Stress and anxiety during pregnancy predict perinatal complications over the course of pregnancy and labor as well as premature birth and low infant birth weight. The current study examined whether relaxation training provided to women at the beginning of the 2nd trimester could reduce stress and anxiety and assessed the impact of the intervention on perinatal complications, premature delivery, and infant outcomes at birth. Twenty-six moderately anxious pregnant women between 14 and 20 weeks gestation participated in the treatment study. Women completed a baseline laboratory assessment that involved questionnaires and a psychophysiological assessment. They were randomized to receive either six weeks of relaxation training or a list of tips for reducing stress (control). Women repeated the laboratory tasks post-treatment (Time 2) and again between 34 and 36 weeks gestation (Time 3). The treatment condition did not lead to greater mood change than the control condition at either Time 2 or 3. Several analyses, however, suggest relaxation training has the potential for reducing negative mood and complications over the course of pregnancy. Moderator analyses also revealed the treatment more efficacious for those with greater physiological flexibility.

Increased levels of oestrogen and progesterone during pregnancy may lead to periodontal disease. The anaerobic Gram-negative bacteria called red complex (Porphyromonas gingivalis, Tannerella forsythensis and Treponema denticola) are frequently associated with periodontal disease. Periodontopathogens produce toxins and enzymes which can enter the bloodstream and cross the placenta to harm the foetus. The response of the mother&rsquo / s immune system to infection by these periodontopathogens, brings about the release of inflammatory mediators which may trigger preterm labour or result in low birth-weight infants. The purpose of this study was to examine the prevalence of red complex, using BANA and PCR in subginginval plaque samples from pregnant women. Subgingival plaque samples were obtained from pregnant women between the ages of 17 to 45 years attending a Mitchells Plain ante-natal clinic. Plaque samples were analyzed by the enzymatic BANA-test for detection of the presence of red complex and DNA was extracted and analyzed using 16 rDNA-Polymerase Chain Reaction (PCR).<br /> <br /> Seventy-nine percent of pregnant women showed gingival index scores of &ge / 1 of which 74.24% harboured by at least one of the members of the red complex. P.gingivalis was the most prevalent of the three members of the red complex. Findings of this study confirmed a need for dental preventive measures in pregnant women and microbial monitoring of suspected periodontopathogenes. This could be achieved by joint cooperation between Maternity Obstetric Units (MOU), Dentistry and oral microbiology departments. The results of this study revealed that although PCR is more sensitive than BANA in detecting members of the red complex, BANA showed a better association with the indices used to diagnose periodontal disease.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2006. / Härtill 4 uppsatser.

Thesis (M.P.H.M. (Primary Health Care Management))--Mahidol University, 2004.

Thesis (Ph. D.)--University of Washington, 1996. / Vita. Includes bibliographical references (leaves [91]-100).

Severe maternal morbidity generally refers to the most severe complications of pregnancy and includes: hemorrhage, embolism, acute renal failure, stroke, acute myocardial infarction, and other complications. These complications affect more than 50,000 women in the United States every year, with rates significantly increasing from 1998 to 2011. In an effort to reduce these increasing complication rates, clinicians and researchers have emphasized the need to identify potential modifiable risk factors for severe maternal morbidity, and the need to study the relationships between these risk factors and severe maternal morbidity. The overall goal of this study is to improve the understanding of the increasing rates of severe maternal morbidity. The objective of the first study is to examine the association between prepregnancy BMI and severe maternal morbidity in women residing in Florida who had a live birth during 2007-2014. Additionally, the specific association between prepregnancy BMI and the most common individual conditions that comprise the composite measure of severe maternal morbidity will also be examined. We conducted a population-based retrospective cohort study using Florida’s linked birth certificate and maternal hospital discharge data for the years 2007-2014. The risk of severe maternal morbidity associated with BMI was then estimated by odds ratios (OR) and 95% confidence intervals (CI) derived using generalized estimating equations (GEE) for logistic regression. This final model was rerun separately for the most common conditions that comprise severe maternal morbidity as the outcome measure to assess differences by type of condition. Unadjusted rates of severe maternal morbidity increased with increasing BMI; however, after risk adjustment overweight and obese women had slightly protective odds of severe maternal morbidity when compared with normal weight women. The association between prepregnancy BMI and severe maternal morbidity differs by types of severe maternal morbidity. A protective dose-response relationship was seen for blood transfusion and disseminated intravascular coagulation, with the odds of morbidity decreasing with increasing BMI. The odds of heart failure, adult respiratory distress syndrome, and ventilation all increased with increasing BMI. This study shows that severe maternal morbidity is a complex measure and not just a single condition. In future studies, it will be imperative to analyze severe maternal morbidity as a composite measure and as individual conditions to identify modifiable risk factors to focus on for interventions. The objective of the second study is to identify potential determinants of the increase in the rate of severe maternal morbidity among women residing in Florida who had a live birth during 2005-2014. We examined severe maternal morbidity rates and related risk factors in live births to Florida women between 2005 and 2014, using Florida’s linked birth certificate and hospital discharge data. We initially conducted a Kitagawa analysis to evaluate the components of the increased rate of severe maternal morbidity between 2005 and 2014. Additionally, we performed a multivariable regression analysis to estimate the contribution of the multiple factors to differences in the rate of severe maternal morbidity in 2005 and 2014. The rate of severe maternal morbidity in 2014 was 19.3 per 1,000 live births, which was 1.65 times higher than the rate in 2005. Nearly all of the excess severe maternal morbidity and blood transfusions in 2014 can be explained by differences in the rate of severe maternal morbidity and blood transfusion between the two time periods. In total, sociodemographic factors, medical factors, and individual and hospital health service factors explained 9.1% of the overall severe maternal morbidity increase in 2014 compared with 2005, and only explained 2.5% of the increase in blood transfusions during this time period. Our study findings indicate that the increase in the rate of severe maternal morbidity is comprised almost entirely by an increase in the rate of blood transfusions. Further research will need to be conducted to explain the increase in the rate of severe maternal morbidity and blood transfusions. Consistent with national trends, the rates of severe maternal morbidity have been increasing in Florida. This increase is driven almost entirely by blood transfusions and cannot be explained by traditional factors that are readily available in current datasets. In addition to the differences between the trends of blood transfusions and the 20 severe maternal morbidity conditions, there are also differences in risk factors associated with these different conditions. Prepregnancy overweight and obesity is associated with a protective effect with blood transfusions and disseminated intravascular coagulation that is not seen in the other conditions. Therefore, initiatives to decrease the rates of severe maternal morbidity will need to take these differences into account.

A number of studies have investigated the natural history of asthma in pregnancy. Most of the data suggests that the course of asthma for a given patient is unpredictable. Turner, et al.7 summarize the data from all of the English-language literature of studies on the effect of pregnancy on astha. Of 1054 cases examined, 49% of the asthma conditions remained unchanged, 22% got worst and 29% became better.7 Theophylline has been used safely during pregnancy. A review of the literature by O'Brien, showed that no teratogenic effects were associated with the use of theophylline in 117 cases and aminophylline in 76 cases examined.39,40 Blood concentration in newborns have been found to be similar to concentrations in the mothers.41,42,43 Problems developed because theophylline clearance may be altered during pregnancy and necessitate dosage adjustments and careful drug level monitoring.44 RATIONALE FOR STUDY Campbell, et al.45 developed a caffeine urinary metabolic ratio, in which they were able to demonstrate a correlation between changes in metabolic rations and clearance. The change in the metabolic ration explained the alteration in clearance and determined the specific Cytochrome P-450 system involved. Various physiologic changes occurring during pregnancy can cause changes in drug disposition. Pharmacokinetic parameters that need to be considered are plasma protein binding capacity, absorption, drug metabolizing enzyme activity, renal excretory function and volume of distribution.44,46,47 This study was developed to determine if changes in theophylline disposition during pregnancy were due to changes in drug metabolizing enzyme activity. A urinary test was designed to investigate the ratios of unchanged theophylline and theophylline metabolites to monitor changes in the various Cytochrome P-450 isoenzyme systems. Changes in the ratios could provide a noninvasive procedure to assess the effect of modulating agents or conditions (such as pregnancy) on theophylline metabolizing enzyme activity.

No description available.

Life Cycle and Transmission Toxoplasmosis is a disease produced by infection with the protozoan Toxoplasma gondii, an intracellular parasite which was first isolated from the North African rodent, Cyterodactylus gondii, in 1908. Since that time, this organism has been shown to have worldwide distribution and is probably the most common parasite of mammals, birds and reptiles (Remington., 1960). In 1965, Hutchinson described toxoplasma oocysts in cat feces, but it was not until 1970 that the life cycle of the organism was disclosed. The felidae represent the primary host for toxoplasma and are the only animals known to harbor the intestinal form (Frenkel., 1973). The oocysts are shed by the cat within 3 to 5 days after infection and sporulate within the feces in another 3 to 4 days. This oocyst is fairly resistant to drying and disinfectants and may remain infective in fairly moist soil for up to several years (Jacobs.. 1974). (Figure 1)

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2006. / Härtill 6 uppsatser.