Reproductive health issues in patients with psoriasis (literature review)

Among patients with psoriasis, approximately 50% are women and almost 75 % of them are under the age of 40 years. Thus, most women with psoriasis have childbearing potential. When pregnancy occurs in 22 % of patients, the activity of psoriasis persists, characteristic of the course before pregnancy, in 23 % of women, the course of the disease worsens. The article provides up-to-date data on the management of pregnant patients with psoriasis. To improve pregnancy outcomes in patients with psoriasis, it is important to prevent exacerbation of the disease. The choice of drug therapy in this case is based on an assessment of the ratio of the risk of undesirable effects of the drugs on the developing fetus and the risk of the development of exacerbation of psoriasis, which can cause an adverse pregnancy outcome. Despite the fact that the available clinical experience of using genetically engineered drugs is still limited, with a certain degree of confidence we can say that there is no increase in the risk of adverse pregnancy outcomes associated with therapy with certolizumab pegol.

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Reproductive health issues in female patients with beta-thalassaemia major: a narrative literature review

Journal of Obstetrics and Gynaecology ◽

10.1080/01443615.2019.1692802 ◽

2020 ◽

Vol 40 (7) ◽

pp. 902-911 ◽

Cited By ~ 1

Author(s):

Malihe Nourollahpour Shiadeh ◽

Elena Cassinerio ◽

Maryam Modarres ◽

Armin Zareiyan ◽

Zeinab Hamzehgardeshi ◽

...

Keyword(s):

Reproductive Health ◽

Literature Review ◽

Thalassaemia Major ◽

Health Issues ◽

Female Patients ◽

Beta Thalassaemia ◽

Narrative Literature ◽

Narrative Literature Review

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Neonatal outcome in pregnant patients with antiphospholipid syndrome

Journal of Perinatal Medicine ◽

10.1515/jpm-2014-0118 ◽

2015 ◽

Vol 43 (6) ◽

Cited By ~ 13

Author(s):

Katarina Jeremic ◽

Aleksandar Stefanovic ◽

Jelena Dotlic ◽

Jelena Stojnic ◽

Sasa Kadija ◽

...

Keyword(s):

Risk Factors ◽

Respiratory Distress Syndrome ◽

Pregnancy Outcome ◽

Pregnancy Outcomes ◽

Distress Syndrome ◽

Adverse Pregnancy Outcome ◽

Perinatal Asphyxia ◽

Premature Delivery ◽

Control Group ◽

Adverse Pregnancy

AbstractThe study aim was to evaluate pregnancy outcomes in patients with antiphospholipid syndrome (APS) and to determine which clinical parameters present risk factors for adverse pregnancy outcomes in these patients.The study included 55 patients with APS treated at the Clinic for Ob/Gyn, Clinical Center of Serbia, from 2006 to 2012. The control group consisted of 55 healthy pregnant women. Data regarding previous pregnancies and conception method were registered. Immunological and laboratory tests were performed. Pregnancy outcomes, including miscarriage, intrauterine fetal death, hypertensive disorders, diabetes mellitus, phlebothrombosis, fetal growth restriction, premature delivery, delivery method, perinatal asphyxia, respiratory distress syndrome, intraventricular hemorrhage, and necrotizing enterocolitis were followed.The premature delivery rate in APS patients was 31.8%, and pregnancy loss was 18.2%. Significantly more patients with APS had thrombocytopenia, pregnancy losses, intrauterine growth restriction, and perinatal asphyxia compared with the control group. More miscarriages, preterm delivery, lower birth weight, preeclampsia, and IgM anticardiolipin antibody levels significantly correlated with adverse pregnancy outcomes. Although rare, respiratory distress syndrome can also worsen neonatal health status. According to ROC analysis, previous miscarriages correctly explained 66.3% of adverse pregnancy outcome cases. We generated four equations of adverse pregnancy outcome risk factors.The most important prognostic factor for pregnancy outcome in APS patients is the number of previous miscarriages. Using appropriate current therapeutic protocol can enable live birth of a healthy newborn in most cases.

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Abstract P176: Associations of Gestational Lipids and Apolipoproteins With Pregnancy Outcomes: The Hyperglycemia and Adverse Pregnancy Outcome Study

Circulation ◽

10.1161/circ.141.suppl_1.p176 ◽

2020 ◽

Vol 141 (Suppl_1) ◽

Author(s):

Amanda M Perak ◽

Alan Kuang ◽

Nicola Lancki ◽

Darwin R Labarthe ◽

Svati H Shah ◽

...

Keyword(s):

Blood Pressure ◽

Pregnancy Outcome ◽

Gestational Age ◽

Pregnancy Outcomes ◽

Adverse Pregnancy Outcome ◽

Late Pregnancy ◽

Large For Gestational Age ◽

Obstetric Outcomes ◽

Outcome Study ◽

Adverse Pregnancy

Introduction: Gestational hyperlipidemia has traditionally been considered physiologic and benign, but the significance of inter-individual variation in lipid levels for maternal-fetal health are poorly understood. We examined associations of gestational lipids and apolipoproteins with adverse obstetric and neonatal outcomes. Methods: Data from the Hyperglycemia and Adverse Pregnancy Outcome Study were analyzed, including 1,813 mother-child dyads from 9 field centers in 6 countries: US (25%), Barbados (24%), UK (20%), China (16%), Thailand (8%), and Canada (7%). Fasting lipids and apolipoproteins were directly measured at a mean of 28 (range 23-34) weeks’ gestation. Cord blood was collected at delivery, neonatal anthropometrics were measured within 72 hours, and medical records were abstracted for obstetric outcomes. Logistic regression was utilized to test associations of lipids and apolipoproteins (per +1 SD; log-transformed if skewed) with pregnancy outcomes, adjusted for center, demographics, and maternal covariates such as BMI, blood pressure, and glycemia. Results: See Table for lipid and apolipoprotein levels in pregnant mothers. In fully adjusted models ( Table ), 1 SD higher log-triglycerides (i.e., ~2.7-fold higher triglyceride level) in late pregnancy was significantly associated with higher odds for preeclampsia (OR 1.53 [95% CI, 1.15-2.05]), large for gestational age infant (1.42 [1.21-1.67]), and infant insulin sensitivity <10 th percentile (1.25 [1.03-1.50]), but not with unplanned primary cesarean section or infant sum of skinfolds >90 th percentile. There were no significant associations of maternal HDL-C, LDL-C, or log-ApoB/A1 ratio with any outcome. Conclusion: Triglyceride levels in the latter half of pregnancy were uniquely associated with both maternal risks (preeclampsia) and neonatal risks (large for gestational age and insulin resistance), even after adjustment for maternal BMI, blood pressure, and glycemia.

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Analysis of the clinical features of pericentric inversion of chromosome 9

Journal of International Medical Research ◽

10.1177/0300060520957820 ◽

2020 ◽

Vol 48 (9) ◽

pp. 030006052095782

Author(s):

Xiaolei Xie ◽

Fuguang Li ◽

Weihe Tan ◽

Jiang Tang

Keyword(s):

Amniotic Fluid ◽

Clinical Features ◽

Pregnancy Outcomes ◽

Pericentric Inversion ◽

Adverse Pregnancy Outcome ◽

Normal Population ◽

Chorionic Villus ◽

Clinical Impact ◽

Chromosome 9 ◽

Adverse Pregnancy

Objective The pericentric inversion of chromosome 9 (inv9) is one of the most common structural balanced chromosomal variations, and it is considered to be a normal population variant. The aim of this study was to re-evaluate the clinical impact of patients with inv9. Methods We studied the karyotypes from 4853 patients at a single center and retrospectively reviewed their clinical data. Results There were 67 inv9 patients among 2988 adults, and 62 of them showed different clinical features, including male and female infertility, oligoasthenozoospermia, and azoospermia. Thirty-one cases of inv9 were found in 1865 fetuses, including two cases in chorionic villus (6.90%) and 29 in amniotic fluid (1.67%), but there were no cases in umbilical cord blood. The rates of fetal phenotype abnormal and adverse pregnancy outcome with inv9 in the chorionic villus were 100.00% (2/2), while only 17.24% (5/29) in the amniotic fluid showed abnormalities, among which 60.00% (3/5) had adverse pregnancy outcomes. Conclusions Although there is no clear evidence that inv9 is pathogenic, the genetic counseling on inv9 in early pregnancy and adults needs to be given more attention.

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COVID-19 and Adverse Pregnancy Outcome: A Systematic Review of 104 Cases

Journal of Clinical Medicine ◽

10.3390/jcm9113441 ◽

2020 ◽

Vol 9 (11) ◽

pp. 3441

Author(s):

Ramy Abou Ghayda ◽

Han Li ◽

Keum Hwa Lee ◽

Hee Won Lee ◽

Sung Hwi Hong ◽

...

Keyword(s):

Systematic Review ◽

Pregnant Women ◽

Pregnancy Outcomes ◽

Adverse Pregnancy Outcome ◽

Mode Of Delivery ◽

Maternal Mortality Ratio ◽

Case Series ◽

Neonatal Outcomes ◽

Treatment Modalities ◽

Adverse Pregnancy

(1) Background: Until now, several reports about pregnant women with confirmed coronavirus disease 2019 (COVID-19) have been published. However, there are no comprehensive systematic reviews collecting all case series studies on data regarding adverse pregnancy outcomes, especially association with treatment modalities. (2) Objective: We aimed to synthesize the most up-to-date and relevant available evidence on the outcomes of pregnant women with laboratory-confirmed infection with COVID-19. (3) Methods: PubMed, Scopus, MEDLINE, Google scholar, and Embase were explored for studies and papers regarding pregnant women with COVID-19, including obstetrical, perinatal, and neonatal outcomes and complications published from 1 January 2020 to 4 May 2020. Systematic review and search of the published literature was done using the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA). (4) Results: In total, 11 case series studies comprising 104 pregnant women with COVID-19 were included in our review. Fever (58.6%) and cough (30.7%) were the most common symptoms. Other symptoms included dyspnea (14.4%), chest discomfort (3.9%), sputum production (1.0%), sore throat (2.9%), and nasal obstruction (1.0%). Fifty-two patients (50.0%) eventually demonstrated abnormal chest CT, and of those with ground glass opacity (GGO), 23 (22.1%) were bilateral and 10 (9.6%) were unilateral. The most common treatment for COVID-19 was administration of antibiotics (25.9%) followed by antivirals (17.3%). Cesarean section was the mode of delivery for half of the women (50.0%), although no information was available for 28.8% of the cases. Regarding obstetrical and neonatal outcomes, fetal distress (13.5%), pre-labor rupture of membranes (9.6%), prematurity (8.7%), fetal death (4.8%), and abortion (2.9%) were reported. There are no positive results of neonatal infection by RT-PCR. (5) Conclusions: Although we have found that pregnancy with COVID-19 has significantly higher maternal mortality ratio compared to that of pregnancy without the disease, the evidence is too weak to state that COVID-19 results in poorer maternal outcome due to multiple factors. The number of COVID-19 pregnancy outcomes was not large enough to draw a conclusion and long-term outcomes are yet to be determined as the pandemic is still unfolding. Active and intensive follow-up is needed in order to provide robust data for future studies.

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Applying deep learning for adverse pregnancy outcome detection with pre-pregnancy health data

MATEC Web of Conferences ◽

10.1051/matecconf/201818910014 ◽

2018 ◽

Vol 189 ◽

pp. 10014 ◽

Cited By ~ 2

Author(s):

Yu Mu ◽

Kai Feng ◽

Ying Yang ◽

Jingyuan Wang

Keyword(s):

Deep Learning ◽

Pregnancy Outcome ◽

Pregnancy Outcomes ◽

Learning Algorithm ◽

Adverse Pregnancy Outcome ◽

Health Data ◽

Adverse Pregnancy Outcomes ◽

Deep Learning Algorithm ◽

Adverse Pregnancy

Adverse pregnancy outcomes can bring enormous losses to both families and the society. Thus, pregnancy outcome prediction stays a crucial research topic as it may help reducing birth defect and improving the quality of population. However, recent advances in adverse pregnancy outcome detection are driven by data collected after mothers having been pregnant. In this situation, if a bad pregnancy outcome is diagnosed, the parents will suffer both physically and emotionally. In this paper, we develop a deep learning algorithm which is able to detect and classify adverse pregnancy outcomes before parents getting pregnant. We train a multi-layer neural network by using a dataset of 75542 couples’ multidimension pre-pregnancy health data. Our model outperforms some of algorithms in accuracy, recall and F1 score.

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Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study: Associations of maternal A1C and glucose with pregnancy outcomes

Diabetes Care ◽

10.2337/dc11-1687 ◽

2012 ◽

Vol 35 (3) ◽

pp. 574-580 ◽

Cited By ~ 124

Author(s):

L. P. Lowe ◽

B. E. Metzger ◽

A. R. Dyer ◽

J. Lowe ◽

D. R. McCance ◽

...

Keyword(s):

Pregnancy Outcome ◽

Pregnancy Outcomes ◽

Adverse Pregnancy Outcome ◽

Adverse Pregnancy

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The Hyperglycemia and Adverse Pregnancy Outcome Study: Associations of GDM and obesity with pregnancy outcomes

Diabetes Care ◽

10.2337/dc11-1790 ◽

2012 ◽

Vol 35 (4) ◽

pp. 780-786 ◽

Cited By ~ 466

Author(s):

P. M. Catalano ◽

H. D. McIntyre ◽

J. K. Cruickshank ◽

D. R. McCance ◽

A. R. Dyer ◽

...

Keyword(s):

Pregnancy Outcome ◽

Pregnancy Outcomes ◽

Adverse Pregnancy Outcome ◽

Outcome Study ◽

Adverse Pregnancy

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Assessment of HCMV-encoded microRNAs in Plasma as Potential Biomarkers in Pregnant Women with Adverse Pregnancy Outcomes

10.21203/rs.3.rs-95116/v1 ◽

2020 ◽

Author(s):

Zhiying Gao ◽

Likun Zhou ◽

Jing Bai ◽

Meng Ding ◽

Deshui Liu ◽

...

Keyword(s):

Pregnant Women ◽

Pregnancy Outcomes ◽

Adverse Pregnancy Outcome ◽

Expression Profiles ◽

Plasma Concentrations ◽

Adverse Pregnancy Outcomes ◽

Immunoglobulin M ◽

Validation Data ◽

Adverse Pregnancy ◽

Normal Controls

Abstract Background: Human cytomegalovirus (HCMV) is the most frequent cause of congenital infections and can lead to adverse pregnancy outcomes (APO). HCMV encodes multiple microRNAs (miRNAs) that have been reported to be partially related to host immune responses, cell cycle regulation, viral replication and viral latency, and can be detected in human plasma. However, the relevance of HCMV-encoded miRNAs in maternal plasma as an indicator for APO has never been evaluated.Methods: The expression profiles of 25 HCMV-encoded miRNAs were first measured in plasma samples from 20 pregnant women with APO and 28 normal controls by quantitative reverse-transcription polymerase chain reaction (RT-qPCR) technology. Next, markedly changed miRNAs were validated in another independent validation set consisting of 20 pregnant women with APO and 27 control subjects. HCMV DNA in peripheral blood leukocytes (PBLs) and anti-HCMV immunoglobulin M (IgM) and anti-HCMV immunoglobulin G (IgG) in plasma were also examined in both the training and validation sets. Diagnostic value and risk factors were compared between adverse pregnancy outcome cohorts and normal controls.Results: The analysis of training and validation data sets revealed that plasma concentrations of hcmv-miR-UL148D, hcmv-miR-US25-1-5p and hcmv-miR-US5-1 were obviously increased in pregnant women with APO compared with normal controls. Hcmv-miR-US25-1-5p presented the largest area under the receiver-operating characteristic (ROC) curve (0.735; 95% CI, 0.635–0.836), with a sensitivity of 68% and specificity of 71%. Furthermore, the plasma levels of hcmv-miR-US25-1-5p and hcmv-miR-US5-1 were obviously positively correlated with APO (P = 0.029 and 0.035, respectively). Nevertheless, neither the concentration of HCMV DNA in PBLs nor the positivity rates of anti-HCMV IgM and IgG in plasma showed statistically significant correlation with APO.Conclusion: We identified a unique signature of HCMV-encoded miRNAs in pregnant women with APO, which may be useful as a potential noninvasive biomarker for predicting and monitoring APO during HCMV infection.

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Reproductive Concerns Among Female Leukemia and Lymphoma Survivors with the History of Adverse Pregnancy Outcomes after Cancer Treatment

Blood ◽

10.1182/blood-2018-99-110590 ◽

2018 ◽

Vol 132 (Supplement 1) ◽

pp. 5893-5893

Author(s):

Ksenya Shliakhtsitsava ◽

Emily Myers ◽

Irene Su

Keyword(s):

Pregnancy Outcome ◽

Pregnancy Outcomes ◽

Adverse Pregnancy Outcome ◽

Adverse Pregnancy Outcomes ◽

The Future ◽

Reproductive Concerns ◽

History Of ◽

Adverse Pregnancy ◽

After Cancer ◽

Lymphoma Survivors

Abstract Introduction Due to advances in cancer treatment the majority of young adults diagnosed with leukemia or lymphoma become long-term survivors. These individuals have been shown to have higher pregnancy risks as a result of cancer and treatment exposure. Adverse pregnancy outcomes including miscarriage and premature delivery may impact survivor's reproductive concerns after cancer. We hypothesized that reproductive-aged female leukemia and lymphoma survivors who experienced miscarriage or premature birth after cancer would have higher reproductive concerns as compared to female leukemia and lymphoma survivors who did not have an adverse pregnancy outcome after cancer. Methods This is a retrospective cohort study of young adult female leukemia and lymphoma survivors with at least one pregnancy after cancer, who are participants of the Reproductive Window study. Study participants were recruited between March 2015 and December 2017 from population-based cancer registries (California and Texas), physician and advocacy group referrals. Eligible women were age 18 to 40 at enrollment, age 15-35 at cancer diagnosis, and had at least one ovary. Enrolled participants answered a questionnaire on pregnancy outcomes and reproductive concerns using the Reproductive Concerns After Cancer (RCAC) Scale. The exposure was adverse pregnancy outcome (miscarriage or premature birth). The outcomes were RCAC subscales measuring concerns regarding becoming pregnant in the future and personal and offspring health. Subscale scores were dichotomized at 3, with >3 indicating moderate to severe reproductive concerns. Logistic regression models were used to test the association between an adverse pregnancy outcome (miscarriage or preterm birth) and RCAC subscales of interest, while adjusting for confounding Results 76 participants, mean age 34.3±3.9 years and mean years since cancer diagnosis 12.0± 5.8 years were included. The majority of participants were white (80%), completed college (72%) and were partnered (87%). Thirty eight percent of participants reported an adverse pregnancy outcome after cancer (18% miscarriage, 21% premature delivery). Thirty-two percent reported moderate to severe concerns about becoming pregnant in the future, 60% regarding offspring health, and 46% over personal health. History of miscarriage after cancer, but not preterm birth, was associated with higher concerns about becoming pregnant. In a multivariable model that adjusted for Hispanic ethnicity, current age, and live birth after cancer, participants who experienced a miscarriage after cancer were more likely to have moderate to high concerns about becoming pregnant in the future (adjusted OR 4.1, 95% CI 1.05-15.5, p=0.042) compared to participants with no history of miscarriage. Neither adverse pregnancy outcomes was associated with concerns about offspring or personal health. Conclusions In the cohort of young adult female leukemia and lymphoma survivors, experiencing a miscarriage after cancer was associated with higher concerns regarding becoming pregnant in the future. Additional research is needed to determine whether interventions such as preconception counseling with consideration of prior cancer treatments may help manage these concerns and improve pregnancy outcomes. Disclosures No relevant conflicts of interest to declare.

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