Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0728731 (prematurity)
 7,134 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This is an updated review of the literature on the risks of impaired future fertility due to induced abortion, emphasizing large studies on pregnancy termination by vacuum aspiration in the 1st trimester. Anecdotal reports have implicated abortion in causing sterility, menstrual disorders, psychiatric sequelae, and increased premature births, tubal pregnancies, stillbirths, birth defects and spontaneous abortions. Except when an infection complicates induced abortion, there is no evidence of an association of abortion with secondary infertility or ectopic pregnancy. The risk of midtrimester spontaneous abortion, premature delivery and low birthweight is not higher in the subsequent 1st term pregnancy. Studies using women in their 2nd pregnancy as controls, rather than controls in their 1st term pregnancy, however, report a slight but not significant increase in risk of prematurity or low birthweight. The 1st pregnancy is known to have an inherent higher risk of low birthweight. Induced abortion by dilatation and evacuation may confer a higher risk of subsequent premature delivery and low birthweight. Very little information is available comparing the various types of instillation abortions and numbers of repeat abortions on future reproduction. No added risks have been found for many conditions such as placenta previa, mental illness, pre-eclampsia, disproportion, hemorrhage, trauma, operative delivery or fetal distress. Anemia of pregnancy has been found to occur less often after abortion while urinary tract infections are significantly increased.
 ...
PMID:The effect of pregnancy termination on future reproduction. 222 7

Sexually transmitted diseases (STDs) are now the most common group of identifiable infectious diseases in many countries, especially among those ages 15-50 and in infants. Their control is important considering the high incidence of acute infections, complications and sequelae, their socioeconomic impact, and their role in increasing transmission of the human immunodeficiency virus (HIV). THe worldwide incidence of major bacterial and viral STDs is estimated to be over 125 million cases yearly. STDs are hyperendemic in many developing countries. However, in industrialized countries, the bacterial STDs such as syphilis, gonorrhea, chancroid declined from their peak during WW II until the late 1950s, increased during the 1960s and early 1970s, and have again decreased since that time. In the industrialized world, diseases due to Chlamydia trachomatis, genital herpes virus, human papillomaviruses, and HIV are now more significant than the classical bacterial ones; both groups remain major health problems in most developing countries. Infection rates are similar in both men and women, but women and infants bear the major burden of complications and serious sequelae. Infertility and ectopic pregnancy are often a result of pelvic inflammatory disease and are preventable. STDs in pregnant women can result in prematurity, stillbirth, and neonatal infections. In many areas, 1-5% of newborns are at risk of gonococcal ophthalmia neonatorum, a disease that blinds and congenital syphilis causes up to 25% of perinatal mortality. Genital and anal cancers (especially cervical cancer) are associated with viral STDs (genital human papillomavirus and herpes virus infections). Urethral stricture and infertility are frequent sequelae in men. (author's modified)
 ...
PMID:Epidemiology of sexually transmitted diseases: the global picture. 228

The obstetric outcome of 1328 deliveries in a tertiary level hospital was examined, focusing on the results of the women over 35. The study group were all pregnant women over 20 primarily cared for and delivered at the New York Hospital-Cornell Medical Center from September 1984- February 1985, excluding those transferred from other institutions for complications. Among the older women, there was a higher incidence of previous abdominal operations, cesarean sections, previous perinatal death, infertility and alcohol abuse, but relatively few had comorbid conditions or obesity. Most were of higher socioeconomic status and had private physicians. The older group tended to begin prenatal care early, and elect to have amniocentesis. They had a higher risk of gestational glucose intolerance, hypertension and hospitalization during this pregnancy. 45% had cesarean delivery, and their hospital stays were longer. Their rates of vertex presentation, prematurity, postmaturity, macrosomia, induced or augmented labor were similar to those of younger women. There were no maternal deaths. The older group had 1 multiple birth, fewer than the younger women. Perinatal mortality was lowest in the older women. There was 1 intrauterine death and 1 congenital anomaly, lower rates than seen in younger women. This series demonstrates that women over 35 are not at greater risk of adverse pregnancy outcomes if they are cared for early and carefully.
 ...
PMID:Impact of advanced maternal age on the outcome of pregnancy. 238 14

Fertility and childbearing rarely occur in Cushing's syndrome because amenorrhea, oligomenorrhea, infertility, and abortions characterize the disease. Currently, a total of 53 cases of Cushing's syndrome and pregnancy have been reported. When Cushing's syndrome occurs during pregnancy, approximately 56 per cent of the cases are associated with adrenal cortical adenoma or carcinoma. Excluding Cushing's disease, nearly 21 percent of the cases are caused by adrenal carcinoma. The maternal catabolic state of glucocorticoid excess contributes to poor fetal outcome with many of the cases complicated by either fetal wastage or prematurity. However, congenital malformations are not seen more frequently than in normal pregnancy. Pregnancy may or may not influence Cushing's syndrome, but Cushing's syndrome definitely complicates pregnancy.
 ...
PMID:Cushing's syndrome in pregnancy. 240 12

Advances in medical science have improved the prospects for pregnant women to deliver safely and for childless women to become pregnant. However, the picture is not as positive as it may seem. The liability crisis that is driving many obstetricians out of practice is likely to persist, limiting women's access to obstetric care. Reliance on cesarean delivery has risen to unacceptable levels, in part as a result of excessive use of electronic fetal monitoring. Pregnancy complications, prematurity and perinatal morbidity and mortality continue to be serious problems. U.S. perinatal mortality data do not compare favorably with those of many other developed nations, and the rate of prematurity will probably exceed that 1990 target of five percent set by the U.S. government. Prematurity and pregnancy complications are rooted in the associated social factors of poverty, welfare dependence and limited education, and they will not be eliminated until those problems are eased. There also is little hope that obstetric outcomes can be improved without reducing the extent of smoking, drug use and alcohol consumption during pregnancy. Infertility also can be caused or worsened by social factors that defy easy resolution. For the next 20 years, dealing with these societal problems should be a top priority.
 ...
PMID:Giving birth in America, 1988. 306 72

This article reviews currently available epidemiologic and experimental data on the effects of cigarette smoking on reproductive health. Specifically addressed are the evidence for and possible physiologic causes of disturbance in 3 areas: female fertility, male fertility, and the effect of smoking on reproduction and pregnancy. Approximately 30% of women and 36% of men of reproductive age in the US are smokers. The literature offers clear support for an association between smoking and decreased female fecundity and fertility, especially with a relationship to primary tubal infertility. Cigarette smoke appears to have adverse effects along a continuum of preimplantation and implantation reproductive processes, including gamete production and function, ovulation and cyclicity, fertilization, early embryonic cleavage, embryo transport, and implantation. In men, there is clear evidence that smoking results in fewer and less motile sperm as well as a lower proportion of normally shaped sperm; however, it remains unclear whether this impairment in spermatogenesis results in clinical impairment of fertility. Studies have demonstrated a significant increase among smoker both in the risk of spontaneously aborting a chromosomally normal fetus and in the risk of spontaneously aborting a chromosomally normal fetus and in the risk of prematurity. Moreover, smoling has been shown to cause a 150-300 gram decrease interm infant birthweight. Al these risks to fecundity and pregnancy outcome are minimized or absent in former smokers. It is stressed that efforts to persuade women to stop smoking have been inadequate. It is particularly imperative for women who have had divviculties conceving or have had a history of miscarraiges to give up cigarette smoking.
 ...
PMID:Smoking and reproduction. 353 Aug 22

The course of the subsequent pregnancy and the maternal and fetal complications were evaluated in 254 couples who were seen in an infertility clinic after primary or multiple spontaneous abortions. The 100 couples who were treated with antibiotics after pregnancy loss showed a significantly better chance of achieving a subsequent pregnancy. The outcome of pregnancy was significantly better in the antibiotic treated group and the rate of spontaneous abortion recurrence was significantly lower (10 versus 38 per cent). The number of maternal complications was significantly less in the treated group--premature rupture of membranes, three (4 per cent) versus 30 (46 per cent), and postpartum fever, three (4 per cent) versus 23 (35 per cent), respectively. The untreated group experienced a significantly lower percentage of vaginal delivery (56 versus 69 per cent) (p less than 0.001). In the antibiotic treated group, there were significantly lower rates of fetal complications, including fetal distress, meconium, respiratory distress syndrome, neonatal infection and hyperbilirubinemia. The mean birth weight of infants in the antibiotic treated group was significantly higher (3,529 versus 3,090 grams; p less than 0.001). Prematurity and postdatism were significantly less frequent in the antibiotic treated group, and the corresponding Apgar scores were significantly better. We, thus, postulate that certain spontaneous abortions may be caused by bacteria present in the genital tract at the time of conception. These bacteria may have an adverse effect on the course of pregnancy and result in increased maternal and fetal complications.
 ...
PMID:Outcome of subsequent pregnancies following antibiotic therapy after primary or multiple spontaneous abortions. 375 Jan 80

This paper provides a comprehensive review of the literature on the epidemiology of sexually transmitted chlamydial infections. Its major sections focus on the following substantive areas: microbiology, serologic classification, infections of men (urethritis, epididymitis, prostatitis), infections of women (endocervicitis, urethritis, salpingitis, endometritis, infertility, ectopic pregnancy), effect of genital chlamydial infections on pregnancy, other diseases (Reiter's syndrome, cervical atypia, gastrointestinal infection, lymphogranuloma venereum), and prevention and control programs. It is conceded that wide gaps remain in our understanding of the epidemiology of these organisms. If the estimate that 20% of salpingitis cases are due to C trachomatis is accepted, then at least 20,000 women/year in the US may be infertile because of chlamydial infection. At present, there is a need to define the prevalence and incidence of chlamydial infection in different populations so that high risk groups can be identified and targeted for prevention programs. Studies must also continue to test the link between maternal chlamydial infection and abortion, prematurity, perinatal mortality, and puerperal maternal infections. Ultimately, the most efficient approach to managing chlamydial infection may be provided by a vaccine.
 ...
PMID:Epidemiology of sexually transmitted Chlamydia trachomatis infections. 635 24

This paper presents the first data available on drinking and reproductive dysfunction from a representative national sample of women. In this stratified household sample of 917 women (weighted n = 2552), dysmenorrhea, heavy menstrual flow, and premenstrual discomfort increased with drinking level and were particularly strongly associated with reported consumption of 6 or more drinks a day at least once a week. Women who consumed 6 or more drinks/day at least 5 times a week had elevated rates of gynecologic surgery other than hysterectomy, but hysterectomy was less common among women averaging 2 oz or more of ethanol/day, with age effects controlled. Lifetime rates of obstetric disorders showed significant elevations at upper levels of drinking (6 or more drinks/day at least 3 times a week for miscarriage or stillbirth and prematurity, and 6 or more drinks/day at least 5 times a week for infertility and birth defects). An unexpected finding was the high rates of menstrual disorders, hysterectomy, miscarriage or stillbirth, and prematurity among temporary abstainers (women reporting alcohol consumption in the past 12 months but not the past 30 days) who had previously drunk only infrequently.
 ...
PMID:Drinking and reproductive dysfunction among women in a 1981 national survey. 639 Dec 55

While the role of cytogenetic study in couples with repeated pregnancy loss is well-established, little information is available for counseling these couples concerning future reproductive outcome. Couples evaluated by chromosome analysis for recurrent abortion between 1972 and 1979 were contacted by phone in 1981. Of those studied cytogenetically, 195 couples (50.1%) could be located, and information concerning outcome of subsequent pregnancies were obtained. Couples (91) with two consecutive pregnancy losses at the time of initial investigation had a 31.3% subsequent abortion rate, but most (68%) had at least one liveborn child. The rate of infertility following evaluation was slightly increased (18.7%), but that of prematurity (11.2%) and congenital anomalies (2.5%) was not. In contrast, couples with greater than or equal to 3 consecutive losses (84) experienced abortion in 45.7% of subsequent pregnancies, and only 54.8% of them eventually had a liveborn child. Again, the rate of infertility was increased (26.2%), but that of prematurity (10%) and congenital defects (3.2%) was not. Nine couples in which one individual was found to have a chromosome abnormality (two inversions and seven translocations) were considered separately. Of these, seven couples had nine liveborn offspring. Amniocentesis was performed in eight cases, with karyotypes showing a balanced translocation identical to that of the parent in 2. All children were phenotypically normal.
 ...
PMID:Subsequent reproductive outcome in couples with repeated pregnancy loss. 666 Feb 50


<< Previous 1 2 3 4 5 6 7 8 Next >>