Perinatal characteristics of the phenotypically and chromosomally abnormal live-born
Since most infants with chromosomal abnormalities are born to women who are not members of high-risk groups for such defects, and since the majority of such infants cannot be identified at birth from phenotype (appearance) alone, better methods of early identification of abnormal babies are needed. It is possible that certain characteristics of chromosomally abnormal infants in the perinatal period (around the time of birth) could be useful for diagnosis. To evaluate this, the obstetric records for 105 live-born infants were evaluated. Chromosomal analysis (karyotyping) had been performed for these infants because of phenotypic abnormalities. Several characteristics of these infants at birth (weight, size, and Apgar scores, which measure physical condition) and of their mothers (age, previous pregnancies, race) were noted. Infants with a normal karyotype were then compared with those with abnormal karyotypes, and with all babies delivered at the hospital during the same five-year period when the study group infants were born. Results showed that 33 infants (31 percent) had abnormal karyotypes, of which 61 percent of the chromosomal abnormalities were trisomy 21 (Down syndrome). The average maternal age for these infants was approximately 26 years, and three-quarters of the mothers were black. Although there was a trend toward older mothers among the abnormal karyotype group as compared with the normal karyotype group, it was not statistically significant. However, the rate of abnormal karyotypes in black infants (37 percent) was almost three times that in white infants (12.5 percent). Infants with abnormal karyotypes were more frequently delivered by cesarean section. They were also smaller than the general population, with lower Apgar scores; however, they were no more likely to be born prematurely. The results imply either that prenatal screening among the black population is less thorough, or that physicians are less able to recognize phenotypic abnormalities in black infants. In any event, karyotyping of newborn infants should be more intensive than it is currently. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Obstetrics and Gynecology
The geriatric gravida: multifetal pregnancy reduction, donor eggs, and aggressive fertility treatments
There appear to be growing trends for infertile women, particularly older women, to use donor eggs to conceive. The characteristics of 523 previously infertile women undergoing procedures to reduce a multiple pregnancy to a single pregnancy between 1986 and 1996 were analyzed. The percentage of women using donor eggs increased from 1.8% before 1994 to 9.8% between 1994 and 1996. Nearly all of the patients older than 45 years used donor eggs. Many of these older women chose to undergo a multiple pregnancy reduction. They indicated financial and age issues as reasons.
Publication Name: American Journal of Obstetrics and Gynecology