WorldWideScience

Sample records for singleton live births

  1. Economic Conditions During Pregnancy and Adverse Birth Outcomes Among Singleton Live Births in the United States, 1990-2013.

    Science.gov (United States)

    Margerison-Zilko, Claire E; Li, Yu; Luo, Zhehui

    2017-11-15

    We know little about the relationship between the macroeconomy and birth outcomes, in part due to the methodological challenge of distinguishing effects of economic conditions on fetal health from effects of economic conditions on selection into live birth. We examined associations between state-level unemployment rates in the first 2 trimesters of pregnancy and adverse birth outcomes, using natality data on singleton live births in the United States during 1990-2013. We used fixed-effect logistic regression models and accounted for selection by adjusting for state-level unemployment before conception and maternal characteristics associated with both selection and birth outcomes. We also tested whether associations between macroeconomic conditions and birth outcomes differed during and after (compared with before) the Great Recession (2007-2009). Each 1-percentage-point increase in the first-trimester unemployment rate was associated with a 5% increase in odds of preterm birth, while second-trimester unemployment was associated with a 3% decrease in preterm birth odds. During the Great Recession, however, first-trimester unemployment was associated with a 16% increase in odds of preterm birth. These findings increase our understanding of the effects of the Great Recession on health and add to growing literature suggesting that macro-level social and economic factors contribute to perinatal health. © The Author(s) 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  2. Pre-term birth and low birth weight following preimplantation genetic diagnosis: analysis of 88 010 singleton live births following PGD and IVF cycles.

    Science.gov (United States)

    Sunkara, Sesh Kamal; Antonisamy, Belavendra; Selliah, Hepsy Y; Kamath, Mohan S

    2017-02-01

    Is PGD associated with the risk of adverse perinatal outcomes such as pre-term birth (PTB) and low birth weight (LBW)? There was no increase in the risk of adverse perinatal outcomes of PTB, and LBW following PGD compared with autologous IVF. Pregnancies resulting from ART are associated with a higher risk of pregnancy complications compared with spontaneously conceived pregnancies. The possible reason of adverse obstetric outcomes following ART has been attributed to the underlying infertility itself and embryo specific epigenetic modifications due to the IVF techniques. It is of interest whether interventions such as embryo biopsy as performed in PGD affect perinatal outcomes. Anonymous data were obtained from the Human Fertilization and Embryology Authority (HFEA), the statutory regulator of ART in the UK. The HFEA has collected data prospectively on all ART performed in the UK since 1991. Data from 1996 to 2011 involving a total of 88 010 singleton live births were analysed including 87 571 following autologous stimulated IVF ± ICSI and 439 following PGD cycles. Data on all women undergoing either a stimulated fresh IVF ± ICSI treatment cycle or a PGD cycle during the period from 1996 to 2011 were analysed to compare perinatal outcomes of PTB and LBW among singleton live births. Logistic regression analysis was performed adjusting for female age category, year of treatment, previous IVF cycles, infertility diagnosis, number of oocytes retrieved, whether IVF or ICSI was used and day of embryo transfer. There was no increase in the risk of PTB and LBW following PGD versus autologous stimulated IVF ± ICSI treatment, unadjusted odds of PTB (odds ratio (OR) 0.68, 95% CI: 0.46-0.99) and LBW (OR 0.56, 95% CI: 0.37-0.85). After adjusting for the potential confounders, there was again no increase in the risk of the adverse perinatal outcomes following PGD: PTB (adjusted odds ratio (aOR) 0.66, 95% CI: 0.45-0.98) and LBW (aOR 0.58, 95% CI: 0.38-0.88). Although the

  3. [Relationship between air pollution exposure during pregnancy and birth weight of term singleton live-birth newborns].

    Science.gov (United States)

    Guo, L Q; Zhang, Q; Zhao, D D; Wang, L L; Chen, Y; Mi, B B; Dang, S N; Yan, H

    2017-10-10

    Objective: This study explored the association between air pollution exposure and birth weight by using the multilevel linear model, after controlling related meteorological factors and individual differences of both mothers and babies. Methods: Women of childbearing age who were pregnant in Xi'an from 2010 to 2013, were selected as objects of this study. Multistage random sampling method was used to select 4 631 subjects followed by a self-designed questionnaire survey. Data related to quality of air and meteorology were gathered from routine monitoring system. Gestational age and date of birth, together with the average levels of air pollution were calculated for each trimester on each mother, and then the impact of air pollution on birth weight was assessed. A multilevel linear model was employed to investigate the association between the levels of exposure to air pollution by birth weight. Confounding factors were under control. We established three models in this study: Model 1 which involving the variable of air pollution exposure. Model 2 was adjusted for variables in Model 1 plus some other individual differences of both mother and baby. Model 3 was adjusted for variables in Model 2 plus meteorological factors. Results: There were significant differences seen in birth weight within the subgroups of gender, gestational age, mother's reproductive age, maternal education, residential areas and family incomes ( P 0.05). Data from Model 3 indicated that a decrease of 13.3 g(10.9 g in Model 2) and 6.6 g (5.9 g in Model 2) in birth weight that were associated with an increase of 10 μg/m(3) in the average level of NO(2) and PM(10) during the second trimester; A decrease of 13.7 g (9.8 g in Model 2) in birth weight was associated with an increase of 10 μg/m(3) in the average level of NO(2) during the third trimester. Conclusion: After controlling for meteorological factors, the levels of exposure to NO(2) and PM(10) during the second trimester and NO(2) during the

  4. Maternal Risk Factors for Singleton Preterm Births and Survival at ...

    African Journals Online (AJOL)

    Context: Risk factors for and survival of singleton preterm births may vary ... factors and survival‑to‑discharge rate for singleton preterm births at the University of ... Statistical analysis involved descriptive and inferential statistics at 95% level of ...

  5. References of birth weights for gestational age and sex from a large cohort of singleton births in cameroon.

    Science.gov (United States)

    Kemfang Ngowa, Jean Dupont; Domkam, Irénée; Ngassam, Anny; Nguefack-Tsague, Georges; Dobgima Pisoh, Walter; Noa, Cyrille; Kasia, Jean Marie

    2014-01-01

    Objective. To establish the percentile charts of birth weights for gestational age and sex within the Cameroonian population. Methods. A review of medical records of infants born between January 2007 and December 2011 at the maternities of two hospitals in Cameroon, Central Africa. Multiple pregnancies, births of HIV infected women, stillbirths, and births with major fetal malformations were excluded. The smooth curves of birth weight for gestational age and sex were created using the Gamlss package under R.3.0.1 software. Results. The birth weights of 12837 live birth singleton infants born to HIV negative women between 28 and 42 weeks of gestation were analyzed to construct the birth weight curves for gestational age and sex. The smoothed percentile curves of birth weights for gestational age and sex of Cameroonian infants have demonstrated an increasing slope until 40 weeks and then a plateau. There was a varied difference of distribution in birth weights for gestational age between Cameroonian, Botswanan, American, and French infants. Conclusion. We established the reference curves of birth weights for gestational age and sex for Cameroonians. The difference in birth weight curves noted between Cameroonian, Botswanan, American, and French infants suggests the importance of establishing the regional birth weight norms.

  6. References of Birth Weights for Gestational Age and Sex from a Large Cohort of Singleton Births in Cameroon

    Directory of Open Access Journals (Sweden)

    Jean Dupont Kemfang Ngowa

    2014-01-01

    Full Text Available Objective. To establish the percentile charts of birth weights for gestational age and sex within the Cameroonian population. Methods. A review of medical records of infants born between January 2007 and December 2011 at the maternities of two hospitals in Cameroon, Central Africa. Multiple pregnancies, births of HIV infected women, stillbirths, and births with major fetal malformations were excluded. The smooth curves of birth weight for gestational age and sex were created using the Gamlss package under R.3.0.1 software. Results. The birth weights of 12837 live birth singleton infants born to HIV negative women between 28 and 42 weeks of gestation were analyzed to construct the birth weight curves for gestational age and sex. The smoothed percentile curves of birth weights for gestational age and sex of Cameroonian infants have demonstrated an increasing slope until 40 weeks and then a plateau. There was a varied difference of distribution in birth weights for gestational age between Cameroonian, Botswanan, American, and French infants. Conclusion. We established the reference curves of birth weights for gestational age and sex for Cameroonians. The difference in birth weight curves noted between Cameroonian, Botswanan, American, and French infants suggests the importance of establishing the regional birth weight norms.

  7. Recurrence risk of preterm birth in subsequent twin pregnancy after preterm singleton delivery

    NARCIS (Netherlands)

    Schaaf, J. M.; Hof, M. H. P.; Mol, B. W. J.; Abu-Hanna, A.; Ravelli, A. C. J.

    2012-01-01

    Please cite this paper as: Schaaf J, Hof M, Mol B, Abu-Hanna A, Ravelli A. Recurrence risk of preterm birth in subsequent twin pregnancy after preterm singleton delivery.BJOG 2012;119:16241629. Objective To determine the risk of preterm birth in a subsequent twin pregnancy after previous singleton

  8. Trends in preterm birth: singleton and multiple pregnancies in the Netherlands, 2000-2007.

    Science.gov (United States)

    Schaaf, J M; Mol, B W J; Abu-Hanna, A; Ravelli, A C J

    2011-09-01

    Several studies have reported increasing trends in preterm birth in developed countries, mainly attributable to an increase in medically indicated preterm births. Our aim was to describe trends in preterm birth among singleton and multiple pregnancies in the Netherlands. Prospective cohort study. Nationwide study. We studied 1,451,246 pregnant women from 2000 to 2007. We assessed trends in preterm birth. We subdivided preterm birth into spontaneous preterm birth after premature prelabour rupture of membranes (pPROM), medically indicated preterm birth and spontaneous preterm birth without pPROM. We performed analyses separately for singletons and multiples. The primary outcome was preterm birth, defined as birth before 37 weeks of gestation, with very preterm birth (birth was 7.7% and the risk of very preterm birth was 1.3%. In singleton pregnancies, the preterm birth risk decreased significantly from 6.4% to 6.0% (P birth without pPROM (3.6-3.1%, P birth risk increased significantly (47.3-47.7%, P = 0.047), mainly as a result of medically indicated preterm birth, which increased from 15.0% to 17.9% (P birth risk in singleton pregnancies decreased significantly over the years. The trend of increasing preterm birth risk reported in other countries was only observed in (medically indicated) preterm birth in multiple pregnancies. © 2011 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2011 RCOG.

  9. Cervical stitch (cerclage) for preventing preterm birth in singleton pregnancy.

    Science.gov (United States)

    Alfirevic, Zarko; Stampalija, Tamara; Medley, Nancy

    2017-06-06

    Cervical cerclage is a well-known surgical procedure carried out during pregnancy. It involves positioning of a suture (stitch) around the neck of the womb (cervix), aiming to give mechanical support to the cervix and thereby reduce risk of preterm birth. The effectiveness and safety of this procedure remains controversial. This is an update of a review last published in 2012. To assess whether the use of cervical stitch in singleton pregnancy at high risk of pregnancy loss based on woman's history and/or ultrasound finding of 'short cervix' and/or physical exam improves subsequent obstetric care and fetal outcome. We searched Cochrane Pregnancy and Childbirth's Trials Register (30 June 2016) and reference lists of identified studies. We included all randomised trials of cervical suturing in singleton pregnancies. Cervical stitch was carried out when the pregnancy was considered to be of sufficiently high risk due to a woman's history, a finding of short cervix on ultrasound or other indication determined by physical exam. We included any study that compared cerclage with either no treatment or any alternative intervention. We planned to include cluster-randomised studies but not cross-over trials. We excluded quasi-randomised studies. We included studies reported in abstract form only. Three review authors independently assessed trials for inclusion. Two review authors independently assessed risk of bias and extracted data. We resolved discrepancies by discussion. Data were checked for accuracy. The quality of the evidence was assessed using the GRADE approach. This updated review includes a total of 15 trials (3490 women); three trials were added for this update (152 women). Cerclage versus no cerclageOverall, cerclage probably leads to a reduced risk of perinatal death when compared with no cerclage, although the confidence interval (CI) crosses the line of no effect (RR 0.82, 95% CI 0.65 to 1.04; 10 studies, 2927 women; moderate quality evidence). Considering

  10. Trends in preterm birth: singleton and multiple pregnancies in the Netherlands, 2000-2007

    NARCIS (Netherlands)

    Schaaf, J. M.; Mol, B. W. J.; Abu-Hanna, A.; Ravelli, A. C. J.

    2011-01-01

    Several studies have reported increasing trends in preterm birth in developed countries, mainly attributable to an increase in medically indicated preterm births. Our aim was to describe trends in preterm birth among singleton and multiple pregnancies in the Netherlands. Prospective cohort study.

  11. Systematic review of progesterone for the prevention of preterm birth in singleton pregnancies

    DEFF Research Database (Denmark)

    Rode, Line; Langhoff-Roos, Jens; Andersson, Charlotte

    2009-01-01

    . SEARCH STRATEGY: A search in the PubMed, Embase, and Cochrane database was performed using the keywords: pregnancy, progesterone, preterm birth/preterm delivery, preterm labor, controlled trial, and randomized controlled trial. SELECTION CRITERIA: Studies on singleton pregnancies. DATA COLLECTION...... AND ANALYSIS: A meta-analysis was performed on randomized trials including singleton pregnancies with previous preterm birth. MAIN RESULTS: Two new randomized controlled trials of women with previous preterm birth were added to the four analyzed in the Cochrane review, and the meta-analysis of all six studies......BACKGROUND: A Cochrane review in 2006 concluded that further knowledge is required before recommendation can be made with regard to progesterone in the prevention of preterm birth. OBJECTIVE: To provide an update on the preventive effect of progesterone on preterm birth in singleton pregnancies...

  12. Trends in preterm birth in singleton deliveries in a Hong Kong population

    NARCIS (Netherlands)

    Hui, Annie S. Y.; Lao, Terence T.; Leung, Tak Yeung; Schaaf, Jelle M.; Sahota, Daljit S.

    2014-01-01

    To examine trends in preterm birth and its relationship with perinatal mortality in Hong Kong. In a retrospective cohort study, data were reviewed from singletons delivered between 1995 and 2011 at a university teaching hospital. Trends in preterm birth (between 24 and 36 weeks of pregnancy),

  13. Trends in birth asphyxia, obstetric interventions and perinatal mortality among term singletons: a nationwide cohort study

    NARCIS (Netherlands)

    Ensing, Sabine; Abu-Hanna, Ameen; Schaaf, Jelle M.; Mol, Ben Willem J.; Ravelli, Anita C. J.

    2015-01-01

    The objective of the present study is to investigate trends in birth asphyxia and perinatal mortality in the Netherlands over the last decade. A nationwide cohort study among women with a term singleton pregnancy. We assessed trends in birth asphyxia in relation to obstetric interventions for fetal

  14. Maternal risk factors for singleton preterm births and survival at the ...

    African Journals Online (AJOL)

    2015-02-24

    Feb 24, 2015 ... The mean age of mothers who delivered singleton preterm babies did not differ significantly from that of mothers .... Classification of preterm babies according to gestational age was ... of admission for preterm babies was 16 ± 5.8 days (range: ..... the etiology of preterm births in the US would be expected.

  15. Child Maltreatment Among Singletons and Multiple Births in Japan: A Population-Based Study.

    Science.gov (United States)

    Yokoyama, Yoshie; Oda, Terumi; Nagai, Noriyo; Sugimoto, Masako; Mizukami, Kenji

    2015-12-01

    The occurrence of multiple births has been recognized as a risk factor for child maltreatment. However, few population-based studies have examined the relationship between multiple births and child maltreatment. This study aimed to evaluate the degree of risk of child maltreatment among singletons and multiple births in Japan and to identify factors associated with increased risk. Using population-based data, we analyzed the database of records on child maltreatment and medical checkups for infants aged 1.5 years filed at Nishinomiya City Public Health Center between April 2007 and March 2011. To protect personal information, the data were transferred to anonymized electronic files for analysis. After adjusting by logistic regression for each associated factor and gestation number, multiples themselves were not associated with the risk of child maltreatment. However, compared with singletons, multiples had a significantly higher rate of risk factors for child maltreatment, including low birth weight and neural abnormality. Moreover, compared with mothers of singleton, mothers of twins had a significantly higher rate of poor health, which is a risk factor of child maltreatment. Multiples were not associated with the risk of child maltreatment. However, compared with singletons, multiples and their mothers had a significantly higher rate of risk factors of child maltreatment.

  16. Preterm birth in singleton and multiple pregnancies : evaluation of costs and perinatal outcomes

    NARCIS (Netherlands)

    van Baaren, Gert J.; Peelen, Myrthe J. C. S.; Schuit, Ewoud; van der Post, Joris A. M.; Mol, Ben W. J.; Kok, Marjolein; Hajenius, Petra J.

    Objective: To estimate costs of preterm birth in singleton and multiple pregnancies. Study design: Cost analysis based on data from a prospective cohort study and three multicentre randomised controlled trials (2006-2012) in a Dutch nationwide consortium for women's health research. Women with

  17. Twin-singleton differences in intelligence: a register-based birth cohort study of Norwegian males.

    Science.gov (United States)

    Eriksen, Willy; Sundet, Jon M; Tambs, Kristian

    2012-10-01

    The aim was to determine the difference in intelligence between singletons and twins in young adulthood. Data from the Medical Birth Register of Norway were linked with register data from the Norwegian National Conscript Service. The study base consisted of data on the 445,463 males who were born alive in either single or twin births in Norway during 1967-1984 and who were examined at the time of the mandatory military conscription (age 18-20). Within this study base, there were data on 1,653 sibships of full brothers that included at least one man born in single birth and at least one man born in twin birth (4,307 persons, including 2,378 twins and 1,929 singletons). The intelligence scores of the singletons were 11% (95% confidence interval [CI]: 9-14%) of a standard deviation higher than those of the twins, after adjustment for birth year, birth order, parental ages at delivery, parental education levels, and other factors. The adjusted within-family difference was also 11% (95 % CI: 6-16%) of a standard deviation, indicating that unmeasured factors shared by siblings (e.g., maternal body height) have not influenced the estimate in important ways. When gestational age at birth was added to the model, the estimate for the difference in intelligence score was approximately the same. Including birth weight in the model strongly reduced the estimate. In conclusion, twins born in Norway during 1967-1984 had slightly lower intelligence in early adulthood compared with the singletons.

  18. Placenta previa and risk of major congenital malformations among singleton births in Finland.

    Science.gov (United States)

    Kancherla, Vijaya; Räisänen, Sari; Gissler, Mika; Kramer, Michael R; Heinonen, Seppo

    2015-06-01

    Placenta previa has been associated with adverse birth outcomes, but its association with congenital malformations is inconclusive. We examined the association between placenta previa and major congenital malformations among singleton births in Finland. We performed a retrospective population register-based study on all singletons born at or after 22+0 weeks of gestation in Finland during 2000 to 2010. We linked three national health registers: the Finnish Medical Birth Register, the Hospital Discharge Register, and the Register of Congenital Malformations, and examined several demographic and clinical characteristics among women with and without placenta previa, in association with major congenital malformations. We estimated adjusted odds ratios and 95% confidence intervals using multivariable logistic regression models. The prevalence of placenta previa was estimated as 2.65 per 1000 singleton births in Finland (95% confidence interval, 2.53-2.79). Overall, 6.2% of women with placenta previa delivered a singleton infant with a major congenital malformation, compared with 3.8% of unaffected women (p ≤ 0.001). Placenta previa was positively associated with almost 1.6-fold increased risk of major congenital malformations in the offspring, after controlling for maternal age, parity, fetal sex, smoking, socio-economic status, chorionic villus biopsy, In vitro fertilization, pre-existing diabetes, depression, preeclampsia, and prior caesarean section (adjusted odds ratio = 1.55; 95% confidence interval, 1.27-1.90). Using a large population-based study, we found that placenta previa was weakly, but significantly associated with an increased risk of major congenital malformations in singleton births. Future studies should examine the association between placenta previa and individual types of congenital malformations, specifically in high-risk pregnancies. © 2015 Wiley Periodicals, Inc.

  19. The placental factor in spontaneous preterm birth in twin vs. singleton pregnancies.

    Science.gov (United States)

    Weiner, Eran; Dekalo, Ann; Feldstein, Ohad; Barber, Elad; Schreiber, Letizia; Bar, Jacob; Kovo, Michal

    2017-07-01

    The association between infection and inflammatory response in singleton preterm birth (PTB) is well established, yet, less is known about PTB in twins. We aimed to compare the placental component and pregnancy outcome in pregnancies complicated with PTB of singletons vs. twin deliveries. We hypothesized that due to different underlying mechanisms, placental inflammatory lesions will be more prevalent in placentas derived from singleton pregnancies than twins. Labor characteristics, neonatal outcome and placental histopathology reports of spontaneous PTB at 24-33 6 / 7 weeks, from 1/2008-12/2015, were reviewed. were compared between dichorionic-diamniotic twin deliveries (twins group) and singleton deliveries (singleton group) matched for gestational age. Excluded from the study medically indicated deliveries, due to preeclampsia or fetal growth restriction, and monochorionic twins. Placental lesions were classified to maternal vascular supply lesions, fetal vascular supply lesions, and maternal (MIR) and fetal (FIR) inflammatory responses. Composite neonatal outcome was defined as one or more of early complications: respiratory distress, necrotizing enterocolitis, sepsis, blood transfusion, ventilation, seizures, intra-ventricular hemorrhage, hypoglycemia, phototherapy, or death. The twins group (n=72) was characterized by higher maternal BMI (p=0.009), and higher rates of assisted reproductive techniques (56.2% vs. 17.8%, pPTBs are characterized by higher rate of inflammatory and malperfusion lesions. The lack of these findings in twins PTBs suggests different factors that participate in the development of preterm birth in twins, such as over-distension of the uterus and up regulation of oxytocin receptors. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. Impact of obstetric history on the risk of spontaneous preterm birth in singleton and multiple pregnancies: a systematic review.

    Science.gov (United States)

    Kazemier, B M; Buijs, P E; Mignini, L; Limpens, J; de Groot, C J M; Mol, B W J

    2014-09-01

    Information about the recurrence of spontaneous preterm birth in subsequent twin/singleton pregnancies is scattered. To quantify the risk of recurrence of spontaneous preterm birth in different subtypes of subsequent pregnancies. An electronic literature search in OVID MEDLINE and EMBASE, complemented by PubMed, to find recent studies. Studies comparing the risk of spontaneous preterm birth after a previous preterm and previous term pregnancy. The absolute risk of recurrence with a 95% confidence interval and the absolute risk of preterm birth after a term delivery were calculated. Data from studies were pooled using the Mantel-Haenszel method. We detected 13 relevant studies. The risk of recurrence of preterm birth was significantly increased in all preterm pregnancy subtypes, compared with their term counterparts. Women pregnant with twins after a previous preterm singleton had the highest absolute risk of recurrence (57.0%, 95% CI 51.9-61.9%), and after a previous term singleton their absolute risk was 25% (95% CI 24.3-26.5%). Women pregnant with a singleton after a previous preterm twin pregnancy have an absolute recurrence risk of 10% (95% CI 8.2-12.3%), whereas a singleton pregnancy after delivering a previous twin up to term yields a low absolute risk of only 1.3% (95% CI 0.8-2.2). Women pregnant with a singleton after a previous preterm singleton have an absolute recurrence risk of 20% (95% CI 19.9-20.6). The risk of recurrence of preterm birth is influenced by the singleton/twin order in both pregnancies, and varies between 10% for a singleton after previous preterm twins to 57% for twins after a previous preterm singleton. © 2014 Royal College of Obstetricians and Gynaecologists.

  1. Lower marriage and divorce rates among twins than among singletons in Danish birth cohorts 1940-1964

    DEFF Research Database (Denmark)

    Petersen, Inge; Martinussen, Torben; McGue, Matthew

    2011-01-01

    compare rates of marriage and divorce in a sample of 35,975 twins and 81,803 singletons born 1940-1964. Cox-regressions are used in order to control for potential confounders. We find that compared with singletons twins have significantly lower marriage rates: (males: 15-19 years: Hazard Ratio (HR) = 0...... twins compared with singletons (HR=0.87, 95%CI: 0.83-0.90). These differences offset each other, thus 57% of both populations remain in their first marriage until censoring. The interpretation may be that since twins have a partner from birth, they do not have the same need for marriage as singletons...

  2. Mothers' marital adaptation following the birth of twins or singletons: empirical evidence and practical insights.

    Science.gov (United States)

    Taubman-Ben-Ari, Orit; Findler, Liora; Bendet, Chaya; Stanger, Varda; Ben-Shlomo, Shirley; Kuint, Jacob

    2008-08-01

    Parenting twins is typically portrayed as more stressful than is parenting single children and, therefore, more of a strain on the marital relationship. With this in mind, the present study examined the contribution of infant characteristics and mother's internal resources (attachment style) and external resources (maternal and paternal grandmothers' perceived support) to their marital adaptation during the first month following delivery, comparing mothers of twins (n = 88) with mothers of singletons (n = 82). The findings indicate that both internal and external resources contribute to the marital adaptation of the two groups, even beyond the contribution of specific circumstances. Thus, it seems that the birth of twins and the birth of a single child are normative life events that have more in common than previously acknowledged. The implications for the focus of social work interventions, particularly in the case of the birth of twins, are discussed.

  3. Impact of obstetric history on the risk of spontaneous preterm birth in singleton and multiple pregnancies: a systematic review

    NARCIS (Netherlands)

    Kazemier, B. M.; Buijs, P. E.; Mignini, L.; Limpens, J.; de Groot, C. J. M.; Mol, B. W. J.; von Dadelszen, P.; Magee, L.; Sawchuck, D.; Gao, E.; Oude Rengerink, K.; Zamora, J.; Fox, C.; Daniels, J.; Khan, K. S.; Thangaratinam, S.; Meads, C.

    2014-01-01

    Information about the recurrence of spontaneous preterm birth in subsequent twin/singleton pregnancies is scattered. To quantify the risk of recurrence of spontaneous preterm birth in different subtypes of subsequent pregnancies. An electronic literature search in OVID MEDLINE and EMBASE,

  4. Singleton birth at term: an old alarm or a new debate?

    Science.gov (United States)

    Hughes, Edward G

    2015-10-01

    In 2004, Human Reproduction published a debate series focusing on the rising tide of multiple pregnancy associated with IVF. The premise of the primary report in that debate was that by considering IVF outcomes differently-by focusing on healthy singleton birth at term rather than clinical pregnancy, the standard currency at that time-the necessary shift toward reduced numbers of embryos transferred might be accelerated. The choice of end-point in that debate-Birth Emphasizing a Successful Singleton at Term (BESST)-was not an effort to 'dumb down' the complex equation linking risks and benefits. That balance is a dynamic and various mix of issues that clinicians discuss with patients on a daily basis. And BESST was certainly not proposed as a new primary outcome for application to other treatment modalities in reproductive medicine, such as ovulation induction. It was simply a responsible and brave call for change in the accelerating and competitive world of IVF. © The Author 2015. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  5. Underlying causes of neonatal deaths in term singleton pregnancies: home births versus hospital births in the United States.

    Science.gov (United States)

    Grünebaum, Amos; McCullough, Laurence B; Arabin, Birgit; Dudenhausen, Joachim; Orosz, Brooke; Chervenak, Frank A

    2017-04-01

    The objective of this study was to evaluate the underlying causes of neonatal mortality (NNM) in midwife-attended home births and compare them to hospital births attended by a midwife or a physician in the United States (US). A retrospective cohort study of the Centers for Disease Control (CDC) linked birth/infant death data set (linked files) for 2008 through 2012 of singleton, term (≥37 weeks) births and normal newborn weights (≥2500 grams). Midwife-attended home births had the highest rate of neonatal deaths [122/95,657 neonatal mortality (NNM) 12.75/10,000; relative risk (RR): 3.6, 95% confidence interval (CI) 3-4.4], followed by hospital physician births (8695/14,447,355 NNM 6.02/10,000; RR: 1.7 95% CI 1.6-1.9) and hospital midwife births (480/1,363,199 NNM 3.52/10,000 RR: 1). Among midwife-assisted home births, underlying causes attributed to labor and delivery caused 39.3% (48/122) of neonatal deaths (RR: 13.4; 95% CI 9-19.9) followed by 29.5% due to congenital anomalies (RR: 2.5; 95% CI 1.8-3.6), and 12.3% due to infections (RR: 4.5; 95% CI 2.5-8.1). There are significantly increased risks of neonatal deaths among midwife-attended home births associated with three underlying causes: labor and delivery issues, infections, and fetal malformations. This analysis of the causes of neonatal death in planned home birth shows that it is consistently riskier for newborns to deliver at home than at the hospital. Physicians, midwives, and other health care providers have a professional responsibility to share information about the clinical benefits and risks of clinical management.

  6. Saving lives at birth

    DEFF Research Database (Denmark)

    Daysal, N. Meltem; Trandafir, Mircea; van Ewijk, Reyn

    2015-01-01

    Many developed countries have recently experienced sharp increases in home birth rates. This paper investigates the impact of home births on the health of low-risk newborns using data from the Netherlands, the only developed country where home births are widespread. To account for endogeneity...... in location of birth, we exploit the exogenous variation in distance from a mother’s residence to the closest hospital. We find that giving birth in a hospital leads to substantial reductions in newborn mortality. We provide suggestive evidence that proximity to medical technologies may be an important...

  7. Development of a prognostic model for predicting spontaneous singleton preterm birth.

    Science.gov (United States)

    Schaaf, Jelle M; Ravelli, Anita C J; Mol, Ben Willem J; Abu-Hanna, Ameen

    2012-10-01

    To develop and validate a prognostic model for prediction of spontaneous preterm birth. Prospective cohort study using data of the nationwide perinatal registry in The Netherlands. We studied 1,524,058 singleton pregnancies between 1999 and 2007. We developed a multiple logistic regression model to estimate the risk of spontaneous preterm birth based on maternal and pregnancy characteristics. We used bootstrapping techniques to internally validate our model. Discrimination (AUC), accuracy (Brier score) and calibration (calibration graphs and Hosmer-Lemeshow C-statistic) were used to assess the model's predictive performance. Our primary outcome measure was spontaneous preterm birth at model included 13 variables for predicting preterm birth. The predicted probabilities ranged from 0.01 to 0.71 (IQR 0.02-0.04). The model had an area under the receiver operator characteristic curve (AUC) of 0.63 (95% CI 0.63-0.63), the Brier score was 0.04 (95% CI 0.04-0.04) and the Hosmer Lemeshow C-statistic was significant (pvalues of predicted probability. The positive predictive value was 26% (95% CI 20-33%) for the 0.4 probability cut-off point. The model's discrimination was fair and it had modest calibration. Previous preterm birth, drug abuse and vaginal bleeding in the first half of pregnancy were the most important predictors for spontaneous preterm birth. Although not applicable in clinical practice yet, this model is a next step towards early prediction of spontaneous preterm birth that enables caregivers to start preventive therapy in women at higher risk. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  8. Health policies for the reduction of obstetric interventions in singleton full-term births in Catalonia.

    Science.gov (United States)

    Pueyo, Maria-Jesus; Escuriet, Ramon; Pérez-Botella, M; de Molina, I; Ruíz-Berdun, D; Albert, S; Díaz, S; Torres-Capcha, P; Ortún, V

    2018-04-01

    To explore the effect of hospital's characteristics in the proportion of obstetric interventions (OI) performed in singleton fullterm births (SFTB) in Catalonia (2010-2014), while incentives were employed to reduce C-sections. Data about SFTB assisted at 42 public hospitals were extracted from the dataset of hospital discharges. Hospitals were classified according to the level of complexity, the volume of births attended, and the adoption of a non-medicalized delivery (NMD) strategy. The annual average change in the percentage for OI was calculated based on Poisson regression models. The rate of OI (35% of all SFTB) including C-sections (20.6%) remained stable through the period. Hospitals attending less complex cases had a lower average of OI, while hospitals attending lower volumes had the highest average. Higher levels of complexity increased the use of C-sections (+4% yearly) and forceps (+16%). The adoption of the NMD strategy decreased the rate of C-sections. The proportion of OI, including C-sections, remained stable in spite of public incentives to reduce them. The adoption of the NMD strategy could help in decreasing the rate of OI. To reduce the OI rate, new strategies should be launched as the development of low-risk pregnancies units, alignment of incentives and hospital payment, increased value of incentives and encouragement of a cultural shift towards non-medicalized births. Copyright © 2018 Elsevier B.V. All rights reserved.

  9. Gestational age and birth weight centiles of singleton babies delivered normally following spontaneous labor, in Southern Sri Lanka

    Science.gov (United States)

    Attanayake, K; Munasinghe, S; Goonewardene, M; Widanapathirana, P; Sandeepani, I; Sanjeewa, L

    2018-03-31

    To estimate the gestational age and birth weight centiles of babies delivered normally, without any obstetric intervention, in women with uncomplicated singleton pregnancies establishing spontaneous onset of labour. Consecutive women with uncomplicated singleton pregnancies, attending the Academic Obstetrics and Gynecology Unit of the Teaching Hospital Mahamodara Galle, Sri Lanka, with confirmed dates and establishing spontaneous onset of labor and delivering vaginally between gestational age of 34 - 41 weeks, without any obstetric intervention , during the period September 2013 to February 2014 were studied. The gestational age at spontaneous onset of labor and vaginal delivery and the birth weights of the babies were recorded. There were 3294 consecutive deliveries during this period, and of them 1602 (48.6%) met the inclusion criteria. Median gestational age at delivery was 275 days (range 238-291 days, IQR 269 to 280 days) and the median birth weight was 3000 g (range1700g - 4350g; IQR 2750-3250g). The 10th, 50th and 90th birth weight centiles of the babies delivered at a gestational age of 275 days were approximately 2570g, 3050g and 3550g respectively. The median gestational age among women with uncomplicated singleton pregnancies who established spontaneous onset of labor and delivered vaginally, without any obstetric intervention, was approximately five days shorter than the traditionally accepted 280 days. At a gestational age of 275 days, the mean birth weight was approximately 3038g and the 50th centile of the birth weight of the babies delivered was approximately 3050g.

  10. Hospital costs of multiple-birth and singleton-birth children during the first 5 years of life and the role of assisted reproductive technology.

    Science.gov (United States)

    Chambers, Georgina M; Hoang, Van Phuong; Lee, Evelyn; Hansen, Michele; Sullivan, Elizabeth A; Bower, Carol; Chapman, Michael

    2014-11-01

    The unprecedented increase in multiple births during the past 3 decades is a major public health concern and parallels the uptake of medically assisted conception. The economic implications of such births are not well understood. To conduct a comprehensive economic and health services assessment of the frequency, duration, and cost of hospital admissions during the first 5 years of life for singleton, twin, and higher-order multiple (HOM) children and to examine the contribution of assisted reproductive technology (ART) to the incidence and cost of multiple births. A retrospective population cohort study using individually linked birth, hospital, and death records among 233,850 infants born in Western Australia between October 1993 and September 2003, and followed up to September 2008. Multiple-gestation delivery and ART conception. Odds of stillbirth, prematurity and low birth weight, frequency and length of hospital admissions, the mean costs by plurality, and the independent effect of prematurity on childhood costs. Of 226,624 singleton, 6941 twin, and 285 HOM infants, 1.0% of singletons, 15.4% of twins, and 34.7% of HOM children were conceived following ART. Compared with singletons, twins and HOMs were 3.4 and 9.6 times, respectively, more likely to be stillborn and were 6.4 and 36.7 times, respectively, more likely to die during the neonatal period. Twins and HOMs were 18.7 and 525.1 times, respectively, more likely to be preterm, and 3.6 and 2.8 times, respectively, more likely to be small for gestational age. The mean hospital costs of a singleton, twin, and HOM child to age 5 years were $2730, $8993, and $24,411 (in 2009-2010 US dollars), respectively, with cost differences concentrated in the neonatal period and during the first year of life. Almost 15% of inpatient costs for multiple births could have been avoided if ART twins and HOMs had been born as singletons. Compared with singletons, multiple-birth infants consume significantly more hospital

  11. Employment trends during preschool years among mothers of term singletons born with low birth weight.

    Science.gov (United States)

    Hauge, Lars Johan; Kornstad, Tom; Nes, Ragnhild Bang; Kristensen, Petter; Irgens, Lorentz M; Landolt, Markus A; Eskedal, Leif T; Vollrath, Margarete E

    2014-11-01

    Children born at term with low birth weight (LBW) are regarded growth restricted and are at particular risk of adverse health outcomes requiring a high degree of parental participation in the day-to-day care. This study examined whether their increased risk of special health care needs compared to other children may influence mothers' opportunities for participation in the labor market at different times after delivery. Data from 32,938 participants in the population-based Norwegian Mother and Child Cohort Study with singleton children born at term in 2004-2006 were linked to national registers in order to investigate the mothers' employment status when their children were 1-3 years in 2007 and 4-6 years in 2010. Children weighing less than two standard deviations below the gender-specific mean were defined as LBW children. Although not significantly different from mothers of children in the normal weight range, mothers of LBW children had the overall highest level of non-employment when the children were 1-3 years. At child age 4-6 years on the other hand, LBW was associated with an increased risk of non-employment (RR 1.39: 95 % CI 1.11-1.75) also after adjustment for factors associated with employment in general. In accordance with employment trends in the general population, our findings show that while mothers of normal birth weight children re-enter the labor market as their children grow older, mothers of LBW children born at term participate to a lesser extent in paid employment and remain at levels similar to those of mothers with younger children.

  12. Live birth and adverse birth outcomes in women with ulcerative colitis and Crohn's disease receiving assisted reproduction

    DEFF Research Database (Denmark)

    Nørgård, Bente Mertz; Larsen, P V; Fedder, J

    2016-01-01

    , the OR of preterm birth was 5.29 (95% CI 2.41 to 11.63) in analyses including singletons and multiple births; restricted to singletons the OR was 1.80, 95% CI 0.49 to 6.62. CONCLUSIONS: Our results suggest that women with UC and CD receiving ART treatments cannot expect the same success for each embryo transfer......OBJECTIVE: To examine the chance of live births and adverse birth outcomes in women with ulcerative colitis (UC) and Crohn's disease (CD) compared with women without inflammatory bowel disease (IBD) who have undergone assisted reproductive technology (ART) treatments. METHODS: This was a nationwide...... cohort study based on Danish health registries, comprising all women with an embryo transfer during 1 January 1994 through 2013. The cohorts comprised 1360 ART treatments in 432 women with UC, 554 ART treatments in 182 women with CD and 148 540 treatments in 52 489 women without IBD. Our primary outcome...

  13. Comparison of 24 months neurodevelopmental outcome in twins and singletons ≤ 34 weeks gestation at birth

    Directory of Open Access Journals (Sweden)

    Maria Kyriakidou

    2013-04-01

    Full Text Available The aim of this study was to screen neurodevelopmental impairment of preterm twins born at less than 34 weeks of gestation, compare them with the outcome of preterm singletons, and to determine potential neonatal factors adversely related to motor and cognitive outcome. Twins of 25-34 weeks gestation were included in the study. In total, 46 twins were matched with 46 singletons and were followed prospectively to 24 months corrected age. Obstetrical and neonatal data were recorded. All infants were assessed using the Bayley Scales of Infant and Toddler Development III For all morbidities, a significant difference could not be demonstrated. At 24 month follow up there was no significant difference in the cognitive outcome for the twins compared to singletons [98.6 (± 10.4 vs 97.8 (± 9.7, respectively]. There was also no significant difference in the motor outcome for the twins compared to singletons [94.8 (± 12.4 vs 98.1 (± 9.6., respectively]. For the twins, we found a link between pre-eclampsia and abnormal cognitive (p = 0.012 and motor (p = 0.030 results. With the number of twins steadily increasing, close developmental monitoring and probably early intervention services are needed to determine future directions for research.

  14. New population-based references for birth weight, length, and head circumference in singletons and twins from 23 to 43 gestation weeks.

    Science.gov (United States)

    Sankilampi, Ulla; Hannila, Marja-Leena; Saari, Antti; Gissler, Mika; Dunkel, Leo

    2013-09-01

    Birth size curves are needed for clinical and epidemiological purposes. We constructed birth weight (BW), length (BL), and head circumference (BHC) references, assessed effects of twinness and parity, and defined cut-off points for small, appropriate, and large for gestational age. Birth register data of all 753,036 infants born in 1996-2008 in Finland were cleaned to create references reflecting optimal intrauterine growth. The final data included 533,666 singletons and 15,033 twins (median gestation weeks (gws) 40.0 and 37.1, respectively, 41.6% primiparous). Sex-specific BW, BL, and BHC references were constructed from 23 to 43 gws separately for singletons and twins born to primiparous or multiparous mothers. GAMLSS method was used for modelling. In singletons from 36 gws onwards, increased BW and BL were observed in comparison to previous reference from 1979-1983. Twins diverged from singletons from 30 gws onwards. At 37.0 gws, mean BW was 400 g lower and mean BL 1.2 cm shorter than in singletons. From 30 gws onwards, birth size was larger in infants of multiparous than primiparous mothers. Population-based birth size references are available for the evaluation of birth size. Accounting for plurality and parity improves the accuracy of birth size evaluation.

  15. The vanishing twin: a major determinant of infant outcome in IVF singleton births

    DEFF Research Database (Denmark)

    Pinborg, Anja; Lidegaard, Ojvind; Andersen, Anders Nyboe

    2006-01-01

    This article attempts to assess the frequency of vanishing twins in assisted reproductive and spontaneously conceived pregnancies, including in-vitro fertilization (IVF), and its impact on the live-born surviving twin.......This article attempts to assess the frequency of vanishing twins in assisted reproductive and spontaneously conceived pregnancies, including in-vitro fertilization (IVF), and its impact on the live-born surviving twin....

  16. [Gestational weight gain and optimal ranges in Chinese mothers giving singleton and full-term births in 2013].

    Science.gov (United States)

    Wang, J; Duan, Y F; Pang, X H; Jiang, S; Yin, S A; Yang, Z Y; Lai, J Q

    2018-01-06

    Objective: To analyze the status of gestational weight gain (GWG) among Chinese mothers who gave singleton and full-term births, and to look at optimal GWG ranges. Methods: In 2013, using the multi-stage stratified and population proportional cluster sampling method, we investigated 8 323 mother-child pairs at their 0-24 months postpartum from 55 counties (cities/districts) of 30 provinces (except Tibet) in mainland China. Questionnaire was used to collect data on body weight before pregnancy and delivery, diseases during gestation, hemorrhage or not at postpartum, child birth weight and length, and other information about pregnant outcomes. We measured mother's body weight and height, and child's body weight and length. Based on 'Chinese Adult Body Weight Standard', we divided mothers into four groups according to their body weight before pregnancy: low weight (BMImothers and children, and according to P25-P75 of GWG among mothers who had good pregnant outcomes and good anthropometry, and whose children had good anthropometry. The status of GWG was assessed by the new optimal ranges. Results: P50 (P25-P75) of GWG among the 8 323 mothers was 15.0 (10.0-19.0) kg. According to the proposed optimal GWG ranges of IOM, the proportions of inadequate, optimal and excessive GWG accounted for 27.2% (2 263 mothers), 36.2% (3 016 mothers) and 36.6% (3 044 mothers). The optimal GWG ranges for low weight, normal weight, overweight and obesity were 11.5-18.0, 10.0-15.0, 8.0-14.0 and 5.0-11.5 kg. Based on these optimal GWG ranges established in this study, the rates of inadequate, optimal and excessive GWG were 15.7% (1 303 mothers), 45.0% (3 744 mothers) and 39.3% (3 276 mothers), and these rates were significantly different from that defined by the IOM standards (χ2=345.36, Pmothers is 15.0 kg, which is at a relatively higher level. This study suggests the optimal GWG ranges for Chinese women who give singleton and full-term babies, which appears lower than IOM's.

  17. High-risk of preterm birth and low birth weight after oocyte donation IVF: analysis of 133,785 live births.

    Science.gov (United States)

    Kamath, Mohan Shashikant; Antonisamy, Belavendra; Mascarenhas, Mariano; Sunkara, Sesh Kamal

    2017-09-01

    A higher risk of pregnancy complications occurs after assisted reproductive techniques compared with spontaneously conceived pregnancies. This is attributed to the underlying infertility and assisted reproduction technique procedures involved during treatment. It is a matter of interest whether use of donor oocytes affects perinatal outcomes compared with pregnancies after autologous IVF. Anonymized data were obtained from the Human Fertilization and Embryology Authority. The analysis included 5929 oocyte donation and 127,856 autologous IVF live births. Data from all women who underwent donor oocyte recipient or autologous IVF cycles, both followed with fresh embryo transfer, were analysed to compare perinatal outcomes of preterm birth (PTB) and low birthweight (LBW) after singleton and multiple live births. The risk of adverse perinatal outcomes after oocyte donation was increased: adjusted OR (aOR) 1.56, 99.5% CI 1.34 to 1.80 for PTB and aOR 1.43, 99.5% CI 1.24 to 1.66 for LBW were significantly higher after oocyte donation compared with autologous IVF singletons. The adjusted odds PTB (aOR 1.21, 99.5% CI 1.02 to 1.43) was significantly higher after oocyte donation compared with autologous IVF multiple births. Analysis of this large dataset suggests significantly higher risk of PTB and LBW after ooctye donation compared with autologous IVF pregnancies. Copyright © 2017 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  18. Difference in birth weight of consecutive sibling singletons is not found in oocyte donation when comparing fresh versus frozen embryo replacements.

    Science.gov (United States)

    Galliano, Daniela; Garrido, Nicolás; Serra-Serra, Vicente; Pellicer, Antonio

    2015-12-01

    First, to assess if there are any differences in birth weight or gestational length in newborns from egg-donation pregnancies delivering singletons, originating from either fresh or frozen-thawed embryos when they were developed and delivered within the same mothers. Second, to determine if there are any clinical, phenotypic, or laboratory factors influencing this relationship, including the origin of the oocyte (same or different donor), the order of the children (first fresh or first frozen-thawed embryo transfer), the embryo freezing technique (vitrification or slow freezing), the in vitro embryo culture length, and the duration that embryos remained frozen. Retrospective cohorts study. University-affiliated infertility centers. A total of 360 women undergoing oocyte donation (OD), delivering (>28 weeks) at least two babies, each one from a single pregnancy, originating from at least one fresh and one frozen-thawed embryo transfer, controlling maternal and laboratory characteristics, to test the effect of embryo freezing on children size (n = 731). None. Birth weight, gestational age, weight percentile, being large for gestational age (LGA), small for gestational age (SGA), size out of normal range (ONR = LGA + SGA), and macrosomy. From fresh versus thawed embryos, respectively, mean birth weight of children was 3,183.7 g versus 3,226.4 g, gestational age was 272.1 days versus 268.8 days, and mean weight percentiles were 47.6 versus 50.1. The proportions and corresponding odds ratios (ORs) from fresh versus thawed embryos, respectively, were for LGA 13.6% versus 11.3% (OR 0.81), for SGA 9.4% versus 12.5% (OR 1.37), for ONR 23.1% versus 23.8% (OR 1.04), and for macrosomy 0.3% versus 0.8% (OR 3.1). After adjusting for clinically relevant variables, the ORs were for LGA 0.96, for SGA 1.40, for ONR 1.20, and for macrosomy not computable. None of the stated measures were significantly different. Also, independent analyses run on the origin of the oocytes

  19. Recurrence risk of low Apgar score among term singletons: a population-based cohort study

    NARCIS (Netherlands)

    Ensing, Sabine; Schaaf, Jelle M.; Abu-Hanna, Ameen; Mol, Ben W. J.; Ravelli, Anita C. J.

    2014-01-01

    To examine the risk of recurrence of low Apgar score in a subsequent term singleton pregnancy. Population-based cohort study. The Netherlands. A total of 190,725 women with two subsequent singleton term live births between 1999 and 2007. We calculated the recurrence risk of low Apgar score after

  20. Predicting live birth, preterm delivery, and low birth weight in infants born from in vitro fertilisation: a prospective study of 144,018 treatment cycles.

    Directory of Open Access Journals (Sweden)

    Scott M Nelson

    2011-01-01

    Full Text Available The extent to which baseline couple characteristics affect the probability of live birth and adverse perinatal outcomes after assisted conception is unknown.We utilised the Human Fertilisation and Embryology Authority database to examine the predictors of live birth in all in vitro fertilisation (IVF cycles undertaken in the UK between 2003 and 2007 (n = 144,018. We examined the potential clinical utility of a validated model that pre-dated the introduction of intracytoplasmic sperm injection (ICSI as compared to a novel model. For those treatment cycles that resulted in a live singleton birth (n = 24,226, we determined the associates of potential risk factors with preterm birth, low birth weight, and macrosomia. The overall rate of at least one live birth was 23.4 per 100 cycles (95% confidence interval [CI] 23.2-23.7. In multivariable models the odds of at least one live birth decreased with increasing maternal age, increasing duration of infertility, a greater number of previously unsuccessful IVF treatments, use of own oocytes, necessity for a second or third treatment cycle, or if it was not unexplained infertility. The association of own versus donor oocyte with reduced odds of live birth strengthened with increasing age of the mother. A previous IVF live birth increased the odds of future success (OR 1.58, 95% CI 1.46-1.71 more than that of a previous spontaneous live birth (OR 1.19, 95% CI 0.99-1.24; p-value for difference in estimate <0.001. Use of ICSI increased the odds of live birth, and male causes of infertility were associated with reduced odds of live birth only in couples who had not received ICSI. Prediction of live birth was feasible with moderate discrimination and excellent calibration; calibration was markedly improved in the novel compared to the established model. Preterm birth and low birth weight were increased if oocyte donation was required and ICSI was not used. Risk of macrosomia increased with advancing

  1. VAGINAL PROGESTERONE VERSUS CERVICAL CERCLAGE FOR THE PREVENTION OF PRETERM BIRTH IN WOMEN WITH A SONOGRAPHIC SHORT CERVIX, SINGLETON GESTATION, AND PREVIOUS PRETERM BIRTH: A SYSTEMATIC REVIEW AND INDIRECT COMPARISON META-ANALYSIS

    Science.gov (United States)

    CONDE-AGUDELO, Agustin; ROMERO, Roberto; NICOLAIDES, Kypros; CHAIWORAPONGSA, Tinnakorn; O'BRIEN, John M.; CETINGOZ, Elcin; DA FONSECA, Eduardo; CREASY, George; SOMA-PILLAY, Priya; FUSEY, Shalini; CAM, Cetin; ALFIREVIC, Zarko; HASSAN, Sonia S.

    2012-01-01

    OBJECTIVE No randomized controlled trial has directly compared vaginal progesterone and cervical cerclage for the prevention of preterm birth in women with a sonographic short cervix in the midtrimester, singleton gestation, and previous spontaneous preterm birth. We performed an indirect comparison of vaginal progesterone versus cerclage, using placebo/no cerclage as the common comparator. STUDY DESIGN Adjusted indirect meta-analysis of randomized controlled trials. RESULTS Four studies evaluating vaginal progesterone versus placebo (158 patients) and five evaluating cerclage versus no cerclage (504 patients) were included. Both interventions were associated with a statistically significant reduction in the risk of preterm birth <32 weeks of gestation and composite perinatal morbidity and mortality compared with placebo/no cerclage. Adjusted indirect meta-analyses did not show statistically significant differences between vaginal progesterone and cerclage in reducing preterm birth or adverse perinatal outcomes. CONCLUSION Based on state-of-the-art methodology for indirect comparisons, either vaginal progesterone or cerclage are equally efficacious in the prevention of preterm birth in women with a sonographic short cervix in the midtrimester, singleton gestation, and previous preterm birth. The selection of the optimal treatment may depend upon adverse events, cost and patient/clinician preferences. PMID:23157855

  2. Preconception and prenatal urinary concentrations of phenols and birth size of singleton infants born to mothers and fathers from the Environment and Reproductive Health (EARTH) study.

    Science.gov (United States)

    Messerlian, Carmen; Mustieles, Vicente; Minguez-Alarcon, Lidia; Ford, Jennifer B; Calafat, Antonia M; Souter, Irene; Williams, Paige L; Hauser, Russ

    2018-05-01

    Although pregnancy concentrations of some phenols have been associated with infant size at birth, there is limited data on the effect of preconception exposure. We aimed to examine paternal and maternal preconception and maternal prenatal urinary phenol concentrations in relation to birth weight and head circumference. We evaluated 346 singletons born to 346 mothers and 184 fathers (184 couples) from a prospective preconception cohort of subfertile couples from the Environment and Reproductive Health (EARTH) Study in Boston, USA. We used multiple urine samples collected before the index pregnancy in both men and women to estimate mean preconception urinary benzophenone-3, triclosan, butylparaben, propylparaben, methylparaben, or ethylparaben concentrations. We also estimated mean maternal prenatal urinary phenol concentrations by averaging trimester-specific urine samples. Birth weight and head circumference were abstracted from delivery records. We estimated the association of natural log-phenol concentrations with birth outcomes using multivariable linear regression models, adjusting for known confounders. In adjusted models, each log-unit increase in paternal preconception benzophenone-3 concentration was associated with a 137 g increase in birth weight (95% CI: 60, 214). Additional adjustment for prenatal benzophenone-3 concentration strengthened this association. None of the maternal preconception phenol concentrations were associated with birth weight. However, maternal prenatal triclosan concentrations were associated with a 38 g decrease in birth weight (95% CI: -76, 0). Few associations were observed between phenols and head circumference except for a decrease of 0.27 cm (95% CI: -54, 0) in relation to maternal preconception methylparaben concentration. Although our findings should be interpreted in light of inherent study limitations, these results suggest potential evidence of associations between some paternal or maternal phenol concentrations and

  3. Risk factors for the increasing trend in low birth weight among live births born by vaginal delivery, Brazil

    Directory of Open Access Journals (Sweden)

    Barbieri Marco A

    2000-01-01

    Full Text Available OBJECTIVE: To identify risk factors for low birth weight (LBW among live births by vaginal delivery and to determine if the disappearance of the association between LBW and socioeconomic factors was due to confounding by cesarean section. METHODS: Data were obtained from two population-based cohorts of singleton live births in Ribeirão Preto, Southeastern Brazil. The first one comprised 4,698 newborns from June 1978 to May 1979 and the second included 1,399 infants born from May to August 1994. The risks for LBW were tested in a logistic model, including the interaction of the year of survey and all independent variables under analysis. RESULTS: The incidence of LBW among vaginal deliveries increased from 7.8% in 1978--79 to 10% in 1994. The risk was higher for: female or preterm infants; newborns of non-cohabiting mothers; newborns whose mothers had fewer prenatal visits or few years of education; first-born infants; and those who had smoking mothers. The interaction of the year of survey with gestational age indicated that the risk of LBW among preterm infants fell from 17.75 to 8.71 in 15 years. The mean birth weight decreased more significantly among newborns from qualified families, who also had the highest increase in preterm birth and non-cohabitation. CONCLUSIONS: LBW among vaginal deliveries increased mainly due to a rise in the proportion of preterm births and non-cohabiting mothers. The association between cesarean section and LBW tended to cover up socioeconomic differences in the likelihood of LBW. When vaginal deliveries were analyzed independently, these socioeconomic differences come up again.

  4. Risk of placenta praevia is linked to endometrial thickness in a retrospective cohort study of 4537 singleton assisted reproduction technology births.

    Science.gov (United States)

    Rombauts, L; Motteram, C; Berkowitz, E; Fernando, S

    2014-12-01

    Is endometrial thickness measured prior to embryo transfer associated with placenta praevia? Following IVF, the risk of placenta praevia is increased 4-fold in women with an endometrial thickness of >12 mm compared with women with an endometrial thickness of IVF treatment but it remains unknown what factors contribute to that increased risk. Retrospective cohort study involving 4007 women who had 4537 singleton assisted reproduction technology (ART) births occurring between January 2006 and June 2012 with no loss to follow-up. The primary outcome measure was the diagnosis of placenta praevia, made by the treating obstetrician on a transvaginal ultrasound in the third trimester. Women who had singleton births following single embryo transfer performed at Monash IVF in Melbourne, Australia were included. Of the 4537 cycles leading to a singleton ART birth, 2951 were stimulated cycles with fresh embryo transfers; 355 were hormone replacement therapy frozen embryo transfers and 1231 were natural cycles with frozen embryo transfers. The dataset was analysed using binary logistic general estimating equations to calculate odds ratios for placenta praevia adjusted (aOR) for known confounders. The study groups did not differ significantly in age, BMI and aetiologies of infertility prior to IVF treatment. When compared with stimulated cycles, placenta praevia was less common in women undergoing natural cycles with frozen embryo transfers (OR 0.44, 95% confidence interval (CI) 0.27-0.70, P 12 mm had an aOR of 3.74 (95% CI 1.90-7.34, P IVF patients and their offspring. The fact that the observed increased risk is not linked to the type of embryo transfer (fresh/frozen) but to the type of endometrial preparation, suggests that the risk of placenta praevia in ART can be reduced by considering an elective frozen embryo transfer in a natural cycle, especially given the growing evidence that this strategy also provides a number of other maternal and neonatal benefits. No funding

  5. Customised and Noncustomised Birth Weight Centiles and Prediction of Stillbirth and Infant Mortality and Morbidity: A Cohort Study of 979,912 Term Singleton Pregnancies in Scotland.

    Directory of Open Access Journals (Sweden)

    Stamatina Iliodromiti

    2017-01-01

    Full Text Available There is limited evidence to support the use of customised centile charts to identify those at risk of stillbirth and infant death at term. We sought to determine birth weight thresholds at which mortality and morbidity increased and the predictive ability of noncustomised (accounting for gestational age and sex and partially customised centiles (additionally accounting for maternal height and parity to identify fetuses at risk.This is a population-based linkage study of 979,912 term singleton pregnancies in Scotland, United Kingdom, between 1992 and 2010. The main exposures were noncustomised and partially customised birth weight centiles. The primary outcomes were infant death, stillbirth, overall mortality (infant and stillbirth, Apgar score <7 at 5 min, and admission to the neonatal unit. Optimal thresholds that predicted outcomes for both non- and partially customised birth weight centiles were calculated. Prediction of mortality between non- and partially customised birth weight centiles was compared using area under the receiver operator characteristic curve (AUROC and net reclassification index (NRI.Birth weight ≤25th centile was associated with higher risk for all mortality and morbidity outcomes. For stillbirth, low Apgar score, and neonatal unit admission, risk also increased from the 85th centile. Similar patterns and magnitude of associations were observed for both non- and partially customised birth weight centiles. Partially customised birth weight centiles did not improve the discrimination of mortality (AUROC 0.61 [95%CI 0.60, 0.62] compared with noncustomised birth weight centiles (AUROC 0.62 [95%CI 0.60, 0.63] and slightly underperformed in reclassifying pregnancies to different risk categories for both fatal and non-fatal adverse outcomes (NRI -0.027 [95% CI -0.039, -0.016], p < 0.001. We were unable to fully customise centile charts because we lacked data on maternal weight and ethnicity. Additional analyses in an

  6. Singleton strings

    International Nuclear Information System (INIS)

    Engquist, J.; Sundell, P.; Tamassia, L.

    2007-01-01

    The group theoretical structure underlying physics in anti de Sitter (AdS) spacetime is intrinsically different with respect to the flat case, due to the presence of special ultra-short representations, named singletons, that do not admit a flat space limit. The purpose of this collaboration is to exploit this feature in the study of string and brane dynamics in AdS spacetime, in particular while trying to establish a connection between String Theory in AdS backgrounds (in the tensionless limit) and Higher-Spin Gauge Theory. (orig.)

  7. Cross-Country Individual Participant Analysis of 4.1 Million Singleton Births in 5 Countries with Very High Human Development Index Confirms Known Associations but Provides No Biologic Explanation for 2/3 of All Preterm Births.

    Science.gov (United States)

    Ferrero, David M; Larson, Jim; Jacobsson, Bo; Di Renzo, Gian Carlo; Norman, Jane E; Martin, James N; D'Alton, Mary; Castelazo, Ernesto; Howson, Chris P; Sengpiel, Verena; Bottai, Matteo; Mayo, Jonathan A; Shaw, Gary M; Verdenik, Ivan; Tul, Nataša; Velebil, Petr; Cairns-Smith, Sarah; Rushwan, Hamid; Arulkumaran, Sabaratnam; Howse, Jennifer L; Simpson, Joe Leigh

    2016-01-01

    Preterm birth is the most common single cause of perinatal and infant mortality, affecting 15 million infants worldwide each year with global rates increasing. Understanding of risk factors remains poor, and preventive interventions have only limited benefit. Large differences exist in preterm birth rates across high income countries. We hypothesized that understanding the basis for these wide variations could lead to interventions that reduce preterm birth incidence in countries with high rates. We thus sought to assess the contributions of known risk factors for both spontaneous and provider-initiated preterm birth in selected high income countries, estimating also the potential impact of successful interventions due to advances in research, policy and public health, or clinical practice. We analyzed individual patient-level data on 4.1 million singleton pregnancies from four countries with very high human development index (Czech Republic, New Zealand, Slovenia, Sweden) and one comparator U.S. state (California) to determine the specific contribution (adjusting for confounding effects) of 21 factors. Both individual and population-attributable preterm birth risks were determined, as were contributors to cross-country differences. We also assessed the ability to predict preterm birth given various sets of known risk factors. Previous preterm birth and preeclampsia were the strongest individual risk factors of preterm birth in all datasets, with odds ratios of 4.6-6.0 and 2.8-5.7, respectively, for individual women having those characteristics. In contrast, on a population basis, nulliparity and male sex were the two risk factors with the highest impact on preterm birth rates, accounting for 25-50% and 11-16% of excess population attributable risk, respectively (pbirth within each country lacks a plausible biologic explanation, and 63% of difference between countries cannot be explained with known factors; thus, research is necessary to elucidate the underlying

  8. The Impact of ART on Live Birth Outcomes: Differing Experiences across Three States.

    Science.gov (United States)

    Luke, Sabrina; Sappenfield, William M; Kirby, Russell S; McKane, Patricia; Bernson, Dana; Zhang, Yujia; Chuong, Farah; Cohen, Bruce; Boulet, Sheree L; Kissin, Dmitry M

    2016-05-01

    Research has shown an association between assisted reproductive technology (ART) and adverse birth outcomes. We identified whether birth outcomes of ART-conceived pregnancies vary across states with different maternal characteristics, insurance coverage for ART services, and type of ART services provided. CDC's National ART Surveillance System data were linked to Massachusetts, Florida, and Michigan vital records from 2000 through 2006. Maternal characteristics in ART- and non-ART-conceived live births were compared between states using chi-square tests. We performed multivariable logistic regression analyses and calculated adjusted odds ratios (aOR) to assess associations between ART use and singleton preterm delivery (birth. ART use in Massachusetts was associated with significantly lower odds of twins as well as triplets and higher order births compared to Florida and Michigan (aOR 22.6 vs. 30.0 and 26.3, and aOR 37.6 vs. 92.8 and 99.2, respectively; Pinteraction order gestations per cycle was lower in Massachusetts, which may be due to the availability of insurance coverage for ART in Massachusetts. © 2016 John Wiley & Sons Ltd.

  9. Live births profile, Maranguape – CE from 2000 to 2003

    OpenAIRE

    Nancy Costa de Oliveira; Escolástica Rejane Ferreira Moura; Cristiana Ferreira da Silva

    2012-01-01

    It was objectified to analyze the profile of the live births in Maranguape-CE registered in the Live Births Information System (SINASC) between January, 2000 and December, 2003.5.032 declarations of live births (DN) of resident mother were analyzed. The DN was included in the SINASC Software of the Health Ministry and the data were presented in tabular format. The maternal age between 21 and 30 was predominant, education between4 and 11 years of study, the increase in the percentage of single...

  10. Physical examination-indicated cerclage in singleton and twin pregnancies: maternal-fetal outcomes.

    Science.gov (United States)

    Bernabeu, Andrea; Goya, Maria; Martra, Miquel; Suy, Anna; Pratcorona, Laia; Merced, Carme; Llurba, Elisa; Casellas, Manel; Carreras, Elena; Cabero, Luis

    2016-01-01

    To study maternal and perinatal outcomes after physical examination-indicated cerclage in both singleton and twin pregnancies and evaluate the possible risk factors associated. Retrospective review of all women undergoing physical examination-indicated cerclage at the Hospital Vall d'Hebro, Barcelona from January 2009 to December 2012 after being diagnosed with cervical incompetence and risk of premature birth. During the study period, 60 cases of women diagnosed with cervical incompetence who were carrying live and morphologically-normal fetuses (53 singleton and 7 twin pregnancies), and who had an imminent risk of premature birth were evaluated. Mean gestational age until birth was 35 weeks in singleton and 32 weeks in twin pregnancies. Four cases (7.5%) of immature births and one case (2.0%) of neonatal death were recorded in singleton pregnancies. No cases of immature births or neonatal deaths were recorded in twin pregnancies. Diagnostic amniocentesis was performed IN all cases to rule out possible chorioamnionitis. Physical examination-indicated cerclage for cervical incompetence in women at risk for immature or preterm birth demonstrates good perinatal prognosis without increasing maternal morbidity in either singleton or twin pregnancies. The increase in gestation time in our study may also have been due to the fact that patients with subclinical chorioamnionitis were excluded by diagnostic amniocentesis.

  11. Prognosis for live birth in women with recurrent miscarriage

    DEFF Research Database (Denmark)

    Lund, Marie; Kamper-Jørgensen, Mads; Nielsen, Henriette Svarre

    2012-01-01

    To establish a method of estimating the proportion of women with a subsequent live birth after a well-defined time period in an open cohort of women referred to a tertiary recurrent miscarriage clinic.......To establish a method of estimating the proportion of women with a subsequent live birth after a well-defined time period in an open cohort of women referred to a tertiary recurrent miscarriage clinic....

  12. Perinatal outcomes among singletons after assisted reproductive technology with single-embryo or double-embryo transfer versus no assisted reproductive technology.

    Science.gov (United States)

    Martin, Angela S; Chang, Jeani; Zhang, Yujia; Kawwass, Jennifer F; Boulet, Sheree L; McKane, Patricia; Bernson, Dana; Kissin, Dmitry M; Jamieson, Denise J

    2017-04-01

    To examine outcomes of singleton pregnancies conceived without assisted reproductive technology (non-ART) compared with singletons conceived with ART by elective single-embryo transfer (eSET), nonelective single-embryo transfer (non-eSET), and double-embryo transfer with the establishment of 1 (DET -1) or ≥2 (DET ≥2) early fetal heartbeats. Retrospective cohort using linked ART surveillance data and vital records from Florida, Massachusetts, Michigan, and Connecticut. Not applicable. Singleton live-born infants. None. Preterm birth (PTB score score approach, we found that singletons conceived after eSET were less likely to have a 5-minute Apgar Reproductive Medicine. All rights reserved.

  13. Congenital Microphthalmia, Anophthalmia and Coloboma among Live Births in Denmark.

    Science.gov (United States)

    Roos, Laura; Jensen, Hanne; Grønskov, Karen; Holst, René; Tümer, Zeynep

    2016-10-01

    This study aims to quantify the occurrence of the congenital eye malformations anophthalmia (AO), microphthalmia (MO) and coloboma among liveborn infants in Denmark, and to estimate the rate of chromosomal abnormalities in this group of patients. A cohort of patients born in 1995-2012 with diagnoses of MO/AO or coloboma was identified from the Danish National Patient Registry (DNPR), and their ocular and extra-ocular diagnoses were reviewed. In order to assess the occurrence of chromosomal abnormalities in the cohort, the data were cross-referenced with the Danish Cytogenetic Central Registry (DCCR). We identified 415 patients with MO/AO/coloboma in the DNPR. The total number of live births from 1995-2012 was 1,174,299, and the average birth prevalence of MO/AO/coloboma was 3.6/10,000 live births and of MO/AO was 1.2/10,000 live births. Extra-ocular abnormalities were observed in 32.1% of MO/AO cases and 21.7% of coloboma cases. Chromosome analysis was performed in 36.1% of the cohort, and 14.7% of cases had an abnormal karyotype. In 8.7% of the cohort, a chromosome microarray analysis was performed, and in 44.4% of cases, a possibly pathogenic copy number variation was observed. The birth prevalence of MO/AO/coloboma in Denmark has been steady at 3.6/10,000 live births during the last 17 years. The rate of syndromic cases was lower compared to other studies. A relatively high rate of pathogenic chromosomal aberrations was observed, suggesting an important role for cytogenetic analysis in this group of patients.

  14. Comparison of academic performance of twins and singletons in adolescence

    DEFF Research Database (Denmark)

    Christensen, Kaare; Petersen, Inge; Skytthe, Axel

    2006-01-01

    deviations for twins and singletons (8.02 v 8.02 and 1.05 v 1.06) despite the twins weighing on average 908 g (95% confidence interval 886 to 930 g) less than the singletons at birth. Controlling for birth weight, gestational age at birth, age at test, and parents' age and education confirmed the similarity......OBJECTIVES: To determine whether twins in recent cohorts show similar academic performance in adolescence to singletons and to test the effect of birth weight on academic performance in twins and singletons. DESIGN: Follow-up study. SETTING: Denmark. PARTICIPANTS: All twins (n=3411) and a 5% random...... sample of singletons (n=7796) born in Denmark during 1986-8. MAIN OUTCOME MEASURES: Test scores in ninth grade (age 15 or 16), birth weight, gestational age at birth, parents' age, and parents' education. RESULTS: Ninth grade test scores were normally distributed, with almost identical mean and standard...

  15. Do very preterm twins and singletons differ in their neurodevelopment at 5 years of age?

    Science.gov (United States)

    Bodeau-Livinec, Florence; Zeitlin, Jennifer; Blondel, Béatrice; Arnaud, Catherine; Fresson, Jeanne; Burguet, Antoine; Subtil, Damien; Marret, Stéphane; Rozé, Jean-Christophe; Marchand-Martin, Laetitia; Ancel, Pierre-Yves; Kaminski, Monique

    2013-11-01

    Twins have inconsistently shown poorer outcomes than singletons. Although a high proportion of twins are born very preterm, data are sparse on the long-term outcomes in very preterm twins. The objective of this study was to compare mortality and neurodevelopmental outcomes of very preterm singletons and twins and to study outcomes in relation to factors specific to twins. Birth cohort study Etude Epidemiologique sur les Petits Ages Gestationnels (EPIPAGE). Nine regions in France. All very preterm live births occurring from 22 to 32 weeks of gestation in all maternity wards of nine French regions in 1997 (n=2773). Neurodevelopmental status, including cerebral palsy, and a cognitive assessment with the Kaufman Assessment Battery for Children, with scores on the Mental Processing Composite (MPC) scale, was available for 1732 and 1473 children at 5 years of age, respectively. Among live births, twins had higher hospital mortality than singletons (adjusted (a)OR: 1.4 (95% CI 1.1 to 1.9)). Among survivors, there was no crude difference at 5 years between twins and singletons in the prevalence of cerebral palsy (8.0% vs 9.1%, respectively), MPC <70 (9.5% vs 11.1%) and mean MPC (94.6 vs 94.4). However, after adjustment for sex, gestational age, intrauterine growth restriction and social factors, twins were more likely to have lower MPC scores (mean difference: -2.4 (95% CI-4.8 to 0.01)). Live born twins had a higher risk of mortality when birth weight discordance was present (aOR:2.9 (95% CI 1.7 to 4.8)), but there were no differences in long-term outcomes. Compared with very preterm singletons, twins had higher mortality, no difference with respect to severe deficiencies, but slightly lower MPC scores at 5 years.

  16. Linkage of Maternity Hospital Episode Statistics data to birth registration and notification records for births in England 2005–2014: Quality assurance of linkage of routine data for singleton and multiple births

    Science.gov (United States)

    2018-01-01

    Objectives To quality assure a Trusted Third Party linked data set to prepare it for analysis. Setting Birth registration and notification records from the Office for National Statistics for all births in England 2005–2014 linked to Maternity Hospital Episode Statistics (HES) delivery records by NHS Digital using mothers’ identifiers. Participants All 6 676 912 births that occurred in England from 1 January 2005 to 31 December 2014. Primary and secondary outcome measures Every link between a registered birth and an HES delivery record for the study period was categorised as either the same baby or a different baby to the same mother, or as a wrong link, by comparing common baby data items and valid values in key fields with stepwise deterministic rules. Rates of preserved and discarded links were calculated and which features were more common in each group were assessed. Results Ninety-eight per cent of births originally linked to HES were left with one preserved link. The majority of discarded links were due to duplicate HES delivery records. Of the 4854 discarded links categorised as wrong links, clerical checks found 85% were false-positives links, 13% were quality assurance false negatives and 2% were undeterminable. Births linked using a less reliable stage of the linkage algorithm, births at home and in the London region, and with birth weight or gestational age values missing in HES were more likely to have all links discarded. Conclusions Linkage error, data quality issues, and false negatives in the quality assurance procedure were uncovered. The procedure could be improved by allowing for transposition in date fields, and more discrimination between missing and differing values. The availability of identifiers in the datasets supported clerical checking. Other research using Trusted Third Party linkage should not assume the linked dataset is error-free or optimised for their analysis, and allow sufficient resources for this. PMID:29500200

  17. Live birth and perinatal outcomes following stimulated and unstimulated IVF: analysis of over two decades of a nationwide data.

    Science.gov (United States)

    Sunkara, Sesh Kamal; LaMarca, Antonio; Polyzos, Nikolaos P; Seed, Paul T; Khalaf, Yakoub

    2016-10-01

    Does ovarian stimulation affect perinatal outcomes of preterm birth (PTB) and low birth weight (LBW) following IVF treatment. Despite no significant differences in the risks of PTB and LBW between stimulated and unstimulated IVF in the present study, the study cannot exclude the effect of ovarian stimulation on the perinatal outcomes following IVF. Pregnancies resulting from assisted reproductive treatments (ART) are associated with a higher risk of pregnancy complications compared to spontaneously conceived pregnancies attributed to the underlying infertility and the in vitro fertilization techniques. It is of interest to determine the effect size of ovarian stimulation use in achieving a live birth and whether ovarian stimulation that is routinely used in IVF, affects perinatal outcomes of birth weight and gestational age at delivery compared to unstimulated IVF. Anonymous data were obtained from the Human Fertilisation and Embryology Authority (HFEA), the statutory regulator of ART in the UK. The HFEA has collected data prospectively on all ART performed in the UK since 1991. Data from 1991 to 2011 comprising a total of 591 003 fresh IVF ± ICSI cycles involving 584 835 stimulated IVF cycles and 6168 unstimulated IVF cycles were analyzed. Data on all women undergoing either stimulated or unstimulated fresh IVF ± ICSI cycles during the period from 1991 to 2011 were analyzed to compare live birth rates, singleton live birth rates, perinatal outcomes of PTB, early PTB (IVF cycles and previous live birth. Analysis of the large nationwide data demonstrated 3.5 times (95% confidence interval (CI): 3.1-3.9) as many unstimulated IVF cycles being required to achieve one live birth compared to stimulated IVF and 2.9 times (95% CI: 2.6-3.2) as many unstimulated IVF cycles being required to achieve one singleton live birth compared to stimulated IVF. There was no significant difference in the unadjusted odds for PTB (odds ratio (OR) 1.27, 95% CI: 0.80-2.00) and LBW (OR 1

  18. Normal live births after intracytoplasmic sperm injection in a man with the rare condition of Eagle-Barrett syndrome (prune-belly syndrome).

    Science.gov (United States)

    Fleming, Steven D; Varughese, Elizabeth; Hua, Vi-Khiem; Robertson, Amanda; Dalzell, Fiona; Boothroyd, Clare V

    2013-12-01

    To report the first live births of male infants resulting from intracytoplasmic sperm injection (ICSI) using spermatozoa from a man with Eagle-Barrett syndrome (EBS). Case report. Assisted conception unit within a private hospital. An infertile couple. An infertile couple received repeated treatment with ICSI. Clinical pregnancy and a normal live birth. In 2008, after microinjection of ten oocytes, the transfer of a single expanded blastocyst led to the premature birth of a morphologically normal male infant at 18 weeks' gestation. This outcome followed preterm rupture of membranes and possible cervical incompetence. In 2009, after microinjection of six oocytes, transfer of a single 5-cell embryo led to a singleton pregnancy, with emergency cervical cerclage being performed at 21 weeks. A healthy male infant was born at 30 weeks, with no evidence of EBS, by lower-segment cesarean section for breech presentation and premature labor. In 2012, after elective laparoscopic placement of cervical suture, microinjection of ten oocytes and transfer of a single 4-cell embryo led to a singleton pregnancy with a healthy male infant, with no evidence of EBS, being born by cesarean section at 38 weeks. This report suggests that EBS is not transmitted to male offspring via ICSI. Crown Copyright © 2013. Published by Elsevier Inc. All rights reserved.

  19. Fertility treatment and childhood type 1 diabetes mellitus: a nationwide cohort study of 565,116 live births.

    Science.gov (United States)

    Kettner, Laura Ozer; Matthiesen, Niels Bjerregaard; Ramlau-Hansen, Cecilia Høst; Kesmodel, Ulrik Schiøler; Bay, Bjørn; Henriksen, Tine Brink

    2016-12-01

    To investigate the association between specific types of fertility treatment and childhood type 1 diabetes mellitus. Nationwide birth cohort study. Not applicable. All pregnancies resulting in a live-born singleton child in Denmark from 1995 to 2003. Not applicable. Childhood type 1 diabetes mellitus identified from redeemed prescriptions for insulin until 2013. The study included 565,116 singleton pregnancies. A total of 14,985 children were conceived by ovulation induction or intrauterine insemination, and 8,490 children were conceived by in vitro fertilization or intracytoplasmic sperm injection. During the follow-up period, 2,011 (0.4%) children developed type 1 diabetes mellitus. The primary analyses showed no association between fertility treatment and childhood type 1 diabetes mellitus. In secondary analyses, ovulation induction or intrauterine insemination with follicle-stimulating hormone was associated with an increased risk of type 1 diabetes mellitus (hazard ratio 3.22; 95% confidence interval 1.20 to 8.64). No clear associations were seen with other types of fertility treatment or with specific treatment indications. No association between fertility treatment and childhood type 1 diabetes mellitus was found. Ovulation induction or intrauterine insemination with follicle-stimulating hormone may be associated with an increased risk of childhood type 1 diabetes mellitus. However, this finding may be due to chance or to confounding by indication and thus requires further investigation. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  20. Linkage of Maternity Hospital Episode Statistics data to birth registration and notification records for births in England 2005-2014: Quality assurance of linkage of routine data for singleton and multiple births.

    Science.gov (United States)

    Harper, Gillian

    2018-03-01

    To quality assure a Trusted Third Party linked data set to prepare it for analysis. Birth registration and notification records from the Office for National Statistics for all births in England 2005-2014 linked to Maternity Hospital Episode Statistics (HES) delivery records by NHS Digital using mothers' identifiers. All 6 676 912 births that occurred in England from 1 January 2005 to 31 December 2014. Every link between a registered birth and an HES delivery record for the study period was categorised as either the same baby or a different baby to the same mother, or as a wrong link, by comparing common baby data items and valid values in key fields with stepwise deterministic rules. Rates of preserved and discarded links were calculated and which features were more common in each group were assessed. Ninety-eight per cent of births originally linked to HES were left with one preserved link. The majority of discarded links were due to duplicate HES delivery records. Of the 4854 discarded links categorised as wrong links, clerical checks found 85% were false-positives links, 13% were quality assurance false negatives and 2% were undeterminable. Births linked using a less reliable stage of the linkage algorithm, births at home and in the London region, and with birth weight or gestational age values missing in HES were more likely to have all links discarded. Linkage error, data quality issues, and false negatives in the quality assurance procedure were uncovered. The procedure could be improved by allowing for transposition in date fields, and more discrimination between missing and differing values. The availability of identifiers in the datasets supported clerical checking. Other research using Trusted Third Party linkage should not assume the linked dataset is error-free or optimised for their analysis, and allow sufficient resources for this. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved

  1. The associations between bridal pregnancy and obstetric outcomes among live births in Korea: population-based study.

    Directory of Open Access Journals (Sweden)

    Jung-Yun Lee

    Full Text Available OBJECTIVE: In East Asia the recently increased number of marriages in response to pregnancy is an important social issue. This study evaluated the association of marriage preceded by pregnancy (bridal pregnancy with obstetric outcomes among live births in Korea. METHODS: In this population-based study, 1,152,593 first singleton births were evaluated from data registered in the national birth registration database from 2004 to 2008 in Korea. In the study population, the pregnancy outcomes among live births from the bridal pregnancy group (N = 62,590 were compared with the outcomes of the post-marital pregnancy group (N = 564,749, composed of women who gave birth after 10 months but before 24 months of marriage. The variables preterm birth (PTB; <37 weeks gestation and low birth weight (LBW; <2.5 kg were used to determine the primary outcome. The adjusted odds ratios (aORs and 95% confidence intervals (CIs were calculated after controlling for socio-demographic factors. RESULTS: The socio-demographic factors among the bridal pregnancy group were associated with a social disadvantage and particular risk factors. In the subgroup analyses of maternal age, differences in adverse pregnancy outcomes from bridal pregnancy were identified between women in the following age group: (i ≤19, (ii 20-39, and (iii ≥40 years. After the multivariate analysis, the aORs for each age group were 1.47 (95% CI: 1.15-1.89, 1.76 (1.70-1.83, and 1.13 (0.77-1.66, respectively, for PTB and 0.92 (0.70-1.21, 1.60 (1.53-1.66, and 1.11 (0.71-1.74, respectively, for LBW. In the adjusted logistic regression models, bridal pregnancy was associated with PTB (1.76, 1.69-1.82 and LBW (1.53, 1.48-1.59. CONCLUSION: Pregnancy outcomes among live births from bridal pregnancies are associated with higher risks for PTB and LBW in Korea.

  2. Neonatal Bacteraemia Among 112,360 Live Births

    LENUS (Irish Health Repository)

    Huggard, D

    2016-10-01

    Our aims were to determine the incidence of bacteraemia in a cohort of neonatal patients over a 14 year period, to describe the organisms involved, and to establish the rates of sepsis with regard to both early onset sepsis (EOS) and late onset sepsis (LOS). Lastly, we investigated the trends of neonatal sepsis, to determine whether changes in clinical practice influenced the rate of blood culture positivity. With regards to EOS, GBS was the predominant pathogen, followed by E.coli, CoNS, and S. aureus . The overall mean EO rate per 1000 live births (LBs) was 1.19. Looking at LOS, S. aureus , CoNS , Enterococcus spp. were the most common bacteria cultured. The mean LOS rate was 1.88 per 1000 live births. The overall rate of EOS remained fairly steady. GBS remains the major pathogen in EOS; however its incidence has remained largely unchanged over time in relation to both EOS and LOS. Conversely the rate of LOS peaked from ’05-’09, mainly due to an increase in Staphylococcus aureus , CoNS and Enterococcus spp. cases, and then improved dramatically in the following years. This was likely due to a change in hospital policies in relation to hand hygiene and intravenous line placement and maintenance.

  3. Cretaceous choristoderan reptiles gave birth to live young

    Science.gov (United States)

    Ji, Qiang; Wu, Xiao-Chun; Cheng, Yen-Nien

    2010-04-01

    Viviparity (giving birth to live young) in fossil reptiles has been known only in a few marine groups: ichthyosaurs, pachypleurosaurs, and mosasaurs. Here, we report a pregnant specimen of the Early Cretaceous Hyphalosaurus baitaigouensis, a species of Choristodera, a diapsid group known from unequivocal fossil remains from the Middle Jurassic to the early Miocene (about 165 to 20 million years ago). This specimen provides the first evidence of viviparity in choristoderan reptiles and is also the sole record of viviparity in fossil reptiles which lived in freshwater ecosystems. This exquisitely preserved specimen contains up to 18 embryos arranged in pairs. Size comparison with small free-living individuals and the straight posture of the posterior-most pair suggest that those embryos were at term and had probably reached parturition. The posterior-most embryo on the left side has the head positioned toward the rear, contrary to normal position, suggesting a complication that may have contributed to the mother’s death. Viviparity would certainly have freed species of Hyphalosaurus from the need to return to land to deposit eggs; taking this advantage, they would have avoided intense competition with contemporaneous terrestrial carnivores such as dinosaurs.

  4. Triassic marine reptiles gave birth to live young.

    Science.gov (United States)

    Cheng, Yen-Nien; Wu, Xiao-Chun; Ji, Qiang

    2004-11-18

    Sauropterygians form the largest and most diverse group of ancient marine reptiles that lived throughout nearly the entire Mesozoic era (from 250 to 65 million years ago). Although thousands of specimens of this group have been collected around the world since the description of the first plesiosaur in 1821 (ref. 3), no direct evidence has been found to determine whether any sauropterygians came on shore to lay eggs (oviparity) like sea turtles, or gave birth in the water to live young (viviparity) as ichthyosaurs and mosasauroids (marine lizards) did. Viviparity has been proposed for plesiosaur, pachypleurosaur and nothosaur sauropterygians, but until now no concrete evidence has been advanced. Here we report two gravid specimens of Keichousaurus hui Young from the Middle Triassic of China. These exquisitely preserved specimens not only provide the first unequivocal evidence of reproductive mode and sexual dimorphism in sauropterygians, but also indicate that viviparity could have been expedited by the evolution of a movable pelvis in pachypleurosaurs. By extension, this has implications for the reproductive pattern of other sauropterygians and Mesozoic marine reptiles that possessed a movable pelvis.

  5. Race, Ethnicity, Concentrated Poverty, and Low Birth Weight Disparities

    OpenAIRE

    Sims, Mario; Sims, Tammy L.; Bruce, Marino A.

    2008-01-01

    This study examines the extent to which the relationship between area socioeconomic position (SEP) and low birth weight (LBW) varies by race and ethnicity. A cross-sectional, secondary data analysis was performed with 1992-1994 Vital Statistics and 1990 U.S. Census data for selected metropolitan areas. Low birth weight (< 2500 grams) rates were calculated for non-Hispanic Black, Latino, and non-Hispanic White live singleton births. Concentrated poverty was defined as poor persons living in ne...

  6. Vanishing twin syndrome among ART singletons and pregnancy outcomes.

    Science.gov (United States)

    Magnus, Maria C; Ghaderi, Sara; Morken, Nils-Halvdan; Magnus, Per; Bente Romundstad, Liv; Skjærven, Rolv; Wilcox, Allen J; Eldevik Håberg, Siri

    2017-11-01

    Among babies born by ART, do singleton survivors of a vanishing twin have lower birth weight than other singletons? Vanishing twin syndrome (VTS) was associated with lower birth weight among ART singletons; a sibship analysis indicated that the association was not confounded by maternal characteristics that remain stable between deliveries. Previous studies indicate that ART singletons with VTS have increased risk of adverse pregnancy outcomes, compared with other ART singletons. The potential contribution of unmeasured maternal background characteristics has been unclear. This was a Norwegian population-based registry study, including 17 368 mothers with 20 410 ART singleton deliveries between January 1984 and December 2013. The study population included 17 291 ART singletons without VTS, 638 ART singletons with VTS and 2418 ART singletons with uncertain vanishing twin status. We estimated differences in birth weight and gestational age comparing ART singletons with VTS first to all ART singletons without VTS, and subsequently to their ART siblings without VTS, using random- and fixed-effects linear regression, respectively. The corresponding comparisons for the associations with preterm birth and small for gestational age (SGA) were conducted using random-and fixed-effects logistic regression. The sibling analysis of preterm birth included 587 discordant siblings, while the sibling analysis of SGA included 674 discordant siblings. ART singletons with VTS had lower birth weight when compared to all ART singletons without VTS, with an adjusted mean difference (95% CI) of -116 g (-165, -67). When we compared ART singletons with VTS to their ART singletons sibling without VTS, the adjusted mean difference was -112 g (-209, -15). ART singletons with VTS also had increased risk of being born SGA, with an adjusted odds ratio (OR) (95% CI) of 1.48 (1.07, 2.03) compared to all ART singletons without VTS, and 2.79 (1.12, 6.91) in the sibship analyses. ART singletons with

  7. Flat-space singletons

    International Nuclear Information System (INIS)

    Fronsdal, C.

    1987-01-01

    Singletons exist, as particles and as local fields, only in 3+2 de Sitter space. Their kinematical properties make them natural candidates for constituents of massless fields, and perhaps for quarks. It is interesting to find out how to describe this type of compositeness in flat space. A theory of interacting singleton fields in de Sitter space is now available, and in this paper we study the flat-space limit of the Green's functions of that theory. The flat-space limit is an autonomous theory of Green's functions, but is not an operator field theory. The three-point function is calculated and its flat-space limit is found to reveal glimpses of a physical interpretation. Causal and spectral properties are in accord with the tenets of axiomatic field theory. The theory is a generalization of local field theory, in which photons appear as composite objects although the physical S matrix is the same as in conventional QED

  8. Saving Lives at Birth : The Impact of Home Births on Infant Outcomes

    NARCIS (Netherlands)

    Meltem Daysal, N.; Trandafir, M.; van Ewijk, R.

    2012-01-01

    Abstract: Many developed countries have recently experienced sharp increases in home birth rates. This paper investigates the impact of home births on the health of low-risk newborns using data from the Netherlands, the only developed country where home births are widespread. To account for

  9. Saving Lives at Birth: The Impact of Home Births on Infant Outcomes

    NARCIS (Netherlands)

    Daysal, N.M.; Trandafir, M.; van Ewijk, R.

    2015-01-01

    Many developed countries have recently experienced sharp increases in home birth rates. This paper investigates the impact of home births on the health of low-risk newborns using data from the Netherlands, the only developed country where home births are widespread. To account for endogeneity in

  10. [Live birth distribution by time and place from 1981 to 1998 in Japan].

    Science.gov (United States)

    Matsushima, Noriko; Morita, Noriko; Ogata, Nozomi; Saeki, Keigo; Matsuda, Ryozo; Kurumatani, Norio

    2003-01-01

    To investigate the diurnal rhythm of live births labored spontaneously, and the effects of obstetric intervention on birth time distributions. The data of live births tabulated by time (one-hour intervals), date and birthplace throughout Japan between 1981 and 1998 were obtained with permission from the former Ministry of Health and Welfare. Together with an investigation of hourly birth numbers by place in each year, an annual transition of hourly birth rates in medical institutions and the diurnal rhythm of birth numbers in maternity homes and at home were analyzed using regression analysis. In every calendar year studied the hourly live birth numbers at hospitals showed a single-peak distribution pattern with maximum values at 13:00-15:00. The annual transition of hourly birth rates showed a 10% (birth numbers base) decrease in the 11:00-13:00 period in 1998 as compared with that in 1981, while there was a corresponding increase of 8% in the 13:00-15:00 period. Hourly birth numbers at clinics showed a double-peak distribution pattern with maximum values during the 11:00-12:00 and 14:00-15:00 periods in early 1980, while a single-peak distribution with a maximum value during the 13:00-15:00 period appeared in 1989 and has remained thereafter. Hourly birth rates (birth numbers base) increased by over 6% in the 13:00-15:00 and 17:00-20:00 periods over the past 18 years, while they decreased by 10% in the 9:00-13:00 period. The results at maternity homes were clearly different from those at hospitals and clinics. The live birth numbers totaled for the 18 years showed a double-phase distribution with a maximum value in the 6:00-7:00 period and a minimum value in the 19:00-20:00 period. The best-fit regression model for the obtained data was a sine curve with a maximum value at 6:00 (coefficient of determination 0.97). Hourly distributions of live births at home also fitted best to a since curve with the maximum value again at 6:00 (coefficient of determination 0

  11. Cervical length screening for prevention of preterm birth in singleton pregnancy with threatened preterm labor: systematic review and meta-analysis of randomized controlled trials using individual patient-level data.

    Science.gov (United States)

    Berghella, V; Palacio, M; Ness, A; Alfirevic, Z; Nicolaides, K H; Saccone, G

    2017-03-01

    Cervical length screening by transvaginal sonography (TVS) has been shown to be a good predictive test for spontaneous preterm birth (PTB) in symptomatic singleton pregnancy with threatened preterm labor (PTL). The aim of this review and meta-analysis of individual participant data was to evaluate the effect of knowledge of the TVS cervical length (CL) in preventing PTB in singleton pregnancies presenting with threatened PTL. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register and the Cochrane Complementary Medicine Field's Trials Register (May 2016) and reference lists of retrieved studies. Selection criteria included randomized controlled trials of singleton gestations with threatened PTL randomized to management based mainly on CL screening (intervention group), or CL screening with no knowledge of results or no CL screening (control group). Participants included women with singleton gestations at 23 + 0 to 36 + 6 weeks with threatened PTL. We contacted corresponding authors of included trials to request access to the data and perform a meta-analysis of individual participant data. Data provided by the investigators were merged into a master database constructed specifically for the review. The primary outcome was PTB DE PARTO PREMATURO: REVISIÓN SISTEMÁTICA Y METAANÁLISIS DE ENSAYOS CONTROLADOS ALEATORIZADOS HACIENDO USO DE LOS DATOS INDIVIDUALES DE LAS PACIENTES: RESUMEN OBJETIVO: El cribado mediante la longitud cervical obtenida con ecografía transvaginal (ETV) ha demostrado ser una buena prueba para la predicción del parto pretérmino espontáneo (PPTE) en embarazos con feto único sintomáticos debido a la amenaza de parto pretérmino (PPT). El objetivo de esta revisión y metaanálisis de los datos de participantes individuales fue evaluar el efecto de medir la longitud cervical (LC) mediante ETV con el fin de prevenir el parto prematuro en embarazos únicos con amenaza de PPT. MÉTODOS: Se realizaron búsquedas en los ficheros

  12. Live birth rate and number of blastomeres on day 2 transfer

    DEFF Research Database (Denmark)

    Azzarello, Antonino; Hoest, Thomas; Hay-Schmidt, Anders

    2016-01-01

    -lapse assessment, ACDs and/or recalculated fragmentation >25 % was recognized in 106/578 (18.3 %) of transferred embryos. None of them resulted in a live birth. After exclusion of these embryos, the number of blastomeres on the day of transfer did not have any impact on life birth rate. Conclusion Conventional...

  13. Live birth rates after MESA or TESE in men with obstructive azoospermia: is there a difference?

    NARCIS (Netherlands)

    van Wely, Madelon; Barbey, Natalie; Meissner, Andreas; Repping, Sjoerd; Silber, Sherman J.

    2015-01-01

    How do live birth rates compare after intracytoplasmic sperm injection (ICSI) for men with obstructive azoospermia when using sperm derived from testicular sperm extraction (TESE) versus microsurgical epididymal sperm aspiration (MESA)? Our study suggests that proximal epididymal sperm (from MESA)

  14. Association between ABO blood type and live-birth outcomes in single-embryo transfer cycles.

    Science.gov (United States)

    Pereira, Nigel; Patel, Hency H; Stone, Logan D; Christos, Paul J; Elias, Rony T; Spandorfer, Steven D; Rosenwaks, Zev

    2017-11-01

    To investigate the association between ABO blood type and live-birth outcomes in patients undergoing IVF with day 5 single-embryo transfer (SET). Retrospective cohort study. University-affiliated center. Normal responders, blood type and live birth, while controlling for confounders. Odds ratios (OR) with 95% confidence intervals (CI) for live birth were estimated. A total of 2,329 patients were included. The mean age of the study cohort was 34.6 ± 4.78 years. The distribution of blood types was as follows: A = 897 (38.5%); B = 397 (17.0%); AB = 120 (5.2%); and, O = 1,915 (39.3%) patients. There was no difference in the baseline demographics, ovarian stimulation, or embryo quality parameters between the blood types. The unadjusted ORs for live birth when comparing blood type A (referent) with blood types B, AB, and O were 0.96 (95% CI, 0.6-1.7), 0.72 (95% CI, 0.4-1.2), and 0.96 (95% CI. 0.6-1.7), respectively. The adjusted ORs for live birth remained not significant when comparing blood type A to blood types B, AB, and O individually. No difference in birth weight or gestational age at delivery was noted among the four blood types. Our findings suggest that ABO blood type is not associated with live-birth rate, birth weight, or gestational age at delivery in patients undergoing IVF with day 5 SET. Copyright © 2017 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  15. Live-Birth Rate Associated With Repeat In Vitro Fertilization Treatment Cycles.

    Science.gov (United States)

    Smith, Andrew D A C; Tilling, Kate; Nelson, Scott M; Lawlor, Debbie A

    The likelihood of achieving a live birth with repeat in vitro fertilization (IVF) is unclear, yet treatment is commonly limited to 3 or 4 embryo transfers. To determine the live-birth rate per initiated ovarian stimulation IVF cycle and with repeated cycles. Prospective study of 156,947 UK women who received 257,398 IVF ovarian stimulation cycles between 2003 and 2010 and were followed up until June 2012. In vitro fertilization, with a cycle defined as an episode of ovarian stimulation and all subsequent separate fresh and frozen embryo transfers. Live-birth rate per IVF cycle and the cumulative live-birth rates across all cycles in all women and by age and treatment type. Optimal, prognosis-adjusted, and conservative cumulative live-birth rates were estimated, reflecting 0%, 30%, and 100%, respectively, of women who discontinued due to poor prognosis and having a live-birth rate of 0 had they continued. Among the 156,947 women, the median age at start of treatment was 35 years (interquartile range, 32-38; range, 18-55), and the median duration of infertility for all 257,398 cycles was 4 years (interquartile range, 2-6; range, cycle was 29.5% (95% CI, 29.3%-29.7%). This remained above 20% up to and including the fourth cycle. The cumulative prognosis-adjusted live-birth rate across all cycles continued to increase up to the ninth cycle, with 65.3% (95% CI, 64.8%-65.8%) of women achieving a live birth by the sixth cycle. In women younger than 40 years using their own oocytes, the live-birth rate for the first cycle was 32.3% (95% CI, 32.0%-32.5%) and remained above 20% up to and including the fourth cycle. Six cycles achieved a cumulative prognosis-adjusted live-birth rate of 68.4% (95% CI, 67.8%-68.9%). For women aged 40 to 42 years, the live-birth rate for the first cycle was 12.3% (95% CI, 11.8%-12.8%), with 6 cycles achieving a cumulative prognosis-adjusted live-birth rate of 31.5% (95% CI, 29.7%-33.3%). For women older than 42 years, all rates within each cycle

  16. The type of culture medium and the duration of in vitro culture do not influence birthweight of ART singletons.

    Science.gov (United States)

    De Vos, A; Janssens, R; Van de Velde, H; Haentjens, P; Bonduelle, M; Tournaye, H; Verheyen, G

    2015-01-01

    Does the type of in vitro culture medium or the duration of in vitro culture influence singleton birthweight after IVF/ICSI treatment? In a comparison of two culture media, neither the medium nor the duration of culture (Day 3 versus Day 5 blastocyst transfer) had any effect on mean singleton birthweight. Previous studies indicated that in vitro culture of human embryos may affect birthweight of live born singletons. Both the type of culture medium and the duration of culture may be implicated. However, these studies are small and report conflicting results. A large retrospective analysis was performed including all singleton live births after transferring fresh Day 3 or Day 5 embryos. IVF and ICSI cycles performed between April 2004 and December 2009 at a tertiary care centre were included for analysis. A total of 2098 singleton live births resulting from singleton pregnancies were included for analysis. Two different sequential embryo culture media were concurrently used in an alternating way: Medicult (n = 1388) and Vitrolife (n = 710). Maternal age, maternal and paternal BMI, maternal parity, maternal smoking, main cause of infertility, cycle rank, stimulation protocol, method of fertilization (IVF or ICSI), time in culture and number of embryos transferred were taken into account. Embryo transfers were performed either on Day 3 (n = 1234) or on Day 5 (n = 864). Singleton birthweight was the primary outcome parameter. Gestational age and gender of the newborn were accounted for in the multiple regression analysis. No significant differences in mean singleton birthweight were observed between the two culture media: Medicult 3222 g (±15 SE) and Vitrolife 3251 g (±21 SE) (P = 0.264). The mean singleton birthweight was not different between Day 3 embryo transfers (3219 ± 16 g) and Day 5 blastocyst transfers (3250 ± 19 g; P = 0.209). Multiple regression analysis controlling for potential maternal, paternal, treatment and newborn confounders confirmed the non

  17. Effect of Embryo Banking on U.S. National Assisted Reproductive Technology Live Birth Rates.

    Directory of Open Access Journals (Sweden)

    Vitaly A Kushnir

    Full Text Available Assisted Reproductive Technology (ART reports generated by the Centers for Disease Control and Prevention (CDC exclude embryo banking cycles from outcome calculations.We examined data reported to the CDC in 2013 for the impact of embryo banking exclusion on national ART outcomes by recalculating autologous oocyte ART live birth rates. Inflation of reported fresh ART cycle live birth rates was assessed for all age groups of infertile women as the difference between fresh cycle live births with reference to number of initiated fresh cycles (excluding embryo banking cycles, as typically reported by the CDC, and fresh cycle live births with reference to total initiated fresh ART cycles (including embryo banking cycles.During 2013, out of 121,351 fresh non-donor ART cycles 27,564 (22.7% involved embryo banking. The proportion of banking cycles increased with female age from 15.5% in women 44 years. Concomitantly, the proportion of thawed cycles decreased with advancing female age (P 44. The inflation of live birth rates in thawed cycles could not be calculated from the publically available CDC data but appears to be even greater.Utilization of embryo banking increased during 2013 with advancing female age, suggesting a potential age selection bias. Exclusion of embryo banking cycles from national ART outcome reports significantly inflated national ART success rates, especially among older women.Exclusion of embryo banking cycles from US National Assisted Reproductive Technology outcome reports significantly inflates reported success rates especially in older women.

  18. Effect of Embryo Banking on U.S. National Assisted Reproductive Technology Live Birth Rates.

    Science.gov (United States)

    Kushnir, Vitaly A; Barad, David H; Albertini, David F; Darmon, Sarah K; Gleicher, Norbert

    2016-01-01

    Assisted Reproductive Technology (ART) reports generated by the Centers for Disease Control and Prevention (CDC) exclude embryo banking cycles from outcome calculations. We examined data reported to the CDC in 2013 for the impact of embryo banking exclusion on national ART outcomes by recalculating autologous oocyte ART live birth rates. Inflation of reported fresh ART cycle live birth rates was assessed for all age groups of infertile women as the difference between fresh cycle live births with reference to number of initiated fresh cycles (excluding embryo banking cycles), as typically reported by the CDC, and fresh cycle live births with reference to total initiated fresh ART cycles (including embryo banking cycles). During 2013, out of 121,351 fresh non-donor ART cycles 27,564 (22.7%) involved embryo banking. The proportion of banking cycles increased with female age from 15.5% in women women >44 years. Concomitantly, the proportion of thawed cycles decreased with advancing female age (P women age >44. The inflation of live birth rates in thawed cycles could not be calculated from the publically available CDC data but appears to be even greater. Utilization of embryo banking increased during 2013 with advancing female age, suggesting a potential age selection bias. Exclusion of embryo banking cycles from national ART outcome reports significantly inflated national ART success rates, especially among older women. Exclusion of embryo banking cycles from US National Assisted Reproductive Technology outcome reports significantly inflates reported success rates especially in older women.

  19. [Evaluation of data on live birth certificates from the Information System on Live Births (SINASC) in Campinas, São Paulo, 2009].

    Science.gov (United States)

    Gabriel, Guilherme Paiva; Chiquetto, Letícia; Morcillo, André Moreno; Ferreira, Maria do Carmo; Bazan, Ivan Gilberto M; Daolio, Luísa Dias; Lemos, Jéssica J Rocha; Carniel, Emília de Faria

    2014-09-01

    To assess the completeness and reliability of the Information System on Live Births (Sinasc) data. A cross-sectional analysis of the reliability and completeness of Sinasc's data was performed using a sample of Live Birth Certificate (LBC) from 2009, related to births from Campinas, Southeast Brazil. For data analysis, hospitals were grouped according to category of service (Unified National Health System, private or both), 600 LBCs were randomly selected and the data were collected in LBC-copies through mothers and newborns' hospital records and by telephone interviews. The completeness of LBCs was evaluated, calculating the percentage of blank fields, and the LBCs agreement comparing the originals with the copies was evaluated by Kappa and intraclass correlation coefficients. The percentage of completeness of LBCs ranged from 99.8%-100%. For the most items, the agreement was excellent. However, the agreement was acceptable for marital status, maternal education and newborn infants' race/color, low for prenatal visits and presence of birth defects, and very low for the number of deceased children. The results showed that the municipality Sinasc is reliable for most of the studied variables. Investments in training of the professionals are suggested in an attempt to improve system capacity to support planning and implementation of health activities for the benefit of maternal and child population. Copyright © 2014 Sociedade de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.

  20. Vaginal progesterone vs intramuscular 17α-hydroxyprogesterone caproate for prevention of recurrent spontaneous preterm birth in singleton gestations: systematic review and meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Saccone, G; Khalifeh, A; Elimian, A; Bahrami, E; Chaman-Ara, K; Bahrami, M A; Berghella, V

    2017-03-01

    Randomized controlled trials (RCTs) have recently compared intramuscular 17α-hydroxyprogesterone caproate (17-OHPC) with vaginal progesterone for reducing the risk of spontaneous preterm birth (SPTB) in singleton gestations with prior SPTB. The aim of this systematic review and meta-analysis was to evaluate the efficacy of vaginal progesterone compared with 17-OHPC in prevention of SPTB in singleton gestations with prior SPTB. Searches of electronic databases were performed to identify all RCTs of asymptomatic singleton gestations with prior SPTB that were randomized to prophylactic treatment with either vaginal progesterone (intervention group) or intramuscular 17-OHPC (comparison group). No restrictions for language or geographic location were applied. The primary outcome was SPTB OBJETIVO: Recientemente se han realizado varios ensayos controlados aleatorios (ECA) que comparaban el caproato de 17α-hidroxiprogesterona (17-OHPC, por sus siglas en inglés) por vía intramuscular con la progesterona por vía vaginal para la reducción del riesgo de parto pretérmino espontáneo (PPTE) en embarazos con feto único de gestantes con historial de PPTE. El objetivo de esta revisión sistemática y metaanálisis fue evaluar la eficacia de la progesterona vaginal en comparación con la 17-OHPC en la prevención de embarazos con feto único de gestantes con historial de PPTE. MÉTODOS: Se realizaron búsquedas en bases de datos electrónicas para identificar todos los ECA con embarazos de feto único asintomáticos con historial de PPTE antes de ser asignados al azar a un tratamiento profiláctico, ya fuera con progesterona vaginal (grupo de intervención) o con 17-OHPC intramuscular (grupo de control). No se aplicaron restricciones respecto al idioma o la ubicación geográfica. El resultado primario fue PPTE < 34 semanas. Los resultados secundarios fueron PPTE <37 semanas, < 32 semanas, < 28 semanas y < 24 semanas, la reacción materna adversa al fármaco y los

  1. The Meaning of Giving Birth: Voices of Hmong Women Living in Vietnam.

    Science.gov (United States)

    Corbett, Cheryl A; Callister, Lynn Clark; Gettys, Jamie Peterson; Hickman, Jacob R

    Increasing knowledge about the sociocultural context of birth is essential to promote culturally sensitive nursing care. This qualitative study provides an ethnographic view of the perspectives on birthing of Hmong mothers living in the highlands of Vietnam. Unique cultural beliefs exist in Hmong culture about the spiritual and physical world as well as ritual practices associated with childbearing. This includes variations of ancestor worship, reincarnation, and healing practices by shamans. Traditionally, Hmong families take an active role in childbirth with birth frequently occurring in the home. Situated within a large collaborative anthropology project, a convenience sample of 8 Hmong women, who had recently given birth, were interviewed regarding the perinatal experience. In addition, ethnic traditional birth attendants (midwives) and other village women contributed perspectives providing richly descriptive data. This ethnographic study was conducted during 6 weeks of immersed participant observation with primary data collection carried out through fieldwork. Data were analyzed to derive cultural themes from interviews and observations. Significant themes included (1) valuing motherhood, (2) laboring and giving birth silently, (3) giving birth within the comfort of home and family, (4) feeling capable of birthing well, (5) feeling anxiety to provide for another child, and (6) embracing cultural traditions. Listening to the voices of Hmong women enhances understanding of the meaning of childbirth. Gaining greater understanding of Hmong cultural beliefs and practices can ensure childbearing women receive respectful, safe, and quality care.

  2. Influences on achieving motor milestones: A twin-singleton study

    NARCIS (Netherlands)

    Brouwer, S.I.; van Beijsterveldt, C.E.M.; Bartels, M.; Hudziak, J.; Boomsma, D.I.

    2006-01-01

    In order to determine if twinning impacted achievement of motor milestones the attainment of early motor milestones in twins was examined and compared to published data from singletons of the same age from the same culture and birth years. We examined the influence of twinning, sex, zygosity and

  3. Living in violence: Neighborhood domestic violence and small for gestational age births.

    Science.gov (United States)

    Felker-Kantor, Erica; Wallace, Maeve; Theall, Katherine

    2017-07-01

    To determine the association between neighborhood domestic violence and small-for-gestational-age (SGA) birth and to examine if there is a differential impact of neighborhood domestic violence on SGA births by race in a high crime community. This analysis includes all birth records issued in New Orleans, Louisiana from 2011 to 2012 geocoded by census tract (N=177 census tracts, N=8322 women). Hierarchical modeling and ecologic spatial analysis were used to examine the area-effect of neighborhood domestic violence on SGA births, independent of individual-level predictors and accounting for the propensity to live in high domestic violence neighborhoods. Tests for spatial autocorrelation reveled area-level clustering and overlap of SGA and domestic violent rates. Pregnant women living in high domestic violence areas were more likely to give birth to an SGA infant compared to women in low-domestic violence areas (OR=1.04, 95%CI: 1.01, 1.08), net of the effects of individual-level factors and propensity scores. Neighborhood-level attributes including rates of domestic violence may increase women's risk for SGA birth, highlighting a policy-relevant and potentially amenable exposure. Copyright © 2017 Elsevier Ltd. All rights reserved.

  4. The influence on birthweight of maternal living conditions a decade prior to giving birth

    Directory of Open Access Journals (Sweden)

    John Singhammer

    2009-10-01

    Full Text Available The study’s aim was to correlate measures of mothers’ socio-economic status, a decade prior to giving birth, with their children’s birthweight. As part of a larger study, information on birth characteristics from 706 babies born 1970-73 were linked with census data obtained from their mothers near the time of birth as well as one decade earlier. The 706 individuals were selected at random from two national surveys in 1998 and 2000 and traced back to the time of birth in the period 1970-73. Information on birth characteristics was linked to census data obtained from the mothers in 1960 and 1970. Included was information on parent’s living conditions (e.g. income, type of dwelling, indoor plumbing, telephone, number of people in the household. Information on mother’s health during pregnancy, a decade before childbirth and near childbirth, and data on mothers’ and the infants’ health at birth was obtained from the Medical Birth Registry of Norway. In analysis that included both early and current socio-economic conditions maternal education and rural residency at the time of giving birth were observed as statistical significant predictors of birthweight. Results were adjusted for maternal age, parity, plurality, gender and diagnoses before and during pregnancy, all factors observed to attenuate birthweight. Indicators of women’s socio-economic conditions a decade prior to giving birth were not significantly associated with birthweight. These findings do not clearly support suggestions in the literature that an infant’s vitality may be influenced by the family’s socio-economic conditions years before birth.

  5. Cost of fertility treatment and live birth outcome in women of different ages and BMI.

    Science.gov (United States)

    Pandey, Shilpi; McLernon, David J; Scotland, Graham; Mollison, Jill; Wordsworth, Sarah; Bhattacharya, Siladitya

    2014-10-10

    What is the impact of different age and BMI groups on total investigation and treatment costs in women attending a secondary/tertiary care fertility clinic? Women in their early to mid-30s and women with normal BMI had higher cumulative investigation and treatment costs, but also higher probability of live birth. Female age and BMI have been used as criteria for rationing publically funded fertility treatments. Population-based data on the costs of investigating and treating infertility are lacking. A retrospective cohort study of 2463 women was conducted in a single secondary/tertiary care fertility clinic in Aberdeen, Scotland from 1998 to 2008. Participants included all women living in a defined geographical area referred from primary care to a specialized fertility clinic over an 11-year period. Women were followed up for 5 years or until live birth if this occurred sooner. Mean discounted cumulative National Health Service costs (expressed in 2010/2011 GBP) of fertility investigations, treatments (including all types of assisted reproduction), and pregnancy (including delivery episode) and neonatal admissions were calculated and summarized by age (≤ 30, 31-35, 36-40, >40 years) and BMI groupings (years, with 694 (55.1%) of these being natural conceptions. The live birth rate was highest among women in the youngest age group (64.3%), and lowest in those aged >40 years (13.4%). Overall live birth rates were generally lower in women with BMI >30 kg/m(2). The total costs of investigations were generally highest among women younger than 30 years (£491 in those with normal BMI), whilst treatment costs tended to be higher in 31-35 year olds (£1,840 in those with normal BMI). Multivariate modelling predicted a cost increase associated with treatment which was highest among women in the lowest BMI group (across all ages), and also highest among women aged 31-35 years. The increase in the predicted probability of live birth with exposure to treatment was consistent

  6. Congenital malformations among live births at arvand hospital, ahwaz, iran - a prospective study

    International Nuclear Information System (INIS)

    Ali, A.; Zahad, S.; Masoumeh, A.; Azar, A.

    2008-01-01

    The aim of the study was to determine the profile of congenital malformations (CM) among live births at Arvand hospital, in Ahwaz city. In this prospective study all of the neonates born at Arvand hospital in Ahwaz from 2004 to 2006 were registered. Stillbirths and those who died in a few hours after birth were excluded and finally 4660 newborns were enrolled. Of the 4660 live births 94 (20.2/1000) had at least a CM. The predominant systems involved were musculoskeletal (7.9/1000), followed by genitourinary (7.1/1000), central nervous (2.4 /1000), digestive (1.1/1000) and chromosomal anomalies (0.9/1000). Although the frequency of malformations in the study was approximately similar to other investigations, if we include abortions, stillbirths and if we used screening tests and genetic studies, this rate was more than 20.1/1000. (author)

  7. Metastatic Choriocarcinoma Following Live Birth – A Rare Presentation

    Directory of Open Access Journals (Sweden)

    Joya Sree Roy

    2011-09-01

    Full Text Available Choriocarcinoma is the most malignant tumor of gestational trophoblastic neoplasia. Post-partum choriocarcinoma is an infrequent event with poor prognosis. The diagnosis is usually delayed due to failure to recognize the mode of presentation of this disease. Being a rare occurrence, limited data is available regarding its clinical features. We present a 24 years old women with parity one delivered by caesarean section indicated for premature rupture of membrane with fetal distress at 39 wks of pregnancy. Frequent episodes of heavy vaginal bleeding had started 28 days following C/S. For this, she had H/O uterine evacuatin twice within 5 days interval. Biopsy report of second curettage showed choriocarcinoma. On admission to Dhaka Medical College Hospital (DMCH, the pretreatment Human Chorionic Gonadotrophin (βhCG level was >200000.0 IU/L, uterine mass of about 18 wks pregnancy size & X-Ray chest showed segmental consolidation in left mid zone of lung. After consultation with oncologist Etoposide, Methotrexate, Dactinomycin, Cyclophosphamide & Vincristine (EMACO therapy was started but before completion of her proposed cycles, she developed a live threatening condition which was managed very urgently and meticulously. Now the patient is under regular monitoring. Key words: GTD; Choriocarcinoma DOI: http://dx.doi.org/10.3329/bsmmuj.v4i2.8642 BSMMU J 2011; 4(2:116-118

  8. Live birth potential of good morphology and vitrified blastocysts presenting abnormal cell divisions

    DEFF Research Database (Denmark)

    Azzarello, Antonino; Høst, Thomas; Hay-Schmidt, Anders

    2017-01-01

    a lower live birth rate (17.0%) than blastocyst with solely regular cell divisions (29.3%). ACDs could occur at more than one cell division in the same good morphology blastocyst. Reported as independent events, we observed ACDs occurring more frequently at the later cell cycles (1st: 1.3%; 2nd: 8.0%; 3rd...

  9. Male and female alcohol consumption and live birth after assisted reproductive technology treatment

    DEFF Research Database (Denmark)

    Vittrup, Ida; Petersen, Gitte Lindved; Kamper-Jørgensen, Mads

    2017-01-01

    The objective was to assess the potential association between female and male alcohol consumption and probability of achieving a live birth after assisted reproductive treatment. From a nationwide Danish register-based cohort information on alcohol consumption at assisted reproductive treatment i...

  10. Risk factors for maternal anaemia and low birth weight in pregnant women living in rural India: a prospective cohort study.

    Science.gov (United States)

    Ahankari, A S; Myles, P R; Dixit, J V; Tata, L J; Fogarty, A W

    2017-10-01

    The aim of this prospective study was to estimate the prevalence and risk factors for maternal anaemia and low birth weight (LBW) in pregnant women living in Maharashtra state, India. This is a prospective study. Women between 3 and 5 months of pregnancy were recruited from 34 villages based in Maharashtra state. Baseline data collection, anthropometric measurements and blood investigations were performed. Participants were followed-up to record birth weight. In total, 303 women were eligible, and 287 (95%) provided data. 77% were anaemic, defined as haemoglobin less than 11.0 g/dl at the time of recruitment, with a mean corpuscular volume of 80.5 fl/cell (standard deviation: 7.22, range: 53.4-93.8). The increased risk of anaemia was seen in women with consanguineous marriages (odds ratio [OR]: 2.41, 95% confidence interval [CI]: 1.16-5.01, P = 0.01) after adjustment for potential confounding factors. Postdelivery data from full-term singleton live births demonstrated a 7% prevalence of LBW. Consanguineous marriage was a major risk factor for LBW (OR: 4.10, 95% CI: 1.25-13.41, P = 0.02). The presence of maternal anaemia during 3-5 months of pregnancy was associated with lower risk of LBW (unadjusted OR: 0.34, 95% CI: 0.13-0.92, P = 0.03). About 30% of our study participants were in a consanguineous marriage, which was identified as a potentially avoidable risk factor for both anaemia and LBW. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  11. Is there a link between blastomere contact surfaces of day 3 embryos and live birth rate?

    Directory of Open Access Journals (Sweden)

    Paternot Goedele

    2012-09-01

    Full Text Available Abstract Background Cell-cell communication and adhesion are essential for the compaction process of early stage embryos. The aim of this study was to develop a non-invasive objective calculation system of embryo compaction in order to test the hypothesis that embryos with a larger mean contact surface result in a higher live birth rate compared to embryos with a lower mean contact surface. Methods Multilevel images of 474 embryos transferred on day 3 were evaluated by the Cellify software. This software calculates the contact surfaces between the blastomeres. The primary outcome of this study was live birth. An ideal range of contact surface was determined and the positive and negative predictive value, the sensitivity, the specificity and the area under the curve for this new characteristic were calculated. Results In total, 115 (24% transferred embryos resulted in a live birth. Selection of an embryo for transfer on its mean contact surface could predict live birth with a high sensitivity (80% and high negative predicting value (83% but with a low positive predictive value (27%, a low specificity (31% and low area under the ROC curve (0.56. The mean contact surface of embryos cultured in a single medium was significantly higher compared to the mean contact surface of embryos cultured in a sequential medium (p = 0.0003. Conclusions Neither the mean contact surface nor the number of contact surfaces of a day 3 embryo had an additional value in the prediction of live birth. The type of culture medium, however, had an impact on the contact surface of an embryo. Embryos cultured in a single medium had a significant larger contact surface compared to embryos cultured in the sequential medium.

  12. Cesarean Section Rate in Singleton Primiparae and Related Factors in Beijing, China

    Directory of Open Access Journals (Sweden)

    Geng Song

    2017-01-01

    Conclusions: Maternal age, prepregnancy body mass index, gestational weight gain, blood glucose levels, residence, education level, and singleton fetal birth weight are all factors that might significantly affect the CSR.

  13. Rates of preterm birth following antenatal exposure to severe life events: A population-based cohort study

    DEFF Research Database (Denmark)

    Khashan, Ali; McNamee, R.; Abel, Kathryn

    2009-01-01

    BACKGROUND: Preterm birth and other pregnancy complications have been linked to maternal stress during pregnancy. We investigated the association between maternal exposure to severe life events and risk of preterm birth. METHODS: Mothers of all singleton live births (n = 1.35 million births...... to estimate the effect of exposure on preterm birth, very preterm birth and extremely preterm birth. RESULTS: There were 58 626 (4.34%) preterm births (births and 3288 (0.24%) extremely preterm births in the study cohort. Severe life events in close relatives in the 6...... months before conception increased the risk of preterm birth by 16% (relative risk, RR = 1.16, [95% CI: 1.08-1.23]). Severe life events in older children in the 6 months before conception increased the risk of preterm birth by 23% (RR = 1.23, [95% CI: 1.02-1.49]) and the risk of very preterm birth by 59...

  14. The first successful live birth following preimplantation genetic diagnosis using PCR for type 1 citrullinemia

    Science.gov (United States)

    Cho, Jae-Hyun; Lee, Kyung-Hee; Jeon, Il-Kyung; Kim, Jae-Min; Kang, Byung-Moon

    2014-01-01

    Type 1 citrullinemia (CTLN1) is an autosomal recessive inherited metabolic disorder caused by anargininosuccinicnate synthetase deficiency. The patient was a 38-year-old Korean woman who is a carrier for CTLN1 and her first baby was diagnosed with CTLN1. Preimplantation genetic diagnosis (PGD) for CTLN1 in day 3 embryos using polymerase chain reaction was performed for live birth of healthy baby who is no affected with CTLN1. One unaffected blastocyst was transferred. This resulted in a clinical pregnancy and the live birth of healthy male twin. They were confirmed to be unaffected with CTNL1 by post natal diagnosis. This is the first case report of the use of PGD for CTNL1. PMID:24883299

  15. Association of light-to-moderate alcohol drinking in pregnancy with preterm birth and birth weight

    DEFF Research Database (Denmark)

    Strandberg-Larsen, Katrine; Poulsen, Gry; Bech, Bodil Hammer

    2017-01-01

    Women who drink light-to-moderately during pregnancy have been observed to have lower risk of unfavourable pregnancy outcomes than abstainers. This has been suggested to be a result of bias. In a pooled sample, including 193 747 live-born singletons from nine European cohorts, we examined...... alcohol. This decreased to 39% in 2000–2004, and 14% in 2005–2011. Before 2000, every additional drink was associated with reduced mean birth weight, whereas in 2005–2011, the mean birth weight increased with increasing intake. The period-specific associations between low-to-moderate drinking and birth...

  16. A cost per live birth comparison of HMG and rFSH randomized trials.

    Science.gov (United States)

    Connolly, Mark; De Vrieze, Kathleen; Ombelet, Willem; Schneider, Dirk; Currie, Craig

    2008-12-01

    To help inform healthcare treatment practices and funding decisions, an economic evaluation was conducted to compare the two leading gonadotrophins used for IVF in Belgium. Based on the results of a recently published meta-analysis, a simulated decision tree model was constructed with four states: (i) fresh cycle, (ii) cryopreserved cycle, (iii) live birth and (iv) treatment withdrawal. Gonadotrophin costs were based on highly purified human menopausal gonadotrophin (HP-HMG; Menopur) and recombinant FSH (rFSH) alpha (Gonal-F). After one fresh and one cryopreserved cycle the average treatment cost with HP-HMG was lower than with rFSH (HP-HMG euro3635; rFSH euro4103). The average cost saving per person started on HP-HMG when compared with rFSH was euro468. Additionally, the average costs per live birth of HP-HMG and rFSH were found to be significantly different: HP-HMG euro9996; rFSH euro13,009 (P cost-saving even after key parameters in the model were varied in the probabilistic sensitivity analysis. Treatment with HP-HMG was found to be the dominant treatment strategy in IVF because of improved live birth rates and lower costs. Within a fixed healthcare budget, the cost-savings achieved using HP-HMG would allow for the delivery of additional IVF cycles.

  17. Live birth sex ratios and father's geographic origins in Jerusalem, 1964-1976.

    Science.gov (United States)

    Groeger, J; Opler, M; Kleinhaus, K; Perrin, M C; Calderon-Margalit, R; Manor, O; Paltiel, O; Conley, D; Harlap, S; Malaspina, D

    2017-05-06

    To examine whether ancestry influenced sex ratios of offspring in a birth cohort before parental antenatal sex selection influenced offspring sex. We measured the sex ratio as the percent of males according to countries of birth of paternal and maternal grandfathers in 91,459 live births from 1964 to 1976 in the Jerusalem Perinatal Study. Confidence limits (CI) were computed based on an expected sex ratio of 1.05, which is 51.4% male. Of all live births recorded, 51.4% were male. Relative to Jewish ancestry (51.4% males), significantly more males (1,761) were born to Muslim ancestry (54.5, 95% CI = 52.1-56.8, P = 0.01). Among the former, sex ratios were not significantly associated with paternal or maternal age, education, or offspring's birth order. Consistent with a preference for male offspring, the sex ratio decreased despite increasing numbers of births over the 13-year period. Sex ratios were not affected by maternal or paternal origins in North Africa or Europe. However, the offspring whose paternal grandfathers were born in Western Asia included fewer males than expected (50.7, 50.1-51.3, P = 0.02), whether the father was born abroad (50.7) or in Israel (50.8). This was observed for descendents of paternal grandfathers born in Lebanon (47.6), Turkey (49.9), Yemen & Aden (50.2), Iraq (50.5), Afghanistan (50.5), Syria (50.6), and Cyprus (50.7); but not for those from India (51.5) or Iran (51.9). The West Asian group showed the strongest decline in sex ratios with increasing paternal family size. A decreased sex ratio associated with ancestry in Western Asia is consistent with reduced ability to bear sons by a subset of Jewish men in the Jerusalem cohort. Lower sex ratios may be because of pregnancy stress, which may be higher in this subgroup. Alternatively, a degrading Y chromosome haplogroup or other genetic or epigenetic differences on male germ lines could affect birth ratios, such as differential exposure to an environmental agent, dietary

  18. Live birth sex ratios and father’s geographic origins in Jerusalem, 1964–1976

    Science.gov (United States)

    Groeger, J; Opler, M; Kleinhaus, K; Perrin, MC; Calderon-Margalit, R; Manor, O; Paltiel, O; Conley, D; Harlap, S; Malaspina, D

    2016-01-01

    Objective To examine whether ancestry influenced sex ratios of offspring in a birth cohort before parental antenatal sex selection influenced offspring sex. Methods We measured the sex ratio as the percent of males according to countries of birth of paternal and maternal grandfathers in 91,459 live births from 1964 to 1976 in the Jerusalem Perinatal Study. Confidence limits (CI) were computed based on an expected sex ratio of 1.05, which is 51.4% male. Results Of all live births recorded, 51.4% were male. Relative to Jewish ancestry (51.4% males), significantly more males (1,761) were born to Muslim ancestry (54.5, 95% CI=52.1–56.8, p=.01). Among the former, sex ratios were not significantly associated with paternal or maternal age, education, or offspring’s birth order. Consistent with a preference for male offspring, the sex ratio decreased despite increasing numbers of births over the 13-year period. Sex ratios were not affected by maternal or paternal origins in North Africa or Europe. However, the offspring whose paternal grandfathers were born in Western Asia included fewer males than expected (50.7, 50.1–51.3, p=.02), whether the father was born abroad (50.7) or in Israel (50.8). This was observed for descendents of paternal grandfathers born in Lebanon (47.6), Turkey (49.9), Yemen & Aden (50.2), Iraq (50.5), Afghanistan (50.5), Syria (50.6), and Cyprus (50.7); but not for those from India (51.5) or Iran (51.9). The West Asian group showed the strongest decline in sex ratios with increasing paternal family size. Conclusions A decreased sex ratio associated with ancestry in Western Asia is consistent with reduced ability to bear sons by a subset of Jewish men in the Jerusalem cohort. Lower sex ratios may be due to pregnancy stress, which may be higher in this subgroup. Alternatively, a degrading Y chromosome haplogroup or other genetic or epigenetic differences on male germ lines could affect birth ratios, such as differential exposure to an

  19. Population trends and live birth rates associated with common ART treatment strategies.

    Science.gov (United States)

    Chambers, Georgina M; Wand, Handan; Macaldowie, Alan; Chapman, Michael G; Farquhar, Cynthia M; Bowman, Mark; Molloy, David; Ledger, William

    2016-11-01

    Have ART live birth rates improved in Australia over the last 12 years? There were striking improvements in per-cycle live birth rates observed for frozen/thaw embryo transfers, blastocyst transfer and single embryo transfer (SET), while live birth rates following ICSI were lower than IVF for non-male factor infertility in most years. ART and associated techniques have become the predominant treatment of infertility over the past 30 years in most developed countries. However, there are differences in ART laboratory and clinical practices, and success rates worldwide. Australia has one of the highest ART utilization rates and lowest multiple birth rates in the world, thus providing a unique setting to investigate the contribution of common ART strategies in an unrestricted population of patients to ART success rates. A retrospective cohort study of 585 065 ART treatment cycles performed in Australia between 2002 and 2013 using the Australian and New Zealand Assisted Reproduction Database (ANZARD). An unrestricted population of all women who underwent autologous ART treatment between 2002 and 2013. Visual descriptive analysis was used to assess the trends in ART procedures by the calendar years. Adjusted odds ratios (aORs) of a live birth for four common ART techniques were calculated after controlling for important confounders including female age, infertility diagnosis, stage of the embryo (blastocyst versus cleavage stage), type of embryo (fresh versus thawed), fertilization method (IVF versus ICSI) and number of embryos transferred (SET versus multiple embryos). The overall live birth rate per embryo transfer increased from 19.2% in 2002 to 23.3% in 2013 (21.9-24.3% for fresh embryo transfers and 14.6-23.3% for frozen/thaw embryo transfers). This occurred concurrently with an increase in SET from 29.7% to 78.9%, and an increase in the average age of women undergoing treatment from 35.0 to 35.9 years. Individuals who had a frozen/thaw embryo transfer cycle in 2002

  20. Effect of simultaneously started clomiphene citrate and gonadotropins in antagonist regimes, on cumulative live births, fresh-cycle live births and cost of stimulation in IVF cycles.

    Science.gov (United States)

    Satwik, Ruma; Kochhar, Mohinder

    2018-04-11

    The aim of the study was to compare simultaneously started clomiphene citrate (CC) and gonadotropins (Gn) with gonadotropins alone in conventional antagonist regimes with respect to fresh-cycle live births, cumulative live births and cost of ovarian stimulation per started cycle. This was a single-center prospective cohort study conducted over 1 year. Women undergoing autologous in vitro fertilization (IVF) treatment in antagonist protocols and who consented to participate in the study were divided into two cohorts. The CC cohort (n = 86) received 50 mg CC for 5 days and individualized Gn daily until the hCG trigger, both starting from day 2 and antagonist daily from day 8 of menstrual cycle. The Gn-only cohort (n = 349) received individualized Gn from day 2 and the antagonist from day 7 of menstrual cycle. IVF outcomes and cost of stimulation were compared between two cohorts across expected ovarian response categories. The CC cohort used a mean lower dose of Gn (1741.38 ± 604.46 vs 1980.54 ± 686.42; MD = -239.16; 95%CI = -348.03 to -189.24; P = 0.003) over fewer days (8.54 ± 1.86 vs 9.25 ± 1.97; MD =-0.71;95% CI = -1.17 to -0.25; P = 0.0026) to achieve similar retrieved oocytes, (9.19 ± 5.92 vs 9.36 ± 6.96; MD = -0.17; 95%CI -1.77 to + 1.43; P = 0.83), positive bhCG rates (40% vs 29.6%, MD = 10.4%; OR = 1.65, 95%CI = 0.95-2.86; P = 0.078) and live births in fresh cycles (32.31% vs 21.30%; MD = 11.01%; OR = 1.76; 95%CI = 0.97-3.19; P = 0.06) and cumulative live births per initiated cycle (30.23% vs 20.34%; MD = 9.89%; OR = 1.697; 95%CI = 0.99-2.88; P = 0.0501). The dose lowering achieved a 28-40% reduction in the cost of stimulation, which was most noticeable in the hyper-responder category for both hMG cycles, (Rs.11 602.3 ± 3365.9 vs 19615 ± 2677.1; MD = -8012.7; %age reduction: 40.8%; P = 0.0007) and recombinant FSH cycles (Rs. 22

  1. Risk of adverse birth outcomes in populations living near landfill sites

    Science.gov (United States)

    Elliott, Paul; Briggs, David; Morris, Sara; de Hoogh, Cornelis; Hurt, Christopher; Jensen, Tina Kold; Maitland, Ian; Richardson, Sylvia; Wakefield, Jon; Jarup, Lars

    2001-01-01

    Objective To investigate the risk of adverse birth outcomes associated with residence near landfill sites in Great Britain. Design Geographical study of risks of adverse birth outcomes in populations living within 2 km of 9565 landfill sites operational at some time between 1982 and 1997 (from a total of 19 196 sites) compared with those living further away. Setting Great Britain. Subjects Over 8.2 million live births, 43 471 stillbirths, and 124 597 congenital anomalies (including terminations). Main outcome measures All congenital anomalies combined, some specific anomalies, and prevalence of low and very low birth weight (<2500 g and <1500 g). Results For all anomalies combined, relative risk of residence near landfill sites (all waste types) was 0.92 (99% confidence interval 0.907 to 0.923) unadjusted, and 1.01 (1.005 to 1.023) adjusted for confounders. Adjusted risks were 1.05 (1.01 to 1.10) for neural tube defects, 0.96 (0.93 to 0.99) for cardiovascular defects, 1.07 (1.04 to 1.10) for hypospadias and epispadias (with no excess of surgical correction), 1.08 (1.01 to 1.15) for abdominal wall defects, 1.19 (1.05 to 1.34) for surgical correction of gastroschisis and exomphalos, and 1.05 (1.047 to 1.055) and 1.04 (1.03 to 1.05) for low and very low birth weight respectively. There was no excess risk of stillbirth. Findings for special (hazardous) waste sites did not differ systematically from those for non-special sites. For some specific anomalies, higher risks were found in the period before opening compared with after opening of a landfill site, especially hospital admissions for abdominal wall defects. Conclusions We found small excess risks of congenital anomalies and low and very low birth weight in populations living near landfill sites. No causal mechanisms are available to explain these findings, and alternative explanations include data artefacts and residual confounding. Further studies are needed to help differentiate between the various

  2. Smoking cessation early in pregnancy and birth weight, length, head circumference, and endothelial nitric oxide synthase activity in umbilical and chorionic vessels: an observational study of healthy singleton pregnancies

    DEFF Research Database (Denmark)

    Andersen, Malene R; Simonsen, Ulf; Uldbjerg, Niels

    2009-01-01

    and chorionic vessels from nonsmokers, smokers, and ex-smokers and related the findings to the fetal outcome. METHODS AND RESULTS: Of 266 healthy, singleton pregnancies, 182 women were nonsmokers, 43 were smokers, and 41 stopped smoking early in pregnancy. eNOS activity and concentration were quantified...... in endothelial cells of the fetal vessels. Cotinine, lipid profiles, estradiol, l-arginine, and dimethylarginines that may affect NO production were determined in maternal and fetal blood. Serum cotinine verified self-reported smoking. Newborns of smokers had a lower weight (P... were similar for nonsmokers, smokers, and ex-smokers. CONCLUSIONS: The findings suggest that maternal smoking reduces eNOS activity in the fetal vascular bed, contributing to retarded fetal growth caused by the reduction of vasodilatory capacity, and suggest that smoking cessation early in pregnancy...

  3. Saving Lives at Birth; development of a retrospective theory of change, impact framework and prioritised metrics.

    Science.gov (United States)

    Lalli, Marek; Ruysen, Harriet; Blencowe, Hannah; Yee, Kristen; Clune, Karen; DeSilva, Mary; Leffler, Marissa; Hillman, Emily; El-Noush, Haitham; Mulligan, Jo; Murray, Jeffrey C; Silver, Karlee; Lawn, Joy E

    2018-01-29

    Grand Challenges for international health and development initiatives have received substantial funding to tackle unsolved problems; however, evidence of their effectiveness in achieving change is lacking. A theory of change may provide a useful tool to track progress towards desired outcomes. The Saving Lives at Birth partnership aims to address inequities in maternal-newborn survival through the provision of strategic investments for the development, testing and transition-to-scale of ground-breaking prevention and treatment approaches with the potential to leapfrog conventional healthcare approaches in low resource settings. We aimed to develop a theory of change and impact framework with prioritised metrics to map the initiative's contribution towards overall goals, and to measure progress towards improved outcomes around the time of birth. A theory of change and impact framework was developed retrospectively, drawing on expertise across the partnership and stakeholders. This included a document and literature review, and wide consultation, with feedback from stakeholders at all stages. Possible indicators were reviewed from global maternal-newborn health-related partner initiatives, priority indicator lists, and project indicators from current innovators. These indicators were scored across five domains to prioritise those most relevant and feasible for Saving Lives at Birth. These results informed the identification of the prioritised metrics for the initiative. The pathway to scale through Saving Lives at Birth is articulated through a theory of change and impact framework, which also highlight the roles of different actors involved in the programme. A prioritised metrics toolkit, including ten core impact indicators and five additional process indicators, complement the theory of change. The retrospective nature of this development enabled structured reflection of the program mechanics, allowing for inclusion of learning from the first four rounds of the

  4. Predicting the chance of live birth for women undergoing IVF: a novel pretreatment counselling tool.

    Science.gov (United States)

    Dhillon, R K; McLernon, D J; Smith, P P; Fishel, S; Dowell, K; Deeks, J J; Bhattacharya, S; Coomarasamy, A

    2016-01-01

    Which pretreatment patient variables have an effect on live birth rates following assisted conception? The predictors in the final multivariate logistic regression model found to be significantly associated with reduced chances of IVF/ICSI success were increasing age (particularly above 36 years), tubal factor infertility, unexplained infertility and Asian or Black ethnicity. The two most widely recognized prediction models for live birth following IVF were developed on data from 1991 to 2007; pre-dating significant changes in clinical practice. These existing IVF outcome prediction models do not incorporate key pretreatment predictors, such as BMI, ethnicity and ovarian reserve, which are readily available now. In this cohort study a model to predict live birth was derived using data collected from 9915 women who underwent IVF/ICSI treatment at any CARE (Centres for Assisted Reproduction) clinic from 2008 to 2012. Model validation was performed on data collected from 2723 women who underwent treatment in 2013. The primary outcome for the model was live birth, which was defined as any birth event in which at least one baby was born alive and survived for more than 1 month. Data were collected from 12 fertility clinics within the CARE consortium in the UK. Multivariable logistic regression was used to develop the model. Discriminatory ability was assessed using the area under receiver operating characteristic (AUROC) curve, and calibration was assessed using calibration-in-the-large and the calibration slope test. The predictors in the final model were female age, BMI, ethnicity, antral follicle count (AFC), previous live birth, previous miscarriage, cause and duration of infertility. Upon assessing predictive ability, the AUROC curve for the final model and validation cohort was (0.62; 95% confidence interval (CI) 0.61-0.63) and (0.62; 95% CI 0.60-0.64) respectively. Calibration-in-the-large showed a systematic over-estimation of the predicted probability of live

  5. Development of Autoimmune Overt Hypothyroidism Is Highly Associated With Live Births and Induced Abortions but Only in Premenopausal Women

    DEFF Research Database (Denmark)

    Carle, Allan; Pedersen, Inge Buelow; Knudsen, Nils

    2014-01-01

    : In conditional multivariate logistic regression models, we analyzed the associations between the development of autoimmune hypothyroidism and age at menarche/menopause, years of menstruations, pregnancies, spontaneous and induced abortions, live births, and years on oral contraceptives and postmenopausal hormone...

  6. Does age of the sperm donor influence live birth outcome in assisted reproduction?

    Science.gov (United States)

    Ghuman, N K; Mair, E; Pearce, K; Choudhary, M

    2016-03-01

    Does age of the sperm donor have an effect on reproductive outcomes (live birth rate and miscarriage occurrence) of donor insemination or in vitro fertilization treatment using donated sperm? Live birth and miscarriage occurrence in assisted reproduction treatment using donor sperms was not found to be affected by the age of sperm donors up to 45 years old. Literature on the effect of sperm donor age on outcome of medically assisted reproduction is scarce. Most researchers agree that semen parameters deteriorate with increasing paternal age. However, there is no substantial evidence to suggest that this deterioration adversely affects the reproductive outcomes in couples undergoing medically assisted reproduction. This retrospective cohort study analysed 46 078 first donor insemination treatments and fresh in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) cycles using donated sperm from 1991 to 2012. The first fresh donor insemination and IVF/ICSI treatment cycles (46 078 treatment cycles) using donated sperm from the long-term anonymized data registry from 1991 to 2012 of the HFEA, the UK regulator, were analysed by the binary logistic modelling technique for association between sperm donor age and reproductive outcomes (live birth occurrence and miscarriage occurrence). The statistical package SPSS (version 21) was used for analysis and results were considered to be statistically significant if the P-value was IVF/ICSI treatment with donor sperm. The live birth occurrence decreased with increasing female age in both treatment groups; In the donor insemination treatment group, it was 11.1% in 18-34 year old women, 8.3% in 35-37 year old women and 4.7% in 38-50 year old women. The corresponding figures in the IVF/ICSI treatment group were 28.9, 22.0 and 12.9% respectively. In each of these subgroups, no evidence of declining likelihood of live birth with increasing sperm donor age was found (P > 0.05). The miscarriage occurrence (i.e. number of

  7. Congenital Malformations in Singleton Infants Conceived by Assisted Reproductive Technologies and Singleton Infants by Natural Conception in Tehran, Iran

    Directory of Open Access Journals (Sweden)

    Ramin Mozafari Kermani

    2017-10-01

    Full Text Available Background: Multiple pregnancies occur more frequently in assisted reproductive technology (ART compared to normal conception (NC. It is known that the risk of congenital malformations in a multiple pregnancy are higher than single pregnancy. The aim of this study is to compare congenital malformations in singleton infants conceived by ART to singleton infants conceived naturally. Materials and Methods: In this historical cohort study, we performed a historical cohort study of major congenital malformations (MCM in 820 singleton births from January 2012 to December 2014. The data for this analysis were derived from Tehran’s ART linked data file. The risk of congenital malformations was compared in 164 ART infants and 656 NC infants. We performed multiple logistic regression analyses for the independent association of ART on each outcome. Results: We found 40 infants with MCM 29 (4.4% NC infants and 14 (8.3% ART infants. In comparison with NC infants, ART infants had a significant 2-fold increased risk of MCM (P=0.046. After adjusting individually for maternal age, infant gender, prior stillbirth, mother’s history of spontaneous abortion, and type of delivery, we did not find any difference in risk. In this study the majority (95.1% of all infants were normal but 4.9% of infants had at least one MCM. We found a difference in risk of MCMs between in vitro fertilization (IVF and intracytoplasmic sperm injection (ICSI. We excluded the possible role of genotype and other unknown factors in causing more malformations in ART infants. Conclusion: This study reported a higher risk of MCMs in ART singleton infants than in NC singleton infants. Congenital heart disease, developmental dysplasia of the hip (DDH, and urogenital malformations were the most reported major malformations in singleton ART infants according to organ and system classification.

  8. A population-level analysis of birth weight indices in Peel Region, Ontario: the impact of ethnic diversity.

    Science.gov (United States)

    Ramuscak, Nancy L; Jiang, Depeng; Dooling, Kathleen L; Mowat, David L

    2012-07-18

    The purpose of this paper is to examine whether the elevated rate of low birth weight (LBW) in the Region of Peel, Ontario can be attributed to the high proportion of immigrants in the population. In addition, we examined how the infant birth weight distribution in Peel differs by maternal region of birth. Provincial live birth registration data were used to compare rates of LBW, preterm birth and small-for-gestational-age (SGA) births in Peel and Ontario for the years 2002 through 2006 by maternal region of birth. Birth weight for gestational age curves were developed for singletons and were specific for infant sex and maternal region of birth using the lambda-mu-sigma (LMS) method. Quantile regression was used to examine whether the median birth weight at term (37 to 42 weeks) differed by maternal region of birth. The rate of LBW was higher in Peel than in Ontario (6.8% and 6.0%, respectively). This is the result of a higher SGA rate and not due to differences in rates of preterm birth. Infants of immigrant mothers had significantly lower median birth weights at all gestations, showing that the birth weight distribution among infants of immigrant mothers is shifted towards lower birth weights. At the population level, the shifted birth weight distribution among singleton infants of immigrant mothers has significant impact on the LBW rate observed in Peel.

  9. Waiting time distribution for the first conception leading to a live birth

    International Nuclear Information System (INIS)

    Shrestha, G.; Biswas, S.

    1985-01-01

    An attempt has been made in this paper to obtain probability model describing the distribution of the waiting time from marriage to first conception based on the data from marriage to first live birth. The speciality of this present approach lies in assuming the marital exposure to be finite which was assumed to be infinite by most of the earlier investigators for mathematical simplicity. Illustration of the applicability of the model on the data pertaining to first order of conception and monthly probability of conception for women married at different age groups have been illustrated in this paper. (author)

  10. Live Birth from Previously Vitrified Oocytes, after Trophectoderm Biopsy, Revitrification, and Transfer of a Euploid Blastocyst

    Directory of Open Access Journals (Sweden)

    Jamie A. Grifo

    2013-01-01

    Full Text Available Our objective is to describe a successful live birth from oocyte vitrification followed by thaw, fertilization, blastocyst culture, trophectoderm biopsy, vitrification, and subsequent thaw. Fifteen mature oocytes were frozen from a patient with uterine factor infertility. Thirteen oocytes survived the thaw, and five underwent trophectoderm biopsy and were refrozen. Three euploid embryos were obtained. A single euploid embryo was transferred in the second thaw cycle to a known recipient leading to the delivery of a normal male infant. This case report is proof of the concept that preimplantation screening and diagnosis is an option for fertility preservation patients.

  11. Coffee Consumption During Pregnancy and Birth Weight

    DEFF Research Database (Denmark)

    Bech, Bodil Hammer; Frydenberg, Morten; Henriksen, Tine Brink

    2015-01-01

    weight and whether it was modified by the mothers' smoking habits. Methods: In the Danish National Birth Cohort, coffee intake and smoking during pregnancy were recorded prospectively in 89,539 pregnancies that ended with live born singletons. Information on birth weight was obtained from the Danish......Background: A previous randomized trial demonstrated an association between coffee intake and birth weight in smokers only. This could be a chance finding or because smoking interferes with caffeine metabolism. This study assessed the association between coffee intake during pregnancy and birth....../cup/day). Compared to non-coffee drinkers, intake of eight or more cups of coffee per day was associated with an adjusted birth weight difference of −65 g [95% confidence interval (CI) −92 to −39] for non-smokers and −79 g [95% CI −124 to −34] for women smoking more than 10 cigarettes per day. Women drinking eight...

  12. Maternal obesity in singleton versus twin gestations: a population-based matched case-control study.

    Science.gov (United States)

    Lucovnik, Miha; Blickstein, Isaac; Verdenik, Ivan; Trojner-Bregar, Andreja; Tul, Natasa

    2015-04-01

    To examine the impact of pre-pregnancy obesity on adverse outcomes in twin compared to singleton pregnancies. Dichorionic twin gestations with maternal body mass index >30 were matched to three singleton controls. Both obese groups were matched (1:3) with non-obese controls. Rates of preeclampsia, gestational diabetes, cesarean section, and preterm birth were compared. One hundred eighty-nine dichorionic twin pregnancies in obese mothers were matched to 567 twin pregnancies in non-obese mothers, and to 567 singleton pregnancies in obese mothers. The latter were matched to 1701 non-obese mothers with singletons. Preeclampsia was more common in obese mothers with both twins and singletons (odds ratio (OR) 3.95, 95% confidence interval (CI) 2.18-7.16 and OR 6.53, 95% CI 3.75-11.4, respectively) as was gestational diabetes (OR 4.35, 95% CI 2.18-8.69; OR 5.53 95% CI 3.60-8.50). Obese mothers with singletons were more likely to deliver abdominally, but the cesarean rates were obesity independent in twins. Obese mothers were more likely to deliver at Obesity-attributable adverse outcomes are lower in twins compared to singletons. Obesity increases the risk of preterm birth regardless of plurality.

  13. The long-term prognosis for live birth in couples initiating fertility treatments

    DEFF Research Database (Denmark)

    Malchau, S. S.; Henningsen, A. A.; Loft, A.

    2017-01-01

    -26% in women ≥40 years, overall, 14% of couples conceived naturally and one-third of couples starting treatments with intrauterine insemination delivered from that treatment. WHAT IS KNOWN ALREADY: Few studies report success rates in fertility treatments across a couple's complete fertility treatment history......STUDY QUESTION: What are the long-term chances of having a child for couples starting fertility treatments and how many conceive with ART, IUI and without treatment? SUMMARY ANSWER: Total 5-year live birthrates were strongly influenced by female age and ranged from 80% in women under 35...... years (N = 3553), 35-39 years (N = 1156) and ≥40 years (N = 451), a total of 64%, 49% and 16% had a live birth due to treatment, respectively. Additionally, in women aged years, 35-39 years and ≥40 years, 16%, 11% and 10% delivered after natural conception, yielding total 5-year birthrates of 80...

  14. The long-term prognosis for live birth in couples initiating fertility treatments.

    Science.gov (United States)

    Malchau, S S; Henningsen, A A; Loft, A; Rasmussen, S; Forman, J; Nyboe Andersen, A; Pinborg, A

    2017-07-01

    What are the long-term chances of having a child for couples starting fertility treatments and how many conceive with ART, IUI and without treatment? Total 5-year live birthrates were strongly influenced by female age and ranged from 80% in women under 35-26% in women ≥40 years, overall, 14% of couples conceived naturally and one-third of couples starting treatments with intrauterine insemination delivered from that treatment. Few studies report success rates in fertility treatments across a couple's complete fertility treatment history, across clinics, evaluating live births after insemination, ART and natural conceptions. This register-based national cohort study from Denmark includes all women initiating fertility treatments in public and private clinics with homologous gametes in 2007-2010. Women were identified in the Danish ART Registry and were cross-linked with the Medical Birth Registry to identify live births. Subfertile couples were followed 2 years (N = 19 884), 3 years (N = 14 445) and 5 years (N = 5165), or until their first live birth. Cumulative live birthrates were estimated 2, 3 and 5 years from the first treatment cycle, in all women, including drop-outs. Birthrates were stratified by type of first treatment (ART/IUI), mode of conception (ART/IUI/natural conception) and female age. Within 5 years, in women aged years (N = 3553), 35-39 years (N = 1156) and ≥40 years (N = 451), a total of 64%, 49% and 16% had a live birth due to treatment, respectively. Additionally, in women aged years, 35-39 years and ≥40 years, 16%, 11% and 10% delivered after natural conception, yielding total 5-year birthrates of 80%, 60% and 26%. In women starting treatments with IUI (N = 3028), 35% delivered after IUI within 5 years, 24% delivered after shift to ART treatments and 17% delivered after natural conception. Within 5 years from starting treatments with ART (N = 2137), 53% delivered after ART, 11% delivered after natural conception and 0.6% delivered after

  15. Birth weight and cognitive function at age 11 years: the Scottish Mental Survey 1932

    OpenAIRE

    Shenkin, S; Starr, J; Pattie, A; Rush, M; Whalley, L; Deary, I; PHARAOH, E. P.

    2001-01-01

    AIMS—To examine the relation between birth weight and cognitive function at age 11 years, and to examine whether this relation is independent of social class.
METHODS—Retrospective cohort study based on birth records from 1921 and cognitive function measured while at school at age 11 in 1932.Subjects were 985 live singletons born in the Edinburgh Royal Maternity and Simpson Memorial Hospital in 1921. Moray House Test scores from the Scottish Mental Survey 1932 were trace...

  16. Birth weight and cognitive function at age 11years: the Scottish Mental Survey 1932

    OpenAIRE

    Shenkin, S D; Starr, John M; Pattie, Alison; Rush, M A; Whalley, Lawrence J; Deary, Ian J

    2001-01-01

    AIMS---To examine the relation between birth weight and cognitive function at age 11 years, and to examine whether this relation is independent of social class. METHODS---Retrospective cohort study based on birth records from 1921 and cognitive function measured while at school at age 11 in 1932. Subjects were 985 live singletons born in the Edinburgh Royal Maternity and Simpson Memorial Hospital in 1921. Moray House Test scores from the Scottish Mental Survey 1932 were traced on 449 of th...

  17. Cumulative live birth rates after IVF in patients with polycystic ovaries: phenotype matters.

    Science.gov (United States)

    De Vos, Michel; Pareyn, Stéphanie; Drakopoulos, Panagiotis; Raimundo, José M; Anckaert, Ellen; Santos-Ribeiro, Samuel; Polyzos, Nikolaos P; Tournaye, Herman; Blockeel, Christophe

    2018-05-07

    Do cumulative live birth rates (CLBR) vary among women with different polycystic ovary syndrome (PCOS) phenotypes who undergo IVF/intracytoplasmic sperm injection (ICSI) treatment? In this retrospective cohort study, data from 567 patients undergoing an assisted reproductive technology (ART) cycle between January 2010 and December 2015 were collected. Demographical traits, cycle characteristics and clinical and laboratory data were analysed. After conventional ovarian stimulation using a gonadotrophin-releasing hormone antagonist protocol, the median number of oocytes retrieved ranged between 11 and 13.5 and did not differ significantly among the studied groups. Live birth rate (LBR) after fresh embryo transfer and CLBR after transfer of all fresh and vitrified embryos were significantly lower in women with hyperandrogenic PCOS phenotypes A (LBR 16.7%, CLBR 25.8%) and C (LBR 18.5%, CLBR 27.8%) compared with women with normoandrogenic PCOS phenotype D (LBR 33.7%, CLBR 48%) (P-value for LBR 0.01 and 0.03, respectively; P-value for CLBR 0.002 and 0.01, respectively) and controls with a polycystic ovarian morphology (LBR 37.1%, CLBR 53.3%) (P-value for LBR 0.002 and 0.01, respectively; P-value for CLBR counselling and tailored approaches when treating PCOS patients with hyperandrogenism who require ART. Copyright © 2018 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  18. Predictors of Pregnancy and Live Birth in Couples with Unexplained or Male-factor Infertility after Insemination

    Science.gov (United States)

    Huang, Hao; Hansen, Karl R.; Factor-Litvak, Pamela; Carson, Sandra A.; Guzick, David S.; Santoro, Nanette; Diamond, Michael P.; Eisenberg, Esther; Zhang, Heping

    2012-01-01

    Objective To identify risk factors for pregnancy outcomes in couples treated with intracervical or intrauterine insemination, with or without superovulation for unexplained or male-factor infertility. The treatment continued for four cycles unless pregnancy was achieved. Design Secondary analysis of data from a randomized superovulation and intrauterine insemination trial. Setting Academic medical centers. Intervention(s) None. Patients Out of 932 couples randomized to four treatment groups, 664 couples who had completed the lifestyle questionnaires were assessed for occurrence of pregnancy and live birth. Main outcome measure(s) pregnancy and live birth. Results The pregnancy and live birth rates were significantly higher in couples in which the female partners reported that they had consumed coffee or tea in the past or drank alcoholic beverages in the past (past users) when compared to those who had never consumed coffee or tea (4.0, 1.6–10.2 for pregnancy; 3.1, 1.2–8.1 for live birth) or alcoholic beverages (1.9, 1.1–3.3 for pregnancy; 2.1, 1.2–3.7 for live birth) (data are adjusted odds ratio and 95% confidence interval). Past users also had significantly higher pregnancy and live birth rates than those who were currently consuming coffee or tea or alcoholic beverages. Demographic, occupational exposures and other lifestyle factors were not significant. Conclusion(s) Couples in which the female partners drank coffee, tea, or alcoholic beverages in the past had higher pregnancy and live birth rates when compared to never or current users. When discontinuing these habits, they might have made other lifestyle changes to improve the pregnancy outcome. PMID:22270557

  19. Cumulative live birth rates after one or more complete cycles of IVF: a population-based study of linked cycle data from 178,898 women.

    Science.gov (United States)

    McLernon, David J; Maheshwari, Abha; Lee, Amanda J; Bhattacharya, Siladitya

    2016-03-01

    What is the chance of a live birth following one or more linked complete cycles of IVF (including ICSI)? The chance of a live birth after three complete cycles of IVF was 42.3% for treatment commencing from 1999 to 2007. IVF success has generally been reported on the basis of live birth rates after a single episode of treatment resulting in the transfer of a fresh embryo. This fails to capture the real chance of having a baby after a number of complete cycles-each involving the replacement of fresh as well as frozen-thawed embryos. Population-based observational cohort study of 178 898 women between 1992 and 2007. Participants included all women who commenced IVF treatment at a licenced clinic in the UK as recorded in the Human Fertilisation and Embryology Authority (HFEA) national database. Exclusion criteria included women whose treatment involved donor insemination, egg donation, surrogacy and the transfer of more than three embryos. Cumulative rates of live birth, term (>37 weeks) singleton live birth, and multiple pregnancy were estimated for two time-periods, 1992-1998 and 1999-2007. Conservative estimates assumed that women who did not return for IVF would not have the outcome of interest while optimal estimates assumed that these women would have similar outcome rates to those who continued IVF. A total of 71 551 women commenced IVF treatment during 1992-1998 and an additional 107 347 during 1999-2007. After the third complete IVF cycle (defined as three fresh IVF treatments-including replacement of any surplus frozen-thawed embryos), the conservative CLBR in women who commenced IVF during 1992-1998 was 30.8% increasing to 42.3% during 1999-2007. The optimal CLBRs were 44.6 and 57.1%, respectively. After eight complete cycles the optimal CLBR was 82.4% in the latter time period. The conservative rate for multiple pregnancy per pregnant woman fell from 31.9% during the earlier time period to 26.2% during the latter. Linkage of all IVF treatments to

  20. Endometriosis fertility index predicts live births following surgical resection of moderate and severe endometriosis.

    Science.gov (United States)

    Maheux-Lacroix, S; Nesbitt-Hawes, E; Deans, R; Won, H; Budden, A; Adamson, D; Abbott, J A

    2017-11-01

    Can live birth be accurately predicted following surgical resection of moderate-severe (Stage III-IV) endometriosis? Live births can accurately be predicted with the endometriosis fertility index (EFI), with adnexal function being the most important factor to predict non-assisted reproductive technology (non-ART) fertility or the requirement for ART (www.endometriosisefi.com). Fertility prognosis is important to many women with severe endometriosis. Controversy persists regarding optimal post-operative management to achieve pregnancy and the counselling of patients regarding duration of conventional treatments before undergoing ART. The EFI is reported to correlate with expectant management pregnancy rate, although external validation has been performed without specifically addressing fertility in women with moderate and severe endometriosis. Retrospective cohort study of 279 women from September 2001 to June 2016. We included women undergoing laparoscopic resection of Stage III-IV endometriosis who attempted pregnancy post-operatively. The EFI was calculated based on detailed operative reports and surgical images. Fertility outcomes were obtained by direct patient contact. Kaplan-Meier model, log rank test and Cox regression were used for analyses. The follow-up rate was 84% with a mean duration of 4.1 years. A total of 147 women (63%) had a live birth following surgery, 94 of them (64%) without ART. The EFI was highly associated with live births (P years was 0% and steadily increased up to 91% with an EFI of 9-10, while the proportion of women who attempted ART and had a live birth, steadily increased from 38 to 71% among the same EFI strata (P = 0.1). A low least function score was the most significant predictor of failure (P = 0.003), followed by having had a previous resection (P = 0.019) or incomplete resection (P = 0.028), being older than 40 compared to years of age (P = 0.027), and having leiomyomas (P = 0.037). The main limitation of this study is its

  1. Costs of achieving live birth from assisted reproductive technology: a comparison of sequential single and double embryo transfer approaches.

    Science.gov (United States)

    Crawford, Sara; Boulet, Sheree L; Mneimneh, Allison S; Perkins, Kiran M; Jamieson, Denise J; Zhang, Yujia; Kissin, Dmitry M

    2016-02-01

    To assess treatment and pregnancy/infant-associated medical costs and birth outcomes for assisted reproductive technology (ART) cycles in a subset of patients using elective double embryo (ET) and to project the difference in costs and outcomes had the cycles instead been sequential single ETs (fresh followed by frozen if the fresh ET did not result in live birth). Retrospective cohort study using 2012 and 2013 data from the National ART Surveillance System. Infertility treatment centers. Fresh, autologous double ETs performed in 2012 among ART patients younger than 35 years of age with no prior ART use who cryopreserved at least one embryo. Sequential single and double ETs. Actual live birth rates and estimated ART treatment and pregnancy/infant-associated medical costs for double ET cycles started in 2012 and projected ART treatment and pregnancy/infant-associated medical costs if the double ET cycles had been performed as sequential single ETs. The estimated total ART treatment and pregnancy/infant-associated medical costs were $580.9 million for 10,001 double ETs started in 2012. If performed as sequential single ETs, estimated costs would have decreased by $195.0 million to $386.0 million, and live birth rates would have increased from 57.7%-68.0%. Sequential single ETs, when clinically appropriate, can reduce total ART treatment and pregnancy/infant-associated medical costs by reducing multiple births without lowering live birth rates. Published by Elsevier Inc.

  2. No excess risk of adverse birth outcomes in populations living near special waste landfill sites in Scotland.

    Science.gov (United States)

    Morris, S E; Thomson, A O; Jarup, L; de Hoogh, C; Briggs, D J; Elliott, P

    2003-11-01

    A recent study showed small excess risks of low birth weight, very low birth weight and certain congenital anomalies in populations living near landfill sites in Great Britain. The objective of the current study was to investigate the risk of adverse birth outcomes associated with residence near special waste landfill sites in Scotland. We studied risks of adverse birth outcomes in populations living within 2 km of 61 Scottish special waste landfill sites operational at some time between 1982 and 1997 compared with those living further away. 324,167 live births, 1,849 stillbirths, and 11,138 congenital anomalies (including terminations) were included in the study. Relative risks were computed for all congenital anomalies combined, some specific anomalies and prevalence of stillbirth and low and very low birth weight (special waste landfill sites was 0.96 (99% confidence interval 0.89 to 1.02) adjusted for confounders. Adjusted risks were 0.71 (0.36 to 1.42) for neural tube defects, 1.03 (0.85 to 1.26) for cardiovascular defects, 0.84 (0.58 to 1.22) for hypospadias and epispadias (with no excess of surgical corrections), 0.78 (0.27 to 2.23) for abdominal wall defects (1.32 (0.42-4.17) for hospital admissions), 1.22 (0.28 to 5.38) for surgical correction of gastroschisis and exomphalos and 1.01 (0.96 to 1.07) and 1.01 (0.90 to 1.15) for low and very low birth weight respectively. There was no excess risk of stillbirth. In conclusion, we found no statistically significant excess risks of congenital anomalies or low birth weight in populations living near special waste landfill sites in Scotland.

  3. Observed Mother- and Father-Child Interaction Differences in Families with Medically Assisted Reproduction-Conceived Twins and Singletons.

    Science.gov (United States)

    Anderson, Kayla N; Rueter, Martha A; Connor, Jennifer J; Koh, Bibiana D

    2017-12-01

    Increased medically assisted reproduction (MAR) use to treat infertility has resulted in a growing twin birth rate. Little is known about parent-child relationships for twin relative to singleton children in middle childhood. This study fills this gap by examining parent-child relationships in 57 families with eighty 6- to 12-year-old MAR twin and singleton children using observational data (warm and supportive communication, control, and hostility). Nested ANCOVAs indicate that while mothers exhibit similar interactional behaviors toward twins and singletons, fathers have less optimum behaviors toward twins relative to singletons. Twins displayed less engaged behavior with mothers and fathers relative to singletons. Given the vitality of parent-child relationships for family and child adjustment, future studies should examine determinants and outcomes of twin-singleton relationship differences to bolster twins' and their families' functioning. © 2016 Family Process Institute.

  4. Predictors of pregnancy and live birth after insemination in couples with unexplained or male-factor infertility.

    Science.gov (United States)

    Huang, Hao; Hansen, Karl R; Factor-Litvak, Pamela; Carson, Sandra A; Guzick, David S; Santoro, Nanette; Diamond, Michael P; Eisenberg, Esther; Zhang, Heping

    2012-04-01

    To identify risk factors for pregnancy outcomes in couples treated with intracervical or intrauterine insemination, with or without superovulation for unexplained or male-factor infertility. Secondary analysis of data from a randomized superovulation and intrauterine insemination trial. Academic medical centers. Treatment continued for four cycles unless pregnancy was achieved. Out of 932 couples randomized to four treatment groups, 664 couples who had completed the lifestyle questionnaires were assessed for occurrence of pregnancy and live birth. Pregnancy and live birth. The pregnancy and live birth rates were significantly higher in couples in which the female partners reported that they had consumed coffee or tea in the past or drank alcoholic beverages in the past (past users) compared with those who had never consumed coffee, tea, or alcoholic beverages. Past users also had significantly higher pregnancy and live birth rates than those currently consuming coffee or tea or alcoholic beverages. Demographic, occupational exposure, and other lifestyle factors were not significant. Couples in which the female partners drank coffee, tea, or alcoholic beverages in the past had higher pregnancy and live birth rates compared with never or current users. When discontinuing these habits, they might have made other lifestyle changes to improve the pregnancy outcome. Copyright © 2012 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  5. Low birth weight,very low birth weight rates and gestational age-specific birth weight distribution of korean newborn infants.

    Science.gov (United States)

    Shin, Son-Moon; Chang, Young-Pyo; Lee, Eun-Sil; Lee, Young-Ah; Son, Dong-Woo; Kim, Min-Hee; Choi, Young-Ryoon

    2005-04-01

    To obtain the low birth weight (LBW) rate, the very low birth weight (VLBW) rate, and gestational age (GA)-specific birth weight distribution based on a large population in Korea, we collected and analyzed the birth data of 108,486 live births with GA greater than 23 weeks for 1 yr from 1 January to 31 December 2001, from 75 hospitals and clinics located in Korea. These data included birth weight, GA, gender of the infants, delivery type, maternal age, and the presence of multiple pregnancy. The mean birth weight and GA of a crude population are 3,188 +/-518 g and 38.7+/-2.1 weeks, respectively. The LBW and the VLBW rates are 7.2% and 1.4%, respectively. The preterm birth rate (less than 37 completed weeks of gestation) is 8.4% and the very preterm birth rate (less than 32 completed weeks of gestation) is 0.7%. The mean birth weights for female infants, multiple births, and births delivered by cesarean section were lower than those for male, singletons, and births delivered vaginally. The risk of delivering LBW or VLBW infant was higher for the teenagers and the older women (aged 35 yr and more). We have also obtained the percentile distribution of GA-specific birth weight in infants over 23 weeks of gestation.

  6. Single blastocyst transfer: The key to reduce multiple pregnancy rates without compromising the live birth rate

    Directory of Open Access Journals (Sweden)

    Uma M Sundhararaj

    2017-01-01

    Full Text Available Background: Historically, to achieve higher pregnancy rates, multiple embryos were transferred after an in-vitro fertilisation (IVF. However, this practice is being reassessed, because it leads to multiple pregnancies that is known to cause adverse maternal and fetal outcomes. Aim: To compare the pregnancy outcomes in fresh IVF or intracytoplasmic sperm injection (ICSI cycles among women undergoing elective single blastocyst transfer (eSBT vs. those undergoing double blastocyst transfer (DBT. Settings and Design: It is a retrospective data analysis of 582 patients undergoing fresh IVF/ICSI cycles performed from January 2012 to June 2015. Materials and Methods: Patients, who underwent IVF/ICSI and developed more than one blastocyst, were included in the study. Donor cycles were excluded from the study. All the embryos were cultured to blastocyst stage in sequential media followed by transfer of two blastocysts (DBT or eSBT and cryopreservation of the remaining. Statistical Analysis: Statistical analysis was performed using chi square test. Results: Out of 582 patients, in 149 patients one blastocyst was transferred and in 433 patients two blastocysts were transferred. There was no statistical difference in the biochemical pregnancy rate, clinical pregnancy rate and live birth rate in both the groups. Statistics demonstrated a significant drop in miscarriage rate in eSBT group. There was no incidence of twins in eSBT group, whereas twin birth rate per clinical pregnancy was 29.02% in DBT group. Conclusion: Single blastocyst transfer is an effective method to reduce the risk of multiple births without compromising the pregnancy outcomes. Given the promising potential of vitrification; the remaining blastocyst can be cryopreserved.

  7. Live birth of twins after IVF of oocytes that were cryopreserved almost 12 years before.

    Science.gov (United States)

    Quintans, Carlos J; Donaldson, Monica J; Urquiza, M Fernanda; Carretero, Inés; Pasqualini, R Agustín; Horton, Marcos; Pasqualini, R Sergio

    2012-12-01

    A 45-year-old woman received embryos from IVF by intracytoplasmic sperm injection (ICSI) with her own oocytes that were cryopreserved (slow freezing in a low-sodium medium) 11 years and 7 and a half months before, when she was 33 years old. From seven metaphase-II oocytes thawed, five survived, four were fertilized after ICSI and two cleaving embryos were transferred on day 3. A diamniotic dichorionic term pregnancy was achieved, ending with the delivery of two healthy girls. As far as is known, this case represents, to date, the longest storage period of cryopreserved human oocytes resulting in a live birth. Copyright © 2012 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  8. Decreased live births among women of Middle Eastern/North African ethnicity compared to Caucasian women.

    Science.gov (United States)

    Salem, W H; Abdullah, A; Abuzeid, O; Bendikson, K; Sharara, F I; Abuzeid, M

    2017-05-01

    The objective of this study is to determine if IVF outcome disparities exist among MENA women in the USA in comparison to a control group of Caucasian women. A retrospective cohort study comparing MENA (N = 190) and Caucasian (N = 200) women undergoing their first IVF cycle between 5/2006 and 5/2014 was carried out at an academically affiliated fertility practice. All MENA cycles during that time period undergoing IVF/ICSI using autologous embryos and blastocyst transfers were compared to a control group of Caucasian women. MENA women were significantly younger (32.9 vs 34.5, P Middle Eastern/North African women have worse IVF outcomes with decreased live birth rates per blastocyst transfer and increased miscarriage rates compared to Caucasian women.

  9. Pre-stimulation parameters predicting live birth after IVF in the long GnRH agonist protocol

    DEFF Research Database (Denmark)

    Pettersson, Göran; Andersen, Anders Nyboe; Broberg, Per

    2010-01-01

    This retrospective study aimed to identify novel pre-stimulation parameters associated with live birth in IVF and to develop a model for prediction of the chances of live birth at an early phase of the treatment cycle. Data were collected from a randomized trial in couples with unexplained...... infertility, tubal factor, mild male factor or other reason for infertility. All women (n=731) had undergone an IVF cycle (no intracytoplasmic sperm injection) after stimulation with human menopausal gonadotrophin or follicle-stimulating hormone following the long gonadotrophin-releasing hormone agonist...

  10. The influence of female and male body mass index on live births after assisted reproductive technology treatment

    DEFF Research Database (Denmark)

    Petersen, Gitte Lindved; Schmidt, Lone; Pinborg, Anja

    2013-01-01

    OBJECTIVE: To investigate the independent and combined associations between female and male body mass index (BMI) on the probability of achieving a live birth after treatments with in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) under adjustment for relevant covariates....... DESIGN: Population-based cohort study. SETTING: Danish national registers. PATIENT(S): Patients with permanent residence in Denmark receiving IVF or ICSI treatment with use of autologous oocytes from January 1, 2006, to September 30, 2010. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Live birth...

  11. Pre-stimulation parameters predicting live birth after IVF in the long GnRH agonist protocol

    DEFF Research Database (Denmark)

    Pettersson, Göran; Andersen, Anders Nyboe; Broberg, Per

    2010-01-01

    infertility, tubal factor, mild male factor or other reason for infertility. All women (n=731) had undergone an IVF cycle (no intracytoplasmic sperm injection) after stimulation with human menopausal gonadotrophin or follicle-stimulating hormone following the long gonadotrophin-releasing hormone agonist......This retrospective study aimed to identify novel pre-stimulation parameters associated with live birth in IVF and to develop a model for prediction of the chances of live birth at an early phase of the treatment cycle. Data were collected from a randomized trial in couples with unexplained...

  12. The changing trends in live birth statistics in Korea, 1970 to 2010

    OpenAIRE

    Jae Woo Lim

    2011-01-01

    Although Korean population has been growing steadily during the past four decades, the nation is rapidly becoming an aging society because of its declining birth rate combined with an increasing life expectancy. In addition, Korea has one of the lowest fertility rates in the world due to fewer married couples, advanced maternal age, and falling birth rate. The prevalence of low birth weight infants and multiple births has been increased compared with the decrease in the birth rate. Moreover, ...

  13. Language Development of Three- to Twelve-Year-Old Twins Compared to Singletons.

    Science.gov (United States)

    Dʼhaeseleer, Evelien; Geenens, Eline; Parmentier, Sarah; Corthals, Paul; Van Lierde, Kristiane

    2016-01-01

    The language development of twins tends to lag behind in comparison to that of singletons. The purpose of this study was to compare expressive and receptive language skills of 3- to 12-year-old twins with singletons. Secondly, correlations between language differences between twins and singletons and age were investigated. Twenty-four twins with a mean age of 5.1 years participated in the study. The control group consisted of 24 singletons who were matched for gender and age. Language development was investigated using the Clinical Evaluation of Language Fundamentals. Twins scored significantly lower for expressive and receptive language skills compared to singletons. Even when excluding preterm-born children, twins still scored significantly lower for expressive language skills. There was no correlation between age and language differences between twins and their matched singletons. Twins score lower for expressive and receptive language skills compared to singletons, and preterm birth cannot be regarded as the main cause for the language delay. The language delay in twins is rather mild but does not seem to decrease with increasing age. © 2016 S. Karger AG, Basel.

  14. Attentional capture by masked colour singletons.

    Science.gov (United States)

    Ansorge, Ulrich; Horstmann, Gernot; Worschech, Franziska

    2010-09-15

    We tested under which conditions a colour singleton of which an observer is unaware captures attention. To prevent visual awareness of the colour singleton, we used backward masking. We find that a masked colour singleton cue captures attention if it matches the observer's goal to search for target colours but not if it is task-irrelevant. This is also reflected in event-related potentials to the visible target: the masked goal-matching cue elicits an attentional potential (N2pc) in a target search task. By contrast, a non-matching but equally strong masked colour singleton cue failed to elicit a capture effect and an N2pc. Results are discussed with regard to currently pertaining conceptions of attentional capture by colour singletons. Copyright 2010 Elsevier Ltd. All rights reserved.

  15. The changing trends in live birth statistics in Korea, 1970 to 2010

    Directory of Open Access Journals (Sweden)

    Jae Woo Lim

    2011-11-01

    Full Text Available Although Korean population has been growing steadily during the past four decades, the nation is rapidly becoming an aging society because of its declining birth rate combined with an increasing life expectancy. In addition, Korea has one of the lowest fertility rates in the world due to fewer married couples, advanced maternal age, and falling birth rate. The prevalence of low birth weight infants and multiple births has been increased compared with the decrease in the birth rate. Moreover, the number of congenital anomalies is expected to increase due to the advanced maternal age. In addition, the number of interracial children is expected to increase due to the rise in the number of international marriages. However, the maternal education level is high, single-mother birth rate is low, and the gender imbalance has lessened. The number of overweight babies has been decreased, as more pregnant women are receiving adequate prenatal care. Compared to the Asian average birth weight, the average birth weight is the highest in Asia. Moreover, the rate of low birth weight infants is low, and infant mortality is similarly low across Asia. Using birth data from Statistics Korea and studies of birth outcomes in Korea and abroad, this study aimed to assess the changes in maternal and infant characteristics associated with birth outcomes during the past four decades and identify necessary information infrastructures to study countermeasures the decrease in birth rate and increase in low birth weight infants in Korea.

  16. The changing trends in live birth statistics in Korea, 1970 to 2010.

    Science.gov (United States)

    Lim, Jae Woo

    2011-11-01

    Although Korean population has been growing steadily during the past four decades, the nation is rapidly becoming an aging society because of its declining birth rate combined with an increasing life expectancy. In addition, Korea has one of the lowest fertility rates in the world due to fewer married couples, advanced maternal age, and falling birth rate. The prevalence of low birth weight infants and multiple births has been increased compared with the decrease in the birth rate. Moreover, the number of congenital anomalies is expected to increase due to the advanced maternal age. In addition, the number of interracial children is expected to increase due to the rise in the number of international marriages. However, the maternal education level is high, single-mother birth rate is low, and the gender imbalance has lessened. The number of overweight babies has been decreased, as more pregnant women are receiving adequate prenatal care. Compared to the Asian average birth weight, the average birth weight is the highest in Asia. Moreover, the rate of low birth weight infants is low, and infant mortality is similarly low across Asia. Using birth data from Statistics Korea and studies of birth outcomes in Korea and abroad, this study aimed to assess the changes in maternal and infant characteristics associated with birth outcomes during the past four decades and identify necessary information infrastructures to study countermeasures the decrease in birth rate and increase in low birth weight infants in Korea.

  17. Preterm birth rates in Japan from 1979 to 2014: Analysis of national vital statistics.

    Science.gov (United States)

    Sakata, Soyoko; Konishi, Shoko; Ng, Chris Fook Sheng; Watanabe, Chiho

    2018-03-01

    Secular trends of preterm birth in Japan between 1979 and 2014 were examined to determine whether changes could be explained by a shift in the distribution of maternal age at delivery and parity and/or by changes in age-specific preterm birth rates. Live birth data for 1979 to 2014 were obtained from the Japanese Ministry of Health, Labour and Welfare. Analyses were limited to singleton children born in Japan (n = 43 632 786). Preterm birth was defined using two cut-offs at rates of preterm birth were calculated for firstborn and later-born singletons by maternal age at delivery for specific time periods. Throughout the study period, the rates of preterm birth (both at rates of preterm birth at rates of preterm birth showed a secular increase for preterm births at rates of preterm birth among mothers aged in their 20s and early 30s increased between 1979 and 2014, which contributed to the secular increase in rates of preterm birth at < 37 weeks. © 2017 Japan Society of Obstetrics and Gynecology.

  18. Effect of levothyroxine on live birth rate in euthyroid women with recurrent miscarriage and TPO antibodies (T4-LIFE study)

    DEFF Research Database (Denmark)

    Vissenberg, R; van Dijk, M M; Fliers, E

    2015-01-01

    . The analysis will be performed according to the intention to treat principle. We need to randomize 240 women (120 per group) to demonstrate an improvement in live birth rate from 55% in the placebo group to 75% in the levothyroxine treatment group. This trial is a registered trial (NTR 3364, March 2012). Here......BACKGROUND: Thyroid peroxidase antibodies (TPO-Ab) in euthyroid women are associated with recurrent miscarriage (RM) and other pregnancy complications such as preterm birth. It is unclear if treatment with levothyroxine improves pregnancy outcome. Aim To determine the effect of levothyroxine...... administration on live birth rate in euthyroid TPO-Ab positive women with recurrent miscarriage. METHODS: /Design We will perform a multicenter, placebo controlled randomized trial in euthyroid women with recurrent miscarriage and TPO-Ab. Recurrent miscarriage is defined as two or more miscarriages before the 20...

  19. Estimates of live birth prevalence of children with Down syndrome in the period 1991-2015 in the Netherlands

    NARCIS (Netherlands)

    de Graaf, G.; Engelen, J. J. M.; Gijsbers, A. C. J.; Hochstenbach, R.; Hoffer, M. J. V.; Kooper, A. J. A.; Sikkema-Raddatz, B.; Srebniak, M. I.; van der Kevie-Kersemaekers, A. M. F.; van Zutven, L. J. C. M.; Voorhoeve, E.

    2017-01-01

    In Western countries, increasing maternal age has led to more pregnancies with a child with Down syndrome (DS). However, prenatal screening programs, diagnostic testing and termination of pregnancy influence the actual DS live birth (LB) prevalence as well. The aim of this study is to examine these

  20. Preconceptional antithyroid peroxidase antibodies, but not thyroid-stimulating hormone, are associated with decreased live birth rates in infertile women.

    Science.gov (United States)

    Seungdamrong, Aimee; Steiner, Anne Z; Gracia, Clarisa R; Legro, Richard S; Diamond, Michael P; Coutifaris, Christos; Schlaff, William D; Casson, Peter; Christman, Gregory M; Robinson, Randal D; Huang, Hao; Alvero, Ruben; Hansen, Karl R; Jin, Susan; Eisenberg, Esther; Zhang, Heping; Santoro, Nanette

    2017-10-25

    To study whether preconceptual thyroid-stimulating hormone (TSH) and antithyroid peroxidase (TPO) antibodies are associated with poor reproductive outcomes in infertile women. Secondary analysis of data from two multicenter, randomized, controlled trials conducted by the Reproductive Medicine Network of the Eunice Kennedy Shriver National Institute of Child Health and Human Development. Multivariable logistic regression analyses were performed to assess the association between preconceptual TSH levels and anti-TPO antibodies. Not applicable. Serum samples from 1,468 infertile women were utilized. None. Cumulative conception, clinical pregnancy, miscarriage, and live birth rates were calculated. Conception, clinical pregnancy, miscarriage, and live birth rates did not differ between patients with TSH ≥2.5 mIU/L vs. TSH < 2.5 mIU/L. Women with anti-TPO antibodies had similar conception rates (33.3% vs. 36.3%) but higher miscarriage rates (43.9% vs. 25.3%) and lower live birth rates (17.1% vs. 25.4%) than those without anti-TPO antibodies. Adjusted, multivariable logistic regression models confirmed elevated odds of miscarriage (odds ratio 2.17, 95% confidence interval 1.12-4.22) and lower odds of live birth (oddr ratio 0.58, 95% confidence interval 0.35-0.96) in patients with anti-TPO antibodies. In infertile women, preconceptional TSH ≥2.5 mIU/L is not associated with adverse reproductive outcomes; however, anti-TPO antibodies are associated with increased risk of miscarriage and decreased probability of live birth. PPCOS II NCT00719186; AMIGOS NCT01044862. Copyright © 2017. Published by Elsevier Inc.

  1. Trends in low birth weight: a comparison of two birth cohorts separated by a 15-year interval in Ribeirão Preto, Brazil.

    OpenAIRE

    Silva, A. A.; Barbieri, M. A.; Gomes, U. A.; Bettiol, H.

    1998-01-01

    The incidence and some determinants of low birth weight (LBW) were studied in two population-based cohorts of singletons born live to families in Ribeirão Preto, São Paulo State, Brazil. The first cohort comprised infants born between June 1978 and May 1979 (6750 births--population survey) and the second, infants born between May and August 1994 (2990 births--sample survey). The incidence of LBW was 7.2% in 1978-79 and 10.6% in 1994. After adjustment for confounding factors, the following det...

  2. Anti-müllerian hormone levels are associated with live birth rates in ART, but the predictive ability of anti-müllerian hormone is modest.

    Science.gov (United States)

    Alson, Sara S E; Bungum, Leif J; Giwercman, Aleksander; Henic, Emir

    2018-06-01

    The aim was to evaluate the association between serum Anti-Müllerian Hormone (AMH) level and cumulative live birth rates (LBR) in patients undergoing their first in vitro fertilization (IVF) treatment cycle, and to compare serum AMH levels with Antral Follicle Count (AFC) and Ovarian Sensitivity Index (OSI) as predictors of live birth. A prospective cohort study of 454 patients under the age of 40 and with a regular menstrual cycle of 21-35 days, undergoing their first IVF treatment cycles between September 2010 and June 2015. Participants were divided into three groups based on their AMH level, (AMH ≤10, AMH 10-distribution between patients with or without live birth was analyzed using a Mann-Whitney-test, and live birth rates were compared between groups by a chi-squared test for linear trend. The ability of AMH, OSI and AFC as predictors of live birth was assessed by a receiver operating characteristics-analysis and the area under the curve (AUC) was calculated. Patients with live birth had a higher AMH, median (range) 26 [0-137] pmol/l, compared with patients without live birth, AMH 22 [0-154] pmol/l, p = 0.035. Mean live birth rate (SD) was 0.36 (0.48) in the total cohort, 0.26 (0.44) in AMH-group birth rates increased with 8% per AMH-group (95% CI: 0.02 -0.14, p = 0.015). The AUC for AFC was 0.56, for AMH 0.57 and for OSI 0.63, respectively. AMH concentration in serum is associated with live birth rates after IVF. Our results suggest that both AMH, AFC and OSI have an equal but modest predictive ability in relation to live birth rate. Copyright © 2018 Elsevier B.V. All rights reserved.

  3. Does a Caesarean section increase the time to a second live birth? A register-based cohort study.

    Science.gov (United States)

    O'Neill, Sinéad M; Khashan, Ali S; Henriksen, Tine B; Kenny, Louise C; Kearney, Patricia M; Mortensen, Preben B; Greene, Richard A; Agerbo, Esben

    2014-11-01

    Does a primary Caesarean section influence the rate of, and time to, subsequent live birth compared with vaginal delivery? Caesarean section was associated with a reduction in the rate of subsequent live birth, particularly among elective and maternal-requested Caesareans indicating maternal choice plays a role. Several studies have examined the relationship between Caesarean section and subsequent birth rate with conflicting results primarily due to poor epidemiological methods. This Danish population register-based cohort study covered the period from 1982 to 2010 (N = 832 996). All women with index live births were followed until their subsequent live birth or censored (maternal death, emigration or study end) using Cox regression models. In all 577 830 (69%) women had a subsequent live birth. Women with any type of Caesarean had a reduced rate of subsequent live birth (hazard ratio [HR] 0.86, 95% confidence intervals [CI] 0.85, 0.87) compared with spontaneous vaginal delivery. This effect was consistent when analyses were stratified by type of Caesarean: emergency (HR 0.87, 95% CI 0.86, 0.88), elective (HR 0.83, 95% CI 0.82, 0.84) and maternal-requested (HR 0.61, 95% CI 0.57, 0.66) and in the extensive sub-analyses performed. Lack of biological data to measure a woman's fertility is a major limitation of the current study. Unmeasured confounding and limited availability of data (maternal BMI, smoking, access to fertility services and maternal-requested Caesarean section) as well as changes in maternity care over time may also influence the findings. This is the largest study to date and shows that Caesarean section is most likely not causally related to a reduction in fertility. Maternal choice to delay or avoid childbirth is the most plausible explanation. Our findings are generalizable to other middle- to high-income countries; however, cross country variations in Caesarean section rates and social or cultural differences are acknowledged. Funding was

  4. Live Births from Domestic Dog (Canis familiaris Embryos Produced by In Vitro Fertilization.

    Directory of Open Access Journals (Sweden)

    Jennifer B Nagashima

    Full Text Available Development of assisted reproductive technologies (ART in the dog has resisted progress for decades, due to their unique reproductive physiology. This lack of progress is remarkable given the critical role ART could play in conserving endangered canid species or eradicating heritable disease through gene-editing technologies-an approach that would also advance the dog as a biomedical model. Over 350 heritable disorders/traits in dogs are homologous with human conditions, almost twice the number of any other species. Here we report the first live births from in vitro fertilized embryos in the dog. Adding to the practical significance, these embryos had also been cryopreserved. Changes in handling of both gametes enabled this progress. The medium previously used to capacitate sperm excluded magnesium because it delayed spontaneous acrosome exocytosis. We found that magnesium significantly enhanced sperm hyperactivation and ability to undergo physiologically-induced acrosome exocytosis, two functions essential to fertilize an egg. Unlike other mammals, dogs ovulate a primary oocyte, which reaches metaphase II on Days 4-5 after the luteinizing hormone (LH surge. We found that only on Day 6 are oocytes consistently able to be fertilized. In vitro fertilization of Day 6 oocytes with sperm capacitated in medium supplemented with magnesium resulted in high rates of embryo development (78.8%, n = 146. Intra-oviductal transfer of nineteen cryopreserved, in vitro fertilization (IVF-derived embryos resulted in seven live, healthy puppies. Development of IVF enables modern genetic approaches to be applied more efficiently in dogs, and for gamete rescue to conserve endangered canid species.

  5. Differences in rates and short-term outcome of live births before 32 weeks of gestation in Europe in 2003: results from the MOSAIC cohort

    DEFF Research Database (Denmark)

    Zeitlin, Jennifer; Draper, Elizabeth S; Kollée, Louis

    2008-01-01

    ,000 total live births were discharged from the hospital alive with a range from 64.1 to 117.1; the range was 10 to 31 per 10,000 live births for infants discharged with a diagnosis of neurologic or respiratory morbidity. CONCLUSIONS: Very preterm mortality and morbidity differed between European regions...

  6. Bias from conditioning on live birth in pregnancy cohorts: an illustration based on neurodevelopment in children after prenatal exposure to organic pollutants

    NARCIS (Netherlands)

    Liew, Zeyan; Olsen, Jørn; Cui, Xin; Ritz, Beate; Arah, Onyebuchi A.

    2015-01-01

    Only 60-70% of fertilized eggs may result in a live birth, and very early fetal loss mainly goes unnoticed. Outcomes that can only be ascertained in live-born children will be missing for those who do not survive till birth. In this article, we illustrate a common bias structure (leading to

  7. Sperm-storage defects and live birth in Drosophila females lacking spermathecal secretory cells.

    Directory of Open Access Journals (Sweden)

    Sandra L Schnakenberg

    2011-11-01

    Full Text Available Male Drosophila flies secrete seminal-fluid proteins that mediate proper sperm storage and fertilization, and that induce changes in female behavior. Females also produce reproductive-tract secretions, yet their contributions to postmating physiology are poorly understood. Large secretory cells line the female's spermathecae, a pair of sperm-storage organs. We identified the regulatory regions controlling transcription of two genes exclusively expressed in these spermathecal secretory cells (SSC: Spermathecal endopeptidase 1 (Send1, which is expressed in both unmated and mated females, and Spermathecal endopeptidase 2 (Send2, which is induced by mating. We used these regulatory sequences to perform precise genetic ablations of the SSC at distinct time points relative to mating. We show that the SSC are required for recruiting sperm to the spermathecae, but not for retaining sperm there. The SSC also act at a distance in the reproductive tract, in that their ablation: (1 reduces sperm motility in the female's other sperm-storage organ, the seminal receptacle; and (2 causes ovoviviparity--the retention and internal development of fertilized eggs. These results establish the reproductive functions of the SSC, shed light on the evolution of live birth, and open new avenues for studying and manipulating female fertility in insects.

  8. CDC-reported assisted reproductive technology live-birth rates may mislead the public.

    Science.gov (United States)

    Kushnir, Vitaly A; Choi, Jennifer; Darmon, Sarah K; Albertini, David F; Barad, David H; Gleicher, Norbert

    2017-08-01

    The Centre for Disease Control and Prevention (CDC) publicly reports assisted reproductive technology live-birth rates (LBR) for each US fertility clinic under legal mandate. The 2014 CDC report excluded 35,406 of 184,527 (19.2%) autologous assisted reproductive technology cycles that involved embryo or oocyte banking from LBR calculations. This study calculated 2014 total clinic LBR for all patients utilizing autologous oocytes two ways: including all initiated assisted reproductive technology cycles or excluding banking cycles, as done by the CDC. The main limitation of this analysis is the CDC report did not differentiate between cycles involving long-term banking of embryos or oocytes for fertility preservation from cycles involving short-term embryo banking. Twenty-seven of 458 (6%) clinics reported over 40% of autologous cycles involved banking, collectively performing 12% of all US assisted reproductive technology cycles. LBR in these outlier clinics calculated by the CDC method, was higher than the other 94% of clinics (33.1% versus 31.1%). However, recalculated LBR including banking cycles in the outlier clinics was lower than the other 94% of clinics (15.5% versus 26.6%). LBR calculated by the two methods increasingly diverged based on proportion of banking cycles performed by each clinic reaching 4.5-fold, thereby, potentially misleading the public. Copyright © 2017 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  9. Live births after polar body biopsy and frozen-thawed cleavage stage embryo transfer: case report.

    Science.gov (United States)

    Guimarães, Fernando; Roque, Matheus; Valle, Marcello; Kostolias, Alessandra; Azevedo, Rodrigo A de; Martinhago, Ciro D; Sampaio, Marcos; Geber, Selmo

    2016-12-01

    Pre-implantation genetic diagnosis (PGD) or screening (PGS) technology, has emerged and developed in the past few years, benefiting couples as it allows the selection and transfer of healthy embryos during IVF treatments. These techniques can be performed in oocytes (polar-body biopsy) or embryos (blastomere or trophectoderm biopsy). In this case report, we describe the first two live births to be published in Brazil after a polar-body (PB) biopsy. In case 1, a 42-year-old was submitted to PB biopsy with PGS due to advanced maternal age and poor ovarian reserve. Five MII oocytes underwent first and second polar body biopsy and four cleavage embryos were cryopreserved. The PGS analysis resulted in two euploid embryos (next generation sequence). A frozen-thawed embryo transfer (FET) was performed after endometrial priming and a healthy baby was delivered after a cesarean section (37 weeks, female, 3390g, 47.5 cm). In case 2, a 40-year old patient with balanced translocation and poor ovarian response was submitted to PB biopsy. Two MII oocytes underwent first and second polar body biopsy and two embryos were cryopreserved in cleavage stage. The analysis resulted in one euploid embryo that was transferred after endometrial priming. A preterm healthy baby (34 weeks, female, 2100g, 40 cm) was delivered via cesarean section. In conclusion, although the blastocyst biopsy is the norm when performing PGS/PGD during IVF treatments, other alternatives (as PB biopsy) should be considered in some specific situations.

  10. Effects of vitamin D supplementation on semen quality, reproductive hormones and live birth rate

    DEFF Research Database (Denmark)

    Blomberg Jensen, Martin; Lawaetz, Jacob Gerner; Petersen, Jørgen Holm

    2018-01-01

    Context: Animal models and cross-sectional cohort studies have suggested a beneficial role for vitamin D in male reproduction. Objective: Determine the effect of vitamin D and calcium supplementation on semen quality in infertile men with serum 25-hydroxyvitamin-D (25OHD)≤ 50 nmol/l. Design: A si...... of vitamin D supplementation on live birth rate and serum inhibin B in oligozoospermic and vitamin D deficient men may be of clinical importance and warrant verification by others. Trial ID: NCT01304927.......Context: Animal models and cross-sectional cohort studies have suggested a beneficial role for vitamin D in male reproduction. Objective: Determine the effect of vitamin D and calcium supplementation on semen quality in infertile men with serum 25-hydroxyvitamin-D (25OHD)≤ 50 nmol/l. Design...... calcium daily for 150 days, while the other group received placebo. Results: Serum concentrations of 25-OHD and 1,25OH2D3 were significantly higher in men treated with vitamin D + calcium for 150 days compared with placebo. Vitamin D supplementation was not associated with changes in semen parameters...

  11. Age-specific cost and public funding of a live birth following assisted reproductive treatment in Japan.

    Science.gov (United States)

    Maeda, Eri; Ishihara, Osamu; Saito, Hidekazu; Kuwahara, Akira; Toyokawa, Satoshi; Kobayashi, Yasuki

    2014-05-01

    The aim of this study was to calculate and assess the cost of assisted reproductive technology (ART) treatment cycles and live-birth events in Japan in 2010. We performed a retrospective analysis of 238,185 ART cycles, registered with the national registry of assisted reproductive treatment during 2010. Costs were calculated, using a decision analysis model. The average cost per live birth was ¥1,974,000. This varied from ¥1,155,000 in women aged birth was ¥442,000. This was ¥6,118,000 in women aged ≥ 45, 15.4 times higher than that of the 35-39-year-old age group. The costs and public funding of a live birth after ART treatment rises with age due to the lower success rates in older women. It may provide economic background to improve the current subsidy system for ART and to provide practical knowledge about fertility for the general population. © 2014 The Authors. Journal of Obstetrics and Gynaecology Research © 2014 Japan Society of Obstetrics and Gynecology.

  12. Prediction of neonatal metaboic acidos in women with a singleton term pregnancy in cephalic presentation

    NARCIS (Netherlands)

    Westerhuis, M.E.M.H.; Schuit, E.; Kwee, A.; Zuithoff, N.P.A.; Groenwold, R.H.H.; Akker, van den E.S.A.; Beek, van E.; Dessel, van H.J.H.M.; Drogtrop, A.P.; Geijn, van H.P.; Graziosi, G.C.M.; Lith, van J.M.M.; Nijhuis, J.G.; Oei, S.G.; Oosterbaan, H.P.; Porath, M.M.; Rijnders, R.J.P.; Schuitemaker, N.W.E.; Wijnberger, L.D.E.; Willekes, C.; Wouters, M.G.A.J.; Visser, G.H.A.; Mol, B.W.J.; Moons, K.G.M.

    2012-01-01

    We sought to predict neonatal metabolic acidosis at birth using antepartum obstetric characteristics (model 1) and additional characteristics available during labor (model 2). In 5667 laboring women from a multicenter randomized trial that had a high-risk singleton pregnancy in cephalic presentation

  13. First Trimester Influenza Vaccination and Risks for Major Structural Birth Defects in Offspring.

    Science.gov (United States)

    Kharbanda, Elyse Olshen; Vazquez-Benitez, Gabriela; Romitti, Paul A; Naleway, Allison L; Cheetham, T Craig; Lipkind, Heather S; Klein, Nicola P; Lee, Grace; Jackson, Michael L; Hambidge, Simon J; McCarthy, Natalie; DeStefano, Frank; Nordin, James D

    2017-08-01

    To examine risks for major structural birth defects in infants after first trimester inactivated influenza vaccine (IIV) exposures. In this observational study, we used electronic health data from 7 Vaccine Safety Datalink sites to examine risks for selected major structural defects in infants after maternal IIV exposure. Vaccine exposures for women with continuous insurance enrollment through pregnancy who delivered singleton live births between 2004 and 2013 were identified from standardized files. Infants with continuous insurance enrollment were followed to 1 year of age. We excluded mother-infant pairs with other exposures that potentially increased their background risk for birth defects. Selected cardiac, orofacial or respiratory, neurologic, ophthalmologic or otologic, gastrointestinal, genitourinary and muscular or limb defects were identified from diagnostic codes in infant medical records using validated algorithms. Propensity score adjusted generalized estimating equations were used to estimate prevalence ratios (PRs). We identified 52 856 infants with maternal first trimester IIV exposure and 373 088 infants whose mothers were unexposed to IIV during first trimester. Prevalence (per 100 live births) for selected major structural birth defects was 1.6 among first trimester IIV exposed versus 1.5 among unexposed mothers. The adjusted PR was 1.02 (95% CI 0.94-1.10). Organ system-specific PRs were similar to the overall PR. First trimester maternal IIV exposure was not associated with an increased risk for selected major structural birth defects in this large cohort of singleton live births. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Validation of birth outcomes from the Society for Assisted Reproductive Technology Clinic Outcome Reporting System (SART CORS): population-based analysis from the Massachusetts Outcome Study of Assisted Reproductive Technology (MOSART).

    Science.gov (United States)

    Stern, Judy E; Gopal, Daksha; Liberman, Rebecca F; Anderka, Marlene; Kotelchuck, Milton; Luke, Barbara

    2016-09-01

    To assess the validity of outcome data reported to the Society for Assisted Reproductive Technology Clinic Outcome Reporting System (SART CORS) compared with data from vital records and the birth defects registry in Massachusetts. Longitudinal cohort. Not applicable. A total of 342,035 live births and fetal deaths from Massachusetts mothers giving birth in the state from July 1, 2004, to December 31, 2008; 9,092 births and fetal deaths were from mothers who had conceived with the use of assisted reproductive technology (ART) and whose cycle data had been reported to the SART CORS. Not applicable. Percentage agreement between maternal race and ethnicity, delivery outcome (live birth or fetal death), plurality (singleton, twin, or triplet+), delivery date, and singleton birth weight reported in the SART CORS versus vital records; sensitivity and specificity for birth defects among singletons as reported in the SART CORS versus the Massachusetts Birth Defects Monitoring Program (BDMP). There was >95% agreement between the SART CORS and vital records for fields of maternal race/ethnicity, live birth/fetal death, and plurality; birth outcome date was within 1 day with 94.9% agreement and birth weight was within 100 g with 89.6% agreement. In contrast, sensitivity for report of any birth defect was 38.6%, with a range of 18.4%-50.0%, for specific birth defect categories. Although most SART CORS outcome fields are accurately reported, birth defect variables showed poor sensitivity compared with the gold standard data from the BDMP. We suggest that reporting of birth defects be discontinued. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  15. Birth Outcomes after the Fukushima Daiichi Nuclear Power Plant Disaster: A Long-Term Retrospective Study

    Directory of Open Access Journals (Sweden)

    Claire Leppold

    2017-05-01

    Full Text Available Changes in population birth outcomes, including increases in low birthweight or preterm births, have been documented after natural and manmade disasters. However, information is limited following the 2011 Fukushima Daiichi Nuclear Power Plant Disaster. In this study, we assessed whether there were long-term changes in birth outcomes post-disaster, compared to pre-disaster data, and whether residential area and food purchasing patterns, as proxy measurements of evacuation and radiation-related anxiety, were associated with post-disaster birth outcomes. Maternal and perinatal data were retrospectively collected for all live singleton births at a public hospital, located 23 km from the power plant, from 2008 to 2015. Proportions of low birthweight (<2500 g at birth and preterm births (<37 weeks gestation at birth were compared pre- and post-disaster, and regression models were conducted to assess for associations between these outcomes and evacuation and food avoidance. A total of 1101 live singleton births were included. There were no increased proportions of low birthweight or preterm births in any year after the disaster (merged post-disaster risk ratio of low birthweight birth: 0.98, 95% confidence interval (CI: 0.64–1.51; and preterm birth: 0.68, 95% CI: 0.38–1.21. No significant associations between birth outcomes and residential area or food purchasing patterns were identified, after adjustment for covariates. In conclusion, no changes in birth outcomes were found in this institution-based investigation after the Fukushima disaster. Further research is needed on the pathways that may exacerbate or reduce disaster effects on maternal and perinatal health.

  16. Live birth rates are satisfactory following multiple IVF treatment cycles in poor prognosis patients.

    Science.gov (United States)

    Mustafa, Kamarul B; Keane, Kevin N; Walz, Nikita L; Mitrovic, Katarina I; Hinchliffe, Peter M; Yovich, John L

    2017-03-01

    This seven-year retrospective study analysed the live birth rate (LBR) for women undergoing IVF treatment with various antral follicle counts (AFC). The LBR decreased with lower AFC ratings, and in 290 treatment cycles for women in the poorest AFC category, ≤4 follicles (group E), the LBR was the lowest at 10.7%. The pregnancy loss rate (PLR) significantly increased with poorer AFC categories, from 21.8% in AFC group A (≥20 follicles), to 54.4% in AFC group E (p<0.0001). This trend was repeated with advancing age, from 21.6% for younger women (<35years), to 32.9, 48.5 and 100% for ages 35-39, 40-44 and ≥45 years, respectively (p<0.0001). However, LBR within the specific AFC group E cohort was also age-dependent and decreased significantly from 30.0% for <35 years old, to 13.3, 3.9 and 0% for patients aged 35-39, 40-44 and ≥45 years, respectively. Most, importantly, LBR rates within these age groups were not dependent on the number of IVF attempts (1st, 2nd, 3rd or ≥4 cycles), which indicated that cycle number should not be the primary deciding factor for cessation of IVF treatment in responding women <45years old. Copyright © 2016 Society for Biology of Reproduction & the Institute of Animal Reproduction and Food Research of Polish Academy of Sciences in Olsztyn. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

  17. The relative proportion of preterm births complicated by premature rupture of membranes in multifetal gestations: a population-based study.

    Science.gov (United States)

    Pakrashi, Tarita; Defranco, Emily A

    2013-01-01

    To compare the relative contribution of premature rupture of membranes (PROM) to preterm births in singleton compared with multifetal gestations. A population-based retrospective cohort study of 291,782 nonanomalous live births in the state of Ohio from January 1, 2006, to December 31, 2007, identified through birth certificate data. Frequency of PROM was compared between singleton and multifetal gestations and then stratified by gestational age at birth. Multivariate regression analysis estimated the risk of PROM by plurality in each gestational age group, accounting for influential risk factors. The frequency of PROM increased with increasing plurality of gestation. The relative proportion of preterm birth < 37 weeks complicated by PROM increased with gestational plurality 13.2% singletons, 16.8% twins, 20.0% triplets, 19.6% quadruplets, and 100% for higher-order multiples (p < 0.001). The frequency of PROM increased with earlier gestational age at birth, regardless of plurality. The increased risk of PROM in multifetal gestation persisted even after adjustment for influential concomitant risk factors. The proportion of preterm birth attributable to PROM increases by plurality of gestation, with its most significant contribution in higher-order multiples and at earliest gestational ages when outcomes are the poorest. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  18. A multicenter prospective study to assess the effect of early cleavage on embryo quality, implantation, and live-birth rate.

    Science.gov (United States)

    de los Santos, Maria José; Arroyo, Gemma; Busquet, Ana; Calderón, Gloria; Cuadros, Jorge; Hurtado de Mendoza, Maria Victoria; Moragas, Marta; Herrer, Raquel; Ortiz, Agueda; Pons, Carme; Ten, Jorge; Vilches, Miguel Angel; Figueroa, Maria José

    2014-04-01

    To investigate the impact of early cleavage (EC) on embryo quality, implantation, and live-birth rates. Prospective cross-sectional study. Multicenter study. Seven hundred embryo transfers and 1,028 early-stage human embryos. None. Implantation according to the presence of EC and embryo quality. The presence of EC is associated with embryo quality, especially in cycles with autologous oocytes. However, the use of EC as an additional criterion for selecting an embryo for transfer does not appear to significantly improve likelihood of implantation. Furthermore, embryos that presented EC had live-birth rates per implanted embryo similar to those that did not show any sign of cleavage. At least for conventional embryo culture and morphologic evaluations, the additional evaluation of EC in embryos may not be valuable to improve embryo implantation. Copyright © 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  19. Birth Order and Injury-Related Infant Mortality in the U.S.

    Science.gov (United States)

    Ahrens, Katherine A; Rossen, Lauren M; Thoma, Marie E; Warner, Margaret; Simon, Alan E

    2017-10-01

    The purpose of this study was to evaluate the risk of death during the first year of life due to injury, such as unintentional injury and homicide, by birth order in the U.S. Using national birth cohort-linked birth-infant death data (births, 2000-2010; deaths, 2000-2011), risks of infant mortality due to injury in second-, third-, fourth-, and fifth or later-born singleton infants were compared with first-born singleton infants. Risk ratios were estimated using log-binomial models adjusted for maternal age, marital status, race/ethnicity, and education. The statistical analyses were conducted in 2016. Approximately 40%, 32%, 16%, 7%, and 4% of singleton live births were first, second, third, fourth, and fifth or later born, respectively. From 2000 to 2011, a total of 15,866 infants died as a result of injury (approximately 1,442 deaths per year). Compared with first-born infants (2.9 deaths per 10,000 live births), second or later-born infants were at increased risk of infant mortality due to injury (second, 3.6 deaths; third, 4.2 deaths; fourth, 4.8 deaths; fifth or later, 6.4 deaths). The corresponding adjusted risk ratios were as follows: second, 1.84 (95% CI=1.76, 1.91); third, 2.42 (95% CI=2.30, 2.54); fourth, 2.96 (95% CI=2.77, 3.16); and fifth or later, 4.26 (95% CI=3.96, 4.57). Singleton infants born second or later were at increased risk of mortality due to injury during their first year of life in the U.S. This study's findings highlight the importance of investigating underlying mechanisms behind this increased risk. Published by Elsevier Inc.

  20. International variations in the gestational age distribution of births: an ecological study in 34 high-income countries.

    Science.gov (United States)

    Delnord, Marie; Mortensen, Laust; Hindori-Mohangoo, Ashna D; Blondel, Béatrice; Gissler, Mika; Kramer, Michael R; Richards, Jennifer L; Deb-Rinker, Paromita; Rouleau, Jocelyn; Morisaki, Naho; Nassar, Natasha; Bolumar, Francisco; Berrut, Sylvie; Nybo Andersen, Anne-Marie; Kramer, Michael S; Zeitlin, Jennifer

    2018-04-01

    Few studies have investigated international variations in the gestational age (GA) distribution of births. While preterm births (22-36 weeks GA) and early term births (37-38 weeks) are at greater risk of adverse health outcomes compared to full term births (39-40 weeks), it is not known if countries with high preterm birth rates also have high early term birth rates. We examined rate associations between preterm and early term births and mean term GA by mode of delivery onset. We used routine aggregate data on the GA distribution of singleton live births from up to 34 high-income countries/regions in 1996, 2000, 2004, 2008 and 2010 to study preterm and early term births overall and by spontaneous or indicated onset. Pearson correlation coefficients were adjusted for clustering in time trend analyses. Preterm and early term births ranged from 4.1% to 8.2% (median 5.5%) and 15.6% to 30.8% (median 22.2%) of live births in 2010, respectively. Countries with higher preterm birth rates in 2004-2010 had higher early term birth rates (r > 0.50, P birth rates suggest that common risk factors could underpin shifts in the GA distribution. Targeting modifiable population risk factors for delivery before 39 weeks GA may provide a useful preterm birth prevention paradigm.

  1. Frequency of marriage and live birth among survivors prenatally exposed to the atomic bomb

    International Nuclear Information System (INIS)

    Blot, W.J.; Shimizu, Y.; Kato, H.; Miller, R.W.

    1975-01-01

    Frequency of marriage and birth as of January 1973 was determined for persons exposed in utero to the atomic bombs in 1945 and for controls. The marriage rate was lower in persons heavily exposed in utero than in the non-exposed or lightly exposed. This difference is attributed partly to the lesser marriageability of persons with mental retardation who are significantly more numerous among the heavily exposed, and partly to unmeasured variables, possibly including social discrimination against survivors of the atomic bomb. No consistent relation was observed between radiation exposure and three reproductive indices: childless marriages, number of births, and interval between marriage and first birth

  2. Feature singletons attract spatial attention independently of feature priming.

    Science.gov (United States)

    Yashar, Amit; White, Alex L; Fang, Wanghaoming; Carrasco, Marisa

    2017-08-01

    People perform better in visual search when the target feature repeats across trials (intertrial feature priming [IFP]). Here, we investigated whether repetition of a feature singleton's color modulates stimulus-driven shifts of spatial attention by presenting a probe stimulus immediately after each singleton display. The task alternated every two trials between a probe discrimination task and a singleton search task. We measured both stimulus-driven spatial attention (via the distance between the probe and singleton) and IFP (via repetition of the singleton's color). Color repetition facilitated search performance (IFP effect) when the set size was small. When the probe appeared at the singleton's location, performance was better than at the opposite location (stimulus-driven attention effect). The magnitude of this attention effect increased with the singleton's set size (which increases its saliency) but did not depend on whether the singleton's color repeated across trials, even when the previous singleton had been attended as a search target. Thus, our findings show that repetition of a salient singleton's color affects performance when the singleton is task relevant and voluntarily attended (as in search trials). However, color repetition does not affect performance when the singleton becomes irrelevant to the current task, even though the singleton does capture attention (as in probe trials). Therefore, color repetition per se does not make a singleton more salient for stimulus-driven attention. Rather, we suggest that IFP requires voluntary selection of color singletons in each consecutive trial.

  3. Acupuncture to improve live birth rates for women undergoing in vitro fertilization: a protocol for a randomized controlled trial

    Science.gov (United States)

    2012-01-01

    Background IVF is a costly treatment option for women, their partners, and the public. Therefore new therapies that improve reproductive and health outcomes are highly desirable. There is a growing body of research evaluating the effect of acupuncture administered during IVF, and specifically on the day of embryo transfer (ET). Many trials are heterogeneous and results inconsistent. There remains insufficient evidence to determine if acupuncture can enhance live birth rates when used as an adjunct to IVF treatment. The study will determine the clinical effectiveness of acupuncture with improving the proportion of women undergoing IVF having live births. Other objectives include: determination of the cost effectiveness of IVF with acupuncture; and examination of the personal and social context of acupuncture in IVF patients, and examining the reasons why the acupuncture may or may not have worked. Methods We will conduct a randomized controlled trial of acupuncture compared to placebo acupuncture. Inclusion criteria include: women aged less than 43 years; undergoing a fresh IVF or ICSI cycle; and restricted to women with the potential for a lower live birth rate defined as two or more previous unsuccessful ETs; and unsuccessful clinical pregnancies of quality embryos deemed by the embryologist to have been suitable for freezing by standard criteria. Women will be randomized to acupuncture or placebo acupuncture. Treatment is administered on days 6 to 8 of the stimulated cycle and two treatments on the day of ET. A non-randomized cohort of women not using acupuncture will be recruited to the study. The primary study outcome is the proportion of women reporting a live birth. Secondary outcomes include the proportion of women reporting a clinical pregnancy miscarriage prior to 12 weeks, quality of life, and self-efficacy. The sample size of the study is 1,168 women, with the aim of detecting a 7% difference in live births between groups (P = 0.05, 80% power

  4. Acupuncture to improve live birth rates for women undergoing in vitro fertilization: a protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Smith Caroline A

    2012-05-01

    Full Text Available Abstract Background IVF is a costly treatment option for women, their partners, and the public. Therefore new therapies that improve reproductive and health outcomes are highly desirable. There is a growing body of research evaluating the effect of acupuncture administered during IVF, and specifically on the day of embryo transfer (ET. Many trials are heterogeneous and results inconsistent. There remains insufficient evidence to determine if acupuncture can enhance live birth rates when used as an adjunct to IVF treatment. The study will determine the clinical effectiveness of acupuncture with improving the proportion of women undergoing IVF having live births. Other objectives include: determination of the cost effectiveness of IVF with acupuncture; and examination of the personal and social context of acupuncture in IVF patients, and examining the reasons why the acupuncture may or may not have worked. Methods We will conduct a randomized controlled trial of acupuncture compared to placebo acupuncture. Inclusion criteria include: women aged less than 43 years; undergoing a fresh IVF or ICSI cycle; and restricted to women with the potential for a lower live birth rate defined as two or more previous unsuccessful ETs; and unsuccessful clinical pregnancies of quality embryos deemed by the embryologist to have been suitable for freezing by standard criteria. Women will be randomized to acupuncture or placebo acupuncture. Treatment is administered on days 6 to 8 of the stimulated cycle and two treatments on the day of ET. A non-randomized cohort of women not using acupuncture will be recruited to the study. The primary study outcome is the proportion of women reporting a live birth. Secondary outcomes include the proportion of women reporting a clinical pregnancy miscarriage prior to 12 weeks, quality of life, and self-efficacy. The sample size of the study is 1,168 women, with the aim of detecting a 7% difference in live births between groups (P

  5. Sex ratios at birth after induced abortion.

    Science.gov (United States)

    Urquia, Marcelo L; Moineddin, Rahim; Jha, Prabhat; O'Campo, Patricia J; McKenzie, Kwame; Glazier, Richard H; Henry, David A; Ray, Joel G

    2016-06-14

    Skewed male:female ratios at birth have been observed among certain immigrant groups. Data on abortion practices that might help to explain these findings are lacking. We examined 1 220 933 births to women with up to 3 consecutive singleton live births between 1993 and 2012 in Ontario. Records of live births, and induced and spontaneous abortions were linked to Canadian immigration records. We determined associations of male:female infant ratios with maternal birthplace, sex of the previous living sibling(s) and prior spontaneous or induced abortions. Male:female infant ratios did not appreciably depart from the normal range among Canadian-born women and most women born outside of Canada, irrespective of the sex of previous children or the characteristics of prior abortions. However, among infants of women who immigrated from India and had previously given birth to 2 girls, the overall male:female ratio was 1.96 (95% confidence interval [CI] 1.75-2.21) for the third live birth. The male:female infant ratio after 2 girls was 1.77 (95% CI 1.26-2.47) times higher if the current birth was preceded by 1 induced abortion, 2.38 (95% CI 1.44-3.94) times higher if preceded by 2 or more induced abortions and 3.88 (95% CI 2.02-7.50) times higher if the induced abortion was performed at 15 weeks or more gestation relative to no preceding abortion. Spontaneous abortions were not associated with male-biased sex ratios in subsequent births. High male:female ratios observed among infants born to women who immigrated from India are associated with induced abortions, especially in the second trimester of pregnancy. © 2016 Canadian Medical Association or its licensors.

  6. IMPACT OF PRENATAL MATERNAL FACTORS AND BIRTH ORDER ON THE ANTHROPOMETRIC STATUS OF NEWBORNS IN IRAN.

    Science.gov (United States)

    Kheirouri, Sorayya; Alizadeh, Mohammad

    2017-03-01

    This cross-sectional study was carried out to capture possible maternal factors affecting newborns' anthropometric measurements. Data were collected from eight public health centres and referral university hospital records in Tabriz and Heriss districts, north-west Iran, for 807 mother-neonate pairs delivering live singleton births and their offspring during the two years up to August 2014. The incidence of low birth weight (LBW) was 5.1%. A close correlation was found between maternal anthropometry and birth order with neonatal anthropometric data. Birth order and maternal height and body mass index (BMI) positively affected neonates' birth size (weight, length and head circumference). The rate of LBW was significantly higher for older (≥35 years), taller (≥170 cm), underweight (BMIbirth neonates. The results indicate that maternal anthropometric indices, age, iron intake and birth order influence the risk of LBW in newborns.

  7. [Prevalence of Down syndrome using certificates of live births and fetal deaths in México 2008-2011].

    Science.gov (United States)

    Sierra Romero, María Del Carmen; Navarrete Hernández, Eduardo; Canún Serrano, Sonia; Reyes Pablo, Aldelmo E; Valdés Hernández, Javier

    Down syndrome (DS) or trisomy 21 is the most common genetic cause of mental retardation with the clinical presentation of a series of well-defined characteristics. Advanced maternal age has been associated with DS. The databases of all the certificates of live births and fetal deaths in Mexico were combined. Codes based on the International Classification of Diseases 10 th Revision (ICD-10) in Chapter XVII "Congenital malformations, deformations and chromosomal abnormalities" were selected. A database of 8,250,375 births during the period 2008-2011 was constructed: 99.2% were live births with 0.8% of fetal deaths and 3,076 cases diagnosed with DS. The importance of this report is to initiate an epidemiological surveillance of newborn cases of DS nationwide and by state using census information systems available in the country since 2008. An increased risk has been observed for having a child with DS since the mother is ≥ 35 years, as has been reported in other studies. Copyright © 2014 Hospital Infantil de México Federico Gómez. Publicado por Masson Doyma México S.A. All rights reserved.

  8. An outcome-based approach for the creation of fetal growth standards: do singletons and twins need separate standards?

    Science.gov (United States)

    Joseph, K S; Fahey, John; Platt, Robert W; Liston, Robert M; Lee, Shoo K; Sauve, Reg; Liu, Shiliang; Allen, Alexander C; Kramer, Michael S

    2009-03-01

    Contemporary fetal growth standards are created by using theoretical properties (percentiles) of birth weight (for gestational age) distributions. The authors used a clinically relevant, outcome-based methodology to determine if separate fetal growth standards are required for singletons and twins. All singleton and twin livebirths between 36 and 42 weeks' gestation in the United States (1995-2002) were included, after exclusions for missing information and other factors (n = 17,811,922). A birth weight range was identified, at each gestational age, over which serious neonatal morbidity and neonatal mortality rates were lowest. Among singleton males at 40 weeks, serious neonatal morbidity/mortality rates were lowest between 3,012 g (95% confidence interval (CI): 3,008, 3,018) and 3,978 g (95% CI: 3,976, 3,980). The low end of this optimal birth weight range for females was 37 g (95% CI: 21, 53) less. The low optimal birth weight was 152 g (95% CI: 121, 183) less for twins compared with singletons. No differences were observed in low optimal birth weight by period (1999-2002 vs. 1995-1998), but small differences were observed for maternal education, race, parity, age, and smoking status. Patterns of birth weight-specific serious neonatal morbidity/neonatal mortality support the need for plurality-specific fetal growth standards.

  9. Twin versus singleton pregnancies: the incidence, pregnancy complications, and obstetric outcomes in a Nigerian tertiary hospital.

    Science.gov (United States)

    Obiechina, Nj; Okolie, Ve; Eleje, Gu; Okechukwu, Zc; Anemeje, Oa

    2011-01-01

    Twin pregnancy is associated with more pregnancy complications and poorer pregnancy outcome than singleton pregnancy. Hence periodic review is necessary to improve on the pregnancy outcome. To determine the incidence and compare pregnancy complications and obstetric outcomes of twin pregnancies and singleton pregnancies. The twin pregnancies (study group) that were delivered at Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, South-East Nigeria from 1st February 2005 to 31st January 2010 were compared with singleton deliveries (control group) that occurred in the same hospital during the same period. A total of 3351 deliveries were conducted during the study period, of which 113 were twin deliveries, giving an incidence of 1:29.6 deliveries. Only 100 case files could be retrieved for analysis. The mean parities for the twins and singletons were 2.7 ± 2.33 weeks and 1.96 ± 1.87 weeks whereas the mean gestational age at delivery for twin and singleton deliveries were 34 ± 5.2 weeks and 38.7 ± 2.4 weeks respectively (P < 0.05). The mean birth weights were 3.14 ± 0.73 kg and 2.3 ± 1.0 kg for singletons and twins respectively (P < 0.05). Hypertensive disorders of pregnancy, cord prolapse, malpresentation, premature rupture of membranes, low Apgar scores, cesarean section rate, and perinatal death were significantly higher in twin pregnancies than in singleton. The incidence of twin pregnancy over the study period was high and was significantly associated with more pregnancy complications and poorer obstetric outcomes. Close antenatal and intrapartum care are needed in order to improve outcome and decrease complications.

  10. The birth of the first child as a positive event in the lives of young parents

    Directory of Open Access Journals (Sweden)

    Wójtowicz-Dacka Małgorzata

    2014-06-01

    Full Text Available The aim of the study was to research the relatioship between level of knowledge possessed by the contemporary parents about the psychological needs of small children and their perception of the birth of their child as a positive event. Study involved 90 parents, aged 25-30, who are currently raising young children up to 1 year of age. The analyses that were carried out verified the existence of such a correlation, but the event of birth is not a positive event for all parents. In summary, the sense of satisfaction with the birth of a child and perceiving this situation as a positive event is especially high among women and those with a higher education. For men and for parents with a low level of education, it can become a positive experience if they raise their level of knowledge about the needs of small children.

  11. Overweight in Singletons Compared to Children with Siblings

    DEFF Research Database (Denmark)

    Hunsberger, Monica; Formisano, Annarita; Reisch, Lucia

    2012-01-01

    and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS (IDEFICS). The present analysis is based on measured anthropometry and parent or guardian-reported socio-demographic characteristics. Subjects include 12 720 children aged 2–9 years for whom number of siblings was known......The aim of this study was to compare the prevalence of overweight in only children to those with siblings and to explore potential behavioral mediating factors. This study relies upon cross-sectional data collected at survey centers in eight European countries participating in Identification....... Singletons were more likely (odds ratio 1.52, 95% confidence interval (CI):1.34–1.72) to be overweight than their peers with siblings when controlling for factors related to childhood overweight, including survey country, parental education, parental weight, maternal age, child's age, birth weight and gender...

  12. Chromosomal Aberrations in Monozygotic and Dizygotic Twins Versus Singletons in Denmark During 1968-2009

    DEFF Research Database (Denmark)

    Kristensen, Lone Krøldrup; Larsen, Lisbeth A; Fagerberg, Christina

    2017-01-01

    BACKGROUND: Hall (Embryologic development and monozygotic twinning. Acta Geneticae Medicae et Gemellologiae, Vol. 45, 1996, pp. 53-57) hypothesized that chromosomal aberrations can lead to monozygotic (MZ) twinning. However, twinning and chromosomal aberrations increase prenatal mortality and could...... reduce the prevalence of chromosomal aberrations in live-born twins. We compared prevalence proportion ratios (PPR) of chromosomal aberrations and trisomy 21 (T21) in live-born twins versus singletons born in Denmark during 1968-2009. METHODS: We linked the Danish Twin Registry and a 5% random sample...... of all singletons to the Danish Cytogenetic Central Register and calculated PPR adjusted for maternal age for MZ, dizygotic (DZ), and all twins versus singletons. Zygosity was based on questionnaires or genetic markers. RESULTS: No overall difference in risk of chromosomal aberrations or T21 in twins...

  13. The Impact of Twin Birth on Early Neonatal Outcomes.

    Science.gov (United States)

    Fumagalli, Monica; Schiavolin, Paola; Bassi, Laura; Groppo, Michela; Uccella, Sara; De Carli, Agnese; Passera, Sofia; Sirgiovanni, Ida; Dessimone, Francesca; Consonni, Dario; Acaia, Barbara; Ramenghi, Luca Antonio; Mosca, Fabio

    2016-01-01

    This study aims to describe the impact of twin birth, chorionicity, intertwin birth weight (BW) discordance and birth order on neonatal outcomes. We performed a hospital-based retrospective study on 2,170 twins (6.4% of all live births) and 2,217 singletons inborn 2007 to 2011. Data on neonatal characteristics, morbidities, and mortality were collected and compared. Univariate and multiple (adjusted for gestational age [GA] and gender) linear random intercept regression models were used. Overall, 62.3% of twins were born premature. At multiple regression, twins were similar to singletons for neonatal morbidities, but they were more likely to have lower BW and to be born by cesarean delivery. Monochorionic twins had lower GA and BW compared with dichorionic ones and were more likely to develop respiratory distress syndrome (odds ratio [OR], 1.7), hypoglycemia (OR, 3.3), need for transfusion, (OR, 3.4) but not brain abnormalities. Moderate and severe BW discordance were associated with longer length of stay and increased risk for morbidities but not for death. Birth order had no effects. Prematurity was the most common outcome in twins and accounted for the apparently increased risk in morbidities. Monochorionicity was confirmed as risk factor for lower GA and neonatal morbidities. BW discordance may play a role in developing neonatal complications and needs to be further investigated. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  14. Singleton pregnancy outcomes after assisted and non-assisted reproductive technology in infertile patients.

    Science.gov (United States)

    Tsutsumi, Ryo; Fujimoto, Akihisa; Osuga, Yutaka; Ooi, Nagisa; Takemura, Yuri; Koizumi, Minako; Yano, Tetsu; Taketani, Yuji

    2012-07-01

    Singleton pregnancy after assisted reproductive technology (ART) has been associated with higher risks of adverse pregnancy outcome than naturally conceived singleton pregnancy. This study was to elucidate whether the ART procedure is responsible for abnormal pregnancy outcome comparing those after ART and non-ART in infertile patients. We compare the singleton pregnancy outcome of infertile patients in our university hospital between 2000 and 2008 following ART (351 pregnancies) and non-ART (213 pregnancies) procedures. Pregnancy outcome parameters were incidence of pregnancy induced hypertension, placenta previa, placental abruption, cesarean delivery, preterm birth, very preterm birth, stillbirth, low birth weight and very low birth weight. Most of the pregnancy outcome parameters were not significantly different between the ART group and the non-ART group. Only placenta previa was significantly higher in the ART group than in the non-ART group (odds ratio 4.0; 95 % CI 1.2-13.7). ART procedure may itself be a risk factor for the development of placenta previa. Some of the abnormal perinatal outcomes that had been previously attributed to ART, however, may be due to the baseline characteristics of infertile patients.

  15. A Study Of 370 Live Births In A Rural Area Of Punjab

    Directory of Open Access Journals (Sweden)

    Singh Surinder

    1988-01-01

    Full Text Available The study was carried out in12 Anganwadi areas of ferozepur District in Punjab to know about the various aspects of reproduction of the population. A total of 13, 782 population was covered. The sex ratio of the surveyed population was 900.7 females to 1000 males. The crude Birth rate of the area came to be 26.83 per 1000 population. In 94.87% of the births, the delivery occurred at the completion of 36 weeks of Gestation period & majority of the births (91.63% occurred to the mothers in the age group of 20 to 35 years . 24.86% of the children were born to the mothers with parity of five and above. 46.75% of the births took place between the months of July and October. 96.22% of the deliveries were conducted at home and majority (93.79% of the mothers utilized the services of indigenous dais( 73.52% of trained dais and 20.27% of untrained dais for the conduction of delivery.

  16. Distinct differences in global gene expression profiles in non-implanted blastocysts and blastocysts resulting in live birth

    DEFF Research Database (Denmark)

    Kirkegaard, Kirstine Kjær; Fredsted, Palle Villesen; Jensen, Jacob Malte

    2015-01-01

    Results from animal models points towards the existence of a gene expression profile that is distinguishably different in viable embryos compared with non-viable embryos. Knowledge of human embryo transcripts is however limited, in particular with regard to how gene expression is related...... to clinical outcome. The purpose of the present study was therefore to determine the global gene expression profiles of human blastocysts. Next Generation Sequencing was used to identify genes that were differentially expressed in non-implanted embryos and embryos resulting in live birth. Three trophectoderm...

  17. Prevalence of Hospitalized Live Births Affected by Alcohol and Drugs and Parturient Women Diagnosed with Substance Abuse at Liveborn Delivery: United States, 1999–2008

    Science.gov (United States)

    Pan, I-Jen; Yi, Hsiao-ye

    2015-01-01

    Objective To describe prevalence trends in hospitalized live births affected by placental transmission of alcohol and drugs, as well as prevalence trends among parturient women hospitalized for liveborn delivery and diagnosed with substance abuse problems in the United States from 1999 to 2008. Comparison of the two sets of trends helps determine whether the observed changes in neonatal problems over time were caused by shifts in maternal substance abuse problems. Methods This study independently identified hospitalized live births and maternal live born deliveries from discharge records in the Nationwide Inpatient Sample, one of the largest hospital administrative databases. Substance-related diagnosis codes on the records were used to identify live births affected by alcohol and drugs and parturient women with substance abuse problems. The analysis calculated prevalence differences and percentage changes over the 10 years, with Loess curves fitted to 10-year prevalence estimates to depict trend patterns. Linear and quadratic trends in prevalence were simultaneously tested using logistic regression analyses. The study also examined data on costs, primary expected payer, and length of hospital stays. Results From 1999 to 2008, prevalence increased for narcotic- and hallucinogen-affected live births and neonatal drug withdrawal syndrome but decreased for alcohol- and cocaine-affected live births. Maternal substance abuse at delivery showed similar trends, but prevalence of alcohol abuse remained relatively stable. Substance-affected live births required longer hospital stays and higher medical expenses, mostly billable to Medicaid. Conclusions The findings highlight the urgent need for behavioral intervention and early treatment for substance-abusing pregnant women to reduce the number of substance-affected live births. PMID:22688539

  18. Prevalence of hospitalized live births affected by alcohol and drugs and parturient women diagnosed with substance abuse at liveborn delivery: United States, 1999-2008.

    Science.gov (United States)

    Pan, I-Jen; Yi, Hsiao-ye

    2013-05-01

    To describe prevalence trends in hospitalized live births affected by placental transmission of alcohol and drugs, as well as prevalence trends among parturient women hospitalized for liveborn delivery and diagnosed with substance abuse problems in the United States from 1999 to 2008. Comparison of the two sets of trends helps determine whether the observed changes in neonatal problems over time were caused by shifts in maternal substance abuse problems. This study independently identified hospitalized live births and maternal live born deliveries from discharge records in the Nationwide Inpatient Sample, one of the largest hospital administrative databases. Substance-related diagnosis codes on the records were used to identify live births affected by alcohol and drugs and parturient women with substance abuse problems. The analysis calculated prevalence differences and percentage changes over the 10 years, with Loess curves fitted to 10-year prevalence estimates to depict trend patterns. Linear and quadratic trends in prevalence were simultaneously tested using logistic regression analyses. The study also examined data on costs, primary expected payer, and length of hospital stays. From 1999 to 2008, prevalence increased for narcotic- and hallucinogen-affected live births and neonatal drug withdrawal syndrome but decreased for alcohol- and cocaine-affected live births. Maternal substance abuse at delivery showed similar trends, but prevalence of alcohol abuse remained relatively stable. Substance-affected live births required longer hospital stays and higher medical expenses, mostly billable to Medicaid. The findings highlight the urgent need for behavioral intervention and early treatment for substance-abusing pregnant women to reduce the number of substance-affected live births.

  19. Combined advanced parental age has an additive negative effect on live birth rates-data from 4057 first IVF/ICSI cycles.

    Science.gov (United States)

    McPherson, Nicole O; Zander-Fox, Deirdre; Vincent, Andrew D; Lane, Michelle

    2018-02-01

    The purpose of this study is to determine if there is an additive effect of combined advanced maternal and paternal age on pregnancy and live birth rates. Retrospective data analysis of 4057 first cycles at a fertility centre between 2009 and 2013 was compiled. Donor, preimplantation genetic screening and double embryo transfer cycles were excluded. Main outcomes measured were clinical pregnancy, viable pregnancy, live birth and term birth. Logistic regression indicated strong negative associations for maternal ages exceeding 27 years with clinical pregnancies (p < 0.001), viable pregnancies (p < 0.001), live births (p < 0.001) and term births (p < 0.001). There was evidence of negative associations between paternal age and both viable pregnancies (p = 0.06) and live births (p = 0.04), such that the probability of pregnancy was 10% further reduced for women who were 35 years with a partner over 40 years vs. women aged 35 years with a partner under 30 years. There was evidence of an interaction between maternal age and the paternal age on term births (p = 0.02) such that advanced paternal age's effect on the probability of a term birth was only evident in couples where the maternal age ranged between ~27 and 35 years. There is an additive effect to pregnancy and live birth rates when both partners are of an advanced age, thus highlighting the need for pre-conception public health messaging and a combined approach to ART counselling assessing both parental ages in combination.

  20. Bias from conditioning on live birth in pregnancy cohorts: an illustration based on neurodevelopment in children after prenatal exposure to organic pollutants

    Science.gov (United States)

    Liew, Zeyan; Olsen, Jørn; Cui, Xin; Ritz, Beate; Arah, Onyebuchi A

    2015-01-01

    Only 60–70% of fertilized eggs may result in a live birth, and very early fetal loss mainly goes unnoticed. Outcomes that can only be ascertained in live-born children will be missing for those who do not survive till birth. In this article, we illustrate a common bias structure (leading to ‘live-birth bias’) that arises from studying the effects of prenatal exposure to environmental factors on long-term health outcomes among live births only in pregnancy cohorts. To illustrate this we used prenatal exposure to perfluoroalkyl substances (PFAS) and attention-deficit/hyperactivity disorder (ADHD) in school-aged children as an example. PFAS are persistent organic pollutants that may impact human fecundity and be toxic for neurodevelopment. We simulated several hypothetical scenarios based on characteristics from the Danish National Birth Cohort and found that a weak inverse association may appear even if PFAS do not cause ADHD but have a considerable effect on fetal survival. The magnitude of the negative bias was generally small, and adjusting for common causes of the outcome and fetal loss can reduce the bias. Our example highlights the need to identify the determinants of pregnancy loss and the importance of quantifying bias arising from conditioning on live birth in observational studies. PMID:25604449

  1. Maternal anthropometric characteristics in pregnancy and blood pressure among adolescents: 1993 live birth cohort, Pelotas, southern Brazil

    Directory of Open Access Journals (Sweden)

    Hallal Pedro C

    2010-07-01

    Full Text Available Abstract Background We investigated the association between maternal anthropometric measurements in prepregnancy and at the end of pregnancy and their children's systolic (SBP and diastolic (DBP blood pressure at 11 years of age, in a prospective cohort study. Methods All hospital births which took place in 1993 in the city of Pelotas - Brazil, were identified (5,249 live births. In 2004, the overall proportion of follow-up was 85% and we obtained arterial blood pressure measurements of 4,452 adolescents. Results Independent variables analyzed included maternal prepregnancy weight and body mass index (BMI and maternal weight, and height at the end of pregnancy. Multiple linear regression analysis controlling for the following confounders were carried out: adolescent's skin color, family income at birth, smoking, alcohol intake during pregnancy, and gestational arterial hypertension. Mean SBP and DBP were 101.9 mmHg (SD 12.3 and 63.4 mmHg (SD 9.9, respectively. Maternal prepregnancy weight and BMI, and weight at the end of pregnancy were positively associated with both SBP and DBP in adolescent subjects of both sexes; maternal height was positively associated with SBP only among males. Conclusions Adequate evaluation of maternal anthropometric characteristics during pregnancy may prevent high levels of blood pressure among adolescent children.

  2. Changes in birth weight between 2002 and 2012 in Guangzhou, China.

    Directory of Open Access Journals (Sweden)

    Yong Guo

    Full Text Available Recent surveillance data suggest that mean birth weight has begun to decline in several developed countries. The aim of this study is to examine the changes in birth weight among singleton live births from 2002 to 2012 in Guangzhou, one of the most rapidly developed cities in China.We used data from the Guangzhou Perinatal Health Care and Delivery Surveillance System for 34108 and 54575 singleton live births with 28-41 weeks of gestation, who were born to local mothers, in 2002 and 2012, respectively. The trends in birth weight, small (SGA and large (LGA for gestational age and gestational length were explored in the overall population and gestational age subgroups.The mean birth weight decreased from 3162 g in 2002 to 3137 g in 2012 (crude mean difference, -25 g; 95% CI, -30 to -19. The adjusted change in mean birth weight appeared to be slight (-6 g from 2002 to 2012 after controlling for maternal age, gestational age, educational level, parity, newborn's gender and delivery mode. The percentages of SGA and LGA in 2012 were 0.6% and 1.5% lower than those in 2002, respectively. The mean gestational age dropped from 39.2 weeks in 2002 to 38.9 weeks in 2012. In the stratified analysis, we observed the changes in birth weight differed among gestational age groups. The mean birth weight decreased among very preterm births (28-31 weeks, while remained relatively stable among other gestational age subcategories.Among local population in Guangzhou from 2002 to 2012, birth weight appeared to slightly decrease. The percentage of SGA and LGA also simultaneously dropped, indicating that newborns might gain a healthier weight for gestational age.

  3. Infant feeding and mental and motor development at 18 months of age in first born singletons.

    Science.gov (United States)

    Florey, C D; Leech, A M; Blackhall, A

    1995-01-01

    To determine the relationship between type of infant feeding and mental and psychomotor development at age 18 months. A follow-up study of children born to primigravidae living in Dundee and booked into antenatal clinics in the City of Dundee (Local Authority District) from 1 May 1985 to 30 April 1986. The study population was 846 first born singletons, of whom 592 attended for developmental assessment at age 18 months. The main outcome measures were the Bayley Scales of Infant Mental and Motor Development. Higher mental development was significantly related to breast feeding on discharge from hospital and according to the health visitors' notes at about 2 weeks after discharge after allowing for partner's social class, mother's education, height, alcohol and cigarette consumption; placental weight and the child's sex, birth weight and gestational age at birth. After adjustment for statistically significant variables, the difference in Bayley mental development index between breast and bottle fed infants was between 3.7 and 5.7 units depending on the source of feeding data. No differences were found for psychomotor development or behaviour. The study provides further evidence of a robust statistical association between type of feeding and child intelligence. However, the literature is replete with suggestions for potential confounding variables which offer alternative causal explanations. To unravel what is an important clinical and public health question, further research should concentrate on randomized trials of supplemented formula feeds for children of mothers opting for bottle feeding and on epidemiological studies designed to disentangle the relation between method of feeding, parental intelligence and social environment.

  4. Live birth rates in the different combinations of the Bologna criteria poor ovarian responders: a validation study.

    Science.gov (United States)

    La Marca, Antonio; Grisendi, Valentina; Giulini, Simone; Sighinolfi, Giovanna; Tirelli, Alessandra; Argento, Cindy; Re, Claudia; Tagliasacchi, Daniela; Marsella, Tiziana; Sunkara, Sesh Kamal

    2015-06-01

    to compare the baseline characteristics and chance of live birth in the different categories of poor responders identified by the combinations of the Bologna criteria and establish whether these groups comprise a homogenous population. database containing clinical and laboratory information on IVF treatment cycles carried out at the Mother-Infant Department of the University Hospital of Modena between year 2007 and 2011 was analysed. This data was collected prospectively and recorded in the registered database of the fertility centre. Eight hundred and thirty women fulfilled the inclusion/ exclusion criteria of the study and 210 women fulfilled the Bologna criteria definition for poor ovarian response (POR). Five categories of poor responders were identified by different combinations of the Bologna criteria. There were no significant differences in female age, AFC, AMH, cycle cancellation rate and number of retrieved oocytes between the five groups. The live birth rate ranged between 5.5 and 7.4 % and was not statistically different in the five different categories of women defined as poor responders according to the Bologna criteria. The study demonstrates that the different groups of poor responders based on the Bologna criteria have similar IVF outcomes. This information validates the Bologna criteria definition as women having a uniform poor prognosis and also demonstrates that the Bologna criteria poor responders in the various subgroups represent a homogenous population with similar pre-clinical and clinical outcomes.

  5. Acupuncture and Clomiphene Citrate for Live Birth in Polycystic Ovary Syndrome: Study Design of a Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Hongying Kuang

    2013-01-01

    Full Text Available Acupuncture is an alternative therapy to induce ovulation in women with polycystic ovary syndrome (PCOS, but there is no study reporting the live birth rate following ovulation induction by acupuncture or its potential as an adjuvant treatment to clomiphene citrate (CC. We assess the efficacy of acupuncture with or without CC in achieving live births among 1000 PCOS women in Mainland China. This paper reports the methodology of an ongoing multicenter randomized controlled trial. The randomization scheme is coordinated through the central mechanism and stratified by the participating sites. Participants will be randomized into one of the four treatment arms: (A true acupuncture and CC, (B control acupuncture and CC, (C true acupuncture and placebo CC, and (D control acupuncture and placebo CC. To ensure the quality and integrity of the trial we have developed a unique multinational team of investigators and Data and Safety Monitoring Board. Up to the end of April 2013, 326 subjects were recruited. In conclusion, the success of this trial will allow us to evaluate the additional benefit of acupuncture beyond the first line medicine for fertility treatment in PCOS women in an unbiased manner.

  6. Birthweight distribution in ART singletons resulting from embryo culture in two different culture media compared with the national population.

    Science.gov (United States)

    Lemmen, J G; Pinborg, A; Rasmussen, S; Ziebe, S

    2014-10-10

    Is there a difference in birthweight distribution in ART singletons born after IVF culture in two different culture media? There is no effect of culture media on both crude and adjusted birthweight distributions in ART singletons from nulliparous mothers. Studies on human ART singletons have reported a difference in birthweight in singletons following IVF culture in different culture media. However, other studies comparing different culture media have not shown any significant differences in birthweight. This study was a retrospective comparison of birthweights in IVF/ICSI singletons conceived after fresh embryo transfer following embryo culture in Cook or Medicult medium and in a national cohort of naturally conceived singletons in nulliparous women. The study compares four independent groups consisting of singletons in nulliparous women from Cook-d2: 2-day culture in Cook medium at Rigshospitalet (n = 974), Medicult-d2: 2-day culture in Medicult EmbryoAssist medium at Rigshospitalet (n = 147), Medicult-d3: 3-day culture in Medicult EmbryoAssist medium with and without added GM-CSF (n = 204), and DK: pregnancies from the Danish birth registry (n = 106842). The study compares the birthweights of singletons from nulliparous women in the four independent groups mentioned above; Cook-d2: Medicult-d2: Medicult-d3: and DK. In addition, distributions of large and small for gestational age infants were compared between the groups and a multiple linear regression analysis was used to determine which factors determined birthweight. We found no significant difference in the crude birthweight distributions between singletons born after culture in Cook-d2 or Medicult-groups. Singleton girls from the Cook-d2 group weighed 3302 ± 28 g, versus 3252 ± 76 in the Medicult-d2 group (difference 50 g; P = 0.547). Singleton boys from the Cook-d2 group weighed 3430 ± 27 g, versus 3354 ± 56 in the Medicult-d2 group (difference 76 g; P = 0.279). In the background population, mean

  7. National Pregnancy and Health Survey: Drug Use Among Women Delivering Live Births (NPHS-1992)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The primary objective of the National Pregnancy and Health Survey (NPHS) was to produce national annual estimates of the percentages and numbers of mothers of live...

  8. Birth Outcomes after the Fukushima Daiichi Nuclear Power Plant Disaster: A Long-Term Retrospective Study.

    Science.gov (United States)

    Leppold, Claire; Nomura, Shuhei; Sawano, Toyoaki; Ozaki, Akihiko; Tsubokura, Masaharu; Hill, Sarah; Kanazawa, Yukio; Anbe, Hiroshi

    2017-05-19

    Changes in population birth outcomes, including increases in low birthweight or preterm births, have been documented after natural and manmade disasters. However, information is limited following the 2011 Fukushima Daiichi Nuclear Power Plant Disaster. In this study, we assessed whether there were long-term changes in birth outcomes post-disaster, compared to pre-disaster data, and whether residential area and food purchasing patterns, as proxy measurements of evacuation and radiation-related anxiety, were associated with post-disaster birth outcomes. Maternal and perinatal data were retrospectively collected for all live singleton births at a public hospital, located 23 km from the power plant, from 2008 to 2015. Proportions of low birthweight (effects on maternal and perinatal health.

  9. Associations between maternal exposure to air pollution and traffic noise and newborn's size at birth

    DEFF Research Database (Denmark)

    Hjortebjerg, Dorrit; Andersen, Anne Marie Nybo; Ketzel, Matthias

    2016-01-01

    BACKGROUND: Maternal exposure to air pollution and traffic noise has been suggested to impair fetal growth, but studies have reported inconsistent findings. Objective To investigate associations between residential air pollution and traffic noise during pregnancy and newborn's size at birth....... METHODS: From a national birth cohort we identified 75,166 live-born singletons born at term with information on the children's size at birth. Residential address history from conception until birth was collected and air pollution (NO2 and NOx) and road traffic noise was modeled at all addresses...... between air pollution and birth weight. Exposure to residential road traffic noise was weakly associated with reduced head circumference, whereas none of the other newborn's size indicators were associated with noise, neither before nor after adjustment for air pollution. CONCLUSIONS: This study indicates...

  10. Birth weight centiles by gestational age for twins born in south India.

    Science.gov (United States)

    Premkumar, Prasanna; Antonisamy, Belavendra; Mathews, Jiji; Benjamin, Santhosh; Regi, Annie; Jose, Ruby; Kuruvilla, Anil; Mathai, Mathews

    2016-03-24

    Birth weight centile curves are commonly used as a screening tool and to assess the position of a newborn on a given reference distribution. Birth weight of twins are known to be less than those of comparable singletons and twin-specific birth weight centile curves are recommended for use. In this study, we aim to construct gestational age specific birth weight centile curves for twins born in south India. The study was conducted at the Christian Medical College, Vellore, south India. The birth records of all consecutive pregnancies resulting in twin births between 1991 and 2005 were reviewed. Only live twin births between 24 and 42 weeks of gestation were included. Birth weight centiles for gestational age were obtained using the methodology of generalized additive models for location, scale and shape (GAMLSS). Centiles curves were obtained separately for monochorionic and dichorionic twins. Of 1530 twin pregnancies delivered during the study period (1991-2005), 1304 were included in the analysis. The median gestational age at birth was 36 weeks (1st quartile 34, 3rd quartile 38 weeks). Smoothed percentile curves for birth weight by gestational age increased progressively till 38 weeks and levels off thereafter. Compared with dichorionic twins, monochorionic twins had lower birth weight for gestational age from after 27 weeks. We provide centile values of birth weight at 24 to 42 completed weeks of gestation for twins born in south India. These charts could be used both in routine clinical assessments and epidemiological studies.

  11. Gestational diabetes mellitus: glycemic control during pregnancy and neonatal outcomes of twin and singleton pregnancies.

    Science.gov (United States)

    Guillén-Sacoto, María Augusta; Barquiel, Beatriz; Hillman, Natalia; Burgos, María Ángeles; Herranz, Lucrecia

    2018-04-20

    To assess the impact of glycemic control in gestational on neonatal weight and metabolic complications of twin and singleton pregnancies. An observational, retrospective study to monitor 120 twin and 240 singleton pregnancies in women with GDM. Maternal glycemic parameters during pregnancy (oral glucose tolerance test results, treatment, insulinization rate, mean HbA1c in the third trimester), and neonatal complications and weight were recorded. A higher infant birth weight ratio (IBWR 1.02±0.12 vs. 0.88±0.12, P<.001) and a lower rate of newborns small for gestational age (severe SGA 2.5% vs. 8.3%, P=.012) were seen after singleton pregnancies as compared to twin pregnancies. The rates of newborns large for gestational age (LGA 12.6% vs. 12.5%, P=.989); macrosomic (6.7% vs. 7.5%, P=.777); or small for gestational age (SGA 6.7% vs. 10.8%, P=.175) were similar in both groups. Neonates from twin pregnancies had a higher risk of hypoglycemia (adjusted OR 4.71; 1.38-16.07, P=.013) and polycythemia (adjusted OR 10.05; 1.82-55.42, P=0.008). A linear relationship was seen between third trimester HbA1c levels and IBWR in singleton (r=.199, P=.003), but not in twin pregnancies (r=0.049, P=0.610). Risk of severe SGA, hypoglycemia, and polycythemia was significantly higher in twin pregnancies of women with GDM. Neonatal weight outcomes and metabolic complications in twin pregnancies of women with GDM were not related to glycemic control. Moreover, in our study population, fasting glucose at diagnosis and mean HbA1c in the third trimester showed a linear relationship with higher birth weights in singleton, but not in twin pregnancies. Copyright © 2018 SEEN y SED. Publicado por Elsevier España, S.L.U. All rights reserved.

  12. Reference birthweight range for multiple birth neonates in Japan

    Directory of Open Access Journals (Sweden)

    Kato Noriko

    2004-02-01

    Full Text Available Abstract Background A reference range for the birthweight of multiple births neonates is necessary for the assessment for intrauterine growth. Methods Pairs of multiple births were identified by birthplace, the ages of the parents, gestational age, and the year and month of birth. We studied a total of 32,232 livebirth-livebirth pairs of twins, 1894 triplet live births, and 206 quadruplet live births. Results The median birthweight of males, taking gestational age into account, was ca. 0.05 kg–0.1 kg heavier than that of females. Compared to singleton neonates, the median birthweight of twins was ca. 0.15 kg smaller at the gestational age of 34 weeks, increasing to ca. 0.5 kg at 42 weeks of gestation. As for birth order, the mean birthweight of the first-born twin was heavier than that of the second-born. The standard deviation of birthweight was larger for second-born twins. The birthweight of twins from multiparous mothers was greater than those from primiparous mothers. The median birthweight according to gestational age was found to be the greatest in twins, lower in triplets and the lowest in quadruplets. In triplets, the 50th percentile was 0.08 kg heavier in boys than for girls. Conclusion Our results can be used for assessment of birthweight of multiple births in Japan.

  13. Differences in outcome between twins and singletons born very preterm: results from a population-based European cohort.

    NARCIS (Netherlands)

    Papiernik, E.; Zeitlin, J.; Delmas, D.; Blondel, B.; Kunzel, W.; Cuttini, M.; Weber, T.; Petrou, S.; Gortner, L.; Kollee, L.A.A.; Draper, E.S.

    2010-01-01

    BACKGROUND: About 10% of twins are born before 32 weeks of gestation and very preterm birth rates are increasing. Preterm twins tend to have more favourable outcomes than singletons of the same gestational age, but fewer data are available for very preterm infants. This study aims to determine

  14. Differences in outcome between twins and singletons born very preterm: results from a population-based European cohort

    DEFF Research Database (Denmark)

    Papiernik, Emile; Zeitlin, Jennifer; Delmas, Dominique

    2010-01-01

    About 10% of twins are born before 32 weeks of gestation and very preterm birth rates are increasing. Preterm twins tend to have more favourable outcomes than singletons of the same gestational age, but fewer data are available for very preterm infants. This study aims to determine whether outcom...

  15. Cortisol production patterns in young children living with birth parents vs children placed in foster care following involvement of Child Protective Services.

    Science.gov (United States)

    Bernard, Kristin; Butzin-Dozier, Zachary; Rittenhouse, Joseph; Dozier, Mary

    2010-05-01

    To examine differences in waking to bedtime cortisol production between children who remained with birth parents vs children placed in foster care following involvement of Child Protective Services (CPS). Between-subject comparison of cortisol patterns among 2 groups of children. Children referred from the child welfare system. Three hundred thirty-nine children aged 2.9 to 31.4 months who were living with birth parents (n = 155) or placed in foster care (n = 184) following CPS involvement as well as 96 unmatched children from low-risk environments. Main Exposures Involvement by CPS and foster care. Main Outcome Measure Salivary cortisol samples obtained at waking and bedtime for children on 2 days. Child Protective Services-involved children who continued to live with birth parents and CPS-involved children placed in foster care differed in cortisol production, with children living with their birth parents showing flatter slopes in waking to bedtime values. Continuing to live with birth parents following involvement of CPS is associated with greater perturbation to the diurnal pattern of cortisol production than living with foster parents. Foster care may have a regulating influence on children's cortisol among children who have experienced maltreatment.

  16. Impact of police-reported intimate partner violence during pregnancy on birth outcomes.

    Science.gov (United States)

    Lipsky, Sherry; Holt, Victoria L; Easterling, Thomas R; Critchlow, Cathy W

    2003-09-01

    To examine the relationship of police-reported intimate partner violence during pregnancy and adverse birth outcomes. We conducted a population-based, retrospective, cohort study in Seattle, Washington, using Seattle police data and Washington State birth certificate files from January 1995 through September 1999. Exposed subjects were women with an intimate partner violence incident reported to police during pregnancy and who subsequently had a singleton live birth or fetal death registered in the state of Washington. Unexposed subjects were randomly selected Seattle residents with a singleton live birth or fetal death in the same time period and who did not report an incident. The main outcome measures were low birth weight (LBW less than 2500 g), very LBW (VLBW less than 1500 g), preterm birth (20-36 weeks' gestation), very preterm birth (20-31 weeks), and neonatal death (before discharge). Women reporting any partner violence during pregnancy were significantly more likely to have a LBW infant (adjusted odds ratio [aOR] 1.70; 95% confidence interval [CI] 1.20, 2.40), a VLBW infant (aOR 2.54; 95% CI 1.32, 4.91), a preterm birth (aOR 1.61; 95% CI 1.14, 2.28), a very preterm birth (aOR 3.71; 95% CI 1.80, 7.63), and a neonatal death (aOR 3.49; 95% CI 1.43, 8.50). Police-reported partner violence during pregnancy is significantly associated with an increased risk of adverse birth outcomes. There is a critical need to identify pregnancy among women with reported incidents and to provide women health and social service information and referrals, particularly referrals to high-risk pregnancy programs.

  17. CDC WONDER: Births

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Births (Natality) online databases in CDC WONDER report birth rates, fertility rates and counts of live births occurring within the United States to U.S....

  18. Live birth rates in the first complete IVF cycle among 20 687 women using a freeze-all strategy.

    Science.gov (United States)

    Zhu, Qianqian; Chen, Qiuju; Wang, Li; Lu, Xuefeng; Lyu, Qifeng; Wang, Yun; Kuang, Yanping

    2018-05-01

    What is the chance of having a child following one complete IVF cycle for patients using a freeze-all strategy? The chance of having a child after the first complete IVF cycle was 50.74% with the freeze-all strategy. Several studies have reported on live birth rates (LBRs) based on only the fresh embryo transfer cycle or fresh and frozen-thawed embryo transfer cycles. However, the LBR using a freeze-all strategy in IVF is unknown. This retrospective cohort study included 20 687 women who started their first IVF cycles using a freeze-all strategy during the period from 1 January 2007, through 31 March 2016, in China. Data on 20 687 women undergoing their first complete cycles using a freeze-all strategy from 2007 to 2016 were analyzed to estimate LBRs. The LBR in a complete cycle was defined as the chance of a live birth from an ovarian stimulation cycle including all subsequent frozen embryo transfers from this stimulation. The relationship between LBR and number of oocyte was explored. The LBR for the first complete cycle was 50.74% for patients using a freeze-all strategy. By age group, the LBR declined from 63.81% for women under 31 years old to 4.71% for women over 40 years old after the first complete cycle. The LBRs improved as the number of oocytes retrieved increased up to 25 in the freeze-all strategy. This was a retrospective study without a control group. Data on BMI and smoking status were not collected in this database. Our results showed that 50.74% of patients could achieve a live birth after the first complete cycle via a freeze-all strategy. In addition, the LBRs were positively correlated with the number of oocytes retrieved via the freeze-all strategy. These findings are critical for patients and clinicians in making an informed decision to embark on IVF treatment. This work was supported by grants from the National Natural Science Foundation of China (NSFC) (31770989 to Y.W.) and the Shanghai Ninth People's Hospital Foundation of China (JYLJ030

  19. Live birth after IVF in a 46-year-old woman.

    Science.gov (United States)

    Dal Prato, Luca; Borini, Andrea; Cattoli, Monica; Preti, Maria Serena; Serrao, Lucia; Flamigni, Carlo

    2005-10-01

    Pregnancies after IVF have been reported in women aged > or =44 years, but nobody older than 45 years at oocyte retrieval delivered. We report a case of birth of a healthy child after IVF in a 46-year-old infertile woman. Ovarian stimulation was performed with clomiphene citrate, 150 mg daily for 5 days. Three oocytes were retrieved and one embryo was replaced. The patient delivered a healthy male infant after Caesarean section at 39 weeks. A successful pregnancy after IVF with homologous oocytes can be achieved in women older than 45 years. At this age IVF is not a cost-effective treatment compared with oocyte donation, but it may be offered in countries in which gamete donation is forbidden.

  20. H-Y antibody titers are increased in unexplained secondary recurrent miscarriage patients and associated with low male : female ratio in subsequent live births

    DEFF Research Database (Denmark)

    Nielsen, H S; Wu, F; Aghai, Z

    2010-01-01

    The birth of a boy is significantly more common than a girl prior to secondary recurrent miscarriage (SRM) and is associated with a poorer chance of a subsequent live birth. Children born after SRM are more likely to be girls. High-titer antisera specific for male antigens (H-Y) have been shown t...... to arrest development of male bovine embryos efficiently. We consequently questioned the role of H-Y antibodies in women with SRM....

  1. Singletons, higher spin massless states and the supermembrane

    International Nuclear Information System (INIS)

    Bergshoeff, E.; Salam, A.; Sezgin, E.; Tanii, Yoshiaki.

    1988-01-01

    We analyse the spectrum of the eleven dimensional supermembrane quantized in AdS 4 xS 7 background. The classical membrane lives at the boundary of AdS 4 which is S 2 xS 1 , and has OSp(8,4) symmetry. We find that the spectrum contains, in addition to the N=8 supersymmetric (massive) singletons (which may possibly be the ultimate preons), also massless states of all higher integer and half-integer spin. These states fill the irreducible representations of OSp(8,4) with highest spin s max =2,4,6,... The s max =2 multiplet corresponds to the states of the de Wit-Nicolai's N=8 gauged supergravity in four dimensions. (author). 24 refs

  2. Estimation of single-year-of-age counts of live births, fetal losses, abortions, and pregnant women for counties of Texas.

    Science.gov (United States)

    Singh, Bismark; Meyers, Lauren Ancel

    2017-05-08

    We provide a methodology for estimating counts of single-year-of-age live-births, fetal-losses, abortions, and pregnant women from aggregated age-group counts. As a case study, we estimate counts for the 254 counties of Texas for the year 2010. We use interpolation to estimate counts of live-births, fetal-losses, and abortions by women of each single-year-of-age for all Texas counties. We then use these counts to estimate the numbers of pregnant women for each single-year-of-age, which were previously available only in aggregate. To support public health policy and planning, we provide single-year-of-age estimates of live-births, fetal-losses, abortions, and pregnant women for all Texas counties in the year 2010, as well as the estimation method source code.

  3. Rate of new HIV diagnoses among Latinos living in Florida: disparities by country/region of birth.

    Science.gov (United States)

    Sheehan, Diana M; Trepka, Mary Jo; Fennie, Kristopher P; Maddox, Lorene M

    2015-01-01

    HIV incidence in the USA is three times higher for Latinos than for non-Latino whites. Latinos differ in educational attainment, poverty, insurance coverage, and health-care access, factors that affect HIV knowledge, risk behaviors, and testing. The purpose of this study was to identify differences in demographics, risk factors, and rate of new HIV diagnoses by birth country/region among Latinos in Florida to guide the targeting of primary and secondary prevention programs. Using Florida HIV/AIDS surveillance data from 2007 to 2011 and the American Community Survey, we compared demographic and risk factors, and calculated annual and five-year age-adjusted rates of new HIV diagnoses for 5801 Latinos by birth country/region. Compared to US-born Latinos, those born in Cuba and South America were significantly more likely to report the HIV transmission mode of MSM; those born in the Dominican Republic (DR) heterosexual transmission; and those born in Puerto Rico injection drug use. Mexican- and Central American-born Latinos were more likely to be diagnosed with AIDS within a month of HIV diagnosis. The rate of new HIV diagnoses among Latinos declined 33% from 2007 to 2011. HIV diagnoses over time decreased significantly for Latinos born in Mexico and increased nonsignificantly for those born in the DR. Although this study was limited to Latinos living in Florida, results suggest that tailoring HIV primary prevention and testing initiatives to specific Latino groups may be warranted.

  4. National screening guidelines and developments in prenatal diagnoses and live births of Down syndrome in 1973–2016 in Denmark

    DEFF Research Database (Denmark)

    Lou, Stina; Petersen, Olav B.; Jørgensen, Finn Stener

    2018-01-01

    INTRODUCTION: Denmark was the first country in the world to implement a national, free-for-all offer of prenatal screening for Down syndrome to all pregnant women. It has a high uptake (> 90%) compared to other countries. Thus, Denmark offers an interesting case for investigating the consequences...... of implementing a comprehensive, national prenatal screening guideline. The aim of this study was to describe the historical developments in invasive procedures, pre-/postnatal diagnoses of Down syndrome and Down syndrome live births in the period 1973-2016 in Denmark MATERIAL AND METHODS: Data on invasive...... procedures, pre- and postnatal Down syndrome diagnoses were retrieved from the Danish Cytogenetic Central Registry RESULTS: From 1973-1993 screening based on maternal age and high-risk indications resulted in a constant increase in invasive procedures. After the introduction of the triple test in 1994...

  5. New Option in the Lives Saved Tool (LiST) Allows for the Conversion of Prevalence of Small-for-Gestational-Age and Preterm Births to Prevalence of Low Birth Weight.

    Science.gov (United States)

    Kozuki, Naoko; Katz, Joanne; Clermont, Adrienne; Walker, Neff

    2017-11-01

    Background: The Lives Saved Tool (LiST) is a software model that estimates the health impact of scaling up interventions on maternal and child health. One of the outputs of the model is an estimation of births by fetal size [appropriate-for-gestational-age (AGA) or small-for-gestational-age (SGA)] and by length of gestation (term or preterm), both of which influence birth weight. LiST uses prevalence estimates of births in these categories rather than of birth weight categories, because the causes and health consequences differ between SGA and preterm birth. The World Health Assembly nutrition plan, however, has set the prevalence of low birth weight (LBW) as a key indicator, with a specific goal of a 30% reduction in LBW prevalence by 2025. Objective: The objective of the study is to develop an algorithm that will allow LiST users to estimate changes in prevalence of LBW on the basis of changes in coverage of interventions and the resulting impact on prevalence estimates of SGA and preterm births. Methods: The study used 13 prospective cohort data sets from low- and middle-income countries (LMICs; 4 from sub-Saharan Africa, 5 from Asia, and 4 from Latin America), with reliable measures of gestational age and birth weight. By calculating the proportion of LBW births among SGA and preterm births in each data set and meta-analyzing those estimates, we calculated region-specific pooled rates of LBW among SGA and preterm births. Results: In Africa, 0.4% of term-AGA, 36.7% of term-SGA, 49.3% of preterm-AGA, and 100.0% of preterm-SGA births were LBW. In Asia, 1.0% of term-SGA, 47.0% of term-SGA, 36.7% of preterm-AGA, and 100.0% of preterm-SGA births were LBW. In Latin America, 0.4% of term-AGA, 34.4% of term-SGA, 32.3% of preterm-AGA, and 100.0% of preterm-SGA births were LBW. Conclusions: The simple conversion factor proposed here allows for the estimation of LBW within LiST for most LMICs. This will allow LiST users to approximate the impact of their health programs on

  6. Elevated serum estradiol levels in artificial autologous frozen embryo transfer cycles negatively impact ongoing pregnancy and live birth rates.

    Science.gov (United States)

    Fritz, Rani; Jindal, Sangita; Feil, Heather; Buyuk, Erkan

    2017-12-01

    The aim of this study is to evaluate the correlation between serum estradiol (E 2 ) levels during artificial autologous frozen embryo transfer (FET) cycles and ongoing pregnancy/live birth rates (OP/LB). A historical cohort study was conducted in an academic setting in order to correlate peak and average estradiol levels with ongoing pregnancy/live birth rates for all autologous artificial frozen embryo transfer cycles performed from 1/2011 to 12/2014. Average and peak E 2 levels from 110 autologous artificial FET cycles from 95 patients were analyzed. Average E 2 levels were significantly lower in cycles resulting in OP/LB compared to those that did not (234.1 ± 16.6 pg/ml vs. 315 ± 24.8 pg/ml, respectively, p = 0.04). Although peak E 2 levels were not significantly different between cycles resulting in OP/LB compared with those that did not (366.9 ± 27.7 pg/ml vs. 459.1 ± 32.3 pg/ml, respectively, p = 0.19), correlation analysis revealed a statistically significant (p = 0.02) downward trend in OP/LB rates with increasing peak E 2 levels. This study suggests that elevated E 2 levels in artificial autologous FET cycles are associated with lower OP/LB rates. Estradiol levels should be monitored during artificial FET cycles.

  7. Selected perinatal outcomes associated with planned home births in the United States.

    Science.gov (United States)

    Cheng, Yvonne W; Snowden, Jonathan M; King, Tekoa L; Caughey, Aaron B

    2013-10-01

    More women are planning home birth in the United States, although safety remains unclear. We examined outcomes that were associated with planned home compared with hospital births. We conducted a retrospective cohort study of term singleton live births in 2008 in the United States. Deliveries were categorized by location: hospitals or intended home births. Neonatal outcomes were compared with the use of the χ(2) test and multivariable logistic regression. There were 2,081,753 births that met the study criteria. Of these, 12,039 births (0.58%) were planned home births. More planned home births had 5-minute Apgar score births (0.24%; adjusted odds ratio, 1.87; 95% confidence interval, 1.36-2.58) and neonatal seizure (0.06% vs 0.02%, respectively; adjusted odds ratio, 3.08; 95% confidence interval, 1.44-6.58). Women with planned home birth had fewer interventions, including operative vaginal delivery and labor induction/augmentation. Planned home births were associated with increased neonatal complications but fewer obstetric interventions. The trade-off between maternal preferences and neonatal outcomes should be weighed thoughtfully. Copyright © 2013 Mosby, Inc. All rights reserved.

  8. Undergoing varicocele repair before assisted reproduction improves pregnancy rate and live birth rate in azoospermic and oligospermic men with a varicocele: a systematic review and meta-analysis.

    Science.gov (United States)

    Kirby, E Will; Wiener, Laura Elizabeth; Rajanahally, Saneal; Crowell, Karen; Coward, Robert M

    2016-11-01

    To evaluate how varicocele repair (VR) impacts pregnancy (PRs) and live birth rates in infertile couples undergoing assisted reproduction wherein the male partner has oligospermia or azoospermia and a history of varicocele. Systematic review and meta-analysis. Not applicable. Azoospermic and oligospermic males with varicoceles and in couples undergoing assisted reproductive technology (ART) with IUI, IVF, or testicular sperm extraction (TESE) with IVF and intracytoplasmic sperm injection (ICSI). Measurement of PRs, live birth, and sperm extraction rates. Odds ratios for the impact of VR on PRs, live birth, and sperm extraction rates for couples undergoing ART. Seven articles involving a total of 1,241 patients were included. Meta-analysis showed that VR improved live birth rates for the oligospermic (odds ratio [OR] = 1.699) and combined oligospermic/azoospermic groups (OR = 1.761). Pregnancy rates were higher in the azoospermic group (OR = 2.336) and combined oligospermic/azoospermic groups (OR = 1.760). Live birth rates were higher for patients undergoing IUI after VR (OR = 8.360). Sperm retrieval rates were higher in persistently azoospermic men after VR (OR = 2.509). Oligospermic and azoospermic patients with clinical varicocele who undergo VR experience improved live birth rates and PRs with IVF or IVF/ICSI. For persistently azoospermic men after VR requiring TESE for IVF/ICSI, VR improves sperm retrieval rates. Therefore, VR should be considered to have substantial benefits for couples with a clinical varicocele even if oligospermia or azoospermia persists after repair and ART is required. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  9. Congenital anomalies among live births in a polluted area. A ten-year retrospective study

    Directory of Open Access Journals (Sweden)

    Gianicolo Emilio Antonio Luca

    2012-12-01

    Full Text Available Abstract Background Congenital anomalies and their primary prevention are a crucial public health issue. This work aimed to estimate the prevalence of congenital anomalies in Brindisi, a city in southeastern Italy at high risk of environmental crisis. Methods This research concerned newborns up to 28 days of age, born between 2001 and 2010 to mothers resident in Brindisi and discharged with a diagnosis of congenital anomaly. We classified cases according to the coding system adopted by the European Network for the Surveillance of Congenital Anomalies (EUROCAT. Prevalence rates of congenital anomalies in Brindisi were compared with those reported by EUROCAT. Logistic regression models were adapted to evaluate the association between congenital anomalies and municipality of residence of the mother during pregnancy. Results Out of 8,503 newborns we recorded 194 subjects with congenital anomalies (228.2/10,000 total births, 1.2 times higher than the one reported by the EUROCAT pool of registries. We observed 83 subjects with congenital heart diseases with an excess of 49.1%. Odds Ratios for congenital heart diseases significantly increased for newborns to mothers resident in Brindisi (OR 1.75 CI 95% 1.30-2.35. Conclusions Our findings indicated an increased prevalence of Congenital Anomalies (especially congenital heart diseases in the city of Brindisi. More research is needed in order to analyze the role of factors potentially involved in the causation of congenital anomalies.

  10. Distinguishing among potential mechanisms of singleton suppression.

    Science.gov (United States)

    Gaspelin, Nicholas; Luck, Steven J

    2018-04-01

    Previous research has revealed that people can suppress salient stimuli that might otherwise capture visual attention. The present study tests between 3 possible mechanisms of visual suppression. According to first-order feature suppression models , items are suppressed on the basis of simple feature values. According to second-order feature suppression models , items are suppressed on the basis of local discontinuities within a given feature dimension. According to global-salience suppression models , items are suppressed on the basis of their dimension-independent salience levels. The current study distinguished among these models by varying the predictability of the singleton color value. If items are suppressed by virtue of salience alone, then it should not matter whether the singleton color is predictable. However, evidence from probe processing and eye movements indicated that suppression is possible only when the color values are predictable. Moreover, the ability to suppress salient items developed gradually as participants gained experience with the feature that defined the salient distractor. These results are consistent with first-order feature suppression models, and are inconsistent with the other models of suppression. In other words, people primarily suppress salient distractors on the basis of their simple features and not on the basis of salience per se. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  11. Birth Settings and the Validation of Neonatal Seizures Recorded in Birth Certificates Compared to Medicaid Claims and Hospital Discharge Abstracts Among Live Births in South Carolina, 1996-2013.

    Science.gov (United States)

    Li, Qing; Jenkins, Dorothea D; Kinsman, Stephen L

    2017-05-01

    Objective Neonatal seizures in the first 28 days of life often reflect underlying brain injury or abnormalities, and measure the quality of perinatal care in out-of-hospital births. Using the 2003 revision of birth certificates only, three studies reported more neonatal seizures recorded among home births ​or planned out-of-hospital births compared to hospital births. However, the validity of recording neonatal seizures or serious neurologic dysfunction across birth settings in birth certificates has not been evaluated. We aimed to validate seizure recording in birth certificates across birth settings using multiple datasets. Methods We examined checkbox items "seizures" and "seizure or serious neurologic dysfunction" in the 1989 and 2003 revisions of birth certificates in South Carolina from 1996 to 2013. Gold standards were ICD-9-CM codes 779.0, 345.X, and 780.3 in either hospital discharge abstracts or Medicaid encounters jointly. Results Sensitivity, positive predictive value, false positive rate, and the kappa statistic of neonatal seizures recording were 7%, 66%, 34%, and 0.12 for the 2003 revision of birth certificates in 547,177 hospital births from 2004 to 2013 and 5%, 33%, 67%, and 0.09 for the 1998 revision in 396,776 hospital births from 1996 to 2003, and 0, 0, 100%, -0.002 among 660 intended home births from 2004 to 2013 and 920 home births from 1996 to 2003, respectively. Conclusions for Practice Despite slight improvement across revisions, South Carolina birth certificates under-reported or falsely reported seizures among hospital births and especially home births. Birth certificates alone should not be used to measure neonatal seizures or serious neurologic dysfunction.

  12. Cord around neck in singleton term pregnancies and its outcome

    International Nuclear Information System (INIS)

    Sajjad, R.; Mustafa, N.

    2014-01-01

    To enlist the complications with nuchal cord in singleton term pregnancies and to determine maternal and fetal outcome in singleton term pregnancies. Design: Descriptive study. Place and duration of study: The study was carried out at Gynaecology and Obstetric department Combined Military Hospital Quetta from Nov 2007 to May 2008. Patients and methods: One hundred women irrespective of parity with healthy, singleton term pregnancy and cephalic presentation, labouring or not labouring, were selected from outpatient department. A total of 41 patients were booked with Doppler ultrasound done in antenatal period. Other 59 were poorly booked and diagnosed with cord around neck by clinical criteria e.g. high head at term, fetal distress, meconium discharge, slow progress in labour leading to prolonged labour. All patients signed well informed written proforma regarding study and its outcome. Vigilant feto maternal monitoring was done during labour. All events during labour were mentioned in proformas which were attached with patients case notes. Data was interperated in term of frequency and percentages. Results: Complications with cord around neck found were still birth 3%, fetal distress 15%, intrauterine death 1%. Prolonged labour was seen in 14%, Meconium discharge in 5%, and high presenting part was found in 11% of cases. Maternal outcome were elective caesarean section in 6%, emergency caesarean-section in 32%, spontaneous vaginal delivery in 54% and instrumental vaginal delivery in 8% of the cases. Different fetal outcomes seen were intrauterine death, stillbirth in 1%, and 3% patients respectively. Regarding neonatal outcome, 31% stayed in neonatal intensive care unit (NICU) for less than 48 hours, 69% stayed in NICU for more than 48 hours out of which 4% had early neonatal deaths (ENND). Fifty nine percent patients detected and suspected during labour were with, high head, slow progress in labour, decreased fetal movements, intra partum fetal distress, meconium

  13. Rate of gestational weight gain and preterm birth in relation to prepregnancy body mass indices and trimester: a follow-up study in China

    OpenAIRE

    Huang, Aiqun; Ji, Zhenpeng; Zhao, Wei; Hu, Huanqing; Yang, Qi; Chen, Dafang

    2016-01-01

    Background To evaluate the association between rate of gestational weight gain and preterm birth varying prepregnancy body mass indices and trimester. Methods Data from Maternal and Newborn?s Health Monitoring System on 17475 pregnant women who delivered live singletons at???28?weeks of gestation between October 2013 and September 2014 from 12 districts/counties of 6 provinces in China and started prenatal care at???12?weeks of gestation was analyzed. Gestational weight gain was categorized b...

  14. Use of multiple linear regression and logistic regression models to investigate changes in birthweight for term singleton infants in Scotland.

    Science.gov (United States)

    Bonellie, Sandra R

    2012-10-01

    To illustrate the use of regression and logistic regression models to investigate changes over time in size of babies particularly in relation to social deprivation, age of the mother and smoking. Mean birthweight has been found to be increasing in many countries in recent years, but there are still a group of babies who are born with low birthweights. Population-based retrospective cohort study. Multiple linear regression and logistic regression models are used to analyse data on term 'singleton births' from Scottish hospitals between 1994-2003. Mothers who smoke are shown to give birth to lighter babies on average, a difference of approximately 0.57 Standard deviations lower (95% confidence interval. 0.55-0.58) when adjusted for sex and parity. These mothers are also more likely to have babies that are low birthweight (odds ratio 3.46, 95% confidence interval 3.30-3.63) compared with non-smokers. Low birthweight is 30% more likely where the mother lives in the most deprived areas compared with the least deprived, (odds ratio 1.30, 95% confidence interval 1.21-1.40). Smoking during pregnancy is shown to have a detrimental effect on the size of infants at birth. This effect explains some, though not all, of the observed socioeconomic birthweight. It also explains much of the observed birthweight differences by the age of the mother.   Identifying mothers at greater risk of having a low birthweight baby as important implications for the care and advice this group receives. © 2012 Blackwell Publishing Ltd.

  15. Infertility and preterm delivery, birthweight, and Caesarean section: a study within the Danish National Birth Cohort

    DEFF Research Database (Denmark)

    Basso, Olga; Baird, Donna D.

    2003-01-01

    , longitudinal studies enrolling couples irrespective of infertility treatment. METHODS: We used data from the Danish National Birth Cohort: 55 906 singleton live births from women who reported their waiting time to pregnancy (TTP) and other covariates in an interview during the 2nd trimester of pregnancy....... RESULTS: A TTP >1 year was associated with an increased risk of all outcomes studied, including preterm birth [odds ratios and 95% confidence intervals were 1.5 (1.2, 1.8) among primiparas and 1.9 (1.5, 2.4) among multiparas]. Odds ratios for preterm remained elevated after adjustment for covariates....... Among couples with a TTP >1 year, infertility treatment was associated with added risk only among multiparas. CONCLUSION: Infertile women are at higher risk of adverse birth outcomes even if they conceive without treatment. With >10% of babies born to infertile couples, it is important to consider...

  16. Use of ICSI in IVF cycles in women with tubal ligation does not improve pregnancy or live birth rates.

    Science.gov (United States)

    Grimstad, F W; Nangia, Ajay K; Luke, B; Stern, J E; Mak, W

    2016-12-01

    Does ICSI improve outcomes in ART cycles without male factor, specifically in couples with a history of tubal ligation as their infertility diagnosis? The use of ICSI showed no significant improvement in fertilization rate and resulted in lower pregnancy and live birth (LB) rates for women with the diagnosis of tubal ligation and no male factor. Prior studies have suggested that ICSI use does not improve fertilization, pregnancy or LB rates in couples with non-male factor infertility. However, it is unknown whether couples with tubal ligation only diagnosis and therefore iatrogenic infertility could benefit from the use of ICSI during their ART cycles. Longitudinal cohort of nationally reported cycles in the Society for Assisted Reproductive Technology Clinic Outcomes Reporting System (SART CORS) of ART cycles performed in the USA between 2004 and 2012. There was a total of 8102 first autologous fresh ART cycles from women with the diagnosis of tubal ligation only and no reported male factor in the SART database. Of these, 957 were canceled cycles and were excluded from the final analysis. The remaining cycles were categorized by the use of conventional IVF (IVF, n = 3956 cycles) or ICSI (n = 3189 cycles). The odds of fertilization, clinical intrauterine gestation (CIG) and LB were calculated by logistic regression modeling, and the adjusted odds ratios (AORs) with 95% confidence intervals were calculated by adjusting for the confounders of year of treatment, maternal age, race and ethnicity, gravidity, number of oocytes retrieved, day of embryo transfer and number of embryos transferred. The main outcome measures of the study were odds of fertilization (2PN/total oocytes), clinical intrauterine gestation (CIG/cycle) and live birth (LB/cycle). The fertilization rate was higher in the ICSI versus IVF group (57.5% vs 49.1%); however, after adjustment this trend was no longer significant (AOR 1.14, 0.97-1.35). Interestingly, both odds of CIG (AOR 0.78, 0

  17. Perinatal Outcomes Associated With Isolated Velamentous Cord Insertion in Singleton and Twin Pregnancies.

    Science.gov (United States)

    Sinkin, Joshua A; Craig, Wendy Y; Jones, Michael; Pinette, Michael G; Wax, Joseph R

    2018-02-01

    To evaluate perinatal outcomes in singleton and twin pregnancies with pathologically confirmed velamentous cord insertion without vasa previa. This retrospective case-control study included all nonanomalous singleton and twin pregnancies with pathologically confirmed velamentous cord insertion delivered in a single institution between January 1, 2005, and July 1, 2015, and having an ultrasound examination by maternal-fetal medicine. For each case, the next 2 consecutive deliveries matched for gestational age at delivery ± 1 week and, in twins, amnionicity and chorionicity served as controls. Primary outcomes included surgical delivery for a nonreassuring intrapartum fetal heart rate tracing, umbilical arterial cord pH of less than 7.2, 5-minute Apgar score of less than 7, birth weight below the 10th percentile, neonatal intensive care unit admission, fetal or neonatal death, and cord avulsion necessitating manual placental extraction. Outcomes were available for 53 singletons with 103 matched controls and 33 twin pregnancies with 65 matched controls. In singletons, velamentous cord insertion was associated with cord pH of less than 7.2 (odds ratio [OR] 3.5; 95% confidence interval [CI], 1.1-11.2; P = .039), 5-minute Apgar score of less than 7 (OR, 5.3; 95% CI, 0.99-28.1; P = .045), and cord avulsion requiring manual placental extraction (7.5% versus 0%; P = .012). Associations were suggested with increased surgical delivery for a nonreassuring intrapartum fetal heart rate tracing (OR, 2.4; 95% CI, 0.9-6.9; P = .14), birth weight below the 10th percentile (OR, 2.1; 95% CI, 0.8-5.9; P = .21), and fetal or neonatal death (3.8% versus 0%; P = .11). Velamentous cord insertions were also associated with placental abruption in singletons (7.5% versus 0%; P = .013). Among twins, velamentous cord insertion was associated with fetal or neonatal death (9.1% versus 0%; P = .036). Isolated confirmed velamentous cord insertion is associated

  18. Birth Outcomes after the Fukushima Daiichi Nuclear Power Plant Disaster: A Long-Term Retrospective Study

    Science.gov (United States)

    Leppold, Claire; Nomura, Shuhei; Sawano, Toyoaki; Ozaki, Akihiko; Tsubokura, Masaharu; Hill, Sarah; Kanazawa, Yukio; Anbe, Hiroshi

    2017-01-01

    Changes in population birth outcomes, including increases in low birthweight or preterm births, have been documented after natural and manmade disasters. However, information is limited following the 2011 Fukushima Daiichi Nuclear Power Plant Disaster. In this study, we assessed whether there were long-term changes in birth outcomes post-disaster, compared to pre-disaster data, and whether residential area and food purchasing patterns, as proxy measurements of evacuation and radiation-related anxiety, were associated with post-disaster birth outcomes. Maternal and perinatal data were retrospectively collected for all live singleton births at a public hospital, located 23 km from the power plant, from 2008 to 2015. Proportions of low birthweight (increased proportions of low birthweight or preterm births in any year after the disaster (merged post-disaster risk ratio of low birthweight birth: 0.98, 95% confidence interval (CI): 0.64–1.51; and preterm birth: 0.68, 95% CI: 0.38–1.21). No significant associations between birth outcomes and residential area or food purchasing patterns were identified, after adjustment for covariates. In conclusion, no changes in birth outcomes were found in this institution-based investigation after the Fukushima disaster. Further research is needed on the pathways that may exacerbate or reduce disaster effects on maternal and perinatal health. PMID:28534840

  19. The value of Anti-Mullerian hormone in low and extremely low ovarian reserve in relation to live birth after in vitro fertilization

    NARCIS (Netherlands)

    Reijnders, I.F.; Nelen, W.L.D.M.; Hout, J. in't; Herwaarden, A.E. van; Braat, D.D.M.; Fleischer, K.

    2016-01-01

    OBJECTIVE: To determine the relation of Anti-Mullerian hormone (AMH) with live birth after in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) in women with (extremely) low ovarian reserve. STUDY DESIGN: This study was a retrospective cohort study in a Dutch tertiary fertility

  20. Effect of clomiphene citrate on endometrial thickness, ovulation, pregnancy and live birth in anovulatory women: systematic review and meta-analysis

    NARCIS (Netherlands)

    Gadalla, M. A.; Huang, S.; Wang, R.; Norman, R. J.; Abdullah, S. A.; El Saman, A. M.; Ismail, A. M.; van Wely, M.; Mol, B. W. J.

    2018-01-01

    To compare the impact of clomiphene citrate (CC) vs other drug regimens on mid-cycle endometrial thickness (EMT), ovulation, pregnancy and live birth rates in women with World Health Organization (WHO) group II ovulatory disorders. We searched MEDLINE, EMBASE, Scopus, Web of Science, The Cochrane

  1. Are all immigrant mothers really at risk of low birth weight and perinatal mortality? The crucial role of socio-economic status.

    Science.gov (United States)

    Racape, Judith; Schoenborn, Claudia; Sow, Mouctar; Alexander, Sophie; De Spiegelaere, Myriam

    2016-04-08

    Increasing studies show that immigrants have different perinatal health outcomes compared to native women. Nevertheless, we lack a systematic examination of the combined effects of immigrant status and socioeconomic factors on perinatal outcomes. Our objectives were to analyse national Belgian data to determine 1) whether socioeconomic status (SES) modifies the association between maternal nationality and perinatal outcomes (low birth weight and perinatal mortality); 2) the effect of adopting the Belgian nationality on the association between maternal foreign nationality and perinatal outcomes. This study is a population-based study using the data from linked birth and death certificates from the Belgian civil registration system. Data are related to all singleton births to mothers living in Belgium between 1998 and 2010. Perinatal mortality and low birth weight (LBW) were estimated by SES (maternal education and parental employment status) and by maternal nationality (at her own birth and at her child's birth). We used logistic regression to estimate the odds ratios for the associations between nationality and perinatal outcomes after adjusting for and stratifying by SES. The present study includes, for the first time, all births in Belgium; that is 1,363,621 singleton births between 1998 and 2010. Compared to Belgians, we observed an increased risk of perinatal mortality in all migrant groups (p order to understand more fully the relationship between migration and perinatal outcomes. Further studies are needed to analyse more finely the impact of socio-economic characteristics on perinatal outcomes.

  2. Preimplantation Genetic Diagnosis and Natural Conception: A Comparison of Live Birth Rates in Patients with Recurrent Pregnancy Loss Associated with Translocation.

    Directory of Open Access Journals (Sweden)

    Shinichiro Ikuma

    Full Text Available Established causes of recurrent pregnancy loss (RPL include antiphospholipid syndrome, uterine anomalies, parental chromosomal abnormalities, particularly translocations, and abnormal embryonic karyotypes. The number of centers performing preimplantation genetic diagnosis (PGD for patients with translocations has steadily increased worldwide. The live birth rate with PGD was reported to be 27-54%. The live birth rate with natural conception was reported to be 37-63% on the first trial and 65-83% cumulatively. To date, however, there has been no cohort study comparing age and the number of previous miscarriages in matched patients undergoing or not undergoing PGD. Thus, we compared the live birth rate of patients with RPL associated with a translocation undergoing PGD with that of patients who chose natural conception.After genetic counseling, 52 patients who desired natural conception and 37 patients who chose PGD were matched for age and number of previous miscarriages and these comprised the subjects of our study. PGD was performed by means of fluorescence in situ hybridization analysis. The live birth rates on the first PGD trial and the first natural pregnancy after ascertainment of the carrier status were 37.8% and 53.8%, respectively (odds ratio 0.52, 95% confidence interval 0.22-1.23. Cumulative live birth rates were 67.6% and 65.4%, respectively, in the groups undergoing and not undergoing PGD. The time required to become pregnancy was similar in both groups. PGD was found to reduce the miscarriage rate significantly. The prevalence of twin pregnancies was significantly higher in the PGD group. The cost of PGD was $7,956 U.S. per patient.While PGD significantly prevented further miscarriages, there was no difference in the live birth rate. Couples should be fully informed of the similarity in the live birth rate, the similarity in time to become pregnancy, the advantages of PGD, such as the reduction in the miscarriage rate, as well as

  3. Effect of maternal smoking on birth weight of twins: a study from the Dutch Twin Register

    NARCIS (Netherlands)

    Orlebeke, J.F.; Boomsma, D.I.; van Baal, G.C.M.; Bleker, O.P.

    1994-01-01

    Since twins weigh about 20% less than singletons at birth, maternal smoking may be a more severe risk for them than for singletons. Therefore, the effect of maternal smoking during pregnancy on birth weight was investigated in a group of 5376 twins. All necessary information was collected by a

  4. Antimüllerian hormone levels and antral follicle count as prognostic indicators in a personalized prediction model of live birth.

    Science.gov (United States)

    Nelson, Scott M; Fleming, Richard; Gaudoin, Marco; Choi, Bokyung; Santo-Domingo, Kenny; Yao, Mylene

    2015-08-01

    To compare antimüllerian hormone (AMH) and antral follicle count (AFC) separately and in combination with clinical characteristics for the prediction of live birth after controlled ovarian stimulation. Retrospective development and temporal external validation of prediction model. Outpatient IVF clinic. We applied the boosted tree method to develop three prediction models incorporating clinical characteristics plus AMH or AFC or the combination on 2,124 linked IVF cycles from 2006 to 2010 and temporally externally validated predicted live-birth probabilities with an independent data set comprising 1,121 cycles from 2011 to 2012. None. Predictive power (posterior log of odds ratio compared to age, or PLORA), reclassification, receiver operator characteristic analysis, calibration, dynamic range. Predictive power, was highest for the AMH model (PLORA = 29.1), followed by the AMH-AFC model (PLORA = 28.3) and AFC model (PLORA = 22.5). The prediction errors were 1% to models, except for the predicted live-birth probabilities of model, where the prediction error was 8%. The improvement in predictive power was highest for the AMH model: 76.2% improvement over age alone relative to 59% improvement for AFC and 73.3% for the combined model. Receiver operating characteristic analysis demonstrated that the AMH and the combined model had comparable discrimination (area under the curve = 0.716) and similar prediction error for high and low strata of live-birth prediction, with an improvement of 6.3% over age alone. The validated prediction model confirmed that AMH when combined with clinical characteristics can accurately identify the likelihood of live birth with a low prediction error. AFC provided no added predictive value beyond AMH. Copyright © 2015 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  5. Cumulative live-birth rate in women with polycystic ovary syndrome or isolated polycystic ovaries undergoing in-vitro fertilisation treatment.

    Science.gov (United States)

    Li, Hang Wun Raymond; Lee, Vivian Chi Yan; Lau, Estella Yee Lan; Yeung, William Shu Biu; Ho, Pak Chung; Ng, Ernest Hung Yu

    2014-02-01

    This retrospective cohort study evaluated the cumulative live birth rate in women with polycystic ovary syndrome (PCOS) and isolated polycystic ovaries (PCO) undergoing in-vitro fertilisation (IVF) treatment. We studied 104 women with PCOS, 184 with PCO and 576 age-matched controls undergoing the first IVF treatment cycle between 2002 and 2009. The main outcome measure was cumulative live birth in the fresh plus all the frozen embryo transfers combined after the same stimulation cycle. Women in both the PCOS (n = 104) and isolated PCO groups (n = 184) had higher ovarian response parameters compared to age-matched controls (n = 576), and higher rates of withholding fresh embryo transfer for risk of ovarian hyperstimulation syndrome (OHSS). The actual incidence of moderate to severe OHSS was significantly higher in the PCOS (11.5 %) but not the isolated PCO group (8.2%) compared to controls (4.9%). The live birth rates in the fresh cycle were comparable among the 3 groups, but the PCOS group had a significantly higher miscarriage rate compared to the other 2 groups. Cumulative live birth rate was significantly higher in the isolated PCO group (60.3%), but not the PCOS group (50.0%), compared to controls (47.5%). Women in the isolated PCO group, but not the PCOS group, had a significantly higher cumulative live birth rate compared to controls. This could be explained by the quantitative effect of the higher number of transferable embryos obtained per stimulation cycle, which is uncompromised by the unfavourable embryo competence otherwise observed in PCOS.

  6. Plurality of Birth and Infant Mortality Due to External Causes in the United States, 2000-2010.

    Science.gov (United States)

    Ahrens, Katherine A; Thoma, Marie E; Rossen, Lauren M; Warner, Margaret; Simon, Alan E

    2017-03-01

    Risk of death during the first year of life due to external causes, such as unintentional injury and homicide, may be higher among twins and higher-order multiples than among singletons in the United States. We used national birth cohort linked birth-infant death data (2000-2010) to evaluate the risk of infant mortality due to external causes in multiples versus singletons in the United States. Risk of death from external causes during the study period was 3.6 per 10,000 live births in singletons and 5.1 per 10,000 live births in multiples. Using log-binomial regression, the corresponding unadjusted risk ratio was 1.40 (95% confidence interval (CI): 1.30, 1.50). After adjustment for maternal age, marital status, race/ethnicity, and education, the risk ratio was 1.68 (95% CI: 1.56, 1.81). Infant deaths due to external causes were most likely to occur between 2 and 7 months of age. Applying inverse probability weighting and assuming a hypothetical intervention where no infants were low birth weight, the adjusted controlled direct effect of plurality on infant mortality due to external causes was 1.64 (95% CI: 1.39, 1.97). Twins and higher-order multiples were at greater risk of infant mortality due to external causes, particularly between 2 and 7 months of age, and this risk appeared to be mediated largely by factors other than low-birth-weight status. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  7. Attentional control during visual search: The effect of irrelevant singletons

    NARCIS (Netherlands)

    Theeuwes, J.; Burger, R.

    1998-01-01

    Four experiments investigated whether a highly salient color singleton can be ignored during serial search. Observers searched for a target letter among nontarget letters and were instructed to ignore an irrelevant, highly salient color singleton that was either compatible or incompatible with the

  8. Role of Frontal Cortex in Attentional Capture by Singleton Distractors

    Science.gov (United States)

    de Fockert, Jan W.; Theeuwes, Jan

    2012-01-01

    The role of frontal cortex in selective attention to visual distractors was examined in an attentional capture task in which participants searched for a unique shape in the presence or absence of an additional colour singleton distractor. The presence of the additional singleton was associated with slower behavioural responses to the shape target,…

  9. Maltreatment in multiple-birth children.

    Science.gov (United States)

    Lang, Cathleen A; Cox, Matthew J; Flores, Glenn

    2013-12-01

    The rate of multiple births has increased over the last two decades. In 1982, an increased frequency of injuries among this patient population was noted, but few studies have evaluated the increased incidence of maltreatment in twins. The study aim was to evaluate the features of all multiple-birth children with substantiated physical abuse and/or neglect over a four-year period at a major children's hospital. A Retrospective chart review was conducted of multiple-gestation children in which at least one child in the multiple set experienced child maltreatment from January 2006 to December 2009. Data regarding the child, injuries, family, and perpetrators were abstracted. We evaluated whether family and child characteristics were associated with maltreatment, and whether types of injuries were similar within multiple sets. For comparison, data from the same time period for single-birth maltreated children also were abstracted, including child age, gestational age at birth, and injury type. There were 19 sets of multiple births in which at least one child had abusive injuries and/or neglect. In 10 of 19 sets (53%), all multiples were found to have a form of maltreatment, and all children in these multiple sets shared at least one injury type. Parents lived together in 63% of cases. Fathers and mothers were the alleged perpetrator in 42% of the cases. Multiple-gestation-birth maltreated children were significantly more likely than single-birth maltreated children to have abdominal trauma (13% vs. 1%, respectively; pchildren often, but not always, were abused. In sets with two maltreated children, children usually shared the same modes of maltreatment. Multiples are significantly more likely than singletons to be younger and experience fractures and abdominal trauma. The findings support the current standard practice of evaluating all children in a multiple set when one is found to be abused or neglected. Copyright © 2013 Elsevier Ltd. All rights reserved.

  10. Estimating the net effect of progesterone elevation on the day of hCG on live birth rates after IVF: a cohort analysis of 3296 IVF cycles.

    Science.gov (United States)

    Venetis, Christos A; Kolibianakis, Efstratios M; Bosdou, Julia K; Lainas, George T; Sfontouris, Ioannis A; Tarlatzis, Basil C; Lainas, Tryfon G

    2015-03-01

    What is the proper way of assessing the effect of progesterone elevation (PE) on the day of hCG on live birth in women undergoing fresh embryo transfer after in vitro fertilization (IVF) using GnRH analogues and gonadotrophins? This study indicates that a multivariable approach, where the effect of the most important confounders is controlled for, can lead to markedly different results regarding the association between PE on the day of hCG and live birth rates after IVF when compared with the bivariate analysis that has been typically used in the relevant literature up to date. PE on the day of hCG is associated with decreased pregnancy rates in fresh IVF cycles. Evidence for this comes from observational studies that mostly failed to control for potential confounders. This is a retrospective analysis of a cohort of fresh IVF/intracytoplasmic sperm injection cycles (n = 3296) performed in a single IVF centre during the period 2001-2013. Patients in whom ovarian stimulation was performed with gonadotrophins and GnRH analogues. Natural cycles and cycles where stimulation involved the administration of clomiphene were excluded. In order to reflect routine clinical practice, no other exclusion criteria were imposed on this dataset. The primary outcome measure for this study was live birth defined as the delivery of a live infant after 24 weeks of gestation. We compared the association between PE on the day of hCG (defined as P > 1.5 ng/ml) and live birth rates calculated by simple bivariate analyses with that derived from multivariable logistic regression. The multivariable analysis controlled for female age, number of oocytes retrieved, number of embryos transferred, developmental stage of embryos at transfer (cleavage versus blastocyst), whether at least one good-quality embryo was transferred, the woman's body mass index, the total dose of FSH administered during ovarian stimulation and the type of GnRH analogues used (agonists versus antagonists) during ovarian

  11. [CHALLENGING THE OPTIMAL NUMBER OF RETRIEVED OOCYTES AND ITS IMPACT ON PREGNANCY AND LIVE BIRTH RATES IN IVF/ICSI CYCLES].

    Science.gov (United States)

    Blais, Idit; Lahav-Baratz, Shirly; Koifman, Mara; Wiener-Megnazi, Zofnat; Auslender, Ron; Dirnfeld, Martha

    2015-06-01

    Large numbers of retrieved oocytes are associated with higher chances of having cryopreservation of embryos. However, the process entailed exposes women to increased risk for ovarian hyperstimulation syndrome. Furthermore, mild ovary stimulation protocols are more patient-friendly and with less adverse effects. Only limited reports exist on the significance of the number of retrieved oocytes achieved in a single stimulation cycle. To investigate the optimal number of retrieved oocytes to achieve pregnancy and live birth. This retrospective analysis included 1590 IVF cycles. Oocytes maturation, fertilization, cleavage, as well as pregnancy and live birth rates were analyzed according to the number of retrieved oocytes. Oocyte maturation, fertilization and cleavage rates were lower in cycles with more than 10 retrieved oocytes compared with other groups. Live birth rates were highest when the number of retrieved oocytes was 11-15. Retrieval of more than 15 oocytes was not associated with a significant increase in chances of conception and birth. The better oocyte quality with 10 or less oocytes retrieved could be the result of a possible interference with the natural selection, or the minimized exposure of growing follicles to the potentially negative effects of ovarian stimulation. Although the average number of available embryos was higher when more than 10 oocytes were retrieved, achievement of more than 15 oocytes did not improve IVF outcome in terms of pregnancy and delivery rates. Analysis of 1590 IVF cycles including the frozen-thawed transfers shows that the best outcomes were achieved with an optimal number of 11-15 oocytes.

  12. Reproductive health and rights in East Jerusalem: the effects of militarisation and biopolitics on the experiences of pregnancy and birth of Palestinians living in the Kufr 'Aqab neighbourhood.

    Science.gov (United States)

    Hamayel, Layaly; Hammoudeh, Doaa; Welchman, Lynn

    2017-10-01

    Research with marginalised communities points to the need to understand political determinants of reproductive health. For residents of Kufr 'Aqab neighbourhood, Israeli biopolitics in East Jerusalem can be barriers to access to maternal health. This is manifested in women having to cross military checkpoints to give birth in hospitals located in Jerusalem to make their children eligible for "permanent residency", a document required for Palestinians to live in Jerusalem. A basic qualitative design is utilised, and semi-structured in-depth interviews with 27 women and 20 men were conducted and thematic analysis was used to extract themes and subthemes. Women reported exposure to risky conditions during pregnancy and worries of giving birth at checkpoints. Social support was restricted for some women due to inability of the husband/family to reach the hospital at the time of birth. Men reported distress related to inability to attend birth. Giving birth in a Jerusalem hospital, as part of passing residency to children, was perceived as reaffirming Palestinian presence in the City and transforming sites of suffering to sites of resistance. Israeli residency policies and segregation of Jerusalem affect Kufr 'Aqab residents' pregnancy and birth on physical, social and psychological levels. Results indicate the importance of incorporating political determinants of access to maternal care and safe pregnancy in the conceptualisation of reproductive rights.

  13. Race, ethnicity, concentrated poverty, and low birth weight disparities.

    Science.gov (United States)

    Sims, Mario; Sims, Tammy L; Bruce, Marino A

    2008-07-01

    This study examines the extent to which the relationship between area socioeconomic position (SEP) and low birth weight (LBW) varies by race and ethnicity. A cross-sectional, secondary data analysis was performed with 1992-1994 Vital Statistics and 1990 U.S. Census data for selected metropolitan areas. Low birth weight (rates were calculated for non-Hispanic Black, Latino, and non-Hispanic White live singleton births. Concentrated poverty was defined as poor persons living in neighborhoods with 40% or more poverty in metropolitan areas. The results showed that the relationship between concentrated poverty and LBW varied by race and ethnicity. Concentrated poverty was significant for Latinos, even when controlling for maternal health and MSA-level factors. By contrast, maternal health characteristics, such as pre-term birth, teen birth and tobacco use, explained much of the variance in African-American and White LBW These findings extend the discussion about race, class, and health disparities to include Latinos and shows how the relationship between SEP and LBW can vary within an ethnic group.

  14. THE LIVED EXPERIENCES OF BLACK AFRICAN MOTHERS FOLLOWING THE BIRTH OF A CHILD WITH DOWN SYNDROME: IMPLICATIONS FOR INDIGENISATION OF SOCIAL WORK

    Directory of Open Access Journals (Sweden)

    Mathebane, Mbazima

    2016-08-01

    Full Text Available The article discusses the lived experiences of black African mothers following the birth of a child with Down syndrome and implications of this for the indigenisation of social work practice in South Africa. A retrospective qualitative study following a phenomenological design was undertaken. Findings indicated that giving birth to a child with Down syndrome evokes intense psychological and social reactions from the mother, family and community. The cultural norms and values of black African people, including principles of ubuntu and their belief in collectivism, provide important opportunities, support systems and resources that could be pooled for efficient and effective helping intervention.

  15. Umbilical cord length in singleton gestations: a Finnish population-based retrospective register study.

    Science.gov (United States)

    Georgiadis, L; Keski-Nisula, L; Harju, M; Räisänen, S; Georgiadis, S; Hannila, M-L; Heinonen, S

    2014-04-01

    Many complications of pregnancy and delivery are associated with umbilical cord length. It is important to examine the variation in length, in order to identify normal and abnormal conditions. Moreover, the factors influencing cord growth and development are not precisely known. The main objectives were to provide updated reference charts for umbilical cord length in singleton pregnancies and to evaluate potential factors affecting cord length. Birth register data of 47,284 singleton pregnant women delivering in Kuopio University Hospital, Finland was collected prospectively. Gender-specific centile charts for cord length from 22 to 44 gestational weeks were obtained using generalized additive models for location, scale, and shape (GAMLSS). Gestational, fetal, and maternal factors were studied for their potential influence on cord length with single variable analysis and stepwise multiple linear regression analysis. Cord length increased according to gestational age, while the growth decelerated post-term. Birth weight, placental weight, pregravid maternal body mass index, parity, and maternal age correlated to cord length. Gestational diabetes and previous miscarriages were associated with longer cords, while female gender and placental abruption were associated with shorter cords. Girls had shorter cords throughout gestation although there was substantial variation in length in both genders. Cord length associated significantly with birth weight, placental weight, and gestational age. Significantly shorter cords were found in women with placental abruption. This important finding requires further investigation. Copyright © 2014 Elsevier Ltd. All rights reserved.

  16. Effect of Different Concentrations of Melatonin on Live Births Resulting from the Transfer of Two-Cell Embryos of NMRI Mice

    Directory of Open Access Journals (Sweden)

    Mahdi Saadati

    2014-12-01

    Full Text Available Background & objectives : Infertility is a global problem affecting millions of men and women in developed and developing countries. In this regard, in-vitro fertilization (IVF plays an important role in improving the quality of life in infertile patients. However, studies have shown that the implantation failure in IVF is the main challenge of this procedure. Melatonin can increase the survival rate of embryos and IVF success rate through eliminating free radicals and removing reactive oxygen species. So, this study is conducted to investigate the effects of different concentrations of melatonin on the rate of newborns of mice following transfer oftwo-cell embryos .   Methods : In this study, female mice with average age of six to eight weeks were superovulated by administering pregnant mares serum gonadotropin (PMSG intraperitoneally (7.5 IU. ip, and followed after 48h by human chorionic gonadotropin (hCG (7.5 IU. ip. Two-cell mouse embryos were obtained from female mice oviduct after 48 h. The embryos transferred bilaterally into pseudopregnant mice of the same strain through surgical procedure and 8-14 embryos were transferred to each tube. The study included 4 treatment groups and one control group (6 mice in each group. The treatment groups were exposed to subcutaneous injection of concentrations of 100 µm , 10 µm , 1 µm and 100 nm of melatonin. After the cesarean on 18th day of pregnancy, the percentage of live births was assessed. The outcomes of the live birth rate were as­sessed using the chi-square test and statistical analyses were carried out using SPSS version 16.0. Percentage of live birth was calculated and compared with the control group.   Results: A total of 701 two-cell mouse embryos were transferred into one control group and four experimental groups. The number and percentage of live births at concentrations of 100 µm and 10 µm of melatonin and the control groups were 21 (15.55%, 13 (9.15% and 9 (6

  17. Neonatal and maternal outcomes comparing women undergoing two in vitro fertilization (IVF) singleton pregnancies and women undergoing one IVF twin pregnancy.

    Science.gov (United States)

    Sazonova, Antonina; Källen, Karin; Thurin-Kjellberg, Ann; Wennerholm, Ulla-Britt; Bergh, Christina

    2013-03-01

    To compare outcomes for women undergoing two in vitro fertilization (IVF) pregnancies with singletons and women undergoing one IVF twin pregnancy. The concept of single-embryo transfer in IVF has reduced the risks of both maternal and neonatal complications, but there is still a discussion of whether or not twins are a desired outcome of IVF. Registry study. Not applicable. All reported twins after IVF with double-embryo transfer (n = 1,982) and their mothers (n = 991) and all mothers (n = 921) who gave birth to two IVF singletons (n = 1,842). None. Maternal and neonatal outcomes including severe neonatal morbidity. Preterm birth, very preterm birth, low birth weight, very low birth weight, and small for gestational age were dramatically increased for IVF twins compared with two IVF singletons with the same mother, with adjusted odds ratios from 4 to 16. Significantly higher rates of respiratory complications, sepsis, and jaundice were detected among the IVF twins. Significantly higher rates of preeclampsia, preterm premature rupture of the membranes, and cesarean section were observed for IVF twin pregnancies. The neonatal and maternal outcomes were dramatically better for women undergoing two IVF singleton pregnancies compared with one IVF twin pregnancy after double-embryo transfer. These results support single-embryo transfer to minimize the risks associated with twin pregnancies. Copyright © 2013 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  18. [Perinatal health: low birth weight and social class].

    Science.gov (United States)

    da Silva, A A; Barbieri, M A; Bettiol, H; Dal Bó, C M; Mucillo, G; Gomes, U A

    1991-04-01

    A survey was carried out in Ribeirão Preto, S. Paulo State, Brazil, between June 1978 and May 1979 with a view to studying the prevalence of low birth weight and its occurrence among different social classes. Data were collected from 8,878 singleton live births in eight maternity hospitals, accounting for 98% of all births in the area. Social classes were determinated by the use of a model proposed by Singer and modified for epidemiological purposes by Barros. Out of the 8,878 births, 660 (7.5%) were of low birth weight. The prevalence of deficient weight at birth (between 2,500 and 2,999 grams) was of 21.1%. Analysis indicated that 50.6% of children with low birth weight were at term and the majority of them suffered form intrauterine growth retardation. The prevalence of low birth weight according to social class was seen to be lower in the bourgeoisie classes (ranging from 2.8% to 3.9%) and higher in working classes (from 7% up to 9.5%). Low birth weight (defined as less than or equal to 2,500 grams) was used for purposes of comparison with other previous surveys. The percentage was lower in this study (8.3%) than that found in the Interamerican Investigation of Mortality in Childhood (8.7%), carried out in 1968-70. No statistically significant differences in the percentage of low birth weight were found in the case of Ribeirão Preto when these two surveys were compared.

  19. Provider-Initiated Late Preterm Births in Brazil: Differences between Public and Private Health Services.

    Science.gov (United States)

    Leal, Maria do Carmo; Esteves-Pereira, Ana Paula; Nakamura-Pereira, Marcos; Torres, Jacqueline Alves; Domingues, Rosa Maria Soares Madeira; Dias, Marcos Augusto Bastos; Moreira, Maria Elizabeth; Theme-Filha, Mariza; da Gama, Silvana Granado Nogueira

    2016-01-01

    A large proportion of the rise in prematurity worldwide is owing to late preterm births, which may be due to the expansion of obstetric interventions, especially pre-labour caesarean section. Late preterm births pose similar risks to overall prematurity, making this trend a concern. In this study, we describe factors associated with provider-initiated late preterm birth and verify differences in provider-initiated late preterm birth rates between public and private health services according to obstetric risk. This is a sub-analysis of a national population-based survey of postpartum women entitled "Birth in Brazil", performed between 2011 and 2012. We included 23,472 singleton live births. We performed non-conditional multiple logistic regressions assessing associated factors and analysing differences between public and private health services. Provider-initiated births accounted for 38% of late preterm births; 32% in public health services and 61% in private health services. They were associated with previous preterm birth(s) and maternal pathologies for women receiving both public and private services and with maternal age ≥35 years for women receiving public services. Women receiving private health services had higher rates of provider-initiated late preterm birth (rate of 4.8%) when compared to the ones receiving public services (rate of 2.4%), regardless of obstetric risk-adjusted OR of 2.3 (CI 1.5-3.6) for women of low obstetric risk and adjusted OR of 1.6 (CI 1.1-2.3) for women of high obstetric risk. The high rates of provider-initiated late preterm birth suggests a considerable potential for reduction, as such prematurity can be avoided, especially in women of low obstetric risk. To promote healthy births, we advise introducing policies with incentives for the adoption of new models of birth care.

  20. Provider-Initiated Late Preterm Births in Brazil: Differences between Public and Private Health Services.

    Directory of Open Access Journals (Sweden)

    Maria do Carmo Leal

    Full Text Available A large proportion of the rise in prematurity worldwide is owing to late preterm births, which may be due to the expansion of obstetric interventions, especially pre-labour caesarean section. Late preterm births pose similar risks to overall prematurity, making this trend a concern. In this study, we describe factors associated with provider-initiated late preterm birth and verify differences in provider-initiated late preterm birth rates between public and private health services according to obstetric risk.This is a sub-analysis of a national population-based survey of postpartum women entitled "Birth in Brazil", performed between 2011 and 2012. We included 23,472 singleton live births. We performed non-conditional multiple logistic regressions assessing associated factors and analysing differences between public and private health services.Provider-initiated births accounted for 38% of late preterm births; 32% in public health services and 61% in private health services. They were associated with previous preterm birth(s and maternal pathologies for women receiving both public and private services and with maternal age ≥35 years for women receiving public services. Women receiving private health services had higher rates of provider-initiated late preterm birth (rate of 4.8% when compared to the ones receiving public services (rate of 2.4%, regardless of obstetric risk-adjusted OR of 2.3 (CI 1.5-3.6 for women of low obstetric risk and adjusted OR of 1.6 (CI 1.1-2.3 for women of high obstetric risk.The high rates of provider-initiated late preterm birth suggests a considerable potential for reduction, as such prematurity can be avoided, especially in women of low obstetric risk. To promote healthy births, we advise introducing policies with incentives for the adoption of new models of birth care.

  1. Pre-Pregnancy Dating Violence and Birth Outcomes Among Adolescent Mothers in a National Sample.

    Science.gov (United States)

    Madkour, Aubrey Spriggs; Xie, Yiqiong; Harville, Emily W

    2014-07-01

    Although infants born to adolescent mothers are at increased risk of adverse birth outcomes, little is known about contributors to birth outcomes in this group. Given past research linking partner abuse to adverse birth outcomes among adult mothers, we explored associations between pre-pregnancy verbal and physical dating violence and the birth weight and gestational age of infants born to adolescent mothers. Data from the National Longitudinal Study of Adolescent Health Waves I (1995/1996), II (1996), and IV (2007/2008) were analyzed. Girls whose first singleton live births occurred after Wave II interview and before age 20 (N = 558) self-reported infants' birth weight and gestational age at Wave IV. Dating violence victimization (verbal and physical) in the 18 months prior to Wave II interview was self-reported. Controls included Wave I age, parent education, age at pregnancy, time between reporting abuse and birth, and childhood physical and sexual abuse. Weighted multivariable regression models were performed separately by race (Black/non-Black).On average, births occurred 2 years after Wave II interview. Almost one in four mothers reported verbal dating violence victimization (23.6%), and 10.1% reported physical victimization. Birth weight and prevalence of verbal dating violence victimization were significantly lower in Black compared with non-Black teen mothers. In multivariable analyses, negative associations between physical dating abuse and birth outcomes became stronger as time increased for Black mothers. For example, pre-pregnancy physical dating abuse was associated with 0.79 kilograms lower birth weight (pdating abuse was unassociated with birth outcomes among non-Black mothers, and verbal abuse was unassociated with birth outcomes for all mothers. Reducing physical dating violence in adolescent relationships prior to pregnancy may improve Black adolescent mothers' birth outcomes. Intervening on long-term violence may be particularly important.

  2. Risk assessment and management to prevent preterm birth

    NARCIS (Netherlands)

    Koullali, B.; Oudijk, M. A.; Nijman, T. A. J.; Mol, B. W. J.; Pajkrt, E.

    2016-01-01

    Preterm birth is the most important cause of neonatal mortality and morbidity worldwide. In this review, we review potential risk factors associated with preterm birth and the subsequent management to prevent preterm birth in low and high risk women with a singleton or multiple pregnancy. A history

  3. Triggering of final oocyte maturation with gonadotropin-releasing hormone agonist or human chorionic gonadotropin. Live birth after frozen-thawed embryo replacement cycles

    DEFF Research Database (Denmark)

    Griesinger, Georg; Kolibianakis, E M; Papanikolaou, E G

    2007-01-01

    OBJECTIVE: To report the outcome of frozen-thawed embryo replacement cycles after GnRH-agonist triggering of final oocyte maturation in the collecting cycle with GnRH-antagonist. DESIGN: Prospective, observational, multicentric clinical study. SETTING: Tertiary university-affiliated IVF centers...... a total of 228 participants. Surplus embryos or oocytes at the pronuclear stage were cryopreserved in 53 patients after hCG administration and 32 patients after GnRH-agonist administration on the basis of patient choice, pronuclear/embryo availability, and local laws. INTERVENTION(S): Transfer of frozen......-thawed embryos. MAIN OUTCOME MEASURE(S): Live birth rate. RESULT(S): Thirty-one and 23 patients after administration of hCG and GnRH-agonist, respectively, started a frozen-embryo replacement cycle by September 2005, with 25 and 16 patients eventually undergoing at least one frozen-thawed ET. Live birth rate per...

  4. Twins: prevalence, problems, and preterm births.

    Science.gov (United States)

    Chauhan, Suneet P; Scardo, James A; Hayes, Edward; Abuhamad, Alfred Z; Berghella, Vincenzo

    2010-10-01

    The rate of twin pregnancies in the United States has stabilized at 32 per 1000 births in 2006. Aside from determining chorionicity, first-trimester screening and second-trimester ultrasound scanning should ascertain whether there are structural or chromosomal abnormalities. Compared with singleton births, genetic amniocentesis-related loss at births is higher (0.9% vs 2.9%, respectively). Selective termination for an anomalous fetus is an option, although the pregnancy loss rate is 7% at experienced centers. For singleton and twin births for African American and white women, approximately 50% of preterm births are indicated; approximately one-third of these births are spontaneous, and 10% of the births occur after preterm premature rupture of membranes. From 1989-2000, the rate of preterm twin births increased, for African American and white women alike, although the perinatal mortality rate has actually decreased. As with singleton births, tocolytics should be used judiciously and only for a limited time (births. Administration of antenatal corticosteroids is an evidence-based recommendation. Copyright © 2010 Mosby, Inc. All rights reserved.

  5. Cost-effectiveness of a mild compared with a standard strategy for IVF: a randomized comparison using cumulative term live birth as the primary endpoint.

    Science.gov (United States)

    Polinder, S; Heijnen, E M E W; Macklon, N S; Habbema, J D F; Fauser, B J C M; Eijkemans, M J C

    2008-02-01

    BACKGROUND Conventional ovarian stimulation and the transfer of two embryos in IVF exhibits an inherent high probability of multiple pregnancies, resulting in high costs. We evaluated the cost-effectiveness of a mild compared with a conventional strategy for IVF. METHODS Four hundred and four patients were randomly assigned to undergo either mild ovarian stimulation/GnRH antagonist co-treatment combined with single embryo transfer, or standard stimulation/GnRH agonist long protocol and the transfer of two embryos. The main outcome measures are total costs of treatment within a 12 months period after randomization, and the relationship between total costs and proportion of cumulative pregnancies resulting in term live birth within 1 year of randomization. RESULTS Despite a significantly increased average number of IVF cycles (2.3 versus 1.7; P costs over a 12-month period (8333 versus euro10 745; P = 0.006) were observed using the mild strategy. This was mainly due to higher costs of the obstetric and post-natal period for the standard strategy, related to multiple pregnancies. The costs per pregnancy leading to term live birth were euro19 156 in the mild strategy and euro24 038 in the standard. The incremental cost-effectiveness ratio of the standard strategy compared with the mild strategy was euro185 000 per extra pregnancy leading to term live birth. CONCLUSIONS Despite an increased mean number of IVF cycles within 1 year, from an economic perspective, the mild treatment strategy is more advantageous per term live birth. It is unlikely, over a wide range of society's willingness-to-pay, that the standard treatment strategy is cost-effective, compared with the mild strategy.

  6. Live birth following serial vitrification of embryos and PGD for fragile X syndrome in a patient with the premutation and decreased ovarian reserve.

    Science.gov (United States)

    Nayot, Dan; Chung, Jin Tae; Son, Weon-Young; Ao, Assangla; Hughes, Mark; Dahan, Michael H

    2013-11-01

    To present a live birth resulting from serial vitrification of embryos and pre-implantation genetic diagnosis (PGD). A 31-year-old with primary infertility, fragile-X premutation, and decreased ovarian reserve (DOR) (baseline FSH level 33 IU/L), presented after failing to stimulate to follicle diameters >10 mm with three cycles of invitro fertilization (IVF). After counseling, the couple opted for serial in-vitro maturation (IVM), embryo vitrification, and genetic testing using array comparative genomic hybridization (aCGH) and PGD. Embryos were vitrified 2 days after intra-cytoplasmic sperm injection (ICSI). Thawed embryos were biopsied on day-three and transferred on day-five. The couple underwent 20 cycles of assisted reproductive technology. A total of 23 in-vivo mature and five immature oocytes were retrieved, of which one matured in-vitro. Of 24 embryos, 17/24 (71 %) developed to day two and 11/24 (46 %) survived to blastocyst stage with a biopsy result available. Four blastocysts had normal PGD and aCGH results. Both single embryo transfers resulted in a successful implantation, one a blighted ovum and the other in a live birth. Young patients with DOR have potential for live birth as long as oocytes can be obtained and embryos created. Serial vitrification may be the mechanism of choice in these patients when PGD is needed.

  7. Antral follicle counts are strongly associated with live-birth rates after assisted reproduction, with superior treatment outcome in women with polycystic ovaries.

    Science.gov (United States)

    Holte, Jan; Brodin, Thomas; Berglund, Lars; Hadziosmanovic, Nermin; Olovsson, Matts; Bergh, Torbjörn

    2011-09-01

    To evaluate the association of antral follicle count (AFC) with in vitro fertilization/intracytoplasmic sperm injection (IVF-ICSI) outcome in a large unselected cohort of patients covering the entire range of AFC. Prospective observational study. University-affiliated private infertility center. 2,092 women undergoing 4,308 IVF-ICSI cycles. AFC analyzed for associations with treatment outcome and statistically adjusted for repeated treatments and age. Pregnancy rate, live-birth rate, and stimulation outcome parameters. The AFC was log-normally distributed. Pregnancy rates and live-birth rates were positively associated with AFC in a log-linear way, leveling out above AFC ∼30. Treatment outcome was superior among women with polycystic ovaries, independent from ovulatory status. The findings were significant also after adjustment for age and number of oocytes retrieved. Pregnancy and live-birth rates are log-linearly related to AFC. Polycystic ovaries, most often excluded from studies on ovarian reserve, fit as one extreme in the spectrum of AFC; a low count constitutes the other extreme, with the lowest ovarian reserve and poor treatment outcome. The findings remained statistically significant also after adjustment for the number of oocytes retrieved, suggesting this measure of ovarian reserve comprises information on oocyte quality and not only quantity. Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  8. Hospital costs during the first 5 years of life for multiples compared with singletons born after IVF or ICSI.

    Science.gov (United States)

    van Heesch, M M J; Evers, J L H; van der Hoeven, M A H B M; Dumoulin, J C M; van Beijsterveldt, C E M; Bonsel, G J; Dykgraaf, R H M; van Goudoever, J B; Koopman-Esseboom, C; Nelen, W L D M; Steiner, K; Tamminga, P; Tonch, N; Torrance, H L; Dirksen, C D

    2015-06-01

    Do in vitro fertilization (IVF) multiples generate higher hospital costs than IVF singletons, from birth up to age 5? Hospital costs from birth up to age 5 were significantly higher among IVF/ICSI multiple children compared with IVF/ICSI singletons; however, when excluding the costs incurred during the birth admission period, hospital costs of multiples and singletons were comparable. Concern has risen over the long-term outcome of children born after IVF. The increased incidence of multiple births in IVF as a result of double-embryo transfer predisposes children to a poorer neonatal outcome such as preterm birth and low birthweight. As a consequence, IVF multiples require more medical care. Costs and consequences of poorer neonatal outcomes in multiples may also exist later in life. All 5497 children born from IVF in 2003-2005, whose parents received IVF or ICSI treatment in one of five participating Dutch IVF centers, served as a basis for a retrospective cohort study. Based on gestational age, birthweight, Apgar and congenital malformation, children were assigned to one of three risk strata (low-, moderate- or high-risk). To enhance the efficiency of the data collection, 816 multiples and 584 singletons were selected for 5-year follow-up based on stratified (risk) sampling. Parental informed consent was received of 322 multiples and 293 singletons. Individual-level hospital resource use data (hospitalization, outpatient visits and medical procedures) were retrieved from hospital information systems and patient charts for 302 multiples and 278 singletons. The risk of hospitalization (OR 4.9, 95% CI 3.3-7.0), outpatient visits (OR 2.6, 95% CI 1.8-3.6) and medical procedures (OR 1.7, 95% CI 1.2-2.2) was higher for multiples compared with singletons. The average hospital costs amounted to €10 018 and €2093 during the birth admission period (P IVF/ICSI multiples compared with IVF/ICSI singletons. Single-embryo transfer may result in substantial savings

  9. Deciding Type Equivalence in a Language with Singleton Kinds

    National Research Council Canada - National Science Library

    Stone, Christopher

    1999-01-01

    ...: S(A) is the kind of all types provably equivalent to the type A. Singletons are interesting because they provide a very general form of definitions for type variables and allow fine-grained control of type computations...

  10. A population-based study of effect of multiple birth on infant mortality in Nigeria

    Directory of Open Access Journals (Sweden)

    Uthman Mubashir B

    2008-09-01

    Full Text Available Abstract Background Multi-foetal pregnancies and multiple births including twins and higher order multiples births such as triplets and quadruplets are high-risk pregnancy and birth. These high-risk groups contribute to the higher rate of childhood mortality especially during early period of life. Methods We examined the relationship between multiple births and infant mortality using univariable and multivariable survival regression procedure with Weibull hazard function, controlling for child's sex, birth order, prenatal care, delivery assistance; mother's age at child birth, nutritional status, education level; household living conditions and several other risk factors. Results Children born multiple births were more than twice as likely to die during infancy as infants born singleton (hazard ratio = 2.19; 95% confidence interval: 1.50, 3.19 holding other factors constant. Maternal education and household asset index were associated with lower risk of infant mortality. Conclusion Multiple births are strongly negatively associated with infant survival in Nigeria independent of other risk factors. Mother's education played a protective role against infant death. This evidence suggests that improving maternal education may be key to improving child survival in Nigeria. A well-educated mother has a better chance of satisfying important factors that can improve infant survival: the quality of infant feeding, general care, household sanitation, and adequate use of preventive and curative health services.

  11. Large for gestational age and macrosomia in singletons born after frozen/thawed embryo transfer (FET) in assisted reproductive technology (ART)

    DEFF Research Database (Denmark)

    Berntsen, Sine; Pinborg, Anja

    2018-01-01

    Increase in success rates with frozen embryo transfer (FET) and reduced risk of ovarian hyperstimulation syndrome (OHSS) and multiple pregnancies has lead to a steady rise in FET. Further, FET is associated with lower risk of prematurity and low birth weight in singletons, when compared with fres...

  12. Perinatal outcomes in 6,338 singletons born after intrauterine insemination in Denmark, 2007 to 2012

    DEFF Research Database (Denmark)

    Malchau, Sara Sofia; Loft, Anne; Henningsen, Anna-Karina Aaris

    2014-01-01

    . INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Preterm birth (PTB), low birth weight (LBW), small for gestational age (SGA). RESULT(S): Children born after IUI-H had higher risks of PTB, LBW, and SGA vs. SC singletons (adjusted odds ratios [aOR] 1.3; 95% confidence interval (CI), 1.1-1.5; 1.4; 95% CI, 1.......2-1.7; and 1.4; 95% CI, 1.2-1.6), respectively. Compared with IVF, risk of SGA was similar, but risks of PTB and LBW were lower (aOR 0.6; 95% CI, 0.5-0.8; and 0.8; 95% CI, 0.6-0.9). Compared with intracytoplasmic sperm injection, no differences were found. For children born after IUI with donor semen, results...

  13. Analysis of intracranial hemorrhage grade in preterm singleton pregnancies delivered vaginally or by cesarean section

    Directory of Open Access Journals (Sweden)

    Ljuština Saša

    2013-01-01

    Full Text Available Background/Aim. Preterm birth is the leading cause of neonatal mortality. Periventricular hemorrhage-intraventricular hemorrhage (PVH-IVH remains a significant cause of both morbidity and mortality in infants prematurely born. The aim of the study was to evaluate the perinatal outcome regarding IVH of premature babies according to the mode of delivery. Methods. A total of 126 women in preterm singleton pregnancies with vertex presentation and 126 neonates weighted from 750 g to 1,500 g at birth were enrolled. The outcomes of 64 neonates born vaginally were compared to 62 neonates born by cesarean section. Results. There was no significant difference in the incidence of IVH among both groups. Conclusion. Our data is consistent with the hypothesis that the mode of delivery does not influence IVH and consenquently perinatal outcome in preterm neonates.

  14. Hospital utilization, costs and mortality rates during the first 5 years of life: a population study of ART and non-ART singletons.

    Science.gov (United States)

    Chambers, G M; Lee, E; Hoang, V P; Hansen, M; Bower, C; Sullivan, E A

    2014-03-01

    Do singletons conceived following assisted reproduction technologies (ARTs) have significantly different hospital utilization, and therefore costs, compared with non-ART children during the first 5 years of life? ART singletons have longer hospital birth-admissions and a small increased risk of re-admission during the first 5 years of life resulting in higher costs of hospital care. ART singletons are at greater risk of adverse perinatal outcomes compared with non-ART singletons. Long-term physical and mental health outcomes of ART singletons are generally reassuring. There is a scarcity of information on health service utilization and the health economic impact of ART conceived children. A population cohort study using linked birth, hospital and death records. Perinatal outcomes, hospital utilization and costs, and mortality rates were compared for non-ART and ART singletons to 5 years. Adjustments were made for maternal age, parity, sex, birth year, socioeconomic status and funding source. Australian Diagnosis Related Groups cost-weights were used to derive costs. All costs are reported in 2009/2010 Australian dollars. All babies born in Western Australia between 1994 and 2003 were included; 224 425 non-ART singletons and 2199 ART conceived singletons. Hospital admission and death records in Western Australia linked to 2008 were used. Overall, ART singletons had a significantly longer length of stay during the birth-admission (mean difference 1.8 days, P birth-admission ($1473). The independent residual cost associated with ART conception was $342 during the birth-admission and an additional $548 up to 5 years of age, indicating that being conceived as an ART child predicts not only higher birth-admission costs but excess costs to at least 5 years of age. This study could not investigate the impact of different ART practices and techniques on perinatal outcomes or hospital utilization, nor could it adjust for parental characteristics such as cause of infertility

  15. Birthweight percentiles by gestational age for births following assisted reproductive technology in Australia and New Zealand, 2002-2010.

    Science.gov (United States)

    Li, Zhuoyang; Wang, Yueping A; Ledger, William; Sullivan, Elizabeth A

    2014-08-01

    What is the standard of birthweight for gestational age for babies following assisted reproductive technology (ART) treatment? Birthweight for gestational age percentile charts were developed for singleton births following ART treatment using population-based data. Small for gestational age (SGA) and large for gestational age (LGA) births are at increased risks of perinatal morbidity and mortality. A birthweight percentile chart allows the detection of neonates at high risk, and can help inform the need for special care if required. This population study used data from the Australian and New Zealand Assisted Reproduction Database (ANZARD) for 72 694 live born singletons following ART treatment between January 2002 and December 2010 in Australia and New Zealand. A total of 69 315 births (35 580 males and 33 735 females) following ART treatment were analysed for the birthweight percentile. Exact percentiles of birthweight in grams were calculated for each gestational week between Week 25 and 42 for fresh and thaw cycles by infant sex. Univariate analysis was used to determine the exact birthweight percentile values. Student t-test was used to examine the mean birthweight difference between male and female infants, between single embryo transfer (SET) and double embryo transfer (DET) and between fresh and thaw cycles. Preterm births (birth before 37 completed weeks of gestation) and low birthweight (fetal growth standards but only the weight of live born infants at birth. The comparison of birthweight percentile charts for ART births and general population births provide evidence that the proportion of SGA births following ART treatment was comparable to the general population for SET fresh cycles and significantly lower for thaw cycles. Both fresh and thaw cycles showed better outcomes for singleton births following SET compared with DET. Policies to promote single embryo transfer should be considered in order to minimize the adverse perinatal outcomes associated

  16. Neighbourhood socioeconomic status and maternal factors at birth as moderators of the association between birth characteristics and school attainment: a population study of children attending government schools in Western Australia.

    Science.gov (United States)

    Malacova, E; Li, J; Blair, E; Mattes, E; de Klerk, N; Stanley, F

    2009-10-01

    This article investigates whether reading and writing skills among children of equivalent perinatal characteristics differ by neighbourhood socioeconomic status and maternal factors. Notifications of births for all non-Aboriginal singletons born in 1990-7 in Western Australia subsequently attending government primary schools were linked to the State literacy tests in grade three and with information on socioeconomic status of the school and the residential area. Using multilevel modelling, the associations between birth characteristics (gestational age, intrauterine growth, birth order and Apgar score at 5 minutes) and literacy attainment in grade three were examined in models that included socioeconomic and demographic factors of the child, mother and community. Higher percentages of optimal head circumference and birth length and term birth were positively and independently associated with literacy scores. A higher percentage of optimal birth weight was associated with higher reading scores especially for children born to mothers residing in educationally advantaged areas. First birth was positively associated with reading and writing attainment: this association was stronger for children born to single mothers and additional advantage in writing was also associated with first birth in children living in disadvantaged areas. These findings suggest that having suboptimal growth in utero or an older sibling at birth increases vulnerability to poor literacy attainment especially among children born to single mothers or those in disadvantaged neighbourhoods. These data provide evidence for advocating lifestyles compatible with optimum fetal growth and socioeconomic conditions conducive to healthy lifestyles, particularly during pregnancy.

  17. Infant outcomes of certified nurse midwife attended home births: United States 2000 to 2004.

    Science.gov (United States)

    Malloy, M H

    2010-09-01

    Home births attended by certified nurse midwives (CNMs) make up an extremely small proportion of births in the United States (home deliveries compared with certified nurse midwife in-hospital deliveries in the United States as measured by the risk of adverse infant outcomes among women with term, singleton, vaginal deliveries. United States linked birth and infant death files for the years 2000 to 2004 were used for the analysis. Adverse neonatal outcomes including death were determined by place of birth and attendant type for in-hospital certified nurse midwife, in-hospital 'other' midwife, home certified nurse midwife, home 'other' midwife, and free-standing birth center certified nurse midwife deliveries. For the 5-year period there were 1 237 129 in-hospital certified nurse midwife attended births; 17 389 in-hospital 'other' midwife attended births; 13 529 home certified nurse midwife attended births; 42 375 home 'other' midwife attended births; and 25 319 birthing center certified nurse midwife attended births. The neonatal mortality rate per 1000 live births for each of these categories was, respectively, 0.5 (deaths=614), 0.4 (deaths=7), 1.0 (deaths=14), 1.8 (deaths=75), and 0.6 (deaths=16). The adjusted odds ratio (95% confidence interval) for neonatal mortality for home certified nurse midwife attended deliveries vs in-hospital certified nurse midwife attended deliveries was 2.02 (1.18, 3.45). Deliveries at home attended by CNMs and 'other midwives' were associated with higher risks for mortality than deliveries in-hospital by CNMs.

  18. First birth Caesarean section and subsequent fertility: a population-based study in the USA, 2000-2008.

    Science.gov (United States)

    Kjerulff, K H; Zhu, J; Weisman, C S; Ananth, C V

    2013-12-01

    Is first birth Caesarean delivery associated with a lower likelihood of subsequent childbearing when compared with first birth vaginal delivery? In this study of US women whose first delivery was in 2000, those who had a Caesarean delivery were less likely to have a subsequent live birth than those who delivered vaginally. Some studies have reported lower birth rates subsequent to Caesarean delivery in comparison with vaginal delivery, while other studies have reported no difference. We conducted a retrospective cohort study of 52 498 women who had a first singleton live birth in the State of Pennsylvania, USA in 2000 and were followed to the end of 2008 via Pennsylvania birth certificate records to identify subsequent live births during the 8- to 9-year follow-up period. Birth certificate records of first singleton births were linked to the hospital discharge data for each mother and newborn, and linked to all birth certificate records for each mother's subsequent deliveries which occurred in 2000 to the end of 2008. Poisson regression models were used to evaluate the association between first birth factors and whether or not there was a subsequent live birth during the follow-up period. Over an average of 8.5 years of follow-up, 40.2% of women with a Caesarean first birth did not have a subsequent live birth, compared with 33.1% of women with a vaginal first birth (risk ratio (RR): 1.21, 95% confidence interval (CI): 1.18-1.25). Adjustment for the demographic confounders of maternal age, race, education, marital status and health insurance coverage attenuated the RR to 1.16 (95% CI: 1.13-1.19). Specific pregnancy and childbirth-related complications associated with not having a subsequent live birth included diabetes-related disorders, abnormalities of organs and soft tissues of the pelvis, fetal abnormalities, premature or prolonged rupture of membranes, hypertensive disorders, amnionitis, fetal distress and other maternal health problems. However, adjustment

  19. Adjustment of a Population of South African Children of Mothers Living With/and Without HIV Through Three Years Post-Birth.

    Science.gov (United States)

    Rotheram-Borus, Mary Jane; Tomlinson, Mark; Scheffler, Aaron; Harris, Danielle M; Nelson, Sandahl

    2017-06-01

    Mothers living with HIV (MLH) and their children are typically studied to ensure that perinatal HIV transmission is blocked. Yet, HIV impacts MLH and their children lifelong. We examine child outcomes from pregnancy to 3 years post-birth among a peri-urban population of pregnant MLH and mothers without HIV (MWOH). Almost all pregnant women in 12 neighborhoods (98 %; N = 584) in Cape Town, South Africa were recruited and repeatedly assessed within 2 weeks of birth (92 %), at 6 months (88 %), 18 months (84 %), and 3 years post-birth (86 %). There were 186 MLH and 398 MWOH. Controlling for neighborhood and repeated measures, child and maternal outcomes were contrasted over time using longitudinal random effects regression analyses. For measures collected only at 3 years, outcomes were analyzed using multiple regressions. Compared to MWOH, MLH had less income, more informal housing and food insecurity, used alcohol more often during pregnancy, and were more depressed during pregnancy and over time. Only 4.8 % of MLH's children were seropositive; seropositive children were excluded from additional analyses. Children of MLH tended to have significantly lower weights (p rates (8.5 %) and were similar in social and behavioral adjustment, vocabulary, and executive functioning at 3 years post-birth. Despite living in households with fewer resources and having more depressed mothers, only the physical health of children of MLH is compromised, compared to children of MWOH. In township neighborhoods with extreme poverty, social, behavioral, language, and cognitive functioning appear similar over the first three years of life between children of MLH and MWOH.

  20. Ambient air pollution exposure and full-term birth weight in California

    Directory of Open Access Journals (Sweden)

    Sadd James L

    2010-07-01

    Full Text Available Abstract Background Studies have identified relationships between air pollution and birth weight, but have been inconsistent in identifying individual pollutants inversely associated with birth weight or elucidating susceptibility of the fetus by trimester of exposure. We examined effects of prenatal ambient pollution exposure on average birth weight and risk of low birth weight in full-term births. Methods We estimated average ambient air pollutant concentrations throughout pregnancy in the neighborhoods of women who delivered term singleton live births between 1996 and 2006 in California. We adjusted effect estimates of air pollutants on birth weight for infant characteristics, maternal characteristics, neighborhood socioeconomic factors, and year and season of birth. Results 3,545,177 singleton births had monitoring for at least one air pollutant within a 10 km radius of the tract or ZIP Code of the mother's residence. In multivariate models, pollutants were associated with decreased birth weight; -5.4 grams (95% confidence interval -6.8 g, -4.1 g per ppm carbon monoxide, -9.0 g (-9.6 g, -8.4 g per pphm nitrogen dioxide, -5.7 g (-6.6 g, -4.9 g per pphm ozone, -7.7 g (-7.9 g, -6.6 g per 10 μg/m3 particulate matter under 10 μm, -12.8 g (-14.3 g, -11.3 g per 10 μg/m3 particulate matter under 2.5 μm, and -9.3 g (-10.7 g, -7.9 g per 10 μg/m3 of coarse particulate matter. With the exception of carbon monoxide, estimates were largely unchanged after controlling for co-pollutants. Effect estimates for the third trimester largely reflect the results seen from full pregnancy exposure estimates; greater variation in results is seen in effect estimates specific to the first and second trimesters. Conclusions This study indicates that maternal exposure to ambient air pollution results in modestly lower infant birth weight. A small decline in birth weight is unlikely to have clinical relevance for individual infants, and there is debate about whether

  1. Capture by colour: evidence for dimension-specific singleton capture.

    Science.gov (United States)

    Harris, Anthony M; Becker, Stefanie I; Remington, Roger W

    2015-10-01

    Previous work on attentional capture has shown the attentional system to be quite flexible in the stimulus properties it can be set to respond to. Several different attentional "modes" have been identified. Feature search mode allows attention to be set for specific features of a target (e.g., red). Singleton detection mode sets attention to respond to any discrepant item ("singleton") in the display. Relational search sets attention for the relative properties of the target in relation to the distractors (e.g., redder, larger). Recently, a new attentional mode was proposed that sets attention to respond to any singleton within a particular feature dimension (e.g., colour; Folk & Anderson, 2010). We tested this proposal against the predictions of previously established attentional modes. In a spatial cueing paradigm, participants searched for a colour target that was randomly either red or green. The nature of the attentional control setting was probed by presenting an irrelevant singleton cue prior to the target display and assessing whether it attracted attention. In all experiments, the cues were red, green, blue, or a white stimulus rapidly rotated (motion cue). The results of three experiments support the existence of a "colour singleton set," finding that all colour cues captured attention strongly, while motion cues captured attention only weakly or not at all. Notably, we also found that capture by motion cues in search for colour targets was moderated by their frequency; rare motion cues captured attention (weakly), while frequent motion cues did not.

  2. [Effect of hyperandrogenism on obstetric complications of singleton pregnancy from in vitro fertilization in women with polycystic ovary syndrome].

    Science.gov (United States)

    Wei, D M; Zhang, Z Z; Wang, Z; Li, P; Wang, J F; Liu, Y J; Zhang, J T; Shi, Y H

    2018-01-25

    Objective: To compare the difference in risks of obstetric complications of singleton pregnancy between women with hyperandrogenic polycystic ovary syndrome (PCOS) and women with normoandrogenic PCOS. Methods: Prospective cohort study. This study was a secondary analysis of data collected during a multicenter randomized controlled clinical trial. Women who got clinical singleton pregnancy were grouped according to whether they were diagnosed with hyperandrogenism at baseline. There were 118 women with hyperandrogenism and 366 women without hyperandrogenism. The incidences of obstetric complications and birth weight were compared between the two groups. Results: Women with hyperandrogenic PCOS had a significantly higher risk of preterm delivery than women with normoandrogenic PCOS [12.7% (15/118) versus 3.6% (13/366); OR= 3.94, 95% CI: 1.82-8.56]. After adjustment of age, duration of infertility, body mass index, and fresh or frozen embryo transfer group, hyperandrogenism was still associated with an increased risk of preterm delivery ( OR= 3.67, 95% CI: 1.67-8.07). Compared with women with normoandrogenic PCOS, women with hyperandrogenic PCOS had similar risks of pregnancy loss, gestational diabetes mellitus, pre-eclampsia, placenta previa, and postpartum hemorrhage (all P> 0.05). Birth weight as well as the risks of being small for gestational age and large for gestational age were also comparable between the two groups (all P> 0.05). Conclusion: In women with PCOS and singleton pregnancy, those with preconceptional hyperandrogenism have a higher risk of preterm delivery than those without hyperandrogenism.

  3. Day 4 good morula embryo transfer provided compatible live birth rate with day 5 blastocyst embryo in fresh IVF/ET cycles.

    Science.gov (United States)

    Li, Ryh-Sheng; Hwu, Yuh-Ming; Lee, Robert Kuo-Kuang; Li, Sheng-Hsiang; Lin, Ming-Huei

    2018-02-01

    Embryo transfers during cleavage stage (day 2 or day 3) and blastocyst stages (day 5 or day 6) are common in current daily practice in fresh IVF/ET cycles. Data regarding transferring day 4 embryos, morula/compact stage, is still restricted and the grading system is also inconsistent, as between IVF clinics. This study provided a new detailed classification system for morula/compact stage embryos and compared successes rates between day 4 and day 5 ET. This was a retrospective study. A review of medical records from January 1st, 2013, to December 31st 2015, performed for all conventional insemination and ICSI cycles with a GnRH-antagonist protocol at the Infertility Division of MacKay Memorial Hospital in Taipei City, Taiwan. There were 427 cycles included in our study, 107 in study group (day 4 MET) and 320 in control group (day 5 BET). Pregnancy rates and live birth rate were compatible, as between morula embryo transfer (MET) and blastocyst embryo transfer (BET). The implantation rate (36.3% vs. 39.6%, respectively, p = 0.500), clinical pregnancy rate (49.5% vs. 51.9%, respectively, p = 0.737), and live birth rate (42.1% vs. 45.6%, respectively, p = 0.574) were statistically insignificant between groups. The term birth rate was statistically higher in the MET group than in the BET group (95.7% vs. 79.5%, respectively, p = 0.006). When the clinical outcomes between day 4 good MET and day 5 good BET were compared, the results were compatible. The implantation rate (48.8% vs. 41.1%, respectively, p = 0.335), clinical pregnancy rate (55.0% vs. 53.2%, respectively, p = 0.867), and live birth rate (47.5% vs. 47.1%, respectively, p = 1.000) showed no significant difference. The term birth rate was also higher in day 4 good MET group than in day 5 good BET group (100% vs. 78.3%, respectively, p = 0.025). In this study, we performed day 4 MET avoid BET on Sunday. The grading system we provided was more detailed for embryo selection and it was easier to

  4. Characteristics and risk factors of preterm births in a tertiary center in Lagos, Nigeria.

    Science.gov (United States)

    Butali, Azeez; Ezeaka, Chinyere; Ekhaguere, Osayame; Weathers, Nancy; Ladd, Jenna; Fajolu, Iretiola; Esezobor, Christopher; Makwe, Christian; Odusanya, Bukola; Anorlu, Rose; Adeyemo, Wasiu; Iroha, Edna; Egri-Okwaji, Mathias; Adejumo, Prisca; Oyeneyin, Lawal; Abiodun, Moses; Badejoko, Bolaji; Ryckman, Kelli

    2016-01-01

    Preterm birth is a dire complication of pregnancy that poses huge long-term medical and financial burdens for affected children, their families, and the health care system. The aim of the present study was to identify characteristics associated with preterm births at the Lagos University Teaching Hospital (LUTH), Lagos, Nigeria from 2011 to 2013. We obtained Information from 5,561 maternal, fetal/neonatal and obstetric records from the labor ward. We excluded delivery at less than 22 weeks (0.25%), post-term birth at ≥42 weeks gestation (1.3%), and unknown gestation (1.4%). Additionally, we excluded records of multiple births (5.4%) and stillbirths (8.3%) leaving 4,691 records of singleton live-births for analysis. Logistic regression analysis was performed comparing preterm birth (22-36 weeks gestation) to term birth (37-41 weeks gestation). Multiple variable models adjusting for maternal age, parity, fetal position, delivery method and booking status were also evaluated. Multinomial regression was used to identify characteristics associated with preterm birth (PTB) defined as early PTB (22-31 weeks gestation), moderate PTB (32-34 weeks gestation), late PTB (35-36 weeks gestation), compared to term birth (37-41 completed weeks gestation). From our data, 16.8% of the singleton live-birth deliveries were preterm (PTBs. Older maternal age (≥35 years) [odds ratio (OR) = 1.41], hypertension (OR = 3.44) and rupture of membranes (OR = 4.03) were significantly associated with increased odds of PTB. Women being treated for the prevention of mother-to-child transmission of HIV were at a significantly decreased risk for PTB (OR = 0.70). Sixteen percent of women in this cohort were not registered for antenatal care in LUTH. These non-registered subjects had significantly greater odds of all categories of PTB, including early (odds ratio (OR) = 20.8), moderate (OR = 8.68), and late (OR = 2.15). PTB and risks for PTB remain high in Nigeria. We recommend that any high risk

  5. Risk factors for the increasing trend in low birth weight among live births born by vaginal delivery, Brazil Fatores de risco para a tendência ascendente do baixo peso ao nascer em nascidos vivos de parto vaginal no Sudeste do Brasil

    Directory of Open Access Journals (Sweden)

    Marco A Barbieri

    2000-12-01

    Full Text Available OBJECTIVE: To identify risk factors for low birth weight (LBW among live births by vaginal delivery and to determine if the disappearance of the association between LBW and socioeconomic factors was due to confounding by cesarean section. METHODS: Data were obtained from two population-based cohorts of singleton live births in Ribeirão Preto, Southeastern Brazil. The first one comprised 4,698 newborns from June 1978 to May 1979 and the second included 1,399 infants born from May to August 1994. The risks for LBW were tested in a logistic model, including the interaction of the year of survey and all independent variables under analysis. RESULTS: The incidence of LBW among vaginal deliveries increased from 7.8% in 1978--79 to 10% in 1994. The risk was higher for: female or preterm infants; newborns of non-cohabiting mothers; newborns whose mothers had fewer prenatal visits or few years of education; first-born infants; and those who had smoking mothers. The interaction of the year of survey with gestational age indicated that the risk of LBW among preterm infants fell from 17.75 to 8.71 in 15 years. The mean birth weight decreased more significantly among newborns from qualified families, who also had the highest increase in preterm birth and non-cohabitation. CONCLUSIONS: LBW among vaginal deliveries increased mainly due to a rise in the proportion of preterm births and non-cohabiting mothers. The association between cesarean section and LBW tended to cover up socioeconomic differences in the likelihood of LBW. When vaginal deliveries were analyzed independently, these socioeconomic differences come up again.OBJETIVO: Identificar fatores de risco para o baixo peso ao nascer (BPN entre nascidos vivos de parto vaginal e verificar se o desaparecimento da associação entre BPN e fatores socioeconômicos foi devido ao confundimento pela cesariana. MÉTODOS: Foram estudadas duas coortes de base populacional de recém-nascidos únicos de parto

  6. Disparities in Birth Weight and Gestational Age by Ethnic Ancestry in South American countries

    Science.gov (United States)

    Wehby, George L.; Gili, Juan A.; Pawluk, Mariela; Castilla, Eduardo E.; López-Camelo, Jorge S.

    2015-01-01

    Objective We examine disparities in birth weight and gestational age by ethnic ancestry in 2000–2011 in eight South American countries. Methods The sample included 60480 singleton live-births. Regression models were estimated to evaluate differences in birth outcomes by ethnic ancestry controlling for time trends. Results Significant disparities were found in seven countries. In four countries – Brazil, Ecuador, Uruguay, and Venezuela – we found significant disparities in both low birth weight and preterm birth. Disparities in preterm birth alone were observed in Argentina, Bolivia, and Colombia. Several differences in continuous birth weight, gestational age, and fetal growth rate were also observed. There were no systematic patterns of disparities between the evaluated ethnic ancestry groups across the study countries, in that no racial/ethnic group consistently had the best or worst outcomes in all countries. Conclusions Racial/ethnic disparities in infant health are common in several South American countries. Differences across countries suggest that racial/ethnic disparities are driven by social and economic mechanisms. Researchers and policymakers should acknowledge these disparities and develop research and policy programs to effectively target them. PMID:25542227

  7. Projecting the potential impact of the Cap-Score™ on clinical pregnancy, live births, and medical costs in couples with unexplained infertility.

    Science.gov (United States)

    Babigumira, Joseph B; Sharara, Fady I; Garrison, Louis P

    2018-01-01

    The Cap-Score™ was developed to assess the capacitation status of men, thereby enabling personalized management of unexplained infertility by choosing timed intrauterine insemination (IUI), versus immediate in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) in individuals with a low Cap-Score™. The objective of this study was to estimate the differences in outcomes and costs comparing the use of the Cap-Score™ with timed IUI (CS-TI) and the standard of care (SOC), which was assumed to be three IUI cycles followed by three IVF-ICSI cycles. We developed and parameterized a decision-analytic model of management of unexplained infertility for women based on data from the published literature. We calculated the clinical pregnancy rates, live birth rates, and medical costs comparing CS-TI and SOC. We used Monte Carlo simulation to quantify uncertainty in projected estimates and performed univariate sensitivity analysis. Compared to SOC, CS-TI was projected to increase the pregnancy rate by 1-26%, marginally reduce live birth rates by 1-3% in couples with women below 40 years, increase live birth rates by 3-7% in couples with women over 40 years, reduce mean medical costs by $4000-$19,200, reduce IUI costs by $600-$1370, and reduce IVF costs by $3400-$17,800, depending on the woman's age. The Cap-Score™ is a potentially valuable clinical tool for management of unexplained infertility because it is projected to improve clinical pregnancy rates, save money, and, depending on the price of the test, increase access to treatment for infertility.

  8. Improving activities of daily living in danish centenarians--but only in women: A comparative study of two birth cohorts born in 1895 and 1905

    DEFF Research Database (Denmark)

    Engberg, Henriette; Christensen, Kaare; Andersen-Ranberg, Karen

    2008-01-01

    ) and Physical Activities of Daily Living (PADLs) were assessed in both cohorts. RESULTS: The 1905 cohort displayed better self-reported ADLs than the 1895 cohort did. Stratified by gender, this apparent cohort advantage was due to women in the 1905 cohort performing significantly better than their female......BACKGROUND: The number of centenarians has increased rapidly since the 1950s. In Denmark, 42% more of the 1905 birth cohort made it to 100 years of age compared to the 1895 cohort. We tested whether this increased survival proportion has resulted in an increased disability level in the more recent...... included all individuals born in Denmark in 1905. At baseline in 1998, a total of 2262 persons participated in the intake survey (63%). In total, 225 of 364 persons (62%) who reached their 100th birthday in the cohort participated in the most recent 2005 wave. Basic Activities of Daily Living (BADLs...

  9. Critical evaluation of national vital statistics: the case of preterm birth trends in Portugal.

    Science.gov (United States)

    Correia, Sofia; Rodrigues, Teresa; Montenegro, Nuno; Barros, Henrique

    2015-11-01

    Using vital statistics, the Portuguese National Health Plan predicts that 14% of live births will be preterm in 2016. The prediction was based on a preterm birth rise from 5.9% in 2000 to 8.8% in 2009. However, the same source showed an actual decline from 2010 onwards. To assess the plausibility of national preterm birth trends, we aimed to compare the evolution of preterm birth and low birthweight rates between vital statistics and a hospital database. A time-trend analysis (2004-2011) of preterm birth (rates was conducted using data on singleton births from the national birth certificates (n = 801,783) and an electronic maternity unit database (n = 21,392). Annual prevalence estimates, ratios of preterm birth:low birthweight and adjusted prevalence ratios were estimated to compare data sources. Although the national prevalence of preterm birth increased from 2004 (5.4%), particularly between 2006 and 2009 (highest rate was 7.5% in 2007), and decreased after 2009 (5.7% in 2011), the prevalence at the maternity unit remained constant. Between 2006 and 2009, preterm birth was almost 1.4 times higher in the national statistics (using the national or the catchment region samples) than in the maternity unit, but no differences were found for low birthweight. Portuguese preterm birth prevalence seems biased between 2006 and 2009, suggesting that early term babies were misclassified as preterm. As civil registration systems are important to support public health decisions, monitoring strategies should be taken to assure good quality data. © 2015 Nordic Federation of Societies of Obstetrics and Gynecology.

  10. Culture media influenced laboratory outcomes but not neonatal birth weight in assisted reproductive technology.

    Science.gov (United States)

    Yin, Tai-lang; Zhang, Yi; Li, Sai-jiao; Zhao, Meng; Ding, Jin-li; Xu, Wang-ming; Yang, Jing

    2015-12-01

    Whether the type of culture media utilized in assisted reproductive technology has impacts on laboratory outcomes and birth weight of newborns in in-vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) was investigated. A total of 673 patients undergoing IVF/ICSI and giving birth to live singletons after fresh embryo transfer on day 3 from Jan. 1, 2010 to Dec. 31, 2012 were included. Three types of culture media were used during this period: Quinn's Advantage (QA), Single Step Medium (SSM), and Continuous Single Culture medium (CSC). Fertilization rate (FR), normal fertilization rate (NFR), cleavage rate (CR), normal cleavage rate (NCR), good-quality embryo rate (GQER) and neonatal birth weight were compared using one-way ANOVA and χ (2) tests. Multiple linear regression analysis was performed to determine the impact of culture media on laboratory outcomes and birth weight. In IVF cycles, GQER was significantly decreased in SSM medium group as compared with QA or CSC media groups (63.6% vs. 69.0% in QA; vs. 71.3% in CSC, P=0.011). In ICSI cycles, FR, NFR and CR were significantly lower in CSC medium group than in other two media groups. No significant difference was observed in neonatal birthweight among the three groups (P=0.759). Multiple linear regression analyses confirmed that the type of culture medium was correlated with FR, NFR, CR and GQER, but not with neonatal birth weight. The type of culture media had potential influences on laboratory outcomes but did not exhibit an impact on the birth weight of singletons in ART.

  11. The associations between birth outcomes and satellite-estimated maternal PM2.5 exposure in Shanghai, China

    Science.gov (United States)

    Xiao, Q.; Liu, Y.; Strickland, M. J.; Chang, H. H.; Kan, H.

    2017-12-01

    Background: Satellite remote sensing data have been employed for air pollution exposure assessment, with the intent of better characterizing exposure spatio-temproal variations. However, non-random missingness in satellite data may lead to exposure error. Objectives: We explored the differences in health effect estimates due to different exposure metrics, with and without satellite data, when analyzing the associations between maternal PM2.5 exposure and birth outcomes. Methods: We obtained birth registration records of 132,783 singleton live births during 2011-2014 in Shanghai. Trimester-specific and total pregnancy exposures were estimated from satellite PM2.5 predictions with missingness, gap-filled satellite PM2.5 predictions with complete coverage and regional average PM2.5 measurements from monitoring stations. Linear regressions estimated associations between birth weight and maternal PM2.5 exposure. Logistic regressions estimated associations between preterm birth and the first and second trimester exposure. Discrete-time models estimated third trimester and total pregnancy associations with preterm birth. Effect modifications by maternal age and parental education levels were investigated. Results: we observed statistically significant associations between maternal PM2.5 exposure during all exposure windows and adverse birth outcomes. A 10 µg/m3 increase in pregnancy PM2.5 exposure was associated with a 12.85 g (95% CI: 18.44, 7.27) decrease in birth weight for term births, and a 27% (95% CI: 20%, 36%) increase in the risk of preterm birth. Greater effects were observed between first and third trimester exposure and birth weight, as well as between first trimester exposure and preterm birth. Mothers older than 35 years and without college education tended to have higher associations with preterm birth. Conclusions: Gap-filled satellite data derived PM2.5 exposure estimates resulted in reduced exposure error and more precise health effect estimates.

  12. Cesarean Section Rate in Singleton Primiparae and Related Factors in Beijing, China.

    Science.gov (United States)

    Song, Geng; Wei, Yu-Mei; Zhu, Wei-Wei; Yang, Hui-Xia

    2017-10-20

    The cesarean section rate (CSR) has been a main concern worldwide. The present study aimed to investigate the CSR in Beijing, China, and to analyze the related factors of CS delivery. An observational study was conducted in 15 medical centers in Beijing using a systemic cluster sampling method. In total, 15,194 pregnancies were enrolled in the study between June 20, 2013 and November 30, 2013. Independent t-tests and Pearson's Chi-square test were used to examine differences between two groups, and related factors of the CSR were examined by multivariable logistic regression. The CSR was 41.9% (4471/10,671) in singleton primiparae. Women who were more than 35 years old had a 7.4-fold increased risk of CS delivery compared with women level. Neonates weighing 3000-3499 g had the lowest CSR (36.2%). Neonates weighing levels, residence, education level, and singleton fetal birth weight are all factors that might significantly affect the CSR.

  13. Time-lapse culture with morphokinetic embryo selection improves pregnancy and live birth chances and reduces early pregnancy loss: a meta-analysis.

    Science.gov (United States)

    Pribenszky, Csaba; Nilselid, Anna-Maria; Montag, Markus

    2017-11-01

    Embryo evaluation and selection is fundamental in clinical IVF. Time-lapse follow-up of embryo development comprises undisturbed culture and the application of the visual information to support embryo evaluation. A meta-analysis of randomized controlled trials was carried out to study whether time-lapse monitoring with the prospective use of a morphokinetic algorithm for selection of embryos improves overall clinical outcome (pregnancy, early pregnancy loss, stillbirth and live birth rate) compared with embryo selection based on single time-point morphology in IVF cycles. The meta-analysis of five randomized controlled trials (n = 1637) showed that the application of time-lapse monitoring was associated with a significantly higher ongoing clinical pregnancy rate (51.0% versus 39.9%), with a pooled odds ratio of 1.542 (P loss (15.3% versus 21.3%; OR: 0.662; P = 0.019) and a significantly increased live birth rate (44.2% versus 31.3%; OR 1.668; P = 0.009). Difference in stillbirth was not significant between groups (4.7% versus 2.4%). Quality of the evidence was moderate to low owing to inconsistencies across the studies. Selective application and variability were also limitations. Although time-lapse is shown to significantly improve overall clinical outcome, further high-quality evidence is needed before universal conclusions can be drawn. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  14. Antimüllerian hormone as a predictor of live birth following assisted reproduction: an analysis of 85,062 fresh and thawed cycles from the Society for Assisted Reproductive Technology Clinic Outcome Reporting System database for 2012-2013.

    Science.gov (United States)

    Tal, Reshef; Seifer, David B; Wantman, Ethan; Baker, Valerie; Tal, Oded

    2018-02-01

    To determine if serum antimüllerian hormone (AMH) is associated with and/or predictive of live birth assisted reproductive technology (ART) outcomes. Retrospective analysis of Society for Assisted Reproductive Technology Clinic Outcome Reporting System database from 2012 to 2013. Not applicable. A total of 69,336 (81.8%) fresh and 15,458 (18.2%) frozen embryo transfer (FET) cycles with AMH values. None. Live birth. A total of 85,062 out of 259,499 (32.7%) fresh and frozen-thawed autologous non-preimplantation genetic diagnosis cycles had AMH reported for cycles over this 2-year period. Of those, 70,565 cycles which had embryo transfers were included in the analysis. Serum AMH was significantly associated with live birth outcome per transfer in both fresh and FET cycles. Multiple logistic regression demonstrated that AMH is an independent predictor of live birth in fresh transfer cycles and FET cycles when controlling for age, body mass index, race, day of transfer, and number of embryos transferred. Receiver operating characteristic (ROC) curves demonstrated that the areas under the curve (AUC) for AMH as predictors of live birth in fresh cycles and thawed cycles were 0.631 and 0.540, respectively, suggesting that AMH alone is a weak independent predictor of live birth after ART. Similar ROC curves were obtained also when elective single-embryo transfer (eSET) cycles were analyzed separately in either fresh (AUC 0.655) or FET (AUC 0.533) cycles, although AMH was not found to be an independent predictor in eSET cycles. AMH is a poor independent predictor of live birth outcome in either fresh or frozen embryo transfer for both eSET and non-SET transfers. Copyright © 2017 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  15. Maternal residential exposure to agricultural pesticides and birth defects in a 2003 to 2005 North Carolina birth cohort.

    Science.gov (United States)

    Rappazzo, Kristen M; Warren, Joshua L; Meyer, Robert E; Herring, Amy H; Sanders, Alison P; Brownstein, Naomi C; Luben, Thomas J

    2016-04-01

    Birth defects are responsible for a large proportion of disability and infant mortality. Exposure to a variety of pesticides have been linked to increased risk of birth defects. We conducted a case-control study to estimate the associations between a residence-based metric of agricultural pesticide exposure and birth defects. We linked singleton live birth records for 2003 to 2005 from the North Carolina (NC) State Center for Health Statistics to data from the NC Birth Defects Monitoring Program. Included women had residence at delivery inside NC and infants with gestational ages from 20 to 44 weeks (n = 304,906). Pesticide exposure was assigned using a previously constructed metric, estimating total chemical exposure (pounds of active ingredient) based on crops within 500 meters of maternal residence, specific dates of pregnancy, and chemical application dates based on the planting/harvesting dates of each crop. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals for four categories of exposure (90(th) percentiles) compared with unexposed. Models were adjusted for maternal race, age at delivery, education, marital status, and smoking status. We observed elevated ORs for congenital heart defects and certain structural defects affecting the gastrointestinal, genitourinary and musculoskeletal systems (e.g., OR [95% confidence interval] [highest exposure vs. unexposed] for tracheal esophageal fistula/esophageal atresia = 1.98 [0.69, 5.66], and OR for atrial septal defects: 1.70 [1.34, 2.14]). Our results provide some evidence of associations between residential exposure to agricultural pesticides and several birth defects phenotypes. Birth Defects Research (Part A) 106:240-249, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  16. Construction of a specification from its singleton part

    NARCIS (Netherlands)

    Fernández, R.; Maillard, G.

    2006-01-01

    We state a construction theorem for specications starting from single-site conditional probabilities (singleton part). We consider general single-site spaces and kernels that are absolutely continuous with respect to a chosen product mea- sure (free measure). Under a natural order-consistency

  17. Pregnancy outcome in singleton term breeches from a referral ...

    African Journals Online (AJOL)

    It is recommended that attention should be given to trainee obstetrician in selective external cephalic version at term and also the procedure of AVBD so as to reduce the caesarean section rate and also neonatal morbidity in term breeches in our community. Keywords: Pregnancy outcome, Singleton breech, Vaginal ...

  18. Pulmonary function in advanced uncomplicated singleton and twin pregnancy

    Directory of Open Access Journals (Sweden)

    Anwar Hasan Siddiqui

    2014-06-01

    Full Text Available Objective: Pregnancy brings about significant changes in respiratory function, as evidenced by alterations in lung volumes and capacities, which are attributable to the mechanical impediment caused by the growing foetus. This study was undertaken in order to identify changes in respiratory function during normal pregnancy and to determine whether such changes are more pronounced in twin pregnancy than in singleton pregnancy. Methods: Respiratory function was assessed in 50 women with twin pregnancies and in 50 women with singleton pregnancies (during the third trimester in both groups, as well as in 50 non-pregnant women. We measured the following pulmonary function test parameters: FVC; FEV1; PEF rate; FEV1/FVC ratio; FEF25-75%; and maximal voluntary ventilation. Results: All respiratory parameters except the FEV1/FVC ratio were found to be lower in the pregnant women than in the non-pregnant women. We found no significant differences between women with twin pregnancies and those with singleton pregnancies, in terms of respiratory function. Conclusions: Despite its higher physiological demands, twin pregnancy does not appear to impair respiratory function to any greater degree than does singleton pregnancy.

  19. Pulmonary function in advanced uncomplicated singleton and twin pregnancy.

    Science.gov (United States)

    Siddiqui, Anwar Hasan; Tauheed, Nazia; Ahmad, Aquil; Mohsin, Zehra

    2014-01-01

    Pregnancy brings about significant changes in respiratory function, as evidenced by alterations in lung volumes and capacities, which are attributable to the mechanical impediment caused by the growing foetus. This study was undertaken in order to identify changes in respiratory function during normal pregnancy and to determine whether such changes are more pronounced in twin pregnancy than in singleton pregnancy. Respiratory function was assessed in 50 women with twin pregnancies and in 50 women with singleton pregnancies (during the third trimester in both groups), as well as in 50 non-pregnant women. We measured the following pulmonary function test parameters: FVC; FEV1; PEF rate; FEV1/FVC ratio; FEF25-75%; and maximal voluntary ventilation. All respiratory parameters except the FEV1/FVC ratio were found to be lower in the pregnant women than in the non-pregnant women. We found no significant differences between women with twin pregnancies and those with singleton pregnancies, in terms of respiratory function. Despite its higher physiological demands, twin pregnancy does not appear to impair respiratory function to any greater degree than does singleton pregnancy.

  20. Auditory Attentional Capture: Effects of Singleton Distractor Sounds

    Science.gov (United States)

    Dalton, Polly; Lavie, Nilli

    2004-01-01

    The phenomenon of attentional capture by a unique yet irrelevant singleton distractor has typically been studied in visual search. In this article, the authors examine whether a similar phenomenon occurs in the auditory domain. Participants searched sequences of sounds for targets defined by frequency, intensity, or duration. The presence of a…

  1. The rising home birth trend in America

    OpenAIRE

    Nurlan Aliyev; Chastidy Roldan; Bulent Cakmak

    2015-01-01

    In recent years home birth rates are increased in the whole world, mainly in the United States (US). Between 2004-2012, non-hospital births increasing rate is 89% in the US. Home birth increased especially among the married, non-Hispanic, over 35 years of age, multipar and singleton pregnancies. However the high rate of cesarean birth did not increase in recent years in the US, now it has been stable at 32%. It is reported that the stability of the cesarean rate is related to rising rate of h...

  2. Increased risk of large-for-gestational age birthweight in singleton siblings conceived with in vitro fertilization in frozen versus fresh cycles.

    Science.gov (United States)

    Luke, Barbara; Brown, Morton B; Wantman, Ethan; Stern, Judy E; Toner, James P; Coddington, Charles C

    2017-02-01

    Children born from fresh in vitro fertilization (IVF) cycles are at greater risk of being born smaller and earlier, even when limited to singletons; those born from frozen cycles have an increased risk of large-for-gestational age (LGA) birthweight (z-score ≥1.28). This analysis sought to overcome limitations in other studies by using pairs of siblings, and accounting for prior cycle outcomes, maternal characteristics, and embryo state and stage. Pairs of singleton births conceived with IVF and born between 2004 and 2013 were identified from the Society for Assisted Reproductive Technology Clinic Outcome Reporting System database, matched for embryo stage (blastocyst versus non-blastocyst) and infant gender, categorized by embryo state (fresh versus frozen) in 1st and 2nd births (four groups). The data included 7795 singleton pairs. Birthweight z-scores were 0.00-0.04 and 0.24-0.26 in 1st and 2nd births in fresh cycles, and 0.25-0.34 and 0.50-0.55 in frozen cycles, respectively. LGA was 9.2-9.8 and 14.2-15.4% in 1st and 2nd births in fresh cycles, and 13.1-15.8 and 20.8-21.0% in 1st and 2nd births in frozen cycles. The risk of LGA was increased in frozen cycles (1st births, adjusted odds ratios (AOR) 1.74, 95% CI 1.45, 2.08; and in 2nd births when the 1st birth was not LGA, AOR 1.70, 95% CI 1.46, 1.98 for fresh/frozen and 1.40, 1.11, 1.78 for frozen/frozen). Our results with siblings indicate that frozen embryo state is associated with an increased risk for LGA. The implications of these findings for childhood health and risk of obesity are unclear, and warrant further investigation.

  3. Endometrial thickness significantly affects clinical pregnancy and live birth rates in frozen-thawed embryo transfer cycles.

    Science.gov (United States)

    Bu, Zhiqin; Wang, Keyan; Dai, Wei; Sun, Yingpu

    2016-07-01

    In order to explore the relationship between endometrial thickness on the day of embryo transfer and pregnancy outcomes in frozen-thawed embryo transfer (FET) cycles, we retrospectively analyzed data from 2997 patients undergoing their first FET cycles from January 2010 to December 2012. All patients were divided into three groups (Group A, ≤8 mm; Group B, 9-13 mm; Group C, ≥14 mm) according to the endometrial thickness on embryo transfer day. Compared with patients in the other two groups, patients with thin endometrial thickness in Group A had significantly lower clinical pregnancy rate (33.4%, 41.3% and 45.4%, p birth rate (23.8%, 32.2% and 34.0%, p confidence interval (CI): 1.10-1.77, p birth rate (aOR: 1.50; 95% CI: 1.16-1.95, p < 0.01) were significant. We conclude that for patients undergoing FET, endometrial thickness on the embryo transfer day significantly affects IVF outcomes in cleavage embryo transfer cycles independent of other factors.

  4. Birth characteristics of Syrian refugees and Turkish citizens in Turkey in 2015.

    Science.gov (United States)

    Demirci, Hakan; Yildirim Topak, Nevruz; Ocakoglu, Gokhan; Karakulak Gomleksiz, Mehtap; Ustunyurt, Emin; Ulku Turker, Ayse

    2017-04-01

    To compare the birth characteristics of Syrian refugees with those of Turkish citizens. In a retrospective study, data were obtained for singleton live births that occurred at a hospital in Bursa, Turkey, between June 1 and December 31, 2015. All Syrian refugees were eligible for inclusion; one Turkish citizen was included for each refugee. Overall, 545 Syrian refugees and 545 Turkish citizens were included. Cesarean delivery was undertaken for 176 (32.3%) Syrians and 235 (43.1%) Turks (PSyrian refugees (3110 g, range 540-4790; PSyrian refugees (PSyrians (P=0.014). Cesarean delivery is more common among pregnant Turkish citizens than among Syrian refugees. Other notable differences between the groups were recorded. © 2016 International Federation of Gynecology and Obstetrics.

  5. Optimal fetal growth for the Caucasian singleton and assessment of appropriateness of fetal growth: an analysis of a total population perinatal database

    Directory of Open Access Journals (Sweden)

    Lawrence David M

    2005-05-01

    Full Text Available Abstract Background The appropriateness of an individual's intra uterine growth is now considered an important determinant of both short and long term outcomes, yet currently used measures have several shortcomings. This study demonstrates a method of assessing appropriateness of intrauterine growth based on the estimation of each individual's optimal newborn dimensions from routinely available perinatal data. Appropriateness of growth can then be inferred from the ratio of the value of the observed dimension to that of the optimal dimension. Methods Fractional polynomial regression models including terms for non-pathological determinants of fetal size (gestational duration, fetal gender and maternal height, age and parity were used to predict birth weight, birth length and head circumference from a population without any major risk factors for sub-optimal intra-uterine growth. This population was selected from a total population of all singleton, Caucasian births in Western Australia 1998–2002. Births were excluded if the pregnancy was exposed to factors known to influence fetal growth pathologically. The values predicted by these models were treated as the optimal values, given infant gender, gestational age, maternal height, parity, and age. Results The selected sample (N = 62,746 comprised 60.5% of the total Caucasian singleton birth cohort. Equations are presented that predict optimal birth weight, birth length and head circumference given gestational duration, fetal gender, maternal height, age and parity. The best fitting models explained 40.5% of variance for birth weight, 32.2% for birth length, and 25.2% for head circumference at birth. Conclusion Proportion of optimal birth weight (length or head circumference provides a method of assessing appropriateness of intrauterine growth that is less dependent on the health of the reference population or the quality of their morphometric data than is percentile position on a birth weight

  6. Sex ratio at birth: scenario from normal- and high-level natural radiation areas of Kerala coast in south-west India

    International Nuclear Information System (INIS)

    Koya, P.K.M.; Jaikrishan, G.; Sudheer, K.R.; Madhusoodhanan, M.; Jagadeesan, C.K.; Das, Birajalaxmi; Andrews, V.J.

    2015-01-01

    Newborns were monitored for congenital malformations in four government hospitals located in high-level (ambient dose >1.5 mGy/year) and normal-level (≤1.5 mGy/year) natural radiation areas of Kerala, India, from August 1995 to December 2012. Sex ratio at birth (SRB) among live singleton newborns and among previous children, if any, of their mothers without history of any abortion, stillbirth or twins is reported here. In the absence of environmental stress or selective abortion of females, global average of SRB is about 1050 males to 1000 females. A total of 151,478 singleton, 1031 twins, 12 triplets and 1 quadruplet deliveries were monitored during the study period. Sex ratio among live singleton newborns was 1046 males (95 % CI 1036-1057) for 1000 females (77,153 males:73,730 females) and was comparable to the global average. It was similar in high-level and normal-level radiation areas of Kerala with SRB of 1050 and 1041, respectively. It was consistently more than 1000 and had no association with background radiation levels, maternal and paternal age at birth, parental age difference, gravida status, ethnicity, consanguinity or year of birth. Analysis of SRB of the children of 139,556 women whose reproductive histories were available suggested that couples having male child were likely to opt for more children and this, together with enhanced rate of males at all birth order, was skewing the overall SRB in favour of male children. Though preference for male child was apparent, extreme steps of sex-selective abortion or infanticide were not prevalent. (orig.)

  7. Sex ratio at birth: scenario from normal- and high-level natural radiation areas of Kerala coast in south-west India

    Energy Technology Data Exchange (ETDEWEB)

    Koya, P.K.M.; Jaikrishan, G.; Sudheer, K.R. [Bhabha Atomic Research Centre, Low Level Radiation Research Laboratory, Low Level Radiation Research Section, Radiation Biology and Health Sciences Division, Bio-Science Group, Kollam (India); Madhusoodhanan, M. [Victoria Hospital, Department of Paediatrics, Kollam (India); Jagadeesan, C.K. [Directorate of Health Services, Thiruvananthapuram (India); Das, Birajalaxmi [Bhabha Atomic Research Centre, Low Level Radiation Research Section, Radiation Biology and Health Sciences Division, Bio-Science Group, Mumbai (India); Andrews, V.J.

    2015-11-15

    Newborns were monitored for congenital malformations in four government hospitals located in high-level (ambient dose >1.5 mGy/year) and normal-level (≤1.5 mGy/year) natural radiation areas of Kerala, India, from August 1995 to December 2012. Sex ratio at birth (SRB) among live singleton newborns and among previous children, if any, of their mothers without history of any abortion, stillbirth or twins is reported here. In the absence of environmental stress or selective abortion of females, global average of SRB is about 1050 males to 1000 females. A total of 151,478 singleton, 1031 twins, 12 triplets and 1 quadruplet deliveries were monitored during the study period. Sex ratio among live singleton newborns was 1046 males (95 % CI 1036-1057) for 1000 females (77,153 males:73,730 females) and was comparable to the global average. It was similar in high-level and normal-level radiation areas of Kerala with SRB of 1050 and 1041, respectively. It was consistently more than 1000 and had no association with background radiation levels, maternal and paternal age at birth, parental age difference, gravida status, ethnicity, consanguinity or year of birth. Analysis of SRB of the children of 139,556 women whose reproductive histories were available suggested that couples having male child were likely to opt for more children and this, together with enhanced rate of males at all birth order, was skewing the overall SRB in favour of male children. Though preference for male child was apparent, extreme steps of sex-selective abortion or infanticide were not prevalent. (orig.)

  8. [The influence of previous pregnancy terminations, miscarriages and still-births on the incidence of babies with low birth weight and premature births as well as a somatic classification of newborns].

    Science.gov (United States)

    Voigt, M; Olbertz, D; Fusch, C; Krafczyk, D; Briese, V; Schneider, K T M

    2008-02-01

    The influence of previous interruptions, miscarriages and IUFD on the IUGR and preterm rate as well as on the somatic staging (gestational age and birth weight) of the new born is a subject of controversial discussion in the literature. The present paper attempts to quantify these risks of the medical history. 2 282 412 singleton pregnancies of the period 1995 to 2000 were evaluated from the German Perinatal Database. For the analysis 1 065 202 pregnancies (46.7 %) of those mothers without any live birth in the medical history were assessed. To exclude any influence from previous abortions patients with previous miscarriages and IUFDs were excluded. The control collective were new borns whose mothers had suffered neither from miscarriages nor from abortions or IUFD. Previous interruptions, miscarriages and IUFD influence the rate of new borns with low birth weight and increase the rate of prematurity. With increasing numbers of isolated or combined risks in the medical history, the rate of newborns with a low birth weight or with prematurity is increased. The lowest risk was found after one interruption, the highest rate with two or more IUFDs. Interruptions, miscarriages or IUFD are not risk factors for IUGR or SGA. Previous interruptions, miscarriages and IUFD are relevant risk factors for prematurity and are related with low birth weight of the new borns. Pregnant women with such risk factors have to been considered as risk pregnancies and need intensive surveillance.

  9. Replacing single frozen-thawed euploid embryos in a natural cycle in ovulatory women may increase live birth rates compared to medicated cycles in anovulatory women.

    Science.gov (United States)

    Melnick, Alexis P; Setton, Robert; Stone, Logan D; Pereira, Nigel; Xu, Kangpu; Rosenwaks, Zev; Spandorfer, Steven D

    2017-10-01

    The goal of this study was to compare pregnancy outcomes between natural frozen embryo transfer (FET) cycles in ovulatory women and programmed FET cycles in anovulatory women after undergoing in vitro fertilization with preimplantation genetic screening (IVF-PGS). This was a retrospective cohort study performed at an academic medical center. Patients undergoing single FET IVF-PGS cycles between October 2011 and December 2014 were included. Patients were stratified by type of endometrial replacement: programmed cycles with estrogen/progesterone replacement and natural cycles. IVF-PGS with 24-chromosome screening was performed on all included patients. Those patients with euploid embryos had single embryo transfer in a subsequent FET. The primary study outcome was live birth/ongoing pregnancy rate. Secondary outcomes included implantation, biochemical pregnancy, and miscarriage rates. One hundred thirteen cycles met inclusion criteria: 65 natural cycles and 48 programmed cycles. The programmed FET group was younger (35.9 ± 4.5 vs. 37.5 ± 3.7, P = 0.03) and had a higher AMH (3.95 ± 4.2 vs. 2.37 ± 2.4, P = 0.045). The groups were similar for BMI, gravidity, parity, history of uterine surgery, and incidence of Asherman's syndrome. There was also no difference in embryo grade at biopsy or transfer, and proportion of day 5 and day 6 transfers. Implantation rates were higher in the natural FET group (0.66 ± 0.48 vs. 0.44 ± 0.50, P = 0.02). There was no difference in the rates of biochemical pregnancy or miscarriage. After controlling for age, live birth/ongoing pregnancy rate was higher in natural FETs with an adjusted odds ratio of 2.68 (95% CI 1.22-5.87). Natural FET in ovulatory women after IVF-PGS is associated with increased implantation and live birth rates compared to programmed FET in anovulatory women. Further investigation is needed to determine whether these findings hold true in other patient cohorts.

  10. Cumulative live birth rates after one ART cycle including all subsequent frozen-thaw cycles in 1050 women

    DEFF Research Database (Denmark)

    Toftager, M; Bogstad, J; Løssl, K

    2017-01-01

    birth increases. There are no previous randomized controlled trials (RCTs) comparing CLBRs in GnRH-antagonist versus GnRH-agonist protocols. Previous studies on CLBR are either retrospective cohort studies including multiple fresh cycles or RCTs comparing single embryo transfer (SET) with double embryo...... transfer (DET). STUDY DESIGN, SIZE, DURATION: CLBR was a secondary outcome in a Phase IV, dual-center, open-label, RCT including 1050 women allocated to a short GnRH-antagonist or a long GnRH-agonist protocol in a 1:1 ratio over a 5-year period using a web-based concealed randomization code. The minimum...... follow-up time from the first IVF cycle was 2 years. The aim was to compare CLBR between the two groups following utilization of all fresh and frozen embryos from the first ART cycle. PARTICIPANTS/MATERIALS, SETTING, METHODS: All women referred for their first ART cycle at two public fertility clinics...

  11. Socioeconomic inequalities in very preterm birth rates.

    Science.gov (United States)

    Smith, L K; Draper, E S; Manktelow, B N; Dorling, J S; Field, D J

    2007-01-01

    To investigate the extent of socioeconomic inequalities in the incidence of very preterm birth over the past decade. Ecological study of all 549 618 births in the former Trent health region, UK, from 1 January 1994 to 31 December 2003. All singleton births of 22(+0) to 32(+6) weeks gestation (7 185 births) were identified from population surveys of neonatal services and stillbirths. Poisson regression was used to calculate incidence of very preterm birth (22-32 weeks) and extremely preterm birth (22-28 weeks) by year of birth and decile of deprivation (child poverty section of the Index of Multiple Deprivation). Incidence of very preterm singleton birth rose from 11.9 per 1000 births in 1994 to 13.7 per 1000 births in 2003. Those from the most deprived decile were at nearly twice the risk of very preterm birth compared with those from the least deprived decile, with 16.4 per 1000 births in the most deprived decile compared with 8.5 per 1000 births in the least deprived decile (incidence rate ratio 1.94; 95% CI (1.73 to 2.17)). This deprivation gap remained unchanged throughout the 10-year period. The magnitude of socio-economic inequalities was the same for extremely preterm births (22-28 weeks incidence rate ratio 1.94; 95% CI (1.62 to 2.32)). This large, unique dataset of very preterm births shows wide socio-economic inequalities that persist over time. These findings are likely to have consequences on the burden of long-term morbidity. Our research can assist future healthcare planning, the monitoring of socio-economic inequalities and the targeting of interventions in order to reduce this persistent deprivation gap.

  12. Birth weight discordance and perinatal mortality among triplets

    Directory of Open Access Journals (Sweden)

    Egić Amira

    2005-01-01

    Full Text Available INTRODUCTION. The incidence of multiple births has increased in the last decade. Perinatal mortality in triplets is significantly greater than in twin and singleton births. OBJECTIVE. The objective of this study was to describe the extent of birth weight discordance among triplets and to identify its association with an increased risk of perinatal mortality. METHOD A retrospective analysis of triplet births, for the period 1993-2003, was conducted at the Gynaecological-Obstetric Clinic "Narodni Front" in Belgrade. Birth weight discordance was defined as the difference in birth weight between the largest and the smallest triplet's weight of more than 20%. RESULTS. The rate of triplets has increased by almost 75% between the first (7.7% and the last (29.6% 5-year period of the last decade. Triplets are becoming more common because of the frequent use of assisted reproductive technology as a treatment for infertility. In the period 1993-2003, there were a total of 40 triplet live births (24 weeks and greater with incidence of 0.06%. There was no clear association between maternal age, parity, method of conception, birth gestational age, and disorders complicating pregnancy with birth discordance more than 20%. Regarding birth weight groups, statistical significance occurred only in the <999 grams group for discordant and in the 2000-2499 grams group for concordant triplets. Overall, the perinatal mortality rate in the group was 10.8%, the foetal mortality rate was 1.7% (2/120, and the neonatal (0-28 days mortality rate was 9.1% (11/120. An odds ratio of 95% confidence interval shows 3 times greater risk for adverse perinatal outcome in the discordant group. However, the difference was not significant. CONCLUSION. Increasing birth weight discordance may increase the risk of adverse perinatal outcome. Triplet pregnancies, being high risk, require intensive antenatal care in order to prevent preterm delivery and ultrasound in order to diagnose foetal

  13. Multivariate analysis of factors affecting probability of pregnancy and live birth with in vitro fertilization: an analysis of the Society for Assisted Reproductive Technology Clinic Outcomes Reporting System.

    Science.gov (United States)

    Baker, Valerie L; Luke, Barbara; Brown, Morton B; Alvero, Ruben; Frattarelli, John L; Usadi, Rebecca; Grainger, David A; Armstrong, Alicia Y

    2010-09-01

    To evaluate factors predictive of clinical pregnancy and of pregnancy loss from assisted reproductive technology (ART) using data from the Society for Assisted Reproductive Technology database for 2004-2006. Retrospective cohort. Clinic-based data. The study population included 225,889 fresh embryo transfer cycles using autologous oocytes and partner semen. None. Clinical intrauterine gestation (presence of gestational sac) and live birth (>or=22 weeks gestation and >or=300 g birth weight). Increasing maternal age was significantly associated with a reduced odds of conception and increased fetal loss until 19 weeks gestation, but not with later pregnancy loss. Intracytoplasmic sperm injection (ICSI), assisted hatching, and increasing number of embryos transferred had significant positive effects on the odds of conception and pregnancy continuation through the first trimester, but did not affect the risk of later loss. Blacks, Asians, and Hispanics had significantly lower odds of clinical pregnancy compared with whites. Also compared with whites, Hispanics and Asians had a significantly greater risk of pregnancy loss in the second and third trimesters, and blacks had a significantly greater risk of pregnancy loss in all trimesters. Certain demographic and ART treatment parameters influenced chance of conception and early pregnancy loss, whereas black race and Hispanic ethnicity were also significantly associated with late pregnancy loss in ART-conceived pregnancies. Copyright (c) 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  14. Use of complementary and alternative medicines associated with a 30% lower ongoing pregnancy/live birth rate during 12 months of fertility treatment

    DEFF Research Database (Denmark)

    Boivin, J; Schmidt, L

    2009-01-01

    BACKGROUND There seems to be little discussion between patient and physician about the use of complementary and alternative medicines (CAMs), perhaps because they are not perceived to have adverse effects on fertility. We therefore compared ongoing pregnancy and live birth rate in spontaneous users......, years infertile). CONCLUSIONS Concurrent use of CAM during treatment with ART was associated with a 30% lower pregnancy rate that could not be explained by poor prognosis or life style factors. The mechanisms that could account for this association were discussed. Concurrent CAM use should be monitored...... women about to have ART for the first time completed self-report assessments prior to treatment (Time 1, T1) and at 12-month follow-up (Time 2, T2). Data from treatment records were also available for n = 590. RESULTS About 30.6% (n = 223) of women used CAMs during the observation period. At T2...

  15. Live birth after rescue in vitro maturation–intracytoplasmic sperm injection in type 1 diabetes, polycystic ovary syndrome patient using clomiphene–antagonist protocol

    Directory of Open Access Journals (Sweden)

    Samundi Sankari

    2018-01-01

    Full Text Available Infertility in patients with polycystic ovary syndrome (PCOS associated with diabetes leads to challenging situations seeking alternative treatments. In vitro maturation (IVM followed by intracytoplasmic sperm injection (ICSI could overcome the challenges with promising pregnancies in such patients. In the treatment of a 32-year-old diabetic woman who also had PCOS, single immature oocyte was retrieved. Rescue IVM followed by ICSI yielded a grade 1 day 3 embryo which on transferring resulted in pregnancy and a healthy infant was delivered. Rescue IVM–ICSI could help in achieving pregnancy and live birth. Stimulation involving clomiphene and gonadotropin-releasing hormone antagonist is an effective and patient-friendly protocol for women with PCOS and diabetes and also for poor responders.

  16. Impact of GnRH agonist triggering and intensive luteal steroid support on live-birth rates and ovarian hyperstimulation syndrome

    DEFF Research Database (Denmark)

    Iliodromiti, Stamatina; Lan, Vuong Thi Ngoc; Tuong, Ho Manh

    2013-01-01

    Conventional luteal support packages are inadequate to facilitate a fresh transfer after GnRH agonist (GnRHa) trigger in patients at high risk of developing ovarian hyperstimulation syndrome (OHSS). By providing intensive luteal-phase support with oestradiol and progesterone satisfactory implanta......Conventional luteal support packages are inadequate to facilitate a fresh transfer after GnRH agonist (GnRHa) trigger in patients at high risk of developing ovarian hyperstimulation syndrome (OHSS). By providing intensive luteal-phase support with oestradiol and progesterone satisfactory...... implantation rates can be sustained. The objective of this study was to assess the live-birth rate and incidence of OHSS after GnRHa trigger and intensive luteal steroid support compared to traditional hCG trigger and conventional luteal support in OHSS high risk Asian patients....

  17. Perfil dos nascidos vivos no Município de Belo Horizonte, 1992-1994 Profile of live births in Belo Horizonte, 1992-1994

    Directory of Open Access Journals (Sweden)

    Celeste de Souza Rodrigues

    1997-01-01

    Full Text Available O Sistema de Informações sobre Nascidos Vivos ­ Sinasc ­ foi desenvolvido pelo Ministério da Saúde, objetivando a melhoria da qualidade das informações sobre estas crianças, no Brasil, e vem sendo usado no Município de Belo Horizonte, efetivamente, desde 1992. Com o objetivo de caracterizar as crianças nascidas vivas e permitir a utilização dos dados para subsidiar o planejamento, organização e avaliação de ações de saúde desenvolvidas, foi analisada a distribuição destas, através de todas as Declarações de Nascidos Vivos ­ DN, de mães residentes em Belo Horizonte, 1992/94, segundo características relativas ao parto,à gravidez e à mãe. Concluiu-se haver necessidade de estudos que aprofundem a análise da morbi-mortalidade materna e infantil e os custos das internações por partos operatórios, por uma atenção especial às adolescentes, além de acompanhamento pré-natal de boa qualidade para todas as gestantes. O Sinasc é um instrumento poderoso de informações rotineiras, devendo ser aprimorado e o seu uso difundido, incluindo a possibilidade não só de cruzamento de dados com os de outros sistemas, especialmente o SIM (Sistema de Informação sobre Mortalidade e o banco de dados de AIH (Autorização para Internação Hospitalar, como também de sua utilização para intervenções específicas e diferenciadas em determinados grupos populacionais e microáreas de risco.The Information System on Live Births - SINASC - was developed by the Health Ministry and designed to improve quality of information on live births in Brazil. It has been effectively used in Belo Horizonte since 1992. The distribution of live births was analysed in order to characterise them and to allow use of existing data to support planning, organisation and evaluation of the health activities developed. It was conducted by using Declarations of Live Births of newborns of mothers resident in Belo Horizonte, in the period 1992-1994, in

  18. Stress-tensor commutators and Schwinger terms in singleton theories

    International Nuclear Information System (INIS)

    Bergshoeff, E.; Sezgin, E.; Tanii, Y.

    1989-06-01

    We compute the commutators of the regularized quantum stress-tensor of singleton theories formulated on the boundary of a (p + 2)-dimensional anti de Sitter space (AdS p+2 ). (These are superconformal field theories on S p x S 1 ). We find that the algebra is not closed except in the case of AdS 3 . It does contain, however, the finite dimensional AdS p+2 algebra SO(p + 1,2). We also find divergent, field dependent as well as field independent Schwinger terms (i.e. the central extensions), which, however, do not lead to anomalies in the algebra of the AdS charges. We also give a simple derivation of the two-point functions for bosonic and fermionic singletons. (author). 15 refs

  19. Oculomotor capture by colour singletons depends on intertrial priming.

    Science.gov (United States)

    Becker, Stefanie I

    2010-10-12

    In visual search, an irrelevant colour singleton captures attention when the colour of the distractor changes across trials (e.g., from red to green), but not when the colour remains constant (Becker, 2007). The present study shows that intertrial changes of the distractor colour also modulate oculomotor capture: an irrelevant colour singleton distractor was only selected more frequently than the inconspicuous nontargets (1) when its features had switched (compared to the previous trial), or (2) when the distractor had been presented at the same position as the target on the previous trial. These results throw doubt on the notion that colour distractors capture attention and the eyes because of their high feature contrast, which is available at an earlier point in time than information about specific feature values. Instead, attention and eye movements are apparently controlled by a system that operates on feature-specific information, and gauges the informativity of nominally irrelevant features. Copyright © 2010 Elsevier Ltd. All rights reserved.

  20. Mortality among twins and singletons in sub-Saharan Africa between 1995 and 2014: a pooled analysis of data from 90 Demographic and Health Surveys in 30 countries.

    Science.gov (United States)

    Monden, Christiaan W S; Smits, Jeroen

    2017-07-01

    Sub-Saharan Africa has the world's highest under-5 and neonatal mortality rates as well as the highest naturally occurring twin rates. Twin pregnancies carry high risk for children and mothers. Under-5 mortality has declined in sub-Saharan Africa over the last decades. It is unknown whether twins have shared in this reduction. We pooled data from 90 Demographic and Health Surveys for 30 sub-Saharan Africa countries on births reported between 1995 and 2014. We used information on 1 685 110 singleton and 56 597 twin livebirths to compute trends in mortality rates for singletons and twins. We examined whether the twin-singleton rate ratio can be attributed to biological, socioeconomic, care-related factors, or birth size, and estimated the mortality burden among sub-Saharan African twins. Under-5 mortality among twins has declined from 327·7 (95% CI 312·0-343·5) per 1000 livebirths in 1995-2001 to 213·0 (196·7-229·2) in 2009-14. This decline of 35·0% was much less steep than the 50·6% reduction among singletons (from 128·6 [95% CI 126·4-130·8] per 1000 livebirths in 1995-2001 to 63·5 [61·6-65·3] in 2009-14). Twins account for an increasing share of under-5 deaths in sub-Saharan Africa: currently 10·7% of under-5 mortality and 15·1% of neonatal mortality. We estimated that about 315 000 twins (uncertainty interval 289 000-343 000) die in sub-Saharan African each year. Excess twin mortality cannot be explained by common risk factors for under-5 mortality, including birthweight. The difference with singletons was especially stark for neonatal mortality (rate ratio 5·0, 95% CI 4·5-5·6). 51·7% of women pregnant with twins reported receiving medical assistance at birth. The fate of twins in sub-Saharan Africa is lagging behind that of singletons. An alarming one-fifth of twins in the region dies before age 5 years, three times the mortality rate among singletons. Twins account for a substantial and growing share of under-5 and neonatal

  1. A note on twin-singleton differences in asthma

    DEFF Research Database (Denmark)

    Thomsen, Simon Francis; Kyvik, Kirsten Ohm; Backer, Vibeke

    2008-01-01

    Twins constitute a valuable resource for genetic studies of asthma. However, critics argue that twins are 'special' in terms of prenatal environment and upbringing and therefore nonrepresentative. In respect to asthma a small range of studies report differential morbidity in twins compared...... with singletons. We review some of the possible explanations for these findings and conclude that results from twin studies of asthma can be extrapolated to the general population....

  2. Offspring preterm birth and birth size are related to long-term risk of maternal diabetes

    DEFF Research Database (Denmark)

    Naver, Klara Vinsand; Secher, Niels Jørgen; Ovesen, Per Glud

    2013-01-01

    The aim of the study is to investigate the association between gestational age, birth size, and the long-term risk of maternal diabetes. We conducted a nation-wide prospective follow-up study of the cohort of all Danish women with a singleton delivery in 1982/1983 (index delivery) and no history...

  3. The influence of living arrangements, marital patterns and family configuration on employment rates among the 1945-1954 birth cohort: evidence from ten European countries.

    Science.gov (United States)

    Ogg, Jim; Renaut, Sylvie

    2007-09-01

    As they approach retirement, Europeans in mid-life display a range of living arrangements and marital patterns. These configurations influence labour force participation for men and women in different ways and these differences are accentuated between countries. Using data from the first Wave (2004) of the Survey on Health, Ageing and Retirement in Europe (SHARE), the paper examines the relationship between living arrangements, marital patterns, family configurations and participation in the labour force for the birth cohort of 1945-1954. The data show that the probability of being in paid employment was higher for respondents living in a couple in northern Europe than in southern Europe. In all countries, men in a couple had significantly higher employment rates than women in a couple, but employment rates of women in a couple differed significantly between countries. Multivariate analysis with country effects confirmed the negative influence of age, poor health, lower levels of education and household income on the probability of being in paid employment, but the effect of variables concerning living arrangements, marital patterns and family configurations varied according to country. A multilevel analysis showed that the between country variance of being in paid employment could not be explained by individual characteristics alone, that a large part of the country variance could be explained by the country specific effect of women in a couple, and that the level of 'modern' life styles in each country (rates of cohabitation outside marriage, divorce or separation and recomposed families) had a significant effect on employment rates, especially for women in a couple.

  4. Perinatal outcome of singleton siblings born after assisted reproductive technology and spontaneous conception: Danish national sibling-cohort study.

    Science.gov (United States)

    Henningsen, Anna-Karina Aaris; Pinborg, Anja; Lidegaard, Øjvind; Vestergaard, Christina; Forman, Julie Lyng; Andersen, Anders Nyboe

    2011-03-01

    To compare the perinatal outcome of singleton siblings conceived differently. National population-based registry study. Denmark, from 1994 to 2008. Pairs of siblings (13,692 pairs; n = 27,384 children) conceived after IVF, intracytoplasmatic sperm injection (ICSI), frozen embryo replacement (FER), or spontaneous conception subcategorized into five groups according to succession: [1] IVF-ICSI vs. spontaneous conception (n = 7,758), [2] IVF-ICSI vs. FER (n = 716), [3] FER vs. FER (n = 34), [4] IVF-ICSI vs. IVF-ICSI (n = 2,876), and [5] spontaneous conception vs. spontaneous conception (n = 16,000). Observations were obtained from national registries. Birth weight, gestational age, low birth weight (children compared with their spontaneously conceived siblings. FER children were 167 g (95% CI, 90-244] heavier than siblings born after replacement of fresh embryos. The difference in birth weight between firstborn and second born sibling depended on order of conception method. Higher risk of low birth weight with (odds ratio [OR], 1.4; 95%CI, 1.1-1.7] and preterm birth (OR, 1.3; 95% CI, 1.1-1.6] was observed in IVF/ICSI compared with spontaneous conception. When differentiating between order and mode of conception, it seems that assisted reproductive technology plays a role in mean birth weight and risk of low birth weight and preterm birth. Birth weight was higher in siblings born after FER compared with fresh embryos replacement. Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  5. Parental occupation and preterm births: a nationwide epidemiological study in Sweden.

    Science.gov (United States)

    Li, Xinjun; Sundquist, Jan; Kane, Kimberly; Jin, Qianren; Sundquist, Kristina

    2010-11-01

    The hypothesis was that some occupations could lead to preterm birth (PTB) because of potential exposures to various agents. The objective in this nationwide follow-up study was to analyse the association between PTB and parental occupational groups, controlling for potential confounders. Data from the Swedish Medical Birth Register, in which all children born in Sweden from 1990 onward are registered with their parents, were linked to census data. Inclusion criteria for the study population were employment (both women and men) and age >20 years (women). There were 816,743 first singleton live births from 1990 to 2004, of whom 43,956 were PTBs. A total of 7659 of the 43,956 PTBs were very PTBs. Odds ratios (ORs) with 95% confidence intervals were calculated separately for mothers and fathers to estimate the odds of PTB and very PTB in 51 occupational groups (reference groups: mothers or fathers who were 'Technical, science research-related workers and physicians') and by family income level. Women and men with low family incomes had increased ORs of PTB and very PTB. Significantly increased ORs of PTB (including very PTB) were found in four maternal and nine paternal occupational groups after accounting for family income, geographic region of residence, civil status, smoking habits, maternal age at infant's birth and period of birth. Further studies should examine specific agents in those parental occupations that were associated with increased odds of PTB and very PTB. © 2010 Blackwell Publishing Ltd.

  6. Cesarean Birth

    Science.gov (United States)

    ... QUESTIONS LABOR, DELIVERY, AND POSTPARTUM CARE FAQ006 Cesarean Birth (C-section) • What is cesarean birth? • What are the reasons for cesarean birth? • Is a cesarean birth necessary if I have ...

  7. Home cervical ripening with dinoprostone gel in nulliparous women with singleton pregnancies.

    Science.gov (United States)

    Stock, Sarah J; Taylor, Rebecca; Mairs, Rebecca; Azaghdani, Abdulhamid; Hor, Kahyee; Smith, Imogen; Dundas, Kirsty; Kissack, Chris; Norman, Jane E; Denison, Fiona

    2014-08-01

    To evaluate whether home cervical ripening is safe and results in shorter hospital stay. This was a retrospective cohort study of women with singleton pregnancies having induction of labor for postmaturity at a single center between January 2007 and June 2010. Women were offered home cervical ripening with 1 mg dinoprostone gel if they were nulliparous, had uncomplicated singleton pregnancies, and the indication for induction was postmaturity. Nine hundred seven of 1,536 (59.1%) nulliparous women having induction of labor for postmaturity were eligible for home cervical ripening. The median number of hours at home was 11.76 hours (range 0-24.82 hours). There were no cases of birth outside of the hospital, uterine rupture, or significant neonatal morbidity or neonatal death related to home cervical ripening. Eighty-five (5.5%) women who underwent hospital cervical ripening because of maternal preference or social issues formed a hospital cervical ripening comparison group. There was no significant difference in the total number of hours before delivery spent in the hospital between the two groups (26.25; 95% confidence interval [CI] 25.27-27.23 in home cervical ripening group compared with 24.28; 95% CI 22.5-26.0 in the hospital group; P=.26). Clinical outcomes are comparable in nulliparous women who receive a single dose of dinoprostone gel for home cervical ripening compared with those who undergo hospital cervical ripening. However, preadmission home cervical ripening with 1 mg dinoprostone does not decrease the number of hours women spend in the hospital. II.

  8. Changes in dietary habits and eating practices in adolescents living in urban South Africa: the birth to twenty cohort.

    Science.gov (United States)

    Feeley, Alison; Musenge, Eustasius; Pettifor, John M; Norris, Shane A

    2012-07-01

    To assess changes in the dietary habits and eating practices of a longitudinal cohort of adolescents over a 5-y period living in Soweto and Johannesburg. An interviewer-assisted questionnaire was used to gather data on the dietary habits and eating practices across three environments: in the home, in the school, and in the community. Participants (n = 1451, 49.1% male, 89% black, and 11% with mixed ancestry) 13, 15, and 17 y old with complete data were included in the analyses. The weekday breakfast consumption decreased over the 5-y period, from 76% to 65% (P breakfast during the weekend more regularly but this also decreased with age. Snacking while watching television increased with age, from 3.6 ± 4.6 to 6.7 ± 5.9 snacks/week, with female subjects consistently consuming more snacks than male subjects (P portion/week over the 5 y and confectionery consumption stayed the same, around 9 items/week in male subjects and 10 items/week in female subjects (P < 0.02). Lunch box usage decreased with age; conversely, the number of tuck shop purchases increased. Poor eating habits in all three environments were found; the participants' propensity for foods that were energy dense and micronutrient poor was high. This study also found that dietary patterns are well established by 13 y of age. Copyright © 2012 Elsevier Inc. All rights reserved.

  9. [In the case of premature live birth, is very early rupture of the membranes an additional risk factor for morbidity and mortality?

    Science.gov (United States)

    Isnard, T; Vincent-Rohfritsch, A; Le Ray, C; Goffinet, F; Patkai, J; Sibiude, J

    2018-02-26

    To describe survival rate after preterm premature rupture of membranes (PPROM) before 25 weeks of gestation and compare neonatal morbidity and mortality among those born alive with a control group of infants born at a similar gestational age without premature rupture of membranes. We conducted a retrospective single-centre study at Port-Royal maternity, from 2007 to 2015, comparing neonatal outcomes between liveborninfants exposed to PPROM prior to 25 weeks of gestation (WG) and a control group not exposed to premature rupture of the membranes. For each live-born child, the next child born after spontaneous labor without PPROM was matched for gestational age at birth, sex, and whether or not they received antenatal corticosteroid therapy. The primary endpoint was severe neonatal complications assessed by a composite endpoint including neonatal deaths, grade 3-4 HIV, bronchopulmonary dysplasia, leukomalacia and stade 3-4 retinopathies. Among 77 cases of very premature rupture of the membranes, 55 children were born alive. Among these, the average gestational age at birth was 28 WG and 1 day. The rate of severe neonatal complications did not differ between the two groups (43.6% in the PPROM group vs. 36.4%, P=0.44) and the survival rate at discharge was also similar in the two groups (85.5% vs. 83.6%, P=0.98). In our cohort and among livebirths after 24 WG, PPROM before 25 WG was not associated with an increased risk of morbidity and mortality compared to children born at the same gestational age after a spontaneous labor with intact membranes. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

  10. Cumulative live-birth rates per total number of embryos needed to reach newborn in consecutive in vitro fertilization (IVF) cycles: a new approach to measuring the likelihood of IVF success.

    Science.gov (United States)

    Garrido, Nicolás; Bellver, José; Remohí, José; Simón, Carlos; Pellicer, Antonio

    2011-07-01

    To report the use of cumulative live-birth rates (CLBRs) per ovarian stimulation cycle to measure the success of IVF is proving to be the most accurate method for advising couples who failed to conceive, although the accuracy yielded is relatively low, and cycle outcome is highly dependent on the number of embryos replaced. Our aim with this work is to report the CLBRs of IVF as a function of the number of embryos required to reach a live birth (EmbR), considering age, day of ET, and infertility etiology. Survival curves and Kaplan-Meier methods to analyze CLBR in a retrospective cohort with respect to the number of EmbR. University-affiliated infertility center. Infertile couples undergoing IVF using own oocytes. None. CLBR per embryo transferred. CLBRs increase rapidly between 1 and 5 EmbR, moderately between 5 and 15, and slowly thereafter. Live-birth rates rise more slowly when embryos are transferred on days 2-3 rather than on days 5-6, with comparable long-term results. Women's age is a negative factor from 35 to 37 years old, with a dramatic decrease in live-birth rates beyond age 40 years. In addition, there are significant worse results in endometriosis patients. The relationship between CLBR and number of EmbR provides realistic and precise information regarding IVF success and can be used to guide couples and practitioners. Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  11. Ovarian response and cumulative live birth rate of women undergoing in-vitro fertilisation who had discordant anti-Mullerian hormone and antral follicle count measurements: a retrospective study.

    Directory of Open Access Journals (Sweden)

    Hang Wun Raymond Li

    Full Text Available OBJECTIVE: To evaluate ovarian response and cumulative live birth rate of women undergoing in-vitro fertilization (IVF treatment who had discordant baseline serum anti-Mullerian hormone (AMH level and antral follicle count (AFC. METHODS: This is a retrospective cohort study on 1,046 women undergoing the first IVF cycle in Queen Mary Hospital, Hong Kong. Subjects receiving standard IVF treatment with the GnRH agonist long protocol were classified according to their quartiles of baseline AMH and AFC measurements after GnRH agonist down-regulation and before commencing ovarian stimulation. The number of retrieved oocytes, ovarian sensitivity index (OSI and cumulative live-birth rate for each classification category were compared. RESULTS: Among our studied subjects, 32.2% were discordant in their AMH and AFC quartiles. Among them, those having higher AMH within the same AFC quartile had higher number of retrieved oocytes and cumulative live-birth rate. Subjects discordant in AMH and AFC had intermediate OSI which differed significantly compared to those concordant in AMH and AFC on either end. OSI of those discordant in AMH and AFC did not differ significantly whether either AMH or AFC quartile was higher than the other. CONCLUSIONS: When AMH and AFC are discordant, the ovarian responsiveness is intermediate between that when both are concordant on either end. Women having higher AMH within the same AFC quartile had higher number of retrieved oocytes and cumulative live-birth rate.

  12. Canonical correlation analysis of infant's size at birth and maternal factors: a study in rural northwest Bangladesh.

    Science.gov (United States)

    Kabir, Alamgir; Merrill, Rebecca D; Shamim, Abu Ahmed; Klemn, Rolf D W; Labrique, Alain B; Christian, Parul; West, Keith P; Nasser, Mohammed

    2014-01-01

    This analysis was conducted to explore the association between 5 birth size measurements (weight, length and head, chest and mid-upper arm [MUAC] circumferences) as dependent variables and 10 maternal factors as independent variables using canonical correlation analysis (CCA). CCA considers simultaneously sets of dependent and independent variables and, thus, generates a substantially reduced type 1 error. Data were from women delivering a singleton live birth (n = 14,506) while participating in a double-masked, cluster-randomized, placebo-controlled maternal vitamin A or β-carotene supplementation trial in rural Bangladesh. The first canonical correlation was 0.42 (P<0.001), demonstrating a moderate positive correlation mainly between the 5 birth size measurements and 5 maternal factors (preterm delivery, early pregnancy MUAC, infant sex, age and parity). A significant interaction between infant sex and preterm delivery on birth size was also revealed from the score plot. Thirteen percent of birth size variability was explained by the composite score of the maternal factors (Redundancy, RY/X = 0.131). Given an ability to accommodate numerous relationships and reduce complexities of multiple comparisons, CCA identified the 5 maternal variables able to predict birth size in this rural Bangladesh setting. CCA may offer an efficient, practical and inclusive approach to assessing the association between two sets of variables, addressing the innate complexity of interactions.

  13. Canonical correlation analysis of infant's size at birth and maternal factors: a study in rural northwest Bangladesh.

    Directory of Open Access Journals (Sweden)

    Alamgir Kabir

    Full Text Available This analysis was conducted to explore the association between 5 birth size measurements (weight, length and head, chest and mid-upper arm [MUAC] circumferences as dependent variables and 10 maternal factors as independent variables using canonical correlation analysis (CCA. CCA considers simultaneously sets of dependent and independent variables and, thus, generates a substantially reduced type 1 error. Data were from women delivering a singleton live birth (n = 14,506 while participating in a double-masked, cluster-randomized, placebo-controlled maternal vitamin A or β-carotene supplementation trial in rural Bangladesh. The first canonical correlation was 0.42 (P<0.001, demonstrating a moderate positive correlation mainly between the 5 birth size measurements and 5 maternal factors (preterm delivery, early pregnancy MUAC, infant sex, age and parity. A significant interaction between infant sex and preterm delivery on birth size was also revealed from the score plot. Thirteen percent of birth size variability was explained by the composite score of the maternal factors (Redundancy, RY/X = 0.131. Given an ability to accommodate numerous relationships and reduce complexities of multiple comparisons, CCA identified the 5 maternal variables able to predict birth size in this rural Bangladesh setting. CCA may offer an efficient, practical and inclusive approach to assessing the association between two sets of variables, addressing the innate complexity of interactions.

  14. Modeling of live-birth rates and cost-effectiveness of oocyte cryopreservation for cancer patients prior to high- and low-risk gonadotoxic chemotherapy.

    Science.gov (United States)

    Lyttle Schumacher, B; Grover, N; Mesen, T; Steiner, A; Mersereau, J

    2017-10-01

    What is the live-birth rate (LBR) and cost-effectiveness of fertility preservation with oocyte cryopreservation (FP-OC) compared to expectant management in cancer patients age 25-40 based on estimated gonadotoxicity of treatments 5 years after cancer diagnosis? Oocyte cryopreservation prior to cancer treatment is more costly, yet more effective (producing more live births), than not undergoing oocyte cryopreservation but it is most beneficial for patients undergoing high-risk chemotherapy (HRC). The decision to undergo FP prior to treatment is multifactorial and can be costly and delay treatment. Not all treatments carry the same gonadotoxicity and patients may choose to undergo FP-OC based on the probability of premature ovarian insufficiency, predicted outcomes and cost. A comprehensive model that incorporates age at diagnosis and toxicity of treatment to help guide patients in the decision to undergo FP-OC does not yet exist. This study used a Decision Analysis Model to estimate effectiveness and cost of FP for cancer patients. Age-based estimates of LBR and cost per live birth were calculated for ages 25-40 years based on gonadotoxicity of treatment. A decision analysis model was constructed using Treeage Pro 2015 with case base probabilities derived from national registries, practice guidelines and medical records from a national network of infertility practices (IntegraMed). Compared to no FP-OC, FP-OC improved LBRs for women of all ages undergoing either low-risk chemotherapy (LRC) or HRC; however, it was most cost effective for women undergoing LRC at older ages or HRC at younger ages. Although FP-OC results in higher LBRs, it was always more costly. Using donor oocyte IVF can be a successful alternative to autologous FP-OC. Decision tree results reflect probabilities of certain events and are compiled from multiple reputable sources but are not directly derived from a recruited cohort of patients. Outcomes are based on United States estimates and should be

  15. Use of donor sperm in addition to oocyte donation after repeated implantation failure in normozoospermic patients does not improve live birth rates.

    Science.gov (United States)

    Blázquez, A; García, D; Rodríguez, A; Vassena, R; Vernaeve, V

    2016-11-01

    Does switching to donor semen after at least three failed oocyte donation (OD) cycles with the partner normozoospermic semen increase the live birth rate in a subsequent OD cycle? Switching to donor semen after at least three failed OD cycles with the partner normozoospermic semen does not increase the live birth rate. In some patients, a viable pregnancy cannot be achieved after several OD cycles, despite normal diagnostic findings for the couple. The ESHRE Capri Workshop Group indicates that, in order to improve reproductive outcomes, a semen donation can be offered after three failed ICSI cycles. A retrospective cohort analysis of fourth and fifth OD cycles with either the partner's normozoospermic semen (OD) or double-donation cycles (DD), performed between January 2011 and December 2014 in a private fertility center. These couples did not have a known male factor. The study included 228 cycles (159 OD and 69 DD). The fertilization method was ICSI in all cycles and embryos were transferred fresh. Fertilization rates were compared between groups using ANOVA while pregnancy outcomes were compared using Chi-square tests. Effect of DD on pregnancy outcomes was further analyzed using a logistic regression model adjusted for recipient's age and BMI, number of embryos transferred, day of embryo transfer and morphological embryo quality score. There was no difference in live birth rate between the DD and OD groups (38.2 versus 35.8%, P = 0.73), even after adjustment for confounding factors (odds ratio 1.41, 95% confidence interval 0.72, 2.76; P = 0.31). Rates of biochemical pregnancy (52.2 versus 54.1%, P = 0.79), clinical pregnancy (41.2 versus 45.9%, P = 0.51) and ongoing pregnancy (38.2 versus 37.1%, P = 0.87) were not different between the DD and the OD groups, as well as fertilization rate (75.3 versus 75.2%, P = 0.97). The DD and OD groups were comparable at baseline in all demographic and cycle variables analyzed (recipient's BMI, number of

  16. Pattern and determinants of birth weight in Oman.

    Science.gov (United States)

    Islam, M M; ElSayed, M K

    2015-12-01

    The aim of this study was to analyse the pattern of birth weight (BW) and identify the factors affecting BW and the risk factors of low birth weight (LBW) in Oman. The data for the study came from the 2000 Oman National Health Survey conducted by the Ministry of Health. The survey covered a nationally representative sample of 2037 ever married Omani women of reproductive age. Data on birth weight were gathered from health cards of the infants born within five years before the survey date. The study considered 977 singleton live births for whom data on birth weights were available. LBW was defined as BW less than 2500 g. Descriptive statistics, analysis of variance, multivariate linear regression and logistic regression models were used for data analysis. The mean BW was found to be 3.09 (SD 0.51) kg. BW was found to be significantly lower among the infants with the following characteristics: born in Ad-Dhakhliyah region, born in rural areas, and whose mothers had low economic status, low parity (0-2), and late initiation of antenatal care (ANC) visit. The incidence of LBW was found to be 9% in Oman in 2000. Mother's education, economic status, region of residence, late initiation of first ANC visit and experience of pregnancy complications appeared as the significant determinants of LBW in Oman. In contrast to most other studies, this study demonstrates that mothers with an advanced level of education (secondary and above) are more likely to have infants with LBW in Oman. The study findings highlight the need of intervention for specific groups of women with higher risk of adverse BW outcomes. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  17. Gestational weight gain among minority adolescents predicts term birth weight.

    Science.gov (United States)

    Ekambaram, Maheswari; Irigoyen, Matilde; DeFreitas, Johelin; Rajbhandari, Sharina; Geaney, Jessica Lynn; Braitman, Leonard Edward

    2018-03-07

    In adolescents, there is limited evidence on the independent and additive effect of prepregnancy body mass index (BMI) and gestational weight gain on infant birth weight. Data also show that this effect may vary by race. We sought to examine the impact of maternal prepregnancy BMI and gestational weight gain on birth weight and risk of large for gestational age (LGA) in term newborns of minority adolescent mothers. This was a retrospective cohort study of 411 singleton live term infants born to mothers ≤ 18 years. Data were abstracted from electronic medical records. Gestational weight gain was related to infant birth weight (ρ = 0.36, P gain, gestational age and Hispanic ethnicity were independent predictors of birth weight, controlling for maternal age, BMI, parity, tobacco/drug use and preeclampsia. The probability of having an LGA infant increased with weight gain [adjusted odds ratio (aOR) 1.14, 95% confidence interval (CI) 1.07-1.21] but not with BMI. Mothers who gained weight in excess of 2009 Institute of Medicine (IOM) recommendations had a greater risk of having an LGA infant compared to those who gained within recommendations (aOR 5.7, 95% CI 1.6-19.5). Minority adolescents with greater gestational weight gain had infants with higher birth weight and greater risk of LGA; BMI was not associated with either outcome. Further studies are needed to examine the applicability of the 2009 BMI-specific IOM gestational weight gain recommendations to adolescents in minority populations.

  18. The long lives of giant clumps and the birth of outflows in gas-rich galaxies at high redshift

    Energy Technology Data Exchange (ETDEWEB)

    Bournaud, Frédéric; Renaud, Florent; Daddi, Emanuele; Duc, Pierre-Alain; Elbaz, David; Gabor, Jared M.; Juneau, Stéphanie; Kraljic, Katarina; Le Floch' , Emeric [CEA, IRFU/SAp, F-91191 Gif-Sur-Yvette (France); Perret, Valentin; Amram, Philippe; Epinat, Benoit [Aix Marseille Université, CNRS, LAM (Laboratoire d' Astrophysique de Marseille), F-13388 Marseille (France); Dekel, Avishai [Center for Astrophysics and Planetary Science, Racah Institute of Physics, The Hebrew University, Jerusalem 91904 (Israel); Elmegreen, Bruce G. [IBM Research Division, T.J. Watson Research Center, Yorktown Heights, NY 10598 (United States); Elmegreen, Debra M. [Department of Physics and Astronomy, Vassar College, Poughkeepsie, NY 12604 (United States); Teyssier, Romain [Institute for Theoretical Physics, University of Zurich, CH-8057 Zurich (Switzerland)

    2014-01-01

    Star-forming disk galaxies at high redshift are often subject to violent disk instability, characterized by giant clumps whose fate is yet to be understood. The main question is whether the clumps disrupt within their dynamical timescale (≤50 Myr), like the molecular clouds in today's galaxies, or whether they survive stellar feedback for more than a disk orbital time (≈300 Myr) in which case they can migrate inward and help building the central bulge. We present 3.5-7 pc resolution adaptive mesh refinement simulations of high-redshift disks including photoionization, radiation pressure, and supernovae feedback. Our modeling of radiation pressure determines the mass loading and initial velocity of winds from basic physical principles. We find that the giant clumps produce steady outflow rates comparable to and sometimes somewhat larger than their star formation rate, with velocities largely sufficient to escape the galaxy. The clumps also lose mass, especially old stars, by tidal stripping, and the stellar populations contained in the clumps hence remain relatively young (≤200 Myr), as observed. The clumps survive gaseous outflows and stellar loss, because they are wandering in gas-rich turbulent disks from which they can reaccrete gas at high rates compensating for outflows and tidal stripping, overall keeping realistic and self-regulated gaseous and stellar masses. The outflow and accretion rates have specific timescales of a few 10{sup 8} yr, as opposed to rapid and repeated dispersion and reformation of clumps. Our simulations produce gaseous outflows with velocities, densities, and mass loading consistent with observations, and at the same time suggest that the giant clumps survive for hundreds of Myr and complete their migration to the center of high-redshift galaxies. These long-lived clumps are gas-dominated and contain a moderate mass fraction of stars; they drive inside-out disk evolution, thickening, spheroid growth, and fueling of the central

  19. Associations between maternal exposure to air pollution and traffic noise and newborn's size at birth: A cohort study.

    Science.gov (United States)

    Hjortebjerg, Dorrit; Andersen, Anne Marie Nybo; Ketzel, Matthias; Pedersen, Marie; Raaschou-Nielsen, Ole; Sørensen, Mette

    2016-10-01

    Maternal exposure to air pollution and traffic noise has been suggested to impair fetal growth, but studies have reported inconsistent findings. Objective To investigate associations between residential air pollution and traffic noise during pregnancy and newborn's size at birth. From a national birth cohort we identified 75,166 live-born singletons born at term with information on the children's size at birth. Residential address history from conception until birth was collected and air pollution (NO2 and NOx) and road traffic noise was modeled at all addresses. Associations between exposures and indicators of newborn's size at birth: birth weight, placental weight and head and abdominal circumference were analyzed by linear and logistic regression, and adjusted for potential confounders. In mutually adjusted models we found a 10μg/m(3) higher time-weighted mean exposure to NO2 during pregnancy to be associated with a 0.35mm smaller head circumference (95% confidence interval (CI): 95% CI: -0.57; -0.12); a 0.50mm smaller abdominal circumference (95% CI: -0.80; -0.20) and a 5.02g higher placental weight (95% CI: 2.93; 7.11). No associations were found between air pollution and birth weight. Exposure to residential road traffic noise was weakly associated with reduced head circumference, whereas none of the other newborn's size indicators were associated with noise, neither before nor after adjustment for air pollution. This study indicates that air pollution may result in a small reduction in offspring's birth head and abdominal circumference, but not birth weight, whereas traffic noise seems not to affect newborn's size at birth. Copyright © 2016 Elsevier Ltd. All rights reserved.

  20. A longitudinal perspective on violence in the lives of South African children from the Birth to Twenty Plus cohort study in JohannesburgSoweto

    Directory of Open Access Journals (Sweden)

    L Richter

    2018-03-01

    Full Text Available Background. Violence against children is a significant cause of personal suffering and long-term ill health, poor psychological adjustment, and a range of social difficulties, including adverse effects intergenerationally.Objectives. Using a large corpus of longitudinal data collected in the Birth to Twenty Plus cohort, to give an overview of exposure to and experience of violence, as well as perpetration of violence, across childhood, reported contemporaneously by several informants. This overcomes limitations of retrospectively recalled information collected from one person at one point in time.Methods. We identified 280 data points relating to exposure to and perpetration of violence in 14 of the 21 waves of data collection from birth to 22 years of age. Data were classified into four developmental stages (preschool, primary school years, adolescence and young adulthood and seven categories (exposure to violence in the community, home and school; exposure to peer violence; being a victim of violence, excluding sexual violence; sexual violence; and perpetration of violence. Both descriptive and inferential statistics were employed to analyse the data.Results. Over the past two decades, only 1% of the sample had not been exposed to or experienced violence in their home, school and/or community. Two-thirds of children of schoolgoing age were reported as having been exposed to community violence, and more than half of all children to violence in their home. Reports of sexual violence increased from 10% among primary school-aged children to ~30% among adolescents and young adults. Over the course of their lives, ~40% of children were reported as having been exposed to or being victims of five or six of the categories of violence coded in this analysis. High levels of violence perpetration were reported across childhood. Age and gender differences in exposure to and experience and perpetration of violence were evident, and all categories of

  1. Pregnancy and live birth after follicle-stimulating hormone treatment for an infertile couple including a male affected by Sertoli cell-only syndrome

    Directory of Open Access Journals (Sweden)

    Paulis G

    2017-10-01

    established and developed. Subsequently, the pregnancy resulted in the live birth of a girl. Keywords: azoospermia, Sertoli cell-only syndrome, FSH, ICSI, TESE sperm retrieval, live birth pregnancy

  2. A qualitative study exploring newborn care behaviours after home births in rural Ethiopia: implications for adoption of essential interventions for saving newborn lives.

    Science.gov (United States)

    Salasibew, Mihretab Melesse; Filteau, Suzanne; Marchant, Tanya

    2014-12-12

    Ethiopia is among seven high-mortality countries which have achieved the fourth millennium development goal with over two-thirds reduction in under-five mortality rate. However, the proportion of neonatal deaths continues to rise and recent studies reported low coverage of the essential interventions saving newborn lives. In the context of low uptake of health facility delivery, it is relevant to explore routine practices during home deliveries and, in this study, we explored the sequence of immediate newborn care practices and associated beliefs following home deliveries in rural communities in Ethiopia. Between April-May 2013, we conducted 26 semi-structured interviews and 2 focus group discussions with eligible mothers, as well as a key informant interview with a local expert in traditional newborn care practices in rural Basona woreda (district) near the urban town of Debrebirhan, 120 km from Addis Ababa, Ethiopia. The most frequently cited sequence of newborn care practices reported by mothers with home deliveries in the rural Basona woreda was to tie the cord, immediately bath then dry the newborn, practice 'Lanka mansat' (local traditional practice on newborns), give pre-lacteal feeding and then initiate breastfeeding. For 'Lanka mansat', the traditional birth attendant applies mild pressure inside the baby's mouth on the soft palate using her index finger. This is performed believing that the baby will have 'better voice' and 'speak clearly' later in life. Coverage figures fail to tell the whole story as to why some essential interventions are not practiced and, in this study, we identified established norms or routines within the rural communities that determine the sequence of newborn care practices following home births. This might explain why some mothers delay initiation of breastfeeding and implementation of other recommended essential interventions saving newborn lives. An in-depth understanding of established routines is necessary, and community

  3. Low birthweight and preterm birth rates 1 year before and after the Irish workplace smoking ban.

    Science.gov (United States)

    Kabir, Z; Clarke, V; Conroy, R; McNamee, E; Daly, S; Clancy, L

    2009-12-01

    It is well-established that maternal smoking has adverse birth outcomes (low birthweight, LBW, and preterm births). The comprehensive Irish workplace smoking ban was successfully introduced in March 2004. We examined LBW and preterm birth rates 1 year before and after the workplace smoking ban in Dublin. A cross-sectional observational study analysing routinely collected data using the Euroking K2 maternity system. Coombe University Maternal Hospital. Only singleton live births were included for analyses (7593 and 7648, in 2003 and 2005, respectively). Detailed gestational and clinical characteristics were collected and analysed using multivariable logistic regression analyses and subgroup analyses. Maternal smoking rates, mean birthweights, and adjusted odds ratios (ORs) of LBW and preterm births in 2005 versus 2003. There was a 25% decreased risk of preterm births (OR, 0.75; 95% CI, 0.59-0.96), a 43% increased risk of LBW (OR, 1.43; 95% CI, 1.10-1.85), and a 12% fall in maternal smoking rates (from 23.4 to 20.6%) in 2005 relative to 2003. Such patterns were significantly maintained when specific subgroups were also analysed. Mean birthweights decreased in 2005, but were not significant (P=0.99). There was a marginal increase in smoking cessation before pregnancy in 2005 (P=0.047). Significant declines in preterm births and in maternal smoking rates after the smoking ban are welcome signs. However, the increased LBW birth risks might reflect a secular trend, as observed in many industrialised nations, and merits further investigations.

  4. Is the fertile window extended in women with polycystic ovary syndrome? Utilizing the Society for Assisted Reproductive Technology registry to assess the impact of reproductive aging on live-birth rate.

    Science.gov (United States)

    Kalra, Suleena Kansal; Ratcliffe, Sarah J; Dokras, Anuja

    2013-07-01

    To assess whether women with polycystic ovary syndrome (PCOS) follow the same age-related decline in IVF outcomes as women with tubal factor infertility over the reproductive life span. PCOS is characterized by increased ovarian reserve as assessed by antral follicle counts and anti-Müllerian hormone levels. It is unclear whether these surrogate markers of ovarian reserve reflect a true lengthening of the reproductive window. Retrospective cohort. Not applicable. Women with PCOS and tubal factor infertility (42,286 cycles). IVF. Pregnancy and live-birth rates. The mean number of oocytes retrieved was higher in women with PCOS compared with in women with tubal factor (16.4 vs. 12.8; odds ratio [OR], 1.27; 95% confidence interval [CI], 1.25-1.29). The clinical pregnancy (42.5% vs. 35.8%; OR, 1.32; 95% CI, 1.27-1.38) and live-birth rates were also increased in women with PCOS (34.8% vs. 29.1%; OR, 1.30; 95% CI, 1.24-1.35). A similar rate of decline in clinical pregnancy and live-birth rates was noted in both groups (20-44 years). The implantation, clinical pregnancy, miscarriage, and live-birth rates were not significantly different for each year after age 40 in the two groups. Despite a higher oocyte yield in all age groups, women with PCOS over age 40 had similar clinical pregnancy and live-birth rates compared with women with tubal factor infertility. These findings suggest that the reproductive window may not be extended in PCOS and that patients with infertility should be treated in a timely manner despite indicators of high ovarian reserve. Copyright © 2013 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  5. The usefulness of traditional birth attendants to women living with HIV in resource-poor settings: the case of Mfuwe, Zambia.

    Science.gov (United States)

    Muzyamba, Choolwe; Groot, Wim; Tomini, Sonila M; Pavlova, Milena

    2017-01-01

    Although there is increased attention on the role of trained traditional birth attendants (TBAs) in maternal care, most of the research has mainly focused on providing evidence of the relevance of trained TBAs to women in general without a specific focus on women who are HIV positive, despite them being most vulnerable. Therefore, the aim of this study is to fill this gap by assessing the relevance of trained TBAs to women living with HIV in resource-poor settings by using Zambia as a case study. Our data collection consisted of two focus group discussions, one involving HIV-positive women utilizing trained TBAs and the other with women not utilizing TBAs. Additionally, in-depth interviews were conducted with trained TBAs and health workers. Thematic analysis was used to analyze the data. In general, women living with HIV positively characterized the services of TBAs. In the face of an inefficient health system, trained TBAs were seen to be useful in providing efficient, cheap and quality care, counseling, and referral and logistical support, including treatment adherence support. In Zambia, trained TBAs and professional care are not mutually exclusive but complementary. There is no doubt that HIV-positive women need professionals to handle complications and offer antiretroviral treatment to ensure prevention of mother to child transmission (PMTCT). However, additional "soft" services offered by trained TBAs are equally important in the promotion of maternal health care among HIV-positive women. Thus, it seems there is more to gain by systematically allowing trained TBAs to work alongside professionals in a well-coordinated and complementary manner.

  6. The association of low birth weight with serum C reactive protein in 3‐year‐old children living in Cuba: A population‐based prospective study

    Science.gov (United States)

    Fundora‐Hernández, Hermes; Batista‐Gutierrez, Lourdes; Suárez‐Medina, Ramón; de la C. Mora‐Faife, Esperanza; García‐García, Gladys; del Valle‐Infante, Ileana; Gómez‐Marrero, Liem; Britton, John; Fogarty, Andrew W.

    2016-01-01

    Abstract Objective Low birthweight is associated with a decreased risk of childhood leukemia and an increased risk of both cardiovascular disease and all‐cause mortality in adult life. Possible biological mediators include systemic innate immunity and inflammation. We tested the hypothesis that birthweight was inversely associated with serum high sensitivity C reactive protein assay (hsCRP), a measure of both innate immunity and systemic inflammation. Methods Data on birthweight and current anthropometric measures along with a range of exposures were collected at 1 and 3 years of age in a population‐based cohort study of young children living in Havana, Cuba. A total of 986 children aged 3‐years‐old provided blood samples that were analyzed for serum hsCRP levels. Results Nearly 49% of children had detectable hsCRP levels in their serum. Lower birthweight was linearly associated with the natural log of hsCRP levels (beta coefficient −0.70 mg L−1 per kg increase in birthweight, 95% CI: −1.34 to −0.06). This was attenuated but still present after adjustment for the child's sex and municipality (−0.65 mg L−1 per kg birthweight; 95% CI: −1.38 to +0.08). There were no associations between growth from birth or anthropometric measures at 3 years and systemic inflammation. Conclusions Birthweight was inversely associated with serum hsCRP levels in children aged 3 years living in Cuba. These observations provide a potential mechanism that is present at the age of 3 years to explain the association between low birthweight and both decreased childhood leukemia and increased cardiovascular disease in adults. PMID:27859847

  7. Mothers' Marital Adaptation following the Birth of Twins or Singletons: Empirical Evidence and Practical Insights

    Science.gov (United States)

    Taubman-Ben-Ari, Orit; Findler, Liora; Bendet, Chaya; Stanger, Varda; Ben-Shlomo, Shirley; Kuint, Jacob

    2008-01-01

    Parenting twins is typically portrayed as more stressful than is parenting single children and, therefore, more of a strain on the marital relationship. With this in mind, the present study examined the contribution of infant characteristics and mother's internal resources (attachment style) and external resources (maternal and paternal…

  8. Live birth sex ratio after in vitro fertilization and embryo transfer in China--an analysis of 121,247 babies from 18 centers.

    Science.gov (United States)

    Bu, Zhiqin; Chen, Zi-Jiang; Huang, Guoning; Zhang, Hanwang; Wu, Qiongfang; Ma, Yanping; Shi, Juanzi; Xu, Yanwen; Zhang, Songying; Zhang, Cuilian; Zhao, Xiaoming; Zhang, Bo; Huang, Yuanhua; Sun, Zhengyi; Kang, Yuefan; Wu, Riran; Wu, Xueqing; Sun, Haixiang; Sun, Yingpu

    2014-01-01

    In order to study the impact of procedures of IVF/ICSI technology on sex ratio in China, we conducted this multi-center retrospective study including 121,247 babies born to 93,895 women in China. There were 62,700 male babies and 58,477 female babies, making the sex ratio being 51.8% (Male: Female  = 107:100). In univariate logistic regression analysis, sex ratio was imbalance toward females of 50.3% when ICSI was preformed compared to 47.7% when IVF was used (Pratio in IVF/ICSI babies was significantly higher toward males in transfers of blastocyst (54.9%) and thawed embryo (52.4%) when compared with transfers of cleavage stage embryo (51.4%) and fresh embryo (51.5%), respectively. Multiple delivery was not associated with sex ratio. However, in multivariable logistic regression analysis after controlling for related factors, only ICSI (adjusted OR =  .90, 95%CI: 0.88-0.93; Pratio in IVF/ICSI babies. In conclusion, the live birth sex ratio in IVF/ICSI babies was influenced by the use of ICSI, which may decrease the percentage of male offspring, or the use of blastocyst transfer, which may increase the percentage of male offspring.

  9. Neurodevelopmental outcomes of triplets or higher-order extremely low birth weight infants.

    Science.gov (United States)

    Wadhawan, Rajan; Oh, William; Vohr, Betty R; Wrage, Lisa; Das, Abhik; Bell, Edward F; Laptook, Abbot R; Shankaran, Seetha; Stoll, Barbara J; Walsh, Michele C; Higgins, Rosemary D

    2011-03-01

    Extremely low birth weight twins have a higher rate of death or neurodevelopmental impairment than singletons. Higher-order extremely low birth weight multiple births may have an even higher rate of death or neurodevelopmental impairment. Extremely low birth weight (birth weight 401-1000 g) multiple births born in participating centers of the Neonatal Research Network between 1996 and 2005 were assessed for death or neurodevelopmental impairment at 18 to 22 months' corrected age. Neurodevelopmental impairment was defined by the presence of 1 or more of the following: moderate to severe cerebral palsy; mental developmental index score or psychomotor developmental index score less than 70; severe bilateral deafness; or blindness. Infants who died within 12 hours of birth were excluded. Maternal and infant demographic and clinical variables were compared among singleton, twin, and triplet or higher-order infants. Logistic regression analysis was performed to establish the association between singletons, twins, and triplet or higher-order multiples and death or neurodevelopmental impairment, controlling for confounding variables that may affect death or neurodevelopmental impairment. Our cohort consisted of 8296 singleton, 2164 twin, and 521 triplet or higher-order infants. The risk of death or neurodevelopmental impairment was increased in triplets or higher-order multiples when compared with singletons (adjusted odds ratio: 1.7 [95% confidence interval: 1.29-2.24]), and there was a trend toward an increased risk when compared with twins (adjusted odds ratio: 1.27 [95% confidence: 0.95-1.71]). Triplet or higher-order births are associated with an increased risk of death or neurodevelopmental impairment at 18 to 22 months' corrected age when compared with extremely low birth weight singleton infants, and there was a trend toward an increased risk when compared with twins.

  10. Assisted reproductive technology and major birth defects in Western Australia.

    Science.gov (United States)

    Hansen, Michele; Kurinczuk, Jennifer J; de Klerk, Nicholas; Burton, Peter; Bower, Carol

    2012-10-01

    To estimate the prevalence of major birth defects diagnosed by 6 years of age in all births and terminations of pregnancy for fetal anomaly conceived by assisted reproductive technology (when this included intracytoplasmic sperm injection and in vitro fertilization [IVF]) and the remainder of nonassisted reproductive technology-conceived children born in Western Australia from 1994 to 2002. This retrospective cohort study used data linkage between three population-based registers (Reproductive Technology Register, Western Australian Register of Developmental Anomalies, and Midwives' Notification of Birth System) to identify all assisted reproductive technology (n=2,911) and nonassisted reproductive technology (n=210,997) births with and without birth defects diagnosed by age 6 and all terminations of pregnancy for fetal anomaly. A major birth defect was diagnosed in 8.7% of assisted reproductive technology and 5.4% of nonassisted reproductive technology singletons (odds ratio [OR] 1.53, 95% confidence interval [CI] 1.30-1.79), as well as 7.1% of assisted reproductive technology twins and 5.9% of nonassisted reproductive technology twins of unlike sex (OR 1.08, 95% CI 0.77-1.51). The prevalence of birth defects in assisted reproductive technology singletons and twins decreased markedly over the study period. This change was evident across all three clinics contributing data over the whole study and was particularly marked for children conceived as a result of IVF. There has been a decrease in the prevalence of birth defects over time in children born as a result of assisted reproductive technology in Western Australia; however, the prevalence of major birth defects in assisted reproductive technology singletons remains increased compared with nonassisted reproductive technology singletons. II.

  11. The association between low level exposures to ambient air pollution and term low birth weight: a retrospective cohort study

    Directory of Open Access Journals (Sweden)

    Stieb David

    2006-02-01

    Full Text Available Abstract Background Studies in areas with relatively high levels of air pollution have found some positive associations between exposures to ambient levels of air pollution and several birth outcomes including low birth weight (LBW. The purpose of this study was to examine the association between LBW among term infants and ambient air pollution, by trimester of exposure, in a region of lower level exposures. Methods The relationship between LBW and ambient levels of particulate matter up to 10 um in diameter (PM10, sulfur dioxide (SO2 and ground-level ozone (O3 was evaluated using the Nova Scotia Atlee Perinatal Database and ambient air monitoring data from the Environment Canada National Air Pollution Surveillance Network and the Nova Scotia Department of Environment. The cohort consisted of live singleton births (≥37 weeks of gestation between January1,1988 and December31,2000. Maternal exposures to air pollution were assigned to women living within 25 km of a monitoring station at the time of birth. Air pollution was evaluated as a continuous and categorical variable (using quartile exposures for each trimester and relative risks were estimated from logistic regression, adjusted for confounding variables. Results There were 74,284 women with a term, singleton birth during the study period and with exposure data. In the analyses unadjusted for year of birth, first trimester exposures in the highest quartile for SO2 and PM10suggested an increased risk of delivering a LBW infant (relative risk = 1.36, 95% confidence interval = 1.04 to 1.78 for SO2 exposure and relative risk = 1.33, 95% confidence interval = 1.02 to 1.74 for PM10. After adjustment for birth year, the relative risks were attenuated somewhat and not statistically significant. A dose-response relationship for SO2 was noted with increasing levels of exposure. No statistically significant effects were noted for ozone. Conclusion Our results suggest that exposure during the first

  12. Birth Control

    Science.gov (United States)

    Birth control, also known as contraception, is designed to prevent pregnancy. Birth control methods may work in a number of different ... eggs that could be fertilized. Types include birth control pills, patches, shots, vaginal rings, and emergency contraceptive ...

  13. Association between maternal exposure to elevated ambient sulfur dioxide during pregnancy and term low birth weight

    International Nuclear Information System (INIS)

    Lin, C.-M.; Li, C.-Y.; Yang, G.-Y.; Mao, I.-F.

    2004-01-01

    This retrospective cohort study investigated whether the risk of delivering full term (37-44 completed weeks of gestation) low birth weight (LBW) infants is associated with differences in exposure to air pollutants in different trimesters. Full-term infants (37 completed weeks of gestation) with a birth weight below 2500 g were classified as term LBW infants. The study infants comprised 92,288 full-term live singletons identified from the Taiwan birth registry and born in the city of Taipei or Kaoshiung in Taiwan between 1995 and 1997. Maternal exposures to various air pollutants including CO, SO 2 , O 3 , NO 2 , and PM 10 in each trimester of pregnancy was estimated as the arithmetic means of all daily measurements taken by the air quality monitoring station nearest to the district of residence of the mother at birth. The multivariable logistic regression model with adjustment for potential confounders was used to assess the independent effect of specific air pollutants on the risk of term LBW. This study suggested a 26% increase in term LBW risk given maternal ambient exposure to SO 2 concentration exceeding 11.4 ppb during pregnancy compared to low exposure ( 12.4 ppb of SO 2 in the last trimester showed 20% higher risk (OR=1.20, 95% CI=1.01-1.41) of term LBW delivery than mothers with lower exposure (<6.8 ppb). No significant elevation ORs was observed for other air pollutants

  14. Factors associated with low birth weight in Goiás State

    Directory of Open Access Journals (Sweden)

    Ruth Minamisava

    2006-12-01

    Full Text Available ABSTRACT: Low birth weight (LBW is public health problem, because they are associated with increased risk of morbidity and mortality. No previous studies on factors associated with LBW carried out in central Brazil were found in the literature. The main aims of this study were to determine the prevalence and the factors associated with LBW in children born alive in the State of Goiás, Brazil. A cross-sectional analysis was performed using data from the Live Births Information System from the Brazilian Health Ministry. All 92.745 singleton births in the State of Goiás during the year of 2000 were examined. Logistic regression analysis was used to examine the factors associated with LBW (< 2500 g. In Goiás, the prevalence of LBW was 5.96% and the most important factors associated with LBW were: prematurity, young and older mothers, unmarried women, mother illiteracy, mothers who had less than seven prenatal care visits, non-hospital delivery, and female infants. Local public health actions are necessary to reduce inequalities in infant and maternal care. KEYWORDS: newborn, birth weight, prenatal care.

  15. Birth weight curves tailored to maternal world region.

    Science.gov (United States)

    Ray, Joel G; Sgro, Michael; Mamdani, Muhammad M; Glazier, Richard H; Bocking, Alan; Hilliard, Robert; Urquia, Marcelo L

    2012-02-01

    Newborns of certain immigrant mothers are smaller at birth than those of domestically born mothers. Contemporary, population-derived percentile curves for these newborns are lacking, as are estimates of their risk of being misclassified as too small or too large using conventional rather than tailored birth weight curves. We completed a population-based study of 766 688 singleton live births in Ontario from 2002 to 2007. Smoothed birth weight percentile curves were generated for males and females, categorized by maternal world region of birth: Canada (63.5%), Europe/Western nations (7.6%), Africa/Caribbean (4.9%), Middle East/North Africa (3.4%), Latin America (3.4%), East Asia/Pacific (8.1%), and South Asia (9.2%). We determined the likelihood of misclassifying an infant as small for gestational age (≤ 10th percentile for weight) or as large for gestational age (≥ 90th percentile for weight) on a Canadian-born maternal curve versus one specific to maternal world region of origin. Significantly lower birth weights were seen at gestation-specific 10th, 50th, and 90th percentiles among term infants born to mothers from each world region, with the exception of Europe/Western nations, compared with those for infants of Canadian-born mothers. For example, for South Asian babies born at 40 weeks' gestation, the absolute difference at the 10th percentile was 198 g (95% CI 183 to 212) for males and 170 g (95% CI 161 to 179) for females. Controlling for maternal age and parity, South Asian males had an odds ratio of 2.60 (95% CI 2.53 to 2.68) of being misclassified as small for gestational age, equivalent to approximately 116 in 1000 newborns; for South Asian females the OR was 2.41 (95% CI 2.34 to 2.48), equivalent to approximately 106 per 1000 newborns. Large for gestational age would be missed in approximately 61 per 1000 male and 57 per 1000 female South Asian newborns if conventional rather than ethnicity-specific birth weight curves were used. Birth weight curves

  16. Preterm birth, an unresolved issue

    OpenAIRE

    Beliz?n, Jose M; Hofmeyr, Justus; Buekens, Pierre; Salaria, Natasha

    2013-01-01

    Premature birth is the world?s leading cause of neonatal mortality with worldwide estimates indicating 11.1% of all live births were preterm in 2010. Preterm birth rates are increasing in most countries with continual differences in survival rates amongst rich and poor countries. Preterm birth is currently an important unresolved global issue with research efforts focusing on uterine quiescence and activation, the ?omics? approaches and implementation science in order to reduce the incidence ...

  17. Residential proximity to gasoline service stations and preterm birth.

    Science.gov (United States)

    Huppé, Vicky; Kestens, Yan; Auger, Nathalie; Daniel, Mark; Smargiassi, Audrey

    2013-10-01

    Preterm birth (PTB) is a growing public health problem potentially associated with ambient air pollution. Gasoline service stations can emit atmospheric pollutants, including volatile organic compounds potentially implicated in PTB. The objective of this study was to evaluate the relationship between residential proximity to gasoline service stations and PTB. Singleton live births on the Island of Montreal from 1994 to 2006 were obtained (n=267,478). Gasoline service station locations, presence of heavy-traffic roads, and neighborhood socioeconomic status (SES) were determined using a geographic information system. Multivariable logistic regression was used to analyze the association between PTB and residential proximity to gasoline service stations (50, 100, 150, 200, 250, and 500 m), accounting for maternal covariates, neighborhood SES, and heavy-traffic roads. For all distance categories beyond 50 m, presence of service stations was associated with a greater odds of PTB. Associations were robust to adjustment for maternal covariates for distance categories of 150 and 200 m but were nullified when adjusting for neighborhood SES. In analyses accounting for the number of service stations, the likelihood of PTB within 250 m was statistically significant in unadjusted models. Associations were, however, nullified in models accounting for maternal covariates or neighborhood SES. Our results suggest that there is no clear association between residential proximity to gasoline service stations in Montreal and PTB. Given the correlation between proximity of gasoline service stations and SES, it is difficult to delineate the role of these factors in PTB.

  18. Socio-cultural determinants of contraceptive use among rural women aged 15-29 years from marriage to first live birth

    Directory of Open Access Journals (Sweden)

    Amir Mohammad Sayem

    2008-07-01

    Full Text Available Contraceptive prevalence rate (CPR is lower while the fertility is higher among rural married women aged 15-29 in Bangladesh. Thus, this comparative study attempted to identify the socio-economic and cultural determinants of contraceptive use in different rural settings. In this primary data based cross sectional study, a semi-structured questionnaire was applied to women aged 15-29 years in two rural areas who had at least one live birth on/before 20 December, 2006. The study areas were identified by multi-stage random sampling technique. Results showed that CPR was slightly higher in Dariadaulat (43.4% than that of Chardigoldi union (41.6% while the mean duration of use was slightly higher in Chardigoldi compared to Dariadaulat (5.04 v. 4.59 mo. Regression model for Dariadaulat (38.7% with P<0.001 better explained the use of contraception than that of Chardigoldi (30.0% with P<0.001. Among the determinants in Dariadaulat the most explanatory variable was mass media exposure (15.8% while it was desired number of children in Chardigoldi (12.6%. Among others, joint decision of using contraception, familiarity with contraceptives before marriage, desired number of children, electricity, family interference and family size were found to have significant impact in Dariadaulat. On the other hand, the other explanatory variables in Chardigoldi were joint decision of using contraception, family interference and familiarity with contraceptives before marriage and age at present. It may be concluded that the CPR is markedly low in rural communities. The lack of accessibility to mass media, lack of joint decision with husband, premarital unawareness regarding contraceptive use, lack of post-marital planning and family interference are major contributory factors for the low CPR in the study population. Ibrahim Med. Coll. J. 2008; 2(2: 49-54

  19. Factors associated with a poor prognosis for the IVF-ICSI live birth rate in women with rAFS stage III and IV endometriosis.

    Science.gov (United States)

    Roux, Pauline; Perrin, Jeanne; Mancini, Julien; Agostini, Aubert; Boubli, Léon; Courbiere, Blandine

    2017-07-01

    To assess the factors associated with a poor prognosis for a cumulative IVF live birth rate (LBR) in women with stage III and IV endometriosis according to the revised classification of the American Fertility Society (rAFS). A retrospective cohort study was conducted between January 1, 2010, and December 31, 2014, in our Reproductive Medicine Center. We analyzed different factors associated with a poor prognosis for a cumulative IVF LBR in women with rAFS stage III and IV endometriosis. A total of 101 patients were included, representing 232 IVF-ICSI cycles and 212 embryo transfers. The primary endpoint was the cumulative LBR per cycle and per patient. The cumulative LBR per cycle was 14.7% (n = 34) and that per patient was 31.7% (n = 32). The cumulative LBR was significantly decreased by active smoking [ adj OR = 3.4, 95% CI (1.12-10.60), p = 0.031], poor ovarian response (POR) according to the Bologna criteria [ adj OR = 11.5, 95% CI (1.37-96.83), p = 0.024], and rAFS stage IV [ adj OR = 3.2, 95% CI (1.13-8.95), p = 0.024]. The cumulative LBR per women was 59.4% without factors associated with a poor prognosis and 25.6% in the case of one factor, and it decreased to 7.7% in the case of two or three factors (p endometriosis had a negative impact on the IVF-ICSI cumulative LBR for women with rAFS stage III and IV endometriosis. Because smoking dramatically decreases the LBR with endometriosis, stopping smoking before IVF-ICSI should be strongly advised.

  20. Metformin improves pregnancy and live-birth rates in women with polycystic ovary syndrome (PCOS): a multicenter, double-blind, placebo-controlled randomized trial.

    Science.gov (United States)

    Morin-Papunen, Laure; Rantala, Anni S; Unkila-Kallio, Leila; Tiitinen, Aila; Hippeläinen, Maritta; Perheentupa, Antti; Tinkanen, Helena; Bloigu, Risto; Puukka, Katri; Ruokonen, Aimo; Tapanainen, Juha S

    2012-05-01

    The role of metformin in the treatment of infertility in women with polycystic ovary syndrome (PCOS) is still controversial. OBJECTIVE AND OUTCOMES: We investigated whether metformin decreases the early miscarriage rate and improves the pregnancy rates (PR) and live-birth rates (LBR) in PCOS. This was a multicenter, randomized (1:1), double-blind, placebo-controlled study. Three hundred twenty women with PCOS and anovulatory infertility were randomized to metformin (n = 160, Diformin; obese women, 1000 mg two times daily; nonobese subjects, 500 mg + 1000 mg daily) or identical doses of placebo (n = 160). After 3 months' treatment, another appropriate infertility treatment was combined if necessary. If pregnancy occurred, metformin/placebo was continued up to the 12th week. Miscarriage rates were low and similar in the two groups (metformin 15.2% vs. placebo 17.9%, P = 0.8). Intent-to-treat analysis showed that metformin significantly improved PR and LBR (vs. placebo) in the whole study population (PR: 53.6 vs. 40.4%, P = 0.006; LBR: 41.9 vs. 28.8%, P = 0.014) and PR in obese women (49.0 vs. 31.4%, P = 0.04), and there was a similar trend in nonobese (PR: 58.6 vs. 47.6%, P = 0.09; LBR: 46.7 vs. 34.5%, P = 0.09) and in obese women with regard to LBR (35.7 vs. 21.9%, P = 0.07). Cox regression analysis showed that metformin plus standard infertility treatment increased the chance of pregnancy 1.6 times (hazard rate 1.6, 95% confidence interval 1.13-2.27). Obese women especially seem to benefit from 3 months' pretreatment with metformin and its combination thereafter with routine ovulation induction in anovulatory infertility.

  1. Endometrial scratching in women with implantation failure after a first IVF/ICSI cycle; does it lead to a higher live birth rate? The SCRaTCH study: a randomized controlled trial (NTR 5342).

    Science.gov (United States)

    van Hoogenhuijze, N E; Torrance, H L; Mol, F; Laven, J S E; Scheenjes, E; Traas, M A F; Janssen, C; Cohlen, B; Teklenburg, G; de Bruin, J P; van Oppenraaij, R; Maas, J W M; Moll, E; Fleischer, K; van Hooff, M H; de Koning, C; Cantineau, A; Lambalk, C B; Verberg, M; Nijs, M; Manger, A P; van Rumste, M; van der Voet, L F; Preys-Bosman, A; Visser, J; Brinkhuis, E; den Hartog, J E; Sluijmer, A; Jansen, F W; Hermes, W; Bandell, M L; Pelinck, M J; van Disseldorp, J; van Wely, M; Smeenk, J; Pieterse, Q D; Boxmeer, J C; Groenewoud, E R; Eijkemans, M J C; Kasius, J C; Broekmans, F J M

    2017-07-21

    Success rates of assisted reproductive techniques (ART) are approximately 30%, with the most important limiting factor being embryo implantation. Mechanical endometrial injury, also called 'scratching', has been proposed to positively affect the chance of implantation after embryo transfer, but the currently available evidence is not yet conclusive. The primary aim of this study is to determine the effect of endometrial scratching prior to a second fresh in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) cycle on live birth rates in women with a failed first IVF/ICSI cycle. Multicenter randomized controlled trial in Dutch academic and non-academic hospitals. A total of 900 women will be included of whom half will undergo an endometrial scratch in the luteal phase of the cycle prior to controlled ovarian hyperstimulation using an endometrial biopsy catheter. The primary endpoint is the live birth rate after the 2 nd fresh IVF/ICSI cycle. Secondary endpoints are costs, cumulative live birth rate (after the full 2 nd IVF/ICSI cycle and over 12 months of follow-up); clinical and ongoing pregnancy rate; multiple pregnancy rate; miscarriage rate and endometrial tissue parameters associated with implantation failure. Multiple studies have been performed to investigate the effect of endometrial scratching on live birth rates in women undergoing IVF/ICSI cycles. Due to heterogeneity in both the method and population being scratched, it remains unclear which group of women will benefit from the procedure. The SCRaTCH trial proposed here aims to investigate the effect of endometrial scratching prior to controlled ovarian hyperstimulation in a large group of women undergoing a second IVF/ICSI cycle. NTR 5342 , registered July 31 st , 2015. Version 4.10, January 4th, 2017.

  2. Birth Defects

    Science.gov (United States)

    A birth defect is a problem that happens while a baby is developing in the mother's body. Most birth defects happen during the first 3 months of ... in the United States is born with a birth defect. A birth defect may affect how the ...

  3. Birth outcomes of planned home births in Missouri: a population-based study.

    Science.gov (United States)

    Chang, Jen Jen; Macones, George A

    2011-08-01

    We evaluated the birth outcomes of planned home births. We conducted a retrospective cohort study using Missouri vital records from 1989 to 2005 to compare the risk of newborn seizure and intrapartum fetal death in planned home births attended by physicians/certified nurse midwives (CNMs) or non-CNMs with hospitals/birthing center births. The study sample included singleton pregnancies between 36 and 44 weeks of gestation without major congenital anomalies or breech presentation ( N = 859,873). The adjusted odds ratio (aOR) of newborn seizures in planned home births attended by non-CNMs was 5.11 (95% confidence interval [CI]: 2.52, 10.37) compared with deliveries by physicians/CNMs in hospitals/birthing centers. For intrapartum fetal death, aORs were 11.24 (95% CI: 1.43, 88.29), and 20.33 (95% CI: 4.98, 83.07) in planned home births attended by non-CNMs and by physicians/CNMs, respectively, compared with births in hospitals/birthing centers. Planned home births are associated with increased likelihood of adverse birth outcomes. © Thieme Medical Publishers.

  4. Infertility, infertility treatment, and congenital malformations: Danish national birth cohort

    Science.gov (United States)

    Zhu, Jin Liang; Basso, Olga; Obel, Carsten; Bille, Camilla; Olsen, Jørn

    2006-01-01

    Objectives To examine whether infertile couples (with a time to pregnancy of > 12 months), who conceive naturally or after treatment, give birth to children with an increased prevalence of congenital malformations. Design Longitudinal study. Setting Danish national birth cohort. Participants Three groups of liveborn children and their mothers: 50 897 singletons and 1366 twins born of fertile couples (time to pregnancy ≤ 12 months), 5764 singletons and 100 twins born of infertile couples who conceived naturally (time to pregnancy > 12 months), and 4588 singletons and 1690 twins born after infertility treatment. Main outcome measures Prevalence of congenital malformations determined from hospital discharge diagnoses. Results Compared with singletons born of fertile couples, singletons born of infertile couples who conceived naturally or after treatment had a higher prevalence of congenital malformations—hazard ratios 1.20 (95% confidence interval 1.07 to 1.35) and 1.39 (1.23 to 1.57). The overall prevalence of congenital malformations increased with increasing time to pregnancy. When the analysis was restricted to singletons born of infertile couples, babies born after treatment had an increased prevalence of genital organ malformations (hazard ratio 2.32, 1.24 to 4.35) compared with babies conceived naturally. No significant differences existed in the overall prevalence of congenital malformations among twins. Conclusions Hormonal treatment for infertility may be related to the occurrence of malformations of genital organs, but our results suggest that the reported increased prevalence of congenital malformations seen in singletons born after assisted reproductive technology is partly due to the underlying infertility or its determinants. The association between untreated infertility and congenital malformations warrants further examination. PMID:16893903

  5. Decomposition Analysis of Black-White Disparities in Birth Outcomes: The Relative Contribution of Air Pollution and Social Factors in California.

    Science.gov (United States)

    Benmarhnia, Tarik; Huang, Jonathan; Basu, Rupa; Wu, Jun; Bruckner, Tim A

    2017-10-04

    Racial/ethnic disparities in preterm birth (PTB) are well documented in the epidemiological literature, but little is known about the relative contribution of different social and environmental determinants of such disparities in birth outcome. Furthermore, increased focus has recently turned toward modifiable aspects of the environment, including physical characteristics, such as neighborhood air pollution, to reduce disparities in birth outcomes. To apply decomposition methods to understand disparities in preterm birth (PTB) prevalence between births of non-Hispanic black individuals and births of non-Hispanic white individuals in California, according to individual demographics, neighborhood socioeconomic environment, and neighborhood air pollution. We used all live singleton births in California spanning 2005 to 2010 and estimated PTBs and other adverse birth outcomes for infants borne by non-Hispanic black mothers and white mothers. To compare individual-level, neighborhood-level, and air pollution [Particulate Matter, 2.5 micrometers or less (PM 2.5 ) and nitrogen dioxide (NO 2 )] predictors, we conducted a nonlinear extension of the Blinder-Oaxaca method to decompose racial/ethnic disparities in PTB. The predicted differences in probability of PTB between black and white infants was 0.056 (95% CI: 0.054, 0.058). All included predictors explained 37.8% of the black-white disparity. Overall, individual (17.5% for PTB) and neighborhood-level variables (16.1% for PTB) explained a greater proportion of the black-white difference in birth outcomes than air pollution (5.7% for PTB). Our results suggest that, although the role of individual and neighborhood factors remains prevailing in explaining black-white differences in birth outcomes, the individual contribution of PM 2.5 is comparable in magnitude to any single individual- or neighborhood-level factor. https://doi.org/10.1289/EHP490.

  6. Temporal trends in pregnancy weight gain and birth weight in Bavaria 2000–2007: slightly decreasing birth weight with increasing weight gain in pregnancy

    OpenAIRE

    Schiessl, Barbara; Beyerlein, Andreas; Lack, Nicholas; Kries, Rüdiger von

    2009-01-01

    Aims: To assess temporal trends in birth weight and pregnancy weight gain in Bavaria from 2000 to 2007. Methods: Data on 695,707 mother and infant pairs (singleton term births) were available from a compulsory reporting system for quality assurance, including information on birth weight, maternal weight at delivery and at booking, maternal smoking, age, and further anthropometric and lifestyle factors. Pregnancy weight gain was defined as: weight prior to delivery minus weight at first booki...

  7. Vanishing twins: a predictor of small-for-gestational age in IVF singletons

    DEFF Research Database (Denmark)

    Pinborg, Anja; Lidegaard, Ojvind; Freiesleben, Nina la Cour

    2007-01-01

    The purpose of this study was to assess the effect of a vanishing twin on the risk of being small-for-gestational age (SGA) in in vitro fertilization (IVF) singletons.......The purpose of this study was to assess the effect of a vanishing twin on the risk of being small-for-gestational age (SGA) in in vitro fertilization (IVF) singletons....

  8. Irrelevant Singletons in Pop-Out Search: Attentional Capture or Filtering Costs?

    Science.gov (United States)

    Becker, Stefanie I.

    2007-01-01

    The aim of the present study was to investigate whether costs invoked by the presence of an irrelevant singleton distractor in a visual search task are due to attentional capture by the irrelevant singleton or spatially unrelated filtering costs. Measures of spatial effects were based on distance effects, compatibility effects, and differences…

  9. Attentional Capture by an Unannounced Color Singleton Depends on Expectation Discrepancy

    Science.gov (United States)

    Horstmann, Gernot

    2005-01-01

    Eight experiments examined the conditions under which a color singleton that is presented for the 1st time without prior announcement captures attention. The main hypothesis is that an unannounced singleton captures attention to the extent that it deviates from expectations. This hypothesis was tested within a visual-search paradigm in which…

  10. Higher Prevalence of Left-Handedness in Twins? Not After Controlling Birth Time Confounders.

    Science.gov (United States)

    Heikkilä, Kauko; Vuoksimaa, Eero; Saari-Kemppainen, Aulikki; Kaprio, Jaakko; Rose, Richard J; Haukka, Jari; Pitkäniemi, Janne; Iivanainen, Matti

    2015-10-01

    Pregnancy- and birth-related factors may have an effect on handedness. Compared with singletons, twins have a lower birth weight, shorter gestational age, and are at higher risk for birth complications. We tested whether the prevalence of left-handedness is higher among twins than singletons, and if so, whether that difference is fully explained by pregnancy and birth-related differences between twins and singletons. We analyzed Finnish population-based datasets; included were 8,786 twins and 5,892 singletons with information on birth weight (n = 12,381), Apgar scores (n = 11,129), and gestational age (n = 11,811). Two twin cohorts were involved: FinnTwin12 included twins born during 1983-1987, and FinnTwin16 included twins born during 1974-1979. We had two comparison groups of singletons: 4,101 individuals born during 1986-1988 and enrolled in the Helsinki Ultrasound Trial, and 1,791 individuals who were partners of FinnTwin16 twins. We used logistic regression models with writing hand as the outcome for comparison and evaluating effects of covariates. Left-handedness was more common in twins (9.67%) than in singletons (8.27%; p = .004). However, Apgar scores were associated with handedness, and after controlling for covariates, we found no difference in the prevalence of left-handedness between twins and singletons. Increased left-handedness among twins, often reported by others, was evident in our data, but only among our older twin cohorts, and that association disappeared after removing effects of perinatal covariates.

  11. Undiagnosed coeliac disease in a father does not influence birthweight and preterm birth.

    LENUS (Irish Health Repository)

    Khashan, Ali S

    2012-01-31

    There is conflicting evidence regarding the effect of coeliac disease (CD) in the father on birthweight and preterm birth. We investigated the association between paternal CD and birthweight and preterm birth. Medical records of all singleton live-born children in Denmark between 1 January 1979 and 31 December 2004 were linked to information about parents\\' diseases. Fathers who were diagnosed with CD were then identified. Fathers with CD were considered treated if they were diagnosed before pregnancy and untreated if they were diagnosed after the date of conception. The outcome measures were: birthweight, small-for-gestational age (birthweight<10th centile for gestational age) and preterm birth (<37 weeks). We compared the offspring of men without CD (n = 1 472 352) and offspring of those with CD [untreated (n = 138) and treated (n = 473)]. There was no significant association between untreated CD in the father and birthweight (adjusted mean difference = -3 g; [95% CI -46, 40]) or preterm birth (adjusted odds ratio (OR) = 0.86, [95% CI 0.53, 1.37]) (compared with no CD). There was some evidence for an association between treated paternal CD and birthweight (adjusted mean difference = -81 g; [95% CI -161, -3]), but not preterm birth (adjusted OR = 1.76, [95% CI 0.95, 3.26]). Untreated paternal CD was not associated with an increased risk of reduced birthweight, or of preterm birth. There was some evidence that diagnosis and presumed treatment of paternal CD with a gluten-free diet is associated with reduced birthweight.

  12. Revisiting the mode of delivery and outcome of singleton breech ...

    African Journals Online (AJOL)

    There was an increased rate of special care baby unit admission in the group that had assisted vaginal breech delivery than in those that had elective caesarean section. There was no difference in terms of birth injury, neonatal death and maternal morbidities between those that had assisted vaginal breech delivery and ...

  13. Becoming a parent to a child with birth asphyxia—From a traumatic delivery to living with the experience at home

    Directory of Open Access Journals (Sweden)

    Alina Heringhaus

    2013-04-01

    Full Text Available The aim of this study is to describe the experiences of becoming a parent to a child with birth asphyxia treated with hypothermia in the neonatal intensive care unit (NICU. In line with the medical advances, the survival of critically ill infants with increased risk of morbidity is increasing. Children who survive birth asphyxia are at a higher risk of functional impairments, cerebral palsy (CP, or impaired vision and hearing. Since 2006, hypothermia treatment following birth asphyxia is used in many of the Swedish neonatal units to reduce the risk of brain injury. To date, research on the experience of parenthood of the child with birth asphyxia is sparse. To improve today's neonatal care delivery, health-care providers need to better understand the experiences of becoming a parent to a child with birth asphyxia. A total of 26 parents of 16 children with birth asphyxia treated with hypothermia in a Swedish NICU were interviewed. The transcribed interview texts were analysed according to a qualitative latent content analysis. We found that the experience of becoming a parent to a child with birth asphyxia treated with hypothermia at the NICU was a strenuous journey of overriding an emotional rollercoaster, that is, from being thrown into a chaotic situation which started with a traumatic delivery to later processing the difficult situation of believing the child might not survive or was to be seriously affected by the asphyxia. The prolonged parent–infant separation due to the hypothermia treatment and parents’ fear of touching the infant because of the high-tech equipment seemed to hamper the parent–infant bonding. The adaption of the everyday life at home seemed to be facilitated by the follow-up information of the doctor after discharge. The results of this study underline the importance of family-centered support during and also after the NICU discharge.

  14. Becoming a parent to a child with birth asphyxia-From a traumatic delivery to living with the experience at home.

    Science.gov (United States)

    Heringhaus, Alina; Blom, Michaela Dellenmark; Wigert, Helena

    2013-04-30

    The aim of this study is to describe the experiences of becoming a parent to a child with birth asphyxia treated with hypothermia in the neonatal intensive care unit (NICU). In line with the medical advances, the survival of critically ill infants with increased risk of morbidity is increasing. Children who survive birth asphyxia are at a higher risk of functional impairments, cerebral palsy (CP), or impaired vision and hearing. Since 2006, hypothermia treatment following birth asphyxia is used in many of the Swedish neonatal units to reduce the risk of brain injury. To date, research on the experience of parenthood of the child with birth asphyxia is sparse. To improve today's neonatal care delivery, health-care providers need to better understand the experiences of becoming a parent to a child with birth asphyxia. A total of 26 parents of 16 children with birth asphyxia treated with hypothermia in a Swedish NICU were interviewed. The transcribed interview texts were analysed according to a qualitative latent content analysis. We found that the experience of becoming a parent to a child with birth asphyxia treated with hypothermia at the NICU was a strenuous journey of overriding an emotional rollercoaster, that is, from being thrown into a chaotic situation which started with a traumatic delivery to later processing the difficult situation of believing the child might not survive or was to be seriously affected by the asphyxia. The prolonged parent-infant separation due to the hypothermia treatment and parents' fear of touching the infant because of the high-tech equipment seemed to hamper the parent-infant bonding. The adaption of the everyday life at home seemed to be facilitated by the follow-up information of the doctor after discharge. The results of this study underline the importance of family-centered support during and also after the NICU discharge.

  15. Prevalence and perinatal mortality associated with preterm births in a tertiary medical center in South East Nigeria

    Directory of Open Access Journals (Sweden)

    Iyoke CA

    2014-10-01

    Full Text Available Chukwuemeka Anthony Iyoke,1 Osaheni Lucky Lawani,2 Euzebus Chinonye Ezugwu,1 Gideon Ilechukwu,3 Peter Onubiwe Nkwo,1 Sunday Gabriel Mba,1 Isaac Nwabueze Asinobi41Department of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria; 2Department of Obstetrics and Gynaecology, Federal Teaching Hospital, Abakaliki, Nigeria; 3Department of Paediatrics, Whiston Hospital, St Helen's and Knowsley Teaching Hospitals NHS Trust, Prescot, Lancashire, UK; 4Department of Paediatrics, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, NigeriaBackground: Preterm birth is a high risk condition associated with significant mortality and morbidity in the perinatal, neonatal, and childhood periods, and even in adulthood. Knowledge of the epidemiology of preterm births is necessary for planning appropriate maternal and fetal care.Objective: The objective of this study was to determine the prevalence, pattern, and perinatal mortality associated with preterm births at the University of Nigeria Teaching Hospital, Enugu, South East Nigeria.Methods: This was a review of prospectively collected routine delivery data involving preterm deliveries that occurred between 1 January 2009 and 31 December 2013. Data analysis involved descriptive and inferential statistics at 95% level of confidence using SPSS version 17.0 for Windows.Results: There were 3,760 live births over the 5-year study period out of which 636 were preterm births, giving a prevalence rate of 16.9%. Spontaneous preterm births occurred in approximately 57% of preterm births while provider-initiated births occurred in 43%. The mean gestational age at preterm deliveries was 32.6±3.2 weeks while the mean birth weight was 2.0±0.8 kilograms. Approximately 89% of preterm births involved singleton pregnancies. Sixty-eight percent of preterm births were moderate to late preterm. The male:female ratio of preterm babies born during the period was 1.2:1. The adjusted

  16. Breech birth

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/patientinstructions/000623.htm Breech birth To use the sharing features on this page, ... safer for your baby to pass through the birth canal. In the last weeks of pregnancy, your ...

  17. Cost-effectiveness of embryo transfer strategies: a decision analytic model using long-term costs and consequences of singletons and multiples born as a consequence of IVF.

    Science.gov (United States)

    van Heesch, M M J; van Asselt, A D I; Evers, J L H; van der Hoeven, M A H B M; Dumoulin, J C M; van Beijsterveldt, C E M; Bonsel, G J; Dykgraaf, R H M; van Goudoever, J B; Koopman-Esseboom, C; Nelen, W L D M; Steiner, K; Tamminga, P; Tonch, N; Torrance, H L; Dirksen, C D

    2016-11-01

    What is the cost-effectiveness of elective single embryo transfer (eSET) versus double embryo transfer (DET) strategies from a societal perspective, when applying a time horizon of 1, 5 and 18 years? From a short-term perspective (1 year) it is cost-effective to replace DET with single embryo transfer; however when intermediate- (5 years) and long-term (18 years) costs and consequences are incorporated, DET becomes the most cost-effective strategy, given a ceiling ratio of €20 000 per quality-adjusted life years (QALY) gained. According to previous cost-effectiveness research into embryo transfer strategies, DET is considered cost-effective if society is willing to pay around €20 000 for an extra live birth. However, interpretation of those studies is complicated, as those studies fail to incorporate long-term costs and outcomes and used live birth as a measure of effectiveness instead of QALYs. With this outcome, both multiple and singletons were valued as one live birth, whereas costs of all children of a multiple were incorporated. A Markov model (cycle length: 1 year; time horizon: 1, 5 and 18 years) was developed comparing a maximum of: (i) three cycles of eSET in all patients; (ii) four cycles of eSET in all patients; (iii) five cycles of eSET in all patients; (iv) three cycles of standard treatment policy (STP), i.e. eSET in women costs were estimated for all comparators. Input parameters were derived from a retrospective cohort study, in which hospital resource data were collected (n=580) and a parental questionnaire was sent out (431 respondents). Probabilistic sensitivity analysis (5000 iterations) was performed. With a time horizon of 18 years, DETx3 is most effective (0.54 live births, 10.2 LYs and 9.8 QALYs) and expensive (€37 871) per couple starting IVF. Three cycles of eSET are least effective (0.43 live births, 7.1 LYs and 6.8 QALYs) and expensive (€25 563). We assumed that society is willing to pay €20 000 per QALY gained. With a time

  18. The relation between maternal schizophrenia and low birth weight is modified by paternal age.

    Science.gov (United States)

    Lin, Herng-Ching; Lee, Hsin-Chien; Tang, Chao-Hsuin; Chen, Yi-Hua

    2010-06-01

    Paternal characteristics have never been considered in the relation between maternal schizophrenia and adverse pregnancy outcomes. The aim of our study was to consider different paternal ages while investigating the relation between maternal schizophrenia and low birth weight (LBW), using a nationwide population-based dataset. Our study used data from the 2001 to 2003 Taiwan National Health Insurance Research Dataset and birth certificate registry. A total of 543 394 singleton live births were included. We performed multivariate logistic regression analyses to explore the relation between maternal schizophrenia and the risk of LBW, taking different paternal age groups into account (aged 29 years or younger, 30 to 39 years, and 40 years and older), and after adjusting for other characteristics of infant, mother, and father as well as the difference between the parent's ages. Mothers with schizophrenia had a higher percentage of LBW infants than mothers who did not (11.8%, compared with 6.8%). For infants whose mothers had schizophrenia, the adjusted odds ratios of LBW were 1.47 (95% CI 1.02 to 2.27, P paternal age groups of 30 to 39 years and 40 years or older, respectively. However, maternal schizophrenia was not a significant predictor of LBW for infants whose fathers were aged 29 years and younger. The relation between LBW and maternal schizophrenia is modified by paternal age. More attention should be paid to the interaction of paternal characteristics and maternal psychiatric disorders in producing adverse pregnancy outcomes.

  19. Contribution of maternal age to preterm birth rates in Denmark and Quebec, 1981-2008

    DEFF Research Database (Denmark)

    Auger, Nathalie; Hansen, Anne V; Mortensen, Laust Hvas

    2013-01-01

    OBJECTIVES: We sought evidence to support the hypothesis that advancing maternal age is potentially causing a rise in preterm birth (PTB) rates in high-income countries. METHODS: We assessed maternal age-specific trends in PTB using all singleton live births in Denmark (n = 1 674 308) and Quebec (n...... = 2 291 253) from 1981 to 2008. We decomposed the country-specific contributions of age-specific PTB rates and maternal age distribution to overall PTB rates over time. RESULTS: PTB rates increased from 4.4% to 5.0% in Denmark and from 5.1% to 6.0% in Quebec. Rates increased the most in women aged 20...... to 29 years, whereas rates decreased or remained stable in women aged 35 years and older. The overall increase over time was driven by age-specific PTB rates, although the contribution of younger women was countered by fewer births at this age in both Denmark and Quebec. CONCLUSIONS: PTB rates increased...

  20. Contribution of maternal age to preterm birth rates in Denmark and Quebec, 1981-2008.

    Science.gov (United States)

    Auger, Nathalie; Hansen, Anne V; Mortensen, Laust

    2013-10-01

    We sought evidence to support the hypothesis that advancing maternal age is potentially causing a rise in preterm birth (PTB) rates in high-income countries. We assessed maternal age-specific trends in PTB using all singleton live births in Denmark (n = 1 674 308) and Quebec (n = 2 291 253) from 1981 to 2008. We decomposed the country-specific contributions of age-specific PTB rates and maternal age distribution to overall PTB rates over time. PTB rates increased from 4.4% to 5.0% in Denmark and from 5.1% to 6.0% in Quebec. Rates increased the most in women aged 20 to 29 years, whereas rates decreased or remained stable in women aged 35 years and older. The overall increase over time was driven by age-specific PTB rates, although the contribution of younger women was countered by fewer births at this age in both Denmark and Quebec. PTB rates increased among women aged 20 to 29 years, but their contribution to the overall PTB rates was offset by older maternal age over time. Women aged 20 to 29 years should be targeted to reduce PTB rates, as potential for prevention may be greater in this age group.

  1. Factors associated with delaying birth of first child: A Case Study of 15- 49 years old married women lived in Meybod town

    Directory of Open Access Journals (Sweden)

    R Zare Mehrjardi

    2016-09-01

    Full Text Available Introduction: The purpose of this paper is to examine the impact of demographic, social, economic and cultural factors on delaying the Birth of the first child in Meybod town. Spacing between marriage and the birth of the first child is a crucial factor in demographic planning. Methods: The survey was research method and Information collected by the structured questionnaire. The study population was married women 15 to 49 years old in the city Meybod, and the sample population included 379 such women were selected with using of multi stage cluster random sampling. Results: The results of the study show that there are a meaningful relationship between the variables of women’s tendency to pregnancy, kind of family, women’s age and duration of marriage, Education of women and their husbands, geographic origin of women, occupational status of women, and their type of marriage with the dependent variable the length of period from marriage to first child birth. Also, Results of multivariate regression shows that the Use of contraceptive, women’s marriage age, women’s geographic origin, Duration of marriage, Gender Equality and kind of family, Respectively, Have a major role in determining this spacing, and able to predict 34% of the variance in the dependent variable. Conclusion: The results of this study and previous studies shows that in recent years, the space between marriage and birth of first child has increased and from the intensity of fertility is reduced. Overall, from the findings can be concluded that impact of demographic, social and cultural Condition on increase in delaying of the first child birth, and therefore the fertility decline of society is far more than economic conditions. So, to reduce the space between marriage and the birth of first child in the planning, should pay more attention to demographic and social-cultural Factors.

  2. The impact of maternal celiac disease on birthweight and preterm birth: a Danish population-based cohort study.

    LENUS (Irish Health Repository)

    Khashan, A S

    2012-01-31

    BACKGROUND: Adverse pregnancy outcomes have been associated with maternal celiac disease (CD). In this study, we investigate the effect of treated and untreated maternal CD on infant birthweight and preterm birth. METHODS: A population-based cohort study consisted of all singleton live births in Denmark between 1 January 1979 and 31 December 2004 was used. A total of 1,504,342 babies were born to 836,241 mothers during the study period. Of those, 1105 babies were born to women with diagnosed CD and 346 were born to women with undiagnosed CD. Women with diagnosed CD were considered as treated with a gluten free diet while women with undiagnosed CD were considered as untreated. The outcome measures were: birthweight, small for gestational age (SGA: birthweight <10th centile), very small for gestational age (VSGA: birthweight <5th centile) and preterm birth. We compared these measures in treated and untreated women with those of a reference group (no history of CD). RESULTS: Women with untreated CD delivered smaller babies [difference = -98 g (95% CI: -130, -67)], with a higher risk of SGA infants [OR = 1.31 (95% CI: 1.06, 1.63)], VSGA infants [OR = 1.54 (95% CI: 1.17, 2.03)] and preterm birth [OR = 1.33 (95% CI: 1.02, 1.72)] compared with women without CD. Women with treated CD had no increased risk of reduced mean birthweight, risk of delivering SGA and VSGA infants or preterm birth compared with women without CD. CONCLUSION: Untreated maternal CD increases the risk of reduced birthweight, the risk of delivering SGA and VSGA infants and preterm birth. Diagnosis and presumed treatment of maternal CD with a gluten-free diet appeared to result in a birthweight and preterm birth rate similar to those in women without CD.

  3. Preterm birth and reduced birthweight in first and second teenage pregnancies: a register-based cohort study.

    LENUS (Irish Health Repository)

    Khashan, Ali S

    2010-01-01

    BACKGROUND: Higher risks of preterm birth and small for gestational age babies have been reported in teenagers. The aim of this study was to investigate the relationship between first and second teenage pregnancies and preterm birth, birthweight and small for gestational age (SGA). METHODS: All women aged 14 to 29 yrs who gave birth to live singletons in the North Western Region of England between January 1st 2004 and December 31st 2006 were identified. Women were classified in three groups; 14-17 yrs, 18-19 yrs and 20-29 yrs (reference group). The outcome measures were preterm birth, very preterm birth, birthweight, SGA (< 5th percentile), very SGA (VSGA< 3rd percentile). We compared these outcome measures in teenagers\\' first and second pregnancies with those of mothers aged 20 to 29 yrs. RESULTS: The risk of preterm birth was increased in first (OR = 1.21, [95% CI: 1.01-1.45]) and second (OR = 1.93, [95% CI: 1.38-2.69]) time mothers aged 14-17 yrs compared to the reference group. Birthweight was reduced in the first (mean difference = -24 g; [95% CI: -40, -7]) and second (mean difference = -80 g; [95% CI: -115, -46]) time mothers aged 14-17 yrs compared to the reference group. There was some evidence of a protective effect against VSGA in 14-17 yr old first time mothers (OR = 0.79, [95% CI: 0.63-0.99]). CONCLUSIONS: Teenage mothers are at increased risk of preterm birth compared to adult mothers and this risk is further increased in second time teen pregnancies. This study highlights the importance of ensuring pregnant teenagers have appropriate antenatal care. A first pregnancy may be the first and only time a pregnant teenager interacts with health services and this opportunity for health education and the promotion of contraception should not be overlooked.

  4. Preterm birth and reduced birthweight in first and second teenage pregnancies: a register-based cohort study

    Directory of Open Access Journals (Sweden)

    Baker Philip N

    2010-07-01

    Full Text Available Abstract Background Higher risks of preterm birth and small for gestational age babies have been reported in teenagers. The aim of this study was to investigate the relationship between first and second teenage pregnancies and preterm birth, birthweight and small for gestational age (SGA. Methods All women aged 14 to 29 yrs who gave birth to live singletons in the North Western Region of England between January 1st 2004 and December 31st 2006 were identified. Women were classified in three groups; 14-17 yrs, 18-19 yrs and 20-29 yrs (reference group. The outcome measures were preterm birth, very preterm birth, birthweight, SGA (th percentile, very SGA (VSGArd percentile. We compared these outcome measures in teenagers' first and second pregnancies with those of mothers aged 20 to 29 yrs. Results The risk of preterm birth was increased in first (OR = 1.21, [95% CI: 1.01-1.45] and second (OR = 1.93, [95% CI: 1.38-2.69] time mothers aged 14-17 yrs compared to the reference group. Birthweight was reduced in the first (mean difference = -24 g; [95% CI: -40, -7] and second (mean difference = -80 g; [95% CI: -115, -46] time mothers aged 14-17 yrs compared to the reference group. There was some evidence of a protective effect against VSGA in 14-17 yr old first time mothers (OR = 0.79, [95% CI: 0.63-0.99]. Conclusions Teenage mothers are at increased risk of preterm birth compared to adult mothers and this risk is further increased in second time teen pregnancies. This study highlights the importance of ensuring pregnant teenagers have appropriate antenatal care. A first pregnancy may be the first and only time a pregnant teenager interacts with health services and this opportunity for health education and the promotion of contraception should not be overlooked.

  5. Trends and predictors of cesarean birth in Singapore, 2005-2014: A population-based cohort study.

    Science.gov (United States)

    Chi, Claudia; Pang, Deanette; Aris, Izzuddin M; Teo, Wei Ting; Li, Sarah Weiling; Biswas, Arijit; Yong, Eu Leong; Chong, Yap Seng; Tan, Kelvin; Kramer, Michael S

    2018-02-17

    Rates of cesarean birth have continued to rise in many high-income countries. We examined the temporal trends and predictors of cesarean birth in Singapore. Linked hospitalization and Birth Registry data were used to examine all live births to Singaporean citizens and permanent residents between January 1, 2005 and December 31, 2014 (n = 342 932 births). We calculated cesarean rates and age-adjusted average annual percent change (AAPC) in those rates and used sequential multivariable regression modeling to assess the contribution of changes in predictors to the change in cesarean rates over time. The overall cesarean rate in Singapore rose from 32.2% in 2005 to 37.4% in 2014. Among singleton, cephalic, term pregnancies, the two major predictions of cesarean were nulliparity and previous cesarean, each accounting for just over one-third of all cesareans. Higher AAPC was observed in nulliparous women of Indian ethnicity (0.74% [95% confidence interval 0.68-0.80]) compared with Chinese (0.62% [0.60-0.65]) or Malay women (0.63% [0.59-0.68]), and in women who delivered in private hospitals (0.62% [0.60-0.64]) compared with those delivered under subsidized care in public hospitals (0.58% [0.52-0.63]). Parity and education had the largest influences on cesarean birth trend (attenuation of AAPC from 0.62% [0.59-0.66] to 0.39% [0.38-0.40] after adjustment). Cesarean birth has continued to rise at a steady rate in Singapore. Strategies to curb this temporal increase include avoidance of medically unnecessary primary cesarean and attempts at trial of labor and vaginal delivery among women with a history of prior cesarean. © 2018 Wiley Periodicals, Inc.

  6. From institutionalized birth to home birth

    Directory of Open Access Journals (Sweden)

    Clara Fróes de Oliveira Sanfelice

    2014-06-01

    Full Text Available The study aimed to describe the experiences of a group of nurse-midwives from the city of Campinas, SP, Brasil, regarding the transition process from attending institutionalized births to attending home births, in the period 2011 – 2013. The study is of the experience report type; the reflections, perceptions and challenges experienced in this process were collected using the technique of brainstorming. Content analysis, as proposed by Bardin, was used, which yielded four thematic categories: a the hospital experience; b living with obstetric violence; c returning home and d the challenges of home care. It is concluded that attending home births offers greater satisfaction to the nurses, even in the face of various obstacles, as it is possible to offer a care to the woman and new-born which covers both the concept of comprehensiveness and the current scientific recommendations.

  7. The contribution of gestational age, area deprivation and mother’s country of birth to ethnic variations in infant mortality in England and Wales: A national cohort study using routinely collected data

    Science.gov (United States)

    Quigley, Maria A.; Dattani, Nirupa; Gray, Ron; Jayaweera, Hiranthi; Kurinczuk, Jennifer J.; Macfarlane, Alison; Hollowell, Jennifer

    2018-01-01

    Objectives We aimed to describe ethnic variations in infant mortality and explore the contribution of area deprivation, mother’s country of birth, and prematurity to these variations. Methods We analyzed routine birth and death data on singleton live births (gestational age≥22 weeks) in England and Wales, 2006–2012. Infant mortality by ethnic group was analyzed using logistic regression with adjustment for sociodemographic characteristics and gestational age. Results In the 4,634,932 births analyzed, crude infant mortality rates were higher in Pakistani, Black Caribbean, Black African, and Bangladeshi infants (6.92, 6.00, 5.17 and 4.40 per 1,000 live births, respectively vs. 2.87 in White British infants). Adjustment for maternal sociodemographic characteristics changed the results little. Further adjustment for gestational age strongly attenuated the risk in Black Caribbean (OR 1.02, 95% CI 0.89–1.17) and Black African infants (1.17, 1.06–1.29) but not in Pakistani (2.32, 2.15–2.50), Bangladeshi (1.47, 1.28–1.69), and Indian infants (1.24, 1.11–1.38). Ethnic variations in infant mortality differed significantly between term and preterm infants. At term, South Asian groups had higher risks which cannot be explained by sociodemographic characteristics. In preterm infants, adjustment for degree of prematurity (ethnic inequalities in infant mortality. PMID:29649290

  8. Perinatal mortality in twin pregnancy: an analysis of birth weight-specific mortality rates and adjusted mortality rates for birth weight distributions.

    Science.gov (United States)

    Fabre, E; González de Agüero, R; de Agustin, J L; Pérez-Hiraldo, M P; Bescos, J L

    1988-01-01

    The objective of this study is to compare the fetal mortality rate (FMR), early neonatal mortality rate (ENMR) and perinatal mortality rate (PMR) of twin and single births. It is based on a survey which was carried out in 22 Hospital Centers in Spain in 1980, and covered 1,956 twins born and 110,734 singletons born. The FMR in twins was 36.3/1000 and 8.8/1000 for singletons. The ENMR in twins was 36.1/1000 and 5.7/1000 for singletons. The PMR in twins was 71.1/1000 and 14.4/1000 for singletons. When birthweight-specific PMR in twin and singletons births are compared, there were no differences between the rates for groups 500-999 g and 1000-1499 g. For birthweight groups of 1500-1999 g (124.4 vs 283.8/1000) and 2000-2999 g (29.6 vs 73.2/1000) the rates for twins were about twice lower than those for single births. The PMR for 2500 g and over birthweight was about twice higher in twins than in singletons (12.5 vs 5.5/1000). After we adjusted for birthweight there was a difference in the FMR (12.6 vs 9.8/1000) and the PMR (19.1 vs 16.0/1000, and no difference in the ENMR between twins and singletons (5.9 vs 6.4/1000), indicating that most of the differences among crude rates are due to differences in distribution of birthweight.

  9. Births: Final Data for 1998.

    Science.gov (United States)

    Ventura, Stephanie J.; Martin, Joyce A.; Curtin, Sally C.; Matthews, T. J.; Park, Melissa M.

    2000-01-01

    This report presents 1998 data on U.S. births according to a wide variety of characteristics. Data are presented for maternal demographic characteristics, including: (1) age, live-birth order, race, Hispanic origin, marital status, and educational attainment; (2) maternal lifestyle and health characteristics, such as medical risk factors, weight…

  10. Births: Final Data for 2001.

    Science.gov (United States)

    Martin, Joyce A.; Hamilton, Brady E.; Ventura, Stephanie J.; Menacker, Fay; Park, Melissa M.; Sutton, Paul D.

    2002-01-01

    This report presents 2001 data on U.S. births according to maternal demographics (age, live-birth order, marital status, race, Hispanic origin, and educational attainment); maternal characteristics (medical risk factors, weight gain, and tobacco and alcohol use); pregnant women's medical care utilization (prenatal care, obstetric procedures,…

  11. What and where in speech recognition: Geminates and singletons in spoken Italian

    NARCIS (Netherlands)

    Tagliapietra, L.; McQueen, J.M.

    2010-01-01

    Four cross-modal repetition priming experiments examined whether consonant duration in Italian provides listeners with information not only for segmental identification ("what" information: whether the consonant is a geminate or a singleton) but also for lexical segmentation ("where" information:

  12. Singleton Pregnancy Outcomes after In Vitro Fertilization with Fresh or Frozen-Thawed Embryo Transfer and Incidence of Placenta Praevia

    Directory of Open Access Journals (Sweden)

    Sara Korosec

    2014-01-01

    Full Text Available The aim of the study was to compare the single pregnancy and neonate outcome after fresh and frozen-thawed embryo transfer in the in vitro fertilization programme (IVF. The study focused on clinical and laboratory factors affecting the abnormal placentation, especially placenta praevia, in patients conceiving in the IVF programme. The results confirm that neonates born after frozen-thawed embryo transfer had significantly higher mean birth weight than after fresh embryo transfer (ET. Moreover, the birth weight distribution in singletons was found to shift towards “large for gestation” (LGA after frozen-thawed ET. On the other hand, the pregnancies after fresh ET were characterized by a higher incidence of placenta praevia and 3rd trimester bleeding. Placenta praevia was more common in IVF patients with fresh ET in a stimulated cycle than in patients with ET in a spontaneous cycle. It occurred more frequently in patients with transfer of 2 embryos. From this point of view, single ET and ET in a spontaneous cycle should be encouraged in good prognosis patients in the future with more than two good quality embryos developed. An important issue arose of how the ovarian hormonal stimulation relates to abnormal placentation and if the serum hormone levels interfere with in the IVF treatment results.

  13. Large baby syndrome in singletons born after frozen embryo transfer (FET)

    DEFF Research Database (Denmark)

    Pinborg, Anja; Henningsen, AA; Loft, A

    2013-01-01

    Are singletons born after frozen embryo transfer (FET) at increased risk of being born large for gestational age (LGA) and if so, is this caused by intrinsic maternal factors or related to the freezing/thawing procedures?......Are singletons born after frozen embryo transfer (FET) at increased risk of being born large for gestational age (LGA) and if so, is this caused by intrinsic maternal factors or related to the freezing/thawing procedures?...

  14. Twin-singleton differences in cognitive abilities in a sample of Africans in Nigeria.

    Science.gov (United States)

    Hur, Yoon-Mi; Lynn, Richard

    2013-08-01

    Recent studies comparing cognitive abilities between contemporary twins and singletons in developed countries have suggested that twin deficits in cognitive abilities no longer exist. We examined cognitive abilities in a sample of twins and singletons born recently in Nigeria to determine whether recent findings can be replicated in developing countries. Our sample consisted of 413 pairs of twins and 280 singletons collected from over 45 public schools in Abuja and its neighboring states in Nigeria. The ages of twins and singletons ranged from 9 to 20 years with a mean (SD) of 14.6 years (2.2 years) for twins and 16.1 years (1.8 years) for singletons. Zygosity of the same-sex twins was determined by analysis of 16 deoxyribonucleic acid markers. We asked participants to complete a questionnaire booklet that included Standard Progressive Matrices-Plus Version (SPM+), Mill-Hill Vocabulary Scale (MHV), Family Assets Questionnaire, and demographic questions. The data were corrected for sex and age and then analyzed using maximum likelihood model-fitting analysis. Although twins and singletons were comparable in family social class indicators, singletons did better than twins across all the tests (d = 0.10 to 0.35). The average of d for SPM+ total [0.32; equivalent to 4.8 Intelligence Quotient (IQ) points] and d for MHV (0.24; equivalent to 3.6 IQ points) was 0.28 (equivalent to 4.2 IQ points), similar to the twin-singleton gap found in old cohorts in developed countries. We speculate that malnutrition, poor health, and educational systems in Nigeria may explain the persistence of twin deficits in cognitive abilities found in our sample.

  15. Ovarian hyperstimulation syndrome in a spontaneous singleton pregnancy.

    Science.gov (United States)

    Cabar, Fábio Roberto

    2016-05-24

    The ovarian hyperstimulation syndrome is the combination of increased ovarian volume, due to the presence of multiple cysts and vascular hyperpermeability, with subsequent hypovolemia and hemoconcentration. We report a case of spontaneous syndrome in a singleton pregnancy. This was a spontaneous pregnancy with 12 weeks of gestational age. The pregnancy was uneventful until 11 weeks of gestational age. After that, the pregnant woman complained of progressive abdominal distention associated with abdominal discomfort. She did not report other symptoms. In the first trimester, a routine ultrasonography showed enlarged ovaries, multiples cysts and ascites. Upon admission, the patient was hemodynamically stable, her serum β-hCG was 24,487mIU/mL, thyroid-stimulating hormone was 2.2µUI/mL and free T4 was 1.8ng/dL. All results were within normal parameters. However, levels of estradiol were high (10,562pg/mL). During hospitalization, she received albumin, furosemide and prophylactic dose of enoxaparin. The patient was discharged on the sixth hospital day. RESUMO A síndrome de hiperestimulação ovariana é a combinação do aumento dos ovários, devido à presença de múltiplos cistos e de hiperpermeabilidade vascular, com subsequente hipovolemia e hemoconcentração. Relata-se um caso de síndrome espontânea em uma gestação única. Trata-se de gravidez espontânea com 12 semanas de idade gestacional. A gravidez ocorreu sem intercorrências até 11 semanas de idade gestacional. Após, a gestante passou a se queixar de distensão abdominal progressiva, associada com desconforto abdominal. A paciente não relatava outros sintomas. A ultrassonografia de rotina no primeiro trimestre mostrou ovários aumentados com múltiplos cistos e ascite. No momento da internação, a paciente apresentava-se hemodinamicamente estável, com β-hCG sérico de 24.487mUI/mL, hormônio estimulante da tireoide de 2,2µUI/m e T4 livre de 1,8ng/dL, ou seja, valores dentro dos par

  16. Selected preconception health indicators and birth weight disparities in a national study.

    Science.gov (United States)

    Strutz, Kelly L; Richardson, Liana J; Hussey, Jon M

    2014-01-01

    This analysis explored the effect of timing, sequencing, and change in preconception health across adolescence and young adulthood on racial/ethnic disparities in birth weight in a diverse national cohort of young adult women. Data came from Waves I (1994-1995), III (2001-2002), and IV (2007-2008) of the National Longitudinal Study of Adolescent Health. Eligibility was restricted to all singleton live births to female non-Hispanic White, non-Hispanic Black, Mexican-origin Latina, or Asian/Pacific Islander participants (n = 3,014) occurring between the Wave III (ages 18-26 years) and IV (ages 24-32 years) interviews. Birth weight was categorized into low (4,000 g). Preconception health indicators were cigarette smoking, heavy alcohol consumption, overweight or obesity, and inadequate physical activity, measured in adolescence (Wave I, ages 11-19 years) and early adulthood (Wave III) and combined into four-category variables to capture the timing and sequencing of exposure. Measures of preconception health did not explain the Black-White disparity in low birth weight, which increased after adjustment for confounders (odds ratio [OR], 2.17; 95% confidence interval [CI], 1.33-3.53) and effect modification by overweight/obesity (OR, 3.58; 95% CI, 1.65-7.78). A positive association between adult-onset overweight/obesity and macrosomia was modified by race (OR, 3.83; 95% CI, 1.02-14.36 for Black women). This longitudinal analysis provides new evidence on preconception health and racial/ethnic disparities in birth weight. Specifically, it indicates that interventions focused on prevention of overweight/obesity and maintenance of healthy weight during the transition to adulthood, especially among Black females, may be warranted. Copyright © 2014 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

  17. Dissociating Compatibility Effects and Distractor Costs in the Additional Singleton Paradigm

    Directory of Open Access Journals (Sweden)

    Charles eFolk

    2013-07-01

    Full Text Available The interpretation of identity compatibility effects associated with irrelevant items outside the nominal focus of attention has fueled much of the debate over early versus late selection and perceptual load theory. However, compatibility effects have also played a role in the debate over the extent to which the involuntary allocation of spatial attention (i.e., attentional capture is completely stimulus-driven or whether it is contingent on top-down control settings. For example, in the context of the additional singleton paradigm, irrelevant color singletons have been found to produce not only an overall cost in search performance but also significant compatibility effects. This combination of search costs and compatibility effects has been taken as evidence that spatial attention is indeed allocated in a bottom-up fashion to the salient but irrelevant singletons. However, it is possible that compatibility effects in the additional singleton paradigm reflect parallel processing of identity associated with low perceptual load rather than an involuntary shift of spatial attention. In the present experiments, manipulations of load were incorporated into the traditional additional singleton paradigm. Under low load conditions, both search costs and compatibility effects were obtained, replicating previous studies. Under high load conditions, search costs were still present, but compatibility effects were eliminated. This dissociation suggests that the costs associated with irrelevant singletons may reflect filtering processes rather than the allocation of spatial attention.

  18. Conformity expectations: Differential effects on IVF twins and singletons' parent-child relationships and adjustment.

    Science.gov (United States)

    Anderson, Kayla N; Rueter, Martha A; Connor, Jennifer J; Chen, Muzi; Damario, Mark

    2015-08-01

    Increased utilization of in vitro fertilization (IVF) to treat infertility has resulted in a growing twin birthrate. Despite early childhood risks, twins have fewer psychosocial problems in middle childhood than singleton children. This study proposes that parents' conformity expectations for children have differential effects on parent-child relationships for twin and singleton children, which indirectly explains twins' more optimum psychosocial adjustment. Parental conformity expectations, parent-child relationship satisfaction, and children's emotional, behavioral, and attention problems were assessed in a sample of 288 6- to 12-year-old IVF-conceived twins and singletons. Overall, parents of twins had higher expectations for child conformity to parent rules than singleton parents. Path models demonstrate that twin status and parental expectations for child conformity interact to influence parent-child relationships, and this interaction indirectly accounted for differences in twins' and singletons' psychosocial adjustment. Findings suggest parenting constructs have differential influences on the association between twin status and parent-child relationships. Parenting research, predominantly conducted with singletons, should be reexamined before applying existing research to twin children and their families. (c) 2015 APA, all rights reserved).

  19. Low birth weight, small for gestational age and preterm births before and after the economic collapse in Iceland: a population based cohort study.

    Science.gov (United States)

    Eiríksdóttir, Védís Helga; Ásgeirsdóttir, Tinna Laufey; Bjarnadóttir, Ragnheiður Ingibjörg; Kaestner, Robert; Cnattingius, Sven; Valdimarsdóttir, Unnur Anna

    2013-01-01

    Infants born small for gestational age (SGA) or preterm have increased rates of perinatal morbidity and mortality. Stressful events have been suggested as potential contributors to preterm birth (PB) and low birth weight (LBW). We studied the effect of the 2008 economic collapse in Iceland on the risks of adverse birth outcomes. The study population constituted all Icelandic women giving birth to live-born singletons from January 1(st) 2006 to December 31(st) 2009. LBW infants were defined as those weighing birth, PB infants as those born before 37 weeks of gestation and SGA as those with a birth weight for gestational age more than 2 standard deviations (SD's) below the mean according to the Swedish fetal growth curve. We used logistic regression analysis to estimate odds ratios [OR] and corresponding 95 percent confidence intervals [95% CI] of adverse birth outcomes by exposure to calendar time of the economic collapse, i.e. after October 6(th) 2008. Compared to the preceding period, we observed an increased adjusted odds in LBW-deliveries following the collapse (aOR = 1.24, 95% CI [1.02, 1.52]), particularly among infants born to mothers younger than 25 years (aOR = 1.85, 95% CI [1.25, 2.72]) and not working mothers (aOR = 1.61, 95% CI [1.10, 2.35]). Similarly, we found a tendency towards higher incidence of SGA-births (aOR = 1.14, 95% CI [0.86, 1.51]) particularly among children born to mothers younger than 25 years (aOR = 1.87, 95% CI [1.09, 3.23]) and not working mothers (aOR = 1.86, 95% CI [1.09, 3.17]). No change in risk of PB was observed. The increase of LBW was most distinct 6-9 months after the collapse. The results suggest an increase in risk of LBW shortly after the collapse of the Icelandic national economy. The increase in LBW seems to be driven by reduced fetal growth rate rather than shorter gestation.

  20. Low birth weight, small for gestational age and preterm births before and after the economic collapse in Iceland: a population based cohort study.

    Directory of Open Access Journals (Sweden)

    Védís Helga Eiríksdóttir

    Full Text Available Infants born small for gestational age (SGA or preterm have increased rates of perinatal morbidity and mortality. Stressful events have been suggested as potential contributors to preterm birth (PB and low birth weight (LBW. We studied the effect of the 2008 economic collapse in Iceland on the risks of adverse birth outcomes.The study population constituted all Icelandic women giving birth to live-born singletons from January 1(st 2006 to December 31(st 2009. LBW infants were defined as those weighing <2500 grams at birth, PB infants as those born before 37 weeks of gestation and SGA as those with a birth weight for gestational age more than 2 standard deviations (SD's below the mean according to the Swedish fetal growth curve. We used logistic regression analysis to estimate odds ratios [OR] and corresponding 95 percent confidence intervals [95% CI] of adverse birth outcomes by exposure to calendar time of the economic collapse, i.e. after October 6(th 2008.Compared to the preceding period, we observed an increased adjusted odds in LBW-deliveries following the collapse (aOR = 1.24, 95% CI [1.02, 1.52], particularly among infants born to mothers younger than 25 years (aOR = 1.85, 95% CI [1.25, 2.72] and not working mothers (aOR = 1.61, 95% CI [1.10, 2.35]. Similarly, we found a tendency towards higher incidence of SGA-births (aOR = 1.14, 95% CI [0.86, 1.51] particularly among children born to mothers younger than 25 years (aOR = 1.87, 95% CI [1.09, 3.23] and not working mothers (aOR = 1.86, 95% CI [1.09, 3.17]. No change in risk of PB was observed. The increase of LBW was most distinct 6-9 months after the collapse.The results suggest an increase in risk of LBW shortly after the collapse of the Icelandic national economy. The increase in LBW seems to be driven by reduced fetal growth rate rather than shorter gestation.

  1. [Birth weight distribution among premature infants and related social factors].

    Science.gov (United States)

    Guo, Li-jun; Ye, Rong-wei; Wang, Gui-xia; Wang, Juan; Li, Zhi-wen; Ren, Ai-guo

    2009-12-01

    To understand the distribution of birth weight among premature infants and the associated social factors. The study population consisted of 97 537 women who delivered singleton live birth of 20 to 41 gestational weeks in 4 counties/cities, Jiangsu and Zhejiang provinces, China from 1995 to 2000. Chi-square test was employed to test the difference of proportions between respective groups. One- way ANOVA was used to test the differences regarding the mean of gestational weeks at the first prenatal visit and the mean of prenatal visits between the two groups. Multivariate logistic regression was conducted to examine the factors associated with premature birth. Women aged 35 years had higher (8.8%) premature incidence than those aged less than 24 years (5.6%), 25 - 29 years (4.6%), or 30 - 34 years (4.5%, P premature incidence than those with height taller than 150 cm (5.0%). Women whose BMI were at least 28 and 24 - 28 had higher (5.5%, 5.5%) premature incidences than those whose BMI were 18.5 - 24.0 (5.0%), premature birth was 6.0% among women without previous pregnancy, higher than that among those women with 4 times of pregnancies (5.7%), 2 times of pregnancies (4.3%), and 3 times of pregnancies (4.0%). Parous women with at least two deliveries had higher (9.3%) premature incidence than the primiparous women (5.2%) and whose women with only one delivery (4.5%, P premature incidence than those who did not receive the service (6.1%). The mean times of prenatal visits among women with premature births was 8.53, less than that of those with full term delivery (10.97). Women with less than four times of prenatal visit had higher (18.9%) premature incidence than those with at least five prenatal visits (4.9%). Multivariate logistic regression showed that premature delivery risk was associated with age, height, BMI, gravidity, parity, early prenatal care, the mean of gestational weeks at first prenatal visit and the mean number of prenatal visits etc. Premature delivery

  2. Impact of a stepwise introduction of smoke-free legislation on the rate of preterm births: analysis of routinely collected birth data.

    Science.gov (United States)

    Cox, Bianca; Martens, Evelyne; Nemery, Benoit; Vangronsveld, Jaco; Nawrot, Tim S

    2013-02-14

    To investigate the incidence of preterm delivery in the Belgian population after implementation of smoke-free legislation in three phases (in public places and most workplaces January 2006, in restaurants January 2007, and in bars serving food January 2010). Logistic regression analyses on routinely collected birth data from January 2002 to December 2011. Flanders, Belgium. All live born singleton births delivered at 24-44 weeks of gestation (n = 606,877, with n = 448,520 spontaneous deliveries). Preterm birth (gestational age restaurants), and an annual slope change of -2.65% (-5.11% to -0.13%; P=0.04) after 1 January 2010 (ban on smoking in bars serving food). The analysis for all births gave similar results: a step change of -3.18% (-5.38% to -0.94%; P<0.01) on 1 January 2007, and an annual slope change of -3.50% (-6.35% to -0.57%; P=0.02) after 1 January 2010. These changes could not be explained by personal factors (infant sex, maternal age, parity, socioeconomic status, national origin, level of urbanisation); time related factors (underlying trends, month of the year, day of the week); or population related factors (public holidays, influenza epidemics, and short term changes in apparent temperature and particulate air pollution). Our study shows a consistent pattern of reduction in the risk of preterm delivery with successive population interventions to restrict smoking. This finding is not definitive but it supports the notion that smoking bans have public health benefits from early life.

  3. National collection of embryo morphology data into Society for Assisted Reproductive Technology Clinic Outcomes Reporting System: associations among day 3 cell number, fragmentation and blastomere asymmetry, and live birth rate.

    Science.gov (United States)

    Racowsky, Catherine; Stern, Judy E; Gibbons, William E; Behr, Barry; Pomeroy, Kimball O; Biggers, John D

    2011-05-01

    To evaluate the validity of collecting day 3 embryo morphology variables into the Society for Assisted Reproductive Technology Clinic Outcomes Reporting System (SART CORS). Retrospective. National database-SART CORS. Fresh autologous assisted reproductive technology (ART) cycles from 2006-2007 in which embryos were transferred singly (n=1,020) or in pairs (n=6,508) and embryo morphology was collected. None. Relationship between live birth, maternal age, and morphology of transferred day 3 embryos as defined by cell number, fragmentation, and blastomere symmetry. Logistic multiple regressions and receiver operating characteristic curve analyses were applied to determine specificity and sensitivity for correctly classifying embryos as either failures or successes. Live birth rate was positively associated with increasing cell number up to eight cells (8 cells: 16.2%), but was negatively associated with maternal age, increasing fragmentation, and asymmetry scores. An area under the receiver operating curve of 0.753 (95% confidence interval 0.740-0.766) was derived, with a sensitivity of 45.0%, a specificity of 83.2%, and 76.4% of embryos being correctly classified with a cutoff probability of 0.3. This analysis provides support for the validity of collecting morphology fields for day 3 embryos into SART CORS. Standardization of morphology collections will assist in controlling for embryo quality in future database analyses. Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  4. Prenatal screening for fetal aneuploidy in singleton pregnancies.

    Science.gov (United States)

    Chitayat, David; Langlois, Sylvie; Douglas Wilson, R

    2011-07-01

    To develop a Canadian consensus document on maternal screening for fetal aneuploidy (e.g., Down syndrome and trisomy 18) in singleton pregnancies. Pregnancy screening for fetal aneuploidy started in the mid 1960s, using maternal age as the screening test. New developments in maternal serum and ultrasound screening have made it possible to offer all pregnant patients a non-invasive screening test to assess their risk of having a fetus with aneuploidy to determine whether invasive prenatal diagnostic testing is necessary. This document reviews the options available for non-invasive screening and makes recommendations for Canadian patients and health care workers. To offer non-invasive screening for fetal aneuploidy (trisomy 13, 18, 21) to all pregnant women. Invasive prenatal diagnosis would be offered to women who screen above a set risk cut-off level on non-invasive screening or to pregnant women whose personal, obstetrical, or family history places them at increased risk. Currently available non-invasive screening options include maternal age combined with one of the following: (1) first trimester screening (nuchal translucency, maternal age, and maternal serum biochemical markers), (2) second trimester serum screening (maternal age and maternal serum biochemical markers), or (3) 2-step integrated screening, which includes first and second trimester serum screening with or without nuchal translucency (integrated prenatal screen, serum integrated prenatal screening, contingent, and sequential). These options are reviewed, and recommendations are made. Studies published between 1982 and 2009 were retrieved through searches of PubMed or Medline and CINAHL and the Cochrane Library, using appropriate controlled vocabulary and key words (aneuploidy, Down syndrome, trisomy, prenatal screening, genetic health risk, genetic health surveillance, prenatal diagnosis). Results were restricted to systematic reviews, randomized controlled trials, and relevant observational

  5. Low-birthweight rates higher among Bangladeshi neonates measured during active birth surveillance compared to national survey data.

    Science.gov (United States)

    Klemm, Rolf D W; Merrill, Rebecca D; Wu, Lee; Shamim, Abu Ahmed; Ali, Hasmot; Labrique, Alain; Christian, Parul; West, Keith P

    2015-10-01

    Birth size is an important gauge of fetal and neonatal health. Birth size measurements were collected within 72 h of life for 16 290 live born, singleton infants in rural Bangladesh from 2004 to 2007. Gestational age was calculated based on the date of last menstrual period. Newborns were classified as small-for-gestational age (SGA) based on a birthweight below the 10th percentile for gestational age, using three sets of US reference data. Birth size distributions were explored based on raw values as well as after z-score standardisation in reference to World Health Organization (WHO) 2006 growth standards. Mean (SD) birthweight (g), length (cm) and head circumference (cm) measurements, completed within [median (25th, 75th percentile)] 15 (8, 23) h of life, were 2433 (425), 46.4 (2.4) and 32.4 (1.6), respectively. Twenty-two per cent were born preterm. Over one-half (55.3%) of infants were born low birthweight; 46.6%, 37.0% and 33.6% had a weight, length and head circumference below -2 z-scores of the WHO growth standard at birth; and 70.9%, 72.2% and 59.8% were SGA for weight based on Alexander et al., Oken et al. and Olsen et al. references, respectively. Infants in this typical rural Bangladesh setting were commonly born small, reflecting a high burden of fetal growth restriction and preterm birth. Our findings, produced by active birth surveillance, suggest that low birthweight is far more common than suggested by cross-sectional survey estimates. Interventions that improve fetal growth during pregnancy may have the largest impact on reducing SGA rates. © 2013 John Wiley & Sons Ltd.

  6. Avaliação de preditores do óbito neonatal em uma série histórica de nascidos vivos no Nordeste brasileiro An evaluation of the predictors of neonatal death in a time series of live births in the Northeast Region of Brazil

    Directory of Open Access Journals (Sweden)

    Lygia Carmen de Moraes Vanderlei

    2010-12-01

    Full Text Available OBJETIVOS: avaliar tendência dos preditores do óbito neonatal entre os nascidos vivos e qualidade do preenchimento do Sistema de Informações para Nascidos Vivos (Sinasc institucional. MÉTODOS: série histórica do Sinasc do Instituto de Medicina Integral Prof. Fernando Figueira (1995-2006 em Recife, Pernambuco, Brasil. Foram avaliadas: completitude de preenchimento das variáveis e tendência dos indicadores de risco para mortalidade infantil (baixo peso ao nascer; anóxia; prematuridade; cesariana; ausência de pré-natal; mãe adolescente; analfabetismo e nenhum filho nascido vivo e morto. Significância estatística para teste t de Student foi de 5% em um modelo de regressão linear. RESULTADOS: 58.689 nascidos vivos com contínuo incremento a partir de 2002; baixo peso ao nascer, 22,8%; Apgar OBJECTVES: to evaluate predictors of neonatal death among live births and the quality of use of the institutional Live Birth Information System register (Sinasc. METHODS: a time serie based on data from the Sinasc of the Instituto de Medicina Integral Prof. Fernando Figueira (1995-2006 in the city Recife, Pernambuco, Brazil. The following were evaluated: the completeness of the forms and the tendency regarding risk factors for infant mortality (low birth weight; anoxia; premature birth; caesarian birth; lack of prenatal care; adolescent pregnancy; illiteracy; and having had no live or still born child. Statistical significance was tested using Student's t test with p<0.05 in a linear regression model. RESULTS: 58,689 live births occurred with a continued rise from 2002 onwards; low birth weight, 22.8%; Apgar <7 1º minute 15.3%; premature 22.4%; Caesarian birth 38,2%; adolescent mothers 27.2%; illiteracy 2.7% and 89% with no live or still born child. One percent of variables were not recorded. The following variables increased (p<0.05: Apgar in the 1st minute, low birth weight, premature birth and caesarian birth; and the following decreased (p<0

  7. The influence of living arrangements, marital patterns and family configuration on employment rates among the 1945–1954 birth cohort: evidence from ten European countries

    OpenAIRE

    Ogg, Jim; Renaut, Sylvie

    2007-01-01

    As they approach retirement, Europeans in mid-life display a range of living arrangements and marital patterns. These configurations influence labour force participation for men and women in different ways and these differences are accentuated between countries. Using data from the first Wave (2004) of the Survey on Health, Ageing and Retirement in Europe (SHARE), the paper examines the relationship between living arrangements, marital patterns, family configurations and participation in the ...

  8. Birthing Classes

    Science.gov (United States)

    ... management options. Breastfeeding basics. Caring for baby at home. Birthing classes are not just for new parents, though. ... midwife. Postpartum care. Caring for your baby at home, including baby first aid. Lamaze One of the most popular birthing techniques in the U.S., Lamaze has been around ...

  9. Birth Control

    Science.gov (United States)

    ... even if you aren’t going for birth control. What doesn’t work to prevent pregnancy? top It’s ... and taking care of a baby’s many needs. What if I need birth control in an emergency? top Emergency contraception (EC) is ...

  10. [Home births].

    Science.gov (United States)

    Welffens, K; Kirkpatrick, C; Daelemans, C; Derisbourg, S

    In Belgium, very few women give birth outside the delivery room. In the United Kingdom and in the Netherlands, they are more numerous. Several studies evaluated obstetric and neonatal outcomes of home births compared with hospital births. We selected seven recent and large studies (with cohorts of more than 5.000 women) using PubMed, Science Direct and Cochrane Database of Systematic Reviews. Several questions were examined. Is there any difference in maternal and neonatal outcomes depending on the intended place of birth? Does parity affect outcomes ? What are the characteristics of women who choose to deliver at home ? We conclude that giving birth at home improves obstetric outcomes but is riskier for the baby, especially for the first one. The women delivering at home are mainly white Europeans, between 25 and 35 years old, in a relationship, multiparous and wealthier. In order to avoid this increased risk for the baby while preserving the obstetric advantages, alongside birth centers offer an intermediate solution. They combine the reassuring home-like atmosphere with the safety of the hospital. In Belgium, the first alongside birth center " Le Cocon " (a low technicity unit distinct from the delivery room) offers now this type of alternative place of birth for women in Hôpital Erasme in Brussels.

  11. Preterm birth, an unresolved issue.

    Science.gov (United States)

    Belizán, Jose M; Hofmeyr, Justus; Buekens, Pierre; Salaria, Natasha

    2013-11-15

    Premature birth is the world's leading cause of neonatal mortality with worldwide estimates indicating 11.1% of all live births were preterm in 2010. Preterm birth rates are increasing in most countries with continual differences in survival rates amongst rich and poor countries. Preterm birth is currently an important unresolved global issue with research efforts focusing on uterine quiescence and activation, the 'omics' approaches and implementation science in order to reduce the incidence and increase survival rates of preterm babies. The journal Reproductive Health has published a supplement entitled Born Too Soon which addresses factors in the preconception and pregnancy period which may increase the risk of preterm birth and also outlines potential interventions which may reduce preterm birth rates and improve survival of preterm babies by as much as 84% annually. This is critical in order to achieve the Millennium Development Goal (MDG 4) for child survival by 2015 and beyond.

  12. Low Birth Weight, Very Low Birth Weight Rates and Gestational Age-Specific Birth Weight Distribution of Korean Newborn Infants

    OpenAIRE

    Shin, Son-Moon; Chang, Young-Pyo; Lee, Eun-Sil; Lee, Young-Ah; Son, Dong-Woo; Kim, Min-Hee; Choi, Young-Ryoon

    2005-01-01

    To obtain the low birth weight (LBW) rate, the very low birth weight (VLBW) rate, and gestational age (GA)-specific birth weight distribution based on a large population in Korea, we collected and analyzed the birth data of 108,486 live births with GA greater than 23 weeks for 1 yr from 1 January to 31 December 2001, from 75 hospitals and clinics located in Korea. These data included birth weight, GA, gender of the infants, delivery type, maternal age, and the presence of multiple pregnancy. ...

  13. False Labor at Term in Singleton Pregnancies: Discharge After a Standardized Assessment and Perinatal Outcomes.

    Science.gov (United States)

    Nelson, David B; McIntire, Donald D; Leveno, Kenneth J

    2017-07-01

    To evaluate perinatal outcomes in women sent home with a diagnosis of false labor at term and assess the time interval to return for delivery. This was a prospective observational cohort study of women at 37 0/7 to 41 6/7 weeks of gestation without pre-existing medical complications who presented to our hospital-based triage unit with symptoms of labor and underwent a standardized evaluation. Women diagnosed as having false labor with a live singleton fetus in cephalic presentation without a prior cesarean delivery and sent home were compared with a group of similar women diagnosed to be in spontaneous labor. Women with hypertension, diabetes, and known fetal malformations were excluded. Using a perinatal composite outcome of respiratory insufficiency, intraventricular hemorrhage, culture-proven sepsis, Apgar score 3 or less at 5 minutes, phototherapy, and perinatal death, we tested the noninferiority of being sent home compared with being admitted for labor. The relationship of cervical dilatation to the time interval from discharge home to delivery was also analyzed. Between October 2012 and March 2016, a total of 3,949 women met inclusion criteria and were diagnosed with false labor, discharged, and returned to deliver, whereas 2,592 similar women were admitted in early labor. The mean interval from discharge to return was 4.9 days. Cesarean delivery rates were not different between the study groups-11% for both (P=.69), and the perinatal composite outcome rates were not significantly different between those sent home and those admitted-3.2% compared with 3.1% (P=.79). Women with more advanced cervical dilatation at discharge returned and delivered significantly earlier than those with less dilatation regardless of parity. Discharge with false labor at term after a standardized assessment in a triage unit was not associated with increased rates of adverse perinatal composite outcomes or cesarean delivery. The time interval to return for delivery was

  14. Place matters: variation in the black/white very preterm birth rate across U.S. metropolitan areas, 2002-2004.

    Science.gov (United States)

    Kramer, Michael R; Hogue, Carol R

    2008-01-01

    We reported on the distribution of very preterm (VPT) birth rates by race across metropolitan statistical areas (MSAs). Rates of singleton VPT birth for non-Hispanic white, non-Hispanic black, and Hispanic women were calculated with National Center for Health Statistics 2002-2004 natality files for infants in 168 MSAs. Subanalysis included stratification by parity, age, smoking, maternal education, metropolitan size, region, proportion of MSA that was black, proportion of black population living below the poverty line, and indices of residential segregation. The mean metropolitan-level VPT birth rate was 12.3, 34.8, and 15.7 per 1,000 live births for white, black, and Hispanic women, respectively. There was virtually no overlap in the white and black distributions. The variation in mean risk across cities was three times greater for black women compared with white women. The threefold disparity in mean rate, and two- to threefold increased variation as indicated by standard deviation, was maintained in all subanalyses. Compared with white women, black women have three times the mean VPT birth risk, as well as three times the variance in city-level rates. The racial disparity in VPT birth rates was composed of characteristics that were constant across MSAs, as well as factors that varied by MSA. The increased sensitivity to place for black women was unexplained by measured maternal and metropolitan factors. Understanding determinants of differences in both the mean risk and the variation of risk among black and white women may contribute to reducing the disparity in risk between races.

  15. Births: preliminary data for 2005.

    Science.gov (United States)

    Hamilton, Brady E; Martin, Joyce A; Ventura, Stephanie J

    2006-12-28

    This report presents preliminary data for 2005 on births in the United States. U.S. data on births are shown by age, live-birth order, race, and Hispanic origin of mother. Data on marital status, cesarean delivery, preterm births, and low birthweight (LBW) are also presented. Data in this report are based on 99.2 percent of births for 2005. The records are weighted to independent control counts of all births received in state vital statistics offices in 2005. Comparisons are made with 2004 data. The crude birth rate in 2005 was 14.0 births per 1,000 total population, unchanged from 2004. The general fertility rate, however, rose to 66.7 births per 1,000 women aged 15-44 years in 2005, the highest level since 1993. The birth rate for teenagers declined by 2 percent in 2005, falling to 40.4 births per 1,000 women aged 15-19 years, the lowest ever recorded in the 65 years for which a consistent series of rates are available. The rate declined for teenagers 15-17 years to 21.4 births per 1,000, but was essentially stable for older teenagers 18-19 years. The birth rate for women aged 20-24 years rose in 2005, whereas the rate for women aged 25-29 years was essentially unchanged. The birth rates for women aged 30 years and over rose to levels not seen in almost 40 years. Childbearing by unmarried women increased to record levels for the Nation in 2005. The birth rate rose 3 percent to 47.6 births per 1,000 unmarried women aged 15-44 years; the proportion of all births to unmarried women increased to 36.8 percent. The cesarean delivery rate rose by 4 percent in 2005 to 30.2 percent of all births, another record high for the Nation. The preterm birth rate continued to rise (to 12.7 percent in 2005) as did the rate for LBW births (8.2 percent).

  16. A policy of routine umbilical cord blood gas analysis decreased missing samples from high-risk births.

    Science.gov (United States)

    Ahlberg, M; Elvander, C; Johansson, S; Cnattingius, S; Stephansson, O

    2017-01-01

    This study compared obstetric units practicing routine or selective umbilical cord blood gas analysis, with respect to the risk of missing samples in high-risk deliveries and in infants with birth asphyxia. This was a Swedish population-based cohort study that used register data for 155 235 deliveries of live singleton infants between 2008 and 2014. Risk ratios and 95% confidence intervals were calculated to estimate the association between routine and selective umbilical cord blood gas sampling strategies and the risk of missing samples. Selective sampling increased the risk ratios when routine sampling was used as the reference, with a value of 1.0, and these were significant in high-risk deliveries and birth asphyxia. The risk ratios for selective sampling were large-for-gestational age (9.07), preterm delivery at up to 36 weeks of gestation (8.24), small-for-gestational age (7.94), two or more foetal scalp blood samples (5.96), an Apgar score of less than seven at one minute (2.36), emergency Caesarean section (1.67) and instrumental vaginal delivery (1.24). Compared with routine sampling, selective umbilical cord blood gas sampling significantly increased the risks of missing samples in high-risk deliveries and in infants with birth asphyxia. ©2016 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  17. Attentional Capture to a Singleton Distractor Degrades Visual Marking in Visual Search

    Directory of Open Access Journals (Sweden)

    Kenji Yamauchi

    2017-05-01

    Full Text Available Visual search is easier after observing some distractors in advance; it is as if the previewed distractors were excluded from the search. This effect is referred to as the preview benefit, and a memory template that visually marks the old locations of the distractors is thought to help in prioritizing the locations of newly presented items. One remaining question is whether the presence of a conspicuous item during the sequential shift of attention within the new items reduces this preview benefit. To address this issue, we combined the above preview search and a conventional visual search paradigm using a singleton distractor and examined whether the search performance was affected by the presence of the singleton. The results showed that the slope of reaction time as a function of set size became steeper in the presence of a singleton, indicating that the singleton distractor reduced the preview benefit. Furthermore, this degradation effect was positively correlated with the degree of conventional attentional capture to a singleton measured in a separate experiment with simultaneous search. These findings suggest that the mechanism of visual marking shares common attentional resources with the search process.

  18. Cost analysis of singleton versus twin pregnancies after in vitro fertilization.

    Science.gov (United States)

    Lukassen, H G Marieke; Schönbeck, Yvonne; Adang, Eddy M M; Braat, Didi D M; Zielhuis, Gerhard A; Kremer, Jan A M

    2004-05-01

    To determine the difference in costs between singleton and twin pregnancies after IVF treatment from pregnancy to 6 weeks after delivery from a health care perspective. Retrospective cost analysis. IVF department at the University Medical Center Nijmegen, The Netherlands. A representative sample of singleton and twin pregnancies after IVF treatment between 1995 and 2001 at the University Medical Center Nijmegen. IVF with or without intracytoplasmic sperm injection and with or without cryopreservation. Medical costs per singleton and twin pregnancy after IVF. In patients pregnant with twins, the incidence of hospital antenatal care, complicated vaginal deliveries, and cesarean sections was higher and was associated with more frequent and longer maternal and neonatal hospital admissions. Maternal and neonatal hospital admissions were the major cost drivers. The medical cost per twin pregnancy was found to be more than five times higher than per singleton pregnancy, 13,469 and 2,550, respectively. The medical cost per twin pregnancy was more than 10,000 higher than per singleton pregnancy. A reduction in the number of twin pregnancies by elective single ET will save substantial amounts of money. This money might be used for the additional IVF cycles that will probably be needed to achieve similar success rates between single ET and two-embryo transfer.

  19. Disproportion in the falling birth rate.

    Science.gov (United States)

    Gordon, R R

    1977-10-08

    Since 1962 there has been a disproportionately greater fall in the number of small (less than 1000 g) live births than total live births: this has applied to Sheffield and to England and Wales but more to the former. This may have affected falling neonatal mortality rates.

  20. Differences in the pregnancy gestation period and mean birth weights in infants born to Indian, Pakistani, Bangladeshi and white British mothers in Luton, UK: a retrospective analysis of routinely collected data.

    Science.gov (United States)

    Garcia, Rebecca; Ali, Nasreen; Guppy, Andy; Griffiths, Malcolm; Randhawa, Gurch

    2017-08-11

    To compare mean birth weights and gestational age at delivery of infants born to Indian, Pakistani, Bangladeshi and white British mothers in Luton, UK. Retrospective analysis using routinely recorded secondary data in Ciconia Maternity information System, between 2008 and 2013. Luton, UK. Mothers whose ethnicity was recorded as white British, Bangladeshi, Pakistani or Indian and living in Luton, aged over 16, who had a live singleton birth over 24 weeks of gestation were included in the analysis (n=14 871). Primary outcome measures were mean birth weight and gestational age at delivery. After controlling for maternal age, smoking, diabetes, gestation age, parity and maternal height and body mass index at booking, a significant difference in infants' mean birth weight was found between white British and Indian, Pakistani and Bangladeshi infants, F(3, 12 287)=300.32, pmothers, compared with Indian mothers (Wald=8.192, df 1, pmothers and preterm delivery, when compared with Pakistani, Bangladeshi and white British women. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  1. Rate of gestational weight gain and preterm birth in relation to prepregnancy body mass indices and trimester: a follow-up study in China.

    Science.gov (United States)

    Huang, Aiqun; Ji, Zhenpeng; Zhao, Wei; Hu, Huanqing; Yang, Qi; Chen, Dafang

    2016-08-12

    To evaluate the association between rate of gestational weight gain and preterm birth varying prepregnancy body mass indices and trimester. Data from Maternal and Newborn's Health Monitoring System on 17475 pregnant women who delivered live singletons at ≥ 28 weeks of gestation between October 2013 and September 2014 from 12 districts/counties of 6 provinces in China and started prenatal care at ≤ 12 weeks of gestation was analyzed. Gestational weight gain was categorized by rate of weight gain during the 2(nd) and 3(rd) trimester, based on the 2009 Institute of Medicine guidelines. Multivariable binary logistic regression models were conducted to investigate the association between rate of gestational weight gain and preterm birth stratified by prepregnancy body mass indices and trimester. Excessive weight gain occurred in 57.9 % pregnant women, and insufficient weight gain 12.5 %. Average rate of gestational weight gain in 2(nd) and 3(rd) trimester was independently associated with preterm birth (U-shaped), and the association varied by prepregnancy body mass indices and trimesters. In underweight women, excessive gestational weight gain was positively associated with preterm birth (OR 1.93, 95 % confidence interval (CI): 1.29- 2.88) when compared with women who gained adequately. While in overweight/obese women, insufficient gestational weight gain was positively associated with preterm birth (OR 3.92, 95 % CI: 1.13-13.67). When stratifying by trimester, we found that excessive weight gain in 3(rd) trimester had a significantly positive effect on preterm birth (OR 1.27, 95 % CI: 1.02-1.58). Excessive gestational weight gain among underweight pregnant women, insufficient gestational weight gain among overweight/obese women and excessive gestational weight gain in 3(rd) trimester were important predictors of preterm birth.

  2. Risk of preterm birth by subtype among Medi-Cal participants with mental illness.

    Science.gov (United States)

    Baer, Rebecca J; Chambers, Christina D; Bandoli, Gretchen; Jelliffe-Pawlowski, Laura L

    2016-10-01

    Previous studies have demonstrated an association between mental illness and preterm birth (before 37 weeks). However, these investigations have not simultaneously considered gestation of preterm birth, the indication (eg, spontaneous or medically indicated), and specific mental illness classifications. The objective of the study was to examine the likelihood of preterm birth across gestational lengths and indications among Medi-Cal (California's Medicaid program) participants with a diagnostic code for mental illness. Mental illnesses were studied by specific illness classification. The study population was drawn from singleton live births in California from 2007 through 2011 in the birth cohort file maintained by the California Office of Statewide Health Planning and Development, which includes birth certificate and hospital discharge records. The sample was restricted to women with Medi-Cal coverage for prenatal care. Women with mental illness were identified using International Classification of Diseases, ninth revision, codes from their hospital discharge record. Women without a mental illness International Classification of Diseases, ninth revision, code were randomly selected at a 4:1 ratio. Adjusting for maternal characteristics and obstetric complications, relative risks and 95% confidence intervals were calculated for preterm birth comparing women with a mental illness diagnostic code with women without such a code. We identified 6198 women with a mental illness diagnostic code and selected 24,792 women with no such code. The risk of preterm birth in women with a mental illness were 1.2 times higher than women without a mental illness (adjusted relative risk, 1.2, 95% confidence interval, 1.1-1.3). Among the specific mental illnesses, schizophrenia, major depression, and personality disorders had the strongest associations with preterm birth (adjusted relative risks, 2.0, 2.0 and 3.3, respectively). Women receiving prenatal care through California's low

  3. The Relevance of Maternal Socioeconomic Characteristics for Low Birth Weight – a Case-Control Study

    Science.gov (United States)

    Altenhöner, T.; Köhler, M.; Philippi, M.

    2016-01-01

    Introduction: The number of children born underweight (low birth weight, LBW) is increasing despite extensive prevention and screening programmes. The cost is high for the health system, and affected children are burdened with health predictors that can affect them negatively throughout their lives. This study investigates to what extent socioeconomic factors, in addition to known medical causes and the health behaviour of pregnant women, influence LBW. Materials and Methods: In this case-control study 131 mothers of singletons with a birth weight ≤ 2500 g (cases) and 323 mothers of normal birth weight babies (controls) were interviewed with respect to socioeconomic status, health behaviour and stress in the workplace. Medical data were collected by specialist staff using a questionnaire. Results: Independent of medical diagnosis and health behaviour, women with lower level education (OR [95 % CI] = 2.24 [1.12; 4.51]) and those who were not working (OR [95 % CI] = 1.82 [1.10; 3.00]) were more likely to have an LBW baby. No effect was shown for immigrant background (OR [95 % CI] = 1.14 [0.59; 2.21]) or stress in the workplace (OR [95 % CI] = 1.17 [0.90; 1.51]). Discussion and Conclusion: These results show that the association between social and health inequalities starts from before birth. In order to reduce the rising number of babies born underweight, socioeconomic determinants in the care and supervision of pregnant women should systematically receive more attention to enable appropriate early preventive strategies to be implemented. PMID:27065486

  4. The Relevance of Maternal Socioeconomic Characteristics for Low Birth Weight - a Case-Control Study.

    Science.gov (United States)

    Altenhöner, T; Köhler, M; Philippi, M

    2016-03-01

    Introduction: The number of children born underweight (low birth weight, LBW) is increasing despite extensive prevention and screening programmes. The cost is high for the health system, and affected children are burdened with health predictors that can affect them negatively throughout their lives. This study investigates to what extent socioeconomic factors, in addition to known medical causes and the health behaviour of pregnant women, influence LBW. Materials and Methods: In this case-control study 131 mothers of singletons with a birth weight ≤ 2500 g (cases) and 323 mothers of normal birth weight babies (controls) were interviewed with respect to socioeconomic status, health behaviour and stress in the workplace. Medical data were collected by specialist staff using a questionnaire. Results: Independent of medical diagnosis and health behaviour, women with lower level education (OR [95 % CI] = 2.24 [1.12; 4.51]) and those who were not working (OR [95 % CI] = 1.82 [1.10; 3.00]) were more likely to have an LBW baby. No effect was shown for immigrant background (OR [95 % CI] = 1.14 [0.59; 2.21]) or stress in the workplace (OR [95 % CI] = 1.17 [0.90; 1.51]). Discussion and Conclusion: These results show that the association between social and health inequalities starts from before birth. In order to reduce the rising number of babies born underweight, socioeconomic determinants in the care and supervision of pregnant women should systematically receive more attention to enable appropriate early preventive strategies to be implemented.

  5. Infant Mortality Statistics From the 2013 Period Linked Birth/Infant Death Data Set.

    Science.gov (United States)

    Matthews, T J; MacDorman, Marian F; Thoma, Marie E

    2015-08-06

    This report presents 2013 period infant mortality statistics from the linked birth/infant death data set (linked file) by maternal and infant characteristics. The linked file differs from the mortality file, which is based entirely on death certificate data. Descriptive tabulations of data are presented and interpreted. The U.S. infant mortality rate was 5.96 infant deaths per 1,000 live births in 2013, similar to the rate of 5.98 in 2012. The number of infant deaths was 23,446 in 2013, a decline of 208 infant deaths from 2012. From 2012 to 2013, infant mortality rates were stable for most race and Hispanic origin groups; declines were reported for two Hispanic subgroups: Cuban and Puerto Rican. Since 2005, the most recent high, the U.S. infant mortality rate has declined 13% (from 6.86), with declines in both neonatal and postneonatal mortality overall and for most groups. In 2013, infants born at 37–38 weeks of gestation (early term) had mortality rates that were 63% higher than for full-term (39–40 week) infants. For multiple births, the infant mortality rate was 25.84, 5 times the rate of 5.25 for singleton births. In 2013, 36% of infant deaths were due to preterm-related causes of death, and an additional 15% were due to causes grouped into the sudden unexpected infant death category. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.

  6. Late preterm birth and previous cesarean section: a population-based cohort study.

    Science.gov (United States)

    Yasseen Iii, Abdool S; Bassil, Kate; Sprague, Ann; Urquia, Marcelo; Maguire, Jonathon L

    2018-02-21

    Late preterm birth (LPB) is increasingly common and associated with higher morbidity and mortality than term birth. Yet, little is known about the influence of previous cesarean section (PCS) and the occurrence of LPB in subsequent pregnancies. We aim to evaluate this association along with the potential mediation by cesarean sections in the current pregnancy. We use population-based birth registry data (2005-2012) to establish a cohort of live born singleton infants born between 34 and 41 gestational weeks to multiparous mothers. PCS was the primary exposure, LPB (34-36 weeks) was the primary outcome, and an unplanned or emergency cesarean section in the current pregnancy was the potential mediator. Associations were quantified using propensity weighted multivariable Poisson regression, and mediating associations were explored using the Baron-Kenny approach. The cohort included 481,531 births, 21,893 (4.5%) were LPB, and 119,983 (24.9%) were predated by at least one PCS. Among mothers with at least one PCS, 6307 (5.26%) were LPB. There was increased risk of LPB among women with at least one PCS (adjusted Relative Risk (aRR): 1.20 (95%CI [1.16, 1.23]). Unplanned or emergency cesarean section in the current pregnancy was identified as a strong mediator to this relationship (mediation ratio = 97%). PCS was associated with higher risk of LPB in subsequent pregnancies. This may be due to an increased risk of subsequent unplanned or emergency preterm cesarean sections. Efforts to minimize index cesarean sections may reduce the risk of LPB in subsequent pregnancies.

  7. Risk of Metabolic Syndrome and Diabetes Mellitus Among Young Twins and Singletons in Guinea-Bissau

    DEFF Research Database (Denmark)

    Bjerregaard-Andersen, Morten; Hansen, Lone; da Silva, Leontina I

    2013-01-01

    OBJECTIVETwins in Africa may be at increased risk of metabolic disorders due to strained conditions in utero, including high exposure to infections. We studied metabolic syndrome (MS) and diabetes mellitus (DM) among young twins and singletons in Guinea-Bissau.RESEARCH DESIGN AND METHODSThe study...... was cross-sectional and occurred from October 2009 until August 2011 at the Bandim Health Project, a demographic surveillance site in the capital Bissau. Twins and singleton controls between 5 and 32 years were visited at home. Fasting blood samples for metabolic measurements were collected. Zygosity...... was established genetically for a subset. DM was defined as HbA1c ≥6.5% (48 mmol/mol) and MS by the International Diabetes Federation criteria.RESULTSHbA1c was available for 574 twins and 463 singletons. Mean age was 15.3 years versus 15.8 years, respectively. Eighteen percent of twins were monozygotic...

  8. Ethnic disparities in the risk of adverse neonatal outcome after spontaneous preterm birth

    NARCIS (Netherlands)

    Schaaf, Jelle M.; Mol, Ben-Willem J.; Abu-Hanna, Ameen; Ravelli, Anita C. J.

    2012-01-01

    Objective. To describe ethnic disparities in the risk of spontaneous preterm birth and related adverse neonatal outcome. Design. Nationwide prospective cohort study. Setting. The Netherlands, 19992007. Population. Nine hundred and sixty-nine thousand, four hundred and ninety-one singleton

  9. Developmental Trajectories From Birth to School Age in Healthy Term-Born Children

    NARCIS (Netherlands)

    Roze, E.; Meijer, Lisethe; Van Braeckel, K.N.J.A.; Ruiter, S.A.J.; Bruggink, J.L.M.; Bos, A.F.

    OBJECTIVE: To determine the stability of the scores obtained on tests of motor development from birth until school age in healthy, term singletons and to determine if early motor scores are associated with more complex cognitive functions at school age, such as attention and memory. PATIENTS AND

  10. Preterm Birth

    Science.gov (United States)

    ... for Health Care Providers For Health Care Providers: Electronic Nicotine Delivery Systems and Pregnancy CDC Activities Resources ... births and improving neonatal outcomes. View the archived presentation and publication Related Links Is It Worth It? ...

  11. Brothers and reduction of the birth weight of later-born siblings

    DEFF Research Database (Denmark)

    Nielsen, Henriette Svarre; Mortensen, Laust; Nygaard, Ulrikka

    2008-01-01

    It has been speculated whether maternal immune responses against male-specific minor histocompatibility (H-Y) antigens affect pregnancies negatively. This study explores, on a population level, whether previous births of boys compared with girls are associated with a decrease in birth weight...... of later-born siblings. The population was identified in the Danish Birth Registry and consisted of all Danish women who gave birth to their first-born singleton from 1980 to 1998. The women were followed until 2004, and their subsequent births were recorded. A total of 545,839 second- to fourth......-born children were identified. The authors used linear regression to analyze the association between sex of preceding children and birth weight of subsequent siblings. Brothers compared with sisters reduced the birth weight of later-born siblings. One or two brothers, respectively, reduced the mean birth weight...

  12. Concomitant preterm birth and severe small-for-gestational age birth weight among infants of immigrant mothers in Ontario originating from the Philippines and East Asia: a population-based study.

    Science.gov (United States)

    Bartsch, Emily; Park, Alison L; Jairam, Jennifer; Ray, Joel G

    2017-07-18

    Women from the Philippines form one of the largest immigrant groups to North America. Their newborns experience higher rates of preterm birth (PTB), and separately, small-for-gestational age (SGA) birth weight, compared with other East Asians. It is not known if Filipino women are at elevated risk of concomitant PTB and severe SGA (PTB-SGA), a pathological state likely reflective of placental dysfunction and neonatal morbidity. We conducted a population-based study of all singleton or twin live births in Ontario, from 2002 to 2011, among immigrant mothers from the Philippines (n=27 946), Vietnam (n=15 297), Hong Kong (n=5618), South Korea (n=5148) and China (n=42 517). We used modified Poisson regression to generate relative risks (RR) of PTB-SGA, defined as a birth gestation and a birth weight mothers from China (2.3 per 1000), the rate of PTB-SGA was significantly higher among infants of mothers from the Philippines (6.5 per 1000; RR 2.91, 95% CI 2.27 to 3.73), and those from Vietnam (3.7 per 1000; RR 1.68, 95% CI 1.21 to 2.34). The RR of PTB-SGA was not higher for infants of mothers from Hong Kong or South Korea. Among infants born to immigrant women from five East Asian birthplaces, the risk of PTB-SGA was highest among those from the Philippines. These women and their fetuses may require additional monitoring and interventions. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  13. Delivery of double singleton pregnancies in a woman with a double uterus, double cervix, and complete septate vagina

    Directory of Open Access Journals (Sweden)

    Ming-Jie Yang

    2015-12-01

    Full Text Available Uterine anomalies involving a double uterus, double cervix, also known as didelphys uterus, and complete septate vagina are rarely seen and have an associated fertility problem. However, artificial reproductive technology with embryo transfers can help solve this fertility challenge. Conception in the uterus in just one side is commonly seen for embryos, which are always transferred through the usually used (dilated vagina. We here present a patient with the above uterine anomaly who conceived with the aid of in vitro fertilization and embryo transfer to both uterine cavities under general anesthesia, which resulted in successful double singleton pregnancies with one fetus in each uterus. With intensive prenatal care, the pregnancy course for each fetus was rather uneventful. Although both fetuses were in cephalic presentation, cesarean section was performed at the 39th week of gestation with good outcomes in order to preclude anticipated difficulties if the baby had been delivered through the rarely dilated vagina. However, order of birth between the two fetuses was a crucial decision during the operation.

  14. A systematic review and meta-analysis of velamentous cord insertion among singleton pregnancies and the risk of preterm delivery.

    Science.gov (United States)

    de Los Reyes, Samantha; Henderson, Janice; Eke, Ahizechukwu C

    2018-03-23

    Observational studies have reported varying results about the association of velamentous cord insertion (VCI) with adverse pregnancy outcomes. To evaluate the risk of preterm delivery among singleton pregnancies complicated by VCI. Various databases were searched for English-language articles published up to February, 28, 2017, using keywords including VCI; abnormal placentation; abnormal cord insertions; adverse perinatal outcomes; and preterm birth. Outcome measures included preterm delivery; pre-eclampsia; cesarean delivery; fetal demise in utero (FDIU); and small for gestational age (SGA). Only studies involving VCI were included in the meta-analysis. Analyses were performed using RevMan version 5.3.5 (The Nordic Cochrane Centre, Copenhagen, Denmark). There were six studies included in the analysis. The VCI and control groups comprised 16 295 and 1 366 485 women, respectively. An increased incidence of preterm delivery was found for the VCI group compared with the control group (11.8% vs 7.0%; adjusted odds ratio [aOR] 1.95, 95% confidence interval [CI] 1.85-2.04). A diagnosis of VCI was also associated with cesarean delivery (aOR 1.17, 95% CI 1.12-1.23), SGA (aOR 1.93, 95% CI 1.83-2.04), and FDIU (aOR 3.96, 95% CI 3.21-4.89). The presence of VCI was associated with adverse pregnancy outcomes. © 2018 International Federation of Gynecology and Obstetrics.

  15. Comparison of acupuncture pretreatment followed by letrozole versus letrozole alone on live birth in anovulatory infertile women with polycystic ovary syndrome: a study protocol for a randomised controlled trial

    Science.gov (United States)

    Li, Juan; Ng, Ernest Hung Yu; Stener-Victorin, Elisabet; Hu, Zhenxing; Wu, Wanting; Lai, Maohua; Wu, Taixiang; Ma, Hongxia

    2016-01-01

    Introduction The high prevalence of insulin resistance in women with polycystic ovary syndrome (PCOS) is considered to be one of the major pathophysiological changes in PCOS that leads to anovulatory infertility. We hypothesise that electroacupuncture pretreatment improves insulin sensitivity and leads to a higher ovulation rate and greater chances of live birth after the induction of ovulation. The effect of electroacupuncture pretreatment followed by ovulation induction in women with anovulatory PCOS has not been investigated before, and we present here a randomised controlled trial to test this hypothesis by comparing electroacupuncture pretreatment followed by letrozole versus letrozole alone in anovulatory women with PCOS. Methods/analysis This is a multicentre, randomised,and controlled trial. A total of 384 patients will be enrolled in this study and will be randomly allocated by a central randomisation system to the treatment group or the control group in a 1:1 ratio. The treatment group will undergo 16 weeks of electroacupuncture pretreatment followed by 4 cycles of letrozole, and the control group will only undergo 4 cycles of letrozole. The primary outcome will be the live birth rate. All statistical analyses will be performed using the SPSS program V.21.0 (SPSS, Chicago, Illinois, USA), and a p value <0.05 will be considered statistically significant. Ethics/dissemination This study has been approved by the ethics committees of each participating centre. Written consent will be obtained from each patient and her husband before any study procedure is performed. Adverse events will be categorised, and the percentage of patients experiencing adverse events or serious adverse events during the treatment period will be documented. The results of this trial will be disseminated in peer-reviewed journals and presented at international meetings. Trial registration number NCT02491333. PMID:27855085

  16. Gestational age, gender and parity specific centile charts for placental weight for singleton deliveries in Aberdeen, UK.

    Science.gov (United States)

    Wallace, J M; Bhattacharya, S; Horgan, G W

    2013-03-01

    The weight of the placenta is a crude but useful proxy for its function in vivo. Accordingly extremes of placental weight are associated with adverse pregnancy outcomes while even normal variations in placental size may impact lifelong health. Centile charts of placental weight for gestational age and gender are used to identify placental weight extremes but none report the effect of parity. Thus the objective was to produce gender and gestational age specific centile charts for placental weight in nulliparous and multiparous women. Data was extracted from the Aberdeen Maternity and Neonatal Databank for all women delivering singleton babies in Aberdeen city and district after 24 weeks gestation. Gestational age specific centile charts for placental weight by gender and parity grouping (n = 88,649 deliveries over a 30 year period) were constructed using the LMS method after exclusion of outliers (0.63% of deliveries meeting study inclusion criteria). Tables and figures are presented for placental weight centiles according to gestational age, gender and parity grouping. Tables are additionally presented for the birth weight to placental weight ratio by gender. Placental weight and the fetal:placental weight ratio were higher in male versus female deliveries. Placental weight was greater in multiparous compared with nulliparous women. We present strong evidence that both gender and parity grouping influence placental weight centiles. The differences at any given gestational age are small and the effects of parity are greater overall than those of gender. In contrast the birth weight to placental weight ratio differs by gender only. These UK population specific centile charts may be useful in studies investigating the role of the placenta in mediating pregnancy outcome and lifelong health. Copyright © 2012 Elsevier Ltd. All rights reserved.

  17. Stressful life events in pregnancy and head circumference at birth

    DEFF Research Database (Denmark)

    Obel, Carsten; Hedegaard, Morten; Henriksen, Tine Brink

    2003-01-01

    A strong association between stress in pregnancy and small head circumference in infants at birth was reported in 1994. This important finding has never been replicated. In a follow-up study of 4211 participants with singleton pregnancies, information on life events was collected twice during...... pregnancy and head circumference measured shortly after birth following standard procedures. No association was found between experienced or perceived stress as a result of life events during pregnancy and head circumference in the infants. In conclusion, stress in pregnancy may influence foetal brain...

  18. Risk assessment and management to prevent preterm birth.

    Science.gov (United States)

    Koullali, B; Oudijk, M A; Nijman, T A J; Mol, B W J; Pajkrt, E

    2016-04-01

    Preterm birth is the most important cause of neonatal mortality and morbidity worldwide. In this review, we review potential risk factors associated with preterm birth and the subsequent management to prevent preterm birth in low and high risk women with a singleton or multiple pregnancy. A history of preterm birth is considered the most important risk factor for preterm birth in subsequent pregnancy. General risk factors with a much lower impact include ethnicity, low socio-economic status, maternal weight, smoking, and periodontal status. Pregnancy-related characteristics, including bacterial vaginosis and asymptomatic bacteriuria, appear to be of limited value in the prediction of preterm birth. By contrast, a mid-pregnancy cervical length measurement is independently associated with preterm birth and could be used to identify women at risk of a premature delivery. A fetal fibronectin test may be of additional value in the prediction of preterm birth. The most effective methods to prevent preterm birth depend on the obstetric history, which makes the identification of women at risk of preterm birth an important task for clinical care providers. Copyright © 2016 Elsevier Ltd. All rights reserved.

  19. Risk factors and birth prevalence of birth defects and inborn errors of ...

    African Journals Online (AJOL)

    Children with any birth defect or metabolic errors of metabolism at birth or in the neonatology section were our sample for study. Control group was randomly selected from the cases with normal live births. Blood tests were performed for children suspected to suffer from genetic blood disorders. The principal BD as per the ...

  20. Birth interval and its predictors among married women in Dabat ...

    African Journals Online (AJOL)

    2008-12-30

    Birth intervals (time between two successive live births) if short are associated with diverse complications. We assessed birth interval and its predictors among 613 married women who gave birth from January 1 to December 30, 2008. Data were collected in April 2012. Life table and Kaplan-Meier curve were used to ...

  1. The association between living through a prolonged economic depression and the male:female birth ratio--a longitudinal study from Cuba, 1960-2008.

    Science.gov (United States)

    Venero Fernández, Silvia Josefina; Medina, Ramon Suárez; Britton, John; Fogarty, Andrew W

    2011-12-15

    The Trivers-Willard hypothesis suggests that populations respond to scarcity by decreasing the ratio of males to females at livebirth. Cuba experienced an extreme economic depression in the 1990s called the "special period." Using time-series analysis, the authors studied the impact of this event on the male:female sex ratio at birth in Cuba from 1960 to 2008. From 1990 to 1993, the per capita gross domestic product in Cuba decreased by 36%. By use of a definition of the special period from 1991 to 1998, there was a prolonged increase in the male:female ratio of livebirths during this period of economic depression (P Cuba, contrary to the Trivers-Willard hypothesis, the human population responded to conditions of scarcity by increasing the ratio of males to females at livebirth. These data may be relevant in the modeling of demographic projections in countries that experience prolonged economic depression and in understanding adaptive human reproductive responses to environmental change.

  2. Genetic Evidence for Causal Relationships Between Maternal Obesity-Related Traits and Birth Weight.

    Science.gov (United States)

    Tyrrell, Jessica; Richmond, Rebecca C; Palmer, Tom M; Feenstra, Bjarke; Rangarajan, Janani; Metrustry, Sarah; Cavadino, Alana; Paternoster, Lavinia; Armstrong, Loren L; De Silva, N Maneka G; Wood, Andrew R; Horikoshi, Momoko; Geller, Frank; Myhre, Ronny; Bradfield, Jonathan P; Kreiner-Møller, Eskil; Huikari, Ville; Painter, Jodie N; Hottenga, Jouke-Jan; Allard, Catherine; Berry, Diane J; Bouchard, Luigi; Das, Shikta; Evans, David M; Hakonarson, Hakon; Hayes, M Geoffrey; Heikkinen, Jani; Hofman, Albert; Knight, Bridget; Lind, Penelope A; McCarthy, Mark I; McMahon, George; Medland, Sarah E; Melbye, Mads; Morris, Andrew P; Nodzenski, Michael; Reichetzeder, Christoph; Ring, Susan M; Sebert, Sylvain; Sengpiel, Verena; Sørensen, Thorkild I A; Willemsen, Gonneke; de Geus, Eco J C; Martin, Nicholas G; Spector, Tim D; Power, Christine; Järvelin, Marjo-Riitta; Bisgaard, Hans; Grant, Struan F A; Nohr, Ellen A; Jaddoe, Vincent W; Jacobsson, Bo; Murray, Jeffrey C; Hocher, Berthold; Hattersley, Andrew T; Scholtens, Denise M; Davey Smith, George; Hivert, Marie-France; Felix, Janine F; Hyppönen, Elina; Lowe, William L; Frayling, Timothy M; Lawlor, Debbie A; Freathy, Rachel M

    2016-03-15

    Neonates born to overweight or obese women are larger and at higher risk of birth complications. Many maternal obesity-related traits are observationally associated with birth weight, but the causal nature of these associations is uncertain. To test for genetic evidence of causal associations of maternal body mass index (BMI) and related traits with birth weight. Mendelian randomization to test whether maternal BMI and obesity-related traits are potentially causally related to offspring birth weight. Data from 30,487 women in 18 studies were analyzed. Participants were of European ancestry from population- or community-based studies in Europe, North America, or Australia and were part of the Early Growth Genetics Consortium. Live, term, singleton offspring born between 1929 and 2013 were included. Genetic scores for BMI, fasting glucose level, type 2 diabetes, systolic blood pressure (SBP), triglyceride level, high-density lipoprotein cholesterol (HDL-C) level, vitamin D status, and adiponectin level. Offspring birth weight from 18 studies. Among the 30,487 newborns the mean birth weight in the various cohorts ranged from 3325 g to 3679 g. The maternal genetic score for BMI was associated with a 2-g (95% CI, 0 to 3 g) higher offspring birth weight per maternal BMI-raising allele (P = .008). The maternal genetic scores for fasting glucose and SBP were also associated with birth weight with effect sizes of 8 g (95% CI, 6 to 10 g) per glucose-raising allele (P = 7 × 10(-14)) and -4 g (95% CI, -6 to -2 g) per SBP-raising allele (P = 1×10(-5)), respectively. A 1-SD ( ≈ 4 points) genetically higher maternal BMI was associated with a 55-g higher offspring birth weight (95% CI, 17 to 93 g). A 1-SD ( ≈ 7.2 mg/dL) genetically higher maternal fasting glucose concentration was associated with 114-g higher offspring birth weight (95% CI, 80 to 147 g). However, a 1-SD ( ≈ 10 mm Hg) genetically higher maternal SBP was associated with a 208-g

  3. Birth prevalence of Prader-Willi syndrome in Australia.

    Science.gov (United States)

    Smith, A; Egan, J; Ridley, G; Haan, E; Montgomery, P; Williams, K; Elliott, E

    2003-03-01

    This is the first population based study to estimate the birth prevalence of DNA proven Prader-Willi syndrome. Thirty infants were reported to the Australian Paediatric Surveillance Unit between 1998 and 2000, a prevalence of 4 per 100,000 live births or approximately 1/25,000 live births per annum.

  4. Perinatal outcome in singletons after modified natural cycle IVF and standard IVF with ovarian stimulation

    NARCIS (Netherlands)

    Pelinck, Marie-Jose; Keizer, Marjan H.; Hoek, Annemieke; Simons, Arnold H. M.; Schelling, Karin; Middelburg, Karin; Heineman, Maas Jan

    Objective: Singletons born after IVF treatment are at risk for adverse pregnancy outcome, the cause of which is unknown. The aim of the present study was to investigate the influence of ovarian stimulation on perinatal outcome. Study design: In this single-centre retrospective study, perinatal

  5. Perinatal outcome in singletons after modified natural cycle IVF and standard IVF with ovarian stimulation

    NARCIS (Netherlands)

    Pelinck, Marie-José; Keizer, Marjan H.; Hoek, Annemieke; Simons, Arnold H. M.; Schelling, Karin; Middelburg, Karin; Heineman, Maas Jan

    2010-01-01

    Objective: Singletons born after IVF treatment are at risk for adverse pregnancy outcome, the cause of which is unknown. The aim of the present study was to investigate the influence of ovarian stimulation on perinatal outcome. Study design: In this single-centre retrospective study, perinatal

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

    DEFF Research Database (Denmark)

    Pinborg, A; Wennerholm, U B; Romundstad, L B

    2013-01-01

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

  7. Development and health of 5 - 8-year-old singletons born after intracytoplasmic sperm injection

    NARCIS (Netherlands)

    Knoester, Marjolein

    2007-01-01

    This thesis describes the Leiden Artificial Reproductive Techniques Follow-up Project. In this project, the potential long-term effects of intracytoplasmic sperm injection (ICSI) were assessed in 5 – 8-year-old singleton children. ICSI is the method of artificial reproduction in which a sperm cel is

  8. A Specific IFIH1 Gain-of-Function Mutation Causes Singleton-Merten Syndrome

    NARCIS (Netherlands)

    Rutsch, Frank; Macdougall, Mary; Lu, Changming; Buers, Insa; Mamaeva, Olga; Nitschke, Yvonne; Rice, Gillian I.; Erlandsen, Heidi; Kehl, Hans Gerd; Thiele, Holger; Nürnberg, Peter; Höhne, Wolfgang; Crow, Yanick J.; Feigenbaum, Annette; Hennekam, Raoul C.

    2015-01-01

    Singleton-Merten syndrome (SMS) is an infrequently described autosomal-dominant disorder characterized by early and extreme aortic and valvular calcification, dental anomalies (early-onset periodontitis and root resorption), osteopenia, and acro-osteolysis. To determine the molecular etiology of

  9. Precipitous Birth

    Directory of Open Access Journals (Sweden)

    Jennifer Yee

    2017-09-01

    Full Text Available Audience: This scenario was developed to educate emergency medicine residents on the management of a precipitous birth in the emergency department (ED. The case is also appropriate for teaching of medical students and advanced practice providers, as well as reviewing the principles of crisis resource management, teamwork, and communication. Introduction: Patients with precipitous birth require providers to manage two patients simultaneously with limited time and resources. Crisis resource management skills will be tested once baby is delivered, and the neonate will require assessment for potential neonatal resuscitation. Objectives: At the conclusion of the simulation session, learners will be able to manage women who have precipitous deliveries, as well as perform neonatal assessment and management. Method: This session was conducted using high-fidelity simulation, followed by a debriefing session and lecture on precipitous birth management and neonatal evaluation.

  10. Is the birthweight of singletons born after IVF reduced by ovarian stimulation or by IVF laboratory procedures?

    NARCIS (Netherlands)

    Pelinck, M. J.; Hadders-Algra, M.; Haadsma, M. L.; Nijhuis, W. L.; Kiewiet, S. M.; Hoek, A.; Heineman, M. J.; Middleburg, K. J.

    Singletons born after IVF are at risk of adverse pregnancy outcome, the cause of which is unknown. The present study investigated the influence of ovarian stimulation and IVF laboratory procedure on birthweight. Birthweight of singleton pregnancies resulting from IVF treatment with (n = 161) and

  11. Is the birthweight of singletons born after IVF reduced by ovarian stimulation or by IVF laboratory procedures?

    NARCIS (Netherlands)

    Pelinck, M. J.; Hadders-Algra, M.; Haadsma, M. L.; Nijhuis, W. L.; Kiewiet, S. M.; Hoek, A.; Heineman, M. J.; Middelburg, K. J.

    2010-01-01

    Singletons born after IVF are at risk of adverse pregnancy outcome, the cause of which is unknown. The present study investigated the influence of ovarian stimulation and IVF laboratory procedure on birthweight. Birthweight of singleton pregnancies resulting from IVF treatment with (n = 161) and

  12. Associations between late and moderately preterm birth and smoking, alcohol, drug use and diet: a population-based case-cohort study.

    Science.gov (United States)

    Smith, Lucy K; Draper, Elizabeth S; Evans, T Alun; Field, David J; Johnson, Samantha J; Manktelow, Bradley N; Seaton, Sarah E; Marlow, Neil; Petrou, Stavros; Boyle, Elaine M

    2015-11-01

    This study explores the associations between lifestyle factors and late and moderate preterm birth (LMPT: 32(+0)-36(+6) weeks' gestation), a relatively under-researched group. A population-based case-cohort study was undertaken involving 922 LMPT and 965 term (37+ weeks' gestation) singleton live and stillbirths born between 1 September 2009 and 31 December 2010 to women residing in Leicestershire and Nottinghamshire, UK. Poisson multivariable regression models were fitted to estimate relative risks (RR) of LMPT birth associated with maternal smoking, alcohol and recreational drug use, and diet. Women who smoked during pregnancy were at 38% increased risk of LMPT birth compared with non-smokers (RR 1.38, 95% CI (1.04 to 1.84)). Low consumption of fruit and vegetables was associated with a 31% increased risk compared with those who reported eating higher consumption levels (RR 1.31 (1.03 to 1.66)). Women who did not have any aspects of a Mediterranean diet were nearly twice as likely to deliver LMPT compared with those whose diet included more Mediterranean characteristics (RR 1.81 (1.04 to 3.14)). Women who smoked and consumed low levels of fruit and vegetables (5% of women) were at particularly high risk (RR=1.81 (1.29 to 2.55)). There was no significant effect of alcohol or recreational drug use on LMPT birth. Smoking and poor diet during pregnancy, factors that strongly impact on very preterm birth, are also important at later gestations and experienced together are associated with an elevated rate of risk. Our findings suggest early cessation of smoking during pregnancy may be an effective strategy to reduce LMPT births. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  13. Birthweight distribution in ART singletons resulting from embryo culture in two different culture media compared with the national population

    DEFF Research Database (Denmark)

    Lemmen, Josephine Gabriela; Pinborg, Anja; Rasmussen, S

    2014-01-01

    IS KNOWN ALREADY: Studies on human ART singletons have reported a difference in birthweight in singletons following IVF culture in different culture media. However, other studies comparing different culture media have not shown any significant differences in birthweight. STUDY DESIGN, SIZE, DURATION......: This study was a retrospective comparison of birthweights in IVF/ICSI singletons conceived after fresh embryo transfer following embryo culture in Cook or Medicult medium and in a national cohort of naturally conceived singletons in nulliparous women. The study compares four independent groups consisting...... of singletons in nulliparous women from Cook-d2: 2-day culture in Cook medium at Rigshospitalet (n = 974), Medicult-d2: 2-day culture in Medicult EmbryoAssist medium at Rigshospitalet (n = 147), Medicult-d3: 3-day culture in Medicult EmbryoAssist medium with and without added GM-CSF (n = 204), and DK...

  14. Contingent orienting or contingent capture: a size singleton matching the target-distractor size relation cannot capture attention.

    Science.gov (United States)

    Du, Feng; Yin, Yue; Qi, Yue; Zhang, Kan

    2014-08-01

    In the present study, we examined whether a peripheral size-singleton distractor that matches the target-distractor size relation can capture attention and disrupt central target identification. Three experiments consistently showed that a size singleton that matches the target-distractor size relation cannot capture attention when it appears outside of the attentional window, even though the same size singleton produces a cuing effect. In addition, a color singleton that matches the target color, instead of a size singleton that matches the target-distractor size relation, captures attention when it is outside of the attentional window. Thus, a size-relation-matched distractor is much weaker than a color-matched distractor in capturing attention and cannot capture attention when the distractor appears outside of the attentional window.

  15. FastStats: Birth Defects or Congenital Anomalies

    Science.gov (United States)

    ... this? Submit What's this? Submit Button NCHS Home Birth Defects or Congenital Anomalies Recommend on Facebook Tweet ... 4,825 Infant deaths per 100,000 live births: 121.3 Cause of infant death rank: 1 ...

  16. Drug Improves Birth Rates for Women with Ovary Disorder

    Science.gov (United States)

    ... NIH Research Matters July 21, 2014 Drug Improves Birth Rates for Women with Ovary Disorder At a ... more effective than standard therapy in increasing live births for women with polycystic ovary syndrome. Letrozole could ...

  17. Birth weight trends among interracial black and white infants.

    Science.gov (United States)

    Parker, J D

    2000-05-01

    I examined time trends in low birth weight (LBW) and very low birth weight (VLBW) among interracial compared with single-race infants. Using natality data from 1978 through 1997 for singleton births to black and white parents, I calculated relative risks (RRs) of LBW and VLBW for interracial compared with single-race births, stratified by maternal race and adjusted for maternal characteristics. Among black mothers, interracial births had lower risks of LBW and VLBW than single-race births, and RRs were similar throughout the time period [for example, adjusted RR = 0.76 and 95% confidence interval (CI) = 0.73-0.80 for LBW in 1994-1997]. Among white mothers, interracial infants had higher risks of LBW than single-race infants; however, the adjusted RRs declined over the time period, from 1.22 (95% CI = 1.19-1.27) in 1978-1981 to 1.05 (95% CI = 1.03-1.08) in 1994-1997. Since 1978, there has been some relative improvement in birth outcomes for infants of white mothers and black fathers compared with single-race white births. There was, however, no relative improvement for black mother/black father infants relative to black mother/white father births.

  18. The influence of the induction of farrowing on live birth, body mass, appearance of dystocia, mortality and surviving of neonatal pigs in litter during the first ten days

    Directory of Open Access Journals (Sweden)

    Jović Slavoljub

    2016-01-01

    Full Text Available The objective of this work was to investigate the influence of the the day of farrowing induction on the number of newborn piglets (live born and dead born, body mass and mortality of neonatal pigs in litter by the tenth day of age. For the investigation purpose, there were chosen 167 pregnant animals, 34 gilts and 133 sows, divided into 3 groups each, according to the day of pregnancy when prostaglandin analogue, dinoprost-tromethamine, was applied (from 112th to 114th day. Fastest- induced parturition was in gilts which were administered dinoprost on the 113th day of pregnancy, (34,30 ± 6,23 h after application, that is, in sows which were administered prostaglandin on the 114th day of pregnancy, (29,57 ± 4,14 h after application of dinoprost. Most gilts (75 % and sows (90,91% started farrowing 24-36 h after dinoprost application, when it was given on the 113th day of pregnancy. During daily twelve-hour working time (7-19 h, 67,07% out of all the treated animals started farrowing. When farrowing was induced on the 112th day of pregnancy, 17 sows (12,78% needed obstetric assistance for dystocia, while 47 (35,34 % sows had troublesome farrowing. Along with the delayed induction, body mass of newborn pigs increased, and the largest recorded weight was 1,27 kg in sows, that is 1,38 kg in gilts, which were given dinoprost on the 114th day of pregnancy, with the lowest number of live born pigs of body mass less than 1 kg (23,76%. In this experiment there was determined the connection between the body mass and vitality of newborn piglets, so the lowest mortality rate of the pigs by the 10th day of age was noticed in sows and gilts which were given dinoprost on the 114th day of pregnancy (11,05%, in regard to the pigs born of sows and gilts which were given dinoprost on the 112th day of pregnancy (15,39 %.

  19. Births: final data for 2004.

    Science.gov (United States)

    Martin, Joyce A; Hamilton, Brady E; Sutton, Paul D; Ventura, Stephanie J; Menacker, Fay; Kirmeyer, Sharon

    2006-09-29

    This report presents 2004 data on U.S. births according to a wide variety of characteristics. Data are presented for maternal demographic characteristics including age, live-birth order, race, Hispanic origin, marital status, and educational attainment; maternal lifestyle and health characteristics (medical risk factors, weight gain, and tobacco use); medical care utilization by pregnant women (prenatal care, obstetric procedures, characteristics of labor and/or delivery, attendant at birth, and method of delivery); and infant characteristics (period of gestation, birthweight, Apgar score, congenital anomalies, and multiple births). Also presented are birth and fertility rates by age, live-birth order, race, Hispanic origin, and marital status. Selected data by mother's state of residence are shown, as well as data on month and day of birth, sex ratio, and age of father. Trends in fertility patterns and maternal and infant characteristics are described and interpreted. Descriptive tabulations of data reported on the birth certificates of the 4.1 million births that occurred in 2004 are presented. Denominators for population-based rates are post-censal estimates derived from the U.S. 2000 census. In 2004, 4,112,052 births were registered in the United States, less than 1 percent more than the number in 2003. The crude birth rate declined slightly; the general fertility rate increased by less than 1 percent. Childbearing among teenagers and women aged 20-24 years declined to record lows. Rates for women aged 25-34 and 45-49 years were unchanged, whereas rates for women aged 35-44 years increased. All measures of unmarried childbearing rose in 2004. Smoking during pregnancy continued to decline. No improvement was seen in the timely initiation of prenatal care. The cesarean delivery rate jumped 6 percent to another all-time high, whereas the rate of vaginal birth after previous cesarean fell by 13 percent. Preterm and low birthweight rates continued their steady rise

  20. The spatial evaluation of neighborhood clusters of birth defects

    Energy Technology Data Exchange (ETDEWEB)

    Frisch, J.D.

    1990-04-16

    Spatial statistics have recently been applied in epidemiology to evaluate clusters of cancer and birth defects. Their use requires a comparison population, drawn from the population at risk for disease, that may not always be readily available. In this dissertation the plausibility of using data on all birth defects, available from birth defects registries, as a surrogate for the spatial distribution of all live births in the analysis of clusters is assessed. Three spatial statistics that have been applied in epidemiologic investigations of clusters, nearest neighbor distance, average interpoint distance, and average distance to a fixed point, were evaluated by computer simulation for their properties in a unit square, and in a zip code region. Comparison of spatial distributions of live births and birth defects was performed by drawing samples of live births and birth defects from Santa Clara County, determining the street address at birth, geocoding this address and evaluating the resultant maps using various statistical techniques. The proposed method was then demonstrated on a previously confirmed cluster of oral cleft cases. All live births for the neighborhood were geocoded, as were all birth defects. Evaluation of this cluster using the nearest neighbor and average interpoint distance statistics was performed using randomization techniques with both the live births population and the birth defect population as comparison groups. 113 refs., 36 figs., 16 tabs.

  1. Smoking ban and small-for-gestational age births in Ireland.

    Directory of Open Access Journals (Sweden)

    Zubair Kabir

    Full Text Available BACKGROUND: Ireland introduced a comprehensive workplace smoke-free legislation in March, 2004. Smoking-related adverse birth outcomes have both health care and societal cost implications. The main aim of this study was to determine the impact of the Irish smoke-free legislation on small-for-gestationa- age (SGA births. METHODS AND FINDINGS: We developed a population-based birthweight (BW percentile curve based on a recent study to compute SGA (BW <5(th percentile and very SGA (vSGA - BW<3(rd percentile for each gestational week. Monthly births born between January 1999 and December 2008 were analyzed linking with monthly maternal smoking rates from a large referral maternity university hospital. We ran individual control and CUSUM charts, with bootstrap simulations, to pinpoint the breakpoint for the impact of ban implementation ( = April 2004. Monthly SGA rates (% before and after April 2004 was considered pre and post ban period births, respectively. Autocorrelation was tested using Durbin Watson (DW statistic. Mixed models using a random intercept and a fixed effect were employed using SAS (v 9.2. A total of 588,997 singleton live-births born between January 1999 and December 2008 were analyzed. vSGA and SGA monthly rates declined from an average of 4.7% to 4.3% and from 6.9% to 6.6% before and after April 2004, respectively. No auto-correlation was detected (DW = ~2. Adjusted mixed models indicated a significant decline in both vSGA and SGA rates immediately after the ban [(-5.3%; 95% CI -5.43% to -5.17%, p<0.0001 and (-0.45%; 95% CI: -0.7% to -0.19%, p<0.0007], respectively. Significant gradual effects continued post the ban periods for vSGA and SGA rates, namely, -0.6% (p<0.0001 and -0.02% (p<0.0001, respectively. CONCLUSIONS: A significant reduction in small-for-gestational birth rates both immediately and sustained over the post-ban period, reinforces the mounting evidence of the positive health effect of a successful comprehensive

  2. Social stigma and compounded losses: quality-of-life issues for multiple-birth families.

    Science.gov (United States)

    Ellison, Marcia A; Hall, Janet E

    2003-08-01

    To determine the quality-of-life domains most impacted by multiple births. Focus groups, qualitative research. Human volunteers in a medical research environment.Forty-three mothers, 29 raising multiple-birth children, 13 raising singletons, identified from random and convenience samples. None. Maternal self-reports of the psychosocial sequelae of multiple or singleton births, based on qualitative data analysis of transcribed group discussions. The quality-of-life domains that were most impacted by raising multiple birth children were social stigma, pregnancy loss, marital satisfaction, children's health, unmet family needs, parenting stress, maternal depression, and the infertility experience. Qualitative methods identified two novel quality-of-life domains in iatrogenic multiple birth families: social stigma and compounded losses. An unexpected finding was the potential for increased marital solidification as parents coped with the inordinate stresses of multiple births. As anticipated, children's health, unmet family needs, maternal depression, and parental stress were key areas of concern. In addition, the infertility experience had a lasting impact. These findings are significant, given that at least 38% of all assisted conceptions result in a multiple birth. This study lays the groundwork for further research on the impact of iatrogenic multiple births.

  3. An Australian Aboriginal birth cohort: a unique resource for a life course study of an Indigenous population. A study protocol

    Directory of Open Access Journals (Sweden)

    Flynn Kathryn

    2003-03-01

    Full Text Available Abstract Background The global rise of Type 2 diabetes and its complications has drawn attention to the burden of non-communicable diseases on populations undergoing epidemiological transition. The life course approach of a birth cohort has the potential to increase our understanding of the development of these chronic diseases. In 1987 we sought to establish an Australian Indigenous birth cohort to be used as a resource for descriptive and analytical studies with particular attention on non-communicable diseases. The focus of this report is the methodology of recruiting and following-up an Aboriginal birth cohort of mobile subjects belonging to diverse cultural and language groups living in a large sparsely populated area in the Top End of the Northern Territory of Australia. Methods A prospective longitudinal study of Aboriginal singletons born at the Royal Darwin Hospital 1987–1990, with second wave cross-sectional follow-up examination of subjects 1998–2001 in over 70 different locations. A multiphase protocol was used to locate and collect data on 686 subjects with different approaches for urban and rural children. Manual chart audits, faxes to remote communities, death registries and a full time subject locator with past experience of Aboriginal communities were all used. Discussion The successful recruitment of 686 Indigenous subjects followed up 14 years later with vital status determined for 95% of subjects and examination of 86% shows an Indigenous birth cohort can be established in an environment with geographic, cultural and climatic challenges. The high rates of recruitment and follow up indicate there were effective strategies of follow-up in a supportive population.

  4. Preterm birth in the Inuit and First Nations populations of Québec, Canada, 1981–2008

    Directory of Open Access Journals (Sweden)

    Nathalie Auger

    2012-03-01

    Full Text Available Objectives: To evaluate preterm birth (PTB for Inuit and First Nations vs. non-Indigenous populations in the province of Québec, Canada. Study design: Retrospective cohort study. Methods: We evaluated singleton live births for Québec residents, 1981–2008 (n = 2,310,466. Municipality of residence (Inuit-inhabited, First Nations-inhabited, rest of Québec and language (Inuit, First Nations, French/English were used to identify Inuit and First Nations births. The outcome was PTB (<37 completed weeks. Cox proportional hazards regression was employed to estimate hazard ratios (HR and 95% confidence intervals (CI of PTB, adjusting for maternal age, education, marital status, parity and birth year. Results: PTB rates were higher for Inuit language speakers in Inuit-inhabited areas and the rest of Québec compared with French/English speakers in the rest of Québec, and disparities persisted over time. Relative to French/English speakers in the rest of Québec, Inuit language speakers in the rest of Québec had the highest risk of PTB (HR 1.98, 95% CI: 1.62–2.41. The risk was also elevated for Inuit language speakers in Inuit-inhabited areas, though to a lesser extent (HR 1.29, 95% CI: 1.18–1.41. In contrast, First Nations language speakers in First Nations-inhabited areas and the rest of Québec had similar or lower risks of PTB relative to French/English speakers in the rest of Québec. Conclusions: Inuit populations, especially those outside Inuit-inhabited areas, have persistently elevated risks of PTB, indicating a need for strategies to prevent PTB in this population.

  5. HOW TO MAKE A SINGLETON sdB STAR VIA ACCELERATED STELLAR EVOLUTION

    International Nuclear Information System (INIS)

    Clausen, Drew; Wade, Richard A.

    2011-01-01

    Many hot subdwarf B stars (sdBs) are in close binaries, and the favored formation channels for subdwarfs rely on mass transfer in a binary system to strip a core He-burning star of its envelope. However, these channels cannot account for sdBs that have been observed in long-period binaries nor the narrow mass distribution of isolated (or 'singleton') sdBs. We propose a new formation channel involving the merger of a helium white dwarf and a low-mass, hydrogen-burning star, which addresses these issues. Hierarchical triples whose inner binaries merge and form sdBs by this process could explain the observed long-period subdwarf+main-sequence binaries. This process would also naturally explain the observed slow rotational speeds of singleton sdBs. We also briefly discuss the implications of this formation channel for extreme horizontal branch morphology in globular clusters and the UV upturn in elliptical galaxies.

  6. The role of unique color changes and singletons in attention capture.

    Science.gov (United States)

    von Mühlenen, Adrian; Conci, Markus

    2016-10-01

    Previous studies have shown that a sudden color change is typically less salient in capturing attention than the onset of a new object. Von Mühlenen, Rempel, and Enns (Psychological Science 16: 979-986, 2005) showed that a color change can capture attention as effectively as the onset of a new object given that it occurs during a period of temporal calm, where no other display changes happen. The current study presents a series of experiments that further investigate the conditions under which a change in color captures attention, by disentangling the change signal from the onset of a singleton. The results show that the item changing color receives attentional priority irrespective of whether this change goes along with the appearance of a singleton or not.

  7. Assisted Reproductive Technology and Newborn Size in Singletons Resulting from Fresh and Cryopreserved Embryos Transfer

    OpenAIRE

    Levi Dunietz, Galit; Holzman, Claudia; Zhang, Yujia; Talge, Nicole M.; Li, Chenxi; Todem, David; Boulet, Sheree L.; McKane, Patricia; Kissin, Dmitry M.; Copeland, Glenn; Bernson, Dana; Diamond, Michael P.

    2017-01-01

    Objectives and Study Design The aim of this study was two-fold: to investigate the association of Assisted Reproductive Technology (ART) and small newborn size, using standardized measures; and to examine within strata of fresh and cryopreserved embryos transfer, whether this association is influenced by parental infertility diagnoses. We used a population-based retrospective cohort from Michigan (2000?2009), Florida and Massachusetts (2000?2010). Our sample included 28,946 ART singletons con...

  8. Maternal age, birth order, and race: differential effects on birthweight

    Science.gov (United States)

    Swamy, Geeta K; Edwards, Sharon; Gelfand, Alan; James, Sherman A; Miranda, Marie Lynn

    2014-01-01

    Background Studies examining the influence of maternal age and birth order on birthweight have not effectively disentangled the relative contributions of each factor to birthweight, especially as they may differ by race. Methods A population-based, cross-sectional study of North Carolina births from 1999 to 2003 was performed. Analysis was restricted to 510 288 singleton births from 28 to 42 weeks’ gestation with no congenital anomalies. Multivariable linear regression was used to model maternal age and birth order on birthweight, adjusting for infant sex, education, marital status, tobacco use and race. Results Mean birthweight was lower for non-Hispanic black individuals (NHB, 3166 g) compared with non-Hispanic white individuals (NHW, 3409 g) and Hispanic individuals (3348 g). Controlling for covariates, birthweight increased with maternal age until the early 30s. Race-specific modelling showed that the upper extremes of maternal age had a significant depressive effect on birthweight for NHW and NHB (35+ years, p<0.001), but only age less than 25 years was a significant contributor to lower birthweights for Hispanic individuals, p<0.0001. Among all racial subgroups, birth order had a greater influence on birthweight than maternal age, with the largest incremental increase from first to second births. Among NHB, birth order accounted for a smaller increment in birthweight than for NHW and Hispanic women. Conclusion Birth order exerts a greater influence on birthweight than maternal age, with signficantly different effects across racial subgroups. PMID:21081308

  9. Shifts of visuospatial attention to invisible (metacontrast-masked) singletons: Clues from reaction times and event-related potential

    OpenAIRE

    Manfred Heumann; Ulrich Ansorge

    2006-01-01

    In the current study, we tested whether a masked and, thus, invisible singleton-cue captures atten-tion in a stimulus-driven manner or in a top-down contingent manner. The manual RT (Reaction Time) capture effect with the invisible singleton--cue decreased substantially when a match between the singleton-cue and the top-down controlled set of searched-for target features was also decreased. By contrast, with the PCN (Posterior Contralateral Negativity), an electrophysiological measure of the ...

  10. Does culture medium influence offspring birth weight?

    Science.gov (United States)

    Carrasco, Beatriz; Boada, Montserrat; Rodríguez, Ignacio; Coroleu, Buenaventura; Barri, Pedro N; Veiga, Anna

    2013-11-01

    To determine whether the type of medium used to culture human embryos in vitro influences neonatal birth weight after IVF/intracytoplasmic sperm injection (ICSI). A prospective study and a retrospective study. Private assisted reproduction center. The prospective study included 449 IVF/ICSI cycles from August to December 2008. The retrospective analysis was performed for 2,518 IVF/ICSI cycles from October 2006 to December 2010. In the prospective study, patients were randomized for embryo culture in Cook or Vitrolife medium. The retrospective study was performed with three different culture media (MediCult, Cook, and Vitrolife). Mean birth weight, adjusted for gestational age and gender (z score) of newborns. In the prospective study, the average z score was -0.19 ± 0.85 in Cook and 0.08 ± 1.40 in Vitrolife. In the retrospective study, the z scores obtained in each group were as follows: Cook, -0.14 ± 0.96; MediCult, 0.06 ± 1.13; and Vitrolife, 0.03 ± 1.05. No significant differences were observed regarding the birth weight of children born in the different groups in both studies. The results do not show any relationship between the medium used for in vitro culture and mean birth weight adjusted for gestational age and gender of singletons born after IVF/ICSI. Copyright © 2013 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  11. Sub-registro de nascimentos vivos em localidade do Estado de Piauí, Brasil Underregistration of live births in city of the State of Piauí, Brazil

    Directory of Open Access Journals (Sweden)

    Maria Helena de Rezende Brito Portela

    1989-12-01

    Full Text Available Decorrente de falta de dados que informem de modo fidedigno aos planejadores da área de Saúde, objetivou-se estimar a taxa mínima de sub-registro de nascimentos vivos na cidade de Piripiri, Piauí, no período de 1 de julho de 1983 a 30 de junho de 1984. O método utilizado para medir o sub-registro foi a comparação dos dados oficiais (Cartório de Registro Civil com os não oficiais (Fundação Serviço Especial de Saúde Pública - FSESP e Igreja Católica, cujo resultado mostrou uma taxa mínima de sub-registro muito alta (68,4% quando comparada com taxas de outras localidades brasileiras. Estudou-se a associação entre registro civil e variáveis interveníentes como local do parto, sexo da criança, estado civil e zona de residência da mãe. Concluiu-se ser o sub-registro um problema de Saúde Pública cujos fatores fundamentais como a educação, a conscientização da população e a gratuidade do registro, dentre outros, poderão contribuir para sua diminuição, com a conseqüente melhoria do planejamento das ações na área da Saúde Pública, de benéfica repercussão na vida da população.The minimum rate of underregistration of live births in the city of Piripiri, Piauí, between Jury 1,1983 and June 30,1984, is calculated. The lack of trustworthy data on underregistration of births is of the utmost importance in the area of Public Health, principally to those responsible for planning the Health Services. The method used to measure underregistration was the comparison of official data (Civil Registry Office with unofficial data (Foundation SESP and the Catholic Church, the results of which show a very high minimum rate of underregistration - 68.4% - as compared with the rates of other places in Brazil. The association between the civil register and such variables as place of births, sex of child, civil status and residential zone of mother was also studies. It is concluded that underregistration is a public health problem

  12. Vaginal birth after cesarean: neonatal outcomes and United States birth setting.

    Science.gov (United States)

    Tilden, Ellen L; Cheyney, Melissa; Guise, Jeanne-Marie; Emeis, Cathy; Lapidus, Jodi; Biel, Frances M; Wiedrick, Jack; Snowden, Jonathan M

    2017-04-01

    Women who seek vaginal birth after cesarean delivery may find limited in-hospital options. Increasing numbers of women in the United States are delivering by vaginal birth after cesarean delivery out-of-hospital. Little is known about neonatal outcomes among those who deliver by vaginal birth after cesarean delivery in- vs out-of-hospital. The purpose of this study was to compare neonatal outcomes between women who deliver via vaginal birth after cesarean delivery in-hospital vs out-of-hospital (home and freestanding birth center). We conducted a retrospective cohort study using 2007-2010 linked United States birth and death records to compare singleton, term, vertex, nonanomolous, and liveborn neonates who delivered by vaginal birth after cesarean delivery in- or out-of-hospital. Descriptive statistics and multivariate regression analyses were conducted to estimate unadjusted, absolute, and relative birth-setting risk differences. Analyses were stratified by parity and history of vaginal birth. Sensitivity analyses that involved 3 transfer status scenarios were conducted. Of women in the United States with a history of cesarean delivery (n=1,138,813), only a small proportion delivered by vaginal birth after cesarean delivery with the subsequent pregnancy (n=109,970; 9.65%). The proportion of home vaginal birth after cesarean delivery births increased from 1.78-2.45%. A pattern of increased neonatal morbidity was noted in unadjusted analysis (neonatal seizures, Apgar score birthing their second child by vaginal birth after cesarean delivery in out-of-hospital settings had higher odds of neonatal morbidity and death compared with women of higher parity. Women who had not birthed vaginally prior to out-of-hospital vaginal birth after cesarean delivery had higher odds of neonatal morbidity and mortality compared with women who had birthed vaginally prior to out-of-hospital vaginal birth after cesarean delivery. Sensitivity analyses generated distributions of plausible

  13. Predictive accuracy of changes in transvaginal sonographic cervical length over time for preterm birth: a systematic review and metaanalysis.

    Science.gov (United States)

    Conde-Agudelo, Agustin; Romero, Roberto

    2015-12-01

    To determine the accuracy of changes in transvaginal sonographic cervical length over time in predicting preterm birth in women with singleton and twin gestations. PubMed, Embase, Cinahl, Lilacs, and Medion (all from inception to June 30, 2015), bibliographies, Google scholar, and conference proceedings. Cohort or cross-sectional studies reporting on the predictive accuracy for preterm birth of changes in cervical length over time. Two reviewers independently selected studies, assessed the risk of bias, and extracted the data. Summary receiver-operating characteristic curves, pooled sensitivities and specificities, and summary likelihood ratios were generated. Fourteen studies met the inclusion criteria, of which 7 provided data on singleton gestations (3374 women) and 8 on twin gestations (1024 women). Among women with singleton gestations, the shortening of cervical length over time had a low predictive accuracy for preterm birth at predictive accuracy for preterm birth at predictive accuracies for preterm birth of cervical length shortening over time and the single initial and/or final cervical length measurement in 8 of 11 studies that provided data for making these comparisons. In the largest and highest-quality study, a single measurement of cervical length obtained at 24 or 28 weeks of gestation was significantly more predictive of preterm birth than any decrease in cervical length between these gestational ages. Change in transvaginal sonographic cervical length over time is not a clinically useful test to predict preterm birth in women with singleton or twin gestations. A single cervical length measurement obtained between 18 and 24 weeks of gestation appears to be a better test to predict preterm birth than changes in cervical length over time. Published by Elsevier Inc.

  14. Updated birth weight centiles for England and Wales.

    Science.gov (United States)

    Norris, Tom; Seaton, Sarah E; Manktelow, Brad N; Baker, Philip N; Kurinczuk, Jennifer J; Field, David; Draper, Elizabeth S; Smith, Lucy K

    2017-12-07

    Construct updated birth weight-for-gestational age centile charts for use in the UK and compare these to the currently used UK-WHO charts. Secondary analysis of national birth data. Centiles were constructed using 1 269 403 singleton births occurring in England and Wales in 2013-2014 as part of the MBRRACE-UK national perinatal surveillance programme. These were then validated using 642 737 singleton births occurring in England and Wales in 2015. Sex-specific birth weight-for-gestational age centiles. Centiles were created using the lambda-mu-sigma method via the GAMLSS package in R. This method transforms the skewed birth weight distribution to approximate a normal distribution, allowing any birth weight centile to be produced. The new centiles performed well in the validation sample, with the observed and expected proportion of births below a given centile in agreement. Overall, driven by the predominance of term births, the UK-WHO charts classify a smaller proportion of infants as below a given centile. For example, the UK-WHO estimates classified only 1.32% (8035/606 430) of term infants born in 2015 as below the second centile, compared with 1.97% (11 975/606 430) using the new MBRRACE-UK centiles. At the earliest gestational ages, however, the opposite is observed, with the UK-WHO classifying a larger proportion of infants as below a given centile, particularly at the lower end of the birthweight distribution. We have constructed and validated updated birth weight-for-gestational age centiles using a contemporary sample of births occurring in England and Wales. The benefits of these updated centiles will be first to assist the national surveillance of perinatal mortality programme by improving the identification of the proportion of stillbirths and neonatal deaths affected by intrauterine growth restriction and, second, to aid clinicians by more accurately identifying babies who require increased monitoring in the period immediately following birth.

  15. Effects of socioeconomic position and clinical risk factors on spontaneous and iatrogenic preterm birth.

    Science.gov (United States)

    Joseph, K S; Fahey, John; Shankardass, Ketan; Allen, Victoria M; O'Campo, Patricia; Dodds, Linda; Liston, Robert M; Allen, Alexander C

    2014-03-27

    The literature shows a variable and inconsistent relationship between socioeconomic position and preterm birth. We examined risk factors for spontaneous and iatrogenic preterm birth, with a focus on socioeconomic position and clinical risk factors, in order to explain the observed inconsistency. We carried out a retrospective population-based cohort study of all singleton deliveries in Nova Scotia from 1988 to 2003. Data were obtained from the Nova Scotia Atlee Perinatal Database and the federal income tax T1 Family Files. Separate logistic models were used to quantify the association between socioeconomic position, clinical risk factors and spontaneous preterm birth and iatrogenic preterm birth. The study population included 132,714 singleton deliveries and the rate of preterm birth was 5.5%. Preterm birth rates were significantly higher among the women in the lowest (versus the highest) family income group for spontaneous (rate ratio 1.14, 95% confidence interval (CI) 1.03, 1.25) but not iatrogenic preterm birth (rate ratio 0.95, 95% CI 0.75, 1.19). Adjustment for maternal characteristics attenuated the family income-spontaneous preterm birth relationship but strengthened the relationship with iatrogenic preterm birth. Clinical risk factors such as hypertension were differentially associated with spontaneous (rate ratio 3.92, 95% CI 3.47, 4.44) and iatrogenic preterm (rate ratio 14.1, 95% CI 11.4, 17.4) but factors such as diabetes mellitus were not (rate ratio 4.38, 95% CI 3.21, 5.99 for spontaneous and 4.02, 95% CI 2.07, 7.80 for iatrogenic preterm birth). Socioeconomic position and clinical risk factors have different effects on spontaneous and iatrogenic preterm. Recent temporal increases in iatrogenic preterm birth appear to be responsible for the inconsistent relationship between socioeconomic position and preterm birth.

  16. Shifts of visuospatial attention to invisible (metacontrast-masked singletons: Clues from reaction times and event-related potential

    Directory of Open Access Journals (Sweden)

    Manfred Heumann

    2006-01-01

    Full Text Available In the current study, we tested whether a masked and, thus, invisible singleton-cue captures atten-tion in a stimulus-driven manner or in a top-down contingent manner. The manual RT (Reaction Time capture effect with the invisible singleton--cue decreased substantially when a match between the singleton-cue and the top-down controlled set of searched-for target features was also decreased. By contrast, with the PCN (Posterior Contralateral Negativity, an electrophysiological measure of the capture of visuospatial attention by the invisible singleton-cue, no significant decrement was observed. Taken together, the results support the assumption that an invisible singleton-cue can capture attention in a stimulus-driven manner, and that different delays in the deallocation of attention (i.e., attention is deallocated more efficiently from acue that does not match the top-down controlled set than from a cue that does match the same set account for the weaker manual RT capture effect with a set- -nonmatching invisible singleton-cue.

  17. Twins less frequent than expected among male births in risk averse populations.

    Science.gov (United States)

    Karasek, Deborah; Goodman, Julia; Gemmill, Alison; Falconi, April; Hartig, Terry; Magganas, Aristotle; Catalano, Ralph

    2015-06-01

    Male twin gestations exhibit higher incidence of fetal morbidity and mortality than singleton gestations. From an evolutionary perspective, the relatively high rates of infant and child mortality among male twins born into threatening environments reduce the fitness of these gestations, making them more vulnerable to fetal loss. Women do not perceive choosing to spontaneously abort gestations although the outcome may result from estimates, made without awareness, of the risks of continuing a pregnancy. Here, we examine whether the non-conscious decisional biology of gestation can be linked to conscious risk aversion. We test this speculation by measuring the association between household surveys in Sweden that gauge financial risk aversion in the population and the frequency of twins among live male births. We used time-series regression methods to estimate our suspected associations and Box-Jenkins modeling to ensure that autocorrelation did not confound the estimation or reduce its efficiency. We found, consistent with theory, that financial risk aversion in the population correlates inversely with the odds of a twin among Swedish males born two months later. The odds of a twin among males fell by approximately 3.5% two months after unexpectedly great risk aversion in the population. This work implies that shocks that affect population risk aversion carry implications for fetal loss in vulnerable twin pregnancies.

  18. Infant Deaths per Thousand Live Births 1990

    Data.gov (United States)

    U.S. Environmental Protection Agency — Variable was created as part of a set of indicators that demonstrate links between the condition of natural areas and human concerns and that quantify dependencies...

  19. Maternal pesticide use and birth weight in the agricultural health study.

    Science.gov (United States)

    Sathyanarayana, Sheela; Basso, Olga; Karr, Catherine J; Lozano, Paula; Alavanja, Michael; Sandler, Dale P; Hoppin, Jane A

    2010-04-01

    Studies examining the association between maternal pesticide exposure and low birth weight yield conflicting results. The authors examined the association between maternal pesticide use and birth weight among women in the Agricultural Health Study, a large study of pesticide applicators and their spouses in Iowa and North Carolina. The authors evaluated self-reported pesticide use of 27 individual pesticides in relation to birth weight among 2246 farm women whose most recent singleton birth occurred within 5 years of enrollment (1993-1997). The authors used linear regression models adjusted for site, preterm birth, medical parity, maternal body mass index, height, and smoking. The results showed that mean infant birth weight was 3586 g (+/- 546 g), and 3% of the infants were low birth weight (birth weight. Ever use of the pesticide carbaryl was associated with decreased birth weight (-82 g, 95% confidence interval [CI] = -132, -31). This study thus provides limited evidence about pesticide use as a modulator of birth weight. Overall, the authors observed no associations between birth weight and pesticide-related activities during early pregnancy; however, the authors have no data on temporal specificity of individual pesticide exposures prior to or during pregnancy and therefore cannot draw conclusions related to these exposure windows. Given the widespread exposure to pesticide products, additional evaluation of maternal pregnancy exposures at specific time windows and subsequent birth outcomes is warranted.

  20. Prete