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International Journal of Women's Health 2024We aimed to examine the association between exercise during pregnancy and preterm birth (PTB).
PURPOSE
We aimed to examine the association between exercise during pregnancy and preterm birth (PTB).
METHODS
This study was a baseline survey of the Jinan birth cohort. The study subjects were the mothers one month after giving birth, which were investigated by questionnaires retrospectively containing physical exercise (frequency, time, and primary exercise patterns) during pregnancy and each trimester. Individual time spent on exercise and energy expenditure were assessed based on the questionnaires. PTB was clinically defined as a newborn born on or before the last day of the 37th week. Adjusted odds ratios () were estimated using logistic regression to assess the relationship between exercise during pregnancy and the risk of PTB. Variable selection for the multivariate models was guided by the directed acyclic graph. The median effect was analyzed by the sequential test.
RESULTS
The prevalence of PTB in this study was 4.38% (285/6501). The adjusted (95% ) for the risk of PTB related to exercise during pregnancy was 0.74 (0.58-0.95). During the 1st and 2nd trimesters, the s (95% ) for 2.5 to 7 hours of exercise per week were 0.77 (0.59-0.99) and 0.74 (0.57-0.96). During the 3rd trimester, the s (95% ) for 2.5 to 7 hours and more than 7 hours of exercise per week were 0.74 (0.56-0.96) and 0.65 (0.44-0.94). After stratifying the subjects, the association was only found among subjects without pregnancy complications. Pregnancy complications partially mediated (52.40%) the relationship between exercise during pregnancy and PTB.
CONCLUSION
Exercise during pregnancy can reduce the risk of PTB for women without pregnancy complications. 2.5 to 7 hours of exercise (like walking) per week may be appropriate in three trimesters of pregnancy, and the time could be extended in the 3rd trimester.
PubMed: 38344255
DOI: 10.2147/IJWH.S447270 -
Nutrients Aug 2023The post-delivery period could be characterized by psychological distress (e.g., anxiety, sadness, and irritability), leading to postpartum depression (PPD). : The... (Randomized Controlled Trial)
Randomized Controlled Trial
The post-delivery period could be characterized by psychological distress (e.g., anxiety, sadness, and irritability), leading to postpartum depression (PPD). : The present clinical study assesses the effect of probiotic supplementation containing PBS072 and BB077 (4 × 10 CFU/day) on the mother's mood and breastfeeding quality during the first trimester after delivery. : A Randomized, Double-Blind, Controlled (RDBPC) trial was carried out on 200 healthy new mothers divided into an active group taking a supplement containing PBS072 and BB077 (4 × 10 CFU/day) plus multivitamins and a control group (multivitamin complex only) for 90 days. Symptoms related to maternal depression and breastfeeding quality were evaluated at days 45 and 90 using the Edinburgh Postnatal Depression Scale (EPDS) and the Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF). : At days 45 and 90, the probiotic treatment significantly ameliorated the mothers' mood compared to the control treatment ( < 0.001). Likewise, the breastfeeding quality and the baby's cries significantly improved in the probiotic group ( < 0.001). : Microbiota alterations could influence a post-delivery woman's mental state. According to our results, PBS072 and BB077 are potential candidates that are able to improve stress resilience in the postpartum period.
Topics: Infant; Pregnancy; Humans; Female; Limosilactobacillus reuteri; Bifidobacterium breve; Pregnancy Trimester, First; Breast Feeding; Postpartum Period; Mothers
PubMed: 37630704
DOI: 10.3390/nu15163513 -
International Journal of Molecular... Jul 2023A specific feature of dyslipidemia in pregnancy is increased high-density lipoprotein (HDL) cholesterol concentration, which is probably associated with maternal...
A specific feature of dyslipidemia in pregnancy is increased high-density lipoprotein (HDL) cholesterol concentration, which is probably associated with maternal endothelium protection. However, preeclampsia is most often associated with low HDL cholesterol, and the mechanisms behind this change are scarcely explored. We aimed to investigate changes in HDL metabolism in risky pregnancies and those complicated by late-onset preeclampsia. We analyze cholesterol synthesis (cholesterol precursors: desmosterol, 7-dehydrocholesterol, and lathosterol) and absorption markers (phytosterols: campesterol and β-sitosterol) within HDL particles (NCS), the activities of principal modulators of HDL cholesterol's content, and major HDL functional proteins levels in mid and late pregnancy. On the basis of the pregnancy outcome, participants were classified into the risk group (RG) (70 women) and the preeclampsia group (PG) (20 women). HDL cholesterol was lower in PG in the second trimester compared to RG ( < 0.05) and followed by lower levels of cholesterol absorption markers ( < 0.001 for campesterol and < 0.05 for β-sitosterol). Lowering of HDL cholesterol between trimesters in RG ( < 0.05) was accompanied by a decrease in HDL phytosterol content ( < 0.001), apolipoprotein A-I (apoA-I) concentration ( < 0.05), and paraoxonase 1 (PON1) ( < 0.001), lecithin-cholesterol acyltransferase (LCAT) ( < 0.05), and cholesterol ester transfer protein (CETP) activities ( < 0.05). These longitudinal changes were absent in PG. Development of late-onset preeclampsia is preceded by the appearance of lower HDL cholesterol and NCS in the second trimester. We propose that reduced capacity for intestinal HDL synthesis, decreased LCAT activity, and impaired capacity for HDL-mediated cholesterol efflux could be the contributing mechanisms resulting in lower HDL cholesterol.
Topics: Humans; Female; Pregnancy; Cholesterol, HDL; Pre-Eclampsia; Cholesterol; Cholesterol Ester Transfer Proteins; Biological Transport; Apolipoprotein A-I; Aryldialkylphosphatase
PubMed: 37511116
DOI: 10.3390/ijms241411357 -
European Journal of Medical Research Aug 2023Pregnancy and childbirth are considered natural events in the life cycle of women. However, it is also a stressful experience along with physiological and psychological...
BACKGROUND
Pregnancy and childbirth are considered natural events in the life cycle of women. However, it is also a stressful experience along with physiological and psychological changes. Therefore, it is important to study the dimensions that cause more worry in each of the pregnant trimesters. This study aimed to determine and compare the dimensions of worry of Iranian primiparous women in each trimester of pregnancy.
METHODS
This cross-sectional study was conducted on 300 primiparous women (n = 100 in each trimester) referred to seven health centers affiliated with the Iran University of Medical Sciences, Tehran, Iran. The sampling was multistage. We collected data from a demographic and fertility questionnaire and the Cambridge Worry Scale (CWS).
RESULTS
The mean score of worry during the entire pregnancy was 28.16. The mean and standard deviation of the worry score in the first trimester was (27.35 ± 12.22). The second trimester was (27.80 ± 12.53) and the third trimester was (29.34 ± 11.11). The highest mean score of worry in the first and third trimmers was the dimension of own health. The second trimester was the dimension of socio-medical. The lowest mean score of worry in all trimmers was the dimension of relationships. Among CWS-related items, the highest mean score of worry in the first trimester was giving birth (3.34) and the possibility of miscarriage (3.22). In the second trimester was the possibility of going into labour too early (3.3) and the possibility of miscarriage (3.12), and in the third trimester was the possibility of going into labour too early (3.33) and giving birth (3.27). The lowest mean score of worry in all three trimesters was related to problems with the law.
CONCLUSION
pregnancy worry in the third trimester was more than the other two trimesters, and worrying about own health was the most important dimension of worry for pregnant women. Paying attention to the dimensions of worry of pregnant women helps design appropriate interventions to increase the mental and physical health of pregnant women.
Topics: Pregnancy; Female; Humans; Iran; Abortion, Spontaneous; Cross-Sectional Studies; Pregnancy Trimester, First; Labor, Obstetric
PubMed: 37587539
DOI: 10.1186/s40001-023-01258-5 -
Environment International Aug 2023Breast cancer is now the most common cancer globally, accounting for 12% of all new annual cancer cases worldwide. Despite epidemiologic studies having established a...
Breast cancer is now the most common cancer globally, accounting for 12% of all new annual cancer cases worldwide. Despite epidemiologic studies having established a number of risk factors, knowledge of chemical exposure risks is limited to a relatively small number of chemicals. In this exposome research study, we used non-targeted, high-resolution mass spectrometry of pregnancy cohort biospecimens in the Child Health and Development Studies to test for associations with breast cancer identified via the California Cancer Registry. Second and third trimester archival samples were analyzed from 182 women who subsequently developed breast cancer and 384 randomly selected women who did not develop breast cancer. Environmental chemicals were annotated with the Toxin and Toxin-Target Database for chemical signals that were higher in breast cancer cases and used with an exposome epidemiology analytic framework to identify suspect chemicals and associated metabolic networks. Network and pathway enrichment analyses showed consistent linkage in both second and third trimesters to inflammation pathways, including linoleate, arachidonic acid and prostaglandins, and identified new suspect environmental chemicals associated with breast cancer, i.e., an N-substituted piperidine insecticide and a common commercial product, 2,4-dinitrophenol, linked to variations in amino acid and nucleotide pathways in second trimester and benzo[a]carbazole and a benzoate derivative linked to glycan and amino sugar metabolism in third trimester. The results identify new suspect environmental chemical risk factors for breast cancer and provide an exposome epidemiology framework for discovery of suspect environmental chemicals and potential mechanistic associations with breast cancer.
Topics: Female; Humans; Pregnancy; Amino Acids; Breast Neoplasms; Environmental Exposure; Exposome; Mass Spectrometry
PubMed: 37517180
DOI: 10.1016/j.envint.2023.108112 -
Acta Obstetricia Et Gynecologica... Dec 2023The aim of our study was to investigate the causes of fetal growth <10th centile diagnosed <26 weeks' gestation in singleton pregnancies and compare pregnancy outcomes...
INTRODUCTION
The aim of our study was to investigate the causes of fetal growth <10th centile diagnosed <26 weeks' gestation in singleton pregnancies and compare pregnancy outcomes in relation to the identified etiology.
MATERIAL AND METHODS
Historical cohort study conducted in two Italian hospitals which included all small-for-gestational-age fetuses diagnosed between 18+0 and 26+0 weeks over a 10-year period. Fetuses were divided into three groups depending on the prenatally suspected etiology: chromosomal abnormalities (Group 1), malformations (Group 2) and isolated (Group 3). These groups were compared regarding pregnancy outcomes. Fetuses in Group 3 were divided into small-for-gestational-age and fetal growth restriction following the Delphi Consensus criteria and the outcomes were further compared. Fisher's Exact or Mann-Whitney test were used for comparison of groups.
RESULTS
In all, 435 fetuses were included. Of these, 20 cases (4.6%) were associated with chromosomal abnormalities (Group 1), 98 (22.5%) with fetal malformations (Group 2) and 317 (72.9%) were isolated (Group 3). A higher percentage of live births was reported for Group 3 (P < 0.001). Termination of pregnancy was more common in Group 1 (P < 0.001). No differences in gestational age at delivery, birthweight, intrauterine death or neonatal death were detected within groups. Growth-restricted fetuses had lower gestational age at delivery, birthweight and number of live births (P < 0.001), higher rates of termination of pregnancy, intrauterine death (P < 0.001) and neonatal death <10 days (P = 0.002) compared to small-for-gestational-age. In 17 cases a chromosomal abnormality, genetic syndrome or adverse neurological outcome was diagnosed after birth: six from Group 2 (11.3% of live births in this group) and 11 from Group 3 (4.3%).
CONCLUSIONS
We report that fetal growth <10th percentile diagnosed before 26 weeks is not isolated before birth in 27% of cases. Malformations and chromosomal abnormalities are common etiologies; therefore, detailed anomaly scans and invasive testing should be offered. In addition, there is a residual risk of neonatal death and postnatal diagnosis of a genetic syndrome or neurodevelopmental impairment despite normal prenatal tests. These results expand the small amount of information on the outcome of cases with very early diagnosis of impaired fetal growth currently available and highlight the importance of detailed counseling with couples.
Topics: Pregnancy; Infant, Newborn; Female; Humans; Infant; Fetal Growth Retardation; Birth Weight; Pregnancy Trimester, Second; Cohort Studies; Perinatal Death; Ultrasonography, Prenatal; Infant, Small for Gestational Age; Stillbirth; Gestational Age; Fetus; Chromosome Aberrations; Retrospective Studies
PubMed: 37723850
DOI: 10.1111/aogs.14679 -
JAMA Network Open Jun 2024Significant evidence gaps exist regarding the safety of smoking cessation pharmacotherapies during pregnancy, especially for the risk of congenital malformations....
IMPORTANCE
Significant evidence gaps exist regarding the safety of smoking cessation pharmacotherapies during pregnancy, especially for the risk of congenital malformations. Consequently, professional bodies advise against the use of varenicline and bupropion and recommend caution with nicotine replacement therapy (NRT). Contemporary estimates of the use of smoking cessation pharmacotherapies during pregnancy are lacking.
OBJECTIVE
To quantify the proportion of individuals using prescribed smoking cessation pharmacotherapies during pregnancy and during the first trimester specifically, in 4 countries.
DESIGN, SETTING, AND PARTICIPANTS
This retrospective, population-based cohort study used linked birth records, hospital admission records, and dispensing records of prescribed medications from all pregnancies resulting in birth between 2015 and 2020 in New South Wales, Australia; New Zealand; Norway; and Sweden. Data analyses were conducted in October and November 2023.
EXPOSURE
Prescribed smoking cessation pharmacotherapy use (varenicline, NRT, and bupropion) during pregnancy was defined as days' supply overlapping the period from date of conception to childbirth.
MAIN OUTCOMES AND MEASURES
Prevalence of use among all pregnancies and pregnancies with maternal smoking were calculated. Among women who used a pharmacotherapy, the proportion of women with use during the first trimester of pregnancy was also calculated.
RESULTS
Among 1 700 638 pregnancies in 4 countries, 138 033 (8.1%) had maternal smoking and 729 498 (42.9%) were younger than 30 years. The prevalences ranged from 0.02% to 0.14% for varenicline, less than 0.01% to 1.86% for prescribed NRT, and less than 0.01% to 0.07% for bupropion. Among pregnant individuals who smoked, use of pharmacotherapies was up to 10 times higher, with maximum prevalences of 1.25% for varenicline in New South Wales, 11.39% for NRT in New Zealand, and 0.39% for bupropion in New Zealand. Use in the first trimester occurred among more than 90% of individuals using varenicline, approximately 60% among those using NRT, and 80% to 90% among those using bupropion.
CONCLUSIONS AND RELEVANCE
In this cohort study of pregnant individuals in 4 high-income countries, the low prevalence of varenicline and bupropion use during pregnancy and higher prevalence of NRT use aligned with current clinical guidelines. As most use occurred in the first trimester, there is a need for evidence on the risk of congenital malformations for these medications.
Topics: Humans; Female; Pregnancy; Smoking Cessation; Adult; Retrospective Studies; Smoking Cessation Agents; Varenicline; Bupropion; New Zealand; Tobacco Use Cessation Devices; Pregnancy Complications; Sweden; New South Wales; Norway; Young Adult; Smoking; Pregnancy Trimester, First
PubMed: 38941092
DOI: 10.1001/jamanetworkopen.2024.19245 -
Environmental Health Perspectives Aug 2023Previous studies aiming at relating exposure to phenols and phthalates with child social behavior characterized exposure using one or a few spot urine samples, resulting... (Review)
Review
Early-Life Exposure to a Mixture of Phenols and Phthalates in Relation to Child Social Behavior: Applying an Evidence-Based Prioritization to a Cohort with Improved Exposure Assessment.
BACKGROUND
Previous studies aiming at relating exposure to phenols and phthalates with child social behavior characterized exposure using one or a few spot urine samples, resulting in substantial exposure misclassification. Moreover, early infancy exposure was rarely studied.
OBJECTIVES
We aimed to examine the associations of phthalates and phenols with child social behavior in a cohort with improved exposure assessment and to identify the chemicals supported by a higher weight of evidence.
METHODS
Among 406 mother-child pairs from the French Assessment of Air Pollution exposure during Pregnancy and Effect on Health (SEPAGES) cohort, 25 phenols/phthalate metabolites were measured in within-subject pools of repeated urine samples collected at the second and third pregnancy trimesters ( samples/trimester) and at 2 months and 1-year of age ( samples/period). Social behavior was parent-reported at 3 years of age of the child using the Social Responsiveness Scale (SRS). A structured literature review of the animal and human evidence was performed to prioritize the measured phthalates/phenols based on their likelihood to affect social behavior. Both adjusted linear regression and Bayesian Weighted Quantile Sum (BWQS) regression models were fitted. False discovery rate (FDR) correction was applied only to nonprioritized chemicals.
RESULTS
Prioritized compounds included bisphenol A, bisphenol S, triclosan (TCS), diethyl-hexyl phthalate (), mono-ethyl phthalate (MEP), mono--butyl phthalate (MnBP), and mono-benzyl phthalate (MBzP). With the exception of bisphenols, which showed a mixed pattern of positive and negative associations in pregnant mothers and neonates, few prenatal associations were observed. Most associations were observed with prioritized chemicals measured in 1-y-old infants: Each doubling in urinary TCS (; 95% CI: 0.00, 1.55) and MEP (; 95% CI: , 1.96) concentrations were associated with worse total SRS scores, whereas MnBP and were associated with worse Social Awareness (; 95% CI: 0.01, 0.50) and Social Communication (; 95% CI: , 0.89) scores, respectively. BWQS also suggested worse total SRS [; 95% credible interval (CrI): , 2.97], Social Awareness (; 95% CrI: 0.06, 0.70), and Social Communication (; 95% CrI: 0.31, 1.53) scores per quartile increase in the mixture of prioritized compounds assessed in 1-y-old infants. The few associations observed with nonprioritized chemicals did not remain after FDR correction, with the exception of benzophenone-3 exposure in 1-y-old infants, which was suggestively associated with worse Social Communication scores (corrected ).
DISCUSSION
The literature search allowed us to adapt our statistical analysis according to the weight of evidence and create a corpus of experimental and epidemiological knowledge to better interpret our findings. Early infancy appears to be a sensitive exposure window that should be further investigated. https://doi.org/10.1289/EHP11798.
Topics: Pregnancy; Female; Infant, Newborn; Infant; Humans; Bayes Theorem; Diethylhexyl Phthalate; Phthalic Acids; Mothers; Triclosan; Dibutyl Phthalate; Phenols; Environmental Exposure; Environmental Pollutants
PubMed: 37556305
DOI: 10.1289/EHP11798 -
Cureus Aug 2023Pregnancy is a natural physiological process that leads to the outstanding outcome of giving birth. It involves normal and abnormal signs and symptoms that women need to...
BACKGROUND
Pregnancy is a natural physiological process that leads to the outstanding outcome of giving birth. It involves normal and abnormal signs and symptoms that women need to be aware of during this period.
OBJECTIVES
This study aims to assess the awareness and knowledge about normal and abnormal signs and symptoms of pregnancy among women of childbearing age in Saudi Arabia.
METHODS
This is an online questionnaire-based cross-sectional study done in 2023 among women in Saudi Arabia, aged 18 to 45. The estimated sample size was 385 after applying inclusion and exclusion criteria. However, 981 responses were collected and included.
RESULTS
A total of 981 participants were included in our study. The study findings noted that the majority of women demonstrated a good level of knowledge about the normal signs and symptoms of pregnancy. About 82% of the women reported that they knew mood swings were normal symptoms during pregnancy, 80.1% were aware of nausea, 75.9% knew about fatigue, and 68.9% knew about fainting or dizziness. The findings noted that less than half of the participants were fully aware of the abnormal obstetric signs. For the abnormal signs and symptoms during the first trimester, only 45.2% were fully aware of the symptoms. In the second trimester, 39.0% were fully aware of the symptoms. Only 30.5% of the participants were fully aware of the abnormal signs and symptoms in the third trimester. The study established a statistically significant relationship between age and knowledge of abnormal symptoms during the first, second, and third trimesters (P=0.027, 0.041, and 0.006) (r=0.139, 0.105, and 0.146). Furthermore, a statistically significant relationship was found between the level of education of the participants and the level of awareness of abnormal symptoms during the first trimester (P=0.043). However, there was no significant relationship between education level and the level of knowledge regarding abnormal symptoms during the second and third trimesters (r=0.22, 0.061, P=0.578, 0.603).
CONCLUSION
The study found that the majority of women had a good level of awareness and knowledge about normal signs and symptoms of pregnancy, while less than half of the women were fully aware of the abnormal signs and symptoms at different stages of pregnancy. The older respondents and people with higher levels of education demonstrated more knowledge. The two variables, age and education level, had a statistically significant relationship with knowledge of abnormal signs and symptoms of pregnancy with education level being only significant during the first trimester period. Our study concluded that women had different symptoms during pregnancy, both normal and abnormal. Their knowledge about these signs and symptoms was considerably moderate, but further awareness about the normality of these signs is needed. The study recommends more research to measure women's awareness about normal and abnormal symptoms of pregnancy, and more awareness programs should be carried out in the region as a way of enhancing a better understanding of normal and abnormal pregnancy symptoms. This will go a long way in helping women through their pregnancy and make them more comfortable.
PubMed: 37791216
DOI: 10.7759/cureus.44470 -
Annals of Agricultural and... Dec 2023The article assesses the knowledge, attitudes, and practices of Obstetrician-Gynaecologists (OB/GYNs) in Israel regarding COVID-19, its impact on fertility, pregnancy...
INTRODUCTION AND OBJECTIVE
The article assesses the knowledge, attitudes, and practices of Obstetrician-Gynaecologists (OB/GYNs) in Israel regarding COVID-19, its impact on fertility, pregnancy and childbirth, and their positions on COVID-19 vaccines.
MATERIAL AND METHODS
A cross-sectional anonymous survey was employed, and the data analyzed using logistic regression models.
RESULTS
A total of 172 OB/GYN participants aged 44.9 years, primarily female (59.7%), mostly attending physicians (60.4%), had a mean knowledge score of 75.62%, with 81.1% having sufficient knowledge about general COVID-19 information, 11.9% having specific knowledge about pregnancy, birth, and breastfeeding, and 40.3% having knowledge about COVID-19 vaccination. Notably, only 27% of participants correctly identified the increased risk of preeclampsia in pregnant women with COVID-19. Nevertheless, all OB/GYN participants recommended the COVID-19 vaccination during pregnancy. The majority (65.1%) recommended vaccination across all trimesters, while a smaller percentage recommended it only in the second (25%) or third (6%) trimesters, and very few in the first trimester (4%). The study found that attitudes towards vaccination were influenced by workplace, role, religion, religious observance, and marital status.
CONCLUSIONS
The study showed a good level of knowledge regarding COVID-19 vaccines which contributed to OB/GYNs' recommendations to their patients. These findings can be valuable for designing future COVID-19 vaccination campaigns.
Topics: Humans; Female; Pregnancy; Gynecology; Obstetrics; COVID-19 Vaccines; Cross-Sectional Studies; Health Knowledge, Attitudes, Practice; Obstetricians; COVID-19; Surveys and Questionnaires
PubMed: 38153070
DOI: 10.26444/aaem/176959