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Purpose: we aimed to estimate the anxiety levels of pregnant women following maternal serum screening for CMV infection.Materials and methods: In this case-control study conducted from April 2016 to June 2017, we enrolled all pregnant women referred to our hospital who were CMV immunoglobulin (Ig) M antibody positive (IgM-positive group, n = 51); further, those who were CMV IgG positive but IgM negative (IgM-negative group, n = 51) during the same period were included as study controls. Data were collected on patient characteristics, CMV IgM levels, and whether patients were accompanied by their partners during the first hospital visit after CMV IgM testing. The State-Trait Anxiety Inventory was used to assess anxiety levels.Results: Both groups were age matched [mean age (years): IgM-positive, 30 ± 4.2 and IgM-negative, 29.9 ± 4.6]. The mean state-anxiety score was higher in the IgM-positive group (53 ± 9.6) than in the IgM-negative group (38.5 ± 7.0, p < .05) with no between-group differences in trait-anxiety scores. Similarly, a higher number of women were accompanied by their partners in the IgM-positive group. The state-anxiety scores and CMV IgM levels were not correlated in the IgM-positive group.Conclusion: Counseling support is essential for IgM-positive pregnant women following serum screening, and the screening should be avoided if support systems are unavailable. [ABSTRACT FROM AUTHOR]

Aim: To investigate the effects of Mycoplasma/Ureaplasma cultured in amniotic fluid on perinatal characteristics in preterm delivery between 22 and 33 weeks of gestation. Methods: The study was conducted in a tertiary perinatal center and involved 38 pregnant women who had undergone amniocentesis to evaluate intrauterine infection due to preterm labor or premature rupture of membranes. The subjects were divided into three groups based on the culture results: negative (Negative Group, n = 24), positive for Mycoplasma/Ureaplasma (M/U Group, n = 6), and positive for other pathogens (Other Pathogens Group, n = 8). One‐way analysis of variance was used to compare the three groups. Results: The incidence of histological chorioamnionitis and neonatal sepsis was significantly different among the three groups (the Negative Group and the Other Pathogens Group, P < 0.01; the M/U Group and the Other Pathogens Group, P = 0.03). In the M/U Group, no infants had sepsis, severe intraventricular hemorrhage, cystic periventricular leukomalacia, or poor neurological outcomes, but one infant developed bronchopulmonary dysplasia and needed home oxygen treatment. Although one died of gastrorrhexis, the remaining five patients had normal brain magnetic resonance imaging findings and developed normally. Conclusion: The presence of Mycoplasma/Ureaplasma isolated from amniotic fluid did not cause neonatal sepsis or poor prognosis. In some infants, there was no histological chorioamnionitis in the placenta. These pathogens thus seem to be less invasive than any other microbes with respect to perinatal outcomes. [ABSTRACT FROM AUTHOR]

Objective: We investigated the risk factors of perinatal death and neurological damage. Methods: Perinatal death and neurological damage were retrospectively investigated using a population-based study of 108 024 deliveries from 1998 to 2007. Main factors studied were asphyxia, growth restriction and preterm delivery < 34 weeks of gestation, since these three factors were most often associated with poor prognosis. The impact of each factor was identified by multiple regression analyses. Results: There were 459 perinatal deaths (4.3/1000) and 220 neurological damages (2.0/1000). Preterm delivery accounted for 50% of perinatal deaths and neurological damage, whereas it constituted 2.6% of total births. Multiple regression analyses showed that prematurity < 34 weeks (10-fold), asphyxia (10-fold) and growth restriction (2-fold) were independent and significant risk factors associated with poor outcomes, and that the magnitude was similar throughout the three consecutive critical events of fetal death, neonatal death and neurological damage. Conclusions: Prematurity < 34 weeks, asphyxia and growth restriction are independent and persistent risk factors from perinatal death to neurological damage. [ABSTRACT FROM AUTHOR]

Aim: This paper presents the serological and epidemiological background of the rubella-infected pregnant women following the rubella outbreak throughout Tokunoshima Island that occurred after the revision of the immunization law in Japan. Methods: Twelve of 149 pregnant women managed in Miyagami Hospital were enrolled as having a high risk for congenital rubella infection. They were interviewed about their immunization history with rubella vaccine, the presence of rash, onset of rash, and the presence and timing of contact with rubella-infected patients. The obstetric histories were investigated for past rubella HI antibody titer. Nine of 12 women continued their pregnancy and delivered a baby. A serological test for rubella IgM antibody and a reversed transcription-nested PCR assay using umbilical cord blood and the newborn urine for virus genome detection were performed for all babies. We also enrolled all 309 mothers who delivered during the last 2 years in Miyagami Hospital, and retrospectively collected their rubella HI titers. Results: Congenital rubella syndrome (CRS) and congenitally infected babies were born from 12 high-risk mothers. In our study, six pregnant women to be immunized by a catch-up program showed a lack of immunity to rubella. The remaining six women had low rubella immunity. Nine acquired rubella from members of their family, including their husband. The incidence of negative HI titer was 25% in women less than 25 years old who delivered during the last 2 years in this hospital. Conclusions: More intensive immunization should be considered to eradicate CRS completely in Japan. [ABSTRACT FROM AUTHOR]

Background: Due to circulatory instability, premature infants require volume loads, catecholamines and steroid supplementation to improve mortality and neurodevelopmental outcome. However, a complete quantitative analysis concerning the relationship between supplementation and gestational age, especially in infants born at 22 to 24 weeks of gestation, is lacking., Aim: To investigate whether less mature infants need higher doses of catecholamine, volume loads and steroid, and whether those who require higher doses have poorer outcome., Study Design: A retrospective, observational study was performed at a tertiary center in a university setting. Among the consecutive 221 premature infants born at 22 to 28 weeks of gestation, we selected 108 infants who had no apparent pathological conditions other than prematurity. Catecholamines, volume loads and steroid, given to attain sufficient blood pressure and urinary output, were quantitatively analyzed during the first 24 hours., Outcome Measures: Quantity of catecholamines, volume expanders and steroid supplementation as a function of gestational age and childhood outcome at 2 years., Results: Catecholamines and volume loads were increased in a step-wise manner with decreasing gestational age. Intact survival rate was significantly lower in infants born before 25 weeks of gestation compared with the more mature infants. Among infants born at 22 to 24 weeks' gestation, catecholamine and volume load increased significantly in poor outcome infants compared with good outcome infants., Conclusions: From a developmental viewpoint, progressively larger doses of catecholamine, volume expanders and corticosteroid are required to stabilize circulatory adaptation to neonatal life in infants between 22 to 28 weeks of gestation., (2010 Elsevier Ltd. All rights reserved.)

In a population-based study we investigated the early-onset, invasive sepsis caused by group B streptococcus (GBS) and non-GBS in the era of intrapartum antimicrobial prophylaxis. From 1998 to 2006, we had 387 perinatal deaths in 98,495 deliveries, and 9 full-term infants met the criteria of early-onset, invasive sepsis, in which microorganisms were proven from blood sampling. Of these cases, 4 involved GBS, 2 ampicillin-resistant Escherichia coli, 2 methicillin-resistant Staphylococcus aureus, and 1 was unidentified. All 4 cases of GBS related death underwent improper procedures contrary to the prophylaxis recommendation. Eighty percent of non-GBS related deaths had septicemia of antibiotic-resistant pathogens. We found in our population-based study that early-onset, fatal sepsis in full-term infants is associated with insufficient adherence to the prophylaxis strategy for GBS and with the emergence of antimicrobial resistant non-GBS bacteria.