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ObjectivesTo assess deviations in longitudinally measured cytokines with preterm birth (PTB).MethodsProspective longitudinal study targeting 80 subjects. Phlebotomy specimens for broad panel of cytokine analysis were obtained at three time (T) intervals: first trimester (T1: 8-14 weeks' gestation), second trimester (T2: 18-22 weeks' gestation), and third trimester (T3: 28-32 weeks' gestation). Important demographics and outcomes were tracked. Data were stratified and the target groups were analyzed as follows: "Uncomplicated" (delivered ≥37 weeks) or "Preterm Birth" (

Objectives. To determine rate and factors associated with small-for-gestational-age (SGA) births to women with HIV. Methods. Prospective data were collected from 183 pregnant women with HIV in an urban HIV prenatal clinic, 2000-2011. An SGA birth was defined as less than the 10th or 3rd percentile of birth weight distribution based upon cut points developed using national vital record data. Bivariate analysis utilized chi-squared and t-tests, and multiple logistic regression analyses were used. Results. The prevalence of SGA was 31.2% at the 10th and 12.6% at the 3rd percentile. SGA at the 10th (OR 2.77; 95% CI, 1.28-5.97) and 3rd (OR 3.64; 95% CI, 1.12-11.76) percentiles was associated with cigarette smoking. Women with CD4 count >200 cells/mm3 at the first prenatal visit were less likely to have an SGA birth at the 3rd percentile (OR 0.29; 95% CI, 0.10-0.86). Women taking NNRTI were less likely to have an SGA infant at the 10th (OR 0.28; 95% CI, 0.10-0.75) and 3rd (OR 0.16; 95% CI, 0.03-0.91) percentiles compared to those women on PIs. Conclusions. In this cohort with high rates of SGA, severity of HIV disease, not ART, was associated with SGA births after adjusting for sociodemographic, medication, and disease severity. [ABSTRACT FROM AUTHOR]

Residential context has received increased attention as a possible contributing factor to race/ethnic and socio-economic disparities in birth outcomes in the United States. Utilising vital statistics birth record data, this study examined the association between neighbourhood deprivation and the risk of a term small-for-gestational-age (SGA) birth among non-Hispanic whites and non-Hispanic blacks in eight geographical areas. An SGA birth was defined as a newborn weighing <10th percentile of the sex- and parity-specific birthweight distribution for a given gestational week. Multi-level random intercept logistic regression models were employed and statistical tests were performed to examine whether the association between neighbourhood deprivation and SGA varied by race/ethnicity and study site. The risk of term SGA was higher among non-Hispanic blacks (range 10.8-17.5%) than non-Hispanic whites (range 5.1-9.2%) in all areas and it was higher in cities than in suburban locations. In all areas, non-Hispanic blacks lived in more deprived neighbourhoods than non-Hispanic whites. However, the adjusted associations between neighbourhood deprivation and term SGA did not vary significantly by race/ethnicity or study site. The summary fully adjusted pooled odds ratios, indicating the effect of one standard deviation increase in the deprivation score, were 1.15 [95% CI 1.08, 1.22] for non-Hispanic whites and 1.09 [95% CI 1.05, 1.14] for non-Hispanic blacks. Thus, neighbourhood deprivation was weakly associated with term SGA among both non-Hispanic whites and non-Hispanic blacks. [ABSTRACT FROM AUTHOR]

The article discusses a study which evaluated short-term outcomes associated with discordant twin pairs admitted to the neonatal intensive care unit (NICU). The study involved 384 discordant twin pairs whose mean gestational age was 32.6 weeks. It was concluded that larger twins had more acute respiratory issues but achieved certain milestones more rapidly with fewer complications.

Objective: The purpose of this study was to assess the contribution of depressive symptoms and poor contraceptive use early in the first postpartum year to the risk of unintended repeat pregnancy at the end of that year among adults with low educational status (<12th grade or equivalence). Study design: This was a prospective observational cohort study of 643 sexually active, low-income, inner-city adult women (age ≥ 19) who enrolled prenatally (14.7 ± 6.9 weeks gestational age) and were followed twice after delivery (3.3 ± 1.3 months and 11.0 ± 1.3 months). Associations were assessed by multivariate logistic regression. Results: Low educational status (odds ratio, 2.32; 95% CI, 1.25-4.33) and less effective contraceptive use (odds ratio, 2.31; 95% CI, 1.05-4.51) were associated with unintended pregnancy. Neither depressive symptoms nor contraceptive use reduced the risk of pregnancy that was associated with low educational status. Conclusion: Low educational status was associated with more than twice the risk of unintended pregnancy 1 year after delivery. We found no evidence that depression or poor contraceptive use mediate this relationship. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The purpose of this work was to compare the processes of care and to evaluate outcomes of premature neonates delivered to women with Medicaid managed care versus private insurance. DESIGN/METHODS: All of the infants born at <37 weeks' gestation between January 2001 and August 2005 in the ParadigmHealth database were included in these analyses (n = 24 151). Infants were categorized by maternal health insurance status as private insurance or Medicaid managed care and analyzed for differences in demographic data and length of stay. For survivors, differences in respiratory care, nutritional, and maturational milestones were assessed. In addition, age to wean to open crib, weight gain, home oxygen, and apnea monitor use were compared. Adverse outcomes, including necrotizing enterocolitis, sepsis, severe intraventricular hemorrhage, severe retinopathy of prematurity, bronchopulmonary dysplasia, apnea, and mortality, were compared. Statistical tests used were Students t test, χ2 and Kruskall-Wallis test. Multiple logistic regression was performed after controlling for demographic variables. RESULTS: Of the 24 151 infants studied, 19046 (78.9%) had private insurance, and 5105 (21.1%) had Medicaid managed care. There were no differences in gestational age at birth; however, Medicaid managed care infants had lower birth weight, lower Apgar score at 5 minutes, increased incidence of necrotizing enterocolitis and bacterial sepsis, and longer length of stay. Of the surviving infants, more neonates with private insurance went home on oxygen and apnea monitors despite no differences found in the incidences of apnea or bronchopulmonary dysplasia between the groups. There were no differences in processes of care for feeding and respiratory milestones, but infants with Medicaid managed care weaned to an open crib later and had greater overall weight gain compared with infants with private insurance. CONCLUSIONS: We speculate that, in addition to the known impact of insurance status on well-being at birth, Medicaid managed care is independently associated with adverse neonatal outcomes in preterm infants, as well as differences in neonatal intensive care discharge processes. [ABSTRACT FROM AUTHOR]