Abstract:
BACKGROUND:The American Heart Association's formal characterization of cardiovascular health combines several metrics in a health-oriented, rather than disease-oriented, framework. Although cardiovascular health assessment during pregnancy has been recommended, its significance for pregnancy outcomes is unknown. OBJECTIVE:The purpose of this study was to examine the association of gestational cardiovascular health-formally characterized by a combination of 5 metrics-with adverse maternal and newborn outcomes. STUDY DESIGN:We analyzed data from the Hyperglycemia and Adverse Pregnancy Outcome study, including 2304 mother-newborn dyads from 6 countries. Maternal cardiovascular health was defined by the combination of the following 5 metrics measured at a mean of 28 (24-32) weeks' gestation: body mass index, blood pressure, lipids, glucose, and smoking. Levels of each metric were categorized using pregnancy guidelines, and the total cardiovascular health was scored (0-10 points, where 10 was the most favorable). Cord blood was collected at delivery, newborn anthropometrics were measured within 72 hours, and medical records were abstracted for obstetrical outcomes. Modified Poisson and multinomial logistic regression were used to test the associations of gestational cardiovascular health with pregnancy outcomes, adjusted for center and maternal and newborn characteristics. RESULTS:The average age of women at study exam was 29.6 years old, and they delivered at a mean gestational age of 39.8 weeks. The mean total gestational cardiovascular health score was 8.6 (of 10); 36.3% had all ideal metrics and 7.5% had 2+ poor metrics. In fully adjusted models, each 1 point higher (more favorable) cardiovascular health score was associated with lower risks for preeclampsia (relative risk, 0.67 [95% confidence interval, 0.61-0.73]), unplanned primary cesarean delivery (0.88 [0.82-0.95]), newborn birthweight >90th percentile (0.81 [0.75-0.87]), sum of skinfolds >90th percentile (0.84 [0.77-0.92]), and insulin sensitivity <10th percentile (0.83 [0.77-0.90]). Cardiovascular health categories demonstrated graded associations with outcomes; for example, relative risks (95% confidence intervals) for preeclampsia were 3.13 (1.39-7.06), 5.34 (2.44-11.70), and 9.30 (3.95-21.86) for women with ≥1 intermediate, 1 poor, or ≥2 poor (vs all ideal) metrics, respectively. CONCLUSION:More favorable cardiovascular health at 24 to 32 weeks' gestation was associated with lower risks for several adverse pregnancy outcomes in a multinational cohort.
journal_name
Am J Obstet Gynecoljournal_title
American journal of obstetrics and gynecologyauthors
Perak AM,Lancki N,Kuang A,Labarthe DR,Allen NB,Shah SH,Lowe LP,Grobman WA,Scholtens DM,Lloyd-Jones DM,Lowe WL Jr,Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study Cooperative Research Group.doi
10.1016/j.ajog.2020.07.053subject
Has Abstractpub_date
2020-08-05 00:00:00eissn
0002-9378issn
1097-6868pii
S0002-9378(20)30828-0pub_type
杂志文章abstract:BACKGROUND:Pelvic organ prolapse is common, but the underlying etiologies are poorly understood, which limits our current prevention and treatment options. OBJECTIVE:Our primary objective was to compare the uterosacral ligament histologic features in women with and without prolapse using the novel pelvic organ prolaps...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2020.10.040
更新日期:2021-01-01 00:00:00
abstract:OBJECTIVE:Our objective was to evaluate women with clinical signs or chemical evidence of androgen excess by corticotropin stimulation testing. STUDY DESIGN:Seventy-six women with evidence of androgen excess were evaluated by corticotropin stimulation testing. Results were examined by plasma levels of dehydroepiandros...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(11)91406-9
更新日期:1992-08-01 00:00:00
abstract::The objective of this study was to evaluate the impact of an interdisciplinary team-training program in obstetric emergencies on identifying unsupportive institutional policies and systems-based practices. We implemented a qualitative study design with a purposive sample of interdisciplinary physicians, nurses, and an...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2011.02.022
更新日期:2011-10-01 00:00:00
abstract::One hundred ninety-nine female patients with candidal vulvovaginitis were included in an open, randomized, mycologically controlled study carried out at three Dutch gynecologic clinics to determine the efficacy and tolerability of a single vaginal tablet containing 500 mg clotrimazole in comparison with a 6-day treatm...
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/s0002-9378(85)80008-9
更新日期:1985-08-01 00:00:00
abstract::We have investigated the effect of 17beta-estradiol on lung surfactant production in the fetal rabbit. Pregnant rabbits were administered intramuscularly 75microgram of 17beta-estradiol per day at 25 and 26 days' gestation. Control rabbits were similarly injected with the solvent only. At 27 days' gestation the fetuse...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(79)90479-4
更新日期:1979-01-15 00:00:00
abstract::Transferrin receptors have been identified on the villous trophoblast of normal chorionic villi by immunohistochemical techniques. The current study investigated the expression of transferrin receptors on molar chorionic villi by using a monoclonal antibody in immunofluorescence assays. The villous trophoblast of mola...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(85)90438-7
更新日期:1985-01-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to evaluate maternal alloimmunization to paternal leukocytes as a treatment for hemolytic disease of the fetus/newborn in a rabbit model. STUDY DESIGN:Twelve does and paired red blood cell-incompatible bucks underwent the experimental protocol. Fetal hematologic parameters that ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2002.126960
更新日期:2002-10-01 00:00:00
abstract::Vasa previa is a rare accident in obstetrics with high fetal mortality. There are simple tests available to distinguish fetal from maternal blood. Recently it has been called into medicolegal question whether patients with third-trimester bleeding need to be tested for fetal bleeding. We surveyed 100 community hospita...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(87)90016-0
更新日期:1987-06-01 00:00:00
abstract:OBJECTIVE:The objective of the study was to investigate whether performing an amniocentesis increased mother-to-child transmission of human immunodeficiency virus (HIV)-1 (MTCT). STUDY DESIGN:We studied HIV -1 infected mothers and their children enrolled in the multicenter French Perinatal HIV Cohort from 1985 to 2006...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2008.08.049
更新日期:2009-02-01 00:00:00
abstract:OBJECTIVE:To test the hypothesis that amniotic fluid volume is increased in aquaporin 1 knockout mice. STUDY DESIGN:Transgenic mice deficient in aquaporin 1 protein were generated by targeted gene disruption, as described previously. After a cesarean section was performed, intact, individual gestational sacs were remo...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2005.02.046
更新日期:2005-06-01 00:00:00
abstract:OBJECTIVE:We measured the concentrations of plasma P selectin (or GMP-140) and glycocalicin in preeclamptic and eclamptic women. Correlations between these two parameters and blood pressures, platelet counts, or plasma thrombin-antithrombin complex values were evaluated. STUDY DESIGN:By use of enzyme-linked immunosorb...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(96)70407-6
更新日期:1996-01-01 00:00:00
abstract:OBJECTIVE:Our purpose was to compare three techniques in their ability to decrease anxiety induced by the pelvic examination among children of different races. STUDY DESIGN:Eighty-nine subjects between 3 and 8 years old of white, African-American, and Hispanic race or ethnicity were randomly assigned to one of three d...
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/s0002-9378(98)70341-2
更新日期:1998-06-01 00:00:00
abstract:OBJECTIVE:The recommendation to perform a perimortem cesarean delivery within 4 minutes of maternal cardiac arrest was introduced in 1986. This recommendation was based on the assumptions that cardiopulmonary resuscitation is ineffective in the third trimester because of aortocaval compression, and that fetal and perha...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1016/j.ajog.2005.02.038
更新日期:2005-06-01 00:00:00
abstract::We have extended our evaluation of the effects of three beta-adrenergic agents in near-term pregnant sheep to include a period of infusion three times longer than previously studied. This extension has provided the following information: (1) Initial depression of uterine blood flow and mean arterial pressure associate...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(77)90708-6
更新日期:1977-08-01 00:00:00
abstract::Color Doppler imaging could easily and rapidly detect the absence of an umbilical artery, despite the presence of oligohydramnios in one case and multiple cord loops involving a normal cord in the other case. In the third case, which on gray-scale imaging appeared as an indeterminate cystic structure of the cord, colo...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(89)90663-7
更新日期:1989-11-01 00:00:00
abstract::Two hundred seventy-eight high-risk patients were managed by a comprehensive assessment of the anatomic, biochemical, and functional environment of the fetoplacental unit utilizing predetermined guidelines. Decisions to terminate pregnancy were reserved for patients who demonstrated a positive OCT. Perinatal outcome i...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(79)90835-4
更新日期:1979-07-01 00:00:00
abstract::Postpartum ultrasonographic examination of a patient with a retained placenta showed findings consistent with placenta accreta. The diagnosis was confirmed after surgery with histopathologic examination of the uterus. This case illustrates the possible clinical application of ultrasonography in the postpartum diagnosi...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(11)91557-9
更新日期:1992-09-01 00:00:00
abstract:OBJECTIVE:In about 3% to 4% of all pregnancies at term, the fetal presentation will be noncephalic. External cephalic version (ECV) at term has been shown to decrease the rate of noncephalic presentation at birth and to decrease the rate of cesarean section associated with breech presentation. However, success rates fo...
journal_title:American journal of obstetrics and gynecology
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1067/mob.2003.442
更新日期:2003-07-01 00:00:00
abstract:OBJECTIVE:The objective of the study was to describe the assessment of lower segment uterine scar (LSCS) by transvaginal ultrasound (TVUS) during a first-trimester scan. STUDY DESIGN:Patients with a history of LSCS were prospectively enrolled over a 6 month period. Four groups were defined: type 1A, thin scar within c...
journal_title:American journal of obstetrics and gynecology
pub_type: 临床试验,杂志文章
doi:10.1016/j.ajog.2011.06.104
更新日期:2011-12-01 00:00:00
abstract::Progeny of women, whose thyroid function was studied gestationally, had psychological and/or neurologic examinations at 8 months, 4 years and 7 years of age. In more than 100 pregnancies (at least 3 per cent of total pregnancies) hypothyroxinemia occurred and was treated adequately or inadequately. Children were deliv...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1976-08-01 00:00:00
abstract::In recent years numerous articles have reported on the inaccuracies of the dilatation and curettage procedure, citing a false-negative rate of up to 10% to 15%. Indeed, several articles have reported that, in this era of simplified endoscopy, the blind dilatation and curettage should no longer play a significant role ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(88)90367-5
更新日期:1988-06-01 00:00:00
abstract:OBJECTIVE:Pregnancies complicated by gestational diabetes mellitus (GDM) or preexisting diabetes mellitus (DM) are at high risk for adverse newborn outcomes. Whether GDM history, recurrence, or transition to DM modifies such risks is unknown. STUDY DESIGN:Medical record data on 62,013 repeat singleton pregnancies were...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2013.12.026
更新日期:2014-05-01 00:00:00
abstract::Crude glycosaminoglycan preparations were isolated from acetone-powder of first-, second-, and third-trimester human placentas. Glycosaminoglycan composition was examined by electrophoresis and densitometric scanning before and after treatment with testicular hyaluronidase and chondroitinase ABC. Hexosamines were dete...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(16)32733-8
更新日期:1980-12-01 00:00:00
abstract:OBJECTIVE:Recent randomized trials comparing total laparoscopic hysterectomy (TLH) and vaginal hysterectomy (VH) have produced conflicting results. The role of TLH in women suitable for VH remains uncertain. STUDY DESIGN:This study was a metaanalysis of randomized studies comparing TLH and VH for benign disease. Poole...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,meta分析
doi:10.1016/j.ajog.2010.12.059
更新日期:2011-05-01 00:00:00
abstract:OBJECTIVE:The objective of the study was to establish predictors of vaginal twin birth and evaluate perinatal morbidity according to mode of delivery. STUDY DESIGN:One thousand twenty-eight twin pregnancies were prospectively recruited. For this prespecified secondary analysis, obstetric characteristics and a composit...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2011.05.033
更新日期:2011-09-01 00:00:00
abstract:OBJECTIVE:Estrogen receptor-positive cancers that initially respond to hormone therapy often progress to a resistant state. The breast cancer cell line T47Dco is a model for such resistance. It is a polymorphic line, composed of multiple cell populations that demonstrate the presence of mutant estrogen receptors by clo...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(11)90590-0
更新日期:1992-04-01 00:00:00
abstract::Luteal phase deficiency is thought to be a cause of female infertility. Nevertheless, little agreement exists concerning either its diagnosis or its treatment. To address the latter question, we reviewed the English literature and examined the effect of treatment on pregnancy rates. One randomized controlled trial fou...
journal_title:American journal of obstetrics and gynecology
pub_type: 临床试验,杂志文章,随机对照试验,评审
doi:10.1016/s0002-9378(11)91724-4
更新日期:1992-11-01 00:00:00
abstract:BACKGROUND:The effect of maternal mood disorders on neonatal measurements is not well-defined. The Fetal Growth Studies-Singletons provide a unique opportunity to evaluate the relationship between perceived maternal stress and neonatal growth measurements. OBJECTIVE:The purpose of this study was to determine whether p...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ajog.2017.02.039
更新日期:2017-07-01 00:00:00
abstract:BACKGROUND:The Apgar score is universally used for fetal assessment at the time of birth, whereas, the collection of fetal cord blood gases is performed commonly in high-risk situations or in the setting of Apgar scores of <7, which is a less standardized approach. It has been well-established that neonatal acidemia at...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2016.05.035
更新日期:2016-10-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to determine the accuracy of clinical assessment of paravaginal defects in women with anterior vaginal wall prolapse. STUDY DESIGN:A retrospective chart review of all women undergoing surgery for anterior vaginal wall prolapse during the years of 1994 to 1996 identified operat...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(99)70440-0
更新日期:1999-07-01 00:00:00