1.  Peer Reviewed Title: ACOG Committee Opinion No. 427: Misoprostol for postabortion care. Author: American College of Obstetricians and Gynecologists Source: Obstetrics and Gynecology. 2009 Feb;113(2 Pt 1):465-8. Abstract: The World Health Organization estimates that 67,000 women, mostly in developing countries, die each year from untreated or inadequately treated abortion complications. Postabortion care, a term commonly used by the international reproductive health community, refers to a specific set of services for women experiencing problems from all types of spontaneous or induced abortion. There is increasing evidence that misoprostol is a safe, effective, and acceptable method to achieve uterine evacuation for women needing postabortion care. To reduce maternal mortality, availability of postabortion care services must be increased. Misoprostol must be readily available especially for women who do not otherwise have access to postabortion care. Nurses and midwives can safely provide first-line postabortion care services, including in outpatient settings,provided they receive appropriate training and support. Access to contraception and safe abortion services prevents complications from unsafe abortion and decreases the need for postabortion care. It is much less expensive and far better for women's health to prevent the problem of unsafe abortion rather than to treat resulting complications. Language: English Keywords: DEVELOPING COUNTRIES | RESEARCH REPORT | WOMEN | ABORTION | ABORTION, SPONTANEOUS | POSTABORTION CARE | MISOPROSTOL | HEALTH SERVICES | REPRODUCTIVE HEALTH | MATERNAL HEALTH | MATERNAL MORTALITY | PREVENTION AND CONTROL | NEEDS ASSESSMENT | PROGRAM ACCESSIBILITY | Demographic Factors | Population | Fertility Control, Postconception | Family Planning | Pregnancy Complications | Diseases | Delivery of Health Care | Health | Prostaglandins, Synthetic | Prostaglandins | Endocrine System | Physiology | Biology | Mortality | Population Dynamics | Evaluation | Program Evaluation | Programs | Organization and Administration Document Number: 341050 |
| 2. Peer Reviewed Title: Spousal violence and potentially preventable single and recurrent spontaneous fetal loss in an African setting: cross-sectional study. Author: Alio A; Nana PN; Salihu HM Source: Lancet. 2009;373:318-324. Abstract: Background Spousal violence is a global issue, with ramifications for the reproductive health of women. We aimed to investigate the effect of physical, sexual, and emotional violence on potentially preventable single and recurrent spontaneous fetal loss. Methods We analysed data from the Cameroon Demographic Health Survey. In the violence module of this survey, women were questioned about their experience of physical, emotional, and sexual violence inflicted by their spouses. Respondents were also asked about any stillbirths and spontaneous abortions. We measured risk for single and recurrent fetal loss with odds ratios, with adjustment for intracluster correlations as appropriate. We also estimated the proportion of preventable excess fetal loss at various levels of violence reduction. Findings 2562 women responded to the violence module. Those exposed to spousal violence (n=1307) were 50% more likely to experience at least one episode of fetal loss compared with women not exposed to abuse (odds ratio 1-5; 95% CI 1-3-1-8). Recurrent fetal mortality was associated with all forms of spousal violence, but emotional violence had the strongest association (1-7; 1-2-2-3). If the prevalence of spousal abuse could be reduced to 50%, 25%, or entirely eliminated, preventable excess recurrent fetal demise would be 17%, 25%, and 33%, respectively. Interpretation Spousal violence increases the likelihood of single and repeated fetal loss. A large proportion of risk for recurrent fetal mortality is attributable to spousal violence and, therefore, is potentially preventable. Our findings support the idea of routine prenatal screening for spousal violence in the African setting, a region with the highest rate of fetal death in the world. Language: English Keywords: AFRICA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | DEMOGRAPHIC AND HEALTH SURVEYS | WOMEN | ABORTION, SPONTANEOUS | DOMESTIC VIOLENCE | PHYSICAL ABUSE | IMPACT | Developing Countries | Research Methodology | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Pregnancy Complications | Diseases | Crime | Social Problems | Sociocultural Factors | Violence | Behavior | Communication Document Number: 340220 |
| 3. Title: Consanguinity and reproductive wastage in the Palestinian Territories. Author: Assaf S; Khawaja M; DeJong J; Mahfoud Z; Yunis K Source: Paediatric and Perinatal Epidemiology. 2009 Mar;23(2):107-15. Abstract: Many studies have found that consanguinity poses a threat to child mortality and health and can also pose a threat to offspring survival before birth. However, there are conflicting findings with some studies having found no increased risk on offspring survival associated with consanguinity. Data from a population-based survey conducted in 2004 in the Palestinian Territories was used to assess the risk of consanguinity on offspring survival. The analysis was conducted on 4418 women aged 15-49 who were asked whether or not they had experienced a stillbirth or a spontaneous abortion. These two outcomes were combined together for the analysis of reproductive wastage. Multivariable negative binomial regression was conducted to calculate the incidence risk ratios (IRR) for each region in the Palestinian Territories separately. The strongest risk factors for reproductive wastage, after controlling for other variables, were found to be consanguinity, age and parity with age presenting the highest IRRs. Standard of living, locality type, education level, women's employment and past intrauterine device use were not found to be significant risk factors for reproductive wastage. In the West Bank only first cousin level of consanguinity was found to be significant and 'hamola' level (or from same family clan) lost its significance after adjusting for other variables. In the Gaza Strip both the first cousin and 'hamola' levels of consanguinity were significant and presented almost equal IRRs of 1.3. In conclusion, consanguinity was found to be a significant risk factor for reproductive wastage. Language: English Keywords: MIDDLE EAST | RESEARCH REPORT | RISK ASSESSMENT | ABORTION, SPONTANEOUS | FETAL DEATH | MATERNAL AGE | CONSANGUINITY | RISK FACTORS | CHILD MORTALITY | Evaluation | Pregnancy Complications | Diseases | Mortality | Population Dynamics | Demographic Factors | Population | Parental Age | Age Factors | Population Characteristics | Genetics | Biology | Health Document Number: 331057 |
| 4. Title: Clandestine induced abortion: prevalence, incidence and risk factors among women in a Latin American country. Author: Bernabe-Ortiz A; White PJ; Carcamo CP; Hughes JP; Gonzales MA; Garcia PJ; Garnett GP; Holmes KK Source: CMAJ. 2009 Feb 3;180(3):298-304. Abstract: BACKGROUND: Clandestine induced abortions are a public health problem in many developing countries where access to abortion services is legally restricted. We estimated the prevalence and incidence of, and risk factors for, clandestine induced abortions in a Latin American country. METHODS: We conducted a large population-based survey of women aged 18-29 years in 20 cities in Peru. We asked questions about their history of spontaneous and induced abortions, using techniques to encourage disclosure. RESULTS: Of 8242 eligible women, 7992 (97.0%) agreed to participate. The prevalence of reported induced abortions was 11.6% (95% confidence interval [CI] 10.9%-12.4%) among the 7962 women who participated in the survey. It was 13.6% (95% CI 12.8%-14.5%) among the 6559 women who reported having been sexually active. The annual incidence of induced abortion was 3.1% (95% CI 2.9%-3.3%) among the women who had ever been sexually active. In the multivariable analysis, risk factors for induced abortion were higher age at the time of the survey (odds ratio [OR] 1.11, 95% CI 1.07-1.15), lower age at first sexual intercourse (OR 0.87, 95% CI 0.84-0.91), geographic region (highlands: OR 1.56, 95% CI 1.23-1.97; jungle: OR 1.81, 95% CI 1.41-2.31 [v. coastal region]), having children (OR 0.82, 95% CI 0.68-0.98), having more than 1 sexual partner in lifetime (2 partners: OR 1.61, 95% CI 1.23-2.09; > or = 3 partners: OR 2.79, 95% CI 2.12-3.67), and having 1 or more sexual partners in the year before the survey (1 partner: OR 1.36, 95% CI 1.01-1.72; > or = 2 partners: OR 1.54, 95% CI 1.14-2.02). Overall, 49.0% (95% CI 47.6%-50.3%) of the women who reported being currently sexually active were not using contraception. INTERPRETATION: The incidence of clandestine, potentially unsafe induced abortion in Peru is as high as or higher than the rates in many countries where induced abortion is legal and safe. The provision of contraception and safer-sex education to those who require it needs to be greatly improved and could potentially reduce the rate of induced abortion. Language: English Keywords: LATIN AMERICA | RESEARCH REPORT | INCIDENCE | PREVALENCE | WOMEN | RISK FACTORS | ABORTION | ABORTION, SPONTANEOUS | SEX EDUCATION | RISK ASSESSMENT | Americas | Developing Countries | Measurement | Research Methodology | Demographic Factors | Population | Biology | Fertility Control, Postconception | Family Planning | Pregnancy Complications | Diseases | Education | Evaluation Document Number: 330468 Notification |
| 5. Peer Reviewed Title: Exposure to maternal and paternal tobacco consumption and risk of spontaneous abortion. Author: Blanco-Munoz J; Torres-Sanchez L; Lopez-Carrillo L Source: Public Health Reports. 2009 Mar-Apr;124(2):317-22. Abstract: Conclusive evidence shows that maternal tobacco consumption increases the risk of infertility, subfertility, ectopic pregnancy, preterm birth, low birthweight, and stillbirth. Nevertheless, evidence with respect to the risk of spontaneous abortion (SA) (i.e., miscarriage) is inconsistent. In a case-control study, Kline et al. identified an increase in miscarriages in women who were smokers. In Canadian women, Armstrong et al. found a 20% increase in the risk of SA for every 10 cigarettes consumed daily. Other authors have also shown a positive association between cotinine levels in urine and SA. On the other hand, in Rasch's study, after adjusting for other risk factors, women who smoked 10 to 19 cigarettes and 20 or more cigarettes per day did not have significantly increased odds ratios (ORs) for having SAs. The role of paternal tobacco exposure in adverse reproductive effects has been scarcely evaluated. Some reports in the literature assert that tobacco consumption in men is associated with morphological alterations in sperm, a decrease in sperm density and motility, and a reduction in semen volume,11 which could have implications for male fertility and embryo viability. However, the scarce studies that to date have evaluated the association between exposure to paternal tobacco and SA are also contradictory. (excerpt) Language: English Keywords: MEXICO | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | COHORT ANALYSIS | PREGNANT WOMEN | WOMEN IN DEVELOPMENT | SEXUAL PARTNERS | COUPLES | ABORTION RATE | RISK FACTORS | TOBACCO USE | ABORTION, SPONTANEOUS | North America | Americas | Developing Countries | Research Methodology | Population Characteristics | Demographic Factors | Population | Economic Development | Economic Factors | Sex Behavior | Behavior | Family Characteristics | Family and Household | Sociocultural Factors | Fertility Control, Postconception | Family Planning | Health | Pregnancy Complications | Diseases Document Number: 331257 |
| 6. Title: Rates of spontaneous and therapeutic abortions following use of antidepressants in pregnancy: results from a large prospective database. Author: Einarson A; Choi J; Einarson TR; Koren G Source: Journal of Obstetrics and Gynaecology Canada. 2009 May;31(5):452-6. Abstract: OBJECTIVE: The use of antidepressants during pregnancy remains a controversial issue, and there is little information on the risk of spontaneous abortions following antidepressant exposure in early pregnancy. We sought to examine whether use of antidepressants increases the rates of spontaneous abortion (SA) and therapeutic abortion (TA) in women exposed in early pregnancy. METHODS: In a cohort of women who contacted the Motherisk program during pregnancy, we compared two groups of women, one exposed and the other not exposed to antidepressants during pregnancy, and calculated the associated rates of SA and TA. RESULTS: Among 937 women exposed to antidepressants prior to and during early pregnancy, there were 122 SAs (13.0%) including three ectopic pregnancies, and in the comparison group there were 75 SAs (8.0%) and no ectopic pregnancies. The relative risk was 1.63 (95% CI 1.24-2.14). Three-fold more women reported a TA in the exposed group, 26 (2.4%) compared to 8 (0.7%) in the non-exposed group (RR 3.25; 95% CI 1.48-7.14). A sub-analysis revealed that in both groups, of 338 women with a prior SA, 58 (17.2%) reported having a SA in the current pregnancy, compared with 61/652 (9.4%) with no prior SA (chi square = 12.09, P lt; 0.001). In the antidepressant group, the incidence was 20.7%, and in the non-exposed group, it was 13.3%. Logistic regression confirmed that only antidepressant exposure and prior SA were significantly associated with current SA. CONCLUSION: Exposure to antidepressants in the first trimester of pregnancy appears to be associated with a small but statistically significant increased risk of SA and decision to terminate a pregnancy. The risk for SA is further elevated with a history of previous SA. However, any underlying depression must be taken into consideration when evaluating these results. Language: English Keywords: CANADA | RESEARCH REPORT | PROSPECTIVE STUDIES | PREGNANT WOMEN | ABORTION, SPONTANEOUS | ABORTION | RISK FACTORS | DEPRESSION | DRUGS | PREGNANCY, FIRST TRIMESTER | INCIDENCE | INTERVIEWS | Developed Countries | North America, Northern | Americas | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Pregnancy Complications | Diseases | Fertility Control, Postconception | Family Planning | Health | Mental Disorders | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Pregnancy | Reproduction | Measurement | Data Collection Document Number: 342785 Notification |
| 7. Title: Previous abortion and risk of pre-term birth: a population study. Author: Freak-Poli R; Chan A; Tucker G; Street J Source: Journal of Maternal-Fetal and Neonatal Medicine. 2009 Jan;22(1):1-7. Abstract: OBJECTIVE: This population study was undertaken to determine whether previous abortion is an independent risk factor for pre-term birth and to calculate population-attributable risks for risk factors. METHODS: All South Australian first singleton births in 1998-2003 (n = 42 269) were included in a multivariable logistic regression analysis, comparing pre-term births with term births. RESULTS: Risk factors for pre-term birth were found to be: being indigenous, single, a smoker [adjusted odds ratio (AOR) 1.28, 95% confidence interval 1.17-1.41], age 40 years or older, reproductive technology assistance, threatened miscarriage, antepartum haemorrhage, urinary tract infection, pregnancy hypertension and suspected intra-uterine growth restriction. A previous spontaneous abortion was of borderline statistical significance, whereas a previous induced abortion (AOR 1.25, 1.13-1.40) was an independent risk factor. A dose-response relationship was found with increasing number of previous spontaneous or induced abortions. Population-attributable risks were highest for pregnancy hypertension (12.4%) and antepartum haemorrhage (9.2%). Smoking and previous induced abortion had risks of 4.7% and 2.7%, respectively. Among indigenous women, 51% of whom smoked, 16.4% of pre-term birth could be attributed to smoking. CONCLUSIONS: A previous induced abortion and smoking during pregnancy (particularly among indigenous women) are preventable risk factors for pre-term birth. Their population-attributable risks are likely to be under-estimates from under-reporting. Language: English Keywords: AUSTRALIA | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | PREGNANT WOMEN | INDIGENOUS POPULATION | PREVALENCE | ABORTION | RISK ASSESSMENT | PREMATURE BIRTH | RISK FACTORS | REPRODUCTIVE TECHNOLOGIES | ABORTION, SPONTANEOUS | MATERNAL AGE | PREECLAMPSIA | Oceania | Developed Countries | Research Methodology | Population Characteristics | Demographic Factors | Population | Measurement | Fertility Control, Postconception | Family Planning | Evaluation | Pregnancy Outcomes | Pregnancy | Reproduction | Health | Pregnancy Complications | Diseases | Parental Age | Age Factors Document Number: 330718 Notification |
| 8. Peer Reviewed Title: Use of combined oral contraceptives post abortion. Author: Gaffield ME; Kapp N; Ravi A Source: Contraception. 2009 Oct;80(4):355-62. Abstract: BACKGROUND: Providing combined oral contraceptives (COCs) following surgical or medical induced abortion offers women an opportune moment to initiate a reliable contraceptive method. STUDY DESIGN: We conducted a systematic review, searching MEDLINE and The Cochrane Library for articles in any language concerning COC use following spontaneous, induced (medical or surgical) or septic abortion, from 1966 through June 2008. Seven articles were identified and evaluated using the United States Preventive Services Task Force system. RESULTS: Immediate COC initiation after first-trimester medical or surgical induced abortion did not increase side effects or prolong vaginal bleeding compared with use of a placebo, copper-bearing intrauterine device (IUD), nonhormonal contraceptive method or COC initiation at a later time. Initiating COCs after first-trimester surgical abortion produced small increases in coagulation parameters compared with IUD use; although they are statistically significant, their clinical relevance is unlikely. No study examined second-trimester induced or spontaneous abortion, or septic abortion. CONCLUSIONS: Evidence shows that COCs can be safely initiated immediately following surgical and medical abortion in the first-trimester of pregnancy. Language: English Keywords: GLOBAL | LITERATURE REVIEW | ABORTION | ABORTION, SPONTANEOUS | PREGNANCY, FIRST TRIMESTER | POSTABORTION CARE | ORAL CONTRACEPTIVES, COMBINED | CONTRACEPTIVE SAFETY | MENSTRUATION | ORAL CONTRACEPTIVES, SIDE EFFECTS | BLOOD COAGULATION EFFECTS | Fertility Control, Postconception | Family Planning | Pregnancy Complications | Diseases | Pregnancy | Reproduction | Health Services | Delivery of Health Care | Health | Oral Contraceptives | Contraceptive Methods | Contraception | Safety | Public Health | Hematological Effects | Hemic System | Physiology | Biology Document Number: 342771 Notification |
| 9. Title: Seropositivity for Listeria monocytogenes in women with spontaneous abortion: a case-control study in Iran. Author: Jamshidi M; Jahromi AS; Davoodian P; Amirian M; Zangeneh M; Jadcareh F Source: Taiwanese Journal of Obstetrics and Gynecology. 2009 Mar;48(1):46-8. Abstract: OBJECTIVE: There are many studies supporting the role of certain asymptomatic infections such as Listeria monocytogenes (L. monocytogenes) in spontaneous abortion. In some cases, latent listeriosis may complicate the pregnancy, and serologic tests can, therefore, be used to detect the disease. This study was designed to assess the relationship between seropositivity for L. monocytogenes and spontaneous abortion. MATERIALS AND METHODS: A total of 250 women with previous spontaneous abortion and a control group of 200 women with normal full-term deliveries entered the study as case and control groups, respectively. Demographic characteristics were recorded for each subject, and serum samples were obtained from all participants. All serum samples were examined using the indirect immunofluorescence antibody test for L. monocytogenes antibody. Data was analyzed using Chi-squared and t tests. RESULTS: The average age of participants was 25.6 +/- 7.6 years in cases and 25.3 +/- 6.5 years in controls. Eighty-nine (35.6%) of the cases with abortion and 35 (17.5%) of the control group were positive for L. monocytogenes antibody (p = 0.001). No relationship was observed between the number of pregnancies and infection with L. monocytogenes (p = 0.4), or between the number of previous abortions and L. monocytogenes seropositivity (p = 0.2). CONCLUSION: We suggest monitoring L. monocytogenes seroprevalence in pregnant women at high risk of threatened abortion, and further microbiological assessment of symptomatic women for detection of L. monocytogenes and insidious infection. Language: English Keywords: IRAN | RESEARCH REPORT | CASE STUDIES | WOMEN | ABORTION, SPONTANEOUS | PREGNANCY | MONITORING | INFECTIONS | TESTING | Middle East | Developing Countries | Studies | Research Methodology | Demographic Factors | Population | Pregnancy Complications | Diseases | Reproduction | Evaluation | Measurement Document Number: 342081 |
| 10. Peer Reviewed Title: Spontaneous breakage and expulsion of a stem fragment of levonorgestrel intrauterine system (Mirena) following duplicate insertion [letter] Author: Jindal S; Sharma SS; Ikomi A Source: Archives of Gynecology and Obstetrics. 2009 Jan;279(1):95-7. Abstract: BACKGROUND: Removal and changing an intra-uterine device (IUD) involves good history taking, a proper examination and appropriate experience in fitting IUDs. CASE: We present a case of a woman who had two insertions of the levonorgestrel intrauterine system (LNG-IUS) which was diagnosed only at hysteroscopy when she presented with the spontaneous expulsion of a vertical stem of one of the devices. CONCLUSION: This is a unique case where two LNG-IUS were inserted in error and hence it teaches the clinicians the importance of good training and being aware of the possibility of the missing thread which deserves further investigations especially when such cases are encountered in a busy general practice. Language: English Keywords: UNITED KINGDOM | RESEARCH REPORT | CASE STUDIES | WOMEN | IUD EXPULSION | HYSTEROSCOPY | LEVONORGESTREL | INSERTION | SURGICAL ERROR | ABORTION, SPONTANEOUS | Developed Countries | Europe, Western | Europe | Studies | Research Methodology | Demographic Factors | Population | IUD | Contraceptive Methods | Contraception | Family Planning | Endoscopy | Physical Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Treatment | Surgery | Pregnancy Complications | Diseases Document Number: 329580 |
| 11. Peer Reviewed Title: Oral contraceptive pretreatment in women undergoing controlled ovarian stimulation in ganirelix acetate cycles may, for a subset of patients, be associated with low serum luteinizing hormone levels, reduced ovarian response to gonadotropins, and early pregnancy loss. Author: Meldrum DR; Scott RT Jr; Levy MJ; Alper MM; Noyes N Source: Fertility and Sterility. 2009 May;91(5):1963-5. Abstract: Oral contraceptive pretreatment facilitated scheduling of pure FSH/GnRH antagonist cycles but in a small subset of patients was associated with low serum LH levels, reduced ovarian response, and early pregnancy loss. Supplementation with LH could be examined as a possible way to improve cycle outcome. Language: English Keywords: UNITED STATES OF AMERICA | CALIFORNIA | RESEARCH REPORT | WOMEN | GONADOTROPINS, PITUITARY | IMPLANTATION | ABORTION, SPONTANEOUS | PREGNANCY | ORAL CONTRACEPTIVES | Developed Countries | North America | Americas | Demographic Factors | Population | Gonadotropins | Hormones | Endocrine System | Physiology | Biology | Pregnancy, First Trimester | Reproduction | Pregnancy Complications | Diseases | Contraceptive Methods | Contraception | Family Planning Document Number: 341248 |
| 12. Title: Expectant management of incomplete abortion in the first trimester. Author: Pauleta JR; Clode N; Graca LM Source: International Journal of Gynaecology and Obstetrics. 2009 Mar 28; Abstract: OBJECTIVE: To evaluate the effectiveness and acceptability of expectant management of induced and spontaneous first trimester incomplete abortion. METHODS: A prospective observational trial, conducted between June 2006 and November 2007, of 2 groups of patients diagnosed with an incomplete abortion: 66 patients who had received misoprostol for an induced abortion (group 1) and 30 patients who had had a spontaneous abortion (group 2). Transvaginal ultrasound was performed weekly. The success rate (complete abortion without surgery), time to resolution, duration of bleeding and pelvic pain, rate of infection, number of unscheduled hospital visits, and level of satisfaction with expectant management were recorded. RESULTS: The incidence of complete abortion was 86.4% and 82.1% in groups 1 and 2 respectively at day 14 after diagnosis, and 100% in both groups at day 30 (two group 2 patients underwent curettage and were excluded from the analysis). Both groups reported 100% satisfaction with expectant management, although over 90% of the women reported feeling anxious. CONCLUSION: Expectant management for incomplete abortion in the first trimester after use of misoprostol or after spontaneous abortion may be practical and feasible, although it may increase anxiety associated with the impending abortion. Language: English Keywords: PORTUGAL | RESEARCH REPORT | PROSPECTIVE STUDIES | CLINICAL RESEARCH | PREGNANT WOMEN | ABORTION | PREGNANCY, FIRST TRIMESTER | ABORTION, SPONTANEOUS | MISOPROSTOL | ULTRASONICS | TIME FACTORS | BLEEDING | PAIN | INFECTIONS | Developed Countries | Europe, Southwestern | Europe | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Fertility Control, Postconception | Family Planning | Pregnancy | Reproduction | Pregnancy Complications | Diseases | Prostaglandins, Synthetic | Prostaglandins | Endocrine System | Physiology | Biology | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Population Dynamics | Signs and Symptoms Document Number: 341468 |
| 13. Peer Reviewed Title: An assessment of fetal loss among currently married women in India. Author: Rajaram S; Zottarelli LK; Sunil TS Source: Journal of Biosocial Science. 2009 May;41(3):309-27. Abstract: The present paper assesses fetal loss among currently married women in India. In addition, the effects of social, economic, demographic and health factors on fetal loss are studied. The study uses data from the second National Family Health Survey conducted in India during 1998-2000. The results show wide variations in fetal loss (induced abortion, spontaneous abortion and still-birth) measures across the country. The importance of mother's nutritional status, birth spacing, risky behaviours such as smoking, drinking and chewing tobacco and age at marriage for pregnancy outcomes in India is also discussed. The study results imply a broad understanding of reproductive health in India, and emphasize the importance of widening the scope of community-based reproductive health education programmes to improve the reproductive health of women. Language: English Keywords: INDIA | RESEARCH REPORT | HEALTH SURVEYS | CURRENTLY MARRIED | WOMEN | PREGNANCY OUTCOMES | FETAL DEATH | ABORTION | ABORTION, SPONTANEOUS | RISK FACTORS | PREGNANCY INTERVALS | Asia, Southern | Asia | Developing Countries | Health | Marital Status | Nuptiality | Demographic Factors | Population | Pregnancy | Reproduction | Mortality | Population Dynamics | Fertility Control, Postconception | Family Planning | Pregnancy Complications | Diseases | Fertility Measurements | Fertility Document Number: 341400 |
| 14. Title: Maternal MTHFR polymorphisms and risk of spontaneous abortion. Author: Rodriguez-Guillen Mdel R; Torres-Sanchez L; Chen J; Galvan-Portillo M; Blanco-Munoz J; Anaya MA; Silva-Zolezzi I; Hernandez-Valero MA; Lopez-Carrillo L Source: Salud Publica de Mexico. 2009 Jan-Feb;51(1):19-25. Abstract: OBJECTIVE: To asses the association between intake of folate and B vitamins and the incidence of spontaneous abortion (SA) according to the maternal methylenetetrahydrofolate reductase (MTHFR) polymorphisms (677 C>T and 1298 A>C). MATERIAL AND METHODS: We conducted a nested case-control study within a perinatal cohort of women recruited in the state of Morelos, Mexico. Twenty-three women with SA were compared to 74 women whose pregnancy survived beyond week 20th. Intake of folate and B vitamins respectively, was estimated using a validated food frequency questionnaire. Maternal MTHFR polymorphisms were determined by PCR-RFLP and serum homocysteine levels by HPLC. RESULTS: Carriers of MTHFR 677TT and 1298AC genotypes respectively showed an increased risk of SA (OR 677TT vs. CC/CT=5.0; 95% CI: 1.2, 20.9 and OR 1298 AC vs. AA=5.5; 95% CI: 1.1, 26.6). CONCLUSIONS: Our results support the role of MTHFR polymorphisms as a risk factor for SA, regardless of dietary intake of B vitamins. Language: English Keywords: MEXICO | RESEARCH REPORT | COHORT ANALYSIS | INCIDENCE | PREGNANT WOMEN | ABORTION, SPONTANEOUS | VITAMINS AND MINERALS | MATERNAL NUTRITION | RISK FACTORS | North America | Americas | Developing Countries | Research Methodology | Measurement | Population Characteristics | Demographic Factors | Population | Pregnancy Complications | Diseases | Physiology | Biology | Nutrition | Health Document Number: 330500 |
| 15. Peer Reviewed Title: Spousal violence and spontaneous fetal loss [letter] Author: Shelton JD; Adetunji J Source: Lancet. 2009 May 2;373(9674):1520; author reply 1520-1. Abstract: Amina Alio and colleagues (Jan 24, p 318) make an admirable effort to unravel a myriad of confounders to explain their finding of a statistical relation between spousal violence and spontaneous fetal loss. Spousal violence is clearly deplorable. But, as Alio and colleagues note, it included a wide range of behaviours, including "saying something to humiliate" and pushing and twisting the arm, as well as more violent acts. A biological explanation for such spousal violence "ever" to account for a 50% increase in fetal loss "ever" does not seem obvious. Another explanation is major misclassification with induced abortion. Although the 2004 Demographic and Health Survey instrument for Cameroon attempted to distinguish between the two, responses on numbers of induced abortions, spontaneous abortions, and still births were contained within the same question. It would be easy for respondents to report induced abortions as spontaneous. Induced abortion is notoriously underreported, especially in countries such as Cameroon where it is illegal. On the other hand, both induced abortion and spousal violence might be common markers of other factors such as relationship stress or other dysfunction and thus lead to a spurious finding. There is a response from Amina Alio included. Language: English Keywords: CAMEROON | CRITIQUE | RESEARCH REPORT | METHODOLOGICAL STUDIES | CLASSIFICATION | DEMOGRAPHIC AND HEALTH SURVEYS | SPOUSE | WOMEN IN DEVELOPMENT | PREGNANT WOMEN | DOMESTIC VIOLENCE | ABORTION, SPONTANEOUS | ABORTION | FETAL DEATH | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Studies | Research Methodology | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Economic Development | Economic Factors | Population Characteristics | Crime | Social Problems | Pregnancy Complications | Diseases | Fertility Control, Postconception | Family Planning | Mortality Document Number: 341098 |
| 16. Peer Reviewed Title: Abortion and the risk of subsequent preterm birth: a systematic review with meta-analyses. Author: Swingle HM; Colaizy TT; Zimmerman MB; Morriss FH Jr Source: Journal of Reproductive Medicine. 2009 Feb;54(2):95-108. Abstract: OBJECTIVE: To conduct a systematic review and meta-analyses of studies that test the association between induced or spontaneous abortion and subsequent preterm birth. STUDY DESIGN: International databases were reviewed (1995-2007) using the terms preterm, premature, birth, labor, delivery, abortion, induced abortion, miscarriage and spontaneous abortion. Only studies that met prespecified objective criteria for methodologic design and reporting were included in the meta-analyses. RESULTS: Twelve induced and 9 spontaneous abortion studies met inclusion criteria. Common adjusted odds ratios (ORs) for preterm birth following 1 and > or = 2 induced abortions were 1.25 (95% confidence interval [95% CI] 1.03-1.48) and 1.51 (95% CI 1.21-1.75), respectively. Four studies provided a common adjusted OR for < or = 32 weeks' births of 1.64 (95% CI 1.38-1.91). Meta-regression analysis revealed a previously unrecognized inverse relationship between the In OR and the control population preterm birth rate, explaining in part the observed heterogeneity among studies. Analysis of spontaneous abortion and subsequent preterm birth revealed a similar common adjusted OR and inverse meta-regression on the control preterm birth rates. CONCLUSION: Induced and spontaneous abortion are associated with similarly increased ORs for preterm birth in subsequent pregnancies, and they vary inversely with the baseline preterm birth rate, explaining some of the variability among studies. Language: English Keywords: UNITED STATES OF AMERICA | LITERATURE REVIEW | STATISTICAL REGRESSION | CASE CONTROL STUDIES | CLINICAL RESEARCH | WOMEN | ABORTION | ABORTION, SPONTANEOUS | PREMATURE BIRTH | RISK FACTORS | BIRTH RATE | Developed Countries | North America | Americas | Data Analysis | Research Methodology | Studies | Demographic Factors | Population | Fertility Control, Postconception | Family Planning | Pregnancy Complications | Diseases | Pregnancy Outcomes | Pregnancy | Reproduction | Health | Fertility Measurements | Fertility | Population Dynamics Document Number: 341116 |
| 17. Title: Seasonal modulation of reproductive effort during early pregnancy in humans. Author: Vitzthum VJ; Thornburg J; Spielvogel H Source: American Journal of Human Biology. 2009 Jul-Aug;21(4):548-58. Abstract: Life history theory predicts that early pregnancy presents a relatively low cost, uncontested opportunity for a woman to terminate investment in a current reproductive opportunity if a conceptus is of poor quality and/or maternal status or environmental conditions are not propitious for a successful birth. We tested this hypothesis in rural Bolivian women experiencing substantial seasonal variation in workload and food resources. Significant risk factors for early pregnancy loss (EPL) included agropastoralism versus other economic strategies, conception during the most arduous seasons versus other seasons, and increasing maternal age. Anovulation rate (AR) was higher during the most arduous seasons and in older women. Breastfeeding and indicators of social status and living conditions did not significantly influence either risk of EPL or AR. Averaged over the year, anovulation occurred in about 1/4 of the cycles and EPL occurred in about 1/3 of the conceptions. This is the first evidence of seasonality of EPL in a non-industrialized population, and the first to demonstrate a relationship between economic activities and EPL. These findings suggest that both anovulation and EPL are potential mechanisms for modulating reproductive effort; such "failures" may also be nonadaptive consequences of conditions hostile to a successful pregnancy. In either case, variation in EPL risk associated with different subsistence activities can be expected to influence fertility levels and birth seasonality in both contemporary and past human populations. These consequences of variability in the risk of EPL can impact efforts to understand the sources of variation in reproductive success. Language: English Keywords: BOLIVIA | RESEARCH REPORT | RURAL AREAS | PREGNANCY | SEASONAL VARIATION | ABORTION, SPONTANEOUS | RISK FACTORS | ECONOMIC FACTORS | MARITAL STATUS | TIME FACTORS | Developing Countries | South America, Central | South America | Latin America | Americas | Geographic Factors | Population | Reproduction | Population Dynamics | Demographic Factors | Pregnancy Complications | Diseases | Health | Nuptiality Document Number: 342988 |
| 18. Title: [Self-concept during high-risk pregnancy and recurrent gestational loss] Autoconcepto en el embarazo de alto riesgo y en la perdida gestacional Author: Campillo GG; Bravo CS; Lopez ME; Calva EA; Carmona FM Source: Ginecologia y Obstetricia de Mexico. 2008 Mar;76(3):143-50. Abstract: BACKGROUND: Within medical environment, emotional aspect of therapy strategy is frequently ignored or confused with different psychological aspects. There are scarce reports of high-risk pregnancies or recurrent gestational loss, most of them focused on an isolated event or factor related with self-concept. OBJECTIVE: To get self-concept profiles in two important reproductive different moments (high-risk pregnancy and recurrent gestational loss) and better focus therapy strategies. PATIENTS AND METHODS: Exploratory, transversal, retrospective, non-experimental, descriptive, and closed study. Two hundred patients referred from external consultation at Instituto Nacional de Perinatologia: 100 with high-risk pregnancy (A group), and 100 with recurrent gestational loss history (B group). Pregnant patients must have no abortion history. RESULTS: Patients with recurrent gestational loss had lower score in every clinical scale, and statistically meaningful differences. Both profiles had peak and sinusoid similarities. Intensity difference was evident and clarifies the psychological dynamics of both contingencies. Language: Spanish Keywords: RESEARCH REPORT | CLINICAL TRIALS | WOMEN | HIGH RISK WOMEN | PREGNANCY, HIGH RISK | ABORTION, SPONTANEOUS | PSYCHOLOGICAL FACTORS | Clinical Research | Research Methodology | Demographic Factors | Population | Reproduction | Pregnancy | Pregnancy Complications | Diseases | Behavior Document Number: 329027 |
| 19. Title: Pregnancy outcomes and intimate partner violence in New Zealand. Author: Fanslow J; Silva M; Whitehead A; Robinson E Source: Australian and New Zealand Journal of Obstetrics and Gynaecology. 2008 Aug;48(4):391-7. Abstract: AIM: This study aims to describe pregnancy outcomes for a population-based sample of New Zealand women, and to explore the relationship between lifetime experience of intimate partner violence (IPV) and two non-birth pregnancy outcomes: spontaneous abortion (miscarriage) and termination of pregnancy (abortion). METHODS: Face-to-face interviews were conducted with a random sample of 2391 women who had ever been pregnant, aged 18-64 years old, in two regions (urban and rural). Both outcome measures were determined by asking women if they had ever had a miscarriage or an abortion. Analyses were conducted using logistic regression. RESULTS: Almost one in three ever-pregnant women reported having at least one miscarriage, and at least one in ten reported terminating a pregnancy. Even controlling for potential confounders, women who had ever experienced IPV were 1.4 times more likely to report they had ever had a miscarriage compared with women who had never experienced violence (P = 0.008), and were 2.5 times more likely to report they had ever had an abortion (P < 0.0001). Ethnicity was significantly associated with experiencing a miscarriage (Asian and Pacific women were less likely compared with European/Pakeha women), and having ever had an abortion (Asian women were 3.5 times more likely compared with Pakeha women). CONCLUSIONS: In this population-based sample, miscarriage was relatively common, as was termination of pregnancy. IPV was significantly associated with both induced and spontaneous abortion. Healthcare settings that see women experiencing these pregnancy outcomes need to be cognisant of the link with current and historical IPV, and be able to respond to women appropriately. Language: English Keywords: NEW ZEALAND | RESEARCH REPORT | INTERVIEWS | WOMEN | COUPLES | ABORTION | ABORTION, SPONTANEOUS | WOMEN'S HEALTH | VIOLENCE AGAINST WOMEN | PREGNANCY | Oceania | Developed Countries | Data Collection | Research Methodology | Demographic Factors | Population | Family Characteristics | Family and Household | Sociocultural Factors | Fertility Control, Postconception | Family Planning | Pregnancy Complications | Diseases | Health | Domestic Violence | Crime | Social Problems | Reproduction Document Number: 330840 Notification |
| 20. Peer Reviewed Title: Abortion-related complications in Cambodia. Author: Fetters T; Vonthanak S; Picardo C; Rathavy T Source: BJOG: An International Journal of Obstetrics and Gynaecology. 2008 Jul;115(8):957-968. Abstract: Introduction: Although termination of pregnancy (termination) has been legal in the Kingdom of Cambodia since 1997, a number of barriers to safe termination services persist and many women continue to induce their own terminations or seek unsafe services that result in complications requiring 'post-abortion' care. Objective: To describe the complications of miscarriage and failed terminations and document the magnitude of the resulting morbidity in the Cambodian public sector. Design: Cross-sectional descriptive study. Setting: Public sector hospitals and health centres. Sample: Stratified multistage sampling design included all hospitals (n = 71), 14% of eligible high-level health centres (n = 58) and 22% of eligible low-level health centres (n = 57). Methods: Data collectors used a standardised questionnaire to record information on diagnosis, reproductive history and treatment from 629 women seeking care for termination or miscarriage-related complications in study facilities over a 3-week period. Main outcome measures: Annual estimate of cases, clinical symptoms, severity distribution of morbidity, ratio of complications to live births and incidence of abortion complications for Cambodian public health facilities. Results: In 2005, an estimated 31 579 women with complications of miscarriage or terminations were treated in Cambodian government facilities; 80% of these women sought care at a health centre. Forty percent of all women seeking care for complications either reported or showed strong clinical evidence of prior attempted terminations. Nearly 17% of these women were in the second trimester of pregnancy and 42% of them presented with high severity complications. The annual incidence of termination and miscarriage complications (abortion complications) was 867 per 100 000 women of reproductive age. The projected ratio of complications was 93 per 1000 live births. Conclusions: To reduce maternal morbidity in Cambodia, women must be encouraged to seek safe termination services or seek postabortion care without delay. Additionally, providers need further training, and facilities greater commitment, to provide safe terminations and care for complications of unsafe terminations and miscarriage. (author's) Language: English Keywords: CAMBODIA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | PREGNANT WOMEN | HOSPITALS | POSTABORTION CARE | PREGNANCY COMPLICATIONS | TREATMENT | EXAMINATIONS AND DIAGNOSES | ABORTION, SPONTANEOUS | Developing Countries | Asia, Southeastern | Asia | Research Methodology | Population Characteristics | Demographic Factors | Population | Health Facilities | Delivery of Health Care | Health | Health Services | Diseases | Medical Procedures | Medicine Document Number: 327336 |
| 21. Peer Reviewed Title: The influence of medical abortion compared with surgical abortion on subsequent pregnancy outcome. Author: Gan C; Zou Y; Wu S; Li Y; Liu Q Source: International Journal of Gynecology and Obstetrics. 2008 Jun;101(3):231-238. Abstract: Seven prospective cohort studies (12484 cases) were included in this review of the respective effects on the next pregnancy of medical and surgical abortion in early pregnancy. The incidence of miscarriage and postpartum hemorrhage was significantly lower in the pregnancy following a medical abortion. No other significant differences were found. With respect to the outcome of the next pregnancy, first-trimester medical abortions may thus be safer than the surgical option. (author's) Language: English Keywords: GLOBAL | CHINA | LITERATURE REVIEW | RESEARCH REPORT | COHORT ANALYSIS | PREGNANT WOMEN | PREGNANCY OUTCOMES | ABORTION | ABORTION, SPONTANEOUS | SAFETY | POSTPARTUM | BLEEDING | Asia, Eastern | Asia | Developing Countries | Research Methodology | Population Characteristics | Demographic Factors | Population | Pregnancy | Reproduction | Fertility Control, Postconception | Family Planning | Pregnancy Complications | Diseases | Public Health | Health | Puerperium | Signs and Symptoms Document Number: 326853 Notification |
| 22. Title: Low serum vitamin B12 is associated with recurrent pregnancy loss in Syrian women. Author: Hubner U; Alwan A; Jouma M; Tabbaa M; Schorr H; Herrmann W Source: Clinical Chemistry and Laboratory Medicine. 2008;46(9):1265-9. Abstract: BACKGROUND: Hyperhomocysteinemia and B-vitamin deficiency are associated with recurrent abortion. Recent studies have not investigated functional markers of vitamin B12 deficiency, such as methylmalonic acid. METHODS: A total of 43 consecutive Syrian women with unexplained recurrent abortion and 32 pregnant controls were enrolled in the study. Serum folate, vitamin B12, methylmalonic acid and plasma homocysteine were determined. RESULTS: Vitamin B12 was significantly decreased in patients with recurrent abortion compared to controls (mean concentrations 197 vs. 300 pg/mL, p=0.004). The lowest mean serum vitamin B12 (172 pg/mL) was observed in primary aborters. Homocysteine was elevated in aborters in comparison to controls (8.3 vs. 7.1 micromol/L, p=0.093). Folate and methylmalonic acid did not differ significantly between the study groups. A highly significant correlation between homocysteine and methylmalonic acid and vitamin B12 was observed only in patients but not in controls (p<0.001 and p=0.002, respectively). In the logistic regression model, only serum vitamin B12 emerged with a significant odds ratio. CONCLUSIONS: The results confirm low serum vitamin B12 in recurrent abortion patients. However, methylmalonic acid did not support that functional vitamin B12 plays a role in this group. This unexpected result might be due to a decrease of the metabolically inert vitamin B12 fraction (holohaptocorrin) or confounding factors. Further studies are necessary to investigate the role of vitamin B12 deficiency in recurrent abortion. Language: English Keywords: SYRIA | RESEARCH REPORT | WOMEN | PREGNANT WOMEN | FETAL DEATH | VITAMINS AND MINERALS | ABORTION, SPONTANEOUS | Middle East | Developing Countries | Demographic Factors | Population | Population Characteristics | Mortality | Population Dynamics | Physiology | Biology | Pregnancy Complications | Diseases Document Number: 329297 |
| 23. Peer Reviewed Title: Platelet-derived microparticle levels in women with recurrent spontaneous abortion. Author: Kaptan K; Beyan C; Ifran A; Pekel A Source: International Journal of Gynecology and Obstetrics. 2008 Sep;102(3):271-274. Abstract: Objective: To investigate the significance of platelet-derived microparticles (PMPs) in women with recurrent spontaneous abortion. Methods: We measured platelet P-selectin (CD62P) as a platelet activation marker and CD42b+ microparticles as PMPs by flow cytometry in whole blood of 20women with recurrent spontaneous abortion and 20 age-matched healthy controls with no previous history of spontaneous abortion. Results: PMP levels in women with recurrent spontaneous abortion were higher than in women in the control group (4.79 +or- 1.18% vs 3.06 +or- 0.92%; Pb0.000). CD62P levels were not significantly higher in the study group compared with the control group (13.78 +or- 8.62% vs 10.78 +or- 7.35%; PN0.05). Conclusion: Our findings suggest that PMPs may have a role in the pathogenesis of recurrent spontaneous abortion. Language: English Keywords: TURKEY | RESEARCH REPORT | COMPARATIVE STUDIES | CONTROL GROUPS | WOMEN | ABORTION, SPONTANEOUS | BLOOD | LABORATORY PROCEDURES | Developing Countries | Europe, Southeastern | Europe | Studies | Research Methodology | Demographic Factors | Population | Pregnancy Complications | Diseases | Hemic System | Physiology | Biology | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 308281 |
| 24. Peer Reviewed Title: Endothelial nitric oxide synthase gene polymorphisms in recurrent spontaneous abortions. Author: Karvela M; Papadopoulou S; Tsaliki E; Konstantakou E; Hatzaki A Source: Archives of Gynecology and Obstetrics. 2008 Oct;278(4):349-352. Abstract: Objective: The risk of miscarriage is enhanced by a variety of genetic and environmental factors. Previous studies indicated an association between endothelial nitric oxide synthase (eNOS) activity, and implantation and maintenance of pregnancy, but it is rather controversial whether polymorphisms of the gene encoding for eNOS are associated with recurrent spontaneous abortions (RSA). The aim of our study was to determine whether the 27 bp intron 4 repeat polymorphism (4VNTR) and a Glu298Asp missense mutation encoded by exon 7 of the eNOS gene are associated with an increased risk for recurrent spontaneous abortions (RSA), in the Greek population. Methods: A total of 126 women who had at least three unexplained spontaneous abortions before 20 weeks of gestation, with the same partner, were included in the study group. The control group consistent of 130 women with at least two live childbirths and without history of abortions. All patients and controls were investigated for the two polymorphisms. To genotype the cohorts we used the PCRRFLPs method. Results: The observed frequencies of bb, ba, aa genotypes of the VNTR, in intron 4, polymorphism were 0.75, 0.24, 0.01, respectively, for the patient group and 0.73, 0.24, 0.03, respectively, for the control group. The observed frequencies of GG, GT, TT of the Glu298Asp polymorphism were 0.42, 0.45, 0.13, respectively, for the patient group and 0.47, 0.45, 0.08, respectively, for the control group. Statistical analysis of the results indicates no significant difference between the two groups, for both the two studied polymorphisms. Conclusion: Our results do not show any influence of the two polymorphisms, VNTR in intron 4 and Glu298Asp of the eNOS gene, on early pregnancy. Language: English Keywords: GREECE | RESEARCH REPORT | CLINICAL RESEARCH | GENETIC TECHNIQUES | CASE CONTROL STUDIES | PREGNANT WOMEN | ABORTION, SPONTANEOUS | GENETICS | CHROMOSOME ABNORMALITIES | RISK FACTORS | Europe, Southern | Europe | Developed Countries | Research Methodology | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Studies | Population Characteristics | Demographic Factors | Population | Pregnancy Complications | Diseases | Biology | Neonatal Diseases and Abnormalities Document Number: 328064 |
| 25. Peer Reviewed Title: Miscarriage but not stillbirth rates are higher among younger nulliparas in rural Southern Nepal. Author: Katz J; Khatry SK; LeClerq SC; Shrestha SR; West KP Jr Source: Journal of Adolescent Health. 2008 Jun;42(6):587-595. Abstract: The purpose of this study was to examine the impact of young maternal age on miscarriages and stillbirths in rural Southern Nepal. Pregnancies, miscarriages, and stillbirths were prospectively identified in two randomized trials of maternal micronutrient supplementation. This analysis included 5861 women of parity 0 (nulliparas) and 4459 of parity 1 (primiparas) who were <26 years of age. Among nulliparous women, 5.7% and 4.6% of pregnancies ended in miscarriage and stillbirth. The adjusted relative risk of miscarriage was 2.07 for girls <15 (95% confidence interval [CI] = 1.17-3.66) compared with those 18 and 19 years, and was 1.40 (95% CI = 1.06 -1.84) among those 15-17 years. Stillbirth rates did not differ significantly by maternal age. There were no differences in miscarriage or stillbirth rates by maternal age among primiparas. Young maternal age increased the risk of miscarriages but not stillbirths for nulliparas. Miscarriages and stillbirths did not differ by maternal age for primiparous women. (author's) Language: English Keywords: NEPAL | RESEARCH REPORT | PROSPECTIVE STUDIES | WOMEN | RURAL POPULATION | ADOLESCENT PREGNANCY | FETAL DEATH | ABORTION, SPONTANEOUS | PARITY | AGE FACTORS | Developing Countries | Asia, Southern | Asia | Studies | Research Methodology | Demographic Factors | Population | Population Characteristics | Reproductive Behavior | Fertility | Population Dynamics | Mortality | Pregnancy Complications | Diseases | Fertility Measurements Document Number: 326907 |
| 26. Title: Use of vaginal pH in diagnosis of infections and its association with reproductive manifestations. Author: Mania-Pramanik J; Kerkar SC; Mehta PB; Potdar S; Salvi VS Source: Journal of Clinical Laboratory Analysis. 2008;22(5):375-9. Abstract: Increase in vaginal secretion pH is an indicator of bacterial vaginosis (BV), but is yet to be in use as a diagnostic tool by clinicians. Similarly, no reports are available on the effect of cervical chlamydia infection and different reproductive manifestations on vaginal secretion pH. This study evaluated the use of vaginal pH for screening of BV, the effect of Chlamydia trachomatis (C. trachomatis) infection, and different reproductive manifestations on vaginal pH of women attending the gynecology outpatient department of a general hospital. Vaginal pH was recorded while diagnosing infections in 358 women, among which 45 were with repeated spontaneous abortion, 79 with infertility, 185 had sign and symptoms of lower genital tract infection, and 49 had no history or symptom of any complications or infections. Normal vaginal pH, BV, and C. trachomatis infection were observed in 72.6, 21.5, and 10.1% of women, respectively. BV and C. trachomatis were observed in 78.6 and 4.1% of women, respectively, with high vaginal pH; 12.3% of women with normal vaginal pH had C. trachomatis infection. C. trachomatis infection or different reproductive manifestations do not lead to change in vaginal pH but high vaginal pH correlated with BV and should be used as a simple tool for its diagnosis. Language: English Keywords: INDIA | RESEARCH REPORT | CLINICAL RESEARCH | WOMEN IN DEVELOPMENT | LABORATORY EXAMINATIONS AND DIAGNOSES | VAGINOSIS | ABORTION, SPONTANEOUS | CHLAMYDIA | SIGNS AND SYMPTOMS | VAGINAL ABNORMALITIES | SCREENING | BACTERIAL AND FUNGAL DISEASES | INFERTILITY | REPRODUCTIVE TRACT INFECTIONS | TRACHOMA | Developing Countries | Asia, Southern | Asia | Research Methodology | Economic Development | Economic Factors | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Diseases | Pregnancy Complications | Sexually Transmitted Diseases | Infections | Reproduction Document Number: 329331 |
27.  Peer Reviewed Title: Pregnancy and miscarriage are not the main reasons for leaving school in Africa. Author: Melhado L Source: International Family Planning Perspectives. 2008 Sep;34(3):147-148. Abstract: Although "schoolgirl pregnancy" is commonly thought to be a key reason why many young women in developing countries do not complete their education, an analysis of Demographic and Health Survey data indicate that early pregnancy and marriage generally account for only about 20% of school dropouts among female adolescents in Sub-Saharan Africa. Of the two causes, it is union formation, rather than pregnancy, that is most likely to precipitate dropping out. Moreover, as rates of early marriage and childbearing have declined in the region, so too has the risk of leaving school for either reason. While policymakers and the media often cite pregnancy and marriage as the primary drivers for female adolescents' leaving school prematurely (i.e., before completion of secondary school) in Sub-Saharan Africa, the circumstances that predispose young women to have premarital sex or to marry early, such as poverty and poor school performance, may themselves lead students to drop out. To determine the relative importance of these various factors, researchers analyzed data on reproductive and educational outcomes from Demographic and Health Surveys conducted in 1994-1999 in 20 Sub-Saharan African countries. In the surveys, women of reproductive age who were no longer in school were asked to give the primary reason they left school and, in five of the countries, the age at which they left. The researchers examined how frequently women said that pregnancy or marriage was the main reason that they left school, and whether these reasons were more commonly cited in countries with high rates of early marriage and childbearing. These analyses were restricted to women aged 20-24. (excerpt) Language: English Keywords: AFRICA, SUB SAHARAN | RESEARCH REPORT | CRITIQUE | DEMOGRAPHIC AND HEALTH SURVEYS | WOMEN IN DEVELOPMENT | ADOLESCENTS, FEMALE | DROPOUTS | ADOLESCENT PREGNANCY | MOTIVATION | ABORTION, SPONTANEOUS | AGE FACTORS | MARITAL STATUS | Africa | Developing Countries | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Economic Development | Economic Factors | Adolescents | Youth | Population Characteristics | Programs | Organization and Administration | Reproductive Behavior | Fertility | Psychological Factors | Behavior | Pregnancy Complications | Diseases | Nuptiality Document Number: 322607 |
| 28. Peer Reviewed Title: A firstborn boy is suggestive of a strong prognostic factor in secondary recurrent miscarriage: A confirmatory study. Author: Nielsen HS; Andersen AN; Kolte AM; Christiansen OB Source: Fertility and Sterility. 2008 Apr;89(4):907-911. Abstract: The objective was to test our previously generated hypothesis that women with secondary recurrent miscarriages with a firstborn boy have a poorer pregnancy prognosis than those with a firstborn girl. The design used was a study of a retrospective and a prospective cohort. The setting was the Danish recurrent miscarriage clinic. Two cohorts of 175 and 130 consecutive patients with unexplained secondary recurrent miscarriage referred from 1986 to 1999 (cohort 1) and 2000 to 2005 (cohort 2), respectively. Main Outcome Measure(s): The odds ratio (OR) for a live birth in the first pregnancy after referral in those with a firstborn boy compared with a firstborn girl in each of the two cohorts. The corresponding OR for a live birth adjusted for relevant prognostic variables in the combined group of patients. The crude ORs for a live birth in those with a firstborn boy compared with a firstborn girl were very similar in cohorts 1 and 2 (OR = 0.35, 0.33). In the adjusted analysis only two of five included variables significantly predicted live birth: a firstborn boy and the number of previous miscarriages. Male sex of the firstborn child is a strong negative prognostic factor in women with secondary recurrent miscarriage. A possible explanation is an abnormal maternal immune response against male-specific minor histocompatibility (HY) antigens. (author's) Language: English Keywords: DENMARK | RESEARCH REPORT | CLINICAL RESEARCH | COHORT ANALYSIS | LONGITUDINAL STUDIES | PREGNANT WOMEN | INFANT | ABORTION, SPONTANEOUS | ABORTION, HABITUAL | RISK FACTORS | SEX FACTORS | IMMUNOLOGICAL EFFECTS | ANTIGENS | HISTOCHEMICAL EFFECTS | Developed Countries | Europe, Northern | Europe | Research Methodology | Studies | Population Characteristics | Demographic Factors | Population | Youth | Age Factors | Pregnancy Complications | Diseases | Biology | Immunity | Immune System | Physiology | Immunologic Factors | Cytologic Effects Document Number: 325840 |
| 29. Peer Reviewed Title: Clinic-based surveillance of adverse pregnancy outcomes to identify induced abortions in Accra, Ghana. Author: Oliveras E; Ahiadeke C; Adanu RM; Hill AG Source: Studies in Family Planning. 2008 Jun;39(2):133-140. Abstract: Reliable measures of induced abortion remain elusive, especially when the public perception is that the procedure is immoral or improper. This study draws on interviews using a modified preceding birth technique (PBT) with women attending antenatal and maternity clinics in Accra to compare rates of adverse pregnancy outcomes (stillbirths, miscarriages, and induced abortions) with rates from a household maternity history and the Ghana Demographic and Health Survey. The reports from the antenatal clinics produced some of the highest rates for adverse outcomes of pregnancy. In light of the generally high coverage of antenatal services found even in developing countries, the method based on the PBT holds promise for the improvement of reports of miscarriage and abortion worldwide. (author's) Language: English Keywords: GHANA | RESEARCH REPORT | METHODOLOGICAL STUDIES | EPIDEMIOLOGIC METHODS | DEMOGRAPHIC AND HEALTH SURVEYS | KAP SURVEYS | PREGNANT WOMEN | WOMEN IN DEVELOPMENT | PREGNANCY OUTCOMES | ABORTION | ANTENATAL CARE | ABORTION, SPONTANEOUS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Research Methodology | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Surveys | Sampling Studies | Studies | Population Characteristics | Economic Development | Economic Factors | Pregnancy | Reproduction | Fertility Control, Postconception | Family Planning | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Health | Pregnancy Complications | Diseases Document Number: 326974 Notification |
| 30. Peer Reviewed Title: Sexual violence-related fistulas in the Democratic Republic of Congo. Author: Onsrud M; Sjoveian S; Luhiriri R; Mukwege D Source: International Journal of Gynecology and Obstetrics. 2008 Sep 22;:[5] p. Abstract: Objective: To determine the magnitude of traumatic gynecologic fistulas caused by sexual violence in the Democratic Republic of Congo. Methods: A retrospective analysis of hospital records from 604 consecutive patients who received treatment for gynecologic fistulas at Panzi Hospital between November 2005 and November 2007. Results: Of the 604 patients, 24 (4%) reported that their fistulas had been caused by sexual violence; of these, 5 (0.8%) had developed fistulas as a direct result of forced penetration with foreign objects and/or gang rapes. Of the remaining patients, 6 had a fistula before they were raped, 9 developed iatrogenic fistulas following inappropriate instrumentation to manage rape-induced spontaneous abortion or stillbirth, or after abdominal hysterectomy, and 4 developed fistulas after prolonged and obstructed labor. Conclusion: Traumatic fistulas are rare compared to obstetric fistulas. Fistulas indirectly related to sexual violence are likely to be more common than those directly related. All fistulas resulting from sexual violence, whether direct or indirect, should be considered traumatic and special care should be given to these women. Language: English Keywords: DEMOCRATIC REPUBLIC OF THE CONGO | RESEARCH REPORT | RETROSPECTIVE STUDIES | EXAMINATIONS AND DIAGNOSES | RECORDS | SEXUAL ABUSE | SEX BEHAVIOR | VIOLENCE | VIOLENCE AGAINST WOMEN | RAPE | FISTULA | ABORTION, SPONTANEOUS | HYSTERECTOMY | Africa, Central | Africa, Sub Saharan | Africa | Developing Countries | Studies | Research Methodology | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Information Processing | Information | Crime | Social Problems | Sociocultural Factors | Behavior | Domestic Violence | Diseases | Pregnancy Complications | Gynecologic Surgery | Urogenital Surgery | Surgery | Treatment Document Number: 328492 |
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