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Investigating outcomes following the use of selective serotonin reuptake Inhibitors for treating depression in pregnancy a focus on methodological issues

Grzeskowiak, L.E.; Gilbert, A.L.; Morrison, J.L.
Fonte: Springer Publicador: Springer
Tipo: Artigo de Revista Científica
Publicado em //2011 EN
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The aim of this review was to critically appraise the existing literature with a particular focus on identifying methodological issues associated with studying outcomes following the use of selective serotonin reuptake inhibitors (SSRIs) during pregnancy. Existing studies evaluating outcomes following prenatal SSRI exposure suffer from a number of important methodological limitations that should be taken into account when interpreting their results. The contradictory results obtained from prospective and retrospective cohort studies and case-control studies could be accounted for by dissimilarity between study populations, selection bias, detection bias, confounding, or differences in underlying maternal illness, data sources used, exposure classification, follow-up and statistical power/analysis. Only a small number of studies actually account for underlying maternal illness and how this may lead to adverse pregnancy outcomes. Even when such information is available, studies that include data on maternal illness have small sample sizes, limiting the statistical power to identify statistically and clinically relevant associations. Pregnancy outcomes may be confounded by the higher incidence of smoking, alcohol consumption and substance abuse frequently encountered amongst those suffering from depression...

Tissue oxygenation and red cell 2,3-diphosphoglycerate in normal and abnormal pregnancy

MacLennan, A.H.; Emerson, P.M.; Hunter, D.J.S.; Darley, J.H.
Fonte: Blackwell Science Publicador: Blackwell Science
Tipo: Artigo de Revista Científica
Publicado em //1976 EN
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Maternal tissue oxygenation was reflected by the level of red cell, 2,3-diphosphoglycerate (DPG) was measured before, during and after normal pregnancy. Following an initial fall at the beginning of pregnancy there was a significant rise in the mean level of DPG during pregnancy with an abrupt fall in the puerperium. The mean red cell DPG level in the third trimester of pregnancies complicated by pre-eclampsia and diabetes was not statistically different from the normal but the mean value of all pregnancies in which the fetus was stillborn or growth retarded was significantly lower (p less than 0-001). The possible mechanism of the changes in normal and abnormal pregnancy is discussed and it is suggested that the measurement of red cell DPG in the third trimester of pregnancy may prove to be a useful parameter of placental oxygenation.; A. H. Maclennan, Pauline M. Emerson, D. J. S. Hunter and J. H. Darley; Article first published online: 23 AUG 2005

Association between weight gain during pregnancy and pregnancy outcomes after dietary and lifestyle interventions: a meta-analysis

Ruifrok, A.E.; Van Poppel, M.N.M.; Van Wely, M.; Rogozińska, E.; Khan, K.S.; De Groot, C.J.M.; Thangaratinam, S.; Mol, B.W.
Fonte: Thieme Publishing Publicador: Thieme Publishing
Tipo: Artigo de Revista Científica
Publicado em //2014 EN
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OBJECTIVES: Lifestyle interventions in obese pregnant women reduce adverse maternal outcomes of pregnancy. However, the association between weight change due to interventions and the actual reduction in complications is unknown. The objective of this study was to determine the association between gestational weight gain (GWG) and the rate of pregnancy complications. STUDY DESIGN: The authors included randomized controlled trials (RCTs) assessing the effect of lifestyle interventions during pregnancy on GWG and adverse maternal and fetal outcomes. For each outcome they assessed the association between GWG and the risk of adverse pregnancy outcomes. RESULTS: They analyzed data of 23 RCTs (4,990 women). Increased GWG was associated with a nonsignificant increase in the incidence of preeclampsia (PE) (0.2% per gained kg, 95% confidence interval [CI] 0.5 to 0.9%, p > 0.05), gestational diabetes (GDM) (0.3% per gained kg, 95% CI -0.5 to 1.0%, p > 0.05), and induction of labor (IOL) (1.5% per gained kg, 95% CI -0.9 to 3.9%, p > 0.05). CONCLUSIONS: Reduction in GWG due to lifestyle interventions in pregnancy had statistically nonsignificant effects on lowering the incidence of PE, GDM, and IOL. Possibly, the beneficial effect of lifestyle interventions on pregnancy outcomes is due to an effect independent of the reduction of GWG.; A.E. Ruifrok...

Postpartum depression among women with unintended pregnancy

Brito,Cynthia Nunes de Oliveira; Alves,Sandra Valongueiro; Ludermir,Ana Bernarda; Araújo,Thália Velho Barreto de
Fonte: Faculdade de Saúde Pública da Universidade de São Paulo Publicador: Faculdade de Saúde Pública da Universidade de São Paulo
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2015 EN
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OBJECTIVE To analyze the association between unintended pregnancy and postpartum depression.METHODS This is a prospective cohort study conducted with 1,121 pregnant aged 18 to 49 years, who attended the prenatal program devised by the Brazilian Family Health Strategy, Recife, PE, Northeastern Brazil, between July 2005 and December 2006. We interviewed 1,121 women during pregnancy and 1,057 after childbirth. Unintended pregnancy was evaluated during the first interview and postpartum depression symptoms were assessed using the Edinburgh Postnatal Depression Screening Scale. The crude and adjusted odds ratios for the studied association were estimated using logistic regression analysis.RESULTS The frequency for unintended pregnancy was 60.2%; 25.9% presented postpartum depression symptoms. Those who had unintended pregnancies had a higher likelihood of presenting this symptoms, even after adjusting for confounding variables (OR = 1.48; 95%CI 1.09;2.01). When the Self Reporting Questionnaire (SRQ-20) variable was included, the association decreased, however, remained statistically significant (OR = 1.42; 95%CI 1.03;1.97).CONCLUSIONS Unintended pregnancy showed association with subsequent postpartum depressive symptoms. This suggests that high values in Edinburgh Postnatal Depression Screening Scale may result from unintended pregnancy.

Spontaneous preterm birth and small for gestational age infants in women who stop smoking early in pregnancy: prospective cohort study

McCowan, L.; Dekker, G.; Chan, E.; Stewart, A.; Chappell, L.; Hunter, M.; Moss-Morris, R.; North, R.
Fonte: British Med Journal Publ Group Publicador: British Med Journal Publ Group
Tipo: Artigo de Revista Científica
Publicado em //2009 EN
Relevância na Pesquisa
36.5%
OBJECTIVES: To compare pregnancy outcomes between women who stopped smoking in early pregnancy and those who either did not smoke in pregnancy or continued to smoke. DESIGN: Prospective cohort study. SETTING: Auckland, New Zealand and Adelaide, Australia. PARTICIPANTS: 2504 nulliparous women participating in the Screening for Pregnancy Endpoints (SCOPE) study grouped by maternal smoking status at 15 (+/-1) week's gestation. MAIN OUTCOME MEASURES: Spontaneous preterm birth and small for gestational age infants (birth weight <10th customised centile). We compared odds of these outcomes between stopped smokers and non-smokers, and between current smokers and stopped smokers, using logistic regression, adjusting for demographic and clinical risk factors. RESULTS: 80% (n=1992) of women were non-smokers, 10% (n=261) had stopped smoking, and 10% (n=251) were current smokers. We noted no differences in rates of spontaneous preterm birth (4%, n=88 v 4%, n=10; adjusted odds ratio 1.03, 95% confidence interval l0.49 to 2.18; P=0.66) or small for gestational age infants (10%, n=195 v 10%, n=27; 1.06, 0.67 to 1.68; P=0.8) between non-smokers and stopped smokers. Current smokers had higher rates of spontaneous preterm birth (10%, n=25 v 4%, n=10; 3.21...

Magnesium supplementation in pregnancy

Makrides, M.; Crowther, C.A.
Fonte: Universidade de Adelaide Publicador: Universidade de Adelaide
Tipo: Artigo de Revista Científica
Publicado em //2001 EN
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BACKGROUND: Many women, especially those from disadvantaged backgrounds, have intakes of magnesium below recommended levels. Magnesium supplementation during pregnancy may be able to reduce fetal growth retardation and pre-eclampsia, and increase birth weight. OBJECTIVES: The objective of this review was to assess the effects of magnesium supplementation during pregnancy on maternal, neonatal and paediatric outcomes. SEARCH STRATEGY: We searched the Cochrane Cochrane Controlled Trials Register. The date of the last search was June 2001. SELECTION CRITERIA: Randomised and quasi-randomised trials of dietary magnesium supplementation during pregnancy. DATA COLLECTION AND ANALYSIS: Suitability for inclusion and methodological quality were separately assessed by each reviewer. Data were independently extracted by the two reviewers. MAIN RESULTS: Seven trials involving 2689 women were included. Six of these trials randomly allocated women to either an oral magnesium supplement or a control group, whist the largest trial with 985 women had a cluster design where randomisation was according to study centre. The analysis was conducted with and without the cluster trial. In the analysis of all trials, oral magnesium treatment from before the 25th week of gestation was associated with a lower frequency of preterm birth...

The impact of nausea and vomiting on women: a burden of early pregnancy

Smith, C.; Crowther, C.; Beilby, J.; Dandeaux, J.
Fonte: Blackwell Publishing Asia Publicador: Blackwell Publishing Asia
Tipo: Artigo de Revista Científica
Publicado em //2000 EN
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36.5%
Nausea and vomiting are troublesome symptoms occurring in the first trimester of pregnancy. The aim of this study was to describe the impact these symptoms have on women in early pregnancy by interviewing, using a structured questionnaire, 593 pregnant women presenting with nausea and vomiting in the first trimester of pregnancy. The women were asked to complete the Rhodes index of nausea and vomiting and the MOS 36 Short Form Health Survey (SF-36). Symptoms of nausea and vomiting started early in pregnancy. Nausea was the most troublesome symptom experienced by women, both in its duration and intensity. Low scores for the SF-36 were found for all items, particularly physical functioning, energy and social functioning. The women described substantial effects on working, household duties and parenting activities. Findings from this study suggest nausea and vomiting in early pregnancy has a profound impact on women's general sense of well-being and day to day life activities.

Mother's trauma during pregnancy affects fluctuating asymmetry in offspring's face

Za̧dzińska, E.; Kozieł, S.; Kurek, M.; Spinek, A.
Fonte: E. Schweizerbart'sche Publicador: E. Schweizerbart'sche
Tipo: Artigo de Revista Científica
Publicado em //2013 EN
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OBJECTIVE: Fluctuating asymmetry (FA) of paired body structures is considered to be a reliable measurement of developmental instability of humans. The aim of the study is to examine whether the mother's traumatic experience during pregnancy results in an increase of the level of fluctuating asymmetry of the structures of the face. METHODS: Average relative FA of six cephalometric traits was calculated in 269 boys aged 7-10 years from Lodz, Poland. The influence of experienced trauma during pregnancy on the level of the FA was assessed by multiple regression analysis allowing for others stressors during mothers' pregnancy. In order to assess which trimester of pregnancy of the experience of the trauma had an influence on the FA level, analysis of variance was used. RESULTS; Boys whose mothers had experienced a traumatic incident during pregnancy were characterized by a significantly higher level of facial asymmetry at the age of 7-10 years (t = 2.74; p = 0.007). The experience of trauma by a pregnant woman was only one factor among other stressors, which significantly rose the FA level of the child's face (Beta = 0.182; t = 2.94; p = 0.004). The time of the experience of the trauma--the first, the second or the third trimester of pregnancy--had not any effect on the FA level. CONCLUSION: The experience of trauma during pregnancy can result in visible disturbances of development of offspring. A decreased level of cortisol is associated with psychosomatic disorders and may also be potentially responsible for disorders of homeostasis in the process of formation of such morphological structures of the face.; Elzbieta Zadzińska...

Vitamin E supplementation in pregnancy

Rumbold, A.; Crowther, C.
Fonte: Update Software Ltd Publicador: Update Software Ltd
Tipo: Artigo de Revista Científica
Publicado em //2005 EN
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BACKGROUND: Vitamin C supplementation may help reduce the risk of pregnancy complications like pre-eclampsia, intrauterine growth restriction and maternal anaemia. There is a need to evaluate the efficacy and safety of vitamin C supplementation in pregnancy. OBJECTIVES: To evaluate the effects of vitamin C supplementation, alone or in combination with other separate supplements, on pregnancy outcomes, adverse events, side-effects and use of health resources. SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth Group Trials Register (23 June 2004), Cochrane Central Register of Controlled Trials (The Cochrane Library, Issue 2, 2004), MEDLINE, Current Contents and EMBASE. SELECTION CRITERIA: All randomised or quasi-randomised controlled trials evaluating vitamin C supplementation in pregnant women. Interventions using a multivitamin supplement containing vitamin C or where the primary supplement was iron were excluded. DATA COLLECTION AND ANALYSIS: Two authors independently assessed trials for inclusion, extracted data and assessed trial quality. MAIN RESULTS: Five trials, involving 766 women, are included in this review. No difference was seen between women supplemented with vitamin C alone or combined with other supplements compared with placebo for the risk of stillbirth (relative risk (RR) 0.87...

Specialised antenatal clinics for women with a multiple pregnancy to improve maternal and infant outcomes

Dodd, J.; Crowther, C.
Fonte: Update Software Ltd Publicador: Update Software Ltd
Tipo: Artigo de Revista Científica
Publicado em //2007 EN
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Background Regular antenatal care for women with a multiple pregnancy is accepted practice, and while most women have an increase in the number of antenatal visits, there is no consensus as to what constitutes optimal care. 'Specialised' antenatal clinics have been advocated as a way of improving outcomes for women and their infants. Objectives To assess, using the best available evidence, the benefits and harms of 'specialised' antenatal clinics compared with 'standard' antenatal care for women with a multiple pregnancy. Search strategy We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (October 2006), the Cochrane Central Register of Controlled Trials (CENTRAL)(The Cochrane Library 2005, Issue 4), and PubMed (January 1966 to January 2006). Selection criteria Randomised controlled trials with reported data that compared outcomes in mothers and babies who received 'specialised' antenatal care with outcomes in mothers and babies who received 'standard' antenatal care. Data collection and analysis Both review authors independently assessed trial quality and extracted data. Main results There are no included studies. Authors' conclusions There is no information available from randomised controlled trials to support the role of 'specialised' antenatal clinics for women with a multiple pregnancy compared with 'standard' antenatal care in improving maternal and infant health outcomes. The value of 'specialised' multiple pregnancy clinics in improving health outcomes for women and their infants requires evaluation in appropriately powered and designed randomised controlled trials; Dodd JM...

CHEMICAL AND MECHANICAL ADAPTATIONS OF THE RESPIRATORY SYSTEM AT REST AND DURING EXERCISE IN HEALTHY HUMAN PREGNANCY: IMPLICATIONS FOR RESPIRATORY SENSATION

Jensen, DENNIS
Fonte: Quens University Publicador: Quens University
Tipo: Tese de Doutorado Formato: 5334248 bytes; application/pdf
EN; EN
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Human pregnancy is characterized by significant increases in central ventilatory drive and perceived respiratory discomfort (breathlessness). The physiological mechanisms of hyperventilation and breathlessness in pregnancy remain largely unknown and understudied. Objective: The main purpose of this research was to elucidate the mechanisms of maternal hyperventilation, and to systematically examine the contribution of alterations in central ventilatory drive, static/dynamic respiratory mechanics and their interaction with respect to the intensity of perceived breathlessness during exercise in pregnancy. General Methods: Experiments were conducted between 34-38 wks gestation and again 4-5 months post-partum in a total of 35 healthy, young women. A comprehensive mathematical model of ventilatory control was used to examine the role of alterations in wakefulness and central chemoreflex drives to breathe, acid-base balance and female sex hormones in maternal hyperventilation. The effects of pregnancy on detailed ventilatory (breathing pattern, airway function, operating lung volumes, esophageal pressure-derived indices of respiratory mechanics) and perceptual (breathing and leg discomfort) responses to incremental cycle exercise to the limits of tolerance were also examined. Results: Maternal hyperventilation resulted from a complex interaction between alterations in arterial and central acid-base balance and other factors that directly affect ventilation...

THE ROLE OF ABNORMAL MATERNAL INFLAMMATION IN THE PATHOGENESIS OF PREGNANCY COMPLICATIONS

COTECHINI, TIZIANA
Fonte: Quens University Publicador: Quens University
Tipo: Tese de Doutorado
EN; EN
Relevância na Pesquisa
36.5%
Pre-eclampsia (PE), fetal growth restriction (FGR) and fetal death are common complications associated with human pregnancy. A hallmark of these adverse pregnancy outcomes is reduced utero-placental perfusion, which is believed to arise as a consequence of deficient trophoblast-mediated spiral artery remodelling. Other common features of PE, FGR and fetal demise include reduced nitric oxide (NO) bioavailability, alterations in maternal hemostasis and an abnormal maternal inflammatory response. Despite all that is known, the causative factors leading to the development of these adverse pregnancy outcomes remain unidentified. The results of this thesis identify aberrant maternal inflammation as key to the pathogenesis of PE, FGR and fetal loss using a rat model in which pregnant rats are injected with low-dose lipopolysaccharide (LPS). In particular, our in vivo animal studies revealed a causal role for tumour necrosis factor-alpha (TNF) in the development of FGR, features of PE and the development of maternal coagulopathies associated with fetal death. Our work also revealed a pregnancy-specific effect whereby the deleterious effects of LPS administration to pregnant rats (i.e. cytokine release, glomerular pathology, elevated white blood cell counts) did not occur to the same magnitude when LPS was administered to non-pregnant animals. Gross examination of placentas from saline and LPS-treated animals revealed that inflammation altered placental morphometrics resulting in reduced placental weight and area. Importantly...

Effects of Pregnancy and Physical Activity on Angiogenesis and Endothelial Function: Implications for the Development of Preeclampsia

WEISSGERBER, TRACEY
Fonte: Quens University Publicador: Quens University
Tipo: Tese de Doutorado Formato: 2336434 bytes; application/pdf
EN; EN
Relevância na Pesquisa
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Prospective epidemiological studies indicate that regular exercise during the year prior to conception reduces preeclampsia risk, whereas exercise during affects pregnancy reduces preeclampsia risk only at specific dosages, or in specific subpopulations. The risk of severe preeclampsia is increased among women who exercise for more than 270 minutes/week in early pregnancy. Physiology studies are needed to identify mechanisms through which regular exercise may influence preeclampsia risk. This dissertation examined the effects of pregnancy (30-36 weeks gestation), and regular exercise participation, on two important pathophysiological features of preeclampsia; circulating anti-angiogenic markers, represented by soluble fms-like tyrosine kinase-1 (sFlt-1) and soluble endoglin (sEng), and endothelial dysfunction. The results demonstrate that regularly exercising, pregnant non-smoking women have higher levels of serum placental growth factor (PlGF), lower levels of serum sFlt-1 and sFlt-1:PlGF, and are less likely to experience high serum sEng levels, than sedentary women. The effects of exercise on PlGF and sFlt-1:PlGF are more pronounced among women exercising less than 270 minutes/week in pregnancy. Anti-angiogenic changes that could contribute to preeclampsia were not observed immediately after short-duration...

Associação entre crescimento neoplasico e gravidez : estudo do perfil hormonal e alterações placentarias em ratas prenhes potadoras do carcinossarcoma de walker 256; Neoplasic growth and pregnancy : hormonal profile and placental alterations in pregnant tumor-bearing rats

Angela Luzia Drezza
Fonte: Biblioteca Digital da Unicamp Publicador: Biblioteca Digital da Unicamp
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 15/08/2008 PT
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A gravidez gera modificações no organismo materno para a implantação do blastocisto, que são provocadas por hormônios como estradiol e progesterona. O tempo e curso de gravidez dependem da unidade materno / fetal, a placenta, que é o órgão responsável pela trocas entre mãe e feto, além de secretar vários hormônios, dentre eles prolactina, estrógenos e progesterona. Quando a gravidez encontra-se associada ao desenvolvimento tumoral, situação de intensa multiplicação celular, podem ocorrer disfunções no desenvolvimento embrionário. Os hormônios sexuais e a prolactina têm suas concentrações alteradas durante a gravidez, para que a mesma transcorra corretamente e, além disso, esses hormônios podem interagir com células do sistema imune. A ação do desenvolvimento tumoral, por sua vez, também é responsável pela elevação, ainda maior, na quantidade de citocinas presentes no organismo. Dessa forma, no presente trabalho, avaliou-se a influência do câncer na regulação dos hormônios necessários à gravidez, bem como no desenvolvimento placentário, uma vez que citocinas presentes no líquido ascítico de animais portadores do carcinossarcoma de Walker 256 afetariam o curso normal da prenhez em ratas. Este trabalho foi realizado através da análise de 3 grupos experimentais (ratas prenhes controle...

Truancy and teenage pregnancy in English adolescent girls: can we identify those at risk?

Zhou, Yin; Puradiredja, Dewi Ismajani; Abel, Gary
Fonte: OUP Publicador: OUP
Tipo: Article; published version
EN
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This is the final published version. It first appeared at http://dx.doi.org/10.1093/pubmed/fdv029; Background Truancy has been linked to risky sexual behaviours in teenagers. However, no studies in England have examined the association between truancy and teenage pregnancy, and the use of truancy as a marker of teenagers at risk of pregnancy. Methods Using logistic regression, we investigated the association between truancy at age 15 and the likelihood of teenage pregnancy by age 19 among 3837 female teenagers who participated in the Longitudinal Study of Young People of England. We calculated the areas under the ROC curves of four models to determine how useful truancy would be as a marker of future teenage pregnancy. Results Truancy showed a dose?response association with teenage pregnancy after adjusting for ethnicity, educational intentions at age 16, parental socioeconomic status and family composition (?several days at a time? versus ?none?, odds ratio 3.48 95% confidence interval 1.90?6.36, P < 0.001). Inclusion of risk behaviours improved the accuracy of predictive models only marginally (area under the ROC curve 0.76 full model versus 0.71 sociodemographic characteristics only). Conclusions Truancy is independently associated with teenage pregnancy among English adolescent girls. However...

The effects of anemia on pregnancy outcome in patients with pyelonephritis.

Dotters-Katz, SK; Grotegut, CA; Heine, RP
Fonte: Universidade Duke Publicador: Universidade Duke
Tipo: Artigo de Revista Científica Formato: 780960 - ?
Publicado em //2013 ENG
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OBJECTIVE: Pyelonephritis is a common infectious morbidity of pregnancy. Though anemia is commonly associated with pyelonephritis, there are little data describing the effect of pyelonephritis with anemia on pregnancy outcomes. The purpose of this study was to further assess the association of anemia with infectious morbidity and pregnancy complications among women with pyelonephritis. STUDY DESIGN: We conducted a retrospective cohort study of pregnant women admitted to Duke University Hospital between July 2006 and May 2012 with pyelonephritis. Demographic, laboratory, and clinical data from the subject's pregnancy and hospitalizations were analyzed. Patients with pyelonephritis and anemia (a hematocrit < 32) were compared to those without anemia. Descriptive statistics were used to compare the two groups. RESULTS: 114 pregnant women were admitted with pyelonephritis and 45 (39.5%) had anemia on admission. There was no significant difference in age, race, preexisting medical conditions, or urine bacterial species between patients with anemia and those without. Women with anemia were more likely to deliver preterm (OR 3.3 (95% CI 1.07, 11.4), P = 0.04). When controlling for race and history of preterm delivery, women with anemia continued to have increased odds of preterm birth (OR 6.0...

Association of early and late maternal smoking during pregnancy with offspring body mass index at 4 to 5 years of age

Grzeskowiak, L.E.; Hodyl, N.A.; Stark, M.J.; Morrison, J.L.; Clifton, V.L.
Fonte: Cambridge University Press Publicador: Cambridge University Press
Tipo: Artigo de Revista Científica
Publicado em //2015 EN
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36.5%
The objective was to investigate the association between early and late maternal smoking during pregnancy on offspring body mass index (BMI). We undertook a retrospective cohort study using linked records from the Women's and Children's Health Network in South Australia. Among a cohort of women delivering a singleton, live-born infants between January 2000 and December 2005 (n=7658), 5961 reported not smoking during pregnancy, 297 reported quitting smoking during the first trimester of pregnancy, and 1400 reported continued smoking throughout pregnancy. Trained nurses measured the height and weight of the children at preschool visits in a state-wide surveillance programme. The main outcome measure was age- and sex-specific BMI z-score. At 4 to 5 years, mean (s.d.) BMI z-score was 0.40 (1.05), 0.60 (1.07) and 0.65 (1.18) in children of mothers who reported never smoking, quitting smoking and continued smoking during pregnancy, respectively. Compared with the group of non-smokers, both quitting smoking and continued smoking were associated with an increase in child BMI z-score of 0.15 (95% confidence interval: 0.01-0.29) and 0.21 (0.13-0.29), respectively. A significant dose-response relationship was also observed between the number of cigarettes smoked per day on average during the second half of pregnancy and the increase in offspring BMI z-score (P<0.001). In conclusion...

Incidência e preditores de gestação em mulheres com HIV/Aids no Rio de Janeiro; Incidencia y predictores de gestación en mujeres con VIH/SIDA en Rio de Janeiro, Sureste de Brasil; Pregnancy rates and predictors in women with HIV/AIDS in Rio de Janeiro, Southeastern Brazil

Friedman, Ruth Khalili; Bastos, Francisco I; Leite, Iuri Costa; Veloso, Valdiléa G; Moreira, Ronaldo I; Cardoso, Sandra W; Andrade, Ângela C Vasconcelos de; Sampaio, Michelle Cristina; Currier, Judith; Grinsztejn, Beatriz
Fonte: Universidade de São Paulo. Faculdade de Saúde Pública Publicador: Universidade de São Paulo. Faculdade de Saúde Pública
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; ; ; ; ; Formato: application/pdf
Publicado em 01/04/2011 ENG
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OBJETIVO: Identificar incidência e preditores incidência da primeira gestação entre mulheres com HIV/Aids. MÉTODOS: Estudo prospectivo de coorte conduzido entre 1996 e 2003 no Rio de Janeiro, RJ, com 225 mulheres acompanhadas até a primeira gestação ou até o primeiro evento considerado censura (histerectomia, ligadura tubárea, menopausa, 50 anos de idade, perda de acompanhamento, óbito ou final de dezembro de 2003). Taxas de incidência de gestação e de aborto foram estimadas e modelos de riscos proporcionais de Cox foram usados para identificar as características da visita de inclusão associadas com o risco de gestação. RESULTADOS: As mulheres foram acompanhadas por 565 pessoas/ano, com média de acompanhamento de 3 anos por mulher. A idade média foi de 32 anos (DP: 7) e 54,7% eram brancas. Sessenta gestações foram observadas em 39 mulheres e 18 resultaram em abortos induzidos (taxas de incidência de 6,9% e 2,1% mulheres/ano, respectivamente). Gestações repetidas ocorreram em 33,3% das mulheres (13/39). Maior risco de gestação foi observado entre mulheres jovens (HR = 3,42; IC95%:1,69;6,95) e entre aquelas vivendo com seus parceiros (HR = 1,89; IC95%:1,00;3,57). Menor risco de gestação esteve associado à maior escolaridade (HR = 0...

Prevalência do uso de medicamentos na gravidez: uma abordagem farmacoepidemiológica; Prevalence of drug use during pregnancy: a pharmacoepidemiological approach

Fonseca, Márcia Regina Campos Costa da; Fonseca, Edson da; Bergsten-Mendes, Gun
Fonte: Universidade de São Paulo. Faculdade de Saúde Pública Publicador: Universidade de São Paulo. Faculdade de Saúde Pública
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; ; ; ; ; Formato: application/pdf
Publicado em 01/04/2002 POR
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36.5%
INTRODUÇÃO: Tendo em vista as mudanças freqüentes do mercado de medicamentos que influenciam o padrão de prescrição e automedicação, realizou-se estudo para conhecer a utilização de medicamentos entre mulheres durante a gravidez. MÉTODOS: Em um estudo retrospectivo sobre o padrão do uso de medicamentos durante a gravidez realizado em um hospital-escola de Campinas, SP, 1.000 puérperas foram entrevistadas após o parto, ainda no hospital, por meio de um questionário estruturado. Foram registrados: características sociodemográficas, antecedentes obstétricos e de contracepção, dados sobre assistência pré-natal e sobre uso de medicamentos na gravidez. Para análise estatística dos dados, foram utilizados Anova e qui-quadrado considerando o nível de significância (sinal de menor a 0,05). RESULTADOS: Das entrevistadas, 94,6% tomaram pelo menos um medicamento durante a gravidez, e 46,1% das pacientes utilizaram medicamentos no primeiro trimestre. Dos 3.778 itens de medicamentos relatados, 88,8% foram prescritos por médico. A mediana de medicamentos utilizados foi de 3 (0-18). As seis classes de medicamentos mais usados foram: analgésicos, antiespasmódicos, antiinfecciosos ginecológicos, antianêmicos, antiácidos e antibióticos sistêmicos. Os cinco medicamentos mais utilizados foram: butilescopolamina...

Pregnancy in renal transplanted patients: effects on the mother and the newborn - 29 years of experience in a single centre

Cândido,Cristina; Viegas,Márcio; Matias,Patrícia; Birne,Rita; Jorge,Cristina; Weigert,André; Adragão,Teresa; Bruges,Margarida; Machado,Domingos
Fonte: Sociedade Portuguesa de Nefrologia Publicador: Sociedade Portuguesa de Nefrologia
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/09/2015 EN
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36.5%
Background: Chronic kidney disease causes decreased fertility. With kidney transplantation, fertility is restored within a few months. Objective: To analyse the feasibility of pregnancy with renal transplantation and its impact on renal function, complications in women and newborns. Methods: Retrospective study of pregnancies that occurred in kidney transplant recipients between 1985 and 2014 in one Transplantation Unit, with a follow-up of 12 months post-partum. Results: Eighteen pregnancies were included (one twin pregnancy) in 13 kidney transplant recipients with an average age of 31 years. Of these, 12 pregnancies progressed, five resulted in miscarriage and one in abortion. Only one pregnancy was complicated by gestational diabetes. There were two stillbirths (twin pregnancy). The average weight of 11 newborns was 2.6 kilograms. There was a significant decrease of estimated glomerular filtration rate at 3 months post-partum [p < 0.05], but a year after delivery, the tendency was not maintained [p > 0.05]. Regarding proteinuria, the significant rise at 3 months was maintained until one year [p <0.05]. A significant increase in blood pressure was observed only on the 3rd trimester [p < 0.05], which did not maintain a year after delivery [p > 0.05]. In patients taking cyclosporine...