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Preterm pregnancy

Stefanie Parks, Matthew K Hoffman, Shivaprasad S Goudar, Archana Patel, Sarah Saleem, Sumera Aziz Ali, Robert L Goldenberg, Patricia L Hibberd, Janet Moore, Dennis Wallace, Elizabeth M McClure, Richard J Derman
OBJECTIVE: To describe the association of maternal anaemia with maternal, foetal and neonatal outcomes. DESIGN: Prospective cohort study. SETTING: Rural India and Pakistan. POPULATION: Pregnant women residing in the study catchment area. METHODS: We performed an analysis of a prospective pregnancy registry wherein haemoglobin is commonly obtained as well as maternal, foetal and neonatal outcomes through 42 days post-delivery...
December 16, 2018: BJOG: An International Journal of Obstetrics and Gynaecology
Tara A Lynch, Courtney Olson-Chen, Sarah Colihan, Jeffrey Meyers, Conisha Holloman, Dongmei Li, Heather Link, Paola Torres, Annie Kim, Devon J King, Cari Eckman, Anna Varlamov, Scott Dexter, Eva K Pressman, Eleazar Soto-Torres, Amol Malshe
OBJECTIVE:  To evaluate outcomes with expectant management of preterm prelabor rupture of membranes (PROM) until 35 weeks versus immediate delivery at ≥34 weeks. STUDY DESIGN:  This was a multicenter retrospective cohort study of singletons with preterm PROM at >20 weeks from 2011 through 2017. Groups were defined as expectant management until 35 weeks versus immediate delivery at ≥34 weeks. Primary outcome was composite neonatal morbidity: need for respiratory support, culture positive neonatal sepsis, or antibiotic administration for >72 hours...
December 15, 2018: American Journal of Perinatology
Jean-Charles Pasquier, Olivier Claris, Muriel Rabilloud, René Ecochard, Jean-Charles Picaud, Stéphanie Moret, Danielle Buch, Georges Mellier
OBJECTIVES: Preterm premature rupture of fetal membranes (PPROM) exposes the fetus to preterm birth, and optimal timing for delivery is controversial. The aim of this study was to compare intentional early delivery ("active management") with expectant management in very preterm birth (28-32 weeks). STUDY DESIGN: We conducted a prospective randomized controlled trial with intent-to-treat analysis, at 19 tertiary-care hospitals in France and 1 in Geneva, Switzerland...
December 5, 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Jean Guglielminotti, Ruth Landau, Alexander M Friedman, Guohua Li
Objectives This study examined the prevalence and temporal trends in (a) pulmonary hypertension (PH) during pregnancy and (b) mortality and morbidity during pregnancy with and without PH. Methods This was a retrospective observational study of the 2003-2014 New York State Inpatient Database. PH was categorized as primary or secondary and pregnancy as loss or termination of pregnancy, preterm birth, or term birth. The Centers for Disease Control and Prevention definition of maternal morbidity was used, including 17 diagnoses and 5 procedures...
December 14, 2018: Maternal and Child Health Journal
Emmanuel Bassily, Cameron Bell, Sean Verma, Nidhi Patel, Aarti Patel
The maternal cardiovascular system undergoes profound changes to support the increasing demands of fetal growth during pregnancy. An accumulating body of evidence has shown that common pregnancy complications, including gestational diabetes mellitus, preeclampsia, low birth weight, and preterm delivery, can be associated with future cardiovascular adverse events in mothers. Factors such as glucose metabolism, hyperlipidemia, inflammatory markers, large and small vessel stiffness/functionality have been linked with these pregnancy conditions...
December 11, 2018: American Journal of Medicine
Hyun Sun Ko, Jeong Ha Wie, Sae Kyung Choi, In Yang Park, Yong-Gyu Park, Jong Chul Shin
PURPOSE: To examine the competing risks of stillbirth versus infant death and to evaluate the optimal time of delivery in the population of small for gestational age (SGA) and non-SGA late preterm and term fetuses. METHODS: This was a retrospective national cohort study of all singleton births between 34 0/7 and 42 6/7 weeks of gestation using the Korean vital statistics (n = 2,106,159). We compared the risk of infant mortality with a composite of fetal-infant mortality risk that would occur after expectant management for one additional week and evaluated the optimal time of delivery, in SGA and non-SGA pregnancies...
2018: PloS One
Amihai Rottenstreich, Gabriel Levin, Geffen Kleinstern, Roy Zigron, Misgav Rottenstreich, Uriel Elchalal, Simcha Yagel
OBJECTIVES: Cervical cerclage when performed in twin gestation has been reported to be associated with poor outcome. However, the role of first-trimester history-indicated cerclage among women with twin pregnancy and a prior history of preterm birth has not been studied. We aimed to assess pregnancy outcomes among women with twin pregnancy who underwent first-trimester history-indicated cervical cerclage compared to expectant management. METHODS: A retrospective matched case-control study...
December 13, 2018: Ultrasound in Obstetrics & Gynecology
Jacquelyn Grev, Marie Berg, Roger Soll
BACKGROUND: Inflammation may contribute to preterm birth and to morbidity of preterm infants. Preterm infants are at risk for alterations in the normal protective microbiome. Oral probiotics administered directly to preterm infants have been shown to decrease the risk for severe necrotizing enterocolitis (NEC) as well as the risk of death, but there are safety concerns about administration of probiotics directly to preterm infants. Through decreasing maternal inflammation, probiotics may play a role in preventing preterm birth and/or decreasing the inflammatory milieu surrounding delivery of preterm infants, and may alter the microbiome of the preterm infant when given to mothers during pregnancy...
December 12, 2018: Cochrane Database of Systematic Reviews
Tiphaine Gaillard, Manon Boxberger, Marylin Madamet, Bruno Pradines
According to the World Health Organization (WHO), Plasmodium falciparum malaria during pregnancy is responsible for deleterious consequences for the mother and her child. The administration of intermittent preventive treatment (IPTp) with sulfadoxine-pyrimethamine (SP) at each antenatal care visit as early as 13 weeks of gestation until the time of delivery is a strategy that is currently recommended by WHO for the prevention of malaria in pregnancy. However, the emergence and the spread of the resistance to SP in Africa raise the question of the short-term effectiveness of the strategy...
December 14, 2018: Malaria Journal
Azam Kouhkan, Mohammad E Khamseh, Reihaneh Pirjani, Ashraf Moini, Arezoo Arabipoor, Saman Maroufizadeh, Roya Hosseini, Hamid Reza Baradaran
BACKGROUND: Growing evidence indicates that the risk of obstetric and perinatal outcomes is higher in women with assisted reproductive technology (ART). However, there is little known about pregnancy related complications and co-morbidity in gestational diabetes mellitus (GDM) following singleton pregnancies achieved by ART in comparison with spontaneous conception (SC). METHODS: Two hundred sixty singleton pregnant women conceived by ART and 314 pregnant women conceived by spontaneous conception (SC) were participated in this prospective cohort study...
December 14, 2018: BMC Pregnancy and Childbirth
Kai Wei Lee, Siew Mooi Ching, Vasudevan Ramachandran, Anne Yee, Fan Kee Hoo, Yook Chin Chia, Wan Aliaa Wan Sulaiman, Subapriya Suppiah, Mohd Hazmi Mohamed, Sajesh K Veettil
BACKGROUND: Gestational diabetes mellitus (GDM) is a of the major public health issues in Asia. The present study aimed to determine the prevalence of, and risk factors for GDM in Asia via a systematic review and meta-analysis. METHODS: We systematically searched PubMed, Ovid, Scopus and ScienceDirect for observational studies in Asia from inception to August 2017. We selected cross sectional studies reporting the prevalence and risk factors for GDM. A random effects model was used to estimate the pooled prevalence of GDM and odds ratio (OR) with 95% confidence interval (CI)...
December 14, 2018: BMC Pregnancy and Childbirth
Mark A Clapp, Kaitlyn E James, Anjali J Kaimal
OBJECTIVE: The primary objective was to determine the association between preconception insurance and initiation of prenatal care. STUDY DESIGN: This retrospective cohort uses data from the Pregnancy Risk Assessment Monitoring System (2009-2013). Self-reported preconception insurance status was the primary exposure. The primary outcome was first trimester initiation of prenatal care. Secondary outcomes included: preterm delivery, birth weight, and the presence of birth defects...
December 13, 2018: Journal of Perinatology: Official Journal of the California Perinatal Association
Min Jiang, Miskatul Mustafa Mishu, Dan Lu, Xianghua Yin
OBJECTIVE: The aim is to examine risk factors and neonatal outcomes of preterm birth and to provide basis in preventing preterm birth. MATERIALS AND METHODS: we carried out our study on 1328 term controls and 1328 preterm birth cases. By using multivariable logistic regression procedures we estimated odds ratio (OR) of potential preterm birth risk factors. T-test and chi-square test were used to estimate differences between groups. RESULTS: Maternal age, prior history of pregnancy and abortion, prenatal care, complications of pregnancy (includes hypertension, intrahepatic cholestasis of pregnancy (ICP), fetal growth restriction (FGR), premature rupture of the membranes (PROM), placenta previa, abnormal presentation, abnormal S/D ratio et al...
December 2018: Taiwanese Journal of Obstetrics & Gynecology
Romana C Mayer, Kathrine R Tan, Julie R Gutman
Background: Malaria during pregnancy increases the risk of maternal and fetal complications. There are very limited options available for prophylaxis in pregnant travelers. Atovaquone-Proguanil (AP or Malarone®) is an effective and well-tolerated antimalarial medication, but is not recommended for use in pregnancy due to limited data on safety. Passively reported adverse event data may provide additional information on the safety of AP during pregnancy. Methods: We analyzed adverse event data on pregnancy and birth outcomes following accidental exposures to AP during pregnancy passively reported to GlaxoSmithKline LLC (GSK) between May 13, 1997 and August 15, 2017...
December 13, 2018: Journal of Travel Medicine
Keren Agay-Shay, Yaron Michael, Xavier Basagaña, Èrica Martínez-Solanas, David Broday, Itamar M Lensky, Mary Rudolf, Lisa Rubin, Rafi Kent, Nadav Levy, Ziona Haklai, Itamar Grotto
Background: Natural environments may have beneficial impacts on pregnancy outcomes. However, longitudinal evidence is limited and the associations with variance in surrounding greenness is unknown. Our objective was to evaluate these associations among 73 221 live births in Tel Aviv, Israel. Methods: Longitudinal exposure to mean of greenness during pregnancy and trimesters were calculated using satellite-based Moderate Resolution Imaging Spectroradiometer (MODIS) Normalised Difference Vegetation Index (NDVI) data...
December 13, 2018: International Journal of Epidemiology
Isabelle Monier, Nathalie Lelong, Pierre-Yves Ancel, Alexandra Benachi, Babak Khoshnood, Jennifer Zeitlin, Béatrice Blondel
OBJECTIVE: To estimate the prevalence and indications of terminations of pregnancy (TOP) between 22+0 and 31+6 weeks of gestational age in France and to examine the characteristics of women by indication of TOP. STUDY DESIGN: From the EPIPAGE 2 population-based cohort study of preterm births in France in 2011, we selected 5009 singleton live births, stillbirths and TOP that occurred between 22 and 31 weeks. We estimated the proportion of TOP by gestational age. We then classified terminations by indications into 4 categories: fetal anomalies (TOPFA), preterm premature rupture of the membranes (PPROM), maternal conditions and fetal growth restriction (FGR)...
December 3, 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Xiyuan Zhang, Emily Lu, Sarah L Stone, Hafsatou Diop
Objectives Data on the potential effect of dental cleaning and community water fluoridation (CWF) on pregnancy outcomes are scarce. While numerous studies confirm the cost-effectiveness of fluoride in preventing dental caries, the benefit of CWF during pregnancy has not been well established. Methods This cross-sectional study used data from 2009 to 2016 Massachusetts Pregnancy Risk Assessment Monitoring System and restricted to singleton live births (n = 9234, weighted response rate = 64.3%). Our exposures were: (1) dental cleaning alone during pregnancy; (2) CWF alone; and (3) dental cleaning and CWF combined (DC-CWF)...
December 12, 2018: Maternal and Child Health Journal
Silvina E Cocucci, Mirtha G Santacruz Silvero, Mirta O Losada, María S Touzón, Hilda RudaVega, Manuel Vazquez Blanco, Sergio L Provenzano, Carlos A Vay, Ángela M R Famiglietti, Beatriz E Perazzi
The etiology leading to neonatal damage is multifactorial, being genital infections one of the causes. The objective of the study was to identify microorganisms of the maternal genital tract that are associated with neonatal damage, in order to prevent future perinatal complications. Seven hundred and eleven pregnant patients attended their prenatal control during the period January 2010-July 2013. Ureaplasma urealyticum and Mycoplasma hominis presence was investigated in umbilical cord blood by metabolic substrates (Micofast-Biomerieux) and that of T...
December 9, 2018: Revista Argentina de Microbiología
Diane C Berry, Sonia Davis Thomas, Karen F Dorman, Amber Rose Ivins, Maria de Los Angeles Abreu, Laura Young, Kim Boggess
BACKGROUND: Annually in the US, over 100,000 pregnant women with overt type 2 diabetes give birth. Strict maternal glycemic control is the key to optimizing infant outcomes. Medical treatment of type 2 diabetes in pregnancy is generally restricted to insulin, as data on the safety and efficacy of oral hypoglycemic agents in pregnancy are limited. However, over one-third of infants born to women with type 2 diabetes experience an adverse outcome, such as premature delivery, large-for-gestational age, hypoglycemia, hyperbilirubinemia, or birth trauma, suggesting that current treatment regimens fall short of optimizing outcomes...
December 12, 2018: BMC Pregnancy and Childbirth
Stefania Ronzoni, Valerie Steckle, Rohan D'Souza, Kellie E Murphy, Stephen Lye, Oksana Shynlova
Premature prelabor rupture of the membranes (PPROM) causes one-third of preterm births worldwide and is most likely caused by subclinical intrauterine infection and/or inflammation. We proposed that women with systemic inflammation at the time of PPROM would have shorter latency. Peripheral blood samples were collected from 20 singleton pregnant women with PPROM between 23 ± 1 and 33 ± 6 weeks. The first sample was drawn within 48 hours of admission, followed by weekly blood draws until delivery. Pregnancies complicated with acute chorioamnionitis, preeclampsia, intrauterine growth restriction, obesity, substance abuse, and chronic maternal disease were excluded...
December 12, 2018: Reproductive Sciences
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