Journal of Perinatal Medicine最新文献_第4页

Factors of poor prognosis in newborns with a prenatal diagnosis of gastroschisis in Bogota, Colombia. 哥伦比亚波哥大产前诊断为胃畸形的新生儿预后不良的因素。

IF 1.7 4区医学

Journal of Perinatal Medicine Pub Date : 2024-05-20 Print Date: 2024-07-26 DOI: 10.1515/jpm-2023-0520

Viviana Dávila Romero, Rafael L Aragón Mendoza, Saulo Molina-Giraldo, Emiliano M Herrera, Elman H Leal, Roberto Gallo Roa, Jorge A Rodríguez Ortiz, Angelica M Toro, Rafael R Peña, Diana Gómez Hoyos, Tammy Nudelman, Cristian L Vargas Fiallo

{"title":"Factors of poor prognosis in newborns with a prenatal diagnosis of gastroschisis in Bogota, Colombia.","authors":"Viviana Dávila Romero, Rafael L Aragón Mendoza, Saulo Molina-Giraldo, Emiliano M Herrera, Elman H Leal, Roberto Gallo Roa, Jorge A Rodríguez Ortiz, Angelica M Toro, Rafael R Peña, Diana Gómez Hoyos, Tammy Nudelman, Cristian L Vargas Fiallo","doi":"10.1515/jpm-2023-0520","DOIUrl":"10.1515/jpm-2023-0520","url":null,"abstract":"Objectives: To identify factors associated with poor prognoses in newborns with a prenatal diagnosis of gastroschisis in eight hospitals in Bogota, Colombia, from 2011 to 2022.Methods: A multi-center retrospective case-control study was conducted on newborns with gastroschisis in eight hospitals in Bogota, Colombia. Poor prognosis was defined as the presence of sepsis, intestinal complications, or death.Results: The study included 101 patients. Preterm newborns under 32 weeks had a poor neonatal prognosis (OR 6.78 95 % CI 0.75-319). Oligohydramnios (OR 4.95 95 % CI 1.15-21.32) and staged closure with silo (OR 3.48; 95 % CI 1.10-10.96) were risk factors for neonatal death, and intra-abdominal bowel dilation of 20-25 mm was a factor for the development of intestinal complications (OR 3.22 95 % CI 1.26-8.23).Conclusions: Intra-abdominal bowel dilation between 20 and 25 mm was associated with intestinal complications, while oligohydramnios was associated with the risk of perinatal death, requiring increased antenatal surveillance of fetal wellbeing. Management with primary reduction when technically feasible is recommended in these infants, considering that the use of silos was associated with higher mortality.","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":"665-670"},"PeriodicalIF":1.7,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140957895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Association of BDNF polymorphism with gestational diabetes mellitus risk: a novel insight into genetic predisposition. BDNF多态性与妊娠糖尿病风险的关系：对遗传易感性的新认识。

IF 1.7 4区医学

Journal of Perinatal Medicine Pub Date : 2024-05-13 Print Date: 2024-07-26 DOI: 10.1515/jpm-2023-0366

Danyel Chermon, Ruth Birk

{"title":"Association of BDNF polymorphism with gestational diabetes mellitus risk: a novel insight into genetic predisposition.","authors":"Danyel Chermon, Ruth Birk","doi":"10.1515/jpm-2023-0366","DOIUrl":"10.1515/jpm-2023-0366","url":null,"abstract":"Objectives: Gestational diabetes mellitus (GDM) is a prevalent metabolic disorder during pregnancy with potential long-term health implications for the mother and child. The interplay between genetics and GDM susceptibility remains an area of active research. Recently, brain-derived neurotrophic factor (BDNF) was investigated in relation to obesity and impaired glucose metabolism and pathogenesis. We aimed to investigate the association of common BDNF polymorphisms, with GDM risk in Israeli females.Methods: A cohort of 4,025 Israeli women data for BDNF common SNPs was analyzed for potential association with GDM using binary logistic regressions analysis (SPSS 29.0 and R) adjusted for confounding variables (age, T1DM, T2DM, PCOS) under different genetic models.Results: The GDM and Non-GDM genetic frequencies for the BDNF rs925946 Tag-SNP were significantly different. The genetic frequencies were 54.16 %, and 66.91 % for the wild type (GG), 38.88 and 29.64 % for the heterozygotes (TC), and 6.94 and 3.48 % for the risk allele homozygotes (TT) for the GDM non-GDM populations, respectively. Carriers of BDNF rs925946 were significantly associated with higher risk for GDM, following the dominant genetic model (OR=1.7, 95 % CI 1.21-2.39, p=0.002), the recessive genetic model (OR=2.05, 95 % CI 1.04-4.03, p=0.03), and the additive genetic model (OR=1.62, 95 % CI 1.13-2.3, p=0.008). This association persisted after adjusting for age, T1DM, T2DM, and polycystic ovary syndrome (PCOS).Conclusions: Carrying BDNF rs925946 polymorphism predisposes to a higher risk of GDM pathogenesis. Its role and implications warrant further investigation, especially when considering preventive measures for GDM development.","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":"611-616"},"PeriodicalIF":1.7,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140897733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Intrapartum pyrexia, cardiotocography traces and histologic chorioamnionitis: a case-control study 产前热病、心动图痕迹和组织学绒毛膜羊膜炎：病例对照研究

IF 2.4 4区医学

Journal of Perinatal Medicine Pub Date : 2024-04-29 DOI: 10.1515/jpm-2023-0330

Sara Barbieri, Anna Fichera, Rossana Orabona, Nicola Fratelli, Franco E. Odicino, Federico Prefumo

{"title":"Intrapartum pyrexia, cardiotocography traces and histologic chorioamnionitis: a case-control study","authors":"Sara Barbieri, Anna Fichera, Rossana Orabona, Nicola Fratelli, Franco E. Odicino, Federico Prefumo","doi":"10.1515/jpm-2023-0330","DOIUrl":"https://doi.org/10.1515/jpm-2023-0330","url":null,"abstract":"Objectives To compare characteristics of labor, cardiotocography traces, and maternal and neonatal outcomes, in a cohort of pregnancies at term complicated by maternal intrapartum pyrexia, with or without a histologic diagnosis of chorioamnionitis. Methods This is a retrospective case-control study including pregnancies at term with detection of maternal intrapartum pyrexia, delivered between January 2020 and June 2021. Cardiotocography traces were entirely evaluated, since admission till delivery, and classified according to the International Federation of Obstetrics and Gynecology (FIGO) guideline. Maternal and neonatal outcomes were also recorded as secondary outcomes. Placentas have been studied according to the Amniotic Fluid Infection Nosology Committee. Results Forty four patients met the inclusion criteria and were included in the study cohort. There was a significant association between the use of oxytocin augmentation in labor and the histologic diagnosis of chorioamnionitis. A significative recurrence of loss and/or absence of accelerations at the point of pyrexia was also documented in women with histological chorioamnionitis compared to the others. Conclusions Chorioamnionitis appears to be associated with myometrial disfunction, as suggested by the increased use of oxytocin augmentation during active labor of women at term with intrapartum pyrexia and histologic diagnosis of chorioamnionitis.","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":"1 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140840774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Does delayed cord clamping result in higher maternal blood loss in primary cesarean sections? A retrospective comparative study 延迟夹断脐带是否会导致初次剖宫产的产妇失血量增加？回顾性比较研究

IF 2.4 4区医学

Journal of Perinatal Medicine Pub Date : 2024-04-27 DOI: 10.1515/jpm-2023-0450

Fabia L. Urech, Thierry Girard, Maya Brunner, Andreas Schoetzau, Olav Lapaire

{"title":"Does delayed cord clamping result in higher maternal blood loss in primary cesarean sections? A retrospective comparative study","authors":"Fabia L. Urech, Thierry Girard, Maya Brunner, Andreas Schoetzau, Olav Lapaire","doi":"10.1515/jpm-2023-0450","DOIUrl":"https://doi.org/10.1515/jpm-2023-0450","url":null,"abstract":"Objectives The University Hospital Basel implemented delayed umbilical cord clamping of 30–60 s in all laboring women on April 1, 2020. This practice has been widely researched showing substantial benefit for the neonate. Few studies focused on maternal blood loss. The objective of our retrospective comparative study was to assess the impact of immediate vs. delayed cord clamping on maternal blood loss in primary scheduled cesarean sections. Methods We analyzed data of 98 women with singleton gestations undergoing primary scheduled cesarean section at term. Data from procedures with early cord clamping (ECC) were compared to those after implementation of delayed cord clamping (DCC). Primary outcomes were perioperative change in maternal hemoglobin levels, estimated and calculated blood loss. Secondary outcomes included duration of cesarean section and neonatal data. Results There was a statistically significant difference in the mean perioperative decline of hemoglobin of 10.4 g/L (SD=7.92) and 18.7 g/L (SD=10.4) between the ECC and DCC group, respectively (p<0.001). The estimated (482 mL in ECC vs. 566 mL in DCC (p=0.011)) and the calculated blood loss (438 mL in ECC vs. 715 mL in DCC (p=0.002)) also differed significantly. Secondary outcomes showed no significant differences. Conclusions In our study DCC resulted in a statistically significant higher maternal blood loss. In our opinion the widely researched neonatal benefit of DCC outweighs the risk of higher maternal blood loss in low-risk patients. However, maternal risks must be minimized, improvements to preoperative blood management and operative techniques are required.","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":"7 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140812335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Reducing decisional conflict in decisions about prenatal genetic testing: the impact of a dyadic intervention at the start of prenatal care 减少产前基因检测决策中的决策冲突：产前护理开始时进行的父子干预的影响

IF 2.4 4区医学

Journal of Perinatal Medicine Pub Date : 2024-04-26 DOI: 10.1515/jpm-2023-0442

Christina Collart, Caitlin Craighead, Meng Yao, Susannah Rose, Edward K. Chien, Richard M. Frankel, Marissa Coleridge, Bo Hu, Brownsyne Tucker Edmonds, Angela C. Ranzini, Ruth M. Farrell

{"title":"Reducing decisional conflict in decisions about prenatal genetic testing: the impact of a dyadic intervention at the start of prenatal care","authors":"Christina Collart, Caitlin Craighead, Meng Yao, Susannah Rose, Edward K. Chien, Richard M. Frankel, Marissa Coleridge, Bo Hu, Brownsyne Tucker Edmonds, Angela C. Ranzini, Ruth M. Farrell","doi":"10.1515/jpm-2023-0442","DOIUrl":"https://doi.org/10.1515/jpm-2023-0442","url":null,"abstract":"Objectives Decisional conflict and regret about prenatal genetic screening and diagnostic tests may have important consequences in the current pregnancy and for future reproductive decisions. Identifying mechanisms that reduce conflict associated with the decision to use or decline these options is necessary for optimal patient counseling. Methods We conducted a cluster-randomized controlled trial of a shared decision-making tool (NEST) at the beginning of prenatal care. Enrolled patients completed follow-up surveys at the time of testing (QTT) and in the second–third trimester (QFF), including the Decision Conflict Scale (DCS). Total DCS scores were analyzed using a multivariate linear mixed-effect model. Results Of the total number of participants (n=502) enrolled, 449 completed the QTT and QFF surveys. The mean age of participants was 31.6±3.8, with most parous at the time of study participation (n=321; 71.7 %). Both the NEST (the intervention) and control groups had lower median total DCS scores at QFF (NEST 13.3 [1.7, 25.0] vs. control 16.7 [1.7, 25.0]; p=0.24) compared to QTT (NEST 20.8 [5.0, 25.0] vs. control 18.3 [3.3, 26.7]; p=0.89). Participants exposed to NEST had lower decisional conflict at QFF compared to control (β −3.889; [CI −7.341, −0.437]; p=0.027). Conclusions Using a shared decision-making tool at the start of prenatal care decreased decisional conflict regarding prenatal genetic testing. Such interventions have the potential to provide an important form of decision-making support for patients facing the unique type of complex and preference-based choices about the use of prenatal genetic tests.","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":"39 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140806757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Value of fetal echocardiographic examination in pregnancies complicated by preterm premature rupture of membranes 胎膜早破并发妊娠中胎儿超声心动图检查的价值

IF 2.4 4区医学

Journal of Perinatal Medicine Pub Date : 2024-04-19 DOI: 10.1515/jpm-2023-0448

Monika Pasieczna, Joanna Kuran-Ohde, Agnieszka Grzyb, Renata Bokiniec, Agata Wójcik-Sęp, Krzysztof Czajkowski, Joanna Szymkiewicz-Dangel

{"title":"Value of fetal echocardiographic examination in pregnancies complicated by preterm premature rupture of membranes","authors":"Monika Pasieczna, Joanna Kuran-Ohde, Agnieszka Grzyb, Renata Bokiniec, Agata Wójcik-Sęp, Krzysztof Czajkowski, Joanna Szymkiewicz-Dangel","doi":"10.1515/jpm-2023-0448","DOIUrl":"https://doi.org/10.1515/jpm-2023-0448","url":null,"abstract":"Objectives Cardiopulmonary and infectious complications are more common in preterm newborns after preterm premature rupture of membranes (pPROM). Fetal echocardiography may be helpful in predicting neonatal condition. Our aim was to assess the cardiovascular changes in fetuses from pregnancies complicated by pPROM and possible utility in predicting the intrauterine or neonatal infection, and neonatal heart failure (HF). Methods It was a prospective study enrolling 46 women with singleton pregnancies complicated by pPROM between 18+0 and 33+6 weeks of gestation and followed until delivery. 46 women with uncomplicated pregnancies served as a control group. Fetal echocardiographic examinations with the assessment of cardiac structure and function (including pulmonary circulation) were performed in all patients. Results Mean gestational age of pPROM patients was 26 weeks. Parameters suggesting impaired cardiac function in fetuses from pPROM were: higher right ventricle Tei index (0.48 vs. 0.42 p<0.001), lower blood flow velocity in Ao z-score (0.14 vs. 0.84 p=0.005), lower cardiovascular profile score (CVPS), higher rate of tricuspid regurgitation (18.2 % vs. 4.4 % p=0.04) and pericardial effusion (32.6 vs. 0 %). Intrauterine infection was diagnosed in 18 patients (39 %). 4 (8.7 %) newborns met the criteria of early onset sepsis (EOS). HF was diagnosed in 9 newborns. In fetal echocardiographic examination HF group had shorter mitral valve inflow time and higher left ventricle Tei index (0.58 vs. 0.49 p=0.007). Conclusions Worse cardiac function was observed in fetuses from pPROM compared to fetuses from uncomplicated pregnancies.","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":"21 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140626330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Understanding current antenatal Hepatitis C testing and care in maternity services in England 了解英格兰产前丙肝检测和产科服务的现状

IF 2.4 4区医学

Journal of Perinatal Medicine Pub Date : 2024-04-19 DOI: 10.1515/jpm-2023-0508

Amoolya Vusirikala, Georgia Threadgold, Rachel Roche, Matthew Hibbert, Ruth Simmons, Sharon Webb, Mark Gillyon-Powell, Monica Desai, Sema Mandal

{"title":"Understanding current antenatal Hepatitis C testing and care in maternity services in England","authors":"Amoolya Vusirikala, Georgia Threadgold, Rachel Roche, Matthew Hibbert, Ruth Simmons, Sharon Webb, Mark Gillyon-Powell, Monica Desai, Sema Mandal","doi":"10.1515/jpm-2023-0508","DOIUrl":"https://doi.org/10.1515/jpm-2023-0508","url":null,"abstract":"Objectives Universal opt-out antenatal screening for Hepatitis C virus (HCV) is not currently recommened and it is recommended that maternity services offer risk-based testing. We aimed to investigate antenatal HCV testing and adherence to testing guidance. Methods A cross-sectional survey was circulated to maternity service providers between November–December 2020 which included testing policy, training for healthcare staff, and management of women found to be HCV positive. Descriptive data are presented. Results 75 questionnaires were returned, representing 48 % of English maternity service providers. 87 % of providers reported offering antenatal HCV risk-based testing. Risk factors used to identify pregnant women for testing varied. Less than 15 % of respondents considered women that were ever homeless or with history of incarceraton or from higher HCV prevalence areas as high risk. Conclusions Current antenatal HCV testing practices are inadequate and HCV infection likely goes undiagnosed in pregnancy, especially among vulnerable population groups. In the absence of universal antenatal screening, re-framing antenatal HCV risk-based testing and management as a quality improvement initiative and developing HCV specific pathway guidance for maternity units is required.","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":"123 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140626061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Bias in the prenatal lung measurements in fetal congenital diaphragmatic hernia with intrauterine growth restriction 胎儿先天性膈疝合并宫内生长受限时产前肺测量的偏差

IF 2.4 4区医学

Journal of Perinatal Medicine Pub Date : 2024-04-18 DOI: 10.1515/jpm-2023-0425

Emrah Aydın, Narmina Khanmammadova, Patricia Burns, Foong-Yen Lim, Mounira A. Habli, Jose Luis Peiró

{"title":"Bias in the prenatal lung measurements in fetal congenital diaphragmatic hernia with intrauterine growth restriction","authors":"Emrah Aydın, Narmina Khanmammadova, Patricia Burns, Foong-Yen Lim, Mounira A. Habli, Jose Luis Peiró","doi":"10.1515/jpm-2023-0425","DOIUrl":"https://doi.org/10.1515/jpm-2023-0425","url":null,"abstract":"Objectives The failure of a fetus to develop to its full potential due to maternal or placental factors is known as intrauterine growth restriction (IUGR). Fetal head growth is usually preserved in that situation producing a potential discordance between head and body size. Our goal is to discover if IUGR has an impact on the prenatal ultrasound measurements taken to assess pulmonary development in congenital diaphragmatic hernia (CDH). Methods A retrospective chart review (IRB#2017-6361) was performed on all prenatally diagnosed CDH patients from 2007 to 2016. Patient demographics, fetal and neonatal anthropometric measurements, and fetal lung parameters were the main subjects of the data that were gathered. Fetal growth was assessed by the curves based on US data by Olsen et al. and by Peleg et al. Of 147 CDH patients, 19 (12.9 %) patients were diagnosed with IUGR before the 30th gestational week while there were 20 (13.6 %) patients after the 30th gestational week. Results Patients with IUGR and the observed-to-expected lung-to-head ratio (O/E LHR) less than 25 % had better survival rates both to discharge and date compared to non IUGR group (p=0.226, OR 2.25 95 % CI 0.60–1.08 and p=0.175, OR 2.40 95 % CI 0.66–1.17, respectively). Moreover, the ECMO need of the patients who had IUGR and O/E LHR less than 25 % was significantly less than the patients without IUGR (38.5 vs. 80.0 %, p=0.005). Conclusions This study confirms that the intrauterine measurements to predict pulmonary hypoplasia in CDH patients are misleading in the presence of IUGR and cause an overestimation.","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":"131 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140629926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Association between aneuploidy screening analytes and adverse outcomes in twin gestations 非整倍体筛查分析物与双胎妊娠不良结局之间的关系

IF 2.4 4区医学

Journal of Perinatal Medicine Pub Date : 2024-04-18 DOI: 10.1515/jpm-2023-0499

Kelly Yamasato, Aiwa Ono

{"title":"Association between aneuploidy screening analytes and adverse outcomes in twin gestations","authors":"Kelly Yamasato, Aiwa Ono","doi":"10.1515/jpm-2023-0499","DOIUrl":"https://doi.org/10.1515/jpm-2023-0499","url":null,"abstract":"Objectives To evaluate associations between serum analytes used for genetic screening and obstetric complications among twin pregnancies. Methods This cohort included twins delivered at a tertiary care hospital from 2009 to 2017. Abnormal levels of pregnancy associated plasma protein (PAPP-A), first and second trimester human chorionic gonadotropin (hCG), alpha fetoprotein (AFP), estriol, and inhibin, reported as multiples of the median (MoM), were defined as <5 %ile or >95 %ile for our cohort. Associations between abnormal analytes and preterm delivery, small for gestational age, and pregnancy-associated hypertension were calculated using Fisher’s exact test. Results A total of 357 dichorionic/diamniotic and 123 monochorionic/diamniotic twins were included. Among dichorionic/diamniotic twins, elevated AFP (>3.70 MoM) was associated with increased preterm delivery <34 weeks (44.4 vs. 16.5 %, p=0.007), while elevated inhibin (>4.95 MoM) was associated with increased preterm delivery<37 weeks (94.1 vs. 58.8 %, p=0.004). For monochorionic/diamniotic twins, elevated inhibin (>6.34 MoM) was associated increased preterm delivery <34 weeks (66.7 vs. 24.8 %, p=0.04) and hypertension (66.7 vs. 21.4 %, p=0.03). Conclusions Selected abnormal analyte levels were associated with increased rates of adverse outcomes in twin pregnancies, which differed by chorionicity. Our findings assist providers in interpreting abnormal analyte levels in twin pregnancies and may help to identify those at increased risk for adverse outcomes.","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":"9 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140630661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Current obstetric outcomes in Jamaican women with sickle hemoglobinopathy – a balance of risks for aspirin? 患有镰状血红蛋白病的牙买加妇女目前的产科结果--阿司匹林的风险平衡？

IF 2.4 4区医学

Journal of Perinatal Medicine Pub Date : 2024-04-17 DOI: 10.1515/jpm-2023-0378

Shanea M. P. Gibson, Tiffany A. Hunter, Phillip E. Charles, Melonie A. C. Morgan, Shari K. R. Griffith-Anderson, J. Kennedy Cruickshank, Maxine D. Gossell-Williams, Nadine A. Johnson

{"title":"Current obstetric outcomes in Jamaican women with sickle hemoglobinopathy – a balance of risks for aspirin?","authors":"Shanea M. P. Gibson, Tiffany A. Hunter, Phillip E. Charles, Melonie A. C. Morgan, Shari K. R. Griffith-Anderson, J. Kennedy Cruickshank, Maxine D. Gossell-Williams, Nadine A. Johnson","doi":"10.1515/jpm-2023-0378","DOIUrl":"https://doi.org/10.1515/jpm-2023-0378","url":null,"abstract":"Objectives Sickle cell disease (SCD) occurs in 2.8 % of our Jamaican antenatal population with homozygous HbSS being most associated with adverse maternal and perinatal outcomes. Methods A retrospective comparative analysis of HbSS, HbSC and HbSβThal pregnancy outcomes at the University Hospital of the West Indies (UHWI) between January 2012 and December 2022 was conducted. Results Of 120 patients (138 pregnancies), obesity occurred in 36 % (20/56) of the ‘non-HbSS’ group, i.e. HbSβThal (55 %, 5/9) and HbSC (32 %, 15/47) combined vs. 9.7 % of the HbSS (8/82). HbSS patients had more crises requiring transfusions, acute chest syndrome (ACS), maternal ‘near-misses’ (OR=10.7, 95 % 3.5–32.3; p<0.001), hospitalizations (OR 7.6, 95 % CI 3.4–16.9; p<0.001), low birth weight (LBW) neonates (OR 3.1, 1.1–8.9; p=0.037) and preterm birth (OR=2.6, 1.2–5.8; p=0.018) compared to HbSC and HbSβThal. Low dose aspirin was prescribed in 43 %. Logistic regression showed those NOT on aspirin (n=76) had more miscarriages (22 v. 2 %), were LESS likely to have a live birth (75 v. 95 % (0.2, 0.04–0.57, p=0.005)), but surprisingly had fewer painful crises (28 v. 46 % (0.5, 0.03–0.9, p=0.03)). Conclusions HbSS women had a 10-fold excess of maternal near-misses. Additional research may further clarify the effects of aspirin on pregnancy outcomes as related to SCD genotypes.","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":"2012 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140612956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0