Subpopulation Of Pregnant Women Research Articles

Physical inactivity in early pregnancy and the determinants in an urban city setting of Kuala Lumpur, Malaysia

BackgroundPhysical inactivity in pregnancy has been associated with excessive gestational weight gain, hypertensive disorders, gestational diabetes mellitus and postpartum depression. Despite these risks, physical inactivity level remains high especially in higher income countries. The prevalence of physical inactivity among women in Malaysia aged ≥16 years was 28.2% in 2019 exceeding men by 6.1%. However, little is known regarding the subpopulation of pregnant women especially in Kuala Lumpur which is the most urbanized and highly populated city in Malaysia. Therefore, the aim of this study is to measure the physical inactivity prevalence among first trimester pregnant women in Kuala Lumpur and to identify its determining factors.MethodsThis was a cross-sectional study in which 339 first trimester pregnant women were sampled from 13 maternal and child health clinics located in all four parliament districts of Kuala Lumpur. Self-administered questionnaires which contained the Malay version of the pregnancy physical activity questionnaire (PPAQ) were used. Descriptive analysis was conducted to determine the physical inactivity prevalence followed by simple and multiple logistic regression to identify the determinants of physical inactivity with significant level of 5%.ResultsThe prevalence of physical inactivity was 38.3%. The highest activity was seen in the household activity domain, despite only 24.8% of the respondents were housewives/unemployed. There was little to no participation observed in the vigorous intensity category. The determinants of physical inactivity were primigravida (aOR 3.54 95% CI 1.40, 8.97), education level (aOR 3.77 95% CI 1.35, 10.52) and body mass index (aOR 0.88 95% CI 0.80, 0.97) which explained 22.6% variation of physical inactivity in the final adjusted model.ConclusionThe prevalence of physical inactivity among first trimester pregnant mothers in this study was 38.3%, and the highest activity was seen in the household category. Health education on physical activity in pregnancy should be focused on those who are primigravida and have no tertiary education. The educational content should be updated and tailored to current pandemic situation where self-isolation is the new norm, by advocating for home-based, moderate to vigorous intensity physical activities.

Value of serial cervical length measurement in prediction of spontaneous preterm birth in post-conization pregnancy without short mid-trimester cervix

Serial cervical length (CL) measurement in mid-trimester is recommended in post-conization pregnancy to estimate the risk of spontaneous preterm birth (SPTB). A short mid-trimester cervix (CL < 25 mm) has been considered as a strong predictor for SPTB. However, the low incidence of short cervix limits the utility of mid-trimester CL measurement in prediction of SPTB. A great proportion of women who develop SPTB don’t have a short mid-trimester cervix. Therefore, this study was aimed to investigate the additional value of serial CL measurement in predicting SPTB in addition to detecting short cervix alone. A total of 613 post-conization pregnant women who did not have short mid-trimester cervix between January 2004 and January 2014 were included in this study. Serial CL measurements were taken by transvaginal ultrasound at three timepoints (A: 13 + 0–15 + 6 weeks, B: 16 + 0–18 + 6 weeks, and C: 20 + 0–22 + 6 weeks). Eight parameters were analyzed for predicting SPTB, including CL measurements at different timepoints (CLA, CLB, CLC), the maximum and minimum CL measurements (CLMAX, CLMIN), and the percentage change in CL measurement between different timepoints (%ΔCLAB, %ΔCLBC, %ΔCLAC). After univariate and multivariate analysis, CLMAX and %ΔCLAC were independent variables in predicting SPTB. Lower CLMAX (OR [95%CI]: 0.92 [0.90–0.93]) and higher %ΔCLAC (OR [95%CI]: 1.05 [1.01–1.09]) were related to an increasing risk of SPTB. In conclusion, our study for the first time in literature reported the value of serial CL measurement in prediction of SPTB in post-conization pregnancy without short mid-trimester cervix. In the subpopulation of pregnant women who did not have short mid-trimester cervix, CLMAX and %ΔCLAC were of value in predicting SPTB, which warranted further investigations.

Maternal-Fetal Cancer Risk Assessment of Ochratoxin A during Pregnancy.

Increasing evidence has demonstrated that in utero exposure to environmental chemicals may interfere with fetal development and increase the risk of disease and cancer development later in life. Ochratoxin A (OTA) has been proven to induce diverse toxic effects including teratogenicity, carcinogenicity, immunotoxicity and potential endocrine disruption. Due to the continuous and widespread occurrence of OTA as a potential contaminant of staple foods, there is increasing concern of in utero exposure of fetus to this mycotoxin. In this study, maternal-fetal risk assessment of OTA during pregnancy was conducted using the benchmark dose approach for genotoxic carcinogens. The daily intake of OTA for Egyptian pregnant women was estimated based on their serum OTA level using the refined Klaassen equation for pregnancy. Fetal exposure level was also estimated based on the maternal data. Comparison between the estimated daily exposure and the negligible cancer risk intake (NCRI), and the calculation of margin of exposure (MOE) implicated that OTA exposure from dietary intake would be of low health concern for this general subpopulation of Egyptian women. This subpopulation of pregnant women was generally estimated not to be in high-risk for toxicity induced by OTA.

Prevalence of Rhesus D-negative blood type and the challenges of Rhesus D immunoprophylaxis among obstetric population in Ogbomoso, Southwestern Nigeria

Background: Rhesus incompatibility could pose a major problem in pregnancy, and it could be the cause of obstetric failure in a handful of women. Implementation of programs for antenatal and postnatal (Rhesus D) RhD immune globulin prophylaxis has led to a significant reduction in the frequency of maternal RhD alloimmunization and associated fetal and neonatal complications. Aims: To determine the prevalence of RhD negative among the pregnant population attending the antenatal clinic of a young tertiary health institution in Ogbomoso, a semi-urban town in southwestern Nigeria, and also the challenges faced by this sub-population of pregnant women. Materials and Methods: A retrospective review of the antenatal and labour records of obstetric patient attending Ladoke Akintola University of Technology Teaching Hospital (LTH), Ogbomoso, Nigeria. Variables were expressed as percentages. Result: Of the 596 booked patient who had their blood group systems determined, 563 women (94.5%) were RhD-positive, and 33(5.5%) women were RhD-negative. Almost 50% of the Rh-negative pregnant women were primipara. Twenty-three (69.7%) of the study population had a previous delivery or abortion, but only 9 (39.1%) of these had the Rhesus anti-D immunoglobulin following the delivery or the abortion. One of the RhD-negative women had been sensitized to the RhD positive antigen from the previous delivery at the time of booking the index pregnancy. Of the study population that delivered in our facility, only 11 (33.3%) received the anti-D immunoglobulin after the delivery, and financial inability to purchase the anti-D immunoglobulin was a major reason for refusing the immunoprophylaxis. Conclusion: Although the prevalence of RhD negative still remains low, and the rate of Rh-immunoprophylaxis remains quite low in our obstetric population, the risk of haemolytic disease of the newborn with its attendant perinatal morbidity and mortality is real in our community. The anti-D immunoglobulin should be made available and affordable.

Retinal vein occlusion and pregnancy, pre-eclampsia, and eclampsia: the results from a nationwide, population-based study using the national claim database.

ObjectiveTo investigate the incidence of retinal vein occlusion (RVO) in pregnant women and in the subpopulation of pregnant women with pre-eclampsia/eclampsia compared to that in the age-matched general female population to determine if there is increased risk of RVO in pregnancy.DesignNationwide population-based retrospective study using data entered into the Korean national health claims database from 2007 to 2011.Setting and ParticipantsOf the incident RVO cases in the database, RVO cases that occurred during the pregnancy-associated period, which spanned a 52-week period from 40-weeks-before to 12-weeks-after childbirth, were identified. Of these cases, the presence of pre-eclampsia/eclampsia was determined.Main Outcome and MeasureThe standardized incidence ratios (SIRs) of RVO in the general pregnant population and in the pregnant population with pre-eclampsia/eclampsia were determined with respect to the age-matched general female population.ResultsPregnancy-related RVO was identified in 33 cases from the 1.8 million women who experience childbirth during the study period, while the expected number of cases calculated by the direct standardization to the age-matched general population was 113. Of the 33 patients, 12 patients (36.4%) had pre-eclampsia or eclampsia. The SIR for the general pregnant population in reference to the age-matched general female population was 0.29 (95% CI, 0.20–0.41). In contrast, the SIR for the pregnant population with pre-eclampsia/eclampsia in reference to the age-matched general female population and the age-matched general pregnant population was 67.50 (95% CI, 34.88–117.92) and 246.50 (95% CI, 127.37–430.59), respectively.Conclusions and RelevanceThe results suggest that pre-eclampsia/eclampsia is a risk factor for RVO, while pregnancy itself may not be a risk factor for RVO.

Profil des hormones thyroïdiennes chez les femmes enceintes : analyse de 125 cas à l’hôpital général de Yaoundé

This study was aimed at determining the evolution and the kinetics of thyroid hormones in a sub-population of pregnant women in Cameroon. We carried out a prospective study (from January 2005 to January 2006) on 125 consenting pregnant women at the Yaoundé General Hospital. Clinical and gyneco obstetric data with the gestational age were noted on a pre-designed questionnaire. Blood samples were drawn for serum assay of thyroxin (T4), triiodothyronine (T3) and thyroid stimulating hormone. The results were read with the “Oakfield health care” Gamma – 12 counter using the RIASTAT software. These patients, divided into four groups consisted of: 32 non pregnant women in the control group; 33 pregnant women in the first trimester; 30 pregnant women in the second trimester and 30 at the third trimester. The mean serum levels of T3 and T4 were relatively high in all pregnant women (irrespective of the gestational age) than in the control group. Serum levels of T3 and T4 were raised the first trimester with and progressively reduced in 2nd and 3rd trimester. On otherhand, TSH levels progressively increased as from the 2nd trimester to attain a maximum in the 3rd trimester. We can therefore conclude that blood levels of thyroid hormone as well as TSH vary during pregnancy and differ in titres with respect to the gestation age.

Migraines During Pregnancy Linked to Stroke and Vascular Diseases: US Population-Based Case-Control Study

The prevalence of migraine in women of childbearing age ranges from 11% to 26%. Two previous population-based reports found that migraine was associated with a 4-fold increased risk of acute myocardial infarction in pregnant women and a 17-fold increased risk of pregnancy-related stroke. Few studies have investigated the prevalence of migraine in pregnant women, and its incidence in this population is largely unknown. This population based case-control study determined the prevalence of migraine during pregnancy and examined the association between migraine and pregnancy-related cardiovascular diseases. Data on 18,345,538 pregnancy-related discharges from hospitals in the United States between 2000 and 2003 were obtained from the Nationwide inpatient sample, from the Healthcare Cost and Utilization Project of the Agency for Healthcare Research and Quality. ICD-9 codes were used to identify migraine, stroke, and other cardiovascular diagnoses. Codes for preeclampsia were separated from the other cardiovascular codes. Of the pregnancy-related discharges, 33,956 had a diagnosis of migraine, a rate of 185 per 100,000 deliveries. Multivariable logistic regression analysis showed that diagnoses independently associated with migraine discharge codes were preeclampsia (adjusted odds ratio [aOR], 2.29; 95% confidence interval [CI], 2.13-2.46), stroke (aOR, 15.05; 95% CI, 8.26-27.4), venous thromboembolism/pulmonary embolus (aOR, 3.23; 95% CI, 2.06-7.07), acute myocardial infarction/heart disease (aOR, 2.11; 95% CI, 1.76-2.54), smoking (aOR, 2.85; 95% CI, 2.53-3.21), and diabetes (aOR, 1.96; 95% CI, 1.64-2.35). The relation between migraine and stroke had the strongest association. There was no association found between a diagnosis of migraine and several nonvascular diagnoses (pneumonia, transfusions, postpartum infection) or intrauterine fetal death. These findings show a strong association between codes for a diagnosis of migraine and codes for cardiovascular events among a subpopulation of pregnant women with active migraine during admission to hospital. These data do not show whether migraine occurred before or after a vascular event and suggest no cause or effect mechanism.