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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.


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Journal ArticleDOI
TL;DR: Maternal depressive symptoms in this sample of African-American women were independently associated with spontaneous preterm birth, suggesting effective treatment of depression in pregnant women could ultimately result in a reduction of spontaneous pre term births.
Abstract: The purpose of this study was to examine the relation between maternal depressive symptoms and spontaneous preterm birth. From 1991 to 1993, pregnant, African-American women were prospectively enrolled at four hospital-based clinics in Baltimore, Maryland, that serve low-income areas of the city. The Center for Epidemiologic Studies Depression (CES-D) Scale was used to assess depressive symptoms. Multiple logistic regression analysis estimated the independent contribution of maternal depressive symptoms to spontaneous preterm birth, controlling for behavioral, clinical, and demographic variables. Among the 1,399 women in the sample, 117 (8.4%) had a spontaneous preterm delivery. Spontaneous preterm birth occurred among 12.7% of those with a CES-D score in the upper 10th percentile and among 8.0% of those with a lower score (relative risk = 1.59). The adjusted odds ratio for an elevated CES-D score was 1.96 (95% confidence interval: 1.04, 3.72); hence, maternal depressive symptoms in this sample of African-American women were independently associated with spontaneous preterm birth. Effective treatment of depression in pregnant women could ultimately result in a reduction of spontaneous preterm births.

449 citations

Journal ArticleDOI
TL;DR: It is recommended that all pregnant women be screened for the presence of bacteriuria at their first prenatal visit because as many as one third will experience a recurrence of urinary tract infections.

449 citations

Journal ArticleDOI
TL;DR: It is demonstrated that trophoblast expresses both paternally and maternally inherited HLA-C surface proteins and that maternal KIR AA frequencies are increased in affected pregnancies only when the fetus has more group 2 Hla-C genes than the mother, raising the possibility that there is a deleterious allogeneic effect stemming from paternal C2.
Abstract: Many common disorders of pregnancy are attributed to insufficient invasion of the uterine lining by trophoblast, fetal cells that are the major cell type of the placenta. Interactions between fetal trophoblast and maternal uterine NK (uNK) cells — specifically interactions between HLA-C molecules expressed by the fetal trophoblast cells and killer Ig-like receptors (KIRs) on the maternal uNK cells — influence placentation in human pregnancy. Consistent with this, pregnancies are at increased risk of preeclampsia in mothers homozygous for KIR haplotype A (KIR AA). In this study, we have demonstrated that trophoblast expresses both paternally and maternally inherited HLA-C surface proteins and that maternal KIR AA frequencies are increased in affected pregnancies only when the fetus has more group 2 HLA-C genes (C2) than the mother. These data raise the possibility that there is a deleterious allogeneic effect stemming from paternal C2. We found that this effect also occurred in other pregnancy disorders (fetal growth restriction and recurrent miscarriage), indicating a role early in gestation for these receptor/ligand pairs in the pathogenesis of reproductive failure. Notably, pregnancy disorders were less frequent in mothers that possessed the telomeric end of the KIR B haplotype, which contains activating KIR2DS1. In addition, uNK cells expressed KIR2DS1, which bound specifically to C2+ trophoblast cells. These findings highlight the complexity and central importance of specific combinations of activating KIR and HLA-C in maternal-fetal immune interactions that determine reproductive success.

449 citations

Journal ArticleDOI
TL;DR: Exposure to certain psychotropic drugs in utero may increase the risk for some specific congenital anomalies, but the rate of occurrence of these anomalies even with the increased risk remains low.
Abstract: Objective : Given concerns about use of psychotropic medication during pregnancy, the authors reviewed the literature regarding the effects of prenatal exposure to psychotropic medications on fetal outcome. Method : A MEDLINE search of all articles written in English from 1966 to 1995 was performed to review information on the effects of psychotropic drug use during pregnancy on fetal outcome. Where sufficient data were available and when methodologically appropriate, meta-analyses were performed to assess risk of fetal exposure by psychotropic medication class. Results : Three primary effects are associated with medication use during pregnancy : 1) teratogenicity, 2) perinatal syndromes (neonatal toxicity), and 3) postnatal behavioral sequelae. For many drug classes there are substantial data regarding risk for teratogenicity. Tricyclic antidepressants do not seem to confer increased risk for organ dysgenesis. The available data indicate that first-trimester exposure to low-potency phenothiazines, lithium, certain anticonvulsants, and benzodiazepines may increase the relative risk for congenital anomalies. However, the absolute risk of congenital malformations following prenatal exposure to most psychotropics is low. Conclusions : Exposure to certain psychotropic drugs in utero may increase the risk for some specific congenital anomalies, but the rate of occurrence of these anomalies even with the increased risk remains low. Use of psychotropic medications during pregnancy is appropriate in many clinical situations and should include thoughtful weighing of risk of prenatal exposure versus risk of relapse following drug discontinuation. The authors present disorder-based guidelines for psychotropic drug use during pregnancy and for psychiatrically ill women who wish to conceive.

449 citations

Journal ArticleDOI
TL;DR: The presence of maternal antibody to CMV before conception provides substantial protection against damaging congenital CMV infection in the newborn.
Abstract: Background. Intrauterine transmission of cytomegalovirus (CMV) can occur whether a mother has prior immunity or acquires CMV for the first time during pregnancy. The degree of protection afforded an infected infant by the presence of antibody in the mother before conception is uncertain. Methods. We compared the outcomes of CMV-infected infants born to mothers who acquired primary CMV infection during pregnancy (primary-infection group) with those of CMV-infected infants born to mothers with immunity (recurrent-infection group). Screening for viruria identified 197 newborns with congenital CMV infection. Stored serum samples were used to categorize maternal infection as either primary or recurrent. We followed 125 infants from the primary-infection group and 64 from the recurrent-infection group. Serial medical, audiologic, psychometric, and eye examinations were used to identify sequelae of CMV infection. Results. Only infants in the primary-infection group had symptomatic CMV infection at birth...

449 citations


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Performance
Metrics
No. of papers in the topic in previous years
YearPapers
20246
202312,193
202225,740
20218,002
20207,983
20196,948