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PubMed1985

The ontogeny of hypothalamic pituitary function in the pig. I. Pituitary LH and FSH in the fetus and neonate.

Pituitaries were collected from fetal and postnatal pigs from day 55 p.c. until 6 weeks after birth at closely spaced intervals. LH and FSH in individual pituitaries were quantified by both homologous RIA and homologous RRA. No significant difference was found between results obtained by RIA and RRA. Both LH and FSH are first detected by RIA and RRA in the porcine fetal pituitary at 75 days p.c. Thereafter both LH and FSH pituitary content rises until term. LH pituitary concentration in both male and female fetuses and FSH pituitary concentration in males exhibit a peak just before birth. FSH pituitary concentration in females rises until birth and thereafter remains elevated. A statistically significant sex difference was found postnatally with regard to FSH content and concentration but not for LH.

Animals↗
PubMed1982

Growth in the first year of life: effects of sex and weight for gestational age at birth.

Fifty-five small-for-dates (SFD), 56 average-for-dates (AFD) and 55 large-for-dates (LFD) babies were weighed and measured at regular intervals from birth to 12 months. Within the SFD and AFD groups weight gain was greater for boys than for girls so that by one year there were highly significant differences between the two sexes. Within the LFD group the sex difference was slight at all ages. Gain in length was similar to that for weight within each group; but head circumference showed a different pattern. Absolute increase in head circumference respectively for boys and girls between birth and one year was greatest in the SFD group and least in the LFD group. Within all three groups it was greater for boys than girls. By the age of six months AFD boys had larger heads than LFD girls and SFD boys had larger heads than AFD girls. At 12 months the head-circumference values for LFD girls and SFD boys did not significantly differ.

Birth Weight↗
PubMed1992

[Antenatal surveillance and risks of prematurity and fetal growth retardation].

The essential aim of this work was to investigate the relationship between antenatal care and preterm delivery or low birth weight. This study has been done by means of a case-control survey carried out among 435 women who delivered in 4 Maternity Hospitals in Aix-en-Provence-Pertuis area, between November 20th, 1987 and September 30th, 1988. Cases consisted of 124 women having delivered single livebirths before 37 weeks' gestation and 69 women having delivered, at term, single livebirths weighting less than 2,500 g. Controls were 242 women who delivered normal single livebirths. Results showed that, within the geographic area of the study, low birth weight and preterm delivery rates were respectively 6% and 5.4%. Antenatal care was generally according to medical profession recommendations: average number of visits: 7.9; first visit achieved, for 98.8% of women, within first trimester; intervention of a specialist in 97.1% of pregnancies; average number of ultrasound examinations: 3.5. Only mothers of low birthweight infants had more often an inadequate antenatal care (OR = 2.63, 95% confidence interval: 1.22-5.70). The risk factors for low birth weight were: previous history of preterm and/or low birth weight delivery, single marital status, low lever father's education, smoking during pregnancy, no contact with maternity team and for preterm delivery: previous history of preterm and/or low birth weight delivery, complications during the penultimate pregnancy, hypertension, metrorragies. These results suggest that it seems unlikely, in the future, to decrease unfavorable pregnancy outcomes by increasing antenatal care.

Case-Control Studies↗
PubMed2004

Pregnancy outcome of Mexican-American women: the effect of generational residence in the United States.

OBJECTIVE: To determine whether duration of generational residence in the United States is associated with the pregnancy outcome of Mexican Americans. DESIGN: This is a population-based study. METHODS: Stratified analyses were performed on a data set of 1989-1991 Illinois computerized vital records of Mexican-American infants. RESULTS: First generation (N=2,203) and second or higher (N=4,192) US-born Mexican-American women had infant low birth-weight rates of 7.5% and 6.1%, respectively, compared to 5.1% for Mexican-born women (N=39,050); relative risk=1.4 (1.2-1.7) and 1.2 (1.1-1.4), respectively. Among women with one or more high-risk sociodemographic characteristics (age less than 20 years, educational attainment less than 12 years, unmarried, high parity, or inadequate prenatal care), first generation (N=1,624) and second or higher generation (N=2,874) US-born Mexican-American women had infant low birth-weight rates of 8.3% and 6.5%, respectively, vs 5.2% for Mexican-born women (N=33,625); relative risk = 1.6 (95% confidence interval [CI], 1.3-1.9) and 1.2 (95% CI, 1.0-1.4), respectively. Among women with the lowest sociodemographic risk profile, infant low birthweight rates did not vary between the subgroups. CONCLUSIONS: For second or higher generation US-born Mexican-American women, the rate of infant low birth weight does not exceed that of first generation US-born women; it actually approximates that of Mexican-born women across a broad range of sociodemographic characteristics.

Adult↗
PubMed2005

[Is breast-feeding a protective factor for infectious diseases? A case-control study].

AIM: To analyze if breast-feeding (BF) is a protective factor against infectious diseases. DESIGN: Case-control study. Retrospective study during 1998. SETTING: Primary care. Teaching health center. Population of 22,500 inhabitants. PATIENTS: We consider an alpha risk of .05 and a beta risk of .20, unilateral hypothesis. We estimated a sample of 48 children in the "case" group and 144 in the "control" group. Random sample. MEASURES: Cases were children with 3 or more acute respiratory or digestive infectious episodes during the first year of age. Controls were children with less than 3 episodes. We analyze exposure to breast feeding (BF) and we consider it if the child had at least 3 months of BF. In other case we define as a non-exposure child. We have calculated odds ratio (OR) and its 95% confidence intervals. RESULTS: 60.4% of the children were BF after birth. But only 28.5% lasted 3 months, and only 13.9% lasted 1 year. The median of BF was 3.3 months (SD 4.2). 79.2% of the children have a respiratory infectious disease in the first year and 14.6% diarrhea. In children less than 1 year old the OR was 0.81 (95% CI, 0.40-1.63). In the period 3-6 months old we have found an OR of 0.346 (95% CI 0.161-0.744). CONCLUSIONS: In children aged less than 1 year, we have not found protective effects of breast-feeding against acute respiratory infectious diseases. Only in the period 3-6 months old, we have found that BF protects against these diseases.

Age Factors↗
PubMed1997

Randomised controlled trial of aspirin and aspirin plus heparin in pregnant women with recurrent miscarriage associated with phospholipid antibodies (or antiphospholipid antibodies)

OBJECTIVE: To determine whether treatment with low dose aspirin and heparin leads to a higher rate of live births than that achieved with low dose aspirin alone in women with a history of recurrent miscarriage associated with phospholipid antibodies (or antiphospholipid antibodies), lupus anticoagulant, and cardiolipin antibodies (or anticardiolipin antibodies). DESIGN: Randomised controlled trial. SETTING: Specialist clinic for recurrent miscarriages. SUBJECTS: 90 women (median age 33 (range 22-43)) with a history of recurrent miscarriage (median number 4 (range 3-15)) and persistently positive results for phospholipid antibodies. INTERVENTION: Either low dose aspirin (75 mg daily) or low dose aspirin and 5000 U of unfractionated heparin subcutaneously 12 hourly. All women started treatment with low dose aspirin when they had a positive urine pregnancy test. Women were randomly allocated an intervention when fetal heart activity was seen on ultrasonography. Treatment was stopped at the time of miscarriage or at 34 weeks' gestation. MAIN OUTCOME MEASURES: Rate of live births with the two treatments. RESULTS: There was no significant difference in the two groups in age or the number and gestation of previous miscarriages. The rate of live births with low dose aspirin and heparin was 71% (32/45 pregnancies) and 42% (19/45 pregnancies) with low dose aspirin alone (odds ratio 3.37 (95% confidence interval 1.40 to 8.10)). More than 90% of miscarriages occurred in the first trimester. There was no difference in outcome between the two treatments in pregnancies that advanced beyond 13 weeks' gestation. Twelve of the 51 successful pregnancies (24%) were delivered before 37 weeks' gestation. Women randomly allocated aspirin and heparin had a median decrease in lumbar spine bone density of 5.4% (range -8.6% to 1.7%). CONCLUSION: Treatment with aspirin and heparin leads to a significantly higher rate of live births in women with a history of recurrent miscarriage associated with phospholipid antibodies than that achieved with aspirin alone.

Abortion, Habitual↗
PubMed2000

Risk of breast cancer with oral contraceptive use in women with a family history of breast cancer.

CONTEXT: Oral contraceptive (OC) use is weakly associated with breast cancer risk in the general population, but the association among women with a familial predisposition to breast cancer is less clear. OBJECTIVE: To determine whether the association between OC use and risk of breast cancer is influenced by family history of the disease. DESIGN AND SETTING: Historical cohort study of 426 families of breast cancer probands diagnosed between 1944 and 1952 at the Tumor Clinic of the University of Minnesota Hospital. Follow-up data on families were collected by telephone interview between 1991 and 1996. PARTICIPANTS: A total of 394 sisters and daughters of the probands, 3002 granddaughters and nieces, and 2754 women who married into the families. MAIN OUTCOME MEASURE: Relative risk (RR) of breast cancer associated with history of OC use by relationship to proband. RESULTS: After accounting for age and birth cohort, ever having used OCs was associated with significantly increased risk of breast cancer among sisters and daughters of the probands (RR, 3.3; 95% confidence interval [CI], 1.6-6.7), but not among granddaughters and nieces of the probands (RR, 1.2; 95% CI, 0.8-2.0) or among marry-ins (RR, 1.2; 95% CI, 0.8-1.9). Results were essentially unchanged after adjustment for parity, age at first birth, age at menarche, age at menopause, oophorectomy, smoking, and education. The elevated risk among women with a first-degree family history of breast cancer was most evident for OC use during or prior to 1975, when formulations were likely to contain higher dosages of estrogen and progestins (RR, 3.3; 95% CI, 1.5-7.2). A small number of breast cancer cases (n = 2) limited the statistical power to detect risk among women with a first-degree relative with breast cancer and OC use after 1975. CONCLUSIONS: These results suggest that women who have ever used earlier formulations of OCs and who also have a first-degree relative with breast cancer may be at particularly high risk for breast cancer. Further studies of women with a strong family history who have used more recent lower-dosage formulations of OCs are needed to determine how women with a familial predisposition to breast cancer should be advised regarding OC use today. JAMA. 2000;284:1791-1798.

Adult↗
PubMed1995

Failure to identify human immunodeficiency virus-seropositive newborns: epidemiology and enrollment patterns in a predominantly white, nonurban setting.

OBJECTIVE: To describe the epidemiology of newborn seroprevalence for human immunodeficiency virus (HIV) in a predominantly white, nonurban population, and to determine the factors associated with enrollment at a regional pediatric acquired immunodeficiency syndrome (AIDS) center serving that population. DESIGN: Retrospective case series of children enrolled at a regional pediatric AIDS center during a 6-year period and comparison with universal blind newborn screening data collected by the state of New York during the same time interval. SETTING: The Pediatric AIDS Center at State University of New York-Health Science Center at Syracuse, which serves as the only source of HIV-related pediatric care for children in a 16-country region of upstate New York totaling 1.8 million population. RESULTS: One hundred thirty-nine HIV-seropositive infants were born in the region during the 6-year study period; complete blind screening data were available for 138. Sixty-five (47%) of these infants were white. Thirty-nine (28%) of 138 had been enrolled at the Pediatric AIDS Center within the first 90 days of life. An additional 22 (16%) were enrolled at older than 90 days of life. The remaining 77 (56%) have never been seen at the center and are presumed to be unidentified. County enrollment rates varied from 0% to 100% and correlated with percent nonwhite births (r = .58; 95% confidence interval, 0.04-0.86). Children in outlying counties were at greater risk for nonenrollment than children from Onondaga County (site of the Pediatric AIDS Center) (adjusted relative risk, 1.38; 95% confidence interval, 1.05-1.85). White infants residing outside of Onondaga County were at the greatest risk of nonenrollment; of 50 seropositive white infants residing outside of Onondaga County, only 7 (14%) were enrolled at the center within the first 90 days of life. CONCLUSIONS: Local demographic factors can skew the racial distribution of HIV-seropositive infants dramatically compared with the national experience. White race and residence in counties away from the medical center each constituted risk factors for nonenrollment at the Pediatric AIDS Center. The epidemiology of HIV in this predominantly white, rural population, coupled with physician practices, probably contributed to low identification and enrollment rates. As the AIDS epidemic spreads into similar populations elsewhere, HIV infection in pregnant women or newborn infants is likely to become progressively harder to detect, unless universal screening is adopted.

Black or African American↗
PubMed2004

Trends in the incidence of severe retinopathy of prematurity in a geographically defined population over a 10-year period.

OBJECTIVE: To examine trends in the incidence of severe (> or =grade 3) retinopathy of prematurity (ROP) in infants with birth weight of < or =1250 g in a geographically defined population over a 10-year period. METHODS: An observational study was conducted of all infants who had a birth weight < or =1250 g and were born to mothers who were resident in the county of Leicestershire, United Kingdom, during the period January 1, 1990, to December 30, 1999. Cases were identified by the Trent Neonatal Survey. The incidence of severe ROP (> or =grade 3) was compared in 2 successive 5-year periods: 1990-1994 and 1995-1999. RESULTS: Comparing the first 5-year period (1990-1994) with the second (1995-1999), the total number of live births fell (60 789 vs 56 564). However, there was a significant increase in the number of births with birth weight < or =1250 g (including live and dead; 615 vs 734; live births only: 455 vs 556). Survival to 42 weeks of infants who were born at < or =1250 g was significantly better in the latter time period (203 vs 302; odds ratio [OR] for death: 0.54; 95% confidence interval [CI]: 0.39-0.75). The number of cases of severe ROP was 4 times higher during the second time period compared with the first (9 vs 36). A significantly increased risk for the development of severe ROP was seen during the second time period (OR: 2.92; 95% CI: 1.37-6.20). Even after allowing for the change in gestation induced by the improved survival during the second time period, the increased risk remained (OR: 2.81; 95% CI: 1.27-6.21). CONCLUSIONS: There is strong evidence that the incidence of severe ROP among infants with birth weight < or =1250 g increased in the latter half of the last decade. The increased risk seems to be independent of the increase in survival.

Birth Weight↗
PubMed2004

Maternal breast cancer risk after the death of a child.

The possible association between a severe traumatic life event (death of a child) and breast cancer risk was examined in a case-control study nested within a nation-wide cohort in Sweden. Our study population included 27,571 women with breast cancer and 141,798 control women born between 1925-1976. After adjustment for age, parity, age at first birth and education, the overall risk estimate for breast cancer among all women that had experienced the death of a child was 1.05 (95% confidence interval [CI] = 0.96-1.15). Among uniparous women the corresponding odds ratio (OR) was 1.27 (95% CI = 0.98-1.64). When stratifying for child's age at death a significant risk increase was detected among women that had lost their only child when the child was between 1-4 years of age (OR = 2.65; 95% CI = 1.06-6.60). These findings do not support an overall increase in breast cancer risk after the death of a child, a severe traumatic life event. Based on a small number of subjects, our finding of an increased risk in a subgroup of uniparous women losing their only child could be due to chance.

Adolescent↗
PubMed2000

A probabilistic approach to the assessment of some life history pattern parameters in a Middle Pleistocene human population.

Parameters of a Middle Pleistocene human population such as the expected length of the female reproductive period (E(Y)), the expected interbirth interval (E(X)), the survival rate (tau) for females after the expected reproductive period, the rate (phi(2)) of women who, given that they reach first birth, do not survive to the end of the expected reproductive period, and the female infant plus juvenile mortality rate (phi(1)) have been assessed from a probabilistic standpoint provided that such a population were stationary. The hominid sample studied, the Sima de los Huesos (SH) cave site, Sierra de Atapuerca (Spain), is the most exhaustive human fossil sample currently available. Results suggest that the Atapuerca (SH) sample can derive from a stationary population. Further, in the case that the expected reproductive period ends between 37 and 40 yr of age, then 24 less, similarE(Y) less, similar27 yr, E(X)=3 yr, 0.224</=tau</=0.246,0.49<phi(2)</=0.754 and 0</=phi(1)<0.264. When, however, the end of the expected reproductive period occurs after 40 yr of age, it turns out that 24 less, similarE(Y) less, similar30 yr, E(X)=3 yr, 0.204</=tau</=0.246, 0.74<phi(2)</=0.754 and 0</=phi(1)<0.056.

Adult↗
PubMed2000

Reproductive performance of purebred landrace and Yorkshire sows in Thailand with special reference to seasonal influence and parity number.

The purpose of this study was to analyze reproductive performance in purebred Landrace and Yorkshire sows with special reference to seasonal influence and parity number, under tropical conditions where day length is almost constant throughout the year. Data from three purebred sow herds in Thailand during the period from 1993 to 1996 were analyzed. The two breeds were present in all three herds. The analysis comprised records of 3848 Landrace sow litters and 2033 Yorkshire sow litters. The statistical models included the fixed effects of month, year, parity, breed of the sow, herd, and two-way interactions of breed-parity, breed-herd, breed-month, breed-year, parity-month, month-herd, year-herd and month-year. The random effect of sow within breed was included in all models. Analysis of covariance was performed to analyze the effect of temperature, humidity and heat index on number of total born per litter (NTB), weaning to first service interval (WSI) and farrowing rate (FR). Landrace sows had significantly higher NTB (0.6 piglets), number of live born per litter (0.5 piglets), and average birth weight (0.13 kg) than Yorkshire sows (P<0.001). Farrowing rate was 3.9% higher in Landrace sows than in Yorkshire sows (P<0.01). However, Yorkshire sows had significantly shorter WSI (P<0.001) and significantly higher proportion of sows served within 7 days after weaning (P<0.01) than Landrace sows. No breed differences were found in number of stillborn per litter and weaning to conception interval. Parity had significant effect on all reproductive parameters analyzed. Number of total born and live born per litter was significantly lower for sows farrowing during the rainy season than in other seasons. Farrowing rate was low for sows mated during the hot and rainy season. Weaning to service interval and WSI7 were prolonged for sows weaned during the hot and rainy season. Reproductive performance was significantly unfavorably influenced by elevated temperature and heat index after mating (NTB and FR) or during lactation (WSI).

Animals↗
PubMed2002

Lifestyle and other risk factors for thyroid cancer in Los Angeles County females.

PURPOSE AND METHODS: We conducted a population-based case-control study of thyroid cancer. Cases were 292 women, aged 15-54 when diagnosed between the years 1980 and 1983 (145 diagnosed in 1980-81 and 147 diagnosed in 1982-83). Female neighborhood controls (n = 292) were matched to each case on birth-year and race. RESULTS: Among women < 35 years, thyroid disease in first-degree relatives increased thyroid cancer risk [odds ratio (OR) = 2.0, 95% confidence interval (CI) = 1.1-3.7]. Risk was not associated with fish consumption, although high childhood consumption of shellfish decreased thyroid cancer risk (OR = 0.2, 95% CI = 0.05-0.7 for consumption at least a few times weekly). Among papillary thyroid cancers (82% of cases), frequent adult consumption of saltwater fish decreased risk. Cancer risk was reduced with consumption of certain vegetables, wine, and tea. Other dietary variables, including milk, beer and hard liquor, and coffee were not related to thyroid cancer risk. Among the papillary sample, risk increased with longer use of multivitamins (OR = 2.9, 95% CI = 1.2-7.4 for > 10 years of use). Smoking and body mass were not associated with thyroid cancer risk. CONCLUSIONS: These results suggest a role of family history of thyroid disease and certain dietary variables in the etiology of thyroid cancer in adult females.

Adolescent↗
PubMed1999

Preterm delivery and risk of breast cancer.

To explore the risk of breast cancer in relation to the length of a pregnancy we tested whether a preterm delivery carries a higher risk of breast cancer than does a full-term delivery. Based on information from the Civil Registration System, and the National Birth Registry in Denmark, we established a population-based cohort of 474 156 women born since April 1935, with vital status and detailed parity information, including the gestational age of liveborn children and stillbirths. Information on spontaneous and induced abortions was obtained from the National Hospital Discharge Registry and the National Registry of Induced Abortions. Incident cases of breast cancer in the cohort (n = 1363) were identified through linkage with the Danish Cancer Registry. The period at risk started in 1978 and continued until a breast cancer diagnosis, death, emigration, or 31 December, 1992, whichever occurred first. After adjusting for attained age, parity, age at first birth and calendar period, we observed the following relative risks of breast cancer for different lengths of the pregnancy: < 29 gestational weeks = 2.11 (95% confidence interval 1.00-4.45); 29-31 weeks = 2.08 (1.20-3.60); 32-33 weeks = 1.12 (0.62-2.04); 34-35 weeks = 1.08 (0.71-1.66); 36-37 weeks = 1.04 (0.83-1.32); 38-39 weeks = 1.02 (0.89-1.17); 40 weeks = 1 (reference). Parous women who had a preterm delivery below 32 weeks gestation had a 1.72-fold (1.14-2.59) increased risk of breast cancer compared with other parous women. In conclusion, a preterm delivery of 32+ weeks gestation did not significantly increase a woman's risk of contracting breast cancer. Only for the very small group of women with preterm deliveries of less than 32 weeks gestation did we observe an increased risk.

Adult↗
PubMed1998

Characterisation of the coding sequence and fine mapping of the human DFFRY gene and comparative expression analysis and mapping to the Sxrb interval of the mouse Y chromosome of the Dffry gene.

DFFRY (the Y-linked homologue of the DFFRX Drosophila fat-facets related X gene) maps to proximal Yq11.2 within the interval defining the AZFa spermatogenic phenotype. The complete coding region of DFFRY has been sequenced and shows 89% identity to the X-linked gene at the nucleotide level. In common with DFFRX , the potential amino acid sequence contains the conserved Cys and His domains characteristic of ubiquitin C-terminal hydrolases. The human DFFRY mRNA is expressed in a wide range of adult and embryonic tissues, including testis, whereas the homologous mouse Dffry gene is expressed specifically in the testis. Analysis of three azoospermic male patients has shown that DFFRY is deleted from the Y chromosome in these individuals. Two patients have a testicular phenotype which resembles Sertoli cell-only syndrome, and the third diminished spermatogenesis. In all three patients, the deletions extend from close to the 3' end into the gene, removing the entire coding sequence of DFFRY. The mouse Dffry gene maps to the Sxrb deletion interval on the short arm of the mouse Y chromosome and its expression in mouse testis can first be detected between 7.5 and 10.5 days after birth when type A and B spermatogonia and pre-leptotene and leptotene spermatocytes are present.

Adult↗
PubMed1995

Agricultural work during pregnancy and selected structural malformations in Finland.

We studied the relation between birth defects and maternal agricultural work in a nationwide time- and area-matched case-referent series of 1,306 pairs of infants (581 orofacial clefts, 365 central nervous system defects, 360 skeletal defects) obtained through the Finnish Register of Congenital Malformations. We supplemented the Register data, including the mothers' latest and previous pregnancies, diseases, consumption of drugs and alcohol, smoking habits, and the like, with detailed interviews on the mothers' work conditions. When all of the birth defects were pooled and agricultural work was compared with nonagricultural work in the first trimester of pregnancy, the adjusted odds ratio was 1.4 [95% confidence interval (CI) = 0.9-2.0]. For orofacial clefts, the corresponding odds ratio was 1.9 (95% CI = 1.1-3.5). An industrial hygienist's blinded assessment indicated that seven mothers of infants with orofacial clefts and three reference mothers had been exposed to pesticides in agricultural work; the adjusted odds ratio for work with pesticide exposure, when compared with unexposed agricultural work, was 1.9 (95% CI = 0.4-8.3). Exposure to solvents did not explain the observed association.

Abnormalities, Drug-Induced↗
PubMed2004

Second-trimester asynchronous multifetal delivery results in poor perinatal outcome.

OBJECTIVE: The purpose of this study is to estimate the maternal and fetal morbidities associated with asynchronous delivery. METHODS: A review of maternal and fetal medical records was performed at 2 tertiary care centers over 12 years. Charts were identified by the International Classification of Diseases, 9th Revision, Clinical Modification codes for twin and triplet gestations. Asynchronous delivery was defined as an active attempt (tocolysis and/or emergent cerclage placement) to increase latency between delivery of the first fetus and subsequent fetuses. RESULTS: Fourteen cases of asynchronous delivery were identified out of 96922 deliveries including 1352 pregnancies complicated by multifetal gestation. The occurrence rate of asynchronous delivery was 0.14 per 1000 births. The etiology of preterm birth of the first fetus in 12 (86%) of 14 cases was second-trimester rupture of membranes. The mean gestational age for delivery of the first fetus was 21.+/- 2.0 weeks. All women received tocolysis and intravenous antibiotics. Two of 3 attempts at cerclage placement were successful. Median latency obtained was 2 days (range less than 1-70 days). There was 1 survival of a first born. There were 19 retained fetuses, 2 died in utero, 10 died between birth and day 57 of life, and 7 survived (37%; 95% confidence interval 16%, 62%) until hospital discharge. Six of 7 survivors had major sequelae from prematurity. One of 19 fetuses was discharged without major sequelae (5%; 95% confidence interval 0%, 25%). Maternal morbidity included 2 placental abruptions and 8 cases of infectious morbidity including 1 case of septic shock. CONCLUSION: Attempts at asynchronous deliveries are uncommon and are associated with a high rate of perinatal death. Most fetal survivors have significant damage from preterm birth.

Adult↗
PubMed2007

Chlamydia trachomatis infections increase the risk for ectopic pregnancy: a population-based, nested case-control study.

BACKGROUND: Chlamydia trachomatis (CT) as a risk factor for ectopic pregnancy (EP) has mainly been established through seroepidemiologic cross-sectional studies. GOAL: The goal of this study was to obtain EP risk estimates for women diagnosed with CT using women with negative tests as the reference group. METHODS: We linked prospectively collected CT laboratory data (1990-2003) to EP hospital data (discharge and outpatient registries) in a nested case-control study. Six hundred sixteen women with CT test(s) before first EP were eligible as cases. Three controls were matched to each case for year of birth, age at first test, and number of prior tests. RESULTS: Previous CT infection was associated with elevated EP risk (odds ratio [OR], 1.4; 95% confidence interval [CI], 1.0-2.0). In stratified analysis, the association was only significant for the youngest women (born 1970-1984) who had a nearly complete CT testing history (OR, 2.1; 95% CI, 1.3-3.2). CONCLUSION: A history of diagnosed CT infection is associated with a 2-fold increased EP risk.

Adult↗