Healthy Non-pregnant Controls Research Articles

Contribution of Neutrophil Activation in the Differentiation of Urine Infection and Contamination in Pregnant Women

Background: Urinary tract infections are among the most common bacterial infections of humans. Urine culture is the gold standard for asymptomatic bacteriuria and pyuria is not always present in bacteriuria, nor is it specific for bacteriuria. Objective: The aim of the present study was to determine neutrophil activation and the contributions of this activation in the differentiation of infection and contamination. Methods: The serum and urine myeloperoxidase (MPO) levels of 50 pregnant females with symptoms suggesting UTI and 25 healthy non-pregnant control subjects were measured using the enzyme-linked immunosorbent assay (ELISA) method and the obtained values were compared with the results of urine microscopy and urine culture. Results: The leukocyte count in urine was significantly higher in group 1 (infection) and group 2 (contamination) when compared with the control group (group 1 mean: 18.2; group 2 mean: 14.2; control mean: 4.8; ANOVA test, p ≤ 0.00). According to the obtained ELISA values, a statistical difference in the levels of urine MPO between the patient and control groups was seen (p ≤ 0.00). There was no statistical difference among the groups for serum MPO levels (p ≥ 0.451). Conclusion: The study findings suggest that standardized measurement techniques such as dipstick screening assay for urine MPO level may be useful in differentiating infection and contamination, especially in pregnant patients.

Prevalence of gestational thyroid disorders in Zaria, north-western Nigeria

Background: Thyroid disorders are the second most common endocrine disorders found during pregnancy. Normal maternal thyroid function is critical for normal fetal development. Gestational thyroid dysfunctions complicate pregnancy with a significant increase in maternal and perinatal morbidity and mortality. Objective: To assess the prevalence of thyroid disorders among pregnant women in Zaria. Materials and Methods: Study population consisted of 300 apparently healthy pregnant women and 100 apparently healthy age-matched nonpregnant controls. Participants were not on any drug that can affect thyroid function. Serum thyroid hormones [thyroid stimulating hormone, free triiodothyronine (T 3 ), free thyroxine (T 4 ), and thyroid peroxidase (TPO) antibody] were assayed using enzyme-linked immunosorbent assay (ELISA). Data were analyzed using Epi Info 3.5.3 and P-values ≤0.05 were considered statistically significant. Results: Ages (mean ± SD) were 25.41 ± 5.98 and 26.70 ± 5.83 years for pregnant women and controls, respectively. Parity mean ± SD were 2.32 ± 2.24 and 2.63 ± 2.75 for pregnant women and controls, respectively. The mean gestational age ± SD was 21.68 ± 10.38 weeks. Three percent (3%) were hypothyroid, while 2.3% were hyperthyroid. Nine percent (9%) were TPO antibody positive. Conclusion: Prevalence of thyroid disorders among pregnant women in Zaria was high therefore routine screening of all pregnant women for thyroid disorders during antenatal care visits may be of benefit.

Effect of Advanced Uncomplicated Pregnancy on Pulmonary Function Parameters in a Tertiary Care Hospital

The study was conducted on 50 normal pregnant women in third trimester of uncomplicated pregnancy (Test Group) and 50 age-matched non-pregnant women (Control Group) of identical socio economic background in the age group of 20–35 years in AGMC & GBP Hospital, Agartala, a tertiary care hospital in the North-Eastern India. Pulmonary function test parameters FVC, FEV1, FEF25-75%, PEFR & FEV1/FVC ratio were recorded by electronic Spirometer using Helios 401 software. There was a statistically significant decrease in all the pulmonary function test parameters in 3rd trimester of normal pregnancy when compared with the age-matched healthy non-pregnant control group. These changes in pulmonary functions are attributed to major adaptations in the maternal respiratory system and are also be influenced by the mechanical pressure of enlarging gravid uterus.

Marked changes in olfactory perception during early pregnancy: a prospective case-control study.

Pregnancy seems to be related with a significant change in olfaction. Here, we investigate this theory by testing the odor identification abilities of uncomplicated pregnant women and compare the results with non-pregnant controls. The study included 31 healthy pregnant women in the first trimester (Group 1), 30 in the second trimester (Group 2), 31 in the third trimester, and 30 non-pregnant healthy controls (Group 4). In order to measure odor identification abilities, each subject completed the 12-item Brief Smell Identification Test (BSIT). Next, the demographic characteristics and BSIT scores of the groups were compared. The total BSIT scores of the subjects in Group 1 were found to be significantly lower than those of the other groups (p < 0.001). This reduction in odor identification abilities was particularly noticeable for leather, pine, and soot. Pregnant women in the second and third trimesters had similar odor identification abilities to the healthy controls (p > 0.05). Early pregnancy might be related to significant changes in olfactory performance. The distortion of odor identification in the first trimester might be a causative factor for the development of pregnancy-specific conditions, such as morning sickness and hyperemesis gravidarum, which are both common complaints during the early phase of parturition.

106 Echocardiographic Evaluation Of Post-partum Ventricular Remodelling – Implications For The Detection Of Cardiac Disease

BackgroundPeripartum cardiomyopathy (PPCM) is a potentially life-threatening cause of heart failure that often presents soon after delivery. Diagnosis of the condition may be difficult due to the physiological changes in...

A1.40 Adiponektin and resistin levels in pregnant patients with rheumatoid arthritis

BackgroundPregnancy induces a modulation of the maternal immune system in order to install tolerance towards the semiallogeneic fetus. This change of the maternal immune systems influences some autoimmune diseases such...

Evaluation of the macula, retinal nerve fiber layer and choroid in preeclampsia, healthy pregnant and healthy non-pregnant women using spectral-domain optical coherence tomography

Objective: To evaluate the macular, retinal nerve fiber layer (RNFL) and choroidal thickness alterations by using spectral-domain optical coherence tomography (SD-OCT) in preeclampsia and compare with healthy pregnant and healthy non-pregnant controls. Method: The study population included healthy pregnant control group (n: 25), healthy non-pregnant control group (n: 26) and study group with preeclampsia (n: 27). Retinal thickness parameters were measured by SD-OCT. Results: There was a statistically significant difference among all of the groups for choroidal thickness (p < 0.001). Choroidal thickness in preeclamptic women was significantly thinner than healthy pregnant women. The most thick choroid layer was detected in healthy pregnant group, and also the most thin choroidal thickness was detected in healthy non-pregnant group (p < 0.001). Macular central subfield and foveal center thickness were significantly thinner in preeclamptic study and healthy pregnant groups than healthy non-pregnant group (p < 0.001). However, there was no statistically significant difference between preeclamptic study group and healthy pregnant group for both macular central subfield and foveal center thickness. Average of RNFL thickness was significantly thicker in healthy pregnant group than healthy non-pregnant group (p = 0.004). Conclusions: This study revealed that choroidal thickness measured using SD-OCT increased in women with preeclampsia and healthy pregnant women but the increase in choroidal thickness in preeclampsia was lower than the healthy pregnant controls. This lower rise in choroidal thickness can be generally attributed to the markedly increased systemic vascular vasospasm secondary to preeclampsia.

CD4+CD25+FoxP3+ regulatory T cells and cytokines interact with estradiol in cases of missed abortion

The aim of this study was to examine the interaction of estradiol (E2) with CD4+CD25+FoxP3+ regulatory T (Treg) cells and cytokines in cases of missed abortion (MA). The peripheral blood lymphocytes from patients with MA and controls (normal pregnancy and non-pregnant females) were isolated from the blood by Ficoll density gradient centrifugation. CD4+CD25+ Treg cells were isolated from peripheral blood mononuclear cells (PBMCs). The frequencies of CD4+CD25+FoxP3+ Treg cells and mRNA expression of transcription factor forkhead box protein 3 (FoxP3) in the peripheral blood of MA (n=33), normal pregnancy (n=33) and non-pregnant females (n=27) were determined by intracellular three-color flow cytometry and quantitative polymerase chain reaction (qPCR), respectively. The serum levels of interferon-γ (IFN-γ) and interleukin-4 (IL-4) were measured by enzyme-linked immunosorbent assay (ELISA) and a chemiluminescent immunoassay was used to examine the serum E2 levels. It was observed that the percentage of Foxp3+ T cells in the peripheral blood of patients with MA were lower compared with those in the normal pregnancy and healthy non-pregnant controls. The results demonstrated that MA patients exhibited decreased levels of a peripheral Th2-related cytokine (IL-4) and E2. Furthermore, the low levels of CD4+CD25+Foxp3+ T cells and IL-4 correlated positively with serum concentrations of E2. The data indicated that maternal immunological changes may reverse maternal tolerance in MA, and this phenomenon may be due to the interaction of E2 with CD4+CD25+Foxp3+ T cells and cytokines in MA.

Increased plasma levels of CK-18 as potential cell death biomarker in patients with HELLP syndrome

HELLP (hemolysis, elevated liver enzymes, low platelets) syndrome represents a life-threatening pregnancy disorder with high fetal and maternal mortality, but its underlying molecular mechanisms remain unknown. Although apoptosis has been implicated in HELLP syndrome, its pathogenic role remains largely unclear. In the present study, we investigated whether the detection of apoptosis by novel plasma biomarkers is of diagnostic value in HELLP patients. For this purpose, we analyzed two biomarkers that specifically detect apoptosis or overall cell death of epithelial cells, such as hepatocytes or placental trophoblasts, through the release of caspase-cleaved or total (caspase-cleaved and uncleaved) cytokeratin-18 (CK-18) in plasma of HELLP patients compared with pregnant as well as non-pregnant healthy women. In addition, caspase activation and cell death were determined in placental tissues of HELLP patients and individuals with normal pregnancy. In contrast to pregnant or non-pregnant healthy controls, we observed significantly increased levels of both caspase-cleaved and total CK-18 in plasma of HELLP patients. Following delivery, CK-18 levels rapidly decreased in HELLP patients. Caspase activation and cell death were also elevated in placental tissues from HELLP patients compared with healthy pregnant women. These data demonstrate not only that apoptosis is increased in HELLP syndrome, but also that caspase-cleaved or total CK-18 are promising plasma biomarkers to identify patients with HELLP syndrome. Thus, further studies are warranted to evaluate the utility of these biomarkers for monitoring disease activity in HELLP syndrome.

Alterations in inflammatory, antiviral and regulatory cytokine responses in peripheral blood mononuclear cells from pregnant women with asthma

Severe asthma exacerbations during pregnancy are a common complication leading to poor health outcomes for both the mother and the baby. Asthma exacerbations are caused most frequently by respiratory viruses. A balance between antiviral and inflammatory immune responses is critical during pregnancy; the balance may be altered by asthma and respiratory virus infection. Peripheral blood mononuclear cells (PBMCs) were isolated from (i) non-pregnant healthy controls, (ii) pregnant non-asthmatics, (iii) post-partum non-asthmatics, (iv) non-pregnant asthmatics (v) pregnant asthmatics, and (vi) post-partum asthmatics. Cells were cultured in vitro with the mitogen phytohaemagglutinin or with a strain of the 2009 pandemic swine influenza. Interferon (IFN)-γ, interleukin (IL)-10 and IL-17 protein were measured from culture supernatant. Neutrophil counts were obtained in samples from pregnant and post-partum women. Following the phytohaemagglutinin stimulation of PBMCs, pregnant asthmatics had significantly higher IL-17 and significantly lower IFN-γ responses compared with healthy non-pregnant women. Following infection with influenza, a significant reduction was also observed in IFN-γ and IL-10 production from PBMC of pregnant asthmatics. The IL-17 response to phytohaemagglutinin correlated with the neutrophil percentage. Differences in IFN-γ, IL-10 and IL-17 were found to persist for at least 6 months post-partum. A reduction in antiviral and regulatory immunity with increased inflammation during pregnancy occurs in PBMC from pregnant women with asthma. This novel information may relate to the increased susceptibility and disease severity to respiratory virus infections observed during pregnancy.

Relationship of Circulating Soluble Urokinase Plasminogen Activator Receptor (suPAR) Levels to Disease Control in Asthma and Asthmatic Pregnancy

Asthma has a high burden of morbidity if not controlled and may frequently complicate pregnancy, posing a risk for pregnancy outcomes. Elevated plasma level of the inflammatory biomarker soluble urokinase plasminogen activator receptor (suPAR) is related to a worse prognosis in many conditions such as infectious, autoimmune, or pregnancy-related diseases; however the value of suPAR in asthma and asthmatic pregnancy is unknown. The present study aimed to investigate the suPAR, CRP and IL-6 levels in asthma (asthmatic non-pregnant, ANP; N = 38; female N = 27) and asthmatic pregnancy (AP; N = 15), compared to healthy non-pregnant controls (HNP; N = 29; female N = 19) and to healthy pregnant women (HP; N = 58). The relationship between suPAR levels and asthma control was also evaluated. The diagnostic efficacy of suPAR in asthma control was analyzed using ROC analysis. IL-6 and CRP levels were comparable in all study groups. Circulating suPAR levels were lower in HP and AP than in HNP and ANP subjects, respectively (2.01 [1.81–2.38] and 2.39 [2.07–2.69] vs. 2.60 [1.82–3.49] and 2.84 [2.33–3.72] ng/mL, respectively, p = 0.0001). suPAR and airway resistance correlated in ANP (r = 0.47, p = 0.004). ROC analysis of suPAR values in ANP patients with PEF above and below 80% yielded an AUC of 0.75 (95% CI: 0.57–0.92, p = 0.023) and with ACT total score above and below 20 an AUC of 0.80 (95% CI: 0.64–0.95, p = 0.006). The cut-off value of suPAR to discriminate between controlled and not controlled AP and ANP was 4.04 ng/mL. In conclusion, suPAR may help the objective assessment of asthma control, since it correlates with airway resistance and has good sensitivity in the detection of impaired asthma control. Decrease in circulating suPAR levels detected both in healthy and asthmatic pregnant women presumably represents pregnancy induced immune tolerance.

Quantitative Polymerase Chain Reaction–Based Analysis of Podocyturia Is a Feasible Diagnostic Tool in Preeclampsia

Preeclampsia is a significant cause of maternal and fetal morbidity and mortality worldwide. A clinically useful screening test that can predict development of preeclampsia at an early stage is urgently needed. The detection of podocyturia by immunohistochemistry after cell culture has been noted as a reliable marker for preeclampsia. However, this method is laborious and carries the risk of cell culture contamination. The aim of this study was to investigate the diagnostic value of quantitative polymerase chain reaction as a rapid method to detect preeclampsia. Clean-catch urine samples were collected from preeclamptic (n=35), healthy pregnant (n=34), and healthy nonpregnant (n=12) women. Furthermore, a control group of women with gestational hypertension (n=5) was included. Quantitative polymerase chain reaction analysis was performed for podocyte-specific markers. Receiver operating characteristic curve analyses were performed. Significantly elevated mRNA levels of nephrin, podocin, and vascular endothelial growth factor were detected in preeclamptic women compared with healthy pregnant and healthy nonpregnant controls. In addition, significantly elevated levels of nephrin mRNA were detected in urine of preeclamptic women compared with women with gestational hypertension. A positive correlation (ρ=0.82; P<0.0001) was observed between nephrin and vascular endothelial growth factor mRNA levels in preeclamptic women. Receiver operating characteristic curve analyses demonstrated a strong ability of this method to discriminate between the different study groups. Quantitative polymerase chain reaction analysis of podocyte-specific molecules in urine samples is a rapid and reliable method to quantify podocyturia. We demonstrate that this method distinguishes preeclamptic patients from healthy controls and women with gestational hypertension. This method may be a tool for the detection of preeclampsia at an earlier stage, thereby preventing maternal and fetal morbidity and mortality.

Alterations of sympathetic nervous system, coagulation and platelet function in gestational diabetes

Gestational diabetes is associated with increased risk for venous thromboembolism. Activation of sympathetic nervous system affects blood coagulation, fibrinolysis and platelet activation by several mechanisms. We aimed to study the relationship of sympathetic nervous system, coagulation and platelet function in gestational diabetes. Forty-one white women with gestational diabetes, 22 healthy pregnant and 14 nonpregnant controls were studied. We assayed serial nocturnal (at 12 p.m., 4 a.m. and 7 a.m.) changes of the adrenergic transmitter noradrenaline, coagulation variables and platelet activation with PFA-100. Plasma noradrenaline increased from 4 to 7 a.m. in both pregnant groups. During the same time period, prothrombin time (PT) shortened in gestational diabetes compared with healthy pregnant and nonpregnant controls. In gestational diabetes, nocturnal FVIII:C levels were lower compared with normal pregnancy and also variables associated with von Willebrand factor tended to be lower. Platelet activity increased at midnight in pregnant women compared with nonpregnant women without differences between gestational diabetes and normal pregnancy. Gestational diabetes is associated with concomitant early morning sympathetic stimulation and activation of extrinsic coagulation pathway (shortened PT). Decreased FVIII:C may refer to compensatory anticoagulatory mechanism. These alterations could reflect increased risk of pregnancy-related thromboembolism in gestational diabetes.

OS092. qPCR-based analysis of podocyturia is a feasible diagnostic tool in preeclampsia

Preeclampsia affects 5% of all pregnancies and is a significant cause of maternal and fetal morbidity and mortalityworldwide. A clinically useful screening test that can predict the development of preeclampsia at an early stage is urgently needed. The detection of podocyturia by immunohistochemistry following cell culture has been noted as a sensitive and specific marker for preeclampsia. However, this method is laborious and carries the risk of cell-culture contamination. The aim of this study was to investigate the diagnostic value of qPCR as a rapid and sensitive method to detect podocyturia in women with preeclampsia. Mid-stream urine samples were collected from preeclamptic [1] (n=35), healthy pregnant matched for gestational age (n=34), and healthy non-pregnant (n=12) women. mRNA was isolated using the Trizol method. qPCR analysis was performed for nephrin, VEGF, podocin, GAPDH and megalin transcripts. A ROC-curve analysis was performed. Significantly elevated mRNA expression levels of nephrin, podocin and VEGF were detected in preeclamptic women compared to healthy pregnant and healthy non-pregnant controls. A positive correlation (ρ=0.82, p<0.0001) was observed between nephrin and VEGF mRNA expression in preeclamptic women. ROC curve analyses demonstrated a strong ability of this method to discriminate between the different study groups. qPCR analysis of podocyte-specific molecules in urine samples is a rapid and reliable method to quantify podocyturia. We demonstrate that this method distinguishes preeclamptic patients from healthy controls at disease onset. This method may be a tool for the detection of preeclampsia at an earlier stage, thereby preventing maternal and fetal morbidity and mortality.

Variation in Stability of Endogenous Reference Genes in Fallopian Tubes and Endometrium from Healthy and Ectopic Pregnant Women

RT-qPCR is commonly employed in gene expression studies in ectopic pregnancy. Most use RN18S1, β-actin or GAPDH as internal controls without validation of their suitability as reference genes. A systematic study of the suitability of endogenous reference genes for gene expression studies in ectopic pregnancy is lacking. The aims of this study were therefore to evaluate the stability of 12 reference genes and suggest those that are stable for use as internal control genes in fallopian tubes and endometrium from ectopic pregnancy and healthy non-pregnant controls. Analysis of the results showed that the genes consistently ranked in the top six by geNorm and NormFinder algorithms, were UBC, GAPDH, CYC1 and EIF4A2 (fallopian tubes) and UBC and ATP5B (endometrium). mRNA expression of NAPE-PLD as a test gene of interest varied between the groups depending on which of the 12 reference genes was used as internal controls. This study demonstrates that arbitrary selection of reference genes for normalisation in RT-qPCR studies in ectopic pregnancy without validation, risk producing inaccurate data and should therefore be discouraged.

Nutritional status among women with pre‐eclampsia and healthy pregnant and non‐pregnant women in a Latin American country

Pre-eclampsia (PE) is one of the leading causes of maternal and perinatal morbidity and mortality worldwide. It has been proposed that, among other risk factors, the nutritional status of women can lead to the endothelial dysfunction that characterizes this entity. The aim of the present study was to compare the nutritional status of women with PE with healthy pregnant and non-pregnant women. A multicenter case-control study was carried out. Between September 2006 and July 2009, 201 women with PE were compared with 201 pregnant, and 201 non-pregnant aged-matched women without cardiovascular or endocrine diseases. A clinical history and physical examination was performed. Fasting blood samples were drawn to measure serum glucose and lipid profile. The nutritional status of participants was assessed using a food frequency questionnaire. The average age of women was 26.6 ± 7.2 years. Compared to healthy pregnant controls, women with PE had a higher body mass index, higher fasting blood glucose levels, higher triglycerides, and lower high-density lipoprotein cholesterol levels. Women with PE had a higher intake of carbohydrates, energy intake and cereal compared to healthy pregnant and non-pregnant controls. A conditional logistic regression demonstrated that carbohydrate and sodium intake are associated with PE development. Diets of women with PE were characterized by higher energy and carbohydrate intake compared to normal pregnant and non-pregnant women. This suggests that higher carbohydrate and sodium intake increases the risk of PE among women in Colombia.

Serum cytokine levels and T lymphocyte subsets in pregnant women with eclampsia

Background: Eclampsia, defined as the occurrence during pregnancy of hypertension, oedema, proteinuria and/or other neurologic abnormalities, causes substantial morbidity and mortality for both mother and foetus. However, its aetiology is largely unknown. Genetic and immune factors may play a role including a reduced maternal response to paternal antigen and an altered adaptation of the maternal immune system to the foetus. Methods: Participants consisted of pregnant women with and without a diagnosis of eclampsia (N = 20, each group), and normal healthy nonpregnant controls (N = 18). Women with smear positive malaria or clinical infections were excluded. Serum levels of TNFα and IL-10 were assayed by ELISA. T lymphocyte subsets of pregnant patients with and without eclampsia were also studied by direct immunofluorescence using monoclonal antibodies and compared with the control group of 18 normal healthy nonpregnant women (NHC). Results: Eclampsia was associated with significantly lower mean serum IL-10 levels compared to normal pregnant and nonpregnant controls. Levels of the pro-inflammatory cytokine TNFα were higher in pregnant women with and without eclampsia, compared to control nonpregnant women. Further differences on serum cytokine levels were observed in the significantly increasing ratio of IL-10 to TNFα from nonpregnant controls to normal pregnant women and to pregnant women with eclampsia. The mean values of CD3+ and CD4+ positive lymphocytes was significantly decreased in patients with eclampsia (p < 0.05) in this study compared to pregnant controls. Similarly, CD3+ and CD4+ T cells were further decreased in eclampsia and pregnant controls compared to nonpregnant controls (p < 0.05). A decreasing CD4/CD8 ratio was observed from non-pregnant to pregnant controls and to patients with eclampsia buttressing an increase in CD8+ cells in eclampsia and pregnancy compared to controls. Conclusions: While a pro-inflammatory immune milieu during pregnancy complicated with eclampsia was demonstrated, the presence of eclampsia was not associated with further cytokine differences.

Arterial stiffness, central hemodynamics and wave reflection in normal pregnancy and control nonpregnant women

ObjectivesPregnancy is accompanied by different physiological adaptations in the cardiovascular system. However, information on central blood pressures, wave reflection, arterial stiffness in uncomplicated pregnancy compared with nonpregnant women is limited. Study designForty-six women (mean age 28 years) in the third trimester of pregnancy and 45 healthy age- and height-matched controls were evaluated. Arterial stiffness, central hemodynamics and wave reflection was assessed with the use of digital volume pulse analysis and pulse wave analysis. ResultsIn comparison with nonpregnant participants, pregnant women had significantly lower mean (p=0.04) and central systolic (p=0.02) blood pressure, central pulse pressure (p=0.02), augmentation index (p=0.02) and augmentation pressure (p=0.002), whereas their pulse pressure amplification was significantly higher (p=0.001). Similarly, arterial stiffness index was higher in pregnant women than in healthy nonpregnant controls (p=0.006). This index was correlated significantly with central augmentation index and augmentation pressure (r=0.5, p=0.0005 and r=0.52, p=0.0002, respectively) but only in nonpregnant women. ConclusionsHealthy pregnancy is associated with increased pulse pressure amplification as well as diminished wave reflection, which results in lower central augmentation index and augmentation pressure. Women in the third trimester of pregnancy have slightly higher arterial stiffness in comparison with healthy nonpregnant, age- and height-matched controls. The increased value of measures of arterial stiffness might be secondary to a known physiological increase of cardiac output and the amount of circulating blood.

Bone turnover and maternal 25(OH) vitamin D3 levels during pregnancy and the postpartum period: should routine vitamin D supplementation be increased in pregnant women?

Objective To investigate the relationship between 25(OH) vitamin D3 levels and maternal bone turnover during pregnancy and lactation. Study design Thirty pregnant women and 30 healthy non-pregnant controls were included the study. The pregnant women were examined in the 12th, 25th and 32nd gestational weeks and 6 weeks after delivery. The controls were examined once. Serum concentrations of 25(OH) vitamin D3, parathyroid hormone (PTH), cross-linked C-terminal telopeptide of type I collagen (CTX), calcium, and phosphate were measured. Results In the 32nd week and the postpartum period, 25(OH) vitamin D3 deficiency rates were 13.3% and 33.3%, respectively. Serum 25(OH) vitamin D3 levels were below the detection limit in 10% and 33%, respectively, of the same subjects. In the control group, rates of 25(OH) vitamin D3 deficiency and “below detection limit” were 30% and 23%, respectively. While 25(OH) vitamin D3 and CTX levels were not correlated to each other in the first trimester, a negative correlation was found in the 2nd and 3rd trimesters and the postpartum period between 25(OH) vitamin D3 and CTX levels ( r = −0.472, p = 0.048; r = −0.893, p < 0.0001, r = −0.881, p < 0.001, respectively). No correlation between 25(OH) vitamin D3 and CTX levels was found in controls. Conclusion We consider that 25(OH) vitamin D3 supplementation of women could both decrease maternal bone resorption and lead to enhanced bone mass in offspring during later life. Since women are prone to 25(OH) vitamin D3 insufficiency, we suggest higher doses of 25(OH) vitamin D3 should be given to pregnant subjects.

Cardiovascular and electrocardiographic changes in Nigerians with a normal pregnancy

Pregnancy is associated with major haemodynamic and cardiac changes, which can mimic or precipitate cardiac diseases. There is a paucity of this kind of data among pregnant Nigerian women. This study was aimed at describing the cardiovascular and electrocardiographic changes found among healthy pregnant Nigerian women. This was an age-matched control study of 69 consecutive normal pregnant and 70 healthy non-pregnant controls. The study protocol included history, physical examination and 12-lead electrocardiography. Diastolic blood pressure < 60 mmHg was significantly commoner among pregnant subjects than controls (64.7 vs 24.3%, respectively, p < 0.005). Mean heart rate was higher among pregnant women (88.34 ± 11.46 bpm) than the controls (75.16 ± 12.22 bpm, p = 0.020). Pregnant subjects also had a higher proportion of left ventricular hypertrophy (LVH) (10.2 vs 0%, p < 0.05) than non-pregnant controls. Abnormal cardiac findings included a loud second heart sound (P(2)), missed beats and systolic murmurs (41.2% in pregnant subjects vs 12.9% in non-pregnant controls, p < 0.05). Negroid-pattern ST-segment elevation was commoner among controls (24.3%) than pregnant subjects (2.9%, p < 0.005). Arrhythmias were rare among the study participants. Significant findings on examination were low diastolic blood pressure and a systolic ejection murmur. However, ECG changes showed a normal frontal-plane QRS axis, normal PR interval, significantly rare normal Negroidpattern ST elevation, significant LVH based on Araoye RI > 12 mm and a rarity of all forms of arrhythmias. These data may help resolve some cardiac diagnostic difficulties during pregnancy.