[
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"key": "TJF72ZXM",
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"creatorSummary": "Kendler et al.",
"parsedDate": "2017-06-09",
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"data": {
"key": "TJF72ZXM",
"version": 1965,
"itemType": "journalArticle",
"title": "The Protective Effect of Pregnancy on Risk for Drug Abuse: A Population, Co-Relative, Co-Spouse, and Within-Individual Analysis",
"creators": [
{
"creatorType": "author",
"firstName": "Kenneth S.",
"lastName": "Kendler"
},
{
"creatorType": "author",
"firstName": "Henrik",
"lastName": "Ohlsson"
},
{
"creatorType": "author",
"firstName": "Dace S.",
"lastName": "Svikis"
},
{
"creatorType": "author",
"firstName": "Kristina",
"lastName": "Sundquist"
},
{
"creatorType": "author",
"firstName": "Jan",
"lastName": "Sundquist"
}
],
"abstractNote": "OBJECTIVE: The authors sought to determine whether pregnancy is an intrinsic motivator for cessation of drug abuse.\nMETHOD: The authors conducted prospective cohort, co-relative, co-spouse, and within-person analyses of registration for drug abuse during pregnancy among Swedish women born between 1980 and 1990 who gave birth between ages 20 and 35 (N=149,512). Drug abuse was assessed from medical, criminal, and pharmacy registries.\nRESULTS: In the population, rates of drug abuse were lower during pregnancy (unadjusted odds ratio=0.67, 95% CI=0.60, 0.74). Compared with population results, the negative association between pregnancy and drug abuse was moderately stronger in cousins (odds ratio=0.49, 95% CI=0.39, 0.62) and substantially stronger in siblings (odds ratio=0.35, 95% CI=0.24, 0.51) discordant for pregnancy. The estimated odds ratio for drug abuse in pregnancy-discordant monozygotic twins was even stronger, at 0.17 (95% CI=0.10, 0.31). Within individuals, the odds ratio for drug abuse while pregnant compared with an equivalent prepregnancy interval was similar to that seen in pregnancy-discordant monozygotic twins, at 0.22 (95% CI=0.19, 0.26). Compared with cohabiting fathers, mothers had a greater reduction in risk for drug abuse during pregnancy (odds ratio=0.40, 95% CI=0.34, 0.47). Pregnancy was more protective in women with low parental education and without a cohabiting, actively drug-abusing father. Compared with prepregnancy baseline, within-individual analyses indicate that risk for drug abuse is also substantially reduced in the postpartum period, for example, the odds ratio for postpartum days 0-242 was 0.13 (95% CI=0.11, 0.16).\nCONCLUSIONS: Risk for drug abuse in women is substantially reduced during pregnancy. Multiple analyses suggest that this association is largely causal, suggesting that pregnancy is indeed a strong intrinsic motivator for drug abuse cessation. Similar strong protective effects may be present in the immediate postpartum period. Our results have implications for our etiologic models of drug abuse and especially for contingency management programs seeking to reduce drug abuse risk.",
"publicationTitle": "The American Journal of Psychiatry",
"publisher": "",
"place": "",
"date": "Jun 09, 2017",
"volume": "",
"issue": "",
"section": "",
"partNumber": "",
"partTitle": "",
"pages": "appiajp201716091006",
"series": "",
"seriesTitle": "",
"seriesText": "",
"journalAbbreviation": "Am J Psychiatry",
"DOI": "10.1176/appi.ajp.2017.16091006",
"citationKey": "",
"url": "",
"accessDate": "",
"PMID": "",
"PMCID": "",
"ISSN": "1535-7228",
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"shortTitle": "The Protective Effect of Pregnancy on Risk for Drug Abuse",
"language": "eng",
"libraryCatalog": "PubMed",
"callNumber": "",
"rights": "",
"extra": "PMID: 28595490",
"tags": [
{
"tag": "Adult"
},
{
"tag": "Cohort Studies"
},
{
"tag": "EPIDEMIOLOGY",
"type": 1
},
{
"tag": "Epidemiology"
},
{
"tag": "Fathers"
},
{
"tag": "Female"
},
{
"tag": "Humans"
},
{
"tag": "Male"
},
{
"tag": "Mothers"
},
{
"tag": "Odds Ratio"
},
{
"tag": "Postpartum Period"
},
{
"tag": "Pregnancy"
},
{
"tag": "Prospective Studies"
},
{
"tag": "Protective Factors"
},
{
"tag": "Psychoactive Substance Use Disorder"
},
{
"tag": "Registries"
},
{
"tag": "Risk Factors"
},
{
"tag": "Spouses"
},
{
"tag": "Substance-Related Disorders"
},
{
"tag": "Sweden"
},
{
"tag": "Twins, Monozygotic"
},
{
"tag": "Young Adult"
}
],
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"key": "UF9ZK6PY",
"version": 1987,
"library": {
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"creatorSummary": "Bergink et al.",
"parsedDate": "2017-09-20",
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"data": {
"key": "UF9ZK6PY",
"version": 1987,
"itemType": "journalArticle",
"title": "Comorbidity of autoimmune thyroid disorders and psychiatric disorders during the postpartum period: a Danish nationwide register-based cohort study",
"creators": [
{
"creatorType": "author",
"firstName": "V.",
"lastName": "Bergink"
},
{
"creatorType": "author",
"firstName": "V. J. M.",
"lastName": "Pop"
},
{
"creatorType": "author",
"firstName": "P. R.",
"lastName": "Nielsen"
},
{
"creatorType": "author",
"firstName": "E.",
"lastName": "Agerbo"
},
{
"creatorType": "author",
"firstName": "T.",
"lastName": "Munk-Olsen"
},
{
"creatorType": "author",
"firstName": "X.",
"lastName": "Liu"
}
],
"abstractNote": "BACKGROUND: The postpartum period is well-known risk period for the first onset of autoimmune thyroid disorders (AITDs) as well as first onset of psychiatric disorders. These two disorders are some of the most prevalent medical conditions postpartum, often misdiagnosed and disabling if left untreated. Our study was designed to explore the possible bidirectional association between AITDs and psychiatric disorders during the postpartum period.\nMETHODS: A population-based cohort study through linkage of Danish national registers, which comprised 312 779 women who gave birth to their first child during 1997-2010. We conducted Poisson regression analysis to estimate the incidence rate ratio (IRR) of psychiatric disorders among women with first-onset AITDs, the IRR of AITDs among women with first-onset psychiatric disorders as well as the overlap between these disorders using a comorbidity index.\nRESULTS: Women with first-onset AITDs postpartum were more likely to have first-onset psychiatric disorders than women who did not have postpartum AITDs (IRR = 1.88, 95% confidence interval (CI): 1.25-2.81). Women with first-onset postpartum psychiatric disorders had a higher risk of AITDs than women with no psychiatric disorders (IRR = 2.16, 95% CI: 1.45-3.20). The comorbidity index 2 years after delivery was 2.26 (95% CI: 1.61-2.90), indicating a comorbidity between first-onset AITDs and psychiatric disorders.\nCONCLUSIONS: First-onset AITDs and psychiatric disorders co-occur in the postpartum period, which has relevance to further studies on the etiologies of these disorders and why childbirth in particular triggers the onset.",
"publicationTitle": "Psychological Medicine",
"publisher": "",
"place": "",
"date": "Sep 20, 2017",
"volume": "",
"issue": "",
"section": "",
"partNumber": "",
"partTitle": "",
"pages": "1-9",
"series": "",
"seriesTitle": "",
"seriesText": "",
"journalAbbreviation": "Psychol Med",
"DOI": "10.1017/S0033291717002732",
"citationKey": "",
"url": "",
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"PMID": "",
"PMCID": "",
"ISSN": "1469-8978",
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"shortTitle": "Comorbidity of autoimmune thyroid disorders and psychiatric disorders during the postpartum period",
"language": "eng",
"libraryCatalog": "PubMed",
"callNumber": "",
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"extra": "PMID: 28929982",
"tags": [
{
"tag": "Anxiety"
},
{
"tag": "depression"
},
{
"tag": "postpartum"
},
{
"tag": "psychosis"
},
{
"tag": "thyroid"
},
{
"tag": "thyroiditis"
}
],
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"version": 1986,
"itemType": "journalArticle",
"title": "Committee Opinion No. 711 Summary: Opioid Use and Opioid Use Disorder in Pregnancy",
"creators": [],
"abstractNote": "Opioid use in pregnancy has escalated dramatically in recent years, paralleling the epidemic observed in the general population. To combat the opioid epidemic, all health care providers need to take an active role. Pregnancy provides an important opportunity to identify and treat women with substance use disorders. Substance use disorders affect women across all racial and ethnic groups and all socioeconomic groups, and affect women in rural, urban, and suburban populations. Therefore, it is essential that screening be universal. Screening for substance use should be a part of comprehensive obstetric care and should be done at the first prenatal visit in partnership with the pregnant woman. Patients who use opioids during pregnancy represent a diverse group, and it is important to recognize and differentiate between opioid use in the context of medical care, opioid misuse, and untreated opioid use disorder. Multidisciplinary long-term follow-up should include medical, developmental, and social support. Infants born to women who used opioids during pregnancy should be monitored for neonatal abstinence syndrome by a pediatric care provider. Early universal screening, brief intervention (such as engaging a patient in a short conversation, providing feedback and advice), and referral for treatment of pregnant women with opioid use and opioid use disorder improve maternal and infant outcomes. In general, a coordinated multidisciplinary approach without criminal sanctions has the best chance of helping infants and families.",
"publicationTitle": "Obstetrics and Gynecology",
"publisher": "",
"place": "",
"date": "Aug 2017",
"volume": "130",
"issue": "2",
"section": "",
"partNumber": "",
"partTitle": "",
"pages": "488-489",
"series": "",
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"journalAbbreviation": "Obstet Gynecol",
"DOI": "10.1097/AOG.0000000000002229",
"citationKey": "",
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"shortTitle": "Committee Opinion No. 711 Summary",
"language": "eng",
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"tag": "Obstetrics"
},
{
"tag": "Opioid-Related Disorders"
},
{
"tag": "Pregnancy"
},
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"tag": "Pregnancy Complications"
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"tag": "Prenatal Care"
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"creatorSummary": "Rasmussen et al.",
"parsedDate": "2017-09",
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"data": {
"key": "7HYMLKGS",
"version": 2011,
"itemType": "journalArticle",
"title": "Risk, treatment duration, and recurrence risk of postpartum affective disorder in women with no prior psychiatric history: A population-based cohort study",
"creators": [
{
"creatorType": "author",
"firstName": "Marie-Louise H.",
"lastName": "Rasmussen"
},
{
"creatorType": "author",
"firstName": "Marin",
"lastName": "Strøm"
},
{
"creatorType": "author",
"firstName": "Jan",
"lastName": "Wohlfahrt"
},
{
"creatorType": "author",
"firstName": "Poul",
"lastName": "Videbech"
},
{
"creatorType": "author",
"firstName": "Mads",
"lastName": "Melbye"
}
],
"abstractNote": "BACKGROUND: Some 5%-15% of all women experience postpartum depression (PPD), which for many is their first psychiatric disorder. The purpose of this study was to estimate the incidence of postpartum affective disorder (AD), duration of treatment, and rate of subsequent postpartum AD and other affective episodes in a nationwide cohort of women with no prior psychiatric history.\nMETHODS AND FINDINGS: Linking information from several Danish national registers, we constructed a cohort of 457,317 primiparous mothers with first birth (and subsequent births) from 1 January 1996 to 31 December 2013 (a total of 789,068 births) and no prior psychiatric hospital contacts and/or use of antidepressants. These women were followed from 1 January 1996 to 31 December 2014. Postpartum AD was defined as use of antidepressants and/or hospital contact for PPD within 6 months after childbirth. The main outcome measures were risk of postpartum AD, duration of treatment, and recurrence risk. We observed 4,550 (0.6%) postpartum episodes of AD. The analyses of treatment duration showed that 1 year after the initiation of treatment for their first episode, 27.9% of women were still in treatment; after 4 years, 5.4%. The recurrence risk of postpartum AD for women with a PPD hospital contact after first birth was 55.4 per 100 person-years; for women with postpartum antidepressant medication after first birth, it was 35.0 per 100 person-years. The rate of postpartum AD after second birth for women with no history of postpartum AD was 1.2 per 100 person-years. After adjusting for year of birth and mother's age, women with PPD hospital contact after first birth had a 46.4 times higher rate (95% CI 31.5-68.4) and women with postpartum antidepressant medication after their first birth had a 26.9 times higher rate (95% CI 21.9-33.2) of a recurrent postpartum episode after their second birth compared to women with no postpartum AD history. Limitations include the use of registry data to identify cases and limited confounder control.\nCONCLUSIONS: In this study, an episode of postpartum AD was observed for 0.6% of childbirths among women with no prior psychiatric history. The observed episodes were characterized by a relatively short treatment duration, yet the women had a notably high rate of later AD and recurrent episodes of postpartum AD. The recurrence risk of postpartum AD was markedly higher among women with PPD hospital contact after first birth compared to women with postpartum antidepressant medication after first birth. Our results underline the necessity of measures targeted at specific vulnerable groups, such as women who experience PPD as a first psychiatric episode.",
"publicationTitle": "PLoS medicine",
"publisher": "",
"place": "",
"date": "Sep 2017",
"volume": "14",
"issue": "9",
"section": "",
"partNumber": "",
"partTitle": "",
"pages": "e1002392",
"series": "",
"seriesTitle": "",
"seriesText": "",
"journalAbbreviation": "PLoS Med.",
"DOI": "10.1371/journal.pmed.1002392",
"citationKey": "",
"url": "",
"accessDate": "",
"PMID": "",
"PMCID": "",
"ISSN": "1549-1676",
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"shortTitle": "Risk, treatment duration, and recurrence risk of postpartum affective disorder in women with no prior psychiatric history",
"language": "eng",
"libraryCatalog": "PubMed",
"callNumber": "",
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"extra": "PMID: 28949960\nPMCID: PMC5614423",
"tags": [
{
"tag": "Adult"
},
{
"tag": "Antidepressive Agents"
},
{
"tag": "Denmark"
},
{
"tag": "Female"
},
{
"tag": "Humans"
},
{
"tag": "Incidence"
},
{
"tag": "Mood Disorders"
},
{
"tag": "Puerperal Disorders"
},
{
"tag": "Recurrence"
},
{
"tag": "Registries"
},
{
"tag": "Risk"
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{
"tag": "Risk Factors"
}
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"creatorSummary": "Liu et al.",
"parsedDate": "2017-09-06",
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"data": {
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"version": 2019,
"itemType": "journalArticle",
"title": "Antidepressant use during pregnancy and psychiatric disorders in offspring: Danish nationwide register based cohort study",
"creators": [
{
"creatorType": "author",
"firstName": "Xiaoqin",
"lastName": "Liu"
},
{
"creatorType": "author",
"firstName": "Esben",
"lastName": "Agerbo"
},
{
"creatorType": "author",
"firstName": "Katja G.",
"lastName": "Ingstrup"
},
{
"creatorType": "author",
"firstName": "Katherine",
"lastName": "Musliner"
},
{
"creatorType": "author",
"firstName": "Samantha",
"lastName": "Meltzer-Brody"
},
{
"creatorType": "author",
"firstName": "Veerle",
"lastName": "Bergink"
},
{
"creatorType": "author",
"firstName": "Trine",
"lastName": "Munk-Olsen"
}
],
"abstractNote": "Objective To investigate the association between in utero exposure to antidepressants and risk of psychiatric disorders.Design Population based cohort study.Setting Danish national registers.Participants 905 383 liveborn singletons born during 1998-2012 in Denmark and followed from birth until July 2014, death, emigration, or date of first psychiatric diagnosis, whichever came first. The children were followed for a maximum of 16.5 years and contributed 8.1×10(6) person years at risk.Exposures for observational studies Children were categorised into four groups according to maternal antidepressant use within two years before and during pregnancy: unexposed, antidepressant discontinuation (use before but not during pregnancy), antidepressant continuation (use both before and during pregnancy), and new user (use only during pregnancy).Main outcome measure First psychiatric diagnosis in children, defined as first day of inpatient or outpatient treatment for psychiatric disorders. Hazard ratios of psychiatric disorders were estimated using Cox regression models.Results Overall, psychiatric disorders were diagnosed in 32 400 children. The adjusted 15 year cumulative incidence of psychiatric disorders was 8.0% (95% confidence interval 7.9% to 8.2%) in the unexposed group, 11.5% (10.3% to 12.9%) in the antidepressant discontinuation group, 13.6% (11.3% to 16.3%) in the continuation group, and 14.5% (10.5% to 19.8%) in the new user group. The antidepressant continuation group had an increased risk of psychiatric disorders (hazard ratio 1.27, 1.17 to 1.38), compared with the discontinuation group.Conclusions In utero exposure to antidepressants was associated with increased risk of psychiatric disorders. The association may be attributable to the severity of underlying maternal disorders in combination with antidepressant exposure in utero. The findings suggest that focusing solely on a single psychiatric disorder among offspring in studies of in utero antidepressant exposure may be too restrictive.",
"publicationTitle": "BMJ (Clinical research ed.)",
"publisher": "",
"place": "",
"date": "Sep 06, 2017",
"volume": "358",
"issue": "",
"section": "",
"partNumber": "",
"partTitle": "",
"pages": "j3668",
"series": "",
"seriesTitle": "",
"seriesText": "",
"journalAbbreviation": "BMJ",
"DOI": "",
"citationKey": "",
"url": "",
"accessDate": "",
"PMID": "",
"PMCID": "",
"ISSN": "1756-1833",
"archive": "",
"archiveLocation": "",
"shortTitle": "Antidepressant use during pregnancy and psychiatric disorders in offspring",
"language": "eng",
"libraryCatalog": "PubMed",
"callNumber": "",
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"extra": "PMID: 28877907\nPMCID: PMC5594425",
"tags": [
{
"tag": "Adolescent"
},
{
"tag": "Antidepressive Agents"
},
{
"tag": "Child"
},
{
"tag": "Child, Preschool"
},
{
"tag": "Cohort Studies"
},
{
"tag": "Denmark"
},
{
"tag": "Disease Susceptibility"
},
{
"tag": "Female"
},
{
"tag": "Humans"
},
{
"tag": "Infant"
},
{
"tag": "Infant, Newborn"
},
{
"tag": "Mental Disorders"
},
{
"tag": "Pregnancy"
},
{
"tag": "Pregnancy Complications"
},
{
"tag": "Prenatal Exposure Delayed Effects"
},
{
"tag": "Registries"
},
{
"tag": "Risk Factors"
},
{
"tag": "Withholding Treatment"
}
],
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"creatorSummary": "Hendrix et al.",
"parsedDate": "2017-09-19",
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"data": {
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"version": 1967,
"itemType": "journalArticle",
"title": "Physiological attunement in mother-infant dyads at clinical high risk: The influence of maternal depression and positive parenting",
"creators": [
{
"creatorType": "author",
"firstName": "Cassandra L.",
"lastName": "Hendrix"
},
{
"creatorType": "author",
"firstName": "Zachary N.",
"lastName": "Stowe"
},
{
"creatorType": "author",
"firstName": "D. Jeffrey",
"lastName": "Newport"
},
{
"creatorType": "author",
"firstName": "Patricia A.",
"lastName": "Brennan"
}
],
"abstractNote": "A growing number of research studies have examined the intradyadic coregulation (or attunement) of hypothalamus-pituitary-adrenal axis functioning in mothers and their children. However, it is unclear how early this coregulation may be present in dyads at clinical high risk and whether certain factors, such as maternal depression or positive parenting, are associated with the strength of this coregulation. The present study examined cortisol attunement within mother-infant dyads in a high-risk sample of 233 mothers who received treatment for psychiatric illness during pregnancy and whose infants were 6 months old at the study visit. Results showed that maternal and infant cortisol covaried across four time points that included a stressor paradigm and a mother-infant interaction task. Greater maternal positive affect, but not depression, predicted stronger cortisol attunement. In addition, infants' cortisol level following separation from the mother predicted mothers' cortisol level at the next time point. Mothers' cortisol level following the separation and the laboratory stress paradigm predicted infants' cortisol levels at each successive time point, over and above infants' own cortisol at the previous time point. These findings suggest that maternal and infant cortisol levels influence one another in a bidirectional fashion that may be temporally and context dependent.",
"publicationTitle": "Development and Psychopathology",
"publisher": "",
"place": "",
"date": "Sep 19, 2017",
"volume": "",
"issue": "",
"section": "",
"partNumber": "",
"partTitle": "",
"pages": "1-12",
"series": "",
"seriesTitle": "",
"seriesText": "",
"journalAbbreviation": "Dev. Psychopathol.",
"DOI": "10.1017/S0954579417001158",
"citationKey": "",
"url": "",
"accessDate": "",
"PMID": "",
"PMCID": "",
"ISSN": "1469-2198",
"archive": "",
"archiveLocation": "",
"shortTitle": "Physiological attunement in mother-infant dyads at clinical high risk",
"language": "eng",
"libraryCatalog": "PubMed",
"callNumber": "",
"rights": "",
"extra": "PMID: 28925341",
"tags": [],
"collections": [
"6Q5X6D5K"
],
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"dateAdded": "2017-10-25T16:35:59Z",
"dateModified": "2017-10-25T16:35:59Z"
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},
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"key": "6CEQ5DSI",
"version": 1967,
"library": {
"type": "group",
"id": 79334,
"name": "Psychiatrie perinatale",
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},
"creatorSummary": "De Roose et al.",
"parsedDate": "2017-09-20",
"numChildren": 0
},
"data": {
"key": "6CEQ5DSI",
"version": 1967,
"itemType": "journalArticle",
"title": "Level of parenting stress in mothers of singletons and mothers of twins until one year postpartum: A cross-sectional study",
"creators": [
{
"creatorType": "author",
"firstName": "Marjon",
"lastName": "De Roose"
},
{
"creatorType": "author",
"firstName": "Dimitri",
"lastName": "Beeckman"
},
{
"creatorType": "author",
"firstName": "Katrijn",
"lastName": "Eggermont"
},
{
"creatorType": "author",
"firstName": "Elke",
"lastName": "Vanhouche"
},
{
"creatorType": "author",
"firstName": "Ann",
"lastName": "Van Hecke"
},
{
"creatorType": "author",
"firstName": "Sofie",
"lastName": "Verhaeghe"
}
],
"abstractNote": "PROBLEM: To date, it is unclear which factors are associated with parenting stress.\nBACKGROUND: There are no studies investigating the association between parenting stress and coping strategies such as coparenting and social support, while simultaneously considering demographic and obstetric factors, in mothers of singletons and twins.\nAIM: To investigate if parenting stress is associated with personal, and obstetric characteristics, the level of coparenting, and the availability of and satisfaction with social support in mothers of singletons and twins until one year postpartum.\nMETHODS: A cross-sectional study was conducted. A total of 151 singleton mothers and 101 twin mothers were included.\nRESULTS: Both singleton and twin mothers experiencing lower parenting stress levels indicated a better coparenting relationship quality (β=-0.253, p<0.01; β=-0.341, p=0.001). Elevated parenting stress levels positively influenced the level of satisfaction with social support in only mothers of twins (β=0.273, p<0.01). The availability of social support, personal, and obstetric characteristics were not associated with the level of parenting stress in neither singleton nor twin mothers.\nCONCLUSION: Coparenting seems to be a significant coping strategy reducing the level of parenting stress in singleton and twin mothers, irrespective of their personal and obstetric characteristics. Large-scale longitudinal research is needed to identify predictors of parenting stress, which may help to develop parenting stress reducing interventions. The acknowledgement and support of an adequate coparenting relationship quality by health care professionals might be an important factor to include in such interventions.",
"publicationTitle": "Women and Birth: Journal of the Australian College of Midwives",
"publisher": "",
"place": "",
"date": "Sep 20, 2017",
"volume": "",
"issue": "",
"section": "",
"partNumber": "",
"partTitle": "",
"pages": "",
"series": "",
"seriesTitle": "",
"seriesText": "",
"journalAbbreviation": "Women Birth",
"DOI": "10.1016/j.wombi.2017.09.003",
"citationKey": "",
"url": "",
"accessDate": "",
"PMID": "",
"PMCID": "",
"ISSN": "1878-1799",
"archive": "",
"archiveLocation": "",
"shortTitle": "Level of parenting stress in mothers of singletons and mothers of twins until one year postpartum",
"language": "eng",
"libraryCatalog": "PubMed",
"callNumber": "",
"rights": "",
"extra": "PMID: 28941782",
"tags": [
{
"tag": "Coparenting",
"type": 1
},
{
"tag": "Parenting stress",
"type": 1
},
{
"tag": "Singletons",
"type": 1
},
{
"tag": "Social support",
"type": 1
},
{
"tag": "Twins",
"type": 1
}
],
"collections": [
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"dateAdded": "2017-10-25T16:35:55Z",
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"version": 1967,
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"creatorSummary": "Manson et al.",
"parsedDate": "2017",
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"data": {
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"version": 1967,
"itemType": "journalArticle",
"title": "Menopausal Hormone Therapy and Long-term All-Cause and Cause-Specific Mortality: The Women's Health Initiative Randomized Trials",
"creators": [
{
"creatorType": "author",
"firstName": "JoAnn E.",
"lastName": "Manson"
},
{
"creatorType": "author",
"firstName": "Aaron K.",
"lastName": "Aragaki"
},
{
"creatorType": "author",
"firstName": "Jacques E.",
"lastName": "Rossouw"
},
{
"creatorType": "author",
"firstName": "Garnet L.",
"lastName": "Anderson"
},
{
"creatorType": "author",
"firstName": "Ross L.",
"lastName": "Prentice"
},
{
"creatorType": "author",
"firstName": "Andrea Z.",
"lastName": "LaCroix"
},
{
"creatorType": "author",
"firstName": "Rowan T.",
"lastName": "Chlebowski"
},
{
"creatorType": "author",
"firstName": "Barbara V.",
"lastName": "Howard"
},
{
"creatorType": "author",
"firstName": "Cynthia A.",
"lastName": "Thomson"
},
{
"creatorType": "author",
"firstName": "Karen L.",
"lastName": "Margolis"
},
{
"creatorType": "author",
"firstName": "Cora E.",
"lastName": "Lewis"
},
{
"creatorType": "author",
"firstName": "Marcia L.",
"lastName": "Stefanick"
},
{
"creatorType": "author",
"firstName": "Rebecca D.",
"lastName": "Jackson"
},
{
"creatorType": "author",
"firstName": "Karen C.",
"lastName": "Johnson"
},
{
"creatorType": "author",
"firstName": "Lisa W.",
"lastName": "Martin"
},
{
"creatorType": "author",
"firstName": "Sally A.",
"lastName": "Shumaker"
},
{
"creatorType": "author",
"firstName": "Mark A.",
"lastName": "Espeland"
},
{
"creatorType": "author",
"firstName": "Jean",
"lastName": "Wactawski-Wende"
},
{
"creatorType": "author",
"name": "WHI Investigators"
}
],
"abstractNote": "Importance: Health outcomes from the Women's Health Initiative Estrogen Plus Progestin and Estrogen-Alone Trials have been reported, but previous publications have generally not focused on all-cause and cause-specific mortality.\nObjective: To examine total and cause-specific cumulative mortality, including during the intervention and extended postintervention follow-up, of the 2 Women's Health Initiative hormone therapy trials.\nDesign, Setting, and Participants: Observational follow-up of US multiethnic postmenopausal women aged 50 to 79 years enrolled in 2 randomized clinical trials between 1993 and 1998 and followed up through December 31, 2014.\nInterventions: Conjugated equine estrogens (CEE, 0.625 mg/d) plus medroxyprogesterone acetate (MPA, 2.5 mg/d) (n = 8506) vs placebo (n = 8102) for 5.6 years (median) or CEE alone (n = 5310) vs placebo (n = 5429) for 7.2 years (median).\nMain Outcomes and Measures: All-cause mortality (primary outcome) and cause-specific mortality (cardiovascular disease mortality, cancer mortality, and other major causes of mortality) in the 2 trials pooled and in each trial individually, with prespecified analyses by 10-year age group based on age at time of randomization.\nResults: Among 27 347 women who were randomized (baseline mean [SD] age, 63.4 [7.2] years; 80.6% white), mortality follow-up was available for more than 98%. During the cumulative 18-year follow-up, 7489 deaths occurred (1088 deaths during the intervention phase and 6401 deaths during postintervention follow-up). All-cause mortality was 27.1% in the hormone therapy group vs 27.6% in the placebo group (hazard ratio [HR], 0.99 [95% CI, 0.94-1.03]) in the overall pooled cohort; with CEE plus MPA, the HR was 1.02 (95% CI, 0.96-1.08); and with CEE alone, the HR was 0.94 (95% CI, 0.88-1.01). In the pooled cohort for cardiovascular mortality, the HR was 1.00 (95% CI, 0.92-1.08 [8.9 % with hormone therapy vs 9.0% with placebo]); for total cancer mortality, the HR was 1.03 (95% CI, 0.95-1.12 [8.2 % with hormone therapy vs 8.0% with placebo]); and for other causes, the HR was 0.95 (95% CI, 0.88-1.02 [10.0% with hormone therapy vs 10.7% with placebo]), and results did not differ significantly between trials. When examined by 10-year age groups comparing younger women (aged 50-59 years) to older women (aged 70-79 years) in the pooled cohort, the ratio of nominal HRs for all-cause mortality was 0.61 (95% CI, 0.43-0.87) during the intervention phase and the ratio was 0.87 (95% CI, 0.76-1.00) during cumulative 18-year follow-up, without significant heterogeneity between trials.\nConclusions and Relevance: Among postmenopausal women, hormone therapy with CEE plus MPA for a median of 5.6 years or with CEE alone for a median of 7.2 years was not associated with risk of all-cause, cardiovascular, or cancer mortality during a cumulative follow-up of 18 years.\nTrial Registration: clinicaltrials.gov Identifier: NCT00000611.",
"publicationTitle": "JAMA",
"publisher": "",
"place": "",
"date": "09 12, 2017",
"volume": "318",
"issue": "10",
"section": "",
"partNumber": "",
"partTitle": "",
"pages": "927-938",
"series": "",
"seriesTitle": "",
"seriesText": "",
"journalAbbreviation": "JAMA",
"DOI": "10.1001/jama.2017.11217",
"citationKey": "",
"url": "",
"accessDate": "",
"PMID": "",
"PMCID": "",
"ISSN": "1538-3598",
"archive": "",
"archiveLocation": "",
"shortTitle": "Menopausal Hormone Therapy and Long-term All-Cause and Cause-Specific Mortality",
"language": "eng",
"libraryCatalog": "PubMed",
"callNumber": "",
"rights": "",
"extra": "PMID: 28898378",
"tags": [
{
"tag": "Aged",
"type": 1
},
{
"tag": "Cardiovascular Diseases",
"type": 1
},
{
"tag": "Cause of Death",
"type": 1
},
{
"tag": "Double-Blind Method",
"type": 1
},
{
"tag": "Estrogen Replacement Therapy",
"type": 1
},
{
"tag": "Estrogens, Conjugated (USP)",
"type": 1
},
{
"tag": "Female",
"type": 1
},
{
"tag": "Follow-Up Studies",
"type": 1
},
{
"tag": "Humans",
"type": 1
},
{
"tag": "Medroxyprogesterone",
"type": 1
},
{
"tag": "Middle Aged",
"type": 1
},
{
"tag": "Mortality",
"type": 1
},
{
"tag": "Neoplasms",
"type": 1
},
{
"tag": "Postmenopause",
"type": 1
},
{
"tag": "Risk",
"type": 1
}
],
"collections": [
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],
"relations": {},
"dateAdded": "2017-10-25T16:35:41Z",
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"key": "UDKTHCS5",
"version": 1968,
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"creatorSummary": "Yonkers et al.",
"parsedDate": "2017-09-13",
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"data": {
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"version": 1968,
"itemType": "journalArticle",
"title": "Association of Panic Disorder, Generalized Anxiety Disorder, and Benzodiazepine Treatment During Pregnancy With Risk of Adverse Birth Outcomes",
"creators": [
{
"creatorType": "author",
"firstName": "Kimberly Ann",
"lastName": "Yonkers"
},
{
"creatorType": "author",
"firstName": "Kathryn",
"lastName": "Gilstad-Hayden"
},
{
"creatorType": "author",
"firstName": "Ariadna",
"lastName": "Forray"
},
{
"creatorType": "author",
"firstName": "Heather S.",
"lastName": "Lipkind"
}
],
"abstractNote": "Importance: Registry data show that maternal panic disorder, or anxiety disorders in general, increase the risk for adverse pregnancy outcomes. However, diagnoses from registries may be imprecise and may not consider potential confounding factors, such as treatment with medication and maternal substance use.\nObjective: To determine whether panic disorder or generalized anxiety disorder (GAD) in pregnancy, or medications used to treat these conditions, are associated with adverse maternal or neonatal pregnancy outcomes.\nDesign, Setting, and Participants: This cohort study conducted between July 1, 2005, and July 14, 2009, recruited women at 137 obstetric practices in Connecticut and Massachusetts before 17 weeks of pregnancy and reassessed them at 28 (±4) weeks of pregnancy and 8 (±4) weeks postpartum. Psychiatric diagnoses were determined by answers to the World Mental Health Composite International Diagnostic Interview. Assessments also gathered information on treatment with medications and confounding factors, such as substance use, previous adverse birth outcomes, and demographic factors.\nExposure: Panic disorder, GAD, or use of benzodiazepines or serotonin reuptake inhibitors.\nMain Outcomes and Measures: Among mothers: preterm birth, cesarean delivery, and hypertensive diseases of pregnancy. Among neonates: low birth weight, use of minor respiratory interventions, and use of ventilatory support.\nResults: Of the 2654 women in the final analysis (mean [SD] age, 31.0 [5.7] years), most were non-Hispanic white (1957 [73.7%]), 98 had panic disorder, 252 had GAD, 67 were treated with a benzodiazepine, and 293 were treated with a serotonin reuptake inhibitor during pregnancy. In adjusted models, neither panic disorder nor GAD was associated with maternal or neonatal complications of interest. Most medication exposures occurred early in pregnancy. Maternal benzodiazepine use was associated with cesarean delivery (odds ratio [OR], 2.45; 95% CI, 1.36-4.40), low birth weight (OR, 3.41; 95% CI, 1.61-7.26), and use of ventilatory support for the newborn (OR, 2.85; 95% CI, 1.2-6.9). Maternal serotonin reuptake inhibitor use was associated with hypertensive diseases of pregnancy (OR, 2.82; 95% CI, 1.58-5.04), preterm birth (OR, 1.56; 95% CI, 1.02-2.38), and use of minor respiratory interventions (OR, 1.81; 95% CI, 1.39-2.37). With maternal benzodiazepine treatment, rates of ventilatory support increased by 61 of 1000 neonates and duration of gestation was shortened by 3.6 days; with maternal serotonin reuptake inhibitor use, gestation was shortened by 1.8 days, 152 of 1000 additional newborns required minor respiratory interventions, and 53 of 1000 additional women experienced hypertensive diseases of pregnancy.\nConclusions and Relevance: Panic disorder and GAD do not contribute to adverse pregnancy complications. Women may require treatment with medications during pregnancy, which can shorten the duration of gestation slightly. Maternal treatment with a serotonin reuptake inhibitor is also associated with hypertensive disease of pregnancy and cesarean delivery.",
"publicationTitle": "JAMA psychiatry",
"publisher": "",
"place": "",
"date": "Sep 13, 2017",
"volume": "",
"issue": "",
"section": "",
"partNumber": "",
"partTitle": "",
"pages": "",
"series": "",
"seriesTitle": "",
"seriesText": "",
"journalAbbreviation": "JAMA Psychiatry",
"DOI": "10.1001/jamapsychiatry.2017.2733",
"citationKey": "",
"url": "",
"accessDate": "",
"PMID": "",
"PMCID": "",
"ISSN": "2168-6238",
"archive": "",
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"shortTitle": "",
"language": "eng",
"libraryCatalog": "PubMed",
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"extra": "PMID: 28903165",
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],
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"dateAdded": "2017-10-25T16:35:36Z",
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}
},
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"itemType": "blogPost",
"title": "ACOG Releases Revised Guidelines for Treatment of Opioid Use During Pregnancy",
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"creatorType": "author",
"firstName": "MGH Center for Women's Mental",
"lastName": "Health"
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"abstractNote": "Due to a dramatic increase in the number of women abusing opiates during pregnancy, ACOG has released guidelines on the treatment of opioid use during pregnancy.",
"blogTitle": "MGH Center for Women's Mental Health",
"websiteType": "",
"date": "2017-09-26T10:04:35+00:00",
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"url": "https://womensmentalhealth.org/posts/acog-releases-revised-guidelines-treatment-opioid-use-pregnancy/",
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"ISSN": "",
"shortTitle": "",
"language": "",
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"relations": {},
"dateAdded": "2017-10-25T16:34:20Z",
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"creatorSummary": "Health",
"parsedDate": "2017-10-16",
"numChildren": 0
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"data": {
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"version": 1966,
"itemType": "blogPost",
"title": "In Brief: Folate Supplements During Pregnancy Reduce Risk of Autism",
"creators": [
{
"creatorType": "author",
"firstName": "MGH Center for Women's Mental",
"lastName": "Health"
}
],
"abstractNote": "A recent study from California indicates that taking high-dose folic acid cuts the risk of ASD in half, as compared to women who received lower doses.",
"blogTitle": "MGH Center for Women's Mental Health",
"websiteType": "",
"date": "2017-10-16T10:07:43+00:00",
"DOI": "",
"citationKey": "",
"url": "https://womensmentalhealth.org/posts/brief-folate-supplements-pregnancy-reduce-risk-autism/",
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"data": {
"key": "RG6SNBRS",
"version": 1966,
"itemType": "blogPost",
"title": "Maternal Bipolar Disorder Not a Predictor of Infant Developmental Deficits at One Year of Age",
"creators": [
{
"creatorType": "author",
"firstName": "MGH Center for Women's Mental",
"lastName": "Health"
}
],
"abstractNote": "Findings suggest that perinatal exposure to maternal bipolar disorder was not a predictor of deficits in motor, cognitive, and behavioral development",
"blogTitle": "MGH Center for Women's Mental Health",
"websiteType": "",
"date": "2017-10-18T10:04:42+00:00",
"DOI": "",
"citationKey": "",
"url": "https://womensmentalhealth.org/posts/maternal_bipolar_disorder_not_predictor_of_infant_developmental_deficits/",
"accessDate": "2017-10-25T16:33:58Z",
"ISSN": "",
"shortTitle": "",
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"J6ZNSQE9"
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"key": "N6WEHPEI",
"version": 1956,
"library": {
"type": "group",
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"name": "Psychiatrie perinatale",
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"creatorSummary": "Joseph et al.",
"parsedDate": "2015",
"numChildren": 0
},
"data": {
"key": "N6WEHPEI",
"version": 1956,
"itemType": "journalArticle",
"title": "Can Drug Effects Explain the Recent Temporal Increase in Atonic Postpartum Haemorrhage?",
"creators": [
{
"creatorType": "author",
"firstName": "K. S.",
"lastName": "Joseph"
},
{
"creatorType": "author",
"firstName": "O.",
"lastName": "Sheehy"
},
{
"creatorType": "author",
"firstName": "A.",
"lastName": "Mehrabadi"
},
{
"creatorType": "author",
"firstName": "M. L.",
"lastName": "Urquia"
},
{
"creatorType": "author",
"firstName": "J. A.",
"lastName": "Hutcheon"
},
{
"creatorType": "author",
"firstName": "M.",
"lastName": "Kramer"
},
{
"creatorType": "author",
"firstName": "A.",
"lastName": "Berard"
}
],
"abstractNote": "Background: Rates of postpartum haemorrhage and atonic postpartum haemorrhage have increased in several high-income countries. We carried out a study to examine if drug use in pregnancy, or drug and other interactions, explained this increase in postpartum haemorrhage. Methods: The linked administrative and hospital databases of the Quebec Pregnancy Cohort were used to define a cohort of pregnant women in Quebec, Canada, from 1998 to 2009 (n = 138 704). Case-control studies on any postpartum haemorrhage and atonic postpartum haemorrhage were carried out within this population, with up to five controls randomly selected for each case after matching on index date and hospital of delivery (incidence density sampling). Conditional logistic regression was used to estimate the effects of drug use on postpartum haemorrhage and atonic postpartum haemorrhage. Results: There was an unexpected non-linear, declining temporal pattern in postpartum haemorrhage and atonic postpartum haemorrhage between 1998 and 2009. Use of antidepressants (mainly selective serotonin reuptake inhibitors) was associated with higher rates of postpartum haemorrhage [adjusted rate ratio (aRR) 1.48, 95% confidence interval (CI) 1.23, 1.77] and atonic postpartum haemorrhage [aRR 1.40, 95% CI 1.13, 1.74]. Thrombocytopenia was also associated with higher rates of postpartum haemorrhage [aRR 1.52, 95% CI 1.16, 2.00]. There were no statistically significant drug interactions. Adjustment for maternal factors and drug use had little effect on temporal trends in postpartum haemorrhage and atonic postpartum haemorrhage. Conclusions: Although antidepressant use and thrombocytopenia were associated with higher rates of atonic postpartum haemorrhage, antidepressant and other drug use did not explain temporal trends in postpartum haemorrhage. Copyright © 2015 The Authors. Paediatric and Perinatal Epidemiology Published by John Wiley & Sons Ltd.",
"publicationTitle": "Paediatric and Perinatal Epidemiology",
"publisher": "",
"place": "",
"date": "2015",
"volume": "29",
"issue": "3",
"section": "",
"partNumber": "",
"partTitle": "",
"pages": "220-231",
"series": "",
"seriesTitle": "",
"seriesText": "",
"journalAbbreviation": "",
"DOI": "10.1111/ppe.12190",
"citationKey": "",
"url": "http://www.wiley.com/bw/journal.asp?ref=0269-5022&site=1 http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=emed18b&AN=613866023",
"accessDate": "",
"PMID": "",
"PMCID": "",
"ISSN": "0269-5022",
"archive": "",
"archiveLocation": "613866023",
"shortTitle": "Can Drug Effects Explain the Recent Temporal Increase in Atonic Postpartum Haemorrhage?",
"language": "English",
"libraryCatalog": "",
"callNumber": "",
"rights": "",
"extra": "",
"tags": [
{
"tag": "*drug effect"
},
{
"tag": "*postpartum hemorrhage"
},
{
"tag": "*serotonin uptake inhibitor"
},
{
"tag": "*thrombocytopenia"
},
{
"tag": "Canada"
},
{
"tag": "adverse drug reaction"
},
{
"tag": "confidence interval"
},
{
"tag": "controlled clinical trial"
},
{
"tag": "controlled study"
},
{
"tag": "data base"
},
{
"tag": "drug effect"
},
{
"tag": "female"
},
{
"tag": "hospital"
},
{
"tag": "human"
},
{
"tag": "logistic regression analysis"
},
{
"tag": "major clinical study"
},
{
"tag": "population based case control study"
},
{
"tag": "postpartum hemorrhage"
},
{
"tag": "pregnancy"
},
{
"tag": "pregnant woman"
},
{
"tag": "randomized controlled trial"
},
{
"tag": "sampling"
},
{
"tag": "serotonin uptake inhibitor"
},
{
"tag": "side effect"
},
{
"tag": "thrombocytopenia"
}
],
"collections": [
"A7W57G2M"
],
"relations": {
"dc:replaces": "http://zotero.org/groups/79334/items/H26JSVRJ"
},
"dateAdded": "2017-02-03T13:49:37Z",
"dateModified": "2017-10-25T16:31:55Z"
}
},
{
"key": "A2I4JAUA",
"version": 1956,
"library": {
"type": "group",
"id": 79334,
"name": "Psychiatrie perinatale",
"links": {
"alternate": {
"href": "https://www.zotero.org/groups/psychiatrie_perinatale",
"type": "text/html"
}
}
},
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"href": "https://api.zotero.org/groups/79334/items/A2I4JAUA",
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},
"creatorSummary": "Nivatpumin and Thamvittayakul",
"parsedDate": "2016-08",
"numChildren": 0
},
"data": {
"key": "A2I4JAUA",
"version": 1956,
"itemType": "journalArticle",
"title": "Ephedrine versus ondansetron in the prevention of hypotension during cesarean delivery: a randomized, double-blind, placebo-controlled trial",
"creators": [
{
"creatorType": "author",
"firstName": "P.",
"lastName": "Nivatpumin"
},
{
"creatorType": "author",
"firstName": "V.",
"lastName": "Thamvittayakul"
}
],
"abstractNote": "Background Maternal hypotension is common after spinal anesthesia for cesarean delivery. We compared the effects of prophylactic ephedrine with ondansetron on post-spinal blood pressure. Methods One hundred and sixty-eight term, singleton parturients were enrolled in this prospective, double-blind, placebo-controlled trial. Patients were randomized to receive either prophylactic intravenous ephedrine 10 mg (Group E), ondansetron 8 mg (Group O) or normal saline (Group P) immediately after spinal anesthesia. The primary outcome was maternal blood pressure between spinal block and delivery; secondary outcomes were nausea and vomiting scores, Apgar scores, numbers requiring intraoperative vasoconstrictors and the dose of vasoconstrictors required. Results Fifty-six patients were recruited to each group, but two in Group P were excluded from the analysis owing to protocol violations. There were no significant differences between the groups in maternal systolic, diastolic or mean arterial pressures, or the proportion of patients experiencing hypotension. The proportion of patients in Group E requiring intraoperative ephedrine or any vasoconstrictor (ephedrine and/or norepinephrine) was significantly lower than that in Group P (P=0.023 and 0.034, respectively). The proportion of patients in Group O requiring intraoperative norepinephrine was significantly lower than that in Group P (P=0.02). There was no difference in the proportions of patients in Groups E and O requiring any vasoconstrictors (P=0.34). Conclusions There was no significant difference in maternal blood pressure in women administered prophylactic ephedrine or ondansetron after spinal anesthesia for cesarean delivery compared with placebo. Ephedrine reduced the proportion of patients requiring a rescue vasoconstrictor before delivery. Copyright © 2016 Elsevier Ltd",
"publicationTitle": "International Journal of Obstetric Anesthesia",
"publisher": "",
"place": "",
"date": "2016 Aug",
"volume": "27",
"issue": "",
"section": "",
"partNumber": "",
"partTitle": "",
"pages": "25-31",
"series": "",
"seriesTitle": "",
"seriesText": "",
"journalAbbreviation": "",
"DOI": "10.1016/j.ijoa.2016.02.003",
"citationKey": "",
"url": "http://www.elsevier-international.com/journals/ijoa/ http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=emed18b&AN=609241986",
"accessDate": "",
"PMID": "",
"PMCID": "",
"ISSN": "0959-289X",
"archive": "",
"archiveLocation": "609241986",
"shortTitle": "Ephedrine versus ondansetron in the prevention of hypotension during cesarean delivery: a randomized, double-blind, placebo-controlled trial",
"language": "English",
"libraryCatalog": "",
"callNumber": "",
"rights": "",
"extra": "",
"tags": [
{
"tag": "*cesarean section"
},
{
"tag": "*ephedrine/cm [Drug Comparison]"
},
{
"tag": "*ephedrine/dt [Drug Therapy]"
},
{
"tag": "*ephedrine/iv [Intravenous Drug Administration]"
},
{
"tag": "*hypotension/co [Complication]"
},
{
"tag": "*hypotension/dt [Drug Therapy]"
},
{
"tag": "*hypotension/pc [Prevention]"
},
{
"tag": "*ondansetron/cm [Drug Comparison]"
},
{
"tag": "*ondansetron/dt [Drug Therapy]"
},
{
"tag": "*ondansetron/iv [Intravenous Drug Administration]"
},
{
"tag": "Apgar score"
},
{
"tag": "adult"
},
{
"tag": "anesthesia complication/co [Complication]"
},
{
"tag": "anesthesia complication/pc [Prevention]"
},
{
"tag": "article"
},
{
"tag": "atropine"
},
{
"tag": "blood pressure measurement"
},
{
"tag": "bupivacaine"
},
{
"tag": "cesarean section"
},
{
"tag": "clinical trial"
},
{
"tag": "controlled clinical trial"
},
{
"tag": "controlled study"
},
{
"tag": "diastolic blood pressure"
},
{
"tag": "double blind procedure"
},
{
"tag": "drug dosage form"
},
{
"tag": "drug efficacy"
},
{
"tag": "elective surgery"
},
{
"tag": "ephedrine"
},
{
"tag": "ephedrine/cm [Drug Comparison]"
},
{
"tag": "ephedrine/dt [Drug Therapy]"
},
{
"tag": "ephedrine/iv [Intravenous Drug Administration]"
},
{
"tag": "female"
},
{
"tag": "human"
},
{
"tag": "hypotension"
},
{
"tag": "hypotension/co [Complication]"
},
{
"tag": "hypotension/dt [Drug Therapy]"
},
{
"tag": "hypotension/pc [Prevention]"
},
{
"tag": "infusion fluid"
},
{
"tag": "major clinical study"
},
{
"tag": "maternal blood"
},
{
"tag": "mean arterial pressure"
},
{
"tag": "metoclopramide/iv [Intravenous Drug Administration]"
},
{
"tag": "morphine/tl [Intrathecal Drug Administration]"
},
{
"tag": "nausea and vomiting"
},
{
"tag": "noradrenalin"
},
{
"tag": "noradrenalin/dt [Drug Therapy]"
},
{
"tag": "ondansetron"
},
{
"tag": "ondansetron/cm [Drug Comparison]"
},
{
"tag": "ondansetron/dt [Drug Therapy]"
},
{
"tag": "ondansetron/iv [Intravenous Drug Administration]"
},
{
"tag": "operation duration"
},
{
"tag": "outcome assessment"
},
{
"tag": "patient satisfaction"
},
{
"tag": "placebo"
},
{
"tag": "postoperative nausea and vomiting/co [Complication]"
},
{
"tag": "prevention"
},
{
"tag": "prophylaxis"
},
{
"tag": "prospective study"
},
{
"tag": "randomized controlled trial"
},
{
"tag": "sodium chloride"
},
{
"tag": "spinal anesthesia"
},
{
"tag": "systolic blood pressure"
},
{
"tag": "vasoconstrictor agent"
}
],
"collections": [
"A7W57G2M"
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}
},
{
"key": "JXTQ9EG4",
"version": 1956,
"library": {
"type": "group",
"id": 79334,
"name": "Psychiatrie perinatale",
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"creatorSummary": "Mon et al.",
"parsedDate": "2017-02",
"numChildren": 0
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"data": {
"key": "JXTQ9EG4",
"version": 1956,
"itemType": "journalArticle",
"title": "Cardiac output changes with phenylephrine and ephedrine infusions during spinal anesthesia for cesarean section: A randomized, double-blind trial",
"creators": [
{
"creatorType": "author",
"firstName": "W.",
"lastName": "Mon"
},
{
"creatorType": "author",
"firstName": "A.",
"lastName": "Stewart"
},
{
"creatorType": "author",
"firstName": "R.",
"lastName": "Fernando"
},
{
"creatorType": "author",
"firstName": "K.",
"lastName": "Ashpole"
},
{
"creatorType": "author",
"firstName": "N.",
"lastName": "El-Wahab"
},
{
"creatorType": "author",
"firstName": "S.",
"lastName": "MacDonald"
},
{
"creatorType": "author",
"firstName": "P.",
"lastName": "Tamilselvan"
},
{
"creatorType": "author",
"firstName": "M.",
"lastName": "Columb"
},
{
"creatorType": "author",
"firstName": "Y. M.",
"lastName": "Liu"
}
],
"abstractNote": "Hypotension is a common side effect of spinal anesthesia. Phenylephrine and ephedrine are the two most frequently used vasopressors to treat spinal hypotension during cesarean delivery. In this randomized double-blind study, we aimed to evaluate cardiac output (CO) changes with phenylephrine or ephedrine infusions titrated to maintain baseline systolic blood pressure (bSBP) during spinal anesthesia. Women (n = 40) scheduled for elective cesarean delivery received either phenylephrine 100 mug/min or ephedrine 5 mg/min infusions. Baseline hemodynamics (cardiac output, heart rate, systolic blood pressure) were recorded in the left lateral tilt position before fluid preload, and recorded every minute after spinal anesthesia until delivery. Umbilical cord blood gases were analyzed within 5 minutes of delivery. Good systolic blood pressure control was attained in both groups with minimal periods of hypotension (SBP <80% of bSBP) or hypertension (SBP >120% of bSBP). Cardiac output and heart rate increased over time with ephedrine, but decreased with phenylephrine. The maximum increase in CO from the baseline was 12%, in the ephedrine group, and this occurred 20 minutes after spinal injection. Cardiac output fell by more than 17% in the phenylephrine group, maximal at 10 minutes following spinal injection. Despite good systolic blood pressure control and increased cardiac output with ephedrine, administration of ephedrine was associated with significantly more fetal acidosis [Median (Interquartile range, IQR) UApH - phenylephrine = 7.33 (7.31-7.34) and ephedrine = 7.22 (7.16-7.27), P < .05]. Copyright © 2016 Elsevier Inc.",
"publicationTitle": "Journal of Clinical Anesthesia",
"publisher": "",
"place": "",
"date": "2017 Feb",
"volume": "37",
"issue": "",
"section": "",
"partNumber": "",
"partTitle": "",
"pages": "43-48",
"series": "",
"seriesTitle": "",
"seriesText": "",
"journalAbbreviation": "",
"DOI": "10.1016/j.jclinane.2016.11.001",
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"url": "http://www.elsevier.com/locate/jclinane http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=emed18b&AN=613847825",
"accessDate": "",
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"ISSN": "0952-8180",
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"shortTitle": "Cardiac output changes with phenylephrine and ephedrine infusions during spinal anesthesia for cesarean section: A randomized, double-blind trial",
"language": "English",
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"tags": [
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},
{
"tag": "*ephedrine/ae [Adverse Drug Reaction]"
},
{
"tag": "*ephedrine/cm [Drug Comparison]"
},
{
"tag": "*ephedrine/ct [Clinical Trial]"
},
{
"tag": "*ephedrine/sp [Intraspinal Drug Administration]"
},
{
"tag": "*heart output"
},
{
"tag": "*phenylephrine/ae [Adverse Drug Reaction]"
},
{
"tag": "*phenylephrine/cm [Drug Comparison]"
},
{
"tag": "*phenylephrine/ct [Clinical Trial]"
},
{
"tag": "*phenylephrine/sp [Intraspinal Drug Administration]"
},
{
"tag": "*spinal anesthesia"
},
{
"tag": "acidosis"
},
{
"tag": "acidosis/si [Side Effect]"
},
{
"tag": "adult"
},
{
"tag": "alkalosis/si [Side Effect]"
},
{
"tag": "anesthesia level"
},
{
"tag": "article"
},
{
"tag": "bioequivalence"
},
{
"tag": "blood gas"
},
{
"tag": "blood gas analysis"
},
{
"tag": "blood pressure regulation"
},
{
"tag": "bradycardia/si [Side Effect]"
},
{
"tag": "cardiopulmonary hemodynamics"
},
{
"tag": "cesarean section"
},
{
"tag": "clinical article"
},
{
"tag": "clinical trial"
},
{
"tag": "cold sensation"
},
{
"tag": "controlled clinical trial"
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{
"tag": "controlled study"
},
{
"tag": "crystalloid"
},
{
"tag": "double blind procedure"
},
{
"tag": "drug dose titration"
},
{
"tag": "drug effect"
},
{
"tag": "ephedrine"
},
{
"tag": "ephedrine/ae [Adverse Drug Reaction]"
},
{
"tag": "ephedrine/cm [Drug Comparison]"
},
{
"tag": "ephedrine/ct [Clinical Trial]"
},
{
"tag": "ephedrine/sp [Intraspinal Drug Administration]"
},
{
"tag": "female"
},
{
"tag": "fetus"
},
{
"tag": "fetus disease/si [Side Effect]"
},
{
"tag": "heart output"
},
{
"tag": "heart preload"
},
{
"tag": "heart rate"
},
{
"tag": "heart stroke volume"
},
{
"tag": "human"
},
{
"tag": "hypertension"
},
{
"tag": "hypotension"
},
{
"tag": "infusion"
},
{
"tag": "injection"
},
{
"tag": "nausea and vomiting/si [Side Effect]"
},
{
"tag": "outcome assessment"
},
{
"tag": "phenylephrine"
},
{
"tag": "phenylephrine/ae [Adverse Drug Reaction]"
},
{
"tag": "phenylephrine/cm [Drug Comparison]"
},
{
"tag": "phenylephrine/ct [Clinical Trial]"
},
{
"tag": "phenylephrine/sp [Intraspinal Drug Administration]"
},
{
"tag": "priority journal"
},
{
"tag": "randomized controlled trial"
},
{
"tag": "spinal anesthesia"
},
{
"tag": "supine position"
},
{
"tag": "systolic blood pressure"
},
{
"tag": "touch"
},
{
"tag": "umbilical cord blood"
}
],
"collections": [
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},
{
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"abstractNote": "Background Health benefits of postpartum antiretroviral therapy (ART) for human immunodeficiency virus (HIV) positive women with high CD4+ T-counts have not been assessed in randomized trials. Methods Asymptomatic, HIV-positive, non-breastfeeding women with pre-ART CD4+ T-cell counts >= 400 cells/mm3 started on ART during pregnancy were randomized up to 42 days after delivery to continue or discontinue ART. Lopinavir/ritonavir plus tenofovir/emtricitabine was the preferred ART regimen. The sample size was selected to provide 88% power to detect a 50% reduction from an annualized primary event rate of 2.07%. A post-hoc analysis evaluated HIV/AIDS-related and World Health Organization (WHO) Stage 2 and 3 events. All analyses were intent to treat. Results 1652 women from 52 sites in Argentina, Botswana, Brazil, China, Haiti, Peru, Thailand and the US were enrolled (1/2010-11/2014). Median age was 28 years and major racial categories were Black African (28%), Asian (25%) White (15%). Median entry CD4 count was 696 cells/mm3 (IQR 575+/-869), median ART exposure prior to delivery was 19 weeks (IQR 13+/- 24) and 94% had entry HIV-1 RNA < 1000 copies/ml. After a median follow-up of 2.3 years, the primary composite endpoint rate was significantly lower than expected, and not significantly different between arms (continue arm 0.21 /100 person years(py); discontinue 0.31/ 100 py, Hazard ratio (HR) 0.68, 95% CI: 0.19, 2.40). WHO Stage 2 and 3 events were significantly reduced with continued ART (2.08/100 py vs. 4.36/100 py in the discontinue arm; HR 0.48, 95%CI: 0.33, 0.70). Toxicity rates did not differ significantly between arms. Among women randomized to continue ART, 189/827 (23%) had virologic failure; of the 155 with resistance testing, 103 (66%) failed without resistance to their current regimen, suggesting non-adherence. Conclusions Overall, serious clinical events were rare among young HIV-positive post-partum women with high CD4 cell counts. Continued ART was safe and was associated with a halving of the rate of WHO 2/3 conditions. Virologic failure rates were high, underscoring the urgent need to improve adherence in this population. Trial registration ClinicalTrials.gov NCT00955968.",
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"DOI": "10.1371/journal.pone.0176009",
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"tag": "China"
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"title": "Etonogestrel-Releasing Contraceptive Implant for Postpartum Adolescents: A Randomized Controlled Trial",
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"creatorType": "author",
"firstName": "Bryant",
"lastName": "A.g"
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{
"creatorType": "author",
"firstName": "Bauer",
"lastName": "A.e"
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"creatorType": "author",
"firstName": "Stuart",
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"firstName": "Levi",
"lastName": "E.e"
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"abstractNote": "Study Objective To compare immediate postpartum insertion of the contraceptive implant to placement at the 6-week postpartum visit among adolescent and young women. Design Non-blinded, randomized controlled trial. Setting and Participants Postpartum adolescents and young women ages 14-24 years who delivered at an academic tertiary care hospital serving rural and urban populations in North Carolina. Interventions Placement of an etonogestrel-releasing contraceptive implant before leaving the hospital postpartum, or at the 4-6 week postpartum visit. Main Outcome Measures Contraceptive implant use at 12 months postpartum. Results Ninety-six participants were randomized into the trial. Data regarding use at 12 months were available for 64 participants, 37 in the immediate group and 27 in the 6-week group. There was no difference in use at 12 months between the immediate group and the 6-week group (30 of 37, 81% vs 21 of 27, 78%; P =.75). At 3 months, the immediate group was more likely to have the implant in place (34 of 37, 92% vs 19 of 27, 70%; P =.02). Conclusion Placing the contraceptive implant in the immediate postpartum period results in a higher rate of use at 3 months postpartum and appears to have similar use rates at 12 months compared with 6-week postpartum placement. Providing contraceptive implants to adolescents before hospital discharge takes advantage of access to care, increases the likelihood of effective contraception in the early postpartum period, appears to have no adverse effects on breastfeeding, and might lead to increased utilization at 1 year postpartum. Copyright © 2016 North American Society for Pediatric and Adolescent Gynecology",
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{
"creatorType": "author",
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"abstractNote": "We recruited 144 women of whom 131 underwent scheduled caesarean section and were allocated to intrathecal bupivacaine without (46) or with (47) morphine and postoperative rectus sheath bupivacaine; or intrathecal bupivacaine with morphine and postoperative rectus sheath saline (38). We measured postoperative pain with a 10-point numeric rating scale. The mean (SD) areas under the curve for pain on movement during 48 postoperative hours were 273.5 (63.6), 223.8 (80.7) and 223.8 (80.7), respectively, p = 0.008. There was no difference between women who had intrathecal morphine with or without rectus sheath bupivacaine, p = 1. The equivalent values for pain at rest were 160.8 (64.7), 85.8 (79.4) and 82.8 (74.3), respectively, p < 0.001. There was no difference between women who had intrathecal morphine with or without rectus sheath bupivacaine, p = 0.98. Copyright © 2017 The Association of Anaesthetists of Great Britain and Ireland",
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"title": "Antidepressant use during pregnancy and risk of postpartum hemorrhage: A systematic review and meta-analysis",
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{
"creatorType": "author",
"firstName": "H. Y.",
"lastName": "Jiang"
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"creatorType": "author",
"firstName": "L. L.",
"lastName": "Xu"
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{
"creatorType": "author",
"firstName": "Y. C.",
"lastName": "Li"
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"creatorType": "author",
"firstName": "M.",
"lastName": "Deng"
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"creatorType": "author",
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"lastName": "Peng"
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"abstractNote": "Evidence about relationship between antidepressant use during pregnancy and the risk of postpartum hemorrhage (PPH) is conflicting. The aim of this meta-analysis was to systematically assess this relationship. To identify relevant studies, we conducted systematic searches in PubMed and Embase of articles published through May 2016. Random-effects models were adopted to estimate overall relative risk. In total, eight studies involving more than 40,000 PPH cases were included in our meta-analysis. After pooling the estimates, the odds for developing PPH were 1.32-fold higher (risk ratio, RR = 1.32; 95% confidence interval, CI = 1.17-1.48) in antidepressant users compared with individuals who had not taken antidepressants. In subgroup analyses, the associations still exist for women with exposure to non-SRI (RR = 1.31, 95% CI = 1.1-1.56), SRIs (RR = 1.23, 95% CI = 1.06-1.44), SSRIs (RR = 1.2, 95% CI = 1.04-1.38), and SNRIs (RR = 1.62, 95% CI = 1.41-1.85). Based on exposure window, we found an increased risk of PPH among current (RR = 1.37, 95% CI = 1.09-1.71) and recent users (RR = 1.32, 95% CI = 1.15-1.51), but not past users (RR = 1.08, 95% CI = 0.88-1.31). The findings of this meta-analysis support an increased risk of PPH in women exposure to antidepressant during late gestation. Copyright © 2016 Elsevier Ltd",
"publicationTitle": "Journal of Psychiatric Research",
"publisher": "",
"place": "",
"date": "2016 Dec",
"volume": "83",
"issue": "",
"section": "",
"partNumber": "",
"partTitle": "",
"pages": "160-167",
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"DOI": "10.1016/j.jpsychires.2016.09.001",
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"tag": "fluoxetine/ae [Adverse Drug Reaction]"
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"tag": "monoamine oxidase inhibitor/ae [Adverse Drug Reaction]"
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"tag": "outcome assessment"
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"tag": "paroxetine/ae [Adverse Drug Reaction]"
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"tag": "perinatal drug exposure"
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"title": "Caffeine to improve breathing effort of preterm infants at birth: A randomized controlled trial",
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"creatorType": "author",
"firstName": "Dekker",
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"abstractNote": "BackgroundCaffeine promotes spontaneous breathing by antagonizing adenosine. We assessed the direct effect of caffeine on respiratory effort in preterm infants at birth.MethodsThirty infants of 24-30 weeks of gestation were randomized for receiving caffeine directly after birth in the delivery room (caffeine DR group) or later in the neonatal intensive care unit (control group). Primary outcome was respiratory effort, expressed as minute volume, tidal volumes, respiratory rate, rate of rise to maximum tidal volume, and recruitment breaths at 7-9 min after birth.ResultsAfter correction for gestational age, minute volumes ((mean+/-SD; 189+/-74 vs. 162+/-70 ml/kg/min; P<0.05) and tidal volumes ((median (interquartile range (IQR)) 5.2 (3.9-6.4) vs. 4.4 (3.0-5.6) ml/kg) were significantly greater in the caffeine DR group. Although respiratory rates were similar ((mean+/-SD) 35+/-10 vs. 33+/-10), RoR increased significantly ((median (IQR) 14.3 (11.2-19.8) vs. 11.2 (7.9-15.2) ml/kg/s), and more recruitment breaths were observed (13 vs. 9%).ConclusionCaffeine increases respiratory effort in preterm infants at birth, but the effect on clinical outcomes needs further investigation. Copyright © 2017 International Pediatric Research Foundation, Inc.",
"publicationTitle": "Pediatric Research",
"publisher": "",
"place": "",
"date": "2017 Aug",
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"DOI": "10.1038/pr.2017.45",
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"title": "Maternal and neonatal effects of vasopressors used for treating hypotension after spinal anesthesia for caesarean section: A randomized controlled study",
"creators": [
{
"creatorType": "author",
"firstName": "Soxhuku-Isufi",
"lastName": "A"
},
{
"creatorType": "author",
"firstName": "Shpata",
"lastName": "V"
},
{
"creatorType": "author",
"firstName": "Sula",
"lastName": "H"
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],
"abstractNote": "AIM: The aim of the study was to examine whether ephedrine and phenylephrine were different in their efficacy for managing maternal hypotension and their effect of adverse maternal and neonatal outcome. METHODS: A double-blind randomized controlled study in healthy pregnant women ASA physical status 2, which underwent elective caesarian delivery under spinal anesthesia. Patients were randomized to receive an intravenous bolus of either phenylephrine (Ph group) or ephedrine (E group) immediately after the episode of hypotension after spinal anesthesia. Maternal and neonatal outcomes were recorded. RESULTS: Two hundred and two (202) pregnant women at term were entered in this study. There were no differences between group E and group Ph regarding the incidence of hypotension after vasopressor therapy, and the incidence of nausea and vomiting. There was no significant difference between groups in the first-minute and the 5th minute Apgar score, none of the neonates had the true fetal acidosis. CONCLUSIONS: Ephedrine and phenylephrine have the same efficacy in treating hypotension after spinal anesthesia for caesarean section. The use of Phenylephrine was associated with better fetal acid-base status, and there were no differences on Apgar score values and on the incidence of maternal bradycardia and hypotension. Copyright © 2016 Alma Soxhuku-Isufi, Vjollca Shpata, Hektor Sula.",
"publicationTitle": "Journal of Medical Sciences",
"publisher": "",
"place": "",
"date": "2016 Mar",
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"DOI": "10.3889/oamjms.2016.003",
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"tag": "female"
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"tag": "fetus"
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"tag": "hypertensive factor"
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"title": "A randomized trial comparing prophylactic phenylephrine and ephedrine infusion during spinal anesthesia for emergency cesarean delivery in cases of acute fetal compromise",
"creators": [
{
"creatorType": "author",
"firstName": "Jain",
"lastName": "K"
},
{
"creatorType": "author",
"firstName": "Makkar",
"lastName": "J.k"
},
{
"creatorType": "author",
"firstName": "Subramani Vp",
"lastName": "S"
},
{
"creatorType": "author",
"firstName": "Gander",
"lastName": "S"
},
{
"creatorType": "author",
"firstName": "Kumar",
"lastName": "P"
}
],
"abstractNote": "Background Previous evidence showed that use of phenylephrine was associated with higher umbilical artery pH (UA pH) than ephedrine after elective cesarean delivery (CD). However, the best choice of vasopressor and its effect on funic gases in cases of acute fetal compromise require additional studies. Methods Ninety parturients showing acute fetal compromise during intrapartum period and taken up for CD (category II) under spinal anesthesia were randomized to receive prophylactic infusion of ephedrine 2.5 mg/min or phenylephrine 30 mug/min. Systolic blood pressure was targeted between 90% and 110% of baseline. Incidence of fetal acidosis (UA pH < 7.2 and/or base deficit > 12 mmol/L) was recorded. Other parameters of cord gases, Apgar score, need for immediate resuscitation, maternal hemodynamics, and adverse events were also compared. Results Number of neonates showing acidosis with ephedrine or phenylephrine was comparable (P =.22). Of these, newborns with base deficit > 12 mmol had low 1-minute Apgar scores (n = 15/23). The ephedrine group had higher oxygen content in UA (P =.03). There was no adverse neonatal outcome during the period of observation. Incidence of maternal nausea and vomiting was higher with ephedrine than with phenylephrine (22.2% vs 4.4%; P =.02). Maternal bradycardia was observed with phenylephrine (P =.02). Conclusion Our data report similar fetal acidosis with either phenylephrine or ephedrine administered during spinal anesthesia for treating maternal hypotension in cases of emergency CD. Copyright © 2016 Elsevier Inc. All rights reserved.",
"publicationTitle": "Journal of Clinical Anesthesia",
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"DOI": "10.1016/j.jclinane.2016.03.015",
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"creatorSummary": "Mohta et al.",
"parsedDate": "2016-08",
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"title": "Randomized double-blind comparison of ephedrine and phenylephrine for management of post-spinal hypotension in potential fetal compromise",
"creators": [
{
"creatorType": "author",
"firstName": "M.",
"lastName": "Mohta"
},
{
"creatorType": "author",
"firstName": "M.",
"lastName": "Aggarwal"
},
{
"creatorType": "author",
"firstName": "A. K.",
"lastName": "Sethi"
},
{
"creatorType": "author",
"firstName": "P.",
"lastName": "Harisinghani"
},
{
"creatorType": "author",
"firstName": "K.",
"lastName": "Guleria"
}
],
"abstractNote": "Background Most studies comparing phenylephrine and ephedrine have been conducted during elective caesarean sections in healthy mothers with no fetal compromise. The effect of vasopressors on fetal outcome may differ between healthy and compromised fetuses. There has been little research into the effect of phenylephrine and ephedrine, when used for management of post-spinal hypotension in the presence of potential fetal compromise. Methods Healthy women with a singleton pregnancy undergoing emergency caesarean section for fetal compromise under spinal anaesthesia were studied. One-hundred-and-six consecutive subjects, who developed hypotension after spinal anaesthesia, were randomly allocated to two groups of 53 each, to receive either phenylephrine (Group P) or ephedrine (Group E). For every systolic blood pressure reading <100 mmHg patients received phenylephrine 100 mug or ephedrine 8 mg depending on group allocation. Umbilical blood gas parameters and Apgar scores were recorded. Results There was no statistically significant difference in umbilical arterial pH (P=0.79), umbilical venous pH (P=0.98), other blood gas parameters, incidence of fetal acidosis (P=1.00) and Apgar scores. The number of hypotensive episodes, vasopressor doses for treatment of the first hypotensive episode and the total number of doses used during the study period were comparable. The median [IQR] total number of doses of phenylephrine and ephedrine used before delivery were 2 [1-2] and 2 [1-2], respectively (P=0.67). More patients receiving ephedrine (24.5%) developed tachycardia than those receiving phenylephrine (3.8%) (P=0.004). Bradycardia was more common with phenylephrine, with 39.6% of patients in Group P as compared to only 1.9% of patients in Group E developing a heart rate <60 beats/min after vasopressor administration (P=0.001). Conclusions Both phenylephrine 100 mug and ephedrine 8 mg boluses are equally efficacious when treating post-spinal hypotension in the presence of potential fetal compromise. However, phenylephrine may be a better choice in the presence of maternal tachycardia. Copyright © 2016 Elsevier Ltd",
"publicationTitle": "International Journal of Obstetric Anesthesia",
"publisher": "",
"place": "",
"date": "2016 Aug",
"volume": "27",
"issue": "",
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"partTitle": "",
"pages": "32-40",
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"DOI": "10.1016/j.ijoa.2016.02.004",
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"language": "English",
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"tags": [
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},
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"tag": "*ephedrine/cm [Drug Comparison]"
},
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"tag": "acidosis"
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"tag": "adult"
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"tag": "glycopyrronium/iv [Intravenous Drug Administration]"
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"tag": "heart rate"
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"tag": "prospective study"
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"tag": "ranitidine/iv [Intravenous Drug Administration]"
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"creatorSummary": "Margulis A.V. et al.",
"parsedDate": "2017",
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"itemType": "journalArticle",
"title": "Antiepileptic drugs in pregnancy: Searching for a reference drug for comparative safety",
"creators": [
{
"creatorType": "author",
"name": "Margulis A.V."
},
{
"creatorType": "author",
"name": "Oberg A.S."
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"creatorType": "author",
"name": "Hernandez-Diaz S."
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],
"abstractNote": "Background: Women with epilepsy are at higher risk of delivering preterm infants or infants with low birth weight (LBW) than women without epilepsy, and epileptic women treated with antiepileptic drugs (AEDs) are at higher risk than untreated epileptic women. Less is known about the risks of individual AEDs. This information is key for comparative safety research, in which we compare patients on one drug with patients on another drug with similar indications and, preferably, a benign safety profile. Objectives: To identify via a systematic literature review individual AEDs that could serve as the reference in comparative safety research on the association of maternal AED use, pregnancy duration and newborn size. Methods: We searched PubMed without date limits. Observational studies were eligible if they provided adjusted measures of association; any reference group was acceptable. Results: The search retrieved 872 papers; 71 were retained after screening of title/abstract and 11 were selected after full-text review. Of these papers, published in 1981-2014, 4 reported on overall use of AEDs and 10 reported on monotherapy; measures of association included standard deviation scores, odds ratios, relative risks, and linear regression coefficients. Adjustment of effect estimates varied. We considered results too heterogeneous for meta-analysis. We focused on the three most commonly reported AEDs (carbamazepine [CBZ], valproic acid [VPA], and lamotrigine [LMT]) and the outcomes preterm delivery and LBW (BW < 2500 g). Three papers reported on each of these associations for overall use with reference to unexposed women. For CBZ, point estimates for LBW ranged from 1.7 to 2.3, with lower bounds of the 95% confidence intervals (CI) of 1.2 or higher and upper bounds of 3.1 or lower. For preterm delivery, point estimates ranged from 1.4 to 1.8 (CI range, 1.1 to 2.4). For VPA, point estimates for LBW ranged from 1.0 to 2.1 (CI range, 0.5 to 2.9). For preterm delivery, point estimates ranged from 1.0 to 1.4 (CI range, 0.6 to 2.1). For LMT, point estimates for LBW ranged from 1.1 to 1.8 (CI range, 0.7 to 1.2). For preterm delivery, point estimates ranged from 0.9 to 1.6 (CIs range, 0.5 to 1.9). Conclusions: In this systematic review of heterogeneous studies, LMT and VPA had the more benign safety profiles. Given the known VPA teratogenicity, LMT is an appropriate reference drug for comparative safety research on neonatal outcomes. Few studies reported on the newer AEDs and preterm delivery and LBW.",
"publicationTitle": "Pharmacoepidemiology and Drug Safety",
"publisher": "",
"place": "",
"date": "2017",
"volume": "26",
"issue": "(Margulis) RTI Health Solutions, Barcelona, Spain",
"section": "",
"partNumber": "",
"partTitle": "",
"pages": "408-409",
"series": "33rd International Conference on Pharmacoepidemiology and Therapeutic Risk Management. Canada.",
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"tag": "*first trimester pregnancy"
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"tag": "*pregabalin"
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"tag": "ICD-9"
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"tag": "epilepsy"
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"tag": "female"
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"tag": "fibromyalgia"
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"tag": "hospital patient"
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{
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"tag": "infant"
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"tag": "linear regression analysis"
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"tag": "low birth weight"
},
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"tag": "medicaid"
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"tag": "meta analysis"
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"tag": "monotherapy"
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"tag": "multicenter study (topic)"
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"tag": "neuropathic pain"
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"tag": "newborn"
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"tag": "observational study"
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"tag": "outpatient"
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"tag": "pharmacokinetics"
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{
"tag": "prematurity"
},
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"tag": "propensity score"
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"tag": "risk assessment"
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"tag": "risk factor"
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{
"tag": "seizure"
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"tag": "sensitivity analysis"
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{
"tag": "side effect"
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"tag": "stratification"
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"tag": "systematic review"
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"tag": "teratogenicity"
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"creatorSummary": "S and M.l",
"parsedDate": "2017-06",
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"itemType": "journalArticle",
"title": "Neurodevelopmental outcomes in infants exposed in utero to antipsychotics: A systematic review of published data",
"creators": [
{
"creatorType": "author",
"firstName": "Gentile",
"lastName": "S"
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"creatorType": "author",
"firstName": "Fusco",
"lastName": "M.l"
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],
"abstractNote": "The proportion of pregnancies exposed to either second-generation antipsychotics (SGAs) or first-generation antipsychotics (FGAs) varies between 0.3%-2% of all pregnancies, but, until now, little is known about the potential neurobehavioral teratogenicity of antipsychotics. Assessing this safety facet is the aim of this article. PubMed, Scopus, and Google Scholar were searched for eligible articles. PubMed (1954 to May 2016) was searched using several medical subject headings, variously combined. PubMed search results were also limited using the search filter for human studies published in English. Scopus and Google Scholar searches were filtered for article title (antipsychotics/neuroleptics, pregnancy). After excluding duplicates, 9,250 articles were identified and 29 met the following inclusion criteria: only articles that provided original/primary data on neurodevelopmental outcome in human offspring older than 4 months of age, independently of the study design, were selected for review. Indeed, some relevant neurodevelopmental milestones are achieved at this time. Length of study and neurodevelopmental assessment methodology did not influence the study selection. Unfortunately, published data on neurodevelopmental teratogenicity of SGAs mainly derive from case reports and small case-series studies. Even findings emerging from case-control and prospective/retrospective studies are of limited clinical relevance because of their small sample sizes. Limited data are also available on FGAs. Hence, we have to conclude that the long-term neurodevelopmental outcomes for children exposed in utero remain unclear. Low to very low quality evidence of retrieved data makes impossible to confirm or exclude potential long-lasting untoward effects on infant neurocognitive development associate with antenatal exposure to either SGAs or FGAs. Copyright © Cambridge University Press 2016.",
"publicationTitle": "CNS Spectrums",
"publisher": "",
"place": "",
"date": "2017 Jun",
"volume": "",
"issue": "",
"section": "",
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"language": "English",
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"tag": "*nerve cell differentiation"
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"type": 1
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"tag": "amisulpride"
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