The relationship between discordant birth weight in twin pairs and the development of retinopathy of prematurity.

The association of low birth weight and development of retinopathy of prematurity (ROP) is well established for singletons; however, the association of birth weight and ROP in twins of discordant weight is understudied. Using an ROP registry, we investigated whether smaller twins were at greater risk for developing any stage ROP (stage 1 or greater in either eye) compared with their larger siblings, after adjusting for birth weight and gestational age. Discordance was defined as a birth weight difference of >25%.

Maternal obesity, gestational weight gain, and offspring adiposity: the exploring perinatal outcomes among children study.

Objective: To determine whether adequate vs excessive gestational weight gain (GWG) attenuated the association between maternal obesity and offspring outcomes.

Study Design: Data from 313 mother-child pairs participating in the Exploring Perinatal Outcomes among Children study were used to test this hypothesis. Maternal prepregnancy body mass index (BMI) and weight measures throughout pregnancy were abstracted from electronic medical records.

The long-term impact of intrauterine growth restriction in a diverse U.S. cohort of children: the EPOCH study.

Objective: To explore the long-term impact of intrauterine growth restriction (IUGR) among a diverse, contemporary cohort of U.S. children.

Long-term impact of neonatal breastfeeding on childhood adiposity and fat distribution among children exposed to diabetes in utero.

Objective: To evaluate whether breastfeeding attenuates increased childhood adiposity associated with exposure to diabetes in utero.

Research Design And Methods: Retrospective cohort study of 89 children exposed to diabetes in utero and 379 unexposed youth with measured BMI, waist circumference, skinfolds, visceral (VAT) and subcutaneous (SAT) abdominal fat. A measure of breast milk-months was derived from maternal self-report and used to categorize breastfeeding status as low (<6) and adequate (≥ 6 breast milk-months).

A descriptive evaluation of unfractionated heparin use during pregnancy.

Background: The mainstay of oral anticoagulant therapy, warfarin sodium, crosses the placenta during pregnancy and may cause fetal complications. Unfractionated heparin (UFH) and low-molecular-weight heparin (LMWH) do not cross the placenta and have demonstrated utility in the prevention and treatment of thrombosis during pregnancy.

Objectives: The purpose of this study was to review treatment strategy, indication, and maternal and fetal outcomes in anticoagulated pregnancies at Kaiser Permanente Colorado.

Intrauterine balloon tamponade in the management of postpartum hemorrhage.

This article reviews our experience with the use of intrauterine tamponade with balloon catheters in the management of severe postpartum hemorrhage. This is a case series report of 23 patients with postpartum hemorrhage unresponsive to medical therapy managed with intrauterine balloon tamponade. We identified these patients by International Classification of Diseases (ICD-9) codes and by reviewing labor and delivery logs.

Perinatal loss among twins.

Objective: We evaluated prenatal factors related to perinatal loss in twins, using medical records and death certificates, to determine the main perinatal event that contributed to babies' deaths.

Design: This was a retrospective cohort study of 550 monochorionic diamniotic or diamniotic dichorionic twins who were delivered at Kaiser Permanente Colorado between 1994 and 2001.

Main Outcome: The main outcome of the study was perinatal loss (stillbirth or neonatal death).

Increasing prevalence of gestational diabetes mellitus (GDM) over time and by birth cohort: Kaiser Permanente of Colorado GDM Screening Program.

Objective: The prevalence of gestational diabetes mellitus (GDM) varies in direct proportion with the prevalence of type 2 diabetes in a given population or ethnic group. Given that the number of people with diabetes worldwide is expected to increase at record levels through 2030, we examined temporal trends in GDM among diverse ethnic groups.

Research Design And Methods: Kaiser Permanente of Colorado (KPCO) has used a standard protocol to universally screen for GDM since 1994.

Perinatal factors and development of islet autoimmunity in early childhood: the diabetes autoimmunity study in the young.

The objective of this study was to test whether maternal age at delivery, child's birth order, cesarean section, complicated delivery, maternal smoking during pregnancy, or neonatal jaundice predict islet autoimmunity in children at genetically increased risk of type 1 diabetes in a birth cohort with blood draws at ages 9, 15, and 24 months and yearly thereafter. Newborns with diabetes-associated human leukocyte antigen genotypes (n = 938) and offspring or siblings of persons with type 1 diabetes (n = 428) from the Denver, Colorado, metropolitan area were examined from January 1994 to February 2003. Information on perinatal factors was collected by using questionnaires soon after the birth.

Experimental intrauterine infection with Prevotella bivia in New Zealand White rabbits.

Objective: The purpose of this study was to develop a model of chronic intrauterine and fetal infection with Prevotella bivia, an anaerobe of the lower genital tract that is associated often with bacterial vaginosis.

Study Design: Thirty timed pregnant New Zealand White rabbits on gestational day 21 were inoculated with P bivia or saline solution in a planned ratio of 4:1 (24 P bivia: 6 saline solution). Rabbits were inoculated 6 cm transcervically with 10(5) to 10(8) colony-forming units/uterine horn of P bivia or with saline solution.

The contribution of assisted conception, chorionicity and other risk factors to very low birthweight in a twin cohort.

Objectives: To investigate the contribution of assisted conception (assisted reproductive technology and ovulation induction), chorionicity and selected maternal risk factors for very low birthweight.

Design: Retrospective twin cohort study.

Setting: Staff model Colorado Health Maintenance Organization.

Chronic intrauterine and fetal infection with Gardnerella vaginalis.

Objective: We sought to develop a model of chronic intrauterine and fetal infection with Gardnerella vaginalis.

Study Design: The uterine horns of pregnant New Zealand White rabbits were inoculated on day 21 of gestation with either 10(7) colony-forming units (cfu) of G vaginalis or saline solution. At necropsy, cultures were taken from blood, uterus, amniotic fluid, and fetal tissues.

Preeclampsia in multiple gestation: the role of assisted reproductive technologies.

Objective: To estimate the relationship of assisted reproductive technologies and ovulation-inducing drugs with preeclampsia in multiple gestations.

Methods: This historical cohort study was conducted on 528 multiple gestations from a Colorado health maintenance organization. Using univariate and logistic regression analysis, we determined if women who conceived a multiple gestation as a result of assisted conception were at a greater risk of preeclampsia than those who conceived spontaneously.

Chronic intrauterine infection and inflammation in the preterm rabbit, despite antibiotic therapy.

Objective: In a pregnant rabbit model using intracervical inoculation of Escherichia coli with delayed antibiotic therapy, we investigated the rate of positive cultures and histologic inflammation of maternal and fetal compartments and the concentration of tumor necrosis factor-alpha in the amniotic fluid for up to 5 days.

Study Design: New Zealand White rabbits at 70% gestation were inoculated intracervically with 10(3) - 10(4) colony-forming units of E coli per uterine horn. At varying intervals after inoculation (0.