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PubMed1991

Maternal and fetal haemodynamics in hypertensive pregnancies during maternal treatment with intravenous hydralazine or labetalol.

Intravenous treatment with 10 mg of hydralazine or 100 mg of labetalol was randomly allocated to 30 hypertensive pregnant women. Umbilical artery flow velocity waveforms were recorded using a pulsed Doppler duplex scanner (ATL Mk V) and umbilical artery pulsatility index (PI) and fetal heart rate (FHR) were derived from these recordings. Maternal blood pressure decreased significantly after both drugs. Maternal pulse rate increased after hydralazine but did not change significantly after labetalol. FHR did not change significantly after hydralazine but decreased after labetalol. PI decreased after hydralazine and increased after labetalol--most fetuses showed little change but a few in each group showed large changes in PI, as did two of five additional patients studied. We attributed the decrease in PI in some fetuses after hydralazine to vasodilation, and the increase in PI in some fetuses after labetalol to vasoconstriction in the fetoplacental circulation, suggesting that fetal beta-blockade may occur after maternal treatment with labetalol.

Adult↗
PubMed2003

Porphyromonas gingivalis infection during pregnancy increases maternal tumor necrosis factor alpha, suppresses maternal interleukin-10, and enhances fetal growth restriction and resorption in mice.

Epidemiological studies have shown a potential association between maternal periodontitis and pregnancy complications. We used a pregnant murine model to study the effect of infection with the periodontal pathogen Porphyromonas gingivalis on pregnancy outcomes. Female BALB/c mice were inoculated with heat-killed P. gingivalis (10(9) CFU) in a subcutaneous chamber and mated 2 weeks later. At gestation day (GD) 7.5, mice were challenged with live P. gingivalis (10(7) CFU) (n = 20) or broth (control; n = 8) and sacrificed at GD 16.5. Fetal growth restriction (FGR, <0.46 g) was defined as fetuses with weights 2 standard deviations (SD) smaller than controls (0.56 +/- 0.05 g [mean +/- SD]). Among the 20 challenged mice, 8 had both normal-weight (0.51 +/- 0.11 g) and FGR (0.34 +/- 0.1 g) fetuses within the same litter. All other challenged dams had normal-weight fetuses (0.57 +/- 0.04 g). Maternal liver, uterus, and spleen samples were examined for P. gingivalis DNA using a PCR technique. Of the eight challenged mice with FGR fetuses, three had PCR signals for P. gingivalis in liver and uterus, but not in the spleen. Liver, uterus, and spleen were negative for P. gingivalis DNA among all other challenged and control mice. In serum of dams with FGR fetuses, tumor necrosis factor alpha levels were elevated significantly, while interleukin-10 levels were significantly reduced compared to levels in dams with normal fetuses. P. gingivalis-specific serum immunoglobulin G levels were significantly elevated in dams with FGR fetuses compared to dams without any FGR fetuses. These data demonstrate that P. gingivalis-induced murine FGR is associated with systemic dissemination of the organism and activated maternal immune and inflammatory responses.

Animals↗
PubMed2006

Bone mass in Indian children--relationships to maternal nutritional status and diet during pregnancy: the Pune Maternal Nutrition Study.

CONTEXT/OBJECTIVE: Bone mass is influenced by genetic and environmental factors. Recent studies have highlighted associations between maternal nutritional status during pregnancy and bone mass in the offspring. We hypothesized that maternal calcium intakes and circulating micronutrients during pregnancy are related to bone mass in Indian children. DESIGN/SETTING/PARTICIPANTS/MAIN OUTCOME MEASURES: Nutritional status was measured at 18 and 28 wk gestation in 797 pregnant rural Indian women. Measurements included anthropometry, dietary intakes (24-h recall and food frequency questionnaire), physical workload (questionnaire), and circulating micronutrients (red cell folate and plasma ferritin, vitamin B12, and vitamin C). Six years postnatally, total body and total spine bone mineral content and bone mineral density (BMD) were measured using dual-energy x-ray absorptiometry (DXA) in the children (n = 698 of 762 live births) and both parents. RESULTS: Both parents' DXA measurements were positively correlated with the equivalent measurements in the children (P < 0.001 for all). The strength of these correlations was similar for fathers and mothers. Children of mothers who had a higher frequency of intake of calcium-rich foods during pregnancy (milk, milk products, pulses, non-vegetarian foods, green leafy vegetables, fruit) had higher total and spine bone mineral content and BMD, and children of mothers with higher folate status at 28 wk gestation had higher total and spine BMD, independent of parental size and DXA measurements. CONCLUSIONS: Modifiable maternal nutritional factors may influence bone health in the offspring. Fathers play a role in determining their child's bone mass, possibly through genetic mechanisms or through shared environment.

Absorptiometry, Photon↗
PubMed1982

Effects of maternal ethanol intake during pregnancy on fetal and maternal liver enzyme systems in Wistar rats.

In the present study, the effects of maternal ethanol intake during pregnancy on microsomal cytochrome contents and on enzyme activities in the developing fetus were investigated. Ethanol intake to pregnant females did not affect the maternal body weight or number of fetuses, but tended to reduce the mean fetal body weight, especially the fetuses from a litter of mother who were treated with ethanol during day zero to 20 of gestation showed significant decreases in the body and liver weights. No significant changes were observed in the contents of cytochrome P-450 and b5 and the activities of NADPH-cytochrome c reductase and heme oxygenase in the livers of fetuses whose mothers were exposed to ethanol during pregnancy when compared with that of untreated pregnant rats. However, NADH-cytochrome b5 reductase activity in the fetal livers was found to significantly decrease by maternal ethanol intake during pregnancy.

Animals↗
PubMed1983

Influences of maternal ethanol intake on maternal and perinatal hepatic heme and drug metabolizing enzymes in rats.

The effect of ethanol on maternal and neonatal hepatic heme and drug metabolizing systems was determined. Ethanol (16%, w/v) was administered orally as drinking solution to pregnant or lactating rats at different pre- and post-natal stages. The dams and pups were sacrificed on days 7, 14 and 21 after parturition, respectively. Ethanol administration to lactating rats from just after birth caused an appreciable decrease in the maternal and neonatal body and liver weights. In addition, the activities of nicotinamide adenine dinucleotide phosphate-cytochrome c reductase, nicotinamide adenine dinucleotide-cytochrome b5 reductase and heme oxygenase were significantly enhanced in the livers of neonates whose mothers were exposed to the ethanol during only first week of lactation, but those activities were not altered in the maternal livers. However, no remarkable alterations were observed in the contents of cytochrome P-450 and b5, and the activities of aminopyrine demethylase, aniline hydroxylase and delta-aminolevulinic acid synthetase in the livers of neonates from mothers who had received ethanol during lactation period or last week of gestation, although the activities of aminopyrine demethylase and aniline hydroxylase were enhanced significantly in lactating dams by ethanol consumption for 14 d after parturition.

Animals↗
PubMed2002

Early risk factors for mental retardation: role of maternal age and maternal education.

The predictive value of maternal age and education in relation to rates of administratively defined mental retardation in a 3-year birth cohort (N = 267,277) was studied. Low maternal education placed individuals at increased risk for both educable mentally handicapped (EMH) and trainable mentally handicapped (TMH) placements. Older maternal age was associated with increased risk of mental retardation, but for individuals with EMH, this age effect was only seen in the lowest education group. In terms of population-level risk, it was younger mothers with 12 years of education or less whose births were associated with the greatest proportion of mental retardation. From a public policy viewpoint, children born to mothers with low levels of education are an important group to target for prevention/early intervention efforts.

Adult↗
PubMed1998

[Risk factors for low birth weight: influence of maternal age, parity, gestational age, nutritional status and maternal pathology].

A retrospective study carried on between april 1st and september 31st 1997 has helped in collecting. 69 cases of low birth weight new-born (weight < 2500 g) at Abass Ndao hospital center in Dakar. The above population has been compared to 79 eutrophic new-born of mean birth weight equal to 3047.7 +/- 311 g (witnesses). The goal of this study is to appreciate the relationship between the maternal age, the number of the gestation, the parity, the nutritional status, the maternal pathologies during pregnancy and the low weight at birth. There was no difference between both groups as regards to the mean age (p = 0.44), the mean number of gestation (p = 0.7) and the mean parity (p = 0.48). On the other hand, the weight of the mother is smaller as for the group of low birth weight but the mean body mass index stand at normal in both groups. The pathologies during pregnancy period were obviously more frequent in the group of low birth weight new-born. There is a real need to insist on the preventive measures to be taken and the treatment of the maternal pathologies during pregnancy.

Adult↗
PubMed2002

Can mothers afford maternal health care costs? User costs of maternity services in rural Tanzania.

Following the difficult economic situation various countries introduced health sector reforms, including user charges to finance the system. The assessment of user costs for maternity services in Tanzania was part of a larger study, which covered inputs, outputs and efficiency of services. The study was carried out from October 1997 to January 1998 in Mtwara urban and rural district in South Tanzania. One hundred and seven women attending a quarter of government health facilities were randomly selected and interviewed. Twenty one key informants were also interviewed and service procedures observed. Users of maternity services pay mainly for admission, drugs, other supplies and travel costs. Travel costs represent about half of these financial costs. The average total costs vary between US$11.60 for antenatal consultation and US$135.40 for caesarean section at the hospital. Unofficial payments are not included in the calculation. The amounts vary and payment is irregular. We therefore conclude that time costs are constantly higher than financial costs. High direct payments and the fear of unofficial costs are acute barriers to the use of maternity services. User costs can substantially be reduced by the re-organisation of service delivery especially at antenatal consultation.

Cost-Benefit Analysis↗
PubMed2006

Maternal smoking: risks related to maternal asthma and reduced birth weight in a Pacific Island birth cohort in New Zealand.

AIMS: This study investigated associations between smoking and maternal asthma and two indicators of pregnancy outcome: birth weight and preterm delivery. METHODS: Data were gathered as part of the Pacific Islands Families (PIF) Study. Mothers of a cohort of 1398 Pacific infants born in South Auckland, New Zealand during 2000 were interviewed when their infants were 6 weeks old. Mothers were questioned regarding maternal health and lifestyle behaviours such as cigarette smoking. Additional data were obtained from hospital records. Analyses focused on 1368 biological mothers. RESULTS: Approximately 20% of mothers reported smoking during their last trimester of pregnancy. Logistic regression analyses showed that smokers had over twice the risk of having maternal asthma as well as a low birth weight (LBW) or small for gestational age (SGA) infant than non-smokers. Smoking significantly reduced mean birth weight from between 149.2 grams (1-9 cigarettes) to 204.3 grams (10+ cigarettes). No significant association was found between smoking and preterm birth. CONCLUSIONS: Smoking is preventable, yet continues to have negative consequences for mothers and their offspring. Findings can inform public health policy and smoking cessation programmes for Pacific families.

Adult↗
PubMed1991

Local norms of maternal serum alpha-fetoprotein values in early second trimester: a prelude to a Down's syndrome screening programme incorporating maternal serum alpha-fetoprotein values.

Maternal alpha-fetoprotein in (MSAFP) has recently been proposed for screening of Down's syndrome. This is based on the association of a lowered MSAFP level at a given gestational age in Down's syndrome (DS) pregnancies. Most conventional 'screening' programmes in DS are based on the maternal age alone, selecting older mothers, who are at greater risk of having a DS infant born, for antenatal karyotyping. However, as 75% of DS infants are born to mothers less than 35 years old, a combination of blood tests including MSAFP and maternal age as independent risk factors would screen the younger mothers as a good cost-benefit ratio in selecting the 'at-risk' mothers for karyotyping. In this study, the gestational age was calculated from the first day of the last menstrual period (LMP) as well as from ultrasound cephalometry. The local MSAFP levels follow the same trend at a slightly higher level as those based on clinical evaluation of the Abbot AFP-EIA Monoclonal kits.

Down Syndrome↗
PubMed1991

[Maternal mortality in France. Frequency and reasons for its under-estimation in the statistics of medical cause of death. Group of Experts on Maternal Mortality].

All deaths of women of reproductive age notified in France over four months were the subject of an enquiry carried out through the post to the doctors who had written the certificates of death. The objective was to try to evaluate the true maternal mortality on a national scale. This enquiry was carried out on 4,102 female deaths and showed that 68 of these (1.6%) were in pregnant or puerperal women. 45 of these deaths were classified as maternal which was twice the number that showed up on the official statistics of the causes of death. On one hand the under notification--due to failure to realise that the patient was pregnant at the time of certification, and on the other hand the under registration because of the complexity of the pathological states explain this under estimation. The frequency of maternal mortality has been evaluated at 18 per 100,000 live births and 60% of these deaths are considered as due to a direct obstetric cause. The most frequent causes are embolisms, then haemorrhages and hypertension of pregnancy.

Adolescent↗
PubMed1990

[A statistical study of the countermeasures to reduce the maternal mortality based on the relationship between the maternal mortality rate and perinatal mortality rate].

Although both the Japanese maternal mortality rate (MMR) and the perinatal mortality rate (PMR) have decreased remarkably in recent decades, the former is still high compared with other advanced countries. A statistical analysis on the relationship between the MMR and the PMR was performed to investigate this discrepancy. During the period of study, both rates fell by over 50 percent. There were definite statistical differences among the PMR for each prefecture but almost none among the MMR. The prefectures with high PMR remained generally high in the PMR and the prefectures with low PMR also remained low in the MMR. There was no significant correlation between the PMR and the MMR. Both maternal and perinatal deaths due to common causes decreased in number, and there were few regional differences concerning effective measures against them. The leading causes of maternal death which are irrelevant to perinatal death are emboli, bleeding, and some other rare medical complications. Emphasis should therefore be laid upon the early diagnosis and treatment of amniotic fluid embolism apart from measures against haemorrhage. Countermeasures for rare complications are also of great importance.

Embolism, Amniotic Fluid↗
PubMed1984

25-Hydroxyvitamin D concentrations in maternal and cord blood at delivery and in maternal blood during lactation in Finland.

The 25-hydroxyvitamin D concentration (25-OHD) in maternal and cord blood of 192 mothers was determined at delivery from June to the end of November. Ninety-nine mothers had received a daily supplementation of 12.5 micrograms of vitamin D during pregnancy and this group had a significantly higher 25-OHD concentration both in maternal and in cord blood than in the corresponding non-supplemented group. A daily supplement of 2.5 micrograms of vitamin D was given to 63 of the mothers during lactation. Of these mothers 44 were still lactating after 6 months. The dietary vitamin D intake of 31 mothers was calculated. We found a significant correlation between the maternal serum 25-OHD concentration 16-18 weeks after delivery and the total vitamin D intake. The intake (5.5 micrograms/d, including supplementation) was lower than that recommended for lactating mothers which is 10 micrograms/d (Food and Nutrition Board, 1980).

Adolescent↗
PubMedDate not supplied

[Maternal mortality at the Charles Nicolle Hospital Maternity Department in Tunis between 1972 and 1975. With the exclusion of abortions (author's transl)].

The change in maternal mortality during the time of pregnancy, labour and the puerperium is similar in our department to that reported in many countries. The overall figure for maternal mortality between 1972 and 1975 is 0.54 per 1000 (54 per 100,000 deliveries. This is a halving of numbers as compared with our previous statistics. This improvement can be ascribed to several factors, which are increased in number and quality of medical and para-medical personnel, and the better environmental factors of the inhabitants of the region. On the other hand if mortality is looked at in relationship to aetiology, there has been no change in the order of the causes, which are principally haemorrhage and eclampsia. The former is avoidable in most cases by better prevention and blood replacement, which has to be fought for. The second, in spite of the drop of 50%, remains very worrying. Improvement in the prognosis for the mother depends on measures that are taken such as better equipment of maternity departments and informing and educating pregnant women.

Eclampsia↗
PubMed1992

Booked and unbooked mothers delivering at Harare Maternity Hospital, Zimbabwe: a comparison of maternal characteristics and foetal outcome.

This study was prompted by the poor maternal and foetal outcome at Harare Maternity Hospital, Zimbabwe, in unbooked mothers compared to women who had booked for antenatal care. Comparison was made of 195 recently delivered unbooked mothers with 196 booked mothers. Unbooked mothers were significantly more likely to be younger, of lower parity, be single, have lower socio-economic status, live in or migrate from rural areas, be uneducated and have an unwanted pregnancy. Their infants were significantly more likely to preterm and/or of low birth weight and had a higher perinatal mortality. The major reasons cited by the women for not booking were lack of money and delivery occurring before the intended time of booking. Discussion focuses on how to improve outcome in unbooked mothers.

Adult↗
PubMed1991

Trisomy 16q23----qter arising from a maternal t(13;16)(p12;q23): case report and evidence of the reciprocal balanced maternal rearrangement by the Ag-NOR technique.

We describe a female new-born with partial trisomy of the long arm of chromosome 16. The chromosome anomaly was the result of an unbalanced segregation of a maternal translocation t(13;16)(p12;q23). Dynamic (RBG, GBG) banding and the Ag-NOR technique ascertained the reciprocal balanced maternal translocation between the 16q23----qter and 13q12----pter segments because nucleolar organizers were present on the tip of long arms of the derivative 16 maternal chromosome. As monosomy 13p has little or no deleterious effect we consider our case as exhibiting the phenotype of trisomy 16q23----qter free from any monosomic feature. Clinical effects are of less consequence as compared with previously published cases of partial trisomy 16q.

Chromosome Banding↗
PubMed1990

Influences of maternal smoking and fetal sex on maternal serum oestriol, prolactin, hCG, and hPI levels.

A total of 222 pregnant women had repeated hormone assays between 20 weeks and delivery; 86 of the women were smokers. The maternal hormone balance appeared to be affected by smoking. Smoking affected maternal serum levels of hPL and hCG in pregnancies with a female fetus whereas maternal serum concentrations of oestriol and prolactin were affected in pregnancies with a male fetus. Significantly higher hCG levels were found in mothers who smoked and had a girl than in those who smoked and had a boy. On the basis of our results we feel that smoking mainly affects the placenta.

Adult↗
PubMed1995

Low-dose aspirin in nulliparous women: safety of continuous epidural block and correlation between bleeding time and maternal-neonatal bleeding complications. National Institute of Child Health and Human Developmental Maternal-Fetal Medicine Network.

OBJECTIVE: Our purpose was to determine the frequency and safety of the use of epidural anesthesia and the correlation between bleeding time and maternal-neonatal bleeding complications in a group of pregnant women who participated in a multicenter trial of low-dose aspirin in pregnancy. STUDY DESIGN: Data regarding type of anesthesia used for labor and delivery were available in 1629 nulliparous women who were randomly assigned at 13 to 27 weeks to receive 60 mg/day aspirin or a placebo. A total of 891 (55%) received epidural anesthesia, and the remaining 738 did not. RESULTS: Among the 891 women known to have received epidural anesthesia, 451 were assigned to low-dose aspirin and 440 to placebo. There was no instance of bleeding related to epidural use. In addition, there were no differences in maternal and neonatal complications between those receiving or not receiving epidural anesthesia. Within the group receiving epidural anesthesia there were no differences in bleeding complications between those assigned to aspirin on placebo. One of the five centers also obtained bleeding times in 303 women (149 received aspirin and 154 received placebo). The mean +/- SD bleeding time in women assigned to low-dose aspirin was significantly higher than in women assigned to placebo (6.99 +/- 2.95 minutes vs 5.99 +/- 2.43 minutes, p = 0.004). In addition, the frequency of women having a bleeding time > 10 minutes was higher in the aspirin group (14.1% vs 5.2%, p = 0.01). Interestingly, women who received an epidural anesthetic had a lower bleeding time than those not receiving an epidural (p = 0.003), irrespective of the treatment used. CONCLUSIONS: In women assigned to low-dose aspirin there were no adverse effects related to epidural anesthesia. In spite of an increased bleeding time in a subset of pregnant women assigned to low-dose aspirin, maternal-neonatal bleeding complications were not increased.

Analysis of Variance↗