bluuebunny/crossref_metadata_2025_split huggingface dataset:
Microbial invasion and cytokine response in amniotic fluid in a Swedish population of women in preterm labor
Authors: Jacobsson Bo , Mattsby‐Baltzer Inger , Andersch Björn , Bokström Hans , Holst Rose‐Marie , Wennerholm Ulla‐Britt , Hagberg Henrik 
Published: December 2004

Background. Previous studies indicate an association between intra‐amniotic microbial invasion and/or inflammation and spontaneous preterm birth, but there is a limited amount of data available from Europe. The aim of this study was to investigate the occurrence of intra‐amniotic microorganisms and cytokines (interleukin‐6 and interleukin‐8) in a Swedish population of women in preterm labor and their correlation with preterm birth.Methods. Amniotic fluid was retrieved transabdominally from 61 patients in preterm labor before 34 weeks of gestation. Polymerase chain reaction analyses for Ureaplasma urealyticum and Mycoplasma hominis and culture for aerobic and anaerobic bacteria were performed. Interleukin‐6 and interleukin‐8 were analyzed with enzyme‐linked immunosorbent assay.Results. Microorganisms in amniotic fluid were detected in 10 patients (16%). Patients with detected bacteria in the amniotic fluid had significantly higher levels of interleukin‐6 and interleukin‐8. There was also an association between interleukin‐6/‐8, the amniocentesis‐delivery interval (≤ 7 days) and preterm birth (<34 weeks). An amniotic fluid concentration of interleukin‐6 ≥ 1.5 ng/mL or interleukin‐8 ≥ 1.3 ng/mL was associated with an increased risk of delivery within 7 days (interleukin‐6: relative risk 7.3; 95% confidence interval: 2.8–19; sensitivity 83%, specificity 87%; interleukin‐8: relative risk 14, 95% confidence interval: 3.6–55, sensitivity 91%, specificity 87%).Conclusions. The occurrence of intra‐amniotic microbial invasion and inflammation in this population of Swedish women in preterm labor was similar to data reported from populations with a higher incidence of preterm delivery. Amniotic interleukin‐6 and interleukin‐8 correlated with the presence of microorganisms and with preterm birth.
Evaluation of an Internet‐based database on infectious disorders during pregnancy: INFPREG
Authors: Petersson Karin , Forsgren Marianne , Sjödin Marie , Kublickas Marius , Westgren Magnus 
Published: December 2004

Objective. To evaluate the use of an Internet‐based information system on infectious disorders (INFPREG) in antenatal care in Sweden.Methods. A postal questionnaire was sent to all antenatal clinics in Sweden in 2000 (n = 515) and 2002 (n = 503). The questionnaire consisted of sections covering use of computers, availability of Internet connections and the use of INFPREG in patient care.Results. We received 404 completed questionnaires in 2000 and 501 in 2002. In 2000, 81% of the midwives had access to computers at their antenatal clinics, and this number had increased to 93% in 2002. Sixty‐eight percent and 88% in 2000 and 2002, respectively, had computers with an Internet connection.Of the responding midwives, 74% in 2000 and 84% in 2002 had received information concerning INFPREG. In 2000, 29% of the midwives had visited INFPREG and this figure had increased to 58% in 2002. Of the midwives that had used INFPREG, 67% in 2000 and 81% in 2002 reported that the information obtained from the site was implemented in the patient care.Of the responders, 45% in 2000 and 43% in 2002 claimed that they needed more information on how to use INFPREG.Conclusions. A majority of midwives at antenatal clinics in Sweden have access to the Internet and are confident in using an Internet‐based knowledge center on infectious disorders in pregnancy. The present study indicates a rapid acceptance among health care providers in antenatal care in Sweden of this new method for dissemination of information and guidelines. However, many midwives still want more information and knowledge on how to use an Internet‐based information system.
Serial serum ferritin estimation in pregnant women at risk of preterm labor
Authors: Goel Anupam , Jain Vanita , Gupta Indu , Varma Neelam 
Published: December 2004

Background. To estimate serial serum ferritin (SF) concentrations after 20 weeks of pregnancy in women at risk of having a preterm labor and to correlate them with the outcome of pregnancy.Methods. Venous blood samples were drawn serially at 26, 30 and 34 weeks of gestation in one hundred pregnant women who were at risk of having a preterm delivery. Samples were analyzed for hemoglobin (Hb), leukocyte count, hemotocrit serum iron (SI), total iron‐binding capacity (TIBC), SF and transferrin saturation. Seventy‐six subjects delivered at term and 24 subjects delivered before 37 weeks. The various parameters were compared between the term and the preterm groups.Results. Mean SF at different gestations in the term and the preterm group was not statistically different. Serial SF levels in subjects in the term group showed a declining trend with advancing gestation as seen in normal pregnancies. However, in the preterm group, a rising trend was observed. Further, SF levels of > 30 µg/dl at 26 weeks and > 40 µg/dl at 34 weeks were found to have a reasonable sensitivity and specificity for predicting preterm delivery.Conclusion. A SF concentration of > 40 µg/dl and a rise in SF concentration with increasing gestation should alert the clinician regarding the possibility of preterm delivery.
Long CAG repeats in theARgene are not associated with infertility in Finnish males
Authors: Lund Annastiina , Tapanainen Juha S. , Lähdetie Jaana , Savontaus Marja‐Liisa , Aittomäki Kristiina 
Published: December 2004

Background.The modulatory domain of the human androgen receptor gene contains a polymorphic CAG repeat coding for a polyglutamine tract. The length of the polyglutamine tract is inversely correlated with transcriptional activity of the androgen receptor. As androgens are crucial to spermatogenesis, decreased transcriptional activity of the androgen receptor associated with a long polyglutamine tract could lead to failure in spermatogenesis. Accordingly, long CAG repeats within the normal range have been suggested to be more common in infertile males than in the control population.Methods.To test this hypothesis, we examined the CAG repeat number of 192 Finnish males with moderate or severe spermatogenic failure and 149 control males.Results.Our results did not support the hypothesis, the controls harbored slightly longer CAG repeats than the infertile males.Conclusion.At least in the present study population from Finland, long CAG repeats in the androgen receptor gene do not play a significant role in spermatogenic failure.
Shoulder dystocia and brachial plexus injury: a case–control study
Authors: Christoffersson Magnus , Kannisto Paivi , Rydhstroem Hakan , Stale Håkan , Walles Bengt 
Published: December 2004

Objective and background. To evaluate risk factors for shoulder dystocia and brachial plexus injury using a case–control study at the departments of obstetrics and gynecology at the four largest hospitals in southern Sweden. All cases of shoulder dystocia between 1987 and 1993 inclusive were identified. For each case, two control infants with similar birthweight (± 100 g) and identical year of birth were randomly selected.Methods. Original maternal records were reviewed and information regarding 10 potential risk factors was extracted. Odds ratios (ORs) were calculated using the Mantel–Haenszel method. Stratification was made for year of delivery, parity (0, I, II, III+), and maternal age (5‐year class).Results. In all, 107 infants with shoulder dystocia and 198 controls were included. The OR was greater than unity for all risk factors except gestational age. Three of the risk factors, induction of labor, epidural analgesia, and instrumental delivery, reached statistical significance. Thirty‐four infants also suffered brachial plexus injury, giving a brachial plexus injury rate of 32% among the shoulder dystocia cases. We also made a separate analysis of the nine risk factors for brachial plexus injury following a shoulder dystocia, however none reached statistical significance.Conclusion. In this case–control study based on more than 100 000 deliveries at four large hospitals during a 7‐year period, induction of labor, epidural analgesia, and instrumental delivery turned out to be significant risk factors for shoulder dystocia. For brachial plexus injury following shoulder dystocia, no significant risk factor was identified.
Elective cervical cerclage for prevention of preterm birth: a systematic review
Authors: Bachmann Lucas M. , Coomarasamy Aravinthan , Honest Honest , Khan Khalid S. 
Published: December 2004

Background.  Elective cervical cerclage has been purported to prevent spontaneous preterm birth. We present a systematic review to determine the effectiveness of cervical cerclage in preventing spontaneous preterm birth before 34 weeks' gestation.Methods.  Searches were conducted in MEDLINE, EMBASE, Cochrane Library, and Science Citation Index to identify randomized trials published between 1966 and 2002. All randomized trials that evaluated the effectiveness of elective cerclage compared with no cerclage in women who were at risk of preterm birth before 34 weeks' gestation were included for analysis. Quality assessment and data extraction were performed in duplicate.Results.  There were seven relevant trials, comprising 2354 women. Meta‐analysis was inappropriate because of large differences in the quality of the studies. However, in the largest single trial of good quality, cerclage was shown to prevent birth before 34 weeks' gestation. In this single study the reported number to be treated to prevent one additional preterm birth before 34 weeks was 24 women (95% CI: 10–61). The results of other trials were consistent with the finding of the largest trial. Data on complications were sparse and inconclusive.Conclusion.  Our systematic review shows that elective cervical cerclage has a significant effect in preventing spontaneous preterm birth before 34 weeks' gestation. Further research should focus on identification and quantification of possible complications, and of risk factors and tests that identify high‐risk women who would benefit most from cerclage.
Eligibility and willingness of young Icelandic women to participate in a HPV vaccination trial
Authors: Gudmundsdóttir Thorbjörg , Tryggvadóttir Laufey , Allende Maria , Mast Thomas Christopher , Briem Haraldur , Sigurdsson Kristián 
Published: December 2004

Background and aims. Cervical cancer is an important health problem worldwide, and the incidence of preinvasive cervical cancer is increasing among young sexually active women. The causal association between human papilloma virus (HPV) and cervical cancer makes it theoretically possible to eradicate the disease through vaccination. The aim of this study was to analyze the eligibility and willingness of 18–23‐year‐old Icelandic women to participate in a vaccination trial to prevent HPV infection and to assess knowledge of HPV.Material and methods. A questionnaire was formulated with questions on demographics, HPV knowledge, sexual behavior, attitude towards HPV vaccination, and other health‐related issues. The questionnaire was tested on a subgroup of women before being mailed to 300 women aged 18–23 years, randomly selected by date of birth from the total population living in the Capital area of Reykjavík.Results. The response rate of the mailed questionnaire was 54%. Of respondents, 96% reported having had sexual debut and 39% were aged 15 years or younger at first intercourse. Knowledge of HPV infections and associated diseases was limited, indicating the need for an educational campaign. Although 60% of the respondents were willing to participate in a HPV vaccination trial, the eligibility rate for the invited women was estimated to be approximately 13% (95% CI: 9–17%) after accounting for various exclusion criteria such as number of sexual partners, abnormal Pap smears, planning a pregnancy, or travelling abroad for more than 6 months.Conclusions. Icelandic women between 18 and 23 years of age have a sexual behavior profile and lifestyle that may decrease their eligibility in future prophylactic HPV vaccine trials. Improved education about HPV infection and its consequences is needed. Future trials may need to include younger women to improve recruitment.
Maternal prepregnancy body mass index and psychomotor development in children
Authors: Neggers Yasmin H. , Goldenberg Robert L. , Ramey Sharon L. , Cliver Suzane P. 
Published: December 2004

Background. In a prospective study, the association between maternal nutritional status and psychomotor development of low‐income African–American children was evaluated. We hypothesized that low maternal body mass index (BMI) would predict worse neurodevelopmental status in children, while higher maternal BMIs would be associated with better neurodevelopmental outcomes.Methods. Psychomotor tests for general intelligence and motor skills were given to 355 children at a mean age of 5.3 years. Maternal nutritional status was assessed by prepregnancy body mass index (BMI) and weight gain during pregnancy.Results. Fifty‐four percent of the women in this study were overweight or obese. The means of the general IQ, nonverbal and verbal ability, and Gross Motor Scales of the children were 82.1 ± 12.6, 87.4 ± 15.7, 80.1 ± 10.8 and 332.3 ± 13.2, respectively. Seventeen percent of the children had general IQ scores of less than 70. To our surprise, in multiple regression analyses, adjusting for other covariates, maternal prepregnancy BMI was a significant negative predictor of IQ (β = − 0.25, P = 0.001) and nonverbal ability (β = − 0.29, P = 0.02). The IQ and nonverbal scores of children of women who were obese before pregnancy were approximately 5 units lower than for children whose mothers had a normal prepregnancy BMI. The other significant predictors of IQ and nonverbal scores of the children were childcare status (β = 3.5, P = 0.04 and β = 0.26, P < 0.0001, respectively) and the mother's receptive language scores (β = 5.2, P = 0.01 and β = 0.25, P < 0.0001, respectively).Conclusion. This study of low‐income African–American children indicates that obese women are at risk of having children with diminished intellectual ability, but not motor skills.
Intraoperative surgical complication during cesarean section: an observational study of the incidence and risk factors
Authors: Bergholt Thomas , Stenderup Jens Karl , Vedsted‐Jakobsen Agnete , Helm Peter , Lenstrup Carsten 
Published: December 2004

Background. The study was intended to estimate the incidence of intraoperative surgical complications with the impact of the educational level of the surgeon and a history of previous cesarean section on intraoperative complications at cesarean childbirth.Methods. In the period between August 1st 1995 and July 30th 1996, 7782 women gave birth at the three Obstetric Departments in Copenhagen County, Denmark, of which 929 (11.9%) were delivered by cesarean section. These women served as the study population, and their medical records were reviewed and data obtained immediately after delivery.Results. The overall intraoperative complication rate was 12.1%. The rate of complications in emergency cesarean sections was 14.5% compared with 6.8% in the elective group. The educational level of the surgeon and a history of previous cesarean section were not found to be significantly associated to intraoperative complications. Low station of the presenting part of the fetus, high fetal birth weight, fetal distress and dystocia as indications and increasing maternal age were significant risk factors of lacerations. Placenta previa and placental abruption as indications, increasing prepregnancy body mass index, as well as low and high birth weight were significant risk factors for intraoperative blood loss more than 1 l. Duration of regular painful contractions had a preventive effect.Conclusion. Utero‐cervical lacerations and blood loss of more than 1 l were the most frequent intraoperative complications in cesarean section in the present study. The educational level of the surgeon or history of a previous cesarean section were not significantly related to these complications.
Intrapartum influences on cesarean delivery in multiple gestation
Authors: Williams Keith P. , Galerneau France 
Published: December 2004

Objective. To evaluate which intrapartum factors influence the method of delivery in a group of twin pregnancies eligible for vaginal delivery.Study design. Over a 10‐year period, 967 consecutive twin pregnancies at gestational age ≥32 weeks with twin A presenting as a vertex and eligible for vaginal delivery were reviewed. Excluded were 40 (4.1%) patients who underwent a repeat and elective cesarean section. All patients who underwent a cesarean section were placed into one of two groups according to the method of delivery of both twins: group 1, cesarean section/cesarean section delivery; and group 2, vaginal/cesarean section delivery. The impact of the following intrapartum factors on the type of delivery were assessed: (1) presentation of the 2nd twin: vertex vs. breech vs. other; (2) experience of the obstetrician: ≤€10 years vs. > 10 years in practice; (3) multiparity: nulliparous vs. multiparous; (4) incidence of epidural usage; (5) induction vs. spontaneous labor; and (6) difference in fetal weight between twin B and twin A: <€25% difference vs. ≥ 25% difference. The chi‐square statistic was used to compare differences in the incidence of cesarean section between the groups.Results. Total incidence of cesarean section was 266/927 (28.7%). Risk of delivering by a combined vaginal delivery and cesarean section was reduced if the presentation of twin B was vertex or breech (RR: 0.114; 95% confidence interval: 0.049–0.266) or if an epidural was used (RR: 0.380; 95% confidence interval: 0.163–0.883).In twin gestations eligible for vaginal delivery the risk of requiring delivery by cesarean section for both twins is reduced if the presentation of twin B was vertex (RR: 0.782; 95% confidence interval; 0.631–0.968), if an epidural was used (RR: 0.461; 95% confidence interval: 0.375–0.566), or if the birthweight discrepancy was <€25% (RR: 0.695; 95% confidence interval: 0.524–0.922).Conclusion. Twin gestations with twin B presenting as vertex or breech or with an epidural were less likely to undergo combined vaginal delivery and cesarean section. The liberal use of epidural anesthesia may reduce the need for cesarean section in patients with twin gestations considered good candidates for vaginal delivery.
Prevalence of urinary and fecal incontinence and symptoms of genital prolapse in women
Authors: Eva Uustal Fornell , Gun Wingren , Preben KjØlhede 
Published: December 2004

Background. Urinary incontinence is common in women. How often incontinence occurs has been only briefly investigated. Studies on the prevalence of fecal incontinence are few. The epidemiology of genital prolapse symptoms is unknown. This epidemiological study describes a general population of women aged 40 and 60 years with regard to the prevalence and frequency of urinary and fecal incontinence and the prevalence of genital prolapse symptoms.Methods. A questionnaire on medical background, urinary and fecal incontinence, and genital prolapse symptoms was sent to 1000 40‐year‐old and 1000 60‐year‐old randomly selected women.Results. Sixty‐seven per cent answered: 53% were continent for urine; 9% of the 40‐year‐olds and 19% of the 60‐year‐olds had urinary incontinence weekly or more often. Detrusor instability score was significantly higher in the 60‐year‐olds. Incontinence of flatus, weekly or more often, was reported by 9% and 19%, loose feces by 5% and 8%, and solid feces by 0.3% and 1.7% according to the 40‐ and 60‐year‐olds, respectively. Fifty‐three per cent reported no flatus incontinence. Of the prolapse symptoms investigated, 15% of the females reported pelvic heaviness, 4% genital bulge, and 12% use of fingers in the vagina or perineum by defecation.Conclusions. Incontinence of urine is common in this population. Flatus incontinence is as common, but the concept must be operationalized if used as an endpoint in research. The International Continence Society's (ICS) definition of urinary incontinence is unpractical for use in epidemiological research. We suggest leakage weekly or more often as a criterion for significant incontinence in epidemiological research.
Prospective study of mother‐to‐infant transmission of hepatitis C virus: a 10‐year survey (1990–2000)
Authors: Ferrero Simone , Lungaro Pietro , Bruzzone Bianca Marisa , Gotta Cristina , Bentivoglio Giorgio , Ragni Nicola 
Published: December 2004

Background. The purpose of this study was to determine the rate of vertical transmission of hepatitis C virus (HCV). We also aimed to analyze the time of clearance of maternal antibodies in the serum of non‐infected babies.Methods. Between March 1990 and March 2000, 170 consecutive anti‐HCV‐positive women and their 188 babies entered this prospective study. All women were analyzed for HCV‐RNA using polymerase chain reaction (PCR). The babies were followed‐up until HCV‐antibody clearance or until the diagnosis of HCV infection.Results. The vertical transmission rate was 2.7% overall, and it was higher in HIV co‐infected women (5.4%, 2/37) than in HIV‐negative women (2.0%, 3/151). All infected infants were born to mothers who had HCV viremia at delivery. The transmission rate was influenced by maternal levels of viremia. 37.2% of uninfected children became HCV‐antibody negative by 6 months and 88.0% by 12 months. Babies born from HCV‐RNA‐positive mothers lost anti‐HCV antibodies later (9.21 ± 3.72 months) than babies born from HCV‐RNA‐negative mothers (7.47 ± 3.46 months) ( p < 0.05, Kolmogorov‐Smirnov test).Conclusions. The risk of HCV vertical transmission is very low in HCV‐positive/HIV‐negative women and it is restricted to infants born to HCV viremic mothers. High maternal viral load is predictive of the vertical transmission. The clearance time of antibodies in non‐infected babies is significantly longer if the mother is viremic.
Nitric oxide: does it have an etiological role in pre‐eclampsia?
Authors: Rajagopal Mooken , Moodley Jack , Chetty Runjan 
Published: December 2004

Aim. To determine evidence of nitric oxide (NO) in decidual biopsies and fetal membranes of preeclamptic women.Background. Nitric oxide, a potent vasodilator, has been postulated to have a role in the etiology of preeclampsia. Investigations in peripheral blood have led to conflicting results. We therefore decided to study whether immunohistochemically detectable nitric oxide is produced in the decidua and within the fetal membranes.Methods. Forty‐two pregnant women at 28 weeks gestation or more were enrolled. Twenty were normotensive and 22 had preeclampsia. Women with chronic hypertension, diabetes and multiple pregnancies were excluded. Maternal blood samples prior to cesarean section (CS), decidual biopsies during CS, and fetal membrane specimens were obtained. The tissue specimens were fixed immediately (after delivery of the baby and placenta) in formalin, washed, and embedded in paraffin. Immunohistochemical staining for nitric oxide synthases (NOS) I, II, III was performed and reviewed in conjunction with routine hematoxylin and eosin sections, using light microscopy.Results. There was no statistically significant difference in the level of immunostaining of nitric oxide synthases in both normotensive and hypertensive patients.Discussion. The severity of blood pressure did not influence expression of nitric oxide synthases.