bluuebunny/crossref_metadata_2025_split huggingface dataset:
Increase of acetone emitted by urine in relation to ovulation
Authors: Smith David , Ismail Khaled M. K. , Diskin Ann M. , Chapman Gail , Magnay Julia L. , Španěl Patrik , O'Brien Shaughn 
Published: December 2009

AbstractBackground. Selected ion flow tube mass spectrometry allows trace gas quantification in exhaled breath and in the air/vapor above liquids (headspace) down to the 10 parts‐per‐billion level. During selected ion flow tube mass spectrometry investigation of the volatile compounds emitted by urine, high acetone levels were incidentally identified in the headspace of urine from healthy female volunteers around their mid‐cycle. Hence, this study was designed to measure urine headspace acetone levels throughout the menstrual cycle. Methods. Using selected ion flow tube mass spectrometry we measured daily urine headspace acetone concentrations of seven ovulating (group 1) and three postmenopausal volunteers (group 2). Results. A several‐fold increase in urine headspace acetone level was detected 2–3 days after the predicted day of ovulation in 5 of the 7 volunteers in group 1. No such rise was detected in group 2. Conclusion. This study provides the basis for future research to understand the reason for and the potential utility of this phenomenon.
Eclampsia in Dar es Salaam, Tanzania — incidence, outcome, and the role of antenatal care
Authors: Urassa David P. , Carlstedt Anders , Nyström Lennarth , Massawe Siriel N. , Lindmark Gunilla 
Published: December 2009

AbstractBackground In order to assess the effectiveness of antenatal care for prevention of eclampsia, a retrospective case‐control study was performed at the Muhimbili National Hospital (MNH), Dar es Salaam, Tanzania. All women with eclampsia seen at MNH during 1999–2000 and controls without eclampsia were included.Methods. The study used a labor ward database and antenatal cards of eclamptic women and non‐eclamptic controls. For each of the 741 eclamptic women who delivered at MNH, two non‐eclamptic controls were chosen from the database. For 399 of the eclampsia cases and 420 non‐eclamptic controls, the antenatal records could be traced and compared.Main outcome measures. Maternal and perinatal mortality, detection of antenatal risk factors, appropriate referrals, and incidence of eclampsia.Results. Hospital and population‐based incidences of eclampsia were 200/10 000 and 67/10 000, respectively. The case‐fatality rate for eclampsia was 5.0% for women who delivered at MNH and 16% for those referred to MNH after being delivered elsewhere. The risk of low birth weight and perinatal death was significantly increased in eclamptic women (odds ratio = 6 and 10, respectively). The screening coverage for signs of pre‐eclampsia was >85%, except for proteinuria (33%). Fewer than 50% of the women who developed eclampsia had been referred from the ANC clinic and <10% were admitted to the antenatal ward at MNH before onset of eclamptic fits.Conclusions. The current practice of antenatal care is insufficient as a prevention strategy for eclampsia in a low‐resource setting with high incidence of eclampsia.
Long‐term results of the tension‐free vaginal tape operation in an unselected group of 129 stress incontinent women
Authors: KUUVA NINA , NILSSON CARL GUSTAF 
Published: December 2009

AbstractBackground. This study was undertaken to examine the long‐term effects and effectiveness of the tension‐free vaginal tape (TVT) procedure in an unselected group of women. Method. One hundred and twenty‐nine stress urinary incontinent women (including primary, recurrent, mixed, and low pressure urethra cases) were studied prospectively and examined according to a strict protocol at a mean time of 6 years after their TVT operation. Cough and pad tests were used for objective evaluation, whereas visual analog scale and patients' verbal estimation were applied for subjective evaluation. Results. As assessed by the cough stress test and the pad test, 74 and 81% of the women were totally cured, respectively. Symptoms possibly indicating reduced urine flow were reported from 17% of the women and recurrent urinary tract infections from 9.3% of the women. The de novo urge rate was 4.7%. The tape was visualized in 3.1% of the women and necessitated resection in 1.6% of the cases due to subjective discomfort. No serious or unexpected adverse events were revealed. Conclusion. The TVT operation appears to be a safe and effective anti‐incontinence procedure in all female stress incontinence subgroups.
Childhood sexual abuse (CSA) experiences: an underestimated factor in perinatal care
Authors: Leeners B. , Neumaier‐Wagner P. , Quarg A.F. , Rath W. 
Published: December 2009

AbstractBackground. Childhood sexual abuse can have several negative consequences on pregnancy, birth, and the early neonatal period. However, most obstetricians are not aware if their patients have a history of childhood sexual abuse. We therefore investigated childhood sexual abuse experiences in 226 women three to eight months after delivery of a healthy child. Methods. 415 women were approached to answer a self‐administered questionnaire including obstetrical questions and questions focusing on abuse experiences. 320 women agreed to participate, 226 (69.1% of the women fulfilling inclusion criteria) of which returned a completed questionnaire. Sexual abuse was explored using a modified version of a questionnaire developed by Wyatt. The complete questionnaire was designed in cooperation with the German “Frauennotruf”, a society providing care for victims of sexual abuse. Results. The prevalence of childhood sexual abuse was a minimum of 11.5% and a maximum of 14.6% if women who were not sure about such experiences during their childhood were included. Another 1.3% of the women had experienced sexual abuse as an adult. Lifetime sexual abuse prevalence was 12.8% and 15.9%, respectively. Of the women with an experience of childhood sexual abuse, 42.3% mentioned an ongoing abuse situation for at least six months. Conclusions. As approximately every 9th woman presenting for obstetrical care has experienced childhood sexual abuse, and as those experiences may have a negative impact on fetal and maternal well‐being, adequate counseling models should be offered to victims of sexual abuse.
Increased sexual risk taking behavior among Swedish female university students: repeated cross‐sectional surveys
Authors: Larsson Margareta , Tydén Tanja 
Published: December 2009

AbstractBackground. The aim of this study was to perform a repeated cross‐sectional study of female university students’ sexual and contraceptive behavior, as well as experiences of pornography and sexual harassment and compare the findings with those from earlier studies. Methods. Waiting‐room questionnaires to female university students (n=315) visiting a Student Health Centre in Sweden. Similar investigations had been performed earlier, which enabled comparisons. Results. Almost all women (98%) had experienced intercourse and giving oral sex (94%). Condoms were most often used at first intercourse (72%) and combined oral contraceptives at latest intercourse (67%). The ever use of emergency contraceptive pills had increased from 22% to 52% over five years and there was a tendency towards more risk‐taking behavior with more sexual partners (mean 5.4 in 1999 and mean 7.4 in 2004), more experience of first‐date intercourse without a condom (37–45%), and more self‐reported sexually transmitted infections (14–21%). The proportion of women who had undergone an abortion remained stable (6%) and fewer women reported ever being sexually harassed in 2004 compared to 1999. Conclusions. In conclusion, contraceptive use remained stable over time, but there was a trend towards more risky sexual behavior with more sexual partners, more unprotected first‐date intercourse, and more self‐reported sexually transmitted infections. Induced abortions, however, had not increased, but the use of emergency contraceptive pills had more than doubled in the five years between 1999 and 2004.
Prognosis of women with pelvic pain during pregnancy: a long‐term follow‐up study
Authors: Röst Cecile C.M. , Jacqueline J. , Kaiser A. , Verhagen Arianne P. , Koes Bart W. 
Published: December 2009

AbstractStudy design. A follow‐up study of women with pelvic pain during pregnancy. Objectives. To evaluate prognostic factors for pelvic pain. Methods. Out of a cohort of 870 pelvic pain patients, 598 women, who delivered less than 42 months prior to the follow‐up measurement, were selected for follow‐up. Results. Data of 430 women were available for analysis with a mean follow‐up duration of 18 months postpartum. Forty‐three women still experienced moderate or severe pain and were seriously hindered in more than one activity. At intake symptomatic women experienced a higher overall severity of complaints, more walking deficiencies, and mentioned prepregnancy back pain more often and reported labor lasting longer than 18 h 2.5 times more often than asymptomatic women. Explained variance of these factors is small. Conclusions. Mean 18 months postpartum a small group had moderate or severe pain. Prepregnancy back pain, severity of complaints, and number of walking deficiencies at primary referral as well as duration of labor showed a significant relation with symptoms.
Optimal treatment of premature ovarian failure after treatment for Hodgkin's lymphoma is often withheld
Authors: Verschuuren Sylvia I. , Schaap Jiska J. , van't Veer Mars B. , Stijnen Theo , Burger Curt W. , Ansink Anca C. 
Published: December 2009

AbstractBackground. The purpose of this study is to determine: 1. the effect of treatment for Hodgkin's lymphoma on ovarian function, and 2. the interventions to relieve postmenopausal symptoms. Methods. Seventy‐seven consecutive patients treated between 1989 and 2003 in the Rotterdam region for Hodgkin's lymphoma stages I and II were approached for this study. A questionnaire consisting of 45 questions was carried out to evaluate premature menopausal symptoms, hormonal replacement therapy and use of contraception, menstrual cycle, and subsequent pregnancies. Results. After informed consent 67 patients were willing to participate in the study and 66 patients filled in a questionnaire. After antitumor treatment 13 patients developed treatment‐related premature ovarian failure, 35 patients had a spontaneous cycle, and 18 patients could not be classified as they used hormonal contraception. Women who developed treatment‐related premature ovarian failure had a significantly higher mean age at the start of treatment for Hodgkin's lymphoma than women who remained premenopausal (p<0.002). Only 6 of these 13 women (46%) received hormonal substitution. In all, 21 women conceived after antitumor treatment, and 28 children were born. All pregnancies were the result of spontaneous conception. Conclusions. The effect of antitumor treatment for Hodgkin's lymphoma on ovarian function is age dependent (odds ratio of 1.18 per year). There is a striking inconsistency regarding the management of ovarian protection before and during antitumor treatment. Premenopausal women who undergo therapy for Hodgkin's lymphoma should be offered hormonal substitution therapy after loss of ovarian function.
Newborns of pre‐eclamptic women: a biochemical difference present in utero
Authors: OPHIR ELLA , DOURLESHTER GREGORY , HIRSH YAEL , FAIT VLADIMIR , GERMAN LEONID , BORNSTEIN JACOB 
Published: December 2009

AbstractBackground. Offspring exposed to pre‐eclampsia in utero had higher systolic blood pressure, and were more obese during adolescence. We hypothesized that metabolic changes, a marker of cardiovascular disease, may be affected by intrauterine exposure to pre‐eclampsia. Methods. Blood samples were collected from cord blood of 36 newborns who were exposed to pre‐eclampsia in utero and their mothers, and of 35 newborns and their mothers with noncomplicated pregnancies. Serum levels of lipids, homocysteine, and fibrinogen were determined in all samples. Results. Fetuses exposed to pre‐eclampsia in utero had lower birth weight, smaller abdominal circumference (p<0.002; p<0.03 respectively) and higher levels of low‐density lipoprotein, homocysteine, and fibrinogen (p<0.01; p<0.001; p<0.001, respectively), compared with fetuses of normotensive, pregnancies. A significant correlation existed between maternal homocysteine concentration and that of newborn infants (r = 0.539; p<0.001) and between maternal low‐density lipoprotein and newborn homocysteine (r = 0.36; p<0.03). Significant negative correlations were found between abdominal circumference of newborns and cord blood concentration of fibrinogen (r = − 0.52; p<0.001) and low‐density lipoprotein (r = − 0.42; p<0.001). Maternal plasma homocysteine, low‐density lipoprotein, and triglyceride were significantly higher, while high‐density lipoprotein was significantly lower in pregnancies with pre‐eclampsia as compared with the uncomplicated pregnancy group (p<0.001 for all). Cord blood level of low‐density lipoprotein and fibrinogen were best predicted by abdominal circumference of newborn, though maternal level of homocysteine was the most powerful independent predictor of cord homocysteine. Conclusion. Intrauterine exposure to pre‐eclampsia was associated with untoward effects on biochemical risk factor markers for cardiovascular disease. Our findings suggest that the cardiovascular risk of newborns of pre‐eclamptic mothers may begin in utero.
Geographical variation in neonatal phenotype
Authors: Leary Sam , Fall Caroline , Osmond Clive , Lovel Hermione , Campbell Doris , Eriksson Johan , Forrester Terrence , Godfrey Keith , Hill Jacqui , Jie Mi , Law Catherine , Newby Rachel , Robinson Sian , Yajnik Chittaranjan 
Published: December 2009

AbstractBackground. Recent studies have shown associations between size and body proportions at birth and health outcomes throughout the life cycle, but there are few data on how neonatal phenotype varies in different populations around the world. Methods. Data from the UK, Finland, India, Sri Lanka, China, DR Congo, Nigeria, and Jamaica (n=22,067) were used to characterize geographical differences in phenotype in singleton, live‐born newborns. Measurements included birth weight, placental weight, length, head, chest, abdominal and arm circumferences, and skinfolds. Results. Neonates in Europe were the largest, followed by Jamaica, East Asia (China), then Africa and South Asia. Birth weight varied widely (mean values 2,730–3,570 g), but in contrast, head circumference was similar in all except China (markedly smaller). The main difference in body proportions between populations was the head to length ratio, with small heads relative to length in China and large heads relative to length in South Asia and Africa. Conclusions. These marked geographical differences in neonatal phenotype need to be considered when investigating determinants of fetal growth, and optimal phenotype for short‐term and long‐term outcomes.
The prevalence of depressive symptoms in the postnatal period in Lalitpur district, Nepal
Authors: DØRHEIM HO‐YEN SIGNE , TSCHUDI BONDEVIK GUNNAR , EBERHARD‐GRAN MALIN , BJORVATN BJØRN 
Published: December 2009

AbstractBackground. Mental disorders are highly prevalent across different cultures and are often associated with serious role impairment. In developing countries, more than three‐quarters of people with serious mental disease do not receive any treatment. Identifying and treating maternal depression is important also in Nepal, where suicide is the second largest cause of deaths among women of reproductive age. The emotional, cognitive, and physical development of the infant is also negatively influenced by maternal depression.Objectives. The aim of this study was to estimate the prevalence of depressive symptoms among mothers 5–10 weeks after delivery in a clinical, a rural, and an urban population in Lalitpur district, Nepal.Methods. A total of 426 postnatal women were included in a cross‐sectional structured interview study of mental health. Depressive symptoms were measured by the Edinburgh Postnatal Depression Scale (EPDS), and mental distress by the Self Report Questionnaire‐20 (SRQ‐20).Results. The overall prevalence of depressive symptoms in the postnatal period (defined as EPDS > 12) was 4.9% (95% CI 2.9–7.0). The prevalence of mental distress (defined as SRQ‐20 > 10) was 3.1% (95% CI 1.4–4.7). There were no significant differences in prevalences among the three populations studied.Conclusions. The prevalence of depressive symptoms in the postnatal period was lower than previously reported from Nepal. The value of possible protective and precipitating factors needs to be explored.
Differences within couples’ experience of their hospital care and well‐being three months after experiencing a stillbirth
Authors: SÄFLUND KARIN , WREDLING REGINA 
Published: December 2009

AbstractBackground. The present study aimed to investigate possible differences, within the couple, in their encounter with their stillborn child and the assistance of caregivers during the event and to evaluate the parents’ psychological well‐being three months after the stillbirth.Methods. Twenty‐two couples, who experienced a stillbirth, participated in the study. A study‐specific questionnaire and a previously evaluated well‐being questionnaire were used to assess the parents’ psychological condition. Chi‐square analysis, Wilcoxon's signed rank test, Student's paired t‐test, and Spearman's rank correlation coefficient were used to detect differences within the couples.Results. The parents had feelings of fear when they conceptualized the stillborn child, but with support from staff all but one couple held their child. The fathers had the same strong feelings of warmth, pride, tenderness, and grief as the mothers when they held the child. Most parents reported that the staff had treated them with understanding during the delivery. Three months after the event the mothers scored significantly higher on Negative Well‐being, lower on Positive Well‐being, and lower on General Well‐being than the fathers. A majority of the mothers, but no fathers, were on sick leave three months after the event.Conclusions. Our study suggests that mothers and fathers need to be emotionally supported in the encounter with their stillborn child. The mothers’ scoring of lower well‐being may be due to a stronger antenatal attachment to the child. This should, however, be a subject of further studies.
Urine albumin/creatinine ratio for the assessment of albuminuria in pregnancy hypertension
Authors: NISELL HENRY , TRYGG MARIA , BÄCK RUNE 
Published: December 2009

AbstractBackground. An accurate method to assess albuminuria in pregnancy is mandatory to diagnose pre‐eclampsia. Twenty‐four‐hour urine collection is still the only universally accepted method. This is, however, a cumbersome and inconvenient method. Therefore, the present study aimed at assessing the accuracy of a spot urine albumin/creatinine ratio in pregnant women with hypertension. Material and methods. In 54 pregnant women with blood pressure ≥140/90 mmHg, 24‐h albumin excretion and subsequent albumin/creatinine ratio on morning spot urine were analyzed in the individual patients. Altogether 75 paired samples were included. Receiver operating characteristic curves, relating different albumin/creatinine ratio cut‐off values to 24‐h albumin excretion >300 mg were constructed. Correlations were assessed by Spearman rank correlation tests. Results. The area under the receiver operating characteristic curve was 0.985. At the optimal cut‐off albumin/creatinine ratio value of 27 mg/mmol the sensitivity, specificity, positive and negative predictive value for detecting albuminuria >300 mg/24 h were: 95, 100, 100 and 86% respectively. There was a close correlation between albumin/creatinine ratio and 24‐h albumin excretion values (r = 0.95; p<0.001). Conclusions. It is suggested that in most cases the more cumbersome 24‐h urine collection can be replaced by the more convenient albumin/creatinine ratio on spot urine.
Emotional well‐being and predictors of birth‐anxiety, self‐efficacy, and psychosocial adaptation in healthy pregnant women
Authors: SIEBER SANDRA , GERMANN NICOLE , BARBIR ALINE , EHLERT ULRIKE 
Published: December 2009

AbstractBackground. A broad body of studies have shown that emotional well‐being during pregnancy influences birth outcome and postpartum mood state, but few longitudinal studies have examined the extent of changes of emotional well‐being during late pregnancy. Furthermore, up to now it has remained unclear which factors are predictive for emotional well‐being during pregnancy. This prospective longitudinal study has two main aims. First of all, possibly occurring changes of birth anxiety, self‐efficacy for labor and delivery, and psychosocial adaptation to pregnancy in primiparous healthy women during the final trimenon will be described. Second, predictors of these assessed constructs during the final trimenon as well as the extent of these constructs as predictors for the psychological status postpartum will be shown. Methods. A prospective longitudinal study was conducted with 61 pregnant women recruited from childbirth classes. Results. The results showed significant changes in emotional well‐being – measured by birth anxiety, self‐efficacy for labor and delivery, and psychosocial adaptation to pregnancy – during the final trimenon: the women were more confident in their ability to cope with labor and delivery. Birth anxiety did not change significantly during the final trimenon. Regression analyses revealed different psychosocial predictor variables for emotional well‐being during late pregnancy. The predictive factor for an unfavorable psychological status postpartum was birth anxiety. Conclusions. The results of this study suggest that the importance of discovering psychosocial problems of pregnant woman early in pregnancy could be imperative in preventing psychosocial problems later in pregnancy as well as postpartum.
Obstetric anal sphincter rupture in older primiparous women: a case–control study
Authors: DAHL CHRISTIAN , KJØLHEDE PREBEN 
Published: December 2009

AbstractObjective. To determine if maternal age (35 years of age or older) in primiparous women is a risk factor for the development of obstetric anal sphincter rupture (OASR) and to identify obstetric factors associated with it. Material and methods. This is a retrospective case–control study. The study population was made up of the 5,345 primiparous women aged 24–45 years who delivered vaginally with singleton live‐born neonates during 1990–99 at the Department of Obstetrics and Gynecology, Linköping University Hospital, Sweden. As cases the 327 primiparous women aged 35–45 years at delivery were selected. For each case two primiparous controls ten years younger were selected, matched for gestational age and year of delivery, in all 654 controls. Maternal, obstetrical, and neonatal data were obtained from the delivery records. Obstetric factors for the development of OASR were assessed with multivariate logistic regression analysis. Results. No significant association was found between the primiparous age category and OASR. Vacuum extraction, forceps delivery, and the head circumference of the neonate were found to be independent risk factors for OASR, while the use of mediolateral episiotomy or epidural analgesia were independent protective factors for developing OASR. Conclusions. Primiparous women, 35 years of age or older, do not seem to have a greater risk of OASR than younger primiparous women. Risk factors for OASR are instrumental vaginal delivery and the size of the neonate. Mediolateral episiotomy and epidural analgesia seem to reduce the risk for OASR.