Investigation of maternal environmental exposures in association with self-reported preterm birth

Patel, Chirag; Yang, Ting; Hu, Zhongkai; Wen, Qiaojun; Sung, Joyce F.; El‐Sayed, Yasser Y.; Cohen, Harvey; Gould, Jeffrey B.; Stevenson, David K.; Shaw, Gary M.; Ling, Xuefeng B.; Butte, Atul J.

doi:10.1016/j.reprotox.2013.12.005

Cited by 44 publications

(32 citation statements)

References 54 publications

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“…De forma oposta a outros autores 5,6 , nosso estudo verificou que antecedentes obstétricos de parto pré-termo e um comprimento cervical foram predominantes no grupo do PPTe quando comparado com o grupo de RPM-PT. Da mesma forma, o tabagismo descrito por vários autores como fator de risco para o desencadeamento de PPT 5,6,8 apresentou, na nossa amostra, valores sobreponíveis em ambos os grupos, não estando associado com nenhum dos subtipos analisados.…”

Section: Discussionunclassified

“…A literatura mostra taxas de PPT entre os 6 e 10% de todos os nascimentos, sendo mais baixa na Europa (6,2%) e mais alta na América do Norte (10,6%) 1,2 . A etiologia dos PPT ainda não se encontra completamente esclarecida, contudo vários são os estudos que apontam para uma etiologia complexa e multifatorial 1,[3][4][5][6][7] . Alguns autores têm proposto sistemas para classificar o PPT a fim de compreender a sua patogênese.…”

Section: Introductionunclassified

“…Ao longo desses últimos anos, vários têm sido os autores a debruçar-se sobre a análise das mais variadas condições que poderão aumentar o risco desse desfecho obstétrico, entre elas o tabagismo, o consumo de bebidas alcoólicas, o elevado stress socioeconômico, os antecedentes de PPT, a existência de infecções, a magreza materna e a desnutrição 1,[3][4][5][6] . Um estudo que avalia essas condições apenas em situações com RPM-PT mostrou maior incidência dessa complicação em mulheres com baixos níveis de escolaridade e socioeconômicos, em fumadoras e com antecedentes de PPT 8 .…”

Section: Introductionunclassified

“…No entanto, a sua aplicação reveste-se de especial importância quando se pretende atrasar o parto o tempo suficiente para completar a administração de corticoterapia pré-natal ou para efetuar uma transferên-cia "in útero" para um hospital com cuidados neonatais mais diferenciados 1 . Dado que o PPT é multifatorial e complexo, no que se refere à sua etiologia, a identificação de fatores pessoais e ambientais que possam aumentar esse risco constitui uma prioridade no sentido de serem considerados um alvo para prevenção, diagnóstico ou terapêutica, reduzindo o mau desfecho obstétrico 5 . Nosso estudo tem como objetivo avaliar e comparar características maternas, obstétricas e neonatais em situações de PPT associado ou não à RPM-PT.…”

Section: Introductionunclassified

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Parto pré-termo com e sem rotura prematura de membranas: características maternas, obstétricas e neonatais

Brandão¹,

Domingues²,

Fonseca³

et al. 2015

Rev. Bras. Ginecol. Obstet.

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ResumoOBJETIVO: Avaliação das caraterísticas maternas, obstétricas e neonatais nos partos pré-termo (PPT) associados ou não à rotura prematura de membranas pré-termo. MÉTODOS: Estudo retrospetivo de gestações de feto único, com um parto pré-termo, entre 2003 e 2012. Critérios de inclusão: a ocorrência de parto associado ou não à rotura prematura de membranas pré-termo. Critérios de exclusão: partos motivados por comorbidades fetal e/ou maternas (iatrogênicos); e processos não disponíveis ou incompletos para consulta. Foram comparadas caraterísticas entre os dois grupos de PPT: PPT espontâneo (PPTe) versus rotura prematura de membranas pré-termo (RPM-PT), tendo sido utilizados na análise estatística os testes Kolmogorov-Smirnov, Levene, χ ) and higher infectious parameters (Protein C Reactive: 2.2 versus 1.2 mg/L; Leukocytes: 13.3 versus 12.4x10 9 ) were more frequent in PBTs (p<0,001). Neonatal outcomes, specially neurologic outcomes (4.7 versus 2.8%, p<0,001), were worst in PBTs. CONCLUSION: PTB with or without PPROM has a complex etiology. From all evaluated features in our study, only maternal thinness, multiparity with a previous PTB, the cervical length and worst systemic infections parameters were significant in sPTB. This group also showed worst neonatal outcomes, specially on neurological outcomes.

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Section: Discussionunclassified

Section: Introductionunclassified

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Parto pré-termo com e sem rotura prematura de membranas: características maternas, obstétricas e neonatais

Brandão¹,

Domingues²,

Fonseca³

et al. 2015

Rev. Bras. Ginecol. Obstet.

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“…Prioritization and/or hypothesis generation research aimed at delineating the prognostic role of semen phenotypes for male fecundity may benefit from the use of emerging methods capable of systematically analysing many factors to identify environmental exposures and phenotypes associated with disease (Patel & Ioannidis, 2014). Examples of analogous data‐driven investigations included searches of environmental or behavioral factors associated with type 2 diabetes (Patel et al ., 2010), serum lipids (Patel et al ., 2012), blood pressure (Tzoulaki et al ., 2012), endometrial cancer (Merritt et al ., 2015), all‐cause mortality (Patel et al ., 2014), family income (Patel et al ., 2015) and pre‐term birth (Patel et al ., 2013). …”

Section: Introductionmentioning

confidence: 99%

A data‐driven search for semen‐related phenotypes in conception delay

2016

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SummarySperm count, morphology, and motility have been reported to be predictive of pregnancy, although with equivocal basis prompting some authors to question the prognostic value of semen analysis. To assess the utility of including semen quality data in predicting conception delay or requiring >6 cycles to become pregnant (referred to as conception delay), we utilized novel data‐driven analytic techniques in a pre‐conception cohort of couples prospectively followed up for time‐to‐pregnancy. The study cohort comprised 402 (80%) male partners who provided semen samples and had time‐to‐pregnancy information. Female partners used home pregnancy tests and recorded results in daily journals. Odds ratios (OR), false discovery rates, and 95% confidence intervals (CIs) for conception delay (time‐to‐pregnancy > 6 cycles) were estimated for 40 semen quality phenotypes comprising 35 semen quality endpoints and 5 closely related fecundity determinants (body mass index, time of contraception, lipids, cotinine and seminal white blood cells). Both traditional and strict sperm phenotype measures were associated with lower odds of conception delay. Specifically, for an increase in percent morphologically normal spermatozoa using traditional methods, we observed a 40% decrease in conception delay (OR = 0.6, 95% CI = 0.50, 0.81; p = 0.0003). Similarly, for an increase in strict criteria, we observed a 30% decrease in odds for conception delay (OR = 0.7, 95% CI = 0.52, 0.83; p = 0.001). On the other hand, an increase in percent coiled tail spermatozoa was associated with a 40% increase in the odds for conception delay (OR = 1.4, 95% CI = 1.12, 1.75; p = 0.003). However, our findings suggest that semen phenotypes have little predictive value of conception delay (area under the curve of 73%). In a multivariate model containing significant semen factors and traditional risk factors (i.e. age, body mass index, cotinine and ever having fathered a pregnancy), there was a modest improvement in prediction of conception delay (16% increase in area under the curve, p < 0.0002).

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Bisphenols and phthalates: Plastic chemical exposures can contribute to adverse cardiovascular health outcomes

Ramadan

Cooper

Posnack

2020

Birth Defects Research

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Phthalates and bisphenols are high production volume chemicals that are used in the manufacturing of consumer and medical products. Given the ubiquity of bisphenol and phthalate chemicals in the environment, biomonitoring studies routinely detect these chemicals in 75-90% of the general population. Accumulating evidence suggests that such chemical exposures may influence human health outcomes, including cardiovascular health. These associations are particularly worrisome for sensitive populations, including fetal, infant and pediatric groups-with underdeveloped metabolic capabilities and developing organ systems. In the presented article, we aimed to review the literature on environmental and clinical exposures to bisphenols and phthalates, highlight experimental work that suggests that these chemicals may exert a negative influence on cardiovascular health, and emphasize areas of concern that relate to vulnerable pediatric groups. Gaps in our current knowledge are also discussed, so that future endeavors may resolve the relationship between chemical exposures and the impact on pediatric cardiovascular physiology.

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Investigation of maternal environmental exposures in association with self-reported preterm birth

Cited by 44 publications

References 54 publications

Parto pré-termo com e sem rotura prematura de membranas: características maternas, obstétricas e neonatais

Parto pré-termo com e sem rotura prematura de membranas: características maternas, obstétricas e neonatais

A data‐driven search for semen‐related phenotypes in conception delay

Bisphenols and phthalates: Plastic chemical exposures can contribute to adverse cardiovascular health outcomes

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