The impact of total gonadotropin dose on spontaneous abortion rates and early pregnancy outcomes in infertile couples undergoing gonadotropin induction/intrauterine insemination cycles

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.

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The influence of disease activity on pregnancy outcomes in women with inflammatory bowel disease: A systematic review and meta-analysis

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjaa225 ◽

2020 ◽

Author(s):

Min-A Kim ◽

Young-Han Kim ◽

Jaeyoung Chun ◽

Hye Sun Lee ◽

Soo Jung Park ◽

...

Keyword(s):

Systematic Review ◽

Preterm Birth ◽

Disease Activity ◽

Spontaneous Abortion ◽

Pregnancy Outcomes ◽

Meta Analysis ◽

Cochrane Library ◽

Increased Risk ◽

Adverse Pregnancy ◽

The Impact

Abstract Background & Aims Robust evidence regarding the impact of disease activity on pregnancy outcomes in women with IBD is crucial for both clinicians and patients in preparing a birth plan. We sought to perform a systematic review and meta-analysis to assess the pooled influences of disease activity on pregnancy outcomes in women with IBD. Methods We searched MEDLINE, EMBASE, and COCHRANE library to identify articles comparing pregnancy outcomes between active and inactive IBD at the time of conception or during pregnancy. A meta-analysis was performed using a random-effects model to pool estimates and report odds ratios (ORs). Results A total of 28 studies were identified as eligible for the meta-analysis. In women with active IBD, the pooled ORs for low birth weight (LBW), preterm birth, small for gestational age (SGA), spontaneous abortion, and stillbirths were 3.81 (95% confidence interval [CI] 1.81-8.02), 2.42 (95% CI 1.74-3.35), 1.48 (95% CI 1.19-1.85), 1.87 (95% CI 1.17-3.0), and 2.27 (95% CI 1.03-5.04) compared to women with inactive IBD, respectively. In the subgroup analysis based on disease type, women with active ulcerative colitis had an increased risk of LBW, preterm birth, and spontaneous abortion. Women with active Crohn’s disease had a higher risk of preterm birth, SGA, and spontaneous abortion. Conclusions Active IBD during the periconception period and pregnancy is associated with increased risk of adverse pregnancy outcomes. Our data suggest that pregnancy should be planned when the disease is quiescent, and continuous disease control is important even during pregnancy.

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Predictive value of serum β-hCG for early pregnancy outcomes among women with recurrent spontaneous abortion

International Journal of Gynecology & Obstetrics ◽

10.1016/j.ijgo.2016.03.007 ◽

2016 ◽

Vol 135 (1) ◽

pp. 16-21 ◽

Cited By ~ 2

Author(s):

Yinglin Liu ◽

Yukun Liu ◽

Xuejiao Li ◽

Xuedan Jiao ◽

Rui Zhang ◽

...

Keyword(s):

Spontaneous Abortion ◽

Early Pregnancy ◽

Pregnancy Outcomes ◽

Predictive Value ◽

Recurrent Spontaneous Abortion ◽

Β Hcg

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The Impact of the Coronavirus Disease 19 Pandemic on Early Pregnancy Outcomes Among Patients Undergoing In Vitro Fertilization Treatment

Women's Health Reports ◽

10.1089/whr.2021.0054 ◽

2021 ◽

Vol 2 (1) ◽

pp. 473-478

Author(s):

Devora Aharon ◽

Dmitry Gounko ◽

Joseph A. Lee ◽

Alan B. Copperman ◽

Eric Flisser

Keyword(s):

In Vitro Fertilization ◽

Early Pregnancy ◽

Pregnancy Outcomes ◽

Vitro Fertilization ◽

The Impact

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Association of Maternal-Neonatal Steroids With Early Pregnancy Endocrine Disrupting Chemicals and Pregnancy Outcomes

Journal of the Endocrine Society ◽

10.1210/jendso/bvab048.1637 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. A805-A805

Author(s):

Margaret Banker ◽

Muraly Puttabyatappa ◽

Patrick O’Day ◽

Jaclyn M Goodrich ◽

Angela S Kelley ◽

...

Keyword(s):

Early Pregnancy ◽

Pregnancy Outcomes ◽

Maternal Age ◽

Endocrine Disrupting Chemicals ◽

Real Life ◽

Principal Component ◽

Cumulative Impact ◽

Fetal Sex ◽

Endocrine Disrupting ◽

The Impact

Abstract Steroids are important for fetal development and parturition, and aberrant exposure during gestation can lead to abnormal fetal outcome. Gestational exposures to endocrine disrupting chemicals (EDCs) have the potential to alter pregnancy steroidal milieu. Most studies to date have focused on individual EDCs, when in real life humans are exposed to a host of EDCs in parallel, emphasizing the need to consider cumulative impact. To meet this goal, 121 pregnant women (18-42 years of age) were recruited between 8 and 14 weeks of gestation from Southeastern Michigan, and maternal samples at recruitment and delivery were collected, as well as neonatal cord blood. Maternal and neonatal steroids were measured by liquid chromatography/tandem mass spectrometry (LC-MS/MS) in blood samples collected from 121 mother-infant dyads of spontaneously conceived singleton pregnancies. A total of 41 EDCs encompassing commonly encountered environmental EDCs (phenols and phthalates), metals and metalloids were quantified in early pregnancy maternal urine from a subset (56 dyads) via LC-MS/MS. Maternal and neonatal steroid levels from all 121 subjects were related to pregnancy outcomes and, in the subset, individual and uniquely weighted EDC mixtures were related to steroid milieu. Additionally, the influence of BMI, maternal age, and offspring sex in modulating the EDC associations with steroids were determined. To determine the association of steroids at each time point with pregnancy outcomes or individual EDCs, multiple linear regression was used. Correlations between the steroids and potential confounding variables were analyzed using Spearman correlation. The cumulative effect of EDC mixtures generated by Principal Component Analysis on steroid measures was determined using Principal Component regression. The Benjamini-Hochberg False Discovery Rate procedure was employed to account for the multiple outcomes in each analysis. The findings showed 1) steroid-specific positive or negative associations with pregnancy measures; (2) many maternal first trimester EDCs were negatively associated with estrogens and positively with androgen/estrogen ratios; (3) EDC-steroid associations were influenced by maternal age, pre-pregnancy BMI, and fetal sex and (4) EDCs individually and as mixtures showed direct and inverse fetal sex-dependent associations with maternal and neonatal steroids. These findings indicate that maternal and neonatal steroids influence pregnancy outcomes depending on maternal age, pre-pregnancy BMI, and fetal sex and that the effects of EDCs on steroids differs when considered individually or as mixtures. Our results suggest that steroid measures might serve as biomarkers for the impact of EDC exposures on fetal outcomes during pregnancy, but these measures must be corrected for maternal factors. (Supported by P01 ES022844/RD 83543601, 1U2C ES026553, P30 ES017885)

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Association of Maternal-Neonatal Steroids with Early Pregnancy Endocrine Disrupting Chemicals and Pregnancy Outcomes

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/clinem/dgaa909 ◽

2020 ◽

Author(s):

Margaret Banker ◽

Muraly Puttabyatappa ◽

Patrick O’Day ◽

Jaclyn M Goodrich ◽

Angela S Kelley ◽

...

Keyword(s):

Early Pregnancy ◽

Pregnancy Outcomes ◽

Maternal Age ◽

Endocrine Disrupting Chemicals ◽

Real Life ◽

First Trimester ◽

University Hospital ◽

Fetal Sex ◽

Endocrine Disrupting ◽

The Impact

Abstract Context Steroids play an important role in fetal development and parturition. Gestational exposures to endocrine disrupting chemicals (EDCs) affect steroidal milieu and pregnancy outcomes, raising the possibility of steroids serving as biomarkers. Most studies have not addressed the impact of EDC mixtures, which are reflective of real life scenarios. Objective Assess the association of maternal and neonatal steroids with pregnancy outcomes and early pregnancy EDC levels. Design Prospective analysis of mother-infant dyads. Setting University hospital. Participants 121 mother-infant dyads. Main Outcome Measures The associations of maternal and neonatal steroidal hormones from 121 dyads with pregnancy outcomes, the associations of first trimester EDCs individually and as mixtures with maternal and neonatal steroids in a sub-set of 56 dyads and the influence of BMI, age and offspring sex in modulating the EDC associations with steroids were determined. Results (1) Steroid-specific positive or negative associations with pregnancy measures were evident; (2) many maternal first trimester EDCs were negatively associated with estrogens and positively with androgen/estrogen ratios; (3) EDC-steroid associations were influenced by maternal age, pre-pregnancy BMI, and fetal sex and (4) EDCs individually and as mixtures showed direct and inverse fetal sex-dependent associations with maternal and neonatal steroids. Conclusions This proof-of-concept study indicates association of steroids with pregnancy outcomes depending on maternal age, pre-pregnancy BMI, and fetal sex, with the effects of EDCs differing when considered individually or as mixtures. These findings suggest that steroidal hormonal measures have potential to serve as biomarkers of impact of EDC exposures and pregnancy outcome.

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