Maternal hypertensive disorders, antihypertensive medication use, and the risk of birth defects: a case-control study

Introduction Basal plate myometrium (BPMYO), the pathological presence of myometrial fibers in the basal plate, is a common finding on pathological examination of the placenta, yet its clinical correlates are not well studied. As myometrial fibers are frequently located in proximity to poorly converted maternal spiral arteries, our objective was to determine whether BPMYO is associated with hypertensive disorders of pregnancy (HDP), a well-known clinical sequela of abnormal maternal artery remodeling. Methods This case–control study included women who delivered a live-born singleton gestation whose placentas were sent for pathological examination. Cases were women with HDP (gestational hypertension, preeclampsia, or HELLP syndrome) as defined by American College of Obstetricians and Gynecologists. Controls were women without HDP. Women with chronic hypertension were excluded. The primary outcome was the presence of BPMYO. Secondary outcomes included the pathologic stage of BPMYO and the incidence of pathologically defined accreta. Each outcome was compared between cases and controls in bivariable and multivariable analyses. Results Of the 306 women who met inclusion criteria, 230 (75%) had HDP. BPMYO was present in 99 (32%) of placentas. Compared to controls, cases were younger, had higher body mass index, and were more likely to have diabetes, be nulliparous, deliver preterm, and have had a prior cesarean. There were no differences in the incidence of BPMYO, stage of BPMYO, or incidence of pathologically defined accreta between cases and controls. These findings persisted after controlling for potential confounders. Conclusions Although BPMYO may be more common in the setting of abnormal placental vasculature, there is no significant association between BPMYO and HDP.

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Risk of Multiple Myeloma following Medication Use and Medical Conditions: A Case-Control Study in Connecticut Women

Cancer Epidemiology Biomarkers & Prevention ◽

10.1158/1055-9965.epi-06-0097 ◽

2006 ◽

Vol 15 (12) ◽

pp. 2342-2347 ◽

Cited By ~ 44

Author(s):

Ola Landgren ◽

Yawei Zhang ◽

Sheila Hoar Zahm ◽

Peter Inskip ◽

Tongzhang Zheng ◽

...

Keyword(s):

Multiple Myeloma ◽

Case Control Study ◽

Medication Use ◽

Case Control ◽

Medical Conditions ◽

Control Study

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Testing for Interaction between Maternal Smoking and TGFA Genotype among Oral Cleft Cases Born in Maryland 1992–1996

The Cleft Palate-Craniofacial Journal ◽

10.1597/1545-1569_1997_034_0447_tfibms_2.3.co_2 ◽

1997 ◽

Vol 34 (5) ◽

pp. 447-454 ◽

Cited By ~ 17

Author(s):

Terri H. Beaty ◽

Nancy E. Maestri ◽

Jacqueline B. Hetmanski ◽

Diego F. Wyszynski ◽

Craig A. Vanderkolk ◽

...

Keyword(s):

Birth Defects ◽

Maternal Smoking ◽

Case Control Study ◽

Case Control ◽

Comprehensive Treatment ◽

Environment Interaction ◽

Oral Clefts ◽

Oral Cleft ◽

Increased Risk ◽

Control Study

Objective: Infants born in Maryland between June 1992 and June 1996 were used in a case-control study of nonsyndromic oral clefts to test for effects of maternal smoking and a polymorphic genetic marker at the transforming growth factor alpha (TGFA) locus, both of which have been reported to be risk factors for these common birth defects. Design and Setting: Cases were infants with an oral cleft ascertained through three comprehensive treatment centers, with additional ascertainment through a registry of birth defects maintained by the Maryland Health Department. Controls were healthy infants. Medical history information on infants and mothers were collected, along with DNA samples Patients, Participants: Among 286 cases contacted (72% ascertainment), there were 192 nonsyndromic isolated oral clefts (106 M; 86 F) available for this case-control study. Main Outcome Measures: The largest group of 149 Caucasian nonsyndromic cases and 86 controls was used to test for association with maternal smoking and genotype at the Taq1 polymorphism in TGFA. Results: While this modest sample had limited statistical power to detect gene-environment interaction, there was a significant marginal Increase In risk of having an oral cleft If the mother smoked (odds ratio = 1.75, 95%CI = 1.01 to 3.02). We could not demonstrate statistical interaction between maternal smoking and TGFA genotype in this study, however, and the observed increase in the C2 allele among cases was not statistically significant. Conclusions: We could not confirm either the reported association between oral clefts and TGFA genotype or its interaction with maternal smoking. However, these data do show an increased risk if the mother smoked during pregnancy, and this effect was greatest among infants with a bilateral cleft and no close family history of clefts.

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Determinants of Low APGAR score in Newborns Delivered at Lemlem Karl General Hospital, Northern Ethiopia, 2018: A Case Control Study

10.21203/rs.3.rs-32019/v1 ◽

2020 ◽

Author(s):

Mussie Mulugeta Gebremedhin ◽

Mengistu Welday Gebremichael ◽

Berhane Gebreegizabiher Gebremichael ◽

Mihrete-ab Mehari Reda ◽

Tesfay Adhena Hailu ◽

...

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

General Hospital ◽

Apgar Score ◽

Case Control Study ◽

Case Control ◽

Northern Ethiopia ◽

Determinant Factors ◽

Hypertensive Disorders ◽

Control Study

Abstract BACKGROUND: The Apgar score is a method to quickly summarize the health of newborn children. It establishes a simple and clear classification of newborns, which could be used to predict survival and to compare methods of resuscitation and perinatal experience across hospitals and obstetric practices. Low Apgar score is associated with various immediate and long-term adverse health outcomes of newborns. Hence; in order to decrease the risk/complications, identifying the determinant factors of low Apgar is crucial to act on the modifiable risk factors. This study is aimed to investigate the determinant factors of a low Apgar score in newborn children.METHOD: The study was conducted in Lemelem Karl general hospital; northern Ethiopia. An institutional-based unmatched, case-control study was implemented. Data were retrieved from medical charts of 662 newborns’ mothers who gave birth in the hospital from Sep 2014 to Sep 2017. Among these, 221 of them were cases (charts of mothers whose newborns’ fifth minute Apgar score was <7) and 441 of them were controls (charts of mothers whose newborns’ Apgar score was 7 and above). Data was collected using a pretested and structured checklist using systematic sampling and data was entered & analyzed using SPSS version 20. Binary and multivariable logistic regression was done to determine the association and statistical significance was declared at P-value of ≤0.05. RESULTS: This study revealed that low Apgar score was significantly associated with antepartum hemorrhage [Adjusted odss ratio (AOR) 3.509; 95% confidence interval (CI) 1.526-8.067), P= 0.003], pregnancy-induced hypertensive disorders [AOR 2.69; 95% CI (1.351-5.357), P= 0.005], prolonged second stage of labor [AOR 2.63; 95% CI (1.399-4.944), P= 0.003], Cesarean delivery [AOR 2.005; 95%CI (1.223-3.287), P= 0.006],meconium-stained liquor [AOR 6.955; 95% CI (3.721-13.001), P<0.001], and low birth weight [AOR 4.38; 95% CI (2.216-8.657), P<0.001].CONCLUSION: Result from this study showed a remarkable linkage of low Apgar score with antepartum hemorrhage, pregnancy-induced hypertensive disorders, meconium-stained liquor, and low birth weight. Therefore, meticulous antenatal care and labour management service are recommended to prevent low Apgar score and the concomitant neonatal death.

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