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Clinical and Translational... Apr 2024
Topics: Humans; Female; Pancreatitis, Chronic; Pregnancy; Pregnancy Complications; Genetic Predisposition to Disease
PubMed: 38661173
DOI: 10.14309/ctg.0000000000000698 -
Ugeskrift For Laeger Jul 2023Peripartum cardiomyopathy is a rare and potentially dangerous form of heart failure presenting in women in the last month of pregnancy until five months post partum. The...
Peripartum cardiomyopathy is a rare and potentially dangerous form of heart failure presenting in women in the last month of pregnancy until five months post partum. The pathogenesis is believed to be multifactorial. This case report describes a young woman with adiposity and preeclampsia who was admitted to hospital and whose clinical condition quickly deteriorated. During the emergency caesarian section, the woman suffered a cardiac arrest and was successfully resuscitated. Echocardiography showed heart failure with an ejection fraction less-than 45% confirming the diagnosis of peripartum cardiomyopathy.
Topics: Female; Pregnancy; Humans; Cesarean Section; Peripartum Period; Pregnancy Complications, Cardiovascular; Cardiomyopathies; Heart Failure; Heart Arrest
PubMed: 37539794
DOI: No ID Found -
Social Psychiatry and Psychiatric... Nov 2023This systematic review of systematic reviews aims to provide the first global picture of the prevalence and correlates of perinatal depression, and to explore the... (Review)
Review
PURPOSE
This systematic review of systematic reviews aims to provide the first global picture of the prevalence and correlates of perinatal depression, and to explore the commonalities and discrepancies of the literature.
METHODS
Seven databases were searched from inception until April 2022. Full-text screening and data extraction were performed independently by two researchers and the AMSTAR tool was used to assess the methodological quality.
RESULTS
128 systematic reviews were included in the analysis. Mean overall prevalence of perinatal depression, antenatal depression and postnatal depression was 26.3%, 28.5% and 27.6%, respectively. Mean prevalence was significantly higher (27.4%; SD = 12.6) in studies using self-reported measures compared with structured interviews (17.0%, SD = 4.5; d = 1.0) and among potentially vulnerable populations (32.5%; SD = 16.7, e.g. HIV-infected African women) compared to the general population (24.5%; SD = 8.1; d = 0.6). Personal history of mental illness, experiencing stressful life events, lack of social support, lifetime history of abuse, marital conflicts, maternity blues, child care stress, chronic physical health conditions, preeclampsia, gestational diabetes mellitus, being exposed to second-hand smoke and sleep disturbance were among the major correlates of perinatal depression.
CONCLUSION
Although the included systematic reviews were all of medium-high quality, improvements in the quality of primary research in this area should be encouraged. The standardisation of perinatal depression assessment, diagnosis and measurement, the implementation of longitudinal designs in studies, inclusions of samples that better represent the population and better control of potentially confounding variables are encouraged.
Topics: Female; Humans; Pregnancy; Child; Depression; Prevalence; Systematic Reviews as Topic; Depression, Postpartum; Pregnancy Complications
PubMed: 36646936
DOI: 10.1007/s00127-022-02386-9 -
Archives of Gynecology and Obstetrics Jun 2024Lymphangioleiomyomatosis(LAM) is a slow progressive, rare cystic lung disease in women of reproductive age, associated with infiltration of the lung by atypical smooth... (Review)
Review
Lymphangioleiomyomatosis(LAM) is a slow progressive, rare cystic lung disease in women of reproductive age, associated with infiltration of the lung by atypical smooth muscle like cells, leading to the cystic destruction of the lung parenchyma. As LAM exclusively affects women of childbearing age, it can arise or exacerbate during pregnancy. Many patients with LAM are discouraged from pregnancy, although there is not much objective evidence effect on fertility. Patients diagnosed with LAM during pregnancy experience worse outcomes, so the safety of pregnancy is a vexing problem. What was worse, treatment strategies are limited on the effects of LAM on pregnancy outcomes. Pregnancy could be considered in LAM patients. Successful delivery in women with LAM depends on the condition of the LAM, which is in turn dependent on obstetricians and respiratory physicians. In this review, we describe the epidemiology, pathogenesis, diagnosis, clinical features and the treatment strategies of LAM during pregnancy.
Topics: Humans; Female; Lymphangioleiomyomatosis; Pregnancy; Pregnancy Complications, Neoplastic; Pregnancy Outcome; Lung Neoplasms
PubMed: 38594407
DOI: 10.1007/s00404-024-07478-2 -
Methodist DeBakey Cardiovascular Journal 2024Valvular heart disease is a common cause of peripartum cardiovascular morbidity and mortality. The hemodynamic changes of pregnancy and their impact on preexisting... (Review)
Review
Valvular heart disease is a common cause of peripartum cardiovascular morbidity and mortality. The hemodynamic changes of pregnancy and their impact on preexisting valvular lesions are described in this paper. Tools for calculation of maternal and fetal risk during pregnancy are also discussed. The pathophysiology and management of valvular lesions, both obstructive and regurgitant, are then described, followed by discussion of mechanical and bioprosthetic valve complications during pregnancy.
Topics: Female; Humans; Pregnancy; Heart Valve Diseases; Pregnancy Complications, Cardiovascular
PubMed: 38495658
DOI: 10.14797/mdcvj.1323 -
Frontiers in Endocrinology 2023Systemic lupus erythematosus is a debilitating autoimmune disease characterized by uncontrolled activation of adaptive immunity, particularly B cells, which... (Review)
Review
Systemic lupus erythematosus is a debilitating autoimmune disease characterized by uncontrolled activation of adaptive immunity, particularly B cells, which predominantly affects women in a 9 to 1 ratio compared to men. This stark sex disparity strongly suggests a role for female sex hormones in the disease's onset and progression. Indeed, it is widely recognized that estradiol not only enhances the survival of autoreactive B cells but also stimulates the production of autoantibodies associated with systemic lupus erythematosus, such as anti-nuclear antibodies and anti-dsDNA antibodies. Clinical manifestations of systemic lupus erythematosus typically emerge after puberty and persist throughout reproductive life. Furthermore, symptoms often exacerbate during the premenstrual period and pregnancy, as increased levels of estradiol can contribute to disease flares. Despite being fertile, women with lupus face a heightened risk of pregnancy-related complications, including pregnancy loss and stillbirth, which significantly surpass the rates observed in the healthy population. Therefore, this review aims to summarize and discuss the existing literature on the influence of female sex hormones on B-cell activation in patients with systemic lupus erythematosus, with a particular emphasis on their impact on pregnancy loss.
Topics: Pregnancy; Male; Humans; Female; Lupus Erythematosus, Systemic; Autoantibodies; Pregnancy Complications; Estradiol; Abortion, Habitual
PubMed: 37859991
DOI: 10.3389/fendo.2023.1233883 -
JAMA Dec 2023Cannabis use is increasing among reproductive-age individuals and the risks associated with cannabis exposure during pregnancy remain uncertain.
IMPORTANCE
Cannabis use is increasing among reproductive-age individuals and the risks associated with cannabis exposure during pregnancy remain uncertain.
OBJECTIVE
To evaluate the association between maternal cannabis use and adverse pregnancy outcomes known to be related to placental function.
DESIGN, SETTING, AND PARTICIPANTS
Ancillary analysis of nulliparous individuals treated at 8 US medical centers with stored urine samples and abstracted pregnancy outcome data available. Participants in the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be cohort were recruited from 2010 through 2013; the drug assays and analyses for this ancillary project were completed from June 2020 through April 2023.
EXPOSURE
Cannabis exposure was ascertained by urine immunoassay for 11-nor-9-carboxy-Δ9-tetrahydrocannabinol using frozen stored urine samples from study visits during the pregnancy gestational age windows of 6 weeks and 0 days to 13 weeks and 6 days (visit 1); 16 weeks and 0 days to 21 weeks and 6 days (visit 2); and 22 weeks and 0 days to 29 weeks and 6 days (visit 3). Positive results were confirmed with liquid chromatography tandem mass spectrometry. The timing of cannabis exposure was defined as only during the first trimester or ongoing exposure beyond the first trimester.
MAIN OUTCOME AND MEASURE
The dichotomous primary composite outcome included small-for-gestational-age birth, medically indicated preterm birth, stillbirth, or hypertensive disorders of pregnancy ascertained by medical record abstraction by trained perinatal research staff with adjudication of outcomes by site investigators.
RESULTS
Of 10 038 participants, 9257 were eligible for this analysis. Of the 610 participants (6.6%) with cannabis use, 32.4% (n = 197) had cannabis exposure only during the first trimester and 67.6% (n = 413) had ongoing exposure beyond the first trimester. Cannabis exposure was associated with the primary composite outcome (25.9% in the cannabis exposure group vs 17.4% in the no exposure group; adjusted relative risk, 1.27 [95% CI, 1.07-1.49]) in the propensity score-weighted analyses after adjustment for sociodemographic characteristics, body mass index, medical comorbidities, and active nicotine use ascertained via urine cotinine assays. In a 3-category cannabis exposure model (no exposure, exposure only during the first trimester, or ongoing exposure), cannabis use during the first trimester only was not associated with the primary composite outcome; however, ongoing cannabis use was associated with the primary composite outcome (adjusted relative risk, 1.32 [95% CI, 1.09-1.60]).
CONCLUSIONS AND RELEVANCE
In this multicenter cohort, maternal cannabis use ascertained by biological sampling was associated with adverse pregnancy outcomes related to placental dysfunction.
Topics: Female; Humans; Infant; Infant, Newborn; Pregnancy; Cannabis; Cohort Studies; Dronabinol; Hallucinogens; Marijuana Abuse; Maternal Exposure; Placenta; Placenta Diseases; Pregnancy Outcome; Premature Birth; Stillbirth; Pregnancy Complications
PubMed: 38085313
DOI: 10.1001/jama.2023.21146 -
International Journal of Molecular... Sep 2023Following our first Special Issue, we are pleased to present this Special Issue in the entitled 'Placental Related Disorders of Pregnancy 2 [...].
Following our first Special Issue, we are pleased to present this Special Issue in the entitled 'Placental Related Disorders of Pregnancy 2 [...].
Topics: Female; Humans; Pregnancy; Placenta; Pregnancy Complications
PubMed: 37762593
DOI: 10.3390/ijms241814286 -
Acta Obstetricia Et Gynecologica... Jun 2024
Topics: Humans; Female; Pregnancy; Pelvic Floor Disorders; Pelvic Floor; Delivery, Obstetric; Pregnancy Complications; Obstetric Labor Complications
PubMed: 38764284
DOI: 10.1111/aogs.14875 -
International Journal of Epidemiology Dec 2023Cerebral palsy (CP) is the most common cause of childhood physical disability whose aetiology remains unclear in most cases. Maternal pre-existing and pregnancy...
BACKGROUND
Cerebral palsy (CP) is the most common cause of childhood physical disability whose aetiology remains unclear in most cases. Maternal pre-existing and pregnancy complications are recognized risk factors of CP but the extent to which their effects are mediated by pre-term birth is unknown.
METHODS
Population-based cohort study in Sweden including 2 055 378 singleton infants without congenital abnormalities, born between 1999 and 2019. Data on maternal and pregnancy characteristics and diagnoses of CP were obtained by individual record linkages of nationwide Swedish registries. Exposure was defined as maternal pre-pregnancy and pregnancy disorders. Inpatient and outpatient diagnoses were obtained for CP after 27 days of age. Adjusted rate ratios (aRRs) were calculated, along with 95% CIs.
RESULTS
A total of 515 771 (25%) offspring were exposed to maternal pre-existing chronic disorders and 3472 children with CP were identified for a cumulative incidence of 1.7 per 1000 live births. After adjusting for potential confounders, maternal chronic cardiovascular or metabolic disorders, other chronic diseases, mental health disorders and early-pregnancy obesity were associated with 1.89-, 1.24-, 1.26- and 1.35-times higher risk (aRRs) of CP, respectively. Most notably, offspring exposed to maternal antepartum haemorrhage had a 6-fold elevated risk of CP (aRR 5.78, 95% CI, 5.00-6.68). Mediation analysis revealed that ∼50% of the effect of these associations was mediated by pre-term delivery; however, increased risks were also observed among term infants.
CONCLUSIONS
Exposure to pre-existing maternal chronic disorders and pregnancy-related complications increases the risk of CP in offspring. Although most infants with CP were born at term, pre-term delivery explained 50% of the overall effect of pre-pregnancy and pregnancy disorders on CP.
Topics: Infant; Child; Pregnancy; Female; Humans; Cohort Studies; Term Birth; Cerebral Palsy; Pregnancy Complications; Risk Factors
PubMed: 37494957
DOI: 10.1093/ije/dyad106