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At least 19 recordsLinked to original sources
PubMed1979

The changing perinatal and maternal outcome in chorioamnionitis.

Chorioamnionitis is difficult to detect clinically, but its recognition in those at risk is essential. A retrospective study of 140 patients from among 26,129 deliveries was conducted over a 2-year period. The findings suggest that in modern obstetric practice, both perinatal and maternal complications associated with chorioamnionitis (particularly sepsis) are infrequent problems. Four neonatal deaths occurred but no infants died of sepsis. There were no maternal deaths, but 38 patients developed postpartum infections. Cesarean section did not appear to improve either perinatal or maternal outcome. With the use of appropriate modern antibiotics, extraperitoneal cesarean section and cesarean hysterectomy are probably no longer indicated. Not all neonates born out of a microbiologically contaminated intrauterine environment required antibiotic therapy, however, and individualization is recommended.

Amnion↗
PubMed2025

Systems Factors Contributing to Racial/Ethnic Disparities in Maternal Health: A Systematic Review.

INTRODUCTION: Despite ongoing efforts to reduce adverse maternal outcomes, including maternal mortality and severe maternal morbidity, racial/ethnic disparities in outcomes persist in high-income countries, including the United States (US) and Canada. Limited research has examined hospital-level factors that may drive disparities and contribute to adverse outcomes. This systematic review summarizes factors within the health system contributing to adverse outcomes and racial/ethnic disparities in the US and Canada to inform future policies and practices. METHOD: We searched SCOPUS, PubMed, EBSCOhost, and ProQuest Healthcare Administration for studies that reported hospital-level factors contributing to adverse maternal outcomes and racial/ethnic disparities. The review followed a two-stage screening process. The risk of bias of the included studies was evaluated using the Mixed Methods Appraisal Tool. The System Engineering Initiative for Patient Safety (SEIPS) 2.0 framework guided the identification and categorization of factors. RESULTS: Of 2441 studies retrieved, 30 met the inclusion criteria. Twenty-eight studies were conducted in the US, and 2 were conducted in Canada. The review included 16 qualitative, 11 quantitative, and 3 mixed-methods studies. We identified 60 factors associated with different system components, including person(s) (12%), tasks (28%), tools and technology (7%), internal environment (10%), organization (28%), and external environment (15%). Shortage of resources, including staffing, poor care coordination, and discriminatory organizational practices, were key factors described in the studies. CONCLUSION: Addressing health system factors in addition to broader societal factors is important to reduce adverse outcomes and promote equity for all women and birthing persons.

Humans↗
PubMed2026

Paediatric outcomes after maternal nipocalimab for haemolytic disease of the fetus and newborn: an open-label, single-arm study.

OBJECTIVES: To describe haemolytic disease outcomes, growth, neurodevelopment and health-related quality of life (HRQoL) through 24 months of life in infants exposed to nipocalimab in pregnancies at high risk of early-onset severe haemolytic disease of the fetus and newborn (EOS-HDFN). DESIGN: A multicentre, open-label, single-arm trial. SETTING: Centres with expertise in HDFN management. PATIENTS: Pregnant individuals with previous EOS-HDFN and maternal anti-D titres &#x2265;32&#x2009;or anti-K titres &#x2265;4. INTERVENTIONS: Weekly nipocalimab (30 and/or 45 mg/kg) from 14 to 35&#x2009;gestational weeks. MAIN OUTCOME MEASURES: Infants' cord-blood alloantibody titres at birth, HDFN management, growth through 6 months, neurodevelopment (caregiver-reported Ages and Stages Questionnaire, third edition (ASQ-3)) and HRQoL assessments through 24 months of life. RESULTS: Of 13 pregnancies, 12 resulted in live births; one fetal loss occurred due to intrauterine transfusion (IUT) complications. A single simple transfusion was administered in one of seven infants delivered after a maternal nipocalimab course without IUTs, where cord blood alloantibody titres were <8. Multiple transfusions (one to seven&#x2009;simple transfusions/infant; one exchange transfusion) were administered to five infants delivered after early nipocalimab discontinuation and IUTs, with cord-blood alloantibody titres ranging from 512 to 32 768. No unusual growth patterns were observed through 6 months. No neurodevelopmental delays were identified through 24 months of life, with mean ASQ-3 domain scores within normal ranges. HRQoL outcomes were positive across physical, emotional, social and cognitive functioning. CONCLUSIONS: Maternal nipocalimab in pregnancies at high risk of EOS-HDFN may reduce adverse neonatal outcomes correlating with low cord-blood alloantibody titres, without affecting growth through 6 months, neurodevelopment or HRQoL through 24 months of life. TRIAL REGISTRATION NUMBER: NCT03842189.

Child Health↗
PubMed2026

Recurrence of peripartum cardiomyopathy in subsequent pregnancy stratified by left ventricular function: a systematic review and meta-analysis.

AIMS: Subsequent pregnancy in women with prior peripartum cardiomyopathy (PPCM) carries a risk of relapse and adverse maternal outcomes. This meta-analysis aimed to determine the recurrence of PPCM relapse and associated maternal and foetal outcomes during subsequent pregnancy, stratified by baseline (pre-subsequent pregnancy) left ventricular ejection fraction (LVEF). METHODS: A systematic review and meta-analysis was conducted in accordance with PRISMA guidelines. Nine databases were searched through June 2025 for cohort studies reporting subsequent pregnancy outcomes in women with prior PPCM, stratified as recovered (LVEF &#x2265;50%) or non-recovered (LVEF <50%) groups. Outcomes included PPCM relapse, maternal mortality, LVEF during and after pregnancy, LV recovery, symptom worsening, and obstetric/neonatal events. Risk of bias was assessed with ROBINS-E, and random-effects models were used. RESULTS: Six cohort studies comprising 266 women were included (174 in recovered group and 92 in non-recovered group). Relapse occurred in both groups with no significant difference [rate ratio (RR) 0.77, 95% CI 0.50-1.19; I2 = 3%]. Maternal mortality was significantly lower in the recovered group (1.7% vs 10.9%; RR 0.27, 95% CI 0.09-0.87; I2 = 0%). Recovered group had higher mean LVEF during subsequent pregnancy (mean difference [MD] 17.0; P < .001), higher postpartum LVEF (MD 11.69; P = .005; I2 = 84%), and greater likelihood of LV recovery (RR 2.07; P = .005; I2 = 0%). No significant differences were observed in symptom worsening or obstetric/neonatal outcomes. CONCLUSION: Recovered LVEF prior to subsequent pregnancy is associated with improved maternal outcomes, yet relapse remains common. Left ventricular ejection fraction alone is insufficient for risk stratification, and individualized multidisciplinary care is essential for all women with prior PPCM.

Female↗
PubMed2026

Magnesium sulphate for women at risk of preterm birth for neuroprotection of the fetus.

BACKGROUND: Magnesium sulphate is a common therapy in perinatal care. Its benefits when given to women at risk of preterm birth for fetal neuroprotection (prevention of cerebral palsy for children) were shown in a 2009 Cochrane review. Internationally, use of magnesium sulphate for preterm cerebral palsy prevention is now recommended practice. As new randomised controlled trials (RCTs) and longer-term follow-up of prior RCTs have since been conducted, this review updates the previously published version. OBJECTIVES: To assess the effectiveness and safety of magnesium sulphate as a fetal neuroprotective agent when given to women considered to be at risk of preterm birth. SEARCH METHODS: We searched Cochrane Pregnancy and Childbirth's Trials Register, ClinicalTrials.gov, and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) on 17 March 2023, as well as reference lists of retrieved studies. SELECTION CRITERIA: We included RCTs and cluster-RCTs of women at risk of preterm birth that assessed prenatal magnesium sulphate for fetal neuroprotection compared with placebo or no treatment. All methods of administration (intravenous, intramuscular, and oral) were eligible. We did not include studies where magnesium sulphate was used with the primary aim of preterm labour tocolysis, or the prevention and/or treatment of eclampsia. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed RCTs for inclusion, extracted data, and assessed risk of bias and trustworthiness. Dichotomous data were presented as summary risk ratios (RR) with 95% confidence intervals (CI), and continuous data were presented as mean differences with 95% CI. We assessed the certainty of the evidence using the GRADE approach. MAIN RESULTS: We included six RCTs (5917 women and their 6759 fetuses alive at randomisation). All RCTs were conducted in high-income countries. The RCTs compared magnesium sulphate with placebo in women at risk of preterm birth at less than 34 weeks' gestation; however, treatment regimens and inclusion/exclusion criteria varied. Though the RCTs were at an overall low risk of bias, the certainty of evidence ranged from high to very low, due to concerns regarding study limitations, imprecision, and inconsistency. Primary outcomes for infants/children: Up to two years' corrected age, magnesium sulphate compared with placebo reduced cerebral palsy (RR 0.71, 95% CI 0.57 to 0.89; 6 RCTs, 6107 children; number needed to treat for additional beneficial outcome (NNTB) 60, 95% CI 41 to 158) and death or cerebral palsy (RR 0.87, 95% CI 0.77 to 0.98; 6 RCTs, 6481 children; NNTB 56, 95% CI 32 to 363) (both high-certainty evidence). Magnesium sulphate probably resulted in little to no difference in death (fetal, neonatal, or later) (RR 0.96, 95% CI 0.82 to 1.13; 6 RCTs, 6759 children); major neurodevelopmental disability (RR 1.09, 95% CI 0.83 to 1.44; 1 RCT, 987 children); or death or major neurodevelopmental disability (RR 0.95, 95% CI 0.85 to 1.07; 3 RCTs, 4279 children) (all moderate-certainty evidence). At early school age, magnesium sulphate may have resulted in little to no difference in death (fetal, neonatal, or later) (RR 0.82, 95% CI 0.66 to 1.02; 2 RCTs, 1758 children); cerebral palsy (RR 0.99, 95% CI 0.69 to 1.41; 2 RCTs, 1038 children); death or cerebral palsy (RR 0.90, 95% CI 0.67 to 1.20; 1 RCT, 503 children); and death or major neurodevelopmental disability (RR 0.81, 95% CI 0.59 to 1.12; 1 RCT, 503 children) (all low-certainty evidence). Magnesium sulphate may also have resulted in little to no difference in major neurodevelopmental disability, but the evidence is very uncertain (average RR 0.92, 95% CI 0.53 to 1.62; 2 RCTs, 940 children; very low-certainty evidence). Secondary outcomes for infants/children: Magnesium sulphate probably resulted in little to no difference in severe intraventricular haemorrhage (grade 3 or 4) (RR 0.81, 95% CI 0.64 to 1.04; 6 RCTs, 6542 infants; moderate-certainty evidence) and may have resulted in little to no difference in chronic lung disease/bronchopulmonary dysplasia (average RR 0.92, 95% CI 0.77 to 1.10; 5 RCTs, 6689 infants; low-certainty evidence). Primary outcomes for women: Magnesium sulphate may have resulted in little or no difference in severe maternal outcomes potentially related to treatment (death, cardiac arrest, respiratory arrest) (RR 0.32, 95% CI 0.01 to 7.92; 4 RCTs, 5300 women; low-certainty evidence). However, magnesium sulphate probably increased maternal adverse effects severe enough to stop treatment (average RR 3.21, 95% CI 1.88 to 5.48; 3 RCTs, 4736 women; moderate-certainty evidence). Secondary outcomes for women: Magnesium sulphate probably resulted in little to no difference in caesarean section (RR 0.96, 95% CI 0.91 to 1.02; 5 RCTs, 5861 women) and postpartum haemorrhage (RR 0.94, 95% CI 0.80 to 1.09; 2 RCTs, 2495 women) (both moderate-certainty evidence). Breastfeeding at hospital discharge and women's views of treatment were not reported. AUTHORS' CONCLUSIONS: The currently available evidence indicates that magnesium sulphate for women at risk of preterm birth for neuroprotection of the fetus, compared with placebo, reduces cerebral palsy, and death or cerebral palsy, in children up to two years' corrected age. Magnesium sulphate may result in little to no difference in outcomes in children at school age. While magnesium sulphate may result in little to no difference in severe maternal outcomes (death, cardiac arrest, respiratory arrest), it probably increases maternal adverse effects severe enough to stop treatment. Further research is needed on the longer-term benefits and harms for children, into adolescence and adulthood. Additional studies to determine variation in effects by characteristics of women treated and magnesium sulphate regimens used, along with the generalisability of findings to low- and middle-income countries, should be considered.

Humans↗
PubMed2026

Maternal prior pregnancy outcome subtype and offspring cryptorchidism: A retrospective case-control study.

OBJECTIVE: To determine whether maternal prior pregnancy outcome subtype and frequency are associated with cryptorchidism in male offspring, and whether first-trimester exogenous progesterone exposure mediates any observed association. MATERIALS AND METHODS: We conducted a hospital-based retrospective case-control study of 1220 mother-son pairs (610 cryptorchidism cases; 610 controls). Maternal prior pregnancy outcome subtype was defined using a prespecified proximal-event approach based on the most recent qualifying pregnancy event before the index pregnancy: no prior pregnancy loss or termination, miscarriage, or pregnancy termination. Subtype-specific frequency was categorized as 0, 1, or &#x2265;2. Adjusted odds ratios (aORs) were estimated using multivariable logistic regression; robustness was examined using 1:1 propensity score matching with conditional logistic regression. Exploratory mediation analysis estimated indirect effects through first-trimester exogenous progesterone exposure. RESULTS: In fully adjusted models, miscarriage was associated with higher odds of cryptorchidism compared with no prior pregnancy loss or termination (aOR 1.97; 95% CI 1.26-3.09), whereas pregnancy termination was not (aOR 1.14; 95% CI 0.86-1.52). In joint subtype-frequency analyses, odds increased with the number of miscarriages (one: aOR 1.74; 95% CI 1.07-2.83; two or more: aOR 3.77; 95% CI 1.22-11.66) and were higher for two or more pregnancy terminations (aOR 1.77; 95% CI 1.10-2.84). Matched analyses were directionally consistent. Mediation analyses suggested a modest indirect effect through first-trimester progesterone exposure for the miscarriage association. CONCLUSIONS: Maternal prior miscarriage was associated with cryptorchidism in male offspring, whereas pregnancy termination showed higher odds only among women with two or more prior procedures. First-trimester exogenous progesterone exposure may account for a modest proportion of the miscarriage-cryptorchidism association.

Humans↗
PubMed2026

Exploring birth options after three or four cesarean sections in Poland: maternal and neonatal outcomes following vaginal vs repeat surgical deliveries.

OBJECTIVES: The study aimed to analyze maternal and neonatal outcomes of women with a history of three or four caesarean sections (CS) and to evaluate the feasibility and safety of vaginal birth after multiple caesarean sections (VBAC &#x2265; 3) in Polish clinical practice. MATERIAL AND METHODS: A retrospective analysis was conducted on medical records of 186 women with three or four prior CS who delivered at St. Sophia Specialist Hospital in Warsaw between 2017 and 2024. Data on delivery mode, obstetric management, complications, and neonatal outcomes were assessed. Multivariate logistic regression was applied to identify factors associated with successful VBAC. RESULTS: Of the study group, 62 women attempted trial of labour after caesarean (TOLAC), resulting in 32 successful vaginal births (success rate 53.2%). 124 women chose Elective CS. Logistic regression showed that prior vaginal birth (OR = 20.34; p = 0.008) and the use of epidural anaesthesia (OR = 22.88; p = 0.006) significantly increased the likelihood of successful VBAC. Spontaneous onset of labour showed a positive but non-significant trend (OR = 2.52; p = 0.230). The model demonstrated a classification accuracy of 77.4% and a good overall fit (Nagelkerke R&#xb2; = 0.456). Uterine rupture occurred in three cases (4.8%), while no maternal or neonatal deaths were reported. CONCLUSIONS: Vaginal birth after three or more CS may be a viable option for carefully selected women, provided it is offered in tertiary centers with immediate surgical readiness. Key predictors of success include prior vaginal birth and epidural anaesthesia. Further large-scale studies are needed to refine guidelines and inform clinical practice in this high-risk group.

Humans↗
PubMed2026

Neonatal outcomes following antenatal corticosteroid administration before planned caesarean birth at late preterm or early term (36-38 weeks' gestation): a retrospective cohort study.

OBJECTIVE: To investigate the benefits and harms associated with antenatal corticosteroids (ACS) prior to planned caesarean birth at late preterm or early term. DESIGN: Retrospective cohort study. SETTING: South Australia, Australia, 2005-2018. PATIENTS: Women with singleton pregnancies undergoing planned caesarean birth between 36+0 and 38+6 weeks' gestation. METHODS: We used routinely collected electronic maternity and neonatal data. Adjusted risk differences (aRD) with 95% CIs were calculated for neonatal and maternal outcomes. OUTCOME MEASURES: Neonatal outcomes included respiratory distress requiring oxygen, hypoglycaemia requiring glucose, neonatal unit (NNU) admission and prolonged NNU admission (&#x2265;48&#x2009;hours). RESULTS: Among the cohort of 4049 women, the proportion receiving ACS was 54.8%, 48.4% and 5.6% at 36, 37 and 38 completed weeks' gestation, respectively. ACS administration was associated with a significant reduction in respiratory distress across all gestations, with the greatest reduction seen at 36 weeks' gestation (aRD -12.5%; 95% CI -21.4% to -3.6%). At 38 weeks' gestation, ACS administration was associated with an increased risk of neonatal hypoglycaemia (aRD 5.7%; 95% CI 1.1% to 10.2%), NNU admission (aRD 5.4%; 95% CI 0.1% to 10.7%) and prolonged NNU admission (aRD 4.6%; 95% CI 0.2% to 8.9%). CONCLUSIONS: ACS administration prior to late preterm and early term planned caesarean birth was associated with reduced risk of respiratory distress. The net benefit of ACS administration before planned caesarean birth remains unclear; however, there was evidence of potential neonatal harm when birth occurred after 37 weeks' gestation.

Epidemiology↗
PubMed2026

Respiratory-onset peripartum cardiomyopathy: a systematic review of diagnostic pitfalls and clinical outcomes.

INTRODUCTION: Peripartum cardiomyopathy (PPCM) may initially present with prominent respiratory symptoms that resemble primary pulmonary disease, particularly in late pregnancy and the early postpartum period. In clinical practice, this presentation often triggers alternative diagnostic pathways, introducing delay at a time when rapid cardiac assessment is critical. Although respiratory-dominant presentations are repeatedly described across case-based and observational reports, they have not been systematically examined as a distinct diagnostic pathway within the PPCM literature. CONTENT: This PRISMA-guided systematic review synthesized evidence relating to respiratory-onset presentations of PPCM. Major databases and registers were searched comprehensively. Following screening of 589 records and full-text assessment of 145 reports, 49 studies met inclusion criteria. Twenty studies were qualitatively prioritized for narrative synthesis using ROBIS-informed methodological appraisal. Evidence was examined across diagnostic misclassification patterns, cardiopulmonary mechanisms, differential diagnoses, investigative strategies, and acute and longitudinal management considerations. SUMMARY: Respiratory-led presentations were commonly misattributed to asthma, pneumonia, pulmonary embolism, or perioperative causes, with diagnostic delay frequently reported. Across heterogeneous study designs, cardiogenic pulmonary edema with left-ventricular systolic dysfunction emerged as a recurring unifying mechanism. Early use of echocardiography, natriuretic peptides, and targeted imaging consistently aided differentiation from primary respiratory pathology. Severe clinical deterioration was often described in the context of delayed recognition. OUTLOOK: Respiratory-onset PPCM represents a high-risk diagnostic pathway rather than a discrete disease entity. Prospective registries, standardized diagnostic algorithms, and closer integration of obstetric and cardiopulmonary care are needed to refine early recognition and improve maternal outcomes.

Humans↗
PubMed1978

Haemoglobin Aic (glycohaemoglobin) in diabetic pregnancy: an indicator of glucose control and fetal size.

Haemoglobin AIc (Hb AIc), a glycohaemoglobin present in normal human blood, is elevated in glucose intolerant individuals. In non-pregnant diabetic subjects, a direct relationship has been established between per cent Hb AIc and blood and urinary glucose levels over weeks and months. In this study, Hb AIc level and mean random blood glucose concentration in the third trimester of pregnancy were found to correlate directly in 12 diabetic women without vascular disease (P less than 0.001). In this same group of women, third trimester Hb AIc levels also correlated significantly with infant birth weight (P less than 0.05) and birth weight adjusted for gestational are (P less than 0.01). Finally, third trimester mean blood glucose concentrations also correlated directly with birth weight (P less than 0.05) and adjusted birth weight (P less than 0.001). In pregnancies complicated by diabetes, rigid glucose control has been recommended to achieve optimal fetal and maternal outcomes. Hb AIc is a new tool with which to assess blood glucose control during diabetic pregnancy.

Birth Weight↗
PubMed1979

Maternal hypotension: fetal outcome in treated and untreated cases.

Within the last 3 years a prospective study on 70 pregnant women suffering from hypotension was carried out. In all these patients the endocrine placental function was examined regularly by measuring the HPL and E3 level in the maternal serum (from the 16th week of pregnancy onwards). In order to get information on the uteroplacental perfusion rate, placental flow measurements using radioisotopes were carried out. Whereas the endocrine parameters revealed no abnormality, the results of the flow measurements were significantly low in more than 80%. In 30 out of the total of 70 patients no medication was given and after termination of pregnancy the fetal outcome was investigated. The neonates of this group were significantly smaller than normal, the rate of dystrophy was considerably high. The other 40 women were subjected to a drug regimen. Depending on pressure values and type of complaints they were given a crystal suspension of deoxycorticosterone trimethylacetate intramuscularly. In this group of patients the placental perfusion rate improved significantly after medication, the fetal outcome did not differ in comparison to cases with normotension. In the light of our study we suggest that a maternal blood pressure of 110/65 and below has to be treated not only because of maternal indication, but as well because of the fetus' sake.

Birth Weight↗
PubMed1979

Long-term propranolol therapy in pregnancy: maternal and fetal outcome.

Propranolol, a beta-adrenergic blocking agent, has found an important position in the practice of medicine. Its use in pregnancy, however, is an open question as a number of detrimental side effects have been reported in the fetus and neonate. Ten patients and 12 pregnancies are reported where chronic propranolol has been administered. Five patients with serial pregnancies with and without propranolol therapy are also examined. Maternal, fetal, and neonatal complications are examined. An attempt is made to differentiate drug-related complications from maternal disease--related complications. We conclude that previously reported hypoglycemia, hyperbilirubinemia, polycythemia, neonatal apnea, and bradycardia are not invariable and cannot be statistically correlated with chronic propranolol therapy. Growth retardation, however, appears to be significant in both of our series.

Asphyxia Neonatorum↗
PubMed1978

Maternal and fetal outcome of Lamaze-prepared patients.

To determine whether Lamaze childbirth preparation is harmless, harmful, or beneficial, 500 consecutive Lamaze-prepared patients were compared to 500 hand-picked controls, matched for age, race, parity, and educational level. Lamaze preparation was found to have a significant beneficial effect in almost every obstetric preformance category. The Lamaze-oriented patients had one-fourth the number of cesarean sections and one-fifth the amount of fetal distress (P less than .005). Postpartum infection, measured both by maternal febrile morbidity and by the incidence of antibiotic use, was one-third that of the controls (P less than .005). Similarly, the "prepared" patients had fewer perineal lacerations and those that occurred were not as serious as those in the control patients (P less than .005). The control patients had three times as many cases of toxemia of pregnancy (P less than .005) and twice as many of prematurity (P less than .05).

Adult↗
PubMed2026

Perinatal depression, maternal thyroid status and fetus/infant health and development: A systematic review.

BACKGROUND: Thyroid hormones are known to influence both maternal depression and child developmental outcomes, while maternal depression independently affects child outcomes. The potential interaction between thyroid dysfunction and depression in shaping child development remains insufficiently explored. The present study addresses such interplay. METHODS: Following PRISMA 2020 and JBI guidelines, three databases were searched through December 2025 for primary studies on maternal thyroid status, perinatal depression, and child development. Risk of bias (RoB) was assessed using validated tools. Due to clinical and methodological heterogeneity, data were synthesized narratively following SWiM guidelines. RESULTS: Eleven studies were included. Beyond independent risks for preterm birth and behavioral problems, limited evidence supports a synergistic model, while most studies likely reflect the simple co-occurrence of risks. Maternal thyroid peroxidase antibodies (TPO-Ab) were associated with child externalizing problems exclusively in the presence of clinical depression. High depressive symptoms also attenuated the cognitive benefits of prenatal iodine supplementation. Thyroid status appears to function as a risk moderator rather than a mediator. However, 50% of observational studies presented high RoB, primarily due to participant attrition. CONCLUSION: Findings are still scarce to support a synergistic risk model where specific maternal thyroid parameters (i.e. thyroid autoimmunity and iodine status) may moderate the impact of depressive symptoms on child development. Despite the high RoB in half of the studies, results highlight the need for integrated screening protocols. Simultaneously assessing mental health and thyroid status may optimize risk stratification for high-risk mother-infant dyads.

Female↗
PubMed1976

Prediction of fetal outcome by urinary estriol, maternal serum placental lactogen, and alpha-fetoprotein in diabetes and hepatosis of pregnancy.

Urinary estriol, serum placental lactogen (hPL), and alphafetoprotein (AFP) levels were investigated in singleton pregnancies of 75 diabetic women and 84 women with obstetric hepatosis. Fetal distress was demonstrated in 19 diabetic patients (25%) and in 18 cases of obstetric hepatosis (21%). Low urinary estriol correctly predicted fetal distress in 26% of the cases of diabetes and in 29% of the cases of hepatosis. False pathologic readings were found in 9% of pregnancies in either group. Diabetes was associated with higher than normal hPL levels with overlap of levels between cases with fetal distress and normal outcome. hPL levels were higher than normal and correctly predicted fetal distress in 2 of 18 cases of hepatosis (11%) with no false pathologic values. In diabetes, AFP predicted fetal distress in 2 of 4 cases in which a subsequent perinatal death occurred, and 1 additional case of fetal distress. False pathologic values were found in 4% of cases. Maternal AFP levels were normal in 2 cases of closed neural tube anomalies. In cases of hepatosis, AFP gave no information. In combination, estriol and AFP determinations gave correct information in 35% of diabetic pregnancies with pernatal morbidity or death. In hepatosis, estriol and hPL pointed out 33% of the cases of fetal distress.

Estriol↗