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Maternal morbidity

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https://www.readbyqxmd.com/read/29330733/intergenerational-continuity-in-depression-the-importance-of-time-varying-effects-maternal-co-morbid-health-risk-behaviors-and-child-s-gender
#1
Megan Bears Augustyn, Celia J Fulco, Kimberly L Henry
Intergenerational continuity in depressive symptoms is well established between mother and child, but there are still important facets of this relationship that are underexplored. We examine intergenerational continuity in depressive symptoms between mother-child dyads as a flexible function of child age and account for the potential moderating role of maternal co-morbid health risk behaviors. Using prospective, self-report data collected yearly from 413 mother-child dyads (210 mother-son dyads and 203 mother-daughter dyads) between child ages 12-17, the results indicate that the effect of maternal depressive symptoms on daughters' depressive symptoms steadily increases throughout adolescence whereas the effect of maternal depressive symptoms on sons' depressive symptoms is relatively small, stable, and non-significant during mid-adolescence before increasing in effect in later adolescence...
January 12, 2018: Journal of Youth and Adolescence
https://www.readbyqxmd.com/read/29330153/heart-failure-in-pregnant-women-a-concern-across-the-pregnancy-continuum
#2
Mulubrhan F Mogos, Mariann R Piano, Barbara L McFarlin, Jason L Salemi, Kylea L Liese, Joan E Briller
BACKGROUND: Heart failure (HF) is a leading cause of maternal morbidity and mortality in the United States, but prevalence, correlates, and outcomes of HF-related hospitalization during antepartum, delivery, and postpartum periods remain unknown. The objective was to examine HF prevalence, correlates, and outcomes among pregnancy-related hospitalizations among women 13 to 49 years of age. METHODS AND RESULTS: We used the 2001 to 2011 Nationwide Inpatient Sample...
January 2018: Circulation. Heart Failure
https://www.readbyqxmd.com/read/29329688/motorizing-and-optimizing-ultrasound-strain-elastography-for-detection-of-intrauterine-growth-restriction-pregnancies
#3
Shier Nee Saw, Jess Yi Ru Low, Citra Nurfarah Zaini Mattar, Arijit Biswas, Lujie Chen, Choon Hwai Yap
Intrauterine growth restriction is a prevalent disease in pregnancy in which placental insufficiency leads to 5 to 10 times higher mortality and lifelong morbidities. The current detection rate is poor, and recently, ultrasound strain elastography (USEL) was proposed as a new diagnostic technique. Currently, placental USEL uses maternal subcutaneous fat as the reference layer, but this is not ideal as fat tissue stiffness can vary widely between subjects. Current USEL also uses manual palpation, and under different compression depths and rates, viscoelastic tissues such as placenta can yield different stiffness results...
January 9, 2018: Ultrasound in Medicine & Biology
https://www.readbyqxmd.com/read/29329366/delineating-differential-regulatory-signatures-of-the-human-transcriptome-in-the-choriodecidua-and-myometrium-at-term-labor
#4
Sylvia Lui, Cyntia Duval, Farkhondeh Farrokhnia, Sylvie Girard, Lynda K Harris, Clare L Tower, Adam Stevens, Rebecca L Jones
Background: Preterm deliveries remain the leading cause of neonatal morbidity and mortality. Current therapies target only myometrial contractions and are largely ineffective. As labor involves multiple coordinated events across maternal and fetal tissues, identifying fundamental regulatory pathways of normal term labor is vital to understanding successful parturition and consequently labor pathologies. We aimed to identify transcriptomic signatures of human normal term labor of two tissues: in the fetal-facing choriodecidua and the maternal myometrium...
January 10, 2018: Biology of Reproduction
https://www.readbyqxmd.com/read/29327608/pregnancy-outcomes-of-women-with-spina-bifida
#5
Nathalie Auger, Laura Arbour, Mireille E Schnitzer, Jessica Healy-Profitós, Geneviève Nadeau, William D Fraser
PURPOSE: To assess the pregnancy outcomes of women with spina bifida. MATERIALS AND METHODS: We analyzed a population-based cohort of 397 pregnant women with spina bifida and 1,083,211 without spina bifida who delivered infants in hospitals in Quebec, Canada, 1989-2013. Outcomes included maternal and infant morbidity and mortality at delivery. We used log-binomial regression models to estimate prevalence ratios (PR) and 95% confidence intervals (CI) for the association of maternal spina bifida with pregnancy outcomes, accounting for maternal characteristics...
January 12, 2018: Disability and Rehabilitation
https://www.readbyqxmd.com/read/29326182/variations-in-childbirth-interventions-in-high-income-countries-protocol-for-a-multinational-cross-sectional-study
#6
Anna Seijmonsbergen-Schermers, Ank de Jonge, Thomas van den Akker, Katrien Beeckman, Annick Bogaerts, Monalisa Barros, Patricia Janssen, Lorena Binfa, Eva Rydahl, Lucy Frith, Mechthild Gross, Berglind Hálfdánsdóttir, Deirdre Daly, Jean Calleja-Agius, Patricia Gillen, Anne Britt Vika Nilsen, Eugene Declercq
INTRODUCTION: There are growing concerns about the increase in rates of commonly used childbirth interventions. When indicated, childbirth interventions are crucial for preventing maternal and perinatal morbidity and mortality, but their routine use in healthy women and children leads to avoidable maternal and neonatal harm. Establishing ideal rates of interventions can be challenging. This study aims to describe the range of variations in the use of commonly used childbirth interventions in high-income countries around the world, and in outcomes in nulliparous and multiparous women...
January 10, 2018: BMJ Open
https://www.readbyqxmd.com/read/29325544/prevalence-and-associated-factors-of-wheezing-illnesses-of-children-aged-three-to-five-years-living-in-under-served-settlements-of-the-colombo-municipal-council-in-sri-lanka-a-cross-sectional-study
#7
Ruwanika Seneviratne, Nalika S Gunawardena
BACKGROUND: A rising trend in Sri Lanka for asthma and wheezing illness is observed with higher morbidity in younger children and a paucity of related research. 'Under-served settlements' (USS) of Colombo Municipal Council (CMC) have poor living environments conducive to childhood wheezing. The objective was to describe the prevalence and associated factors of wheezing illnesses of three to five year old children living in low-income settlements in CMC. METHODS: A cross-sectional study was conducted on 460 three to five year old children and their caregivers using cluster sampling among residents of two randomly selected USSs of CMC...
January 11, 2018: BMC Public Health
https://www.readbyqxmd.com/read/29325069/effect-of-healthcare-spending-on-the-relationship-between-the-human-development-index-and-maternal-and-neonatal-mortality
#8
Kaamel M Nuhu, Justin T McDaniel, Genevieve A Alorbi, Juan I Ruiz
Background: Several factors affect morbidity and mortality the world over. Previous research shows mortality rates are higher among individuals of lower socio-economic status. We investigated the trajectory of neonatal (NM) and maternal (MM) mortality between 2010 and 2014 and the effect of healthcare spending on the relationship between the Human Development Index (HDI) and NM and MM. Methods: Data were obtained from the United Nations Development Program and World Bank...
January 9, 2018: International Health
https://www.readbyqxmd.com/read/29324609/outcomes-of-planned-compared-with-urgent-deliveries-using-a-multidisciplinary-team-approach-for-morbidly-adherent-placenta
#9
Alireza A Shamshirsaz, Karin A Fox, Hadi Erfani, Steven L Clark, Amir A Shamshirsaz, Ahmed A Nassr, Nathan C Sundgren, Jeffery A Jones, Matthew L Anderson, Elias Kassir, Bahram Salmanian, Alexandra W Buffie, Shiu-Ki Hui, Jimmy Espinoza, Lynda A Tyer-Viola, Martha Rac, Niloofar Karbasian, Jerasimos Ballas, Gary A Dildy, Michael A Belfort
OBJECTIVE: To compare outcomes between planned and urgent cesarean hysterectomy for morbidly adherent placenta managed by a multidisciplinary team. METHODS: This is a retrospective case-control study of women with singleton pregnancies with antenatally suspected and pathologically confirmed morbidly adherent placenta who underwent cesarean hysterectomy between January 1, 2011, and February 30, 2017. Timing of delivery was classified as either planned (delivery at 34-35 weeks of gestation) or urgent (need for urgent delivery as a result of uterine contractions, bleeding, or both)...
January 9, 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29324605/estimating-the-hospital-delivery-costs-associated-with-severe-maternal-morbidity-in-new-york-city-2008-2012
#10
Renata E Howland, Meghan Angley, Sang Hee Won, Wendy Wilcox, Hannah Searing, Tsu-Yu Tsao
OBJECTIVE: To quantify the average and total hospital delivery costs associated with severe maternal morbidity in excess of nonsevere maternal morbidity deliveries over a 5-year period in New York City adjusting for other sociodemographic and clinical factors. METHODS: We conducted a population-based cross-sectional study using linked birth certificates and hospital discharge data for New York City deliveries from 2008 to 2012. Severe maternal morbidity was defined using a published algorithm of International Classification of Diseases, 9 Revision, Clinical Modification disease and procedure codes...
January 9, 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29324600/reassessing-the-duration-of-the-second-stage-of-labor-in-relation-to-maternal-and-neonatal-morbidity
#11
Katherine L Grantz, Rajeshwari Sundaram, Ling Ma, Stefanie Hinkle, Vincenzo Berghella, Matthew K Hoffman, Uma M Reddy
OBJECTIVE: To assess the morbidity associated with continuing the second-stage duration of labor, weighing the probability of spontaneous vaginal birth without morbidity compared with birth with serious maternal or neonatal complications. METHODS: In a retrospective cohort, we analyzed singleton, vertex births at 36 weeks of gestation or greater without prior cesarean delivery (n=43,810 nulliparous and 59,605 multiparous women). We calculated rates of spontaneous vaginal birth and composite serious maternal or neonatal complications...
January 9, 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29324599/risk-factors-incidence-and-morbidity-associated-with-obstetric-clostridium-difficile-infection
#12
Jacob Ruiter-Ligeti, Sophie Vincent, Nicholas Czuzoj-Shulman, Haim Arie Abenhaim
OBJECTIVE: To evaluate the risk factors, incidence, and morbidity associated with the diagnosis of obstetric Clostridium difficile infection. METHODS: We performed a retrospective cohort study on women admitted for delivery using the Healthcare Cost and Utilization Project Nationwide Inpatient Sample from the United States. The delivery admission records of pregnant women were reviewed between 1999 and 2013. After adjusting for demographic and clinical characteristics, we assessed risk factors for the diagnosis of C difficile infection using unconditional logistic regression...
January 9, 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29323435/soluble-cd14-levels-in-plasma-and-breastmilk-of-malawian-hiv-women-lack-of-association-with-morbidity-and-mortality-in-their-exposed-infants
#13
Silvia Baroncelli, Clementina M Galluzzo, Giuseppe Liotta, Mauro Andreotti, Fausto Ciccacci, Sandro Mancinelli, Victor T Tolno, Jane Gondwe, Roberta Amici, Maria C Marazzi, Stefano Vella, Marina Giuliano, Leonardo Palombi, Lucia Palmisano
PROBLEM: Data on soluble CD14 (sCD14) during pregnancy and lactation are scarce. We assessed the levels of sCD14 in plasma and breastmilk of Malawian HIV-positive women and evaluated the possible association with morbidity and mortality in the HIV-exposed children. METHOD OF STUDY: One hundred and forty-nine mother/child pairs were studied. Women received antiretroviral therapy from 26 weeks of gestation to at least 6 months of exclusive breastfeeding. sCD14 concentrations were determined using an enzyme-linked immunosorbent assay...
January 11, 2018: American Journal of Reproductive Immunology: AJRI
https://www.readbyqxmd.com/read/29323064/vascular-endothelial-growth-factor-expression-in-placenta-of-hypertensive-disorder-in-pregnancy
#14
Abd Fuaat Azliana, Mohamad Razi Zainul-Rashid, Sabrina Florence Chandramaya, Wirda Indah Farouk, Alfian Nurwardah, Yin Ping Wong, Geok Chin Tan
INTRODUCTION: Hypertensive disorder in pregnancy (HDP) represents the most common medical complication in pregnancy. It is the leading cause of maternal and perinatal mortality and morbidity. Vascular endothelial growth factor (VEGF) stimulates vascular endothelial cell growth, survival, and proliferation, and they are known to be expressed in human placenta. The aim of this study was to determine the VEGF expression in the placenta of hypertensive and normotensive patients. MATERIALS AND METHODS: This is a retrospective, cross-sectional study from January 1, 2015 to December 31, 2015...
October 2017: Indian Journal of Pathology & Microbiology
https://www.readbyqxmd.com/read/29321548/role-and-mechanism-of-at1-aa-in-the-pathogenesis-of-hellp-syndrome
#15
Shurui Bu, Yuxian Wang, Shuqing Sun, Yanqian Zheng, Zhu Jin, Jianming Zhi
HELLP syndrome remains a leading cause of maternal and neonatal mortality and morbidity worldwide, which symptoms include hemolysis, elevated liver enzymes and low platelet count. The objective of this study was to determine whether HELLP is associated with AT1-AA. The positive rate and titer of AT1-AA in plasma from pregnant women were determined, and the correlation of AT1-AA titer with the grade of HELLP was analyzed. A HELLP rat model established by intravenous injection of AT1-AA. Our experimental results show the AT1-AA titer and positive rate were significantly higher in HELLP group, and AT1-AA titer were positively correlated with the level of TNF-α and ET-1 in plasma and the grade of HELLP syndrome...
January 10, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29320992/caesarean-delivery-related-blood-transfusion-correlates-in-a-tertiary-hospital-in-southwest-nigeria
#16
Fatimat M Akinlusi, Kabiru A Rabiu, Idayat A Durojaiye, Adeniyi A Adewunmi, Tawaqualit A Ottun, Yusuf A Oshodi
BACKGROUND: Caesarean delivery carries a risk of major intra-operative blood loss and its performance is often delayed by non-availability of blood and blood products. Unnecessary cross-matching and reservation of blood lead to apparent scarcity in centres with limited supply. This study set out to identify the risk factors for blood transfusion in women who underwent caesarean delivery at a tertiary obstetric unit with a view to ensuring efficient blood utilization. METHODS: A prospective cohort analysis of 906 women who had caesarean deliveries at the Lagos State University Teaching Hospital, Nigeria between January and December, 2011...
January 10, 2018: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29320516/impact-of-mode-of-delivery-on-pregnancy-outcomes-in-women-with-premature-rupture-of-membranes-after-28-weeks-of-gestation-in-a-low-resource-setting-a-prospective-cohort-study
#17
Herbert Kayiga, Felicia Lester, Pauline Mary Amuge, Josaphat Byamugisha, Amy Meg Autry
BACKGROUND: Despite the high prevalence of premature rupture of membranes (PROM) in low-resource settings, the preferred mode of delivery remains unclear. We compared the perinatal mortality in a prospective cohort of women with PROM after 28 weeks following vaginal or caesarean delivery at Mulago Hospital with the aim of adopting evidence based practice and improving patient care. METHODS: Between November 2015 and May 2016, 1455 women with PROM after 28 weeks of gestation and their newborns were prospectively followed from admission to discharge at Mulago Hospital...
2018: PloS One
https://www.readbyqxmd.com/read/29319586/the-role-of-the-anesthesiologist-in-preventing-severe-maternal-morbidity-and-mortality
#18
Emily McQuaid, Lisa R Leffert, Brian T Bateman
Anesthesiologists are responsible for the safe and effective provision of analgesia for labor and anesthesia for cesarean delivery and other obstetric procedures. In addition, obstetric anesthesiologists often have a unique role as the intensivists of the obstetric suite. The anesthesiologist is frequently the clinician with the greatest experience in the acute bedside management of a hemodynamically unstable patient and expertise in life-saving interventions. This review will discuss (1) risks associated with neuraxial and general anesthesia for labor and delivery, and (2) clinical scenarios in which the obstetric anesthesiologist is commonly called upon to function as a "peridelivery intensivist...
January 9, 2018: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29318985/a-randomised-controlled-trial-and-economic-evaluation-of-intraoperative-cell-salvage-during-caesarean-section-in-women-at-risk-of-haemorrhage-the-salvo-cell-salvage-in-obstetrics-trial
#19
Khalid S Khan, Philip Moore, Matthew Wilson, Richard Hooper, Shubha Allard, Ian Wrench, Tracy Roberts, Carol McLoughlin, Lee Beresford, James Geoghegan, Jane Daniels, Sue Catling, Vicki A Clark, Paul Ayuk, Stephen Robson, Fang Gao-Smith, Matthew Hogg, Louise Jackson, Doris Lanz, Julie Dodds
BACKGROUND: Caesarean section is associated with blood loss and maternal morbidity. Excessive blood loss requires transfusion of donor (allogeneic) blood, which is a finite resource. Cell salvage returns blood lost during surgery to the mother. It may avoid the need for donor blood transfusion, but reliable evidence of its effects is lacking. OBJECTIVES: To determine if routine use of cell salvage during caesarean section in mothers at risk of haemorrhage reduces the rates of blood transfusion and postpartum maternal morbidity, and is cost-effective, in comparison with standard practice without routine salvage use...
January 2018: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29317701/a-genome-wide-association-study-identifies-only-two-ancestry-specific-variants-associated-with-spontaneous-preterm-birth
#20
Nadav Rappoport, Jonathan Toung, Dexter Hadley, Ronald J Wong, Kazumichi Fujioka, Jason Reuter, Charles W Abbott, Sam Oh, Donglei Hu, Celeste Eng, Scott Huntsman, Dale L Bodian, John E Niederhuber, Xiumei Hong, Ge Zhang, Weronika Sikora-Wohfeld, Christopher R Gignoux, Hui Wang, John Oehlert, Laura L Jelliffe-Pawlowski, Jeffrey B Gould, Gary L Darmstadt, Xiaobin Wang, Carlos D Bustamante, Michael P Snyder, Elad Ziv, Nikolaos A Patsopoulos, Louis J Muglia, Esteban Burchard, Gary M Shaw, Hugh M O'Brodovich, David K Stevenson, Atul J Butte, Marina Sirota
Preterm birth (PTB), or the delivery prior to 37 weeks of gestation, is a significant cause of infant morbidity and mortality. Although twin studies estimate that maternal genetic contributions account for approximately 30% of the incidence of PTB, and other studies reported fetal gene polymorphism association, to date no consistent associations have been identified. In this study, we performed the largest reported genome-wide association study analysis on 1,349 cases of PTB and 12,595 ancestry-matched controls from the focusing on genomic fetal signals...
January 9, 2018: Scientific Reports
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