Infant births during the internal night are at increased risk for operative delivery and NICU admission.

PURPOSE: The purpose of the present study was to compare neonatal morbidity between night and the rest of day and investigate potential differences of birth outcomes during the internal night. METHODS: We conducted a retrospective study based on maternal and neonatal data of period 2004-2007, enrolling exclusively spontaneous deliveries of term (≥ 37 weeks), singleton pregnancies with cephalic presentation that were in labor. Time of day was divided into the night-shift period, from 11.00 p.m. to 7.00 a.m. (period 1) and the rest-of-day period, from 7.00 a.m. to 11.00 p.m. (period 2). The night-shift period was further sub-divided into period 1a (11.00 p.m.-3.00 a.m.) and period 1b (3.00 a.m.-7.00 a.m.). Epidemiological and obstetric characteristics as well as neonatal outcomes were initially compared between periods 1 and 2 and thereafter between sub-periods 1a and 1b. RESULTS: There were 3,055 cases with complete data meeting our inclusion criteria, of which 871 (28.5%) were delivered during period 1 and 2,184 (71.5%) during period 2. Furthermore, 51.3% of night-born infants were delivered during period 1a and the remaining 48.7% during period 1b. All examined parameters were not significantly different between periods 1 and 2. Analyzing night internally, the rate of emergent CS was significantly higher for period 1a (13.2%), compared with period 1b (4%). Furthermore, incidence of NICU admission was significantly higher for the first half of the night-shift period (2.7%) compared to the relative of the second half (0.5%). CONCLUSIONS: Neonatal morbidity was comparable between night-shift and rest-of-day periods, but the rates of emergent CS and NICU admission were significantly increased in the first half of the night-shift period (11.00 p.m.-3.00 a.m.).

Immigrants present improved obstetric and neonatal outcomes compared to native women. A northern greek population analysis.

To compare the incidence of obstetric and neonatal outcomes between native and immigrant women. A retrospective cohort of singleton pregnancies was conducted concerning the period 2003-2009. Women were divided in group 1, including natives and group 2, including immigrants. Epidemiological characteristics, obstetric outcomes and neonatal morbidity parameters were studied. Out of 7033 singleton pregnancies delivered during this period, 6980 with complete information were finally included. Immigrants consisted 47.59 % of all gravidas (group 2, n = 3322), presenting significantly lower rates of emergency caesarean section, preeclampsia, preterm delivery, placenta praevia and fetal distress. Furthermore, all parameters of neonatal morbidity, including Mean Apgar score in the 1st and 5th minute as well as rates of NICU admission and emergency intubation were significantly improved in the group of immigrants. According to our results, pregnancies of immigrant women are less likely to be complicated by severe obstetric and neonatal outcomes.

Homocysteine, folic acid and B12 serum levels in pregnancy complicated with preeclampsia.

OBJECTIVE: Elevated plasma homocysteine has been implicated in vascular changes compatible with atherosis and endothelial dysfunction similar to the vascular changes of the placenta in preeclampsia. Previous reports have indicated an increased incidence of hyperohomocysteinemia in preeclamptic patients. The aim of this study was to examine the association of homocysteine levels and preeclampsia in our patients. STUDY DESIGN: Prospective study of 28 preeclamptic patients that were matched with 26 normal controls of the same gestational age. RESULTS: The preeclamptic group had an increased incidence of cesarean sections (75%), of growth retarded fetuses (50%), intrauterine deaths (7%) and placental abruptions (7%). Mean levels of homocysteine were significantly elevated in the preeclamptic than in control group (11.11 vs. 6.40 micromol/l, P < 0.001). There were no differences between the groups regarding the levels of folic acid (11.12 vs. 9.73 ng/ml, P = 0.55) and vitamin B12 (295.76 vs. 356.15 pg/ml, P = 0.43). CONCLUSION: It is concluded that in our study homocysteine levels are significantly elevated in patients with preeclampsia compared with control group, while no vitamin deficiencies were observed.

Tibolone therapy in breast cancer survivors: a retrospective study.

AIM: To investigate a possible relationship between tibolone therapy and recurrence or mortality in breast cancer survivors. METHODS: In a retrospective study, data from files of 247 patients who had been treated for breast cancer were analyzed. Twenty women were treated with tibolone because of menopausal symptoms (Group 1: mean duration of tibolone use 37.1 months). One hundred and one women who did not take tibolone were selected as the control group (Group 2). All women were followed up in our Department on our standard protocol (mean follow up: 73.4 months in Group 1, 67.4 months in Group 2). Comparison of the survival curves was applied with the Wilcoxon (Gehan) statistic. Cox regression analysis was also applied in order to identify significant coefficients in the survival curve. RESULTS: Recurrence of breast cancer was observed in two (10%) Group 1 women versus 21 (21%) Group 2 women (P = NS). Two Group 1 women died (one from breast cancer recurrence) versus 15 Group 2 women (14 from breast cancer recurrence). CONCLUSIONS: Despite of the inherent limitations of this small retrospective study, it seems that tibolone does not reveal an apparent negative impact on breast cancer outcome when given to breast cancer survivors.