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The impact of Hurricane Katrina, a major natural disaster, on assisted reproductive outcomes through an analysis of 451,848 ART cycles. Sci Rep 2021; 11:17864. [PMID: 34504216 PMCID: PMC8429435 DOI: 10.1038/s41598-021-97402-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 08/11/2021] [Indexed: 11/09/2022] Open
Abstract
To evaluate whether pregnancies conceived via assisted reproductive technology and exposed to Hurricane Katrina (HK), one of the most destructive natural disasters in United States history, were more prone to adverse perinatal outcomes, miscarriages, or sex disparities compared with pregnancies established but not directly exposed to the natural disaster. Retrospective cohort study. Women 18 years and older undergoing fresh ART cycles that resulted in singleton pregnancies and entered in the SART CORS database from 2004 to 2008. Incidence of full-term and preterm delivery, miscarriage rate, infant weight at birth, and infant sex ratio. Total follicle stimulating hormone (FSH) stimulation dosage and number of oocytes retrieved. Between January 2004 and December 2008, a total of 451,848 fresh autologous IVF cycles were recorded in SART CORS, leading to 190,624 pregnancies and 129,499 live births. After controlling for potential confounders, our results demonstrate no association between HK exposure and overall preterm deliveries (< 37 weeks) in women with singleton pregnancies conceived after ART. Other perinatal outcomes such as rate of spontaneous abortion or infant weight at birth in the exposed and unexposed groups were also not associated with HK. A comparison of pre and post disaster sex ratios revealed fewer males were born after HK (51.0% vs. 49.4%), showing a trend of decreased male infant births that was least in part associated with HK (CI 0.81-1.01; p = 0.07). Exposure to HK did not appear to affect perinatal outcomes such as the rate of preterm delivery or the rate of spontaneous abortion. Extreme stress may be a factor that contributes to a reduced male to female secondary sex ratio.
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Lane-Cordova AD, Carnethon MR, Catov JM, Montag S, Lewis CE, Schreiner PJ, Dude A, Sternfeld B, Badon SE, Greenland P, Gunderson EP. Cardiorespiratory fitness, exercise haemodynamics and birth outcomes: the Coronary Artery Risk Development in Young Adults Study. BJOG 2018; 125:1127-1134. [PMID: 29377552 PMCID: PMC6045450 DOI: 10.1111/1471-0528.15146] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2017] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Determine associations of cardiorespiratory fitness, exercise systolic blood pressure (SBP) and heart rate recovery (HRR) following a maximal exercise test performed years preceding pregnancy with odds of preterm birth (PTB; <37 weeks' gestation) and small for gestational age (SGA; birthweight <10th percentile) delivery. DESIGN Prospective, longitudinal. SETTING Multi-site, observational cohort study initially consisting of 2787 black and white women aged 18-30 at baseline (1985-86) and followed for 25 years (Y25; 2010-2011). POPULATION 768 nulliparous women at baseline who reported ≥1 live birth by the Y25 exam. METHODS We used Poisson regression to determine associations of exposures with PTB/SGA. MAIN OUTCOME MEASURES PTB and/or SGA births. RESULTS Women with PTB (n = 143) and/or SGA (n = 88) were younger, had completed fewer years of education and were more likely to be black versus women without PTB/SGA (n = 546). Women with PTB/SGA had lower fitness (501 ± 9 versus 535 ± 6 seconds, P < 0.002) and higher submaximal SBP than women without PTB/SGA (144 ± 1 versus 142 ± 1 mmHg, P < 0.04). After adjustment, no exercise test variables were associated with PTB/SGA, though the association with HRR and submaximal SBP approached significance in the subset of women who completed the exercise test <5 years before the index birth. CONCLUSIONS Neither fitness nor haemodynamic responses to exercise a median of 5 years preceding pregnancy, were associated with PTB/SGA. These findings indicate excess likelihood of PTB/SGA is not detectable by low fitness or exercise haemodynamic responses 5 years preceding pregnancy, but exercise testing, especially HRR and submaximal SBP, may be more useful when conducted closer to the onset of pregnancy. TWEETABLE ABSTRACT Exercise testing conducted >5 years before pregnancy may not detect women likely to have PTB/SGA.
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Affiliation(s)
- Abbi D Lane-Cordova
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC
| | - Mercedes R Carnethon
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Janet M Catov
- Departments of Obstetrics, Gynecology, and Reproductive Sciences and Epidemiology, University of Pittsburgh School of Medicine, Pittsburgh, PA; Department of Magee-Women’s Research Institute, Pittsburgh, PA
| | - Samantha Montag
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Cora E Lewis
- Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Pamela J Schreiner
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Annie Dude
- Department of Maternal-Fetal Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Barbara Sternfeld
- Division of Research, Kaiser Permanente Northern California, Oakland, California
| | - Sylvia E Badon
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA
| | - Philip Greenland
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Erica P Gunderson
- Division of Research, Kaiser Permanente Northern California, Oakland, California
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Meah VL, Backx K, Davenport MH. Functional hemodynamic testing in pregnancy: recommendations of the International Working Group on Maternal Hemodynamics. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2018; 51:331-340. [PMID: 28857365 DOI: 10.1002/uog.18890] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Revised: 08/16/2017] [Accepted: 08/18/2017] [Indexed: 06/07/2023]
Abstract
In the general population, functional hemodynamic testing, such as that during submaximal aerobic exercise and isometric handgrip, and the cold pressor test, has long been utilized to unmask abnormalities in cardiovascular function. During pregnancy, functional hemodynamic testing places additional demands on an already stressed maternal cardiovascular system. Dysfunctional responses to such tests in early pregnancy may predict the development of hypertensive disorders that develop later in gestation. For each of the above functional hemodynamic tests, these recommendations provide a description of the test, test protocol and equipment required, and an overview of the current understanding of clinical application during pregnancy. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- V L Meah
- Centre for Exercise and Health, Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK
| | - K Backx
- Centre for Exercise and Health, Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK
| | - M H Davenport
- Program for Pregnancy & Postpartum Health, Physical Activity and Diabetes Laboratory, Faculty of Physical Education & Recreation, Alberta Diabetes Institute, Women and Children's Health Research Institute, University of Alberta, Edmonton, Alberta, Canada
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Premji SS, Yim IS, Dosani (Mawji) A, Kanji Z, Sulaiman S, Musana JW, Samia P, Shaikh K, Letourneau N, MiGHT Group. Psychobiobehavioral Model for Preterm Birth in Pregnant Women in Low- and Middle-Income Countries. BIOMED RESEARCH INTERNATIONAL 2015; 2015:450309. [PMID: 26413524 PMCID: PMC4564601 DOI: 10.1155/2015/450309] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Accepted: 04/03/2015] [Indexed: 12/19/2022]
Abstract
Preterm birth (PTB) is a final common outcome resulting from many interrelated etiological pathways; of particular interest is antenatal psychosocial distress (i.e., stress, anxiety, and depression). In LMI countries, both exposure to severe life stressors and rate of PTB are on average greater when compared with high-income countries. In LMI countries women are exposed to some of the most extreme psychosocial stress worldwide (e.g., absolute poverty, limited social resources). High prevalence of antenatal stress and depression have been observed in some studies from LMI countries. We propose a psychosocial, biological, and behavioral model for investigating the complex multisystem interactions in stress responses leading to PTB and explain the basis of this approach. We discuss ethical considerations for a psychosocial, biological, and behavioral screening tool to predict PTB from a LMI country perspective.
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Affiliation(s)
- Shahirose S. Premji
- Faculty of Nursing, University of Calgary, 2500 University Drive NW, Calgary, AB, Canada T2N 1N4
- Department of Community Health Sciences, Faculty of Medicine, University of Calgary, TRW Building, 3rd Floor, 3280 Hospital Drive NW, Calgary, AB, Canada T2N 4Z6
- Alberta Children's Hospital Research Institute for Child and Maternal Health, Heritage Medical Research Building, 3330 Hospital Drive NW, Calgary, AB, Canada T2N 4N1
- O'Brien Institute for Public Health, University of Calgary, 3280 Hospital Dr NW, Calgary, AB, Canada T2N 4Z6
| | - Ilona S. Yim
- Department of Psychology and Social Behavior, University of California, Irvine, 4562 Social and Behavioral Sciences Gateway, Irvine, CA 92697-7085, USA
| | - Aliyah Dosani (Mawji)
- School of Nursing and Midwifery, Mount Royal University, 4825 Mount Royal Gate SW, Calgary, AB, Canada T3E 6K6
| | - Zeenatkhanu Kanji
- School of Nursing and Midwifery, Aga Khan University-East Africa, Opposite Aga Khan Primary School Plot (9/11), Colonel Muammar Gaddafi Road, P.O. Box 8842, Kampala, Uganda
| | - Salima Sulaiman
- School of Nursing and Midwifery, Aga Khan University-Karachi, Stadium Road, P.O. Box 3500, Karachi 74800, Pakistan
| | - Joseph W. Musana
- Department of Obstetrics & Gynecology, Faculty of Health Sciences, Aga Khan University-Nairobi, 3rd Parklands Avenue off Limuru Road, P.O. Box 30270, Nairobi 00100, Kenya
| | - Pauline Samia
- Department of Pediatrics, Aga Khan University-Nairobi, 2nd Parklands Avenue, East Tower Block, Room 505, Nairobi 00100, Kenya
| | - Kiran Shaikh
- School of Nursing and Midwifery, Aga Khan University-Karachi, Stadium Road, P.O. Box 3500, Karachi 74800, Pakistan
| | - Nicole Letourneau
- Faculty of Nursing, University of Calgary, 2500 University Drive NW, Calgary, AB, Canada T2N 1N4
- Alberta Children's Hospital Research Institute for Child and Maternal Health, Heritage Medical Research Building, 3330 Hospital Drive NW, Calgary, AB, Canada T2N 4N1
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Physiological reactivity to psychological stress in human pregnancy: current knowledge and future directions. Prog Neurobiol 2012; 99:106-16. [PMID: 22800930 DOI: 10.1016/j.pneurobio.2012.07.003] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2011] [Revised: 06/21/2012] [Accepted: 07/09/2012] [Indexed: 12/18/2022]
Abstract
Cardiovascular and neuroendocrine reactivity to acute stress are important predictors of health outcomes in non-pregnant populations. Greater magnitude and duration of physiological responses have been associated with increased risk of hypertensive disorders and diabetes, greater susceptibility to infectious illnesses, suppression of cell-mediated immunity as well as risk for depression and anxiety disorders. Stress reactivity during pregnancy has unique implications for maternal health, birth outcomes, and fetal development. However, as compared to the larger literature, our understanding of the predictors and consequences of exaggerated stress reactivity in pregnancy is limited. This paper reviews the current state of this literature with an emphasis on gaps in knowledge and future directions.
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Park YC, Park SC, Park MI. The preconception stress and mental health of couples. JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2011. [DOI: 10.5124/jkma.2011.54.8.832] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Yong Chon Park
- Department of Neuropsychiatry, Hanyang University College of Medicine, Seoul, Korea
| | - Seon-Cheol Park
- Department of Neuropsychiatry, Hanyang University College of Medicine, Seoul, Korea
| | - Moon-Il Park
- Department of Obstetrics and Gynecology, Hanyang University College of Medicine, Seoul, Korea
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