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PubMed1985

Relationship between maternal and fetal fuels and placental glucose transfer in rats with maternal diabetes of varying severity.

Gestational diabetes mellitus (GDM) is a nonhomogeneous entity known to affect fetal development in different ways in both rats and human beings. The degree of severity of diabetes could affect the maternal-fetal transfer of metabolic fuels and consequently influence fetal development. To study this hypothesis, pregnant rats were made diabetic by streptozocin (STZ) treatment (45 mg/kg) at day 7 of gestation and were treated with different daily doses of insulin until the 20th day of gestation, when they were killed and examined. Differences in plasma glucose levels in the groups studied were not accompanied by differences in plasma glycerol, beta-hydroxybutyrate (beta-OHB), or total amino acid levels in mothers or their fetuses. Fetal/maternal ratios of these circulating fuels were not modified by maternal diabetes, whereas the glucose level was enhanced in diabetic rats not treated with insulin. Placental glucose transfer was studied directly with a recently reported in situ experimental design and was found to increase linearly with maternal glycemia, independently of whether this was modified by insulin treatment or by acute intravenous (i.v.) infusion of glucose in normal animals. Lactate production by the fetal/placental unit decreased in proportion to the glucose level in the maternal circulation. The present data indicate that the diabetic condition of the mother rat does not modify the mechanisms of placental transfer of metabolic fuels to the fetus, and that the actual transfer is mainly dependent on the concentrations of these fuels in the maternal circulation.(ABSTRACT TRUNCATED AT 250 WORDS)

3-Hydroxybutyric Acid↗
PubMed1995

A community based investigation of causes of maternal mortality in rural and urban Zimbabwe. Maternal Mortality Study Group.

UNLABELLED: Most data on maternal mortality in Zimbabwe has been urban hospital based. Using a network of informants and sensitized health workers an attempt was made to identify and investigate all maternal deaths in rural Masvingo and urban Harare over a two year period. The present report discusses place of death and the medical causes in both populations. Results gave maternal mortality rates of 168 and 85 per 100,000 live births for Masvingo and Harare respectively. These rates are significantly higher than those from conventional reporting systems especially in the rural area where 27 pc of deaths occurred at home or in transit. The leading medical causes of death were haemorrhage in Masvingo (25 pc of deaths) and eclampsia in Harare (26 pc), with puerperal and post abortal sepsis as the next most common causes in both cases. Malaria featured as the major indirect cause in Masvingo (7.6 pc). There were four suicides committed following unwanted pregnancy. The rural/urban variation in causation of death is discussed and the study results compared with other community based studies internationally. SYNOPSIS: This community based study revealed higher maternal mortality rates (MMR) than conventional statistics, especially in the rural area where deaths occurred at home or in transit. In the rural area the MMR was higher and the leading cause of death was haemorrhage, compared to eclampsia in the urban area. Strategies to reduce maternal deaths should include factors both within and outside health service structures.

Adolescent↗
PubMedDate not supplied

[Maternal mortality in the Huichol area of Jalisco state, Mexico. The Study Group on Maternal Mortality].

With the aim of estimating the level of maternal mortality, a field survey in 349 Huichol families was carried out from August 1990 to August 1991, using an ad-hoc questionnaire. In 208 deliveries, five maternal deaths were recorded, rendering a maternal mortality rate of 2,403.8 per 100,000 live births. This is a considerably higher rate than those reported at the state and national levels, as well as in other municipalities of the region. All five deaths were due to direct maternal causes and took place during the puerperium. None of the patients received medical care. The high maternal mortality rate observed among Huichol groups can be explained by their disadvantageous social conditions, their lack of access to health care, and also their cultural patterns which, in turn, determine their reproductive behaviour. All these elements place Huichol groups among the worst served populations in Mexico.

Adolescent↗
PubMed2000

Outcome at age 4 years in offspring of women with maternal phenylketonuria: the Maternal PKU Collaborative Study.

CONTEXT: Untreated maternal phenylketonuria (PKU) increases risk for developmental problems in offspring. The extent to which this risk is reduced by maternal dietary therapy at various stages of pregnancy is not known. OBJECTIVE: To determine whether dietary treatment during pregnancy of women with PKU affects developmental outcomes of offspring. DESIGN: The Maternal PKU Collaborative Study, an ongoing, longitudinal prospective study begun in 1984. SETTING: A total of 78 metabolic clinics and obstetrical offices in the United States, Canada, and Germany. PARTICIPANTS: A total of 253 children of women with PKU (n = 149), with untreated mild hyperphenylalaninemia (n = 33), or without known metabolic problems (comparison group; n = 71) were followed up to age 4 years. INTERVENTION: Women with PKU were offered a low-phenylalanine diet prior to or during pregnancy with the aim of maintaining metabolic control (plasma phenylalanine < or =10 mg/dL [< or =605 micromol/L]). Women with mild hyperphenylalaninemia, who had plasma phenylalanine levels of no more than 10 mg/dL (605 micromol/L) on a normal diet, were not treated. MAIN OUTCOME MEASURES: Children's scores on cognitive and behavioral assessments (McCarthy Scales of Children's Abilities, Test of Language Development, Achenbach Child Behavior Checklist, Vineland Adaptive Behavior Scales, and Home Observation for Measurement of the Environment), compared by maternal metabolic status at 0 to 10 weeks', 10 to 20 weeks', and after 20 weeks' gestation. RESULTS: Scores on the McCarthy General Cognitive Index decreased as weeks to metabolic control increased (r = -0.58; P<.001). Offspring of women who had metabolic control prior to pregnancy had a mean (SD) score of 99 (13). Forty-seven percent of offspring whose mothers did not have metabolic control by 20 weeks' gestation had a General Cognitive Index score 2 SDs below the norm. Overall, 30% of children born to mothers with PKU had social and behavioral problems. CONCLUSIONS: Our data suggest that delayed development in offspring of women with PKU is associated with lack of maternal metabolic control prior to or early in pregnancy. Treatment at any time during pregnancy may reduce the severity of delay.

Child Behavior↗
PubMed2005

Interaction between the ADH1C polymorphism and maternal alcohol intake in the risk of nonsyndromic oral clefts: an evaluation of the contribution of child and maternal genotypes.

BACKGROUND: Maternal alcohol consumption has been associated with an increased risk of nonsyndromic oral clefts in some studies. Study of gene-environment interaction may provide insight into the reasons for their discrepancies observed. We focused on a polymorphism of the ADH1C gene (third gene of the class I alcohol dehydrogenase family), involved in the metabolism of ethanol and other alcohols. METHODS: Data come from a French case-control study (1998-2001), which tested the association between maternal alcohol consumption during the first trimester of pregnancy and the risk of nonsyndromic oral clefts (240 cases, 236 controls). A case-parent study design looked at the association with an ADH1C polymorphism (Ile349Val site) and potential gene-environment interaction effects. A log-linear model was used to distinguish the direct effect of the child's genotype from the maternally mediated effects. RESULTS: An increased risk of nonsyndromic oral clefts was observed for women who reported drinking alcohol during the first trimester, compared with women who did not. The mutated ADH1C allele carried by the child seemed to have a protective effect against the risk of oral clefts (RRone copy, 0.71; 95% confidence interval [CI], 0.50-1.02; RRtwo copies, 0.63; 95% CI, 0.3-1.3). The maternal genotype played a less important role than the child's, and its action remains unclear. No significant evidence of interaction effects between the ADH1C genotype and maternal alcohol consumption was observed. CONCLUSIONS: Because the ADH1C gene is involved in the metabolic pathways of many alcohols, we propose several hypotheses about the causal pathway, including ethanol oxidation activity and, more probably, retinol oxidation.

Adult↗
PubMed2003

Maternal weight correction of maternal serum PAPP-A and free beta-hCG MoM when screening for trisomy 21 in the first trimester of pregnancy.

OBJECTIVE: To assess the suitability of either the log-linear or reciprocal-linear regression procedure for maternal weight correction of biochemical marker MoMs in the first trimester. METHODS: Data from two prospective first-trimester OSCAR screening programmes including 32,010 women with first-trimester maternal serum-free beta-hCG and PAPP-A measured by the Kryptor analyser was analysed by regression analysis to provide parameters for the log-linear and reciprocal-linear MoM correction procedures. Assessment was made by goodness of fit to the data. The impact on detection rate and false-positive rate of the different correction procedures was assessed using statistical modelling with biochemical markers alone. RESULTS: Both log-linear and reciprocal-linear correction were shown to fit the data well. For free beta-hCG, the log-linear procedure was marginally superior to the reciprocal-linear procedure (r2=0.986 v 0.980), whilst for PAPP-A the reciprocal-linear procedure was marginally better (r2=0.991 v 0.985). Log-linear correction reduced the variance for both markers more than did the reciprocal-linear procedure. For free beta-hCG, the sd was reduced from 0.2675 to 0.2605 and for PAPP-A, it was reduced from 0.2545 to 0.2336. Correcting for maternal weight was shown to reduce the population false-positive rate from 7.0 to 6.5%, whilst maintaining the same detection rate at a risk cut-off of 1 in a 100. At individual levels, a two-fold variation in risk was demonstrated depending upon the individual's weight. CONCLUSIONS: To provide accurate individual patient-specific risks for trisomy 21, maternal weight must be taken into account and should be a mandatory data item for screening programmes. Maternal weight correction in the first trimester using free beta-hCG and PAPP-A can be best achieved using the log-linear procedure.

Adult↗
PubMed2001

Predictors of maternal child-feeding style: maternal and child characteristics.

We investigated relationships among maternal and child characteristics, and two aspects of maternal child-feeding styles that may place daughters at risk for developing problems with energy balance. Participants included 104 overweight (BMI> or =25) and 92 non-overweight (BMI<25) mothers and their 5-year-old, non-Hispanic, White daughters. Child-feeding styles included (a) restriction of daughters' intake of energy-dense snack food, and (b) pressure to eat more food. Predictors of child-feeding styles included measures of (1) maternal investment in weight and eating issues, including dietary restraint and weight concern, (2) child adiposity, (3) maternal perceptions of the child as underweight or overweight, and (4) maternal concern for child weight. Mothers reported using more restrictive feeding practices when they were invested in weight and eating issues, when they perceived daughters as overweight, when they were concerned about daughters' weight, and when daughters were heavier. Mothers reported using more pressure in child feeding when daughters were thinner, and when mothers perceived daughters as underweight. Further analyses examined whether relationships among child-feeding styles were different for overweight and non-overweight mothers. Overweight mothers' child-feeding styles appeared to be influenced by observable child weight characteristics, concerns for the child's weight status, and mothers' own history of overweight. Non-overweight mothers' child-feeding styles appeared to be influenced by distorted perceptions of and concerns for children, as well as distorted self-perceptions.

Adult↗
PubMed1992

A comparison of organochlorine pesticide residues in maternal adipose tissue, maternal blood, cord blood, and human milk from mother/infant pairs.

A total of 41 samples of maternal blood, milk, subcutaneous fat and umbilical cord blood were collected from mothers giving birth by Caesarean operation at Kenyatta National Hospital in Nairobi in 1986. The samples were analyzed for organochlorine contaminants. The main contaminants found in all the samples were p,p'-DDT (100%), p,p'-DDE (100%), o,p'-DDT (59%), dieldrin (27%), transnonachlor (15%), beta-HCH (12%) and lindane (2%) of all the samples analyzed. Polychlorobiphenyl (PCB) residues were not detected in any of the samples. The mean levels (mg/kg fat) of sum of DDT were 5.9 in subcutaneous fat, 4.8 in mothers milk, 2.7 in maternal serum and 1.9 in umbilical cord serum. There was a significant correlation between the levels of sum DDT in subcutaneous fat and milk fat (r = 0.963), subcutaneous fat and maternal serum fat (r = 0.843), and maternal serum fat and maternal milk fat (r = 0.868), indicating the coherence of DDT in the body. Hexachlorocyclohexane (beta-HCH) was found in subcutaneous fat and milk fat with the mean levels of 0.03 and 0.26 mg/kg fat, respectively. Dieldrin detected in mothers milk and subcutaneous fat could not be quantified.

Adipose Tissue↗
PubMed1984

The effect of maternal diabetes on the synthesis and secretion of phosphatidylcholine in fetal and maternal rat lungs in vitro.

Incorporation of (methyl-14C)choline into phosphatidylcholine and the release of prelabelled phosphatidylcholine was investigated in vitro using lung slices from pregnant rats and their offspring near term. Tissue from normal, diabetic and insulin-treated diabetic pregnant rats and their offspring was utilized to assess the effects of maternal diabetes on fetal lung maturation. The results show that the synthesis of phosphatidylcholine in fetal/newborn lungs through the cytidine 5'-diphosphocholine pathway was not affected by maternal diabetes. However, secretion of phosphatidylcholine from the lungs of fetuses of diabetic mothers was very much suppressed one day after parturition. Insulin treatment of the diabetic pregnant rats restored secretion of phosphatidylcholine from the fetal/newborn lungs to control values. These results suggest that an impaired secretion of phosphatidylcholine from the lungs of fetuses of diabetic mothers may be partly responsible for the higher incidence of respiratory distress syndrome among children of diabetic mothers. The results also revealed some correlation between the secretion of phosphatidylcholine from maternal lungs, maternal serum phospholipids and synthesis of phosphatidylcholine by fetal lungs during late gestation, suggesting a possible relationship between maternal phospholipid metabolism and fetal lung maturation.

Animals↗
PubMed2005

Assessing psychosocial risk in pregnant/postpartum women using the Contextual Assessment of Maternity Experience (CAME)--recent life adversity, social support and maternal feelings.

BACKGROUND: The Contextual Assessment of Maternity Experience (CAME) interview was developed to characterise the psychosocial context relevant to the maternity experience by providing a detailed picture of women's lives during the transition to motherhood. More specifically, it was designed to enable the assessment of major risk factors for emotional disturbances in pregnant and postpartum women, especially depression, within the same instrument and using a coherent methodological framework. METHOD: The CAME assesses three domains relevant to motherhood: 1) recent life adversity or stressors; 2) the quality of social support and key relationships including partner relationship; and 3) maternal feelings towards pregnancy, motherhood and the baby. Two high-risk samples of inner-city London women were used to test the psychometric qualities of the CAME components. RESULTS: Overall, the internal consistencies of the relevant components were high in both samples examined. The validity of the three components of the measure was evidenced by their association with either maternal characteristics or parenting assessments. CONCLUSION: It was concluded that the CAME shows promise as a measure of the psychosocial risk factors involved in the maternity experience for future research in this field.

Affective Symptoms↗
PubMed2006

Does maternal psychopathology discriminate between children with DSM-IV generalised anxiety disorder or oppositional defiant disorder? The predictive validity of maternal axis I and axis II psychopathology.

What dimensions of maternal psychopathology predict internalising or externalising disorder in children? We conducted a study of maternal axis I and axis II psychopathology in a group of children 8-12 years of age with Generalised Anxiety Disorder (GAD), Oppositional Defiant Disorder (ODD) and non-patient controls (NC). By using Multigroup Discriminant Analyses (MDA) on three groups of children (N = 85) and measures of axis I and axis II psychopathology of their mothers, we attempted to discriminate between these groups on a data driven basis. Two separate MDA were computed, one based on maternal axis I disorders, and one based on maternal axis II disorders. The results demonstrated that maternal symptomatic and personality psychopathology was differentially related to childhood anxiety or behavioural disorders. Mothers of children with ODD were characterised by more negative emotions and detached personality styles, whereas mothers of children with GAD seemed to be more somatic preoccupied, controlling and over-protective.

Anxiety Disorders↗
PubMed2006

Associations among maternal soy intake, isoflavone levels in urine and blood samples, and maternal and umbilical hormone concentrations (Japan).

OBJECTIVES: In utero exposure to high levels of endogenous estrogens has been hypothesized to increase breast cancer risk in later life. A high intake of soy has been suggested to protect against breast cancer. We examined the hypothesis that maternal soy intake may be inversely associated with pregnancy hormone levels. METHODS: The concentrations of hormones (estradiol, estriol, and testosterone) and isoflavones (genistein, deidzein, and equol) were measured in the maternal urine and serum, and umbilical cord blood of 194 women during pregnancy and at delivery. Soy intake during pregnancy was assessed by 5-day diet records at approximately the 29th week of pregnancy. RESULTS: High correlations were observed for isoflavone levels between maternal samples and umbilical cord blood, indicating that isoflavone can be transferred from the maternal to the fetal compartment. None of the hormones measured in umbilical cord blood was significantly associated with any of the isoflavones measured. There were a few significant associations between maternal hormone levels and isoflavone measures during pregnancy, but their patterns of associations varied by gestational week and differed depending on whether isoflavone exposure was measured by diet records, urine or serum. CONCLUSION: Our data contain no strong evidence showing that soy intake affects hormone levels during pregnancy.

Adult↗
PubMed1984

Catecholamine physiology in the ovine fetus. III. Maternal and fetal response to acute maternal exercise.

A study was made of the effects of maternal exercise on fetal plasma concentrations of catecholamines in nine ewes with chronically catheterized singleton fetuses at 125 to 137 days' gestation. The ewes were subjected to acute treadmill exercise of 2.5 mph for 45 minutes with continuous recording of maternal and fetal blood pressures. Samples of arterial blood were obtained for measurement of catecholamines, glucose, and blood gases. Changes in blood flow in fetal organs in response to maternal exercise were assessed by injection of radioactive microspheres. The maternal plasma catecholamine responses were related to the severity of the exercise stress as indicated by the index of cardiac effort. The fetal responses did not correlate with maternal cardiac effort. A significant decrease in fetal Po2 with a moderate alkalosis occurred, accompanied by a significant elevation in circulating levels of norepinephrine. At the peak of exercise, there was an increase in fetal renal, adrenal, and placental blood flows, as compared to the control period.

Animals↗
PubMed1984

Maternal glucose injections do not alter the suppression of fetal breathing following maternal ethanol ingestion.

In order to determine whether intravenous injections of glucose could reverse the effects of maternal ingestion of ethanol (0.25 gm/kg), glucose (25 gm intravenously) or an equal volume of saline solution was administered to eight pregnant women at 37 to 40 weeks' gestation after ingestion of ethanol. Fetal breathing movements were abolished within 30 minutes after ingestion of ethanol and were not increased by maternal intravenous injections of glucose. Maternal heart rate was increased by ethanol. The disposition of ethanol in maternal blood was not altered by injection of glucose, and fetal gross body movements were not influenced by maternal ingestion of ethanol or by injections of glucose after ethanol.

Blood Glucose↗
PubMed1986

Effect of fetal and maternal intravascular antipyrine infusion on maternal plasma prostaglandin concentrations in the pregnant sheep at 104 to 127 days' gestation.

Antipyrine is commonly used to measure umbilical and uterine blood flow in the pregnant sheep. In the present experiment we investigated the effect of antipyrine on prostaglandin metabolism. Four pregnant ewes at 104 to 127 days' gestation were infused with either 1, 4, or 15 mg of antipyrine per minute via the fetal jugular vein. The 15 mg X min-1 dose was also infused into the maternal jugular vein in a fourth experiment. Prostaglandins in the uterine vein draining the pregnant horn were measured by radioimmunoassay and antipyrine by high-performance liquid chromatography. No change in the concentrations of either 13,14-dihydro-15-keto-prostaglandin F2 alpha or 6-keto-prostaglandin F1 alpha was observed with infusion of antipyrine at 1 mg X min-1. The 4 and 15 mg X min-1 infusion rates into the fetal jugular vein induced a significant decrease (p less than 0.05) in maternal uterine vein 13,14-dihydro-15-keto-prostaglandin F2 alpha plasma concentrations. These concentrations decreased from 669.3 +/- 161.3 pg X ml-1 (mean +/- SD) before infusion to 306.5 +/- 104.0 pg X ml-1 after 3 hours of infusion at 4 mg X min-1 and from 744.2 +/- 256.8 to 105.0 +/- 24.2 pg X ml-1 at 15 mg X min-1. Significant changes in maternal uterine vein plasma 6-keto-prostaglandin F1 alpha and the 6-keto-prostaglandin F1 alpha/13,14-dihydro-15-keto-prostaglandin F1 alpha ratio occurred only at the 15 mg X min-1 infusion of antipyrine into the fetal jugular vein (p less than 0.05). Maternal uterine vein 6-keto-prostaglandin F1 alpha fell from 86.0 +/- 31.6 to 37.0 +/- 11.5 pg X ml-1 and the 6-keto-prostaglandin F1 alpha/13,14-dihydro-15-keto-prostaglandin F2 alpha ratio rose from 0.14 +/- 0.10 to 0.35 +/- 0.10. We conclude that: antipyrine at doses currently used to measure uterine and umbilical blood flows inhibits 13,14-dihydro-15-keto-prostaglandin F2 alpha production and infusion rates of antipyrine less than 1 mg X min-1 probably do not affect maternal prostaglandin metabolism. We therefore recommend that if this method is to be used for measuring blood flow, antipyrine infusion rates should be less than 1 mg X min-1.

6-Ketoprostaglandin F1 alpha↗
PubMed1997

Fetal growth is associated positively with maternal intake of riboflavin and negatively with maternal intake of linoleic acid.

OBJECTIVE: To examine whether dietary factors in pregnancy are related to fetal growth. DESIGN: Prospective longitudinal study during pregnancy; midway through gestation a dietary history was obtained. SUBJECTS/SETTING: Subjects (n = 372) were participants in a study on maternal essential fatty acid status during pregnancy who did not have hypertension or any metabolic, cardiovascular, neurological, or renal disorder. Only pregnant white women with the intention to give birth in one of the three hospitals involved in the study were included. All three hospitals were located in the southern part of the Netherlands. STATISTICAL ANALYSES PERFORMED: The relation between maternal nutrition and fetal growth was evaluated using multiple regression analyses. RESULTS: Maternal intake of n-3 fatty acids plus arachidonic acid and of riboflavin were associated positively with fetal growth. A negative relation was observed between linoleic acid intake and fetal growth. APPLICATIONS/CONCLUSIONS: Our data suggest that the maternal diet during pregnancy is associated with fetal growth. Although this relationship ought to be more closely investigated, our results imply that much more attention should be paid to an adequate maternal diet during pregnancy, especially with respect to riboflavin and fatty acid intake.

Adolescent↗
PubMed1990

The effect of adjusting maternal serum alpha-fetoprotein levels for maternal weight in pregnancies with fetal open spina bifida. A United States collaborative study.

The effect of adjustment of maternal serum alpha-fetoprotein levels for maternal weight was evaluated in 143 pregnancies associated with fetal open spina bifida. The cases were analyzed with gestational dates as initially assigned either by last menstrual period (73%) or by ultrasonography (27%). The weights of women with pregnancies affected by open spina bifida were found not to be different from unaffected pregnancies. Adjustment resulted in a net increase in detected cases at two commonly used cutoff points: 2.0 and 2.5 multiples of the median. At 2.0 multiples of the median, the detection rate increased from 80% to 84%, whereas at 2.5 multiples of the median the rate rose from 68% to 69%. Adjustment for maternal weight has previously been shown to reduce the false-positive rate in maternal serum alpha-fetoprotein screening for fetal open spina bifida by reducing variance in unaffected pregnancies; our data provide further support for consideration of maternal weight when interpreting material serum alpha-fetoprotein measurements.

Body Weight↗
PubMed1998

Maternal serum thromboxane B2 concentrations do not predict improved outcomes in high-risk pregnancies in a low-dose aspirin trial. The National Institute of Child Health and Human Development Network of Maternal-Fetal Medical Units.

OBJECTIVE: The aim of the study was too determine whether, in a low-dose aspirin trial in high-risk pregnancies, a decrease in maternal serum thromboxane B2 level predicted improved pregnancy outcomes. STUDY DESIGN: This multicenter, randomized, double-blind trial included 2539 women, 1010 of whom had sufficient serum samples at enrollment and at 24 to 28 weeks' gestation, 34 to 38 weeks' gestation, or both to assess longitudinal changes in thromboxane B2 level and their effects on pregnancy outcomes. Women were randomly assigned between 13 and 26 weeks' gestation to receive daily aspirin (60 mg) or placebo. RESULTS: Overall and in all subgroups women assigned to receive aspirin had markedly lower maternal thromboxane B2 concentration values than did those assigned to receive a placebo (P =.0001). Changes in thromboxane levels were not, however, correlated with adverse pregnancy outcomes. Women with >/=50% reduction in maternal serum thromboxane B2 concentrations from baseline had occurrences of preeclampsia (P =.922), preterm birth (P =.375), small for gestational age neonates (P =.938), and grade III or IV intraventricular hemorrhage (P = 1.000) similar to those of women who had <50% reduction. Similar results were found for women with thromboxane B2 level decreases of <15 versus >15 ng/mL and women with thromboxane B2 level decreases to <10 versus >/=10, <5 versus >/=5, and <1 versus >/=1 ng/mL. Maternal thromboxane B2 concentrations at enrollment were also not predictive of adverse outcomes. CONCLUSION: Neither maternal serum thromboxane B2 concentrations at enrollment nor their subsequent reduction were predictive of adverse pregnancy outcomes in a low-dose aspirin trial.

Aspirin↗