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preconception risk

Laura R Stroud, George D Papandonatos, Stephanie H Parade, Amy L Salisbury, Maureen G Phipps, Barry M Lester, James F Padbury, Carmen J Marsit
OBJECTIVES: Extending prior studies of prenatal adversity and depressive symptoms, we tested associations between maternal prenatal major depressive disorder (MDD) and infant cortisol regulation. Based on prior findings by our group, we also tested placenta glucocorticoid (HSD11B2 methylation) and serotonin (SLC6A4 gene expression) signaling as moderators of links between prenatal MDD and infant cortisol. METHODS: Participants were 153 mother-infant pairs from a low-income, diverse sample (M [SD] age = 26[6] years)...
October 19, 2016: Psychosomatic Medicine
Catriona Mill, Joanne Enders, Cynthia Montanaro, Kieran Michael Moore
The trend toward delayed parenthood is on the rise across Canada. Societal emphasis on attaining higher education, career advancement and financial security may be some reasons why individuals delay becoming a parent; whatever the reason, this trend is linked to significant health and economic impacts. Many Canadians are unaware of the impact this may have on their fertility and potential birth outcomes. It is important that health care professionals apprise individuals in their reproductive years about these issues and the steps they can take to mitigate these risks...
October 20, 2016: Canadian Journal of Public Health. Revue Canadienne de Santé Publique
Cristina R Lammers, Polly A Hulme, Howard Wey, Jennifer Kerkvliet, Shivaram P Arunachalam
Despite evidence of the benefits of preconception health care (PCHC), little is known about awareness and access to PCHC for rural, reproductive-aged women. This study aimed to assess the prevalence of PCHC conversations between rural reproductive-age women and health care providers, PCHC interventions received in the past year, and ascertain predictors of PCHC conversations and interventions. Women (n = 868; 18-45 years) completed a questionnaire including reproductive history, health care services utilization, and interest in PCHC...
October 18, 2016: Journal of Community Health
Rose G Radin, Lindsey A Sjaarda, Neil J Perkins, Robert M Silver, Zhen Chen, Laurie L Lesher, Noya Galai, Jean Wactawski-Wende, Sunni L Mumford, Enrique F Schisterman
CONTEXT: Among women with a single, recent pregnancy loss, daily preconception low-dose aspirin (LDA) increased the live birth rate with no effect on pregnancy loss. The mechanism underlying this effect is unclear, but it may work through ovulation. OBJECTIVE: We estimated the effect of LDA on the per-cycle risk of anovulation among eumenorrheic women. DESIGN: The Effects of Aspirin in Gestation and Reproduction trial, a multi-center, randomized, double-blind, placebo-controlled trial of daily LDA on reproductive outcomes...
October 18, 2016: Journal of Clinical Endocrinology and Metabolism
Franca Marangoni, Irene Cetin, Elvira Verduci, Giuseppe Canzone, Marcello Giovannini, Paolo Scollo, Giovanni Corsello, Andrea Poli
The importance of lifestyle and dietary habits during pregnancy and breastfeeding, for health of mothers and their offspring, is widely supported by the most recent scientific literature. The consumption of a varied and balanced diet from the preconceptional period is essential to ensure both maternal well-being and pregnancy outcomes. However, the risk of inadequate intakes of specific micronutrients in pregnancy and lactation is high even in the most industrialized countries. This particularly applies to docosahexaenoic acid (DHA), iron, iodine, calcium, folic acid, and vitamin D, also in the Italian population...
October 14, 2016: Nutrients
Nancy Baugh, David E Harris, AbouEl-Makarim Aboueissa, Cheryl Sarton, Erika Lichter
The objective of this study is to understand the relationships between prepregnancy obesity and excessive gestational weight gain (GWG) and adverse maternal and fetal outcomes. Pregnancy risk assessment monitoring system (PRAMS) data from Maine for 2000-2010 were used to determine associations between demographic, socioeconomic, and health behavioral variables and maternal and infant outcomes. Multivariate logistic regression analysis was performed on the independent variables of age, race, smoking, previous live births, marital status, education, BMI, income, rurality, alcohol use, and GWG...
2016: Journal of Pregnancy
Lucilla Poston, Rishi Caleyachetty, Sven Cnattingius, Camila Corvalán, Ricardo Uauy, Sharron Herring, Matthew W Gillman
Obesity in women of reproductive age is increasing in prevelance worldwide. Obesity reduces fertility and increases time taken to conceive, and obesity-related comorbidities (such as type 2 diabetes and chronic hypertension) heighten the risk of adverse outcomes for mother and child if the woman becomes pregnant. Pregnant women who are obese are more likely to have early pregnancy loss, and have increased risk of congenital fetal malformations, delivery of large for gestational age infants, shoulder dystocia, spontaneous and medically indicated premature birth, and stillbirth...
October 10, 2016: Lancet Diabetes & Endocrinology
Mark Hanson, Mary Barker, Jodie M Dodd, Shiriki Kumanyika, Shane Norris, Eric Steegers, Judith Stephenson, Shakila Thangaratinam, Huixia Yang
Prevention of obesity in women of reproductive age is widely recognised to be important both for their health and for that of their offspring. Weight-control interventions, including drug treatment, in pregnant women who are obese or overweight have not had sufficient impact on pregnancy and birth outcomes, which suggests that the focus for intervention should include preconception or post-partum periods. Further research is needed into the long-term effects of nutritional and lifestyle interventions before conception...
October 10, 2016: Lancet Diabetes & Endocrinology
Nicole A Huijgen, Maria A J de Ridder, Katia M Verhamme, Gert R Dohle, Ann M Vanrolleghem, Miriam C J M Sturkenboom, Joop S E Laven, Régine P M Steegers-Theunissen
OBJECTIVE: To determine associations between proton-pump inhibitor (PPI) use and semen parameters in young men of couples who are planning pregnancy. DESIGN: Case-control study of a population-based registry. SETTING: Not applicable. PATIENT(S): General practitioner patients comprising 2,473 men from couples planning pregnancy with a recorded semen analysis: 241 with a low total motile sperm count (TMSC ≤1) and 714 with TMSC >1 as matched controls...
October 12, 2016: Fertility and Sterility
Hsin-Hsu Chou, Meng-Jiun Chiou, Fu-Wen Liang, Lea-Hua Chen, Tsung-Hsueh Lu, Chung-Yi Li
BACKGROUND: Information about known risk factors for congenital heart disease is scarce. In this population-based study, we aimed to investigate the relation between maternal chronic disease and congenital heart disease in offspring. METHODS: The study cohort consisted of 1 387 650 live births from 2004 to 2010. We identified chronic disease in mothers and mild and severe forms of congenital heart disease in their offspring from Taiwan's National Health Insurance medical claims...
October 11, 2016: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
Emily E Petersen, Dana Meaney-Delman, Robyn Neblett-Fanfair, Fiona Havers, Titilope Oduyebo, Susan L Hills, Ingrid B Rabe, Amy Lambert, Julia Abercrombie, Stacey W Martin, Carolyn V Gould, Nadia Oussayef, Kara N D Polen, Matthew J Kuehnert, Satish K Pillai, Lyle R Petersen, Margaret A Honein, Denise J Jamieson, John T Brooks
CDC has updated its interim guidance for persons with possible Zika virus exposure who are planning to conceive (1) and interim guidance to prevent transmission of Zika virus through sexual contact (2), now combined into a single document. Guidance for care for pregnant women with possible Zika virus exposure was previously published (3). Possible Zika virus exposure is defined as travel to or residence in an area of active Zika virus transmission (, or sex* without a condom(†) with a partner who traveled to or lived in an area of active transmission...
October 7, 2016: MMWR. Morbidity and Mortality Weekly Report
Laura M Borgelt, Felecia M Hart, Jacquelyn L Bainbridge
In the US, more than one million women with epilepsy are of childbearing age and have over 20,000 babies each year. Patients with epilepsy who become pregnant are at risk of complications, including changes in seizure frequency, maternal morbidity and mortality, and congenital anomalies due to antiepileptic drug exposure. Appropriate management of epilepsy during pregnancy may involve frequent monitoring of antiepileptic drug serum concentrations, potential preconception switching of antiepileptic medications, making dose adjustments, minimizing peak drug concentration with more frequent dosing, and avoiding potentially teratogenic medications...
2016: International Journal of Women's Health
D Lo Presti, G Gagliardi, G M Tiralongo, I Pisani, D Farsetti, R L Scala, G P Novelli, B Vasapollo, A Andreoli, H Valensise
INTRODUCTION: Several studies have demonstrated the correlation between maternal obesity and pregnancy complications. Obese women seem to be at higher risk to develop late preeclampsia, which shows a more favorable perinatal outcome compared to the early form. The assessment of total vascular resistance (TVR) could play an additional role in the detection of these patients. Targets: To identify patients at higher risk of hypertensive complications through the assessment of pre-pregnancy maternal fat mass (FM) and TVR...
August 2016: Journal of Maternal-fetal & Neonatal Medicine
Sanne van der Hout, Kim Ca Holtkamp, Lidewij Henneman, Guido de Wert, Wybo J Dondorp
Expanded universal carrier screening (EUCS) entails a twofold expansion of long-standing (preconception) carrier screening programmes: it not only allows the simultaneous screening of a large list of diseases ('expanded'), but also refers to a pan-ethnic screening offer ('universal'). Advocates mention three main moral advantages of EUCS as compared with traditional (targeted and/or ancestry-based) forms of carrier screening: EUCS will (1) maximise opportunities for autonomous reproductive choice by informing prospective parents about a much wider array of reproductive risks; (2) provide equity of access to carrier testing services; (3) reduce the risk of stigmatisation...
September 28, 2016: European Journal of Human Genetics: EJHG
Stefanie N Hinkle, Sunni L Mumford, Katherine L Grantz, Robert M Silver, Emily M Mitchell, Lindsey A Sjaarda, Rose G Radin, Neil J Perkins, Noya Galai, Enrique F Schisterman
Importance: Nausea and vomiting during pregnancy have been associated with a reduced risk for pregnancy loss. However, most prior studies enrolled women with clinically recognized pregnancies, thereby missing early losses. Objective: To examine the association of nausea and vomiting during pregnancy with pregnancy loss. Design, Setting, and Participants: A randomized clinical trial, Effects of Aspirin in Gestation and Reproduction, enrolled women with 1 or 2 prior pregnancy losses at 4 US clinical centers from June 15, 2007, to July 15, 2011...
September 26, 2016: JAMA Internal Medicine
Yusuf C Kaplan, Elif Keskin-Arslan, Selin Acar, Kaan Sozmen
OBJECTIVE: To determine whether an up-to-date systematic review and meta-analysis of observational studies would support the previously suggested associations regarding prenatal selective serotonin reuptake inhibitor (SSRI) use and the risk for autism spectrum disorders (ASD) in children. METHODS: PubMed/MEDLINE, Cochrane Central Register of Controlled Trials and Reprotox databases were searched; observational studies with an exposed and unexposed group were included...
September 22, 2016: Reproductive Toxicology
George Petrakos, Panagiotis Andriopoulos, Maria Tsironi
Advances in treatment of thalassemia have led to the aging of thalassemic patients, and consequently concern about successful reproductive outcome is augmented. Although women with thalassemia intermedia only were considered competent of achieving pregnancy, case series reveal the willingness of both thalassemia major and thalassemia intermedia women to have a family. Pregnancy in general is characterized by dynamic multiple-system changes and increased susceptibility to oxidative stress, while homozygous, transfusion-dependent, β-thalassemia patients manifest cardiac, hepatic, endocrine, and metabolic disorders attributable to chronic anoxia and iron overload and thalassemia intermedia, usually nontransfused, is associated with augmented risk of thromboembolic events...
2016: International Journal of Women's Health
Maria Ekstrand Ragnar, Tanja Tydén, Ulrik Kihlbom, Margareta Larsson
INTRODUCTION: Genetic technologies advance rapidly. It is possible to undergo genetic carrier screening before pregnancy to examine genetic risks to future offspring. We aimed to investigate parents' interest and motives towards preconception genetic carrier screening (PCS) as well as factors associated with interest in PCS. MATERIAL AND METHODS: Our study sample consists of 777 parent couples within the longitudinal Swedish Pregnancy Planning study. Women responded to questionnaires at three occasions: in early pregnancy, late pregnancy, and one year after childbirth...
September 20, 2016: Upsala Journal of Medical Sciences
Obiamaka Ojukwu, Dilisha Patel, Judith Stephenson, Beth Howden, Jill Shawe
BACKGROUND: Preconception health and care aims to reduce parental risk factors before pregnancy through health promotion and intervention. Little is known about the preconception interventions that general practitioners (GPs) provide. The aim of this study was to examine GPs' knowledge, attitudes, and views towards preconception health and care in the general practice setting. METHODS: As part of a large mixed-methods study to explore preconception care in England, we surveyed 1,173 women attending maternity units and GP services in London and interviewed women and health professionals...
September 20, 2016: Upsala Journal of Medical Sciences
Helena Kopp Kallner, Kristina Gemzell Danielsson
Preservation of fertility and optimizing health before pregnancy is becoming increasingly important in societies where childbirth often is postponed. Research shows that as women postpone childbirth they achieve higher levels of education and higher incomes. This leads to advantages for their children and for society. However, as women postpone childbearing they are at risk for contracting conditions which may affect fertility and/or pregnancies, pregnancy outcome, and the newborn child. Preconception counseling is therefore becoming increasingly important...
September 20, 2016: Upsala Journal of Medical Sciences
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