NSIDRC Journal Article Alert — July 16, 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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Sudden Infant Death
1. Opdal SH, Rognum TO
Gene variants predisposing to SIDS: current knowledge
Forensic Sci Med Pathol. 2010 Jul 11. [Epub ahead of print]
Institute of Forensic Medicine, University of Oslo, Oslo, Norway, s.h.opdal@medisin.uio.no.
Genetic risk factors play a role in sudden unexpected infant
death; either as a cause of death, such as in cases with medium-chain
acyl-coenzyme A dehydrogenase deficiency and cardiac arrest
due to long QT syndrome, or as predisposing factors for sudden
infant death syndrome (SIDS). Most likely genetic predisposition
to SIDS represent a polygenic inheritance pattern leading to
sudden death when combined with other risk factors, such as
a vulnerable developmental stage of the central nervous system
and/or the immune system, in addition to environmental risk
factors, such as a common cold or prone sleeping position.
Genes involved in the regulation of the immune system, cardiac
function, the serotonergic network and brain function and development
have so far emerged as the most important with respect to SIDS.
The purpose of the present paper is to survey current knowledge
on SIDS and possible genetic contributions.
Miscarriage/Stillbirth/Prenatal Issues
1. Bérard A, Nakhai-Pour HR, Broy P
Antidepressant use (during pregnancy) and miscarriage
CMAJ. 2010 Jul 13;182(10):1079
2. Kong GW, Chung TK, Lai BP, Lok IH
Gender comparison of psychological reaction after miscarriage-a
1-year longitudinal study
BJOG. 2010 Jul 8. [Epub ahead of print]
Department of Obstetrics and Gynaecology, The Chinese University
of Hong Kong, Prince of Wales Hospital, Hong Kong, China.
Abstract
Please cite this paper as: Kong G, Chung T, Lai B, Lok I. Gender comparison of psychological reaction after miscarriage-a 1-year longitudinal study. BJOG 2010; DOI: 10.1111/j.1471-0528.2010.02653.x. Objective To explore men's psychological reaction and its evolutionary course over 1 year after miscarriage, to compare this reaction with that of their female partners and to investigate the possible correlation of psychological states between partners. Design Prospective 1-year longitudinal observational study. Setting A university-affiliated tertiary referral hospital in Hong Kong. Sample Eighty-three miscarrying couples. Methods The psychological reactions of miscarrying women and their male partners were assessed immediately and at 3, 6 and 12 months after miscarriage. Main outcome measures Psychological outcomes were assessed using the 12-item General Health Questionnaire (GHQ-12) and Beck Depression Inventory (BDI). Results A substantial proportion of men (43.4%) scored high in GHQ-12 and 16.9% scored high in BDI immediately after miscarriage. In men, both psychometric scores decreased sharply within the first 3 months and reached a plateau. When compared with women, men scored significantly lower in GHQ-12 and BDI during the 1-year course after miscarriage. A planned pregnancy was a significant risk factor (P = 0.008) associated with an initial high BDI score in men. There was a significant positive correlation between couples in both GHQ-12 and BDI scores throughout the longitudinal course. Conclusions Although the psychological impact of miscarriage on men was less enduring when compared with that on women, a significant proportion of men demonstrated psychological distress after miscarriage. The significant positive correlation in a couple's psychological reaction indicated that psychological morbidity was not confined only to a woman's own experience, but also affected her relationship with her male partner.
3. Nakhai-Pour HR, Broy P, Bérard A
Use of antidepressants during pregnancy and the risk of spontaneous
abortion
CMAJ. 2010 Jul 13;182(10):1031-7. Epub 2010 May 31
BACKGROUND: The risk of relapse of depression or the diagnosis of some other psychiatric disorders during pregnancy necessitates the use of antidepressants despite possible adverse effects. Whether such use increases the risk of spontaneous abortion is still being debated. We evaluated the risk of spontaneous abortion in relation to the use of antidepressants during pregnancy. METHODS: Using a nested case-control study design, we obtained data from the Quebec Pregnancy Registry for 5124 women who had a clinically detected spontaneous abortion. For each case, we randomly selected 10 controls from the remaining women in the registry who were matched by the case's index date (date of spontaneous abortion) and gestational age at the time of spontaneous abortion. Use of antidepressants was defined by filled prescriptions and was compared with nonuse. We also studied the classes, types and doses of antidepressants. RESULTS: A total of 284 (5.5%) of the women who had a spontaneous abortion had at least one prescription for an antidepressant filled during the pregnancy, as compared with 1401 (2.7%) of the matched controls (odds ratio [OR] 2.09, 95% confidence interval [CI] 1.83-2.38). After adjustment for potential confounders, we found that the use of antidepressants during pregnancy was associated with an increased risk of spontaneous abortion (OR 1.68, 95%CI 1.38-2.06). Stratified analyses showed that use of selective serotonin reuptake inhibitors alone (OR 1.61, 95% CI 1.28-2.04), serotonin-norepinephrine reuptake inhibitors alone (OR 2.11, 95% CI 1.34-3.30) and combined use of antide-pressants from different classes (OR 3.51, 95% CI 2.20-5.61) were associated with an increased risk of spontaneous abortion. When we looked at antidepressant use by type versus no use, paroxetine use alone (OR 1.75, 95% CI 1.31-2.34) and venlafaxine use alone (OR 2.11, 95% CI 1.34-3.30) were associated with an increased risk of spontaneous abortion. INTERPRETATION: The use of antidepressants, especially paroxetine, venlafaxine or the combined use of different classes of antidepressants, during pregnancy was associated with an increased risk of spontaneous abortion.
4. Wong S, Petersen S, Idris N, Thomae M, McIntyre H
The use of ductus venosus velocimetry in the monitoring of
pregnancy in women with pre-gestational diabetes mellitus
Ultrasound Obstet Gynecol. 2010 Jul 8. [Epub ahead of print]
Department of Maternal Fetal Medicine, University of Queensland,
Mater Mothers' Hospital, South Brisbane, QLD4101, Australia.
Abstract
OBJECTIVE: To assess the role of ductus venosus (DV) Doppler study in predicting adverse perinatal outcomes for pregnancies complicated by pre-existing diabetes mellitus. METHODOLOGY: This is a prospective study conducted at a tertiary referral obstetric facility in Brisbane, Australia. The study group included women with pre-gestational diabetes mellitus who delivered in the hospital from January 1(st) 1995 to December 31(st) 2006. The DV Doppler index was defined as abnormal if the DV-PVIV was at or above the 95(th) percentile for gestation.Adverse perinatal outcome included one or more of the following criteria: Small for gestational age infant, cesarean section for non-reassuring fetal status, fetal acidemia at delivery, 1-minute Apgar score </= 3, 5-minute Apgar score <7, hypoxic ischemic encephalopathy, stillbirth or neonatal death.The maternal characteristics and perinatal outcomes of pregnancies with normal or abnormal DV Doppler indices were compared. RESULTS: 82 pre-gestational diabetic pregnancies were studied and an abnormal ductus venosus Doppler index was identified in 25 (30.5%) cases. Adverse perinatal outcome was identified in 8/25 (32.0%) pregnancies with an abnormal DV-(peak velocity index for veins) PVIV compared to 7/57 (12.3%) pregnancies with a normal DV-PVIV (p<0.05). The sensitivity of the DV-PVIV in predicting adverse perinatal outcomes in pre-gestational diabetic pregnancies was 53.3%, the specificity was 74.6%, the positive predictive value was 32.0% and negative predictive value was 87.7%. CONCLUSION: DV PVIV may be useful as part of antenatal screening of pregnancies complicated by pre-gestational diabetes. Copyright (c) 2010 ISUOG. Published by John Wiley & Sons, Ltd.
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