Mean Birth Weight Of Newborns Research Articles

Application of uterine lower part breakwater-like suture operation in placenta previa

Objective: To explore the efficacy and safety of uterine lower posterior wall breakwater-like suture technique in controlling the intraoperative bleeding of placenta previa. Methods: From June 2016 to June 2017, 47 patients were diagnosed placenta previa in Union Hospital, Tongji Medical College of Huazhong University of Science and Technology. Posterior wall breakwater-like suture technique was used preferentially, as for cases with poor myometrium layer, lower anterior wall stitch suture was used at the same time. Bilateral descending branches of uterine artery ligation and Cook balloon compression of uterine lower segment was conducted when necessary. The clinic data of the 47 cases were analyzed. Results: Thirty cases (63.8, 30/47) were diagnosed placenta inccreta or percreta by ultrasound or MRI preoperatively. Senventeen cases were diagnosed as placenta accreta (36.2%, 17/47) . Thirty-four cases had the previous history of cesarean section. The average cervical canal length of 47 patients was (2.8±0.9) cm. There were 19 cases (40.4%,19/47) with 1 time posterior wall breakwater-like sutured and 16 cases (34.0%,16/47) with 2 or 3 times posterior wall breakwater-like sutured; 12 cases (25.5%,12/47) were treated with anterior wall stitch suture simultaneously.Ten cases (21.3%, 10/47) underwent uterine artery ligation, 17 cases (36.2%, 17/47) underwent COOK balloon compression on the staxis surface of lower segment. None of them had postpartum hemorrhage or performed internal iliac artery embolization. The median blood loss in the operation was 700 ml, the percentiles 25 was 500 ml, and the percentiles 75 was 1 200 ml. The blood loss ≥1 000 ml in 18 (38.3%, 18/47) patients,and the most serious one was 2 500 ml. The median blood transfusion volume (including allogenetic transfusion and autotransfusion) was 450 ml, the percentiles 25 was 228 ml, and the percentiles 75 was 675 ml. The average vaginal bleeding volume was (150±63) ml first day after operation. The mean hospitalization time was (4.7±1.0) days. The mean gestational weeks of pregnancy termination was (36.1±1.5) weeks, and the mean birth weight of newborns was (2 817±492) g. Apgar score:1-minute 7.8±1.1, 5-minute 8.9±0.8. No neonatal death, 16 cases were transferred to neonatal ICU (34.0%, 16/47) mainly for premature delivery and low birth weight. No complication was found in 6 months post-operation. Conclusions: Uterine posterior wall breakwater-like suture technique is a simple, safe and effective way in controlling intraoperative bleeding of placental previa.Lower anterior wall stitch suture could effectively stop bleeding and restore the normal uterine shape. Combined application of various methods could significantly reduce the incidence of postpartum hemorrhage and hysterectomy, and improve maternal and fetal prognosis.

A comparison of maternal and perinatal outcome between in vitro fertilization and spontaneous dichorionic-diamniotic twin pregnancies

Objective: To compare the maternal and neonatal outcome of dichorionic diamniotic in vitro fertilization (IVF) twin and spontaneous twin pregnancies.Material and methods: Maternal and fetal data of all consecutive dichorionic-diamniotic twin pregnancies delivered in our institution between January 2009 and May 2015 were abstracted from medical records and pregnancy outcome of IVF twin was compared to spontaneous twin.Results: Overall 708 twin pregnancies (449 IVF and 259 spontaneous) were included. Women in the IVF group were 2 years older and more frequently nulliparous. The rate of pregnancy induced hypertension and preeclampsia (PIH/PET) was three times higher in the IVF group than in the spontaneous group. The rate of preterm births, before 37 weeks of gestation and the rate of cesarean section were higher in the IVF group. These results were confirmed by multivariate analysis. The neonatal outcome was similar in both the groups except for a lower mean newborn birthweight in the IVF group.Conclusion: Women with IVF twins are at a significantly higher risk of having preterm births, PIH/PET and cesarean section but there was no significant adverse effect on neonatal outcome except for a lower mean newborn birth weight.

Obésité et primiparité : accouchement à risque ?

To evaluate the risk of materno-foetal complications in obese primiparous women (Body Mass Index (BMI)≥30) MATERIALS AND METHODS: A retrospective study was conducted in our tertiary referral labour ward from 1st January 2009 to 31st December 2010, including primiparous women delivering living cephalic singleton pregnancies after 37 weeks of amenorrhea. Two groups were compared: obese patients (BMI≥30) and non-obese (BMI<30). Obstetrical and neonatal data were collected. Among 1636 primiparous women, 132 (8%) had a BMI≥30. Induction of labor, prolonged pregnancy and post-partum hemorrhage were significatively more frequent in obese group (P<0.001). Those patients have an increased risk of cesarean section (P<0.001). Mean birth weight of newborns from obese mothers is significatively higher (3493g vs 3265g, P<0.001), as is the frequency of macrosomia (16.7% vs 5.2%, P<0.001). Obesity is associated with obstetrical complications in primiparous obese women, who are to be considered risky patients at their arrival in the labour ward, and specific obstetrical management must be planned to improve maternal and neonatal outcomes.

Gestantes vivendo com HIV/AIDS: características antropométricas e peso ao nascer dos seus recém-nascidos

To describe the anthropometric and pregnancy characteristics of women with HIV/AIDS, assisted by the Brazilian National Health System and the birth weight of their newborns. The participants were women assisted at public STD/AIDS clinics of the Municipal Health system of São Paulo. The anthropometric characteristics were evaluated by trained nutritionists and other information was obtained from the medical records. For comparison of the survey data to those of the general population, secondary maternal and pregnancy data were obtained from live birth certificates through the Live Birth Information System. Continuous variables were summarized as mean and standard deviation or as the 25th, 50th and 75th percentiles and minimum and maximum values. The other variables are presented as percentages. Means were compared by the Student's t-test or Kruskal-Wallis test depending on the fulfillment of assumptions, with the decision based on the p value. We found the presence of inadequate maternal nutrition according to triceps skinfold (60.9%). The BMI/gestational age showed the presence of underweight (18.5%) and overweight or obesity (40%). There was no association between disease status (HIV or AIDS) and weight, height, and lean or fat mass. Mean newborn birth weight was lower than the value for the general population without infection or disease. The results of this study indicate the need to develop adapted curves to allow a more accurate nutritional assessment of this population group.

Factors associated with low birth weight among newborns in an urban slum community in Bhopal

A community based cohort study on birth weight of newborns was conducted among pregnant women of an urban slum in Bhupal, India. The study was carried out to assess the magnitude of low birth weight (LBW) and factors contributing it in an urban slum community. Socio-demographic and maternal characteristics were examined applying statistical techniques to find out the variables associated with the LBW. An additional schedule was used to collect information from mothers about their socio-demographic background, dietary intake and the rest during the pregnancy. Weight of newborns of mothers registered in the study and delivering at the district hospital was recorded. Mean birth weight of newborns of 290 registered mothers was 2.57 ± 0.36 g. One hundred and five newborns (36.2%) had a birth weight lesser than 2500 g. Among different variables studied, statistically significant association was found in case of occupation, daily calorie intake and duration of day-time rest taken by pregnant women.

Factors Affecting Birth Weight of a Newborn – A Community Based Study in Rural Karnataka, India

BackgroundLow birth weight (LBW) is a major public health problem in many developing countries, especially so in India. Although we do not know all the causes of LBW, maternal and environmental factors appear to be significant risk factors in its occurrence.ObjectivesTo know the factors affecting the birth weight of a newborn and to estimate the prevalence of LBW.MethodsThe present study was carried out amongst 1138 pregnant women and their newborns residing in area covered by Kinaye Primary Health Centre in rural Karnataka, India. The study was conducted from 1st June 2008 to 31st December 2009.ResultsThe mean birth weight of newborns was 2.6 kg with a range of 1.2 to 3.8 kg. The prevalence of LBW was 22.9%. Among the studied risk factors, 25 of them were significantly associated with the birth weight of a newborn on univariate logistic regression analysis. Maternal education [Odds Ratio (OR) 3.2], exposure to passive smoking [OR 2.3], age at first pregnancy ≥25 years [OR 3.6], birth interval <2 years [OR 2.4], previous history of LBW baby [OR 3.3], weight gain ≤4 kg during pregnancy [OR 7.0], maternal weight at last week of gestation ≤45 kg [OR 2.3], pregnancy induced hypertension [OR 3.3], high risk pregnancy [OR 3.6] and late antenatal registration [OR 3.6] emerged as significant risk factors on multivariate analysis.ConclusionThe problem of LBW is multidimensional, and hence, we need an integrated approach incorporating medical, social, economical and educational measures to address this issue.

Can Community-Based, Low-Cost Antenatal Care in the Third Trimester of Pregnancy Reduce the Incidence of Low Birth Weight Newborns?

To determine if community-based, low-cost interventions during third trimester of pregnancy can reduce the incidence of low birth weight babies. In a case control study, 290 pregnant women from a slum area were registered in the beginning of third trimester of pregnancy and provided full antenatal care comprising fortnightly check up, one IFA tablet daily, counseling for minimum one-and-a-half hour post-lunch rest in left lateral position, additional diet to ensure minimum 2,200kcal per day, and management of clinical conditions, if any. An equal number of pregnant women belonging to the same slum area were registered as control who received routine antenatal services from the existing health care facilities. The birth weight of the babies in the two groups were recorded and compared. Test of significance and correlation coefficient were applied to the data. Mean birth weight of the babies of the Subjects was 2.76kg (SD 0.39) compared to mean birth weight of 2.57kg (SD 0.36) of the babies in the Control group. Incidence of low birth weight babies among subjects who consumed minimum 2,400kcal per day, had one-and-a-half hour post-lunch rest in left lateral position and who consumed one tablet of IFA (100mg iron and 5mg folic acid) per day during the last trimester of pregnancy was lower (17.6%) as compared with women in the Control group (36.2%). The difference in the mean birth weight of newborns of the two groups was statistically significant (t=2.52, p<0.01). Incidence of low birth weight babies can be significantly reduced by providing simple, low-cost care to pregnant women during the last trimester of pregnancy in the community setting.

A Comparative Study of Breastfeeding During Pregnancy

Despite widespread cultural vilification, lactation-pregnancy overlap remains common. Its actual adverse effects remain uncertain. This study compared rates of success in reaching full-term delivery and newborn birth weights between two groups of multiparous pregnant women: those who breast-fed during pregnancy and those who did not. This was a comparative study conducted over 9 months, which examined two groups of women in the maternity units of two hospitals in Birjand, Iran. The first group comprised 80 women who breast-fed for 30 days or more during pregnancy; the second group comprised 240 women who did not. The two groups had similar distributions in terms of maternal age, parity, medical/midwifery problems, and nutritional changes during pregnancy. Two trained nurses used a self-developed questionnaire to collect data. Results found no significant difference in full-term or non-full-term births rates and mean newborn birth weight between the two groups. We further found no significant difference between full-term or non-full-term births and mean newborn birth weight for those who continued and discontinued breastfeeding during pregnancy in the overlap group. Results suggest that breastfeeding during normal pregnancy does not increase chance of untoward maternal and newborn outcomes. Nurses and midwives should give expectant mothers appropriate evidence-based guidance and focus attention on promoting proper nutritional intake based on lactation status during pregnancy.

Parenthood and immunomodulation in patients with multiple sclerosis

Little is known about the influence of immunomodulation on parenthood, in particular paternity in multiple sclerosis (MS). The objective was to determine whether there is an increased risk for pregnancies initiated by MS-parents under disease modifying therapies (DMT). We investigated the clinical outcome of pregnancies fathered by MS-patients under DMT by nationwide questionnaire and within our own outpatient clinic. Additionally, we compared the birth weight of children from MS-fathers exposed to DMT, MS-mothers without DMT, MS-mothers under interferon-beta (IFN beta) at the time of conception and healthy controls (HCs). DMT was reported for 32 paternities of 46 children; 30 under IFN beta, 12 under glatiramer acetate, 2 under natalizumab, 1 under methotrexate and 1 under combined azathioprine- and IFN beta-1b-treatment. Six (13%) pregnancies ended in early spontaneous abortions; of the 40 children of MS-fathers under DMT, 2 (5%) were preterm, 1 (2.5%) had a spinal lipoma and 3 (7.5%) had moderate hip dysplasia, of whom 2 were siblings whose mother had severe hip dysplasia. Mean birth weight of newborns from MS-fathers under DMT was not significantly reduced compared to HCs. Comparing birth weight of newborns of MS-mothers versus MS-fathers, we found a significant difference to the disadvantage of MS-mothers with or without IFN beta-treatment. No statistical difference in birth weight of IFN beta-exposed versus untreated MS-mothers was observed. Despite the small numbers, our available data suggest safe paternity by MS-patients. IFN beta-treatment of mothers does not seem to have an impact on birth weight, however, MS may contribute to a reduced birth weight.

Relationship between parental knowledge of fetal gender and newborns' birthweight among Jordanian families

The purpose of this study was to examine the relationship between women knowing the fetal gender and their newborns' birthweight. Four-hundred and eighty-four post-partum mothers before discharge from the maternity unit participated in this study. We collected our data from the women by using two sources: a demographic data questionnaire and reviews of hospital records. For this study, we considered normal birthweight as > 2500 and < 4000 g and low birthweight as < 2500 g. The findings of the study suggested that knowledge of fetal gender was significantly related to the mean birthweight of newborns. When the gender was known prenatally, the mean birthweight of male newborns was significantly higher than that of female newborns. Also knowledge of fetal gender was found to increase the probability of low birthweight among female newborns compared with male newborns. Identifying sociocultural factors that might be linked to the gender preference could improve mothers' and their newborns' well-beings. Nurses have to be aware of the consequences of gender preference such as low birthweight.

Birth Weight among Singletons Born to Foreign-Born Mothers in Taiwan: A Population-Based Birth Register Study

BackgroundWe compared the birth weight of newborns born to foreign-born mothers (FBMs) and Taiwan-born mothers (TBMs), using data from the 2005–2006 Taiwan Birth Registry of singleton live births.MethodsThe Wilcox–Russell method, data restriction, and multiple linear regression were used to analyze the data. The rates of low birth weight (<2500 g) with 95% confidence intervals were computed for TBMs, and for each of the nationalities of FBMs.ResultsThe mean birth weight of newborns of FBMs was 3157 g, which was higher than that of newborns of TBMs (3109 g). On analysis using the Wilcox–Russell method, both the rate and residual proportion of low-birth-weight (LBW) births were lower among newborns of FBMs (4.1% and 1.1%, respectively) than among newborns of TBMs (5.9% and 1.7%, respectively). After adjusting for sex, mode of delivery, maternal age, smoking status, predisposing maternal risk factors, and condition during pregnancy, the newborns of FBMs weighed 72.9 g (95% CI, 68.8 g to 77.0 g) more than the newborns of TBMs. When data were restricted to mothers without any adverse conditions and adjusted for maternal age, the differences in birth weight between the 2 groups remained unchanged. The rates of LBW deliveries among FBMs in Taiwan were significantly lower than those in their respective countries of origin.ConclusionsIn Taiwan, newborns of FBMs had a higher birth weight than those of TBMs, even after accounting for potential confounding factors, and had lower rates of LBW deliveries than did mothers in their respective countries of origin.

Frequency of hepatitis C in pregnancy and pregnancy outcome.

To determine the frequency of HCV infections in pregnant women, to find out the risk factors for HCV infection in pregnant women and to compare pregnancy outcome of the sero-positive women with sero-negative women. Case-control study. Shifa International Hospital, Islamabad, from June 2001 to May 2002. Study was conducted on 947 booked pregnant women who were screened for HCV antibodies during antenatal consultation and were admitted for delivery in labour room. At the time of admission in labour ward, medical records of all patients were reviewed for anti HCV antibody testing and the presence of risk factors for HCV infection. Previous vaginal deliveries with episiotomy, previous surgeries, blood transfusions, and D&C for abortion or dysfunctional uterine bleeding were taken as independent variables. The obstetric outcome variables studied were: completed weeks of gestation by mother, birth weight and apgar score of newborns. The risk factors under study and the outcome variables were compared among HCV positive and negative women through a case-control study and measures of association calculated. The proportion of HCV sero-positivity among pregnant woman in our study was 3.27%. Among all the risk factors under study, previous surgery was found to have a significant association with HCV positive status of women (p=0.001). Other variables did not have significant association with HCV positive status in our study. There was no statistical difference in the mean birth weight of newborns (p= 0.94), mean Apgar score of newborns (p= 0.73) and mean gestational period among HCV positive cases and controls (p= 0.47). Prevalence of hepatitis C in pregnant women was 3.27%. Past history of surgical procedures was the most important factor for transmission of hepatitis C virus infection. No adverse effect on pregnancy outcome was observed in terms of gestational age, Apgar score and baby weight when compared with the controls.

Gestational and Neonatal Characteristics of Children with Cystic Fibrosis: A Cohort Study

To examine whether the birth weight (BW) and the risks of being pre-term, low birth weight (LBW), and small for gestational age (SGA) of children with cystic fibrosis (CF) are different from nonaffected children. Retrospective cohort study. We examined all the children with CF born in Tuscany, Italy, from 1991 to 2002 (n = 70) comparing them to the entire population of non-CF-affected children born in the same period (n = 290,059). The mean BW of newborns with CF was 246.2 g lower than the mean BW of the non-CF neonatal population (P = .0003). Children with CF had a higher risk of being born pre-term (RR 2.62, P = .001), LBW (RR 2.66, P = .0009), and SGA (RR = 1.74, P = .04) than the non-CF-affected children. The mean BW of term newborns with CF was 205.7 g lower than that of term non-CF-affected babies (P = .0002). Our data show an association between CF and reduced BW and show a greater risk of being pre-term for babies with CF.

Fetal Growth Assessment and Neonatal Birth Weight in Fetuses With an Isolated Single Umbilical Artery

To evaluate interval fetal growth and compare the incidence of small-for-gestational age (SGA) newborns between fetuses with an isolated single umbilical artery and those with a 3-vessel umbilical cord. A retrospective, case-controlled study in which 84 singleton pregnancies with an isolated single umbilical artery were compared with 3-vessel umbilical cord fetuses as the control group. There was no statistical difference between the groups in maternal demographic data, except for ethnicity and neonatal outcomes, respectively. The mean newborn birth weight was similar between the isolated single umbilical artery and the control groups, 3,268 +/- 596 g and 3,274 +/- 627 g, respectively. The prevalence of SGA newborns was 7.1% (6 of 84) in the isolated single umbilical artery group and 4.8% (4 of 84) in the control group. An ultrasound examination demonstrated fetal growth restriction in 50% of cases (3 of 6) in the isolated single umbilical artery group and in 25% of subjects (1 of 4) in the control group, respectively. Fetuses with an isolated single umbilical artery are at similar risk for SGA compared with fetuses with 3-vessel umbilical cords. It appears that antepartum serial ultrasound examination does not provide more information for interval fetal growth assessment in fetuses with an isolated single umbilical artery.

Pregnancy during hemodialysis: perinatal outcome in our cases

The perinatal outcome of patients undergoing chronic hemodialysis has been improved in recent years. In this report we review the treatment and outcome of seven pregnancies in women undergoing chronic hemodialysis before and during pregnancy between 2000 and 2002. The hemodialysis schedule was increased from 4 hours twice weekly to 4 hours four to six times weekly. Hemodialysis was performed using a high-flux dialyzer with volume-controlled ultrafiltration. The patients were followed in close collaboration between the obstetrician and the nephrologist. Monitoring of fetal well-being was started after 24 weeks' gestation, using cardiotocography by a nonstress test twice weekly and by weekly Doppler flow measurements. All patients underwent uterine contraction monitoring immediately after the dialysis. The mean gestational age at delivery was 32 weeks (range, 26 to 36 weeks). The causes of preterm delivery were premature contractions, premature rupture of membranes, preeclampsia, and intrauterine growth restriction. The outcomes were two pregnancies complicated by polyhydramnios and six pregnancies, that resulted in live births, all of whom survived. There was one neonatal death. The mean newborn birthweight was 1400 g (range, 420 to 2640 g) and the 1- and 5-minute Apgar scores ranged from 2/8 and 4/10, respectively one infant at 29-weeks gestation experienced respiratory distress syndrome but did well after 12 days. Cesarean section was performed in four pregnancies. The mothers were discharged on postoperative days 3 to 5. It is well known that the management of pregnant patients undergoing chronic hemodialysis is difficult. However, advances in dialysis, obstetrics, and neonatal care have improved the outcomes.

Alterations in height, weight, and body mass index of newborns, children, and young adults in eastern Germany after German reunification

Objective To examine the effects of the socioeconomic changes occurring during the German reunification on anthropometric data of newborns, children, and young adults. Study design Data were drawn from different perinatal surveys and cross-sectional studies that were conducted in the newly formed German states before and after reunification (1984-2000). Results The mean birth weight of newborns increased 151 g between 1984 and 1985 (n = 51,447) and 1997 (n = 83,052), whereas length increased by 0.2 cm. Among 7- to 10-year-old school children in the federal state of Saxonia between 1984 and 1985 (n = 2359) and 1999 and 2000 (n = 11,575), an increase of height by 1 to 2 cm and weight by 1.2 to 2.6 kg was observed. Average body mass index (BMI) increased by 0.7 to 0.9 kg/m2. Among military recruits from Eastern Germany, an increase in weight and height was observed between 1985 and 1998. BMI values rose from 21.5 to 22.6 kg/m2, and “centimeter weight” increased from 381 to 405 g/cm. Conclusion The results show that the change in socioeconomic conditions was associated with alteration in anthropometric measures within a short period. This may have been caused by changes in the nutrient supply and composition as well as reduced physical activity. (J Pediatr 2003;142:259-62)

Letting the “Gini” out of the bottle: Social causation and the obesity epidemic

Letting the “Gini” out of the bottle: Social causation and the obesity epidemic

Factors related to perceived labor pain in primiparas.

The purpose of this study was to investigate the association between demographic-obstetric factors and perceived labor pain in primiparas. The participants in this study were 90 primiparas having normal childbirths at the Department of Obstetrics, Chi-Mei Medical Center in southern Taiwan between September 1999 and June 2000. The perceived intensity of labor pain was measured using the visual analogue scale for pain and the present behavioral intensity score in the latent phase (cervix dilated 3-4 cm), active phase (cervix dilated 5-7 cm), and transitional phase (cervix dilated 8-10 cm). The subjects' mean age was 27.82 +/- 3.64 years (range, 20-39 yr), and the mean newborn birth weight was 3,162 +/- 387 g (range, 2,340-4,120 g). The primiparas' perceived labor pain at each of the three phases of labor was positively related to expected labor pain, but had no significant association with newborn birth weight, maternal age, body mass index, confidence in labor, or duration of labor. The expected labor pain of the primiparas had a negative correlation with body mass index. The birth weight of the newborn was positively related to the duration of labor. These findings suggest that primiparas' perceived labor pain is correlated with psychogenic rather than physical factors.

Pregnancy outcome in renal transplant recipients

Objective: To correlate pregnancy outcome with complications in pregnancy and transplantation-to-pregnancy interval in renal transplant recipients in Croatia. Method: Data on 23 pregnancies after prepregnancy stabilization of blood pressure and normalization of graft function were retrospectively analyzed. Result: The mean interval between transplantation and conception was 3.1 years. Primary renal disease was chronic glomerulonephritis in 7, chronic pyelonephritis in 7 and agenesis of right kidney and stenosis of left renal artery in 1 patient. There were 10 term and 5 preterm deliveries, 6 induced and 2 spontaneous abortions. The mean gestational age was 38.1 weeks and the mean newborn birthweight was 3015 g. The prematurity rate was 21.7%. Patients with arterial hypertension in pregnancy, elevated serum creatinine level and bacteriuria, as well as those with conception occurring less than 2 years after transplantation, had a higher rate of therapeutic and spontaneous abortions, preterm deliveries and low birth weight infants. Conclusion: The interval between transplantation and conception, as well as allograft function during pregnancy, seem to be of great importance for successful obstetric outcome in renal transplant patients.

Pruritic Urticarial Papules and Plaques of Pregnancy and Its Relationship to Maternal-Fetal Weight Gain and Twin Pregnancy

Thirty women who were seen at our institution between 1984 and 1988 for pruritic urticarial papules and plaques of pregnancy (PUPPP) were retrospectively evaluated and interviewed. We found a significantly increased maternal weight gain and newborn birth weight in patients with PUPPP, compared with age and parity-matched controls. The average weight gain during pregnancy was 18.1 +/- 0.9 (SEM) kg for the patients with PUPPP (excluding twin gestations) and 14.6 +/- 1.0 kg for the controls. The mean newborn birth weight was 3.6 +/- 0.09 kg for the PUPPP group and 3.3 +/- 0.08 kg for the control group. There were three twin pregnancies (10%), compared with the twin gestation rate at our institution of 1.6%. Therefore, based on our findings of an increased maternal weight gain and neonatal birth weight, an increased twin rate, and an abdominal eruption that occurs in primigravidas in their third trimester of pregnancy, we suggest that abdominal distention or a reaction to it may play a role in the development of PUPPP.