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Medical disease with pregnancy

Jonas F Ludvigsson, Benjamin Lebwohl, Anders Ekbom, Ravi Kiran, Peter Hr Green, Jonas Höijer, Olof Stephansson
BACKGROUND & AIMS: Endoscopy is an integral part of the investigation and management of gastrointestinal disease. We aimed to examine outcomes of pregnancies for women who underwent endoscopy during their pregnancy. METHODS: We performed a nationwide population-based cohort study, linking data from the Swedish Medical Birth Registry (for births from 1992 through 2011) with those from the Swedish Patient Registry. We identified 3052 pregnancies exposed to endoscopy (2025 upper endoscopies, 1109 lower endoscopies, 58 endoscopic retrograde cholangiopancreatographies)...
October 20, 2016: Gastroenterology
Uma Mahadevan, Ryan A McConnell, Christina Chambers
The management of the pregnant patient with inflammatory bowel disease (IBD) is complicated by multiple providers, misinformation and a disease entity that, particularly when active, can adversely affect pregnancy outcomes. This paper seeks to frame the debate on medication safety in pregnancy and lactation using the Food and Drug Administration's new Pregnancy and Lactation Labeling Rule (PLLR) and the most up to date safety information to discuss the risks and benefits of using each class of IBD medication...
October 18, 2016: Gastroenterology
Oluwagbemiga Oluwole Ayoola, Peter Bulus, Olabisi Morebisi Loto, Bukunmi Michael Idowu
AIM: To determine the Doppler indices of the umbilical arteries in normal singleton pregnancy with a view to generating local reference ranges. METHODS: In this prospective, cross-sectional study, 400 pregnant women at 15-39 weeks' gestational age, with estimated fetal weight within the 10th and 90th percentile, no fetal malformation(s), and without any history of maternal medical disease, were recruited. Umbilical arteries were assessed on ultrasound, with the subjects in the supine position...
October 20, 2016: Journal of Obstetrics and Gynaecology Research
Y Yu, S Cnattingius, J Olsen, E T Parner, M Vestergaard, Z Liew, N Zhao, J Li
BACKGROUND: The loss of a close relative is one of the most stressful life events. In pregnancy, this experience has been associated with a higher risk of fetal death and under-five mortality, but little is known about potential effects on long-term mortality in offspring. We examined the association between prenatal maternal bereavement and mortality in a cohort of 5.3 million children followed until up to 37 years of age. METHOD: The population-based cohort study included 5 253 508 live singleton births in Denmark (1973-2004) and Sweden (1973-2006)...
October 20, 2016: Psychological Medicine
Marina Parca Cavelagna Teixeira, Tatiana Peloso Reis Queiroga, Maria Dos Anjos Mesquita
Objective: To determine the frequency and risk factors of small-for-gestational-age newborns in a high-risk maternity. Methods: This is an observational, cross-sectional, and case-control study, conducted in a public tertiary care maternity hospital. Data from 998 newborns and their mothers were collected through interviews and review of medical records and prenatal care cards. Some placentas underwent histopathological analysis. The variables of small-for-gestational-age and non-small-for-gestational-age newborns and of their mothers were statistically compared by means of Student's t test, Fisher's exact test, and odds ratio...
July 2016: Einstein
Flavia Westphal, Suzete Maria Fustinoni, Vânia Lopes Pinto, Patrícia de Souza Melo, Anelise Riedel Abrahão
Objective: To identify the profile of women seen in a Fetal Medicine unit, diagnosed with fetal abnormality incompatible with neonatal survival in their current pregnancy, and to check the association of gestational age upon diagnosis with the option of pregnancy termination. Methods: This is a retrospective cohort study carried out in the Fetal Medicine Outpatients Clinic of a university hospital, in the city of São Paulo (SP), Brazil, using medical records of pregnant women with fetus presenting abnormalities incompatible with neonatal survival...
July 2016: Einstein
Suzanne Oparil
Heart disease, stroke, and kidney failure are leading causes of death worldwide, and hypertension is a significant risk factor for each. Hypertension is less common in women, compared to men, in those younger than 45 years of age. This trend is reversed in those 65 years and older. In the US between 2011-2014, the prevalence of hypertension in women and men by age group was 6% vs 8% (18-39 years), 30% vs 35% (40-59 years), and 67% vs 63% (60 years and over). Awareness, treatment, and control rates differ between genders with women being more aware of their diagnosis (85% vs 80%), more likely to take their medications (81% vs 71%) and more frequently having controlled hypertension (55% vs 49%)...
September 2016: Journal of Hypertension
Mao-Jun Li, Qing Wu, Wei Shi, Qian Yang, Bin-Zhi Tang, Chang-Hui Chen
OBJECTIVE: To study clinical features of respiratory distress syndrome (RDS) in neonates of different gestational ages (GA). METHODS: According to GA, 133 neonates with RDS were classified into GA <34 weeks group (n=66), GA 34-36 weeks group (late preterm neonates; n=31), and GA ≥37 weeks group (full-term neonates; n=36). The mothers' medical history during pregnancy and the condition of the neonates at birth were retrospectively analyzed, and the clinical data were compared between groups...
October 2016: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
Elisabeth Leirgul, Kristoffer Brodwall, Gottfried Greve, Stein E Vollset, Henrik Holmstrøm, Grethe S Tell, Nina Øyen
OBJECTIVE: To investigate the association between pregestational or gestational diabetes and offspring risk of congenital heart defects and the association between large-for-gestational-age birth weight and risk of cardiac defects in offspring of diabetic women. METHODS: Information on pregestational and gestational diabetes, cardiac defects, and birth weight among all births in Norway in 1994-2009 was ascertained from the Medical Birth Registry of Norway, national health registries, and the Cardiovascular Disease in Norway project...
October 6, 2016: Obstetrics and Gynecology
Val Catanzarite, Larry Cousins, Sean Daneshmand, Wade Schwendemann, Holly Casele, Joanna Adamczak, Tevy Tith, Ami Patel
OBJECTIVE: To describe outcomes for a large cohort of women with prenatally diagnosed vasa previa, determine the percentage in patients without risk factors, and compare delivery timing and indications for singletons and twins. METHODS: This was a retrospective case series of women with prenatally diagnosed vasa previa delivered at a single tertiary center over 12 years. Potential participants were identified using hospital records and perinatal databases. Patients were included if vasa previa was confirmed at delivery and by pathologic examination...
October 6, 2016: Obstetrics and Gynecology
Gabriella Bröms, Fredrik Granath, Olof Stephansson, Helle Kieler
BACKGROUND: The inflammatory bowel diseases (IBD), Crohn's disease (CD) and ulcerative colitis (UC) have been associated with an increased risk of preterm birth. MATERIAL AND METHODS: We identified all 246 singleton preterm births among women with IBD between July 2006 and December 2010 as cases and an equal number of controls with IBD from the Swedish national health registers, matched by maternal age, parity and IBD diagnosis (CD/UC). From register data and medical charts, we obtained information on reproductive history, comorbidity, disease activity and drug treatment (corticosteroids, 5-aminosalicylates, sulfasalazine, thiopurines and anti-TNF) as risk factors for preterm birth...
December 2016: Scandinavian Journal of Gastroenterology
Stefan Orwat, Gerhard-Paul Diller, Iris M van Hagen, Renate Schmidt, Daniel Tobler, Matthias Greutmann, Regina Jonkaitiene, Amro Elnagar, Mark R Johnson, Roger Hall, Jolien W Roos-Hesselink, Helmut Baumgartner
BACKGROUND: Controversial results on maternal risk and fetal outcome have been reported in women with aortic stenosis (AS). OBJECTIVES: The authors sought to investigate maternal and fetal outcomes in patients with AS in a large cohort. METHODS: The Registry on Pregnancy and Cardiac Disease (ROPAC) is a global, prospective observational registry of women with structural heart disease, providing a uniquely large study population. Data of women with moderate (peak gradient 36 to 63 mm Hg) and severe AS (peak gradient ≥64 mm Hg) were analyzed...
October 18, 2016: Journal of the American College of Cardiology
Orkun Cetin, Erbil Karaman, Harun Arslan, Ali Kolusarı, Recep Yıldızhan, Mesut Ozgokce, Abdussamet Batur, Ibrahim Akbudak
PURPOSE: To compare maternal liver elasticity scores by Acoustic Radiation Force Impulse (ARFI) elastosonography in healthy and preeclamptic pregnancies and its association with the severity of the disease. MATERIALS AND METHODS: Forty-two healthy, 33 mild, 33 severe preeclamptic and 28 pregnant women with Hemolysis, Elevated Liver enzymes, and Low Platelets (HELLP) syndrome were included into the study. Maternal liver elasticity was measured by ARFI elastosonography at the first day of puerperium...
October 13, 2016: Journal of Maternal-fetal & Neonatal Medicine
Vivian Wai-Mei Huang, Hsiu-Ju Chang, Karen Ivy Kroeker, Karen Jean Goodman, Kathleen M Hegadoren, Levinus Albert Dieleman, Richard Neil Fedorak
Background. Inflammatory bowel disease (IBD) affects patients in their young reproductive years. Women with IBD require maintenance therapies during pregnancy and breastfeeding. However, physician management of IBD during pregnancy and breastfeeding has not been well characterized. Objective. To characterize physician perceptions and management of IBD during pregnancy and breastfeeding. Methods. A cross-sectional survey of Canadian physicians who are involved in the care of women with IBD was conducted. The survey included multiple-choice and Likert scale questions about perceptions and practice patterns regarding the management of IBD during pregnancy and breastfeeding...
2016: Canadian Journal of Gastroenterology & Hepatology
Jenny Brouwer, Rosalie Fleurbaaij, Johanna M W Hazes, Radboud J E M Dolhain, Joop S E Laven
Objective - Subfertility is frequently encountered amongst female rheumatoid arthritis (RA) patients and has been associated with disease activity and anti-rheumatic drugs. However, little is known about the results of the fertility work-up in these women. Our aim was to study the outcome of fertility assessments in subfertile women with RA. Methods - A cross-sectional study was performed in a nationwide cohort of female RA patients who were pregnant or were trying to conceive between 2002 and 2010 (PARA study)...
October 9, 2016: Arthritis Care & Research
Andrea G Kattah, Dawn C Scantlebury, Sanket Agarwal, Michelle M Mielke, Walter A Rocca, Amy L Weaver, Lisa E Vaughan, Virginia M Miller, Tracey L Weissgerber, Wendy White, Vesna D Garovic
BACKGROUND: Several registry-based studies, using diagnostic codes, have suggested that preeclampsia is a risk factor for end-stage renal disease (ESRD). However, because the 2 diseases share risk factors, the true nature of their association remains uncertain. Our goals were to conduct a population-based study to determine the magnitude of the association between preeclampsia and ESRD and evaluate the role of shared risk factors. STUDY DESIGN: Population-based nested case-control study...
October 1, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Gustaf Brander, Mina Rydell, Ralf Kuja-Halkola, Lorena Fernández de la Cruz, Paul Lichtenstein, Eva Serlachius, Christian Rück, Catarina Almqvist, Brian M D'Onofrio, Henrik Larsson, David Mataix-Cols
Importance: Perinatal complications may increase the risk of obsessive-compulsive disorder (OCD). Previous reports were based on small, retrospective, specialist clinic-based studies that were unable to rigorously control for unmeasured environmental and genetic confounding. Objective: To prospectively investigate a wide range of potential perinatal risk factors for OCD, controlling for unmeasured factors shared between siblings in the analyses. Design, Setting, and Participants: This population-based birth cohort study included all 2 421 284 children from singleton births in Sweden from January 1, 1973, to December 31, 1996, who were followed up through December 31, 2013...
October 5, 2016: JAMA Psychiatry
Francisca Caimari, Elena Valassi, Patricia Garbayo, Charlotte Steffensen, Alicia Santos, Rosa Corcoy, Susan M Webb
Pregnancy in Cushing's syndrome (CS) is extremely rare due to the influence of hypercortisolism on the reproductive axis. Purpose of this study is to investigate whether the etiology of CS in pregnancy determines a different impact on the fetal/newborn and maternal outcomes. We performed a systematic review of cases published in the literature from January 1952 to April 2015 including the words "Cushing AND pregnancy". We included 168 manuscripts containing 220 patients and 263 pregnancies with active CS during pregnancy and with a history of CS but treated and cured hypercortisolism at the time of gestation...
October 4, 2016: Endocrine
Stine Linding Andersen, Peter Laurberg
Hyperthyroidism in women who are of childbearing age is predominantly of autoimmune origin and caused by Graves' disease. The physiological changes in the maternal immune system during a pregnancy may influence the development of this and other autoimmune diseases. Furthermore, pregnancy-associated physiological changes influence the synthesis and metabolism of thyroid hormones and challenge the interpretation of thyroid function tests in pregnancy. Thyroid hormones are crucial regulators of early development and play an important role in the maintenance of a normal pregnancy and in the development of the fetus, particularly the fetal brain...
2016: International Journal of Women's Health
Ava L Liberman, Hooman Kamel, Michael T Mullen, Steven R Messé
BACKGROUND: Cerebral venous thrombosis (CVT) is a relatively rare and understudied disease. We sought to determine the accuracy of International Classification of Diseases, Ninth Revision (ICD-9) diagnosis codes to identify CVT. METHODS: Retrospective chart review using the electronic medical record (EMR) to identify all patients discharged with CVT following admission or emergency department visit from May 1, 2010 to May 1, 2015 at our center. RESULTS: We identified 111 patients with an ICD-9 discharge diagnosis code of 325...
October 2016: Neurohospitalist
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