The complex Impact of Five Years of Stress Related to Life-Threatening Events on Pregnancy Outcomes: A Preliminary Retrospective Study

2015 ◽  
Vol 30 (2) ◽  
pp. 317-321 ◽  
Author(s):  
M. Keren ◽  
N. Keren ◽  
A. Eden ◽  
S. Tsangen ◽  
A. Weizman ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Pregnancy Outcomes ◽  
Pregnancy Complications ◽  
The Other ◽  
Late Period ◽  
Intermediate Period ◽  
Membrane Rupture ◽  
Middle Period ◽  
Life Threatening ◽  
The Impact

AbstractObjective:To study the impact of chronic, life-threatening stressors in the form of daily missile attacks, for five consecutive years, on pregnancy outcomes.Method:Charts of deliveries from two neighboring towns in the south of Israel, covering the years 2000 and 2003–2008, were reviewed retrospectively. One city had been exposed to missile attacks, while the other was not. For each year, 100 charts were chosen at random.Results:Significant association was found between exposure to stress and frequency of pregnancy complications (P = 0.047) and premature membrane rupture (P = 0.029). A more detailed analysis, based on dividing the stressful years into three distinct periods: early (2003–2004), intermediate (2005–2006) and late (2007–2008), revealed that preterm deliveries were significantly more frequent (P = 0.044) during the intermediate period, as was premature membrane rupture during the late period (P = 0.014).Conclusion:Exposure to chronic life-threatening stress resulted in more pregnancy complications and in particular more premature membrane ruptures. The impact was most significant during the middle period of the 5-year-exposure to the stressor. Hence it seems that factors of duration and habituation may play a role in the impact of chronic, life-threatening stressors on pregnancy.

scholarly journals Adversity magnifies the importance of social information in decision-making

2016 ◽  
Author(s):  
Alfonso Perez-Escudero ◽  
Gonzalo G de Polavieja
Keyword(s):  
Decision Making ◽  
Mathematical Analysis ◽  
Social Information ◽  
The Other ◽  
Adverse Conditions ◽  
Social Species ◽  
Life Threatening ◽  
Low Levels ◽  
The Impact ◽  
Different Levels

In adverse conditions, individuals follow the majority more strongly. This phenomenon is very general across social species, but explanations have been particular to the species and context, including antipredatory responses, deflection of responsibility, or increase in uncertainty. Here we show that the impact of social information in realistic decision-making typically increases with adversity, giving more weight to the choices of the majority. The conditions for this social magnification are very natural, but were absent in previous decision-making models due to extra assumptionsthat simplified mathematical analysis, like very low levels of stochasticity or the assumption that when one option is good the other one must be bad. We show that decision-making in collectives can quantitatively explain the different impact of social influence with different levels of adversity for different species and contexts, including life-threatening situations in fish and simple experiments in humans.

scholarly journals Associations of hysteroscopic features of chronic endometritis with pregnancy outcomes of in vitro fertilization: A retrospective study

2021 ◽  
Author(s):  
Hui Wang ◽  
Chang-hong Liu ◽  
Cui-fang Hao
Keyword(s):  
Retrospective Study ◽  
Embryo Transfer ◽  
Pregnancy Outcomes ◽  
Birth Rate ◽  
Standardized Patients ◽  
Miscarriage Rate ◽  
Fresh Embryo Transfer ◽  
Chronic Endometritis ◽  
The Impact

Abstract The impact of the hysteroscopic features of chronic endometritis (CE) on pregnancy outcomes is unclear. This study explored whether the morphological features of CE on hysteroscopy were associated with in vitro fertilization (IVF) pregnancy outcomes. This retrospective study was conducted at Yantai Yuhuangding Hospital from 01/2017 to 09/2018. Infertile women who underwent hysteroscopy before IVF were grouped according to CE. To decrease confounding, a group of standardized patients was selected from the women enrolled in this study to compare pregnancy outcomes between the CE and non-CE groups. The outcomes were clinical pregnancy rate (CPR), live birth rate (LBR), miscarriage rate, and premature birth rate. In this study, 3280 women underwent IVF, and 3179 of these patients underwent hysteroscopy. In standardized patients, significant differences were found between the CE and non-CE groups in CPR (54.3% vs. 65.6%, P=0.02) and LBR (45.7% vs. 58.3%, P=0.012). In patients who underwent fresh embryo transfer, CPR differed among groups (P=0.002) and was highest in the hemorrhagic spots group (61.7%). In patients who underwent frozen embryo transfer (FET), CPR was higher in the CE group than in the non-CE group (54.7% vs. 43.0%, P<0.001), highest in the hemorrhagic spots group (70.6%, P=0.002) and lowest in the hyperemia combined with micropolyps group (39.4%, P=0.022). The only factor independently associated with CPR was hysteroscopic features of CE (odds ratio: 1.47, 95% confidence interval: 1.21–1.80, P<0.001). Hysteroscopic features of CE are associated with adverse pregnancy outcomes after IVF.

scholarly journals Depressive Disorders and Incidence of COVID-19: Is There a Correlation and Management Interference?

2020 ◽  
pp. 1-7
Author(s):  
Nagwa Ali Sabri ◽  
Nagwa Ali Sabri ◽  
Mohamed Ahmed Raslan ◽  
Eslam Mansour Shehata ◽  
Sara Ahmed Raslan
Keyword(s):  
Insulin Resistance ◽  
Depressive Disorder ◽  
Depressive Disorders ◽  
Virus Disease ◽  
The Other ◽  
Acute Pneumonia ◽  
Threatening Condition ◽  
Life Threatening ◽  
Respiratory Droplets ◽  
The Impact

Corona virus Disease-2019 is a new strain of Coronaviruses (COVID-19) causing an infection which has rapidly spread all over the Globe, where the primary pathways of infection spreading reported to be through large respiratory droplets and the disease severity has varied from mild self-limiting flu like illness to acute pneumonia, respiratory collapse and death. On the other hand, depression is a disease that could be progress to a life-threatening condition that affects globally hundreds of millions of people. The aim of this review is desired to investigate and find a correlation between depressive disorders and the incidence of COVID19, where, pathogeneses of depressive disorder and its effect on the immunity system was addressed, besides the impact of depression on individual food intake and its complications regarding weight gain, insulin resistance, and immune system disruption was also discussed which by turn might increase the risk for infection with COVID-19. Finally, the possible drug-drug interactions between drugs included in management protocols of both depressive disorder including antidepressants and anxiolytics and COVID19 with possible proposed alternatives.

scholarly journals A Retrospective Study on the Impact of Bar Flipping on the Recurrence of Pectus Excavatum after the Nuss Procedure

2021 ◽  
Author(s):  
Yu-Jiun Fan ◽  
Po-Cheng Lo ◽  
Yuan-Yu Hsu ◽  
I-Shiang Tzeng ◽  
Bo-Chun Wei ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Pectus Excavatum ◽  
Slope Angle ◽  
Chest Radiographs ◽  
The Other ◽  
Nuss Procedure ◽  
Patient Groups ◽  
Lateral Chest ◽  
The Impact ◽  
Improvement Index

Abstract BackgroundThe Nuss procedure is widely used to correct pectus excavatum. Bar displacement is a common complication associated with this procedure. How the flipping of the bar affects pectus excavatum recurrence has not been reported. In our study, we discuss this and also offer an easier method to determine bar flipping.MethodsThis retrospective study analyzed pectus excavatum patients who underwent primary Nuss repair from August 2014 to December 2018. The preoperative and postoperative Haller indices were measured on chest radiographs (cxrHI). The slope angle of bar flipping (α) was measured on lateral chest radiographs. The improvement index after surgical repair was calculated by: ([preoperative cxrHI-postoperative cxrHI]/preoperative cxrHI×100). The impact of α on the improvement index was analyzed using one-way analysis of variance and receiver operating characteristic tests.ResultsIn this study, 359 adult and adolescent patients with an average age of 23.9±7.7 years were included. We formed four subgroups based on the α value: α ≤ 10° (n=131), α = 11-20° (n=154), α = 21-30° (n=51), and α > 30° (n=23). The mean improvement indices in these groups were 27%, 28%, 26%, and 13%, respectively. Patients with α > 30° were associated with a significantly poorer improvement index than those from the other subgroups (p<0.001).ConclusionsThe α value is an alternative measurement method for presenting the radiological outcomes after the Nuss procedure. An α > 30° indicates a possible recurrence of pectus excavatum after the Nuss repair. Surgical revision may be considered in patients with an α > 30°, while monitoring should be considered in the other patient groups.

scholarly journals A retrospective study on the impact of bar flipping on the recurrence of pectus excavatum after the Nuss procedure

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Yu-Jiun Fan ◽  
Po-Cheng Lo ◽  
Yuan-Yu Hsu ◽  
I-Shiang Tzeng ◽  
Bo-Chun Wei ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Pectus Excavatum ◽  
Slope Angle ◽  
Chest Radiographs ◽  
The Other ◽  
Nuss Procedure ◽  
Patient Groups ◽  
Lateral Chest ◽  
The Impact ◽  
Improvement Index

Abstract Background The Nuss procedure is widely used to correct pectus excavatum. Bar displacement is a common complication associated with this procedure. How the flipping of the bar affects pectus excavatum recurrence has not been reported. In our study, we discuss this and also offer an easier method to determine bar flipping. Methods This retrospective study analyzed pectus excavatum patients who underwent primary Nuss repair from August 2014 to December 2018. The preoperative and postoperative Haller indices were measured on chest radiographs (cxrHI). The slope angle of bar flipping (α) was measured on lateral chest radiographs. The improvement index after surgical repair was calculated by: ([preoperative cxrHI-postoperative cxrHI]/preoperative cxrHI × 100). The impact of α on the improvement index was analyzed using one-way analysis of variance and receiver operating characteristic tests. Results In this study, 359 adult and adolescent patients with an average age of 23.9 ± 7.7 years were included. We formed four subgroups based on the α value: α ≤ 10° (n = 131), α = 11–20° (n = 154), α = 21–30° (n = 51), and α > 30° (n = 23). The mean improvement indices in these groups were 27%, 28%, 26%, and 13%, respectively. Patients with α > 30° were associated with a significantly poorer improvement index than those from the other subgroups (p < 0.001). Conclusions The α value is an alternative measurement method for presenting the radiological outcomes after the Nuss procedure. An α > 30° indicates a possible recurrence of pectus excavatum after the Nuss repair. Surgical revision may be considered in patients with an α > 30°, while monitoring should be considered in the other patient groups.

scholarly journals Prescription Opioid Use Among Populations of Reproductive Age: Effects on Fertility, Pregnancy Loss, and Pregnancy Complications

2020 ◽  
Author(s):  
Kerry S Flannagan ◽  
Lindsey A Sjaarda ◽  
Sunni L Mumford ◽  
Enrique F Schisterman
Keyword(s):  
Pregnancy Outcomes ◽  
Pregnancy Complications ◽  
Pregnancy Loss ◽  
Opioid Use Disorder ◽  
Reproductive Age ◽  
Prescription Opioid ◽  
Opioid Use ◽  
Short Term ◽  
Prescription Opioid Use ◽  
The Impact

Abstract Prescription opioid use is common among men and women of reproductive age, including during assisted-reproduction procedures. Opioid use disorder and chronic use are associated with harms to fertility and pregnancy outcomes, but it is unclear whether these associations extend to common short-term patterns of prescription opioid use. We conducted a literature review using PubMed, Embase, Web of Science, and Scopus to identify studies of nonchronic, nondependent opioid use and reproductive endpoints including fertility, pregnancy loss, and pregnancy complications (i.e., preterm birth, birth weight, gestational diabetes, and hypertensive disorders of pregnancy). Seventeen studies were included. Although results of the studies suggest possible harms of short-term opioid use on fertility and pregnancy loss, methodologic limitations and the small number of studies make the literature inconclusive. This review highlights important data gaps that must be addressed to make conclusions about potential reproductive effects of short-term opioid use. These include the need for additional data on opioid use before clinically recognized pregnancy; accurate measurement of opioid exposure by multiple means with detailed information on the types and quantity of opioids used; assessment of important confounders, including opioid use indication, comorbidities, and use of other medications and substances; and studies of paternal opioid use, fertility, and pregnancy outcomes. A primary limitation of this review targeting studies of nonchronic opioid exposure is the possibility that selected studies included populations with unspecified chronic or dependent opioid use. Efforts to understand the impact of the prescription opioid epidemic should address potential reproductive harms of these medications among people of reproductive age.

scholarly journals Fetal growth restriction as the initial finding of preeclampsia is a clinical predictor of maternal and neonatal prognoses: a single-center retrospective study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Masaya Takahashi ◽  
Shintaro Makino ◽  
Kyoko Oguma ◽  
Haruka Imai ◽  
Ai Takamizu ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Fetal Growth ◽  
Pregnancy Outcomes ◽  
Pregnancy Complications ◽  
Fetal Growth Restriction ◽  
Premature Birth ◽  
Adverse Pregnancy Outcomes ◽  
Growth Restriction ◽  
Hypertensive Disorder ◽  
Adverse Pregnancy

Abstract Background Preeclampsia (PE) is a hypertensive disorder specific to pregnancy that can cause severe maternal-neonatal complications. The International Society for the Study of Hypertension in Pregnancy revised the PE criteria in 2018; a PE diagnosis can be established in the absence of proteinuria when organ or uteroplacental dysfunction occurs. The initial findings of PE (IFsPE) at the first diagnosis can vary considerably across patients. However, the impacts of different IFsPE on patient prognoses have not been reported. Thus, we investigate the predictors of pregnancy complications and adverse pregnancy outcomes based on IFsPE according to the new criteria. Methods This retrospective study included 3729 women who delivered at our hospital between 2015 and 2019. All women were reclassified based on the new PE criteria and divided into three groups based on the IFsPE: Classification 1 (C-1), proteinuria (classical criteria); Classification 2 (C-2), damage to other maternal organs; and Classification 3 (C-3), uteroplacental dysfunction. Pregnancy complications and adverse pregnancy outcomes were assessed and compared among the three groups. Results In total, 104 women with PE were included. Of those, 42 (40.4%), 28 (26.9%), and 34 (32.7%) were assigned to C-1, C-2, and C-3 groups, respectively. No significant differences in maternal characteristics were detected among the three groups, except for gestational age at PE diagnosis (C-1, 35.5 ± 3.0 weeks; C-2, 35.2 ± 3.6 weeks; C-3, 31.6 ± 4.6 weeks, p <  0.01). The rates of premature birth at < 37 weeks of gestation, fetal growth restriction (FGR), and neonatal acidosis were significantly higher in the C-3 group compared to the C-1 and C-2 groups. Additionally, the composite adverse pregnancy outcomes of the C-3 group compared with C-1 and C-2 represented a significantly higher number of patients. Conclusions PE patients with uteroplacental dysfunction as IFsPE had the most unfavorable prognoses for premature birth, FGR, acidosis, and composite adverse pregnancy outcomes.

Pregnancy after 24 Postoperative Months of Roux-En-Y Gastric Bypass Presents Risk of Pregnancy Complications Similar to Pregnancy within the First Postoperative Year

2019 ◽  
Vol 75 (1) ◽  
pp. 24-30 ◽  
Author(s):  
Sabrina Cruz ◽  
Andrea Matos ◽  
Suelem Cruz ◽  
Silvia Pereira ◽  
Carlos Saboya ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Gastric Bypass ◽  
Urinary Tract Infection ◽  
Retrospective Study ◽  
Birth Weight ◽  
Urinary Tract ◽  
Tract Infection ◽  
Pregnancy Complications ◽  
The Other ◽  
Time Interval

Background: To assess the influence of the time interval between pregnancy and the Roux-en-Y gastric bypass (RYGB) on maternal-infant complications. Methods: This is an analytical, longitudinal and retrospective study comprising 42 pregnant women who had previously undergone RYGB, subdivided according to the time interval between pregnancy and bariatric surgery: ≤12 months (G1), >12 and <24 months (G2) and ≥24 months (G3). Anthropometric variables of mothers, newborns and information on pregnancy complications were collected. Results: G1 was the group more likely to develop urinary tract infection, dumping syndrome and inadequacy of birth weight than G2. Pregnancy complications were similar and >80.0% both in the first 12 months and after 24 months of the RYGB and the smallest percentages occurred in the time interval of 12–24 months after it. In addition, the percentage of neonatal complications was the highest in G1 when compared to the other times studied. Conclusion: Our findings indicate less predisposition to maternal-infant complications in pregnancies occurring in the time interval of >12 and <24 months and suggest that pregnancy after 24 months can be as harmful as pregnancies occurring before the first 12 postoperative months, since a great catabolism occurs at this time as it has been shown in the literature.

scholarly journals Impact of SARS-CoV-2 Infection on Pregnancy Outcomes: A Population-Based Study

2021 ◽  
Author(s):  
Francesca Crovetto ◽  
Fàtima Crispi ◽  
Elisa Llurba ◽  
Rosalia Pascal ◽  
Marta Larroya ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Preterm Delivery ◽  
Pregnancy Outcomes ◽  
Pregnancy Complications ◽  
Primary Outcome ◽  
Fetal Distress ◽  
Population Based ◽  
Rt Pcr ◽  
Population Based Study ◽  
The Impact

Abstract Background A population-based study to describe the impact of SARS-CoV-2 infection on pregnancy outcomes. Methods Prospective, population-based study including pregnant women consecutively attended at first/second trimester or at delivery at three hospitals in Barcelona, Spain. SARS-CoV-2 antibodies (IgG and IgM/IgA) were measured in all participants and nasopharyngeal RT-PCR was performed at delivery. The primary outcome was a composite of pregnancy complications in SARS-CoV-2 positive versus negative women: miscarriage, preeclampsia, preterm delivery, perinatal death, small-for-gestational age, neonatal admission. Secondary outcomes were components of the primary outcome plus abnormal fetal growth, malformation, intrapartum fetal distress. Outcomes were also compared between positive symptomatic and positive asymptomatic SARS-CoV-2 women. Results Of 2,225 pregnant women, 317 (14.2%) were positive for SARS-CoV-2 antibodies (n=314, 99.1%) and/or RT-PCR (n=36, 11.4%). Among positive women, 217 (68.5%) were asymptomatic, 93 (29.3%) had mild COVID-19 and 7 (2.2%) pneumonia, of which 3 required intensive care unit admission. In women with and without SARS-CoV-2 infection, the primary outcome occurred in 43 (13.6%) and 268 (14%), respectively [risk difference -0.4%, (95% CI: -4.1% to 4.1)]. As compared with non-infected women, women with symptomatic COVID-19 had increased rates of preterm delivery (7.2% vs. 16.9%, p=0.003) and intrapartum fetal distress (9.1% vs. 19.2%, p=0.004), while asymptomatic women had similar rates to non-infected cases. Among 143 fetuses from infected mothers, none had anti-SARS-CoV-2 IgM/IgA in cord blood. Conclusions The overall rate of pregnancy complications in women with SARS-CoV-2 infection was similar to non-infected women. However, symptomatic COVID-19 was associated with modest increases in preterm delivery and intrapartum fetal distress.

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