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At risk pregnancies

Yaniv Zipori, Karen Reidy, T Gilchrist, Lex W Doyle, Mark P Umstad
BACKGROUND: Monochorionic diamniotic (MCDA) twin pregnancies are associated with adverse perinatal outcome. Intertwin discordances at the time of nuchal translucency (NT) screening may have a value in the prediction of fetal loss or twin-to-twin transfusion syndrome. We aimed to determine the ability of intertwin NT and crown rump length (CRL) discordances among MCDA twins to predict adverse outcomes. MATERIAL AND METHODS: All MCDA twins with a documented routine ultrasound at 11 to 13+6 weeks' gestation, and known pregnancy outcome between August 2003 and August 2012 were included...
October 21, 2016: Twin Research and Human Genetics: the Official Journal of the International Society for Twin Studies
Marcos Augusto Bastos Dias, Rosa Maria Soares Madeira Domingues, Arthur Orlando Corrêa Schilithz, Marcos Nakamura-Pereira, Maria do Carmo Leal
BACKGROUND: The rate of cesarean delivery (CD) in Brazil has increased over the past 40 years. The CD rate in public services is three times above the World Health Organization recommended values. Among strategies to reduce CD, the most important is reduction of primary cesarean. This study aimed to describe factors associated with CD during labor in primiparous women with a single cephalic pregnancy assisted in the Brazilian Public Health System (SUS). METHODS: This study is part of the Birth in Brazil survey, a national hospital-based study of 23,894 postpartum women and their newborns...
October 17, 2016: Reproductive Health
Mariza Miranda Theme-Filha, Marcia Leonardi Baldisserotto, Ana Claudia Santos Amaral Fraga, Susan Ayers, Silvana Granado Nogueira da Gama, Maria do Carmo Leal
BACKGROUND: Unintended pregnancy, a pregnancy that have been either unwanted or mistimed, is a serious public health issue in Brazil. It is reported for more than half of women who gave birth in the country, but the characteristics of women who conceive unintentionally are rarely documented. The aim of this study is to analyse the prevalence and the association between unintended pregnancy and a set of sociodemographic characteristics, individual-level variables and history of obstetric outcomes...
October 17, 2016: Reproductive Health
Marcos Nakamura-Pereira, Maria do Carmo Leal, Ana Paula Esteves-Pereira, Rosa Maria Soares Madeira Domingues, Jacqueline Alves Torres, Marcos Augusto Bastos Dias, Maria Elisabeth Moreira
BACKGROUND: Cesarean section (CS) rates are increasing worldwide but there is some concern with this trend because of potential maternal and perinatal risks. The Robson classification is the standard method to monitor and compare CS rates. Our objective was to analyze CS rates in Brazil according to source of payment for childbirth (public or private) using the Robson classification. METHODS: Data are from the 2011-2012 "Birth in Brazil" study, which used a national hospital-based sample of 23,940 women...
October 17, 2016: Reproductive Health
Annah Lane, Ling Lee, Donna Traves, Andreas Lee
INTRODUCTION: The antenatal diagnosis of open spina bifida (OSB), a neural tube defect, is predominantly made at the second trimester morphology scan by ultrasound detection of structural abnormalities resulting from the associated Chiari II malformation. Evidence has emerged suggesting that these structural abnormalities can be detected earlier, by examination of the posterior fossa as part of the first trimester nuchal translucency scan. In particular, absence of the intra-cranial translucency (IT) of the fourth ventricle has shown promise as a diagnostic marker of OSB, although the sensitivity and specificity of this finding varies widely in the literature...
October 21, 2016: Journal of Medical Imaging and Radiation Oncology
Toshiyuki Miyata, Keiko Maruyama, Fumiaki Banno, Reiko Neki
In recent years, genetic analyses of congenital deficiencies of three anticoagulant proteins, antithrombin, protein C (PC) and protein S (PS), in East Asian patients with venous thromboembolism (VTE) have greatly increased. The PS-K196E mutation is often identified in the Japanese population with an allelic frequency of 0.86 %, and a total of approximately 10,000 Japanese are estimated to be homozygotes. The heterozygotes show PS anticoagulant activities ranging from 40 to 110 %, and 16 % lower mean anticoagulant activity than that in wild-type individuals...
2016: Thrombosis Journal
Z Y Dai, D Liu, R Li, Y Wang, J Zhang, J Liu, R Zhou, G Zeng
Objective: To understand the association between gestational weight gain (GWG) per trimester/total (GWG) and gestational diabetes mellitus (GDM). Methods: A prospective cohort study was conducted among 829 healthy pregnant women from Chengdu who delivered a singleton during March-September 2013. Basic information about pre-pregnancy was collected at the first time, exercise information per trimester, dietary intake information per trimester and gestational age at delivery were obtained by questionnaire. Weight at the (12 ± 1)(th), (28 ± 1)(th), (36 ± 1)(th) and last week before delivery were measured...
October 10, 2016: Zhonghua Liu Xing Bing Xue za Zhi, Zhonghua Liuxingbingxue Zazhi
Nicolas Sananès, Victor Gabriele, Anne Sophie Weingertner, Rodrigo Ruano, Magdalena Sanz-Cortes, Adrien Gaudineau, Bruno Langer, Israël Nisand, Chérif Youssef Akladios, Romain Favre
OBJECTIVE: The primary objective of our study was to evaluate the long-term neurodevelopment outcome after laser surgery for twin-twin transfusion syndrome (TTTS). The secondary objective was to identify perinatal prognostic factors associated with neurodevelopmental impairment. METHOD: This was a single-center cohort prospective study carried out in pregnancies complicated by TTTS and treated by laser. Neurodevleopmental assesment included the administration of Ages and Stages Questionnaires® (ASQ), for the infants between two and five years of age...
October 20, 2016: Prenatal Diagnosis
Dorte Rytter, Bodil Hammer Bech, Thorhallur Ingi Halldorsson, Tine Brink Henriksen, Charlotta Grandström, Arieh Cohen, Sjurdur Frodi Olsen
BACKGROUND/OBJECTIVES: Vitamin D deficiency is common among pregnant women and since the fetus relies exclusively on maternal supply, deficiency could potentially interfere with fetal development. Vitamin D blood concentrations during pregnancy have been associated with offspring cardio-metabolic health in a few previous studies but the evidence is still inconsistent and only one previous study has followed the offspring into adulthood. The aim of the present study was to investigate the association between maternal serum concentration of vitamin D (25(OH)D) in week 30 of gestation and offspring cardio-metabolic risk factors at 20 years...
2016: PloS One
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
Sabrina S Plitt, Mariam Osman, Vanita Sahni, Bonita E Lee, Carmen Charlton, Kimberley Simmonds
OBJECTIVES: In 2009, due to increasing congenital syphilis rates, prenatal syphilis tests (PST) at both mid-gestation and delivery were added to first trimester prenatal screening in the province of Alberta. We sought to determine the proportion of mothers who had all three recommended PSTs during this period and to identify factors associated with incomplete PST. METHODS: A cohort of all pregnancies resulting in a live or stillborn infant in Alberta for 2010 and 2011 was developed from Vital Statistics and linked with prenatal screening data to determine the number and timing of PSTs for pregnant women...
October 20, 2016: Canadian Journal of Public Health. Revue Canadienne de Santé Publique
Linling Zhu, Yu Zhang, Yifeng Liu, Runjv Zhang, Yiqing Wu, Yun Huang, Feng Liu, Meigen Li, Saijun Sun, Lanfeng Xing, Yimin Zhu, Yiyi Chen, Li Xu, Liangbi Zhou, Hefeng Huang, Dan Zhang
This study was carried out to explore associations between assisted reproductive technology (ART) and maternal and neonatal outcomes compared with similar outcomes following spontaneously conceived births. We conducted a retrospective cohort study of pregnancies conceived by ART (N = 2641) during 2006-2014 compared to naturally conceived pregnancies (N = 5282) after matching for maternal age and birth year. Pregnancy complications, perinatal complications and neonatal outcomes of enrolled subjects were investigated and analysed by multivariate logistic regression...
October 20, 2016: Scientific Reports
Danielle Dowdall, Christopher Flatley, Sailesh Kumar
OBJECTIVE: The objective of this study is to evaluate the association between birth weight centiles and the risk of intrapartum compromise and adverse neonatal outcomes in term pregnancies. METHODS: Retrospective study of 32 468 term singleton births at a major tertiary maternity hospital in Australia. Data comprised gestation, mode, and indication for delivery and adverse perinatal outcomes. Fetal sex and gestational age-specific birth weight centiles were the main exposure variable...
October 20, 2016: Journal of Maternal-fetal & Neonatal Medicine
Mikko J Peltola, Tiina Mäkelä, E Juulia Paavonen, Elina Vierikko, Outi Saarenpää-Heikkilä, Tiina Paunio, Jari K Hietanen, Anneli Kylliäinen
Maternal prenatal anxiety is associated with infants' temperamental negative affectivity (NA), but it is unclear to what extent children vary in their susceptibility to prenatal influences. We tested a hypothesis that infants' respiratory sinus arrhythmia (RSA), an index of parasympathetic vagal tone and a potential marker of differential susceptibility to environmental influences, moderates the effects of maternal prenatal anxiety on the development of infant NA. Prenatal anxiety was assessed during the last trimester of pregnancy in a low-risk community sample...
October 20, 2016: Developmental Psychobiology
Hanna Gustafsson, Colleen Doyle, Michelle Gilchrist, Elizabeth Werner, Catherine Monk
The consequences of childhood maltreatment are profound and long lasting. Not only does the victim of abuse suffer as a child, but there is mounting evidence that a history of maltreatment places the next generation at risk for significant psychopathology. Research identifies postnatal factors as affecting this intergenerational transmission of trauma. However, emerging evidence suggests that part of this risk may be transmitted before birth, passed on via abuse-related alterations in the in utero environment that are as yet largely unidentified...
October 20, 2016: Development and Psychopathology
Yi Mu, Nolan McDonnell, Zhuoyang Li, Juan Liang, Yanping Wang, Jun Zhu, Elizabeth Sullivan
BACKGROUND: To analyse the maternal mortality ratio, demographic and pregnancy related details in women who suffered a fatal amniotic fluid embolism (AFE) in China. METHODS: A retrospective population based study using data collected as part of the National Maternal Mortality Surveillance System between 1996 and 2013. Data were collected onto a standardised form from women whose cause of death was listed as being secondary to AFE. RESULTS: Records were available for 640 deaths...
October 19, 2016: BMC Pregnancy and Childbirth
Mohamed Kandil, Zakaria Sanad, Tarek Sayyed, Hamed Ellakwa
In this prospective cohort study, one hundred participants were allocated into four groups according to their body mass indices. Vaginal ultrasound was performed at enrolment to measure cervical length. The shortest cervical measurement was recorded. Overweight and obese groups had significantly longer mean cervical length than women in the normal weight group when measured at 20-22 weeks of gestation (p < .001). Underweight women had the shortest mean cervical length. The incidence of preterm delivery was the highest in underweight women (RR; 1...
October 20, 2016: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
Eunice López-Muñoz, Jorge Antonio Ibarra-Avalos, Rosario Guadalupe Chan-Verdugo, Leovigildo Mateos-Sánchez, Olivia Sánchez-Rodríguez
In order to determine the prevalence of overt and subclinical hypothyroidism, and isolated hypothyroxinemia during pregnancy, thyroid hormone reference values established by UMAE HGO4, IMSS in Mexico City and those suggested by the American Thyroid Association (ATA) were used. All pregnant patients, whose thyroid function was measured and whose pregnancy was monitored and resolved in UMAE HGO4, IMSS from 1 January to 31 December 2013, were included. Significant differences (p = .00419) were observed in the frequency of subclinical hypothyroidism, being higher when using ATA criteria (18...
October 20, 2016: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
G Chistyakova, I Gazieva, I Remizova, L Ustyantseva, V Lyapunov, S Bychkova
We conducted a study of markers of endothelial dysfunction and angiogenesis regulation, as well as the identification of the main lymphocyte populations, activated CD3 (+) CD95(+)-cells and cytokine-producing CD4 (+) IFN-γ(+)-, CD4 (+) IL-4(+ )-lymphocytes in the 1st trimester of gestation in women with ART-induced pregnancy and spontaneous pregnancy. We used the same indicators to assess the immune status of ELBW infants at birth and at the post-conceptual age of 38-40 weeks. It was determined that the risk factors of very early preterm delivery are: threatened miscarriage, chronic placental insufficiency, endothelial dysfunction, increased spontaneous production of intracellular cytokines...
October 2016: Gynecological Endocrinology
E G Deryabina, G V Yakornova, L A Pestryaeva, N D Sandyreva
Preterm birth is defined as all births before 37 completed weeks of gestation. Preterm birth can be further sub-divided based on gestational age: extremely preterm (<28 weeks), very preterm (28 to <32 weeks) and moderate preterm (32 to <37 weeks). Retrospective observational case-control study review (1 year i.e., 2015) is to assess pregnancy outcome among women with gestational diabetes mellitus (GDM) delivering very preterm (28 + 0/7 to 31 + 6/7 weeks of gestation). The study group included all women diagnosed with GDM and were compared to a control group of women delivering at the same gestational age period but without GDM...
October 2016: Gynecological Endocrinology
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