scholarly journals Challenges in the Delivery Room: Integrated Analysis of Biomarkers Predicting Complications in Lupus Pregnancy

2021 ◽  
Author(s):  
Eugen Ancuta ◽  
Dragos Valentin Crauciuc ◽  
Emil Anton ◽  
Carmen Anton ◽  
Eduard Crauciuc ◽  
...  
Keyword(s):  
Pregnancy Outcomes ◽  
Reproductive Age ◽  
Integrated Analysis ◽  
Immune Mediated ◽  
Pregnancy And Postpartum ◽  
Rheumatic Conditions ◽  
Adverse Pregnancy ◽  
Drug Optimization ◽  
The Impact

Pregnancy in autoimmune rheumatic diseases remains a real challenge in clinical practice due to complex interplay between disease activity, pregnancy and drugs, and account for potential influence of pregnancy on rheumatic condition and the impact of disease on pregnancy outcomes. Indeed, innovative and successful therapies have dramatically improved the quality of life in immune-mediated rheumatic conditions and, subsequently, allowed more patients of reproductive age to plan a pregnancy/to conceive. The purpose of this chapter is to discuss emerging data about the interaction of pregnancy and systemic erythematosus lupus (SLE) focusing on modulation of the immune system by pregnancy, pregnancy outcomes in women with active lupus, biomarkers of adverse pregnancy outcomes (APO) including predictors of pre-eclampsia, predictors of obstetric complications in SLE, the influence of autoantibodies on fetal health, and, finally, evidence about rheumatologic and obstetric follow-up. There are still unmet needs in this new field of reproductive rheumatology and it becomes crucial that researchers, physicians (rheumatologists, specialists in maternofetal medicine, obstetricians) and midwifes share their knowledge and expertise in counseling women with SLE wishing to conceive, assisting pregnancy and managing different issues related to APO as well as drug optimization in preconception, during pregnancy and postpartum period.

scholarly journals Antenatal depression and risk of gestational diabetes, adverse pregnancy outcomes and postpartum quality of life

2021 ◽  
Author(s):  
Caro Minschart ◽  
Kyara De Weerdt ◽  
Astrid Elegeert ◽  
Paul Van Crombrugge ◽  
Carolien Moyson ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Depressive Symptoms ◽  
Gestational Diabetes ◽  
Glucose Tolerance ◽  
Pregnancy Outcomes ◽  
Oral Glucose ◽  
Sf 36 ◽  
Adverse Pregnancy ◽  
The Impact

Abstract Aims To determine the impact of depressive symptoms on pregnancy outcomes and postpartum quality of life in women with gestational diabetes mellitus (GDM) and normal glucose tolerance (NGT). Methods 1843 women from a prospective cohort study received universal GDM screening with an oral glucose tolerance test (OGTT). The Center for Epidemiologic Studies - Depression questionnaire was completed before GDM diagnosis was communicated, and in GDM women in early postpartum. All participants completed the SF-36 health survey postpartum. Results Women who developed GDM (231; 12.5%) had significantly more often depressive symptoms than NGT (1612; 87.5%) women [21.3% (48) vs. 15.1% (239), OR 1.52, 95% CI (1.08-2.16), p=0.017]. Compared to GDM women without depressive symptoms, depressed GDM women attended less often the postpartum OGTT [68.7% (33) vs. 87.6% (155), p=0.002], remained more often depressed [37.1% (13) vs. 12.4% (19), p<0.001] and had lower SF-36 scores postpartum. There were no significant differences in pregnancy outcomes between both groups. Rates of labor inductions were significantly higher in the NGT group with depressive symptoms compared to the non-depressed NGT group [31.7% (75) vs. 24.7% (330), aOR 1.40, 95% CI (1.01-1.93), p=0.041]. NGT women with depressive symptoms had lower SF-36 scores (p<0.001) postpartum compared to non-depressed NGT women. Conclusions Women with antenatal symptoms of depression develop more often GDM. GDM women with depressive symptoms remain more often depressed postpartum with lower quality of life. NGT women with depressive symptoms have higher rates of labor inductions and lower quality of life postpartum compared to non-depressed NGT women.

scholarly journals Hepatitis B Virus Infection in Pregnancy: Immunological Response, Natural Course and Pregnancy Outcomes

2021 ◽  
Vol 10 (13) ◽  
pp. 2926
Author(s):  
Sirinart Sirilert ◽  
Theera Tongsong
Keyword(s):  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Pregnancy Outcomes ◽  
Natural Course ◽  
Hbv Infection ◽  
Chronic Hbv Infection ◽  
B Virus ◽  
Chronic Hbv ◽  
Adverse Pregnancy ◽  
The Impact

This review aimed to provide an update on the impact of pregnancy on the natural course of hepatitis B virus (HBV) infection and also on the impact of HBV infection on adverse pregnancy outcomes, including mother-to-child transmission (MTCT). For the literature review, original research articles, review articles, and guidelines were narratively reviewed and comprehensively validated. The databases of PubMed, EMBASE, and CINAHL were carefully searched for articles in English on topics related to HBV infection, pregnancy, and vertical transmission from 1960 to May 2021. Immunological changes during pregnancy such as suppression of Th1 response and induction of Th2 immunity lead to an impaired immune reaction to HBV and stimulate viral activity along with the reduction of CD8 T cells to escape immune detection. The impact of pregnancy on the natural course of chronic HBV infection seems to be minimal, while pregnancy can increase morbidity and mortality in the case of advanced HBV hepatitis or cirrhosis. Importantly, hepatitis flare or alanine aminotransferase (ALT) flare can occur during pregnancy and is more common during the postpartum period due to the interaction between HBV and the immune response. Interestingly, the impact of HBV infection on adverse pregnancy outcomes is more serious than ever thought. Updated evidence indicates that pregnancies with chronic HBV infection increase the risk of preterm birth and gestational diabetes, especially in cases of positive hepatitis e antigen (HBeAg).

scholarly journals Impact of Wildfire Smoke on Adverse Pregnancy Outcomes in Colorado, 2007–2015

2019 ◽  
Vol 16 (19) ◽  
pp. 3720 ◽  
Author(s):  
Mona Abdo ◽  
Isabella Ward ◽  
Katelyn O’Dell ◽  
Bonne Ford ◽  
Jeffrey Pierce ◽  
...  
Keyword(s):  
Birth Weight ◽  
Pregnancy Outcomes ◽  
Gestational Hypertension ◽  
Adverse Pregnancy Outcomes ◽  
Adverse Outcomes ◽  
Wildfire Smoke ◽  
Secondary Outcomes ◽  
Adverse Pregnancy ◽  
The Impact ◽  
Zip Code

Colorado is regularly impacted by long-range transport of wildfire smoke from upwind regions. This smoke is a major source of ambient PM2.5. Maternal exposure to total PM2.5 during pregnancy has been linked to decreased birth weight and other adverse outcomes, although the impact of wildfire smoke contribution has only recently been investigated. The objective of this study was to estimate associations between adverse pregnancy outcomes and ambient wildfire smoke PM2.5. Wildfire smoke PM2.5 exposures were estimated using a previously published method incorporating ground-based monitors and remote sensing data. Logistic regression models stratified by ZIP code and mixed models with random intercept by ZIP code were used to test for associations. The primary outcomes of interest were preterm birth and birth weight. Secondary outcomes included gestational hypertension, gestational diabetes, neonatal intensive care unit admission, assisted ventilation, small for gestational age, and low birth weight. Exposure to wildfire smoke PM2.5 over the full gestation and during the second trimester were positively associated with pre-term birth (OR = 1.076 (μg/m3)−1 [95% CI = 1.016, 1.139; p = 0.013] and 1.132 (μg/m3)−1 [95% CI = 1.088, 1.178]; p < 0.0001, respectively), while exposure during the first trimester was associated with decreased birth weight (−5.7 g/(μg/m3) [95% CI: −11.1, −0.4; p = 0.036]). Secondary outcomes were mixed.

scholarly journals The Burden of Endometriosis on Women’s Lifespan: A Narrative Overview on Quality of Life and Psychosocial Wellbeing

2020 ◽  
Vol 17 (13) ◽  
pp. 4683 ◽  
Author(s):  
Luigi Della Corte ◽  
Claudia Di Filippo ◽  
Olimpia Gabrielli ◽  
Sabrina Reppuccia ◽  
Valentina Lucia La Rosa ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Social Relationships ◽  
Health Resources ◽  
Chronic Inflammatory Disease ◽  
Reproductive Age ◽  
Sexual Life ◽  
Women's Lives ◽  
Pain Symptoms ◽  
The Impact

Endometriosis is a chronic, inflammatory disease affecting more than 170 million women worldwide and up to 10% of women of reproductive age. As a consequence of inflammatory reaction and infiltration of anatomic structures, endometriosis can cause “pain symptoms” including dysmenorrhea, dyspareunia, dyschezia, dysuria, and chronic pelvic pain. In this review, we summarized the impact of endometriosis on quality of life in all its aspects including sexual life, work, and social relationships. The data research was conducted using web-based search engines and/or various electronic research databases querying for all articles related to endometriosis and quality of life from the inception of the database up to February 2020. Endometriosis has not only physical but also psychological effects, causing depression, anxiety, and compromising social relationships. Furthermore, endometriosis negatively impacts sexual life and social relationships. At last, the economic burden of endometriosis should not be underestimated, both individually and for the community, as this pathology leads to a loss of productivity at work and large use of health resources. Thus, endometriosis-related symptoms control women’s lives compromising the quality of life in all aspects. In this review, we summarized the impact of endometriosis on various aspects of women’s lives.

scholarly journals Applying deep learning for adverse pregnancy outcome detection with pre-pregnancy health data

2018 ◽  
Vol 189 ◽  
pp. 10014 ◽  
Author(s):  
Yu Mu ◽  
Kai Feng ◽  
Ying Yang ◽  
Jingyuan Wang
Keyword(s):  
Deep Learning ◽  
Pregnancy Outcome ◽  
Pregnancy Outcomes ◽  
Learning Algorithm ◽  
Adverse Pregnancy Outcome ◽  
Health Data ◽  
Adverse Pregnancy Outcomes ◽  
Deep Learning Algorithm ◽  
Adverse Pregnancy

Adverse pregnancy outcomes can bring enormous losses to both families and the society. Thus, pregnancy outcome prediction stays a crucial research topic as it may help reducing birth defect and improving the quality of population. However, recent advances in adverse pregnancy outcome detection are driven by data collected after mothers having been pregnant. In this situation, if a bad pregnancy outcome is diagnosed, the parents will suffer both physically and emotionally. In this paper, we develop a deep learning algorithm which is able to detect and classify adverse pregnancy outcomes before parents getting pregnant. We train a multi-layer neural network by using a dataset of 75542 couples’ multidimension pre-pregnancy health data. Our model outperforms some of algorithms in accuracy, recall and F1 score.

Preconception Care in the Veterans Health Administration

2018 ◽  
Vol 36 (06) ◽  
pp. 327-339
Author(s):  
Lisa Callegari ◽  
Stephanie Edmonds ◽  
Sonya Borrero ◽  
Ginny Ryan ◽  
Caitlin Cusack ◽  
...  
Keyword(s):  
Pregnancy Outcomes ◽  
Partner Violence ◽  
Preconception Care ◽  
Women Veterans ◽  
Ethnic Disparities ◽  
Well Being ◽  
Reproductive Age ◽  
Health Administration ◽  
Childbearing Age ◽  
Adverse Pregnancy

AbstractPreconception care (PCC), defined as a set of interventions to help women optimize their health and well-being prior to pregnancy, can improve pregnancy outcomes and is recommended by national organizations including the Centers for Disease Control and Prevention and the American College of Obstetricians and Gynecologists. Women Veterans who use the Department of Veterans Affairs (VA) health care system may face elevated risks of adverse pregnancy and birth outcomes due to a high prevalence of chronic medical and mental health conditions as well as psychosocial stressors including sexual trauma history and intimate partner violence. Many women Veterans of childbearing age experience poverty and homelessness, which are key social determinants of poor reproductive health outcomes. Furthermore, racial/ethnic disparities in maternal and neonatal outcomes are well documented, and nearly half of women Veterans of reproductive age are minority race/ethnicity. High-quality, equitable, patient-centered PCC services to address modifiable risks in this population are therefore a priority for VA. In this article, we provide a brief background of PCC, discuss the health risks of Veterans associated with adverse pregnancy outcomes, and highlight VA initiatives related to PCC. Lastly, we discuss implications and future directions for PCC research and policy within VA and across other health systems.

scholarly journals Nutritional status of pregnant women: prevalence and associated pregnancy outcomes

2001 ◽  
Vol 35 (6) ◽  
pp. 502-507 ◽  
Author(s):  
Luciana Bertoldi Nucci ◽  
Maria Inês Schmidt ◽  
Bruce Bartholow Duncan ◽  
Sandra Costa Fuchs ◽  
Eni Teresinha Fleck ◽  
...  
Keyword(s):  
Gestational Diabetes ◽  
Nutritional Status ◽  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Educational Level ◽  
Adverse Pregnancy Outcomes ◽  
World Health ◽  
Prepregnancy Weight ◽  
Adverse Pregnancy ◽  
The Impact

INTRODUCTION: Although obesity is well recognized as a current public health problem, its prevalence and impact among pregnant women have been less investigated in Brazil. The objective of the study was to evaluate the impact of pre-obesity and obesity among pregnant women, describing its prevalence and risk factors, and their association with adverse pregnancy outcomes. METHODS: A cohort of 5,564 pregnant women, aged 20 years or more, enrolled at aproximately 20 to 28 weeks of pregnancy, seen in prenatal public clinics of six state capitals in Brazil were followed up, between 1991 and 1995. Prepregnancy weight, age, educational level and parity were obtained from a standard questionnaire. Height was measured in duplicate and the interviewer assigned the skin color. Nutritional status was defined using body mass index (BMI), according to World Health Organization (WHO) criteria. Odds ratios and 95% confidence interval were calculated using logistic regression. RESULTS: Age-adjusted prevalences (and 95% CI) based on prepregnancy weight were: underweight 5.7% (5.1%-6.3%), overweight 19.2% (18.1%-20.3%), and obesity 5.5% (4.9%-6.2%). Obesity was more frequently observed in older black women, with a lower educational level and multiparous. Obese women had higher frequencies of gestational diabetes, macrosomia, hypertensive disorders, and lower risk of microsomia. CONCLUSIONS: Overweight nutritional status (obesity and pre-obesity) was seen in 25% of adult pregnant women and it was associated with increased risk for several adverse pregnancy outcomes, such as gestational diabetes and pre-eclampsia.

scholarly journals The Impact of Exposure Misclassification on Associations Between Prepregnancy BMI and Adverse Pregnancy Outcomes

Obesity ◽  
2010 ◽  
Vol 18 (11) ◽  
pp. 2184-2190 ◽  
Author(s):  
Lisa M. Bodnar ◽  
Anna Maria Siega-Riz ◽  
Hyagriv N. Simhan ◽  
Jill C. Diesel ◽  
Barbara Abrams
Keyword(s):  
Pregnancy Outcomes ◽  
Adverse Pregnancy Outcomes ◽  
Exposure Misclassification ◽  
Prepregnancy Bmi ◽  
Adverse Pregnancy ◽  
The Impact

scholarly journals Myomas and Adenomyosis: Impact on Reproductive Outcome

2017 ◽  
Vol 2017 ◽  
pp. 1-14 ◽  
Author(s):  
Nikos F. Vlahos ◽  
Theodoros D. Theodoridis ◽  
George A. Partsinevelos
Keyword(s):  
Preterm Birth ◽  
Postpartum Hemorrhage ◽  
Placenta Previa ◽  
Reproductive Age ◽  
Current Evidence ◽  
Reproductive Outcome ◽  
Increased Risk ◽  
Structural Abnormalities ◽  
Adverse Pregnancy ◽  
The Impact

Among uterine structural abnormalities, myomas and adenomyosis represent two distinct, though frequently coexistent entities, with a remarkable prevalence in women of reproductive age. Various mechanisms have been proposed to explain the impact of each of them on reproductive outcome. In respect to myomas, current evidence implies that submucosal ones have an adverse effect on conception and early pregnancy. A similar effect yet is not quite clear and has been suggested for intramural myomas. Still, it seems reasonable that intramural myomas greater than 4 cm in diameter may negatively impair reproductive outcome. On the contrary, subserosal myomas do not seem to have a significant impact, if any, on reproduction. The presence of submucosal and/or large intramural myomas has also been linked to adverse pregnancy outcomes. In particular increased risk for miscarriage, fetal malpresentation, placenta previa, preterm birth, placenta abruption, postpartum hemorrhage, and cesarean section has been reported. With regard to adenomyosis, besides the tentative coexistence of adenomyosis and infertility, to date a causal relationship among these conditions has not been fully confirmed. Preterm birth and preterm premature rupture of membranes, uterine rupture, postpartum hemorrhage due to uterine atony, and ectopic pregnancy have all been reported in association with adenomyosis. Further research on the impact of adenomyosis on reproductive outcome is welcome.

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