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The Journal of Maternal-fetal &... Jun 2020We aimed to investigate and compare the background knowledge and attitudes of pregnant women and their partners about antenatal ultrasound scans. A cross-sectional...
We aimed to investigate and compare the background knowledge and attitudes of pregnant women and their partners about antenatal ultrasound scans. A cross-sectional survey was conducted in a university perinatology clinic. Pregnant women and their partners who underwent the first trimester ultrasound scan or the second trimester anomaly scan were invited to complete a questionnaire which contained items on their sociodemographic characteristics, knowledge, and attitude. In total, 500 eligible expectant mothers and their partners (220 in the first trimester and 280 in the second trimester) were recruited. The knowledge and attitude of expectant mothers and fathers were statistically similar. Working status, education level, and presence of chronic disease were the factors affecting the number of correct answers in both expectant mothers and fathers. The knowledge levels of both the expectant mothers and fathers were similar in the first and second trimesters. Pregnant women's and their partners' attitudes and knowledge on antenatal ultrasound scans were similar and generally satisfactory.
Topics: Adult; Cross-Sectional Studies; Female; Health Knowledge, Attitudes, Practice; Humans; Male; Parents; Pregnancy; Pregnancy Trimester, First; Pregnancy Trimester, Second; Socioeconomic Factors; Turkey; Ultrasonography, Prenatal
PubMed: 30261776
DOI: 10.1080/14767058.2018.1530209 -
Gynecological Endocrinology : the... Jun 2023Serum uric acid (SUA) is considered as a risk factor for gestational diabetes mellitus (GDM). However, current studies showed inconsistent results. This study aimed to... (Meta-Analysis)
Meta-Analysis Review
AIMS
Serum uric acid (SUA) is considered as a risk factor for gestational diabetes mellitus (GDM). However, current studies showed inconsistent results. This study aimed to explore the relationship between SUA levels and GDM risk.
METHODS
Eligible studies were retrieved from PubMed, Web of Science, Embase, China National Knowledge Infrastructure, and Wanfang databases up to November 1, 2022. The pooled standardized mean difference (SMD) and 95% confidence interval (CI) were used to represent the difference in SUA levels between GDM women and controls. The combined odds ratios (OR) and 95% CI were applied to assess association between SUA levels and GDM risk. Subgroup analyses were conducted on study continents, design, and quality, detection time of SUA, and GDM diagnostic criteria.
RESULTS
Totally 11 studies including five case-control and six cohort studies, in which 80,387 pregnant women with 9815 GDM were included. The overall meta-analysis showed that the mean SUA level in GDM group was significantly higher than in controls (SMD = 0.423, 95%CI = 0.019-0.826, = .040, = 93%). Notably, pregnant women with elevated levels of SUA had a significantly increased risk of GDM (OR = 1.670, 95%CI = 1.184-2.356, = .0035, = 95%). Furthermore, subgroup analysis performed on the detection time of SUA showed a significant difference in the association between SUA and GDM risk within different trimesters (1st trimester: OR = 3.978, 95%CI = 2.177-7.268; 1st to 2nd trimester: OR = 1.340, 95%CI = 1.078-1.667; between subgroups <.01).
CONCLUSIONS
Elevated SUA was positively associated with GDM risk, particularly in the 1st trimester of pregnancy. Further studies with high quality are required to validate the findings of this study.
Topics: Pregnancy; Female; Humans; Diabetes, Gestational; Uric Acid; Pregnancy Trimester, First; Risk Factors; Pregnancy Trimester, Second
PubMed: 37406646
DOI: 10.1080/09513590.2023.2231101 -
Prenatal Diagnosis Nov 2015I performed a systematic review and pooled analysis to study the utility of the placental vascular flow indices vascularization index (VI), flow index (FI) and... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
I performed a systematic review and pooled analysis to study the utility of the placental vascular flow indices vascularization index (VI), flow index (FI) and vascularization flow index (VFI) in the prediction or identification of in-utero growth restriction (IUGR).
METHOD
A comprehensive literature search for relevant studies was conducted using PubMed and Web of Knowledge databases. Included were cohort or case-control studies which reported (1) the statistical position and dispersion of vascular indices in a population of normal pregnancies at various trimesters of pregnancy; (2) correlation between vascular indices and gestational age; or (3) the vascular index values stratified according to the presence of SGA/IUGR versus a population of controls.
RESULTS
Seven studies met the criteria of inclusion, for a total of 788 controls and 82 SGA cases in the first trimester, and 169 controls and 80 IUGR cases essentially enrolled in the 3rd trimester. After normalization of the means, the pooled detection rates (DRs) at a 10% false positive rate were 32.5%, 53.8% and 51.0%, respectively, for the vascular indices VI, FI and VFI in the third trimester. No significant discriminant ability was detected in the first trimester.
CONCLUSION
A significant DR for IUGR was demonstrated only in the third trimester, thus limiting the utility of vascular indices to predict IUGR. VI and VFI are more reliable and yield better DR and better performance in terms of homogeneity than FI and should be evaluated in the management of third trimester IUGR and prediction of outcome.
Topics: Female; Fetal Growth Retardation; Humans; Imaging, Three-Dimensional; Infant, Newborn; Infant, Small for Gestational Age; Placenta; Placenta Diseases; Placental Circulation; Pregnancy; Pregnancy Trimester, First; Pregnancy Trimester, Third; Regional Blood Flow; Ultrasonography, Doppler; Ultrasonography, Prenatal
PubMed: 26126703
DOI: 10.1002/pd.4646 -
Archives of Women's Mental Health Apr 2018Few published studies have examined the relationship between exercise during pregnancy, quality of life (QOL), and postpartum depressive symptoms in healthy pregnant...
Few published studies have examined the relationship between exercise during pregnancy, quality of life (QOL), and postpartum depressive symptoms in healthy pregnant women. A prospective cohort of 578 healthy pregnant women were followed during their pregnancy through 6 months postpartum. Levels of self-reported exercise and QOL before, during, and following pregnancy were assessed using standardized questionnaires during each trimester of pregnancy and 6 months postpartum. Depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS) at 28 weeks gestation and 6 weeks postpartum. Participants were classified as having "sufficient exercise" if they achieved at least 150 min of exercise per week. Sufficient exercisers reported significantly higher ratings on most domains of QOL during each trimester of pregnancy and in the postpartum follow-up, compared with insufficient exercisers. There were no significant between-group differences in depressive symptoms. In examining the impact of exercise during each trimester, active women who became sedentary during their third trimester demonstrated a decline in their QOL. Achieving recommended levels of exercise during pregnancy was associated with higher QOL during pregnancy and the postpartum in healthy pregnant women. Decreasing the amount of exercise during pregnancy was associated with reduced QOL. These results suggest that it may be important for health care professionals to counsel healthy pregnant women about both the benefits of being physically active during pregnancy, and to provide guidance on how to remain physically active during a healthy pregnancy.
Topics: Adolescent; Adult; Depression; Depression, Postpartum; Exercise; Female; Humans; Middle Aged; Pregnancy; Pregnancy Trimesters; Prospective Studies; Quality of Life; Young Adult
PubMed: 29067551
DOI: 10.1007/s00737-017-0783-0 -
Physiology & Behavior Feb 2015Disgust, an emotion triggering behavioral avoidance of pathogens, serves as a first line of defense against infections. Since behavior related to disgust involves some...
Disgust, an emotion triggering behavioral avoidance of pathogens, serves as a first line of defense against infections. Since behavior related to disgust involves some cost, the aversive reaction should be adjusted to the level of an individual's immunocompetence, and raise only when immunological function is lower (e.g. during pregnancy). We studied changes in disgust sensitivity in pregnant women, and tested if disgust sensitivity is related to a fetus's sex. 92 women participated in a three-stage research, answering the Disgust Scale-Revised questionnaire at each trimester of pregnancy. The result showed that total disgust and disgust sensitivity in the Core Domain were the highest in the first trimester (when maternal immunosuppression is also the highest), and decreased during pregnancy in women bearing daughters. Women bearing sons had relatively high disgust sensitivity persisting in the first and in the second trimester. The elevation in disgust sensitivity during the second trimester for mothers bearing male fetus can be explained by the necessity to protect for a longer time, a more ecologically sensitive fetus, and also herself when bearing a more energetically costly sex. The proximate mechanism may involve the differences in maternal testosterone and cortisol concentrations in the second trimester of pregnancy.
Topics: Adult; Emotions; Female; Fetus; Humans; Longitudinal Studies; Male; Postpartum Period; Pregnancy; Pregnancy Trimesters; Surveys and Questionnaires; Young Adult
PubMed: 25449396
DOI: 10.1016/j.physbeh.2014.11.032 -
The Journal of Sexual Medicine Feb 2015The physiological changes during each trimester of pregnancy have a significant impact on women's sexual behavior.
INTRODUCTION
The physiological changes during each trimester of pregnancy have a significant impact on women's sexual behavior.
AIM
The aim of the work was to assess changes in the sexual function during pregnancy.
METHODS
The prospective study encompassed 520 pregnant women aged between 18 and 45, of whom 168 were qualified for the final analysis. The research tool was a purpose-designed research questionnaire and the standardized Female Sexual Function Index.
MAIN OUTCOME MEASURES
To assess changes in the sexual function among pregnant women aged 18-45 in the three pregnancy trimesters.
RESULTS
All the studied parameters, i.e., desire, arousal, lubrication, orgasm, satisfaction, and pain, decreased significantly with the progression of pregnancy. Analyzing the frequency of sexual intercourse in the studied group before and during pregnancy, a statistically significant decrease (P<0.000001) was observed. Sexual desire changed statistically significantly (P=0.0004). The direction of change concerned decreased sexual desire in the three trimesters compared with the situation before pregnancy. Statistical significance was demonstrated for: decreased sexual desire (P=0.00007), partner's reluctance (P=0.002), and pregnancy-related changes in appearance (P=0.03).
CONCLUSIONS
Sexual function was compromised and sexual activity decreased as the pregnancy progressed. Changes in the domains of arousal, lubrication, and orgasm were particularly notable in primaparae in the third trimester of pregnancy. Unsatisfying partner relationship was a significant factor affecting the quality of sexual life during pregnancy.
Topics: Adult; Arousal; Female; Humans; Libido; Orgasm; Pain; Personal Satisfaction; Pregnancy; Pregnancy Trimesters; Prospective Studies; Psychometrics; Sexual Behavior; Surveys and Questionnaires
PubMed: 25378082
DOI: 10.1111/jsm.12747 -
PloS One 2018To explore noninvasively the complex interactions of the maternal hemodynamic system throughout pregnancy and the resulting after-effect six weeks postpartum.
OBJECTIVE
To explore noninvasively the complex interactions of the maternal hemodynamic system throughout pregnancy and the resulting after-effect six weeks postpartum.
METHODS
Eighteen women were tested beginning at the 12th week of gestation at six time-points throughout pregnancy and six weeks postpartum. Heart rate, heart rate variability, blood pressure, pulse transit time (PTT), respiration, and baroreceptor sensitivity were analyzed in resting conditions. Additionally, hemoglobin, asymmetric and symmetric dimethylarginine and Endothelin (ET-1) were obtained.
RESULTS
Heart rate and sympathovagal balance favoring sympathetic drive increased, the vagal tone and the baroreflex sensitivity decreased during pregnancy. Relative sympathetic drive (sympathovagal balance) reached a maximum at 6 weeks postpartum whereas the other variables did not differ compared to first trimester levels. Postpartum diastolic blood pressure was higher compared to first and second trimester. Pulse transit time and endothelial markers showed no difference throughout gestation. However, opposing variables PTT and asymmetric dimethylarginine (ADMA) were both higher six weeks postpartum.
CONCLUSIONS
The sympathetic up regulation throughout pregnancy goes hand in hand with a decreased baroreflex sensitivity. In the postpartum period, the autonomic nervous system, biochemical endothelial reactions and PTT show significant and opposing changes compared to pregnancy findings, indicating the complex aftermath of the increase of blood volume, the changes in perfusion strategies and blood pressure regulation that occur in pregnancy.
Topics: Adult; Arginine; Baroreflex; Blood Pressure; Cardiovascular Physiological Phenomena; Endothelin-1; Endothelium; Female; Heart Rate; Hemodynamics; Hemoglobins; Humans; Postpartum Period; Pregnancy; Pregnancy Trimesters; Pressoreceptors; Prospective Studies
PubMed: 29782509
DOI: 10.1371/journal.pone.0197748 -
American Journal of Obstetrics &... Apr 2024In nonpregnant individuals, the rate-pressure product, the product of heart rate and systolic blood pressure, is used as a noninvasive surrogate of myocardial O...
BACKGROUND
In nonpregnant individuals, the rate-pressure product, the product of heart rate and systolic blood pressure, is used as a noninvasive surrogate of myocardial O consumption during cardiac stress testing. Pregnancy is considered a physiological cardiovascular stress test. Evidence describing the impact of pregnancy on myocardial O demand, as assessed by the rate-pressure product, is limited.
OBJECTIVE
This study aimed to describe changes in the rate-pressure product for each pregnancy trimester, during labor and delivery, and the postpartum period among low-risk pregnancies.
STUDY DESIGN
This was a retrospective cohort study that assessed uncomplicated pregnancies delivered vaginally at term. We collected rate-pressure product (heart rate × systolic blood pressure) values preconception, during pregnancy for each trimester (at ≤13 weeks + 6/7 days, at 14 weeks + 0/7 days through 27 weeks + 6/7 days, and at ≥28 weeks + 0/7 days), during the labor and delivery encounter (hospital admission until complete cervical dilation, complete cervical dilation until placental delivery, and after placental delivery until hospital discharge), and during the outpatient postpartum visit at 2 to 6 weeks after delivery. We calculated the percentage change at each time point from the preconception rate-pressure product (delta rate-pressure product). We used a mixed-linear model to analyze differences in the mean delta rate-pressure product over time and the influence of prepregnancy age, prepregnancy body mass index, and neuraxial anesthesia status during labor and delivery on these estimates.
RESULTS
Our cohort comprised 316 patients. The mean rate-pressure product increased significantly from preconception starting at the third trimester of pregnancy and during labor and delivery (P≤.05). The mean delta rate-pressure product peaked at 12% and 38% in the third trimester and during labor and delivery, respectively. Prepregnancy body mass index was inversely correlated with the mean delta rate-pressure product changes (estimate, -0.308; 95% confidence interval, -0.536 to -0.80; P=.008). In contrast, neither the prepregnancy age, nor neuraxial anesthesia status during labor had a significant influence on this parameter.
CONCLUSION
This study validates the transient but significant increase in the rate-pressure product, a clinical estimate of myocardial O demand, during uncomplicated pregnancies delivered vaginally at term. Pregnant individuals with lower prepregnancy body mass index experienced a sharper increase in this parameter. Patients who receive neuraxial anesthesia during labor and delivery experience similar changes in the rate-pressure product as those who did not.
Topics: Humans; Female; Pregnancy; Adult; Retrospective Studies; Blood Pressure; Heart Rate; Postpartum Period; Pregnancy Trimesters; Oxygen Consumption; Labor, Obstetric; Delivery, Obstetric; Young Adult; Cohort Studies
PubMed: 38453019
DOI: 10.1016/j.ajogmf.2024.101338 -
The Journal of Clinical Endocrinology... Dec 2019Previous studies suggest that maternal thyroid function affects fetal growth, but the association between combined thyroid hormones from early to late pregnancy and...
CONTEXT
Previous studies suggest that maternal thyroid function affects fetal growth, but the association between combined thyroid hormones from early to late pregnancy and newborn birth weight remains unknown.
OBJECTIVE
To explore the association of maternal thyroid function during early and late pregnancy with birth weight.
DESIGN
A large prospective cohort study of a Chinese population.
SETTING
This study recruited pregnant women who underwent first-trimester prenatal screenings at the International Peace Maternity and Child Health Hospital between January 2013 and December 2016.
PARTICIPANTS
This study enrolled 46,186 mothers in whom TSH, free thyroxine (FT4), T3, and thyroid peroxidase antibody concentrations were measured in the first and third trimesters and in whom data on birth weight were available.
MAIN OUTCOME MEASURES
Birth weight, small for gestational age, large for gestational age (LGA).
RESULTS
A higher TSH or FT4 concentration, or a lower T3 concentration, during the first or third trimester was associated with a lower birth weight. The lowest percentiles of maternal FT4 (FT4 < 2.5th percentile) in both trimesters were associated with a 0.34-SD higher birth weight. The effect estimates were greater in those in the first trimester (0.23 SD) or in the third trimester (0.17 SD). The association of maternal TSH and FT4 with birth weight differed according to fetal sex.
CONCLUSIONS
Persistently low FT4 concentrations throughout pregnancy were associated with higher birth weight and an increased risk of LGA. Based on these findings, we recommend monitoring mildly altered concentrations of thyroid hormone throughout pregnancy.
Topics: Adult; Birth Weight; China; Female; Fetal Development; Humans; Infant, Newborn; Infant, Small for Gestational Age; Male; Maternal Exposure; Pregnancy; Pregnancy Trimester, First; Pregnancy Trimester, Third; Prospective Studies; Thyroid Function Tests; Thyroid Hormones
PubMed: 31216012
DOI: 10.1210/jc.2019-00390 -
Clinical Neurology and Neurosurgery Jul 2020Pregnancy and lactation are important issues for women with multiple sclerosis (MS). The purpose of this study was to investigate the effect of pregnancy and exclusive...
OBJECTIVES
Pregnancy and lactation are important issues for women with multiple sclerosis (MS). The purpose of this study was to investigate the effect of pregnancy and exclusive breastfeeding on the rate of relapse and degree of disability within two years after delivery among patients with relapsing remitting multiple sclerosis (RRMS).
PATIENTS AND METHODS
30 pregnant women with RRMS who had exclusive breastfeeding for 4 months were compared with 67 non-pregnant women with RRMS between 2012 and 2017. Each patient was examined every three months for 33 months. In the study group, patients were examined at the beginning of pregnancy, and then every three months till 24th months after delivery.
RESULTS
In the study group, Expanded Disability Status Scale (EDSS) during the third trimester of pregnancy, between four to nine month after delivery, and the last 6 months of the study were significantly lower than the control group (p < 0.05). At the end of the study, the mean EDSS of the study group was significantly lower than the control group (p < 0.05). Also, EDSS during the second and third trimesters of pregnancy were significantly lower than the EDSS before pregnancy (p < 0.05). The mean number of relapses in the second and third trimesters of pregnancy, between four to six months after delivery, and the total number of relapses were significantly lower than the control group.
CONCLUSION
Pregnancy and exclusive breastfeeding can have a positive effect in reducing relapse rate and disability. This effect will continue until the 24th month after childbirth.
Topics: Adolescent; Adult; Breast Feeding; Cohort Studies; Disability Evaluation; Female; Humans; Infant, Newborn; Multiple Sclerosis, Relapsing-Remitting; Pregnancy; Pregnancy Complications; Pregnancy Trimester, Second; Pregnancy Trimester, Third; Recurrence; Young Adult
PubMed: 32305825
DOI: 10.1016/j.clineuro.2020.105829