Newborns Of Women Research Articles

Особливості перебігу пологів та стан новонароджених у жінок із безплідністю ендокринного і запального ґенезу в анамнезі залежно від способу запліднення (дані архівів: ДУ «Інститут педіатрії, акушерства і гінекології імені академіка О.М. Лук'янової НАМН України» та репродуктивної клініки «Надія»)

Особливості перебігу пологів та стан новонароджених у жінок із безплідністю ендокринного і запального ґенезу в анамнезі залежно від способу запліднення (дані архівів: ДУ «Інститут педіатрії, акушерства і гінекології імені академіка О.М. Лук'янової НАМН України» та репродуктивної клініки «Надія»)

Gestational weight gain and newborn anthropometric outcomes in rural Bangladesh.

Low gestational weight gain (GWG) is a known predictor of fetal growth restriction in higher income countries, but there is little information on this association in lower income countries. Our objective is to describe the association between GWG and birth outcomes among pregnant women in rural Bangladesh. Pregnant women were identified in a community-based programme and enrolled into the study at an average of 13weeks' gestation (n=4,011). Maternal weight and height were measured at enrolment, maternal weight was measured at 36weeks' gestation, and newborns were measured after birth. Rate of GWG (g/weeks) was calculated, and women were categorized as having adequate or inadequate GWG (Institute of Medicine recommendations). Newborn anthropometric outcomes included weight-for-age z score (WAZ), length-for-age z score (LAZ), head-circumference-for-age z score (HCZ), body mass index (BMI)-for-age z score (BMIZ), low birthweight (LBW<2,500g), WAZ<-2, LAZ<-2, HCZ<-2, BMIZ<-2, and small for gestational age (SGA: <10th percentile). Multivariate models were adjusted for confounders. Only 26% of the 2,562 women in these analyses had adequate GWG. Compared with newborns of women with inadequate GWG, infants of women with adequate GWG had a lower risk of adverse anthropometric outcomes (relative risk [95% confidence interval]: LBW=0.68 [0.59, 0.80], LAZ<-2=0.64 [0.51, 0.80], HCZ<-2=0.75 [0.60, 0.93], BMIZ<-2=0.70 [0.59, 0.83], and SGA=0.80 [0.73, 0.86]), but there was no significant difference in mean (SE) duration of gestation, 39.7 (0.08) versus 39.7 (0.05)weeks. In this population, GWG rate is a strong predictor of newborn anthropometric outcomes, but not duration of gestation.

Особливості перебігу пологів та стану новонароджених у вагітних із пролонгованою та переношеною вагітністю (дані ретроспективного аналізу)

Особливості перебігу пологів та стану новонароджених у вагітних із пролонгованою та переношеною вагітністю (дані ретроспективного аналізу)

Ophthalmologic findings in newborns of women with Zika virus infection during pregnancy: A case series

Ophthalmologic findings in newborns of women with Zika virus infection during pregnancy: A case series

Maternal and cord blood prolactin level and pregnancy complications.

Objectives:To explore the correlation between maternal and cord blood prolactin, the correlation between cord prolactin and birth weight, and to compare cord blood prolactin in new-borns of women with normal pregnancy and women with pregnancy complications namely; gestational hypertension, gestational diabetes and preterm labour.Methods:This study was performed from September to December 2018. Thirty-two women, delivered at Baghdad teaching hospital, and their newborns (32) were included. Maternal blood (5 ml) was taken before labour and cord blood (5 ml) was collected after placenta expulsion. Maternal and cord blood prolactin were analysed using fluorescence immunoassay.Results:Cord blood prolactin was higher in babies born to hypertensive women (405.28±77.52 ng/ml) than normal pregnancy women (244.80±60.80 ng/ml), P=0.000. Also, cord prolactin in gestational hypertension group was significantly higher than diabetic (P=0.006) and preterm labour (P=0.000) groups. No significant difference was noticed in cord blood prolactin in newborns of diabetic and normal pregnancy women (299.28±37.01, 244.80±60.80 ng/ml respectively, P=0.053). Preterm babies had lower cord prolactin (204.57±22.90 ng/ml) than normal pregnancy babies (244.80±60.80 ng/ml), however the difference was non-significant, P=0.118. Positive correlation was found between cord and maternal prolactin (P=0.000) and between cord prolactin and birth weight (P=0.018).Conclusion:Cord blood prolactin is high in newborns of hypertensive women, low in preterm neonates. Diabetes has no effect on cord prolactin level.

Advanced maternal age and factors associated with neonatal near miss in nulliparous and multiparous women

The early neonatal period accounts for approximately half of the deaths of young children under one year of age, and the neonatal near miss can recognize factors causing this high number of deaths. Thus, the aim of this study is to determine whether advanced maternal age increases the chance of neonatal near miss, in addition is to identify which factors are associated with the neonatal near miss, stratified by parity. Data are from the 2011-2012 Birth in Brazil study, which used a national population-based sample of 15,092 newborns of women between 20-29 and 35 years of age or more (advanced maternal age). Multiple logistic regression was performed to test the association between neonatal near miss and prenatal and childbirth variables, pre-gestational diseases, obstetric history and socioeconomic characteristics, stratified by parity. Advanced maternal age was to be statistically associated with neonatal near miss in nulliparous (OR = 1.62; 95%CI: 1.05-2.50) and multiparous (OR = 1.51; 95%CI: 1.20-1.91) when compared to women 20-29 years of age. For nulliparous women, the main variables statistically associated with neonatal near miss were multiple gestation (OR = 8.91) and hypertensive disease (OR = 2.57), whereas forceps-assisted vaginal delivery (OR = 7.19) and multiple gestation (OR = 4.47) were the variables associated for multiparous women. Neonatal near miss has been shown to be connected with access to health services for childbirth, gestational complications and maternal characteristics, mainly advanced maternal age. Therefore, to properly monitor and classify maternal gestational risk, to control gestational complications during prenatal care, and to correctly refer these women to childbirth care should be priority strategies for healthcare services.

Особливості перебігу пологів у жінок з перинатальними втратами в анамнезі

The objective: was to determine the features of the course of labor in women with a history of perinatal lesions. Materials and methods. A prospective, concurrent, controlled, randomized study was conducted involving 68 women aged 26.8 ±0.5 years, with a gestation period of 28.1 ±0.56 weeks, 41 of whom had perinatal history lesions (main group) and comparable for anthropodemographic indicators and terms of gestation of 27 women with a repeat pregnancy without abortion or unsuccessful childbirth (child death) in the history (comparison group). Results. In the anamnestic aspect, the characteristics of pregnant women with a history of perinatal losses are a relatively shorter interval between repeated pregnancies, a more frequent development of extragenital pathology - the respiratory, nervous, endocrine, cardiovascular and orthopedic disorders, and a higher incidence of gynecological anamnesis. In the context of complications of delivery, women with perinatal losses are characterized by premature birth, anomalies of labor, early discharge of amniotic fluid, ruptures of soft tissues. Conclusion. It is necessary to make a comparative analysis of the course of pregnancy, childbirth and the state of health of newborns in women with a history of obstetrical anamnesis in connection with violations of neurovegetative regulation. Key words: perinatal losses, anamnesis, childbirth, current.

Birthweight and large for gestational age trends in non-diabetic women with three consecutive term deliveries.

Increased birthweight is a risk factor for early neonatal complications, as well as cardiovascular and metabolic disease later in adulthood. We aimed to assess birthweight trends and the rate of large for gestational age newborns in women in their third delivery according to birthweight in the first and second deliveries. A retrospective cohort study of all women who delivered their first three consecutive deliveries in a single medical center (1994-2013). Only non-diabetic women with term (≥ 37weeks) singleton deliveries in all three deliveries were included. BW centile (according to local gender- and gestational age-specific birth curves) trends between deliveries was assessed. In addition, the risk for large for gestational age (≥ 90th centile) infants in the third delivery was assessed according to the presence or absence of large for gestational age in previous deliveries. Pregnancies complicated by multiple gestations, preeclampsia, chronic or gestational hypertension or fetal anomalies were excluded. Of the 121,728 deliveries during the study period, 3521 women (10,563 deliveries [8.6%]) met inclusion criteria. Mean birthweight centile in the first, second and third deliveries were 47.2 ± 26.3, 58.3 ± 25.8 and 61.5 ± 24.7, respectively (p < 0.001). While 45.9% women had their maximal birthweight centile in the third delivery, only 16.5% had it in the first delivery (p < 0.001). In multivariate analysis, adjusted for maternal age, gestational age at delivery and neonatal gender, the rate of large for gestational age infants in the third delivery was increased as the number of previous large for gestational age deliveries increased in a dose-dependent pattern (aOR = 4.37, CI 2.89-6.61 for women with large for gestational age infant only in the first delivery, aOR = 5.31, CI 4.15-6.79 for women with large for gestational age infants only in the second delivery, aOR = 10.62, CI 6.89-16.38 for women with large for gestational infants age in the first and second deliveries; women with no large for gestational age infants in both the first and second delivery served as reference group). In women with repeated term deliveries, birthweight centile is frequently increased in the third delivery compared to the previous two deliveries. Moreover, the number and order of previous large for gestational age deliveries in the first two deliveries are major risk factors for large for gestational age in the third delivery.

The Impact of Prepregnancy Body Mass Index and Gestational Weight Gain on Perinatal Outcomes for Women With Gestational Diabetes Mellitus.

Gestational diabetes mellitus (GDM), an obstetric disease that affects the health of pregnant women, is one of the key factors associated with perinatal mortality or disease. To explore the impact of prepregnancy body mass index (BMI) and gestational weight gain (GWG) on perinatal outcomes for women with GDM. With a retrospective study design, women were recruited who received prenatal checkups, gave birth at two teaching hospitals in southern Taiwan from 1995 to 2011, and received a diagnosis of GDM by an obstetrician. A trained research assistant collected the participants' data in each hospital's archives room. The researcher used a retrospective casestudy method to identify women who received a GDM diagnosis between 1995 and 2011. Women with GDM and with an overweight prepregnancy BMI were more likely to have cesarean deliveries and to use glucose-lowering medicines after delivery. Their newborns also had a higher birth weight. In addition, gestational hypertension and cesarean delivery were more common in women with GDM and with excessive GWG than in women with GDM and with normal GWG. The newborns of women with GDM and with excessive GWG had higher birth weights and more nuchal cord than those of women with GDM and with normal GWG. More women with GDM and with excessive GWG underwent blood glucose monitoring than did women with GDM and with normal GWG. The prepregnancy weight and GWG significantly affected perinatal outcomes in both the women with GDM themselves and their newborns. Healthcare professionals must provide childbearing women with additional health education in the areas of health promotion, nutrition, weight control, exercise, and maintaining regular everyday lives.

Effect of Glyburide vs Subcutaneous Insulin on Perinatal Complications Among Women With Gestational Diabetes

Randomized trials have not focused on neonatal complications of glyburide for women with gestational diabetes. To compare oral glyburide vs subcutaneous insulin in prevention of perinatal complications in newborns of women with gestational diabetes. The Insulin Daonil trial (INDAO), a multicenter noninferiority randomized trial conducted between May 2012 and November 2016 (end of participant follow-up) in 13 tertiary care university hospitals in France including 914 women with singleton pregnancies and gestational diabetes diagnosed between 24 and 34 weeks of gestation. Women who required pharmacologic treatment after 10 days of dietary intervention were randomly assigned to receive glyburide (n=460) or insulin (n=454). The starting dosage for glyburide was 2.5 mg orally once per day and could be increased if necessary 4 days later by 2.5 mg and thereafter by 5 mg every 4 days in 2 morning and evening doses, up to a maximum of 20 mg/d. The starting dosage for insulin was 4 IU to 20 IU given subcutaneously 1 to 4 times per day as necessary and increased according to self-measured blood glucose concentrations. The primary outcome was a composite criterion including macrosomia, neonatal hypoglycemia, and hyperbilirubinemia. The noninferiority margin was set at 7% based on a 1-sided 97.5% confidence interval. Among the 914 patients who were randomized (mean age, 32.8 [SD, 5.2] years), 98% completed the trial. In a per-protocol analysis, 367 and 442 women and their neonates were analyzed in the glyburide and insulin groups, respectively. The frequency of the primary outcome was 27.6% in the glyburide group and 23.4% in the insulin group, a difference of 4.2% (1-sided 97.5% CI, -∞ to 10.5%; P=.19). This study of women with gestational diabetes failed to show that use of glyburide compared with subcutaneous insulin does not result in a greater frequency of perinatal complications. These findings do not justify the use of glyburide as a first-line treatment. clinicaltrials.gov Identifier: NCT01731431.

Особливості перебігу вагітності, пологів, стану плода й новонародженого у вагітних–переміщених осіб (Ретроспективний аналіз)

The less investigated problem of modern obstetrics is psychological condition of women during pregnancy and labors, who were affected by negative influence of nowadays, especially the military aggression, because precisely stress hormones determine the failure of adaptation, metabolic disorders and, as a result, an activation of infectious and chronic diseases, which determined the direction, the aim and the task of the work. The objective: to investigate peculiarities of course of pregnancy and labors, condition of a fetus and a newborn in pregnant women – displaced ones (IDP) in order to develop the improved methods of obstetric and perinatal complication prophylaxis in such women. Materials and methods. In order to achieve the object view, retrospective clinic and statistic analysis of 225 case histories of pregnancies and labors of IDP (the main group) and 51 pregnant women (control group), who continuously has been living in the territories controlled by Ukraine and did not stay in the military actions area during the process of investigation, were conducted. Pregnant women from the main and control groups were giving birth in the Delivery Departments of Central Cities Multyfield Hospitals of Belokurakino and Rubizhne of Luhansk Region in 2014–2017 years. Results. Pregnancy in IDP women is coursing under the maximal psycho emotional tension and stress, which promote complications development during gestation and labors. The risk factors which affects of the manifestation of pregnancy complications are: violations in psycho emotional condition of pregnant women, high infectious morbidity during puberty period, presents of chronic somatic pathology and high rate of inflammatory diseases of the female reproductive organs. Develop of placental-associated complications of pregnancy are typical in majority of IDP pregnant women: threatening of early and late spontaneous abortions, preterm labors, early gestosis, placental dysfunction and asiderotic anemia. Violations of labor act complications such as preterm and early rupture of amniotic membranes, weakness of labor activity and traumas of maternal ways, which lead to increase of specific gravity of complicated labors up to 20.3% and operative deliveries by the means of the Caesarian Section up to 23.6%, are most common for the main group of pregnant women. Newborns of the IDP women had an average weight less than 217 grams after delivery, in the asphyxia of different degrees one in eleven children was born. 34.8% of IDP women newborns had a pathological course of neonatal period which caused the further supervision on the 2nd level of neonatal care and was the reason of extra charges from the side of the parents. Conclusion. It is desirable to provide a full-fledged psychological support and routine treatment of chronic extragenital diseases at the periconceptional stage in IDP women. The preventive measures during pregnancy must foresee the violation of psychological condition correction and development of placental-associated complications. Key words: pregnancy, labors, complication, psychological violations, forced displaced people.

Barriers to Exclusive Breastfeeding Among Women With Gestational Diabetes Mellitus in the United States

ObjectiveTo identify differences in breastfeeding-related knowledge, attitudes, beliefs, and experiences between women with gestational diabetes mellitus (GDM) and women without GDM. DesignCross-sectional and prospective cohort study. SettingSecondary analysis of data from the U.S. Infant Feeding Practices Study II. ParticipantsPregnant women with GDM (n = 195) and pregnant women without GDM (n = 2,815) were included in cross-sectional analyses. For prospective analyses, complete data were available at the postpartum time point for 107 women with and 1,626 women without GDM. MethodsWe compared women with and without GDM for breastfeeding knowledge, attitudes, and beliefs during pregnancy and hospital experiences and problems with breastfeeding after birth. We used multivariate logistic regression to estimate associations between GDM and dependent variables. ResultsWomen with GDM were less likely to say that breastfeeding is the best way to feed an infant (adjusted odds ratio [aOR] = 0.62, 95% confidence interval [CI] [0.46, 0.85]), more likely to say that the fathers of their infants prefer formula feeding (aOR = 1.74, 95% CI [1.02, 2.97]) or mixed feeding (aOR = 1.78, 95% CI [1.21, 2.61]), and more likely to say their physicians prefer formula (aOR = 2.82, 95% CI [1.17, 6.79]). Women with GDM were less likely to report feeling comfortable breastfeeding in front of female friends (aOR = 0.70, 95% CI [0.50, 0.98]). Newborns of women with GDM were less likely to stay in their mothers’ hospital rooms (aOR = 0.55, 95% CI [0.36, 0.85]). ConclusionWe identified differences in breastfeeding-related knowledge, attitudes, beliefs, and experiences between women with GDM and women without GDM that could be targets for further research and intervention.

Tratamiento con inmunoglobulina G intravenosa (lgGiv). Inmunomodulación en fallas reproductivas

Abstract: Approved uses of intravenous IgG suspensions (IgGiv) are agammaglobulinemias, immune thrombocytopenia, rheumatoid arthritis, Guillán-Barré syndrome, myasthenia gravis, multiple sclerosis. IgGiv is proposed as an immunomodulatory agent in reproductive failures since it has been used to evaluate rates of newborns in women with repeated failures in implantation (RFI) and recurrent abortions (RAb). However, this indication is not specified in the package leaflet (“off-label use”). Between 2010 and 2015, anamnesis and complete reproductive history were performed on 2333 couples, evaluating several factors. Of 447 pregnancies, 143 patients received IgGiv UNC treatment. 79 consulted for RAb (55%) and 64 for RFI (45%). The diagnosis of Hashimoto’s thyroiditis was positive in 91 patients (64%). In 3 patients (2%) there were adverse reactions. Live newborns were 83, success rate 58%. This high rate and the absence of adverse reactions are evidences of effectiveness and safety of IgGiv

The impact of maternal epilepsy on perinatal outcome in singleton gestations

Objective: We sought to evaluate perinatal outcomes in women with epilepsy.Methods: We performed a retrospective cohort study between 2007 and 2014, at a tertiary, university-affiliated medical center. All women with singleton gestation who delivered during the study period were included, except for pregnancies in which fetuses with chromosomal or structural anomalies were diagnosed. Perinatal outcome was compared between two groups: women diagnosed with epilepsy and women without epilepsy.Results: Out of 62,102 deliveries during the study period, 61,455 met the inclusion criteria, of whom 206 (0.3%) had epilepsy. The only difference found in maternal demographics was higher rate of nulliparity in the epilepsy group (p = .02). As for maternal adverse outcome, higher rates of placental abruption and longer postpartum admission were found in women with epilepsy (p = .02 and p < .001, respectively). Comparing neonatal outcomes between the two groups, higher rates of neonatal intensive care unit admission (16.5 versus 9.2%), seizures (1.9 versus 0.4%), transient tachypnea of the newborn (2.4 versus 1.0%) and respiratory distress syndrome (1.9 versus 0.4%) were significantly higher to newborns of women with epilepsy (p < .05 for all). On multivariable logistic regression, epilepsy was found to be independently and significantly associated with placental abruption (OR 4.04, 95%CI 1.27–12.83, p = .02), neonatal intensive care unit (NICU) admissions (OR 1.84, 95%CI 1.25–2.70, p = .002), seizures (OR 4.33, 95%CI 1.60–11.77, p = .004), transient tachypnea of the newborn (OR 2.47, 95%CI 1.005–6.05, p = .049) and respiratory distress syndrome (OR 7.16, 95%CI 2.47–20.76, p < .001).Conclusions: Epilepsy in pregnant women is associated with adverse perinatal outcomes, including neonatal seizures, placental abruption and respiratory problems.

The Effects of Race and Ethnicity on the Risk of Large-for-Gestational-Age Newborns in Women Without Gestational Diabetes by Prepregnancy Body Mass Index Categories.

Objectives Children born large for gestational age (LGA) are at risk of numerous adverse outcomes. While the racial/ethnic disparity in LGA risk has been studied among women with Gestational Diabetes Mellitus (GDM), the independent effect of race on LGA risk by maternal prepregnancy BMI is still unclear among women without GDM. Therefore, the objective of this study was to assess the association between maternal race/ethnicity and LGA among women without GDM. Methods This was a population-based cohort study of 2,842,278 singleton births using 2012 U.S. Natality data. We conducted bivariate and multivariate logistic regression analyses to assess the association between race and LGA. Due to effect modification by maternal prepregnancy BMI, we stratified our analysis by four BMI subgroups. Results The prevalence of LGA was similar across the different racial/ethnic groups at about 9%, but non-Hispanic Asian Americans had slightly higher prevalence of 11%. After controlling for potential confounders, minority women had higher odds of birthing LGA babies compared to non-Hispanic white women. Non-Hispanic Asian Americans had the highest odds of LGA babies across all BMI categories: underweight (aOR = 2.67; 95% CI: 2.24, 3.05); normal weight (aOR = 2.53; 2.43, 2.62); overweight (aOR = 2.45; 2.32, 2.60) and obese (aOR = 2.05; 1.91, 2.20). Conclusions for practice Racial/ethnic disparities exist in LGA odds, particularly among women with underweight or normal prepregnancy BMI. Most minorities had higher LGA odds than non-Hispanic white women regardless of prepregnancy BMI category. These racial/ethnic disparities should inform public health policies and interventions to address this problem.

Increased fetal adiposity prior to diagnosis of gestational diabetes in South Asians: more evidence for the \u2018thin\u2013fat\u2019 baby

Aims/hypothesisGestational diabetes mellitus (GDM) is associated with an increased future risk of obesity in the offspring. Increased adiposity has been observed in the newborns of women with GDM. Our aim was to examine early fetal adiposity in women with GDM.MethodsObstetric and sonographic data was collated for 153 women with GDM and 178 controls from a single centre in Chennai, India. Fetal head circumference (HC), abdominal circumference (AC), femur length (FL) and biparietal diameter (BPD) were recorded at 11, 20 and 32 weeks. Anterior abdominal wall thickness (AAWT) as a marker of abdominal adiposity at 20 and 32 weeks was compared between groups. Adjustments were made for maternal age, BMI, parity, gestational weight gain, fetal sex and gestational age.ResultsFetuses of women with GDM had significantly higher AAWT at 20 weeks (β 0.26 [95% CI 0.15, 0.37] mm, p < 0.0001) despite lower measures of HC, FL, BPD and AC. AAWT remained higher in the fetuses of women with GDM at 32 weeks (β 0.48 [0.30, 0.65] mm, p < 0.0001) despite similar measures for HC, FL, BPD and AC between groups. Both groups had similar birthweights at term. There was an independent relationship between fasting plasma glucose levels and AAWT after adjustment as described above.Conclusions/interpretationA ‘thin but fat’ phenotype signifying a disproportionate increase in adiposity despite smaller or similar lean body mass was observed in the fetuses of mothers with GDM, even at 20 weeks, thus pre-dating the biochemical diagnosis of GDM. Increased AAWT may serve as an early marker of GDM.

Anthropometric measurements of newborns of women who smoke waterpipe during pregnancy: a comparative retrospective design

Waterpipe tobacco smoking carries adverse health consequences due to high level of chemical toxicants. This study investigated the anthropometric measurements of singleton newborns of Jordanian women with no known chronic diseases who smoked waterpipe during pregnancy, and the difference in these measurements in newborns of pregnant women who smoked waterpipe, cigarettes, both types, and none during pregnancy. The study also investigated the pattern of different types of tobacco smoking as a function of pregnancy trimester. A descriptive, comparative, retrospective, cross-sectional design was used. Two hundred and eight-five women (74 waterpipe, 84 cigarettes, 26 dual, 101 none) and their newborns were recruited from three hospitals. A questionnaire was used while interviewing mothers to assess tobacco smoking pattern. The results showed that compared with non-smokers, mean birth weight was 0.47 kg (95%CI = −0.70 to −0.35) lower for waterpipe-only smokers, 0.23 kg (95%CI = −0.41 to −0.8) lower for cigarette-only users, and 0.59 kg (95%CI = −0.81 to −0.31) lower for dual users. Compared to non-smokers, mean newborn length was 2.7 cm (95%CI = −3.80 to −1.42) lower for dual smokers, 2.2 cm (95%CI = −3.28 to −1.58) lower for waterpipe smokers, and 1.2 cm (95%CI = −2.01 to −0.45) lower for cigarette smokers. Compared with non-smokers, mean newborn head circumference was 1.9 cm (95%CI = −2.72 to −1.65) lower for waterpipe smokers, 1.7 cm (95%CI = −2.65 to −1.16) lower for dual smokers, and 0.8 cm (95%CI= −1.34 to −0.36) lower for cigarette smokers. From these results, we may conclude that waterpipe tobacco smoking during pregnancy can contribute to a reduction in newborn's anthropometric measurements. Increasing awareness of waterpipe tobacco smoking adverse effects and developing cessation interventions in pregnancy is needed.

Procalcitonin and C-Reactive Protein in Umbilical Cord Blood as Markers for Early Suspicion of Infection in Newborns of Women with Prenatal Urinary Tract Infection

Objective: to investigate whether concentrations of procalcitonin (PCT) and C-reactive protein (CRP) in the umbilical cord blood (UCB) are valid biomarkers for the detection of infection in newborns of pregnant women with urinary tract infection (UTI). Methods: PCT and CRP were measured from UCB and were verified through a prospective study of newborns with appropriate birth weights, without asphyxia or signs of bacterial infection whose mothers were diagnosed with untreated or inadequately treated UTI during the final trimester of pregnancy. The blood of newborns was analyzed according to Rodwell criteria. Was calculated the relative risk to detect altered PCT and/or CRP concentration in UCB in newborn with positive Rodwell criteria. Results: samples from 97 newborns at term were analyzed according to Rodwell criteria. Fifty-six of them showed negative criteria. The RR was 2.0 (95% CI – 1.1 – 3.6 p = 0.03) according to PCT and 2.3 (95% CI – 1.1- 4.9) p = 0.03 according to CRP. Conclusion: A normal value to PCT or CRP available from UCB duplicate the possibility to Rodwell negative criteria result in peripheral blood of the neonate, away from the possibility of infection in newborn infants of mothers who had UTI in the pregnancy.

Congenital abnormalities in newborns of women with pregestational diabetes: A time-trend analysis, 1994 to 2009.

The main objective of the current study is to examine the trend of congenital abnormalities among children born by women with and without diabetes, and to explore the impact of food fortification by folic acid on the rate of birth defects among these two groups of mothers. All children born alive in Ontario, Canada, during 1994 to 2009 and their mothers were included in study. Diagnosis of pregestational diabetes among mothers was identified using Diabetes registry, and diagnosis of birth defects among children were identified using hospital records. The prevalence of births among diabetic mothers increased by almost 200% during the study period. Among children born to mothers with diabetes, the prevalence for all anomalies combined was approximately 47% higher and for various cardiac and central nervous system anomalies up to a three- to fivefold higher than those born to nondiabetic mothers. While the rate of birth defects in both groups observed a considerable decline after food fortification in 1999, but the gap between two groups remained unchanged over time. While the prevalence of birth defects among diabetic pregnancies is still considerably higher that nondiabetic pregnancies, results of the current study indicate a declining trend in the prevalence of some congenital abnormalities among babies born to both diabetic and nondiabetic mothers after 1999. We need to be more aggressive in implementing preventive measures, including a national diabetes plan or the proposed universal policy of supra-dietary folic acid supplementation for women with diabetes who are of reproductive age. Birth Defects Research (Part A) 106:831-839, 2016. © 2016 Wiley Periodicals, Inc.

Pityriasis rosea in pregnancy: report of a spousal occurrence and craniosynostosis in the healthy newborn.

Background:Pityriasis rosea is a papulosquamous disease. It may occur during pregnancy; in this setting, it has occasionally been associated with adverse outcomes.Purpose:A woman who developed pityriasis rosea at the beginning of her eighth week of gestation is described. The outcomes in newborns delivered by pregnant women who developed pityriasis rosea during gestation are summarized.Method:A 28-year-old woman developed pityriasis rosea during her eighth week of pregnancy. Her husband had pityriasis rosea two months earlier. PubMed was searched for the following terms: conjugal, craniosynostosis, newborn, pityriasis, pregnancy, rosea, sagittal, spouse. The papers were reviewed and the references cited were evaluated.Results:Our patient delivered a healthy male infant after 41 weeks of gestation. He had normal weight, height, and Apgar scores. Isolated sagittal craniosynostosis was diagnosed and was successfully treated at nine weeks after birth without complications.Conclusion:Several retrospective studies have investigated the possibility of adverse outcomes in infants born to women who developed pityriasis rosea during pregnancy, such as stillbirth, low gestational weight, hypotonia, and premature delivery. However, there are also reports of healthy newborns in women who have had pityriasis rosea during gestation. Our patient carried the fetus one week post-term and delivered a healthy boy via C-section; isolated sagittal craniosynostosis was later diagnosed and successfully repaired. The occurrence of craniosynostosis in a woman who developed pityriasis rosea during her first trimester of pregnancy may be two coincidental events.