scholarly journals Both Low and High PAPP-A Concentrations in the First Trimester of Pregnancy Are Associated with Increased Risk of Delivery before 32 Weeks in Twin Gestation

2020 ◽  
Vol 9 (7) ◽  
pp. 2099
Author(s):  
Aleksandra Saletra-Bielińska ◽  
Katarzyna Kosińska-Kaczyńska ◽  
Iwona Szymusik ◽  
Bartosz Kaczyński ◽  
Robert Brawura-Biskupski-Samaha ◽  
...  
Keyword(s):  
High Risk ◽  
Pregnancy Complications ◽  
Perinatal Outcome ◽  
First Trimester ◽  
Continuous Variable ◽  
Increased Risk ◽  
First Trimester Of Pregnancy ◽  
High Concentrations ◽  
The Relationship ◽  
Twin Pregnancies

In twin gestation, the relationship between pregnancy associated plasma protein (PAPP-A) and perinatal outcome is unclear. The aim of the study was to determine if low and high concentrations of PAPP-A in the first trimester are related to perinatal outcome in twins. A retrospective study was conducted. Medical data of women in twin pregnancies who delivered between 2013 and 2018 were analyzed. PAPP-A concentrations were measured between 10 + 0 and 13 + 6 weeks. The associations between low (<10th percentile) and high (>90th percentile) values of PAPP-A and pregnancy complications were analyzed. A total of 304 patients were included. PAPP-A <10th percentile was associated with a high risk of preterm delivery (OR 6.14; 95% CI 2.1–18), delivery <34 weeks (OR 2.39; 95% CI 1.1–5.1) or <32 weeks (OR3.06; 95% CI 1.4–6.8). Significant relations between PAPP-A >90th percentile and delivery <34 weeks (OR4.09; 95% CI 1.8–9.1) or <32 weeks (OR 2.83; 95% CI 1.2–6.6) were found. PAPP-A >90th percentile was related to high risk of intrauterine fetal demise (OR 10; 95% CI 2.4–42.5). Both low and high PAPP-A concentrations seem to be related to pregnancy outcome. Further research is needed to investigate evaluation of risk of pregnancy complications according to PAPP-A concentrations as a continuous variable.

Is Moderate Drinking During Pregnancy Associated With an Increased Risk for Malformations?

PEDIATRICS ◽  
1987 ◽  
Vol 80 (3) ◽  
pp. 309-314 ◽  
Author(s):  
James L. Mills ◽  
Barry I. Graubard
Keyword(s):  
Alcohol Consumption ◽  
Congenital Malformations ◽  
Heavy Drinking ◽  
First Trimester ◽  
Organ System ◽  
Moderate Drinking ◽  
Increased Risk ◽  
First Trimester Of Pregnancy ◽  
Group Averaging ◽  
The Relationship

The relationship between heavy drinking during pregnancy and congenital malformations is well known; however, whether moderate or light drinking is teratogenic is controversial. This prospective birth defects study collected information from 32,870 women about alcohol consumption during the first trimester of pregnancy. Total malformation rates were not significantly higher among offspring of women who had an average of less than one drink per day (77.3/1,000) or one to two drinks per day (83.2/1,000) than among nondrinkers (78.1/1,000). An increased risk as small as 12% in the group averaging less than one drink per day and 45% in those averaging one to two drinks per day would most likely have been detected if it were present. Likewise, major malformations were not increased in these drinking groups. Examining malformations by organ system and individual defect revealed that sex organ malformations and all genitourinary malformations increased significantly (P &lt; .05) with increasing alcohol consumption. These findings suggest that alcohol, at the levels usually consumed during pregnancy, is not a significant cause of malformations. Nonetheless, the possibility that there are some malformations for which no safe drinking level exists requires additional investigation.

scholarly journals Hair cortisol levels in pregnancy as a possible determinant of fetal sex: a longitudinal study

2021 ◽  
pp. 1-6
Author(s):  
Borja Romero-Gonzalez ◽  
Jose A. Puertas-Gonzalez ◽  
Raquel Gonzalez-Perez ◽  
Marta Davila ◽  
Maria Isabel Peralta-Ramirez
Keyword(s):  
Low Birthweight ◽  
First Trimester ◽  
Hair Cortisol ◽  
Negative Results ◽  
Stress Vulnerability ◽  
Biological Stress ◽  
First Trimester Of Pregnancy ◽  
Prenatal Distress ◽  
Cortisol Levels ◽  
The Relationship

Abstract Stress during pregnancy has been widely studied and associated to different variables, usually with negative results for the health of the mother and the newborn, such as having a higher risk of suffering postpartum depression, premature birth, obstetrics complications or low birthweight, among others. However, there are not many lines of research that study the role that the sex of the baby plays on this specific stress and vice versa. Thus, the main objective was to analyse the relationship between the sex of the offspring and the stress of the mothers in the first trimester of pregnancy. In order to achieve this, 108 women had their biological stress measured (trough hair cortisol levels) and psychological stress evaluated (the Prenatal Distress Questionnaire (PSS), the Perceived Stress Scale (PDQ) and the Stress Vulnerability Inventory (IVE)). The results revealed significant differences in maternal hair cortisol levels in the first trimester based on the sex of the baby they had given birth to (t = −2.04; P < 0.05): the concentration of the hormone was higher if the baby was a girl (164.36:54.45-284.87 pg/mg) than if it was a boy (101.13:37.95-193.56 pg/mg). These findings show that the sex of the future baby could be conditioned, among many other variables, by the mother´s stress levels during conception and first weeks of pregnancy. Further research is needed in this area to support our findings.

Both low birthweight and high birthweight are associated with cognitive impairment in persons with schizophrenia and their first-degree relatives

2013 ◽  
Vol 43 (11) ◽  
pp. 2361-2367 ◽  
Author(s):  
M. Torniainen ◽  
A. Wegelius ◽  
A. Tuulio-Henriksson ◽  
J. Lönnqvist ◽  
J. Suvisaari
Keyword(s):  
Low Birthweight ◽  
Neuropsychological Test ◽  
Estimating Equation ◽  
Population Based ◽  
Continuous Variable ◽  
First Degree Relatives ◽  
Increased Risk ◽  
Axis I ◽  
Persons With Schizophrenia ◽  
The Relationship

BackgroundBoth low birthweight and high birthweight have been associated with an increased risk for schizophrenia and cognitive impairments in the general population. We assessed the association between birthweight and cognitive performance in persons with schizophrenia and their unaffected first-degree relatives.MethodWe investigated a population-based family sample comprising persons with schizophrenia (n = 142) and their unaffected first-degree relatives (n = 277). Both patients and relatives were interviewed with the Structured Clinical Interview for DSM-IV Axis I Disorders, Clinician Version (SCID-CV) and a comprehensive neuropsychological test battery was administered. Information on birthweight was obtained from obstetric records. We used generalized estimating equation (GEE) models to investigate the effect of birthweight, as a continuous variable, on cognitive functioning, adjusting for within-family correlation and relevant covariates.ResultsBoth low birthweight and high birthweight were associated with lower performance in visuospatial reasoning, processing speed, set-shifting and verbal and visual working memory among persons with schizophrenia and their unaffected first-degree relatives compared to individuals with birthweight in the intermediate range. The group × birthweight interactions were non-significant.ConclusionsBoth low birthweight and high birthweight are associated with deficits in cognition later in life. Schizophrenia does not seem to modify the relationship between birthweight and cognition in families with schizophrenia.

Effect of renal function (RF) on outcomes in the adjuvant treatment of older women with breast cancer (>65 years): CALGB/CTSU 49907 (CC) ancillary data study.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 9515-9515
Author(s):  
Stuart M. Lichtman ◽  
Constance Cirrincione ◽  
Arti Hurria ◽  
Aminah Jatoi ◽  
Maria Theodoulou ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Renal Function ◽  
Renal Insufficiency ◽  
Continuous Variable ◽  
Hematologic Toxicity ◽  
Logrank Test ◽  
Dose Modification ◽  
Increased Risk ◽  
Therapy Completion ◽  
The Relationship

9515 Background: CC 49907 showed superiority of standard therapy (cyclophosphamide/doxorubicin [AC] or cyclophosphamide/methotrexate/5-fluorouracil [CMF]) over capecitabine[C]. Dose adjustments made for renal insufficiency (RI) for methotrexate and C; ideal body weight used. Purpose was to analyze the relationship between RF at baseline and 5 endpoints: toxicity, dose modification, therapy completion, relapse-free survival [RFS] and overall survival [OS]. Methods: Pre-treatment RF was calculated (Cockcroft-Gault). Endpoints assessed by regimen. RF was tested as a dichotomous and continuous variable of stages 1,2 vs. 3,4 kidney disease (National Kidney Foundation). Logistic regression modeled the relationship between renal stage and the first three endpoints of toxicity, dose modification and therapy completion. Toxicity divided by hematologic or not. The relationship of RFS and OS with RF was assessed with the logrank test and as a continuous variable with Wald chi square. Results: 619 patients; incidence of stage 3/4 RI(<60 ml/min) was: CMF=72%; AC=64%; C=75%. With AC the incidence of toxicity differed by renal function. 31% of patients with poorer function >grade 3 non-hematologic toxicity vs. 14% with better function(p=0.011). There was a suggestion of effect of RF on OS and RFS for C-treated patients. RF was not associated with dose modification, premature therapy termination, RFS or OS for the CMF-treated patients. Conclusions: 1) AC: declining RF was associated with increased non-hematologic toxicity. 2)Patients with RI who received dose modifications were not at increased risk for complications in comparison to those who did not have renal insufficiency and received full dose. 3)Declining RF did not affect therapy completion. 4)C: suggestion that worse RF was related to poorer RFS or OS. 5)Exclusion of patients from clinical trials with RI based on concern of excessive hematologic toxicity may not be justified with appropriate modification. 6)Results should be considered in the design of clinical trials for older patients.

scholarly journals Could molecular assessment of calcium metabolism be a useful tool to early screen patients at risk for pre-eclampsia complicated pregnancy? Proposal and rationale

2015 ◽  
Vol 53 (7) ◽  
Author(s):  
Salvatore Gizzo ◽  
Marco Noventa ◽  
Stefania Di Gangi ◽  
Carlo Saccardi ◽  
Erich Cosmi ◽  
...  
Keyword(s):  
Calcium Intake ◽  
Calcium Metabolism ◽  
Large Scale ◽  
Calcium Supplementation ◽  
English Literature ◽  
First Trimester ◽  
Control Group ◽  
Hypertensive Disorders ◽  
Increased Risk ◽  
First Trimester Of Pregnancy

AbstractOne of the most frequent causes of maternal and perinatal morbidity is represented by hypertensive disorders during pregnancy. Women at high risk must be subjected to a more intensive antenatal surveillance and prophylactic treatments. Many genetic risk factors, clinical features and biomarkers have been proposed but none of these seems able to prevent pre-eclampsia onset. English literature review of manuscripts focused on calcium intake and hypertensive disorders during pregnancy was performed. We performed a critical analysis of evidences about maternal calcium metabolism pattern in pregnancy analyzing all possible bias affecting studies. Calcium supplementation seems to give beneficial effects on women with low calcium intake. Some evidence reported that calcium supplementation may drastically reduce the percentage of pre-eclampsia onset consequently improving the neonatal outcome. Starting from this evidence, it is intuitive that investigations on maternal calcium metabolism pattern in first trimester of pregnancy could represent a low cost, large scale tool to screen pregnant women and to identify those at increased risk of pre-eclampsia onset. We propose a biochemical screening of maternal calcium metabolism pattern in first trimester of pregnancy to discriminate patients who potentially may benefit from calcium supplementation. In a second step we propose to randomly allocate the sub-cohort of patients with calcium metabolism disorders in a treatment group (calcium supplementation) or in a control group (placebo) to define if calcium supplementation may represent a dietary mean to reduce pre-eclampsia onset and to improve pregnancy outcome.

scholarly journals Interleukin-1 Receptor Antagonist Gene Polymorphism, Vaginal Interleukin-1 Receptor Antagonist Concentrations, and Vaginal Ureaplasma urealyticum Colonization in Pregnant Women

2003 ◽  
Vol 71 (1) ◽  
pp. 271-274 ◽  
Author(s):  
Parrin T. Barton ◽  
Stefan Gerber ◽  
Daniel W. Skupski ◽  
Steven S. Witkin
Keyword(s):  
Pregnant Women ◽  
Receptor Antagonist ◽  
Ureaplasma Urealyticum ◽  
Interleukin 1 ◽  
First Trimester ◽  
Enzyme Linked Immunosorbent Assay ◽  
Interleukin 1 Receptor Antagonist ◽  
First Trimester Of Pregnancy ◽  
The Relationship ◽  
Uneventful Pregnancy

ABSTRACT Ureaplasma urealyticum is the microorganism most frequently isolated from amniotic fluids of women in preterm labor. The relationship between vaginal colonization with U. urealyticum, vaginal interleukin-1 receptor antagonist (IL-1ra) levels, and the IL-1ra genotype in pregnant women was examined. Vaginal specimens, obtained with a cotton swab from 207 women in their first trimester of pregnancy, were tested for IL-1ra concentrations by enzyme-linked immunosorbent assay and for U. urealyticum and IL-1ra genotypes by PCR. U. urealyticum was detected in 85 (41.1%) women. The median IL-1ra level was 450 ng/ml in women positive for U. urealyticum, as opposed to 225 ng/ml in women negative for this microorganism (P < 0.0001). Sixty-two percent of the 16 women who were homozygous for allele 2 of the IL-1ra gene (IL-1RN*2) were colonized with U. urealyticum, as opposed to 47% of the 49 women who were IL-1RN*1/IL-1RN*2 heterozygotes and 34% of the 133 women who were IL-1RN*1 homozygotes (P < 0.05). Median IL-1ra levels were 750 ng/ml in IL-1RN*2 homozygotes, 300 ng/ml in IL-1RN*1/IL-1RN*2 heterozygotes, and 250 ng/ml in IL-1RN*1 homozygotes (P = 0.02). The vast majority of subjects had an uneventful pregnancy and delivered a healthy infant at term. The IL-1ra genotype or U. urealyticum colonization was unrelated to birth weight. Pregnant women who are colonized with U. urealyticum during the first trimester have elevated vaginal IL-1ra concentrations and a higher prevalence of the IL-1RN*2 homozygote genotype than do noncolonized women.

scholarly journals Twin Pregnancies Labour Modus and Timing

2021 ◽  
Author(s):  
Panagiotis Tsikouras ◽  
Anna Chalkidou ◽  
Anastasia Bothou ◽  
Angeliki Gerede ◽  
Xanthoula Anthoulaki ◽  
...  
Keyword(s):  
High Risk ◽  
Vaginal Delivery ◽  
Perinatal Outcome ◽  
Twin Pregnancy ◽  
Monozygotic Twins ◽  
Morbidity And Mortality ◽  
Assessment And Evaluation ◽  
Dizygotic Twins ◽  
The Impact ◽  
Twin Pregnancies

Twin pregnancies are categorized according to three factors, zygosity, chorionicity and amnionicity. Dizygotic twins are always dichorionic and diamniotic, where each twin has its own chorionic and amniotic sac. Monozygotic twins account for 1/3 of twin pregnancies and show higher morbidity and mortality. In monozygotic twins, chorionicity and amnionicity are determined by the time of zygote division. Chorionicity and amnionicity determine the risks of twin pregnancy. Morbitidies are shown notable decreasing tendency depending on improving of high risk obstetric and neonatal care, however is still discussed the optimum labour management in twin pregnancies Vaginal delivery in twin pregnancies is possible when both have cephalic presentation and in the late weeks of pregnancy during which the risks of prematurity are minimized. The aim of this review was the assessment and evaluation the impact of the labour modus and timing of termination of twin pregnancies due to rise of their occurrence based on scientific aspects of the new published literature on perinatal outcome.

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