scholarly journals Effectiveness of Prenatal Tdap Immunization in the Prevention of Infant Pertussis in the United States

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S68-S68
Author(s):  
Sylvia Becker-Dreps ◽  
Anne M Butler ◽  
Leah J McGrath ◽  
Kim A Boggess ◽  
David J Weber ◽  
...  
Keyword(s):  
United States ◽  
Pregnant Women ◽  
Gestational Age ◽  
Clinical Effectiveness ◽  
The United States ◽  
Optimal Timing ◽  
Third Trimester ◽  
The Third ◽  
Control And Prevention ◽  
Insurance Claims Data

Abstract Background The Centers for Disease Control and Prevention recommends that all pregnant women in the United States receive tetanus-diphtheria-acellular pertussis (Tdap) immunization to prevent infant pertussis. While the vaccine may be administered at any time during pregnancy, the recommendations define administration at 27 to 36 weeks of gestation as optimal timing to prevent infant pertussis. These recommendations were primarily based on immunogenicity studies. The objective of this study was to examine the clinical effectiveness of prenatal Tdap, and to understand whether effectiveness varies by gestational age at immunization. Methods We performed a nationwide cohort study of pregnant women with deliveries in 2010–2014 and their infants. Commercial insurance claims data were used to identify receipt of Tdap immunization in the pregnant women, and hospitalizations and outpatient visits for pertussis in their infants until 18 months of age. To address the difficulties in diagnosing pertussis, we also employed a “probable pertussis” definition, as an inpatient or outpatient diagnosis of pertussis, plus antibiotic treatment with a macrolide or trimethoprim/sulfamethoxazole within 7 days of diagnosis. Pertussis occurrence was compared between infants of mothers who received prenatal Tdap (overall, and stratified by gestational age at administration) and infants of unvaccinated mothers. Results There were 675,167 mother–infant pairs included in the cohort. Among infants whose mothers received Tdap at any time during pregnancy, the rate of pertussis hospitalization was 50% lower (adjusted hazards ratio (HR) = 0.50, 95% CI: 0.23, 1.09), and the rate of probable pertussis was 42% lower (HR = 0.58, 95% CI: 0.38, 0.89) than infants of unimmunized mothers. Pertussis rates were also lower for infants whose mothers received prenatal Tdap during the third trimester. Infants whose mothers received Tdap before the third trimester also tended to have lower rates of pertussis, but these estimates were imprecise. Conclusion Infants of mothers who received prenatal Tdap experienced half the rate of pertussis as compared with infants of unimmunized mothers. Our results do not provide evidence to support changing the currently recommended timing of Tdap administration in pregnancy. Disclosures S. Becker-Dreps, Pfizer: Consultant and Grant Investigator, Consulting fee and Research grant; A. M. Butler, Astra Zeneca: Consultant, Support to institution; Amgen: Grant Investigator, Investigator initiated grant to institution; 
D. J. Weber, Merck: Consultant and Speaker’s Bureau, Consulting fee and Speaker honorarium; Pfizer: Consultant, Consulting fee; J. B. Layton, Merck: Member of Center for Pharmacoepidemiology, Support to institution; GlaxoSmithKline: Member of Center for Pharmacoepidemiology, Support to institution; UCB Biosciences: Member of Center for Pharmacoepidemiology, Support to institution

The sFlt-1 to PlGF Ratio in Pregnant Women with Rheumatoid Arthritis: Impact of Disease Activity and Sulfasalazine Use

Rheumatology ◽  
2021 ◽  
Author(s):  
Rugina I Neuman ◽  
Hieronymus T W Smeele ◽  
A H Jan Danser ◽  
Radboud J E M Dolhain ◽  
Willy Visser
Keyword(s):  
Rheumatoid Arthritis ◽  
Cohort Study ◽  
Disease Activity ◽  
Pregnant Women ◽  
Gestational Age ◽  
Third Trimester ◽  
Low Disease Activity ◽  
The Third ◽  
Observational Prospective Cohort Study ◽  
Plgf Ratio

Abstract Objectives An elevated sFlt-1/PlGF-ratio has been validated as a significant predictor of preeclampsia, but has not been established in women with rheumatoid arthritis (RA). We explored whether the sFlt-1/PlGF-ratio could be altered due to disease activity in RA, and could be applied in this population to predict preeclampsia. Since sulfasalazine has been suggested to improve the angiogenic imbalance in preeclampsia, we also aimed to examine whether sulfasalazine could affect sFlt-1 or PlGF levels. Methods Making use of a nationwide, observational, prospective cohort study on pregnant women with RA, sFlt-1 and PlGF were measured in the third trimester. A total of 221 women, aged 21–42 years, were included, with a median gestational age of 30 + 3 weeks. Results No differences in sFlt-1 or PlGF were observed between women with high, intermediate or low disease activity (p= 0.07 and p= 0.41), whereas sFlt-1 and PlGF did not correlate with DAS28-CRP score (r=-0.01 and r=-0.05, respectively). Four (2%) women with a sFlt-1/PlGF-ratio ≤38 developed preeclampsia in comparison to three (43%) women with a ratio > 38, corresponding to a negative predictive value of 98.1%. Sulfasalazine users (n = 57) did not show altered levels of sFlt-1 or PlGF in comparison to non-sulfasalazine users (n = 164, p= 0.91 and p= 0.11). Conclusion Our study shows that in pregnant women with RA, the sFlt-1/PlGF-ratio is not altered due to disease activity and a cut-off ≤38 can be used to exclude preeclampsia. Additionally, sulfasalazine use did not affect sFlt-1 or PlGF levels in this population.

scholarly journals Correlation study between increased fetal movement during the third trimester and neonatal outcome

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Cuiqin Huang ◽  
Wei Han ◽  
Yajing Fan
Keyword(s):  
Amniotic Fluid ◽  
Pregnant Women ◽  
Gestational Age ◽  
Neonatal Outcome ◽  
Stress Test ◽  
Neonatal Outcomes ◽  
Control Group ◽  
Third Trimester ◽  
The Third ◽  
Fetal Movements

Abstract Background We aimed to analyze the correlation between increased fetal movements in the third trimester and neonatal outcomes. Methods We enrolled pregnant women (n = 219) who reported increased/excessive fetal movements in the third trimester in our hospital. A control group of healthy women (n = 278) who had undergone regular childbirth and delivery in our hospital during the same period and did not report abnormal fetal movements were also recruited. All pregnant women underwent fetal non-stress test. We analyzed the neonatal weight, appearance, pulse, grimace, activity, and respiration score, degrees of amniotic fluid contamination, amniotic fluid volume, conditions of umbilical cord around the neck and cord length, and incidence of small for gestational age. In addition, the incidence of preterm delivery, cesarean section rate, postpartum hemorrhage, and other postpartum complications were also analyzed. We then analyzed the correlation between increased/excessive fetal activity and neonatal outcomes. Results Women with complaints of increased/excessive fetal movements exhibited increased fetal movements mainly around 31 and 39 weeks of gestation. Several pregnancy variables, including number of previous delivery, gestational age (less than 34 weeks and more than 37 weeks) and vaginal birth rate, were associated with increased/excessive fetal movements. In addition, women who reported increased/excessive fetal movements had higher odds of large for gestational age (LGA), particularly those with gestational age over 37 weeks. Conclusion Increased/excessive fetal movements may be used to predict adverse neonatal outcome such as LGA.

scholarly journals Preterm and term rupture of the amniotic sac in the third trimester: outcomes for mother and child

2021 ◽  
Vol 12 (4) ◽  
pp. 12-19
Author(s):  
E. V. Enkova ◽  
A. S. Fomina ◽  
V. V. Enkova ◽  
O. V. Khoperskaya
Keyword(s):  
Pregnant Women ◽  
Gestational Age ◽  
Pregnancy Outcomes ◽  
Neonatal Intensive Care ◽  
Latency Period ◽  
Breech Presentation ◽  
Maternity Hospital ◽  
Third Trimester ◽  
The Third ◽  
Prelabor Rupture Of Membranes

Objective: To evaluate the characteristics of women in labor and pregnancy outcomes at different gestational periods with preterm prelabor rupture of membranes (PPROM) and preterm rupture of membranes (PROM) in the third trimester of pregnancy.Materials and Methods: The study included pregnant women in the third trimester, at the gestation period of 28-41.6 weeks of pregnancy, divided into groups of PROM and PPROM: 173 (80.8%) and 41 (19.2%) pregnant women, respectively.Results: It was found that PPROM is associated with a significantly lower gestational age, higher levels of C-reactive protein, and higher body temperature upon admission to the maternity hospital (P <0.05). Breech presentation and history of cesarean section were significantly associated with PPROM (P < 0.05), rather than PROM. The PPROM group had a significantly longer latency period compared to the PROM group, in which the latency period increased with a lower gestational age (28–31.6 weeks). A significantly higher rate of admission to the neonatal intensive care unit (NICU) was observed in the PPROM group compared to the PROM group. Also, at the gestational age of 28-31.6 weeks, a significantly higher rate of admission to the NICU was revealed compared to the gestational age of 32-36. 6 weeks (P < 0.05).Conclusions: The purpose of this retrospective study was to evaluate the characteristics of women in labor and pregnancy outcomes at different gestational periods with PPROM and PROM in the third trimester of pregnancy.

scholarly journals Evaluation of a federally funded mass media campaign and smoking cessation in pregnant women: a population-based study in three states

BMJ Open ◽  
2017 ◽  
Vol 7 (12) ◽  
pp. e016826 ◽  
Author(s):  
Lucinda England ◽  
Van T Tong ◽  
Karilynn Rockhill ◽  
Jason Hsia ◽  
Tim McAfee ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Pregnant Women ◽  
Population Based ◽  
Federally Funded ◽  
Third Trimester ◽  
The Third ◽  
Quit Attempts ◽  
Control And Prevention ◽  
Former Smokers ◽  
Adjusted Logistic Regression

ObjectivesIn 2012, theCenters for Disease Control and Prevention initiated a national anti-smoking campaign,Tips from Former Smokers(Tips). As a result of the campaign, quit attempts among smokers increased in the general population by 3.7 percentage points. In the current study, we assessed the effects ofTipson smoking cessation in pregnant women.MethodsWe used 2009–2013 certificates of live births in three US states: Indiana, Kentucky and Ohio. Smoking cessation by the third trimester of pregnancy was examined among women who smoked in the 3 months prepregnancy. Campaign exposure was defined as overlap between the airing ofTips2012 (March 19–June 10) and the prepregnancy and pregnancy periods. Women who delivered beforeTips2012 were not exposed. Adjusted logistic regression was used to determine whether exposure toTipswas independently associated with smoking cessation.ResultsCessation rates were stable during 2009–2011 but increased at the timeTips2012 aired and remained elevated. Overall, 32.9% of unexposed and 34.7% of exposed smokers quit by the third trimester (p<0.001). Exposure toTips2012 was associated with increased cessation (adjusted OR: 1.07, 95% CI 1.05 to 1.10).ConclusionsExposure to a national anti-smoking campaign for a general audience was associated with smoking cessation in pregnant women.

Midwifery Care for Pregnant Women With Back Pain Discomfort in Trimester III Pregnancy at the Karunia Birth Clinic, Sidoarjo.

Academia Open ◽  
2021 ◽  
Vol 5 ◽  
Author(s):  
Anggraeni Kriswidya Putri ◽  
Hanik Machfudloh
Keyword(s):  
Back Pain ◽  
Data Collection ◽  
Pregnant Women ◽  
Gestational Age ◽  
Analysis Data ◽  
Second Trimester ◽  
Third Trimester ◽  
Midwifery Care ◽  
The Third ◽  
Maternity Clinic

Pregnancy is a process that begins with the unification of spermatozoa with ovum called fertilization and then continued with implantation. Normal pregnancies generally last for 9 months, and are divided into the first 3 trimesters 1-12 weeks, the second trimester 13-27 weeks, the third trimester 28-40 weeks. Various complaints felt by pregnant women, one of which is back pain that causes pregnant women discomfort. This aerikel was written taken from the place of Maternity Clinic Karunia Sidoarjo on January 05, 2020. The way of data collection is by means of anamnesa, examination of analysis, data then documenting by comparing between the data that has been obtained with existing theories. Mrs. .m 40 weeks gestational age, with complaints of physiological back pain with good maternal and fetal conditions.

OBSTETRIC TACTICS FOR COVID - 19(LITERATURE REVIEW)

2021 ◽  
pp. 9-14
Author(s):  
Ж.С. БЕГНИЯЗОВА ◽  
Б.Н. БИЩЕКОВА ◽  
Н.Ж. ДЖАРДЕМАЛИЕВА ◽  
А.М. МУХАМЕДОВА ◽  
Ф.А. АРИФОВА ◽  
...  
Keyword(s):  
United States ◽  
Risk Factors ◽  
Infant Mortality ◽  
Literature Review ◽  
Pregnant Women ◽  
The United States ◽  
Ultrasound Scan ◽  
Third Trimester ◽  
Neonatal Complications ◽  
Management Protocol

Статья посвящена одной из актуальных проблем современного акушерства на сегодняшний день - Covid-19.На сегодняшний день нет достаточного количества наблюдений за беременными женщинами, инфицированными Covid-19, однако некоторые наблюдения за инфицированными беременными в Китае, США, России позволяют сделать некоторые выводы. Таким образом, Covid-19 наиболее опасен во втором и третьем триместре с учетом нагрузок на разные системы организма. Ни в коем случае нельзя забывать и про факторы риска самой беременности. Чтобы не увеличивать процент материнской или младенческой смертности, не надо забывать о периоде, когда больная должна проходить скрининги. Все беременные независимо от коронавируса должны проходить обследования в четко установленные протоколом ведения беременности сроки. Своевременно сдавать анализы, проводить УЗИ, консультироваться у врача. Не пропускать сроков акушерского скрининга - это гарантия снижения акушерских и неонатальных осложнений. To date, there are not enough observations of pregnant women infected with COVID-19, however, some observations of infected pregnant women in China, the United States, Russia allow us to draw some conclusions. Thus, COVID-19 is most dangerous in the second and third trimester, taking into account the loads on different body systems. In no case should we forget about the risk factors of pregnancy itself. In order not to increase the percentage of maternal or infant mortality, one should not forget about the period when the patient should be screened. All pregnant women, regardless of the coronavirus, must undergo examinations within the periods clearly established by the pregnancy management protocol. Timely take tests, conduct an ultrasound scan, consult a doctor. Not missing the deadlines for obstetric screening is a guarantee of reducing obstetric and neonatal complications.

scholarly journals Survey of Obstetrician-Gynecologists in the United States About Toxoplasmosis

2001 ◽  
Vol 9 (1) ◽  
pp. 23-31 ◽  
Author(s):  
Jeffrey L. Jones ◽  
Vance J. Dietz ◽  
Michael Power ◽  
Adriana Lopez ◽  
Marianna Wilson ◽  
...  
Keyword(s):  
United States ◽  
Pregnant Women ◽  
False Positive ◽  
Universal Screening ◽  
The United States ◽  
Research Network ◽  
Educational Materials ◽  
The Past ◽  
Control And Prevention ◽  
Acute Toxoplasmosis

Background:Although the incidence of toxoplasmosis is low in the United States, up to 6000 congenital cases occur annually. In September 1998, the Centers for Disease Control and Prevention held a conference about toxoplasmosis; participants recommended a survey of the toxoplasmosis-related knowledge and practices of obstetrician-gynecologists and the development of professional educational materials for them.Methods:In the fall of 1999, surveys were mailed to a 2% random sample of American College of Obstetricians and Gynecologists (ACOG) members and to a demographically representative group of ACOGmembers known as theCollaborative Ambulatory Research Network(CARN). Responses were not significantly different for the random and CARN groups for most questions (pvalue shown when different).Results:Among 768 US practicing ACOG members surveyed, 364 (47%) responded. Seven per cent (CARN 10%, random 5%) had diagnosed one or more case(s) of acute toxoplasmosis in the past year. Respondents were well-informed about how to prevent toxoplasmosis. However, only 12% (CARN 11%, random 12%) indicated that a positiveToxoplasmaIgM test might be a false–positive result, and only 11% (CARN 14%, random 9%) were aware that the Food and Drug Administration sent an advisory to all ACOG members in 1997 stating that someToxoplasmaIgM test kits have high false–positive rates. Most of those surveyed (CARN 70%, random 59%;X2p< 0.05) were opposed to universal screening of pregnant women.Conclusions:Many US obstetrician-gynecologists will encounter acute toxoplasmosis during their careers, but they are frequently uncertain about interpretation of the laboratory tests for the disease. Most would not recommend universal screening of pregnant women.

scholarly journals Influence of Sampling Time on Salivary Oestriol Concentrations in Pregnant Women

1984 ◽  
Vol 21 (1) ◽  
pp. 22-25 ◽  
Author(s):  
Paulette E Cusick ◽  
Peter L Truran ◽  
Graham F Read ◽  
William C Alston
Keyword(s):  
At Risk ◽  
Pregnant Women ◽  
Gestational Age ◽  
Early Morning ◽  
Sampling Time ◽  
Sample Collection ◽  
Third Trimester ◽  
Normal Range ◽  
The Third ◽  
The Difference

Saliva specimens were collected at weekly intervals during the third trimester of 61 uncomplicated pregnancies. Oestriol concentrations, measured in samples collected in the early morning from fasting, recumbent subjects, were used to construct a provisional normal range. This proved to be higher than the corresponding normal range reported from another laboratory applying the same method to samples obtained at random from a different population of ambulant subjects. Interlaboratory variation in the assay of salivary oestriol was not sufficient to account for the difference in normal range. It is concluded that consideration should be given to the timing of sample collection if salivary oestriol concentration is to be monitored as a possible means of assessing fetoplacental function. A normal range for salivary oestriol concentration versus gestational age obtained from women sampled randomly may not be appropriate for monitoring patients with ‘at-risk’ pregnancies who are normally bed-rested.

Cross‐national comparison of family dynamics during the third trimester of pregnancy in the United States and Iceland

1996 ◽  
Vol 17 (2) ◽  
pp. 97-107 ◽  
Author(s):  
Marjorie A. White ◽  
Margaret E. Wilson ◽  
Barbara Tomlinson ◽  
Margrét Tómasdóttir
Keyword(s):  
United States ◽  
Family Dynamics ◽  
The United States ◽  
Third Trimester ◽  
The Third ◽  
National Comparison ◽  
Cross National

scholarly journals Tingkat Kecemasan Berhubungan dengan Kualitas Tidur Ibu Hamil Trimester III

2021 ◽  
Vol 2 (2) ◽  
pp. 52
Author(s):  
Eline Charla Sabatina Bingan
Keyword(s):  
Sleep Quality ◽  
Pregnant Women ◽  
Health Center ◽  
The United States ◽  
Anxiety Level ◽  
Poor Sleep ◽  
Third Trimester ◽  
Correlation Test ◽  
The Third

Pregnancy is a biological and psychological condition which certainly requires adaptation for women who are experiencing it. In the United States there are 40 million people experiencing anxiety disorders before childbirth. Third trimester pregnant women often feel afraid and anxious about the child who will be born later, so that pregnant women experience sleep quality disturbances. The purpose of this study was to determine the relationship between anxiety level and sleep quality of third trimester pregnant women at Ketapang Health Center. This type of quantitative research with a cross sectional approach. The population was 130 respondents in the third trimester of pregnant women at the Ketapang Health Center. The number of samples was 45 respondents using purposive sampling technique. Sleep quality variables used the PSQI (Pittsburgh Sleep Quality Index) questionnaire and the anxiety level variables used the HARS (Hamilton Rating Scale For Anxiety) questionnaire with data analysis tests using the Spearman Rho correlation test with a 95% confidence level. The results of the bivariate analysis showed that respondents who experienced mild anxiety with good sleep quality were 3 people (60%) and respondents who experienced severe anxiety with poor sleep quality were 15 people (83.3%). The correlation test between Anxiety Level and Sleep Quality for Third Trimester Pregnant Women obtained p value = 0.000, so it can be concluded that there is a relationship between anxiety levels and sleep quality for third trimester pregnant women at the Ketapang Health Center. Future research is expected to use other factors that can affect the quality of sleep of pregnant women, especially in the third trimester of pregnancy.

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