Consanguineous marriage, prepregnancy maternal characteristics and stillbirth risk: A population-based case-control study

Introduction. Consanguineous marriage is associated with increased risks for congenital anomalies, low birthweight, and other adverse perinatal outcomes. In this population-based, case-control study we investigated the association between consanguineous marriage (first-cousin marriage) and stillbirth risk, using prospectively collected information from prepregnancy visits. Material and methods. From 2007 to 2009, we identified 283 stillbirths (cases) and 2088 randomly selected live control births through prepregnancy visits in rural Golestan, Iran. The associations between consanguinity and prepregnancy maternal characteristics and stillbirth risk were examined using multivariate logistic regression. Results. The rate of consanguineous marriage was 19.4% among cases and 13.6% among controls. Consanguinity was associated with increased stillbirth risk [odds ratio (OR) 1.53; 95% CI 1.10-2.14]. The association was significantly increased for preterm stillbirth (< 37 gestational weeks) (OR 2.43; 95% CI 1.46-4.04) but not for term stillbirth (≥ 37 weeks) (OR 1.14; 95% CI 0.75-1.74). Low and high maternal age, underweight, obesity, nulliparity, a history of infertility or miscarriage, previous obstetric complications (preeclampsia, preterm delivery, and stillbirth in previous pregnancies) were also associated with increased stillbirth risks. Conclusions. Consanguineous marriage is associated with increased risk of stillbirth, particularly preterm stillbirth. Findings for other maternal risk factors for stillbirth in rural Iran are consistent with previously reported findings from high-income countries. © 2015 Nordic Federation of Societies of Obstetrics and Gynecology

Neisseria gonorrhoeae challenge increases matrix metalloproteinase-8 expression in fallopian tube explants

Indexación: Scopus.Background: Neisseria gonorrhoeae (Ngo) is the etiological agent of gonorrhea, a sexually transmitted infection that initially infects the female lower genital tract. In untreated women, the bacteria can ascend to the upper genital reproductive tract and infect the fallopian tube (FTs), which is associated with salpingitis and can lead to impaired FT function and infertility. The extracellular matrix (ECM) plays an important role in cell migration and differentiation in the female genital tract, and some pathogens modify the ECM to establish successful infections. The ECM is regulated by matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs), their endogenous inhibitors; MMP deregulation causes pathological conditions in a variety of tissues. Results: The aim of this work was to analyze the expression and localization of MMP-3, MMP-8, MMP-9, and TIMP-1 in FT explants during Ngo infection using real-time PCR, immunohistochemistry, zymography and ELISA. No significant variations in MMP-3, MMP-9, and TIMP-1 transcript levels were observed. In contrast, a significant increase (p < 0.05) was observed for MMP-8 expression and was accompanied by stromal immunoreactivity in infected explants. ELISA results supported these findings and showed that MMP-8 release increased upon gonococcal infection. Conclusions: Our results indicate that gonococcal infection induces increased MMP-8 expression, which might contribute to FT damage during infection. © 2017 Juica, Rodas, Solar, Borda, Vargas, Muñoz, Paredes, Christodoulides and Velasquez.https://www.frontiersin.org/articles/10.3389/fcimb.2017.00399/ful

Time-to-birth prediction models and the influence of expert opinions

Preterm birth is the leading cause of death among children under five years old. The pathophysiology and etiology of preterm labor are not yet fully understood. This causes a large number of unnecessary hospitalizations due to high--sensitivity clinical policies, which has a significant psychological and economic impact. In this study, we present a predictive model, based on a new dataset containing information of 1,243 admissions, that predicts whether a patient will give birth within a given time after admission. Such a model could provide support in the clinical decision-making process. Predictions for birth within 48 h or 7 days after admission yield an Area Under the Curve of the Receiver Operating Characteristic (AUC) of 0.72 for both tasks. Furthermore, we show that by incorporating predictions made by experts at admission, which introduces a potential bias, the prediction effectiveness increases to an AUC score of 0.83 and 0.81 for these respective tasks

Body mass index and sperm quality: effects of overweight and underweight

2 p.We previously reported a negative association between body mass index (BMI) and sperm motility and seminal alpha-glucosidase concentrations (NAG), suggesting that epididymis may be a target organ for weight-linked alterations. In this study, we analyzed a possible association between BMI and semen quality in 4876 patients with no genitourinary diseases or toxin exposure, including morbidly-obese and underweight patients. We performed multivariate regression analysis using BMI,, age and abstinence as independent variables and demonstrated that BMI was inversely and significantly associated with semen volume, total sperm count, motility and NAG (slopes: -0.01, -1.33, -0.18, -0.75; p<0.05); in addition, we found a significant negative associations between BMI and viability, morphology and HOST.Fil: Martini, Ana. Universidad Nacional de Córdoba. Facultad de Ciencias Médicas. Cátedra de Fisiología Humana; ArgentinaFil: Martini, Ana. Centro Integral de Ginecología, Obstetricia y Reproducción (CIGOR); ArgentinaFil: Martini, Ana. Laboratorio de Andrología y Reproducción (LAR); ArgentinaFil: Tissera, Andrea. Laboratorio de Andrología y Reproducción (LAR)Fil: Tissera, Andrea. Centro Integral de Ginecología, Obstetricia y Reproducción (CIGOR); ArgentinaFil: Tissera, Andrea. Universidad Nacional de Córdoba. Facultad de Ciencias Médicas. Cátedra de Fisiología Humana. ArgentinaFil; Vincenti, Laura. Universidad Nacional de Córdoba. Facultad de Ciencias Médicas. Cátedra de Fisología Humana; ArgentinaFil: Vincenti, Laura. Laboratorio de Andrología y Reproducción (LAR); ArgeninaFil: Vincenti, Laura. Centro Integral de Ginecología, Obstetricia y Reproducción (CIGOR); ArgentinaFil: Beltramone, Fernando. Universidad Nacional de Córdoba. Facultad de Ciencias Médicas. Cátedra de Fisiología Humana; ArgentinaFil: Beltramone, Fernando. Centro Integral de Ginecología, Obstetricia y Reproducción (CIGOR); ArgentinaFil: Beltramone, Fernando. Laboratorio de Andrología y Reproducción (LAR); ArgentinaFil: Sad, José. Universidad Nacional de Córdoba. Facultad de Ciencias Médicas. Cátedra de Fisiología Humana; ArgentinaFil: Sad, José. Laboratorio de Andrología y Reproducción (LAR); ArgentinaFil: Sad, José. Centro Integral de Ginecología, Obstetricia y Reproducción (CIGOR); ArgentinaFil: Ruíz, Rubén. Universidad Nacional de Córdoba. Facultad de Ciencias Médicas. Cátedra de Fisiología Humana; ArgentinaFil: Ruíz, Rubén. Centro Integral de Ginecología, Obstetricia y Reproducción (CIGOR); ArgentinaFil: Ruíz, Rubén. Laboratorio de Andrología y Reproducción (LAR); ArgentinaFil: Fiol de Cuneo, Marta. Universidad Nacional de Córdoba. Facultad de Ciencias Médicas. Cátedra de Fisiología Humana; ArgentinaFil: Fiol de Cuneo. Laboratorio de Andrología y Reproducción (LAR); ArgentinaFil: Fiol de Cúneo. Centro Integral de Ginecología, Obstetricia y Reproducción (CIGOR); ArgentinaOtras Ciencias de la Salu

Influence of Contraception Use on the Reproductive Health of Adolescents and Young Adults

Oral contraceptives (OCs) are often prescribed to adolescents and young adults for the treatment of health problems and to avoid unwanted pregnancies. We hypothesized that the use of OCs, among adolescents and young adults, is associated with a greater likelihood of pregnancy, abortion, sexually transmitted diseases (STDs), pelvic inflammatory disease (PID), and sexual behaviors that will enhance those problems (i.e., earlier sexual debut and more sexual partners) than adolescents and young adults not using OCs. To test this hypothesis, data from 1,365 adolescents and young adults in the 2011–2013 National Survey of Family Growth (NSFG) were used to describe the influence of ever use of OCs on ever having sex, sexual debut, multiple sexual partners, STDs, PID, pregnancy, and abortion. A secondary purpose was to evaluate protective factors from unhealthy sexual practices like religiosity, church attendance, and intact families. We found that the “ever use” of OCs by US adolescents and young adults results in a greater likelihood of ever having sex, STDs, PID, pregnancy, and abortion compared with those adolescents and young adults who never used OCs. Furthermore, those adolescents who ever used OCs had significantly more male sexual partners than those who never used OCs, and they also had an earlier sexual debut by almost two years. Conversely, we found that frequent church attendance, identification of the importance of religion, and having an intact family among adolescents were associated with less likelihood of unsafe sexual practices. We concluded that the use of OCs by adolescents and young adults might be considered a health risk. Further research is recommended to confirm these associations. Summary: The purpose of this article was to show the correlation between contraceptive use in adolescents and negative sexual outcomes. We used data from the 2011–2013 NSFG and demonstrated that never married adolescents who used oral hormonal contraception were three times more likely to have an STD, have PID, and to become pregnant, and, surprisingly, ten times more likely of having an abortion compared to noncontracepting adolescents. These are outcomes that contraception is intended to prevent. These data also showed that the contraceptors had significantly more male partners than their contraceptive counterparts. Protective factors such as church attendance and family cohesiveness were associated with a decreased likelihood of sexual activity

The use of salutogenesis theory in empirical studies of maternity care for healthy mothers and babies

Background: Health care outcomes used in service evaluation and research tend to measure morbidity and mortality. This is the case even in maternity care, where most women and babies are healthy. Salutogenesis theory recognises that health is a continuum, with explicit inclusion of well-being as well as illness and pathology. This offers the potential to reframe the outcomes and therefore, the focus of, maternity care research and provision. Aim: The aim of this study was to identify how salutogenesis has been defined and used in maternity care research undertaken with healthy women. Method: A scoping review was undertaken, using a formal pre-defined search strategy. Inclusion criteria encompassed research papers relating to the maternity episode up to 1 year after birth, using salutogenesis or any of its associated concepts, focused on healthy women, and written in a language which any of the members of the group could understand. The search was undertaken in two phases (database inception - April 2011 and May 2011-February 2013). Included studies were subject to narrative analysis. Findings: Eight papers met the inclusion criteria. They covered seven topics, spanning the antenatal, intrapartum and postnatal periods. Only two papers employed both positive health orientation and explicit use of Antonovsky's theory. The remaining studies used discrete aspects of the theory. Conclusion: Salutogenic framing is rarely used in maternity care research with healthy participants. An increase in research that measures salutogenically orientated outcomes could, eventually, provide a balance to the current over-emphasis on pathology in maternity care design and provision worldwide

Manejo del bajo gasto cardíaco en el posoperatorio cardiovascular pediátrico

Fil: Grzona, María Estela. Universidad Nacional de Cuyo. Facultad de Ciencias Médicas. Departamento de Pediatría, Gineco-Obstetricia y Salud Públic

When intra-partum electronic fetal monitoring becomes court business

Sadly but inevitably, the clinical fruit of all scientific research, like the profile of the Roman god Janus, presents us with two faces - one is patient benefit while the other is medico-legal vulnerability. As part of defensive medicine, there are situations where malpractice risk is minimised by actual elimination of certain high-risk procedures e.g. in the case of some neurosurgical operations. Intra-partum electronic fetal monitoring (IPEFM) is the commonest obstetric procedure in the developed world, producing valuable information of fetal well being as co-related to maternal uterine activity with a scope of guarding fetal well-being in labour. It is a prime example of the therapeutic/ legal liability duality which haunts modern Medicine.peer-reviewe