Trimester Of Pregnancy Research Articles

Personal growth during early and advanced pregnancy according to women’s mode of conception

ABSTRACT Background Pregnancy can be a complex and stressful period, especially for women conceiving through fertility treatment, but this can foster the experience of personal growth (PG). Most of the knowledge on women’s PG during pregnancy is based on a single measurement and relates to conceiving achieved through fertility treatments in general. Relying on Schaefer and Moos’s PG model, the current prospective study sought to (1) investigate the differences in PG according to women’s mode of conception (spontaneous; first-line fertility treatment; IVF) and (2) examine the contribution of the mode of conception, perceived stress, self-mastery, and cognitive appraisal (threat, challenge, and self-efficacy) to PG in two phases during pregnancy. Methods Israeli pregnant women (Mean age = 32) recruited through a convenience sample, completed self-report questionnaires twice: the first or second trimester of pregnancy (Phase 1; n = 400) and the third trimester (Phase 2; n = 268). A total of 268 participants completed both assessments. Results Women who conceived through IVF experienced higher PG and lower self-mastery than women who conceived spontaneously. Regression analyses indicated that IVF, being primiparous, lower self-mastery, lower threat appraisal, and higher challenge appraisal were related to greater PG in Phase 1. Only expecting the first child and challenge appraisal predicted women’s PG in Phase 2. Conclusions The study highlights that women who conceive through IVF experience greater PG than other women and the significant role of cognitive appraisal in PG over time during pregnancy. These findings may inform focused-based interventions to enhance women’s mental health during this period.

Defining normal serum creatinine in pregnancy -results from the AKID UK prospective cohort study

Abstract Background Abnormal kidney function in pregnancy may represent chronic kidney disease or pregnancy-associated acute kidney injury - both associated with adverse outcomes during and after pregnancy. Serum creatinine remains the standard biomarker for kidney function in pregnancy but normal levels change dynamically through pregnancy and at term. Existing gestation-specific reference ranges for serum creatinine, and recommendations to investigate for abnormal kidney function in pregnancy are based on limited data. Data describing trajectories of serum creatinine through pregnancy and the normal, physiological increase in serum creatinine at term are also lacking. Methods We recruited 476 healthy pregnant individuals aged 16 years or over, 2019-21, measuring serum creatinine in the first, second and third trimesters of pregnancy, , at birth and postpartum. Clinical data were abstracted. Gestation-specific reference ranges for serum creatinine were defined as mean±1.96 x SD, after excluding those with adverse pregnancy outcomes. Trajectories of serum creatinine through pregnancy, and the change in serum creatinine at delivery were described. Results 1875 creatinine measurements were recorded. Reference ranges for serum creatinine in the first, second and third trimesters of healthy pregnancy were 37-67μmol/L (0.42-0.75mg/dl), 34-63μmol/L (0.38-0.71mg/dl), and 34-66μmol/L (0.39-0.75mg/dl). Increasing serum creatinine in early pregnancy was more common in those with hypertensive disorders of pregnancy, prior to disease onset. In healthy participants, median serum creatinine increase from 36 weeks to birth was 6.8% (95% CI 4.5%, 9.1%). Conclusions Investigation for abnormal kidney function in pregnancy should be considered at a lower creatinine threshold than currently recommended. Detecting abnormal creatinine trajectories may help early identification of high-risk pregnancies.

A maternal sweet diet is associated with the gut dysbiosis in the first trimester of pregnancy

BackgroundThe composition of maternal gut phylum in each trimester of pregnancy has been associated with fetal development, separately. Diet is a main effective factor on the gut composition of phylum. However, associations between dietary glycemic index (GI), load (GL) and total antioxidant capacity (TAC) not studied with the gut population of phylum in mothers at the first trimester of pregnancy.Materials and methodsNinety healthy pregnant women aged 18–40 yrs, in the first trimester, were participated. Stool samples were gathered in a fasting state. Population of dominant phylum was determined after DNA extraction based on the 16SrRNA expression, as a housekeeping gene. Dietary intake was collected by a validated food frequency questionnaire and dietary indices were computed.ResultsThe Proteobacteria population was significantly higher in the gut of pregnant mothers than the other phylum (p < 0.001). Participants in the highest level of dietary GI had lower Bacteroidetes (p < 0.001) and Actinobacteria (p = 0.04) in their gut compared to the lowest level. Participants in the lowest level of dietary GL had higher Bacteroidetes (p < 0.001) and lower proteobacteria (p = 0.04) in their gut than the highest level. Dietary selenium showed a significant negative effect on the Firmicutes (p = 0.04) and Proteobacteria (p = 0.04), however positively affected the Actinobacteria (p = 0.01) population. Dietary zinc and manganese showed a negative effect on the Firmicutes population (p = 0.01 and p = 0.003). Zinc and vitamin E showed a negative effect on the Proteobacteria population (p = 0.04 and p = 0.03).ConclusionsA maternal diet with high GI and GL have been associated with the gut dysbiosis, however dietary intake of selenium, zinc, manganese and vitamin E act in favor of the intestinal eubiosis in the first trimester of pregnancy.

Effects of pre-pregnancy body mass index on cardiometabolic biomarkers in pregnant emirati women

BackgroundTo study effect of pregnancy on obese women’s maternal cardiometabolic biomarkers as a signature for maternal morbidity and complications.MethodsThis cross-sectional cohort study involved pregnant Emirati women who had regular menstrual cycles and had normal blood pressure. Pre-pregnancy body mass index was calculated using height and weight measurements recorded within three months before current pregnancy. Average systolic and diastolic blood pressure measurements were calculated from each visit. Blood samples were collected randomly once and following cardiometabolic biomarkers were measured.ResultsWe enrolled 178 pregnant women, with a mean age ± standard deviation of cohort was 29.9 ± 4.97 years and Pre-pregnancy body mass index 28.11 ± 6.58 kg/m2. None of blood pressure measurements or biomarkers serum concentrations were statistically different across Pre-pregnancy body mass index groups except for soluble intercellular cytoadhesive molecule-1levels which were the highest in underweight women. Pregnant women with pre-gestational obesity had higher systolic and diastolic blood pressure levels compared to women with normal or overweight. All variables were statistically significantly different by trimesters except systolic blood pressure, random blood glucose, lipoprotein-A, and high-sensitivity C-Reactive Protein. After adjusting, in a multivariate linear regression model, for maternal age, trimester of pregnancy, education level, parity and smoking, none of biomarkers or blood pressure were found to be significantly associated with Pre-pregnancy body mass index. In a multivariate linear regression model adjusting for maternal age, Pre-pregnancy body mass index, education level, parity and smoking, gamma-glutamyl transferase, total cholesterol, high density lipoprotein, low-density lipoprotein, triglycerides, apolipoprotein A & B, interleukin-6, tumor necrosis factor-alpha and insulin-like growth factor-1 concentrations remained significantly associated with advancing trimester of pregnancy. There was a significant interaction between Pre-pregnancy body mass index and trimester of pregnancy for serum gamma-glutamyl transferase and soluble intercellular cytoadhesive molecule-1concentration.ConclusionThis study emphasizes how pregnancy has a significant impact on cardiometabolic markers in obese women, indicating both hyperlipidemic status of pregnancy and diabetogenic tendency in obese patients who are not diabetics. These findings may suggest that pregnancy in obese patients increases risk of developing metabolic syndrome in future, therefore more attention is recommended of pregnant obese women and further study of establishing specific cardiometabolic biomarkers screening program.

Prospective associations of infant food exposures and appetitive traits with early childhood diet quality

BackgroundEarly-life food exposures may influence food preferences and receptivity, thereby impacting long-term diet quality. Infant exposure to discretionary foods may be more detrimental for infants with high food approach traits; conversely, early exposure to fruits and vegetables may be more important for those with high food avoidance traits. This study investigated associations of infant food exposures with early childhood diet quality and whether these associations are modified by infant appetitive traits.MethodsData are from the Pregnancy Eating Attributes Study (PEAS) and Sprouts follow-up study, a prospective cohort assessed from the first trimester of pregnancy through early childhood. Birthing parents completed the Baby Eating Behavior Questionnaire assessing food-approach and food-avoidance appetitive traits at 6 months and food frequency questionnaires assessing infant age at introduction to and frequency of consuming food groups at ages 6 months, 1 year, and 2 years. At child ages 3.5 and 5 years, parents provided two 24-h dietary recalls, from which the Healthy Eating Index-2020 was calculated to measure diet quality. Structural equation models using maximum likelihood estimation examined associations of age at introduction to, and intake frequency of, fruit/vegetables and discretionary foods, and their interactions with food-approach and food-avoidance appetitive traits, on child diet quality at ages 3.5 & 5 years, controlling for income, education, and breastfeeding duration.ResultsHigher childhood diet quality was associated with later infant age at introduction to discretionary foods, lower intake of discretionary foods at ages 1 and 2 years, and greater intake of fruits and vegetables at age 2 years. Childhood diet quality was not associated with infant age at introduction to fruits and vegetables. Intake of fruits and vegetables at age 1 year interacted with food avoidance traits, indicating that the association of fruit and vegetable intake with childhood diet quality was magnified by greater food avoidance.ConclusionsExposure to discretionary food in the first two years of life was consistently associated with lower diet quality in early childhood regardless of the strength of appetitive traits. Findings suggest that improving child diet quality may require stronger efforts to limit exposure to discretionary foods in infancy.

The Effect of Prenatal Exercise and Effleurage Massage Techniques on the Perception of Back Pain in Third Trimester Pregnant Women

The perception of back pain is a common discomfort experienced by women in the third trimester of pregnancy. This pain occurs due to the release of the hormones progesterone and relaxin, which loosen the pelvic ligaments, and due to changes in body posture adapting to fetal development. The aim of this study is to analyze the effect of reducing pain before and after implementing prenatal exercises and effleurage massage in third-trimester pregnant women. This research used a quasi-experimental design with only one experimental group and no control group. The study population consisted of all third-trimester pregnant women experiencing back pain, with sampling conducted using accidental sampling. Data was collected using questionnaires and analyzed with the SPSS program, employing both univariate and bivariate tests. The results of the Paired Sample T-Test showed a significant difference between the pre-test and post-test values, with a significance value (2-tailed) of p = 0.000, &lt; 0.05. The null hypothesis (H0) was rejected, and the alternative hypothesis (Ha) was accepted, indicating a notable difference between the effects of prenatal exercise and effleurage massage before and after treatment in 180 third-trimester pregnant. There is a significant impact of prenatal exercise and effleurage massage on reducing back pain.

Metabarcoding analysis of oral microbiome during pregnancy

Pregnancy is a dynamic physiological process involving significant hormonal, immune, and metabolic changes to support fetal growth and development. This study investigates the changes in salivary microbiome and biochemical markers from the second to the third trimester of pregnancy. Saliva samples were collected from 45 pregnant women enrolled in the Qatar Birth Cohort study at two time points (second and third trimesters). DNA was extracted and subjected to 16S rRNA gene sequencing using Oxford Nanopore Technology. Microbial diversity and taxonomic analyses were performed, along with correlation analyses between microbial abundance and clinical parameters. Biochemically, significant increases in BMI, pulse rate, HbA1c, LDL, total cholesterol, and triglycerides were observed in the third trimester compared to the second. Microbial diversity analysis revealed significant changes in microbial richness and composition. Taxonomy analysis showed a significant 3-fold increase in Bacteroidota. Also, a significant decline in Selenomonas and a significant increase in Veillonella, specifically Veillonella dispar and Veillonella atypica, as well as an increase in Granulicatella were observed in the third trimester, along with a significant decrease in Streptococcus sanguinis. Correlation analysis during the second trimester revealed positive associations between BMI, cholesterol, LDL, and Selenomonas, and negative correlations with Streptococcus and Gemella. In the third trimester, BMI was negatively correlated with Campylobacter, glucose levels were negatively correlated with Neisseria, and triglyceride levels were negatively correlated with Prevotella. These findings highlight significant biochemical and microbial shifts during pregnancy, underscoring the importance of monitoring oral health and metabolic changes in pregnant women.

Prenatal Hemoglobin Concentration and Long-Term Child Neurocognitive Development.

Anemia in pregnancy, defined by a hemoglobin level (Hb) of less than 110 g/L, contributes to infant mortality and morbidity in sub-Saharan Africa. Maternal Hb changes physiologically and pathologically during pregnancy. However, the impact of these changes on long-term child neurocognitive function is unknown. This study therefore investigates the association between Hb at specific antenatal care visits and prenatal Hb trajectories during pregnancy and long-term child neurocognitive function. We analyzed data from a prospective cohort study that included 6-year-old singleton children born to women enrolled before 29 weeks of gestation into an antimalarial drug clinical trial. Hemoglobin level was analyzed from venous blood collected at least twice during pregnancy and at delivery. We used group-based trajectory modeling to identify distinct prenatal Hb trajectories. In total, 478 children (75.1% of eligible children) had assessment of cognitive and motor functions at 6 years of age. Three distinct Hb trajectories were identified: persistently anemic (Hb <110 g/L throughout the second and third trimesters), anemic to nonanemic (Hb <110 g/L at second trimester with increasing Hb toward the third trimester to Hb ≥110 g/L), and persistently nonanemic (Hb ≥110 g/L throughout the second and third trimesters). Children of women in the persistently anemic and anemic-to-nonanemic groups had significantly lower neurocognitive scores than children of women in the persistently nonanemic group (β = -6.8, 95% CI: -11.7 to -1.8; and β = -6.3, 95% CI: -10.4 to -2.2, respectively). The study shows that maintaining an elevation of Hb at or above 110 g/L from the second to third trimester of pregnancy may be associated with optimal long-term child neurocognitive function.

Pemphigoide of Pregnancy: Case Report and Review of the Literature

Pemphigoid of pregnancy (PG) is a rare autoimmune bullous dermatosis, affecting 1 in 20000 to 50000 pregnant women. PG is linked to anti-BP180 autoantibodies whose synthesis follows a breakdown in mother-fetal immunological tolerance. Bullae formation results from a complex mechanism involving TH2 lymphocytes, cytokines and polynuclear cells. PG manifests itself as a pruritic erythematopapular rash of varying extent, progressing to the inconstant but suggestive appearance of vesicles and bullae. The disease progresses to gradual recovery after delivery, sometimes after a post-partum flare-up. Recurrence during subsequent pregnancies is frequent. Relapses can also be triggered by estrogen-progestogen contraception. Diagnosis is confirmed by direct immunofluorescence, which shows C3 +/- IgG deposits along the basement membrane. The BP180-NC16A ELISA technique is highly sensitive for the detection of circulating antibodies. Fetal prognosis is good, but early onset in the 1st or 2nd trimester of pregnancy of pregnancy and the presence of bullae are risk factors for prematurity or hypotrophy. Very rarely, the newborn may present transient bullae. Several publications show that very strong dermocorticoids are effective and can be used as first-line treatment for moderate PG. We report the case of a patient admitted to a maternity hospital emergency department, with a pregnancy of 37 weeks' gestation and a non-reassuring fetal condition presenting as pemphigoid of pregnancy (PG).

Comparison between Lavender and Chamomile Essential Oils for Pain and Anxiety Reduction during Amniocentesis in Second Trimester Pregnancy: A Randomized Controlled Trial

Objective: To investigate the effectiveness of aromatherapy using lavender and chamomile essential oils, to alleviate pain and reduce anxiety during the amniocentesis procedure in second trimester pregnancy. Materials and Methods: The present was a randomized controlled trial approved by the Human Research Ethics Committee of Thammasat University (MTU-EC-OB-1-023/66) and registered in the Thai Clinical Trials Registry on June 29, 2023 (TCTR20230629001). The present study was conducted at the Maternal and Fetal Medicine Unit, Thammasat University Hospital, Pathum Thani, Thailand between July and November 2023. The participants were pregnant women undergoing amniocentesis. Participants were randomly assigned into three groups, lavender, chamomile, and normal saline, which was the control group. Participants in each group were instructed to inhale the assigned scent, lavender, chamomile, or normal saline, for 15 minutes prior to the amniocentesis procedure. For each participant, a cotton swab containing four drops of the assigned scent was held 10 centimeters from the participant’s nose. Pain and anxiety were recorded using visual analog scale (VAS) and visual facial anxiety scale (VFAS). Expected pain and anxiety were recorded before amniocentesis (Te), immediate after procedure (T0), and at 15 and 30 minutes after the procedure (T15 and T30). Results: One hundred fifty participants were allocated into three groups. To ensure comparability, demographic characteristics were matched across the three groups. The present study revealed that both lavender and chamomile lowered pain more than the control at 15 minutes after amniocentesis (T15), and only lavender can reduce pain during the procedure (T0). Both lavender and chamomile reduced anxiety more than the control 15 minutes after amniocentesis (T15), and only chamomile continued to reduce anxiety 30 minutes post procedure (T30). Thus, lavender proved to be more effective in managing pain during the amniocentesis procedure, whereas chamomile offers a prolonged effect in reducing anxiety, lasting up to 30 minutes post-procedure. Conclusion: Aromatherapy effectively reduces pain and anxiety associated with amniocentesis. In the present study. Both lavender and chamomile reduced pain at 15 minutes after the procedure, but only lavender has efficacy in pain reduction during the procedure. Both lavender and chamomile reduced anxiety 15 minutes after the procedure, but only chamomile continued to reduce anxiety 30 minutes post procedure. However, when comparing lavender and chamomile, there was no statistically significant difference in efficacy of pain or anxiety reduction. Keywords: Lavender; Chamomile; Aromatherapy; Essential oil; Amniocentesis; Pain; Anxiety

Case Report of a Second Trimester Diagnosis of Binder Syndrome

ABinder’s facies is a rare congenital malformation that has multifactorial aetiologies. This anomaly affects the anterior part of the maxilla and the nasal cavity. A 30-year-old primigravida with a non-consanguineous marriage presented for a second opinion regarding an anomaly scan at the fetal medicine department of our institute at 21 weeks. Her scan performed elsewhere suggested a flat and short nasal bridge. A thorough 2D and 3D examination of the fetus was carried out. The midsagittal view of the face showed a flat nose with an increased fronto-nasal angle. In this study, we discuss the diagnosis of Binder syndrome during the second trimester of pregnancy.

Comparison of open and laparoscopic appendectomy according to the trimester of pregnancy: A nationwide observational study.

To compare the outcomes of open appendectomy (OA) and laparoscopic appendectomy (LA) for acute appendicitis during pregnancy by trimester. We conducted a nationwide retrospective cohort study using the Diagnosis Procedure Combination database in Japan. We identified pregnant women diagnosed with appendicitis who underwent OA or LA from 2010 to 2022. Pathological confirmation of appendicitis was not required for inclusion. The patients were categorized by the trimester of pregnancy. Outcomes were compared using multivariate analysis with generalized estimating equations. A total of 1624 patients were included. In the first trimester, 64.2% patients underwent OA, whereas 35.8% patients underwent LA; in the second trimester, 59.1% patients had OA and 40.9% patients had LA; and in the third trimester, 72.8% patients had OA and 27.2% patients had LA. LA was associated with a higher rate of preterm labor, preterm delivery, or abortion in the second (odds ratio, 3.37; 95% confidence interval, 1.76-6.47; and p<0.001) and third trimesters (odds ratio, 2.57; 95% confidence interval, 1.15-5.70; and p=0.021) but not in the first trimester. The duration of surgery was longer across all trimesters in patients who underwent LA. Additionally, the postoperative hospital stay was shorter in patients who had LA than in those who had OA in the second trimester. In-hospital outcomes vary by trimester, and our results suggest that LA does not consistently lead to better outcomes than OA. Based on our findings, treatment options for appendicitis during pregnancy must be carefully selected.

The mediating role of rumination in the relationship between negative cognitive styles and depression among pregnant women in Guangzhou, China

BackgroundsNegative cognitive styles (NCSs) have been identified as risk factor for the onset of depression. However, little empirical evidence is available to support its role in psychological disorders in the perinatal period. Moreover, less is known about the underlying mechanism in the relation between NCSs and depression in pregnant women. The purpose of this study was to examine the mediation effect of rumination on the relationship between NCSs and antenatal depression (AD). Specifically, the mediation effects of two subtypes of rumination were tested.MethodsA cross-sectional study was conducted from February to May 2023 using anonymous online questionnaire among women in their third trimester of pregnancy in the antenatal care clinic of a tertiary hospital. The Edinburgh Postnatal Depression Scale was used to screen antenatal depression. Attributional Style Questionnaire and Ruminative Responses Scale were employed to assess NCSs and rumination respectively. Correlational analysis of the associations between NCSs, rumination, and AD was conducted. Bootstrap mediation analysis and multiple mediation models were applied to investigate whether rumination, and its brooding and reflection components would mediate the relationship between NCSs and AD.ResultsNCSs had a significant positive effect on depression in pregnant women (c=1.45, SE=0.03, p&amp;lt;0.001, 95%CI: 0.92∼1.70). Rumination mediated the relationship between NCSs and depression in pregnant women (point estimate=0.41, 95%CI: 0.13∼0.79, effect size=0.22, K2 = 0.19). Multiple mediation analysis revealed that brooding, instead of reflection, mediated the relationship between NCSs and depression in pregnant women (point estimate=0.41, 95%CI: 0.15∼0.78).ConclusionThis study provided novel evidence for the role of rumination, specifically its brooding subtype, in shaping the link between NCSs and depression in pregnant women, highlighting potentially useful targets for interventions aimed at preventing the onset of AD.

Genotype–Phenotype Correlation in a Couple in Which the Wife Is a Carrier of the Beta-Thalassemia Trait and the Husband Is a Carrier of a Mutation in the ALAS2 Gene: Both Gene Defects Are Associated with Non-Iron-Deficiency Microcytic Anemia

Introduction: Generally, microcytic anaemia is caused by sideropenia or a genetic gap. The suspicion that microcytic anaemia is caused by a genetic gap must always be considered in the face of an inadequate response to martial therapy. The aim of this paper is to highlight how biochemical diagnosis alone is sometimes not sufficient to understand the cause of microcytic anaemia. For this reason, for a correct genotype–phenotype correlation, it is essential to identify the defective gene underlying the microcytic anaemia. Detailed Case Description: This case concerns a married couple who both have microcytic anaemia. They came to our attention because the lady, pregnant at 12 weeks, underwent screening for chromosomal abnormalities using combined tests in the first trimester of pregnancy. A biochemical screening performed ten years earlier showed that both spouses were healthy carriers of the beta-thalassemia trait. A careful analysis of the biochemical data and an in-depth molecular diagnosis of the alpha and beta globin genes showed that the woman was a healthy carrier of the beta-thalassemia trait while the husband was a healthy carrier of a mutation in the ALAS2 gene. Analysis of the biochemical data of her husband and family members revealed that she had X-linked microcytic sideroblastic anaemia caused by an alteration in the function of the ALAS2 (5′-Aminolevulinate Synthase 2) gene located on the short arm of the X chromosome (Xp11.21). Discussion and Conclusions: This result is very relevant as, during genetic counselling, we explained to the couple that invasive prenatal diagnosis was not necessary as there is no risk of procreating a transfusion-dependent individual.

Are assisted reproductive technology pregnancies more likely to be exposed to teratogenic medication? A whole-population study.

Assisted reproductive technology (ART) pregnancies are at greater risk of birth defects than non-ART pregnancies. Teratogenic medication exposure is a potential cause of birth defects that has not been compared between ART and non-ART pregnancies. To determine whether the prevalence of exposure to teratogenic medicines during pregnancy varies by conception method (ART and three non-ART groups: ovulation induction (OI), subfertile untreated, and fertile naturally conceiving). We linked state and commonwealth datasets for all live and stillbirths (≥20 weeks) in Western Australia with a conception date ≥1 July 2012 and date of birth ≤31 December 2014. We calculated the prevalence of exposure to teratogenic medicines (Therapeutic Goods Association Category D/X) across conception groups for the: (i) first trimester, and (ii) second and third trimesters. We identified 2041 ART, 590 OI, 2063 subfertile and 52 987 fertile pregnancies (57 681). The overall prevalence of exposure to Category D/X medicines was 0.8% in the first trimester, and 0.7% in the second and third trimesters. Category X medicines exposure was <0.5% for all conception groups and trimesters. The first trimesters of ART and OI pregnancies were more often exposed to Category D medicines than subfertile and fertile pregnancies, (ART = 4.9%, OI = 2.0% vs subfertile = 1.3%, fertile = 0.6%) as were later trimesters (ART = 3.4%, OI = 1.4% vs subfertile = 0.9%, fertile = 0.6%). The overall prevalence of exposure to teratogenic medicines is low; however, exposure was greatest in pregnancies arising from ART and may be a modest contributing factor to the higher rate of birth defects observed among ART babies.

A clinical study to evaluate the efficacy of Shaliparnyadi Yusha in Garbhini Parshwagraha (Flank Rigidity with Lower Back Pain) During the Second and Third Trimester

This study investigates the efficacy of Shaliparnyadi Yusha, a traditional Ayurvedic formulation, in the management of Garbhini Parshwagraha (flank rigidity associated with lower back pain) during the second and third trimester of pregnancy. The study was conducted on 32 patients, with outcomes measured by reductions in pain and improvements in mobility. The results indicate significant relief of symptoms, supporting the use of this Ayurvedic therapy for pregnant women experiencing discomfort due to musculoskeletal strain.

Association between consumption of ultra-processed foods and glycemic self-monitoring in women with gestational diabetes mellitus and their newborns: A cohort study.

To evaluate the association between the consumption of ultra-processed foods (UPFs) and outcomes of self-monitoring of blood glucose in pregnant woman with gestational diabetes mellitus (GDM) and the occurrence of hypoglycemia in their newborns. Prospective cohort study of pregnant woman with GDM who were followed up from the second trimester of pregnancy in high-risk prenatal care until the immediate postpartum period. Dietary intake was assessed using 24-h recalls and analyzed according to the Nova Classification. The glycemic profile was assessed by self-monitoring of fasting and postprandial capillary glycemia (pregnant) and by capillary glycemia in the first 48 h of life (neonate). Multilevel binary logistic regression models were used to assess the relationship between increasing UPF intake, considering the highest tertile of UPF consumption, and women's glycemic control and the occurrence of neonatal hypoglycemia. UPFs provided 15% of calories consumed; 33.3% (n = 30) and 52.3% (n = 45) of the women had hyperglycemia in the second and third trimesters of pregnancy, respectively. After adjustment it was observed that UPF consumption had no significant association with maternal glycemic control but it showed a positive association with the occurrence of neonatal hypoglycemia (odds ratio [OR] 1.144, 95% confidence interval [CI] 1.037-1.262, p = 0.007). These data reinforce the need to address food processing during high-risk prenatal care in order to help reduce the negative impacts of UPF consumption on the mother-infant dyad.

Associations of systemic immune-inflammation index and systemic inflammation response index with maternal gestational diabetes mellitus: Evidence from a prospective birth cohort study.

The role of inflammation in the development of gestational diabetes mellitus (GDM) has recently become a focus of research. The systemic immune-inflammation index (SII) and systemic inflammation response index (SIRI), novel indices, reflect the body's chronic immune-inflammatory state. This study aimed to investigate the associations between the SII or SIRI and GDM. A prospective birth cohort study was conducted at Beijing Obstetrics and Gynecology Hospital from from February 2018 to December 2020, recruiting participants in their first trimester of pregnancy. Baseline SII and SIRI values were derived from routine clinical blood results, calculated as follows: SII=neutrophil (Neut) count×platelet (PLT) count/lymphocyte (Lymph) count, SIRI=Neut count×monocyte (Mono) count/Lymph count, with participants being stratified into quartiles. Follow-up included a 75-g, 2-h oral glucose tolerance test (OGTT) at 20-32weeks of gestation, using the glucose thresholds of the International Association of Diabetes and Pregnancy Study Groups (IADPSG). Logistic regression was used to analyze the odds ratios (ORs) (95% confidence intervals [CIs]) for the SII, SIRI, and GDM risk. Among the 28,124 women included in the study, the average age was 31.8±3.8years, and 15.76% (4432/28,124) developed GDM. Higher SII and SIRI quartiles were correlated with increased GDM rates, with rates ranging from 12.26% (862/7031) in the lowest quartile to 20.10% (1413/7031) in the highest quartile for the SII ( Ptrend <0.001) and 11.92-19.31% for the SIRI ( Ptrend <0.001). The SII and SIRI were positively correlated with GDM risk. The ORs (95% CIs) of the second, third, and fourth SII quartiles were 1.09 (0.98-1.21), 1.21 (1.09-1.34), and 1.39 (1.26-1.54), respectively. The SIRI findings paralleled the SII outcomes. For the second through fourth quartiles, the ORs (95% CIs) were 1.24 (1.12-1.38), 1.41 (1.27-1.57), and 1.64 (1.48-1.82), respectively. These associations were maintained in subgroup and sensitivity analyses. The SII and SIRI are potential independent risk factors contributing to the onset of GDM.

Profile of triple elimination in maternal at Wangaya regional hospital in 2023

Background: Triple elimination is a program implemented by the Ministry of Health of the Republic of Indonesia, this program was adopted from the World Health Program or WHO to combat the transmission of HIV (Human immunodeficiency virus), syphilis and hepatitis B in pregnant women to their babies The aim of this study of this research is to determine the profile of pregnant women who undergo triple elimination testing. Methods: This study was a descriptive observational study with a retrospective study design. The data was collected from the medical records of pregnant women at Wangaya Regional Hospital from January 2023 to December 2023. Results: In this study involving 101 subjects, in this study, there were 65 people who underwent triple elimination examination and 36 people did not undergo triple elimination. These included HIV with 13 cases (12.8%) and hepatitis b with 4 cases (3.9%) and syphilis with 2 cases (1.98%). Conclusions: The triple elimination screening is a mandatory examination for pregnant women conducted during the first trimester of pregnancy. Pregnant women who do not undergo the triple elimination screening may lack knowledge, sufficient information and proper education and communication from healthcare providers about the triple elimination program. Improving these factors will enhance pregnant women's motivation to utilize and access healthcare services.

The Utility of Hypochromic Markers in the Detection of Latent Iron Deficiency in Women in their First Trimester of Pregnancy

Background and Objectives: While iron deficiency anemia is a documented common problem in pregnancy, there is limited information on latent iron deficiency. Accordingly, we aimed to determine the frequency of the latter in the first trimester of pregnancy and assess the utility of new hypochromic markers in screening for it. Methods: In this cross-sectional study, we recruited 100 pregnant women in their first trimester attending the Maternity Hospital in the period between January and March 2023. Inclusion criteria included hemoglobin &gt;11.0 g/dl, and no iron supplements. Serum ferritin was used to classify patients into latent iron deficiency or iron replete state. While a hematology analyzer was used to determine the new hypochromic markers: namely %Hypo-He, Ret-He, % Hyper-He, RBC-He. Results: The mean age of enrollees was 29.3 (SD 5.5) years and included 38% with latent iron deficiency (hemoglobin &gt; 11 g/dl and S. ferritin ? 30 ng/ml). The latter group had significantly lower hemoglobin (P=0.03), and %Hypo-He (P&lt;0.001) than iron replete women. While neither MCV, MCH, reticulocyte counts, Ret-He, or RBC-He were different. Furthermore, %Hypo-He was significantly negatively correlated with serum ferritin (P&lt;0.001) and had a fair discriminating power between latent iron deficiency and iron replete status. Conclusion: High prevalence of latent iron deficiency was documented among pregnant women in their first trimester; Furthermore, %Hypo-He was a better red cell index to screen for it. Because of its high frequency and anticipated impact on fetal and maternal health, routine screening for latent iron deficiency in pregnancy may be warranted.