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Objectives: To compare maternal and perinatal outcomes in pregnancies with transient and persistent idiopathic polyhydramnios to those with normal amniotic fluid volume. Methods: This retrospective cohort study included subjects delivering a singleton pregnancy between January 1, 2015, and June 30, 2020, with sonography ≥26 weeks' gestation demonstrating transient or persistent idiopathic polyhydramnios (amniotic fluid index [AFI] ≥24.0 cm) or normal AFI (referent group). The primary maternal outcome was a composite of spontaneous preterm delivery <37 weeks, cesarean delivery for malpresentation, abnormal labor progress, or nonreassuring fetal status, operative vaginal delivery, hemorrhage requiring transfusion, and umbilical cord prolapse. The primary perinatal outcome was a composite of birthweight >4500 g, fetal or neonatal death, 5‐minute Apgar score <7, and neonatal intensive care unit admission for >24 hours. Results: Patients with transient polyhydramnios (n = 259) exhibited maternal outcomes similar to those of the referent group (n = 435) but had significantly increased odds for the primary perinatal outcome (odds ratio [OR] 1.70, 95% confidence interval [CI] 1.15–2.53; P =.008) and for birthweight ≥4500 g (OR 8.70, 95% CI 1.89–40.0; P =.005). Persistent polyhydramnios (n = 176) was significantly associated with both the primary maternal (OR 1.93, 95% CI 1.27–2.95, P =.002) and primary perinatal outcome (OR 2.15, 95% CI 1.40–3.30; P <.001), and individually with cesarean delivery for abnormal labor (OR 3.22, 95% CI 1.55–6.68; P =.002) and birthweight ≥4500 g (OR 8.97, 95% CI 1.84–43.6; P =.007). Conclusions: Transient idiopathic polyhydramnios does not impact maternal outcomes but is associated with increased odds of newborn birthweight >4500 g. Persistent polyhydramnios is associated with both adverse maternal and perinatal outcomes. [ABSTRACT FROM AUTHOR]

Cigarette smoking is known to contribute to coronary heart disease by altering blood lipids (fats). In adults, cigarette smoking causes an increase in total cholesterol, triglycerides, low (LDL) and very low density lipoproteins (VLDL), as well as decreases in high density lipoproteins (HDL) and apolipoproteins (the protein associated with HDL). Research indicates that low HDL and high LDL levels (a high LDL/HDL ratio) increase the risk for coronary artery disease. These alterations in blood lipids contribute to atherosclerosis, the narrowing of blood vessels, particularly those supplying the heart muscle. To see if these changes also occur in children, all available information on children between eight and 19 years old was reviewed. Children in this age group had 11.8 percent higher triglycerides, 12.4 percent higher VLDL, and 4.1 percent higher LDL. They also had 8.5 percent lower HDL and 3.7 lower total cholesterol. Although these results are similar to those found among smoking adults, except for the higher level of total cholesterol, the percentages were higher among children who smoked. Total cholesterol represents the net shift in the relationship of HDL and LDL and does not necessarily reflect adverse changes in lipoprotein levels. It is unclear whether children between eight and 19 who smoke, have an increased risk for coronary heart disease later in life. (Consumer Summary produced by Reliance Medical Information, Inc.)

Objectives: We sought to study potential diagnostic criteria for marginal placental cord insertions as determined by associations with obstetric outcomes. Methods: This single‐center retrospective cohort investigation included singleton gestations delivering from January 1, 2012, to December 31, 2016, and having a standard or detailed fetal ultrasound examination from 18 weeks to 21 weeks 6 days. Cord insertion–to–placental edge distances were used to create a referent comparison group and 3 patient groups: greater than 3.0 cm (comparison); greater than 2.0 to 3.0 cm (group 1); greater than 1.0 to 2.0 cm (group 2); and 1.0 cm or less (group 3). The primary outcome consisted of any one of spontaneous delivery before 37 weeks, fetal growth restriction, oligohydramnios, placental abruption, or intrauterine fetal demise. Results: The numbers of participants and mean distances ± SDs for the comparison group and groups 1 to 3, respectively, were 628 and 4.68 ± 1.17 cm, 106 and 2.52 ± 0.26 cm, 131 and 1.60 ± 0.29 cm, and 77 and 0.36 ± 0.37 cm, respectively. The primary outcome was significantly associated only with cord insertion–to–placental edge distances of 1.0 cm or less (adjusted odds ratio, 3.05; 95% confidence interval, 1.73–5.38). Conclusions: Marginal cord insertions may be diagnosed when the cord insertion–to–placental edge distance is 1.0 cm or less. [ABSTRACT FROM AUTHOR]