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The relation between cigarette smoking with delivery outcomes. An evaluation of a database of more than nine million deliveries.

J Perinat Med 2021 Jul 30. Epub 2021 Jul 30.

Division of Reproductive Endocrinology and Infertility, McGill University Health Care Center, Montreal, QC, Canada.

Objectives: Smoking in pregnancy is associated with an increased risk of preterm birth (PTB), intrauterine growth restriction, placental abruption and perinatal death. The association between smoking and other delivery outcomes, such as chorioamnionitis, mode of delivery or post partum hemorrhage (PPH), however, is insufficient as only few studies addressed these issues. The aim of the study was to evaluate the association between prenatal smoking and delivery outcomes in a large database, while controlling for confounding effects. Read More

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The impact of COVID-19 visitor policy restrictions on birthing communities of colour.

J Adv Nurs 2021 Jul 30. Epub 2021 Jul 30.

School of Social Work, University of Washington, Seattle, Washington, USA.

Aims: To explore the experiences of care for pregnant and birthing people, and the nurses who cared for them, during the COVID-19 pandemic, with special emphasis on the impact of visitor restrictions policies.

Design: Qualitative study using critical thematic analysis.

Methods: We conducted semi-structured interviews with 15 community members who were pregnant and/or gave birth and 14 nurses who worked in the perinatal setting between April and August 2020. Read More

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Risk of mother-to-child transmission of hepatitis B virus after fetal blood sampling: a report of six cases.

BMC Infect Dis 2021 Jul 30;21(1):716. Epub 2021 Jul 30.

Department of Obstetrics and Gynecology, Third Affiliated Hospital of Sun Yat-sen University, No. 600 Tianhe Road, Tianhe District, Guangzhou, 510630, Guangdong Province, China.

Background: Hepatitis B virus (HBV) remains a major global public health problem worldwide; in endemic areas, mother-to-child transmission (MTCT) of HBV is the most common transmission route. Previous studies have shown that amniocentesis for prenatal diagnosis increases the risk of MTCT of HBV among highly viraemic mothers. However, no data is available on MTCT related fetal blood sampling (FBS) because of the paucity of cases or lack of attention. Read More

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Placental lesions and SARS-Cov-2 infection: Diffuse placenta damage associated to poor fetal outcome.

Placenta 2021 Jul 15;112:97-104. Epub 2021 Jul 15.

Institut de Pathologie Multisite des Hospices Civils de Lyon, 69677, Bron Cedex, Lyon, France; SOFFOET-Société Française de Fœtopathologie, 75014, Paris, France; Université Claude Bernard Lyon 1, Faculté de Médecine Lyon Est, 69008, France.

Introduction: Pregnant women with covid-19 are more likely to experience preterm birth. The virus seems to be associated with a wide range of placental lesions, none of them specific.

Method: We collected cases of Covid-19 maternal infection during pregnancy associated with poor pregnancy outcomes, for which we received the placenta. Read More

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Attitudes towards gender roles and prevalence of intimate partner violence perpetrated against pregnant and postnatal women: Differences between women immigrants from conflict-affected countries and women born in Australia.

PLoS One 2021 30;16(7):e0255105. Epub 2021 Jul 30.

School of Psychiatry, Faculty of Medicine, University of New South Wales, Kensington, New South Wales, Australia.

Background: The aim was to compare, for the first time in a large systematic study, women born in conflict-affected countries who immigrated to Australia with women born in Australia for attitudes towards gender roles and men's use of IPV and the actual prevalence of IPV. The study also examined if any associations remained across the two timepoints of pregnancy and postpartum.

Methods: Women were interviewed during their first visit to one of three Australian public hospital antenatal clinics and re-interviewed at home six months after giving birth. Read More

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Social determinants associated with Zika virus infection in pregnant women.

PLoS Negl Trop Dis 2021 Jul 30;15(7):e0009612. Epub 2021 Jul 30.

Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brazil.

This study aims to describe the sociodemographic determinants associated with exposure to Zika Virus (ZIKV) in pregnant women during the 2015-2016 epidemic in Salvador, Brazil.

Methods: We recruited women who gave birth between October 2015 and January 2016 to a cross-sectional study at a referral maternity hospital in Salvador, Brazil. We collected information on their demographic, socioeconomic, and clinical characteristics, and evaluated their ZIKV exposure using a plaque reduction neutralization test. Read More

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Trends in stress among pregnant and postpartum women during the COVID-19 pandemic.

JMIR Ment Health 2021 Jul 2. Epub 2021 Jul 2.

Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, 130 De Soto Street, Pittsburgh, US.

Background: Stress is associated with adverse birth and postpartum health outcomes. Few studies have longitudinally explored racial differences in maternal stress in a birthing population in the United States (US) during the ongoing COVID-19 pandemic.

Objective: This study aimed to: (1) assess changes in reported stress before, during, and after initial emergency declarations (e. Read More

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MYNd&CO (Mindfulness, Yoga, Nutrition, development & Coaching, and Osteopathy) randomized controlled trial for a positive psychophysical experience in pregnancy and after birth: a study protocol.

Acta Biomed 2021 Jul 29;92(S2):e2021032. Epub 2021 Jul 29.

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Background And Aim: The medicalisation of birth pathway may negatively impact on women's empowerment, enhancing distress even in cases of healthy pregnancies. We have built a program which is comprised of Mindfulness, Yoga, Nutrition, development & Counselling, Coaching, antenatal classes, and Osteopathic treatment (MYNd&CO).

Methods: This study is a randomized controlled trial involving low-risk pregnant women. Read More

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Delays during emergency obstetric care and their determinants among mothers who gave birth in South Gondar zone hospitals, Ethiopia. A cross-sectional study design.

Glob Health Action 2021 Jan;14(1):1953242

Department of Midwifery, College of Medicine and Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia.

Background: The majority of maternal deaths occur during delivery and the immediate postnatal period as a result of delays in seeking care, failure to reach health institutions, and receiving inappropriate health care. In developing countries, delayed access to timely healthcare contributes to high maternal mortality and morbidity.

Objective: This study aimed to assess the delays during emergency obstetric care and associated factors with delays during emergency obstetric care. Read More

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January 2021

Patient and Provider Perspectives on Acceptability, Access, and Adherence to 17-Alpha-Hydroxyprogesterone Caproate for Preterm Birth Prevention.

Womens Health Rep (New Rochelle) 2021 27;2(1):295-304. Epub 2021 Jul 27.

PolicyLab, Children's Hospital of Philadelphia and Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.

Preterm birth (PTB) is a pressing maternal and child health issue with long-standing racial inequities in outcomes and care provision. 17-Alpha-hydroxyprogesterone caproate (17OHPC) has been one of few clinical interventions for recurrent PTB prevention. Little is known about the factors influencing successful administration and receipt of 17OHPC among mothers in the Medicaid program. Read More

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Maternal and neonatal outcomes related to Zika virus in pregnant women in Southern Vietnam: An epidemiological and virological prospective analysis.

Lancet Reg Health West Pac 2021 Jun 8;11:100163. Epub 2021 Jun 8.

Institut Pasteur, Paris, France.

Background: In 2016-2017, 68 women in Southern Vietnam had RT-PCR confirmed Zika virus (ZIKV) infection during pregnancy. We report here the outcomes of the pregnancies and the virological analyses related to this outbreak.

Methods: We collected clinical and epidemiological information from the women who were enrolled in the study. Read More

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Incidence of concomitant illnesses in pregnancy in Indonesia: Estimates from 1990-2019, with projections to 2030.

Lancet Reg Health West Pac 2021 May 13;10:100139. Epub 2021 Apr 13.

School of Public Health, University of Adelaide, Adelaide, SA 5005, Australia.

Background: 'Indirect' causes of maternal death including concomitant illnesses such as infectious and non-communicable diseases (NCDs), accounted for 23% of maternal deaths in Indonesia in 2010. Reproductive-age women in Indonesia face a "double burden" of disease with increasing rates of NCDs and persisting rates of infectious disease. However, there is a lack of data on the burden of these diseases in pregnancy. Read More

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/Madre de Dios Birth Cohort to Study Effects of in-utero Trace Metals Exposure in the Southern Peruvian Amazon.

Ann Glob Health 2021 19;87(1):69. Epub 2021 Jul 19.

School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru.

Background: In-utero exposure to mercury and other trace metals pose a significant threat to child health and development, but exposures and health impacts in artisanal and small-scale gold mining (ASGM) environments are poorly defined.

Objectives: We describe the CONAMAD study design, a prospective birth cohort consisting of multiparous women (18 and over) living in rural and peri-urban Peruvian Amazon communities exposed to ASGM.

Methods: Pregnant women are enrolled from health posts across four zones of Madre de Dios, Peru. Read More

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Role of community engagement in maternal health in rural Pakistan: Findings from the CLIP randomized trial.

J Glob Health 2021 17;11:04045. Epub 2021 Jul 17.

Center of Excellence in Women & Child Health, The Aga Khan University, Pakistan and East Africa, Karachi, Pakistan.

Background: Community-based strategies to promote maternal health can help raise awareness of pregnancy danger signs and preparations for emergencies. The objective of this study was to assess change in birth preparedness and complication readiness (BPCR) and pregnant women's knowledge about pre-eclampsia as part of community engagement (CE) activities in rural Pakistan during the Community Level Interventions for Pre-eclampsia (CLIP) Trial.

Methods: The CLIP Trial was a cluster randomized controlled trial that aimed to reduce maternal and perinatal morbidity and mortality using CE strategies alongside mobile health-supported care by community health care providers. Read More

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Patients With Deep Ovarian Suppression Following GnRH Agonist Long Protocol May Benefit From a Modified GnRH Antagonist Protocol: A Retrospective Cohort Study.

Front Endocrinol (Lausanne) 2021 13;12:618580. Epub 2021 Jul 13.

Medical Center for Human Reproduction, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.

Objective: To verify if patients with deep ovarian suppression following gonadotropin releasing hormone (GnRH) agonist long protocol may benefit from a modified GnRH antagonist protocol based on luteinizing hormone (LH) levels.

Design: Retrospective cohort study.

Setting: University-based hospital. Read More

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Elevated Levels of Soluble Axl (sAxl) Regulates Key Angiogenic Molecules to Induce Placental Endothelial Dysfunction and a Preeclampsia-Like Phenotype.

Front Physiol 2021 13;12:619137. Epub 2021 Jul 13.

Department of Obstetrics and Gynecology, Center for Translational Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China.

Preeclampsia (PE), a severe pregnancy-specific syndrome, is characterized by impaired placental angiogenesis. Although the pathogenesis of this condition remains largely unclear, vascular systemic endothelial injury is thought to be the common contributing factor. Soluble Axl (sAxl), a biomarker of endothelial dysfunction, is known to be abnormally increased in a variety of diseases associated with vascular injury. Read More

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Differential immune responses in pregnant patients recovered from COVID-19.

Signal Transduct Target Ther 2021 Jul 29;6(1):289. Epub 2021 Jul 29.

Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.

Pregnant women are generally more susceptible to viral infection. Although the impact of SARS-CoV-2 in pregnancy remains to be determined, evidence indicates that the risk factors for severe COVID-19 are similar in pregnancy to the general population. Here we systemically analyzed the clinical characteristics of pregnant and non-pregnant female COVID-19 patients who were hospitalized during the same period and found that pregnant patients developed marked lymphopenia and higher inflammation evident by higher C-reactive protein and IL-6. Read More

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Oral Misoprostol alone versus oral misoprostol followed by oxytocin for labour induction in women with hypertension in pregnancy (MOLI): protocol for a randomised controlled trial.

BMC Pregnancy Childbirth 2021 Jul 29;21(1):537. Epub 2021 Jul 29.

Department of Women's and Children's Health, Liverpool Women's Hospital, University of Liverpool, Crown Street, Liverpool, L8 7SS, UK.

Background: Every year approximately 30,000 women die from hypertensive disease in pregnancy. Magnesium sulphate and anti-hypertensives reduce morbidity, but delivery is the only cure. Low dose oral misoprostol, a prostaglandin E1 analogue, is a highly effective method for labour induction. Read More

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Relationship between maternal vitamin D status in the first trimester of pregnancy and maternal and neonatal outcomes: a retrospective single center study.

BMC Pediatr 2021 Jul 29;21(1):330. Epub 2021 Jul 29.

International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, 910# Hengshan Road, Shanghai, 20030, China.

Background: This study aimed to investigate the relationship between maternal serum vitamin D status in the first trimester of pregnancy and maternal as well as neonatal outcomes, considered the prevalence of vitamin D deficiency (serum 25(OH)D < 50 nmol/L) around the world, especially in the pregnant women.

Methods: From January 2015 to December 2016, in this cross-sectional retrospective study, we enrolled women receiving regular prenatal examinations and giving birth in the International Peace Maternity and Child Health Hospital. Cases confirmed as multiple pregnancy, incomplete medical records, and vitamin D level recorded after 13 weeks of gestation were excluded. Read More

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Impact of domestic violence against pregnant women in Minia governorate, Egypt: a cross sectional study.

BMC Pregnancy Childbirth 2021 Jul 29;21(1):535. Epub 2021 Jul 29.

Department of Obstetrics and Gynecology, Faculty of Medicine, Minia University, Minia, 61511, Egypt.

Background: Domestic violence is a common problem that is related to many serious short-term and long-term health hazards around the world.

Methods: During obtaining the medical history from the participants, the questions used to assess the abuse were derived from the widely used Abuse Assessment Screen (AAS). Potential risk factors including a variety of socio-demographic and reproductive health-relation indicators were assessed. Read More

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Predictive models to identify Holstein cows at risk of metritis and clinical cure and reproductive/productive failure following antimicrobial treatment.

Prev Vet Med 2021 Jul 13;194:105431. Epub 2021 Jul 13.

Department of Large Animal Clinical Sciences, University of Florida, Gainesville, 32610, USA; Department of Animal Sciences, Institute of Food and Agricultural Sciences, University of Florida, Gainesville, 32610, USA. Electronic address:

Precision dairy farming, specifically the design of management strategies according to the animal's needs, may soon become the norm since automated technologies that generate large amounts of data for each individual are becoming more affordable. Our objectives were to determine whether the use of behavioral changes could improve the accuracy of prediction of the risk of metritis and the risk of clinical cure of cows diagnosed with metritis. Addition of behavioral data to the algorithms to predict the outcomes of interest increased their accuracy by 7 to 32%. Read More

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Birth weight rather than birth length is associated with childhood behavioural problems in a Czech ELSPAC cohort.

PLoS One 2021 29;16(7):e0253607. Epub 2021 Jul 29.

Research Centre for Toxic Compounds in the Environment (RECETOX), Masaryk University, Brno, Czech Republic.

Many physical and psychological characteristics are influenced by prenatal development. Some studies have located links between low birth parameters and behavioural problems, with the latter in turn associated with educational progress, career success, overall health, and subsequent life events. However, few studies have investigated whether this association also applies to children in the normal birth growth range. Read More

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Herbalism for Modern Obstetrics.

Clin Obstet Gynecol 2021 Sep;64(3):611-634

Saint Louis University, Saint Louis, Missouri.

More pregnant and nursing mothers are using herbal remedies than health care providers realize. Lack of familiarity with herbalism in addition to the sparsity of high-quality research for many complementary and alternative medicines are barriers for the western practitioner to engage a patient about herbal therapies. This review provides historical information and available evidence for Traditional Chinese and Western herbal medicines commonly sought by pregnant and nursing mothers. Read More

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September 2021

Gilbert's Syndrome With Diabetes Mellitus.

Cureus 2021 Jul 22;13(7):e16557. Epub 2021 Jul 22.

Obstetrics and Gynecology, The First Affiliated Hospital of Jinan University, Guangzhou, CHN.

Gilbert's syndrome (GS) could lead to the high bilirubin, and gestational diabetes mellitus might reverse this index. A primigravida with a pregnancy of 38 weeks and 4 days was identified having gestational diabetes mellitus (GDM) with Gilbert's syndrome. General laboratory tests were normal except mild unconjugated hyperbilirubinaemia and hyperglycemia. Read More

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Neonatal Abstinence Syndrome and Maternal Opioid-Related Diagnoses: Analysis of ICD-10-CM Transition, 2013-2017.

Hosp Pediatr 2021 Jul 28. Epub 2021 Jul 28.

Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, US Department of Health and Human Services, Atlanta.

Background And Objectives: Hospital discharge records remain a common data source for tracking the opioid crisis among pregnant women and infants. The (ICD-10-CM) transition from the may have affected surveillance. Our aim was to evaluate this transition on rates of neonatal abstinence syndrome (NAS), maternal opioid use disorder (OUD), and opioid-related diagnoses (OUD with ICD-10-CM codes for long-term use of opioid analgesics and unspecified opioid use). Read More

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The relationship between social support and mental health problems during pregnancy: a systematic review and meta-analysis.

Reprod Health 2021 Jul 28;18(1):162. Epub 2021 Jul 28.

Australian Centre for Public and Population Health Research, School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia.

Background: Pregnancy is a time of profound physical and emotional change as well as an increased risk of mental illness. While strengthening social support is a common recommendation to reduce such mental health risk, no systematic review or meta-analysis has yet examined the relationship between social support and mental problems during pregnancy.

Methods: The PRISMA checklist was used as a guide to systematically review relevant peer-reviewed literature reporting primary data analyses. Read More

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Patterns and predictors of gestational weight gain in Addis Ababa, Central Ethiopia: a prospective cohort study.

Reprod Health 2021 Jul 28;18(1):159. Epub 2021 Jul 28.

School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, Sydney, NSW, Australia.

Introduction: Gaining excessive or inadequate gestational weight is associated with many adverse maternal and fetal outcomes. Inadequate gestational weight gain (GWG) increases the risk of fetal growth restriction, pre-term birth, and low birth weight. It is a public health concern in sub-Saharan Africa. Read More

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Circulating angiogenic factors and HIV among pregnant women in Zambia: a nested case-control study.

BMC Pregnancy Childbirth 2021 Jul 28;21(1):534. Epub 2021 Jul 28.

Division of Global Women's Health, Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.

Background: Maternal HIV increases the risk of adverse birth outcomes including preterm birth, fetal growth restriction, and stillbirth, but the biological mechanism(s) underlying this increased risk are not well understood. We hypothesized that maternal HIV may lead to adverse birth outcomes through an imbalance in angiogenic factors involved in the vascular endothelial growth factor (VEGF) signaling pathway.

Methods: In a case-control study nested within an ongoing cohort in Zambia, our primary outcomes were serum concentrations of VEGF-A, soluble endoglin (sEng), placental growth factor (PlGF), and soluble fms-like tyrosine kinase-1 (sFLT-1). Read More

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The asthma predictive index as a surrogate diagnostic tool in preschoolers: Analysis of a longitudinal birth cohort.

Pediatr Pulmonol 2021 Jul 28. Epub 2021 Jul 28.

Division of Pediatrics, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.

Diagnosing asthma in preschool children remains an unsolved challenge, at a time when early identification would allow for better education and treatment to prevent morbidity and lung function deterioration.

Objective: To evaluate if the asthma predictive index (API) can be used as surrogate for asthma diagnosis in preschoolers.

Methods: Birth cohort of 339 pregnant women enrolled at delivery and their offspring, who were followed for atopy, wheezing, and other respiratory illnesses through 30 months of age. Read More

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A Trial of Hyperimmune Globulin to Prevent Congenital Cytomegalovirus Infection.

N Engl J Med 2021 Jul;385(5):436-444

From the Department of Obstetrics and Gynecology, Brown University, Providence, RI (B.L.H., D.J.R., D.A.); George Washington University Biostatistics Center, Washington, DC (R.G.C., L.M.F.); the University of Texas Medical Branch, Galveston (G.R.S.), the University of Texas Health Science Center at Houston, Children's Memorial Hermann Hospital, Houston (S.P.C.), and the University of Texas Southwestern Medical Center, Dallas (B.M.C.); Northwestern University, Chicago (M.J.D., G.M.); Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD (U.M.R.); Columbia University, New York (C.G.-B.); the University of Utah Health Sciences Center, Salt Lake City (M.W.V.); the University of North Carolina at Chapel Hill, Chapel Hill (W.H.G.), and Duke University, Durham (G.K.S.) - both in North Carolina; the Department of Pediatrics (R.P.), University of Alabama at Birmingham (A.T.N.T.), Birmingham; Ohio State University, Columbus (M.M.C.), the University of Colorado School of Medicine, Anschutz Medical Campus, Aurora (R.S.G.); Case Western Reserve University, Cleveland (E.K.C.); Stanford University, Stanford, CA (Y.Y.E.-S.); the University of Pennsylvania, Philadelphia (S.P.), and the University of Pittsburgh, Pittsburgh (H.N.S.); Madigan Army Medical Center, Joint Base Lewis-McChord, WA (P.G.N.); and Washington University, St. Louis (G.A.M.).

Background: Primary cytomegalovirus (CMV) infection during pregnancy carries a risk of congenital infection and possible severe sequelae. There is no established intervention for preventing congenital CMV infection.

Methods: In this multicenter, double-blind trial, pregnant women with primary CMV infection diagnosed before 24 weeks' gestation were randomly assigned to receive a monthly infusion of CMV hyperimmune globulin (at a dose of 100 mg per kilogram of body weight) or matching placebo until delivery. Read More

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