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The article relates proceedings during the workshop "Timing of Indicated Late Pre-Term and Early Term Births," held in February 2011. The workshop's participants identified various placental, fetal, and maternal conditions that may necessitate late pre-term or early term delivery in order to avert or minimize undesirable outcomes to both mothers and children, as well as developed consensus recommendations for the optimal gestational age for delivery in relation to such conditions.

The article discusses a study that offers information about the risks of uterine rupture and negative perinatal outcome for women at term with a history of prior cesarean delivery. Results reveal that at term, the risk of uterine rupture and adverse perinatal outcome for women with a singleton and previous cesarean delivery is low regardless of mode of delivery, occurring in 3 per 1,000 women. Maternal complications occurred in 3%-8% of women within the five delivery groups.

The article focuses on the treatment for hypoxic ischemic encephalopathy. According to the author, hypoxic ischemic encephalopathy occurs in 1 to 8 per 1,000 births greater than 34 weeks of gestation. This condition, also know as birth asphyxia, perinatal asphyxia, or neonatal encephalopathy. This complication of pregnancy is especially difficult-by definition these are term or near-term pregnancies.

The article details a study which assessed the relationship between different degrees of maternal hyperglycemia and pregnancy outcomes. Study authors compared four cohorts of women to test treatment for mild gestational diabetes. They discovered an increasing relationship between fasting glucose and all postload levels. The study concluded that increasing maternal glycemia is related to perinatal morbidity. It also noted the need to re-evaluate the current oral glucose tolerance test (OGTT).

OBJECTIVE: To estimate the relationship between 1-hour 50 g glucose challenge test values and perinatal outcomes. METHODS: This was a secondary analysis of data from a multicenter treatment trial of mild gestational diabetes mellitus. Women with glucose challenge test values of 135-199 mg/dL completed a 3-hour oral glucose tolerance test. Mild gestational diabetes mellitus was defined as fasting glucose less than 95 mg/dL and two or more abnormal oral glucose tolerance test values: 1-hour 180 mg/dL or more; 2-hour 155 mg/dL or more; and 3-hour 140 mg/dL or more. Our study included untreated women with glucose challenge test values of 135-139 mg/dL and 140-199 mg/dL and a comparison group with values less than 120 mg/dL. Primary outcomes included a perinatal composite (stillbirth, neonatal death, hypoglycemia, hyperbilirubinemia, neonatal hyperinsulinemia, and birth trauma), large for gestational age (LGA, birth weight above the 90th percentile based on sex-specific and race-specific norms), and macrosomia (greater than 4,000 g). RESULTS: There were 436 women with glucose challenge test values less than 120 mg/dL and 1,403 with values of 135 mg/dL or more (135-139, n=135; 140-199, n=1,268). The composite perinatal outcome occurred in 25.6% of those with glucose challenge test values less than 120 mg/dL compared with 21.1% for values of 135-139 mg/dL and 35.3% for values of 140-199 mg/dL. Rates of LGA by group were 6.6%, 6.8%, and 12.4%, respectively. Rates of macrosomia by group were 7.8%, 6.1%, and 12.1%, respectively. Compared with glucose challenge test values less than 120 mg/dL, the adjusted odds ratios (ORs) (95% confidence intervals [Cls]) for values of 140-199 mg/dL were 1.48 (1.14-1.93) for the composite outcome, 1.97 (1.29-3.11) for LGA, and 1.61 (1.07-2.49) for macrosomia. For glucose challenge test values of 135-139 mg/dL, adjusted ORs and 95% Cls were 0.75 (0.45-1.21), 1.04 (0.44-2.24), and 0.75 (0.30-1.66), respectively. The subcategories with glucose challenge test values of 140-144 mg/dL and 145-149 mg/dL also were associated with an increase in selected outcomes when compared with those with values less than 120 mg/dL. CONCLUSIONS: Glucose challenge test values of 135-139 mg/dL were not associated with adverse outcomes compared with values less than 120 mg/dL; however, glucose challenge test values of 140 mg/dL or more were associated with an increase in odds of the composite perinatal outcome, LGA, and macrosomia. [ABSTRACT FROM AUTHOR]

The article discusses the results of a study examining the risk factors of pregnant and postpartum women for influenza-like disease during the influenza pandemic from 2009-2010. According to the authors, pregnant women who smoke and with chronic hypertension increase the possibility of admission in intensive care unit (ICU) for influenza-like illness. They add that the administration of antiviral treatment may reduce the frequency of acquiring the illness.

The article presents a study regarding the connection of family history of venous thromboembolism and factor V Leiden mutation in gravid women. It says that the study calculated the sensitivity as well as the positive and negative values of family history to determine the status of factor V Leiden mutation carrier in 140 women. Results of the study revealed the association of family history of venous thromboembolism with factor V Leiden mutation during pregnancy.

The article presents a study which investigates the rate of vaginal birth after cesarean delivery (VBAC) success of diabetic women based on White's Classification. It states that a secondary analysis of an observational study conducted in 19 medical centers of women undertaking VBAC was done. It says that only 624 of 11,856 met all study criteria. It also mentions that the study indicated a relatively low rate of perinatal complications after undertaking VBAC by diabetic women.

The article estimates the relationship between the number of prior cesarean deliveries and pregnancy outcomes among women with placenta previa. Results reveal that multiple measures of maternal morbidity, such as coagulopathy, hysterectomy, and pulmonary edema, increased in frequency as the number of prior cesarean deliveries increased. Gestational age at delivery and negative perinatal outcome were not related to the number of prior cesarean deliveries.

The article investigates whether HIV-infected women have a higher rate of postcesarean morbidity and mortality compared with women without HIV infection. According to the authors, women with HIV infection undergoing cesarean delivery are at increased risk for perioperative morbidity and maternal mortality.

The article examines the possible association of maternal obesity with pulmonary and nonpulmonary pregnancy complications in asthmatic women. Results indicate that obesity is associated with an increased risk of asthma exacerbations during pregnancy. The increased rate of nonpulmonary complications is associated with obesity in the sampled population.

A letter to the editor is presented in response to the article "The Relationship Between Maternal Glycemia and Perinatal Outcome," by Mark B. Landon and colleagues in an issue.