共查询到20条相似文献,搜索用时 69 毫秒
1.
Klára Rosta Attila Molvarec Anna Enzsöly Bálint Nagy Zsolt Rónai Andrea Fekete Mária Sasvári-Székely János Rigó Jr. Ágota Vér 《European journal of obstetrics, gynecology, and reproductive biology》2009
Objective
Placental and systemic oxidative stress with an imbalance in the oxidant/antioxidant activity seems to play a central role in the pathogenesis of pre-eclampsia. The aim of our study was to examine whether two missense polymorphisms of the extracellular superoxide dismutase (SOD3) gene (Arg213Gly and Ala40Thr) are associated with pre-eclampsia in a Caucasian population from Hungary.Study design
One hundred and fifty-nine pre-eclamptic patients and 114 normotensive, healthy pregnant women were involved in this case-control study. The SOD3 Arg213Gly and Ala40Thr genotypes were determined using the polymerase chain reaction-restriction length polymorphism (PCR-RFLP) and allele-specific amplification methods.Results
The Arg213Gly variant was not detected in our population. There were no significant differences in the genotype and allele frequencies of the SOD3 Ala40Thr polymorphism between pre-eclamptic patients and control subjects. However, the mutant allele carriers of this polymorphism showed an increased risk for severe fetal growth restriction-complicated pre-eclampsia, which was independent of maternal age, prepregnancy BMI, primiparity and smoking status (OR: 6.07, 95% CI: 1.33–27.8, p = 0.020; adjusted OR: 4.89, 95% CI: 1.03–23.2, p = 0.046).Conclusion
Our results suggest a role of SOD3 Ala40Thr single nucleotide polymorphism in the risk of severe fetal growth restriction-complicated pre-eclampsia. However, further studies are needed with a larger sample size to confirm our findings and to explore the exact molecular basis of this observation. 相似文献2.
Alfred K. Mbah Amina P. Alio Phillip J. Marty Karen Bruder Valerie E. Whiteman Hamisu M. Salihu 《European journal of obstetrics, gynecology, and reproductive biology》2010
Objective
To examine the association between prior pre-eclampsia and subsequent stillbirth in black women and white women.Study design
This is a population-based retrospective study of Missouri maternally linked birth cohort files from 1989 to 2005. We analyzed singleton first and second births to mothers in the state of Missouri. The study population comprised women who experienced pre-eclampsia in their first pregnancy and a comparison group consisting of women who did not. The two groups were followed to their second pregnancy to document stillbirth occurrence. Adjusted odds ratios (OR) and 95% confidence intervals (CI) for the association between prior pre-eclampsia and subsequent stillbirth were obtained from logistic regression models.Results
Women who experienced prior pre-eclampsia had a 43% increased risk of subsequent stillbirth [OR = 1.43; 95% CI = 1.08–1.89]. Whereas women with a history of late-onset pre-eclampsia had no elevated risk for subsequent stillbirth, those whose first pregnancy resulted in early-onset pre-eclampsia had a more than 4-fold increased risk of stillbirth in their second pregnancy [OR = 4.07; 95% CI = 2.32–7.14]. When sub-analysis was performed on the two main racial groups in the State, we found that elevated risk for subsequent stillbirth in a second pregnancy was observed among black women with prior early-onset pre-eclampsia (OR = 8.21; 95% CI = 4.03–16.70) but not in whites (OR = 1.95; 95% CI = 0.72–5.26).Conclusion
Initiation of pregnancy with pre-eclampsia elevates the risk for subsequent stillbirth. The risk elevation is most pronounced in black women with early-onset pre-eclampsia in their first pregnancy. This information is valuable for inter-pregnancy counseling of affected women. 相似文献3.
Jenny G.Y. Chung Rennae S. Taylor John M.D. Thompson Ngaire H. Anderson Gustaaf A. Dekker Louise C. Kenny Lesley M.E. McCowan 《European journal of obstetrics, gynecology, and reproductive biology》2013
Objective
Excessive gestational weight gain (GWG) is an important contributing factor to the obesity epidemic in women and is associated with pregnancy complications. We investigated the relationship between GWG and caesarean delivery in labour, large for gestational age (LGA), small for gestational age (SGA) infants and pregnancy-induced hypertension by maternal pre-pregnancy body mass index (BMI) in a contemporary nulliparous cohort.Study design
Using 2009 Institute of Medicine guidelines, participants in the SCOPE study (from Cork, Ireland, Auckland, New Zealand and Adelaide, Australia) were classified into GWG categories (low, normal and high) according to pre-pregnancy BMI. Maternal characteristics and pregnancy outcomes were compared between weight gain categories. SGA and LGA were defined as <10th and >90th customised birthweight centile. Multivariable analysis adjusted for confounding factors that impact on GWG including BMI.Results
Of 1950 participants, 17.2% (n = 335) achieved the recommended GWG, 8.6% (n = 167) had low and 74.3% (n = 1448) had high GWG. Women with high GWG had increased rates of LGA infants [adjusted OR 4.45 (95% CI 2.49–7.99)] and caesarean delivery in labour [aOR 1.46 (1.03–2.07)]. SGA was increased in women with low GWG [aOR 1.79 (1.06–3.00)].Conclusion
Three quarters of participants had high GWG, which was associated with an independent risk of LGA infants and caesarean in labour. Low GWG was associated with SGA infants. These adverse outcomes are potentially modifiable by achievement of normal GWG, which should be an important focus of antenatal care. 相似文献4.
Sedigheh Hantush Zadeh Dezireh Khosravi Fatemeh Shahbazi Zeinab Kaviani Jebeli Farokhlegha Ahmadi Mahboobeh Shirazi 《European journal of obstetrics, gynecology, and reproductive biology》2013
Objective
To determine whether maternal urinary findings in the first trimester of pregnancy are associated with fetal growth restriction.Study design
The prevalence of urinary findings in singleton pregnancies complicated by fetal growth restriction were compared with a low-risk control group of pregnancies who gave birth to normal weight babies, in the same condition.Results
There were significant statistical differences in the mean gestational age (p < 0.001), isolated asymptomatic bacteriuria (p < 0.001), hematuria (p = 0.002, OR = 6.6, CI = 1.8–24.2) and proteinuria (p = 0.016, OR = 4.1, CI = 1.2–13.3). There was no recognizable relation between ketonuria and fetal growth restriction.Conclusion
Our data showed a relation between the increase of adverse pregnancy outcomes, including fetal growth restriction, and hematuria, proteinuria and asymptomatic bacteriuria. Appropriate monitoring of pregnant women using these findings may be helpful in the identification of more complications. 相似文献5.
Gali Pariente Eyal Sheiner Roy Kessous Sherf Michael Ilana Shoham-Vardi 《International journal of gynaecology and obstetrics》2013
Objective
To investigate whether delivering a small-for-gestational-age (SGA) newborn is a risk factor for subsequent long-term maternal cardiovascular morbidity.Methods
Data were analyzed from consecutive pregnant women who delivered at Soroka University Medical Center, Beer-Sheva, Israel, between 1988 and 1999, and were followed-up retrospectively until 2010. Long-term cardiovascular morbidity was compared among women with and without SGA neonates.Results
During the study period, 47 612 deliveries met the inclusion criteria, and 4411 (9.3%) women delivered an SGA neonate. Delivery of an SGA neonate was a risk factor for long-term complex cardiovascular events, including congestive heart failure, hypertensive heart and kidney disease, and acute cor pulmonale (odds ratio [OR], 2.3; 95% confidence interval [CI], 1.3–4.4; P = 0.006); and long-term cardiovascular mortality (OR, 3.4; 95% CI, 1.5–7.6; P = 0.006). Women who delivered an SGA neonate had a significantly higher risk for cardiovascular mortality during the follow-up period (Kaplan–Meier survival analysis, P = 0.002). Delivery of an SGA neonate remained an independent risk factor for long-term maternal cardiovascular mortality (Cox multivariable regression: adjusted hazard ratio, 3.5; 95% CI, 1.5–8.2; P = 0.004).Conclusion
Delivery of an SGA neonate is an independent risk factor for long-term cardiovascular morbidity in a follow-up period of more than 10 years. 相似文献6.
Factors associated with maternal near-miss morbidity and mortality in Kowloon Hospital,Suzhou, China
Fang-Rong Shen Ming Liu Xia Zhang Weiwen Yang You-Guo Chen 《International journal of gynaecology and obstetrics》2013
Objective
To investigate factors associated with acute maternal morbidity and mortality in Kowloon Hospital, Suzhou, China.Methods
Data from cases of near-miss and maternal death between January 2008 and December 2012 were reviewed retrospectively. Maternal characteristics and related factors were identified, and multiple regression analysis was used to calculate adjusted odds ratios (aORs) and 95% confidence intervals (CIs).Results
During the study period, there were 18 104 deliveries, 69 near-miss cases, and 3 maternal deaths. Women who had no health insurance (aOR, 4.55; 95% CI, 0.87–21.8), had fewer than 6 prenatal consultations (aOR, 6.76; 95% CI, 0.76–45.8), were part of a migrant population (aOR, 2.34; 95% CI, 0.45–24.9), or delayed seeking healthcare (aOR, 4.76; 95% CI, 0.89–13.6) had a greater risk of near-miss morbidity or death. Admission to intensive care (aOR, 6.75; 95% CI, 0.89–34.6) and blood transfusion within 30 min (aOR, 3.79; 95% CI, 0.65–8.67) were protective factors in disease progression.Conclusion
The factors associated with maternal near-miss morbidity and mortality were closely related to health insurance and socioeconomic status, suggesting that the government should take an active role in the community in preventing morbidity and mortality in pregnancy. 相似文献7.
Tai-Ho Hung T’sang-T’ang Hsieh Liang-Ming Lo Tsung-Hung Chiu Ching-Chang Hsieh Jenn-Jeih Hsu 《International journal of gynaecology and obstetrics》2013
Objective
To determine risk factors and perinatal outcomes associated with small for gestational age (SGA) neonates among healthy pregnant women.Methods
A retrospective cohort study was conducted of 49 945 women who gave birth at Chang Gung Memorial Hospital, Taipei, Taiwan, after 24 weeks of pregnancy. Idiopathic SGA newborns (n = 3398) were characterized by a birth weight below the 10th percentile for mean weight corrected for GA and fetal sex.Results
Risk factors for idiopathic SGA newborns included hypercoiling of the umbilical cord (adjusted odds ratio [aOR], 3.3; 95% confidence interval [CI], 1.6–7.0); prior fetal death (aOR, 2.8; 95% CI, 2.0–3.9); primiparity (aOR, 1.5; 95% CI, 1.4–1.7); adolescent pregnancy (aOR, 1.5; 95% CI, 1.2–2.0), low prepregnancy weight (aOR, 1.6; 95% CI, 1.5–1.8), low prepregnancy body mass index (aOR, 1.1; 95% CI, 1.0–1.3); short stature (aOR, 1.3; 95% CI, 1.1–1.4); and entangled umbilical cord (aOR, 1.1; 95% CI, 1.0–1.3). Idiopathic SGA newborns correlated with increased risk of adverse perinatal outcomes, including fetal death, low Apgar scores, oligohydramnios, placental abruption, and admission to the neonatal intensive care unit.Conclusion
Some risk factors for idiopathic SGA newborns were modifiable, suggesting potential implications for public health. 相似文献8.
Kathleen Tomsin Tinne Mesens Geert Molenberghs Louis Peeters Wilfried Gyselaers 《European journal of obstetrics, gynecology, and reproductive biology》2013
Objective
To assess the feasibility of non-invasive measurements of maternal cardiac output in relation to birth weight percentile and cardiovascular physiology in preeclampsia.Study design
In a cohort of 62 women with preeclampsia, impedance cardiography was used to measure cardiac output and to evaluate heart and arteries. Venous characteristics were assessed by combined electrocardiogram-Doppler ultrasonography. Statistical differences were evaluated by Mann–Whitney U-tests.Results
Cardiac output correlated with birth weight percentile (P = .002), with more small for gestational age newborns in low cardiac output preeclampsia (<7.5 L/min) than in high cardiac output preeclampsia (≥8.9 L/min) (12/29 vs. 2/16, P = .044). This was associated with lower aortic flow indices and shorter venous pulse transit times in low than in high cardiac output preeclampsia.Conclusion
Non-invasive impedance cardiography measurements of maternal cardiac output correlate with birth weight percentile and are associated with different functionality of heart, arteries, and veins in low and high cardiac output preeclampsia. 相似文献9.
Ana R.A.P. Bandeira Cezar A.L. Rezende Zilma S.N. Reis Achilles R. Barbosa Frederico J.A. Peret Antônio C.V. Cabral 《International journal of gynaecology and obstetrics》2014
Objective
To identify the epidemiologic profile, maternal survival, and prognosis factors that might affect survival rates in the obstetric intensive care unit (ICU).Methods
A prospective cohort study was conducted between January 2007 and February 2009 in a tertiary referral ICU, Belo Horizonte, Brazil. Critical patients during pregnancy and puerperium were followed from admission until discharge or death. Maternal survival was assessed in association with the cause of ICU admission, grouped into direct or indirect obstetric causes, by Kaplan–Meier curves and log-rank tests.Results
Among 298 patients admitted to the ICU during the study period, mortality was 4.7% (n = 14). Hypertensive disorders (46.0%), hemorrhage (15.9%), sepsis (14.2%), and heart disease (5.7%) were the main causes of admission. Half of the patients who died were admitted for direct obstetric reasons (n = 7). Survival was statistically linked to the cause of admission: most survivors were admitted for a direct obstetric cause (75.5%; P = 0.044). Maternal survival rates of patients admitted for indirect obstetric causes were lower than those admitted for direct obstetric causes (27.8 and 19.6 days, respectively; P = 0.019).Conclusion
The main cause of admission was a decisive factor for maternal survival in the obstetric ICU. Direct obstetric complications had a better prognosis. 相似文献10.
Xiaoming Wu Xiaohuan Wang Ying Chan Shuting Jia Ying Luo Wenru Tang 《European journal of obstetrics, gynecology, and reproductive biology》2013
Objectives
MTHFR C677T and A1298C have been associated with the risk of having an infant with Down syndrome (DS), but results were conflicting. We performed this meta-analysis to derive a more precise estimation of the association between maternal MTHFR polymorphisms and DS.Study design
An electronic search of PubMed and Chinese Biomedicine database was conducted to select studies for meta-analysis. Twenty-eight case–control studies containing MTHFR C677T and A1298C gene polymorphisms were chosen, and odds ratio (OR) with confidence interval (CI) was used to assess the strength of this association.Results
Case–control studies including 2806 cases and 4597controls for MTHFR C677T were identified. The overall results suggested that the variant genotypes MTHFR C677T were associated with DS risk (TT+CT vs. CC: OR = 1.305, 95% CI: 0.125–1.514, p = 0). In the stratified analysis, individuals with the T-carriers genotype in the dominant model had increased risk of DS (OR = 1.171, 95% CI: 0.976–1.405, p = 0.09) in Caucasian subjects and in Asian subjects (OR = 1.749, 95% CI: 1.084–2.824, p = 0.022). In addition, case–control studies including 1854 cases and 2364 controls for MTHFR A1298C were chosen. Associations between MTHFR A1298C and the risk of having a child with DS were not found. A symmetric funnel plot, the Egger's test (p = 0.126) suggested a lack of publication bias.Conclusion
This meta-analysis supports the idea that MTHFR C677T genotype is associated with increased risk for DS offspring. 相似文献11.
Boldizsár Horvath Magda Grasselly Tamas Bodecs Imre Boncz József Bodis 《European journal of obstetrics, gynecology, and reproductive biology》2012
Objective
To determine the interaction between histological chorioamnionitis and unexplained neonatal cerebral palsy among low birth weight infants.Study design
We studied 141 preterm infants below 1500 g delivered between 2000 and 2010. Clinical data, neonatal neuroimaging, laboratory results, the histopathological features of the placenta and gastric smear within the first hour of delivery, were evaluated.Results
Cerebral palsy was detected in 11 out of 141 preterm newborns (7.8%). The incidence of silent histological chorioamnionitis was 33.6% (43 of 128 cases). Chorioamniontis was significantly associated with the risk of unexplained cerebral palsy (p = 0.024). There were also significant correlations between maternal genital infections and chorioamnionitis (p = 0.005), and between maternal infections and a positive smear of neonatal gastric aspirates (p = 0.000). The rate of cesarean section was 67.4% (95 out of 141 deliveries), and elective cesarean section was performed in 68 cases.Conclusion
Intrauterine exposure to maternal infection was associated with a marked increase in the risk of cerebral palsy in preterm infants. 相似文献12.
Vimla Sharma Gabrielle Colleran Brendan Dineen Marie B. Hession Gloria Avalos John J. Morrison 《European journal of obstetrics, gynecology, and reproductive biology》2009
Objective
To evaluate the effects of maternal age, induction of labour, epidural analgesia and birth weight on mode of delivery in nulliparous women with a singleton pregnancy and cephalic presentation at ≥36 weeks gestation, and to describe how these factors and their influence have changed over a 17-year period from 1989 to 2005.Study design
The study was conducted in the obstetric department of a university teaching hospital in Ireland. Of 45,647 women delivered, 14,867 were nulliparous with a singleton pregnancy and cephalic presentation and undergoing labour at ≥36 weeks gestation, and were included in the study. The main outcome measures were the influence of maternal age, induction of labour, epidural analgesia and birth weight on the mode of delivery. Multinomial logistic regression analysis for type of delivery and the associated explanatory variables and trend analysis of these variables were performed.Results
There was a significant progressive increase in both unplanned abdominal delivery and instrumental vaginal delivery, with advancing maternal age. Induction of labour increased the risk of unplanned abdominal delivery (OR 1.92; 95% CI 1.73–2.14). Epidural analgesia was associated with an increased risk of instrumental vaginal delivery (OR 4.68; 95% CI 4.18–5.25), and unplanned abdominal delivery (OR 2.29; 95% CI 1.98–2.66). Mothers of infants with birth weight ≥4.5 kg were less likely to be delivered by instrumental vaginal delivery (OR 0.60; 95% CI 0.41–0.88), than mothers delivering infants in the 2.50–4.49 kg birth weight category. Between 1989 and 2005 there was a significant increase in maternal age (P = 0.0001), birth weight (P = 0.042) and unplanned abdominal delivery rates (P = 0.0004), and a reduction in instrumental vaginal delivery rates (P = 0.0013).Conclusions
These data demonstrate that the increasing trend of unplanned abdominal delivery in nulliparous women with a singleton pregnancy and cephalic presentation may be partially explained by advancing maternal age, and other obstetric factors also play a significant role. 相似文献13.
Juan De Leon-Luis Ricardo Perez Pilar Pintado Recarte Alfredo Avellaneda Fernandez Carlos Romero Roman Eugenia Antolin Alvarado Luis Ortiz-Quintana Maravillas Izquierdo Martinez 《European journal of obstetrics, gynecology, and reproductive biology》2012
Objectives
Adiponectin is an adipocyte-derived plasma protein with insulin-sensitizing and antiatherosclerotic properties. The objectives of the present study were to determine the amniotic fluid (AF) concentration of adiponectin during the second trimester of pregnancy and to demonstrate its association with maternal and fetal variables and AF concentrations of insulin, leptin, and pregnancy-associated-plasma-protein A (PAPP-A).Study design
We performed a cross-sectional study of 222 pregnant women who underwent amniocentesis at 15–18 weeks for genetic reasons. No malformation or chromosomal disorder was found in the newborn after birth. AF adiponectin, leptin, PAPP-A, and insulin concentrations were measured using commercially available assays. All maternal, fetal, and biochemical variables were studied using univariate and multivariate linear regression analysis to determine their association with the AF concentration of adiponectin.Results
Adiponectin concentration was negatively correlated with maternal smoking status (β = −5.208; p < 0.001) and positively correlated with levels of insulin (β = 0.621; p = 0.002) and PAPP-A (β = 40.150; p < 0.001). Non-significant correlations were found between adiponectin concentration and maternal age, maternal body mass index, gestational age at amniocentesis, fetal gender, and AF level of leptin.Conclusion
These findings suggest that the fetus and its membrane adipocytokines, in relationship with maternal and other fetal variables, play a dynamic role in the regulation of energy and oxidative stress homeostasis due to its insulin-sensitizing and antiatherosclerotic effects. The association of these molecules with maternal tobacco consumption during pregnancy could have perinatal implications. 相似文献14.
Hossam O. Hamed Muneera A. Alsheeha Ahmad M. Abu-Elhasan Alaa E. Abd Elmoniem Manal M. Kamal 《International journal of gynaecology and obstetrics》2014
Objective
To compare outcomes between elective delivery at 37 weeks of pregnancy and expectant management among pregnant women with mild to moderate chronic hypertension.Methods
In a two-center study, 76 women with mild to moderate chronic hypertension were randomly allocated to planned delivery at 37 completed weeks (group A) or expectant management for spontaneous onset of labor or reaching 41 weeks (group B) between April 2012 and October 2013. Differences were compared by t test, χ2 test, or Fisher exact test. Odds ratios (ORs) with 95% confidence interval (CIs) were determined.Results
There were no differences in superimposed pre-eclampsia (SPE), severe hypertension, preterm delivery, placental abruption, oligohydramnios, intrauterine growth restriction, or perinatal mortality between the groups. Group B had higher gestational age at delivery (P = 0.001) and birth weight (P = 0.01), but lower cesarean (OR 3.4; 95% CI, 1.2–10.3; P = 0.03) and neonatal care unit admission (OR 5.4; 95% CI, 1.4–21.0; P = 0.01) rates. More women with SPE were diagnosed before than after 37 weeks in group B (P = 0.01). Overall, patients who developed SPE had more adverse pregnancy outcomes than those who did not.Conclusion
Mild to moderate chronic hypertension could be managed expectantly up to 41 weeks if SPE did not develop. 相似文献15.
Graham Hutchings Thomas Gevaert Jan Deprest Bernd Nilius Olivia Williams Dirk De Ridder 《European journal of obstetrics, gynecology, and reproductive biology》2009
Objectives
Extracellular ATP is involved in cell–cell signalling in a variety of tissues but its effects in tissue level signalling in the myometrium have been poorly studied to date. We hypothesised that extracellular ATP was involved in the control of myometrial contractile frequency and/or force.Study design
In vitro study of the effect of altering the concentration of extracellular ATP on the spontaneous contractility of human myometrial strips obtained from term elective caesarean sections.Results
Decreasing extracellular ATP levels by the ectoATP-ase agent apyrase VI (1–50 units/mL) produced a dose dependent decrease in contractile frequency (decrease of 46.3% compared with the baseline frequency at 20 units/mL, p = 0.001, n = 6). Contractility was unchanged by apyrase VII (20 units/mL), an agent with relatively greater ADPase activity, indicating an effect via ATP and not ADP. Contractile frequency increased after addition of ATP 10–100 μM (an increase to 145.8% of baseline frequency at 100 μM: 126.1–165.5%, p = 0.005, n = 7) or the ATPase inhibitor ARL at 100 μM (an increase to 136.3% of the baseline frequency: 107.1–165.5, p = 0.03, n = 7). Contractile force remained unchanged by these agents.Conclusions
Extracellular ATP shows a dose–response relationship to contractile frequency but does not affect contractile force. Consequently it may be involved in the pacemaking mechanism for the generation of uterine contractions. 相似文献16.
Vincent Lavoué Laure Voguet Bruno Laviolle Caroline Piau Marie Pascale Beaumont Laure-Anne Haumont Hélène Isly Linda Lassel Estelle Bauville Karine Morcel Patrick Pladys Patrice Poulain Pierre Bétrémieux Claude Bendavid 《European journal of obstetrics, gynecology, and reproductive biology》2013
Objectives
The incidence of neonatal respiratory morbidity following an elective caesarean section is 2–3 times higher than after a vaginal delivery. The microviscosity of surfactant phospholipids, as measured with fluorescence polarisation, is linked with the functional characteristics of fetal surfactant and thus fetal lung maturity, but so far this point has received little attention in new-borns at term. The aim of the study is to evaluate the correlation between neonatal respiratory morbidity and amniotic microviscosity (Fluorescence Polarisation Index) in women undergoing caesarean section after 37 weeks’ gestation.Study design
The files of 136 women who had undergone amniotic microviscosity studies during elective caesarean deliveries at term were anonymised. Amniotic fluid immaturity (AFI) was defined as a Fluorescence Polarisation Index higher than 0.335.Results
Respiratory morbidity was observed in 10 babies (7.3%) and was independently associated with AFI (OR: 6.11 [95% CI, 1.20–31.1] with p = 0.029) and maternal body mass index (OR: 1.12 [95% CI, 1.02–1.22] with p = 0.019). Gestational age at the time of caesarean delivery was inversely associated with AFI (odds ratio, 0.46 [95% confidence interval, 0.29–0.71], p < 0.001), especially before 39 weeks, and female gender was associated with an increased risk (odds ratio, 3.29 [95% confidence interval, 1.48–7.31], p = 0.004).Conclusions
AFI assessed by amniotic microviscosity was significantly associated with respiratory morbidity and independently correlated with shorter gestational age especially before 39 weeks. This finding provides a physiological rationale for recommending delaying elective caesarean section delivery until 39 weeks of gestation to decrease the risk for respiratory morbidity. 相似文献17.
Objective
To determine the association of body mass index (BMI) on complications, recurrence, and survival in GOG LAP2, a randomized comparison of laparoscopic versus open staging in clinically early stage uterine cancer (EC).Methods
An ancillary data analysis of GOG LAP2 was performed. Categorical variables were compared using Pearson chi-square test and continuous variables using the Wilcoxon–Mann–Whitney and Kruskal–Wallis tests by BMI group. Survival was estimated using the Kaplan–Meier method. Cox proportional hazards model was used to evaluate independent prognostic factors on survival. Statistical tests were two-tailed with α = 0.05, except where noted. Statistical analyses utilized R programming language.Results
2596 women were included. BMI (kg/m2) groups were < 25 (29.5%), 25–30 (28.2%), 30–35 (21%), 35–40 (10.9%), and ≥ 40 (10.4%). Stage (p = 0.021), grade (p < 0.001), and histology (p = 0.005) differed by BMI. Obese women were less likely to have high risk (HR) disease (+ lymph nodes/ovaries/cytology) or tumor features that met GOG99 high intermediate risk (HIR) criteria (p < 0.001). Adjuvant therapy (p = 0.151) and recurrence (p = 0.46) did not vary by BMI. Hospitalization > 2 days, antibiotic use, wound infection, and venous thrombophlebitis were higher with BMI ≥ 40. BMI (p = 0.016), age (p < 0.0001), race (p = 0.033), and risk group (p < 0.0001) predicted all-cause mortality. BMI was not predictive of disease-specific survival (p = 0.79), but age (p = 0.032) and risk group (p < 0.0001) were significant factors.Conclusion
Obese women have greater surgical risk and lower risk of metastatic disease. BMI is associated with all-cause but not disease-specific mortality, emphasizing the detrimental effect of obesity (independent of EC), which deserves particular attention. 相似文献18.
Anne Marie Darling Enju Liu Said Aboud Willy Urassa Donna Spiegelman Wafaie Fawzi 《International journal of gynaecology and obstetrics》2014
Objective
To evaluate maternal glucose levels during pregnancy as a predictor of adverse perinatal outcomes in Dar es Salaam, Tanzania.Methods
Random blood glucose measurements were analyzed from 3383 pregnant women enrolled in a randomized trial to assess the impact of multivitamins on pregnancy outcomes in Dar es Salaam between August 2001 and July 2004. Information on maternal and neonatal morbidity was recorded at monthly study visits, delivery, and 6 weeks postpartum. Binomial regression and generalized estimating equations were used to determine the relationship between elevated glucose (> 7.8 mmol/L) and pregnancy outcomes.Results
In total, 25 women had elevated glucose (0.7%). Hyperglycemia was associated with an increased risk of delivery before 37 weeks [relative risk (RR), 2.11; 95% confidence interval [CI], 1.07–4.13; P = 0.03), delivery before 34 weeks (RR, 4.15; 95% CI, 1.43–12.03, P = 0.009), incident gestational hypertension (RR, 2.90; 95% CI, 1.24–6.76; P = 0.01), low birth weight (RR, 2.87; 95% CI, 1.18–6.99; P = 0.02), reduced newborn head circumference (mean difference, –1.57; 95% CI, –2.51 to − 0.62; P = 0.001), and fetal loss (RR, 3.38; 95% CI, 1.13–10.08; P = 0.03).Conclusion
Maternal hyperglycemia is uncommon among pregnant Tanzanian women, but nonetheless seems to increase the risk of several adverse perinatal outcomes. 相似文献19.
Maurizio Serati Gabriele Siesto Simona Carollo Giorgio Formenti Cristina Riva Antonella Cromi Fabio Ghezzi 《European journal of obstetrics, gynecology, and reproductive biology》2012
Objective
To evaluate the risk factors potentially involved in the development of cervical intraepithelial neoplasia (CIN) recurrence after cervical conization in a long-term follow-up period.Study design
Consecutive patients with histologically proven CIN who had undergone either cold knife conization or a loop electrosurgical excision procedure were enrolled and scheduled for serial follow-up examinations over a 10-year period. Data were stored in a digital database. Multivariate analysis was performed to identify factors for recurrence.Results
Between January 1999 and December 2009, 282 patients fulfilled the inclusion criteria and were included in the final statistical analysis. After a median follow-up of 26.7 months (range 6–100), 64 (22.7%) women developed histologically confirmed recurrence. The 2-year recurrence-free survival was 83.7% and 66.7% for women with negative and positive margins, respectively (p = 0.008). The 5-year recurrence-free survival was 75.4% and 50.3% for patients with negative and positive margins, respectively (p = 0.0004). Positive surgical margin was the most important independent predictor of recurrence [HR 2.5 (95%CI 1.5–4.5), p = 0.0007; Wald 11.338]. After multinomial logistic regression the indication for conization based on persistent CIN1 was the only independent predictor for negative margin [OR 0.3 (95%CI 0.1–0.7), p = 0.008].Conclusions
Our study demonstrated that the surgical margin status represents the most important predictor for CIN recurrence after conization. After excisional therapy, close follow-up is mandatory for the early detection of recurrent disease. The identification of risk factors for recurrence may guide clinical decision-making on expectant management versus re-intervention. 相似文献20.
Fredrik Ahlsson Barbro Diderholm Uwe Ewald Björn Jonsson Anders Forslund Mats Stridsberg Jan Gustafsson 《European journal of obstetrics, gynecology, and reproductive biology》2013