Human chorionic gonadotropin (HCG) is used parenterally for treatment of threatened abortions and repeated spontaneous abortion in pregnant women. No controlled epidemiological studies of preterm birth and low birthweight newborns in pregnant women with HCG treatment have been published while the results of animal investigations were controversial. The data of 97 pregnant women with HCG treatment in the second and third months of pregnancy due to threatened abortion and/or previous spontaneous abortion(s) was compared with the data of other 38,054 pregnant women in the population-based large data set of the Hungarian Case-Control Surveillance of Congenital Abnormalities. There was no difference in mean gestational age at delivery and birth weight, in addition the rate of preterm birth and low birthweight newborns. Parenteral HCG treatment in the early pregnancy due to threatened abortion did not associate with a higher risk for preterm births or low birthweight newborns. However, a higher occurrence of gestational diabetes was found in pregnant women with HCG treatment and there was a slight male excess among newborn infants (p=0.06).
Previous studies reported controversial results regarding the possible association of recurrent genital herpes during pregnancy with a higher risk of preterm birth/low birth weight in newborns. Thus, birth outcomes of mothers with prospective and medically recorded symptomatic recurrent genital herpes confirmed by serological examination and of mothers without genital herpes were compared in the population-based large data set of the Hungarian Case-Control Surveillance of Congenital Abnormalities. Our results showed that of 38,151 newborn infants, 86 (0.23%) had mothers with symptomatic recurrent genital herpes confirmed by serological examination during pregnancy. The rate of preterm births (14.0% vs. 9.2%) was higher in babies born to mothers with symptomatic recurrent genital herpes (OR with 95% CI: 1.7, 1.0–3.1) and this increase showed a trimester dependence with the highest rate in the third trimester (23.5%; OR with 95% CI: 2.6, 1.5–4.5). In conclusion, clinically diagnosed recurrent genital herpes during the third trimester of pregnancy associated with high risk for preterm birth.
The possible association between prospectively and medically recorded vulvovaginitis-bacterial vaginosis (VV-BV) and different congenital abnormalities (CA) has not been studied. The data set of the population-based Hungarian Case-Control Surveillance of Congenital Abnormalities between 1980 and 1996 were evaluated, i.e. 22,843 pregnant women who had newborns or fetuses with congenital abnormality (cases) and 38,151 pregnant women who delivered newborn babies without any congenital abnormality (controls). The main outcome measures were different congenital abnormalities. Of 22,843 cases with CA, 1,536 (6.7%) had mothers with VV-BV, while of 38,151 matched controls without CA, 2,698 (7.1%) had mothers with VV-BV in the second and/or third gestational month of pregnancy. Nearly all pregnant women with VV-BV were treated during pregnancy, but a higher risk for the total group of CAs (adjusted POR with 95% CI: 0.95, 0.89–1.02) or any CA group was not found. In addition, the risk for total CAs was significantly lower in cases born to mothers with VV-BV and appropriate treatment than born to mothers with VV-BV but without treatment. Thus maternal VV-BV needs treatment during pregnancy as well, because it helps reduce the rate of preterm birth without a risk for CAs.
The objective of the study was to estimate the prevalence at birth and epidemiologic characteristics of patients/cases with both isolated and multiple “syndromic” external ear congenital abnormalities (CAs) in Hungary. The Hungarian Congenital Abnormality Registry, 1980–1996, included 649 cases with isolated external ear CAs, while the number of cases with unclassified multiple CA, including ear CAs, was 331. Thus the prevalence at birth of cases with isolated external ear CAs and unclassified multiple CAs was 0.30 and 0.15, respectively, for a total 0.46 per 1000 births. After reevaluation of reported 354 cases with isolated external ears CAs in the Hungarian Case-Control Surveillance of Congenital Abnormalities, 74 (20.9%) and 236 (66.7%) were affected with mild and severe microtia, while 24 (6.8%) had anotia. The fourth group included 20 cases with the combination of anotia/microtia and external/middle ear CAs. Isolated ear CAs showed a slight male excess (54.0%) and strong predominance of unilateral manifestation (93.4%). Multiple ear CAs showed a stronger male excess (65.4%) and less frequent unilateral affection (62.2%). In conclusion, ear CAs had a low diagnostic validity; thus it was necessary to reassess the data and to reclassify several cases.
Hungarian Preconceptional Care includes the preconceptional screening of sexually transmitted infections/disorders (STD) and vaginal candidosis of potential mothers and pyospermia of potential fathers. The aim of this study was to evaluate the effect of this screening and treatment for the rate of preterm births. Clinical and subclinical vaginal candidiasis (asymptomatic candida colonisation), combination of STD and vaginal candidiasis, STD without vaginal candidiasis, finally women without STD and vaginal candidiasis as references were evaluated in 4,672 pregnant women. The association of STD in pregnant women with higher risk of preterm birth was confirmed. However, an association was also found between clinically diagnosed vaginal candidiasis, asymptomatic candida colonisation, and a higher risk for preterm births. This risk was reduced with clotrimazole treatment. However, pregnant women without recognized STD and/or vaginal candidiasis had a higher risk for preterm birth than pregnant women with STD or vaginal candidiasis after appropriate treatment. Thus the conclusion of the study is that the preconceptional screening of STD and vaginal candidiasis followed by appropriate treatment is important to prevent a certain part of preterm birth but it is necessary to improve the efficacy of the previously used methods for this screening.
The objective of our project is to reveal the possible etiological factors of different congenital cardiovascular abnormalities. In this study, we evaluated single ventricular septal defect (VSD) after surgical correction or with lethal outcome. The birth outcomes of these cases in the function of maternal socio-demographic features were evaluated. Data are based on 1,659 VSD cases, 2,534 matched controls and 38,151 all controls without any defects, in addition in the mothers of 19,393 malformed controls with other isolated defects in the population-based large dataset of the Hungarian Case-Control Surveillance of Congenital Abnormalities. VSD had mild female excess with a higher rate of preterm birth and mainly low birth weight indicating intrauterine growth restriction of affected fetuses, particularly in males and full-term or average weighted cases. The mothers of cases with VSD had lower socioeconomic status and higher rate of smoking and particularly drinking habit. The evaluation of medically recorded pregnancy complications showed an association of gestational diabetes with a higher risk of VSD. In conclusion, the association of small localized size of VDS and obvious fetal growth restriction needs further explanation in these cases, while gestational diabetes, lower socioeconomic status and adverse lifestyle of pregnant women may have a role in the origin of VSD.
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