Association of Prenatal Exposure to Maternal Drinking and Smoking With the Risk of Stillbirth.

Importance: Prenatal smoking is a known modifiable risk factor for stillbirth; however, the contribution of prenatal drinking or the combination of smoking and drinking is uncertain.

Objective: To examine whether prenatal exposure to alcohol and tobacco cigarettes is associated with the risk of stillbirth.

Design, Setting, And Participants: The Safe Passage Study was a longitudinal, prospective cohort study with data collection conducted between August 1, 2007, and January 31, 2015.

Concurrent prenatal drinking and smoking increases risk for SIDS: Safe Passage Study report.

Background: Sudden infant death syndrome (SIDS) is the leading cause of postneonatal mortality. Although the rate has plateaued, any unexpected death of an infant is a family tragedy thus finding causes and contributors to risk remains a major public health concern. The primary objective of this investigation was to determine patterns of drinking and smoking during pregnancy that increase risk of SIDS.

Home Monitoring for Fetal Heart Rhythm During Anti-Ro Pregnancies.

Background: Fetal atrioventricular block (AVB) occurs in 2% to 4% of anti-Ro antibody-positive pregnancies and can develop in <24 h. Only rarely has standard fetal heart rate surveillance detected AVB in time for effective treatment.

Objectives: Outcome of anti-Ro pregnancies was surveilled with twice-daily home fetal heart rate and rhythm monitoring (FHRM) and surveillance echocardiography.

Pregnancy and vaccines.

Vaccination during pregnancy is important for both women and their offspring; however, vaccination rates can be improved, and health care providers are in a unique position to be able to do so. This article summarizes current information on vaccinations and strategies for addressing patients' concerns related to immunization during pregnancy. Particular attention is given to influenza and tetanus, diphtheria and pertussis vaccinations.

The prevalence of urinary incontinence in American Indian women from a South Dakota tribe.

Introduction And Hypothesis: The purpose of this pilot study was to evaluate the prevalence and associated risk factors for urinary incontinence in a Northern Plains tribe of American Indian women.

Methods: The Urogenital Distress Inventory-Short Form was used to assess urinary incontinence in a sample of American Indian women from one tribe. This was a cross-sectional convenience sampling of 234 eligible participants.

Obesity in pregnancy.

More than one-third of U.S. women are obese, and the prevalence of obesity in childhood has increased.

First-trimester genetic diagnosis: a series of six cases.

A first-trimester screen consists of a nuchal translucency (NT) ultrasound measurement as well as maternal serum testing for pregnancy-associated plasma protein-A (PAPP-A) and human chorionic gonadotropin (hCG). An increased nuchal translucency (NT) thickness at 11 to 14 weeks gestational age is a common finding for Down syndrome, Trisomy 18 and cardiac defects. We present a series of six patients, four with NT measurements greater than the 95th centile, and two additional cases where the NT was normal, but maternal serum biochemical markers were unusual.

The first-trimester screen in clinical practice.

The first-trimester screen combines nuchal translucency measurement and serum levels ot PAPP-A and beta-hCG between 11 and 13 weeks gestational age which can be used to calculate the risk of fetal Trisomy 21 and 18. Although these trisomies are the most common conditions detected, recognition of increased risk for several other fetal conditions and maternal complications have also been documented. A common misconception is that requesting this test implies that the patient will automatically terminate an affected fetus.

Clinical course of a 20-month-old child diagnosed prenatally with mosaic ring chromosome 18 and monosomy 18.

We report on a 20-month-old male, diagnosed prenatally with de novo mosaic ring chromosome 18 and low level monosomy 18, who also exhibited an inherited and apparently balanced translocation between chromosomes 3 and 6. We believe this to be the first reported case of prenatally diagnosed mosaic ring chromosome 18 and monosomy 18 in which the child was carried to term. Ring chromosomes are associated with an abnormal phenotype that is dependent on the amount of material that is deleted from the p and q arms.

Annexin A5 levels in midtrimester amniotic fluid: association with intrauterine growth restriction.

Objective: The purpose of this study was to determine whether amniotic fluid levels of annexin A5 (AF-AnxA5) may be associated with intrauterine growth restriction (IUGR).

Study Design: Amniotic fluid was obtained in a cohort of pregnant patients (n = 172) undergoing amniocentesis at 15 to 24 weeks' gestation and annexin A5 (AnxA5) levels were determined with enzyme-linked immunosorbent assay (ELISA). Patients who developed IUGR were compared with the remainder of the cohort.