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Bulka CM, Everson TM, Burt AA, Marsit CJ, Karagas MR, Boyle KE, Niemiec S, Kechris K, Davidson EJ, Yang IV, Feinberg JI, Volk HE, Ladd-Acosta C, Breton CV, O’Shea TM, Fry RC. Sex-based differences in placental DNA methylation profiles related to gestational age: an NIH ECHO meta-analysis. Epigenetics 2023; 18:2179726. [PMID: 36840948 PMCID: PMC9980626 DOI: 10.1080/15592294.2023.2179726] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 12/08/2022] [Accepted: 12/21/2022] [Indexed: 02/26/2023] Open
Abstract
The placenta undergoes many changes throughout gestation to support the evolving needs of the foetus. There is also a growing appreciation that male and female foetuses develop differently in utero, with unique epigenetic changes in placental tissue. Here, we report meta-analysed sex-specific associations between gestational age and placental DNA methylation from four cohorts in the National Institutes of Health (NIH) Environmental influences on Child Health Outcomes (ECHO) Programme (355 females/419 males, gestational ages 23-42 weeks). We identified 407 cytosine-guanine dinucleotides (CpGs) in females and 794 in males where placental methylation levels were associated with gestational age. After cell-type adjustment, 55 CpGs in females and 826 in males were significant. These were enriched for biological processes critical to the immune system in females and transmembrane transport in males. Our findings are distinct between the sexes: in females, associations with gestational age are largely explained by differences in placental cellular composition, whereas in males, gestational age is directly associated with numerous alterations in methylation levels.
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Affiliation(s)
- Catherine M. Bulka
- Department of Environmental Sciences and Engineering, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Todd M. Everson
- Gangarosa Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Amber A. Burt
- Gangarosa Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Carmen J. Marsit
- Gangarosa Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Margaret R. Karagas
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Kristen E. Boyle
- Section of Nutrition, Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Colorado School of Public Health, The Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, Aurora, CO, USA
| | - Sierra Niemiec
- Colorado School of Public Health, The Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, Aurora, CO, USA
| | - Katerina Kechris
- Colorado School of Public Health, The Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, Aurora, CO, USA
- Department of Biostatistics & Informatics, Colorado School of Public Health, Aurora, CO, USA
| | | | - Ivana V. Yang
- Colorado School of Public Health, The Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, Aurora, CO, USA
- Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Jason I. Feinberg
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, ML, USA
| | - Heather E. Volk
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, ML, USA
| | - Christine Ladd-Acosta
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, ML, USA
| | - Carrie V. Breton
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - T. Michael O’Shea
- Department of Pediatrics, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Rebecca C. Fry
- Department of Environmental Sciences and Engineering, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Institute for Environmental Health Solutions, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Curriculum in Toxicology and Environmental Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Effect of maternal age on neonatal outcomes in very low birth weight singleton infants: a population-based study. J Perinatol 2023; 43:424-429. [PMID: 36739362 DOI: 10.1038/s41372-023-01620-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 03/23/2022] [Accepted: 01/20/2023] [Indexed: 02/05/2023]
Abstract
BACKGROUND Little is known on the impact of maternal age (MA) on very low birth weight (VLBW) infants' outcomes. We tested the hypothesis that at both ends of MA there are increased adverse neonatal outcomes in VLBW infants. METHODS We used the Israel National Neonatal Network VLBW (≤1500 g) database. Maternal age was stratified as: <20, 20-24, 25-34 (reference group), 35-39 and ≥40 years. Statistical analyses were univariate and multivariable logistic regression analysis. RESULTS After adjustment, the infant outcomes of older mothers were similar to those of the reference group for mortality, RDS, severe ROP, NEC and sepsis. Mothers < 20 and 20-24 years old had higher odds of IVH grades 3-4 (OR 1.45, 95% CI 1.09-1.93 and OR 1.26, 95% CI 1.10-1.45, respectively), and BPD (OR 1.55, 95% CI 1.13-2.13 and OR 1.40, 95% CI 1.22-1.62, respectively). There were higher odds for PVL in infants of <20 year-old mothers (OR 1.83, 95% CI 1.26-2.65) and in infants of 35-39 year-old mothers (OR 1.38, 95% CI 1.12-1.69). Poor composite outcomes were significantly higher in the youngest maternal age categories (<20-year-old mothers (OR 1.63, 95% CI 1.28-2.08), and 20-24-year-old (OR 1.28, 95% CI 1.15-1.43). CONCLUSIONS Neonatal outcomes differ in relation to maternal age among very low birth weight newborns, with adverse outcomes more predominant in infants of younger mothers.
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AKTÜRK E, EMEKLİOGLU CN, CINGILLIOĞLU B, GENÇ S, YURCİ A, MİHMANLI V. Risk factors and maternal/fetal outcomes of pregnant women with abruptio placenta: a retrospective, descriptive study. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2022. [DOI: 10.32322/jhsm.1161262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Aim: Abruptio placenta is one of the most important causes of antepartum bleeding and is linked to the major (unpleasant) obstetrics consequences leading to the increased risks of fetal and maternal morbidity and mortality. The aim of our study is to establish a prevalence in our tertiary hospital and find out the fetal and maternal outcomes, along with the patient’s demographic characteristics and risk factors of abruptio placenta.
Material and Method: This trial was carried out in Profesör Doktor Cemil Taşçıoğlu State Hospital, between January 2018 and March 2022. Patient data were extracted from computer system, and files were retrospectively evaluated. We established the fetal and maternal outcomes, along with the demographic characteristics and risk factors of abruptio placenta. All analysis was performed using SPSS software (Statistical Package for the Social Sciences, version 25.0, SPSS Inc., Chicago, IL, USA).
Results: Within the review period there were 7126 deliveries. And 112 cases with abruptio placenta were seen out of the total deliveries. In our population, prevalence of the abruptio placenta was calculated as 1.5%. Because of the incomplete data in certain files, only a total of 102 cases (91%) were eligible for the study.
Conclusion: In conclusion, since the abruptio placenta is highly associated with maternal and fetal morbidity and mortality, timely diagnosis is crucial to prevent devastating consequenuces.
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Affiliation(s)
- Erhan AKTÜRK
- UNIVERSITY OF HEALTH SCIENCES, İSTANBUL OKMEYDANI HEALTH RESEARCH CENTER, DEPARTMENT OF SURGICAL MEDICAL SCIENCES, DEPARTMENT OF OBSTETRICS AND GYNAECOLOGY
| | - Cagdas Nurettin EMEKLİOGLU
- UNIVERSITY OF HEALTH SCIENCES, İSTANBUL OKMEYDANI HEALTH RESEARCH CENTER, DEPARTMENT OF SURGICAL MEDICAL SCIENCES, DEPARTMENT OF OBSTETRICS AND GYNAECOLOGY
| | - Başak CINGILLIOĞLU
- UNIVERSITY OF HEALTH SCIENCES, İSTANBUL OKMEYDANI HEALTH RESEARCH CENTER, DEPARTMENT OF SURGICAL MEDICAL SCIENCES, DEPARTMENT OF OBSTETRICS AND GYNAECOLOGY
| | - Simten GENÇ
- UNIVERSITY OF HEALTH SCIENCES, İSTANBUL OKMEYDANI HEALTH RESEARCH CENTER, DEPARTMENT OF SURGICAL MEDICAL SCIENCES, DEPARTMENT OF OBSTETRICS AND GYNAECOLOGY
| | - Arzu YURCİ
- Bahcelievler Memorial Hospital, Clinic of Obstetrics and Gynecology, In Vitro Fertilization Unit
| | - Veli MİHMANLI
- UNIVERSITY OF HEALTH SCIENCES, İSTANBUL OKMEYDANI HEALTH RESEARCH CENTER, DEPARTMENT OF SURGICAL MEDICAL SCIENCES, DEPARTMENT OF OBSTETRICS AND GYNAECOLOGY
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Iron deficiency anaemia associated with increased placenta praevia and placental abruption: a retrospective case-control study. Eur J Clin Nutr 2022; 76:1172-1177. [PMID: 35301462 DOI: 10.1038/s41430-022-01086-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 12/24/2021] [Accepted: 01/19/2022] [Indexed: 11/08/2022]
Abstract
BACKGROUND/OBJECTIVES A few studies reported association between placenta praevia (PP) and placental abruption (PA) with maternal iron deficiency anaemia (IDA), which is not an established risk factor for these conditions. This retrospective case-control study was performed to determine the relationship between IDA with PP and PA. METHODS Maternal characteristics, risk factors for and incidence of antepartum haemorrhage overall, and PP and PA, were compared between women with IDA only and controls without IDA or haemoglobinopathies matched for exact age and parity (four controls to each index case), who carried singleton pregnancy to ≥22 weeks and managed under our care from 1997 to 2019. RESULTS There were 1,176 women (0.8% of eligible women in the database) with IDA only, who exhibited slightly but significantly different maternal characteristics, and increased antepartum haemorrhage overall (3.4% versus 2.2%, p = 0.031, OR 1.522, 95% CI 1.037-2.234) and PP (1.8% versus 0.9%, p = 0.010, OR 1.953, 95% CI 1.164-3.279), but not PA (1.2% versus 1.1%, p = 0.804, OR 1.077, 95% CI 0.599-1.936). When stratified by parity status, increased PP was found in nulliparous women only. On multivariate analysis adjusting for parity, previous abortion history, overweight and obesity, short stature, other antenatal complications as a composite factor, preterm (<37) delivery, previous caesarean delivery, and infant gender, IDA was associated with PP (aOR 3.485, 95% CI 1.959-6.200) and PA (aOR 2.181, 95% CI 1.145-4.155). CONCLUSIONS Both PP and PA are increased in women with IDA, the prevention of which could be a means to reduce the occurrence of both PP and PA.
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Zhang P, Haymar T, Al-Sayyed F, Dygulski S, Dygulska B, Devi A, Lederman S, Salafia C, Baergen R. Placental pathology associated with maternal age and maternal obesity in singleton pregnancy. J Matern Fetal Neonatal Med 2022; 35:9517-9526. [PMID: 35225123 DOI: 10.1080/14767058.2022.2044777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Maternal age, maternal obesity and neonatal sex dimorphism are known to affect pregnancy and neonatal outcome. However, the effects of these factors on specific placental pathology are less well-documented. STUDY DESIGN Clinical information, placental pathology and neonatal data from singleton delivery were collected at our hospital in March 2020 to October 2021 and correlation studies were performed. RESULTS A total 3,119 singleton placentas were examined between March 2020 and October 2021 in conjunction with clinical information and neonatal birth data. Advanced maternal age (>35) was significantly associated with a variety of pregnancy complications and placental pathology including preeclampsia/pregnancy induced hypertension (Pre/PIH), gestational diabetes mellitus (GDM2), intrauterine growth restriction (IUGR), and increased maternal body mass index (BMI) at delivery. Maternal obesity (BMI >30 at the time of delivery) was significantly associated with a variety of clinical features and placental pathology including PRE/PIH, GDM2 and decidual vasculopathy (mural arterial hypertrophy). No specific placental pathology was associated with neonatal sex except for more maternal inflammatory response (MIR, chronic deciduitis) in neonates of male sex. CONCLUSION Maternal age and maternal obesity were associated with not only clinical complications of pregnancy and neonatal birth weight but also specific placental pathology. Understanding the effects of maternal and environmental factors will help improve pregnancy outcome.
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Affiliation(s)
- Peilin Zhang
- Department of Pathology, New York Presbyterian - Brooklyn Methodist Hospital, Brooklyn, New York, USA
| | - Tsu Haymar
- Department of Pathology, New York Presbyterian - Brooklyn Methodist Hospital, Brooklyn, New York, USA
| | - Farah Al-Sayyed
- Department of Obstetrics and Gynecology, New York Presbyterian - Brooklyn Methodist Hospital, Brooklyn, New York, USA
| | - Sylvia Dygulski
- Department of Pediatrics, New York Presbyterian - Brooklyn Methodist Hospital, Brooklyn, New York, USA
| | - Beata Dygulska
- Department of Pediatrics, New York Presbyterian - Brooklyn Methodist Hospital, Brooklyn, New York, USA
| | - Arooj Devi
- Department of Pathology, New York Presbyterian - Brooklyn Methodist Hospital, Brooklyn, New York, USA
| | - Sanford Lederman
- Department of Obstetrics and Gynecology, New York Presbyterian - Brooklyn Methodist Hospital, Brooklyn, New York, USA
| | - Carolyn Salafia
- Department of Obstetrics and Gynecology, New York Presbyterian - Brooklyn Methodist Hospital, Brooklyn, New York, USA
| | - Rebecca Baergen
- Pathology and Laboratory Medicine, Weill Cornell Medical Center, New York, NY, USA
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Broere-Brown ZA, Adank MC, Benschop L, Tielemans M, Muka T, Gonçalves R, Bramer WM, Schoufour JD, Voortman T, Steegers EAP, Franco OH, Schalekamp-Timmermans S. Fetal sex and maternal pregnancy outcomes: a systematic review and meta-analysis. Biol Sex Differ 2020; 11:26. [PMID: 32393396 PMCID: PMC7216628 DOI: 10.1186/s13293-020-00299-3] [Citation(s) in RCA: 71] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 04/08/2020] [Indexed: 12/15/2022] Open
Abstract
Background Since the placenta also has a sex, fetal sex–specific differences in the occurrence of placenta-mediated complications could exist. Objective To determine the association of fetal sex with multiple maternal pregnancy complications. Search strategy Six electronic databases Ovid MEDLINE, EMBASE, Cochrane Central, Web-of-Science, PubMed, and Google Scholar were systematically searched to identify eligible studies. Reference lists of the included studies and contact with experts were also used for identification of studies. Selection criteria Observational studies that assessed fetal sex and the presence of maternal pregnancy complications within singleton pregnancies. Data collection and analyses Data were extracted by 2 independent reviewers using a predesigned data collection form. Main results From 6522 original references, 74 studies were selected, including over 12,5 million women. Male fetal sex was associated with term pre-eclampsia (pooled OR 1.07 [95%CI 1.06 to 1.09]) and gestational diabetes (pooled OR 1.04 [1.02 to 1.07]). All other pregnancy complications (i.e., gestational hypertension, total pre-eclampsia, eclampsia, placental abruption, and post-partum hemorrhage) tended to be associated with male fetal sex, except for preterm pre-eclampsia, which was more associated with female fetal sex. Overall quality of the included studies was good. Between-study heterogeneity was high due to differences in study population and outcome definition. Conclusion This meta-analysis suggests that the occurrence of pregnancy complications differ according to fetal sex with a higher cardiovascular and metabolic load for the mother in the presence of a male fetus. Funding None.
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Affiliation(s)
- Zoe A Broere-Brown
- Department of Obstetrics and Gynecology, Erasmus Medical Center, Rotterdam, the Netherlands.,Generation R Study Group, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Maria C Adank
- Department of Obstetrics and Gynecology, Erasmus Medical Center, Rotterdam, the Netherlands.,Generation R Study Group, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Laura Benschop
- Department of Obstetrics and Gynecology, Erasmus Medical Center, Rotterdam, the Netherlands.,Generation R Study Group, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Myrte Tielemans
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands.,Department Microbiology and Infectious Diseases, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Taulant Muka
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands.,Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Romy Gonçalves
- Department of Obstetrics and Gynecology, Erasmus Medical Center, Rotterdam, the Netherlands.,Generation R Study Group, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Wichor M Bramer
- Medical Library, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Josje D Schoufour
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands.,Hogeschool van Amsterdam (HvA), Amsterdam, the Netherlands
| | - Trudy Voortman
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Eric A P Steegers
- Department of Obstetrics and Gynecology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Oscar H Franco
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands.,Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Sarah Schalekamp-Timmermans
- Department of Obstetrics and Gynecology, Erasmus Medical Center, Rotterdam, the Netherlands. .,Generation R Study Group, Erasmus Medical Center, Rotterdam, the Netherlands.
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Onishi K, Tsuda H, Fuma K, Kuribayashi M, Tezuka A, Ando T, Mizuno K. The impact of the abruption severity and the onset-to-delivery time on the maternal and neonatal outcomes of placental abruption. J Matern Fetal Neonatal Med 2019; 33:3775-3783. [PMID: 30849924 DOI: 10.1080/14767058.2019.1585424] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objective: We examined the impact of the abruption severity and the onset-to-delivery time on the maternal and neonatal outcomes of cases of clinically diagnosed placental abruption (PA).Material and methods: We investigated 84 patients who were diagnosed with PA at our hospital from January 2009 to September 2017. We classified the patients with PA into three groups based on the extent of the abruption: (1) mild abruption, <20%; (2) moderate abruption, 20-49%; (3) severe abruption, ≥50%, which was defined by the attending obstetricians at the time of delivery. The neonatal outcome was measured by the umbilical artery pH and the maternal outcome was measured by the obstetric disseminated intravascular coagulation score (DIC score).Results: The rate of hypertensive disorders of pregnancy in the moderate abruption group was significantly lower than that in other groups (p = .010). The umbilical artery pH was below 7.00 in 29 cases. The umbilical artery pH of the severe abruption group (6.92) was the lowest and was significantly lower in comparison to other groups (mild group [7.24], p < .001; moderate group [7.11], p < .05). There was a significant correlation between the onset-to-delivery time and the umbilical artery pH in the moderate group (R = -0.43). The maternal DIC scores in the three groups did not differ to a statistically significant extent.Conclusions: The severity of placental separation is significantly correlated with poor neonatal outcomes and there was a significant negative correlation between the onset-to-delivery time and the umbilical artery pH in moderate abruption.
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Affiliation(s)
- Kazuma Onishi
- Department of Obstetrics and Gynecology, Japanese Red Cross Nagoya Daiichi Hospital, Nagoya, Japan
| | - Hiroyuki Tsuda
- Department of Obstetrics and Gynecology, Japanese Red Cross Nagoya Daiichi Hospital, Nagoya, Japan
| | - Kazuya Fuma
- Department of Obstetrics and Gynecology, Japanese Red Cross Nagoya Daiichi Hospital, Nagoya, Japan
| | - Momoko Kuribayashi
- Department of Obstetrics and Gynecology, Japanese Red Cross Nagoya Daiichi Hospital, Nagoya, Japan
| | - Atsuko Tezuka
- Department of Obstetrics and Gynecology, Japanese Red Cross Nagoya Daiichi Hospital, Nagoya, Japan
| | - Tomoko Ando
- Department of Obstetrics and Gynecology, Japanese Red Cross Nagoya Daiichi Hospital, Nagoya, Japan
| | - Kimio Mizuno
- Department of Obstetrics and Gynecology, Japanese Red Cross Nagoya Daiichi Hospital, Nagoya, Japan
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Mondal D, Galloway TS, Bailey TC, Mathews F. Elevated risk of stillbirth in males: systematic review and meta-analysis of more than 30 million births. BMC Med 2014; 12:220. [PMID: 25428603 PMCID: PMC4245790 DOI: 10.1186/s12916-014-0220-4] [Citation(s) in RCA: 93] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Accepted: 10/24/2014] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Stillbirth rates have changed little over the last decade, and a high proportion of cases are unexplained. This meta-analysis examined whether there are inequalities in stillbirth risks according to sex. METHODS A systematic review of the literature was conducted, and data were obtained on more than 30 million birth outcomes reported in observational studies. The pooled relative risk of stillbirth was estimated using random-effects models. RESULTS The crude mean rate (stillbirths/1,000 total births) was 6.23 for males and 5.74 for females. The pooled relative risk was 1.10 (95% confidence interval (CI): 1.07-1.13). The attributable fraction in the whole population was 4.2% (95% CI: 3.70-4.63), and the attributable fraction among male fetuses was 7.8% (95% CI: 7.0-8.66). Study populations from countries with known sex-biased sex selection issues had anomalous stillbirth sex ratios and higher overall stillbirth risks than other countries, reflecting increased mortality among females. CONCLUSIONS Risk of stillbirth in males is elevated by about 10%. The population-attributable risk is comparable to smoking and equates to approximately 100,000 stillbirths per year globally. The pattern is consistent across countries of varying incomes. Given current difficulties in reducing stillbirth rates, work to understand the causes of excess male risk is warranted. We recommend that stillbirths are routinely recorded by sex. This will also assist in exposing prenatal sex selection as elevated or equal risks of stillbirth in females would be readily apparent and could therefore be used to trigger investigation.
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Affiliation(s)
- Debapriya Mondal
- />Biosciences, College of Life and Environmental Sciences, Hatherly Laboratories, University of Exeter, Prince of Wales Road, Exeter, EX4 4PS UK
- />Current address: School of Environment and Life Sciences, University of Salford, Room 322, Peel Building, Salford, UK
| | - Tamara S Galloway
- />Biosciences, College of Life and Environmental Sciences, Hatherly Laboratories, University of Exeter, Prince of Wales Road, Exeter, EX4 4PS UK
| | - Trevor C Bailey
- />Mathematics, College of Engineering, Harrison Building, Mathematical and Physical Sciences, University of Exeter, Exeter, EX4 4QF UK
| | - Fiona Mathews
- />Biosciences, College of Life and Environmental Sciences, Hatherly Laboratories, University of Exeter, Prince of Wales Road, Exeter, EX4 4PS UK
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Boisramé T, Sananès N, Fritz G, Boudier E, Aissi G, Favre R, Langer B. Placental abruption: risk factors, management and maternal–fetal prognosis. Cohort study over 10 years. Eur J Obstet Gynecol Reprod Biol 2014; 179:100-4. [DOI: 10.1016/j.ejogrb.2014.05.026] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Revised: 05/19/2014] [Accepted: 05/22/2014] [Indexed: 10/25/2022]
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