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PeerJ 2024To determine the association between lipid metabolism and intrahepatic cholestasis of pregnancy (ICP), and explore the value of maternal alanine...
Evaluation of alanine aminotransferase/aspartate aminotransferase ratio and high-density lipoprotein for predicting neonatal adverse outcomes associated with intrahepatic cholestasis of pregnancy.
BACKGROUND
To determine the association between lipid metabolism and intrahepatic cholestasis of pregnancy (ICP), and explore the value of maternal alanine aminotransferase/aspartate aminotransferase (ALT/AST) and high-density lipoprotein (HDL) in predicting adverse neonatal outcomes in women with ICP.
METHODS
A total of 147 pregnant women with ICP admitted to The Fourth Hospital of Shijiazhuang and 120 normal pregnant women in the same period were selected in this study. The Mann-Whitney U test and Chi-square tests were used to compare the differences in clinical data. Multivariate logistic regression was used to analyze the relationship between ALT/AST and the occurrence of adverse pregnancy outcomes in patients with ICP. The combined predictive value of ALT/AST and HDL was determined by receiver operating characteristic (ROC) curve analysis.
RESULTS
Among 147 women with ICP, 122 women had total bile acid (TBA) levels of 10-39.9 µmol/L, and 25 had TBA ≥ 40 µmol/L. There was significantly lower gestational age in patients with severe ICP than in those with mild and control groups (all < 0.05), and the weight of newborns in the maternal ICP group was significantly lower than in the control group ( < 0.05). Increasing TBA levels was associated with higher AST, ALT, ALT/AST, and lower HDL level (all < 0.05). Meanwhile, higher levels of ALT/AST was positively associated with neonatal hyperbilirubinemia [adjusted odds ratio (AOR) = 4.019, 95% CI [1.757-9.194, = 0.001] and cardiac injury [AOR = 3.500, 95% CI [1.535-7.987], = 0.003]. HDL was a significant protective factor for neonatal hyperbilirubinemia and cardiac injury [AOR = 0.315, 95% CI [0.126-0.788], = 0.014; AOR = 0.134 (0.039-0.461), = 0.001]. The area under the ROC curve (AUC) for prediction of neonatal hyperbilirubinemia by ALT/AST combined with HDL was 0.668 [95% CI [56.3-77.3%], = 0.002], and the sensitivity and specificity were 47.1% and 84.0%, respectively. To predict neonatal cardiac injury, the AUC value was 0.668 [95% CI [56.4-77.1%], = 0.002], with sensitivity and specificity were 41.2% and 87.1%, respectively.
CONCLUSIONS
The levels of higher ALT/AST and lower HDL were significantly associated with the risk of ICP-related adverse neonatal outcomes. Moreover, ALT/AST combined with HDL has moderate clinical value in predicting the adverse outcomes of neonatal hyperbilirubinemia and cardiac injury.
Topics: Humans; Female; Pregnancy; Cholestasis, Intrahepatic; Pregnancy Complications; Alanine Transaminase; Adult; Aspartate Aminotransferases; Infant, Newborn; Lipoproteins, HDL; Pregnancy Outcome; ROC Curve; Predictive Value of Tests; Biomarkers; Case-Control Studies
PubMed: 38938614
DOI: 10.7717/peerj.17613 -
Frontiers in Endocrinology 2024Endocannabinoids and their -acyl-ethanolamines (NAEs) and 2monoacyl-glycerols (2-MAGs) congeners are involved in the central and peripheral regulation of energy...
OBJECTIVE
Endocannabinoids and their -acyl-ethanolamines (NAEs) and 2monoacyl-glycerols (2-MAGs) congeners are involved in the central and peripheral regulation of energy homeostasis, they are present in human milk and are associated with obesity. Infants exposed to gestational diabetes mellitus (GDM) are more likely to develop obesity. The objective of this cross-sectional study is to compare the profile of eCBome mediators in milk of women with gestational diabetes (GDM+) and without (GDM-) and to assess the association with offspring growth. The hypothesis is that the eCBome of GDM+ human milk is altered and associated with a difference in infant growth.
METHODS
Circulating eCBome mediators were measured by LC-MS/MS in human milk obtained at 2 months postpartum from GDM+ (n=24) and GDM- (n=29) women. Infant weight and height at 2 months were obtained from the child health record. Z-scores were calculated.
RESULTS
Circulating Npalmitoylethanolamine (PEA) was higher in human milk of GDM+ women than in GDM- women (4.9 ± 3.2 vs. 3.3 ± 1.7, p=0.04). Higher levels were also found for several 2monoacyl-glycerols (2-MAGs) (p<0.05). The levels of NAEs (β=-4.6, p=0.04) and especially non-omega-3 NAEs (B=-5.6, p=0.004) in human milk were negatively correlated with weight-for-age z-score of GDM+ offspring.
CONCLUSION
The profile of eCBome mediators in human milk at 2 months postpartum was different in GDM+ compared to GDM- women and was associated with GDM+ offspring growth at 2 months.
CLINICAL TRIAL REGISTRATION
ClinicalTrials.gov, identifier (NCT04263675 and NCT02872402).
Topics: Humans; Endocannabinoids; Milk, Human; Female; Pregnancy; Diabetes, Gestational; Infant, Newborn; Adult; Cross-Sectional Studies; Male; Infant; Child Development
PubMed: 38938519
DOI: 10.3389/fendo.2024.1415630 -
Open Veterinary Journal May 2024Beta-glucan (β-glucan) is a polysaccharide containing β-glycosidic bonds that is an important structure part of different yeast cells.
BACKGROUND
Beta-glucan (β-glucan) is a polysaccharide containing β-glycosidic bonds that is an important structure part of different yeast cells.
AIM
The purpose of the study is to characterize β-glucan obtained from isolated from caprine mastitis
METHODS
The β-glucan was extracted by using utilizing an Alkaline-acidic extraction technique. The dry weight of extracted β-glucan was 7.47/150 g with 4.98%.
RESULTS
The findings demonstrated that the extracted β-glucan had similarity in the primary peak 5.78 of liquid samples using the method of high-performance liquid chromatography when compared to the standard form of β-glucan. However, scanning electron microscopy studies revealed that the standard of β-glucan was distinct in morphology but similar to β-glucan isolated from in terms of particle sizes in the range of 1.60-2.65 m and the lack of cell wall traces. The findings of an investigation using energy-dispersive X-ray fluorescence spectroscopy (EDS/EDX) of extracted and standard β-glucan, showed the principal elements discovered were carbon (C), oxygen (O), and nitrogen (N). Aluminum (Al), silicon (Si), nickel (Ni), and gold (Au) were also present, but in less amounts.
CONCLUSION
The extracted β-glucan displayed a high degree of similarity and purity to the standard β-glucan, according to the findings of Fourier transform infrared spectroscopy (FT-IR) research.
Topics: Animals; Goats; beta-Glucans; Candida albicans; Female; Goat Diseases; Mastitis; Microscopy, Electron, Scanning
PubMed: 38938423
DOI: 10.5455/OVJ.2024.v14.i5.22 -
JACC. Advances Jun 2023
PubMed: 38938251
DOI: 10.1016/j.jacadv.2023.100400 -
JACC. Advances Jun 2023Persons with COVID-19 infection have an increased risk of pregnancy-related complications. However, data on acute cardiovascular (CV) complications during delivery...
BACKGROUND
Persons with COVID-19 infection have an increased risk of pregnancy-related complications. However, data on acute cardiovascular (CV) complications during delivery admissions remain limited.
OBJECTIVES
The purpose of this study was to determine whether pregnant individuals with COVID-19 have an increased risk of acute peripartum CV complications during their delivery admission.
METHODS
This population-based retrospective cohort study used the 2020 National Inpatient Sample database. The International Classification of Diseases, 10th Revision codes were used to identify delivery admissions with a diagnosis of COVID-19. A multivariable logistic regression model was performed to determine the association between COVID-19 and acute peripartum CV complications at delivery.
RESULTS
A total of 3,458,691 weighted delivery admissions were identified, of which 1.3% were among persons with COVID-19 (n = 46,375). Persons with COVID-19 were younger (median 28 vs 29 years, < 0.01) and had a higher prevalence of gestational diabetes mellitus, preterm births, and Cesarean delivery ( < 0.01). After adjustment for age, race/ethnicity, comorbidities, insurance, and income, COVID-19 remained independently associated with peripartum CV complications including preeclampsia (adjusted odds ratio [aOR]: 1.33 [95% CI, 1.29-1.37]), peripartum cardiomyopathy (aOR: 2.09 [1.54-2.84]), acute coronary syndrome (aOR: 12.94 [8.85-18.90]), and arrhythmias (aOR: 1.55 [1.45-1.67]), compared with no COVID-19. Likewise, the risks of in-hospital mortality, acute kidney injury, stroke, pulmonary edema, and venous thromboembolism were higher with COVID-19. For resource utilization, the cost of hospitalization ($5,374 vs $4,837, < 0.01) was higher for deliveries among persons with COVID-19.
CONCLUSIONS
In the year 2020, pregnant persons with COVID-19 had a higher risk of preeclampsia, in-hospital mortality, and other serious CV complication during delivery hospitalizations compared to pregnant individuals without COVID-19.
PubMed: 38938230
DOI: 10.1016/j.jacadv.2023.100386 -
Journal of Preventive Medicine and... Jun 2024A substantial proportion of women experience mental health challenges during pregnancy or the postpartum period. Common mental disorders (CMDs), including depression,...
OBJECTIVES
A substantial proportion of women experience mental health challenges during pregnancy or the postpartum period. Common mental disorders (CMDs), including depression, anxiety, and obsessive-compulsive disorder, are prevalent. Identifying causes and associated risk factors is imperative for early intervention and the prevention of mental health issues.
METHODS
This study utilized data from the 2018 Basic Health Research, which was conducted nationwide in Indonesia, using a cross-sectional approach. We focused on women aged 13-49 years who were currently or previously married, and had experienced pregnancy, including 8,889 pregnant women and 77,012 women who had delivered between January 1, 2013, and August 31, 2018. The Self-Reporting Questionnaire-20 was employed to assess CMDs. Multivariate logistic regression was performed.
RESULTS
The prevalence of CMDs in pregnant women was 12.6%, while postpartum mothers exhibited a prevalence of 10.1%. Poor health status displayed the strongest impact on CMDs during both pregnancy (Adjusted Odds Ratio [AOR]: 12.23, 95% Confidence Interval [CI]: 9.06-16.60) and the postpartum period (AOR: 16.72, 95% CI: 14.85-18.82). Additional significant factors for both group include young maternal age, lack of education, unemployment, hystory of hypertension, and smoking status. Among pregnant women, CMDs was also associated with first-trimester pregnancy, previous pregnancy complications, and small upper arm circumference. For postpartum mothers, significant factors include history of abortion, unwanted pregnancy, pregnancy complications, lack of antenatal care, spontaneous delivery, postpartum complications and contraceptive use.
CONCLUSIONS
CMDs can impact in pregnant and postpartum women. Early diagnosis and management must be seamlessly integrated into primary healthcare practices.
PubMed: 38938048
DOI: 10.3961/jpmph.24.082 -
Contraception and Reproductive Medicine Jun 2024Unintended pregnancies pose significant health risks, particularly in sub-Saharan Africa, where millions of cases are recorded annually, disproportionately affecting...
BACKGROUND
Unintended pregnancies pose significant health risks, particularly in sub-Saharan Africa, where millions of cases are recorded annually, disproportionately affecting adolescent women. Utilization of modern contraceptives is crucial in managing fertility and reducing unintended pregnancies, abortions, and associated health complications. This study aimed to assess the prevalence, distribution and factors associated with modern contraceptives utilization among women aged 15-49 in Uganda.
METHODS
The study used secondary data from the 2016 Uganda Demographic and Health Survey (UDHS). The study sample comprise of 9,235 women aged 15-49 who used any method to prevent pregnancy in the five years preceding 2016 UDHS survey. The outcome variable for this study is utilization of modern contraceptives. Univariate, bivariate, and multilevel binary logistic regression was used to examine the relationship between individual and contextual factors on the modern contraceptive use among women aged 15-49 in Uganda. Choropleth mapping and network analysis in ArcGIS 10.8.2 was used to visualize spatial distribution of modern contraceptive use and measure community access to health facilities respectively.
RESULTS
The prevalence of modern contraceptive use was 53.19% (n = 4,919) in Uganda, with significant spatial variation by district. Higher prevalence (23.18%) was observed among women aged 20-29 compared to adolescents (4.1%). Only 21.9% of married women reported using modern contraceptives. At the individual-level, the factors that positively influenced use of modern contraceptives included: women's marital status, wealth index and level of education while sex of the household head, ever terminated a pregnancy and religion negatively affected the use of modern contraceptives. At community-level, community access to health facilities was found to have negative influence on the use of modern contraceptives among women. In communities where women frequently visited health facilities in the 12 months preceding the survey, the use of modern contraceptives reduced by 3.9%. Accessibility analysis revealed challenges, with women in northeastern districts (rural districts) facing travel times exceeding four hours to reach health facilities.
CONCLUSION
Utilization of modern contraceptives are essential for promoting women's health and well-being, particularly concerning maternal healthcare. This study highlights disparities in modern contraceptive use across age groups and the districts, emphasizing the need for targeted interventions. Policymakers and stakeholders must prioritize strategies that promote utilization of modern contraceptives and maternal healthcare services to address these disparities effectively. Such efforts are crucial for improving reproductive health outcomes and reducing the burden of unintended pregnancies and related complications in Uganda.
PubMed: 38937845
DOI: 10.1186/s40834-024-00288-6 -
BMC Women's Health Jun 2024The nutritional status of the mothers before pregnancy and the weights gained during pregnancy are very crucial factors affecting the pregnancy outcomes and health of...
BACKGROUND
The nutritional status of the mothers before pregnancy and the weights gained during pregnancy are very crucial factors affecting the pregnancy outcomes and health of the infants. This study aimed to assess early pregnancy weight, determine the magnitude of gestational weight gain, and investigate the factors affecting gestational weight gain among pregnant women in the Gurage zone, 2022.
METHODS
A prospective cohort study was conducted among pregnant women who started antenatal care follow-up before the 16th week of gestation in the selected hospitals and health centers of the Gurage zone, Ethiopia. The gestational weight gain was obtained by subtracting the early pregnancy weight from the last pregnancy weight and categorizing based on the Institute of Medicine (IOM) recommendation.
RESULTS
The early pregnancy weight status of the women at enrollment indicates that 10% of them were underweight and 83% of them had normal weight. On average, the study participants gained 13.3 kgs of weight with [95% CI: 13.0, 13.6]. More than half (56%) of them gained adequate weight, a quarter (26%) of them gained inadequate weight, and 18% of them gained excess weight during pregnancy compared to the IOM recommendation. Maternal age, occupational status, and early pregnancy weight status were found to have a statistically significant association with the gestational weight gained.
CONCLUSION
Almost half (44%) of the pregnant women gained either inadequate or excess weight during pregnancy. Promoting gestational weight gain within recommended guidelines should be emphasized for younger, employed women and those who are either underweight or overweight.
Topics: Humans; Female; Pregnancy; Ethiopia; Gestational Weight Gain; Adult; Prospective Studies; Young Adult; Cohort Studies; Thinness; Prenatal Care; Body Mass Index; Nutritional Status; Pregnancy Complications; Adolescent; Pregnant Women; Maternal Age
PubMed: 38937766
DOI: 10.1186/s12905-024-03223-8 -
BMC Psychiatry Jun 2024This scoping review sought to investigate the association between pregnancy-related complications and post-traumatic stress disorder (PTSD) among postpartum women, then... (Review)
Review
OBJECTIVE
This scoping review sought to investigate the association between pregnancy-related complications and post-traumatic stress disorder (PTSD) among postpartum women, then summarize effective psychological interventions for pregnancy-related PTSD or sub-PTSD.
METHOD
Publications in English and Chinese were searched in PubMed, Embase, Cochrane, ISI Web of Science, China National Knowledge Infrastructure (CNKI), and WanFang databases using the subject headings of "Stress Disorders, Post-Traumatic", "Pregnant Women", and "psychotherapy". To ensure that as many relevant studies are incorporated as possible, free terms such as prenatal, postnatal, perinatal and gestation were also used. Intervention studies and related cases published by July 1st, 2023, were also searched.
RESULTS
Twenty-one articles (including 3,901 mothers) were included in this review. Evidence showed that typical psychological interventions exhibited great effect, and family support programs, peer support, online yoga, and music therapy were also effective in reducing risk and improving the psychological well-being of the studied population.
CONCLUSION
Fetal abnormalities, miscarriage, premature birth, infants with low birth weights, hypertension, pre-eclampsia, HELLP syndrome, and hyperemesis gravidarum are associated with an increased risk of PTSD. Moreover, high-risk pregnant women may benefit from psychological interventions such as cognitive behavioral therapy (CBT). It may also be feasible and well-accepted for music therapy and exposure therapy to lessen the intensity of PTSD in mothers.
Topics: Humans; Pregnancy; Stress Disorders, Post-Traumatic; Female; Pregnancy Complications; Psychosocial Intervention; Psychotherapy
PubMed: 38937748
DOI: 10.1186/s12888-024-05926-6 -
BMC Pregnancy and Childbirth Jun 2024Maternal injury with any form of perineal trauma following vaginal delivery is very common which ranges globally from 16.2 to 90.4%. The frequency of Obstetric anal...
Prevalence and associated factors of maternal birth trauma following vaginal delivery at University of Gondar Comprehensive Specialized Hospital, North-West Ethiopia, 2022.
BACKGROUND
Maternal injury with any form of perineal trauma following vaginal delivery is very common which ranges globally from 16.2 to 90.4%. The frequency of Obstetric anal sphincter Injuries and the incidence of cervical laceration increases rapidly. However, in Ethiopia, there is limited evidence on the prevalence of maternal birth trauma and its determinant factors after vaginal delivery.
OBJECTIVE
To assess the magnitude and associated factors of Maternal Birth Trauma after vaginal delivery at University of Gondar Comprehensive Specialized Hospital, Gondar, North-West Ethiopia, 2022.
METHODS
An Institution based cross-sectional study was conducted among mothers with singleton vaginal delivery at University of Gondar Comprehensive Specialized Hospital from 9th May to 9th August 2022 among 424 study participants. Pre-tested semi-structured questioner was utilized. Epi-Data version 4.6 was used for data entry and exported to SPSS version 25 for data management and analysis. To identify the determinant factors, binary logistic regression model was fitted and variables with p-value < 0.2 were considered for the multivariable binary logistic regression analysis. In the multivariable binary logistic regression analysis, Variables with P-value < 0.05 were considered to have statistical significant association with the outcome variable. The Adjusted Odds Ratio (AOR) with 95% CI was reported to declare the statistical significance and strength of association between Maternal Birth Trauma and independent variables.
RESULTS
A total of 424 mothers who delivered vaginally were included. The mean age of participants was 26.83 years (± 5.220 years). The proportion of birth trauma among mothers after vaginal delivery was47.4% (95%CI: 43.1, 51.7). Of different forms of perineal trauma, First degree tear in 42.8%, OASIs in 1.5% and Cervical laceration in 2.5% study participants. In the multivariable binary logistic regression analysis being primiparous (AOR = 3.00; 95%CI: 1.68, 5.38), Gestational age ≥ 39 weeks at delivery (AOR = 2.96; 95%CI: 1.57, 5.57), heavier birth weight (AOR = 12.3; 95%CI: 7.21, 40.1), bigger head circumference (AOR = 5.45; 95%CI: 2.62, 11.31), operative vaginal delivery (AOR = 6.59; 95%CI: 1.44, 30.03) and delivery without perineum and/or fetal head support (AOR = 6.30; 95%CI: 2.21, 17.94) were significantly associated with the presence of maternal birth trauma.
CONCLUSION AND RECOMMENDATION
Maternal birth trauma following vaginal delivery was relatively high in this study. Prim parity, gestational age beyond 39 weeks at delivery, heavier birth weight, bigger head circumference, operative vaginal delivery and delivery without perineum and/or fetal head supported were factors affecting perineal outcome. The Ministry of Health of Ethiopia should provide regular interventional training as to reduce maternal birth trauma.
Topics: Humans; Female; Ethiopia; Adult; Pregnancy; Cross-Sectional Studies; Prevalence; Delivery, Obstetric; Young Adult; Risk Factors; Perineum; Obstetric Labor Complications; Anal Canal; Birth Injuries; Lacerations
PubMed: 38937688
DOI: 10.1186/s12884-024-06635-4