317 results on '"Dekker GA"'
Search Results
2. Fetal exposure to herpesviruses may be associated with pregnancy-induced hypertensive disorders and preterm birth in a Caucasian population*
- Author
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Gibson, CS, Goldwater, PN, MacLennan, AH, Haan, EA, Priest, K, and Dekker, GA
- Published
- 2008
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3. Socio-economic status influences the relationship between obesity and antenatal depression: Data from a prospective cohort study
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Molyneaux, E, Pasupathy, D, Kenny, LC, McCowan, LME, North, RA, Dekker, GA, Walker, JJ, Baker, PN, Poston, L, and Howard, LM
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Adult ,Antenatal depression ,EPDS, Edinburgh postnatal depression scale ,Depression ,socio-economic status ,Short Communication ,BMI, body mass index ,Socio-economic status ,SCOPE cohort, screening for pregnancy endpoints cohort study ,Pregnancy Complications ,Clinical Psychology ,Psychiatry and Mental health ,Social Class ,Pregnancy ,Risk Factors ,Odds Ratio ,Humans ,SES, socio-economic status ,Female ,Prospective Studies ,Self Report ,Obesity ,antenatal depression - Abstract
Background Obesity has been associated with increased risk of antenatal depression, but little is known about this relationship. This study tested whether socio-economic status (SES) influences the relationship between obesity and antenatal depression. Methods Data were taken from the Screening for Pregnancy Endpoints (SCOPE) cohort. BMI was calculated from measured height and weight at 15±1 weeks' gestation. Underweight women were excluded. SES was indicated by self-reported household income (dichotomised around the median: low SES ≤£45,000; high SES >£45,000). Antenatal depression was defined as scoring ≥13 on the Edinburgh Postnatal Depression Scale at both 15±1 and 20±1 weeks' gestation, to identify persistently elevated symptoms of depression. Results Five thousand five hundred and twenty two women were included in these analyses and 5.5% had persistently elevated antenatal depression symptoms. There was a significant interaction between SES and BMI on the risk of antenatal depression (p=0.042). Among high SES women, obese women had approximately double the odds of antenatal depression than normal weight controls (AOR 2.11, 95%CI 1.16–3.83, p=0.014, adjusted for confounders). Among low SES women there was no association between obesity and antenatal depression. The interaction effect was robust to alternative indicators of SES in sensitivity analyses. Limitations 1) Antenatal depression was assessed with a self-reported screening measure; and 2) potential mediators such as stigma and poor body-image could not be examined. Conclusions Obesity was only associated with increased risk of antenatal depression among high SES women in this sample. Healthcare professionals should be aware that antenatal depression is more common among low SES women, regardless of BMI category., Highlights • High SES obese women had twice the odds of antenatal depression than high SES normal weight controls. • There was no significant association between obesity and antenatal depression among low SES women. • Antenatal depression was substantially more common among low SES women, regardless of BMI category.
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- 2016
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4. Metabolic syndrome and time to pregnancy: a retrospective study of nulliparous women
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Grieger, JA, primary, Grzeskowiak, LE, additional, Smithers, LG, additional, Bianco‐Miotto, T, additional, Leemaqz, SY, additional, Andraweera, P, additional, Poston, L, additional, McCowan, LM, additional, Kenny, LC, additional, Myers, J, additional, Walker, JJ, additional, Norman, RJ, additional, Dekker, GA, additional, and Roberts, CT, additional
- Published
- 2019
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5. AGREEMENT BETWEEN CENTRAL VENOUS PRESSURE AND PULMONARY CAPILLARY WEDGE PRESSURE IN SEVERE PREECLAMPSIA
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Bolte, van Eyck, J, van Schijndel, R Strack, van Geijn, and Dekker, GA
- Published
- 1998
6. CHANGE IN PATERNITY: A RISK FACTOR FOR PREECLAMPSIA IN MULTIPAROUS WOMEN?
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Dekker, GA, Tubbergen, P, Valk, M, Althuisius, and Lachmeijer, AMA
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- 1998
7. KETANSERIN, A BETTER OPTION IN THE TREATMENT OF PREECLAMPSIA?
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Bolte, Gafar, S, van Eyck, J, van Geijn, and Dekker, GA
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- 1998
8. Clinical, ultrasound and molecular biomarkers for early prediction of large for gestational age infants in nulliparous women:An international prospective cohort study
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Vieira, MC, McCowan, LME, Gillett, A, Poston, L, Fyfe, E, Dekker, GA, Baker, PN, Walker, JJ, Kenny, LC, and Pasupathy, D
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Adult ,Internationality ,Imaging Techniques ,Physiology ,Endocrine Disorders ,Maternal Health ,Carbohydrates ,Gestational Age ,Research and Analysis Methods ,Weight Gain ,Biochemistry ,Ultrasonography, Prenatal ,Diagnostic Radiology ,Labor and Delivery ,Young Adult ,Mathematical and Statistical Techniques ,Endocrinology ,Pregnancy ,Diagnostic Medicine ,Ultrasound Imaging ,Medicine and Health Sciences ,Diabetes Mellitus ,Journal Article ,Birth Weight ,Humans ,Prospective Studies ,Statistical Methods ,Organic Compounds ,Radiology and Imaging ,Monosaccharides ,Organic Chemistry ,Body Weight ,Chemical Compounds ,Biology and Life Sciences ,Obstetrics and Gynecology ,Chemistry ,Glucose ,Physiological Parameters ,Metabolic Disorders ,Physical Sciences ,Birth ,Women's Health ,Female ,Biomarkers ,Mathematics ,Statistics (Mathematics) ,Research Article ,Forecasting - Abstract
OBJECTIVE: To develop a prediction model for term infants born large for gestational age (LGA) by customised birthweight centiles.METHODS: International prospective cohort of nulliparous women with singleton pregnancy recruited to the Screening for Pregnancy Endpoints (SCOPE) study. LGA was defined as birthweight above the 90th customised centile, including adjustment for parity, ethnicity, maternal height and weight, fetal gender and gestational age. Clinical risk factors, ultrasound parameters and biomarkers at 14-16 or 19-21 weeks were combined into a prediction model for LGA infants at term using stepwise logistic regression in a training dataset. Prediction performance was assessed in a validation dataset using area under the Receiver Operating Characteristics curve (AUC) and detection rate at fixed false positive rates.RESULTS: The prevalence of LGA at term was 8.8% (n = 491/5628). Clinical and ultrasound factors selected in the prediction model for LGA infants were maternal birthweight, gestational weight gain between 14-16 and 19-21 weeks, and fetal abdominal circumference, head circumference and uterine artery Doppler resistance index at 19-21 weeks (AUC 0.67; 95%CI 0.63-0.71). Sensitivity of this model was 24% and 49% for a fixed false positive rate of 10% and 25%, respectively. The addition of biomarkers resulted in selection of random glucose, LDL-cholesterol, vascular endothelial growth factor receptor-1 (VEGFR1) and neutrophil gelatinase-associated lipocalin (NGAL), but with minimal improvement in model performance (AUC 0.69; 95%CI 0.65-0.73). Sensitivity of the full model was 26% and 50% for a fixed false positive rate of 10% and 25%, respectively.CONCLUSION: Prediction of LGA infants at term has limited diagnostic performance before 22 weeks but may have a role in contingency screening in later pregnancy.
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- 2017
9. Antidepressant use in late gestation and risk of postpartum haemorrhage: a retrospective cohort study
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Grzeskowiak, LE, primary, McBain, R, additional, Dekker, GA, additional, and Clifton, VL, additional
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- 2015
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10. A five century evolution of cervical incompetence as a clinical entity
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Althuisius Sm and Dekker Ga
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Pharmacology ,Gynecology ,medicine.medical_specialty ,Obstetrics ,business.industry ,medicine.medical_treatment ,History, 19th Century ,History, 20th Century ,History, 18th Century ,History, 17th Century ,Uterine cervix ,Pregnancy ,Drug Discovery ,medicine ,Animals ,Humans ,Cervical cerclage ,Female ,Uterine Cervical Incompetence ,business ,Preterm delivery ,Cervical length ,Cerclage, Cervical - Abstract
Since cervical incompetence was introduced in the English literature in 1678, our understanding and obstetric management of this clinical entity, have changed tremendously over the years. This review shows the historical perspective of the development of cervical incompetence as a distinct clinical entity and an all or nothing phenomenon to cervical incompetence as part of a spectrum leading to preterm delivery, which can express differently in subsequent pregnancies. These changes in our understanding imply consequences for the obstetric management of cervical incompetence. This review focuses on the obstetric management of women considered to be at high risk of preterm delivery due to cervical incompetence, by transvaginal ultrasonographic follow-up of cervical length and transvaginal cervical cerclage.
- Published
- 2005
11. Preeclampsia: a couple's disease with maternal and fetal manifestations
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Dekker Ga and Robillard Py
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Adult ,Male ,Disease ,Preeclampsia ,Insulin resistance ,Immune system ,Obstetric Labor, Premature ,Pre-Eclampsia ,HLA Antigens ,Pregnancy ,Drug Discovery ,medicine ,Humans ,Pharmacology ,Fetus ,Cytotrophoblast ,business.industry ,Infant, Newborn ,Placentation ,medicine.disease ,Obesity ,Spermatozoa ,Fetal Diseases ,medicine.anatomical_structure ,embryonic structures ,Immunology ,Female ,business - Abstract
Preeclampsia still ranks as one of obstetrics major problems. Clinicians typically encounter preeclampsia as maternal disease with variable degrees of fetal involvement. More and more the unique immunogenetic maternal-paternal relationship is appreciated, and as such also the specific 'genetic conflict' that is characteristic of haemochorial placentation. From that perspective preeclampsia can also been seen as a disease of an individual couple with primarily maternal and fetal manifestations. Factors that are unique to a specific couple would include the length and type of sexual relationship, the maternal (decidual natural killer cells) acceptation of the invading cytotrophoblast (paternal HLA-C), and seminal levels of transforming growth factor-beta and probably other cytokines. The magnitude of the maternal response would be determined by factors including a maternal set of genes determining her characteristic inflammatory responsiveness, age, quality of her endothelium, obesity/insulin resistance and probably a whole series of susceptibility genes amongst which the thrombophilias received a lot of attention in recent years.
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- 2005
12. Antidepressant use in late gestation and risk of postpartum haemorrhage: a retrospective cohort study.
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Grzeskowiak, LE, McBain, R, Dekker, GA, Clifton, VL, Grzeskowiak, L E, Dekker, G A, and Clifton, V L
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ANTIDEPRESSANTS ,HEMORRHAGE ,PREGNANCY complications ,PREGNANT women ,ANEMIA ,CESAREAN section ,PUERPERAL disorders ,RETROSPECTIVE studies - Abstract
Objective: To investigate the association between antidepressant use in late gestation and postpartum haemorrhage (PPH).Design: Retrospective cohort study.Setting: Tertiary teaching hospital in Adelaide, Australia.Population: A total of 30 198 women delivering between 2002 and 2008.Methods: Relative risks adjusted for maternal sociodemographics and comorbidities (aRRs) were calculated for PPH, comparing women with late-gestation exposure to antidepressants (n = 558), women with a psychiatric illness but no antidepressant use (n = 1292), and women with neither antenatal exposures (n = 28 348). Additional sensitivity analyses were undertaken, examining associations with severe PPH and postpartum anaemia.Main Outcome Measures: The primary outcome was PPH, defined as a recorded blood loss of ≥500 mL for vaginal deliveries and ≥1000 mL for caesarean sections. Secondary outcomes included severe PPH (≥1000 mL blood loss, irrespective of method of delivery), and the presence of postpartum anaemia (identified from hospital medical records).Results: Compared with unexposed controls, women exposed to antidepressants had an increased risk of PPH (aRR 1.53; 95% confidence interval, 95% CI 1.25-1.86), whereas no increased risk was observed for women with a psychiatric illness but no antidepressant use (aRR 1.04; 95% CI 0.89-1.23). In sensitivity analyses, late gestation antidepressant exposure was associated with an increased risk of severe PPH (aRR 1.84; 95% CI 1.39-2.44), as well as postpartum anaemia (aRR 1.80; 95% CI 1.46-2.22).Conclusions: Exposure to antidepressants in late gestation was associated with a significantly increased risk of PPH. Although potential confounding by unmeasured factors cannot be ruled out, these findings suggest a direct effect of antidepressant exposure on PPH.Tweetable Abstract: Late gestation antidepressant exposure is associated with a significantly increased risk of postpartum haemorrhage. [ABSTRACT FROM AUTHOR]- Published
- 2016
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13. OP06 Prevalence and predictors of alcohol use during pregnancy: findings from international multi-centre cohort studies
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O’Keeffe, LM, primary, Kearney, PM, additional, McCarthy, FP, additional, Khashan, AS, additional, Greene, RA, additional, North, RA, additional, Poston, L, additional, McCowan, LME, additional, Baker, PN, additional, Dekker, GA, additional, Walker, JJ, additional, Taylor, R, additional, and Kenny, LC, additional
- Published
- 2014
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14. Linkage and association studies of IL1B and IL1RN gene polymorphisms in preeclampsia
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Lachmeijer, AMA, Nosti-Escanilla, MP, Bastiaans, EB, Pals, G, Sankuijl, LA, Kostense, PJ, Aarnoudse, JG, Crusius, JBA, Pena, AS, Dekker, GA, Arngrimsson, R, ten Kate, LP, and Faculteit Medische Wetenschappen/UMCG
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PLASMA ,FACTOR-ALPHA ,WOMEN ,IL1B ,MATERNAL SUSCEPTIBILITY LOCUS ,DISEASE ,polymorphism ,preeclampsia ,INTERLEUKIN-1 RECEPTOR ANTAGONIST ,PREGNANCY ,IL-1-BETA ,IL1RN ,FACTOR-V-LEIDEN ,genetics ,TUMOR-NECROSIS-FACTOR - Abstract
Objective: To determine whether preeclampsia is either associated with or linked to two polymorphisms in the IL1B gene (IL1B-TaqI and IL1B-511) and one polymorphism in the IL1RN gene (IL1RN-IVS2). Methods: Genotyping was performed in 150 affected sib-pair families and 104 healthy Dutch blood donors. Genotype and allele frequencies as well as allelic associations were assessed in three groups of unrelated women fro m these 150 families 133 with either eclampsia. preeclampsia or the haemolysis. elevated liver enzymes. low platelets (HELLP) syndrome. 101 with preeclampsia only, and 63 with HELLP syndrome only. These frequencies were compared to those in controls. Frequencies of transmitted and nontransmitted haplotypes, inferred from the three polymorphisms. were compared. Allele sharing between affected siblings from all 150 families was assessed by means of multipoint nonparametric affected sib-pair analyses. Results: No significant differences in genotype and allele frequencies were found between the unrelated study groups and controls, No allelic associations were apparent, nor were there differences in frequencies of transmitted and nontransmitted haplotypes within affected families. Excess allele sharing for any of the three polymorphic markers was absent in affected sib-pairs. Conclusions: None of, the IL1B and IL1RN polymorphisms provided evidence for either association or linkage with the risk for (pre)eclampsia/HELLP syndrome, preeclampsia only, or HELLP syndrome only.
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- 2002
15. Risk of uterine rupture in Australian women attempting vaginal birth after one prior caesarean section: a retrospective population-based cohort study
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Dekker, GA, primary, Chan, A, additional, Luke, CG, additional, Priest, K, additional, Riley, M, additional, Halliday, J, additional, King, JF, additional, Gee, V, additional, O’Neill, M, additional, Snell, M, additional, Cull, V, additional, and Cornes, S, additional
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- 2010
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16. Preeclampsia - a state of sympathetic overactivity
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Dekker Ga and Reinold O. B. Gans
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business.industry ,Pre-Eclampsia/physiopathology ,Obesity/physiopathology ,General Medicine ,medicine.disease ,Bioinformatics ,Sympathetic Nervous System/physiopathology ,Preeclampsia ,Pregnancy ,medicine ,Humans ,Female ,business ,Insulin Resistance/physiology - Published
- 1997
17. F096 low-dose HRT reduces vascular resistance in the central retinal artery
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van Baal, W.M., primary, Mijatovic, V, additional, Stehouwer, CDA, additional, van Vugt, JMG, additional, Dekker, GA, additional, van Geijn, HP, additional, Peters-Muller, ERA, additional, Voetberg, GA, additional, van der Mooren, MJ, additional, and Kenemans, P, additional
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- 1996
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18. Angiogenic factors combined with clinical risk factors to predict preterm pre-eclampsia in nulliparous women: a predictive test accuracy study.
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Myers, JE, Kenny, LC, McCowan, LME, Chan, EHY, Dekker, GA, Poston, L, Simpson, NAB, and North, RA
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VASCULAR endothelial growth factors ,PREMATURE labor ,PREECLAMPSIA ,NULLIPARAS ,COHORT analysis - Abstract
Objectives To assess the performance of clinical risk factors, uterine artery Doppler and angiogenic markers to predict preterm pre-eclampsia in nulliparous women. Design Predictive test accuracy study. Setting Prospective multicentre cohort study Screening for Pregnancy Endpoints ( SCOPE). Methods Low-risk nulliparous women with a singleton pregnancy were recruited. Clinical risk factor data were obtained and plasma placental growth factor ( Pl GF), soluble endoglin and soluble fms-like tyrosine kinase-1 (s Flt-1) were measured at 14-16 weeks of gestation. Prediction models were developed using multivariable stepwise logistic regression. Main outcome measure Preterm pre-eclampsia (delivered before 37
+0 weeks of gestation). Results Of the 3529 women recruited, 187 (5.3%) developed pre-eclampsia of whom 47 (1.3%) delivered preterm. Controls ( n = 188) were randomly selected from women without preterm pre-eclampsia and included women who developed other pregnancy complications. An area under a receiver operating characteristic curve ( AUC) of 0.76 (95% CI 0.67-0.84) was observed using previously reported clinical risk variables. The AUC improved following the addition of Pl GF measured at 14-16 weeks (0.84; 95% CI 0.77-0.91), but no further improvement was observed with the addition of uterine artery Doppler or the other angiogenic markers. A sensitivity of 45% (95% CI 0.31-0.59) (5% false-positive rate) and post-test probability of 11% (95% CI 9-13) were observed using clinical risk variables and Pl GF measurement. Conclusions Addition of plasma Pl GF at 14-16 weeks of gestation to clinical risk assessment improved the identification of nulliparous women at increased risk of developing preterm pre-eclampsia, but the performance is not sufficient to warrant introduction as a clinical screening test. These findings are marker dependent, not assay dependent; additional markers are needed to achieve clinical utility. [ABSTRACT FROM AUTHOR]- Published
- 2013
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19. Adverse perinatal outcome and maternal risk factors in population versus customized defined SGA babies.
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Van Eerd EA, Roex AJ, Nikpoor P, and Dekker GA
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- 2012
20. The impact of maternal body mass index on the phenotype of pre-eclampsia: a prospective cohort study.
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Anderson, NH, McCowan, LME, Fyfe, EM, Chan, EHY, Taylor, RS, Stewart, AW, Dekker, GA, and North, RA
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PREECLAMPSIA ,PREGNANT women ,BODY weight ,PERFUSION ,PLACENTA abnormalities ,UTERINE artery - Abstract
Please cite this paper as: Anderson N, McCowan L, Fyfe E, Chan E, Taylor R, Stewart A, Dekker G, North R, on behalf of the SCOPE Consortium. The impact of maternal body mass index on the phenotype of pre-eclampsia: a prospective cohort study. BJOG 2012;119:589-595. Objective We hypothesised that among nulliparous women with pre-eclampsia, overweight or obese women would have a different phenotype of pre-eclampsia compared with normal weight women with pre-eclampsia. Specifically, they are more likely to develop term pre-eclampsia and less likely to have indicators of impaired placental perfusion, e.g. abnormal uterine artery Doppler or a small-for-gestational-age (SGA) infant. Design Prospective, multicentre, cohort SCOPE study ( n = 3170). Setting New Zealand and Australia. Population Nulliparous women who developed pre-eclampsia. Methods Participants were interviewed at 14-16 weeks of gestation, uterine artery Doppler studies were performed at 19-21 weeks and pregnancy outcome was tracked prospectively. Main outcome measures Rates of abnormal uterine artery Doppler indices, term/preterm birth and SGA infants were compared between normal, overweight and obese women with pre-eclampsia. Multivariable analysis was performed to examine the association between body mass index (BMI) and term pre-eclampsia. Results Of 178 women with pre-eclampsia, one underweight woman was excluded and 66 (37%) were normal weight, 52 (29%) were overweight and 59 (34%) were obese. Pre-eclampsia developed preterm in 26% of women and at term in 74% of women. There were no differences in the rates of term/preterm pre-eclampsia, abnormal uterine artery Doppler indices or SGA infants between BMI groups ( P > 0.10). No independent association between BMI and term pre-eclampsia was found ( P = 0.56). Conclusions Among women with pre-eclampsia, those who are overweight or obese in early pregnancy are not more likely to have term pre-eclampsia compared with women with a normal BMI. Overweight and obese women require vigilant surveillance for the development of preterm as well as term pre-eclampsia. [ABSTRACT FROM AUTHOR]
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- 2012
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21. Association of Vascular Endothelial Growth Factor +936 C/T Single-Nucleotide Polymorphism With Pregnancies Complicated by Small-for-Gestational-Age Babies.
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Andraweera PH, Dekker GA, Thompson SD, Nowak RC, Zhang JV, McCowan LM, North RA, and Roberts CT
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- 2011
22. Epidemiologic associations with cerebral palsy.
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O'Callaghan ME, MacLennan AH, Gibson CS, McMichael GL, Haan EA, Broadbent JL, Goldwater PN, Dekker GA, Australian Collaborative Cerebral Palsy Research Group, O'Callaghan, Michael E, MacLennan, Alastair H, Gibson, Catherine S, McMichael, Gai L, Haan, Eric A, Broadbent, Jessica L, Goldwater, Paul N, and Dekker, Gustaaf A
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- 2011
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23. Paternal contribution to small for gestational age babies: a multicenter prospective study.
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McCowan LM, North RA, Kho EM, Black MA, Chan EH, Dekker GA, Poston L, Taylor RS, and Roberts CT
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- 2011
24. The Australian cerebral palsy research study--protocol for a national collaborative study investigating genomic and clinical associations with cerebral palsy.
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O'Callaghan ME, MacLennan AH, Gibson CS, McMichael GL, Haan EA, Broadbent J, Priest K, Goldwater PN, Dekker GA, and Australian Collaborative Cerebral Palsy Research Group
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- 2011
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25. Risk factors for small-for-gestational-age infants by customised birthweight centiles: data from an international prospective cohort study.
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McCowan LM, Roberts CT, Dekker GA, Taylor RS, Chan EH, Kenny LC, Baker PN, Moss-Morris R, Chappell LC, North RA, and SCOPE Consortium
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- 2010
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26. Avoidable risk factors in perinatal deaths: a perinatal audit in South Australia.
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de Lange TE, Budde MP, Heard AR, Tucker G, Kennare R, and Dekker GA
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Objectives: To analyse risk factors of perinatal death, with an emphasis on potentially avoidable risk factors, and differences in the frequency of suboptimal care factors between maternity units with different levels of care. Methods: Six hundred and eight pregnancies (2001-2005) in South Australia resulting in perinatal death were described and compared to 86 623 live birth pregnancies. Results: Two hundred and seventy cases (44.4%) were found to have one or more avoidable maternal risk factors, 31 cases (5.1%) had a risk factor relating access to care, while 68 cases (11.2%) were associated with deficiencies in professional care. One hundred and four women (17.1% of cases) presented too late for timely medical care: 85% of these did have a sufficient number of antenatal visits. The following independent maternal risk factors for perinatal death were found: assisted reproductive technology (adjusted odds ratio (AOR) 3.16), preterm labour (AOR 22.05), antepartum haemorrhage (APH) abruption (AOR 6.40), APH other/unknown cause (AOR 2.19), intrauterine growth restriction (AOR 3.94), cervical incompetence (AOR 8.89), threatened miscarriage (AOR 1.89), pre-existing hypertension (AOR 1.72), psychiatric disorder (AOR 1.85) and minimal antenatal care (AOR 2.89). The most commonly found professional care deficiency in cases was the failure to act on or recognise high-risk pregnancies/complications, found in 49 cases (8.1%). Conclusion: Further improvements in perinatal mortality may be achieved by greater emphasis on the importance of antenatal care and educating women to recognise signs and symptoms that require professional assessment. Education of maternity care providers may benefit from a further focus on how to recognise and/or manage high-risk pregnancies. [ABSTRACT FROM AUTHOR]
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- 2008
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27. Nifedipine pharmacokinetics and plasma levels in the management of preterm labor.
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Paptsonis DNM, Bos JM, van Geijn HP, Lok CAR, and Dekker GA
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- 2007
28. Genetic polymorphisms and spontaneous preterm birth.
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Gibson CS, MacLennan AH, Dekker GA, Goldwater PN, Dambrosia JM, Munroe DJ, Tsang S, Stewart C, and Nelson KB
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- 2007
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29. Ketanserin in women with chronic hypertension and underlying thrombophilia.
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Banga FR, Bolte AC, Dekker GA, and van Geijn HP
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- 2004
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30. Cervical incompetence prevention randomized cerclage trial: emergency cerclage with bed rest versus bed rest alone.
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Althuisius SM, Dekker GA, Hummel P, van Geijn HP, Althuisius, Sietske M, Dekker, Gustaaf A, Hummel, Pieter, van Geijn, Herman P, and Cervical incompetence prevention randomized cerclage trial
- Abstract
Objective: The purpose of this study was to compare preterm delivery rates and neonatal morbidity/mortality rates for women with cervical incompetence with membranes at or beyond a dilated external cervical os that was treated with emergency cerclage, bed rest plus indomethacin, versus just bed rest.Study Design: Women with cervical incompetence with membranes at or beyond a dilated external cervical os, before 27 weeks of gestation, were treated with antibiotics and bed rest and randomly assigned for emergency cerclage and indomethacin or bed rest only.Results: Twenty-three women were included; 13 women were allocated randomly to the emergency cerclage and indomethacin group, and 10 women were allocated randomly to the bed rest-only group. Gestational age at time of randomization was 22.2 weeks in the emergency cerclage and indomethacin group and 23.0 weeks in the bed rest-only group. Mean interval from randomization until delivery was 54 days in the emergency cerclage and indomethacin group and 20 days in the bed rest-only group (P=.046). Mean gestational age at delivery was 29.9 weeks in the emergency cerclage and indomethacin group and 25.9 weeks in the bed rest-only group. Preterm delivery before 34 weeks of gestation was significantly lower in the emergency cerclage and indomethacin group, with 7 of 13 deliveries versus all 10 deliveries in the bed rest-only group (P=.02).Conclusions: Emergency cerclage, indomethacin, antibiotics, and bed rest reduce preterm delivery before 34 weeks compared with bed rest and antibiotics alone. [ABSTRACT FROM AUTHOR]- Published
- 2003
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31. Antenatal causes of cerebral palsy: associations between inherited thrombophilias, viral and bacterial infection, and inherited susceptibility to infection.
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Gibson CS, MacLennan AH, Goldwater PN, and Dekker GA
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- 2003
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32. Neonatal effects of nifedipine and ritodrine for preterm labor.
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Papatsonis DNM, Kok JH, Van Geijn HP, Bleker OP, Adèr HJ, Dekker GA, Papatsonis, D N, Kok, J H, van Geijn, H P, Bleker, O P, Adèr, H J, and Dekker, G A
- Published
- 2000
33. Haemostatic and metabolic abnormalities in women with unexplained recurrent abortion.
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Coumans, ABC, Huijgens, PC, Jakobs, C, Schats, R, de Vries, JIP, van Pampus, MG, Dekker, GA, Coumans, A B, Huijgens, P C, de Vries, J I, van Pampus, M G, and Dekker, G A
- Abstract
The objective of this study was to establish whether or not patients with unexplained recurrent abortion have an increased incidence of haemostatic or metabolic abnormalities. Fifty-two patients with a history of unexplained habitual abortion (two or more spontaneous abortions before 16 weeks' gestation) were tested for protein S, protein C and antithrombin (AT) III deficiency, activated protein C (aPC) resistance, hyperhomocysteinaemia and anticardiolipin antibodies (ACA). The control group consisted of 67 healthy women with a history of only uncomplicated pregnancies. Blood samples were taken for measuring protein S, protein C, AT III, ACA and activated protein C resistance and a methionine loading test was performed. Of the 46 patients tested for protein S deficiency, 8 (17.4%) were positive. Of the 43 patients tested, two (4.7%) were protein C deficient and none was AT III deficient. Of the 42 patients tested for ACA, eight (19.1%) had detectable antibodies. Of the 44 patients tested for aPC resistance, two (4.6%) were positive. Finally, 35 patients were tested for hyperhomocysteinaemia and six (17.1%) were positive. It was concluded that parous women with a history of unexplained recurrent abortion have an increased incidence of hyperhomocysteinaemia and a trend of increased incidence of ACA can be found. [ABSTRACT FROM PUBLISHER]
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- 1999
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34. Smoking status in pregnancy is associated with daily stressors and low well-being.
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Paarlberg KM, Vingerhoets AJJ, Passchier J, Heinen AGJ, Dekker GA, and van Geijn HP
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- 1999
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35. Reappearance of End-Diastolic Velocities in the Umbilical Artery Following Maternal Volume Expansion: A Preliminary Study.
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Karsdorp, Vhm, Vugt, Jmg Van, Dekker, Ga, and Geijn, Hp Van
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- 1992
36. Measurement of cardiac output in normal pregnancy by a non-invasive two-dimensional independent Doppler device.
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Kager CCM, Dekker GA, and Stam MC
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- 2009
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37. Vitamins C and E and the risks of preeclampsia and perinatal complications.
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Rumbold AR, Crowther CA, Haslam RR, Dekker GA, Robinson JS, and ACTS Study Group
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- 2006
38. Circulating IGF1 and IGF2 and SNP genotypes in men and pregnant and non-pregnant women
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K L Gatford, G K Heinemann, S D Thompson, J V Zhang, S Buckberry, J A Owens, G A Dekker, C T Roberts, Gatford, Kathryn L, Heinemann, GK, Thompson, SD, Zhang, JV, Buckberry, S, Owens, JA, Dekker, GA, and Roberts, CT
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endocrine system ,animal structures ,endocrine system diseases ,Endocrinology, Diabetes and Metabolism ,030209 endocrinology & metabolism ,03 medical and health sciences ,0302 clinical medicine ,Endocrinology ,Genotype ,Internal Medicine ,SNP ,Medicine ,human ,SNP genotype ,030304 developmental biology ,Genetics ,0303 health sciences ,business.industry ,Research ,IGF1 ,IGF2 ,Non pregnant ,female genital diseases and pregnancy complications ,pregnancy ,business ,hormones, hormone substitutes, and hormone antagonists - Abstract
Circulating IGFs are important regulators of prenatal and postnatal growth, and of metabolism and pregnancy, and change with sex, age and pregnancy. Single-nucleotide polymorphisms (SNPs) in genes coding for these hormones associate with circulating abundance of IGF1 and IGF2 in non-pregnant adults and children, but whether this occurs in pregnancy is unknown. We therefore investigated associations of plasma IGF1 and IGF2 with age and genotype at candidate SNPs previously associated with circulating IGF1, IGF2 or methylation of the INS–IGF2–H19 locus in men (n=134), non-pregnant women (n=74) and women at 15 weeks of gestation (n=98). Plasma IGF1 concentrations decreased with age (PPINS–IGF2–H19 locus were associated with plasma IGF1 (IGF2 rs680, IGF2 rs1004446 and IGF2 rs3741204) and IGF2 (IGF2 rs1004446, IGF2 rs3741204 and H19 rs217727). In single SNP models, effects of IGF2 rs680 were similar between groups, with higher plasma IGF1 concentrations in individuals with the GG genotype when compared with GA (P=0.016), or combined GA and AA genotypes (P=0.003). SNPs in the IGF2 gene associated with IGF1 or IGF2 were in linkage disequilibrium, hence these associations could reflect other genotype variations within this region or be due to changes in INS–IGF2–H19 methylation previously associated with some of these variants. As IGF1 in early pregnancy promotes placental differentiation and function, lower IGF1 concentrations in pregnant women carrying IGF2 rs680 A alleles may affect placental development and/or risk of pregnancy complications.
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- 2014
39. Fetal sex and the circulating renin-angiotensin system during early gestation in women who later develop preeclampsia or gestational hypertension
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Eugenie R. Lumbers, Claire T. Roberts, Gustaaf A. Dekker, Ang Zhou, S D Sykes, Kirsty G. Pringle, Sykes, SD, Pringle, KG, Zhou, A, Dekker, GA, Roberts, CT, Lumbers, ER, and SCOPE consortium
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Gestational hypertension ,Adult ,Male ,medicine.medical_specialty ,Sex Determination Analysis ,angiotensin-(1–7) ,Hypertension in Pregnancy ,Blood Pressure ,Gestational Age ,angiotensin II ,Peptidyl-Dipeptidase A ,Risk Assessment ,Ultrasonography, Prenatal ,Preeclampsia ,preeclampsia ,Renin-Angiotensin System ,Young Adult ,angiotensin-converting enzyme ,Sex Factors ,Pre-Eclampsia ,Pregnancy ,Risk Factors ,Internal medicine ,Renin ,gestational hypertension ,Internal Medicine ,medicine ,Humans ,Fetus ,biology ,business.industry ,Angiotensin II ,prorenin ,Angiotensin-converting enzyme ,Ultrasonography, Doppler ,Hypertension, Pregnancy-Induced ,medicine.disease ,Peptide Fragments ,Endocrinology ,Case-Control Studies ,biology.protein ,Gestation ,Female ,Angiotensin I ,business ,Biomarkers - Abstract
There are fetal sex-specific differences in the balance between angiotensin (Ang) II and Ang-(1-7) in the maternal circulation during pregnancy. To determine whether at 15 weeks' gestation plasma levels of Ang II and Ang-(1-7), as well as levels of prorenin and Ang-converting enzyme (ACE), predicted the development of gestational hypertension (GH) or preeclampsia (PreE) and were associated with estimates of fetal and maternal health, women who later developed GH (n=50) or PreE (n=50) were compared with body mass index-matched controls (n=100). Women who subsequently developed PreE or GH had increased Ang-(1-7) levels at 15 weeks' gestation compared with women with normal pregnancies. When separated by fetal sex, this difference was seen only in women carrying a female fetus. Prorenin and ACE concentrations were not useful biomarkers for the prediction of either PreE or GH at 15 weeks' gestation. Women with a male fetus who developed PreE and women who subsequently developed GH had increased blood pressures at 15 weeks' gestation compared with women with normal pregnancies, suggesting that these women were on an early trajectory for the development of hypertension. We propose that measurement of Ang-(1-7) during early gestation could be useful in predicting, those women who will go on to develop new-onset hypertension in pregnancy. Refereed/Peer-reviewed
- Published
- 2012
40. The association of AGTR2 polymorphisms with preeclampsia and uterine artery bilateral notching is modulated by maternal BMI
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Gustaaf A. Dekker, Ang Zhou, Eugenie R. Lumbers, Shalem Lee, Lesley M. E. McCowan, S. D. Thompson, Claire T. Roberts, Zhou, A, Dekker, GA, Lumbers, ER, Lee, SY, Thompson, SD, McCowan, LME, and Roberts, CT
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Adult ,Male ,medicine.medical_specialty ,Pregnancy Complications, Cardiovascular ,AGTR2 A1675G ,Mothers ,Polymorphism, Single Nucleotide ,Receptor, Angiotensin, Type 2 ,Preeclampsia ,Body Mass Index ,polymorphism ,preeclampsia ,Young Adult ,BMI ,Pre-Eclampsia ,Pregnancy ,AGTR2 C4599A ,medicine.artery ,bilateral notching ,medicine ,Humans ,Genetic Predisposition to Disease ,uterine artery ,Young adult ,Uterine artery ,Genetic Association Studies ,Gynecology ,Uterine Diseases ,business.industry ,Case-control study ,Infant, Newborn ,Obstetrics and Gynecology ,medicine.disease ,Uterine Artery ,Reproductive Medicine ,Case-Control Studies ,Cohort ,Gestation ,Female ,Gene-Environment Interaction ,business ,Body mass index ,Developmental Biology - Abstract
Introduction This study aimed to determine the association of AGTR1 and AGTR2 polymorphisms with preeclampsia and whether these are affected by environmental factors and fetal sex. Methods Overall 3234 healthy nulliparous women, their partners and babies were recruited prospectively to the SCOPE study in Adelaide and Auckland. Data analyses were confined to 2121 Caucasian parent-infant trios, among whom 123 had preeclamptic pregnancies. 1185 uncomplicated pregnancies served as controls. DNA was extracted from buffy coats and genotyped by utilizing the Sequenom MassARRAY system. Doppler sonography on the uterine arteries was performed at 20 weeks' gestation. Results Four polymorphisms in AGTR1 and AGTR2 genes, including AGTR1 A1166C , AGTR2 C4599A , AGTR2 A1675G and AGTR2 T1134C , were selected and significant associations were predominately observed for AGTR2 C4599A . When the cohort was stratified by maternal BMI, in women with BMI ≥ 25 kg/m 2 , the AGTR2 C4599A AA genotype in mothers and neonates was associated with an increased risk for preeclampsia compared with the CC genotype [adjusted OR 2.1 (95% CI 1.0–4.2) and adjusted OR 3.0 (95% CI 1.4–6.4), respectively]. In the same subset of women, paternal AGTR2 C4599A A allele was associated with an increased risk for preeclampsia and uterine artery bilateral notching at 20 weeks' gestation compared with the C allele [adjusted OR 1.9 (95% CI 1.1–3.3) and adjusted OR 2.1 (95% CI 1.3–3.4), respectively]. Conclusion AGTR2 C4599A in mothers, fathers and babies was associated with preeclampsia and this association was only apparent in pregnancies in which the women had a BMI ≥ 25 kg/m 2 , suggesting a gene–environment interaction.
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- 2012
41. Influence of Socioeconomic Status on the Association Between Pregnancy Complications and Premature Coronary Artery Disease: Linking Three Cohorts.
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Khoja A, Andraweera PH, Tavella R, Gill TK, Dekker GA, Roberts CT, Edwards S, and Arstall MA
- Abstract
Background: We hypothesized that there is an influence of socioeconomic status (SES) on association between pregnancy complications and premature coronary artery disease (PCAD) risk., Materials and Methods: This project involved a data linkage approach merging three databases of South Australian cohorts using retrospective, age-matched case-control study design. Cases ( n = 721), that is, women aged <60 years from Coronary Angiogram Database of South Australia (CADOSA) were linked to South Australian Perinatal Statistics Collection (SAPSC) to ascertain prior pregnancy outcomes and SES. Controls ( n = 194) were selected from North West Adelaide Health Study (NWAHS), comprising women who were healthy or had health conditions unrelated to CAD, age matched to CADOSA (±5 years), and linked to SAPSC to determine prior pregnancy outcomes and SES. This project performed comparative analysis of SES using socioeconomic indexes for areas-index of relative socioeconomic advantage and disadvantage (SEIFA-IRSAD) scores across three databases., Results: Findings revealed that SEIFA-IRSAD scores at the time of pregnancy ( p -value = 0.005) and increase in SEIFA-IRSAD scores over time ( p -value = 0.040) were significantly associated with PCAD. In addition, when models were adjusted for SEIFA-IRSAD scores at the time of pregnancy and age, risk factors including placenta-mediated pregnancy complications such as preterm birth (odds ratio [OR] = 4.77, 95% confidence interval [CI]: 1.74-13.03) and history of a miscarriage (OR = 2.14, 95% CI: 1.02-4.49), and cardiovascular disease (CVD) risk factors including smoking (OR = 8.60, 95% CI: 3.25-22.75) were significantly associated with PCAD. When the model was adjusted for change in SEIFA-IRSAD scores (from CADOSA/NWAHS to SAPSC) and age, pregnancy-mediated pregnancy complications including preterm birth (OR = 4.40, 95% CI: 1.61-12.05) and history of a miscarriage (OR = 2.09, 95% CI: 1.00-4.35), and CVD risk factor smoking (OR = 8.75, 95% CI: 3.32-23.07) were significantly associated with PCAD., Conclusion: SES at the time of pregnancy and change in SES were not associated with PCAD risk., Competing Interests: No competing financial interests exist., (© Adeel Khoja et al., 2024; Published by Mary Ann Liebert, Inc.)
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- 2024
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42. Mesenchymal stem cell secretome ameliorates over-expression of soluble fms-like tyrosine kinase-1 (sFlt-1) and fetal growth restriction (FGR) in animal SLE model.
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Bachnas MA, Dekker GA, Mudigdo A, Purwanto B, Sulistyowati S, Dachlan EG, Akbar MIA, Chouw A, Sartika CR, and Widjiati W
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- Animals, Female, Humans, Mice, Pregnancy, Abortion, Spontaneous metabolism, Biomarkers metabolism, Birth Weight, Models, Animal, Placenta metabolism, Placenta Growth Factor metabolism, Vascular Endothelial Growth Factor A metabolism, Vascular Endothelial Growth Factor Receptor-1 metabolism, Fetal Growth Retardation therapy, Fetal Growth Retardation metabolism, Mesenchymal Stem Cells, Secretome, Lupus Erythematosus, Systemic
- Abstract
Introduction: In the near future, stem cell research may lead to several major therapeutic innovations in medical practice. Secretome, a "by-product" of stem cell line cultures, has many advantages. Its easiness of storage, usage, and fast direct effect are some of those to consider. Fetal growth restriction (FGR) remains one of the significant challenges in maternal-fetal and neonatal medicine. Placentation failure is one of the most profound causal and is often related to increasing sFlt-1 in early pregnancy. This study aimed to investigate hUC-MSC secretome in ameliorating sFlt-1 and how to improve outcomes in preventing FGR in an animal model., Materials and Methods: Pristane-induced systemic lupus erythematosus (SLE) in a mouse model was used to represent placentation failure and its consequences. Twenty-one mice were randomized into three groups: (I) normal pregnancy, (II) SLE, and (III) SLE with secretome treatment. Pristane was administered in all Groups four weeks prior mating period. Secretome was derived from human umbilical cord mesenchymal stem cells (hUC-MSC) conditioned medium on the 3rd and 4th passage, around day-21 until day-28 from the start of culturing process. Mesenchymal stem cell was characterized using flow cytometry for CD105+, CD90+, and CD73+ surface antigen markers. Immunohistochemistry anlysis by using Remmele's Immunoreactive Score (IRS) was used to quantify the placental sFlt-1 expression in each group. Birth weight and length were analyzed as the secondary outcome. The number of fetuses obtained was also calculated for pregnancy loss comparison between Groups., Results: The administration of secretome of hUC-MSC was found to lower the expression of the placental sFlt-1 significantly in the pristane SLE animal model (10.30 ± 1.40 vs. 4.98 ± 2.57; p < 0.001) to a level seen in normal mouse pregnancies in Group I (3.88 ± 0.49; p = 0.159). Secretome also had a significant effect on preventing fetal growth restriction in the pristane SLE mouse model (birth weight: 354.29 ± 80.76 mg vs. 550 ± 64.03 mg; p < 0.001 and birth length: 14.43 ± 1.27 mm vs. 19.00 ± 1.41 mm), comparable to the birth weight and length of the normal pregnancy in Group I (540.29 ± 75.47 mg and 18.14 ± 1.34 mm, p = 0.808 and = 0.719). Secretome administration also showed a potential action to prevent high number of pregnancy loss as the number of fetuses obtained could be similar to those of mice in the normal pregnant Group (7.71 ± 1.11 vs. 7.86 ± 1.06; p = 0.794)., Conclusions: Administration of secretome lowers sFlt-1 expression in placenta, improves fetal growth, and prevents pregnancy loss in a mouse SLE model.
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- 2023
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43. Anxiety and Depression in Early Gestation and the Association with Subsequent Gestational Diabetes Mellitus in a Disadvantaged Population.
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Pathirana MM, Andraweera PH, Leemaqz S, Aldridge E, Arstall MA, Dekker GA, and Roberts CT
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- Pregnancy, Female, Humans, Depression epidemiology, Vulnerable Populations, Risk Factors, Prospective Studies, Anxiety epidemiology, Diabetes, Gestational epidemiology, Diabetes, Gestational diagnosis
- Abstract
Objectives: Evaluate the association between poor mental health and risk of developing gestational diabetes mellitus (GDM) in a cohort of women from a socioeconomically disadvantaged community., Methods: A total of 1363 nulliparous women with singleton pregnancies recruited to the Screening Tests to Predict Poor Outcomes of Pregnancy study in Adelaide, Australia. Women were assessed for mental health in the first trimester, including likelihood of depression, high functioning anxiety, perceived stress and risk of developing a mental health disorder. GDM was diagnosed based on the International Association of Diabetes in Pregnancy Study Group (IADPSG) criteria. Socioeconomic status was measured using the New Zealand Socioeconomic Index (NZSEI)., Results: Complete mental health data was available for 1281 participants. There was no statistically significant difference in SEI, depression, risk of mental health issues, high functioning anxiety and perceived stress between women who developed GDM and those who did not. There was no difference in history of depression nor risk of developing a high mental health disorder in first trimester after adjusting for SEI, BMI in first trimester, smoking status in first trimester and maternal age between women with a GDM pregnancy and those who did not., Conclusions for Practice: There was no difference in markers of poor mental health in early pregnancy between women who subsequently did or did not develop GDM. Cohort participants were socioeconomically disadvantaged, potentially contributing to the lack of apparent differences in depression observed between groups. Socioeconomically disadvantaged women should be targeted in pre-conception planning to reduce risk of GDM., (© 2023. Crown.)
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- 2023
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44. Pregnancy Complications Are Associated with Premature Coronary Artery Disease: Linking Three Cohorts.
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Khoja A, Andraweera PH, Tavella R, Gill TK, Dekker GA, Roberts CT, Edwards S, and Arstall MA
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- Pregnancy, Humans, Infant, Newborn, Female, Case-Control Studies, Retrospective Studies, Australia, Pregnancy Outcome epidemiology, Coronary Artery Disease diagnostic imaging, Coronary Artery Disease epidemiology, Premature Birth epidemiology, Pregnancy Complications epidemiology, Diabetes, Gestational epidemiology
- Abstract
Background: There is increasing evidence that women who experience placenta-mediated pregnancy complications and gestational diabetes mellitus (GDM) are at higher risk for the development of coronary artery disease (CAD) later in life. We hypothesized that there is an association between placenta-mediated pregnancy complications, GDM, and risk of premature CAD (PCAD). Methods: This research project involved a data linkage approach merging three databases of South Australian cohorts by using a retrospective, age-matched case-control study design. Cases ( n = 721) were ascertained from the Coronary Angiogram Database of South Australia (CADOSA). Women <60 years from CADOSA were linked to South Australian Perinatal Statistics Collection (SAPSC) to ascertain their prior pregnancy outcomes. Controls ( n = 194) were selected from North West Adelaide Health Study (NWAHS) and comprised women who were healthy or had other health conditions unrelated to CAD, age-matched to CADOSA (±5 years), and linked to SAPSC to determine their pregnancy outcomes. PCAD was defined as >50% stenosis in one or more coronary arteries at coronary angiography. Results: Compared with women without a history of PCAD, women who were diagnosed with PCAD were more likely to have experienced the placenta-mediated pregnancy complications of preterm birth (adjusted odds ratio [OR] = 2.46, 95% confidence interval [CI]: 1.21-5.00) or low-birth weight (adjusted OR = 2.44, 95% CI: 1.22-4.88), or have been diagnosed with active asthma during pregnancy (adjusted OR = 3.52, 95% CI: 1.05-11.76). Conclusion: Placenta-mediated pregnancy complications should be recognized as clear risk markers for future PCAD.
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- 2023
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45. The association of breast feeding for at least six months with hemodynamic and metabolic health of women and their children aged three years: an observational cohort study.
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Pathirana MM, Andraweera PH, Aldridge E, Harrison M, Harrison J, Leemaqz S, Arstall MA, Dekker GA, and Roberts CT
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- Pregnancy, Infant, Humans, Infant, Newborn, Female, Infant, Premature, Cohort Studies, Hemodynamics, Breast Feeding, Pregnancy Complications
- Abstract
Background: Breastfeeding is important for both mother and child in reducing risk of future cardiovascular disease. Therefore, it may be an effective method to improve cardio-metabolic health, particularly those who are exposed to pregnancy complications which increase later CVD risk for both mother and child. The aim of this study is to assess differences in cardiometabolic health at three years postpartum in mothers who breastfed for at least six months and their children compared to those who did not., Methods: Women and children from the Screening Tests to Predict Poor Outcomes of Pregnancy (STOP) study (2015-2017) were invited to attend a health check-up at three years postpartum. Women's breastfeeding status at least six months postpartum was ascertained through their child health record. Anthropometric and hemodynamic measurements were taken from women and their children. A fasting blood sample was taken from women to measure blood glucose and lipids., Results: A total of 160 woman-child dyads were assessed in this study. Women who breastfed for at least six months had significantly lower maternal BMI, systolic blood pressure, diastolic blood pressure, mean arterial pressure, central systolic blood pressure, and central diastolic blood pressure than those who did not and this did not change after adjusting for BMI and socioeconomic index in early pregnancy, prenatal smoking and maternal age in early pregnancy. Subgroup analysis on women who had one or more pregnancy complications during the index pregnancy (i.e. preeclampsia, gestational hypertension, delivery of a small for gestational age infant, delivery of a preterm infant, and/or gestational diabetes mellitus) demonstrated that women who breastfed for at least six months had significantly lower maternal systolic and diastolic blood pressures, serum insulin and triglycerides, and higher HDL cholesterol. There were no differences in child anthropometric or hemodynamic variables at three years of age between those children who had been breastfed for at least six months and those who had not., Conclusion: Breastfeeding for at least six months may reduce some maternal; cardiovascular risk factors in women at three years postpartum, in particular, in those who have experienced a complication of pregnancy., Trial Registration: ACTRN12614000985684 (12/09/2014)., (© 2023. The Author(s).)
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- 2023
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46. Women's awareness of cardiovascular disease risk after complications of pregnancy.
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Aldridge E, Pathirana M, Wittwer M, Sierp S, Roberts CT, Dekker GA, and Arstall M
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- Infant, Newborn, Pregnancy, Female, Humans, Placenta, Postpartum Period, Cardiovascular Diseases complications, Pregnancy Complications diagnosis, Hypertension complications
- Abstract
Background: Certain maternal complications of pregnancy, including hypertensive disorders of pregnancy, gestational diabetes mellitus, birth of a growth restricted infant, idiopathic preterm labour, and placental abruption, are associated with a significantly increased risk of future maternal cardiovascular disease. In Australia, it is relatively unknown how many women with a history of complicated pregnancies are aware of their future cardiovascular disease risk., Aim: The aim of this study was to determine what percentage of women attending a cardiovascular disease prevention clinic in South Australia soon after a complicated pregnancy were aware of their increased risk of cardiovascular disease., Methods: This prospective observational study included 188 women attending a postpartum prevention clinic between 7th August 2018 and 10th February 2021. These women had experienced a serious maternal complication of pregnancy approximately seven months earlier. Women completed a self-administered health awareness survey immediately prior to their first clinic appointment to assess their awareness of their increased cardiovascular risk., Findings: Over two-thirds (69.1 %) of the women were unaware of the association between pregnancy complications and cardiovascular disease, and 6.4 % of the cohort did not realise they had experienced a complicated pregnancy. Almost 10 % of the cohort did not correctly identify the complication/s they had been diagnosed with during pregnancy., Conclusion: Awareness of the association between complications of pregnancy and future cardiovascular disease was low in our cohort of women who had experienced a complication of pregnancy only seven months earlier. This emphasises the need for improved education for and communication with women to assist in implementing preventative care strategies., (Copyright © 2023 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.)
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- 2023
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47. Elevated Maternal Folate Status and Changes in Maternal Prolactin, Placental Lactogen and Placental Growth Hormone Following Folic Acid Food Fortification: Evidence from Two Prospective Pregnancy Cohorts.
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Jankovic-Karasoulos T, Smith MD, Leemaqz S, Williamson J, McCullough D, Arthurs AL, Jones LA, Bogias KJ, Mol BW, Dalton J, Dekker GA, and Roberts CT
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- Humans, Pregnancy, Female, Aged, Placental Lactogen metabolism, Folic Acid, Prolactin, Food, Fortified, Prospective Studies, Placenta metabolism, Growth Hormone metabolism, Glucose metabolism, Diabetes, Gestational metabolism, Insulin Resistance
- Abstract
Folic acid (FA) food fortification in Australia has resulted in a higher-than-expected intake of FA during pregnancy. High FA intake is associated with increased insulin resistance and gestational diabetes. We aimed to establish whether maternal one-carbon metabolism and hormones that regulate glucose homeostasis change in healthy pregnancies post-FA food fortification. Circulating folate, B12, homocysteine, prolactin (PRL), human placental lactogen (hPL) and placental growth hormone (GH2) were measured in early pregnancy maternal blood in women with uncomplicated pregnancies prior to (SCOPE: N = 604) and post (STOP: N = 711)-FA food fortification. FA food fortification resulted in 63% higher maternal folate. STOP women had lower hPL (33%) and GH2 (43%) after 10 weeks of gestation, but they had higher PRL (29%) and hPL (28%) after 16 weeks. FA supplementation during pregnancy increased maternal folate and reduced homocysteine but only in the SCOPE group, and it was associated with 54% higher PRL in SCOPE but 28% lower PRL in STOP. FA food fortification increased maternal folate status, but supplements no longer had an effect, thereby calling into question their utility. An altered secretion of hormones that regulate glucose homeostasis in pregnancy could place women post-fortification at an increased risk of insulin resistance and gestational diabetes, particularly for older women and those with obesity.
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- 2023
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48. Early pregnancy cardio metabolic risk factors and the prevalence of metabolic syndrome 10 years after the first pregnancy.
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Andraweera PH, Plummer MD, Garrett A, Leemaqz S, Wittwer MR, Aldridge E, Pathirana MM, Dekker GA, Roberts CT, and Arstall MA
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- Female, Humans, Pregnancy, Obesity epidemiology, Prevalence, Risk Factors, Cardiovascular Diseases epidemiology, Cardiovascular Diseases etiology, Cardiovascular Diseases prevention & control, Metabolic Syndrome complications, Pregnancy Complications epidemiology
- Abstract
Background: We aimed to compare risk factors for CVD 10 years postpartum among women who had ≥ 1 compared to no cardio metabolic risk factor in early first pregnancy., Methods: Women of the SCOPE (Screening fOr Pregnancy Endpoints) study from Adelaide, South Australia were invited to participate in a cardiovascular risk assessment 10 years after the delivery of the first child. Data from 141 women who completed all the assessments are included in the analyses., Result: Compared to women who did not have any cardio metabolic risk factor at 15 ± 1 weeks' gestation during the first pregnancy, those who had ≥ 1 risk factor were 5.5 times more likely to have metabolic syndrome 10 years postpartum (aOR = 5.5, 95% CI 1.8-17.3, p = 0.004). Women who had ≥ 1cardio metabolic risk factor during the first pregnancy were more likely to be obese (p = 0.001), have high total cholesterol levels (p <0.001) or have increased insulin resistance (p <0.001) 10 years later compared to women who had no risk factor during the first pregnancy. 63.5% of the women with no cardio metabolic risk factor compared to 39% of women who had ≥ 1 risk factor in first pregnancy, had neither a complicated first pregnancy nor was diagnosed with MetS 10 years postpartum (p = 0.023)., Conclusion: Cardio metabolic risk factors at the booking visit in the first pregnancy may be useful in identifying young women at risk of future CVD., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Andraweera et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
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- 2023
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49. Testing equivalence of two doses of intravenous iron to treat iron deficiency in pregnancy: A randomised controlled trial.
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Froessler B, Schubert KO, Palm P, Church R, Aboustate N, Kelly TL, Dekker GA, and Hodyl NA
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- Female, Humans, Pregnancy, Iron, Maltose therapeutic use, Ferric Compounds therapeutic use, Administration, Intravenous, Iron Deficiencies, Anemia, Iron-Deficiency drug therapy
- Abstract
Objective: To test the equivalence of two doses of intravenous iron (ferric carboxymaltose) in pregnancy., Design: Parallel, two-arm equivalence randomised controlled trial with an equivalence margin of 5%., Setting: Single centre in Australia., Population: 278 pregnant women with iron deficiency., Methods: Participants received either 500 mg (n = 152) or 1000 mg (n = 126) of intravenous ferric carboxymaltose in the second or third trimester., Main Outcome Measures: The proportion of participants requiring additional intravenous iron (500 mg) to achieve and maintain ferritin >30 microg/L (diagnostic threshold for iron deficiency) at 4 weeks post-infusion, and at 6 weeks, and 3-, 6- and 12-months postpartum. Secondary endpoints included repeat infusion rate, iron status, birth and safety outcomes., Results: The two doses were not equivalent within a 5% margin at any time point. At 4 weeks post infusion, 26/73 (36%) participants required a repeat infusion in the 500-mg group compared with 5/67 (8%) in the 1000-mg group: difference in proportions, 0.283 (95% confidence interval [CI] 0.177-0.389). Overall, participants in the 500-mg arm received twice the repeat infusion rate (0.81 [SD = 0.824] versus 0.40 [SD = 0.69], rate ratio 2.05, 95% CI 1.45-2.91)., Conclusions: Administration of 1000 mg ferric carboxymaltose in pregnancy maintains iron stores and reduces the need for repeat infusions. A 500- mg dose requires ongoing monitoring to ensure adequate iron stores are reached and sustained., (© 2022 The Authors. BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd.)
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- 2023
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50. Pravastatin suppresses inflammatory cytokines and endothelial activation in patients at risk of developing preeclampsia: INOVASIA study.
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Akbar MIA, Yosediputra A, Pratama RE, Fadhilah NL, Sulistyowati S, Amani FZ, Dachlan EG, Dikman Angsar M, and Dekker GA
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- Female, Humans, Infant, Newborn, Pregnancy, Biomarkers, Cohort Studies, Cytokines, Interleukin-6, Pravastatin therapeutic use, Pravastatin pharmacology, Vascular Endothelial Growth Factor A, Pre-Eclampsia
- Abstract
Introduction: The Indonesian INOVASIA study is an ongoing multicentre randomized, open controlled trial of pravastatin for the prevention of preeclampsia in patients deemed to be high risk. Here we evaluate the effects of pravastatin on circulating inflammatory and endothelial markers, i.e. Vascular Endothelial Growth Factor (VEGF), Interleukin-6 (IL-6), Endothelin-1 (ET-1), and Nitric Oxide (NO)., Methods: Pregnant women deemed to be at a high risk of developing preeclampsia women were recruited based on the Fetal Medicine Foundation preeclampsia screening test or a history of preterm preeclampsia, or clinical risk factors in combination with an abnormal uterine artery Doppler flow pattern at 11-20 week's gestation. This is a nested cohort study within the larger trial (INOVASIA); 38 patients were consecutively recruited and assigned to the pravastatin group and the control group. Participants in the pravastatin group received pravastatin (2 × 20 mg p.o) in addition to a standard regimen of aspirin (80 mg p.o) and calcium (1 g p.o), from 14 to 20 weeks until delivery. Blood samples to measure the various biomarkers were obtained in consecutive patients before starting the research medication and just before delivery (pre and post-test examination)., Result: The number of samples on the 2 time points for the various biomarkers was: VEGF: 38, IL-6: 30, ET-1: 38, and NO: 35. IL-6 levels decreased significantly in the pravastatin group (mean ± SD): (191.87 ± 82.99 vs. 151.85 + 48.46, p = .013), while levels in the control group did not change significantly (median (interquartile range)) (144.17 (53.91) vs. 140.82 (16.18), p = .177). ET-1 levels decreased significantly in the pravastatin group (3.64 ± 0.85 vs. 3.01 ± 0.74, p = .006) while the control group had more or less stable levels (3.57 ± 1.12 vs. 3.78 ± 0.73 p = .594). NO was the only serum marker that showed significant changes in both groups. NO levels increased in pravastatin group (11.30 (17.43) vs. 41.90 (53.18), p = .044) and decreased in control group (38.70 (34.80) vs. 10.03 (26.96), p = .002). VEGF levels appeared to follow opposite trends in the 2 groups (NS) (Pravastatin: 3.22 (0.62) vs. 3.28 (0.75), p = .402. Control: 3.38 (0.83) vs. 3.06 (0.74), p = .287)., Conclusion: Administration of 40 mg pravastatin resulted in an improvement in NO levels, and a decrease in IL-6 and endothelin (ET-1) levels. The direction of the effect of pravastatin on these biomarkers appears to underpin the potential for a beneficial effect of pravastatin in the prevention of preeclampsia.
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- 2022
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