Mexican Pregnant Women Research Articles

Prevalence of Licit and Illicit Drugs Use during Pregnancy in Mexican Women.

For the first time, the present study employed hair testing to investigate the prevalence of classical drugs of abuse and new psychoactive substances use during gestation in a cohort of 300 Mexican pregnant women. An interview was conducted to collect data on sociodemographic aspects of the patients, and a 9 cm-long hair strand was taken from the back of the head of each mother one month after delivery. A validated ultra-high-performance liquid chromatography–high-resolution mass spectrometry method was used for the screening of classic drugs, new psychoactive substances, and medications in maternal hair. Out of 300 examined hair samples from pregnant women, 127 (42.3%) resulted positive for psychoactive substances: 45 (35.4%) for cannabis only, 24 (18.9%) for methamphetamine only, 13 (10.2%) for cocaine only, 1 (0.3%) for heroin, 1 for N-N-dimethyltryptamine (0.3%), 1 for ketamine (0.8%), and 35 (16.3%) for more than one psychoactive substance. Furthermore, seven samples (2.3%) resulted positive for new psychoactive substances (NPS): two samples for synthetic cannabinoids, two for synthetic cathinones, and three for nor-fentanyl, and 3.3% of women hair resulted positive for anticonvulsant, antidepressant, and antipsychotic medications. Finally, 83 women hair samples (27.7%) tested positive for nicotine. Nonsteroidal anti-inflammatory drugs (NSAIDs) and other painkillers (60.0%), medications for the treatment of nausea and vomiting (12.3%), antihistamines (8.7%) and nasal/sinus decongestants (6.7%), cough suppressants (5.0%), and bronchodilator agents (5.0%) were also detected in pregnant women hair. The gestational use of psychoactive substances and exposure to tobacco smoke, assessed by hair testing, were associated with a significantly younger age and with a low education grade of the mothers (p < 0.005). This study provides a significant preliminary indication of the under-reported gestational consumption of licit and illicit psychoactive and pharmacologically active drugs in a Mexican environment, showing the value of toxicological and forensic analyses in the global effort to determine the health risks caused by classic drugs and new psychoactive substances during pregnancy.

Follow-up and growing-up formula promotion among Mexican pregnant women and mothers of children under 18 months old.

Milk formula sales have grown globally, particularly through follow‐up formulas (FUF) and growing‐up milks (GUM). Marketing strategies and weak regulatory and institutional arrangements are important contributors to caregivers' decisions about child feeding choices. This study describes maternal awareness, beliefs, and normative referents of FUFs and GUMs among Mexican pregnant women and mothers of children 0–18 months (n = 1044) through the lens of the theory of reasoned action (TRA). A cross‐sectional survey was undertaken in two large metropolitan areas of Mexico. Descriptive analyses were conducted following the constructs of the TRA. One‐third of the participants had heard about FUFs, mainly through health professionals (51.1%) and family (22.2%). Once they had heard about FUFs, the majority (80%) believed older infants needed this product due to its benefits (hunger satisfaction, brain development, and allergy management). One quarter of the participants were already using or intended to use FUFs; the majority had received this recommendation from doctors (74.6%) and mothers/mothers‐in‐law (25%). Similarly, 19% of the women had heard about GUMs. The pattern for the rest of TRA constructs for GUMs was similar to FUFs. Mexican women are exposed to FUFs and GUMs, once women know about them, the majority believe older infant and young children need these products, stating perceived benefits that match the poorly substantiated marketing claims of breast‐milk substitutes. Health professionals, particularly doctors, act as marketing channels for FUFs and GUMs. Marketing of FUFs and GUMs represents a threat to breastfeeding in Mexico and a more protective regulatory and institutional environment is needed.

Assessment of licit and illicit drugs consumption during pregnancy by Ultra-High Performance Liquid Chromatography-High Resolution Mass Spectrometry (UHPLC-HRMS) target screening in Mexican women hair

Substance use in pregnancy is a global public health problem, both in developed and developing countries. Whereas information is available for major western countries, scarce data are present for the second ones. The objective assessment of pregnancy consumption of xenobiotic is provided by analysis of maternal hair, which can account for gestational consumption, given the possibility to analyze 9 cm hair corresponding to the pregnancy months. Here, we describe an ultra-high-performance liquid chromatography high-resolution mass spectrometry (UHPLC-HRMS) method used as screening analysis of classic drugs, new psychoactive substances and medications in hair from a cohort of pregnant Mexican women. The UHPLC-HRMS method included Accucore™ phenyl Hexyl (100 × 2.1 mm, 2.6 µm, Thermo, USA) column with a gradient mobile phase and a full-scan data-dependent MS2 (ddMS2) mode for substances identification (mass range 100–750 m/z). Results from the first 100 samples disclosed the presence of several undeclared and declared psychoactive substances and medications, being methamphetamine and paracetamol the most prevalent ones found in 20% and 43% cases, respectively. In addition, biomarkers of cannabis and tobacco use as well as those of antihistamines and antiemetic drugs were also prevalent. Albeit preliminary, these data confirm the feasibility of hair screening by UHPLC-HRMS to objectively assess xenobiotic consumption in pregnant women with consequent risk of fetal exposure to toxic substances.

Diet Quality Is Associated with a High Newborn Size and Reduction in the Risk of Low Birth Weight and Small for Gestational Age in a Group of Mexican Pregnant Women: An Observational Study.

A high-quality diet during pregnancy may have positive effects on fetal growth and nutritional status at birth, and it may modify the risk of developing chronic diseases later in life. The aim of this study was to evaluate the association between diet quality and newborn nutritional status in a group of pregnant Mexican women. As part of the ongoing Mexican prospective cohort study, OBESO, we studied 226 healthy pregnant women. We adapted the Alternated Healthy Eating Index-2010 for pregnancy (AHEI-10P). The association between maternal diet and newborn nutritional status was investigated by multiple linear regression and logistic regression models. We applied three 24-h recalls during the second half of gestation. As the AHEI-10P score improved by 5 units, the birth weight and length increased (β = 74.8 ± 35.0 g and β = 0.3 ± 0.4 cm, respectively, p < 0.05). Similarly, the risk of low birth weight (LBW) and small for gestational age (SGA) decreased (OR: 0.47, 95%CI: 0.27–0.82 and OR: 0.55, 95%CI: 0.36–0.85, respectively). In women without preeclampsia and/or GDM, the risk of stunting decreased as the diet quality score increased (+5 units) (OR: 0.62, 95%IC: 0.40–0.96). A high-quality diet during pregnancy was associated with a higher newborn size and a reduced risk of LBW and SGA in this group of pregnant Mexican women.

Vitamin D Status and Its Determinants in Mexican Pregnant Women from a Rural and an Urban Area: A Comparative Study.

Background: During pregnancy, vitamin D requirements are higher due to fetal growth and development. Vitamin D production occurs mainly through sunlight exposure, which is affected by geographic location and lifestyle factors. Methods: This was a case-control study nested within two cohorts of adult pregnant women (n = 298): urban (Mexico City) and rural (Cuetzalan). To reduce confounding, pairs were selected by age, pregestational body mass index, and pregnancy trimester. Generalized linear models were used to assess the two groups according to their vitamin D status. Results: A total of 298 adult women were studied: 149 from a rural area and 149 from an urban area. Vitamin D deficiency and insufficiency were observed in 28% and 38.2% of women, respectively. A trend for higher 25(OH)D concentrations was observed in women from the rural area (27.5 ng/mL vs. 25.8 ng/mL), probably related to the type of job, where women with partial jobs showing less probability of having vitamin D deficiency (OR = 0.26; CI = 0.06–1.16; p = 0.08) and vitamin D insufficiency (OR = 0.24; CI = 0.06–0.99; p = 0.05). Women whose Last Menstrual Period occurred in spring showed lower vitamin D concentration compared to those whose LMP occurred in winter (p < 0.01). Conclusions: A high prevalence of vitamin D deficiency was observed in both rural and urban areas. Women living in rural areas tended to have higher 25(OH)D concentrations, probably related to more sunlight exposure associated with their type of job.

VP02.22: Knowledge and expectations of Mexican pregnant women about the mid‐trimester anomaly scan

VP02.22: Knowledge and expectations of Mexican pregnant women about the mid‐trimester anomaly scan

Vitamin D Deficiency in Mexican Pregnant Women: Is Supplementation with ≤400 IU/day Enough?

Controversy remains surrounding vitamin D routine supplementation in healthy pregnancy, and the doses are unclear. The aim of this study was to describe maternal vitamin D status throughout pregnancy in a group of Mexican women and evaluate the effect of frequently prescribed doses of vitamin D3 on longitudinal 25-OH-D concentrations, adjusting for obesity, season, and other factors. We conducted a cohort study (Instituto Nacional de Perinatología-INPer) (2017–2020)) of healthy pregnant women without complications. Pregestational overweight/obesity (body mass index ≥ 25), vitamin D3 supplementation (prescribed by physician; 0–250, 250–400, and >400 IU/day), and serum 25-OH-D concentrations (ELISA) were evaluated in each trimester of pregnancy. Vitamin D deficiency or insufficiency was computed (<20 and <30 ng/mL, respectively). We studied 141 adult women; 58.5% had pregestational obesity or overweight. In the first trimester, 45.8% of the women were supplemented with vitamin D3; 51.4% had vitamin D insufficiency and 37.3%, deficiency. In the third trimester, 75.4% of the women were supplemented, and 20% of them still had deficiency. The final general mixed linear model showed that 25-OH-D significantly increased throughout pregnancy (p < 0.001); the highest increase was observed in the third trimester in women with doses >400 IU/day of vitamin D3 (+4 ng/mL, 95% CI: 1.72–8.11 ng/mL). In winter/autumn, 25-OH-D concentrations were also lower (p ≤ 0.05). In this group of pregnant Mexican women, the prevalence of vitamin D deficiency and insufficiency was high. A higher increase in 25-OH-D concentrations during pregnancy was observed when the women were supplemented with >400 IU/day. Common supplementation doses of 250–400 IU/day were insufficient for achieving an adequate maternal vitamin D status.

Factors associated with insufficient weight gain among Mexican pregnant women with HIV infection receiving antiretroviral therapy.

We identified clinical, dietary, and socioeconomic factors associated with insufficient gestational weight gain among Mexican pregnant women with human immunodeficiency virus (HIV) infection. This was a cross-sectional study involving 112 pregnant women with HIV infection receiving antiretroviral therapy (ART). Data including viral load, complete blood analysis, and CD4 counts were extracted from medical records. An inquiry form was used to collect data on socioeconomic status and frequency of food intake. Pre-gestational weight was calculated based on pregnancy weight to obtain the body mass index (BMI) and weight gain for gestational age according the US Institute of Medicine. Of the study population, 68.7% were in consensual union, 31.3% were single, and 33.9% belonged to the two lowest socioeconomic strata. The median age and CD4 count were 27 (interquartile range [IQR]: 23-32) years and 418 (IQR: 267-591), respectively. The adequacy of energy was 91.8% (IQR: 74.1-117.7). The median energy intake from protein was 13.5% (IQR: 12.2-14.9) and from lipids, 35.5% (IQR: 31.1-40.3). Pregnant women with gastrointestinal symptoms and CD4 count <350 were seven times more likely to have folate deficiency (odds ratio [OR] 7.8, 95% confidence interval [CI] 1.6-38.1; p = 0.009) and six times more likely to have poor zinc intake (OR 6.7, 95% CI 1.3-36.8; p = 0.014). In all, 42.9% of the pregnant women consumed iron and folic acid supplements and 54.4% consumed multivitamin supplements. Moreover, 45.5% had a normal pre-gestational BMI, 41.1% were classified overweight, and 13.4% had obesity, whereas 62.5% showed insufficient gestational weight gain, and 18.8% experienced weight loss. The variables associated with insufficient weight gain were consensual union (OR 5.3, 95% CI 1.9-15.0; p = 0.002) and belonging to the lowest socioeconomic stratum (E) (OR 3.1, 95% CI 1.0-9.2; p = 0.046). Dietary strategies to improve gestational weight gain for Mexican women with HIV infection receiving ART must consider clinical and socioeconomic factors.

Psychometric properties of the Hospital Anxiety and Depression Scale in Mexican pregnant women

Introduction. Anxiety and depression in pregnant women are a public health problem. Their adequate detection requires valid and reliable instruments that are also useful for prevention and treatment. Objective. To identify the psychometric properties of the Hospital Anxiety and Depression Scale (HADS) in a sample of Mexican pregnant women. Method. The HADS was applied to 716 pregnant women between 13 and 46 years old (M = 26.55; SD = 6.56) attended in a public hospital in Mexico City. Results. With a sample of 358 participants, a parallel analysis indicated a bifactorial structure for HADS, identified by exploratory factor analysis (Factor 1: anxiety, Factor 2: depression). The factors explained 53% of the variance and correlated positively (r = .36). The global internal consistency (Cronbach’s α = .81; ordinal α = .93) and by factor (anxiety: Cronbach’s α = .79; ordinal α = .88; depression: Cronbach’s α = .79; ordinal α = .87) was acceptable. With data from the remaining 358 participants, a confirmatory factor analysis showed an acceptable fit for the structure detected (χ2/gl = 2.72; RMSEA = .06 [IC .05, .08]; GFI = .93; AGFI = .90; TLI = .90; CFI = .92). Discussion and conclusions. The Hospital Anxiety and Depression Scale has adequate psychometric properties to be used in pregnant Mexican women. Its use in routine pregnancy controls would be useful to prevent, detect, and timely treat these conditions.

Mexican pregnant women show higher depression and anxiety with rising age and in thecase of being single.

Pregnancy is an important predisposition period to develop anxiety and depression, with adirect impact on thewoman's offspring. Theaim of this study was to report thecorrelation between depression and anxiety in pregnant women and its association with themarital status and age. A descriptive, retrospective and cross-sectional study was conducted in theoutpatient care of thePsychology Service at the"Mónica Pretelini Sáenz" Maternal Perinatal Hospital (HMPMPS), Toluca, Mexico, from June 2012 to March 2019. As routine, the Beck Depression Inventory (BDI-II) and the Beck Anxiety Inventory-Trait (BAIT), were applied to all women seeking attention at the HMPMPS. Only pregnant patients were selected for this study, with thewomen referred for thefirst time to theexternal Psychology Clinic as inclusion criteria. Pearson's correlation coefficient and thefrequency of cases for age, BDI-II, and BAIT were obtained using theIBM SPSS Statistics ® v.23 software. The study included 2947 pregnant patients with amean age of 28.6±6.9 years. Of these, 2616(88.8%) presented with mild anxiety, 269(9.1%) with moderate, and 62(2.1%) with severe anxiety. On theother hand, 2149(72.9%) patients presented with minimal depression, 341(11.6%) mild depression, 268(9.1%) moderate depression, and 189 (6.4%) had severe depression. Thecorrelations between age and BDI-II was -0.026 (P=0.152), between age and BAI was -0.038 (P=0.037), and between BAIT and BDI-II 0.650 (P≤0.001). Theage group with thehighest frequency of depression and anxiety was from 20 to 29 years. Theabsence of astable partner represented an important risk factor for anxiety and depression during pregnancy.

Human papillomavirus as a single infection in pregnant women from Northeastern Mexico: Cross-sectional study.

BackgroundThe role of human papillomavirus (HPV) as single or multiple infections in pregnant women would be relevant to determine the time to progression and/or the time to regression of cervical lesions.Objective In this preliminary study, we determined the prevalence of HPV as single or multiple infections in pregnant women from Northeastern Mexico.Materials and MethodsSamples from 31 pregnant and 62 nonpregnant women were examined between January 2015 and November 2015 at UMAE-23 of the Instituto Mexicano del Seguro Social (IMSS). The samples of cervicovaginal exudate were obtained for HPV DNA detection using the INNO-LiPA test, and HPV infections were analyzed as single or multiple infections. Participants completed a questionnaire on sociodemographic, gynecological, obstetric, and sexual behavior characteristics.ResultsThe mean age of the pregnant women was 25.7 4.8 yr, with an average time of pregnancy of 6 1 months at the time of the study. With respect to age, parity, smoking history, or oral contraceptive use no statistically significant differences between the two studied groups was observed. The HPV infection was 2.7 times higher in pregnant women (35%) than in the control group (13%). In total, 78% of the pregnant women who were HPV-positive presented with single infections compared with 28% of the nonpregnant women.ConclusionA higher prevalence of HPV as a single infection was found in this sample of pregnant Mexican women. Follow-up is necessary to evaluate the persistence or regression of the infection.

Awareness, Expectations, and Perception of Anomaly Scan Among Mexican Pregnant Women

Awareness, Expectations, and Perception of Anomaly Scan Among Mexican Pregnant Women

Intención de Lactar exclusivamente con Leche Materna: Un Estudio Basado en la Teoría de la Conducta Planeada

espanolRESUMEN La lactancia materna exclusiva (LME) aporta diversos beneficios a la salud del nino y de la madre. La Teoria de la Conducta Planeada (TCP) es un modelo enfocado en la prediccion de algunas conductas relacionadas con la salud, como la LME. Elobjetivo de este estudio fue identificar la relacion de las variables de la TCP con la intencion de dar LME. Se llevo a cabo un estudio transversal con 442 mujeres embarazadas de la Ciudad de Mexico. Las variables de la TCP se midieron con instrumentos previamente validados. Un analisis de regresion logistica multiple, ajustado por paridad y edad materna, identifico asociaciones significativas entre la intencion de amamantar y la norma subjetiva, OR = 1.07 (IC 95% [1.01, 1.14]), y el control conductual percibido, OR = 1.05 (IC 95% [1.01, 1.11]), con la intencion. Como conclusion, en esta muestra se asociaron dos constructos de la TCP con la intencion de lactar de forma exclusiva. EnglishABSTRACT Breastfeeding provides health benefits to children and mothers. WHO recommends it be exclusive until 6 months of age. The Theory of Planned Behavior (TPB) focus on the prediction of health-related behaviors, such as breastfeeding. Theobjective of this study was to identify the relationship of attitudes, subjective norm, and perceived behavioral control with the intention of exclusively breastfeeding in a sample of Mexican pregnant women. A cross-sectional study was carried out with 442 pregnant women from Mexico City. Psychosocial variables were measured with a set of scales previously validated. A multiple logistic regression analysis, adjusted for the number of previous children and maternal age, identified significant associations between intention to breastfeed and one dimension of the subjective norm (participants’ mothers opinions), OR = 1.07 (IC 95% [1.01, 1.14]), as well as perceived behavioral control, OR = 1.05 (IC 95% [1.01, 1.11]). In the case of this sample, TCP constructs associated to the intention to exclusively breastfeed.

Unhealthy Levels of Phthalates and Bisphenol A in Mexican Pregnant Women with Gestational Diabetes and Its Association to Altered Expression of miRNAs Involved with Metabolic Disease.

Several studies indicate that bisphenol A (BPA) and phthalates may have a role in the development of metabolic diseases using different molecular pathways, including epigenetic regulatory mechanisms. However, it is unclear whether exposure to these chemicals modifies serum levels of miRNAs associated with gestational diabetes mellitus (GDM) risk. In the present study, we evaluated the serum levels of miRNAs associated with GDM (miR-9-5p, miR-16-5p, miR-29a-3p and miR-330-3p) and urinary levels of phthalate metabolites (mono-n-butyl phthalate (MBP), mono-isobutyl phthalate (MiBP), mono-benzyl phthalate (MBzP) and mono(2-ethyl hexyl) phthalate (MEHP)) and bisphenol A in GDM patients and women without GDM during the second trimester of gestation. We observed higher levels of miR-9-5p, miR-29a-3p and miR-330-3p in sera of patients with GDM compared to non-diabetic subjects. Phthalates were detected in 97–100% of urine samples, while BPA only in 40%. Urinary MEHP and BPA concentrations were remarkably higher in both study groups compared to previously reported data. Unadjusted MEHP levels and adjusted BPA levels were higher in non-diabetics than in GDM patients (p = 0.03, p = 0.02). We found positive correlations between adjusted urinary MBzP levels and miR-16-5p expression levels (p < 0.05), adjusted MEHP concentrations and miR-29a-3p expression levels (p < 0.05). We also found negative correlations between unadjusted and adjusted MBP concentrations and miR-29a-3p expression levels (p < 0.0001, p < 0.05), unadjusted MiBP concentrations and miR-29a-3p expression levels (p < 0.01). Urinary MEHP levels reflect a striking exposure to di(2-ethylhexyl) phthalate (DEHP) in pregnant Mexican women. This study highlights the need for a regulatory strategy in the manufacture of several items containing endocrine disruptors in order to avoid involuntary ingestion of these compounds in the Mexican population.

Reference intervals for hemoglobin A1c (HbA1c) in healthy Mexican pregnant women: a cross-sectional study

BackgroundThe reference intervals for hemoglobin A1c (HbA1c) in pregnant Mexican women without diabetes are not well defined. The study aims to determine the reference intervals for HbA1c at each trimester in healthy Mexican pregnant women.MethodsThis cross-sectional study included healthy Mexican pregnant women in trimester 1 (T1), 6–13.6 weeks of gestation (WG), trimester 2 (T2), 14–27 WG, and trimester 3 (T3), ≥27–36 WG, with a maternal age > 18 years, and pregestational body mass index (BMI) ranging between 18.5–24.9 kg/m2. Women with gestational diabetes mellitus, pregestational diabetes, anemia, a pregestational BMI < 18.5 or ≥ 25 kg/m2, and any hematologic, hepatic, immunological, renal, or cardiac disease were excluded. HbA1c was measured using high-performance liquid chromatography based on the National Glycohemoglobin Standardization Program-certified PDQ Primus guidelines. The HbA1c reference intervals were calculated in terms of the 2.5th to the 97.5th percentiles.ResultsWe analyzed the HbA1c values of 725 women (T1 n = 84, T2 n = 448, and T3 n = 193). The characteristics of the participants were expressed as mean ± standard deviation and included: maternal age (28.2 ± 6.7 years), pregestational weight (54.8 ± 5.9 Kg), pregestational BMI (22.2 ± 1.7 Kg/m2), and glucose values using a 75 g-2 h oral glucose tolerance test; fasting 4.5 ± 0.3 mmol/L (81.5 ± 5.5 mg/dL), 1 h 6.4 ± 1.5 mmol/L (115.3 ± 26.6 mg/dL), and 2 h 5.7 ± 1.1 mmol/L (103.5 ± 19.6 mg/dL). Reference intervals for HbA1c, expressed as median and 2.5th to 97.5th percentile for each trimester were: T1: 5.1 (4.5–5.6%), T2: 5.0 (4.4–5.5%), and T3: 5.1 (4.5–5.6%).ConclusionsThe reference range of HbA1C in healthy Mexican pregnant women during pregnancy was 4.4% to 5.6%. We suggest as upper limits of HbA1c value ≤5.6%, 5.5%, and 5.7% for T1, T2, and T3, respectively among Mexican pregnant women.

Conocimientos sobre salud bucal en un grupo de gestantes mexicanas

El embarazo es un período único durante la vida de la mujer que se caracteriza por una serie de cambios fisiológicos complejos, que pueden afectar negativamente la salud oral. El objetivo del presente trabajo fue evaluar el nivel de conocimientos sobre salud bucal en un grupo de gestantes mexicanas. Se aplicó un cuestionario a mujeres embarazadas (N = 50) bajo control médico prenatal en el Hospital General de la Mujer Zacatecana, México, durante el periodo noviembre 2015 a febrero 2016. Se evaluó el nivel general de conocimientos sobre salud bucal, considerando medidas preventivas, enfermedades bucales, atención odontológica a la gestante y desarrollo dental. Se utilizó la prueba X2 para analizar el nivel de conocimientos respecto a la edad, lugar de procedencia y grado de instrucción. Se encontró de manera general que 58% de las encuestadas tiene un nivel regular de conocimientos sobre salud bucal. Respecto a medidas preventivas, 44% tiene un conocimiento regular. Se halló en los rubros sobre enfermedades bucales, atención odontológica y desarrollo dental un nivel de conocimientos malo. Diferencias estadísticamente significativas fueron observadas entre el nivel de conocimientos sobre salud bucal, la edad (p = 0.0008) y el lugar de procedencia de la gestante (p = 0.0266). La educación en salud bucal durante el control prenatal debe ser una tarea prioritaria de los servicios de salud, tanto a nivel de motivación como de formar hábitos saludables para la familia.

Correlation between intake of omega-3 fatty acids and depressive and anxiety symptoms during pregnancy

Introduction. Anxiety and depression during pregnancy are disabling disorders associated to complications during the pregnancy, delivery, and postpartum period, with a significant prevalence, between 9 and 20%, hence its importance. Nutritional factors, such as omega-3 fatty acids (ω-3FA) deficiency, have been related with both disorders during pregnancy, especially docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA). Objective. To evaluate the association between dietary intake of EPA and DHA, and anxiety symptoms (AS) and depressive symptoms (DS) in Mexican pregnant women. Method. The sample consisted of 151 women in the second trimester of pregnancy. Instruments included a Food Frequency Questionnaire, the Trait Anxiety Inventory, and the Edinburgh Postnatal Depression Scale. Results. A daily intake of DHA and EPA of 70 mg/d and 30 mg/d, respectively, was found. The prevalence of AS was 44.4%, and 17.9% for DS. We also found the correlation negatively moderate between dietary intake of DHA and EPA and AS (p = .003, p = .017) and DS (p = .001, p = .020) in the group of women who had a severely insufficient intake of ω-3FA. Discussion and conclusion. The statistical significance shows a negative correlation between variables and the dietary intake of ω-3FA explains in a very small percentage the variability of AS and DS, according to their coefficient of determination. These results suggest the need for an investigation of this relationship through interventional studies.

Randomized clinical trial of the safety and immunogenicity of the Tdap vaccine in pregnant Mexican women

ABSTRACTImmunization with the tetanus, diphtheria, and pertussis (Tdap) vaccine raises controversies on immunogenicity and possible antibody interference. We performed an experimental, double-blind, parallel group controlled clinical trial to evaluate the safety and immunogenicity of the Tdap vaccine in 204 pregnant women and their children and to determine its interference in antibody production. Pregnant women 18 to 38 y of age with 12 to 24 weeks gestation, a low obstetric risk, and without serious disease were randomly selected. The experimental group received 0.5 mL IM of Tdap and the control group normal saline. Six blood samples were drawn before and after solution application, and from the umbilical cord of the infants and at 2, 4, and 6 months of age. Pertactin and Pertussis toxin antibodies and possible interference of maternal antibodies with the vaccine were determined.In the experimental group, antibodies against Bordetella pertussis pertactin (anti-PRN) (112 E/mL 95% CI 89.9–139.9) and antibodies against pertussis toxin (anti-PT) (24.0 E/mL, 95% CI 18.3–31.4) were elevated in the mother before vaccination. These were higher in the umbilical cord and descended in the infant at 2 months (71.4 (95% CI 56.8–89.7 and 10.9; 95% CI 8.7–13.7, respectively). Anti-PT showed a delay in production. Tdap safety was confirmed with only mild local pain at 24 and 48 hours.Anti-PRN and anti-PT antibodies in the infant descend at 2 months of age. There is a delay in anti-PT in children of immunized mothers. Further studies are needed to elucidate its clinical significance.

Killer-cell immunoglobulin-like receptors and cytomegalovirus reactivation during late pregnancy.

Human cytomegalovirus (CMV) represents an important public health concern as it is associated with severe morbidity and mortality in transplant recipients, HIV-infected individuals and pregnant women given the risk of congenital infection. Congenital CMV is a leading cause of neurological sequelae, developmental delay and birth defects worldwide. Cytomegalovirus can be transmitted to the foetus following maternal infection or reactivation. NK cells expressing killer-cell immunoglobulin-like receptors (KIR) are part of the innate immune system and the first line of defence against viral incursions. Previous reports have shown that KIR genes are associated with CMV infections in the post-transplant setting. In this study, we set out to determine whether a protective effect of KIR genes over CMV infection is seen in Mexican pregnant women. Cytomegalovirus infection was assessed through nucleic acid testing in 200 pregnant women and 600 healthy blood donors comprising the Mexican mestizo reference population. Killer-cell immunoglobulin-like receptors and HLA-C genotypes were obtained from 200 pregnant women and 300 reference samples using a comprehensive PCR-SSP approach. We observed statistically lower carrier frequencies of cB03|tA01 gene-content haplotype, of cB03 haplotype motif, of the KIR2DL5+2DS3/2DS5 gene pair and of KIR2DL5 amongst CMV-positive pregnant women in comparison with those CMV negative. None of these were associated with CMV status in the reference population. Logistic regression analysis revealed that the most important factor determining CMV status during third-trimester pregnancies was the KIR2DL5+2DS3/2DS5 gene pair (OR 0.376 (95%CI 0.174, 0.811, P=0.013). Our results indicate that CMV-protective KIR gene associations described in Caucasoid populations are also present in the genetically distinct Mexican mestizo population. Our results suggest that certain KIR gene combinations provide protection against CMV infections occurring during late-term pregnancies, a finding of utmost epidemiological importance given its implication with congenital CMV infections.

Detection of mental disorders other than depression with the Edinburgh Postnatal Depression Scale in a sample of pregnant women in northern Mexico

We sought to evaluate the capacity of the Edinburgh Postnatal Depression Scale (EPDS) in discriminating mental disorders other than depression in pregnant women in northern Mexico. Three hundred pregnant women attending prenatal consultations in a public hospital in Durango City, Mexico submitted a validated EPDS and were examined for mental disorders other than depression using the Diagnostic and Statistical Manual of Mental Disorders - 4th Ed. (DSM-IV) criteria. Sensitivity and specificity of cut-off points of the EPDS, and positive and negative predictive values were calculated. Of the 300 pregnant women studied, 21 had mental disorders other than depression by the DSM-IV criteria. The best EPDS score for screening mental disorders other than depression was 8/9. This threshold showed a sensitivity of 52.4%, a specificity of 67.0%, a positive predictive value of 11.5%, a negative predictive value of 95.4%, and an area under the curve of 0.643 (95% confidence interval: 0.52-0.76). The EPDS can be considered for screening mental disorders other than depression in Mexican pregnant women whenever a cut-off score of 8/9 is used. However, the tool showed small power to separate pregnant women with and without mental disorders other than depression.