Presence Of Congenital Malformations Research Articles

Use of leflunomide among girls and women of childbearing age and occurrence of leflunomide-exposed pregnancies in Germany

Leflunomide is contraindicated during pregnancy and treatment cessation is recommended two years before pregnancy. We aimed to describe leflunomide use in women of childbearing age in Germany, the occurrence of pregnancies in women using leflunomide and malformations among children possibly exposed in utero. Using the GePaRD database (claims data, ∼20% of the German population), we determined annual age-standardized prevalences of leflunomide use between 2004 and 2019 among females aged 13–49 years. Further, we estimated the number of exposed pregnancies by assessing whether the exposure window assigned to the last dispensation before pregnancy (days covered by the dispensation plus two years) overlapped the onset of pregnancy or whether there was a dispensation in the first eight weeks of pregnancy. For exposed live births, a mother-baby linkage was performed and the presence of congenital malformation was assessed. The age-standardized prevalence of leflunomide use ranged between 0.34 and 0.46 per 1000 females during the study period. About one third of the users were ≤40 years. We identified 205 leflunomide-exposed pregnancies ending during the study period. 71% of these pregnancies ended in a live birth (26% preterm) and 10% in an induced abortion. In 86% of the live births (n=125) the mother-baby linkage was successful. Among these 125 children, 13 children (10%) had congenital malformations. In conclusion, we observed a considerable number of pregnancies in women using leflunomide in the two years before or during early pregnancy. This highlights the importance of monitoring the implementation of existing risk minimization measures for leflunomide in Germany.

Bayesian binary regression using power and power reverse link functions: an application to premature birth data

This study aims to determine factors associated (and quantify) with prematurity through binary regression models, considering power and reverse power link functions, with asymmetric characteristics. As criteria for the model selection, the Bayesian Deviance Information Criterion (DIC), predictive evaluation, and residual analysis. All models analyzed presented similar predictive capacity, however, the model with a reverse power logit link function, with asymmetry parameter =0.336 was chosen, since it presented the lowest value of DIC=3,203, residues that indicated a good fitted of the model. There was an association of prematurity with the following variables: maternal - age over 35 years (OR=1.485), with a partner (OR=0.731), and primiparous (OR=1.307); of pregnancy and childbirth - multiple pregnancy (OR=36.360), cesarean childbirth (OR=1.337) and number of prenatal consultations less than seven (OR=3.305); and newborns of white race/skin (OR=0.731) and presence of congenital malformation (OR=2.663). Considering the proposed criteria, an asymmetric link function (reverse power logit) was the most parsimonious for the model. From this, there were high chances of factors associated with the occurrence of prematurity, indicating the need for actions to minimize them.

Maternal and neonatal outcomes after benzodiazepine and benzodiazepine agonist exposure during pregnancy in women with mental disorders.

To compare the gestational age of neonates in utero exposed to benzodiazepines (BDZs) with nonexposed controls. Secondary objectives were birth weight, presence of congenital malformations, APGAR score and the need for >3 months (prolonged) maternal psychiatric care. A retrospective cohort study of women and neonates from 2013 to 2021 with univariate and multivariable analysis to study the associations between BDZ exposure and gestational age compared to nonexposed women with mental health problems. We found that BDZ exposure was not associated with a lower gestational age. We found that women in the exposed group had an increased risk of psychiatric care (adjusted odds ratio 2.58 [95% confidence interval 1.71-3.91], P< .001). We found that in utero BDZ exposure was not associated with a significantly lower gestational age of the neonates and was associated with prolonged psychiatric care of their mothers.

Risk factors for perinatal death in high-risk pregnant women at a tertiary hospital in Curitiba-PR, Brazil: a case-control study

A case-control study was carried out to estimate risk factors for perinatal mortality in a referral hospital for high-risk pregnancies in Curitiba-PR. Sociodemographic, maternal, pregnancy and concept characteristics data were obtained from the hospital records of 316 cases and 316 controls from 2013 to 2017. A hierarchical multiple logistic regression analysis was performed, remaining in the final model variables with p < 0.05. The results show an increased risk of perinatal death in mothers with blood type B (OR = 2.82; 95%CI: 1.07-7.43), who did not undergo prenatal care (OR = 30.78; 95%CI: 4.23-224.29), fetuses with congenital malformations (OR = 63.90; 95%CI: 27.32-149.48), born under 28 (OR = 24.21; 95%CI: 1, 10-531.81) and between 28-31 weeks of gestation (OR = 6.03; 95%CI: 1.34-27.17) and birth weight below 1,000g (OR = 51.94; 95%CI: 4.31-626.46), between 1,000-1,499g (OR = 11.17; 95%CI: 2.29-54.41) and between 1,500-2,499g (OR = 2.75; 25-6.06). Concepts of pregnancies with premature outcome, low birth weight and the presence of congenital malformations are the main risk factors for perinatal death. On the other hand, adequate prenatal care is an important protective factor.

Fatores de risco para óbito perinatal em gestantes de alto risco de um hospital terciário de Curitiba-PR, Brasil: estudo caso-controle

Abstract A case-control study was carried out to estimate risk factors for perinatal mortality in a referral hospital for high-risk pregnancies in Curitiba-PR. Sociodemographic, maternal, pregnancy and concept characteristics data were obtained from the hospital records of 316 cases and 316 controls from 2013 to 2017. A hierarchical multiple logistic regression analysis was performed, remaining in the final model variables with p &lt; 0.05. The results show an increased risk of perinatal death in mothers with blood type B (OR = 2.82; 95%CI: 1.07-7.43), who did not undergo prenatal care (OR = 30.78; 95%CI: 4.23-224.29), fetuses with congenital malformations (OR = 63.90; 95%CI: 27.32-149.48), born under 28 (OR = 24.21; 95%CI: 1, 10-531.81) and between 28-31 weeks of gestation (OR = 6.03; 95%CI: 1.34-27.17) and birth weight below 1,000g (OR = 51.94; 95%CI: 4.31-626.46), between 1,000-1,499g (OR = 11.17; 95%CI: 2.29-54.41) and between 1,500-2,499g (OR = 2.75; 25-6.06). Concepts of pregnancies with premature outcome, low birth weight and the presence of congenital malformations are the main risk factors for perinatal death. On the other hand, adequate prenatal care is an important protective factor.

Neonatal perioperative resuscitation (NePOR) protocol-An update.

Unexpected cardiac arrest in the perioperative period is a devastating complication. Owing to immaturity of organ systems, and presence of congenital malformations, morbidity and mortality are higher in neonates. There is abundant literature about early recognition and management of perioperative adverse events in children, but similar data and guidelines for surgical neonates is lacking. The current neonatal resuscitation guidelines cater to a newborn requiring resuscitation at the time of birth in the delivery room. The concerns in a newborn undergoing transition from intrauterine to extra uterine life is significantly different from a neonate undergoing surgery. This review highlights the causes and factors responsible for peri-arrest situations in neonates in the perioperative period, suggests preoperative surveillance for prevention of these conditions, and finally presents the resuscitation protocol of the surgical neonate. All these are comprehensively proposed as Neonatal Peri-operative Resuscitation (NePOR) protocol.

Патологія провізорних органів, ускладнення вагітності, пологів і стан малюків при вроджених вадах сечовидільної та нервової систем

Congenital malformations (CM) in fetuses and neonates belong to main causes of perinatal morbidity and mortality. Provision organs malformation and malfunction in such cohorts is less studied. The purpose - to analyze the course of pregnancy, the data of ultrasound imaging of provisional organs in the presence of CM of central nervous system (CNS) and/or of nephro-urinary system (NUS) in the fetus and newborn. Materials and methods. The results of prenatal and postnatal ultrasound, anamnestic and general clinical data of a sample of cases with prenatally diagnosed CM of CNS and/or NUS for the period 2017-2021 were analyzed. Results. There were 45 newborns with CNS malformations, and 54 newborns with CM of NUS. Malformations of NUS and/or CNS in the examined newborns were combined with anomalies of other systems in a third of cases - 29.6% and 31.1%, respectively. According to the results of prenatal ultrasound examinations, polyhydramnios (16.7%) was most often recorded in the pregnancies with fetal CM of NUS, and cases of fetal CM of CNS most commonly were registered placental hyperplasia (35.6%), fetal growth retardation (24.4%) and fetal distress (26.7%). Postnatally in both cohorts (with NUS malformations and with CNS malformations) a high rate of following complications were recorded: prematurity (16.7% and 15.6%, respectively), birth asphyxia (48% and 55.6%, respectively), and early neonatal death (11% and 6.6%). Сonclusions. Pregnant women with CM of CNS and/or NUS in the fetus belong to the group of high perinatal risk because of the high rate of perinatal complications. Information about the identified high perinatal risks in fetuses and newborns with CM of the CNS and/or NUS should be provided to parents and taken into account when planning management of pregnancy and labor.

Incidence of Congenital Clubfoot: Preliminary Data from Italian CeDAP Registry.

(1) Background: We find the incidence of clubfoot in Italy from “Certificate of Delivery Care Registry (CeDAP)”, a database of the Italian Ministry of Health, the most comprehensive public data available for this purpose. (2) Methods: The CeDAP registry is a web system that provides epidemiological and sociodemographic information about newborns. It started on 1 January 2002, following the ministerial Decree no. 349 of 16 July 2001. The certificate is structured into six sections; each collects specific information referring to the birthplace, parents, pregnancy, childbirth, newborn, and the possible presence of congenital malformations or the causes of neonatal mortality. The midwife or the doctor draws up the certificate no later than ten days after birth. Each region transmits the data every six months to the Ministry of Health. The period between 2013 and 2017 has been selected for the study, with every Italian region’s data. We conducted a retrospective descriptive study. (3) Results: The overall rate in northern Italy is 1.09 (with some exceptions described), but we think it is essential to reevaluate this number again, given more accurate data collections by every Italian hospital. (4) Conclusions: This study intends to build a framework for future epidemiologic studies about clubfoot in Italy.

Prevalence of Toxoplasma gondii among women and ewes in Kirkuk city

This study was conducted in Kirkuk city during the period from October 2020 to March 2021. The study aims to study the prevalence of Toxoplasma gondii infection among pregnant women and ewes. Toxoplasmosis is a common disease between humans and animals and diffused throughout the world by 30-60%, caused by a single-celled parasite called Toxoplasma gondii. Toxoplasmosis is a parasite disease that causes a variety of major health concerns in pregnant women. Miscarriages and congenital abnormalities in fetuses are caused by this condition. It may also affect the neurological system and the brain’s important functions. In Iraq, the prevalence of the Toxoplasma parasite in pregnant women and sheep was measured, and the association between the pathogen and abortion was investigated. According to the findings, the condition is prevalent in 51 percent of pregnant women and 41 percent of ewes. The findings revealed a link between the frequency of abortions in pregnant women and Toxoplasma gondii infection, with the greatest infection rate of 38 percent for women who had three abortions, whereas the highest risk of abortion in sheep was 43 percent for one abortion. The study also found that women between the ages of 25 and 40 are the most susceptible to infection, with a 40% infection rate, while the highest risk of infection in sheep was 58 percent for the age group 1-2. In addition, the results illustrated a relationship between sheep infection with Toxoplasma gondii and the presence of congenital malformations in aborted fetuses. In other words, the rate of infection among sheep that aborted deformed fetuses was 89.5%. The relation between the level of the hormone’s progesterone and oestrogen in infected women was studied. It was noted that the ratio of the two hormones was higher in those who were infected than in healthy women, where the proportion of progesterone was 20 mg/ml, while the proportion of estrogen was pg/ml 92.5.

PRE- AND POSTNATAL DIAGNOSIS OF DOWN SYNDROME

The article presents an analysis of live births and abortions with confirmed Down syndrome (DS) in Kyiv in 2018-2020. During this period, 86 children with DS were born in Kyiv, which corresponds to an average frequency of 8.6 per 10,000 live births. The frequency of births of children with DS decreased from 10.4 in 2018 to 6.5 in 2020 per 10,000 live births. The percentage of male probands is 59 %, and female – 41 %. Timely diagnosis of DS in live births allows for surgical correction in the presence of congenital malformations and reduces mortality in early childhood.&#x0D; Diagnosis of DS at the prenatal stage allows doctors to make decisions on abortion at the request of the woman. The analysis of cases of abortions for the period 2018-2020 shows a tendency to increase the number of aborted pregnancies. The rate of abortions with DS in Kyiv was 40 % in 2018, in 2019 – 52 %, and in 2020 – 67 %. and reached the mark of Western Europe. The high rate of aborted pregnancies correlates with a decrease in the number of births of children with DS during this period. The data show an increase in public awareness of hereditary pathology, an increase in referrals to a geneticist and an increase in the effectiveness of prenatal diagnosis.&#x0D; During the period: 2018-2020, there is an increase in medical coverage; genetic counseling; and invasive interventions to establish the karyotype in high-risk women who were included in the high-risk group as a result of combined prenatal screening or had been diagnosed with birth defects or have ultrasound markers of chromosomal pathology. It is established that this pathology occurs in mothers of any age, not only in women over 35 years, which indicates the feasibility of mass use of prenatal diagnosis in all age groups.&#x0D; The presented statistical data makes the case to use prenatal testing and how to rationally distribution financial resources. The prospect of further research is to analyze cases of live births and abortions with confirmed DS at the national level.

Perinatal factors and hospitalisations for severe childhood infections: a population-based cohort study in Sweden

ObjectiveTo examine the association between perinatal factors and hospitalisations for sepsis and bacterial meningitis in early childhood (from 28 days to 2 years of age).DesignA population‐based cohort study. The Swedish...

Plasma Calcifedol Concentration as a Marker of Vitamin D Deficiency in Newborns with Congenital Malformations

Diagnosis of vitamin D deficiency and its management is the most difficult problem of modern neonatology.The objective: to study the concentration of 25(OH)D3 in newborns of St. Petersburg depending on the presence of congenital malformations (CM).Subjects and methods. 60 newborns were examined, their gestational age made 39.4 (38-41) weeks. Children were divided into 2 groups: Group 1 – healthy children, Group 2 – children with CM.Results. Regardless of the presence of CM, the calcifedol plasma concentration was below 15 ng/ml. It was found that children with CM whose plasma calcifedol concentration was below 8.0 ng/ml needed long-term invasive mechanical ventilation (80.0 vs 40.0 hours; p &lt; 0.005) and longer treatment in ICU (7.0 vs 4.0; p &lt; 0,002). Negative correlations were revealed between calcifedol concentration, duration of narcotic analgesics administration (R = -0.44; p = 0.01), duration of mechanical ventilation (R = -0.49; p = 0.003) and stay in ICU (R = -0.54; p = 0.001).Conclusion. The most pronounced deficiency of calcifedol was in children with severe CM requiring long-term treatment in ICU.

Hearing impairment among high risk neonates born in a tertiary care hospital in north Kerala: a cross sectional study

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Hearing is necessary for the proper mental and social development of a new-borns child. Delay in diagnosis leads to improper development of social and mental skills. The prevalence of congenital hearing loss is greater than prevalence of screened metabolic syndromes. There are multiple maternal and intrapartum risk factors associated with hearing impairment. Most of the causes are treatable. Objectives was to find out the proportion of hearing impairment in neonates and its risk factors in a tertiary care hospital in north Kerala.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; This cross-sectional research was performed in a tertiary care hospital in Northern Kerala between January 2018 and June 2019 after obtaining informed consent and institutional ethical committee clearance among those who fulfilled the inclusion and exclusion criteria. All the high-risk new-borns were subjected to Otoacoustic examination. Those who did not pass the first OAE were subjected to second OAE after one month. Those who did not pass in the examination were subjected to BERA. Those high risk children who did not pass the BERA were considered having hearing impairment and were subjected to further investigation and appropriate management. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; The prevalence of hearing impairment was 0.5%. 0.25% were unilateral and 0.25% were bilateral. Pregnancy induced hypertension, premature labour, lower segment Caesarian section, low birth weight, small for gestational age, respiratory distress, hyperbilirubinemia and presence of congenital malformations were significantly associated with hearing impairment. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Since most of the congenital hearing loss among high risk neonates can be treated, a nationwide standardized hearing assessment program is advocated for the early detection of high risk children with hearing loss.&lt;/p&gt;

Umbilical cord constriction as a cause of intrauterine fetal death

ABSTRACT The umbilical cord constriction (UCC) is an uncommon condition and an important etiology for stillborn fetuses. The main goal of this study was to verify the UCC occurrence as the cause of intrauterine fetal death, the associated etiology and its pathological characteristics. Therefore, a descriptive retrospective cross-sectional study was developed using the database from a Pathology Institute, in Brazil, from 1995 to 2017. The results presented a total of 1,359 embryo/fetus deaths – 69 (5.07%) due to UCC, 60.9% males and 39.1% females. The average age of pregnant women was 27.5 years ± 7.2 years of standard deviation (SD). The majority of deaths occurred during the second trimester (76.5%), followed by the first (14.7%) and third (8.8%) trimesters, respectively. One constriction alone was found in 87% of cases, 11% had two constrictions and only 1% had three or more. The presence of congenital malformations was detected in 20.2% of necropsies, the identification of chronic fetal distress was described in 71% of the technical reports and 17% of the cases had obstructive vasculopathy characteristics in microscopy analysis. Regarding the anatomopathological characteristics between the male and female sexes, no significant difference was found (p > 0.05) correlating gestational age, weight or congenital malformations. UCC was a cause of fetal death found in 5% of the cases, and it was linked to congenital malformations, fetal distress and obliterative vasculopathy.

COMPARISON OF PERINATAL OUTCOME IN TWIN PREGNANCY WITH AND WITHOUT CERVICAL CERCLAGE

Background: The incidence of multifetal pregnancies has registered increase globally. Babies born from multiplebirth pregnancies are much more likely to result in premature birth than those from single pregnancies. Knowledge of role of cervical cerclage in preventing preterm birth especially in twin pregnancy can be helpful to prevent complication related to preterm birth and ultimately of low birth weight babies. Methods: Depending upon who opt for the procedure 100 patients were divided equally into two groups: 1)Twin pregnancy with cervical cerclage; 2)Twin pregnancy without cervical cerclage. We measured maternal outcomes which include time for which patient required to be hospitalized, maternal pyrexia, cervical or bladder injury and other maternal morbidity and perinatal outcomes which include preterm delivery (delivery before 37 completed weeks), low birth weight (birth weight ≤2000 g), IUGR, perinatal mortality, indicators of perinatal morbidity (APGAR scores and neonatal unit admission), stillbirth, second trimester loss and presence of congenital malformations. Results: In Study group 22% delivered before 34 weeks of gestation, 46% delivered between 34 and 37 weeks of gestation, 32% delivered after 37 weeks of gestation compared to 44%, 48% and 8% respectively in Control group. The mean gestational age at delivery was 35.3 weeks in Study group and was 33.2 weeks in Control group. In study group 47% neonates had birth weight less than 2Kg and in Control group 69% neonates had birth weight less than 2Kg. In Study group 95% had Apgar score more than 6 whereas in Control group 86% had APGAR score more than 6. The mean APGAR for Study group was 8.5 and for Control group was 7.5. 45% neonates had complications in Study group whereas 67% neonates in Control group. Overall Low birth weight was most common complications in both the groups. Respiratory distress was more common in Control group. Conclusions: In spite of close vigilance, preterm birth in twin gestation is common and unpredictable. It is difficult to predict those who may require cervical cerclage although all multiple pregnancies are at high risk. Cerclage should be considered an option for patients with twin pregnancies in the second trimester to prolong the duration of gestation as close to term as possible.

RECENT ADVANCES IN HEMATOPOIETIC STEM CELL TRANSPLANTATION FOR INHERITED BONE MARROW FAILURE SYNDROMES

The inherited bone marrow failure syndromes (IBMFS) are a heterogeneous group of genetic disorders characterized by the inadequate production of at least one of the hematopoietic lineages, leading to the development of both isolated cytopenia (anemia, neutropenia, or thrombocytopenia) or pancytopenia. Different biological mechanisms justify the pathophysiological changes found in the IBMFS, emphasizing the repair pathways in Fanconi anemia (FA), maintenance of telomeres in congenital dyskeratosis, and ribosome biogenesis in Shwachman Diamond syndrome (SSD) and Blackfan Diamond anemia. These disorders are generally associated with the presence of congenital malformations and an increased risk of cancer, mainly hematological, gynecological, and head and neck neoplasms. Although the diagnosis occurs typically in childhood, adult patients, mostly below 40 years of age with signs and symptoms suggestive of IBMFS, should be investigated. Currently, hematopoietic stem cell transplantation (HSCT) is the only curative option for hematological complications related to IBMFS. It is essential to highlight that these patients must be monitored throughout their lives to prevent or detect early treatable neoplasia.

Meconium microbiome and its relation to neonatal growth and head circumference catch-up in preterm infants.

The purpose was identify an association between meconium microbiome, extra-uterine growth restriction, and head circumference catch-up. Materials and methods: Prospective study with preterm infants born <33 weeks gestational age (GA), admitted at Neonatal Unit and attending the Follow-Up Preterm Program of a tertiary hospital. Excluded out born infants; presence of congenital malformations or genetic syndromes; congenital infections; HIV-positive mothers; and newborns whose parents or legal guardians did not authorize participation. Approved by the institution's ethics committee. Conducted 16S rRNA sequencing using PGM Ion Torrent meconium samples for microbiota analysis. Results: Included 63 newborns, GA 30±2.3 weeks, mean weight 1375.80±462.6 grams, 68.3% adequate weight for GA at birth. Polynucleobacter (p = 0.0163), Gp1 (p = 0.018), and Prevotella (p = 0.038) appeared in greater abundance in meconium of preterm infants with adequate birth weight for GA. Thirty (47.6%) children reached head circumference catch-up before 6 months CA and 33 (52.4%) after 6 months CA. Salmonella (p<0.001), Flavobacterium (p = 0.026), and Burkholderia (p = 0.026) were found to be more abundant in meconium in the group of newborns who achieved catch-up prior to 6th month CA. Conclusion: Meconium microbiome abundance was related to adequacy of weight for GA. Meconium microbiome differs between children who achieve head circumference catch-up by the 6th month of corrected age or after this period.

Maternal and perinatal characteristics, congenital malformations and the risk of wilms tumor: the ESTELLE study.

Wilms tumor (WT), or nephroblastoma, is an embryonic tumor that constitutes the most common renal tumor in children. Little is known about the etiology of WT. The aim of this study was to investigate whether maternal or perinatal characteristics were associated with the risk of WT. The ESTELLE study is a national-based case-control study that included 117 cases of WT and 1,100 controls younger than 11years old. The cases were children diagnosed in France in 2010-2011 and the controls were frequency matched with cases by age and gender. The mothers of case and control children responded to a telephone questionnaire addressing sociodemographic and perinatal characteristics, childhood environment, and lifestyle. Unconditional logistic regression models adjusted on potential cofounders were used to estimate the odds ratios (OR) and their confidence intervals (95% CI). High birth weight and the presence of congenital malformation were associated with WT (OR 1.9 [95% CI 1.0-3.7] and OR 2.5 [95% CI 1.1-5.8], respectively). No association with breastfeeding or folic acid supplementation was observed. Although potential recall bias cannot be excluded, our findings reinforce the hypothesis that high birth weight and the presence of congenital malformation may be associated with an increased risk of WT. Further investigations are needed to further elucidate the possible role of maternal characteristics in the etiology of WT.

Postpartum Depression and its Risk Factors among Indian Women

Postpartum depression (PPD) is a mood disorder that can affect women after childbirth. The ill effects of PPD include maladaptive mother-infant interactions, negative effect on cognitive and behavioural development of infants. There are wide variations in reported prevalence of PPD ranging from 0.5 percent to 60 percent among various countries as estimated by the Edinburgh Postnatal Depression Scale (EPDS). PPD screening is not a routine part of postpartum care in India and postpartum women suffering from PPD may remain largely unrecognized and untreated. The study aimed to assess the prevalence of depression and its risk factors in postpartum women attending well-baby clinic at 6 weeks postpartum at a tertiary hospital in India. A total of 284 women who came for immunisation of their babies in well baby clinic at 6 to 8 weeks postpartum were assessed for PPD using the EPDS, after taking consent. Ethical approval was taken from the ethics committee of the organisation. Demographic pro le was collected and women were assessed for risk factors of PPD using a self-developed performa. The point prevalence of PPD was 21.5 percent with a cut off EPDS score of 12 (mean=7.67±5.94). Presence of congenital malformation or neonatal morbidity, problems related to feeding, sleep, satisfaction with marital relationship, violence in the family, relationship with mother-in-law, and presence of stressor in the family were signi cantly associated with PPD. The study brings out the importance of screening for PPD at accessible points like well-baby clinic. Maternal health programmes need to address the mental wellbeing of postpartum women

Obstetrical and Neonatal Outcome after Pre Implantation Genetic Diagnosis; Eight Year Experience at King Faisal Specialized Hospital &amp; Research Center

Objectives: To determine if there is any observable effect of pre implantation genetic diagnosis (PGD) on obstetrical outcome and perinatal morbidity and mortality, birth defects, neonatal outcome in addition, finding the rate of misdiagnosis. Setting: King Faisal Specialist Hospital and Research Center (Reproductive Medicine &amp; Perinatology Sections) at Riyadh, Saudi Arabia. Design: A retrospective chart review of PGD patients from Jan 2001- Dec 2009. Materials and Methods: A total of 70 PGD pregnancies and 70 matching spontaneously conceived pregnancies were reviewed. The main outcome measures were rate of multiple pregnancies, gestational age (GA) at delivery, mode of delivery, sex, apgar score (A/S), birth weight, presence of birth defects, misdiagnosis and perinatal and neonatal mortalities. Results: Data were collected from 79 children born after PGD and compared to 72 children born after spontaneous pregnancies. PGD group had significantly more multiple pregnancies. However, there was no statistically significant difference between other outcomes in terms of: birth weight, GA at delivery, sex distribution, perinatal mortality and presence of congenital malformations. The misdiagnosis rate was 1.4%. Conclusion: PGD does not add risk factors to the health of babies born after the procedure. The perinatal death rate and rate of congenital malformations were not higher for PGD group in this study.