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Preterm pregnancy

Amanda Roman, Gabriele Saccone, Carolynn M Dude, Andrew Ward, Hannah Anastasio, Lorraine Dugoff, Fulvio Zullo, Vincenzo Berghella
OBJECTIVE: To compare the mean transvaginal ultrasound (TVU) cervical length (CL) at midtrimester screening for spontaneous preterm birth in asymptomatic monochorionic diamniotic versus dichorionic diamniotic twin pregnancies STUDY DESIGN: This was a multicenter retrospective cohort study. Study subjects were identified at the time of a routine second trimester fetal ultrasound exam at 18 0/7-23 6/7 weeks gestation. We excluded women that received progesterone, pessary, or cerclage. Distribution of CL was determined and normality was examined...
August 8, 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Vanessa Arizo-Luque, Ana M García, Marisa Estarlich, Ferran Ballester, Guillermo Fernández-Tardón, Adonina Tardón, Mónica Guxens, Martine Vrijheid, Aitana Lertxundi, Loreto Santa-Marina, Elena Ronda-Pérez
OBJECTIVE: Published studies are not conclusive on the impact of certain occupational exposures in pregnancy, stressing the need to consider the double role, professional and family, of women. The objective of this study is to evaluate the effect of employment and domestic load on the duration of pregnancy and fetal development. METHODS: Using Univariate and Multivariate regression models, we studied the association of preterm deliveries (PPT) (<37 weeks), full term newborns with low weight (BPT) (<2500g) and small for their gestational age (PEG) (<10th percentile) in weight, length and head circumference according to work situation (employment/non-employment) and domestic load (low/ medium/ high) in 2506 women...
August 17, 2018: Revista Española de Salud Pública
Steven J Korzeniewski, Jaime Slaughter, Madeleine Lenski, Peterson Haak, Nigel Paneth
Cerebral palsy (CP) is the most prevalent, severe and costly motor disability of childhood. Consequently, CP is a public health priority for prevention, but its aetiology has proved complex. In this Review, we summarize the evidence for a decline in the birth prevalence of CP in some high-income nations, describe the epidemiological evidence for risk factors, such as preterm delivery and fetal growth restriction, genetics, pregnancy infection and other exposures, and discuss the success achieved so far in prevention through the use of magnesium sulfate in preterm labour and therapeutic hypothermia for birth-asphyxiated infants...
August 13, 2018: Nature Reviews. Neurology
Girmay Teklay, Tsega Teshale, Hagos Tasew, Teklewoini Mariye, Hagos Berihu, Teklay Zeru
OBJECTIVE: The aim of the study was to identify the risk factors for preterm birth in public hospitals of the central zone, Tigray, Ethiopia 2017/2018. RESULT: A total of 88 neonates who born preterm (cases) and 176 neonates who born term (controls) with their index mothers were included making a response rate of 100%. About 84/88 (95.5%) mothers in cases and 173/176 (98.3%) in control had antenatal care follow up. Among them, 33 (39.3%) cases and 102 (58%) controls were had antenatal care follow up four times and above...
August 13, 2018: BMC Research Notes
Ababe Tamirat Deressa, Amsale Cherie, Teshome Melese Belihu, Gemechu Ganfure Tasisa
BACKGROUND: Spontaneous preterm birth is commencement of labor with intact or pre labor rapture of membrane and birth before 37 weeks of gestation. The aim of this study was to identify common factors associated with spontaneous preterm birth in Addis Ababa public hospitals. METHODS: After random selection of three hospitals from the six Addis Ababa's Public hospitals having Neonatal intensive care unit, systematic sampling was employed to select study units from admission log book of the neonates...
August 13, 2018: BMC Pregnancy and Childbirth
Allison R Walker, Bethany T Waites, Aaron B Caughey
BACKGROUND: . Diabetes mellitus (DM) during pregnancy increases the risk for many complications such as preeclampsia and cesarean section. Teen (age <20) and advanced maternal age (AMA, age ≥35) pregnancies are both at increased risk for maternal and neonatal morbidity and mortality. Understanding the risks and complications unique to teen and AMA women with pregestational DM is imperative to providing care and improving outcomes. OBJECTIVE: . This study sought to determine how maternal and neonatal outcomes are affected by pregestational DM in teen and AMA pregnancies...
August 13, 2018: Journal of Maternal-fetal & Neonatal Medicine
Giorgina Barbara Piccoli, Isabelle Annemijn Kooij, Rossella Attini, Benedetta Montersino, Federica Fassio, Martina Gerbino, Marilisa Biolcati, Gianfranca Cabiddu, Elisabetta Versino, Tullia Todros
BACKGROUND: IgA nephropathy is the most common primary glomerulonephritis in pregnancy and shares with other immunologic diseases and kidney diseases a relationship with adverse maternal outcomes, whose entity and pattern is only partially quantified. Recent studies provide new information and a systematic review regarded progression of kidney disease. The discussion of the outcomes with respect to low-risk pregnancies may help to perfect the estimation of the risks, and to identify specific research needs...
August 11, 2018: Journal of Clinical Medicine
Matthew M Finneran, Devin D Smith, Catalin S Buhimschi
OBJECTIVE:  To quantify the potential cost savings if azithromycin is substituted for erythromycin in women with preterm premature rupture of membranes (PPROM). STUDY DESIGN:  Secondary analysis of a multicentered study investigating magnesium sulfate for the prevention of cerebral palsy in premature infants. All patients with PPROM who received antibiotics for prophylaxis were included in the analysis. The number of expected doses each patient would have received was calculated for erythromycin, multidose azithromycin, and single-dose azithromycin regimens accounting for latency from PPROM to delivery...
August 13, 2018: American Journal of Perinatology
Aneesha Varrey, Roberto Romero, Bogdan Panaitescu, Derek Miller, Tinnakorn Chaiworapongsa, Manasi Patwardhan, Jonathan Faro, Percy Pacora, Sonia S Hassan, Chaur-Dong Hsu, Nardhy Gomez-Lopez
PROBLEM: Human β-defensins (HBDs) are antimicrobial peptides that participate in the soluble innate immune mechanisms against infection. Herein, we determined whether HBD-1 was present in amniotic fluid during normal pregnancy and whether its concentrations change with intra-amniotic inflammation and/or infection. METHOD OF STUDY: Amniotic fluid was collected from 219 women in the following groups: (a) midtrimester who delivered at term (n = 35); (b) term with (n = 33) or without (n = 17) labor; (c) preterm labor with intact membranes who delivered at term (n = 29) or who delivered preterm with (n = 19) and without (n = 29) intra-amniotic inflammation and infection or with intra-amniotic inflammation but without infection (n = 21); and (d) preterm prelabor rupture of membranes (pPROM) with (n = 19) and without (n = 17) intra-amniotic inflammation/infection...
August 12, 2018: American Journal of Reproductive Immunology: AJRI
Rosa M Alvarez, Ioannis Biliatis, Andrea Rockall, Eleni Papadakou, S Aslam Sohaib, Nandita M deSouza, John Butler, Marielle Nobbenhuis, Desmond J P Barton, John H Shepherd, Thomas E J Ind
OBJECTIVE: To determine the association between the residual cervix measured on post-operative MRI after radical vaginal trachelectomy (RVT) and adverse obstetric outcomes. DESIGN: Observational study. SETTING: Referral Cancer centre. POPULATION: Women who conceived after RVT for cervical cancer at the Royal Marsden Hospital, London, between 1995 and 2015. METHODS: Post-operative MRI scans were analysed by three researchers...
August 12, 2018: BJOG: An International Journal of Obstetrics and Gynaecology
Laura Ormesher, Jenny E Myers, Catherine Chmiel, Mark Wareing, Susan L Greenwood, Teresa Tropea, Jon O Lundberg, Eddie Weitzberg, Carina Nihlen, Colin P Sibley, Edward D Johnstone, Elizabeth C Cottrell
Chronic hypertension in pregnancy is associated with significant adverse pregnancy outcomes, increasing the risk of pre-eclampsia, fetal growth restriction and preterm birth. Dietary nitrate, abundant in green leafy vegetables and beetroot, is reduced in vivo to nitrite and subsequently nitric oxide, and has been demonstrated to lower blood pressure, improve vascular compliance and enhance blood flow in non-pregnant humans and animals. The primary aims of this study were to determine the acceptability and efficacy of dietary nitrate supplementation, in the form of beetroot juice, to lower blood pressure in hypertensive pregnant women...
August 9, 2018: Nitric Oxide: Biology and Chemistry
Amihai Rottenstreich, Gabriel Levin, Geffen Kleinstern, Rani Haj Yahya, Misgav Rottenstreich, Simcha Yagel, Uriel Elchalal
INTRODUCTION: Previous reports have shown that suboptimal antenatal corticosteroids administration occurs in most cases. However, as multifetal gestations were either excluded or constituted a small proportion of the subjects in these studies, little is known about the patterns of use of antenatal corticosteroids in twin pregnancies. MATERIAL AND METHODS: We reviewed the records of women who received antenatal corticosteroids and delivered between 240/7 and 346/7 weeks of gestation during 2015-2017 at two university hospitals...
August 11, 2018: Acta Obstetricia et Gynecologica Scandinavica
Robert M Rossi, Carri R Warshak
OBJECTIVE: To quantify the rising prevalence of maternal hepatitis C virus (HCV) infection in Ohio during the peak of the opioid epidemic and to identify maternal characteristics and obstetric outcomes associated with maternal HCV infection. METHODS: We conducted a population-based retrospective cohort study of all live births in Ohio (2006-2015). Frequency of maternal HCV infection as reported on birth certificates was compared across each year of the study period...
August 6, 2018: Obstetrics and Gynecology
Frederik J R Hermans, Ewoud Schuit, Mireille N Bekker, Mallory Woiski, Marjon A de Boer, Marieke Sueters, Hubertina C J Scheepers, Maureen T M Franssen, Eva Pajkrt, Ben Willem J Mol, Marjolein Kok
OBJECTIVE: To assess the effectiveness of cervical pessary in reducing the rate of preterm birth in women at high risk for preterm birth who did not deliver after an episode of threatened preterm labor. METHODS: In a multicenter open-label randomized controlled trial, a cervical pessary was compared with no intervention (control group) (one-to-one ratio). Women between 24 and 34 weeks of gestation at high risk for preterm birth based on a short cervical length (less than 15 mm) or an intermediate cervical length (between 15 and 30 mm) with a positive fetal fibronectin test who did not deliver after an episode of threatened preterm labor were eligible...
August 6, 2018: Obstetrics and Gynecology
Shihoko Komine-Aizawa, Sohichi Aizawa, Satoshi Hayakawa
From last decade of the 20th century, numerous epidemiological studies and intervention trials have attempted to prove the relationships between maternal periodontal diseases and adverse pregnancy outcomes (APO). Periodontal diseases are considered a risk factor for APO, including preterm birth, fetal growth restriction, low birthweight, pre-eclampsia and gestational diabetes. However, the efficacy of periodontal treatment during pregnancy is controversial. Two pathogenic mechanisms might explain the potential effect of periodontal diseases on pregnancy outcomes...
August 9, 2018: Journal of Obstetrics and Gynaecology Research
Alex Y Wang, Nadom Safi, Fathalla Ali, Kei Lui, Zhuoyang Li, Mark P Umstad, Elizabeth A Sullivan
BACKGROUND: While their incidence is on the rise, twin pregnancies are associated with risks to the mothers and their babies. This study aims to investigate the likelihood of adverse neonatal outcomes of twins following assisted reproductive technology (ART) compared to non-ART twins. METHODS: A retrospective population study using the Australian National Perinatal Data Collections (NPDC) which included 19,662 twins of ≥20 weeks gestational age or ≥ 400 g birthweight in Australia...
August 8, 2018: BMC Pregnancy and Childbirth
Chittaranjan Andrade
Major congenital malformation risks in association with gestational exposure to antiepileptic drugs (AEDs) have been extensively studied. Less information is available on other adverse outcomes associated with the use of these drugs during pregnancy. This article critically examines the risk of fetal loss, intrauterine growth retardation (IUGR), and preterm birth following gestational exposure to 14 AEDs, based on information obtained from a recent network meta-analysis of mostly nonrandomized, observational studies...
July 31, 2018: Journal of Clinical Psychiatry
Emily S Barrett, Wendy Vitek, Omar Mbowe, Sally W Thurston, Richard S Legro, Ruben Alvero, Valerie Baker, G Wright Bates, Peter Casson, Christos Coutifaris, Esther Eisenberg, Karl Hansen, Stephen Krawetz, Randal Robinson, Mitchell Rosen, Rebecca Usadi, Heping Zhang, Nanette Santoro, Michael Diamond
STUDY QUESTION: Among infertile women undergoing ovarian stimulation, is allostatic load (AL), a measure of chronic physiological stress, associated with subsequent fertility and pregnancy outcomes? SUMMARY ANSWER: AL at baseline was not associated with conception, spontaneous abortion or live birth, however, it was significantly associated with increased odds of pre-eclampsia and preterm birth among women who had a live birth in the study. WHAT IS KNOWN ALREADY: Several studies have linked AL during pregnancy to adverse outcomes including preterm birth and pre-eclampsia, hypothesizing that it may contribute to well-documented disparities in pregnancy and birth outcomes...
August 1, 2018: Human Reproduction
Helen Perry, Henriette Lehmann, Elena Mantovani, Basky Thilaganathan, Asma Khalil
INTRODUCTION: Pregnancies affected by hypertensive disorders (HDP) have increased uterine artery pulsatility index (UTA PI) compared to healthy pregnancies. De novo increases in UTA PI in the third trimester have been reported, making these changes less attributable to inadequate spiral artery invasion, which is typically recognised as an early pregnancy phenomenon. Women with HDP are also known to have lower cardiac output and increased systemic vascular resistance. The aim of this study was to investigate the relationship between central and uterine haemodynamics, in both HDP and uncomplicated pregnancies...
August 6, 2018: Ultrasound in Obstetrics & Gynecology
Carmen Giurgescu, Lara Fahmy, Jaime Slaughter-Acey, Alexandra Nowak, Cleopatra Caldwell, Dawn P Misra
Background: While maternal depressive symptoms during pregnancy have been linked to preterm birth (PTB; birth before 37 completed weeks of gestation), little has been reported on potential buffering factors, particularly specific to Black women who are at much higher risk. We examined the association between depressive symptoms and PTB in pregnant Black women, with father of the baby (FOB) support as a potential buffering factor. Methods: Data were obtained from the life-course influences on fetal environments study (2009-2011), a cohort of 1,410 Black women in metropolitan Detroit, Michigan (71% response rate) using maternal interviews and medical record abstraction collected during the postpartum hospitalization...
2018: AIMS Public Health
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