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Katherine A Guthrie, Hilary S Gammill, Mads Kamper-Jørgensen, Anne Tjønneland, Vijayakrishna K Gadi, J Lee Nelson, Wendy Leisenring
Natural acquisition of small amounts of foreign cells or DNA, referred to as microchimerism, occurs primarily through maternal-fetal exchange during pregnancy. Microchimerism can persist long-term and has been associated with both beneficial and adverse human health outcomes. Quantitative microchimerism data present challenges for statistical analysis, including a skewed distribution, excess zero values, and occasional large values. Methods for comparing microchimerism levels across groups while controlling for covariates are not well established...
October 21, 2016: American Journal of Epidemiology
Maria do Carmo Leal, Ana Paula Esteves-Pereira, Marcos Nakamura-Pereira, Jacqueline Alves Torres, Mariza Theme-Filha, Rosa Maria Soares Madeira Domingues, Marcos Augusto Bastos Dias, Maria Elizabeth Moreira, Silvana Granado Gama
BACKGROUND: The rate of preterm birth has been increasing worldwide, including in Brazil. This constitutes a significant public health challenge because of the higher levels of morbidity and mortality and long-term health effects associated with preterm birth. This study describes and quantifies factors affecting spontaneous and provider-initiated preterm birth in Brazil. METHODS: Data are from the 2011-2012 "Birth in Brazil" study, which used a national population-based sample of 23,940 women...
October 17, 2016: Reproductive Health
Ahmad Tavakoli, Seyed Hamidreza Monavari, Farah Bokharaei-Salim, Hamidreza Mollaei, Bahman Abedi-Kiasari, Fatemeh Hoda Fallah, Helya Sadat Mortazavi
This study aims to determine the prevalence of herpes simplex virus (HSV) infection among pregnant women as well as congenital infection of their newborns in Tehran. One hundred samples of blood sera from pregnant women were analyzed for the presence of HSV specific antibodies. Umbilical cord blood samples from the newborns were analyzed for the presence of HSV DNA using real-time PCR. HSV IgG and IgM antibodies were found in 97% and 2% of pregnant women, respectively. Of all the 100 cord blood samples, 6 were positive for HSV DNA in which 2 cases were from mothers who had detectable IgM...
October 20, 2016: Fetal and Pediatric Pathology
Aurélie Smets, Thomas Fauchier, Grégory Michel, Pierre Marty, Christelle Pomares
A maternal Toxoplasma gondii infection during pregnancy is a risk for congenital infection through maternal-fetal transplacental transmission. Estimation of the date of infection is of the utmost importance for management and treatment recommendations. In this setting, IgG avidity has been shown to be useful as high avidity rules out an infection dating less than 4 months. The estimated date of infection can also be obtained by the ratio of T. gondii IgG titers measured by the Vidas (bioMérieux) assay versus T...
2016: Parasite: Journal de la Société Française de Parasitologie
Molly M Killion
No abstract text is available yet for this article.
November 2016: MCN. the American Journal of Maternal Child Nursing
Hicham El Costa, Jordi Gouilly, Jean-Michel Mansuy, Qian Chen, Claude Levy, Géraldine Cartron, Francisco Veas, Reem Al-Daccak, Jacques Izopet, Nabila Jabrane-Ferrat
The outbreak of the Zika Virus (ZIKV) and its association with fetal abnormalities have raised worldwide concern. However, the cellular tropism and the mechanisms of ZIKV transmission to the fetus during early pregnancy are still largely unknown. Therefore, we ex vivo modeled the ZIKV transmission at the maternal-fetal interface using organ culture from first trimester pregnancy samples. Here, we provide evidence that ZIKV strain circulating in Brazil infects and damages tissue architecture of the maternal decidua basalis, the fetal placenta and umbilical cord...
October 19, 2016: Scientific Reports
Katelyn M Mika, Vincent J Lynch
Variation in female reproductive traits, such as fertility, fecundity, and fecundability, is heritable in humans, but identifying and functionally characterizing genetic variants associated with these traits has been challenging. Here, we explore the functional significance and evolutionary history of a T/C polymorphism of SNP rs2071473, which we have previously shown is an eQTL for TAP2 and significantly associated with fecundability (time to pregnancy). We replicated the association between the rs2071473 genotype and TAP2 expression by using GTEx data and demonstrated that TAP2 is expressed by decidual stromal cells at the maternal-fetal interface...
September 24, 2016: American Journal of Human Genetics
Andrea G Edlow, Brian L Edlow, Jonathan A Edlow
Acute neurologic symptoms in pregnant and postpartum women may be caused by exacerbation of a preexisting neurologic condition, the initial presentation of a non-pregnancy-related problem, or a new neurologic problem. Pregnant and postpartum patients with headache and neurologic symptoms are often diagnosed with preeclampsia or eclampsia; however, other etiologies must also be considered. A team approach with close communication between emergency physicians, neurologists, maternal-fetal medicine specialists, and radiologists is the key to obtaining best outcomes...
November 2016: Emergency Medicine Clinics of North America
Sudipa Sarkar, Lindsay A Bischoff
Hyperthyroidism can occur during pregnancy and the postpartum period, and the treatment of hyperthyroidism should be considered in the preconception phase. Pregnancy has multiple normal physiologic effects on thyroid hormone, which is a separate process distinct from syndromes such as transient hyperthyroidism of hyperemesis gravidarum. The rationale regarding antithyroid drug use during different stages of pregnancy is reviewed, including the literature regarding adverse neonatal outcomes such as aplasia cutis and methimazole embryopathy in the setting of first trimester maternal methimazole use...
October 14, 2016: Seminars in Reproductive Medicine
Lynn M Yee, Grecio Sandoval, Jennifer Bailit, Uma M Reddy, Ronald J Wapner, Michael W Varner, Steve N Caritis, Mona Prasad, Alan T N Tita, George Saade, Yoram Sorokin, Dwight J Rouse, Sean C Blackwell, Jorge E Tolosa
OBJECTIVE: To describe factors associated with delayed pushing and evaluate the relationship between delayed pushing and perinatal outcomes in nulliparous women with singleton term gestations. METHODS: This was a secondary analysis of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Assessment of Perinatal Excellence cohort of 115,502 women and their neonates born in 25 U.S. hospitals from 2008 to 2011. Nulliparous women with singleton, cephalic, nonanomalous term births who achieved 10-cm cervical dilation were included...
October 6, 2016: Obstetrics and Gynecology
Amy C Hermesch, Amanda A Allshouse, Kent D Heyborne
OBJECTIVE: To investigate the relationship between body mass index (BMI) and the onset of parturition throughout gestation. METHODS: This was a secondary analysis of the Maternal-Fetal Medicine Units Network Preterm Prediction Study. Time-to-spontaneous-birth-event (ie, "survival") methods were used to study the association of BMI with the timing of spontaneous onset of labor throughout gestation with indicated births censored at delivery. A Kaplan-Meier estimate of the probability of spontaneous labor was compared with a log rank test across five categories of BMI (kg/m): underweight (less than 18...
October 6, 2016: Obstetrics and Gynecology
Martha A Monson, Karen J Gibbons, M Sean Esplin, Michael W Varner, Tracy A Manuck
OBJECTIVE: To characterize subsequent pregnancy outcomes among women with a history of previable, preterm prelabor rupture of membranes (PROM) and assess factors associated with recurrent preterm birth. METHODS: This was a retrospective cohort study of women cared for with a history of one or more singleton pregnancy complicated by preterm PROM at less than 24 weeks of gestation between 2002 and 2013 who were cared for in two tertiary care health systems by a single group of maternal-fetal medicine specialists...
October 6, 2016: Obstetrics and Gynecology
Cristina Faralla, Gabrielle A Rizzuto, David E Lowe, Byoungkwan Kim, Cara Cooke, Lawrence R Shiow, Anna I Bakardjiev
Intrauterine infection is a major detriment for maternal-child health and occurs despite local mechanisms that protect the maternal-fetal interface from a wide variety of pathogens. The bacterial pathogen Listeria monocytogenes causes spontaneous abortion, stillbirth, and preterm labor in humans, and serves as a model for placental pathogenesis. Given the unique immunological environment of the maternal-fetal interface we hypothesized that virulence determinants with placental tropism are required for infection of this tissue...
October 10, 2016: Infection and Immunity
Kenna Degner, Ronald R Magness, Dinesh M Shah
The uterine vasculature undergoes marked changes during pregnancy in order to provide the necessary increase in blood flow to support growth and nutrition of the uterus, placenta, and developing fetus. Pregnancy-associated uterine vascular transformations are orchestrated by a complex array of endocrine and cellular mechanisms to bring about structural modifications at the maternal-fetal interface, which collectively lead to development of the uteroplacental circulation. Understanding intrinsic uterine vascular remodeling in pregnancy is essential for understanding the physiologic and pathophysiologic regulation of maternal uterine blood flow...
October 12, 2016: Reproductive Sciences
Bradley D Holbrook, Stephen M Petterson, William F Rayburn
Objectives Retirement of "baby boomer" physicians is a matter of growing concern in light of the shortage of certain physician groups. The objectives of this investigation were to define what constitutes a customary retirement age range of maternal-fetal medicine (MFM) physicians and examine how that compares with other obstetrician-gynecologist (ob-gyn) specialists. Study Design This descriptive study was based on American Medical Association Masterfile survey data from 2010 to 2014. Data from the National Provider Identifier were used to correct for upward bias in reporting retirement ages...
October 12, 2016: American Journal of Perinatology
Susan M Sereika, Dorothy Becker, Patricia Schmitt, A Blair Powell, Ana Maria Diaz, Andrea F R Fischl, Jennifer Thurheimer-Cacciotti, William H Herman, Denise Charron-Prochownik
OBJECTIVE: Because unplanned pregnancies could cause maternal-fetal complications for women with diabetes, family planning vigilance (FPV) is imperative. The aims of this article are to operationalize and describe FPV and examine the associations among FPV behaviors and diabetes self-care management (DSM) and health outcomes of women with type 1 diabetes (T1D). RESEARCH DESIGN AND METHODS: Retrospective data were used from a follow-up study of adult women with T1D who participated as adolescents in a preconception counseling (PC) intervention trial and matched comparison women with T1D who did not receive the adolescent PC intervention...
October 11, 2016: Diabetes Care
John J Mccarthy, Martin H Leamon, Loretta P Finnegan, Catherine Fassbender
Increase in the number of opioid dependent pregnant women delivering babies at risk for neonatal abstinence syndrome (NAS) prompted a General Accountability Office (GAO) report documenting deficits in research and provider knowledge about care of the maternal/fetal unit and the neonate. There are three general sources of dependence: untreated opioid use disorder (OUD), pain management, and medication assisted treatment with methadone or buprenorphine. A survey of methadone patients' experiences when telling a physician of their pregnancy and opioid dependence demonstrated physician confusion about proper care, frequent negative interactions with the mother, and failures to provide appropriate referral...
October 8, 2016: American Journal of Obstetrics and Gynecology
Sofie Ingdam Halkjaer, Lisbeth Nilas, Emma Malchau Carlsen, Dina Cortes, Thórhallur Ingi Halldórsson, Sjúrdur Frodi Olsen, Anders Elm Pedersen, Karen Angeliki Krogfelt, Andreas Munk Petersen
BACKGROUND: Maternal obesity is associated with increased risks of adverse pregnancy-related complications and outcomes for both mothers and infants. Overweight and obese women have an increased risk of pregnancy-induced hypertension, preeclampsia and gestational diabetes mellitus (GDM). Infant Body Mass index (BMI) and the risk of obesity in adulthood are related to maternal gestational weight gain (GWG). Preventive lifestyle and dietary interventions are time-consuming and do not always reduce GWG or the risk of maternal pregnancy complications...
October 11, 2016: Trials
Marc A Rodger, Jean-Christophe Gris, Johanna I P de Vries, Ida Martinelli, Évelyne Rey, Ekkehard Schleussner, Saskia Middeldorp, Risto Kaaja, Nicole J Langlois, Timothy Ramsay, Ranjeeta Mallick, Shannon M Bates, Carolien N H Abheiden, Annalisa Perna, David Petroff, Paulien de Jong, Marion E van Hoorn, P Dick Bezemer, Alain D Mayhew
BACKGROUND: Placenta-mediated pregnancy complications include pre-eclampsia, late pregnancy loss, placental abruption, and birth of a small-for-gestational-age (SGA) neonate. These complications are leading causes of maternal, fetal, and neonatal morbidity and mortality in high-income countries. Affected women are at high risk of recurrence in subsequent pregnancies; however, effective strategies to prevent recurrence are absent. Findings from our previous study-level meta-analysis suggested that low-molecular-weight heparin reduced the risk of recurrent placenta-mediated pregnancy complications...
October 6, 2016: Lancet
M Le Chevalier de Préville, J-L Alessandri, N Traversier, F Cuillier, S Robin, D Ramful
OBJECTIVE: To evaluate the maternal-fetal management and follow-up of infants at risk for congenital syphilis. STUDY DESIGN: Monocentric retrospective cohort study at the Félix Guyon Hospital, Saint-Denis, La Réunion between January 2008 and December 2014. Management of 38 pregnancies (35 women, 39 fetuses) with a positive syphilis serology was evaluated according to the Centers for Disease Control and Prevention (CDC) guidelines. RESULTS: A total of 68% (n=26) of pregnancies were screened before 16 weeks of gestation, and 26% (n=10) had appropriate treatment...
October 6, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
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