scholarly journals Reproductive History and Burden of Adverse Pregnancy Outcomes in Women in Southern India (P11-006-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Amy Fothergill ◽  
Yan Ping Qi ◽  
Krista Crider ◽  
Christina Johnson ◽  
Wesley Bonam ◽  
...  
Keyword(s):  
Birth Defects ◽  
Pregnancy Outcomes ◽  
Cleft Lip ◽  
Reproductive History ◽  
Reproductive Age ◽  
Southern India ◽  
Women Of Reproductive Age ◽  
Community Based Research ◽  
Live Births ◽  
Talipes Equinovarus

Abstract Objectives To characterize the reproductive history and pregnancy outcomes in women of reproductive age as part of an ongoing periconceptional surveillance program in Southern India. Methods Participants were women of reproductive age (15-40 y) who were not pregnant or lactating and resided in households within the 50 km2 catchment area of our community-based research site in Southern India (n = 813). After obtaining informed consent/assent, reproductive and obstetric histories were captured by a trained OB/GYN nurse via an electronic interviewer-administered questionnaire with the study participants. Results In this population, most participants reported being married (76.1%) and having some formal education (83.7%), with a median age of 30 (interquartile range [IQR] 24, 36) years. The average age of menarche reported was 13.0 (IQR 12.0, 14.0) years, and the median age at first pregnancy was 19.0 (IQR 17.0, 21.0) years. A total of 76.6% of women reported at least one previous pregnancy; 7.9% were primiparous and 65.7% were multiparous, with a median of 2.0 (IQR 2.0, 2.0) children currently living per woman. Approximately 80% of women reported taking any iron (80.4%) or folic acid (77.9%) supplements at any point during pregnancy. To date, women reported a total of 1,614 previous pregnancies with 1,318 live births (n = 1,308 singleton live births, n = 5 sets of twins), 169 spontaneous abortions, 94 induced abortions, and 42 stillbirths. Fifteen pregnancies were reported to have been affected by birth defects (n = 1 cleft lip, n = 2 cleft palate with cleft lip, n = 2 talipes equinovarus/clubfoot, n = 3 spina bifida, n = 3 encephalocele, n = 1 anencephaly, and n = 3 other birth defects). A total of 48 women reported a biological relative with a birth defect diagnosed at birth. Conclusions A substantial burden of birth defects was reported in this population (7 neural tube defects in 1,614 pregnancies). Findings from this survey will inform the establishment of an ongoing birth defects surveillance system and a randomized efficacy trial for prevention of anemia and birth defects in Southern India. Funding Sources Centers for Disease Control and Prevention. AF was supported by the National Institutes of Health #5 T32 HD087137

scholarly journals Periconceptional surveillance for prevention of anaemia and birth defects in Southern India: protocol for a biomarker survey in women of reproductive age

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e038305
Author(s):  
Julia L Finkelstein ◽  
Amy Fothergill ◽  
Christina B Johnson ◽  
Heather M Guetterman ◽  
Beena Bose ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Birth Defects ◽  
Population Based ◽  
Medical Centre ◽  
Reproductive Age ◽  
Southern India ◽  
Vitamin B ◽  
Micronutrient Deficiencies ◽  
Women Of Reproductive Age ◽  
Registration Number

IntroductionWomen of reproductive age (WRA) are a high-risk population for anaemia and micronutrient deficiencies. Evidence supports the role of periconceptional nutrition in the development of adverse pregnancy complications. However, in India, there are limited population-based data to guide evidence-based recommendations and priority setting. The objective of this study is to conduct a population-based biomarker survey of anaemia and vitamin B12 and folate status in WRA as part of a periconceptional surveillance programme in Southern India.MethodsWRA (15–40 years) who are not pregnant or lactating and reside within 50 km2 of our community research site in Southern India will be screened and invited to participate in the biomarker survey at our research facility at Arogyavaram Medical Centre. After informed consent/assent, structured interviews will be conducted by trained nurse enumerators to collect sociodemographic, dietary, anthropometry, health and reproductive history data. Venous blood samples will be collected at enrolment; whole blood will be analysed for haemoglobin. Plasma, serum and red blood cells (RBCs) will be processed and stored <−80°C until batch analysis. Vitamin B12 concentrations will be measured via chemiluminescence, and RBC and serum folate concentrations will be evaluated using the World Health Organisation (WHO)-recommended microbiological assay at our laboratory in Bangalore. A WHO surveillance system will also be established to determine the baseline prevalence of birth defects in this setting.Ethics and disseminationThis study has obtained clearance from the Health Ministry Screening Committee of the Indian Council of Medical Research. The study protocol was reviewed and approved by the Institutional Review Board at Cornell University and the Institutional Ethics Committees at Arogyavaram Medical Centre and St. John’s Research Institute. Findings from this biomarker survey will establish the burden of anaemia and micronutrient deficiencies in WRA and directly inform a randomised trial for anaemia and birth defects prevention in Southern India. The results of this study will be disseminated at international research conferences and as published articles in peer-reviewed journals.Trial registration numbersClinical trials registration number NCT04048330, NCT03853304 and Clinical Trials Registry of India (CTRI) registration number REF/2019/03/024479.

scholarly journals Health Education to Prevent Anemia Among Women of Reproductive Age in Southern India

2006 ◽  
Vol 27 (2) ◽  
pp. 131-144 ◽  
Author(s):  
Pernilla Ny ◽  
Elisabeth Dejin-Karlsson ◽  
Giggi Udén ◽  
Ted Greiner
Keyword(s):  
Health Education ◽  
Reproductive Age ◽  
Southern India ◽  
Women Of Reproductive Age

scholarly journals Endometrium and polycystic ovary syndrome

2018 ◽  
Vol 67 (4) ◽  
pp. 60-66
Author(s):  
Pavel P Yakovlev ◽  
Igor Yu Kogan
Keyword(s):  
Endometrial Cancer ◽  
Polycystic Ovary Syndrome ◽  
Pregnancy Outcomes ◽  
Polycystic Ovary ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Ovary Syndrome ◽  
Endocrine Disorder ◽  
Increased Risk ◽  
Adverse Pregnancy

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age. Patients with PCOS present with several endometrial abnormalities possibly explaining some of the adverse endometrium-related outcomes in these women. PCOS is inconsistently associated adverse pregnancy outcomes and an increased risk of endometrial cancer. The purpose of this review is to systematize the available data on endometrial dysfunction associated with PCOS. (For citation: Yakovlev PP, Kogan IYu. Endometrium and polycystic ovary syndrome. Journal of Obstetrics and Women’s Diseases. 2018;67(4):60-66. doi: 10.17816/JOWD67460-66).

scholarly journals Pregnancy outcomes from the global pharmacovigilance database on interferon beta-1b exposure

2020 ◽  
Vol 13 ◽  
pp. 175628642091031 ◽  
Author(s):  
Kerstin Hellwig ◽  
Fernando Duarte Caron ◽  
Eva-Maria Wicklein ◽  
Aasia Bhatti ◽  
Alessandra Adamo
Keyword(s):  
Cohort Study ◽  
Health Status ◽  
Spontaneous Abortion ◽  
Birth Defects ◽  
Pregnancy Outcomes ◽  
Congenital Anomalies ◽  
Interferon Beta ◽  
Live Births ◽  
Congenital Birth Defects ◽  
Pharmacovigilance Database

Background: The goal of the present cohort study was to review outcomes of patients exposed to interferon beta-1b during pregnancy. Methods: Pregnancy cases with exposure to interferon beta-1b reported to Bayer’s pharmacovigilance (PV) database from worldwide sources from January 1995 through February 2018 were retrieved for evaluation. Only cases where pregnancy outcomes were unknown at the time of reporting (i.e. prospective cases) were included in the analysis of this retrospective cohort study. Results: As of February 2018, 2581 prospective pregnancies exposed to interferon beta-1b were retrieved from the database; 1348 pregnancies had documented outcomes. The majority of outcomes [1106 cases (82.0%)] were live births. Health status was known for 981 live births (no known health status for 125). Most of the prospective pregnancies with known outcomes corresponded to live births with no congenital anomalies [896 cases (91.3%)]. Spontaneous abortion occurred in 160 cases (11.9%). Congenital birth defects were observed in 14/981 live births with known health status [1.4%, 95% confidence interval (CI) 0.78–2.38]. No consistent pattern in the type of birth defect was identified. Rates of both spontaneous abortion and birth defects were not higher than the general population. Conclusions: These PV data, the largest sample of interferon beta-1b-exposed patients reported to date, suggest no increase in risk of spontaneous abortion or congenital anomalies in women exposed during pregnancy.

Incidence of Cleft Lip and Palate and Risks of Additional Malformations

1998 ◽  
Vol 35 (1) ◽  
pp. 40-45 ◽  
Author(s):  
Catharina Hagberg ◽  
Ola Larson ◽  
Josef Milerad
Keyword(s):  
Birth Weight ◽  
Birth Defects ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Live Births ◽  
Different Types ◽  
Mother’S Age ◽  
Rate Ratios ◽  
Isolated Cleft Palate ◽  
Similar Incidence

Objective and Methods Children with cleft lip and/or palate (n = 251) born between 1991 and 1995 in the county of Stockholm, Sweden, were studied with reference to incidence and rate ratios (RRs) of different types of clefts, gender, birth weight, mother's age, and length of pregnancy. Children who had clefts and additional malformations were compared with children who had clefts but no additional malformations. Results The incidence of clefts was 2.0/1000 live births, and it was higher among males than among females. The RR, an index of relative risk, was 1.58. The main groups, children with isolated cleft lip, children with cleft lip and palate, and children with isolated cleft palate, showed similar incidence values (0.6-0.7/1000 live births). Children with bilateral clefts had an incidence of 0.3/1000 live births. Additional malformations were found in approximately every sixth newborn with a cleft when children with Robin sequence were excluded. There was a tendency for newborns with bilateral clefts to have additional malformations (RR = 1.36; confidence interval = 0.74-2.49). Children with clefts and additional malformations had lower birth weight and were born earlier than children with clefts only. Conclusion Preterm cleft children with low birth weight should be screened for the presence of other birth defects.

scholarly journals PATHOGENETIC ASPECTS OF METABOLIC SYNDROME IN WOMEN OF REPRODUCTIVE AGE (A LITERATURE REVIEW)

2019 ◽  
Vol 26 (2) ◽  
pp. 162-172
Author(s):  
Nina D. Kastueva ◽  
Tatyana D. Tsidaeva ◽  
Zalina F. Belikova ◽  
Liana V. Maysuradze
Keyword(s):  
Risk Factors ◽  
Metabolic Syndrome ◽  
Pregnancy Outcomes ◽  
Polycystic Ovary ◽  
Reproductive Age ◽  
Cochrane Library ◽  
Bibliographic Databases ◽  
Published Data ◽  
Women Of Reproductive Age ◽  
Adverse Pregnancy

Aim. The aim of this work was to analyze recently published data on the risk factors and pathogenetic aspects of metabolic syndrome (MS) in women of reproductive age.Materials and methods. This review covers data presented in foreign and Russian literature, which has been published in electronic bibliographic databases Pubmed and the Cochrane Library over the past 10 years. Specifi cally, we carried out an analysis of works containing information on risk factors, pathogenetic aspects and diagnostic criteria of MS in women of reproductive age, as well as on methods currently used for the treatment of this condition.Results. We characterize modern theories that explain mechanisms triggering the development of MS complicated with diabetes 2 type and polycystic ovary syndrome (PCOS). Data on proteomic markers refl ecting the complex pathogenesis of PCOS is generalized, along with their role in the diagnosis and treatment of this disease. The possibility of using these markers for predicting pregnancy outcomes is shown. The importance of regulating metabolic processes for the preparation of women for pregnancy and fertility recovery is emphasized.Conclusion. Hyperandrogenism, insulin resistance, obesity, diabetes 2 type, dyslipidemia, PCOS are shown to be the most signifi cant factors determining pathological changes in fertile age women with metabolic syndrome. The correction of these factors should be included in the course of pregravid preparation for the prevention of adverse pregnancy outcomes. 

scholarly journals Childlessness among women of reproductive age in Serbia from a demographic perspective

Stanovnistvo ◽  
2021 ◽  
pp. 2-2
Author(s):  
Goran Penev ◽  
Biljana Stankovic
Keyword(s):  
Marital Status ◽  
Age Groups ◽  
Single Women ◽  
Married Women ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Female Population ◽  
Live Births ◽  
Childless Women ◽  
The Postponement

The social, economic, and cultural changes that have taken place in Europe in the past few decades in the field of fertility have been accompanied by an increase in permanent childlessness. The childlessness level among women born in 1968 is 12% in Serbia, slightly below the European average (14%). The aim of this paper is to explore in more detail the level of childlessness in Serbia and the characteristics of women aged 15-49 without live births. Changes in childlessness over a 60-year period (1961-2020) by five-year age groups were analysed. The basic characteristics of childless women of reproductive age by education, marital status, and age were observed from 1991 to 2011. The paper is based on census and vital statistics data. The authors introduce two new indicators of childlessness: the general childlessness rate (GChR) as the share of women without live births in the total female population aged 15-49, and the age-specific childlessness rate (ASChR) as the percentage of childless women by age. Changes in cumulative fertility rates by age were less influenced by the reproductive behaviour of mothers and much more by an increase in the proportion of childless women. The general childlessness rate until 1991 was relatively stable in Serbia. Since then, it has increased intensely (from 30.1% in 1991 to 41.6% in 2011, and 43.4% in 2020). The increase in childlessness is largely a consequence of the postponement of first births, but also of the increase in permanent childlessness among women aged 45-49. The postponement of first births has occured in all age groups and the ASChR has increased across the board. In Serbia, in 2020, the ASChR reached record values for all five-year age groups (36.5% for women aged 30-34, 21.4% for ages 35-39), as did the level of permanent childlessness (13.8% for ages 45-49). The paper also analyses childlessness by education and marital status. According to census data (1991, 2002, and 2011), the general childlessness rate is lowest among women without any formal education and those who haven?t completed primary school, and highest among women with a primary education. Childlessness rates are particularly high among women in their thirties and forties. The influence of marital status on the level of childlessness was also confirmed. The GChR of single women was at least 10 times higher than the value for ever married women. The GChR ranged from 96% to 89% for single women and invariably slightly above 8% for ever married women. The results of direct standardization showed the greater importance of the changes that occurred between 1991 and 2011 by education and marital status of women aged 15-49 on the childlessness level, as well as their completely opposite effects compared to those caused by the change in the age structure. The large impact of changes in marital structure also indicates the possibility of a certain influence on reducing childlessness in Serbia. As the decreasein marriage is not accompanied by a higher prevalence of stable extramarital unions, it?s possible that the creation of more favourable circumstances for an independent life for young people and for forming a union could contribute to reducing the postponement of childbearing, and thus reducing childlessness during and at the end of the reproductive age. This is especially important considering that family and children are highly valued in Serbia. It should be noted that the high and growing shares of women without children in the 30-34 and 35-39 age groups limit the possibilities of reducing permanent childlessness, particularly in the near future.

scholarly journals Anemia and Iron Status in Women of Reproductive Age in Southern India

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 826-826
Author(s):  
Julia Finkelstein ◽  
Amy Fothergill ◽  
Heather Guetterman ◽  
Christina Johnson ◽  
Beena Bose ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Disease Control ◽  
Reproductive Age ◽  
Southern India ◽  
Deficiency Anemia ◽  
Severe Anemia ◽  
Women Of Reproductive Age ◽  
Blood Samples ◽  
Control And Prevention ◽  
Roche Diagnostics

Abstract Objectives To conduct a biomarker survey to examine the burden of anemia, iron deficiency, and inflammation in women of reproductive age in Southern India. Methods Participants were women of reproductive age (15–40 y; n = 980) who were not pregnant or lactating and resided in households within the 50 km,2 catchment area of our periconceptional surveillance program in Southern India. Venous blood samples were collected at enrollment by a trained laboratory technician at our research facility. Whole blood samples were analyzed for hemoglobin (Hb) using an automated Coulter counter. Plasma, serum, and red blood cells were separated by centrifugation, processed, and stored &lt;−80°C until analysis. Serum ferritin (SF) was measured by electrochemiluminescence (E411, Roche Diagnostics Mannheim). Soluble transferrin receptor (sTfR), C-reactive protein (CRP), and alpha-1 acid glycoprotein (AGP) were analyzed via the Roche COBAS Integra 400 plus analyzer (Roche Diagnostics). Anemia and severe anemia were defined as hemoglobin &lt;12.0 g/dL and &lt;8.0 g/dL, respectively. Serum ferritin concentrations were adjusted for inflammation using BRINDA methods. Iron deficiency was defined as SF &lt; 15.0 µg/L, and iron deficiency anemia was defined as Hb &lt; 12.0 g/dL and SF &lt; 15.0 µg/L. Inflammation was defined as elevated CRP or AGP concentrations, using established cut-offs (CRP &gt; 5.0 mg/L, AGP &gt; 1.0 g/L). Results A total of 41.1% of women were anemic and 2.9% had severe anemia. In the biomarker analyses, 53.8% of women were iron deficient (67.2% after BRINDA adjustment) and 29.1% had iron deficiency anemia (31.2% after BRINDA adjustment). A total of 14.7% of women had elevated CRP levels (&gt;5.0 mg/L) and 24.4% had elevated AGP (&gt;1.0 g/L) concentrations. Conclusions The substantial burden of anemia and iron deficiency in this study population suggest an opportunity for prevention of anemia and micronutrient deficiencies. Findings from this biomarker survey will inform the development of a randomized efficacy trial for the prevention of anemia and birth defects in Southern India. Funding Sources This study was supported by the Centers for Disease Control and Prevention (CDC), and the University of South Carolina's Disability Research and Dissemination Center through its cooperative agreement with the Centers for Disease Control and Prevention. AF was supported by the National Institutes of Health.

053 Pregnancy outcomes with delayed-release dimethyl fumarate: interim results from an international registry

2018 ◽  
Vol 89 (6) ◽  
pp. A22.1-A22
Author(s):  
Nicholas J Everage ◽  
Shifang Liu ◽  
Jang Yun ◽  
Claudia Prada ◽  
Jerome Hanna
Keyword(s):  
Birth Defects ◽  
Pregnancy Outcomes ◽  
Ductus Arteriosus ◽  
Dimethyl Fumarate ◽  
Essential Information ◽  
Live Births ◽  
Delayed Release ◽  
International Registry ◽  
Post Marketing ◽  
Reported Data

IntroductionClinical trials and post marketing reports show no safety signals with delayed-release dimethyl fumarate (DMF) exposure during pregnancy; however, these data are limited and the product label recommends use during pregnancy only if the potential benefit justifies the potential risk to the foetus. We assessed pregnancy outcomes in an ongoing international registry (NCT01911767) of women with MS exposed to DMF since the first day of their last menstrual period prior to conception or at any time during pregnancy.MethodsDMF-exposed women were prospectively evaluated for live births and pregnancy loss. Ectopic and molar pregnancies, birth defects, congenital anomalies or infant death occurring at ≤52 weeks of age, and maternal death at ≤12 weeks post-delivery, were reported. Data were collected at baseline (enrolment), 6–7 months of gestation, 4 weeks after the estimated delivery date, and 4, 12, and 52 weeks after birth. Potential birth defects were adjudicated by an external expert.ResultsAs of 30, Sept 2016 104 patients were enrolled in the registry; mean (SD) age was 315 years. DMF exposure occurred in the first (95%), second (1%), and third (0%) trimester in the 94 patients with a known exposure date. To date, 58 pregnancy outcomes have been reported, including 52 patients with 54 live births and 4 (7%) spontaneous abortions (<22 weeks). Of the 54 (93%) live births, 47 (87%) were full term (delivered ≥37 weeks) and four (7%) premature. Two (4%) infants had adjudicator-confirmed birth defects; one with pyloric stenosis, and one with transposition of the great vessels/patent ductus arteriosus. No maternal, neonatal, perinatal, or infant deaths were reported.ConclusionThe results from this ongoing registry did not identify a safety signal for DMF exposure on pregnancy outcomes, are consistent with previous reports, and provide essential information concerning exposure to DMF during pregnancy.

scholarly journals Psychological Aspects in Children with Cleft Lip and/or Palate: a Brief Commentary on Some Relevant Findings for Health Teams

2019 ◽  
Vol 23 (3) ◽  
pp. 89-91
Author(s):  
Marcos Roberto Tovani-Palone
Keyword(s):  
Environmental Factors ◽  
Birth Defects ◽  
Cleft Lip ◽  
Psychological Aspects ◽  
Live Births ◽  
Genetic And Environmental Factors

Cleft lip and/or palate (CL/P) are among the most prevalent of all birth defects in human, affecting approximately 1:700 live births(1). The etiology of CL/P is thought to be multifactorial, involving an interaction between genetic and environmental factors (2,3).

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