Showing papers on "Pregnancy published in 1978"

Prenatal loss of father and psychiatric disorders.

Abstract: • To test the role of maternal stress during pregnancy in psychiatric and behavior disorders, a retrospective epidemiological study was conducted, using the Finnish population register for persons born between 1925 and 1957. One hundred sixtyseven persons were detected whose fathers had died before their children's births; a control group comprised 168 persons whose fathers died during the first year of their children's lives. The number of diagnosed schizophrenics treated in psychiatric hospitals and the number of persons committing crimes were significantly higher in the index than in the control group. The incidence of alcoholism and personality disorders was relatively high in both groups. The index psychiatric cases had a low frequency of birth complications, whereas those of the control group were high. The results suggest that especially during months 3 to 5 and 9 to 10 of pregnancy, maternal stress may increase the risk of the child for psychiatric disorders, perhaps mediated through the inborn temperament of the child.

Epidemiology of Group B Streptococcus: Longitudinal Observations during Pregnancy

Abstract: A longitudinal, three-year study of the epidemiology of group B Streptococcus was conducted with repeated (four to 11) observations of 382 patients followed through pregnancy, delivery, and the postpartum period. Group B streptococci (2.3% of which were nonhemolytic) were isolated from the birth canal at first visit from 15% of the patients and from 28% with repeated cultures. Overall, group B streptococci were isolated at 12% of culture visits. Streptococcal carriage was significantly less common among patients who were Mexican-American, 20 years old or older, or in a fourth or later pregnancy. Multivariate analysis indicated that each of these three factors had a significant, independent bearing upon carriage of group B streptococci. Of 108 patients harboring these organisms in the birth canal, 36% could be classified as chronic, 20% as transient, and 15% as intermittent carriers. The relationship of infant colonization to the presence of streptococci in the birth canal at delivery and not to previous or subsequent carriage by the mother was consistent with the observation that maternal colonization was often inconstant.

Prevalence of intrahepatic cholestasis of pregnancy in Chile.

Abstract: The prevalence of intrahepatic cholestasis of pregnancy was studied immediately postpartum in 869 women from three distant Chilean cities differing in climate and food supply Cholestatic jaundice of pregnancy was detected in 24% and pruritus gravidarum in 132%, without significant differences between the three cities Every woman was then ethnically classified as predominantly Caucasoid, Araucanian Indian, or Aimara Indian A significantly higher prevalence of cholestatic jaundice of pregnancy (55%) and pruritus gravidarum (221%) was found in Araucanians than in Caucasoids (25% and 126% respectively) or in the Aimaras (0 and 118% respectively) The prevalence of intrahepatic cholestasis of pregnancy in Araucanians increased directly with the degree of "ethnic purity" Recurrence of the disease in multiparous women was also greater in Araucanians (138%) than in Caucasoids (55%) or in the Aimaras (39%) We propose that an ethnic predisposition to develop intrahepatic cholestasis of pregnancy is present in Araucanian women and that the high prevalence of the disease in Chile is mainly influenced by ethnic admixture with this South American Indian (ethnic) group

Rh isoimmunization during pregnancy: antenatal prophylaxis

Abstract: Of 3533 Rh-negative women who began a pregnancy without detectable Rh antibodies, 62 (1.8%) demonstrated evidence of Rh isoimmunization during pregnancy or within 3 days after delivery. All denied transfusions as well as abortions or previous pregnancies not followed by the administration of Rh immune globulin. Rh isoimmunization during pregnancy or within 3 days after delivery, which will not be prevented by the administration of Rh immune globulin after delivery, is the most important cause of residual Rh isoimmunization. A clinical trial of antenatal administration of Rh immune globulin, initially at 34 weeks9s and subsequently at 28 and 34 weeks9 gestation, in 1357 Rh-negative pregnant women who were delivered of Rh-positive babies, was effective in preventing the development of Rh isoimmunization during pregnancy or within 3 days after delivery. Antenatal prophylaxis with Rh immune globulin will be necessary if the incidence of Rh isoimmunization is to be reduced to its lowest possible level. Antenatal prophylaxis at 28 weeks9 gestation is now an insured service in Manitoba.

Cigarette smoking during pregnancy and the occurrence of spontaneous abortion and congenital abnormality

Abstract: A multiple logistic regression analysis of 12,914 pregnancies and 10,523 live births, based on a mail survey of professional women in medicine, was carried out to determine the relationship between maternal cigarette smoking, and spontaneous abortion and congenital abnormality. After controlling for interfering variables (age, exposure to trace anesthetic gases, pregnancy history, and mailing response), a statistically significant increase in risk associated with maternal cigarette smoking was found for spontaneous abortions and congenital abnormalities. The risk of spontaneous abortion for the heavy smoker is estimated to be as much as 1.7 times that of the nonsmoker in certain risk groups. The risk for congenital abnormality for babies born of smoking mothers is estimated to be as much as 2.3 times that of the nonsmoker, depending on age, pregnancy history, and other factors.

Alcohol consumption in pregnant women and the outcome of pregnancy.

Abstract: A prospective study of more than 9000 women shows that during pregnancy, women consuming alcoholic beverages in excess of 40 cl of wine per day have an increased risk of the following unfavorable pregnancy outcomes: (1) the risk of stillbirth is elevated, especially for death from abruptio placentae: (2) mean birth weight is lower, and the risk of a small-for-date infant is increased; (3) placental weight is also decreased. Although heavier drinkers differ from lighter drinkers in a certain number of variables that are risk factors for the outcome of pregnancy, the increase in risk with increased alcohol consumption remains evident after adjustment for these confounding variables. The increase in risk for heavier drinkers appears to be due to beer consumption, in spite of the lower average amount of ethanol consumed by beer drinkers as compared to wine drinkers.

Congenital cytomegalovirus infection in newborn infants of mothers infected before pregnancy.

Abstract: The rate of congenital cytomegalovirus (CMV) infection was studied in newborn infants in an African population in which all adults had experienced primary CMV infection during childhood. Viruria within the first 12 hours after delivery was taken as evidence of prenatal CMV infection. 28 of 2032 newborn infants examined had viruria, giving a rate of 1.4% congenital CMV infection. The presence of meternal serum antibody therefore appears not to protect the fetus from intrauterine infection. Either reactivation of latent maternal CMV infection or recurrence of infection during pregnancy despite the presence of serum antibodies may explain these findings. Whether the long-term effects of CMV infection acquired in utero differ in cases of primary maternal infection from those due to reactivated or recurrent infection in seropositive mothers, remains undecided. Thus, the value of a live CMV vaccine to prevent prenatal CMV infection may be questioned.

Blunt maternal trauma: A review of 103 cases

Abstract: One hundred three pregnant women hospitalized following blunt trauma had injuries classified as: major (20%); minor (17%); or insignificant (63%). Maternal mortality related only to the severity of maternal injuries: 24% of women who sustained major injuries died. Pregnancy ended unsuccessfully in 18% of all women with known pregnancy outcome. The incidence of unsuccessful pregnancy was 61% following major injuries and 27% following minor injuries. Insignificant maternal injuries did not affect pregnancy outcome. Fetal survival did not relate to gestational age per se. Pregnancy uniformly ended unsuccessfully in the presence of maternal death, placental injury, uterine injury, and direct fetal injury, and occurred in 80% of women admitted in hemorrhagic shock. An understanding of the ways that the anatomic and physiologic changes of pregnancy alter the nature and frequency of maternal injuries and that maternal response to injury is altered is essential. The best chance for fetal survival is to assure maternal survival.

Delay in postnatal growth and development of offspring produced by maternal restraint stress during pregnancy in the rat

Abstract: Rats were subjected to restraint stress for nine hours daily, on three consecutive days, at various stages of pregnancy from days 9–20, and the postnatal development and behaviour of the offspring assessed on a wide-ranging battery of tests. Stress at any of the stages of pregnancy investigated caused a significant decrease in offspring body weight persisting up to 6 weeks of age, and delayed the appearance of certain developmental landmarks such as ear opening, auditory startle and cliff avoidance responses. Postnatal mortality and impairment of ability to orient to the home cage were also significantly increased in the offspring from rats stressed on days 18–20 of pregnancy. In a second experiment, the effects of restraint stress on days 18–20 were investigated in more detail. At birth, stressed and control offspring were fostered onto mothers from the same treatment group or cross-fostered onto mothers from the opposite treatment group and assessed as before, to determine whether the adverse effects observed in the first experiment were prenatally or postnatally mediated. The effects were most marked in prenatally stressed pups reared by stressed mothers and least marked in controls reared by controls, with the other two cross-fostered groups being intermediate; this indicates that the effects were induced partly prenatally at the time of treatment and partly postnatally by the rearing mothers that had been stressed.

The safety of immunotherapy during pregnancy

Abstract: A group of 121 pregnancies from 90 atopic mothers who had received immunotherapy during pregnancy were studied retrospectively with the use of physician or maternal questionnaires and obstetric records. The incidence of prematurity, toxemia, abortion, neonatal death, and congenital malformation was no greater than that for the general population. The offspring of the treated mothers developed allergic disease as frequently as children born into allergic families. A group of 147 untreated pregnancies of atopic mothers were similarly studied, and the incidence of those parameters were similar except for a greater incidence of abortion. The implications of these findings are discussed.

Sampling pure fetal blood by fetoscopy in second trimester of pregnancy.

Abstract: A technique for fetal blood-sampling in the second trimester of pregnancy (between 16 and 22 weeks' gestation) combining fetoscopy with real-time ultrasound was used in 48 attempts at fetal blood-sampling. Specimens containing fetal red cells with or without amniotic fluid or maternal blood, and adequate for diagnosing haemoglobinopathies, were obtained in 45 of the 48 fetoscopies. Sampling was successful in all 18 patients with a posterior placenta, and in 27 of the 30 with an anterior placenta. In 22 of the last 27 consecutive fetoscopies pure fetal blood was taken; the placenta was anterior in 16 and posterior in six. Out of 17 cases sampled between 18 and 22 weeks' gestation pure fetal blood was obtained in 16. The volume of the samples varied from 50 to 500 microliter. The ability to obtain pure fetal blood consistently even when the placenta is anterior will increase knowledge of fetal physiology and the scope of prenatal diagnosis.

Changes of serum anti-thyroid antibodies during and after pregnancy in autoimmune thyroid diseases.

Abstract: Changes of serum anti-thyroglobulin haemagglutination antibodies (TGHA) and anti-thyroid microsomal haemagglutination antibodies (MCHA) were observed during pregnancy and after delivery in Graves' disease and autoimmune thyroiditis. Both TGHA and MCHA decreased as pregnancy progressed, and sometimes they became negative in late pregnancy. Transient increases of TGHA and MCHA were observed after delivery and the antibody titres reached peaks about 3-4 months post-partum in more than halft the patients. In some patients, antibodies developed after delivery. Similar transient increases of antibodies were observed after spontaneous and therapeutic abortion. These changes seem to be induced by physiological and immunological changes occurring during pregnancy and after delivery.

Fetal and maternal risk factors in herpes gestationis.

Abstract: • Forty-one cases of immunologically proved herpes gestationis (HG) are reviewed and there appears to be an increased risk of fetal morbidity and mortality. The onset of HG is most frequent in the second and third trimesters of pregnancy although postpartum onset or exacerbation is common. The presence of high-titer, antibasement membrane zone antibody seems to correlate with a severe clinical disease. Systemic treatment with corticosteroids is frequently necessary in order to control maternal signs and symptoms of HG. ( Arch Dermatol 114:552-555, 1978)

Pregnancy outcome of patients treated for Hodgkin's disease: a controlled study.

Abstract: Normal reproduction prosepcts for Hodgkin's disease patients are unknown. This study compares the outcome of 93 pregnancies in 48 patients with 228 pregnancies in 69 sibling controls. No statistically significant differences for spontaneous abortions or abnormal offspring were noted comparing all patients with all controls or 35 irradiated patients with all controls. Pregnancy outcome of 13 patients who received both irradiation and chemotherapy prior to pregnancy appeared to be compromised compared to controls. Wives of male patients in this category were more likely to have spontnaeous abortions than wives of male controls; female patients in this category were significantly more likely to produce abnormal offspring than were female controls (p = 0.047). In this series of patients therapeutic irradiation alone did not appear to jeoparadize posttreatment reproduction in fertile Hodgkin's disease patients but in the smaller group of patients who received both irradiation and chemotherapy the reproduction picture was statistically not as good.

Clinical course and outcome of pregnancies in amenorrhoeic women with hyperprolactinaemia and pituitary tumours

Abstract: Seventeen term pregnancies occurred in 14 amenorrhoeic women with hyperprolactinaemia and radiological evidence of pituitary tumour. The abortion rate was high (32%). All but one of the term pregnancies occurred after ovulation-inducing treatment with human gonadotrophins and bromocriptine (four and 12 pregnancies respectively). Two of the 14 women had visual complications during pregnancy, but neither had serious residual visual impairment. Two patients had possible pituitary enlargement during pregnancy. Bromocriptine may be the most suitable primary treatment for many infertile women with prolactin-secreting tumours. Tumour complications during pregnancy are a definite risk, but most pregnancies went uneventfully to term. Patients with pituitary tumour should be carefully evaluated before starting ovulation-inducing treatment with bromocriptine alone, and they should be told of the possible risks and of the advantages and disadvantages of pretreatment with irradiation or surgery. Patients should be carefully monitored during pregnancy and have their visual fields checked frequently. If visual complications due to tumour enlargement occur during a pregnancy, reinstituting bromocriptine may be the treatment of choice. If this fails, other forms of treatment such as induction of labour, high-dose corticosteroid treatment, pituitary implantation of yttrium-90, or surgery may be effective.