinuance were disease (15.6% for OCPS, bleeding (27% for IUD, unwanted pregnancy (21% for Condoms and also disease (75% for Injection method. Discussion: According to the results, not only education programs regarding family planning before starting each pregnancy prevention method to women is recommended, but a complete incentive consultation about these methods is essential. This educational & consultation programs should be implemented initially for women using OCP method.

  19. The Lived Experience of Pregnancy Among HIV-Positive Refugee Women: A Qualitative Study.

    Science.gov (United States)

    Chulach, Teresa; Gagnon, Marilou; Holmes, Dave

    2016-01-01

    Increasingly HIV-positive refugee women are becoming pregnant. The objective of this qualitative study was to describe and explore the meaning and experience of pregnancy from the perspective of HIV-positive refugee women. The phenomenological analysis revealed 4 core themes. "Making up stories" for privacy and protection emerged as the first theme. The second theme illuminates 2 types of isolation: a double isolation based on refugee and HIV statuses, and isolation endured throughout the pregnancy. Being-in-Between describes the third theme. Finally, the fourth theme sheds light on the experience of disconnection: from baby, culture, body/self, and health care providers.

  20. Study of Abnormal Liver Function Test during Pregnancy in a Tertiary Care Hospital in Chhattisgarh.

    Science.gov (United States)

    Mishra, Nalini; Mishra, V N; Thakur, Parineeta

    2016-10-01

    Abnormal liver function tests (LFTs) in pregnancy require proper interpretation in order to avoid pitfalls in the diagnosis. The underlying disorder can have a significant effect on the outcome of both mother and foetus. The present study was done with the objective to study the clinical profile, incidence and possible causes of derangements of liver function tests. Eighty pregnant women with abnormal liver dysfunction were studied prospectively. Women with chronic liver disease and drug-induced abnormal liver function test were excluded. All available LFTs including LDH were studied along with some more definitive tests to aid identification of underlying cause. Foetomaternal outcome was noted in all. The incidence of abnormal LFT was 0.9 %. 13/80 (16.75 %) women had liver disorder not specific to pregnancy, whereas 67/80 (83.25 %) women had pregnancy-specific liver dysfunction. Of these, 65(81.25 %) women with liver dysfunction had pre-eclampsia including 11 (13.75 %) with HELLP and six women with eclampsia. 48/65 (60 %) women had pre-eclampsia in the absence of HELLP syndrome or eclampsia. The mean value for bilirubin (mg %) in hypertensive disorders of pregnancy ranged from 1.64 to 3.8, between 5 and 10 for ICP and AFLP and >10 in infective hepatitis. Transaminases were highest in infective hepatitis, whereas alkaline phosphate was highest in ICP. Total 27 (33.75 %) women suffered from adverse outcome with four (5 %) maternal deaths and 23 (28.75 %) major maternal morbidities. 33/80 (41.25 %) women had intrauterine death. 26.25 % babies were small for date. Pregnancy-specific disorders are the leading cause of abnormal liver function test during pregnant state particularly in the third trimester. Pre-eclampsia-related disorder is the commonest. Gestational age of pregnancy and relative values of various liver function tests in different pregnancy-specific and pregnancy nonspecific disorders appear to be the best guide to clinch the diagnosis.

  1. A prospective cohort study of alcohol exposure in early and late pregnancy within an urban population in Ireland.

    LENUS (Irish Health Repository)

    Murphy, Deirdre J

    2014-02-01

    Most studies of alcohol consumption in pregnancy have looked at one time point only, often relying on recall. The aim of this longitudinal study was to determine whether alcohol consumption changes in early and late pregnancy and whether this affects perinatal outcomes. We performed a prospective cohort study, conducted from November 2010 to December 2011 at a teaching hospital in the Republic of Ireland. Of the 907 women with a singleton pregnancy who booked for antenatal care and delivered at the hospital, 185 (20%) abstained from alcohol in the first trimester but drank in the third trimester, 105 (12%) consumed alcohol in the first and third trimesters, and the remaining 617 (68%) consumed no alcohol in pregnancy. Factors associated with continuing to drink in pregnancy included older maternal age (30-39 years), Irish nationality, private healthcare, smoking, and a history of illicit drug use. Compared to pre-pregnancy, alcohol consumption in pregnancy was markedly reduced, with the majority of drinkers consuming ≤ 5 units per week (92% in first trimester, 72-75% in third trimester). Perhaps because of this, perinatal outcomes were similar for non-drinkers, women who abstained from alcohol in the first trimester, and women who drank in the first and third trimester of pregnancy. Most women moderate their alcohol consumption in pregnancy, especially in the first trimester, and have perinatal outcomes similar to those who abstain.

  2. A prospective longitudinal cohort study: evolution of GERD symptoms during the course of pregnancy

    Directory of Open Access Journals (Sweden)

    Fill Malfertheiner Sara

    2012-09-01

    Full Text Available Abstract Background Symptoms of gastro-esophageal reflux disease (GERD in pregnancy are reported with a prevalence of 30–80%. The aim of this study was to assess the prevalence and severity of GERD symptoms during the course of pregnancy. Furthermore current practice in medical care for GERD during pregnancy was assessed. Methods We performed a prospective longitudinal cohort study on 510 pregnant women (mean age 28.12, SD 5.3. Investigations for reflux symptoms where based on the use of validated reflux-disease questionnaire (RDQ. Additional information was collected about the therapy. A group of non-pregnant women (mean age 24.56, SD 5.7 was included as controls. Frequency and severity of reflux symptoms were recorded in each trimester of pregnancy. Results The prevalence of GERD symptoms in pregnant women increased from the first trimester with 26.1 to 36.1% in the second trimester and to 51.2% in the third trimester of pregnancy. The prevalence of GERD symptoms in the control group was 9.3%. Pregnant women received medication for their GERD symptoms in 12.8% during the first, 9.1% during the second and 15.7% during the third trimester. Medications used >90% antacids, 0% PPI. Conclusion GERD symptoms occur more often in pregnant women than in non-pregnant and the frequency rises in the course of pregnancy. Medical therapy is used in a minority of cases and often with no adequate symptom relief.

  3. Maternal Blood Lipid Profile during Pregnancy and Associations with Child Adiposity: Findings from the ROLO Study.

    Science.gov (United States)

    Geraghty, Aisling A; Alberdi, Goiuri; O'Sullivan, Elizabeth J; O'Brien, Eileen C; Crosbie, Brenda; Twomey, Patrick J; McAuliffe, Fionnuala M

    2016-01-01

    The in-utero environment affects fetal development; it is vital to understand how maternal diet during pregnancy influences childhood body composition. While research indicates that triglycerides in hyperglycaemic women may increase birth weight, little is known about this relationship in euglycemic women. This study examines the relationship between maternal blood lipid status and infant adiposity up to 2 years of age. Data from 331 mother-child pairs from the ROLO longitudinal birth cohort study was analysed. Maternal dietary intakes were recorded and fasting blood lipids, leptin and HOMA were measured in early and late pregnancy and cord blood. Infant anthropometric measurements and skin-fold thicknesses were recorded at birth, 6 months and 2 years. Correlation and regression analyses were used to explore associations between maternal blood lipid status and infant adiposity. All maternal blood lipids increased significantly during pregnancy. Maternal dietary fat intake was positively associated with total cholesterol levels in early pregnancy. Late pregnancy triglycerides were positively associated with birth weight (P = 0.03) while cord blood triglycerides were negatively associated with birth weight (P = 0.01). Cord HDL-C was negatively associated with infant weight at 6 months (P = 0.005). No other maternal blood lipids were associated with infant weight or adiposity up to 2 years of age. Maternal and fetal triglycerides were associated with birth weight and cord HDL-C with weight at 6 months. Thus, maternal lipid concentrations may exert in-utero influences on infant body composition. There may be potential to modulate infant body composition through alteration of maternal diet during pregnancy.

  4. 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.

  5. Correlation of serum fructosamine and recurrent pregnancy loss: Case-control study.

    Science.gov (United States)

    Romero, Stephanie T; Sharshiner, Rita; Stoddard, Gregory J; Ware Branch, D; Silver, Robert M

    2016-07-01

    Pre-gestational diabetes is associated with an elevated risk of pregnancy loss, but it is unclear whether subclinical glucose intolerance is associated with pregnancy loss, especially recurrent pregnancy loss (RPL). The aim of this study was therefore to compare maternal serum fructosamine (a marker of glycemic control) in patients with and without RPL. A case-control study was carried out of 117 women with unexplained RPL, defined as two or more pregnancy losses with no more than one live birth, and 117 age-matched controls with at least one full-term uncomplicated pregnancy and no more than one pregnancy loss. No RPL patients or controls had a clinical diagnosis of pre-gestational or gestational diabetes. Maternal serum was analyzed for fructosamine on quantitative spectrophotometry. Mean body mass index (BMI) of RPL patients was 26.0 ± 6.4 kg/m(2) compared with 26.6 ± 5.8 kg/m(2) (P = 0.40). Fructosamine was higher in women with RPL (224.1 ± 28.79 μmol/mL) compared with controls (188.9 ± 19.3 μmol/mL, P 285 μmol/L) was similar in RPL patients and controls. The RPL patients and controls had a similar proportion of women with elevated fructosamine considered diagnostic of diabetes. Serum fructosamine was increased in women with RPL compared with controls. Thus, subclinical glucose intolerance may be associated with an increased risk of RPL. These data support further investigation into the mechanisms of RPL associated with glucose intolerance, but do not support testing for subclinical glucose intolerance in women with RPL. © 2016 Japan Society of Obstetrics and Gynecology.

  6. Exploring Australian women’s level of nutrition knowledge during pregnancy: a cross-sectional study

    Science.gov (United States)

    Bookari, Khlood; Yeatman, Heather; Williamson, Moira

    2016-01-01

    Background The Australian Guide to Healthy Eating (AGHE) for pregnancy provides a number of food- and nutrition-related recommendations to assist pregnant women in optimizing their dietary behavior. However, there are limited data demonstrating pregnant women’s knowledge of the AGHE recommendations. This study investigated Australian pregnant women’s knowledge of the AGHE and related dietary recommendations for maintaining a healthy pregnancy. The variations in nutrition knowledge were compared with demographic characteristics. Methods A cross-sectional study assessed eight different nutrition knowledge domains and the demographic characteristics of pregnant women. Four hundred women across Australia completed a multidimensional online survey based on validated and existing measures. Results More than half of the pregnant women surveyed (65%) were not familiar with the AGHE recommendations. The basic recommendations to eat more fruit, vegetables, bread, and cereals but less meat were poorly understood. An in-depth investigation of knowledge of nutrition information revealed misconceptions in a range of areas, including standard serving size, nutrients content of certain foods, energy density of fat, and the importance of key nutrients in pregnancy. Univariate analysis revealed significant demographic variation in nutrition knowledge scores. Multiple regression analysis confirmed the significant independent effects on respondents’ nutrition knowledge score (P<0.000) of the education level, income, age, stage of pregnancy, language, and having a health/nutrition qualification. The model indicated that independent variables explained 33% (adjusted R2) of the variance found between respondents’ knowledge scores. Conclusion Australian pregnant women’s knowledge regarding AGHE for pregnancy and other key dietary recommendations is poor and varies significantly with their demographic profile. The setting of dietary guidelines is not sufficient to ensure

  7. Healthcare databases in Europe for studying medicine use and safety during pregnancy.

    Science.gov (United States)

    Charlton, Rachel A; Neville, Amanda J; Jordan, Sue; Pierini, Anna; Damase-Michel, Christine; Klungsøyr, Kari; Andersen, Anne-Marie Nybo; Hansen, Anne Vinkel; Gini, Rosa; Bos, Jens H J; Puccini, Aurora; Hurault-Delarue, Caroline; Brooks, Caroline J; de Jong-van den Berg, Lolkje T W; de Vries, Corinne S

    2014-06-01

    The aim of this study was to describe a number of electronic healthcare databases in Europe in terms of the population covered, the source of the data captured and the availability of data on key variables required for evaluating medicine use and medicine safety during pregnancy. A sample of electronic healthcare databases that captured pregnancies and prescription data was selected on the basis of contacts within the EUROCAT network. For each participating database, a database inventory was completed. Eight databases were included, and the total population covered was 25 million. All databases recorded live births, seven captured stillbirths and five had full data available on spontaneous pregnancy losses and induced terminations. In six databases, data were usually available to determine the date of the woman's last menstrual period, whereas in the remainder, algorithms were needed to establish a best estimate for at least some pregnancies. In seven databases, it was possible to use data recorded in the databases to identify pregnancies where the offspring had a congenital anomaly. Information on confounding variables was more commonly available in databases capturing data recorded by primary-care practitioners. All databases captured maternal co-prescribing and a measure of socioeconomic status. This study suggests that within Europe, electronic healthcare databases may be valuable sources of data for evaluating medicine use and safety during pregnancy. The suitability of a particular database, however, will depend on the research question, the type of medicine to be evaluated, the prevalence of its use and any adverse outcomes of interest. © 2014 The Authors. Pharmacoepidemiology and Drug Safety published by John Wiley & Sons, Ltd. © 2014 The Authors. Pharmacoepidemiology and Drug Safety published by John Wiley & Sons, Ltd.

  8. Physical Activity Patterns During Pregnancy in a Sample of Portuguese Women: A Longitudinal Prospective Study

    Science.gov (United States)

    Santos, Paula Clara; Abreu, Sandra; Moreira, Carla; Santos, Rute; Ferreira, Margarida; Alves, Odete; Moreira, Pedro; Mota, Jorge

    2016-01-01

    Background Physical activity (PA) patterns during pregnancy have not been explored in depth and most previous studies lack assessment of variables such as type, frequency, duration and intensity of activity. Objectives This study had two goals: 1) to analyze PA patterns during pregnancy according to weekly time spent on different types of activity; and 2) to determine women’s perception about health care providers regarding PA advisement during pregnancy. Patients and Methods A longitudinal prospective study was carried out with a 118-pregnant women cohort. Participants were evaluated during all trimesters. Self-reported questionnaires were used to collect personal and obstetric data. Type, duration and frequency of PA were evaluated using the pregnancy physical activity questionnaire (PPAQ) and intensity levels were calculated. Repeated measure analysis of variance was performed to determine differences between trimesters, and Wilcoxon signed-rank test was performed when appropriate. Results A decrease in values of self-reported PA (MET.h.wk-1) was found from the first to the second and the first to the third trimester of pregnancy, respectively; total (270.91 vs 220.54 vs 210.35; P pregnancy. Women spent most of their weekly time during the entire pregnancy on household and caregiving activities, occupational activities and leisure, except sport activities. Swimming was the most reported organized PA, reaching its highest proportion (12.7%) in the second trimester. Prenatal exercise classes were reported by 39.8% of women during the 3rd trimester. Pregnant women reported that PA was recommended by health professionals: 53.9% in the 1st trimester, 70.4% in the 2nd trimester and 56.8% in the 3rd trimester. Conclusions Self-reported PA decreased, especially from the first to the second trimester, in total, light and moderate intensity. Women spent most of their weekly time on domestic, occupational and leisure activities, except sport activities. There are some

  9. The Study of Congenital Anomalies Resulting in Legal Termination of Pregnancy in Iran

    Directory of Open Access Journals (Sweden)

    Saeid Dastgiri

    2015-08-01

    Full Text Available Background and objectives : Safe pregnancy is among the goals and missions of reproductive health which has an important part in Millennium Development Goals. Unfortunately, bad conditions in reproductive health are the major cause of women mortality in fertility age all over the world especially in developing countries. Congenital anomalies are pregnancy problems that in case of early diagnosis, the anomaly will be done according to list 51. The aim of this study was to determine families’ demographic situations, frequency of congenital anomalies types and the factors of legally termination of pregnancy to suggest solutions in order to reduce anomalies and promote reproductive health. Material and Methods : This is a case-control study carried out for 1 year period from 2010 to 2011 in which 603 pregnant women that were diagnosed/recommended to the Legal Medicine Organization for the termination of pregnancy as having a fetus with some types of birth defect(s. Among them, 201 were categorized as case group (receiving termination permission because their pregnancy was before week 20 and 402 of them were categorized as control group 1 (not receiving termination permission because their pregnancy was after week 20 and 200 women as control group 2 who referred to Alzahra hospital to give childbirth. A questionnaire containing demographic and geographical information was made for all the women in those three groups. Results : The average age of mothers in this study was 27.2 years (15-47 years old. In 100 % of women, at least 1 ultrasound examination was performed and genetic and Amniocentesis tests were conducted in 2.1 % and 3.5 % respectively in order to diagnose anomaly. In total, 33 % of pregnant women with congenital anomalies received pregnancy termination permission. The majority of congenital anomalies were neural tube defects 16.9 %, hydrocephaly 8.6 %, limb deformation 7.7 % and Down syndrome 6.4 %. Mother’s age, the history of

  10. Physical exercise during pregnancy and the risk of preterm birth: a study within the Danish National Birth Cohort

    DEFF Research Database (Denmark)

    Juhl, Mette; Andersen, Per Kragh; Olsen, Jørn

    2008-01-01

    According to many national recommendations, women should be physically active during pregnancy, but empirical evidence to support this recommendation is sparse. The authors' aim in this study was to examine the relation between physical exercise during pregnancy and the risk of preterm birth. Self......-reported data on physical exercise during pregnancy were collected prospectively for 87,232 singleton pregnancies included in the Danish National Birth Cohort between 1996 and 2002. Hazard ratios for preterm birth according to hours of exercise per week, type of exercise, and metabolic equivalent-hours per week...

  11. Enhanced prostaglandin F2α formation in human pregnancy and the effect of increased oily fish intake: results from the Salmon in Pregnancy Study.

    Science.gov (United States)

    Helmersson-Karlqvist, Johanna; Miles, Elizabeth A; Vlachava, Maria; Kremmyda, Lefkothea-Stella; Noakes, Paul S; Diaper, Norma D; Godfrey, Keith M; Calder, Philip C; Basu, Samar

    2012-01-01

    Oily fish intake during pregnancy may reduce the risk of allergic diseases in infancy possibly by shifts in the fatty acid balance and subsequent altered prostaglandin (PG) formation. This intervention is the first study to evaluate if increased oily fish intake affects in vivo PGF(2α) formation during pregnancy. British pregnant women were randomised to two portions of farmed salmon weekly (n=47), or maintenance of their normal diet low in fish (n=41), from pregnancy week 20 until parturition. The concentrations of eicosapentaenoic and docosahexaenoic acids in plasma phosphatidylcholine (PC) were higher and the concentration of arachidonic acid in plasma PC was lower in the salmon group than the control group at weeks 34 and 38 of pregnancy. PGF(2α) formation was evaluated by urinary measurement of 15-keto-dihydro-PGF(2α), a major PGF(2α) metabolite, at 20, 34 and 38 weeks. In both the salmon and control groups urinary 15-keto-dihydro-PGF(2α) concentrations increased significantly during pregnancy, which may be of physiological importance. Oily fish intervention altered fatty acid concentrations but did not affect urinary 15-keto-dihydro-PGF(2α) concentrations in pregnant women.

  12. Ectopic Pregnancy in Uncommon Implantation Sites: Intramural Pregnancy and Rudimentary Horn Pregnancy

    OpenAIRE

    Yi Wang; Fan Yu; Li-Qin Zeng

    2015-01-01

    Ectopic pregnancy is commonly located in the fallopian tube. Nevertheless, two unusual types of ectopic pregnancy, intramural pregnancy and rudimentary horn pregnancy, seriously threaten maternal life. The diagnosis and treatment of these unusual implantation sites present a clinical challenge. In this study, we illustrated the two unusual types of ectopic pregnancy and summarized the current data regarding diagnosis and optimal treatment from our experience.

  13. 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...

  14. Placenta associated pregnancy complications in pregnancies complicated with placenta previa

    National Research Council Canada - National Science Library

    Yael Baumfeld; Reli Herskovitz; Zehavi Bar Niv; Salvatore Andrea Mastrolia; Adi Y. Weintraub

    2017-01-01

    Objectives: The purpose of our study was to examine the hypothesis that pregnancies complicated with placenta previa have an increased risk of placental insufficiency associated pregnancy complications...

  15. PRegnancy Outcomes after a Maternity Intervention for Stressful EmotionS (PROMISES: study protocol for a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    de Jonge Peter

    2011-06-01

    Full Text Available Abstract Background There is ample evidence from observational prospective studies that maternal depression or anxiety during pregnancy is a risk factor for adverse psychosocial outcomes in the offspring. However, to date no previous study has demonstrated that treatment of depressive or anxious symptoms in pregnancy actually could prevent psychosocial problems in children. Preventing psychosocial problems in children will eventually bring down the huge public health burden of mental disease. The main objective of this study is to assess the effects of cognitive behavioural therapy in pregnant women with symptoms of anxiety or depression on the child's development as well as behavioural and emotional problems. In addition, we aim to study its effects on the child's development, maternal mental health, and neonatal outcomes, as well as the cost-effectiveness of cognitive behavioural therapy relative to usual care. Methods/design We will include 300 women with at least moderate levels of anxiety or depression at the end of the first trimester of pregnancy. By including 300 women we will be able to demonstrate effect sizes of 0.35 or over on the total problems scale of the child behavioural checklist 1.5-5 with alpha 5% and power (1-beta 80%. Women in the intervention arm are offered 10-14 individual cognitive behavioural therapy sessions, 6-10 sessions during pregnancy and 4-8 sessions after delivery (once a week. Women in the control group receive care as usual. Primary outcome is behavioural/emotional problems at 1.5 years of age as assessed by the total problems scale of the child behaviour checklist 1.5 - 5 years. Secondary outcomes will be mental, psychomotor and behavioural development of the child at age 18 months according to the Bayley scales, maternal anxiety and depression during pregnancy and postpartum, and neonatal outcomes such as birth weight, gestational age and Apgar score, health care consumption and general health status

  16. Effects of lung exposure to carbon nanotubes on female fertility and pregnancy. A study in mice.

    Science.gov (United States)

    Hougaard, Karin S; Jackson, Petra; Kyjovska, Zdenka O; Birkedal, Renie K; De Temmerman, Pieter-Jan; Brunelli, Andrea; Verleysen, Eveline; Madsen, Anne Mette; Saber, Anne T; Pojana, Giulio; Mast, Jan; Marcomini, Antonio; Jensen, Keld A; Wallin, Håkan; Szarek, Józef; Mortensen, Alicja; Vogel, Ulla

    2013-11-01

    We studied the effects of preconceptional exposure to multiwalled carbon nanotubes (MWCNTs): mature, female C57BL/6J mice were intratracheally instilled with 67μg NM-400 MWCNT, and the following day co-housed with mature males, in breeding pairs. Time to delivery of the first litter, litter parameters, maternal inflammation and histopathology of lung and liver were recorded. In male offspring, locomotor activity, startle response, and daily sperm production (DSP) were assessed. In the dams, lung and liver bore evidence of MWCNT exposure when assessed 6 weeks and 4 months after exposure. A short delay in the delivery of the first litter was observed in exposed females. Litter parameters, behavior and DSP were similar in control and exposed groups. In conclusion, instillation of a single dose of MWCNT induced long lasting pathological changes in dam lung and liver. Theoretically, lung inflammation due to particle exposure could interfere with female reproductive parameters. Whether the observed lag in delivery of a first litter was in fact caused by exposure to MWCNT should be addressed in a study designed specifically to elucidate effects on the early processes involved in establishment of pregnancy. Exposure was not associated with changes in the assessed gestational or offspring parameters.

  17. Pregnancy Research on Osteopathic Manipulation Optimizing Treatment Effects: The PROMOTE Study A Randomized Controlled Trial

    Science.gov (United States)

    HENSEL, Kendi L.; BUCHANAN, Steve; BROWN, Sarah K.; RODRIGUEZ, Mayra; CRUSER, des Anges

    2014-01-01

    Objective To evaluate the efficacy of Osteopathic Manipulative Treatment (OMT) to reduce low back pain and improve functioning during the third trimester in pregnancy and improve selected outcomes of labor and delivery. Study Design PROMOTE was a randomized, placebo-controlled trial of 400 women in their third trimester. Women were randomized to usual care only (UCO), usual care plus OMT (OMT), or usual care plus placebo ultrasound treatment (PUT). The study included seven treatments over nine weeks. The OMT protocol included specific techniques administered by board-certified OMT specialists. Outcomes were assessed using self-report measures for pain and back-related functioning, and medical records for delivery outcomes. Results There were 136 women in the OMT group, 131 in PUT, and 133 in UCO. Characteristics at baseline were similar across groups. Findings indicate significant treatment effects for pain and back related functioning (POMT group similar to that of the PUT, but both groups were significantly improved compared to UCO. For secondary outcome of meconium- stained amniotic fluid there were no differences between the groups. Conclusion OMT was effective for mitigating pain and functional deterioration compared to the UCO group; however OMT did not differ significantly from PUT. This may be attributed to PUT being a more active treatment than intended. There was no higher likelihood of conversion to high risk status based on treatment group. Therefore, OMT is a safe, effective adjunctive modality to improve pain and functioning during their third trimester. PMID:25068560

  18. Exploring Australian women’s level of nutrition knowledge during pregnancy: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Bookari K

    2016-08-01

    Full Text Available Khlood Bookari,1 Heather Yeatman,1 Moira Williamson2,3 1School of Health and Society, Faculty of Social Sciences, 2School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, 3School of Nursing and Midwifery, Higher Education Division, Central Queensland University, Noosaville, QLD, Australia Background: The Australian Guide to Healthy Eating (AGHE for pregnancy provides a number of food- and nutrition-related recommendations to assist pregnant women in optimizing their dietary behavior. However, there are limited data demonstrating pregnant women’s knowledge of the AGHE recommendations. This study investigated Australian pregnant women’s knowledge of the AGHE and related dietary recommendations for maintaining a healthy pregnancy. The variations in nutrition knowledge were compared with demographic characteristics. Methods: A cross-sectional study assessed eight different nutrition knowledge domains and the demographic characteristics of pregnant women. Four hundred women across Australia completed a multidimensional online survey based on validated and existing measures. Results: More than half of the pregnant women surveyed (65% were not familiar with the AGHE recommendations. The basic recommendations to eat more fruit, vegetables, bread, and cereals but less meat were poorly understood. An in-depth investigation of knowledge of nutrition information revealed misconceptions in a range of areas, including standard serving size, nutrients content of certain foods, energy density of fat, and the importance of key nutrients in pregnancy. Univariate analysis revealed significant demographic variation in nutrition knowledge scores. Multiple regression analysis confirmed the significant independent effects on respondents’ nutrition knowledge score (P<0.000 of the education level, income, age, stage of pregnancy, language, and having a health/nutrition qualification. The model indicated that

  19. Violence against women by their intimate partner during pregnancy and postnatal depression: a prospective cohort study.

    Science.gov (United States)

    Ludermir, Ana Bernarda; Lewis, Glyn; Valongueiro, Sandra Alves; de Araújo, Thália Velho Barreto; Araya, Ricardo

    2010-09-11

    Partner violence against women is common during pregnancy and might have an adverse effect on the mental health of women after delivery. We aimed to investigate the association of postnatal depression with psychological, physical, and sexual violence against women by their intimate partners during pregnancy. In a prospective cohort study undertaken in Recife, northeastern Brazil, between July, 2005, and December, 2006, we enrolled pregnant women (aged 18-49 years) in their third trimester of pregnancy who were attending primary health-care clinics. The women were interviewed during pregnancy and after delivery. The form of partner violence in pregnancy was assessed with a validated questionnaire, and the Edinburgh postnatal depression scale was used to measure postnatal depression. Associations were estimated with odds ratios (ORs), adjusted for confounding factors contributing to the association between postnatal depression and intimate partner violence. 1133 pregnant women were eligible for inclusion in the study, of whom 1045 had complete data for all variables and were included in the analysis. 270 women (25.8%, 95% CI 23.2-28.6) had postnatal depression. The most common form of partner violence was psychological (294 [28.1%, 25.4-31.0]). Frequency of psychological violence during pregnancy was positively associated with occurrence of postnatal depression, and although this association was attenuated after adjustment, women reporting the highest frequency of psychological violence were more likely to have postnatal depression even after adjustment (adjusted OR 2.29, 95% CI 1.15-4.57). Women who reported physical or sexual violence in pregnancy were more likely to develop postnatal depression (OR 3.28, 2.29-4.70), but this association was substantially reduced after adjustment for psychological violence and confounding factors. Psychological violence during pregnancy by an intimate partner is strongly associated with postnatal depression, independently of

  20. A study of neonatal and maternal outcomes of asthma during pregnancy

    Directory of Open Access Journals (Sweden)

    Babu Lal Meena

    2013-02-01

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

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

    LENUS (Irish Health Repository)

    Murphy, Deirdre J

    2013-09-01

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

  2. Local illness concepts and their relevance for the prevention and control of malaria during pregnancy in Ghana, Kenya and Malawi: findings from a comparative qualitative study.

    Science.gov (United States)

    Menaca, Arantza; Pell, Christopher; Manda-Taylor, Lucinda; Chatio, Samuel; Afrah, Nana A; Were, Florence; Hodgson, Abraham; Ouma, Peter; Kalilani, Linda; Tagbor, Harry; Pool, Robert

    2013-07-22

    In sub-Saharan Africa, the burden of morbidity and mortality linked to malaria during pregnancy (MiP) is significant and compounded by its unclear symptoms and links with other health problems during pregnancy. Mindful of the biomedical and social complexity of MiP, this article explores and compares local understandings of MiP and their links with other pregnancy-related health problems. A comparative qualitative study was undertaken at four sites in three countries: Ghana, Malawi and Kenya. Individual and group interviews were conducted with pregnant women, their relatives, opinion leaders, other community members and health providers. MiP-related behaviours were also observed at health facilities and in local communities. Across the four sites, local malaria concepts overlapped with biomedically defined malaria. In terms of symptoms, at-risk groups, outcomes and aetiology of malaria during pregnancy, this overlap was however both site-specific and partial. Moreover, the local malaria concepts were not monolithic and their descriptions varied amongst respondents. The symptoms of pregnancy and malaria also overlapped but, for respondents, symptom severity was the distinguishing factor. Malaria was generally, though not universally, perceived as serious for pregnant women. Miscarriage was the most widely known outcome, and links with anaemia, low birth weight and congenital malaria were mentioned. Nonetheless, amongst many potential causes of miscarriage, malaria was not recognized as the most important, but rather interacted with other pregnancy-related problems. Given the overlap of common pregnancy problems with the symptoms of malaria, and the limited association of malaria with its main outcomes, a comprehensive antenatal care programme is the most appropriate strategy for the provision of health education, prevention and treatment for MiP. Variations in locally shared understandings of MiP must however be taken into account when designing and promoting Mi

  3. Fever in pregnancy and risk of fetal death: a cohort study

    DEFF Research Database (Denmark)

    Andersen, Anne-Marie Nybo; Vastrup, Pernille; Wohlfahrt, Jan

    2002-01-01

    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...

  4. Pregnancy chances on an IVF/ICSI waiting list: a national prospective cohort study.

    NARCIS (Netherlands)

    Eijkemans, M.J.; Lintsen, A.M.E.; Hunault, C.C.; Bouwmans, C.A.; Hakkaart, L.; Braat, D.D.M.; Habbema, J.D.

    2008-01-01

    BACKGROUND: The effectiveness of IVF over expectant management has been proven only for bilateral tubal occlusion. We aimed to estimate the chance of pregnancy without treatment for IVF patients, using data on the waiting period before the start of IVF. METHODS: A prospective cohort study included

  5. Laboratory work and pregnancy outcomes: a study within the National Birth Cohort in Denmark

    DEFF Research Database (Denmark)

    Zhu, J L; Knudsen, Lisbeth E.; Andersen, Anne-Marie Nybo;

    2006-01-01

    AIMS: To examine pregnancy outcomes in women doing laboratory work. METHODS: Using data from the Danish National Birth Cohort (1997-2003), the authors conducted a prospective cohort study of 1025 female laboratory technicians and 8037 female teachers (as reference). The laboratory technicians wer...

  6. Genetic amniocentesis in twin pregnancies: results of a multicenter study of 529 cases

    NARCIS (Netherlands)

    Pruggmayer, M.R.K.; M.G. Jahoda (M.); Van der Pol, J.G.; Baumann, P.; Holzgreve, W.; Karkut, G.; Lettau, R.; Eiben, B.; Osmers, R.; Gola, H.W.; Duda, V.; Polak, P.; Körner, H.; Schulte‐Valentin, M.; Schütte, H.

    1992-01-01

    textabstractTo evaluate the risk of abortion after genetic amniocentesis in twin pregnancies, a retrospective study of 15 centers was performed. The spontaneous abortion rate up to 20 completed weeks of gestation was 2.3%; the abortion rate up to 28 completed weeks, as defined by WHO, was 3.7%. The

  7. Status of 25(OHD levels in pregnancy: A study from the North Eastern part of India

    Directory of Open Access Journals (Sweden)

    A Dasgupta

    2012-01-01

    Full Text Available Introduction: An increased prevalence of vitamin D deficiency has been reported from across the globe including India. Various studies have shown an intrinsic relation between various parameters of maternal and fetal wellbeing with maternal vitamin D status during pregnancy. Aims: To look for any association of vitamin D status during pregnancy with the modifiable factors - extent of sun exposure, sunscreen use, vegetarian diet, dietary calcium intake, and multivitamin supplementation. Materials and Methods: A total of 50 pregnant females, aged 20-40 years were studied during the first trimester of pregnancy. Fifty age and body mass index (BMI matched females were taken as controls. Serum 25(OHD was measured by radioimmunoassay (Diasorin. Result: Forty-two percent of the cases were found to have vitamin D deficiency and 14% were found to have vitamin D insufficiency, whereas 20% of the controls had vitamin D deficiency and 24% had vitamin D insufficiency (P =0.0375. There was a significant association of 25(OHD levels with extent of sun exposure, sunscreen use, and vegetarian diet. There was no association of 25(OHD levels with multivitamin supplementation or dietary calcium intake. Conclusion: Vitamin D deficiency was less in our study group as compared with that reported in other Indian studies. Sun exposure, sunscreen use, and vegetarian diet are important modifiable variables significantly associated with vitamin D status in pregnancy.

  8. Pregnancy, the postpartum period and prothrombotic defects: risk of venous thrombosis in the MEGA study

    NARCIS (Netherlands)

    Pomp, E.R.; Lenselink, A.M.; Rosendaal, F.R.; Doggen, C.J.M.

    2008-01-01

    Background: Venous thrombosis is one of the leading causes of maternal morbidity and mortality. Objective: In the MEGA study, we evaluated pregnancy and the postpartum period as risk factors for venous thrombosis in 285 patients and 857 control subjects. Patients/methods: Between March 1999 and Sept

  9. Residential traffic exposure and pregnancy-related outcomes: A prospective birth cohort study

    NARCIS (Netherlands)

    Hooven, E.H. van den; Jaddoe, V.W.; Kluizenaar, Y. de; Hofman, A.; MacKenbach, J.P.; Steegers, E.A.; Miedema, H.M.; Pierik, F.H.

    2009-01-01

    Background. The effects of ambient air pollution on pregnancy outcomes are under debate. Previous studies have used different air pollution exposure assessment methods. The considerable traffic-related intra-urban spatial variation needs to be considered in exposure assessment. Residential proximity

  10. Sexual Dimorphism in Adverse Pregnancy Outcomes - A Retrospective Australian Population Study 1981-2011

    NARCIS (Netherlands)

    Verburg, Petra E.; Tucker, Graeme; Scheil, Wendy; Erwich, Jan Jaap H. M.; Dekker, Gus A.; Roberts, Claire Trelford

    2016-01-01

    Objectives Sexual inequality starts in utero. The contribution of biological sex to the developmental origins of health and disease is increasingly recognized. The aim of this study was to assess and interpret sexual dimorphisms for three major adverse pregnancy outcomes which affect the health of t

  11. Residential traffic exposure and pregnancy-related outcomes: A prospective birth cohort study

    NARCIS (Netherlands)

    E.H. van den Hooven (Edith); V.W.V. Jaddoe (Vincent); Y. de Kluizenaar (Yvonne); A. Hofman (Albert); J.P. Mackenbach (Johan); R.P.M. Steegers-Theunissen (Régine); H.M. Miedema (Henk); F.H. Pierik (Frank)

    2009-01-01

    textabstractBackground. The effects of ambient air pollution on pregnancy outcomes are under debate. Previous studies have used different air pollution exposure assessment methods. The considerable traffic-related intra-urban spatial variation needs to be considered in exposure assessment. Residenti

  12. A Quasi-Experimental Study of Maternal Smoking during Pregnancy and Offspring Academic Achievement

    Science.gov (United States)

    D'Onofrio, Brian M.; Singh, Amber L.; Iliadou, Anastasia; Lambe, Mats; Hultman, Christina M.; Neiderhiser, Jenae M.; Langstrom, Niklas; Lichtenstein, Paul

    2010-01-01

    The current study, based on all births in Sweden from 1983 to 1991 (N = 654,707), explored the processes underlying the association between smoking during pregnancy (SDP) and offspring school grades and mathematic proficiency at age 15. The analyses compared relatives who varied in their exposure to SDP and who varied in their genetic relatedness.…

  13. Adolescent Students and Their Experiences of Dealing with Pregnancy: A Mexican Mixed-Method Study

    Science.gov (United States)

    Atienzo, Erika E.; Campero, Lourdes; Marín, Eréndira; González, Guillermo

    2017-01-01

    In impoverished communities in Mexico, most adolescent mothers do not attend school; but typically, they become pregnant once they dropped out. Understanding the experiences of adolescents who have had a pregnancy and continue in school is complicated since few manage to do it. The goal of this study is to describe experiences within the family…

  14. 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...

  15. Genetic amniocentesis in twin pregnancies: results of a multicenter study of 529 cases

    NARCIS (Netherlands)

    Pruggmayer, M.R.K.; M.G. Jahoda (M.); Van der Pol, J.G.; Baumann, P.; Holzgreve, W.; Karkut, G.; Lettau, R.; Eiben, B.; Osmers, R.; Gola, H.W.; Duda, V.; Polak, P.; Körner, H.; Schulte‐Valentin, M.; Schütte, H.

    1992-01-01

    textabstractTo evaluate the risk of abortion after genetic amniocentesis in twin pregnancies, a retrospective study of 15 centers was performed. The spontaneous abortion rate up to 20 completed weeks of gestation was 2.3%; the abortion rate up to 28 completed weeks, as defined by WHO, was 3.7%. The

  16. Teenage pregnancy and social disadvantage: systematic review integrating controlled trials and qualitative studies.

    Science.gov (United States)

    Harden, Angela; Brunton, Ginny; Fletcher, Adam; Oakley, Ann

    2009-11-12

    To determine the impact on teenage pregnancy of interventions that address the social disadvantage associated with early parenthood and to assess the appropriateness of such interventions for young people in the United Kingdom. Systematic review, including a statistical meta-analysis of controlled trials on interventions for early parenthood and a thematic synthesis of qualitative studies that investigated the views on early parenthood of young people living in the UK. 12 electronic bibliographic databases, five key journals, reference lists of relevant studies, study authors, and experts in the field. Review methods Two independent reviewers assessed the methodological quality of studies and abstracted data. Ten controlled trials and five qualitative studies were included. Controlled trials evaluated either early childhood interventions or youth development programmes. The overall pooled effect size showed that teenage pregnancy rates were 39% lower among individuals receiving an intervention than in those receiving standard practice or no intervention (relative risk 0.61; 95% confidence interval 0.48 to 0.77). Three main themes associated with early parenthood emerged from the qualitative studies: dislike of school; poor material circumstances and unhappy childhood; and low expectations for the future. Comparison of these factors related to teenage pregnancy with the content of the programmes used in the controlled trials indicated that both early childhood interventions and youth development programmes are appropriate strategies for reducing unintended teenage pregnancies. The programmes aim to promote engagement with school through learning support, ameliorate unhappy childhood through guidance and social support, and raise aspirations through career development and work experience. However, none of these approaches directly tackles all the societal, community, and family level factors that influence young people's routes to early parenthood. A small but

  17. 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

  18. Pregnancy-associated deaths: a 15-year retrospective study and overall review of maternal pathophysiology.

    Science.gov (United States)

    Christiansen, Lydia R; Collins, Kim A

    2006-03-01

    referred for autopsy to the Forensic Section of the Medical University of South Carolina from January 1989 through December 2003. All decedents listed as pregnant or postpartum were analyzed as to maternal age, race, past medical history, previous pregnancies and outcome, prenatal care, gestational age, fetal or neonatal outcome, location of delivery, placental findings, maternal autopsy findings, toxicology, cause of death, manner of death, and fetal or neonatal autopsy findings. The authors present this retrospective study to better determine the factors leading to maternal demise and discuss the autopsy/ancillary techniques useful in determining the cause of death in this challenging area.

  19. Contraceptive discontinuation and pregnancy postabortion in Nepal: a longitudinal cohort study.

    Science.gov (United States)

    Puri, Mahesh; Henderson, Jillian T; Harper, Cynthia C; Blum, Maya; Joshi, Deepak; Rocca, Corinne H

    2015-04-01

    To examine postabortion contraceptive discontinuation and pregnancy in Nepal, where abortion was decriminalized in 2002. We conducted an observational cohort study of 654 women obtaining abortions from four public and nongovernmental facilities in 2011. Patients completed questionnaires at their abortion visit and 6 and 12 months later. We used Cox proportional hazards models to assess contraceptive discontinuation and pregnancy by method initiated postabortion and other sociodemographic and reproductive factors. Among the 78% (508/654) of women who initiated a modern contraceptive method within 3 months postabortion, the 1-year contraceptive discontinuation rate was 62 per 100 person-years. Discontinuation was far lower among the 5% of women using long-acting reversible methods (21/100 person-years) than among those using condoms (74/100 person-years), pills (61/100 person-years) and the injectable [64/100 person-years; adjusted hazard ratio (aHR)=0.32 (0.15-0.68)]. Unmarried women and those not living with their husband experienced higher contraceptive discontinuation [aHR=2.16 (1.47-3.17)]. The 1-year pregnancy rate for all women was 9/100 person-years. Pregnancy was highest among those who initiated no modern method postabortion (13/100 person-years) and condoms (12/100 person-years), and pregnancy was lowest among users of long-acting reversible methods (3/100 person-years). The poorest women were at increased pregnancy risk [aHR=2.31 (1.32-4.10)]. Women using intrauterine devices and implants experienced greatly reduced contraceptive discontinuation and pregnancy within a year postabortion, although initiation of these long-acting methods was low. Increased availability of long-acting methods in Nepal and similar settings may help to prevent unwanted pregnancy and attendant maternal mortality and morbidities. Initiation of modern contraception was high postabortion; however, 1-year discontinuation was high for the condom, pill and injectable, the methods most

  20. Intrahepatic cholestasis of pregnancy : Maternal and fetal outcomes associated with elevated bile acid levels

    NARCIS (Netherlands)

    Brouwers, Laura; Koster, Maria P H; Page-Christiaens, Godelieve C M L; Kemperman, Hans;