Obesity increases the risk of failure of noninvasive prenatal screening regardless of gestational age.

Background: Noninvasive prenatal screening has become an increasingly prevalent choice for women who desire aneuploidy screening. Although the test characteristics are impressive, some women are at increased risk for noninvasive prenatal screen failure. The risk of test failure increases with maternal weight; thus, obese women may be at elevated risk for failure.

Evidence for a Complex Relationship Among Weight Retention, Cortisol and Breastfeeding in Postpartum Women.

Objective To assess the relationship between cortisol slope, a biologic marker of stress, and postpartum weight retention. Methods We included 696 women in a secondary analysis from a multi-site study conducted using principles of community-based participatory research to study multi-level sources of stress on pregnancy outcomes. As a stress marker, we included salivary cortisol slope; the rate of cortisol decline across the day.

Association of Fetal Abdominal-Head Circumference Size Difference With Shoulder Dystocia: A Multicenter Study.

Objective This study aims to determine if shoulder dystocia is associated with a difference in the fetal abdominal (AC) to head circumference (HC) of 50 mm or more noted on antenatal ultrasound. Study Design A multicenter matched case-control study was performed comparing women who had shoulder dystocia to controls who did not. Women with vaginal births of live born nonanomalous singletons ≥ 36 weeks of gestation with an antenatal ultrasound within 4 weeks of delivery were included.

Postpartum weight retention risk factors and relationship to obesity at 1 year.

Objective: To explore risk factors for postpartum weight retention at 1 year after delivery in predominantly low-income women.

Methods: Data were collected from 774 women with complete height and weight information from participants in the Eunice Kennedy Shriver National Institute of Child Health and Human Development Community Child Health Network, a national five-site, prospective cohort study. Participants were enrolled primarily in the hospitals immediately after delivery.

Postplacental insertion of the levonorgestrel intrauterine device after cesarean delivery vs. delayed insertion: a randomized controlled trial.

Objective: This trial was designed to compare levonorgestrel intrauterine device (LNG-IUD) use at 1 year after delivery between women randomized to postplacental insertion at the time of cesarean delivery and delayed insertion 4-8 weeks after delivery.

Study Design: This randomized controlled trial was conducted at two urban medical centers. Eligible pregnant women with planned cesarean deliveries were randomized to immediate postplacental insertion during cesarean or delayed insertion after 4-8 weeks.

Influence of gestational age and body weight on the pharmacokinetics of labetalol in pregnancy.

Background And Objectives: Labetalol is frequently prescribed for the treatment of hypertension during pregnancy; however, the influence of pregnancy on labetalol pharmacokinetics is uncertain, with inconsistent findings reported by previous studies. This study examined the population pharmacokinetics of oral labetalol during and after pregnancy in women receiving labetalol for hypertension.

Methods: Data were collected from 57 women receiving the drug for hypertension from the 12th week of pregnancy through 12 weeks postpartum using a prospective, longitudinal design.

Reliability of a preventability model in maternal death and morbidity.

Objective: The purpose of this study was to measure the reliability of a model that defines preventability in maternal morbidity and death.

Study Design: One hundred cases of serious morbidity and death among peripartum women were reviewed by 2 independent groups of medical experts to identify potentially preventable provider or system events that may have led to the progression of illness.

Results: Seventy-seven percent of the cases had concordant findings in both groups regarding the identification of any preventable events.

The incidence of Sheehan's syndrome after obstetric hemorrhage.

Objective: To estimate the incidence of Sheehan's syndrome in a well-described cohort of patients with obstetric hemorrhage.

Design: Retrospective cohort study.

Setting: Tertiary care center.

Epidemiology and biology of multiple gestations.

Twins have always aroused interest and have been represented throughout history. Conjoined twins have caused even more sensation, the best-known pair being Chang and Eng Bunker, who were born in Thailand in 1811 and inspired the term Siamese twins. Recently, higher-order multiples have caused controversy, and there has been heavy media coverage of large-number deliveries, such as the McCaughey septuplets.

Interleukin-6 and tumor necrosis factor alpha as predictors of success after emergent cerclage.

Serum levels of interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-alpha) were measured in patients requiring an emergent cerclage to determine if they are predictive of successful pregnancy outcome. Women with a clinical diagnosis of cervical incompetence requiring an emergent cerclage between 15 and 24 weeks gestation were enrolled. Asymptomatic women of the same gestational age range were recruited as controls.

Health literacy and pregnancy preparedness in pregestational diabetes.

Objective: We investigated the association between functional health literacy and markers of pregnancy preparedness in women with pregestational diabetes.

Research Design And Methods: English- and Spanish-speaking pregnant women with pregestational diabetes were recruited. Women completed the Test of Functional Health Literacy in Adults (TOFHLA) short form and a questionnaire.

Isolated low second-trimester maternal serum beta-human chorionic gonadotropin is not associated with adverse pregnancy outcome.

Objective: We investigated whether low human chorionic gonadotropin from maternal serum screening is associated with adverse pregnancy outcome.

Study Design: Women between 15 and 20 completed weeks of gestation who had a maternal serum screen performed from June 1999 to November 2001 were studied. Cases included women with human chorionic gonadotropin values of View Article and Find Full Text PDF

Relationship between tumor necrosis factor-alpha genotype and success of emergent cerclage.

The guanine to adenine substitution at the -308 position in the tumor necrosis factor-alpha (TNF-alpha) gene promoter region results in a 5-fold greater cytokine response to an inciting event. We investigated whether this polymorphism is associated with cervical incompetence and adverse pregnancy outcome after emergent cerclage. Women with a diagnosis of cervical incompetence requiring an emergent cerclage between 15 and 24 weeks were enrolled.