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Scandinavian Journal of Clinical and... Oct 2018Pregnancy is associated with an increased risk of venous thromboembolism (VTE). D-dimer is a biomarker used as an exclusion criterion of VTE disease, but its usefulness...
Pregnancy is associated with an increased risk of venous thromboembolism (VTE). D-dimer is a biomarker used as an exclusion criterion of VTE disease, but its usefulness during pregnancy shows limitations because D-dimer levels physiologically increase through pregnancy. The aim of our study was to follow the changes of D-dimer levels and to establish trimester-specific reference intervals during normal pregnancy. This is a longitudinal prospective study in which the reference population finally included 102 healthy pregnant women. Plasma D-dimer levels were measured during the three trimesters of pregnancy, using a latex-based immunoturbidimetric assay. Reference intervals were calculated according to the Clinical and Laboratory Standards Institute recommendations. D-dimer levels increased progressively and significantly through pregnancy and peaked in the third trimester, in which D-dimer levels were above the conventional cut-off point (500 µg/L) in 99% of pregnant women. The following reference intervals were defined: first trimester: 169-1202 µg/L, second trimester: 393-3258 µg/L and third trimester: 551-3333 µg/L. The study provides reference intervals of D-dimer during the pregnancy using latex-based immunoturbidimetry on the ACL 300 TOP automated coagulation analyser. Further prospective studies of pregnant women with clinical suspicion of VTE are needed to validate these results.
Topics: Adult; Biomarkers; Blood Chemical Analysis; Female; Fibrin Fibrinogen Degradation Products; Humans; Pregnancy; Pregnancy Trimesters; Prospective Studies; Reference Values; Venous Thromboembolism
PubMed: 29975107
DOI: 10.1080/00365513.2018.1488177 -
BMC Medicine Oct 2019Periconceptional folic acid prevents neural tube defects (NTDs), but it is uncertain whether there are benefits for offspring neurodevelopment arising from continued... (Randomized Controlled Trial)
Randomized Controlled Trial
Effect of continued folic acid supplementation beyond the first trimester of pregnancy on cognitive performance in the child: a follow-up study from a randomized controlled trial (FASSTT Offspring Trial).
BACKGROUND
Periconceptional folic acid prevents neural tube defects (NTDs), but it is uncertain whether there are benefits for offspring neurodevelopment arising from continued maternal folic acid supplementation beyond the first trimester. We investigated the effect of folic acid supplementation during trimesters 2 and 3 of pregnancy on cognitive performance in the child.
METHODS
We followed up the children of mothers who had participated in a randomized controlled trial in 2006/2007 of Folic Acid Supplementation during the Second and Third Trimesters (FASSTT) and received 400 μg/d folic acid or placebo from the 14th gestational week until the end of pregnancy. Cognitive performance of children at 7 years was evaluated using the Wechsler Preschool and Primary Scale of Intelligence (WPPSI-III) and at 3 years using the Bayley's Scale of Infant and Toddler Development (BSITD-III).
RESULTS
From a total of 119 potential mother-child pairs, 70 children completed the assessment at age 7 years, and 39 at age 3 years. At 7 years, the children of folic acid treated mothers scored significantly higher than the placebo group in word reasoning: mean 13.3 (95% CI 12.4-14.2) versus 11.9 (95% CI 11.0-12.8); p = 0.027; at 3 years, they scored significantly higher in cognition: 10.3 (95% CI 9.3-11.3) versus 9.5 (95% CI 8.8-10.2); p = 0.040. At both time points, greater proportions of children from folic acid treated mothers compared with placebo had cognitive scores above the median values of 10 (girls and boys) for the BSITD-III, and 24.5 (girls) and 21.5 (boys) for the WPPSI-III tests. When compared with a nationally representative sample of British children at 7 years, WPPSI-III test scores were higher in children from folic acid treated mothers for verbal IQ (p < 0.001), performance IQ (p = 0.035), general language (p = 0.002), and full scale IQ (p = 0.001), whereas comparison of the placebo group with British children showed smaller differences in scores for verbal IQ (p = 0.034) and full scale IQ (p = 0.017) and no differences for performance IQ or general language.
CONCLUSIONS
Continued folic acid supplementation in pregnancy beyond the early period recommended to prevent NTD may have beneficial effects on child cognitive development. Further randomized trials in pregnancy with follow-up in childhood are warranted.
TRIAL REGISTRATION
ISRCTN ISRCTN19917787 . Registered 15 May 2013.
Topics: Child; Child Development; Child, Preschool; Cognition; Dietary Supplements; Female; Folic Acid; Follow-Up Studies; Gestational Age; Humans; Male; Pregnancy; Pregnancy Trimester, First; Pregnancy Trimester, Second; Pregnancy Trimester, Third
PubMed: 31672132
DOI: 10.1186/s12916-019-1432-4 -
The Journal of Obstetrics and... Dec 2021To investigate the clinical and the sonographic characteristics of adnexal torsion (AT) during pregnancy and to underline differences in AT manifestation between...
AIM
To investigate the clinical and the sonographic characteristics of adnexal torsion (AT) during pregnancy and to underline differences in AT manifestation between pregnancy trimesters.
METHODS
This is a retrospective cohort study in a tertiary medical center. The study included all pregnant women with surgically confirmed AT between March 2011 and April 2020. The patients were divided into three groups according to pregnancy trimesters, and the clinical and sonographic characteristics were compared between the groups.
RESULTS
The study cohort included 140 cases of AT. Ninety-nine (70.7%) of the cases occurred during the 1st trimester, and 31 (22.1%) and 10 (7.1%) occurred during the 2nd and the 3rd trimesters, respectively. Conception by assisted-reproductive technologies (ART), nausea, and finding of enlarged ovary on ultrasound scan were all more common among patients in the 1st trimester group as compared to the 3rd trimester group (p = 0.001, 0.015, and 0.024, respectively). The mean time from admission to surgery was significantly shorter in the 1st trimester group as compared to late pregnancy (p = 0.001). The majority of cases were right-sided. There was a significant difference in the organs involved in every trimester of pregnancy-ovary only, ovary and fallopian tube, and fallopian tube only (p = 0.023).
CONCLUSIONS
Most AT cases during pregnancy occurred during the 1st trimester. Conception by ART and enlarged ovary on ultrasound scan were also more common in AT cases during early pregnancy. Time from admission to surgery was longer as pregnancy progressed and organs involved differed between trimesters. Understanding the difference in manifestation of AT in every trimester might improve the preoperative evaluation of AT in pregnancy.
Topics: Adnexal Diseases; Female; Humans; Ovarian Torsion; Pregnancy; Pregnancy Trimester, Third; Pregnancy Trimesters; Retrospective Studies; Torsion Abnormality
PubMed: 34605118
DOI: 10.1111/jog.15048 -
Acta Obstetricia Et Gynecologica... Oct 2023Pain during pregnancy affects women's well-being, causes worry and is a risk factor for the child and the mother during labor. The aim was to investigate the relative...
INTRODUCTION
Pain during pregnancy affects women's well-being, causes worry and is a risk factor for the child and the mother during labor. The aim was to investigate the relative importance of an extensive set of pregnancy-related physiological symptoms and psychosocial factors assessed in the first trimester compared with the occurrence of pregnancy-related pain symptoms later in the pregnancy.
MATERIAL AND METHODS
Included were all women who booked an appointment for a first prenatal visit in one of 125 randomly selected general practitioner practices in Eastern Denmark from April 2015 to August 2016. These women answered an electronic questionnaire containing questions on the occurrence of five pregnancy-related pain symptoms: back pain, leg cramps, pelvic cavity pain, pelvic girdle pain and uterine contractions. The questionnaire also included sociodemographic questions and questions on chronic diseases, physical symptoms, mental health symptoms, lifestyle and reproductive background. The questionnaire was repeated in each trimester. The relative importance of this set of factors from the first trimester on the five pregnancy-related pain symptoms compared with the second and third trimesters was assessed in a dominance analysis.
RESULTS
A total of 1491 women were included. The most important factor for pregnancy-related pain in the second trimester and third trimester is the presence of the corresponding pain in the first trimester. Parity was associated with pelvic cavity pain and uterine contractions in the following pregnancies. For back pain and pelvic cavity pain, the odds increased as the women's estimated low self-assessed fitness decreased and had low WHO-5 wellbeing scores.
CONCLUSIONS
When including physical risk factors, sociodemographic factors, psychological factors and clinical risk factors, women's experiences of pregnancy-related pain in the first trimester are the most important predictors for pain later in pregnancy. Beyond the expected positive effects of pregnancy-related pain, notably self-assessed fitness, age and parity were predictive for pain later in pregnancy.
Topics: Pregnancy; Child; Female; Humans; Pregnancy Trimester, Third; Pregnancy Complications; Pregnancy Trimester, First; Pregnancy Trimester, Second; Pelvic Pain
PubMed: 37771202
DOI: 10.1111/aogs.14670 -
Journal of Hypertension Apr 2011
Topics: Blood Pressure; Female; Humans; Pregnancy; Pregnancy Trimesters
PubMed: 21389814
DOI: 10.1097/HJH.0b013e32834443d6 -
Nigerian Journal of Medicine : Journal... 2015Normal pregnancy is a hypercoagulable state; a physiological safety valve aimed at preventing excessive maternal blood loss at delivery.
BACKGROUND
Normal pregnancy is a hypercoagulable state; a physiological safety valve aimed at preventing excessive maternal blood loss at delivery.
OBJECTIVE
To evaluate the influence of normal pregnancy on blood coagulation and to explore changes in activity from the first through the third trimester.
SUBJECT AND METHODS
Sixty (60) apparently healthy pregnant women (20 from each trimester) and 20 healthy non-pregnant age-matched controls were recruited. Each participant had Prothrombin time (PT). Activated partial thromboplastin time (APTT) and platelet count done. Multiple comparisons were made between control values and coagulation profile at different stages of pregnancy using the Bonferroni statistics. Results were expressed as means and standard deviations, p < 0.01 was significant at 95 % CI. Ethical approval for the study was obtained from the Institutional review board.
RESULTS
The means of the APTT were significantly lower in the first, second and third trimesters compared with controls (35.59 ± 4.95 seconds, 32.22 ± 5.79 seconds and 29.60 ± 3.66 seconds, respectively, vs. 40.55 ± 5.95 seconds; p = 0.01). Correspondingly, the platelet count was significantly lower in the 3 trimester of pregnancy compared with controls (178.35 ± 41.52 x 10(9)/L vs. 233.86 ± 55.34 x 10(9)/L; p < 0.01) and equally with level in the 2nd trimester (178.35 ± 41.52 x 10(9)/L vs. 232.10 ± 48.67 x 10(9)/L; p < 0.01).
CONCLUSION
The APTT and platelet counts are significantly lower in the 3 trimester of normal pregnancy.
Topics: Adult; Blood Coagulation; Female; Humans; Partial Thromboplastin Time; Pregnancy; Pregnancy Trimester, First; Pregnancy Trimester, Second; Pregnancy Trimester, Third; Young Adult
PubMed: 25807675
DOI: No ID Found -
Thrombosis Research Aug 2017Due to the normal physiological need of pregnancy and childbirth, the haemostatic system of pregnant women is different from that of healthy non-pregnant women. The aim...
BACKGROUND
Due to the normal physiological need of pregnancy and childbirth, the haemostatic system of pregnant women is different from that of healthy non-pregnant women. The aim of this study was to establish trimester-specific reference intervals of coagulation screening tests and thrombophilia markers in pregnancies without complications of females with Han ethnicity from North China.
METHODS
In total 744 Han healthy pregnant women (first trimester 207 cases, second trimester 222 cases and third trimester 315 cases) and 121 healthy non-pregnant women were recruited in North China. Eight tests-activated partial thromboplastin time (APTT), prothrombin time (PT), thrombin time (TT), fibrinogen (Fib), d-Dimer, antithrombin (AT), protein C (PC) and free protein S (fPS)-were processed on ACL TOP automated coagulation analyzer. The non-parametric 2.5th-97.5th percentiles reference intervals were calculated to establish trimester-specific reference intervals.
RESULTS
The reference intervals for APTT, PT, TT, Fib, d-Dimer, AT, PC, and fPS at first trimester were 26.4-41.9s, 9.7-12.5s, 11.7-17.0s, 2.38-4.44g/L, 0.01-0.31μg/mL, 72-120%, 29-150%, 21-143%, respectively. At second trimester, the reference intervals were 24.4-35.8s, 8.5-13.2s, 10.0-16.0s, 2.40-5.97g/L, 0.05-0.73μg/mL, 68-125%, 20-138%, 24-155%, respectively. At third trimester, the reference intervals were 25.6-34.9s, 8.6-12.4s, 11.1-15.5s, 2.79-5.91g/L, 0.14-2.82μg/mL, 56-119%, 20-134%, 17-140%, respectively. From the first trimester to the third trimester, APTT, PT and TT presented shortened trends, Fib and d-Dimer presented increasing trends, AT, PC and fPS activity presented decreasing trends, respectively.
CONCLUSIONS
The trimester-specific reference intervals of coagulation screening tests and thrombophilia markers in pregnancies without complications of females with Han ethnicity from North China are presented in this study, which may provide effective evidence for doctors to accurately diagnose and treat the disease during pregnancy.
Topics: Adult; Blood Coagulation; Blood Coagulation Tests; Female; Humans; Middle Aged; Pregnancy; Pregnancy Trimesters; Young Adult
PubMed: 28605659
DOI: 10.1016/j.thromres.2017.05.021 -
The Journal of Sexual Medicine Jan 2010Sexuality is an important part of health and well-being. Sexual behavior modifies as pregnancy progresses, influenced by biological, psychological, and social factors.
INTRODUCTION
Sexuality is an important part of health and well-being. Sexual behavior modifies as pregnancy progresses, influenced by biological, psychological, and social factors.
AIM
To evaluate changes in sexual perceptions and activities during pregnancy and to determine sexual dysfunctions in that period.
MAIN OUTCOME MEASURES
Sexual perceptions (desire from the partner, feelings of attractiveness, and fear of sexual intercourse), sexual activities during pregnancy (sexual intercourse frequency, the most frequent sexual intercourse trimester, sexual activity during the birth week, type(s) of sexual intercourse, changes in sexual satisfaction and desire compared with the pre-pregnancy period, and changes in sexual intercourse frequency during each trimester compared with the pre-pregnancy period), and sexual dysfunctions.
METHODS
Puerperal women were asked to anonymously complete a self-administered and structured questionnaire at the day of discharge from hospital.
RESULTS
One hundred and eighty-eight women, aged between 17 years and 40 years with a mean age of 28.9 years, were analyzed. The first trimester was considered the most frequent period of sexual intercourse (44.7%), followed by the second trimester (35.6%). Fifty-five percent reported a decrease of sexual activity during the third trimester. Fear of sexual intercourse was referred by 23.4% of the women questioned. Sexual satisfaction was unchanged in 48.4% of the subjects and decreased in 27.7% (P < 0.0001); sexual desire is reported to be unchanged in 38.8% and decreased in 32.5% (P = 0.196) of the population. Vaginal, oral, anal sex, and masturbation were performed by 98.3%, 38.1%, 6.6%, and 20.4% of the women, respectively.
CONCLUSIONS
We determined in our study that sexual satisfaction do not change in pregnancy compared with the pre-pregnancy patterns despite a decline of sexual activity during the third trimester. A discussion of expected changes in sexuality should be routinely done by the doctor in order to improve couples' perception of possible sexual modifications induced by pregnancy.
Topics: Adolescent; Adult; Body Image; Coitus; Female; Health Surveys; Humans; Libido; Pregnancy; Pregnancy Complications; Pregnancy Trimesters; Sexual Behavior; Sexual Dysfunctions, Psychological; Young Adult
PubMed: 19845548
DOI: 10.1111/j.1743-6109.2009.01538.x -
Reproductive Biomedicine Online Sep 2020Does the length of the anogenital distance (AGD), an anthropometric biomarker of fetal androgen exposure, change across pregnancy? It has been suggested that AGD remains...
RESEARCH QUESTION
Does the length of the anogenital distance (AGD), an anthropometric biomarker of fetal androgen exposure, change across pregnancy? It has been suggested that AGD remains stable during adulthood with no changes across the menstrual cycle. No studies, however, have been carried out during pregnancy, during which women are exposed to important hormonal and anthropometric variations.
DESIGN
A cohort study of 186 singleton pregnant women recruited in the first trimester of pregnancy. Measurements from the anterior clitoral surface to the upper verge of the anus (AGD), and from the posterior fourchette to the upper verge of the anus (AGD) and body mass index (BMI) were obtained in each trimester. Generalized linear model for repeated measures was carried out to assess differences in AGDs and BMI across the three trimesters of the pregnancy.
RESULTS
In crude analyses, AGD was progressively and significantly longer as the pregnancy developed (first trimester: 87.69 ± 13.14mm; second trimester: 89.69 ± 13.47mm; third trimester: 91.95 ± 13.25 mm; P < 0.001), whereas AGD did not significantly change throughout pregnancy (first trimester: 28.37 ± 6.94 mm; second trimester: 28.09 ± 7.66 mm; third trimester: 28.94 ± 6.7 mm). In the multivariable mixed-effect models for fixed effect (trimester) and time-covariate (BMI), AGDs did not show significant associations with trimesters of pregnancy when BMI was included in the model.
CONCLUSIONS
Our results suggest that AGD and AGD, when adjusted by BMI, do not change throughout gestation despite maternal anthropometric variations during pregnancy. AGD may be a meaningful measurement at any time during pregnancy without considering BMI. Therefore, maternal AGD may be used as a prenatal biomarker of the mother's in-uteru hormonal exposure even during pregnancy.
Topics: Adult; Anal Canal; Anthropometry; Biomarkers; Body Mass Index; Case-Control Studies; Female; Genitalia, Female; Humans; Pregnancy; Pregnancy Trimester, First; Pregnancy Trimester, Third
PubMed: 32586732
DOI: 10.1016/j.rbmo.2020.05.009 -
Endocrine May 2021
Topics: COVID-19; Female; Humans; Postpartum Period; Pregnancy; Pregnancy Trimester, First; Pregnancy Trimesters; SARS-CoV-2; Thyroid Gland
PubMed: 33721205
DOI: 10.1007/s12020-021-02678-1