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14 results on '"MESH : Pregnancy Outcome"'

1. Pre-Pregnancy Body Mass Index and Weight Gain During Pregnancy: Relations with Gestational Diabetes and Hypertension, and Birth Outcomes

Author

Monique Kaminski, Anne Forhan, Olivier Thiebaugeorges, Marie-Aline Charles, Michel Schweitzer, Bernard Foliguet, Guillaume Magnin, Valérie Goua, Barbara Heude, Centre de recherche en épidémiologie et santé des populations ( CESP ), Université de Versailles Saint-Quentin-en-Yvelines ( UVSQ ) -Université Paris-Sud - Paris 11 ( UP11 ) -Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Service de Foetopathologie et placentologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy ( CHRU Nancy ), Service de gynécologie et obstétrique [Poitiers], Université de Poitiers-Centre hospitalier universitaire de Poitiers ( CHU Poitiers ), Recherche Epidémiologique en Santé Périnatale et Santé des Femmes et des Enfants ( UMR_S 953 ), Université Paris-Sud - Paris 11 ( UP11 ) -Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), We acknowledge all the funding sources for the EDEN study: Fondation pour la Recherche Médicale (FRM), French Ministry of Research: IFR and Cohort program, INSERM Nutrition Research Program, French Ministry of Health Perinatality Program, French Agency for Environment Security (AFFSET), French National Institute for Population Health Surveillance (INVS), Paris-Sud University, French National Institute for Health Education (INPES), Nestlé, Mutuelle Générale de l'Education Nationale (MGEN), French speaking association for the study of diabetes and metabolism (Alfediam), National Agency for Research (ANR non thematic program), National Institute for Research in Public Health (IRESP: TGIR cohorte santé 2008 program), and EDEN Mother-Child Cohort Study group

Subjects
Epidemiology, Weight Gain, Body Mass Index, Fetal Macrosomia, 0302 clinical medicine, Pregnancy, Risk Factors, Birth Weight, MESH : Female, 030212 general & internal medicine, 2. Zero hunger, MESH : Pregnancy Outcome, 030219 obstetrics & reproductive medicine, Obstetrics, Pregnancy Outcome, Obstetrics and Gynecology, Gestational age, MESH : Weight Gain, MESH : Infant, [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, MESH : Adult, MESH : Maternal Age, MESH : Risk Factors, 3. Good health, Gestational diabetes, MESH : Hypertension, Pregnancy-Induced, Gestation, MESH : Obesity, Female, gestational diabetes, medicine.symptom, Maternal Age, Adult, medicine.medical_specialty, hypertension, Birth weight, Gestational Age, Article, 03 medical and health sciences, medicine, Fetal macrosomia, Humans, Obesity, business.industry, MESH : Humans, Public Health, Environmental and Occupational Health, Infant, MESH : Birth Weight, Hypertension, Pregnancy-Induced, medicine.disease, MESH : Pregnancy, MESH : Body Mass Index, Diabetes, Gestational, MESH : Fetal Macrosomia, Pediatrics, Perinatology and Child Health, MESH : Diabetes, Gestational, business, Body mass index, Weight gain, MESH : Gestational Age
Abstract

International audience; To study the relationship between pre-pregnancy body mass index (BMI) and weight gain during pregnancy with pregnancy and birth outcomes, with a focus on gestational diabetes and hypertension and their role in the association with fetal growth. We studied 1,884 mothers and offspring from the Eden mother-child cohort. Weight before pregnancy (W1) and weight after delivery (W2) were collected and we calculated BMI and net gestational weight gain (netGWG = (W2 - W1)/(weeks of gestation)). Gestational diabetes, hypertension gestational age and birth weight were collected. We used multivariate linear or logistic models to study the association between BMI, netGWG and pregnancy and birth outcomes, adjusting for center, maternal age and height, parity and average number of cigarettes smoked per day during pregnancy. High BMI was more strongly related to the risk of giving birth to a large-for-gestational-age (LGA) baby than high netGWG (odds ratio OR [95% CI] of 3.23 [1.86-5.60] and 1.61 [0.91-2.85], respectively). However, after excluding mothers with gestational diabetes or hypertension the ORs for LGA, respectively weakened (OR 2.57 [1.29-5.13]) for obese women and strengthened for high netGWG (OR 2.08 [1.14-3.80]). Low in comparison to normal netGWG had an OR of 2.18 [1.20-3.99] for pre-term birth, which became stronger after accounting for blood pressure and glucose disorders (OR 2.70 [1.37-5.34]). Higher net gestational weight gain was significantly associated with an increased risk of LGA only after accounting for blood pressure and glucose disorders. High gestational weight gain should not be neglected in regard to risk of LGA in women without apparent risk factors.

Published
2011
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2. Dengue epidemics and adverse obstetrical outcomes in French Guiana: a semi-ecological study

Author

Hanf, Matthieu, Friedman, Eleanor, Basurko, Celia, Roger, Amaury, Bruncher, Pascal, Dussart, Philippe, Flamand, Claude, Carles, Gabriel, Buekens, Pierre, Breart, Gerard, Carme, Bernard, Nacher, Mathieu, Centre d'investigation clinique Antilles-Guyane ( CIC - Antilles Guyane ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de la Martinique-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Department of Epidemiology, Tulane University, Protection Maternelle et Infantile, Conseil Général de la Guyane, Centre National de Référence des Arboviroses, Institut Pasteur de la Guyane, Réseau International des Instituts Pasteur ( RIIP ) -Réseau International des Instituts Pasteur ( RIIP ), Cellule de l'InVS en Région Antilles Guyane, Institut de Veille Sanitaire (INVS), Service de Gynécologie Obstétrique, Centre Hospitalier de l'Ouest Guyanais, Recherche Epidémiologique en Santé Périnatale et Santé des Femmes et des Enfants ( UMR_S 953 ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université Paris Descartes - Paris 5 ( UPD5 ) -Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Université Paris-Sud - Paris 11 ( UP11 ), INSERM (Institut National de la Santé et de la Recherche Médicale) and the Cayenne General Hospital., Centre d'investigation clinique Antilles-Guyane (CIC - Antilles Guyane), Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de la Martinique [Fort de France]-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Centre National de Référence pour les Arbovirus - Laboratoire de Virologie [Cayenne, Guyane française] (CNR - laboratoire associé), Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP), Recherche Epidémiologique en Santé Périnatale et Santé des Femmes et des Enfants (UMR_S 953), Université Paris-Sud - Paris 11 (UP11)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU de la Martinique [Fort de France]-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Descartes - Paris 5 (UPD5)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Université Paris-Sud - Paris 11 (UP11)

Subjects
MESH : French Guiana, MESH: Premature Birth, MESH : Prevalence, MESH : Dengue, MESH : Pregnancy Trimester, First, MESH: Dengue, MESH: Dengue Virus, MESH : Postpartum Hemorrhage, MESH: Pregnancy, MESH: French Guiana, MESH : Dengue Virus, MESH : Female, MESH: Prevalence, MESH: Epidemics, MESH : Pregnancy Outcome, MESH: Humans, MESH : Epidemics, MESH : Humans, preterm birth, [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Pregnancy Outcome, Dengue fever, MESH: Postpartum Hemorrhage, French Guiana, MESH : Premature Birth, MESH : Pregnancy, postpartum hemorrhage, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, pregnancy, MESH: Pregnancy Trimester, First, MESH: Female
Abstract

International audience; OBJECTIVE: To determine whether dengue epidemics are associated with an increase in adverse obstetrical outcomes. METHODS: Semi-ecological study combining individual data on obstetrical events from the perinatal registry and aggregated exposure data from the epidemiologic surveillance of dengue in Cayenne, French Guiana between 2004 and 2007. RESULTS: After adjustment for individual risk factors, analysis showed that an epidemic level of dengue transmission during the first trimester was associated with an increased risk of post-partum haemorrhage and preterm birth. The associated risks seemed to depend on the epidemic level. CONCLUSIONS: Despite its limitations, this study suggests that dengue in the first trimester may be related to preterm birth and to post-partum bleeding, thus leading to specific hypotheses that should be tested in prospective studies.

Published
2014
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3. Maternal weight change before pregnancy in relation to birthweight and risks of adverse pregnancy outcomes. : Maternal weight change related to birthweight

Author

Monique Kaminski, Olivier Thiebaugeorges, Barbara Heude, Anne Forhan, Marie-Aline Charles, Ibrahima Diouf, Centre de recherche en épidémiologie et santé des populations ( CESP ), Université de Versailles Saint-Quentin-en-Yvelines ( UVSQ ) -Université Paris-Sud - Paris 11 ( UP11 ) -Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Service de Foetopathologie et placentologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy ( CHRU Nancy ), Recherche Epidémiologique en Santé Périnatale et Santé des Femmes et des Enfants ( UMR_S 953 ), Université Paris-Sud - Paris 11 ( UP11 ) -Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), The EDEN Study is funded by grants from the Foundation for Medical Research, the French Ministry of Research: the Institut Fédératif de Recherche program, the Institut National de la Santé et de la Recherche Médicale Human Nutrition National Research Program, and the Diabetes National Research Program (via a collaboration with the French Association for Diabetes Research), the French Ministry of Health Perinatality Program, the French Agency for Environment Security, the French National Institute for Population Health Surveillance, the Paris-Sud University, the French National Institute for Health Education, Nestlé, the National Education Health Insurance (MGEN), the French Speaking Association for the Study of Diabetes and Metabolism, the National Agency for Research (nonthematic program), and the National Institute for Research in Public Health (TGIR health cohort 2008 program)., the EDEN Mother-child cohort study group, Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Recherche Epidémiologique en Santé Périnatale et Santé des Femmes et des Enfants (UMR_S 953), Université Paris-Sud - Paris 11 (UP11)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Descartes - Paris 5 (UPD5)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Université Paris-Sud - Paris 11 (UP11)

Subjects
adverse pregnancy outcomes, Epidemiology, MESH : Pregnancy Trimester, Third, MESH : Pregnancy Trimester, Second, Weight Gain, Body Mass Index, Cohort Studies, Fetal Development, 0302 clinical medicine, MESH: Pregnancy, Weight loss, Pregnancy, MESH: Gestational Age, Surveys and Questionnaires, MESH : Socioeconomic Factors, Birth Weight, MESH : Female, 030212 general & internal medicine, MESH: Cohort Studies, 2. Zero hunger, MESH : Pregnancy Outcome, Obstetrics, Weight change, Pregnancy Outcome, Gestational age, MESH : Questionnaires, MESH : Weight Gain, [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, MESH : Adult, MESH: Mothers, 3. Good health, Gestational diabetes, birthweight, MESH: Pregnancy Complications, Pregnancy Trimester, Second, MESH : Mothers, MESH: Pregnancy Trimester, Second, MESH: Pregnancy Trimester, Third, MESH: Weight Gain, Female, France, medicine.symptom, MESH: Fetal Development, Adult, medicine.medical_specialty, MESH: Socioeconomic Factors, Birth weight, Pregnancy Trimester, Third, Mothers, MESH : Cohort Studies, 030209 endocrinology & metabolism, Gestational Age, MESH : Hospitals, Teaching, MESH : Pregnancy Complications, Article, MESH: Body Mass Index, 03 medical and health sciences, medicine, Humans, MESH: Birth Weight, Hospitals, Teaching, MESH : France, MESH: Humans, business.industry, MESH: Questionnaires, MESH : Humans, MESH: Adult, MESH : Birth Weight, MESH: Hospitals, Teaching, medicine.disease, MESH: Pregnancy Outcome, MESH: France, Pregnancy Complications, MESH : Pregnancy, MESH : Body Mass Index, Socioeconomic Factors, MESH : Fetal Development, Small for gestational age, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, Weight gain, MESH: Female, MESH : Gestational Age
Abstract

International audience; Maternal weight change before pregnancy can be considered as an indicator of maternal energy balance and nutritional status before conception, and may be involved in early life programming. We aimed to investigate the association of maternal Weight Change Before Pregnancy (WCBP) with fetal growth and adverse pregnancy outcomes. Data are from the French EDEN mother-child cohort where 1,756 mother-child pairs had information on mother's weight at 20 years, weight just before pregnancy, fetal anthropometry at second and third trimesters, infant's birthweight and pregnancy complications. The average annual WCBP between 20 years and start of pregnancy (in kg/year) was categorized as: "Weight Loss" (n = 320), "Moderate weight gain" (n = 721) and "High weight gain" (n = 715). The associations of WCBP with fetal and newborn characteristics and with adverse pregnancy outcomes were analyzed, adjusting for maternal and pregnancy characteristics, including the mother's prepregnancy BMI. Interactions between WCBP and prepregnancy BMI were tested. Birthweight and estimated fetal weight in the third trimester increased significantly with increasing WCBP in mothers with BMI

Published
2011
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4. Is a planned cesarean necessary in twin pregnancies?

Author

Vendittelli , Françoise, Rivière , Olivier, Crenn-Hébert , Catherine, Riethmuller , Didier, Schaal , Jean-Patrick, Dreyfus , Michel, Renseigné , Non, Périnatalité, grossesse, Environnement, PRAtiques médicales et DEveloppement (PEPRADE), CHU Clermont-Ferrand-Université d'Auvergne - Clermont-Ferrand I (UdA), Chirurgie Gynécologique et Obstétrique (CGO), Hôpital Louis Mourier - AP-HP [Colombes], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (EA 3181) (CEF2P / CARCINO), Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Service de Gynécologie-Obstétrique et Médecine de la Reproduction [CHU Caen], Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (UR 3181) (CEF2P / CARCINO), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Périnatalité, grossesse, Environnement, PRAtiques médicales et DEveloppement ( PEPRADE ), Université d'Auvergne - Clermont-Ferrand I ( UdA ) -CHU Clermont-Ferrand, Chirurgie Gynécologique et Obstétrique ( CGO ), Hopital Louis Mourier - AP-HP [Colombes], Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC ( CEF2P / CARCINO ), Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Université Bourgogne Franche-Comté ( UBFC ) -Université de Franche-Comté ( UFC ), Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ), Service de Gynécologie - Obstétrique et médecine de la reproduction [Caen], and CHU Caen

Subjects
Databases, Factual, Twins, Labor Presentation, Cohort Studies, MESH: Pregnancy, Pregnancy, MESH: Gestational Age, Infant Mortality, MESH : Female, MESH: Infant Mortality, MESH: Surgical Procedures, Elective, MESH: Cohort Studies, reproductive and urinary physiology, MESH : Pregnancy Outcome, MESH: Infant, Newborn, Pregnancy Outcome, Prenatal Care, MESH: Follow-Up Studies, MESH : Maternal Age, MESH: Cesarean Section, [ SDV.BDLR ] Life Sciences [q-bio]/Reproductive Biology, MESH: Labor Presentation, Elective Surgical Procedures, MESH : Delivery, Obstetric, Female, MESH : Sensitivity and Specificity, Pregnancy, Multiple, Maternal Age, MESH : Labor Presentation, MESH : Surgical Procedures, Elective, MESH : Cohort Studies, MESH: Pregnancy, Multiple, Gestational Age, MESH : Databases, Factual, MESH : Infant, Newborn, Sensitivity and Specificity, MESH : Prenatal Care, MESH : Cesarean Section, Humans, MESH : Infant Mortality, MESH: Prenatal Care, MESH: Humans, MESH: Twins, Cesarean Section, MESH : Pregnancy, Multiple, MESH : Humans, Infant, Newborn, MESH : Follow-Up Studies, [SDV.BDLR]Life Sciences [q-bio]/Reproductive Biology, MESH: Pregnancy Outcome, Delivery, Obstetric, MESH: Databases, Factual, MESH : Twins, MESH: Sensitivity and Specificity, MESH : Pregnancy, MESH: Maternal Age, MESH: Delivery, Obstetric, MESH: Female, MESH : Gestational Age, Follow-Up Studies
Abstract

International audience; OBJECTIVE: Evaluation of elective cesarean section for twin delivery as a standard of care. DESIGN: Historical cohort in a national database (2 597 twin pregnancies). SETTING: France. SAMPLE: Twins with first child in cephalic presentation. METHODS: Decision analysis. MAIN OUTCOME MEASURES: All neonatal complications, i.e. death, whether intrapartum or in the delivery room or the immediate postpartum period, or neonatal transfer to intensive (or special) care, or trauma, of one or both twins. RESULTS: When we focused on neonatal complications for either or both twins, the strategy of planned vaginal delivery was preferable; the weight of its decision tree branch was lower than that for planned cesarean (26.5 vs. 31.7). If only twin 2 was considered, vaginal delivery was also preferred (weight of vaginal delivery=27.6 vs. 32.7 for planned cesarean). As long as the morbidity and mortality of twin 1 or twin 2 or both during a cesarean for twin 2 in the case of planned vaginal delivery does not exceed 31.5%, all else being equal, vaginal delivery should be preferred to a planned cesarean for twin 1 and twin 2. The two-variable sensitivity analysis confirmed the robustness of the results. CONCLUSIONS: The results of our study do not support a policy of planned cesarean delivery for twin pregnancies at and after 34 weeks of gestation. Level of evidence: II.

Published
2011
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5. Pregnancy-associated hemolytic uremic syndrome revisited in the era of complement gene mutations

Author

Marion Sallée, Marie Essig, David Ribes, Marie-Agnès Dragon-Durey, Sophie Caillard, Eric Rondeau, Véronique Frémeaux-Bacchi, Fadi Fakhouri, Lionel Couzi, Lubka T. Roumenina, Franck Bridoux, François Provôt, Service de néphrologie pédiatrique [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de néphrologie, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Composantes innées de la réponse immunitaire et différenciation (CIRID), Université Bordeaux Segalen - Bordeaux 2-Centre National de la Recherche Scientifique (CNRS), Université Bordeaux Segalen - Bordeaux 2, ifr 66, Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Néphrologie-transplantation-dialyse [Bordeaux], CHU Bordeaux [Bordeaux], Pharmacologie des Immunosuppresseurs et de la Transplantation (PIST), Université de Limoges (UNILIM)-CHU Limoges-Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST FR CNRS 3503)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Néphrologie, Dialyse, Transplantations [CHU Limoges], CHU Limoges, Laboratoire d'Immunologie Biologique, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Physiologie Moléculaire de la Réponse Immune et des Lymphoproliférations (PMRIL), Université de Limoges (UNILIM)-Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST FR CNRS 3503)-Centre National de la Recherche Scientifique (CNRS), CHU Necker - Enfants Malades [AP-HP] - Assistance publique - Hôpitaux de Paris (AP-HP), Université Bordeaux Segalen - Bordeaux 2 - Centre National de la Recherche Scientifique (CNRS), Université de Limoges (UNILIM) - CHU Limoges - Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST FR CNRS 3503) - Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) - Hôpital Européen Georges Pompidou [APHP] (HEGP), and Université de Limoges (UNILIM) - Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST FR CNRS 3503) - Centre National de la Recherche Scientifique (CNRS)

Subjects
Hemolytic anemia, MESH : Retrospective Studies, 030232 urology & nephrology, MESH : Hemolytic-Uremic Syndrome, MESH: Pregnancy Complications, Hematologic, 030204 cardiovascular system & hematology, Gene mutation, urologic and male genital diseases, 0302 clinical medicine, MESH: Pregnancy, Pregnancy, hemic and lymphatic diseases, MESH : Female, MESH : Pregnancy Outcome, Pregnancy Outcome, General Medicine, MESH : Adult, 3. Good health, Nephrology, MESH: Hemolytic-Uremic Syndrome, MESH: Young Adult, MESH : Complement C3 Convertase, Alternative Pathway, Gestation, [SDV.IMM]Life Sciences [q-bio]/Immunology, Female, Adult, medicine.medical_specialty, [SDV.IMM] Life Sciences [q-bio]/Immunology, Thrombotic thrombocytopenic purpura, MESH : Young Adult, Preeclampsia, 03 medical and health sciences, Young Adult, MESH : Pregnancy Complications, Hematologic, Clinical Research, Internal medicine, Atypical hemolytic uremic syndrome, medicine, Humans, Retrospective Studies, Complement C3 Convertase, Alternative Pathway, MESH: Humans, business.industry, MESH : Humans, Pregnancy Complications, Hematologic, MESH: Complement C3 Convertase, Alternative Pathway, MESH: Adult, MESH: Retrospective Studies, medicine.disease, MESH: Pregnancy Outcome, MESH : Pregnancy, Immunology, Hemolytic-Uremic Syndrome, business, MESH: Female, Kidney disease
Abstract

International audience; In contrast to pregnancy-associated thrombotic thrombocytopenic purpura, the pathogenesis and presentation of pregnancy-associated atypical hemolytic uremic syndrome (P-aHUS) remain ill-defined. We conducted a retrospective study to assess the presentation and outcomes of patients presenting with P-aHUS and the prevalence of alternative C3 convertase dysregulation. P-aHUS occurred in 21 of the 100 adult female patients with atypical HUS, with 79% presenting postpartum. We detected complement abnormalities in 18 of the 21 patients. The outcomes were poor: 62% reached ESRD by 1 month and 76% by last follow-up. The risk for P-aHUS was highest during a second pregnancy. Thirty-five women, 26 (74%) of whom had complement abnormalities, had at least one pregnancy before the onset of a non-pregnancy-related aHUS. Outcomes did not differ between patients with pregnancy-related and non-pregnancy-related aHUS. Mutations in the SCR19-20 domains of factor H were less frequent in P-aHUS patients compared with non-pregnancy-related aHUS. Pregnancies in female patients with complement abnormalities (n = 44) were complicated by fetal loss and preeclampsia in 4.8% and 7.7%, respectively. Better understanding of complement dysregulation in pregnancy complications is essential, especially to guide development of pharmacologic agents to modulate this system.

Published
2010
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6. Chronic infection during placental malaria is associated with up-regulation of cycloxygenase-2

Author

Emilie Fréalle, Odile Mercereau-Puijalon, Hamoud O Brahim, Alioune Gaye, Laurence Marrama, Jean Marie Dangou, Jean Y. Lehesran, Demba Sarr, Makhtar Niang, Ronan Jambou, Delphine Aldebert, Institut Pasteur de Dakar, Réseau International des Instituts Pasteur (RIIP), Centre de Santé Roi Baudoin, Immunologie moléculaire des parasites, Institut Pasteur [Paris] (IP)-Centre National de la Recherche Scientifique (CNRS), UR10, Mother & Child Unit, Mother & Child Unit, Santé de la mère et de l'enfant en milieu tropical : épidémiologie génétique et périnatale, Université Paris Descartes - Paris 5 (UPD5), Département de Parasitologie Mycologie, Institut Pasteur [Paris] (IP), Institut Pasteur de Dakar - Réseau International des Instituts Pasteur (RIIP), Institut Pasteur [Paris] - Centre National de la Recherche Scientifique (CNRS), Institut Pasteur [Paris], and Institut Pasteur [Paris]-Centre National de la Recherche Scientifique (CNRS)

Subjects
MESH: Inflammation, MESH : RNA, Messenger, Placenta Diseases, Placenta, 0302 clinical medicine, MESH: Pregnancy, Pregnancy, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, MESH : Pregnancy Complications, Parasitic, MESH: Up-Regulation, MESH : Up-Regulation, 0303 health sciences, MESH : Reverse Transcriptase Polymerase Chain Reaction, Pregnancy Outcome, MESH: Placenta, MESH : Senegal, Immunohistochemistry, MESH: Case-Control Studies, 3. Good health, Up-Regulation, Interleukin 10, MESH : Placenta, MESH: Young Adult, MESH : Infant, Low Birth Weight, MESH : Case-Control Studies, lcsh:RC955-962, MESH : Cyclooxygenase 2, MESH : Young Adult, MESH: Infant, Low Birth Weight, lcsh:Infectious and parasitic diseases, 03 medical and health sciences, MESH: Senegal, MESH : Adolescent, Humans, RNA, Messenger, MESH: Adolescent, MESH : Inflammation, MESH: Humans, MESH : Humans, MESH: Adult, medicine.disease, MESH : Pregnancy, MESH : Biopsy, Case-Control Studies, Immunology, Parasitology, Cyclooxygenase, MESH: Female, Malaria, MESH: Interleukin-10, MESH : Immunohistochemistry, Biopsy, MESH : Malaria, Falciparum, MESH: Pregnancy Complications, Parasitic, MESH: Placenta Diseases, MESH: Biopsy, MESH: Reverse Transcriptase Polymerase Chain Reaction, MESH : Female, Malaria, Falciparum, MESH : Pregnancy Outcome, biology, Reverse Transcriptase Polymerase Chain Reaction, MESH: Malaria, Falciparum, MESH: Infant, Newborn, MESH : Adult, Senegal, Interleukin-10, Infectious Diseases, medicine.anatomical_structure, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Female, medicine.symptom, MESH: Cyclooxygenase 2, Adult, lcsh:Arctic medicine. Tropical medicine, Adolescent, 030231 tropical medicine, MESH : Placenta Diseases, Inflammation, MESH : Infant, Newborn, Young Adult, MESH : Interleukin-10, medicine, lcsh:RC109-216, 030304 developmental biology, MESH: RNA, Messenger, Research, Infant, Newborn, MESH: Immunohistochemistry, Infant, Low Birth Weight, MESH: Pregnancy Outcome, Chronic infection, Cyclooxygenase 2, Pregnancy Complications, Parasitic, biology.protein
Abstract

BackgroundPlacental malaria (PM) is associated with poor foetal development, but the pathophysiological processes involved are poorly understood. Cyclooxygenase (COX) and lipoxygenase (LOX) which convert fatty acids to prostaglandins and leukotrienes, play important roles in pregnancy and foetal development. COX-2, currently targeted by specific drugs, plays a dual role as it associates with both pre-eclampsia pathology and recovery during infection. The role of COX during PM was questioned by quantifying at delivery COX-1, COX-2, 15-LOX, and IL-10 expression in two groups of malaria infected and uninfected placenta.MethodsPlacental biopsies were collected at delivery for mRNA isolation and quantification, using real time PCR.ResultsCOX-2 and IL-10 mRNAs increased mainly during chronic infections (nine- and five-times, respectively), whereas COX-1 transcripts remained constant. COX-2 over-expression was associated with a higher birth weight of the baby, but with a lower rate of haemoglobin of the mother. It was associated with a macrophage infiltration of the placenta and with a low haemozoin infiltration. In the opposite way, placental infection was associated with lower expression of 15-LOX mRNA. A high degree of haemozoin deposition correlates with low birth weight and decreased expression of COX-2.ConclusionThese data provide evidence that COX-2 and IL-10 are highly induced during chronic infection of the placenta, but were not associated with preterm delivery or low birth weight. The data support the involvement of COX-2 in the recovery phase of the placental infection.

Published
2010
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7. Maternal residence near municipal waste incinerators and the risk of urinary tract birth defects

Author

Christine Monfort, Mireille Chiron, Elisabeth Robert-Gnansia, Sylvaine Cordier, Cécile Chevrier, Martine Hours, Lucie Anzivino-Viricel, Anne Lehébel, Emmanuelle Amar, Forgeron, Christine, Groupe d'Etude de la Reproduction Chez l'Homme et les Mammiferes (GERHM), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Registre des Malformations Rhône-Alpes, REMERA, Unité Mixte de Recherche Epidémiologique et de Surveillance Transport Travail Environnement (UMRESTTE), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche sur les Transports et leur Sécurité (INRETS), Groupe d'Etude de la Reproduction Chez l'Homme et les Mammiferes ( GERHM ), Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -IFR140-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Unité Mixte de Recherche Epidémiologique et de Surveillance Transport Travail Environnement ( UMRESTTE ), Université Claude Bernard Lyon 1 ( UCBL ), Université de Lyon-Université de Lyon-Institut National de Recherche sur les Transports et leur Sécurité ( INRETS ) -Institut de Veille Sanitaire (INVS), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)

Subjects
Hazardous Waste, Municipal solid waste, MESH : Prenatal Exposure Delayed Effects, [ SDV.TOX ] Life Sciences [q-bio]/Toxicology, Incineration, 010501 environmental sciences, 01 natural sciences, 0302 clinical medicine, MESH: Pregnancy, Pregnancy, Surveys and Questionnaires, Epidemiology, MESH: Urinary Tract, MESH: Incineration, MESH : Female, 030212 general & internal medicine, Urinary Tract, MESH : Incineration, [SDV.BDD]Life Sciences [q-bio]/Development Biology, 2. Zero hunger, education.field_of_study, MESH : Pregnancy Outcome, MESH: Dioxins, MESH: Infant, Newborn, Pregnancy Outcome, MESH : Questionnaires, MESH : Urinary Tract, [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Congenital Abnormalities, MESH : Adult, MESH: Case-Control Studies, [SDV.TOX] Life Sciences [q-bio]/Toxicology, Prenatal Exposure Delayed Effects, [SDV.TOX]Life Sciences [q-bio]/Toxicology, Female, MESH: Hazardous Waste, France, Adult, medicine.medical_specialty, MESH : Case-Control Studies, MESH: Air Pollution, Population, Dioxins, MESH : Infant, Newborn, Congenital Abnormalities, MESH: Prenatal Exposure Delayed Effects, 03 medical and health sciences, MESH : Dioxins, Environmental health, Air Pollution, [SDV.BDD] Life Sciences [q-bio]/Development Biology, medicine, Humans, [ SDV.BDD ] Life Sciences [q-bio]/Development Biology, MESH : Hazardous Waste, education, MESH : France, 0105 earth and related environmental sciences, MESH: Humans, business.industry, MESH: Questionnaires, MESH : Humans, Public Health, Environmental and Occupational Health, Infant, Newborn, Ecological study, MESH: Adult, MESH : Congenital Abnormalities, medicine.disease, MESH: Pregnancy Outcome, MESH: France, MESH : Pregnancy, 13. Climate action, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Case-Control Studies, MESH : Air Pollution, Residence, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, MESH: Female, Waste disposal
Abstract

International audience; OBJECTIVES: Waste incineration releases a mixture of chemicals with high embryotoxic potential, including heavy metals and dioxins/furans, into the atmosphere. In a previous ecological study we found an association between the risk of urinary tract birth defects and residence in the vicinity of municipal solid waste incinerators (MSWIs). The objective of the present study was to specifically test this association. METHODS: A population-based case-control study compared 304 infants with urinary tract birth defects diagnosed in the Rhône-Alpes region (2001-2003) with a random sample of 226 population controls frequency-matched for infant sex and year and district of birth. Exposure to dioxins in early pregnancy at the place of residence, used as a tracer of the mixture released by 21 active waste incinerators, was predicted with second-generation Gaussian modelling (ADMS3 software). Other industrial emissions of dioxins, population density and neighbourhood deprivation were also assessed. Individual risk factors including consumption of local food were obtained by interviews with 62% of the case and all control families. RESULTS: Risk was increased for mothers exposed to dioxins above the median at the beginning of pregnancy (OR 2.95, 95% CI 1.47 to 5.92 for dioxin deposits). When only interviewed cases were considered, risk estimates decreased mainly because the non-interviewed cases were more likely to live in exposed residential environments (OR 2.05, 95% CI 0.92 to 4.57). The results suggest that consumption of local food modifies this risk. CONCLUSIONS: This study confirms our previous observation of a link between the risk of urinary tract birth defects and exposure to MSWI emissions in early pregnancy and illustrates the effect of participation bias on risk estimates of environmental health impacts.

Published
2010
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8. When to stop pushing: effects of duration of second-stage expulsion efforts on maternal and neonatal outcomes in nulliparous women with epidural analgesia

Author

Camille Le Ray, François Audibert, William D. Fraser, François Goffinet, Maternité Port-Royal [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Département d'Obstétrique Gynécologie, Université de Montréal (UdeM)-CHU Sainte Justine [Montréal], Recherches épidémiologiques en santé périnatale et santé des femmes, Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Debs, Nayla, Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Cochin [AP-HP], Université de Montréal-CHU Sainte Justine [Montréal], Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), and Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
Multivariate analysis, MESH : Analgesia, Obstetrical, law.invention, 0302 clinical medicine, MESH: Pregnancy, Randomized controlled trial, law, MESH: Risk Factors, MESH : Female, 030212 general & internal medicine, Stage (cooking), Duration (project management), Young adult, MESH : Pregnancy Outcome, 030219 obstetrics & reproductive medicine, Obstetrics, Obstetrics and Gynecology, [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, MESH : Adult, MESH : Risk Factors, MESH: Postpartum Hemorrhage, 3. Good health, MESH: Young Adult, Anesthesia, Apgar score, MESH : Delivery, Obstetric, medicine.symptom, MESH : Fever, MESH: Analgesia, Epidural, MESH : Time Factors, medicine.medical_specialty, MESH : Young Adult, MESH : Labor Stage, Second, MESH : Postpartum Hemorrhage, MESH: Multivariate Analysis, 03 medical and health sciences, MESH: Fever, medicine, MESH: Labor Stage, Second, MESH : Parity, Asphyxia, Pregnancy, MESH: Humans, business.industry, MESH : Humans, MESH: Time Factors, MESH: Parity, MESH : Multivariate Analysis, MESH: Adult, Odds ratio, medicine.disease, MESH: Pregnancy Outcome, Confidence interval, MESH : Pregnancy, MESH: Analgesia, Obstetrical, Neonatal outcomes, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, MESH : Analgesia, Epidural, MESH: Delivery, Obstetric, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, MESH: Female
Abstract

International audience; OBJECTIVE: The purpose of this study was to assess the influence of the duration of active second-stage labor on maternal and neonatal outcomes. STUDY DESIGN: Secondary analysis of the Pushing Early Or Pushing Late with Epidural trial that included 1862 nulliparous women with epidural analgesia who were in the second stage of labor. According to duration of active second-stage labor, we estimated the proportion of spontaneous vaginal deliveries (SVD) with a newborn infant without signs of asphyxia (5-minute Apgar score > or =7 and arterial pH >7.10). We also analyzed maternal and neonatal outcomes according to the duration of expulsive efforts. RESULTS: Relative to the first hour of expulsive efforts, the chances of a SVD of a newborn infant without signs of asphyxia decreased significantly every hour (1- to 2-hour adjusted odds ratio, 0.4; 95% confidence interval [CI], 0.3-0.6; 2- to 3-hour adjusted odds ratio, 0.1; 95% CI, 0.09-0.2; >3-hour adjusted odds ratio, 0.03; 95% CI, 0.02-0.05). The risk of postpartum hemorrhage and intrapartum fever increased significantly after 2 hours of pushing. CONCLUSION: Faced with a decreasing probability of SVD and increased maternal risk of morbidity after 2 hours, we raise the question as to whether expulsive efforts should be continued after this time.

Published
2009
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9. Organisation of obstetric services for very preterm births in Europe: results from the MOSAIC project

Author

Blondel, B., Papiernik, E., Delmas, D., Kunzel, W., Weber, T., Maier, R. F., Kollee, L., Zeitlin, J., Paesano, Rosalba, Recherche Epidémiologique en Santé Périnatale et Santé des Femmes et des Enfants ( UMR_S 953 ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université Paris Descartes - Paris 5 ( UPD5 ) -Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Université Paris-Sud - Paris 11 ( UP11 ), Recherches épidémiologiques en santé périnatale et santé des femmes, Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Maternité Port-Royal [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Cochin [AP-HP], Department of Obstetrics and Gynaecology, CHU Giessen, Department of Obstetrics, Hvidovre University Hospital, Department of Neonatology, CHU Marburg, University Children's Hospital, Radbout University Nijmegen Medical Centre, the Mosaic Research Group, Recherche Epidémiologique en Santé Périnatale et Santé des Femmes et des Enfants (UMR_S 953), Université Paris-Sud - Paris 11 (UP11)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Descartes - Paris 5 (UPD5)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Université Paris-Sud - Paris 11 (UP11)

Subjects
MESH: Infant, Premature, MESH : Infant, Premature, Diseases, very preterm birth, MESH: Premature Birth, MESH : Europe, Infant, Premature, Diseases, Hospitals, Maternity, MESH : Infant, Newborn, Article, MESH: Pregnancy, Pregnancy, Residence Characteristics, MESH: Maternal Health Services, Humans, Maternal Health Services, MESH : Female, MESH: Residence Characteristics, MESH : Pregnancy Outcome, MESH: Humans, MESH : Hospitals, Maternity, in utero transfer, regionalisation, MESH: Infant, Newborn, MESH : Humans, Infant, Newborn, Pregnancy Outcome, [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, Functional imaging [IGMD 1], MESH: Pregnancy Outcome, MESH: Infant, Premature, Diseases, Europe, Perinatal Care, MESH : Premature Birth, MESH : Pregnancy, MESH : Infant, Premature, MESH: Perinatal Care, MESH : Residence Characteristics, MESH: Hospitals, Maternity, Premature Birth, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Europe, MESH : Perinatal Care, MESH: Female, MESH : Maternal Health Services, Infant, Premature
Abstract

Contains fulltext : 81603.pdf (Publisher’s version ) (Closed access) OBJECTIVE: To study the impact of the organisation of obstetric services on the regionalisation of care for very preterm births. DESIGN: Cohort study. SETTING: Ten European regions covering 490 000 live births. POPULATION: All children born in 2003 between 24 and 31 weeks of gestation. METHOD: The rate of specialised maternity units per 10 000 total births, the proportion of total births in specialised units and the proportion of very preterm births by referral status in specialised units were compared. MAIN OUTCOME MEASURE: Birth in a specialised maternity unit (level III unit or unit with a large neonatal unit (at least 50 annual very preterm admissions). RESULTS: The organisation of obstetric care varied in these regions with respect to the supply of level III units (from 2.3 per 10 000 births in the Portuguese region to 0.2 in the Polish region), their characteristics (annual number of deliveries, 24 hour presence of a trained obstetrician) and the proportion of all births (term and preterm) that occur in these units. The proportion of very preterm births in level III units ranged from 93 to 63% in the regions. Different approaches were used to obtain a high level of regionalisation: high proportions of total deliveries in specialised units, high proportions of in utero transfers or high proportions of high-risk women who were referred to a specialised unit during pregnancy. CONCLUSION: Consensus does not exist on the optimal characteristics of specialised units but regionalisation may be achieved in different models of organisation of obstetric services.

Published
2009
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10. Maternal occupational exposure to solvents and congenital malformations: a prospective study in the general population

Author

Sylvaine Cordier, Florence Rouget, Ronan Garlantézec, Christine Monfort, Forgeron, Christine, Groupe d'Etude de la Reproduction Chez l'Homme et les Mammiferes (GERHM), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Groupe d'Etude de la Reproduction Chez l'Homme et les Mammiferes ( GERHM ), Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -IFR140-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)

Subjects
Pediatrics, MESH : Solvents, MESH : Prospective Studies, MESH: Solvents, MESH: Occupational Exposure, 0302 clinical medicine, MESH: Pregnancy, Pregnancy, Risk Factors, MESH: Risk Factors, MESH : Female, Prospective Studies, 030212 general & internal medicine, MESH: Maternal Exposure, Prospective cohort study, education.field_of_study, MESH : Pregnancy Outcome, Pregnancy Outcome, Abnormalities, Drug-Induced, MESH : Maternal Exposure, MESH : Adult, MESH : Maternal Age, 030210 environmental & occupational health, MESH : Risk Factors, 3. Good health, MESH : Occupational Exposure, [ SDV.BDLR ] Life Sciences [q-bio]/Reproductive Biology, Maternal Exposure, Cohort, Gestation, Female, France, Maternal Age, Cohort study, Adult, medicine.medical_specialty, MESH: Abnormalities, Drug-Induced, Population, Occupational medicine, 03 medical and health sciences, Occupational Exposure, medicine, Humans, education, MESH : Abnormalities, Drug-Induced, MESH : France, [SDV.BDLR] Life Sciences [q-bio]/Reproductive Biology, MESH: Humans, business.industry, MESH : Humans, Public Health, Environmental and Occupational Health, MESH: Adult, [SDV.BDLR]Life Sciences [q-bio]/Reproductive Biology, Odds ratio, medicine.disease, MESH: Pregnancy Outcome, MESH: Prospective Studies, MESH: France, MESH : Pregnancy, Solvents, MESH: Maternal Age, business, MESH: Female
Abstract

International audience; OBJECTIVE: To study the relations between maternal occupational exposure to solvents during pregnancy and the risk of congenital malformations. METHODS: A prospective population-based cohort, specifically designed to study the impact of maternal exposure to solvents on the risk of congenital malformations, began in 2002 in three districts of Brittany (France). 3421 pregnant women were recruited until the end of 2005 by physicians before 19 weeks of gestation and followed through birth. Information on pregnancy outcomes was obtained from the hospital. Occupational exposure to solvents at the beginning of pregnancy was assessed from the women's self-reported occupational exposures at inclusion and from a job-exposure matrix (JEM). Sociodemographic characteristics, lifestyle factors, medical history, diseases during pregnancy were obtained at inclusion and from hospital records. Analyses were restricted to working women (n = 3005). Logistic regressions were used to adjust for potential confounders. RESULTS: 30.2% of the working women declared regular exposure to at least one product that may contain solvents. 21.3% of them were classified at least in the medium exposure category using the JEM. Occupations mainly classified as exposed by both assessment methods were hairdressers, nurses' aides, nurses and chemists/biologists. Significant associations were found between major congenital malformations and maternal occupational exposure to solvents, assessed by both self-report odds ratio (OR = 2.48, 95% CI 1.4 to 4.4 for regular exposure vs no exposure) and the JEM (OR = 3.48, 95% CI 1.4 to 8.4 for highest level of exposure vs no exposure). A significant dose-response trend was observed with both assessment methods. Several subgroups of major malformations were associated with maternal exposure to solvents (oral clefts, urinary malformations and male genital malformations). CONCLUSION: This study provides further evidence of an association between exposure to solvents during pregnancy and the risk of major malformations.

Published
2009
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11. [Term-breech presentation: predictive factors of cesarean section for vaginal-birth failure]

Author

Broche, D.-E., Ramanah, R., Collin, A., Mangin, M., Vidal, C., Maillet, R., Riethmuller, D., Département de Génétique et Reproduction, Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Hôpital Saint-Jacques, Immunologie et Chimie Thérapeutiques (ICT), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC ( CEF2P / CARCINO ), Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Université Bourgogne Franche-Comté ( UBFC ) -Université de Franche-Comté ( UFC ), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Hôpital Saint-Jacques, Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (EA 3181) (CEF2P / CARCINO), Université de Franche-Comté (UFC), and Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)

Subjects
MESH: Breech Presentation, MESH : Trial of Labor, MESH : Retrospective Studies, MESH: Trial of Labor, Gestational Age, [SDV.CAN]Life Sciences [q-bio]/Cancer, MESH: Risk Assessment, Risk Assessment, MESH: Prognosis, [ SDV.CAN ] Life Sciences [q-bio]/Cancer, MESH: Pregnancy, Pregnancy, Risk Factors, MESH: Risk Factors, MESH : Cesarean Section, MESH: Gestational Age, Odds Ratio, Humans, MESH : Female, MESH : Risk Assessment, Breech Presentation, reproductive and urinary physiology, Retrospective Studies, MESH : Breech Presentation, MESH : Pregnancy Outcome, MESH: Humans, MESH : Prognosis, Cesarean Section, MESH : Humans, Pregnancy Outcome, MESH: Retrospective Studies, MESH: Cesarean Section, Delivery, Obstetric, Prognosis, MESH: Pregnancy Outcome, MESH : Risk Factors, Trial of Labor, MESH: Odds Ratio, MESH : Pregnancy, Female, MESH: Delivery, Obstetric, MESH : Delivery, Obstetric, MESH : Odds Ratio, MESH: Female, MESH : Gestational Age
Abstract

International audience; OBJECTIVES: In our maternity ward, vaginal-breech birth is favoured when the protocol for patient's eligibility is respected. But in our practice, 20% patients have a cesarean section during labor for vaginal-birth failure, with a higher rate of neonatal and maternal morbidities. This study tried to consider if some obstetrical elements, not usually used, could help select the candidates in a more efficient way. PATIENTS AND METHODS: This retrospective study included all the singleton-breech deliveries with a gestational age over 37 weeks in our maternity ward from 1994 to 2004. An analysis of obstetrical elements, available before and during labour, has been carried out. RESULTS: Three hundred and seventy-six deliveries were indexed for a vaginal-birth trial. We carried out a cesarean section in 21.3% cases. We have found five obstetrical elements, not used in the vaginal birth protocol, which were significant risk factors for a cesarean section: nulliparity (OR=0.25 [0.11-0.57]), maternal height (OR=0.56 [0.30-1.03]), ultrasound estimated fetal weight (OR=7.76 [2.29-26.28]), fundal height (OR=3.9 [2.41-8.62]) and dystocia in first stage of labour (OR=4.97 [2.67-9.25]). DISCUSSION: A cesarean section during labor is responsible for a high-morbidity rate. We have to reduce this obstetrical event, especially in breech presentation, by a better selection of patients. From this study, we have created a statistical model to screen patients, but we have to lead a prospective study to validate it.

Published
2008
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12. [Assisted vaginal delivery using the vacuum extractor in frank breech presentation]

Author

D-E, Broche, D, Riethmuller, D, Maticot-Baptista, R, Ramanah, S, Cossa, R, Maillet, Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (EA 3181) (CEF2P / CARCINO), Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Immunologie et Chimie Thérapeutiques (ICT), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC ( CEF2P / CARCINO ), and Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Université Bourgogne Franche-Comté ( UBFC ) -Université de Franche-Comté ( UFC )

Subjects
Adult, MESH: Breech Presentation, Vacuum Extraction, Obstetrical, MESH : Retrospective Studies, MESH: Vacuum Extraction, Obstetrical, Gestational Age, [SDV.CAN]Life Sciences [q-bio]/Cancer, [ SDV.CAN ] Life Sciences [q-bio]/Cancer, MESH: Pregnancy, Pregnancy, Risk Factors, MESH : Cesarean Section, MESH: Risk Factors, MESH: Gestational Age, Humans, MESH : Apgar Score, MESH : Female, Breech Presentation, reproductive and urinary physiology, Retrospective Studies, MESH : Pregnancy Outcome, MESH : Breech Presentation, Labor, Obstetric, MESH: Humans, Cesarean Section, MESH : Humans, Pregnancy Outcome, MESH: Adult, MESH: Retrospective Studies, MESH : Adult, MESH: Cesarean Section, Delivery, Obstetric, MESH: Pregnancy Outcome, MESH : Risk Factors, MESH: Labor, Obstetric, female genital diseases and pregnancy complications, MESH: Apgar Score, MESH : Pregnancy, MESH : Labor, Obstetric, Apgar Score, MESH : Vacuum Extraction, Obstetrical, Female, MESH : Delivery, Obstetric, MESH: Delivery, Obstetric, MESH: Female, MESH : Gestational Age
Abstract

International audience; OBJECTIVES: When all the breech conditions for the acceptance of a vaginal breech birth are present, we occasionally practise a total breech extraction for non frank breech presentations. Similarly, for frank breech presentations, instead of using the fetal leg as tractor, we sometimes apply the vacuum extractor on the breech presentation in order to perform the first step of the total breech extraction. The vacuum extractor is not traumatic for the fetus and enable a quick extraction. This study was conducted to describe the technique we use in our ward. PATIENTS AND METHODS: A retrospective study including every singleton delivery with a breech presentation and a tried and assisted vaginal delivery using the vacuum extractor in our maternity ward from 1994 to 2004. A descriptive analysis of maternal, fetal and obstetrical elements has been carried out. RESULTS: Twenty-eight deliveries were indexed. In each case, a vaginal delivery was performed. Neonatal outcomes were satisfactory with a five minutes Apgar score always higher than 7. In all 96.5% of the extractions were realized under pelvic level +2. The main indication of extraction (78.5%) was a second stage of labour which was too long. CONCLUSION: Obstetricians should know several techniques to accept and to manage breech deliveries. Indications for assisted vaginal delivery using the vacuum extractor in frank breech presentation are unusual, concerning delay in the second stage with an engaged foetus. This technique may avoid some cesarean sections. Nevertheless vaginal breech delivery try should be happening with great caution and with a strict patient's eligibility.

Published
2008
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13. Collecting population-based perinatal data efficiently: the example of the Lebanese National Perinatal Survey

Author

Nada Ghosn, Béatrice Blondel, Gérard Bréart, Christiane Du Mazaubrun, Ali Zein, Recherche Epidémiologique en Santé Périnatale et Santé des Femmes et des Enfants (UMR_S 953), Université Paris-Sud - Paris 11 (UP11)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), UNICEF, UNICEF Headquarters, Epidemiological Surveillance Unit, Ministry of Public Health, Debs, Nayla, Recherche Epidémiologique en Santé Périnatale et Santé des Femmes et des Enfants ( UMR_S 953 ), and Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université Paris Descartes - Paris 5 ( UPD5 ) -Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Université Paris-Sud - Paris 11 ( UP11 )

Subjects
Epidemiology, MESH: Health Care Surveys, 0302 clinical medicine, MESH: Pregnancy, Pregnancy, Risk Factors, MESH: Risk Factors, MESH: Gestational Age, Health care, Birth Weight, MESH : Female, 030212 general & internal medicine, Lebanon, MESH: Developing Countries, Home Childbirth, MESH : Pregnancy Outcome, Minimum Data Set, education.field_of_study, 030219 obstetrics & reproductive medicine, Obstetrics, Medical record, MESH: Infant, Newborn, Pregnancy Outcome, [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, Prenatal Care, MESH : Adult, MESH: Cesarean Section, MESH : Risk Factors, MESH: Mothers, 3. Good health, Parity, Perinatal Care, MESH : Infant, Premature, MESH : Mothers, MESH: Perinatal Care, Educational Status, MESH : Delivery, Obstetric, Female, Infant, Premature, MESH: Home Childbirth, Adult, MESH: Infant, Premature, MESH : Home Childbirth, medicine.medical_specialty, Birth weight, Population, Mothers, Gestational Age, Prenatal care, MESH : Infant, Newborn, Article, 03 medical and health sciences, MESH : Prenatal Care, MESH : Cesarean Section, medicine, Humans, MESH : Developing Countries, MESH : Health Care Surveys, MESH: Lebanon, MESH: Birth Weight, education, MESH : Parity, Developing Countries, MESH: Prenatal Care, Health policy, MESH: Humans, business.industry, Cesarean Section, MESH : Humans, MESH: Parity, Infant, Newborn, MESH : Birth Weight, MESH: Adult, medicine.disease, Delivery, Obstetric, MESH: Pregnancy Outcome, MESH : Pregnancy, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Health Care Surveys, Pediatrics, Perinatology and Child Health, MESH: Delivery, Obstetric, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, MESH : Lebanon, MESH : Perinatal Care, business, MESH: Educational Status, MESH: Female, MESH : Educational Status, MESH : Gestational Age, Demography
Abstract

We describe the methodology and the main results of the Lebanese perinatal health survey; the aim of the survey was to obtain a minimum data set on all births occurring during a short period of time. The survey was carried out during two consecutive weeks in fall 1999 and in spring 2000. All live births and stillbirths occurring during these periods in medical settings were recorded. The sample included 5231 women and 5333 newborns. Data were obtained from medical records and by interviewing the women in hospital after delivery. All maternity units and birth centers agreed to participate. Maternal characteristics, medical care during pregnancy and delivery, and pregnancy outcome were similar for the two study periods. However gestational age distribution differed between the two periods. In total, 9.0% of infants were born before 37 weeks of gestation and 7.0% weighed less than 2500 grams at birth. Wide regional variations were observed for many indicators of health, care and risk factors. For instance, the cesarean section rate varied from 16.2% in the North Region to 28.0% in Beirut. The survey protocol was successfully applied in Lebanon and may be useful in other countries that have a relatively well-developed health care system, but few sources of reliable population-based statistics on health and medical care. This type of survey may also be an appropriate instrument for collecting additional data for health policy evaluations.

Published
2006
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14. Employment, working conditions, and preterm birth: results from the Europop case-control survey

Author

Saurel-Cubizolles, Marie-Josèphe, Zeitlin, Jennifer, Lelong, Nathalie, Papiernik, Emile, Di Renzo, Gian Carlo, Bréart, Gérard, Group, Europop, Recherches épidémiologiques en santé périnatale et santé des femmes, Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Gynécologie-Obstétrique de Port-Royal, Université Paris Descartes - Paris 5 (UPD5), Department of Gynaecology, Obstetric and Paediatric Sciences, Università degli Studi di Perugia (UNIPG), Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Université Paris Descartes - Paris 5 ( UPD5 ), Università degli Studi di Perugia ( UNIPG ), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Università degli Studi di Perugia = University of Perugia (UNIPG), and Kaniewski, Nadine

Subjects
Research Report, Pediatrics, Epidemiology, MESH: Research Support, Non-U.S. Gov't, maternal health, MESH: Occupational Exposure, MESH : Research Support, Non-U.S. Gov't, MESH: Pregnancy, Risk Factors, MESH: Risk Factors, MESH : Population Surveillance, Medicine, MESH : Female, [ SDV.MHEP.GEO ] Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, MESH : Pregnancy Outcome, MESH: Employment, MESH: Infant, Newborn, Pregnancy Outcome, Absolute risk reduction, [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Confidence Intervals, MESH : Risk Factors, MESH: Case-Control Studies, Europe, MESH : Employment, MESH : Occupational Exposure, MESH : Infant, Premature, Population Surveillance, Gestation, Term Birth, Female, Job satisfaction, pregnancy, Infant, Premature, Women, Working, Employment, MESH: Infant, Premature, medicine.medical_specialty, MESH : Case-Control Studies, MESH : Europe, Context (language use), [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, MESH : Infant, Newborn, MESH : Confidence Intervals, MESH: Population Surveillance, Occupational Exposure, Confidence Intervals, Humans, Occupations, Risk factor, Pregnancy, health risk, MESH: Humans, MESH: Occupations, business.industry, Public health, working conditions, MESH : Humans, Infant, Newborn, Public Health, Environmental and Occupational Health, MESH : Occupations, medicine.disease, MESH: Pregnancy Outcome, [SDV.MHEP.GEO] Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, MESH : Pregnancy, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Case-Control Studies, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Europe, business, MESH: Female, Demography
Abstract

Study objective: To analyse the relation between preterm birth and working conditions in Europe using common measures of exposure and to test whether employment related risks varied by country of residence. Design: A case-control study in which cases included all consecutive singleton preterm births and controls included one of every ten singleton term births in each participating maternity unit. Data about working conditions were obtained by interview from women after delivery. Setting: Sixteen European countries. Participants: The analysis included 5145 preterm and 7911 term births of which 2369 preterm and 4098 term births were to women employed during pregnancy. Analyses of working conditions were carried out for women working through at least the third month of pregnancy. Main results: Employed women did not have an excess risk of preterm birth. Among working women, a moderate excess risk was observed for women working more than 42 hours a week (OR = 1.33, CI = 1.1 to 1.6), standing more than six hours a day (OR = 1.26, CI = 1.1 to 1.5), and for women with low job satisfaction (OR = 1.27, CI = 1.1 to 1.5). There were stronger links in countries with a lower overall level of perinatal health and a common practice of long prenatal leaves. Conclusion: These findings show that specific working conditions affect the risk of preterm birth. They also suggest employment related risks could be mediated by the social and legislative context.

Published
2004

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