Precocious cervical ripening as a screening target to predict spontaneous preterm delivery among asymptomatic singleton pregnancies: a systematic review.

Routine second-trimester transvaginal ultrasonographic (TVU) screening for short cervical length (CL) predicts spontaneous preterm delivery (SPTD), albeit with limited sensitivity (35-40%) and a moderate positive likelihood ratio of 4-6. However, CL describes one of the multidimensional changes that are associated with precocious cervical ripening (PCCR) and that also include cervical softening, cervical funneling (CF), and dilation. PCCR, a precursor and a strong predictor for SPTD, was proposed as a potential screening target.

A Time-motion Comparison of Itemized Treatment Costs in First and Second In Vitro Fertilization Attempts: A United Kingdom Fertility Centre Experience.

To assess the difference in cost between initial and second in vitro fertilization (IVF) cycles in the United Kingdom. This prospective time-motion analysis captured data on average time spent on 31 representative components of the IVF sequence as provided by clinical team members in seven categories. Audits of consumables and observations on personnel costs were made from total of 120 fertility patients undergoing initial or second IVF cycles (n=736) between 1 January 2002 and 31 December 2002 at a UK assisted fertility unit.

Cervical intraepithelial neoplasia and cancer in women 35 years and older.

Objective: To evaluate the distribution of abnormal cytohistopathology among low-income women 35 years and older compared with women younger than 35 years.

Materials And Methods: This was a retrospective analysis of the 896 women who presented to the dysplasia clinic at an urban, public, tertiary care hospital with abnormal cervical cytology from September 23, 2008, to September 23, 2010. Statistical comparisons were made using t, χ(2), and Wilcoxon rank sum tests.

Cigarette smoking and fetal morbidity outcomes in a large cohort of HIV-infected mothers.

Background: Reproductive-age women comprise approximately 25% of all persons living with HIV/AIDS in the United States. HIV infection and smoking during pregnancy are independent risk factors for adverse fetal outcomes. We examined predictors of fetal growth restriction among infants born to HIV-infected mothers who smoke cigarettes in pregnancy.

Detection of alcohol use in the second trimester among low-income pregnant women in the prenatal care settings in Jefferson County, Alabama.

Background: Prenatal alcohol use, a leading preventable cause of birth defects and developmental disabilities, remains a prevalent public health concern in the United States. This study aims to detect the proportion and correlates of prenatal alcohol use in the prenatal care settings in Alabama. Prenatal care settings were chosen because of their potential as stable locations to screen for and to reduce prenatal alcohol use within a community.

Prediction of individual probabilities of livebirth and multiple birth events following in vitro fertilization (IVF): a new outcomes counselling tool for IVF providers and patients using HFEA metrics.

In vitro fertilization (IVF) has become a standard treatment for subfertility after it was demonstrated to be of value to humans in 1978. However, the introduction of IVF into mainstream clinical practice has been accompanied by concerns regarding the number of multiple gestations that it can produce, as multiple births present significant medical consequences to mothers and offspring. When considering IVF as a treatment modality, a balance must be set between the chance of having a live birth and the risk of having a multiple birth.

Folic acid and human reproduction-ten important issues for clinicians.

This article presents data on the current best evidence-based clinical practices and controversies surrounding folic acid supplementation/fortification for the prevention of neural tube defects (NTDs) during early pregnancy. Formatted as a series of ten clinical questions, answers and extensive discussion are provided for each point. We assess the history and evidence behind supplementation and fortification, racial/ethnic disparities in NTDs on a global scale, and present information on risk factors for NTDs other than dietary folic acid deficiency.

Male subfertility and the role of micronutrient supplementation: clinical and economic issues.

The concept of male subfertility has evolved rapidly since 2000. This term is discussed based upon evidence relating to its first entrance into the literature, along with contemporary references to its purported incidence and prevalence. Factors affecting sperm quality are described in detail, and available data pertaining to the effects of micronutrients on spermatic parameters and resulting pregnancies are described.

The differential association between education and infant mortality by nativity status of Chinese American mothers: a life-course perspective.

Objectives: Integrating evidence from demography and epidemiology, we investigated whether the association between maternal achieved status (education) and infant mortality differed by maternal place of origin (nativity) over the life course of Chinese Americans.

Methods: We conducted a population-based cohort study of singleton live births to US-resident Chinese American mothers using National Center for Health Statistics 1995 to 2000 linked live birth and infant death cohort files. We categorized mothers by nativity (US born [n = 15 040] or foreign born [n = 150 620]) and education (≥ 16 years, 13-15 years, or ≤ 12 years), forming 6 life-course trajectories.

A population based economic analysis of cross-border payments for fertility services in Luxembourg.

Objective: How fertility patients utilise assisted reproductive services can depend on how easy it is to access such services locally. Little data exist to document the extent of economic outflow that accompanies cross-border patient travel specifically for medical procedures that cannot be obtained in country.

Methods: In this investigation, data from Luxembourg's social security agency were used to audit medical reimbursement payments for IVF within and outside the Grand Duchy of Luxembourg between 1998 and 2007.

Comparative study on the use of analytical software to identify the different stages of breast cancer using discrete temperature data.

Breast cancer is the second leading cause of death in women. It occurs when cells in the breast begin to grow out of control and invade nearby tissues or spread throughout the body. The limitations of mammography as a screening modality, especially in young women with denser breasts, necessitated the development of novel and more effective screening strategies with acceptable sensitivity and specificity.

Hyperfertility, obesity, and stillbirth: new considerations for clinical practice.

This research focuses on two well known phenomenon that regularly confront obstetricians on a worldwide basis. The first is hyperfertility, whose effects are well known within and outside the obstetrics community. The second is obesity, a problem of growing importance throughout the developed and developing world.

Perinatal outcomes among foreign-born and US-born Chinese Americans, 1995-2000.

This paper examines nativity differences in adverse perinatal outcomes of Chinese-American mothers. Singleton live births to US-resident Chinese women (150,620 foreign-born, 15,040 US-born) and a random sample of 150,620 non-Hispanic White mothers were selected from 1995 to 2000 national linked birth/infant death certificate files. Associations between maternal nativity status and adverse perinatal outcomes were assessed using multivariable logistic regressions.

The association between maternal characteristics and different types and levels of discordance in triplet pregnancies.

Objective: This study evaluated the association of maternal factors known to influence outcomes of triplets, different discordance levels (-25, 25.1-35, and )35%), and three types (according to the birth weight of the middle-sized triplet) of birth weight discordance in triplets.

Methods: We used data collected by the Women's Health Division of Matria Healthcare, Inc.

The Istanbul international consensus statement on the perinatal care of multiple pregnancy.

The purpose of this document is to expand the 1995 ISTS/COMBO Declaration of Rights which was initially produced to promote awareness of the special needs of multiple birth infants, children, and adults. It addresses the clinical and ethical dimensions of perinatal care of multiple pregnancy. The ad hoc committee was chaired by Isaac Blickstein.

Impact of advanced maternal age on neonatal survival of twin small-for-gestational-age subtypes.

Aim: We examined the impact of advanced maternal age (>40 years old) on the survival of twin small-for-gestational-age (SGA) infants, that is, infants who were smaller in size than was expected for the baby's sex, genetic heritage, and gestational age.

Methods: The present study was a retrospective cohort study on twin live births in the USA from 1995 to 1998 inclusive. Two categories of SGA babies were defined: discordant (when only one of a twin pair was SGA) and concordant (when both were SGA).

On the possible cause of monozygotic twinning: lessons from the 9-banded armadillo and from assisted reproduction.

Available hypotheses proposed to explain the mechanism of zygotic splitting fail to explain why monozygotic twins are more prevalent after all methods of assisted reproduction and which structure is likely to control this phenomenon. Arguably, a small proportion of oocytes might have an inborn propensity to undergo splitting upon fertilization leading to the constant prevalence of spontaneous monozygotic conceptions among different populations. Ovarian stimulation would then predictably increase the number of available splitting-prone oocytes and consequently would increase the chance for such oocytes to develop into monozygotic twins, leading to a 'dose'-dependent relationship between monozygosity rates and the combined effect of infertility treatment.

Comparison between singleton- and triplet-specific "growth" curves to detect growth restricted triplet infants.

Objective: To evaluate whether triplet- or singleton-specific growth standards should be used to define the growth restricted triplet fetus/neonate.

Study Design: We retrospectively compared the predictive values of singleton vs. triplet-specific "growth" standards using the neonatal ponderal index as reference for growth restriction.

Slow change in body mass index during early triplet pregnancy is associated with decreased birth weight.

Objective: This study evaluates the impact of an average change in body mass index (BMI) during the first 16-25 weeks on outcomes of triplet pregnancies.

Study Design: In this retrospective observational study we evaluated a cohort of triplets born to 1235 nulliparas and 705 multiparas. The difference between the pregravid body mass index (BMI) and that obtained upon admission at 16-25 weeks' gestation was averaged to obtain the weekly change in BMI, defined as slow, typical, or fast by values<1SD, +/-1SD, and >1SD from the mean average weekly change in BMI.

Early weight gain does not decrease the incidence of low birth weight and small for gestational age triplets in mothers with normal pre-gestational body mass index.

Objective: To examine if the recommended weight gain of >680 g/week during the first 24 weeks of pregnancy decreases the frequency of adverse birth weight outcomes in triplet mothers with a normal pregravid BMI.

Study Design: Retrospective observational study of a large sample of triplet mothers with a normal (19.8-26) pregravid BMI.

SGA subtypes and mortality risk among singleton births.

Objectives: To determine whether early mortality (first year of life) risks among small for gestational age (SGA) neonates were similar regardless of SGA subtype based on three chronological classifications (term, preterm and post-term).

Study Design: Retrospective cohort study on all singleton live births in the United States from 1995 to 1999 inclusive. Adjusted risk estimates were computed from logistic regression models using non-SGA infants as the referent.

The association between small-for-gestational age triplet pregnancies and neonatal mortality: a novel approach to growth assessment in multiple gestations.

It is customary to estimate the uteroplacental function in singletons by defining appropriateness of birth weight by gestational age. Such a measure, however, is not available for the entire multiple pregnancy set. We evaluate a new index, total triplet birth weight, expressed as multiples of the median (MOM) birth weight of singleton gestations.

The Northwestern twin chorionicity study: testing the 'placental crowding' hypothesis.

Objective: To evaluate the relation between placental proximity and frequency of birth weight discordance and small-for-gestational age (SGA) infants.

Study Design: Retrospective three-tier chorionicity analysis of 1155 twin placentas comparing birth weight characteristics of the twins in different placental types.

Results: Dichorionic-separate, but not dichorionic-fused twins, are heavier than monochorionic-diamniotic and monoamniotic twins (2376+/-721 vs.