Pregnancy abnormal outcomes

Everybody wants to know the safe level of drinking during pregnancy. As our brief discussion of FAS suggests, no simple answer is available. Actually, it is best to think of FAS as the most severe result of a continuum of effects of prenatal exposure to alcohol (Rasmussen, 2005). Subtle behavioral or cognitive cfVects may be observed on the other end of the continuum. Each abnormal outcome may have its own yardstick of amount of alcohol exposure and timing of exposure (Jacob.son et al., 1993 USDHHS, 1990). 

Shohat, M., Merlob, P. and Reisner, S.H. (1984). Neonatal polycythemia I. Early diagnosis and incidence relating to time of sampling. Pediatrics, 73, 7-13 Sokol, R.J. (1981). Alcohol and abnormal outcomes of pregnancy. Can. Med. Assoc. ]., 125, 143-148... 

Okey AB, Giannone JV, Smart W, Wong JM, Manchester DK, Parker NB, Feeley MM, Grant DL, Gilman A. Binding of 2,3,7,8-tetrachlorodibenzo-p-dioxin to AH receptor in placentas from normal versus abnormal pregnancy outcomes. Chemosphere 1997 34 1535-1547. 

Less than half of all human pregnancies result in the birth of a normal, healthy infant. An estimated one-third of all pregnancies are spontaneously aborted, and among those that produce offspring, 6-7% and 14% exhibit major and minor birth defects, respectively, within the first year. Abnormal neurological functions, which are not always apparent within the first few years of life, are estimated to occur in 16-17% of offspring. These adverse outcomes to pregnancy have an enormous impact on individual and public health. 

Steegers-Theunissen RP, Renter WO, Borm GF, Thomas CM, Merkus HM, Op de Coul DA, De Jong PA, van Geijn HP, Wouters M, Eskes TK. Factors influencing the risk of abnormal pregnancy outcome in epileptic women a multi-centre prospective study. Epilepsy Res 1994 18(3) 261-9. 

The first 3 cases (serial nos 604, 638, 515) in the table had hormonal profiles entirely consistent with severe hypothyroidism although these women did not exhibit the clinical features of hypothyroidism In all three cases the pregnancy outcome was a stillblrth/early neonatal death In the succeeding 3 cases (serial nos 568, 245, 430) the maternal total and free thyroxine values were low but triiodothyronine values were within the normal range In one of these the outcome was a stillbirth/early neonatal death and one child has a hearing/speech defect but no other abnormality and, by our definition, cannot be labelled as an endemic cretin ... 

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