Profile Of Pregnant Women Research Articles

Peculiarities of blood flow in the uterine arteries, factors of angiogenesis, hormonal profile and their relationships in pregnant women with hypertension

The objective: to assess and establish the relationships between Doppler blood flow indicators in the uterine arteries, angiogenesis factors and hormones of the mother-placenta-fetus system in pregnant women with arterial hypertension I-II degree.Materials and methods. A prospective study of 88 pregnant women at 11–12 weeks of gestation was carried out: 61 pregnant women with chronic arterial hypertension (CH) of the I–II degree (main group) and 27 healthy pregnant women with physiological pregnancy (control group). All patients have been examined: blood flow Doppler in the left and right uterine arteries – pulsation index (PI), resistance index (IR) and systolic-diastolic ratio (SDR). Chorionic gonadotropin (HCG), progesterone (PG), estradiol (E) and angiogenesis indices (placental growth factor (PlGF) as a pro-angiogenic factor) and placental-soluble fms-like tyrosine kinase (sFlt-1) as an anti-angiogenic factor and the ratio of sFlt-1/PlGF) were determined in blood. Statistical analysis was performed using the program “STATISTICA 13”.Results. There was no statistically significant difference in SDR and IP indicators between the groups. PI values in the right uterine artery in pregnant women of the main group were significantly higher than the indicator of healthy pregnant women (1.73 (1.65; 1.8) units versus 1.33 (1.1; 1.49) units, respectively). The PI values in the left uterine artery in pregnant women with CAH also significantly differed from those in women with the physiological course of pregnancy (1.7 (1.66; 1.79) units and 1.35 (1.22; 1.51) units, respectively). A significant correlation between SDR indicators and markers of angiogenesis and hormonal profile in women of the main group has not been established. In pregnant women with CAH, an inverse relationship was observed between PI and PlGF (mean strength R=-0.34 for PI in the right uterine artery and R= -0.41 for PI in the left uterine artery), respectively, between PI and sFlt-1/PlGF – direct relationship (average strength R=+ 0.37 for PI in the right uterine artery and R=+0.43 for PI in the left uterine artery). In women with the physiological course of pregnancy and childbirth, the PI value in the right uterine artery correlated with the sFlt-1/PlGF ratio (direct relationship) and PlGF level (feedback). PI in the left uterine artery had a direct relationship with the value of the sFlt-1/PlGF ratio. In pregnant women with CAH, the PlGF level decreases, while the PI value, on the contrary, increases.Conclusions. The significant differences between the indicators of SDS and IR in pregnant women with CAH and pregnant women without CAH have not been established. In women with CAH, significantly higher PI values were found in the right and left uterine arteries compared to those in women without CAH. The course of pregnancy in women with CAH is accompanied by a shift in the balance between pro- and anti-angiogenic factors, as evidenced by a statistically significant increase in sFlt-1 level against the background of a decrease in PlGF level, as well as a corresponding increase in the sFlt-1/PlGF ratio as compared with pregnant women without CAH. There are no correlations between indicators of SDR and IR in the uterine arteries, markers of angiogenesis and hormonal profile in pregnant women with and without CAH. Nevertheless, PI values in the right and left uterine arteries correlate with the PlGF level (feedback) and the sFlt-1/PlGF ratio (direct relationship) in pregnant women with CAH. This indicates the presence of disorders in this contingent of women in the I trimester of pregnancy.

DAMPs are able to skew CD4+ T cell subsets and increase the inflammatory profile in pregnant women with preeclampsia

Preeclampsia (PE) is characterized by abnormal activation of the immune system. The intense systemic inflammatory reaction, could be related to the presence of molecules released after cell stress or death, that are capable of inducing inflammation and are known as damage-associated molecular patterns (DAMP). This study evaluated the profile of T cells through the analysis of transcription factors and the cytokines produced after culture with or without DAMPs: heat shock protein 70 (Hsp70), hyaluronan (HA) and monosodium urate (MSU). Twenty pregnant women with PE, 20 normotensive (NT) pregnant women and 20 non-pregnant (NP) women were studied. The results showed polarization toward Th1/Th17 and a decrease in Th2/Treg profiles in preeclamptic women associated with elevated levels of TNF, IFN-γ, and IL-17A and diminished levels of TGF-β1 and IL-10 when compared to the normotensive group. In addition, preeclamptic women had a higher percentage of cells co-expressing T-bet/GATA-3 and T-bet/RORγt and fewer T-bet/FoxP3 cells when compared to normotensive group. MSU induced an increase in IFN-γ and IL-22 in all studied groups. MSU, HA, and Hsp70 induced significant higher production of TNF in the PE and NP groups. The PE group showed elevated levels of TGF-β1 after incubation with MSU, HA, and Hsp70, whereas HA and Hsp70 decreased TGF-β1 production in NT group. The results suggest that these alarmins may play a role in the activation of innate and adaptive immune systems by skewing CD4 + T cells and increasing the release of inflammatory cytokines, thereby contributing to the pathogenesis of this important syndrome.

Cyclosporine A to Treat Unexplained Recurrent Spontaneous Abortions: A Prospective, Randomized, Double-Blind, Placebo-Controlled, Single-Center Trial.

BackgroundThe World Health Organization (WHO) has defined Unexplained Recurrent Spontaneous Abortion (URSA) as three and more consecutive miscarriages before the 20th week of gestation. To date, empiric therapy for patients with unexplained recurrent pregnancy loss (URPL) is not precise. Studies have shown that URSAs are associated with Th1/Th2 and Th17/Treg immune imbalances at the maternal-fetal interface. The immunosuppressant cyclosporine A (CsA) is widely used in patients with organ transplantation or autoimmune diseases, and it has a good safety profile in pregnant women. However, high-quality evidence for CsA treatment of URSAs is lacking. Our purpose with this study is to evaluate the efficacy and safety of CsA for improving pregnancy outcomes in patients with URSAs and to explore the role of CsA in regulating the immune balance.Methods/DesignWe expect to officially initiate our study at the Taizhou People’s Hospital in March 2022. We defined the live birth rate as the primary outcome, and the secondary outcomes include the rates of successful pregnancy, miscarriage, pregnancy complications, and adverse pregnancy outcomes, and newborn birth weights. Patients who meet URSA eligibility criteria will be randomized in a 1:1 ratio into either a study group receiving CsA 2 weeks after fertilization or a control group receiving placebo at 2 weeks after fertilization (the women in both groups will receive the relevant treatment for 6 months). In addition, we will collect peripheral blood samples of the participants before and after the treatments, and we will isolate mononuclear cells and measure cytokine levels (IFN-γ, TNF-α, IL-2, IL-10, IL-6, IL-4) and Th1/Th2, Th17/Treg ratios.DiscussionThis is the first randomized controlled trial to evaluate the clinical and immunomodulatory effects of CsA on the pregnancy outcomes of women with URSA and our results will provide evidence to evaluate the use of CsA as a treatment for women with URSAs.

Lead exposure and serum metabolite profiles in pregnant women in Mexico City

BackgroundLead (Pb) exposure is a global health hazard causing a wide range of adverse health outcomes. Yet, the mechanisms of Pb toxicology remain incompletely understood, especially during pregnancy. To uncover biological pathways impacted by Pb exposure, this study investigated serum metabolomic profiles during the third trimester of pregnancy that are associated with blood Pb and bone Pb.MethodsWe used data and specimens from 99 women enrolled in the Programming Research in Obesity, Growth, Environment, and Social Stressors birth cohort in Mexico City. Maternal Pb exposure was measured in whole blood samples from the third trimester of pregnancy and in the tibia and patella bones at 1 month postpartum. Third-trimester serum samples underwent metabolomic analysis; metabolites were identified based on matching to an in-house analytical standard library. A metabolome-wide association study was performed using multiple linear regression models. Class- and pathway-based enrichment analyses were also conducted.ResultsThe median (interquartile range) blood Pb concentration was 2.9 (2.6) µg/dL. Median bone Pb, measured in the tibia and patella, were 2.5 (7.3) µg/g and 3.6 (9.5) µg/g, respectively. Of 215 total metabolites identified in serum, 31 were associated with blood Pb (p < 0.05). Class enrichment analysis identified significant overrepresentation of metabolites classified as fatty acids and conjugates, amino acids and peptides, and purines. Tibia and patella Pb were associated with 14 and 8 metabolites, respectively (p < 0.05). Comparing results from bone and blood Pb, glycochenodeoxycholic acid, glycocholic acid, and 1-arachidonoylglycerol were positively associated with blood Pb and tibia Pb, and 7-methylguanine was negatively associated with blood Pb and patella Pb. One metabolite, 5-aminopentanoic acid, was negatively associated with all three Pb measures.ConclusionsThis study identified serum metabolites in pregnant women associated with Pb measured in blood and bone. These findings provide insights on the metabolic profile around Pb exposure in pregnancy and information to guide mechanistic studies of toxicological effects for mothers and children.

Profile of abortion seekers in the tertiary center of northern hills with review of medical termination of pregnancy act in India

The aim of the present study was to investigate the socio-demographic and obstetric profile of pregnant women, seeking medical termination of pregnancy in accordance with the Medical Termination of Pregnancy (MTP) Act and the reasons for undergoing termination of pregnancy in the tertiary care center of the hilly region of Northern India and to further review the amendments in the Medical Termination of Pregnancy Act 1971 along with its future implications in legalizing abortions in India.&#x0D; Materials and Methods: A registry-based retrospective study was carried out among pregnant women, attending the gynecologic outpatient department for termination of pregnancy at the tertiary care teaching hospital and the referral center for Himalayan foothills in Northern India. The records of women, seeking termination of pregnancy during a 1-year period between October 2020 and September 2021, were reviewed and information on their demographic and obstetric profile, reason for undergoing termination of pregnancy, and acceptance of contraception, following termination of pregnancy was recorded in the data sheet. The information obtained was analyzed using SPSS version 20 (IBM, Chicago, USA) for descriptive statistics.&#x0D; Results: A total of 400 pregnant women underwent Medical Termination of Pregnancy between October 2020 and September 2021. 30.5 % (122/400) women between 26–30 years of age underwent termination of pregnancy, followed by 27.3 % women aged between 31–35 years. Social reasons for termination of pregnancy were more evident in women aged 26 years and above. 84.09 % pregnancies were terminated in the second trimester (&gt;12 weeks) on eugenic ground, while 65.01 % pregnancies were terminated in the first trimester (6–12 weeks) on social grounds. Only 7.75 % (31/400) women opted for sterilization or family planning after MTP, out of which the majority opted for temporary methods of contraception.&#x0D; Conclusion: We conclude from the results of the present study that women in the peak reproductive age (26–30 years) are more likely to seek pregnancy termination and this group of women needs to be the focus of contraceptive counseling and family planning services. Timely ultrasound scans by an expert sonologist may be a step forward towards lowering the rates of late pregnancy termination. There is a need to educate women to avail and use contraceptive methods in an effective manner and to make them aware of utilizing sterilization services, once they complete their families to avoid unwanted pregnancies.

Associations of Diet with Cardiometabolic and Inflammatory Profiles in Pregnant Women at Risk for Metabolic Complications.

Dietary intakes play an important role in the development of metabolic complications during pregnancy. While reported observational studies reveal an inverse association of healthy diets with weight gain, gestational diabetes, and hypertensive complications during pregnancy, there is a paucity of studies conducted among women of specific ethnicities vulnerable to higher risks of pregnancy complications. This is a secondary cross sectional analysis using baseline data from a previously reported clinical trial. We aim to identify associations of maternal habitual dietary intakes with cardiometabolic risks and inflammatory profiles in primarily African American (AA) and Hispanic women in the first half of pregnancy. Fifty-two women met the study criteria and anthropometric, clinical, and dietary data were obtained at baseline. Linear regression analysis was used to determine associations after covariate adjustments. Among the maternal dietary nutrient intakes, total fats were positively associated with maternal body weight, BMI, and serum CRP (β ± SE: 0.25 ± 0.13, 0.28 ± 0.18, and 0.29 ± 0.14, respectively, all p < 0.05), and saturated fats were positively associated with glycated hemoglobin (0.32 ± 0.12). Dietary fiber intake showed a consistent inverse association with body weight (−0.26 ± 0.13), BMI (−0.19 ± 0.15), glycated hemoglobin (−0.22 ± 0.16), as well as serum CRP (−0.19 ± 0.14). Among the maternal food group intakes, dairy intake was inversely associated with systolic blood pressure (−0.18 ± 0.15) and serum IL-6 (−0.22 ± 0.17), and vegetable intake showed an inverse association with serum CRP (−0.17 ± 0.12) all in adjusted analyses (all p < 0.05). Thus, maternal diet modifications, especially decreasing fats and increasing fiber and dairy may help address obesity and inflammation leading to pregnancy complications in AA and Hispanic women.

Body Image During Pregnancy in the Era of Coronavirus Disease 2019: The Role of Heterogeneous Patterns of Perceived Social Support.

Objective: The aim of this study was to explore the profiles of pregnant women on perceived social support with regard to sociodemographic variables, coronavirus disease 2019 (COVID-19)-related distress issues, and body image. We compared the aforementioned relationships within the study variables between pregnant women and a control group of non-pregnant women.Method: The study sample comprised 345 women, 157 pregnant women, and 188 women in the control group. Participants filled out paper-and-pencil or online psychometric questionnaires to assess the variables analyzed in our research.Results: Latent profile analysis revealed six profiles of pregnant women based on perceived social support, which varied in terms of body image evaluation. The high-support profile differed from the profiles with the lowest scores in all support domains. Significant differences in body image between the profiles of pregnant women and the control group were noted.Conclusion: Understanding the mechanisms through which women can attain more body satisfaction during pregnancy is an important research topic that can inspire planning for more effective psychological help, especially in the context of the COVID-19 pandemic and related psychological distress.

Relationship between anaemia, coagulation parameters during pregnancy and postpartum haemorrhage at childbirth: a prospective cohort study

ObjectivesTo investigate the association between coagulation parameters and severity of anaemia (moderate anaemia: haemoglobin (Hb) 7–9.9 g/dL and severe anaemia: Hb <7 g/dL) during pregnancy and relate these to postpartum...

Nutritional, Anthropometric and Sociodemographic Factors Affecting Fatty Acids Profile of Pregnant Women’s Serum at Labour—Chemometric Studies

Diet influences the health of pregnant women and their children in prenatal, postnatal and adult periods. GC-FID fatty acids profile analysis in maternal serum and a survey of dietary habits were performed in 161 pregnant patients from the II Faculty and Clinic of Obstetrics and Gynaecology of the Medical University of Warsaw. Their diet did not fulfil all nutritional recommendations regarding dietary fat sources. Olive and rapeseed oil were the most popular edible oils. High usage of sunflower oil as well as high consumption of butter were also observed, whereas fish and fish oil intake by pregnant women was low. A chemometric approach for nutritional data, connected with anthropometric, sociodemographic and biochemical parameters regarding mothers and newborns, was conducted for diet and its impact estimation. It revealed four clusters of patients with differing fatty acids profile, which resulted from differences in their dietary habits. Multiparous women to a lesser extent followed dietary recommendations, which resulted in deterioration of fatty acids profile and higher frequency of complications. Observed high usage of sunflower oil is disquieting due to its lower oxidative stability, whereas high butter consumption is beneficial due to conjugated linoleic acids supply. Pregnant women should also be encouraged to introduce fish and fish oil into their diet, as these products are rich sources of long chain polyunsaturated fatty acids (LC PUFA). Multiparous women should be given special medical care by medical providers (physicians, midwifes and dietitians) and growing attention from the government to diminish the risk of possible adverse effects affecting mother and child.

A study of biochemical parameters in pregnant women in III trimester with non-alcoholic fatty liver disease (NAFLD)

Introduction and Aim: Non-alcoholic fatty liver disease (NAFLD) is one of the common causes of liver cirrhosis among general population.Studieshave identified NAFLD and evaluated lipid profile in pregnant women. Some have explored association that existed between lipid levels and adverse pregnancy outcome in western countries. Our aim was to find the prevalence of non-alcoholic fatty liver disease (NAFLD) in pregnant women among rural population in their III trimester and to assess dyslipidemia in these women.&#x0D; &#x0D; Materials and Methods: This is a prospective study conducted on 101 rural pregnant women coming for antenatal visits in their third trimester to Dept.,of Obstetrics and Gynaecology,PESIMSR, Kuppam.Liver scan was done during the regular obstetric scan to identify NAFLD. All pregnant women underwent lipid profile testing (Triglyceride,Total Cholesterol, HDL,LDL,VLDL).&#x0D; &#x0D; Results: There was a 1% prevalence of NAFLD among 101 rural expectant mothers.Lipid profile significantly (p&lt;0.05)increased with increased BMI, parity and highly educated and fairly good socioeconomic background. Women with higher body mass index and triglyceride levels delivered babies with large birth weight(p&lt;0.05).&#x0D; &#x0D; Conclusion: There are metabolic derangements in pregnant women leading to dyslipidemia even among those who did not have NAFLD. High parity women and those with high atherogenicity are at cardiovascular risk diseases in future. We suggest further studies to establish biological reference ranges for lipid profile during pregnancy. There is a need for, pregnant women to be assessed for dyslipidemia and screened for NAFLD by scanning liver along with routine obstetric scan in tertiary care centre.

Vaginal Bacterial Profile in Pregnant Women

Summary This study aimed to determine the bacterial profile of vaginal samples from pregnant women and the prevalence of identified microorganisms. Materials and methods: A prospective epidemiological study was conducted on 150 pregnant women admitted to the Clinic of Obstetrics and Gynecology at Dr. G. Stranski University Hospital in Pleven. Vaginal secretion samples were collected from all the 150 women. Direct microscopy of native smears prepared by the wet mount method to detect Trichomonas vaginalis and direct microscopy of Gram-stained smears was performed. Aerobic culture studies were conducted to identify pathogenic bacteria and Sabouraud glucose agar (SGA) to detect the presence of Candida spp. Samples were also collected from 107 of the women for PCR tests for mycoplasma detection. Results: The highest relative share in the study was women aged 21 to 35 years 104 (69.33%). Of all the hospitalized and examined pregnant women, 87 (57.99%) had medical problems during the current pregnancy and postpartum complications, and 63 women (42%) gave birth without accompanying complications. In 86 (57.32%) of the women, bacteria were detected by direct microscopy of Gram-stained smears. Of these, 24 (16%) had gram-negative rods, 28 (18.66%) had gram-positive cocci. In 34 (22.66%), we found gram-negative and gram-variable pleomorphic bacteria. The aerobic culture study revealed microbiological growth in 44 (29.33%) of the women investigated. Conclusions: Studies on the profile of the vaginal microbiota in pregnant women and the spread of pathogenic microorganisms are essential for make prognoses for pregnancy outcome, evaluating the risk of developing a maternal-fetal infection, and discussing options for timely treatment.

Implications of SCFAs on the Parameters of the Lipid and Hepatic Profile in Pregnant Women.

Short-chain fatty acids (SCFAs) are the product of the anaerobic intestinal bacterial fermentation of dietary fiber and resistant starch. An abnormal intestinal microbiota may cause a reduction in the production of SCFAs, which stimulate the development of intestinal epithelial cells, nourish enterocytes, influence their maturation and proper differentiation, reduce the pH, and are an additional source of energy for the host. There have been reports of the special role of SCFAs in the regulation of glucose and lipid metabolism during pregnancy. Aim: The aim of the study was to analyze the correlation of SCFAs with lipid and hepatic metabolism during pregnancy in relation to the body weight of pregnant women. Material and methods: This study was conducted in pregnant women divided into two groups: Obese (OW—overweight and obese women; n = 48) and lean (CG—control group; n = 48) individuals. The biochemical plasma parameters of lipid metabolism (TG, CH, LDL, HDL), inflammation (CRP), and liver function (ALT, AST, GGT) were determined in all of the subjects. SCFA analysis was performed in the stool samples to measure acetic acid (C 2:0), propionic acid (C 3:0), isobutyric acid (C 4:0 i), butyric acid (C 4:0 n), isovaleric acid (C 5:0 i) valeric acid (C 5:0 n), isocaproic acid (C 6:0 i), caproic acid (C 6:0 n), and heptanoic acid (C 7:0). Results: Statistically significant differences in the concentrations of C 3:0 and C 6:0 n were found between women in the OW group compared to the CG group. The other SCFAs tested did not differ significantly depending on BMI. The C 2:0, C 3:0, and C 4:0 n ratios showed differences in both OW and CG groups. In the OW group, no relationship was observed between the concentrations of the SCFAs tested and CRP, ALT, AST. A surprising positive relationship between C 5:0 n and all fractions of the tested lipids and branched C 5:0 with CHL, HDL, and LDL was demonstrated. In the OW group, HDL showed a positive correlation with C 3:0. However, lower GGT concentrations were accompanied by higher C 4:0 and C 5:0 values, and this tendency was statistically significant. Conclusions: The results of our research show that some SCFAs are associated with hepatic lipid metabolism and CRP concentrations, which may vary with gestational weight. Obesity in pregnancy reduces the amount of SCFAs in the stool, and a decrease in the level of butyrate reduces liver function.

The immunological profile of maternal obesity at 28 weeks gestation underpins common negative pregnancy outcomes

Abstract Maternal obesity has been implicated in adverse pregnancy outcomes such as miscarriage, preeclampsia and gestational diabetes mellitus (GDM) and poses a risk to the neonate. There is a knowledge gap surrounding obesity and changes to the maternal immune system. Hypothesis: Obesity exacerbates systemic inflammation in pregnant women at 28 weeks of gestation. Samples: Peripheral blood was collected from fasted women at 26–28 weeks of gestation; all were GDM-negative Results: Insulin (p=&amp;lt;0.0001) and PAI-1 (p=0.0487) levels were increased in obese versus non-obese pregnant women. Obese women had a relative neutrophilia (p=0.0429) accompanied by diminished eosinophil (p=0.0178) and NKT cell (p=0.0124) numbers. The inflammatory cytokine profile of MNCs was mostly unchanged with obesity but the Th profile of pregnant women with obesity appears skewed towards Th17: on stimulation with CytoStim™, IL-6 (p=0.0183), TNFα (p=0.0478), IL-17F (p=0.0183) and IL-22 (p=0.0183) levels were increased; Th2 cells (p=0.0250) were also reduced with maternal obesity. Monocyte phenotypes showed some changes with obesity; on intermediate monocytes, CD86 (p=0.0068) was decreased yet CD163 (p=0.0421) was increased, and CCR2 expression was elevated on classical (p=0.0040) and intermediate (p=0.0340) monocytes. There is a shift to Th1 and Th17 in obesity in the general populations, whereas pregnancy is associated with a shift to Th2 and Treg. Here, we show that this profile is compromised in maternal obesity, which might underpin detrimental effects on pregnancy. Further research should investigate homogenous populations of cells such as eosinophils, monocytes and T cells, to further understand the immunological consequences of maternal obesity.

Urinary Tract Infection, Drug Resistance Profile And Fetal Outcomes Among Pregnant Women In Selected Health Facilites Of Addis Ababa, Ethiopia: A CrossSectional Study Design

Background: Urinary tract infection (UTI) is a commonly encountered health problem among pregnant women. Untreated UTI may result in fetal complications like preterm birth, low birth weight, intra uterine growth retardation and intrauterine fetal death. One of the major problems with bacterial pathogens is their ability to develop drug resistance. Determining drug susceptibility pattern of bacteria from urinary tract helps to identify effective drugs and minimize further adverse perinatal outcomes. The purpose of this study was to describe the magnitude and drug resistance profile of pregnant women and related fetal outcomes. Methods:A cross-sectional study was conducted from March to June 2019. Socio-demographic data of the study participants was collected by administering structured questionnaire after obtaining full consent of the participants. Clean catch mid-stream urine was collected from the study participants and the samples were transported to the laboratory with screw-capped container. Blood and MacConkey agar were used to cultivate bacteria from urine sample. Bacterial colonies were isolated and identified using standard biochemical properties. Antibacterial susceptibility test was done on Muller-Hinton agar using antibiotic discs. At the time of delivery, infant’s birth weight and gestational age was recorded on the log book as part of the daily work. Fetal outcome data were recorded from the log book and entered to EPI data management software then transferred to SPSS for analysis. Results:Out of 424 urine samples processed, 63 (14.9%) yielded significant bacteriuria. Fifty-nine out of 63 (93.7%) cases of UTIs were recorded among age group of 15-34 years. Escherichia coli, Klebsiellapneumoniae, and Staphylococcus aureus were the three dominant bacterial isolates. Most of the gram negative bacterial isolates were resistant to ampicillin and ceftazidime (43.2% each) while gram positive was resistant for tetracycline (36.8%). The result of this study showed that UTI had statistical association with the occurrence of Intrauterine Fetal Death (IUFD) and Prerupture of Membrane (PROM) (P&lt;.05). Conclusion: Adverse fetal outcomes are significantly linked with the presence of UTI during pregnancy. The condition can be managed if early diagnosis and treatments are made for the mother

Quantitative proteomic profiling of Cervicovaginal fluid from pregnant women with term and preterm birth

BackgroundPreterm birth (PTB) is one of major causes of perinatal mortality and neonatal morbidity, but knowledge of its complex etiology is still limited. Here we present cervicovaginal fluid (CVF) protein profiles of pregnant women who subsequently delivered at spontaneous preterm or term, aiming to identify differentially expressed CVF proteins in PTB and term birth.MethodsThe CVF proteome of women who sequentially delivered at preterm and term was analyzed using isobaric tags for relative and absolute quantitation (iTRAQ) coupled with two-dimensional nanoflow liquid chromatography-tandem mass spectrometry (2D-nLC-MS/MS). We compared the CVF proteome of PTB (n = 5) and control subjects (term birth, n = 7) using pooled control CVF (term birth, n = 20) as spike-in standard.ResultsWe identified 1294 CVF proteins, of which 605 were newly identified proteins. Of 990 proteins quantified in both PTB and term birth, 52 proteins were significantly up/down-regulated in PTB compared to term birth. The differentially expressed proteins were functionally associated to immune response, endopeptidase inhibitors and structural constituent of cytoskeleton. Finally, we confirm the down-regulation of SERPINB7 (a serine-type protease inhibitor) in PTB compared to control by Western blot.ConclusionsTaken together, our study provide quantitative CVF proteome profiles of pregnant women who ultimately delivered at preterm and term. These promising results could help to improve the understanding of PTB etiology and to discover biomarkers for asymptomatic PTB.

Perfil de gestantes com distúrbios hipertensivos gestacionais e desenvolvimento de instrumento para qualificação do atendimento hospitalar

Distúrbios Hipertensivos Gestacionais (DHG) são as principais causas de morte materna, sendo necessário desenvolver meios de padronização e qualificação do atendimento hospitalar dessas gestantes e puérperas. Objetivo: Descrever o perfil de gestantes com DHG e o desenvolvimento de instrumentos para qualificação do cuidado hospitalar. Métodos: o estudo foi desenvolvido em uma instituição privada do sul do Brasil. O perfil das gestantes foi avaliado no período de janeiro a dezembro de 2017. Foram avaliadas as seguintes variáveis: PA, IG, tempo de internação, gestação anterior, prematuridade, reinternação, internação em CTI. Para qualificar o atendimento hospitalar foram desenvolvidos um protocolo institucional e uma carteirinha com orientações de alta para a puérpera. O desenvolvimento dos instrumentos baseou-se em grupos focais com profissionais especialistas e seguiu as seguintes etapas: definição de equipe de trabalho, revisão da literatura, identificação das necessidades de padronização e qualificação no atendimento; protótipo; ajustes; aprovação e implementação. Resultados: 3.458 gestantes internadas em 2017, 684 (19,78%) apresentaram pressão arterial elevada durante a internação e 120 (3,47%) desenvolveram DHG. Entre as alterações hipertensivas (n=684), a média de idade foi 31,6 anos; idade gestacional no parto em média 37,7 semanas, maioria primigesta (n=377; 55,2%). O protocolo contemplou os seguintes itens: Padronização da Aferição da pressão arterial (PA); Conduta se PA elevada; Diagnóstico; Classificação; Fatores predisponentes; Critério para internação; Manejo; Interrupção da gestação; Alta hospitalar e medicamento na lactação. A carteirinha apresenta orientações sobre cuidados no puerpério. Conclusão: Complicações da HAS gestacional estendem-se ao puerpério. Os produtos qualificam a assistência.

The association between perfluoroalkyl substances and lipid profile in exposed pregnant women in the Veneto region, Italy

BackgroundResidents of a large area of North-Eastern Italy were exposed for decades to high concentrations of perfluoroalkyl and polyfluoroalkyl substances (PFAS) via drinking water. Serum PFAS levels have been consistently associated with elevated serum lipids, but few studies have been conducted among pregnant women, and none has stratified analyses by trimester of gestation. Elevated serum lipid levels during pregnancy can have both immediate and long-lasting effects on pregnant women and the developing fetus. We evaluated the association between perfluorooctane sulfonate (PFOS), perfluorooctanoic acid (PFOA), and perfluoro-hexanesulfonate (PFHxS) levels in relation to lipid profiles in highly-exposed pregnant women. MethodsA cross-sectional analysis was conducted in 319 pregnant women (age 14–48 years) enrolled in the Regional health surveillance program. Non-fasting blood samples were obtained in any trimester of pregnancy and analyzed for PFOA, PFOS and PFHxS, total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C). Low-density lipoprotein cholesterol (LDL-C) was calculated. The associations between ln-transformed PFAS (and categorized into quartiles) and lipids were assessed using generalized additive models. Analyses were adjusted for potential confounders and stratified according to pregnancy trimester. ResultsThe geometric means of PFOA, PFOS and PFHxS were 14.78 ng/mL, 2.67 ng/mL and 1.89 ng/mL, respectively. The plasma levels of TC, HDL-C and LDL-C increased steadily throughout the trimesters. In the 1st trimester, PFOS was positively associated with TC and PFHxS with HDL-C. In the 3rd trimester, instead, an inverse relationship was seen between PFOA and PFHxS and both TC and LDL-C. ConclusionsResults suggest the associations between PFAS concentrations and lipid profiles in pregnant women might differ by trimesters of pregnancy. In the first trimester, patterns are similar to those of non-pregnant women, while they differ late in pregnancy. Different independent behavior of PFAS and lipid levels throughout the pregnancy might explain our observations. These findings support the ubiquitous exposure to PFAS and possible influence on lipid metabolisms during pregnancy and suggest a careful evaluation of the timing of PFAS measurement, when examining effects of PFAS during pregnancy on gestational outcomes related to serum lipids amounts.

Streptococcus agalactiae: Sensitivity profile in pregnant women attending health units in northeastern Brazil

Streptococcus agalactiae: Sensitivity profile in pregnant women attending health units in northeastern Brazil

Lipid Profile in Pregnant Women With and Without Gestational Diabetes Mellitus: A Case-Control Study

Background: Gestational diabetes mellitus (GDM), the most common metabolic disorder of pregnancy, is associated with alterations in circulating lipids. Objectives: The aim of this study was to compare lipid profiles in women with and without GDM. Methods: This study was performed on 84 pregnant women at 26-30 weeks of gestation (42 pregnant women with GDM as cases and 42 healthy pregnant women as controls). After obtaining informed consent and gathering demographic data, subjects underwent a 75-g oral glucose tolerance test and lipid profile was also measured in all subjects. Results: We found that high-density lipoprotein (HDL) levels were significantly higher in the GDM group (53.10±1.72 vs 46.64±1.70 mg/dL, P=0.008). Total cholesterol (228.96±52.03 vs 211.59±41.83 mg/ dL) and triglyceride (TG) levels (225.58±89.84 vs 208.38±80.66 mg/dL) were also higher in the GDM group; however, the differences were not statistically significant (P=0.770 and P=0.327, respectively). On the contrary, low-density lipoprotein was found to be non-significantly higher in the healthy group (144.54±26.01 vs 122.41±4.82 mg/dL, P=0.709). Besides, there was a significant association between HDL levels and GDM (OR: 1.049; 95% CI: 1.009-1.090, P=0.015). This association remained significant when adjusted for age, body mass index (BMI), and gestational age (OR: 1.010; 95% CI: 1.002-1.017, P=0.009). No significant association was found between GDM and TG, cholesterol, and LDL levels. Conclusion: HDL levels are significantly higher in pregnant women with GDM compared to pregnant women without GDM. HDL level is significantly associated with GDM even after adjustment for age, BMI, and gestational age.

Challenges in estimating HIV prevalence trends and geographical variation in HIV prevalence using antenatal data: Insights from mathematical modelling.

BackgroundHIV prevalence data among pregnant women have been critical to estimating HIV trends and geographical patterns of HIV in many African countries. Although antenatal HIV prevalence data are known to be biased representations of HIV prevalence in the general population, mathematical models have made various adjustments to control for known sources of bias, including the effect of HIV on fertility, the age profile of pregnant women and sexual experience.Methods and findingsWe assessed whether assumptions about antenatal bias affect conclusions about trends and geographical variation in HIV prevalence, using simulated datasets generated by an agent-based model of HIV and fertility in South Africa. Results suggest that even when controlling for age and other previously-considered sources of bias, antenatal bias in South Africa has not been constant over time, and trends in bias differ substantially by age. Differences in the average duration of infection explain much of this variation. We propose an HIV duration-adjusted measure of antenatal bias that is more stable, which yields higher estimates of HIV incidence in recent years and at older ages. Simpler measures of antenatal bias, which are not age-adjusted, yield estimates of HIV prevalence and incidence that are too high in the early stages of the HIV epidemic, and that are less precise. Antenatal bias in South Africa is substantially greater in urban areas than in rural areas.ConclusionsAge-standardized approaches to defining antenatal bias are likely to improve precision in model-based estimates, and further recency adjustments increase estimates of HIV incidence in recent years and at older ages. Incompletely adjusting for changing antenatal bias may explain why previous model estimates overstated the early HIV burden in South Africa. New assays to estimate the fraction of HIV-positive pregnant women who are recently infected could play an important role in better estimating antenatal bias.