Maternal and perinatal outcomes of a venous thromboembolism high-risk cohort using a multidisciplinary treatment approach.

Objective: To evaluate the maternal and perinatal outcomes in a cohort of pregnant women at high risk of venous thromboembolism (VTE).

Methods: Women at high risk of VTE were evaluated in a multidisciplinary program using a complete diagnostic workup, and specific prophylactic or therapeutic treatment.

Results: Women were considered at high risk of VTE in 57% (85/148) because of prior (75) or current (10) thromboembolism, and in 27% (40/148) of the cases due to adverse obstetric history.

Infant morbidity and mortality attributable to prenatal smoking in Chile.

Objective: To estimate annual infant morbidity and mortality attributable to prenatal smoking in Chile during 2008-2012.

Methods: Population-attributable fractions (PAFs) for several infant outcomes were calculated based on previous study estimates of prenatal smoking prevalence and odds ratios associated with exposure (prenatal smoking relative to non-prenatal smoking). Prenatal smoking-attributable infant morbidity and mortality cases were calculated by multiplying the average annual number of morbidity and mortality cases registered in Chile during 2008-2012 by the corresponding PAF.

[Rising infant mortality in down syndrome in Chile from 1997 to 2013].

Background: Down syndrome (DS) is associated with higher child mortality especially due to cardiac malformations.

Aim: To describe the trend in Chilean infant mortality in DS in the period 1997-2013 as compared to the general population without DS.

Material And Methods: Raw data on infant deaths were extracted from the yearbooks of vital statistics of the National Institute of Statistics.

Oxytocin for preventing postpartum haemorrhage (PPH) in non-facility birth settings.

Background: Postpartum haemorrhage (PPH) is the single leading cause of maternal mortality worldwide. Most of the deaths associated with PPH occur in resource-poor settings where effective methods of prevention and treatment - such as oxytocin - are not accessible because many births still occur at home, or in community settings, far from a health facility. Likewise, most of the evidence supporting oxytocin effectiveness comes from hospital settings in high-income countries, mainly because of the need of well-organised care for its administration and monitoring.

Is ursodeoxycholic acid effective for intrahepatic cholestasis of pregnancy?

Intrahepatic cholestasis of pregnancy is a condition associated with fetal morbidity and mortality. Ursodeoxycholic acid has been proposed as a treatment alternative, but its use remains controversial. Searching in Epistemonikos database, which is maintained by screening 30 databases, we identified three systematic reviews including eight randomized trials.

Preventive letter: doubling the return rate after gestational diabetes mellitus.

To measure the impact of a "Preventive Letter" designed to encourage the return of gestational diabetes mellitus (GDM) mothers to follow up visit after delivery, in the context of a worldwide concern about low return rates after delivery of these patients. Mothers with GDM require medical evaluation and an oral glucose tolerance test (OGTT) 6 weeks after delivery, in order to: [a] confirm remission of GDM and [b] provide advice on the prevention of type 2 diabetes. In the year 2003 we developed a "Preventive Letter", containing three aspects: [a] current treatment, [b] suggested management during labor, and [c] a stapled laboratory order for OGTT to be performed 6 weeks after delivery.

Maternal hypertriglyceridemia: A link between maternal overweight-obesity and macrosomia in gestational diabetes.

Objective: Infants born from overweight and obese mothers with glucose-controlled gestational diabetes (GDM) tend to be large-for-gestational age (LGA). It is hypothesized that this is due to an excessive rise in maternal triglyceride levels.

Methods: Two-hundred and seventy nine singleton GDM pregnancies were divided into three groups according to prepregnancy BMI: normal weight (BMI = 20-24.

[Women age as a risk factor for maternal, fetal, neonatal and infant mortality].

Background: Adolescent pregnancy and advanced maternal age are associated with increased risk for maternal, perinatal and infant death. However, the maternal age with the lowest reproductive risk has not been established.

Aim: To determine the range of maternal age with the lowest reproductive risk.

[Odds ratio: theoretical and practical issues].

Odds Ratio (OR) is an effect measure frequently used to communicate results of health research. Mathematically, OR is the quotient between two odds, being odds an alternative way to express possibility of occurrence of an outcome or presence of an exposition. From a methodological perspective, OR can be calculated from prospective, retrospective and cross-sectional designs, and under certain conditions it can replace the Relative Risk.

A population-based cohort study of breastfeeding according to gestational age at term delivery.

Objective: Because breastfeeding is the optimal form of infant feeding, this study was conducted to determine the effect of gestational age on breastfeeding in term infants.

Study Design: A retrospective population-based cohort study of singleton/twin hospital births was conducted in Ontario, Canada between April 1, 2009, and March 31, 2010. Multivariate logistic regression was used to determine the adjusted effect of gestational age on breastfeeding.

Prevalence and predictors of exclusive breastfeeding at hospital discharge.

Objective: To estimate the population-based prevalence and predictors of exclusive breastfeeding at hospital discharge in singleton and twin term newborns.

Methods: We studied all hospital births in the province of Ontario, Canada, between April 1, 2009, and March 31, 2010, to perform a retrospective cohort study. We included live singleton and twin births, at term (37 0/7 weeks of gestation to 41 6/7 weeks of gestation), with information about feeding at maternal-newborn discharge.

Potential impact on estimated treatment effects of information lost to follow-up in randomised controlled trials (LOST-IT): systematic review.

Objective: To assess the reporting, extent, and handling of loss to follow-up and its potential impact on the estimates of the effect of treatment in randomised controlled trials.

Design: Systematic review. We calculated the percentage of trials for which the relative risk would no longer be significant under a number of assumptions about the outcomes of participants lost to follow-up.

Specific instructions for estimating unclearly reported blinding status in randomized trials were reliable and valid.

Objective: To test the reliability and validity of specific instructions to classify blinding, when unclearly reported in randomized trials, as "probably done" or "probably not done."

Study Design And Setting: We assessed blinding of patients, health care providers, data collectors, outcome adjudicators, and data analysts in 233 randomized trials in duplicate and independently using detailed instructions. The response options were "definitely yes," "probably yes," "probably no," and "definitely no.

Non-hormonal interventions for hot flushes in women with a history of breast cancer.

Background: Hot flushes are common in women with a history of breast cancer. Hormonal therapies are known to reduce these symptoms but are not recommended in women with a history of breast cancer due to their potential adverse effects. The efficacy of non-hormonal therapies is still uncertain.

LOST to follow-up Information in Trials (LOST-IT): a protocol on the potential impact.

Background: Incomplete ascertainment of outcomes in randomized controlled trials (RCTs) is likely to bias final study results if reasons for unavailability of patient data are associated with the outcome of interest. The primary objective of this study is to assess the potential impact of loss to follow-up on the estimates of treatment effect. The secondary objectives are to describe, for published RCTs, (1) the reporting of loss to follow-up information, (2) the analytic methods used for handling loss to follow-up information, and (3) the extent of reported loss to follow-up.

[Under diagnosis of fetal growth restriction by the new growth curves of the Chilean Ministry of Health].

Background: Fetal growth restriction (FGR) is associated with increased risk of perinatal morbidity or death. Nationwide implementation of new fetal growth charts, requires a lower fetal weight for the diagnosis of FGR, compared to previous ones. This may lead to an under diagnosis of FGR in a large proportion of neonates.