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Northern Clinics of Istanbul 2023The objective of the study is to examine the sexual functions and anxiety levels of the same pregnant women during the three periods of pregnancy, and to observe how...
OBJECTIVE
The objective of the study is to examine the sexual functions and anxiety levels of the same pregnant women during the three periods of pregnancy, and to observe how they change between trimesters and also the effect of nulliparity on these changes.
METHODS
This prospective clinical study was conducted between 2019 and 2021 in the University Hospital. Healthy, heterosexual pregnant women were included in this study and were consecutively interviewed regarding their anxiety levels and sexual function in the three trimesters of pregnancy. Participants in the study filled out two questionnaires, the Female Sexual Function Index (FSFI) form and the beck anxiety inventory (BAI). All data were analyzed using SPSS 21 statistical software.
RESULTS
There were a total of 35 pregnant women who met the inclusion criteria and completed the questionnaire forms in the three trimesters of pregnancy. Nineteen of the study group were nulliparous (54.3%). FSFI scores were found to be below the cutoff value required to diagnose sexual dysfunction in all three trimesters. The anxiety scores were found to be statistically significantly compatible with mild anxiety in all three periods. In the variance analysis of the survey scores over the three periods, a statistical significance was found for both the FSFI scores and the BAI scores. It was observed that nulliparity had no effect on the change between periods.
CONCLUSION
Sexual functions decrease and anxiety increases as we approach the 3 trimester of pregnancy. There was no significant effect of the parity on the significant change in sexual functions and anxiety between trimesters.
PubMed: 37719246
DOI: 10.14744/nci.2022.85226 -
Molecular and Cellular Probes Dec 2023We established efficient first trimester prediction models for small-for-gestational age (SGA) and fetal growth restriction (FGR) without the presence of preeclampsia...
We established efficient first trimester prediction models for small-for-gestational age (SGA) and fetal growth restriction (FGR) without the presence of preeclampsia (PE) regardless of the gestational age of the onset of the disease [early FGR occurring before 32 gestational week or late FGR occurring after 32 gestational week]. The retrospective study was performed on singleton Caucasian pregnancies (n = 6440) during the period 11/2012-3/2020. Finally, 4469 out of 6440 pregnancies had complete medical records since they delivered in the Institute for the Care of Mother and Child, Prague, Czech Republic. The study included all cases diagnosed with SGA (n = 37) or FGR (n = 82) without PE, and 80 selected normal pregnancies. Four microRNAs (miR-1-3p, miR-20a-5p, miR-146a-5p, and miR-181a-5p) identified 75.68 % SGA cases at 10.0 % false positive rate (FPR). Eight microRNAs (miR-1-3p, miR-20a-5p, miR-20b-5p, miR-126-3p, miR-130b-3p, miR-146a-5p, miR-181a-5p, and miR-499a-5p) identified 83.80 % SGA cases at 10.0 % FPR. The prediction model for SGA based on microRNAs was further improved via implementation of maternal clinical characteristics [maternal age and BMI, an infertility treatment by assisted reproductive technology (ART), first trimester screening for PE and/or FGR and for spontaneous preterm, both by FMF algorithm]. Then 81.08 % and 89.19 % pregnancies developing SGA were identified at 10.0 % FPR in case of utilization of 4 microRNA and 8 microRNA biomarkers. Simplified prediction model for SGA based on limited number of maternal clinical characteristics (maternal age and BMI, an infertility treatment by ART, and 4 microRNAs) does not improve the detection rate of SGA (70.27 % SGA cases at 10.0 % FPR) when compared with prediction model for SGA based just on the expression profile of 4 or 8 microRNAs biomarkers. Seven microRNAs only (miR-16-5p, miR-20a-5p, miR-145-5p, miR-146a-5p, miR-181a-5p, miR-342-3p, and miR-574-3p) identified 42.68 % FGR cases at 10.0 % FPR (AUC 0.725). However, the combination of 10 microRNAs only (miR-16-5p, miR-20a-5p, miR-100-5p, miR-143-3p, miR-145-5p, miR-146a-5p, miR-181a-5p, miR-195-5p, miR-342-3p, and miR-574-3p) reached a higher discrimination power (AUC 0.774). It identified 40.24 % FGR cases at 10.0 % FPR. The prediction model for any subtype of FGR based on microRNAs was further improved via implementation of maternal clinical characteristics [maternal age and BMI, an infertility treatment by ART, the parity (nulliparity), the occurrence of SGA or FGR in previous gestation, and the occurrence of any autoimmune disorder, and the presence of chronic hypertension]. Then 64.63 % and 65.85 % pregnancies destinated to develop FGR were identified at 10.0 % FPR in case of utilization of 7 microRNA biomarkers or 10 microRNA biomarkers. When other clinical variables next to those ones mentioned above such as first trimester screening for PE and/or FGR and for spontaneous preterm, both by FMF algorithm, were added to the prediction model for FGR, the detection power was even increased to 74.39 % cases and 78.05 % cases at 10.0 % FPR.
Topics: Pregnancy; Child; Female; Infant, Newborn; Humans; Infant; Pre-Eclampsia; Pregnancy Trimester, First; Fetal Growth Retardation; Retrospective Studies; Gestational Age; MicroRNAs; Biomarkers; Infertility; Fetus
PubMed: 37951512
DOI: 10.1016/j.mcp.2023.101941 -
BMC Pregnancy and Childbirth Sep 2023Physiological glycated hemoglobin (HbA1c) values in each trimester are not well defined. This study aimed to determine trimester-specific reference intervals for HbA1c...
BACKGROUND
Physiological glycated hemoglobin (HbA1c) values in each trimester are not well defined. This study aimed to determine trimester-specific reference intervals for HbA1c levels in non-diabetic pregnant women in China.
METHODS
In this cross-sectional study, 5,042 Chinese pregnant women from 6 to 41 weeks of gestation were screened. An inclusion of 4,134 non-diabetic women was made to determine the reference intervals, they were divided into three trimesters: trimester 1 (T1), 6 weeks to 13 weeks + 6 days, trimester 2 (T2), 14 weeks to 27 weeks + 6 days, and trimester 3 (T3), 28 weeks to 41 weeks + 6 days. A total of 4,134 women (T1 n = 760, T2 n = 1,953, and T3 n = 1,421) provided blood samples which were analyzed for HbA1c concentrations. HbA1c was measured using high-performance liquid chromatography. The median and percentile (2.5th to 97.5th) for the HbA1c reference intervals were calculated for each trimester.
RESULTS
In total, 8,732 HbA1c measurements were taken. Reference intervals for HbA1c expressed as median and percentile (2.5th to 97.5th) for each trimester were: T1: 4.7 (4.0-5.5%), T2: 4.5 (3.9-5.3%), and T3: 4.8 (4.1-5.7%) respectively. The HbA1c levels were significantly lower in the second trimester compared to those in the first trimester (p < 0.0001), and higher in the third trimester compared to the second trimester (p < 0.0001).
CONCLUSIONS
The reference intervals for HbA1c levels were 3.9-5.7% with upper limits of 5.5% in the first trimester, 5.3% in the second trimester, and 5.7% in the third trimester. These findings highlight the importance of considering trimester-specific reference intervals for HbA1c in non-diabetic pregnant women to promote maternal and fetal health.
Topics: Female; Humans; Pregnancy; Cross-Sectional Studies; East Asian People; Glycated Hemoglobin; Pregnancy Trimesters; Reference Values; Diabetes Mellitus
PubMed: 37726666
DOI: 10.1186/s12884-023-05980-0 -
JAMA Network Open May 2024Disturbances in maternal, placental, and fetal metabolism are associated with developmental outcomes. Associations of maternal, placental, and fetal metabolism with...
IMPORTANCE
Disturbances in maternal, placental, and fetal metabolism are associated with developmental outcomes. Associations of maternal, placental, and fetal metabolism with subsequent neurodevelopmental outcomes in the child are understudied.
OBJECTIVE
To investigate the metabolic associations within the maternal-placental-fetal unit and subsequent neurodevelopmental outcomes in younger siblings of children with autism spectrum disorder (ASD).
DESIGN, SETTING, AND PARTICIPANTS
This cohort study was conducted within a subset of the Markers of Autism Risk in Babies, Learning Early Signs (MARBLES) cohort. MARBLES is a prospective birth cohort of younger siblings of children with ASD assessed for neurodevelopmental outcomes at approximately age 36 months. Participants in MARBLES were recruited through the UC Davis MIND Institute. This subset of the MARBLES cohort included younger siblings born between 2009 and 2015. Maternal third trimester serum, placental tissue, and umbilical cord serum samples were collected from participants. Only pregnancies with at least 2 of these sample types were included in this analysis. Data analysis was conducted from March 1, 2023, to March 15, 2024.
EXPOSURES
Quantitative metabolomics analysis was conducted on maternal third trimester serum, as well as placental tissue and umbilical cord serum collected at delivery.
MAIN OUTCOMES AND MEASURES
Using the Autism Diagnostic Observation Schedule and Mullen Scales of Early Learning, outcomes were classified as ASD, other nontypical development (non-TD), and typical development (TD).
RESULTS
This analysis included 100 maternal serum samples, 141 placental samples, and 124 umbilical cord serum samples from 152 pregnancies (median [IQR] maternal age, 34.6 [30.8-38.3] years; median [IQR] gestational age, 39.0 [38.6-39.7] weeks; 87 [57.2%] male infants). There was no evidence that the maternal third trimester serum metabolome was significantly associated with the other metabolomes. The placental and cord serum metabolomes were highly correlated (first latent variate pair: R2 = 0.75; P < .001) and the variate scores for each tissue were significantly associated with reduced risk of non-TD (placenta: relative risk [RR], 0.13; 95% CI, 0.02-0.71; cord: RR, 0.13; 95% CI, 0.03-0.70) but not ASD (placenta: RR, 1.09; 95% CI, 0.42-2.81; cord: RR, 0.63; 95% CI, 0.23-1.73) compared with the TD reference group.
CONCLUSIONS AND RELEVANCE
In this cohort study of children with high familial risk of ASD, placental and cord serum metabolism at delivery were highly correlated. Furthermore, placental and cord serum metabolic profiles were associated with risk of non-TD.
Topics: Humans; Female; Pregnancy; Placenta; Autism Spectrum Disorder; Male; Prospective Studies; Child, Preschool; Adult; Fetal Blood; Metabolomics; Child Development; Infant; Cohort Studies; Siblings; Pregnancy Trimester, Third
PubMed: 38805224
DOI: 10.1001/jamanetworkopen.2024.13399 -
Journal of Reproductive Immunology Feb 2024The prevention of pre-eclampsia is difficult due to the syndromic nature and multiple underlying mechanisms of this severe complication of pregnancy. The current... (Review)
Review
The prevention of pre-eclampsia is difficult due to the syndromic nature and multiple underlying mechanisms of this severe complication of pregnancy. The current clinical distinction between early- and late-onset disease, although clinically useful, does not reflect the true nature and complexity of the pathologic processes leading to pre-eclampsia. The current gaps in knowledge on the heterogeneous molecular pathways of this syndrome and the lack of adequate, specific diagnostic methods are major obstacles to early screening and tailored preventive strategies. The development of novel diagnostic tools for detecting the activation of the identified disease pathways would enable early, accurate screening and personalized preventive therapies. We implemented a holistic approach that includes the utilization of different proteomic profiling methods of maternal plasma samples collected from various ethnic populations and the application of systems biology analysis to plasma proteomic, maternal demographic, clinical characteristic, and placental histopathologic data. This approach enabled the identification of four molecular subclasses of pre-eclampsia in which distinct and shared disease mechanisms are activated. The current review summarizes the results and conclusions from these studies and the research and clinical implications of our findings.
Topics: Pregnancy; Female; Humans; Pre-Eclampsia; Placenta; Proteomics; Goals; Pregnancy Trimester, First; Biomarkers
PubMed: 38141514
DOI: 10.1016/j.jri.2023.104172 -
Placenta Jul 2024Knowledge on prevalence and association of human papillomavirus (HPV) in third trimester placentae and adverse pregnancy outcomes is limited. We investigated the...
INTRODUCTION
Knowledge on prevalence and association of human papillomavirus (HPV) in third trimester placentae and adverse pregnancy outcomes is limited. We investigated the prevalence of placental HPV at delivery, explored urine HPV characteristics associated with placental HPV and whether placental HPV increased the risk adverse pregnancy outcomes.
METHODS
Pregnant women were enrolled in the Scandinavian PreventADALL mother-child cohort study at midgestation. Human papillomavirus genotyping was performed on placental biopsies collected at delivery (n = 587) and first-void urine at midgestation and delivery (n = 556). Maternal characteristics were collected by questionnaires at gestational week 18 and 34. Adverse pregnancy outcomes were registered from chart data including hypertensive disorders of pregnancy, gestational diabetes mellitus and newborns small for gestational age. Uni- and multivariable regression models were used to investigate associations.
RESULTS
Placental HPV was detected in 18/587 (3 %). Twenty-eight genotypes were identified among the 214/556 (38 %) with midgestational urine HPV. Seventeen of the 18 women with placental HPV were midgestational HPV positive with 89 % genotype concordance. Midgestational high-risk-(HR)-HPV and high viral loads of Any- or HR-HPV were associated with placental HPV. Persisting HPV infection from midgestation to delivery was not associated with placental HPV. Adverse pregnancy outcomes were seen in 2/556 (0.4 %) of women with placental HPV.
DISCUSSION
In this general cohort of pregnant women, the prevalence of placental HPV was 3 %, and midgestational urinary HPV 38 %. High HPV viral load increased the risk for placental HPV infections. We observed no increased risk for adverse pregnancy outcomes in women with placental HPV.
Topics: Humans; Female; Pregnancy; Papillomavirus Infections; Adult; Placenta; Pregnancy Outcome; Pregnancy Complications, Infectious; Papillomaviridae; Cohort Studies; Pregnancy Trimester, Third; Young Adult
PubMed: 38768555
DOI: 10.1016/j.placenta.2024.05.126 -
Turkish Journal of Medical Sciences 2023To evaluate whether there is a relationship between serum myosin-binding protein C (MyBP-C) levels measured in the first trimester and the timing of delivery, and, if a...
BACKGROUND/AIM
To evaluate whether there is a relationship between serum myosin-binding protein C (MyBP-C) levels measured in the first trimester and the timing of delivery, and, if a relationship is detected, the potential of this relationship in distinguishing between preterm and term labor.
MATERIALS AND METHODS
This prospective case-control study was conducted with 701 pregnant women who applied to the Obstetrics Outpatient Clinic of Gaziosmanpaşa Training and Research Hospital in the first trimester, between 11 and 14 gestational weeks. MyBP-C serum samples from the first trimester were stored under appropriate conditions until the time of delivery. Of these pregnant women, 628 completed the study. According to the delivery time, the pregnant women were divided into two groups, as those who delivered prematurely before 37 weeks and those who gave birth at term. The case group comprised 45 women who gave birth prematurely, while 583 women gave birth at term. A control group was formed with 45 pregnant women of the same age, who were selected by randomization using a simple random sampling method from the 583 pregnant women. The MyBP-C levels were measured and compared from the first-trimester serum materials of both groups.
RESULTS
The MyBP-C levels of the preterm delivery group were significantly higher than those of the term delivery control group (4.51 ± 1.69 vs. 3.09 ± 1.44 pg/mL, respectively; p < 0.001). Receiver operating characteristic (ROC) curve analysis showed that the MyBP-C levels in the first trimester with a cut-off value of 4.76 ng/dL indicated women with preterm delivery with a sensitivity of 42.22% and specificity of 95.56% (AUC: 0.734, 95% CI: 0.630-0.822). The overall differential diagnosis performance of the MyBP-C level for preterm delivery was determined as 73.4% (p < 0.001). The MyBP-C levels were found to be significantly higher both in the early preterm group compared with the late preterm group (p < 0.001), and in those with premature rupture of membranes (PROM) compared with those without (p < 0.001).
CONCLUSION
The preterm delivery group exhibited high serum MyBP-C levels in the serum samples taken in the first trimester. First-trimester serum MyBP-C levels seem to be a simple and easy way to exclude preterm delivery risk in a significant manner. In addition, levels are significantly higher for early preterm compared with late preterm and early PROM compared with intact membranes.
Topics: Humans; Female; Pregnancy; Premature Birth; Prospective Studies; Biomarkers; Adult; Case-Control Studies; Carrier Proteins; Pregnancy Trimester, First; ROC Curve
PubMed: 38813022
DOI: 10.55730/1300-0144.5717 -
Clinical Microbiology and Infection :... Oct 2023This study aimed to evaluate the risk of congenital malformation among pregnant women exposed to the mRNA COVID-19 vaccines during the first trimester of pregnancy,...
OBJECTIVES
This study aimed to evaluate the risk of congenital malformation among pregnant women exposed to the mRNA COVID-19 vaccines during the first trimester of pregnancy, which is a developmental period where the foetus is at risk of teratogenicity.
METHODS
Pregnant women were prospectively enrolled from March 2021 to March 2022, at the time of COVID-19 vaccination. Pregnant women exposed to at least one dose of mRNA COVID-19 vaccine from conception to 11 weeks of gestations and 6 days were compared with pregnant women exposed to the vaccine from 12 weeks to the end of pregnancy. The primary outcome was a confirmed congenital malformation at birth.
RESULTS
A total of 1450 pregnant women were enrolled including 124 in the first trimester and 1326 in the second and third trimester. The overall proportion of congenital malformation was 0.81% (n = 1/124; 95% CI: 0.02-4.41) and 0.83% (n = 11/1326; 95% CI: 0.41-1.48) among pregnant exposed to the COVID-19 vaccine during the first and second/third trimester, respectively. First trimester exposure was not associated with a higher risk of congenital malformation with a relative risk of 0.89 (95% CI: 0.12-6.80) with no significant changes after adjustment through exploratory analysis.
CONCLUSIONS
Pregnant women exposed to mRNA COVID-19 vaccine before 12 weeks of gestation did not have an increased risk of congenital malformation compared with women exposed outside the teratogenic window. Because vaccination is safe and effective, emphasis must be placed on promoting vaccination during pregnancy.
Topics: Infant, Newborn; Pregnancy; Female; Humans; Pregnancy Trimester, First; COVID-19 Vaccines; Prospective Studies; COVID-19; RNA, Messenger; Vaccination
PubMed: 37343619
DOI: 10.1016/j.cmi.2023.06.015 -
Environmental Research Oct 2023Health concerns about the potential impact of exposure to fluoride via drinking water (DW) on neuropsychological development include behavioral outcomes such as ADHD.
BACKGROUND
Health concerns about the potential impact of exposure to fluoride via drinking water (DW) on neuropsychological development include behavioral outcomes such as ADHD.
OBJECTIVE
We aimed to examine the association between prenatal maternal urinary fluoride and symptoms associated with attention-deficit/hyperactivity disorder (ADHD) at the age of 8 and 11 years.
METHOD
Data from 255 to 236 mother-child pairs from the "Infancia y Medio Ambiente" (INMA) birth cohort (Gipuzkoa; Spain) with maternal urinary F adjusted for creatinine (MUFcr) during pregnancy (first and third trimester) and child assessments of ADHD-like symptoms reported by Conners' Rating Scales-Revised at age of 8 and 11 years was available. Clinical approach was also used: cut off criteria (T > 66). Multiple linear regression models were fitted when outcomes were analyzed as continuous, and logistic regression models when the outcomes were analyzed with a categorical clinical approach. Covariates related to maternal characteristics, birth outcomes, childhood, quality of family context and biomarkers of neuro-toxicants were used.
RESULTS
No association was found between MUFcr levels during pregnancy and cognitive problems-inattention, hyperactivity or ADHD index score of symptoms at 8 or 11 years. When results were analyzed from the perspective of a clinical approach, at the age of 11 years, there were significant inverse association between MUFcr and being categorized as a cognitive problems-inattention case. ORs were also indicative of a lower risk, although not significant, for ADHD index at age 11. Sensitivity analyses, taking into consideration quality of family context or the levels of other toxicants during pregnancy showed similar results.
CONCLUSIONS
Higher levels of MUFcr in pregnant women were associated with a lower risk of cognitive problems-inattention at 11 years. These findings are inconsistent with those from previous studies and indicate the need for other population-based studies to confirm or overturn these results.
Topics: Humans; Female; Pregnancy; Child; Attention Deficit Disorder with Hyperactivity; Fluorides; Pregnancy Trimester, Third; Vitamins; Creatinine; Prenatal Exposure Delayed Effects
PubMed: 37479215
DOI: 10.1016/j.envres.2023.116705 -
Cureus Sep 2023The current study aimed to search the prevalence and severity of restless legs syndrome (RLS) in pregnancy according to the three trimesters and predictive factors of...
OBJECTIVES
The current study aimed to search the prevalence and severity of restless legs syndrome (RLS) in pregnancy according to the three trimesters and predictive factors of RLS in pregnancy based on validated diagnostic tools and a thorough literature review.
METHODS
The cross-sectional descriptive study included 500 pregnant women without comorbidities who were interviewed face-to-face. Age, height, weight, week of pregnancy, smoking, alcohol, caffeine use, regular exercise, and lab test results from the last visit were all included in the data. Only women satisfying the RLS diagnostic criteria were given the Restless Legs Syndrome Rating Scale.
RESULTS
The prevalence of RLS was found to be 29.2% with the highest rate in the third trimester (64.4%). In all trimesters, low ferritin (first trimester: p = 0.004; second trimester: p < 0.001; third trimester: p < 0.001), folic acid (first trimester: p = 0.001; second trimester: p < 0.001; third trimester: p < 0.001), vitamin B12 (first trimester: p = 0.003; second trimester: p < 0.001; third trimester: p < 0.001), and hemoglobin (first trimester: p < 0.001; second trimester: p < 0.001; third trimester: p < 0.001) levels were associated with RLS. In the second and third trimesters, low magnesium (p < 0.001 and p < 0.001, respectively) and high creatinine (p = 0.027 and p < 0.001, respectively) levels were associated with RLS. Higher thyroid-stimulating hormone and free T4 levels were associated with RLS in the third trimester but not in the first and second trimesters (median: 2.4 vs. 2.1, p < 0.001; median: 1.5 vs. 1.2, p < 0.001). In the multivariate regression analysis, age (p = 0.034, OR: 1.060, 95% CI: 1.005-1.119), present BMI (p < 0.001, OR: 1.8884, 95% CI: 1.597-2.222), BMI before conception (p < 0.001, OR: 0.607, 95% CI: 0.513-0.718), gravida (p < 0.001, OR: 2.172, 95% CI: 1.547-3.049), low ferritin level (p < 0.001, OR: 6.396, 95% CI: 0.00744-0.010405), low vitamin B12 (p < 0.001, OR: 10.347, 95% CI: 0.00120-0.00176), low folate (p < 0.001, OR: 5.841, 95% CI: 0.00616-0.01240), RLS history before conception (p = 0.013, OR: 4.963, 95% CI: 1.402-17.57), and RLS family history (p < 0.001, OR: 7.914, 95% CI: 0.18760-0.31151) were found to be predictive factors for RLS in pregnancy.
CONCLUSION
More attention is needed to RLS during pregnancy to prevent or treat this syndrome.
PubMed: 37692184
DOI: 10.7759/cureus.44884