NSIDRC Journal Article Alert — January 29, 2010
Prepared by the National Sudden and Unexpected Infant/Child Death and Pregnancy Loss Resource Center at Georgetown University.
These articles have been selected from PubMed, a service of the National Library of Medicine that includes over 19 million citations from MEDLINE and other life science journals for biomedical articles back to 1948. PubMed includes links to full text articles and other related resources.
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Miscarriage/Stillbirth/Prenatal Issues
1. Tan PC, Vani S, Lim BK, Omar SZ
Anxiety and depression in hyperemesis gravidarum: prevalence, risk factors and correlation with clinical severity
Eur J Obstet Gynecol Reprod Biol. 2010 Jan 22. [Epub ahead of print]
Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Malaya, Lembah Pantai, 50603 Kuala Lumpur, Wilayah Persekutuan, Malaysia.
OBJECTIVE: To evaluate prevalence, risk factors and clinical severity correlates of anxiety and depression caseness in hyperemesis gravidarum (HG). STUDY DESIGN: A prospective study of self-assessment using the Hospital Anxiety and Depression Scale (HADS) was performed. Women at their first hospitalization for HG were recruited as soon as possible after hospital admission. Cut-off at the score of 7/8 was used for both the anxiety and depression subscales of HADS to denote anxiety and depression caseness respectively. Risk factors for anxiety and depression caseness were identified using Chi-square test, Fisher's exact test, Mann-Whitney's U-test or the Student's t-test. Multivariable logistic regression analysis incorporating all co-variables with crude P<0.1 was performed to identify independent risk factors. Bivariate analyses were performed to identify associations between clinical markers of severity and anxiety and depression caseness. Prolonged hospitalization and a number of biochemical and hematological abnormalities were used as clinical markers of HG severity. RESULTS: Criteria for anxiety and depression caseness were fulfilled in 98/209 (46.9%) and 100/209 (47.8%) women respectively. 78 (37.3%) participants fulfilled the criteria for both anxiety and depression caseness, 89 (42.6%) neither, 20 (9.6%) anxiety caseness only and 22 (10.5%) depression caseness only. Gestational age at commencement of vomiting, duration of vomiting leading up to hospitalization and paid employment status had crude P<0.1 in association with anxiety caseness. After adjustment, only paid employment was independently associated with anxiety caseness (AOR 2.9 95% CI 1.3-6.5; P=0.009). Previous miscarriage, gestational age at commencement of vomiting and duration of vomiting leading up to hospitalization all had P<0.1 in association with depression caseness. After adjustment, only previous miscarriage was negatively associated with depression caseness (AOR 0.4 95% CI 0.2-0.9; P=0.022). There was no marker of HG severity associated with anxiety caseness on bivariate analysis. High hematocrit was associated with depression caseness (OR 2.1 95% CI 1.1-3.9; P=0.027). CONCLUSION: Anxiety and depression caseness is common in HG and risk factors can be identified. There is no convincing association between anxiety and depression and more severe illness. Psychological symptoms may be a response to physical illness but further studies are needed. Copyright © 2009 Elsevier Ireland Ltd. All rights reserved.
2. Bader E, Alhaj AM, Hussan AA, Adam I
Malaria and stillbirth in Omdurman Maternity Hospital, Sudan.
Int J Gynaecol Obstet. 2010 Jan 21. [Epub ahead of print]
Faculty of Medicine, University of Khartoum, Khartoum, Sudan.
OBJECTIVE: The study was conducted in the labor ward of Omdurman Maternity Hospital, Sudan, from November 2007 to February 2008 to investigate the prevalence and risks factors for stillbirth. METHODS: A case-control study. Cases were women who delivered stillbirths; 2 consecutive women who delivered a live-born singleton neonate at term (37-42weeks) per case were used as controls. Sociodemographic, clinical (including malaria infections), and obstetric histories were gathered using standard questionnaires. Maternal body mass index and hemoglobin levels were measured. Maternal, placental, and cord blood smears were investigated for malaria parasites. RESULTS: Among 4760 singleton deliveries, there were 103 stillbirths, yielding a stillbirth rate of 22 per 1000 deliveries. Over half (52.4%) of these stillbirths were macerated stillbirths. Maternal sociodemographic characteristics were not associated with stillbirth, while a history of maternal malaria in the index pregnancy was the main risk factor for stillbirth (odds ratio, 3.0; 95% confidence interval, 1.0-8.9; P=0.04). CONCLUSION: Measures to prevent malaria infection should help to prevent stillbirth in this part of Sudan. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.
3. Bansil P, Kuklina EV, Meikle SF, Posner SF, Kourtis AP, Ellington SR, Jameison DJ
Maternal and Fetal Outcomes Among Women with Depression
J Womens Health (Larchmt). 2010 Jan 24. [Epub ahead of print]
1 CONRAD , Atlanta, Georgia
Abstract Objective: To compare maternal and fetal outcomes among women with and without diagnosed depression at the time of delivery. Methods: Hospital discharge data from the 1998-2005 Nationwide Inpatient Sample (NIS) were used to examine delivery-related hospitalizations for select maternal and fetal outcomes by depression diagnosis. Results: The rate of depression per 1000 deliveries increased significantly from 2.73 in 1998 to 14.1 in 2005 (p < 0.001). Women diagnosed with depression were significantly more likely to have cesarean delivery, preterm labor, anemia, diabetes, and preeclampsia or hypertension compared with women without depression. Fetal outcomes significantly associated with maternal depression were fetal growth restriction, fetal abnormalities, fetal distress, and fetal death. Conclusions: These findings suggest that depression is associated with adverse maternal and fetal outcomes. Our results provide additional impetus to screen for depression among women of reproductive age, especially those who plan to become pregnant.
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