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Diseases (Basel, Switzerland) May 2024This comparative cross-sectional study conducted at the "Pius Brinzeu" healthcare center in Timisoara explored the differential impacts of pregnancy planning status on...
This comparative cross-sectional study conducted at the "Pius Brinzeu" healthcare center in Timisoara explored the differential impacts of pregnancy planning status on sexual function, body image, and relationship satisfaction among pregnant women. Employing the Female Sexual Function Index (FSFI), Body Esteem Scale for Adolescents and Adults (BESAQ), and the Beck Depression Inventory (BDI-II), the study analyzed responses from 107 participants divided into groups of planned ( = 59, mean age 28.5 ± 5.2) and unplanned ( = 48, mean age 27.3 ± 4.8) pregnancies. In the first trimester, unplanned pregnancies reported higher median scores in desire (4.7 vs. 3.6, = 0.005), arousal (4.5 vs. 3.8, = 0.001), and lubrication (4.6 vs. 3.7, = 0.015) compared to planned pregnancies. Satisfaction scores also favored unplanned pregnancies in the first trimester (4.8 vs. 3.9, = 0.009). Similar trends were observed in subsequent trimesters, with unplanned pregnancies consistently reporting higher FSFI scores, indicating a robust sexual function. Risk factors significantly associated with sexual dysfunction were a higher BMI in the first trimester (beta coefficient: -0.124, = 0.019), unmarried civil status (beta coefficient: -0.323, = 0.045), history of previous abortion (beta coefficient: -0.451, = 0.012), irregular menstrual cycles (beta coefficient: -0.384, = 0.026), and rural living area (beta coefficient: -0.278, = 0.034). Notably, unplanned pregnancy itself was not a significant risk factor for sexual dysfunction (beta coefficient: -0.054, = 0.095). Regarding relationship dynamics, planned pregnancies exhibited significantly higher satisfaction with partner support (4.1 ± 0.9 vs. 3.7 ± 1.1, = 0.041) and communication within the couple (4.0 ± 1.0 vs. 3.5 ± 1.2, = 0.020), whereas unplanned pregnancies reported higher satisfaction with emotional closeness (4.3 ± 0.7 vs. 3.8 ± 1.0, = 0.004). Concerns about managing professional activities and household chores were significantly more prevalent in the unplanned pregnancy group (62.50% vs. 33.90%, = 0.014). Unplanned pregnancies demonstrated better initial sexual function but faced greater challenges in relationship satisfaction and managing pregnancy demands. Identifying and addressing the risk factors associated with sexual dysfunction can provide targeted interventions to improve the well-being of pregnant women, regardless of pregnancy planning status.
PubMed: 38920541
DOI: 10.3390/diseases12060109 -
Annali Dell'Istituto Superiore Di Sanita 2024Maternal antenatal depression affects 21-28% of expectants globally and negatively impacts both maternal and child health in the short and long term. (Comparative Study)
Comparative Study
BACKGROUND
Maternal antenatal depression affects 21-28% of expectants globally and negatively impacts both maternal and child health in the short and long term.
OBJECTIVE
To compare the psychometric properties and clinical utility of the Edinburgh Postnatal Depression Scale (EPDS) and the Patient Health Questionnaire (PHQ-9) in pregnant individuals.
METHODS
In this cross-sectional study, 953 third-trimester pregnant Italian individuals completed both the EPDS and the PHQ-9.
RESULTS
Both scales demonstrated good internal consistency (EPDS ω=0.83, PHQ-9 ω=0.80) and a moderate correlation between their scores (r=0.59). Concordance at recommended cut-off points (≥14 for both) was moderate (k=0.55). Factor analyses indicated a bifactor solution for the EPDS (dimensions: "depression" and "anxiety") and for the PHQ-9 (dimensions: "depression", "pregnancy symptoms", "somatic"). Benchmarks for clinical change were also established.
CONCLUSIONS
The EPDS and PHQ-9 capture distinct aspects of perinatal depressive symptomatology. Clinically, these findings recommend using both scales in obstetric and gynaecologic settings to minimize false positives and negatives.
Topics: Humans; Female; Pregnancy; Adult; Cross-Sectional Studies; Pregnancy Complications; Psychometrics; Depression; Patient Health Questionnaire; Psychiatric Status Rating Scales; Depression, Postpartum; Italy; Young Adult; Surveys and Questionnaires; Reproducibility of Results; Mass Screening
PubMed: 38920259
DOI: 10.4415/ANN_24_01_08 -
Annals of the Academy of Medicine,... Aug 2023To determine the distribution of major fetal congenital heart diseases (CHDs) diagnosed antenatally during routine second-trimester obstetric anatomical scans in an...
OBJECTIVE
To determine the distribution of major fetal congenital heart diseases (CHDs) diagnosed antenatally during routine second-trimester obstetric anatomical scans in an unselected population at a single tertiary centre and to characterise and stratify risk factors, genetic diagnosis and long-term health at 4 years old.
METHOD
A single-centre cohort study of all major fetal CHDs detected on routine obstetric fetal anatomical ultrasound scans between January 2014 and December 2017 was performed in an unselected population. Demographic details, fetal echocardiogram reports, genetic test results, delivery outcomes and postnatal progress were stratified by CHD subtype.
RESULTS
Of 20,031 screened pregnancies, 109 pregnancies (0.53%) had major fetal CHDs. The most common subtypes were coarctation of aorta (17.4%), transposition of great arteries (16.5%), and tetralogy of Fallot and univentricular hearts (13.8% each). Of the 60.5% that underwent confirmatory genetic testing-mostly conventional karyotyping and testing for 22q11 microdeletion-about a quarter had abnormalities, of which 22q microdeletion was the most common. We had complete obstetric data in 85 pregnancies (78%), of which 76.5% progressed to live birth. Among these, 92.1% of postnatal echocardiograms concurred with antenatal ones. At 4 years old, 43.2% of offspring had no medical or developmental issues, 20.0% had mild medical or developmental issues, 21.5% had major medical or developmental issues, and 12.3% had deceased.
CONCLUSION
Fetal echocardiograms accurately diagnose CHDs. Future studies should evaluate the roles of chromosomal microarray and next-generation sequencing in diagnosing CHD.
Topics: Humans; Female; Pregnancy; Heart Defects, Congenital; Ultrasonography, Prenatal; Genetic Testing; Echocardiography; Adult; Cohort Studies; Pregnancy Trimester, Second; Child, Preschool; Singapore; Karyotyping
PubMed: 38920167
DOI: 10.47102/annals-acadmedsg.2022472 -
Archive of Clinical Cases 2024Mediastinal tumors are exceedingly rare during fetal development, presenting significant diagnostic challenges and potentially leading to severe outcomes such as...
Mediastinal tumors are exceedingly rare during fetal development, presenting significant diagnostic challenges and potentially leading to severe outcomes such as stillbirth or metastatic disease if not promptly identified and managed. Pleuropulmonary blastomas are primitive mesenchymal tumors often linked to mutations in the DICER1 gene, indicating a hereditary pattern associated with other common adult neoplasms with dominant inheritance. This report describes a case involving a 20-year-old Caucasian woman whose pregnancy was complicated by a stillbirth in the second trimester. Initial suspicions of a mediastinal tumor arose from blood tests and ultrasound examinations during pregnancy surveillance. However, the definitive diagnosis of a type II pleuropulmonary blastoma was established through a pathological examination at autopsy. This case underscores the complexities of diagnosing fetal mediastinal tumors and contributes to the sparse literature on neonatal pleuropulmonary blastomas. Our comprehensive review of the differential diagnoses and literature emphasizes the unique characteristics of pleuropulmonary blastoma and its similarities to other soft tissue sarcomas, enhancing understanding of their clinical and genetic profiles.
PubMed: 38919847
DOI: 10.22551/2024.43.1102.10286 -
Journal of Pregnancy 2024Thyroid hormones regulate fetal growth and differentiation of several tissues. Maternal dietary patterns may be correlated with changes in the level of neonatal...
Thyroid hormones regulate fetal growth and differentiation of several tissues. Maternal dietary patterns may be correlated with changes in the level of neonatal thyroid-stimulating hormone (TSH). We hypothesized that since maternal nutrition affects birth weight and offspring growth, it may also impact endocrine patterns in offspring. This study is aimed at assessing the relationship between maternal dietary phytochemical index (DPI) in the first trimester of pregnancy and neonatal cord blood thyroid hormone levels. This cross-sectional study is a substudy of a birth cohort. Overall, 216 mothers, aged 16-45 years, were recruited in their first trimester of pregnancy. To calculate DPI, the daily energy percentage of phytochemical-rich foods was divided by the total daily energy intake. At delivery time, TSH and free thyroxine (FT4) levels were measured in cord blood samples using chemiluminescence immunoassay. The mean (standard deviation (SD)) age of mothers was 29.56 (5.50) years, and 47% of newborns were girls. The mean (SD) of DPI in the first, second, third, and fourth quartiles was 25.03 ± 4.67, 33.87 ± 2.18, 40.64 ± 2.10, and 51.17 ± 4.98, respectively. There was not any significant correlation between DPI score with cord serum TSH and FT4 levels in crude and adjusted analysis. No significant relationship between maternal DPI with cord serum TSH and FT4 levels was shown. Limited experience exists about the effect of maternal diet quality indices on neonatal thyroid function, and further studies are needed in this regard.
Topics: Humans; Female; Adult; Infant, Newborn; Cross-Sectional Studies; Pregnancy; Thyrotropin; Young Adult; Thyroxine; Adolescent; Fetal Blood; Male; Phytochemicals; Diet; Thyroid Gland; Maternal Nutritional Physiological Phenomena; Middle Aged; Thyroid Function Tests
PubMed: 38919582
DOI: 10.1155/2024/9558023 -
BMC Research Notes Jun 2024To assess first-trimester recruitment and retention of pregnant patients who regularly used cannabis, but not other substances, measured by willingness to participate in...
OBJECTIVE
To assess first-trimester recruitment and retention of pregnant patients who regularly used cannabis, but not other substances, measured by willingness to participate in a research study, completion of self-administered electronic questionnaires, and willingness to provide urine samples during each trimester of pregnancy. We designed and launched a prospective feasibility study titled, Cannabis Legalization in Michigan (CALM) - Maternal & Infant Health (MIH), in two Michigan clinics after the recreational use of cannabis became legal for adults 21 years and older.
RESULTS
Over half (52%) of patients asked to participate in CALM-MIH were consented to the study. Two-thirds (66%) of screened patients initiated prenatal care during their first trimester of pregnancy and 50% used cannabis, of which the majority did not concurrently use other substances. Of those recruited into the prospective study, all participants completed the first-trimester questionnaire and provided urine samples. Study retention was 80% and all participants who completed follow-up assessments were willing to provide urine samples.
Topics: Humans; Female; Pregnancy; Feasibility Studies; Adult; Prospective Studies; Cannabis; Pregnancy Trimester, First; Patient Selection; Surveys and Questionnaires; Young Adult; Michigan; Prenatal Care
PubMed: 38918795
DOI: 10.1186/s13104-024-06826-4 -
Clinica Chimica Acta; International... Jun 2024Pregnancy induces physiological changes that can affect serologic and immunologic markers, potentially resulting in lower or undetectable haptoglobin values compared to...
BACKGROUND-AIM
Pregnancy induces physiological changes that can affect serologic and immunologic markers, potentially resulting in lower or undetectable haptoglobin values compared to non-pregnant counterparts. Such variations may lead to inaccurate diagnosis of hemolysis.
METHODS
We report a case of a patient in second trimester of pregnancy receiving induction chemotherapy due to B-cell acute lymphocytic leukemia with undetectable haptoglobin levels in a routine laboratory sample collected less than 12 h posttransfusion of red cell unit. Despite undetectable haptoglobin, lactate dehydrogenase (LD) was within reference intervals (RI). The patient was evaluated for acute hemolytic transfusion reaction (AHTR) and followed up. Haptoglobin levels showed an upward trend during follow-up visits, reaching 15 mg/dL, and within RI in the third trimester.
RESULTS
The patient did not meet the Center for Disease Control (CDC) criteria for AHTR. Alternative explanations for the observed laboratory findings were explored. Undetectable haptoglobin levels were attributed to various factors, including recent RBC transfusion, pregnancy-related physiological changes, and potential hyperhydration treatment plan due to chemotherapy.
CONCLUSION
This case underscores the importance of cautious interpretation of laboratory results in pregnant patients, necessitating trimester-specific reference intervals for haptoglobin. A multidisciplinary approach to patient care is crucial for accurate diagnosis and management.
PubMed: 38917868
DOI: 10.1016/j.cca.2024.119829 -
American Journal of Perinatology Jun 2024Maternal preconception diet influences pregnancy health and fetal outcomes. We examined the relationship between preconception fatty acid (FA) intake and uterine artery...
OBJECTIVE
Maternal preconception diet influences pregnancy health and fetal outcomes. We examined the relationship between preconception fatty acid (FA) intake and uterine artery indices in mid-gestation in a large, heterogeneous cohort of nulliparous individuals.
STUDY DESIGN
This is a secondary analysis of the nuMom2b study. Dietary ꞷ-6 and ꞷ-3 FA intake was assessed with food frequency questionnaires and uterine artery indices were obtained via doppler studies in the second trimester. For our primary outcome of pulsatility index (PI) > 1.6, we compared proportions by each dichotomous FA exposure and tested differences with chi-square.
RESULTS
For PI >1.6, OR for the unfavorable FA quartile compared to remaining quartiles for the exposures were 0.96 - 1.25, p 0.157 (ꞷ-6 FA); 0.97 - 1.26, p 0.124 (ꞷ-3 FA); 0.87 -1.14, p 1.00 (ꞷ-6:ꞷ-3 FA ratio).
CONCLUSION
No significant associations between self-reported maternal preconception ꞷ-6 and ꞷ-3 FA intake and uterine artery doppler indices measured during the second trimester were observed.
PubMed: 38917867
DOI: 10.1055/a-2351-9810 -
International Journal of Nursing Studies Jun 2024Physical activity during pregnancy has been recommended as an effective measure to prevent various pregnancy complications. However, global physical activity... (Review)
Review
BACKGROUND
Physical activity during pregnancy has been recommended as an effective measure to prevent various pregnancy complications. However, global physical activity participation during pregnancy is not optimal, and the factors influencing physical activity participation during pregnancy need to be further investigated. In China, where there are no localized guidelines for physical activity during pregnancy, the prevalence of meeting recommended physical activity levels among Chinese pregnant women is still unclear.
OBJECTIVES
This study aimed to comprehensively review the prevalence of meeting recommended physical activity levels among pregnant women in China and to further explore the factors influencing physical activity participation during pregnancy.
DESIGN
This was a systematic review and meta-analysis.
METHODS
A systematic review was conducted in both English and Chinese databases from inception until August 1, 2023. Two reviewers independently screened literature, assessed study eligibility and extracted data. The Agency for Healthcare Research and Quality was used to evaluate methodological quality of included studies. The pooled prevalence was calculated using a random-effects model. Subgroup analyses were conducted to explore sources of heterogeneity.
RESULTS
A total of 12 cross-sectional studies, including 11,323 Chinese pregnant women with a mean age ranging from 27.0 to 33.0 years, met the inclusion criteria. The prevalence of meeting recommended physical activity levels among pregnant women in China was 21.0 % (95 % confidence interval (CI):12.5 %-29.5 %). A higher prevalence of meeting recommended physical activity levels was observed among pregnant women who were in their second trimester, who were living in the southern region, who were assessed by validated questionnaires, and who used 150 min physical activity per week as a criterion for meeting recommendation.
CONCLUSIONS
The findings suggested a low prevalence of meeting recommended physical activity levels among Chinese pregnant women, which was affected by a variety of factors. It is recommended that further research be conducted in the future to explore physical activity intervention strategies for women of childbearing age before and during pregnancy based on the factors affecting physical activity to improve physical activity compliance, maternal and child health and population quality.
REGISTRATION NUMBER
CRD42022372722 (PROSPERO).
PubMed: 38917748
DOI: 10.1016/j.ijnurstu.2024.104841 -
The Journal of Clinical Endocrinology... Jun 2024Children of women with gestational diabetes (GDM) are often born with a higher birthweight and have an increased risk of overweight during childhood. High fetal growth...
CONTEXT
Children of women with gestational diabetes (GDM) are often born with a higher birthweight and have an increased risk of overweight during childhood. High fetal growth rate is also associated with being overweight in childhood.
OBJECTIVE
To examine excessive fetal growth rate as a mediator between GDM and overweight in the offspring.
METHODS
This was a longitudinal cohort study, using routinely collected data on children born 2008-2014 in Aarhus, Denmark. Fetal biometrics were extracted from the patient records at Aarhus University Hospital and childhood weight from the health records at Aarhus Municipality Healthcare Service. We calculated growth trajectories for fetuses affected by GDM and for unaffected fetuses using cubic mixed model regression. We extracted individual fetal growth rate and estimated the contributing effect of fetal growth rate on the risk of being overweight in the 5-9 year-old offspring.
RESULTS
We included 6794 mother-child pairs, 295 with GDM. Fetal growth was higher in women with GDM from week 25, and the offspring had an increased risk of being overweight (OR: 2.02 (95%CI: 1.44 - 2.84)). When adjusting for fetal growth rate in week 28 the effect attenuated by 15%, and to 1.10 (95%CI: 0.76 - 1.60) when further adjusting for pre-pregnancy BMI.
CONCLUSION
Pregnancies affected by GDM had higher fetal growth rate and the offspring had a higher risk of being overweight at 5-9 years. Fetal growth rate in early third trimester was a mediator of up to 15% of this association, but pre-pregnancy BMI contributed strongly as well.
PubMed: 38916475
DOI: 10.1210/clinem/dgae428