Status Of Pregnant Women Research Articles

Impact of vitamin D on the course of COVID-19 during pregnancy: A case control study

ObjectiveWe aimed to evaluate the vitamin D status of pregnant women with COVID-19, and the association between vitamin D level and severity of COVID-19. MethodsIn this case control study, 159 women with a single pregnancy and tested positive for SARS-CoV-2, and randomly selected 332 healthy pregnant women with similar gestational ages were included. COVID-19 patients were classified as mild, moderate, and severe. Vitamin D deficiency was defined as 25-hydroxycholecalciferol <20 ng/mL (50 nmol/L), and 25-OH D vitamin <10 ng/mL was defined as severe vitamin D deficiency, also 25-OH D vitamin level between 20−29 ng/mL (525−725 nmol/L) was defined as vitamin D insufficiency. ResultsVitamin D levels of the pregnant women in the COVID-19 group (12.46) were lower than the control group (18.76). 25-OH D vitamin levels of those in the mild COVID-19 category (13.69) were significantly higher than those in the moderate/severe category (9.06). In terms of taking vitamin D supplementation, there was no statistically significant difference between the groups. However, it was observed that all of those who had severe COVID-19 were the patients who did not take vitamin D supplementation. ConclusionThe vitamin D levels are low in pregnant women with COVID-19. Also, there is a significant difference regarding to vitamin D level and COVID-19 severity in pregnant women. Maintenance of adequate vitamin D level can be useful as an approach for the prevention of an aggressive course of the inflammation induced by this novel coronavirus in pregnant women.

Longitudinal changes in vitamin D and its metabolites in pregnant South Africans

BackgroundVitamin D deficiency (VDD) has been associated with adverse maternal and foetal outcomes and is determined by measuring 25 hydroxyvitamin D (25(OH)D). The 25(OH)D is catabolized to 24, 25-(OH) 2D and the ratio of 25(OH) D to 24, 25-(OH)2D, the vitamin D metabolite ratio (VMR), is thought to be a superior marker of VDD, being elevated in such states. The aims of this study were to assess the longitudinal vitamin D status of pregnant women by measuring cholecalciferol, 25(OH)D, 24, 25-(OH)2D and VMR at two time points and also to determine any association of vitamin D and metabolites with gestational age at birth, birth length and weight. MethodsWe recruited 400 pregnant black African women in their first trimester (V1) and measured weights and heights. Ultrasound scans were performed for gestational age. Blood was drawn at V1 and at about 26 weeks (V2) of gestation for cholecalciferol, 25(OH)D, 24, 25-(OH)2D, VMR and parathyroid hormone (PTH). An OGTT was performed at V2 where fasting glucose, insulin and 30-minute glucose were measured. At birth, we measured birth weight, length and gestational age. Maternal insulin, PTH and vitamin D binding protein (VDBP) were measured by immunoassay. Maternal albumin was measured colorimetrically. Maternal cholecalciferol, 25(OH)D and 24, 25-(OH)2D, were measured by mass spectrometry and free and bioavailable vitamin D were calculated. Initial gestation was determined by ultrasound. We compared analytes by visit as well as by 25(OH)D status. Vitamin D deficiency (<30 nmol/L) was defined according to the National Academy of Medicine guidelines. Linear regression analysis was used to determine associations of vitamin D molecules with maternal blood pressure, fasting and 30-minute insulin and blood glucose and neonatal parameters. ResultsResults are presented for participants for whom we had complete data (n = 330–346 depending on variable). The prevalence of vitamin D deficiency (VDD) was 35.8 % at V1 and 32.4 % at V2. Levels of 25(OH)D did not change significantly between visits. Levels of 24, 25(OH)2D dropped from the first to the second visit (17.64 ± 12.64 to 9.39 ± 9.07 nmol/L; p < 0.0001) while VMR increased ((3.15 (1.31; 7.67) to 7.90 (2.44; 25.98); p < 0.0001). The proportion of women with the lowest cholecalciferol concentrations increased at V2 compared to the V1 (36.1–42.8 %; p = 0.02). In multivariable regression models 25(OH)D was negatively associated with 30-minute glucose concentrations (p = 0.038) whilst 24, 25-(OH)2D was positively associated with fasting insulin (p = 0.017) and HOM A-I R (p = 0.023). There was no correlation of 25(OH)D or metabolites with infant birth weight, birth length or gestational age. ConclusionsMaternal VDD is common in pregnant black South African women. Decreased VMR suggest that catabolism of 25(OH)D is reduced in pregnancy to maintain adequate free vitamin D levels.

The Effect of Dietary Supplements on Oxidative Stress in Pregnant Women with Gestational Diabetes Mellitus: A Network Meta-Analysis.

Background: Gestational diabetes mellitus (GDM) exacerbates the oxidative stress status of the pregnant women. Τo improve the oxidative stress status, several therapeutic interventions have been suggested. The aim of this network meta-analysis is to assess the effect of different dietary supplements on the oxidative stress status in pregnant women with GDM. Methods: A network meta-analysis of randomized control trials was performed comparing the changes delta (Δ) in total antioxidant capacity (TAC) and concentration of malondialdehyde (MDA) as primary outcomes, following different therapeutic interventions with dietary supplements in pregnant women with GDM. Four electronic databases and grey literature sources were searched. The secondary outcomes were other markers of oxidative stress. Results: The meta-analysis included 16 studies of 1173 women with GDM. Regarding ΔTAC: probiotics and omega-3 with vitamin E were superior to placebo/no intervention. Regarding ΔMDA: vitamin D with calcium, omega-3, vitamin D, omega-3 with vitamin E, magnesium with zinc and calcium, and probiotics were superior to placebo/no intervention. Conclusions: Administration of dietary supplements in women with GDM can be helpful in limiting the oxidative stress which develop in these pregnancies.

Heart disease in pregnancy

Heart disease are common condition in pregnant women. Even, some of the cases diagnose just during the pregnancy. In this article, we summarize common cardiac disorders, which might encounter during the pregnancy and after birth. Furthermore, we discuss some etiological factors, pathophysiology, clinical manifestation, treatment and outcomes of the cardiac disease in pregnancy.

Porushennia sertsevo-sudynnoi diialnosti ta endotelialnoi funktsii u vahitnykh iz nedyferentsiiovanoiu spoluchnotkanynnoiu dysplaziieiu; yikh korektsiia zavdiaky vkliuchenniu do protokolnoi prohramy likuvannia karnitynarhininovoho kompleksu

Context. Undifferentiated connective tissue dysplasia (UCTD) has negative impact on myocardial contractility and endothelial microvascular dysfunction and their frequent combination with cardiac arrhythmias suggests an unfavorable course of pregnancy and childbirth due to the formation of uteroplacental dysfunction. Objective. To reduce the incidence of obstetric complications associated with cardiovascular disorders in women with UCTD by including carnitine-arginine complex in the treatment program. Materials and methods. 58 pregnant women with diagnosed signs of UCTD, including mitral valve prolaps (MVP) with and without frequent extrasystoles, and 14 pregnant women of control group were examined. Metabolic support with of 4.2 g of L-arginine and 2.0 g of L-carnitine in the form of a solution for intravenous infusion once a day for 5 days were used for prenatal care of pregnant women with UCTD and prevention of obstetric complications in the experimental group. Results. There are violations of morpho-functional parameters of the heart with the development of moderate systolic-diastolic myocardial dysfunction and endothelial microvascular dysfunction in the initial state of pregnant women with MVP and extrasystolic arrhythmia against the background of UCTD. They were significantly more often diagnosed with miscarriage, late preeclampsia, placental dysfunction, birth defects, birth trauma, postpartum hemorrhage, etc. Echostructural abnormalities of the heart acted as predictors of arrhythmias, the presence of which was associated with more pronounced disorders of intracardiac hemodynamics. The results of a comprehensive study of the clinical and functional status of pregnant women with phenotypic signs of UCTD, MVP and extrasystolic arrhythmia suggest that in most cases they occur with moderate heart remodeling and significant endothelial dysfunction of the microvascular circulation, that was accompanied by significant deterioration of the obstetric situation. The use of standard medication by pregnant women did not significantly restore the incidence of arrhythmias, inotropic capacity of the myocardium and endothelial function of microvessels. Supraventricular and ventricular arrhythmias remained resistant to standard treatment, which justified the use of additional antiarrhythmic drugs. At the same time, there was a significant reduction in the incidence of arrhythmias in the group of patients with MVP and frequent ventricular or mixed extrasystoles – by 90.6 and 77.8 % respectively under the influence of complex drug treatment with the inclusion of L-arginine and L-carnitine. In the group of pregnant women with supraventricular arrhythmias, the antiarrhythmic effect was observed in only 37.5 % of patients, which justified the additional use of nebivolol hydrochloride at a dose of 2.5 mg/day. At the same time, such a comprehensive treatment in pregnant women with MVP and arrhythmia on the background of UCTD contributed to the restoration of the studied indicators of endothelial function of microvessels. Conclusions. In pregnant women with MVP and extrasystolic arrhythmia against the background of UCTD in the initial state there are violations of morpho-functional parameters of the heart with the development of moderate systolic-diastolic myocardial dysfunction and endothelial microvascular dysfunction, which are triggers of complicated pregnancy and childbirth. The inclusion of L-arginine and L-carnitine led to a significant improvement in the parameters of central cardiohemodynamics and restoration of endothelial function of microvessels and accompanied by a significant reduction of the incidence of extrasystolic arrhythmia and pregnancy complications.

Ginger (Zingiber Officinale) and Mint Leaves (Mentha Piperrita L) Alleviate Emesis Gravidarum

Background: Emesis gravidarum is a feeling of nausea that appears in pregnant women, especially in the morning. Pregnant women experience nausea, vomiting, 2% in the morning, 80% throughout the day and 18% progress to delivery. In Indonesia, there are 50-75% cases of nausea and vomiting experienced by pregnant women. The cause is an increase in the hormones estrogen, progesterone and the secretion of hCG. The content in ginger (Zingiber OffIcinale) and mint leaves (Mentha Piperrita L) can reduce the incidence of emesis gravidarum thereby preventing bad health conditions of pregnant women that interfere with fetal growth and development. Purpose: To know the effectiveness of giving ginger and mint leaves to reduce emesis gravidarum for pregnant women. Methods: The research method used is the Quasy Experiment method with the Two Group Pre and Post-Test Design approach. The population of first trimester pregnant women is 60 people. The number of samples in each group was 4 women using the 2 free sample formula and purposive sampling technique. The results of the normal distribution test with the Saphiro Wilk test, the data are normally distributed so that it uses the paired t-test and the independent t-test. Results: Based on the univariate test, it was found that the average before infusion of ginger was 9.25 and 5.25 after being given steeped ginger. On average, before being given the mint leaf steeped was 10.0 and after being given the mint leaf steeped was 7.00. Based on the paired t-test, it was found that the p-value of steeped ginger was 0.011 &lt;0.05, while the p-value of steeped mint leaves was 0.024 &lt;0.05. Based on the independent t-test, it was found that the effectiveness of giving steeped ginger and mint leaves was p-value 0.013 &lt;0.05. Conclusion: Ginger and mint leaves statistically alleviate emesis gravidarum in the first trimester of pregnancy. Midwives could suggest the women to consume ginger and mint leaves as alternative or complementary treatment of emesis gravidarum.

Hubungan KEK dengan Anemia Gravidarum pada Ibu Riwayat BBLR

KEK (Chronic Energy Deficiency) is a condition of the mother suffering from lack of calories and protein (malnutrition) that lasts chronic (chronic) at risk of causing complications in the mother one of which is anemia gravidarum. Anemia in pregnancy is a decrease in Hb levels, so that the carrying capacity of oxygen for the needs of vital organs in the mother and fetus is reduced. The purpose of this study is to determine the relationship of KEK with anemia gravidarum in mothers with low birth weigth history. The correlation analytic research design is a case control study approach, the population is 68 mothers with low birth weight history, using simple random sampling technique, the sample is calculated using Slovin formula, the number of 58 low birth weight history mothers fulfills the inclusion criteria. The research instrument used observation sheets to look at secondary data on cohorts of pregnant women, data analysis using the chi square test obtained a p value of 0, 001 means that p &lt;0.05 indicates the relationship of KEK with anemia gravidarum in women with low birth weight history with a close relationship is sufficient. The value of the Contingency Coefficient in the Chronic Energy Deficiency variable is 0.39, which means that the relationship between KEK and anemia gravidarum is sufficient. The Odds Ratio (OR) value in the Chronic Energy Deficiency variable is 6.9, which means that pregnant women with nutritional status of Chronic Energy Deficiency have a 6.9 times greater risk of anemia during pregnancy than those who are not. Inadequate nutritional needs have a greater risk of anemia during pregnancy and the risk of giving birth to Low Birth Weight Babies. Researchers suggest providing counseling to women of adolescence, women of childbearing age and especially pregnant women so that they can add more information about the importance of nutritional status in pregnant women, the dangers of anemia during pregnancy and also the importance of consuming blood booster tablets during pregnancy. So that it is expected to reduce the incidence of anemia pregnant women case and low birth weight history.

Psychological сomponents of miscarriage. Ways to overcome

Habitual miscarriage is a stressful condition and a significant factor of frustration for married couples. The psycho-emotional state of the pregnant woman affects the course of the subsequent pregnancy and its outcome. Correction of the psychological component of habitual miscarriage is a promising direction for preventing reproductive losses. The aim of the work is to study the psychological components of miscarriage and determine the ways of their correction. Materials and methods. The level of chronic stress was studied in pregnant women with symptoms of miscarriage and a history of habitual reproductive losses (main group) based on indicators of psychoemotional state, the condition of the autonomic nervous system, and the degree of activation of stress-implementing systems. The results were evaluated with the scale PSS, PSM-25 as adapted by N. Ye. Vodopianova, Spielberger–Khanin inventory and the scale by L. D. Malkova, Baevsky index, cortisol content in the blood and urine. The pregnant women with a physiological course of pregnancy and uncomplicated history were included in the control group. Based on the fact that the etiology of habitual miscarriage is multifactorial, and the psychological component is amenable to correction, stress-protective therapy was included in the treatment complex of habitual miscarriage. To assess the effectiveness of treatment, the main group was divided into subgroups: 1 – with psychotherapy, 2 – without psychotherapy. Results. A high level of personal perception of stress, anxiety and asthenia determine the psycho-emotional state of the main group pregnant women, among whom two dominant psycho types were identified: A – a high level of anxiety and low neuropsychic resistance; B – poise and good adaptive ability against the background of stress. Non-drug stress-protective therapy in the complex of miscarriage treatment contributes to: a decrease in psycho-emotional stress in pregnant women with psycho type A – 2.6 times, anxiety level – 1.7 times, asthenia level – 2.3 times; and also: a decrease in similar indicators in pregnant women with psycho type B – 1.6 times, 3.9 times and 2.5 times, respectively (P &lt; 0.05); a decrease in the frequency of premature termination of pregnancy by more than 11 %. Conclusions. The psychological component of miscarriage is a high level of personal perception of stress, anxiety and asthenia. Stress-protective therapy in combination with pathogenetic therapy of miscarriage improves pregnancy outcomes for the mother and the fetus. It is advisable to conduct pregravid training with the participation of a psychologist in women with a history of reproductive losses in order to overcome the psychological component of stress perception, expand adaptive potential, increase neuropsychic stability, and form a positive orientation toward pregnancy and motherhood.

Cerebral Sinus Thrombosis with Coexisting Secondary Hypoparathyroidism: Case Report for Clinical Education

Cerebral venous sinus thrombosis is a rare and infrequent condition in pregnant women. Hemorrhagic infarction can occur in early stages of cerebral venous thrombosis. This article reports a rare case of cerebral transverse sinus thrombosis presenting in pregnant women with unidentified secondary hypoparathyroidism, highlighting the difficulties in identifying this rare case from common diagnosis like preeclampsia. According to the differential diagnoses for this case, it can be a good exercise to strengthen clinical reasoning in students and medical teachers to improve the quality of clinical education.

959-P: Mothers’ Weight Class in Pregnancy and Beta-Cell Function in Their Infants

Background: Poor nutritional status in pregnant women can impact the risk of diabetes in their children. The Asian Indian Beta Cell function (ABCs) in Infants Study examined the association of maternal weight class and pregnancy weight gain on infant pancreatic beta-cell function during the first year of life. Methods: A convenience sample of 150 pregnant women ages 18-35 years were recruited in Hyderabad, India. Women were classified by 1st trimester (a) underweight (UW), i.e., BMI&amp;lt;18.5kg/m2 or (b) non-underweight (N-UW), i.e., BMI=18.5-27.4kg/m2. At 8 months postpartum, infants had a newly developed oral glucose tolerance test (OGTT, 1.75g glucose/kg, 33% w/v) after a 3-hour fast. Maternal BMI groups were examined for 30-min C-peptide by ANOVA. Results: In the first trimester, UW (n=62) and N-UW mothers (n=69) were similar in mean age (22 years) with differing mean BMI (UW: 17.0 ± SD 1.2, N-UW: 22.4 ± 2.6 kg/m2). At the time of birth, % female and mean gestational age were similar (half female; 38 weeks). UW-infants had lower birthweight (2.7± 0.4 kg) than N-UW (2.9 ± 0.4 kg, p&amp;lt;0.008), but not length (UW: 47.0 ± 2.3, N-UW: 47.1 ± 3.1cm, p=0.2). During OGTT, infants had similar fasting glucose (UW: 79.8 ± 9.5, N-UW: 82.8 ± 13.7 mg/dL, p=0.16) and fasting C-peptide (UW: 157.7 ± 161.7, N-UW: 201.7 ± 166.4 pmol/L, p=0.13). Although mean differences were not statistically significant, 30-min glucose was 6% lower in UW vs. N-UW (UW: 106.1 ± 21.9, N-UW: 113.0 ± 21.9 mg/dL, p=0.08), whereas 30-min C-peptide was 27% lower in UW vs. N-UW (UW: 397.0 ± 233.2 vs. N-UW: 543.9 ± 270.0 pmol/L, p=0.20). Conclusions: While Asian Indian infants from underweight mothers had similar basal C-peptide and glucose levels to infants from normal- and overweight mothers, first phase insulin secretion may be lower in infants from underweight mothers. The results from this pilot study warrant further examination of intergenerational risk of beta cell dysfunction and support ongoing antenatal care strategies to improve nutritional status in pregnancy. Disclosure L. R. Staimez: None. K. Betha: None. P. Prabhakaran: None. A. Dutta: None. Y. S. Beyh: None. S. Vyakaranam: None. H. K. Noule: None. D. Kothapally: None. K. Narayan: None. R. Gupta: None. D. Prabhakaran: None. Funding Emory Global Health Institute; Emory Global Diabetes Research Center

Features of systemic and local immunity in pregnant women with a history of sexually transmitted infections

The objective: to study the features of systemic and local immunity in pregnant women with a history of sexually transmitted infections.Materials and methods. We examined 100 patients, which were divided into groups: Group I (main) – 50 pregnant women with a history of sexually transmitted infections, with a high risk of placental dysfunction of infectious origin; Group II (control) – 50 pregnant women without obstetric and somatic pathology, who became pregnant spontaneously and had vaginal delivery.In-depth immunological examination included: determination of absolute (×109/л) and relative (%) number of subpopulations of CD3+ lymphocytes (T-lymphocytes), CD4+ (helpers-inductors), CD8+ (cytotoxic suppressors), CD56+ (natural killers), CD19 + (B-lymphocytes); determination of levels of IgG, IgM, IgA in serum and vaginal secretions; studied the content of a number of cytokines (interleukins – IL-1, IL-2, IL-4, IL-10, TNF-α, INFγ) in serum and vaginal contents.Results. The results of studies indicate that in pregnant women with a history of sexually transmitted infections (STIs), that formulate a group of high infectious risk, changes in systemic and local immunity, cytokine status are statistically prognostic. Levels of pro-inflammatory cytokines IL-1, IL-2, TNF-α and anti-inflammatory cytokines IL-4, IL-10 and γ IFN in serum and vaginal contents can be used as prognostic criteria for complications before their clinical manifestations and clinical features of pregnancy. It was also detected that the percentage of СD56+-lymphocytes with properties of natural killers was greater in group of pregnant women with a history of sexually transmitted infections than in the control group dynamically throughout pregnancy (12,3±1,7%, 15,1±1,7%, 13,9±1,73% against 8,6±1,4%, 8,1±1,18%, 7,2±0,98%; р&lt;0,05). Studies also showed a significant increase in IgG levels in pregnant women with a history of sexually transmitted infections compared to the pregnant women in the control group (p &lt;0,05).Conclusion. The study of systemic and local immunity, cytokine status in pregnant women with a history of sexually transmitted infections expands the possibilities of choice of rational, pathogenetic therapy, thereby reducing the incidence of early placental dysfunction of infectious origin, intrauterine infection, obstetric and perinatal complications in these patients.

Nutritional Iodine Status in Pregnant Women from Health Area IV in Asturias (Spain): Iodised Salt Is Enough.

Background: Iodine deficiency during pregnancy may have adverse effects on the neurodevelopment of the foetus. Recent studies of pregnant women in Asturias (Spain) indicate that nutritional iodine levels are sufficient. The objective of this study was to confirm the appropriate nutritional iodine status and to analyse the influence of the ingestion of iodine on maternal urinary iodine concentration (UIC) and thyroid function. Methods: An observational study was carried out between May and June 2017 on women in the first trimester of pregnancy from Health Area IV in Asturias. The women completed a questionnaire related to their consumption of iodine and samples were taken to analyse UIC and thyroid function. Results: Three hundred and eighteen pregnant women were involved. Of these, 51.10% used iodised salt, 48.90% consumed ≥ 2 servings of dairy products daily and 87.08% took iodine supplements. The median UIC was 171.5 μg/L (116–265 μg/L) and 60.41% of women had UIC ≥ 150 μg/L. Multivariate logistic regression analysis demonstrated that iodised salt had a protective effect on UIC < 150 μg/L (odds ratio (OR) 0.404 (0.237–0.683), p = 0.001), but not iodine supplements (OR 0.512 (0.240–1.085), p = 0.080). The average level of thyroid stimulating hormone (TSH) was 2.26 ± 0.94 mIU/L; 68.40% of pregnant women taking iodine supplements had TSH < 2.5 mIU/L compared to 30.00% of those who were not taking supplements (p = 0.031). Conclusions: The pregnant women in our health area are maintaining appropriate nutritional iodine levels. The consumption of iodised salt protects against iodine deficiency; thus, iodine supplements should be taken on an individualised basis.

Ubiquitin-Specific Peptidase 5 is Involved in the Proliferation of Trophoblast Cells by Regulating Wnt/β-Catenin Signaling.

Preeclampsia (PE) is a pathologic condition in pregnant women which accounts for the inhibition of proliferation, migration and invasion of trophoblast cells. This study aimed to investigate the regulation of ubiquitin-specific peptidase 5 (USP5) on the trophoblast cells in PE. Expressions of USP5 in the placentas of PE patients and healthy donors were examined by qRT-PCR and Western blot. Hypoxia/reoxygenation (H/R) model in trophoblast cells was further established. Cell viability was examined using CCK-8 assay. Finally, the effect of overexpression and silence of USP5 using lentivirus transduction was studied. Our results showed that USP5 was lowly expressed in the placentas of PE patients as well as in H/R-induced trophoblast cells. In the experiments of overexpression, USP5 promoted the proliferation of trophoblast cells, and up-regulated the expressions of β-catenin and the downstream signals c-Myc and Cyclin D1 in trophoblast cells. On the other hand, silence of USP5 elicited the opposite results. The overexpression of USP5 in the H/R model greatly released the H/R-induced inhibition in the trophoblast cells, and moderated the down-regulation of β-catenin and c-Myc induced by H/R. We concluded that USP5 promoted the proliferation of trophoblast cells via the up-regulation of the Wnt/β-catenin signaling pathway.

Proposal of MUAC as a fast tool to monitor pregnancy nutritional status: results from a cohort study in Brazil

ObjectiveIn Brazil, although the assessment of maternal nutritional status is recommended using body mass index (BMI), this is only possible in settings adequately prepared. Midupper arm circumference (MUAC) is another...

Evaluation of Serum Zinc Status of Pregnant Women in the China Adult Chronic Disease and Nutrition Surveillance (CACDNS) 2015.

Objective: The purpose of this study was to evaluate serum zinc status of pregnant women in the China Adult Chronic Disease and Nutrition Surveillance (CACDNS) in 2015–2016. Methods: A total of 7147 apparently healthy pregnant women were randomly selected in 302 national monitoring sites. Information on age, race, residence region, education, pregnancy, and family income per annum was collected, and the concentration of serum zinc was determined. The evaluation of serum zinc status was further performed according to the recommendations by the International Zinc Nutrition Consultative Group (IZiNCG). Results: The median concentration of serum zinc was 858.9 μg/L with an interquartile range (IQR) of 712.9 μg/L and 1048.9 μg/L, while the overall prevalence of zinc deficiency was 3.5% with a 95% confidence interval (CI) of 3.0% and 3.9%. Serum zinc status of pregnant women changed greatly in the different categories, particular in pregnancy and family income per annum (p < 0.05), but no significant difference was observed in the prevalence of zinc deficiency (p > 0.05). Conclusions: The lower prevalence of zinc deficiency generally indicated a better zinc status for pregnant women in the CACDNS in 2015–2016. However, a well-designed evaluation system of zinc status for pregnant women should be continually optimized and improved by inducing more parameters such as biochemical, dietary, or functional indicators.

Evaluation of Zinc and Homocysteine Status in Pregnant Women and Their Association with Pre-eclampsia in Jordan.

Pre-eclampsia (PE) is considered a major complication of pregnancy. Hyperhomocyteinemia (H-Hcy) has been proposed to be associated with a number of placenta-mediated diseases, such as PE. Zinc (Zn) is involved in the regulation of total homocysteine (Hcy) levels. A case-control study design was used to examine serum Zn and Hcy statuses, and their association to PE risk. Thirty pregnant women with PE 21∼35 years of age, and 30 matched healthy pregnant women were recruited from Amman, Jordan. Plasma Hcy was measured using liquid chromatography-mass spectrometry, and Zn was measured using atomic absorption. Hcy levels were significantly higher among women with PE compared with controls (16.35±0.43 and 7.25±0.21 μmol/L, respectively; P<0.05). However, there was no significant difference in Zn levels between women with PE and controls (65.37±1.27 and 63.71±1.24 μg/dL, respectively; P>0.05). Blood levels of Hcy (μmol/L) were positively associated with systolic and diastolic blood pressure (β=3.54 and β=1.81, respectively; P<0.05), and Zn levels [odds ratios (OR)=0.84; 95% confidence intervals (CI): 0.71∼0.98] were significantly associated with PE risk (P<0.05). Although women with PE had significantly higher Hcy levels than controls, H-Hcy was not associated with increased PE risk. However, there was a strong association between severity of hypertension and serum Hcy levels, and serum Zn levels were inversely associated with H-Hcy. The likelihood of PE was significantly higher in women who were Zn deficient compared with healthy controls. To conclude, early management of H-Hcy and associated risk factors may be effective in decreasing the incidence of PE.

Psychological state during pregnancy is associated with sleep quality: preliminary findings from MY-CARE cohort study

ABSTRACT Psychological distress during pregnancy may increase the risk of adverse maternal and infant outcomes. Past studies have demonstrated the association between circadian disturbances with psychological health. However, the roles of chronotype and social jetlag on psychological state during pregnancy are yet to be identified. We aimed to examine the psychological state in pregnant women and its relations to chronotype, social jetlag (SJL), sleep quality and cortisol rhythm. The current study included a subsample of participants from an ongoing cohort study. A total of 179 primigravidas (mean age 28.4 ± 4.0 years) were recruited. Chronotype and sleep quality during the second trimester were assessed using the Morning-Eveningness Questionnaire (MEQ) and Pittsburgh Sleep Quality Index (PSQI), respectively. SJL was calculated based on the difference between mid-sleep on workdays and free days. Psychological state of participants was evaluated using the Depression, Anxiety, and Stress Scale-21 (DASS-21). Subsamples (n = 70) provided salivary samples at 5 time points over a 24 h period during the second trimester for cortisol assay. A higher proportion of pregnant women experienced moderate to severe anxiety symptoms (n = 77, 43.0%), followed by depressive (n = 17, 9.5%) and stress (n = 14, 7.8%) symptoms. No association was observed between chronotype and psychological distress during pregnancy. There was no significant difference in cortisol rhythms in relation to psychological distress. SJL and sleep quality were significantly associated with stress symptoms among pregnant women in the second trimester. Poor sleep quality, particularly daytime dysfunction (β = 0.37, p = .006) and sleep disturbances (β = 0.23, p = .047), were significantly associated with psychological distress (depressive, anxiety and stress symptoms) during the second trimester. The findings suggest that sleep is a potential modifiable lifestyle factor that can be targeted to improve psychological health among pregnant women.

Magnesium level correlation with clinical status and quality of life in women with hormone related conditions and pregnancy based on real world data

This study was aimed to assess the effectiveness of magnesium (Mg)-vitamin B 6 replenishment and its correlation with clinical status in pregnant women (PW), and quality of life in women with hormone-related conditions (HRCW) and hypomagnesemia (HME). Data collected in four observational studies were pooled and analysed. All women received Mg supplementation for 4 weeks. The proportion of women with normalized Mg level, and the correlation between serum Mg dynamics and number of symptoms/complaints (PW) or changes in World Health Organization quality of life questionnaire scores (WHOQOL; HRCW) were evaluated. 869 PW and 957 HRCW were included in the study. Normalization of serum Mg level to ≥ 0.66 mmol/L occurred in 92.1% of PW and 78.4% of HRCW, and to ≥ 0.8 mmol/L in 73.8% and 58.9%, respectively. Mg normalization was accompanied by a median decrease of 1 symptom and 1 complaint in PW. Serum Mg level increase by 0.1 mmol/L was associated to significant changes in the WHOQOL scores in HRCW. Treatment of HME with the Mg for approximately 4 weeks provided a high response rate of Mg serum level, was associated with an improvement in symptom severity and complaints in PW, and WHOQOL score in HRCW. A 0.8 mmol/L cut-off appeared to be more relevant in terms of patient-reported outcomes.

Pregnancy and Childbirth in Women with Confirmed COVID-19

Introduction: A new viral infection, dubbed “COVID-19” in the spring of 2020, became pandemic. Data on the impact of Covid-19 on pregnant women and childbirth are scarce and contradictory. Purpose: to study the peculiarities of the course and outcome of labor in women with positive results from COVID-19. Materials and Methods: An analysis of 222 birth histories of women with laboratory-confirmed COVID-19 PCR directed to delivery to the specialized obstetric department of the Fergana city medical association for October-December 2020 is presented. Results: A mild form of infection was in 70,2%, moderate - in 21.2%, severe - in 8.1%, and critical - in 0.5%. The frequency and nature of the upper and lower respiratory tract lesions, SPO2 parameters and lung damage, as well as the age of pregnant women, parity, the presence of somatic and obstetric pathology are presented. The frequency of delivery by weight section was 25.2%, preterm birth - 9.5%. Conclusions: In most pregnant women the severe form of COVID-19 is characterized by bilateral pneumonia with ARS and anemia in 100% of cases, the frequency of miscarriage in them is high and reaches 37%. The condition of pregnant women with COVID-19 aggravated the development of severe preeclampsia, premature placental abruption, and multiple pregnancy

PENDAMPINGAN IBU HAMIL DI PUSKESMAS KALASAN KABUPATEN SLEMAN YOGYAKARTA

Midwifery services are an integral part of health services, to achieve family health in order to achieve a quality family. Midwifery services include individuals, families and communities as an effort to improve, prevent, cure and recover. Midwifery services are provided by midwives in accordance with their authority with the aim of improving the health of mothers and children, in order to achieve a quality, happy and prosperous family. The mortality rate in developing countries, about 25-50%, is caused by problems related to pregnancy, childbirth and childbirth. Maternal mortality rate (MMR) is still the government's main concern, both at the central and regional governments. One of the efforts to reduce maternal, infant and under-five mortality rates is by maximizing mentoring for pregnant women. The working area of Puskesmas Kalasan has a target level of maternal health which is also lacking. For this reason, efforts are needed from the health office and health workers in the form of assistance for pregnant women so that the goal is achieved. The mentoring program for pregnant women is a work program aimed at providing assistance, motivation and motivating pregnant women to be diligent in checking their health during pregnancy to the postpartum period. In this program, monitoring is carried out regarding the condition of pregnant women and the fetus they are carrying.Keywords: Mentoring, Pregnant Women, Public Health Center.