Our data demonstrate a relevant B19-associated risk of fetal death, which is largely confined to maternal B19 infection in the first 20 WG. Timely intrauterine transfusion of fetuses with severe hydrops fetalis reduces the risk of fetal death. Parvovirus B19-associated stillbirth without hydropic presentation is not a common finding.
There is growing evidence for an association between obesity and asthma, but little is known about the underlying mechanisms. We hypothesized that high plasma leptin and low plasma adiponectin concentrations might be related to asthma and allergies in children. Plasma leptin and adiponectin concentrations were measured in a cross‐sectional study involving 462 children aged 10 years. Information on disease symptoms and diagnosis was collected by parental questioning. Multivariate linear and logistic regression models were used to assess the association between biomarkers and disease. High leptin levels were associated with increased lifetime prevalence of asthma [odds ratio (OR): 3.76; 95% confidence interval (CI): 1.42–9.92]. The relationship was particularly strong for non‐atopic asthma (OR: 5.51; 95% CI: 1.99–17.51). No associations were observed between plasma leptin levels and hay fever, and rhinoconjunctivitis. Low adiponectin levels were associated with increased prevalence of both symptoms of atopic dermatitis (OR: 3.23; 95% CI: 1.28–7.76) and ever‐diagnosed eczema (OR: 2.35; 95% CI: 1.13–4.89). In girls and non‐atopic children, stronger associations for both leptin and adiponectin levels with asthma than in boys and atopic children were observed. These results suggest that adipokines may contribute to increased asthma and allergy risk in obese subjects. Stronger associations among girls with non‐atopic asthma may indicate diverse pathological mechanisms.
curred in 19 women and resulted in 17 full-term pregnancies. An increase in the levothyroxine dose was necessary during 17 pregnancies. The mean levothyroxine requirement increased by 47% during the first half of pregnancy. Given the importance of maternal euthyroidism for normal fetal cognitive development, the authors proposed that the women with hypothyroidism increase their levothyroxine dose by approximately 30% as soon as the pregnancy is confirmed. (N Engl J Med 2004;351:241).In some of the children in the study abstracted here, a high maternal TH level may have induced a catabolic state during fetal life leading to decreased birth weight. This may be the first evidence that maternally transferred TH in an euthyroid mother could have a direct toxic effect on fetal development. Maintenance of euthyroidism in a pregnant patient by increasing levels of TH replacement may not be as safe and simple as previously understood.In November 2001, ACOG published a practice bulletin on the clinical management guidelines for thyroid disease in pregnancy. This bulletin clearly outlines the physiological changes in thyroid function during pregnancy to indicate that TSH, free thyroxine (FT4), and free thyroxin index (FTI) do not change in pregnancy. In pregnant patients suspected of being hyperthyroid or hypothyroid, FT4 or FTI should be measured. The goal of management would be to maintain FT4 of the FTI in the high-normal range using the lowest possible dose of medication (Obstet Gynecol 2001;98:883).-RCC)
ABSTRACTBetween one third and two thirds of pregnant women in different parts of the world are susceptible to human parvovirus B19 (B19) infection. Acute infection by B19 during pregnancy has been associated with fetal anemia, hydrops fetalis, nonhydropic intrauterine fetal death, and asymptomatic fetal infection.
Among children, ETS exposure was associated with a low-grade inflammatory response and altered markers of lipid metabolism, which may initiate atherosclerosis in early life. However, longitudinal studies are necessary to determine the potential causal relevance of these associations.
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