Matern Fetal Neonatal Med Research Articles

Proposal for supplemental intake of folic acid to reduce the risk of neural tube defects.

Congenital AnomaliesVolume 57, Issue 2 p. 44-44 Message from the JTSFree Access Proposal for supplemental intake of folic acid to reduce the risk of neural tube defects First published: 07 March 2017 https://doi.org/10.1111/cga.12210Citations: 5AboutSectionsPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL The Japanese Teratology Society releases the following message for reducing the birth of babies with neural tube defects (congenital defects in the brain and/or spinal cord). Women who are planning to get pregnant or those who may be pregnant are advised to reduce the risk of having a baby with such defects by taking 400 μg (0.4 mg) of supplementary folic acid per day from 4 weeks before impregnation through gestation week 12. We also suggest that women who are at a high risk, such as those having a neural tube defect patient within their family and those having delivered a baby with such defects previously, should take hospital consultation on folic acid intake because the risk of their next baby suffering from neural tube defects is relatively higher than usual. Neural tube defects (spina bifida, anencephaly and encephalocele) arise at around gestation week 6 (4 weeks after fertilization) to obstruct the normal development of the brain and spinal cord. Most patients with spina bifida need to receive medical treatment including a surgical treatment soon after birth and treatments for hydrocephaly, walking difficulties and/or excretion disturbances, which may be followed by continuous rehabilitation through their whole life. Babies with anencephaly hardly survive after birth and those having encephalocele may suffer from neurological disorders even if the mass on the brain is removed surgically. Epidemiological studies have shown that maternal intake of folic acid, a kind of water soluble vitamins, decreases the risk of neural tube defects. According to a British epidemiological study (MRC Vitamin Research Group 1991), treatment of women of the high risk group, who have had a baby with neural tube defects previously, with 4 mg/day of folic acid successfully reduced the incidence of these anomalies in the next pregnancy: the preventive efficiency was estimated to be 72%. Another study in China (Berry et al. 1999) also demonstrated similar preventive effects of folic acid supplementation in primiparas (women bearing their first child) at daily doses of 0.4 mg. The Japanese Ministry of Health and Welfare (MHW), the present Ministry of Health, Labor and Welfare (MHLW), announced in 2000 that women who are planning to get pregnant should take 0.4 mg/day of supplementary folic acid, in addition to well-balanced food containing 0.4 mg/day of folic acid (MHW 2000). Daily intake of folic acid at approximately 1 mg/day does not cause excess symptoms (MHLW 2014). However, the percentage of Japanese women who take folic acid supplement is only 10–20% (Kondo et al. 2013; Obara et al. 2016) and the incidence of neural tube defects in Japan has remained unreduced (International Clearinghouse for Birth Defects Serveilance and Research 2014, MHW 2000). The Japanese Teratology Society aims to contribute to the health and welfare of Japanese people by making efforts to prevent the birth of babies with congenital anomalies. References MRC Vitamin Study Research Group. 1991. Prevention of neural tube defects: results of the Medical Research Council Vitamin Study. Lancet 338: 131– 137. Berry RJ, Li Z, Erickson JD. 1999. Prevention of neural-tube defects with folic acid in China. China-U.S. Collaborative Project for Neural Tube Defect Prevention. N Engl J Med 341: 1485– 1490. International Clearinghouse for Birth Defects Serveilance and Research (ICBDSR) (2014) ICBDSR Annual Report 2014 with data for 2012. http://www.icbdsr.org/filebank/documents/ar2005/Report2014.pdf Kondo A, Morota N, Ihara S. 2013. Risk factors for the occurrence of spina bifida (a case–control study) and the prevalence rate of spina bifida in Japan. Birth Defects Res A Clin Mol Teratol 97: 610– 615. Ministry of Health and Welfare (MHW) in Japan (2000) 12-Jibo no. 72 (in Japanese). http://www1.mhlw.go.jp/houdou/1212/h1228-1_18.html Ministry of Health, Labor and Welfare (MHLW) in Japan (2014) Dietary refference intakes for Japanese (in Japanese). https://www.icbdsr.org/filebank/documents/ar2005/Report2014.pdf Obara T, Nishigori H, Nishigori T. 2016. Prevalence and determinants of inadequate use of folic acid supplementation in Japanese pregnant women: the Japan Environment and Children's Study (JECS). J Matern Fetal Neonatal Med 26: 1– 6. Citing Literature Volume57, Issue2March 2017Pages 44-44 ReferencesRelatedInformation

Improving the Prediction of Neonatal Outcomes in Isolated Left-Sided Congenital Diaphragmatic Hernia by Direct and Indirect Sonographic Assessment of Liver Herniation.

Liver herniation can be assessed sonographically by either a direct (liver-to-thoracic area ratio) or an indirect (stomach position) method. Our objective was to evaluate the utility of those methods to assess liver herniation for the prediction of neonatal outcomes in patients with isolated left-sided congenital diaphragmatic hernia (CDH). We conducted a retrospective cohort study of all patients with CDH who had prenatal assessment and were delivered at Texas Children's Hospital between January 2004 and April 2014. The predictive value of sonographic parameters for mortality and the need for extracorporeal membrane oxygenation was evaluated by univariate, multivariate, and factor analysis and by receiver operating characteristics curves. A total of 77 fetuses with isolated left-sided CDH were analyzed. The lung-to-head ratio, liver-to-thorax ratio, and stomach position (according to the classifications of Kitano et al [Ultrasound Obstet Gynecol 2011; 37:277-282] and Cordier et al [J Matern Fetal Neonatal Med 2015; 28:190-195]) were significantly associated with both neonatal outcomes (P < .03). Significant correlations were observed between all of these sonographic parameters. A combination of the liver-to-thorax ratio and stomach position (Kitano) or stomach position (Cordier) with the lung-to-head ratio increased the area under the receiver operating characteristic curve of the lung-to-head ratio for mortality prediction (0.86 [95% confidence interval, 0.74-0.98], 0.83 [0.72-0.95], and 0.83 [0.74-0.92], respectively). Sonographic measurements of liver herniation (liver-to-thorax ratio and stomach position) are predictive of neonatal outcomes in isolated left-sided congenital diaphragmatic hernia. Our study shows that the combination of those sonographic measurements of liver herniation and lung size improves the accuracy of predicting mortality in those fetuses.

399: Conversion of society for maternal fetal medicine (SMFM) abstract presentations to manuscript publications

To evaluate the rate of conversion of SMFM Annual Meeting abstract presentations (’abstracts’) to full manuscript publication (‘pub’) over time. Full manuscript publications corresponding to all SMFM oral abstracts 2003-2009 inclusive, and SMFM poster abstracts in 2003, 2005, and 2007 (random sample years selected) were manually searched in PubMed. An abstract was considered to ‘match’ a full pub if the abstract and pub titles as well as main methods and results were similar and the abstract 1st author was a pub author. In cases of uncertainty, the abstract-pub match was reviewed by a 2nd physician researcher. Time to pub, pub rates over time, and pub rates among US vs. non-US authors were examined. PMID numbers were also collected to determine if >1 abstract contributed to a manuscript. Data were analyzed using Wilcoxon rank-sum, ANOVA, and chi-square. 2455 abstracts presented at SMFM over the study period, including 544 orals (56 main plenary, 56 fellows plenary, 432 concurrent), were reviewed. 1406/2455 (57%) were published, generating 1228 unique pubs. Oral abstracts had a consistently higher rate of conversion to pubs vs. posters (78% vs. 51%, p<0.001). The median time to pub was 19 (IQR 9-39) months, and was significantly shorter for orals vs. posters (12.5 vs. 22 months, p<0.001). Pubs related to SMFM abstracts were published in 175 different journals, most commonly AJOG (602/1406, 43%), Obstet Gynecol (139/1406, 10%), and J Matern Fetal Neonatal Med (92/1406, 7%). The proportion of abstracts resulting in pub varied significantly over the study period (p<0.001, figure). Pub rates were higher if the abstract’s 1st author was affiliated with a non-US institution (66% vs. 55%, p<0.001). Non-US authors were less likely to combine multiple abstracts into one publication (8% vs. 14%, p=0.003). Most SMFM abstract presentations are converted to full manuscript publications. Abstracts presented as orals and by non-US primary authors had higher rates of publication.

The Big Screen Difference

The Big Screen Difference

Role of decidual natural killer cells, interleukin-15, and interferon-γ in placental development and preeclampsia.

Preeclampsia is a hypertensive, proteinuric disease that affects 5-10% of all pregnancies and is a leading cause of maternal and perinatal morbidity/mortality (Soto et al., J Matern Fetal Neonatal Med 25: 498-507, 2011). The primary treatment for preeclampsia still is delivery of the fetus and placenta. The underlying mechanisms remain elusive. One possibility is inadequate uterine angiogenesis/vascularity (decidualization) at the time of implantation (Torry et al., Am J Reprod Immunol 51: 257-268, 2004). Here, we review evidence for dysregulation of decidual natural killer (dNK) cells, which secrete important angiogenic factors during decidualization, as a contributing factor in preeclampsia.

PFM.39 Diagnostic accuracy of antenatal magnetic resonance imaging (MRI) to predict birth weight >90th centile or < 10th centile in the third trimester

IntroductionAccurate diagnosis of disturbance in fetal size is needed to manage pregnancies and ensure optimal outcome. Conventionally ultrasound is used to estimate fetal weight (EFW) but diagnostic accuracy is poor.MethodsFetal...

PF.68 TORCH Screening, Where Are We Now?

TORCH screening is used in pregnancy in a wide number of indications. In 1990 the Public Health Laboratory service advised that individual serology tests, rather than a TORCH screen, should...

PM.61 The Use of Quantitative Fetal Fibronectin to Predict Obstetric Outcome: A Comparison of a New and Established Quantitative Bedside Analyser in Asymptomatic High-Risk Women

Background Preterm birth (PTB) remains a significant cause of neonatal morbidity and mortality. The most accurate predictors of PTB are ultrasound determined cervical length (CL) and fetal fibronectin (fFN)1. Quantitative...

Statement of Retraction: Ortendahl M, Näsman P. “Quitting smoking is perceived to have an effect on somatic health among pregnant and non-pregnant women”

The Editors and Publisher would like to inform the readers the following article has been retracted from publication in The Journal of Maternal-Fetal & Neonatal Medicine:Ortendahl M, Näsman P. Quitting smoking is perceived to have an effect on somatic health among pregnant and non-pregnant women. J Matern Fetal Neonatal Med. 2008;21:239–246. (doi:10.1080/14767050801924829).This article has been found to reproduce content to a high degree of similarity, without appropriate attribution or acknowledgement by the authors, from the following original article:Ortendahl M, Näsman P. Perception of Smoking-Related Health Consequences among Pregnant and Non-Pregnant Women. Am J Addict. 2007;16:521--527. (doi:10.1080/10550490701643088)The text in the manuscript published in The Journal of Maternal-Fetal & Neonatal Medicine was found to be almost word-for-word identical to the text published in the American Journal of Addictions. The data presented in all 4 tables is also essentially the same, but just presented in a different layout.The authors have been fully co-operative with our investigations and agree with the Editors and Publisher on this course of action to correct the redundancy in the literature record.The journal’s policy in this respect is clear: The Journal of Maternal-Fetal & Neonatal Medicine considers all manuscripts on the strict condition that they have been submitted only to The Journal of Maternal-Fetal & Neonatal Medicine, that they have not been published already, nor are they under consideration for publication or in press elsewhere.The Journal of Maternal-Fetal & Neonatal Medicine published this article in good faith, and on the basis of signed statements made by the corresponding author regarding the originality of their work. The article is withdrawn from all print and electronic editions.Gian Carlo Di Renzo and Dev Maulik(Editors-in-Chief)Anna Treadway(Head of Journals Publishing, Informa Healthcare)

ACOG approves new trisomy screen for high‐risk pregnancies

ACOG approves new trisomy screen for high‐risk pregnancies

1336 Postnatal Serum Creatinine Trends in Neonates: Jaffe Compared to Enzymatic Quantification Technique

BackgroundSerum creatinine (Scr) reflects to a certain extent GFR in neonates, but postnatal observations also depends on the technique used (Jaffe colorimetry or enzymatic quantification) as recently quantified in ELBW...

Neonatal outcome in cases of nuchal cord in Cameroon

[1] KhanM, Pillay T, Connolly CA, Moodley JM. Durban Perinatal TB HIV-1 Study Group. Maternal mortality associated with tuberculosis-HIV-1 co-infection in Durban, South Africa. AIDS 2001;15(14):1857–63. [2] Jana N, Vasishta K, Jindal SK, Khunnu B, Ghosh K. Perinatal outcome in pregnancies complicated by pulmonary tuberculosis. Int J Gynecol Obstet 1994;44(2):119–24. [3] Ali AA, Adam I. Lack of antenatal care, education, and high maternal mortality in Kassala hospital, eastern Sudan during 2005–2009. J Matern Fetal Neonatal Med 2011;24(8):1077–8. [4] Maddineni M, Panda M. Pulmonary tuberculosis in a young pregnant female: challenges in diagnosis and management. Infect Dis Obstet Gynecol 2008;2008: 628985.

Primiparity at Very Advanced Maternal Age (≥45 years)

This study describes maternal and birth outcomes of primiparae aged ≥ 45. High rates of pregnancy complications and poor birth outcomes were found, stressing that the personal risks and ramifications to the health system should be taken into account in establishing obstetric health policy regarding primiparity at advanced maternal age.

Acupressure may relieve pain, delivery time and oxytocin use during labour

Kashanian M, Shahali S. Effects of acupressure at the Sanyinjiao point (SP6) on the process of active phase of labor in nulliparas women. J Matern Fetal Neonatal Med 2010; 23: 638–1.

First-Trimester Prediction of Early Preeclampsia

Preeclampsia, which presents after midgestation, is the most common pregnancy complication associated with serious maternal-fetal morbidity and mortality; and at present the only effective treatment is delivery of the placenta. The ability to predict in very early pregnancy those women at risk for preeclampsia might decrease maternal and fetal morbidity through closer surveillance by physicians experienced or specialized in high-risk obstetrics, as well as delivery at tertiary care centers. Reliable prediction would also permit institution of preventive or treatment regimens, unavailable in 2009, although exciting possibilities are under scrutiny.1 Investigators have been evaluating tests to predict preeclampsia for >50 years without much success.2,3 These have included tests relating to placental perfusion and vascular resistance (eg, the “rollover” and cold pressor tests, as well as uterine artery Doppler evaluation); placental products (eg, proangiogenic and antiangiogenic proteins, human chorionic gonadotropin, placental protein 13, and inhibin A); renal dysfunction (eg, fractional urate clearance and microalbuminuria); and endothelial dysfunction (eg, fibronectin, P- and L-selectin, and vascular cell adhesion molecule 1). The list is enormous, and recently investigators have begun exploring the fields of proteomics and metabolomics for tests to predict preeclampsia. A large systemic review published in 20042 and to be updated in 20093 concluded that no single …

Sonographic examination of the fetal central nervous system: guidelines for performing the ‘basic examination’ and the ‘fetal neurosonogram’

Sonographic examination of the fetal central nervous system: guidelines for performing the ‘basic examination’ and the ‘fetal neurosonogram’