The annual meeting of the Society of Maternal-Fetal Medicine was held from Feb. 2 to 7 in San Diego and attracted more than 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 one study, Eyal Sheiner, M.D., of the University of Negev in Beer-Sheva, Israel, and colleagues found that maternal low birth weight and preeclampsia are both independent risk factors for recurrence in the next generation.
“Maternal low birth weight increased the risk by 70 percent for low birth weight in her offspring. Maternal preeclampsia was found to be an independent risk factor for preeclampsia during the pregnancy of her offspring,” Sheiner said. “Pregnant women with maternal family history of low birth weight or preeclampsia should be informed regarding these outcomes, and should be monitored more closely.”
In another study, Bardett Fausett, M.D., of Women’s and Children’s Hospital in Lafayette, La., and colleagues found that precise measurement of fetal head movement relative to the maternal pelvis and real-time auditory and visual feedback to the mother about that position shortens pushing time in nulliparous women receiving epidural anesthesia.
“More importantly, this feedback and measurement system reduces composite perinatal adverse outcomes and the likelihood of operative vaginal deliveries, severe perineal trauma, and neonatal intensive care unit admissions specifically,” Fausett said. “We also found that the majority of patients were highly satisfied with the feedback device. They strongly agreed that the feedback gave them a better sense of control during labor. Ninety percent would recommend to friends and family.”
Joseph R. Biggio Jr., M.D., of the University of Alabama at Birmingham, and colleagues evaluated the occurrence and location of copy number variants in mothers and their infants and compared these in term and spontaneous preterm (<34 weeks) births.
“When we looked at the mothers, we did not find any link between any of these changes and preterm birth. In contrast, when we looked at the infants we found a number of different changes that were associated with preterm birth,” Biggio said. “While these findings do not have immediate implications for clinical care, given the persistent problem of preterm birth worldwide, they present a new avenue to explore for research that can enhance our understanding of the things that cause preterm birth, as well as identify potential treatment targets someday down the road.”
Erin A.S. Clark, M.D., of the University of Utah School of Medicine in Salt Lake City, and colleagues evaluated a large group of Utah births that occurred between 1998 and 2006. Using data from birth certificates and from a registry of autism cases in Utah (Utah Registry of Autism and Developmental Disabilities), the investigators compared 2,547 children with autism spectrum disorder (ASD) to 166,283 children without ASD.
“Children exposed to induction/augmentation during labor did not have an increased risk of ASD after adjusting for important factors such as socioeconomic status, maternal health, pregnancy-related events and conditions, and year of birth. The results were the same for girls and boys,” Clark said. “This study reassures both patients and physicians that induction and augmentation of labor do not appear to be associated with increased risk of autism in children.”
Madeline Rice, Ph.D., of George Washington University in Washington, D.C., and colleagues found that women with pregnancy-associated hypertension were two to three times more likely to develop hypertension, and women with pregnancy-associated hypertension who delivered preterm were almost two times more likely to be subsequently classified with metabolic syndrome.
“The addition to the growing body of evidence that our study provides is that women were enrolled during pregnancy with prospective follow-up and the data were collected in a rigorous and standardized research setting, rather than relying on vital statistics and administrative data sets. Data collection also included collection of other important factors (potential confounders) which were adjusted for in the analysis,” Rice said. “This study provides additional support for the concept of pregnancy as a window to future health and the need for physicians to continue to monitor and counsel patients with conditions such as preeclampsia and gestational hypertension, especially if its onset was early or if the woman also delivered preterm.”
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