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

Universal urine testing for cocaine, amphetamines, and opiates was performed on 1643 women admitted to an obstetric service for a 1-year period with 20.5% having positive results. There were 299 patients with positive toxicology results matched for race and discharge date with patients having negative toxicology and drug history. Significant differences in age, prior obstetric history, prenatal care, alcohol history, and smoking were noted between groups. There was a significant decrease in birth weight, head circumference, length, and gestational age for the drug-positive group, which was most marked in cocaine and multiple drug users. These differences persisted after we controlled for smoking, prenatal care, and prior preterm births. Differences in birth weight and head circumference remained after we controlled for gestational age. Rates of congenital anomalies and abruptio placental were similar between groups. Perinatal substance abuse is independently associated with growth retardation and prematurity. Multiple risk factors are frequently present, necessitating a comprehensive approach to prenatal care.
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PMID:The perinatal impact of cocaine, amphetamine, and opiate use detected by universal intrapartum screening. 224 Jan 3

Substance abuse in pregnancy places both mother and infant at extremely high risk. There is little information, however, about the impact of changing patterns of drug use and improvements in medical technology on pregnancy outcome. The Family Center Program utilizes a team approach to provide counseling, support, and education as well as complete medical care for substance-abusing pregnant women. We reviewed the records of women seen in the Family Center Program from 1981 to 1983 to evaluate the effect of intervention on pregnancy outcome. Complications, including prematurity, growth retardation, intrauterine fetal demise, and neonatal abstinence, were common, although early prenatal care and frequent visits appear to reduce the risk of low birth weight infants. Uncorrected perinatal mortality was 11/163 (67/1,000). Compared to earlier experience in this program, few women delivered with no prenatal care. Thus a program designed specifically for the needs of these women is successful in increasing the number seeking prenatal care and appears to improve pregnancy outcome. Despite this, serious problems are common and further improvement seems unlikely unless such women can be maintained in a stable, drug-free environment during their pregnancies.
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PMID:Pregnancy in a drug-abusing population. 350 67

A previous report has suggested an increased incidence of chorioamnionitis in the placentae of sudden infant death syndrome (SIDS) victims. To further evaluate placental pathology in SIDS, 27 cases were identified from coroner's records and matched to two control groups. Both control groups were matched for birthweight, gestational age, and season, with the second also matched for maternal race, infant sex, blood type B, and maternal parity. No significant increase in chorioamnionitis or other placental abnormalities were found in SIDS victims when controlling for prematurity, which is a factor related to chorioamnionitis. An increased incidence of vaginal bleeding (P less than 0.04) and possibly substance abuse or anemia at delivery was found in SIDS mothers. There were more premature and black infants found in the SIDS group compared with the general birth population, and also lower five-minute Apgar scores (P less than 0.02) compared to matched controls. Analysis of the second control group match, including infant Apgar scores, maternal hematocrit, maternal age, and complications of pregnancy and delivery, did not influence any of our conclusions. The data suggests that matching for prematurity may be important in identifying the strength of additional risk factors for SIDS, since the risk factors for SIDS and premature delivery are similar.
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PMID:Placental pathology is not predictive for sudden infant death syndrome (SIDS). 365 Nov 89

We report six cases of chronic intervillositis, an infrequently recognized placental lesion that is characterized by a prominent mononuclear inflammatory cell infiltrate in the intervillous space and that is associated with poor fetal outcome. In all six placentas, the inflammatory infiltrate was essentially limited to the intervillous space: chronic villitis was present focally only in one and absent in the other five. Additional placental histopathologic findings included increased villous fibrinoid material in all six, infarcts in two, atherosis in decidual vessels in two, and acute chorioamnionitis in two. Results of immunohistochemical staining confirmed the predominantly histiocytic nature of the intervillous infiltrate. Two mothers had a history of severe preeclampsia, one had elevated blood pressure at the time of delivery, two had a history of substance abuse, two had a history of systemic lupus erythematosus treated with prednisone, and one of these last two also had diabetes. Five of the six pregnancies resulted in perinatal death. One fetus was nonviable, one was anencephalic, one died in utero, and two died of complications of prematurity shortly after birth; one of the premature infants was small for gestational age. The mononuclear nature of the inflammatory cell infiltrate and its association with increased villous fibrinoid material and atherosis suggests an immunological origin, although the possibility that this lesion may have an infectious cause cannot be excluded.
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PMID:Chronic intervillositis of the placenta. 821 26

Children of substance abuse mothers have an increased risk of severe pathological disorders such as perinatal diseases (prematurity, intrauterine growth retardation, infections) with their neurological and respiratory complications and sequelae, and transmission of drug addiction related infections, ie human immunodeficiency virus, hepatitis B and C virus, syphilis. Many of these children present a drug withdrawal syndrome characterized by restlessness and jetteriness during the neonatal period. This is frequently followed by a post withdrawal period of several weeks duration with crying, excitement, sleep and feeding difficulties. Although these drug withdrawal manifestations have no incidence on the vital prognosis, it severely impairs the mother-infant interaction. Despite these disorders it appears that the outcome of these children is mainly related to their familial environment which is exposed to many risk factors: mother-child separation, violence, delinquency, precariousness, unhealthy housing, prostitution, drug dependency, parental death or imprisonment... Early medico-psycho-social intervention starting during pregnancy and a prolonged support for several years are the only way to improve their spontaneously poor outcome.
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PMID:[Management of drug addict pregnant women and their children]. 918 Oct 22

This study presents the findings of 54 infants sent home on event recording apnea/heart rate monitors over a seven month period. The average gestational age was 35 weeks. The number of referring facilities was 13 hospitals and the number of referring physicians was 41. We separated the admitting diagnostic groups into the following categories: Apnea of prematurity, apnea of infancy, apparent life threatening event, subsequent SIDS sibling, gastroesophogeal reflux, maternal substance abuse, seizure disorders, respiratory distress syndrome, bradycardia of unknown origin, bronchopulmonary dysplasia, and Pierre Robin syndrome. From March 1990 to October 1990, a period of seven months, these children were placed in our services on event recording home apnea/heart rate monitors. The average time on service for these patients was 2.90 months, (p less than .07). This data indicates that event recording home apnea/heart rate monitoring greatly decreases the length of home monitoring.
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PMID:The effect of event recording home infant apnea/heart rate monitoring in the greater Los Angeles area. 1014 2

Adolescent pregnancy is associated with adverse maternal and fetal effects. Potential risk factors involve early dating behavior, early initiation of smoking, alcohol and substance abuse, low academic interest, single-parent families and, above all, poverty. Girls younger than 18 years and not legally majors are psychologically and socially underdeveloped, presenting higher obstetrical risks. Maternal complications due to adolescent pregnancy include, among others: anemia; pregnancy induced hypertension; sexually transmitted diseases; and premature labor and delivery. The most common complications concerning the infant are related to: low birth weight, due either to prematurity or intrauterine growth restriction; infection; chemical dependence (due to maternal substance abuse); sudden infant death syndrome; and increased morbidity and mortality during the 1st year of age. In addition, education of teenage mothers on the importance of pre-and postnatal care can reduce the poor perinatal outcome of both mother and infant.
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PMID:Adolescent pregnancy and perinatal outcome. 1664 54

Worldwide, approximately 15 million babies (1 in 10) are born prematurely each year. Prematurity is the leading cause of death among newborns, accounting for 1 million deaths per year, and, after pneumonia, is the second leading cause of death in children under age 5 years. Newborns who do survive preterm delivery (PTD) struggle with visual, auditory, and learning disabilities. In order to reach the fourth Millennium Development Goal (MDG-4) of reducing the mortality rate in children under age 5 years by two-thirds between 1990 and 2015, there must be significantly fewer PTDs. In high-income nations, 50% of babies born at 24 weeks survive, whereas in low-resource nations, this survival rate is not achieved until 32 weeks of gestation. Over 90% of babies born in low-resource settings before 28 weeks die in the first few days of life (< 10% die in high-income nations), a 10:90 survival gap. Over 60% of PTDs worldwide occur in Sub-Saharan Africa and South Asia. Risk factors for PTD include adolescent pregnancy, short interval between births, poor prepregnancy weight (very low or high body mass index), chronic diseases (diabetes and hypertension), infectious disease, substance abuse, cervical incompetence, and poor psychological health. Thus, a commitment to improving maternal health and the quality of prenatal care is necessary to achieve the MDG-4.
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PMID:Premature delivery and the millennium development goal. 2286 89

Substance abuse during pregnancy is an important public health issue affecting the mother and the growing infant. Preterm labor, miscarriage, abruption and postpartum hemorrhage are obstetric complications which have been associated with women who are dependent on abused substances. Moreover, women are also at an increased risk of medical problems such as poor nutrition, anemia, urinary tract infections as well as sexually transmitted infections, hepatitis, HIV and problems related to infection. Intrauterine growth restriction, prematurity, stillbirth, neonatal abstinence syndrome, and Sudden Infant Death Syndrome represent only some of fetal effects. Later on, during childhood, it has been shown that in utero exposure to substances of abuse is associated with increased rates of respiratory infections, asthma, ear and sinus infections. Moreover, these children are more irritable, have difficulty focusing their attention, and have more behavioral problems. Therefore, the assessment of in utero exposure to abused substance is extremely necessary and is relevant for the care of the mother and the offspring. In this sense, several approaches are possible; however, recently the evaluation of in utero exposure to abused drugs has been achieved by testing biological specimens coming from fetus or newborn, pregnant or nursing mother, or from both the fetus and the mother. Maternal and neonatal biological materials reflect exposure in a specific time period and each of them has different advantages and disadvantages in terms of accuracy, time window of exposure and cost/benefit ratio. The methodology for identification and determination of abused substances in biological materials are of great importance. Consequently, sensitive and specific bioanalytical methods are necessary to accurately measure biomarkers. Different immunoassays methods are used as screening methods for drug testing in the above reported specimens, however, the results from immunoassays should be carefully interpreted and confirmed by a more specific and sensitive chromatographic methods such as GC-MS or LC-MS. The interest in the development and optimization of analytical techniques to detect abused substances in different specimens is explained by the several possibilities and information that they can provide.
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PMID:Prenatal exposure to substance of abuse: a worldwide problem. 2345 10

Prenatal and postnatal period presents the highest prevalence of mental disorders in women's lives and depression is the most frequent one, affecting approximately one in every five mothers. The aggravating factor here is that during this period psychiatric symptoms affect not only women's health and well-being but may also interfere in the infant's intra and extra-uterine development. Although the causes of the relationship between maternal mental disorders and possible risks to a child's health and development remain unknown, it is suspected that these risks may be related to the use of psychotropic drugs during pregnancy, to substance abuse and the mother's lifestyle. Moreover, after delivery, maternal mental disorders may also impair the ties of affection (bonding) with the newborn and the maternal capacity of caring in the post-partum period thus increasing the risk for infant infection and malnutrition, impaired child growth that is expressed in low weight and height for age, and even behavioral problems and vulnerability to presenting mental disorders in adulthood. Generally speaking, research on this theme can be divided into the type of mental disorder analyzed: studies that research minor mental disorders during pregnancy such as depression and anxiety find an association between these maternal disorders and obstetric complications such as prematurity and low birth weight, whereas studies that evaluate severe maternal mental disorders such as schizophrenia and bipolar disorder have found not only an association with general obstetric complications as well as with congenital malformations and perinatal mortality. Therefore, the success of infant growth care programs also depends on the mother's mental well being. Such findings have led to the need for new public policies in the field of maternal-infant care geared toward the population of mothers. However, more research is necessary so as to confirm the association between all factors with greater scientific rigor.
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PMID:Maternal mental disorders in pregnancy and the puerperium and risks to infant health. 2525 63


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