Épidémiologie des pertes de grossesse

Delabaere, Amélie; Huchon, Cyrille; Deffieux, X.; Beucher, G.; Gallot, V.; Nedellec, S.; Vialard, François; Carcopino, Xavier; Quibel, Thibaud; Subtil, D.; Barasinski, Chloé; Gallot, D.; Vendittelli, Françoise; Laurichesse‐Delmas, H.; Lémery, D.

doi:10.1016/j.jgyn.2014.09.011

Cited by 39 publications

(18 citation statements)

References 69 publications

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“…Sixty percent of women with GDM in Cayenne had a history of obstetrical complications, 10% of macrosomia, and we highlighted a frequent history of miscarriages in comparison with other French territories, much higher than the 12% reported in mainland France (23,24). This high frequency miscarriages, especially in Western French Guiana (43%), emphasizes the challenges associated with monitoring difficult pregnancies.…”

Section: Discussionmentioning

confidence: 61%

Does Universal Screening for Gestational Diabetes Mellitus Improve Neonatal Outcomes in a Socially Vulnerable Population: A Prospective Study in French Guiana

et al. 2021

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Aims/IntroductionFrench Guiana has a high prevalence of metabolic diseases, which are risk factors for gestational diabetes mellitus. Despite routine screening for gestational diabetes, treatment is still challenging because of health inequalities and different cultural representations of disease and pregnancy. This study was conducted to assess the role of early and universal GDM screening on obstetrical and neonatal complications in a socially deprived population.Materials and MethodsA prospective study was conducted, in the level III maternity in French Guiana. Of 2136 deliveries, 223 had gestational diabetes mellitus, 110 of whom were followed-up for 6 month to detail their social and laboratory parameters.ResultsThe prevalence of gestational diabetes in French Guiana (Cayenne Hospital) was estimated at 10.3%. The study population was very precarious with 70% of patients on welfare (universal health coverage or state medical assistance). The following obstetrical complications were observed: cesarean delivery (32%), history of miscarriage (26%) and preeclampsia (7.4%). Nevertheless, neonatal complications were rarely present and included hypoglycemia (2.8%) and macrosomia (2.8%).ConclusionIn French Guiana, gestational diabetes mellitus is very common. However, in a context of widespread poverty and diverse cultural representations, universal screening and monitoring limited the risk of macrosomia.

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Section: Discussionmentioning

confidence: 61%

Does Universal Screening for Gestational Diabetes Mellitus Improve Neonatal Outcomes in a Socially Vulnerable Population: A Prospective Study in French Guiana

et al. 2021

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“…First trimester losses represented a normal rate of 13% of clinically recognised pregnancies. 27 Of 11 caesarean sections, only one was exclusively ARVD/C indicated (HF). The 28% caesarean-section rate was unremarkable, given the population rates of 33% in the USA and 17% in the Netherlands.…”

Section: Discussionmentioning

confidence: 99%

Pregnancy course and outcomes in women with arrhythmogenic right ventricular cardiomyopathy

Hodes

Tichnell

Riele

et al. 2015

Heart

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ObjectivesTo characterise pregnancy course and outcomes in women with arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C).MethodsFrom a combined Johns Hopkins/Dutch ARVD/C registry, we identified 26 women affected with ARVD/C (by 2010 Task Force Criteria) during 39 singleton pregnancies >13 weeks (1–4 per woman). Cardiac symptoms, treatment and episodes of sustained ventricular arrhythmias (VAs) and heart failure (HF) ≥ Class C were characterised. Obstetric outcomes were ascertained. Incidence of VA and HF were compared with rates in the non-pregnant state. Long-term disease course was compared with 117 childbearing-aged female patients with ARVD/C who had not experienced pregnancy with ARVD/C.ResultsTreatment during pregnancy (n=39) included β blockers (n=16), antiarrhythmics (n=6), diuretics (n=3) and implantable cardioverter defibrillators (ICDs) (n=28). In five pregnancies (13%), a single VA occurred, including two ICD-terminated events. Arrhythmias occurred disproportionately in probands without VA history (p=0.045). HF, managed on an outpatient basis, developed in two pregnancies (5%) in women with pre-existing overt biventricular or isolated right ventricular disease. All infants were live-born without major obstetric complications. Caesarean sections (n=11, 28%) had obstetric indications, except one (HF). β Blocker therapy was associated with lower birth weight (3.1±0.48 kg vs 3.7±0.57 kg; p=0.002). During follow-up children remained healthy (median 3.4 years), and mothers were without cardiac mortality or transplant. Neither VA nor HF incidence was significantly increased during pregnancy. ARVD/C course (mean 6.5±5.6 years) did not differ based on pregnancy history.ConclusionsWhile most pregnancies in patients with ARVD/C were tolerated well, 13% were complicated by VA and 5% by HF.

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“…Data on 148,494 ART pregnancies in United States conceived from 1999 through 2002 had indicated that the PL rate in ART was up to 29% [ 7 ]. The potential risk of pregnancy loss in natural conceived conception was mainly determined by elder maternal age (≥35 years) [ 8 ], overweight or obese [ 9 ], history of abortion [ 4 ], microbial infections [ 10 ] and elevated reproductive hormones [ 11 ]. As for ART population, the elevated potential risk of loss had also been related to some potentially factors specific to women with infertility, such as fresh or frozen cycle type, uterine factor [ 12 ], polycystic ovary syndrome (PCOS) status [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Influencing factors of pregnancy loss and survival probability of clinical pregnancies conceived through assisted reproductive technology

Hu¹,

Du²,

Lv³

et al. 2018

Reprod Biol Endocrinol

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BackgroundPregnancies following assisted reproductive technology (ART) may have elevated potential risk of pregnancy loss (PL) when compared to natural conception. However, rare studies comprehensively analyzed the IVF/ICSI cycle-dependent factors for loss of clinical pregnancy. Therefore, we aimed to determine the ART subgroup-specific risks of PL throughout pregnancy and explore different risk factors for early miscarriage and late miscarriage among pregnancies conceived through ART.MethodsA retrospective cohort study was launched in two infertility treatment centers in Nanjing and Changzhou including 5485 IVF/ICSI embryo transfer cycles with known outcomes after clinical pregnancy by the end of 2015. Cox proportional hazards regression analysis was performed to estimate the hazard ratios and their 95% confidence intervals. The associations between survival time during pregnancy and demographics and clinical characteristics of clinical pregnancies were estimated using the Kaplan-Meier method and the Log-rank test.ResultsThe overall PL rate in current ART population was 12.5%. Among the 685 pregnancy loss cycles, a total of 460 ended as early miscarriage, 191 as late miscarriage. We found couples in ART pregnancies demonstrated a significantly increased risk of PL as maternal age (HR = 1.31, Ptrend < 0.001) grows. Pregnancies received controlled ovarian hyperstimulation (COH) protocol like GnRH antagonist protocol (HR = 3.49, P < 0.001) and minimal stimulation protocol (HR = 1.83, P < 0.001) had higher risk of PL than GnRH-a long protocol. Notably, in contrast to fresh cycle, women who received frozen cycle embryo had a significant increased risk of early miscarriage (P < 0.001), while frozen cycle was linked with lower risk of late miscarriage (P = 0.045). In addition, four factors (maternal age, COH protocol, cycle type and serum hCG level 14 days after transfer) had independent impact on miscarriage mainly before 12 weeks of gestational age.ConclusionsWith these findings in this study, clinicians may make it better to evaluate a patient’s risk of PL based on the maternal age at the time of treatment, COH protocol, cycle type and serum hCG level 14 days after transfer and the gestational week of the fetus, and we hope that it contributes to future study on its etiology and guide the clinical prevention and treatment.Electronic supplementary materialThe online version of this article (10.1186/s12958-018-0390-6) contains supplementary material, which is available to authorized users.

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Épidémiologie des pertes de grossesse

Cited by 39 publications

References 69 publications

Does Universal Screening for Gestational Diabetes Mellitus Improve Neonatal Outcomes in a Socially Vulnerable Population: A Prospective Study in French Guiana

Does Universal Screening for Gestational Diabetes Mellitus Improve Neonatal Outcomes in a Socially Vulnerable Population: A Prospective Study in French Guiana

Pregnancy course and outcomes in women with arrhythmogenic right ventricular cardiomyopathy

Influencing factors of pregnancy loss and survival probability of clinical pregnancies conceived through assisted reproductive technology

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