NSIDRC Journal Article Alert — May 28, 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.Bellver J, Meseguer M, Muriel L, García-Herrero S, Barreto
MA, Garda AL, Remohí J, Pellicer A, Garrido N
Y chromosome microdeletions, sperm DNA fragmentation and sperm
oxidative stress as causes of recurrent spontaneous abortion
of unknown etiology
Hum Reprod. 2010 May 24. [Epub ahead of print]
Instituto Valenciano de Infertilidad (IVI), University of Valencia, Plaza de la Policía Local, 3, 46015 Valencia, Spain.
BACKGROUND The aim of the present study was to evaluate the implication of male factor, in terms of sperm DNA oxidation and fragmentation, and Y chromosome microdeletions in recurrent spontaneous abortion (RSA) of unknown origin in a strictly selected cohort. METHODS A prospective cohort study was carried out in a private university-affiliated setting. Three groups, each comprised of 30 males, were compared. The first was formed by healthy and fertile sperm donors (SD) with normal sperm parameters (control group), the second by men presenting severe oligozoospermia (SO) without RSA history, and the third by men from couples who had experienced idiopathic RSA. Frequency of Y chromosome microdeletions and mean sperm DNA fragmentation and oxidation were determined. RESULTS Y chromosome microdeletions were not detected in any of the males enrolled in the study. Moreover, sperm DNA oxidation measurements were not demonstrated to be relevant to RSA. Interestingly, sperm DNA fragmentation was higher in the SO group than in the RSA and the SD groups, and also higher in the RSA group compared with the SD group, but lacked an adequate predictive power to be employed as a discriminative test of RSA condition. CONCLUSIONS Sperm DNA features and Y chromosome microdeletions do not seem to be related to RSA of unknown origin. Other molecular features of sperm should be studied to determine their possible influence on RSA. Clinicaltrials.gov reference: nCT00447395.
2. Bruckner TA, Catalano R, Ahern J
Male fetal loss in the U.S. following the terrorist attacks
of September 11, 2001
BMC Public Health. 2010 May 25;10(1):273. [Epub ahead of print]
ABSTRACT: SUMMARY BACKGROUND: The secondary sex ratio (i.e., the odds of a male birth) reportedly declines following natural disasters, pollution events, and economic collapse. It remains unclear whether this decline results from an excess of male fetal loss or reduced male conceptions. The literature also does not converge as to whether the terrorist attacks of September 11, 2001 induced "communal bereavement", or the widespread feeling of distress among persons who never met those directly involved in the attacks. We test the communal bereavement hypothesis among gravid women by examining whether male fetal deaths rose above expected levels in the US following September 11, 2001. METHODS: We apply interrupted time-series methods to all fetal deaths at or greater than the 20th week of gestation in the US from 1996 to 2002. Time-series methods control for trends, seasonality, and other forms of autocorrelation that could induce spurious associations. RESULTS: Results support the hypothesis in that the fetal death sex ratio (i.e., the odds of a male fetal death) increased above its expected value in September 2001. Additional analysis of the secondary sex ratio indirectly supports that the terrorist attacks may have threatened the gestation of male more than female fetuses. CONCLUSIONS: Societal responses to events such as September 11, 2001 do not appear confined only to persons who have ever met the deceased. The fetal death sex ratio in the US population may serve as a sentinel indicator of the degree to which pregnant women react to population stressors.
3. Calleja-Agius J, Schembri-Wismayer P, Calleja N, Brincat
M, Spiteri D
Obstetric outcome and cytokine levels in threatened miscarriage
Gynecol Endocrinol. 2010 May 26. [Epub ahead of print]
EGA, Institute for Women's Health, Department of Obstetrics and Gynaecology, University College London (UCL), London, United Kingdom.
Objectives. To evaluate the proportion of women with threatened miscarriage (TM) who proceed to miscarriage in a population of single ethnicity and to investigate prospectively their risk of adverse pregnancy outcome in relationship with the cytokines levels in their circulation. Methods. We conducted a prospective observational study over a period of 1 year of 94 Maltese women presenting with TM at the same hospital and compared their clinical data with those of 564 age-matched controls from the National Obstetric Information System (NOIS) of Malta. Main outcome measures included gestational age and weight at delivery and incidence of adverse pregnancy outcomes. A pilot study was carried out, where in subgroups of 10 women with TM (n = 10), non-pregnant women (n = 12), normal pregnant controls (n = 9) and women presenting with missed-miscarriage (n = 11), the plasma levels of beta-human chorionic gonadotrophin (beta-hCG), tumour necrosis factor alpha (TNFalpha), interferon gamma (IFNgamma), interleukin-6 (IL-6), interleukin-10 (IL-10) and TNF-receptors 1 (R1) and 2 (R2) were measured. Results. Of the women presenting with TM, 25 (26.6%) proceeded to complete miscarriage. The TM group had also a significantly higher incidence of antepartum haemorrhage (p < 0.005), pre-eclampsia (p < 0.05), foetal growth restriction (p < 0.05), premature labour (p < 0.001) and retained placenta (p < 0.005). In the pilot biochemical analysis, significantly (p < 0.05) higher levels of TNFalpha and lower levels of TNFR2 were found in the TM subgroup compared to non-pregnant controls. The ratio TNFalpha/IL-10 was significantly (p < 0.05) higher and the beta-hCG levels was significantly lower (p < 0.01) in missed-miscarriage and non-pregnant subgroups than in TM and normal pregnant controls. The IFNgamma/1L-10 and IFNgamma/1L-6 ratio were significantly (<0.001) different between the four subgroups with the lowest level found in TM. No similar gradient was found for the TNFalpha/1L-6 ratio. Conclusion. Women presenting with TM are at significantly increased risk of adverse pregnancy outcome and the pathophysiology of these conditions involves a change in the Th1/Th2 balance. Changes in levels of cytokines could help to predict and thus prevent the development of some of these complications.
4. Chang JJ, Muglia LJ, Macones GA
Association of early-onset pre-eclampsia in first pregnancy
with normotensive second pregnancy outcomes: a population-based
study
BJOG. 2010 May 25. [Epub ahead of print]
Department of Community Health in Epidemiology, Saint Louis University School of Public Health in St. Louis, MO, USA.
Please cite this paper as: Chang J, Muglia L, Macones G. Association of early-onset pre-eclampsia in first pregnancy with normotensive second pregnancy outcomes: a population-based study. BJOG 2010; DOI: 10.1111/j.1471-0528.2010.02594.x. Objective To evaluate pregnancy outcomes in normotensive second pregnancy following pre-eclampsia in first pregnancy. Design Population-based retrospective cohort study. Setting State of Missouri in the USA. Sample White European origin or African-American women who delivered their first two non-anomalous singleton pregnancies between 20 and 44 weeks of gestation in Missouri, USA, 1989-2005, without chronic hypertension, renal disease or diabetes mellitus (n = 12 835). Methods Pre-eclampsia or delivery at 34 weeks of gestation or less in first pregnancy was defined as early-onset pre-eclampsia, whereas late-onset pre-eclampsia was defined as pre-eclampsia with delivery after 34 weeks of gestation. Multivariate regression models were fitted to estimate the crude and adjusted odds ratios and 95% confidence intervals. Main outcome measures Preterm delivery, large and small-for-gestational-age infant, Apgar scores at 5 minutes, fetal death, caesarean section, placental abruption. Results Women with early-onset pre-eclampsia in first pregnancy were more likely to be younger, African-American, recipients of Medicaid, unmarried and smokers. Despite a second normotensive pregnancy, women with early-onset pre-eclampsia in their first pregnancy had greater odds of a small-for-gestational-age infant, preterm birth, fetal death, caesarean section and placental abruption in the second pregnancy, relative to women with late-onset pre-eclampsia, after controlling for confounders. Moreover, maternal ethnic origin modified the association between early-onset pre-eclampsia in the first pregnancy and preterm births in the second pregnancy. Having a history of early-onset pre-eclampsia reduces the odds of having a large-for-gestational-age infant in the second pregnancy. Conclusion A history of early-onset pre-eclampsia is associated with increased odds of adverse pregnancy outcomes despite a normotensive second pregnancy.
5. Calleja-Agius J, Calleja N, Brincat M, Spiteri D
Obstetric outcome in cases of threatened spontaneous abortion
Int J Gynaecol Obstet. 2010 May 20. [Epub ahead of print]
Department of Obstetrics and Gynaecology, University of Malta, Tal-Qroqq, Birkirkara, Malta; Department of Health Information and Research, Gwardamangia, Malta.
6. Bendon RW
Review of autopsies of stillborn infants with retroplacental
hematoma or hemorrhage
Pediatr Dev Pathol. 2010 May 21. [Epub ahead of print]
1 Kosair Children's Hospital.
Abstract Background: Intrathoracic petechiae are a potential marker of acute asphyxia in stillborn infants. Retroplacental hematoma (RPH) is a cause of acute asphyxia. The histological features of RPH can be timed using criteria for intrauterine duration of fetal death.Design: Autopsies of stillborn infants > 26 weeks gestation with RPH were evaluated for gross or microscope evidence of petechiae. Placental gross and microscopic features were recorded. Eleven controls from other mechanisms of death were randomly selected.Results: Intrathoracic petechiae were present in all 17 infants with RPH > 50% of the placental area, in 3 of 7 infants with < 50% area RPH and in 2 of 11 infants with other diagnoses. The placenta demonstrated basal plate neutrophils in all cases of RPH (N=21). Early coagulation necrosis in the villi overlying the RPH was present in 5 of 13 cases after 4 to 24 hours, and complete coagulation necrosis was present in 3 of 4 cases after 24 hours. Conclusion: Infants with RPH underlying >50% of the placenta demonstrate intrathoracic petechiae, but controls and infants with smaller RPH do so much less frequently. This is consistent with the hypothesis that intrathoracic petechiae are a marker for intrauterine asphyxia. Basal plate neutrophils are a useful early marker of retroplacental hemorrhage. Early coagulation necrosis of the placenta over RPH begins in 4 to 24 hours, but is not complete until more than 24 hours.(fetal asphyxia, intrathoracic petechiae, placental abruption, retroplacental hematoma, stillbirth).
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