The effect of race on the relationship between fetal death and altered fetal growth

Article Abstract:

Poor fetal growth is one of many problems that may occur in pregnancy and is a risk factor for fetal death. Abnormal fetal growth is usually indicated in relation to a standard. Thus, a birth weight which is below the 10th percentile, or below the birth weight of 90 percent of the general newborn population, is considered abnormal. However, the 10th percentile standard does not correlate with similar relative risk for fetal death across the different gestational ages. Thus, quadrupling of the fetal death rate is associated with the second percentile of birth weight at birth occurring at 25 weeks but the 17th percentile at 40 weeks. In addition, the race of the fetus also affects the relationship between birth weight and gestational age. However, fetal growth is usually assessed without regard to race. The effect of race on the relationship between birth weight, stillbirth rate, and gestational age at birth was studied using data from 782,430 births in Illinois from 1980 to 1984. The mean and 10th percentile birth weight curves for white and black infants were very close up to 34 weeks. However, mean and 10th percentile birth weights in whites gradually increased so that at 40 weeks, there was a difference of one-half pound. The birth weight associated with a quadrupled risk of fetal death was fairly constant in whites at the 12th percentile, throughout the gestational age at birth. However, fetal death rate in black infants was associated with much lower birth weights at earlier gestational age, about the fifth percentile, but increased with gestational age to the 15th to 18th percentile by 40 weeks. The study suggests that a significant proportion of both white and black infants are at elevated risk for fetal death even though their weights are not currently associated with abnormal fetal growth. In addition, the weights at which fetal death risk quadruples is different for white and black infants, and medical assessments should start to take this into account so as to improve treatment. (Consumer Summary produced by Reliance Medical Information, Inc.)

Risk factors, Fetus, Demographic aspects, Fetal growth retardation, Fetal death

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The prevalence of autoantibodies and lupus anticoagulant in healthy pregnant women

Article Abstract:

How the immune system responds during pregnancy is controversial. An autoimmune reaction occurs when the body reacts against its own tissues as if they were foreign, producing autoantibodies against normal constituents of the body. Some studies have suggested an increase in autoantibodies in some cases of infertility, pregnancy loss and adverse pregnancy outcomes. An increase in the anticoagulant autoantibody that characterizes lupus is associated with a poor fetal outcome. Pregnancy can result in an increase or decrease in the amount of circulating autoantibodies depending on the type of autoimmune disease present. However, the effect of the normal physiological changes of pregnancy (particularly the increased blood volume) on autoantibody levels has not been well-studied. To establish normal autoantibody levels throughout pregnancy, 43 healthy pregnant women were matched with 50 nonpregnant women. Autoantibodies and all types of immunoglobulins (IgG, IgM, IgA), naturally occurring antibodies, were measured. Throughout pregnancy, the level of autoantibodies did not differ from nonpregnant women and remained within the normal range. However, there was an increase in autoantibodies at the time of delivery. (Consumer Summary produced by Reliance Medical Information, Inc.)

Measurement, Autoantibodies, Physiological aspects, Pregnancy

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