Weeks Of Gestation Research Articles

Surgical induced abortion between 14 and 16 weeks of gestation: Complications.

Surgical induced abortion between 14 and 16 weeks of gestation: Complications.

The ambivalence of abortion: An explorative study on attitudes towards elective abortion and abortion limits among pregnant women in Denmark.

The ambivalence of abortion: An explorative study on attitudes towards elective abortion and abortion limits among pregnant women in Denmark.

Living in a bubble with profound difficulties-parents' experiences of extremely preterm survivors.

To analyse the challenges faced by parents of extremely preterm infants born before 24 weeks of gestation and the potential buffering effect of perceived resources on the family's health continuum. The qualitative data were obtained from 70 parents of 70 infants born before 24 weeks of gestation, through open-ended questions in a survey. An inductive content analysis was conducted to identify themes and patterns in the parents' experiences. To enhance the understanding of the findings, salutogenic theory was incorporated to contextualise the emerging patterns of resources and deficits. Parents described the neonatal care as exemplary. However, the integrated results showed that parents reported profound difficulties characterised as 'living in a bubble' with comprehensive neonatal care and varied access to support and participation. In addition, the parents had to manage a preterm born child with medical complexities and encountered significant barriers between care levels. The findings highlight the need to improve support systems and address challenges for families of preterm born children. Enhancing collaboration between healthcare providers and families, identifying and overcoming barriers during care, and providing comprehensive support services are crucial. Addressing the parents' experienced deficits may mitigate potential adverse effects on family health outcomes.

Unique motif Sequences for early diagnosis of preeclampsia.

Unique motif Sequences for early diagnosis of preeclampsia.

Variation in Inpatient Admission for Management and Cost Drivers in Placenta Accreta Spectrum Disorder.

To assess variation in inpatient antepartum management strategies for placenta accreta spectrum (PAS) disorder and their association with hospitalization costs in a national sample. This retrospective cohort study used the 2016-2021 Nationwide Readmissions Database to identify individuals aged 15-54 years who underwent cesarean hysterectomy for PAS between 23 and 35 weeks of gestation. Patients were categorized into four management groups based on whether they had a separate antepartum hospitalization and their predelivery length of stay (LOS) during the delivery hospitalization. Median total hospitalization costs (inclusive of separate antepartum and delivery hospitalization), adjusted to 2023 dollars, were analyzed as continuous and dichotomized outcomes (above the 90th percentile). Unadjusted and adjusted logistic and median regression models assessed whether inpatient management variation, postpartum LOS, demographic, and clinical factors influenced hospitalization costs. Among 3,237 individuals with PAS, 50.5% had no prior antepartum admission and a predelivery LOS of 2 days or less, 31.9% had no prior antepartum admission and a predelivery LOS of more than 2 days, 11.8% had a prior antepartum admission and a predelivery LOS of 2 days or less, and 5.8% had a prior antepartum admission and a predelivery LOS of more than 2 days. Median total hospitalization costs varied significantly by management group, with mean costs ranging from $21,829 to $51,039. Management variation was associated with nearly 3- to 29-times higher likelihood of high total hospitalization costs and $8,907-29,021 adjusted higher median cost depending on the specific management group. Of evaluated clinical factors, only disseminated intravascular coagulation was associated with an adjusted median cost increase of $12,921. Nearly one in five patients with PAS experienced an all-cause antepartum hospitalization. Variation in inpatient admission for management of PAS was evident in this national sample and was a significant driver of hospitalization costs. Although some antepartum hospitalizations and prolonged predelivery lengths of stay are unavoidable due to the complexity and severity of PAS, efforts to reduce unnecessary variations could reduce total hospitalization costs.

Associations of Bronchopulmonary Dysplasia and Infection with School-Age Brain Development in Children Born Preterm.

Associations of Bronchopulmonary Dysplasia and Infection with School-Age Brain Development in Children Born Preterm.

Association of prenatal exposure to perfluoroalkyl and polyfluoroalkyl substances with fetal growth trajectories.

Association of prenatal exposure to perfluoroalkyl and polyfluoroalkyl substances with fetal growth trajectories.

Risk factors for postpartum hemorrhage in pregnancies complicated by polyhydramnios.

Risk factors for postpartum hemorrhage in pregnancies complicated by polyhydramnios.

Unraveling the onset and continuity of depressive symptoms from early pregnancy to six weeks postpartum: A longitudinal network analysis.

Unraveling the onset and continuity of depressive symptoms from early pregnancy to six weeks postpartum: A longitudinal network analysis.

Rectus muscle reapproximation at cesarean delivery: a randomized controlled trial.

Rectus muscle reapproximation at cesarean delivery: a randomized controlled trial.

Prenatal per- and polyfluoroalkyl substance mixtures and weight for length from birth to 12months: The New Hampshire Birth Cohort Study.

Prenatal per- and polyfluoroalkyl substance mixtures and weight for length from birth to 12months: The New Hampshire Birth Cohort Study.

Outcomes After Prenatal Exposure to Raltegravir-Containing Antiretroviral Therapy: A Multicohort European Study.

Raltegravir is an HIV integrase strand transfer inhibitor recommended for use in pregnancy. The aim of this study was to assess risk of birth defects and other suboptimal outcomes after prenatal exposure to raltegravir. We used pooled, prospectively collected individual patient data from studies in the European Pregnancy and Paediatric Infections Cohort Collaboration. Pregnancies with any prenatal exposure to raltegravir with outcomes in 2008-2020 were included. Birth defects were classified according to World Health Organization's International Classification of Diseases and EUROCAT criteria. Earliest prenatal exposure timing was classified as periconception [exposure at ≤6 completed gestational weeks (GWs)], later first trimester (T1) (exposure in T1 at >6 completed GWs), and second/third trimester (exposure at >12 completed GWs). A total of 1499 pregnancies across 9 cohorts were included. Where timing was available (n = 1449), earliest raltegravir exposure was in the periconception period for 505 (34.8%), later T1 in 65 (4.5%), and T2/T3 in 879 (60.7%). The overall prevalence of birth defects among live-born infants with prenatal raltegravir exposure was 3.9% (95% confidence interval: 2.9, 5.0) (1443/1466) (International Classification of Diseases), with no increased risk observed for those exposed in the periconception period ( P = 0.290). Among singleton live-born infants, 11.9% (160/1346) were born preterm, 11.3% (148/1307) low birthweight, and 8.6% (111/1291) small for gestational age, with no difference in outcomes observed by timing of raltegravir exposure. These findings add to the evidence base around safety of raltegravir use in pregnancy, although ongoing safety monitoring is needed to rule out risk of rare outcomes.

Higher PFOS exposure associated with higher SHBG in third trimester. The Odense Child Cohort.

Higher PFOS exposure associated with higher SHBG in third trimester. The Odense Child Cohort.

The impact of maternal age and body mass index on hypertensive disorders of pregnancy: Moving beyond the cut-off effect.

Maternal age (MA) and body mass index (BMI) are known risk factors for hypertensive disorders of pregnancy (HDP). Different threshold values are used to calculate preeclampsia risk scores, but the appropriateness of a cut point model has not been extensively evaluated. This is because the effects of both MA and BMI occur continuously. We aimed to investigate the relationship between MA, BMI, and HDP, respecting the continuous nature of the two independent variables. We retrospectively selected all nulliparous women with singleton pregnancies who delivered after 22 gestational weeks from January 2005 to December 2019 (25,165 women). We used univariate and multivariable logistic regression analyses implementing linear, quadratic, cubic, and penalized splines functions to test, investigate, and describe the relationship between continuous BMI, continuous MA, and risk of HDP. MA, BMI, and infertility treatments are independently associated with the risk of developing all HDP in nulliparous women. The impacts of MA and BMI on the risk of developing HDP occur gradually, and penalized splines functions resulted in the best model to describe these associations with a different model for each HDP. No interaction factors were retained between MA, BMI, and infertility treatments. Given the relevance of HDP on maternal mortality, an accurate identification of women at increased risk of developing the disease is crucial. In an era where technology is rapidly advancing, new models for customized risk assessment of HDP, considering the continuous nature of MA and pregestational BMI, must be implemented.

Safety of pertussis vaccination in pregnancy and effectiveness in infants: a Danish national cohort study 2019-2023.

Safety of pertussis vaccination in pregnancy and effectiveness in infants: a Danish national cohort study 2019-2023.

Blood pressure patterns of gestational hypertension or non-severe pre-eclampsia beyond 36weeks' gestation and the adverse maternal outcomes: Secondary analysis of the HYPITAT study.

To identify patterns in changes of blood pressure for women with gestational hypertension (GH) or non-severe pre-eclampsia (PE) beyond 36 gestational weeks, and assess their association with a composite adverse maternal outcome. Secondary analysis of a randomized controlled trial (HYPITAT). We investigated patterns of one-week blood pressure changes post-admission, explored factors contributing to diverse patterns using ANOVA and Chi-square tests, and assessed the correlation between these patterns and a composite adverse maternal outcome defined as severe maternal morbidity, mortality, post-partum hemorrhage and cesarean section. Among 384 women, 187 developed the composite outcome. We identified three and four typical patterns in systolic and diastolic blood pressure changes, respectively. Diastolic blood pressure patterns statistically significantly varied across maternal ethnicity and diagnosis at admission. Compared to a pattern of steady diastolic blood pressure, the odds ratio (95% confidence interval) for the composite adverse maternal outcome was 2.59 (1.31, 5.13) or 2.09 (1.02, 4.26), contingent on covariates, when a pattern of increasing diastolic blood pressure was present. The results of sensitivity analysis excluding severe hypertension from the composite outcome indicated that the main findings are robust. Maternal ethnicity and diagnosis may affect diastolic blood pressure patterns, and a pattern of increasing diastolic blood pressure was likely associated with elevated risk of the composite adverse maternal outcome. This underscores the potential significance of recognizing these patterns for sequential risk assessment and individualized management in late GH and non-severe PE.

Handgrip strength during pregnancy: A first reference values based on nationally representative survey.

Handgrip strength during pregnancy: A first reference values based on nationally representative survey.

Obstetrical outcomes of women with previous preterm cesarean delivery.

Obstetrical outcomes of women with previous preterm cesarean delivery.

Maternal serum concentrations of vitamin D in pregnancy and preterm birth: a case-control study in Southern Sweden

PurposeThe purpose of this case-control study was to investigate the associations between maternal serum concentrations of vitamin D early in pregnancy and the occurrence of preterm birth.MethodsThe study included 269 women (cases) whose children were born preterm (< 37 gestational weeks [gw]) and 332 women (controls) whose children were born term (≥ 37 gw). Among the cases, 59 were extreme preterm (< 28 gw), 74 severe preterm (28‒32 gw), and 136 late preterm (33‒36 gw). All women gave birth in Scania, the most Southern County of Sweden. Concentrations of 25-hydroxyvitamin D3 (vitamin D) in maternal serum collected early in pregnancy were analyzed using liquid chromatography-tandem-mass-spectrometry (LC/MS/MS). The serum concentrations of vitamin D were trichotomized based on the distributions among the controls (≤ 44.9; 45.0‒68.8; and ≥ 68.9 nmol/L) as well as dichotomized at a predefined cut-off (< 50 and ≥ 50 nmol/L). Logistic regression was used to estimate the associations between vitamin D and preterm births, partly when all cases were included in the analyses, and partly when the three different case groups were included separately. The category with the highest vitamin D concentration was used as a reference in the regression analyzes. The analyses were performed without as well as with adjustments for potential confounders.ResultsWhen the category with the lowest vitamin D concentrations were compared with the reference category in the analyses where the vitamin D concentrations were trichotomized, no statistically significant associations were observed. However, among the extreme preterm an adjusted odds ratio of 1.93 (95% confidence interval 0.83‒4.48) was observed. The patterns were similar when 50 nmol/L was used as the cut-off.ConclusionAlthough all comparisons gave adjusted odds ratios in the direction that low maternal vitamin D concentrations early in pregnancy increase the risk of preterm birth, none of these were statistically significant. Accordingly, the present study gives no to very weak support for an association.

Effect of myo-inositol on the prevention of gestational diabetes in high-risk pregnant women: An RCT

Background: Gestational diabetes mellitus (GDM) is a rising problem which, if not diagnosed and treated in time, can lead to maternal, fetal, and neonatal complications. Therefore, it is very important to consider predisposing factors and prevention of GDM. Objective: This study aims to investigate the effect of myo-inositol (MI) on the prevention of GDM and other pregnancy outcomes. Materials and Methods: This randomized controlled trial was conducted at the Arash Women’s hospital and Yas hospital Complex, Tehran, Iran between November 2019 and May 2020 and included 150 women; the study was divided into 2 groups (n = 75/each). Women received 4000 mg of MI plus 400 mg of folic acid daily in the MI group and 400 mg of folic acid in the placebo group from 11–14 gestational weeks for 14 wk. Participants underwent 75 gr oral glucose tolerance test at 24–28 wk and were followed up until delivery. Results: After adjustment for confounding factors, MI treatment was associated with a significant reduction of GDM (aRR: 0.58, 0.36, 0.91, p = 0.020). However, no significant difference was observed between the 2 groups in cases of other pregnancy outcomes and glycemia at each step of oral glucose tolerance test values. Conclusion: Our results showed that MI significantly reduced GDM. With insufficient evidences, more studies with an appropriate sample size are recommended.