Eyal Sheiner

Ben-Gurion University of the Negev, Be'er Sheva`, Southern District, Israel

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Publications (425)614.8 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: To investigate whether visually impaired women are at higher risk for adverse maternal and perinatal complications, with an emphasis on visual impairment due to autoimmune etiology.
    Archives of Gynecology and Obstetrics 08/2014; · 1.33 Impact Factor
  • Kent Willis, Nicky Lieberman, Eyal Sheiner
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    ABSTRACT: The global obesity epidemic is changing the face of maternal-fetal medicine. One in five women are obese at time of conception, and increasing numbers of parturients have undergone bariatric surgery. Recent publication of large, population-based studies and comparison studies of preoperative and postoperative pregnancies have highlighted new risks and benefits to mother and child. Pregnancy after bariatric surgery appears to effectively reduce the risk of complications such as fetal macrosomia, gestational diabetes mellitus and hypertensive disorders of pregnancy, however, women who become pregnant after bariatric surgery may constitute a unique obstetric population with an increased risk for preterm and small-for-gestational-age infants. In this article, we provide an overview of the current knowledge of the impact of maternal bariatric surgery on neonatal and pregnancy outcomes.
    Best Practice & Research Clinical Obstetrics & Gynaecology. 08/2014;
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    ABSTRACT: To investigate whether women who experienced at least one stillbirth are at increased risk for subsequent maternal long-term atherosclerotic morbidity.
    American journal of obstetrics and gynecology. 07/2014;
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    ABSTRACT: Abstract Objective: To investigate risk factors for postpartum hemorrhage (PPH) in vaginal deliveries and the influence of previous PPH on the subsequent pregnancy. Study design: A retrospective cohort study including first singleton deliveries between the years 1988 and 2012 was performed comparing deliveries with and without PPH. In addition, perinatal outcomes of the subsequent pregnancy were evaluated. Multivariable analysis was performed to control for confounders. Results: PPH complicated 0.8% of all first vaginal deliveries. Significant risk factors for PPH in vaginal delivery, using a multiple logistic regression model, were: post-term pregnancy, fertility treatments, hypertensive disorders, labor dystocia during the 2nd, and perineal tears grade 2 and 3 respectively. Previous PPH was found to be an independent risk factor for PPH in the subsequent pregnancy. Moreover, previous PPH was found to be a significant risk factor for CS deliver, to complicate delivery with revision of uterus cavity, anemia, and to require blood transfusion. Conclusion: Previous PPH poses a risk for recurrent PPH in subsequent delivery and an increased risk for CS. As PPH remains one of the major causes of maternal morbidity, this study strengthens the need for a comprehensive evaluation of prior PPH as a major risk factor for PPH recurrence.
    Journal of Maternal-Fetal and Neonatal Medicine. 07/2014;
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    ABSTRACT: Abstract Objectives: To investigate parturients at risk to develop venous thrombo-embolic events (VTE) in the puerperium or later in life, during a follow-up of more than a decade , and compare risk factors for VTE during the puerperium with VTE later in life. Methods: A nested case-control study was conducted to profile parturients at risk for VTE and a secondary analysis to compare risk factors for VTE during or after puerperium. We used a cohort of 95,257 women that gave birth between the years 1988-1998. Results: Independent risk factors to develop VTE were peripartum hysterectomy, stillbirth, cesarean delivery (CD), obesity,pregnancy related hypertension, grandmultiparity and advanced maternal age. Women undergoing CD and these receiving blood transfusion were more likely to develop early vs. late VTE (OR=2.0, 95% Cl=1.15-3.5, and OR=11.0, 95% Cl=2.25-55.5; respectively.(Patients that encountered VTE during the puerperium had more pulmonary emboli and less deep vein thrombosis , compared with the late VTE group (p< 0.001). Conclusions: Maternal age, grandmultiparity, pregnancy related hypertension, CD, obesity, stillbirth and peripartum hysterectomy are independent risk factors for the development of VTE. CD and blood transfusion were predictive of early vs. late VTE.
    Journal of Maternal-Fetal and Neonatal Medicine. 07/2014;
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    ABSTRACT: Abstract Objective: To establish whether failure to progress during labor poses a risk factor for another non-progressive labor (NPL) during the subsequent delivery. Methods: A retrospective cohort study including singleton pregnancies that failed to progress during the previous labor and resulted in a CS was conducted. Parturients were classified into three groups for both previous and subsequent labors: CS due to NPL stage I, stage II and an elective CS as a comparison group. Results: Out of 202,462 deliveries, 10,654 women met the inclusion criteria: 3,068 women were operated due to NPL stage I and 1218 due to NPL stage II; The comparison group included 6368 women. Using a multivariable logistic regression models, NPL stage I during the previous delivery was found as an independent risk factor for another NPL stage I in the subsequent labor (adjusted OR=2.9; 95% CI=2.4-3.7; p<0.001). Similarly, NPL at stage I or II was found to be an independent risk factor for a NPL stage II during the subsequent labor (adjusted OR=1.4; 95% CI=1.1-2.1; p=0.033; adjusted OR=5.3; 95% CI=3.7-7.5; p<0.001; respectively). Conclusion: A previous CS due to a NPL is an independent risk factor for another NPL in the subsequent pregnancy and for recurrent cesarean delivery.
    Journal of Maternal-Fetal and Neonatal Medicine. 07/2014;
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    ABSTRACT: To investigate whether patients with a history of recurrent pregnancy loss (RPL) have an increased risk for future maternal atherosclerotic morbidity.
    American journal of obstetrics and gynecology. 06/2014;
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    ABSTRACT: Abstract Objective: To examine possible correlation between α1-antitrypsin (AAT) levels and activity in patients with and without obesity, after excluding complications such as gestational diabetes mellitus (GDM), during pregnancy. Study design: A prospective case-control study was conducted. AAT levels were determined by standard human AAT ELISA according to the manufacturer's instructions. Elastase inhibition was determined by kinetic assay according to manufacturer recommendations. Assays were performed in duplicates and repeated twice for each sample in separate sessions. Patients with diabetes mellitus were excluded from the study. Mann-Whitney U-test was performed in order to determine statistical differences between the groups, and AAT concentration and activity. Results: During the study period 43 patients were recruited: 21 with isolated obesity and 22 non-obese parturients (control group). According to ELISA, AAT concentrations were mildly lower in obese women compared to non-obese women (8.31 ± 0.28 mg/ml vs. 9.5 ± 0.37 mg/ml, p=0.0155). However, elastase inhibitory capacity was markedly lower in obese vs. non-obese parturients (mean 27.33 ± 2.08 % vs. 43.73 ± 3.1%, p<0.001). Conclusions: Isolated obesity in pregnancy is associated with lower activity of AAT. These findings correlate with the reduced concentration and activity of AAT found in patients with GDM. Accordingly, it might suggest an inflammatory axis shared by obesity and the development of insulin resistance.
    Journal of Maternal-Fetal and Neonatal Medicine. 05/2014;
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    ABSTRACT: To determine whether women with a previous uterine scar dehiscence are at increased risk of adverse perinatal outcomes in the following delivery. A retrospective cohort study was conducted of all subsequent singleton cesarean deliveries performed at the Soroka University Medical Center, Beer-Sheva, Israel, between January 1, 1988, and December 31, 2011. Clinical and demographic characteristics, maternal obstetric complications, and fetal complications were evaluated among women with or without a previous documented uterine scar dehiscence. Of the 5635 pregnancies associated with at least two previous cesarean deliveries, 180 (3.2%) occurred among women with a previous uterine scar dehiscence. Women with this condition in a prior pregnancy were more likely than those without previous uterine scar dehiscence to experience subsequent preterm delivery (86 [47.8%] vs 1350 [24.7%]; P<0.001), low birth weight (47 [26.1%] vs 861 [15.8%]; P<0.001), and peripartum hysterectomy (5 [2.8%] vs 20 [0.4%]; P<0.001). Nevertheless, previous uterine scar dehiscence did not increase the risk of uterine rupture, placenta accreta, or adverse perinatal outcomes, such as low Apgar scores at 5minutes and perinatal mortality. Uterine scar dehiscence in a previous pregnancy is a potential risk factor for preterm delivery, low birth weight, and peripartum hysterectomy in the following pregnancy.
    International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics 04/2014; · 1.41 Impact Factor
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    ABSTRACT: Background To evaluate the role of umbilical artery (UA) peak systolic velocity (PSV) measurements in the prediction of perinatal outcome in fetuses with intrauterine growth restriction (IUGR). MethodsA prospective study was performed, including patients with a suspected diagnosis of IUGR. Exclusion criteria were multiple gestations, unreliable gestational age, and known fetal malformations. Doppler measurements of the UA and middle cerebral artery (MCA) were recorded. ResultsSeventy-two patients were enrolled and a total of 192 Doppler measurements were performed between 24 and 39 weeks' gestation. Mean gestational age at delivery was 36.9 ± 2.7 days and mean birth weight was 2,166 ± 497 grams. Nine patients (12.5%) had oligohydramnios; 50 (69.4%) delivered preterm (<37 weeks), and 26 underwent a cesarean section, of those 7 (29.2%) cesarean sections were for a nonreassuring fetal heart rate tracing. Fifty-one (70.8%) neonates were actually small for gestational age. No correlation was found between UA-PSV and MCA-PSV to perinatal outcome. Correlation was found between UA pulsatility index and cerebroplacental ratio to perinatal outcome before 34 weeks' gestation. ConclusionsUA PSV measurements do not correlate with adverse perinatal outcome. A correlation exists between UA pulsatility index and cerebroplacental ratio and perinatal outcome prior to 34 weeks' gestation. It seems that UA PSV and MCA PSV do not contribute to the management of fetuses with IUGR. © 2014 Wiley Periodicals, Inc. J Clin Ultrasound, 2014
    Journal of Clinical Ultrasound 03/2014; · 0.70 Impact Factor
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    ABSTRACT: Objective: To examine the association between calcium levels during the first trimester of pregnancy and preeclampsia. Methods: The study population included registered births (n = 5233) in a tertiary medical center between 2001 and 2011. A comparison was performed between women with and without hypocalcemia during the first trimester of pregnancy. A second analysis was performed after correcting calcium levels for albumin. Multiple logistic regression models were used to control for confounders. Receiver operating characteristic curve analysis graphs were used to describe the relationship between the true-positive rate (sensitivity) and the false-positive rate for different values of calcium during the first half of pregnancy in the prediction of preeclampsia. Results: Of 5233 deliveries, 841 (16%) had hypocalcemia and 4392 (84%) had a normal calcium level. No significant difference were found between the groups regarding mild preeclampsia [odds ratio (OR) = 1.216; 95% confidence interval (CI) 0.831-1.779; p = 0.312], severe preeclampsia (OR = 1.618; 95% CI 0.919-2.849; p = 0.092) and any hypertensive disorders (OR = 1.324; 95% CI 0.963-1.821; p = 0.083). Conclusions: Hypocalcemia during the first trimester of pregnancy is not a risk factor for preeclampsia.
    Hypertension in Pregnancy 01/2014; · 0.93 Impact Factor
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    ABSTRACT: Objective To determine whether women with a previous uterine scar dehiscence are at increased risk of adverse perinatal outcomes in the following delivery. Methods A retrospective cohort study was conducted of all subsequent singleton cesarean deliveries performed at the Soroka University Medical Center, Beer-Sheva, Israel, between January 1, 1988, and December 31, 2011. Clinical and demographic characteristics, maternal obstetric complications, and fetal complications were evaluated among women with or without a previous documented uterine scar dehiscence. Results Of the 5635 pregnancies associated with at least two previous cesarean deliveries, 180 (3.2%) occurred among women with a previous uterine scar dehiscence. Women with this condition in a prior pregnancy were more likely than those without previous uterine scar dehiscence to experience subsequent preterm delivery (86 [47.8%] vs 1350 [24.7%]; P < 0.001), low birth weight (47 [26.1%] vs 861 [15.8%]; P < 0.001), and peripartum hysterectomy (5 [2.8%] vs 20 [0.4%]; P < 0.001). Nevertheless, previous uterine scar dehiscence did not increase the risk of uterine rupture, placenta accreta, or adverse perinatal outcomes, such as low Apgar scores at 5 minutes and perinatal mortality. Conclusion Uterine scar dehiscence in a previous pregnancy is a potential risk factor for preterm delivery, low birth weight, and peripartum hysterectomy in the following pregnancy.
    International Journal of Gynecology & Obstetrics. 01/2014;
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    ABSTRACT: Abstract Objectives: To determine the effect of cervical cerclage on obstetrical complications and perinatal outcomes of patients following conization. Design: A retrospective population based cohort study Setting: Tertiary academic medical center that covers all the deliveries of the region Population: All patients with previous cervical conization who delivered between the years 1994-2011. Methods: A retrospective population based study. Main outcome measures: the effect of cerclage placement on the rate of preterm birth. Results: During the study period there were 109 deliveries of patients following a cervical conization. Cervical cerclage was placed in 22 deliveries that served as the study group and the rest (n=87) served as the comparison group. The rate of early preterm delivery (PTD; <34 weeks) was significantly higher in women who had a cerclage. In a logistic regression model cerclage was found to be an independent risk factor for early PTD. Conclusion: Cerclage is an independent risk factor for early PTD In patients who had a conization due to CIN.
    The journal of maternal-fetal & neonatal medicine: the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians 12/2013; · 1.36 Impact Factor
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    ABSTRACT: Abstract Objective - To investigate whether a diagnosis of anxiety disorder is a risk factor for adverse obstetric and neonatal outcome. Methods - A retrospective population based study was conducted comparing obstetric and neonatal complications in patients with and without a diagnosis of anxiety. Multivariable analysis was performed to control for confounders. Results - During the study period 256,312 singleton deliveries have occurred, out of which 224 (0.09%) in patients with a diagnosis of anxiety disorder. Patients with anxiety disorders were older(32.17±5.1 vs. 28.56±5.9), were more likely to be smokers (7.1% vs.1.1%) and higher rate of preterm deliveries(PTD; 15.2% vs. 7.9%), as compared with the comparison group. Using a multiple logistic regression model, anxiety disorders were independently associated with advanced maternal age (OR 1.087; 95% CI 1.06-1.11; P=0.001), smoking (OR 4.51; 95% CI 2.6-7.29; P=0.001)and preterm labor (OR 1.92; 95% CI 1.32-2.8; P=0.001). In addition, having a diagnosis of an anxiety disorder was found to be an independent risk factor for cesarean section (adjusted OR 2.5; 95% CI 1.82-3.46; p<0.001), using another multivariable model. No association was noted between anxiety disorders and adverse neonatal outcomes including small for gestational age, low Apgar scores and perinatal mortality. Conclusion -Anxiety disorders are an independent risk factor for spontaneous preterm delivery and cesarean section, but in our population, is not associated with adverse perinatal outcome.
    The journal of maternal-fetal & neonatal medicine: the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians 11/2013; · 1.36 Impact Factor
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    ABSTRACT: Abstract Objective: To investigate pregnancy outcome in patient who conceived by assisted reproductive techniques. Methods: A retrospective population based study was conducted, comparing obstetrical complications and neonatal outcomes of singleton pregnancies conceived by in vitro fertilization (IVF; n=1,296) and ovulation induction (n=1,988) as compared to singleton pregnancies conceived spontaneously (n=172,288). Multivariable models were constructed to control for confounders. Results: A significant linear association (using the chi-square test for trends) was documented among the three groups in adverse outcomes such as gestational diabetes mellitus (17.3% in the IVF, 14.2% in the ovulation induction, 6.6% in the comparison group, p<0.001), severe preeclampsia (2.7% in the IVF, 1.8% in the ovulation induction, 1.1% in the comparison group, p<0.001) and perinatal mortality (3.3% in the IVF, 2.1% in the ovulation induction, 1.3% in the comparison group, p<0.001). In vitro fertilization and ovulation induction treatments were found to be independent risk factors for gestational diabetes mellitus, using two different multiple logistic regression models controlling for confounders such as maternal age (adjusted OR=1.77, 95% CI-1.52-2.07, P<0.001 and adjusted OR=1.93, 95% CI-1.69-2.21, P<0.001; respectively). Conclusions: Pregnancies conceiving following assisted reproductive techniques are at an increased risk for adverse obstetrics outcomes. The risk is higher for pregnancies following IVF compared with these conceived following ovulation induction.
    The journal of maternal-fetal & neonatal medicine: the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians 10/2013; · 1.36 Impact Factor
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    ABSTRACT: S100B is a brain damage biomarker. When measured immediately after birth it reflects neonatal brain damage following asphyxia. In this study we used feticide as a novel model of fetal brain damage. We examined whether such damage is reflected by a rise in S100B in maternal blood before delivery. Eight pregnant women were recruited between January and July 2012. Maternal blood samples were drawn before and after feticide at predetermined time points (0, 15, 30, 60, 120 and 240 minutes). S100B, lactate dehydrogenase (LDH), Creatine kinase (CK) and Creatinine concentrations were measured by standard human ELISA and chemical analyzer. No significant difference was noted between S100B levels before and after feticide, neither in non-specific cell death markers (LDH, CK), which remained within normal range. S100B ranged between 0.015-0.04 µg/L through all the predetermined time points. No statistically significant differences were demonstrated in S100B levels before and after feticide. This article is protected by copyright. All rights reserved.
    Prenatal Diagnosis 10/2013; · 2.68 Impact Factor
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    ABSTRACT: To investigate the risk for subsequent cardiovascular events in women having placental abruption during a follow-up period of more than 10 years. A population-based study of the incidence of cardiovascular events in women who had placental abruption with women without placental abruption during 1988-99 and with follow-up until 2010. Associations between placental abruption and maternal long-term cardiovascular morbidity and mortality were investigated. Kaplan-Meier survival curves and multivariable Cox regression were used to estimate cumulative incidence of cardiovascular mortality. During the study period, there were 47 585 deliveries meeting the inclusion criteria; of these, 653 occurred in patients with placental abruption. No significant association was noted between placental abruption and subsequent long-term hospitalisations because of cardiovascular causes. However, placental abruption was associated with long-term cardiovascular mortality [odds ratio (OR) = 6.6; 95% confidence interval (CI) 2.3, 18.3]. The cardiovascular case fatality rate for the placental abruption group was 13.0% vs. 2.5% in the comparison group (P < 0.001). Patients with a history of placental abruption had a significantly higher risk for cardiovascular mortality during the follow-up period (Log-rank test P = 0.017). Using Cox multivariable regression models, placental abruption remained an independent risk factor for long-term maternal cardiovascular mortality [adjusted hazard ratio (HR) = 4.3; 95% CI 1.1, 18.6). Placental abruption is a significant risk factor for long-term cardiovascular mortality in a follow-up period of more than a decade.
    Paediatric and Perinatal Epidemiology 10/2013; · 2.16 Impact Factor
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    ABSTRACT: Objective: The purpose of this study was to evaluate the association between AFI and adverse perinatal outcome, and whether a critical cutoff can be defined. Methods: A retrospective cohort study was conducted. Included were patients that were admitted to the ultrasound unit of the tertiary medical center between the years 1988 and 2010. Parturients were classified into five groups according to their AFI: <20 (n=9974; comparison group), 20-23 (n=2771), 24-27 (n=1315), 28-31 (n=494) and 32+ (n=260). Pregnancy and the perinatal outcomes were compared between the groups. Statistical analysis included the chi-square tests for trends, and multivariable models to control for confounders (with AFI as a dummy variable). Results: A significant linear association was found between AFI and adverse perinatal outcomes including hypertensive disorders, diabetes mellitus, preterm labor, macrosomia, placental abruption and low birth weight. Furthermore, using multivariable logistic regression models, controlling for confounders such as maternal and gestational age, hypertension, diabetes mellitus etc., the significant association between all 4 subgroups of AFI>20 and adverse perinatal outcomes remained. Conclusion: A significant linear association exists between AFI>20 and perinatal complications such as perinatal mortality, low Apgar scores and preterm labor. Hence, the critical cutoff for polyhydramnios should be reevaluated.
    The journal of maternal-fetal & neonatal medicine: the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians 10/2013; · 1.36 Impact Factor
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    ABSTRACT: Drugs of abuse affect pregnancy outcomes, however, the mechanisms in which cannabis exert its effects are not well understood. The aim of this study was to examine the influence of short-term (1-2h) exposure to cannabidiol (CBD), a major phytocannabinoid, on human placental Breast Cancer Resistance Protein (BCRP) function. The in vitro effect of short-term exposure to CBD on BCRP in BeWo and Jar cells (MCF7/P-gp cells were used for comparison) was tested with Mitoxantrone (MX) uptake, and Nicardipine was used as positive control. The ex vivo perfused cotyledon system was used for testing the effect of CBD on glyburide transport across the placenta. Glyburide (200ng/ml) was introduced to maternal (M) and fetal (F) compartments through a re-circulating 2h perfusion, and its transplacental transport was tested with [n=8] or without [n=8] CBD. 1) CBD inhibition of BCRP-dependent MX efflux was concentration dependent and of a non-cell type specific nature (p<0.0001); 2) In the cotyledon perfusion assay, the administration of CBD to the maternal perfusion media increased the F/M ratio of glyburide concentrations (1.3±0.1 vs 0.8±0.1 at 120 min. of perfusion, p<0.001). 1) Placental BCRP function is inhibited following even a short term exposure to CBD; 2) the ex vivo perfusion assay emphasize this effect by increased placental penetration of glyburide to the fetal compartment; and 3) these findings suggest that marijuana consumption enhances placental barrier permeability to xenobiotics and could endanger the developing fetus. Thus, the safety of drugs that are BCRP substrates is questionable during cannabis consumption by pregnant women.
    American journal of obstetrics and gynecology 08/2013; · 3.28 Impact Factor
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    ABSTRACT: To investigate whether delivering a small-for-gestational-age (SGA) newborn is a risk factor for subsequent long-term maternal cardiovascular morbidity. Data were analyzed from consecutive pregnant women who delivered at Soroka University Medical Center, Beer-Sheva, Israel, between 1988 and 1999, and were followed-up retrospectively until 2010. Long-term cardiovascular morbidity was compared among women with and without SGA neonates. During the study period, 47 612 deliveries met the inclusion criteria, and 4411 (9.3%) women delivered an SGA neonate. Delivery of an SGA neonate was a risk factor for long-term complex cardiovascular events, including congestive heart failure, hypertensive heart and kidney disease, and acute cor pulmonale (odds ratio [OR], 2.3; 95% confidence interval [CI], 1.3-4.4; P=0.006); and long-term cardiovascular mortality (OR, 3.4; 95% CI, 1.5-7.6; P=0.006). Women who delivered an SGA neonate had a significantly higher risk for cardiovascular mortality during the follow-up period (Kaplan-Meier survival analysis, P=0.002). Delivery of an SGA neonate remained an independent risk factor for long-term maternal cardiovascular mortality (Cox multivariable regression: adjusted hazard ratio, 3.5; 95% CI, 1.5-8.2; P=0.004). Delivery of an SGA neonate is an independent risk factor for long-term cardiovascular morbidity in a follow-up period of more than 10years.
    International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics 07/2013; · 1.41 Impact Factor

Publication Stats

3k Citations
614.80 Total Impact Points

Institutions

  • 1998–2014
    • Ben-Gurion University of the Negev
      • • Division of Obstetrics and Gynecology
      • • Department of Radiology
      • • Shraga Segal Department of Microbiology and Immunology
      • • Division of Anesthesiology
      • • Faculty of Health Sciences
      Be'er Sheva`, Southern District, Israel
  • 2000–2013
    • Soroka Medical Center
      • • Division of Obstetrics and Gynecology
      • • Department of Internal Medicine
      Be'er Sheva`, Southern District, Israel
  • 2012
    • Hillel Yaffe Medical Center
      Hědērā, Haifa District, Israel
  • 2005–2011
    • Rush University Medical Center
      • • Division of Pharmacology
      • • Department of Obstetrics and Gynecology
      Chicago, IL, United States
  • 2008
    • Loyola University Maryland
      Baltimore, Maryland, United States
  • 2007
    • University of Chicago
      • Department of Obstetrics & Gynecology
      Chicago, IL, United States