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- Baeten, JM, et al.
(författare)
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Pregnancy complications and outcomes among overweight and obese nulliparous women
- 2001
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Ingår i: American journal of public health. - : American Public Health Association. - 0090-0036 .- 1541-0048. ; 91:3, s. 436-440
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: This study examined the associations between prepregnancy weight and the risk of pregnancy complications and adverse outcomes among nulliparous women. METHODS: We conducted a population-based cohort study with 96,801 Washington State birth certificates from 1992 to 1996. Women were categorized by body mass index. Multivariate logistic regression was performed. RESULTS: The rate of occurrence of most of the outcomes increased with increasing body mass index category. Compared with lean women, both overweight and obese women had a significantly increased risk for gestational diabetes, preeclampsia, eclampsia, cesarean delivery, and delivery of a macrosomic infant. CONCLUSIONS: Among nulliparous women, not only prepregnancy obesity but also overweight increases the risk of pregnancy complications and adverse pregnancy outcomes.
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- Brown, BP, et al.
(författare)
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Copper intrauterine device increases vaginal concentrations of inflammatory anaerobes and depletes lactobacilli compared to hormonal options in a randomized trial
- 2023
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Ingår i: Nature communications. - : Springer Science and Business Media LLC. - 2041-1723. ; 14:1, s. 499-
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Tidskriftsartikel (refereegranskat)abstract
- Effective contraceptives are a global health imperative for reproductive-aged women. However, there remains a lack of rigorous data regarding the effects of contraceptive options on vaginal bacteria and inflammation. Among 218 women enrolled into a substudy of the ECHO Trial (NCT02550067), we evaluate the effect of injectable intramuscular depot medroxyprogesterone acetate (DMPA-IM), levonorgestrel implant (LNG), and a copper intrauterine device (Cu-IUD) on the vaginal environment after one and six consecutive months of use, using 16S rRNA gene sequencing and multiplex cytokine assays. Primary endpoints include incident BV occurrence, bacterial diversity, and bacterial and cytokine concentrations. Secondary endpoints are bacterial and cytokine concentrations associated with later HIV seroconversion. Participants randomized to Cu-IUD exhibit elevated bacterial diversity, increased cytokine concentrations, and decreased relative abundance of lactobacilli after one and six months of use, relative to enrollment and other contraceptive options. Total bacterial loads of women using Cu-IUD increase 5.5 fold after six months, predominantly driven by increases in the concentrations of several inflammatory anaerobes. Furthermore, growth of L. crispatus (MV-1A-US) is inhibited by Cu2+ ions below biologically relevant concentrations, in vitro. Our work illustrates deleterious effects on the vaginal environment induced by Cu-IUD initiation, which may adversely impact sexual and reproductive health.
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