Digoxin antibody fragment, antigen binding (Fab), treatment of preeclampsia in women with endogenous digitalis-like factor: a secondary analysis of the DEEP Trial.

Objective: Endogenous digitalis-like factors (EDLFs) are elevated in women with preeclampsia, and the use of an anti-digoxin antibody Fab (DIF) in women with preeclampsia who were remote from term reduced maternal blood pressure and preserved renal function. The objective was to determine whether DIF treatment in women with severe preeclampsia in association with positive EDLFs in maternal serum improves maternal-perinatal outcomes.

Study Design: This was a planned secondary analysis from a randomized, placebo-controlled, double-blind study of DIF in women with severe preeclampsia with positive EDLF status that was managed expectantly between 23 weeks 5 days and 34 weeks' gestation (19 women received placebo, and 17 women received DIF).

Health characteristics and outcomes of two randomized vitamin D supplementation trials during pregnancy: a combined analysis.

Objective: To assess the safety and health effects of vitamin D supplementation during pregnancy.

Methods And Design: Datasets from two randomized clinical trials were first analyzed separately then combined for this analysis using a common data dictionary. In the NICHD trial, women were randomized to 400, 2000, or 4000IU vitamin D3/day, stratified by race.

Association of maternal vitamin D and placenta growth factor with the diagnosis of early onset severe preeclampsia.

Objective: Decreased maternal 25-hydroxyvitamin D (25-OH-D) and placenta growth factor (PlGF) have both been associated with the diagnosis of early onset severe preeclampsia (EOSPE). This investigation aimed to define the association of these biomarkers with EOSPE.

Study Design: Patients with EOSPE (n = 40) and healthy controls (n = 40) were recruited and information on demographics, outcomes, and plasma was collected at diagnosis of EOSPE or gestational age-matched controls.

Vitamin D and its role during pregnancy in attaining optimal health of mother and fetus.

Despite its discovery a hundred years ago, vitamin D has emerged as one of the most controversial nutrients and prohormones of the 21st century. Its role in calcium metabolism and bone health is undisputed but its role in immune function and long-term health is debated. There are clear indicators from in vitro and animal in vivo studies that point to vitamin D's indisputable role in both innate and adaptive immunity; however, the translation of these findings to clinical practice, including the care of the pregnant woman, has not occurred.

The role of vitamin D in pregnancy and lactation: emerging concepts.

Pregnancy is a critical time in the lifecycle of a woman where she is responsible not only for her own well-being, but also that of her developing fetus, a process that continues during lactation. Until recently, the impact of vitamin D status during this period had not been fully appreciated. Data regarding the importance of vitamin D in health have emerged to challenge traditional dogma, and suggest that vitamin D - through its effect on immune function and surveillance - plays a role beyond calcium and bone metabolism on the health status of both the mother and her fetus.

Maternal vitamin D and fetal growth in early-onset severe preeclampsia.

Objective: Recently, vitamin D deficiency has been associated with increased risks for preeclampsia and diagnosis of early-onset, severe preeclampsia (EOSPE). The purpose of this investigation was to examine the association between vitamin D levels and small-for-gestational age (SGA) in patients with EOSPE.

Study Design: Patients with EOSPE were recruited, and demographics, outcomes, and plasma were collected.

Examining the effect of maternal obesity on outcome of labor induction in patients with preeclampsia.

Objective: The objective of this investigation was to evaluate the effect of maternal obesity, as measured by prepregnancy body mass index (BMI), on the mode of delivery in women undergoing indicated induction of labor for preeclampsia.

Study Design: Following Institutional Review Board (IRB) approval, patients with preeclampsia who underwent an induction of labor from 1997 to 2007 were identified from a perinatal information database, which included historical and clinical information. Data analysis included bivariable and multivariable analyses of predictor variables by mode of delivery.

Plasma 25-hydroxyvitamin D levels in early-onset severe preeclampsia.

Objective: Vitamin D deficiency has been linked to adverse pregnancy outcomes. The purpose of this investigation was to assess total 25-hydroxyvitamin D (25-OH-D) levels at diagnosis of early-onset severe preeclampsia (EOSPE).

Study Design: After institutional review board approval, we enrolled subjects with EOSPE (<34 weeks' gestation with severe preeclampsia) in this case-control investigation in a 1:2 ratio with gestation-matched, contemporaneous control subjects.

Vitamin D deficiency and insufficiency is common during pregnancy.

The objective was to determine the incidence of vitamin D deficiency, insufficiency, and sufficiency in African-American, Hispanic, and Caucasian pregnant women. Blood samples were taken from 154 African-American, 194 Hispanic, and 146 Caucasian women at <14 weeks of gestation; 25 hydroxyvitamin D levels (25(OH)D) levels were measured by radioimmunoassay. The mean 25(OH)D levels in African-American, Hispanic, and Caucasian pregnant women were 15.

Maternal super-obesity (body mass index > or = 50) and adverse pregnancy outcomes.

Objective: To determine if pregnancy complications are increased in super-obese (a body mass index (BMI) of 50 or more) compared to other, less obese parturients.

Design: Cross-sectional study.

Setting And Population: All 19,700 eligible women, including 425 (2.

Timing of elective repeat cesarean delivery at term and neonatal outcomes: a cost analysis.

Objective: The purpose of this investigation was to examine the economic impact of performing elective repeat cesarean during 37 or 38 weeks of gestation relative to the American College of Obstetricians and Gynecologists recommendation of a 39-week delivery.

Study Design: Decision analysis modeling was used to estimate economic outcomes for a hypothetical cohort of neonates using data from the Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network study of "Timing of Elective Repeat Cesarean Delivery at Term and Neonatal Outcomes." Costs and charges were estimated using the Florida Healthcare Cost and Utilization Project.

Digoxin immune fab treatment for severe preeclampsia.

We evaluated the efficacy, safety, and biological mechanisms of digoxin immune Fab (DIF) treatment of severe preeclampsia. Fifty-one severe preeclamptic patients were randomized in double-blind fashion to DIF ( N = 24) or placebo ( N = 27) for 48 hours. Primary outcomes were change in creatinine clearance (CrCl) at 24 to 48 hours and antihypertensive drug use.

Early-onset severe preeclampsia: induction of labor vs elective cesarean delivery and neonatal outcomes.

Objective: The purpose of this study was to describe the success rate of and analyze differences in neonatal outcomes with labor induction, compared with elective cesarean delivery in women with early-onset severe preeclampsia.

Study Design: We conducted a cross-sectional study of women with severe preeclampsia who required delivery between 24 and 34 weeks of gestation. Bivariate and multivariable regression analyses were used to determine factors that were associated with assignment to, success of, and odds of neonatal outcomes after induction of labor.

Prediction of pelvic organ prolapse using an artificial neural network.

Objective: The objective of this investigation was to test the ability of a feedforward artificial neural network (ANN) to differentiate patients who have pelvic organ prolapse (POP) from those who retain good pelvic organ support.

Study Design: Following institutional review board approval, patients with POP (n = 87) and controls with good pelvic organ support (n = 368) were identified from the urogynecology research database. Historical and clinical information was extracted from the database.

Second-trimester angiogenic factors as biomarkers for future-onset preeclampsia.

Objective: The purpose of this study was to determine whether second-trimester soluble fms-like tyrosine kinase-1 and placenta growth factor (PlGF) are altered in patients who have preeclampsia develop compared with controls. Furthermore, soluble fms-like tyrosine kinase-1 and placenta growth factor levels in patients with chronic hypertension are described.

Study Design: With the use of a research database, 21 patients who had severe preeclampsia develop, 34 controls, and 9 patients with chronic hypertension were enrolled.

Soluble endoglin as a second-trimester marker for preeclampsia.

Objective: The objective of this investigation was to characterize soluble endoglin (sEng) concentrations in second-trimester serum of women who either develop preeclampsia or have a normal pregnancy.

Study Design: Single second-trimester serum samples obtained from healthy, nonsmoking women who subsequently developed severe preeclampsia (n = 48) or from healthy nonsmoking women who experienced a normal pregnancy (n = 56) were measured by enzyme-linked immunosorbent assay. Data were reported as mean +/- standard deviation.

Evaluation of placenta growth factor and soluble Fms-like tyrosine kinase 1 receptor levels in mild and severe preeclampsia.

Objective: The purpose of this study was to determine if maternal serum concentrations of placenta growth factor (PlGF) and soluble Fms-like tyrosine kinase 1 receptor (s-Flt1) are more abnormal in patients with severe preeclampsia compared with mild preeclampsia.

Study Design: Serum samples were collected from 32 control patients and 80 patients with mild or severe preeclampsia. PlGF and s-Flt1 concentrations were quantitated by enzyme-linked immunosorbent assay (ELISA).