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Journal of Vascular Research 2021Data regarding women and thromboangiitis obliterans (TAO) are conflicted, and a few cases of pregnancy have been described. We aimed to describe the interplay between...
Data regarding women and thromboangiitis obliterans (TAO) are conflicted, and a few cases of pregnancy have been described. We aimed to describe the interplay between TAO and pregnancies. Among 224 TAO patients, 22.8% were women. Demographic data, clinical manifestations, and outcomes were similar between men and women. Twenty-one (41.2%) women had 48 pregnancies. Thirty-six (75%) pregnancies with on term and complication free delivery occurred. None of the patients experienced a disease flare of TAO during pregnancy. TAO does not seem to affect pregnancy complications, and pregnancy does not seem to interfere with the course of TAO.
Topics: Adult; Female; France; Humans; Live Birth; Middle Aged; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Prognosis; Retrospective Studies; Risk Assessment; Risk Factors; Thromboangiitis Obliterans
PubMed: 33434911
DOI: 10.1159/000512596 -
Pediatric Research Mar 2017Studies have shown that hypospadias is associated with placenta-mediated pregnancy complication (PMPC). The role of placental lesions is still unclear. We aimed to...
BACKGROUND
Studies have shown that hypospadias is associated with placenta-mediated pregnancy complication (PMPC). The role of placental lesions is still unclear. We aimed to examine the association between hyposadias and placental pathology, and the effect of PMPC.
METHODS
Using data from the US Collaborative Perinatal Project in 1959-1966, we identified 15,780 male subjects (167 hypospadias) for analysis. Detailed placental examinations were conducted following a standard protocol. Subjects were divided into two groups according to whether they had PMPC, including small-for-gestational-age, pre-eclampsia/eclampsia or placental abruption. Logistic regression models were used to explore the association.
RESULTS
The prevalence of hypospadias was two times higher in subjects with PMPC than those without. Compared to pregnancies with PMPC but no hypospadias, those with both PMPC and hypospadias had significant higher prevalence of placental lesions, such as low placental weight, vascular lesions, villous lesions, and membranous insertion of cord (adjusted odds ratio (OR) ranging from 2.6 to 5.2) after adjusting for potential confounders. In subjects without PMPC, no significant difference of placental pathology was found between those with or without hypospadias.
CONCLUSION
About one third of hypospadias cases were complicated with PMPC and had a higher risk of placental lesions, suggesting heterogeneity of hypospadias etiology and mechanisms.
Topics: Abruptio Placentae; Adult; Female; Gestational Age; Humans; Hypospadias; Infant; Infant, Newborn; Male; Odds Ratio; Placenta; Pre-Eclampsia; Pregnancy; Pregnancy Complications; Prospective Studies; Regression Analysis; Risk Factors
PubMed: 27855149
DOI: 10.1038/pr.2016.246 -
Birth Defects Research Jul 2017Major depressive disorder (MDD) is a common complication of pregnancy. Once the diagnosis of MDD is made, the physician must assist the pregnant woman in developing a... (Review)
Review
BACKGROUND
Major depressive disorder (MDD) is a common complication of pregnancy. Once the diagnosis of MDD is made, the physician must assist the pregnant woman in developing a treatment plan.
METHODS
In considering antidepressants, the benefit of medication treatment for maternal disease control must be balanced against the risk of the drug to the developing embryo-fetus. This is an individualized decision depending on the disease characteristics, likelihood of maternal depression response, probability of adverse fetal effects, and patient characteristics and values.
RESULTS
There is no "zero risk" solution in caring for the pregnant woman with MDD; both the disorder and the medication present risks to the mother and the embryo-fetus. If the decision to use antidepressant medication during pregnancy is made, the justification is that the disease is associated with greater risk than the treatment. The goal should be remission of symptoms to maximally reduce disease risk to the mother and developing fetus.
CONCLUSION
Optimization of selective serotonin reuptake inhibitor dosing during pregnancy dictates several treatment goals: (1) the drug must be at the optimal dose for the woman; that is, the dose that produces the best response with tolerable side effects; (2) a continuous measure of symptoms must be repeated and adjustments to maintain optimal antidepressant efficacy may be required, due to pharmacokinetic changes during pregnancy; and (3) the resolution of pregnancy at birth also requires dose adjustment in accord with the woman's transition to the nonpregnant, breastfeeding state. Birth Defects Research 109:879-887, 2017.© 2017 Wiley Periodicals, Inc.
Topics: Adult; Antidepressive Agents; Depression; Depressive Disorder, Major; Female; Humans; Pregnancy; Pregnancy Complications; Prenatal Exposure Delayed Effects; Risk; Selective Serotonin Reuptake Inhibitors
PubMed: 28714606
DOI: 10.1002/bdr2.1074 -
Vascular and Endovascular Surgery Oct 2018Pregnancy is a hypercoagulable state, conferring an increased risk of venous thromboembolism (VTE). However, treatment algorithms for deep venous thrombosis and... (Review)
Review
BACKGROUND
Pregnancy is a hypercoagulable state, conferring an increased risk of venous thromboembolism (VTE). However, treatment algorithms for deep venous thrombosis and pulmonary embolism are based on studies of nonpregnant patients.
METHODS
A literature review of cases in which thrombolysis was used for the treatment of VTE during pregnancy was conducted using the PubMed (National Institutes of Health) database.
RESULTS
A PubMed database search of English language articles for reports of thrombolysis for the treatment of VTE in pregnancy identified 215 cases, including 183 cases of systemic thrombolysis, 19 cases of catheter-directed thrombolysis, and 13 cases of mechanical thrombectomy. For systemic thrombolysis, the maternal complication rate was 4.40% and the fetal complication rate was 1.65%. For catheter-directed thrombolysis, the maternal complication rate was 14.75% and the fetal complication rate was 5.2%. In cases of mechanical thrombectomy, there were no reported maternal or fetal complications.
CONCLUSIONS
Although conservative strategies are preferred in pregnancy, thrombolysis is an adjunct for limb or life-threatening VTE. Review of past reports suggests low rates of maternal and fetal complications following systemic thrombolysis and mechanical thrombectomy but higher rates of complications after catheter-directed thrombolysis in the treatment of VTE during pregnancy.
Topics: Blood Coagulation; Female; Fibrinolytic Agents; Humans; Pregnancy; Pregnancy Complications, Cardiovascular; Risk Factors; Thrombolytic Therapy; Treatment Outcome; Venous Thromboembolism
PubMed: 29804522
DOI: 10.1177/1538574418777822 -
Human Reproduction (Oxford, England) Oct 2019Are reproductive characteristics associated with genome-wide DNA methylation and epigenetic age?
STUDY QUESTION
Are reproductive characteristics associated with genome-wide DNA methylation and epigenetic age?
SUMMARY ANSWER
Our data suggest that increasing parity is associated with differences in blood DNA methylation and small increases in epigenetic age.
WHAT IS KNOWN ALREADY
A study of 397 young Filipino women (ages 20-22) observed increasing epigenetic age with an increasing number of pregnancies.
STUDY DESIGN, SIZE, DURATION
We used data from 2356 non-Hispanic white women (ages 35-74) enrolled in the Sister Study cohort.
PARTICIPANTS/MATERIALS, SETTING, METHODS
Data on reproductive history were ascertained via questionnaire. Of the 2356 women, 1897 (81%) reported at least one live birth. Among parous women, 487 (26%) women reported ever experiencing a pregnancy complication. Three epigenetic clocks (i.e. Hannum, Horvath and Levine) and genome-wide methylation were measured in DNA from whole blood using Illumina's HumanMethylation450 BeadChip. We estimated association β-values and 95% CIs using linear regression.
MAIN RESULTS AND THE ROLE OF CHANCE
All three epigenetic clocks showed weak associations between number of births and epigenetic age (per live birth; Hannum: β = 0.16, 95% CI = 0.02, 0.29, P = 0.03; Horvath: β = 0.12, 95% CI = -0.04, 0.27, P = 0.14; Levine: β = 0.27, 95% CI = 0.08, 0.45, P = 0.01); however, additional adjustment for current BMI attenuated the associations. Among parous women, a history of abnormal glucose tolerance during pregnancy was associated with increased epigenetic age by the Hannum clock (β = 0.96; 95% CI = 0.10, 1.81; P = 0.03) and Levine clocks (β = 1.69; 95% CI = 0.54, 2.84; P < 0.01). In epigenome-wide analysis, increasing parity was associated with methylation differences at 17 CpG sites (Bonferroni corrected P≤ 1.0 × 10-7).
LIMITATIONS, REASONS FOR CAUTION
We relied on retrospective recall to ascertain reproductive history and pregnancy complications.
WIDER IMPLICATIONS OF THE FINDINGS
Our findings suggest that parity is associated with small increases in epigenetic age and with DNA methylation at multiple sites in the genome.
STUDY FUNDING/COMPETING INTEREST(S)
This research was supported by the Intramural Research program of the NIH, National Institute of Environmental Health Sciences (Z01-ES049033, Z01-ES049032 and Z01-ES044055). None of the authors have a conflict of interest.
TRIAL REGISTRATION NUMBER
Not applicable.
Topics: Adult; Age Factors; Aged; Aging; Body Mass Index; DNA Methylation; Epigenesis, Genetic; Female; Humans; Live Birth; Middle Aged; Parity; Pregnancy; Pregnancy Complications; Prospective Studies; Puerto Rico; Retrospective Studies; Surveys and Questionnaires; United States
PubMed: 31600381
DOI: 10.1093/humrep/dez149 -
Acta Neurologica Scandinavica Jul 2022While neurologic complications are frequently reported among patients with COVID-19 in the general population, they are unknown in pregnant women. This paper summarizes... (Review)
Review
While neurologic complications are frequently reported among patients with COVID-19 in the general population, they are unknown in pregnant women. This paper summarizes the case reports of pregnant women with confirmed SARS-CoV-2 infection plus a specified neurologic diagnosis. Until November 2021, 18 case reports were found. Both the central and peripheral nervous systems were equally affected: delirium (n = 1), posterior reversible encephalopathy syndrome (n = 4), cerebrovascular disease (n = 2), acute cerebral demyelinating disease (n = 1), acute necrotizing encephalopathy (n = 1), Guillain-Barré syndrome (n = 5), including one patient who also had vestibular neuritis, Bell's palsy (n = 3), and rhabdomyolysis (n = 1). The median maternal age was 32.5 (25-35) years, the median gestational age was 34 (30-36.5) weeks, and 38.9% presented previous medical conditions. Respiratory symptoms were reported in 76.5%, and 76.5% received immunotherapies to treat the COVID-19 or the neurologic complications. Half the women required admission to ICU and, more often, were those with central nervous system involvement (77.8% vs. 22.2%; Chi-square test, p = .018). For 64.7% of women, the most common method of delivery was surgical, although just one case was due to the neurologic complication. There were reports of one spontaneous abortion, two fetal deaths, and no maternal deaths. Only one case presented a poor neurologic outcome. It is possible that our findings are underestimated, considering that there are thousands of reports regarding neurologic complications in the general population with COVID-19.
Topics: Abortion, Spontaneous; Adult; COVID-19; Female; Humans; Infant; Posterior Leukoencephalopathy Syndrome; Pregnancy; Pregnancy Complications; Pregnancy Outcome; SARS-CoV-2
PubMed: 35388457
DOI: 10.1111/ane.13621 -
BMC Pregnancy and Childbirth Mar 2022This study aimed to compare obstetric outcomes in Korean women with and without future cardiovascular disease (CVD) within 10 years after pregnancy, and assessed...
BACKGROUND
This study aimed to compare obstetric outcomes in Korean women with and without future cardiovascular disease (CVD) within 10 years after pregnancy, and assessed whether pregnancy complications are independent risk factors, and whether the combination of pregnancy complications has an additive function for risk factors for CVD.
METHODS
This was a nationwide population-based study combining the database of the Korea National Health Insurance claims and National Health Screening Programs to assess preeclampsia, low birth weight (LBW), and preterm delivery as risk factors for CVD. Cox proportional hazards models was used to evaluate the risk of total CVD, ischemic heart disease (IHD), and stroke after the pregnancy complications, with adjustment for potential confounding variables.
RESULTS
Women with CVD were likely to have a higher prevalence of pregnancy complications than women without CVD. The risk of total CVD was associated with preeclampsia (adjusted hazard ratio (HR), 1.60 [95% confidence interval (CI) 1.50-1.72]), LBW (1.20 [1.12-1.28]), and preterm delivery (1.32 [1.22-1.42]), after adjustment for confounders, including cardiovascular risk factors before pregnancy. The risk estimates of pregnancy complications for IHD were higher than those for stroke. In this study, the risk of total CVD was higher in the combined presence of preeclampsia and preterm delivery (2.23 [1.57-3.17] or all three complications (2.06 [1.76-2.40]), relative to no complications. The highest HR was noted in the risk of all pregnancy complications for IHD (2.39 [1.98-2.89]).
CONCLUSION
Preeclampsia, preterm delivery, and LBW were independently associated with CVD in young Korean women. In addition, the combination of pregnancy complications had less-than-additive effects on CVD incidence.
Topics: Cardiovascular Diseases; Female; Humans; Infant, Newborn; Pregnancy; Pregnancy Complications; Premature Birth; Republic of Korea; Risk Factors
PubMed: 35313851
DOI: 10.1186/s12884-022-04578-2 -
Advances in Experimental Medicine and... 2020During pregnancy and lactation, breast vascularity increases and edema occurs in the breast . As a consequence, rate of complications of breast biopsy and surgery like... (Review)
Review
During pregnancy and lactation, breast vascularity increases and edema occurs in the breast . As a consequence, rate of complications of breast biopsy and surgery like bleeding, infection, delayed healing and wound dehiscence is expected to be higher. Milk fistula is a rare event that may complicate surgery or needle biopsy of the breast in a breastfeeding woman, or in late stages of pregnancy . Suppression of lactation has been proposed in the literature as both a preventive and a therapeutic step. However, the advantages of nursing for both mother and child are numerous, and the author do not propose it as a preventive measure nor as a must in treatment of milk fistula. Prevention and management of milk fistula are discussed in this chapter.
Topics: Biopsy, Needle; Breast; Breast Feeding; Breast Neoplasms; Female; Fistula; Humans; Infant; Lactation; Milk, Human; Pregnancy; Pregnancy Complications
PubMed: 32816268
DOI: 10.1007/978-3-030-41596-9_13 -
BMC Pregnancy and Childbirth Mar 2023Unlike other causes such as abortion, obstetric complications like hemorrhage, and hypertensive disorders of pregnancy, which are difficult to resolve for women who give... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Unlike other causes such as abortion, obstetric complications like hemorrhage, and hypertensive disorders of pregnancy, which are difficult to resolve for women who give birth out of health facilities are persisted or increased to be the cause of maternal mortality in Ethiopia. Direct obstetric complications resulted in the crude direct obstetric case fatality rate in this country. This study aimed to assess the relationship between Complication Experience during Pregnancy and Place of Delivery among Pregnant Women.
METHOD
A community-based cross-sectional study was conducted to assess the baseline information as a part of a randomized control trial study. The sample size that was calculated for the cohort study with the assumptions to detect an increase in a minimum acceptable diet from 11 to 31%, with 95% CIs and 80% power, an intra-cluster correlation coefficient of 0·2 for a cluster size of 10 was used for this study. Statistical analysis was done using SPSS version 22.
RESULT
The prevalence of self-reported pregnancy-related complications and home delivery were 79(15.9%, CI; 12.7-19.1) and 46.90% (95%CI; 42.5-51.1) respectively. Women who did not face vaginal bleeding were five times AOR 5.28(95% CI: 1.79-15.56) more like to give birth at home than those who faced this problem. Women who did not face severe headache were nearly three AOR 2.45(95%CI:1.01-5.97) times more like to give birth at home.
CONCLUSION
This study concluded that home delivery was high among the study participants whereas pregnancy-related complications such as vaginal bleeding and severe headache were identified as protective factors for facility delivery. Hence, the researchers recommended the incorporation of "storytelling" into the existing health extension program packages to improve facility delivery which shall be applied after the approval of its effectiveness by further research.
Topics: Pregnancy; Female; Humans; Pregnant Women; Cross-Sectional Studies; Cohort Studies; Surveys and Questionnaires; Health Knowledge, Attitudes, Practice; Parturition; Pregnancy Complications; Uterine Hemorrhage; Ethiopia; Headache; Delivery, Obstetric; Prenatal Care
PubMed: 36906518
DOI: 10.1186/s12884-023-05390-2 -
The Journal of Maternal-fetal &... Aug 2018A pregnancy complicated with rheumatologic diseases can have various influences on the fetus and/or neonate. Maternal systemic lupus erythematosus (SLE) may cause... (Review)
Review
A pregnancy complicated with rheumatologic diseases can have various influences on the fetus and/or neonate. Maternal systemic lupus erythematosus (SLE) may cause preterm and/or small for gestational age (SGA) delivery and neonatal lupus (NL). Some neonates with NL have congenital heart block (CHB) with increased morbidity and mortality, even requiring pacemakers. Antiphospholipid syndrome may occur with SLE and affect fetal and/or neonatal outcomes. Pregnancy involving primary Sjögren's syndrome (pSS) tends to result in preterm delivery and low birthweight infants. Moreover, CHB is the most challenging complication for neonates delivered by women with pSS. Pregnant women with rheumatoid arthritis (RA) are at an increased risk for delivering a preterm or SGA neonate. In addition, RA drugs may have adverse effects on the fetus and breast-fed neonate. With dermatomyositis/polymyositis, pregnancies are at increased risk for spontaneous abortion, perinatal death, and preterm delivery. At present, overall neonatal survival rates are good for pregnancies involving systemic sclerosis, despite an increased frequency of premature and SGA neonates. In conclusion, maternal rheumatological diseases require careful monitoring to ensure the best possible management for fetal and neonatal outcomes.
Topics: Connective Tissue Diseases; Contraception; Female; Humans; Infant, Newborn; Pregnancy; Pregnancy Complications
PubMed: 28532196
DOI: 10.1080/14767058.2017.1334048