Objective. To determine the contribution of maternal lipids in predicting large‐for‐gestational age (LGA) newborns born to women with gestational diabetes mellitus (GDM). Design. Retrospective study. Setting. Yonsei University Health System, Korea. Population. A total of 104 women diagnosed with GDM between January 2000 and June 2008. Methods. Women who were positive on the 50 g oral glucose challenge test (24–28 weeks' gestation) and who were referred patients suspected of GDM underwent a 3 hours, 100 g oral glucose tolerance test for GDM diagnosis. Maternal fasting serum triglycerides and total, high‐density lipoprotein (HDL), and low‐density lipoprotein cholesterol levels were determined at 24–32 weeks' gestation. Logistic regression analysis was performed to determine maternal parameters independently associated with delivering LGA newborns at term. Main outcome measures. Risk contributions for LGA newborns. Results. Maternal fasting serum triglyceride levels were significantly higher in mothers of LGA newborns compared with other mothers; however, no significant correlations were found between newborn birthweight and maternal fasting glucose, total cholesterol, or HDL cholesterol levels. After adjusting for confounding variables including prepregnancy body mass index, weight gain during pregnancy, age, and parity, maternal hypertriglyceridemia at 24–32 weeks' gestation remained an independent parameter for identifying term LGA newborns. Conclusions. In GDM pregnancies, determining maternal serum triglyceride levels during midpregnancy may help identify women likely to give birth to LGA newborns.

The purpose of this study was to determine the prevalence of Ureaplasma urealyticum (UU) and Mycoplasma hominis (MH) in patients with preterm labor or preterm premature rupture of membranes (PPROM) and to determine the effect of these organisms on pregnancy outcomes based on the density of colonization. The study group consisted of 184 women with preterm labor or PPROM. Vaginal cultures for UU and MH were performed for all patients at admission, and the placentas were histologically evaluated after delivery. The prevalence of positive vaginal fluid cultures for genital mycoplasma was 62.5% (112/179). This group included 99 patients carrying only UU and 13 carrying both organisms. No patients were found to carry only MH. Compared to patients only positive for UU, patients with both organisms showed significantly decreased gestational age at birth and birth weight, and significant increases in the incidences of preterm birth, NICU admissions and histologic chorioamnionitis. Vaginal MH tends to be detected with UU, and patients carrying both organisms simultaneously had more severe adverse pregnancy outcomes compared to patients in preterm labor or PPROM who were only positive for UU.

Congenital uterine anomalies (CUA) may influence reproductive performance, resulting in adverse pregnancy associated complications. This study aimed to assess the association of CUA subtypes with reproductive, obstetric, and perinatal outcomes. We performed a systematic search of the MEDLINE, EMBASE, and Cochrane libraries for studies comparing pregnancy outcomes between women with CUA and those with a normal uterus. The random effects model was used to estimate the odds ratios (ORs) with a 95% confidence interval (CI). Women with CUA had a lower rate of live births (OR 0.47; 95% CI 0.33–0.69), and a higher rate of first trimester miscarriage (OR, 1.79; 95% CI 1.34–2.4), second trimester miscarriage (OR 2.92; 95% CI 1.35–6.32), preterm birth (OR 2.98; 95% CI 2.43–3.65), malpresentation (OR 9.1; 95% CI 5.88–14.08), cesarean section (OR 2.87; 95% CI 1.56–5.26), and placental abruption (OR 3.12; 95% CI 1.58–6.18). Women with canalization defects appear to have the poorest reproductive performance during early pregnancy. However, unification defects were associated with obstetric and neonatal outcomes throughout the course of pregnancy. It may be beneficial for clinicians to advise on potential complications that may be increased depending on the type and severity of CUA.

Nam KH, et al. J Gynecol Oncol. 2010 Dec;21(4):225-229. http://dx.doi.org/10.3802/jgo.2010.21.4.225