In this pilot study, significant differences in the amniotic fluid proteomic profiles in cases of cervical insufficiency compared to genetic amniocentesis were observed. Proteomic signatures were predictive of achieving latency > 1 week after diagnosis of cervical insufficiency. These preliminary findings suggest that proteomic analysis may be of value in predicting outcome following cervical insufficiency and warrants further validation in larger studies.
Adolescent pregnancy, especially prior to age 16 years, could potentially interfere with bone mass accrual. Multiple studies show decreased bone density immediately following teenage pregnancy, but few data describe the adult outcome after early teenage pregnancy. We hypothesized that low adult bone density follows early adolescent pregnancy.Participants were eligible if they delivered prior to age 16 and were aged 20 to 45 at time of study; 256 women were identified by chart review. We excluded women with serious fetal outcomes, difficult social situations or who were living too far from the study centre. The assessment included 1) an interview focused on diet, lifestyle and quality of life, 2) measurement of 25-hydroxyvitamin D (25-OHD) and 3) bone densitometry of the lumbar spine and total hip by DXA (Hologic QDR-4500). We computed the mean Z score and standard deviation.Of the 213 eligible women, 64 could be contacted and 28 participated. Their average age was 28 (range: 20 to 35 years), average parity was 3.2 (range 1 to 8), and 12 (44%) had at least 1 other pregnancy before age 18. 25-OHD levels were low: 40% <40 nmol/L including 20% <25 nmol/L. The average (+/-SD) Z scores were spine e0.06 (+/e0.95) and total hip e0.22 (+/e0.90).Our preliminary analysis does not show a statistically significant decrease in young adult bone mass despite early teenage pregnancy in a cohort characterized by high parity, high incidence of multiple teenage pregnancy, poor diet, low vitamin D status and low socioeconomic status. Optimizing calcium and vitamin D intake remains prudent.
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