Abstract:
BACKGROUND:Oxytocin is a potent uterotonic agent that is widely used for induction and augmentation of labor. Oxytocin has a narrow therapeutic index and the optimal dosing for any individual woman varies widely. OBJECTIVE:The objective of this study was to determine whether genetic variation in the oxytocin receptor (OXTR) or in the gene encoding G protein-coupled receptor kinase 6 (GRK6), which regulates desensitization of the oxytocin receptor, could explain variation in oxytocin dosing and labor outcomes among women being induced near term. STUDY DESIGN:Pregnant women with a singleton gestation residing in Durham County, NC, were prospectively enrolled as part of the Healthy Pregnancy, Healthy Baby cohort study. Those women undergoing an induction of labor at 36 weeks or greater were genotyped for 18 haplotype-tagging single-nucleotide polymorphisms in OXTR and 7 haplotype-tagging single-nucleotide polymorphisms in GRK6 using TaqMan assays. Linear regression was used to examine the relationship between maternal genotype and maximal oxytocin infusion rate, total oxytocin dose received, and duration of labor. Logistic regression was used to test for the association of maternal genotype with mode of delivery. For each outcome, backward selection techniques were utilized to control for important confounding variables and additive genetic models were used. Race/ethnicity was included in all models because of differences in allele frequencies across populations, and Bonferroni correction for multiple testing was used. RESULTS:DNA was available from 482 women undergoing induction of labor at 36 weeks or greater. Eighteen haplotype-tagging single-nucleotide polymorphisms within OXTR and 7 haplotype-tagging single-nucleotide polymorphisms within GRK6 were examined. Five single-nucleotide polymorphisms in OXTR showed nominal significance with maximal infusion rate of oxytocin, and two single-nucleotide polymorphisms in OXTR were associated with total oxytocin dose received. One single-nucleotide polymorphism in OXTR and two single-nucleotide polymorphisms in GRK6 were associated with duration of labor, one of which met the multiple testing threshold (P = .0014, rs2731664 [GRK6], mean duration of labor, 17.7 hours vs 20.2 hours vs 23.5 hours for AA, AC, and CC genotypes, respectively). Three single-nucleotide polymorphisms, two in OXTR and one in GRK6, showed nominal significance with mode of delivery. CONCLUSION:Genetic variation in OXTR and GRK6 is associated with the amount of oxytocin required as well as the duration of labor and risk for cesarean delivery among women undergoing induction of labor near term. With further research, pharmacogenomic approaches may potentially be utilized to develop personalized treatment to improve safety and efficacy outcomes among women undergoing induction of labor.
journal_name
Am J Obstet Gynecoljournal_title
American journal of obstetrics and gynecologyauthors
Grotegut CA,Ngan E,Garrett ME,Miranda ML,Ashley-Koch AE,Swamy GKdoi
10.1016/j.ajog.2017.05.023subject
Has Abstractpub_date
2017-09-01 00:00:00pages
367.e1-367.e9issue
3eissn
0002-9378issn
1097-6868pii
S0002-9378(17)30632-4journal_volume
217pub_type
杂志文章abstract::Placental-related fetal growth restriction arises primarily due to deficient remodeling of the uterine spiral arteries supplying the placenta during early pregnancy. The resultant malperfusion induces cell stress within the placental tissues, leading to selective suppression of protein synthesis and reduced cell proli...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1016/j.ajog.2017.11.577
更新日期:2018-02-01 00:00:00
abstract:OBJECTIVE:Women who develop certain common pregnancy complications have a greater chance of developing cardiovascular disease (CVD) later in life. However, most health care providers do not provide postpartum cardiovascular risk counselling or follow-up. The Maternal Health Clinic was established to address this gap in...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2013.12.001
更新日期:2014-05-01 00:00:00
abstract::The accuracy of clinical diagnosis for pelvic inflammatory disease was determined in 95 women who presented with pelvic pain to primary care physicians and then were referred to gynecologists. Laparoscopy or laparotomy with endometrial biopsy and fimbrial minibiopsy revealed that prevalence of pelvic inflammatory was ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(91)90639-9
更新日期:1991-01-01 00:00:00
abstract::Performing a platelet count in fetal scalp blood was hitherto the only method to predict whether the infant of a mother with idiopathic thrombocytopenic purpura will be thrombocytopenic. Fifteen such cases are reported. Falsely low platelet counts were found in almost half of these fetal scalp samples. In two patients...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(87)80074-1
更新日期:1987-10-01 00:00:00
abstract:OBJECTIVE:Our purpose was to determine what factors occurring after digital separation of the chorionic membranes from the lower uterine segment (membrane stripping) are involved in observed clinical changes compared with patients not so treated. STUDY DESIGN:Thirty patients were randomly divided among a study populat...
journal_title:American journal of obstetrics and gynecology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0002-9378(93)90134-5
更新日期:1993-07-01 00:00:00
abstract::Two studies were performed to assess the effect of fat feeding on glucose tolerance before, during, and after gestation of BHE rats. In the first study 5% or 22% fat diets were fed from 3 weeks before mating until after gestation. In the second study, these diets were fed from weaning until 400 days of age. Glucose to...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(89)90272-x
更新日期:1989-07-01 00:00:00
abstract:OBJECTIVE:This study was undertaken to study the statistical correlation between lecithin/sphingomylein (L/S) ratio, percent phosphatidylglycerol (%PG), lamellar body count (LBC), and surfactant-to-albumin ratio (TDx-FLM(II)) in amniotic fluid (AF); and derive gestational age-specific (GA) predicted risk of neonatal re...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2005.03.080
更新日期:2005-11-01 00:00:00
abstract::Intravenous leiomyomatosis is a rare benign neoplasm that commonly grows into the pelvic veins and the inferior vena cava and, rarely, the right side of the heart. We report the first case of intravenous leiomyomatosis with cardiac involvement in a pregnant woman. The treatment of choice is surgical resection in two s...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(98)70453-3
更新日期:1998-03-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to demonstrate that daily 40-minute whole body exposure to an inhomogeneous static magnetic field (SMF) prolongs induced preterm birth (PTB) in mice. STUDY DESIGN:The murine model for PTB induction was performed by the administration of 25 μg/animal lipopolysaccharide (LPS) intr...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2011.05.012
更新日期:2011-10-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to investigate the frequency of confined placental mosaicism (CPM) in placentas from liveborn infants. STUDY DESIGN:A retrospective analysis of 51 placentas from small-for-gestational-age (SGA), live born infants (birthweight below 5th centile), and 45 placentas from normally gr...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2007.08.027
更新日期:2008-02-01 00:00:00
abstract::Histidyl proline diketopiperazine values have been established in human amniotic fluid (n = 81) and maternal serum (n = 36) throughout gestation (10 to 42 weeks). Newborn cord serum (n = 10) and first-voided fetal urine (n = 10) levels were also documented. These measurements reveal increasing amniotic fluid levels wi...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(90)90998-m
更新日期:1990-03-01 00:00:00
abstract::In the next decade many women will turn to the medical community for advice on maintaining or improving health after menopause. Estrogen replacement therapy, with or without progestins, alleviates menopausal symptoms, prevents or manages osteoporosis, and reduces the increased cardiovascular disease risk that results ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1067/mob.2001.109656
更新日期:2001-02-01 00:00:00
abstract:BACKGROUND:Vaginal agenesis in Mayer-Rokitansky-Küster-Hauser syndrome can be managed either by various surgeries or dilation. The choice still depends on surgeon's preferences rather than on quality comparative studies and validated protocols. OBJECTIVE:We sought to compare dilation and surgical management of vaginal...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ajog.2018.07.015
更新日期:2018-09-01 00:00:00
abstract:OBJECTIVE:Increasing numbers of mature women are achieving pregnancy largely through assisted reproductive technology (ART). Our objective was to investigate women over 45 years of age to determine the impact of pregnancy complications on newborn outcome. STUDY DESIGN:A study of women older than 45 years at their esti...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ajog.2004.07.035
更新日期:2005-01-01 00:00:00
abstract::Attempts were made to produce inferior vena cava (IVC) compression in 14 pregnant and 12 nonpregnant bitches. Ligation of the iliac veins, the IVC below the renal veins, or the left renal vein separately produced minimal hemodynamic disturbances. Only ligation of the two renal veins or of the IVC above the renal veins...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(78)90365-4
更新日期:1978-01-15 00:00:00
abstract:OBJECTIVE:The purpose of this study was to compare fetal middle cerebral artery peak systolic velocity with amniotic fluid delta optical density at 450 nm in the prediction of fetal anemia. STUDY DESIGN:A prospective study that involved 28 singleton pregnancies that were at-risk for fetal anemia was carried out in a t...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2003.63
更新日期:2003-01-01 00:00:00
abstract:OBJECTIVE:The study was conducted to systematically investigate previous anecdotal reports of memory decline during pregnancy. STUDY DESIGN:We used a longitudinal design to investigate memory in women throughout pregnancy and in the postpartum period. Closely matched, nonpregnant women were similarly studied at equiva...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(98)70073-0
更新日期:1998-09-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to investigate the diagnostic impact of preoperative serum p53 antibody (S-p53 Ab) in patients with endometrial cancer. STUDY DESIGN:A hospital-based series of 67 patients, comprising 58 endometrioid adenocarcinomas (EA) and 9 serous adenocarcinomas (SA) between 1998-2002 were i...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2007.04.033
更新日期:2007-11-01 00:00:00
abstract:OBJECTIVE:We sought to evaluate whether serial amnioinfusions for persistent oligohydramnios can affect the perinatal and long-term outcomes in extreme cases of preterm premature rupture of membranes. STUDY DESIGN:All singleton pregnancies with preterm premature rupture of membranes at <26 weeks' gestation and lasting...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2000.108873
更新日期:2000-10-01 00:00:00
abstract::The intervillous blood flow and other maternal hemodynamic parameters were assessed in 40 mothers with pregnancy-induced hypertension in late pregnancy before and after hypotensive treatment. Furosemide caused a significant decrease in the intervillous blood flow, whereas the effects of dihydralazine and metoprolol we...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(86)90093-1
更新日期:1986-07-01 00:00:00
abstract:OBJECTIVE:We previously demonstrated that prenatal nicotine exposure decreases neonatal pulmonary function in nonhuman primates, and maternal vitamin C supplementation attenuates these deleterious effects. However, the effect of nicotine on placental perfusion and development is not fully understood. This study utilize...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2014.12.042
更新日期:2015-03-01 00:00:00
abstract:OBJECTIVE:To determine if variation exists between ethnicities for risk of perineal, vaginal, and cervical laceration at vaginal delivery. STUDY DESIGN:Retrospective cohort study of nulliparous women who underwent vaginal delivery of a vertex presentation. Predictor variable was ethnicity with outcome variables cervic...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2004.12.007
更新日期:2005-08-01 00:00:00
abstract:OBJECTIVE:Our purpose was to describe the techniques we have developed to remove nonpalpable subcutaneous and intramuscular Norplant capsules with the patient under local anesthesia and with use of real-time ultrasonographic guidance in an office setting. STUDY DESIGN:This was a noncomparative, descriptive study of ou...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(98)70321-7
更新日期:1998-06-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to assess whether endometrial polyps (EMPs) represent cancer precursors. STUDY DESIGN:Age standardized incidence ratios (SIRs) of histologically verified endometrial cancers (EmCas) were estimated in women with EMPs and in women with uterine leiomyomata, which is a condition tha...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2010.03.036
更新日期:2010-09-01 00:00:00
abstract:OBJECTIVE:This study was designed to investigate the effects of estrogen alone or combined with two different progestins, norethindrone or norgestimate, on bone density and compressive mechanical properties in an aged rat model. STUDY DESIGN:Twenty 11-month-old female Sprague-Dawley rats were sham operated (intact con...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(95)90638-x
更新日期:1995-11-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to investigate the potential efficacy of high-intensity focused ultrasound for the treatment of uterine fibroid tumors in a nude mouse model. STUDY DESIGN:A total of 60 female athymic nude mice were inoculated subcutaneously with 3 to 5 x 10(6) ELT-3 cells, a uterine fibroid tum...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2000.105347
更新日期:2000-07-01 00:00:00
abstract:BACKGROUND:Preterm premature rupture of membranes complicates 2-3% of pregnancies. Many institutions have advocated for the use of azithromycin instead of erythromycin. This is secondary to national shortages of erythromycin, ease of administration, better side effect profile, and decreased cost of azithromycin as comp...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ajog.2019.03.009
更新日期:2019-08-01 00:00:00
abstract:OBJECTIVES:We aimed to analyze the predictive value of the fetal scalp blood lactate concentration and pH, especially in regard to outcome variables that are strong predictors of impaired long-term outcome. An additional aim was to establish cutoff lactate levels in fetal scalp blood. STUDY DESIGN:We conducted a retro...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(99)70083-9
更新日期:1999-11-01 00:00:00
abstract::Fetal plasma amino acid concentrations were obtained by cordocentesis at midgestation in 11 normal (appropriate for gestational age) fetuses and at late gestation in 12 small-for-gestational-age fetuses, and at cesarean section in 14 normal term infants. In normal fetuses total molar amino acid concentrations and feta...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(90)90860-a
更新日期:1990-01-01 00:00:00
abstract:OBJECTIVE:Our purpose was to review our results of multimodality treatment of lymph node metastasis in endometrial cancer (stage IIIC). STUDY DESIGN:All patients underwent surgical staging for endometrial cancer with complete pelvic and aortic lymphadenectomy. All macroscopic nodal metastases were resected. Patients w...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2001.115225
更新日期:2001-05-01 00:00:00