Objective: To investigate whether small-for-gestational-age (SGA) and large-for-gestational-age (LGA) birth weight at-term poses an increased risk for long-term pediatric endocrine morbidity. Study design: A retrospective population-based cohort study compared the incidence of long-term pediatric hospitalizations due to endocrine morbidity of singleton children born SGA, appropriate-for-gestational-age (AGA), and LGA at-term. A multivariate generalized estimating equation (GEE) logistic regression model analysis was used to control for confounders. Results: During the study period, 235,614 deliveries met the inclusion criteria; of which 4.7% were SGA (n = 11,062), 91% were AGA (n = 214,249), and 4.3% were LGA neonates (n = 10,303). During the follow-up period, children born SGA or LGA at-term had a significantly higher rate of long-term endocrine morbidity. Using a multivariable GEE logistic regression model, controlling for confounders, being delivered SGA or LGA at-term was found to be an independent risk factor for long-term pediatric endocrine morbidity (Adjusted OR = 1.4; 95%CI = 1.1–1.8; p = .015 and aOR = 1.4; 95%CI = 1.1–1.8; p = .005, respectively). Specifically, LGA was found an independent risk factor for overweight and obesity (aOR = 1.7; 95%CI = 1.2–2.5; p = .001), while SGA was found an independent risk factor for childhood hypothyroidism (aOR = 3.2; 95%CI = 1.8–5.8; p = .001). Conclusions: Birth weight either SGA or LGA at-term is an independent risk factor for long-term pediatric endocrine morbidity.

Ehlers-Danlos Syndrome (EDS) is an inherited connective tissue disorder caused by abnormal collagen synthesis. Little is known about its effects on pregnancy. The purpose of this study was to evalu...

Objective The objective of this study was to investigate whether maternal bronchial asthma increases the risk for long-term respiratory morbidity of the offspring. Study Design A population-based cohort study compared the incidence of long-term pediatric hospitalizations due to respiratory disease of the offspring of mothers with and without bronchial asthma. Deliveries occurred between the years 1991 and 2014 in a tertiary medical center. Congenital malformations as well as multiple pregnancies were excluded. Kaplan–Meier's survival curve was used to estimate cumulative incidence of respiratory morbidity. A multivariate generalized estimating equation (GEE) logistic regression model analysis was used to control for confounders. Results During the study period, 253,808 deliveries met the inclusion criteria; of which 1.3% were born to mothers with bronchial asthma (n = 3,411). During the follow-up period, children born to women with bronchial asthma had a significantly higher rate of long-term respiratory morbidity (odds ratio [OR] = 1.5; 95% confidence interval [CI] = 1.3–1.7; p < 0.001). Specifically, the rate of childhood asthma was higher among offspring of mothers with asthma (OR = 2.3; 95% CI = 1.8–2.9; p < 0.001). Children born to women with asthma had higher cumulative incidence of respiratory morbidity, using a Kaplan–Meier's survival curve (log-rank test; p < 0.001). Using two multivariable GEE logistic regression models, controlling for the time to event, maternal age, and gestational age at delivery, maternal bronchial asthma was found to be an independent risk factor for long-term respiratory disease of the offspring (adjusted OR = 1.6; 95% CI = 1.4–1.9; p < 0.001), and specifically for bronchial asthma (adjusted OR = 2.5; 95% CI = 1.9–3.1; p < 0.001). Conclusion Maternal bronchial asthma is an independent risk factor for long-term respiratory morbidity of the offspring.

Background: Placental abruption (PA) is an unpredictable obstetric complication associated with substantial maternal and fetal/neonatal morbidity and mortality in the index and subsequent pregnancies. The previous PA severity classification categorizes more than two-thirds of cases as severe, which limits its clinical utility despite its association with adverse maternal outcomes. Objective: We aimed to develop a novel, clinically applicable PA severity classification and to determine its ability to predict its recurrence in subsequent pregnancies. Study design: This retrospective, population-based cohort study included medical records of all women who delivered at our medical center from 2001 to 2021. Pregnancies complicated by chromosomal abnormalities or major congenital anomalies were excluded. The novel PA severity classification included maternal (transfusion of ≥4 units of red blood cells, admission to an intensive care unit, DIC, hysterectomy, or maternal death) and neonatal (birth asphyxia, hypoxic–ischemic encephalopathy, umbilical cord blood acidosis defined as pH < 7.0, neonatal intensive care unit admission at ≥35 weeks gestation, or perinatal death) complications. Maternal characteristics, clinical features, and perinatal outcomes were compared between the novel and the existing PA severity classifications. A multivariate regression model was used to determine the association between PA severity and the risk of its recurrent in subsequent pregnancies. Results: Our cohort included 298,281 deliveries; of them, 1567 (0.5%) had PA. The rate of severe PA was lower in the novel vs. the existing classification (p < 0.001). Within the novel classification, severe PA was associated with higher rates of mild and severe preeclampsia and lower mean fibrinogen concentrations and platelet counts compared with mild abruption (all p < 0.001). Severe PA was independently associated with an increased risk of recurrence in subsequent pregnancies (OR 1.82, 95% CI 1.05–3.14). Conclusions: We propose a novel, clinically relevant PA severity classification that accurately identifies severe disease providing prognostic information regarding the risk of PA recurrence in future pregnancies.