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.

Adenocarcinoma of the vagina. Association of maternal stilbestrol therapy with tumor appearance in young women.

Abstract: Although cancer of the vagina is rare and occurs principally in women over age 50 in the form of epidermoid carcinoma 8 girls (15-22) between 1966 and 1969 with adenocarcinoma of the vagina (clear-cell or endometrial) were seen at 2 Boston hospitals. The 4 controls (female) for each case were born within 5 days of the patient and on the same type of service (ward or private). The association between treatment of the mothers (7 or 8) with estrogen diethylstilbestrol during the pregnancies and the development of adenocarcinoma of the vagina in the girls is highly significant (p less than 0.00001). All 7 mothers began therapy in the first trimester and received either a constant dose administered to term or a continually increasing dose given almost to term. Other factors with lower levels of significance are maternal bleeding in the study pregnancy (p less than 0.05) and any prior pregnancy loss (p less than 0.01). Non-significant factors include maternal age at time of birth smoking in parents intrauterine x-ray exposure and breast feeding.

A controlled trial of antepartum glucocorticoid treatment for prevention of the respiratory distress syndrome in premature infants

Abstract: A controlled trial of betamethasone therapy was carried out in 282 mothers in whom premature delivery threatened or was planned before 37 weeks9 gestation, in the hope of reducing the incidence of neonatal respiratory distress syndrome by accelerating functional maturation of the fetal lung. Two hundred and thirteen mothers were in spontaneous premature labor. When necessary, ethanol or salbutamol infusions were used to delay delivery while steroid or placebo therapy was given. Delay for at least 24 hours was achieved in 77% of the mothers. In these unplanned deliveries, early neonatal mortality was 3.2% in the treated group and 15.0% in the controls (p 0.01). There were no deaths with hyaline membrane disease or intraventricular cerebral hemorrhage in infants of mothers who had received betamethasone for at least 24 hours before delivery. The respiratory distress syndrome occurred less often in treated babies (9.0%) than in controls (25.8%, p 0.003), but the difference was confined to babies of under 32 weeks9 gestation who had been treated for at least 24 hours before delivery (11.8% of the treated babies compared with 69.6% of the control babies p. 0.02). There may be an increased risk of fetal death in pregnancies complicated by severe hypertensionedema-proteinuria syndromes and treated with betamethasone, but no other hazard of steroid therapy was noted. We conclude that this preliminary evidence justifies further trials, but that further work is needed before any new routine procedure is established.

Maternal thyroid deficiency during pregnancy and subsequent neuropsychological development of the child.

Abstract: Background When thyroid deficiency occurs simultaneously in a pregnant woman and her fetus, the child's neuropsychological development is adversely affected. Whether developmental problems occur when only the mother has hypothyroidism during pregnancy is not known. Methods In 1996 and 1997, we measured thyrotropin in stored serum samples collected from 25,216 pregnant women between January 1987 and March 1990. We then located 47 women with serum thyrotropin concentrations at or above the 99.7th percentile of the values for all the pregnant women, 15 women with values between the 98th and 99.6th percentiles, inclusive, in combination with low thyroxine levels, and 124 matched women with normal values. Their seven-to-nine-year-old children, none of whom had hypothyroidism as newborns, underwent 15 tests relating to intelligence, attention, language, reading ability, school performance, and visual–motor performance. Results The children of the 62 women with high serum thyrotropin concentrations performed sli...

Gestational diabetes and the incidence of type 2 diabetes: a systematic review.

Abstract: OBJECTIVE —To examine factors associated with variation in the risk for type 2 diabetes in women with prior gestational diabetes mellitus (GDM). RESEARCH DESIGN AND METHODS —We conducted a systematic literature review of articles published between January 1965 and August 2001, in which subjects underwent testing for GDM and then testing for type 2 diabetes after delivery. We abstracted diagnostic criteria for GDM and type 2 diabetes, cumulative incidence of type 2 diabetes, and factors that predicted incidence of type 2 diabetes. RESULTS —A total of 28 studies were examined. After the index pregnancy, the cumulative incidence of diabetes ranged from 2.6% to over 70% in studies that examined women 6 weeks postpartum to 28 years postpartum. Differences in rates of progression between ethnic groups was reduced by adjustment for various lengths of follow-up and testing rates, so that women appeared to progress to type 2 diabetes at similar rates after a diagnosis of GDM. Cumulative incidence of type 2 diabetes increased markedly in the first 5 years after delivery and appeared to plateau after 10 years. An elevated fasting glucose level during pregnancy was the risk factor most commonly associated with future risk of type 2 diabetes. CONCLUSIONS —Conversion of GDM to type 2 diabetes varies with the length of follow-up and cohort retention. Adjustment for these differences reveals rapid increases in the cumulative incidence occurring in the first 5 years after delivery for different racial groups. Targeting women with elevated fasting glucose levels during pregnancy may prove to have the greatest effect for the effort required.