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Women's Health Issues : Official... 2009We examined whether adult women's intention for future pregnancy predicted actual pregnancies occurring in a 2-year follow-up study.
OBJECTIVE
We examined whether adult women's intention for future pregnancy predicted actual pregnancies occurring in a 2-year follow-up study.
METHODS
Data are from the Central Pennsylvania Women's Health Study population-based longitudinal survey of women ages 18-45 (n = 1,420). The analytic sample consists of 889 nonpregnant women who had reproductive capacity. Intention for future pregnancy was ascertained at baseline, and women were re-interviewed 2 years later to document interval pregnancies. The impact of pregnancy intention on subsequent pregnancy was analyzed using multiple logistic regression adjusting for relevant covariates.
RESULTS
At baseline, 46% of women were considering a future pregnancy. One hundred thirty-seven women became pregnant during the 2-year study; of these pregnancies, 83% were intended (occurring in women considering a future pregnancy at baseline) and 17% were unintended (occurring in women not considering a future pregnancy at baseline). Pregnancies occurred in 28% of women who at baseline were considering future pregnancy and 5% of women not considering pregnancy. In adjusted analysis, baseline pregnancy intention was predictive of with pregnancy occurrence in women ages 25-34 (adjusted odds ratio [OR], 4.19; 95% confidence interval [CI], 2.20-7.97) and ages 35-45 (adjusted OR, 26.89; 95% CI, 9.05-79.93), but not in women ages 18-24.
CONCLUSIONS
In this prospective study, pregnancy intention was strongly associated with pregnancy incidence over a 2-year follow-up period among women ages 25 and older, suggesting that pregnancy intentions could be used to identify women at greater risk of pregnancy. Future investigation is needed to confirm these findings and to explore the reasons why pregnancy intentions were not predictive for women ages 18-24.
Topics: Adolescent; Adult; Female; Humans; Intention; Longitudinal Studies; Middle Aged; Pennsylvania; Pregnancy; Young Adult
PubMed: 19447320
DOI: 10.1016/j.whi.2009.02.001 -
International Journal of Molecular... Jan 2024Steroid hormones have diverse roles in pregnancy; some help stabilise pregnancy and influence the stability of pregnancy and the onset of labour. Changes and disorders...
Steroid hormones have diverse roles in pregnancy; some help stabilise pregnancy and influence the stability of pregnancy and the onset of labour. Changes and disorders in steroidogenesis may be involved in several pregnancy pathologies. To date, only a few studies have performed a very limited steroid analysis in multiple pregnancies. Our teams investigated multiple pregnancies regarding the biosynthesis, transport, and effects of steroids. We recruited two groups of patients: pregnant women with multiple pregnancies as the study group, and a control singleton pregnancies group. Blood samples were drawn from the participants and analysed. Information about the mother, foetus, delivery, and newborn was extracted from medical records. The data were then analysed. The gestational age of twin pregnancies during delivery ranged from 35 + 3 to 39 + 3 weeks, while it was 38 + 1 to 41 + 1 weeks for the controls. Our findings provide answers to questions regarding the steroidome in multiple pregnancies. Results demonstrate differences in the steroidome between singleton and twin pregnancies. These were based on the presence of two placentae and two foetal adrenal glands, both with separate enzymatic activity. Since every newborn was delivered by caesarean section, analysis was not negatively influenced by changes in the steroid metabolome associated with the spontaneous onset of labour.
Topics: Infant, Newborn; Pregnancy; Humans; Female; Infant; Pregnancy, Twin; Pregnancy Outcome; Cesarean Section; Steroids; Metabolome; Retrospective Studies
PubMed: 38338872
DOI: 10.3390/ijms25031591 -
Medicinski Pregled 2010There are two kinds of unknown pregnancies. A denied, unknown pregnancy, graviditatas ignota, when the pregnant woman unconsciously denies the existence of the...
INTRODUCTION
There are two kinds of unknown pregnancies. A denied, unknown pregnancy, graviditatas ignota, when the pregnant woman unconsciously denies the existence of the pregnancy. Contrary to the denied pregnancy there is a hidden pregnancy, a concealed pregnancy in women who know they are pregnant but actively hide their pregnancy from the family, partner, friends, teachers, colleagues, etc. The prevalence of an unknown pregnancy during the first 20 gestation weeks is 1 in 475 pregnancies, in the second half of pregnancy it is 1 in 2455 pregnancies and at the moment of delivery it is 1 in 7225.
CASE REPORT
A 40-year-old woman was transported by an ambulance and admitted to Gynecology and Obstetrics Clinic in Kragujevac after the delivery in home conditions and this patient found out about her pregnancy at the moment of delivery.
DISCUSSION
This case presents a classical example of a denied pregnancy. The reasons are probably at all levels, physiological, psychological and social. The patient was 40 years old, with two children aged 17 and 15 and irregular periods. Denied pregnancies present a multidisciplinary problem, which requires work of different specialties and services and this interferes with family and social life.
CONCLUSION
The denied pregnancy should always be taken into consideration in case of irregular periods, especially in perimenopause. Patients in perimenopause should have regular medical examination by their gyneocolgists, at least once in six months and the delivery outside hospital conditions that bears a great risk should be avoided at any rate.
Topics: Adult; Denial, Psychological; Female; Humans; Perimenopause; Pregnancy; Pregnancy, Unplanned
PubMed: 21446106
DOI: 10.2298/mpns1010728d -
Obstetrics and Gynecology Mar 2006To examine the relative risk of pregnancy-related mortality between multifetal pregnancies and singleton pregnancies.
OBJECTIVE
To examine the relative risk of pregnancy-related mortality between multifetal pregnancies and singleton pregnancies.
METHODS
We used data from the Centers for Disease Control and Prevention's Pregnancy Mortality Surveillance System to examine singleton and multifetal pregnancy-related deaths among women with a live birth or fetal death from 1979-2000. The plurality-specific (singleton or multifetal) pregnancy-based mortality ratio was defined as the number of pregnancy-related deaths per 100,000 pregnancies with a live birth. We analyzed the risk of death due to pregnancy for singleton and multifetal pregnancies by age, race, education, marital status, and cause of death.
RESULTS
Of 4,992 pregnancy-related deaths in 1979-2000, 4.2% (209 deaths) were among women with multifetal pregnancies. The risk of pregnancy death among women with twin and higher-order pregnancies was 3.6 times that of women with singleton pregnancies (20.8 compared with 5.8). The leading causes of death were similar for women with singleton pregnancies and women with multifetal pregnancies: embolism, hypertensive complications of pregnancy, hemorrhage, and infection.
CONCLUSION
Women with multifetal pregnancies have a significantly higher risk of pregnancy-related death than their counterparts with singleton pregnancies; this holds true for all women regardless of age, race, marital status, and level of education.
LEVEL OF EVIDENCE
II-2.
Topics: Centers for Disease Control and Prevention, U.S.; Female; Fetal Death; Humans; Live Birth; Population Surveillance; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Pregnancy, Multiple; Risk Factors; United States
PubMed: 16507925
DOI: 10.1097/01.AOG.0000200045.91015.c6 -
Fertility and Sterility Oct 2005To investigate whether the outcome of a pregnancy is related to the time required to achieve that pregnancy (TTP). (Comparative Study)
Comparative Study
OBJECTIVE
To investigate whether the outcome of a pregnancy is related to the time required to achieve that pregnancy (TTP).
DESIGN
The distribution of the TTP for pregnancies ending in multiple birth, early (before week 12) and late (weeks 12-28) miscarriage, stillbirth, and extrauterine pregnancy was compared to that of pregnancies ending in singleton birth. Furthermore, the distribution of the TTP for preterm singleton births was compared to that of full-term singleton births.
SETTING
Sweden.
PATIENT(S)
Information from three previous studies on reproduction was used: Women chosen for exposure to persistent organochlorine pollutants, or exposure as a hairdresser, and their respective controls.
INTERVENTION(S)
None.
MAIN OUTCOME MEASURE(S)
Self-reported pregnancy outcome.
RESULT(S)
An increased TTP (i.e., decreased fecundability) was associated with pregnancies ending in miscarriage (early as well as late) and extrauterine pregnancies. Pregnancies ending in multiple live birth tended to have shorter TTPs than those ending in single live birth. No association between TTP and stillbirths was found. Among women whose pregnancies ended in singleton birth, a prolonged TTP was associated with preterm delivery.
CONCLUSION(S)
The TTP of a pregnancy seemed to be associated with the outcome of that pregnancy. The mechanisms behind this phenomenon are, however, unclear.
Topics: Abortion, Spontaneous; Adolescent; Adult; Female; Humans; Live Birth; Multivariate Analysis; Odds Ratio; Pregnancy; Pregnancy Outcome; Pregnancy, Multiple; Premature Birth; Risk Factors; Stillbirth; Time Factors
PubMed: 16213851
DOI: 10.1016/j.fertnstert.2005.04.030 -
Obstetrics and Gynecology Mar 2005To examine the effect of pregnancy and the interval between pregnancies on arterial compliance as measured by mean arterial pressure (MAP) and pulse pressure.
OBJECTIVE
To examine the effect of pregnancy and the interval between pregnancies on arterial compliance as measured by mean arterial pressure (MAP) and pulse pressure.
METHODS
We conducted a 3-month chart review of deliveries at a tertiary care hospital (index pregnancies). Data collected included demographics, obstetric history, blood pressures, prepregnancy weight, weight gain, and neonatal outcome. If a subject's first delivery occurred at our institution, these records were reviewed in a similar fashion. Mean antepartum MAP and pulse pressure were calculated and compared for each trimester between index and first pregnancies. Statistical methods employed included repeated measures analysis of variance, repeated measures analysis of covariance, and correlation analysis.
RESULTS
Two hundred eighty-five charts were reviewed. Forty-seven women had complete data covering both index and first pregnancy. Mean arterial pressure was significantly higher in all trimesters of first compared with index pregnancies (first pregnancy-first trimester 82.0 +/- 8.1 mm Hg, index pregnancy-first trimester 79.4 +/- 7.6 mm Hg, P = .032; first-second trimester 81.6 +/- 6.7 mm Hg, index-second trimester 78.7 +/- 6.6 mm Hg, P = .016; first-third trimester 83.9 +/- 6.9 mm Hg, index-third trimester 81.6 +/- 6.9 mm Hg, P = .047). Repeated measures analysis of covariance confirmed that pregnancy order contributed independently to differences in MAP. The interval between pregnancies was found to be inversely related to the difference in MAP from first to index pregnancies by trimester (r = -0.41, P = .004) and the change in MAP within pregnancy from first to third trimester (r = -0.31, P = .046).
CONCLUSION
Mean arterial pressure is reduced in subsequent pregnancies compared with first pregnancies. This raises the possibility that pregnancy plays a role in modifying cardiovascular compliance. Consistent with this, the effect has temporal limitations in that the shorter the interval between pregnancies, the greater the reduction in MAP.
Topics: Adult; Arteries; Birth Intervals; Blood Pressure; Compliance; Female; Humans; Parity; Pregnancy; Pulse
PubMed: 15738034
DOI: 10.1097/01.AOG.0000152346.45920.45 -
Human Reproduction (Oxford, England) Dec 2016What are associated factors of unplanned pregnancies ending in birth?
STUDY QUESTION
What are associated factors of unplanned pregnancies ending in birth?
SUMMARY ANSWER
Pregnancies that were less planned were associated with women of lower socio-economic status (SES), an unhealthier lifestyle before and during the pregnancy, more stress, and less social support.
WHAT IS KNOWN ALREADY
In Europe, the prevalence of unplanned pregnancy leading to birth varies. Unplanned pregnancy is more common among socially disadvantaged women, and associated with adverse pregnancy outcomes.
STUDY DESIGN, SIZE, DURATION
In a cross-sectional study, 517 women were recruited from May through September 2015.
PARTICIPANTS/MATERIALS, SETTING, METHODS
Women were recruited from six hospitals in Flanders, Belgium. Data from self-report and medical records were collected during the first 5 days postpartum. The validated London Measure of Unplanned Pregnancy was used to collect data regarding pregnancy planning. Data were analysed with Mann-Whitney U tests, Kruskal-Wallis tests, and multiple linear regression analysis.
MAIN RESULTS AND THE ROLE OF CHANCE
The majority of the pregnancies (83%) ending in birth were planned, 15% were ambivalent, and 2% unplanned. Women who are multigravida (95% CI -0.30 to -0.02), less well educated (95% CI 0.07-0.85), single or having a non-cohabiting relationship (95% CI 0.01-2.53), having history of drug abuse (95% CI -2.07 to -0.35), and experiencing intimate partner violence (95% CI -3.82 to -1.59) tended to have a significantly higher risk of a less planned pregnancy. Less planned pregnancies were significantly associated with initially unwanted pregnancies (P < 0.001), no folic acid or vitamin use before pregnancy (P < 0.001), lower number of prenatal visits (P = 0.03), smoking during pregnancy (P < 0.001), more stress (P = 0.002), lower relationship satisfaction (P = 0.001), and less social support (P < 0.001). Less planned pregnancies were also significantly associated with hyperemesis (P < 0.001) and shorter duration of delivery (P = 0.03). No differences were found in neonatal outcomes.
LIMITATIONS, REASONS FOR CAUTION
The prevalence of unplanned pregnancies is probably underestimated due to overrepresentation of women with higher SES in this study. Women's emotions may have influenced the answer to certain questions. Owing to the cross-sectional design, no causal relationships could be established.
WIDER IMPLICATIONS OF THE FINDINGS
This study emphasizes the importance of targeting socially disadvantaged women in the prevention of unplanned pregnancies.
STUDY FUNDING/COMPETING INTERESTS
This study was funded by the Research Foundation - Flanders (FWO). The authors have no conflict of interests.
TRIAL REGISTRATION NUMBER
Not applicable.
Topics: Adolescent; Adult; Belgium; Cross-Sectional Studies; Female; Humans; Middle Aged; Parturition; Pregnancy; Pregnancy Outcome; Pregnancy, Unplanned; Pregnancy, Unwanted; Prenatal Care; Prevalence; Social Support; Socioeconomic Factors; Young Adult
PubMed: 27798048
DOI: 10.1093/humrep/dew266 -
Biology of Reproduction Nov 2017Intracytoplasmic sperm injection (ICSI) and embryo transfer (ET) in nonhuman primates, e.g. rhesus and cynomolgus monkeys, has been widely used in researches of...
Intracytoplasmic sperm injection (ICSI) and embryo transfer (ET) in nonhuman primates, e.g. rhesus and cynomolgus monkeys, has been widely used in researches of reproductive and developmental biology, and the success rate has been improved significantly. However, unwanted multiple pregnancy occurs frequently during the ICSI-ET in monkeys, most of which leads to miscarriages. To improve the birth rate of pregnancies and to safeguard health of host and baby monkeys, multifetal pregnancy reduction (MPR) is necessary. In this study, a total of 10 monkeys with multiple pregnancies received MPR through transabdominal ultrasound-guided potassium chloride injection into beating hearts of selective fetuses. To assess MPR efficiency, 31 monkeys with normal singleton pregnancies and 25 monkeys with twin pregnancies without MPR were used as controls. The aim of the reduction is to keep only one fetus, no matter twin or triplet pregnancy originally. Our results show that six cases of MPR were successful and all of them retained single fetus. Moreover, about 1 month (30.2 ± 1.2 days) of gestation is a better timing for MPR than later stage (50.7 ± 1.9 days). We also found that the remaining fetuses developed normally with full-term gestation and normal birth weight. In conclusion, transabdominal ultrasound-guided potassium chloride injection is a safe and effective MPR method for monkeys with multiple pregnancies.
Topics: Abortion, Spontaneous; Animals; Embryo Transfer; Female; Haplorhini; Pregnancy; Pregnancy Outcome; Pregnancy Reduction, Multifetal; Pregnancy, Animal; Pregnancy, Multiple
PubMed: 29069285
DOI: 10.1093/biolre/iox130 -
Demography Jun 2023We examine whether changes in U.S. pregnancy, birth, and abortion rates between 2009 and 2015 reflect underlying change in the incidence of pregnancies classified by...
We examine whether changes in U.S. pregnancy, birth, and abortion rates between 2009 and 2015 reflect underlying change in the incidence of pregnancies classified by retrospectively reported pregnancy desires: pregnancies reported as having occurred at about the right time, later than wanted, too soon, or not wanted at all, and those for which individuals expressed other feelings, including uncertainty, ambivalence, or indifference. We calculate the proportionate distributions of these pregnancies and rates among U.S. women aged 15-44, as well as change over time, overall and among age groups. Characterization of desires for a past pregnancy shifted in a number of ways between 2009 and 2015, and changes across age groups were not uniform. Rates of pregnancies reported as occurring later than wanted increased among older women, while rates of pregnancies reported as occurring too soon decreased among all women. These findings shed light on previous research documenting an increasing age at first birth, increasing rates of pregnancy and childbearing among the oldest age groups, and changes in patterns of contraceptive use, particularly among young women. Our analysis explores limitations and challenges of two major sources of data on pregnancies in the United States and their measures of retrospectively reported pregnancy desires.
Topics: Aged; Female; Humans; Pregnancy; Abortion, Induced; Contraceptive Agents; Retrospective Studies; United States; Pregnancy, Unplanned; Pregnancy, Unwanted
PubMed: 37185659
DOI: 10.1215/00703370-10690005 -
Reproductive Biology and Endocrinology... Mar 2024It is generally beneficial and recommended that dichorionic triamniotic (DCTA) triplet pregnancies be reduced to monochorionic (MC) twin or singleton pregnancies after...
BACKGROUND
It is generally beneficial and recommended that dichorionic triamniotic (DCTA) triplet pregnancies be reduced to monochorionic (MC) twin or singleton pregnancies after assisted reproductive technology (ART). However, some infertile couples still have a firm desire to retain twins. For this reason, the best foetal reduction strategies need to be available for infertile couples and clinicians. Given that data on the elective reduction of DCTA triplet pregnancies to twin pregnancies are scarce, we investigated the outcomes of elective reduction of DCTA triplet pregnancies through the retrospective analysis of previous data.
METHOD
Patients with DCTA triplet pregnancies who underwent elective foetal reduction between January 2012 and June 2020 were recruited. A total of 67 eligible patients with DCTA triplet pregnancies were divided into two groups: a DCTA-to-dichorionic diamniotic (DCDA) twin group (n = 38) and a DCTA-to-monochorionic diamniotic (MCDA) twin group (n = 29); the basic clinical data of the two groups were collected for comparison.
RESULTS
Compared with the DCDA-to-MCDA twin group, the DCTA-to-DCDA twin group had lower rates of complete miscarriage (7.89% versus 31.03%, p = 0.014), early complete miscarriage (5.26% versus 24.14%, p = 0.034), late preterm birth (25.71% versus 65.00%, p = 0.009) and very low birth weight (0 versus 11.11%, p = 0.025). In addition, the DCTA-to-DCDA twin group had higher rates of full-term delivery (65.71% versus 25.00%, p = 0.005), survival (92.11% versus 68.97%, p = 0.023), and taking the babies home (92.11% versus 68.97%, p = 0.023) than did the DCTA-to-MCDA twin group. In terms of neonatal outcomes, a significantly greater gestational age (38.06 ± 2.39 versus 36.28 ± 2.30, p = 0.009), average birth weight (3020.77 ± 497.33 versus 2401.39 ± 570.48, p < 0.001), weight of twins (2746.47 ± 339.64 versus 2251.56 ± 391.26, p < 0.001), weight of the larger neonate (2832.94 ± 320.58 versus 2376.25 ± 349.95, p < 0.001) and weight of the smaller neonate (2660.00 ± 345.34 versus 2126.88 ± 400.93, p < 0.001) was observed in the DCTA-to-DCDA twin group compared to the DCTA-to-MCDA twin group.
CONCLUSION
The DCTA-to-DCDA twin group had better pregnancy and neonatal outcomes than the DCTA-to-MCDA twin group. This reduction approach may be beneficial for patients with dichorionic triamniotic triplet pregnancies who have a strong desire to have DCDA twins.
Topics: Pregnancy; Infant; Female; Infant, Newborn; Humans; Pregnancy, Triplet; Abortion, Spontaneous; Retrospective Studies; Pregnancy Reduction, Multifetal; Premature Birth; Pregnancy, Twin; Reproductive Techniques, Assisted; Pregnancy Outcome; Edetic Acid
PubMed: 38491531
DOI: 10.1186/s12958-024-01199-6