Interaction between interleukin-1 receptor 2 and Toll-like receptor 4, and cervical cytokines.

The objective was to assess the impact of genetic variation on cervical cytokine concentrations of interleukin (IL)-1α, IL-1β, IL-6, IL-8 and tumor necrosis factor alpha (TNF-α), and first, to determine if these variants interact with polymorphisms in Toll-like receptor 4 (TLR4) that were previously shown to associate with pro-inflammatory cervical cytokine concentrations, and second, to determine if findings are affected by bacterial vaginosis (BV). We examined 183 single nucleotide polymorphisms (SNPs) in 13 cytokine genes and receptors for associations with cervical cytokine levels in 188 African American and European American women. We tested for associations of gene-gene interactions between SNPs in TLR4 and cytokine gene and receptor polymorphisms with cervical pro-inflammatory cytokines.

Cervical cancer and risk for delivery of small-for-gestational age neonates.

Objective: To determine if cervical intraepithelial neoplasia grade 3 (CIN-3) and cervical cancer are associated with adverse obstetrical outcomes.

Methods: Women with diagnoses of CIN-3 and cervical cancer were first identified from the University of Pittsburgh Medical Center (UPMC) Network Cancer Registry by using respective ICD-3 codes. Identified records were then linked to the Magee Obstetrical Maternal and Infant (MOMI) database to identify women who subsequently delivered pregnancies at Magee-Womens Hospital.

Lower urinary tract symptoms in women with pelvic organ prolapse.

Introduction And Hypothesis: The objective of this study was to describe lower urinary tract symptoms (LUTS) and urinary incontinence (UI) symptoms in women with prolapse.

Methods: LUTS were measured with the urinary distress inventory (UDI) and UI symptoms with UDI and the Medical, Epidemiological and Social Aspects of Aging (MESA) in women with POPQ stage >or=I support. UI symptoms were classified as stress- or urge-only, stress-predominant or urge-predominant mixed, or mixed.

Rectal colonization by group B Streptococcus as a predictor of vaginal colonization.

Objective: The purpose of this article was to describe rectal colonization by group B Streptococcus (GBS) and its role in the prediction of vaginal colonization.

Study Design: In this prospective cohort of 1248 nonpregnant women, vaginal and rectal swabs for GBS culture were obtained at enrollment and at three 4-month intervals. Generalized estimating equations were used to identify factors that are associated with colonization.

Maternal vitamin D deficiency is associated with bacterial vaginosis in the first trimester of pregnancy.

Bacterial vaginosis (BV) is a highly prevalent vaginal infection that is associated with adverse pregnancy outcomes. Vitamin D exerts an influence on the immune system and may play a role in BV. The objective of this study was to examine the association between maternal vitamin D status and the prevalence of BV in early pregnancy.

Cervical cytokine network patterns during pregnancy: the role of bacterial vaginosis and geographic ancestry.

Few studies have examined the coordinated regulation of the extensive network of cytokines, chemokines, and growth factors involved in the immune response to bacterial vaginosis (BV) during pregnancy. We compared these patterns between women with (BV(+)) and without (BV(-)) bacterial vaginosis and between women of African and of European ancestry. This cohort included 83 Whites (28 BV(+) and 55 BV(-)) and 80 Blacks (41 BV(+) and 39 BV(-)).

First-trimester cervical inflammatory milieu and subsequent early preterm birth.

Objective: Our objective was to explore the relation between the pro- and antiinflammatory cervical cytokine balance in early pregnancy and subsequent early preterm birth.

Study Design: In this prospective cohort of 218 pregnant women who were enrolled in the first trimester, we assayed cervical concentrations of interleukin-1alpha, -1beta, -6, -4, -10, and -13. Based on these cytokines, we categorized subjects into 1 of 3 strata: high proinflammatory/low antiinflammatory, high antiinflammatory/low proinflammatory, or balanced.

Maternal and fetal Toll-like receptor 4 genotype and chorionic plate inflammatory lesions.

Objective: The objective of the study was to explore the relation between maternal and fetal genetic variation in Toll-like receptor 4 (TLR4) and chorionic plate inflammation

Study Design: In this prospective observational cohort of 109 women with singleton gestations, 13 tag single nucleotide polymorphisms (SNPs) were genotyped in the TLR4 gene. The diagnosis of chorionic plate inflammation was made by a single blinded perinatal pathologist.

Results: After adjustment for multiple comparisons, 1 maternal SNP (rs10759932) and 1 fetal SNP (rs1554973) in the TLR4 gene demonstrated highly significant association with chorionic plate inflammation.

Genetic regulation of cervical antiinflammatory cytokine concentrations during pregnancy.

Objective: The purpose of this study was to evaluate the contribution of maternal genotype to the concentration of interleukin (IL)-4, -10, and -13 in the cervix during the first trimester in the context of bacterial vaginosis and cigarette smoking.

Study Design: In this prospective cohort of 116 pregnant women, we examined 72 single nucleotide polymorphisms (SNPs) in 6 genes: IL-4, IL-4 receptor, IL-10, IL-10 receptor alpha, IL-10 receptor beta, and IL-13.

Results: Among black women, an IL-10 receptor beta SNP (rs6517158) demonstrated significant association with IL-10 concentration (P = .

Paternal race and preterm birth.

Objective: The purpose of this study was to describe the contribution of paternal race and parental racial discordance to preterm birth

Study Design: We used a US natality cohort of 2,845,686 singleton births. Race was self-reported. Preterm birth was defined as a birth at <34 weeks of gestation.

Episiotomy and increase in the risk of obstetric laceration in a subsequent vaginal delivery.

Objective: To examine whether episiotomy at first vaginal delivery increases the risk of spontaneous obstetric laceration in the subsequent delivery.

Methods: A review was conducted of women with consecutive vaginal deliveries at Magee-Womens Hospital between 1995 and 2005, using the Magee Obstetrical Maternal and Infant database. The primary exposure of interest was episiotomy at first vaginal delivery.

Racial differences in cervical cytokine concentrations between pregnant women with and without bacterial vaginosis.

We have examined the association between cervical cytokine, chemokine and growth factor concentrations with bacterial vaginosis (BV) in pregnant white and black women. A nested case-control analysis was performed to examine 28 cervical cytokine, chemokine and growth factor concentrations in 83 white women (55 with normal flora and 28 with BV) and 81 black women (39 with normal flora and 42 with BV). White women with BV had significantly lower IP10 (P=0.

Paternal race and bacterial vaginosis during the first trimester of pregnancy.

Objective: The purpose of this study was to determine the joint effects of maternal and paternal race on risk of bacterial vaginosis (BV) during the first trimester.

Study Design: In this cohort of black women and white women with singleton gestation at <13 weeks (n = 325), BV was diagnosed by vaginal pH and Gram stain.

Results: BV was less common among white women than black women.

A delicate balance: risk factors for acquisition of bacterial vaginosis include sexual activity, absence of hydrogen peroxide-producing lactobacilli, black race, and positive herpes simplex virus type 2 serology.

Background: The etiology of bacterial vaginosis (BV) is poorly understood, but better definition of the risk factors associated with its acquisition should improve our understanding of this complex disease entity.

Methods: A longitudinal cohort study of young sexually active women was conducted to identify variables associated with BV acquisition. Seven hundred seventy-three women without BV at enrollment were followed at 4-month intervals for 1 year.

Risk factors for primary and subsequent anal sphincter lacerations: a comparison of cohorts by parity and prior mode of delivery.

Objective: This study was performed to assess the effect of pregnancy, route of delivery, and parity on the risk of primary and subsequent anal sphincter laceration in women at first vaginal delivery (1st VD), vaginal birth after cesarean delivery (VBAC), or second vaginal delivery (2nd VD).

Methods: This retrospective cohort study used data from a perinatal database that included all deliveries at Magee-Womens Hospital from 1995 to 2002. Anal sphincter laceration was the primary outcome, defined as third- and fourth-degree perineal lacerations.

Host immune consequences of asymptomatic Trichomonas vaginalis infection in pregnancy.

Objective: The purpose of this study was to define the impact of asymptomatic trichomoniasis on lower genital tract neutrophil activation in pregnancy.

Study Design: In this nested cohort study, pelvic examination was performed on 65 asymptomatic pregnant women between 7 and 22 weeks' with vaginal pH > 4.4.

Colposcopically obtained images of vulvar, vaginal, and cervical epithelium for assessment of safety of intravaginal agents among normal adolescent females: comparison with in vivo exam and interobserver agreement.

Objectives: This study was designed to assess identification of epithelial abnormalities of both in vivo examination as compared with colposcopically obtained images and interobserver assessment of the same images of the lower genital tract in healthy women.

Materials And Methods: Ninety women between the ages of 14 and 21 years were recruited for a phase II trial of a vaginal Lactobacillus crispatus capsule. All women underwent a baseline and 1-week colposcopic examination.

Cervical anti-inflammatory cytokine concentrations among first-trimester pregnant smokers.

Objective: Anti-inflammatory cytokines play a role in the lower genital tract immune defense. We examined the impact of cigarette smoking in pregnancy on the detection of the 3 most important anti-inflammatory cytokines (interleukin-4, -10, and -13) in the cervix.

Study Design: One hundred fourteen gravid women from 4 to 16 weeks of gestation without bacterial vaginosis or sexually transmitted disease were queried regarding demographic factors and smoking.

Knowledge about sexually transmitted diseases in women among primary care physicians.

Objectives: Little is known about sexually transmitted disease (STD) knowledge of primary care providers. The objectives of this study were to determine the knowledge about the management of STDs among primary care physicians and to identify physician characteristics associated with possession of STD knowledge.

Study: A self-administered questionnaire was mailed to a random sample of 1600 obstetrician/gynecologists, pediatricians, family physicians, and internists practicing in Pennsylvania.

Second pregnancy outcomes following preeclampsia in a first pregnancy.

Objectives: We compared second pregnancy outcomes among women with and without preeclampsia in their first pregnancies who all had second pregnancies without preeclampsia.

Methods: One hundred thirty women with and 6148 without preeclampsia in their first pregnancies, who all had nonpreeclamptic second pregnancies, were included. Outcomes, including delivery gestational age, birthweight, small-for-gestational-age (SGA), and preterm delivery were compared.

The impact of endometrial ablation technique at a large university women's hospital.

Objective: To determine the effect of ThermaChoice uterine balloon system on the practice patterns of endometrial ablations performed at a large university-based teaching hospital.

Study Design: A retrospective chart review was conducted of 226 patients who underwent endometrial ablation. Data were analyzed to determine any change in the type and rate of ablations performed since the introduction of second-generation technologies.

Comparison of acute and subclinical pelvic inflammatory disease.

Objective: The objective of this study was to compare the demographic, clinical, and microbiologic findings in women with subclinical pelvic inflammatory disease (PID) and women with acute PID.

Study: A cross-sectional study was performed using cohorts from 2 separate studies of 1293 women at risk for PID. Most participants were recruited from emergency departments, sexually transmitted disease clinics, and family planning clinics in metropolitan centers.

Antibiotic prophylaxis and non-group B streptococcal neonatal sepsis.

Objective: To assess the effect of increased use of intravenous penicillin for group B streptococcus (Streptococcus agalactiae, GBS) antibiotic prophylaxis on non-GBS neonatal sepsis and antibiotic resistance.

Methods: We undertook a nonconcurrent cohort study. Microbiology cultures originating from infants with early-onset neonatal sepsis in our neonatal intensive care unit (NICU) from 1992 to 1999 were reviewed.

Factors associated with absence of H2O2-producing Lactobacillus among women with bacterial vaginosis.

Background: Women with bacterial vaginosis have different microbiological profiles. Our objective was to identify risk factors for an absence of H(2)O(2)-producing lactobacilli among women with bacterial vaginosis.

Methods: We performed a retrospective analysis of 947 women with bacterial vaginosis who were enrolled in prospective studies investigating vaginal colonization and genital-tract infections.

The vaginal inflammatory milieu and the risk of early premature preterm rupture of membranes.

Objective: The purpose of this study was to determine the association of vaginal pH > or =5.0 and vaginal neutrophils >5 per oil field with preterm rupture of membranes (PPROM).

Study Design: This was a secondary analysis of the Vaginal Infections and Prematurity cohort, and was comprised of 12,734 evaluable women enrolled between 23 and 26 weeks' gestation.