D. Cabrol

Association between oocyte donation and maternal and perinatal outcomes in women aged 43 years or older

BACKGROUNDnAlthough older maternal age is a risk factor for pregnancy complications, an increasing number of women delay conception until the age of 40, and some must resort to IVF with oocyte donation. Our objective was to study the association between IVF, both with and without oocyte donation, and maternal and perinatal outcomes in a population of older women.nnnMETHODSnThis retrospective study covered all women, aged 43 or more, who gave birth between 2008 and 2010. Univariate and multivariate analyses with logistic regression models were used to compare maternal and perinatal outcomes as a function of mode of conception: without IVF, with IVF using own oocytes or with IVF and oocyte donation.nnnRESULTSnThe study included 380 women, including 40 who had IVF without oocyte donation (10.5%) and 104 who had both (27.4%). There were 326 singleton and 54 multiple pregnancies. Overall, the complication rate was high: 8.7% pre-eclampsia, 6.1% gestational diabetes, 20.2% preterm delivery and 8.2% very preterm delivery (before 33 weeks), 44.8% Cesarean sections and 7.4% severe post-partum hemorrhage (PPH). The pre-eclampsia rate differed significantly between the groups (3.8% after no IVF, 10.0% after IVF only and 19.2% after IVF with oocyte donation, P< 0.001). After adjustment, the risk of pre-eclampsia was significantly higher in women with donated oocytes compared with pregnant women without IVF [adjusted OR = 3.3 (1.2-8.9)]. The rate of twin pregnancy was significantly higher in women with IVF and oocyte donation (39.4 versus 15.0% with IVF only and 2.5% without IVF, P< 0.001). Twin pregnancy was significantly associated with the risk of preterm delivery [adjusted OR = 8.9 (4.0-19.9)] and PPH [adjusted OR = 3.5 (1.3-9.5)].nnnCONCLUSIONnIn women aged 43 years or older, pregnancies obtained by IVF with oocyte donation are associated with higher rates of pre-eclampsia and twin pregnancies than those obtained without IVF or with IVF using their own oocytes.

Subtypes of Developmental Coordination Disorder: Research on Their Nature and Etiology

Children with Developmental Coordination Disorder (DCD) are a group embracing clumsiness and developmental dyspraxia. Our study provides a better understanding of the nature of DCD and its etiology, and identifies subtypes of dyspraxia. Forty-three children with DCD (5–15 years) were enrolled on the Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM-IV-TR]; American Psychiatric Association, 2000) criteria. Extensive standardized evaluations were conducted. We distinguished from two patterns of “pure” developmental dyspraxia: ideomotor and visual-spatial/visual-constructional, and mix dyspraxia with more co-morbidities. Our study provides a better understanding of the nature of DCD, and sheds light on its etiology and brain dysfunction, so as to identify subtypes of developmental DCD/dyspraxia with specific clinical criteria.

Bacterial vaginosis: prevalence and predictive value for premature delivery and neonatal infection in women with preterm labour and intact membranes

OBJECTIVESnAssess the predictive values of bacterial vaginosis (BV) for preterm delivery (PD) and neonatal infection and compare them with standard markers of infection among women with preterm labour (PL).nnnSTUDY DESIGNnProspective blinded study in a tertiary referral centre in Paris. Women hospitalised for PL with intact membranes at a term between 24 and 34 weeks were included. Vaginal fluid, collected at inclusion was Gram-stained, scored, and interpreted according to Nugents criteria.nnnRESULTSnOut of 354 women tested, 254 had normal flora (72.3%), 76 intermediate (21.7%) and 24 BV (6.8%). A history of spontaneous miscarriage after 14 weeks was the only risk factor significantly associated with BV. BV was not significantly associated with PD<35 weeks or neonatal infection. Very preterm delivery (before 33 weeks) was significantly associated with the flora grade (P=0.02): women with normal, intermediate and abnormal flora, respectively had 27 (10.6%), 14 (18.4%) and 6 (25.0%) births before 33 weeks. Of the markers tested, the highest risk of very preterm delivery was associated with BV (odds ratio 2.95, 95% CI (1.1-0.8.1)) and CRP>20mg/dl (4.23 95% CI (1.8-9.7)). Predictive value of BV for preterm birth before 33 weeks were: sensitivity 12.8%, specificity 95.0%, positive predictive value 35.3%, and negative predictive value 84.3%.nnnCONCLUSIONSnThe frequency of BV and its association with PD are probably very variable and must be interpreted differently from one population to another. While we found an association between BV results and delivery before 33 weeks, the predictive value of BV was disappointing. Although these findings reinforce the importance of a useful marker of subclinical infection, the usefulness of testing for BV in women with PL has not been demonstrated.

(Non)words, (non)words, (non)words: evidence for a protolexicon during the first year of life

Previous research with artificial language learning paradigms has shown that infants are sensitive to statistical cues to word boundaries (Saffran, Aslin & Newport, 1996) and that they can use these cues to extract word-like units (Saffran, 2001). However, it is unknown whether infants use statistical information to construct a receptive lexicon when acquiring their native language. In order to investigate this issue, we rely on the fact that besides real words a statistical algorithm extracts sound sequences that are highly frequent in infant-directed speech but constitute nonwords. In three experiments, we use a preferential listening paradigm to test French-learning 11-month-old infants recognition of highly frequent disyllabic sequences from their native language. In Experiments 1 and 2, we use nonword stimuli and find that infants listen longer to high-frequency than to low-frequency sequences. In Experiment 3, we compare high-frequency nonwords to real words in the same frequency range, and find that infants show no preference. Thus, at 11 months, French-learning infants recognize highly frequent sound sequences from their native language and fail to differentiate between words and nonwords among these sequences. These results are evidence that they have used statistical information to extract word candidates from their input and stored them in a protolexicon, containing both words and nonwords.

Neonatal Stepping in Relation to Terrestrial Optic Flow.

This experiment examined whether newborn stepping, a primitive form of bipedal locomotion, could be modulated by optical flow. Forty-eight 3-day-old infants were exposed to optical flows that were projected onto a horizontal surface above which the infants were suspended. Significantly more air steps were elicited by exposure to a terrestrial optical flow specifying forward translation than by a rotating optical flow or a static optical pattern. Thus, a rudimentary coupling between optical flow and stepping is present at birth, suggesting a precocious capacity in the newborn to perceive and utilize visual information specifying self-motion. The findings may help the early diagnosis of infants with visual or visual-motor deficits and the development of visually based interventions for disabled infants.

First‐trimester ultrasound diagnosis of skeletal dysplasia associated with increased nuchal translucency thickness

A series of five cases of skeletal dysplasia is reported in which the diagnosis was reached at the 11–14‐week routine ultrasound examination in our referral center. All five cases had increased nuchal translucency thickness (NT) associated with bone abnormalities. We review the current literature on skeletal dysplasia in the first trimester of pregnancy associated with increased NT. Copyright

Vertical and horizontal smooth pursuit eye movements in children with developmental coordination disorder.

Our aim was to study horizontal and vertical smooth pursuit eye movements in children with developmental coordination disorder (DCD).

Assessment of the Cervix in Pregnant Women Using Shear Wave Elastography: A Feasibility Study

The quantitative assessment of the cervix is crucial for the estimation of pre-term delivery risk and the prediction of the success of labor induction. We conducted a cross-sectional study using shear wave elastography based on the supersonic shear imaging technique. The shear wave speed (SWS) of the lower anterior part of the cervix was quantified over an 8-mm region of interest in 157 pregnant women. Cervical SWS is slightly but significantly reduced in patients diagnosed with pre-term labor and in patients who actually delivered pre-term.

Selective use of sonographic cervical length measurement for predicting imminent preterm delivery in women with preterm labor and intact membranes

To determine, in a population of women with preterm labor and intact membranes, whether ultrasound cervical length measurement performed only in patients selected according to the Bishop score predicts imminent preterm delivery better than does systematic cervical length measurement in the entire population.

Function Words Constrain On-Line Recognition of Verbs and Nouns in French 18-Month-Olds

In this experiment using the conditioned head-turn procedure, 18-month-old French-learning toddlers were trained to respond to either a target noun (“la balle”/the ball) or a target verb (“je mange”/I eat). They were then tested on target word recognition in two syntactic contexts: the target word was preceded either by a correct function word (“une balle”/a ball or “on mange”/they eat), or by an incorrect function word, signaling a word from the other category (*“on balle”/they ball or *“une mange”/a eat). We showed that 18-month-olds exploit the syntactic context on-line to recognize the target word: verbs were recognized when preceded by a personal pronoun but not when preceded by a determiner and vice-versa for nouns. These results suggest that 18-month-olds already know noun and verb contexts. As a result, they might be able to exploit them to categorize unknown words and constrain their possible meaning (nouns typically refer to objects whereas verbs typically refer to actions).