Objective: We have previously found an association between the combination of topical and vaginal clotrimazole treatment during pregnancy and a decreased prevalence of preterm births in the populationbased data set ...Objective: We have previously found an association between the combination of topical and vaginal clotrimazole treatment during pregnancy and a decreased prevalence of preterm births in the populationbased data set of the Hungarian CaseControl Surveillance of Congenital Abnormalities. Thus the objective of this secondary analysis in the expanded data set was to evaluate potential confounders and to examine the possible interaction of clotrimazole with other drugs. Study design: Medically recorded birth weight/gestational age, in addition the prevalence of preterm birth and low birthweight infants of newborn infants without birth defects born to mothers with or without clotrimazole treatment during pregnancy were compared in the expanded control data set of the Hungarian CaseControl Surveillance of Congenital Abnormalities, 1980-1996. Results: The 17-year data set included 38,151 newborn infants and 8.1%were born to mothers who received clotrimazole treatment during pregnancy. There was an increase in mean gestational age among the exposed relative to the unexposed, resulting in a significant (34-64%) reduction in the prevalence of preterm births. This finding could not be explained by confounders and/or interaction with other drugs. Conclusion: The protective effect of clotrimazole for preterm birth was confirmed. We conclude that the protective effect of topical clotrimazole during pregnancy may be attributable to the beneficial effect of clotrimazole in the restoration of the abnormal colonization of the female genital organs and its known antibacterial and/or antiprotozoal effect.展开更多
Objective: The purpose of this study was to evaluate the relationship between prepregnancy maternal body mass index and spontaneous preterm birth and indicated preterm birth. Study design: This was a secondary analysi...Objective: The purpose of this study was to evaluate the relationship between prepregnancy maternal body mass index and spontaneous preterm birth and indicated preterm birth. Study design: This was a secondary analysis of the Maternal- Fetal Medicine Units Network, Preterm Prediction study. Patients were classified into categories that were based on their body mass index. Rates of indicated and spontaneous preterm birth were compared. Results: Five hundred ninety- seven (20.5% ) of 2910 women were obese. Obese women had fewer spontaneous preterm births at < 37 weeks of gestation (6.2% vs 11.2% ; P <. 001) and at < 34 weeks of gestation (1.5% vs 3.5% ; P =. 012). Women with a body mass index of < 19 kg/m2 had 16.6% spontaneous preterm birth, with a body mass index of 19 to 24.9 kg/m2 had 11.3% spontaneous preterm birth, with a body mass index of 25 to 29.9 kg/m2 had 8.1% spontaneous preterm birth, with a body mass index of 30 to 34.9 kg/m2 had 7.1% spontaneous preterm birth, and with a body mass index of ≥ 35 kg/m2 had 5.2% spontaneous eterm birth (P <. 0001). Indicated delivery was responsible for an increasing proportion of preterm births with increasing body mass index (P =. 001). Obese women had lower rates of cervical length < 25 mm (5% vs 8% pr.; P =. 012). Multivariable regression analysis confirmed a lower rate of spontaneous preterm birth in obese gravid women (odds ratio, 0.57; 95% CI, 0.39- 0.83; P =. 003). Conclusion: Obesity before pregnancy is associated with a lower rate of spontaneous preterm birth.展开更多
The incidence of prematurity in Germany is about 10%and premature infants with haemophilia A (OMIM 306700) are in fact very rare.We report two new cases, one born in the 28th gestational week, weighing 1200 g with a f...The incidence of prematurity in Germany is about 10%and premature infants with haemophilia A (OMIM 306700) are in fact very rare.We report two new cases, one born in the 28th gestational week, weighing 1200 g with a factor VIII (FVIII)-level of 0.03 IU/ml treated with bolus injections of plasma derived FVIII concentrate (pdFVIII), and one born at week 30, weighing only 710 g with a factor level of <0.01 IU/ml and treated with recombinant FVIII concentrate (rFVIII).Recovery of FVIII was 96%in case 1 and 120%in case 2, FVIII half-life was 6 h and 8 h, respectively.During FVIII substitution, neither bleeding, thrombosis nor inhibitor development were noted in both infants.Conclusion: Immediate and frequent factor VIII substitution appears to be safe and effective for prophylaxis and treatment in premature haemophilic neonates.展开更多
Objective: This study sought to quantify the risks of preterm birth that are ascribable to potentially treatable reproductive tract infections among black women in Denver, Colorado. Study design: A secondary analysis ...Objective: This study sought to quantify the risks of preterm birth that are ascribable to potentially treatable reproductive tract infections among black women in Denver, Colorado. Study design: A secondary analysis was conducted of 4 prospective studies in Denver, Colorado, that included 1038 women who were enrolled at < 29 weeks of gestation and whose cases were followed through delivery. Rates of preterm birth, preterm labor, and preterm premature rupture of membranes were the primary outcomes that were examined. Results: Bacterial vaginosis, infection with Chlamydia trachomatis, Trichomonas vaginalis,Mycoplasma hominis, Neisseria gonorrhoeae, and group B streptococcal colonization were more common among black women (P < .01) than among comparators. Preterm birth occurred more often among black women with infections that were being studied (20.4% ), compared with uninfected black women (9.5% ; relative risk, 2.2; 95% CI, 1.1- 4.1). Up to 42% of preterm births among black women were attributable to the presence of bacterial vaginosis,T vaginalis, or C trachomatis alone or in combinations. The risk for preterm birth among infected black women who received Centers for Disease Control and Prevention recommended treatment was reduced significantly (relative risk, 0.16; 95% CI, 0.04- 0.66). Conclusion: Black women have increased risks of prematurity that are associated with prevalent reproductive tract infections during pregnancy. Preterm birth among similar urban black women could be reduced by > 40% by the screening and treatment of common genitourinary tract infections in pregnancy.展开更多
文摘Objective: We have previously found an association between the combination of topical and vaginal clotrimazole treatment during pregnancy and a decreased prevalence of preterm births in the populationbased data set of the Hungarian CaseControl Surveillance of Congenital Abnormalities. Thus the objective of this secondary analysis in the expanded data set was to evaluate potential confounders and to examine the possible interaction of clotrimazole with other drugs. Study design: Medically recorded birth weight/gestational age, in addition the prevalence of preterm birth and low birthweight infants of newborn infants without birth defects born to mothers with or without clotrimazole treatment during pregnancy were compared in the expanded control data set of the Hungarian CaseControl Surveillance of Congenital Abnormalities, 1980-1996. Results: The 17-year data set included 38,151 newborn infants and 8.1%were born to mothers who received clotrimazole treatment during pregnancy. There was an increase in mean gestational age among the exposed relative to the unexposed, resulting in a significant (34-64%) reduction in the prevalence of preterm births. This finding could not be explained by confounders and/or interaction with other drugs. Conclusion: The protective effect of clotrimazole for preterm birth was confirmed. We conclude that the protective effect of topical clotrimazole during pregnancy may be attributable to the beneficial effect of clotrimazole in the restoration of the abnormal colonization of the female genital organs and its known antibacterial and/or antiprotozoal effect.
文摘Objective: The purpose of this study was to evaluate the relationship between prepregnancy maternal body mass index and spontaneous preterm birth and indicated preterm birth. Study design: This was a secondary analysis of the Maternal- Fetal Medicine Units Network, Preterm Prediction study. Patients were classified into categories that were based on their body mass index. Rates of indicated and spontaneous preterm birth were compared. Results: Five hundred ninety- seven (20.5% ) of 2910 women were obese. Obese women had fewer spontaneous preterm births at < 37 weeks of gestation (6.2% vs 11.2% ; P <. 001) and at < 34 weeks of gestation (1.5% vs 3.5% ; P =. 012). Women with a body mass index of < 19 kg/m2 had 16.6% spontaneous preterm birth, with a body mass index of 19 to 24.9 kg/m2 had 11.3% spontaneous preterm birth, with a body mass index of 25 to 29.9 kg/m2 had 8.1% spontaneous preterm birth, with a body mass index of 30 to 34.9 kg/m2 had 7.1% spontaneous preterm birth, and with a body mass index of ≥ 35 kg/m2 had 5.2% spontaneous eterm birth (P <. 0001). Indicated delivery was responsible for an increasing proportion of preterm births with increasing body mass index (P =. 001). Obese women had lower rates of cervical length < 25 mm (5% vs 8% pr.; P =. 012). Multivariable regression analysis confirmed a lower rate of spontaneous preterm birth in obese gravid women (odds ratio, 0.57; 95% CI, 0.39- 0.83; P =. 003). Conclusion: Obesity before pregnancy is associated with a lower rate of spontaneous preterm birth.
文摘The incidence of prematurity in Germany is about 10%and premature infants with haemophilia A (OMIM 306700) are in fact very rare.We report two new cases, one born in the 28th gestational week, weighing 1200 g with a factor VIII (FVIII)-level of 0.03 IU/ml treated with bolus injections of plasma derived FVIII concentrate (pdFVIII), and one born at week 30, weighing only 710 g with a factor level of <0.01 IU/ml and treated with recombinant FVIII concentrate (rFVIII).Recovery of FVIII was 96%in case 1 and 120%in case 2, FVIII half-life was 6 h and 8 h, respectively.During FVIII substitution, neither bleeding, thrombosis nor inhibitor development were noted in both infants.Conclusion: Immediate and frequent factor VIII substitution appears to be safe and effective for prophylaxis and treatment in premature haemophilic neonates.
文摘Objective: This study sought to quantify the risks of preterm birth that are ascribable to potentially treatable reproductive tract infections among black women in Denver, Colorado. Study design: A secondary analysis was conducted of 4 prospective studies in Denver, Colorado, that included 1038 women who were enrolled at < 29 weeks of gestation and whose cases were followed through delivery. Rates of preterm birth, preterm labor, and preterm premature rupture of membranes were the primary outcomes that were examined. Results: Bacterial vaginosis, infection with Chlamydia trachomatis, Trichomonas vaginalis,Mycoplasma hominis, Neisseria gonorrhoeae, and group B streptococcal colonization were more common among black women (P < .01) than among comparators. Preterm birth occurred more often among black women with infections that were being studied (20.4% ), compared with uninfected black women (9.5% ; relative risk, 2.2; 95% CI, 1.1- 4.1). Up to 42% of preterm births among black women were attributable to the presence of bacterial vaginosis,T vaginalis, or C trachomatis alone or in combinations. The risk for preterm birth among infected black women who received Centers for Disease Control and Prevention recommended treatment was reduced significantly (relative risk, 0.16; 95% CI, 0.04- 0.66). Conclusion: Black women have increased risks of prematurity that are associated with prevalent reproductive tract infections during pregnancy. Preterm birth among similar urban black women could be reduced by > 40% by the screening and treatment of common genitourinary tract infections in pregnancy.
