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Background: Gut microbiome influences cutaneous diseases including atopic dermatitis. Possible impact of intrauterine exposure to meconium on the occurrence of dermatitis and skin rash was proposed. Objective: We investigated the possible influence of intrauterine exposure to meconium‐stained amniotic fluid (MSAF) on the occurrence of dermatitis and skin rash‐related hospitalizations throughout childhood. Methods: Singleton deliveries occurring between 1991 and 2014 at a single medical centre were divided into two study groups based on presence or lack of MSAF during delivery. Population‐based cohort analysis, Kaplan–Meier survival analysis and Cox proportional hazards model were used to study the association between MSAF and cutaneous morbidity‐related hospitalizations. Results: A lower rate of the total dermatitis or skin eruption‐related hospitalization was documented in the MSAF‐exposed group; 0.78 per 1000‐person years (0.9%, n = 312), as compared to 0.98 per 1000‐person years in the unexposed group (1.0%, n = 1992) with a hazard ratio of 0.86 (95% CI 0.76‐0.96, P = 0.011). The survival curve showed lower cumulative hospitalization rate in the MSAF‐exposed group as compared to the unexposed group (log rank P = 0.01). The Cox analysis, controlled for confounders, demonstrated MSAF exposure to be an independent protective factor for dermatitis and skin rash‐related hospitalizations during childhood (adjusted HR 0.878 (95% CI 0.779‐0.990, P = 0.034). Conclusion: Fetal exposure to MSAF appears to be an independent protective factor for dermatitis and skin rash‐related hospitalizations in the offspring throughout childhood and adolescence. [ABSTRACT FROM AUTHOR]

Objective: To investigate whether small-for-gestational-age (SGA) and large-for-gestational-age (LGA) birth weight at-term poses an increased risk for long-term pediatric endocrine morbidity.Study Design: A retrospective population-based cohort study compared the incidence of long-term pediatric hospitalizations due to endocrine morbidity of singleton children born SGA, appropriate-for-gestational-age (AGA), and LGA at-term. A multivariate generalized estimating equation (GEE) logistic regression model analysis was used to control for confounders.Results: During the study period, 235,614 deliveries met the inclusion criteria; of which 4.7% were SGA (n = 11,062), 91% were AGA (n = 214,249), and 4.3% were LGA neonates (n = 10,303). During the follow-up period, children born SGA or LGA at-term had a significantly higher rate of long-term endocrine morbidity. Using a multivariable GEE logistic regression model, controlling for confounders, being delivered SGA or LGA at-term was found to be an independent risk factor for long-term pediatric endocrine morbidity (Adjusted OR = 1.4; 95%CI = 1.1-1.8; p = .015 and aOR = 1.4; 95%CI = 1.1-1.8; p = .005, respectively). Specifically, LGA was found an independent risk factor for overweight and obesity (aOR = 1.7; 95%CI = 1.2-2.5; p = .001), while SGA was found an independent risk factor for childhood hypothyroidism (aOR = 3.2; 95%CI = 1.8-5.8; p = .001).Conclusions: Birth weight either SGA or LGA at-term is an independent risk factor for long-term pediatric endocrine morbidity. [ABSTRACT FROM AUTHOR]

Objective: To investigate whether small-for-gestational-age (SGA) and large-for-gestational-age (LGA) birth weight at-term poses an increased risk for long-term pediatric endocrine morbidity.Study Design: A retrospective population-based cohort study compared the incidence of long-term pediatric hospitalizations due to endocrine morbidity of singleton children born SGA, appropriate-for-gestational-age (AGA), and LGA at-term. A multivariate generalized estimating equation (GEE) logistic regression model analysis was used to control for confounders.Results: During the study period, 235,614 deliveries met the inclusion criteria; of which 4.7% were SGA (n = 11,062), 91% were AGA (n = 214,249), and 4.3% were LGA neonates (n = 10,303). During the follow-up period, children born SGA or LGA at-term had a significantly higher rate of long-term endocrine morbidity. Using a multivariable GEE logistic regression model, controlling for confounders, being delivered SGA or LGA at-term was found to be an independent risk factor for long-term pediatric endocrine morbidity (Adjusted OR = 1.4; 95%CI = 1.1-1.8; p = .015 and aOR = 1.4; 95%CI = 1.1-1.8; p = .005, respectively). Specifically, LGA was found an independent risk factor for overweight and obesity (aOR = 1.7; 95%CI = 1.2-2.5; p = .001), while SGA was found an independent risk factor for childhood hypothyroidism (aOR = 3.2; 95%CI = 1.8-5.8; p = .001).Conclusions: Birth weight either SGA or LGA at-term is an independent risk factor for long-term pediatric endocrine morbidity. [ABSTRACT FROM AUTHOR]

Other than obesity, no definitive insights have been gained regarding the apparent association between mode of delivery and long-term endocrine and metabolic outcomes in the offspring. We aimed to determine whether elective cesarean delivery (CD) impacts on long-term endocrine and metabolic morbidity of the offspring. A population-based cohort analysis was performed including all singleton-term deliveries occurring between 1991 and 2014 at a single tertiary medical center. A comparison was performed between children delivered via a non-emergent CD and those delivered vaginally (VD). Hospitalizations of the offspring up to the age of 18 years involving endocrine morbidity were evaluated. A Kaplan–Meier survival curve was used to compare cumulative morbidity incidence. Cox and a Weibull regression models were used to control for confounders. During the study period 131,880 term deliveries met the inclusion criteria; 8.9% were elective non-urgent CDs (n =11,768) and 91.1% (n =120,112) were VDs. The survival curve demonstrated a significantly higher cumulative incidence of endo-metabolic morbidity in offspring born via CD (P =0.010). In the regression models, adjusted for maternal obesity, CD was not noted as an independent risk factor for long-term pediatric endocrine and metabolic morbidity of the offspring while maternal obesity emerged as a strong predictor. We therefore conclude that CD per-se does not appear to increase the risk for long-term pediatric endo-metabolic morbidity of the offspring. [ABSTRACT FROM AUTHOR]

Background: Low birth weight and preeclampsia are both adverse pregnancy and delivery outcomes, with possible influence on future health status. Previous studies have shown that intergenerational factors may be important prognostic information in evaluating women prior to or after conception. Our objective was to evaluate the role of intergenerational factors on the incidence of preeclampsia and low birth weight (LBW).Methods: A retrospective population-based study was conducted. Perinatal information was gathered from 2311 familial triads, comprising mothers (F1), daughters (F2), and children (F3). All births occurred in a tertiary medical center between 1991 and 2013. A multivariate generalized estimating equation logistic regression model analysis was used to study the association between LBW and preeclampsia across generations while controlling for confounders and for clusters of families in the database.Results: A total of 1490 in F1, 1616 in F2, and 2311 in F3 were included. LBW in mothers (F2), adjusted for possible confounders, was found to be a significant predictor for LBW in offspring (OR = 1.6, 95% CI 1.02-2.6, p = .043). Likewise, preeclampsia was also noted as a significant intergenerational factor following adjustments for possible confounders (OR = 2.9, 95% CI 1.4-5.8, p = .004).Conclusions: Maternal LBW and preeclampsia are both independent risk factors for recurrence in the next generation. [ABSTRACT FROM AUTHOR]

Objective The objective of this study was to investigate whether maternal bronchial asthma increases the risk for long-term respiratory morbidity of the offspring. Study Design A population-based cohort study compared the incidence of long-term pediatric hospitalizations due to respiratory disease of the offspring of mothers with and without bronchial asthma. Deliveries occurred between the years 1991 and 2014 in a tertiary medical center. Congenital malformations as well as multiple pregnancies were excluded. Kaplan-Meier's survival curve was used to estimate cumulative incidence of respiratory morbidity. A multivariate generalized estimating equation (GEE) logistic regression model analysis was used to control for confounders. Results During the study period, 253,808 deliveries met the inclusion criteria; of which 1.3% were born to mothers with bronchial asthma (n = 3,411). During the follow-up period, children born to women with bronchial asthma had a significantly higher rate of long-term respiratory morbidity (odds ratio [OR] = 1.5; 95% confidence interval [CI] = 1.3-1.7; p < 0.001). Specifically, the rate of childhood asthma was higher among offspring of mothers with asthma (OR = 2.3; 95% CI = 1.8-2.9; p < 0.001). Children born to women with asthma had higher cumulative incidence of respiratory morbidity, using a Kaplan-Meier's survival curve (log-rank test; p < 0.001). Using two multivariable GEE logistic regression models, controlling for the time to event, maternal age, and gestational age at delivery, maternal bronchial asthma was found to be an independent risk factor for long-term respiratory disease of the offspring (adjusted OR = 1.6; 95% CI = 1.4-1.9; p < 0.001), and specifically for bronchial asthma (adjusted OR = 2.5; 95% CI = 1.9-3.1; p < 0.001). Conclusion Maternal bronchial asthma is an independent risk factor for long-term respiratory morbidity of the offspring. [ABSTRACT FROM AUTHOR]

Objective The objective of this study was to investigate whether patients who undergo fertility treatments (ovulation induction or in vitro fertilization) have an increased risk for future maternal cardiovascular morbidity. Design A population-based study compared the incidence of long-term cardiovascular morbidity in a cohort of women with and without a previous exposure to fertility treatments. Deliveries occurred during a 25-year period, with a mean follow-up of 11.7 years. Women with known cardiovascular disease and congenital cardiovascular malformations diagnosed before the index pregnancy and multiple pregnancies were excluded. Results During the study period, 99,291 patients met the inclusion criteria; 4.1% (n = 4,153) occurred in patients with exposure to fertility treatments. Patients with exposure to fertility treatments did not have higher rates of cardiovascular morbidity. Using a Kaplan-Meier survival curve, patients with an exposure to fertility treatments had no higher cumulative incidence of cardiovascular hospitalizations. Using a Cox proportional hazards model, adjusted for confounders such as preeclampsia, diabetes mellitus, and obesity, exposure to fertility treatments remained unassociated with cardiovascular hospitalizations (adjusted hazard ratio = 1.1; 95% confidence interval, 0.9-1.3; p = 0.441). Conclusion In our population, during a mean follow-up period of 11.7, results showed no increased risk for cardiovascular morbidity in women undergoing fertility treatments. [ABSTRACT FROM AUTHOR]

Objective: To investigate whether patients with a history of placental abruption have an increased risk for subsequent maternal long-term morbidity. Study design: A population-based study compared the incidence of long-term renal morbidity in cohort of women with and without a history of placental abruption. Deliveries occurred during a 25-year period, with a mean follow-up duration of 11.2 years. Renal morbidity included kidney transplantation, chronic renal failure, hypertensive renal disease, etc. Results: During the study period 99 354 deliveries met the inclusion criteria; 1.8% (n = 1807) occurred in patients with a diagnosis of placental abruption. Patients with placental abruption did not have higher cumulative incidence of renal related hospitalizations, using Kaplan–Meier survival curve. During the follow-up period patients with a history of placental abruption did not have higher rate of renal morbidity (0.2% versus 0.1%; OR 1.8; 95% CI 0.6–4.8;p = 0.261). When performing a Cox proportional hazards model, adjusted for confounders such as parity and diabetes mellitus, a history of placental abruption was not associated with renal related hospitalizations (adjusted HR, 1.6; 95% CI, 0.6–4.2;p = 0.381). Conclusion: Placental abruption, even though considered a part of the “placental syndrome” with possible vascular etiology, is not a risk factor for long-term maternal renal complications. [ABSTRACT FROM PUBLISHER]

Cervical dilation progression rate was significantly slower in twin deliveries compared to singletons: twins mean 1.89 cm/h (95 SP th sp centile-0.51 cm/h) and singletons mean 2.48 cm/h (95 SP th sp centile 0.73 cm/h) (p < 0.001). Conclusions Twin labours are characterised by slower progression of the active and 2nd stages of labour as compared to singletons in nulliparas and multiparas. Failure to progress is one of the leading indications for Caesarean delivery in trials of labour of twin gestations. [Extracted from the article]

Objective: The purpose of this study was to evaluate the association between amniotic fluid index (AFI) and adverse perinatal outcome, and whether a critical cutoff can be defined. Methods: A retrospective cohort study was conducted. Included were patients who were admitted to the ultrasound unit of the tertiary medical center between the years 1988 and 2010. Parturients were classified into five groups according to their AFI: <20 (n = 9974; comparison group), 20-23 (n = 2771), 24-27 (n = 1315), 28-31 (n=494) and 32 + (n = 260). Pregnancy and the perinatal outcomes were compared between the groups. Statistical analysis included the chi-square tests for trends, and multivariable models to control for confounders (with AFI as a dummy variable). Results: A significant linear association was found between AFI and adverse perinatal outcomes including hypertensive disorders, diabetes mellitus, preterm labor, macrosomia, placental abruption and low birth weight. Furthermore, using multivariable logistic regression models, controlling for confounders such as maternal and gestational age, hypertension, diabetes mellitus, etc., the significant association between all four subgroups of AFI >20 and adverse perinatal outcomes remained. Conclusion: A significant linear association exists between AFI >20 and perinatal complications such as perinatal mortality, low Apgar scores and preterm labor. Hence, the critical cutoff for polyhydramnios should be re-evaluated. [ABSTRACT FROM AUTHOR]

Objective: To determine whether blood glucose values of over 200 mg/dL in the oral glucose tolerance test (OGTT) are associated with pregnancy complications and adverse perinatal outcomes in patients with gestational diabetes mellitus (GDM). Methods: A retrospective cohort study was performed comparing patients with GDM A1 (diet controlled) that had at least one value of 200 mg/dL or higher in the OGTT, to those who did not. Patients were treated at the diabetes day care clinic of a tertiary medical center between the years 1999 and 2010. Data were available from the computerized perinatal databases. Results: During the study period, 778 women with GDM were treated at the diabetes day care clinic. Of these, 162 had at least one test value of 200 mg/dL or greater. No significant differences regarding maternal and perinatal complications, such as polyhydramnios, macrosomia (birth-weight above 4 kg), shoulder dystocia, low Apgar scores at 5 min (<7) and cesarean section were noted between the groups. Conclusions: A value of 200 mg/dL or more in the OGTT is not an indicator of perinatal complications. [ABSTRACT FROM AUTHOR]