Distinguishing between Fertilization Failure and Early Pregnancy Loss when Identifying Male-Mediated Adverse Pregnancy Outcomes

2003 ◽  
pp. 189-198 ◽  
Author(s):  
Sally D. Perreault
Keyword(s):  
Early Pregnancy ◽  
Pregnancy Outcomes ◽  
Pregnancy Loss ◽  
Adverse Pregnancy Outcomes ◽  
Fertilization Failure ◽  
Early Pregnancy Loss ◽  
Adverse Pregnancy

scholarly journals How does subchorionic hematoma in the first trimester affect pregnancy outcomes?

2021 ◽  
Author(s):  
Taner Günay ◽  
Oğuz Yardımcı
Keyword(s):  
Pregnant Women ◽  
Preterm Delivery ◽  
Early Pregnancy ◽  
Pregnancy Outcomes ◽  
Vaginal Bleeding ◽  
Pregnancy Loss ◽  
Placental Abruption ◽  
First Trimester ◽  
Early Pregnancy Loss ◽  
Adverse Pregnancy

IntroductionSubchorionic hematoma (SCH) in pregnancy has been associated with increased risk of adverse pregnancy outcomes. We aimed to investigate the association of SCH with adverse pregnancy outcomes in pregnant women in relation to size of hematoma and control subjects.Material and methodsThis study included 178 pregnant women with sonographically detected SCH in the 1st trimester, and 350 pregnant controls without SCH. Data on maternal age, smoking status, gestational week at diagnosis, location of SCH, medications before diagnosis, gestational week at delivery, delivery route and pregnancy outcomes (first trimester vaginal bleeding, pre-eclampsia, gestational diabetes, intrauterine growth restriction (IUGR), placental abruption, preterm delivery < 37 weeks, early pregnancy loss and intrauterine death) were retrieved retrospectively from hospital records. Pregnant women with SCH were divided into 3 groups according to the size of hematoma including small SCH (SCH-I group, n = 47), medium- size SCH (SCH-II group, n = 110) and large SCH (SCH-III group, n = 21) groups.ResultsSubchorionic hematoma was associated with significantly lower gestational age at delivery (p < 0.001) and higher rate of first trimester bleeding (p < 0.001) compared with the control group, regardless of the size of the hematoma. Placental abruption (p = 0.002) and early pregnancy loss (p < 0.001) were significantly more common in SCH-II and -III groups than in the control group. SCH-III group was associated with a significantly higher rate of < 37 gestational weeks at delivery (p < 0.001), first trimester vaginal bleeding (p < 0.001), early pregnancy loss (p < 0.001), IUGR (p = 0.003) and preterm delivery (p < 0.001) compared to both lesser size hematoma and control groups.ConclusionsIn conclusion, our findings suggest that large SCH might indicate an increased risk of adverse pregnancy outcomes such as 1st trimester vaginal bleeding, early pregnancy loss, IUGR, placental abruption or preterm delivery. These findings are important to guide the patients with SCH for detailed clinical evaluation.

scholarly journals Levothyroxine and the risk of adverse pregnancy outcomes in women with subclinical hypothyroidism: a systematic review and meta-analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Magnus Bein ◽  
Oriana Hoi Yun Yu ◽  
Sonia Marzia Grandi ◽  
Francesca Y. E. Frati ◽  
Ihab Kandil ◽  
...  
Keyword(s):  
Systematic Review ◽  
Subclinical Hypothyroidism ◽  
Pregnancy Outcomes ◽  
Neonatal Death ◽  
Observational Studies ◽  
Pregnancy Loss ◽  
Meta Analysis ◽  
Adverse Pregnancy Outcomes ◽  
Adverse Pregnancy ◽  
Levothyroxine Treatment

Abstract Background Levothyroxine replacement therapy may decrease the risk of adverse pregnancy outcomes among women with subclinical hypothyroidism (SCH). The aim of this study is to conduct a systematic review and meta-analysis to examine the risk of adverse pregnancy, perinatal, and early childhood outcomes among women with SCH treated with levothyroxine. Methods A systematic literature search was conducted using Ovid-Medline, Ovid-EMBASE, Pubmed (non-Medline), Ebsco-CINAHL Plus with full text and Cochrane Library databases. Randomized controlled studies (RCTs) and observational studies examining the association between treatment of SCH during pregnancy and our outcomes of interest were included. Studies that compared levothyroxine treatment versus no treatment were eligible for inclusion. Data from included studies were extracted and quality assessment was performed by two independent reviewers. Results Seven RCTs and six observational studies met our inclusion criteria. A total of 7342 individuals were included in these studies. RCTs demonstrated several sources of bias, with lack of blinding of the participants or research personnel; only one study was fully blinded. In the observational studies, there was moderate to serious risk of bias due to lack of adjustment for certain confounding variables, participant selection, and selective reporting of results. Pooled analyses showed decreased risk of pregnancy loss (RR: 0.79; 95% CI: 0.67 to 0.93) and neonatal death (RR: 0.35; 95% CI: 0.17 to 0.72) associated with levothyroxine treatment during pregnancy among women with SCH. There were no associations between levothyroxine treatment and outcomes during labour and delivery, or cognitive status in children at 3 or 5 years of age. Conclusion Treatment of SCH with levothyroxine during pregnancy is associated with decreased risks of pregnancy loss and neonatal death. Given the paucity of available data and heterogeneity of included studies, additional studies are needed to address the benefits of levothyroxine use among pregnant women with SCH.

scholarly journals Impact of TPOAb-negative maternal subclinical hypothyroidism in early pregnancy on adverse pregnancy outcomes

2021 ◽  
Vol 12 ◽  
pp. 204201882110546
Author(s):  
Ping Zhu ◽  
Ruifeng Chu ◽  
Shilei Pan ◽  
Xiaolan Lai ◽  
Jianmin Ran ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Early Pregnancy ◽  
Subclinical Hypothyroidism ◽  
Pregnancy Outcomes ◽  
Odds Ratio ◽  
Thyroid Stimulating Hormone ◽  
Adverse Pregnancy Outcomes ◽  
American Thyroid Association ◽  
Adverse Pregnancy ◽  
Stimulating Hormone

Purpose: To investigate the effect of subclinical hypothyroidism on pregnancy outcomes of women early in their pregnancy with different thyroid-stimulating hormone levels and thyroid peroxidase antibody–negative status and to explore reasonable thyroid-stimulating hormone levels for subclinical hypothyroidism in early pregnancy. Methods: A total of 2378 women early in their pregnancy were studied retrospectively. The baseline characteristics were collected from medical records. Pregnancy outcomes were compared between the euthyroidism and subclinical hypothyroidism groups that were diagnosed by 2011 or 2017 American Thyroid Association guidelines. In addition, the effect of different maternal thyroid-stimulating hormone levels on adverse pregnancy outcomes was analyzed using binary logistic regression. Results: According to the 2011 American Thyroid Association diagnostic criteria of subclinical hypothyroidism, the prevalence of pregnancy outcomes was not significantly higher in the subclinical hypothyroidism group than in the euthyroidism group. However, pregnant women with subclinical hypothyroidism identified by the 2017 American Thyroid Association criteria had a higher risk of premature delivery (odds ratio = 3.93; 95% confidence interval = 1.22–12.64), gestational diabetes mellitus (odds ratio = 2.69; 95% confidence interval = 1.36–5.32), and gestational anemia (odds ratio = 3.28; 95% confidence interval = 1.60–6.75). Moreover, no differences in the prevalence of adverse pregnancy outcomes were observed between the mildly elevated thyroid-stimulating hormone group (2.5 < thyroid-stimulating hormone ⩽4.0 mIU/l) and the normal thyroid-stimulating hormone group (0.27 < thyroid-stimulating hormone ⩽2.5 mIU/l). The significantly elevated thyroid-stimulating hormone group (4.0 < thyroid-stimulating hormone < 10.0 mIU/l) had a higher prevalence of premature delivery, gestational diabetes mellitus, and gestational anemia than the normal thyroid-stimulating hormone group, even after controlling for potential confounding factors. Conclusion: A mildly elevated thyroid-stimulating hormone level or maternal subclinical hypothyroidism diagnosed by 2011 American Thyroid Association guidelines during early pregnancy in thyroid peroxidase antibody–negative women was not associated with adverse pregnancy outcomes. However, maternal subclinical hypothyroidism identified by the 2017 American Thyroid Association guidelines increased the risks of several adverse pregnancy outcomes in women untreated with levothyroxine. The 2017 American Thyroid Association guidelines could be more reasonable for the diagnosis of subclinical hypothyroidism in southern China.

scholarly journals The Impact of Gestational Weight Gain on the Risks of Adverse Maternal and Infant Outcomes among Normal BMI Women with High Triglyceride Levels during Early Pregnancy

Nutrients ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 3454
Author(s):  
Xia-Fei Jiang ◽  
Hui Wang ◽  
Dan-Dan Wu ◽  
Jian-Lin Zhang ◽  
Ling Gao ◽  
...  
Keyword(s):  
Weight Gain ◽  
Preterm Birth ◽  
Gestational Diabetes ◽  
Early Pregnancy ◽  
Pregnancy Outcomes ◽  
Gestational Hypertension ◽  
Adverse Pregnancy Outcomes ◽  
Gestational Weight ◽  
Adverse Pregnancy ◽  
The Impact

A high maternal triglyceride (mTG) level during early pregnancy is linked to adverse pregnancy outcomes, but the use of specific interventions has been met with limited success. A retrospective cohort study was designed to investigate the impact of gestational weight gain (GWG) on the relationship between high levels of mTG and adverse pregnancy outcomes in normal early pregnancy body mass index (BMI) women. The patients included 39,665 women with normal BMI who had a singleton pregnancy and underwent serum lipids screening during early pregnancy. The main outcomes were adverse pregnancy outcomes, including gestational hypertension, preeclampsia, gestational diabetes, cesarean delivery, preterm birth, and large or small size for gestational age (LGA or SGA) at birth. As a result, the high mTG (≥2.05mM) group had increased risks for gestational hypertension ((Adjusted odds ratio (AOR), 1.80; 95% CI, 1.46 to 2.24)), preeclampsia (1.70; 1.38 to 2.11), gestational diabetes (2.50; 2.26 to 2.76), cesarean delivery (1.22; 1.13 to 1.32), preterm birth (1.42, 1.21 to 1.66), and LGA (1.49, 1.33 to 1.68) compared to the low mTG group, after adjustment for potential confounding factors. Additionally, the risks of any adverse outcome were higher in each GWG subgroup among women with high mTG than those in the low mTG group. High mTG augmented risks of gestational hypertension, preeclampsia, preterm birth, and LGA among women with 50th or greater percentile of GWG. Interestingly, among women who gained less than the 50th percentile of GWG subgroups, there was no relationship between high mTG level and risks for those pregnancy outcomes when compared to low mTG women. Therefore, weight control and staying below 50th centile of the suggested GWG according to gestational age can diminish the increased risks of adverse pregnancy outcomes caused by high mTG during early pregnancy.

Novel 3-Dimensional Placental Measurements in Early Pregnancy as Predictors of Adverse Pregnancy Outcomes

2010 ◽  
Vol 29 (8) ◽  
pp. 1203-1212 ◽  
Author(s):  
Nadav Schwartz ◽  
Jaclyn Coletta ◽  
Cara Pessel ◽  
Rui Feng ◽  
Ilan E. Timor-Tritsch ◽  
...  
Keyword(s):  
Early Pregnancy ◽  
Pregnancy Outcomes ◽  
Adverse Pregnancy Outcomes ◽  
3 Dimensional ◽  
Adverse Pregnancy
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