PREGNANCY 2009 <97>
Database EMBASE
Accession Number 0020180667
Authors Jones H.E. Heil S.H. O'Grady K.E. Martin P.R. Kaltenbach K. Coyle M.G. Stine S.M. Selby P. Arria A.M.
Fischer G.
Institution
(Jones, Heil, O'Grady, Martin, Kaltenbach, Coyle, Stine, Selby, Arria, Fischer) Department of Psychiatry, Johns
Hopkins University, Baltimore, Maryland, USA.
Country of Publication
United Kingdom
Title
Smoking in pregnant women screened for an opioid agonist medication study
compared to related pregnant and non-pregnant patient samples.
Source
The American journal of drug and alcohol abuse. 35(5)(pp 375-380), 2009. Date of
Publication: 2009.
Abstract
BACKGROUND: Little is known about the prevalence and severity of smoking in pregnant
opioid dependent patients. OBJECTIVES: To first characterize the prevalence and severity of
smoking in pregnant patients screened for a randomized controlled trial, Maternal Opioid
Treatment: Human Experimental Research (MOTHER), comparing two agonist medications;
and second, to compare the MOTHER screening sample to published samples of other
pregnant and/or patients with substances use disorders. METHODS: Pregnant women (N =
108) screened for entry into an agonist medication comparison study were retrospectively
compared on smoking variables to samples of pregnant methadone-maintained patients (N =
50), pregnant opioid or cocaine dependent patients (N = 240), non-pregnant methadonemaintained women (N = 75), and pregnant non-drug-addicted patients (N = 1,516).
RESULTS: Of screened patients, 88% (n = 95) smoked for a mean of 140 months (SD =
79.0) starting at a mean age of 14 (SD = 3.5). This rate was similar to substance use
disordered patients and significantly higher compared to general pregnant patients (88% vs.
22%, p < .001). CONCLUSION AND SCIENTIFIC SIGNIFICANCE: Aggressive efforts are
needed to reduce/eliminate smoking in substance-abusing pregnant women.
Publication Type Journal: Article
Journal Name The American journal of drug and alcohol abuse
Volume 35
Issue Part 5
Page 375-380
Year of Publication 2009
Date of Publication 2009
PREGNANCY 2009 <99>
Database EMBASE
Accession Number 0020180664
Authors Tuten M. Fitzsimons H. Chisolm M.S. Jones H.E. Heil S.H. O'Grady K.E.
Institution
(Tuten, Fitzsimons, Chisolm, Jones, Heil, O'Grady) Department of Psychiatry and Behavioral Sciences, Johns
Hopkins University School of Medicine, Baltimore, Maryland, USA.
Country of Publication
United Kingdom
Title
The impact of mood disorders on the delivery and neonatal outcomes of methadonemaintained pregnant patients.
Source
The American journal of drug and alcohol abuse. 35(5)(pp 358-363), 2009. Date of
Publication: 2009.
Abstract
Methadone-maintained pregnant patients with mood disorders have compromised treatment
outcomes ( [1] ). This study examined the relationship between the presence of mood
disorders and delivery and neonatal outcomes. Participants were categorized into two groups:
no current mood disorder (n = 30) or primary mood disorder (n = 38). The mood disorder
group reported more serious lifetime and current depression than did the no current mood
disorder group. Neonates from mothers with mood disorders had a longer length of stay in the
neonatal intensive care unit than the no current mood disorder group. Findings emphasize the
need to treat mood disorders in methadone-maintained pregnant patients.
Publication Type Journal: Article
Journal Name The American journal of drug and alcohol abuse
Volume 35
Issue Part 5
Page 358-363
Year of Publication 2009
Date of Publication 2009
PREGNANCY 2009 <682>
Database Ovid MEDLINE(R) In-Process & Other Non-Indexed Citations and Ovid MEDLINE(R)
Unique Identifier 19588322
Status MEDLINE
Authors Lumley J. Chamberlain C. Dowswell T. Oliver S. Oakley L. Watson L.
Authors Full Name Lumley, Judith. Chamberlain, Catherine. Dowswell, Therese. Oliver, Sandy. Oakley, Laura.
Watson, Lyndsey.
Institution
Mother and Child Health Research, La Trobe University, 324-328 Little Lonsdale Street, Melbourne, Victoria,
Australia, 3000.
Title
Interventions for promoting smoking cessation during pregnancy. [Review] [301
refs][Update of Cochrane Database Syst Rev. 2004;(4):CD001055; PMID: 15495004]
Source
Cochrane Database of Systematic Reviews. (3):CD001055, 2009.
Journal Name
Cochrane Database of Systematic Reviews
Country of Publication
England
Abstract
BACKGROUND: Tobacco smoking in pregnancy remains one of the few preventable factors
associated with complications in pregnancy, low birthweight, preterm birth and has serious
long-term health implications for women and babies. Smoking in pregnancy is decreasing in
high-income countries and increasing in low- to middle-income countries and is strongly
associated with poverty, low educational attainment, poor social support and psychological
illness. OBJECTIVES: To assess the effects of smoking cessation interventions during
pregnancy on smoking behaviour and perinatal health outcomes. SEARCH STRATEGY: We
searched the Cochrane Pregnancy and Childbirth Group's Trials Register (June 2008), the
Cochrane Tobacco Addiction Group's Trials Register (June 2008), EMBASE, PsycLIT, and
CINAHL (all from January 2003 to June 2008). We contacted trial authors to locate additional
unpublished data. SELECTION CRITERIA: Randomised controlled trials where smoking
cessation during pregnancy was a primary aim of the intervention. DATA COLLECTION AND
ANALYSIS: Trials were identified and data extracted by one person and checked by a
second. Subgroup analysis was conducted to assess the effect of risk of trial bias, intensity of
the intervention and main intervention strategy used. MAIN RESULTS: Seventy-two trials are
included. Fifty-six randomised controlled trials (over 20,000 pregnant women) and nine
cluster-randomised trials (over 5000 pregnant women) provided data on smoking cessation
outcomes.There was a significant reduction in smoking in late pregnancy following
interventions (risk ratio (RR) 0.94, 95% confidence interval (CI) 0.93 to 0.96), an absolute
difference of six in 100 women who stopped smoking during pregnancy. However, there is
significant heterogeneity in the combined data (I(2) > 60%). In the trials with the lowest risk of
bias, the interventions had less effect (RR 0.97, 95% CI 0.94 to 0.99), and lower
heterogeneity (I(2) = 36%). Eight trials of smoking relapse prevention (over 1000 women)
showed no statistically significant reduction in relapse.Smoking cessation interventions
reduced low birthweight (RR 0.83, 95% CI 0.73 to 0.95) and preterm birth (RR 0.86, 95% CI
0.74 to 0.98), and there was a 53.91g (95% CI 10.44 g to 95.38 g) increase in mean
birthweight. There were no statistically significant differences in neonatal intensive care unit
admissions, very low birthweight, stillbirths, perinatal or neonatal mortality but these analyses
had very limited power. AUTHORS' CONCLUSIONS: Smoking cessation interventions in
pregnancy reduce the proportion of women who continue to smoke in late pregnancy, and
reduce low birthweight and preterm birth. Smoking cessation interventions in pregnancy need
to be implemented in all maternity care settings. Given the difficulty many pregnant women
addicted to tobacco have quitting during pregnancy, population-based measures to reduce
smoking and social inequalities should be supported. [References: 301]
Publication Type Journal Article. Meta-Analysis. Review.
Date of Publication 2009
Year of Publication 2009
Issue/Part 3
Page CD001055
PREGNANCY 2009 <683>
Database Ovid MEDLINE(R) In-Process & Other Non-Indexed Citations and Ovid MEDLINE(R)
Unique Identifier 19519880
Status MEDLINE
Authors Malek A. Obrist C. Wenzinger S. von Mandach U.
Authors Full Name Malek, Antoine. Obrist, Cristina. Wenzinger, Silvana. von Mandach, Ursula.
Institution
Department of Obstetrics, Zurich University Hospital, Frauenklinikstr, 10, 8091 Zurich, Switzerland.
antoine.malek1@gmail.com
Title
The impact of cocaine and heroin on the placental transfer of methadone.
Source
Reproductive Biology & Endocrinology. 7:61, 2009.
Journal Name
Reproductive Biology & Endocrinology
Other ID
Source: NLM. PMC2703629
Country of Publication
England
Abstract
BACKGROUND: Methadone is the therapeutic agent of choice for the treatment of opiate
addiction in pregnancy. The co-consumption (heroin, cocaine) which may influence the effects
of methadone is frequent. Therefore, the impact of cocaine and heroin on the placental
transfer of methadone and the placental tissue was investigated under in vitro conditions.
METHODS: Placentae (n = 24) were ex-vivo perfused with medium (m) (control, n = 6), m
plus methadone (n = 6), m plus methadone and cocaine (n = 6) or m plus methadone and
heroin (n = 6). Placental functionality parameters like antipyrine permeability, glucose
consumption, lactate production, hormone production (hCG and leptin), microparticles release
and the expression of P-glycoprotein were analysed. RESULTS: Methadone accumulated in
placental tissue. Methadone alone decreased the transfer of antipyrine from 0.60 +/- 0.07 to
0.50 +/- 0.06 (fetal/maternal ratio, mean +/- SD, P < 0.01), whereas the combination with
cocaine or heroin increased it (0.56 +/- 0.08 to 0.68 +/- 0.13, P = 0.03 and 0.58 +/- 0.21 to
0.71 +/- 0.24; P = 0.18). Microparticles (MPs) released from syncytiotrophoblast into maternal
circuit increased by 30% after cocaine or heroin (P < 0.05) and the expression of Pglycoprotein in the tissue increased by >or= 49% after any drug (P < 0.05). All other
measured parameters did not show any significant effect when methadone was combined
with cocaine or heroine. CONCLUSION: The combination of cocaine or heroin with
methadone increase antipyrine permeability. Changes of MPs resemble findings seen in
oxidative stress of syncytiotrophoblast.
Publication Type In Vitro. Journal Article. Research Support, Non-U.S. Gov't.
Date of Publication 2009
Year of Publication 2009
Volume 7
Page 61
PREGNANCY 2009 <148>
Database EMBASE
Accession Number 2009110618
Authors Jansson L.M. Dipietro J.A. Velez M. Elko A. Knauer H. Kivlighan K.T.
Institution
(Jansson, Velez, Knauer) Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD,
United States.
(Dipietro, Kivlighan) Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School
of Public Health, Baltimore, MD, United States.
(Elko) Department of Obstetrics and Gynecology, Johns Hopkins Bayview Medical Center, Baltimore, MD, United
States.
(Jansson) Johns Hopkins University School of Medicine, Center for Addiction and Pregnancy, 4940 Eastern
Avenue, D5, Baltimore, MD 21224, United States.
Country of Publication
United Kingdom
Title
Maternal methadone dosing schedule and fetal neurobehaviour.
Source
Journal of Maternal-Fetal and Neonatal Medicine. 22(1)(pp 29-35), 2009. Date of
Publication: January 2009.
Publisher
Taylor and Francis Ltd.
Abstract
Objective. Daily methadone maintenance is the standard of care for opiate dependency
during pregnancy. Previous research has indicated that single-dose maternal methadone
administration significantly suppresses fetal neurobehaviours. The purpose of this study was
to determine if split-dosing would have less impact on fetal neurobehaviour than single-dose
administration. Methods. Forty methadone-maintained women were evaluated at peak and
trough maternal methadone levels on single- and split-dosing schedules. Monitoring sessions
occurred at 36- and 37-weeks gestation in a counterbalanced study design. Fetal measures
included heart rate, variability, accelerations, motor activity and fetal movement-heart rate
coupling (FM-FHR). Maternal measures included heart period, variability, skin conductance,
respiration and vagal tone. Repeated measure analysis of variance was used to evaluate
within-subject changes between split- and single-dosing regimens. Results. All fetal
neurobehavioural parameters were suppressed by maternal methadone administration,
regardless of dosing regimen. Fetal parameters at peak were significantly lower during single
versus split methadone administration. FM-FHR coupling was less suppressed from trough to
peak during split-dosing versus single-dosing. Maternal physiologic parameters were
generally unaffected by dosing condition. Conclusion. Split-dosed fetuses displayed less
neurobehavioural suppression from trough to peak maternal methadone levels as compared
with single-dosed fetuses. Split-dosing may be beneficial for methadone-maintained pregnant
women. copyright 2009 Informa Healthcare USA, Inc.
ISSN 1476-7058
Publication Type Journal: Article
Journal Name Journal of Maternal-Fetal and Neonatal Medicine
Volume 22
Issue Part 1
Page 29-35
Year of Publication 2009
Date of Publication January 2009
PREGNANCY (A) 2009 <167>
Database EMBASE
Accession Number 2009076829
Authors Lin C.S. Tao P.L. Jong Y.J. Chen W.F. Yang C.H. Huang L.T. Chao C.F. Yang S.N.
Institution
(Lin, Chao) Graduate Institute of Medical Sciences, National Defense Medical Center, Taiwan (Republic of China).
(Lin) Department of Emergency and Critical Care Medicine, Cheng Hsin Rehabilitation Medical Center, Taiwan
(Republic of China).
(Tao) Department of Pharmacology, National Defense Medical Center, Taiwan (Republic of China).
(Jong, Yang) Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung Medical University,
Taiwan (Republic of China).
(Jong, Yang, Yang) Graduate Institute of Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical
University, No. 100, Tz-Yu 1st Road, Kaohsiung, 807, Taiwan (Republic of China).
(Chen) Department of Neurosurgery, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung
University College of Medicine, Taiwan (Republic of China).
(Huang) Department of Pediatrics, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung
University College of Medicine, Taiwan (Republic of China).
(Yang) Center of Excellence for Environmental Medicine, Kaohsiung Medical University, Taiwan (Republic of
China).
Country of Publication
United Kingdom
Title
Prenatal morphine alters the synaptic complex of postsynaptic density 95 with Nmethyl-d-aspartate receptor subunit in hippocampal CA1 subregion of rat offspring
leading to long-term cognitive deficits.
Source
Neuroscience. 158(4)(pp 1326-1337), 2009. Date of Publication: 18 Feb 2009.
Publisher
Elsevier Ltd
Abstract
Infants who are passively exposed to morphine or heroin through their addicted mothers
usually develop neurobiological changes. The postsynaptic density 95 (PSD-95) protein, a
submembranous cytoskeletal specialization, is dynamically linked with N-methyl-d-aspartate
receptors (NMDARs) to form a synaptic complex in postsynaptic neurons. This complex
serves important neurobiological functions, including mammalian learning and memory.
However, the effects of prenatal morphine exposure on this synaptic complex are not well
understood. In this study, we determined whether prenatal morphine exposure altered the
synaptic complex association between PSD-95 and three major NMDAR subunits (NR1,
NR2A, and NR2B), at the mRNA and protein levels, within the hippocampal CA1 subregion
(an important integration area for mammalian learning and memory) of rat offspring along with
the performance of long-term cognitive functions. Sprague-Dawley rat offspring from
morphine-addicted mothers were studied at a younger age (postnatal day 14; P14) and at an
older age (P45). Subsequently, an eight-arm radial maze task was applied to analyze the
working and cued reference memory in such offspring (P45). The real-time polymerase chain
reaction results showed that prenatal morphine exposure caused significant decreases in
mRNA levels of the PSD-95 and three NMDAR subunits (NR1, NR2A, and NR2B) in offspring
(P14 and P45). Similarly, at the protein level, immunoblotting showed that decreased whole
levels of PSD-95 and NMDAR subunits were seen in offspring subjected with prenatal
morphine. Furthermore, the protein interaction of the synaptic complex between the PSD-95
and NMDAR subunit, as indicated by coimmunoprecipitation, was less in prenatal morphine
samples than in vehicle controls (P14 and P45). The prenatal morphine group also showed
poorer performance for an eight-arm radial maze task than the vehicle-control group. These
results are particularly important for a better understanding of certain opioid-mediated
neurobehavioral cognitive changes in offspring associated with altered protein interaction
between PSD-95 and NMDAR subunits within the developing brain. copyright 2009 IBRO.
ISSN 0306-4522
Publication Type Journal: Article
Journal Name Neuroscience
Volume 158
Issue Part 4
Page 1326-1337
Year of Publication 2009
Date of Publication 18 Feb 2009
PREGNANCY 2009 <255>
Database EMBASE
Accession Number 2008592392
Authors Held-Egli K. Ruegger C. Das-Kundu S. Schmitt B. Bucher H.U.
Institution
(Held-Egli, Ruegger, Das-Kundu, Bucher) Clinic for Neonatology, University Hospital Zurich, Zurich, Switzerland.
(Schmitt) Division of Clinical Neurophysiology, University Children's Hospital Zurich, Zurich, Switzerland.
(Bucher) Clinic for Neonatology, University Hospital, CH-8091 Zurich, Switzerland.
Country of Publication
United Kingdom
Title
Benign neonatal sleep myoclonus in newborn infants of opioid dependent mothers.
Source
Acta Paediatrica, International Journal of Paediatrics. 98(1)(pp 69-73), 2009. Date of
Publication: January 2009.
Publisher
Blackwell Publishing Ltd
Abstract
Objective: The aim of our study was to evaluate the incidence, duration and risk factors for
benign neonatal sleep myoclonus (BNSM) in infants with neonatal abstinence syndrome
(NAS) treated with opioids or sedatives, compared with control infants. Methods: This is a
single centre observational case control study. Seventy-eight near term and term infants with
neonatal opiate abstinence syndrome confirmed by meconium analysis were included.
Exclusion criteria were cerebral malformation, intracranial haemorrhage and perinatal
asphyxia. The babies were assessed eight hourly with a modified Finnegan score that
included sleep myoclonus. Seventy-eight infants not exposed to opiates during pregnancy,
hospitalized for at least 14 days and matched for gestational age were used as controls.
Results: The median gestational age was 38 1/7 (95% CI: 35 3/7-41 2/7) weeks, birth weight
2730 (95% CI: 1890-3600) g, umbilical artery pH 7.25 (CI 7.10-7.37) and Apgar score at 5
minutes 9 (95% CI: 7-10). The control infants did not differ in these characteristics. Sleep
myoclonus was diagnosed in 52 (67%) of the infants with NAS and 2 (2.6%) of the controls
(OR 26 [95% CI: 7-223], p < 0.001). Myoclonus appeared as early as day 2 and as late as
day 56 of life (median day 6) and lasted for 1 to 93 days (median 13 days). All infants had
serum glucose > 2.5 mmol/L at first occurrence. The neurological examinations as well as
cerebral ultrasound scans were normal. An electroencephalogram (EEG) carried out in 18
infants showed no signs of epileptic activity. Conclusion: BNSM has a high incidence in
infants with NAS. The diagnosis can be made clinically. In the absence of other neurological
symptoms further investigations such as EEG are not necessary and anticonvulsive treatment
is not indicated. copyright 2008 The Author(s).
ISSN 0803-5253
Publication Type Journal: Article
Journal Name Acta Paediatrica, International Journal of Paediatrics
Volume 98
Issue Part 1
Page 69-73
Year of Publication 2009
Date of Publication January 2009
PREGNANCY 2009 <329>
Database EMBASE
Accession Number 2009299727
Authors Lewis S.E. Maccarrone M.
Institution
(Lewis) School of Medicine, Centre for Public Health, Queen's University Belfast, Grosvenor Road, Belfast, BT12
6BJ, United Kingdom.
(Maccarrone) Department of Biomedical Sciences, University of Teramo, Teramo, Italy.
(Maccarrone) European Center for Brain Research (CERC), S. Lucia Foundation, Rome, Italy.
Country of Publication
United Kingdom
Title
Endocannabinoids, sperm biology and human fertility.
Source
Pharmacological Research. 60(2)(pp 126-131), 2009. Date of Publication: August 2009.
Publisher
Academic Press
Abstract
Aims: In this review, we shall summarize the current knowledge on the endocannabinoid
system (ECS), and on its involvement in the multifaceted process of male reproduction. In
particular, we shall discuss the role of ECS in sperm biology and Sertoli cell proliferation and
death, showing how endocannabinoids may regulate spermatogenesis and reproductive
potential. Data synthesis: The available evidence highlights the existence of a distinctive
network, including endocannabinoids and sex hormones, that warrants a successful
pregnancy in mammals. In particular, it appears that the endocannabinoid-degrading enzyme
FAAH (fatty acid amide hydrolase) has a central role in this array of signals, because it
controls several steps of sperm biology, from motility to capacitation and acrosome reaction.
Since the regulation of FAAH activity and expression by autocrine and paracrine factors may
occur through genomic or non-genomic mechanisms mediated by type-1 cannabinoid
receptor (CB1R) signaling, we also raise concerns about the use of CB1R agonists (like
marijuana) or antagonists (like the anti-obesity drug Acomplia) in subjects of reproductive
age. Conclusion: Based on the present data, we point out that FAAH might be a novel and
potentially important target for the development of next generation therapeutics against
infertility. In particular, a reduced reproductive potential seems to be paralleled by defective
FAAH, suggesting that therapeutics able to enhance, rather than inhibit, enzyme activity might
be useful fertility enhancers. copyright 2009 Elsevier Ltd.
ISSN 1043-6618
Publication Type Journal: Review
Journal Name Pharmacological Research
Volume 60
Issue Part 2
Page 126-131
Year of Publication 2009
Date of Publication August 2009
PREGNANCY 2009 <362>
Database EMBASE
Accession Number 2009325772
Authors O'Grady M.J. Hopewell J. White M.J.
Institution
(O'Grady, Hopewell, White) Coombe Women and Infants University Hospital, Dublin, Ireland.
(O'Grady) University College Hospital, Newcastle Road, Galway, Ireland.
Country of Publication
United Kingdom
Title
Management of neonatal abstinence syndrome: A national survey and review of
practice.
Source
Archives of Disease in Childhood: Fetal and Neonatal Edition. 94(4)(pp F249-F252), 2009.
Date of Publication: July 2009.
Publisher
BMJ Publishing Group
Abstract
Aim: To ascertain the present management of neonatal abstinence syndrome (NAS) in
neonatal units in the United Kingdom (UK) and Ireland. Methods: Postal questionnaire to 235
neonatal units, with telephone follow-up of non-respondents. Results: The response rate was
90%, and 96% of respondents had a formal NAS guideline. The median number of infants
treated annually for NAS was 6 (range 1-100). The method of Finnegan was the most widely
used scoring system (52%). Morphine sulphate was the most commonly used first line agent
for both opiate (92%) and polysubstance (69%) withdrawal. Dosing regimens varied widely.
Units using a maximum daily morphine dose of ,400 mg/kg/day were more likely to require the
addition of a second agent (76% vs 58%, p=0.027). Phenobarbitone was the drug of choice to
treat seizures secondary to both opiate and polydrug withdrawal in 73% and 81% of units,
respectively. 29% of units allowed infants to be discharged home on medication. 58% of
these allowed administration of opiates in the community and in almost half of cases this was
managed by a parent. Mothers on methadone whose serology was positive for hepatitis B
and/or C were four times more likely to be discouraged from breastfeeding. Conclusions: The
majority of units currently use an opiate as the drug of first choice as recommended. Doses
utilised and second agents added vary significantly between units. Many of our findings reflect
the lack of high-quality randomised studies regarding management of NAS.
ISSN 0003-9888
Publication Type Journal: Article
Journal Name Archives of Disease in Childhood: Fetal and Neonatal Edition
Volume 94
Issue Part 4
Page F249-F252
Year of Publication 2009
Date of Publication July 2009
PREGNANCY 2009 <364>
Database EMBASE
Accession Number 2009337227
Authors Malek A. Obrist C. Wenzinger S. von Mandach U.
Institution
(Malek, Obrist, Wenzinger, von Mandach) Department of Obstetrics, Zurich University Hospital, Frauenklinikstr. 10,
8091 Zurich, Switzerland.
Country of Publication
United Kingdom
Title
The impact of cocaine and heroin on the placental transfer of methadone.
Source
Reproductive Biology and Endocrinology. 7, 2009. Article Number: 61. Date of Publication:
11 Jun 2009.
Publisher
BioMed Central Ltd.
Abstract
Background: Methadone is the therapeutic agent of choice for the treatment of opiate
addiction in pregnancy. The co-consumption (heroin, cocaine) which may influence the effects
of methadone is frequent. Therefore, the impact of cocaine and heroin on the placental
transfer of methadone and the placental tissue was investigated under in vitro conditions.
Methods: Placentae (n = 24) were ex-vivo perfused with medium (m) (control, n = 6), m plus
methadone (n = 6), m plus methadone and cocaine (n = 6) or m plus methadone and heroin
(n = 6). Placental functionality parameters like antipyrine permeability, glucose consumption,
lactate production, hormone production (hCG and leptin), microparticles release and the
expression of P-glycoprotein were analysed. Results: Methadone accumulated in placental
tissue. Methadone alone decreased the transfer of antipyrine from 0.60 +/- 0.07 to 0.50 +/0.06 (fetal/maternal ratio, mean +/- SD, P < 0.01), whereas the combination with cocaine or
heroin increased it (0.56 +/- 0.08 to 0.68 +/- 0.13, P = 0.03 and 0.58 +/- 0.21 to 0.71 +/- 0.24;
P = 0.18). Microparticles (MPs) released from syncytiotrophoblast into maternal circuit
increased by 30% after cocaine or heroin (P < 0.05) and the expression of P-glycoprotein in
the tissue increased by [greater-than or equal to] 49% after any drug (P < 0.05). All other
measured parameters did not show any significant effect when methadone was combined
with cocaine or heroine. Conclusion: The combination of cocaine or heroin with methadone
increase antipyrine permeability. Changes of MPs resemble findings seen in oxidative stress
of syncytiotrophoblast. copyright 2009 Malek et al; licensee BioMed Central Ltd.
Publication Type Journal: Article
Journal Name Reproductive Biology and Endocrinology
Volume 7
Year of Publication 2009
Date of Publication 11 Jun 2009
PREGNANCY 2009 <402>
Database EMBASE
Accession Number 2009354518
Authors Alati R. Van Dooren K. Najman J.M. Williams G.M. Clavarino A.
Institution
(Alati, Van Dooren, Najman, Williams) School of Population Health, University of Queensland, Public Health
Building Herston Road, Herston, QLD 4006, Australia.
(Najman) School of Social Science, University of Queensland, QLD, Australia.
(Clavarino) School of Pharmacy, University of Queensland, QLD, Australia.
Country of Publication
United Kingdom
Title
Early weaning and alcohol disorders in offspring: Biological effect, mediating factors
or residual confounding?
Source
Addiction. 104(8)(pp 1324-1332), 2009. Date of Publication: August 2009.
Publisher
Blackwell Publishing Ltd
Abstract
Aims This study explores associations between early weaning and alcohol use disorders in
youth and mechanisms by which these associations may operate. Design We used data from
the Mater University Study of Pregnancy and its outcomes, an Australian birth cohort study
based in Brisbane. Setting and participants: This study is based on a subsample of 2370
participants for whom complete data were available at age 21 years. Length and method of
breastfeeding were assessed at 6 months. Measurements Alcohol use disorders were
assessed at age 21 using the life-time version of the Composite International Diagnostic
Interview - computerized version (CIDI-Auto). We adjusted for maternal age, marital status,
education, alcohol, tobacco use, anxiety, depression and maternal attitudes towards the baby.
Attention Deficit and Hyperactivity Disorders (ADHD) and Intellect Quotient (IQ) were
measured with the Child Behaviour Checklist (5 years) and the Ravens SM (14 years),
respectively. Findings Those who had been weaned within 2 weeks of being born and
breastfed at regular intervals were at increased risk of meeting criteria for alcohol use
disorders at age 21 [odds ratio (OR) 1.71, 95% confidence interval (CI):1.07, 2.72].
ConclusionThis study confirms a small but robust association between early weaning and
increased risk of alcohol use disorders. copyright 2009 Society for the Study of Addiction.
ISSN 0965-2140
Publication Type Journal: Article
Journal Name Addiction
Volume 104
Issue Part 8
Page 1324-1332
Year of Publication 2009
Date of Publication August 2009
PREGNANCY 2009 <416>
Database EMBASE
Accession Number 2009354495
Authors Gray R. Mukherjee R.A.S. Rutter M.
Institution
(Gray) National Perinatal Epidemiology Unit, University of Oxford, Old Road Campus, Headington, Oxford OX3 7LF,
United Kingdom.
(Mukherjee) Surrey and Borders Partnership NHS Trust, Oxted, Surrey, United Kingdom.
(Rutter) SGDP Centre, Institute of Psychiatry, Kings College London, London, United Kingdom.
Country of Publication
United Kingdom
Title
Alcohol consumption during pregnancy and its effects on neurodevelopment: What is
known and what remains uncertain.
Source
Addiction. 104(8)(pp 1270-1273), 2009. Date of Publication: August 2009.
Publisher
Blackwell Publishing Ltd
Abstract
It has been claimed that mothers' drinking during pregnancy may affect the
neurodevelopment of around 1% of all children. If this is true, then prenatal alcohol exposure
represents an important risk factor for neurodevelopmental problems, giving rise to a large
burden of disability which could be potentially preventable. Evidence to support this idea has
come from animal experiments and human observational studies. However, such findings
need to be supported by more robust research designs. Because randomized controlled trials
in this area are neither feasible nor ethical, suggestions are made for further research making
more use of natural experiments. copyright 2009 Society for the Study of Addiction.
ISSN 0965-2140
Publication Type Journal: Review
Journal Name Addiction
Volume 104
Issue Part 8
Page 1270-1273
Year of Publication 2009
Date of Publication August 2009
PREGNANCY 2009 <466>
Database
EMBASE
Accession Number
2009381975
Authors
Madsen I.R. Hrder K. Stving R.K.
Institution
(Madsen, Hrder, Stving) Department of Endocrinology, Center for Eating Disorders, Odense University Hospital,
Odense, Denmark.
Country of Publication
United Kingdom
Title
Remission of eating disorder during pregnancy: Five cases and brief clinical review.
Source
Journal of Psychosomatic Obstetrics and Gynecology. 30(2)(pp 122-126), 2009. Date of
Publication: June 2009.
Publisher
Taylor and Francis Ltd.
Abstract
Eating disorder during pregnancy is associated with a diversity of adverse outcomes and is
of potential danger to both mother and child. There is, however, a tendency for remission of
the eating disorder during pregnancy with improvement of symptoms such as restrictive
dieting, binging and purging, and some women actually manage to put the disease behind
them. This case report describes five women with different eating disorders and focuses on
the symptomatology during pregnancy and in the months postpartum. The discussion deals
with the possible psychological, social and endocrinological reasons for remission and the
subsequent relapse, the definition of recovery and the factors which should alert health care
professionals of the at-risk pregnancies in cases of undisclosed eating disorder. Furthermore,
therapeutic interventions are proposed.
ISSN 0167-482X
Publication Type Journal: Article
Journal Name Journal of Psychosomatic Obstetrics and Gynecology
Volume 30
Issue Part 2
Page 122-126
Year of Publication 2009
Date of Publication June 2009
PREGNANCY 2009 <473>
Database EMBASE
Accession Number 2009384553
Authors Martin P.R. Arria A.M. Fischer G. Kaltenbach K. Heil S.H. Stine S.M. Coyle M.G. Selby P. Jones H.E.
Institution
(Martin) Department of Psychiatry, Vanderbilt University School of Medicine, Vanderbilt Psychiatric Hospital, 1601
23rd Avenue South, Nashville, TN 37232-8650,
(Arria) Center for Substance Abuse Research, University of Maryland College Park, College Park, MD,
(Fischer) Department of Psychiatry, Medical University of Vienna, Vienna, Austria.
(Kaltenbach) Department of Pediatrics, Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA,
(Heil) Department of Psychiatry, University of Vermont, Burlington, VT,
(Stine) Department of Psychiatry and Behavior Neurosciences, Wayne State University, Detroit, MI,
(Coyle) Department of Pediatrics, Warren Alpert Medical School, Brown University, Providence, RI,
(Selby) Departments of Family and Community Medicine, Psychiatry and Public Health Sciences, University of
Toronto, Toronto, ON, Canada.
(Jones) Department of Psychiatry, Johns Hopkins School of Medicine, Baltimore, MD,
Country of Publication
United Kingdom
Title
Psychopharmacologic management of opioid-dependent women during pregnancy.
Source
American Journal on Addictions. 18(2)(pp 148-156), 2009. Date of Publication: March 2009.
Publisher
Informa Healthcare
Abstract
Illicit drug use during pregnancy presents complex clinical challenges, including reducing
drug use and treating psychiatric disorders. Pharmacologic treatment of psychiatric disorders
in a pregnant woman requires an evaluation of the balance between potential clinical benefit
and the risk of potential neonatal consequences. This study describes psychiatric symptoms
in 111 opioid-dependent pregnant women and their prescribed psychotropic medications.
Hypomania, generalized anxiety disorder and depression were the most common disorders
for which psychiatric symptoms were endorsed. Over half of women studied were prescribed
some form of psychoactive medication during pregnancy. Pharmacologic vs. nonpharmacologic treatment approaches in this patient population are discussed.
ISSN 1055-0496
Publication Type Journal: Article
Journal Name American Journal on Addictions
Volume 18
Issue Part 2
Page 148-156
Year of Publication 2009
Date of Publication March 2009
PREGNANCY 2009 <525>
Database EMBASE
Accession Number 2009486387
Authors Kashiwagi M. Sieber S. Rechsteiner C. Lauper U. Zimmermann R. Ehlert U.
Institution
(Kashiwagi, Lauper, Zimmermann) Department of Obstetrics Gynecology, Clinic of Obstetrics, University Hospital
Zurich, Switzerland.
(Sieber, Rechsteiner, Ehlert) Department of Clinical Psychology, University of Zurich, Switzerland.
(Kashiwagi) University Hospital Zurich, Clinic of Obstetrics, Frauenklinikstr. 10, 8091 Zurich, Switzerland.
Country of Publication
United Kingdom
Title
Psychological mood state of opiate addicted women during pregnancy and
postpartum in comparison to non-addicted healthy women.
Source
Journal of Psychosomatic Obstetrics and Gynecology. 30(3)(pp 201-204), 2009. Date of
Publication: September 2009.
Publisher
Informa Healthcare
Abstract
Opiate addiction has been widely documented to have negative impact on pregnancy course
and outcome. Unfavorable psychosocial situation of addicted women predispose for poor
processing of the physiological and psychological demands of pregnancy. Thus aim of our
study was to investigate the psychological mood state of opiate addicts during pregnancy and
postpartum in comparison to healthy women. In a case-controlled, prospective, longitudinal
study nine pregnant opiate addicts and nine healthy pregnant women matched by age, level
of education and gestational age at birth were interviewed in the third trimester of pregnancy
and postpartum. Standardized questionnaires and inventories for assessment of the general
psychopathology and emotional state, the perceived self-efficacy expectancy, the
psychosocial adaptation to pregnancy and the fear of delivery, respectively were applied.
Addicted women achieved significantly higher scores in the test assessing general
psychopathology and emotional state before delivery compared to abstinent women.
Interestingly this difference was unverifiable postpartum. This study reaffirms the presumption
of a disadvantageous psychological condition in pregnant opiate addicts in comparison to
healthy pregnant women for the first time in a prospective case-control study design.
copyright 2009 Informa UK Ltd.
ISSN 0167-482X
Publication Type Journal: Article
Journal Name Journal of Psychosomatic Obstetrics and Gynecology
Volume 30
Issue Part 3
Page 201-204
Year of Publication 2009
Date of Publication September 2009
PREGNANCY 2009 <561>
Database EMBASE
Accession Number 2009469485
Authors Scott G.J. Holding S. Purcell A. Tutty S. Lindow S.W.
Institution
(Scott, Holding, Purcell, Tutty, Lindow) Women and Children's Hospital, Hull Royal Infirmary, Anlaby Road, Hull,
East Yorkshire, HU3 2JZ, United Kingdom.
Country of Publication
United Kingdom
Title
The influence of maternal opiate use in pregnancy on second trimester biochemical
markers for Down syndrome.
Source
Prenatal Diagnosis. 29(9)(pp 863-865), 2009. Date of Publication: September 2009.
Publisher
John Wiley and Sons Ltd
Abstract
Objective: The object of this study is to examine the influence of maternal opiate use on the
levels of second trimester biochemical markers for Down syndrome. Maternal opiate use is
known to be associated with problems of placental origin and it is possible that the secretion
of alpha-feto protein (AFP), free-beta human chorionic gonadotrophin (HCG) and
unconjugated oestriol (UE) differs from that of a normal population. Method: Seventy nine
women who used opiates in pregnancy were compared to a control group of seventy nine
women who did not use opiates and their adjusted marker levels analysed. Results: The
adjusted median MoM in the opiate and control groups respectively were: AFP (1.00 vs 0.94),
HCG (0.95 vs 1.04) and UE (0.96 vs 1.02), with no significant difference between these
groups. Conclusion: This study suggests that the current practice of calculating the risk of
Down syndrome from second trimester biochemistry in women using opiate can be performed
using data derived from a normal population. Copyright copyright 2009 John Wiley & Sons,
Ltd.
ISSN 0197-3851
Publication Type Journal: Article
Journal Name Prenatal Diagnosis
Volume 29
Issue Part 9
Page 863-865
Year of Publication 2009
Date of Publication September 2009
PREGNANCY 2009 <572>
Database EMBASE
Accession Number 2009495862
Authors Cornelius M.D. Day N.L.
Institution
(Cornelius, Day) Western Psychiatric Institute and Clinic, Pittsburgh, PA, United States.
(Cornelius) Department of Psychiatry and Epidemiology, Western Psychiatric Institute and Clinic, Pittsburgh, PA,
United States.
Country of Publication
United Kingdom
Title
Developmental consequences of prenatal tobacco exposure.
Source
Current Opinion in Neurology. 22(2)(pp 121-125), 2009. Date of Publication: April 2009.
Publisher
Lippincott Williams and Wilkins
Abstract
Purpose of Review: This paper reviews results from published, in press, and conference
proceedings from 2007 and 2008 that link in-utero tobacco exposure to neurodevelopmental
outcomes in exposed offspring. Recent findings Prenatal tobacco exposure (PTE) affected
speech processing, levels of irritability and hypertonicity, attention levels, ability to selfregulate, need to be handled, and response to novelty preference in infants. In early
childhood, PTE effects were mostly behavioral outcomes including activity and inattention and
externalizing behaviors, including conduct disorder and antisocial behavior. In adolescents,
PTE predicted increased attention deficit hyperactivity disorder, modulation of the cerebral
cortex and white matter structure, and nicotine addiction. Several studies found moderating
effects with PTE and genetic susceptibilities including dopamine transporter, serotonergic
synaptic function, and monomine oxidase pathways. Other studies suggested that
environmental and genetic factors might be more important than the direct teratological
effects of PTE. Summary: The majority of studies reviewed were prospective and tobacco
exposure was quantified biologically. Most demonstrated a direct association between PTE
and neurodevelopmental outcomes. More work is needed to examine multifactorial
influences. Effects of PTE on the offspring appear to be moderated by genetic variability,
neurobehavioral disinhibition, and sex. copyright 2009 Wolters Kluwer Health | Lippincott
Williams & Wilkins.
ISSN 1350-7540
Publication TypeJournal: Review
Journal Name Current Opinion in Neurology
Volume 22
Issue Part 2
Page 121-125
Year of Publication 2009
Date of Publication April 2009
PREGNANCY 2009 <585>
Database EMBASE
Accession Number 2009538490
Authors Zammit S. Thomas K. Thompson A. Horwood J. Menezes P. Gunnell D. Hollis C. Wolke D. Lewis G.
Harrison G.
Institution
(Zammit) Department of Psychological Medicine, School of Medicine, Cardiff University, Heath Park, Cardiff CF14
4XN, United Kingdom.
(Thomas, Horwood, Gunnell) Department of Social Medicine, University of Bristol,
(Thompson, Menezes, Lewis, Harrison) Academic Unit of Psychiatry, University of Bristol, United Kingdom.
(Hollis) Division of Psychiatry, University of Nottingham, United Kingdom.
(Wolke) Department of Psychology, Health Research Institute, University of Warwick, United Kingdom.
Country of Publication
United Kingdom
Title
Maternal tobacco, cannabis and alcohol use during pregnancy and risk of adolescent
psychotic symptoms in offspring.
Source
British Journal of Psychiatry. 195(4)(pp 294-300), 2009. Date of Publication: October 2009.
Publisher
Royal College of Psychiatrists
Abstract
Background: Adverse effects of maternal substance use during pregnancy on fetal
development may increase risk of psychopathology. Aims: To examine whether maternal use
of tobacco, cannabis or alcohol during pregnancy increases risk of offspring psychotic
symptoms. Method: A longitudinal study of 6356 adolescents, age 12, who completed a semistructured interview for psychotic symptoms in the Avon Longitudinal Study of Parents and
Children (ALSPAC) birth cohort. Results: Frequency of maternal tobacco use during
pregnancy was associated with increased risk of suspected or definite psychotic symptoms
(adjusted odds ratio 1.20, 95% CI 1.05-1.37, P = 0.007). Maternal alcohol use showed a non-
linear association with psychotic symptoms, with this effect almost exclusively in the offspring
of women drinking >21 units weekly. Maternal cannabis use was not associated with
psychotic symptoms. Results for paternal smoking during pregnancy and maternal smoking
post-pregnancy lend some support for a causal effect of tobacco exposure in utero on
development of psychotic experiences. Conclusions: These findings indicate that risk factors
for development of non-clinical psychotic experiences may operate during early development.
Future studies of how in utero exposure to tobacco affects cerebral development and function
may lead to increased understanding of the pathogenesis of psychotic phenomena.
ISSN 0007-1250
Publication Type Journal: Article
Journal Name British Journal of Psychiatry
Volume 195
Issue Part 4
Page 294-300
Year of Publication 2009
Date of Publication October 2009
PREGNANCY 2009 <591>
Database EMBASE
Accession Number 2009480452
Authors Lumley J. Chamberlain C. Dowswell T. Oliver S. Oakley L. Watson L.
Institution
(Lumley, Chamberlain) 3Centres Collaboration, Women and Children's Program, Southern Health, Locked Bag 29,
Clayton South, VIC 3169, Australia.
(Watson) Mother and Child Health Research, La Trobe University, Melbourne, VIC, Australia.
(Dowswell) School of Reproductive and Developmental Medicine, Division of Perinatal and Reproductive Medicine,
University of Liverpool, Liverpool, United Kingdom.
(Oliver) Social Science Research Unit, Institute of Education, University of London, London, United Kingdom.
(Oakley) Non-communicable Disease Epidemiology Unit, London School of Hygiene and Tropical Medicine,
London, United Kingdom.
Country of Publication
United Kingdom
Title
Interventions for promoting smoking cessation during pregnancy.
Source
Cochrane Database of Systematic Reviews. (3), 2009. Article Number: CD001055. Date of
Publication: 2009.
Publisher
John Wiley and Sons Ltd
Abstract
Background: Tobacco smoking in pregnancy remains one of the few preventable factors
associated with complications in pregnancy, low birthweight, preterm birth and has serious
long-term health implications for women and babies. Smoking in pregnancy is decreasing in
high-income countries and increasing in low- to middle-income countries and is strongly
associated with poverty, low educational attainment, poor social support and psychological
illness. Objectives: To assess the effects of smoking cessation interventions during
pregnancy on smoking behaviour and perinatal health outcomes. Search strategy: We
searched the Cochrane Pregnancy and Childbirth Group's Trials Register (June 2008), the
Cochrane Tobacco Addiction Group's Trials Register (June 2008), EMBASE, PsycLIT, and
CINAHL (all from January 2003 to June 2008). We contacted trial authors to locate additional
unpublished data. Selection criteria: Randomised controlled trials where smoking cessation
during pregnancy was a primary aim of the intervention. Data collection and analysis: Trials
were identified and data extracted by one person and checked by a second. Subgroup
analysis was conducted to assess the effect of risk of trial bias, intensity of the intervention
and main intervention strategy used. Main results: Seventy-two trials are included. Fifty-six
randomised controlled trials (over 20,000 pregnant women) and nine cluster-randomised trials
(over 5000 pregnant women) provided data on smoking cessation outcomes. There was a
significant reduction in smoking in late pregnancy following interventions (risk ratio (RR) 0.94,
95% confidence interval (CI) 0.93 to 0.96), an absolute difference of six in 100 women who
stopped smoking during pregnancy. However, there is significant heterogeneity in the
combined data (I2 > 60%). In the trials with the lowest risk of bias, the interventions had less
effect (RR 0.97, 95% CI 0.94 to 0.99), and lower heterogeneity (I2 = 36%). Eight trials of
smoking relapse prevention (over 1000 women) showed no statistically significant reduction in
relapse. Smoking cessation interventions reduced low birthweight (RR 0.83, 95% CI 0.73 to
0.95) and preterm birth (RR 0.86, 95% CI 0.74 to 0.98), and there was a 53.91g (95% CI
10.44 g to 95.38 g) increase in mean birthweight. There were no statistically significant
differences in neonatal intensive care unit admissions, very low birthweight, stillbirths,
perinatal or neonatal mortality but these analyses had very limited power. Authors'
conclusions: Smoking cessation interventions in pregnancy reduce the proportion of women
who continue to smoke in late pregnancy, and reduce low birthweight and pretermbirth.
Smoking cessation interventions in pregnancy need to be implemented in all maternity care
settings. Given the difficulty many pregnant women addicted to tobacco have quitting during
pregnancy, population-based measures to reduce smoking and social inequalities should be
supported. Copyright copyright 2009 The Cochrane Collaboration. Published by John Wiley &
Sons, Ltd.
ISSN 1469-493X
Publication Type Journal: Review
Journal Name Cochrane Database of Systematic Reviews
Issue Part 3
Year of Publication 2009
Date of Publication 2009
PREGNANCY 2009 <702>
Database EMBASE
Accession Number 2009583739
Authors Chisolm M.S. Tuten M. Brigham E.C. Strain E.C. Jones H.E.
Institution
(Chisolm, Tuten, Strain, Jones) Department of Psychiatry and Behavioral Sciences, Johns Hopkins University,
School of Medicine, Baltimore, MD, United States.
(Chisolm, Tuten, Jones) Center for Addiction and Pregnancy, Johns Hopkins Bayview Medical Center, Baltimore,
MD, United States.
(Brigham) Department of General Internal Medicine, Johns Hopkins University, School of Medicine, Baltimore, MD,
United States.
Country of Publication
United Kingdom
Title
Relationship between cigarette use and mood/anxiety disorders among pregnant
methadone-maintained patients.
Source
American Journal on Addictions. 18(5)(pp 422-429), 2009. Date of Publication: 10 Aug
2009.
Publisher
Informa Healthcare
Abstract
This study investigates the association between cigarette use and current mood/anxiety
disorders among pregnant opioid-dependent patients. Pregnant methadone-maintained
women (N = 122) completed the Addiction Severity Index and Structured Clinical Interview for
DSM-IV. Participants were categorized based on past 30 days cigarette use: no (n = 15) and
any smoking (n = 107); this latter group was then subdivided into light (one to ten
cigarettes/day; n = 55), and heavy smokers (11 cigarettes/day; n = 52). Any smoking was
significantly associated with any current mood/anxiety disorder (p < 0.001), any current mood
disorder (p = 0.007), and any current anxiety disorder (p < 0.001). No significant association
was found between specific level of cigarette use and mood/anxiety disorders. This
association between smoking and psychiatric disorders has implications for the mental and
physical health of methadone-maintained women and their children, and may contribute to the
understanding of the physiological mechanisms underlying smoking and nicotine
dependence. copyright 2009 Informa Healthcare USA, Inc.
ISSN 1055-0496
Publication Type Journal: Article
Journal Name American Journal on Addictions
Volume 18
Issue Part 5
Page 422-429
Year of Publication 2009
Date of Publication 10 Aug 2009
PREGNANCY 2009 <721>
Database EMBASE
Accession Number 2009606875
Authors Domenici C. Cuttano A. Nardini V. Varese L. Ghirri P. Boldrini A.
Institution
(Domenici, Cuttano, Varese, Ghirri, Boldrini) U.O. of Neonatology, S. Chiara Hospital, University of Pisa, Pisa, Italy.
(Nardini) U.O. of Pathology, S. Chiara Hospital, University of Pisa, Pisa, Italy.
Country of Publication
United Kingdom
Title
Drug addiction during pregnancy: Correlations between the placental health and the
newborn's outcome Elaboration of a predictive score.
Source
Gynecological Endocrinology. 25(12)(pp 786-792), 2009. Date of Publication: December
2009.
Publisher
Informa Healthcare
Abstract
During pregnancy, drug addiction represents one of the most dangerous situations. Each
drug can badly affect the fetal development and, when the pregnancy is over, the negative
influence continues in the newborn which is exposed to many risks, in particular the
withdrawal syndrome. Since it is difficult to predict the newborn's outcome only on the basis of
the kind of drug assumed by the mother during pregnancy, we propose the idea of a score
based on the placenta's state of health. The aim of the study is to correlate the placental
score to the withdrawal symptoms graveness. Our retrospective study includes 35 newborns
exposed in uterus to illegal and legal drugs. We used the Finnegan's scoring system to
quantify withdrawal symptoms and the placental score, based on the anatomopathological
analysis, to assess the placenta's health. The newborns included in our study have been
divided into two groups depending on the result of the placental score ([less-than or equal to]2
or [greater-than or equal to]3). We found a significant statistical difference between the
newborns whose placental score was low ([less-than or equal to]2) and those whose score
was high ([greater-than or equal to]3): the second group showed severe withdrawal
symptoms for a longer time during the hospital stay (p=0.014). copyright 2009 Informa UK
Ltd.
ISSN 0951-3590
Publication Type Journal: Article
Journal Name Gynecological Endocrinology
Volume 25
Issue Part 12
Page 786-792
Year of Publication 2009
Date of Publication December 2009
PREGNANCY 2009 <843>
Database EMBASE
Accession Number 2009635733
Authors McCowan L. Horgan R.P.
Institution
(McCowan) Department of Obstetrics and Gynaecology, Faculty of Medicine and Health Sciences, University of
Auckland, Private Bag 92019, Auckland, New Zealand.
(Horgan) The Anu Research Centre, Department of Obstetrics and Gynaecology, University College Cork, Cork,
Ireland.
Country of Publication
United Kingdom
Title
Risk factors for small for gestational age infants.
Source
Best Practice and Research: Clinical Obstetrics and Gynaecology. 23(6)(pp 779-793), 2009.
Date of Publication: December 2009.
Publisher
Bailliere Tindall Ltd
Abstract
There are many established risk factors for babies who are small for gestational age (SGA)
by population birth weight centiles (usually defined as <10th centile). The confirmed maternal
risk factors include short stature, low weight, Indian or Asian ethnicity, nulliparity, mother born
SGA, cigarette smoking and cocaine use. Maternal medical history of: chronic hypertension,
renal disease, anti-phospholipid syndrome and malaria are associated with increased SGA.
Risk factors developing in pregnancy include heavy bleeding in early pregnancy, placental
abruption, pre-eclampsia and gestational hypertension. A short or very long inter-pregnancy
interval, previous SGA infant or previous stillbirth are also risk factors. Paternal factors
including changed paternity, short stature and father born SGA also contribute. Factors
associated with reduced risk of SGA or increased birth weight include high maternal milk
consumption and high intakes of green leafy vegetables and fruit. Future studies need to
investigate risk factors for babies SGA by customised centiles as these babies have greater
morbidity and mortality than babies defined as SGA by population centiles. copyright 2009
Elsevier Ltd. All rights reserved.
ISSN 1521-6934
Publication Type Journal: Article
Journal Name Best Practice and Research: Clinical Obstetrics and Gynaecology
Volume 23
Issue Part 6
Page 779-793
Year of Publication 2009
Date of Publication December 2009
PREGNANCY 2009 <892>
Database EMBASE
Accession Number 2010006915
Authors Haas D.M. Hebert M.F. Soldin O.P. Flockhart D.A. Madadi P. Nocon J.J. Chambers C.D. Hankins G.D.
Clark S. Wisner K.L. Li L. Renbarger J.L. Learman L.A.
Institution
(Haas, Flockhart, Nocon, Li, Renbarger, Learman) Indiana University School of Medicine, Pregmed, The Indiana
Univ. Center for Pharmacogenetics, Therapeutics Research in Maternal and Child Health, Indiana, United States.
(Hebert) University of Washington, Seattle, Washington, United States.
(Soldin) Georgetown University, Washington, District of Columbia, United States.
(Madadi) Motherisk, Sick Kids Hospital, Toronto, Canada.
(Chambers) University of California, San Diego, California, United States.
(Hankins, Clark) University of Texas Medical Branch, Galveston, Texas, United States.
(Wisner) University of Pittsburgh, Pennsylvania, United States.
Country of Publication
United Kingdom
Title
Pharmacotherapy and pregnancy: Highlights from the second international
conference for individualized pharmacotherapy in pregnancy.
Source
Clinical and Translational Science. 2(6)(pp 439-443), 2009. Date of Publication: December
2009.
Publisher
Blackwell Publishing
Abstract
To address provider struggles to provide evidence-based, rational drug therapy to pregnant
women, a second conference was convened to highlight the current research in the field.
Speakers from academic centers and institutions spoke about: the unique physiology and
pathology of pregnancy; pharmacokinetic changes in pregnancy; thyroid disorders in
pregnancy; pharmacogenetics in pregnancy; the role of CYP2D6 in pregnancy; treating
addiction in pregnancy; the power of teratology networks to inform clinical decisions; the use
of anti-depressants in pregnancy; and how to utilize computer-based modeling to aid with
individualized pharmacotherapy in pregnancy. The Conference highlighted several areas of
collaboration with the current Obstetrics Pharmacology Research Units Network (OPRU) and
hoped to stimulate further collaboration and knowledge in the area with the common goal to
improve the ability to safely and effectively use individualized pharmacotherapy in pregnancy.
copyright 2009 Wiley Periodicals, Inc.
ISSN 1752-8054
Publication Type Journal: Article
Journal Name Clinical and Translational Science
Volume 2
Issue Part 6
Page 439-443
Year of Publication 2009
Date of Publication December 2009
PREGNANCY 2009 <919>
Database EMBASE
Accession Number 2010018654
Authors Allegaert K.
Institution
(Allegaert) Neonatal Intensive Care Unit, Division of Woman and Child, University Hospitals Leuven, Herestraat 49,
3000 Leuven, Belgium.
Country of Publication
United Kingdom
Title
Clinical pharmacology of systemic analgesics in neonates.
Source
Current Drug Therapy. 4(3)(pp 152-158), 2009. Date of Publication: September 2009.
Publisher
Bentham Science Publishers B.V.
Abstract
Prevention and treatment of pain in preterm and term neonates became major issues in
neonatal care since the landmark observations of Anand et al. on the impact of (in) adequate
analgesia on mortality and morbidity after surgery in preterm neonates. Safe and effective
analgesia does require thorough understanding of maturational clinical pharmacology. In the
current review we summarized the available data on both pharmacokinetics and -dynamics of
analgesics of various potency (potent opioids, moderate potent opioids, non-selective cyclooxygenase inhibitors and acetaminophen) in neonates. The available information on
developmental pharmacology in neonates has extended significantly, but we have to be
aware that most studies focussed on aspects of pharmacokinetics, and not yet on aspects of
pharmacodynamics. The currently available information on developmental pharmacology of
analgesics in neonates still needs to be further integrated in a multimodal, approach to
prevent and treat pain in the neonate. copyright2009 Bentham Science Publishers Ltd.
ISSN 1574-8855
Publication Type Journal: Review
Journal Name Current Drug Therapy
Volume 4
Issue Part 3
Page 152-158
Year of Publication 2009
Date of Publication September 2009