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Medication in pregnancy

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
María Isabel Fernández-Cano, Xavier Espada-Trespalacios, Azahara Reyes-Lacalle, Josep Maria Manresa Domínguez, Lluís Armadans-Gil, Magda Campins-Martí, Gemma Falguera-Puig, Pere Toran Monserrat
INTRODUCTION: The re-emergence of pertussis and the severity of its complications in infants younger than 3 months, were determining factors for starting a vaccination program for pregnant women in the third trimester of gestation in Catalonia in February 2014. This was the first autonomous community to introduce it in Spain. The aim of the study was to estimate the coverage of the program in its first year of implementation. METHODS: A retrospective analysis was performed on the data from the Primary Care Centre computerised medical records of pregnant women attending Sexual and Reproductive Health Care centres of the Metropolitan Nord area of the province of Barcelona, part of the Catalan Institute of Health...
October 18, 2016: Enfermedades Infecciosas y Microbiología Clínica
Evangelia Elenis, Gunilla Sydsjö, Alkistis Skalkidou, Claudia Lampic, Agneta Skoog Svanberg
BACKGROUND: Pregnancies resulting through oocyte donation have been associated with increased risk for adverse outcomes for the mother, such as gestational hypertensive disorders. However, little is known about possible neonatal complications of such pregnancies. The purpose of this study was to evaluate the neonatal health outcomes among singleton pregnancies in a population of relatively young and healthy oocyte recipients in Sweden, taking into account the medical indication leading to treatment...
October 21, 2016: BMC Pediatrics
Alexandra C Sundermann, Troy D Abell, Lisa C Baker, Mark B Mengel, Kathryn E Reilly, Michael A Bonow, Gregory E Hoy, Richard D Clover
BACKGROUND: The specialization of human fat deposits is an inquiry of special importance in the study of fetal growth. It has been theorized that maternal lower-body fat is designated specifically for lactation and not for the growth of the fetus. OBJECTIVE: Our goal was to compare the contributions of maternal upper-body versus lower-body adiposity to infant birth weight. We hypothesized that upper-body adiposity would be strongly associated with infant birth weight and that lower-body adiposity would be weakly or negligibly associated with infant birth weight-after adjusting for known determinants...
September 21, 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Toshiyuki Iwahata, Takeshi Shin, Yukihito Shimomura, Keisuke Suzuki, Tomohiro Kobayashi, Akane Miyata, Yoshitomo Kobori, Shigehiro Soh, Hiroshi Okada
OBJECTIVES: To present a single-center experience with testicular sperm extraction and intracytoplasmic sperm injection for fathering biological children in patients with ejaculatory dysfunction as a result of spinal cord injury. METHODS: Testicular sperm extraction was carried out in 52 male patients with ejaculatory dysfunction as a result of spinal cord injury. We investigated sperm retrieval rates and pregnancy rates from medical records. Data on age, testicular volume, hormonal status (luteinizing hormone, follicle stimulating hormone and testosterone), and time since spinal cord injury were obtained and analyzed to detect potential associations with the presence of spermatogenesis...
October 21, 2016: International Journal of Urology: Official Journal of the Japanese Urological Association
Lianne M Tomfohr-Madsen, Hamideh Bayrampour, Suzanne Tough
OBJECTIVES: Exposure to child abuse (CA) is associated with an increased risk of developing asthma and allergies; it is unknown if that risk is present across generations. This study investigated if 2-year-old children born to mothers with a history of CA were at an increased risk of receiving a diagnosis of asthma or allergies. METHODS: Data from 1,551 participants were collected as part of the All Our Babies (AOB) study, a prospective pregnancy cohort. During pregnancy, each woman provided information about her own history of CA, and at 24 months postpartum, she provided information about her child's medical diagnoses...
October 19, 2016: Psychosomatic Medicine
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
Waltraud Maierhofer, Emanuella Israel
The Fifty Shades trilogy by E.L. James has taken the world by storm and become a cultural phenomenon. The lack of contraceptive use in the erotic fiction, first pointed out by bloggers, is analysed in this article and compared to medical information. James may be praised for sexualising condom use. However, her protagonist makes poor choices in terms of hormonal contraception and is negligent about its use, resulting in an unintended pregnancy and resolved in marital bliss and motherhood. What is of more interest here than a possible message about contraceptive use, is the outcome that the fiction's negligence in birth control and responsibility affirms an ideology in which female sexuality and sexual experimentation can only be tolerated within the context of procreation and affirmation of motherhood...
October 20, 2016: Culture, Health & Sexuality
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
A M Kurmanova, G M Kurmanova, V N Lokshin
The viral hepatitis abnormalities in the female reproductive system are due to hepatic and extrahepatic damage. On the background of HBV- and HCV-infections, menstrual disorders prevail in the structure of reproductive system pathology; disorders of reproductive function in the form of pregnancy loss and infertility are detected in each second case. Depression of T-cell immunity in the immune status is observed in the patients with intact reproductive function. When miscarriage was in past medical history then divergent changes subpopulations of lymphocytes are found...
October 2016: Gynecological Endocrinology
Kelton Tremellen, Sam Everingham
BACKGROUND: Australian law allows for altruistic surrogacy but prohibits compensation of surrogates beyond their expenses, or the use of professional surrogacy agencies. These restrictions limit local access to surrogacy, driving Australians overseas where they can access commercial surrogacy. AIM: To assess the Australian public's views regarding the use of gestational surrogacy under various social and medical scenarios, together with their level of support for financial compensation of surrogates and the use of professional surrogacy agencies...
October 19, 2016: Australian & New Zealand Journal of Obstetrics & Gynaecology
Michael Feichtinger, Tina Stopp, Sandra Hofmann, Stephanie Springer, Sophie Pils, Alexandra Kautzky-Willer, Herbert Kiss, Wolfgang Eppel, Andrea Tura, Latife Bozkurt, Christian S Göbl
AIMS/HYPOTHESIS: A history of gastric bypass surgery can influence the results of the OGTT recommended during pregnancy. Therefore, we compared OGTT glucose kinetics and pregnancy outcome between pregnant gastric bypass patients and BMI-matched, lean and obese controls. METHODS: Medical records were used to collect data on glucose measurements during the 2 h 75 g OGTT as well as on pregnancy and fetal outcome for 304 women (n = 76 per group, matched for age and date of delivery)...
October 18, 2016: Diabetologia
Kara N Durski, Carol Tituli, Divi Ogaoga, Jennie Musto, Cynthia Joshua, Alfred Dofai, Jennie Leydon, Eric Nilles
INTRODUCTION: During May 2012, a rubella outbreak was declared in Solomon Islands. A suspected case of congenital rubella syndrome (CRS) was reported from one hospital 11 months later in 2013. This report describes the subsequent CRS investigation, findings and measures implemented. METHODS: Prospective CRS surveillance was conducted at the newborn nursery, paediatric and post-natal wards, and the paediatric cardiology and ophthalmology clinics of the study hospital from April to July 2013...
January 2016: Western Pacific Surveillance and Response Journal: WPSAR
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
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
Arun More, Ranjit Kadam, Kaanchan Mohite, Chetan Mittal, Amol Bukan, Pramod Patil, Tanaji Kate, Ajay Gade, N S Neki
OBJECTIVE: To find out implications of the healthcare structure on diagnosis and management of Hypertension in Rural India. DESIGN AND METHOD: A door to door survey with a questionnaire and measurement of blood pressure (BP) in adults. Villages were classified as "hospital" and "no Hospital" on basis of availability of healthcare facility. Villages from districts of Maharashtra state of India were included. India currently has Health workers, Primary Health Centre (PHC), Rural Hospitals (RH),District Hospitals, Medical Colleges and tertiary referral centers in the healthcare structure...
September 2016: Journal of Hypertension
Kristin M Berg, Stevens S Smith, Jessica W Cook, Michael C Fiore, Douglas E Jorenby
While women Veterans have a higher prevalence of smoking than civilian women, little is known about their quitting behavior. Via a chart review, we characterized referral and enrollment patterns in tobacco cessation services (TCS), and quit attempts among 366 women Veteran smokers at a Midwestern Veterans Hospital. Cases receiving referrals to TCS (n = 183) were matched 1:1 to controls who did not (n = 183), by year of referral. Variables included age, marital status, urbanicity, smoking status, comorbidities, pregnancy, packs per day, number of prior smoking cessation medications, provider gender, provider type, and clinical location of referral placement...
October 2016: Military Medicine
Mary Anne Armstrong, Debbie A Postlethwaite, Jeanne A Darbinian, Mark McCoy, Amy Law
BACKGROUND: In 2007, high-deductible plans were added to the primarily nondeductible Kaiser Permanente Northern California (KPNC) integrated health plan, which had covered 100% of device and procedure costs of long-acting reversible contraception (LARC) for members regardless of prescription/visit copay amount. We hypothesized that nondeductible plans and prior LARC use decreased unintended pregnancy. OBJECTIVE: The purpose of this study was to determine if health plan design (nondeductible vs...
October 18, 2016: Journal of Women's Health
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