Abstract:
BACKGROUND:Data regarding pregnancy outcomes in sickle cell disease are conflicting. Previous studies are limited by small sample size, narrow geographic area, and a wide range of resource availability. OBJECTIVE:The purpose of this study was to examine the association between maternal sickle cell disease and adverse pregnancy outcomes in a contemporary North American cohort. STUDY DESIGN:We performed a retrospective cohort study of 2,027,323 women with singleton pregnancies delivered in California from 2005-2008. Deliveries at <24 or >42 6/7 weeks of gestation were excluded. Women with sickle cell disease were compared with control subjects. Maternal outcomes of interest included preeclampsia, preterm delivery, placental abruption, oligohydramnios, and cesarean delivery; neonatal outcomes included small for gestational age, anomalies, stillbirth, neonatal death, and infant death. RESULTS:The prevalence of sickle cell disease was 0.017%. Compared with control subjects, women with sickle cell disease were more likely to have limited prenatal care (7.4 vs 3.8%; P=.001), underlying chronic hypertension (2.3% vs 1.1%; P=.038), and fetal anomalies (14.0 vs 6.4%; P<.001). The increased odds of fetal anomalies persisted after adjustment for multiple confounders (odds ratio, 1.73; 95% confidence interval, 1.26-2.38). Women with sickle cell disease also had higher odds of severe preeclampsia (odds ratio, 3.75; 95% confidence interval, 2.21-6.38), preterm delivery (odds ratio, 2.50; 95% confidence interval, 1.93-3.21), small for gestational age (odds ratio, 1.96; 95% confidence interval, 1.18-3.25), and cesarean delivery (odds ratio, 1.93; 95% confidence interval, 1.40-2.67). CONCLUSION:Women with sickle cell disease are at high risk of maternal and neonatal morbidity. Low rates of fetal and neonatal death may reflect improved antenatal surveillance and management as compared with previous studies. The association between sickle cell disease and fetal anomalies warrants further investigation.
journal_name
Am J Obstet Gynecoljournal_title
American journal of obstetrics and gynecologyauthors
Kuo K,Caughey ABdoi
10.1016/j.ajog.2016.05.032subject
Has Abstractpub_date
2016-10-01 00:00:00pages
505.e1-5issue
4eissn
0002-9378issn
1097-6868pii
S0002-9378(16)30246-0journal_volume
215pub_type
杂志文章abstract:OBJECTIVE:This study explores decisional processes regarding termination of pregnancy because of Down syndrome and aims to identify possibilities for improving counseling. STUDY DESIGN:Seventy-one women completed questionnaires 4 months after termination of pregnancy for Down syndrome, including motivations for the de...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2006.09.013
更新日期:2007-02-01 00:00:00
abstract::Sixty-one percent of refractory vulvodynia patients evaluated in a tertiary care vulvovaginal clinic had clinically relevant dermatoses based on dermatopathologist-analyzed vulvar biopsy including: lichen sclerosus, allergic/irritant dermatitis, lichen planus, and other inflammatory or neoplastic dermatoses. Given the...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2008.03.004
更新日期:2008-11-01 00:00:00
abstract:OBJECTIVE:Women with Papanicolaou tests classified as cervical intraepithelial neoplasia grade I or II are treated conservatively in many countries. However, these women are at an increased risk of having underlying prevalent and incident grade III cervical intraepithelial neoplasia and invasive cancer. This study was ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2002.118918
更新日期:2002-01-01 00:00:00
abstract::A sensitive and specific double antibody radioimmunoassay for gonadotropin-releasing hormone (GnRH) has been developed for measurement in ethanol extracts of human plasma. Iodinated hormone was prepared with the use of the chloramine-T method, and antibodies were developed in rabbits over a six-month period with a GnR...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(76)90090-9
更新日期:1976-02-15 00:00:00
abstract:OBJECTIVE:The objective of this study was to determine the efficacy of 3 previously described ovarian cancer serum biomarkers (apolipoprotein-1 [ApoA-I], prealbumin [TTR], transferrin [TF]) in the detection of endometrioid and papillary serous adenocarcinoma of the endometrium. STUDY DESIGN:ApoA-I, TTR, and TF levels ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2009.07.049
更新日期:2010-01-01 00:00:00
abstract:BACKGROUND:Medical school graduates should be able to enter information from patient encounters and to write orders and prescriptions in the electronic health record. Studies have shown that, although students often can access electronic health records, some students may receive inadequate preparation for these skills....
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2020.02.004
更新日期:2020-09-01 00:00:00
abstract:OBJECTIVE:The objective of the Sleep Disordered Breathing substudy of the Nulliparous Pregnancy Outcomes Study Monitoring Mothers-to-be (nuMoM2b) is to determine whether sleep disordered breathing during pregnancy is a risk factor for adverse pregnancy outcomes. STUDY DESIGN:NuMoM2b is a prospective cohort study of 10...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ajog.2015.01.021
更新日期:2015-04-01 00:00:00
abstract:OBJECTIVE:The prototype of surgical treatment for vulvar vestibulitis has been the Woodruff vulvoplasty. A simpler surgery could be less morbid, technically easier, and equally effective. STUDY DESIGN:Twelve patients underwent vestibular revision, nine with local anesthesia. They were followed up for between 6 months ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(96)70200-4
更新日期:1996-06-01 00:00:00
abstract::Decisions in regard to the management of patients with premature rupture of the membranes depend on the relative risks of prematurity, infection, and hypoxia for the fetus or neonate and infection and cesarean section for the mother. These risks vary primarily with gestational age. Because of the many variables and ne...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(85)90369-2
更新日期:1985-04-15 00:00:00
abstract::Among a large series of high-risk patients who had direct electronic monitoring, 330 fetuses presented "variable" decelerations and 598 had no decelerations. Among those with variable decelerations, there were 18 who presented such associated fetal heart rate (FHR) alterations as tachycardia, fixed baseline, and slow ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(78)80014-3
更新日期:1978-12-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to determine the risk of cumulative cervical intraepithelial neoplasia (CIN) grade 2 or 3 according to initial colposcopy and directed biopsy results among women with low-grade squamous intraepithelial lesions (LSIL) or human papillomavirus (HPV) DNA positive atypical squamous ce...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2003.461
更新日期:2003-06-01 00:00:00
abstract:OBJECTIVE:Pertussis causes significant morbidity among adults, children, and especially infants. Since 2006, pertussis vaccination has been recommended for women after delivery. We conducted a prospective, controlled evaluation of in-hospital postpartum pertussis vaccination of birth mothers from October 2009 through J...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2013.09.043
更新日期:2014-03-01 00:00:00
abstract:OBJECTIVE:We undertook this investigation to explore the effects of ethanol exposure on nitric oxide synthase levels and nitric oxide release. Our hypothesis was that ethanol exposure modifies nitric oxide activity within the placenta as a result of oxidative stress. STUDY DESIGN:Four 10-g samples of term normal human...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2000.104201
更新日期:2000-03-01 00:00:00
abstract:OBJECTIVE:Before parturition are there useful and valid predictors of successful or unsuccessful vaginal birth after previous cesarean birth that could be used to enhance the obstetric care of a patient and her pregnancy? STUDY DESIGN:The clinical course and outcome of all patients who attempted vaginal birth after ce...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(92)91572-r
更新日期:1992-06-01 00:00:00
abstract::In November, 1978, the fetal heart rate nonstress test (NST) was instituted as the primary screening procedure for the evaluation of fetal well-being at Vanderbilt University Hospital. The results of the first 1,000 patients tested are presented. The stillborn rate within 8 days of a reactive NST was 6.4 per 1,000, wi...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(16)32583-2
更新日期:1981-09-15 00:00:00
abstract::Sixty patients with chronic pelvic pain were monitored after diagnostic laparoscopy had excluded obvious pelvic pathology. Six months after the procedure only two patients described their symptoms as unchanged or worse. Treatment should be limited to the minority of patients whose symptoms remain 6 months after laparo...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(92)91343-9
更新日期:1992-03-01 00:00:00
abstract:BACKGROUND:Maternal mortality ratios (MMR) appear to have increased in the United States over the last decade. Three potential contributing factors are (1) a shifting maternal age distribution, (2) changes in age-specific MMR, and (3) the addition of a checkbox indicating recent pregnancy on the death certificate. OBJ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2017.04.042
更新日期:2017-09-01 00:00:00
abstract:OBJECTIVE:We sought to evaluate the accuracy of a novel system for measuring fetal heart rate (FHR) and ST-segment changes using noninvasive electrodes on the maternal abdomen. STUDY DESIGN:Fetal electrocardiograms were recorded using abdominal sensors from 32 term laboring women who had a fetal scalp electrode (FSE) ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2011.02.066
更新日期:2011-07-01 00:00:00
abstract::Uterine fibroids are common in women of reproductive age and can have a significant impact on quality of life and fertility. Although a number of international obstetrics/gynecology societies have issued evidence-based clinical practice guidelines for the management of symptomatic uterine fibroids, many of these guide...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1016/j.ajog.2017.12.206
更新日期:2018-06-01 00:00:00
abstract:OBJECTIVE:Gastroschisis is increasing in many countries, especially among young women. Because young women may have inadequate nutrition, we assessed the relationship between individual nutrients and the risk for gastroschisis. STUDY DESIGN:We analyzed data from the National Birth Defects Prevention Study, a populatio...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2010.12.053
更新日期:2011-05-01 00:00:00
abstract::In Finland an organized mass screening program covers the total female population. Based on the material (429,832) from a nationwide mass screening registry it was estimated that the female population not subjected to electrocoagulation of the uterine cervix (362,511) had a sixfold risk of frankly invasive carcinoma, ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(78)90115-1
更新日期:1978-07-01 00:00:00
abstract:OBJECTIVE:Our aim was to assess the association between loop electrosurgical excision procedure (LEEP) and the subsequent risk for spontaneous preterm delivery, with the use of population-based data from various nationwide registries. STUDY DESIGN:The study population consisted of all singleton deliveries in Denmark d...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2009.02.004
更新日期:2009-07-01 00:00:00
abstract:BACKGROUND:Although preterm birth <37 weeks' gestation is the leading cause of neonatal morbidity and mortality in the United States, the majority of data regarding preterm neonatal outcomes come from older studies, and many reports have been limited to only very preterm neonates. Delineation of neonatal outcomes by de...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2016.01.004
更新日期:2016-07-01 00:00:00
abstract::One hundred twenty preterm newborns less than 34 weeks' gestational age have been studied prospectively to determine the frequency of fetal and newborn metabolic acidosis and to examine the relationship of metabolic acidosis to periventricular leukomalacia as demonstrated by serial newborn ultrasonographic examination...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(90)91299-r
更新日期:1990-04-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to assess the role of cervical ultrasonography in the prediction of spontaneous preterm birth in triplet gestations and to compare various ultrasonographic cervical parameters with respect to predictive ability. STUDY DESIGN:This prospective cohort study included 51 triplet gestatio...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2000.108875
更新日期:2000-11-01 00:00:00
abstract::A case of fetal exsanguination after midtrimester genetic amniocentesis is reported. Examination of the ration of fetal-to-meternal red cells in the amniotic fluid obtained by amniocentesis for genetic study from 242 consecutive patients, including the reported case, suggests that fetal hemorrhage is relatively common...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(77)90812-2
更新日期:1977-09-01 00:00:00
abstract::Endometrial adenocarcinomas from 96 patients were studied for their biochemical estrogen receptor content as well as immunohistochemical localization of estrogen receptor. A well-characterized specific monoclonal antihuman estrogen receptor antibody (H222 sp gamma) as amplified by peroxidase/antiperoxidase techniques ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(87)80090-x
更新日期:1987-10-01 00:00:00
abstract:OBJECTIVE:Our purpose was to examine the hypothesis that hysterectomy without adnexectomy after tubal interruption is associated with the development of hydrosalpinx. STUDY DESIGN:In this case-control study, patients with a pathologic diagnosis of hydrosalpinx were compared with a group of patients undergoing adnexect...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2002.130212
更新日期:2002-12-01 00:00:00
abstract::Our present knowledge of the role of sex steroids in the development as well as the prevention of endometrial cancer is reviewed. Factors which increase the exposure of the uterus to unopposed estrogens, either exogenous or endogenous, are associated with increased risk of endometrial adenocarcinoma. However, there is...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1016/0002-9378(83)91014-1
更新日期:1983-07-15 00:00:00
abstract:OBJECTIVE:The objective of this study was to test the hypothesis that cocaine alters placental prostaglandin production in vitro. STUDY DESIGN:Placentas were obtained from healthy women (n = 6) after normal vaginal delivery at term. Placental explants (300 mg) were incubated in duplicate at 37 degrees C in the presenc...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(94)90015-9
更新日期:1994-10-01 00:00:00