PubMed Health⌕ Search

Biomedical subjects

E Capuzzo

Publications and source records attributed to E Capuzzo.

At least 37 records · Page 2Linked to original sources
PubMed1995

Effect of preterm premature rupture of membranes on neurodevelopmental outcome: follow up at two years of age.

OBJECTIVE: To evaluate the impact of preterm premature rupture of membranes on the neurodevelopmental outcome of infants, assessed at two years of age. DESIGN: A prospective observational study of surviving preterm infants born after premature rupture of membranes and of infants born after spontaneous preterm labour with intact membranes. The study was carried out in the period 1986 to 1991. SETTING: Pavia, Italy. SUBJECTS: One hundred and forty singleton infants born prematurely after premature rupture of membranes between 24 and 34 weeks of gestation and 120 controls of similar gestational age born after spontaneous preterm labour with intact membranes. MAIN OUTCOME MEASURES: Infant neurodevelopmental outcome at two-year follow up. RESULTS: After adjustment, by logistic analysis for the effect of gestational age and birthweight, infants born after premature rupture of membranes were more likely to have severe neurodevelopmental impairment (spastic tetraplegia and/or Bayley mental developmental index < 71) than controls (adjusted OR 5.75, 95% CI 1.22-27.18). Multivariate analysis of linear trend showed a statistically significant relation of duration of membrane rupture to occurrence of severe intraventricular haemorrhage, cystic periventricular leucomalacia and moderate to severe infant neurodevelopmental impairment. CONCLUSION: Infants born after prolonged premature rupture of membranes are at higher risk of subsequent moderate to severe neurodevelopmental impairment than those born after spontaneous labour with intact membranes.

Birth Weight↗
PubMed1995

The effect of work activity in pregnancy on the risk of severe preeclampsia.

The aim of this study was to evaluate the impact of type of employment and level of physical activity at work on the risk of severe preeclampsia. For this purpose, we carried out a case control study of 160 nulliparous pregnant women with severe preeclampsia and 320 normotensive nulliparous controls who received prenatal care from members of one medical staff. The type of employment and the level of physical activity sustained at work were ascertained at birth through an interview based on a standard questionnaire. The degree of physical activity at work was assessed by a 4-level activity score based on type of work, physical intensity, posture at work, and weekly working hours. In logistic regression analysis, after adjustment for potential confounders (maternal age, time of stopping work, prepregnancy body mass index, social status of the partner, history of previous abortion, and prepregnancy smoking status), clerical workers had a significantly lower risk of severe preeclampsia than women who were unemployed at the beginning of pregnancy (OR 0.53, 95% CI 0.30, 0.96). In multivariate analysis, there was a significant linear trend relating the degree of physical activity at work, to the risk of preeclampsia (likelihood chi-square = 9.38, 3 df, p = 0.002). We then restricted the analysis to women who had ever worked in pregnancy (n = 339) also adjusting for confounders, and found that clerical workers were still at significantly lower risk of severe preeclampsia than women not formally employed (OR 0.2, 95% CI 0.08, 0.49). In addition, moderate/high physical activity at work was associated with a 2-fold increase in the risk of severe preeclampsia compared to mild activity (OR 2.08, 95% CI 1.11, 3.88). We conclude that moderate to high physical activity at work seems to increase the risk of severe preeclampsia.

Adult↗
PubMed1995

Perinatal factors and 2-year minor neurodevelopmental impairment in low birth weight infants.

Perinatal factors were investigated in 53 low birth weight infants with minor neurodevelopmental dysfunction at 2-year follow-up and in 106 consecutive controls matched for gestational age and birth weight (within 100-gram intervals). The obstetrical history, as evaluated by the obstetrical optimality score, was significantly worse in the cases than in controls (obstetrical optimality score = 50.9 +/- 5.9 vs. 53.2 +/- 6.9, p = 0.019 by Mann-Whitney test). Multiple conditional logistic regression analysis showed that after adjustment for socioeconomic status and education of the mother, a low number (< 3) of prenatal visits, and a third trimester hemorrhage were the only antenatal factors significantly associated with an increased risk of minor infant neurodevelopmental impairment. Neonatal acidosis (pH < 7.2 in the first 24 h of life) and male gender were additional significant perinatal risk factors. Only a few antenatal and perinatal factors are correlated with subsequent minor neurodevelopmental impairment in low birth weight infants.

Acidosis↗
PubMed1995

Early neonatal complications after elective preterm delivery in hypertensive pregnancies.

We evaluated the rates of short-term neonatal complications, neonatal brain damage or mortality in a group of 96 singleton pregnancies complicated by hypertension and electively delivered before 36 weeks gestation. The neonatal outcome of these pregnancies was compared with that of a matched control group of 192 uneventful pregnancies delivered because of spontaneous preterm labor or premature rupture of membranes. Although the rates of acidosis, apneoic crises, bradycardia and ventilatory support were higher among cases than controls, the risk of intraventricular hemorrhage, severe brain damage (grade III-IV intraventricular hemorrhage or periventricular leucomalacia) or neonatal mortality were comparable between the two groups. Neonatal complications were more frequent among infants born to mothers with severe hypertension or severe proteinuria. In conclusion, this study has shown that short term neonatal complications after elective preterm delivery in hypertensive pregnancies are increased in comparison with low risk controls. However, these complications, which were well managed in our intensive care nursery, did not affected neonatal mortality or severe brain damage.

Acidosis↗
PubMed1995

Pregnancies complicated by idiopathic intrauterine growth retardation. Severity of growth failure, neonatal morbidity and two-year infant neurodevelopmental outcome.

We evaluated the impact of the severity of intrauterine growth retardation (IUGR) measured as the proportion of expected birth weight (birth weight x 100/median birth weight) on short-term neonatal complications and two-year infant neurodevelopmental outcome. The study was carried out on 236 singleton pregnancies complicated by idiopathic IUGR. The rates of bradycardia, respiratory distress syndrome, hypocalcemia, ventilatory support, apneic crises, transient neurologic signs and poor neonatal outcome (neonatal death or cerebral palsy) significantly correlated with the increasing severity of IUGR. In logistic regression analysis more severely growth retarded infants (< 67.5% of expected birth weight) had higher rates of bradycardia, respiratory distress syndrome, hypocalcemia and bacterial sepsis when compared with those less severely affected (84-67.5% of expected birth weight). In pregnancies complicated by idiopathic IUGR, most short-term neonatal complications are inversely related to the severity of growth failure as evaluated by the proportion of expected birth weight.

Adult↗
PubMed1995

Case-control study of maternal blood group and severe pre-eclampsia.

The relation of maternal blood group to pre-eclampsia has not been adequately studied in previous research. To investigate this relation, we conducted a case-control study of primigravidae. Data on 204 consecutive severely pre-eclamptic patients delivered pre-term and 744 controls were analysed using multivariate methods. After adjustment for the confounding effects of maternal age, social class, origin, education, pre-pregnancy weight and body mass index, and weight gain in pregnancy, we found an increased risk of pre-eclampsia for mothers with blood type AB (adjusted odds ratio = 3.07; 95% confidence interval 1.48-6.36). With respect to blood group O, A, B and Rh type, no statistically significant correlation with severe pre-eclampsia was found. Although these results should be considered with caution, they support the hypothesis of a linkage mechanism involving blood group in the inheritance of susceptibility to pre-eclampsia.

Adult↗
PubMed1995

[Genital infections as a cause of abortion in the first trimester of pregnancy. Review of the literature].

The rate of spontaneous abortion from embryo-fetal infection is believed to range from 10 to 15%. This figure, however, is likely to be underestimated because of subclinical abortions occurring at the earliest stages of gestation that go undiagnosed. The actual frequency of infections resulting in 1st trimester spontaneous abortion is therefore unknown, whereas the impact of infectious agents in the TORCH group on the pathogenesis of such event is well known, although the pathogenetic mechanisms are not well understood. A wide range of microorganisms have been isolated by several investigators from the lower genital tract of women with 1st trimester spontaneous abortion. No causative relationship of HIV-1 infection to spontaneous abortion has been established yet. The diagnosis of abortion from infection can only be made retrospectively based on histologic examination of fetal and placental tissue and isolation on culture of the infectious agent assumed to have caused infection.

Abortion, Spontaneous↗
PubMed1994

Interaction between fetal gender and risk factors for fetal growth retardation.

OBJECTIVE: Our purpose was to evaluate the interactions between fetal gender and recognized risk factors of fetal growth retardation. STUDY DESIGN: A case-control study of 530 singleton pregnancies complicated by fetal growth retardation and 782 control pregnancies with appropriately grown fetuses was conducted. Interactions were evaluated by logistic regression analysis. RESULTS: In logistic regression analysis fetal growth retardation was more frequent in female than male fetuses (odds ratio 1.39, 95% confidence interval 1.06 to 1.82). In female fetuses hypertension-related fetal growth retardation was three times more common than in males. On the other hand, a low (< 50 kg) maternal prepregnancy weight and a low (< 18) body mass index (kg/m2) were significant risk factors for fetal growth retardation in male fetuses only. Although maternal smoking in pregnancy was a significant risk factor for growth retardation in both male and female fetuses, its effect was significantly stronger in male fetuses. CONCLUSION: Fetal gender can affect the magnitude of the classic risk factors for fetal growth retardation.

Case-Control Studies↗
PubMed1994

Maternal high-risk factors and severity of growth deficit in small for gestational age infants.

The relationship between maternal risk factors and severity of fetal growth deficit was evaluated in a population of 613 small for gestational age (SGA) infants and 784 appropriately grown controls. The severity of growth deficit among SGA infants was expressed as 'fetal growth ratio' (observed/expected birthweight, where expected birthweight is the mean birthweight of the Italian population for a given gestational age). In multivariate models, preeclampsia was the only maternal high-risk factor positively correlated with a more severe growth deficit among SGA infants. Chronic cardiac or renal maternal diseases and female fetal sex were associated with mild forms of SGA, thus showing an inverse relationship with severity of growth deficit. Finally, the association between maternal smoking in pregnancy, low (< 0.2 kg/week) maternal weight gain, low (< 50 kg) pre-pregnancy weight, severe (Hb, < 8 g/dl) maternal anaemia, low education (< 6th grade), history of a previous low birthweight infant or recurrent spontaneous abortion, nulliparity and SGA was homogeneous across the severity strata of fetal growth deficit.

Anemia↗
PubMed1994

Early morbidity and neurodevelopmental outcome in low-birthweight infants born after third trimester bleeding.

Neonatal mortality, morbidity, and neurodevelopmental sequelae were compared between a consecutive series of 77 liveborn, low-birthweight (less than 2500 g) infants delivered after third trimester bleeding and 154 appropriate control infants of similar gestational age. Infants born after abruptio placentae had lower Apgar scores at 1 minute and higher rates of acidosis in comparison with control infants. In multivariate analysis, the infants in this group had higher risks of severe intraventricular hemorrhage and poor outcome (neonatal death or cerebral palsy) in comparison with control infants. In placenta previa, the infants had a higher prevalence of respiratory distress syndrome, whereas unclassified antepartum bleeding was associated with a high rate of neonatal hypoglycemia. After adjustment, by logistic regression analysis, for the effect of confounding factors (gestational age, birthweight, social class, and education of the mother), the risk of minor infant neurodevelopmental abnormalities at 2-year follow-up was increased in infants delivered after total or partial placenta previa or after unclassified antepartum bleeding. Third trimester bleeding should be considered a strong risk factor for both short-term neonatal morbidity and subsequent infant neurodevelopmental impairment in the low-birthweight infant population.

Abruptio Placentae↗
PubMed1994

Factors potentiating the smoking-related risk of fetal growth retardation.

OBJECTIVE: To estimate the risk of fetal growth retardation resulting from the interaction between maternal smoking during pregnancy and other recognized risk factors. DESIGN: Case-control study of prospectively recorded data. SETTING: Department of Obstetrics and Gynaecology, University of Pavia, Italy. SUBJECTS: Three hundred and forty-seven singleton pregnancies with diagnosis of fetal growth retardation and 694 control pregnancies with appropriately grown fetuses. RESULTS: The overall odds ratio for fetal growth retardation associated with maternal smoking was 2.87 (95% confidence interval, 2.17-3.80). In logistic models the factors which independently increased the smoking-related risk of fetal growth retardation were a male fetus, nulliparity, maternal age 20 years or less, a history of first trimester haemorrhage and low (less than 50 kg) pre-pregnancy weight. The combined effect of smoking and caffeine consumption on the risk of fetal growth retardation was found to be additive rather than multiplicative. CONCLUSIONS: Several factors can affect the risk of fetal growth retardation associated with maternal smoking. The prenatal identification of these factors could help detect subgroups of women at high risk of fetal growth retardation.

Adult↗
PubMed1994

Clinical and microbiological characteristics of symptomatic vulvovaginal candidiasis in HIV-seropositive women.

OBJECTIVES: To evaluate the clinical and microbiological characteristics of symptomatic vaginal candidiasis in Human Immunodeficiency Virus (HIV)-seropositive women attending a gynaecologic outpatient clinic for sexually transmitted diseases (STDs). DESIGN: Vaginal, rectal and oral specimens from cases and controls were cultured for Candida spp. SUBJECTS: Eighty-four consecutive HIV-seropositive and 384 HIV-seronegative women with clinical signs of vulvovaginitis. SETTING: A gynaecological out-patient clinic in Pavia, Italy. RESULTS: The overall prevalence of vaginal candidiasis was 61.9% (52/84) in the cases and 32.3% (124/384; p < .001) in the controls. After adjustment by logistic regression analysis for confounding factors (age at first intercourse, lifetime sex partners, new partner/s in the last 6 months, type of contraceptive used), HIV-seropositive patients were at higher risk for both Candida albicans (odds ratio = 2.5; 95% confidence interval 1.31-4.69; p = 0.006) and Torulopsis glabrata vaginitis (OR = 3.5; 95% CI = 1.05-11.60; p = 0.04) than controls. HIV-seropositive subjects had also increased rates of oral and rectal colonisation with Candida spp. Finally, the time to recurrence of vaginal infection was significantly shorter in HIV-seropositive patients than controls and was correlated with the severity of HIV-induced immunodepression. CONCLUSIONS: Vulvovaginal candidiasis is very common in HIV-seropositive women and its prevalence is correlated with the immunological status of the host. These patients have higher frequencies of Torulopsis glabrata vaginal infection and are more prone to recurrence than HIV-seronegative controls.

AIDS-Related Opportunistic Infections↗
PubMed1994

Two-year infant neurodevelopmental outcome after expectant management and indicated preterm delivery in hypertensive pregnancies.

BACKGROUND: To evaluate the impact of the expectant management of hypertensive disorders of pregnancy on infant neurodevelopmental outcome. METHODS: The two-year neurodevelopmental outcome of infants delivered prematurely because of complications of maternal hypertension after expectant management was compared with that of infants of uncomplicated age-matched pregnancies delivered after spontaneous preterm labor or premature rupture of membranes. RESULTS: The rate of cerebral palsy was similar between the two groups. Conditional logistic regression analysis of the matched sets showed an increased risk of minor neurodevelopmental impairment among infants delivered after severe hypertension (odds ratio (OR) = 4.0, 95% confidence interval (CI) 1.34-12.1) or preeclampsia (OR = 4.0, 95% CI = 1.61-10.2). Fetal growth retardation was not associated with increasing infant neurodevelopmental morbidity. CONCLUSIONS: Infants delivered prematurely because of preeclampsia or severe hypertension are at increased risk of later minor neurodevelopmental problems.

Cerebral Palsy↗
PubMed1994

Factors associated with abruptio placentae in preterm deliveries.

OBJECTIVE: To evaluate risk factors associated with occurrence of abruptio placentae in preterm deliveries. METHODS: Risk factors were evaluated in 55 consecutive index cases of abruptio placentae and 726 control patients delivered between 24-36 weeks' gestation. RESULTS: In logistic regression analysis abruptio placentae was associated with a low number of antenatal visits, smoking in pregnancy, hypertension, intravenous drug abuse and a history of recent abdominal trauma. Among hypertensive disorders of pregnancy, preeclampsia superimposed on chronic hypertension was associated with the highest risk of premature placental separation. Finally, there was a significant trend relating duration of premature rupture of membranes with abruptio placentae (chi-square for trend = 3.93, p = 0.047). CONCLUSIONS: Several risk factors seem strongly associated with abruptio placentae in preterm deliveries; the presence of these risk factors should dictate intensive surveillance.

Abruptio Placentae↗
PubMed1994

Cigarette smoking in pregnancy and risk of pre-eclampsia.

The relationship between smoking in pregnancy and the development of pre-eclampsia has not been well studied. Smoking habits were prospectively evaluated in 117 patients with pre-eclampsia and 468 normotensive control pregnancies. Twenty cases (17.1%) and 120 controls (25.6%) reported smoking at any time during pregnancy. In stepwise multiple logistic regression analysis, smoking in pregnancy was a significant protective factor against the occurrence of pre-eclampsia (adjusted odds ratio = 0.50; 95% confidence interval 0.28-0.80, P = 0.018). On the other hand, a history of pre-eclampsia in previous pregnancies, low (< 6th grade) educational level, a body mass index > 24 and maternal blood group AB were factors independently associated with an increased risk of pre-eclampsia. In conclusion, this study confirms that smoking in pregnancy reduces the risk of pre-eclampsia. However, the harmful consequences of smoking on pregnancy outcome far outweigh this risk reduction.

Adolescent↗