Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Preconception Care”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 379 records · Page 21Linked to original sources
PubMed1992

Diabetes mellitus in pregnancy and periconceptional genetic counseling.

Gestational diabetes constitutes 90% of all pregnant diabetic patients, whereas insulin-dependent diabetes mellitus (IDDM) and non-insulin-dependent diabetes mellitus (NIDDM) together account for the remaining 10%. Diabetes is considered a heterogeneous disease with a continuous spectrum between IDDM and NIDDM. It is believed that gestational diabetes is also a heterogeneous disorder representing, at least in part, patients who are destined to develop in later life either IDDM or NIDDM. Studies in identical twins have shown clear-cut differences in the genetic inheritance of IDDM and NIDDM. Nearly 100% of identical twins were found to be concordant for NIDDM; whereas in IDDM the concordance rate ranges between 20 and 50%. This concordant pattern indicates a higher genetic contribution in NIDDM than IDDM. Furthermore, IDDM is an HLA-linked disorder, and NIDDM is not. The exact mechanism of inheritance of IDDM and NIDDM is not known; therefore the information used in genetic counseling is based on empirical risk estimates. Recent information demonstrates that IDDM is transmitted less frequently to the offspring of diabetic mothers than diabetic fathers (1.3% versus 6%). The estimated risk of recurrence of IDDM to offsprings with one already affected sibling and unaffected parents is 5 to 6%. Additionally, the empirical risk of NIDDM first-degree relatives developing diabetes is much higher than the observed in IDDM relatives, 15% for first-degree relatives and 60 to 75% when both parents have NIDDM.(ABSTRACT TRUNCATED AT 250 WORDS)

Diabetes Mellitus, Type 1↗
PubMed1992

Prevention of the first occurrence of neural-tube defects by periconceptional vitamin supplementation.

BACKGROUND: The risk of recurrent neural-tube defects is decreased in women who take folic acid or multivitamins containing such during the periconceptional period. The extent to which folic acid supplementation can reduce the first occurrence of defects is not known. METHODS: We conducted a randomized, controlled trial of periconceptional multivitamin supplementation to test the efficacy of this treatment in reducing the incidence of a first occurrence of neural-tube defects. Women planning a pregnancy (in most cases their first) were randomly assigned to receive a single tablet of a vitamin supplement (containing 12 vitamins, including 0.8 mg of folic acid; 4 minerals; and 3 trace elements) or a trace-element supplement (containing copper, manganese, zinc, and a very low dose of vitamin C) daily for at least one month before conception and until the date of the second missed menstrual period or later. RESULTS: Pregnancy was confirmed in 4753 women. The outcome of the pregnancy (whether the fetus or infant had a neural-tube defect or congenital malformation) was known in 2104 women who received the vitamin supplement and in 2052 who received the trace-element supplement. Congenital malformations were significantly more prevalent in the group receiving the trace-element supplement than in the vitamin-supplement group (22.9 per 1000 vs. 13.3 per 1000, P = 0.02). There were six cases of neural-tube defects in the group receiving the trace-element supplement, as compared with none in the vitamin-supplement group (P = 0.029). The prevalence of cleft lip with or without cleft palate was not reduced by periconceptional vitamin supplementation. CONCLUSIONS: Periconceptional vitamin use decreases the incidence of a first occurrence of neural-tube defects.

Cleft Lip↗
PubMed1999

Prevention of neural-tube defects with folic acid in China. China-U.S. Collaborative Project for Neural Tube Defect Prevention.

BACKGROUND AND METHODS: Periconceptional administration of folic acid can reduce a woman's risk of having a fetus or infant with a neural-tube defect. As part of a public health campaign conducted from 1993 to 1995 in an area of China with high rates of neural-tube defects (the northern region) and one with low rates (the southern region), we evaluated the outcomes of pregnancy in women who were asked to take a pill containing 400 microg of folic acid alone daily from the time of their premarital examination until the end of their first trimester of pregnancy. RESULTS: Among the fetuses or infants of 130,142 women who took folic acid at any time before or during pregnancy and 117,689 women who had not taken folic acid, we identified 102 and 173, respectively, with neural-tube defects. Among the fetuses or infants of women who registered before their last menstrual period and who did not take any folic acid, the rates of neural-tube defects were 4.8 per 1000 pregnancies of at least 20 weeks' gestation in the northern region and 1.0 per 1000 in the southern region. Among the fetuses or infants of the women with periconceptional use of folic acid, the rates were 1.0 per 1000 in the northern region and 0.6 per 1000 in the southern region. The greatest reduction in risk occurred among the fetuses or infants of a subgroup of women in the northern region with periconceptional use who took folic acid pills more than 80 percent of the time (reduction in risk, 85 percent as compared with the fetuses or infants of women who registered before their last menstrual period and who took no folic acid; 95 percent confidence interval, 62 to 94 percent) [corrected]. In the southern region the reduction in risk among the fetuses or infants of women with periconceptional use of folic acid was also significant (reduction in risk, 41 percent; 95 percent confidence interval, 3 to 64 percent). CONCLUSIONS: Periconceptional intake of 400 microg of folic acid daily can reduce the risk of neural-tube defects in areas with high rates of these defects and in areas with low rates.

Adult↗
PubMed2002

Folic acid supplementation use among women who contact a teratology information service.

OBJECTIVE: The purpose of this study was to determine the percentage of the women who call a teratology information service who take folic acid before conception. STUDY DESIGN: A pilot-tested questionnaire was used to survey women who called a teratology information service about their use of folic acid supplementation. Frequencies were generated by pregnancy status, age, race, and parity. RESULTS: Of the 693 pregnant callers, 42% of the women initiated folic acid use 6 weeks before pregnancy, 35% of the women initiated folic acid use during pregnancy. Thirty-seven percent of the total caller population reported taking folic acid. Forty-seven percent of pregnant white women versus 27% of pregnant black women reported preconceptional folic acid use (P =.005). Thirty-nine percent of pregnant women who were <30 years old reported preconceptional folic acid use versus 48% of women who were >30 years old (P =.018). CONCLUSION: Most pregnant women take folic acid; however, only a minority of them start before conception. The use of preconceptional folic acid, although higher than the national average of 30%, was still low. Many women start taking folic acid in their pregnancy after the neural tube is closed.

Black or African American↗
PubMed2004

Assessment of Turkish women's knowledge concerning folic acid and prevention of birth defects.

OBJECTIVES: In Turkey, the incidence of neural tube defects (NTDs) is 30.1 per 10,000 births. For this reason it seems an important problem for women of childbearing age. Adequate periconceptional consumption of folic acid could prevent NTDs. Most women are unaware of this recommendation. The objectives of this study were to evaluate women' knowledge and beliefs with regard to folic acid, and to estimate the consumption frequency of vitamin supplements periconceptionally and during the first trimester of pregnancy. DESIGN: Eight hundred and eighteen married women who had delivered a live-born infant within the previous 12 months completed the questionnaire. Each subject participated in a 20-minute interview, with the questionnaire comprising multiple-choice statements. A random sample of 10 public health centres was drawn from 27 in three districts in Konya where about 50% of the population lives. RESULTS: Only 22% of subjects had heard or read about folic acid. Thirteen per cent of women indicated knowledge of the direct link between folic acid supplementation and NTD prevention. The knowledge was greatest among 26- to 35-year-olds. Women with a university degree were more likely to have heard about folic acid than were less-educated women. CONCLUSION: The results indicate that further government efforts are needed to inform the population and promote the optimal use of folic acid supplements and folate-enriched foods. It is the responsibility of national authorities to increase health education concerning folic acid and the prevention of NTDs in their countries.

Adolescent↗
PubMed2006

Maternal smoking predicts the risk of spontaneous abortion.

BACKGROUND: Few studies have examined smoking prior to pregnancy and the occurrence of spontaneous abortion, as most studies have addressed the risk of spontaneous abortion in relation to smoking during pregnancy. However, results are not entirely consistent. The aim of the present study was to assess the risk of spontaneous abortion considering smoking prior to pregnancy. METHODS: We performed a nested case-control study using prospective data from a population-based cohort comprising 11,088 women aged 20-29 years. From this cohort, women who experienced either a spontaneous abortion (n=343) or who gave birth (n=1,578) during follow-up were selected. Associations between self-reported smoking at enrollment and subsequent spontaneous abortion were analyzed by means of multiple logistic regression. RESULTS: The risk of spontaneous abortion in relation to pre-pregnancy smoking showed a clear dose-response effect. The adjusted odds ratio (95% confidence interval) for spontaneous abortion among current smokers prior to conception was 1.20 (1.04-1.39) per every extra five cigarettes smoked per day. The increased risk was only present for current smokers. The duration of smoking prior to pregnancy was not a significant predictor for subsequent spontaneous abortion. CONCLUSIONS: The amount of daily smoking prior to pregnancy seems to be associated with an increased risk of spontaneous abortion, whereas the duration of smoking does not seem to be related to an increased risk of spontaneous abortion.

Abortion, Spontaneous↗
PubMed2006

College women's reported behaviors and beliefs regarding fish and folic acid and their roles in birth defects.

The purpose of the current study was to examine college women's beliefs and behaviors regarding birth defect prevention via folic acid intake and avoidance of fish with high mercury levels. We surveyed 313 college women and found that the majority of them reported eating fish despite their awareness that certain types of fish contained levels of mercury that are dangerous for women of childbearing age. We also found that the majority of the women did not comply with dietary guidelines for vegetable and legume consumption, and more than half of them did not take vitamin supplements that provide folic acid.

Adolescent↗
PubMed2005

Hepatic lipase gene polymorphism, pre-pregnancy overweight status and risk of preeclampsia among Peruvian women.

We examined the association between the hepatic lipase (LIPC) gene promoter polymorphism (-514C/T) and risk of preeclampsia among Peruvian women. We also evaluated whether this association is modified by maternal pre-pregnancy overweight status. Using a case control study design, 157 preeclampsia cases and 180 normotensive controls were enrolled in the study. Genotyping was conducted using PCR amplification, NlaIII enzyme digestion and gel electrophoresis. Logistic regression procedures were used to calculate adjusted odds ratios (ORs) and 95% confidence intervals (CI). After adjusting for confounding by maternal age, parity and pre-pregnancy body mass index (BMI), the relative risks of preeclampsia for women with LIPC -514CT and LIPC -514TT genotypes were 1.0 (95% CI 0.5-2.2) and 1.5 (95% CI 0.7-3.3) respectively, using women with LIPC -514CC genotype as a reference. Women who were both overweight and who had the LIPC -514TT genotype had a significant 3-fold increased risk of preeclampsia (Adj. OR:3.0 95% CI 1.3-6.8) as compared to those women who were not overweight and had the LIPC -514CC/CT genotype. In this study, we found that LIPC -514TT genotype and overweight status, when occurring together, were associated with a 3-fold increase in risk of preeclampsia among Peruvian women.

Body Mass Index↗
PubMedDate not supplied

Problem drinking in women evaluated for infertility.

Clinicians may wish to use the T-ACE, a screening instrument for prenatal risk drinking, for their infertile patients. Twenty-eight T-ACE negative and 23 T-ACE positive women presenting to an academic infertility clinic completed two interviews about their drinking. The 23 T-ACE positive participants were also randomized to receive a brief intervention. The T-ACE distinguished between heavier and lighter patterns of alcohol use in this sample. Moreover, it appeared that although the average quantity of alcohol consumed per drinking day was unchanged, the overall mean percentage of days drinking declined significantly from the time of enrollment to follow-up in all groups.

Adult↗
PubMed2005

Successful pregnancy after unilateral adrenalectomy in a case of primary pigmented adrenocortical disease.

We describe a case of successful pregnancy in a patient with primary pigmented nodular adrenocortical disease. Unilateral adrenalectomy was performed pre-conception as treatment for the patient's bilateral adrenal disease. She later delivered a healthy infant by cesarean section at week 38 of gestation. There was no evidence of either hyper- or hypo-cortisolism during the pregnancy. The unilateral laparoscopic adrenalectomy was successful in controlling her hypercortisolism during the ensuing pregnancy, and might provide a valid (albeit temporary) solution in similar situations.

Adrenal Cortex Diseases↗
PubMed2002

Use of angiotensin-converting enzyme inhibitors in patients with diabetic nephropathy.

Diabetic nephropathy is the most common cause of end-stage renal failure in the Western world. It accounts for 15-25% of all renal failure in patients requiring chronic dialysis. About 20% of patients with insulin-dependent diabetes and less than 15% of patients with non-insulin-dependent diabetes develop clinically significant nephropathy. The prevalence of diabetic nephropathy in pregnant patients with insulin-dependent diabetes is estimated to be 6%. Angiotensin converting enzyme (ACE) inhibitors are the drug of choice in treating women with diabetic nephropathy. In addition, many of these drugs may be started before conception. Unfortunately, these agents might be fetotoxic when taken during pregnancy. This article reviews the epidemiology and natural history of diabetic nephropathy, discusses the renoprotective effect of ACE inhibitors, reviews the effect of ACE inhibitors on fetomaternal outcome when used prior to and during pregnancy in women with diabetic nephropathy and discusses the new class of drugs, angiotensin II receptor antagonists, in the management of diabetics who have or are prone to developing diabetic nephropathy.

Angiotensin II↗