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[PMID]:28465095
[Au] Autor:Arriola CS; Vasconez N; Thompson MG; Olsen SJ; Moen AC; Bresee J; Ropero AM
[Ad] Endereço:Epidemic Intelligence Service Program, Centers for Disease Control and Prevention, Atlanta, GA, USA; Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA. Electronic address: wus3@cdc.gov.
[Ti] Título:Association of influenza vaccination during pregnancy with birth outcomes in Nicaragua.
[So] Source:Vaccine;35(23):3056-3063, 2017 05 25.
[Is] ISSN:1873-2518
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Studies have shown that influenza vaccination during pregnancy reduces the risk of influenza disease in pregnant women and their offspring. Some have proposed that maternal vaccination may also have beneficial effects on birth outcomes. In 2014, we conducted an observational study to test this hypothesis using data from two large hospitals in Managua, Nicaragua. METHODS: We conducted a retrospective cohort study to evaluate associations between influenza vaccination and birth outcomes. We carried out interviews and reviewed medical records post-partum to collect data on demographics, influenza vaccination during pregnancy, birth outcomes and other risk factors associated with adverse neonatal outcomes. We used influenza surveillance data to adjust for timing of influenza circulation. We assessed self-reports of influenza vaccination status by further reviewing medical records of those who self-reported but did not have readily available evidence of vaccination status. We performed multiple logistic regression (MLR) and propensity score matching (PSM). RESULTS: A total of 3268 women were included in the final analysis. Of these, 55% had received influenza vaccination in 2014. Overall, we did not observe statistically significant associations between influenza vaccination and birth outcomes after adjusting for risk factors, with either MLR or PSM. With PSM, after adjusting for risk factors, we observed protective associations between influenza vaccination in the second and third trimester and preterm birth (aOR: 0.87; 95% confidence interval (CI): 0.75-0.99 and aOR: 0.66; 95% CI: 0.45-0.96, respectively) and between influenza vaccination in the second trimester and low birth weight (aOR: 0.80; 95% CI: 0.64-0.97). CONCLUSIONS: We found evidence to support an association between influenza vaccination and birth outcomes by trimester of receipt with data from an urban population in Nicaragua. The study had significant selection and recall biases. Prospective studies are needed to minimize these biases.
[Mh] Termos MeSH primário: Vacinas contra Influenza/administração & dosagem
Influenza Humana/prevenção & controle
Complicações Infecciosas na Gravidez/prevenção & controle
Resultado da Gravidez
[Mh] Termos MeSH secundário: Adolescente
Adulto
Estudos de Coortes
Feminino
Seres Humanos
Recém-Nascido de Baixo Peso
Recém-Nascido
Modelos Logísticos
Registros Médicos
Nicarágua/epidemiologia
Gravidez
Complicações Infecciosas na Gravidez/epidemiologia
Trimestres da Gravidez
Nascimento Prematuro/epidemiologia
Pontuação de Propensão
Estudos Retrospectivos
População Urbana/estatística & dados numéricos
Vacinação
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY; RESEARCH SUPPORT, NON-U.S. GOV'T; RESEARCH SUPPORT, U.S. GOV'T, P.H.S.
[Nm] Nome de substância:
0 (Influenza Vaccines)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170504
[St] Status:MEDLINE


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[PMID]:28470164
[Au] Autor:Park JE; Lee BS
[Ad] Endereço:Department of Nursing, Uiduk University, Gyeongju, Korea.
[Ti] Título:[Experience of Becoming a Father of a High Risk Premature Infant].
[So] Source:J Korean Acad Nurs;47(2):277-288, 2017 Apr.
[Is] ISSN:2093-758X
[Cp] País de publicação:Korea (South)
[La] Idioma:kor
[Ab] Resumo:PURPOSE: This study was performed to identify the experience of becoming a father of a high risk premature infant. METHODS: Grounded theory was used for this research. The participants were 12 fathers who had premature infants lighter than 2,500g of birth weight, less than 37 weeks of gestational age and having stayed 2 weeks or longer in a NICU right after birth. Theoretical sampling was done to identify participants and indepth interviews were done for the data collection. For data analysis, the process suggested by Corbin and Strauss was used. RESULTS: For these participants the core phenomenon of the experience of becoming a father of a high risk premature infant was 'striving through with belief and patience'. The phenomenon was 'being frustrated in an unrealistic shock'. Contextual conditions were 'uncertainty in the health status of the premature baby' and 'no one to ask for help' and intervening conditions were 'possibility in the health recovery of the premature baby' and 'assistance from significant others'. Action/interaction strategies were 'withstanding with belief in the baby' and 'enduring with willpower as head of the family' and the consequence was 'becoming a guardian of the family'. CONCLUSION: For the participants, the process of becoming the father of a high risk premature infant was striving through the situation with belief in their babies' ability to overcome the crisis and waiting for the babies' recovery with patience.
[Mh] Termos MeSH primário: Pai/psicologia
[Mh] Termos MeSH secundário: Adaptação Psicológica
Adulto
Relações Pai-Filho
Idade Gestacional
Seres Humanos
Recém-Nascido
Recém-Nascido Prematuro
Entrevistas como Assunto
Masculino
Poder Familiar
Nascimento Prematuro
Autoeficácia
Apoio Social
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM; N
[Da] Data de entrada para processamento:170505
[St] Status:MEDLINE
[do] DOI:10.4040/jkan.2017.47.2.277


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[PMID]:28748341
[Au] Autor:David M; Borde T; Brenne S; Ramsauer B; Henrich W; Breckenkamp J; Razum O
[Ad] Endereço:Department of Gynecology, Charité University Medicine Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany. matthias.david@charite.de.
[Ti] Título:Obstetric and perinatal outcomes among immigrant and non-immigrant women in Berlin, Germany.
[So] Source:Arch Gynecol Obstet;296(4):745-762, 2017 Oct.
[Is] ISSN:1432-0711
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: In Germany, regular immigrants and their descendants have legal and financial access to health care equal to the general citizenry. Nonetheless, some of their health outcomes are comparatively unfavorable, and that is only partially explained by their lower socioeconomic status (SES). The aim of this study was to assess whether this disparity exists also for obstetric and perinatal outcomes. METHODS: We compared obstetric and perinatal outcomes between immigrant women (first or second generation) and non-immigrant women, delivering at three maternity hospitals in Berlin, Germany, 2011-2012. Multivariable logistic regression analysis was used to assess immigrant status and other possible risk factors for the baby being delivered preterm, small for gestational age (SGA), or transferred to neonatal care. RESULTS: The final database retained 6702 women, of whom 53.1% were first- or second-generation immigrants. First-generation Turkish immigrant women had significantly lower odds of preterm birth (OR 0.37, P < 0.001), SGA (OR 0.60, P = 0.0079), and transfer of the newborn to neonatal care (OR 0.61, P = 0.0034). Second-generation immigrant women had significantly lower odds of preterm birth (OR 0.67, P = 0.0049) or transfer of the newborn to neonatal care (OR 0.76, P = 0.0312). Moreover, women with education below university level, age 35+, or smokers had higher odds for poor outcomes. CONCLUSIONS: This study provides strong evidence that health disparities for obstetric and perinatal health outcomes do not exist in immigrants relative to native Germans, but exist instead in women without post-secondary-level education compared to women with such education, regardless of ethnicity or migration history.
[Mh] Termos MeSH primário: Emigrantes e Imigrantes/estatística & dados numéricos
Resultado da Gravidez/etnologia
Nascimento Prematuro/etnologia
[Mh] Termos MeSH secundário: Adulto
Berlim
Escolaridade
Feminino
Alemanha/epidemiologia
Seres Humanos
Recém-Nascido
Recém-Nascido Pequeno para a Idade Gestacional
Gravidez
Fatores de Risco
Turquia/etnologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170728
[St] Status:MEDLINE
[do] DOI:10.1007/s00404-017-4450-5


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[PMID]:29351561
[Au] Autor:Snijdewind IJM; Smit C; Godfried MH; Bakker R; Nellen JFJB; Jaddoe VWV; van Leeuwen E; Reiss P; Steegers EAP; van der Ende ME
[Ad] Endereço:Department of Internal Medicine, Section Infectious Diseases, Erasmus Medical Center, Rotterdam, The Netherlands.
[Ti] Título:Preconception use of cART by HIV-positive pregnant women increases the risk of infants being born small for gestational age.
[So] Source:PLoS One;13(1):e0191389, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The benefits of combination anti-retroviral therapy (cART) in HIV-positive pregnant women (improved maternal health and prevention of mother to child transmission [pMTCT]) currently outweigh the adverse effects due to cART. As the variety of cART increases, however, the question arises as to which type of cART is safest for pregnant women and women of childbearing age. We studied the effect of timing and exposure to different classes of cART on adverse birth outcomes in a large HIV cohort in the Netherlands. MATERIALS AND METHODS: We included singleton HEU infants registered in the ATHENA cohort from 1997 to 2015. Multivariate logistic regression analysis for single and multiple pregnancies was used to evaluate predictors of small for gestational age (SGA, birth weight <10th percentile for gestational age), low birth weight and preterm delivery. RESULTS: A total of 1392 children born to 1022 mothers were included. Of these, 331 (23.8%) children were SGA. Women starting cART before conception had an increased risk of having a SGA infant compared to women starting cART after conception (OR 1.35, 95% CI 1.03-1.77, p = 0.03). The risk for SGA was highest in women who started a protease inhibitor-(PI) based regimen prior to pregnancy, compared with women who initiated PI-based cART during pregnancy. While the association of preterm delivery and preconception cART was significant in univariate analysis, on multivariate analysis only a non-significant trend was observed (OR 1.39, 95% CI 0.94-1.92, p = 0.06) in women who had started cART before compared to after conception. In multivariate analysis, the risk of low birth weight (OR 1.34, 95% CI 0.94-1.92, p = 0.11) was not significantly increased in women who had started cART prior to conception compared to after conception. CONCLUSION: In our cohort of pregnant HIV-positive women, the use of cART prior to conception, most notably a PI-based regimen, was associated with intrauterine growth restriction resulting in SGA. Data showed a non-significant trend in the risk of PTD associated with preconception use of cART compared to its use after conception. More studies are needed with regard to the mechanisms taking place in the placenta during fetal growth in pregnant HIV-positive women using cART. It will only be with this knowledge that we can begin to understand the potential impact of HIV and cART on the fetus, in order to be able to determine the optimal individualised drug regimen for HIV-infected women of childbearing age.
[Mh] Termos MeSH primário: Fármacos Anti-HIV/efeitos adversos
Infecções por HIV/complicações
Infecções por HIV/tratamento farmacológico
Complicações Infecciosas na Gravidez/tratamento farmacológico
[Mh] Termos MeSH secundário: Adulto
Fármacos Anti-HIV/administração & dosagem
Estudos de Coortes
Quimioterapia Combinada
Feminino
Retardo do Crescimento Fetal/etiologia
Infecções por HIV/transmissão
Seres Humanos
Recém-Nascido de Baixo Peso
Recém-Nascido
Recém-Nascido Pequeno para a Idade Gestacional
Transmissão Vertical de Doença Infecciosa/prevenção & controle
Masculino
Países Baixos
Cuidado Pré-Concepcional/métodos
Gravidez
Resultado da Gravidez
Nascimento Prematuro/etiologia
Estudos Retrospectivos
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Anti-HIV Agents)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180120
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0191389


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[PMID]:29450525
[Au] Autor:Daw JR; Sommers BD
[Ad] Endereço:Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts.
[Ti] Título:Association of the Affordable Care Act Dependent Coverage Provision With Prenatal Care Use and Birth Outcomes.
[So] Source:JAMA;319(6):579-587, 2018 02 13.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Importance: The effect of the Affordable Care Act (ACA) dependent coverage provision on pregnancy-related health care and health outcomes is unknown. Objective: To determine whether the dependent coverage provision was associated with changes in payment for birth, prenatal care, and birth outcomes. Design, Setting, and Participants: Retrospective cohort study, using a differences-in-differences analysis of individual-level birth certificate data comparing live births among US women aged 24 to 25 years (exposure group) and women aged 27 to 28 years (control group) before (2009) and after (2011-2013) enactment of the dependent coverage provision. Results were stratified by marital status. Main Exposures: The dependent coverage provision of the ACA, which allowed young adults to stay on their parent's health insurance until age 26 years. Main Outcomes and Measures: Primary outcomes were payment source for birth, early prenatal care (first visit in first trimester), and adequate prenatal care (a first trimester visit and 80% of expected visits). Secondary outcomes were cesarean delivery, premature birth, low birth weight, and infant neonatal intensive care unit (NICU) admission. Results: The study population included 1 379 005 births among women aged 24-25 years (exposure group; 299 024 in 2009; 1 079 981 in 2011-2013), and 1 551 192 births among women aged 27-28 years (control group; 325 564 in 2009; 1 225 628 in 2011-2013). From 2011-2013, compared with 2009, private insurance payment for births increased in the exposure group (36.9% to 35.9% [difference, -1.0%]) compared with the control group (52.4% to 51.1% [difference, -1.3%]), adjusted difference-in-differences, 1.9 percentage points (95% CI, 1.6 to 2.1). Medicaid payment decreased in the exposure group (51.6% to 53.6% [difference, 2.0%]) compared with the control group (37.4% to 39.4% [difference, 1.9%]), adjusted difference-in-differences, -1.4 percentage points (95% CI, -1.7 to -1.2). Self-payment for births decreased in the exposure group (5.2% to 4.3% [difference, -0.9%]) compared with the control group (4.9% to 4.3% [difference, -0.5%]), adjusted difference-in-differences, -0.3 percentage points (95% CI, -0.4 to -0.1). Early prenatal care increased from 70% to 71.6% (difference, 1.6%) in the exposure group and from 75.7% to 76.8% (difference, 0.6%) in the control group (adjusted difference-in-differences, 0.6 percentage points [95% CI, 0.3 to 0.8]). Adequate prenatal care increased from 73.5% to 74.8% (difference, 1.3%) in the exposure group and from 77.5% to 78.8% (difference, 1.3%) in the control group (adjusted difference-in-differences, 0.4 percentage points [95% CI, 0.2 to 0.6]). Preterm birth decreased from 9.4% to 9.1% in the exposure group (difference, -0.3%) and from 9.1% to 8.9% in the control group (difference, -0.2%) (adjusted difference-in-differences, -0.2 percentage points (95% CI, -0.3 to -0.03). Overall, there were no significant changes in low birth weight, NICU admission, or cesarean delivery. In stratified analyses, changes in payment for birth, prenatal care, and preterm birth were concentrated among unmarried women. Conclusions and Relevance: In this study of nearly 3 million births among women aged 24 to 25 years vs those aged 27 to 28 years, the Affordable Care Act dependent coverage provision was associated with increased private insurance payment for birth, increased use of prenatal care, and modest reduction in preterm births, but was not associated with changes in cesarean delivery rates, low birth weight, or NICU admission.
[Mh] Termos MeSH primário: Cobertura do Seguro
Reembolso de Seguro de Saúde/estatística & dados numéricos
Patient Protection and Affordable Care Act
Resultado da Gravidez
Cuidado Pré-Natal/utilização
[Mh] Termos MeSH secundário: Adulto
Fatores Etários
Cesárea/estatística & dados numéricos
Feminino
Seres Humanos
Recém-Nascido de Baixo Peso
Cobertura do Seguro/estatística & dados numéricos
Seguro Saúde
Unidades de Terapia Intensiva Neonatal
Modelos Lineares
Medicaid/estatística & dados numéricos
Gravidez
Nascimento Prematuro/epidemiologia
Cuidado Pré-Natal/economia
Estudos Retrospectivos
Estados Unidos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180217
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2018.0030


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Registro de Ensaios Clínicos
Registro de Ensaios Clínicos
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[PMID]:29260226
[Au] Autor:Saccone G; Maruotti GM; Giudicepietro A; Martinelli P; Italian Preterm Birth Prevention (IPP) Working Group
[Ad] Endereço:Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy.
[Ti] Título:Effect of Cervical Pessary on Spontaneous Preterm Birth in Women With Singleton Pregnancies and Short Cervical Length: A Randomized Clinical Trial.
[So] Source:JAMA;318(23):2317-2324, 2017 12 19.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Importance: Spontaneous preterm birth is a major cause of perinatal morbidity and mortality. It is unclear if a cervical pessary can reduce the risk of spontaneous preterm delivery. Objective: To test whether in asymptomatic women with singleton pregnancies and no prior spontaneous preterm birth but with short cervical length on transvaginal ultrasound, use of a cervical pessary would reduce the rate of spontaneous preterm birth at less than 34 weeks of gestation. Design, Setting, and Participants: Parallel-group, nonblinded, randomized clinical trial conducted from March 1, 2016, to May 25, 2017, at a single center in Italy. Asymptomatic women with singleton gestations, no previous spontaneous preterm births, and cervical lengths of 25 mm or less at 18 weeks 0 days to 23 weeks 6 days of gestation were eligible. Interventions: Patients were randomized 1:1 to receive either cervical pessary (n = 150) or no pessary (n = 150). The pessary was removed between 37 weeks 0 days and 37 weeks 6 days of gestation or earlier if clinically indicated. The control group received standard care. For cervical length of 20 mm or shorter, women in both groups were prescribed vaginal progesterone, 200 mg/d, until 36 weeks 6 days of gestation. No bed rest or activity restriction was recommended. Main Outcomes and Measures: The primary end point was spontaneous preterm birth at less than 34 weeks of gestation. Secondary outcomes were adverse events. Results: Among 300 women who were randomized (mean age, 29 [SD, 6.3] years; mean gestational age, 22 [SD, 1.3] weeks), 100% completed the trial. The primary end point occurred in 11 women (7.3%) in the pessary group and 23 women (15.3%) in the control group (between-group difference, -8.0% [95% CI, -15.7% to -0.4]; relative risk, 0.48 [95% CI, 0.24-0.95]). During follow-up, the pessary group had a higher rate of increased or new vaginal discharge (86.7% vs 46.0%; between-group difference, +40.7% [95% CI, +30.1%-+50.3%]; relative risk, 1.88 [95% CI, 1.57-2.27]). Conclusions and Relevance: Among women without prior spontaneous preterm birth who had asymptomatic singleton pregnancies and short transvaginal cervical length, use of a cervical pessary, compared with no pessary use, resulted in a lower rate of spontaneous preterm birth at less than 34 weeks of gestation. The results of this single-center, nonblinded study among selected pregnant women require confirmation in multicenter clinical trials. Trial Registration: clinicaltrials.gov Identifier: NCT02716909.
[Mh] Termos MeSH primário: Colo do Útero/anatomia & histologia
Pessários
Nascimento Prematuro/prevenção & controle
[Mh] Termos MeSH secundário: Administração Intravaginal
Adulto
Medida do Comprimento Cervical
Terapia Combinada
Feminino
Seres Humanos
Estimativa de Kaplan-Meier
Gravidez
Progesterona/uso terapêutico
Progestinas/uso terapêutico
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Progestins); 4G7DS2Q64Y (Progesterone)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171221
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2017.18956


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[PMID]:28469094
[Au] Autor:Feng H; Zhu WW; Yang HX; Wei YM; Wang C; Su RN; Hod M; Hadar E
[Ad] Endereço:Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing 100034, China.
[Ti] Título:Relationship between Oral Glucose Tolerance Test Characteristics and Adverse Pregnancy Outcomes among Women with Gestational Diabetes Mellitus.
[So] Source:Chin Med J (Engl);130(9):1012-1018, 2017 May 05.
[Is] ISSN:0366-6999
[Cp] País de publicação:China
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Hyperglycemia is associated with adverse pregnancy outcomes. However, the relationships between them remain ambiguous. This study aimed to analyze the effect of different oral glucose tolerance test (OGTT) results on adverse perinatal outcomes. METHODS: This retrospective cohort study included data from 15 hospitals in Beijing from June 20, 2013 to November 30, 2013. Women with gestational diabetes mellitus (GDM) were categorized according to the number and distribution of abnormal OGTT values, and the characteristics of adverse pregnancy outcomes were evaluated. Chi-square test and logistic regression analysis were used to determine the associations. RESULTS: In total, 14,741 pregnant women were included in the study population, 2927 (19.86%) of whom had GDM. As the number of hyperglycemic values in the OGTT increased, the risk of cesarean delivery, preterm births, large-for-gestational age (LGA), macrosomia, and neonatal complications significantly increased. Fasting hyperglycemia had clear associations with macrosomia (odds ratios [OR s]:1.84, 95% confidence intervals [CI s]: 1.39-2.42,P < 0.001), LGA (OR: 1.70, 95% CI: 1.29-2.25,P < 0.001), and cesarean delivery (OR: 1.33, 95% CI: 1.15-1.55,P < 0.001). The associations were stronger as fasting glucose increased. GDM diagnosed by hyperglycemia at OGTT-2 h was more likely to lead to preterm birth (OR: 1.50, 95% CI: 1.11-2.03,P < 0.01). CONCLUSIONS: Various characteristics of OGTTs are associated with different adverse outcomes. A careful reconsideration of GDM with hierarchical and individualized management according to OGTT characteristics is needed.
[Mh] Termos MeSH primário: Diabetes Gestacional/sangue
Teste de Tolerância a Glucose/métodos
[Mh] Termos MeSH secundário: Peso ao Nascer/fisiologia
Glicemia/metabolismo
Índice de Massa Corporal
Cesárea
Distribuição de Qui-Quadrado
Diabetes Gestacional/fisiopatologia
Feminino
Macrossomia Fetal/sangue
Macrossomia Fetal/fisiopatologia
Seres Humanos
Gravidez
Complicações na Gravidez
Resultado da Gravidez
Nascimento Prematuro/sangue
Nascimento Prematuro/fisiopatologia
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Blood Glucose)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170505
[St] Status:MEDLINE
[do] DOI:10.4103/0366-6999.204928


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[PMID]:29443736
[Au] Autor:Tang M; Xu JM; Song SS; Mei Q; Zhang LJ
[Ad] Endereço:Department of Gastroenterology, the First Hospital of Anhui Medical University.
[Ti] Título:What may cause fetus loss from acute pancreatitis in pregnancy: Analysis of 54 cases.
[So] Source:Medicine (Baltimore);97(7):e9755, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Acute pancreatitis in pregnancy (APIP) poses a serious threat to the mother and her fetus, and might lead to fetal loss including miscarriage and stillbirth in certain patients. We sought to identify possible factors that affect fetal distress and evaluated outcomes of patients with APIP.We retrospectively reviewed clinical records of 54 pregnant women with APIP, who were treated at 2 tertiary clinical centers over a 6-year period. Clinical characteristics including etiology and severity of APIP, fetal monitoring data, and maternofetal outcomes were analyzed.Etiology of APIP included acute biliary pancreatitis (ABP, n = 14), hyperlipidemic pancreatitis (HLP, n = 22), and other etiologies (n = 18). Severity was classified as mild acute pancreatitis (MAP, n = 23), moderately severe acute pancreatitis (MSAP, n = 24), and severe acute pancreatitis (SAP, n = 7). The incidence of preterm delivery, fetal distress, and fetal loss increased with the progression of severity of APIP (P < .05). The severity of HLP was significantly higher than that of ABP and APIP of other etiology (P < .01). HLP was more likely to lead to fetal distress than other APs (P < .01). Only 12 (22.2%) patients had fetal monitoring including non-stress test (NST); 1 case of SAP (14.3%) and 15 cases of MSAP (62.5%) were not transferred to intensive care unit for intensive monitoring.The incidence of fetal distress and fetal loss increased with worsening of APIP severity. HLP tends to result in worse fetal outcomes. The deficiencies of fetal state monitoring, lack of assessment, and management of pregnant women might increase the fetal loss in APIP.
[Mh] Termos MeSH primário: Morte Fetal/etiologia
Pancreatite/complicações
Complicações na Gravidez
[Mh] Termos MeSH secundário: Doença Aguda
Adulto
Progressão da Doença
Feminino
Sofrimento Fetal/epidemiologia
Sofrimento Fetal/etiologia
Seres Humanos
Hiperlipidemias/complicações
Incidência
Pancreatite/epidemiologia
Pancreatite/etiologia
Gravidez
Complicações na Gravidez/epidemiologia
Complicações na Gravidez/etiologia
Nascimento Prematuro/epidemiologia
Nascimento Prematuro/etiologia
Estudos Retrospectivos
Índice de Gravidade de Doença
Adulto Jovem
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE; MULTICENTER STUDY
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180222
[Lr] Data última revisão:
180222
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180215
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009755


  9 / 10058 MEDLINE  
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[PMID]:29385154
[Au] Autor:Fuchs F; Monet B; Ducruet T; Chaillet N; Audibert F
[Ad] Endereço:Division of Obstetric Medicine, Department of Obstetrics and Gynecology CHU Sainte Justine, Montréal, Québec, Canada.
[Ti] Título:Effect of maternal age on the risk of preterm birth: A large cohort study.
[So] Source:PLoS One;13(1):e0191002, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Maternal age at pregnancy is increasing worldwide as well as preterm birth. However, the association between prematurity and advanced maternal age remains controversial. OBJECTIVE: To evaluate the impact of maternal age on the occurrence of preterm birth after controlling for multiple known confounders in a large birth cohort. STUDY DESIGN: Retrospective cohort study using data from the QUARISMA study, a large Canadian randomized controlled trial, which collected data from 184,000 births in 32 hospitals. Inclusion criteria were maternal age over 20 years. Exclusion criteria were multiple pregnancy, fetal malformation and intra-uterine fetal death. Five maternal age categories were defined and compared for maternal characteristics, gestational and obstetric complications, and risk factors for prematurity. Risk factors for preterm birth <37 weeks, either spontaneous or iatrogenic, were evaluated for different age groups using multivariate logistic regression. RESULTS: 165,282 births were included in the study. Chronic hypertension, assisted reproduction techniques, pre-gestational diabetes, invasive procedure in pregnancy, gestational diabetes and placenta praevia were linearly associated with increasing maternal age whereas hypertensive disorders of pregnancy followed a "U" shaped distribution according to maternal age. Crude rates of preterm birth before 37 weeks followed a "U" shaped curve with a nadir at 5.7% for the group of 30-34 years. In multivariate analysis, the adjusted odds ratio (aOR) of prematurity stratified by age group followed a "U" shaped distribution with an aOR of 1.08 (95%CI; 1.01-1.15) for 20-24 years, and 1.20 (95% CI; 1.06-1.36) for 40 years and older. Confounders found to have the greatest impact were placenta praevia, hypertensive complications, and maternal medical history. CONCLUSION: Even after adjustment for confounders, advanced maternal age (40 years and over) was associated with preterm birth. A maternal age of 30-34 years was associated with the lowest risk of prematurity.
[Mh] Termos MeSH primário: Idade Materna
Nascimento Prematuro
[Mh] Termos MeSH secundário: Adulto
Feminino
Seres Humanos
Gravidez
Estudos Retrospectivos
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180221
[Lr] Data última revisão:
180221
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180201
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0191002


  10 / 10058 MEDLINE  
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[PMID]:29190738
[Au] Autor:McGee D; Smith A; Poncil S; Patterson A; Bernstein AI; Racicot K
[Ad] Endereço:Department of Obstetrics, Gynecology and Reproductive Biology, College of Human Medicine, Michigan State University, Grand Rapids, MI, United States of America.
[Ti] Título:Cervical HSV-2 infection causes cervical remodeling and increases risk for ascending infection and preterm birth.
[So] Source:PLoS One;12(11):e0188645, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Preterm birth (PTB), or birth before 37 weeks gestation, is the leading cause of neonatal mortality worldwide. Cervical viral infections have been established as risk factors for PTB in women, although the mechanism leading to increased risk is unknown. Using a mouse model of pregnancy, we determined that intra-vaginal HSV2 infection caused increased rates of preterm birth following an intra-vaginal bacterial infection. HSV2 infection resulted in histological changes in the cervix mimicking cervical ripening, including significant collagen remodeling and increased hyaluronic acid synthesis. Viral infection also caused aberrant expression of estrogen and progesterone receptor in the cervical epithelium. Further analysis using human ectocervical cells demonstrated a role for Src kinase in virus-mediated changes in estrogen receptor and hyaluronic acid expression. In conclusion, HSV2 affects proteins involved in tissue hormone responsiveness, causes significant changes reminiscent of premature cervical ripening, and increases risk of preterm birth. Studies such as this improve our chances of identifying clinical interventions in the future.
[Mh] Termos MeSH primário: Medida do Comprimento Cervical
Herpes Genital/patologia
Herpesvirus Humano 2/patogenicidade
Nascimento Prematuro
[Mh] Termos MeSH secundário: Animais
Infecções por Escherichia coli/complicações
Infecções por Escherichia coli/fisiopatologia
Feminino
Herpes Genital/complicações
Herpes Genital/fisiopatologia
Seres Humanos
Camundongos
Camundongos Endogâmicos C57BL
Modelos Animais
Gravidez
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180217
[Lr] Data última revisão:
180217
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171201
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0188645



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