Pregnant Women In Second Trimester Research Articles

Hemodynamic, ventilatory and gas exchange responses to exercise using a cycle ergometer and the incremental shuttle walk test in pregnant women

BackgroundCardiovascular disease, including hypertension, in pregnant women is a leading cause of morbidity and mortality globally. The development of reference intervals for cardiovascular responses using exercising testing to measure oxygen utilisation (V̇O2) with cardiopulmonary exercise testing (CPET), and distances walked using the incremental shuttle walk test (ISWT), may be promising methods to assess and stratify pregnant women regarding their risk of adverse pregnancy outcomes, to encourage exercise during pregnancy, and to improve exercise prescriptions during pregnancy. We aimed to determine the reference intervals for V̇O2 at rest, anaerobic threshold (AT) and submaximal exercise using CPET, and the reference interval for the ISWT, to develop a correlation equitation that predicts submaximal V̇O2 from the distance walked in the ISWT, and to explore the relationship between hemoglobin (Hb) and ferritin concentration and V̇O2 at AT in women in second trimester. MethodsAfter prospective IRB approval (HREC 15/23) and clinical trials registration (ANZCTR ACTRN12615000964516), and informed written consent, we conducted CPET and the ISWT according to international guidelines in a university associated tertiary referral obstetric and adult medicine hospital, in healthy pregnant women in second trimester (14 to 27 gestational weeks). Hemoglobin and ferritin concentrations were recorded from pathology results in the participants’ medical records at the time of exercise testing. Adverse events were recorded. Results90 participants undertook CPET, 28 of which also completed the ISWT. The mean ± SD age and body mass index (BMI) were 32 ± 3.2 years, and 25 ± 2.7 kg/m2. Median (IQR) gestation was 23 (22,24) weeks. One in four women were 24 weeks or greater gestation. The reference intervals for V̇O2 at rest, AT and submaximal exercise were 2.9 to 5.3, 8.1 to 20.7 and 14.1 to 30.5 mL/kg/min respectively. The reference interval for the ISWT was 218 to 1058 meters.metres. The correlation equation to predict submaximal V̇O2 from the distance walked in the ISWT was submaximal V̇O2 (mL/kg/min) = 0.012*distance walked in ISWT (m) + 14.7 (95% CI slope 0.005 to 0.070, Pearson r = 0.5426 95% CI 0.2126 to 0.7615, P=0.0029). Hemoglobin concentration was positively correlated with V̇O2 at AT (AT V̇O2 (mL/kg/min) = 0.08*Hb (g/L) + 4.9 (95% CI slope 0.0791 to 0.143, Pearson r = 0.2538 95% CI 0.049 to 0.438, P=0.016). There was no linear association between ferritin and submaximal V̇O2 (Pearson r = 0.431 P=0.697). There were no maternal or fetal complications. ConclusionsCPET and ISWT are safe and feasible in women in second trimester including those at or beyond 24 weeks gestation. We have established the reference interval for V̇O2 at rest, AT and submaximal exercise by CPET, the reference interval for the distance walked for the ISWT, and a correlation equation to predict submaximal V̇O2 for use in clinical practice and research. Hemoglobin rather than ferritin is likely correlated with exercise capacity in pregnancy suggesting vigilance to correct lower hemoglobin levels may positively impact maternal health. Clinical trials registryThe study was prospectively registered with the Australian and New Zealand Clinical Date of registration – 15/9/2015; Date of initial participant enrolment - 4/11/2015; Clinical trial identification number; ACTRN12615000964516; URL of the registration site - https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=369216 Prior presentation and published abstract“Oxygen utilization and anaerobic threshold measured using cardiopulmonary exercise testing in healthy pregnant women.” Obstetric Anaesthetists Association Meeting Edinburgh May 2023 Traer E, Ismail H, Leeton L, Bernhard R, Dennis AT. Oxygen utilisation and anaerobic threshold measured using cardiopulmonary exercise testing in healthy pregnant women. International Journal of Obstetric Anesthesia 2023;54: Supplement 1. Article 103659 O7 Traer E, Ismail H, Leeton L, Bernhard R, Dennis AT. “Oxygen utilization and anaerobic threshold measured using cardiopulmonary exercise testing in healthy pregnant women.” Poster presentation, iPOETTS abstract competition. Evidence Based Perioperative Medicine EPBOM World Congress of Perioperative Medicine, July 2023, London, U.K.

Effect of Moringa Oleifera leaves powder on hemoglobin level in second-trimester pregnant women of Karachi, Pakistan.

Background: Anemia, particularly iron-deficiency anemia during pregnancy, has substantial implications for maternal health and fetal growth. Moringa leaves are known to be rich in iron and may offer a dietary solution to combat anemia in pregnant women. However, evidence on the association between fresh Moringa leaf consumption and maternal hemoglobin levels during pregnancy is lacking. Hence, this study aims to assess the impact of Moringa Oleifera leaf powder supplementation on hemoglobin levels during the second trimester of pregnancy in Karachi, Pakistan. Methodology: A community-based comparative cross-sectional study was conducted at Koohi Goth Women's Hospital, Karachi, Pakistan, from November 2021 to May 2023. The study involved 200 pregnant women who consumed fresh Moringa leaves and 200 non-consumers. Data were collected through an interviewer-administered structured questionnaire, and hemoglobin levels were measured using HemoCue Hb 301. Results: The demographic characteristics of the study participants were analyzed, revealing that most participants in both groups were between 20 and 30 years old. Additionally, most participants in both groups were pregnant for the first time. Hemoglobin (Hb) levels were measured across trimesters, with the Moringa leaf extract group showing levels of 9.43 ± 0.62 g/dL in the first trimester, 8.98 ± 1.12 g/dL in the second trimester, and 9.09 ± 1.04 g/dL in the third trimester. The folic iron group exhibited a higher increase in hemoglobin concentration (10.14 ± 0.91 g/dL) compared to the Moringa leaf extract group (8.98 ± 1.12 g/dL), but the difference between the two groups was not statistically significant. Conclusion: In conclusion, iron-rich foods such as Moringa leaves and iron tablets are recommended to enhance hemoglobin levels in pregnant women.

PENGARUH PENGGUNAAN MATERNITY BELT TERHADAP PENURUNAN DERAJAT NYERI PUNGGUNG PADA IBU HAMIL TRIMESTER II

Background: Pregnancy begins at conception and lasts until childbirth. During this period, pregnant women experience both psychological and physical changes that can lead to back pain. The initial cause of back pain is the forward growth of the uterus, which shifts the center of gravity of the earth towards the lower body. To help alleviate back pain in pregnant women, a maternity belt can be used to increase lumbopelvic stability by simultaneously pressing on the sacroiliac joint surface and positioning the sacroiliac joint in a specific position to enhance stability. In this research, before and after the intervention, the level of pain will be measured using the Numeric Rating Scale (NRS). Objective: to determine whether the level of back pain in second-trimester pregnant women decreases after using a maternity belt. Method and Subjects: This study is a quasi-experiment with a pre-test and post-test design. Samples were chosen using purposive sampling. The research instrument used the Numeric Rating Scale (NRS) and was analyzed using the Wilcoxon test with SPSS. Results: The pain scale before using the maternity belt had a minimum value of 3 (mild pain), a maximum value of 6 (moderate pain) with an average of 4.44 (moderate pain), whereas the pain scale after using the maternity belt had a minimum value of 1 (mild pain), a maximum value of 2 (mild pain) with an average of 1.32 (mild pain). Conclusion: There is an effect of using a maternity belt on the reduction of the degree of pain before and after using the maternity belt by 3.12 where p=0.000 (p<0.05)

EVALUATION OF LIPID AND THYROID STATUS IN PREGNANCY AND ITS EFFECT ON NEONATAL OUTCOME

Objective: Maternal nutritional status is essential for the achievement of maternal and fetal growth. Blood lipid concentrations have been associated with adverse pregnancy outcomes such as gestational diabetes, pregnancy-induced hypertension, and high birth weight. As blood lipids are not routinely measured during pregnancy, there is limited information on what is considered normal during pregnancy. In early pregnancy, there is an increase in fat buildup associated with increased fat concentration in blood, lipoprotein, and apolipoprotein in plasma increased significantly during pregnancy. This study was aimed at the analysis of lipid profile and thyroid profile in second- and third-trimester pregnant women, with the incidence of hypertension and their possible effect on neonatal outcome. Methods: Blood samples were collected from the Beri Maternity Hospital, Amritsar, and were analyzed for biochemical investigation, namely lipid profile and thyroid profile. Results: The levels of total cholesterol, triglycerides, high-density lipoprotein (HDL), low-density lipoprotein (LDL), and very LDL have been significantly increased in third-trimester pregnant women as compared to second-trimester pregnant women. However, the level of HDL diminished in the third trimester as compared to the second trimester. Thyroid-stimulating hormone (TSH) levels increased in third-trimester pregnant women. Conclusion: Our findings highlighted the importance of maternal lipid metabolism in preventing pregnancy complications and adverse birth outcomes as human gestation is associated with an “atherogenic” lipid profile which could act as a potential risk factor for pre-eclampsia and endothelial cell dysfunction if further enhanced than the normal limits. Increased blood lipid concentrations during pregnancy are altered by maternal body mass index. This study will help in understanding baseline lipid parameters in the second and third trimesters among pregnant women. Excessive dietary nutrition intake and inadequate physical activity during pregnancy may be important contributors of dyslipidemia which can lead to complications.

The Effects of Pregnancy and Childbirth on Women's Health-Related Quality of Life: A Scoping Review

Context: Although pregnancy and childbearing are the most natural processes for women, it is accompanied by significant life changes for the mother, who needs to adjust to parenting. Hormonal variables cause these changes, resulting in physiological and emotional consequences. Although the changes that pregnant women experience are only transitory, they might affect their quality of life.
 Aim: This scoping review highlight the effect of pregnancy and childbearing on women’s health-related quality of life.
 Methods: A scoping review was completed by searching data converging about pregnancy and childbirth's effects on women's health-related quality of life utilizing databases from 2015-2022 papers. The review was done via different database engines. The research selection procedure uses Mesh keywords to find the most relevant papers, and the PRISMA flowchart helped pick research papers. The search engines were picked from the Saudi digital library and Google Scholar. Three main themes and three subthemes were created in this scoping review. A total of 82 articles were initially retrieved. Twenty-four duplications were removed. Thirty-four articles that did not meet the aim were excluded. The remaining 26 were screened; the non-English, outdated articles, text articles, and more reasons were counted, so another ten articles were removed. So, 14 studies met the criteria and were eligible to be included in this review.
 Results: revealed a correlation between delayed first birth and better health-related quality of life. It is highlighted that physical quality of life-related to maternal age, gestational age, BMI before 12 weeks of pregnancy, mother's education and work, and spouse's education (p<0.05). Psychological quality of life-related to gestational age, mother's education and occupation, and spouse's education. The main characteristics related to greater quality of life were mean maternal age, primiparity, early gestational age, the lack of social and economic issues, having family and friends, exercising, being happy to be pregnant, and being hopeful. Early second-trimester pregnant women had the best health-related quality of life drops in the third trimester. More than half of the participants in the reviewed studies had urinary incontinence as a main pelvic floor disorder. Mothers showed lower gray matter (GM) volumes and higher white matter (WM) volumes in empathy and reward networks. Those who gave birth vaginally reported the highest HRQoL, whereas those who underwent cesareans reported the lowest.
 Conclusion: The study elucidates the fluctuations in quality of life throughout pregnancy, showing its dependence on various demographic and health-related aspects. The nuanced variations and pathological features emerging during pregnancy encompass the impact of morning sickness, sleep patterns, and pelvic floor disorders. The influence of the mode of delivery on women's health-related quality of life emphasizes differences in pain, physical functioning, and mental health between those who undergo cesarean sections and those who have vaginal births. Collectively, these findings underscore the complexity of the maternal experience, calling for a holistic approach to healthcare that addresses the diverse challenges women face during this pivotal life stage.

Epidemiological Survey on Vitamin A, D, E Levels of Pregnant Women in Baoding

Objective: To understand the vitamin levels in pregnant women and its influencing factors and provide a basis for formulating scientific and reasonable vitamin supplement plans for pregnant women. Methods: Pregnant women with a pregnancy period of 12 weeks to 36 weeks in Baoding area were selected as the research subjects using the random sampling method. The sample size is estimated to be 5,000 people, and the diversity of the research subjects, such as age, education level, pregnancy, etc., were recorded through a survey. The content of the survey included the personal information of the research subjects, pregnancy conditions, eating habits, vitamin supplements taken, etc. At the same time, blood tests were carried out on the research subjects to detect indicators such as vitamin levels. Results: The results of serum measurement showed that the vitamin A level of pregnant women was 0.38 ± 0.12 mg/L, the vitamin E level was 13.51 ± 3.17 mg/L, and the vitamin D level was 17.82 ± 4.18 ng/L; the level of vitamin A of pregnant women in the first trimester was significantly lower than those in the second and third trimesters, and the level of vitamin E of pregnant women in second trimester was significantly higher than those in the first and third trimesters, with statistically significant differences (P < 0.05). The rate of vitamin A deficiency in the early stage was significantly higher than that in the middle and late stages of pregnancy, (P < 0.05); vitamin D deficiency existed in all pregnant women. Conclusion: Pregnant women should maintain a reasonable diet and eat more vitamin-rich foods, such as vegetables, fruits, etc.; besides, pregnant women should take vitamin supplements under the guidance of doctors or professionals according to their own conditions; moreover, the publicity and education for pregnant women should be improved with more emphasis on vitamin supplementation.

The Role of Nutrient Intake and Social Determinants in Anemia among Pregnant Women at Lampung Malaria Endemic Areas

Anemia in pregnancy is a health problem, associated with an increased risk of morbidity and mortality during childbirth. The study’s purpose was to determine the role of nutrient intake and social determinants on anemia in pregnancy in the Pesawaran district. This study was an analytic observational study using a cross-sectional design, conducted in malaria-endemic areas, Pesawaran district, Lampung, from June to Desember 2021. The sample was 75 pregnant women in second trimester, taken by purposive sampling technique. Anemia was measured by examining haemogobins, data on education, family income, age, and parity were obtained from interviews, maternal knowledge using questionnaires, and food intake using a 2x24-hour food recall questionnaire. Data were analyzed univariate, bivariate, and multivariate. The results showed that anemia in pregnancy was 42,7%. Most of the pregnant women are poorly educated (50,7%), have poor knowledge (64%), sufficient income (53,3%), multiparous (68%), good age (64%), inadequate energy intake (72%), inadequate protein intake (58,7%), and inadequate iron intake (56%). The results showed that education (p=0.003), knowledge (p=0.015), income (p=0.009), parity (p=0.004), age (p=0.004), energy intake (p=0.02), protein intake (p = 0.025), and iron intake (p=0,031) has a role on anemia in pregnancy. The factors that most play a role are education, income, parity, and iron intake.

Feasibility and Acceptability of a Mindfulness-Based Smartphone App among Pregnant Women with Obesity.

Maternal obesity is associated with an increased risk for prenatal depressive symptoms. Mindfulness-based interventions (MBIs) have been shown to reduce the risk of prenatal depression. This pilot study assesses the feasibility and acceptability of a smartphone-based MBI among pregnant women with obesity, and its potential for improving maternal mental and behavioral health outcomes. Five second-trimester pregnant women with a prepregnancy body mass index > 30 kg/m2 participated in a 30-day audio-guided mindfulness practice using the Headspace app. All participants engaged in the pregnancy module, while three concurrently engaged in the mindful eating module. Daily engagement with the app was tracked and a post-trial survey assessed maternal acceptability. Validated pre- and post-trial questionnaires explored changes in perceived stress, anxiety, depression, and eating habits. All participants completed the study with varying levels of adherence to the prescribed daily practice; the average number of days of engagement was 23/30 (77%) for the pregnancy module and 20/30 (67%) for the mindful eating module. All subjects reported some degree of perceived benefit, and none reported negative experiences. Trends were observed for improvements in maternal mental wellbeing and eating behaviors. This pilot study shows that a smartphone-based MBI is feasible, acceptable, and perceived to provide benefit among pregnant women with obesity.

Effects of Gravidity on Atherogenic Indices in Normotensive and Hypertensive Second Trimester Pregnant Women

Background: Pregnancy results in certain physiological and metabolic changes that results to shift in certain biochemical markers and could even result in hypertension in some women thus predisposing them to risk of cardiovascular disease. While this is true, some women express these predisposing risk factors in subsequent pregnancies. Therefore, it may be a significant contribution to understand the dynamics of artherogenic indices with increasing number of pregnancies.
 Aim: The goal of the study was aimed to assess gravidity effect on artherogenic indices in both normotensive and hypertensive second-trimester pregnant women.
 Materials and Methods: At Rivers State University Teaching Hospital, a cross-sectional study was carried out with 100 pregnant women. The consenting patients who met the inclusion criteria were classified into two groups: normotensive (50 normotensive pregnant women in their second trimester) and hypertensive (50 hypertensive pregnant women in their second trimester) (HPW2T). The participants were subsequently split into three subgroups depending on gravidity: primigravida (no of pregnancy=1), multigravida (no of pregnancies>1), and grand multigravida (no of pregnancies≥5). For the assessment of TC, TG, HDL, and LDL, fasting blood samples were taken using the venepuncture technique. Mathematically, artheriogenic indices (AIP, CR-I, CR-II, AC, and APoB/APoA1) were calculated. At a P-value>0.05, the data was examined using ANOVA and the Tukey comparison test.
 Results: There was no significant difference in artheriogenic indices between the gravidity groups in the normotensive group, with a P-value>0.05, which was also the cases among those in the hypertensive group.
 Conclusion: The study has shown that gravidity does not have any effect on artheriogenic indices among normotensive and hypertensive pregnant women in the second trimester in Rivers State University Teaching Hospital.

Effect of moringa leaf capsules and fe administration to increase hemoglobin levels, weight, and upper arm circumference (LILA) in trimester II pregnant women with chronic energy deficiency (KEK)

Moringa leaves are nutrient-rich plants that increase hemoglobin (Hb) levels, nutritional intake, and nutritional status. Therefore, this research aims to determine the effect of administering Moringa leaf capsules and Fe to increase hemoglobin levels, body weight, and upper arm circumference (LILA) in second-trimester pregnant women suffering from chronic energy deficiency (KEK). It was carried out for 2 months in the working area of the Banabungi Public Health Center, Buton Regency, Indonesia. The method adopted was an experimental design using a double-blind randomized controlled trial with a pre and post-test as well as a control group pattern. The samples were 34 second-trimester pregnant women suffering from KEK and divided into 2 groups, namely Moringa capsules + Fe (n=17) and Fe (n=17). The data were analyzed using the Chisquare, Paired, and Independent T-Test. The analysis was conducted based on the characteristics of the majority of the samples aged from 20 to 35 years, gravida, higher education, work, and income less than the minimum wage with a p-value > 0.05. The results showed a significant increase in hemoglobin levels in the Moringa leaf capsule group + Fe from 9.47 ± 2.11 to 11.67 ± 1.32 p = 0.001.

Role of Beta Cell Function and Insulin Resistance in the Development of Gestational Diabetes Mellitus.

Background: Gestational diabetes mellitus (GDM) is a pregnancy complication characterized by second trimester hyperglycemia. Untreated, GDM is related to an increased risk for adverse pregnancy outcomes. Both beta cell dysfunction and insulin resistance underlie impaired glucose tolerance. Understanding the dominant mechanism predisposing to GDM may be important to provide effective treatment in order to improve perinatal outcomes. We hypothesize that insulin resistance rather that beta cell dysfunction predisposes to GDM. Methods: A 75g oral glucose tolerance test (OGTT) was performed on 2112 second-trimester pregnant women to determine the relationship between insulin resistance (HOMA-IR), beta cell function (HOMA-β), and the prevalence of abnormal glucose handling. Results: High insulin resistance raised the risk of GDM (relative risk (RR) 6.1, 95% confidence interval (CI) (4.4–8.5)), as did beta cell dysfunction (RR 3.8, 95% CI (2.7–5.4)). High insulin resistance, but not beta cell function, enhances the necessity for additional glucose lowering medication on top of a low carbohydrate diet in women diagnosed with GDM. Conclusions: Both high insulin resistance and beta cell dysfunction increase the risk of GDM. As increased insulin resistance, rather than beta cell function, is related to an insufficient response to a low carbohydrate diet, we speculate that insulin sensitizers rather than insulin therapy may be the most targeted therapeutic modality in diet-insensitive GDM.

Combined quantitative detection of IGFBP-- 1/fFn for predicting premature rupture of membranes and preterm delivery

Objective: To evaluate the clinical value of IGFBP-1 and fFN in preterm birth prediction. Method: Second-trimester pregnant women who choose to come to our hospital for pregnancy check-screening. Results: The combined detection of IGFBP-1 and fFN was consistent with the clinical diagnosis .Conclusion: fFN and IGFBP-1 are effective indicators for predicting premature rupture of membranes and preterm birth, and the combined application can maximize the diagnostic coincidence rate.

COVID-19 Lockdown Increased the Risk of Preterm Birth.

Purpose: To estimate whether the city-specific lockdown in Shanghai induced by the COVID-19 pandemic affected preterm birth rates among uninfected pregnant women in different trimesters.Methods: The population-based retrospective cohort study was conducted in the International Peace Maternity and Child Health Hospital (IPMCH) in Shanghai, China. Pregnant women without COVID-19 received perinatal healthcare during lockdown (from January 24, 2020 to March 24, 2020) and non-lockdown (from January 24, 2019 to March 24, 2019) period and giving birth to a live infant at IPMCH were enrolled. 1:1 propensity score matching and Inverse probability of treatment weighting were used to evaluate preterm birth (<37 weeks), very preterm birth (<34 weeks), preterm birth with premature rupture of membranes (PROM-PTB), spontaneous preterm birth with intact membranes (S-PTB), and medically induced preterm birth (MI-PTB) between two groups.Results: 8,270 pregnant women were in the lockdown group, and 9,815 were in the non-lockdown group. Pregnant women in second trimester during lockdown had a higher risk of PTB than those during the non-lockdown period [OR: 1.43 (CI 1.01–2.02), ARD: 1.7% (CI 0.04–3.4%), p = 0.045]. Furthermore, pregnant women in third trimester during lockdown had a higher risk of PROM-PTB than those during the non-lockdown period [OR: 1.64 (CI 1.09–2.47), ARD: 0.9% (CI 0.2–1.6%), p = 0.02]; no group differences were found related to rates of VPTB, S-PTB or MI-PTB.Conclusion: In this cohort study in China, we found that there was an increased risk in preterm birth for non-infected women in COVID-19 lockdown who were in their second trimester.

THE RELATIONSHIP OF SOCIAL SUPPORT WITH THE DEGREE OF NAUSEA AND VOMITING IN PREGNANCY

Abstract Background : At the beginning of a pregnancy the mother experiences various processes of transition or adaptation regarding changes in herself, so that she really needs support from her environment. Lack of social support can worsen the physiological complaints of pregnant women including Nausea and Vomiting in Pregnancy (NVP). Complaints of nausea and vomiting can affect the mother in carrying out daily activities, affect the mother's social situation with the environment and cause stress. Therefore, it is important to research the relationship between social support and the degree of nausea and vomiting in first and second-trimester pregnant women. Method : This research method is observational analytic with cross sectional research design. Sampling used the total sampling method with the criteria of pregnant women who had complaints of nausea and vomiting. Collecting data using primary data using a 24-hour PUQE questionnaire that measures the duration and frequency of nausea and vomiting and the MSPSS questionnaire measuring social support. The data collected were analyzed using the Spearman test (p&lt;0.15). Results : Out of 47 respondents, 34 pregnant women (72.3%) received high social support. Besides that, 24 out of 47 respondents (51.1%) experienced moderate degree of NVP. In this study, there were no respondents who experienced severe degree of NVP. Spearman test analysis results obtained p= 0.833 or p&gt;0.15. Conclusion : There is no relationship between social support with NVP in first and second trimester of pregnancy.

Steroid profile analysis by liquid chromatography-tandem mass spectrometry in second-trimester pregnant women for trisomy 21 screening

BackgroundTrisomy 21 is a serious chromosome abnormality. The conventional Down’s screening test is the most widely used for trisomy 21 screening. However, this method could lead to a higher false positive rate. Therefore, we aim to analyze steroid profile in second-trimester pregnant women and identify novel serum biomarkers of trisomy 21. MethodsWe employed an LC–MS/MS method to measure the steroid profile. The concentrations and product-to-substrate ratios in 71 second-trimester pregnant women were determined and statistically analyzed to identify novel biomarkers for trisomy 21 screening. ResultsWe found that there were significant differences in levels of E3, 11-deoxycortisol, and 11-deoxycortisol /17-hydroxyprogesterone between two groups. The OPLS-DA plots revealed obvious separation between two groups. Combining VIP analysis (VIP > 1.0) with volcano plot (P < 0.05 and fold change >1.2 or < 0.83), 11-deoxycortisol was identified as a novel biomarker for trisomy 21. After controlling for confounders, we found 11-deoxycortisol was associated with trisomy 21 (adjusted P = 0.009), and the fully adjusted OR (95 % CI) was 0.098 (0.016−0.593) in highest quartile versus lowest quartile of 11-deoxycortisol (P = 0.011). ConclusionsSteroid profile analysis for the first time showed that steroid hormones perturbations occurred in pregnant women carrying a fetus affected by trisomy 21 and decreased 11-deoxycortisol levels were associated with trisomy 21.

Relationship of the lunar cycle with Down's syndrome screening and its effects.

The present study aimed to analyze the positive rate of Down syndrome in second-trimester pregnant women in 1 lunar cycle and calculate variation coefficients of daily person numbers and daily positive rates in this population so as to explore the relationship of the lunar cycle with Down syndrome screening and its effects.Data and laboratory results of 51,450 second-trimester pregnant women who underwent Down syndrome screening between May 2013 and June 2017 of the Chinese lunar calendar were collected. The patients were allocated into groups according to the time period of the lunar cycle based on the start date of their last menstruation. In the Chinese lunar calendar, 1 lunar cycle is divided into eight time periods. The positive rate of Down syndrome in pregnant women with the same start date of last menstruation and changes in their variation coefficients of daily person numbers and daily positive rates were analyzed.The findings displayed the lowest positive rate of Down syndrome in the group of pregnant women who had the start date of last menstruation within the full-moon time period. The greatest variation coefficients of daily person numbers and daily positive rates were also found in the same group.The study showed that the moon indeed affected pregnant women, and the effect reached the peak by the full moon. The effect interfered with the body homeostasis of pregnant women to a certain degree. Therefore, the relationship of the lunar cycle with Down syndrome screening reflected the interaction of the moon with the homeostasis of pregnant women.

Studies on serum soluble endoglin: An indicator for preeclampsia

Introduction: To study the concentration of serum soluble endoglin during second trimester pregnancy and monitor for the development of preeclampsia. Materials and Methods: Seventy-five healthy singleton pregnant women in second trimester was evaluated in this study. ELISA technique was used for measuring the concentration of Serum soluble endoglin. Patients with increased level of serum endoglin were monitored for signs and symptoms of preeclampsia. Result: Thirty five pregnant women developed preeclampsia among 75 pregnant women. The mean value for sENG in cases was 8.7 ± 1.4 and control 5.9 ± 0.6. The normal value of serum sENG varies from 2.54 to 7.06 ng/ml. Hence, it is higher than the normal limit in cases. Conclusions: The concentration of sENG was studied and women were monitored for development of preeclampsia. The present study showed that women with increased serum soluble endoglin levels developed preeclampsia later. Hence, it is suggested that soluble endoglin will be useful in predicting pre eclampsia. Keywords: Endoglin, Preeclampsia, ELISA, sENG.

The EFFECTIVENESS OF UTERINE MULTI- MICRONUTRIENT SUPPLEMENTATION COMPARED WITH BLOOD- BOOSTING TABLETS TO THE LEVEL OF MMUNOG LOBULINE G IN PREGNANT WOMEN TRIMESTER II ANEMIA

The need for nutrients intake during pregnancy is very important to determine the quality of a child in the future. Several micronutrients take a key role for stimulating the immune system . Zinc is the most important one. This study aims to evaluate the effect of multi micronutrient (MMN) on immunoglobulin G levels of the anemic pregnant women in Second trimester, compared to iron folic acid (IFA). A single blind randomized controlled trial was conducted in Surabaya City. The samples size of 30 pregnant women were randomly allocated into two groups or 15 pregnant women in each group. Control group received iron folic acid , and the treatment group received multi micronutrient UNIMMAP formula. Either IFA or MMN was consumed daily for one month. Statistics analysis was done using Chi square test on data (age, education, income), paired t test , independent t test and the data are not normally distributed then use Mann Whitney. The results showed no significant difference in immunoglobulin G level between the two groups. It can be concluded that the administration of multiple micronutrients (MMN) cannot increase immunoglobulin G in pregnant women with anemia, this is probably due to consumption of macro nutrients that are poor compared to daily needs during pregnancy. &#x0D;

Beta-amyloid peptides(1\u201342) and (1\u201340) in the cerebrospinal fluid during pregnancy: a prospective observational study

To evaluate changes in concentrations of selected biomarkers, neurotrophic factors, and growth factors in the cerebrospinal fluid during pregnancy. A prospective observational study was conducted in 32 pregnant women undergoing gynecological and obstetrical surgery under spinal anesthesia in a university hospital. Beta-amyloid(1–42) and beta-amyloid(1–40) peptides, brain-derived neurotrophic factor, glial cell line-derived neurotrophic factor, and vascular endothelial growth factor were analyzed in cerebrospinal fluid using an enzyme-linked immunosorbent assay. Eight women in second trimester pregnancy who underwent spinal anesthesia for gynecological or obstetrical surgery were compared with 24 matched women in third trimester pregnancies. CSF concentrations of beta-amyloid(1–42) were significantly higher in third trimester pregnancies (p = 0.025). During third trimester, the beta-amyloid ratio correlated with the vascular endothelial growth factor (rs = 0.657; p = 0.008). Higher concentrations of beta-amyloid(1–42) in cerebrospinal fluid of third trimester pregnancies and correlations between the beta-amyloid ratio and the vascular endothelial growth factor support the hypothesis that beta-amyloid peptides are involved in complex adaptive brain alterations during pregnancy.

The Combination of Benson Relaxation and Pelvic Tilting on the Scale of Low Back Pain in Pregnant Women

Introduction: Lower back pain in pregnant women trimester II and III causes difficulty in standing or even moving from bed, and the lousy impact is difficulty in walking if it has spread to the lumbar or pelvic region. The study aimed to know the effects of the combination of Benson relaxation and pelvic tilting on back pain in pregnant women.Methods: The research was Quasi-experiment. The population is second-trimester pregnant women who experience lower back pain in the Public Health Center Mojo and Public Health Center Gading, Surabaya. Purposive sampling was used to gain 56 respondents. The independent variable of this study was the second trimester pregnant women with low back pain treated for two weeks. The dependent variable was the intensity of the pain level. Research data obtained by pre-test and post-test with VAS questioner. Analyzed using the Wilcoxon sign rank test and Mann- Whitney test.Results: As a result of the combination of Benson's relaxation and pelvic tilting, there was an influence on the back pain of second-trimester pregnant women. Based on the Mann-Whitney test, there were significant differences in the treatment group or the control group with p = 0.000.Conclusion: The combination of Benson relaxation and pelvic tilting decreases the scale of low back pain in pregnant women. Pelvic tilting is more influential because it can reduce the pain scale.