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Aspirin in pregnancy

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https://www.readbyqxmd.com/read/29913174/low-dose-aspirin-is-associated-with-reduced-spontaneous-preterm-birth-in-nulliparous-women
#1
Maria Andrikopoulou, Stephanie E Purisch, Roxane Handal-Orefice, Cynthia Gyamfi-Bannerman
BACKGROUND: Preterm birth (PTB) is one of the leading causes of perinatal morbidity and mortality. Clinical data suggests that low dose aspirin may decrease the rate of overall PTB, but investigators have speculated that this is likely due to a decrease in medically indicated PTB through its effect on the incidence of preeclampsia and other placental disease. We hypothesized that low dose aspirin may also impact the mechanism of spontaneous preterm labor. OBJECTIVE: Our objective was to determine whether low dose aspirin reduces the rate of spontaneous PTB in nulliparous women without medical co-morbidities...
June 15, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29877031/molecular-actions-of-heparin-and-their-implications-in-preventing-preeclampsia
#2
REVIEW
Jovian M Wat, Melanie Audette, John C Kingdom
Preeclampsia, a hypertensive disorder of pregnancy, continues to be a significant cause of global maternal morbidity. Low-dose aspirin remains the only standard of care prophylactic therapy for preventing preeclampsia, but is limited in efficacy. Heparin and its derivatives may further enhance the efficacy of aspirin therapy to prevent preeclampsia, but the mechanisms mediating this augmentative effect are not known. While heparin is an anticoagulant agent, it also possesses many anticoagulant-independent properties that may be relevant in the prevention of preeclampsia, including effects on placental, vascular, and inflammatory function...
June 7, 2018: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/29867924/risk-factors-for-adverse-maternal-and-fetal-outcomes-in-women-with-confirmed-apl-positivity-results-from-a-multicenter-study-of-283-pregnancies
#3
Micaela Fredi, Laura Andreoli, Elena Aggogeri, Elisa Bettiga, Maria Grazia Lazzaroni, Véronique Le Guern, Andrea Lojacono, Nathalie Morel, Jean Charles Piette, Sonia Zatti, Nathalie Costedoat-Chalumeau, Angela Tincani
Objective: Antiphospholipid antibodies positivity (aPL) is considered as a risk factor for adverse pregnancy outcome (APO). The aim of this study was to determine the risk factors for APO in patients with confirmed aPL positivity, isolated (aPL carriers) or associated with a definite primary antiphospholipid syndrome (PAPS). Methods: The clinical and laboratory features of 283 pregnancies occurring between 2000 and 2014 in 200 women were collected in three institutions...
2018: Frontiers in Immunology
https://www.readbyqxmd.com/read/29863532/gastroschisis-and-cumulative-stressor-exposures
#4
Martha M Werler, Esther Guéry, Dorothy K Waller, Samantha E Parker
BACKGROUND: Gastroschisis, a congenital defect of the abdominal wall, occurs disproportionately more in offspring of young mothers and has been increasing in prevalence over the past decades. A wide range of exposures have been reported in association with an increased gastroschisis risk, independent of mother's age; many have also been correlated with stress responses. METHODS: We explored cumulative exposures to such stressor exposures among 1,261 mothers of gastroschisis cases and 10,682 mothers of controls in the National Birth Defects Prevention Study (1997-2011)...
May 31, 2018: Epidemiology
https://www.readbyqxmd.com/read/29852233/the-first-trimester-of-pregnancy-a-window-of-opportunity-for-prediction-and-prevention-of-pregnancy-complications-and-future-life
#5
REVIEW
Liona C Poon, H David McIntyre, Jonathan A Hyett, Eduardo Borges da Fonseca, Moshe Hod
The International Federation of Gynecology and Obstetrics (FIGO) has identified non communicable maternal diseases (NCDs) as a new focus area. NCDs and exposures as related to pregnancy complications and later impairment of maternal and offspring health will form the basis for action in the forthcoming years. This paper summarizes recent advances, centered on the use of first-trimester testing, as a window of opportunity to predict and prevent many pregnancy complications; and for potential future prevention of NCDs in mother and offspring...
May 28, 2018: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/29802215/aspirin-effect-on-adverse-pregnancy-outcomes-associated-with-stage-1-hypertension-in-a-high-risk-cohort
#6
Alisse Hauspurg, Elizabeth F Sutton, Janet M Catov, Steve N Caritis
Recently, the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines revised the recommendations for diagnosis of chronic hypertension. The new classification system includes a diagnosis of stage 1 hypertension in adults with blood pressures 130 to 139/80 to 89 mm Hg. We sought to compare outcomes among women at high risk for preeclampsia with stage 1 hypertension and assessed whether women with stage 1 hypertension had benefit from aspirin treatment compared with high-risk normotensive women...
May 25, 2018: Hypertension
https://www.readbyqxmd.com/read/29786509/-targeted-screening-for-pre-eclampsia-in-the-first-trimester-of-pregnancy-at-toulouse-university-hospital
#7
A Genoux, P Guerby, M Morin, B Perret, C Vayssière, S M Hamdi
GOALS: Preeclampsia (PE) is a leading cause of maternal and neonatal morbidity and mortality. Early treatment by aspirin has been shown to significantly reduce PE risk before 37weeks supporting the implementation of first-trimester screening. SUBJECTS AND METHODS: A targeted screening was recently implemented at Toulouse University Hospital for women in their first pregnancy or those with personal or familial history of PE. It uses Fetal Medicine Foundation (FMF) algorithm that combines maternal characteristics, clinical, biophysical and biochemical (PAPP-A, Pregnancy Associated Plasma Protein-A, and PlGF, Placental Growth Factor) data...
May 18, 2018: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/29771194/preconception-antiphospholipid-antibodies-and-risk-of-subsequent-early-pregnancy-loss
#8
K J Gibbins, S L Mumford, L A Sjaarda, D W Branch, N J Perkins, A Ye, E F Schisterman, R M Silver
Objectives To prospectively estimate the association of preconception antiphospholipid antibodies (aPL) with subsequent pregnancy loss using a cohort design. aPL have been associated with recurrent early pregnancy loss (EPL) prior to 10 weeks in previous case-control studies. Prospective ascertainment of pregnancy loss is challenging, as most women do not seek care prior to EPL. Methods Secondary analysis of the Effects of Aspirin in Gestation and Reproduction trial of preconception low-dose aspirin. Preconception anticardiolipin (aCL) and anti-β2-glycoprotein-I (a-β2-I) were assessed in 1208 women with one or two prior pregnancy losses and no more than two prior live births...
January 1, 2018: Lupus
https://www.readbyqxmd.com/read/29767694/shorter-time-to-pregnancy-with-increasing-preconception-carotene-concentrations-among-women-with-1-to-2-previous-pregnancy-losses
#9
Keewan Kim, Enrique F Schisterman, Robert M Silver, Brian D Wilcox, Anne M Lynch, Neil J Perkins, Richard W Browne, Laurie L Lesher, Joseph B Stanford, Aijun Ye, Jean Wactawski-Wende, Sunni L Mumford
Although maternal nutrition may impact fecundity, associations between preconception micronutrients and time to pregnancy (TTP) has not been examined. We assessed the relationship between preconception fat-soluble micronutrient concentrations and TTP among women with 1-2 prior pregnancy losses. This is a prospective cohort study of 1,228 women set in the EAGeR Trial (US, 2007-2011), which assessed the effect of preconception-initiated daily low dose aspirin on reproductive outcomes. We measured preconception zeaxanthin, cryptoxanthin, lycopene, α- and β-carotene, and α- and γ-tocopherol in serum...
May 14, 2018: American Journal of Epidemiology
https://www.readbyqxmd.com/read/29747656/maternal-drug-use-and-the-risk-of-anorectal-malformations-systematic-review-and-meta-analysis
#10
REVIEW
Nadine Zwink, Ekkehart Jenetzky
BACKGROUND: Origin of anorectal malformations (ARM) are considered multifactorial. Several genetic and non-genetic risk factors are discussed in literature. Maternal periconceptional medical drug use as possible risk factor, however, has not been reviewed systematically. METHODS: Studies published between 1977 and April 2017 were reviewed through systematic search in PubMed, ISI Web of Knowledge and Scopus databases. Furthermore, related and cross-referencing publications were reviewed...
May 10, 2018: Orphanet Journal of Rare Diseases
https://www.readbyqxmd.com/read/29739273/angiogenic-dysregulation-in-pregnancy-related-hypertension-a-role-for-metformin
#11
Nerolen Soobryan, Saravanakumar Murugesan, Arunagiri Pandiyan, Jagidesa Moodley, Irene Mackraj
In the face of escalating maternal and fetal health threats, hypertensive pregnancy disorders (HPDs) is one of the leading cause of maternal and fetal morbidity and mortality. The range of HPDs include white-coat hypertension, chronic hypertension, gestational hypertension, mild-to-moderate and severe preeclampsia and eclampsia. Current evidence implicates an imbalance of circulating anti- and angiogenic factors in HPDs emanating from the placental vasculature, impacting on angiogenesis. Delivery of the fetus is thus far the only curative measure, albeit with increased risk...
January 1, 2018: Reproductive Sciences
https://www.readbyqxmd.com/read/29718107/the-intervention-effect-of-aspirin-on-a-lipopolysaccharide-induced-preeclampsia-like-mouse-model-by-inhibiting-the-nf-%C3%AE%C2%BAb-pathway
#12
Guanlin Li, Liyang Ma, Li Lin, Yan-Ling Wang, Huixia Yang
Preeclampsia is a severe pregnancy-related disorder, and patients usually present with high circulating inflammatory factor production as well as excessive activation of the nuclear factor-κB (NF-κB) pathway. Administration of aspirin (ASP) is effective for the prevention of preeclampsia, we proposed that ASP might affect placental function by regulating the NF-κB pathway. Systemic lipopolysaccharide (LPS) (20 μg/kg) was used to induce preeclampsia-like pregnant mouse model and low-dose ASP (15.2 mg/kg) were further treated...
April 27, 2018: Biology of Reproduction
https://www.readbyqxmd.com/read/29709100/a-comparison-of-effectiveness-among-frequent-treatments-of-recurrent-spontaneous-abortion-a-bayesian-network-meta-analysis
#13
Sha Lv, Jing Yu, Xiaoxiao Xu
OBJECTIVE: A comprehensive network meta-analysis was designed to clarify contradictions and offer valuable clinical guidance in the treatment of recurrent spontaneous abortion (RSA). METHOD: The included clinical trials were selected from the relevant medical journal databases and screened. Treatments were ranked by the surface under the cumulative ranking curve. Heat plots were constructed to analyze the inconsistency between direct data and network results, and adjusted funnel plots were constructed to assess publication bias...
April 30, 2018: American Journal of Reproductive Immunology: AJRI
https://www.readbyqxmd.com/read/29704277/prediction-and-prevention-of-small-for-gestational-age-neonates-evidence-from-spree-and-aspre
#14
M Y Tan, L C Poon, D L Rolnik, A Syngelaki, C de Paco Matallana, R Akolekar, S Cicero, D Janga, M Singh, F S Molina, N Persico, J C Jani, W Plasencia, E Greco, G Papaioannou, D Wright, K H Nicolaides
OBJECTIVES: To examine the effect of first-trimester screening for pre-eclampsia (PE) on the prediction of delivering a small-for-gestational-age (SGA) neonate and the effect of prophylactic use of aspirin on the prevention of SGA. METHODS: The data for this study were derived from two multicenter studies. In SPREE, we investigated the performance of screening for PE by a combination of maternal characteristics and biomarkers at 11-13 weeks' gestation. In ASPRE, women with a singleton pregnancy identified by combined screening as being at high risk for preterm PE (> 1 in 100) participated in a trial of aspirin (150 mg/day from 11-14 until 36 weeks' gestation) compared to placebo...
April 28, 2018: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29701415/antiphospholipid-syndrome-and-acute-postpartum-limb-ischemia
#15
Inês Antunes, Carlos Pereira, Rui Machado, Duarte Rego, Vitor Ferreira, João Gonçalves, Gabriela Teixeira, Carlos Veiga, Daniel Mendes, Rui Almeida
INTRODUCTION: The diagnosis of Antiphospholipid syndrome (APS) implies the identification of antiphospoholipid antibodies and arterial/venous thrombosis or pregnancy loss. During pregnancy, there is an increased risk of thrombotic complications. METHODS: Present a case of acute lower limb ischemia in a patient with APS during postpartum period Materials/ Methods: review of a clinical case and available literature Results: Patient diagnosed with APS (triple antibody positive and antecedent of 3 previous abortions) underwent cesarean at 29 weeks of gestation...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29692672/effectiveness-of-high-dose-i-v-immunoglobulin-therapy-for-pregnant-women-with-aspirin-heparin-resistant-secondary-antiphospholipid-syndrome
#16
Yoko Maesawa, Masashi Deguchi, Kenji Tanimura, Mayumi Morizane, Yasuhiko Ebina, Hideto Yamada
Purpose: This study aimed to assess the efficacy of high-dose i.v. immunoglobulin (HIVIg) therapy in pregnant women with antiphospholipid syndrome (APS) secondary to systemic lupus erythematosus with a history of pregnancy failure, despite receiving low-dose aspirin plus unfractionated heparin therapy, of which condition being designated as "aspirin-heparin-resistant APS" (AHRAPS). Methods: The HIVIg therapy (20 g/d, 5 days) was performed for the pregnancies of five women with AHRAPS...
April 2018: Reproductive Medicine and Biology
https://www.readbyqxmd.com/read/29683306/maternity-care-update-prenatal-care-and-specific-conditions
#17
Andrew Smith, Wendy B Barr, Erin Bassett-Novoa, Nicholas LeFevre
Early initiation of prenatal care is associated with improved health outcomes for women and newborns. An essential element of prenatal care is determining the estimated due date, ideally using a first-trimester ultrasound. Laboratory tests should be obtained to screen for conditions that can affect pregnancy. Routine immunizations for all pregnant women include influenza vaccine; tetanus toxoid, reduced diphtheria, acellular pertussis (Tdap) vaccine. All women should be screened for gestational diabetes mellitus in midpregnancy...
April 2018: FP Essentials
https://www.readbyqxmd.com/read/29674206/using-extended-theory-of-planned-behavior-to-understand-aspirin-adherence-in-pregnant-women
#18
Chung-Ying Lin, Anders Broström, Per Nilsen, Amir H Pakpour
OBJECTIVE: To use the Theory of Planned Behavior (TPB) combined with action and coping planning plus global relationship with husband to explain the aspirin adherence in a sample of women with high-risk pregnancy. METHODS: A total of 535 Iranian women (mean age = 32.29 ± 4.98; year of marriage = 6.89 ± 3.61) completed the study. Each participant filled out several questionnaires on TPB (i.e., a widely applied theory describing how behaviors are influenced by beliefs, attitudes, perceived behavioral control and behavioral intentions), action planning, coping planning and relationship with husband at baseline...
April 2018: Pregnancy Hypertension
https://www.readbyqxmd.com/read/29656983/prophylaxis-and-treatment-of-foetal-growth-restriction
#19
REVIEW
Aamod Nawathe, Anna L David
Foetal growth restriction (FGR) and associated placental pathologies such as pre-eclampsia and stillbirth arise in early pregnancy when inadequate remodelling of maternal spiral arteries leads to persistent high-resistance low-flow uteroplacental circulation. Current interventions concentrate on targeting the placental ischaemia-reperfusion injury and oxidative stress associated with an imbalance in angiogenic/anti-angiogenic factors. Recent meta-analyses confirm that aspirin modestly reduces the risk for small-for-gestational-age pregnancy in high-risk women...
May 2018: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29648647/a-prospective-study-of-physical-activity-and-fecundability-in-women-with-a-history-of-pregnancy-loss
#20
Lindsey M Russo, Brian W Whitcomb, Sunni L Mumford, Marquis Hawkins, Rose G Radin, Karen C Schliep, Robert M Silver, Neil J Perkins, Keewan Kim, Ukpebo R Omosigho, Daniel L Kuhr, Tiffany L Holland, Lindsey A Sjaarda, Enrique F Schisterman
STUDY QUESTION: Is physical activity (PA) associated with fecundability in women with a history of prior pregnancy loss? SUMMARY ANSWER: Higher fecundability was related to walking among overweight/obese women and to vigorous PA in women overall. WHAT IS KNOWN ALREADY: PA may influence fecundability through altered endocrine function. Studies evaluating this association have primarily utilized Internet-based recruitment and self-report for pregnancy assessment and have yielded conflicting results...
April 10, 2018: Human Reproduction
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