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Sample records for 12th gestational week

  1. Imbalance of mononuclear cell infiltrates in the placental tissue from foetuses after spontaneous abortion versus therapeutic termination from 8th to 12th weeks of gestational age.

    PubMed

    Lambropoulou, M; Tamiolakis, D; Venizelos, J; Liberis, V; Galazios, G; Tsikouras, P; Karamanidis, D; Petrakis, G; Constantinidis, T; Menegaki, M; Papadopoulos, N

    2006-12-01

    Placental macrophages (Hofbauer cells) are located close to trophoblastic cells and foetal capillaries, which make them perfect candidates for involvement in regulatory processes within the villous core. Their capacity of producing several cytokines and prostaglandin-synthesising enzymes, and expressing vascular endothelial growth factor, indicate a possible role in placental development and angiogenesis in order to support pregnancy. Common cells to Hofbauer macrophages sharing similar cell surface markers (HLA-A, -B, -C and leukocyte common antigen) have been reported in the stroma, decidua and amnion, indicating additional foetal protection. Yet this is not always the case. Most spontaneous abortions occur before 12 weeks' gestation, and most are due to chromosomal errors in the conceptus. Relatively few truly spontaneous abortions take place between 12 and 20 weeks' gestation. Thereafter, between 20 and 30 weeks, another type of premature spontaneous termination becomes prevalent, which is due to ascending infection. The numbers of cells expressing the various markers of the monocytemacrophage lineage change throughout pregnancy. In the present study, we investigated the immunohistochemical expression of mononuclear infiltrations in paraffin-embedded placentas, from foetuses after spontaneous abortion (8th, 10th and 12th weeks of gestational age), and those after therapeutic abortion at the same time, using a panel of monoclonal antibodies for the identification of leukocytes (CD45/LCA), B-lymphocytes (CD20/L-26), T lymphocytes (CD45RO/UCHL1), CD68 and CD14 cells. Immunologic factors in human reproductive failure are plausible mechanisms of infertility and spontaneous abortion. Approximately 25% of cases of premature ovarian failure appear to result from an autoimmune aetiology. Unfortunately, current therapeutic options for these women are limited to exogenous hormone or gamete substitution. Local inflammations at the sites of endometriosis implants are

  2. A stormy and rare presentation: Eclampsia at 18 weeks of gestation

    PubMed Central

    Eltayeb, Saniya; Othman, Sarah; Haddabi, Rahma; Tazneem, Shahila

    2013-01-01

    Eclampsia is an Obstetric emergency. It is uncommon in early second trimester and an early diagnosis will aid in preventing complications. We report an unusual case of eclampsia at an 18 weeks gestation with a good maternal outcome.

  3. Utility of First Trimester Ultrasonography before 11 Weeks of Gestation: A Retrospective Study

    PubMed Central

    Celen, Sevki; Dover, Necmiye; Seckin, Berna; Goker, Ufuk; Yenicesu, Okan; Danisman, Nuri

    2012-01-01

    We showed the utility of first trimester ultrasonography before 11 weeks of gestation for antenatal followup. We retrospectively analyzed 1295 records of patients who underwent first trimester ultrasonography (transvaginal/abdominal) in our antenatal clinic in Ankara, Turkey. Maternal age, parity, gestational age, and maternal gestational history were compared with ultrasonographic findings. Patients were divided into 12 groups based on ultrasonographic diagnoses in the first ultrasonographic scan, and called for a control examination within 10 days if the diagnostic findings were abnormal. The data were statistically analyzed using Kruskal-Wallis and chi-square tests. We noted 81.3% patients to have single, viable, intrauterine pregnancies, while 18.7% had abnormal or complicated pregnancies with uterine anomalies, ovarian cysts, fibroids, or subchorionic hematomas. Normal and anembryonic pregnancies had significantly lower median diagnostic period in the control ultrasonography than in the first examination. First trimester ultrasonography before 11 weeks of gestation is valuable in determining pregnancy outcomes. PMID:23097712

  4. The effect of fetal gender on nuchal translucency at 10-14 weeks of gestation.

    PubMed

    Lam, Y H; Tang, M H; Lee, C P; Sin, S Y; Tang, R; Wong, H S; Wong, S F

    2001-08-01

    Recent data have suggested that fetal nuchal translucency (NT) is affected by fetal gender. We investigated the size of this effect in 12 189 unselected pregnancies with known normal outcomes that had undergone NT measurements between 10 and 14 weeks of gestation. NT increased with gestation and was converted to multiples of the median (MoM) for the gestational day. The median NT MoM (95% CI) for female fetuses was 0.98 (0.97-0.99). This was significantly lower than that of the male fetuses (1.03; range 1.02-1.04) (p<0.0005; Wilcoxon rank-sum test). The gender difference was not observed at 10 weeks but was observed from 11 weeks onwards. There is no obvious explanation for the above findings. PMID:11536259

  5. Factors Affecting Vocabulary Acquisition at Age 2 in Children Born between 23 and 28 Weeks' Gestation

    ERIC Educational Resources Information Center

    Marston, Louise; Peacock, Janet L.; Calvert, Sandra A.; Greenough, Anne; Marlow, Neil

    2007-01-01

    Language development is often slower in preterm children compared with their term peers. We investigated factors associated with vocabulary acquisition at 2 years in a cohort of children born at 28 weeks' gestation or less. For children entered into the United Kingdom Oscillation Study, language development was evaluated by using the…

  6. Feto-maternal plasma phenylalanine concentration gradient from 19 weeks gestation to term.

    PubMed

    Schoonheyt, W E; Clarke, J T; Hanley, W B; Johnson, J M; Lehotay, D C

    1994-03-01

    Plasma phenylalanine concentrations in fetal blood, obtained by cordocentesis, were compared with simultaneous peripheral venous plasma phenylalanine levels in mothers. The feto-maternal phenylalanine concentration ratio showed a gradual decrease from 19 weeks of gestation to term with an overall ratio of 1.35 +/- 0.42 (mean +/- S.D., n = 14). PMID:8088005

  7. Achondrogenesis type 2 diagnosed by transvaginal ultrasound at 12 weeks' gestation.

    PubMed

    Soothill, P W; Vuthiwong, C; Rees, H

    1993-06-01

    Ultrasound examination at 12 weeks' gestation revealed severe generalised subcutaneous oedema in a pregnancy at risk for achondrogenesis type II. Transvaginal scanning confirmed the oedema and suggested abnormal limb development. The prenatal diagnosis was confirmed by X-ray examination after transvaginal termination. PMID:8372079

  8. "Hugging sisters": thoracoomphalopagus with anencephaly confirmed by three-dimensional ultrasonography at 9 weeks of gestation.

    PubMed

    Shim, Jae-Yoon; Joo, Da-Hye; Won, Hye-Sung; Lee, Pil Ryang; Kim, Ahm

    2011-06-01

    We describe a rare conjoined twinning at 9 weeks of gestation. We compared the results of two- and three-dimensional sonography with autopsy findings after the termination of pregnancy. These results showed a thoracoomphalopagus with a shared heart and visceral organs. Three-dimensional sonography showed anencephaly in one of the embryos. Early and accurate prenatal diagnosis of this type of conjoined twins using three-dimensional sonography is critical for both parental counseling and minimizing maternal morbidity. PMID:21547928

  9. [Significance of nitric oxide inhalation (NO) in preterm infants< 34 weeks of gestation].

    PubMed

    Wirbelauer, J; Speer, C P

    2010-03-01

    In 2001, NO was approved as a therapeutic agent in Europe for the treatment of persistent pulmonary hypertension in late preterm infants >34 weeks of gestational age and term newborns. Recent observational studies suggest, that preterm infants <34 weeks of gestation with acute hypoxic lung failure could benefit from inhaled NO (iNO) by improved oxygenation. To date, 21 randomised-controlled trials have enrolled 3 336 preterm infants <34 weeks of gestation for iNO treatment. Overall, iNO treatment does not reduce the rate of bronchopulmonary dysplasia (BPD) or death compared to controls. In addition, iNO treatment of preterm infants with hypoxic respiratory failure or increased risk of BPD does not affect the combined incidence of death and BPD. However, early prophylactic use of iNO in preterm infants with respiratory distress seems to improve survival without BPD or severe cerebral damage. Current data of long term neurological outcome of iNO-treated preterm infants do not seem to justify iNO administration. Outside of well designed clinical trials iNO-treatment of preterm infants can currently not be recommended. PMID:20175046

  10. Is Cesarean Delivery Preferable in Twin Pregnancies at >=36 Weeks Gestation?

    PubMed Central

    Dong, Yu; Luo, Zhong-Cheng; Yang, Zu-Jing; Chen, Lu; Guo, Yu-Na; Branch, Ware; Zhang, Jun; Huang, Hong

    2016-01-01

    Background The optimal mode of delivery in twin pregnancies remains controversial. A recent randomized trial did not find any benefit of planned cesarean vs. vaginal delivery at 32–38 weeks gestation, but the trial was not powered to detect a moderate effect. We aimed to evaluate the impact of cesarean delivery on perinatal mortality and severe neonatal morbidity in twin pregnancies at ≥32 weeks through a large database exploration approach with the power to detect moderate risk differences. Methods In a retrospective birth cohort study using the U.S. matched multiple births, 1995–2000 (the available largest multiple birth dataset), we compared perinatal outcomes in twins (n = 181,810 pregnancies) delivered at 32–41 weeks gestation without congenital anomalies. The primary outcome was a composite of perinatal death and severe neonatal morbidity. Cox regression was used to estimate the adjusted hazard ratio (aHR) controlling for the propensity to cesarean delivery, fetal characteristics (sex, birth weight, birth weight discordance, same-sex twin or not) and twin-cluster level dependence. Prospective risks were calculated using the fetuses-at-risk denominators. Results The overall rates of the primary outcome were slightly lower in intended cesarean (6.20%) vs. vaginal (6.45%) deliveries. The aHRs of the primary outcome were in favor of vaginal delivery at 32 (aHR = 1.06, p = 0.03) or 33 (aHR = 1.22, p<0.001) weeks, neutral at 34–35 weeks, but in favor of cesarean delivery at 36 (aHR = 0.94, p = 0.004), 37, 38 and 39+ weeks (aHR: 0.72 to 0.78, all p<0.001). The lower risk of the primary outcome for cesarean vs. vaginal deliveries at 36+ weeks of gestation remained when the analyses were restricted to different-sex (dichorionic) twins (aHR = 0.84, 95% CI 0.80–0.88). Conclusion Cesarean delivery may be beneficial for perinatal outcomes overall in twin pregnancies at ≥36 weeks gestation. PMID:27227678

  11. Strabismus at Age 2 Years in Children Born Before 28 Weeks' Gestation: Antecedents and Correlates.

    PubMed

    VanderVeen, Deborah K; Allred, Elizabeth N; Wallace, David K; Leviton, Alan

    2016-03-01

    Children born very preterm are at greater risk of ophthalmic morbidities, including strabismus, than children born at term. We evaluated perinatal factors associated with strabismus at age 2 years in a large population of infants delivered before 28 weeks' gestation. A total of 996 infants in the multicenter ELGAN (Extremely Low Gestational Age Newborn) study who had a retinal exam in infancy and a developmental assessment at 2 years corrected age are included. Their mothers were interviewed about the pregnancy, and both mother and newborn charts were reviewed. Certified examiners administered the Bayley Scales of Infant Development-II and performed an examination of ocular alignment. Time-oriented logistic regression risk models were created to evaluate the associations of characteristics and exposures with the development of strabismus. Overall, 14% (n = 141) of the children had strabismus at 2 years, and 80% of strabismic children had esotropia. Characteristics associated with strabismus were birth before 26 weeks' gestation, severe fetal growth restriction, and maternal history of aspirin ingestion. Associated postnatal factors included a SNAP-II (Score for Neonatal Acute Physiology) illness severity value ≥ 30, brain ventriculomegaly, type I retinopathy of prematurity, and ventilator-dependent severe bronchopulmonary dysplasia. Strabismus in very preterm populations is associated with a number of antenatal and postnatal antecedents as well as clinical and imaging correlates indicative of brain damage in these children. Routine ophthalmologic assessments in the early years can allow appropriate and timely interventions. PMID:26350726

  12. Histological characteristics of singleton placentas delivered before the 28th week of gestation

    PubMed Central

    Hecht, Jonathan L.; Allred, Elizabeth N.; Kliman, Harvey J.; Zambrano, Eduardo; Doss, Barbara J.; Husain, Aliya; Pflueger, Solveig M. V.; Chang, Chung-ho; Livasy, Chad A.; Roberts, Drucilla; Bhan, Ina; Ross, Dennis W.; Senagore, Patricia Kaman; Leviton, Alan

    2010-01-01

    Summary Aims The placenta is a record of the fetal environment and its examination may provide information about the baby’s subsequent growth and development. We describe the histological characteristics of 947 singleton placentas from infants born between 23 and 27 weeks gestation. Methods Consent was obtained from mothers who delivered before 28 weeks (clinical estimate). We evaluated the gross and histopathological features of the placenta and assessed pair-wise correlations between variables. Results Lesions of uteroplacental circulation (abruption, extensive infarction or thrombosis, marked basal or perivillous fibrin deposition, increased syncytial knots) were inversely related to those associated with inflammation of the membranes and cord. Earlier age favoured inflammatory variables, while older age favoured characteristics attributed to impaired blood flow. We observed inflammation of the chorionic plate in 43%, the cord in 19%, and of chorionic plate vessels in 30%. Of the placentas with umbilical cord inflammation, 8% had no inflammation of the chorionic plate. Conclusions This study population is unique in its size and recruitment by gestational age rather than birth weight. Inflammation occurred frequently, but not in placentas that had characteristics of vasculopathy. The prevalence of inflammation decreased with increasing gestational age, while vasculopathy increased. Funisitis need not be accompanied by chorionic inflammation. PMID:18446627

  13. Cervical preparation for second-trimester surgical abortion prior to 20 weeks of gestation.

    PubMed

    Fox, Michelle C; Hayes, Jennifer L

    2007-12-01

    Roughly 11% of induced abortions in the United States are performed after 14 weeks of gestation, most commonly by dilation and evacuation (D&E). For a D&E procedure, the cervix must be dilated sufficiently to allow passage of operative instruments and products of conception without injuring the uterus or cervical canal. Preoperative preparation of the cervix reduces the risk of cervical laceration and uterine perforation. The cervix may be prepared with osmotic dilators, prostaglandin analogues, or both. Osmotic dilators currently available in the United States include Dilapan-S, Lamicel, and laminaria. Laminaria tents are made from dehydrated seaweed and require 12-24 h to achieve greatest dilation. The synthetic products, Dilapan-S and Lamicel, achieve maximum effect within 6 h. Dilapan-S achieves greater dilation than the others and, thus, requires fewer dilators to be placed but may be more difficult to remove. For same day procedures, Dilapan-S and Lamicel are preferable to laminaria. A single set of one to several dilators is usually adequate for D&E before 20 weeks of gestation. Additional sets over 1-2 days may be needed in challenging cases. Misoprostol, a prostaglandin analogue, is sometimes used instead of osmotic dilators; however, the data to support such use are limited. Misoprostol is inferior to overnight dilation with laminaria for cervical priming prior to D&E. Misoprostol use as an adjunct to overnight osmotic dilation is only marginally beneficial for priming beyond 16 weeks and does not truly demonstrate any benefit before 19 weeks of gestation. Limited data demonstrate the safety of misoprostol prior to D&E in patients with a uterine scar. The Society of Family Planning recommends preoperative cervical preparation to decrease the risk of complications when performing a D&E prior to 20 weeks of gestation. The three currently available osmotic dilators (laminaria, Lamicel, and Dilapan-S) are safe and effective for this use. Since no single

  14. Stage IB2 adenosquamous cervical cancer diagnosed at 19-weeks' gestation.

    PubMed

    Peculis, Luiza D; Ius, Yvette; Campion, Michael; Friedlander, Michael; Hacker, Neville

    2015-02-01

    Neoadjuvant chemotherapy (NACT) for advanced cervical cancer in pregnancy has been shown to increase operability and be effective against spread of disease. In all reported cases of advanced disease, residual tumour has been found at surgery following NACT. We present a case of a 27-year old diagnosed with stage IB2 adenosquamous cervical carcinoma at 19-weeks' gestation who was treated with NACT. Following caesarean section and radical hysterectomy, histopathology showed no evidence of residual tumour in the cervix and negative pelvic lymph nodes. PMID:25470742

  15. A Case of Vaginal Stillbirth in the Presence of Placenta Previa at 33 Weeks of Gestation

    PubMed Central

    Chinen, Yukiko; Kinjo, Tadatsugu; Nitta, Hayase; Kinjo, Yui; Masamoto, Hitoshi

    2016-01-01

    It was demonstrated that second- and third-trimester therapeutic termination of pregnancy (TOP) is feasible in cases with placenta previa. We report a 34-year-old woman with complex fetal malformations associated with placenta previa. An ultrasound examination at 21 weeks of gestation revealed fetal growth restriction (FGR) and complex fetal malformations associated with a placenta previa. After extensive information, the parents opted for careful observation. Thereafter, FGR gradually progressed and we observed arrest of end-diastolic velocity of the umbilical artery. Finally, intrauterine fetal death (IUFD) was confirmed at 33 weeks of gestation. Two days after IUFD, the patient experienced labor pain. The placenta and dead fetus weighing 961 g were vaginally delivered, and total bleeding was 270 mL. Although further studies to confirm the dynamic change of the uteroplacental blood flow are necessary to avoid the risk of maternal hemorrhage, vaginal TOP with placenta previa after feticide or IUFD would be feasible. PMID:27579202

  16. Spontaneous uterine rupture in the 35th week of gestation after laparoscopic adenomyomectomy

    PubMed Central

    Nagao, Yukari; Osato, Kazuhiro; Kubo, Michiko; Kawamura, Takuya; Ikeda, Tomoaki; Yamawaki, Takaharu

    2016-01-01

    Uterine rupture rarely occurs during pregnancy, but it is a critical situation if so. It is already known that a history of uterine surgeries, such as cesarean section or myomectomy, is a risk factor for uterine rupture. Currently, the laparoscopic adenomyomectomy is a widely performed procedure, but associated risks have not been defined. We observed a case of spontaneous uterine rupture in a patient during the 35th week of gestation, after a laparoscopic adenomyomectomy. A 42-year-old, gravida 2, para 0 woman became pregnant after a laparoscopic adenomyomectomy and her pregnancy was conventional. At a scheduled date in the 35th week of gestation, after combined spinal epidural anesthesia and frequent uterine contractions, a weak pain suddenly ensued. After 13 minutes of uterine contractions, vaginal bleeding was evident. A cesarean section was performed, and the uterine rupture was found in the scar. After a laparoscopic adenomyomectomy, a pregnant uterus can easily rupture by rather weak and short uterine contractions, and is characterized by vaginal bleeding. When uterine bleeding is observed in pregnant women that have a history of adenomyomectomy, one should consider uterine rupture. PMID:26719729

  17. A Case of Vaginal Stillbirth in the Presence of Placenta Previa at 33 Weeks of Gestation.

    PubMed

    Chinen, Yukiko; Kinjo, Tadatsugu; Nitta, Hayase; Kinjo, Yui; Masamoto, Hitoshi; Aoki, Yoichi

    2016-01-01

    It was demonstrated that second- and third-trimester therapeutic termination of pregnancy (TOP) is feasible in cases with placenta previa. We report a 34-year-old woman with complex fetal malformations associated with placenta previa. An ultrasound examination at 21 weeks of gestation revealed fetal growth restriction (FGR) and complex fetal malformations associated with a placenta previa. After extensive information, the parents opted for careful observation. Thereafter, FGR gradually progressed and we observed arrest of end-diastolic velocity of the umbilical artery. Finally, intrauterine fetal death (IUFD) was confirmed at 33 weeks of gestation. Two days after IUFD, the patient experienced labor pain. The placenta and dead fetus weighing 961 g were vaginally delivered, and total bleeding was 270 mL. Although further studies to confirm the dynamic change of the uteroplacental blood flow are necessary to avoid the risk of maternal hemorrhage, vaginal TOP with placenta previa after feticide or IUFD would be feasible. PMID:27579202

  18. The clustering of disorders in infants born before the 28th week of gestation

    PubMed Central

    Leviton, Alan; Dammann, Olaf; Engelke, Stephen; Allred, Elizabeth; Kuban, Karl C. K.; O’Shea, T. Michael; Paneth, Nigel

    2015-01-01

    Aim To see if disorders prevalent in infants born extremely preterm cluster. Design Observational cohort study Setting University-affiliated newborn intensive care nurseries Subjects 1223 infants born before the 28th week of gestation who survived until 36 weeks when the diagnosis of bronchopulmonary dysplasia (BPD) could be made. Interventions None Main outcome measures An echolucent lesion of the cerebral white matter, moderate or severe ventriculomegaly on a protocol cranial ultrasound scan, BPD, retinopathy of prematurity (ROP), necrotizing enterocolitis (NEC), and early and late bacteremia. Results After adjustment for gestational age, children who had severe NEC (Bell stage IIIb) were at increased risk of severe ROP (stage 3+), severe BPD (defined as both oxygen and ventilator dependent), and late bacteremia. Children who had early bacteremia were at increased risk of late bacteremia and severe ROP. Those who had late bacteremia were at increased risk of severe ROP, while children who had severe ROP were at increased risk of severe BPD. Conclusions NEC is the disorder common to most of the clusters, but we do not know if its onset occurred before the others. Organ-damage-promoting substances, however, have been found in the circulation of newborn animals with bowel inflammation, supporting the view that NEC contributes to the damage of other organs. PMID:20712837

  19. Vaginal misoprostol alone for medical abortion up to 9 weeks of gestation: efficacy and acceptability.

    PubMed

    Ngai, S W; Tang, O S; Chan, Y M; Ho, P C

    2000-05-01

    Misoprostol and mifepristone have been shown to be effective for medical abortion up to 9 weeks of gestation. When used alone, the successful complete abortion rate dropped to approximately 60%. It has been demonstrated that by adding water to misoprostol, the success rate rose to 92%. This is the first randomized study to investigate the efficacy of misoprostol and water versus misoprostol alone for first trimester medical abortion in women at weeks of gestation. Eighty women were randomly assigned to group 1 (water added to misoprostol) and group 2 (misoprostol alone). Vaginal misoprostol 800 microgram was given on days 1, 3 and 5. If the woman did not require vacuum aspiration during the period up to the return of first menstruation after medical abortion, the outcome was classified as complete abortion. The incidence of side-effects and the acceptability were assessed through a standardized questionnaire during and after the abortion. The complete abortion rate appeared higher when water was added but the difference did not reach statistical significance. Gastro-intestinal side-effects were common but well tolerated in both groups. Overall, 40% of the women preferred a surgical method in the future because of the high failure rate. With an overall complete abortion rate of 85%, it is probably not a clinically acceptable method even if the addition of water can improve the results. We conclude that the addition of water onto misoprostol tablets does not improve its efficacy in first trimester medical abortion. Misoprostol alone is not recommended for medical abortion (up to 9 weeks of pregnancy) because of the high failure rate and low acceptability. PMID:10783370

  20. Gastric Cancer Presenting as a Krukenberg Tumor at 22 Weeks' Gestation

    PubMed Central

    Gupta, Ashutosh; Attar, Bashar M; Demetria, Melchor

    2014-01-01

    Gastric cancer is rare during pregnancy, and often advanced upon presentation. A Krukenberg tumor presents a diagnostic and therapeutic challenge in the pregnant patient. We present a case of a 38-year-old woman at 22 weeks' gestation who presented with worsening epigastric pain, and was found to have a left pelvic mass on ultrasound, which was confirmed by magnetic resonance imaging. She went into active labor and delivered a viable infant via vaginal delivery. An exploratory laparotomy revealed a large mass originating from her left ovary and diffuse thickening of the lesser curvature of the stomach. Frozen section investigation revealed the presence of signet cell adenocarcinoma. Subsequent upper endoscopy showed linitis plastica, while biopsy confirmed the presence of adenocarcinoma. In conclusion, the occurrence of gastric cancer in pregnancy is rare despite extremely common symptoms. The management poses a challenge because of the need for early treatment, and the continuation of the pregnancy. PMID:25580361

  1. Spontaneous Rupture of an Unscarred Gravid Uterus in a Primigravid Woman at 32 Weeks of Gestation

    PubMed Central

    Mizutamari, Etsuko; Honda, Tomoko; Ohba, Takashi; Katabuchi, Hidetaka

    2014-01-01

    Uterine rupture usually occurs in a scarred uterus, especially secondary to prior cesarean section. Antepartum uterine rupture in an unscarred uterus is extremely rare. We report a case of spontaneous rupture of an unscarred gravid uterus at 32 weeks of gestation in a primigravid woman. Ultrasonography and magnetic resonance imaging showed a bulging cystic lesion communicating with the intrauterine cavity. Operative findings during emergent cesarean section revealed uterine perforation in the right cornual area and a prolapsed, nonbleeding amniotic sac. The left cornual area was also focally thin. An arcuate uterus was suspected based on follow-up hysterosalpingography. Antepartum uterine rupture tends to occur in the uterine cornual area. In this case, Müllerian duct anomalies may have been associated with focal myometrial defects. PMID:25093133

  2. Trends in Survival and Incidence of Bronchopulmonary Dysplasia in Extremely Preterm Infants at 23–26 Weeks Gestation

    PubMed Central

    2016-01-01

    The aim of this study was to investigate the relationship between survival and incidence of bronchopulmonary dysplasia (BPD) in extremely premature infants, and identify clinical factors responsible for this association. Medical records of 350 infants at 23–26 weeks gestation from 2000 to 2005 (period I, n = 137) and 2006 to 2010 (period II, n = 213) were retrospectively reviewed. The infants were stratified into 23–24 and 25–26 weeks gestation, and the survival, BPD incidence, and clinical characteristics were analyzed. BPD was defined as oxygen dependency at 36 weeks postmenstrual age. The overall survival rate was significantly improved in period II compared to period I (80.3% vs. 70.0%, respectively; P = 0.028), especially in infants at 23–24 weeks gestation (73.9% vs. 47.4%, respectively; P = 0.001). The BPD incidence in survivors during period II (55.0%) was significantly decreased compared to period I (67.7%; P = 0.042), especially at 25–26 weeks gestation (41.7% vs. 62.3%, respectively; P = 0.008). Significantly improved survival at 23–24 weeks gestation was associated with a higher antenatal steroid use and an improved 5-minute Apgar score. A significant decrease in BPD incidence at 25–26 weeks gestation was associated with early extubation, prolonged use of less invasive continuous positive airway pressure, and reduced supplemental oxygen. Improved perinatal and neonatal care can simultaneously lead to improved survival and decreased BPD incidence in extremely premature infants. PMID:26955244

  3. Factors Associated With Treatment for Hypotension in Extremely Low Gestational Age Newborns During the First Postnatal Week

    PubMed Central

    Laughon, Matthew; Bose, Carl; Allred, Elizabeth; O'Shea, T. Michael; Van Marter, Linda J.; Bednarek, Francis; Leviton, Alan

    2009-01-01

    Objective The goals were to identify the blood pressures of extremely low gestational age newborns that prompt intervention, to identify other infant characteristics associated with receipt of therapies intended to increase blood pressure, and to assess the interinstitutional variability in the use of these therapies. Methods The cohort included 1507 extremely low gestational age newborns born at 23 weeks to 276/7 weeks of gestation, at 14 institutions, between March 2002 and August 2004; 1387 survived the first postnatal week. Blood pressures were measured as clinically indicated. Interventions were grouped as any treatment (ie, vasopressor and/or fluid boluses of >10 mL/kg) and vasopressor treatment, and logistic regression analyses were performed. Results At each gestational age, the lowest mean arterial pressures in treated and untreated infants tended to increase with advancing postnatal age. Infants who received any therapy tended to have lower mean arterial pressures than infants who did not, but uniform thresholds for treatment were not apparent. The proportion of infants receiving any treatment decreased with increasing gestational age from 93% at 23 weeks to 73% at 27 weeks. Treatment nearly always began during the first 24 hours of life. Lower gestational age, lower birth weight, male gender, and higher Score for Neonatal Acute Physiology–II values were associated with any treatment and vasopressor treatment. Institutions varied greatly in their tendency to offer any treatment and vasopressor treatment. Neither the lowest mean arterial pressure on the day of treatment nor other characteristics of the infants accounted for center differences in treatment. Conclusions Blood pressure in extremely premature infants not treated for hypotension increased directly with both increasing gestational age and postnatal age. The decision to provide treatment was associated more strongly with the center where care was provided than with infant attributes. PMID

  4. [Approach to preterm birth on the threshold of viability (the 22-25 week) of gestation].

    PubMed

    Göthová, M

    2013-12-01

    Preterm birth represents a serious socioeconomic problem because of costs for the care and integration of some premature children with disabilities into society. It is a syndrome which results from many initiating reasons. It takes three basic forms of the clinical view: premature labour with contractions, premature rupture of the membranes and incompetence of cervix. The frequency of preterm births is stable in most countries of the Euro-Atlantic Region, which does not correspond to still improving perinatal care. Viability is known as an ability to survive, grow and develop in a standard way. The threshold of viability in regard to the possibility to be born alive and survive lies between week 22 and 23 at present. By neonatologists, the 22-25 weeks of gestation is known as the grey zone, during which the prognosis of mortality and morbidity is uncertain. The recommendations of most West European countries emphasize the importance of individual approach to the 24-25 week. The parents must be informed about the prognosis of mortality and morbidity of the foetus. The criterion of quality of life should also be respected. Therefore the wishes of parents not to provide the aid to the newborn baby may be more important than the criterion of maturity. PMID:24372437

  5. Perinatal Outcomes of Monochorionic-Diamniotic Twin Pregnancies Uncomplicated at 28 Weeks of Gestation

    PubMed Central

    Suzuki, Shunji

    2016-01-01

    We examined the prevalence of specific perinatal complications of monochorionic-diamniotic twin pregnancies in cases without any abnormal findings until the second trimester of pregnancy. This was a retrospective cohort study performed at a tertiary perinatal center in Tokyo, Japan. There were 88 cases of uncomplicated monochorionic-diamniotic twin pregnancies at 28 weeks of gestation. In five of them (5.7%), there were serious complications associated with placental circulatory imbalance between the twins during the third trimester of pregnancy. Two cases were complicated by twin–twin transfusion syndrome, two cases were complicated by twin anemia–polycythemia sequence, and one case was complicated by acute twin–twin transfusion syndrome. In the five cases, no abnormal ultrasonographic findings or symptoms were recognized one or two weeks prior to the diagnosis. Fifty-eight cases (65.9%) were delivered at term uneventfully. Serious complications due to placental circulatory imbalance between twins occurred in about 6% of cases during the third trimester of pregnancy. PMID:27257402

  6. Factors affecting vocabulary acquisition at age 2 in children born between 23 and 28 weeks' gestation.

    PubMed

    Marston, Louise; Peacock, Janet L; Calvert, Sandra A; Greenough, Anne; Marlow, Neil

    2007-08-01

    Language development is often slower in preterm children compared with their term peers. We investigated factors associated with vocabulary acquisition at 2 years in a cohort of children born at 28 weeks' gestation or less. For children entered into the United Kingdom Oscillation Study, language development was evaluated by using the MacArthur-Bates Communicative Development Inventories score, completed by parents as part of a developmental questionnaire. The effect of demographic, neonatal, socioeconomic factors, growth, and disability were investigated using multifactorial random effects modelling. Questionnaires were returned by 288 participants (148 males, 140 females). The mean number of words vocalized was 42 (SD 29). Multifactorial analysis showed only four factors were significantly associated with vocabulary acquisition. These were: (1) level of disability (mean words: no disability, 45; other disability, 38; severe disability, 30 [severe disability is defined as at least one extreme response in one of the following clinical domains: neuromotor, vision, hearing, communication, or other physical disabilities]; 95% confidence interval [CI] for the difference between no and severe disability 7- 23); (2) sex (39 males, 44 females; 95% CI 0.4-11); (3) length of hospital stay (lower quartile, 47; upper quartile, 38; 95% CI -12 to -4); and (4) weight SD score at 12 months (lower quartile, 39; upper quartile, 44; 95% CI 1-9). There was no significant association between gestational age and vocabulary after multifactorial analysis. There was no significant effect of any socioeconomic factor on vocabulary acquisition. We conclude that clinical factors, particularly indicators of severe morbidity, dominate the correlates of vocabulary acquisition at age 2 in children born very preterm. PMID:17635204

  7. Successful term delivery cases of trans-abdominal cervicoisthmic cerclage performed at more than 18 weeks of gestation

    PubMed Central

    Joung, Eun-Joo; Go, Eun-Byeol; Kwack, Jae Young

    2016-01-01

    A 38-year-old nulliparous woman was referred to our clinic because of cervical incompetence at 19 weeks of gestation. Trans-abdominal cervicoisthmic cerclage was performed after failure of modified Shirodkar cerclage operation in the patient at 21 weeks of gestation via a laparotomic approach. Another 38-year-old patient, who underwent loop electrosurgical excision procedure conization for treatment of cervical dysplasia 4 years ago, presented for cervical incompetence. At 18 weeks of gestation, we performed trans-abdominal laparotomic cervicoisthmic cerclage without any post-operative complications. During antenatal follow-up, there were no obstetrical co-morbidities and finally she gave birth to a healthy infant at full term by cesarean section. We report two cases of women who underwent trans-abdominal cervicoisthmic cerclage surgery because of cervical incompetence as they were not suitable for transvaginal cervical cerclage. Both patients successfully maintained their pregnancy until full term after undergoing transabdominal cervicoisthmic cerclage at more than 18 weeks of gestation. PMID:27462601

  8. The Feasibility of Tracking Elective Deliveries Prior to 39 Gestational Weeks: Lessons From Three California Projects.

    PubMed

    Korst, Lisa M; Fridman, Moshe; Estarziau, Melanie; Gregory, Kimberly D; Mitchell, Connie

    2015-10-01

    The tracking of elective deliveries (ED) prior to 39 gestational weeks has become a mandatory requirement for all hospitals with ≥1,100 deliveries for accreditation by The Joint Commission (TJC); however, the feasibility and accuracy of monitoring efforts remain problematic for many hospitals. Here, we evaluated the feasibility of three operational approaches to tracking ED. We used mixed methods to evaluate the feasibility of 3 different approaches to tracking ED: (1) using administrative data, (2) using electronic medical record (EMR) data, and (3) using targeted data collection in a county-wide quality improvement (QI) effort. For (1), we analyzed data from the California 2009 linked birth cohort dataset, and calculated hospital rates of ED using TJC technical specifications. For (2), we performed a case study of a project that recruited hospitals to provide EMR data for the TJC measure calculation. For (3), we performed a case study of a project that recruited hospitals to prospectively track elective inductions of labor. For (1), hospital discharge data were insufficient without supplementation from the EMR or birth certificate. For (2), legal and operational issues surrounding data sharing, and non-standardized data elements prohibited hospital participation. For (3), the QI approach successfully established policies and data collection systems yet lacked infrastructure to assure sustainability at a hospital or regional level. In summary, ED tracking required the coordination and support of multiple resources to enable hospitals to satisfactorily report on this measure. PMID:25656731

  9. Association of antenatal corticosteroids with mortality and neurodevelopmental outcomes among infants born at 22–25 weeks gestation

    PubMed Central

    Carlo, Waldemar A.; McDonald, Scott A.; Fanaroff, Avroy A.; Vohr, Betty R.; Stoll, Barbara J.; Ehrenkranz, Richard A.; Andrews, William W.; Wallace, Dennis; Das, Abhik; Bell, Edward F.; Walsh, Michele C.; Laptook, Abbot R.; Shankaran, Seetha; Poindexter, Brenda B.; Hale, Ellen C.; Newman, Nancy S.; Davis, Alexis S.; Schibler, Kurt; Kennedy, Kathleen A.; Sanchez, Pablo J.; Van Meurs, Krisa P.; Goldberg, Ronald N.; Watterberg, Kristi L.; Faix, Roger G.; Frantz, Ivan D.; Higgins, Rosemary D.

    2013-01-01

    Context Current guidelines, initially published in 1995, recommend antenatal corticosteroids for mothers with preterm labor from 24–34 weeks gestational age, but not before 24 weeks because of lack of data. However, many infants born before 24 weeks are provided intensive care now. Objective To determine if antenatal corticosteroids are associated with improvement in major outcomes in infants born at 22 and 23 weeks. Design, Setting, Participants Data for this cohort study were collected prospectively on 401–1000 gram inborn infants (N=10,541) of 22–25 weeks gestation born between 1993–2009 at 23 academic perinatal centers in the United States. Certified examiners unaware of exposure to antenatal corticosteroids performed follow-up examinations on 4,924 (86.5%) of the infants born in 1993–2008 who survived to 18–22 months. Logistic regression models generated adjusted odds ratios, controlling for maternal and neonatal variables. Main Outcome Measures Mortality and neurodevelopmental impairment at 18–22 months corrected age RESULTS Death or neurodevelopmental impairment at 18–22 months was lower for infants whose mothers received antenatal corticosteroids born at 23 weeks (antenatal corticosteroids, 83.4% vs no antenatal corticosteroids, 90.5%; adjusted odds ratio 0.58; 95% CI, 0.42–0.80), at 24 weeks (antenatal corticosteroids, 68.4% vs no antenatal corticosteroids, 80.3%; adjusted odds ratio 0.62; 95% CI, 0.49–0.78), and at 25 weeks (antenatal corticosteroids, 52.7% vs no antenatal corticosteroids, 67.9%; adjusted odds ratio 0.61; 95% CI, 0.50–0.74) but not at 22 weeks (antenatal corticosteroids, 90.2% vs no antenatal corticosteroids, 93.1%; adjusted odds ratio 0.80; 95% CI, 0.29–12.21). Death by 18–22 months, hospital death, death/intraventricular hemorrhage/periventricular leukomalacia, and death/necrotizing enterocolitis were significantly lower for infants born at 23, 24, and 25 weeks gestational age if the mothers had received

  10. Morphological features and length measurements of fetal lateral ventricles at 16-25 weeks of gestation by magnetic resonance imaging.

    PubMed

    Taketani, Kaori; Yamada, Shigehito; Uwabe, Chigako; Okada, Tomohisa; Togashi, Kaori; Takakuwa, Tetsuya

    2015-05-01

    Normal growth of the lateral ventricles (LVs) was characterized three-dimensionally using magnetic resonance imaging (MRI) data from 16 human fetuses at 16-25 weeks of gestation. The LV was differentiated into four primary regions, the anterior horn, central parts, posterior horn, and inferior horn, at 16 weeks of gestation. The LV changed shape mainly by elongation and narrowing, which corresponded to the external and internal growth of the surrounding cerebrum. Six length parameters measured in the LV correlated with biparietal diameter by simple regression analysis (R(2) range, 0.56-0.93), which may be valuable for establishing a standardized prenatal protocol to assess fetal well-being and development across intrauterine periods. No correlation was found between biparietal diameter and LV volume (R(2) = 0.13). PMID:25059317

  11. A Triplet Pregnancy with Spontaneous Delivery of a Fetus at Gestational Age of 20 Weeks and Pregnancy Continuation of Two Other Fetuses until Week 33

    PubMed Central

    Ghorbani, Maryam; Moghadam, Somayeh

    2016-01-01

    Introduction: The prevalence of pregnancies with triplet or more has been increased due to using assisted reproductive treatments. Meanwhile, multiple pregnancies have higher risks and long-term maternal-fetal complications compared to twin and singleton pregnancies. Delayed interval delivery (DID) is a new approach in the management of multiple pregnancies following delivery or abortion. The purpose of this paper is to evaluate the benefits of DID and presents a case that used this method. Methods: This paper covers a report on a case of triplet pregnancy resulting from assisted reproductive techniques with spontaneous delivery of a fetus at gestational age of 20 weeks and the use of conservative DID for two other fetuses until the 33rd week. Results: In our case, the delivery of two other fetuses occurred spontaneously at gestational age of 33 weeks after the delivery of the first fetus at week 20. Conclusions: Using DID is a useful and reliable method, but requires careful monitoring, especially in patients with a history of infertility. PMID:26383220

  12. Executive Functioning and Learning Skills of Adolescent Children Born at Fewer than 26 Weeks of Gestation

    PubMed Central

    Farooqi, A.; Adamsson, M.; Serenius, F.; Hägglöf, B.

    2016-01-01

    Aims To assess the cognitive and behavioral aspects of executive functioning (EF) and learning skills in extremely preterm (EPT) children compared with term control children aged 10 to 15 years. Methods A total of 132 of 134 (98% of all eligible survivors) EPT children born at the 2 Swedish regional tertiary care centers from 1992 to 1998 (mean age = 12 years, mean birth weight = 718 g, and mean gestational age = 24.4 weeks) and 103 matched term controls were assessed. General intelligence was assessed using the Wechsler Intelligence Scale for Children (WISC-III-R), and cognitive aspects of EF were analyzed using EF-sensitive subscales of the WISC-III-R and Tower test of the Delis-Kaplan Executive Function Scale (D-KEFS). Behaviors related to EF and learning skills were assessed using the Five to Fifteen questionnaire, which is a validated parent and teacher instrument. Academic performance in school was assessed by teachers’ responses on Achenbach’s Teachers Report Form. Analyses performed included multivariate analyses of covariance (ANCOVA and MANCOVA) and logistic regression analyses. Results The EPT children displayed significant deficits in cognitive aspects of EF compared with the controls, exhibiting decreases on the order of 0.9 SD to 1.2 SD for tasks of verbal conceptual reasoning, verbal and non-verbal working memory, processing speed and planning ability (P <0.001 for all). After excluding the children with major neurosensory impairment (NSI) or a Full Scale intelligence quotient (FSIQ) of < 70, significant differences were observed on all tests. Compared with controls, parents and teachers of EPT children reported significantly more EF-related behavioral problems. MANCOVA of teacher-reported learning skills in children with FSIQ >70 and without major NSI revealed no interactions, but significant main effects were observed for the behavioral composite executive function score, group status (EPT vs control) and FSIQ, for which all effect sizes were

  13. Cervical preparation for second-trimester surgical abortion prior to 20 weeks' gestation: SFP Guideline #2013-4.

    PubMed

    Fox, Michelle C; Krajewski, Colleen M

    2014-02-01

    For a dilation and evacuation (D&E) procedure, the cervix must be dilated sufficiently to allow passage of operative instruments and products of conception without injuring the uterus or cervical canal. Preoperative preparation of the cervix reduces the risk of cervical laceration and uterine perforation. The cervix may be prepared with osmotic dilators, pharmacologic agents or both. Dilapan-S™ and laminaria are the two osmotic dilators currently available in the United States. Laminaria tents, made from dehydrated seaweed, require 12-24 h to achieve maximum dilation. Dilapan-S™, made of synthetic hydrogel, achieves significant dilation within 4 h and is thus preferable for same-day procedures. A single set of one to several dilators is usually adequate for D&E before 20 weeks' gestation. Misoprostol, a prostaglandin E1 analogue, is sometimes used instead of osmotic dilators. It is generally regarded as safe and effective; however, misoprostol achieves less dilation than overnight osmotic tents. The literature supports same-day cervical preparation with misoprostol or Dilapan-S™ up to 18 weeks' gestation. As the evidence regarding alternative regimens increases, highly experienced D&E providers may consider same-day regimens at later gestations utilizing serial doses of misoprostol or a combination of osmotic and pharmacologic agents. Misoprostol use as an adjunct to overnight osmotic dilation is not significantly beneficial before 19 weeks' gestation. Limited data demonstrate the safety of misoprostol before D&E in patients with a prior cesarean delivery. Mifepristone, a progesterone receptor antagonist, is also effective for cervical preparation prior to D&E, although data to support its use are limited. The Society of Family Planning recommends preoperative cervical preparation to decrease the risk of complications when performing a D&E. Since no single protocol has been found to be superior in all situations, clinical judgment is warranted when selecting

  14. Technetium-99m-methylene diphosphonate uptake in the fetal skeleton at 30 weeks gestation

    SciTech Connect

    McKenzie, A.F.; Budd, R.S.; Yang, C.

    1994-08-01

    Retention of {sup 99m}Tc-MDP in the fetal skeleton and placenta at 30 and 32 wk gestation was observed during bone scan examination of the maternal skeleton for staging of malignant tumors. The implications and significance of these observations are discussed. 8 refs., 2 figs., 1 tab.

  15. Fetal brain disruption sequence in a newborn infant with a history of cordocentesis at 21 weeks gestation

    PubMed Central

    Villo, N; Beceiro, J; Cebrero, M; de Frias, E G.

    2001-01-01

    The case is reported of a full term infant with severe microcephaly, overlapping sutures, prominence of the occipital bone, and scalp rugae. No other associated malformations were observed. The only obstetric history of interest was the performance of cordocentesis at 21 weeks gestational age because of low maternal α fetoprotein levels. Ultrasound scans performed until then were normal. Cranial growth retardation was detected on ultrasound scanning at 25 weeks and intrauterine growth retardation as well as severe microcephaly at 34 weeks. Neuroimaging studies performed on the newborn infant showed intense cerebral atrophy in both hemispheres. Other complementary investigations gave negative results. A relation is proposed between the cordocentesis and the development of vascular disruption, which could have caused the fetal brain disruption sequence in this case.

 PMID:11124930

  16. Chronic Lung Disease and Developmental Delay at 2 Years of Age in Children Born Before 28 Weeks' Gestation

    PubMed Central

    Laughon, Matthew; O'Shea, Michael T.; Allred, Elizabeth N.; Bose, Carl; Kuban, Karl; Van Marter, Linda J.; Ehrenkranz, Richard A.; Leviton, Alan

    2009-01-01

    Introduction Extremely low gestational age newborns (ELGANs) are at increased risk of chronic lung disease (CLD) and of developmental delay. Some studies have suggested that CLD contributes to developmental delay. Patients and Methods We examined data collected prospectively on 915 infants born before the 28th week of gestation in 2002–2004 who were assessed at 24 months of age with the Bayley Scales of Infant Development-2nd Edition or the Vineland Adaptive Behavior Scales. We excluded infants who were not able to walk independently (Gross Motor Function Classification System score < 1) and, therefore, more likely to have functionally important fine motor impairments. We defined CLD as receipt of oxygen at 36 weeks' postmenstrual age and classified infants as either not receiving mechanical ventilation (MV) (CLD without MV) or receiving MV (CLD with MV). Results Forty-nine percent of ELGANs had CLD; of these, 14% were receiving MV at 36 weeks' postmenstrual age. ELGANs without CLD had the lowest risk of a Mental Developmental Index (MDI) or a Psychomotor Developmental Index (PDI) of <55, followed by ELGANs with CLD not receiving MV, and ELGANs with CLD receiving MV (9%, 12%, and 18% for the MDI and 7%, 10%, and 20% for the PDI, respectively). In time-oriented multivariate models, the risk of an MDI of <55 was associated with the following variables: gestational age of <25 weeks; single mother; late bacteremia; pneumothorax; and necrotizing enterocolitis. The risk of a PDI of <55 was associated with variables such as single mother, a complete course of antenatal corticosteroids, early and persistent pulmonary dysfunction, pulmonary deterioration during the second postnatal week, pneumothorax, and pulmonary interstitial emphysema. CLD, without or with MV, was not associated with the risk of either a low MDI or a low PDI. However, CLD with MV approached, but did not achieve, nominal statistical significance (odds ratio: 1.9 [95% confidence interval: 0.97–3

  17. Pregnancy Disorders That Lead to Delivery Before the 28th Week of Gestation: An Epidemiologic Approach to Classification

    PubMed Central

    Hecht, J. L.; Dammann, O.; Boggess, K.; Onderdonk, A.; Markenson, G.; Harper, M.; Delpapa, E.; Allred, E. N.; Leviton, A.

    2008-01-01

    Epidemiologists have grouped the multiple disorders that lead to preterm delivery before the 28th week of gestation in a variety of ways. The authors sought to identify characteristics that would help guide how to classify disorders that lead to such preterm delivery. They enrolled 1,006 women who delivered a liveborn singleton infant of less than 28 weeks' gestation at 14 centers in the United States between 2002 and 2004. Each delivery was classified by presentation: preterm labor (40%), prelabor premature rupture of membranes (23%), preeclampsia (18%), placental abruption (11%), cervical incompetence (5%), and fetal indication/intrauterine growth restriction (3%). Using factor analysis (eigenvalue = 1.73) to compare characteristics identified by standardized interview, chart review, placental histology, and placental microbiology among the presentation groups, the authors found 2 broad patterns. One pattern, characterized by histologic chorioamnionitis and placental microbe recovery, was associated with preterm labor, prelabor premature rupture of membranes, placental abruption, and cervical insufficiency. The other, characterized by a paucity of organisms and inflammation but the presence of histologic features of dysfunctional placentation, was associated with preeclampsia and fetal indication/intrauterine growth restriction. Disorders leading to preterm delivery may be separated into two groups: those associated with intrauterine inflammation and those associated with aberrations of placentation. PMID:18756014

  18. Changing prognosis for babies of less than 28 weeks' gestation in the north of England between 1983 and 1994. Northern Neonatal Network.

    PubMed Central

    Tin, W.; Wariyar, U.; Hey, E.

    1997-01-01

    OBJECTIVE: To investigate the changing prognosis for babies of less than 28 weeks' gestation. DESIGN: A prospective, collaborative, population based survey. SETTING: The former Northern Regional Health Authority. SUBJECTS: All the births between 1983 and 1994 at 22 to 27 completed weeks' gestation to women normally resident in the region. MAIN OUTCOME MEASURES: Miscarriage, stillbirth, death in the first year of life, and disability in survivors. RESULTS: There were 479070 registered births in the study period. No baby of 22 weeks' gestation survived; only eight (4%) of the 197 babies of 23 weeks who were alive at the onset of labour survived for a year-a proportion that did not change during the study period. Survival among other babies of less than 28 weeks improved progressively between 1983-6 and 1991-4, but administration of artificial surfactant to babies requiring ventilation from mid-1990 was associated with further improvement in survival only in those over 25 weeks' gestation. Babies of 24 weeks required three times as much high dependency care per survivor as babies of 27 weeks (76 v 26 days). The rate of severe disability in the one year survivors of less than 26 weeks' gestation (30/123; 24%) was similar to that seen in the sampled survivors of 26 and 27 weeks (29/108; 27%); the proportion disabled did not change significantly during the study period. All the children born in 1983, 1987, and 1991 were later reassessed in greater detail: 10% (13/136) seemed destined for a continuing life of total dependency. CONCLUSIONS: Gestation, if accurately assessed, can give a woman facing very preterm delivery a clear indication of the prognosis for her baby and help her judge the appropriateness of accepting obstetric intervention and sustained perinatal support. PMID:9006468

  19. Relationships among the concentrations of 25 inflammation-associated proteins during the first postnatal weeks in the blood of infants born before the 28th week of gestation

    PubMed Central

    Leviton, Alan; Allred, Elizabeth N.; Yamamoto, Hidemi; Fichorova, Raina N.

    2011-01-01

    Background Inflammation appears to be involved in processes leading to organ damage in preterm newborns, yet little is known about the relationships among elevated concentrations of inflammation-associated proteins in the blood of preterm newborns. Methods In this exploratory study, we used an electrochemiluminescence method to measure 25 proteins in blood obtained on postnatal day 1 (range 1–3), day 7 (range 5–8), and day 14 (range 12–15) from 939 children born before the 28th week of gestation and evaluated to what extent those whose concentration of each protein was elevated (defined as in the highest quartile for gestational age and day the specimen was obtained) also had an elevated concentration of every other protein the same day or on a day 1 or 2 weeks later (p < .0001). Results On each of the 3 days assessed, elevated concentrations of 17 proteins were associated with elevated concentrations of 15 or more of the other 24 proteins. VEGF, VEGF-R1, VEGF-R2 were among these proteins, while IGFBP-1 was associated with 13 other proteins on day 7. An elevated concentration of 8 proteins on day 1 predicted an elevated concentration of 10 or more proteins on day 7, while an elevated concentration of only two proteins on day 7 were associated with elevated concentrations of 10 or more proteins on day-14. Few associations were seen between day 1 and day 14. Conclusions/inferences Inflammation is a diffuse process in ELGANs, with elevated concentrations of cytokines, chemokines, adhesion molecules, matrix metalloproteinases, a growth factor and its receptors, as well as a growth factor binding protein associated with each other the same day, as well as on subsequent days. PMID:22133344

  20. [Ultrasound imaging of normal fetal central nervous system at 8 to 12 weeks of gestation].

    PubMed

    Vojtech, J; Krofta, L; Urbánková, I; Dlouhá, K; Haaková, L; Feyereisl, J

    2011-12-01

    With ongoing evolution of advanced ultrasound diagnostic in prenatal care the trend is to detect potential fetal anomalies in the first trimester if possible. Complex knowledge of normal fetal anatomy, embryology and ultrasound anatomy is important to be able to identify subtle abnormalities. In this review we demonstrate the possibilities of ultrasound imaging of fetal brain at late first trimester and describe normal central nervous system development week by week. Original images are presented. PMID:22312839

  1. Antenatal Magnesium Sulfate, Necrotizing Enterocolitis, and Death among Neonates < 28 Weeks Gestation

    PubMed Central

    Kamyar, Manijeh; Clark, Erin A. S.; Yoder, Bradley A.; Varner, Michael W.; Manuck, Tracy A.

    2016-01-01

    Objective This study aims to examine the relationship between antenatal magnesium sulfate (MgSO4) and neonatal death and/or severe necrotizing enterocolitis (NEC) among infants < 28 weeks. Methods Secondary analysis of a multicenter randomized trial of antenatal MgSO4 versus placebo administered to women to prevent death and cerebral palsy. Neonates < 28 weeks were included. The primary outcome was neonatal death before NICU discharge, and/or severe NEC (Bell criteria stage II/III). Neonates with and without death/severe NEC were compared. Results A total of 697 neonates met the criteria. Out of which 150 (21.5%) died and/or were diagnosed with severe NEC. Antenatal MgSO4 exposure was not associated with death/severe NEC in infants < 28 weeks. In a subgroup analysis of neonates < 26 weeks, treatment group assignment to antenatal MgSO4 was associated with an increased odds of death/severe NEC (adjusted odds ratio: 1.90, 95% confidence interval: 1.12–3.22, p = 0.017). Conclusions Among neonates < 26 weeks, antenatal MgSO4 was associated with death and severe NEC. Further prospective study in larger populations is needed. PMID:27054046

  2. Cervical dilation before first-trimester surgical abortion (<14 weeks' gestation).

    PubMed

    Allen, Rebecca H; Goldberg, Alisa B

    2016-04-01

    First-trimester surgical abortion is a common, safe procedure with a major complication rate of less than 1%. Cervical dilation before suction abortion is usually accomplished using tapered mechanical dilators. Risk factors for major complications in the first trimester include increasing gestational age and provider inexperience. Cervical priming before first-trimester surgical abortion has been studied using osmotic dilators and pharmacologic agents, most commonly misoprostol. Extensive data demonstrate that a variety of agents are safe and effective at causing preoperative cervical softening and dilation; however, given the small absolute risk of complications, the benefit of routine use of misoprostol or osmotic dilators in first-trimester surgical abortion is unclear. Although cervical priming results in reduced abortion time and improved provider ease, it requires a delay of at least 1 to 3 h and may confer side effects. The Society of Family Planning does not recommend routine cervical priming for first-trimester suction abortion but recommends limiting consideration of cervical priming for women at increased risk of complications from cervical dilation, including those late in the first trimester, adolescents and women in whom cervical dilation is expected to be challenging. PMID:26683499

  3. Assessment of cardiorespiratory stability using the infant car seat challenge before discharge in preterm infants (<37 weeks' gestational age).

    PubMed

    Narvey, Michael R

    2016-04-01

    Preterm infants younger than 37 weeks corrected gestational age are at increased risk for abnormal control of respiration. The infant car seat challenge has been used as a screening tool to ensure cardiorespiratory stability before discharging preterm infants from many hospitals in Canada. While it is clear that infants placed in a car seat are more likely to experience oxygen desaturation and/or bradycardia than when they are supine, neither positioning predicts an adverse neurodevelopmental outcome or mortality post-discharge. A review of the literature yielded insufficient evidence to recommend routine use of the infant car seat challenge as part of discharge planning for preterm infants. This finding has prompted a change in recommendation from a previous Canadian Paediatric Society position statement published in 2000. PMID:27398056

  4. Ruptured Interstitial Ectopic Pregnancy at 18 Weeks Gestation Diagnosed by MRI: A Case Report

    PubMed Central

    Hamouda, Ehab SM; Littooij, Annemieke S; Thia, Edwin WH; Ong, Chiou L

    2013-01-01

    Ectopic pregnancy in the interstitial part of the fallopian tube is a rare event, associated with a high rate of complications due to delayed diagnosis. Rupture of such pregnancy often results in catastrophic hemorrhage. Several reports highlighted the role of magnetic resonance imaging in establishing the diagnosis of interstitial pregnancy, but magnetic resonance imaging findings of a ruptured advanced interstitial ectopic pregnancy have not been published before. The authors therefore present characteristic findings on magnetic resonance imaging of a ruptured interstitial ectopic pregnancy which had reached 18 weeks, in a 25-year-old woman who presented with acute abdominal pain. PMID:24421921

  5. Cervical dilation before first-trimester surgical abortion (<14 weeks' gestation). SFP Guideline 20071.

    PubMed

    Allen, Rebecca H; Goldberg, Alisa B

    2007-08-01

    First-trimester surgical abortion is a common, safe procedure with a major complication rate of less than 1%. Cervical dilation before suction aspiration is usually accomplished using tapered mechanical dilators. Risk factors for major complications in the first trimester are increasing gestational age and provider inexperience. Use of laminaria for cervical priming reduces the risk of cervical laceration and, to a lesser extent, uterine perforation. While pharmacological priming agents may potentially have the same effects, no published studies to date have been large enough to assess these outcomes. Given an experienced provider, the risk of these injuries during suction aspiration is very small. Cervical priming can be achieved with osmotic dilators or pharmacological agents. The advantages of osmotic dilators such as laminaria, Dilapan-S and Lamicel are their ability to produce wide cervical dilation, and for the synthetic types, their advantages include predictable effects and rapid onset of action. A disadvantage of osmotic dilators is that they require a speculum examination and a trained clinician to perform the insertion. When cervical priming is performed, misoprostol is the prostaglandin analogue most commonly used worldwide. Compared to laminaria, vaginal misoprostol requires a shorter period of time to achieve the same dilatation, is associated with less discomfort and is preferred by women. The sublingual route appears as effective as vaginal administration and requires less time for priming (2 h), but it is associated with more side effects. Oral administration can produce equivalent dilation to vaginal or sublingual administration, but higher doses and longer treatment periods (8 to 12 h) are required. Buccal administration of misoprostol appears to have a pharmacokinetic and physiologic profile similar to vaginal administration; however, there are no published studies of buccal misoprostol prior to first-trimester suction abortion. While extensive

  6. Standardized weaning of infants <32 weeks of gestation from continuous positive airway pressure - a feasibility study.

    PubMed

    Kidszun, André; Plate, Maren; Arnold, Christine; Winter, Julia; Gerhold-Ay, Aslihan; Mildenberger, Eva

    2016-10-01

    The practice of weaning premature infants from continuous positive airway pressure (CPAP) varies considerably and is usually performed without written standards. In this study, the feasibility of a standardized weaning approach was evaluated. In a quasi-experimental design, data from a prospective, post-intervention cohort (n=41) were compared to data from a pre-intervention cohort (n=36). Standardized weaning was feasible but no significant differences in short-term respiratory outcomes were observed. Weaning from CPAP was achieved at 32.1 ± 1.6 (post-intervention) versus 32.5 ± 2.3 weeks (pre-intervention) postmenstrual age. More rigorous, large-scale clinical trials are necessary before firm recommendations on distinct weaning regimens can be made. PMID:26552715

  7. Predictors of RSV LRTI Hospitalization in Infants Born at 33 to 35 Weeks Gestational Age: A Large Multinational Study (PONI)

    PubMed Central

    Saliba, Elie; Kosma, Paraskevi; Posfay-Barbe, Klara; Yunis, Khalid; Farstad, Teresa; Unnebrink, Kristina; van Wyk, Jean; Wegzyn, Colleen; Notario, Gerard; Kalus, Stefanie; Campbell, Fiona J.

    2016-01-01

    Background Preterm infants are at high risk of developing respiratory syncytial virus (RSV)-associated lower respiratory tract infection (LRTI). This observational epidemiologic study evaluated RSV disease burden and risk factors for RSV-associated LRTI hospitalization in preterm infants 33 weeks+0 days to 35 weeks+6 days gestational age not receiving RSV prophylaxis. Methods Preterm infants ≤6 months of age during RSV season (1 October 2013–30 April 2014) were followed at 72 sites across 23 countries from September 2013–July 2014 (study period). RSV testing was performed according to local clinical practice. Factors related to RSV-associated hospitalization for LRTI were identified using multivariable logistic regression with backward selection. Results Of the 2390 evaluable infants, 204 and 127 were hospitalized for LRTI during the study period and RSV season, respectively. Among these subjects, 64/204 and 46/127, respectively, were hospitalized for confirmed RSV LRTI. Study period and RSV season normalized RSV hospitalization rates (per 100 infant years) were 4.1 and 6.1, respectively. Factors associated with an increased risk of RSV-related LRTI hospitalization in multivariable analyses were smoking of family members (P<0.0001), non-hemodynamically significant congenital heart disease diagnosis (P = 0.0077), maternal age of ≤25 years at delivery (P = 0.0009), low maternal educational level (P = 0.0426), household presence of children aged 4 to 5 years (P = 0.0038), age on 1 October ≤3 months (P = 0.0422), and presence of paternal atopy (P<0.0001). Conclusions During the 2013–2014 RSV season across 23 countries, for preterm infants 33–35 weeks gestation ≤6 months old on 1 October not receiving RSV prophylaxis, confirmed RSV LRTI hospitalization incidence was 4.1 per 100 infant years during the study period and 6.1 per 100 infant years during the RSV season. This study enhances the findings of single-country studies of common risk factors for

  8. Maternal Whole Blood Gene Expression at 18 and 28 Weeks of Gestation Associated with Spontaneous Preterm Birth in Asymptomatic Women

    PubMed Central

    Pennell, Craig E.; McDonald, Sheila W.; Vinturache, Angela E.; Xu, Jingxiong; Lee, Mary W. F.; Briollais, Laurent; Lyon, Andrew W.; Slater, Donna M.; Bocking, Alan D.; de Koning, Lawrence; Olson, David M.; Dolan, Siobhan M.; Tough, Suzanne C.; Lye, Stephen J.

    2016-01-01

    The heterogeneity of spontaneous preterm birth (SPTB) requires an interdisciplinary approach to determine potential predictive risk factors of early delivery. The aim of this study was to investigate maternal whole blood gene expression profiles associated with spontaneous preterm birth (SPTB, <37 weeks) in asymptomatic pregnant women. The study population was a matched subgroup of women (51 SPTBs, 114 term delivery controls) who participated in the All Our Babies community based cohort in Calgary (n = 1878). Maternal blood at 17–23 (sampling time point 1, T1) and 27–33 weeks of gestation (T2) were collected. Total RNA was extracted and microarray was performed on 326 samples (165 women). Univariate analyses determined significant clinical factors and differential gene expression associated with SPTB. Thirteen genes were validated using qRT-PCR. Three multivariate logistic models were constructed to identify gene expression at T1 (Model A), T2 (Model B), and gene expression fold change from T1 to T2 (Model C) associated with SPTB. All models were adjusted for clinical factors. Model C can predict SPTB with 65% sensitivity and 88% specificity in asymptomatic women after adjusting for history of abortion and anaemia (occurring before T2). Clinical data enhanced the sensitivity of the Models to predict SPTB. In conclusion, clinical factors and whole blood gene expression are associated with SPTB in asymptomatic women. An effective screening tool for SPTB during pregnancy would enable targeted preventive approaches and personalised antenatal care. PMID:27333071

  9. [Maternal and fetal morbidity in patients with premature rupture of the membrane after 27-week gestation. Causes and costs].

    PubMed

    Nava Flores, Jorge; Enríquez Miranda, Ma Cecilia; Hernández-Valencia, Marcelino

    2003-07-01

    Premature rupture of the membranes (PROM) occurs in a third of the childbirths preterm, this represents 8% of all pregnancies, with same morbidity and mortality in developing and developed countries, PROM is the more common cause of neonatal morbidity and mortality, making this obstetric complication a worldwide problem of health, since it contributes to the economic problem for the cost risen in medical attention for both, mothers and live birth. PROM is considered a mutifactorial entity. This study was carried out in the Hospital de Ginecología y Obstetricia of the Centro Médico "La Raza" in Mexico City, where women entered in serial form with pregnancies from 27 to 34 weeks of gestation and spontaneous PROM, without any other pathology. 120 patients were included, with 26.8 +/- 5.9 year-old age. The gestational age with more frequency of PROM were from 30 to 33 weeks, 22.5% of the patients had 4 days with PROM, 6 of this cases arrived up to 13 days with this complication at delivery. 2.5% of the patients presented deciduitis, with adequated response to the use of antibiotics. When analyzing the hospital stay, a stay was observed from 4 to 7 days (5.26 +/- 1.96 M +/- SD), with a total cost for maternal stay of 2 millions 445,650 pesos. Those babies born had an average of 23 days of hospital stay and the total cot of the days of stay was 4 millions 963,978 pesos. Other costs were the attention of maternal and pediatrics specialty, the obstetric resolution of the pregnancy, obstetric ultrasonography and crystallographies. Thus, the total costs of the attention of this complication in these patients with PROM was of 10 millions 296,988 pesos. The international reference is the American dollar that was in 10 pesos for dollar to the moment of this study. The maternal morbidity is low to that described in previous studies, but in spite of the exhaustive efforts on the prevention, prediction, diagnosis and treatment, the premature rate due to PROM has not diminished

  10. 12th NREL photovoltaic program review

    SciTech Connect

    Noufi, R.; Ullal, H.S. )

    1994-01-01

    The 12th NREL Photovoltaic Program Review was held in Denver in October 1993. This represents the U.S. Department of Energy's National Photovoltaic Program. Invited speakers from private industry, university etc., discussed topics such as: materials growth and testing, photovoltaic cell manufacturing, system engineering and applications, single and multijunction device etc.. These proceedings represent collection of papers presented at the review, most of the research reported is sponsored by the Department of Energy. Sixty six papers were presented at the review, out of these fifty nine have been abstracted for the Energy Science and Technology database. (AIP)

  11. Primary Genital Herpes Simplex Virus Type I in Preterm Prelabour Rupture of Membranes at 30 Weeks' Gestation

    PubMed Central

    Dalton, Anna; Grivell, Rosalie

    2015-01-01

    Background. Disseminated herpes simplex virus (HSV) in the neonate is associated with significant morbidity and mortality. Current guidelines recommend caesarean in third-trimester maternal primary genital HSV outbreaks to prevent transmission from mother to fetus. In the premature fetus, however, expectant management is often necessary to reduce morbidity of prematurity. The benefit of performing caesarean after 6 hrs of rupture of membranes (ROM) to reduce maternal-fetal transmission is unclear. Case. A female patient with primary genital HSV type 1 outbreak coinciding with preterm, prelabour rupture of membranes (PPROM) at 30 + 3 weeks' gestation. An immediate caesarean section was not performed after multidisciplinary team discussion due to the benefits of glucocorticoids on immune complications of prematurity. The patient had expectant management for 5 days with intravenous (IV) aciclovir and then delivered an infant vaginally with disseminated neonatal HSV. Conclusion. We address the rare presentation of primary HSV infection associated with PPROM and the dilemma of how to manage these patients given the limited literature. We discuss the role of intrauterine compartment monitoring with amniocentesis, the mode of delivery when ROM has occurred for 120 hours, expectant management to reduce prematurity, and the effectiveness of aciclovir to reduce viral shedding in the prevention of neonatal HSV. PMID:26649212

  12. Static and Functional Hemodynamic Profiles of Women with Abnormal Uterine Artery Doppler at 22–24 Weeks of Gestation

    PubMed Central

    Widnes, Christian

    2016-01-01

    Objective To compare cardiac function, systemic hemodynamics and preload reserve of women with increased (cases) and normal (controls) uterine artery (UtA) pulsatility index (PI) at 22–24 weeks of gestation. Materials and Methods A prospective cross-sectional study of 620 pregnant women. UtA blood flow velocities were measured using Doppler ultrasonography, and PI was calculated. Mean UtA PI ≥ 1.16 (90th percentile) was considered abnormal. Maternal hemodynamics was investigated at baseline and during passive leg raising (PLR) using impedance cardiography (ICG). Preload reserve was defined as percent increase in stroke volume (SV) 90 seconds after passive leg raising compared to baseline. Results Mean UtA PI was 1.49 among cases (n = 63) and 0.76 among controls (n = 557) (p < 0.0001). Eighteen (28.6%) cases and 53 (9.5%) controls developed pregnancy complications (p <0.0001). The mean arterial pressure and systemic vascular resistance were 83 mmHg and 1098.89±293.87 dyne s/cm5 among cases and 79 mmHg and 1023.95±213.83 dyne s/cm5 among controls (p = 0.007 and p = 0.012, respectively). Heart rate, SV and cardiac output were not different between the groups. Both cases and controls responded with a small (4–5%) increase in SV in response to PLR, but the cardiac output remained unchanged. The preload reserve was not significantly different between two groups. Conclusion Pregnant women with abnormal UtA PI had higher blood pressure and systemic vascular resistance, but similar functional hemodynamic profile at 22–24 weeks compared to controls. Further studies are needed to clarify whether functional hemodynamic assessment using ICG can be useful in predicting pregnancy complications. PMID:27308858

  13. Perinatal outcomes of pregnancies complicated by preterm premature rupture of the membranes before 34 weeks of gestation in a tertiary center in China: A retrospective review.

    PubMed

    Yu, Haiyan; Wang, Xiaodong; Gao, Haocheng; You, Yong; Xing, Aiyun

    2015-02-01

    Preterm premature rupture of the membranes (PPROM) remains the leading cause of preterm deliveries and neonatal mortality and morbidity. The current cohort study sought to retrospectively examine perinatal outcomes in cases of PPROM < 34 weeks' gestation that were managed conservatively from 2010 to 2012 and to identify risk factors for short-term neonatal outcomes. Subjects were 510 pregnancies consisting of 114 twin and 396 singleton pregnancies. Clinical chorioamnionitis occurred in 17.8% of the pregnancies. Neonatal mortality was 7.4%, the rate of major neonatal conditions was 40%, and the rate of NICU admission was 72.9%. The latency period exceeded 48 h in 62.5% of the pregnancies and 7 days in 24.3% of the pregnancies. Twin pregnancies had a shorter latency period than singleton pregnancies (median of 2 days versus 4 days, p < 0.001). Pregnancies complicated with early vaginal bleeding had a higher neonatal mortality (13.95% vs. 6.36%, p = 0.013) and morbidity (51.16% vs. 38.32%, p = 0.024), fewer weeks of gestation at PPROM (p = 0.029). Multivariate logistic regression analysis revealed that weeks of gestation at PPROM (OR: 0.953, 95% CI: 0.939-0.966, p < 0.001) and a latency period (OR: 0.948, 95%CI: 0.926-0.970, p < 0.001) were associated with neonatal mortality or morbidity. A twin pregnancy (OR: 0.319, 95% CI: 0.17-0.6, p < 0.001) and weeks of gestation at PPROM (OR: 0.737, 95% CI: 0.66-0.822, p < 0.001) were associated with the latency period. Gestational age at PPROM, a twin pregnancy, and the latency period are associated with neonatal mortality and morbidity. PMID:25787907

  14. Improving the outcome of infants born at <30 weeks' gestation - a randomized controlled trial of preventative care at home

    PubMed Central

    2009-01-01

    Background Early developmental interventions to prevent the high rate of neurodevelopmental problems in very preterm children, including cognitive, motor and behavioral impairments, are urgently needed. These interventions should be multi-faceted and include modules for caregivers given their high rates of mental health problems. Methods/Design We have designed a randomized controlled trial to assess the effectiveness of a preventative care program delivered at home over the first 12 months of life for infants born very preterm (<30 weeks of gestational age) and their families, compared with standard medical follow-up. The aim of the program, delivered over nine sessions by a team comprising a physiotherapist and psychologist, is to improve infant development (cognitive, motor and language), behavioral regulation, caregiver-child interactions and caregiver mental health at 24 months' corrected age. The infants will be stratified by severity of brain white matter injury (assessed by magnetic resonance imaging) at term equivalent age, and then randomized. At 12 months' corrected age interim outcome measures will include motor development assessed using the Alberta Infant Motor Scale and the Neurological Sensory Motor Developmental Assessment. Caregivers will also complete a questionnaire at this time to obtain information on behavior, parenting, caregiver mental health, and social support. The primary outcomes are at 24 months' corrected age and include cognitive, motor and language development assessed with the Bayley Scales of Infant and Toddler Development (Bayley-III). Secondary outcomes at 24 months include caregiver-child interaction measured using an observational task, and infant behavior, parenting, caregiver mental health and social support measured via standardized parental questionnaires. Discussion This paper presents the background, study design and protocol for a randomized controlled trial in very preterm infants utilizing a preventative care program

  15. Fetal growth restriction and risk of chronic lung disease among infants born before the 28th week of gestation

    PubMed Central

    Bose, Carl; Van Marter, Linda J.; Laughon, Matthew; O'Shea, T. Michael; Allred, Elizabeth N.; Karna, Padmani; Ehrenkranz, Richard A.; Boggess, Kim; Leviton, Alan

    2009-01-01

    Objective Improvement in survival of extremely premature infants over the past several decades has resulted in an increase in the number infants with chronic lung disease (CLD). Historical neonatal exposures associated with CLD now less frequently precede the disease. There is now increasing interest in exposures and events before delivery that predict CLD. The objective of this study was to identify current antenatal predictors of CLD. Patients and Methods We collected data about antenatal, placental and neonatal characteristics of 1241 newborns delivered before completion of the 28th week of gestation who were enrolled in a 14-center, observational study conducted during the years 2002-2004. Associations between antenatal factors, microbiologic and histologic characteristics of the placenta, and selected neonatal characteristics and CLD risk were first evaluated in univariate analyses. Subsequent multivariate analyses investigated the contribution of antenatal factors, particularly fetal growth restriction (FGR), to CLD risk. Results Among the antenatal factors, birth weight Z-score, used as a marker of FGR, provided the most information about CLD risk. Indicators of placental inflammation and infection were not associated with increased risk of CLD. Within nearly all strata of antenatal, placental and neonatal variables, growth restricted infants were at increased CLD risk compared with infants who were not growth restricted. FGR was the only maternal or antenatal characteristic that was highly predictive of CLD after adjustment for other risk factors. Conclusions FGR is independently associated with the risk of CLD. Thus factors that control fetal somatic growth may have a significant impact on vulnerability to lung injury, and in this way increase CLD risk. Future investigations should focus on the impact of FGR on growth factors that modulate lung growth. PMID:19706590

  16. Neonatal mortality due to preterm birth at 28-36 weeks' gestation in China, 2003-2008.

    PubMed

    Liang, Juan; Mao, Meng; Dai, Li; Li, Xiaohong; Miao, Lei; Li, Qi; He, Chunhua; Li, Mingrong; Wang, He; Zhu, Jun; Wang, Yanping

    2011-11-01

    Almost all (99%) neonatal deaths occur in developing countries, where the progress in reducing neonatal mortality rates (NMR) has been small; the Millennium Development Goal for child survival cannot be met if this situation continues. China is among the 10 countries that have the largest numbers of neonatal deaths. In order to provide effective interventions to reduce the national NMR for government policy makers, we analyse the trends, causes and characteristics of the neonatal deaths of preterm babies in different regions of China during the period 2003-2008. The data for this retrospective study were retrieved from the population-based Maternal and Child Health Surveillance System of China. The Cochran-Armitage trend test was used to analyse the trend of NMRs due to immaturity. The national NMR due to immaturity has decreased by 38.7% in 6 years. However, the proportion of preterm births among the causes of neonatal death has increased significantly from 33.6% in 2003 to 40.9% in 2008. The relative risk of neonatal death among preterm babies has shown significant regional disparity. In 2008, the adjusted relative risk was 1.30 [95% confidence interval (CI) 0.95, 1.78] in the inland regions and 2.37 [95% CI 1.56, 3.60] in the remote regions, both compared with the coastal regions. The proportion of neonatal deaths with a gestational age <32 weeks or a birthweight <1500 g was highest among the coastal regions. Most neonatal deaths of preterm babies in remote areas were born at home and were not treated before death. Our study suggests that preterm birth is the leading cause of neonatal death in China and neonatal mortality due to immaturity displayed regional differences. The Chinese government should implement major effective strategies for reducing the mortality of preterm infants to further decrease the total NMR. Priority interventions should be region-specific, depending on the availability of economic and health care resources. PMID:21980948

  17. 12th International CHARGE syndrome conference proceedings.

    PubMed

    Martin, Donna M; Salem-Hartshorne, Nancy; Hartshorne, Timothy S; Scacheri, Peter C; Hefner, Margaret A

    2016-04-01

    The CHARGE Syndrome Foundation holds an International conference for families and professionals every other summer. In July, 2015, the 12th meeting was held in Schaumburg, Illinois, at the Renaissance Schaumburg Hotel. Day one of the 4-day conference was dedicated to professionals caring for and researching various aspects of CHARGE, including education, medical management, animal models, and stem cell-based approaches to understanding and treating individuals with CHARGE. Here, we summarize presentations from the meeting, including a synopsis of each of the three different breakout sessions (Medical/Clinical, Basic Science/CHD7, and Education), followed by a list of abstracts and authors for both platform and poster presentations. PMID:26754144

  18. IMPORTANCE OF BIRTH WEIGHT AS A RISK FACTOR FOR SEVERE RETINOPATHY OF PREMATURITY WHEN GESTATIONAL AGE IS 30 OR MORE WEEKS

    PubMed Central

    Holzman, Ian R.; Ginsburg, Robin N.; Brodie, Scott E.; Stroustrup, Annemarie

    2015-01-01

    Purpose To determine whether birth weight less than1,500 grams is a relevant guideline indicating the need for examination for retinopathy of prematurity (ROP) when gestational age at birth is 30 or more completed weeks. Design A retrospective observational cohort study. Methods 266 infants in a single institutional neonatal intensive care unit (NICU), whose gestational age at birth was 30 or more weeks but whose birth weight was less than 1,500 grams, were examined according to published guidelines. Infants with lethal congenital anomalies or major ocular abnormalities were excluded. Outcomes were vascularization in retinal zone III without a prior need for treatment, or ROP warranting treatment. Results A study outcome was reached by 212 infants. Two hundred and eleven (99.5%) became vascularized through zone III without needing treatment. Only 1 (0.5%) required treatment for ROP. The 95% confidence interval for the occurrence rate of ROP requiring treatment in this cohort was 0.01 to 2.60%. Conclusion Our results suggest that the occurrence rates of ROP requiring treatment in infants with gestational age 30 or more weeks and birth weight less than 1,500 grams is very low, and could indicate the need to revise examination guidelines for this subgroup of infants. PMID:24582994

  19. Attempting to Honor Beliefs of Jehovah's Witnesses at the Edge of Viability in an Infant Born at 23 Weeks' Gestational Age.

    PubMed

    Sauer, Charles W; Marc-Aurele, Krishelle L

    2016-01-01

    BACKGROUND Infants born at 23 weeks' gestation have a poor prognosis and require intensive care, including blood transfusions, to survive. Generally speaking, the decision to forgo life support is acceptable. Jehovah's Witnesses believe that life is sacred and want lifesaving interventions except for blood transfusions. Therefore, an ethical dilemma exists when a baby is born on the edge of viability to parents that are Jehovah's Witnesses. In this case, if parents and healthcare professionals disagree on the best interests of the child, the medical team should obtain a court order from the state to intervene. CASE REPORT We present the case of an infant born at 23 weeks' gestation to parents who are Jehovah's Witnesses. The parents wanted full life-support, except for blood transfusions, to be given. The clinical team obtained a court order to transfuse the infant. The infant unfortunately died despite all efforts. CONCLUSIONS Currently, it is nearly impossible to honor the beliefs of Jehovah's Witnesses to provide lifesaving treatments without blood transfusions for infants born at the border of viability. If the goal is to prolong life, the standard of care for a premature infant is for a doctor to obtain a court order to override the beliefs and wishes of Jehovah's Witness parents and transfuse blood products as medically indicated. Although bloodless techniques for high-risk surgeries are under development, care for premature infants at 23 weeks' gestation necessitates red cell transfusions. PMID:27255268

  20. 12th Annual Conference on Vaccine Research.

    PubMed

    O'Brien, Jennifer

    2009-09-01

    The 12th Annual Conference on Vaccine Research, hosted by the National Foundation for Infectious Disease, attracted approximately 450 leaders in the fields of epidemiology, health economics, immunology and vaccinology, making it the largest scientific meeting devoted exclusively to vaccine research and technology. The conference highlighted recent issues in vaccine safety, including the history and design of a vaccine for rotavirus. Other topics included discussions of the synergies between veterinary and human vaccine development, updates on the development of vaccines for tuberculosis and malaria, and a comprehensive overview of immunization initiatives and goals for extending coverage of new and underused vaccines. Keynote remarks were provided by David Salisbury (Department of Health, London, UK) who outlined the aims and objectives of the Global Immunization Vision and Strategy (GIVS), an agenda created by the WHO and UNICEF. Salisbury highlighted the four primary aims of GIVS: immunize more people against more diseases, introduce a range of newly available vaccines and technologies, integrate other critical health interventions with immunization, and manage vaccination programs within the context of global interdependence. The GIVS initiative spans the time period of 2006-2015. PMID:19722886

  1. Retinopathy of prematurity in infants born before 25 weeks gestation in a Korean single neonatal intensive care unit: incidence, natural history and risk factors.

    PubMed

    Kong, Mingui; Shin, Dong Hoon; Kim, Sang Jin; Ham, Don Il; Kang, Se Woong; Chang, Yun Sil; Park, Won Soon

    2012-12-01

    As younger preterm infants are able to survive, more extremely preterm infants are at risk of developing retinopathy of prematurity (ROP). To investigate the incidence, progression and risk factors of ROP in extremely preterm infants in Korea, the medical records of infants born before 25 weeks gestation were retrospectively reviewed. The criteria for laser treatment agreed with type 1 ROP as defined by the Early Treatment for Retinopathy of Prematurity study. Of the 121 infants included in the analysis, 119 (98.4%) infants developed any stage ROP, including 78 infants (64.5%) with type 1 ROP. The mean postmenstrual age (PMA) at the onset of any ROP and type 1 ROP were 33.5 and 36.1 weeks, respectively. All but one infant developed type 1 ROP after 31 weeks PMA. Univariate analysis showed that duration of total parenteral nutrition and onset of any ROP (PMA) were associated with the development of type 1 ROP. In conclusion, this study shows high incidence of ROP in extremely preterm infants and suggests that, although current screening protocols are feasible for most preterm infants born before 25 weeks gestation, earlier screening before 31 weeks PMA may be necessary in infants with an unstable clinical course. PMID:23255858

  2. Online Calculator to Improve Counseling of Short-Term Neonatal Morbidity and Mortality Outcomes at Extremely Low Gestational Age (23-28 Weeks).

    PubMed

    King, Carol P; da Silva, Orlando; Filler, Guido; Lopes, Laudelino M

    2016-07-01

    Objective Extremely low gestational age (ELGA) infants are at high risk of perinatal and neonatal morbidity and mortality. Accurate and relevant data are essential for developing a health care plan and providing realistic estimates of infants' outcomes. Study Design Retrospective analysis of all infants delivered between 23(0/7) and 28(6/7) weeks' gestation over 11 years at a single center. Using logistic regression analysis, gestational age (GA)-specific mortality and morbidity rates, and the effects of gender, antenatal corticosteroids, multiple gestation, and birth weight (BW) were determined. Results Of the 766 study infants, 644 (84.1%) were admitted to the neonatal intensive care unit, of which 502 (75.8%) survived to discharge. GA, antenatal corticosteroids, and BW were significant predictors of survival (GA: odds ratio [OR] = 1.83, 95% confidence interval [CI] = 1.64-2.04; corticosteroids: OR = 7.62, 95% CI = 5.19-11.18; BW: OR = 1.56, 95% CI = 1.44-1.69). Increasing BW correlated with a decreasing mortality rate. Conclusion This study provides recent outcome data of ELGA infants delivered at a tertiary level center. The results have been translated into an online counseling tool (http://murmuring-brook-6600.herokuapp.com/ELGA.html). PMID:27057769

  3. Three-dimensional reconstruction and morphologic measurements of human embryonic hearts: a new diagnostic and quantitative method applicable to fetuses younger than 13 weeks of gestation

    PubMed Central

    Schleich, Jean-Marc; Dillenseger, Jean-Louis; Loeuillet, Laurence; Moulinoux, Jacques-Philippe; Almange, Claude

    2005-01-01

    Improvements in the diagnosis of congenital malformations explain the increasing early termination of pregnancies. Before 13 weeks of gestation, an accurate in vivo anatomical diagnosis cannot currently be made in all fetuses with the imaging instrumentation available. Anatomo-pathological examinations remain the gold standard to make accurate diagnoses, although they reach limits between 9 and 13 weeks of gestation. We present the first results of a methodology that can be applied routinely, using standard histological section, enabling the reconstruction, visual estimate and quantitative analysis of 13 weeks of age human embryonic cardiac structures. The cardiac blocks were fixed, included in paraffin and entirely sliced by a microtome. One slice out of 10 was topographically colored and digitized on an optical microscope. The cardiac volume was recovered by a semi-automatic realignment of the sections. Another semi-automatic procedure allowed extracting and labeling of the cardiac structures from the volume. The structures were studied with display tools, disclosing the internal and external cardiac components, and enabling the determination of size, thickness and precise position of the ventricles, atria and large vessels. This pilot study confirmed that a new 3-D reconstruction and visualization method enabled to make accurate diagnoses, including in embryos <13 weeks old. Its implementation at earlier stages of embryogenesis will provide a clearer view of cardiac development. PMID:16211458

  4. Respiratory Syncytial Virus Related Readmission in Preterm Infants Less than 34 weeks' Gestation Following Discharge from a Neonatal Intensive Care Unit in Korea

    PubMed Central

    Lee, Jang Hoon; Kim, Chun Soo; Chang, Yun Sil

    2015-01-01

    This study was done to evaluate respiratory syncytial virus (RSV) related readmission (RRR) and risk factors of RRR in preterm infants < 34 weeks gestational age (GA) within 1 yr following discharge from the neonatal intensive care unit (NICU). Infants (n = 1,140) who were born and admitted to the NICUs of 46 hospitals in Korea from April to September 2012, and followed up for > 1 yr after discharge from the NICU, were enrolled. The average GA and birth weight of the infants was 30+5 ± 2+5 weeks and 1,502 ± 474 g, respectively. The RRR rate of enrolled infants was 8.4% (96/1,140), and RSV accounted for 58.2% of respiratory readmissions of infants who had laboratory tests confirming etiological viruses. Living with elder siblings (odd ratio [OR], 2.68; 95% confidence interval [CI], 1.68-4.28; P < 0.001), and bronchopulmonary dysplasia (BPD) (OR, 2.95; 95% CI, 1.44-6.04; P = 0.003, BPD vs. none) increased the risk of RRR. Palivizumab prophylaxis (OR, 0.06; 95% CI, 0.03-0.13; P < 0.001) decreased the risk of RRR. The risk of RRR of infants of 32-33 weeks' gestation was lower than that of infants < 26 weeks' gestation (OR, 0.11; 95% CI, 0.02-0.53; P = 0.006). This was a nationwide study that evaluated the rate and associated risk factors of RRR in Korean preterm infants. Preterm infants with BPD or living with siblings should be supervised, and administration of palivizumab to prevent RRR should be considered. PMID:26566351

  5. Panel Recommends State-Level NAEP for 12th Graders

    ERIC Educational Resources Information Center

    Olson, Lynn

    2004-01-01

    A national commission formed to review the future of the 12th grade National Assessment of Educational Progress (NAEP) has recommended that the nation's primary barometer of student performance should expand dramatically to provide mandatory state results on the achievement of 12th graders and to measure their readiness for college, employment,…

  6. Use of Medical Resources by Preterm Infants Born at Less than 33 Weeks' Gestation Following Discharge from the Neonatal Intensive Care Unit in Korea.

    PubMed

    Lee, Jang Hoon; Chang, Yun Sil

    2015-10-01

    This study was aimed to provide data on the use of medical resources by preterm infants following discharge from the neonatal intensive care unit (NICU). The cohort included preterm infants (n=2,351) born at 22-32 weeks' gestation who were discharged from the NICUs of 44 Korean hospitals between April 2009 to March 2010. Mean duration of post-discharge follow-up was 425±237 days. After discharge from the NICU, 94.5% of total infants visited a pediatric outpatient clinic (11.5±9.8 mean visits), 42.9% visited a pediatric clinic for respiratory problems irregularly (4.9±6.6 mean visits), and 31.1% utilized emergency center at least once. Among all visits to the emergency center, 24.7% resulted in readmission and 50.8% of those visits were due to respiratory problems. At least one episode of readmission was required by 33.6% (788/2,346) of total infants, and 18.4% (431/2,346) of total infants were readmitted with respiratory problems at least once. Among all infants readmitted for respiratory problems, 16.2% (70/341) were diagnosed with respiratory syncytial virus infection which accounted for 30.3% of viral etiologies confirmed by laboratory testing. Infants born at <30 weeks' gestation had more frequent total readmission and respiratory readmission than those ≥30 weeks' gestation (2±1.7 vs. 1.7±1.2, P=0.009, 1.8±1.2 vs. 1.5±1.1, 0.027, respectively). Overall, use of medical resources is common, and respiratory problems are the leading cause of use of medical resources. Total readmissions and respiratory readmissions are more frequent in more immature infants. PMID:26566364

  7. Spontaneous uterine rupture after abdominal myomectomy at the gestational age of 20 weeks in pregnancy: A case report

    PubMed Central

    Pakniat, Hamideh; Soofizadeh, Nasrin; Khezri, Marzieh Beigom

    2016-01-01

    Background: Uterine rupture in pregnancy is rare and often could be life threatening and catastrophic. Myomectomy is one of very common surgeries in gynecology, performed as the vaginal, abdominal and laparoscopic surgeries. Pregnancies occured after abdominal and laparoscopic myomectomy are high risk for uterine rapture. Case: Patient was a 28 Years old female, pregnant woman at the 20 wks of gestational age with abdominal pain and a history of abdominal myomectomy 6 yrs ago. Uterus was ruptured and fetus in amniotic sac was found in abdominal cavity. Conclusion: Early diagnosis of uterine rupture after myomectomy can save patients from death. PMID:27525334

  8. Blood protein concentrations in the first two postnatal weeks that predict bronchopulmonary dysplasia among infants born before the 28th week of gestation

    PubMed Central

    Bose, Carl; Laughon, Matthew; Allred, Elizabeth N.; Van Marter, Linda J.; O’Shea, T. Michael; Ehrenkranz, Richard A.; Fichorova, Raina; Leviton, Alan

    2011-01-01

    Lung inflammation contributes to the pathogenesis of bronchopulmonary dysplasia (BPD) and may be accompanied by a systematic inflammatory response. The objective of this study was to investigate the role of systemic inflammation in the development of BPD in a cohort of extremely low gestational age newborns (ELGANs) by examining the relationships between inflammation-associated proteins in neonatal blood samples and pulmonary outcomes. Proteins were measured in blood specimens collected on postnatal days 1–3, 5–8 and 12–15 from 932 ELGANs. Increased risk of BPD was associated with elevated blood concentrations of a variety of pro-inflammatory cytokines, adhesion molecules and proteases. Reduced risk was prominently associated with increased concentrations of one chemokine, RANTES. Elevations of inflammatory proteins associated with BPD risk occurred during the first days following birth, and inflammation intensified thereafter. Therefore, exposures that promote inflammation after the first postnatal days may be more critical in the pathogenesis of BPD. Fetal growth restriction, a known BPD risk factor, was not accompanied by proteins elevations and therefore does not appear to be mediated by systemic inflammation. By contrast, mechanical ventilation altered protein levels and may be associated with systemic inflammation. PMID:21150694

  9. Normal ranges of biorbital and interorbital distances in healthy Turkish pregnancies at 19–23 weeks of gestation and correlation with craniofacial structures

    PubMed Central

    Pala, Halil Gürsoy; Artunç-Ülkümen, Burcu; Koyuncu, Faik Mümtaz; Uyar, Yıldız; Bülbül-Baytur, Yeşim

    2015-01-01

    Objective We aimed to determine the normal ranges for biorbital (BOD) and interorbital distances (IOD) during the second trimester in Turkish women with normal pregnancies and to assess the correlation between BOD, IOD, and other fetal craniofacial structures and biometric parameters. Material and Methods Our retrospective study comprised 1328 women with singleton normal pregnancies who had undergone ultrasonography (USG) examinations at 19–23 weeks of gestation in the second trimester screening. The measurements of BOD and IOD were obtained with the coronal section of the fetal face at the plane of orbits. Results Mean BOD was 3.4±0.33 cm, whereas mean IOD was 1.28±0.24 cm. Correlation analysis revealed that BOD was significantly correlated with IOD, transcerebellar diameter (TCD), cisterna manga (CM), nuchal fold (NF), nasal bone (NB), biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), femur length (FL), and gestational week. There was a significant relation between IOD and the lateral ventricle posterior horn, TCD, CM, NF, NB, BPD, HC, AC, and FL. Conclusion The reference ranges obtained in our study enabled accurate evaluation of BOD and IOD in the second trimester of normal pregnancies. USG detection of fetal orbital biometric anomalies may alert the clinician for different anomalies associated with abnormal development of eye. PMID:26401111

  10. Perinatal care at the limit of viability between 22 and 26 completed weeks of gestation in Switzerland. 2011 revision of the Swiss recommendations.

    PubMed

    Berger, Thomas M; Bernet, Vera; El Alama, Susanna; Fauchère, Jean-Claude; Hösli, Irène; Irion, Olivier; Kind, Christian; Latal, Bea; Nelle, Mathias; Pfister, Riccardo E; Surbek, Daniel; Truttmann, Anita C; Wisser, Joseph; Zimmermann, Roland

    2011-01-01

    Perinatal care of pregnant women at high risk for preterm delivery and of preterm infants born at the limit of viability (22-26 completed weeks of gestation) requires a multidisciplinary approach by an experienced perinatal team. Limited precision in the determination of both gestational age and foetal weight, as well as biological variability may significantly affect the course of action chosen in individual cases. The decisions that must be taken with the pregnant women and on behalf of the preterm infant in this context are complex and have far-reaching consequences. When counselling pregnant women and their partners, neonatologists and obstetricians should provide them with comprehensive information in a sensitive and supportive way to build a basis of trust. The decisions are developed in a continuing dialogue between all parties involved (physicians, midwives, nursing staff and parents) with the principal aim to find solutions that are in the infant's and pregnant woman's best interest. Knowledge of current gestational age-specific mortality and morbidity rates and how they are modified by prenatally known prognostic factors (estimated foetal weight, sex, exposure or nonexposure to antenatal corticosteroids, single or multiple births) as well as the application of accepted ethical principles form the basis for responsible decision-making. Communication between all parties involved plays a central role. The members of the interdisciplinary working group suggest that the care of preterm infants with a gestational age between 22 0/7 and 23 6/7 weeks should generally be limited to palliative care. Obstetric interventions for foetal indications such as Caesarean section delivery are usually not indicated. In selected cases, for example, after 23 weeks of pregnancy have been completed and several of the above mentioned prenatally known prognostic factors are favourable or well informed parents insist on the initiation of life-sustaining therapies, active obstetric

  11. A High Ductal Flow Velocity Is Associated with Successful Pharmacological Closure of Patent Ductus Arteriosus in Infants 22–27 Weeks Gestational Age

    PubMed Central

    Olsson, Karl Wilhelm; Jonzon, Anders; Sindelar, Richard

    2012-01-01

    Objective. To identify factors affecting closure of patent ductus arteriosus (PDA) in newborn infants born at 22–27 weeks gestational age (GA) during pharmacological treatment with cyclooxygenase inhibitors. Method. Infants born at 22–27 weeks of GA between January 2006 and December 2009 who had been treated pharmacologically for PDA were identified retrospectively. Medical records were assessed for clinical, ventilatory, and outcome parameters. Echocardiographic examinations during treatment were reviewed. Results. Fifty-six infants were included in the study. Overall success rate of ductal closure with pharmacological treatment was 52%. Infants whose PDA was successfully closed had a higher GA (25 + 4 weeks versus 24 + 3 weeks; P = 0.047), and a higher pretreatment left to right maximal ductal flow velocity (1.6 m/s versus 1.1 m/s; P = 0.023). Correcting for GA, preeclampsia, antenatal steroids, and age at start of treatment, a higher maximal ductal flow velocity was still associated with successful ductal closure (OR 3.04; P = 0.049). Conclusion. Maximal ductal flow velocity was independently associated with success of PDA treatment. PMID:23316351

  12. NICU Bedside Caregivers Sustain Process Improvement and Decrease Incidence of Bronchopulmonary Dysplasia in Infants < 30 Weeks Gestation

    PubMed Central

    Mola, Sara J; Annibale, David J; Wagner, Carol L; Hulsey, Thomas C; Taylor, Sarah N

    2015-01-01

    Background The objective of this study was to investigate whether a respiratory care bundle, implemented through participation in the Vermont Oxford Network-sponsored Neonatal Intensive Care Quality Improvement Collaborative (NIC/Q 2005) and primarily dependent on bedside caregivers, resulted in sustained decrease in the incidence of bronchopulmonary dysplasia (BPD) in infants < 30 wk gestation. Methods A retrospective cohort study was conducted. Infants inborn between 23 wk and 29 wk + 6 d of gestation were included. Patients with congenital heart disease, significant congenital or lung anomalies, or death before intubation were excluded. Four time periods (T1–T4) were identified: T1: September 1,2002 to August 31,2004; T2: September 1, 2004 to August 31,2006; T3: September 1,2006 to August 31,2008; T4: September 1,2008 to August 31, 2010. Results A total of 1,050 infants were included in the study. BPD decreased significantly in T3 post-implementation of the respiratory bundle compared with T1 (29.9% vs 51.2%, respectively; adjusted odds ratio [aOR] = 0.06 [95% CI 0.03-0.13], P = < .001). The decrease was not sustained into T4. There was a significant increase in the rate of BPD-free survival to discharge in T3 compared with T1 (53.1% vs 47%; aOR = 1.68 [95% CI 1.11-2.56], P = .01) that was also not sustained. The rate of infants requiring O2 at 28 d of life decreased significantly in T3 versus T1 (40.3% vs 69.9%, respectively; aOR = 0.12 [95% CI 0.07-0.20], P = < .001). Increases in the rate of surfactant administration by 1 h of life and rate of caffeine use were observed in T4 versus T1, respectively. There was a significant decrease in median ventilator days and a significant increase in the median number of noninvasive CPAP days throughout the study period. Conclusions In this study, implementation of a respiratory bundle managed primarily by nurses and respiratory therapists was successful in increasing the use of less invasive respiratory support in a

  13. Impaired visual fixation at age 2 years in children born before the 28th week of gestation. Antecedents and correlates in the multi-center ELGAN Study

    PubMed Central

    Phadke, Anuradha; Msall, Michael E; Droste, Patrick; Allred, Elizabeth N; O'Shea, T. Michael; Kuban, Karl; Dammann, Olaf; Leviton, Alan

    2014-01-01

    Background Very little is known about the prevalence, antecedents and correlates of impaired visual fixation in former very preterm newborns. Methods In the multi-center ELGAN Study sample of 1057 infants born before the 28th week of gestation who had a developmental assessment at 2 years corrected age, we identified 73 who were unable to follow an object across the midline. We compared them to the 984 infants who could follow an object across the midline. Results In this sample of very preterm newborns, those who had impaired visual fixation were much more likely than those without impaired visual fixation to have been born after the shortest of gestations (odds ratio = 3.2; 99% confidence interval =1.4, 7.5) and exposed to maternal aspirin (OR: 5.2; 99% CI: 2.2, 12). They were also more likely than their peers to have had prethreshold ROP (OR: 4.1; 99% CI: 1.8, 9.0). At age 2 years, the children with impaired fixation were more likely than others to be unable to walk (even with assistance) (OR: 7.5; 99% CI: 2.2, 26) and have a Mental Development Index more than 3 standard deviations below the mean of a normative sample (OR:3.6; 99% CI: 1.4, 8.2). Conclusion Risk factors for brain and retinal damage, such as very low gestational age, appear to be risk factors for impaired visual fixation. This inference is further supported by the co-occurrence at age 2 years of impaired visual fixation, inability to walk, and a very low Mental Development Index PMID:24938138

  14. Newly diagnosed hyperthyroidism in the 25th gestational week of pregnancy presenting with systolic arterial hypertension only.

    PubMed

    Zaveljcina, Janez; Legan, Mateja; Gaberšček, Simona

    2016-05-01

    We present a case of a 30-year-old woman diagnosed with arterial hypertension in the 25th week of pregnancy. Our search for secondary causes of arterial hypertension revealed hyperthyroid Hashimoto's thyroiditis (HT), which was treated with propilthiouracil. Three weeks after delivery, she was normotensive without medication. In the next four months, she developed hypothyroidism and treatment with L-thyroxine was started. In conclusion, in the second half of pregnancy, a hyperthyroid HT can occur - in spite of the well-known amelioration of autoimmune thyroid disorders in that period, and can be the only cause of arterial hypertension. PMID:26979941

  15. Neuropsychological analysis of the visuomotor problems in children born preterm at < or = 32 weeks of gestation: a 5-year prospective follow-up.

    PubMed

    Luoma, L; Herrgård, E; Martikainen, A

    1998-01-01

    Forty-six intellectually normal children born preterm (< or =32 weeks of gestation) without major neurological disabilities and a control group of term children matched for age, sex, and parental educational and occupational status were assessed at the age of 5 years using neuropsychological tests emphasizing perceptual and visuomotor functions. The results show that in terms of cognitive functions these preterm children are a very heterogenous group, but many of them still have problems in visuospatial and sensorimotor functions. The preterm children achieved lower mean scores in tests where coordination and voluntary control of hands in combination with tactile, kinaesthetic, and visuospatial perception were needed. They had most difficulty with drawing directions of lines and in integrating two or more forms. They also had problems with 3-dimensional constructions as well as visual perception of rotated shapes or slopes of lines. PMID:9459213

  16. Case with a Nonreassuring Fetal Status Induced by Massive Hematemesis due to Mallory-Weiss Tear That Required Emergency Cesarean Section at 38 Weeks' Gestation

    PubMed Central

    Suzuki, Takashi; Wagata, Maiko; Konno, Hiroko; Ito, Takahiro; Torii, Yuichi; Murakoshi, Takeshi

    2015-01-01

    We describe a rare case of Mallory-Weiss tear with massive hematemesis at 38 weeks' gestation. A 35-year-old woman presented with epigastralgia followed by massive hematemesis. An emergency endoscopy indicated active pulsatile bleeding at the esophagocardial junction. Although an emergency endoscopic hemostasis was successful, late decelerations without acceleration on cardiotocogram were observed. Therefore, the patient underwent emergency cesarean section, along with blood transfusion, following the endoscopic hemostasis. The hemoglobin level just before the operation was 5.1 g/dL. We suspected that massive hematemesis induced maternal acute anemia and hypovolemia, which resulted in a nonreassuring fetal status. Hence, urgent endoscopic hemostasis, adequate blood transfusion, and emergency cesarean section were needed. Mallory-Weiss tear during the third trimester may have a possibility of massive hematemesis and urgent blood transfusion, emergency endoscopic hemostasis, and emergency cesarean section may be needed. PMID:26881157

  17. Relations of Plasma Polyunsaturated Fatty Acids With Blood Pressures During the 26th and 28th Week of Gestation in Women of Chinese, Malay, and Indian Ethnicity

    PubMed Central

    Lim, Wai-Yee; Chong, Mary; Calder, Philip C.; Kwek, Kenneth; Chong, Yap-Seng; Gluckman, Peter D.; Godfrey, Keith M.; Saw, Seang-Mei; Pan, An

    2015-01-01

    Abstract Observational and intervention studies have reported inconsistent results of the relationship between polyunsaturated fatty acids (PUFAs) and hypertension during pregnancy. Here, we examined maternal plasma concentrations of n-3 and n-6 PUFAs between the 26th and the 28th week of gestation in relation to blood pressures and pregnancy-associated hypertension. We used data from a birth cohort study of 751 Chinese, Malay, and Indian women. Maternal peripheral systolic blood pressure (SBP) and diastolic blood pressure (DBP) were taken from the brachial arm, and central SBP and pulse pressures (PPs) were derived from radial artery pressure waveforms between the 26th and the 28th week of gestation. Pregnancy-associated hypertension (including gestational hypertension and preeclampsia) was ascertained from medical records. Plasma phosphatidylcholine n-3 and n-6 PUFAs were measured by gas chromatography and expressed as percentage of total fatty acids. Peripheral SBP was inversely associated with total n-3 PUFAs [−0.51 (95% confidence interval, CI, −0.89 to −0.13) mm Hg] and long-chain n-3 PUFAs [−0.52 (CI −0.92 to −0.13) mmHg]. Similar but weaker associations were observed for central SBP and PP. Dihomo-γ-linolenic acid was marginally positively associated with peripheral SBP, central SBP, and PP, whereas linoleic acid and total n-6 PUFAs showed no significant associations with blood pressures. We identified 28 pregnancy-associated hypertension cases, and 1% increase in total n-3 PUFAs was associated with a 24% lower odds of pregnancy-associated hypertension (odds ratio 0.76; 95% CI 0.60 to 0.97). Maternal ethnicity modified the PUFAs–blood pressure relations, with stronger inverse associations with n-3 PUFAs in Chinese women, and stronger positive associations with n-6 PUFAs in Indian women (P values for interaction ranged from 0.02 to 0.07). Higher n-3 PUFAs at midgestation are related to lower maternal blood pressures and pregnancy

  18. Relations of plasma polyunsaturated Fatty acids with blood pressures during the 26th and 28th week of gestation in women of Chinese, Malay, and Indian ethnicity.

    PubMed

    Lim, Wai-Yee; Chong, Mary; Calder, Philip C; Kwek, Kenneth; Chong, Yap-Seng; Gluckman, Peter D; Godfrey, Keith M; Saw, Seang-Mei; Pan, An

    2015-03-01

    Observational and intervention studies have reported inconsistent results of the relationship between polyunsaturated fatty acids (PUFAs) and hypertension during pregnancy. Here, we examined maternal plasma concentrations of n-3 and n-6 PUFAs between the 26th and the 28th week of gestation in relation to blood pressures and pregnancy-associated hypertension.We used data from a birth cohort study of 751 Chinese, Malay, and Indian women. Maternal peripheral systolic blood pressure (SBP) and diastolic blood pressure (DBP) were taken from the brachial arm, and central SBP and pulse pressures (PPs) were derived from radial artery pressure waveforms between the 26th and the 28th week of gestation. Pregnancy-associated hypertension (including gestational hypertension and preeclampsia) was ascertained from medical records. Plasma phosphatidylcholine n-3 and n-6 PUFAs were measured by gas chromatography and expressed as percentage of total fatty acids.Peripheral SBP was inversely associated with total n-3 PUFAs [-0.51 (95% confidence interval, CI, -0.89 to -0.13) mm Hg] and long-chain n-3 PUFAs [-0.52 (CI -0.92 to -0.13) mmHg]. Similar but weaker associations were observed for central SBP and PP. Dihomo-γ-linolenic acid was marginally positively associated with peripheral SBP, central SBP, and PP, whereas linoleic acid and total n-6 PUFAs showed no significant associations with blood pressures. We identified 28 pregnancy-associated hypertension cases, and 1% increase in total n-3 PUFAs was associated with a 24% lower odds of pregnancy-associated hypertension (odds ratio 0.76; 95% CI 0.60 to 0.97). Maternal ethnicity modified the PUFAs-blood pressure relations, with stronger inverse associations with n-3 PUFAs in Chinese women, and stronger positive associations with n-6 PUFAs in Indian women (P values for interaction ranged from 0.02 to 0.07).Higher n-3 PUFAs at midgestation are related to lower maternal blood pressures and pregnancy-associated hypertension in Asian women

  19. PREFACE 12th International Workshop on Slow Positron Beam Techniques

    NASA Astrophysics Data System (ADS)

    Buckman, Stephen; Sullivan, James; White, Ronald

    2011-01-01

    Preface These proceedings arose from the 12th International Workshop on Slow Positron Beam Techniques (SLOPOS12), which was held on Magnetic Island, North Queensland, Australia, between 1-6th August 2010. Meetings in the SLOPOS series are held (roughly) every three years and have now been held on (almost) all continents, indicating the truly international nature of the field. SLOPOS12 marked the second time that the Workshop had been held in the southern hemisphere, and the first time in Australia. SLOPOS12 attracted 122 delegates from 16 countries. Most encouraging was the attendance of 28 student delegates, and that about half of the overall delegates were early career researchers - a good sign for the future of our field. We also enjoyed the company of more than a dozen partners and families of delegates. In a slight departure from previous SLOPOS meetings, the International Advisory Committee approved a broader scope of scientific topics for inclusion in the program for the 2010 Workshop. This broader scope was intended to capture the applications of positrons in atomic, molecular and biomedical areas and was encapsulated in the byeline for SLOPOS-12: The 12th International Workshop on Slow Positron Beam Techniques for Solids, Surfaces, Atoms and Molecules. The scientific and social program for the meeting ran over 6 days with delegates gathering on Sunday August 1st and departing on August 6th. The scientific program included plenary, invited, contributed and student lectures, the latter being the subject of a student prize. In all there were 53 oral presentations during the week. There were also two poster sessions, with 63 posters exhibited, and a prize was awarded for the best poster by a student delegate. The standard of the student presentations, both oral and posters, was outstanding, so much so that the judging panel recommended an additional number of prizes be awarded. Topics that were the focus of invited presentations and contributed papers at

  20. Spontaneous uterine rupture at 14 weeks gestation during a pregnancy consecutive to an oocyte donation in a woman with Turner's syndrome.

    PubMed

    Masia, Florent; Zoric, Lana; Ripart-Neveu, Sylvie; Marès, Pierre; Ripart, Jacques

    2015-04-01

    We describe a spontaneous uterine rupture at 14 weeks gestation in a Turner patient. A 39 year-old patient was admitted for abdominal pain and hypotension at 14 weeks of pregnancy. The pregnancy had been obtained by oocyte donation and in vitro fertilization (IVF) because of Turner's syndrome. The abdominal ultrasound scan showed a normal pregnancy and a conserved foetal cardiac activity. It also showed a large amount of free fluid in the perihepatic space. Haemoglobin was 11.2 g/dL. After hemodynamic degradation, urgent laparoscopy showed an unrepairable uterine rupture with partial exteriorisation of the pregnancy, and placenta percreta. Urgent conversion to laparotomy allowed haemostatic hysterectomy. Uterine rupture during pregnancy obtained by oocyte donation in Turner's syndrome may be life threatening. The possibility of such a complication should be considered before oocyte donation for IVF in Turner's patients. Early spontaneous uterine rupture (second trimester) is a challenging diagnostic that should be evoked in case of non-specific abdominal pain in the presence of risk factors. PMID:25858617

  1. Early intrauterine development: I. The rate of growth of Caucasian embryos and fetuses between the 6th and 20th weeks of gestation.

    PubMed

    Iffy, L; Jakobovits, A; Westlake, W; Wingate, M; Caterini, H; Kanofsky, P; Menduke, H

    1975-08-01

    Liberalization of abortion laws in various countries and states of Europe and America has offered an opportunity for the study of the correlations between menstrual age and the rate of bodily development of human embryos and fetuses. In several institutions where local bylaws mandated the consent of the patients requesting therapeutic abortion to pathological investigation of the products of conception, various parameters of growth were measured systematically. These included crown-rump and foot lengths and body weight. The analysis of the data indicated that in the embryosic stages of development the rate of growth is substantially slower than it had been assumed previously. In the more advanced fetal stages of development the findings supported the validity of the long-established standard of Streeter. Since the current study has been based on apparently normal gestations of healthy women, whereas earlier data had rested, to a great extent, on spontaneously aborted and extopic embryon and fetuses, it seems evident that pathological specimens are not suitable for the purpose of establishing reliable standards of normal intrauterine growth rate. The present data support the suggestion, based on various experimental and clinical observations, that pathological gestations often result from abnormal ovulations that occur at times other than the mid-cycle and that such conceptions are frequently followed by a bleeding episode that simulates menstruation. It is likely that the inclusion of a high number of such cases biased the results of earlier investigations concerning embryonic growth rate on account of the frequent incidence of erroneous menstrual histories. The material available did not permit the extension of the investigation beyond the 20th week of gestation. It appears, however, that the average growth rate in the mid-trimester may be slower than the data adopted by the American Academy of Pediatrics would indicate. The possible causes of some phenomena

  2. Fetal outcome of trisomy 18 diagnosed after 22 weeks of gestation: Experience of 123 cases at a single perinatal center.

    PubMed

    Nagase, Hiromi; Ishikawa, Hiroshi; Toyoshima, Katsuaki; Itani, Yasufumi; Furuya, Noritaka; Kurosawa, Kenji; Hirahara, Fumiki; Yamanaka, Michiko

    2016-01-01

    To investigate the pregnancy outcome of the fetuses with trisomy 18, we studied 123 cases of trisomy 18 who were born at our hospital from 1993 to 2009. Among them, 95.9% were diagnosed with trisomy 18 prenatally. Prenatal ultrasound findings showed fetal growth restriction in 77.2%, polyhydramnios in 63.4% and congenital heart defects in 95.1%. For 18 cases, cesarean section (C-section) was chosen, and for 75 cases, transvaginal delivery was chosen. Premature delivery occurred in 35.5%. Stillbirths occurred in 50 cases (40.7%). Fetal demise before onset of labor occurred in 30 cases and fetal demise during labor occurred in 20 cases which was 26.7% of vaginal deliveries. Among the 73 live-born infants, the survival rate for 24 h, 1 week, 1 month and 1 year were 63%, 43%, 33% and 3%. The median survival time was 3.5 days. There was no significant difference between the survival time of C-section and that of vaginal delivery. However, for the births involving breech presentation, the survival time of C-section was significantly longer than that of vaginal delivery. When the fetus is diagnosed with trisomy 18, the parents have to make many choices. These findings constitute critical information in prenatal counseling to the couples whose fetuses have been found to have trisomy 18, especially when they choose palliative approaches in the perinatal management. PMID:26104883

  3. Change of Spectral Analysis of Fetal Heart Rate During Clinical Hypnosis: a Prospective Randomised Trial from the 20th Week of Gestation Till Term

    PubMed Central

    Reinhard, J.; Hayes-Gill, B. R.; Schiermeier, S.; Hatzmann, W.; Heinrich, T. M.; Hüsken-Janßen, H.; Herrmann, E.; Louwen, F.

    2012-01-01

    Objective: To investigate the functional adaptive process of the fetal autonomic nervous system during hypnosis from the 20th week of gestation till term. Are there changes in the power spectrum analysis of fetal heart rate when the mother is having a clinical hypnosis or control period? Study Design: Fourty-nine FHR recordings were analysed. Included recordings were from singletons and abdominal fetal ECG-monitored pregnancies. All women were randomised to receive clinical hypnosis followed by a period with no intervention or vice versa. Statistical analyses were performed with the Wilcoxon signed ranks and Spearman rho correlation tests. Results: There was a significant difference found between fetal heart rate at baseline (144.3 ± 6.0) and hypnosis (142.1 ± 6.4). A difference was also detected between the standard deviation of the heart rate between baseline (6.7 ± 1.9) and hypnosis (6.8 ± 3.5). LFnu was smaller during baseline (80.2 ± 5.3) than during hypnosis (82.1 ± 5.7), whereas HFnu was significantly larger (19.8 ± 5.3 vs. 17.9 ± 5.7). There was no correlation between the gestation age and the change in LFnu, HFnu or ratio LF/HF due to the hypnosis intervention. Conclusion: The functional adaptive process of the fetal autonomic system during hypnosis is reflected by a sympathovagal shift towards increased sympathetic modulation. PMID:25284838

  4. Cord pilot trial - immediate versus deferred cord clamping for very preterm birth (before 32 weeks gestation): study protocol for a randomized controlled trial

    PubMed Central

    2014-01-01

    Background Preterm birth is the most important single determinant of adverse outcome in the United Kingdom; one in every 70 babies (1.4%) is born before 32 weeks (very preterm), yet these births account for over half of infant deaths. Deferring cord clamping allows blood flow between baby and placenta to continue for a short time. This often leads to increased neonatal blood volume at birth and may allow longer for transition to the neonatal circulation. Optimal timing for clamping the cord remains uncertain, however. The Cochrane Review suggests that deferring umbilical cord clamping for preterm births may improve outcome, but larger studies reporting substantive outcomes and with long-term follow-up are needed. Studies of the physiology of placental transfusion suggest that flow in the umbilical cord at very preterm birth may continue for several minutes. This pilot trial aims to assess the feasibility of conducting a large randomised trial comparing immediate and deferred cord clamping in the UK. Methods/Design Women are eligible for the trial if they are expected to have a live birth before 32 weeks gestation. Exclusion criteria are known monochorionic twins or clinical evidence of twin-twin transfusion syndrome, triplet or higher order multiple pregnancy, and known major congenital malformation. The interventions will be cord clamping within 20 seconds compared with cord clamping after at least two minutes. For births with cord clamping after at least two minutes, initial neonatal care is at the bedside. For the pilot trial, outcomes include measures of recruitment, compliance with the intervention, retention of participants and data quality for the clinical outcomes. Information about the trial is available to women during their antenatal care. Women considered likely to have a very preterm birth are approached for informed consent. Randomisation is close to the time of birth. Follow-up for the women is for one year, and for the children to two years of

  5. Association between maternal micronutrient status, oxidative stress, and common genetic variants in antioxidant enzymes at 15 weeks׳ gestation in nulliparous women who subsequently develop preeclampsia

    PubMed Central

    Mistry, Hiten D.; Gill, Carolyn A.; Kurlak, Lesia O.; Seed, Paul T.; Hesketh, John E.; Méplan, Catherine; Schomburg, Lutz; Chappell, Lucy C.; Morgan, Linda; Poston, Lucilla

    2015-01-01

    Preeclampsia is a pregnancy-specific condition affecting 2–7% of women and a leading cause of perinatal and maternal morbidity and mortality. Deficiencies of specific micronutrient antioxidant activities associated with copper, selenium, zinc, and manganese have previously been linked to preeclampsia at the time of disease. Our aims were to investigate whether maternal plasma micronutrient concentrations and related antioxidant enzyme activities are altered before preeclampsia onset and to examine the dependence on genetic variations in these antioxidant enzymes. Predisease plasma samples (15±1 weeks׳ gestation) were obtained from women enrolled in the international Screening for Pregnancy Endpoints (SCOPE) study who subsequently developed preeclampsia (n=244) and from age- and BMI-matched normotensive controls (n=472). Micronutrient concentrations were measured by inductively coupled plasma mass spectrometry; associated antioxidant enzyme activities, selenoprotein-P, ceruloplasmin concentration and activity, antioxidant capacity, and markers of oxidative stress were measured by colorimetric assays. Sixty-four tag–single-nucleotide polymorphisms (SNPs) within genes encoding the antioxidant enzymes and selenoprotein-P were genotyped using allele-specific competitive PCR. Plasma copper and ceruloplasmin concentrations were modestly but significantly elevated in women who subsequently developed preeclampsia (both P<0.001) compared to controls (median (IQR), copper, 1957.4 (1787, 2177.5) vs 1850.0 (1663.5, 2051.5) µg/L; ceruloplasmin, 2.5 (1.4, 3.2) vs 2.2 (1.2, 3.0) µg/ml). There were no differences in other micronutrients or enzymes between groups. No relationship was observed between genotype for SNPs and antioxidant enzyme activity. This analysis of a prospective cohort study reports maternal micronutrient concentrations in combination with associated antioxidant enzymes and SNPs in their encoding genes in women at 15 weeks׳ gestation that subsequently

  6. Gestational gigantomastia

    PubMed Central

    John, Mary K; Rangwala, Tasneem Husaini

    2009-01-01

    A case of massive hypertrophy of the breasts in pregnancy was seen in our institution, which is a tertiary referral centre for the United Arab Emirates region with a delivery rate of 7000/year. It is a very rare condition (1 in 100000) and the only case seen in our hospital over the past 20 years. No similar case has been reported from the United Arab Emirates or Gulf regions, to our knowledge. The patient presented at a gestational age of 18 weeks on account of progressive swelling of the breasts which started at 14 weeks’ gestation. In pregnancy she was managed conservatively with analgesics, bromocriptine and breast support. She had bilateral reduction mammoplasty 1 year after delivery. The outcome was satisfactory, and the patient was pleased with the cosmetic result. PMID:21686430

  7. Making New Links, 12th Grade and beyond: Technical Panel on 12th Grade Preparedness Research. Final Report

    ERIC Educational Resources Information Center

    National Assessment Governing Board, 2009

    2009-01-01

    The Technical Panel on 12th Grade Preparedness Research, convened by the Governing Board, consists of seven members with expertise in a variety of measurement and policy areas related to preparedness. The purpose of the Panel was to assist the National Assessment Governing Board (NAGB) in planning research and validity studies that will enable the…

  8. Neonatal Mortality and Long-Term Outcome of Infants Born between 27 and 32 Weeks of Gestational Age in Breech Presentation: The EPIPAGE Cohort Study

    PubMed Central

    Azria, Elie; Kayem, Gilles; Langer, Bruno; Marchand-Martin, Laetitia; Marret, Stephane; Fresson, Jeanne; Pierrat, Véronique; Arnaud, Catherine; Goffinet, François; Kaminski, Monique; Ancel, Pierre-Yves

    2016-01-01

    Objective To determine whether breech presentation is an independent risk factor for neonatal morbidity, mortality, or long-term neurologic morbidity in very preterm infants. Design Prospective population-based cohort. Population Singletons infants without congenital malformations born from 27 to 32 completed weeks of gestation enrolled in France in 1997 in the EPIPAGE cohort. Methods The neonatal and long-term follow-up outcomes of preterm infants were compared between those in breech presentation and those in vertex presentation. The relation of fetal presentation with neonatal mortality and neurodevelopmental outcomes was assessed using multiple logistic regression models. Results Among the 1518 infants alive at onset of labor included in this analysis (351 in breech presentation), 1392 were alive at discharge. Among those eligible to follow up and alive at 8 years, follow-up data were available for 1188 children. Neonatal mortality was significantly higher among breech than vertex infants (10.8% vs. 7.5%, P = 0.05). However the differences were not significant after controlling for potential confounders. Neonatal morbidity did not differ significantly according to fetal presentation. Severe cerebral palsy was less frequent in the group born in breech compared to vertex presentation but there was no difference after adjustment. There was no difference according to fetal presentation in cognitive deficiencies/learning disabilities or overall deficiencies. Conclusion Our data suggest that breech presentation is not an independent risk factor for neonatal mortality or long-term neurologic deficiencies among very preterm infants. PMID:26744838

  9. Spontaneous Uterine Rupture at 15 Weeks' Gestation in a Patient with a History of Cesarean Delivery after Removal of Shirodkar Cerclage

    PubMed Central

    Kanao, Serika; Fukuda, Aya; Fukuda, Hirotsugu; Miyamoto, Mayuko; Marumoto, Eriko; Furuya, Kiichiro; Nishiyama, Rie; Ohyagi, Chifumi; Ogawa, Haruki

    2013-01-01

    A pregnant woman presented with acute upper abdominal pain and nausea at 15 weeks' gestation. She had a history of cesarean delivery for abruption after the removal of a Shirodkar cerclage that was placed because of cervical shortening caused by conization. She became pregnant again 14 months later. Ultrasonography revealed no significant findings, and a single intrauterine pregnancy with positive fetal heart activity was confirmed. An intestinal obstruction was suspected because abdominal radiography showed multiple air–fluid levels in the colon. Over the 3 hours following admission, her symptoms gradually worsened, and plain abdominal computed tomography (CT) showed a large hemorrhage in the abdominal cavity, but the uterine wall appeared intact at this time. Subsequently, dynamic CT revealed discontinuity of the uterine muscle layer. During laparotomy, uterine rupture with complete opening of the uterine wall at the site of the previous transverse scar was identified. A dead fetus was located within the amniotic sac in a blood-filled abdominal cavity. She received a total of 10 units of packed red blood cells and 6 units of fresh frozen plasma for the resuscitation. She was discharged on the eighth postoperative day without any complications. PMID:25032050

  10. The Future of 12th Grade NAEP: Report of the Ad Hoc Committee on Planning for NAEP 12th Grade Assessments in 2009

    ERIC Educational Resources Information Center

    National Assessment Governing Board, 2006

    2006-01-01

    The task of the Ad Hoc Committee on Planning for the the National Assessment of Educational Progress (NAEP) 12th Grade Assessments in 2009 addresses three policy areas: (1) Conducting assessment at the state level in 12th grade; (2) Reporting on 12th grade student preparedness for college-credit coursework, training for employment and entrance…

  11. Blood protein concentrations in the first two postnatal weeks associated with early postnatal blood gas derangements among infants born before the 28th week of gestation. The ELGAN Study

    PubMed Central

    Leviton, Alan; Allred, Elizabeth N.; Kuban, Karl C. K.; Dammann, Olaf; Fichorova, Raina N; O’Shea, T. Michael; Paneth, Nigel

    2016-01-01

    Aim To explore the relationships between blood gas derangements and blood concentrations of inflammation-related proteins shortly after preterm birth. Design Observational cohort Setting 14 neonatal intensive care units Subjects 734 infants born before the 28th week of gestation who were classified by their blood gas derangements during the first three postnatal days and by the concentrations of 25 proteins in their blood on days 1, 7, and 14. We classified these newborns by whether or not they had a highest or lowest PaO2, PCO2, and lowest pH in the most extreme quartile, and by whether or not they had a protein concentration in the highest quartile. Results Blood gas derangements on two days were much more likely to be accompanied or followed by sustained or recurrent systemic inflammation than a derangement on only one day. This was most evident for acidemia, and slightly less so for hypercapnia. Conclusions Our finding that protein concentration patterns indicative of systemic inflammation are associated with several blood gas derangements raises the possibility that organ damage attributed to these derangements might be accompanied by or involve an inflammatory response. PMID:21821429

  12. PREFACE 12th International Workshop on Slow Positron Beam Techniques

    NASA Astrophysics Data System (ADS)

    Buckman, Stephen; Sullivan, James; White, Ronald

    2011-01-01

    Preface These proceedings arose from the 12th International Workshop on Slow Positron Beam Techniques (SLOPOS12), which was held on Magnetic Island, North Queensland, Australia, between 1-6th August 2010. Meetings in the SLOPOS series are held (roughly) every three years and have now been held on (almost) all continents, indicating the truly international nature of the field. SLOPOS12 marked the second time that the Workshop had been held in the southern hemisphere, and the first time in Australia. SLOPOS12 attracted 122 delegates from 16 countries. Most encouraging was the attendance of 28 student delegates, and that about half of the overall delegates were early career researchers - a good sign for the future of our field. We also enjoyed the company of more than a dozen partners and families of delegates. In a slight departure from previous SLOPOS meetings, the International Advisory Committee approved a broader scope of scientific topics for inclusion in the program for the 2010 Workshop. This broader scope was intended to capture the applications of positrons in atomic, molecular and biomedical areas and was encapsulated in the byeline for SLOPOS-12: The 12th International Workshop on Slow Positron Beam Techniques for Solids, Surfaces, Atoms and Molecules. The scientific and social program for the meeting ran over 6 days with delegates gathering on Sunday August 1st and departing on August 6th. The scientific program included plenary, invited, contributed and student lectures, the latter being the subject of a student prize. In all there were 53 oral presentations during the week. There were also two poster sessions, with 63 posters exhibited, and a prize was awarded for the best poster by a student delegate. The standard of the student presentations, both oral and posters, was outstanding, so much so that the judging panel recommended an additional number of prizes be awarded. Topics that were the focus of invited presentations and contributed papers at

  13. Screening for Gestational Diabetes

    MedlinePlus

    ... Task Force learned about the potential benefits and harms of screening for gestational diabetes: (1) All women ... not enough evidence to judge the benefits and harms of screening women before 24 weeks of pregnancy. ...

  14. The role of maternal serumbeta-HCG and PAPP-A levels at gestational weeks 10 to 14 in the prediction of pre-eclampsia

    PubMed Central

    Ozdamar, Ozkan; Gun, Ismet; Keskin, Ugur; Kocak, Necmettin; Mungen, Ercument

    2014-01-01

    Objective: We aimed to detect whether maternal serum free β-hCG and PAPP-A levels and NT measurements vary between normal pregnancies and those that subsequently develop pre-eclampsia and to evaluate the role of these screening serum analytes in the prediction of pre-eclampsia. Methods: Using a case-control study design, we identified all women who had been screened by double test within 11+0 and 13+6 weeks of gestation and who had developed pre-eclampsia during the subsequent pregnancy course, over a 6-year period between January 2006 and December 2012 at two tertiary referral hospital. All women who had undergone a double test during that time, without a diagnosis of pre-eclampsia and who had not had any adverse obstetric outcomes, were also identified, and three women among them were randomly selected as controls for each case. Maternal and neonatal data were abstracted from the medical records and PAPP-A, β-hCG, NT and CRL MoM values were compared between the two groups. Results: Although β-hCG values show no statistically significant difference (p=0.882), PAPP-A levels were significantly reduced in the pre-eclampsia group compared to the control group (p<0.001). NT and CRL values showed no significant difference between the two groups (p=0.674 and p=0.558, respectively). Conclusion: Measuring PAPP-A in the first trimester may be useful in the prediction of pre-eclampsia. PMID:24948981

  15. Is there a trans-abdominal testicular descent during the second gestational trimester? Study in human fetuses between 13 and 23 weeks post conception

    PubMed Central

    Favorito, Luciano A.; Bernardo, Fabio O.; Costa, Suelen F.; Sampaio, Francisco J. B.

    2016-01-01

    ABSTRACT Objectives To confirm if a real inner descend of testis occurs, correlating the testicular position with fetal parameters and analyzing the position of the testes relative to the internal ring. Material and Methods Twenty nine human fetuses between 13 and 23 weeks post conception (WPC) were studied. The fetuses were carefully dissected with the aid of a stereoscopic lens with 16/25X magnification and testicular position observed. With the aid of a digital pachymeter the distance between the lower pole of the kidney and the upper extremity of the testis (DK-T) was measured to show the position of the testis. During the dissection we also indicated the position of the testes relative to the internal ring. Means were statistically compared using simple linear regression and the paired T-test. Results The 58 testes had abdominal position. The DK-T in the right side measured between 0.17 and 1.82cm (mean=0.79cm) and in the left side it was between 0.12 and 1.84cm (mean=0.87cm), without statistically differences (p=0.0557). The linear regression analysis indicated that DK-T in both sides correlated significantly and positively with fetal age. All fetuses with more than 20 WPC, heavier than 350g and with CRL over 22cm had a greater distance than the average DK-T. We xobserved that the 58 testis remains adjacent to the internal ring throughout the period studied. Conclusions The testes remains adjacent to the internal ring throughout the period studied, indicating that there is no real trans-abdominal testicular descent during the second gestational trimester. PMID:27286121

  16. Antenatal Risk Factors of Postpartum Depression at 20 Weeks Gestation in a Japanese Sample: Psychosocial Perspectives from a Cohort Study in Tokyo

    PubMed Central

    Tachibana, Yoshiyuki; Koizumi, Tomoe; Takehara, Kenji; Kakee, Naoko; Tsujii, Hiromi; Mori, Rintaro; Inoue, Eisuke; Ota, Erika; Yoshida, Keiko; Kasai, Keiko; Okuyama, Makiko; Kubo, Takahiko

    2015-01-01

    Background Prevalence of postnatal depression (PND) is high (Western countries, 10–15%; Japan, 17%). PND can cause parenting impairment and affect family health (e.g. child behaviors, cognitive development and physical health). This study aimed to reveal the risk factors of PND during the pregnancy period in a Japanese sample, and to identify the psychosocial risk factors of PND that should be appended to existing obstetric interview sheets. A cohort study with a Japanese sample was conducted. Methods All 14 obstetrics hospitals in the Setagaya ward, Tokyo, Japan, participated in this study. Pregnant women who booked their delivery between December 2012 and May 2013 were enrolled. Data used for this study were collected at 20 weeks gestation, a few days and one month postnatal. The questionnaires consisted of psychosocial factors and the Edinburgh Postnatal Depression Scale (EPDS). To identify PND risk factors, multivariate analyses were performed. Results A total of 1,775 women participated in this study. Eventually, the data of 1,133 women were used for the multivariate analyses. The demonstrated significant risk factors include EPDS score, primipara, “a perceived lack of family cohesion”, “current physical illness treatment” and “current psychiatric illness treatment”. Conclusion This study highlights the importance of mental health screening using psychological measures during the pregnancy period. In addition, family environment, parity, physical and psychiatric illness should be paid attention by professionals in maternal and child health. The results also suggest that mothers’ feelings of developing their families should be supported. PMID:26625132

  17. Energy education resources: Kindergarten through 12th grade

    SciTech Connect

    1998-09-01

    Energy Education Resources: Kindergarten Through 12th Grade is published by the National Energy Information Center (NEIC) a service of the Energy Information Administration (EIA), to provide students, educators, and other information users, a list of generally available free or low-cost energy-related educational materials. Each entry includes the address, telephone number, and description of the organization and the energy-related materials available. Most of the entries also include Internet (Web) and electronic mail (E-Mail) addresses. Each entry is followed by a number, which is referenced in the subject index in the back of this book.

  18. The CD200 tolerance-signaling molecule and its receptor, CD200R1, are expressed in human placental villus trophoblast and in peri-implant decidua by 5 weeks' gestation.

    PubMed

    Clark, David A; Arredondo, Jorge L; Dhesy-Thind, Sukhbinder

    2015-11-01

    CD200 expression in murine trophoblast and decidua prevents semi-allogeneic and LPS-induced abortions by binding to CD200 receptor-bearing cells to suppress NK activity, induces IDO in macrophages, and promotes the generation of regulatory T cell subsets. CD200 and its receptor CD200R1 reported in 7-9 weeks' gestation human villus trophoblasts are reduced in spontaneous abortion syncytiotrophoblasts. By specific antibody staining, we find that both CD200 and CD200R1 are expressed even earlier, by 5 weeks' gestation, by villus trophoblasts and by decidual cells. Expression of CD200 was validated using two independent antibodies. CD200-CD200R1 signaling may be required for human pregnancy success. PMID:26123445

  19. Vaginal bleeding before 20 weeks gestation due to placental abruption leading to disseminated intravascular coagulation and fetal loss after appearing to satisfy criteria for routine threatened abortion: a case report and brief review of the literature.

    PubMed

    Hodgson, Danner T; Lotfipour, Shahram; Fox, J Christian

    2007-05-01

    We present a case of placental abruption with concomitant disseminated intravascular coagulation in a woman who presented with vaginal bleeding. A 32-year-old pregnant woman at 17 and 4/7 weeks gestation with a 1-month history of intermittent abdominal pain presented to our Emergency Department (ED) with 1 h of vaginal bleeding. Upon initial history, the patient reported that she was diagnosed with "blood behind the placenta" the day before and was discharged on pelvic precautions. An ED ultrasound confirmed the sub-amniotic hematoma with placental hematoma and a viable intrauterine fetus. A low fibrinogen level was suggested for disseminated intravascular coagulation and increasing hemorrhage necessitated dilation and evacuation and multiple units of blood products on an emergent basis. Only a few cases have been described in the literature demonstrating disseminated intravascular coagulation in patients at fewer than 20 weeks gestation with routine ultrasound findings of live intrauterine pregnancy and subchorionic hemorrhage. PMID:17499692

  20. The combined antenatal corticosteroids and vitamin K therapy for preventing periventricular-intraventricular hemorrhage in premature newborns less than 35 weeks gestation.

    PubMed

    Liu, Jing; Wang, Qi; Zhao, Jin-hui; Chen, Yan-hua; Qin, Gui-lian

    2006-10-01

    We prospectively evaluated whether combined antenatal corticosteroid and vitamin K administration have any benefit, over and above that of corticosteroid or vitamin K used alone, in reducing the frequency and the degree of PIVH in premature newborns less than 35 weeks' gestation. All of these 280 pregnant women were randomly allocated into five groups according to the in-patient sequence. Group A (vitamin K1 group) including 38 pregnant women (40 newborns) received antenatal intramuscular or intravenously injection of vitamin K1 10 mg per day for 2-7 days. Group B (single dose corticosteroid group) including 57 pregnant women (63 newborns) received antenatal intramuscular or intravenously injection of dexamethasone 10 mg per day for 1 day. Group C (two dose corticosteroid group) including 62 pregnant women (70 newborns) received antenatal intramuscular or intravenously injection of dexamethasone 10 mg per day for 2 days. Group D (combined using dexamethasone and vitamin K1) including 41 pregnant women (44 newborns) received dexamethasone 10 mg per day for 1 day and vitamin K110 mg per day for 2-7 days. Control group, including 82 pregnant women (87 newborns) were received neither dexamethasone nor vitamin K1 injection. The results showed PIVH was diagnosed in 17 of 40 (42.5%) in Group A, 34 of 63 (54.0%) in Group B, 36 of 70 (51.4%) in Group C, 14 of 44 (31.8%) in Group D, and 57 of 87 (65.2%) in control infants (p = 0.004). More infants in the control group had grade III or IV intracranial hemorrhage after birth (p = 0.049). After antenatal supplement of dexamethasone and vitamin K1, both the total incidence of PIVH and the frequency of severe PIVH decreased significantly. The total and severe incidence of PIVH in Group B (single doses dexamethasone) and Group C (two courses dexamethasone) there were no significant difference. It showed that after antenatal supplement of dexamethasone and vitamin K1, both the total incidence of PIVH and the frequency of severe

  1. International Geomagnetic Reference Field: the 12th generation

    NASA Astrophysics Data System (ADS)

    Thébault, Erwan; Finlay, Christopher C.; Beggan, Ciarán D.; Alken, Patrick; Aubert, Julien; Barrois, Olivier; Bertrand, Francois; Bondar, Tatiana; Boness, Axel; Brocco, Laura; Canet, Elisabeth; Chambodut, Aude; Chulliat, Arnaud; Coïsson, Pierdavide; Civet, François; Du, Aimin; Fournier, Alexandre; Fratter, Isabelle; Gillet, Nicolas; Hamilton, Brian; Hamoudi, Mohamed; Hulot, Gauthier; Jager, Thomas; Korte, Monika; Kuang, Weijia; Lalanne, Xavier; Langlais, Benoit; Léger, Jean-Michel; Lesur, Vincent; Lowes, Frank J.; Macmillan, Susan; Mandea, Mioara; Manoj, Chandrasekharan; Maus, Stefan; Olsen, Nils; Petrov, Valeriy; Ridley, Victoria; Rother, Martin; Sabaka, Terence J.; Saturnino, Diana; Schachtschneider, Reyko; Sirol, Olivier; Tangborn, Andrew; Thomson, Alan; Tøffner-Clausen, Lars; Vigneron, Pierre; Wardinski, Ingo; Zvereva, Tatiana

    2015-05-01

    The 12th generation of the International Geomagnetic Reference Field (IGRF) was adopted in December 2014 by the Working Group V-MOD appointed by the International Association of Geomagnetism and Aeronomy (IAGA). It updates the previous IGRF generation with a definitive main field model for epoch 2010.0, a main field model for epoch 2015.0, and a linear annual predictive secular variation model for 2015.0-2020.0. Here, we present the equations defining the IGRF model, provide the spherical harmonic coefficients, and provide maps of the magnetic declination, inclination, and total intensity for epoch 2015.0 and their predicted rates of change for 2015.0-2020.0. We also update the magnetic pole positions and discuss briefly the latest changes and possible future trends of the Earth's magnetic field.

  2. 12th Anglo-French Physical Acoustics Conference (AFPAC2013)

    NASA Astrophysics Data System (ADS)

    2014-04-01

    The Anglo-French Physical Acoustics Conference (AFPAC) had its 12th annual meeting in Villa Clythia, Fréjus, France, from 16th to 18th January 2013. This series of meetings is a collaboration between the Physical Acoustics Group (PAG) of the Institute of Physics and the Groupe d'Acoustique Physique, Sous-marine et UltraSonore (GAPSUS) of the Société Française d'Acoustique. This year, attendees got the opportunity to see the French Riviera with its Mediterranean vegetation covered by a nice thick snow layer. The participants heard 34 excellent oral presentations and saw 3 posters covering an exciting and diverse range of subjects and of frequencies, from ultrasonic wave propagation in chocolate to metamaterials applied to seismic waves for protecting buildings. Among them, invited talks were given by Pr F A Duck ( Enhanced healing by ultrasound: clinical effects and mechanisms), Pr. J-C Valiére, who actually gave two invited talks ( 1. Measurement of audible acoustic particle velocity using laser: Principles, signal processing and applications, 2. Acoustic pots in ancient and medieval buildings: Literary analysis of ancient texts and comparison with recent observations in French churches), Dr P Huthwaite ( Ultrasonic imaging through the resolution of inverse problems), Dr X Lurton ( Underwater acoustic systems on oceanographic research vessels: principles and applications), Dr S Guenneau ( From platonics to seismic metamaterials). For the fifth consecutive year AFPAC is followed by the publication of its proceedings with 12 peer-reviewed papers which cover the most recent research developments in the field of Physical Acoustics in the UK and France. Alain Lhémery (CEA, France) and Nader Saffari (UCL, United Kingdom) French Riviera 12th AFPAC — Villa Clythia, Fréjus (French Riviera), the 17th of January 2013

  3. Gestational diabetes

    MedlinePlus

    Gestational diabetes is high blood sugar ( diabetes ) that starts or is first diagnosed during pregnancy. ... woman's blood. You are at greater risk for gestational diabetes if you: Are older than 25 when you ...

  4. 12th meeting of Asian Parliamentarians on Population and Development.

    PubMed

    1999-01-01

    At the 12th annual Asian Parliamentarians Meeting on Population and Development, co-sponsored by the Asian Population and Development Association (APDA) of Japan and the Philippine Legislative Committee on Population and Development (PLCPD), the adverse effect of population growth on economic development and the importance of improvements in women's status were central themes. Fukusaburo Maeda, President of APDA Japan, noted that an understanding of women's issues is key to solving global population problems. Numerous participants urged rapid implementation of plans outlined at recent conferences in Cairo and Beijing to empower women and involve them in all stages of the development process. Even issues of food security are linked to women's issues, since women are generally responsible for feeding their families. Participants voted to adopt the "Manila Resolution on Women, Gender, Population, and Development"--a call for social and economic empowerment of women and resources for gender-related programs. Dr. Patricia Licuanan, Chair of the UN Committee on the Status of Women, noted that men should not feel threatened by women holding positions of power; rather, they should welcome an equal partnership between men and women. In her closing address, Senator Leticia Ramos Shahani, Chair of PLCPD, stressed the importance of placing women's empowerment on various parliamentary agendas and commended APDA for its research and population-based surveys in Asia. PMID:12320525

  5. The 12th International Workshops on Opportunistic Protists (IWOP-12)

    PubMed Central

    Weiss, Louis M.; Cushion, Melanie T.; Didier, Elizabeth; Xiao, Lihua; Marciano-Cabral, Francine; Sinai, Anthony P.; Matos, Olga; Calderon, Enrique J.; Kaneshiro, Edna S.

    2013-01-01

    The 12th International Workshops on Opportunistic Protists (IWOP-12) was held in August 2012 in Tarrytown, New York. The objectives of the IWOP meetings are to: (1) serve as a forum for exchange of new information among active researchers concerning the basic biology, molecular genetics, immunology, biochemistry, pathogenesis, drug development, therapy, and epidemiology of these immunodeficiency-associated pathogenic eukaryotic microorganisms that are seen in patients with AIDS and (2) foster the entry of new and young investigators into these underserved research areas. The IWOP meeting focuses on opportunistic protists, e.g. the free-living amoebae, Pneumocystis, Cryptosporidium, Toxoplasma, the Microsporidia, and kinetoplastid flagellates. This conference represents the major conference that brings together research groups working on these opportunistic pathogens. Slow but steady progress is being achieved on understanding the biology of these pathogenic organisms, their involvement in disease causation in both immune-deficient and immune-competent hosts, and is providing critical insights into these emerging and reemerging pathogens. This IWOP meeting demonstrated the importance of newly developed genomic level information for many of these pathogens and how analysis of such large data sets is providing key insights into the basic biology of these organisms. A great concern is the loss of scientific expertise and diversity in the research community due to the ongoing decline in research funding. This loss of researchers is due to the small size of many of these research communities and a lack of appreciation by the larger scientific community concerning the state of art and challenges faced by researchers working on these organisms. PMID:23560871

  6. Metastasis of Pregnancy-Associated Breast Cancer (Suspected to Be Hereditary Breast and Ovarian Cancer) to the Brain, Diagnosed at 18 Weeks' Gestation: A Case Report and Review of the Literature

    PubMed Central

    Okuda, Tomohiro; Yamamoto, Sakura; Matsuo, Seiki; Kataoka, Hisashi; Kitawaki, Jo

    2016-01-01

    We report a case of pregnancy-associated breast cancer with metastasis to the brain, likely resulting from hereditary breast and ovarian cancer (HBOC). A 35-year-old woman (gravida 2, para 0-1-0-1) underwent a right mastectomy and right axillary dissection after a cesarean section at 30 years of age; her mother died at 47 years of age due to breast cancer. Histopathological examination indicated an invasive ductal carcinoma with triple-negative cancer (cancer stage 2B [pT3N0M0]). The patient refused adjuvant therapy because of the risk of infertility. After 4 years, she became pregnant naturally. At 18 weeks' gestation, she experienced aphasia and dyslexia due to brain metastasis. The pregnancy was terminated at 21 weeks' gestation after thorough counseling. Her family history, young-onset disease, and histopathological findings suggested HBOC. She declined genetic testing for BRCA1/2, though genetic counseling was provided. In cases of pregnancy-related breast cancer, consideration must be given to whether the pregnancy should be continued and to posttreatment fertility. HBOC should also be considered. Genetic counseling should be provided and the patient should be checked for the BRCA mutation, as it is meaningful for the future of any potential children. Genetic counseling should be provided even if the cancer is advanced or recurrent. PMID:26981296

  7. Effects of gestational and postnatal age on body temperature, oxygen consumption, and activity during early skin-to-skin contact between preterm infants of 25-30-week gestation and their mothers.

    PubMed

    Bauer, K; Pyper, A; Sperling, P; Uhrig, C; Versmold, H

    1998-08-01

    Temporary skin-to-skin contact between preterm infant and the mother is increasingly used in neonatal medicine to promote bonding. It is not known at which gestational age (GA) and postnatal age skin-to-skin contact outside the incubator is a sufficiently warm environment and is tolerated by preterm infants without a decrease in body temperature, oxygen consumption (VO2) increase, or unrest. We conducted a prospective clinical study of 27 spontaneously breathing preterm infants of 25-30-wk GA. Rectal temperature (Trecta), VO2 (indirect calorimetry), and activity were continuously measured in the incubator (60 min), during skin-to-skin contact (60 min), and back in the incubator (60 min) in wk 1 and 2 of life. In wk 1 the change in Trectal during skin-to-skin contact was related to GA (r=0.585, p=0.0027): infants of 25-27-wk GA lost heat during skin-to-skin contact, whereas infants of 28-30 wk gained heat and their mean Trectal during skin-to-skin contact was 0.3 degrees C higher than before (p < 0.01). No significant changes of VO2 or activity occurred. In wk 2 the infants' VO2 was higher than in wk 1, but VO2 during skin-to-skin contact was the same as in the incubator. Only small fluctuations in Trectal occurred. In wk 2 all infants slept more during skin-to-skin contact than in the incubator (p < 0.02). We conclude that, for preterm infants of 28-30-wk GA, skin-to-skin contact was a sufficiently warm environment as early as postnatal wk 1. For infants of 25-27-wk GA skin-to-skin contact should be postponed until wk 2 of life, when their body temperature remains stable and they are more quiet during skin-to-skin contact than in the incubator. PMID:9702922

  8. Seven Destructive Seismic Crises in 12th Century Syria

    NASA Astrophysics Data System (ADS)

    Guidoboni, E.; Bernardini, F.

    2002-12-01

    the region bridging the present-day Syro-Turkish border. The long and devastating series of shakes in 1156-59 and the great earthquake of June 1170, affected a huge area within the current territories of north-western Syria, northern Lebanon and the region of inter Antioch (modern Antakya, in southern Turkey). The effects of the earthquakes in August 1110 and June 1117 have been attested to in southern Lebanon and Palestine. On the grounds of the detailed seismic scenarios of the 5 most documented earthquakes we have also been able to advance some hypotheses as to the seismogenic structures involved. In the first half of the 12th century the most intense seismicity seems to be concentrated in the zones bordering south-eastern Turkey and north-western Syria, suggesting a likely involvement both of the northernmost portion of the Dead Sea Fault System (DSFS), and the south-western segment of the East-Anatolian Fault System (EAFS), as well as, perhaps, also the convergence structures present in south-eastern Turkey (Bitlis suture zone?). Beginning from around mid-1150 the greatest seismic activity seems to migrate more southwards, along the structures of the DSFS that cross western Syria (Ghab and Missyaf faults) and northern Lebanon (Akkar fault?). Lastly, for the great event of 1170, the sources we have retrieved and analysed contain information concerning damage or felt effects in slightly fewer than 30 Crusader and Arab locations, 15 of which new and never before identified. The detailed macroseismic picture that has been reconstructed has thus also allowed us to propose an estimate of the main shock parameters for this earthquake.

  9. Gestational diabetes

    MedlinePlus

    Gestational diabetes is high blood sugar ( diabetes ) that starts or is first diagnosed during pregnancy. ... 9 pounds or had a birth defect Have high blood pressure Have too much amniotic fluid Have ...

  10. 75 FR 10483 - Filing Dates for the Pennsylvania Special Election in the 12th Congressional District

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-08

    ... From the Federal Register Online via the Government Publishing Office FEDERAL ELECTION COMMISSION Filing Dates for the Pennsylvania Special Election in the 12th Congressional District AGENCY: Federal Election Commission. ACTION: Notice of filing dates for special election. SUMMARY: Pennsylvania...

  11. Postnatal overestimation of gestational age in preterm infants.

    PubMed

    Shukla, H; Atakent, Y S; Ferrara, A; Topsis, J; Antoine, C

    1987-10-01

    In a study involving 25 preterm infants, obstetric clinical age (standard gestational age) was determined by history, physical examination, and ultrasonographic evaluation. Postnatally, these infants were then evaluated using the Dubowitz Scoring System (DSS) for gestational age assessment. The DSS, as administered by us, significantly overestimated gestational age compared with the standard gestational age (mean +/- 1 SD: 34.2 +/- 2.9 vs 32.5 +/- 3.9 weeks, respectively) in preterm infants. To illustrate, the gestational ages of 13 newborns (52%) in the total study group were each overestimated by more than two weeks. This percentage increased to 75% among the 16 infants whose gestational ages were less than 34 weeks (by standard gestational age). When the standard gestational age was underestimated by the DSS, this difference never exceeded two weeks. These findings suggest that the present system of postnatal assessment of gestational age in preterm infants needs further investigation. PMID:3307384

  12. Environmental Education in High School 9th-12th Biology Course Curricula Started to Be Implemented in 2007

    ERIC Educational Resources Information Center

    Erdogan, Mehmet; Bahar, Mehmet; Usak, Muhammet

    2012-01-01

    The aim of this study is to analyze 9th-12th grade Biology Course Curricula started to be implemented in 2007 with regard to concepts and attainments addressing to environmental education. In this regard, 9th-12th grade Biology Course Curricula were analyzed using content-analysis technique, one of the qualitative research methods. 9th-12th grade…

  13. Gestational surrogacy.

    PubMed

    Brinsden, Peter R

    2003-01-01

    Gestational surrogacy is a treatment option available to women with certain clearly defined medical problems, usually an absent uterus, to help them have their own genetic children. IVF allows the creation of embryos from the gametes of the commissioning couple and subsequent transfer of these embryos to the uterus of a surrogate host. The indications for treatment include absent uterus, recurrent miscarriage, repeated failure of IVF and certain medical conditions. Treatment by gestational surrogacy is straightforward and follows routine IVF procedures for the commissioning mother, with the transfer of fresh or frozen-thawed embryos to the surrogate host. The results of treatment are good, as would be expected from the transfer of embryos derived from young women and transferred to fit, fertile women who are also young. Clinical pregnancy rates achieved in large series are up to 40% per transfer and series have reported 60% of hosts achieving live births. The majority of ethical or legal problems that have arisen out of surrogacy have been from natural or partial surrogacy arrangements. The experience of gestational surrogacy has been largely complication-free and early results of the follow-up of children, commissioning couples and surrogates are reassuring. In conclusion, gestational surrogacy arrangements are carried out in a few European countries and in the USA. The results of treatment are satisfactory and the incidence of major ethical or legal complications has been limited. IVF surrogacy is therefore a successful treatment for a small group of women who would otherwise not be able to have their own genetic children. PMID:14640380

  14. Labor patterns in twin gestations

    PubMed Central

    Leftwich, Heidi K.; Zaki, Mary N.; Wilkins, Isabelle; Hibbard, Judith U.

    2014-01-01

    Objective To compare labor progression in twin vs singleton gestations. Study Design Retrospective review of electronic database created by Consortium on Safe Labor, reflecting labor and delivery information from 12 clinical centers 2002-2008. Women with twin gestations, cephalic presentation of presenting twin, gestational age ≥34 weeks, with ≥2 cervical examinations were included. Exclusion criteria were fetal anomalies or demise. Singleton controls were selected by the same criteria. Categorical variables were analyzed by χ2; continuous by Student t test. Interval censored regression was used to determine distribution for time of cervical dilation in centimeters, or “traverse times,” and controlled for confounding factors. Repeated-measures analysis constructed mean labor curves by parity and number of fetuses. Results A total of 891 twin gestations were compared with 100,513 singleton controls. Twin gestations were more often older, white or African American, earlier gestational age, increased prepregnancy body mass index, and with lower birthweight. There was no difference in number of prior cesarean deliveries, induction, or augmentation, or epidural use. Median traverse times increased at every centimeter interval in nulliparous twins, in both unadjusted and adjusted analysis (P < .01). A similar pattern was noted for multiparas in both analyses. Labor curves demonstrated a delayed inflection point in the labor pattern for nulliparous and multiparous twin gestations. Conclusion Both nulliparous and multiparous women have slower progression of active phase labor with twins even when controlling for confounding factors. PMID:23871795

  15. Relationships between Grade Levels, Personal Factors, and Instructional Variation among 4th-12th Grade Teachers

    ERIC Educational Resources Information Center

    White, Jacquelyn M.

    2011-01-01

    The purpose of this quantitative correlational study was to investigate relationships between grade levels, personal factors of teachers, and instructional variety used by 4th-12th grade teachers in Kern County, California. The population under investigation included 2,844 teachers. 235 elementary, middle school/junior high, and secondary teachers…

  16. 12th Grade Student Achievement in America: A New Vision for NAEP

    ERIC Educational Resources Information Center

    National Assessment Governing Board, 2004

    2004-01-01

    Early in 2003, the National Assessment Governing Board established the National Commission on the National Assessment of Educational Progress (NAEP) 12th Grade Assessment and Reporting, following the recommendation of retiring Governing Board Executive Director Roy Truby. The Governing Board's charge to the Commission was "To review the current…

  17. 78 FR 24069 - Safety Zone; 12th Annual Saltwater Classic; Port Canaveral Harbor; Port Canaveral, FL

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-24

    .... SUPPLEMENTARY INFORMATION: Table of Acronyms DHS Department of Homeland Security FR Federal Register NPRM Notice... SECURITY Coast Guard 33 CFR Part 165 RIN 1625-AA00 Safety Zone; 12th Annual Saltwater Classic; Port Canaveral Harbor; Port Canaveral, FL AGENCY: Coast Guard, DHS. ACTION: Temporary final rule. SUMMARY:...

  18. Crime and the Law: A 12th Grade Social Studies Course.

    ERIC Educational Resources Information Center

    Wisconsin State Dept. of Education, Madison.

    The document outlines a semester-long 12th grade study of criminal law which is accomplished through an examination of Wisconsin and constitutional law. Six sections comprise the teaching outline. Section I, The Legislative Process, considers the legislature, various statutes and terminologies, revision of legislation, and penalties. Section II,…

  19. Asian Studies: Experimental Course of Study, 11th or 12th Year Elective.

    ERIC Educational Resources Information Center

    Fryberg, Carl

    This experimental course of study has a twofold purpose. Primarily, it is intended to serve as basis for an elective for the 11th or 12th year student. Openended in organization, it encourages teachers and students to add new dimensions. It provides a comprehensive bibliography and detailed information with which to develop an elective in the area…

  20. A Positive Move: 12th Annual College M&O Cost Study

    ERIC Educational Resources Information Center

    Agron, Joe

    2006-01-01

    Colleges placed more of an emphasis on maintenance and operations (M&O) this school year by increasing the amount spent on M&O as a percentage of total budget. According to "American School & University's" 12th annual College Maintenance and Operations Cost Study, spending on M&O as a percentage of total college budget increased to 11 percent from…

  1. Engaging the Learner. Annual Instructional Technology Conference (12th, Murfreesboro, Tennessee, April 1-3, 2007)

    ERIC Educational Resources Information Center

    Smith, Carter F.; Schneider, Gary F.; Kontos, George; Kuzat, Hanan; Janossy, James; Thurmond, Karen; Moore, Beth; Whitledge, Lynn; Speer, Priscilla; Harber, Annette; Bailey, Kathrine; Penney, Samantha

    2007-01-01

    The following is a collection of papers presented at the 12th annual Instructional Technology Conference at Middle Tennessee State University in Murfreesboro, Tennessee. This conference is an opportunity for higher-education professionals from across the country to discuss opportunities and challenges presented by instructional technology. The…

  2. Why 12th Grade Must Be Redesigned Now--and How

    ERIC Educational Resources Information Center

    Vargas, Joel

    2015-01-01

    This first report in a new series by Jobs For the Future (JFF) provides the rationale for restructuring 12th grade and tying it more tightly to the first year of college through new high school and college partnerships. The paper proposes a new common benchmark of readiness that high schools and colleges can work together to meet to ensure…

  3. Gestational trophoblastic disease

    MedlinePlus

    ... type of cancer) Hydatiform mole (also called a molar pregnancy) References Goldstein DP, Berkowitz RS. Gestational trophoblastic disease. ... 90. McGee J, Covens A. Gestational trophoblastic disease: hydatidiform mole, nonmetastatic and metastatic gestational trophoblastic tumor: diagnosis and ...

  4. Target Allocation Methodology for China's Provinces: Energy Intensity in the 12th FIve-Year Plan

    SciTech Connect

    Ohshita, Stephanie; Price, Lynn

    2011-03-21

    Experience with China's 20% energy intensity improvement target during the 11th Five-Year Plan (FYP) (2006-2010) has shown the challenges of rapidly setting targets and implementing measures to meet them. For the 12th FYP (2011-2015), there is an urgent need for a more scientific methodology to allocate targets among the provinces and to track physical and economic indicators of energy and carbon saving progress. This report provides a sectoral methodology for allocating a national energy intensity target - expressed as percent change in energy per unit gross domestic product (GDP) - among China's provinces in the 12th FYP. Drawing on international experience - especially the European Union (EU) Triptych approach for allocating Kyoto carbon targets among EU member states - the methodology here makes important modifications to the EU approach to address an energy intensity rather than a CO{sub 2} emissions target, and for the wider variation in provincial energy and economic structure in China. The methodology combines top-down national target projections and bottom-up provincial and sectoral projections of energy and GDP to determine target allocation of energy intensity targets. Total primary energy consumption is separated into three end-use sectors - industrial, residential, and other energy. Sectoral indicators are used to differentiate the potential for energy saving among the provinces. This sectoral methodology is utilized to allocate provincial-level targets for a national target of 20% energy intensity improvement during the 12th FYP; the official target is determined by the National Development and Reform Commission. Energy and GDP projections used in the allocations were compared with other models, and several allocation scenarios were run to test sensitivity. The resulting allocations for the 12th FYP offer insight on past performance and offer somewhat different distributions of provincial targets compared to the 11th FYP. Recommendations for reporting

  5. Predicting gestational age using neonatal metabolic markers

    PubMed Central

    Ryckman, Kelli K.; Berberich, Stanton L.; Dagle, John M.

    2016-01-01

    Background Accurate gestational age estimation is extremely important for clinical care decisions of the newborn as well as for perinatal health research. Although prenatal ultrasound dating is one of the most accurate methods for estimating gestational age, it is not feasible in all settings. Identifying novel and accurate methods for gestational age estimation at birth is important, particularly for surveillance of preterm birth rates in areas without routine ultrasound dating. Objective We hypothesized that metabolic and endocrine markers captured by routine newborn screening could improve gestational age estimation in the absence of prenatal ultrasound technology. Study Design This is a retrospective analysis of 230,013 newborn metabolic screening records collected by the Iowa Newborn Screening Program between 2004 and 2009. The data were randomly split into a model-building dataset (n = 153,342) and a model-testing dataset (n = 76,671). We performed multiple linear regression modeling with gestational age, in weeks, as the outcome measure. We examined 44 metabolites, including biomarkers of amino acid and fatty acid metabolism, thyroid-stimulating hormone, and 17-hydroxyprogesterone. The coefficient of determination (R2) and the root-mean-square error were used to evaluate models in the model-building dataset that were then tested in the model-testing dataset. Results The newborn metabolic regression model consisted of 88 parameters, including the intercept, 37 metabolite measures, 29 squared metabolite measures, and 21 cubed metabolite measures. This model explained 52.8% of the variation in gestational age in the model-testing dataset. Gestational age was predicted within 1 week for 78% of the individuals and within 2 weeks of gestation for 95% of the individuals. This model yielded an area under the curve of 0.899 (95% confidence interval 0.895−0.903) in differentiating those born preterm (<37 weeks) from those born term (≥37 weeks). In the subset of

  6. Gestational weight gain trajectories in primary care

    PubMed Central

    Piccinini-Vallis, Helena; Lee-Baggley, Dayna; Stewart, Moira; Ryan, Bridget

    2016-01-01

    Objective To identify gestational weight gain trajectories, stratified by prepregnancy body mass index (BMI), of women with singleton pregnancies who received prenatal care in a primary care setting, and to compare these trajectories with the 2009 Institute of Medicine gestational weight gain recommendations. Design Retrospective cohort study. Setting Halifax, NS. Participants Women who received prenatal care at the Dalhousie Family Medicine clinics in Halifax from 2009 to 2013. Main outcome measures For each prenatal visit, gestational age and weight measurements were obtained. Multilevel modeling was used to analyze the gestational weight gain trajectories. The upper limit of the guideline-recommended weekly gestational weight gain was compared with the 95% CI of the observed mean weekly gestational weight gain for each prepregnancy BMI category. Results A total of 280 women were included in the analyses. There was a significant interaction between prepregnancy BMI category and gestational weight gain over time (P < .001), with gestational weight gain being significantly lower among women with prepregnancy BMI of 30.0 kg/m2 or greater compared with those with BMI of 18.5 to less than 25.0 kg/m2 and 25.0 to less than 30.0 kg/m2. When comparing women’s weight gain with the recommendations, women with prepregnancy BMI of 25.0 to less than 30.0 kg/m2 had the most guideline discordance, deviating from the weight gain recommendations at 20 weeks’ gestation. Conclusion These results are relevant and of benefit to women and clinicians wishing to address excess gestational weight gain, and to researchers and policy makers developing interventions aimed at curbing gestational weight gain in primary care. Although our results showed women with prepregnancy BMI of 25.0 to less than 30.0 kg/m2 gained the most excess, guideline-discordant weight, interventions should target all women planning or experiencing a pregnancy.

  7. Recent Declines in Induction of Labor by Gestational Age

    MedlinePlus

    ... rates at 38 weeks of gestation declined for all maternal age groups under 40. Trends in induction ... 38 weeks declined in nearly three-quarters of all states. The largest declines in labor induction for ...

  8. Outcomes of Small for Gestational Age Infants < 27 Weeks’ Gestation

    PubMed Central

    De Jesus, Lilia C.; Pappas, Athina; Shankaran, Seetha; Li, Lei; Das, Abhik; Bell, Edward F.; Stoll, Barbara J.; Laptook, Abbot R.; Walsh, Michele C.; Hale, Ellen C.; Newman, Nancy S.; Bara, Rebecca; Higgins, Rosemary D.

    2014-01-01

    Objective To determine whether small for gestational age (SGA) infants <27 weeks gestation is associated with mortality, morbidity, growth and neurodevelopmental impairment at 18–22 months’ corrected age (CA). Study design This was a retrospective cohort study from National Institute of Child Health and Human Development Neonatal Research Network’s Generic Database and Follow-up Studies. Infants born at <27 weeks’ gestation from January 2006 to July 2008 were included. SGA was defined as birth weight <10th percentile for gestational age by the Olsen growth curves. Infants with birth weight ≥10th percentile for gestational age were classified as non-SGA. Maternal and infant characteristics, neonatal outcomes and neurodevelopmental data were compared between the groups. Neurodevelopmental impairment was defined as any of the following: cognitive score <70 on BSID III, moderate or severe cerebral palsy, bilateral hearing loss (+/− amplification) or blindness (vision <20/200). Logistic regression analysis evaluated the association between SGA status and death or neurodevelopmental impairment. Results There were 385 SGA and 2586 non-SGA infants. Compared with the non-SGA group, mothers of SGA infants were more likely to have higher level of education, prenatal care, cesarean delivery, pregnancy-induced hypertension and antenatal corticosteroid exposure. SGA infants were more likely to have postnatal growth failure, a higher mortality and to have received prolonged mechanical ventilation and postnatal steroids. SGA status was associated with higher odds of death or neurodevelopmental impairment [OR 3.91 (95% CI: 2.91–5.25), P<0.001]. Conclusion SGA status among infants <27 weeks’ gestation was associated with an increased risk for postnatal steroid use, mortality, growth failure and neurodevelopmental impairment at 18–22 months’ CA. PMID:23415614

  9. 12th international conference on human retrovirology: HTLV and related retroviruses

    PubMed Central

    Lairmore, Michael D; Fujii, Masahiro

    2005-01-01

    The 12th International Conference on Human Retrovirology: HTLV and Related Retroviruses, was held at the Half Moon Hotel in Montego Bay, Jamaica, from June 22nd to June 25th 2005. The scientific conference, sponsored by the International Retrovirology Association, is held biennially at rotating international venues around the world. The meeting brings together basic scientists, epidemiologists and clinical researchers to discuss findings to prevent HTLV infection or develop new therapies against HTLV-mediated diseases. The Association fosters the education and training of young scientists to bring new approaches to the complex problems of HTLV research, such as translational research to bring findings from the laboratory into clinical trials that benefit HTLV-infected patients. The breadth and quality of research presentations and workshops at the 12th International Conference indicate that these goals are being accomplished. As HTLV research enters its third decade a new generation of scientists face many challenges. However, HTLV scientists and clinicians displayed exciting new approaches and discoveries during plenary talks and poster sessions. The conference encouraged research in HTLV infections and disease, fostered collaborations, and stimulated new partnerships between clinicians and scientists to encourage clinical trials and novel therapeutic interventions. PMID:16202161

  10. [Gestational diabetes mellitus].

    PubMed

    Kautzky-Willer, Alexandra; Harreiter, Jürgen; Bancher-Todesca, Dagmar; Berger, Angelika; Repa, Andreas; Lechleitner, Monika; Weitgasser, Raimund

    2016-04-01

    Gestational diabetes (GDM) is defined as any degree of glucose intolerance with onset during pregnancy and is associated with increased feto-maternal morbidity as well as long-term complications in mothers and offspring. Women detected to have diabetes early in pregnancy receive the diagnosis of overt, non-gestational, diabetes (glucose: fasting > 126 mg/dl, spontaneous > 200 mg/dl or HbA1c > 6.5 % before 20 weeks of gestation). GDM is diagnosed by an oral glucose tolerance test (OGTT) or fasting glucose concentrations (> 92 mg/dl). Screening for undiagnosed type 2 diabetes at the first prenatal visit (Evidence level B) is recommended in women at increased risk using standard diagnostic criteria (high risk: history of GDM or pre-diabetes (impaired fasting glucose or impaired glucose tolerance); malformation, stillbirth, successive abortions or birth weight > 4,500 g in previous pregnancies; obesity, metabolic syndrome, age > 45 years, vascular disease; clinical symptoms of diabetes (e. g. glucosuria)). Performance of the OGTT (120 min; 75 g glucose) may already be indicated in the first trimester in some women but is mandatory between 24 and 28 gestational weeks in all pregnant women with previous non-pathological glucose metabolism (Evidence level B). Based on the results of the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study GDM is defined, if fasting venous plasma glucose exceeds 92 mg/dl or 1 h 180 mg/dl or 2 h 153 mg/dl after glucose loading (OGTT; international consensus criteria). In case of one pathological value a strict metabolic control is mandatory. This diagnostic approach was recently also recommended by the WHO. All women should receive nutritional counseling and be instructed in blood glucose self-monitoring and to increase physical activity to moderate intensity levels- if not contraindicated. If blood glucose levels cannot be maintained in the normal range (fasting < 95 mg/dl and 1 h after meals < 140

  11. The abortion debate: measuring gestational age.

    PubMed

    Santee, B; Henshaw, S K

    1992-01-01

    Abortion statistics are flawed by the lack of consistency in reporting gestational age. Several methods are generally used, and the number of abortions occurring before 12 weeks changes considerably depending upon the method used to determine gestational age. Pregnancy can be measured from the beginning of last menstruation or from fertilization, which is 14 days after the 1st day of the last menstrual period. Neither method accurately records pregnancy as determined by specialists in embryology and fetal development. Pregnancy actually begins with implantation, which begins 6-7 days after fertilization and ends 10-14 days later. Completion of fertilization and implantation occurs as much as 28 days after the 1st day of the last menstrual period. A report of an 8-week pregnancy is actually 6 weeks from fertilization and 4-5 weeks from implantation. The Centers for Disease Control and other abortion data collecting agencies use the 1st day of the last menstrual period. Statistics generally show that 50% of abortions occur before 8 weeks of gestation and 90% by 12 weeks. When gestation is considered at fertilization, 78% of abortions occur under 9 weeks, while 52% of abortions under 9 weeks are performed with data beginning at the 1st day of the last menstrual period. For abortions occurring under 12 weeks, 95% beginning at fertilization and 90% occur at the 1st day of the last menstrual period. 2/1000 vs. 5/1000 abortions occur under 20 weeks for data beginning at fertilization vs. at the onset of the last period. It is important to report abortion data accurately and to specify the method used to determine the gestational time period. PMID:1526273

  12. Proceedings of the 12th Biennial Conference of Research on the Colorado Plateau

    USGS Publications Warehouse

    2016-01-01

    The 12th Biennial Conference held in Flagstaff, Arizona, from September 16 to 19, 2013, covered a range of topics in the physical, biological, and socio-cultural sciences. The conference was organized and hosted by Northern Arizona University’s (NAU) Merriam-Powell Center for Environmental Research, the Colorado Plateau Cooperative Ecosystem Studies Unit, and the U.S. Geological Survey Southwest Biological Science Center. Financial and in-kind support was provided by a wide range of organizations including the U.S. Forest Service, National Park Service, Bureau of Land Management, Grand Canyon Trust, Colorado Plateau Research Station, and various NAU entities. NAU sponsors include the Landscape Conservation Initiative, School of Forestry, School of Earth Science and Environmental Sustainability, Office of the Provost, and Office of the Vice President of Research. Contributors to these proceedings include researchers and managers from Federal, State, and Tribal governments, universities, private entities, a

  13. 12th Man in Space Symposium: The Future of Humans in Space. Abstract Volume

    NASA Technical Reports Server (NTRS)

    1997-01-01

    The National Aeronautics and Space Administration (NASA) is pleased to host the 12th IAA Man in Space Symposium. A truly international forum, this symposium brings together scientists, engineers, and managers interested in all aspects of human space flight to share the most recent research results and space agency planning related to the future of humans in space. As we look out at the universe from our own uniquely human perspective, we see a world that we affect at the same time that it affects us. Our tomorrows are highlighted by the possibilities generated by our knowledge, our drive, and our dreams. This symposium will examine our future in space from the springboard of our achievements.

  14. Placenta changes in pregnancy with gestational diabetes.

    PubMed

    Edu, Antoine; Teodorescu, Cristina; Dobjanschi, Carmen Gabriela; Socol, ZiŢa Zsuzsana; Teodorescu, Valeriu; Matei, Alexandru; Albu, Dinu Florin; Radulian, Gabriela

    2016-01-01

    Placental damage may be responsible for the fetal complications in pregnancies complicated by diabetes. We have analyzed the prevalence of gestational diabetes (GD) in a population of 109 pregnant women, the risk factors and the placental changes associated with gestational diabetes. Tests carried out were oral glucose tolerance test at 24-28 weeks of gestation, using the IADPSG (International Association of Diabetes and Pregnancy Study Groups) criteria for gestational diabetes, glycated hemoglobin, fasting insulin, total cholesterol, high density lipoprotein (HDL)-cholesterol, low density lipoprotein (LDL)-cholesterol, triglycerides, two-dimensional (2D) ultrasound and, also, there were analyzed macro and microscopic placental fragments from pregnant women with÷without GD. It has been recorded the weight of placenta at birth and there were analyzed the possible pathological changes. The prevalence of GD was 11.9%. We have applied the direct logistic regression to determine the impact of some factors over the probability of association with gestational diabetes. The most powerful predictor was the placental maturity grade, the patients with decreased maturity grade having chances 52.6 times higher than those with an increased placental maturity grade to associate gestational diabetes. Sizes of placentas in patients with gestational diabetes mellitus were significantly increased than in patients without this diagnosis (p=0.012) from week 24-28. Pathological changes were discovered in six of the 13 placentas of women with gestational diabetes mellitus, independent of the level of glycated hemoglobin (p=0.72). The level of hyperglycemia is only partially associated with the presence of placental changes, which may be caused by other maternal factors. PMID:27516026

  15. The BGS magnetic field candidate models for the 12th generation IGRF

    NASA Astrophysics Data System (ADS)

    Hamilton, Brian; Ridley, Victoria A.; Beggan, Ciarán D.; Macmillan, Susan

    2015-05-01

    We describe the candidate models submitted by the British Geological Survey for the 12th generation International Geomagnetic Reference Field. These models are extracted from a spherical harmonic `parent model' derived from vector and scalar magnetic field data from satellite and observatory sources. These data cover the period 2009.0 to 2014.7 and include measurements from the recently launched European Space Agency (ESA) Swarm satellite constellation. The parent model's internal field time dependence for degrees 1 to 13 is represented by order 6 B-splines with knots at yearly intervals. The parent model's degree 1 external field time dependence is described by periodic functions for the annual and semi-annual signals and by dependence on the 20-min Vector Magnetic Disturbance index. Signals induced by these external fields are also parameterized. Satellite data are weighted by spatial density and by two different noise estimators: (a) by standard deviation along segments of the satellite track and (b) a larger-scale noise estimator defined in terms of a measure of vector activity at the geographically closest magnetic observatories to the sample point. Forecasting of the magnetic field secular variation beyond the span of data is by advection of the main field using core surface flows.

  16. NOAA/NGDC candidate models for the 12th generation International Geomagnetic Reference Field

    NASA Astrophysics Data System (ADS)

    Alken, Patrick; Maus, Stefan; Chulliat, Arnaud; Manoj, Chandrasekharan

    2015-05-01

    The International Geomagnetic Reference Field (IGRF) is a model of the geomagnetic main field and its secular variation, produced every 5 years from candidate models proposed by a number of international research institutions. For this 12th generation IGRF, three candidate models were solicited: a main field model for the 2010.0 epoch, a main field model for the 2015.0 epoch, and the predicted secular variation for the five-year period 2015 to 2020. The National Geophysical Data Center (NGDC), part of the National Oceanic and Atmospheric Administration (NOAA), has produced three candidate models for consideration in IGRF-12. The 2010 main field candidate was produced from Challenging Minisatellite Payload (CHAMP) satellite data, while the 2015 main field and secular variation candidates were produced from Swarm and Ørsted satellite data. Careful data selection was performed to minimize the influence of magnetospheric and ionospheric fields. The secular variation predictions of our parent models, from which the candidate models were derived, have been validated against independent ground observatory data.

  17. [Recent history: 12th International Conference on Cancer, Buenos Aires, Argentina, 1978].

    PubMed

    Spinelli, Hugo

    2014-04-01

    Using the approaches of history of the present, this article recovers the discussions surrounding the 12th International Conference on Cancer carried out in Buenos Aires in 1978, in reaction to which Georges Périès organized a "counter-conference" in Paris. In order to understand this discussion, the political situation of the time is described, as is the state of human rights at the time in Argentina, the role of the media - in particular the newspapers La Nación and Clarín and the magazine Gente - and the institutional position adopted by the National Academy of Medicine, as expressed in a letter sent to the presidents of the primary scientific societies of the world. The letter is reprinted in this text as a documentary source, taken from Memoria: Año 1978 (Presidencia de Dr. José E. Rivarola) [Acta: Year 1978 (Presidency of Dr. José E. Rivarola)]. The framework of the discussion makes reference to science's social policy versus science's supposed neutrality and the role of scientific societies. PMID:24823605

  18. A Bayesian QTL linkage analysis of the common dataset from the 12th QTLMAS workshop

    PubMed Central

    Bink, Marco CAM; van Eeuwijk, Fred A

    2009-01-01

    Background To compare the power of various QTL mapping methodologies, a dataset was simulated within the framework of 12th QTLMAS workshop. A total of 5865 diploid individuals was simulated, spanning seven generations, with known pedigree. Individuals were genotyped for 6000 SNPs across six chromosomes. We present an illustration of a Bayesian QTL linkage analysis, as implemented in the special purpose software FlexQTL. Most importantly, we treated the number of bi-allelic QTL as a random variable and used Bayes Factors to infer plausible QTL models. We investigated the power of our analysis in relation to the number of phenotyped individuals and SNPs. Results We report clear posterior evidence for 12 QTL that jointly explained 30% of the phenotypic variance, which was very close to the total of included simulation effects, when using all phenotypes and a set of 600 SNPs. Decreasing the number of phenotyped individuals from 4665 to 1665 and/or the number of SNPs in the analysis from 600 to 120 dramatically reduced the power to identify and locate QTL. Posterior estimates of genome-wide breeding values for a small set of individuals were given. Conclusion We presented a successful Bayesian linkage analysis of a simulated dataset with a pedigree spanning several generations. Our analysis identified all regions that contained QTL with effects explaining more than one percent of the phenotypic variance. We showed how the results of a Bayesian QTL mapping can be used in genomic prediction. PMID:19278543

  19. PREFACE: 12th International Conference on Gas Discharge Plasmas and Their Applications

    NASA Astrophysics Data System (ADS)

    Koval, N.; Landl, N.; Bogdan, A.; Yudin, A.

    2015-11-01

    The 12th International Conference ''Gas Discharge Plasmas and Their Applications'' (GDP 2015) was held in Tomsk, Russia, on September 6-11, 2015. GDP 2015 represents a continuation of the conferences on physics of gas discharge held in Russia since 1984 and seminars and conferences on the technological applications of low temperature plasmas traditionally organized in Tomsk. The six-day Conference brought together the specialists from different countries and organizations and provided an excellent opportunity to exchange knowledge, make oral contributions and poster presentations, and initiate discussions on the topics that are of interest to the Conference participants. The selected papers of the Conference cover a wide range of technical areas and modern aspects of the physical processes in the generators of low-temperature plasma, the low and high-pressure discharges, the pulsed plasma sources, the surface modification, and other gas-discharge technologies. The Conference was hosted by Institute of High Current Electronics SB RAS, Tomsk Polytechnic University, Tomsk Scientific Center, and Tomsk State University of Architecture and Building.

  20. Design Document for 12th Grade NAEP Preparedness Research Judgmental Standard Setting Studies: Setting Standards on the National Assessment of Educational Progress in Reading and Mathematics for 12th Grade Preparedness

    ERIC Educational Resources Information Center

    National Assessment Governing Board, 2010

    2010-01-01

    The National Assessment Governing Board adopted a Program of Preparedness Research in March 2009. Several categories of research studies were recommended to produce results for reporting 12th grade preparedness for the 2009 grade 12 National Assessment of Educational Progress (NAEP) in reading and mathematics. The categories included content…

  1. Delayed interval delivery in a triplet gestation

    PubMed Central

    Wooldridge, Rachel J; Oliver, Emily A; Singh, Tulika

    2012-01-01

    A 27-year-old Ghanaian primigravida with a known triamniotic trichorionic triplet pregnancy presented at 17 weeks gestation following a miscarriage of one triplet at home. Examination and investigation revealed no signs of imminent delivery or infection. After careful counselling with regard to prognosis and options available for management, the couple opted for intervention including rescue cerclage. The patient received antibiotic prophylaxis for five days and daily progesterone suppositories until delivery. An ultrasound scan was performed every three weeks to monitor fetal growth and cervical length. At 24 weeks corticosteroids for fetal lung maturity were given. At 31 weeks gestation she experienced spontaneous rupture of membranes followed by active labour and forceps delivery. There were no maternal complications. Both babies were born in a good condition, but required ventilatory support for 72 h. PMID:23188854

  2. Am I at Risk for Gestational Diabetes?

    MedlinePlus

    ... level is: High 1 Average 0 Low Your health care provider: Will test you as soon as you know you are ... their lifetime. If you had gestational diabetes, your health care provider will test you for diabetes 6 weeks after you give ...

  3. 12th Annual Comparative Analysis of the Racine Unified School District: Demographics, Attendance, Finances, Student Engagement, and Achievement

    ERIC Educational Resources Information Center

    Henken, Rob; Dickman, Anneliese; Schmidt, Jeff; Kramer, Renee

    2009-01-01

    This is the 12th annual report on conditions affecting the Racine Unified School District (RUSD). This year, the analysis again focuses on the long-term historical trends in RUSD. The analysis compares RUSD data to data of nine peer school districts as well as statewide data. The peer districts are defined as those Wisconsin districts with…

  4. The Consistency of the Opinions of 12th-Grade Biology Pupils on the Desirability of Biotechnologies.

    ERIC Educational Resources Information Center

    Dreyfus, Amos; Roth, Zvi

    1986-01-01

    This study examined 12th-grade biology students' opinions and beliefs on the desirability of the use and/or development of various biotechnologies. Describes the development of and presents results from the three questionnaires employed in the study. Includes a listing of the 15 biotechnology topics investigated in the study. (ML)

  5. Adventuring with Books: A Booklist for Pre-K--Grade 6. 12th Edition. NCTE Bibliography Series.

    ERIC Educational Resources Information Center

    Pierce, Kathryn Mitchell, Ed.

    Books that expand children's horizons and stimulate their imaginations are the focus of this 12th edition, an annotated bibliography of selected children's books published between 1996 and 1998. The 20 chapters in the book contain traditional and nontraditional categories of literature: Stories of the Universe: From Questions and Observations to…

  6. The Civic Development of 9th- through 12th-Grade Students in the United States: 1996. Statistical Analysis Report.

    ERIC Educational Resources Information Center

    Niemi, Richard G.; Chapman, Chris

    This report provides an extensive picture of factors often thought to be associated with promoting good citizenship among youth. In particular, it focuses on the civic development of 9th- through 12th-grade students. Broadly speaking, student characteristics, family influences, the role of schools, media factors, and the possible benefits of…

  7. Project Based Learning for Life Skill Building in 12th Grade Social Studies Classrooms: A Case Study

    ERIC Educational Resources Information Center

    Zimmerman, Daniele C.

    2010-01-01

    Based on the assumption that project based learning (PBL) in 12th grade social studies classrooms contributes to the development of life skills for high school seniors in this advanced and globalized time, this research will investigate student experiences with PBL methods for helping them acquire skills along with a case study of a successful PBL…

  8. Campus Computing, 2001: The 12th National Survey of Computing and Information Technology in American Higher Education.

    ERIC Educational Resources Information Center

    Green, Kenneth C.

    The 2001 Campus Computing Survey, the 12th such survey, is the largest continuing study of the role of computing and information technology in U.S. higher education today. The survey results in this report summarize data from 590 two- and four-year, public and private colleges across the United States, representing a 38.4% response rate. The focus…

  9. Examining the Alignment of Chinese National Physics Curriculum Guidelines and 12th-Grade Exit Examinations: A Case Study

    ERIC Educational Resources Information Center

    Liang, Ling L.; Yuan, Haiquan

    2008-01-01

    This study reports findings from an analysis of the 2002 Chinese National Physics Curriculum Guidelines and the alignment between the curriculum guidelines and two most recent provincial-level 12th-grade exit examinations in China. Both curriculum guidelines and test content were represented using two-dimensional matrices (i.e., topic by level of…

  10. Proceedings of the International Academy for Information Management Annual Conference (12th, Atlanta, Georgia, December 12-14, 1997).

    ERIC Educational Resources Information Center

    Rogers, Camille, Ed.

    This proceedings includes 62 papers presented at the 12th annual International Academy for Information Management (IAIM) conference. Topics of papers include: electronic undergraduate courses; software for teaching change management; cooperative projects; experiential learning; World Wide Web applications; internationalization of the information…

  11. Observation in a School without Walls: Peer Observation of Teaching in a 2nd-12th Grade Independent School

    ERIC Educational Resources Information Center

    Salvador, Josephine

    2012-01-01

    What happens when teachers start to observe each other's classes? How do teachers make meaning of observing and being observed? What effects, if any, does requiring peer observation have on the teaching community? This research explores these questions in a qualitative study of peer observation of teaching (POT) in the 2nd-12th grades of an…

  12. A Content Analysis of Kindergarten-12th Grade School-Based Nutrition Interventions: Taking Advantage of Past Learning

    ERIC Educational Resources Information Center

    Roseman, Mary G.; Riddell, Martha C.; Haynes, Jessica N.

    2011-01-01

    Objective: To review the literature, identifying proposed recommendations for school-based nutrition interventions, and evaluate kindergarten through 12th grade school-based nutrition interventions conducted from 2000-2008. Design: Proposed recommendations from school-based intervention reviews were developed and used in conducting a content…

  13. How to Treat Gestational Diabetes

    MedlinePlus

    ... A Listen En Español How to Treat Gestational Diabetes Be sure to see the latest Diabetes Forecast ... and a healthy start for your baby. Gestational Diabetes – Looking Ahead Gestational diabetes usually goes away after ...

  14. Predicting the risk of pre-eclampsia between 11 and 13 weeks gestation by combining maternal characteristics and serum analytes, PAPP-A and free β-hCG

    PubMed Central

    GOETZINGER, Katherine R.; SINGLA, Ashima; GERKOWICZ, Sabrina; DICKE, Jeffrey M.; GRAY, Diana L.; ODIBO, Anthony O.

    2011-01-01

    Objective To determine if a simplified model for predicting pre-eclampsia can be developed by combining first trimester serum analytes, PAPP-A and free β-hCG, and maternal characteristics. Methods A retrospective cohort study of patients seen for first-trimester aneuploidy screening from 2003–2009. The 5th, 10th, 90th and 95th percentiles for the analyte-MoMs for our population were determined and evaluated for association with pre-eclampsia. Univariate and backward stepwise logistic regression analyses were performed and the area under the ROC curves (AUC) used to determine the best models for predicting pre-eclampsia. Results Among 4,020 women meeting the inclusion criteria, outcome data was available for 3,716 (93%). There were 293 cases of pre-eclampsia. The final model identified a history of pre-gestational diabetes (aOR 2.6, 95% CI 1.7–3.9), chronic hypertension (aOR 2.6, 95% CI 1.7–3.9), maternal BMI >25 (aOR 2.5, 95% CI 1.9–3.4), African American race (aOR 1.8, 95% CI 1.3–2.6), and PAPP-A MoM <10th percentile (aOR 1.6, 95% CI 1.1–2.4) to be significant predictors of pre-eclampsia. (AUC= 0.70, 95% CI 0.65–0.72) Conclusion Low first-trimester PAPP-A levels are associated with the development of pre-eclampsia; however, the model was only modestly efficient in its predictive ability. PMID:20936638

  15. PREFACE: 12th European Workshop on Advanced Control and Diagnosis (ACD 2015)

    NASA Astrophysics Data System (ADS)

    Straka, Ondřej; Punčochář, Ivo; Duník, Jindřich

    2015-11-01

    The 12th European Workshop on Advanced Control and Diagnosis (ACD 2015) took place at the Research Centre NTIS - New Technologies for the Information Society, Faculty of Applied Sciences, University of West Bohemia, Pilsen, Czech Republic, on November 19 - 20, 2015. The annual European Workshop on Advanced Control and Diagnosis has been organized since 2003 by Control Engineering departments of several European universities in Germany, France, the UK, Poland, Italy, Hungary, and Denmark to bring together senior and junior academics and engineers from diverse fields of automatic control, fault detection, and signal processing. The workshop provides an opportunity for researchers and developers to present their recent theoretical developments, practical applications, or even open problems. It also offers a great opportunity for industrial partners to express their needs and priorities and to review the current activities in the fields. A total of 74 papers have been submitted for ACD 2015. Based on the peer reviews 48 papers were accepted for the oral presentation and 10 papers for the poster presentation. The accepted papers covered areas of control theory and applications, identification, estimation, signal processing, and fault detection. In addition, four excellent plenary lectures were delivered by Prof. Fredrik Gustafsson (Automotive Sensor Mining for Tire Pressure Monitoring), Prof. Vladimír Havlena (Advanced Process Control for Energy Efficiency), Prof. Silvio Simani (Advanced Issues on Wind Turbine Modelling and Control), and Prof. Robert Babuška (Learning Control in Robotics). The ACD 2015 was for the first time in the workshop history co-sponsored by the International Federation of Automatic Control (IFAC). On behalf of the ACD 2015 organising committee, we would like to thank all those who prepared and submitted papers, participated in the peer review process, supported, and attended the workshop.

  16. PREFACE: 12th High-Tech Plasma Processes Conference (HTPP-12)

    NASA Astrophysics Data System (ADS)

    Gleizes, Alain; Ghedini, Emanuele; Gherardi, Matteo; Sanibondi, Paolo; Dilecce, Giorgio

    2012-12-01

    The High-Tech Plasma Processes - 12th European Plasma Conference (HTPP-12) was held in Bologna (Italy) on 24-29 June 2012. The conference series started in 1990 as a thermal plasma conference and gradually expanded to include other topic fields as well. Now the High-Tech Plasma Processes - European Plasma Conference (HTPP) is a bi-annual international conference based in Europe with topics encompassing the whole area of plasma processing science. The aim of the conference is to bring different scientific communities together, facilitate the contacts between science, technology and industry and provide a platform for the exploration of both fundamental topics and new applications of plasmas. Thanks to the efforts of the conference chairman, Professor Vittorio Colombo and of the co-chair, Professor Piero Favia, a well balanced participation from both the communities of thermal and nonthermal plasma researchers was achieved; this resulted in just about 196 attendees from 39 countries, with 8 plenary and 15 invited talks, plus 50 oral and 140 poster contributions. This volume of Journal of Physics: Conference Series gathers papers from regular contributions of HTPP-12; each contribution submitted for publication has been peer reviewed and the Editors are very grateful to the referees for their careful support in improving the original manuscripts. In the end, 39 manuscripts were accepted for publication, covering different topics of plasma processing science: from plasma fundamentals and modelling to source design and process diagnostics, from nanomaterial synthesis to surface modification, from waste treatment to plasma applications in a liquid environment. It is an honour to present this volume of Journal of Physics: Conference Series and we deeply thank the authors for their enthusiastic and high-grade contribution. Finally, we would like to thank the conference chairmen, the members of the steering committee, the international scientific committee, the local

  17. "Loops and Legs in Quantum Field Theory", 12th DESY Workshop on Elementary Particle Physics

    NASA Astrophysics Data System (ADS)

    The bi-annual international conference "Loops and Legs in Quantum Field Theory" has been held at Weimar, Germany, from April 27 to May 02, 2014. It has been the 12th conference of this series, started in 1992. The main focus of the conference are precision calculations of multi- loop and multi-leg processes in elementary particle physics for processes at present and future high-energy facilities within and beyond the Standard Model. At present many physics questions studied deal with processes at the LHC and future facilities like the ILC. A growing number of contributions deals with important developments in the field of computational technologies and algorithmic methods, including large-scale computer algebra, efficient methods to compute large numbers of Feynman diagrams, analytic summation and integration methods of various kinds, new related function spaces, precise numerical methods and Monte Carlo simulations. The present conference has been attended by more than 110 participants from all over the world, presenting more than 75 contributions, most of which have been written up for these pro- ceedings. The present volume demonstrates in an impressive way the enormous development of the field during the last few years, reaching the level of 5-loop calculations in QCD and a like- wise impressive development in massive next-to-leading order and next-to-next-to-leading order processes. Computer algebraic and numerical calculations require terabyte storage and many CPU years, even after intense parallelization, to obtain state-of-the-art theoretical predictions. The city of Weimar gave a suitable frame to the conference, with its rich history, especially in literature, music, arts, and architecture. Goethe, Schiller, Wieland, Herder, Bach and Liszt lived there and created many of their masterpieces. The many young participants signal that our field is prosperous and faces an exciting future. The conference hotel "Kaiserin Augusta" offered a warm hospitality and

  18. Knowledge and Attitudes of French and Israeli 12th Graders in Agricultural or Rural Secondary Schools about Water and Irrigation Related Issues.

    ERIC Educational Resources Information Center

    Dreyfus, Amos; Jacobi, Daniel; Mazouz, Yossef; Lacroix, Jean-Louis

    1997-01-01

    Knowledge and attitudes of 154 Israeli 12th graders, expected to be very aware of water-related agricultural issues, and of 447 French 12th graders were compared, focusing on possibilities of change of existing situations. Israeli students put much greater emphasis on the role of scientific knowledge and the authorities in water control issues.…

  19. The Minnesota 11th and 12th Grade Post-Secondary Enrollment Options Program: Is It Changing the Traditional Structure of Secondary and Post-Secondary Schools?

    ERIC Educational Resources Information Center

    Boughton, Roger W.

    In 1985, the Minnesota Legislature passed legislation permitting and encouraging 11th and 12th grade students attending public high schools to enroll in public and private postsecondary institutions. Approximately 2% of all 11th and 12th grade students in the state took part in the program during its first year of operation, with the majority of…

  20. Can China comply with its 12th five-year plan on industrial emissions control: a structural decomposition analysis.

    PubMed

    Zhang, Wei; Wang, Jinnan; Zhang, Bing; Bi, Jun; Jiang, Hongqiang

    2015-04-21

    China's rapid economic growth has caused serious environmental problems, resulting in the implementation of two major measures-end-of-pipe facilities and the phasing out of backward capacity-to reduce China's industrial emissions as part of its 11th Five-Year Plan (FYP, 2006-2010). It is important to determine whether China can meet the targets set forth in its 12th FYP (2011-2015) for industrial pollution reduction using these same solutions. In this paper, structural decomposition analysis (SDA) was used to identify the contributions of the adopted measures-as well as other underlying factors-and to evaluate the feasibility of the reduction target in China's 12th FYP. Results show that the decrease in major industrial pollutant emissions achieved during the 11th FYP resulted from improved technological efficiency, including end-of-pipe abatement efficiency and pollutant generation intensity. The same measures adopted during China's 12th FYP can address the problem of industrial wastewater emissions resulting from economic growth when the economic structure is kept constant. But it may not fulfill its commitment of reducing industrial atmospheric pollutants emissions unless the economic structure and growth patterns are drastically reformed. PMID:25790340

  1. The influence of fetal sex in screening for trisomy 21 by fetal nuchal translucency, maternal serum free beta-hCG and PAPP-A at 10-14 weeks of gestation.

    PubMed

    Spencer, K; Ong, C Y; Liao, A W; Papademetriou, D; Nicolaides, K H

    2000-08-01

    In a study of 2923 normal pregnancies and 203 pregnancies affected by trisomy 21 we have shown a significant difference in the median MoM of the markers: fetal nuchal translucency, maternal serum free beta-hCG and PAPP-A in the presence of a female fetus compared with a male fetus. For maternal serum free beta-hCG levels are higher by 15% if the fetus is chromosomally normal and by 11% if the fetus has trisomy 21. For maternal serum PAPP-A the levels in chromosomally normal fetuses are 10% higher in the presence of a female fetus and 13% higher if the fetus has trisomy 21. In contrast, fetal nuchal translucency is 3-4% lower in both chromosomally normal and trisomy 21 female fetuses. The consequence of such changes when screening for trisomy 21 will be a reduction in the detection rate in female fetuses by a factor of 1-2%. Correction of risk algorithms for fetal sex, however, is probably not feasible, since ultrasound detection of fetal sex is only 70-90% accurate in the 10-14 week period. PMID:10951481

  2. PREFACE: 12th International Symposium on Multiscale, Multifunctional and Functionally Graded Materials (FGM 2012)

    NASA Astrophysics Data System (ADS)

    Zhou, Zhangjian; Li, Jingfeng; Zhang, Lianmeng; Ge, Changchun

    2013-03-01

    The 12th International Symposium on Multiscale, Multifunctional and Functionally Graded Materials (FGM-2012) was held in Beijing, China, from 22-36 October 2012. This was part of a series of conferences organized every two years endorsed by International Advisory Committee for FGM's, which serves as a forum for scientists, educators, engineers and young students interested in the development of functionally graded materials (FGM). The series continues from the previous international symposium on FGM held in Sendai, Japan (1990), San Francisco, USA (1992), Lausanne, Switzerland (1994), Tsukuba, Japan (1996), Dresden, Germany (1998), Estes Park, USA (2000), Beijing, China (2002), Leuven, Belgium (2004), Hawaii, USA (2006), Sendai, Japan (2008) and Guimaraes, Portugal (2010). Functionally graded materials are non-uniform materials which are designed with embodied continuous spatial variations in composition and microstructure for the specific purpose of adjusting their thermal, structural, mechanical, biological or functional response to specific application conditions. Such multi-phase materials cover a range of space and time scales, and are best understood by means of a comprehensive multiscale, multiphysics approach. These kinds of materials are presently in the forefront of materials research, receiving worldwide attention. They have a broad range of applications including for example, biomedical, biomechanical, automotive, aerospace, mechanical, civil, nuclear, and naval engineering. New applications are continuously being discovered and developed. The objective of the FGM-2012 intends to provide opportunities for exchanging ideas and discussing state-of-the-art theories, techniques and applications in the fields of multiscale, multifunctional and FGM, through invited lectures, oral and poster presentations. FGM-2012 was organized and hosted by University of Science and Technology Beijing, China, together with Tsing-hua University and Wuhan University of

  3. PREFACE: 12th International Symposium on Multiscale, Multifunctional and Functionally Graded Materials (FGM 2012)

    NASA Astrophysics Data System (ADS)

    Zhou, Zhangjian; Li, Jingfeng; Zhang, Lianmeng; Ge, Changchun

    2013-03-01

    The 12th International Symposium on Multiscale, Multifunctional and Functionally Graded Materials (FGM-2012) was held in Beijing, China, from 22-36 October 2012. This was part of a series of conferences organized every two years endorsed by International Advisory Committee for FGM's, which serves as a forum for scientists, educators, engineers and young students interested in the development of functionally graded materials (FGM). The series continues from the previous international symposium on FGM held in Sendai, Japan (1990), San Francisco, USA (1992), Lausanne, Switzerland (1994), Tsukuba, Japan (1996), Dresden, Germany (1998), Estes Park, USA (2000), Beijing, China (2002), Leuven, Belgium (2004), Hawaii, USA (2006), Sendai, Japan (2008) and Guimaraes, Portugal (2010). Functionally graded materials are non-uniform materials which are designed with embodied continuous spatial variations in composition and microstructure for the specific purpose of adjusting their thermal, structural, mechanical, biological or functional response to specific application conditions. Such multi-phase materials cover a range of space and time scales, and are best understood by means of a comprehensive multiscale, multiphysics approach. These kinds of materials are presently in the forefront of materials research, receiving worldwide attention. They have a broad range of applications including for example, biomedical, biomechanical, automotive, aerospace, mechanical, civil, nuclear, and naval engineering. New applications are continuously being discovered and developed. The objective of the FGM-2012 intends to provide opportunities for exchanging ideas and discussing state-of-the-art theories, techniques and applications in the fields of multiscale, multifunctional and FGM, through invited lectures, oral and poster presentations. FGM-2012 was organized and hosted by University of Science and Technology Beijing, China, together with Tsing-hua University and Wuhan University of

  4. 12th IAEA Technical Meeting on Energetic Particles in Magnetic Confinement Systems

    SciTech Connect

    Berk, Herbert L.; Breizman, Boris N.

    2014-02-21

    The 12th IAEA Technical Meeting on Energetic Particles in Magnetic Confinement Systems took place in Austin, Texas (7–11 September 2011). This meeting was organized jointly with the 5th IAEA Technical Meeting on Theory of Plasma Instabilities (5–7 September 2011). The two meetings shared one day (7 September 2011) with presentations relevant to both groups. Some of the work reported at these meetings was then published in a special issue of Nuclear Fusion [Nucl. Fusion 52 (2012)]. Summaries of the Energetic Particle Conference presentations were given by Kazuo Toi and Boris Breizman. They respectively discussed the experimental and theoretical progress presented at the meeting. Highlights of this meeting include the tremendous progress that has been achieved in the development of diagnostics that enables the ‘viewing’ of internal fluctuations and allows comparison with theoretical predictions, as demonstrated, for example, in the talks of P. Lauber and M. Osakabe. The need and development of hardened diagnostics in the severe radiation environment, such as those that will exist in ITER, was discussed in the talks of V. Kiptily and V.A. Kazakhov. In theoretical studies, much of the effort is focused on nonlinear phenomena. For example, detailed comparison of theory and experiment on D-III-D on the n = 0 geodesic mode was reported in separate papers by R. Nazikian and G. Fu. A large number of theoretical papers were presented on wave chirping including a paper by B.N. Breizman, which notes that wave chirping from a single frequency may emanate continuously once marginal stability conditions have been established. Another area of wide interest was the detailed study of alpha orbits in a burning plasma, where losses can come from symmetry breaking due to finite coil number or magnetic field imperfections introduced by diagnostic or test modules. An important area of development, covered by M.A. Hole and D.A. Spong, is concerned with the self

  5. PREFACE: EMAS 2011: 12th European Workshop on Modern Developments in Microbeam Analysis

    NASA Astrophysics Data System (ADS)

    Brisset, François; Dugne, Olivier; Robaut, Florence; Lábár, János L.; Walker, Clive T.

    2012-03-01

    This volume of IOP Conference Series: Materials Science and Engineering contains papers from the 12th Workshop of the European Microbeam Analysis Society (EMAS) on Modern Developments and Applications in Microbeam Analysis, which took place from the 15-19 May 2011 in the Angers Congress Centre, Angers, France. The primary aim of this series of workshops is to assess the state-of-the-art and reliability of microbeam analysis techniques. The workshops also provide a forum where students and young scientists starting out on a career in microbeam analysis can meet and discuss with the established experts. The workshops have a very specific format comprising invited plenary lectures by internationally recognized experts, poster presentations by the participants and round table discussions on the key topics led by specialists in the field. This workshop was organized in collaboration with GN-MEBA - Groupement National de Microscopie Electronique à Balayage et de microAnalysis, France. The technical programme included the following topics: the limits of EPMA, new techniques, developments and concepts in microanalysis, microanalysis in the SEM, and new and less common applications of micro- and nanoanalysis. As at previous workshops there was also a special oral session for young scientists. The best presentation by a young scientist was awarded with an invitation to attend the 2012 Microscopy and Microanalysis meeting at Phoenix, Arizona. The prize went to Pierre Burdet, of the Federal Institute of Technology of Lausanne (EPFL), for his talk entitled '3D EDS microanalysis by FIB-SEM: enhancement of elemental quantification'. The continuing relevance of the EMAS workshops and the high regard in which they are held internationally can be seen from the fact that 74 posters from 18 countries were on display at the meeting, and that the participants came from as far away as Japan, Canada and the USA. A selection of participants with posters were invited to give a short oral

  6. Low-Dose Aspirin in Early Gestation for Prevention of Preeclampsia and Small-for-Gestational-Age Neonates: Meta-analysis of Large Randomized Trials.

    PubMed

    Roberge, Stéphanie; Sibai, Baha; McCaw-Binns, Affette; Bujold, Emmanuel

    2016-07-01

    Objectives Meta-analyses of small to moderate size randomized controlled trials (RCTs) suggested that aspirin started before 17 weeks' gestation reduces the risk of preeclampsia and small-for-gestational-age (SGA) neonates. We evaluated data from large randomized trials originally excluded from meta-analyses. Methods We performed meta-analyses of RCTs including more than 350 participants that compared aspirin to placebo during pregnancy. Corresponding authors were contacted to obtain data according to gestational age. Outcomes included preeclampsia, severe preeclampsia, and SGA. Relative risks (RRs) with their 95% confidence intervals (CIs) were calculated. Results Data for women recruited before 17 weeks' gestation were obtained for three (50%) of the six eligible trials for a total of 11,949 participants including 3,293 recruited before 17 weeks' gestation with available data. We observed no impact of low-dose aspirin (60 mg) started before 17 weeks' gestation on the risk of preeclampsia (RR: 0.93; 95% CI: 0.75-1.15), severe preeclampsia (RR: 0.96; 95% CI: 0.71-1.28), or SGA (RR: 0.84; 95% CI: 0.56-1.26) and it was not statistically different than when started at or after 17 weeks' gestation. Conclusion Data from large randomized trials do not support greater benefits of low-dose aspirin (at 60 mg daily) when started before 17 weeks' gestation for the prevention of preeclampsia or SGA. PMID:26906184

  7. Gestational age at delivery and neonatal outcome in uncomplicated twin pregnancies: what is the optimal gestational age for delivery according to chorionicity?

    PubMed Central

    Lee, Hye-Jung; Kim, Soo Hyun; Chang, Kylie Hae-Jin; Sung, Ji-Hee; Oh, Soo-young; Roh, Cheong-Rae; Kim, Jong-Hwa

    2016-01-01

    Objective To investigate the neonatal outcome according to the gestational age at delivery and to determine the optimal timing for delivery in uncomplicated monochorionic and dichorionic twin pregnancies. Methods This is a retrospective cohort study of women with uncomplicated twin pregnancies delivered at or beyond 35 weeks of gestation from 1995 to 2013. The primary outcome was neonatal composite morbidity, which was defined as when either one or both twins have one or more of the followings: fetal death after 35 weeks gestation, admission to neonatal intensive care unit, mechanical ventilator requirement, respiratory distress syndrome and neonatal death. To determine the optimal gestational age for delivery according to chorionicity, we compared the neonatal composite morbidity rate between women who delivered and women who remained undelivered at each gestational week in both monochorionic and dichorionic twin pregnancies. Results A total of 697 twin pregnancies were included (171 monochorionic and 526 dichorionic twins). The neonatal composite morbidity rate significantly decreased with advancing gestational age at delivery and its nadir was observed at 38 and ≥39 weeks of gestation in monochorionic and dichorionic twins, respectively. However, the composite morbidity rate did not differ between women who delivered and women who remained undelivered ≥36 and ≥37 weeks in monochorionic and dichorionic twins, respectively. Conclusion Our data suggest that the optimal gestational age for delivery was at ≥36 and ≥37 weeks in uncomplicated monochorionic and dichorionic twin pregnancies, respectively. PMID:26866030

  8. Diagnosing gestational diabetes.

    PubMed

    Ryan, E A

    2011-03-01

    The newly proposed criteria for diagnosing gestational diabetes will result in a gestational diabetes prevalence of 17.8%, doubling the numbers of pregnant women currently diagnosed. These new diagnostic criteria are based primarily on the levels of glucose associated with a 1.75-fold increased risk of giving birth to large-for-gestational age infants (LGA) in the Hyperglycemia Adverse Pregnancy Outcome (HAPO) study; they use a single OGTT. Thus, of 23,316 pregnancies, gestational diabetes would be diagnosed in 4,150 women rather than in 2,448 women if a twofold increased risk of LGA were used. It should be recognised that the majority of women with LGA have normal glucose levels during pregnancy by these proposed criteria and that maternal obesity is a stronger predictor of LGA. The expected benefit of a diagnosis of gestational diabetes in these 1,702 additional women would be the prevention of 140 cases of LGA, 21 cases of shoulder dystocia and 16 cases of birth injury. The reproducibility of an OGTT for diagnosing mild hyperglycaemia is poor. Given that (1) glucose is a weak predictor of LGA, (2) treating these extra numbers has a modest outcome benefit and (3) the diagnosis may be based on a single raised OGTT value, further debate should occur before resources are allocated to implementing this change. PMID:21203743

  9. [Gestational trophoblastic disease].

    PubMed

    Allias, Fabienne; Bolze, Pierre-Adrien; Gaillot-Durand, Lucie; Devouassoux-Shisheboran, Mojgan

    2014-12-01

    Gestational trophoblastic disease encompresses a group of interrelated diseases, following a pregnancy after a variable period of time. Hydatiform mole corresponds to premalignant disorders composed of villi with excess of paternal genetic material, with a malignant potential more important for complete mole than partial mole. Gestational trophoblastic neoplasia includes invasive mole, choriocarcinoma, placental site trophoblatic tumor and epithelioid trophoblastic tumor. Their histological diagnosis may be problematic on curettage material and needs to be correlated to serum hCG level and radiological findings. The use of chemotherapy has dramatically improved the prognosis of these lesions. All patients with this rare disease need to be registered in the national service for gestational trophoblastic disease (http://www.mole-chorio.com), which coordinates their management at the national level. PMID:25499859

  10. STEM development: A study of 6th--12th grade girls' interest and confidence in mathematics and science

    NASA Astrophysics Data System (ADS)

    Heaverlo, Carol Ann

    Researchers, policymakers, business, and industry have indicated that the United States will experience a shortage of professionals in the Science, Technology, Engineering, and Mathematics (STEM) fields. Several strategies have been suggested to address this shortage, one of which includes increasing the representation of girls and women in the STEM fields. In order to increase the representation of women in the STEM fields, it is important to understand the developmental factors that impact girls' interest and confidence in STEM academics and extracurricular programs. Research indicates that greater confidence leads to greater interest and vice versa (Denissen et al., 2007). This study identifies factors that impact girls' interest and confidence in mathematics and science, defined as girls' STEM development. Using Bronfenbrenner's (2005) bioecological model of human development, several factors were hypothesized as having an impact on girls' STEM development; specifically, the macrosystems of region of residence and race/ethnicity, and the microsystems of extracurricular STEM activities, family STEM influence, and math/science teacher influence. Hierarchical regression analysis results indicated that extracurricular STEM involvement and math teacher influence were statistically significant predictors for 6--12th grade girls' interest and confidence in mathematics. Furthermore, hierarchical regression analysis results indicated that the only significant predictor for 6--12th grade girls' interest and confidence in science was science teacher influence. This study provides new knowledge about the factors that impact girls' STEM development. Results can be used to inform and guide educators, administrators, and policy makers in developing programs and policy that support and encourage the STEM development of 6--12th grade girls.

  11. Small for gestational age (SGA)

    MedlinePlus

    ... medlineplus.gov/ency/article/002302.htm Small for gestational age (SGA) To use the sharing features on this page, please enable JavaScript. Small for gestational age means that a fetus or an infant is ...

  12. Large for gestational age (LGA)

    MedlinePlus

    ... medlineplus.gov/ency/article/002248.htm Large for gestational age (LGA) To use the sharing features on this page, please enable JavaScript. Large for gestational age means that a fetus or infant is larger ...

  13. The impact of home computers on 12th grade students' achievement in the computer science curriculum in Riyadh, Saudi Arabia

    NASA Astrophysics Data System (ADS)

    Aljuwaiber, Mohammed A.

    Technology has improved many educational issues. This is a very exciting time for technology and education. The primary purpose of this study was aimed at understanding the impact of home computer use on academic achievement in the computer curriculum of the 12th grade students in Riyadh, Kingdom of Saudi Arabia. In particular, the study attempted to determine if the use of home computers would be an effective manner for increasing students' academic achievement. The participants of the study were 240 male and female students as a random sample from 12th grade from eight random high schools in Riyadh, Saudi Arabia. An achievement exam and survey were developed by the researcher based on the computer science curriculum topics, the quantitative data was collected in both a single achievement exam and a single survey from a sample of 240 Saudi high school students. Both the survey and an achievement exam were split equally between male and female students. The study sought the answer to 10 questions. Analysis of variance (ANOVA), followed by tests of simple main effects and post hoc comparisons using Scheffe, as well as Pearson Correlation were conducted to answer the research questions. The study results pointed out that home computers were important to support the students in their academic achievement in the computer science curriculum. Therefore, more attention must be given to the use of home computers for all students. Moreover, we should attempt to treat the difficulties which students face for getting computers in their homes.

  14. Types of alcoholic beverages usually consumed by students in 9th-12th grades--four states, 2005.

    PubMed

    2007-07-27

    Excessive alcohol consumption contributes to approximately 4,500 deaths among underage youths in the United States each year (e.g., from homicides, motor-vehicle crashes, and suicides) and an average of 60 years of life lost per death. However, little is known about the specific types of alcoholic beverages consumed by youths. These data are important because numerous evidence-based strategies for reducing underage drinking rates are beverage-specific, including increasing alcohol excise taxes and increasing restrictions on the distribution and sale of alcoholic beverages. To examine types of alcoholic beverages usually consumed by students in 9th-12th grades, CDC analyzed 2005 Youth Risk Behavior Survey (YRBS) data from the four state surveys that included a question on the type of alcohol consumed (Arkansas, Nebraska, New Mexico, and Wyoming). This report describes the results of that analysis, which indicated that liquor (e.g., bourbon, rum, scotch, vodka, or whiskey) was the most prevalent type of alcoholic beverage usually consumed among students in 9th-12th grades who reported current alcohol use or binge drinking. These findings suggest that considering beverage-specific alcohol consumption by youths is important when developing alcohol-control policies, specifically those related to the price and availability of particular types of alcoholic beverages. PMID:17657207

  15. Gestational mutations in radiation carcinogenesis

    NASA Astrophysics Data System (ADS)

    Meza, R.; Luebeck, G.; Moolgavkar, S.

    Mutations in critical genes during gestation could increase substantially the risk of cancer. We examine the consequences of such mutations using the Luebeck-Moolgavkar model for colorectal cancer and the Lea-Coulson modification of the Luria-Delbruck model for the accumulation of mutations during gestation. When gestational mutation rates are high, such mutations make a significant contribution to cancer risk even for adult tumors. Furthermore, gestational mutations ocurring at distinct times during emryonic developmemt lead to substantially different numbers of mutated cells at birth, with early mutations leading to a large number (jackpots) of mutated cells at birth and mutation occurring late leading to only a few mutated cells. Thus gestational mutations could confer considerable heterogeneity of the risk of cancer. If the fetus is exposed to an environmental mutagen, such as ionizing radiation, the gestational mutation rate would be expected to increase. We examine the consequences of such exposures during gestation on the subsequent development of cancer.

  16. Gestational hypothyroxinemia and cognitive function in offspring.

    PubMed

    Kasatkina, E P; Samsonova, L N; Ivakhnenko, V N; Ibragimova, G V; Ryabykh, A V; Naumenko, L L; Evdokimova, Yu A

    2006-07-01

    The effects of gestational hypothyroxinemia on the neurointellectual prognosis of children in the first year of life living in an industrial city (megalopolis) with mild iodine deficiency were studied in 13 children of mothers with thyroid hormone-corrected gestational hypothyroxinemia in the first trimester and 10 children of mothers with normal levels of free thyroxine by assessing cognitive functions at ages six, nine, and 12 months using the Gnome mental development scale. The results showed that maternal free thyroxine levels at the early stages (5-9 weeks) of pregnancy correlated significantly with the coefficients of mental development among the children at ages 6, 9, and 12 months, i.e., represented one of the factors defining the neuropsychological development of offspring. Early (not later than nine weeks) correction of gestational hypothyroxinemia with levothyroxine at a mean daily dose of at lest 1.2 microg/kg improved the neurointellectual prognosis of the offspring, increasing the coefficient of mental development of children to 92-97 points during the first year of life, i.e., to the level of development of mental functions of children born to mothers with normal thyroxine levels. PMID:16783515

  17. Forgiveness Week.

    ERIC Educational Resources Information Center

    Milner, Art

    1984-01-01

    Carefully orchestrated public relations and publicity campaign at Free Library of Philadelphia motivated an estimated 35,000 patrons to return almost 160,000 overdues during "no fines" week. Coverage by radio stations, newspapers, and television aided recovery of materials including rare 1910 score of a Rachmaninoff symphony which was 31 years…

  18. 12th meeting of the Scientific Group on Methodologies for the Safety Evaluation of Chemicals: susceptibility to environmental hazards.

    PubMed Central

    Barrett, J C; Vainio, H; Peakall, D; Goldstein, B D

    1997-01-01

    The 12th meeting of the Scientific Group on Methodologies for the Safety Evaluation of Chemicals (SGOMSEC) considered the topic of methodologies for determining human and ecosystem susceptibility to environmental hazards. The report prepared at the meeting describes measurement of susceptibility through the use of biological markers of exposure, biological markers of effect, and biomarkers directly indicative of susceptibility of humans or of ecosystems. The utility and validity of these biological markers for the study of susceptibility are evaluated, as are opportunities for developing newer approaches for the study of humans or of ecosystems. For the first time a SGOMSEC workshop also formally considered the issue of ethics in relation to methodology, an issue of particular concern for studies of susceptibility. PMID:9255554

  19. Maternal Continuing Folic Acid Supplementation after the First Trimester of Pregnancy Increased the Risk of Large-for-Gestational-Age Birth: A Population-Based Birth Cohort Study

    PubMed Central

    Wang, Sufang; Ge, Xing; Zhu, Beibei; Xuan, Yujie; Huang, Kun; Rutayisire, Erigene; Mao, Leijing; Huang, Sanhuan; Yan, Shuangqin; Tao, Fangbiao

    2016-01-01

    Supplementation with folic acid (FA) was proven to prevent neural tube defects (NTDs) and was recommended worldwide before and during early pregnancy. However, much less is known regarding the role of FA after the 12th gestational week (GW). This study aimed to investigate the related effects of continued FA supplementation after the first trimester of pregnancy on fetal growth. The study subjects came from the Ma’anshan-Anhui Birth Cohort Study (MABC) that recruited 3474 pregnant women from the city of Ma’anshan in Anhui Province in China during the period of May 2013 to September 2014. The information on use of vitamin and mineral supplements was recorded in different periods (the first/second/third trimester of pregnancy). Small-for-gestational-age (SGA) births were live-born infants that were <10th percentile of birth weight, and large-for-gestational-age (LGA) births were live-born infants that were ≥90th percentile of birth weight according to nomograms based on gender and gestational age from the latest standards. We used multivariable logistic regression to evaluate the effects of FA supplement consumption in the second/third trimester of pregnancy on the risk of LGA and SGA. In addition, propensity score analysis was also performed to examine the effects. In this prospective birth cohort study conducted in Chinese women who had taken FA in the first trimester of pregnancy, we found that continued FA supplementation with 400 micrograms/day in the second and third trimesters of pregnancy significantly increased the risk of LGA (RR = 1.98 (1.29, 3.04)). This relation was strong or monotonic after adjusting for maternal age, newborn’s gender, maternal pre-pregnancy BMI, maternal education level, smoking, alcohol consumption and calcium supplementation. We did not observe that continuing FA supplementation after the first trimester of pregnancy remarkably decreased the risk of SGA. The propensity score analysis showed similar results. To confirm these

  20. Maternal Continuing Folic Acid Supplementation after the First Trimester of Pregnancy Increased the Risk of Large-for-Gestational-Age Birth: A Population-Based Birth Cohort Study.

    PubMed

    Wang, Sufang; Ge, Xing; Zhu, Beibei; Xuan, Yujie; Huang, Kun; Rutayisire, Erigene; Mao, Leijing; Huang, Sanhuan; Yan, Shuangqin; Tao, Fangbiao

    2016-01-01

    Supplementation with folic acid (FA) was proven to prevent neural tube defects (NTDs) and was recommended worldwide before and during early pregnancy. However, much less is known regarding the role of FA after the 12th gestational week (GW). This study aimed to investigate the related effects of continued FA supplementation after the first trimester of pregnancy on fetal growth. The study subjects came from the Ma'anshan-Anhui Birth Cohort Study (MABC) that recruited 3474 pregnant women from the city of Ma'anshan in Anhui Province in China during the period of May 2013 to September 2014. The information on use of vitamin and mineral supplements was recorded in different periods (the first/second/third trimester of pregnancy). Small-for-gestational-age (SGA) births were live-born infants that were <10th percentile of birth weight, and large-for-gestational-age (LGA) births were live-born infants that were ≥90th percentile of birth weight according to nomograms based on gender and gestational age from the latest standards. We used multivariable logistic regression to evaluate the effects of FA supplement consumption in the second/third trimester of pregnancy on the risk of LGA and SGA. In addition, propensity score analysis was also performed to examine the effects. In this prospective birth cohort study conducted in Chinese women who had taken FA in the first trimester of pregnancy, we found that continued FA supplementation with 400 micrograms/day in the second and third trimesters of pregnancy significantly increased the risk of LGA (RR = 1.98 (1.29, 3.04)). This relation was strong or monotonic after adjusting for maternal age, newborn's gender, maternal pre-pregnancy BMI, maternal education level, smoking, alcohol consumption and calcium supplementation. We did not observe that continuing FA supplementation after the first trimester of pregnancy remarkably decreased the risk of SGA. The propensity score analysis showed similar results. To confirm these

  1. Gestational diabetes mellitus in South Asia: Epidemiology.

    PubMed

    Jawad, Fatema; Ejaz, Kiran

    2016-09-01

    Gestational diabetes mellitus, is defined by the American Diabetes Association as "diabetes diagnosed in the second or third trimester of pregnancy that is not clearly overt diabetes". WHO has further classified the period of diagnosis as Hyperglycaemia in Pregnancy and Gestational Diabetes Mellitus. The former term is applicable in the early period of gestation and GDM is detected after 24 weeks. Irrespective of the guidelines followed, the presence of Diabetes Mellitus during pregnancy, has to be taken seriously as it is an important metabolic derangement and can prove to be harmful for the mother and dangerous for the foetus. The rising incidence of Type 2 Diabetes Mellitus in the world along with obesity, is a major contributing factor for GDM. The trend of this rise is more steep in the low and middle income countries thus proportionately increasing the risk for GDM. South Asia falls in this bracket and the responsible factors have to be identified and corrected. Management should begin from primordial prevention for which education is a key factor. Every woman should be taught the way to follow a healthy life style. Identification of the contributing factors and universal screening facilities for all pregnant women living in both rural and urban areas, should be given prime importance. On detecting Hyperglycaemia in Pregnancy or GDM, monitoring and health care facilities should be provided. This review provides some available figures of GDM in South Asia, the risk factors in this population and the steps for prevention. PMID:27582153

  2. Peritoneal pregnancy with massive hemoperitoneum in early gestation: two case reports

    PubMed Central

    Miyauchi, Azumi; Yamada, Mitsutoshi; Furuya, Masataka; Matsumura, Satoko; Murayama, Shinji; Yoshimura, Yasunori; Tanaka, Mamoru

    2015-01-01

    Key Clinical Message Peritoneal pregnancy may cause severe abdominal bleeding without genital bleeding as early as the fifth week of gestation. Awareness that pregnancy can exist in unusual locations is imperative. PMID:26185643

  3. [Gestational diabetes mellitus].

    PubMed

    Anazawa, Sonoko

    2015-12-01

    Five years have passed since the criteria of gestational diabetes mellitus (GDM) were revised. Under these new criteria, prevalence of GDM has increased from 2-3% to 8-10%. This increase raises many arguments especially about cost effectiveness of managing newly diagnosed mild GDM showing only one abnormal value in 75 gOGTT. No evidence is yet to be found. But in our everyday experience, we find out few poor perinatal outcome with mild GDM mothers who are treated only with diet regimen to control their body weight. Considering later development to type 2 diabetes with these mild GDM mothers, they show no obvious difference from non GDM mothers in the retrospective study. PMID:26666146

  4. In Japanese, there is no word for abstinence. Report from the 12th World Congress of Sexology.

    PubMed

    Haffner, D W

    1995-01-01

    The 12th World Congress of Sexology took place in August 1995 in Japan under the sponsorship of the World Association for Sexology, a conglomerate of 60 member organizations representing 25 countries. The conference focused on sexuality education, and participants from around the world recounted how sexuality education and sexual rights are being politicalized in their countries. Sexuality professionals world-wide look to US professionals for information about effective programs, resources, and research, but the US has a great deal to learn from countries such as those in Scandinavia which have extremely low levels of unplanned pregnancy or sexually transmitted diseases as a result of their commitment to sexuality education and services for young people. During the Congress, debates centered around whether the nature of sexuality is a social construct or is innate and universal. The biological nature of sexuality was explored, and reports of sexuality surveys from around the world revealed surprisingly similar patterns of behavior. Homosexuality emerged as the issue most shaped by culture. In some countries, male same-sex behavior is recognized without being categorized into a separate identity. Terminology for sex behavior also differs across cultures. For example, there is no word for "abstinence" in Japanese or in Swedish. Conference participants were urged to exchange information, expand their work in sex education to "sexuality" education, evaluate their efforts, educate themselves and others, and encourage reforms to assure sexuality education and sexual rights. PMID:12290592

  5. Three centuries of geomagnetic field intensity changes in Spain (from the 9th to the 12th centuries)

    NASA Astrophysics Data System (ADS)

    Gomez-Paccard, M.; Osete, M. L.; Chauvin, A.; Jimenez-Castillo, P.; Perez-Asensio, M.

    2013-12-01

    Available European data indicate that during the past 2500 years there have been periods of rapid intensity geomagnetic fluctuations (at least of ~20 μT/century) interspersed with periods of little change. The challenge now is to precisely describe these rapid changes by the acquisition of well-dated high-quality archeomagnetic data. In this study we report the archeomagnetic study of Spanish ceramic fragments. The collected fragments belong to 14 superposed stratigraphic levels corresponding to a surface no bigger than 3 m by 7 m. The pottery fragments dates back to the 9th and 11th centuries. The dating was established by 4 radiocarbon dates and by archeological/historical constraints including typological comparisons and well-controlled stratigraphic constrains between the different stratigraphic units. From classical Thellier experiments including TRM anisotropy and cooling rate corrections upon archeointensity estimates and conducted on 79 fragments, twelve new high-quality mean intensities have been obtained. Together with previously published high-quality data from Western Europe, the new data provide an improved description of the intensity changes that took place in Spain between the 9th and the 12th centuries. The results confirm that rapid intensity changes took place in Western Europe during the recent history of the Earth.

  6. The Vietnam War: A Four Week Instructional Unit. Grades 11-12.

    ERIC Educational Resources Information Center

    Meadows, Darrell

    This 4-week curriculum is designed to help 11th and 12th grade students reach an understanding of the history and culture of Vietnam and the roots of U.S. military involvement there, and also to draw lessons from U.S. actions during the war in Vietnam. Students are encouraged to engage in critical thinking, evaluation, drawing conclusions, taking…

  7. The Advanced Program of Vocational Agriculture in Louisiana. Ag III and Ag IV (11th and 12th Grades). Volume II. Bulletin No. 1725.

    ERIC Educational Resources Information Center

    Louisiana State Dept. of Education, Baton Rouge. Div. of Vocational Education.

    This curriculum guide consists of materials for use in teaching an advanced course in agricultural mechanics designed for 11th and 12th grade students. Addressed in the individual units of the guide are arc welding; oxy-acetylene welding; soldering; electricity; tractor maintenance, operation, and safety; small engines; farm structures; and cold…

  8. Cooperative Learning, Motivational Effects, and Student Characteristics: An Experimental Study Comparing Cooperative Learning and Direct Instruction in 12th Grade Physics Classes

    ERIC Educational Resources Information Center

    Hanze, Martin; Berger, Roland

    2007-01-01

    One hundred thirty-seven students in 12th grade physics classes participated in a quasi-experimental study comparing the jigsaw classroom method of cooperative instruction with traditional direct instruction. While no differences were found between the two conditions for physics achievement gains, the results revealed differences in students'…

  9. Fixitup Faucet Company's Overseas Move. 12th Grade Lesson. Schools of California Online Resources for Education (SCORE): Connecting California's Classrooms to the World.

    ERIC Educational Resources Information Center

    Harris, Judy; Jacobson, Edy

    This lesson asks 12th grade students to imagine that they are special assistants to the Undersecretary of Commerce for a foreign country who must answer a letter from a U.S. company planning to move its manufacturing operations overseas. The lesson also asks them to design a business brochure that will convince the company to come to their…

  10. Influence of Skip Patterns on Item Non-Response in a Substance Use Survey of 7th to 12th Grade Students

    ERIC Educational Resources Information Center

    Ding, Kele; Olds, R. Scott; Thombs, Dennis L.

    2009-01-01

    This retrospective case study assessed the influence of item non-response error on subsequent response to questionnaire items assessing adolescent alcohol and marijuana use. Post-hoc analyses were conducted on survey results obtained from 4,371 7th to 12th grade students in Ohio in 2005. A skip pattern design in a conventional questionnaire…

  11. Legal Implications of Personnel Management. Proceedings of the Annual Summer Workshop, Southeastern Community College Leadership Program (12th, Tallahassee, Florida, July 18-20, 1973).

    ERIC Educational Resources Information Center

    Clampitt, Joyce, Ed.

    The 12th Annual Summer Workshop, Southeastern Community College Leadership Program, focused on "first-level managers" and on the increasing role of the courts in the day-to-day operation of the college. The first session of the workshop was a video-tape presentation entitled "Legal Implications of Personnel Management." These proceedings provide…

  12. Making the Grade: Do Nebraska Teachers and Administrators Working in Public Schools in 7th-12th Grade Settings Agree about What Constitutes Sound Grading Practice?

    ERIC Educational Resources Information Center

    Olson, Mark E.

    2013-01-01

    In this study, the researcher sought to determine whether Nebraska teachers and administrators agreed about what constitutes sound grading practice. The results of this study indicated that Nebraska teachers and administrators working in public schools in 7th-12th grade settings did not always agree about what constituted sound grading practice.…

  13. [Obstetric consequences of uncontrolled gestational diabetes--a case study].

    PubMed

    Murlewska, Julia; Pietryga, Marek; Bagnosz-Magnuszewska, Alina; Zawiejska, Agnieszka; Brazert, Jacek; Gadzinowski, Janusz; Wender-Ozegowska, Ewa

    2011-08-01

    This paper presents a case of a pregnant woman who was admitted to the obstetrics and gynecology department because of a new onset of uncontrolled diabetes in 27 weeks gestation. The maternal and fetal diabetic complications suggested a chronic character of the disease which must have been undiagnosed before pregnancy. Many of the co-existing infections caused a life-threatening ketoacidosis. Fortunately with the adequate treatment it was possible to ensure appropriate birth weight of the newborn baby despite the ultrasound markers for LGA (Large For Gestational Age) observed during pregnancy. Intensive insulin therapy was obligatorily continued by the mother after the delivery. PMID:21957610

  14. EDITORIAL: Proceedings of the 12th Gravitational Wave Data Analysis Workshop (GWDAW 12), Cambridge, MA, USA, 13 16 December 2007

    NASA Astrophysics Data System (ADS)

    Hughes, S.; Katsavounidis, E.

    2008-09-01

    It was a great pleasure and an honor for us to host the 12th Gravitational Wave Data Analysis Workshop (GWDAW) at MIT and the LIGO Laboratory in Cambridge, Massachusetts, the place where this workshop series started in 1996. This time the conference was held at the conference facilities of the Royal Sonesta Hotel in Cambridge from 13 16 December, 2007. This 12th GWDAW found us with the ground interferometers having just completed their most sensitive search for gravitational waves and as they were starting their preparation to bring online and/or propose more sensitive instruments. Resonant mass detectors continued to observe the gravitational wave sky with instruments that have been operating now for many years. LISA, the Laser Interferometer Space Antenna, was recently reviewed by NASA's Beyond Einstein Program Assessment Committee (BEPAC) convened by the National Research Council (NRC) and found that 'on purely scientific grounds LISA is the mission that is the most promising and least scientifically risky…thus, the committee gave LISA its highest scientific ranking'. Even so, JDEM, the Joint Dark Energy Mission, was identified to go first, with LISA following a few years after. New methods, analysis ideas, results from the analysis of data collected by the instruments, as well as Mock Data Challenges for LISA were reported in this conference. While data from the most recent runs of the instruments are still being analyzed, the first upper limit results show how even non-detection statements can be interesting astrophysics. Beyond these traditional aspects of GWDAW though, for the first time in this workshop we tried to bring the non-gravitational wave physics and astronomy community on board in order to present, discuss and propose ways to work together as we pursue the first detection of gravitational waves and as we hope to transition to gravitational wave astronomy in the near future. Overview talks by colleagues leading observations in the electromagnetic

  15. Foreword: The 12th International Conference on Vibrations at Surfaces (VAS 12) (Erice, 20 26 July 2007)

    NASA Astrophysics Data System (ADS)

    Benedek, Giorgio; Vattuone, Luca

    2008-06-01

    The 12th International Conference on Vibrations at Surfaces (VAS 12) took place from 20 26 July 2007 as an event of the International School of Solid State Physics at the Ettore Majorana Foundation and Centre for Scientific Culture, Erice (Italy). The format and special environment of the conference have contributed to its transition from a traditional, medium-size conference into a more effective workshop, with a series of lectures reporting the most recent developments in the field, two poster sessions presenting recent results and even works in progress being discussed. The papers collected in this issue cover the highlights of the conference very thoroughly. Quite a few novel aspects concerning vibrations at surfaces are represented here, for example: new aspects in surface phonon spectroscopy, such as the very recent progress in inelastic x-ray scattering, the first observation of the boson peak in disordered surfaces, progress in the theory of atom scattering inelastic resonances, the action spectroscopy, the study of polycrystalline surfaces with electron energy-loss spectroscopy etc; parallel developments in experimental vibrational studies of adsorbed phases, either inorganic or organic, with those in ab initio theoretical simulations; the theory of enhanced electron--phonon interaction in low dimensions (2D and 1D); the extension from the traditional realm of surface vibrations and spectroscopy to other aspects of surface dynamics, like friction and various nonlinear effects, and to relevant dynamical phenomena occurring at interfaces. Other novelties presented at the conference, but already published in recent issues of the Journal of Physics: Condensed Matter, are also worth mentioning: the spin-echo spectroscopy with 3He allowing for slow-dynamics spectroscopy at very high, unprecedented resolutions (2007 J. Phys.: Cond. Matter 19 300301 and 305010; the first demonstration of dissociative surface trapping of molecules (2007 J. Phys.: Cond. Matter 19

  16. Trends in weight management goals and behaviors among 9th-12th grade students: United States, 1999-2009.

    PubMed

    Demissie, Zewditu; Lowry, Richard; Eaton, Danice K; Nihiser, Allison J

    2015-01-01

    To examine trends in weight management goals and behaviors among U.S. high school students during 1999-2009. Data from six biennial cycles (1999-2009) of the national Youth Risk Behavior Survey were analyzed. Cross-sectional, nationally representative samples of 9th-12th grade students (approximately 14,000 students/cycle) completed self-administered questionnaires. Logistic regression models adjusted for grade, race/ethnicity, and obesity were used to test for trends in weight management goals and behaviors among subgroups of students. Combined prevalences and trends differed by sex and by race/ethnicity and weight status within sex. During 1999-2009, the prevalence of female students trying to gain weight decreased (7.6-5.7 %). Among female students trying to lose or stay the same weight, prevalences decreased for eating less (69.6-63.2 %); fasting (23.3-17.6 %); using diet pills/powders/liquids (13.7-7.8 %); and vomiting/laxatives (9.5-6.6 %) for weight control. During 1999-2009, the prevalence of male students trying to lose weight increased (26.1-30.5 %). Among male students trying to lose or stay the same weight, the prevalence of exercising to control weight did not change during 1999-2003 and then increased (74.0-79.1 %) while the prevalence of taking diet pills/powders/liquids for weight control decreased (6.9-5.1 %) during 1999-2009. Weight management goals and behaviors changed during 1999-2009 and differed by subgroup. To combat the use of unhealthy weight control behaviors, efforts may be needed to teach adolescents about recommended weight management strategies and avoiding the risks associated with unhealthy methods. PMID:24781877

  17. [The 12th amendment to the German Drug Law. Chances and obstacles for investigator-initiated clinical trials].

    PubMed

    Dreier, G; Marx, C; Schmoor, C; Maier-Lenz, H

    2005-04-01

    The European Union's so called Clinical Trials Directive 2001/20/EC was implemented in national law in Germany in August 2004, leading to the 12th amendment of the German Drug Law (Arzneimittelgesetz). The directive is intended to harmonize the clinical trial's regulatory environment across the European Union and to improve protection of human subjects. It lays down the principles and guidelines of Good Clinical Practice (GCP). As the regulation applies to all clinical trials on medicinal products for human use, and as only non-interventional studies are excluded, academic, investigator-initiated clinical trials will also have to comply with the EU clinical trials directive implemented in the German Drug Law. In an investigator-initiated trial in which the investigator takes the responsibility of a sponsor, the investigator-sponsor must take total legal and financial responsibility for the clinical trial. Since publicly funded clinical trials make a large contribution to improved care, concern has been expressed that non-commercial research projects will be reduced and the vital medical research conducted at academic institutions curtailed. Nonetheless GCP ensures a valid study design, qualified data management, analysis and monitoring of the trial and thereby promotes more valid data and protection of study participants. The trials are more likely to lead to reliable results leading to new therapies, strategies or a better understanding of diseases. What is needed, therefore, is an increase in public funding and the establishment of clinical trial units/organizations associated with the universities or hospitals where independent researchers have the possibility to obtain theoretical advice and practical help, professional training and support. In the end, the directive may serve as a stimulus to build a better national research environment and to promote public funding, and may lead to fewer but more valid clinical trials. PMID:15830256

  18. Main field and secular variation candidate models for the 12th IGRF generation after 10 months of Swarm measurements

    NASA Astrophysics Data System (ADS)

    Saturnino, Diana; Langlais, Benoit; Civet, François; Thébault, Erwan; Mandea, Mioara

    2015-06-01

    We describe the main field and secular variation candidate models for the 12th generation of the International Geomagnetic Reference Field model. These two models are derived from the same parent model, in which the main field is extrapolated to epoch 2015.0 using its associated secular variation. The parent model is exclusively based on measurements acquired by the European Space Agency Swarm mission between its launch on 11/22/2013 and 09/18/2014. It is computed up to spherical harmonic degree and order 25 for the main field, 13 for the secular variation, and 2 for the external field. A selection on local time rather than on true illumination of the spacecraft was chosen in order to keep more measurements. Data selection based on geomagnetic indices was used to minimize the external field contributions. Measurements were screened and outliers were carefully removed. The model uses magnetic field intensity measurements at all latitudes and magnetic field vector measurements equatorward of 50° absolute quasi-dipole magnetic latitude. A second model using only the vertical component of the measured magnetic field and the total intensity was computed. This companion model offers a slightly better fit to the measurements. These two models are compared and discussed.We discuss in particular the quality of the model which does not use the full vector measurements and underline that this approach may be used when only partial directional information is known. The candidate models and their associated companion models are retrospectively compared to the adopted IGRF which allows us to criticize our own choices.

  19. What I Need to Know about Gestational Diabetes

    MedlinePlus

    ... of Diabetes: Neonatal Diabetes Mellitus and MODY Gestational Diabetes What is gestational diabetes? Gestational diabetes is a type of diabetes that ... 8747 and request a copy. What causes gestational diabetes? Gestational diabetes happens when your body can't ...

  20. Vitamin D status and gestational diabetes mellitus

    PubMed Central

    Muthukrishnan, Jayaraman; Dhruv, Goel

    2015-01-01

    Context: Vitamin D (Vit D) deficiency and gestational diabetes mellitus (GDM) are increasingly being seen in Indian women. The role of Vit D in causing GDM is not clear. Aims: (1) To compare Vit D status in pregnant women with or without GDM. (2) Frequency of GDM in women with Vit D insufficiency and deficiency. (3) To reassess glucose tolerance after replacement of Vit D in those women with Vit D deficiency and GDM. Settings and Design: Tertiary Care Hospital, Antenatal Care Department based prospective, controlled study. Subjects and Methods: Seventy-eight consecutive women (<28 weeks gestational period) were screened for GDM by glucose tolerance test (GTT) (75 g 2 h). Fifty-nine of these women were confirmed to have GDM (2 h postglucose > 140 mg/dl). Eight of these women were excluded as per laid exclusion criteria. Remaining 19 women with normal glucose tolerance (NGT) were included as controls. Serum 25-OH Vit D level was estimated by radioimmuno assay. Standard advice regarding diet, sunlight exposure, and exercise was given to all by the same dietician. Women with Vit D levels below 20 ng/ml were prescribed 60,000 IU of oral cholecalciferol to be administered twice weekly for 4 weeks. GTT was repeated after 6 weeks. Frequency of glucose intolerance was compared between Vit D sufficient and deficient groups. Women with GDM and Vit D deficiency who revert to NGT after supplementation with cholecalciferol were evaluated. Statistical Analysis used: Paired t-test for comparing means, and Fisher's test for comparing proportions. Results: Baseline characteristics of GDM and NGT with respect to their age, prepregnancy body mass index, and gestational period were comparable. Serum 25-OH Vit D levels were significantly lower in GDM 24.7 (±17.6) ng/ml versus NGT (45.8 ± 28) group (P = 0.0004). Frequency of GDM was similar irrespective of Vit D status 67% versus 42% (P = 0.09). Standard advice on diet and exercise with or without Vit D supplementation did not

  1. EDITORIAL: Special issue containing papers presented at the 12th International Workshop on H-mode Physics and Transport Barriers Special issue containing papers presented at the 12th International Workshop on H-mode Physics and Transport Barriers

    NASA Astrophysics Data System (ADS)

    Hahm, T. S.

    2010-06-01

    The 12th International Workshop on H-mode Physics and Transport Barriers was held at the Princeton Plasma Physics Laboratory, Princeton, New Jersey, USA between September 30 and October 2, 2009. This meeting was the continuation of a series of previous meetings which was initiated in 1987 and has been held bi-annually since then. Following the recent tradition at the last few meetings, the program was sub- divided into six sessions. At each session, an overview talk was presented, followed by two or three shorter oral presentations which supplemented the coverage of important issues. These talks were followed by discussion periods and poster sessions of contributed papers. The sessions were: Physics of Transition to/from Enhanced Confinement Regimes, Pedestal and Edge Localized Mode Dynamics, Plasma Rotation and Momentum Transport, Role of 3D Physics in Transport Barriers, Transport Barriers: Theory and Simulations and High Priority ITER Issues on Transport Barriers. The diversity of the 90 registered participants was remarkable, with 22 different nationalities. US participants were in the majority (36), followed by Japan (14), South Korea (7), and China (6). This special issue of Nuclear Fusion consists of a cluster of 18 accepted papers from submitted manuscripts based on overview talks and poster presentations. The paper selection procedure followed the guidelines of Nuclear Fusion which are essentially the same as for regular articles with an additional requirement on timeliness of submission, review and revision. One overview paper and five contributed papers report on the H-mode pedestal related results which reflect the importance of this issue concerning the successful operation of ITER. Four papers address the rotation and momentum transport which play a crucial role in transport barrier physics. The transport barrier transition condition is the main focus of other four papers. Finally, four additional papers are devoted to the behaviour and control of

  2. Gestational diabetes: A clinical update

    PubMed Central

    Kampmann, Ulla; Madsen, Lene Ring; Skajaa, Gitte Oeskov; Iversen, Ditte Smed; Moeller, Niels; Ovesen, Per

    2015-01-01

    Gestational diabetes mellitus (GDM) is increasing in prevalence in tandem with the dramatic increase in the prevalence of overweight and obesity in women of childbearing age. Much controversy surrounds the diagnosis and management of gestational diabetes, emphasizing the importance and relevance of clarity and consensus. If newly proposed criteria are adopted universally a significantly growing number of women will be diagnosed as having GDM, implying new therapeutic challenges to avoid foetal and maternal complications related to the hyperglycemia of gestational diabetes. This review provides an overview of clinical issues related to GDM, including the challenges of screening and diagnosis, the pathophysiology behind GDM, the treatment and prevention of GDM and the long and short term consequences of gestational diabetes for both mother and offspring. PMID:26240703

  3. Gestational diabetes - self-care

    MedlinePlus

    ... most women with gestational diabetes will not need diabetes medicines or insulin. If changing your diet does not control your blood sugar levels, you may need oral medicine (taken by mouth) or insulin therapy (shots).

  4. Trying to understand gestational diabetes

    PubMed Central

    Catalano, P. M.

    2014-01-01

    Women with normal glucose tolerance pre-gravid and developing gestational diabetes in late gestation have subclinical metabolic dysfunction prior to conception compared with women with normal glucose tolerance. Because of the 60 % decrease in insulin sensitivity with normal pregnancy, these women develop clinical hyperglycaemia/gestational diabetes in late gestation. The metabolic dysfunction includes impaired insulin response, decreased hepatic suppression of glucose production during insulin infusion and decreased insulin-stimulated glucose uptake in skeletal muscle, i.e. peripheral insulin resistance. The insulin resistance in normal glucose tolerance pregnancy is related to a decrease in the post-receptor insulin signalling cascade, specifically decreased insulin receptor substrate 1 tyrosine phosphorylation. In women with normal glucose tolerance this is reversed post-partum. In contrast, in gestational diabetes, in addition to the decrease in insulin receptor substrate 1 tyrosine phosphorylation, there is an additional decrease in tyrosine phosphorylation of the intracellular portion of the insulin receptor that is not related to the insulin receptor protein content. Post-partum women with gestational diabetes, who had retention of gestational weight gain, had no significant improvement in insulin sensitivity and increased inflammation expressed as increased plasma and skeletal muscle tumour necrosis factor alpha. The increased inflammation or meta-inflammation is a hallmark of obesity and during pregnancy develops in both white adipose tissue and placenta. Last gene array studies of placenta were associated with alterations in gene expression relating primarily to lipid in contrast to glucose metabolic pathways in gestational diabetes compared with Type 1 diabetes. Future studies are directed at decreasing inflammation prior to and during pregnancy using various lifestyle and nutritional interventions. PMID:24341419

  5. Assisted Gestation and Transgender Women.

    PubMed

    Murphy, Timothy F

    2015-07-01

    Developments in uterus transplant put assisted gestation within meaningful range of clinical success for women with uterine infertility who want to gestate children. Should this kind of transplantation prove routine and effective for those women, would there be any morally significant reason why men or transgender women should not be eligible for the same opportunity for gestation? Getting to the point of safe and effective uterus transplantation for those parties would require a focused line of research, over and above the study of uterus transplantation for non-transgender women. Some commentators object to the idea that the state has any duty to sponsor research of this kind. They would limit all publicly-funded fertility research to sex-typical ways of having children, which they construe as the basis of reproductive rights. This objection has no force against privately-funded research, of course, and in any case not all social expenditures are responses to 'rights' properly speaking. Another possible objection raised against gestation by transgender women is that it could alter the social meaning of sexed bodies. This line of argument fails, however, to substantiate a meaningful objection to gestation by transgender women because social meanings of sexed bodies do not remain constant and because the change in this case would not elicit social effects significant enough to justify closing off gestation to transgender women as a class. PMID:25522123

  6. [Split hand-foot: sonographic detection at 12 weeks].

    PubMed

    González-Ballano, Isabel; Savirón-Cornudella, Ricardo; Alastuey-Aisa, María; Garrido-Fernández, Pilar; Lerma-Puertas, Diego

    2014-07-01

    Split hand-foot malformation is a rare disorder inherited in an autosomal dominant pattern with variable expression. Inour case, it was detected early by ultrasound in the twelfth week of gestation. The sonographic findings were bilateral split hands and feet. No other alterations were observed in the rest of the systematic assessment of the foetal anatomy. The pathological findings were consistent with the sonographic diagnosis. Prenatal diagnosis by corionic villus sampling was performed and voluntary termination of gestation decided. PMID:25102675

  7. The predictors of chemistry achievement of 12th grade students in secondary schools in the United Arab Emirates

    NASA Astrophysics Data System (ADS)

    Khalaf, Ali Khalfan

    2000-10-01

    The purpose of this study is to explore variables related to chemistry achievement of 12th grade science students in the United Arab Emirates (UAE). The focus is to identify student, teacher, and school variables that predict chemistry achievement. The analysis sample included 204 males and 252 females in 66 classes in 60 schools from 10 districts or bureaus of education in the UAE. Thirty-two male and 33 female chemistry teachers and 60 school principals were included. The Khalaf Chemistry Achievement Test, GALT, the Student Questionnaire, Teacher Questionnaire, and School Information Questionnaire were administered. Descriptive statistics, correlations, analyses of variance, factor analysis, and stepwise multiple linear regression analyses were done. The results indicate that demographic, home environment, prior knowledge, scholastic ability, attitudes and perceptions related to chemistry and science, and student perception of instructional practices variables correlated with student chemistry achievement. The amount of help teachers received from the supervisor, class size, and courses in geology were teacher variables that correlated with class chemistry achievement. Nine school variables involving school, division, and class sizes correlated with school chemistry achievement. Analyses of variance revealed significant interaction effects: district by school size and district by student gender. In two districts, students in small schools achieved better than those in large schools. Generally female students achieved equal to or better than males. Three factors from the factor analysis: School Size, Prior Student Achievement, and Student Perception of Teacher Effectiveness, correlated with school chemistry achievement. The results of the multiple linear regression indicated that the factors of Prior Student Achievement, Student Perception of Teacher Effectiveness, and Teacher Experience and Expertise accounted for 45% of the variance in school chemistry

  8. Advances in ultrasound imaging for congenital malformations during early gestation

    PubMed Central

    Rayburn, William F.; Jolley, Jennifer A.; Simpson, Lynn L.

    2015-01-01

    With refinement in ultrasound technology, detection of fetal structural abnormalities has improved and there have been detailed reports of the natural history and expected outcomes for many anomalies. The ability to either reassure a high-risk woman with normal intrauterine images or offer comprehensive counseling and offer options in cases of strongly suspected lethal or major malformations has shifted prenatal diagnoses to the earliest possible gestational age. When indicated, scans in early gestation are valuable in accurate gestational dating. Stricter sonographic criteria for early nonviability guard against unnecessary intervention. Most birth defects are without known risk factors, and detection of certain malformations is possible in the late first trimester. The best time for a standard complete fetal and placental scan is 18–20 weeks. In addition, certain soft anatomic markers provide clues to chromosomal aneuploidy risk. Maternal obesity and multifetal pregnancies are now more common and further limit early gestation visibility. Other advanced imaging techniques during early gestation in select cases of suspected malformations include fetal echocardiography and magnetic resonance imaging. PMID:25820190

  9. Gestational age assessment by nurses in a developing country using the Ballard method, external criteria only.

    PubMed

    Verhoeff, F H; Milligan, P; Brabin, B J; Mlanga, S; Nakoma, V

    1997-12-01

    The aim of this study was to evaluate postnatal examination of the newborn by nurses in a developing country, using a modified Ballard method, scoring for the six external criteria only (Ballard-ext). Applicability of gestational age estimates with the Ballard-ext. was assessed by calculating its agreement with gestational age derived from the last menstrual period (LMP), fundal height and the Dubowitz method. The smallest difference in gestational age and the most narrow limits of agreement were found between the Ballard-ext. and the Dubowitz method. No reliable gestational age could be obtained from LMP or fundal height. At low gestational ages, Ballard-ext. tended to give lower gestational ages compared with the Dubowitz method. At an average gestational age of more than 251 days, Ballard-ext. gave higher values compared with Dubowitz. Both Ballard-ext. and the Dubowitz method identified 48% of low birthweight babies as growth-retarded (gestational age > or = 37 weeks). No significant difference in gestational age assessment of newborns between nurses was observed. The Ballard method, scoring for external criteria alone, compared favourably with the Dubowitz method. The test is simple to perform and can be reliably used routinely by nurses. PMID:9578793

  10. Longer Gestation Is Associated with More Efficient Brain Networks in Preadolescent Children

    PubMed Central

    Kim, Dae-Jin; Davis, Elysia Poggi; Sandman, Curt A.; Sporns, Olaf; O’Donnell, Brian F.; Buss, Claudia; Hetrick, William P.

    2014-01-01

    Neurodevelopmental benefits of increased gestation have not been fully characterized in terms of network organization. Since brain function can be understood as an integrated network of neural information from distributed brain regions, investigation of the effects of gestational length on network properties is a critical goal of human developmental neuroscience. Using diffusion tensor imaging and fiber tractography, we investigated the effects of gestational length on the small-world attributes and rich club organization of 147 preadolescent children, whose gestational length ranged from 29 to 42 weeks. Higher network efficiency was positively associated with longer gestation. The longer gestation was correlated with increased local efficiency in the posterior medial cortex, including the precuneus, cuneus, and superior parietal regions. Rich club organization was also observed indicating the existence of highly interconnected structural hubs formed in preadolescent children. Connectivity among rich club members and from rich club regions was positively associated with the length of gestation, indicating the higher level of topological benefits of structural connectivity from longer gestation in the predominant regions of brain networks. The findings provide evidence that longer gestation is associated with improved topological organization of the preadolescent brain, characterized by the increased communication capacity of the brain network and enhanced directional strength of brain connectivity with central hub regions. PMID:24983711

  11. Gestational age assessment in malaria pregnancy cohorts: a prospective ultrasound demonstration project in Malawi

    PubMed Central

    2013-01-01

    Background Malaria during pregnancy is associated with an increased risk for low birth weight (<2500 grams). Distinguishing infants that are born premature (< 37 weeks) from those that are growth-restricted (less than the 10th percentile at birth) requires accurate assessment of gestational age. Where ultrasound is accessible, sonographic confirmation of gestational age is more accurate than menstrual dating. The goal was to pilot the feasibility and utility of adding ultrasound to an observational pregnancy malaria cohort. Methods In July 2009, research staff (three mid-level clinical providers, one nurse) from The Blantyre Malaria Project underwent an intensive one-week ultrasound training to perform foetal biometry. Following an additional four months of practice and remote image review, subjects from an ongoing cohort were recruited for ultrasound to determine gestational age. Gestational age at delivery established by ultrasound was compared with postnatal gestational age assessment (Ballard examination). Results One hundred and seventy-eight women were enrolled. The majority of images were of good quality (94.3%, 509/540) although a learning curve was apparent with 17.5% (24/135) images of unacceptable quality in the first 25% of scans. Ultrasound was used to date 13% of the pregnancies when menstrual dates were unknown and changed the estimated gestational age for an additional 25%. There was poor agreement between the gestational age at delivery as established by the ultrasound protocol compared to that determined by the Ballard examination (bias 0.8 weeks, limits of agreement -3.5 weeks to 5.1 weeks). The distribution of gestational ages by Ballard suggested a clustering of gestational age around the mean with 87% of the values falling between 39 and 41 weeks. The distribution of gestational age by ultrasound confirmed menstrual dates was more typical. Using ultrasound confirmed dates as the gold standard, 78.5% of preterm infants were misclassified as

  12. Gestational weight gain, prepregnancy body mass index related to pregnancy outcomes in KAZERUN, FARS, IRAN

    PubMed Central

    Tabatabaei, Mozhgan

    2011-01-01

    Objective: The aim of this study was to evaluate associations between pregnancy outcomes and prepregnancy body mass index and gestational weight gain among pregnant women who regularly attended health centers of Kazerun, Fars, Iran. Methods: In this descriptive study records from 5172 pregnant women were considered in this study, based on the methodology criteria. Women were distributed across 4 prepregnancy categories according to the Institute of Medicine (IOM) (1990) classification of body mass index, and to 4 end-of-pregnancy categories according to median weekly gestational weight gain. Results: The risks for gestational diabetes, gestational hypertension, pre-eclampsia, and preterm premature rupture of membranes were higher for those who were overweight or obese before becoming pregnant (P < 0.05). Moreover, a gestational weight gain of 0.50 kg per week or greater was associated with a higher risk for gestational hypertension, preterm premature rupture of membranes, and fetal macrosomia (P < 0.05). Women in the highest quartile for weight gain (≥ 0.59 kg per week) were at higher risk for pre-eclampsia (P < 0.05). Discussion: The results seems to indicate that excessive gestational weight gain and high prepregnancy body mass index were associated with increased risks for adverse pregnancy outcomes. PMID:22439074

  13. Ethical issues in gestational surrogacy.

    PubMed

    Ber, R

    2000-01-01

    The introduction of contraceptive technologies has resulted in the separation of sex and procreation. The introduction of new reproductive technologies (mainly IVF and embryo transfer) has led not only to the separation of procreation and sex, but also to the redefinition of the terms mother and family. For the purpose of this essay, I will distinguish between: 1. the genetic mother--the donor of the egg; 2. the gestational mother--she who bears and gives birth to the baby; 3. the social mother--the woman who raises the child. This essay will deal only with the form of gestational surrogacy in which the genetic parents intend to be the social parents, and the surrogate mother has no genetic relationship to the child she bears and delivers. I will raise questions regarding medical ethical aspects of surrogacy and the obligation(s) of the physician(s) to the parties involved. I will argue that the gestational surrogate is "a womb to rent," that there is great similarity between gestational commercial surrogacy and organ transplant marketing. Furthermore, despite claims to freedom of choice and free marketing, I will claim that gestational surrogacy is a form of prostitution and slavery, exploitation of the poor and needy by those who are better off. The right to be a parent, although not constitutional, is intuitive and deeply rooted. However, the issue remains whether this right overrules all other rights, and at what price to the parties involved. I will finally raise the following provocative question to society: In the interim period between today's limited technology and tomorrow's extra-corporeal gestation technology (ectogenesis), should utilizing females in PVS (persistent vehetative state) for gestational surrogacy be socially acceptable/permissible--provided they have left permission in writing? PMID:10967951

  14. FOREWORD: 12th International Workshop on Plasma-Facing Materials and Components for Fusion Applications 12th International Workshop on Plasma-Facing Materials and Components for Fusion Applications

    NASA Astrophysics Data System (ADS)

    Kreter, Arkadi; Linke, Jochen; Rubel, Marek

    2009-12-01

    The 12th International Workshop on Plasma-Facing Materials and Components for Fusion Applications (PFMC-12) was held in Forschungszentrum Jülich (FZJ) in Germany in May 2009. This symposium is the successor to the International Workshop on Carbon Materials for Fusion Applications series. Between 1985 and 2003, 10 'Carbon Workshops' were organized in Jülich, Stockholm and Hohenkammer. After this time, the scope of the symposium was redefined to reflect the new requirements of ITER and the ongoing evolution of the field. The workshop was first organized under its new name in 2006 in Greifswald, Germany. The main objective of this conference series is to provide a discussion forum for experts from research institutions and industry dealing with materials for plasma-facing components in present and future controlled fusion devices. The operation of ASDEX-Upgrade with tungsten-coated wall, the fast progress of the ITER-Like Wall Project at JET, the plans for the EAST tokamak to install tungsten, the start of ITER construction and a discussion about the wall material for DEMO all emphasize the importance of plasma-wall interactions and component behaviour, and give much momentum to the field. In this context, the properties and behaviour of beryllium, carbon and tungsten under plasma impact are research topics of foremost relevance and importance. Our community realizes both the enormous advantages and serious drawbacks of all the candidate materials. As a result, discussion is in progress as to whether to use carbon in ITER during the initial phase of operation or to abandon this element and use only metal components from the start. There is broad knowledge about carbon, both in terms of its excellent power-handling capabilities and the drawbacks related to chemical reactivity with fuel species and, as a consequence, about problems arising from fuel inventory and dust formation. We are learning continuously about beryllium and tungsten under fusion conditions, but our

  15. Screening and diagnosis of gestational diabetes mellitus.

    PubMed

    Gupta, Yashdeep; Kalra, Bharti

    2016-09-01

    American Diabetes Association defines gestational diabetes mellitus (GDM) as diabetes which is diagnosed in the 2nd or 3rd trimester of pregnancy and is not clearly overt diabetes. GDM, if missed or not treated properly can result in maternal and foetal complications, short as well as long term. Screening for overt diabetes, especially for high risk women should be done at the earliest in pregnancy and for GDM, universally at 24-28 weeks of gestation. One step screening by IADPSG (75 gram OGTT), has been recently adopted by most of professional bodies to achieve uniformity. IADPSG criteria have resulted in increase in prevalence of GDM, and consequently increase pressure on health care services as well as on patients. This has resulted in discordance of view on universal adoption of the criteria. Many feel this criteria results in over diagnosis without clear benefits. This brief review will provide the answers to some of the important questions pertaining to screening for GDM. PMID:27582144

  16. Updated guidelines on screening for gestational diabetes

    PubMed Central

    Gupta, Yashdeep; Kalra, Bharti; Baruah, Manash P; Singla, Rajiv; Kalra, Sanjay

    2015-01-01

    Gestational diabetes mellitus (GDM) is associated with an increased risk of complications for both mother and baby during pregnancy as well as in the postpartum period. Screening and identifying these high-risk women is important to improve short- and long-term maternal and fetal outcomes. However, there is a lack of international uniformity in the approach to the screening and diagnosis of GDM. The main purpose of this review is to provide an update on screening for GDM and overt diabetes during pregnancy, and discuss the controversies in this field. We take on debatable issues such as adoption of the new International association of diabetes and pregnancy study groups criteria instead of the Carpenter and Coustan criteria, one-step versus two-step screening, universal screening versus high-risk screening before 24 weeks of gestation for overt diabetes, and, finally, the role of HbA1c as a screening test of GDM. This discussion is followed by a review of recommendations by professional bodies. Certain clinical situations, in which a pragmatic approach is needed, are highlighted to provide a comprehensive overview of the subject. PMID:26056493

  17. Effects of available surface on gaseous emissions from group-housed gestating sows kept on deep litter.

    PubMed

    Philippe, F X; Canart, B; Laitat, M; Wavreille, J; Bartiaux-Thill, N; Nicks, B; Cabaraux, J F

    2010-10-01

    In the European Union, the group-housed pregnant sows have to have a minimal legal available area of 2.25 m2/sow. However, it has been observed that an increased space allowance reduces agonistic behaviour and consecutive wounds and thus induces better welfare conditions. But, what about the environmental impacts of this greater available area? Therefore, the aim of this study was to quantify pollutant gases emissions (nitrous oxide, N2O, methane, CH4, carbon dioxide, CO2 and ammonia, NH3), according to the space allowance in the raising of gestating sows group-housed on a straw-based deep litter. Four successive batches of 10 gestating sows were each divided into two homogeneous groups and randomly allocated to a treatment: 2.5 v. 3.0 m2/sow. The groups were separately kept in two identical rooms. A restricted conventional cereals based diet was provided once a day in individual feeding stalls available only during the feeding time. Rooms were automatically ventilated. The gas emissions were measured by infra red photoacoustic detection during six consecutive days at the 6th, 9th and 12th weeks of gestation. Sows performance (body weight gain, backfat thickness, number and weight of piglets) was not significantly different according to the space allowance. In the room with 3.0 m2/sow and compared with the room with 2.5 m2/sow, gaseous emissions were significantly greater for NH3 (6.29 v. 5.37 g NH3-N/day per sow; P < 0.01) and significantly lower for N2O (1.78 v. 2.48 g N2O-N/day per sow; P < 0.01), CH4 (10.15 v. 15.21 g/day per sow; P < 0.001), CO2 equivalents (1.11 v. 1.55 kg/day per sow; P < 0.001), CO2 (2.12 v. 2.41 kg/day per sow; P < 0.001) and H2O (3.10 v. 3.68 kg/day per sow; P < 0.001). In conclusion, an increase of the available area for group-housed gestating sow kept on straw-based deep litter seems to be ambiguous on an environmental impacts point of view. Compared with a conventional and legal available area, it favoured NH3 emissions, probably due

  18. The management of gestational diabetes

    PubMed Central

    Cheung, N Wah

    2009-01-01

    The incidence of gestational diabetes is increasing. As gestational diabetes is associated with adverse pregnancy outcomes, and has long-term implications for both mother and child, it is important that it is recognized and appropriately managed. This review will examine the pharmacological options for the management of gestational diabetes, as well as the evidence for blood glucose monitoring, dietary and exercise therapy. The medical management of gestational diabetes is still evolving, and recent randomized controlled trials have added considerably to our knowledge in this area. As insulin therapy is effective and safe, it is considered the gold standard of pharmacotherapy for gestational diabetes, against which other treatments have been compared. The current experience is that the short acting insulin analogs lispro and aspart are safe, but there are only limited data to support the use of long acting insulin analogs. There are randomized controlled trials which have demonstrated efficacy of the oral agents glyburide and metformin. Whilst short-term data have not demonstrated adverse effects of glyburide and metformin on the fetus, and they are increasingly being used in pregnancy, there remain long-term concerns regarding their potential for harm. PMID:19436673

  19. Earthquake relocations and InSAR analysis following the June 12th 2011 eruption of Nabro volcano, Afar

    NASA Astrophysics Data System (ADS)

    Hamlyn, Joanna; Wright, Tim; Keir, Derek; Neuberg, Jurgen; Grandin, Raphael; Goitom, Berhe; Hammond, James; Kibreab, Alem; Ogubazghi, Ghebrebrhan; Pagli, Carolina; Sansosti, Eugenio

    2014-05-01

    Nabro volcano sits on the southern part of Danakil block to the east of the Afar depression, on the Arabian plate. On the 12th June 2011, Nabro volcano suddenly erupted after being inactive for 10,000 years. The eruption caused a 17-km-long lava flow, a 15-km-high ash cloud, and ranks as one of the largest emissions of SO2 since the Mt. Pinatubo (1991) event. This eruption creates an important opportunity to use seismicity and surface deformation measurements to understand the subsurface magmatic system and deformation of a hazardous, off axis caldera during continental rupture. We installed a network of 8 seismometers around Nabro caldera which began recording on the 31st August and tasked SAR acquisitions from TerraSAR-X (TSX) and Cosmo-SkyMed (CSK) satellites. The SAR images used for this study post date the eruption. We used TSX stripmap mode images from ascending and descending orbits. Using a small baseline approach, we used 25 images acquired between the 1st July 2011 to the 5th October 2012 on descending orbit 046, to create 34 interferograms. We complemented these with 19 images from ascending orbit 130 spanning the 6th July 2011 to the 10th October 2012 from ascending orbit 130, which we used to create 21 interferograms. We produced a velocity ratemap and timeseries using π-RATE showing subsidence of up to 25cm/yr centred on Nabro. We used a Monte-Carlo hybrid downhill simplex technique to invert the dataset and found the best fitting solution as a mogi source at 6.9 ±1.1 km depth, and located at a 13.35 (lat) and 41.69 (long). The time dependence observed is consistent with a viscoelastic relaxation around the magma chamber, following depletion. Concurrent with the TSX acquisitions, CSK imaged the volcano on a descending track between 26th June 2011 and 18th July 2012 within the ASI project SAR4Volcanoes, and 64 images were used to produce 171 interferograms which were inverted to form a timeseries using a SBAS approach. This dataset has an overall

  20. Effects of Gestational Housing on Reproductive Performance and Behavior of Sows with Different Backfat Thickness

    PubMed Central

    Kim, K. H.; Hosseindoust, A.; Ingale, S. L.; Lee, S. H.; Noh, H. S.; Choi, Y. H.; Jeon, S. M.; Kim, Y. H.; Chae, B. J.

    2016-01-01

    The present study investigated the effects of back-fat thickness at d 107 of gestation and housing types during gestation on reproductive performance and behavior of sows. A total of 64 crossbred sows (Landrace×Yorkshire) in their 3 to 4 parities were allotted to one of four treatments (n = 16) over two consecutive parities. During each parity, sows were assigned to two gestational housing types (stall or group housing) and two level of back-fat thickness (<20 or ≥20) at d 107 of gestation. Gestating sows were transferred from gestational crates to stalls or pens (group housing) 5 weeks before farrowing. All sows were moved to farrowing crates on d 109 of gestation. At weaning, back-fat thickness changes were lesser (p<0.05) in sows having back-fat thickness <20 mm than that of sows with ≥20 mm back-fat thickness at 107 d of gestation. Group housed sows had greater (p<0.05) feed intake and shorter (p<0.05) weaning-to-estrus interval than that of sows in stalls. At weaning, back-fat thickness changes were lesser (p<0.05) in group housed sows than that of sows in stalls. The number of piglets at weaning, growth rate and average daily gain were greater (p<0.05) in group housed sows than that of sows in stalls. During gestation, walking duration was more (p<0.05) in group housed sows. Group housed sows had lesser (p<0.05) farrowing duration and greater (p<0.05) eating time than that of sows in stalls. Result obtained in present study indicated that sows with ≥20 mm back-fat thickness at 107 days had better reproductive performance. Additionally, group housing of sows during last five week of gestation improved the performance and behavior and reproductive efficiency of sows. PMID:26732338

  1. Serum YKL-40 and gestational diabetes - an observational cohort study.

    PubMed

    Gybel-Brask, Dorte; Johansen, Julia S; Christiansen, Ib J; Skibsted, Lillian; Høgdall, Estrid V S

    2016-09-01

    To examine serum YKL-40 in women developing gestational diabetes mellitus (GDM). In the present large observational cohort study of 1179 pregnant women, we determined serum YKL-40 four times during pregnancy (at gestational age 12, 20, 25, and 32 weeks). Pregnancy outcome was obtained from medical records. Sixty-eight women (5.8%) developed GDM. Serum YKL-40 increased from gestational age (GA) 12 weeks and the following weeks in the women who developed GDM and was independent of BMI, parity, and maternal age (OR = 2.69, 95% CI: 1.45-5.00, p = 0.002). No association was found between serum YKL-40 and the oral glucose tolerance test results. In conclusion, YKL-40 significantly increased in pregnant women with GDM compared with women without GDM, probably reflecting the low-grade inflammation of GDM. However, we did not find an association between serum concentrations of YKL-40 in early pregnancy and the development of GDM and thus we conclude that YKL-40 alone is not usable as a biomarker for early prediction of GDM. PMID:27457220

  2. FOREWORD: 12th International Workshop on Plasma-Facing Materials and Components for Fusion Applications 12th International Workshop on Plasma-Facing Materials and Components for Fusion Applications

    NASA Astrophysics Data System (ADS)

    Kreter, Arkadi; Linke, Jochen; Rubel, Marek

    2009-12-01

    The 12th International Workshop on Plasma-Facing Materials and Components for Fusion Applications (PFMC-12) was held in Forschungszentrum Jülich (FZJ) in Germany in May 2009. This symposium is the successor to the International Workshop on Carbon Materials for Fusion Applications series. Between 1985 and 2003, 10 'Carbon Workshops' were organized in Jülich, Stockholm and Hohenkammer. After this time, the scope of the symposium was redefined to reflect the new requirements of ITER and the ongoing evolution of the field. The workshop was first organized under its new name in 2006 in Greifswald, Germany. The main objective of this conference series is to provide a discussion forum for experts from research institutions and industry dealing with materials for plasma-facing components in present and future controlled fusion devices. The operation of ASDEX-Upgrade with tungsten-coated wall, the fast progress of the ITER-Like Wall Project at JET, the plans for the EAST tokamak to install tungsten, the start of ITER construction and a discussion about the wall material for DEMO all emphasize the importance of plasma-wall interactions and component behaviour, and give much momentum to the field. In this context, the properties and behaviour of beryllium, carbon and tungsten under plasma impact are research topics of foremost relevance and importance. Our community realizes both the enormous advantages and serious drawbacks of all the candidate materials. As a result, discussion is in progress as to whether to use carbon in ITER during the initial phase of operation or to abandon this element and use only metal components from the start. There is broad knowledge about carbon, both in terms of its excellent power-handling capabilities and the drawbacks related to chemical reactivity with fuel species and, as a consequence, about problems arising from fuel inventory and dust formation. We are learning continuously about beryllium and tungsten under fusion conditions, but our

  3. Prevention of Gestational Diabetes Mellitus (GDM).

    PubMed

    Kalra, Sanjay; Gupta, Yashdeep; Kumar, Arun

    2016-09-01

    Prevention of Gestational diabetes mellitus holds the key to prevention of the diabetes and metabolic syndrome epidemic sweeping the world. This review discusses prevention of gestational diabetes and provides a scientific framework for the study of this topic. It classifies prevention in various ways, and suggests strategies which fit the different levels of prevention of gestational diabetes. The review also cites recent evidence and best practices to support the feasibility of prevention of gestational diabetes. PMID:27582141

  4. Impact of gestational risk factors on maternal cardiovascular system

    PubMed Central

    Perales, María; Santos-Lozano, Alejandro; Luaces, María; Pareja-Galeano, Helios; Garatachea, Nuria; Barakat, Rubén; Lucia, Alejandro

    2016-01-01

    Background Scarce evidence is available on the potential cardiovascular abnormalities associated with some common gestational complications. We aimed to analyze the potential maternal cardiac alterations related to gestational complications, including body mass index (BMI) >25 kg/m2, gaining excessive weight, or developing antenatal depression. Methods The design of this study was a secondary analysis of a randomized controlled trial. Echocardiography was performed to assess cardiovascular indicators of maternal hemodynamic, cardiac remodeling and left ventricular (LV) function in 59 sedentary pregnant women at 20 and 34 weeks of gestation. Results Starting pregnancy with a BMI >25 kg/m2, gaining excessive weight, and developing antenatal depression had no cardiovascular impact on maternal health (P value >0.002). Depressed women were more likely to exceed weight gain recommendations than non-depressed women (P value <0.002). Conclusions The evaluated gestational complications seem not to induce cardiovascular alterations in hemodynamic, remodeling and LV function indicators. However, developing antenatal depression increases the risk of an excessive weight gain. This finding is potentially important because excessive weight gain during pregnancy associates with a higher risk of cardiovascular diseases (CVD) later in life. PMID:27500154

  5. Doppler study of the peripheral flows in early gestation.

    PubMed

    Wloch, A; Sodowski, K; Rozmus-Warcholinska, W; Wloch, S; Bodzek, P; Czuba, B; Borowski, D; Cnota, W; Kuka, D; Szaflik, K; Huhta, J

    2008-09-01

    The aim of this study was to determine the first trimester human peripheral arterial and venous blood flow between 5 - 10 weeks of gestation. Two hundred twenty four women with singleton, uncomplicated pregnancies were prospectively studied with transvaginal ultrasound. Ductus venosus, umbilical artery waveforms and pulsatility indexes (PI) were assessed as well as the waveform of the umbilical vein and the mean velocity (V(mean)) of the umbilical artery flow. The heart rate was also obtained and analyzed. The fetal heart rate showed a positive correlation with increasing gestational age R=0.76 (p<0.000001). Recordings from the umbilical artery, umbilical vein and ductus venosus were obtained starting from 7 weeks of gestation. The signal from the ductus venosus presented always as antegrade flow during atrial contractions. The pulsatility index (PI) of DV as well as PI of the umbilical artery remained unchanged during the study (statistically non-significant). The umbilical artery, using Doppler tracing was investigated and an absent diastolic flow was documented in every case. Umbilical artery V(mean) increased from 3.8 + 0.32 cm/s to 9.0 + 0.21 cm/s from 7 to 10 weeks of gestation (p< 0.005). Recordings from the umbilical vein showed the pulsation during atrial contractions. Ductus venosus blood velocity and waveform patterns did not change significantly during the study period. Pulsation in the umbilical vein is a typical Doppler finding at the embryonic time. Placental volume blood flow increased significantly with no change in the placental vascular impedance. PMID:18955756

  6. Discrimination of DPRK M5.1 February 12th, 2013 Earthquake as Nuclear Test Using Analysis of Magnitude, Rupture Duration and Ratio of Seismic Energy and Moment

    NASA Astrophysics Data System (ADS)

    Salomo Sianipar, Dimas; Subakti, Hendri; Pribadi, Sugeng

    2015-04-01

    On February 12th, 2013 morning at 02:57 UTC, there had been an earthquake with its epicenter in the region of North Korea precisely around Sungjibaegam Mountains. Monitoring stations of the Preparatory Commission for the Comprehensive Nuclear Test-Ban Treaty Organization (CTBTO) and some other seismic network detected this shallow seismic event. Analyzing seismograms recorded after this event can discriminate between a natural earthquake or an explosion. Zhao et. al. (2014) have been successfully discriminate this seismic event of North Korea nuclear test 2013 from ordinary earthquakes based on network P/S spectral ratios using broadband regional seismic data recorded in China, South Korea and Japan. The P/S-type spectral ratios were powerful discriminants to separate explosions from earthquake (Zhao et. al., 2014). Pribadi et. al. (2014) have characterized 27 earthquake-generated tsunamis (tsunamigenic earthquake or tsunami earthquake) from 1991 to 2012 in Indonesia using W-phase inversion analysis, the ratio between the seismic energy (E) and the seismic moment (Mo), the moment magnitude (Mw), the rupture duration (To) and the distance of the hypocenter to the trench. Some of this method was also used by us to characterize the nuclear test earthquake. We discriminate this DPRK M5.1 February 12th, 2013 earthquake from a natural earthquake using analysis magnitude mb, ms and mw, ratio of seismic energy and moment and rupture duration. We used the waveform data of the seismicity on the scope region in radius 5 degrees from the DPRK M5.1 February 12th, 2013 epicenter 41.29, 129.07 (Zhang and Wen, 2013) from 2006 to 2014 with magnitude M ≥ 4.0. We conclude that this earthquake was a shallow seismic event with explosion characteristics and can be discriminate from a natural or tectonic earthquake. Keywords: North Korean nuclear test, magnitude mb, ms, mw, ratio between seismic energy and moment, ruptures duration

  7. Thyroid hormones according to gestational age in pregnant Spanish women

    PubMed Central

    2009-01-01

    Background Thyroid function changes during pregnancy and maternal thyroid dysfunction have been associated with adverse outcomes. Our aim was to evaluate thyroid hormones levels in pregnant women resident in Aragon, Spain. Findings Samples for 1198 pregnant women with no apparent thyroid disorders were analyzed, using paramagnetic microparticle and chemiluminescent detection technologies, in order to determine levels of thyroid stimulating hormone (TSH), free triiodothyronine (FT3), free thyroxine (FT4), thyroid peroxidase antibodies (TPO-Ab), and thyroglobulin antibodies (Tg-Ab). Of the women in our sample, 85.22% had normal values for TPO-Ab and Tg-Ab and 14.77% had results revealing the presence of autoimmune diseases of the thyroid. The thyroid hormone reference values obtained according to gestational age (in brackets) were as follows: for free T3, values were 3.38 ± 0.52 pg/mL (<11 weeks), 3.45 ± 0.54 pg/mL (11-20 weeks), 3.32 ± 0.43 pg/mL (21-30 weeks), 3.21 ± 0.53 pg/mL (31-36 weeks), and 3.23 ± 0.41 pg/mL (>36 weeks); for free T4, values were 1.10 ± 0.14 ng/dL (<10 weeks), 1.04 ± 0.14 ng/dL (11-20 weeks), 0.93 ± 0.12 ng/dL (21-30 weeks), 0.90 ± 0.13 ng/dL (31-36 weeks), and 0.80 ± 0.21 ng/dL (>36 weeks); and for TSH, values were (μIU/mL): 1.12 ± 0.69 (<10 weeks), 1.05 ± 0.67 (11-20 weeks), 1.19 ± 0.60 (21-30 weeks), 1.38 ± 0.76 (31-36 weeks), and 1.46 ± 0.72 (>36 weeks). Conclusion Pregnant women with normal antibody values according to gestational age had values for FT4 and TSH, but not for FT3, that differed to a statistically significant degree. The values we describe can be used as reference values for the Aragon region of Spain. PMID:19939287

  8. The Clinical Significance of Early (<20 Weeks) Versus Late (20–24 Weeks) Detection of a Sonographic Short Cervix in Asymptomatic Women in the Mid-Trimester

    PubMed Central

    Vaisbuch, Edi; Romero, Roberto; Erez, Offer; Kusanovic, Juan Pedro; Mazaki-Tovi, Shali; Gotsch, Francesca; Romero, Vivian; Ward, Clara; Chaiworapongsa, Tinnakorn; Mittal, Pooja; Sorokin, Yoram; Hassan, Sonia S.

    2010-01-01

    Objective The aim of this study was to determine whether the risk of early spontaneous preterm delivery (sPTD) in asymptomatic women with a sonographic cervical length ≤15 mm in the mid-trimester changes as a function of gestational age at diagnos Methods This cohort study included 109 asymptomatic patients with a sonographic sonographic cervical length ≤15 mm diagnosed at 14–24 weeks of gestation. Women with a multifetal gestation, cerclage, and those with a cervical dilatation >2 cm were excluded. The study population was stratified by gestational age at diagnosis (<20 weeks vs. 20–24 weeks) and by cervical length (≤10 mm vs. 11–15 mm). The primary outcome variables were PTD <28 and <32 weeks’ gestation and the diagnosis-to-delivery interval. Results 1) The median gestational age at diagnosis of a short cervix before 20 weeks and at 20–24 weeks was 18.9 and 22.7 weeks, respectively; 2) women diagnosed before 20 weeks had a higher rate of sPTD at <28 weeks (76.9% vs. 30.9%; p<0.001) and at <32 weeks (80.8% vs. 48.1%; p=0.004), and a shorter median diagnosis-to-delivery interval (21 vs. 61.5 days, p=0.003) than those diagnosed at 20–24 weeks; 3) The rate of amniotic fluid “sludge” was higher among patients diagnosed at <20 weeks of gestation than those diagnosed between 20 and 24 weeks (92.3% vs. 48.2%;p<0.001). Conclusions Asymptomatic women with a sonographic cervical length ≤15 mm diagnosed before 20 weeks have a dramatic and significantly higher risk of early preterm delivery than women diagnosed at 20–24 weeks. These findings can be helpful to physicians in counseling these patients, and may suggest different mechanisms of disease leading to a sonographic short cervix before or after 20 weeks of gestation. PMID:20503224

  9. Postpartum Healthcare After Gestational Diabetes and Hypertension

    PubMed Central

    Maiden, Kristin; Rogers, Stephanie; Ball, Amy

    2014-01-01

    Abstract Background: Gestational diabetes and hypertensive disorders of pregnancy identify women with an elevated lifetime risk of diabetes and cardiovascular disease. Methods: Prospective cohort of women recruited from the postpartum service of a large community-based academic obstetrical hospital after delivery of a pregnancy complicated by gestational diabetes (GDM) or a hypertensive disorder of pregnancy (HDP). Interviews were conducted, and validated surveys completed, before hospital discharge and again 3 months postpartum. Results: The study sample included 249 women: 111 with GDM, 127 with HDP, and 11 with both. Most, 230 (92.4%) had a PCP prior to pregnancy and 97 (39.0%) reported an office visit with their PCP during the prenatal period. Of the 176 (70.7%) participants who attended the 3-month study visit, 169 (96.0%) women with either diagnosis reported they had attended their 6-week postpartum visit. By the 3-month study visit, 51 (57.9%) women with GDM had completed follow-up glucose testing; 93 (97.9%) with HDP had follow-up blood pressure testing; and 101 (57.4%) with either diagnosis recalled ever having completed lipid screening. Women least likely to complete screening tests were those who had no college education, less than a high school level of health literacy, and who were not privately insured. Conclusion: There are important opportunities to improve postpartum testing for diabetes and CVD risk factor assessment. Most women were connected to primary care suggesting a “hand-off” to a primary care physician after pregnancy is feasible. More robust strategies may be needed to improve follow-up care for women with less education, lower health literacy, and those without private health insurance. PMID:25089915

  10. Estimating Gestational Age in Late Presenters to Antenatal Care in a Resource-Limited Setting on the Thai-Myanmar Border

    PubMed Central

    Moore, Kerryn A.; Simpson, Julie A.; Thomas, Kyla H.; Rijken, Marcus J.; White, Lisa J.; Lu Moo Dwell, Saw; Paw, Moo Kho; Wiladphaingern, Jacher; Pukrittayakamee, Sasithon; Nosten, François; Fowkes, Freya J. I.; McGready, Rose

    2015-01-01

    Estimating gestational age in resource-limited settings is prone to considerable inaccuracy because crown-rump length measured by ultrasound before 14 weeks gestation, the recommended method for estimating gestational age, is often unavailable. Judgements regarding provision of appropriate obstetric and neonatal care are dependent on accurate estimation of gestational age. We determined the accuracy of the Dubowitz Gestational Age Assessment, a population-specific symphysis-fundal height formula, and ultrasound biometry performed between 16 and 40 weeks gestation in estimating gestational age using pre-existing data from antenatal clinics of the Shoklo Malaria Research Unit on the Thai-Myanmar border, where malaria is endemic. Two cohorts of women who gave birth to live singletons were analysed: 1) 250 women who attended antenatal care between July 2001 and May 2006 and had both ultrasound crown-rump length (reference) and a Dubowitz Gestational Age Assessment; 2) 975 women attending antenatal care between April 2007 and October 2010 who had ultrasound crown-rump length, symphysis-fundal measurements, and an additional study ultrasound (biparietal diameter and head circumference) randomly scheduled between 16 and 40 weeks gestation. Mean difference in estimated newborn gestational age between methods and 95% limits of agreement (LOA) were determined from linear mixed-effects models. The Dubowitz method and the symphysis-fundal height formula performed well in term newborns, but overestimated gestational age of preterms by 2.57 weeks (95% LOA: 0.49, 4.65) and 3.94 weeks (95% LOA: 2.50, 5.38), respectively. Biparietal diameter overestimated gestational age by 0.83 weeks (95% LOA: -0.93, 2.58). Head circumference underestimated gestational age by 0.39 weeks (95% LOA: -2.60, 1.82), especially if measured after 24 weeks gestation. The results of this study can be used to quantify biases associated with alternative methods for estimating gestational age in the absence of

  11. ASSOCIATIONS OF BLOOD PRESSURE CHANGE IN PREGNANCY WITH FETAL GROWTH AND GESTATIONAL AGE AT DELIVERY: FINDINGS FROM A PROSPECTIVE COHORT

    PubMed Central

    Macdonald-Wallis, Corrie; Tilling, Kate; Fraser, Abigail; Nelson, Scott M; Lawlor, Debbie A

    2014-01-01

    Hypertensive disorders of pregnancy are associated with intrauterine growth restriction and preterm birth. However, the associations of patterns of blood pressure change during pregnancy with these outcomes have not been studied in detail. We studied repeat antenatal blood pressure measurements of 9,697 women in the Avon Longitudinal Study of Parents and Children (median (interquartile range) 10 (9, 11) measurements per woman). Bivariate linear spline models were used to relate blood pressure changes to perinatal outcomes. Higher systolic, but not diastolic, blood pressure at baseline (8 weeks gestation) and a greater increase in systolic and diastolic blood pressure between 18 and 36 weeks gestation were associated with lower offspring birthweight and being smaller for gestational age in confounder-adjusted models. For example, the mean difference (95% CI) in birthweight per 1 mmHg/week greater increase in systolic blood pressure between 18-30 weeks was −71g (−134, −14) and between 30-36 weeks was −175g (−208, −145). A smaller decrease in systolic and diastolic blood pressure prior to 18 weeks and a greater increase between 18 and 36 weeks was associated with a shorter gestation (percentage difference in gestational duration per 1 mmHg/week greater increase in systolic blood pressure between 18-30 weeks: −0.60% (−1.01, −0.18) and 30-36 weeks: −1.01% (−1.36, −0.74)). Associations remained strong when restricting to normotensive women. We conclude that greater increases in blood pressure, from the 18-week nadir, are related to reduced fetal growth and shorter gestation even in women whose blood pressure does not cross the threshold for hypertensive disorders of pregnancy. PMID:24821945

  12. Announcement: Healthy and Safe Swimming Week - May 23-29, 2016.

    PubMed

    2016-01-01

    May 23-29, 2016, marks the 12th annual Healthy and Safe Swimming Week.* This observance highlights ways that swimmers; parents of young swimmers; aquatic facility operators; residential pool, hot tub, or spa owners; beach managers; and public health officials can maximize the health benefits of water-based physical activity while minimizing the risk for recreational water-associated illness and injury. PMID:27196718

  13. Birthweight percentiles for twin birth neonates by gestational age in China.

    PubMed

    Zhang, Bin; Cao, Zhongqiang; Zhang, Yiming; Yao, Cong; Xiong, Chao; Zhang, Yaqi; Wang, Youjie; Zhou, Aifen

    2016-01-01

    Localized birthweight references for gestational ages serve as an essential tool in accurate evaluation of atypical birth outcomes. Such references for twin births are currently not available in China. The aim of this study was to construct up-to-data sex specific birth weight references by gestational ages for twin births in China. We conducted a population-based analysis on the data of 22,507 eligible living twin infants with births dated between 8/01/2006 and 8/31/2015 from all 95 hospitals within the Wuhan area. Gestational ages in complete weeks were determined using a combination of last-menstrual-period based (LMP) estimation and ultrasound examination. Smoothed percentile curves were created by the Lambda Mu Sigma (LMS) method. Reference of the 3(rd), 10(th), 25(th), 50(th), 75(th), 90(th), 97(th) percentiles birth weight by sex and gestational age were made using 11,861 male and 10,646 female twin newborns with gestational age 26-42 weeks. Separate birthweight percentiles curves for male and female twins were constructed. In summary, our study firstly presents percentile curves of birthweight by gestational age for Chinese twin neonates. Further research is required for the validation and implementation of twin birthweight curves into clinical practice. PMID:27506479

  14. Birthweight percentiles for twin birth neonates by gestational age in China

    PubMed Central

    Zhang, Bin; Cao, Zhongqiang; Zhang, Yiming; Yao, Cong; Xiong, Chao; Zhang, Yaqi; Wang, Youjie; Zhou, Aifen

    2016-01-01

    Localized birthweight references for gestational ages serve as an essential tool in accurate evaluation of atypical birth outcomes. Such references for twin births are currently not available in China. The aim of this study was to construct up-to-data sex specific birth weight references by gestational ages for twin births in China. We conducted a population-based analysis on the data of 22,507 eligible living twin infants with births dated between 8/01/2006 and 8/31/2015 from all 95 hospitals within the Wuhan area. Gestational ages in complete weeks were determined using a combination of last-menstrual-period based (LMP) estimation and ultrasound examination. Smoothed percentile curves were created by the Lambda Mu Sigma (LMS) method. Reference of the 3rd, 10th, 25th, 50th, 75th, 90th, 97th percentiles birth weight by sex and gestational age were made using 11,861 male and 10,646 female twin newborns with gestational age 26–42 weeks. Separate birthweight percentiles curves for male and female twins were constructed. In summary, our study firstly presents percentile curves of birthweight by gestational age for Chinese twin neonates. Further research is required for the validation and implementation of twin birthweight curves into clinical practice. PMID:27506479

  15. Gestational Diabetes Mellitus Is Associated With Changes in the Concentration and Bioactivity of Placenta-Derived Exosomes in Maternal Circulation Across Gestation.

    PubMed

    Salomon, Carlos; Scholz-Romero, Katherin; Sarker, Suchismita; Sweeney, Emma; Kobayashi, Miharu; Correa, Paula; Longo, Sherri; Duncombe, Gregory; Mitchell, Murray D; Rice, Gregory E; Illanes, Sebastian E

    2016-03-01

    Although there is significant interest in elucidating the role of placenta-derived exosomes (PdEs) during pregnancy, the exosomal profile in pregnancies complicated by gestational diabetes mellitus (GDM) remains to be established. The aim of this study was to compare the gestational-age profile of PdEs in maternal plasma of GDM with normal pregnancies and to determine the effect of exosomes on cytokine release from human umbilical vein endothelial cells. A prospective cohort of patients was sampled at three time points during pregnancy for each patient (i.e., 11-14, 22-24, and 32-36 weeks' gestation). A retrospective stratified study design was used to quantify exosomes present in maternal plasma of normal (n = 13) and GDM (n = 7) pregnancies. Gestational age and pregnancy status were identified as significant factors contributing to variation in plasma exosome concentration (ANOVA, P < 0.05). Post hoc analyses established that PdE concentration increased during gestation in both normal and GDM pregnancies; however, the increase was significantly greater in GDM (∼2.2-fold, ∼1.5-fold, and ∼1.8-fold greater at each gestational age compared with normal pregnancies). Exosomes isolated from GDM pregnancies significantly increased the release of proinflammatory cytokines from endothelial cells. Although the role of exosomes during GDM remains to be fully elucidated, exosome profiles may be of diagnostic utility for screening asymptomatic populations. PMID:26718504

  16. Metabolic effects of growth factors and polycyclic aromatic hydrocarbons on cultured human placental cells of early and late gestation

    SciTech Connect

    Guyda, H.J. )

    1991-03-01

    The metabolic effects of epidermal growth factor (EGF), insulin, insulin-like growth factor-I (IGF-I), and IGF-II were determined on human placental cells in monolayer culture obtained from early gestation (less than 20 weeks) and late gestation (38-42 weeks). Parameters studied were uptake of aminoisobutyric acid (AIB), uptake of 3-O-methylglucose and (3H)thymidine incorporation into cell protein. Since benzo(alpha)pyrene (BP) inhibits EGF binding and autophosphorylation in cultured human placental cells, particularly in early gestation, we also studied the effect of benzo(alpha)pyrene and other polycyclic aromatic hydrocarbons (PAHs) on EGF-mediated AIB uptake. The metabolic effects of EGF, insulin, and the IGFs in cultured human placental cells varied with gestational age and the growth factor studied. All three classes of growth factors stimulated AIB uptake in both early and late gestation at concentrations from 10-100 micrograms/L, well within a physiological range. However, insulin stimulation of AIB uptake was maximal at a high concentration in both early and late gestation cells, suggesting an action via type 1 IGF receptors rather than via insulin receptors. EGF stimulated 3-O-methylglucose uptake only in term placental cells. No significant stimulation of (3H)thymidine incorporation by any of the growth factors tested was seen with either early or late gestation cells. The effect of PAHs on AIB uptake by cultured placental cells was variable. BP alone stimulated AIB uptake by both very early and late gestation cells and enhanced EGF-stimulated AIB uptake. alpha-naphthoflavone alone inhibited AIB uptake at all gestational ages and inhibited EGF-stimulated AIB uptake. beta-Naphthoflavone and 3-methylcholanthrene minimally inhibited AIB uptake by early gestation cells and did not modify EGF-stimulated uptake at any gestational period.

  17. Effects of Gestational Magnetic Resonance Imaging on Methylation Status of Leptin Promoter in the Placenta and Cord Blood

    PubMed Central

    Wang, Ying; Yan, Feng-Shan; Lian, Jian-Min; Dou, She-Wei

    2016-01-01

    Over the past two decades, magnetic resonance imaging (MRI) has been widely used for diagnosis in gestational women. Though it has several advantages, animal and human studies on the safety of MRI for the fetus remain inconclusive. Epigenetic modifications, which are crucial for cellular functioning, are prone to being affected by environmental changes. Therefore, we hypothesized that MRI during gestation may cause epigenetic modification alterations. Here, we investigated DNA methylation patterns of leptin promoter in the placenta and cord blood of women exposed to MRI during gestation. Results showed that average methylation levels of leptin in the placenta and cord blood were not affected by MRI. We also found that the methylation levels in the placenta and cord blood were not affected by different magnetic fields (1.5T and 3.0T MRI). However, if pregnant women were exposed to MRI at 15 to 20 weeks of gestation, the methylation level of leptin in cord blood was visibly lower than that of pregnant women exposed to MRI after 20-weeks of gestation (P = 0.037). mRNA expression level of leptin in cord blood was also altered, though mRNA expression of leptin in the placenta was not significantly affected. Therefore, we concluded that gestational MRI may not have major effects on the methylation level of leptin in cord blood and the placenta except for MRI applied before 20 weeks of gestation. PMID:26789724

  18. Approach to Infants Born at 22 to 24 Weeks’ Gestation: Relationship to Outcomes of More-Mature Infants

    PubMed Central

    Ambalavanan, Namasivayam; Li, Lei; Cotten, C. Michael; Laughon, Matthew; Walsh, Michele C.; Das, Abhik; Bell, Edward F.; Carlo, Waldemar A.; Stoll, Barbara J.; Shankaran, Seetha; Laptook, Abbot R.; Higgins, Rosemary D.; Goldberg, Ronald N.

    2012-01-01

    OBJECTIVE: We sought to determine if a center’s approach to care of premature infants at the youngest gestational ages (22–24 weeks’ gestation) is associated with clinical outcomes among infants of older gestational ages (25–27 weeks’ gestation). METHODS: Inborn infants of 401 to 1000 g birth weight and 22 0/7 to 27 6/7 weeks’ gestation at birth from 2002 to 2008 were enrolled into a prospectively collected database at 20 centers participating in the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Markers of an aggressive approach to care for 22- to 24-week infants included use of antenatal corticosteroids, cesarean delivery, and resuscitation. The primary outcome was death before postnatal day 120 for infants of 25 to 27 weeks’ gestation. Secondary outcomes were the combined outcomes of death or a number of morbidities associated with prematurity. RESULTS: Our study included 3631 infants 22 to 24 weeks’ gestation and 5227 infants 25 to 27 weeks’ gestation. Among the 22- to 24-week infants, use of antenatal corticosteroids ranged from 28% to 100%, cesarean delivery from 13% to 65%, and resuscitation from 30% to 100% by center. Centers with higher rates of antenatal corticosteroid use in 22- to 24-week infants had reduced rates of death, death or retinopathy of prematurity, death or late-onset sepsis, death or necrotizing enterocolitis, and death or neurodevelopmental impairment in 25- to 27-week infants. CONCLUSIONS: This study suggests that physicians’ willingness to provide care to extremely low gestation infants as measured by frequency of use of antenatal corticosteroids is associated with improved outcomes for more-mature infants. PMID:22641761

  19. Trimester-Specific Gestational Weight Gain and Infant Size for Gestational Age

    PubMed Central

    Sridhar, Sneha B.; Xu, Fei; Hedderson, Monique M.

    2016-01-01

    Gestational weight gain is known to influence fetal growth. However, it is unclear whether the associations between gestational weight gain and fetal growth vary by trimester. In a diverse cohort of 8,977 women who delivered a singleton between 2011 and 2013, we evaluated the associations between trimester-specific gestational weight gain and infant size for gestational age. Gestational weight gain was categorized per the 2009 Institute of Medicine (IOM) recommendations; meeting the recommendations was the referent. Large for gestational age and small for gestational age were defined as birthweight > 90th percentile or <10th percentile, respectively, based on a national reference standard birthweight distribution. Logistic regression models estimated the odds of having a large or small for gestational age versus an appropriate for gestational age infant. Only gestational weight gain exceeding the IOM recommendations in the 2nd and 3rd trimesters independently increased the odds of delivering a large for gestational age infant (Odds Ratio (95% Confidence Interval): 1st: 1.17 [0.94, 1.44], 2nd: 1.47 [1.13, 1.92], 3rd: 1.70 [1.30, 2.22]). Gestational weight gain below the IOM recommendations increased the likelihood of having a small for gestational age infant in the 2nd trimester only (1.76 [1.23, 2.52]). There was effect modification, and gestational weight gain below the IOM recommendations increased the likelihood of having a small for gestational age infant in the 2nd trimester and only among women with a pre-pregnancy body mass index from 18.5–24.9 kg/m2 (2.06 [1.35, 3.15]). These findings indicate that gestational weight gain during the 2nd and 3rd trimesters is more strongly associated with infant growth. Interventions to achieve appropriate gestational weight gain may optimize infant size at birth. PMID:27442137

  20. A prospective study to compare serum human placental lactogen and menstrual dates for determining gestational age.

    PubMed

    Whittaker, P G; Lind, T; Lawson, J Y

    1987-01-01

    In a group of 575 healthy pregnant women with certain menstrual dates the estimation of the length of gestation from maternal serum human placental lactogen concentrations has been compared with gestational age calculated from the last menstrual period and ultrasonic measurements of the fetal biparietal diameter. In 412 of these patients labor started spontaneously, and the estimated dates of delivery determined by these three methods were also compared. In the range of 9 to 17 weeks of pregnancy, gestational age can be determined by human placental lactogen measurement to within 7 days (+/- 1 SD) which compares favorably with other methods. Regarding the prediction of the expected date of delivery, 88% were delivered within 2 weeks of the date predicted by last menstrual period, 82% within 2 weeks of the sonar date, and 80% by the date determined by human placental lactogen assessment. Prediction of delivery in a further group of 139 women with uncertain dates gave 73% within 2 weeks by sonar date and 69% within 2 weeks by human placental lactogen determination. We suggest human placental lactogen measurements should become part of routine antenatal care complementing rather than replacing the role of ultrasonic scanning. For those doctors and patients who wish to avoid more exposure to ultrasonic scanning than absolutely necessary, human placental lactogen estimates offer an alternative method for assessing the length of gestation. PMID:3541617

  1. Length of Latency with Preterm Premature Rupture of Membranes before 32 Weeks’ Gestation

    PubMed Central

    PEACEMAN, Alan M.; LAI, Yinglei; ROUSE, Dwight J.; SPONG, Catherine Y.; MERCER, Brian M.; VARNER, Michael W.; THORP, John M.; RAMIN, Susan M.; MALONE, Fergal D.; O'SULLIVAN, Mary J.; HANKINS, Gary D.V.

    2014-01-01

    Objective To describe latency for patients with preterm premature membrane rupture (PPROM) between 24 0/7 and 31 6/7 weeks’ gestation. Study Design Secondary analysis of data collected prospectively in a multicenter clinical trial of magnesium sulfate for cerebral palsy prevention. Women with PPROM and fewer than 6 contractions per hour at enrollment who were candidates for expectant management (n=1377) were included in this analysis. Length of latency was calculated in days by subtracting the time of delivery from the time of membrane rupture. Results At each week of gestation, median latency between 24-28 weeks was similar at approximately 9 days, but was significantly shorter with PPROM at 29, 30, and 31 weeks (p<0.001). In addition, the percentage of patients remaining undelivered at 7 days and 14 days was similar for PPROM between 24-28 weeks, but decreased significantly after that. For each gestational age, the proportion of patients remaining pregnant declined in a fashion similar to exponential pattern. Conclusion Median latency after PPROM is similar from 24-28 weeks’ gestation, but shortens with PPROM at and after 29 weeks. PMID:24819145

  2. Effects of Gestational Age at Birth on Cognitive Performance: A Function of Cognitive Workload Demands

    PubMed Central

    Jaekel, Julia; Baumann, Nicole; Wolke, Dieter

    2013-01-01

    Objective Cognitive deficits have been inconsistently described for late or moderately preterm children but are consistently found in very preterm children. This study investigates the association between cognitive workload demands of tasks and cognitive performance in relation to gestational age at birth. Methods Data were collected as part of a prospective geographically defined whole-population study of neonatal at-risk children in Southern Bavaria. At 8;5 years, n = 1326 children (gestation range: 23–41 weeks) were assessed with the K-ABC and a Mathematics Test. Results Cognitive scores of preterm children decreased as cognitive workload demands of tasks increased. The relationship between gestation and task workload was curvilinear and more pronounced the higher the cognitive workload: GA2 (quadratic term) on low cognitive workload: R2 = .02, p<0.001; moderate cognitive workload: R2 = .09, p<0.001; and high cognitive workload tasks: R2 = .14, p<0.001. Specifically, disproportionally lower scores were found for very (<32 weeks gestation) and moderately (32–33 weeks gestation) preterm children the higher the cognitive workload of the tasks. Early biological factors such as gestation and neonatal complications explained more of the variance in high (12.5%) compared with moderate (8.1%) and low cognitive workload tasks (1.7%). Conclusions The cognitive workload model may help to explain variations of findings on the relationship of gestational age with cognitive performance in the literature. The findings have implications for routine cognitive follow-up, educational intervention, and basic research into neuro-plasticity and brain reorganization after preterm birth. PMID:23717694

  3. Management of late preterm and early-term pregnancies complicated by mild gestational hypertension/pre-eclampsia.

    PubMed

    Sibai, Baha M

    2011-10-01

    Gestational hypertension/pre-eclampsia is the most frequent obstetrical complication, complicating 26%-29% of all gestations in nulliparous women. In general, the diagnosis of mild gestational hypertension/pre-eclampsia is made at 38 weeks or more in approximately 80% of cases. For many years, the optimal timing of delivery for patients with mild gestational hypertension/pre-eclampsia at 37-0/7 to 39-6/7 weeks was unclear. Recently, investigators of the HYPITAT (Pregnancy-induced hypertension and pre-eclampsia after 36 weeks: induction of labor versus expectant monitoring: A comparison of maternal and neonatal outcome, maternal quality of life and costs) randomized trial evaluated maternal and neonatal complications in patients at 36-40 weeks' gestation who were randomized to either induction of labor or expectant monitoring. The results of this trial revealed that induction of labor at or after 37-0 weeks was associated with lower rate of maternal complications without increased rates of either cesarean delivery or neonatal complications. In contrast, the optimum management for those with mild hypertension/pre-eclampsia with stable maternal and fetal conditions at 34-0/7 to 36-6/7 weeks remains uncertain. Therefore, there is urgent need for research to evaluate the reasons for late preterm birth in such women as well as for a randomized trial to evaluate the optimal timing for delivery in such patients. PMID:21962629

  4. Climate Change and the Water Cycle: A New Southwest Regional Climate Hub Curriculum Unit for 6th-12th Grade Students

    NASA Astrophysics Data System (ADS)

    Elias, E.; Steele, C. M.; Bestelmeyer, S.; Haan-Amato, S.; Deswood, H.; Rango, A.; Havstad, K.

    2015-12-01

    As climate change intensifies, increased temperatures and altered precipitation will make water, a limited resource in the arid southwestern United States, even scarcer in many locations. The USDA Southwest Regional Climate Hub (SWRCH) developed Climate Change and the Water Cycle, an engaging and scientifically rigorous education unit for 6th -12th grade students. The unit is aligned with Common Core State Standards and Next Generation Science Standards. Nine activities can be conducted over 10 instruction hours. Each activity can also stand alone. In partnership with SWRCH, the Asombro Institute for Science Education developed the unit. Each activity was reviewed by an educator for educational practices and by a scientist for scientific accuracy. The unit was pilot tested with 524 students in 2014, and pre- and post-tests were administered. Ninety-one percent of students were able to name a greenhouse gas on the post-test, compared to only 48% on the pre-test. On the post-test, 86% of students identified the relationship between average global temperature and carbon dioxide levels in the atmosphere, compared to only 52% on the pre-test. A student commented: "I loved all of the activities! They are fun and help us understand about what goes on in the world." Educators who participated in pilot testing said: "the entire curriculum is great, but I was particularly impressed with the progression of ideas and the variety of lessons," and "students could see the relevance and importance of these real life issues." Anyone interested in using the unit to host workshops for teachers in southwestern states should contact Asombro for more information (information@asombro.org). The Climate Change and the Water Cycle 6th-12th grade curriculum unit is available online: www.swclimatehub.info/education/climate-change-and-water-cycle

  5. Alcohol mixed with energy drink use among U.S. 12th-grade students: Prevalence, correlates, and associations with unsafe driving

    PubMed Central

    Martz, Meghan E.; Patrick, Megan E.; Schulenberg, John E.

    2015-01-01

    Purpose The consumption of alcohol mixed with energy drinks (AmED) is a risky drinking behavior, most commonly studied using college samples. We know little about rates of AmED use and its associations with other risk behaviors, including unsafe driving, among high school students. This study examined the prevalence and correlates of AmED use among high school seniors in the United States. Methods Nationally representative analytic samples included 6,498 12th-grade students who completed Monitoring the Future surveys in 2012 and 2013. Focal measures included AmED use, sociodemographic characteristics, academic and social factors, other substance use, and unsafe driving (i.e., tickets/warnings and accidents) following alcohol consumption. Results Approximately one in four students (24.8%) reported AmED use during the past 12 months. Rates of AmED use were highest among males and White students. Using multivariable logistic regression models controlling for sociodemographic characteristics, results indicate that students who cut class, spent more evenings out for fun and recreation, and reported binge drinking, marijuana use, and illicit drug use had a greater likelihood of AmED use. AmED use was also associated with greater odds of alcohol-related unsafe driving, even after controlling for sociodemographic, academic, and social factors, and other substance use. Conclusions AmED use among 12th-grade students is common and associated with certain sociodemographic, academic, social, and substance use factors. AmED use is also related to alcohol-related unsafe driving, which is a serious public health concern. PMID:25907654

  6. Current status and future trends of SO2 and NOx pollution during the 12th FYP period in Guiyang city of China

    NASA Astrophysics Data System (ADS)

    Tian, Hezhong; Qiu, Peipei; Cheng, Ke; Gao, Jiajia; Lu, Long; Liu, Kaiyun; Liu, Xingang

    2013-04-01

    In order to investigate the future trends of SO2 and NOx pollution in Guiyang city of China, the MM5/CALMET/CALPUFF modeling system is applied to assess the effects of air pollution improvement that would result from reduction targets for SO2 and NOx emissions during the 12th Five-Year Plan (2011-2015). Three scenarios are established for the objective year 2015 based on the reference emissions in base year 2010. Scenario analysis and modeling results show that emissions are projected to increase by 26.5% for SO2 and 138.0% for NOx in 2015 Business-As-Usual (BAU) relative to base year 2010, respectively, which will lead to a substantial worsening tendency of SO2 and NOx pollution. In comparison, both the 2015 Policy Reduction (PR) and 2015 Intensive Policy Reduction (IPR) scenarios would contribute to improve the urban air quality. Under 2015 PR scenario, the maximum annual average concentration of SO2 and NOx will reduce by 54.9% and 31.7%, respectively, relative to the year 2010, with only 2.1% of all individual gridded receptors exceed the national air quality standard limits; while the maximum annual average concentrations of SO2 and NOx can reduce further under 2015 IPR scenario and comply well with standards limits. In view of the technical feasibility and cost-effectiveness, the emission reduction targets set in the 2015 PR scenario are regarded as more reasonable in order to further improve the air quality in Guiyang during the 12th FYP period and a series of comprehensive countermeasures should be effectively implemented.

  7. Exercise guidelines for gestational diabetes mellitus

    PubMed Central

    Padayachee, Cliantha; Coombes, Jeff S

    2015-01-01

    The prevalence of gestational diabetes mellitus (GDM) is increasing worldwide. This disease has many detrimental consequences for the woman, the unborn foetus and child. The management of GDM aims to mediate the effects of hyperglycaemia by controlling blood glucose levels. Along with pharmacology and dietary interventions, exercise has a powerful potential to assist with blood glucose control. Due to the uncertainty of risks and benefits of exercise during pregnancy, women tend to avoid exercise. However, under adequate supervision exercise is both safe and beneficial in the treatment of GDM. Therefore it is vital that exercise is incorporated into the continuum of care for women with GDM. Medical doctors should be able to refer to competently informed exercise professionals to aid in GDM treatment. It is important that exercise treatment is informed by research. Hence, the development of evidence-based guidelines is important to inform practice. Currently there are no guidelines for exercise in GDM. This review aims to assess the efficacy of exercise for the management of GDM in order to establish an exercise prescription guideline specific to the condition. It is recommended that women with GDM should do both aerobic and resistance exercise at a moderate intensity, a minimum of three times a week for 30-60 min each time. PMID:26240700

  8. An isolated fetal cor triatriatum dexter during a targeted anatomic survey at 22 weeks’ gestation

    PubMed Central

    Vigna, Roberto; De Paola, Nico; Cignini, Pietro; Padula, Francesco

    2008-01-01

    Objective: Cor triatriatum dexter is a rare cardiac malformation characterized by division of the right atrium into two compartments by a usually fenestrated membrane, whose degree of partitioning or septation is responsible for different clinical manifestations. Methods: We report the first case of an isolated fetal cor triatriatum dexter that was diagnosed during ultrasound screening at 22 weeks of gestation. Results: The sonographic examination of the fetal cardiac morphology revealed the presence of a membrane stretched between the medial and lateral walls of right atrium in the apical four-chamber view. Fetal morphology and biometric features were normal and appropriate for gestational age. Conclusion: This is the first report of an isolated fetal cor triatriatum dexter that was diagnosed during ultrasound screening at 22 weeks of gestation. PMID:22439029

  9. Incretins, Pregnancy, and Gestational Diabetes.

    PubMed

    Nikolic, Dragana; Al-Rasadi, Khalid; Al Busaidi, Noor; Al-Waili, Khalid; Banerjee, Yajnavalka; Al-Hashmi, Khamis; Montalto, Giuseppe; Rizvi, Ali A; Rizzo, Manfredi; Al-Dughaishi, Tamima

    2016-01-01

    The number of pregnant women affected by gestational diabetes mellitus (GDM) is increasing among Caucasians, and East Asians. GDM also increases the risk for later advent of type 2 diabetes mellitus (T2DM), obesity, and cardiovascular disease in both women and their offspring. The underlying mechanism of GDM is not fully elucidated. Incretins such as glucagon-like peptide 1 (GLP-1) and glucose-dependent insulinotropic peptide (GIP), have been suggested to have a role in maternal metabolism and weight as well as fetal growth. These hormones might be implicated in mechanisms that compensate for the increment in glycemia and insulin resistance seen during pregnancy, while other factors, such as heredity, environment and lifestyle, but also different race/ethnic background might also lead to the comorbid health problems. Some studies indicate that pregnancy is associated with a diminished GLP-1 response which is more prominently evident in women with GDM and normalizes after delivery. Postprandial GIP level seems to be unaffected by pregnancy, despite its increased level in GDM. On the other hand, the reduced incretin effect observed in GDM may represent a risk factor for obesity, T2DM and metabolic disorders even in the offspring of these women. Further investigations are needed to establish the exact role of incretins in pregnancy and gestational glucose intolerance. PMID:26813306

  10. Universal Gestational Age Effects on Cognitive and Basic Mathematic Processing: 2 Cohorts in 2 Countries

    PubMed Central

    Wolke, Dieter; Strauss, Vicky Yu-Chun; Johnson, Samantha; Gilmore, Camilla; Marlow, Neil; Jaekel, Julia

    2015-01-01

    Objective To determine whether general cognitive ability, basic mathematic processing, and mathematic attainment are universally affected by gestation at birth, as well as whether mathematic attainment is more strongly associated with cohort-specific factors such as schooling than basic cognitive and mathematical abilities. Study design The Bavarian Longitudinal Study (BLS, 1289 children, 27-41 weeks gestational age [GA]) was used to estimate effects of GA on IQ, basic mathematic processing, and mathematic attainment. These estimations were used to predict IQ, mathematic processing, and mathematic attainment in the EPICure Study (171 children <26 weeks GA). Results For children born <34 weeks GA, each lower week decreased IQ and mathematic attainment scores by 2.34 (95% CI: −2.99, −1.70) and 2.76 (95% CI: −3.40, −2.11) points, respectively. There were no differences among children born 34-41 weeks GA. Similarly, for children born <36 weeks GA, mathematic processing scores decreased by 1.77 (95% CI: −2.20, −1.34) points with each lower GA week. The prediction function generated using BLS data accurately predicted the effect of GA on IQ and mathematic processing among EPICure children. However, these children had better attainment than predicted by BLS. Conclusions Prematurity has adverse effects on basic mathematic processing following birth at all gestations <36 weeks and on IQ and mathematic attainment <34 weeks GA. The ability to predict IQ and mathematic processing scores from one cohort to another among children cared for in different eras and countries suggests that universal neurodevelopmental factors may explain the effects of gestation at birth. In contrast, mathematic attainment may be improved by schooling. PMID:25842966

  11. Dynamics of lipoprotein level in blood plasma of pregnant women as a function of gestational age according to FTIR spectroscopy

    NASA Astrophysics Data System (ADS)

    Korolik, E. V.; Korolenko, E. A.; Tretinnikov, O. N.; Kozlyakova, O. V.; Korolik, A. K.; Kirkovskiy, V. V.

    2013-01-01

    Results of an IR spectroscopic investigation of films of blood plasma taken from women of reproductive age, pregnant women with positive and negative Rh factors, and Rh-immunized women were presented as a function of gestational age. It was found that the lipoprotein content in blood plasma of all groups of pregnant women increased during the early stages of pregnancy (17-23 weeks) irrespective of the Rh factor and attained its peak value by weeks 30-35. It was shown that the lipoprotein level in blood plasma as a function of gestational age was quantitatively the same for pregnant women with positive and negative Rh factors. It was established for the first time that this dependence for Rh-immunized women featured a considerable increase of lipoprotein content at gestational age 30-32 weeks and declined acutely by week 36.

  12. Exercise: An Alternative Therapy for Gestational Diabetes.

    ERIC Educational Resources Information Center

    Artal, Raul

    1996-01-01

    Exercise is encouraged in the management of pregnant women with gestational diabetes or women with Type II diabetes who become pregnant. Although non-weight-bearing exercises may be best for sedentary women, moderate workouts appear to be safe for most women with gestational diabetes. The role of exercise, risk factors, warning signs, and examples…

  13. Preconception Cardiovascular Risk Factor Differences Between Gestational Hypertension and Preeclampsia

    PubMed Central

    Klungsøyr, Kari; Øyen, Nina; Tell, Grethe S.; Næss, Øyvind; Skjærven, Rolv

    2016-01-01

    Preconception predictors of gestational hypertension and preeclampsia may identify opportunities for early detection and improve our understanding of the pathogenesis and life course epidemiology of these conditions. Female participants in community-based Cohort Norway health surveys, 1994 to 2003, were prospectively followed through 2012 via record linkages to Medical Birth Registry of Norway. Analyses included 13 217 singleton pregnancies (average of 1.59 births to 8321 women) without preexisting hypertension. Outcomes were gestational hypertension without proteinuria (n=237) and preeclampsia (n=429). Mean age (SD) at baseline was 27.9 years (4.5), and median follow-up was 4.8 years (interquartile range 2.6–7.8). Gestational hypertension and preeclampsia shared several baseline risk factors: family history of diabetes mellitus, pregravid diabetes mellitus, a high total cholesterol/high-density lipoprotein cholesterol ratio (>5), overweight and obesity, and elevated blood pressure status. For preeclampsia, a family history of myocardial infarction before 60 years of age and elevated triglyceride levels (≥1.7 mmol/L) also predicted risk while physical activity was protective. Preterm preeclampsia was predicted by past-year binge drinking (≥5 drinks on one occasion) with an adjusted odds ratio of 3.7 (95% confidence interval 1.3–10.8) and by past-year physical activity of ≥3 hours per week with an adjusted odds ratio of 0.5 (95% confidence interval 0.3–0.8). The results suggest similarities and important differences between gestational hypertension, preeclampsia, and preterm preeclampsia. Modifiable risk factors could be targeted for improving pregnancy outcomes and the short- and long-term sequelae for mothers and offspring. PMID:27113053

  14. Determining gestational age based on information from the Birth in Brazil study.

    PubMed

    Pereira, Ana Paula Esteves; Leal, Maria do Carmo; da Gama, Silvana Granado Nogueira; Domingues, Rosa Maria Soares Madeira; Schilithz, Arthur Orlando Corrêa; Bastos, Maria Helena

    2014-08-01

    This study aimed at assessing the validity of different measures for estimating gestational age and to propose the creation of an algorithm for gestational age at birth estimates for the Birth in Brazil survey--a study conducted in 2011-2012 with 23,940 postpartum women. We used early ultrasound imaging, performed between 7-20 weeks of gestation, as the reference method. All analyses were performed stratifying by payment of maternity care (public or private). When compared to early ultrasound imaging, we found a substantial intraclass correlation coefficient of ultrasound-based gestational age at admission measure (0.95 and 0.94) and of gestational age reported by postpartum women at interview measure (0.90 and 0.88) for the public and private payment of maternity care, respectively. Last menstrual period-based measures had lower intraclass correlation coefficients than the first two measures evaluated. This study suggests caution when using the last menstrual period as the first measure for estimating gestational age in Brazil, strengthening the use of information obtained from early ultrasound imaging results. PMID:25167191

  15. Early pregnancy metabolite profiling discovers a potential biomarker for the subsequent development of gestational diabetes mellitus.

    PubMed

    de Seymour, Jamie V; Conlon, Cathryn A; Sulek, Karolina; Villas Bôas, Silas G; McCowan, Lesley M E; Kenny, Louise C; Baker, Philip N

    2014-10-01

    Current early pregnancy screening tools to identify women at risk of developing gestational diabetes mellitus lack both specificity and sensitivity. As a result, the foetus and mother are often subjected to insult during disease progression, prior to diagnosis and treatment in later pregnancy. Metabolomics is an analytical approach, which allows for appraisal of small molecular mass compounds in a biofluid. The aim of this pilot study was to investigate the relationship between the early gestation serum metabolite profile and the subsequent development of gestational diabetes mellitus in the search for early pregnancy biomarkers and potential metabolic mechanisms. Our nested case-control study analysed maternal serum at 20 weeks' gestation, obtained from the New Zealand cohort of the Screening for Pregnancy Endpoints study. Metabolomic profiling was performed using gas chromatography coupled to mass spectrometry, and metabolites were identified using R software and an in-house mass spectral library. Statistical analysis was performed using SPSS version 21.0. Forty-eight metabolites were identified in the serum samples. Itaconic acid (P = 0.0003), with a false discovery rate of 0.012, was found to be significantly more abundant in women who subsequently developed gestational diabetes mellitus, when compared to controls with uncomplicated pregnancies. The current pilot study found that itaconic acid may have potential as a novel biomarker in early pregnancy to predict the subsequent development of gestational diabetes mellitus. However, the findings from this pilot study require validation with a larger, diverse population before translation into the clinical setting. PMID:25064235

  16. Predictors of Size for Gestational Age in St. Louis City and County

    PubMed Central

    2014-01-01

    Objective. To identify social, behavioral, and physiological risk factors associated with small for gestational age (SGA) by gestational age category in St. Louis City and County. Methods. A retrospective cohort study was conducted using birth certificate and fetal death records from 2000 to 2009 (n = 142,017). Adjusted associations of risk factors with SGA were explored using bivariate logistic regression. Four separate multivariable logistic regression analyses, stratified by gestational age, were conducted to estimate adjusted odds ratios. Results. Preeclampsia and inadequate weight gain contributed significantly to increased odds for SGA across all gestational age categories. The point estimates ranged from a 3.41 increased odds among women with preeclampsia and 1.76 for women with inadequate weight gain at 24–28 weeks' gestational age to 2.19 and 2.11 for full-term infants, respectively. Among full-term infants, smoking (aOR = 2.08), chronic hypertension (aOR = 1.46), and inadequate prenatal care (aOR = 1.25) had the next most robust and significant impact on SGA. Conclusion. Preeclampsia and inadequate weight gain are significant risk factors for SGA, regardless of gestational age. Education on the importance of nutrition and adequate weight gain during pregnancy is vital. In this community, disparities in SGA and smoking rates are important considerations for interventions designed to improve birth outcomes. PMID:25105127

  17. Moderate and Vigorous Intensity Exercise During Pregnancy and Gestational Weight Gain in Women with Gestational Diabetes.

    PubMed

    Ehrlich, Samantha F; Sternfeld, Barbara; Krefman, Amy E; Hedderson, Monique M; Brown, Susan D; Mevi, Ashley; Chasan-Taber, Lisa; Quesenberry, Charles P; Ferrara, Assiamira

    2016-06-01

    Objectives To estimate the associations of moderate and vigorous intensity exercise during pregnancy with the rate of gestational weight gain (GWG) from gestational diabetes (GDM) diagnosis to delivery, overall and stratified by prepregnancy overweight/obesity. Methods Prospective cohort study with physical activity reported shortly after the GDM diagnosis and prepregnancy weight and post-diagnosis GWG obtained from electronic health records (n = 1055). Multinomial logistic regression models in the full cohort and stratified by prepregnancy overweight/obesity estimated associations of moderate and vigorous intensity exercise with GWG below and above the Institute of Medicine's (IOM) prepregnancy BMI-specific recommended ranges for weekly rate of GWG in the second and third trimesters. Results In the full cohort, any participation in vigorous intensity exercise was associated with decreased odds of GWG above recommended ranges as compared to no participation [odds ratio (95 % confidence interval): 0.63 (0.40, 0.99)], with a significant trend for decreasing odds of excess GWG with increasing level of vigorous intensity exercise. Upon stratification by prepregnancy overweight/obesity, significant associations were only observed for BMI ≥ 25.0 kg/m(2): any vigorous intensity exercise, as compared to none, was associated with 54 % decreased odds of excess GWG [0.46 (0.27, 0.79)] and significant trends were detected for decreasing odds of GWG both below and above the IOM's recommended ranges with increasing level of vigorous exercise (both P ≤ 0.03). No associations were observed for moderate intensity exercise. Conclusions for Practice In women with GDM, particularly overweight and obese women, vigorous intensity exercise during pregnancy may reduce the odds of excess GWG. PMID:26955997

  18. Moderate and Vigorous Intensity Exercise during Pregnancy and Gestational Weight Gain in Women with Gestational Diabetes

    PubMed Central

    Ehrlich, Samantha F.; Sternfeld, Barbara; Krefman, Amy E.; Hedderson, Monique M.; Brown, Susan D.; Mevi, Ashley; Chasan-Taber, Lisa; Quesenberry, Charles P.; Ferrara, Assiamira

    2016-01-01

    Objectives To estimate the associations of moderate and vigorous intensity exercise during pregnancy with the rate of gestational weight gain (GWG) from gestational diabetes (GDM) diagnosis to delivery, overall and stratified by prepregnancy overweight/obesity. Methods Prospective cohort study with physical activity reported shortly after the GDM diagnosis and prepregnancy weight and post-diagnosis GWG obtained from electronic medical records (n= 1,055). Multinomial logistic regression models in the full cohort and stratified by prepregnancy overweight/obesity estimated associations of moderate and vigorous intensity exercise with GWG below and above the Institute of Medicine’s (IOM) prepregnancy BMI-specific recommended ranges for weekly rate of GWG in the second and third trimesters. Results In the full cohort, any participation in vigorous intensity exercise was associated with decreased odds of GWG above recommended ranges as compared to no participation [Odds Ratio (95% Confidence Interval): 0.63 (0.40, 0.99)], with a significant trend for decreasing odds of excess GWG with increasing level of vigorous intensity exercise. Upon stratification by prepregnancy overweight/obesity, significant associations were only observed for BMI ≥ 25.0 kg/m2: any vigorous intensity exercise, as compared to none, was associated with 54% decreased odds of excess GWG [0.46 (0.27, 0.79)] and significant trends were detected for decreasing odds of GWG both below and above the IOM’s recommended ranges with increasing level of vigorous exercise (both P ≤ 0.03). No associations were observed for moderate intensity exercise. Conclusions In women with GDM, particularly overweight and obese women, vigorous intensity exercise during pregnancy may reduce the odds of excess GWG. PMID:26955997

  19. Genetics of gestational diabetes mellitus.

    PubMed

    Radha, Venkatesan; Kanthimathi, Sekar; Anjana, Ranjit Mohan; Mohan, Viswanathan

    2016-09-01

    Gestational diabetes mellitus (GDM) has now become a major public health problem because of its prevalence and its associated complications during pregnancy. Earlier studies have suggested that type 2 diabetes mellitus (T2DM) and GDM might have similar pathophysiology, such as increased insulin resistance, decreased insulin secretion resulting in hyperglycaemia. Evidence for a genetic basis of GDM has been poorly understood. To some extent, the current advancement in genomic techniques has thrown better light on the genetics of GDM. Based on the candidate gene approach and genome wide association studies, genetic loci in several genes that are responsible for insulin secretion, insulin resistance, lipid and glucose metabolism and other pathways have shown association with the GDM susceptibility. Understanding the possible underlying genetic factors of GDM would help us in gaining knowledge on the pathophysiologic mechanism of the disease. PMID:27582142

  20. Gestational Age and Neonatal Brain Microstructure in Term Born Infants: A Birth Cohort Study

    PubMed Central

    Broekman, Birit F. P.; Wang, Changqing; Li, Yue; Rifkin-Graboi, Anne; Saw, Seang Mei; Chong, Yap-Seng; Kwek, Kenneth; Gluckman, Peter D.; Fortier, Marielle V.; Meaney, Michael J.; Qiu, Anqi

    2014-01-01

    Objective Understanding healthy brain development in utero is crucial in order to detect abnormal developmental trajectories due to developmental disorders. However, in most studies neuroimaging was done after a significant postnatal period, and in those studies that performed neuroimaging on fetuses, the quality of data has been affected due to complications of scanning during pregnancy. To understand healthy brain development between 37–41 weeks of gestational age, our study assessed the in utero growth of the brain in healthy term born babies with DTI scanning soon after birth. Methods A cohort of 93 infants recruited from maternity hospitals in Singapore underwent diffusion tensor imaging between 5 to 17 days after birth. We did a cross-sectional examination of white matter microstructure of the brain among healthy term infants as a function of gestational age via voxel-based analysis on fractional anisotropy. Results Greater gestational age at birth in term infants was associated with larger fractional anisotropy values in early developing brain regions, when corrected for age at scan. Specifically, it was associated with a cluster located at the corpus callosum (corrected p<0.001), as well as another cluster spanning areas of the anterior corona radiata, anterior limb of internal capsule, and external capsule (corrected p<0.001). Conclusions Our findings show variation in brain maturation associated with gestational age amongst ‘term’ infants, with increased brain maturation when born with a relatively higher gestational age in comparison to those infants born with a relatively younger gestational age. Future studies should explore if these differences in brain maturation between 37 and 41 weeks of gestational age will persist over time due to development outside the womb. PMID:25535959

  1. 12th National Cataloguing Conference.

    ERIC Educational Resources Information Center

    Tan, Janine; Olston, Julie; Dearman, Rosemary; Hay, Ros; Butler, Gabrielle; Giopoulos, Jenny; Moloney, Julie; Pearce, Fran

    1997-01-01

    Summarizes issues raised at the 1997 national cataloging conference of the Australian Library and Information Association. Includes a draft procedural document for cataloging Internet sites and provides reports from five workshops on human resource management in cataloging, career strategies for catalogers, cataloging standards, the Anglo-American…

  2. Timing of treatment initiation for mild gestational diabetes and perinatal outcomes

    PubMed Central

    Palatnik, Anna; Mele, Lisa; Landon, Mark B.; Reddy, Uma M.; Ramin, Susan M.; Carpenter, Marshall W.; Wapner, Ronald J.; Varner, Michael W.; Rouse, Dwight J.; Thorp, John M.; Sciscione, Anthony; Catalano, Patrick; Saade, George R.; Caritis, Steve N.; Sorokin, Yoram

    2015-01-01

    Objective To examine the association between gestational age (GA) at the time of treatment initiation for gestational diabetes (GDM) and maternal and perinatal outcomes. Study Design A secondary analysis of a multicenter randomized treatment trial of mild GDM in which women with mild GDM were randomized to treatment versus usual care. The primary outcome of the original trial, as well as this analysis, was a composite perinatal adverse outcome that included neonatal hypoglycemia, hyperbilirubinemia, hyperinsulinemia, and perinatal mortality. Other outcomes examined included the frequency of large for gestational age (LGA), birth weight, neonatal intensive care unit admission (NICU), gestational hypertension / preeclampsia and cesarean delivery. The interaction between GA at treatment initiation (stratified as 24-26 weeks, 27 weeks, 28 weeks, 29 weeks, ≥30 weeks) and treatment group (treated vs. routine care), with the outcomes of interest, was used to determine whether GA at treatment initiation was associated with outcome differences. Results Of 958 women analyzed, those who initiated treatment at an earlier GA did not gain an additional treatment benefit compared to those who initiated treatment at a later GA (p-value for interaction with the primary outcome is 0.44). Similarly, there was no evidence that other outcomes were significantly improved by earlier initiation of GDM treatment (LGA p=0.76; NICU admission p=0.8; cesarean delivery p=0.82). The only outcome that had a significant interaction between GA and treatment was gestational hypertension/preeclampsia (p=0.04), although there was not a clear cut GA trend where this outcome improved with treatment. Conclusion Earlier initiation of treatment of mild GDM was not associated with stronger effect of treatment on perinatal outcomes. PMID:26071920

  3. Evaluating Earth and Space Sciences STEM Research Communication in 7th-12th Grade Rural Mississippi Classrooms and Resulting Student Attitudinal Impacts

    NASA Astrophysics Data System (ADS)

    Radencic, S.; McNeal, K. S.

    2013-05-01

    Observation and evaluation of STEM graduate students from Mississippi State University communicating their research of the Earth and Space Sciences in rural 7th-12th grade classrooms participating in the Initiating New Science Partnerships in Rural Education (INSPIRE) NSF GK-12 project. The methods they utilize to communicate their STEM research includes introducing new technologies and inquiry based learning experiences. These communication experiences have been observed and evaluated using two observational systems, the Mathematics Science Classroom Observational Profile System (M-SCOPS) and the Presentation Skills Protocol (PSP). M-SCOPS has been used over the first three years of the project to evaluate what Earth and Space research the STEM graduate students communicate in classroom activities along with how they are introducing STEM research through a variety of communication methods and levels of understanding. PSP, which INSPIRE began using this year, evaluates and provides feedback to the STEM graduate students on their communication during these classroom experiences using a rubric covering a range of skills for successful communication. PSP also allows the participating INSPIRE teacher partners to provide feedback to the STEM graduate students about development of their communication skills over the course of the year. In addition to feedback from the INSPIRE project and participating teachers, the STEM graduate students have the opportunity to evaluate their personal communication skills through video documentation to determine specific skills they would like to improve. Another area of research to be discussed is how the STEM graduate students communicating Earth and Space sciences research in the participating classrooms is impacting student attitudes about science and mathematics over the last three years. Student Attitudinal Surveys (SAS) are administered as a pre-evaluation tool in the fall when the STEM graduate students first enter into their

  4. 100 Weekly Sky Maps

    NASA Technical Reports Server (NTRS)

    2002-01-01

    100 Aum Weekly Sky Maps for mission weeks 4 to 44, and the 100 Aum Annual Average Map. Shows sky coverage each week of the DIRBE mission over the period during which the COBE cryogen supply lasted. As the Earth, with COBE in orbit, revolved around the Sun, DIRBE viewed the sky from an ever-changing vantage point in the solar system, enabling light reflected and emitted by the interplanetary dust cloud to be modeled.

  5. Estimation of Gestational Age, Using Neonatal Anthropometry: A Cross-sectional Study in India

    PubMed Central

    Thawani, Rajat; Faridi, M.M.A.; Arora, Shilpa Khanna; Kumar, Rajeev

    2013-01-01

    Prematurity is a significant contributor to neonatal mortality in India. Conventionally, assessment of gestational age of newborns is based on New Ballard Technique, for which a paediatric specialist is needed. Anthropometry of the newborn, especially birthweight, has been used in the past to predict the gestational age of the neonate in peripheral health facilities where a trained paediatrician is often not available. We aimed to determine if neonatal anthropometric parameters, viz. birthweight, crown heel-length, head-circumference, mid-upper arm-circumference, lower segment-length, foot-length, umbilical nipple distance, calf-circumference, intermammary distance, and hand-length, can reliably predict the gestational age. The study also aimed to derive an equation for the same. We also assessed if these neonatal anthropometric parameters had a better prediction of gestational age when used in combination compared to individual parameters. We evaluated 1,000 newborns in a cross-sectional study conducted in Guru Teg Bahadur Hospital in Delhi. Detailed anthropometric estimation of the neonates was done within 48 hours after birth, using standard techniques. Gestational age was estimated using New Ballard Scoring. Out of 1,250 consecutive neonates, 1,000 were included in the study. Of them, 800 randomly-selected newborns were used in devising the model, and the remaining 200 newborns were used in validating the final model. Quadratic regression analysis using stepwise selection was used in building the predictive model. Birthweight (R=0.72), head-circumference (R=0.60), and mid-upper arm-circumference (R=0.67) were found highly correlated with gestation. The final equation to assess gestational age was as follows: Gestational age (weeks)=5.437×W–0.781×W2+2.815×HC–0.041×HC2+0.285×MUAC–22.745 where W=Weight, HC=Head-circumference and MUAC=Mid-upper arm-circumference; Adjusted R=0.76. On validation, the predictability of this equation is 46% (±1 week), 75

  6. Early Postpartum Glucose Testing in Women with Gestational Diabetes Mellitus.

    PubMed

    Werner, Erika F; Has, Phinnara; Tarabulsi, Gofran; Lee, Joyce; Satin, Andrew

    2016-08-01

    Objective Given that most women with gestational diabetes mellitus (GDM) never undergo the recommended 6 to 12 weeks postpartum glucose tolerance test (GTT), we assessed the feasibility of performing GTTs on postpartum day 2. Study Design We conducted a prospective cohort study in which women with GDM received a 75-g 2-hour GTT on postpartum day 2. We assessed the feasibility of this GTT and compared the results to the standard of care GTT at 6 to 12 weeks postpartum. We also evaluated maternal and pregnancy characteristics of women who return for 6 to 12 weeks GTTs compared with those lost to follow-up. Results In this study, 98 of 106 participants (92%) completed the postpartum day 2 GTT; 59% had normal glucose values at that time. Only 49 women returned at 6 to 12 weeks postpartum. Among women who had testing at both time points, the 2 days postpartum GTT were 100% sensitive and 94% specific for diabetes mellitus but less sensitive and specific for milder forms of abnormal glucose. Women who did not complete the 6 to 12 weeks postpartum GTT were less educated (p < 0.01) and more often had Medicaid (p < 0.01). Conclusion Performing GTTs on postpartum day 2 is feasible and should be further investigated as an alternative postpartum testing regimen in GDM. PMID:27120481

  7. Slow-release carbohydrates: growing evidence on metabolic responses and public health interest. Summary of the symposium held at the 12th European Nutrition Conference (FENS 2015)

    PubMed Central

    Vinoy, Sophie; Laville, Martine; Feskens, Edith J M

    2016-01-01

    To draw attention to the necessity of considering differences in the digestibility of carbohydrates, and more specifically of starch, a symposium was held at the 12th European Nutrition Conference (FENS), which took place in Berlin from October 20 to 23, 2015. The purpose of this session was to present the consolidated knowledge and recent advances regarding the relationship between slow-release carbohydrates, metabolic responses, and public health issues. Three main topics were presented: 1) the definition of, sources of, and recognised interest in the glycaemic response to slowly digestible starch (SDS); 2) clinical evidence regarding the physiological effects of slow-release carbohydrates from cereal foods; and 3) interest in reducing the postprandial glycaemic response to help prevent metabolic diseases. Foods with the highest SDS content induce the lowest glycaemic responses, as the starch is protected from gelatinisation during processing. In humans, high-SDS food consumption induces slower glucose release, lower postprandial insulinaemia, and stimulation of gut hormones. Moreover, postprandial hyperglycaemia is an independent risk factor for type two diabetes mellitus (T2DM) and cardiovascular disease (CVD). Therefore, given the plausible aetiologic mechanisms, we argue that postprandial glucose levels are relevant for health and disease and represent a meaningful target for intervention, for example, through dietary factors. This symposium was organised by Mondelez International R&D. PMID:27388153

  8. Absence of point mutation in the 12th codon of transformed c-Ha-rasl genes of human cancer of the breast, stomach, melanoma, and neuroblastoma

    SciTech Connect

    Knyazev, P.G.; Schafer, R.; Willecke, K.V.; Seitz, I.F.

    1985-11-01

    In the authors' previous investigations, they established that the tumorous cell lines SK-BR-3 (breast cancer), LAN-1 (neuroblastoma), and a heterotransplant of malignant melanoma Jal contain transforming genes of Ha-ras type. Now, the authors report their results using restriction endonucleases of MspI and HpaII restriction to study nucleotide sequences 5'-CCGGC-3' and 3'GGCCG-5', which contain the 12th codon of GGC for the amino acid glycine in the normal allele of c-Ha-rasl in the three tumors listed above, in addition to human adenocarcinoma of the stomach (CaVSt) and normal cells corresponding to them. For hybridization of MspI/HpaII, fragments of chromosomal DNA isolated from cell lines SK-BR-3, and LAN-1, Ja-1 heterotransplant, and stomach adenocarcinoma CaVSt, the XmaI section of EJ oncogene, c-Ha-rasl (plasmid pEJ 6.6), labeled with /sup 32/P was used in down-translation reaction. Hybridization was performed in 3 x SSC buffer containing 5x Deinhardt's reagent and 10% dextran sulfate at 68/sup 0/C for 16-18 h. Washing of filters was conducted under rigid conditions. For autoradiography, Kodak XR-5 x-ray film in cartridges with reinforcing shields was used at -70/sup 0/C, exposure time of four to six days.

  9. Possible impacts of early-11th-, middle-12th-, and late-13th-century droughts on western Native Americans and the Mississippian Cahokians

    USGS Publications Warehouse

    Benson, L.V.; Berry, M.S.; Jolie, E.A.; Spangler, J.D.; Stahle, D.W.; Hattori, E.M.

    2007-01-01

    One or more of three intense and persistent droughts impacted some Native American cultures in the early-11th, middle-12th and late-13th centuries, including the Anasazi, Fremont, Lovelock, and Mississippian (Cahokian) prehistorical cultures. Tree-ring-based reconstructions of precipitation and temperature indicate that warm drought periods occurred between AD 990 and 1060, AD 1135 and 1170, and AD 1276 and 1297. These droughts occurred during minima in the Pacific Decadal Oscillation and may have been associated with positive values of the Atlantic Multidecadal Oscillation. Each of the Native American cultures was supported, to a greater or lesser degree, by precipitation-dependent resources. Both the Four Corners region and Cahokia were sites of intense growth between about AD 1050 and 1130, and by AD 1150, cultures in both regions were undergoing stress. By AD 1300 the Anasazi and Fremont cultures had collapsed and their residual populations had either left their homelands or withered. In the case of Fremont populations, the AD 990-1060 drought may have had the greatest impact. This drought also may have affected the Anasazi, for it was at the end of this drought that some people from Chaco migrated to the San Juan River valley and founded the Salmon Ruin great house. Detailed data do not exist on the number of Lovelock habitation sites or populations over time; however, Lovelock populations appear to have retreated from the western Great Basin to California by AD 1300 or shortly thereafter.

  10. Longitudinal Study of Career Cluster Persistence from 8th Grade to 12th Grade with a Focus on the Science, Technology, Engineering, & Math Career Cluster

    NASA Astrophysics Data System (ADS)

    Wagner, Judson

    Today's technology driven global economy has put pressure on the American education system to produce more students who are prepared for careers in Science, Technology, Engineering, and Math (STEM). Adding to this pressure is the demand for a more diverse workforce that can stimulate the development of new ideas and innovation. This in turn requires more female and under represented minority groups to pursue future careers in STEM. Though STEM careers include many of the highest paid professionals, school systems are dealing with exceptionally high numbers of students, especially female and under represented minorities, who begin but do not persist to STEM degree completion. Using the Expectancy-Value Theory (EVT) framework that attributes student motivation to a combination of intrinsic, utility, and attainment values, this study analyzed readily available survey data to gauge students' career related values. These values were indirectly investigated through a longitudinal approach, spanning five years, on the predictive nature of 8 th grade survey-derived recommendations for students to pursue a future in a particular career cluster. Using logistic regression analysis, it was determined that this 8 th grade data, particularly in STEM, provides significantly high probabilities of a 12th grader's average grade, SAT-Math score, the math and science elective courses they take, and most importantly, interest in the same career cluster.

  11. Possible impacts of early-11th-, middle-12th-, and late-13th-century droughts on western Native Americans and the Mississippian Cahokians

    NASA Astrophysics Data System (ADS)

    Benson, Larry V.; Berry, Michael S.; Jolie, Edward A.; Spangler, Jerry D.; Stahle, David W.; Hattori, Eugene M.

    2007-02-01

    One or more of three intense and persistent droughts impacted some Native American cultures in the early-11th, middle-12th and late-13th centuries, including the Anasazi, Fremont, Lovelock, and Mississippian (Cahokian) prehistorical cultures. Tree-ring-based reconstructions of precipitation and temperature indicate that warm drought periods occurred between AD 990 and 1060, AD 1135 and 1170, and AD 1276 and 1297. These droughts occurred during minima in the Pacific Decadal Oscillation and may have been associated with positive values of the Atlantic Multidecadal Oscillation. Each of the Native American cultures was supported, to a greater or lesser degree, by precipitation-dependent resources. Both the Four Corners region and Cahokia were sites of intense growth between about AD 1050 and 1130, and by AD 1150, cultures in both regions were undergoing stress. By AD 1300 the Anasazi and Fremont cultures had collapsed and their residual populations had either left their homelands or withered. In the case of Fremont populations, the AD 990-1060 drought may have had the greatest impact. This drought also may have affected the Anasazi, for it was at the end of this drought that some people from Chaco migrated to the San Juan River valley and founded the Salmon Ruin great house. Detailed data do not exist on the number of Lovelock habitation sites or populations over time; however, Lovelock populations appear to have retreated from the western Great Basin to California by AD 1300 or shortly thereafter.

  12. Effects of pubertal timing on deviant behaviors in Taiwan: A longitudinal analysis of 7th- to 12th-grade adolescents.

    PubMed

    Tsai, Meng-Che; Strong, Carol; Lin, Chung-Ying

    2015-07-01

    We investigated the relationship between pubertal timing and deviant behaviors in Taiwan using Taiwan Youth Project (TYP) data. The TYP used multistage-stratified and class-clustered methods in 40 randomly selected schools. We analyzed 1541 adolescents (770 boys; 50.0%) who self-reported their deviant behaviors in 7th, 8th, 10th, and 12th grades. Participants were assigned to early- (n = 244; 15.8%), on-time- (n = 992; 64.4%), and late- (n = 305; 19.8%) puberty groups, and one-way analysis of variance and latent growth modeling were used to examine the frequency of deviant behaviors between them. Early-puberty adolescents had more deviant behaviors (mean = 0.43, SD = 0.74) than did late-puberty adolescents during 7th grade (mean = 0.27, SD = 0.59; p = 0.004), but not after 8th grade. There were no significant differences in the deviance level between on-time-puberty and early- and late-puberty adolescents. Moreover, puberty was not correlated with the growth of deviant behaviors, which decreased with age. However, boys seemed to engage in more deviant behaviors at the beginning, but their engagement seemed to decline faster than it did for girls. In sum, the deviance of early-puberty adolescents seemed to diminish as they got older. PMID:25956430

  13. From autoantibody research to standardized diagnostic assays in the management of human diseases - report of the 12th Dresden Symposium on Autoantibodies.

    PubMed

    Conrad, K; Andrade, L E C; Chan, E K L; Mahler, M; Meroni, P L; Pruijn, G J M; Steiner, G; Shoenfeld, Y

    2016-07-01

    Testing for autoantibodies (AABs) is becoming more and more relevant, not only for diagnosing autoimmune diseases (AIDs) but also for the differentiation of defined AID subtypes with different clinical manifestations, course and prognosis as well as the very early diagnosis for adequate management in the context of personalized medicine. A major challenge to improve diagnostic accuracy is to harmonize or even standardize AAB analyses. This review presents the results of the 12th Dresden Symposium on Autoantibodies that focused on several aspects of improving autoimmune diagnostics. Topics that are addressed include the International Consensus on ANA Patterns (ICAP) and the International Autoantibody Standardization (IAS) initiatives, the optimization of diagnostic algorithms, the description and evaluation of novel disease-specific AABs as well as the development and introduction of novel assays into routine diagnostics. This review also highlights important developments of recent years, most notably the improvement in diagnosing and predicting the course of rheumatoid arthritis, systemic sclerosis, idiopathic inflammatory myopathies, and of autoimmune neurological, gastrointestinal and liver diseases; the potential diagnostic role of anti-DFS70 antibodies and tumor-associated AABs. Furthermore, some hot topics in autoimmunity regarding disease pathogenesis and management are described. PMID:27252254

  14. Long-term outcomes in multiple gestations.

    PubMed

    Rand, Larry; Eddleman, Keith A; Stone, Joanne

    2005-06-01

    Children born from a multiple gestation are at increased risk for cerebral palsy, learning disability, and language and neurobehavioral deficits. With the increased incidence of multiple pregnancies and use of assisted reproductive technology (ART), these issues are more commonly affecting parents. Long-term outcomes are a critical part of preconceptual and early pregnancy counseling for parents faced with a multiple gestation or considering ART, and the provider should be well versed on issues surrounding zygosity, gestational age, higher-order multiples, and the effects of options such as multifetal pregnancy reduction. PMID:15922795

  15. Simple mathematical formulae for estimation of median values of fetal biometry at each gestational age

    PubMed Central

    Choi, Hwa Young; Kim, Jeong Ha; Park, Jee Yoon; Jung, Eun Young; No, Jae Hong; Oh, Kyung Joon

    2016-01-01

    Objective The aim of this study was to propose simple mathematical formulae to estimate median values of fetal biometry including biparietal diameter (BPD), abdominal circumference (AC) and femur length (FL) at each gestational age (GA) easily without looking up the previously established reference values. Methods Simple mathematical formulae to estimate median values of fetal biometric values at each gestational week were inferred. To validate these formulae, three different linear equations were derived from previously reported reference values of median BPD, AC and FL using regression analysis at each gestational week. Finally, calculated data through the inferred formula were compared to retrospectively collected data (observed data). Results The equation revealing the relationship between BPD and GA was: median BPD (cm)=GA (wk)/4. Using this simple mathematical formula, the absolute percentage error between observed data and calculated data ranged from 0.12% to 7.50%. The equation between AC and GA was: median AC (cm)=GA (wk)-5. Through this formula, the absolute percentage error was analyzed same as above and it ranged from 0.30% to 4.76%. Lastly the derived formula between FL and GA was: median FL (cm)=GA (wk)/5 and the absolute percentage error ranged from 4.52% to 16.75%. Conclusion The three simple formulae suggested in our study showed a significantly easy way to estimate the median values of fetal biometry at each gestational week with good reliability. PMID:27004198

  16. A resolution congratulating the students, parents, teachers, and administrators of charter schools across the United States for ongoing contributions to education, and supporting the ideals and goals of the 12th annual National Charter Schools Week.

    THOMAS, 112th Congress

    Sen. Landrieu, Mary L. [D-LA

    2011-05-02

    05/05/2011 Resolution agreed to in Senate without amendment and an amended preamble by Unanimous Consent. (text: CR S2752) (All Actions) Tracker: This bill has the status Passed SenateHere are the steps for Status of Legislation:

  17. Assessment of MRI-Based Automated Fetal Cerebral Cortical Folding Measures in Prediction of Gestational Age in the Third Trimester

    PubMed Central

    Wu, J.; Awate, S.P.; Licht, D.J.; Clouchoux, C.; du Plessis, A.J.; Avants, B.B.; Vossough, A.; Gee, J.C.; Limperopoulos, C.

    2016-01-01

    BACKGROUND AND PURPOSE Traditional methods of dating a pregnancy based on history or sonographic assessment have a large variation in the third trimester. We aimed to assess the ability of various quantitative measures of brain cortical folding on MR imaging in determining fetal gestational age in the third trimester. MATERIALS AND METHODS We evaluated 8 different quantitative cortical folding measures to predict gestational age in 33 healthy fetuses by using T2-weighted fetal MR imaging. We compared the accuracy of the prediction of gestational age by these cortical folding measureswiththeaccuracyofpredictionbybrainvolumemeasurementandbyapreviouslyreportedsemiquantitativevisualscaleofbrain maturity. Regression models were constructed, and measurement biases and variances were determined via a cross-validation procedure. RESULTS The cortical folding measures are accurate in the estimation and prediction of gestational age (mean of the absolute error, 0.43 ± 0.45 weeks) and perform better than (P = .024) brain volume (mean of the absolute error, 0.72 ± 0.61 weeks) or sonography measures (SDs approximately 1.5 weeks, as reported in literature). Prediction accuracy is comparable with that of the semiquantitative visual assessment score (mean, 0.57 ± 0.41 weeks). CONCLUSIONS Quantitative cortical folding measures such as global average curvedness can be an accurate and reliable estimator of gestational age and brain maturity for healthy fetuses in the third trimester and have the potential to be an indicator of brain-growth delays for at-risk fetuses and preterm neonates. PMID:26045578

  18. Ethnic Differences in Gestational Weight Gain: A Population-Based Cohort Study in Norway.

    PubMed

    Kinnunen, Tarja I; Waage, Christin W; Sommer, Christine; Sletner, Line; Raitanen, Jani; Jenum, Anne Karen

    2016-07-01

    Objectives To explore ethnic differences in gestational weight gain (GWG). Methods This was a population-based cohort study conducted in primary care child health clinics in Groruddalen, Oslo, Norway. Participants were healthy pregnant women (n = 632) categorised to six ethnic groups (43 % were Western European women, the reference group). Body weight was measured at 15 and 28 weeks' gestation on average. Data on pre-pregnancy weight and total GWG until delivery were self-reported. The main method of analysis was linear regression adjusting for age, weeks' gestation, pre-pregnancy body mass index, education and severe nausea. Results No ethnic differences were observed in GWG by 15 weeks' gestation. By 28 weeks' gestation, Eastern European women had gained 2.71 kg (95 % confidence interval, CI 1.10-4.33) and Middle Eastern women 1.32 kg (95 % CI 0.14-2.50) more weight on average than the Western European women in the fully adjusted model. Among Eastern European women, the total adjusted GWG was 3.47 kg (95 % CI 1.33-5.61) above the reference group. Other ethnic groups (South Asian, East Asian and African) did not differ from the reference group. When including non-smokers (n = 522) only, observed between-group differences increased and Middle Eastern women gained more weight than the reference group by all time points. Conclusions Eastern European and Middle Eastern women had higher GWG on average than Western European women, especially among the non-smokers. Although prevention of excessive GWG is important for all pregnant women, these ethnic groups might need special attention during pregnancy. PMID:26979613

  19. Prepregnancy body size, gestational weight gain, and risk of preterm birth in African-American women

    PubMed Central

    Wise, Lauren A.; Palmer, Julie R.; Heffner, Linda J.; Rosenberg, Lynn

    2011-01-01

    Objective We examined the risk of preterm birth in relation to prepregnancy BMI (kg/m2), waist circumference, adult weight gain, and gestational weight gain among African-American women. Methods Using prospective data from the Black Women's Health Study, we assessed the association between maternal anthropometric factors and preterm birth among 7,841 singletons born to women ages 21–44 in 1995–2003. We compared mothers of infants born three or more weeks early (597 spontaneous preterm births (SPTB); 517 medically-indicated preterm births (MPTB)) with mothers of 6,727 term infants. We used generalized estimating equation models to derive odds ratios (OR) and 95% confidence intervals (CI) adjusted for potential confounders. Results Women with prepregnancy BMI <18 were at increased risk of SPTB and MPTB relative to normal weight women (BMI 20–24), and obese women (BMI ≥30) were at increased risk of MPTB. There were modest positive associations between waist circumference, a measure of central adiposity, and both preterm birth subtypes. Adult weight gain was also positively related to both preterm birth subtypes. Associations with SPTB were generally stronger for gestations of <32 weeks. Low gestational weight gain (<0.5 lbs/week) was associated with an increased risk of SPTB among normal weight and obese women. High gestational weight gain (≥1.5 lbs/week) was associated with increased risk of SPTB among overweight (BMI 25–29) and obese women. Conclusion Our data suggest that prepregnancy adiposity (overall and central), prepregnancy weight gain, and gestational weight gain influence risk of preterm birth among African-American women. PMID:20124904

  20. Prevention of Gestational Diabetes: Design of a Cluster-Randomized Controlled Trial and One-Year Follow-Up

    PubMed Central

    2010-01-01

    Background Annual prevalence of gestational diabetes mellitus (GDM) is 12.5% among Finnish pregnant women. The prevalence is expected to rise with the increasing overweight among women before pregnancy. Physical activity and diet are both known to have favourable effects on insulin resistance and possibly on the risk of GDM. We aimed to investigate, whether GDM can be prevented by counseling on diet, physical activity and gestational weight gain during pregnancy. Methods/Design A cluster-randomized controlled trial was conducted in 14 municipalities in the southern part of Finland. Pairwise randomization was performed in order to take into account socioeconomic differences. Recruited women were at 8-12 weeks' gestation and fulfilled at least one of the following criteria: body mass index ≥ 25 kg/m2, history of earlier gestational glucose intolerance or macrosomic newborn (> 4500 g), age ≥ 40 years, first or second degree relative with history of type 1 or 2 diabetes. Main exclusion criterion was pathological oral glucose tolerance test (OGTT) at 8-12 weeks' gestation. The trial included one counseling session on physical activity at 8-12 weeks' gestation and one for diet at 16-18 weeks' gestation, and three to four booster sessions during other routine visits. In the control clinics women received usual care. Information on height, weight gain and other gestational factors was obtained from maternity cards. Physical activity, dietary intake and quality of life were followed by questionnaires during pregnancy and at 1-year postpartum. Blood samples for lipid status, hormones, insulin and OGTT were taken at 8-12 and 26-28 weeks' gestation and 1 year postpartum. Workability and return to work were elicited by a questionnaire at 1- year postpartum. Linkage to the national birth register of years 2007-2009 will provide information on perinatal complications and GDM incidence among the non-participants of the study. Cost-effectiveness evaluation will be based on

  1. Drugs Approved for Gestational Trophoblastic Disease

    Cancer.gov

    This page lists cancer drugs approved by the Food and Drug Administration (FDA) for gestational trophoblastic disease. The list includes generic names and brand names. The drug names link to NCI's Cancer Drug Information summaries.

  2. Documentation of Assessment Instrumentation--The NORC/CRESST 12th Grade Science Assessment, Item Databases, and Test Booklets. Project 2.6: Analytic Models To Monitor Status & Progress of Learning & Performance & Their Antecedents: The School Science Assessment Project.

    ERIC Educational Resources Information Center

    Bock, H. Darrell

    The hardware and software system used to create the National Opinion Research Center/Center for Research on Evaluation, Standards, and Student Testing (NORC/CRESST) item databases and test booklets for the 12th-grade science assessment are described. A general description of the capabilities of the system is given, with some specific information…

  3. Building on Family Strengths: Research and Services in Support of Children and Their Families. Proceedings of the Building on Family Strengths Annual Conference (12th, Portland, Oregon, June 23-25, 2005)

    ERIC Educational Resources Information Center

    Gordon, Lyn, Ed.; Bradley, Jennifer, Ed.; Aue, Nicole, Ed.; Holman, Ariel, Ed.

    2006-01-01

    The 12th Annual Building on Family Strengths Conference was held from June 23rd through June 25th 2005 in Portland, Oregon. Highlights included: (1) An information-packed keynote address by Dr. Richard M. Lerner on promoting positive youth development through enhancing the assets of communities; (2) An exciting research plenary panel session that…

  4. Homestead and Gardening Skills. A Guide for Providing Instruction for 11th and 12th Grade Students Enrolled in North Carolina's Secondary Schools [and] Vocational Education Competency Test-Item Bank. Agricultural Education.

    ERIC Educational Resources Information Center

    Robinson, Ward R.

    This document consists of a teacher's guide for a competency-based course on homestead and gardening skills designed for North Carolina's 11th- and 12th-grade students, and a list of competency test items applicable to the course. The teacher's guide contains course specifications, a list of competency statements, a sheet describing each unit of…

  5. Interpreting 12th-Graders' NAEP-Scaled Mathematics Performance Using High School Predictors and Postsecondary Outcomes from the National Education Longitudinal Study of 1988 (NELS:88). Statistical Analysis Report. NCES 2007-328

    ERIC Educational Resources Information Center

    Scott, Leslie A.; Ingels, Steven J.

    2007-01-01

    The search for an understandable reporting format has led the National Assessment Governing Board to explore the possibility of measuring and interpreting student performance on the 12th-grade National Assessment of Educational Progress (NAEP), the Nation's Report Card, in terms of readiness for college, the workplace, and the military. This…

  6. Proceedings of the International Association for Development of the Information Society (IADIS) International Conference on Cognition and Exploratory Learning in the Digital Age (CELDA) (12th, Maynooth, Greater Dublin, Ireland, October 24-26, 2015)

    ERIC Educational Resources Information Center

    Sampson, Demetrios G., Ed.; Spector, J. Michael, Ed.; Ifenthaler, Dirk, Ed.; Isaias, Pedro, Ed.

    2015-01-01

    These proceedings contain the papers of the 12th International Conference on Cognition and Exploratory Learning in the Digital Age (CELDA 2015), October 24-26, 2015, which has been organized by the International Association for Development of the Information Society (IADIS), co-organized by Maynooth University, Ireland, and endorsed by the…

  7. Understanding Gestational Diabetes: A Practical Guide to a Healthy Pregnancy.

    ERIC Educational Resources Information Center

    National Inst. of Child Health and Human Development (NIH), Bethesda, MD.

    This brochure addresses the problem of gestational diabetes and answers the most frequently asked questions about the disease. It begins by defining gestational diabetes and discussing its cause, then addresses such topics as: (1) how gestational diabetes differs from other types of diabetes; (2) who is at risk for developing gestational diabetes…

  8. A case of euglyacemic diabetic ketoacidosis in a patient with gestational diabetes mellitus

    PubMed Central

    Cooke, IE; McCance, DR

    2014-01-01

    A 30-year old woman at 30 weeks gestation with insulin-controlled gestational diabetes was admitted with nausea and vomiting. Plasma glucose was 3.3 mmol/l with pH 7.23 and raised capillary ketones at 6.1 mmol/l. She was diagnosed with euglycaemic diabetic ketoacidosis. Cardiotocography showed good fetal movement and accelerations. She was given intramuscular betamethasone and started on intravenous dextrose, insulin and 0.9% saline with potassium chloride with resolution of ketosis. Euglycaemic diabetic ketoacidosis has been reported during pregnancy in patients with type 1 and type 2 diabetes. We believe that this is a report of such an occurrence in a patient with gestational diabetes.

  9. Bent bone dysplasia (BBD)-FGFR2 type: the radiologic manifestations in early gestation.

    PubMed

    Handa, Atsuhiko; Okajima, Yuka; Izumi, Noriko; Yamanaka, Michiko; Kurihara, Yasuyuki

    2016-02-01

    Bent bone dysplasia-fibroblast growth factor receptor 2 type (BBD-FGFR2) is a recently identified skeletal dysplasia caused by specific FGFR2 mutations, characterized by craniosynostosis and prenatal bowing of the long bones. Only a few cases have been published. We report an affected fetus terminated at 21 weeks of gestation. The clinical and radiologic manifestations mostly recapitulate previous descriptions; however we suggest additional hallmarks of this disorder in early gestation. These hallmarks include distinctive short, thick clavicles and wavy ribs, as well as vertebral bodies that showed striking anteroposterior shortening. Femoral fractures were also present in our case. Although craniosynostosis is a hallmark of the disease, clinicians should be aware that craniosynostosis might not be readily apparent on plain films early in gestation. PMID:26446305

  10. Neonatal Mortality Risk Associated with Preterm Birth in East Africa, Adjusted by Weight for Gestational Age: Individual Participant Level Meta-Analysis

    PubMed Central

    Marchant, Tanya; Willey, Barbara; Katz, Joanne; Clarke, Siân; Kariuki, Simon; ter Kuile, Feiko; Lusingu, John; Ndyomugyenyi, Richard; Schmiegelow, Christentze; Watson-Jones, Deborah; Armstrong Schellenberg, Joanna

    2012-01-01

    Background Low birth weight and prematurity are amongst the strongest predictors of neonatal death. However, the extent to which they act independently is poorly understood. Our objective was to estimate the neonatal mortality risk associated with preterm birth when stratified by weight for gestational age in the high mortality setting of East Africa. Methods and Findings Members and collaborators of the Malaria and the MARCH Centers, at the London School of Hygiene & Tropical Medicine, were contacted and protocols reviewed for East African studies that measured (1) birth weight, (2) gestational age at birth using antenatal ultrasound or neonatal assessment, and (3) neonatal mortality. Ten datasets were identified and four met the inclusion criteria. The four datasets (from Uganda, Kenya, and two from Tanzania) contained 5,727 births recorded between 1999–2010. 4,843 births had complete outcome data and were included in an individual participant level meta-analysis. 99% of 445 low birth weight (<2,500 g) babies were either preterm (<37 weeks gestation) or small for gestational age (below tenth percentile of weight for gestational age). 52% of 87 neonatal deaths occurred in preterm or small for gestational age babies. Babies born <34 weeks gestation had the highest odds of death compared to term babies (odds ratio [OR] 58.7 [95% CI 28.4–121.4]), with little difference when stratified by weight for gestational age. Babies born 34–36 weeks gestation with appropriate weight for gestational age had just three times the likelihood of neonatal death compared to babies born term, (OR 3.2 [95% CI 1.0–10.7]), but the likelihood for babies born 34–36 weeks who were also small for gestational age was 20 times higher (OR 19.8 [95% CI 8.3–47.4]). Only 1% of babies were born moderately premature and small for gestational age, but this group suffered 8% of deaths. Individual level data on newborns are scarce in East Africa; potential biases arising due to the non

  11. Sister-sister in vitro fertilization surrogate pregnancy with donor sperm: the case for surrogate gestational pregnancy.

    PubMed

    Leeton, J; King, C; Harman, J

    1988-10-01

    A case of surrogate pregnancy is described in the sister of a 40-year-old hysterectomized woman where two oocytes of the latter were fertilized in vitro with known donor sperm and transferred into the surrogate. A normal singleton pregnancy developed which was complicated after 24 weeks of gestation with recurrent antepartum hemorrhages due to grade 3 placenta praevia. A healthy female baby was delivered by elective cesarean section at 36 weeks of gestation. The legal, social, psychological, and ethical issues of surrogacy remain unsettled and are discussed in this case report. PMID:3230346

  12. Determinants of depressive symptoms in the early weeks after miscarriage.

    PubMed Central

    Neugebauer, R; Kline, J; O'Connor, P; Shrout, P; Johnson, J; Skodol, A; Wicks, J; Susser, M

    1992-01-01

    OBJECTIVES. We tested whether and under what conditions miscarriage increases depressive symptoms in the early weeks following loss. METHODS. We interviewed 232 women within 4 weeks of miscarriage and 283 pregnant women and 318 community women who had not recently been pregnant. Depressive symptoms were measured with the Center for Epidemiologic Studies Depression (CES-D) Scale. RESULTS. Among women who had miscarried, the proportion who were highly symptomatic on the CES-D was 3.4 times that of pregnant women and 4.3 times that of community women. Among childless women, the proportion of women who had miscarried who were highly symptomatic was 5.7 times that of pregnant women and 11.0 times that of community women. Women who had miscarried were equally depressed regardless of length of gestation; among pregnant women, depressive symptoms declined with length of gestation. Among women who had miscarried, symptom levels did not vary with attitude toward the pregnancy; among pregnant women, depressive symptoms were elevated in those with unwanted pregnancies. Prior reproductive loss and advanced maternal age (35+ years) were not associated with symptom levels in any cohort. CONCLUSIONS. Depressive symptoms are markedly increased in the early weeks following miscarriage. This effect is substantially modified by number of living children, length of gestation at loss, and attitude toward pregnancy. PMID:1415855

  13. Patterns and trajectories of gestational weight gain: a prospective cohort study

    PubMed Central

    Jarman, Megan; Yuan, Yan; Pakseresht, Mohammadreza; Shi, Qian; Robson, Paula J.; Bell, Rhonda C.

    2016-01-01

    Background: Gestational weight gain in excess of or below Health Canada's guidelines is known to increase the risk of adverse outcomes for both the woman and her baby. This study describes patterns and trajectories of total and rate of gestational weight gain in a large prospective cohort of pregnant women and adolescents in the Alberta Pregnancy Outcomes and Nutrition study. Methods: We collected weight and height data for 1541 pregnant adolescents and women (mean age 31 years, < 27 weeks' gestation) recruited through advertisements and physicians' offices in Calgary and Edmonton between May 2009 and November 2012. Data were collected once during each trimester following enrolment and once at about 3 months post partum. The participants were categorized according to their prepregnancy body mass index (BMI) as underweight, of normal weight, overweight or obese. We calculated distributions of total and weekly rates of weight gain and determined trajectories of weight gain for each prepregnancy BMI category. Results: Of the 1541 participants, 761 (49.4%) exceeded Health Canada's guidelines for total gestational weight gain, and 272 (17.6%) gained less weight than recommended. A total of 63 (19.2%) and 38 (23.6%) participants categorized as overweight or obese, respectively, exceeded the recommended upper limit by 5 to less than 10 kg, and 53 (16.2%) and 27 (16.8%), respectively, exceeded the upper limit by at least 10 kg. Ninety-five participants (30.3%) in the overweight group and 59 (39.6%) of those in the obese group gained weight at more than double the recommended rate between the second and third trimesters. The median weight gain for participants in the normal, overweight and obese categories had exceeded recommended upper limits by about 30, 20 and 18 weeks' gestation, respectively. Interpretation: Adherence to Health Canada's guidelines for gestational weight gain was low. Excess gestational weight gain was most marked among those with a prepregnancy BMI in

  14. An analysis of 12th-grade students' reasoning styles and competencies when presented with an environmental problem in a social and scientific context

    NASA Astrophysics Data System (ADS)

    Yang, Fang-Ying

    This study examined reasoning and problem solving by 182 12th grade students in Taiwan when considering a socio-scientific issue regarding the use of nuclear energy. Students' information preferences, background characteristics, and eleven everyday scientific thinking skills were scrutinized. It was found most participants displayed a willingness to take into account both scientific and social information in reasoning the merits of a proposed construction of a nuclear power plant. Students' reasoning scores obtained from the "information reasoning style" test ranged from -0.5 to 1.917. And, the distribution was approximately normal with mean and median at around 0.5. For the purpose of categorization, students whose scores were within one standard deviation from the mean were characterized as having a "equally disposed" reasoning style. One hundred and twenty-five subjects, about 69%, belonged to this category. Students with scores locating at the two tails of the distribution were assigned to either the "scientifically oriented" or the "socially oriented" reasoning category. Among 23 background characteristics investigated using questionnaire data and ANOVA statistical analysis, only students' science performance and knowledge about nuclear energy were statistically significantly related to their information reasoning styles (p < 0.05). The assessed background characteristics addressed dimensions such as gender, academic performances, class difference, future education, career expectation, commitment to study, assessment to educational enrichment, family conditions, epistemological views about science, religion, and the political party preference. For everyday scientific thinking skills, interview data showed that both "scientifically oriented" students and those who were categorized as "equally disposed to using scientific and social scientific sources of data" displayed higher frequencies than "socially oriented" ones in using these skills, except in the use of

  15. Integrated Analysis of the 12th January 2010, Mw 7.0, Haiti Earthquake Using InSAR, MAI, GPS, and Seismic Data

    NASA Astrophysics Data System (ADS)

    Weston, J. M.; Jung, H.; Funning, G. J.; Ferreira, A. M.

    2012-12-01

    The Haiti earthquake, Mw 7.0, 12th January 2010, caused widespread destruction and resulted in more than 230,000 deaths. It is believed to have occurred on previously unknown fault(s), raising many questions concerning the tectonics and seismic hazard in this region. While accurate source models are key for robust seismic hazard assessments, existing source models for the Haiti earthquake from various datasets - geodetic (Calais et al., 2010), seismic (Nettles and Hjorjleifsdottir, 2010) and a combination of the two (Hayes et al., 2010) - show discrepancies, particularly concerning the fault geometry. We investigate these discrepancies using multiple aperture InSAR (MAI) data, along with seismo-geodetic analyses based on a new joint earthquake source inversion approach. Similar to previous geodetic models of this event, this study includes measurements of horizontal and line of sight displacement from GPS and InSAR data, respectively. However, we also extract further horizontal (along-track) measurements from the InSAR data using an updated MAI processing flow, incorporating flat-Earth and topographic phase corrections (Jung et al., 2009) . Despite the additional geodetic measurements, part of the signal is underwater, and thus seismic data (teleseismic long-period body and surface waves) are also included to further constrain the source parameters. We carry out geodetic and seismic-only inversions, as well as novel joint inversions taking, for the first time, realistic 3D Earth structure into account when modelling the seismic data. Initial results suggest that the addition of MAI and GPS data to the source inversions helps better constrain the strike and dip angle. However, the dip of our model is shallower (52°) than existing source models (60° - 70°) and the best fitting fault is buried ~ 4 km deeper than previously reported. We explore and discuss the implications of these findings in terms of earthquake slip distribution, mechanism and its tectonic context.

  16. Sex Dimorphism in Late Gestational Sleep Fragmentation and Metabolic Dysfunction in Offspring Mice

    PubMed Central

    Khalyfa, Abdelnaby; Carreras, Alba; Almendros, Isaac; Hakim, Fahed; Gozal, David

    2015-01-01

    Background: Excessive sleep fragmentation (SF) is common in pregnant women. Adult-onset metabolic disorders may begin during early development and exhibit substantial sex dimorphism. We hypothesized that metabolic dysfunction induced by gestational SF in male mice would not be apparent in female littermates. Methods: Body weight and food consumption were measured weekly in male and female offspring after late gestational SF or control sleep (SC). At 20 weeks, plasma leptin, adiponectin, lipid profiles, and insulin and glucose tolerance tests were assessed. Leptin and adiponectin, M1, and M2 macrophage messenger RNA expression and polarity were examined. Adiponectin gene promoter methylation levels in several tissues were assessed. Results: Food intake, body weight, visceral fat mass, and insulin resistance were higher, and adiponectin levels lower in male but not female offspring exposed to gestational SF. However, dyslipidemia was apparent in both male and female offspring exposed to SF, albeit of lesser magnitude. In visceral fat, leptin messenger RNA expression was selectively increased and adiponectin expression was decreased in male offspring exposed to gestational SF, but adiponectin was increased in exposed female offspring. Differences in adipokine expression also emerged in liver, subcutaneous fat, and muscle. Increased M1 macrophage markers were present in male offspring exposed to SF (SFOM) while increased M2 markers emerged in SF in female offspring (SFOF). Similarly, significant differences emerged in the methylation patterns of adiponectin promoter in SFOM and SFOF. Conclusion: Gestational sleep fragmentation increases the susceptibility to obesity and metabolic syndrome in male but not in female offspring, most likely via epigenetic changes. Thus, sleep perturbations impose long-term detrimental effects to the fetus manifesting as sex dimorphic metabolic dysfunction in adulthood. Citation: Khalyfa A, Carreras A, Almendros I, Hakim F, Gozal D. Sex

  17. Fast Food Consumption and Gestational Diabetes Incidence in the SUN Project

    PubMed Central

    Dominguez, Ligia J.; Martínez-González, Miguel A.; Basterra-Gortari, Francisco Javier; Gea, Alfredo; Barbagallo, Mario; Bes-Rastrollo, Maira

    2014-01-01

    Background Gestational diabetes prevalence is increasing, mostly because obesity among women of reproductive age is continuously escalating. We aimed to investigate the incidence of gestational diabetes according to the consumption of fast food in a cohort of university graduates. Methods The prospective dynamic “Seguimiento Universidad de Navarra” (SUN) cohort included data of 3,048 women initially free of diabetes or previous gestational diabetes who reported at least one pregnancy between December 1999 and March 2011. Fast food consumption was assessed through a validated 136-item semi-quantitative food frequency questionnaire. Fast food was defined as the consumption of hamburgers, sausages, and pizza. Three categories of fast food were established: low (0–3 servings/month), intermediate (>3 servings/month and ≤2 servings/week) and high (>2 servings/week). Non-conditional logistic regression models were used to adjust for potential confounders. Results We identified 159 incident cases of gestational diabetes during follow-up. After adjusting for age, baseline body mass index, total energy intake, smoking, physical activity, family history of diabetes, cardiovascular disease/hypertension at baseline, parity, adherence to Mediterranean dietary pattern, alcohol intake, fiber intake, and sugar-sweetened soft drinks consumption, fast food consumption was significantly associated with a higher risk of incident gestational diabetes, with multivariate adjusted OR of 1.31 (95% conficence interval [CI]:0.81–2.13) and 1.86 (95% CI: 1.13–3.06) for the intermediate and high categories, respectively, versus the lowest category of baseline fast food consumption (p for linear trend: 0.007). Conclusion Our results suggest that pre-pregnancy higher consumption of fast food is an independent risk factor for gestational diabetes. PMID:25215961

  18. Incidence and risk factors for retinopathy of prematurity in multiple gestations: a Chinese population study.

    PubMed

    Yau, Gordon S K; Lee, Jacky W Y; Tam, Victor T Y; Yip, Stan; Cheng, Edith; Liu, Catherine C L; Chu, Benjamin C Y; Wong, Ian Y H

    2015-05-01

    To determine the incidence and risk factors of retinopathy of prematurity (ROP) among new-born Chinese infants of multiple gestations.A retrospective review of medical records was performed for all neonates of multiple gestations screened for ROP between January 2007 and December 2012 in 2 neonatal intensive care units in Hong Kong. Screening was offered to very low birth weight (VLBW; ≤1500 g) and/or preterm (gestation ≤32 weeks) neonates using the Royal College of Ophthalmologists ROP guideline and the International Classification of ROP by 3 pediatric ophthalmologists. Maternal and neonatal covariates were analyzed using univariate and multivariate regression analyses for both ROP and Type 1 ROP.A total of 153 Chinese infants of multiple gestations were included in the study. The mean gestational age (GA) was 30.8 ± 2.4 weeks and the mean birth weight (BW) was 1284.8 ± 267.4 g. The incidence of ROP and Type 1 ROP was 11.8% and 3.9%, respectively. On univariate analysis, younger GA, lighter birth weight, postnatal hypotension, inotropes use, bronchopulmonary disease, and intraventricular hemorrhage were common independent risk factors for the development of ROP and Type 1 ROP (all P ≤ 0.04). On multivariate analysis, younger GA, surfactant use, invasive mechanical ventilation, higher mean oxygen concentration, thrombocytopenia, intraventricular hemorrhage, total parental nutrition, and hypoglycemia were significant risk factors for ROP. For Type 1 ROP, there were no significant dependent risk factors.In preterm Chinese infants born from multiple gestations, prematurity, lighter weight, postnatal hypotension, inotropes use, bronchopulmonary dysplasia, and an intraventricular hemorrhage were common independent risk factors for the development of ROP and Type 1 ROP. PMID:25950699

  19. microRNA expression in the cervix during pregnancy is associated with length of gestation.

    PubMed

    Sanders, Alison P; Burris, Heather H; Just, Allan C; Motta, Valeria; Svensson, Katherine; Mercado-Garcia, Adriana; Pantic, Ivan; Schwartz, Joel; Tellez-Rojo, Martha M; Wright, Robert O; Baccarelli, Andrea A

    2015-01-01

    Preterm birth is a leading cause of infant mortality and can lead to poor life-long health and adverse neurodevelopmental outcomes. The pathophysiologic mechanisms that precede preterm labor remain elusive, and the role that epigenetic phenomena play is largely unstudied. The objective of this study was to assess the association between microRNA (miRNA) expression levels in cervical cells obtained from swabs collected during pregnancy and the length of gestation. We analyzed cervical samples obtained between 16 and 19 weeks of gestation from 53 women in a prospective cohort from Mexico City, and followed them until delivery. Cervical miRNA was extracted and expression was quantified using the NanoString nCounter Analysis System. Linear regression models were used to examine the association between miRNA expression levels and gestational age at delivery, adjusted for maternal age, education, parity, body mass index, smoke exposure, and inflammation assessed on a Papanicolaou smear. We identified 6 miRNAs that were significantly associated with gestational age at the time of delivery, including miR-21, 30e, 142, 148b, 29b, and 223. Notably, per each doubling in miR-21 expression, gestations were 0.9 (95% CI: 0.2-1.5) days shorter on average (P = 0.009). Per each doubling in miR-30e, 142, 148b, 29b, and 223 expression, gestations were shorter by 1.0 to 1.6 days. The predicted targets of the miRNAs were enriched for molecules involved in DNA replication and inflammatory processes. The levels of specific miRNAs in the human cervix during pregnancy are predictive of gestational age at delivery, and should be validated in future studies as potential biomarkers of preterm birth risk. PMID:25611922

  20. It's About Time: A Survival Approach to Gestational Weight Gain and Preterm Delivery.

    PubMed

    Mitchell, Emily M; Hinkle, Stefanie N; Schisterman, Enrique F

    2016-03-01

    There is substantial interest in understanding the impact of gestational weight gain on preterm delivery (delivery <37 weeks). The major difficulty in analyzing the association between gestational weight gain and preterm delivery lies in their mutual dependence on gestational age, as weight naturally increases with increasing pregnancy duration. In this study, we untangle this inherent association by reframing preterm delivery as time to delivery and assessing the relationship through a survival framework, which is particularly amenable to dealing with time-dependent covariates, such as gestational weight gain. We derive the appropriate analytical model for assessing the relationship between weight gain and time to delivery when weight measurements at multiple time points are available. Since epidemiologic data may be limited to weight gain measurements taken at only a few time points or at delivery only, we conduct simulation studies to illustrate how several strategically timed measurements can yield unbiased risk estimates. Analysis of the study of successive small-for-gestational-age births demonstrates that a naive analysis that does not account for the confounding effect of time on gestational weight gain suggests a strong association between higher weight gain and later delivery (hazard ratio: 0.89, 95% confidence interval = 0.84, 0.93). Properly accounting for the confounding effect of time using a survival model, however, mitigates this bias (hazard ratio: 0.98, 95% confidence interval = 0.97, 1.00). These results emphasize the importance of considering the effect of gestational age on time-varying covariates during pregnancy, and the proposed methods offer a convenient mechanism to appropriately analyze such data.See Video Abstract at http://links.lww.com/EDE/B13. PMID:26489043

  1. Gestational age and newborn size according to parental social mobility: an intergenerational cohort study

    PubMed Central

    Gigante, Denise P; Horta, Bernardo L; Matijasevich, Alicia; Loret de Mola, Christian; Barros, Aluisio J D; Santos, Ina S; Barros, Fernando C; Victora, Cesar G

    2015-01-01

    Background We examined the associations between socioeconomic trajectories from birth to adulthood and gestational age and birth size in the next generation, using linked data from two population-based birth cohorts carried out in a Brazilian city. By comparing socioeconomic trajectories of mothers and fathers, we attempted to identify-specific effects of maternal and paternal socioeconomic trajectory on offspring birth weight, birth length, head circumference and gestational age at birth. Methods 2 population-based birth cohort studies were carried out in 1982 and 2004 in Pelotas (Brazil); 156 mothers and 110 fathers from the earlier cohort had children in 2004. Gestational age and birth length, weight and head circumference were measured. Analyses were carried out separately for mothers and fathers. Mediation analyses assessed the role of birth weight and adult body mass index (BMI). Results Among mothers, but not for fathers, childhood poverty was strongly associated with smaller size in the next generation (about 400 g in weight and 1.5 cm in height) and shorter gestations (about 2 weeks). Adult poverty did not play a role. For mothers, the associations with gestational age, birth length and weight—but not with head circumference—persisted after adjusting for maternal birth weight and for the height and weight of the grandmother. Maternal birth weight did not mediate the observed associations, but high maternal BMI in adulthood was partly responsible for the association with gestational age. Conclusions Strong effects of early poverty on gestational age and birth size in the next generation were observed among mothers, but not among fathers. These findings suggest a specific maternal effect of socioeconomic trajectory, and in particular of early poverty on offspring size and duration of pregnancy. PMID:26109560

  2. MotorWeek

    ScienceCinema

    None

    2013-04-19

    In 2008, PBS's MotorWeek, television's original automotive magazine, visited Argonne's Transportation Technology R&D Center "to learn what it really takes to make clean power sources a viable reality."

  3. MotorWeek

    SciTech Connect

    2009-01-01

    In 2008, PBS's MotorWeek, television's original automotive magazine, visited Argonne's Transportation Technology R&D Center "to learn what it really takes to make clean power sources a viable reality."

  4. Prevention of Preeclampsia with Aspirin in Multiple Gestations: A Systematic Review and Meta-analysis.

    PubMed

    Bergeron, Tessa S; Roberge, Stéphanie; Carpentier, Caroline; Sibai, Baha; McCaw-Binns, Affette; Bujold, Emmanuel

    2016-05-01

    Objective The objective of this study was to estimate the effect of low-dose aspirin in multiple gestations to prevent preeclampsia and small for gestational age (SGA) neonates. Methods A systematic review and meta-analysis were performed through electronic database searches. Randomized controlled trials (RCTs) of women with multiple gestations assigned to receive aspirin or placebo or no treatment were included. Outcomes included preeclampsia (mild and severe) and SGA neonates. Relative risks (RR) with their 95% confidence intervals (CI) were calculated. Result Out of 6,853 citations, 6 RCTS, including 898 pregnancies, were included. We observed a significant reduction in the risk of preeclampsia (RR, 0.67; 95% CI, 0.48-0.94) and mild preeclampsia (RR, 0.44; 95% CI, 0.24-0.82) but not severe preeclampsia (RR, 1.02; 95% CI, 0.61-1.72) with low-dose aspirin. The risk of SGA was not changed (RR, 1.09; 95% CI, 0.80-1.47). The reduction of preeclampsia was not different between women randomized before (RR, 0.86; 95% CI, 0.41-1.81) or after 16 weeks' gestation (RR, 0.64; 95% CI, 0.43-0.96) (p = 0.50). Conclusion There is low level of evidence supporting the use of low-dose aspirin for the prevention of preeclampsia and SGA neonates in multiple gestations. PMID:26731178

  5. Fetal kidney length as a useful adjunct parameter for better determination of gestational age

    PubMed Central

    Ugur, Mete G.; Mustafa, Aynur; Ozcan, Huseyin C.; Tepe, Neslihan B.; Kurt, Huseyin; Akcil, Emre; Gunduz, Reyhan

    2016-01-01

    Objectives: To determine the validity of fetal kidney length and amniotic fluid index (AFI) in labor dating. Methods: This prospective study included 180 pregnant women followed up in the outpatient clinic at the Department of Obstetrics and Gynecology, Gaziantep University, Turkey, between January 2014 and January 2015. The gestational age (GA) was estimated by early fetal ultrasound measures and last menstrual period. Routine fetal biometric parameters, fetal kidney length, and amniotic fluid index were measured. We studied the correlation between fetal kidney length, amniotic fluid index, and gestational age. Result: The mean gestational age depending on last menstrual period and early ultrasound was 31.98±4.29 (24-39 weeks). The mean kidney length was 35.66±6.61 (19-49 mm). There was a significant correlation between gestational age and fetal kidney length (r=0.947, p=0.001). However, there was a moderate negative correlation between GA and AFI. Adding fetal kidney length to the routine biometrics improved the effectiveness of the model used to estimate GA (R2=0.965 to R2=0.987). Conclusion: Gestational age can be better predicted by adding fetal kidney length to other routine parameters. PMID:27146616

  6. Executive Functions of Six-Year-Old Boys with Normal Birth Weight and Gestational Age

    PubMed Central

    Phua, Desiree Yee-Ling; Rifkin-Graboi, Anne; Saw, Seang-Mei; Meaney, Michael J.; Qiu, Anqi

    2012-01-01

    Impaired fetal development, reflected by low birth weight or prematurity, predicts an increased risk for psychopathology, especially attention deficit hyperactivity disorder (ADHD). Such effects cut across the normal range of birth weight and gestation. Despite the strength of existing epidemiological data, cognitive pathways that link fetal development to mental health are largely unknown. In this study we examined the relation of birth weight (>2500 g) and gestational age (37–41 weeks) within the normal range with specific executive functions in 195 Singaporean six-year-old boys of Chinese ethnicity. Birth weight adjusted for gestational age was used as indicator of fetal growth while gestational age was indicative of fetal maturity. Linear regression revealed that increased fetal growth within the normal range is associated with an improved ability to learn rules during the intra/extra-dimensional shift task and to retain visual information for short period of time during the delayed matching to sample task. Moreover, faster and consistent reaction times during the stop-signal task were observed among boys born at term, but with higher gestational age. Hence, even among boys born at term with normal birth weight, variations in fetal growth and maturity showed distinct effects on specific executive functions. PMID:22558470

  7. Glycated albumin is an optimal biomarker for gestational diabetes mellitus

    PubMed Central

    HUANG, YAPING; HU, YONGWEI; MA, YU; YE, GUANGYONG

    2015-01-01

    Gestational diabetes mellitus (GDM) refers to abnormal glucose tolerance, which is a common complication that occurs in some women for the first time during the gestation period. However, the relationship between onset of GDM and factors including advanced age and a family history of diabetes remains to be determined. The study aimed to examine the clinical significance of the detection of glycated albumin (GA) in pregnant women with GDM. A total of 893 cases of pregnant women with GDM were included, with 661 healthy pregnant women serving as the normal controls. A conditional logistic regression model was used to analyze the univariate and multivariate data to estimate the odds ratio (OR) and 95% confidence interval (95% CI). As the gestational weeks increased, the fasting blood glucose (FGP) concentration and GA-L value of the pregnant women in the normal control group gradually decreased whereas those of pregnant women with GDM greatly increased. The univariate analysis revealed that the impact factors on the occurrence of early-onset neonatal sepsis included, mother's age >35 years, complication of pregnancy hypertension, family history of hypertension, family history of diabetes, cesarean delivery, height, BMI, GA-L, and FGP. The multivariate logistic regression analysis revealed that the complication of pregnancy hypertension (OR=3.302; 95% CI, 1.705–6.394), family history of hypertension (OR=2.970; 95% CI, 1.520–5.801), GA-L (OR=1.556; 95% CI, 0.940–2.012) and FGP (OR=5.431; 95% CI, 4.097–7.198) were the main factors for pregnant women with GDM. In conclusion, pregnant women with GDM may be affected by various factors. Additionally, GA may be applied to reflect the recent blood glucose control on pregnant women with GDM. PMID:26668607

  8. Childhood Cognitive Ability: Relationship to Gestational Diabetes Mellitus in India

    PubMed Central

    Veena, S R; Krishnaveni, G V; Srinivasan, K; Kurpad, A V; Muthayya, S; Hill, J C; Kiran, K N; Fall, C H D

    2012-01-01

    Aims/Hypothesis To test the hypothesis that maternal gestational diabetes mellitus (GDM) is associated with poorer cognitive ability in children born to mothers with GDM compared to children born to non-GDM mothers in India. Methods During 1997-98 maternal GDM status was assessed at 30±2 weeks of gestation. Between 2007-2008, at a mean age of 9.7 years, 515 children (32-offspring of GDM mothers (ODM’s); 483-offspring of non-GDM mothers (controls)) from the Mysore Parthenon birth cohort underwent cognitive function assessment using tests from the Kaufman Assessment Battery for children-second edition and additional tests measuring learning, long-term storage/retrieval, short-term memory, reasoning, attention and concentration, visuo-spatial and verbal abilities. Results Compared to controls, ODM’S scored higher in tests for learning, long-term retrieval/storage (p=0.008), reasoning (p=0.02), verbal ability (p=0.01) and attention and concentration (p=0.003). In multiple regression, adjusted for the child’s age, sex, gestation, neonatal weight and head circumference, maternal age, parity, BMI, parent’s socio-economic status, education and rural/urban residence, this difference remained significant only for learning, long-term retrieval/storage (β=0.4SD (95% CI: 0.01, 0.75); p=0.042) and verbal ability (β=0.5SD (95% CI: 0.09, 0.83); p=0.015) and not with other test scores. Conclusions/interpretation In this population of healthy Indian children, there was no evidence of lower cognitive ability in ODM’s. In fact some cognitive scores were higher in ODM’s. PMID:20614102

  9. Energy and protein needs of cats for maintenance, gestation and lactation.

    PubMed

    Wichert, B; Schade, L; Gebert, S; Bucher, B; Zottmaier, B; Wenk, C; Wanner, M

    2009-10-01

    In the present investigation, data on the energy intakes and energy needs, as well as protein and fat accretion, of queens during pregnancy, during lactation and after lactation are given. Eleven adult cats were used as experimental animals. Data were collected during the fourth and seventh week of pregnancy, the second and sixth week of lactation and the second and sixth week after lactation. The cats were fed dry kitten food. During gestation and after lactation, all measurements were performed with respiration chambers. During lactation, balance trials without respiration chambers were performed. Body weight was measured and nitrogen, carbon and energy balances were calculated. From these, protein and fat accretion, as well as the metabolisable energy intake, was calculated. The weight gain during gestation was linearly independent of the number of kittens. During lactation, all cats lost weight; nevertheless, all cats except one were heavier 2 weeks after lactation than at mating. The energy intake of the cats during gestation was 1.8 times the maintenance requirement in the fourth week and two times maintenance requirement in the seventh week, and these energy intakes differed greatly among individuals. The energy intake of the cats during lactation was clearly higher than that recommended by National Research Council (NRC)(1), whereas the recommended protein intake in the second week of lactation was met. As the calculated protein balance was negative, the NRC recommendation for protein intake seems to be too low. In comparison to previous data, the cats showed a higher energy intake during lactation (median 502kJ/kgBW/d, second week lactation), and the weight loss was much lower. Further investigations on pregnant and lactating cats are necessary to complete the database. PMID:19564126

  10. Physical activity during pregnancy: predictors of change, perceived support and barriers among women at increased risk of gestational diabetes.

    PubMed

    Leppänen, Marja; Aittasalo, Minna; Raitanen, Jani; Kinnunen, Tarja I; Kujala, Urho M; Luoto, Riitta

    2014-11-01

    The aim of this study was to examine the predictors of change in intensity-specific leisure-time physical activity (LTPA) during pregnancy, and the perceived support and barriers of LTPA in Finnish pregnant women at increased risk of gestational diabetes. The study population consisted of 399 pregnant women who participated in a randomized controlled trial aiming to prevent gestational diabetes. Evaluation of LTPA was based on a self-report at baseline, 26-28, and 36-37 weeks' gestation. Data on predictors of change, perceived support and barriers were collected with questionnaires and from the maternity cards. Multinomial logistic regression was used to assess associations between the variables. The average weekly minutes of light-intensity LTPA were 179 at baseline, 161 at 26-28 weeks' gestation, and 179 at 36-37 weeks' gestation. The corresponding minutes of moderate-to-vigorous-intensity LTPA were 187, 133 and 99. At 26-28 weeks' gestation, the strongest predictors for light-intensity LTPA were meeting the PA recommendations prior to pregnancy, having polytechnic education and working part-time, while having a physically active spouse prior to pregnancy was the strongest predictor for moderate-to-vigorous-intensity LTPA. The people and/or factors that encouraged women to LTPA the most were the spouse, a child, other family members and weather, whereas tiredness, nausea, perceived health, work and lack of time restricted their LTPA the most. The strongest predictors for maintaining LTPA during pregnancy were pre-pregnancy LTPA, education, working part-time and a spouse's LTPA. Most common barriers were perceived health, work and lack of time. PMID:24615354

  11. Effects of human pregnancy and advancing gestation on respiratory discomfort during exercise.

    PubMed

    Jensen, Dennis; Webb, Katherine A; Wolfe, Larry A; O'Donnell, Denis E

    2007-04-16

    This study examined the effects of human pregnancy and advancing gestation on the intensity of respiratory discomfort (dyspnea) during cycle exercise. Fourteen pregnant women (PG) performed a progressive cycle ergometer exercise test involving 20 W/min increases in work rate to symptom limitation and/or a heart rate of 170-175 beats/min at 19.7+/-1.2 weeks (ENTRY), 28.2+/-0.3 weeks (TM2) and 36.3+/-0.3 weeks (TM3) gestation. Eight, age-matched, sedentary non-pregnant women (CG) were also studied for comparison purposes. Measurements included dyspnea intensity (Borg scale), minute ventilation (VE), breathing pattern and other cardiorespiratory parameters. At peak exercise, neither pregnancy nor advancing gestation had an effect on dyspnea, VE, breathing pattern, oxygen uptake or work rate (p>0.05). VE was significantly greater (by 11 L/min at 100 W) in the PG at TM3 versus CG (p<0.05) at all submaximal work rates. VE also increased progressively from ENTRY to TM2 and TM3 during submaximal exercise. Dyspnea was not significantly different at any submaximal work rate in the PG at TM3 versus CG or with advancing gestation in the PG. In addition, dyspnea at a standardized exercise VE of 40 L/min was not different at TM3 versus ENTRY or in the PG at TM3 versus CG. Neither pregnancy nor advancing gestation were associated with increased respiratory discomfort during strenuous non-weight bearing cycle ergometer exercise, despite substantial increases in VE and progressive mechanical adaptations of the respiratory system to accommodate the increasing size of the gravid uterus. PMID:16996321

  12. Correlation between Umbilical Cord Diameter and Cross Sectional Area with Gestational Age and Foetal Anthropometric Parameters.

    PubMed

    Begum, K; Ahmed, M U; Rahman, M M; Hossain, M M; Begum, M; Sarkar, S K; Reza, M T; Hoshneara, M; Beg, A; Sultana, F; Begum, F; Akter, F A

    2016-04-01

    The objective of the study was to find out correlation between umbilical cord diameter, cross sectional area with gestational age and foetal anthropometric parameters. This cross sectional study was conducted among healthy women between the 24th and 40th completed weeks of a normal pregnancy in the Department of Radiology & Imaging, Mymensingh Medical College Hospital, Mymensingh during the study period, from July 2009 to June 2011. A total of 230 consecutive normal pregnancy patients were included in the study. The diameter & cross-sectional area of the umbilical cord were measured on a plane adjacent to the junction of the umbilical cord and the fetal abdomen, in cross-section, with maximum magnification of the image. The cord was manually circled, and it's cross sectional areas was automatically calculated by the ultrasonograph. The mean±SD age was 24.3±4.7 years with range from 19 to 36 years. The mean gestational age was 32.1±4.5 weeks and more than a half (56.4%) of the pregnant women were nulliparas. A positive significant (p<0.001) correlation were found between umbilical cord diameter with bi-parietal diameter (r=0.548); head circumference (r=0.411); abdominal circumference (r=0.444); femur length (r=0.366) and gestational age gestation age (r=0.643). Similarly, a significant (p<0.001) positive week correlation were found between umbilical cross sectional area with bi-parietal diameter (r=0.3303); head circumference (r=0.3202); abdominal circumference (r=0.2651); femur length (r=0.3307) and gestation age (r=0.4051). A positive significant better correlation was found with umbilical cord diameter than cross sectional area with foetal anthropometric parameters. PMID:27277346

  13. Cognitive outcome varies in adolescents born preterm, depending on gestational age, intrauterine growth and neonatal complications

    PubMed Central

    Lundequist, Aiko; Böhm, Birgitta; Lagercrantz, Hugo; Forssberg, Hans; Smedler, Ann-Charlotte

    2015-01-01

    Aim The aim of this study was to investigate long-term cognitive outcome in a cohort of 18-year-olds born preterm and previously assessed at the age of 5.5. Methods We tested 134 adolescents born preterm with a very low birthweight of <1500 g and 94 term-born controls with a comprehensive cognitive battery at 18 years of age. The cohort was subdivided into 73 extremely preterm, 42 very preterm and 19 moderately preterm infants with gestational ages of 23–27, 28–31 and 32–36 weeks, respectively. The moderately preterm group was dominated by adolescents born small for gestational age. Results Very preterm adolescents performed on a par with term-born controls. In contrast, extremely preterm adolescents displayed inferior results on all cognitive tests, more so if they had suffered neonatal complications. Moderately preterm adolescents scored lower than very preterm and full-term born adolescents, particularly on complex cognitive tasks. Conclusion Adolescents born at 28 weeks of gestation or later, with appropriate birthweight and no perinatal complications, functioned like term-born peers at 18 years of age. Extremely preterm birth per se posed a risk for long-term cognitive deficits, particularly executive deficits. Adolescents born moderately preterm but small for gestational age were at risk of general cognitive deficits. PMID:25394225

  14. Monozygotic multiple gestation following in vitro fertilization: analysis of seven cases from Japan

    PubMed Central

    Yanaihara, Atsushi; Yorimitsu, Takeshi; Motoyama, Hiroshi; Watanabe, Hideaki; Kawamura, Toshihiro

    2007-01-01

    We present a series of monozygous multiple gestations achieved following in vitro fertilization (IVF): one case of monochorionic triplet pregnancy and six cases of dizygotic triplet pregnancy. From September 2000 to December 2006, all patients achieving clinical pregnancy by ART were reviewed (n = 2433). A 37 year-old woman who delivered a healthy singleton after IVF returned two years later for FET, and a single blastocyst was transferred. This also resulted in pregnancy, but TV-USG revealed a single gestational sac with three distinct amniotic sacs, each containing a distinct fetal pole with cardiac activity. This pregnancy was electively terminated at nine weeks' gestation. An additional six cases of dizygotic triplets established after fresh embryo transfer (no ICSI or assisted hatching) are also described. Of these, one resulted in a miscarriage at eight weeks' gestation and five patients have an ongoing pregnancy. This case series suggests the incidence of dizygotic/monochorionic triplets following IVF is approximately 10 times higher than the expected rate in unassisted conceptions, and underscores the importance of a conservative approach to lower the number of embryos at transfer. The role of embryo transfer technique and in vitro culture media in the twinning process requires further study. PMID:17888172

  15. The role of maternal cardiac vagal control in the association between depressive symptoms and gestational hypertension.

    PubMed

    Rouleau, Codie R; Tomfohr-Madsen, Lianne M; Campbell, Tavis S; Letourneau, Nicole; O'Beirne, Maeve; Giesbrecht, Gerald F

    2016-05-01

    Reduced cardiac vagal control, indexed by relatively lower high-frequency heart rate variability (HF-HRV), is implicated in depressed mood and hypertensive disorders among non-pregnant adults whereas research in pregnancy is limited. This study examined whether maternal HF-HRV during pregnancy mediates the association between depressed mood and gestational hypertension. Depressive symptoms (Edinburgh Depression Scale) and HF-HRV were measured during early (M=14.9 weeks) and late (M=32.4 weeks) pregnancy in 287 women. Gestational hypertension was determined by chart review. Depressive symptoms were associated with less HF-HRV (b=-0.02, p=.001). There was an indirect effect of depressed mood on gestational hypertension through late pregnancy HF-HRV (b=0.04, 95% CI 0.0038, 0.1028) after accounting for heart rate. These findings suggest cardiac vagal control is a possible pathway through which prenatal depressed mood is associated with gestational hypertension, though causal ordering remains uncertain. PMID:26868182

  16. Effects of late gestation distillers grains supplementation on fall-calving beef cow performance and steer calf growth and carcass characteristics.

    PubMed

    Wilson, T B; Schroeder, A R; Ireland, F A; Faulkner, D B; Shike, D W

    2015-10-01

    Fall-calving, mature Angus and Simmental × Angus cows ( = 251 total) and their progeny were used to evaluate the effects of late gestation dried distillers grains plus solubles (DDGS) supplementation on cow performance and progeny growth and carcass characteristics. Cows were blocked by breed and allotted to 12 tall fescue pastures (6.8 ha average). Pastures were randomly assigned to 1 of 2 treatments: cows were offered 2.1 kg DM DDGS·cow·d (SUP; CP = 23%, fat = 7%; = 6 pastures) or were not offered a supplement (CON; = 6 pastures) 69 ± 9 d before expected calving date. Cows remained on treatments until calving. Once weekly, cows that had calved were removed from treatment pastures and were moved to new tall fescue pastures (21.6 ha average) where cows from both treatments were comingled without further supplementation. Cows ( = 74) were removed from study for calving more than 30 d after expected calving date, calf loss and injury, or euthanasia. Cow BW and BCS were recorded at the beginning of the supplementation period, after calving, and at breeding. Calf BW was taken at birth and early weaning (82 ± 14 d of age). After weaning, 71 steer progeny (representative of dam breed and treatment pastures) were transitioned to a common feedlot diet with individual feed intake monitored using the GrowSafe feeding system. Steers were slaughtered at 47 ± 4 d after a minimum 12th rib fat thickness (back fat) estimation of 0.6 cm, with cattle being shipped in 3 groups. Forage availability was not different between treatments ( = 0.69). Cows offered SUP gained more BW and BCS ( ≤ 0.02) during the supplementation period. There were no differences ( ≥ 0.12) in calving date, calf birth or weaning BW, or preweaning ADG. Cow BW at breeding was not different ( = 0.19); however, BCS at breeding was greater ( < 0.01) for cows offered supplement. No differences ( ≥ 0.11) in milk production, AI conception, or overall pregnancy rate were detected. For steer progeny, initial

  17. Maternal 75-g OGTT glucose levels as predictive factors for large-for-gestational age newborns in women with gestational diabetes mellitus.

    PubMed

    Brankica, Krstevska; Valentina, Velkoska Nakova; Slagjana, Simeonova Krstevska; Sasha, Jovanovska Mishevska

    2016-02-01

    Objective Our goal was to investigate which glucose measurement from the 75-g oral glucose tolerance test (OGTT) has more capability of predicting large for-gestational-age (LGA) newborns of mothers with gestational diabetes mellitus (GDM). Subjects and methods The study group consisted of 118 consecutively pregnant women with singleton pregnancy, patients of Outpatients Department of the Endocrinology, Diabetes, and Metabolic Disorders Clinic. All were prospectively screened for GDM between 24th and 28th week of pregnancy and followed to delivery. Outcome measures included: patients' ages, pre-pregnancy BMI, BMI before delivery, FPG, 1 and 2 hour OGTT glucose values, haemoglobin A1c at third trimester, gestational week of delivery, mode of delivery and baby birth weight. Results From 118 pregnancies, 78 (66.1%) women were with GDM, and 40 (33.9%) without GDM. There were statistically significant differences (30.7 versus 5.0%, p < 0.01) between LGA newborns from GDM and control group, respectively. Gestation week of delivery and fasting glucose levels were independent predictors for LGA (Beta = 0.58 and Beta = 0.37 respectively, p < 0.01). Areas under the receiver operator characteristic curve (AUC) were compared for the prediction of LGA (0.782 (0.685-0.861) for fasting, 0.719 (0.607-0.815) for 1-hour and 0.51 (0.392-0.626) for 2-hour OGTT plasma glucose levels). Conclusion Fasting and 1-hour plasma glucose levels from OGTT may predict LGA babies in GDM pregnancies. PMID:26909480

  18. Amplitude-integrated electroencephalographic activity and middle cerebral artery Doppler flow measurements in preterm small for gestational age infants.

    PubMed

    Kolsuz, Leyla Daban; Topcuoglu, Sevilay; Gursoy, Tugba; Karatekin, Güner; Ovali, H Fahri

    2015-03-01

    Amplitude-integrated encephalography (EEG) is frequently used in neonatal intensive care units to monitor brain functions. Its bedside application and easy interpretation are the most important features. Brain development of small for gestational age infants can be affected by intrauterine chronic hypoxia. The current study aimed to evaluate cerebral functions of small for gestational age infants by means of amplitude-integrated EEG. Thirty- to 34-week-old 22 small for gestational age and 27 appropriate for gestational age preterm infants were included in the study. The mode of delivery, gender, birth weight, and Apgar scores of the patients were recorded. Following middle cerebral artery mean velocity measurement with cranial Doppler at the 24th hour of birth, an amplitude-integrated EEG recording was performed on all infants, for a period of 4 to 24 hours. Small for gestational age infants had significantly higher middle cerebral artery mean velocity than appropriate for gestational age infants (21.09 ± 4.25 vs 17.8 ± 4.07; P = .029). The amplitude-integrated EEG recordings showed lower "lower border of quiet sleep" and total Burdjalov score in small for gestational age infants when compared with appropriate for gestational age infants (2.5 [1-3.25] µV vs 3 [2.75-4] µV; P = .04, 8 [6-10], 9 [9-11]; P = .04, respectively). Increased middle cerebral artery blood flow observed in small for gestational age infants might be a marker of chronic intrauterine hypoxia to which these infants were exposed. These infants demonstrated a more immature pattern of amplitude-integrated EEG. PMID:25296921

  19. Dad's Last Week.

    PubMed

    DeVoe, Jennifer E

    2016-05-01

    I had intended to spend our spring break week in Montana with my kids and my dad, going to parks and museums together. Instead, I spent the week in the hospital, helping my dad make end-of-life choices and learning more about the importance of communication in health care settings and the preciousness of close relationships in life. I am a better person and a better physician because my dad trusted me to be there while he was dying. During his last week, I was grateful to have spent years studying medicine and years getting to know my dad. This combination of professional and personal knowledge enabled me to help him choose his own end-of-life path. As someone who does not like hospitals, I have always wondered why I became a doctor; now I know. PMID:27185000

  20. Earth Science Week evolves

    NASA Astrophysics Data System (ADS)

    Earth Science Week, October 7-13, is an annual grassroots effort sponsored by the American Geological Institute (AGI) and its member societies, of which AGU is the largest. This year, for the first time, Earth Science Week has a general theme, evolution in Earth history. The Earth Science Week information kit for 2001, available from AGI, includes a variety of posters, bookmarks, and other materials that illustrate this concept. The kit contains a new 32-page “Ideas and Activities” booklet that emphasizes evolution in Earth history through an array of activities about rocks, fossils, and geologic time. It also has information on the upcoming Public Broadcasting Service series, “Evolution,” which is to be aired in late September.

  1. Initiating New Science Partnerships in Rural Education: STEM Graduate Students Bring Current Research into 7th-12th Grade Science Classrooms

    NASA Astrophysics Data System (ADS)

    Radencic, S.; Dawkins, K. S.; Jackson, B. S.; Walker, R. M.; Schmitz, D.; Pierce, D.; Funderburk, W. K.; McNeal, K.

    2014-12-01

    Initiating New Science Partnerships in Rural Education (INSPIRE), a NSF Graduate K-12 (GK-12) program at Mississippi State University, pairs STEM graduate students with local K-12 teachers to bring new inquiry and technology experiences to the classroom (www.gk12.msstate.edu). The graduate fellows prepare lessons for the students incorporating different facets of their research. The lessons vary in degree of difficulty according to the content covered in the classroom and the grade level of the students. The focus of each lesson is directed toward the individual research of the STEM graduate student using inquiry based designed activities. Scientific instruments that are used in STEM research (e.g. SkyMaster weather stations, GPS, portable SEM, Inclinometer, Soil Moisture Probe, Google Earth, ArcGIS Explorer) are also utilized by K-12 students in the activities developed by the graduate students. Creativity and problem solving skills are sparked by curiosity which leads to the discovery of new information. The graduate students work to enhance their ability to effectively communicate their research to members of society through the creation of research linked classroom activities, enabling the 7-12th grade students to connect basic processes used in STEM research with the required state and national science standards. The graduate students become respected role models for the high school students because of their STEM knowledge base and their passion for their research. Sharing enthusiasm for their chosen STEM field, as well as the application techniques to discover new ideas, the graduate students stimulate the interests of the classroom students and model authentic science process skills while highlighting the relevance of STEM research to K-12 student lives. The measurement of the student attitudes about science is gathered from pre and post interest surveys for the past four years. This partnership allows students, teachers, graduate students, and the public to

  2. PREFACE: 12th Russia/CIS/Baltic/Japan Symposium on Ferroelectricity and 9th International Conference on Functional Materials and Nanotechnologies (RCBJSF-2014-FM&NT)

    NASA Astrophysics Data System (ADS)

    Sternberg, Andris; Grinberga, Liga; Sarakovskis, Anatolijs; Rutkis, Martins

    2015-03-01

    The joint International Symposium RCBJSF-2014-FM&NT successfully has united two international events - 12th Russia/CIS/Baltic/Japan Symposium on Ferroelectricity (RCBJSF-12) and 9th International Conference Functional Materials and Nanotechnologies (FM&NT-2014). The RCBJSF symposium is a continuation of series of meetings on ferroelectricity, the first of which took place in Novosibirsk (USSR) in 1976. FM&NT conferences started in 2006 and have been organized by Institute of Solid State Physics, University of Latvia in Riga. In 2012 the International program committee decided to transform this conference into a traveling Baltic State conference and the FM&NT-2013 was organized by the Institute of Physics, University of Tartu, Estonia. In 2014 the joint international symposium RCBJSF-2014-FM&NT was organized by the Institute of Solid State Physics, University of Latvia and was part of Riga - 2014, the European Capital of Culture event. The purpose of the joint Symposium was to bring together scientists, students and high-level experts in solid state physics, materials science, engineering and related disciplines. The number of the registered participants from 26 countries was over 350. During the Symposium 128 high quality scientific talks (5 plenary, 42 invited, 81 oral) and over 215 posters were presented. All presentations were divided into 4 parallel sessions according to 4 main topics of the Symposium: Ferroelectricity, including ferroelectrics and multiferroics, pyroelectrics, piezoelectrics and actuators, integrated ferroelectrics, relaxors, phase transitions and critical phenomena. Multifunctional Materials, including theory, multiscale and multiphenomenal material modeling and simulation, advanced inorganic, organic and hybrid materials. Nanotechnologies, including progressive methods, technologies and design for production, investigation of nano- particles, composites, structures, thin films and coatings. Energy, including perspective materials and

  3. Effect of age, gestation and lactation on faecal IgA and calprotectin concentrations in dogs.

    PubMed

    Grellet, Aurélien; Mila, Hanna; Heilmann, Romy M; Feugier, Alexandre; Gruetzner, Niels; Suchodolski, Jan S; Steiner, Jorg M; Chastant-Maillard, Sylvie

    2014-01-01

    Faecal calprotectin and IgA have been suggested as non-invasive markers of gut health. Faecal calprotectin is a marker of intestinal inflammation in adults, whereas IgA has been suggested as a marker of intestinal immunity. The purpose of the present study was to evaluate the effect of gestation, lactation and age on faecal concentrations of these biomarkers. Thirty puppies, nineteen pregnant or lactating bitches and eighty-nine healthy control adult dogs were included in the study. Faeces were collected from the fourth week of gestation until the eighth week of lactation in pregnant and lactating bitches, and between 4 and 9 weeks of age in puppies. Faeces from the eighty-nine healthy control adult dogs were also collected. Faecal calprotectin and IgA concentrations were measured. Faecal calprotectin concentrations in control dogs were significantly lower than faecal calprotectin concentrations in puppies between 4 and 6 weeks of age (P < 0·001) or between 7 and 9 weeks of age (P = 0·004). Puppies between 4 and 6 weeks of age had significantly higher faecal IgA concentrations compared with puppies between 7 and 9 weeks of age (P = 0·001). Bitches during their second month of lactation had significantly lower faecal IgA concentrations compared with their first month of lactation (P = 0·049). Faecal calprotectin and IgA have been suggested as non-invasive and easily measured biomarkers of gut health in adults. However, the present study underlines that faecal IgA and calprotectin concentrations vary markedly depending of physiologic factors such as gestation, lactation and age. These factors need to be considered when these faecal biomarkers are used for evaluation of intestinal immunity or inflammation. PMID:26101610

  4. Gestational diabetes: emerging concepts in pathophysiology

    PubMed Central

    Hodson, Kenneth; Robson, Stephen; Taylor, Roy

    2010-01-01

    Gestational diabetes affects 3 to 5% of pregnancies in the United Kingdom, contributing to significant maternal and fetal morbidity. Understanding the pathophysiology is important as it guides diagnostic screening and treatment. The insulin resistance of normal pregnancy facilitates provision of metabolic substrates to the fetus and is multifactorial in origin. Recent identification of hepatic and skeletal muscle lipid deposition in Type 2 diabetics, demonstrated by novel magnetic resonance spectroscopy techniques, is likely to be the underlying cause of pathological insulin resistance. Similar mechanisms almost certainly underlie gestational diabetes, although further studies are required to prove this. Women who develop gestational diabetes have demonstrable insulin resistance prior to pregnancy that is part of a chronic process of lipid accumulation ultimately leading to type 2 diabetes later in life. The importance of lifestyle advice and dietary modification and the rationale behind the use of metformin are thus explained.

  5. Gestational Lyme borreliosis. Implications for the fetus.

    PubMed

    MacDonald, A B

    1989-11-01

    Great diversity of clinical expression of signs and symptoms of gestational Lyme borreliosis parallels the diversity of prenatal syphilis. It is documented that transplacental transmission of the spirochete from mother to fetus is possible. Further research is necessary to investigate possible teratogenic effects that might occur if the spirochete reaches the fetus during the period of organogenesis. Autopsy and clinical studies have associated gestational Lyme borreliosis with various medical problems including fetal death, hydrocephalus, cardiovascular anomalies, neonatal respiratory distress, hyperbilirubinemia, intrauterine growth retardation, cortical blindness, sudden infant death syndrome, and maternal toxemia of pregnancy. Whether any or all of these associations are coincidentally or causally related remains to be clarified by further investigation. It is my expectation that the spectrum of gestational Lyme borreliosis will expand into many of the clinical domains of prenatal syphilis. PMID:2685924

  6. Polychlorinated biphenyls: influence on birthweight and gestation

    SciTech Connect

    Taylor, P.R.; Lawrence, C.E.; Hwang, H.L.; Paulson, A.S.

    1984-10-01

    Fifty-one infants born to women employed at two capacitor manufacturing facilities with a history of high exposure to polychlorinated biphenyls (PCBs) had a mean birthweight of 153 grams less than that of 337 infants born to women who had worked in low-exposure areas (90 per cent confidence interval, -286 to -20 g); mean gestational age was 6.6 days shorter in the high-exposure infants (90 per cent CI, -10.3 to -2.9 days). After adjusting for gestational age, the difference in birthweight was markedly reduced, indicating that the observed reduction in birthweight was due mainly to shortening of gestational age in the high-exposure group.

  7. Phun Week: Understanding Physiology

    ERIC Educational Resources Information Center

    Limson, Mel; Matyas, Marsha Lakes

    2009-01-01

    Topics such as sports, exercise, health, and nutrition can make the science of physiology relevant and engaging for students. In addition, many lessons on these topics, such as those on the cardiovascular, respiratory, and digestive systems, align with national and state life science education standards. Physiology Understanding Week (PhUn…

  8. Project Week at Yeovil.

    ERIC Educational Resources Information Center

    Gadd, K. F.

    1979-01-01

    This article describes an approach to science teaching in which secondary school students and faculty members lived and worked together for a week at Yeovil College, concentrating on science project work. The projects investigated during this time are briefly described. (GA)

  9. A Week for Space

    ERIC Educational Resources Information Center

    Comstock, Diane

    2008-01-01

    Space Week focuses on concepts that enable students to make concrete observations in the early grades (K-2) and move to concepts that help students develop their internet research and writing skills in middle and upper grades (Grades 3-5), and culminates with the development of science investigation design skills (Grade 6). To help launch your…

  10. Swahili 12 Weeks Course.

    ERIC Educational Resources Information Center

    Defense Language Inst., Washington, DC.

    This 12-weeks course in basic Swahili comprises 55 lesson units in five volumes. The general course format consists of (1) perception drills for comprehension, oral production, and association using "situational picture" illustrations; (2) dialogs in English and Swahili, with cartoon guides; (3) sequenced pattern and recombination drills, and (4)…

  11. A Week of Observations

    ERIC Educational Resources Information Center

    Colasacco, Jenne

    2011-01-01

    Even the most effective teachers have room to grow, but it's not always easy for principals to give adequate guidance through short observations. High school principal Jenne Colasacco decided to bring more depth to her observations by observing each of her teachers during one class for an entire week. The new observation structure, which included…

  12. Achondrogenesis type I diagnosed by transvaginal ultrasonography at 13 weeks' gestation.

    PubMed

    Meizner, I; Barnhard, Y

    1995-11-01

    We present the first transvaginal first-trimester diagnosis of achondrogenesis type I confirmed by radiographic and histologic studies. The ultrasonographic signs included severe short limb mesomelic dwarfism, large head with decreased ossification, and lack of vertebral ossification. PMID:7503212

  13. Torsion of a rudimentary uterine horn at 22 weeks of gestation.

    PubMed

    Wang, Bo; Zhou, Jian-hong; Jin, Hang-mei

    2011-07-01

    Rudimentary uterine horn is an uncommon abnormality of the female reproductive tract. Torsion of rudimentary uterine horn in pregnancy is even rarer. A case of successful excision of distorted rudimentary uterine horn in the second trimester, which caused severe abdominal pain, is described. A congenital absence of the right kidney was discovered simultaneously. The pregnancy continued uneventfully until term delivery. PMID:21450021

  14. [Recurrence of a rudimentary uterine horn rupture at 25 weeks of gestation: a case report].

    PubMed

    Schmied, R; Sentilhes, L; Baron, M; Grzegorczyk, V; Resch, B; Marpeau, L

    2008-03-01

    Pregnancy in a rudimentary uterine horn is a rare event which can be revealed by uterine rupture. Following the fetal extraction, some authors recommend the ablation of the rudimentary horn, in order to limit the risk of uterine rupture in case of subsequent pregnancy in the same horn. We report the obstetrical outcome of a patient with a history of rudimentary uterine horn rupture the treatment of which was conservative. PMID:18308608

  15. [Uterine rupture. A case of spontaneous rupture in a thirty week primiparous gestation ].

    PubMed

    Bretones, S; Cousin, C; Gualandi, M; Mellier, G

    1997-01-01

    Uterine rupture is one of the major complications of pregnancy. Most spontaneous uterine ruptures occur during labor in parturients with a scarred uterus. Spontaneous rupture where the uterus is unscarred are more rare and occur more frequently in older multiparous patients. Starting from a case of uterine rupture occurring in a 40 year-old primiparous women, we will present a review of the literature concerning cases of rupture in healthy uteri with no obvious cause. PMID:9265057

  16. [Management of arterial hypertension before 20weeks gestation in pregnant women].

    PubMed

    Seguro, Florent; Duly Bouhanick, Béatrice; Chamontin, Bernard; Amar, Jacques

    2016-01-01

    In the first 6 months of pregnancy, the primary goal of antihypertensive treatment is to prevent the complications of severe hypertension. Initiation of antihypertensive drug treatment is recommended in pregnant women with severe hypertension (blood pressure>160/110mmHg). Initiation of antihypertensive drug treatment should also be considered in pregnant women at high cardiovascular risk (diabetes, chronic kidney disease, personal history of cardiovascular disease) with moderate hypertension (blood pressure between 140-159/90-109mmHg). A systolic blood pressure goal<160 and a diastolic blood pressure goal between 85 and 100mmHg is recommended in pregnancy. Labetalol, nifedipine, nicardipine and alphamethyldopa should be considered preferential antihypertensive drugs in pregnancy. Salt restriction, physical exercise and weight loss have not demonstrated any effect in the prevention of preeclampsia and serious maternal complications of hypertension. PMID:27554460

  17. Posterior reversible encephalopathy syndrome (PRES) in a thirty-six-week gestation eclamptic.

    PubMed

    Powell, Emilie S; Goldman, Mitchell J

    2007-11-01

    Posterior reversible encephalopathy syndrome (PRES) is a transient clinical neuroradiological entity characterized by clinical signs and symptoms including hypertension, generalized seizure activity, altered mental status, headache, and vision changes; along with characteristic findings on head computed tomography or magnetic resonance imaging scan. Albeit a rare condition, PRES is most commonly reported in the literature in association with obstetric patients suffering from pre-eclampsia or eclampsia. In the acute setting, it is important to recognize the characteristics of PRES and immediately treat the inciting conditions: the patient's hypertension and seizures. Although this condition is usually transient and completely reversible, ischemic injury and irreversible damage have been reported. In the event of early and effective treatment, cognitive function may be completely restored. The following case report reviews a pregnant patient who presented to the Emergency Department with generalized seizure activity and a clinical picture characteristic of PRES. The case demonstrates how appropriate treatment in the acute setting allows complete restoration of cognitive function in the long term. PMID:17976748

  18. [Antenatal discovery of megacystis-microcolon-intestinal hypoperistalsis syndrome (MMIHS) at 12 weeks gestation].

    PubMed

    Cuillier, F; Cartault, F; Rivière, J-P; Tuaillon, J

    2004-09-01

    Megacystis on antenatal scan in female fetuses is rare and has diagnostic implications. We report a case of megacystis-microcolon-intestinal hypoperistalsis syndrome (MMIHS) in a female infant. The antenatal scan revealed abnormalities, but the diagnosis was not established until after delivery. MMIH is a rare autosomal recessive condition which is usually lethal in the first year of life. Prenatal diagnosis is hampered by the lack of specific diagnostic ultrasound findings and the absence of an identified genetic locus. PMID:15480285

  19. Birth weight and longitudinal growth in infants born below 32 weeks’ gestation: a UK population study

    PubMed Central

    Cole, Tim J; Statnikov, Yevgeniy; Santhakumaran, Shalini; Pan, Huiqi; Modi, Neena

    2014-01-01

    Objective To describe birth weight and postnatal weight gain in a contemporaneous population of babies born <32 weeks’ gestation, using routinely captured electronic clinical data. Design Anonymised longitudinal weight data from 2006 to 2011. Setting National Health Service neonatal units in England. Methods Birth weight centiles were constructed using the LMS method, and longitudinal weight gain was summarised as mean growth curves for each week of gestation until discharge, using SITAR (Superimposition by Translation and Rotation) growth curve analysis. Results Data on 103 194 weights of 5009 babies born from 22–31 weeks’ gestation were received from 40 neonatal units. At birth, girls weighed 6.6% (SE 0.4%) less than boys (p<0.0001). For babies born at 31 weeks’ gestation, weight fell after birth by an average of 258 g, with the nadir on the 8th postnatal day. The rate of weight gain then increased to a maximum of 28.4 g/d or 16.0 g/kg/d after 3 weeks. Conversely for babies of 22 to 28 weeks’ gestation, there was on average no weight loss after birth. At all gestations, babies tended to cross weight centiles downwards for at least 2 weeks. Conclusions In very preterm infants, mean weight crosses centiles downwards by at least two centile channel widths. Postnatal weight loss is generally absent in those born before 29 weeks, but marked in those born later. Assigning an infant's target centile at birth is potentially harmful as it requires rapid weight gain and should only be done once weight gain has stabilised. The use of electronic data reflects contemporary medical management. PMID:23934365

  20. Pulmonary disease in gestational trophoblastic neoplasms.

    PubMed Central

    McNair, O. M.; Polk, O. D.

    1992-01-01

    Gestational trophoblastic neoplasms can present as pulmonary nodules without significant disease of the reproductive organs. This article describes a case of metastatic gestational trophoblastic disease to the lungs. This entity must be considered in the differential diagnosis in any female of reproductive age who presents with multiple pulmonary nodules. Thoracotomy has a limited role in the initial evaluation of patients with this disease. However, it may be needed in patients who have evidence of persistent pulmonary disease, despite appropriate therapy. Images Figure 1 Figure 2 Figure 3 PMID:1324326

  1. Pre-gestational vs gestational exposure to maternal obesity differentially programs the offspring in mice

    PubMed Central

    Sasson, Isaac E.; Vitins, Alexa P.; Mainigi, Monica A.; Moley, Kelle H.

    2015-01-01

    Aims/hypothesis Maternal obesity is associated with an increased risk of obesity and impaired glucose homeostasis in offspring. However, it is not known whether a gestational or pre-gestational exposure confers similar risks, and if so, what the underlying mechanisms are. Methods We used reciprocal two-cell embryo transfers between mice fed either a control or high-fat diet (HFD) starting at the time of weaning. Gene expression in placenta was assessed by microarray analyses. Results A pre-gestational exposure to a maternal HFD (HFD/control) impaired fetal and placental growth despite a normal gestational milieu. Expression of imprinted genes and genes regulating vasculogenesis and lipid metabolism was markedly altered in placenta of HFD/control. An exposure to an HFD (control/HFD) only during gestation also resulted in fetal growth restriction and decreased placental weight. Interestingly, only a gestational exposure to an HFD (control/HFD) resulted in obesity and impaired glucose tolerance in adulthood. Conclusions/interpretation An HFD during pregnancy has profound consequences for the offspring later in life. Our data demonstrate that the mechanism underlying this phenomenon is not related to placental dysfunction, intrauterine growth restriction or postnatal weight gain, but rather an inability of the progeny to adapt to the abnormal gestational milieu of an HFD. Thus, the ability to adapt to an adverse intrauterine environment is conferred prior to pregnancy and it is possible that the effects of a maternal HFD may be transmitted to subsequent generations. PMID:25608625

  2. FOREWORD: The 12th International Workshop on Desorption Induced by Electronic Transitions (DIET XII) (Pine Mountain, Georgia, USA, 19-23 April 2009) The 12th International Workshop on Desorption Induced by Electronic Transitions (DIET XII) (Pine Mountain, Georgia, USA, 19-23 April 2009)

    NASA Astrophysics Data System (ADS)

    Orlando, Thomas M.; Diebold, Ulrike

    2010-03-01

    The 12th International Workshop on Desorption Induced by Electronic Transitions (DIET XII) took place from 19-23 April 2009 in Pine Mountain, Georgia, USA. This was the 12th conference in a strong and vibrant series, which dates back to the early 1980s. DIET XII continued the tradition of exceptional interdisciplinary science and focused on the study of desorption and dynamics induced by electronic excitations of surfaces and interfaces. The format involved invited lectures, contributed talks and a poster session on the most recent developments and advances in this area of surface physics. The Workshop International Steering Committee and attendees wish to dedicate DIET XII to the memory of the late Professor Theodore (Ted) Madey. Ted was one of the main pioneers of this field and was one of the primary individuals working to keep this area of science exciting and adventurous. His overall contributions to surface science were countless and his contributions to the DIET field and community were enormous. He is missed and remembered by many friends and colleagues throughout the world. The papers collected in this issue cover many of the highlights of DIET XII. Topics include ultrafast electron transfer at surfaces and interfaces, quantum and spatially resolved mapping of surface dynamics and desorption, photon-, electron- and ion-beam induced processes at complex interfaces, the role of non-thermal desorption in astrochemistry and astrophysics and laser-/ion-based methods of examining soft matter and biological media. Although the workshop attracted many scientists active in the general area of non-thermal surface processes, DIET XII also attracted many younger scientists (i.e., postdoctoral fellows, advanced graduate students, and a select number of advanced undergraduate students). This field has had an impact in a number of areas including nanoscience, device physics, astrophysics, and now biophysics. We believe that this special issue of Journal of Physics

  3. National Society of Black Physicists XXV Annual Day of Scientific Lectures and 21st Annual Meeting - NSBP '98: The Next Generation/12th Annual National Conference of Black Physics Students - NCPBS '98: Physics/Life in Motion

    SciTech Connect

    MacKellar, Alan

    1999-02-28

    The 12th Annual National Conference of Black Physics Students (NCBPS) was held jointly with the Annual Meeting of the National Society of Black Physicists (NSBP) March 4-8, 1998 in Lexington, Ky. The Proceedings consists of scientific talks and abstracts given by NSBP members and students attending the NCBPS meeting. One joint session of general scientific interest was held, with NCBPS students, NSBP members, and about 75 high school students from the state of Kentucky present. NCBPS session included ''How to get into Graduate School'', ''How to Survive in Graduate School'', and a Panel on ''Opportunities for Physics Graduates.'' The report by AIP: ''Survey of Participants of the 12th Annual NCBPS'' is included in the Proceedings.

  4. Associations of Gestational Weight Gain with Preterm Birth among Underweight and Normal Weight Women

    PubMed Central

    Vesco, Kimberly K.; Bulkley, Joanna; Callaghan, William M.; Bruce, F. Carol; Staab, Jenny; Hornbrook, Mark C.; Berg, Cynthia J.

    2015-01-01

    Studies report increased risk of preterm birth (PTB) among underweight and normal weight women with low gestational weight gain (GWG). However, most studies examined GWG over gestational periods that differ by term and preterm which may have biased associations because GWG rate changes over the course of pregnancy. Furthermore, few studies have specifically examined the amount and pattern of GWG early in pregnancy as a predictor of PTB. Within one integrated health care delivery system, we examined 12,526 singleton pregnancies between 2000 and 2008 among women with a body mass index <25 kg/m2, who began prenatal care in the first trimester and delivered a live-birth >28 weeks gestation. Using self-reported pregravid weight and serial measured antenatal weights, we estimated GWG and the area under the GWG curve (AUC; an index of pattern of GWG) during the first and second trimesters of pregnancy (≤28 weeks). Using logistic regression adjusted for covariates, we examined associations between each GWG measure, categorized into quartiles, and PTB (<37 weeks gestation). We additionally examined associations according to the reason for PTB by developing a novel algorithm using diagnoses and procedure codes. Low GWG in the first and second trimesters was not associated with PTB [aOR 1.11, (95 % CI 0.90, 1.38) with GWG <8.2 kg by 28 weeks compared to pregnancies with GWG >12.9]. Similarly, pattern of GWG was not associated with PTB. Our findings do not support an association between GWG in the first and second trimester and PTB among underweight and normal weight women. PMID:25652068

  5. Early-Onset Thrombocytopenia in Small-For-Gestational-Age Neonates: A Retrospective Cohort Study.

    PubMed

    Fustolo-Gunnink, S F; Vlug, R D; Smits-Wintjens, V E H J; Heckman, E J; Te Pas, A B; Fijnvandraat, K; Lopriore, E

    2016-01-01

    Thrombocytopenia is a common finding in small for gestational age (SGA) neonates and is thought to result from a unique pathophysiologic mechanism related to chronic intrauterine hypoxia. Our objective was to estimate the incidence and severity of early-onset thrombocytopenia in SGA neonates, and to identify risk factors for thrombocytopenia. We performed a retrospective cohort study of all consecutive SGA neonates admitted to our ward and a control group of appropriate for gestational age (AGA) neonates matched for gestational age at birth. Main outcome measures were incidence and severity of thrombocytopenia, hematological and clinical risk factors for thrombocytopenia, and bleeding. A total of 330 SGA and 330 AGA neonates were included, with a mean gestational age at birth of 32.9 ± 4 weeks. Thrombocytopenia (<150x109/L) was found in 53% (176/329) of SGA neonates and 20% (66/330) of AGA neonates (relative risk (RR) 2.7, 95% confidence interval (CI) [2.1, 3.4]). Severe thrombocytopenia (21-50x109/L) occurred in 25 neonates (8%) in the SGA and 2 neonates (1%) in the AGA group (RR 12.5, 95% CI [3.0, 52.5]). Platelet counts <20x109/L were not recorded. Within the SGA group, lower gestational age at birth (p = <0.01) and erythroblastosis (p<0.01) were independently associated with a decrease in platelet count. Platelet count was positively correlated with birth weight centiles. In conclusion, early-onset thrombocytopenia is present in over 50% of SGA neonates and occurs 2.7 times as often as in AGA neonates. Thrombocytopenia is seldom severe and is independently associated with lower gestational age at birth and erythroblastosis. PMID:27177157

  6. Executive Function Mediates Effects of Gestational Age on Functional Outcomes and Behavior in Preschoolers

    PubMed Central

    Loe, Irene M.; Feldman, Heidi M.; Huffman, Lynne C.

    2014-01-01

    Objective To investigate the role of executive function (EF) skills, measured by parent-rating and performance-based instruments, as mediators of the effects of gestational age on functional outcomes and behavior symptoms in preterm and full term preschoolers. Patients and methods Children born preterm (n=70; mean gestational age 29.6 weeks and mean birth weight 1365g) were compared to children born full term (n=79) on composite measures of EF (using the Behavior Rating Inventory of Executive Function and a performance-based EF battery), adaptive function, prereading skills, and behavior symptoms. For the entire sample, mediation analyses examined the effect of gestational age on outcomes with EF as mediator. Results Compared to children born full term, children born preterm had significantly higher parent-rated EF scores and lower performance-based EF scores, both indicating more problems; further, children born preterm had lower adaptive function and prereading scores and more problematic behavior. Gestational age contributed to adaptive function, prereading skills, and behavior symptoms for all children. EF acted as a mediator of gestational age for all three outcomes; different patterns emerged for parent-rated and performance-based EF evaluations. For adaptive function, both EF measures significantly mediated effects of gestational age; for prereading skills, only performance-based EF was significant; for behavior symptoms, only parent-rated EF was significant. Conclusions We propose standard assessment of EF, using both parent-rating and performance-based EF measures, in young preterm children and other children at risk of EF impairments. EF skills are measurable, mediate important functional outcomes, and may serve as intervention targets. PMID:24906034

  7. Comparison of Glibenclamide and Insulin on Neonatal Outcomes in Pregnant Women with Gestational Diabetes

    PubMed Central

    Behrashi, Mitra; Samimi, Mansooreh; Ghasemi, Tayyebeh; Saberi, Farzaneh; Atoof, Fatemeh

    2016-01-01

    Background: Untreated or poorly controlled gestational diabetes can cause serious complications for mother and newborn. Glibenclamide is rarely used in treating mothers with this disease. This study aimed at comparing the effect of glibenclamide and insulin on neonatal outcomes in women with gestational diabetes mellitus. Methods: In this randomized controlled clinical trial, 249 pregnant women aged 18–45 years within the 11th–33rd weeks of gestation with gestational diabetes, single fetus pregnancy, and in need of hyperglycemia treatment were entered and grouped randomly as either glibenclamide or insulin. In the insulin group (n = 129), insulin was administered with an initial dose of 0.2 IU/kg subcutaneously twice per day, whereas in the glibenclamide group (n = 120), 1.25 mg oral glibenclamide was administered once daily and increased if needed. Results: The results showed no significant difference in means age, gestational age, and body mass index between women in the two groups. In addition, there were no significant differences in the frequency of neonatal hypoglycemia, anomaly, hyperbilirubinemia, admission in Neonatal Intensive Care Unit (NICU), and neonatal respiratory distress between two groups. Macrosomia was lower in the glibenclamide group than the insulin group (3.3% vs. 13.2%, respectively, P = 0.005). Regression logistics model results showed that the type of treatment (odds ratio [OR]: 4.62; confidence interval [CI]: 1.45–14.02; P = 0.01) and gestational age at delivery (OR: 1.41; CI: 1.04–1.74; P = 0.01) were as predictor factors of macrosomia. Conclusions: The results of this study revealed that glibenclamide is able to reduce the risk of fetal macrosomia without increasing neonatal anomalies, jaundice, hypocalcemia, infant respiratory distress, and NICU admission. PMID:27413519

  8. Effects of Gestational Maternal Undernutrition on Growth, Carcass Composition and Meat Quality of Rabbit Offspring

    PubMed Central

    Symeon, George K.; Goliomytis, Michael; Bizelis, Iosif; Papadomichelakis, George; Pagonopoulou, Olga; Abas, Zafeiris; Deligeorgis, Stelios G.; Chadio, Stella E.

    2015-01-01

    An experiment was conducted in order to evaluate the effects of gestational undernutrition of rabbit does on growth, carcass composition and meat quality of the offsprings. Thirty primiparous non lactating rabbit does were artificially inseminated and randomly divided in three treatment groups: Control (C; fed to 100% of maintenance requirements throughout gestation, n = 10), early undernourished (EU; fed to 50% of maintenance requirements during days 7–19 of gestation, n = 10) and late undernourished (LU; fed to 50% of maintenance requirements during days 20-27 of gestation, n = 10). During the 4th week of the gestation period, LU does significantly lost weight compared to C and EU groups (P<0.05). At kindling, C does produced litters with higher proportions of stillborn kits (P<0.05) while the total litter size (alive and stillborn kits) was not different among groups (10.7, 12.8 and 12.7 kits in C, EU and LU groups, respectively). Kit birth weight tended to be lower in the LU group. During fattening, body weight and feed intake were not different among offsprings of the three experimental groups. Moreover, the maternal undernutrition did not have any impact on carcass composition of the offsprings in terms of carcass parts and internal organs weights as well as meat quality of L. lumborum muscle (pH24, colour, water holding capacity and shear values) at slaughter (70 days of age). Therefore, it can be concluded that the gestational undernutrition of the mother does not have detrimental effects on the productive and quality traits of the offsprings. PMID:25671602

  9. Scaling approach to study the changes through the gestation of human fetal cardiac and circulatory behaviors.

    PubMed

    Pennati, G; Fumero, R

    2000-04-01

    During human gestation, fetal body size increases considerably and important transformations occur to hemodynamics of the cardiovascular system of the fetus. Vascular compliances and resistances as well as the cardiac function show important changes. In order to investigate these modifications, a mathematical approach based on scaling techniques was developed. Vascular and cardiac parameters of the human fetus were related by allometric equations to the anatomical dimensions of vessels that, in turn, depend on the fetal body weight and the gestational age. A scaling factor (b) was identified for each parameter under study: vascular resistances and flow inertances decrease with gestational age (b= -0.33 for flow inertances) whereas vascular compliances remarkably increase (b= 1.33). Scaling factors were also adopted for the fetal cardiac parameters, according to experimental data on the development of fetal myocardium. Parameter values calculated for each week of the last trimester of the fetal gestation, were tested using a mathematical lumped parameter model, previously developed for a human fetus near the term of the gestation. The validation of the scaling method adopted for the parameters was performed by comparing the results of the simulations with a group of data obtained by Doppler velocimetry at different stages of fetal normal gestation. The adopted allometric equations were appropriate in describing the development of the human fetal circulatory system. The ductus venosus, the ductus arteriosus, and the foramen ovale, that conclude their function at the birth moment, as well as the lungs and the brain, do not follow the general growth rate and require different scaling factors. PMID:10870901

  10. Early-Onset Thrombocytopenia in Small-For-Gestational-Age Neonates: A Retrospective Cohort Study

    PubMed Central

    Vlug, R. D.; Smits-Wintjens, V. E. H. J.; Heckman, E. J.; te Pas, A. B.; Fijnvandraat, K.; Lopriore, E.

    2016-01-01

    Thrombocytopenia is a common finding in small for gestational age (SGA) neonates and is thought to result from a unique pathophysiologic mechanism related to chronic intrauterine hypoxia. Our objective was to estimate the incidence and severity of early-onset thrombocytopenia in SGA neonates, and to identify risk factors for thrombocytopenia. We performed a retrospective cohort study of all consecutive SGA neonates admitted to our ward and a control group of appropriate for gestational age (AGA) neonates matched for gestational age at birth. Main outcome measures were incidence and severity of thrombocytopenia, hematological and clinical risk factors for thrombocytopenia, and bleeding. A total of 330 SGA and 330 AGA neonates were included, with a mean gestational age at birth of 32.9 ± 4 weeks. Thrombocytopenia (<150x109/L) was found in 53% (176/329) of SGA neonates and 20% (66/330) of AGA neonates (relative risk (RR) 2.7, 95% confidence interval (CI) [2.1, 3.4]). Severe thrombocytopenia (21-50x109/L) occurred in 25 neonates (8%) in the SGA and 2 neonates (1%) in the AGA group (RR 12.5, 95% CI [3.0, 52.5]). Platelet counts <20x109/L were not recorded. Within the SGA group, lower gestational age at birth (p = <0.01) and erythroblastosis (p<0.01) were independently associated with a decrease in platelet count. Platelet count was positively correlated with birth weight centiles. In conclusion, early-onset thrombocytopenia is present in over 50% of SGA neonates and occurs 2.7 times as often as in AGA neonates. Thrombocytopenia is seldom severe and is independently associated with lower gestational age at birth and erythroblastosis. PMID:27177157

  11. Gestational weight gain standards based on women enrolled in the Fetal Growth Longitudinal Study of the INTERGROWTH-21st Project: a prospective longitudinal cohort study

    PubMed Central

    Bishop, Deborah C; Pang, Ruyan; Ohuma, Eric O; Kac, Gilberto; Abrams, Barbara; Rasmussen, Kathleen; Barros, Fernando C; Hirst, Jane E; Lambert, Ann; Papageorghiou, Aris T; Stones, William; Jaffer, Yasmin A; Altman, Douglas G; Noble, J Alison; Giolito, Maria Rosa; Gravett, Michael G; Purwar, Manorama; Kennedy, Stephen H; Bhutta, Zulfiqar A; Villar, José

    2016-01-01

    Objective To describe patterns in maternal gestational weight gain (GWG) in healthy pregnancies with good maternal and perinatal outcomes. Design Prospective longitudinal observational study. Setting Eight geographically diverse urban regions in Brazil, China, India, Italy, Kenya, Oman, United Kingdom, and United States, April 2009 to March 2014. Participants Healthy, well nourished, and educated women enrolled in the Fetal Growth Longitudinal Study component of the INTERGROWTH-21st Project, who had a body mass index (BMI) of 18.50-24.99 in the first trimester of pregnancy. Main outcome measures Maternal weight measured with standardised methods and identical equipment every five weeks (plus/minus one week) from the first antenatal visit (<14 weeks’ gestation) to delivery. After confirmation that data from the study sites could be pooled, a multilevel, linear regression analysis accounting for repeated measures, adjusted for gestational age, was applied to produce the GWG values. Results 13 108 pregnant women at <14 weeks’ gestation were screened, and 4607 met the eligibility criteria, provided consent, and were enrolled. The variance within sites (59.6%) was six times higher than the variance between sites (9.6%). The mean GWGs were 1.64 kg, 2.86 kg, 2.86 kg, 2.59 kg, and 2.56 kg for the gestational age windows 14-18+6 weeks, 19-23+6 weeks, 24-28+6 weeks, 29-33+6 weeks, and 34-40+0 weeks, respectively. Total mean weight gain at 40 weeks’ gestation was 13.7 (SD 4.5) kg for 3097 eligible women with a normal BMI in the first trimester. Of all the weight measurements, 71.7% (10 639/14 846) and 94.9% (14 085/14 846) fell within the expected 1 SD and 2 SD thresholds, respectively. Data were used to determine fitted 3rd, 10th, 25th, 50th, 75th, 90th, and 97th smoothed GWG centiles by exact week of gestation, with equations for the mean and standard deviation to calculate any desired centiles according to gestational age in exact weeks. Conclusions

  12. Gestational dating by metabolic profile at birth: a California cohort study

    PubMed Central

    Jelliffe-Pawlowski, Laura L.; Norton, Mary E.; Baer, Rebecca J.; Santos, Nicole; Rutherford, George W.

    2016-01-01

    Background Accurate gestational dating is a critical component of obstetric and newborn care. In the absence of early ultrasound, many clinicians rely on less accurate measures, such as last menstrual period or symphysis-fundal height during pregnancy, or Dubowitz scoring or the Ballard (or New Ballard) method at birth. These measures often underestimate or overestimate gestational age and can lead to misclassification of babies as born preterm, which has both short- and long-term clinical care and public health implications. Objective We sought to evaluate whether metabolic markers in newborns measured as part of routine screening for treatable inborn errors of metabolism can be used to develop a population-level metabolic gestational dating algorithm that is robust despite intrauterine growth restriction and can be used when fetal ultrasound dating is not available. We focused specifically on the ability of these markers to differentiate preterm births (PTBs) (<37 weeks) from term births and to assign a specific gestational age in the PTB group. Study Design We evaluated a cohort of 729,503 singleton newborns with a California birth in 2005 through 2011 who had routine newborn metabolic screening and fetal ultrasound dating at 11–20 weeks’ gestation. Using training and testing subsets (divided in a ratio of 3:1) we evaluated the association among PTB, target newborn characteristics, acylcarnitines, amino acids, thyroid-stimulating hormone, 17-hydroxyprogesterone, and galactose-1-phosphate-uridyl-transferase. We used multivariate backward stepwise regression to test for associations and linear discriminate analyses to create a linear function for PTB and to assign a specific week of gestation. We used sensitivity, specificity, and positive predictive value to evaluate the performance of linear functions. Results Along with birthweight and infant age at test, we included 35 of the 51 metabolic markers measured in the final multivariate model comparing PTBs and

  13. Sleep fragmentation during late gestation induces metabolic perturbations and epigenetic changes in adiponectin gene expression in male adult offspring mice.

    PubMed

    Khalyfa, Abdelnaby; Mutskov, Vesco; Carreras, Alba; Khalyfa, Ahamed A; Hakim, Fahed; Gozal, David

    2014-10-01

    Sleep fragmentation (SF) is a common condition among pregnant women, particularly during late gestation. Gestational perturbations promote the emergence of adiposity and metabolic disease risk in offspring, most likely through epigenetic modifications. Adiponectin (AdipoQ) expression inversely correlates with obesity and insulin resistance. The effects of SF during late gestation on metabolic function and AdipoQ expression in visceral white adipose tissue (VWAT) of offspring mice are unknown. Male offspring mice were assessed at 24 weeks after dams were exposed to SF or control sleep during late gestation. Increased food intake, body weight, VWAT mass, and insulin resistance, with reductions in AdipoQ expression in VWAT, emerged in SF offspring. Increased DNMT3a and -b and global DNA methylation and reduced histone acetyltransferase activity and TET1, -2, and -3 expression were detected in VWAT of SF offspring. Reductions in 5-hydroxymethylcytosine and H3K4m3 and an increase in DNA 5-methylcytosine and H3K9m2 in the promoter and enhancer regions of AdipoQ emerged in adipocytes from VWAT and correlated with AdipoQ expression. SF during late gestation induces epigenetic modifications in AdipoQ in male offspring mouse VWAT adipocytes along with a metabolic syndrome-like phenotype. Thus, altered gestational environments elicited by SF impose the emergence of adverse, long-lasting metabolic consequences in the next generation. PMID:24812424

  14. Modeling the relationship between scanned rump and 12th-rib fat in young temperate and tropical bovines: model development and evaluation.

    PubMed

    Walmsley, B J; Wolcott, M L; McPhee, M J

    2010-05-01

    A decision support tool for predicting subcutaneous fat depths called BeefSpecs, based on the Davis growth model (DGM), has been developed by the Cooperative Research Centre for Beef Genetic Technologies. Currently, the DGM predicts 12th-rib fat thickness (RFT, mm). To allow predictions of fat thickness at the P8 rump (P8FT, mm) site, the standard carcass fat measurement in the Australian beef industry, a relationship was developed between ultrasound RFT and P8FT in steers and heifers from temperate (Angus, Hereford, Shorthorn, and Murray Grey) and tropical (Brahman, Belmont Red, and Santa Gertrudis) breed types. Model development involved fitting various combinations of sex, breed type (BrT), BW, age, and RFT to produce 6 models. The models were challenged with data from 3 independent data sets: 1) Angus steers from 2.4 generations of divergent selection for and against residual feed intake; 2) 2 tropically adapted genotypes [Brahman and tropically adapted composites (combinations of Belmont Red, Charbray, Santa Gertrudis, Senepol, and Brahman breeds)]; and 3) a study using sires from Charolais, Limousin, Belgian Blue, and Black and Red Wagyu breeds and 3 genetic lines of Angus to create divergence in progeny in terms of genetic potential for intramuscular fat percent and retail beef yield. When challenged with data from Angus cattle, the mean biases (MB, mm) for models A to F were -1.23, -0.56, -0.56, -0.02, 0.14, and 0.04, and the root mean square errors of predictions (mm) were 1.53, 0.97, 0.97, 0.92, 0.93, and 0.91, respectively. When challenged with data from Brahman cattle, MB were 0.04, -0.22, -0.14, 0.05, -0.11, and 0.02 and root mean square errors of predictions were 1.30, 1.29, 1.27, 1.23, 1.37, and 1.29, respectively. Generally, model accuracy indicated by MB tended to be less for model E, which contained age rather than BW as a covariate. Models B and C were generally robust when challenged with data from Angus, Brahman, and Tropical Composite cattle

  15. What I Need to Know about Gestational Diabetes

    MedlinePlus

    ... Child Health and Human Development Information Resource Center Diabetes Disease Organizations Many organizations provide support to patients ... Español What I need to know about Gestational Diabetes Page Content On this page: What is gestational ...

  16. Gestational Diabetes May Lead to More Body Fat on Babies

    MedlinePlus

    ... 158813.html Gestational Diabetes May Lead to More Body Fat on Babies Finding held even when mom-to- ... mothers with gestational diabetes had 16 percent more body fat than babies of mothers without the disorder. This ...

  17. [Gestational surrogacy - sin, whim or necessity].

    PubMed

    Kosovski, I; Kovachev, E; Alexandrov, K; Kysyov, S; Markova, V

    2014-01-01

    The authors propose the gestational surrogacy to be permitted but only for medical indications and under exact requirements. The surrogate mother if married, her husband, too, sign with the commissioning adopting couple a legal agreement at the beginning of the procedures. PMID:25509646

  18. Placental hyaluronidase expression during gestation in swine

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Previous results have shown that microscopic folds of the epithelial bilayer of the porcine placenta deepen as gestation advances and that epithelial folds of placenta associated with small fetuses deepen more than placenta of large fetuses. These modifications likely provide more surface area for m...

  19. Intermanual Transfer of Shapes in Preterm Human Infants from 33 to 34 + 6 Weeks Postconceptional Age

    ERIC Educational Resources Information Center

    Lejeune, Fleur; Marcus, Leila; Berne-Audeoud, Frederique; Streri, Arlette; Debillon, Thierry; Gentaz, Edouard

    2012-01-01

    This study investigated the ability of preterm infants to learn an object shape with one hand and discriminate a new shape in the opposite hand (without visual control). Twenty-four preterm infants between 33 and 34 + 6 gestational weeks received a tactile habituation task with either their right or left hand followed by a tactile discrimination…

  20. Gestational hypertension and the developmental origins of cardiac hypertrophy and diastolic dysfunction.

    PubMed

    Armstrong, David W J; Tse, M Yat; Wong, Philip G; Ventura, Nicole M; Meens, Jalna A; Johri, Amer M; Matangi, Murray F; Pang, Stephen C

    2014-06-01

    The developmental origins of health and disease refer to the theory that adverse maternal environments influence fetal development and the risk of cardiovascular disease in adulthood. We used the chronically hypertensive atrial natriuretic peptide knockout (ANP-/-) mouse as a model of gestational hypertension, and attempted to determine the effect of gestational hypertension on left ventricular (LV) structure and function in adult offspring. We crossed normotensive ANP+/+ females with ANP-/- males (yielding ANP+/-(WT) offspring) and hypertensive ANP-/- females with ANP+/+ males (yielding ANP+/-(KO) offspring). Cardiac gene expression was measured using real-time quantitative PCR. Cardiac function was assessed using echocardiography. Daily injections of isoproterenol (ISO) were used to induce cardiac stress. Collagen deposition was assessed using picrosirius red staining. All mice were 10 weeks of age. Gestational hypertension resulted in significant LV hypertrophy in offspring, with no change in LV function. Treatment with ISO resulted in significant LV diastolic dysfunction with a restrictive filling pattern (increased E/A ratio and E/e') and interstitial myocardial fibrosis only in ANP+/-(KO) and not ANP+/-(WT) offspring. Gestational hypertension programs adverse LV structural and functional remodeling in offspring. These data suggest that adverse maternal environments may increase the risk of heart failure in offspring later in life. PMID:24718734

  1. Systemic inflammation in the extremely low gestational age newborn following maternal genitourinary infections

    PubMed Central

    Fichorova, Raina N.; Beatty, Noah; Sassi, Rita R. S.; Yamamoto, Hidemi S.; Allred, Elizabeth N.; Leviton, Alan

    2014-01-01

    Problem Gestational genitourinary infections are associated with life-long disabilities, but it is unknown if neonatal inflammation is involved. Method Mothers of 914 infants born before 28th gestation week reported cervical/vaginal infection (CVI), and/or urine/bladder/kidney infection (UTI), or neither. Inflammation proteins measured in baby’s blood on postnatal days 1, 7 and 14 were considered elevated if in the top quartile for gestational age. Logistic regression models adjusting for potential confounders assessed odds ratios. Results Compared to neither UTI/CVI, mothers with CVI were more likely to have infants with elevated CRP, SAA, MPO, IL-1β, IL-6, IL-6R, TNF-α, RANTES, ICAM-3, E-selectin and VEGF-R2 on day 1; those with UTI were more likely to have infants with elevated MPO, IL-6R, TNF-R1, TNF-R2, and RANTES on day 7. Placental anaerobes and genital micoplasma were more common in pregnancies with CVI. Conclusion Gestational UTI/CVI should be targeted for preventing systemic inflammation in the very preterm newborn. PMID:25164433

  2. The role of color Doppler flow in the management of nonmetastatic gestational trophoblastic disease.

    PubMed

    Tepper, R; Shulman, A; Altaras, M; Goldberger, S; Maymon, R; Holzinger, M; Beyth, Y

    1994-01-01

    Three patients with findings suggestive of invasive gestational trophoblastic neoplasm and lung metastasis were assessed by color Doppler transvaginal ultrasound, before and during chemotherapy. The sonographic findings were correlated with beta-hCG levels measured at various stages of treatment. Results were compared with blood flow indices found during normal first trimester pregnancies, and those following elective termination of pregnancy. The mean resistance indices were significantly lower in the patients treated with chemotherapy (0.410 +/- 0.04) than in the early pregnancy control group (5-8 weeks gestation; n = 20, resistance index = 0.494 +/- 0.06). The difference between the groups was statistically significant (chi 2; p < 0.05). No pathological flow patterns could be discerned in 10 patients, who after termination of pregnancy had beta-hCG levels below 5 IU/ml. The response of gestational trophoblastic neoplasms to chemotherapy could be reliably assessed by observing the changes in flow resistance, which paralleled the gradual decrements in serial measurements of beta-hCG levels. Thus, the statistically significant results of our study are very encouraging and may indicate that color Doppler flow is a noninvasive, reproducible, useful and highly reliable new diagnostic approach for the diagnosis and management of patients suffering from uterine malignant gestational trophoblastic disease. PMID:7959318

  3. Increased Cord Blood Betatrophin Levels in the Offspring of Mothers with Gestational Diabetes

    PubMed Central

    Wu, Shimin; Zhao, Yue; Du, Caiqi; Yuan, Guandou; Ning, Qin; McCormick, Kenneth; Luo, Xiaoping

    2016-01-01

    Aim Exposing a fetus to hyperglycemia can increase the risk for later-life metabolic disorders. Betatrophin has been proposed as a key regulator of pancreatic beta cell proliferation and lipid regulation. Highly responsive to nutritional signals, serum betatrophin concentrations have been found to be altered by various physiological and pathological conditions. We hypothesized that betatrophin levels are increased in the cord blood in offspring exposed to intrauterine hyperglycemia. Methods This was a cross-sectional study including 54 mothers who underwent uncomplicated Cesarean delivery in a university hospital. Maternal gestational glucose concentration was determined at 24–48 weeks gestation after a 75-g OGTT. Cord blood and placental tissue was collected immediately post delivery. Metabolic parameters were determined in the Clinical Laboratory. Cord blood betatrophin levels were assayed using a commercially available ELISA kit. Placental mitochondrial content was determined by real-time PCR. Results Cord blood betatrophin levels were increased in the gestational diabetes mellitus (GDM) group compared with the normoglycemic group. Furthermore, betatrophin levels were positively correlated with maternal gestational 2h post-OGTT glucose, cord blood insulin, HOMA-IR, and inversely correlated with placental mitochondrial content. Conclusions Cord blood betatrophin may function as a potential biomarker of maternal intrauterine hyperglycemia and fetal insulin resistance, which may presage for long-term metabolic impact of GDM on offspring. PMID:27196053

  4. Women’s experiences of factors that facilitate or inhibit gestational diabetes self-management

    PubMed Central

    2012-01-01

    Background Gestational diabetes rates have increased dramatically in the past two decades and this pattern of increase appears to relate primarily to the obesity epidemic, older maternal age and migration from world areas of high GDM risk. Women from disadvantaged and migrant backgrounds are most at risk of developing and of mismanaging this condition. The aim of the study was to explore the factors that facilitated or inhibited gestational diabetes self-management among women in a socially deprived area. Methods Fifteen pregnant women, with a diagnosis of gestational diabetes, were purposively recruited for this study. Qualitative semi structured interviews and 1 focus group were conducted when participants were approximately 28–38 weeks gestation. The study’s theoretical framework was based on interpretative phenomenology and data was analysed using a thematic analysis approach. Results Women in this study identified a number of factors that complicated their task of GDM self-management. Barriers included: (1) time pressures; (2) physical constraints; (3) social constraints; (4) limited comprehension of requirements, and (5) insulin as an easier option. Factors facilitating GDM self-management included: thinking about the baby and psychological support from partners and families. Conclusion Women from low socio economic and migrant backgrounds often struggle to comprehend GDM self-management requirements. To improve adherence to management plans, these women require educational and supportive services that are culturally appropriate and aimed at a low level of literacy. PMID:22988897

  5. Gestational Gigantomastia Complicating Pregnancy: A Case Report and Review of the Literature.

    PubMed

    Rezai, Shadi; Nakagawa, Jenna T; Tedesco, John; Chadee, Annika; Gottimukkala, Sri; Mercado, Ray; Henderson, Cassandra E

    2015-01-01

    Background. Gestational gigantomastia is a rare disorder without clear etiology or well-established risk factors. Several pathogenic mechanisms contributing to the disease process have been proposed, all of which can lead to a similar phenotype of breast hypertrophy. Case. A 28-year-old Guinean woman presented at 37 weeks of gestation with bilateral gigantomastia, mastalgia, peau d'orange, and back pain. Prolactin levels were 103.3 μg/L (with a normal reference value for prolactin in pregnancy being 36-372 μg/L). The patient was treated with bromocriptine (2.5 mg twice daily), scheduled for a repeat cesarean, and referred to surgery for bilateral mammoplasty. Conclusion. Gestational gigantomastia is a rare disorder, characterized by enlargement and hypertrophy of breast tissue. Our patient presented with no endocrine or hematological abnormalities, adding to a review of the literature for differential diagnoses, workup, and management of cases of gestational gigantomastia with normal hormone levels. PMID:26713166

  6. Gestational Gigantomastia Complicating Pregnancy: A Case Report and Review of the Literature

    PubMed Central

    Rezai, Shadi; Nakagawa, Jenna T.; Tedesco, John; Chadee, Annika; Gottimukkala, Sri; Mercado, Ray; Henderson, Cassandra E.

    2015-01-01

    Background. Gestational gigantomastia is a rare disorder without clear etiology or well-established risk factors. Several pathogenic mechanisms contributing to the disease process have been proposed, all of which can lead to a similar phenotype of breast hypertrophy. Case. A 28-year-old Guinean woman presented at 37 weeks of gestation with bilateral gigantomastia, mastalgia, peau d'orange, and back pain. Prolactin levels were 103.3 μg/L (with a normal reference value for prolactin in pregnancy being 36–372 μg/L). The patient was treated with bromocriptine (2.5 mg twice daily), scheduled for a repeat cesarean, and referred to surgery for bilateral mammoplasty. Conclusion. Gestational gigantomastia is a rare disorder, characterized by enlargement and hypertrophy of breast tissue. Our patient presented with no endocrine or hematological abnormalities, adding to a review of the literature for differential diagnoses, workup, and management of cases of gestational gigantomastia with normal hormone levels. PMID:26713166

  7. Circulating endothelial progenitor cells in women with gestational alterations of glucose tolerance.

    PubMed

    Penno, Giuseppe; Pucci, Laura; Lucchesi, Daniela; Lencioni, Cristina; Iorio, Maria Carla; Vanacore, Renato; Storti, Eugenia; Resi, Veronica; Di Cianni, Graziano; Del Prato, Stefano

    2011-07-01

    Endothelial progenitor cells (EPCs) play a role in angiogenesis during pregnancy. The aim of this study was to evaluate circulating EPCs in pregnant women with gestational alterations of glucose tolerance. Glucose tolerance, insulin sensitivity and β-cell function were derived from oral glucose tolerance tests in 23 women with normal glucose tolerance (NGT), 18 with gestational impaired glucose tolerance (GIGT) and 24 with gestational diabetes mellitus (GDM). Circulating cells expressing CD34 in combination with CD133, kinase insert domain receptor (KDR) or both were quantified by flow cytometry. Women with GIGT and GDM had lower CD34(+)KDR(+) and CD34(+)CD133( +)KDR(+) cells at 27±3.2 weeks' gestation compared with NGT (ANOVA p<0.02 for both). CD34(+)KDR(+) and CD34(+)CD133(+)KDR(+) cells were inversely correlated with the area-under-the-glucose-curve (p<0.005, for both) and positively to insulin secretion-sensitivity index (p<0.05, for both). Alterations of glucose tolerance during pregnancy are associated with a decrease in EPCs. Hyperglycaemia might exert a direct effect on depletion of EPCs. PMID:21653675

  8. a week in space

    NASA Astrophysics Data System (ADS)

    collette, christian

    2016-04-01

    COLLETTE Christian Institut Saint Laurent Liège Belgium. I am a science teacher at a technical high school. Generally, my students don't come from a privileged social background and are not particularly motivated for studies. For 10 years, I organize, for one of my sections, a spatial (and special) school year that ends in a spatial week. Throughout this year, with the help of my colleagues, I will introduce into all themes a lot of concepts relating to space. French, history, geography, English, mathematics, technical courses, sciences, and even gymnastics will be training actors in space culture. In spring, I will accompany my class in the Euro Space Center (Redu- Belgium) where we will live one week 24 hours on "like astronauts" One third of the time is dedicated to astronaut training (moonwalk, remote manipulator system, mission simulation, weightless wall, building rockets, satellites, etc.), One third to more intellectual activities on space (lectures, research, discovery of the outside run) the last one third of time in outside visits (museums, site of ESA-Redu) or in movies about space (October sky, Apollo 13, etc.) During this year, the profits, so educational as human, are considerable!

  9. The Relationship of Objectively Measured Physical Activity and Sedentary Behaviour with Gestational Weight Gain and Birth Weight

    PubMed Central

    Ruifrok, Anneloes E.; Althuizen, Ellen; Oostdam, Nicolette; van Mechelen, Willem; de Groot, Christianne J. M.; van Poppel, Mireille N. M.

    2014-01-01

    Objective. To evaluate the relationship of physical activity (PA) and sedentary behaviour with gestational weight gain (GWG) and birth weight. Design. Combined data from two prospective studies: (1) nulliparous pregnant women without BMI restrictions and (2) overweight and obese pregnant women at risk for gestational diabetes. Methods. Daily PA and sedentary behaviour were measured with an accelerometer around 15 and at 32–35 weeks of gestation. The association between time spent in moderate-to-vigorous PA (MVPA) and in sedentary activities with GWG and birth weight was determined. Main outcome measures were GWG between 15 and 32 weeks of gestation, average GWG per week, and birth weight. Results. We studied 111 women. Early in pregnancy, 32% of women spent ≥30 minutes/day in at least moderate PA versus 12% in late pregnancy. No significant associations were found between time spent in MVPA or sedentary behaviour with GWG or birth weight. Conclusions. We found no relation between MVPA and sedentary behaviour with GWG or birth weight. The small percentage of women meeting the recommended levels of PA indicates the need to inform and support pregnant women to maintain regular PA, as there seems to be no adverse effect on birth weight and maintaining PA increases overall health. PMID:25309754

  10. Presumed and definite bacteremia in extremely low gestational age newborns

    PubMed Central

    Patel, Sonal; Dammann, Olaf; Martin, Camilia R.; Allred, Elizabeth N.; Leviton, Alan

    2010-01-01

    Aim To explore risk patterns for presumed and definite, early and late neonatal bacteremia. Methods We studied 1106 ELGANs who survived until postnatal day 28. We defined early definite bacteremia as a positive bacterial culture in the first week and definite late bacteremia as a positive bacterial culture in week 2, 3 or 4. Bacteremia was presumed if antibiotics were given for more than 72 hours despite negative blood cultures. Results Risk patterns did not differ much for presumed and definite bacteremia in the first postnatal month. While maternal and pregnancy characteristics were associated with early bacteremia, neonatal co-morbidities, especially NEC, were the main antecedents/correlates of late bacteremia. All four categories of bacteremia were associated with younger gestational age and lower birth weight. Infants with presumed and definite bacteremia had similar distributions of days of ventilation and oxygenation. Conclusion Definite and presumed late bacteremia have rather similar risk patterns, while those of early and late bacteremia differ appreciably. PMID:20712830

  11. Special issue containing papers presented at the 12th IAEA Technical Meeting on Energetic Particles in Magnetic Confinement Systems (7-11 September 2011) Special issue containing papers presented at the 12th IAEA Technical Meeting on Energetic Particles in Magnetic Confinement Systems (7-11 September 2011)

    NASA Astrophysics Data System (ADS)

    Berk, H. L.

    2012-09-01

    The topic of the behaviour of energetic alpha particles in magnetic fusion confined plasmas is perhaps the ultimate frontier plasma physics issue that needs to be understood in the quest to achieve controlled power from the fusion reaction in magnetically confined plasmas. The partial pressure of alpha particles in a burning plasma will be ~5-10% of the total pressure and under these conditions the alpha particles may be prone to develop instability through Alfvénic interaction. This may lead, even with moderate alpha particle loss, to a burn quench or severe wall damage. Alternatively, benign Alfvénic signals may allow the vital information to control a fusion burn. The significance of this issue has led to extensive international investigations and a biannual meeting that began in Kyiv in 1989, followed by subsequent meetings in Aspenäs (1991), Trieste (1993), Princeton (1995), JET/Abingdon (1997), Naka (1999), Gothenburg (2001), San Diego (2003), Takayama (2005), Kloster Seeon (2007) and Kyiv (2009). The meeting was initially entitled 'Alpha Particles in Fusion Research' and then was changed during the 1997 meeting to 'Energetic Particles in Magnetic Confinement Systems' in appreciation of the need to study the significance of the electron runaway, which can lead to the production of energetic electrons with energies that can even exceed the energy produced by fusion products. This special issue presents some of the mature interesting work that was reported at the 12th IAEA Technical Meeting on Energetic Particles in Magnetic Confinement Systems, which was held in Austin, Texas, USA (7-11 September 2011). This meeting immediately followed a related meeting, the 5th IAEA Technical Meeting on Theory of Plasma Wave Instabilities (5-7 September 2011). The meetings shared one day (7 September 2011) with presentations relevant to both groups. The presentations from most of the participants, as well as some preliminary versions of papers, are available at the

  12. Comparative analysis of current diagnostic criteria for gestational diabetes mellitus

    PubMed Central

    Boyadzhieva, Mariya V; Atanasova, Iliana; Zacharieva, Sabina; Tankova, Tsvetalina; Dimitrova, Violeta

    2012-01-01

    Background To compare current guidelines for diagnosis of gestational diabetes mellitus (GDM) and to identify the ones that are the most relevant for application among pregnant Bulgarian population. Methods A total of 800 pregnant women at high risk for GDM underwent 75 g oral glucose tolerance test between 24 and 28 weeks of gestation as antenatal screening. The results were interpreted and classified according to the guidelines of the International Association of Diabetes and Pregnancy Study Groups (IADPSG), American Diabetes Association (ADA), Australasian Diabetes in Pregnancy Society, Canadian Diabetes Association, European Association for the Study of Diabetes, New Zealand Society for the study of Diabetes and World Health Organization. Results The application of different diagnostic criteria resulted in prevalences of GDM between 10.8% and 31.6%. Using any two sets of criteria, women who were classified differently varied between 0.1% and 21.1% (P < 0.001).The IADPSG criteria were the most inclusive criteria and resulted in the highest prevalence of GDM. There was a significant difference in the major metabolic parameters between GDM and control groups, regardless of which of the diagnostic criteria applied. GDM diagnosed according to all criteria resulted in increased proportion of delivery by caesarean section (CS). However, only ADA and IADPSG criteria identified both increased macrosomia (odds ratio, 2.36; 2.29) and CS rate. Conclusion The need for GDM screening is indisputable. In our view, the new IADPSG guidelines offer a unique opportunity for a unified national and global approach to GDM.

  13. Preterm or Not – An Evaluation of Estimates of Gestational Age in a Cohort of Women from Rural Papua New Guinea

    PubMed Central

    Ome-Kaius, Maria; Mola, Glen; White, Lisa; Wangnapi, Regina A.; Rogerson, Stephen J.; Mueller, Ivo

    2015-01-01

    Background Knowledge of accurate gestational age is required for comprehensive pregnancy care and is an essential component of research evaluating causes of preterm birth. In industrialised countries gestational age is determined with the help of fetal biometry in early pregnancy. Lack of ultrasound and late presentation to antenatal clinic limits this practice in low-resource settings. Instead, clinical estimators of gestational age are used, but their accuracy remains a matter of debate. Methods In a cohort of 688 singleton pregnancies from rural Papua New Guinea, delivery gestational age was calculated from Ballard score, last menstrual period, symphysis-pubis fundal height at first visit and quickening as well as mid- and late pregnancy fetal biometry. Published models using sequential fundal height measurements and corrected last menstrual period to estimate gestational age were also tested. Novel linear models that combined clinical measurements for gestational age estimation were developed. Predictions were compared with the reference early pregnancy ultrasound (<25 gestational weeks) using correlation, regression and Bland-Altman analyses and ranked for their capability to predict preterm birth using the harmonic mean of recall and precision (F-measure). Results Average bias between reference ultrasound and clinical methods ranged from 0–11 days (95% confidence levels: 14–42 days). Preterm birth was best predicted by mid-pregnancy ultrasound (F-measure: 0.72), and neuromuscular Ballard score provided the least reliable preterm birth prediction (F-measure: 0.17). The best clinical methods to predict gestational age and preterm birth were last menstrual period and fundal height (F-measures 0.35). A linear model combining both measures improved prediction of preterm birth (F-measure: 0.58). Conclusions Estimation of gestational age without ultrasound is prone to significant error. In the absence of ultrasound facilities, last menstrual period and fundal

  14. Multiple gestations: some public policy issues.

    PubMed

    Jennings, P K; Callahan, J C

    2001-01-01

    Multiple gestations, or multifetal pregnancies, raise a number of significant policy questions concerning the well being of women and the well being of the children fetuses might become. Important questions for feminists pertain not only to multifetal pregnancy itself, but also to the medical interventions associated with these pregnancies. In this paper, we address the questions of how many embryos should be transferred in assisted reproduction, how many fetuses should remain in a multiple gestation, who should make these decisions, and the need to protect women from overexposure to exogenous hormones. Although we focus on assisted reproduction in the United States, we believe that our suggestions are applicable to other countries where the technology is comparable. PMID:11561995

  15. The Effect of Gestational and Lactational Age on the Human Milk Metabolome

    PubMed Central

    Sundekilde, Ulrik K.; Downey, Eimear; O’Mahony, James A.; O’Shea, Carol-Anne; Ryan, C. Anthony; Kelly, Alan L.; Bertram, Hanne C.

    2016-01-01

    Human milk is the ideal nutrition source for healthy infants during the first six months of life and a detailed characterisation of the composition of milk from mothers that deliver prematurely (<37 weeks gestation), and of how human milk changes during lactation, would benefit our understanding of the nutritional requirements of premature infants. Individual milk samples from mothers delivering prematurely and at term were collected. The human milk metabolome, established by nuclear magnetic resonance (NMR) spectroscopy, was influenced by gestational and lactation age. Metabolite profiling identified that levels of valine, leucine, betaine, and creatinine were increased in colostrum from term mothers compared with mature milk, while those of glutamate, caprylate, and caprate were increased in mature term milk compared with colostrum. Levels of oligosaccharides, citrate, and creatinine were increased in pre-term colostrum, while those of caprylate, caprate, valine, leucine, glutamate, and pantothenate increased with time postpartum. There were differences between pre-term and full-term milk in the levels of carnitine, caprylate, caprate, pantothenate, urea, lactose, oligosaccharides, citrate, phosphocholine, choline, and formate. These findings suggest that the metabolome of pre-term milk changes within 5–7 weeks postpartum to resemble that of term milk, independent of time of gestation at pre-mature delivery. PMID:27213440

  16. The Effect of Gestational and Lactational Age on the Human Milk Metabolome.

    PubMed

    Sundekilde, Ulrik K; Downey, Eimear; O'Mahony, James A; O'Shea, Carol-Anne; Ryan, C Anthony; Kelly, Alan L; Bertram, Hanne C

    2016-01-01

    Human milk is the ideal nutrition source for healthy infants during the first six months of life and a detailed characterisation of the composition of milk from mothers that deliver prematurely (<37 weeks gestation), and of how human milk changes during lactation, would benefit our understanding of the nutritional requirements of premature infants. Individual milk samples from mothers delivering prematurely and at term were collected. The human milk metabolome, established by nuclear magnetic resonance (NMR) spectroscopy, was influenced by gestational and lactation age. Metabolite profiling identified that levels of valine, leucine, betaine, and creatinine were increased in colostrum from term mothers compared with mature milk, while those of glutamate, caprylate, and caprate were increased in mature term milk compared with colostrum. Levels of oligosaccharides, citrate, and creatinine were increased in pre-term colostrum, while those of caprylate, caprate, valine, leucine, glutamate, and pantothenate increased with time postpartum. There were differences between pre-term and full-term milk in the levels of carnitine, caprylate, caprate, pantothenate, urea, lactose, oligosaccharides, citrate, phosphocholine, choline, and formate. These findings suggest that the metabolome of pre-term milk changes within 5-7 weeks postpartum to resemble that of term milk, independent of time of gestation at pre-mature delivery. PMID:27213440

  17. Impact of Early Screening for Gestational Diabetes on Perinatal Outcomes in High-Risk Women.

    PubMed

    Hong, Winston Y; Biggio, Joseph R; Tita, Alan; Harper, Lorie M

    2016-07-01

    Objective To examine the benefits of early gestational diabetes mellitus (GDM) screening in a high-risk population. Study Design Retrospective cohort of all singletons diagnosed with GDM with indications for early screening: GDM or macrosomia in a prior pregnancy or obesity. Subjects were classified as early (<20 weeks) or routine (>24 weeks) screening. Patients diagnosed with GDM were managed according to standard institutional protocols. Outcomes examined were cesarean delivery (CD), preeclampsia, large for gestational age (LGA), small for gestational age (SGA), macrosomia, and preterm birth (PTB). Results Subjects screened early were more likely to have had GDM in a prior pregnancy, hypertension, higher body mass index, and higher fasting glucose. Early and routine screening groups had similar incidences of CD (adjusted odds ratio [AOR] 0.95, 95% confidence interval [CI] 0.55-1.64), preeclampsia (AOR 0.84, 95% CI 0.38-1.83), LGA (AOR 0.90, 95% CI 0.51-1.72), SGA (AOR 0.38, 95% CI 0.13-1.13), and macrosomia (AOR 1.00, 95% CI 0.53-1.87). Subjects in the early screening group had a higher incidence of PTB (AOR 1.79, 95% CI 1.08-2.99). Conclusion We did not detect a benefit to early screening for women who met the criteria. The utility of early GDM screening requires evaluation in a prospective trial. PMID:26890436

  18. Gestational weight gain among Hispanic women.

    PubMed

    Sangi-Haghpeykar, Haleh; Lam, Kim; Raine, Susan P

    2014-01-01

    To describe gestational weight gain among Hispanic women and to examine psychological, social, and cultural contexts affecting weight gain. A total of 282 Hispanic women were surveyed post-partum before leaving the hospital. Women were queried about their prepregnancy weight and weight gained during pregnancy. Adequacy of gestational weight gain was based on guidelines set by the Institute of Medicine in 2009. Independent risk factors for excessive or insufficient weight gain were examined by logistic regression. Most women were unmarried (59 %), with a mean age of 28.4 ± 6.6 years and an average weight gain of 27.9 ± 13.3 lbs. Approximately 45 % of women had gained too much, 32 % too little, and only 24 % had an adequate amount of weight gain. The mean birth weight was 7.3, 7.9, and 6.8 lbs among the adequate, excessive, and insufficient weight gain groups. Among women who exercised before pregnancy, two-thirds continued to do so during pregnancy; the mean gestational weight gain of those who continued was lower than those who stopped (26.8 vs. 31.4 lbs, p = 0.04). Independent risk factors for excessive weight gain were being unmarried, U.S. born, higher prepregnancy body mass index, and having indifferent or negative views about weight gain. Independent risk factors for insufficient weight gain were low levels of support and late initiation of prenatal care. Depression, stress, and a woman's or her partner's happiness regarding pregnancy were unrelated to weight gain. The results of this study can be used by prenatal programs to identify Hispanic women at risk for excessive or insufficient gestational weight gain. PMID:23456347

  19. Epidemiology and biology of multiple gestations.

    PubMed

    Endres, Loraine; Wilkins, Isabelle

    2005-06-01

    Twins have always aroused interest and have been represented throughout history. Conjoined twins have caused even more sensation, the best-known pair being Chang and Eng Bunker, who were born in Thailand in 1811 and inspired the term Siamese twins. Recently, higher-order multiples have caused controversy, and there has been heavy media coverage of large-number deliveries, such as the McCaughey septuplets. In this article, we review the incidence, types, and causes of multiple gestations. PMID:15922784

  20. Ultrasound diagnosis of cephalopagus conjoined twin pregnancy at 29 weeks

    PubMed Central

    Sabih, D; Ahmad, E; Sabih, A; Sabih, Q

    2010-01-01

    The authors report a case of a cephalopagus conjoined twin that was diagnosed at 29 weeks of gestation despite the mother having had two ultrasounds done previously. The fetus had one head and face, fused thoraces, common umbilicus but had two pelvises and two sets of genitalia. The fetus had four normally formed legs and arms. Antenatal ultrasound images are supplemented by post natal photographs. A review of literature, clues to ultrasound diagnosis and possible causes of missing this significant abnormality until the 3rd trimester are discussed. PMID:21611074

  1. Rate of Gestational Diabetes Mellitus and Pregnancy Outcomes in Patients with Chronic Hypertension.

    PubMed

    Leon, Mateo G; Moussa, Hind N; Longo, Monica; Pedroza, Claudia; Haidar, Ziad A; Mendez-Figueroa, Hector; Blackwell, Sean C; Sibai, Baha M

    2016-07-01

    Objective This study aims to determine the rate of gestational diabetes mellitus (GDM) in pregnancies complicated by chronic hypertension and to compare the adverse outcomes in chronic hypertensive pregnancies with and without GDM. Study Design A secondary analysis from a multicenter trial of low-dose aspirin for preeclampsia prevention in women with chronic hypertension. The rate of GDM was evaluated among singleton pregnancies complicated with chronic hypertension and grouped according to their GDM status. Pregnancy outcomes and rates of preterm delivery < 35 weeks and < 32 weeks, preeclampsia, indicated preterm birth, small for gestational age, abruptio placentae, and perinatal death were compared between those with and without GDM. A subgroup analysis comparing women who developed superimposed preeclampsia with and without GDM was studied. Multivariate logistic-regression analysis was used to adjust for potentially confounding factors. Results A total of 763 women met the inclusion criteria: 129 (17%) developed GDM. Parity, race, maternal baseline blood pressure, antihypertensive drug use, and assignment to low-dose aspirin were not significantly different between the groups with and without GDM. Using univariate analysis, maternal age (33 vs. 24%, p = 0.03) and body mass index (88 vs. 57%, p < 0.001) were higher in those who had GDM, whereas the rate of preterm delivery < 32 weeks (12 vs. 5%, p = 0.02) was higher among those without GDM. Using logistic-regression analysis, the rate of composite adverse outcomes (adjusted odds ratio [aOR], 0.77; 95% confidence interval [CI], 0.41-1.47) that included indicated preterm birth, small for gestational age, abruptio placentae, and perinatal death showed no significant differences.Superimposed preeclampsia developed in 34 (26%) women with GDM and in 182 (29%) without GDM. When superimposed preeclampsia was present, it developed at an earlier gestational age among the group without GDM (35

  2. Neonatal lamb vigour is improved by feeding docosahexaenoic acid in the form of algal biomass during late gestation.

    PubMed

    Pickard, R M; Beard, A P; Seal, C J; Edwards, S A

    2008-08-01

    To determine whether feeding a sustainable, algal source of docosahexaenoic acid (DHA) to sheep during late pregnancy would improve neonatal lamb vigour, 48 English mule ewes, of known conception date, were divided into four treatment groups. For the last 9 weeks of gestation, ewes received one of two dietary supplements: either a DHA-rich algal biomass providing 12 g DHA/ewe per day, or a control supplement based on vegetable oil. The four dietary treatment groups (n = 12) were: control supplement for the duration of the trial (C), DHA supplement from 9 to 6 weeks before parturition (3 week), DHA supplement from 9 to 3 weeks before parturition (6 week) and DHA supplement for the duration of the trial (9 week). Dietary supplements were fed alongside grass silage and commercial concentrate. There was a tendency for gestation length to be extended with increased duration of DHA supplementation (P = 0.08). After parturition, the concentrations of eicosapentaenoic acid (EPA) and DHA in ewe and lamb plasma and colostrum were elevated in line with increased periods of DHA supplementation. Lambs from the 6-week and 9-week groups stood significantly sooner after birth than lambs from the C group (P < 0.05). These data show that neonatal vigour may be improved by the supplementation of maternal diets with DHA-rich algal biomass and that this beneficial effect depends upon the timing and/or duration of DHA allocation. PMID:22443731

  3. Risk of Autism Spectrum Disorders in Low Birth Weight and Small for Gestational Age Infants

    PubMed Central

    Lampi, Katja M.; Lehtonen, Liisa; Tran, Phuong Lien; Suominen, Auli; Lehti, Venla; Banerjee, P. Nina; Gissler, Mika; Brown, Alan S.; Sourander, Andre

    2012-01-01

    Objective To examine the relationship between birth weight, gestational age, small for gestational age (SGA), and three most common autism spectrum disorder (ASD) subtypes. Study design In this population-based case-control study conducted in Finland, 4713 cases born between 1987 and 2005 with ICD-diagnoses of childhood autism, Asperger syndrome or PDD, were ascertained from the Finnish Hospital Discharge Register. Four controls, individually matched on sex, date of birth, and place of birth, were selected from the Finnish Medical Birth Register for each case. Conditional logistic regression models were used to assess whether birth weight and gestational age information predicted ASD after controlling for maternal age, parity, smoking during pregnancy and psychiatric history, as well as for infant’s major congenital anomalies. Results Very low (<1500g) and moderately low (<2500g) birth weight, very low gestational age (less than 32 weeks), and SGA increased risk of childhood autism (adjusted OR 3.05, 95% CI 1.4–6.5; 1.57, 1.1–2.3; 2.51, 1.3–5.0 and 1.72, 1.1–2.6, respectively). Very low and moderately low birth weight, very low gestational age, and SGA were also associated with increase in PDD risk (OR 3.44, 95% CI 1.9–6.3; 1.81, 1.4–2.4; 2.46, 1.4–2.3 and 2.24, 1.7–3.0, respectively). No associations were found between the perinatal characteristics and Asperger syndrome. The increased risks persisted after controlling for selected potential confounders. Conclusions The finding that low birth weight, prematurity and SGA were related to childhood autism and PDD but not to Asperger syndrome suggests that prenatal factors related to these exposures may differ for these ASD subtypes, which may have preventive implications. PMID:22677565

  4. Application of seamless care service with multidisciplinary diagnosis and treatment in patients with gestational diabetes

    PubMed Central

    Jie, Shen-Qiu; Liang, Xiao; Hong, Pu; Wu, Dan; Ke, Wei-Lin

    2015-01-01

    Background: The objective of this article was to explore the effect of trinity seamless care service (TSCS) in patients with gestational diabetes with multidisciplinary diagnosis and treatment (MDT), and thus, to provide basis for improvement in the quality of patient care. Materials and methods: A total of 200 patients were recruited and randomly divided into observation group and control group with 100 cases in each group, who were diagnosed with gestational diabetes through oral glucose tolerance test (OGTT) at 24 to 28 weeks of gestation from September 2012 to September 2014. In order to control blood glucose and weight, patients in the control group received routine treatment and nursing after diagnosis, while those in the observation group received TSCS with MDT. Rate of insulin usage, weight changes and glycemic indexes before and after nursing were compared within the two groups during pregnancy. Results: Compared with the pregnant patients in the control group, the rate of those in the observation group who needed extra insulin to control blood glucose, or the change of body mass index during pregnancy (ΔBMI) ≥6 kg/m2 and less average weight gain prior to delivery was significantly lower (P<0.05). Glycemic indexes in the observation group after nursing were significantly lower than those in the control group (P<0.05). Incidences of cesarean delivery, polyhydramnios, gestational hypertension and postpartum hemorrhage in the observation group were significantly lower than those in the control group (P<0.05). Incidences of macrosomia, hyperbilirubinemia, fetal distress, stillbirth and teratogeny in the observation group were also significantly lower than those in the control group (P<0.05). Conclusion: Application of TSCS with MDT in patients with gestational diabetes helps to keep appropriate weight gain, control blood glucose by improving glycemic indexes, significantly reduce the incidences of maternal perinatal and neonatal complications and improve

  5. Clinical Values of Studying Kidney Elasticity with Virtual Touch Quantification in Gestational Hypertension Patients.

    PubMed

    Wang, Yi; Feng, Yujin; Yang, Xiaoyun; Zhang, Liyan; Zhang, Tongdi; Wang, Wengang

    2016-01-01

    BACKGROUND The aim of this study was to investigate the differences in shear wave velocity (SWV) in renal cortex, renal medulla, and renal sinuses between gestational hypertension and normal pregnant women. MATERIAL AND METHODS Ninety patients with gestational hypertension and 30 women with normal pregnancy were enrolled in this study. Kidney biopsy was performed within 6 weeks to 3 months postpartum to determine the pathological nature of renal injury. According to the classification criteria for gestational hypertension, the patients were divided into 3 groups. Gestational hypertension only patients were classified as Group A; patients with mild preeclampsia as group B; patients with severe preeclampsia as group C; normal pregnant women as a control group. Virtual Touch Quantification technique was used to measure renal shear wave velocity; blood pressure, urine analysis, and renal function were also tested. RESULTS There was no difference in renal function between patients in group A and the control group (p>0.05), but there was a significant difference in renal function among patients in group A, B, and C, and there was a significant difference in renal function between patients in group B and C versus control (p<0.05 for all comparisons). There was also a significant difference in SWV values of the renal cortex, renal medulla, and renal sinus between patients in group A, B, and C versus control group (p<0.05). CONCLUSIONS The SWV values of the renal cortex, renal medulla, and renal sinus in patients with gestational hypertension were smaller than those of normal pregnant women, and the more severe the kidney injury, the smaller the SWV value. PMID:26851959

  6. Evaluation of the normal fetal kidney length and its correlation with gestational age.

    PubMed

    Seilanian Toosi, Farrokh; Rezaie-Delui, Hossein

    2013-01-01

    A true estimation of gestational age (GA) plays an important role in quality maternity care and scheduling the labor date. This study aimed to evaluate the normal fetal kidney length (KL) and its correlation with GA. A cross-sectional study on 92 pregnant women between 8th and 10th week of gestation with normal singleton pregnancy underwent standard ultrasound fetal biometry and kidney length measurement. univariate and multivariate linear regression analysis was used to create a predictive equation to estimate GA on the KL and fetobiometry parameters. A significant correlation was found between GA and KL (r=0.83, P<0.002). The best GA predictor was obtained by combining head circumference, fetal biparietal diameter, femur length and KL with a standard error (SE) about 14.2 days. Our findings showed that KL measurements combination with other fetal biometric parameters could predict age of pregnancy with a better precision. PMID:23737313

  7. Maternal ambient air pollution exposure preconception and during early gestation and offspring congenital orofacial defects

    PubMed Central

    Zhu, Yeyi; Zhang, Cuilin; Liu, Danping; Grantz, Katherine L.; Wallace, Maeve; Mendola, Pauline

    2015-01-01

    Background Maternal air pollution exposure has been related to orofacial clefts but the literature is equivocal. Potential chronic preconception effects have not been studied. Objectives Criteria air pollutant exposure during three months preconception and gestational weeks 3–8 was studied in relation to orofacial defects. Methods Among 188,102 live births and fetal deaths from the Consortium on Safe Labor (2002–2008), 63 had isolated cleft palate (CP) and 159 had isolated cleft lip with or without cleft palate (CL ± CP). Exposures were estimated using a modified Community Multiscale Air Quality model. Logistic regression with generalized estimating equations adjusted for site/region and maternal demographic, lifestyle and clinical factors calculated the odds ratio (OR) and 95% CI per interquartile increase in each pollutant. Results Preconception, carbon monoxide (CO; OR = 2.24; CI: 1.21, 4.16) and particulate matter (PM) ≤10 μm (OR = 1.72; CI: 1.12, 2.66) were significantly associated with CP, while sulfur dioxide (SO2) was associated with CL ± CP (OR = 1.93; CI: 1.16, 3.21). During gestational weeks 3–8, CO remained a significant risk for CP (OR = 2.74; CI: 1.62, 4.62) and nitrogen oxides (NOx; OR = 3.64; CI: 1.73, 7.66) and PM ≤2.5 μm (PM2.5; OR = 1.74; CI: 1.15, 2.64) were also related to the risk. Analyses by individual week revealed that positive associations of NOx and PM2.5 with CP were most prominent from weeks 3–6 and 3–5, respectively. Conclusions Exposure to several criteria air pollutants preconception and during early gestation was associated with elevated odds for CP, while CL ± CP was only associated with preconception SO2 exposure. PMID:26099933

  8. Impact of low-level gestational exposure to organophosphate pesticides on neurobehavior in early infancy: a prospective study

    PubMed Central

    2013-01-01

    Background National data suggest widespread gestational exposure to organophosphate pesticides (OPs) based on the detection of OP metabolites in the urine of pregnant women. Associations with early infant neurobehavior are largely understudied, with only two studies reporting abnormal reflexes in newborns in association with gestational exposure to OPs. Our objective was to utilize biological markers of OP metabolites in pregnant women and a comprehensive assessment of infant neurobehavior to determine the association of gestational exposure to OPs with neurobehavioral outcomes during early infancy. Methods Among a cohort of 350 mother/infant pairs, we measured six common dialkylphosphate metabolites of OP pesticides in maternal urine, at two times during pregnancy (16 w & 26 w gestation), then calculated aggregate concentrations of diethylphosphate, dimethylphosphate, and total dialkyphosphate metabolites. We measured infant neurobehavior at about five weeks of age using the NICU Network Neurobehavioral Scale (NNNS), a comprehensive assessment of neurobehavior in young infants. Analyses of associations between gestational exposure to OPs and neurobehavior at five weeks included multiple linear and logistic regression. Results After adjustment for covariates, higher creatinine-corrected urinary concentrations of diethylphosphate metabolites were associated with improved attention and reduced lethargy and hypotonia in young infants. Higher creatinine-corrected urinary concentrations of total dialkylphosphate metabolites were associated with fewer signs of autonomic stress. Women who were white, married, had advanced education, and reported more frequent consumption of fresh fruits and vegetables had higher concentrations of OP metabolites during pregnancy. Conclusions In this sample of pregnant women whose urinary concentrations of dialkylphosphate metabolites are representative of national exposure levels, we found no detrimental effects of gestational exposure to

  9. Macrosomia Predictors in Infants Born to Cuban Mothers with Gestational Diabetes.

    PubMed

    Cruz, Jeddú; Grandía, Raiden; Padilla, Liset; Rodríguez, Suilbert; Hernández García, Pilar; Lang Prieto, Jacinto; Márquez-Guillén, Antonio

    2015-07-01

    INTRODUCTION Fetal macrosomia is the most important complication in infants of women with diabetes, whether preconceptional or gestational. Its occurrence is related to certain maternal and fetal conditions and negatively affects maternal and perinatal outcomes. The definitive diagnosis is made at birth if a newborn weighs >4000 g. OBJECTIVE Identify which maternal and fetal conditions could be macrosomia predictors in infants born to Cuban mothers with gestational diabetes. METHODS A case-control study comprising 236 women with gestational diabetes who bore live infants (118 with macrosomia and 118 without) was conducted in the América Arias University Maternity Hospital, Havana, Cuba, during 2002-2012. The dependent variable was macrosomia (birth weight >4000 g). Independent maternal variables included body mass index at pregnancy onset, overweight or obesity at pregnancy onset, gestational age at diabetes diagnosis, pregnancy weight gain, glycemic control, triglycerides and cholesterol. Fetal variables examined included third-semester fetal abdominal circumference, estimated fetal weight at ≥28 weeks (absolute and percentilized by Campbell and Wilkin, and Usher and McLean curves). Chi square was used to compare continuous variables (proportions) and the student t test (X ± SD) for categorical variables, with significance threshold set at p <0.05. ORs and their 95% CIs were calculated. RESULTS Significant differences between cases and controls were found in most variables studied, with the exception of late gestational diabetes diagnosis, total fasting cholesterol and hypercholesterolemia. The highest OR for macrosomia were for maternal hypertriglyceridemia (OR 4.80, CI 2.34-9.84), third-trimester fetal abdominal circumference >75th percentile (OR 7.54, CI 4.04-14.06), and estimated fetal weight >90th percentile by Campbell and Wilkin curves (OR 4.75, CI 1.42-15.84) and by Usher and McLean curves (OR 8.81, CI 4.25-18.26). CONCLUSIONS Most variables assessed

  10. Increased Maternal and Cord Blood Betatrophin in Gestational Diabetes

    PubMed Central

    Wawrusiewicz-Kurylonek, Natalia; Telejko, Beata; Kuzmicki, Mariusz; Sobota, Angelika; Lipinska, Danuta; Pliszka, Justyna; Raczkowska, Beata; Kuc, Pawel; Urban, Remigiusz; Szamatowicz, Jacek; Kretowski, Adam; Laudanski, Piotr; Gorska, Maria

    2015-01-01

    Aim The aim of the study was to compare maternal and cord blood levels of betatrophin – a new peptide potentially controlling beta cell growth - as well as in its mRNA expression in subcutaneous adipose tissue, visceral adipose tissue and placental tissue obtained from pregnant women with normal glucose tolerance (NGT) and gestational diabetes (GDM). Methods Serum betatrophin and irisin concentrations were measured by ELISA in 93 patients with GDM and 97 women with NGT between 24 and 28 week of gestation. Additionally, maternal and cord blood betatrophin and irisin, as well as their genes (C19orf80 and Fndc5) expression were evaluated in 20 patients with GDM and 20 women with NGT at term. Results In both groups, serum betatrophin concentrations were significantly higher in the patients with GDM than in the controls (1.91 [1.40-2.60] ng/ml vs 1.63 [1.21-2.22] ng/ml, p=0.03 and 3.45 [2.77-6.53] ng/ml vs 2.78 [2.16-3.65] ng/ml, p=0.03, respectively). Cord blood betatrophin levels were also higher in the GDM than in the NGT group (20.43 [12.97-28.80] ng/ml vs 15.06 [10.11-21.36] ng/ml, p=0.03). In both groups betatrophin concentrations in arterial cord blood were significantly higher than in maternal serum (p=0.0001). Serum irisin levels were significantly lower in the patients with GDM (1679 [1308-2171] ng/ml) than in the healthy women between 24 and 28 week of pregnancy (1880 [1519-2312] ng/ml, p=0.03). Both C19orf80 and Fndc5 mRNA expression in fat and placental tissue did not differ significantly between the groups studied. Conclusions Our results suggest that an increase in maternal and cord blood betatrophin might be a compensatory mechanism for enhanced insulin demand in GDM. PMID:26115519

  11. Elective Delivery Before 39 Weeks

    MedlinePlus

    ... Delivery, and Postpartum Care Elective Delivery Before 39 Weeks • What is a “medically indicated” delivery? • What is ... the baby grow and develop during the last weeks of pregnancy? • What are the risks for babies ...

  12. Patterns of Respiratory Disease During the First 2 Postnatal Weeks in Extremely Premature Infants

    PubMed Central

    Laughon, Matthew; Allred, Elizabeth N.; Bose, Carl; O'Shea, T. Michael; Van Marter, Linda J.; Ehrenkranz, Richard A.; Leviton, Alan

    2009-01-01

    Background Pulmonary disease among infants of <28 weeks' gestation (extremely low gestational age newborns) often has the following pattern: the infant starts out with little need for supplemental oxygen and ventilatory support in the first postnatal week but then has pulmonary deterioration in the second postnatal week, with an increased need for supplemental oxygen and respiratory support. We evaluated the antecedents and correlates of patterns of early lung disease, with particular emphasis on pulmonary deterioration, in a large cohort study (the Extremely Low Gestational Age Newborn [ELGAN] study). Patients and Methods We examined data collected prospectively on 1340 infants born between 2002 and 2004 at 23 to 27 completed weeks of gestation and who survived to 14 days. Pulmonary deterioration was defined as receipt of fraction of inspired oxygen <0.23 on any day between days 3 and 7 and receipt of fraction of inspired oxygen ≥ 0.25 on day 14. Results One fifth (20%) of the infants had consistently low fraction of inspired oxygen, approximately two fifths (38%) had pulmonary deterioration, and the remaining approximately two fifths (43%) had consistently high fraction of inspired oxygen (early and persistent lung dysfunction). Compared with infants who had consistently low fraction of inspired oxygen, infants who experienced pulmonary deterioration had lower gestational ages and lower birth weights, had higher scores for neonatal acute physiology, and received more intensive modes of respiratory support. Gender, multifetal pregnancy, cesarean delivery, antenatal steroids, chorioamnionitis, and funisitis were not associated with pulmonary deterioration. The incidence of chronic lung disease, defined as oxygen therapy at 36 weeks' postmenstrual age, was 17% in the consistently low fraction of inspired oxygen group, 51% in the pulmonary deterioration group, and 67% in the early and persistent pulmonary dysfunction group. The incidence of death in these 3 groups

  13. Rate of gestational weight gain, pre-pregnancy body mass index and preterm birth subtypes: a retrospective cohort study from Peru

    PubMed Central

    Carnero, AM; Mejía, CR; García, PJ

    2014-01-01

    Objective To examine the shape (functional form) of the association between the rate of gestational weight gain, pre-pregnancy body mass index (BMI), and preterm birth and its subtypes. Design Retrospective cohort study. Setting National reference obstetric centre in Lima, Peru. Population Pregnant women who delivered singleton babies during the period 2006–2009, resident in Lima, and beginning prenatal care at ≤12 weeks of gestation (n = 8964). Methods Data were collected from the centre database. The main analyses consisted of logistic regression with fractional polynomial modelling. Main outcome measures Preterm birth and its subtypes. Results Preterm birth occurred in 12.2% of women, being mostly idiopathic (85.7%). The rate of gestational weight gain was independently associated with preterm birth, and the shape of this association varied by pre-pregnancy BMI. In women who were underweight, the association was linear (per 0.1 kg/week increase) and protective (OR 0.88; 95% CI 0.82–1.00). In women of normal weight or who were overweight, the association was U-shaped: the odds of delivering preterm increased exponentially with rates <0.10 or >0.66 kg/week, and <0.04 or >0.50 kg/week, respectively. In women who were obese, the association was linear, but nonsignificant (OR 1.01; 95% CI 0.95–1.06). The association described for preterm birth closely resembled that of idiopathic preterm birth, although the latter was stronger. The rate of gestational weight gain was not associated with indicated preterm birth or preterm prelabour rupture of membranes. Conclusions In Peruvian pregnant women starting prenatal care at ≤12 weeks of gestation, the rate of gestational weight gain is independently associated with preterm birth, mainly because of its association with idiopathic preterm birth, and the shape of both associations varies by pre-pregnancy BMI. PMID:22607522

  14. [Reorganization of the procedures and the tasks of the responsible ethics committees after the 12th AMG amendment. Concepts of the permanent working group of the medical ethics committees in Germany].

    PubMed

    Wessler, I; Burger, R; Doppelfeld, E

    2005-02-01

    Since 12(th) of August 2004 the EU Directive 2001/20/EG has been implemented into the national law. The 12th AMG amendment of 30 July 2004 and the good clinical practice decree on the conduct of clinical trials on drugs for human use of 9 August 2004 have been authorized and must be considered for new clinical trials with investigational medical products (drugs). The scope of the changes are to increase the quality of clinical trials and to continue the process of harmonization within the European Community. Based on the new law the sponsor has to apply for approval by the competent authority and for a favourable opinion by the responsible ethics committee. Both procedures are independent; a favourable opinion of the responsible ethics committee is a necessary condition before starting the trial. Thus, the role of the ethics committees has been changed; the committees are considered as an institution comparable to an authority to protect the rights and safety of human subjects involved in clinical trials. The permanent working group of the medical ethics committees in Germany has established a procedure to meet these requirements, particularly in the case of multicentre clinical trials, where only a single opinion shall be given for each member state. This article describes this procedure (application, process of ethical consideration among the leading and local ethics committees in multicentre trials, responsibilities during the trial). PMID:15726456

  15. Two-hit model of brain damage in the very preterm newborn: small for gestational age and postnatal systemic inflammation

    PubMed Central

    Leviton, Alan; Fichorova, Raina N.; O’Shea, T. Michael; Kuban, Karl; Paneth, Nigel; Dammann, Olaf; Allred, Elizabeth N.

    2013-01-01

    Background We sought to disentangle the contributions of perinatal systemic inflammation and small for gestational age (SGA) to the occurrence of low Bayley Mental Development Indices (MDIs) at age 2 years. Method We measured the concentration of 25 inflammation-related proteins in blood obtained during the first 2 postnatal weeks from 805 infants who were born before the 28th week of gestation and who had MDI measurements at age 2 years and were able to walk independently. Results SGA newborns who did not have systemic inflammation (a concentration of an inflammation-related protein in the top quartile for gestational age on 2 days a week apart) were at greater risk of an MDI < 55, but not 55–69, than their peers who had neither SGA nor systemic inflammation. SGA infants who had elevated blood concentrations of IL-1beta, TNF-alpha, or IL-8 during the first two postnatal weeks were at even higher risk of an MDI < 55 than their SGA peers without systemic inflammation and of their non-SGA peers with systemic inflammation. Conclusion SGA appears to place very preterm newborns at increased risk of a very low MDI. Systemic inflammation adds considerably to the increased risk. PMID:23364171

  16. Risk of Vaginal Infections at Early Gestation in Patients with Diabetic Conditions during Pregnancy: A Retrospective Cohort Study

    PubMed Central

    Marschalek, Julian; Farr, Alex; Kiss, Herbert; Hagmann, Michael; Göbl, Christian S; Trofaier, Marie-Louise; Kueronya, Verena; Petricevic, Ljubomir

    2016-01-01

    Pregnant women with gestational diabetes mellitus (GDM) are reported to be at increased risk for infections of the genital tract. This study aimed to compare the prevalence of asymptomatic bacterial vaginosis (BV) and Candida colonization at early gestation between pregnant women with and without diabetic conditions during pregnancy. We included data from 8, 486 singleton pregnancies that underwent an antenatal infection screen-and-treat programme at our department. All women with GDM or pre-existing diabetes were retrospectively assigned to the diabetic group (DIAB), whereas non-diabetic women served as controls (CON). Prevalence for BV and Candida colonization was 9% and 14% in the DIAB group, and 9% and 13% in the CON group, respectively (n.s.). No significant difference regarding stillbirth and preterm delivery (PTD), defined as a delivery earlier than 37 + 0 (37 weeks plus 0 days) weeks of gestation was found. We could not find an increased risk of colonization with vaginal pathogens at early gestation in pregnant women with diabetes, compared to non-diabetic women. Large prospective studies are needed to evaluate the long-term risk of colonization with vaginal pathogens during the course of pregnancy in these women. PMID:27167850

  17. Chicken amyloid arthropathy: serum amyloid A, interleukin-1beta, interleukin-6, tumour necrosis factor-alpha and nitric oxide profile in acute phase (12th hour).

    PubMed

    Sevimli, A; Bülbül, T; Bülbül, A; Yagci, A

    2013-01-01

    Acute phase response (APR) is part of the early defense system, which is triggered by different stimuli including, infection, trauma, stres, inflammation and neoplasia. The APR complex is a reaction which induces homeostasis and recovery. In this research, serum amyloid A (SAA), interlaukin (IL)-1beta, IL-6, tumour necrosis factor alpha (TNF-alpha) and nitric oxide (NO) levels were measured 12 hours following injection. For this purpose, Thirty-two 5 weeks old laying chicken were allocated into four groups and intra-articular injections of Freund's adjuvant were used to induce amylod arthropathy in Groups II, III and IV. Vitamin A in group II, and methylprednisolone in group IV were added to enhance and to reduce the severity of amyloidosis, respectively. At the end of the research, it was observed that TNF-alpha and NO increased significantly (P < 0.05) in vitamin A and methylprednisolone groups whereas SAA decreased significantly (P < 0.05) in all groups. It was also observed that IL-6 increased (P < 0.05) in vitamin A group and decreased in all other gorups however, IL-1beta decreased in vitamin A and methylprednisolone groups, while it was increased in the control group. The results of this study suggest that there is a positive correlation between serum TNF-alpha levels in acute and chronic phase in chickens with amyloid arthropathy. PMID:23971191

  18. [Gestational and non-gestational factors for perinatal programming of insulin resistance].

    PubMed

    Varadinova, M; Metodieva, R; Boyadjieva, N

    2014-01-01

    Insulin resistance is well known problem in type 2 diabetes mellitus (T2DM). Various factors play roles in the mechanisms of prenatal programming of insulin resistance. Gestational or non-gestational factors are illustrated in the present paper. Adipocytes (fat cells) produce at least 50 proteins (adipokines; peptides, cytokines, etc.), and a large part of them are involved in prenatal development of insulin resistance. The role of pro-inflammatory cytokines as the tumor necrosis factor 1 (TNF alpha), interleukin-6 (IL-6) and interleukin-1 beta (IL-1 beta) is documented. Leptin from adipocytes as well as from the placenta is involved in pathology of metabolism and plays a role as a gestational factor for the prenatal insulin resistance and the risk for T2DM. Epigenetic mechanisms as the methylation of DNA and histones, the acetylation of histones are documented for prenatal development of insulin resistance. Epigenetic modulations may explain the risk of T2DM for generations. New data indicated that the placenta does not produce adiponectin and it is also one of the important factors for the development of gestational diabetes and risk for the fetus. Taken together all factors documented in the present paper may predict the risk for prenatal T2DM. PMID:25558670

  19. Small for gestational age and exposure to particulate air pollution in the early-life environment of twins.

    PubMed

    Bijnens, Esmée M; Derom, Catherine; Gielen, Marij; Winckelmans, Ellen; Fierens, Frans; Vlietinck, Robert; Zeegers, Maurice P; Nawrot, Tim S

    2016-07-01

    Several studies in singletons have shown that maternal exposure to ambient air pollutants is associated with restricted fetal growth. About half of twins have low birth weight compared with six percent in singletons. So far, no studies have investigated maternal air pollution exposure in association with birth weight and small for gestational age in twins. We examined 4760 twins of the East Flanders Prospective Twins Survey (2002-2013), to study the association between in utero exposure to air pollution with birth weight and small for gestational age. Maternal particulate air pollution (PM10) and nitric dioxide (NO2) exposure was estimated using a spatial temporal interpolation method over various time windows during pregnancy. In the total group of twins, we observed that higher PM10 and NO2 exposure during the third trimester was significantly associated with a lower birth weight and higher risk of small for gestational age. However, the association was driven by moderate to late preterm twins (32-36 weeks of gestation). In these twins born between 32 and 36 weeks of gestation, birth weight decreased by 40.2g (95% CI: -69.0 to -11.3; p=0.006) and by 27.3g (95% CI: -52.9 to -1.7; p=0.04) in association for each 10µg/m³ increment in PM10 and NO2 concentration during the third trimester. The corresponding odds ratio for small for gestational age were 1.68 (95% CI: 1.27-2.33; p=0.0003) and 1.51 (95% CI: 1.18-1.95; p=0.001) for PM10 or NO2, respectively. No associations between air pollution and birth weight or small for gestational age were observed among term born twins. Finally, in all twins, we found that for each 10µg/m³ increase in PM10 during the last month of pregnancy the within-pair birth weight difference increased by 19.6g (95% CI: 3.7-35.4; p=0.02). Assuming causality, an achievement of a 10µg/m³ decrease of particulate air pollution may account for a reduction by 40% in small for gestational age, in twins born moderate to late preterm. PMID

  20. Does Chocolate Intake During Pregnancy Reduce the Risks of Preeclampsia and Gestational Hypertension?

    PubMed Central

    Saftlas, Audrey F.; Triche, Elizabeth W.; Beydoun, Hind; Bracken, Michael B.

    2010-01-01

    Purpose Chocolate consumption is associated with favorable levels of blood pressure and other cardiovascular disease risk markers. We analyzed a prospective cohort study to determine if regular chocolate intake during pregnancy is associated with reduced risks of preeclampsia and gestational hypertension (GH). Methods Subjects were recruited from 13 prenatal care practices in Connecticut (1988-1991). In-person interviews were administered at <16 weeks gestation to ascertain risk factors for adverse pregnancy outcomes. Hospital delivery and prenatal records were abstracted to classify preeclampsia (n=58), GH (n=158), and normotensive pregnancies (n=2351). Chocolate consumption (servings/week) during the 1st and 3rd trimesters was ascertained at initial interview and immediately postpartum, respectively. Consumers of <1 serving/week comprised the referent group. Adjusted odds ratios (aOR) were estimated using logistic regression. Results Chocolate intake was more frequent among normotensives (80.7%) than preeclamptics (62.5%) or GH women (75.8%), and associated with reduced odds of preeclampsia (1st trimester: aOR=0.55, 95% CI: 0.32-0.95; 3rd trimester: aOR=0.56, 95% CI: 0.32-0.97). Only 1st trimester intake was associated with reduced odds of GH (aOR=0.65, 95% CI: 0.45-0.87). Conclusions These findings provide additional evidence of the benefits of chocolate. Prospective studies are needed to confirm and delineate protective effects of chocolate intake on risk of preeclampsia. PMID:20609337

  1. Gestational bisphenol A exposure and testis development

    PubMed Central

    Williams, Cecilia; Bondesson, Maria; Krementsov, Dimitry N; Teuscher, Cory

    2015-01-01

    Virtually all humans are exposed to bisphenol A (BPA). Since BPA can act as a ligand for estrogen receptors, potential hazardous effects of BPA should be evaluated in the context of endogenous estrogenic hormones. Because estrogen is metabolized in the placenta, developing fetuses are normally exposed to very low endogenous estrogen levels. BPA, on the other hand, passes through the placenta and might have distinct adverse consequences during the sensitive stages of fetal development. Testicular gametogenesis and steroidogenesis begin early during fetal development. These processes are sensitive to estrogens and play a role in determining the number of germ stem cells, sperm count, and male hormone levels in adulthood. Although studies have shown a correlation between BPA exposure and perturbed reproduction, a clear consensus has yet to be established as to whether current human gestational BPA exposure results in direct adverse effects on male genital development and reproduction. However, studies in animals and in vitro have provided direct evidence for the ability of BPA exposure to influence male reproductive development. This review discusses the current knowledge of potential effects of BPA exposure on male reproductive health and whether gestational exposure adversely affects testis development. PMID:26167515

  2. Gestational Trophoblastic Disorders: An Update in 2015

    PubMed Central

    Stevens, F. T.; Katzorke, N.; Tempfer, C.; Kreimer, U.; Bizjak, G. I.; Fleisch, M. C.; Fehm, T. N.

    2015-01-01

    Gestational trophoblastic diseases (GTD) are a group of pregnancy-related disorders representing rare human tumours. They encompass premalignant disorders including complete (CHM), partial hydatidiform mole (PHM), exaggerated placental site (EPS), and placental-site nodule (PSN) as well as malignant disorders (also known as “gestational trophoblastic neoplasia [GTN]”) including invasive mole, choriocarcinoma (CC), placenta-site trophoblastic tumour (PSTT), and epitheloid trophoblastic tumours (ETT) (Fig. 1). Originally, GTD develop from abnormal proliferation of trophoblastic tissue and form botryoid arranged vesicles. Premalignant moles are usually treated by suction curettage while persistent and recurrent moles and malignant forms require systemic therapy with methotrexate or combination chemotherapy consisting of etoposide, actimomycin D, methotrexate, vincristine, and cyclophosphamide (EMA-CO). β-human chorion gonadotropin (β-hCG) plays a crucial role in diagnosis and monitoring therapeutic effects. Since the definitive diagnosis cannot be obtained by histology in most cases, persistent or recurrent disease is diagnosed by elevated or persistent serum levels of β-hCG. While curing rates are described to be as high as 98 %, GTD may initially present, recur, or end up as a metastasising systemic disease. This underlines the importance of a regular and consistent follow-up after treatment. PMID:26556906

  3. Maternal obesity characterized by gestational diabetes increases the susceptibility of rat offspring to hepatic steatosis via a disrupted liver metabolome

    PubMed Central

    Pereira, Troy J; Fonseca, Mario A; Campbell, Kristyn E; Moyce, Brittany L; Cole, Laura K; Hatch, Grant M; Doucette, Christine A; Klein, Julianne; Aliani, Michel; Dolinsky, Vernon W

    2015-01-01

    Maternal obesity is associated with a high risk for gestational diabetes mellitus (GDM), which is a common complication of pregnancy. The influence of maternal obesity and GDM on the metabolic health of the offspring is poorly understood. We hypothesize that GDM associated with maternal obesity will cause obesity, insulin resistance and hepatic steatosis in the offspring. Female Sprague-Dawley rats were fed a high-fat (45%) and sucrose (HFS) diet to cause maternal obesity and GDM. Lean control pregnant rats received low-fat (LF; 10%) diets. To investigate the interaction between the prenatal environment and postnatal diets, rat offspring were assigned to LF or HFS diets for 12 weeks, and insulin sensitivity and hepatic steatosis were evaluated. Pregnant GDM dams exhibited excessive gestational weight gain, hyperinsulinaemia and hyperglycaemia. Offspring of GDM dams gained more weight than the offspring of lean dams due to excess adiposity. The offspring of GDM dams also developed hepatic steatosis and insulin resistance. The postnatal consumption of a LF diet did not protect offspring of GDM dams against these metabolic disorders. Analysis of the hepatic metabolome revealed increased diacylglycerol and reduced phosphatidylethanolamine in the offspring of GDM dams compared to offspring of lean dams. Consistent with altered lipid metabolism, the expression of CTP:phosphoethanolamine cytidylyltransferase, and peroxisomal proliferator activated receptor-α mRNA was reduced in the livers of GDM offspring. GDM exposure programs gene expression and hepatic metabolite levels and drives the development of hepatic steatosis and insulin resistance in young adult rat offspring. Key points Gestational diabetes mellitus is a common complication of pregnancy, but its effects on the offspring are poorly understood. We developed a rat model of diet-induced gestational diabetes mellitus that recapitulates many of the clinical features of the disease, including excessive gestational

  4. Preconception and early pregnancy air pollution exposures and risk of gestational diabetes mellitus

    SciTech Connect

    Robledo, Candace A.; Mendola, Pauline; Yeung, Edwina; Männistö, Tuija; Sundaram, Rajeshwari; Liu, Danping; Ying, Qi; Sherman, Seth; Grantz, Katherine L.

    2015-02-15

    Background: Air pollution has been linked to gestational diabetes mellitus (GDM) but no studies have evaluated impact of preconception and early pregnancy air pollution exposures on GDM risk. Methods: Electronic medical records provided data on 219,952 singleton deliveries to mothers with (n=11,334) and without GDM (n=208,618). Average maternal exposures to particulate matter (PM) ≤ 2.5 μm (PM{sub 2.5}) and PM{sub 2.5} constituents, PM ≤ 10 μm (PM{sub 10}), nitrogen oxides (NO{sub x}), carbon monoxide, sulfur dioxide (SO{sub 2}) and ozone (O{sub 3}) were estimated for the 3-month preconception window, first trimester, and gestational weeks 1–24 based on modified Community Multiscale Air Quality models for delivery hospital referral regions. Binary regression models with robust standard errors estimated relative risks (RR) for GDM per interquartile range (IQR) increase in pollutant concentrations adjusted for study site, maternal age and race/ethnicity. Results: Preconception maternal exposure to NO{sub X} (RR=1.09, 95% CI: 1.04, 1.13) and SO{sub 2} (RR=1.05, 1.01, 1.09) were associated with increased risk of subsequent GDM and risk estimates remained elevated for first trimester exposure. Preconception O{sub 3} was associated with lower risk of subsequent GDM (RR=0.93, 0.90, 0.96) but risks increased later in pregnancy. Conclusion: Maternal exposures to NO{sub x} and SO{sub 2} preconception and during the first few weeks of pregnancy were associated with increased GDM risk. O{sub 3} appeared to increase GDM risk in association with mid-pregnancy exposure but not in earlier time windows. These common exposures merit further investigation. - Highlights: • Air pollution may be related to gestational diabetes (GDM). • No prior studies have examined preconception exposure. • Maternal exposure to NO{sub x} and SO{sub 2} before conception increased subsequent GDM risk. • NO{sub x} and SO{sub 2} exposure in the first seven weeks of pregnancy also increased

  5. Solar Week: Learning from Experience

    NASA Astrophysics Data System (ADS)

    Alexander, D.; Hauck, K.

    2003-12-01

    Solar Week is a week-long set of games and activities allowing students to interact directly with solar science and solar scientists. Solar Week was developed as a spin-off of the highly successful Yohkoh Public Outreach Project (YPOP). While YPOP provided access to solar images, movies and activities, the main goal of Solar Week was to enhance the participation of women, who are under-represented in the physical sciences. Solar Week achieves this by providing young women, primarily in grades 6-8, with access to role models in the sciences. The scientists participating in Solar Week are women from a variety of backgrounds and with a variety of scientific expertise. In this paper, our aim is to provide some insight into developing activity-based space science for the web and to discuss the lessons-learned from tailoring to a specific group of participants.

  6. ENDOCRINOLOGY OF PREGNANCY: Gestational diabetes mellitus: definition, aetiological and clinical aspects.

    PubMed

    Baz, Baz; Riveline, Jean-Pierre; Gautier, Jean-François

    2016-02-01

    Gestational diabetes (GDM) is defined as a glucose intolerance resulting in hyperglycaemia of variable severity with onset during pregnancy. This review aims to revisit the pathogenesis and aetiology of GDM in order to better understand its clinical presentation and outcomes. During normal pregnancy, insulin sensitivity declines with advancing gestation. These modifications are due to placental factors, progesterone and estrogen. In a physiological situation, a compensatory increase in insulin secretion maintains a normal glucose homeostasis. GDM occurs if pancreatic β-cells are unable to face the increased insulin demand during pregnancy. GDM is most commonly a forerunner of type 2 diabetes (T2D) - the most prevalent form of diabetes. These women share similar characteristics with predisposed subjects to T2D: insulin resistance before and after pregnancy, and carry more T2D risk alleles. Auto-immune and monogenic diabetes are more rare aetiologies of GDM. Adverse pregnancy outcomes of GDM are mainly related to macrosomia caused by fetal hyperinsulinism in response to high glucose levels coming from maternal hyperglycaemia. Screening recommendations and diagnosis criteria of GDM have been recently updated. High risk patients should be screened as early as possible using fasting plasma glucose, and if normal, at 24-28 weeks of gestation using 75 g oral glucose tolerance test. The treatment of GDM is based on education with trained nurses and dieticians, and if necessary insulin therapy. PMID:26431552

  7. Maternal Microbe-Specific Modulation of Inflammatory Response in Extremely Low-Gestational-Age Newborns

    PubMed Central

    Fichorova, Raina N.; Onderdonk, Andrew B.; Yamamoto, Hidemi; Delaney, Mary L.; DuBois, Andrea M.; Allred, Elizabeth; Leviton, Alan

    2011-01-01

    The fetal response to intrauterine inflammatory stimuli appears to contribute to the onset of preterm labor as well as fetal injury, especially affecting newborns of extremely low gestational age. To investigate the role of placental colonization by specific groups of microorganisms in the development of inflammatory responses present at birth, we analyzed 25 protein biomarkers in dry blood spots obtained from 527 newborns delivered by Caesarean section in the 23rd to 27th gestation weeks. Bacteria were detected in placentas and characterized by culture techniques. Odds ratios for having protein concentrations in the top quartile for gestation age for individual and groups of microorganisms were calculated. Mixed bacterial vaginosis (BV) organisms were associated with a proinflammatory pattern similar to those of infectious facultative anaerobes. Prevotella and Gardnerella species, anaerobic streptococci, peptostreptococci, and genital mycoplasmas each appeared to be associated with a different pattern of elevated blood levels of inflammation-related proteins. Lactobacillus was associated with low odds of an inflammatory response. This study provides evidence that microorganisms colonizing the placenta provoke distinctive newborn inflammatory responses and that Lactobacillus may suppress these responses. PMID:21264056

  8. Neonatal liver failure owing to gestational alloimmune liver disease without iron overload.

    PubMed

    Tsunoda, Tomoyuki; Inui, Ayano; Kawamoto, Manari; Sogo, Tsuyoshi; Komatsu, Haruki; Kasahara, Mureo; Nakazawa, Atsuko; Fujisawa, Tomoo

    2015-05-01

    Although neonatal hemochromatosis (NH) is a well-known cause of liver failure during the neonatal period and iron deposition in extrahepatic tissues is considered essential in the diagnosis of NH, there is no consensus regarding the pathology or diagnostic criteria of NH. Recent studies of immunohistochemical assays have shown that the C5b-9 complex (the terminal membrane attack complement complex) is strongly expressed in the liver of NH cases, suggesting that a gestational alloimmune mechanism is the cause of liver injury. The patient was a low birthweight primiparous male born at 37 weeks of gestation by vaginal delivery. Blood tests 3 h after birth showed signs of liver failure, including high transferrin saturation, resembling the clinical characteristics of NH. However, magnetic resonance imaging and a lip biopsy showed no obvious iron deposition outside the liver. The patient was refractory to exchange transfusion and immunoglobulin therapy but was successfully treated by liver transplantation. Histologically, the explanted liver showed established cirrhosis, with large amounts of human C5b-9 in the residual hepatocytes, suggesting the alloimmune mechanism of liver injury was the cause of his liver failure. Liver failure caused by a gestational alloimmune mechanism should be considered in patients with antenatal liver failure, even without obvious extrahepatic siderosis. PMID:24976253

  9. Maternal manipulation of brown adipose tissue and liver development in the ovine fetus during late gestation.

    PubMed

    Clarke, L; Bryant, M J; Lomax, M A; Symonds, M E

    1997-06-01

    We examined the effect of maternal chronic cold exposure, induced by winter-shearing ewes 4 weeks before their predicted lambing date, on brown adipose tissue (BAT) and liver development in lambs. Fetuses were sampled from under-fed (60% of energy requirements for maintenance and pregnancy of an unshorn ewe) shorn or unshorn ewes at 126, 140 and 145 d of gestation. Lambs were sampled from ewes within 2 h of birth. Throughout gestation fetal body, BAT and liver weights were similar in shorn and unshorn groups. The level of GDP binding to mitochondrial uncoupling protein remained low throughout gestation, but increased dramatically after birth. Lambs born to shorn ewes possessed more mitochondrial protein and exhibited a significantly higher total thermogenic activity in BAT. Type I iodothyronine 5' deiodinase (EC 3.8.1.4) activity in BAT peaked at birth, as did hepatic iodothyronine 5' deiodinase activity and was significantly greater in lambs born to under-fed shorn ewes, which exhibited a higher plasma triiodothyronine concentration. Chronic maternal adaptations to prolonged cold exposure appear to enable pregnant ewes to compensate for the negative effects of under-feeding on fetal growth and development. PMID:9227185

  10. Glycosylated haemoglobin for screening and diagnosis of gestational diabetes mellitus

    PubMed Central

    Phuah, Eileen; Al-Barazan, Abdul Majeed; Nikakis, Irena; Radford, Andrea; Clarkson, Wade; Trevett, Clinton; Brain, Terry; Gebski, Val; Corbould, Anne

    2016-01-01

    Objectives The oral glucose tolerance test (OGTT) is a cumbersome test that is time consuming, labour intensive and often poorly tolerated by pregnant women. To date, glycosylated haemoglobin (HbA1c) is the most accepted measure of chronic glycaemia outside of pregnancy. HbA1c is an uncomplicated test, less time consuming, does not require any specific patient preparation and is considered straightforward compared with the OGTT. Therefore, we prospectively tested the utility of the HbA1c when used as a screening tool in pregnancy for gestational diabetes mellitus (GDM). Settings Primary health care. Single tertiary referral centre, Tasmania, Australia. Participants A direct comparison between HbA1c levels and the OGTT results in pregnant women, tested concurrently at the 24–28 gestational week, was undertaken. A full profile of 480 pregnant women during the period from September 2012 to July 2014 was completed. Median and mean age of participants was 29 years (range 18–47 years). Interventions A simultaneous prospective assessment of HbA1c versus standard OGTT in a cohort of consecutive pregnant women presenting to our institute was performed. Results The number of women who had GDM according to OGTT criteria was 57, representing 11.9% of the evaluated 480 pregnant women. Using a cut-off value for HbA1c at 5.1% (32 mmol/mol) for detecting GDM showed sensitivity of 61% and specificity of 68% with negative predictive value (NPV) of 93%, versus sensitivity of 27% and specificity of 95% with NPV of 91% when using HbA1c cut-off value of 5.4% (36 mmol/mol). Conclusions Our results suggest that pregnant women with an HbA1c of≥5.4% (36 mmol/mol) should proceed with an OGTT. This may result in a significant reduction in the burden of testing on both patients and testing facility staff and resources. Further investigations are required to integrate and optimise the HbA1c as a single, non-fasting, screening tool for GDM. Trial registration number ACTRN

  11. Committee Opinion No. 660 Summary: Family Building Through Gestational Surrogacy.

    PubMed

    2016-03-01

    Gestational surrogacy is an increasingly common form of family building that can allow individuals or a couple to become parents despite circumstances in which carrying a pregnancy is biologically impossible or medically contraindicated. The practice of gestational surrogacy involves a woman known as a gestational carrier who agrees to bear a genetically unrelated child with the help of assisted reproductive technologies for an individual or couple who intend(s) to be the legal and rearing parent(s), referred to as the intended parent(s). Obstetrician-gynecologists may become involved in gestational surrogacy through caring for the gestational carrier or by caring for the intended parent(s). Although gestational surrogacy increases options for family building, this treatment also involves ethical, medical, psychosocial, and legal complexities that must be taken into account to minimize risks of adverse outcomes for the gestational carrier, intended parent(s), and resulting children. The purpose of this document is to provide an overview of gestational surrogacy and to describe the ethical responsibilities for obstetrician-gynecologists who take part in the care of women who participate in these arrangements. PMID:26901333

  12. ACOG Committee Opinion No. 660: Family Building Through Gestational Surrogacy.

    PubMed

    Ryan, Ginny L

    2016-03-01

    Gestational surrogacy is an increasingly common form of family building that can allow individuals or a couple to become parents despite circumstances in which carrying a pregnancy is biologically impossible or medically contraindicated. The practice of gestational surrogacy involves a woman known as a gestational carrier who agrees to bear a genetically unrelated child with the help of assisted reproductive technologies for an individual or couple who intend(s) to be the legal and rearing parent(s), referred to as the intended parent(s). Obstetrician-gynecologists may become involved in gestational surrogacy through caring for the gestational carrier or by caring for the intended parent(s). Although gestational surrogacy increases options for family building, this treatment also involves ethical, medical, psychosocial, and legal complexities that must be taken into account to minimize risks of adverse outcomes for the gestational carrier, intended parent(s), and resulting children. The purpose of this document is to provide an overview of gestational surrogacy and to describe the ethical responsibilities for obstetrician-gynecologists who take part in the care of women who participate in these arrangements. PMID:26901335

  13. Polyunsaturated Fatty Acid (PUFA) Status in Pregnant Women: Associations with Sleep Quality, Inflammation, and Length of Gestation.

    PubMed

    Christian, Lisa M; Blair, Lisa M; Porter, Kyle; Lower, Mary; Cole, Rachel M; Belury, Martha A

    2016-01-01

    Mechanistic pathways linking maternal polyunsaturated fatty acid (PUFA) status with gestational length are poorly delineated. This study examined whether inflammation and sleep quality serve as mediators, focusing on the antiinflammatory ω-3 docosahexaenoic acid (DHA; 22:6n3) and proinflammatory ω-6 arachidonic acid (AA; 20:4n6). Pregnant women (n = 135) provided a blood sample and completed the Pittsburgh Sleep Quality Index (PSQI) at 20-27 weeks gestation. Red blood cell (RBC) fatty acid levels were determined by gas chromatography and serum inflammatory markers [interleukin (IL)-6, IL-8, tumor necrosis factor-α, IL-1β, and C-reactive protein] by electrochemiluminescence using high sensitivity kits. Both higher serum IL-8 (95% CI = 0.10,3.84) and poor sleep (95% CI = 0.03,0.28) served as significant mediators linking lower DHA:AA ratios with shorter gestation. Further, a serial mediation model moving from the DHA:AA ratio → sleep → IL-8 → length of gestation was statistically significant (95% CI = 0.02, 0.79). These relationships remained after adjusting for depressive symptoms, age, BMI, income, race, and smoking. No interactions with race were observed in relation to length of gestation as a continuous variable. However, a significant interaction between race and the DHA:AA ratio in predicting preterm birth was observed (p = 0.049); among African Americans only, odds of preterm birth decreased as DHA:AA increased (p = 0.048). These data support a role for both inflammatory pathways and sleep quality in linking less optimal RBC PUFA status with shorter gestation in African American and European American women and suggest that African-Americans have greater risk for preterm birth in the context of a low DHA:AA ratio. PMID:26859301

  14. Polyunsaturated Fatty Acid (PUFA) Status in Pregnant Women: Associations with Sleep Quality, Inflammation, and Length of Gestation

    PubMed Central

    Christian, Lisa M.; Blair, Lisa M.; Porter, Kyle; Lower, Mary; Cole, Rachel M.; Belury, Martha A.

    2016-01-01

    Mechanistic pathways linking maternal polyunsaturated fatty acid (PUFA) status with gestational length are poorly delineated. This study examined whether inflammation and sleep quality serve as mediators, focusing on the antiinflammatory ω-3 docosahexaenoic acid (DHA; 22:6n3) and proinflammatory ω-6 arachidonic acid (AA; 20:4n6). Pregnant women (n = 135) provided a blood sample and completed the Pittsburgh Sleep Quality Index (PSQI) at 20–27 weeks gestation. Red blood cell (RBC) fatty acid levels were determined by gas chromatography and serum inflammatory markers [interleukin (IL)-6, IL-8, tumor necrosis factor-α, IL-1β, and C-reactive protein] by electrochemiluminescence using high sensitivity kits. Both higher serum IL-8 (95% CI = 0.10,3.84) and poor sleep (95% CI = 0.03,0.28) served as significant mediators linking lower DHA:AA ratios with shorter gestation. Further, a serial mediation model moving from the DHA:AA ratio → sleep → IL-8 → length of gestation was statistically significant (95% CI = 0.02, 0.79). These relationships remained after adjusting for depressive symptoms, age, BMI, income, race, and smoking. No interactions with race were observed in relation to length of gestation as a continuous variable. However, a significant interaction between race and the DHA:AA ratio in predicting preterm birth was observed (p = 0.049); among African Americans only, odds of preterm birth decreased as DHA:AA increased (p = 0.048). These data support a role for both inflammatory pathways and sleep quality in linking less optimal RBC PUFA status with shorter gestation in African American and European American women and suggest that African-Americans have greater risk for preterm birth in the context of a low DHA:AA ratio. PMID:26859301

  15. Blood and urine 8-iso-PGF2α levels in babies of different gestational ages

    PubMed Central

    Li, Sitao; Hao, Hu; Zhou, Ping; Gao, Ping Ming; Xiao, Xin

    2014-01-01

    Objective: We measured cord blood and urine 8-iso-prostaglandin F2α (8-iso-PGF2α) levels in babies of different gestational ages to determine lipid peroxidation status. Methods: Babies at gestational ages of 28-43 weeks were divided into group A (28-32 weeks), group B (33-36 weeks), group C (37-41 weeks), and group D (42-43 weeks). 8-iso-PGF2α in umbilical cord blood (UCB) at birth and urine at 6 hours after birth was and tested by ELISA. Results: UCB and urine 8-iso-PGF2α levels in group C were 130.09 ± 31.73 pg/ml and 27.14 ± 6.73 pg/ml, respectively. UCB 8-iso-PGF2α levels in group A and B were 188.42 ± 59.34 pg/ml and 189.37 ± 68.46 pg/ml, and urine 8-iso-PGF2α were 32.14 ± 7.32 pg/ml and 30.46 ± 8.83 pg/ml, respectively. Blood and urine 8-iso-PGF2α levels in group D (post-term) were 252.01 ± 46.42 pg/ml and 44.00 ± 8.50 pg/ml. For all babies, UCB and urine iso-PGF2α levels were significantly correlated (r = 0.65, P < 0.01). Conclusions: We established blood and urine iso-PGF2α levels in normal full-term babies. Urine 8-iso-PGF2α levels may reflect the extent of lipid peroxidation in babies. In pre-term and post-term babies, there was evidence for increased lipid peroxidation. PMID:25664058

  16. Body mass index, gestational weight gain and fatty acid concentrations during pregnancy: the Generation R Study.

    PubMed

    Vidakovic, Aleksandra Jelena; Jaddoe, Vincent W V; Gishti, Olta; Felix, Janine F; Williams, Michelle A; Hofman, Albert; Demmelmair, Hans; Koletzko, Berthold; Tiemeier, Henning; Gaillard, Romy

    2015-11-01

    Obesity during pregnancy may be correlated with an adverse nutritional status affecting pregnancy and offspring outcomes. We examined the associations of prepregnancy body mass index and gestational weight gain with plasma fatty acid concentrations in mid-pregnancy. This study was embedded in a population-based prospective cohort study among 5636 women. We obtained prepregnancy body mass index and maximum weight gain during pregnancy by questionnaires. We measured concentrations of saturated fatty acid (SFA), monounsaturated fatty acid (MUFA), n-3 polyunsaturated fatty acid (n-3 PUFA) and n-6 polyunsaturated fatty acid (n-6 PUFA) at a median gestational age of 20.5 (95% range 17.1-24.9) weeks. We used multivariate linear regression models. As compared to normal weight women, obese women had higher total SFA concentrations [difference: 0.10 standard deviation (SD) (95% Confidence Interval (CI) 0, 0.19)] and lower total n-3 PUFA concentrations [difference: - 0.11 SD (95% CI - 0.20, - 0.02)]. As compared to women with sufficient gestational weight gain, those with excessive gestational weight gain had higher SFA concentrations [difference: 0.16 SD (95% CI 0.08, 0.25)], MUFA concentrations [difference: 0.16 SD (95% CI 0.08, 0.24)] and n-6 PUFA concentrations [difference: 0.12 SD (95% CI 0.04, 0.21)]. These results were not materially affected by adjustment for maternal characteristics. Our results suggest that obesity and excessive weight gain during pregnancy are associated with an adverse fatty acids profile. Further studies are needed to assess causality and direction of the observed associations. PMID:26666541

  17. Gestational diabetes induces chronic hypoxia stress and excessive inflammatory response in murine placenta

    PubMed Central

    Li, Hua-Ping; Chen, Xuan; Li, Ming-Qing

    2013-01-01

    Metabolic impairments in maternal obesity and gestational diabetes mellitus (GDM) induce an abnormal environment in peripheral blood and cause vascular structure alterations which affect the placental development and function. A GDM model was developed using C57BL/6J female mice fed with high fat food (HF) (40% energy from fat) and a control group with control food (CF) (14% energy from fat) for 14 weeks before mating and throughout the gestation period. A subset of dams was sacrificed at gestational day (GD) 18.5 to evaluate the fetal and placental development. HF-fed dams exhibited significant increase in the maternal weight gain and homeostasis model assessment for insulin resistance index (HOMA-IR), impaired insulin secretion of glucose stimulus and glucose clearance of insulin stimulus before pregnancy; in addition, they also had the increase in the fetal and placental weight. HF-fed dams at GD 18.5 showed the high level of circulating maternal inflammation factors and were associated with increased oxidative stress and hypoxia in the labyrinth, abnormal vascular development with a high level of hypoxia inducible factor-1α (HIF-1α) and VEGF-A expression, but without a parallel increase in CD31 level; were induced an exaggerated inflammatory response in placental vascular endothelial cell. Our findings show that GDM induces more maternal weight gain and fetus weight, with abnormal maternal circulating metabolic and inflammation factors, and forms a placental hypoxia environment and impacts the placental vascular development. Our findings indicate that gestational diabetes induce excessive chronic hypoxia stress and inflammatory response in placentas which may contribute mechanisms to the high risks of perinatal complications of obesity and GDM mothers. PMID:23573311

  18. Preconception Cardiovascular Risk Factor Differences Between Gestational Hypertension and Preeclampsia: Cohort Norway Study.

    PubMed

    Egeland, Grace M; Klungsøyr, Kari; Øyen, Nina; Tell, Grethe S; Næss, Øyvind; Skjærven, Rolv

    2016-06-01

    Preconception predictors of gestational hypertension and preeclampsia may identify opportunities for early detection and improve our understanding of the pathogenesis and life course epidemiology of these conditions. Female participants in community-based Cohort Norway health surveys, 1994 to 2003, were prospectively followed through 2012 via record linkages to Medical Birth Registry of Norway. Analyses included 13 217 singleton pregnancies (average of 1.59 births to 8321 women) without preexisting hypertension. Outcomes were gestational hypertension without proteinuria (n=237) and preeclampsia (n=429). Mean age (SD) at baseline was 27.9 years (4.5), and median follow-up was 4.8 years (interquartile range 2.6-7.8). Gestational hypertension and preeclampsia shared several baseline risk factors: family history of diabetes mellitus, pregravid diabetes mellitus, a high total cholesterol/high-density lipoprotein cholesterol ratio (>5), overweight and obesity, and elevated blood pressure status. For preeclampsia, a family history of myocardial infarction before 60 years of age and elevated triglyceride levels (≥1.7 mmol/L) also predicted risk while physical activity was protective. Preterm preeclampsia was predicted by past-year binge drinking (≥5 drinks on one occasion) with an adjusted odds ratio of 3.7 (95% confidence interval 1.3-10.8) and by past-year physical activity of ≥3 hours per week with an adjusted odds ratio of 0.5 (95% confidence interval 0.3-0.8). The results suggest similarities and important differences between gestational hypertension, preeclampsia, and preterm preeclampsia. Modifiable risk factors could be targeted for improving pregnancy outcomes and the short- and long-term sequelae for mothers and offspring. PMID:27113053

  19. Roles of Perinatal Problems on Adolescent Antisocial Behaviors among Children Born after 33 Completed Weeks: A Prospective Investigation

    ERIC Educational Resources Information Center

    Nomura, Yoko; Rajendran, Khushmand; Brooks-Gunn, Jeanne; Newcorn, Jeffrey H.

    2008-01-01

    Background: There is uncertainty about the extent to which mildly sub-optimal perinatal characteristics among individuals born near-term (greater than 33 weeks of gestation) are associated with various subsequent childhood problems, including antisocial behavior. There is even more uncertainty about whether the pathway to antisocial behavior…

  20. Early gestation screening of pregnant women for iodine deficiency disorders and iron deficiency in urban centre in Vadodara, Gujarat, India.

    PubMed

    Joshi, K; Nair, S; Khade, C; Rajan, M G R

    2014-02-01

    Pregnancy is a special condition where many metabolic changes may occur because of increased requirement of essential micronutrients such as iron and iodine. Foetal thyroid starts producing its own thyroid hormones after 12 weeks of gestation. Therefore, the first trimester is very crucial for meeting thyroid hormone requirements of the mother and foetus. Iodine deficiency and iron deficiency may affect mental and physical growth of the foetus. Hence, it is very important to establish a programme on the screening of pregnant women for thyroid dysfunction tests along with established iron status assessment. Thus, the study was aimed to screen the pregnant women for iodine deficiency disorders and iron deficiency during early gestation, situational analysis on thyroid insufficiency and iron deficiency in pregnant women (gestational age <15 weeks) in urban Vadodara, Gujarat. n = 256 healthy pregnant women with uncomplicated singleton pregnancy were selected. The thyroid hormone was estimated by RIA, UIE using simple microplate technique and haemoglobin (Hb) concentration by acid hematin method. Median thyrotropin (TSH), free thyroxine (FT4), total thyroxine (TT4) and UIE concentrations were 1.88 μIU/ml, 0.83 ng/dl, 10.24 μg/dl and 297.14 mcg/l, respectively. There was a significant correlation between TSH, FT4 and month of gestation. Mean Hb concentration was 9.27 ± 1.09 g/dl. The prevalence of iodine insufficiency (based on UI) was 16.79% and iron deficiency was 91%. Screening programme for iodine deficiency during early gestation should be implemented along with the existing programme of haemoglobin estimation at first prenatal visit. This would help prevent damage to the developing brain and growth of the foetus and also to trace at-risk pregnant women. PMID:24847692

  1. Vitamin A status in pregnant women in Iran in 2001 and its relationship with province and gestational age

    PubMed Central

    Olang, Beheshteh; Abdollahi, Zahra; Neshati, Roshanak; Ali, Mohamed Atiya; Naghavi, Mohsen; Yngve, Agneta

    2014-01-01

    Background Vitamin A deficiency is considered as one of the public health problems among pregnant women worldwide. Population representative data on vitamin A status in pregnancy have not previously been published from Iran. Objectives The aim of this study was to publish data on vitamin A status in pregnant women in all the provinces of Iran in 2001, including urban and rural areas, and to describe the association of vitamin A status with maternal age, gestational age, and parity. Design This descriptive cross-sectional study was conducted on 3,270 healthy pregnant women from the entire country, 2,631 with gestational age ≤36 weeks, and 639 with gestational age >36 weeks. Vitamin A status was determined in serum using high-performance liquid chromatography. Result Retinol levels corresponding to deficiency were detected in 6.6% (<0.36 µmol/L) and 18% had insufficient vitamin A levels (≥0.36–<0.7 µmol/L). Suboptimal level of serum retinol was observed in 55.3% of the pregnant women (0.7–1.4 µmol/L). Only about 20% of the women had optimal values (>1.4 µmol/L). The level of serum retinol was lower in older pregnant women (p=0.008), and at higher gestational age (p=0.009). High vitamin A levels were observed in pregnant women in the central areas of Iran and the lowest values in those in the southern areas of Iran. Conclusions The vitamin A status was good in 2001 but should be closely monitored also in the future. About 25% of pregnant women had a vitamin A status diagnosed as insufficient or deficient (<0.7 µmol/L). The mean serum retinol decreased as the gestational age increased. The clinical significance of this finding should be further investigated, followed by a careful risk group approach to supplementation during pregnancy. PMID:25317119

  2. Weekly Log Record Sort (WLSORT).

    ERIC Educational Resources Information Center

    Foote, Thomas

    Computer routines to sort the weekly log records submitted by teachers participating in the Southwest Regional Laboratory's communications skills monitoring program are described. Written in Univac FORTRAN V, Weekly Log Record Sort (WLSORT) sorts log records on magnetic tape to enable subsequent computer programs to interpret the input data by…

  3. Screening and management of gestational diabetes.

    PubMed

    Benhalima, Katrien; Devlieger, Roland; Van Assche, André

    2015-04-01

    Gestational diabetes (GDM) is a frequent medical condition during pregnancy. It is associated with an increased risk of complications for both the mother and the baby during pregnancy and post partum. The International Association of Diabetes and Pregnancy Study Groups (IADPSG) has proposed a new screening strategy for overt diabetes in pregnancy and screening for GDM. However, there is still a lack of international uniformity in the approach to the screening and diagnosis of GDM. Controversies include universal versus selective screening, the optimal time for screening, appropriate tests and cutoff values, and whether testing should be conducted in one or two steps. This review gives an update on screening for GDM and overt diabetes during pregnancy. We also give an overview on the medical and obstetrical management of GDM. PMID:25457858

  4. Crazy making: embryos and gestational mothers.

    PubMed

    Annas, G J

    1991-01-01

    Annas discusses the legal and public policy aspects of two 1990 in vitro fertilization cases. In Davis v. Davis, a Tennessee case involving disputed custody of frozen embryos in a divorce, an appellate court reversed a trial judge and ruled that the couple, not just the woman, should decide the disposition of the embryos. In Johnson v. Calvert, a surrogate mother in California failed to gain custody of the child she bore after gestating an embryo from the ovum and sperm of the couple who hired her. The judges in both cases based their decisions on the genetic relationship of the adult parties to the embryos or child. Annas is critical of determining parenthood exclusively on the basis of genes and argues for continuing the current legal presumption that a woman who gives birth to a child should be considered its legal mother. PMID:2004902

  5. Twin Gestation in a Septate Bicornuate Uterus

    PubMed Central

    2012-01-01

    Bicornuate and septate uteri are among the commonest Mullerian anomalies. They are sporadic and fairly distinguished, but hybrid deformities can occur. This combination creates aetiological and clinical difficulties. The alternative theory of concurrent fusion and septal resorption of the Mullerian duct is seen as the basis of the altered foetal embryology, while the favourable outlook of a bicornuate uterus may be offset by the suboptimal implantation across the avascular septum. Obstetric care is based on empirical interventions deduced from case series, with varied and inconsistent outcomes. We present a 32-year-old primipara with a dizygotic twin gestation in separate compartments of a septate bicornuate uterus. She had an elective bilateral caesarean delivery at term with an accidental septal resection for morbidly adherent placenta. Although a summation of obstetric risks is a possibility, an excellent outcome was observed. PMID:23304585

  6. Effects of Supplementing Holstein Heifers with Dietary Melatonin during Late Gestation on Growth and Cardiovascular Measurements of their Offspring.

    PubMed

    Brockus, K E; Hart, C G; Fleming, B O; Smith, T; Ward, S H; Lemley, C O

    2016-04-01

    The objective was to examine the effects of supplementing dams with dietary melatonin during late gestation on offspring growth and cardiovascular measurements. On day 190 of gestation, heifers (n = 20) were blocked by body weight and randomly assigned to one of two dietary treatments consisting of 20 mg of dietary melatonin per day [melatonin (MEL)] or no melatonin supplementation [control (CON)]. Dietary treatments were terminated on day 262 of gestation. At birth, calves were separated from their dams with no further treatments. Calf (n = 18) blood pressure, cortisol, nitrites and total antioxidant capacity were collected on weeks 0, 1, 2, 3 and 4 of age. Calf hepatic portal blood flow and concentrations of insulin-like growth factor 1 were determined on weeks 0 and 4 of age. Calf body weight, abdominal girth, hip height and wither height increased (p < 0.05) with age. An age by treatment interaction (p < 0.01) was observed for calf body weight, which was increased at weeks 8 and 9 of age in calves born to MEL heifers compared to calves born to CON heifers. Pulse pressure, mean arterial pressure, absolute hepatic portal blood flow and blood flow relative to calf body weight were not different (p > 0.05) between treatments. A main effect of calf age (p < 0.05) was observed for concentrations of insulin-like growth factor 1, which was decreased at week 4 compared to week 0. An age by treatment interaction (p < 0.05) was observed for cortisol, which was decreased at week 2 in calves from MEL-treated dams compared to calves from CON-treated dams. Early post-natal growth was altered in offspring born to dams supplemented with dietary melatonin. This could lead to further foetal programming implications in conjunction with post-natal development. PMID:26858012

  7. Dietary restraint and gestational weight gain

    PubMed Central

    Mumford, Sunni L.; Siega-Riz, Anna Maria; Herring, Amy; Evenson, Kelly R.

    2008-01-01

    Objective To determine whether a history of preconceptional dieting and restrained eating was related to higher weight gains in pregnancy. Design Dieting practices were assessed among a prospective cohort of pregnant women using the Revised Restraint Scale. Women were classified on three separate subscales as restrained eaters, dieters, and weight cyclers. Subjects Participants included 1,223 women in the Pregnancy, Infection and Nutrition Study. Main outcome measures Total gestational weight gain and adequacy of weight gain (ratio of observed/expected weight gain based on Institute of Medicine (IOM) recommendations). Statistical analyses performed Multiple linear regression was used to model the two weight gain outcomes, while controlling for potential confounders including physical activity and weight gain attitudes. Results There was a positive association between each subscale and total weight gain, as well as adequacy of weight gain. Women classified as cyclers gained an average of 2 kg more than non-cyclers, and showed higher observed/expected ratios by 0.2 units. Among restrained eaters and dieters, there was a differential effect by BMI. With the exception of underweight women, all other weight status women with a history of dieting or restrained eating gained more weight during pregnancy and had higher adequacy of weight gain ratios. In contrast, underweight women with a history of restrained eating behaviors gained less weight compared to underweight women without those behaviors. Conclusions Restrained eating behaviors were associated with weight gains above the IOM recommendations for normal, overweight, and obese women, and weight gains below the recommendations for underweight women. Excessive gestational weight gain is of concern given its association with postpartum weight retention. The dietary restraint tool is useful for identifying women who would benefit from nutritional counseling prior to or during pregnancy in regards to achieving targeted

  8. Special issue containing papers presented at the 12th IAEA Technical Meeting on Energetic Particles in Magnetic Confinement Systems (7-11 September 2011) Special issue containing papers presented at the 12th IAEA Technical Meeting on Energetic Particles in Magnetic Confinement Systems (7-11 September 2011)

    NASA Astrophysics Data System (ADS)

    Berk, H. L.

    2012-09-01

    The topic of the behaviour of energetic alpha particles in magnetic fusion confined plasmas is perhaps the ultimate frontier plasma physics issue that needs to be understood in the quest to achieve controlled power from the fusion reaction in magnetically confined plasmas. The partial pressure of alpha particles in a burning plasma will be ~5-10% of the total pressure and under these conditions the alpha particles may be prone to develop instability through Alfvénic interaction. This may lead, even with moderate alpha particle loss, to a burn quench or severe wall damage. Alternatively, benign Alfvénic signals may allow the vital information to control a fusion burn. The significance of this issue has led to extensive international investigations and a biannual meeting that began in Kyiv in 1989, followed by subsequent meetings in Aspenäs (1991), Trieste (1993), Princeton (1995), JET/Abingdon (1997), Naka (1999), Gothenburg (2001), San Diego (2003), Takayama (2005), Kloster Seeon (2007) and Kyiv (2009). The meeting was initially entitled 'Alpha Particles in Fusion Research' and then was changed during the 1997 meeting to 'Energetic Particles in Magnetic Confinement Systems' in appreciation of the need to study the significance of the electron runaway, which can lead to the production of energetic electrons with energies that can even exceed the energy produced by fusion products. This special issue presents some of the mature interesting work that was reported at the 12th IAEA Technical Meeting on Energetic Particles in Magnetic Confinement Systems, which was held in Austin, Texas, USA (7-11 September 2011). This meeting immediately followed a related meeting, the 5th IAEA Technical Meeting on Theory of Plasma Wave Instabilities (5-7 September 2011). The meetings shared one day (7 September 2011) with presentations relevant to both groups. The presentations from most of the participants, as well as some preliminary versions of papers, are available at the

  9. Association of Gestational Age at Birth with Reasons for Subsequent Hospitalisation: 18 Years of Follow-Up in a Western Australian Population Study

    PubMed Central

    Slimings, Claudia; Einarsdóttir, Kristjana; Burgner, David

    2015-01-01

    Background Preterm infants are at a higher risk of hospitalisation following discharge from the hospital after birth. The reasons for rehospitalisation and the association with gestational age are not well understood. Methods This was a retrospective birth cohort study of all live, singleton infants born in Western Australia between 1st January 1980 and 31st December 2010, followed to 18 years of age. Risks of rehospitalisation following birth discharge by principal diagnoses were compared for gestational age categories (<32, 32–33, 34–36, 37–38 weeks) and term births (39–41weeks). Causes of hospitalisations at various gestational age categories were identified using ICD-based discharge diagnostic codes. Results Risk of rehospitalisation was inversely correlated with gestational age. Growth-related concerns were the main causes for rehospitalisation in the neonatal period (<1 month of age) for all gestational ages. Infection was the most common reason for hospitalisation from 29 days to 1 year of age, and up to 5 years of age. Injury-related hospitalisations increased in prevalence from 5 years to 18 years of age. Risk of rehospitalisation was higher for all preterm infants for most causes. Conclusions The highest risks of rehospitalisation were for infection related causes for most GA categories. Compared with full term born infants, those born at shorter GA remain vulnerable to subsequent hospitalisation for a variety of causes up until 18 years of age. PMID:26114969

  10. Uric Acid Determination in Gestational Hypertension: Is it as Effective a Delineator of Risk as Proteinuria in High-Risk Women?

    PubMed

    Schmella, Mandy J; Clifton, Rebecca G; Althouse, Andrew D; Roberts, James M

    2015-10-01

    We asked, is uric acid as effective as proteinuria at identifying perinatal risk in high-risk women with gestational hypertension? Uric acid was measured in samples obtained ≈4.6 weeks predelivery in 259 women with prior preeclampsia from the National Institute of Child Health and Human Development network study of low-dose aspirin to prevent preeclampsia. Participants were grouped according to the presence/absence of gestational hypertension (H), proteinuria (P), and hyperuricemia (U). Adverse perinatal outcomes were not different between H or U and women with normal values (normal blood pressure, urinary protein, and uric acid [NNN]). Preterm birth was greater in hypertension and proteinuria (HP) and hypertension and hyperuricemia (HU) compared to NNN (relative risk [RR] = 2.4, P = .03 and 3.8, P < .01), respectively. In addition, in HU women, delivery was earlier (36.6 ± 3.4 vs 38.4 ± 2.3 weeks, P < .001) and small for gestational age infants gestational hypertension. Our results suggest that hyperuricemia is at least as accurate as proteinuria at identifying perinatal risk in high-risk women with gestational hypertension. PMID:25717062

  11. Temperament of Small-for-Gestational-Age and Appropriate- for-Gestational-Age Infants across the First Year of Life.

    ERIC Educational Resources Information Center

    Halpern, Leslie F.; Coll, Cynthia T. Garcia

    2000-01-01

    Temperament development was studied in 39 full-term small-for-gestational-age infants and 30 full-term appropriate-for-gestational-age infants. Temperament was measured at 4, 8, and 12 months of age using a behavioral assessment procedure and questionnaire ratings. Findings indicated that restricted fetal growth negatively affects infant…

  12. Lean body mass in small for gestational age and appropriate for gestational age infants

    SciTech Connect

    Petersen, S.; Gotfredsen, A.; Knudsen, F.U.

    1988-11-01

    Dual photon absorptiometry using /sup 153/Gd in a whole-body scanner was used to measure lean body mass (LBM) in 51 newborn infants. LBM% decreased exponentially with increasing gestational age in both small for gestational age (SGA) and appropriate for gestational age (AGA) infants. In preterm SGA and AGA infants LBM was 104% and 103%, respectively, indicating that no fat was detectable. In term SGA infants LBM was 98%, which corresponded to 48 gm fat on average, and in term AGA infants LBM was 87%, which corresponded to 452 gm fat on average. The LBM%, ponderal index, and skinfold thickness were significantly different between AGA and SGA infants. Infants with clinical signs of intrauterine wastage had significantly higher LBM% than did infants without signs of weight loss. Our results on LBM% by dual photon absorptiometry agree with earlier dissection data; the clinically applicable methods of (1) height combined with weight (i.e., ponderal index), (2) skinfold thickness, and (3) scoring by clinical observations are useful for the estimation of lack of fat as an indicator of intrauterine growth retardation.

  13. Dietary protein-to-carbohydrate ratio and added sugar as determinants of excessive gestational weight gain: a prospective cohort study

    PubMed Central

    Maslova, Ekaterina; Halldorsson, Thorhallur I; Astrup, Arne; Olsen, Sjurdur F

    2015-01-01

    Objective To examine the relation between the protein:carbohydrate (P/C) ratio and added sugar intake in pregnancy and gestational weight gain (GWG). Design A prebirth cohort including 103 119 pregnancies enrolled between 1996 and 2003. Setting All women in Denmark were eligible to participate if they spoke Danish and were planning to carry to term.The pregnant women were recruited and enrolled during their first antenatal visit (6–10 weeks of gestation). Participants Participants included women with live-born singletons and complete data on dietary intake and GWG, leaving 46 262 women for the analysis. Exposure Macronutrient intake was quantified using a validated food frequency questionnaire administered in the 25th week of gestation. The P/C ratio and added sugar intake were examined in quintiles. Primary outcome measures GWG was based on self-reported weight in gestational weeks 12 and 30 and defined as gain in g/week. We used multivariable linear regression, including adjusting for pre-pregnancy body mass index, to calculate relative change in GWG and 95% CI. Results Average GWG was 471(224) g/week. The adjusted weight gain was 16 g/week lower (95% CI 9 to 22, p for trend <0.001) in the highest (Q5) versus lowest (Q1) quintile of the P/C ratio (∼3% average reduction across the entire pregnancy). Weight gain for those with >20%E vs <12%E from protein was 36 g/week lower (95% CI 20 to 53, p for trend <0.0001; ∼8% average reduction). A high P/C ratio was inversely related to intake of added sugars. Added sugar consumption was strongly associated with GWG (Q5 vs Q1: 34, 95% CI 28 to 40 g/week, p for trend <0.0001). Conclusions A high P/C ratio was associated with reduced GWG. This association appeared to be partly driven by a decrease in intake of added sugar. These results are consistent with randomised trials in non-pregnant participants. A dietary intervention targeting an increased P/C ratio with emphasis on reducing added sugar can

  14. Pregnancy Calendar: A Week-by-Week Guide

    MedlinePlus

    ... 42 weeks from the first day of their mom's LMP and only a small percentage of women actually deliver on their due date. Will you find out the sex of your baby before birth? Another common term ...

  15. Quantitative assessment of gestational sac shape: the gestational sac shape score

    PubMed Central

    Deter, R.L.; Li, J.; Lee, W.; Liu, S.; Romero, R.

    2012-01-01

    Objective To develop a quantitative method for characterizing gestational sac shape. Methods Twenty first-trimester gestational sacs in normal pregnancies were studied with three-dimensional (3D) ultrasonography. The 3D coordinates of surface-point sets were obtained for each sac using 30-, 15- and six-slice sampling. Cubic spline interpolation was used with the 15- and six-slice surface-point samples to generate coordinates for those 30-slice surface points not measured. Interpolated and measured values, the latter from the 30-slice sample, were compared and the percent error calculated. Cubic spline interpolation was used to determine the coordinates of a standard surface-point sample (3660) for each sac in each slice sample. These coordinate data were used to give each sac a standard configuration by moving its center of gravity to the origin, aligning its inertial axes along the coordinate axes and converting its volume to 1.0 mL. In this form, a volume shape descriptor could be generated for each sac that was then transformed into a vector containing only shape information. The 20 shape vectors of each slice sample were subjected to principal components analysis, and principal component scores (PCSs) calculated. The first four PCSs were used to define a gestational sac shape score (GSSS-30, GSSS-15 or GSSS-6) for each sac in a given slice sample. The characteristics of each set of GSSSs were determined and those for the GSSS-15 and GSSS-6 were compared with the GSSS-30 characteristics. Results Cubic spline interpolations were very accurate in most cases, with means close to 0%, and approximately 95% of the errors being less than 10%. GSSS-30 accounted for 67.6% of the shape variance, had a mean of zero and an SD of 1.1, was normally distributed and was not related to menstrual age (R = −0.16, P = 0.51). GSSS-15 and GSSS-6 had essentially the same characteristics. No significant differences between individual GSSS-30 values and those for GSSS-15 or GSSS-6

  16. Maternal Body Weight and Gestational Diabetes Differentially Influence Placental and Pregnancy Outcomes

    PubMed Central

    Martino, J.; Sebert, S.; Segura, M. T.; García-Valdés, L.; Florido, J.; Padilla, M. C.; Marcos, A.; Rueda, R.; McArdle, H. J.; Budge, H.; Campoy, C.

    2016-01-01

    Context: Maternal obesity and gestational diabetes mellitus (GDM) can both contribute to adverse neonatal outcomes. The extent to which this may be mediated by differences in placental metabolism and nutrient transport remains to be determined. Objective: Our objective was to examine whether raised maternal body mass index (BMI) and/or GDM contributed to a resetting of the expression of genes within the placenta that are involved in energy sensing, oxidative stress, inflammation, and metabolic pathways. Methods: Pregnant women from Spain were recruited as part of the “Study of Maternal Nutrition and Genetics on the Foetal Adiposity Programming” survey at the first antenatal visit (12–20 weeks of gestation) and stratified according to prepregnancy BMI and the incidence of GDM. At delivery, placenta and cord blood were sampled and newborn anthropometry measured. Results: Obese women with GDM had higher estimated fetal weight at 34 gestational weeks and a greater risk of preterm deliveries and cesarean section. Birth weight was unaffected by BMI or GDM; however, women who were obese with normal glucose tolerance had increased placental weight and higher plasma glucose and leptin at term. Gene expression for markers of placental energy sensing and oxidative stress, were primarily affected by maternal obesity as mTOR was reduced, whereas SIRT-1 and UCP2 were both upregulated. In placenta from obese women with GDM, gene expression for AMPK was also reduced, whereas the downstream regulator of mTOR, p70S6KB1 was raised. Conclusions: Placental gene expression is sensitive to both maternal obesity and GDM which both impact on energy sensing and could modulate the effect of either raised maternal BMI or GDM on birth weight. PMID:26513002

  17. The Effect of Gestational Age at Birth on Post-Term Maturation of Heart Rate Variability

    PubMed Central

    Fyfe, Karinna L.; Yiallourou, Stephanie R.; Wong, Flora Y.; Odoi, Alexsandria; Walker, Adrian M.; Horne, Rosemary S.C.

    2015-01-01

    Study Objective: Preterm birth delays maturation of autonomic cardiovascular control, reflected in reduced heart rate variability (HRV) in preterm compared to term infants at term-equivalent age. It has been suggested that immature cardiovascular control contributes to the increased risk for the sudden infant death syndrome (SIDS) in preterm infants. However, the effects of prone sleeping, the major SIDS risk factor, and of gestational age (GA) at birth on HRV have not been assessed in preterm infants beyond term-equivalent age. Subjects and Methods: Very preterm (n = 21; mean GA 29.4 ± 0.3 weeks), preterm (n = 14; mean GA 33.5 ± 0.3 weeks), and term (n = 17; mean GA 40.1 ± 0.3 weeks) infants were recruited and underwent daytime polysomnography at 2–4 weeks, 2–3 months, and 5–6 months post-term corrected age (CA). Infants slept both supine and prone. HRV was assessed in the low frequency (LF) and high frequency (HF) ranges. Results: There was no effect of prone sleeping on HRV parameters in either preterm group. In term infants LF/HF was significantly elevated in the prone position in AS at 2–4 weeks (P < 0.05). HF HRV was significantly reduced (P < 0.05) and LF/HF increased (P < 0.05) in very preterm compared to both preterm and term infants at 2–3 months CA. Conclusion: Prone sleeping did not significantly impact on heart rate variability (HRV) in preterm infants. However, reduced maturation of high frequency HRV in very preterm infants resulted in significantly altered sympathovagal balance at 2–3 months corrected age, the age of peak sudden infant death syndrome (SIDS) risk. This may contribute to the increased risk of SIDS in infants born at earlier gestational age. Citation: Fyfe KL, Yiallourou SR, Wong FY, Odoi A, Walker AM, Horne RS. The effect of gestational age at birth on post-term maturation of heart rate variability. SLEEP 2015;38(10):1635–1644. PMID:25902805

  18. Birth weight for gestational age norms for a large cohort of infants born to HIV-negative women in Botswana compared with norms for U.S.-born black infants

    PubMed Central

    2011-01-01

    Background Standard values for birth weight by gestational age are not available for sub-Saharan Africa, but are needed to evaluate incidence and risk factors for intrauterine growth retardation in settings where HIV, antiretrovirals, and other in utero exposures may impact birth outcomes. Methods Birth weight data were collected from six hospitals in Botswana. Infants born to HIV-negative women between 26-44 weeks gestation were analyzed to construct birth weight for gestational age charts. These data were compared with published norms for black infants in the United States. Results During a 29 month period from 2007-2010, birth records were reviewed in real-time from 6 hospitals and clinics in Botswana. Of these, 11,753 live infants born to HIV-negative women were included in the analysis. The median gestational age at birth was 39 weeks (1st quartile 38, 3rd quartile 40 weeks), and the median birth weight was 3100 grams (1st quartile 2800, 3rd quartile 3400 grams). We constructed estimated percentile curves for birth weight by gestational age which demonstrate increasing slope during the third trimester and leveling off beyond 40 weeks. Compared with black infants in the United States, Botswana-born infants had lower median birth weight for gestational age from weeks 37 through 42 (p < .02). Conclusions We present birth weight for gestational age norms for Botswana, which are lower at term than norms for black infants in the United States. These findings suggest the importance of regional birth weight norms to identify and define risk factors for higher risk births. These data serve as a reference for Botswana, may apply to southern Africa, and may help to identify infants at risk for perinatal complications and inform comparisons among infants exposed to HIV and antiretrovirals in utero. PMID:22176889

  19. The effect of gestational age on symptom severity in children with autism spectrum disorder.

    PubMed

    Movsas, Tammy Z; Paneth, Nigel

    2012-11-01

    Between 2006 and 2010, two research-validated instruments, Social Communication Questionnaire (SCQ) and Social Responsiveness Scale (SRS) were filled out online by 4,188 mothers of Autism Spectrum Disorder (ASD) children, aged 4-21, as part of voluntary parental participation in a large web-based registry. Univariate and multivariate linear regression analysis (adjusted for child's sex, ability to verbalize, categorical IQ score, and fetal growth rate) demonstrated significantly higher SCQ and SRS scores for ASD children of both preterm (<37 weeks) and post-term (>42 weeks) gestational age (GA) compared to ASD children of normal GA, thus indicating that both preterm and post-term children manifest increased ASD symptomatology. Normal GA at birth appears to mitigate the severity of autistic social impairment in ASD children. PMID:22422339

  20. Effect of a CGMS and SMBG on Maternal and Neonatal Outcomes in Gestational Diabetes Mellitus: a Randomized Controlled Trial

    PubMed Central

    WEI, Qiong; SUN, Zilin; YANG, Yue; YU, Hong; DING, Hongjuan; WANG, Shaohua

    2016-01-01

    In this study, we sought to investigate the effects of a continuous glucose monitoring system (CGMS) on maternal and neonatal outcomes. A total of 106 women with gestational diabetes mellitus (GDM) in gestational weeks 24–28 were randomly allocated to the antenatal care plus CGMS group or the self-monitoring blood glucose (SMBG) group. The CGMS group was subdivided into early and late subgroups. There were no significant differences in prenatal or obstetric outcomes, e.g., caesarean delivery rate, Apgar score at 5 min, macrosomia or neonatal hypoglycaemia, between the CGMS and SMBG groups. The CGMS group had lower glycated haemoglobin (HbA1C) levels than the SMBG group; however, the difference was not statistically significant. The proportion of GDM women with excessive gestational weight gain was lower in the CGMS group than in the SMBG group (33.3% vs. 56.4%, P = 0.039), and women who initiated CGMS earlier gained less weight (P = 0.017). The mode of blood glucose monitoring (adjusted OR 2.40; 95% CI 1.030–5.588; P = 0.042) and pre-pregnancy BMI (adjusted OR 0.578; 95% CI 0.419–0.798; P = 0.001) were independent factors for weight gain. In conclusion, early CGMS for GDM mothers reduces gestational weight gain. A follow-up study with a large cohort is needed. PMID:26814139

  1. A prospective study of birthweight and length of gestation in a population surrounding a lead smelter in Kosovo, Yugoslavia.

    PubMed

    Factor-Litvak, P; Graziano, J H; Kline, J K; Popovac, D; Mehmeti, A; Ahmedi, G; Shrout, P; Murphy, M J; Gashi, E; Haxhiu, R

    1991-09-01

    This paper tests the hypothesis that exposure to lead during pregnancy is associated with reduced intrauterine growth and an increase in preterm delivery. The sample comprises women, recruited at mid-pregnancy, residing in Titova Mitrovica, a lead smelter town, or in Pristina, a non-exposed town 25 miles away. Both towns are in the province of Kosovo, Yugoslavia. Mean blood lead concentrations (BPb's) at mid-pregnancy were 0.92 mumol/L (+/- 0.38, N = 401) in the exposed town and 0.27 mumol/L (+/- 0.09, N = 506) in the comparison town. No differences were found between towns for either birthweight or length of gestation. Mean birthweight was 3308 (+/- 566) grams in Titova Mitrovica and 3361 (+/- 525) grams in Pristina. Mean length of gestation was 274 (+/- 18.8) days in Titova Mitrovica and 275 (+/- 15.6) days in Pristina. After adjustment for the effects of potential confounders, no significant relationships were found between maternal BPb measured at mid-pregnancy, at delivery or in the umbilical cord and either birthweight, length of gestation, or preterm delivery (less than 37 weeks). We conclude that exposure to environmental lead does not impair fetal growth or influence length of gestation. PMID:1955258

  2. Haematological and serum biochemical responses of rabbit does to crude Moringa oleifera leaf extract at gestation and lactation.

    PubMed

    Ewuola, Emmanuel Olubisi; Sokunbi, Olujide Adedamola; Sanni, Kafayat Modupeola; Oyedemi, Oluwaseyi Margaret; Lawal, Temitope Tawakalit

    2015-04-01

    As the plant Moringa oleifera is used in herbal medicines for animals, an experiment was carried out to assess the effects of crude M. oleifera leaf extract (CMOLE) on the blood profile of rabbit does during gestation and lactation. Twenty-four mature does (mean weight 2200 g) housed individually were assigned to four treatments in a completely randomised design. The animals in treatments 2, 3 and 4 were orally given 100, 200 and 300 mL/L CMOLE, respectively, at 2.5 mL/kg body weight at 48 h intervals for 9 weeks. The control animals (treatment 1) were given with water only. All the does were mated with untreated bucks 2 weeks into the experiment. Blood samples were collected at 3rd trimester (day 25 of gestation) and 2nd week of lactation. During gestation, levels of erythrocytes, leukocytes, haematocrit, haemoglobin, lymphocytes, monocytes and eosinophils were not significantly different among the treatments. However, animals on treatment 2 had the highest platelets (148.8 × 10(9)/L), not significantly different from those on treatments 3 (141.5 × 10(9)/L) and 4 (135.0 × 10(9)/L), but higher (p < 0.05) than the control (126.6 × 10(9)/L). Haematological parameters during lactation were not significantly different among the treatments. Of the serum biochemical variables examined during gestation, only urea was higher (p < 0.05) in control rabbits than those administered with 300 mL/L CMOLE. In lactation, only cholesterol was significantly (p < 0.05) reduced with an increase in CMOLE concentration. This suggests that Moringa has a hypocholesterolemic effect and is safe for use up to 300 mL/L for both nutritional and medicinal purposes. PMID:25686552

  3. Gestational age at prior preterm birth does not affect cerclage efficacy

    PubMed Central

    Wing, Deborah A.; Szychowski, Jeff; Owen, John; Hankins, Gary; Iams, Jay D.; Sheffield, Jeanne S.; Perez-Delboy, Annette; Berghella, Vincenzo; Guzman, Edwin R.

    2010-01-01

    OBJECTIVE To evaluate effect of earliest prior spontaneous preterm birth (SPTB) gestational age (GA) on cervical length (CL), pregnancy duration, and ultrasound-indicated cerclage efficacy in a subsequent gestation. STUDY DESIGN Planned secondary analysis of the NICHD- trial of cerclage for CL < 25 mm. Women with at least one prior SPTB between 17-33 6/7 weeks underwent serial vaginal ultrasound screening between 16 and 23 6/7 weeks; CL at qualifying randomization evaluation was utilized. RESULTS We observed a significant correlation (p=0.0008) between prior SPTB GA and qualifying CL. In a linear regression model when controlling for CL and cerclage, neither prior SPTB GA nor the interaction between cerclage and prior birth GA was significant predictor of subsequent birth GA. CONCLUSION While there is an association between prior SPTB GA and CL in women with mid-trimester CL < 25 mm, there does not appear to be a disproportionate benefit of cerclage in women with earlier prior SPTB. PMID:20579957

  4. Gestational Hypertension and Organophosphorus Pesticide Exposure: A Cross-Sectional Study

    PubMed Central

    Ledda, Caterina; Fiore, Maria; Santarelli, Lory; Bracci, Massimo; Mascali, Giuseppe; D'Agati, Maria Grazia; Busà, Alfredo; Ferrante, Margherita; Rapisarda, Venerando

    2015-01-01

    Hypertension is the most common medical problem encountered during pregnancy, complicating 2-3% of pregnancies. High blood pressure (BP) with diastolic BP ≥ 90 mm Hg and/or systolic BP ≥ 140 mm Hg arising after week 22 of pregnancy and resolving after delivery is defined as gestational hypertension (GHY). The aim of this cross-sectional study was to investigate whether occupational and/or environmental exposure to organophosphorus (OP) pesticide affects GHY. Women at approximately 22 weeks of gestation were recruited. OP pesticide exposure in the first trimester of pregnancy was classified into four categories: no exposure, indirect exposure, domestic exposure, and occupational exposure. Application of the exclusion criteria left 2203 participants (mean age 30.4 ± 11.6 years). Data analysis showed that in women with indirect OP pesticide exposure the incidence of GHY was slightly higher than that in the world population, whereas domestic exposure involved a 7% increase and occupational exposure a 12% increase. Analysis of the pesticides used by participants highlighted a possible role for malathion and diazinon (adjusted OR 1.09 and 1.14, resp.). Further investigation of exposed workers and the general population is clearly warranted given the broad diffusion of OP pesticides and their possible public health impact, maybe by including a wider range of health outcomes. PMID:26339602

  5. Plant Operation: Work Week, Administration

    ERIC Educational Resources Information Center

    Nation's Schools and Colleges, 1975

    1975-01-01

    A four-day work week for maintenance workers in the Jefferson County Public Schools in Lakewood, Colorado, reduces absenteeism and increases productivity; a basic manual for physical plant directors is reviewed. (Author/MLF)

  6. My working week: John Innes.

    PubMed

    Innes, John

    2016-07-23

    In the first of a new series of features for Vet Record Careers, John Innes describes a recent working week as referrals director for CVS and a RCVS specialist in small animal orthopaedics. PMID:27450857

  7. TOXICITY AND RECOVERY IN THE PREGNANT MOUSE AFTER GESTATIONAL EXPOSURE TO THE CYANOBACTERIAL TOXIN, CYLINDROSPERMOPSIN

    PubMed Central

    Chernoff, N.; Rogers, E.H.; Zehr, R.D.; Gage, M.I.; Malarkey, D.E.; Bradfield, C. A.; Liu, Y.; Schmid, J.E.; Jaskot, R.H.; Richards, J.H.; Wood, C.R.; Rosen, M.B.

    2010-01-01

    Cylindrospermopsin (CYN) is a tricyclic alkaloid toxin produced by fresh water cyanobacterial species worldwide. CYN has been responsible for both livestock and human poisoning after oral exposure to CYN. This study investigated the toxicity of CYN to pregnant mice exposed during different segments of gestation. The course of recovery and individual responses to the toxin were evaluated. Adverse effects of CYN were monitored up to four weeks post dosing by clinical examination, histopathology, biochemistry, and gene expression. Exposure on gestational days (GD) 8–12 induced significantly more lethality than GD13–17 exposure. Periorbital, gastrointestinal and distal tail hemorrhages were seen in both groups. Serum markers indicative of hepatic injury (alanine amino transferase, aspartate amino transferase and sorbitol dehydrogenase) were increased in both groups; markers of renal dysfunction (blood urea nitrogen and creatinine) were elevated in the GD8–12 animals. Histopathology was observed in the liver (centrilobular necrosis) and kidney (interstitial inflammation) in groups exhibiting abnormal serum markers. The expression profiles of genes involved in ribosomal biogenesis, xenobiotic and lipid metabolism, inflammatory response and oxidative stress were altered 24 hours after the final dose. One week after dosing, gross, histological and serum parameters had returned to normal although increased liver/body weight ratio and one instance of gastrointestinal bleeding was found in the GD13–17 group. Gene expression changes persisted up to two weeks post dosing and returned to normal by four weeks. Responses of individual animals to CYN exposure indicated highly significant inter-animal variability within the treated groups. PMID:20936652

  8. Estimation of gestational age from gall-bladder length.

    PubMed

    Udaykumar, K; Udaykumar, Padmaja; Nagesh, K R

    2016-01-01

    Establishing a precise duration of gestation is vital in situations such as infanticide and criminal abortions. The present study attempted to estimate the gestational age of the foetus from gall-bladder length. Foetuses of various gestational age groups were dissected, and the length of the gall bladder was measured. The results were analysed, and a substantial degree of correlation was statistically confirmed. This novel method is helpful when the foetus is fragmented, putrefied or eviscerated, where this method can be used as an additional parameter to improve the accuracy of foetal age estimation. PMID:25990829

  9. Adiposity in children born small for gestational age.

    PubMed

    Tappy, L

    2006-12-01

    Epidemiological studies indicate that children born small for gestational age (SGA) have an increased risk of metabolic and cardiovascular disorders as adults. This suggests that foetal undernutrition leads to permanent metabolic alterations, which predispose to metabolic abnormalities upon exposure to environmental factors such as low physical activity and/or high-energy intake in later life (thrifty phenotype hypothesis). However, this relationship is not restricted to foetal undernutrition or intrauterine growth retardation, but is also found for children born premature, or for high birth weight children. Furthermore, early post-natal nutrition, and more specifically catch-up growth, appear to modulate cardiovascular risk as well. Intrauterine growth retardation can be induced in animal models by energy/protein restriction, or ligation of uterine arteries. In such models, altered glucose homeostasis, including low beta-cell mass, low insulin secretion and insulin resistance is observed after a few weeks of age. In humans, several studies have confirmed that children born SGA have insulin resistance as adolescents and young adults. Alterations of glucose homeostasis and increased lipid oxidation can indeed be observed already in non-diabetic children born SGA at early pubertal stages. These children also have alterations of stature and changes in body composition (increased fat mass), which may contribute to the pathogenesis of insulin resistance. Permanent metabolic changes induced by foetal/early neonatal nutrition (metabolic inprinting) may involve modulation of gene expression through DNA methylation, or alterations of organ structure. It is also possible that events occurring during foetal/neonatal development lead to long-lasting alterations of the hypothalamo-pituitary-adrenal axis or the hypothalamo-pituitary-insulin-like growth factor-1 axis. PMID:17133233

  10. Selective serotonin reuptake inhibitor use and risk of gestational hypertension

    PubMed Central

    Toh, Sengwee; Mitchell, Allen A.; Louik, Carol; Werler, Martha M.; Chambers, Christina D.; Hernández-Díaz, Sonia

    2009-01-01

    Objective To assess the effects of selective serotonin reuptake inhibitor (SSRI) use on risks of gestational hypertension (GHT) and preeclampsia. Method We used data from 5,731 women with non-malformed infants and no underlying hypertension who participated in the Slone Epidemiology Center Birth Defects Study in 1998-2007. GHT was defined as incident hypertension diagnosed after the 20th week of pregnancy with and without proteinuria (i.e., with and without preeclampsia). We compared the risks of GHT and preeclampsia between users and non-users of SSRIs during pregnancy. Relative risks (RR) and 95% confidence intervals (CI) were estimated by Cox proportional hazard models, adjusting for pre-pregnancy sociodemographic, reproductive, and medical factors. Results GHT was present in 9.0% of the 5,532 non-users and 19.1% of the 199 SSRI users; among users, GHT was present in 13.1% of the 107 women who used SSRIs only in the first trimester and in 26.1% of the 92 who continued SSRIs beyond the first trimester. For preeclampsia, the incidence was 2.4% among non-users, 3.7% among women who were exposed only in the first trimester and 15.2% among those who continued SSRIs beyond the first trimester. Compared with non-users, the adjusted RR of preeclampsia was 1.4 (95% CI: 0.5, 3.8) for women who discontinued and 4.9 (95% CI: 2.7, 8.8) for those who continued SSRIs. Conclusion Whether a causal factor or not, SSRI exposure late in pregnancy might identify women at increased risk for GHT and preeclampsia. Further investigation is required to separate the effects of SSRIs from those of underlying mood disorders. PMID:19122006

  11. Neurological outcome in preterm small for gestational age infants compared to appropriate for gestational age preterm at the age of 18 months: a prospective study.

    PubMed

    Karagianni, Paraskevi; Kyriakidou, Maria; Mitsiakos, Georgios; Chatzioanidis, Helias; Koumbaras, Emmanouel; Evangeliou, Athanasios; Nikolaides, Nikolaos

    2010-02-01

    The aim of this study was to investigate the neurological outcome of premature small for gestational age infants at the corrected age of 18 months by the Hammersmith Infant Neurological Examination. A prospective trial was conducted comparing 41 preterm infants being small for gestational age with 41 appropriate for gestational age infants. Birth weight was significantly lower in small for gestational age infants compared with appropriate for gestational age infants (1724.6 +/- 433 versus 1221 +/- 328 g). There were no significant differences regarding the median gestational age and Apgar scores. Median global scores differ significantly between both groups: 75 (47-78) versus 76 (72-78) for the small for gestational age and appropriate for gestational age infants, respectively. Both groups had optimal scores. In conclusion, although the small for gestational age group scored lower in the Hammersmith Infant Neurological Examination, median global score in both groups was within optimal range. PMID:19372094

  12. 12th Annual School Construction Report, 2007

    ERIC Educational Resources Information Center

    Abramson, Paul

    2007-01-01

    School construction completed in 2006 totaled just more than $20 billion, a drop of seven percent from the record $21.6 billion put in place in 2005. Even so, it was the sixth year in the last seven that annual construction exceeded $20 billion. During the seven years of the present century, school districts have completed construction projects…

  13. The 12th Aerospace Mechanisms Symposium

    NASA Technical Reports Server (NTRS)

    1979-01-01

    Mechanisms developed for various aerospace applications are discussed. Specific topics covered include: boom release mechanisms, separation on space shuttle orbiter/Boeing 747 aircraft, payload handling, spaceborne platform support, and deployment of spaceborne antennas and telescopes.

  14. Gestational diabetes mellitus, programing and epigenetics.

    PubMed

    Yan, Jie; Yang, Huixia

    2014-08-01

    Gestational diabetes mellitus (GDM) is a common medical complication in pregnancy. Offspring exposed to maternal hyperglycemia have a higher birth weight and are prone to develop metabolic disease in adult life. The intrauterine environmental or nutritional status seems to be involved in the fetal programing. The concept of "Developmental Origins of Health and Disease" (DOHaD) has been widely accepted and it brings new insights into the molecular pathogenesis of human diseases. The underlying mechanism is still under discussion and epigenetic mechanisms may provide an explanation for the phenomenon. The aim of this review is to illustrate the role of epigenetic modifications in the development of insulin resistance in metabolic diseases induced by adverse intrauterine exposures. Changes in epigenetic mechanism may be an early event in pathogenesis and progression of the metabolic disease in humans. Studies on epigenetic modifications contribute to our understanding of long-term effects of in utero exposure and shed light on the disease prevention and treatment by modulating epigenetic changes. PMID:24125565

  15. Gestational dexamethasone alters fetal neuroendocrine axis.

    PubMed

    Ahmed, R G

    2016-09-01

    This study tested whether the maternal transport of dexamethasone (DEXA) may affect the development of the neuroendocrine system. DEXA (0.2mg/kg b.w., subcutaneous injection) was administered to pregnant rats from gestation day (GD) 1-20. In the DEXA-treated group, a decrease in maternal serum thyroxine (T4), triiodothyronine (T3), and increase in thyrotropin (TSH) levels (hypothyroid status) were observed at GDs 15 & 20 with respect to control group. The reverse pattern (hyperthyroid status) was observed in their fetuses at embryonic days (EDs) 15 & 20. Although the maternal body weight was diminished, the weight of the thyroid gland was increased at studied GDs as compared to the control group. The fetal growth retardation, hyperleptinemia, hyperinsulinism, and cytokines distortions (transforming growth factor-beta; TGF-β, tumor necrosis factor-alpha; TNF-α, and interferon-γ; IFN-γ) were noticed at examined EDs if compared to the control group. Alternatively, the maternofetal thyroid dysfunctions due to the maternal DEXA administration attenuated the levels of fetal cerebral norepinephrine (NE) and epinephrine (E), and elevated the levels of dopamine (DA) and 5-hydroxytryptamine (5-HT) at considered days. These alterations were age-dependent and might damage the nerve transmission. Finally, maternal DEXA might act as neuroendocrine disruptor causing dyshormonogenesis and fetal cerebral dysfunction. PMID:27220267

  16. Physical activity and gestational diabetes mellitus.

    PubMed

    van Poppel, Mireille N M; Ruchat, Stephanie-May; Mottola, Michelle F

    2014-01-01

    Gestational diabetes mellitus (GDM) is defined as 'carbohydrate intolerance resulting in hyperglycemia of variable severity with onset or first recognition during pregnancy'. GDM is associated with several detrimental health consequences during pregnancy and delivery for both mother and baby. The largest public health impact of GDM is through its role on future diabetes in the mother and obesity and diabetes in the offspring. Physical activity (PA) is likely an effective intervention for prevention and treatment of GDM, given its known effectiveness in prevention and treatment of type 2 diabetes. Based on observational studies, PA initiated before and/or during pregnancy has a positive influence on maternal glucose and insulin metabolism and reduces the risk of GDM. However, although PA interventions have been reported to be effective at improving glycemic control in women who already developed GDM, prenatal PA interventions aimed at preventing GDM have shown modest effectiveness in increasing PA levels and thus were not effective in improving glucose/insulin metabolism or reducing GDM incidence. There is therefore a strong need to develop effective strategies for increasing PA levels, especially in women at high risk for GDM who are often obese and inactive. The optimal intervention for preventing or managing GDM is still unknown, and further studies are needed to determine the type, intensity, frequency and duration for the most successful PA intervention. Furthermore, the effects of PA on neonatal outcomes are not clear, and it is highly recommended that future studies examine more specific neonatal outcomes such as body composition. PMID:25226805

  17. Metformin in gestational diabetes: An emerging contender

    PubMed Central

    Singh, Awadhesh Kumar; Singh, Ritu

    2015-01-01

    Gestational diabetes mellitus (GDM) is defined as any degree of glucose intolerance occurring first time during pregnancy. Its prevalence is simultaneously increasing with the global rise of diabesity. GDM commonly develops, when maternal glucose metabolism is unable to compensate for the progressive development of insulin resistance, arising primarily from the consistently rising diabetogenic placental hormones. It classically develops during the second or third trimester. Theoretically, insulin sensitizers should have been the ideal agent in its treatment, given the insulin resistance, the major culprit in its pathogenesis. Fortunately, majority of women can be treated satisfactorily with lifestyle modification, and approximately 20% requires more intensive treatment. For several decades, insulin has been the most reliable treatment strategy and the gold standard in GDM. Metformin is effective insulin sensitizing agent and an established first line drug in type 2 diabetes currently. As it crosses the placenta, a safety issue remains an obstacle and, therefore, metformin is currently not recommended in the treatment of GDM. Nevertheless, given the emerging clinically equivalent safety and efficacy data of metformin compared to insulin, it appears that it may perhaps open a rather new door in managing GDM. The aim of this review is to critically analyze, the safety and efficacy data of metformin regarding its use in GDM and pregnant mothers with polycystic ovarian disease, which has emerged in past decades. PMID:25729685

  18. Preconceptional Iron Intake and Gestational Diabetes Mellitus.

    PubMed

    Darling, Anne Marie; Mitchell, Allen A; Werler, Martha M

    2016-01-01

    Our objective was to assess the impact of preconceptional heme and non-heme iron on gestational diabetes mellitius (GDM) in the Boston University Slone Epidemiology Birth Defects Study (BDS). This retrospective cohort analysis included 7229 participants enrolled in the BDS between 1998 and 2008 who gave birth to non-malformed infants and were free of pre-existing diabetes. All data were collected through structured interviews conducted within 6 months of delivery. Calorie-adjusted and multivariable odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using logistic regression models. Preconceptional dietary heme iron was modestly associated with an elevated risk of GDM among those (multivariable OR comparing the fifth quintile to the first: 1.55; 95% CI 0.98, 2.46). Conversely, preconceptional dietary non-heme iron was associated with a decreased risk of GDM among those in the fifth quintile of intake compared to the first (multivariable OR: 0.48; 95% CI 0.28, 0.81). Women who consumed supplemental iron during preconception also had a decreased risk of GDM (multivariable OR: 0.78; 95% CI 0.60, 1.02). In conclusion, our data support a positive association between preconceptional heme iron intake and GDM and an inverse association between preconceptional non-heme iron intake from foods and preconceptional intake from supplements. PMID:27231921

  19. Preconceptional Iron Intake and Gestational Diabetes Mellitus

    PubMed Central

    Darling, Anne Marie; Mitchell, Allen A.; Werler, Martha M.

    2016-01-01

    Our objective was to assess the impact of preconceptional heme and non-heme iron on gestational diabetes mellitius (GDM) in the Boston University Slone Epidemiology Birth Defects Study (BDS). This retrospective cohort analysis included 7229 participants enrolled in the BDS between 1998 and 2008 who gave birth to non-malformed infants and were free of pre-existing diabetes. All data were collected through structured interviews conducted within 6 months of delivery. Calorie-adjusted and multivariable odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using logistic regression models. Preconceptional dietary heme iron was modestly associated with an elevated risk of GDM among those (multivariable OR comparing the fifth quintile to the first: 1.55; 95% CI 0.98, 2.46). Conversely, preconceptional dietary non-heme iron was associated with a decreased risk of GDM among those in the fifth quintile of intake compared to the first (multivariable OR: 0.48; 95% CI 0.28, 0.81). Women who consumed supplemental iron during preconception also had a decreased risk of GDM (multivariable OR: 0.78; 95% CI 0.60, 1.02). In conclusion, our data support a positive association between preconceptional heme iron intake and GDM and an inverse association between preconceptional non-heme iron intake from foods and preconceptional intake from supplements. PMID:27231921

  20. Gestational urinary bisphenol A and maternal and newborn thyroid hormone concentrations: The HOME Study

    SciTech Connect

    Romano, Megan E.; Webster, Glenys M.; Vuong, Ann M.; Thomas Zoeller, R.; Chen, Aimin; Hoofnagle, Andrew N.; Calafat, Antonia M.; Karagas, Margaret R.; Yolton, Kimberly; Lanphear, Bruce P.; Braun, Joseph M.

    2015-04-15

    Bisphenol A (BPA), an endocrine disruptor used in consumer products, may perturb thyroid function. Prenatal BPA exposure may have sex-specific effects on thyroid hormones (THs). Our objectives were to investigate whether maternal urinary BPA concentrations during pregnancy were associated with THs in maternal or cord serum, and whether these associations differed by newborn sex or maternal iodine status. We measured urinary BPA concentrations at 16 and 26 weeks gestation among pregnant women in the HOME Study (2003–2006, Cincinnati, Ohio). Thyroid stimulating hormone (TSH) and free and total thyroxine (T{sub 4}) and triiodothyronine (T{sub 3}) were measured in maternal serum at 16 weeks (n=181) and cord serum at delivery (n=249). Associations between BPA concentrations and maternal or cord serum TH levels were estimated by multivariable linear regression. Mean maternal urinary BPA was not associated with cord THs in all newborns, but a 10-fold increase in mean BPA was associated with lower cord TSH in girls (percent change=−36.0%; 95% confidence interval (CI): −58.4, −1.7%), but not boys (7.8%; 95% CI: −28.5, 62.7%; p-for-effect modification=0.09). We observed no significant associations between 16-week BPA and THs in maternal or cord serum, but 26-week maternal BPA was inversely associated with TSH in girls (−42.9%; 95% CI: −59.9, −18.5%), but not boys (7.6%; 95% CI: −17.3, 40.2%; p-for-effect modification=0.005) at birth. The inverse BPA–TSH relation among girls was stronger, but less precise, among iodine deficient versus sufficient mothers. Prenatal BPA exposure may reduce TSH among newborn girls, particularly when exposure occurs later in gestation. - Highlights: • Examined associations of BPA with thyroid hormones in pregnant women and newborns. • Assessed effect modification of BPA–thyroid hormone associations by newborn sex. • Greater BPA related to decreased thyroid stimulating hormone in girls' cord serum. • Results may

  1. Consideration of the gestational carrier: a committee opinion.

    PubMed

    2013-06-01

    Gestational carriers have a right to be fully informed of the risks of the surrogacy process and of pregnancy, should receive psychological evaluation and counseling, and should have independent legal counsel. PMID:23541404

  2. Do We Know What Causes Gestational Trophoblastic Disease?

    MedlinePlus

    ... know what causes gestational trophoblastic disease? Normally, the sperm and egg cells each provide a set of ... hydatidiform (HY-duh-TIH-dih-form) moles , a sperm cell fertilizes an abnormal egg cell that has ...

  3. DALI: Vitamin D and lifestyle intervention for gestational diabetes mellitus (GDM) prevention: an European multicentre, randomised trial – study protocol

    PubMed Central

    2013-01-01

    Background Gestational diabetes mellitus (GDM) is an increasing problem world-wide. Lifestyle interventions and/or vitamin D supplementation might help prevent GDM in some women. Methods/design Pregnant women at risk of GDM (BMI≥29 (kg/m2)) from 9 European countries will be invited to participate and consent obtained before 19+6 weeks of gestation. After giving informed consent, women without GDM will be included (based on IADPSG criteria: fasting glucose<5.1mmol; 1 hour glucose <10.0 mmol; 2 hour glucose <8.5 mmol) and randomized to one of the 8 intervention arms using a 2×(2×2) factorial design: (1) healthy eating (HE), 2) physical activity (PA), 3) HE+PA, 4) control, 5) HE+PA+vitamin D, 6) HE+PA+placebo, 7) vitamin D alone, 8) placebo alone), pre-stratified for each site. In total, 880 women will be included with 110 women allocated to each arm. Between entry and 35 weeks of gestation, women allocated to a lifestyle intervention will receive 5 face-to-face, and 4 telephone coaching sessions, based on the principles of motivational interviewing. The lifestyle intervention includes a discussion about the risks of GDM, a weight gain target <5kg and either 7 healthy eating ‘messages’ and/or 5 physical activity ‘messages’ depending on randomization. Fidelity is monitored by the use of a personal digital assistance (PDA) system. Participants randomized to the vitamin D intervention receive either 1600 IU vitamin D or placebo for daily intake until delivery. Data is collected at baseline measurement, at 24–28 weeks, 35–37 weeks of gestation and after delivery. Primary outcome measures are gestational weight gain, fasting glucose and insulin sensitivity, with a range of obstetric secondary outcome measures including birth weight. Discussion DALI is a unique Europe-wide randomised controlled trial, which will gain insight into preventive measures against the development of GDM in overweight and obese women. Trial registration ISRCTN70595832 PMID:23829946

  4. Recommendations for practices utilizing gestational carriers: a committee opinion.

    PubMed

    2015-01-01

    This document provides the latest recommendations for evaluation of gestational carriers and intended parents. It incorporates recent information from the US Centers for Disease Control and Prevention, the US Food and Drug Administration, and the American Association of Tissue Banks, with which all programs offering gestational carrier services must be thoroughly familiar. This document replaces the previous document of the same name, last published in 2012. PMID:25481637

  5. Is Doppler ultrasound useful for evaluating gestational trophoblastic disease?

    PubMed Central

    Lin, Lawrence H; Bernardes, Lisandra S; Hase, Eliane A; Fushida, Koji; Francisco, Rossana P V

    2015-01-01

    Doppler ultrasound is a non-invasive method for evaluating vascularization and is widely used in clinical practice. Gestational trophoblastic neoplasia includes a group of highly vascularized malignancies derived from placental cells. This review summarizes data found in the literature regarding the applications of Doppler ultrasound in managing patients with gestational trophoblastic neoplasia. The PubMed/Medline, Web of Science, Cochrane and LILACS databases were searched for articles published in English until 2014 using the following keywords: “Gestational trophoblastic disease AND Ultrasonography, Doppler.” Twenty-eight articles met the inclusion criteria and were separated into the 4 following groups according to the aim of the study. 1 Doppler ultrasound does not seem to be capable of differentiating partial from complete moles, but it might be useful when evaluating pregnancies in which a complete mole coexists with a normal fetus. 2 There is controversy in the role of uterine artery Doppler velocimetry in the prediction of development of gestational trophoblastic neoplasia. 3 Doppler ultrasound is a useful tool in the diagnosis of gestational trophoblastic neoplasia because abnormal myometrial vascularization and lower uterine artery Doppler indices seem to be correlated with invasive disease. 4 Lower uterine artery Doppler indices in the diagnosis of gestational trophoblastic neoplasia are associated with methotrexate resistance and might play a role in prognosis. CONCLUSION: Several studies support the importance of Doppler ultrasound in the management of patients with gestational trophoblastic neoplasia, particularly the role of Doppler velocimetry in the prediction of trophoblastic neoplasia and the chemoresistance of trophoblastic tumors. Doppler findings should be used as ancillary tools, along with human chorionic gonadotropin assessment, in the diagnosis of gestational trophoblastic neoplasia. PMID:26735221

  6. Gestational gigantomastia with complete resolution in a Nigerian woman

    PubMed Central

    Ezem, B U; Osuagwu, C C; Opara, K A

    2011-01-01

    Physiological enlargement of the breasts occurs at puberty and during pregnancy. It is known as gestational gigantomastia when enlargement in pregnancy becomes excessive, uncomfortable and embarrassing. Gestational gigantomastia may have far reaching effects for the mother and fetus. This rare condition is associated with considerable morbidity but may be associated with good fetal outcome. Our case was very interesting because it was managed conservatively and postpartum there was complete spontaneous resolution. PMID:22707463

  7. Anembryonic Gestation in Wild South American Sea Lion, Otaria flavescens.

    PubMed

    Grandi, M F; Crespo, E A; Dans, S L

    2016-10-01

    We present the first record and description of an anembryonic gestation in a wild South America sea lion, Otaria flavescens (Carnivora, Pinniped). This is the first report of an anembryonic gestation in a wild marine mammal species. This description furthers the knowledge of general aspects of the reproduction of an otariid species, which presents the particularities of delayed implantation and polygynic breeding system, and adds information on a reproductive abnormality in marine mammals. PMID:26497953

  8. Severe obesity, gestational weight gain, and adverse birth outcomes123

    PubMed Central

    Bodnar, Lisa M; Siega-Riz, Anna Maria; Simhan, Hyagriv N; Himes, Katherine P; Abrams, Barbara

    2010-01-01

    Background: The 2009 Institute of Medicine (IOM) Committee to Reevaluate Gestational Weight Gain Guidelines concluded that there were too few data to inform weight-gain guidelines by obesity severity. Therefore, the committee recommended a single range, 5–9 kg at term, for all obese women. Objective: We explored associations between gestational weight gain and small-for-gestational-age (SGA) births, large-for-gestational-age (LGA) births, spontaneous preterm births (sPTBs), and medically indicated preterm births (iPTBs) among obese women who were stratified by severity of obesity. Design: We studied a cohort of singleton, live-born infants without congenital anomalies born to obesity class 1 (prepregnancy body mass index [BMI (in kg/m2)]: 30–34.9; n = 3254), class 2 (BMI: 35–39.9; n = 1451), and class 3 (BMI: ≥40; n = 845) mothers. We defined the adequacy of gestational weight gain as the ratio of observed weight gain to IOM-recommended gestational weight gain. Results: The prevalence of excessive gestational weight gain declined, and weight loss increased, as obesity became more severe. Generally, weight loss was associated with an elevated risk of SGA, iPTB, and sPTB, and a high weight gain tended to increase the risk of LGA and iPTB. Weight gains associated with probabilities of SGA and LGA of ≤10% and a minimal risk of iPTB and sPTB were as follows: 9.1–13.5 kg (obesity class 1), 5.0–9 kg (obesity class 2), 2.2 to <5.0 kg (obesity class 3 white women), and <2.2 kg (obesity class 3 black women). Conclusion: These data suggest that the range of gestational weight gain to balance risks of SGA, LGA, sPTB, and iPTB may vary by severity of obesity. PMID:20357043

  9. Heterogeneity of maternal characteristics and impact on gestational diabetes (GDM) risk-Implications for universal GDM screening?

    PubMed

    Huvinen, Emilia; Grotenfelt, Nora Elisabeth; Eriksson, Johan Gunnar; Rönö, Kristiina; Klemetti, Miira Marjuska; Roine, Risto; Pöyhönen-Alho, Maritta; Tiitinen, Aila; Andersson, Sture; Laivuori, Hannele; Knip, Mikael; Valkama, Anita; Meinilä, Jelena; Kautiainen, Hannu; Stach-Lempinen, Beata; Koivusalo, Saila Birgitta

    2016-02-01

    Objective To study the incidence of gestational diabetes mellitus (GDM) in relation to phenotypic characteristics and gestational weight gain (GWG) among women at high risk for GDM. Materials and methods This is a secondary analysis of a GDM prevention study (RADIEL), a randomized controlled trial conducted in Finland. 269 women with a history of GDM and/or a pre-pregnancy body mass index (BMI) ≥ 30 kg/m(2) were enrolled before 20 weeks of gestation and divided into four groups according to parity, BMI and previous history of GDM. The main outcome was incidence of GDM. Results There was a significant difference in incidence of GDM between the groups (p < 0.001). Women with a history of GDM and BMI <30 kg/m(2) showed the highest incidence (35.9%). At baseline they had fewer metabolic risk factors and by the second trimester they gained more weight. There was no interaction between GWG and GDM outcome and no significant difference in the prevalence of diabetes-associated antibodies. Conclusion Despite a healthier metabolic profile at baseline the non-obese women with a history of GDM displayed a markedly higher cumulative incidence of GDM. GWG and the presence of diabetes-associated antibodies were not associated with GDM occurrence among these high-risk women. Key message Despite a healthier metabolic profile at baseline the non-obese women with previous gestational diabetes mellitus display a markedly higher cumulative incidence of gestational diabetes mellitus. PMID:26745028

  10. Histopathological placental lesions in mild gestational hyperglycemic and diabetic women

    PubMed Central

    2011-01-01

    Objective To investigate and compare the incidence of histopathological placental lesions in mild gestational hyperglycemia, gestational diabetes and overt diabetes at term and preterm gestation. Research design and methods One-hundred-and-thirty-one placental samples were collected from Diabetes mellitus (DM) positive screened patients. Two diagnostic tests, glycemic profile and 100 g oral glucose tolerance test (OGTT) in parallel identified 4 groups normoglycemic, mild gestational hyperglycemia (MGH), gestational DM (GDM) or overt DM (DM). Placental tissue specimens and sections from 4 groups were obtained by uniform random sampling and stained with hematoxylin-eosin. Results Placentas from MGH group presented 17 types of histopathological change and higher rates of syncytial nodes and endarteritis. GDM placentas presented only nine types of histopathological change, high rates of dysmaturity, low rates of calcification and no syncytial nodes. Overt DM placentas showed 22 types of histopathological change, 21 of which were present in the preterm period. There were histopathological similarities between MGH and DM placentas, but the former exhibited a higher incidence of endarteritis, which has been described as a "post-mortem" phenomenon. Conclusion Our results confirmed that the distinct placental changes associated with DM and MGH depend on gestational period during which the diabetic insult occurs. It may reasonably be inferred that subclinical maternal hyperglycemia during pregnancy, as showed in MGH group, is responsible for increased placental endarteritis, a postmortem lesion in the live fetus. PMID:21831283

  11. Postnatal Foot Length to Determine Gestational Age: A Pilot Study.

    PubMed

    Wyk, Lizelle Van; Smith, Johan

    2016-04-01

    Gestational age is a critical factor in the management, decision-making, prognostication and follow-up of newborn infants. It is also essential for research and epidemiology. In the absence of an early assessment of fetal gestation by abdominal ultrasound, many neonatal units in developing countries determine gestational age by neonatal scores and last menstrual period-both of which are highly inaccurate. The aim of this pilot study was to determine whether postnatal foot length measurement could accurately determine gestational age in a specified South African hospitalized neonatal population. Foot length was measured with a plastic Verniere's caliper. Foot length was shown to correlate well with gestational age (r = 0.919,p < 0.001). Intra-observer and inter-observer variability of foot length measurements was low. Foot length can therefore be used with high accuracy to determine the gestational age in a population where there is poor access to or utilization of antenatal sonar. PMID:26758249

  12. Gestational changes in iodine status in a cohort study of pregnant women from the United Kingdom: season as an effect modifier123

    PubMed Central

    Bath, Sarah C; Furmidge-Owen, Victoria L; Redman, Christopher WG

    2015-01-01

    Background: Iodine is required throughout pregnancy for thyroid hormone production, which is essential for fetal brain development. Studies of iodine status in pregnant women from the United Kingdom (UK) have focused on early gestation (<16 wk). Data on the effect of advancing gestation on urinary iodine excretion are conflicting, with suggestions of both an increase and a decrease. Objectives: The aims were to evaluate iodine status in a cohort of UK pregnant women and to explore how it changes throughout gestation. Design: We used samples and data from 230 UK pregnant women who were recruited to the Selenium in PRegnancy INTervention study. Iodine concentration was measured in spot-urine samples that were collected at ∼12, 20, and 35 wk of gestation; creatinine concentration was also measured to correct for urine dilution. A linear mixed model was used to explore the effect of gestational week on iodine-to-creatinine ratio, with change in season, body mass index, daily milk intake, and maternal age controlled for. Results: The median urinary iodine concentration from urine samples collected at all time points (n = 662) was 56.8 μg/L, and the iodine-to-creatinine ratio was 116 μg/g, thus classifying this cohort as mildly-to-moderately iodine deficient. The median iodine-to-creatinine ratios at 12, 20, and 35 wk were 102.5, 120.0, and 126.0 μg/g, respectively. Only 3% of women were taking iodine-containing prenatal supplements. The iodine-to-creatinine ratio increased with advancing gestation, and there was a significant interaction between gestational week and season (P = 0.026). For a 1-wk increase in gestation, the iodine-to-creatinine ratio increased by a factor of 1.05 (95% CI: 1.02, 1.08) in winter and by a factor of 1.04 (95% CI: 1.00, 1.08) in summer. Conclusions: This group of UK pregnant women was mildly-to-moderately iodine deficient at all trimesters, which is of public health concern. The finding that the iodine-to-creatinine ratio increased over

  13. Screening, diagnosis and management of gestational diabetes mellitus: A national survey

    PubMed Central

    Sukumaran, S; Bustani, R; Song, S; Farrell, T A

    2014-01-01

    Background and methods We conducted a National survey between February and June 2012 to evaluate the practices concerning screening, diagnosis and management of Gestational Diabetes (GDM) in England. Results A total of 102/126 (80%) maternity units responded. The National Institute of Health and Clinical Excellence (NICE) recommended screening criteria were used by 83% of units. All the units performed 2 h 75 g oral glucose tolerance test (OGTT) between 24 and 28 weeks. There was a wide variation in the diagnostic blood glucose values used by different units. About 86% of units used a 2 h blood glucose value of ≥7.8 mmol/l and 45% of units used fasting value ≥6.1 mmol/l to diagnose GDM. Only 26% of units advised self-monitoring of blood glucose pre meal and 1 h post-meal, whereas 64% of units advised monitoring 2 h after the meal. Metformin was started when women did not respond to dietary measures in 101 units (99%). Regular growth scans every four weeks from 28 weeks onwards were performed by 99 units (97%). Women on metformin with no complications were offered induction of labour at 38 completed weeks in 97 units (95%). 84 maternity units (82.3%) offered OGTT six weeks postnatally. Conclusion Our survey has shown consistency in screening using the NICE criteria, use of 2 h 75 g OGTT at 24–28 weeks, in providing dietary support, use of metformin and ultrasound for fetal growth. But there is wide variation in the criteria used to diagnose GDM, self-monitoring of blood glucose, induction of labour and six weeks postnatal testing.

  14. Younger gestational age is associated with worse neurodevelopmental outcomes after cardiac surgery in infancy

    PubMed Central

    Goff, Donna A.; Luan, Xianqun; Gerdes, Marsha; Bernbaum, Judy; D’Agostino, Jo Ann; Rychik, Jack; Wernovsky, Gil; Licht, Daniel J.; Nicolson, Susan C.; Clancy, Robert R.; Spray, Thomas L.; Gaynor, J. William

    2013-01-01

    Objective Evaluate the impact of near-term delivery on neurodevelopmental (ND) outcomes in children with congenital heart disease (CHD). Methods Secondary analysis of data from a study of genetic polymorphisms and ND outcomes after cardiac surgery in infants. The effect of gestational age (GA) as a continuous variable on ND outcomes was evaluated using general linear regression models. GA was also evaluated as a categorical variable to seek a threshold for better outcomes. ND domains tested at 4 years of age included cognition, language skills, attention, impulsivity, memory, executive function, social competence, visual-motor, and fine-motor skills. Results ND outcomes and GA were available for 378 infants. Median GA was 39 weeks (range, 28–42 weeks) with 351 born at 36 weeks or more (near-term/term). In univariate analysis of the near-term/term subgroup, older GA predicted better performance for cognition, visual-motor, and fine-motor skills. After covariate adjustment, older GA predicted better performance for fine-motor skills (P = .018). Performance for cognition, language, executive function, social skills, visual-motor, and fine-motor skills was better for those born at 39 to 40 weeks of GA or more versus those born at less than 39 weeks (all P<.05). Conclusions These findings are consistent with the hypothesis that delivery before 39 to 40 weeks of GA is associated with worse outcomes in patients with CHD. Early delivery of a child with CHD is often indicated because of maternal or fetal health issues. In the absence of these concerns, these data suggest that elective (or spontaneous) delivery at 39 to 40 weeks of GA is associated with better ND outcomes. PMID:22340027

  15. Functional foods for health promotion: state-of-the-science on dietary flavonoids. Extended abstracts from the 12th Annual Conference on Functional Foods for Health Promotion, April 2009.

    PubMed

    Williamson, Gary; Sies, Helmut; Heber, David; Keen, Carl L; Macdonald, Ian A; Actis-Goretta, Lucas; Actis-Gorreta, Lucas; Momma, Tony Y; Ottaviani, Javier I; Holt, Roberta R; Schroeter, Hagen; Heiss, Christian

    2009-12-01

    The extended abstracts in this report are based on presentations from the 12(th) Special Conference on Functional Foods for Health Promotion, cosponsored by the North American branch of the International Life Sciences Institute (ILSI North America) Project Committee on Flavonoids and the American Society for Nutrition at the Experimental Biology meeting in April 2009. The theme of this year's special conference was "State-of-the-Science on Dietary Flavonoids." The conference began with a general introduction and overview of flavonoids and their presence in the diet as well as the estimated intake levels in the US population. Subsequent presentations addressed issues pertaining to study design and interpretation, mechanisms of action, and the potential health impacts related to inflammation, the vasculature, and the brain. The present summary of the current science indicates that dietary flavonoids, particularly flavanols, show promising potential for reducing cardiovascular disease risk via reduction of inflammation and improvement in vascular function. However, the existing data must be interpreted cautiously, with consideration given to the compound tested (i.e., parent or metabolite), the use of controls, and the practicality of the concentrations used. While more data are needed on the long-term health impacts of dietary flavonoids in humans, including the efficacious dose, current data indicate it may soon be possible to develop public health messages about flavonoid-rich foods. PMID:19941619

  16. Maternal folic acid supplementation modulates DNA methylation and gene expression in the rat offspring in a gestation period-dependent and organ-specific manner.

    PubMed

    Ly, Anna; Ishiguro, Lisa; Kim, Denise; Im, David; Kim, Sung-Eun; Sohn, Kyoung-Jin; Croxford, Ruth; Kim, Young-In

    2016-07-01

    Maternal folic acid supplementation can alter DNA methylation and gene expression in the developing fetus, which may confer disease susceptibility later in life. We determined which gestation period and organ were most sensitive to the modifying effect of folic acid supplementation during pregnancy on DNA methylation and gene expression in the offspring. Pregnant rats were randomized to a control diet throughout pregnancy; folic acid supplementation at 2.5× the control during the 1st, 2nd or 3rd week of gestation only; or folic acid supplementation throughout pregnancy. The brain, liver, kidney and colon from newborn pups were analyzed for folate concentrations, global DNA methylation and gene expression of the Igf2, Er-α, Gr, Ppar-α and Ppar-γ genes. Folic acid supplementation during the 2nd or 3rd week gestation or throughout pregnancy significantly increased brain folate concentrations (P<.001), while only folic acid supplementation throughout pregnancy significantly increased liver folate concentrations (P=.005), in newborn pups. Brain global DNA methylation incrementally decreased from early to late gestational folic acid supplementation and was the lowest with folic acid supplementation throughout pregnancy (P=.026). Folic acid supplementation in late gestation or throughout pregnancy significantly decreased Er-α, Gr and Ppar-α gene expression in the liver (P<.05). The kidney and colon were resistant to the effect of folic acid supplementation. Maternal folic acid supplementation affects tissue folate concentrations, DNA methylation and gene expression in the offspring in a gestation-period-dependent and organ-specific manner. PMID:27152636

  17. Portuguese Special Course: 12 Weeks.

    ERIC Educational Resources Information Center

    Defense Language Inst., Washington, DC.

    This 12-week course in beginning Portuguese comprises four volumes of student text (Lessons 1-55) and a fifth volume of Portuguese-English/English-Portuguese vocabulary. Lesson materials consist of basic dialogs with English translation, recombination dialogs, readings and comprehension questions, oral exercises, and in later units, additional…

  18. Adult Learners' Week in Switzerland.

    ERIC Educational Resources Information Center

    Jermann, Ruth

    2002-01-01

    The slogan of International Adult Learners Week in Switzerland is "one hour a day for learning." Four goals of the lifelong learning agenda are government policies to promote access, public awareness campaigns, creation of public learning places, and development of networks for real and virtual learning. (SK)

  19. Thai 18-Week Course: Glossary.

    ERIC Educational Resources Information Center

    Defense Language Inst., Washington, DC.

    This glossary is part of the Defense Language Institute's 18-week "Short Course in Thai." Other course materials include six 10-lesson volumes and accompanying tape recordings together with an "Introduction to Thai Script." The course is designed to train native-English speakers to level 1, elementary proficiency in speaking, understanding, and…

  20. Troponin T and NT ProBNP Levels in Gestational, Type 1 and Type 2 Diabetic Mothers and Macrosomic Infants.

    PubMed

    Mert, Mustafa Kurthan; Satar, Mehmet; Özbarlas, Nazan; Yaman, Akgün; Özgünen, Fatma Tuncay; Asker, Hüseyin Selim; Çekinmez, Eren Kale; Tetiker, Tamer

    2016-01-01

    This study compares NT proBNP and troponin T levels in umbilical cord arterial blood and postnatal echocardiographic findings for infants of gestational and pregestational diabetic mothers and macrosomic infants. Twenty-seven infants of pregestational diabetic mothers, 61 infants of gestational diabetic mothers and 37 macrosomic infants of nondiabetic mothers were prospectively enrolled in this study along with a control group of 58 healthy infants of mothers without any pregestational or gestational disorders as the control group. All enrollees were born after 34 weeks of gestation. For this study, umbilical cord blood was drawn during delivery to determine NT proBNP and troponin T levels. Echocardiography was performed 24-72 h after the delivery. Umbilical cord troponin T and NT proBNP levels were found to be higher in the diabetic and macrosomic groups than in the control group (all of them p < 0.001). NT proBNP levels were positively correlated with interventricular septum thickness in the pregestational and gestational infants of diabetic mothers groups (r = 0.564 and r = 0.560, respectively, p < 0.01). Both pregestational and gestational diabetic mothers were divided into two groups according to HbA1c levels in the third trimester as good (<6.1 %) and suboptimal (>6.1 %) metabolic control. In the good and suboptimal metabolic control diabetic groups, NT proBNP levels were also positively correlated with interventricular septum thickness (r = 0.536 and r = 0.576, respectively, p < 0.01). In the suboptimal metabolic control diabetic group, NT proBNP was only found to be positively correlated with the left ventricular mass index (r = 0.586, p < 0.01). While there was no correlation in the myocardial performance index between infants of diabetic mothers and the control group, the myocardial performance index of macrosomic infants was lower than that of the control group (p = 0.017). Cardiac biomarkers (NT proBNP and troponin T) were

  1. Experimental ovine toxoplasmosis: influence of the gestational stage on the clinical course, lesion development and parasite distribution.

    PubMed

    Castaño, Pablo; Fuertes, Miguel; Regidor-Cerrillo, Javier; Ferre, Ignacio; Fernández, Miguel; Ferreras, M Carmen; Moreno-Gonzalo, Javier; González-Lanza, Camino; Pereira-Bueno, Juana; Katzer, Frank; Ortega-Mora, Luis Miguel; Pérez, Valentín; Benavides, Julio

    2016-01-01

    The relation between gestational age and foetal death risk in ovine toxoplasmosis is already known, but the mechanisms involved are not yet clear. In order to study how the stage of gestation influences these mechanisms, pregnant sheep of the same age and genetic background were orally dosed with 50 oocysts of Toxoplasma gondii (M4 isolate) at days 40 (G1), 90 (G2) and 120 (G3) of gestation. In each group, four animals were culled on the second, third and fourth week post infection (pi) in order to evaluate parasite load and distribution, and lesions in target organs. Ewes from G1 showed a longer period of hyperthermia than the other groups. Abortions occurred in all groups. While in G2 they were more frequent during the acute phase of the disease, in G3 they mainly occurred after day 20 pi. After challenge, parasite and lesions in the placentas and foetuses were detected from day 19 pi in G3 while in G2 or G1 they were only detected at day 26 pi. However, after initial detection at day 19 pi, parasite burden, measured through RT-PCR, in placenta or foetus of G3 did not increase significantly and, at in the third week pi it was lower than that measured in foetal liver or placenta from G1 to G3 respectively. These results show that the period of gestation clearly influences the parasite multiplication and development of lesions in the placenta and foetus and, as a consequence, the clinical course in ovine toxoplasmosis. PMID:26983883

  2. Quantitative Assessment of Cardiac Function in Fetuses of Women with Maternal Gestational Thyroid Dysfunction Using VVI Echocardiography

    PubMed Central

    Liu, Meixin; Yu, Jing; Fu, Xiuxiu; Wan, Wei

    2015-01-01

    Background The study aimed to investigate the clinical value of velocity vector imaging (VVI) in assessing heart function in fetuses of pregnant women with thyroid dysfunction. The inter-observer and intra-observer variability was assessed for all VVI parameters observed. Material/Methods The participants were enrolled from singleton pregnant women with gestational ages ranging 24+0 to 40+1 weeks who visited the Department of Obstetrics and Gynecology at the Affiliated Hospital of Qingdao University, China, for prenatal care from July 2011 to February 2014. Digital 2-dimensional (2D) dynamic 4-chamber images of the heart were collected. A total of qualified 226 images from 125 fetuses of pregnant women with normal thyroid (control group), 64 fetuses of pregnant women with hypothyroidism (hypothyroidism group), and 37 fetuses of pregnant women with hyperthyroidism (hyperthyroidism group) were interrogated offline using VVI software. The echocardiographic parameters including the myocardium peak systolic velocity (Vs), peak diastolic velocity (Vd), peak systolic strain (S), peak systolic strain rate (SRs), peak diastolic strain rate (SRd) of RV and LV, were obtained from the velocity curves of 2D myocardial motion. The heart rate was measured using a virtual M-mode algorithm built into the software. Results The study found that the longitudinal Vs and Vd of both ventricles in the control group gradually decreased from basal segments to apical segments and significantly increased over the gestation. S, SRs, and SRd of both ventricles remained stable after middle gestation. Compared with the control group, the hypothyroidism and hyperthyroidism groups exhibited significantly reduced S, SRs, and SRd, even for fetuses at 24-weeks gestation. There were no significant differences in global Vs and global Vd between the control group and the hyperthyroidism or hypothyroidism groups. Conclusions The thyroid dysfunction of pregnant women may damage fetal heart function, and

  3. Association of in Utero Organophosphate Pesticide Exposure and Fetal Growth and Length of Gestation in an Agricultural Population

    PubMed Central

    Eskenazi, Brenda; Harley, Kim; Bradman, Asa; Weltzien, Erin; Jewell, Nicholas P.; Barr, Dana B.; Furlong, Clement E.; Holland, Nina T.

    2004-01-01

    Although pesticide use is widespread, little is known about potential adverse health effects of in utero exposure. We investigated the effects of organophosphate pesticide exposure during pregnancy on fetal growth and gestational duration in a cohort of low-income, Latina women living in an agricultural community in the Salinas Valley, California. We measured nonspecific metabolites of organophosphate pesticides (dimethyl and diethyl phosphates) and metabolites specific to malathion (malathion dicarboxylic acid), chlorpyrifos [O,O-diethyl O-(3,5,6-trichloro-2-pyridinyl) phosphoro-thioate], and parathion (4-nitrophenol) in maternal urine collected twice during pregnancy. We also measured levels of cholinesterase in whole blood and butyryl cholinesterase in plasma in maternal and umbilical cord blood. We failed to demonstrate an adverse relationship between fetal growth and any measure of in utero organophosphate pesticide exposure. In fact, we found increases in body length and head circumference associated with some exposure measures. However, we did find decreases in gestational duration associated with two measures of in utero pesticide exposure: urinary dimethyl phosphate metabolites [βadjusted = −0.41 weeks per log10 unit increase; 95% confidence interval (CI), −0.75–−0.02; p = 0.02], which reflect exposure to dimethyl organophosphate compounds such as malathion, and umbilical cord cholinesterase (βadjusted = 0.34 weeks per unit increase; 95% CI, 0.13–0.55; p = 0.001). Shortened gestational duration was most clearly related to increasing exposure levels in the latter part of pregnancy. These associations with gestational age may be biologically plausible given that organophosphate pesticides depress cholinesterase and acetylcholine stimulates contraction of the uterus. However, despite these observed associations, the rate of preterm delivery in this population (6.4%) was lower than in a U.S. reference population. PMID:15238287

  4. Cesarean section, gestational age, and transient tachypnea of the newborn: timing is the key.

    PubMed

    Riskin, Arieh; Abend-Weinger, Marta; Riskin-Mashiah, Shlomit; Kugelman, Amir; Bader, David

    2005-10-01

    The purpose of this study was to identify risk factors and to characterize infants with transient tachypnea of the newborn (TTN). A total of 67 newborns with TTN, born at gestational age (GA)>or=35 weeks, were studied. Newborns delivered before and after each study case served as controls. Mean GA was lower and cesarean section (CS) rate was higher in the TTN group (38.2+/-2.3 versus 39.5+/-1.4 weeks, p<0.001; 50.7% versus 22.4%, p<0.001). GA<38 weeks was found to be associated with increased risk for TTN in infants delivered by elective CS. TTN was associated with significant morbidities and longer hospital stay (7.2+/-5.6 versus 2.9+/-1.4 days; p<0.001). Delivery by CS and younger GA are risk factors for TTN. Although TTN is a self-limited disease, it is associated with significant morbidities. Scheduling elective CS at GA of not less than 38 weeks may decrease the frequency of TTN. PMID:16215925

  5. The Effect of Omega-3 Docosahexaenoic Acid Supplementation on Gestational Length: Randomized Trial of Supplementation Compared to Nutrition Education for Increasing n-3 Intake from Foods

    PubMed Central

    Harris, Mary A.; Reece, Melanie S.; McGregor, James A.; Wilson, John W.; Burke, Shannon M.; Wheeler, Marsha; Anderson, Jennifer E.; Auld, Garry W.; French, Janice I.; Allen, Kenneth G. D.

    2015-01-01

    Objective. DHA supplementation was compared to nutrition education to increase DHA consumption from fish and DHA fortified foods. Design. This two-part intervention included a randomized double-blind placebo controlled DHA supplementation arm and a nutrition education arm designed to increase intake of DHA from dietary sources by 300 mg per day. Setting. Denver Health Hospitals and Clinics, Denver, Colorado, USA. Population. 871 pregnant women aged 18–40 were recruited between16 and 20 weeks of gestation of whom 564 completed the study and complete delivery data was available in 505 women and infants. Methods. Subjects received either 300 or 600 mg DHA or olive oil placebo or nutrition education. Main Outcome Variable. Gestational length. Results. Gestational length was significantly increased by 4.0–4.5 days in women supplemented with 600 mg DHA per day or provided with nutrition education. Each 1% increase in RBC DHA at delivery was associated with a 1.6-day increase in gestational length. No significant effects on birth weight, birth length, or head circumference were demonstrated. The rate of early preterm birth (1.7%) in those supplemented with DHA (combined 300 and 600 mg/day) was significantly lower than in controls. Conclusion. Nutrition education or supplementation with DHA can be effective in increasing gestational length. PMID:26413500

  6. The risk of prematurity and small-for-gestational-age birth in Mexico City: the effects of working conditions and antenatal leave.

    PubMed Central

    Cerón-Mireles, P; Harlow, S D; Sánchez-Carrillo, C I

    1996-01-01

    OBJECTIVES: This study examined the effect of working conditions, occupational stress, and antenatal leave on risk of small-for-gestational age and premature births in Mexico City. METHODS: Over a 3-month period, 2663 (96.2%) of 2767 women who gave birth at three major hospitals and worked at least 3 months during pregnancy were interviewed shortly after delivery. After the exclusion of multiple gestations and birth defects, 261 (10.0%) small-for-gestational-age and 288 (11.0%) preterm births were identified. RESULTS: For small-for-gestational-age births, working more than 50 hours a week (odds ratio [OR] = 1.59), standing more than 7 hours a day (OR = 1.40), and no antenatal leave (OR = 1.55) were associated with an increased risk. Women with no antenatal leave were also much more likely to give birth prematurely (OR = 3.04). CONCLUSIONS: In this study, arduous working conditions and lack of antenatal leave benefits were found to increase the risk of poor birth outcome in Mexican women. Enforcement of existing antenatal leave laws and provision of comparable benefits for the uninsured may reduce the incidence of small-for-gestational-age births and prematurity. PMID:8659657

  7. Four Weeks of Sprint Interval Training Improves 5-km Run Performance.

    PubMed

    Denham, Joshua; Feros, Simon A; OʼBrien, Brendan J

    2015-08-01

    Sprint interval training (SIT) rapidly improves cardiorespiratory fitness but demands less training time and volume than traditional endurance training. Although the health and fitness benefits caused by SIT have received considerable research focus, the effect of short-term SIT on 5-km run performance is unknown. Thirty healthy untrained participants (aged 18-25 years) were allocated to a control (n = 10) or a SIT (n = 20) group. Sprint interval training involved 3-8 sprints at maximal intensity, 3 times a week for 4 weeks. Sprints were progressed to 8 by the 12th session. All participants completed a 5-km time trial on a public running track and an incremental treadmill test in an exercise physiology laboratory to determine 5-km run performance and maximum oxygen uptake, respectively, before and after the 4-week intervention. Relative to the controls, sprint interval-trained participants improved 5-km run performance by 4.5% (p < 0.001), and this was accompanied by improvements in absolute and relative maximum oxygen uptake (4.9%, p = 0.04 and 4.5%, p = 0.045, respectively). Therefore, short-term SIT significantly improves 5-km run performance in untrained young men. We believe that SIT is a time-efficient means of improving cardiorespiratory fitness and 5-km endurance performance. PMID:25647646

  8. Maternal caffeine intake during pregnancy is associated with birth weight but not with gestational length: results from a large prospective observational cohort study

    PubMed Central

    2013-01-01

    Background Pregnant women consume caffeine daily. The aim of this study was to examine the association between maternal caffeine intake from different sources and (a) gestational length, particularly the risk for spontaneous preterm delivery (PTD), and (b) birth weight (BW) and the baby being small for gestational age (SGA). Methods This study is based on the Norwegian Mother and Child Cohort Study conducted by the Norwegian Institute of Public Health. A total of 59,123 women with uncomplicated pregnancies giving birth to a live singleton were identified. Caffeine intake from different sources was self-reported at gestational weeks 17, 22 and 30. Spontaneous PTD was defined as spontaneous onset of delivery between 22+0 and 36+6 weeks (n = 1,451). As there is no consensus, SGA was defined according to ultrasound-based (Marsal, n = 856), population-based (Skjaerven, n = 4,503) and customized (Gardosi, n = 4,733) growth curves. Results The main caffeine source was coffee, but tea and chocolate were the main sources in women with low caffeine intake. Median pre-pregnancy caffeine intake was 126 mg/day (IQR 40 to 254), 44 mg/day (13 to 104) at gestational week 17 and 62 mg/day (21 to 130) at gestational week 30. Coffee caffeine, but not caffeine from other sources, was associated with prolonged gestation (8 h/100 mg/day, P <10-7). Neither total nor coffee caffeine was associated with spontaneous PTD risk. Caffeine intake from different sources, measured repeatedly during pregnancy, was associated with lower BW (Marsal-28 g, Skjaerven-25 g, Gardosi-21 g per 100 mg/day additional total caffeine for a baby with expected BW 3,600 g, P <10-25). Caffeine intake of 200 to 300 mg/day increased the odds for SGA (OR Marsal 1.62, Skjaerven 1.44, Gardosi 1.27, P <0.05), compared to 0 to 50 mg/day. Conclusions Coffee, but not caffeine, consumption was associated with marginally increased gestational length but not with spontaneous PTD risk. Caffeine intake was consistently

  9. Recurring patterns in stationary intervals of abdominal uterine electromyograms during gestation.

    PubMed

    Di Marco, Luigi Yuri; Di Maria, Costanzo; Tong, Wing-Chiu; Taggart, Michael J; Robson, Stephen C; Langley, Philip

    2014-08-01

    Abdominal uterine electromyograms (uEMG) studies have focused on uterine contractions to describe the evolution of uterine activity and preterm birth (PTB) prediction. Stationary, non-contracting uEMG has not been studied. The aim of the study was to investigate the recurring patterns in stationary uEMG, their relationship with gestation age and PTB, and PTB predictivity. A public database of 300 (38 PTB) three-channel (S1-S3) uEMG recordings of 30 min, collected between 22 and 35 weeks' gestation, was used. Motion and labour contraction-free intervals in uEMG were identified as 5-min weak-sense stationarity intervals in 268 (34 PTB) recordings. Sample entropy (SampEn), percentage recurrence (PR), percentage determinism (PD), entropy (ER), and maximum length (L MAX) of recurrence were calculated and analysed according to the time to delivery and PTB. Random time series were generated by random shuffle (RS) of actual data. Recurrence was present in actual data (p<0.001) but not RS. In S3, PR (p<0.005), PD (p<0.01), ER (p<0.005), and L MAX (p<0.05) were higher, and SampEn lower (p<0.005) in PTB. Recurrence indices increased (all p<0.001) and SampEn decreased (p<0.01) with decreasing time to delivery, suggesting increasingly regular and recurring patterns with gestation progression. All indices predicted PTB with AUC≥0.62 (p<0.05). Recurring patterns in stationary non-contracting uEMG were associated with time to delivery but were relatively poor predictors of PTB. PMID:25008004

  10. Fatal Cases of Gestational Trophoblastic Neoplasia in a National Trophoblastic Disease Reference Center in Dakar Senegal

    PubMed Central

    Gueye, Mamour; Ndiaye-Gueye, Mame Diarra; Kane Gueye, Serigne Modou; Moreau, Jean Charles

    2016-01-01

    Objectives: The objectives of this study were to analyze deaths after gestational trophoblastic neoplasia and to determine the factors of treatment failure. Methods: This is a retrospective study in Aristide Le Dantec teaching Hospital in Dakar, Senegal, between 1 January 2006 and 31 December 2014. We took into account socio-epidemiological characteristics of patients, initial diagnosis, time between uterine evacuation and admission, time to onset of gestational trophoblastic neoplasia (GTN), treatment received (deadlines, protocols), difficulties experienced in the diagnosis and the initiation of treatment and survival. Results: In total, 1044 patients were admitted during the study period; 164 cases of GTN were diagnosed (15.7%); and 21 deaths occurred leading to a specific lethality of 12.8%. The average age was 30 years. Almost all patients (n = 18; 85.7%) had low income or no income. Eight out of 21 patients (38.1%) were seen in our department after GTN onset. The mean time to onset of GTN of all patients was 22.1 weeks. For 66.6%, histology was not available; the diagnosis of hydatidiform mole was made on the clinical history and sonographic features and GTN on human chorionic gonadotrophin (hCG) evolution and ultrasound findings. None of the patients had regular chemotherapy due to financial reasons. Patients who died within 3 months after diagnosis had metastatic tumors (7 of 21). All these women had resistance to treatment or progressed after three courses of chemotherapy. Ten of the 12 women with high-risk GTN were not treated with multi-agent chemotherapy (EMA-CO) for purely financial reasons. Conclusion and Global Health Implications: The high incidence and mortality require a profound reorganization of our health system and a high awareness of practitioners to refer to time or to declare all suspected cases of hydatidiform mole or gestational trophoblastic neoplasia. PMID:27622010

  11. Acute brief heat stress in late gestation alters neonatal calf innate immune functions.

    PubMed

    Strong, R A; Silva, E B; Cheng, H W; Eicher, S D

    2015-11-01

    Heat stress, as one of the environmental stressors affecting the dairy industry, compromises the cow milk production, immune function, and reproductive system. However, few studies have looked at how prenatal heat stress (HS) affects the offspring. The objective of this study was to evaluate the effect of HS during late gestation on calf immunity. Calves were born to cows exposed to evaporative cooling (CT) or HS (cyclic 23-35°