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1.
Clin Exp Obstet Gynecol ; 42(4): 442-7, 2015.
Article in English | MEDLINE | ID: mdl-26411208

ABSTRACT

PURPOSE: To evaluate the impact of new legislation for assisted reproductive technology (ART) restricting the number of transferred embryos on neonatal prognosis of infants born after infertility treatments. MATERIALS AND METHODS: Neonatal records of all live born infants in Ege University Maternity Ward were reviewed for 2006 and 2012. Neonatal outcome measures such as birth weight (BW), gestational age (GA), preterm birth (PTB), very low birth weight (VLBW), and neonatal intensive care unit (NICU) admission were evaluated. RESULTS: Compared to 2006 percentage of newborns conceived by medically assisted reproduction (MAR) decreased from 14.6% to 5% in all live births, from 23.8% to 8.2% in NICU patients in 2012. The number of fetuses in the last pregnancy, frequency of intrauterine reductions, spontaneous pregnancy losses, antenatal bleeding, and premature delivery decreased. Percentage of multiples among MAR newborns (31.7% vs. 55.7%), twins from 51.4% to 30.9%, triplets from 4.3% to 0.8% all decreased significantly. Mean BW and gestational age increased resulting in decreased frequency of PTB and VLBW. Consequently Level 3 NICU admission rate significantly decreased from 44.3% to 22%. CONCLUSION: The new ART legislation in Turkey resulted in decreased rate of multiple births, prematurity and related complications, and NICU admissions in MAR newborns. However the twin rates are still high. Since uncontrolled ovulation stimulation and intrauterine insemination techniques are also associated with multiple births and unfavorable neonatal outcomes, these procedures deserve close monitorization.


Subject(s)
Embryo Transfer/statistics & numerical data , Pregnancy Complications/epidemiology , Pregnancy, Multiple/statistics & numerical data , Adult , Birth Weight , Embryo Transfer/methods , Female , Hospitalization , Humans , Infant, Low Birth Weight , Infant, Newborn , Infant, Premature , Intensive Care Units, Neonatal , Male , Pregnancy , Pregnancy Outcome , Reproductive Techniques, Assisted/legislation & jurisprudence , Turkey/epidemiology
2.
Genet Couns ; 24(1): 85-91, 2013.
Article in English | MEDLINE | ID: mdl-23610870

ABSTRACT

Caudal appendage is a rare dysmorphic feature of which etiologic mechanisms are not well understood. Here we report monozygotic (MZ) twin brothers who are discordant for the caudal appendage and multiple congenital anomalies. Twins were the product of a 33 weeks of gestation, monochorionic-diamniotic pregnancy. On admission the proband had micrognathia, beaked nose, hypospadias, caudal appendage and juxtaductal aorta coarctation. At birth, he was small for gestational age and he had transient hypothyroidism which was detected in the newborn period. Karyotype analysis showed 46,XY. Monozygosity was shown by 15 microsatellite markers plus amelogenin (AmpFlSTR Identifiler PCR Amplification Kit, Applied Biosystems). Genome-wide copy number analysis of the twins by DNA-DNA hybridization of whole genomic DNA (NimbleGen Human CGH 385K WG-T v2.0 array) showed a significant difference at two neighboring probes with Log2 ratio: 0.72088 which are located on chromosome 3p12.3. Further analysis by high resolution of chromosome 3 array (Roche NimbleGen Human HG18 CHR3 FT Median Probe Spacing 475 bp) and quantitative PCR analysis did not confirm the deletion.


Subject(s)
Abnormalities, Multiple/diagnosis , Abnormalities, Multiple/genetics , Diseases in Twins/diagnosis , Diseases in Twins/genetics , Genome-Wide Association Study/methods , Sacrococcygeal Region/abnormalities , Adipose Tissue/pathology , Adipose Tissue/surgery , Child, Preschool , Connective Tissue/pathology , Connective Tissue/surgery , Female , Fetal Growth Retardation/diagnostic imaging , Humans , Hyaline Cartilage/pathology , Hyaline Cartilage/surgery , Karyotyping/methods , Male , Pregnancy , Sacrococcygeal Region/pathology , Sacrococcygeal Region/surgery , Twins, Monozygotic/genetics , Ultrasonography, Prenatal/methods
3.
Neonatology ; 102(2): 107-13, 2012.
Article in English | MEDLINE | ID: mdl-22677790

ABSTRACT

BACKGROUND: Intermittent hypoxic episodes are common among preterm infants, although longer term consequences on growth pattern and cardiovascular regulation are unclear. Furthermore, the effects of intermittent hypoxia (IH) may depend on the pattern of hypoxia-reoxygenation. OBJECTIVES: We tested the hypothesis that a clustered versus dispersed pattern of repetitive IH during early postnatal life would induce differential long-term alteration in growth and cardiovascular regulation. METHODS: Sprague-Dawley rat pups were exposed to room air or to one of two patterns of IH (clustered vs. dispersed) from 1 to 7 days of life. Body weight was measured daily for the first 8 days and weekly from weeks 2 to 8. Blood pressure (BP) and heart rate were measured weekly from weeks 4 to 8 using a noninvasive tail-cuff method for awake, nonanesthetized animals. RESULTS: Exposure to both patterns of repetitive IH induced early growth restriction followed by later catch-up of growth to controls 3 weeks after completion of IH exposures. IH-exposed rats exhibited a sustained decrease in heart rate regardless of the hypoxic exposure paradigm employed. In contrast, a differential response was seen for arterial pressure; the clustered paradigm was associated with a significantly lower BP versus controls, while the pups exposed to the dispersed paradigm showed no effect on BP. CONCLUSION: We speculate that repetitive IH during a critical developmental window and regardless of IH exposure paradigm contributes to prolonged changes in sympathovagal balance of cardiovascular regulation.


Subject(s)
Cardiovascular System/physiopathology , Growth Disorders/etiology , Hypoxia/complications , Age Factors , Animals , Animals, Newborn , Blood Pressure , Cardiovascular System/growth & development , Cardiovascular System/innervation , Disease Models, Animal , Growth Disorders/physiopathology , Heart Rate , Hypoxia/physiopathology , Rats , Rats, Sprague-Dawley , Time Factors , Weight Gain
4.
Clin Exp Obstet Gynecol ; 33(4): 238-40, 2006.
Article in English | MEDLINE | ID: mdl-17211974

ABSTRACT

PURPOSE: To determine the relationship between maternal serum zinc (Zn) levels and birth weight of the offspring and their correlation with cord blood Zn, insulin-like growth factor (IGF-1) and insulin-like growth factor binding protein-3 (IGFBP-3) levels. METHOD: 22 term small-for-gestational-age (SGA) and 34 term appropriate-for-gestational-age (AGA) infants and their mothers were included. Maternal and cord blood Zn levels and cord blood IGF-1 and IGFBP-3 levels were measured. RESULTS: Eighteen percent of mothers had Zn deficiency (< 75 mcg/dl). No significant difference between IGF-1 and IGFBP-3 levels and birth weight of infants of the mothers with and without Zn deficiency was found. Maternal and neonatal Zn levels correlated (r = 0.38, p < 0.01). Mean IGF-1 and IGFBP-3 levels were significantly lower in the SGA group compared to the AGA group (42.3 +/- 16.8 ng/ml, 1.2 +/- 0.2 mcg/ml, and 62.4 +/- 22.7 ng/ml, 1.5 +/- 0.4 mcg/ml, p < 0.001). A correlation was found between birth weight, IGF-1 and IGFBP-3 levels, and weight gain of the mother during pregnancy (p < 0.01). CONCLUSIONS: Zn deficiency was not observed to be a risk factor for low birth weight. The significant difference between the SGA and AGA babies' IGF-1 and IGFBP-3 levels emphasizes function of the IGF system in intrauterine growth.


Subject(s)
Infant, Small for Gestational Age/blood , Insulin-Like Growth Factor Binding Protein 3/blood , Insulin-Like Growth Factor I/metabolism , Zinc/blood , Adult , Case-Control Studies , Female , Fetal Blood/metabolism , Humans , Infant, Newborn , Male , Maternal-Fetal Exchange/physiology , Pregnancy , Zinc/deficiency
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