Screening for pre-eclampsia by using maternal serum inhibin A, activin A, human chorionic gonadotropin, unconjugated estriol, and alpha-fetoprotein levels and uterine artery Doppler in the second trimester of pregnancy.

AIMS: To analyse the predictive power of maternal serum inhibin A, activin A, human chorionic gonadotropin (hCG), unconjugated estriol (uE(3)), alpha-fetoprotein (AFP) levels and uterine artery Doppler in the second trimester of pregnancy in screening for pre-eclampsia. METHODS: Maternal serum inhibin A, activin A, hCG, uE(3), and AFP levels and uterine artery Doppler were determined in 178 healthy, pregnant women in the second trimester of pregnancy. Serum samples were collected between the 16th and 18th weeks of gestation, and Doppler investigation was performed between the 24th and 26th weeks of gestation. Receiver operating characteristic curves were created to analyse the predictive powers of the above parameters in screening for pre-eclampsia. Different combinations also were analysed. RESULTS: The rate of pre-eclampsia was 7.9% (14/178). Maternal serum inhibin A, activin A, hCG, AFP levels, the rate of presence of the prediastolic notch and uterine artery resistance index (RI) values in pre-eclamptic pregnancies were significantly higher than those in healthy pregnancies. Presence of the prediastolic notch, uterine artery RI, maternal serum activin A and inhibin A levels had high predictive efficacy, and each had a sensitivity between 70 and 93% and a specificity between 87% and 98%. The addition of inhibin A or activin A measurement to the Doppler velocimetry improved the specificity to 99-100%. CONCLUSIONS: Maternal serum inhibin A and activin A levels and uterine artery Doppler appear to be useful screening tests during the second trimester for pre-eclampsia. However, addition of these hormonal markers to Doppler velocimetry only slightly improves the predictive efficacy, which appears clinically insignificant.

Exposure to low outdoor temperature in the midtrimester is associated with low birth weight.

BACKGROUND: Although seasonal variation of birth weight has been reported previously, contributing factors such as the meteorological factor and its specific period of exposure remain unclear. AIM: To investigate the effect of season on birth weight and to determine the meteorological factor and its specific period of exposure which can contribute to any seasonal variation in birth weight. METHODS: Retrospective analysis of 3333 singleton live births after 36 completed weeks of pregnancy. Maternal age, parity, route of delivery, sex and individual meteorological variables for the first, second, and third trimesters of each pregnancy were analysed using multiple regression analysis with the birth weight as the dependent variable. RESULTS: A seasonal pattern was observed with lowest birth weights in women who had their last menstrual periods in summer and autumn. Upon multiple regression analysis, sex, parity, mode of delivery, and the temperature which the mother was exposed to in the second trimester were the independent determinants of birth weight. CONCLUSION: Exposure to low outdoor ambient temperature in the midtrimester can be associated with low birth weight.

Does the mode of delivery affect the birthweight? [corrected].

OBJECTIVE(S): To investigate whether the mode of delivery effects the birthweight. STUDY DESIGN: In this retrospective study, 3092 singleton live births following uncomplicated pregnancies were analyzed. Birthweights were expressed as multiples of the median (MoM) for the relevant gestational week. The birthweight of children born vaginally was compared with those born by cesarean section. RESULTS: The birthweight of children born vaginally was lower than that of those born by cesarean section. However, this difference was not observed at all gestational ages. Increasing cesarean rates and birthweights throughout years were observed, and the women, who delivered by cesarean section, were older than those, who delivered vaginally. CONCLUSION(S): It appears that mode of delivery has negligible effect on birthweight.