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Background: About 20% of the population in Germany has a migration background (1st generation: immigrated themselves; 2nd generation: offspring of immigrants), which can be associated with health differentials. We assessed whether differentials in uptake of antenatal care (ANC) observed in earlier studies still persist today., Methods: Data collection in 3 obstetric hospitals in Berlin, Germany, over a 1-year period 2011/2012. We conducted standardised interviews before delivery and linked the data to routinely collected perinatal data and to data from participants' antenatal cards. We checked for confounders using regression models., Results: Of the 7100 study participants (response 89.6%), 57.9% had a migration background. First ANC attendance occurred in pregnancy weeks 3-19 in 92.1% of 1st generation immigrants vs. 97.8% of non-immigrants (mean week of first attendance: 1st generation immigrants with residence < 5 years: 13.0; 5+ years: 9.9; non-immigrants 9.7). A low ANC utilisation with ≤ 5 visits was found in 644 women (9.1%). Among the non-immigrants there were 7.1% low users, among 1st generation immigrants 11.8% (among women with no German language skills 33.0%, however). Uptake of non-medical support measures was lower among women with migration background., Discussion: In our sample from Berlin, migration background had little effect on ANC uptake. Neither own migration nor low acculturation were independent risk factors for late onset or low utilisation of ANC. However, a small subgroup of women with a short duration of residence in Germany and with German language problems had a lower chance of timely onset and sufficient participation in ANC. This group needs special attention.

Hypothesis: Acculturation is a complex, multidimensional process involving the integration of the traditional norms, values, and lifestyles of a new cultural environment. It is, however, unclear what impact the degree of acculturation has on obstetric outcomes.Methods: Data collection was performed in 2011 and 2012 at three obstetric tertiary centers in Berlin, Germany. Standardized interviews (20-30 min.) were performed with support of evaluated questionnaires. The primary collected data were then linked to the perinatal data recorded at the individual clinics provided from the obstetric centers which correspond with the routinely centralized data collected for quality assurance throughout Germany. The questionnaire included questions on sociodemographic, health care, and migrant-related aspects. Migrant women and women with a migration background were assessed using the Frankfurt Acculturation Scale, a one-dimensional measurement tool to assess the degree of acculturation (15 items on language and media usage as well as integration into social networks).Results: In summary, 7100 women were available for the survey (response rate of 89.6%) of which 3765 (53%) had a migration background. The probability of low acculturation is significantly (p < 0.001) associated with a lower level of German knowledge, a shorter period of residence, and lower education. Pregnant women with a low acculturation also had a significantly greater chance of having the first booking visit after 9 weeks of pregnancy and fewer ultrasound examinations during pregnancy. There is no significant difference depending on the degree of acculturation for the frequency of elective and emergency cesarean sections. The results of the logistic regression analyses for the examination of possible relationships between the degree of acculturation and obstetric parameters show no significant differences for prematurity, 5 min.-Apgar values > 7, arterial umbilical cord pH values > 7.00 and admissions to the neonatal unit.Conclusions: In Berlin, among migrant women a low degree of acculturation may have an unfavorable effect on the utilization of pregnancy care provision. However, there were no relevant differences in obstetric outcome parameters in relation to the degree of acculturation within the migrant population of Berlin. [ABSTRACT FROM AUTHOR]

Background: Maternal excessive weight and smoking are associated with an increased risk of pregnancy complications and adverse pregnancy outcomes. In Germany, immigrant women have a higher prevalence of pre-pregnancy overweight/obesity compared with autochthonous women. We compared the contribution of pre-pregnancy overweight/obesity to adverse pregnancy outcomes among immigrant and autochthonous women in Berlin/Germany. Methods: Data from 2586 immigrant women (from Turkey, Lebanon, other countries of origin) and 2676 autochthonous women delivering in three maternity hospitals of Berlin within 12 months (2011/2012) was used. Cox regression models were applied to estimate the association between overweight/obesity and smoking with the outcomes large-for-gestational-age (LGA), small-for-gestational-age (SGA), preterm birth (PTB) and extreme preterm-birth (E-PTB). Population attributive fractions (PAF) were calculated to quantify the proportion of the outcomes attributable to overweight/obesity and smoking, respectively. Results: Prevalence of overweight and obesity was 33.4% among autochthonous and 53.6% among Turkish women. Prevalence risk ratios of excessive weight were highest for LGA infants among immigrant and autochthonous women. The PAFs were -11.8% (SGA), +16.3% (LGA), +3.6% (PTB) and +16.5% (E-PTB) for the total study population. Conclusions: Overweight/obesity is strongly associated with an increased risk of delivering an LGA infant among both immigrant and autochthonous women. Compared with autochthonous women, the contribution of excessive weight to LGA is even higher among immigrant women, in whom PAFs of overweight/obesity even exceed those of smoking for some outcomes. [ABSTRACT FROM AUTHOR]

Objective: To report all pregnancies to date after magnetic resonance–guided focused ultrasound surgery (MRgFUS) for the conservative treatment of clinically significant uterine fibroids. Design: Prospective registry of all known pregnancies occurring after MRgFUS maintained by the device manufacturer and reported to the Food and Drug Administration. Setting: World experience of pregnancies after treatment with reports from 13 sites in seven countries. Patient(s): Fifty-one reproductive-age women with uterine leiomyomas. Intervention(s): Women underwent MRgFUS treatment for symptomatic uterine leiomyomas before this report. Main Outcome Measure(s): Pregnancy outcomes and complications. Result(s): Fifty-four pregnancies in 51 women have occurred after MRgFUS treatment of uterine leiomyomas. The mean time to conception was 8 months after treatment. Live births occurred in 41% of pregnancies, with a 28% spontaneous abortion rate, an 11% rate of elective pregnancy termination, and 11 (20%) ongoing pregnancies beyond 20 gestational weeks. The mean birth weight was 3.3 kg, and the vaginal delivery rate was 64%. Conclusion(s): Preliminary pregnancy experience after MRgFUS is encouraging, with a high rate of delivered and ongoing pregnancies. [Copyright &y& Elsevier]

Intravenous drug abuse is a risk for alloimmunization in pregnancy. One case is presented of a nulliparous Rhesus-negative parturient who shared her Rhesuspositive partner's needles for the injection of heroin; she subsequently developed elevated antepartum anti-D titers despite routine anti-D prophylaxis. [ABSTRACT FROM AUTHOR]