The annual meeting of the Society of Maternal-Fetal Medicine was held from Feb. 6 to 11 in Dallas and attracted approximately 2,000 participants from around the world, including obstetricians/gynecologists and other clinical practitioners who specialize in maternal-fetal medicine. The conference highlighted recent advances in maternal-fetal medicine, with presentations and abstracts focusing on reducing high-risk pregnancy complications through pregnancy assessment and management.
In the first prospective and blinded study of massively parallel sequencing for all chromosomal abnormalities using maternal plasma DNA, Diana Bianchi, M.D., of the Tufts University School of Medicine in Boston, and colleagues evaluated the performance of a test for fetal chromosomal abnormalities Trisomy 21, 18, and 13, and monosomy X.
"We found that the test provided excellent specificity and sensitivity. The test provided 100 percent specificity, no false positives, and 100 percent sensitivity for Down's syndrome. We found that the sensitivity was nearly 100 percent (97.2 percent) for Trisomy 18, and 78.6 percent for Trisomy 13, which is better than current standard screening capabilities using serum screening and first trimester ultrasound. The study also detected 15 of 16 cases of Turner Syndrome, which is caused by the presence of a single X chromosome," Bianchi said. "This study was completed in high-risk women who were at risk for undergoing an invasive procedure. Further studies need to be done in lower-risk women."
In another study, Egle Bytautiene, M.D., Ph.D., of the University of Texas in Galveston, and colleagues found that giving pioglitazone therapy to mice offspring of obese mothers improved the metabolic status of these offspring.
"We evaluated mice offspring of obese mothers. We evaluated whether giving these mice offspring pioglitazone therapy prior to the onset of disease would prevent the onset of diabetes and other metabolic conditions later in life," Bytautiene said. "We found that the metabolic stats of these offspring improved. These mice experienced less weight gain and had lower fasting glucose levels. However, the limitation of this study was that it was performed only over a two-week period. Future studies will need to evaluate the efficacy of giving pioglitazone for a longer period of time and to follow-up after drug discontinuation to assess whether the effect of the drug holds."
Jen Jen Chang, Ph.D., of the Saint Louis University School of Public Health, and colleagues found that spontaneous preterm delivery in a first pregnancy may be associated with increased risk of small-for-gestational-age births in a full-term second pregnancy.
"Compared to a first full-term pregnancy, women who delivered their first pregnancy at ≤28 weeks, 29 to 32 weeks, and 33 to 36 weeks of gestation had increased risk of small-for-gestational-age birth in second term pregnancy by 68, 118, and 83 percent, respectively, after controlling for maternal age, smoking during pregnancy, Medicaid use, maternal pre-pregnancy body mass index, and inter-pregnancy interval. We observed similar findings with severe small-for-gestational-age birth outcome," Chang said. "If these findings are confirmed by future research, increased surveillance may be considered to monitor fetal growth in the second pregnancy among women with a prior history of preterm birth."
Radek Bukowski, Ph.D., R.N., of the University of Texas in Galveston, and colleagues found that patients who reside in the United States for longer periods of time were at a higher risk of preterm birth.
"We mainly evaluated Hispanic women and found that those who resided in the United States for less than 10 years had a 3.5 percent risk of preterm birth. Women who resided in the United States for 10 or more years had a 7 percent risk, while those born in the United States had a 10 percent risk of preterm birth. These data are part of the National Health and Nutrition Examination Survey, which represents the entire U.S. population," Bukowski said.
The investigators also evaluated other risk factors to determine if they were the cause for preterm birth, including socioeconomic status, reproductive history, sexual behavior, nutrition, and overall health. They found that those factors did not explain the differences seen in preterm birth rates.
"However, because the risk of preterm birth was acquired during residence in the United States, it is likely due to modifiable risk factors," Bukowski said. "Future studies will focus on identifying those potentially modifiable risk factors."
SMFM: Maternal Benefits, Fetal Risks of Home Births Identified
FRIDAY, Feb. 10 (HealthDay News) -- For women who have or intend to have births outside of a hospital, the risk of cesarean delivery is significantly lower, but there is an increased risk of lower five-minute Apgar score and neonatal seizures compared with hospital births, according to a study presented at the annual meeting of the Society for Maternal-Fetal Medicine, held from Feb. 6 to 11 in Dallas.
SMFM: Cesarean Not More Protective for Small Preemies
FRIDAY, Feb. 10 (HealthDay News) -- For preterm, small-for-gestational-age (SGA) neonates, cesarean delivery (CD) does not decrease neonatal complications, and is associated with an increased likelihood of respiratory distress syndrome (RDS), according to a study presented at the annual meeting of the Society for Maternal-Fetal Medicine, held from Feb. 6 to 11 in Dallas.
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