Antihypertensive treatment during pregnancy and functional development at primary school age in a historical cohort study.

Objective: To determine the functional development of children born after treatment of mild-to-moderate gestational hypertension with labetalol versus methyldopa, and no antihypertensive treatment.

Design: Historical cohort study.

Setting: Twelve Dutch hospital departments of obstetrics.

The scientific output of a Catholic university department of obstetrics and gynecology.

The introduction of in-vitro fertilization (IVF) and prenatal diagnostics (PND) raised moral and ethical problems for Catholic universities. As expected, reproductive medicine research output was very low in departments that did not provide these facilities. It can be demonstrated that, by initiating IVF and PND under strong restrictions, a low scientific output in IVF and PND can be compensated for by increasing scientific output in new areas such as maternofetal physiology, primary prevention of birth defects and preconception care (folic acid and neural tube defects).

Why do women live longer than men?

Factors responsible for the gender difference in life-span being 4-5 years in favor of women were investigated. Cardiovascular risks are responsible for a five times higher mortality and three times higher morbidity in men compared with women. Genetics demonstrate marked gender differences in chromosomal constitution and female preponderance of the life-guard telomeres on chromosomes during mitotic cell division.

Oral contraceptives and the absolute risk of venous thromboembolism in women with single or multiple thrombophilic defects: results from a retrospective family cohort study.

Background: The risk of venous thromboembolism (VTE) in women taking combined oral contraceptives (COCs) is attributed to changes in coagulation and fibrinolysis. Their impact may be greater in women with preexistent thrombophilic defects.

Methods: We assessed the effects of COCs on absolute VTE risk in women with single or multiple thrombophilic defects in a retrospective family cohort study.

Abnormal folate metabolism in mothers with Down syndrome offspring: review of the literature.

Altered maternal folate status and homozygous mutation in the methylenetetrahydrofolate reductase (MTHFR) and methionine synthase reductase (MTRR) genes can promote chromosomal instability and non-dysjunction resulting in fetal trisomy 21. Folate supplementation around conception therefore has the potential to reduce the frequency of Down syndrome. This finding, in addition to the prevention of neural tube defects, strengthens the recommendation to use folic acid around conception.

High-resolution 1H NMR spectroscopy of amniotic fluids from spina bifida fetuses and controls.

Objective: To quantify proton containing metabolites by in vitro 1H NMR spectroscopy of amniotic fluids from fetuses with spina bifida and controls.

Study Design: Fourteen amniotic fluids from spina bifida fetuses and 18 controls were obtained. Concentrations of carbohydrates, organic acids and amino acids were determined.

Homocysteine metabolism and B-vitamins in schizophrenic patients: low plasma folate as a possible independent risk factor for schizophrenia.

Two apparently unrelated disorders, neural tube defects (NTD) and schizophrenia showed increased risks in birth cohorts exposed to famine during early gestation. NTD is associated with impaired folate metabolism. We investigated whether schizophrenia is also linked with a dysfunctional folate metabolism.

Obstetrics and gynecology between clinics and research.

An evaluation of a 25-year chairmanship at the University of Nijmegen is given. The main tasks were patient care, teaching and research. Patient care was influenced by new techniques later introduced into the various subdisciplines of Obstetrics and Gynecology.

Decreased relative brain tissue levels of inositol in fetal hydrocephalus.

Objective: Inositol seems to play a role in the development of the central nervous system. In this study, the brain tissue level of inositol in fetal hydrocephalus was compared with that of healthy control subjects.

Study Design: Proton magnetic resonance spectroscopy was used to examine the inositol over creatine ratio in the brain of 10 hydrocephalic human fetuses and 36 normal control subjects.

Homocysteine metabolism and effects of folic acid supplementation in patients affected with spina bifida.

Folic acid supplementation around conception decreases the risk of having offspring with a neural tube defect. However, the aetiology is often still unknown. This study investigated whether spina bifida patients have lower blood folate and higher fasting and post-methionine-load plasma total homocysteine (tHcy) concentrations than control patients.

Clotting disorders and placental abruption: homocysteine--a new risk factor.

Placental abruption is due to the rupture of the uterine spiral artery. The placenta separates totally or partially from the uterine wall during pregnancy. This serious syndrome has a great risk for the mother (shock and disseminated intravascular coagulation) and her child (mortality or morbidity).

Homocysteine and human reproduction.

Homocysteine is an amino acid that is capable of disturbing the proper growth of cells. Hyperhomocysteinemia can lead to a non-closure of the neural tube. The underlying basis is a derangement of homocysteine metabolism due to a missense mutation of the MTHFR enzyme that has to catalyze the folate metabolic cycle furnishing sufficient methyl groups for DNA and tRNA synthesis.

Homocysteine-lowering effect of 500 microg folic acid every other day versus 250 microg/day.

Background/aims: Elevated plasma total homocysteine (tHcy) concentrations are a risk factor for neural tube defects and vascular diseases. Supplementation with folic acid decreases tHcy. We investigated whether supplementation with 500 microg folic acid every other day is as effective in lowering tHcy as 250 microg folic acid each day.

Hyperhomocysteinemia and recurrent early pregnancy loss: a meta-analysis.

Objective: To quantify the risk of recurrent early pregnancy loss in the presence of elevated fasting or afterload homocysteine concentrations or homozygosity for the 677C-->T mutation in the methylenetetrahydrofolate reductase (MTHFR) gene (T/T genotype).

Design: Case-control studies published between January 1992 and November 1999 were identified with a MEDLINE-search. These studies were combined with a recent case-control study performed by our own research group.

Hyperhomocysteinemia and other thrombotic risk factors in women with placental vasculopathy.

Objective: To investigate coagulation inhibitors and abnormalities of the homocysteine metabolism, which are related to an increased thrombotic risk, as risk factors for placental vasculopathy.

Design: A case-control study comparing nonpregnant women with an obstetric history of placental vasculopathy (study group) with nonpregnant women (control group) matched for age and occupation.

Setting: Obstetric outpatient clinic in the University Hospital Nijmegen.

Multicenter study of the efficacy, cycle control and tolerability of a phasic desogestrel-containing oral contraceptive.

Objective: To investigate the efficacy, cycle control and tolerability of a phasic oral contraceptive containing ethinylestradiol 35/30/30 microg and desogestrel 50/100/150 microg.

Methods: A multicenter study was conducted involving 2070 healthy, fertile women, who received study treatment for six treatment cycles.

Results: Most of the participants (79%) had previously been using an alternative oral contraceptive.

Leon C. Chesley and hypertension in pregnant women.

Leon C. Chesley's first paper opened with the title 'Pregnancy in the patient with hypertensive disease'(1). Leon C.

A common mutation in the 5,10-methylenetetrahydrofolate reductase gene as a new risk factor for placental vasculopathy.

Objective: This study was undertaken to investigate whether the cytosine-to-thymine substitution at nucleotide 677 (C677T) in the 5, 10-methylenetetrahydrofolate reductase gene is a risk factor for placental vasculopathy (abruptio placentae or placental infarction with fetal growth restriction).

Study Design: This case-control study enrolled 165 women with placental vasculopathy and 139 matched control women with normal pregnancy outcomes. Measurements included fasting total plasma homocysteine concentration, serum and red blood cell folate concentrations, serum vitamin B(12) concentration, whole-blood vitamin B(6) concentration, and analysis of the 5, 10-methylenetetrahydrofolate reductase gene C677T mutation.

Low-dose folic acid supplementation does not influence plasma methionine concentrations in young non-pregnant women.

An elevated plasma total homocysteine (tHcy) concentration is a risk factor for cardiovascular disease and for having offspring with a neural-tube defect. Folate is a methyl donor in the remethylation of homocysteine into methionine. Although folic acid supplementation decreases tHcy concentrations, effects of folic acid supplementation on plasma methionine concentrations are unclear.

Maternal homocysteine and chorionic vascularization in recurrent early pregnancy loss.

Defective chorionic villous vascularization has been suggested to be associated with embryonic death. There are no reports, however, describing chorionic vascular profiles in spontaneous miscarriage tissue. Therefore, we investigated chorionic villous vascularization by both histopathology and an image analysis system combined with CD34 immunohistochemistry in spontaneous miscarriage tissue of 19 women with recurrent early pregnancy loss (REPL).

Homocysteine and folate levels as risk factors for recurrent early pregnancy loss.

Objective: To estimate the relative risk of recurrent early pregnancy loss for different total plasma homocysteine and serum folate concentrations.

Methods: In a case-control study, we measured homocysteine (fasting and afterload), folate (serum and red cells), pyridoxal 5'-phosphate, and cobalamin concentrations in 123 women who had at least two consecutive spontaneous early pregnancy losses each and compared concentrations with those of 104 healthy controls.

Results: Women with recurrent early pregnancy losses had significantly lower serum folate concentrations than controls, whereas the other measurements were similar to those of controls.

Perinatal audit on avoidable mortality in a Dutch rural region: a retrospective study.

Objective: To analyse the mode and cause of perinatal mortality.

Setting: a rural Dutch region.

Study Design: Over a two-year period (1994-1995), data were collected in the 's Hertogenbosch region.