Absence Of Intrauterine Growth Retardation Research Articles

Risk factors associated with preterm birth in singletons born after IVF: a national cohort study

Research questionWhat are the risk factors for prematurity other than intrauterine growth restriction in singletons after IVF? DesignData were collected from a national registry, based on an observational prospective cohort of 30,737 live births after assisted reproductive technology (fresh embryo transfers: n = 20,932 and frozen embryo transfer [FET] n = 9805) between 2014 and 2015. A population of not-small for gestational age singletons conceived after fresh embryo transfers and FET, and their parents, was selected. Data on a number of variables were collected, including type of infertility, number of oocytes retrieved and vanishing twins. ResultsPreterm birth occurred in 7.7% (n = 1607) of fresh embryo transfers and 6.2% (n = 611) of frozen–thawed embryo transfers (P < 0.0001; adjusted odds ratio [aOR] = 1.34 [1.21–1.49]). Endometriosis and vanishing twin increased the risk of preterm birth after fresh embryo transfer (P < 0.001; aOR 1.32 and 1.78, respectively). Polycystic ovaries or more than 20 oocytes retrieved also increased preterm birth risk (aOR 1.31 and 1.30; P = 0.003 and P = 0.02, respectively); large oocyte cohort (>20) was no longer associated with the risk of prematurity in FET. ConclusionEndometriosis remains a risk for prematurity even in the absence of intrauterine growth retardation, which suggests a dysimmune effect. Large oocyte cohorts obtained by stimulation, without clinical polycystic ovary syndrome diagnosed before attempts, do not affect FET outcomes, reinforcing the idea of a phenotypic difference in the clinical presentation of polycystic ovary syndrome.

Prenatal and perinatal history in Kabuki Syndrome.

Kabuki syndrome (KS) is a disorder of epigenetic dysregulation due to heterozygous mutations in KMT2D or KDM6A, genes encoding a lysine-specific methyltransferase or demethylase, respectively. The phenotype is highly variable, including congenital cardiac and renal anomalies, developmental delay, hypotonia, failure to thrive, short stature, and immune dysfunction. All affected individuals have characteristic facial features. As KS natural history has not been fully delineated, limited information exists on its prenatal and perinatal history. Two tertiary centers collected retrospective data from individuals with KS (N = 49) using a questionnaire followed by review of medical records. Data from 49 individuals (age range: 7 months-33 years; 37% male; 36 with KMT2D mutations, 2 with KDM6A mutations, and 11 diagnosed clinically) were examined. Polyhydramnios affected 16 of 39 (41%) pregnancies. Abnormal quad screens in four out of nine (44%) pregnancies and reduced placental weights also complicated KS pregnancies. These data comprise the first large dataset on prenatal and perinatal history in individuals with confirmed (genetically or clinically) KS. Over a third of pregnancies were complicated by polyhydramnios, possibly secondary to abnormal craniofacial structures and functional impairment of swallowing. The differential diagnosis for polyhydramnios in the absence of intrauterine growth retardation should include KS.

Liens entre prééclampsie et retard de croissance intra-utérin

ObjectivesPreeclampsia is one of the most frequent and most serious complications of pregnancy. Its occurrence is around 5% of the pregnancies. Its pathophysiology is complex and includes several hypotheses. Preeclampsia is inconsistently associated with intrauterine growth retardation (IUGR). The determinants that explain the variability of this association are unknown. The objective of our study was to identify in a population of French patients who had preeclampsia and/or HELLP syndrome, incidence and risk factors of IUGR to isolate specific characteristics of these women. Patients and methodsWe studied 578 pregnant women treated for preeclampsia or HELLP syndrome according to the presence or absence of IUGR (database compiled since 1996). Comparisons between the groups were done with Wilcoxon test (quantitative data) or Fisher's exact test (qualitative data). ResultsWe found that pre-eclampsia appeared earlier and was more severe in the group with IUGR. In addition foetal issues were more defavorable when IUGR was associated with preeclampsia. ConclusionCombination of IUGR and pre-eclampsia or HELLP syndrome is a criterion of severity for both the mother and the fetus. Our data do not allow distinguishing physiopathological mechanism to explain these differences.

Comparison of maternal serum levels of interleukin-10, interleukin-12, and interleukin-2 in normal and preeclamptic pregnancies

Objective The aim of this study was 2 fold: (1) to compare the maternal serum levels of IL-10, IL-12, and IL-2 in preeclamptic and normal pregnant women, and (2) to study the serum levels of these cytokines in preeclamptic pregnancies with and without intrauterine growth retardation. Study design Forty women with singleton pregnancies complicated by preeclampsia (32 severe and 8 mild) and 29 normotensive healthy pregnant women were included in the study. Preeclamptic patients were further divided into 2 groups according to the presence or absence of intrauterine growth retardation. Maternal serum levels of IL-10, IL 12, and IL-2 were compared between these groups using enzyme-linked immunosorbent assays. Results Maternal serum levels of IL-10 were significantly higher in the preeclampsia group than in controls ( p < 0.001). There were no statistically significant differences in maternal serum concentrations of IL-2 and IL-10 between the study and control groups ( p > 0.05). Serum levels of IL-2 and IL-10 in the patients with preeclampsia complicated by IUGR were elevated in comparison with the uncomplicated preeclampsia group. These differences were statistically significant ( p < 0.05 for both). Conclusions IL-10 may be involved in the pathologic process of preeclampsia. Increased serum levels of IL-10 and IL-2 in preeclampsia complicated with IUGR suggests a possible role of these cytokines in IUGR.

Interleukin-12 and pre-eclampsia

The aim of this study was 2 fold: (1) to compare the maternal serum levels of IL-10, IL-12, and IL-2 in preeclamptic and normal pregnant women, and (2) to study the serum levels of these cytokines in preeclamptic pregnancies with and without intrauterine growth retardation.Forty women with singleton pregnancies complicated by preeclampsia (32 severe and 8 mild) and 29 normotensive healthy pregnant women were included in the study. Preeclamptic patients were further divided into 2 groups according to the presence or absence of intrauterine growth retardation. Maternal serum levels of IL-10, IL 12, and IL-2 were compared between these groups using enzyme-linked immunosorbent assays.Maternal serum levels of IL-10 were significantly higher in the preeclampsia group than in controls (p < 0.001). There were no statistically significant differences in maternal serum concentrations of IL-2 and IL-10 between the study and control groups (p > 0.05). Serum levels of IL-2 and IL-10 in the patients with preeclampsia complicated by IUGR were elevated in comparison with the uncomplicated preeclampsia group. These differences were statistically significant (p < 0.05 for both).IL-10 may be involved in the pathologic process of preeclampsia. Increased serum levels of IL-10 and IL-2 in preeclampsia complicated with IUGR suggests a possible role of these cytokines in IUGR.

Birth weight as a determinannt of awake blood pressure in children and adolescents in absence of intrauterine growth retardation

Birth weight as a determinannt of awake blood pressure in children and adolescents in absence of intrauterine growth retardation

VARIABILITY AND STEREOTYPY OF SPONTANEOUS MOTILITY AS A PREDICTOR OF NEUROLOGICAL DEVELOPMENT OF PRETERM INFANTS

Observations of the variability stereotypy ratio of spontaneous motility in a group of 47 preterm infants showed that stereotyped motor activity was related to the neurological diagnosis at term age. A minority of the neurologically deviant infants at term recovered during infancy. The presence of absence of intra-uterine growth retardation and an accumulation of obnoxious antenatal, perinatal and postnatal events seemed to affect outcome, particularly in the presence of extensive and permanent ultrasound findings. A normal neurological condition at term indicates a high probability of normal development.

Improved prediction of intrauterine growth retardation with use of multiple parameters.

Several sonographic parameters have been proposed for predicting intrauterine growth retardation (IUGR), but each has been shown to have a low positive predictive value. To predict IUGR more reliably, the authors developed a multiparameter approach based on sonographic and clinical data from 62 fetuses with IUGR and 91 normal fetuses. Logistic regression analysis revealed that the combination of sonographically estimated fetal weight, amniotic fluid volume, and maternal blood pressure status best correlates with the presence or absence of IUGR and produced an IUGR scoring system based on these three parameters. The scoring system, which has a range of 0-100, was tested on a second set of fetuses (47 with IUGR, 81 normal) to determine its performance characteristics. An IUGR score below 50 virtually excludes the diagnosis of IUGR (0.9% likelihood of IUGR, or negative predictive value of 99.1%). A score above 75 allows confident diagnosis of IUGR (positive predictive value, 82%). A score of 50-75 is equivocal, in that it is associated with an intermediate (24%) likelihood of IUGR. The IUGR score is a practical tool that can be easily used in any ultrasound facility.

Uteroplacental blood flow in pre-eclampsia measurements with indium-113m and a computer-linked gamma camera.

Uteroplacental blood flow was measured with a computer-linked gamma camera after intravenous injection of 1 mCi indium-113m. Results of the measurements from 32 pre-eclamptic pregnancies and 37 normal controls are compared. The uteroplacental blood flow was measured as an index calculated from the rise time and maximum activity of the isotope accumulation curve. The uteroplacental blood flow was reduced with 50% in pre-eclampsia. In severe pre-eclampsia it was more compromised than in mild pre-eclampsia. A diminished uteroplacental blood flow was found in pre-eclampsia even in the absence of intrauterine growth retardation. The maternal placental circulation in the supine position was reduced with one third compared to that in the left lateral recumbent position.

Newborn Brain: Body weight ratios.

Newborn brain:body weight ratios are generally considered to be constant in man. In autopsy studies many factors influence the measured weight of the brain, and therefore the conclusions based on such observations, including the gestational age of the material, the presence or absence of intrauterine growth retardation, and the cause of death. In this study these influences have been eliminated by careful selection of normally grown fullterm newborns not subject to the factors influencing brain weight. Using double logarithmic plots, brain size in fullterm newborns is found to be related to the 0.64 power of birth weight. There is a negative correlation between relative brain size and increasing fullterm birth size in man.