History Of Miscarriage Research Articles

Ovarian endometrioma increases the embryo aneuploid rate: an analysis of 7092 biopsied blastocysts from fertile monogenetic disease carriers

BackgroundEndometriosis affects many reproductive aged patients with fertility decline and poor outcomes of assisted reproductive treatments, mainly by decreased ovarian reserve and lower fertilization and implantation rates. In recent decade, altered oocyte microenvironments and abnormal spindle organization have been reported to be critical to oocyte chromosomal segregation, organization and aneuploid formation. However, clinical evidences are still limited on whether endometriosis influences oocyte and embryo development. We aimed to figure out the impact of endometrioma on embryo aneuploid formation.MethodThis retrospective cohort study included 1,021 patients (7,092 biopsied embryos) from January 2012 to December 2020. Fertile patients without a history of miscarriage who underwent PGT-M treatment with aneuploid screening were included. Patients with ovarian endometrioma were defined as the study group, while patients without endometriosis were defined as the control group. All demographic, controlled ovarian stimulation treatment and aneuploid screening data were recorded and compared.ResultsThe incidence of endometrioma in our study population was 6.5%. There were 7,092 embryos biopsied in total, with 308 embryos in the study group and 6,784 embryos in the control groups. The demographic characteristics were comparable between the two groups except the basal FSH level (6.02 IU/L vs. 5.52 IU/L, p = 0.012). The euploid rate of the study group was significantly lower than that of the control group (52.6% vs. 61.8%, p = 0.012), while the oocyte maturation, fertilization, usable embryo and blastocyst formation rates were comparable. Adjusted for basal FSH level, starting stimulating gonadotropin dosage, total gonadotropin dosage and FSH level on hCG day, euploid rate was still negatively related to endometrioma status.ConclusionsEndometrioma status disturbs oocyte and embryo development. For infertile patients with endometrioma who require assisted reproductive treatment, pre-treatment is necessary to improve treatment outcomes.Trial registrationNot applicable.

Psychopathology Present in Women after Miscarriage or Perinatal Loss: A Systematic Review

Miscarriage or perinatal loss constitutes one of the most important emotional stressors a woman can experience and can be associated with bereavement. This mourning is a way of adapting and coping with the circumstances. However, inadequate management of this process can lead to the development of complicated grief and psychopathologies such as anxiety, depression, and post-traumatic stress disorder. The aim of this systematic review was to evaluate the prevalence of psychopathology (anxiety, depression, and post-traumatic stress disorder) in women with a history of miscarriage or perinatal loss in the year prior, and to compare these results with women without this history. A peer review was conducted in PubMed, Cochrane, Scopus, and Web of Science databases. We included (1) articles that included women of any age who had had a miscarriage or perinatal loss in the year prior, and (2) articles with a longitudinal cohort design with a comparison group of women without a history of miscarriage or perinatal loss. After the screening process, three articles met these inclusion criteria and were included in this study. Psychopathology in women after miscarriage or perinatal loss was higher than in the control groups. In addition, it was observed that these psychopathologies gradually decreased over the first year from the loss. In conclusion, abortion and perinatal loss pose a risk factor for the development of psychopathology. Therefore, we emphasize the importance of implementing a mental health plan for these women.

The Prevalence of Low Birth Weight Among Newborn Babies and Its Associated Maternal Risk Factors: A Hospital-Based Cross-Sectional Study.

Background Low birth weight (LBW) is at the forefront of 100 core health issues that are used as indicatorsto assess the global nutrition monitoring framework as reported by the World Health Organization (WHO). Several factors could contribute to LBW, which essentiallyincludeintrauterine growth retardation and premature delivery/birth. Moreover, LBW predisposes neonates to several developmental disturbances including both physical and mental disorders. Given that LBW is more common in poor and developing countries, there is not much reliable data that could be used to formulate strategies for controlling this problem. This study, therefore, attempts to assess the prevalence of LBW among newborn babies and its associated maternal risk factors. Methods This hospital-based cross-sectional study was carried out between June 2016 and May 2017 (one year) and included 327 LBW babies. A predefined and prevalidated questionnaire was used to obtain data for the study. The data collected includedage, religion,parity, birth spacing, pre-pregnancy weight, weight gain during pregnancy, height, mother's education, occupation, family income, socioeconomic status, obstetric history, previous history of stillbirths and abortions, and history of any LBW baby. Results The prevalence of LBW was noted to be 36.33%. The occurrence of LBW babies was predominant among mothers who were aged <19 years (62.26%) and >35 years (57.14%). Grand multipara women showed the highest rates (53.70%) of LBW babies. Additionally, LBW was predominantly noticed among newborns (46.66%) with a birth spacing of <18 months, those born to mothers with pre-pregnancy weight of <40 Kg (94.04%), mothers with a height of <145 cm (83.46%), mothers who gained <7 kg during the pregnancy (82.20%), illiterate mothers (43.75%), and mothers who were agricultural workers (63.76%). Other maternal factors that could predispose to LBW included lower monthly income (66.25%), low socioeconomic status (52.90%), less number of antenatal visits (59.65%), low blood hemoglobin (100%), history of strenuous physical activities (48.66%), smoking and/or tobacco chewing habit (91.42%), alcoholism (66.66%), lack of iron and folic acid supplementation during pregnancy (64.58%), history of stillbirths (51.51%), and mothers suffering from chronic hypertension, preeclampsia, and eclampsia(47.61%), and tuberculosis (75%). Religion-wise, Muslim mothers revealed the highest prevalence (48.57%) of LBW, followed by Hindus(37.71%) and Christians (20%). The mother's age, pre-pregnancy weight, weight gain during pregnancy, height of the mother, hemoglobin concentration, weight of the baby, and length of the newborn(p≤0.05) couldinfluence the health of the newborn. However, maternal infections, previous bad obstetrics history, presence of systemic illnesses, and protein and calorie supplementation (p≥0.05) had no significant impact on birth weight. Conclusions The results showed that multiple factors are responsible for LBW. Maternal factors such as weight, height, age, parity, weight gained during pregnancy, and anemia during pregnancy could predispose to delivering LBW babies. Additionally, other risk factors for LBW identified in this study were the literacy level of mothers, occupation, family income, socioeconomic status, antenatal care, strenuous physical activity during pregnancy, smoking/tobacco chewing, alcohol/toddy consumption, and iron and folic acid supplementation during pregnancy.

Obstetric Outcome in Present Pregnancy in Patient with History of Previous Spontaneous Abortion

Obstetric Outcome in Present Pregnancy in Patient with History of Previous Spontaneous Abortion

Evidence-based trends and association between symptom disturbance and physical activity among pregnant women: A longitudinal study.

Women usually decrease their physical activity (PA) after becoming pregnant. The change in PA may influence their symptom distress (SD). The changes and correlations between SD and PA throughout pregnancy remain unclear. The aims of this study were to describe PA and SD trajectories across all three trimesters and examine their correlations during pregnancy. A repeated-measure longitudinal study with convenience sampling at a hospital in Northern Taiwan was performed. Participants were recruited at 8-16 weeks of gestation, and two follow-up visits were performed at 24-28 weeks of gestation (second trimester) and after 36 weeks of gestation (third trimester). A total of 225 participants completed the study. The participants completed the Pregnancy Physical Activity Questionnaire (PPAQ) and Pregnancy-related Symptom Disturbance Scale (PSD), and sociodemographic and prenatal variables were recorded. Throughout pregnancy, SD decreased then increased, showing an overall upward trend, whereas PA showed the opposite pattern, increasing then decreasing, with an overall downward trend. Sedentary activity was positively correlated with both physical and psychological SD during the second and third trimesters. Exceeding the Institute of Medicine's recommendations for gestational weight gain, having childcare support, sport/exercise-type, and light-intensity PA were negatively associated with the physical and psychological SD, while a history of miscarriage and sedentary-intensity PA were positively associated with the physical and psychological SD. While several factors, including light-intensity PA, were found negatively associated with the physical and psychological SD, sedentary-intensity PA were positively associated with the physical and psychological SD, our findings shed light on future intervention strategies to relieve SD and decrease sedentary behavior among pregnant women.

The Factors Related to Unwanted Pregnancy Among Pregnant Women: A Case-control Study in Western Iran

Aims: This study aimed to investigate factors affecting unwanted pregnancy in Hamadan. Background: Various factors affect the occurrence and extent of unwanted pregnancies. Methods: The present case-control study was performed on 901 pregnant women admitted to comprehensive health centers in Hamadan in 2020. The case group included women with unwanted pregnancies and the control group consisted of women who became pregnant in a preplanned manner. Data were collected from the samples using a checklist. Data were analyzed with SPSS24 at a significance level of 5%. Results: This case-control study was conducted on 455 mothers in the case group (with unwanted pregnancies) and 456 samples in the control group. The results of the logistic regression model indicated that the history of abortion, education, stillbirth history, history of contraceptive use, history of unwanted pregnancy, marital satisfaction, emotional relation with the spouse, spouse's opinion about contraception method, age, and the first pregnancy age were the predictors of unwanted pregnancy. Conclusion: To prevent unwanted pregnancies, it is recommended to start the correct training of family planning methods from high school and pursue it continuously after marriage, during pregnancy, and postpartum care.

A Rose by Any Other Name: Gender-Affirming Care and Severe Mental Illness

The transgender population has higher rates of psychiatric disorders and stigma within medical settings. Literature suggests that gender-affirming care is the standard when working with such patients. There are limited studies regarding treating these patients with severe mental illness (SMI). This article explores how to treat SMI that impacts patients' reality to the point where their assigned sex cannot be acknowledged. The case presented is that of a transgender woman, where clarification of her natal sex was crucial to treatment. The patient denied her natal sex, endorsing a history of miscarriage. Studies on treatment of transgender SMI patients are limited. Gender-affirming treatment is the standard of care for these patients. Training how to ask pertinent questions and communicate effectively is necessary to prevent misdiagnosis, unnecessary treatment, and agitation. [ Psychiatr Ann. 2023;53(5):221–223.]

Adverse obstetric and perinatal outcomes of patients with history of recurrent miscarriage: a retrospective cohort study

To examine the associations between a history of recurrent miscarriage (RM) and adverse obstetric and perinatal outcomes in the subsequent pregnancy that progressed beyond 24 weeks. Retrospective cohort study. A large tertiary maternity hospital. All women who booked for antenatal care and delivery between January 2014 and August 2021 were recorded. The study was limited to women with a singleton pregnancy, and to avoid intraperson correlation, we selected the first record of delivery from each mother in the study, leaving 108,792 deliveries for analysis. Obstetric and perinatal outcomes were compared among 1994 women (1.83%) with a history of ≥2 miscarriages (RM), 11,477 women (10.55%) with a history of 1 miscarriage, and 95,321 women (87.62%) with no history of miscarriage, respectively. Women with a history of ≥2 miscarriages or RM. Obstetric complications included gestational diabetes mellitus, preeclampsia (subclassified as preterm and term preeclampsia), placenta previa, placenta accreta, and fetal distress. Perinatal outcomes included emergency cesarean section, elective cesarean section, induction, postpartum hemorrhage, preterm birth, stillbirth, Apgar score <7 at 5 minutes, neonatal asphyxia, neonatal sex, congenital; malformation, low birth weight, and neonatal death. After adjusting for relevant confounders, there was an increased risk of adverse obstetric and perinatal outcomes in a subsequent pregnancy for women with a history of RM, specifically for placental dysfunction disorders: preterm preeclampsia (risk ratio [RR] = 1.58; 95% confidence interval [CI], 1.03-2.32), preterm birth (RR = 1.34; 95% CI, 1.15-1.54)], and abnormal placentation, that is placenta previa (RR = 1.78; 95% CI, 1.36-2.28), and placenta accreta (RR = 4.19; 95% CI, 2.75-6.13). Significant associations existed between a history of RM and the occurrence of adverse obstetric and perinatal outcomes including placental dysfunction disorders and abnormal placentation. These findings may contribute to the early detection and appropriate intervention for placenta-associated diseases in women with a history of RM, with the goal of avoiding or reducing the associated detrimental effects.

Longitudinal study of the relationship between number of prior miscarriages or stillbirths and changes in quality of life of pregnant women: the Japan Environment and Children’s Study (JECS)

BackgroundAlthough a history of miscarriage or stillbirth has been reported to negatively affect quality of life (QOL) during the subsequent pregnancy, the association between the number of previous miscarriages or stillbirths and QOL, as well as trends in QOL during pregnancy, has not been clarified. This study sought to determine this association during early and mid- to late pregnancy.MethodsData from 82,013 pregnant women who participated in the Japan Environment and Children’s Study (JECS) from January 2011 to March 2014 were analyzed. In early and mid/late pregnancy, participants completed questionnaires and QOL was assessed using the Physical and Mental Component Summary (PCS and MCS, respectively) scores from the 8-item Short-Form Health Survey (SF-8). The pregnant women were divided into four groups according to number of previous miscarriages or stillbirths (0, 1, 2, and ≥ 3), and the PCS and MCS scores in early pregnancy and mid/late pregnancy were compared between group 0 and groups 1, 2, and ≥ 3. Generalized linear mixed models were used for analysis.ResultsPCS score in early pregnancy was lower in group 1 (β = − 0.29, 95% confidence interval [CI] − 0.42 to − 0.15), group 2 (β = − 0.45, 95% CI − 0.73 to − 0.18), and group ≥ 3 (β = − 0.87, 95% CI − 1.39 to − 0.35) than in group 0. Group 1 and group ≥ 3 showed a trend for increased PCS score during pregnancy (β = 0.22, 95% CI 0.07 to 0.37 and β = 0.75, 95% CI 0.18 to 1.33, respectively) compared with group 0.ConclusionsPCS score in early pregnancy was lower with a more frequent history of miscarriage or stillbirth. However, in terms of changes in QOL during pregnancy, pregnant women with a history of miscarriage or stillbirth showed greater increases in PCS score during mid/late pregnancy than pregnant women with no history of miscarriage or stillbirth.

Assessment of miscarriage factors among Latinas who live in the U.S.: a cross-sectional study.

Latinas in the US are underrepresented in miscarriage research, yet face several risk factors for having a miscarriage, including intimate partner violence, and increasing maternal age. Increased acculturation is associated to increased risk of intimate partner violence and adverse pregnancy outcomes among Latinas yet is also understudied in the realm of miscarriage. Thus, this study aimed to analyze and compare sociodemographic characteristics, health-related factors, intimate partner violence, and acculturation among Latinas with and without a history of miscarriage. This study utilizes a cross-sectional design to analyze baseline data from a randomized clinical trial on the effectiveness of "Salud/Health, Educación/Education, Promoción/Promotion, y/and Autocuidado/Self-care" (SEPA), a human immunodeficiency virus risk reduction intervention for Latinas. Survey interviews were conducted in a private room at the University of Miami Hospital. Survey data analyzed include demographics, a bi-dimensional acculturation scale, a health and sexual health survey, and the hurt, insult, threaten, and scream tool. This study's sample was 296 Latinas, 18 to 50 years old, with and without a history of miscarriage. Data analyses included descriptive statistics, t-tests for continuous variables, negative binomial for counts, and chi-square for dichotomous or categorical variables. Most Latinas were Cuban (53%), lived in the U.S. an average of 8.4 years, had 13.7 years of education, and a monthly family income of $1,683.56. Latinas with history of miscarriage were significantly older, had more children, more pregnancies, and poorer self-rated health than Latinas without history of miscarriage. Although not significant, a high percentage of intimate partner violence (40%) and low levels of acculturation were reported. This study contributes new data about different characteristics of Latinas who have and have not experienced a miscarriage. Results can help identify Latinas at risk for miscarriage or its adverse-related outcomes and help develop public health policies focusing on preventing and managing miscarriage among Latinas. Further research is warranted to determine the role of intimate partner violence, acculturation, and self-rated health perceptions among Latinas who experience miscarriage. Certified nurse midwives are encouraged to provide Latinas with culturally tailored education on the importance of early prenatal care for optimal pregnancy outcomes.

Intrauterine Fetal Death in the Third Trimester of Pregnancy in Kamina, DR Congo: Identification of High-Risk Mothers and Impact of the Periodicity of Antenatal Care

Purpose: Intrauterine fetal death (IUFD) is a problem frequently encountered in obstetrical practice in developing countries. The objectives of this study were to identify maternal risk factors for IUFD in the third trimester of pregnancy and to establish its relationship with the norms of periodicity of antenatal care in Kamina. Materiel and methods: This is a case-control study conducted in 6 health facilities in Kamina from January 2021 to May 2022. The effects of the socio-demographic characteristics and obstetrical history of mothers, number of prenatal attendances, age of pregnancy at the first prenatal attendance and number of consultations in third trimester of pregnancy on the occurrence of IUFD were studied. A total of 78 cases of IUFD were linked to 234 controls. Results: The adjustment allowed us to retain 5 parameters significantly associated with IUFD: residence in a rural environment (aOR=2.25; CI= [1.23-4.48]), absence of a history of abortion (aOR=2.97; CI=[1.21-7.26]), history of stillbirth (aOR=2.97; CI =[1.21-7.26]), non-follow up of prenatal care (aOR=3.69; CI=[1.78-7.68]) and insufficient number of prenatal attendances in the third trimester of pregnancy (aOR= 2.22; CI=[1.04 -4.73]). The values of the area under the ROC curve (AUC) found indicate a good capacity of the model (80.3%). Conclusion: The modifiable maternal determinants and those related to identified ANC should serve providers to reduce the occurrence of IUFD in Kamina and its surroundings.

Is there a link between infertility, miscarriage, stillbirth, and premature or early menopause? Results from pooled analyses of 9 cohort studies

Some reproductive factors (such as age at menarche and parity) have been shown to be associated with age at natural menopause, but there has been little quantitative analysis of the association between infertility, miscarriage, stillbirth, and premature (<40 years) or early menopause (40-44 years). In addition, it has been unknown whether the association differs between Asian and non-Asian women, although the age at natural menopause is younger among Asian women. This study aimed to investigate the association of infertility, miscarriage, and stillbirth with age at natural menopause, and whether the association differed by race (Asian and non-Asian). This was a pooled individual participant data analysis from 9 observational studies contributing to the InterLACE consortium. Naturally postmenopausal women with data on at least 1 of the reproductive factors (ie, infertility, miscarriage, and stillbirth), age at menopause, and confounders (ie, race, education level, age at menarche, body mass index, and smoking status) were included. A multinomial logistic regression model was used to estimate relative risk ratios and 95% confidence intervals for the association of infertility, miscarriage, and stillbirth with premature or early menopause, adjusting for confounders. Between-study difference and within-study correlation were taken into account by including study as a fixed effect and indicating study as a cluster variable. We also examined the association with number of miscarriages (0, 1, 2, ≥3) and stillbirths (0, 1, ≥2), and tested whether the strength of association differed between Asian and non-Asian women. A total of 303,594 postmenopausal women were included. Their median age at natural menopause was 50.0 years (interquartile range, 47.0-52.0). The percentages of women with premature and early menopause were 2.1% and 8.4%, respectively. The relative risk ratios (95% confidence intervals) of premature and early menopause were 2.72 (1.77-4.17) and 1.42 (1.15-1.74) for women with infertility; 1.31 (1.08-1.59) and 1.37 (1.14-1.65) for women with recurrent miscarriages; and 1.54 (1.52-1.56) and 1.39 (1.35-1.43) for women with recurrent stillbirths. Asian women with infertility, recurrent miscarriages (≥3), or recurrent stillbirths (≥2) had higher risk of premature and early menopause compared with non-Asian women with the same reproductive history. Histories of infertility and recurrent miscarriages and stillbirths were associated with higher risk of premature and early menopause, and the associations differed by race, with stronger associations for Asian women with such reproductive history.

Maternal Preconception Body Mass Index Overtakes Age as a Risk Factor for Gestational Diabetes Mellitus.

Introduction-The purpose of this study was to determine the relative impact of modifiable and non-modifiable risk factors in the development of gestational diabetes mellitus (GDM), with a particular focus on maternal preconception body mass index (BMI) and age, two important determinants of insulin resistance. Understanding the factors that contribute most to the current escalation of GDM rates in pregnant women could help to inform prevention and intervention strategies, particularly in areas where this female endocrine disorder has an elevated prevalence. Methods-A retrospective, contemporary, large population of singleton pregnant women from southern Italy who underwent 75 g OGTT for GDM screening was enrolled at the Endocrinology Unit, "Pugliese Ciaccio" Hospital, Catanzaro. Relevant clinical data were collected, and the characteristics of women diagnosed with GDM or with normal glucose tolerance were compared. The effect estimates of maternal preconception BMI and age as risk factors for GDM development were calculated through correlation and logistic regression analysis by adjusting for potential confounders. Results-Out of the 3856 women enrolled, 885 (23.0%) were diagnosed with GDM as per IADPSG criteria. Advanced maternal age (≥35 years), gravidity, reproductive history of spontaneous abortion(s), previous GDM, and thyroid and thrombophilic diseases, all emerged as non-modifiable risk factors of GDM, whereas preconception overweight or obesity was the sole potentially modifiable risk factor among those investigated. Maternal preconception BMI, but not age, had a moderate positive association with fasting glucose levels at the time of 75 g OGTT (Pearson coefficient: 0.245, p < 0.001). Abnormalities in fasting glucose drove the majority (60%) of the GDM diagnoses in this study. Maternal preconception obesity almost tripled the risk of developing GDM, but even being overweight resulted in a more pronounced increased risk of developing GDM than advanced maternal age (adjusted OR for preconception overweight: 1.63, 95% CI 1.320-2.019; adjusted OR for advanced maternal age: 1.45, 95% CI 1.184-1.776). Conclusions-Excess body weight prior to conception leads to more detrimental metabolic effects than advanced maternal age in pregnant women with GDM. Thus, in areas in which GDM is particularly common, such as southern Italy, measures aiming to counteracting maternal preconception overweight and obesity may be efficient in reducing GDM prevalence.

Previous pregnancy loss and gestational cardiovascular health: A prospective cohort of nulliparous women.

To estimate the association of previous pregnancy loss with subsequent cardiovascular health during gestation and to examine the role of high-sensitivity C reactive protein (hs-CRP) in the association. A total of 2,778 nulliparous pregnant women were recruited between March 2015 and November 2020 in Hefei city, China. Their cardiovascular health (CVH) including prepregnancy body mass index (BMI), blood pressure, total cholesterol, fasting plasma glucose, and smoke status were recorded at 24-28 weeks' gestation, as well as their reproductive history. Multivariate linear and logistic regression were performed to examine the association of pregnancy loss with cardiovascular health. And the role of hs-CRP between pregnancy loss and CVH was assessed by the mediation analysis. Compared with women who have no pregnancy loss, women with a history of spontaneous or induced abortions had higher BMI (β, 0.72, 95% CI, 0.50 to 0.94) and fasting plasma glucose (β, 0.04, 95% CI, 0.01 to 0.07), and had lower total CVH scores after adjusting for confounders (β, -0.09, 95% CI, -0.18 to -0.01). CVH scores were most significantly decreased among women with 3 or more induced abortions (β, -0.26, 95% CI, -0.49, -0.02). The contribution of pregnancy loss to poorer gestational CVH mediated by increased hs-CRP levels was 23.17%. Previous pregnancy loss was associated with poorer cardiovascular health during gestation, which may be mediated by their gestational inflammatory status. Exposure to miscarriage alone was not a significant predictor of poorer CVH.

Cervicovaginal microbiome in patients with recurrent pregnancy loss

There have been few studies concerning an association between unexplained recurrent pregnancy loss (RPL) and the microbiome. A recent study including 67 patients demonstrated that an increase in Ureaplasma species in the endometrium raised the risk of miscarriage with an euploid karyotype. While endometrial sampling is invasive, cervicovaginal sampling is not. We compared vaginal and cervical microbiomes with a 16 S ribosomal RNA sequence between 88 patients with unexplained RPL and 17 healthy women with no history of miscarriage. We prospectively assessed risk factors for maternal colonization at a subsequent miscarriage without an aneuploid karyotype in patients. Cervicovaginal bacteria were dominated by Lactobacillus iners, Gardnerella vaginalis, Atopobium vaginae and Bifidobacterium breve in Japanese population. The proportions of Delftia and unknown bacteria in the cervix were significantly higher in patients with RPL than in controls. Streptococcus, Microbacterium, Delftia, Anaerobacillus and Chloroplast in the cervix were significantly higher in patients with a history of chorioamnionitis compared to the controls. The abundance of Cutibacterium and Anaerobacillus in the cervix was significantly higher in patients who had subsequently miscarried compared to those who gave birth. The miscarriage rate in patients with higher proportions of both Cutibacterium and Anaerobacillus (66.7%, 2/3) was significantly greater than that of patients who lacked these bacteria (9.2%, 6/65, adjusted odds ratio 16.90, 95% confidence interval 1.27–225.47, p = 0.032). The presence of certain bacteria could be a predictor of subsequent miscarriage without an aneuploid karyotype. The cervicovaginal microbiome might be useful for investigating a possible cause of RPL.

Prenatal ambient air pollutants exposure and the risk of stillbirth in Wuhan, central of China

BackgroundThe existing studies on the relationships of prenatal ambient air pollutants exposure with stillbirth in the Chinese population are very limited and the results are inconsistent, and the susceptible windows and potential modifiers for air pollutants exposure on stillbirth remain unanswered. ObjectiveWe aimed to determine the relationships between exposure to ambient air pollutants and stillbirth, and explored the susceptible windows and potential modifiers for air pollutants exposure on stillbirth. MethodsA population-based cohort was established through the Wuhan Maternal and Child Health Management Information System involving 509,057 mother-infant pairs in Wuhan from January 1, 2011 through September 30, 2017. Personal exposure concentrations of fine particles (PM2.5), inhalable particles (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), and ozone (O3) for mothers were estimated based on their residential address during pregnancy using the inverse distance weighted (IDW) method. We used the logistic regression models to determine the associations at different stages of pregnancy with adjustment for confounding factors. ResultsThere were 3218 stillbirths and 505,839 live births among the participants. For each 100 μg/m3 of CO and 10 μg/m3 of O3 increase in the first trimester (conception to 13+6 weeks), the risk of stillbirth increased by 1.0% (OR = 1.01, 95%CI: 1.00–1.03) and 7.0% (OR = 1.07, 95%CI: 1.05–1.09). In the second trimester (14 weeks–27+6 weeks), PM2.5, PM10, CO, and O3 exposure were closely related to the risk of stillbirth (P＜0.05). In the third trimester (28 weeks to delivery), for each 10 μg/m3 increase in exposure concentrations of PM2.5, SO2, and O3, the risk of stillbirth increased by 3.4%, 5.9%, and 4.0%, respectively. O3 exposure was positively relevant to the risk of stillbirth (OR = 1.11, 95%CI: 1.08–1.14) in the whole pregnancy. Exposure to NO2 was not significantly associated with the risk of stillbirth. Stratified analyses also presented a stronger association among mothers with boy infant, living in rural areas, delivering between 2011 and 2013, and those without gestational hypertension and history of stillbirth. ConclusionThis study provides evidence that maternal exposure to PM2.5, PM10, SO2, CO, and O3 were related to the increased risk of stillbirth. Both the second and third trimesters might be vital susceptible windows for stillbirth. Our findings expand the evidence base for the important impacts of air pollution on fetal growth.

High seroprevalence of syphilis infection among pregnant women in Public Health facilities in Shashemene town, southern Ethiopia

BackgroundSyphilis infection is a major public health problem in developing countries including Ethiopia. Thus, this study aimed to assess the seroprevalence of syphilis and associated factors among pregnant women attending Antenatal Care (ANC) in Public health facilities in Shashemene town, southern Ethiopia. MethodAn institutional-based cross-sectional study design was conducted among 230 pregnant women from the 27th of August to the 30th of September 2018. Data were collected using a structured interviewer-administered questionnaire. Data were entered into Epi-Info 7 and analyzed with SPSS Version 21. A multivariate logistic regression model was used to investigate factors associated with syphilis infection. A p-value of <0.05 was considered statistically significant. ResultThe overall prevalence of syphilis infection was 22(9.6%)(95% CI, [6.1, 14.1%]). Pregnant mothers who had multiple sexual partners (AOR = 5.12, 95% CI 1.51, 17.44), abnormal vaginal discharge (AOR = 18.13 95%CI 3.66, 88.42), previous history of abortion (AOR = 5.6, 95%CI 2.03, 15.36) and previous history of stillbirth (AOR = 9.98, 95% CI: 2.85, 34.92) were among factors associated with syphilis infection. ConclusionAccording to this study, the magnitude of syphilis infection among pregnant mothers attending ANC was high. Pregnant mothers who had multiple sexual partners, previous history of abortion, previous history of stillbirth, and abnormal vaginal discharge were significantly associated with syphilis infection. Thus, health providers should provide comprehensive health education about syphilis transmission, signs and symptoms, and the methods of prevention as well as create awareness about the adverse outcome of getting syphilis infection.

Association between antithyroid peroxidase antibody and recurrent miscarriage.

Thyroid disease is the second most commonly affected disease in childbearing women, after diabetes, and thyroid autoimmunity in pregnancy has been connected with adverse pregnancy outcomes such as miscarriage, recurrent miscarriage, preterm birth, and low IQ. The study seeks to determine the correlation between anti-thyroid peroxidase antibodies and unexplained recurrent miscarriage. 124 women were included in this case-control study, divided into 62 women who have experienced unexplained recurrent miscarriages and 62 healthy women without a history of miscarriage. Screening for TSH and anti-TPO antibody were done for both groups. The prevalence rate of positive anti-TPO antibody in women with recurrent miscarriage was 19.4%, while in women without miscarriage was 6.5% (which is considerably higher in cases than in women without recurrent miscarriage with a p-value of 0.03 and an odd ratio of 3.48 (95% CI; 1.06-11.48). A statistically significant relationship between anti-TPO antibodies and recurrent miscarriage has been detected. We recommend screening for TSH and thyroid antibodies for women with recurrent miscarriages and further studies on the effect of levothyroxine therapy for euthyroid women with antibody positive.

The Benefit of Counselling to Pregnant Women with a History of Spontaneous Abortion: A Case Report

Background: Abortion becomes a complication that can occur in pregnancy and cause psychological and physical distress. Spontaneous abortion can become trigger anxiety and depression during pregnancy. Midwifery who helps patients in perifer or rural areas need to concern about how to do early detection and counseling to reduce risk of psychological risk which can be elevated. Objective: This report aimed to evaluate the anxiety and depression state with a history of spontaneous abortion in their first pregnancy. Methods: This paper was a case report reporting a patient with a second pregnant condition. This patient has a history of spontaneous abortion in her first pregnancy. Evaluating process with Hamilton Anxiety Rating Scale (HAM-A) dan Hamilton Depression Rating Scale (HDRS) and follow-up after parturition period. Results: Decreasing scores on HAM-A and HAM-D after counseling helped the patient to release her anxiety and depression during pregnancy. The patient is more prepared about signs and symptoms when she feels uneasy and overwhelmed and protects herself from another distortion cognition from spontaneous abortion. Conclusion: Counselling had benefits to decrease anxiety and depression in pregnant women with a history of spontaneous abortion. Keywords: anxiety, depression, spontaneous abortion.

Risk factors of miscarriage among pregnant women attending Omdurman maternity hospital

Background: Around 56 million miscarriages are performed each year in the world, with about 45% are done unsafely. Miscarriage poses great risks and complications that contribute to long-term physical and psychological problems. Good knowledge and practice related to pregnancy follow-up and avoiding the causes of miscarriage will reduce its risks significantly. Aim of current study was to determine and identify the rate and risk factors of miscarriage and the common causes of miscarriage among women in Omdurman Maternity Hospital, Sudan. In addition, to evaluate the level of awareness of the risks and complications of miscarriage among women attending the maternity hospital, Sudan. Methods: A quantitative, cross sectional study using questionnaires (N=100) was used in this study to determine the risk factors of miscarriage in women attending the maternity hospital in Omdurman, Sudan Results: The study revealed that miscarriages were not very frequent, and there was no significant family history of miscarriages. However, those who had a miscarriage were in the first trimester of pregnancy. One of the main causes of miscarriage is the presence of severe stress from work, illness and food poisoning. Conclusions: The findings of this study suggest different interventions to reduce the risks of miscarriages such as educating mothers about antenatal care and to take precautions during the first trimester to avoid miscarriages and educating families about the risks of being in consanguineous relationships. In addition, raising awareness about contraceptive methods to reduce the rates of induced miscarriages.