Pregnancy

About: Pregnancy is a research topic. Over the lifetime, 163969 publications have been published within this topic receiving 4013502 citations. The topic is also known as: pregnancy & gestation.

Psychiatric disorder in pregnancy and the first postnatal year.

Abstract: We interviewed 128 women regularly during pregnancy and the first postnatal year. Psychiatric interviews identified eight 'cases' of psychiatric disorder (6 per cent) in early pregnancy and twenty 'cases' (16 per cent) at six weeks after birth. Postnatal affective disorder, which accounted for 15 of these cases, was significantly associated with dissatisfaction with the marital relationship and also with previous psychiatric history. The implications of the term 'postnatal depression' are considered in terms of the course of the disorder in the 29 women (23 per cent) who had episodes of affective disorder at some time during pregnancy and the postnatal year. We found that the majority of episodes of affective disorder could be understood in terms of previous psychiatric history and/or reaction to life-events, including the stress of childbirth itself.

Maternal Infections and Subsequent Psychosis Among Offspring

Abstract: Background: We tested the hypothesis that maternal infections during pregnancy are associated with the subsequent development of schizophrenia and other psychoses in adulthood. Methods: We conducted a nested case-control study of 27 adults with schizophrenia and other psychotic illnesses and 54 matched unaffected control subjects (matched for sex, ethnicity, and date of birth) from the Providence, RI, cohort of the Collaborative Perinatal Project. We retrieved stored blood samples that had been obtained from these mothers at the end of pregnancy. These samples were analyzed for total class-specific immunoglobulins and for specific antibodies directed at recognized perinatal pathogens capable of affecting brain development.

Antibiotic Therapy for Reduction of Infant Morbidity After Preterm Premature Rupture of the Membranes: A Randomized Controlled Trial

Abstract: Context. —Intrauterine infection is thought to be one cause of preterm premature rupture of the membranes (PPROM). Antibiotic therapy has been shown to prolong pregnancy, but the effect on infant morbidity has been inconsistent. Objective. —To determine if antibiotic treatment during expectant management of PPROM will reduce infant morbidity. Design. —Randomized, double-blind, placebo-controlled trial. Setting. —University hospitals of the National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network. Patients. —A total of 614 of 804 eligible gravidas with PPROM between 24 weeks' and 0 days' and 32 weeks' and 0 days' gestation who were considered candidates for pregnancy prolongation and had not received corticosteroids for fetal maturation or antibiotic treatment within 1 week of randomization. Intervention. —Interavenous ampicillin (2-g dose every 6 hours) and erythromycin (250-mg dose every 6 hours) for 48 hours followed by oral amoxicillin (250-mg dose every 8 hours) and erythromycin base (333-mg dose every 8 hours) for 5 days vs a matching placebo regimen. Group B streptococcus (GBS) carriers were identified and treated. Tocolysis and corticosteroids were prohibited after randomization. Main Outcome Measures. —The composite primary outcome included pregnancies complicated by at least one of the following: fetal or infant death, respiratory distress, severe intraventricular hemorrhage, stage 2 or 3 necrotizing enterocolitis, or sepsis within 72 hours of birth. These perinatal morbidities were also evaluated individually and pregnancy prolongation was assessed. Results. —In the total study population, the primary outcome (44.1% vs 52.9%;P=.04), respiratory distress (40.5% vs 48.7%;P=.04), and necrotizing enterocolitis (2.3% vs 5.8%;P=.03) were less frequent with antibiotics. In the GBS-negative cohort, the antibiotic group had less frequent primary outcome (44.5% vs 54.5%;P=.03), respiratory distress (40.8% vs 50.6%;P=.03), overall sepsis (8.4% vs 15.6%;P=.01), pneumonia (2.9% vs 7.0%;P=.04), and other morbidities. Among GBS-negative women, significant pregnancy prolongation was seen with antibiotics (P Conclusions. —We recommend that women with expectantly managed PPROM remote from term receive antibiotics to reduce infant morbidity.

The development of the immune system during pregnancy and early life.

Abstract: It is a common misconception that the newborn is immunologically naive. However, neonatal human T cells proliferate in response to an array of antigens, including allergens (1±4), autoantigens (5), and parasite antigens (6, 7). The ability to detect antigen-speci®c IgE in umbilical cord blood collected at birth also indicates that neonatal T and B cells have mounted an antigenspeci®c response (8±10). Likewise, newborns of mothers who are vaccinated with tetanus toxoid during pregnancy have speci®c antibody of the IgM class in their serum, although no evidence of class switch before their own vaccination (11). The offspring of mothers infected by Ascaris during the pregnancy (12) also exhibit speci®c reactivity to this parasite at birth. Nevertheless, fetal and newborn mammals have limited ability to mount immune responses in both quantitative and qualitative terms, relative to older age groups. This defect could reside in any combination of functions associated with mounting effective host defence, but, in some circumstances, the magnitude of the defect has been overestimated as a result of the methodology chosen to examine immune function. Most investigations of the functionality of the human fetal immune system have relied on the use of umbilical cord blood collected at birth after a full-term pregnancy (>37 weeks of gestation). Due to ethical limitations, few studies have been conducted on fetal lymphoid tissues or blood at earlier times in gestation. This review contrasts the published data obtained from studies on fetal and newborn peripheral blood mononuclear cells with the more limited information available on samples from infants and young children. In addition, the rami®cations of these ®ndings are discussed in relation to the pathogenesis of allergic disease.

Maternal obesity: pregnancy complications, gestational weight gain and nutrition

Abstract: The obesity epidemic affects all, including women of reproductive age. One in five women attending prenatal care in the UK is obese. Prepregnancy obesity is associated with serious short- and long-term complications for mother and child. Furthermore, gestational weight gain (GWG) of obese pregnant women generally exceeds the Institute of Medicine recommended ranges. This observation can partially be explained by an unbalanced diet and lack of daily physical activity. Despite this, few lifestyle intervention trials in obese pregnant women are available. Two out of seven intervention trials focusing on GWG, nutrition and physical activity, reached a significant decrease in GWG. Developing guidelines to promote appropriated weight gain and healthy lifestyle in overweight and obese pregnant women remains a challenge. This review aims to summarize the complications associated with maternal prepregnancy overweight and obesity and to discuss possible strategies to improve the lifestyle habits of pregnant women.