Short-term neonatal outcomes of pregnancies complicated by maternal obesity.

Background: Maternal obesity complicates a high number of pregnancies. The degree to which neonatal outcomes are adversely affected is unclear.

Objective: This study aimed to evaluate neonatal outcomes of pregnancies complicated by maternal obesity.

The Association between Prenatal Nicotine Exposure and Offspring's Hearing Impairment.

Objectives: The objective of this study is to evaluate whether there is an association between in-utero exposure to nicotine and subsequent hearing dysfunction.

Materials And Methods: Secondary analysis of a multicenter randomized trial to prevent congenital cytomegalovirus (CMV) infection among gravidas with primary CMV infection was conducted. Monthly intravenous immunoglobulin hyperimmune globulin therapy did not influence the rate of congenital CMV.

Association of Maternal Body Mass Index and Maternal Morbidity And Mortality.

Objective: This study aimed to assess the association of maternal body mass index (BMI) with a composite of severe maternal outcomes.

Study Design: Secondary analysis of a cohort of deliveries on randomly selected days at 25 hospitals from 2008 to 2011. Data on comorbid conditions, intrapartum events, and postpartum course were collected.

Amniocentesis to diagnose congenital cytomegalovirus infection following maternal primary infection.

Background: Congenital cytomegalovirus infection following maternal primary cytomegalovirus infection affects approximately 0.4% of newborns in the United States but may be hard to diagnose prenatally.

Objective: To evaluate the current sensitivity and specificity of amniocentesis in detecting congenital cytomegalovirus infection.

Noninvasive Prediction of Congenital Cytomegalovirus Infection After Maternal Primary Infection.

Objective: To develop and internally validate a noninvasive method for the prediction of congenital cytomegalovirus (CMV) infection after primary maternal CMV infection.

Methods: We conducted a secondary analysis of a multicenter randomized placebo-controlled trial of CMV hyperimmune globulin to prevent congenital infection. Women were eligible if they had primary CMV infection, defined as detectable plasma CMV-specific immunoglobulin (Ig)M and CMV-specific IgG with avidity less than 50% before 24 weeks of gestation or IgG seroconversion before 28 weeks, and were carrying a singleton fetus without ultrasonographic findings suggestive of CMV infection.

A Trial of Hyperimmune Globulin to Prevent Congenital Cytomegalovirus Infection.

Background: Primary cytomegalovirus (CMV) infection during pregnancy carries a risk of congenital infection and possible severe sequelae. There is no established intervention for preventing congenital CMV infection.

Methods: In this multicenter, double-blind trial, pregnant women with primary CMV infection diagnosed before 24 weeks' gestation were randomly assigned to receive a monthly infusion of CMV hyperimmune globulin (at a dose of 100 mg per kilogram of body weight) or matching placebo until delivery.

Intrapartum Fetal Heart Rate Tracing Among Small-for-Gestational Age Compared With Appropriate-for-Gestational-Age Neonates.

Objective: To compare fetal heart rate (FHR) patterns during the last hour of labor between small-for-gestational-age (SGA; birth weight less than the 10th percentile for gestational age) and appropriate-for-gestational-age (AGA; birth weight at the 10-90th percentile) neonates at 36 weeks of gestation or greater. We also compared the rate of cesarean delivery and composite neonatal morbidity among SGA and AGA newborns.

Methods: This is a secondary analysis of a randomized trial of intrapartum fetal electrocardiographic ST-segment analysis.

Incidence of early-onset sepsis in infants born to women with clinical chorioamnionitis.

Objective To determine the frequency of sepsis and other adverse neonatal outcomes in women with a clinical diagnosis of chorioamnionitis. Methods We performed a secondary analysis of a multi-center placebo-controlled trial of vitamins C/E to prevent preeclampsia in low risk nulliparous women. Clinical chorioamnionitis was defined as either the "clinical diagnosis" of chorioamnionitis or antibiotic administration during labor because of an elevated temperature or uterine tenderness in the absence of another cause.

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.

Relation between birth weight and weight and height at the age of 2 in children born preterm.

Objective: The aim of the study was to evaluate associations between fetal growth and weight at 2 years in infants born preterm using a customized approach for birth weight.

Study Design: This is a secondary analysis of a multicenter trial that included a 2-year follow-up of children born prematurely. Customized birth weight percentiles were calculated using the Gardosi model for a U.

Cytokine gene polymorphisms and length of gestation.

Objective: To estimate whether there is an association between length of gestation and gene polymorphisms that effect transcription of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), or interleukin-1β (IL-1β).

Methods: Blood for DNA analysis was collected from 834 women at high risk enrolled in a randomized, clinical trial of omega-3 fatty acid supplementation for the prevention of recurrent preterm birth. Genotyping was performed for three single nucleotide polymorphisms (SNPs), TNF-α -308, IL-6 -174, and IL-1β +3954.

Severe hydramnios and preterm delivery in association with transient maternal diabetes insipidus.

Background: Diabetes insipidus is rare in pregnancy. It is characterized by hypoosmolar polyuria and may be central, nephrogenic, or transient in etiology; the latter is presumably related to excess placental vasopresinase production. In theory, fetal effects of this endocrine condition may include hydramnios secondary to fetal polyuria.

Perioperative antibiotic prophylaxis for nonlaboring cesarean delivery.

Objective: To estimate the efficacy of antibiotic prophylaxis at the time of nonlaboring cesarean delivery in reducing postpartum infection-related complications.

Methods: We performed a secondary analysis of an observational study of cesarean deliveries performed at 13 centers from 1999-2000. Patients were included if they had cesarean delivery before labor, did not have intrapartum infection, and were not given antibiotics at delivery for reasons other than prophylaxis.

Shaking rigors in parturients.

Objective: To describe the frequency, duration and timing of shaking rigors during parturition and their associations with several clinical variables.

Study Design: A total of 467 term, singleton paturients at a single hospital over a 13-month recruitment period were observed by their labor nurses for shaking rigors. Thirteen clinical variables, including length of labor, were also recorded.

Late second trimester assessment of pyelectasis (SERP) to predict pediatric urological outcome is improved by checking additional features.

Objective: Counseling for pyelectasis in the late 2nd trimester is usually based only upon assessing the antero-posterior (AP) width of the renal pelvis. We hypothesized that checking additional features would better predict postnatal outcome.

Study Design: Ultrasound (<24 weeks gestational age (GA)) and newborn outcome data collected prospectively since 1986 were analyzed retrospectively.

Use of intrapartum antibiotics and the incidence of postnatal maternal and neonatal yeast infections.

Objectives: To estimate 1) the risk of candidiasis (neonatal thrush or breast infections or both) in nursing mother-infant pairs and 2) whether receipt of intrapartum antibiotics increases this risk.

Methods: Demographic and obstetric data were obtained at delivery, and telephone follow-up was obtained at 1 week and 1 and 3 months and recorded in the Lactation Services database, which was reviewed retrospectively. The diagnoses of thrush and breast candidiasis were based on symptoms and patient reports, as per standard clinical practice.

Predicting failed trial of labor after primary cesarean delivery.

Objective: To apply published scoring systems retrospectively to patients who had undergone a trial of labor after cesarean delivery to estimate whether there was a score at which a trial of labor should be discouraged.

Methods: Patients with 1 previous cesarean delivery who then delivered between January 1, 1998, and December 31, 1998, were studied. An investigator blinded to outcome assigned scores using 3 different scoring systems.

Outcomes after expectant management of extremely preterm premature rupture of the membranes.

Objective: This study was undertaken to assess contemporary outcomes in pregnancies managed expectantly after extremely preterm premature (< or =24 weeks) premature rupture of the membranes (EPPROM).

Study Design: We queried antepartum and ultrasound databases for patients with EPPROM. Data on pregnancy outcome and short-term neonatal outcomes were collected.

Lack of an effect of protease inhibitor use on glucose tolerance during pregnancy.

Objective: We hypothesized that HIV-positive women on protease inhibitors (PIs) would be more likely to have an elevated glucola test result than those not on PIs.

Methods: We reviewed our database of all HIV-positive pregnant women seen at our hospital. Serum glucose was measured 1 hour following a 50-g glucola load, at approximately 26-28 weeks of gestation.