Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 54.182
Filtrar
Mais filtros








Intervalo de ano de publicação
1.
Acta Clin Croat ; 60(2): 246-253, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34744274

RESUMO

Isolated maternal hypothyroxinemia (IMH) is defined as the presence of low maternal total thyroxine (TT4) level in conjunction with normal maternal thyroid-stimulating hormone (TSH) level. The aim was to investigate whether IMH is associated with adverse pregnancy outcome in North Macedonia. Dried blood spot samples were obtained from 359 pregnant women meeting the inclusion criteria and analyzed for TT4 and TSH. Postpartum data were entered from their medical histories. Out of 359 women, 131 (37.42%) belonged to IMH group. There were statistically significant differences in birth weight (p=0.043), intrauterine growth restriction (IUGR) (p=0.028), Apgar score at 1 min <7 (p=0.018) and cesarean section for dystocia/disproportion (p=0.024) between the IMH and normal thyroid function (NTF) groups. In regression analysis, TSH was a significant variable predicting Apgar score (ßst=0.05597, p=0.047), body mass index predicting birth weight (ßst=0.02338, p=0.045) and TT4 predicting small for gestational age/IUGR (ßst=-0.089834, p=0.029) in IMH group. TT4 was a strong predictor of birth weight (ßst=-0.004778, p=0.003) and premature delivery (ßst=0.028112, p=0.004) in NTF group. The impact of IMH in pregnancy remains controversial. IMH was associated with an increased maternal BMI and higher birth weight of neonates. Overweight could be a potential risk factor for thyroid dysfunction in pregnant women, and specifically IMH. The worst fetal outcome was seen in IMH mothers examined in second trimester. We found TSH, TT4 and BMI to be strong predictors of perinatal outcomes.


Assuntos
Cesárea , Complicações na Gravidez , Feminino , Humanos , Recém-Nascido , Gravidez , Complicações na Gravidez/epidemiologia , Resultado da Gravidez/epidemiologia , República da Macedônia do Norte/epidemiologia , Tiroxina
3.
Taiwan J Obstet Gynecol ; 60(6): 1043-1046, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34794735

RESUMO

OBJECTIVES: Aim of this study is to evaluate the prognosis of pregnant women having SARS-CoV-2 infection and investigate whether there was a difference in perinatal outcomes between pregnant women who had SARS-CoV-2 infection and those who did not. MATERIALS AND METHODS: This prospective observational study was conducted with 116 singleton pregnancies. Cases enrolling in the study were divided into two groups. While those in the first group had a history of SARS-CoV-2 infection (n = 46) the second group consisted of healthy pregnant women (n = 70). RESULTS: Emergency Cesarean section was performed on three SARS-CoV-2 infected pregnancies (30, 33 and 34 gestational weeks). Intensive care unit admission was required for all three cases after delivery and two of them died. Among the pregnancies that had an infection in the third trimester, 71.4% (n = 20) of them had delivery in 14 days after diagnosis and 17.4% (n = 8) of their newborns were followed up at newborn intensive care unit. Overall, only one newborn had a positive swab test result for SARS-CoV-2. There was no statistically significant difference between groups regarding their delivery week (37.02 ± 5.85 vs 38.5 ± 2.33). Similarly, there was no significant difference between groups, concerning mean age, parity, and birth weight (P = 0.707, P = 0.092, P = 0.334; P < 0.05). Furthermore, the difference between SARS-CoV-2 infected pregnancies that were followed up as inpatient or outpatient with respect to the delivery week and birth weight was not significant (p > 0.05). Also, APGAR 5 scores of hospitalized women (9.3 ± 1.1) were found to be lower than the outpatient group (9.8 ± 0.8) (P = 0.043; p < 0.05). CONCLUSION: No significant difference was detected between groups in terms of the delivery week, birth weight, and APGAR scores. The inpatient group was found to have lower APGAR 5 scores.


Assuntos
COVID-19/diagnóstico , Cesárea/estatística & dados numéricos , Parto Obstétrico , Transmissão Vertical de Doenças Infecciosas , Complicações Infecciosas na Gravidez/mortalidade , Gestantes/psicologia , Aborto Espontâneo/epidemiologia , Peso ao Nascer , COVID-19/mortalidade , COVID-19/terapia , COVID-19/virologia , Feminino , Humanos , Recém-Nascido , Pandemias , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Complicações Infecciosas na Gravidez/terapia , Complicações Infecciosas na Gravidez/virologia , Resultado da Gravidez , Nascimento Prematuro/epidemiologia , SARS-CoV-2
4.
Zhonghua Yi Xue Yi Chuan Xue Za Zhi ; 38(11): 1041-1044, 2021 Nov 10.
Artigo em Chinês | MEDLINE | ID: mdl-34729739

RESUMO

OBJECTIVE: To explore the clinical effect of expanded non-invasive prenatal testing (NIPT-plus) for prenatal screening. METHODS: The screening result, prenatal diagnosis and pregnancy outcome of 3700 pregnant women who volunteered NIPT-plus screening at our center from September 2018 to December 2019 were reviewed. RESULTS: Among the 3700 pregnant women, 74(2.0%) were scored positive for clinically significant fetal chromosomal abnormalities and underwent NIPT-plus screening. Sixty three women with a high risk underwent invasive prenatal diagnosis, among whom 19 were diagnosed, which yielded a positive predictive value (PPVs) of 30.2% (19/63). Statistical analysis showed that NIPT-plus has higher PPVs for common aneuploidies and low-to-medium PPVs for sex chromosome aneuploidies and microdeletion/microduplication syndromes. CONCLUSION: As a screening technique, NIPT-plus has broader applications compared with conventional techniques, and has reference value for clinicians and pregnant women during pregnancy.


Assuntos
Aneuploidia , Diagnóstico Pré-Natal , Aberrações Cromossômicas , Feminino , Humanos , Gravidez , Resultado da Gravidez , Aberrações dos Cromossomos Sexuais
5.
BMC Pregnancy Childbirth ; 21(1): 761, 2021 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-34758778

RESUMO

BACKGROUND: The ongoing spread coronavirus disease worldwide has caused major disruptions and led to lockdowns. Everyday lifestyle changes and antenatal care inaccessibility during the coronavirus disease 2019 (COVID-19) pandemic have variable results that affect pregnancy outcomes. This study aimed to assess the alterations in stillbirth, neonatal-perinatal mortality, preterm birth, and birth weight during the COVID-19 national lockdown. METHODS: We used the data from the Jordan stillbirths and neonatal death surveillance system to compare pregnancy outcomes (gestational age, birth weight, small for gestational age, stillbirth, neonatal death, and perinatal death) between two studied periods (11 months before the pandemic (May 2019 to March 2020) vs. 9 months during the pandemic (April 2020 to March 1st 2020). Separate multinomial logistic and binary logistic regression models were used to compare the studied outcomes between the two studied periods after adjusting for the effects of mother's age, income, education, occupation, nationality, health sector, and multiplicity. RESULTS: There were 31106 registered babies during the study period; among them, 15311 (49.2%) and 15795 (50.8%) births occurred before and during the COVID-19 lockdown, respectively. We found no significant differences in preterm birth and stillbirth rates, neonatal mortality, or perinatal mortality before and during the COVID-19 lockdown. Our findings report a significantly lower incidence of extreme low birth weight (ELBW) infants (<1kg) during the COVID-19 lockdown period than that before the lockdown (adjusted OR 0.39, 95% CI 0.3-0.5: P value <0.001) CONCLUSIONS: During the COVID-19 lockdown period, the number of infants born with extreme low birth weight (ELBW) decreased significantly. More research is needed to determine the impact of cumulative socio-environmental and maternal behavioral changes that occurred during the pandemic on the factors that contribute to ELBW infants.


Assuntos
COVID-19/epidemiologia , Complicações Infecciosas na Gravidez/epidemiologia , Resultado da Gravidez/epidemiologia , Adulto , Feminino , Humanos , Lactente , Mortalidade Infantil , Recém-Nascido , Recém-Nascido Pequeno para a Idade Gestacional , Transmissão Vertical de Doenças Infecciosas/estatística & dados numéricos , Jordânia , Mortalidade Perinatal , Gravidez , Nascimento Prematuro/epidemiologia , Natimorto/epidemiologia
6.
J Korean Med Sci ; 36(44): e309, 2021 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-34783218

RESUMO

BACKGROUND: We assessed maternal and neonatal outcomes of critically ill pregnant and puerperal patients in the clinical course of coronavirus disease 2019 (COVID-19). METHODS: Records of pregnant and puerperal women with polymerase chain reaction positive COVID-19 virus who were admitted to our intensive care unit (ICU) from March 2020 to August 2021 were investigated. Demographic, clinical and laboratory data, pharmacotherapy, and neonatal outcomes were analyzed. These outcomes were compared between patients that were discharged from ICU and patients who died in ICU. RESULTS: Nineteen women were included in this study. Additional oxygen was required in all cases (100%). Eight patients (42%) were intubated and mechanically ventilated. All patients that were mechanically ventilated have died. Increased levels of C-reactive protein (CRP) was seen in all patients (100%). D-dimer values increased in 15 patients (78.9%); interleukin-6 (IL-6) increased in 16 cases (84.2%). Sixteen patients used antiviral drugs. Eleven patients were discharged from the ICU and eight patients have died due to complications of COVID-19 showing an ICU mortality rate of 42.1%. Mean number of hospitalized days in ICU was significantly lower in patients that were discharged (P = 0.037). Seventeen patients underwent cesarean-section (C/S) (89.4%). Mean birth week was significantly lower in patients who died in ICU (P = 0.024). Eleven preterm (57.8%) and eight term deliveries (42.1%) occurred. CONCLUSION: High mortality rate was detected among critically ill pregnant/parturient patients followed in the ICU. Main predictors of mortality were the need of invasive mechanical ventilation and higher number of days hospitalized in ICU. Rate of C/S operations and preterm delivery were high. Pleasingly, the rate of neonatal death was low and no neonatal COVID-19 occurred.


Assuntos
COVID-19/mortalidade , Complicações Infecciosas na Gravidez/mortalidade , Transtornos Puerperais/mortalidade , SARS-CoV-2 , Adulto , Antivirais/uso terapêutico , COVID-19/sangue , COVID-19/diagnóstico por imagem , COVID-19/terapia , Cesárea , Terapia Combinada , Estado Terminal/mortalidade , Parto Obstétrico/estatística & dados numéricos , Feminino , Mortalidade Hospitalar , Humanos , Recém-Nascido , Unidades de Terapia Intensiva/estatística & dados numéricos , Tempo de Internação/estatística & dados numéricos , Pulmão/diagnóstico por imagem , Oxigenoterapia , Gravidez , Resultado da Gravidez , Respiração Artificial , Estudos Retrospectivos , Resultado do Tratamento , Adulto Jovem
7.
Medicine (Baltimore) ; 100(41): e27505, 2021 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-34731133

RESUMO

OBJECTIVE: To analyze the level of vitamin D and its influencing factors in pregnant women, and to explore the influence of vitamin D deficiency on common adverse pregnancy outcomes in pregnant women, providing evidence for prevention and intervention of vitamin D deficiency in pregnant women. METHODS: The basic data and blood samples of pregnant women in our hospital from January 2019 to June 2020 were collected, and the 25-(OH) D levels of the serum samples were detected. Then the vitamin D levels and its influencing factors were analyzed, and the relationships between vitamin D levels and common adverse pregnancy outcomes in the pregnant women as well as the incidence of small-for-gestational-age newborns were analyzed. RESULTS: The vitamin D deficiency rate, insufficiency rate and sufficiency rate of pregnant women were 83.28%, 15.36%, and 1.36% respectively, with vast majority of the pregnant women in a state of vitamin D deficiency. Analysis of the influencing factors on the vitamin D level of pregnant women showed "28 weeks ≤ gestational age ≤32 weeks, summer and autumn, high school education and above, weekly time outdoors ≥10 hours, supplement of vitamin D and trace elements during pregnancy" were protective factors for vitamin D sufficiency in pregnant women. Linear correlation analysis showed the vitamin D level of pregnant women was highly positively correlated with temperature, the higher the temperature, the higher the vitamin D level (r = 0.907, t = 6.818, P < .001). The level of vitamin D in pregnant women was related to the occurrence of spontaneous abortion and small-for-gestational age (SGA), with the incidence of spontaneous abortion and SGA in the "vitamin D deficiency group" higher than those of other groups (P = .018, P = .016). CONCLUSIONS: The vitamin D level of pregnant women in this area is relatively low, which is affected by multiple factors such as gestational age, season, education level of pregnant women, weekly time outdoors, vitamin D and trace element supplement during pregnancy. Low vitamin D levels can increase the risk of spontaneous abortion and SGA in pregnant women, so relevant measures should be adopted to improve the vitamin D status of pregnant women.


Assuntos
Aborto Espontâneo/etiologia , Retardo do Crescimento Fetal/etiologia , Deficiência de Vitamina D/complicações , Vitamina D/sangue , Aborto Espontâneo/epidemiologia , Adolescente , Adulto , Estudos de Casos e Controles , Escolaridade , Feminino , Retardo do Crescimento Fetal/epidemiologia , Idade Gestacional , Humanos , Incidência , Pessoa de Meia-Idade , Gravidez , Resultado da Gravidez , Fatores de Risco , Estações do Ano , Vitamina D/análogos & derivados , Deficiência de Vitamina D/prevenção & controle , Adulto Jovem
8.
J Int Med Res ; 49(11): 3000605211050798, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34772315

RESUMO

OBJECTIVE: The study aim was to examine the effects of cognitive behavioural therapy (CBT) on the pregnancy outcomes of women receiving in vitro fertilization-embryo transfer (IVF-ET) treatment. METHODS: A literature review was performed using the databases MEDLINE, the Cochrane Database, Embase, Chinese National Knowledge Infrastructure (CNKI) and WANFANG. Eligible studies were selected according to inclusion and exclusion criteria. Relevant data were extracted and the quality of studies assessed. Odds ratios with 95% confidence intervals were pooled to statistically analyse the difference between intervention and control groups. RESULTS: Ten studies were selected for the systematic review and meta-analysis. The findings showed that CBT and cognitive-related therapy significantly improved the pregnancy rate of women undergoing IVF-ET treatment. Subgroup analysis showed that patients who received CBT, rather than complex psychological interventions, and those who received interventions delivered by professional psychologists, were more likely to become pregnant during IVF-ET treatment. CONCLUSION: CBT and cognitive-related interventions had significant effects on the pregnancy outcomes of women receiving IVF-ET treatment. CBT treatment (rather than complex psychological interventions) provided by professional psychologists is strongly recommended.


Assuntos
Terapia Cognitivo-Comportamental , Resultado da Gravidez , Transferência Embrionária , Feminino , Fertilização In Vitro , Humanos , Gravidez , Taxa de Gravidez
9.
Ceska Gynekol ; 86(5): 297-303, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34736326

RESUMO

OBJECTIVE: Evaluation of perinatal results in a set of pregnancies complicated by eclampsia. METHODS: Analysis of 67,304 births performed at the Department of Gynecology and Obstetrics, Masaryk University, Faculty of Medicine and University Hospital, Brno from 2008-2018. During the given period, eclampsia was dia-gnosed in 16 mothers (0.2). The during the time of eclampsia (week of gestation, prepartum, intrapartum, postpartum) fetal and neonatal status (signs of intrauterine distress, pH of the umbilical artery, Apgar score, intrauterine fetal death, death in the early neonatal period) were evaluated. Symptoms and course of the eclamptic attack, maternal comorbidities, associated obstetric complications (placental abruption, surgical complications, blood loss, hysterectomy) and non-obstetric complications (coagulopathy, renal and hepatic impairment, neurological complications) were monitored. RESULTS: Out of a total of 16 cases of eclampsia, 13 cases (81.3%) were confirmed during pregnancy, one case (6.2%) during childbirth, and two cases (12.5%) within 24 hours after childbirth. The mean gestational week of eclampsia was 33 weeks and 3 days. The typical course of an eclamptic attack characterized by headache and visual disturbances followed by a rapid onset of convulsions was noted in five cases (31%). Fetal hypoxia with a pH of the umbilical artery less than 7.10 occurred in four cases (25%). The dependence of the decrease in pH value on the time interval from the dia-gnosis of eclampsia to the termination of pregnancy was demonstrated. The pH of the umbilical artery decreased on average by 0.054 every 30 minutes from the onset of the eclamptic attack until the end of pregnancy. There were 3 perinatal deaths in the group (19%). Intrauterine fetal death occurred in one case due to partial abruption of the placenta during an eclamptic attack; two newborns died in the early neonatal period. The cause of death was sepsis in one case and perforation of the intestine in necrotizing enterocolitis in the other. The death of the mother was not recorded in the file. The incidence of preeclampsia in subsequent pregnancies reached 18.8%. Non-obstetric and neurological complications (amaurosis, subarachnoid hemorrhage, amnesia) occurred in the group in three cases (18.8%), and renal failure occurred in two cases (12.5%). CONCLUSION: The incidence of eclampsia at the Department of Gynecology and Obstetrics, Masaryk University, Faculty of Medicine and University Hospital, Brno reached 0.2 and was stable for a long time. Associated serious maternal complications occurred in 37.5% of cases and neonatal complications in 31.3% of cases. Early dia-gnosis of eclampsia and minimization of the time delay until the end of pregnancy is a prerequisite for reducing the risk of associated complications. An interdisciplinary approach is needed.


Assuntos
Descolamento Prematuro da Placenta , Eclampsia , Pré-Eclâmpsia , Descolamento Prematuro da Placenta/epidemiologia , Descolamento Prematuro da Placenta/etiologia , Parto Obstétrico , Eclampsia/epidemiologia , Eclampsia/etiologia , Feminino , Humanos , Recém-Nascido , Placenta , Gravidez , Resultado da Gravidez
10.
Pan Afr Med J ; 40: 17, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34733385

RESUMO

Introduction: in Tanzania, for the past decade, there has been a rising trend of women with short inter-pregnancy interval (IPI) (16% to 19%). Short IPI is associated with poor maternal and neonatal outcomes. We aimed to determine the factors associated with short IPI among women attending antenatal clinic (ANC) at Mnazi Mmoja Hospital, Dar es Salaam, Tanzania. Methods: a cross-sectional study was conducted in September 2018 at Mnazi Mmoja hospital among women receiving ante-natal care. A total of 530 women were included in the analysis. Analysis was conducted through SPSS version 24 computer program using descriptive analyses to determine the IPI and characteristics thereof, and logistic regression analysis to examine factors associated with IPI among pregnant women. Associations with a p-value < 0.05 were considered statistically significant. Results: twenty-two percent of the women attending ANC in Mnazi Mmoja hospital had short IPI. Short IPI was associated with young (<25years) age (AOR=2.67, 95% CI=1.23-5.79); non-use of a contraceptive method (AOR=2.05, 95%CI=1.22-3.45); breastfeeding for less than 6 months (AOR=3.45, 95% CI=1.17-10.13) and having an antecedent dead child at the time of index conception (AOR=3.38, 95% CI=1.15-9.93). Conclusion: about 1 in every 5 women attending ANC in Dar es Salaam had a short IPI. Addressing short IPI will complement the government´s efforts to improve maternal indicators in Tanzania and areas with similar contexts. Such efforts should emphasize in adherence to recommended infant feeding practices, women at a younger reproductive age group, those with a history of pregnancy loss, and strengthening contraception use among women of reproductive age.


Assuntos
Intervalo entre Nascimentos/estatística & dados numéricos , Comportamento Contraceptivo/estatística & dados numéricos , Resultado da Gravidez , Cuidado Pré-Natal , Adulto , Fatores Etários , Aleitamento Materno/estatística & dados numéricos , Estudos Transversais , Feminino , Humanos , Gravidez , Tanzânia , Fatores de Tempo , Adulto Jovem
11.
Ceska Gynekol ; 86(5): 318-324, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34736329

RESUMO

INTRODUCTION: Despite the ever-improving medical care, pregnancies of women with type 1 diabetes mellitus (T1DM) are at increased risk of complications for both mother and child. Optimal compensation of diabetes before and during pregnancy is an essential protective factor reducing the risk of congenital malformations, pregnancy loss, and other complications. The pregnancy of women with T1DM should be planned, ideally at a time of optimal diabetes compensation. Target glycated hemoglobin (HbA1c) values until the range of 42-48 mmol/mol should be achieved at least three months before pregnancy. Our work aimed to evaluate the perinatal results of pregnancies in women with T1DM and the eff ect of preconception counseling and adequate T1DM compensation before pregnancy on perinatal outcomes. METHODS AND RESULTS: Retrospective analysis of pregnancy and perinatal outcomes of women with T1DM were followed up at the Department of Gynecology and Obstetrics, General University Hospital in Prague and First Faculty of Medicine, Charles University between 2008 to 2018. A total of 221 women with T1DM were included in the analysis. Adequate (HbA1c  48 mmol/mol at least 3 months before conception) and inadequate diabetes compensation at the beginning of the pregnancy had 59 (26.7%) and 162 (72.3%) women, respectively. Pregnancies of women with adequate diabetes compensation were more often planned (55.9 vs. 24.7%; P  95th percentile; 22.0 vs. 35.8%; P = 0.027). CONCLUSION: The pregnancy of women with T1DM is burdened by a number of perinatal and neonatal complications. In the study group, most women with T1DM became pregnant unintentionally at a time of inadequate diabetes compensation. Women who achieved adequate diabetes compensation before pregnancy had a lower incidence of perinatal complications. Therefore, it is advised that women with T1DM should plan their pregnancy, attend preconception and antenatal care, and give birth in perinatal centers, which provide coordinated care from diabetologists, gynecologists, obstetricians, and neonatologists.


Assuntos
Diabetes Mellitus Tipo 1 , Gravidez em Diabéticas , Adulto , Diabetes Mellitus Tipo 1/complicações , Feminino , Humanos , Recém-Nascido , Cuidado Pré-Concepcional , Gravidez , Resultado da Gravidez , Estudos Retrospectivos
12.
Diagn Pathol ; 16(1): 88, 2021 Oct 03.
Artigo em Inglês | MEDLINE | ID: mdl-34602071

RESUMO

INTRODUCTION: COVID-19, the disease caused by the novel coronavirus SARS-CoV-2, is a severe systemic thrombotic syndrome that emerged in 2019, with an ensuing pandemic. To evaluate the impact of this disease on placental tissue and perinatal outcome, histological, immunohistochemical and ultrastructural analyses of placental tissue were performed for five cases of pregnant women with COVID-19. CASE REPORTS: All five pregnant women in this series developed COVID-19 in late pregnancy. Two patients experienced respiratory distress, and computed tomography revealed signs of pneumonia, with bilateral involvement, multiple lobular and subsegmental areas of consolidation and ground-glass opacities. Histological studies of placental tissue revealed the presence of slight signs of maternal vascular underperfusion (MVUs) or foetal vascular underperfusion (FVUs) lesions and mild inflammatory lesions. CD15 immunoreactivity in the placental tissue was low in all cases, demonstrating that in these cases there was not severe foetal hypoxia/asphyxia risk for newborns or distal vascular immaturity. In all cases examined, ultrastructural analyses showed spherical-like coronavirus particles with an electron intermediate-density core as well as projections from the surface as spike-like structures in the syncytiotrophoblasts. At term, all of the women delivered newborns who were negative for SARS-CoV-2 by nasopharyngeal testing in their first day of life. All newborns were exclusively breastfed and were discharged on the 3rd day of life. CONCLUSIONS: In conclusion, placental patterns in pregnancy due to COVID-19 in the late stage of gestation indicate no evidence of vertical trans-placental SARS-CoV-2 transmission or a significant impact on the perinatal outcome of newborns, in both mild and more severe cases.


Assuntos
COVID-19/diagnóstico por imagem , Transmissão Vertical de Doenças Infecciosas , Pandemias , Complicações Infecciosas na Gravidez , SARS-CoV-2/fisiologia , Adulto , COVID-19/epidemiologia , COVID-19/patologia , COVID-19/virologia , Feminino , Humanos , Recém-Nascido , Placenta/diagnóstico por imagem , Placenta/patologia , Placenta/virologia , Gravidez , Resultado da Gravidez , Tomografia Computadorizada por Raios X , Trofoblastos/patologia , Trofoblastos/virologia
13.
Zhonghua Yi Xue Yi Chuan Xue Za Zhi ; 38(10): 1025-1029, 2021 Oct 10.
Artigo em Chinês | MEDLINE | ID: mdl-34625947

RESUMO

Fetal cell free DNA (cfDNA) in maternal blood circulation mainly originates from placental trophoblasts which have dual characteristics of apoptotic cells and the embryo, and can be affected by maternal factors. Pregnancy-related diseases including preeclampsia, gestational diabetes mellitus, preeclampsia, macrosomia and fetal growth restriction can seriously affect maternal health and pregnancy outcome. Early prediction and timely intervention are important means to reduce the risk. Fetal cfDNA and prediction of pregnancy-related diseases have become a hot topicfor current research. This paper reviews the latest progress made in the field.


Assuntos
Ácidos Nucleicos Livres , Complicações na Gravidez , Ácidos Nucleicos Livres/genética , Feminino , Feto , Humanos , Placenta , Gravidez , Resultado da Gravidez
14.
Ann Palliat Med ; 10(9): 9692-9701, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34628895

RESUMO

BACKGROUND: Gestational diabetes mellitus (GDM) increases the incidence of adverse outcomes in pregnant women. Individual diet intervention (IDI) was developed in our center through collaboration with nutritionists to treat GDM and prevent further complications. We then aimed to analyze the effects of IDI on the level of blood glucose and pregnancy outcomes in pregnant women with GDM. METHODS: We retrospectively enrolled pregnant women with GDM between April 2016 and March 2020. Participants in the control group received routine GDM care, and those in the study group received extra IDI on the basis of routine GDM care. Demographic and clinical characteristics of participating pregnant women were retrospectively collected. The study outcomes were the status of blood glucose control after 6 weeks of IDI or conventional intervention and pregnancy outcomes. Univariable and multivariable logistic regression analyses were sequentially performed to determine the predictors of proper blood glucose control and risk factors of adverse pregnancy outcomes in the study population. RESULTS: A total of 817 pregnant women who had been diagnosed as GDM were enrolled in this study, including 435 admitted between April 2016 to March 2018 who received conventional medication and 382 who were admitted between April 2018 to March 2020 and received IDI. Generally, there was no significant difference in baseline characteristics between study and control groups. Glycated hemoglobin (HbA1c) level after intervention was statistically lower in the study group than in the control group (5.6±0.9 vs. 5.5±0.7, P=0.006). Multivariable logistic regression analysis revealed that IDI was a predictor of proper blood glucose control in GDM participants (P=0.003). There were more cesarean sections and cases of macrosomia in the control group than the study group, showing statistical difference (35.9% vs. 28.5%, P=0.026; 8.7% vs. 4.7%, P=0.023, respectively). According to multivariable logistic regression analysis, IDI was identified as playing a protective role against cesarean section in GDM participants (P=0.034) and it could reduce the incidence of macrosomia in GDM participants (P=0.028). CONCLUSIONS: This novel pattern of IDI may not only help stabilize blood glucose levels in pregnant women with GDM, but also reduce the incidence of adverse outcomes to a certain extent.


Assuntos
Diabetes Gestacional , Glicemia , Cesárea , Feminino , Teste de Tolerância a Glucose , Humanos , Gravidez , Resultado da Gravidez , Estudos Retrospectivos
15.
Oral Health Prev Dent ; 19(1): 565-572, 2021 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-34673848

RESUMO

PURPOSE: This study aimed to investigate whether treatment of gingivitis in pregnant women affects pregnancy outcomes. MATERIALS AND METHODS: This was a systematic review and meta-analysis of clinical trials using PRISMA guidelines to appraise the treatment of gingivitis on pregnancy outcomes, including preterm birth (less than 37 weeks), low birth weight (less than 2,500 g), gestational age and birth weight. Pooled odds ratios (OR), mean difference, and 95% confidence intervals (CI) were calculated using the random effect model. A search was conducted in databases including Medline, Pubmed, Web of Science, Google Scholar and Embase without restrictions regarding language or date of publication. RESULTS: Three clinical trials comprising 1,031 participants were included in this review. Treatment of gingivitis during pregnancy was associated with a decreased risk of preterm birth (OR = 0.44, 95% CI [0.20-0.98], P = 0.045) and higher birth weight (weighted mean difference (WMD) =105.36 g, 95% CI [36.72-174.01], P = 0.003). Gestational age at birth in the treatment group (WMD = 0.31 weeks, 95% CI [-0.02-0.64], P = 0.64) as well as likelihood of low birth weight (OR = 0.92, 95% CI [0.38-2.21], P = 0.851) did not reach statistical significance. CONCLUSION: The results of this meta-analysis indicate that treatment of gingivitis in pregnancy may improve pregnancy outcomes including increased infants birth weight and reduced preterm births. Future trials are warranted to validate the true effect size of gingivitis treatment on pregnancy outcomes.


Assuntos
Gengivite , Nascimento Prematuro , Feminino , Idade Gestacional , Gengivite/terapia , Humanos , Recém-Nascido de Baixo Peso , Recém-Nascido , Gravidez , Resultado da Gravidez
16.
Reprod Health ; 18(1): 207, 2021 Oct 16.
Artigo em Inglês | MEDLINE | ID: mdl-34656123

RESUMO

BACKGROUND: Recurrent pregnancy loss (RPL) presents one of the main problems in the field of reproductive medicine, due to the unknown etiology in 50% of cases, as well as limited evidence-based diagnostic and therapeutic modalities. Recent studies indicate that systemic and placental oxidative stress (OS) represents an essential factor in the etiopathogenesis of RPL. This article is a comprehensive narrative synthesis of previously published studies concerning the role of oxidative stress in the etiology of recurrent pregnancy loss. METHODS: We conducted literature search of published studies in the English language focusing on oxidative stress and its association with recurrent pregnancy loss (RPL) utilizing the Medline and Cochrane databases from 2000 through January 2021. The keywords used were "recurrent pregnancy loss" "oxidative stress and recurrent pregnancy loss" and "oxidative stress biomarkers and recurrent pregnancy loss". RESULTS: The search yielded 1116 publications, of which 92 were included in the final analysis. Reactive oxygen species (ROS) and reactive nitrogen species (RNS) at basal levels have various physiological functions whereas deviation from redox window is associated with different pathologies including early pregnancy loss. The currently available studies support the concept that increased oxidative stress (OS) and deficient antioxidant protection is implicated in the etiology of recurrent pregnancy loss (RPL) but underlying mechanisms through which OS affects pregnancy outcome remains largely indefinable. CONCLUSIONS: Future research in this field can provide new insights regarding the OS-mediated damage in recurrent pregnancy loss as well as potential applications of antioxidant therapy in this group of patients.


Assuntos
Aborto Habitual , Placenta , Aborto Habitual/etiologia , Antioxidantes/uso terapêutico , Feminino , Humanos , Estresse Oxidativo , Gravidez , Resultado da Gravidez
17.
J Med Life ; 14(4): 518-522, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34621376

RESUMO

This study aimed to examine the pregnancy outcomes in women infected with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with and without underlying diseases in western Iran. This case-control study compared 49 pregnant women with Coronavirus disease (COVID-19) with underlying diseases (the case group) and 49 women with COVID-19 without underlying diseases (the control group). The groups were pregnant women with COVID-19 admitted to Hamadan hospitals for delivery. COVID-19 was diagnosed by using the reverse transcriptase-polymerase chain reaction (real-time RT-PCR). Data were evaluated using a checklist. Further, the Statistical Package for the Social Sciences (SPSS) version 16 was used for data analysis. A value of p<0.05 was considered statistically significant. The odds of preterm labor were five times higher in women with underlying diseases (OR=5.95, 95% CI (3.01, 7.15), p=0.034). Moreover, the odds of preeclampsia and eclampsia in women with underlying diseases was (OR=3.35, 95% CI (1.18, 4.93), p=0.048) and (OR=2.65, 95% CI (1.43, 3.54), p=0.035), respectively. The results revealed that preterm labor, preeclampsia, and eclampsia were significantly higher in women with COVID-19 and underlying diseases compared to those without underlying diseases. Thus, the need to identify and educate pregnant mothers on underlying diseases and attention to prenatal care, particularly in high-risk groups, is necessary for the COVID-19 pandemic.


Assuntos
COVID-19 , Complicações Infecciosas na Gravidez , Estudos de Casos e Controles , Feminino , Humanos , Recém-Nascido , Pandemias , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Resultado da Gravidez/epidemiologia , Gestantes , SARS-CoV-2
18.
Ann Saudi Med ; 41(5): 274-279, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34618607

RESUMO

BACKGROUND: Pregnancy in women aged 35 years or above is generally considered an advanced maternal age (AMA). AMA is associated with an increased rate of maternal and neonatal complications. OBJECTIVES: Assess the effect of AMA on maternal and neonatal outcomes. DESIGN: Analytical cross-sectional study of medical records. SETTINGS: In-patient hospital tertiary care setting in Jeddah. PATIENTS AND METHODS: All women who attended antenatal care and delivered at King Abdulaziz Medical City in Jeddah in the first half of 2018 were included in the study. Outcomes for women 35 years of age or older were compared with younger women. Significant factors in a univariate analysis were entered in a multiple logistic regression model to assess the association between AMA and outcomes. MAIN OUTCOME MEASURES: Rates of maternal neonatal complications, analysis of factors associated with advanced maternal, gestational diabetes mellitus (GDM), cesarean delivery. SAMPLE SIZE: 1586 women. RESULTS: Of the 1586 women, 406 were 35 years of age or older (25.6%), and 1180 were younger than 35 years. The AMA group had a significantly higher proportion of GDM (32.0% versus 13.2%, P<.001). The adjusted odds ratio (OR) for GDM was 2.6 (95% CI 2-3.5, P<.001.) compared with younger women in the multivariate logistic regression analysis. Older women had a higher rate of cesarean delivery (43.6% versus 30.8%, P<.001). The adjusted OR for cesarean vs. vaginal delivery was 1.5 (CI 1.2-1.9, P=.002). CONCLUSION: Pregnancy in women 35 years or older was associated with an increased risk of GDM and cesarean delivery. LIMITATIONS: Cross-sectional design, small sample size, single hospital. CONFLICT OF INTEREST: None.


Assuntos
Resultado da Gravidez , Adulto , Idoso , Estudos Transversais , Feminino , Humanos , Recém-Nascido , Idade Materna , Gravidez , Resultado da Gravidez/epidemiologia , Arábia Saudita/epidemiologia , Centros de Atenção Terciária
20.
Rev Saude Publica ; 55: 58, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-34706036

RESUMO

OBJECTIVE: Test the association between the practice of physical activity (PA) according to the gestational trimesters and the occurrence of cesarean delivery, prematurity, and low birth weight in puerperal women assisted in the Unified Health System of Santa Catarina, Brazil. METHODS: A cross-sectional study was conducted with a probabilistic sample of puerperal women who gave birth in public maternity hospitals in Santa Catarina from January to August 2019. The cesarean delivery outcome was self-reported, and information on premature birth (< 37 gestational weeks) and low birth weight (< 2,500 grams) were obtained from medical records. The practice of PA during pregnancy and according to each trimester was self-reported. Multivariate Logistic Regression analyses and interviews with 3,580 puerperal women were carried out. RESULTS: PA practice during any period of pregnancy was reported by 20.6% of the sample, with a gradual reduction in prevalence according to the gestational trimester (16.2%, 15.4%, and 12.8%). The highest prevalences of outcomes concerning the total sample were observed in puerperal women who did not practice PA in the third trimester, with 43.9% for cesarean delivery, 7.7% for low birth weight, and 5.5% for premature birth. The odds of cesarean delivery (OR = 1.40; 95%CI 1.10-1.76) and low birth weight (OR = 1.99; 95%CI 1.04-3.79) were, respectively, 40% and 99% higher among puerperal women who did not practice PA in the third trimester of pregnancy when compared to those who practiced PA. There was no association between PA practice and prematurity. CONCLUSION: Puerperal women who did not practice PA in the third trimester of pregnancy were more likely to have cesarean delivery and low birth weight newborns.


Assuntos
Parto , Nascimento Prematuro , Brasil/epidemiologia , Estudos Transversais , Exercício Físico , Feminino , Humanos , Recém-Nascido , Gravidez , Resultado da Gravidez/epidemiologia , Terceiro Trimestre da Gravidez , Nascimento Prematuro/epidemiologia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA