1.  Title: Prevention of low birthweight. Author: Alam DS Source: Nestle Nutrition Workshop Series. Paediatric Programme. 2009;63:209-21; discussion 221-5, 259-68. Abstract: Globally an estimated 20 million infants are born with low birthweight (LBW), of those over 18 million are born in developing countries. These LBW infants are at a disproportionately higher risk of mortality, morbidity, poor growth, impaired psychomotor and cognitive development as immediate outcomes, and are also disadvantaged as adults due to their greater susceptibility to type 2 diabetes, hypertension and coronary heart disease. Maternal malnutrition prior to and during pregnancy manifested by low bodyweight, short stature, inadequate energy intake during pregnancy and coexisting micronutrient deficiency are considered major determinants in developing countries where the burden is too high. LBW is a multifactorial outcome and its prevention requires a lifecycle approach and interventions must be continued for several generations. So far, most interventions are targeted during pregnancy primarily due to the increased nutritional demand and aggravations of already existing inadequacy in most women. Several individually successful interventions during pregnancy include balanced protein energy supplementation, several single micro-nutrients or more recently a mix of multiple micronutrients. Nutrition education has been successful in increasing the dietary intake of pregnant women but has had no effect on LBW. The challenge is to identify a community-specific intervention package. Current evidence supports intervention during pregnancy with increased dietary intakes including promotions of foods rich in micronutrients and micronutrient supplementation, preferably with a multiple micronutrient mix. Simultaneously a culturally appropriate educational component is required to address misconceptions about diet during pregnancy and childbirth including support for healthy pregnancy with promotion of antenatal and perinatal care services. While further research is needed to identify more efficacious interventions, an urgent public health priority would be to select and implement an optimal mix of interventions to avert the immediate adverse consequences of LBW and to prevent the impending epidemic of type 2 diabetes, hypertension and coronary heart disease which are negatively associated with LBW. Language: English Keywords: DEVELOPING COUNTRIES | LITERATURE REVIEW | LOW BIRTH WEIGHT | PREVALENCE | INTERVENTIONS | INTRAUTERINE GROWTH RETARDATION | MATERNAL NUTRITION | FOOD SUPPLEMENTATION | VITAMINS AND MINERALS | DIET | Birth Weight | Body Weight | Physiology | Biology | Measurement | Research Methodology | Programs | Organization and Administration | Congenital Abnormalities | Neonatal Diseases and Abnormalities | Diseases | Nutrition | Health | Nutrition Programs | Primary Health Care | Health Services | Delivery of Health Care Document Number: 341347 |
| 2. Title: Reproductive and hormonal factors, and ovarian cancer risk for BRCA1 and BRCA2 mutation carriers: results from the International BRCA1/2 Carrier Cohort Study. Author: Antoniou AC; Rookus M; Andrieu N; Brohet R; Chang-Claude J Source: Cancer Epidemiology, Biomarkers and Prevention. 2009 Feb;18(2):601-10. Abstract: BACKGROUND: Several reproductive and hormonal factors are known to be associated with ovarian cancer risk in the general population, including parity and oral contraceptive (OC) use. However, their effect on ovarian cancer risk for BRCA1 and BRCA2 mutation carriers has only been investigated in a small number of studies. METHODS: We used data on 2,281 BRCA1 carriers and 1,038 BRCA2 carriers from the International BRCA1/2 Carrier Cohort Study to evaluate the effect of reproductive and hormonal factors on ovarian cancer risk for mutation carriers. Data were analyzed within a weighted Cox proportional hazards framework. RESULTS: There were no significant differences in the risk of ovarian cancer between parous and nulliparous carriers. For parous BRCA1 mutation carriers, the risk of ovarian cancer was reduced with each additional full-term pregnancy (P trend = 0.002). BRCA1 carriers who had ever used OC were at a significantly reduced risk of developing ovarian cancer (hazard ratio, 0.52; 95% confidence intervals, 0.37-0.73; P = 0.0002) and increasing duration of OC use was associated with a reduced ovarian cancer risk (P trend = 0.0004). The protective effect of OC use for BRCA1 mutation carriers seemed to be greater among more recent users. Tubal ligation was associated with a reduced risk of ovarian cancer for BRCA1 carriers (hazard ratio, 0.42; 95% confidence intervals, 0.22-0.80; P = 0.008). The number of ovarian cancer cases in BRCA2 mutation carriers was too small to draw definitive conclusions. CONCLUSIONS: The results provide further confirmation that OC use, number of full-term pregnancies, and tubal ligation are associated with ovarian cancer risk in BRCA1 carriers to a similar relative extent as in the general population. Language: English Keywords: DEVELOPED COUNTRIES | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | COHORT ANALYSIS | CROSS-CULTURAL COMPARISONS | CLINICAL RESEARCH | WOMEN | PREVALENCE | RISK ASSESSMENT | OVARIAN CANCER | CHROMOSOME ABNORMALITIES | PARITY | RISK FACTORS | ORAL CONTRACEPTIVES, SIDE EFFECTS | TUBAL LIGATION | Research Methodology | Comparative Studies | Studies | Demographic Factors | Population | Measurement | Evaluation | Cancer | Neoplasms | Diseases | Neonatal Diseases and Abnormalities | Fertility Measurements | Fertility | Population Dynamics | Health | Contraceptive Safety | Safety | Public Health | Female Sterilization | Sterilization, Sexual | Family Planning Document Number: 331025 |
| 3. Title: Undernutrition malnutrition in infants in developing countries [letter] Author: Ashorn P; Phuka JC; Maleta K; Thakwalakwa C; Cheung YB; Briend A; Manary MJ Source: Archives of Pediatrics and Adolescent Medicine. 2009 Feb;163(2):186. Abstract: We commend Dr Humphrey on an insightful and well-written editorial on infant underweight malnutrition and thank her for her interest in our study on this topic. In our trial, provision of fortified spread, a novel lipid-based nutrient supplement, to Malawian infants was associated with a markedly reduced incidence of severe stunting between 6 and 18 months of age. Yet, there was a large decrease in mean height-for-age, indicating that even the infants given supplementation often failed to maintain normal growth during this critical age. Dr Humphrey proposes 2 explanations for how this might be linked to insufficient dietary intakes: breast-milk displacement and increased energy and nutrient needs due to high rates of disease. Whereas the former has been documented in other settings, we found little evidence supporting this theory in our study area. Diarrhea, malaria, and respiratory infections, on the other hand, are common and associated with infant stunting in this population. Malaria incidence has recently declined, apparently owing to the frequent use of bed nets, but other childhood infections may well have contributed to the growth faltering of our study participants. Besides events after birth, we would like to emphasize the importance of antenatal factors for linear growth failure in many low-income countries. Due to a high proportion of preterm births and the frequency of intrauterine growth retardation, Malawian children are already shorter than expected at birth. In the present trial, mean length-for-age was below a -1 z score by age 6 months.1 In such conditions, it is difficult to prevent growth faltering solely with postnatal interventions; instead, these interventions need to be complemented with others that address antenatal problems, such as maternal undernutrition and infections. On the other hand, when fetal conditions are less distressing and stunting has not started by 6 months of age, an isolated nutrition intervention may prove sufficient. This was illustrated in a recent trial in Ghana, where infants who were given a lipid-based nutrient supplement that was not very different from the one we used in Malawi lost no length-for-age between 6 and 12 months of age. (full-text) Language: English Keywords: MALAWI | CRITIQUE | INFANT | MALNUTRITION | CALORIC INTAKE | SUPPLEMENTARY FEEDING | INTRAUTERINE GROWTH RETARDATION | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Nutrition Disorders | Diseases | Nutrition | Health | Infant Nutrition | Congenital Abnormalities | Neonatal Diseases and Abnormalities Document Number: 330227 |
| 4. Title: Fetal abnormalities leading to third trimester abortion: nine-year experience from a single medical center. Author: Barel O; Vaknin Z; Smorgick N; Reish O; Mendlovic S; Herman A; Maymon R Source: Prenatal Diagnosis. 2009 Mar;29(3):223-8. Abstract: OBJECTIVE: To assess fetal abnormalities and events leading to third-trimester abortion. METHODS: The study population included all parturient women with singleton pregnancy that underwent termination of pregnancy (TOP) in the third trimester in our institute because of fetal indications between 1998 and 2006. RESULTS: There were 777 cases of TOP due to fetal anomalies in our center during the study period, and 52 terminations were carried out in the third trimester. All cases of third-trimester abortions were due to severe malformations with high probability of perinatal death or severe handicap: 65.3% anomalies were structural, and 58.9% of them involved the central nervous system (CNS). Genetic indications included mostly genetic diseases, unlike aneupluidities in earlier terminations. Routine prenatal care raised suspicion of abnormalities in 22 (42.3%) cases, and diagnosis was established by additional tests. Abnormal findings were either missed in 4 (7.7%) cases or developed later in 11 (21.1%) cases. No routine prenatal screening was performed in the remaining 15 (28.8%) cases. CONCLUSIONS: Third-trimester abortion may be obviated by timely screening and scanning in some cases. The possibility of late TOP should be considered in malformations occurring late in pregnancy and in cases that require meticulous evaluation and follow-up from earlier stages of gestation. Language: English Keywords: ISRAEL | RESEARCH REPORT | FETUS | PREGNANCY, THIRD TRIMESTER | CHROMOSOME ABNORMALITIES | CONGENITAL ABNORMALITIES | SCREENING | ABORTION | Developed Countries | Middle East | Pregnancy | Reproduction | Neonatal Diseases and Abnormalities | Diseases | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Fertility Control, Postconception | Family Planning Document Number: 331172 Notification |
| 5. Title: Genetic counseling for teratogenic risk due to exposure to medications: 89 pregnancies conceived during oral contraceptive use. Author: Belli S; Mazzola S; Luongo R; Barcella L; Alushi B Source: American Journal of Medical Genetics. Part A. 2009 Jun 5; Abstract: Congenital malformations are relatively frequent (2% of the general population) but only a small proportion of them can be ascribed to medication exposure during pregnancy. Nevertheless, for the purposes of accurate prenatal diagnosis, monitoring and research, is it important to offer teratology counseling to patients exposed to drugs. There are approximately 20 medications currently on the market that have been universally acknowledged as teratogenic. At the current state of the art, exposure of early embryos to oral contraceptives is not considered teratogenic. Oral contraceptive use may be continuous (estrogen and progesterone or progesterone alone) or emergency (levonorgestrel is the only drug authorized in Italy). Like all drugs, oral contraceptives have a therapeutic failure rate, which means that a number of women on oral contraceptives conceive each year and request genetic counseling about teratogenic effects. During the period 1998-2006 at our genetics clinic we received 89 requests for counseling regarding teratogenic risk due to oral contraceptives. Our study of these patients confirms an absence of teratogenic risk for pregnancies occurring during oral contraceptive use. Teratology counseling was useful to reassure the mothers about the low risk (in the case of oral contraceptive use alone), since only 12 women chose to terminate pregnancy. Language: English Keywords: ITALY | RESEARCH REPORT | GENETICS | COUNSELING | EXPOSURE | ORAL CONTRACEPTIVES | CONTRACEPTIVE AGENTS, ESTROGEN | PROGESTERONE | LEVONORGESTREL | CONGENITAL ABNORMALITIES | RISK FACTORS | PREGNANCY | Developed Countries | Europe, Southern | Europe | Biology | Clinic Activities | Program Activities | Programs | Organization and Administration | Health | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Female | Contraceptive Agents | Progestational Hormones | Hormones | Endocrine System | Physiology | Contraceptive Agents, Progestin | Neonatal Diseases and Abnormalities | Diseases | Reproduction Document Number: 341602 |
| 6. Title: Prenatal origins of undernutrition. Author: Christian P Source: Nestle Nutrition Workshop Series. Paediatric Programme. 2009;63:59-73; discussion 74-7, 259-68. Abstract: Undernutrition continues to be high in many regions of the developing world. Birthweight, a common proxy measure of intrauterine growth, is influenced by nutritional, environmental and lifestyle factors during pregnancy and, in turn, affects immediate survival and function, and is a determinant of later life risk of chronic diseases. Maternal pre-pregnancy weight and height are independently associated with birthweight and also modify the effects of pregnancy weight gain and interventions during pregnancy on birthweight and perinatal mortality. Other prenatal factors commonly known to impact birthweight include maternal age, parity, sex, and birth interval, whereas lifestyle factors such as physical activity and maternal stress, as well as environmental toxicants have variable influences. Tobacco and other substance use and infections, specifically ascending reproductive tract infections, malaria, and HIV, can cause intrauterine growth restriction (IUGR). Few studies have examined the contribution of prenatal factors including low birthweight to childhood wasting and stunting. Studies that have examined this, with adequate adjustment for confounders, have generally found odds ratios associated with low birthweight ranging between 2 and 5. Even fewer studies have examined birth length or maternal nutritional status as risk factors. More research is needed to determine the proportion of childhood under-nutrition attributable to IUGR so that interventions can be targeted to the appropriate life stages. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | ADOLESCENTS, FEMALE | YOUTH | WOMEN | ETHNIC GROUPS | PARITY | REPRODUCTIVE AGE | MALNUTRITION | HEALTH STATUS INDEXES | INTRAUTERINE GROWTH RETARDATION | REPRODUCTIVE TRACT INFECTIONS | MALARIA | HIV INFECTIONS | INTERVENTIONS | Developed Countries | North America | Americas | Adolescents | Age Factors | Population Characteristics | Demographic Factors | Population | Cultural Background | Fertility Measurements | Fertility | Population Dynamics | Reproduction | Nutrition Disorders | Diseases | Health | Congenital Abnormalities | Neonatal Diseases and Abnormalities | Infections | Parasitic Diseases | Viral Diseases | Programs | Organization and Administration Document Number: 341348 |
| 7. Title: Factors influencing the duration of pregnancy termination with vaginal misoprostol for fetal abnormality. Author: Dickinson JE; Doherty DA Source: Prenatal Diagnosis. 2009 May;29(5):520-4. Abstract: OBJECTIVE: Evaluation of factors influencing the duration of second-trimester pregnancy interruption with vaginal misoprostol for fetal abnormality. METHODS: All medical terminations >or=13 weeks of gestation 1/1997 to 12/2007 were prospectively identified. Cases receiving vaginal misoprostol 400 microg 6-hourly were extracted from the database and outcomes reviewed. RESULTS: This consecutive case series comprised 1066 women. Median maternal age was 31 years [interquartile range (IQR) 26, 36] and 15.4% had at least one prior cesarean delivery. Principal indications for termination were aneuploidy (37.6%), neural tube defects (15.9%) and cardiac anomalies (9.4%). Median gestation at termination was 19.5 weeks (IQR 17.9, 21). Median abortion interval was 16.1 h (IQR 12, 23.5). Lower maternal age (median duration 17.6 vs 15.2 vs 13.6 h, age < 30 vs 30-39 vs > 40 years, p < 0.001), nulliparity (median duration 19 vs 14.3 h, nulliparous vs parous, p < 0.001) and increasing gestation (median duration 13 vs 17.8 h, <16 vs >20 weeks, p < 0.001) were associated with abortion prolongation. Controlling for gestation, age and parity, apart from musculoskeletal abnormalities (associated with abortion prolongation, p = 0.03), the specific fetal anomaly did not influence duration. CONCLUSIONS: Three factors: nulliparity, younger maternal age and increasing gestation, were associated with abortion prolongation. Apart from musculoskeletal abnormalities, the fetal anomaly had no impact on abortion duration. Language: English Keywords: AUSTRALIA | RESEARCH REPORT | CONGENITAL ABNORMALITIES | ABORTION | MISOPROSTOL | TIME FACTORS | AGE FACTORS | NULLIPARITY | Oceania | Developed Countries | Neonatal Diseases and Abnormalities | Diseases | Fertility Control, Postconception | Family Planning | Prostaglandins, Synthetic | Prostaglandins | Endocrine System | Physiology | Biology | Population Dynamics | Demographic Factors | Population | Population Characteristics | Parity | Fertility Measurements | Fertility Document Number: 342614 Notification |
| 8. Peer Reviewed Title: Anthropometric indices of infants born to HIV-1-infected mothers: a prospective cohort study in Lagos, Nigeria. Author: Ezeaka VC; Iroha EO; Akinsulie AO; Temiye EO; Adetifa IM Source: International Journal of STD and AIDS. 2009 Aug;20(8):545-8. Abstract: Numerous studies have reported that HIV-infected pregnant women are at increased risk of delivery of low birth weight (LBW) infants, of preterm deliveries and of intrauterine growth restriction. The objective of the study was to determine the effect of maternal HIV infection on the anthropometric characteristics of the babies at birth. A prospective study was carried out at the Lagos University Teaching Hospital, Nigeria. There were three times more LBW babies in the HIV-positive group than in the uninfected mothers (odds ratio = 3.47, 95% confidence interval = 1.69, 7.27; chi(2) = 12.99, P = 0.0003).The maternal weight (t = 15.85; P = 0.0001), maternal body mass index (BMI) (t = 15.07; P = 0.0003), birth weight of infants (t = 27.17; P = 0.0001) and birth length (t = 31.20; P = 0.001) were significantly less in HIV-positive mothers than in controls. In conclusion, poor maternal bodyweight and low BMI are significant contributors to LBW in HIV-infected women. Nutritional counselling, dietary intake and weight monitoring during pregnancy should be emphasized to improve pregnancy outcome in HIV-infected women. Language: English Keywords: NIGERIA | RESEARCH REPORT | PROSPECTIVE STUDIES | COHORT ANALYSIS | PERSONS LIVING WITH HIV/AIDS | MOTHERS | INFANT | INTRAUTERINE GROWTH RETARDATION | MATERNAL NUTRITION | ANTHROPOMETRY | BIRTH WEIGHT | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Studies | Research Methodology | HIV Infections | Viral Diseases | Diseases | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Congenital Abnormalities | Neonatal Diseases and Abnormalities | Nutrition | Health | Measurement | Body Weight | Physiology | Biology Document Number: 342221 |
| 9. Peer Reviewed Title: Rapidly increasing prevalence of HIV and syphilis and HIV-1 subtype characterization among men who have sex with men in Jiangsu, China. Author: Guo H; Wei JF; Yang H; Huan X; Tsui SK; Zhang C Source: Sexually Transmitted Diseases. 2009 Feb;36(2):120-5. Abstract: OBJECTIVES: To investigate the prevalence of HIV, hepatitis B (HBV), hepatitis C (HCV), and syphilis among men who have sex with men (MSM) in 2 cities of Jiangsu, China, and to characterize the HIV-1 subtypes prevalent among this population. METHODS: During September 2006 and July 2007, 296 and 173 MSM were recruited from Nanjing and Yangzhou, respectively. Sera samples were collected and tested for HIV, HBV, HCV, and syphilis infections. The nucleotide sequences of p17 and C2V3 regions were determined by RT-nested-PCR and sequencing. HIV-1 subtypes were characterized by phylogenetic analysis. RESULTS: The prevalence of HIV, HBV, HCV, and syphilis infections among MSM was 5.8%, 11.1%, 0.7%, and 27.7%, respectively. The prevalence of HIV and syphilis was significantly higher in 2006-2007 than in 2003 (P Language: English Keywords: CHINA | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | GENETIC TECHNIQUES | MEN HAVING SEX WITH MEN | PERSONS LIVING WITH HIV/AIDS | URBAN POPULATION | PREVALENCE | HIV INFECTIONS | SYPHILIS | HEPATITIS | GENETICS | CHROMOSOME ABNORMALITIES | Asia, Eastern | Asia | Developing Countries | Research Methodology | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Sex Behavior | Behavior | Persons Living With HIV/AIDS | Viral Diseases | Diseases | Population Characteristics | Demographic Factors | Population | Measurement | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Biology | Neonatal Diseases and Abnormalities Document Number: 330373 |
| 10. Peer Reviewed Title: CONSANGUINEOUS MARRIAGES IN MOROCCO AND THE CONSEQUENCE FOR THE INCIDENCE OF AUTOSOMAL RECESSIVE DISORDERS. Author: Jaouad IC; Elalaoui SC; Sbiti A; Elkerh F; Belmahi L; Sefiani A Source: Journal of Biosocial Science. 2009 May 12;:1-7. Abstract: SummaryConsanguineous marriage is traditionally common throughout Arab countries. This leads to an increased birth prevalence of infants with recessive disorders, congenital malformations, morbidity and mortality. The aim of this study was to evaluate the rate of consanguineous marriage in families with autosomal recessive diseases, and to compare it with the average rate of consanguinity in the Moroccan population. The study was conducted in the Department of Medical Genetics in Rabat on 176 families with autosomal recessive diseases diagnosed and confirmed by clinical, radiological, enzymatic or molecular investigations. The rate of consanguinity was also studied in 852 families who had infants with trisomy 21 confirmed by karyotyping. These families were chosen because: (i) there is no association between trisomy 21 and consanguinity, (ii) these cases are referred from different regions of Morocco and (iii) they concern all social statuses. Among 176 families with autosomal recessive disorders, consanguineous marriages comprised 59.09% of all marriages. The prevalence of consanguinity in Morocco was found to be 15.25% with a mean inbreeding coefficient of 0.0065. The differences in the rates of consanguineous marriages were highly significant when comparing the general population and couples with offspring affected by autosomal recessive conditions. These results place Morocco among the countries in the world with high rates of consanguinity. Autosomal recessive disorders are strongly associated with consanguinity. This study better defines the health risks associated with consanguinity for the development of genetic educational guidelines targeted at the public and the health sector. Language: English Keywords: MOROCCO | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | COUPLES | CHILDREN | PREVALENCE | INCIDENCE | CONGENITAL ABNORMALITIES | CONSANGUINITY | SOCIAL CLASS | BIRTH DEFECTS | Africa, North | Africa | Developing Countries | Research Methodology | Family Characteristics | Family and Household | Sociocultural Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Measurement | Neonatal Diseases and Abnormalities | Diseases | Genetics | Biology | Socioeconomic Status | Socioeconomic Factors | Economic Factors Document Number: 341479 |
| 11. Title: Suggestions for effective contraception in isotretinoin therapy [letter] Author: Kanelleas AI; Thornton S; Berth-Jones J Source: British Journal of Clinical Pharmacology. 2009 Jan;67(1):137-8. Abstract: This letter to the editor argues that parenteral progestogen-only contraceptives are adopted as a standard approach to contraception for female patients considered for isotretinoin therapy, an effective drug for acne. It touches on the issues of isotretinoin, pregnancy, birth defects, and abortion. Language: English Keywords: UNITED KINGDOM | CRITIQUE | CLINICAL RESEARCH | PREGNANT WOMEN | INFANT | CHROMOSOME ABNORMALITIES | CONGENITAL ABNORMALITIES | PREVALENCE | ACNE | DRUGS | TREATMENT | CONTRACEPTIVE SAFETY | INJECTABLES | OSTEOPOROSIS | TIME FACTORS | Developed Countries | Europe, Western | Europe | Research Methodology | Population Characteristics | Demographic Factors | Population | Youth | Age Factors | Neonatal Diseases and Abnormalities | Diseases | Measurement | Dermatitis | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Safety | Public Health | Contraceptive Methods | Contraception | Family Planning | Skeletal Effects | Physiology | Biology | Population Dynamics Document Number: 341136 |
| 12. Peer Reviewed Title: Cyproterone acetate- and ethinyloestradiol-containing oral contraceptive as a risk factor for upper extremity deep venous thrombosis-a case report. Author: Kapur R; Stramrood CA; Schutgens RE; van Asbeck BS Source: European Journal of Contraception and Reproductive Health Care. 2009 Apr;14(2):160-3. Abstract: Deep venous thrombosis of the upper extremity (UEDVT) is a rare variety of deep venous thrombosis. Compared to lower-extremity deep venous thrombosis, less is known about the risk factors for primary UEDVT. We report on a 27-year-old woman with UEDVT extending from the jugular and subclavian veins to the elbow. The thrombosis was possibly provoked by a shoulder trauma, in combination with heterozygosity for the prothrombin G20210A mutation and a protein S-deficiency, which may have been induced by the use of a cyproterone acetate- and ethinyloestradiol (CPA/EE)-containing oral contraceptive. Language: English Keywords: NETHERLANDS | RESEARCH REPORT | CLINICAL RESEARCH | CASE STUDIES | WOMEN | ETHINYL ESTRADIOL | ORAL CONTRACEPTIVES, COMBINED | THROMBOSIS | ACCIDENTS AND INJURIES | CHROMOSOME ABNORMALITIES | CYPROTERONE ACETATE | ORAL CONTRACEPTIVES, SIDE EFFECTS | CONTRACEPTIVE SAFETY | Europe, Western | Europe | Developed Countries | Research Methodology | Studies | Demographic Factors | Population | Contraceptive Agents, Estrogen | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Oral Contraceptives | Contraceptive Methods | Thromboembolism | Embolism | Vascular Diseases | Diseases | Health | Neonatal Diseases and Abnormalities | Hormone Antagonists | Hormones | Endocrine System | Physiology | Biology | Safety | Public Health Document Number: 330935 |
| 13. Peer Reviewed Title: Adjustment to termination of pregnancy for fetal anomaly: a longitudinal study in women at 4, 8, and 16 months. Author: Korenromp MJ; Page-Christiaens GC; van den Bout J; Mulder EJ; Visser GH Source: American Journal of Obstetrics and Gynecology. 2009 Aug;201(2):160.e1-7. Abstract: OBJECTIVE: We studied psychological outcomes and predictors for adverse outcome in 147 women 4, 8, and 16 months after termination of pregnancy for fetal anomaly. STUDY DESIGN: We conducted a longitudinal study with validated self-completed questionnaires. RESULTS: Four months after termination 46% of women showed pathological levels of posttraumatic stress symptoms, decreasing to 20.5% after 16 months. As to depression, these figures were 28% and 13%, respectively. Late onset of problematic adaptation did not occur frequently. Outcome at 4 months was the most important predictor of persistent impaired psychological outcome. Other predictors were low self-efficacy, high level of doubt during decision making, lack of partner support, being religious, and advanced gestational age. Strong feelings of regret for the decision were mentioned by 2.7% of women. CONCLUSION: Termination of pregnancy for fetal anomaly has significant psychological consequences for 20% of women up to > 1 year. Only few women mention feelings of regret. Language: English Keywords: NETHERLANDS | RESEARCH REPORT | LONGITUDINAL STUDIES | WOMEN | POSTABORTION | POSTABORTION CARE | PSYCHOLOGICAL FACTORS | STRESS | DEPRESSION | CONGENITAL ABNORMALITIES | DECISION MAKING | IMPACT | Europe, Western | Europe | Developed Countries | Studies | Research Methodology | Demographic Factors | Population | Reproduction | Health Services | Delivery of Health Care | Health | Behavior | Mental Disorders | Diseases | Neonatal Diseases and Abnormalities | Communication Document Number: 342609 |
| 14. Peer Reviewed Title: Low levels of antiretroviral-resistant HIV infection in a routine clinic in Cameroon that uses the World Health Organization (WHO) public health approach to monitor antiretroviral treatment and adequacy with the WHO recommendation for second-line treatment. Author: Kouanfack C; Montavon C; Laurent C; Aghokeng A; Kenfack A; Bourgeois A; Koulla-Shiro S; Mpoudi-Ngole E; Peeters M; Delaporte E Source: Clinical Infectious Diseases. 2009 May 1;48(9):1318-22. Abstract: A cross-sectional study, performed at a routine human immunodeficiency virus (HIV)/AIDS clinic in Cameroon that uses the World Health Organization public health approach, showed low rates of virological failure and drug resistance at 12 and 24 months after initiation of antiretroviral therapy. Importantly, the cross-sectional study also showed that the World Health Organization recommendation for second-line treatment would be effective in almost all patients with HIV drug resistance mutations. Language: English Keywords: CAMEROON | RESEARCH REPORT | SUMMARY REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | CROSS SECTIONAL ANALYSIS | PERSONS LIVING WITH HIV/AIDS | PREVALENCE | DRUG RESISTANCE | ANTIRETROVIRAL THERAPY | HIV INFECTIONS | WHO | MONITORING | STANDARDIZATION | CHROMOSOME ABNORMALITIES | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Research Methodology | Viral Diseases | Diseases | Measurement | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | HIV | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors | Evaluation | Data Adjustment | Neonatal Diseases and Abnormalities Document Number: 341154 |
| 15. Title: Impact of maternal malaria and under-nutrition on intrauterine growth restriction: a prospective ultrasound study in Democratic Republic of Congo. Author: Landis SH; Lokomba V; Ananth CV; Atibu J; Ryder RW; Hartmann KE; Thorp JM; Tshefu A; Meshnick SR Source: Epidemiology and Infection. 2009 Feb;137(2):294-304. Abstract: Maternal malaria and under-nutrition are established risk factors for small-for-gestational-age (SGA) births; however, whether malaria is associated with intrauterine growth restriction (IUGR) is unknown. We investigated IUGR risk among 177 HIV-negative pregnant women enrolled in a longitudinal ultrasound study conducted in Democratic Republic of Congo from May 2005 to May 2006. Malaria infection, maternal anthropometrics, and ultrasound estimated fetal weight were measured monthly. All positive malaria cases were treated and intermittent presumptive therapy (IPTp) provided. Log-binomial regression models for IUGR were fitted using generalized estimating equations to account for statistical clustering of repeat IUGR measurements. Twenty-nine percent of fetuses experienced an episode of IUGR with the majority occurring in the third trimester. The risk of IUGR associated with malaria was greatest after three or more cumulative infections (RR 3.3, 95% CI 1.3-8.2) and was two- to eight-fold higher among women with evidence of under-nutrition. Receiving antimalarial treatment in the previous month (for IPTp or treatment) was significantly protective against IUGR (RR 0.5, 95% CI 0.3-0.7). The interaction observed between malaria and under-nutrition suggests that antenatal programmes in malaria endemic areas should incorporate nutritional screening and supplementation in addition to IPTp. Language: English Keywords: DEMOCRATIC REPUBLIC OF THE CONGO | RESEARCH REPORT | PROSPECTIVE STUDIES | INTRAUTERINE GROWTH RETARDATION | ULTRASONICS | MALARIA | MATERNAL NUTRITION | RISK FACTORS | Africa, Central | Africa, Sub Saharan | Africa | Developing Countries | Studies | Research Methodology | Congenital Abnormalities | Neonatal Diseases and Abnormalities | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Parasitic Diseases | Nutrition | Biology Document Number: 330491 |
| 16. Title: Can we reduce the number of low-birth-weight babies? The Cuban experience. Author: Lopez NB; Choonara I Source: Neonatology. 2009;95(3):193-7. Abstract: Low-birth-weight (LBW) infants have a significantly greater mortality than other babies, not only within the neonatal period but also in infancy and early childhood. Babies are LBW either because they are preterm or they have experienced intrauterine growth retardation. Reducing the prevalence of LBW babies is important in reducing child and infant mortality. Risk factors for prematurity and intrauterine growth retardation are well established. Socioeconomic conditions and nutrition during pregnancy are two key factors. Interventions to reduce the prevalence of LBW infants in developed countries have usually been unsuccessful. A few studies in developing countries have, however, achieved positive results. Cuba has managed to reduce the prevalence of LBW infants and their model of healthcare in relation to achieving this is described. Key features of the Cuban healthcare system are that it is both free and universal, and additionally there is a strong emphasis on primary healthcare. It is likely that a similar approach in both developing countries and disadvantaged communities in developed countries would reduce the prevalence of LBW babies. This would have a major impact in relation to reducing infant mortality rates. Language: English Keywords: CUBA | RESEARCH REPORT | LOW BIRTH WEIGHT | PREMATURE BIRTH | INTRAUTERINE GROWTH RETARDATION | MORTALITY | PREVENTION AND CONTROL | Caribbean | Americas | Developing Countries | Birth Weight | Body Weight | Physiology | Biology | Pregnancy Outcomes | Pregnancy | Reproduction | Congenital Abnormalities | Neonatal Diseases and Abnormalities | Diseases | Population Dynamics | Demographic Factors | Population Document Number: 341366 |
| 17. Title: Female issues in epilepsy: a critical review. Author: Luef G Source: Epilepsy and Behavior. 2009 May;15(1):78-82. Abstract: The focus on gender-related issues for women with epilepsy has heightened in recent years. The emphasis, however, has been on the childbearing years. Epilepsy and antiepileptic drug treatment affect sexual development, the menstrual cycle, and aspects of contraception, fertility, and reproduction. Female patients with epilepsy at a reproductive age face a unique set of reproductive issues, ranging from descriptions of disorders of reproduction in epilepsy and its causes, to contraception, pregnancy, sexuality, menopause, and osteoporosis. Conditions and diseases that specifically affect women are discussed. The role of hormones across the life cycle--endogenous and exogenous hormones and their effects on drug interactions, drug metabolism, and therapeutic outcomes--is described. Contraception and pregnancy issues for women with epilepsy have received the appropriate attention. Language: English Keywords: GLOBAL | CRITIQUE | WOMEN | CHRONIC DISEASES | NEUROLOGIC EFFECTS | DRUGS | ENDOCRINE EFFECTS | DRUG INTERACTIONS | HORMONES | ORAL CONTRACEPTIVES, COMBINED | BIRTH DEFECTS | DECREASED LIBIDO | MENOPAUSE | Demographic Factors | Population | Diseases | Physiology | Biology | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Endocrine System | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Neonatal Diseases and Abnormalities | Sex Behavior | Behavior | Reproduction Document Number: 342324 |
| 18. Title: Maternal urinary tract infection: is it independently associated with adverse pregnancy outcome? Author: Mazor-Dray E; Levy A; Schlaeffer F; Sheiner E Source: Journal of Maternal - Fetal and Neonatal Medicine. 2009 Feb;22(2):124-8. Abstract: OBJECTIVE: This population-based study was aimed to determine whether there is an association between urinary tract infections (UTI) during pregnancy, among patients in whom antibiotic treatment was recommended, and maternal and perinatal outcome. METHODS: A retrospective population-based study comparing all singleton pregnancies of patients with and without UTI was performed. Multiple logistic regression models were performed to control for confounders. RESULTS: Out of 199,093 deliveries, 2.3% (n = 4742) had UTI during pregnancy and delivery. Patients with UTI had significantly higher rates of intra-uterine growth restriction (IUGR), pre-eclampsia, caesarean deliveries (CD) and pre-term deliveries (either before 34 weeks or 37 weeks of gestation). Although controlling for possible confounders such as maternal age and parity, using multivariable analyses, the significant association between UTI and IUGR, pre-eclampsia, CD and preterm deliveries persisted. In contrast, no significant differences in 5-min Apgar scores less than 7 or perinatal mortality were noted between the groups (0.6% vs. 0.6%; p = 0.782, and 1.5% vs. 1.4%; p = 0.704, respectively). CONCLUSION: Maternal UTI is independently associated with pre-term delivery, pre-eclampsia, IUGR and CD. Nevertheless, it is not associated with increased rates of perinatal mortality compared with women without UTI. Language: English Keywords: ISRAEL | RESEARCH REPORT | RETROSPECTIVE STUDIES | PREGNANT WOMEN | UROGENITAL EFFECTS | INFECTIONS | PREGNANCY OUTCOMES | RISK FACTORS | PREMATURE BIRTH | INTRAUTERINE GROWTH RETARDATION | PREECLAMPSIA | CESAREAN SECTION | Developed Countries | Middle East | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Urogenital System | Physiology | Biology | Diseases | Pregnancy | Reproduction | Health | Congenital Abnormalities | Neonatal Diseases and Abnormalities | Pregnancy Complications | Obstetrical Surgery | Surgery | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care Document Number: 341696 |
| 19. Title: Genetic variability of human immunodeficiency virus-1 in Bahia state, Northeast, Brazil: high diversity of HIV genotypes. Author: Monteiro JP; Alcantara LC; de Oliveira T; Oliveira AM; Melo MA; Brites C; Galvao-Castro B Source: Journal of Medical Virology. 2009 Mar;81(3):391-9. Abstract: The HIV-1 genetic variability in Bahia state, Brazil, was investigated. DNA samples from 229 and 213 HIV-1-infected individuals were analyzed using the heteroduplex mobility assay (HMA) in gag and env fragments, respectively. One hundred seventy-five samples were characterized in both genes. Thirty-two subtype F and BF recombinant viruses were sequenced and analyzed by phylogenetic methods. The combination of HMA and sequencing results showed that seven different HIV-1 genotypes comprised this sample: 147 (84%) B/B, 4 (2.3%) F/F, 3 (1.7%) B/F, 1 (0.6%) F/B, 1 (0.6%) F/D, 1 (0.6%) BF/F, and 18 (10.3%) BF/B. A significant divergence was observed between these two techniques results (84.4%). This is explained by the low accuracy of the HMA for detecting recombinant viruses. These recombinants were unrelated to CRF12, while two sequences were related to CRF28 and CRF29. Nineteen BF mosaics shared the same gag breakpoint. In conclusion, the use of HMA may be inappropriate in regions where different subtypes are co-circulating. Subtype B is the most common genotype, however, an increased prevalence (13.1%) of different BF variants and a potentially new CRF suggest that recombination is occurring frequently in Bahia. These viruses were associated with women infected heterosexually. Finally, this study identified the presence of an F/D recombinant HIV-1 in Brazil. Language: English Keywords: BRAZIL | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | GENETIC TECHNIQUES | PERSONS LIVING WITH HIV/AIDS | WOMEN IN DEVELOPMENT | HETEROSEXUALS | PREVALENCE | HIV INFECTIONS | CHROMOSOME ABNORMALITIES | GENETICS | Developing Countries | South America, Eastern | South America | Latin America | Americas | Research Methodology | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Persons Living With HIV/AIDS | Viral Diseases | Diseases | Economic Development | Economic Factors | Sex Behavior | Behavior | Measurement | Neonatal Diseases and Abnormalities | Biology Document Number: 330231 |
| 20. Title: Fear and fertility in inflammatory bowel disease: a mismatch of perception and reality affects family planning decisions. Author: Mountifield R; Bampton P; Prosser R; Muller K; Andrews JM Source: Inflammatory Bowel Diseases. 2009 May;15(5):720-5. Abstract: BACKGROUND: Smaller family size and voluntary childlessness has been reported in IBD; however, the disease-related reasons for this from a patient viewpoint are not described. The aims were to 1) determine whether IBD patients' perceptions of the issues surrounding IBD, pregnancy, and childbearing influence their reproductive behavior, and 2) describe these specific perceptions and concerns related to fertility and pregnancy. METHODS: All contactable subjects between 18-50 years of age from a hospital-based IBD database were surveyed by postal questionnaire. Data were obtained regarding age, gender, IBD diagnosis and treatment, body image and sexual relationships, as well as both objective and subjective data regarding fertility and pregnancy. Comparisons were made to community norms where data were available. Contingency tables with Fisher's exact test were used. RESULTS: Of 365 subjects, 255 responded (70%). The mean age was 35.5 years overall, 34.7 years for women. In all, 34% of participants were male, 127 had Crohn's disease (CD), 85 ulcerative colitis (UC), and 5 indeterminate colitis (IC). The average fertility rate was no different between women with CD and UC (1.0 and 1.2 births/woman, respectively; P = 0.553), compared with 1.81 for all Australian women. Although 42.7% of IBD patients reported a fear of infertility, patients only sought medical fertility advice at the same rate as the general population. Fear of infertility was most evident in women, those with CD, and those reporting previous surgery. Specific patient concerns, which appear to have decreased patients' family size, included IBD heritability, the risk of congenital abnormalities, and medication teratogenicity. CONCLUSIONS: The unusually high response rate indicates the centrality of reproductive issues to IBD patients. "Voluntary" childlessness in this group appears to result from concerns about adverse reproductive outcomes that may not be justified. Patients require accurate counseling addressing fertility and pregnancy outcomes in IBD to assist in their decision making. Language: English Keywords: AUSTRALIA | RESEARCH REPORT | SURVEYS | CLIENTS | GASTROINTESTINAL EFFECTS | PERCEPTION | FEAR | PREGNANCY | FERTILITY | CONGENITAL ABNORMALITIES | VOLUNTARY CHILDLESSNESS | Oceania | Developed Countries | Sampling Studies | Studies | Research Methodology | Program Activities | Programs | Organization and Administration | Physiology | Biology | Psychological Factors | Behavior | Emotions | Reproduction | Population Dynamics | Demographic Factors | Population | Neonatal Diseases and Abnormalities | Diseases | Reproductive Behavior Document Number: 342482 |
| 21. Title: Gene knockouts that affect male fertility: novel targets for contraception. Author: Naz RK; Engle A; None R Source: Frontiers In Bioscience. 2009;14:3994-4007. Abstract: There is an urgent need for a better method of contraception that is accepted, effective, and available, due the population explosion and unintended pregnancy. Various targets are being investigated that can be used for contraception. The ideal target should be non-steroidal, intercourse-independent, non-surgical, reversible, and non-barrier with no side effects. The gene knockout technology is a powerful approach to identify such novel targets. We identified at least 93 genes whose deletion demonstrated an effect on fertility in male mice till 2004 (1). In the present article, we found 71 additional gene knockouts in the database since the last report which demonstrated an effect on male fertility. The majority of these knockouts also demonstrated an effect on non-reproductive organs concomitant with an anti-fertility effect or effect on other organs was not examined. The knockouts of only a few genes/proteins induced a specific effect on fertility without a serious side effect. These genes/proteins may provide novel targets for contraception/contraceptive vaccine development. Language: English Keywords: WEST VIRGINIA | RESEARCH REPORT | CLINICAL RESEARCH | MEN | LABORATORY ANIMALS | GENETICS | REPRODUCTIVE BEHAVIOR | SEX BEHAVIOR | REVERSIBLE STERILIZATION | MALE STERILIZATION | CHROMOSOME ABNORMALITIES | PROTEINS | CONTRACEPTIVE VACCINES | Developed Countries | United States of America | North America | Americas | Research Methodology | Demographic Factors | Population | Biology | Fertility | Population Dynamics | Behavior | Sterilization, Sexual | Family Planning | Neonatal Diseases and Abnormalities | Diseases | Physiology | Contraception, Immunological | Contraception Document Number: 330601 |
| 22. Title: Maternal Use of Oral Contraceptives During Early Pregnancy and Risk of Hypospadias in Male Offspring. Author: Norgaard M; Wogelius P; Pedersen L; Rothman KJ; Sorensen HT Source: Urology. 2009 Jul 8; Abstract: OBJECTIVES: To examine the association between maternal use of oral contraceptives in early pregnancy and increased prevalence of hypospadias in male offspring. METHODS: We conducted a nationwide population-based case-control study using data from nationwide medical databases. Among live male births between January 1, 1996, and December 31, 2005, we identified all cases of hypospadias recorded anytime postpartum (n = 1683) and randomly selected 10 controls per case without such a diagnosis (n = 15 650), matched by year and hospital of birth. We used conditional logistic regression to estimate prevalence ratios stratified according to time of diagnosis (within 6 months postpartum, >6 months postpartum), controlling for potential confounding factors including maternal age, birth order, maternal smoking, prescriptions for ovulation-inducing drugs, antiepileptics, and antidiabetics, and a maternal diagnosis of pre-eclampsia. RESULTS: We included 1683 cases of hypospadias and 15 650 population controlsduring 1996-2005. Among the 1186 boys who had their hypospadias diagnosis recorded within 6 months postpartum, 28 (2.4%) had been exposed to oral contraceptives between 30 days before conception until the end of the first trimester. Among the controls, 307 (2.8%) were similarly exposed, corresponding to a prevalence ratio of 0.85 (95% CI: 0.57-1.27) after adjusting for possible confounders. For a diagnosis registered >6 months postpartum, the adjusted prevalence ratio was 1.12 (95% CI: 0.61-2.06). CONCLUSIONS: Our data do not support the hypothesis that maternal use of oral contraceptives around conception is associated with an increased prevalence of hypospadias in the offspring. Language: English Keywords: DENMARK | RESEARCH REPORT | CONTROL GROUPS | STATISTICAL REGRESSION | INFANT | BIRTH DEFECTS | GENITAL EFFECTS, MALE | UROGENITAL EFFECTS | PREVALENCE | RISK FACTORS | ORAL CONTRACEPTIVES, SIDE EFFECTS | PREGNANCY, FIRST TRIMESTER | Developed Countries | Europe, Northern | Europe | Research Methodology | Data Analysis | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Neonatal Diseases and Abnormalities | Diseases | Genitalia, Male | Genitalia | Urogenital System | Physiology | Biology | Measurement | Health | Contraceptive Safety | Safety | Public Health | Pregnancy | Reproduction Document Number: 342127 |
| 23. Peer Reviewed Title: Obstetric and perinatal outcome in HIV positive women receiving HAART in urban Nigeria. Author: Olagbuji BN; Ezeanochie MC; Ande AB; Oboro VO Source: Archives of Gynecology and Obstetrics. 2009 Jul 24; Abstract: PURPOSE: To compare the outcome of pregnancy between HIV positive pregnant women on highly active antiretroviral therapy (HAART) and HIV negative controls. METHODS: A prospective matched case-control study. RESULTS: HIV positive women were significantly more likely to have anaemia in pregnancy [p < 0.001, odds ratio (95% CI) 5.66 (3.0-10.5)], intrauterine growth restriction [p = 0.002, odds ratio (95%CI) 13.82 (1.8-106.7)], preterm labour [p = 0.03, odds ratio (95% CI) 2.89 (1.2-7.0)] and birth weight less than 2,500 g [p < 0.0001, odds ratio (95% CI) 5.43 (2.4-12.0)]. The 5-min apgar score less than 7, admission into neonatal unit, stillbirth and perinatal mortality were comparable between the two groups. CONCLUSION: Anaemia in pregnancy, intrauterine growth restriction, preterm labour and birth weight less than 2,500 g are important complications among HIV positive pregnant women. This information is vital for strategic antenatal care planning to improve obstetric and perinatal outcome in these women. Language: English Keywords: NIGERIA | URBAN AREAS | RESEARCH REPORT | CONTROL GROUPS | PERSONS LIVING WITH HIV/AIDS | WOMEN | ANTIRETROVIRAL THERAPY | PREGNANCY OUTCOMES | ANEMIA | INTRAUTERINE GROWTH RETARDATION | PREMATURE LABOR | LOW BIRTH WEIGHT | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Geographic Factors | Population | Research Methodology | HIV Infections | Viral Diseases | Diseases | Demographic Factors | HIV | Pregnancy | Reproduction | Congenital Abnormalities | Neonatal Diseases and Abnormalities | Birth Weight | Body Weight | Physiology | Biology Document Number: 342225 |
| 24. Peer Reviewed Title: Venous thrombembolism, thrombophilic defects, combined oral contraception and anticoagulation. Author: Ott J; Promberger R; Kaufmann U; Huber JC; Frigo P Source: Archives of Gynecology and Obstetrics. 2009 Feb 26; Abstract: BACKGROUND: Several genetic polymorphisms increase the risk for venous thrombembolism (VTE). In particular, combined oral contraceptives (COCs) are known to enhance the risk for VTE and are therefore contraindicated. CASE: We present here the case of a patient with protein S deficiency, who has used COCs together with anticoagulatory therapy (Phenprocoumon) after suffering from deep venous thromboses for 4 years. At the time of her first consultation at our clinic, the ultrasound examination showed a complete involution of her venous thrombosis. CONCLUSION: COCs can be used in patients with thrombogenic mutations and anticoagulatory therapy in individual cases. Language: English Keywords: AUSTRIA | RESEARCH REPORT | CLINICAL RESEARCH | CASE STUDIES | WOMEN | THROMBOEMBOLISM | ORAL CONTRACEPTIVES, COMBINED | BLOOD COAGULATION EFFECTS | ORAL CONTRACEPTIVES, SIDE EFFECTS | CHROMOSOME ABNORMALITIES | DEFICIENCY DISEASES | PROTEINS | ULTRASONICS | Developed Countries | Europe, Central | Europe | Research Methodology | Studies | Demographic Factors | Population | Embolism | Vascular Diseases | Diseases | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Hematological Effects | Hemic System | Physiology | Biology | Contraceptive Safety | Safety | Public Health | Health | Neonatal Diseases and Abnormalities | Nutrition Disorders | Medical Procedures | Medicine | Health Services | Delivery of Health Care Document Number: 330418 |
| 25. Peer Reviewed Title: Human immunodeficiency virus co-infection increases placental parasite density and transplacental malaria transmission in Western Kenya. Author: Perrault SD; Hajek J; Zhong K; Owino SO; Sichangi M; Smith G; Shi YP; Moore JM; Kain KC Source: American Journal of Tropical Medicine and Hygiene. 2009 Jan;80(1):119-25. Abstract: Plasmodium falciparum malaria and human immunodeficiency virus (HIV)-1 adversely interact in the context of pregnancy, however little is known regarding the influence of co-infection on the risk of congenital malaria. We aimed to determine the prevalence of placental and congenital malaria and impact of HIV co-infection on trans-placental malaria transmission in 157 parturient women and their infants by microscopy and by quantitative real-time polymerase chain reaction (PCR) in western Kenya. The prevalence of placental and cord blood infections were 17.2% and 0% by microscopy, and 33.1% and 10.8% by PCR. HIV co-infection was associated with a significant increase in placental parasite density (P < 0.05). Cord blood malaria prevalence was increased in co-infected women (odds ratio [OR] = 5.42; 95% confidence interval [CI] = 1.90-15.47) and correlated with placental parasite density (OR = 2.57; 95% CI = 1.80-3.67). A 1-log increase in placental monocyte count was associated with increased risk of congenital infection (P = 0.001) (OR = 48.15; 95% CI = 4.59-505.50). The HIV co-infected women have a significantly increased burden of placental malaria that increases the risk of congenital infection. Language: English Keywords: KENYA | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | PERSONS LIVING WITH HIV/AIDS | WOMEN IN DEVELOPMENT | PREGNANT WOMEN | PREVALENCE | HIV INFECTIONS | COMPLICATIONS | MALARIA | CONGENITAL ABNORMALITIES | PREGNANCY COMPLICATIONS | MOTHER-TO-CHILD TRANSMISSION | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Persons Living With HIV/AIDS | Viral Diseases | Diseases | Economic Development | Economic Factors | Population Characteristics | Demographic Factors | Population | Measurement | Parasitic Diseases | Neonatal Diseases and Abnormalities | Transmission | Infections Document Number: 330313 |
| 26. Title: The safety of conception occurring shortly after methotrexate treatment of an ectopic pregnancy. Author: Svirsky R; Rozovski U; Vaknin Z; Pansky M; Schneider D; Halperin R Source: Reproductive toxicology. 2009 Jan;27(1):85-7. Abstract: The objective of this study was to determine whether a single or repeated injection of methotrexate (MTX) to treat ectopic pregnancy results in either teratogenicity or other bad obstetric outcome in the pregnancy that shortly follows treatment. Data were retrieved from the medical records of 314 women treated with MTX for ectopic pregnancy in our institute (2000-2006) included age, MTX dosage, interval between last MTX treatment to conception, results of ultrasonographic follow-up of the subsequent pregnancy, triple test, karyotype testing, pregnancy outcome, and newborn weight and Apgar score. A logistic regression model based on pregnancy outcome as the dependent variable and interval since last MTX treatment as the independent variable estimated the odds ratio for the safety of conception occurring shortly after the treatment. Complete information was obtained for 125 pregnancies. Forty-five pregnancies occurred within 6 months (mean 3.6+/-1.7) after the last MTX treatment. The outcome of these pregnancies was compared with that of 80 pregnancies which occurred > or =6 months (mean 23.6+/-14.7) after the last MTX treatment. The fetal malformation and adverse outcome rates for both groups were similar (odds ratio 1.003, 95% CI 0.98-1.02). According to a logistic regression analysis, the interval between the last MTX treatment for ectopic pregnancy had no effect on the outcome of the pregnancy that shortly followed it. The results of this study support the notion that conceiving within the first 6 months after treatment with MTX for ectopic pregnancy is safe and not associated with any increase in the examined adverse pregnancy outcome parameters. Language: English Keywords: MALAWI | RESEARCH REPORT | RECORDS | DATA COLLECTION | PREGNANCY | PREGNANCY, ECTOPIC | BIRTH DEFECTS | PREGNANCY OUTCOMES | METHOTREXATE | TREATMENT | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Information Processing | Information | Research Methodology | Reproduction | Pregnancy Complications | Diseases | Neonatal Diseases and Abnormalities | Drugs | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 331042 |
| 27. Peer Reviewed Title: Abandonment of infants by HIV-positive women in Russia and prevention measures. Author: Zabina H; Kissin D; Pervysheva E; Mytil A; Dudchenko O; Jamieson D; Hillis S Source: Reproductive Health Matters. 2009 May;17(33):162-170. Abstract: Since 1990, Russia has experienced a dramatic increase in the number of abandoned children, associated with harsh socio-economic conditions, increases in drug and alcohol addiction and HIV infection. Approximately 20% of infants born to HIV-positive mothers are abandoned in Russia. To find out why, we conducted 266 qualitative interviews in 2004–05 in four Russian cities, including HIV-positive women who had abandoned their infants and others who had not, relatives of the women (mostly their mothers), HIV-negative women who had abandoned, and medical experts. Unintended pregnancy was cited as the most important factor influencing the decision to abandon. Other important determinants included lack of partner and family support, drug abuse, fear of birth defects or disabilities, negative attitudes of medical professionals, and marginalized socio-economic status. HIV infection was closely linked to many of these reasons. Important avenues for interventions among HIV-positive women emerged, including improved contraceptive information and provision, education of medical personnel and women on HIV prevention and treatment, enhancement of social support, and strengthening of fostering and adoption programmes for HIV-affected families. Spanish Abstract: Desde 1990, Rusia ha experimentado un alza drástica en el número de niños abandonados, asociado con duras condiciones socioeconómicas, aumentos en drogadicción y alcoholismo e infección por VIH. Aproximadamente el 20% de los bebés nacidos de madres VIH-positivas son abandonados en Rusia. Para saber por qué, realizamos 266 entrevistas cualitativas en 2004 y 2005, en cuatro ciudades rusas, con mujeres VIH-positivas que habían abandonado a sus bebés y otras que no, parientes de las mujeres (principalmente sus madres), mujeres VIH-negativas que habían abandonado y expertos médicos. El embarazo no intencional fue citado como el factor más importante que influye en la decisión de abandonar. Otros determinantes importantes fueron: falta de pareja y apoyo de la familia, abuso de drogas, temor de discapacidades o defectos congénitos, actitudes negativas de los profesionales médicos y condición socioeconómica marginada. La infección por VIH estaba estrechamente asociada con muchas de estas razones. Emergieron importantes vías de intervención entre las mujeres VIH-positivas, como mejor información y suministro de anticonceptivos, educación del personal médico y las mujeres respecto a la prevención y el tratamiento del VIH, mejoramiento del apoyo social y fortalecimiento de los programas de acogida y adopción para familias afectadas por el VIH. French Abstract: Depuis 1990, la Fédération de Russie a enregistré une augmentation alarmante du nombre d'enfants abandonnés, associée à la dureté des conditions socio-économiques, la hausse de la toxicomanie, de l'alcoolisme et de l'infection à VIH. Dans ce pays, près de 20% des nourrissons nés de mères séropositives sont abandonnés. Pour comprendre pourquoi, nous avons mené 266 entretiens qualitatifs en 2004–05 dans quatre villes russes, avec notamment des femmes séropositives qui avaient abandonné leur bébé et d'autres qui l'avaient gardé, des parents de ces femmes (généralement leur mère), des femmes séronégatives ayant abandonné un enfant et des experts médicaux. La grossesse non désirée était le principal facteur cité pour expliquer l'abandon. D'autres déterminants comprenaient le manque d'appui du partenaire ou de la famille, l'abus de drogues, la crainte d'anomalies congénitales ou de handicaps, les attitudes négatives des soignants et la marginalisation socio-économique. L'infection à VIH était étroitement liée à beaucoup de ces raisons. Des voies importantes d'intervention chez les femmes séropositives sont apparues, par exemple l'amélioration de l'information et de la distribution de contraceptifs, la formation du personnel médical et des femmes sur la prévention et le traitement du VIH, la consolidation du soutien social et le renforcement des programmes d'adoption et de placement pour les familles touchées par le VIH. Language: English Keywords: RUSSIA | RESEARCH REPORT | QUALITATIVE RESEARCH | PERSONS LIVING WITH HIV/AIDS | WOMEN | ORPHANS AND VULNERABLE CHILDREN | PREGNANCY, UNWANTED | DECISION MAKING | HIV INFECTIONS | BIRTH DEFECTS | SOCIOECONOMIC STATUS | STIGMA | DRUG USE AND ABUSE | Developing Countries | Asia, Northern | Asia | Research Methodology | Viral Diseases | Diseases | Demographic Factors | Population | Family and Household | Sociocultural Factors | Reproductive Behavior | Fertility | Population Dynamics | Behavior | Neonatal Diseases and Abnormalities | Socioeconomic Factors | Economic Factors | Social Problems Document Number: 342025 |
| 28. Peer Reviewed Title: Pregnancy outcome after levonorgestrel-only emergency contraception failure: a prospective cohort study. Author: Zhang L; Chen J; Wang Y; Ren F; Yu W; Cheng L Source: Human Reproduction. 2009 Mar 31;1(1):1-7. Abstract: BACKGROUND Levonorgestrel (LNG), as a dedicated emergency contraception (EC) product, has been available over-the-counter in China for 10 years. Until now, only a small number of deliveries after LNG-EC failure have been documented. METHODS This study was a prospective comparative cohort study. A group of 332 pregnant women who had used LNG-EC during the conception cycle was recruited, and matched to a group of 332 pregnant women without the exposure to LNG. Congenital malformations, perinatal complications and delivery circumstances were investigated in this study. RESULTS There were 31 pregnant women in the study group and 28 in the comparison group miscarried within 14 weeks of gestation. In the study and comparison groups, four malformations were found in each group. In the study group, both birthweight (3416 versus 3345 g, P = 0.040) and the sex ratio of birth (boys/girls, 1.14 versus 0.90, P = 0.153) were higher than in the comparison group. There were no statistically significant differences in the incidence of miscarriage or malformation or in the neonatal outcome between the two groups. CONCLUSIONS There was no association between the use of LNG-EC pills and the risk of major congenital malformations, pregnancy complications or any other adverse pregnancy outcomes in our study. Language: English Keywords: CHINA | RESEARCH REPORT | CLINICAL RESEARCH | PROSPECTIVE STUDIES | COHORT ANALYSIS | WOMEN IN DEVELOPMENT | INFANT | PREGNANT WOMEN | EMERGENCY CONTRACEPTION | PREGNANCY OUTCOMES | LEVONORGESTREL | CONTRACEPTION FAILURE | CONGENITAL ABNORMALITIES | PREGNANCY COMPLICATIONS | CHILDBIRTH | Asia, Eastern | Asia | Developing Countries | Research Methodology | Studies | Economic Development | Economic Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Contraception | Family Planning | Pregnancy | Reproduction | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Contraceptive Usage | Neonatal Diseases and Abnormalities | Diseases Document Number: 330927 |
| 29. Peer Reviewed Title: Ethical aspects concerning termination of pregnancy following prenatal diagnosis. FIGO Committee for the Ethical Aspects of Human Reproduction and Women’s Health. FIGO committee report. Author: International Federation of Gynecology and Obstetrics [FIGO]. Committee for the Ethical Aspects of Human Reproduction and Women's Health Source: International Journal of Gynecology and Obstetrics. 2008 Jul;102(1):97-98. Abstract: The FIGO Committee for the Ethical Aspects of Human Reproduction and Women's Health considers the ethical aspects of issues that impact the discipline of Obstetrics, Gynecology, and Women's Health. The following document represents the result of that carefully researched and considered discussion. This material is intended to provide material for consideration and debate about these ethical aspects of our discipline for member organizations and their constituent membership. (excerpt) Language: English Keywords: GLOBAL | FRANCE | CONFERENCES AND CONGRESSES | ETHICS | WOMEN | ABORTION | REPRODUCTIVE RIGHTS | BIRTH DEFECTS | ULTRASONICS | SCREENING | BELIEFS | CULTURE | RECOMMENDATIONS | Europe, Western | Europe | Developed Countries | Sociocultural Factors | Demographic Factors | Population | Fertility Control, Postconception | Family Planning | Human Rights | Political Factors | Neonatal Diseases and Abnormalities | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Examinations and Diagnoses Document Number: 327333 Notification |
| 30. Title: No association between maternal recurrent genital herpes in pregnancy and higher risk for congenital abnormalities. Author: Acs N; Banhidy F; Puho E; Czeizel AE Source: Acta Obstetricia et Gynecologica Scandinavica. 2008;87(3):292-299. Abstract: The objective was to study the possible links between recurrent symptomatic genital herpes during pregnancy and risk for congenital abnormalities (CAs). The occurrence of prospectively and medically-recorded recurrent genital herpes during pregnancy in the mothers of cases with different congenital abnormalities and in the mothers of matched controls without CAs was compared in the population-based large data set of the Hungarian Case-Control Surveillance System of Congenital Abnormalities. Of 22,843 cases with CAs, 59 (0.26%) were born to mothers with recurrent symptomatic genital herpes, while of 38,151 control newborns without CAs, 86 (0.23%) were born to mothers with recurrent genital herpes during the study pregnancy (adjusted OR: 1.1, 95% CI: 0.8-1.6). Pregnant women with clinically recognised recurrent genital herpes in the first trimester of pregnancy are not linked with a higher risk for any CAs. Recurrent genital herpes during pregnancy does not associate with a higher risk of CAs. (author's) Language: English Keywords: HUNGARY | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | PROSPECTIVE STUDIES | CASE CONTROL STUDIES | CLINICAL RESEARCH | PREGNANT WOMEN | INFANT | CONGENITAL ABNORMALITIES | PREGNANCY COMPLICATIONS | HERPES GENITALIS | PREVALENCE | MATERNAL-FETAL EXCHANGE | Developing Countries | Europe, Central | Europe | Research Methodology | Studies | Population Characteristics | Demographic Factors | Population | |