Head circumference at birth and exposure to tobacco, alcohol and illegal drugs during early pregnancy.

AIMS: We aimed to assess the effects of exposure to tobacco smoke, alcohol and illegal drugs during early pregnancy on the head circumference (HC) at birth of otherwise healthy neonates. METHODS: A follow-up study from the first trimester of pregnancy to birth was carried out in 419 neonates. An environmental reproductive health form was used to record data of substance exposure obtained during the first obstetric visit at the end of the first trimester. A multiple linear regression model was created for this purpose. RESULTS: Alcohol intake during pregnancy and medical ionizing radiation exposure were the most significant predictors of HC. The mothers' alcohol consumption increased with the mothers' and fathers' education level, net family income and fathers' alcohol consumption. In contrast, maternal smoking decreased with increasing mothers' and fathers' education level and net family income. About 13% of the surveyed embryos were exposed to illegal drugs. CONCLUSIONS: Mild to moderate alcohol consumption diminishes the at-birth HC of theoretically healthy newborns in a linear form. There was no threshold dose. We perceived a need for increasing the awareness, and for training, of health care professionals and parents, in regard to risks of alcohol consumption and for recommending abstinence of these substances in both parents during pregnancy. It should also be remembered that medical ionizing radiation should be performed only during the first half of the cycle in fertile women. We think that our study has an important social impact as it affords data for implementing policies for promoting "healthy pregnancies".

Reproductive outcome after uterine-sparing surgery for endometrial stromal sarcoma.

► This is the second report of pregnancy following endometrial stromal sarcoma (ESS). ► The role of adnexectomy is controversial in stage I ESS. ► Adnexectomy does not appear to affect survival in stage I ESS.

Lactic dehydrogenase-C4 activity in seminal plasma and male infertility.

OBJECTIVE: To determine the lactate dehydrogenase C4 (LDH-C4) isoenzyme activity in seminal fluid with the purpose of studying its clinical use as marker of seminiferous epithelium activity. DESIGN: A total of 224 semen samples were classified into the following four groups: [1] men with proven fertility (n = 27); [2] oligozoospermic patients (n = 34); [3] normozoospermic subjects with infertile couple (n = 120); and [4] vasectomized patients (n = 22). RESULTS: It was found that LDH-C4 activity discriminates well between the infertile groups (groups 2 and 3) with the fertile group (group 1). We correlated LDH-C4 activity with the different parameters of the seminogram, the best correlation being obtained with the sperm count. Lactate dehydrogenase-C4 activity:sperm count ratio showed a high correlation with the "vital" variables of spermatozoon. The logistic regression analysis gave a mathematical model that only includes viability and percent C4. This model accurately classifies 88.4% of the cases. In vasectomized individuals, we proved an earlier disappearance of the LDH-C4 activity, than that of the sperm count. CONCLUSION: Our results confirm the clinical utility of this parameter as a good marker for both germinal activity and spermatozoid quality.