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Chorioamnionitis is an important cause of preterm delivery. Data on neurodevelopmental outcome in exposed infants are inconsistent due to difficulties in diagnosing intrauterine infection/inflammation and lack of detailed long-term follow-up. We investigate cognitive and motor function in preterm infants at early school age and relate the findings to bacteria in amniotic fluid obtained by amniocentesis (microbial invasion of the amniotic cavity (MIAC)) or placenta findings of histological chorioamnionitis (HCA) or fetal inflammatory response syndrome (FIRS). Sixty-six infants with gestational age

The development of immunoassays enables more sophisticated studies of the associations between protein concentrations and pregnancy outcomes, allowing early biomarker identification that can improve neonatal outcomes. The aim of this study was to explore associations between selected mid-trimester amniotic fluid proteins and (1) overall gestational duration and (2) spontaneous preterm delivery. A prospective cohort study, including women undergoing mid-trimester transabdominal genetic amniocentesis, was performed in Gothenburg, Sweden, 2008–2016 (n = 1072). A panel of 27 proteins related to inflammation was analyzed using Meso-Scale multiplex technology. Concentrations were adjusted for gestational age at sampling, experimental factors, year of sampling, and covariates (maternal age at sampling, parity (nulliparous/multiparous), smoking at first prenatal visit, and in vitro fertilization). Cox regression analysis of the entire cohort was performed to explore possible associations between protein concentrations and gestational duration. This was followed by Cox regression analysis censored at 259 days or longer, to investigate whether associations were detectable in women with spontaneous preterm delivery (n = 47). Finally, linear regression models were performed to analyze associations between protein concentrations and gestational duration in women with spontaneous onset of labor at term (n = 784). HMG-1, IGFBP-1, IL-18, MIP-1α, MIP-1β, S100A8, and thrombospondin-1 were significantly associated with gestational duration at term, but not preterm. Increased concentrations of thrombospondin-1, MIP-1β, and S100A8, respectively, were significantly associated with decreased gestational duration after the Holm-Bonferroni correction in women with spontaneous onset of labor at term. This adds to the concept of a pregnancy clock, where our findings suggest that such a clock is also reflected in the amniotic fluid at early mid-trimester, but further research is needed to confirm this.

Objective: The aim of this study was to explore inflammatory response and identify early potential biomarkers in mid-trimester amniotic fluid associated with subsequent spontaneous preterm delivery (PTD). Methods: A cohort study was performed at Sahlgrenska University Hospital/Ostra, Gothenburg, Sweden, between 2008 and 2010. Amniotic fluid was collected from consecutive women undergoing mid-trimester transabdominal genetic amniocentesis at 14–19 gestational weeks. Clinical data and delivery outcome variables were obtained from medical records. The analysis included 19 women with spontaneous PTD and 118 women who delivered at term. A panel of 26 candidate proteins was analyzed using Luminex xMAP technology. Candidate protein concentrations were analyzed with ANCOVA and adjusted for plate effects. Results: The median gestational age at delivery was 35 + 3 weeks in women with spontaneous PTD and 40 + 0 weeks in women who delivered at term. Nominally significantly lower amniotic fluid levels of adiponectin (PTD: median 130,695 pg/mL (IQR 71,852–199,414) vs term: median 185,329 pg/mL (IQR (135,815–290,532)), granulocyte-macrophage colony stimulating factor (PTD: median 137 pg/mL (IQR 74–156) vs term: median 176 pg/mL (IQR 111–262)), and macrophage migration inhibitory factor (PTD: median 3025 pg/mL (IQR 1885–3891) vs term: median 3400 pg/mL (IQR 2181–5231)) were observed in the spontaneous PTD group, compared with the term delivery group, after adjusting for plate effects. No significant differences remained after Bonferroni correction for multiple comparisons. Conclusions: Our results are important in the process of determining the etiology behind spontaneous PTD but due to the non-significance after Bonferroni correction, the results should be interpreted with caution. Further analyses of larger sample size will be required to determine whether these results are cogent and to examine whether microbial invasion of the amniotic cavity or intra-amniotic inflammation occurs in asymptomatic women in the mid-trimester with subsequent spontaneous PTD.

Biometric sensors and portable devices are being increasingly embedded into our everyday life, creating the need for robust physiological models that efficiently represent, analyze, and interpret the acquired signals. We propose a knowledge-driven method to represent electrodermal activity (EDA), a psychophysiological signal linked to stress, affect, and cognitive processing. We build EDA-specific dictionaries that accurately model both the slow varying tonic part and the signal fluctuations, called skin conductance responses (SCR), and use greedy sparse representation techniques to decompose the signal into a small number of atoms from the dictionary. Quantitative evaluation of our method considers signal reconstruction, compression rate, and information retrieval measures, that capture the ability of the model to incorporate the main signal characteristics, such as SCR occurrences. Compared to previous studies fitting a predetermined structure to the signal, results indicate that our approach provides benefits across all aforementioned criteria. This paper demonstrates the ability of appropriate dictionaries along with sparse decomposition methods to reliably represent EDA signals and provides a foundation for automatic measurement of SCR characteristics and the extraction of meaningful EDA features.

Objective: To determine the impact of histological chorioamnionitis (HCA) and funisitis on neonatal outcome in preterm prelabor rupture of membranes (PPROM) pregnancies.Methods: Women with PPROM between 24 + 0 to 36 + 6 weeks of gestation, admitted to the Department of Obstetrics and Gynecology at the University Hospital Hradec Kralove in the Czech Republic, between July 2008 and October 2010, were enrolled in the study (n = 231).Results: The incidence of early-onset sepsis (EOS) differed significantly in neonates born to women with and without HCA, after adjustment for gestational age (11% versus 1%, p = 0.011). The incidence of EOS in neonates was also significantly different, after adjustment for gestational age, in cases with and without funisitis (18% versus 4%, p = 0.002). The same was also found for retinopathy of prematurity (ROP) cases with and without funisitis (23% versus 4%, p = 0.014), after adjustment for gestational age.Conclusions: HCA and funisitis increase the risk of adverse per...

BACKGROUND: Prediction of neonatal respiratory morbidity may be useful to plan delivery in complicated pregnancies. The limited predictive performance of the current diagnostic tests together with the risks of an invasive procedure restricts the use of fetal lung maturity assessment. OBJECTIVE: The objective of the study was to evaluate the performance of quantitative ultrasound texture analysis of the fetal lung (quantusFLM) to predict neonatal respiratory morbidity in preterm and early-term (

Objective. To evaluate the maternal inflammatory response to microbial invasion of the amniotic cavity (MIAC) in women with preterm labor and preterm prelabor rupture of membranes using selected proteins in the maternal serum. Design. A prospective cohort study. Setting. Labor ward from Salgrenska University Hospital. The evaluation of the maternal inflammatory response in the presence of MIAC in preterm labor and preterm prelabor rupture of membranes. Population. One hundred and sixteen women with preterm labor and 73 women with preterm prelabor rupture of membranes between the gestational ages of 22+0 and 33+6 weeks. Methods. Twenty-seven maternal serum proteins were assayed by a multiple immunoassay. Main outcome measures. The maternal serum inflammatory response was evaluated according to the presence of MIAC. Data were stratified by gestational age. Results. There were few differences in the maternal serum protein levels when MIAC was present in both preterm labor and preterm prelabor rupture of membranes. In preterm prelabor rupture of membranes, higher levels of interleukin-18 (median 654 vs. 361 pg/mL, p= 0.003) and lower levels of interleukin-1β (9.5 vs. 19.9 pg/mL, p= 0.008) and monocyte chemotactic protein-1 (139.1 vs. 212.6 pg/mL, p= 0.039) were observed in women with MIAC. Interleukin-6 (20.8 vs. 13.9 pg/mL, p= 0.019) was the only biomarker that increased significantly in preterm labor complicated with MIAC. All of the differences between preterm labor and preterm prelabor rupture of membranes were observed at less than 32+0 weeks of gestation. Conclusions. A weak maternal inflammatory response in the serum was observed in women with MIAC.

Please cite this paper as: Tsiartas P, Holst R, Wennerholm U, Hagberg H, Hougaard D, Skogstrand K, Pearce B, Thorsen P, Kacerovsky M, Jacobsson B. Prediction of spontaneous preterm delivery in women with threatened preterm labour: a prospective cohort study of multiple proteins in maternal serum. BJOG 2012;119:866–873. Objective To analyse whether specific proteins in maternal serum and cervical length, alone or in combination, can predict the likelihood that women with intact membranes with threatened preterm labour will deliver spontaneously within 7 days of sampling. Design Cohort study. Setting Sahlgrenska University Hospital, Gothenburg, Sweden. Population Women at between 22 and 33 weeks of gestation with threatened preterm labour (n = 142) admitted to the Sahlgrenska University Hospital, Gothenburg, Sweden, in 1995–2005. Methods Maternal serum was tested for 27 proteins using multiplex xMAP technology. Individual levels of each protein were compared, and calculations were performed to investigate potential associations between different proteins, cervical length and spontaneous preterm delivery. Receiver operating characteristic curves were used to find the best cut-off values for continuous variables in relation to spontaneous preterm delivery within 7 days of sampling. Prediction models were created based on a stepwise logistic regression using binary variables. Main outcome measure Spontaneous preterm delivery within 7 days. Results In order to determine the best prediction model, we analysed models of serum proteins alone, cervical length alone, and the combination of serum proteins and cervical length. We found one multivariable combined model through the data analysis that more accurately predicted spontaneous preterm delivery within 7 days. This model was based on serum interleukin-10 (IL-10) levels, serum RANTES levels and cervical length (sensitivity 74%, specificity 87%, positive predictive value 76%, negative predictive value 86%, likelihood ratio 5.8 and area under the curve 0.88). Conclusions A combination of maternal serum proteins and cervical length constituted the best prediction model, and would help determine whether women with threatened preterm labour are likely to deliver within 7 days of measurement.

Speech and spoken language cues offer a valuable means to measure and model human behavior. Computational models of speech behavior have the potential to support health care through assistive technologies, informed intervention, and efficient long-term monitoring. The Interspeech 2013 Autism SubChallenge addresses two developmental disorders that manifest in speech: autism spectrum disorders and specific language impairment. We present classification results with an analysis on the development set including a discussion of potential confounds in the data such as recording condition differences. We hence propose study of features within these domains that may inform realistic separability between groups as well as have the potential to be used for behavioral intervention and monitoring. We investigate template-based prosodic and formant modeling as well as goodness of pronunciation modeling, reporting above chance classification accuracies. Index Terms: autism spectrum disorders, intonation, specific language impairment, goodness of pronunciation

Intrapartum application of the continuous glucose monitoring system in pregnancies complicated with diabetes: A review and feasibility study

Objective The objective of the study was to determine whether the bacterial load of genital mycoplasmas and gestation age are related to intraamniotic inflammatory response using the amniotic fluid levels of 18 inflammatory mediators. Study Design A prospective study of 145 women with singleton pregnancies complicated by preterm prelabor rupture of membranes between 24 0/7 and 36 6/7 weeks was conducted. Amniotic fluid was obtained from all women by transabdominal amniocentesis. The amounts of genital mycoplasma deoxyribonucleic acid were determined using the threshold cycle value and relative and absolute quantification techniques. A panel of multiple proteins was analyzed simultaneously using multiplex technology. Results Twenty-four women with the presence of genital mycoplasmas in amniotic fluid were included in the final analyses. The concentrations of 9 of the 18 evaluated proteins in the amniotic fluid correlated with bacterial load of genital mycoplasmas independent of the quantification technique used. Conclusion The intensity of intraamniotic inflammatory response to genital mycoplasmas decreased with gestational age.

delivery in women with preterm labor: analysis of multiple proteins in maternal serum Panagiotis Tsiartas, Rose-Marie Holst, Ulla-Britt Wennerholm, Henrik Hagberg, David Hougaard, Kristin Skogstrand, Brad Pearce, Marian Kacerovsky, Bo Jacobsson Papageorgiou University Hospital of Thessaloniki, Obstetrics and Gynecology, Thessaloniki, Greece, Sahlgrenska University Hospital, Department of Obstetrics and Gynecology, Gothenburg, Sweden, Sahlgrenska University Hospital, East, Obstetrics and Gynecology, Gothenburg, Sweden, Queen Charlottes and Chelsea Hospital, Institute of Reproductive and Developmental Biology, London, United Kingdom, Statens Serum Institut, Department of Clinical Biochemistry and Immunology, Copenhagen, Denmark, Statens Serum Institut, 3Department of Clinical Biochemistry and Immunology, Copenhagen, Denmark, Rollins School of Public Health, Epidemiology, Atlanta, GA, Univerzita Karlova Praha, Porodnicka a gynekologicka klinika FN Hradec Kralova, Praha, Czech Republic OBJECTIVE: To analyze whether specific proteins in maternal serum and the cervical length, alone or in combination, can identify the likelihood that women in preterm labor with intact membranes will deliver spontaneously within 7 days of sampling. STUDY DESIGN: We used in our study two independent cohorts of women, an exploratory cohort from 1995-2005 and a confirmatory cohort from 2008-2010 admitted to the Sahlgrenska University Hospital, Gothenburg, Sweden in preterm labor. In the exploratory cohort of 142 women in preterm labor between 22 and 33 weeks of gestation, maternal serum was collected and tested for twenty-seven proteins using multiplex xMAP technology. The women in the study provided serum samples at admission to the hospital for xMAP analysis. Individual levels of each protein were compared and calculations performed to find associations among different proteins, cervical length, and spontaneous preterm delivery within 7 days of sampling. Prediction models were created based on stepwise logistic regression. We have in a second stage applied our multivariable model in order to confirm its predictive capacity to an independent confirmatory cohort of 42 women between 23 and 33 weeks of gestation, who were admitted to the hospital in preterm labor and provided serum samples for xMAP analysis. RESULTS: We found one multivariable model through the data analysis of the exploratory cohort of women that predicts spontaneous preterm delivery within 7 days. This model was based on serum IL-10, RANTES and cervical length (sensitivity 73.8%, specificity 87.3%, positive predictive value 75.6%, negative predictive value 86.3%, likelihood ratio 5.8 and area under the curve 0.89). From the application of the multivariable model to the confirmatory cohort we found that the model had a sensitivity of 66.6%, specificity 66.6%, positive predictive value 35.3%, negative predictive value 88%, likelihood ratio 2 and area under the curve 0.66. CONCLUSION: A combination of maternal serum proteins and cervical length might help to determine whether women with preterm labor will deliver within 7 days.

A direct analytical technique for measuring the solution quantum efficiencies of photoacid generators (PAGs) is presented. The technique is based on the nonaqueous potentiometric titration of the photogenerated acid and does not require separate calibrations, or the addition of sensing materials such as dyes or bases. Solutions of PAGs in acetonitrile were irradiated at 248 nm and subsequently titrated with known concentrations of triethanolamine base. The only quantities required for an accurate determination of the quantum efficiency are the incident radiation energy and the titration equivalence point. A mathematical analysis that enables this calculation is derived, and a table with calculated quantum efficiency values for three classes of PAGs having a variety of counterions is presented. The method is simple, accurate, and applicable to any class of PAG molecules.