Maternal microbiomes in preterm birth: Recent progress and analytical pipelines
Worldwide, 10% of babies are born preterm, defined as birth before 37 weeks' gestation. We have had little success in developing strategies to prevent preterm births, the majority of which are due to infection or are idiopathic. An emerging hypothesis is that the maternal microbiome —the bacteria that inhabit the mother's body and play vital functions in normal health—contributes to the etiology of preterm birth. Here, we highlight the latest data revealing correlations between preterm birth and maternal intestinal, vaginal, cervical, and placental microbiomes. (Source: Seminars in Perinatology)
Source: Seminars in Perinatology - August 17, 2017 Category: Perinatology & Neonatology Authors: Lindsay A. Parnell, Catherine M. Briggs, Indira U. Mysorekar Source Type: research
In Vitro fertilization and adverse obstetric and perinatal outcomes
Most IVF-conceived children are healthy, but IVF has also been associated with adverse obstetric and perinatal outcomes as well as congenital anomalies. There is also literature suggesting an association between IVF and neurodevelopmental disorders as well as potentially long-term metabolic outcomes. The main driver for adverse outcomes is the higher risk of multiple gestations in IVF, but as the field moves toward single embryo transfer, the rate of multiple gestations is decreasing. Studies have shown that singleton IVF pregnancies still have a higher incidence of adverse outcomes compared to unassisted singleton pregnan...
Source: Seminars in Perinatology - August 14, 2017 Category: Perinatology & Neonatology Authors: Chantae S. Sullivan-Pyke, Suneeta Senapati, Monica A. Mainigi, Kurt T. Barnhart Source Type: research
Birth outcome racial disparities: A result of intersecting social and environmental factors
The objective of this review was to consider societal factors, including suboptimal education, income inequality, and residential segregation, that together lead to toxic environmental exposures and psychosocial stress. Many toxic chemicals, as well as psychosocial stress, contribute to the risk of adverse birth outcomes and black women often are more highly exposed than white women. (Source: Seminars in Perinatology)
Source: Seminars in Perinatology - August 14, 2017 Category: Perinatology & Neonatology Authors: Heather H. Burris, Michele R. Hacker Source Type: research
Current preterm birth prevention strategies
Joy Vink, MD(Guest editor)Cynthia Gyamfi-Bannerman, MD, MSc (Source: Seminars in Perinatology)
Source: Seminars in Perinatology - August 14, 2017 Category: Perinatology & Neonatology Authors: Joy Vink, Cynthia Gyamfi-Bannerman Source Type: research
Preterm prelabor rupture of the membranes: A disease of the fetal membranes
Preterm prelabor rupture of the membranes (pPROM) remains a significant obstetric problem that affects 3 –4% of all pregnancies and precedes 40–50% of all preterm births. pPROM arises from complex, multifaceted pathways. In this review, we summarize some old concepts and introduce some novel theories related to pPROM pathophysiology. Specifically, we introduce the concept that pPROM is a disease of the fetal membranes where inflammation–oxidative stress axis plays a major role in producing pathways that can lead to membrane weakening through a variety of processes. (Source: Seminars in Perinatology)
Source: Seminars in Perinatology - August 11, 2017 Category: Perinatology & Neonatology Authors: Ramkumar Menon, Lauren S. Richardson Source Type: research
Epidemiology of racial/ethnic disparities in severe maternal morbidity and mortality
The literature abounds with examples of racial/ethnic disparities in both obstetric outcomes and care. Disparities in maternal mortality are well documented with non-Hispanic blacks carrying the burden of the highest maternal mortality rates. Maternal deaths likely represent only the “tip of the iceberg” with respect to pregnancy complications, leading many to explore risk factors and disparities in severe maternal morbidity, a more common precursor to maternal mortality. This review article explores commonly cited indicators of severe maternal morbidity and includes a revie w of the epidemiological literature supporti...
Source: Seminars in Perinatology - August 1, 2017 Category: Perinatology & Neonatology Authors: Sarah J. Holdt Somer, Rachel G. Sinkey, Allison S. Bryant Source Type: research
Introduction
Compared to other developed countries, the United States ranks poorly in maternal mortality.1 Reports of an increase in maternal mortality ratios has been particularly alarming.2 This trend has sparked efforts, targeting a variety of potential causes to reduce pregnancy-related death and morbidity. In doing so, significant attention has also been focused on the disparity in morbidity and mortality. In the United States, black women are 3 –4 times more likely to die due to pregnancy-related complications than are white women. (Source: Seminars in Perinatology)
Source: Seminars in Perinatology - August 1, 2017 Category: Perinatology & Neonatology Authors: Judette Louis, Sindhu Srinivas Source Type: research
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Source: Seminars in Perinatology - August 1, 2017 Category: Perinatology & Neonatology Source Type: research
Improving hospital quality to reduce disparities in severe maternal morbidity and mortality
Significant racial/ethnic disparities in maternal morbidity and mortality exist in the United States. Black women are 3 –4 times more likely to die a pregnancy-related death as compared with white women. Growing research suggests that hospital quality may be a critical lever for improving outcomes and narrowing disparities. This overview reviews the evidence demonstrating that hospital quality is related to materna l mortality and morbidity, discusses the pathways through which these associations between quality and severe maternal morbidity generate disparities, and concludes with a discussion of possible levers for act...
Source: Seminars in Perinatology - July 20, 2017 Category: Perinatology & Neonatology Authors: Elizabeth A. Howell, Jennifer Zeitlin Source Type: research
Strategies to reduce disparities in maternal morbidity and mortality: The role of obesity and metabolic disease
Maternal obesity, excessive gestational weight gain, and preexisting diabetes are known risk factors for increased maternal and neonatal morbidity. These conditions are more prevalent in certain racial and ethnic minorities. Identification and acknowledgement of racial and ethnic inequalities related to maternal metabolic disease is crucial for clinicians to provide the most comprehensive care in pregnancy. Research and clinical efforts should focus on implementation of healthy lifestyle interventions preconceptually and risk reduction efforts in disease complications during pregnancy. (Source: Seminars in Perinatology)
Source: Seminars in Perinatology - July 11, 2017 Category: Perinatology & Neonatology Authors: Christina Paidas Teefey, Celeste P. Durnwald Source Type: research
Global disparities in maternal morbidity and mortality
The disparity in maternal mortality for African American women remains one of the greatest public health inequities in the United States (US). To better understand approaches toward amelioration of these differences, we examine settings with similar disparities in maternal mortality and “near misses” based on race/ethnicity. This global analysis of disparities in maternal mortality/morbidity will focus on middle- and high-income countries (based on World Bank definitions) with multiethnic populations. (Source: Seminars in Perinatology)
Source: Seminars in Perinatology - June 29, 2017 Category: Perinatology & Neonatology Authors: Maria J. Small, Terrence K. Allen, Haywood L. Brown Source Type: research
Racial and ethnic differences in contraception use and obstetric outcomes: A review
In the United States, racial and ethnic minority women experience higher rates of contraceptive non-use, failure, unintended pregnancy, and lower use of long-acting reversible contraception (LARC), compared to whites. Simultaneously researchers have found that unintended pregnancy is associated with poor pregnancy outcomes and pregnancy behaviors, including pre-term birth and late initiation of prenatal care, respectively. Due to the association of pregnancy intention and obstetrical outcomes, public health efforts have focused on the increase in contraception use among these populations as a way to decrease poor pregnancy...
Source: Seminars in Perinatology - June 24, 2017 Category: Perinatology & Neonatology Authors: Andrea V. Jackson, Lin-Fan Wang, Jessica Morse Source Type: research
