High Abortion Rate Research Articles

An Audit of Loss of Pregnancy as an Answer to Differentiated Sex Ratio

Context: Abortion and unintended pregnancy in India is on the rise, and a large proportion of these unintended pregnancies end up in induced abortion. The soaring rate of abortion among Indian women can be influenced by a plethora of reasons. Aims: 1) To identify the rate of second trimester abortion2) To determine the reasons behind second trimester abortions Settings and design: An audit of all the abortions in a district of South India was conducted. Material and methods: The data was obtained from the records of abortion reported in the year 2018 from the District Health Office and analysed. Statistical analysis used: Descriptive statistics Results: Majority of the pregnant ladies with abortion (55.73%) were aged between 21-30 years and abortions in second trimester were observed to be comparatively higher (50%). Among the myriad of reasons found for second trimester abortions, spontaneous abortions contributed to around 30% while 11.92% had no cause mentioned. Conclusion: A high rate of second trimester abortion throws suspicion towards sex selective abortions.

The Trouble with Rubbers: A History of Condoms in Modern China

Abstract In recent years, public health officials and scholars have voiced their concerns about comparatively low condom use in China, citing high rates of abortion and the growing HIV/AIDS crisis. By examining condom use through the lenses of gender and the history of medicine, this article traces heterosexual condom consumption in China from the early twentieth century to the present and situates contemporary attitudes toward condoms within long-term contraceptive patterns. Rather than simply taking for granted the role that men play in family planning decisions, this research takes men and masculinity as a central focus. An eye to the past reveals numerous historical obstacles to condom use, as well as an enduring aversion to condoms grounded in fears of reduced male sexual pleasure, and the gendered assumption that birth control is the sole responsibility of women. Analyzing evolving perceptions of condoms sheds light on constructions of sexuality, gender relations, and the roles of the state, society, and the individual in contraceptive decision-making in China.

THU0168 GESTATIONAL DESIRE AND CERTOLIZUMAB PEGOL IN PATIENTS WITH CHRONIC INFLAMMATORY RHEUMATIC DISEASE. PRELIMINARY RESULTS OF THE GESTAMAD COHORT

Background:The use of biological therapies during pregnancy has been contraindicated since the beginning of the use of these drugs. In recent years several studies have demonstrated the minimal-to-no transfer of certolizumab pegol (CZP) to the placenta and breast milk, which has allowed its approval for use in pregnancy and breastfeeding if clinically necessary. However, there are no studies evaluating the use of CZP during this period in real life or the characteristics of this subgroup of patients.Objectives:To describe the profile of women of childbearing age diagnosed with chronic inflammatory rheumatic disease (CIRD): Rheumatoid Arthritis (RA), Psoriatic Arthritis (PsA) and axial Spondyloarthritis (axSpA), who initiate CZP by gestational desire using the GESTAMAD registry (multicenter study of women with chronic inflammatory rheumatic disease of childbearing age who are initiated on CPZ by gestational desire from the Madrid community).Methods:Prospective multicenter study that aims to know the characteristics of women of childbearing age diagnosed with CIRD and gestational desire to which CZP is initiated for this reason. The comorbidities of the patients such as hypertension, diabetes and cardiovascular disease were collected. Disease activity was measured by DAS28 using CRP in RA and PsA and BASDAI in axSpA. The present study presents preliminary data from the initial cohort and will be followed prospectively for 24 months to assess the efficacy and safety of the drug during pre-conception, pregnancy and lactation.Results:A total of 45 patients have been recruited in 6 Madrid hospitals from June to December 2019. Patients had a mean age of 35.9, (36.6 in RA, 35.2 in PA and 35.1 in SPA). Fifty-one percent had RA, 20.0 percent had PA and 28.8 percent had SPA. The mean disease duration for RA, PA and SPA was 9.5, 7.3 and 6.9 years, respectively. 48.9% of women were nulliparous. The abortion rate of patients diagnosed with spondyloarthropathy was upper of 25%. 33.3% of the patients had been treated with previous biologicals, with gestational desire/pregnancy being the reason for the change.75.5% of the patients had been treated with synthetic disease modifying antirheumatic drugs (DMARD) previously. With regard to disease activity, the mean DAS 28 at the start of treatment was 4.5 in RA and 3.8 in PA and BASDAI 7.0 in axSPA.In RA the highest values of CRP and ESR were found prior to initiation with CZP, but this difference was not statistically significant (p=0.644 and 0.605, respectively). 22.2% of patients had previous comorbidities.Conclusion:The mean age of patients with gestational desire in CIRD is high. Women diagnosed with PsA and axSpA have a high rate of previous abortions, upper than 25%. The duration of the disease is equally long at the time of manifesting gestational desire. The use of treatments such as CZP, compatible with pregnancy and lactation would allow a better control of inflammatory joint disease in this period of life, encouraging patients not to postpone their gestational desire.Disclosure of Interests:None declared

An outbreak of abortions, stillbirths and malformations in a Spanish sheep flock associated with a bovine viral diarrhoea virus 2-contaminated orf vaccine.

Bovine viral diarrhoea virus (BVDV) is a pestivirus that affects both cattle and sheep, causing an array of clinical signs, which include abortions and malformations in the offspring. Manufacturing of modified live virus (MLV) vaccines often includes the use of bovine-derived products, which implies a risk of contamination with viable BVDV. Recently, the circulation of a specific strain of BVDV2b among Spanish sheep flocks, associated with outbreaks of abortions and malformations, and whose origin was not determined, has been observed. On February 2018, a MLV orf vaccine was applied to a 1,600 highly prolific sheep flock in the Northeast of Spain that included 550 pregnant ewes. In May 2018, during the lambing season, an unusual high rate (72.7%) of abortions, stillbirths, congenital malformations and neurological signs in the offspring was observed. It was estimated that about 1,000 lambs were lost. Three 1- to 3-day-old affected lambs and a sealed vial of the applied vaccine were studied. Lambs showed variable degrees of central nervous system malformations and presence of pestiviral antigen in the brain. Molecular studies demonstrated the presence of exactly the same BVDV2b in the tissues of the three lambs and in the orf vaccine, thus pointing to a pestivirus contamination in the applied vaccine as the cause of the outbreak. Interestingly, sequencing at the 5'-untranslated region-(UTR) of the contaminating virus showed a complete match with the virus described in the previously reported outbreaks in Spain, thus indicating that the same contaminated vaccine could have also played a role in those cases. This communication provides a clear example of the effects of the application of this contaminated product in a sheep flock. The information presented here can be of interest in putative future cases of suspected circulation of this or other BVDV strains in ruminants.

The in vitro germination and storage characteristics of Keteleeria fortunei var. cyclolepis pollen provide a reference for cross breeding.

Keteleeria fortunei var. cyclolepis is an ideal tree species for mountain afforestation, timber forests, and landscaping. Its pollination process can be affected by the rainy season, making it difficult to pollinate the massive female cones, which leads to a high abortion rate and low quality of seeds. Here, we observed the pollen morphology of K. f. cyclolepis using scanning electron and light microscopes, investigated the characteristics of its in vitro germination by the detached method, and explored the effect of different storage temperatures and times on the pollen germination rate and the activity of superoxide dismutase (SOD), peroxidase (POD), and catalase (CAT). Our results indicated that the pollen of K. f. cyclolepis is a five-cell pollen, comprising one noumenon and two air sacs, both of which were oval in polar view. The optimal condition for pollen germination of K. f. cyclolepis was 240g/L sucrose + 70mg/L CaCl2 + 210mg/L H3BO3 at 24°C and pH6.0, resulting in a germination rate of 45.0%. The effects of different storage temperature and time on pollen germination rate varied significantly. The best storage temperature was - 80°C, at which the germination rate was 20.9% after 365days of storage, and the activity of three protective enzymes remained relatively high, representing relatively strong antioxidation and antiaging activity. Stepwise regression analysis showed that SOD was the main factor affecting the pollen germination rate of K. f. cyclolepis. The function of the three protective enzymes differed under various temperatures, for example, SOD served as a sensitive protective enzyme at room temperature, - 20°C and - 80°C, whereas both SOD and CAT served as sensitive protective enzymes at 4°C.

Impact of Disturbed Glucose Homeostasis Regulated by AMPK in Endometrium on Embryo Implantation in Diabetes Mice.

The incidence of diabetes in women of childbearing age has been increasing recently and implantation failure and early abortion are important reasons for infertility in diabetic women. Glycogen synthesis and decomposition are the cores of glucose homeostasis in endometrium and AMPK is activated when cellular energy consumption increases. Embryo implantation is a complex process required huge energy. Yet the changes of glucose metabolism in endometrium and its impact on embryo implantation in diabetic women are still unclear. In this research, we established diabetic pregnancy mice model by intraperitoneal injecting streptozotocin on pregnant day 1. We first tested the changes of endometrial glucose homeostasis and embryo implantation. Next, we demonstrated abnormal activation of AMPK in the endometrium of diabetic mice and its affecting endometrial glucose homeostasis. Finally, we compared the endometrial glucose homeostasis and embryo implantation outcome in diabetic pregnant mice treated with insulin or insulin combined with metformin. The results indicated that there was disturbed glucose homeostasis associated with excessive activation of AMPK in endometrium of diabetic pregnant mice. AMPK inhibitor improved the over-activation of AMPK pathway in the endometrium, meanwhile, partially corrected the abnormal glycogen metabolism and improved the implantation. Insulin improved the disorder of endometrial glucose homeostasis and implantation of diabetic mice. Our research explores the causes of high abortion and infertility rate in diabetic women which is to provide a therapeutic reference for patients with diabetes complicated with infertility and early abortion.

Socioeconomic characteristics of women with substance use disorder during pregnancy and neonatal outcomes in their newborns: A national registry study from the Czech Republic

BackgroundMaternal substance use can pose a risk to the fetal health. We studied the background characteristics of women with substance use disorders (SUDs) and selected neonatal outcomes in their children. Material and methodsA database-linkage study was performed. The sample consisted of pregnant women with a SUD during pregnancy (ICD-10 diagnosis F10-F19 except F17, n = 1710), women not diagnosed with a SUD (n = 1,511,310) in Czechia in 2000–2014, and their children. The monitored neonatal outcomes were gestational age, birth weight, preterm birth, and small-for-gestational age (SGA). Binary logistic regression adjusted for age, marital status, education, concurrent substance use, and prenatal care was performed. ResultsWomen with illicit SUDs were younger, more often unmarried, with a lower level of education, a higher abortion rate, a higher smoking rate, and lower compliance to prenatal care than women with a SUD related to alcohol, or sedatives and hypnotics (SH). Women with a SUD had worse socioeconomic situations, poorer pregnancy care, and worse neonatal outcomes than women without a SUD. After adjustment, we found no difference in SGA between the illicit SUD groups and the alcohol and the SH groups. The newborns from all SUD groups had a higher risk of SGA when compared to women without a SUD. However after adjustment, the difference remained significant just in the alcohol group (OR = 1.9, 95 % CI = 1.4–2.6). ConclusionMother’s SUD during pregnancy increased risk of fetal growth restriction as measured by SGA. The role of maternal socioeconomic and lifestyle factors for the risk of SGA was substantial.

Медико-биологическое и социальное значение женского бесплодия

As a result of the decline in the population, Russia has faced a number of economic and social problems related to the reduction of the working-age population, as well as the need to reform the existing pension system, one of the measures aimed at improving the demographic situation is the increase in the birth rate. The aim of the study is to study the medical, biological and social significance of female infertility on the basis of a literary review. The results of the review showed a high level of infertility both in Russia and around the world. Among the main medical and biological risk factors for female infertility are the high prevalence of harmful habits, the earlier age of entry into sexual life of the high rate of sexually transmitted infections, gynaecological incidence, the high rate of abortion, the postponement of the birth of children to an older age. Social factors include low family income, poor quality of life, poor relationships with spouses and dissatisfaction with sexual intimacy. The increase in the number of families with infertility indicates an increasing need for assisted reproductive technologies. In developed countries, assisted reproductive technologies produce between 0.4 and 4.0 % children. In Russia, 160836 children were born with assisted reproductive technologies from 2007 to 2013, and the contribution of assisted reproductive technologies to annual fertility increased almost 40 times (from 0.04 to 1.55 %). The conclusion: the restoration of women's reproductive health is one of the promising directions in raising the birth rate and restoring the demographic situation.

Melatonin on hypothyroidism and gonadal development in rats: a review.

We evaluated the evidence in research on the effects of melatonin on hypothyroidism and gonadal development. According to the World Health Organization, thyroid disorders due to iodine deficiency affect about 740 million people worldwide. Hypothyroidism is a thyroid dysfunction characterized by hypometabolism of the gland, with reduced or physiologically normal T3 and T4 serum levels, and high TSH level. This disorder occurs mainly in adult women in the reproductive phase, with a prevalence of 2% among the world's female population, with profound repercussions on gestation and fetal formation. During the gestational period, the thyroid is initially stimulated by high concentrations of human chorionic gonadotrophin; thus, maintaining maternal euthyroidism during pregnancy and lactation is fundamental for fetal growth and development. Besides, the hormones produced by this gland are involved in the formation of various organs, such as the skin, brain and gonads. Hypothyroidism is associated with several menstrual abnormalities, anovulation and hyperprolactinemia, resulting in a high rate of abortions, premature births, placental rupture, and weight-related neonatal deficits. In addition, there are studies showing that hypothyroidism can affect ovarian morphology (number of ovarian follicles) and testicular morphology (changes in the testicular-lumen epithelium). Melatonin is a hormone known to modulate the estrous cycle and pregnancy, and studies show that the exogenous application of melatonin increased T4 levels in female rats and controlled the decrease in T3 serum levels, reverting the sigs of hypothyroidism.

Two Thai Burmese descendants with A4GALT*01N.21, p phenotype, and anti-PP1Pk

Anti-PP1Pk is produced by p individuals without prior red blood cell alloimmunization. This antibody can react over a wide thermal amplitude, has the potential to bind complement, and has caused hemolytic transfusion reaction, hemolytic disease of the fetus and newborn, and a high rate of spontaneous abortions. This report of two cases describes the genetic basis of p phenotype underlying anti-PP1Pk production and the development of a semi-nested polymerase chain reaction (PCR) assay for screening this observed mutation among Thai blood donors. Antibody detection and confirmation were examined by serologic testing. Genomic DNA was extracted from two Thai Burmese descendants with the p phenotype and a history of spontaneous abortions caused by anti-PP1Pk; the entire coding region of the A4GALT gene of each was sequenced and analyzed. Additionally, a semi-nested PCR assay of the observed mutation was developed and used for screening the genomic DNA of 1502 Thai blood donors. Anti-PP1Pk was identified and the p phenotype was confirmed in the two Thai individuals of Burmese descent. A single-base duplication (c.201dupC in exon 3) in the A4GALT gene was detected in both p patients. The duplication is consistent with the A4GALT*01N.21 allele associated with the p phenotype and anti-PP1Pk production. A semi-nested PCR assay was developed and subsequently used for mass screening for this mutation. The mutation was not found among the 1502 Thai blood donors tested with this newly developed assay.

Gastroschisis in Finland 1993 to 2014-Increasing Prevalence, High Rates of Abortion, and Survival: A Population-Based Study.

The study aims to assess the changes in prevalence and mortality of gastroschisis, and to identify associated anomalies. It is a population-based nationwide study. All gastroschisis cases were identified in the Finnish Register of Congenital Malformations and the Care Register for Health Care from 1993 to 2014 including live births, stillbirths, and terminations of pregnancy due to fetal anomalies. Associated anomalies were recorded, and analyzed, and prevalence and infant mortality were calculated. There were 320 cases of gastroschisis; 235 (73%) live births, 16 (5%) stillbirths, and 69 (22%) terminations of pregnancy. Live birth prevalence of gastroschisis in Finland was lower than generally reported (1.73 in 10,000). However, due to relatively high rates of abortion, our total prevalence of 2.57/10,000 was similar with other reports. The most common risk factor was young maternal age. Babies with gastroschisis were born prematurely, on average on the 36th week and most are delivered by caesarean section. There was a significant increasing trend in live birth prevalence (p = 0.0018). Overall infant mortality was 7.7% (18/235), 7.2% (16/222) in simple gastroschisis and 15% (2/13) in complex gastroschisis. Associated anomalies were rare both in aborted fetuses and neonates, and there was only one case with a chromosomal abnormality. Gastroschisis is usually an isolated anomaly with increasing birth prevalence and excellent survival rates. Regardless of the good prognosis, the abortion rates in Finland are higher than previously reported, and we hypothesize this to be due to lack of appropriate antenatal counselling.

Machine learning algorithms, bull genetic information, and imbalanced datasets used in abortion incidence prediction models for Iranian Holstein dairy cattle

The ability to predict abortion incidence, especially in regions with high abortion rates (e.g., Iran), helps improve reproductive performance and, thereby, dairy farm profitability. The objective of this study was to predict pregnancy loss in Iranian dairy herds. For this purpose, the cow history records and bull genetic information available at 6 large commercial dairy farms with cows calved between 2005 and 2014 were extracted from an on-farm record-keeping software. Using WEKA, 12 commonly used machine learning (ML) algorithms were applied to the dataset. The algorithms belonged to 5 classifier groups which were Bayes, meta, functions, rules, and trees. The original dataset including herd-cow factors was randomly divided into 2 subsets: a training dataset and a test one (at a ratio of 60:40). The original dataset was combined with the bull genetic information to create a full dataset. The average abortion rate was 15.4 %, which represented an imbalanced dataset. Therefore, 2 down- and up-sampling techniques were additionally implemented on the original dataset (more specifically on the training one) to create 2 balanced datasets. This ultimately yielded 4 datasets; original, full, down-sampling, and up-sampling. Different algorithms and models were evaluated based on F-measure and area under the curve (AUC). Based on the results obtained, ML algorithms exhibited a high performance in predicting abortion when applied to the balanced dataset. However, their performance varied from 32.3 % (poor) to 69.2 % (medium upward) when applied to the imbalanced original dataset. In addition to the imbalance in the original dataset, the reason for these poor results were attributed to the high proportion of unknown risk factors underlying abortion incidence. Even when including the bull genetic information, it did not lead to any significant improvements in the prediction model. From among the datasets used, the Bayes algorithms outperformed the others in predicting pregnancy losses while rules had the worst performance. Furthermore, while the Bayes algorithms were not affected by the type of dataset (balanced or imbalanced), substantial increases in F-measure and AUC were observed for rules, trees, and functions with balanced datasets. Overall, the balanced models outperformed the others, with the down-sampling method exhibiting the highest performance. Despite the fact that the prediction models used in this study did not perform as expected, it was shown that they can be beneficially used to predict and reduce pregnancy losses, despite their moderate accuracy, especially when used for herds with high abortion rates and low reproductive performances.

Is embryo abortion a post-zygotic barrier to gene flow between Littorina ecotypes?

Genetic incompatibilities contribute to reproductive isolation between many diverging populations, but it is still unclear to what extent they play a role if divergence happens with gene flow. In contact zones between the "Crab" and "Wave" ecotypes of the snail Littorina saxatilis, divergent selection forms strong barriers to gene flow, while the role of post‐zygotic barriers due to selection against hybrids remains unclear. High embryo abortion rates in this species could indicate the presence of such barriers. Post‐zygotic barriers might include genetic incompatibilities (e.g. Dobzhansky–Muller incompatibilities) but also maladaptation, both expected to be most pronounced in contact zones. In addition, embryo abortion might reflect physiological stress on females and embryos independent of any genetic stress. We examined all embryos of >500 females sampled outside and inside contact zones of three populations in Sweden. Females' clutch size ranged from 0 to 1,011 embryos (mean 130 ± 123), and abortion rates varied between 0% and 100% (mean 12%). We described female genotypes by using a hybrid index based on hundreds of SNPs differentiated between ecotypes with which we characterized female genotypes. We also calculated female SNP heterozygosity and inversion karyotype. Clutch size did not vary with female hybrid index, and abortion rates were only weakly related to hybrid index in two sites but not at all in a third site. No additional variation in abortion rate was explained by female SNP heterozygosity, but increased female inversion heterozygosity added slightly to increased abortion. Our results show only weak and probably biologically insignificant post‐zygotic barriers contributing to ecotype divergence, and the high and variable abortion rates were marginally, if at all, explained by hybrid index of females.

Ventral Abdominal Wall Defects.

1. Sara A. Mansfield, MD, MS* 2. Tim Jancelewicz, MD, MA, MS* 1. *Division of Pediatric Surgery, Le Bonheur Children’s Hospital, University of Tennessee Health Science Center, Memphis, TN Clinicians should be aware of the strategies for prenatal and postnatal management of infants with omphalocele and gastroschisis. After completing this article, readers should be able to: 1. Recognize the implications and differences in management between gastroschisis and omphalocele. 2. Review the initial stabilization and management of infants with omphalocele and gastroschisis. 3. Review the surgical management options and rationale for infants with ventral abdominal wall defects. Abdominal wall defects represent a wide spectrum of congenital anomalies. These can range from lethal limb-body wall syndrome to benign umbilical cord hernias. Gastroschisis and omphalocele are the 2 most common defects and are the focus of this review. Although both of these diseases affect the umbilical area, they differ widely in their underlying pathogenesis, genetics, and associated disorders. Consequently, their management techniques and outcomes are quite different. This article reviews the pathogenesis, genetics, diagnostics, and outcomes for each disease, followed by an in-depth review of recent management updates. ### Pathogenesis Omphalocele (or exomphalos) is a herniation of the abdominal viscera through a midline abdominal wall defect (Fig 1). This defect is located at the base of the umbilical stalk, and herniated viscera are covered by a 3-layer membrane of peritoneum, Wharton jelly, and amnion. This contrasts with umbilical cord hernias, which are covered by intact skin and contain only a small protrusion of abdominal contents, and gastroschisis, which has no covering at all and occurs to the right of midline (Table). Omphaloceles are present in approximately 1 per 1,100 pregnancies. However, there is a high rate of spontaneous abortion, making the incidence of omphalocele per live birth approximately 1 per 4,000 to 1 per 6,000. (1) …

Abortion Surveillance - United States, 2016.

PROBLEM/CONDITION Since 1969, CDC has conducted abortion surveillance to document the number and characteristics of women obtaining legal induced abortions in the United States. PERIOD COVERED 2016. DESCRIPTION OF SYSTEM Each year, CDC requests abortion data from the central health agencies of 52 reporting areas (the 50 states, the District of Columbia, and New York City). The reporting areas provide this information voluntarily. For 2016, data were received from 48 reporting areas. Abortion data provided by these 48 reporting areas for each year during 2007-2016 were used in trend analyses. Census and natality data were used to calculate abortion rates (number of abortions per 1,000 women aged 15-44 years) and ratios (number of abortions per 1,000 live births), respectively. RESULTS A total of 623,471 abortions for 2016 were reported to CDC from 48 reporting areas. Among these 48 reporting areas, the abortion rate for 2016 was 11.6 abortions per 1,000 women aged 15-44 years, and the abortion ratio was 186 abortions per 1,000 live births. From 2015 to 2016, the total number of reported abortions decreased 2% (from 636,902), the abortion rate decreased 2% (from 11.8 abortions per 1,000 women aged 15-44 years), and the abortion ratio decreased 1% (from 188 abortions per 1,000 live births). From 2007 to 2016, the total number of reported abortions decreased 24% (from 825,240), the abortion rate decreased 26% (from 15.6 abortions per 1,000 women aged 15-44 years), and the abortion ratio decreased 18% (from 226 abortions per 1,000 live births). In 2016, all three measures reached their lowest level for the entire period of analysis (2007-2016). In 2016 and throughout the period of analysis, women in their 20s accounted for the majority of abortions and had the highest abortion rates. In 2016, women aged 20-24 and 25-29 years accounted for 30.0% and 28.5% of all reported abortions, respectively, and had abortion rates of 19.1 and 17.8 abortions per 1,000 women aged 20-24 and 25-29 years, respectively. By contrast, women aged 30-34, 35-39, and ≥40 years accounted for 18.0%, 10.3%, and 3.5% of all reported abortions, respectively, and had abortion rates of 11.6, 6.9, and 2.5 abortions per 1,000 women aged 30-34, 35-39, and ≥40 years, respectively. From 2007 to 2016, the abortion rate decreased among women in all age groups. In 2016, adolescents aged 13 weeks' gestation remained consistently low (8.2%-9.0%). Among abortions performed at ≤13 weeks' gestation, the percentage distributions of abortions by gestational age were highest among those performed at ≤6 weeks' gestation (35.0%-38.4%). In 2016, 27.9% of all abortions were performed by early medical abortion (a nonsurgical abortion at ≤8 weeks' gestation), 59.9% were performed by surgical abortion at ≤13 weeks' gestation, 8.8% were performed by surgical abortion at >13 weeks' gestation, and 3.4% were performed by medical abortion at >8 weeks' gestation; all other methods were uncommon (0.1%). Among those that were eligible for early medical abortion on the basis of gestational age (i.e., performed at ≤8 weeks' gestation), 41.9% were completed by this method. In 2016, women with one or more previous live births accounted for 59.0% of abortions, and women with no previous live births accounted for 41.0%. Women with one or more previous induced abortions accounted for 43.1% of abortions, and women with no previous abortions accounted for 56.9%. Deaths of women associated with complications from abortion are assessed as part of CDC's Pregnancy Mortality Surveillance System. In 2015, the most recent year for which data were reviewed for abortion-related deaths, two women were identified to have died as a result of complications from legal induced abortion and for one additional death, it was unknown whether the abortion was induced or spontaneous. INTERPRETATION Among the 48 areas that reported data every year during 2007-2016, decreases in the total number, rate, and ratio of reported abortions resulted in historic lows for the period of analysis for all three measures of abortion. PUBLIC HEALTH ACTION The data in this report can help program planners and policymakers identify groups of women with the highest rates of abortion. Unintended pregnancy is the major contributor to induced abortion. Increasing access to and use of effective contraception can reduce unintended pregnancies and further reduce the number of abortions performed in the United States.

Sequencing of the black rockfish chromosomal genome provides insight into sperm storage in the female ovary.

Black rockfish (Sebastes schlegelii) is an economically important viviparous marine teleost in Japan, Korea, and China. It is characterized by internal fertilization, long-term sperm storage in the female ovary, and a high abortion rate. For better understanding the mechanism of fertilization and gestation, it is essential to establish a reference genome for viviparous teleosts. Herein, we used a combination of Pacific Biosciences sequel, Illumina sequencing platforms, 10× Genomics, and Hi-C technology to obtain a genome assembly size of 848.31 Mb comprising 24 chromosomes, and contig and scaffold N50 lengths of 2.96 and 35.63 Mb, respectively. We predicted 39.98% repetitive elements, and 26,979 protein-coding genes. S. schlegelii diverged from Gasterosteus aculeatus ∼32.1-56.8 million years ago. Furthermore, sperm remained viable within the ovary for up to 6 months. The glucose transporter SLC2 showed significantly positive genomic selection, and carbohydrate metabolism-related KEGG pathways were significantly up-regulated in ovaries after copulation. In vitro suppression of glycolysis with sodium iodoacetate reduced sperm longevity significantly. The results indicated the importance of carbohydrates in maintaining sperm survivability. Decoding the S. schlegelii genome not only provides new insights into sperm storage; additionally, it is highly valuable for marine researchers and reproduction biologists.

Genotoxic effects of tobacco use in residents of hilly areas and foot hills of Western Ghats, Southern India

Smoking and smokeless tobacco consumption is a significant risk factor that provokes genetic alterations. The present investigation was to evaluate the biomarkers of genotoxicity including micronucleus (MN), chromosome aberrations (CA) and DNA strand breaks among tobacco consumers and control individuals residing in hilly areas of Western Ghats, Tamilnadu, South India. This study included 268 tobacco consumers with equal number of controls. The tobacco consumers were divided into Group I (<10 years of tobacco consumption with an age range from 15 to 35 years) and group II (>10 years consumption above 35 years of age). Chromosome aberration (CA) and comet assay were performed using blood and micronucleus assay from exfoliated buccal epithelial cells obtained from tobacco consumers and controls. Elevated levels of CA were found in group II (Chromatid type: 2.39 ± 1.13 and chromosome type: 1.44 ± 1.24) exposed subjects, high micronucleus and DNA damage (TL:4.48 ± 1.24 and TM:3.40 ± 1.58) levels were significantly (p < 0.05) observed in both smoking and smokeless tobacco consumers when comparison with group I and controls. This study also observed a lack of awareness among the tobacco consumers about the harmful health effects of tobacco. Tobacco consumption contributes to the significant alteration in genetic materials. In addition, a high rate of spontaneous abortion was also seen in the studied population.

Full genome sequence analysis of a 1-7-4-like PRRSV strain in Fujian Province, China.

PRRS virus (PRRSV) has undergone rapid evolution and resulted in immense economic losses worldwide. In the present study, a PRRSV strain named FJ0908 causing high abortion rate (25%) and mortality (40%) was detected in a swine herd in China. To determine if a new PRRSV genotype had emerged, we characterized the genetic characteristics of FJ0908. Phylogenetic analysis indicated that FJ0908 was related to 1-7-4-like strains circulating in the United States since 2014. Furthermore, the ORF5 sequence restriction fragment length polymorphism (RFLP) pattern of FJ0908 was 1-7-4. Additionally, FJ0908 had a 100 aa deletion (aa329–428) within nsp2, as compared to VR-2332, and the deletion pattern was consistent with most of 1-7-4 PRRSVs. Collectively, the data of this study contribute to the understanding of 1-7-4-like PRRSV molecular epidemiology in China.

15.IMPACT OF MATERNAL AGE IN THE INCIDENCE OF UNIFORM AND MOSAIC ANEUPLOIDIES

Introduction Female fertility decreases with age and increases the incidence of aneuploidies mostly due to meiotic errors. The incidence of aneuploid embryos turn around 60% confirming the high abortion rates observed by the presence of chromosomal aneuploidies. Next generation sequencing (NGS) proved to be the most appropriate technology for aneuploidy testing in trophectoderm biopsies, with accurate results, high throughput and cost efficiency. However, the rates and levels of embryonic mosaicism are still a subject of discussion. It is known that they can lead to miscarriage and birth defects but the data linking advanced maternal age and mosaicism is limited. Thus, this study aims to assess the differences between the incidence of different levels of mosaicism and uniform aneuploidies in blastocyst biopsies according to maternal age to verify if they follow a similar pattern. Material & methods A total of 34,387 blastocyst biopsies were sent for PGT-A analysis between October and December 2018 from private assisted reproduction centers to our laboratory. NGS technology (ThermoFisher platform) combined with diagnosis a proprietary validated algorithm was used to optimize results. Patients were stratified by age in seven groups: 50% - 30% - Results 33,341 biopsies were informative with 6% (n=1997) of total mosaicism, 47% uniform aneuploidy (n= 15.670) and 47% euploid biopsies (n=15.674). Regarding the mosaicism rates, 65.3 % (n= 1305) were low mosaic degree, and 34.6% (n=692) were high mosaic degree. A significant decrease (p Conclusions The rate of euploid embryos decreased with advanced maternal age and aneuploidies increased, corroborating previous data from other studies. Regarding mosaicism different trends were observed for low mosaic degree, with a trend towards a decrease of low mosaic degree with maternal age, and high mosaic degree without an effect of maternal age.

Rift Valley fever: biology and epidemiology.

Rift Valley fever (RVF) is a mosquito-borne viral zoonosis that was first discovered in Kenya in 1930 and is now endemic throughout multiple African countries and the Arabian Peninsula. RVF virus primarily infects domestic livestock (sheep, goats, cattle) causing high rates of neonatal mortality and abortion, with human infection resulting in a wide variety of clinical outcomes, ranging from self-limiting febrile illness to life-threatening haemorrhagic diatheses, and miscarriage in pregnant women. Since its discovery, RVF has caused many outbreaks in Africa and the Arabian Peninsula with major impacts on human and animal health. However, options for the control of RVF outbreaks are limited by the lack of licensed human vaccines or therapeutics. For this reason, RVF is prioritized by the World Health Organization for urgent research and development of countermeasures for the prevention and control of future outbreaks. In this review, we highlight the current understanding of RVF, including its epidemiology, pathogenesis, clinical manifestations and status of vaccine development.