Latest & greatest articles for pregnancy

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Top results for pregnancy

81. HIV in pregnancy: Identification of intrapartum and perinatal HIV exposures

HIV in pregnancy: Identification of intrapartum and perinatal HIV exposures The benefits of human immunodeficiency virus (HIV) testing in pregnancy, when combined with appropriate maternal antiretroviral therapy and intrapartum and postnatal prophylaxis, are well established. The vertical rate of transmission of HIV in North America is now well below 2%. Efforts must continue to ensure that these benefits are sustained. Women who have received little or no prenatal care and those who present (...) for delivery with unknown HIV status need immediate testing. As more infants are exposed to antiretroviral agents, strategies need to be implemented to ensure adequate follow-up of these infants. Issues relating to the identification of HIV-exposed infants are highlighted. Keywords: Human immunodeficiency virus; Infant; Intrapartum transmission; Pregnancy; Screening

2019 Canadian Paediatric Society

82. Efficacy of Regular Exercise During Pregnancy on the Prevention of Postpartum Depression: The PAMELA Randomized Clinical Trial

Efficacy of Regular Exercise During Pregnancy on the Prevention of Postpartum Depression: The PAMELA Randomized Clinical Trial Interventions to reduce postpartum depression have mainly focused on enhancing screening to increase treatment rates among women. Preventive approaches are timely from a population health perspective, particularly in low- and middle-income countries where access to mental health services is limited.To assess the efficacy of regular exercise during pregnancy (...) the intervention group (4.8 [3.7]) and the control group (5.4 [4.1]) (mean difference, -0.6; 95% CI, -1.3 to 0.1). There was also no significant difference in rates of postpartum depression between the intervention group (12 of 192 [6.3%]) and the control group (36 of 387 [9.3%]) (odds ratio, 0.65; 95% CI, 0.33-1.28). Instrumental variable analysis indicated that noncompliance may have attenuated the effect estimates obtained in the primary analysis.Moderate-intensity exercise during pregnancy did not lead

2019 EvidenceUpdates

83. Does Partial Meal Replacement During Pregnancy Reduce 12-Month Postpartum Weight Retention?

Does Partial Meal Replacement During Pregnancy Reduce 12-Month Postpartum Weight Retention? This randomized trial tested whether a behavioral intervention with meal replacements in pregnancy could increase the proportion of women who returned to prepregnancy weight and reduce postpartum weight retention by 12 months after delivery.Women (N = 264; 13.7 weeks' gestation) with overweight or obesity were randomly assigned to usual care or intervention. The intervention reduced excess gestational (...) in the intervention group. Independent of group, lower gestational weight gain was the strongest predictor of achieving prepregnancy weight at 12 months (P = 0.0008).A prenatal behavioral intervention with meal replacements that reduced pregnancy weight gain had no significant effect on 12-month postpartum weight retention.© 2018 The Obesity Society.

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2019 EvidenceUpdates

84. Aspirin reduces a woman’s chance of developing pre-eclampsia in pregnancy

Aspirin reduces a woman’s chance of developing pre-eclampsia in pregnancy Aspirin reduces a woman’s chance of developing pre-eclampsia in pregnancy Discover Portal Discover Portal Aspirin reduces a woman’s chance of developing pre-eclampsia in pregnancy Published on 31 October 2017 doi: Giving low dose aspirin to high-risk women reduced their risk of pre-eclampsia before 37 weeks of pregnancy. Preterm pre-eclampsia developed in 1.6% of women given 150mg aspirin daily compared with 4.3% who took (...) a placebo. Pre-eclampsia is a condition which can harm mother and baby. In the mother, it causes high blood pressure and protein in the urine, which can show in pregnancy after 20 weeks. Women with risk factors, such as previous pre-eclampsia, diabetes or high blood pressure, are often prescribed 75mg aspirin from 12 weeks onwards. This study aimed to test double this dose (still classified as a `low dose’) after using a new risk assessment with additional clinical tests to better identify those at high

2019 NIHR Dissemination Centre

85. Imaging is the only way to diagnose blood clots in pregnancy

Imaging is the only way to diagnose blood clots in pregnancy Imaging is the only way to diagnose blood clots in pregnancy Discover Portal Discover Portal Imaging is the only way to diagnose blood clots in pregnancy Published on 13 March 2018 doi: No blood test can accurately tell if a pregnant or recently pregnant woman has a blood clot. All pregnant women with a suspected clot should continue to have imaging investigations as per current UK guidelines. This NIHR-funded study recruited 328 (...) with and without a clot. Share your views on the research. Why was this study needed? Blood clots are the leading cause of death during pregnancy and after giving birth. Between 2012 and 2014 there were 20 maternal deaths due to blood clots in the UK. There are concerns about using CT scans to diagnose pulmonary embolism in pregnant women as only 5% of scans are positive. This could mean that women and their unborn baby are unnecessarily exposed to radiation. A blood test called D-dimer is used to rule out

2019 NIHR Dissemination Centre

86. Treating subclinical thyroid dysfunction in pregnancy probably has no benefit

Treating subclinical thyroid dysfunction in pregnancy probably has no benefit Treating subclinical thyroid dysfunction in pregnancy probably has no benefit Discover Portal Discover Portal Treating subclinical thyroid dysfunction in pregnancy probably has no benefit Published on 8 August 2017 doi: Testing for and then treating pregnant women with mild or “subclinical” underactive thyroid did not improve pregnancy outcomes, newborn baby outcomes, or the child’s IQ at three to five years (...) . A clearly underactive thyroid (clinical hypothyroidism) in pregnancy has been linked with various adverse outcomes for the mother and baby, including pre-eclampsia, preterm birth, congenital defects and neurodevelopmental delay. This needs treatment. However, there has been debate around the harms and benefits from treating only mildly abnormal blood test results in women who do not show signs of thyroid problems, subclinical hypothyroidism. These two linked trials randomised 1,203 women with borderline

2019 NIHR Dissemination Centre

87. No clear “best” treatment of mild or severe sickness in pregnancy

No clear “best” treatment of mild or severe sickness in pregnancy No clear “best” treatment of mild or severe sickness in pregnancy Discover Portal Discover Portal No clear “best” treatment of mild or severe sickness in pregnancy Published on 3 January 2017 doi: Pregnant women could benefit from simple, cheap, “self-help” remedies for mild nausea and vomiting. Ginger, vitamin B6 and possibly acupressure wrist-bands might relieve symptoms for some women, according to a recent overview (...) range from simple “morning sickness” to the more severe condition of hyperemesis gravidarum. The review gives some evidence on treating pregnant women, but it is limited, especially for more severe symptoms. The authors highlight the need for more robust research to compare treatments with costs and clarify the safety of some drugs. Share your views on the research. Why was this study needed? Up to 85% of women experience nausea and vomiting during pregnancy. Usually, symptoms resolve by about 20

2019 NIHR Dissemination Centre

88. General surgery is mostly safe during pregnancy

General surgery is mostly safe during pregnancy General surgery is mostly safe during pregnancy Discover Portal Discover Portal General surgery is mostly safe during pregnancy Published on 10 January 2017 doi: Routine data from English hospitals show that general surgery during pregnancy, such as removing the appendix or gallbladder, does not commonly harm mother or baby. This suggests that surgery in pregnant women is generally safe, but that mothers could be provided with more specific (...) estimates of the risks. This large observational study assessed the “real world” outcomes of nearly 6.5 million pregnancies at hospitals in England over a 10-year period. Women who had surgery during pregnancy for a condition unrelated to pregnancy were slightly more likely to experience miscarriage, preterm or caesarean delivery or a long stay in hospital. Babies were more also slightly more likely to be low birthweight or stillborn. However, the actual risks of negative outcomes were small

2019 NIHR Dissemination Centre

89. Induction of labour within 24 hours, if waters break at 37 weeks of pregnancy, can reduce womb infection

Induction of labour within 24 hours, if waters break at 37 weeks of pregnancy, can reduce womb infection Induction of labour within 24 hours, if waters break at 37 weeks of pregnancy, can reduce womb infection Discover Portal Discover Portal Induction of labour within 24 hours, if waters break at 37 weeks of pregnancy, can reduce womb infection Published on 23 May 2017 doi: Inducing labour may halve the risk of infection in the womb when waters break from 37 weeks. The procedure was started (...) ? Premature rupture of membranes (PROM) at full term (37 weeks or more) occurs in 8% of pregnancies. Spontaneous onset of labour within 24 hours occurs in approximately 95% of cases. Labour can be delayed for up to seven days if it does not start within 24 hours. The risk of maternal or neonatal infection and the need for caesarean section are increased by PROM. Untreated infections can lead to complications with reproductive organs, problems with fertility and general health. PROM at term is managed

2019 NIHR Dissemination Centre

90. Donor eggs may be linked to higher risk of pregnancy complications following IVF

Donor eggs may be linked to higher risk of pregnancy complications following IVF Donor eggs may be linked to higher risk of pregnancy complications following IVF Discover Portal Discover Portal Donor eggs may be linked to higher risk of pregnancy complications following IVF Published on 26 May 2016 doi: Women who use donor eggs in their IVF may have significantly higher rates of pregnancy complications than those who use their own eggs, a systematic review and meta-analysis has found. Use (...) of donor eggs was linked to up to four times the risk of developing high blood pressure in pregnancy. Other risks associated with donor eggs were low birth weight in the baby, caesarean section and premature delivery. It is always possible that other factors, such as the age of women who use donor eggs, may have influenced the study results. Advanced maternal age is itself associated with pregnancy complications, including high blood pressure. Nevertheless it seems likely from this research that donor

2019 NIHR Dissemination Centre

91. Links between antipsychotics in pregnancy and harmful outcomes for baby may be influenced by mother’s lifestyle

Links between antipsychotics in pregnancy and harmful outcomes for baby may be influenced by mother’s lifestyle Links between antipsychotics in pregnancy and harmful outcomes for baby may be influenced by mother’s lifestyle Discover Portal Discover Portal Links between antipsychotics in pregnancy and harmful outcomes for baby may be influenced by mother’s lifestyle Published on 6 June 2016 doi: This NIHR funded study found that antipsychotic use during pregnancy was not associated with worse (...) child outcomes after poorer health and riskier lifestyles were taken into account. For pregnant women these were things like other medications, obesity, smoking, alcohol and taking illicit drugs. The study also provides further evidence against the use of valproate during pregnancy for epilepsy, bipolar disorder or schizophrenia because of the increased risk of poor outcomes for the child. The risk was double that of taking the alternatives, lamotrigine or carbamazapine during pregnancy. Mental

2019 NIHR Dissemination Centre

92. One type of drug for depression during pregnancy may be linked to a small increase in pre-term births

One type of drug for depression during pregnancy may be linked to a small increase in pre-term births One type of drug for depression during pregnancy may be linked to a small increase in pre-term births Discover Portal Discover Portal One type of drug for depression during pregnancy may be linked to a small increase in pre-term births Published on 9 August 2016 doi: Women who are depressed during pregnancy and who take selective serotonin inhibitors (SSRIs) may be more likely to have a pre (...) -term birth than those who do not take SSRIs. Pre-term birth occurred in 6.8% of women with depression during pregnancy treated with SSRIs compared to 5.8% of depressed women who were treated with talking therapies alone. However, because this is a review of observational (cohort) studies rather than randomised controlled trials it is not possible to say that SSRIs cause pre-term birth. For example, it is possible that women who had worse depression were more likely to be prescribed SSRIs

2019 NIHR Dissemination Centre

93. No benefit from monitoring antiepileptic drug levels in pregnancy

No benefit from monitoring antiepileptic drug levels in pregnancy No benefit from monitoring antiepileptic drug levels in pregnancy Discover Portal Discover Portal No benefit from monitoring antiepileptic drug levels in pregnancy Published on 9 October 2018 doi: Regular monitoring of antiepileptic drug levels in pregnant women with epilepsy does not improve seizure control compared with clinical features-based monitoring. This NIHR-funded study was conducted across 50 UK hospitals (...) and is the largest randomised trial in pregnant women with epilepsy. Just over 260 pregnant women with unstable antiepileptic drug levels were assigned to ongoing monthly blood checks or clinical features monitoring. There were no differences in seizures or other pregnancy outcomes between the two strategies. But umbilical cord blood showed that babies whose mothers received blood checks were exposed to higher levels of antiepileptic drugs. The study provides important information about the utility of monitoring

2019 NIHR Dissemination Centre

94. Diet and exercise can reduce the risk of developing diabetes during pregnancy

Diet and exercise can reduce the risk of developing diabetes during pregnancy Diet and exercise can reduce the risk of developing diabetes during pregnancy Discover Portal Discover Portal Diet and exercise can reduce the risk of developing diabetes during pregnancy Published on 18 December 2018 doi: Diet and exercise are effective ways of preventing the development of diabetes during pregnancy, known as gestational diabetes. Gestational diabetes is becoming more common and is associated (...) suggest, comprehensive risk assessments that consider body mass index alongside other risk factors may help to identify women who could benefit most from structured lifestyle interventions during pregnancy. Share your views on the research. Why was this study needed? Gestational diabetes is associated with various adverse outcomes for mother and baby. Women with the condition are at higher risk of having their labour induced, having a caesarean section, developing pre-eclampsia, or developing type 2

2019 NIHR Dissemination Centre

95. Prepregnancy and early pregnancy calcium supplementation among women at high risk of pre-eclampsia: a multicentre, double-blind, randomised, placebo-controlled trial. (PubMed)

Prepregnancy and early pregnancy calcium supplementation among women at high risk of pre-eclampsia: a multicentre, double-blind, randomised, placebo-controlled trial. Reducing deaths from hypertensive disorders of pregnancy is a global priority. Low dietary calcium might account for the high prevalence of pre-eclampsia and eclampsia in low-income countries. Calcium supplementation in the second half of pregnancy is known to reduce the serious consequences of pre-eclampsia; however, the effect (...) of calcium supplementation during placentation is not known. We aimed to test the hypothesis that calcium supplementation before and in early pregnancy (up to 20 weeks' gestation) prevents the development of pre-eclampsia METHODS: We did a multicountry, parallel arm, double-blind, randomised, placebo-controlled trial in South Africa, Zimbabwe, and Argentina. Participants with previous pre-eclampsia and eclampsia received 500 mg calcium or placebo daily from enrolment prepregnancy until 20 weeks

2019 Lancet Controlled trial quality: predicted high

96. Valproate medicines: are you in acting in compliance with the pregnancy prevention measures?

Valproate medicines: are you in acting in compliance with the pregnancy prevention measures? Valproate medicines: are you acting in compliance with the pregnancy prevention measures? - GOV.UK GOV.UK uses cookies to make the site simpler. Search Valproate medicines: are you acting in compliance with the pregnancy prevention measures? Although use of valproate medicines in female patients continues to slowly decline, there is wide variation in prescribing between Clinical Commissioning Groups (...) December 2018 From: Therapeutic area: , , , , , Contents New information Compliance by healthcare professionals with the new valproate measures for pregnancy prevention appears currently patchy Women are not always receiving Patient Information Leaflets with their medicines, as is required Some women using valproate for off-label indications are not being reviewed in line with the new pregnancy prevention measures is available for psychiatrists on the withdrawal of, and alternatives to, valproate

2019 MHRA Drug Safety Update

97. Chronic Hypertension in Pregnancy

Chronic Hypertension in Pregnancy Sign In (ACOG) Sign in to your ACOG account Email is required. Please enter valid Email. was not found in our system. Would you like to associated with your account? Forgot your email address? JSOG Member? © 2019 - American College of Obstetricians and Gynecologists

2019 American College of Obstetricians and Gynecologists

98. Syphilis in pregnancy

Syphilis in pregnancy Maternity and Neonatal C linical G uideline Queensland Health Syphilis in pregnancy Queensland Clinical Guideline: Syphilis in pregnancy Refer to online version, destroy printed copies after use Page 2 of 31 Document title: Syphilis in pregnancy Publication date: December 2018 Document number: MN18.44-V1-R23 Document supplement: The document supplement is integral to and should be read in conjunction with this guideline. Amendments: Full version history is supplied (...) Officer, Queensland Health, GPO Box 48, Brisbane Qld 4001, email ip_officer@health.qld.gov.au, phone (07) 3234 1479. Queensland Clinical Guideline: Syphilis in pregnancy Refer to online version, destroy printed copies after use Page 3 of 31 Flow Chart: Antenatal care IM: intramuscular injection, MSM: Men who have sex with men, PCR: Polymerase Chain Reaction QSSS: Queensland Syphilis Surveillance Service, STI: sexually transmitted infection, 4 weeks before birth · Indicated following risk assessment

2019 Queensland Health

99. Vaginal progesterone, oral progesterone, 17-OHPC, cerclage, and pessary for preventing preterm birth in at-risk singleton pregnancies: an updated systematic review and network meta-analysis

Vaginal progesterone, oral progesterone, 17-OHPC, cerclage, and pessary for preventing preterm birth in at-risk singleton pregnancies: an updated systematic review and network meta-analysis Recent progesterone trials call for an update of previous syntheses of interventions to prevent preterm birth.To compare the relative effects of different types and routes of administration of progesterone, cerclage, and pessary at preventing preterm birth in at-risk women overall and in specific (...) cervix (≤25 mm), vaginal progesterone reduced preterm birth <34 weeks (OR 0.45, 95% CI 0.24-0.84).Vaginal progesterone was the only intervention with consistent effectiveness for preventing preterm birth in singleton at-risk pregnancies overall and in those with a previous preterm birth.In updated NMA, vaginal progesterone consistently reduced PTB in overall at-risk pregnancies and in women with previous PTB.© 2018 Royal College of Obstetricians and Gynaecologists.

2019 EvidenceUpdates

100. A systematic review of blood gene transcript signature profiling in pregnancies resulting in preterm birth

A systematic review of blood gene transcript signature profiling in pregnancies resulting in preterm birth Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content of this registration record, any associated files

2019 PROSPERO