Background: Pseudoxanthoma elasticum(PXE) is a genetic multisystem disorder characterized by calcified dystrophic elastic fibres in skin, retina and arteries. Much of the earlier literature on pregnancy in PXE contain...Background: Pseudoxanthoma elasticum(PXE) is a genetic multisystem disorder characterized by calcified dystrophic elastic fibres in skin, retina and arteries. Much of the earlier literature on pregnancy in PXE contained reports of severe complications, leading some healthcare providers to advise women with PXE against becoming pregnant and some women with PXE to avoid pregnancy. Objectives: To evaluate the obstetrical outcomes and the incidence of pregnancy complications in women with PXE and to determine if pregnancy is associated with an adverse effect on the course of the disease. Methods: Women with PXE (n=407) answered detailed questionnaires regarding reproductive history and pregnancy as well as the course of their disease. The frequency of reported pregnancy outcomes and complications was determined. Severity indices for the major clinical manifestations of PXE were developed and correlated with gravidity of affected women aged 40 years or over. Results: Among the 306 respondents with PXE who had ever been pregnant, there were 795 pregnancies. Of these, 83%ended in live births and 1%in stillbirth. The median birth weight was within the normal range and the incidence of low birth weight for gestation was low. Hypertension occurred in 10%of pregnancies, gastric bleeding and retinal complications in < 1%, and 12%of pregnancies were associated with worsening of skin manifestations. There was no effect of gravidity and clinical severity on cutaneous (P=0.07), ocular (P=0.59) or cardiac (P=0.42) manifestations of PXE in women aged 40+years, nor did ever having been pregnant adversely affect these clinical severity indices. Of the 101 women who had never been pregnant, 17%made the decision because they were advised against becoming pregnant by a healthcare professional and 11%did not become pregnant because they feared an adverse outcome either in their pregnancy or disease. Conclusions: PXE is not associated with markedly increased fetal loss or adverse reproductive outcomes. The incidence of gastric bleeding, 展开更多
This retrospective study examined the association of endometrial pattern and pregnancy after a day 5 ET. The pregnancy rate of women with a triple- line ultrasound endometrial pattern on the day of hCG administration ...This retrospective study examined the association of endometrial pattern and pregnancy after a day 5 ET. The pregnancy rate of women with a triple- line ultrasound endometrial pattern on the day of hCG administration was significantly higher than the pregnancy rate of women with the other ultrasound patterns. This observation suggests that, in a subset of patients, a suboptimal endometrial lining may interfere with assisted reproductive technology success.展开更多
Objective: To conduct a population-based assessment of associations of intimate partner violence in the year prior to and during pregnancy with maternal and neonatal morbidity. Study design: Data from women giving bir...Objective: To conduct a population-based assessment of associations of intimate partner violence in the year prior to and during pregnancy with maternal and neonatal morbidity. Study design: Data from women giving birth in 26 U.S. states and participating in the 2000 to 2003 Pregnancy Risk Assessment Monitoring System(n=118,579) were analyzed. Results: Women reporting intimate partner violence in the year prior to pregnancy were at increased risk for high blood pressure or edema(adjusted odds ratio 1.37-1.40), vaginal bleeding(adjusted odds ratio 1.54-1.66), severe nausea, vomiting or dehydration(adjusted odds ratio 1.48-1.63), kidney infection or urinary tract infection(adjusted odds ratio 1.43-1.55), hospital visits related to such morbidity(adjusted odds ratio 1.45-1.48), and delivery preterm(adjusted odds ratio 1.37), of a low-birthweight infant(adjusted odds ratio 1.17), and an infant requiring intensive care unit care(adjusted odds ratio 1.31-1.33) compared with those not reporting intimate partner violence. Women reporting intimate partner violence during but not prior to pregnancy experienced higher rates of a subset of these concerns. Conclusion: Women experiencing intimate partner violence both prior to and during pregnancy are at risk for multiple poor maternal and infant health outcomes, suggesting prenatal risks to children from mothers’abusive partners.展开更多
Background: To date there is only a limited number of study data on the changes in the perceived quality of sexuality and relationships of women that occur with pregnancy and childbirth. Apart from prevalence issues p...Background: To date there is only a limited number of study data on the changes in the perceived quality of sexuality and relationships of women that occur with pregnancy and childbirth. Apart from prevalence issues predictors for those changes are important. These questions were addressed with this epidemiological follow-up study. Methods: The study sample consisted of 236 women who gave birth to a child between November 2000 and May 2001 at Bonn University Hospital in Germany. A first visit took place at the hospital a few days after childbirth. Data included sociodemographic data, medical and gynecological data as well as personality traits using the NEO-FFI. A second visit took place 6.6 ±0.8 months after childbirth. It included the BSPS (Bonn Scale for Post-Partum Sexuality) and psychiatric symptoms using the SCL-90-R. Results: Approximately six months after childbirth 40.6%of women perceived a diminished quality of sexual life compared to the time before pregnancy. 23.2%indicated a diminished relationship quality. The potentially relevant co-variables regarding the changes in sexual quality were age, breast feeding, fertilization, use of contraceptives and presence of psychiatric symptoms. With the changes in relationship quality there were correlations with marital status, conscientiousness, and psychiatric symptom load. Discussion: The majority of women six months after childbirth did not return to a perceived sexual life comparable to the time before pregnancy. In addition to the high presence of symptoms of sexual dysfunction, the high psychosocial pressure is of special importance. Therefore the information of patients about the potential development of sexuality after childbirth and an integrative approach by the gynecologist seem important. Particularly the correlation between psychiatric symptom load and their predictive potential regarding satisfaction with sexuality should be accounted for in further epidemiological research.展开更多
文摘Background: Pseudoxanthoma elasticum(PXE) is a genetic multisystem disorder characterized by calcified dystrophic elastic fibres in skin, retina and arteries. Much of the earlier literature on pregnancy in PXE contained reports of severe complications, leading some healthcare providers to advise women with PXE against becoming pregnant and some women with PXE to avoid pregnancy. Objectives: To evaluate the obstetrical outcomes and the incidence of pregnancy complications in women with PXE and to determine if pregnancy is associated with an adverse effect on the course of the disease. Methods: Women with PXE (n=407) answered detailed questionnaires regarding reproductive history and pregnancy as well as the course of their disease. The frequency of reported pregnancy outcomes and complications was determined. Severity indices for the major clinical manifestations of PXE were developed and correlated with gravidity of affected women aged 40 years or over. Results: Among the 306 respondents with PXE who had ever been pregnant, there were 795 pregnancies. Of these, 83%ended in live births and 1%in stillbirth. The median birth weight was within the normal range and the incidence of low birth weight for gestation was low. Hypertension occurred in 10%of pregnancies, gastric bleeding and retinal complications in < 1%, and 12%of pregnancies were associated with worsening of skin manifestations. There was no effect of gravidity and clinical severity on cutaneous (P=0.07), ocular (P=0.59) or cardiac (P=0.42) manifestations of PXE in women aged 40+years, nor did ever having been pregnant adversely affect these clinical severity indices. Of the 101 women who had never been pregnant, 17%made the decision because they were advised against becoming pregnant by a healthcare professional and 11%did not become pregnant because they feared an adverse outcome either in their pregnancy or disease. Conclusions: PXE is not associated with markedly increased fetal loss or adverse reproductive outcomes. The incidence of gastric bleeding,
文摘This retrospective study examined the association of endometrial pattern and pregnancy after a day 5 ET. The pregnancy rate of women with a triple- line ultrasound endometrial pattern on the day of hCG administration was significantly higher than the pregnancy rate of women with the other ultrasound patterns. This observation suggests that, in a subset of patients, a suboptimal endometrial lining may interfere with assisted reproductive technology success.
文摘Objective: To conduct a population-based assessment of associations of intimate partner violence in the year prior to and during pregnancy with maternal and neonatal morbidity. Study design: Data from women giving birth in 26 U.S. states and participating in the 2000 to 2003 Pregnancy Risk Assessment Monitoring System(n=118,579) were analyzed. Results: Women reporting intimate partner violence in the year prior to pregnancy were at increased risk for high blood pressure or edema(adjusted odds ratio 1.37-1.40), vaginal bleeding(adjusted odds ratio 1.54-1.66), severe nausea, vomiting or dehydration(adjusted odds ratio 1.48-1.63), kidney infection or urinary tract infection(adjusted odds ratio 1.43-1.55), hospital visits related to such morbidity(adjusted odds ratio 1.45-1.48), and delivery preterm(adjusted odds ratio 1.37), of a low-birthweight infant(adjusted odds ratio 1.17), and an infant requiring intensive care unit care(adjusted odds ratio 1.31-1.33) compared with those not reporting intimate partner violence. Women reporting intimate partner violence during but not prior to pregnancy experienced higher rates of a subset of these concerns. Conclusion: Women experiencing intimate partner violence both prior to and during pregnancy are at risk for multiple poor maternal and infant health outcomes, suggesting prenatal risks to children from mothers’abusive partners.
文摘Background: To date there is only a limited number of study data on the changes in the perceived quality of sexuality and relationships of women that occur with pregnancy and childbirth. Apart from prevalence issues predictors for those changes are important. These questions were addressed with this epidemiological follow-up study. Methods: The study sample consisted of 236 women who gave birth to a child between November 2000 and May 2001 at Bonn University Hospital in Germany. A first visit took place at the hospital a few days after childbirth. Data included sociodemographic data, medical and gynecological data as well as personality traits using the NEO-FFI. A second visit took place 6.6 ±0.8 months after childbirth. It included the BSPS (Bonn Scale for Post-Partum Sexuality) and psychiatric symptoms using the SCL-90-R. Results: Approximately six months after childbirth 40.6%of women perceived a diminished quality of sexual life compared to the time before pregnancy. 23.2%indicated a diminished relationship quality. The potentially relevant co-variables regarding the changes in sexual quality were age, breast feeding, fertilization, use of contraceptives and presence of psychiatric symptoms. With the changes in relationship quality there were correlations with marital status, conscientiousness, and psychiatric symptom load. Discussion: The majority of women six months after childbirth did not return to a perceived sexual life comparable to the time before pregnancy. In addition to the high presence of symptoms of sexual dysfunction, the high psychosocial pressure is of special importance. Therefore the information of patients about the potential development of sexuality after childbirth and an integrative approach by the gynecologist seem important. Particularly the correlation between psychiatric symptom load and their predictive potential regarding satisfaction with sexuality should be accounted for in further epidemiological research.
