Pregnancy in bulimic women

Citations from the Literature (55/771), rising from 4% (71/173) in thin mothers (Quetelet’s index < 20) to 15% (6/40) in mothers with grades II and III obesity (Quetelet’s index > 30). After adjusting for major demographic and antenatal factors, including serious complications of pregnancy, maternal fatness was second in importance only to length of gestation in predicting death of infants born preterm. In the second analysis mortality overall was 150/o (44/284), rising from 9% (S/53) in thin mothers to 47% (8117) in mothers with grades II and III obesity. In both analyses the relative risk of death by 18 months post-term was nearly four times greater in infants born to obese mothers than in those born to thin mothers. In addition, maternal fatness was associated with reduced birth weight; whereas it is associated with macrosomia in term infants. These data differ fundamentally from those reported in full term babies of obese mothers. It is speculated that the altered metabolic milieu in obesity may reduce the ability of the fetus to adapt to extrauterine life if it is born preterm. Testosterone, androstenedione, fate, and sex-hormone-binding abusers

dehydroepiandrosterone sulglobulin in pregnant alcohol

Ylikorkala 0; Stenman U-H; Halmesmaki E Department of Obstetrics and Gynecology, University Central Hospital, 00290 Helsinki, Finland OBSTET. GYNECOL.; 71/5 (731-735)/1988/ We compared serum concentrations of total and free testosterone, androstenedione, dehydroepiandrosterone sulfate (DHEAS), and sex-hormone-binding globulin in 40 pregnant women exhibiting consistent alcohol abuse and in 20 abstinent pregnant controls. Sixteen drinkers gave birth to infants with fetal alcohol effects; the remaining 24 drinkers delivered healthy infants. Drinking patients with healthy infants had normal concentrations of total and free testosterone, sex-hormone-binding globulin, and DHEAS, but their levels of androstenedione, increased between weeks 20-40 of pregnancy. Maternal drinking leading to fetal alcohol effects was accompanied by lowered concentrations of sex-hormone-binding globulin throughout pregnancy and by low total testosterone concentrations, although the latter difference reached statistical significance only at 16-20 weeks’ gestation. In contrast, drinking leading to fetal damage was associated with higher free testosterone levels between weeks 16-20 of pregnancy and lowered concentrations of DHEAS between weeks 16-32 of gestation, whereas the androstenedione levels tended to be high throughout pregnancy. These changes in androgens can be explained in part by low sex-hormone-binding globulin concentrations, an insufficient supply of DHEAS by the adrenals, and reduced peripheral conversion of androstenedione to testosterone.

Pregnancy in bulimic women

Willis DC; Rand CSW Department of Obstetrics and Gynecology, University of Florida, Gainesville. FL, USA OBSTET. GYNECOL: 71/5 (708-710)/1988/

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Four primiparous bulimic women were interviewed. Pregnancy outcome was not affected adversely by bulimia. Gestational age ranged from 37-41 weeks, and average infant birth weight was 3121 g. Maternal weight gain averaged 40 lb. Bulimic behaviors described during pregnancy, but returned to prepregnant levels after delivery in three of the four women.

FERTILITY AND STERILITY Life table analysis of intrauterine insemination pregnancy rates

Lalich RA; Marut ED; Prins GS; Scommegna A Department of Obstetrics and Gynecology, Michael Reese Hospital and Medical Center, University of Chicago-Pritzker School of Medicine, Chicago, IL, USA AM. .I. OBSTET. GYNECOL.; 158/4 (980-984)/1988/ One hundred twenty-eight couples undergoing intrauterine inseminations were retrospectively reviewed. Life table methodology was used to analyze cumulative pregnancy rates and monthly fecundability. Respective 6- and 12-month cumulative pregnancy rates for each diagnostic group receiving intrauterine insemination were: cervical factor, 28.6% and 42.8%; male factor, 16.7% and 16.7%; female immune factor, 66.7% and 100.0%; male immune factor, 37.5% and 68.8%; and empiric treatment, 60.0% and 60.04ro. There was no difference in pregnancy rates between sperm processed with a swim-up in Ham’s F-10 or a two-gradient Percoll system. Abnormal sperm penetration assay results in patients with male factor did significantly (p = 0.05) lower the pregnancy rate. It is concluded that if no pregnancy has occurred after six cycles of inseminations, further workup or other treatment may be initiated, but additional pregnancies can be achieved from the seventh through the twelfth cycles of intrauterine insemination. Effect of therapy on infertile couples with antisperm antibodies

Smarr SC; Wing R; Hammond MC Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, University of North Carolina, ChapelHill, NC27514, USA AM. J. OBSTET. GYNECOL.; 158/4 (969-973)/‘1988/ One hundred seventy-eight couples with positive antisperm antibody titers in serum and genital secretions were offered treatment with prednisone. Of 60 couples who received prednisone only, 43% conceived. Of 25 who had no therapy, 48% conceived. Fifty-four patients treated with prednisone received additional therapy and 31% conceived. Ten of 39 patients not treated with prednisone but receiving other therapies conceived. Cytotoxic antibodies were reduced in 30% to 42% of serum samples and in 24% to 33% of genital secretion samples. In those couples with decreased cytotoxic antibodies pregnancy rates were 40% to 60% compared with 0% to 23% in those with decreased hemagglutinating antibody titers. Our data suggest that prednisone did not improve overall pregnancy rates; pregnancy rates were comparable in both groups treated with other therapies; donor insemination was the most successful of the alternative therapies; reduction of cytotoxic antibody titers after prednisone treatment was associated with increased pregnancy rates. Int J Gynecol Obstet 28