June 2016

Self-reported and laboratory evaluation of late pregnancy nicotine exposure and drugs of abuse.

J Perinatol doi: 10.1038/jp.2016.100

In this retrospective study, self-reported smoking status was compared to maternal urine results.  Only about half of women with high nicotine levels (15.8%) during the last days of their pregnancies reported that they were still smoking cigarettes. An additional 7.5% had low-level nicotine readings, indicative of second-hand smoke exposure.

Stillbirths: rates, risk factors, and acceleration towards 2030.

Lancet doi:10.1016/S0140-6736(15)00837-5

The Every Newborn Action Plan has the target of 12 or fewer stillbirths per 1000 births in every country by 2030. Mainly high-income countries and upper middle-income countries have already met this target. Most counties where the target has not been met are in low-income and middle-income countries. Congenital abnormalities account for only 7.4% of stillbirths. Diseases such as malaria 8.0% and syphilis 7.7% are preventable causes. Prolonged pregnancies contribute to 14.0% of stillbirths.

Teratogenic effects of the Zika virus and the role of the placenta. Lancet

doi:10.1016/S0140-6736(16)00650-4

Two hypotheses regarding the role of the placenta are possible: one is that the placenta directly conveys the Zika virus to the early embryo or fetus. Alternatively, the placenta itself might be mounting a response to the exposure; this response might be contributing to or causing the brain defect. This distinction is crucial to the diagnosis of fetuses at risk and the design of therapeutic strategies to prevent Zika-induced teratogenesis.