Damm, Julie Agner; Asbjörnsdóttir, Björg; Callesen, Nicoline Foged
To evaluate the prevalence of diabetic nephropathy and microalbuminuria in pregnant women with type 2 diabetes in comparison with type 1 diabetes and to describe pregnancy outcomes in these women following the same antihypertensive protocol....
Albrecht, M; Bánóczy, J; Baranyi, E; Tamás, G; Szalay, J; Egyed, J; Simon, G; Ember, G
The longitudinal examination of 132 pregnant diabetic women under care showed a 96.2% prevalence of gingivitis. The intensity of gingivitis was most marked in weeks 11 to 15, and 24 to 26 of pregnancy, and the correlation with changes in oral hygiene was statistically significant (p less than 0.001). On the other hand, the severity of diabetes had no effect on the degree of gingival inflammation. As for caries, the mean DMF values increased during diabetic pregnancy, the number of carious (D) and filled (F) teeth to a higher, that of extracted (M) teeth to a lesser degree, than in diabetic non-pregnant women.
Szilagyi, A; Szabo, I
Obstetrical and perinatal outcomes in newborns of diabetic pregnant women depend on metabolic control and fetal surveillance during pregnancy. The effects of fetal surveillance on perinatal mortality and morbidity was analyzed in diabetic pregnant women with appropriate glucose control in our regional center for diabetes and pregnancy. 480 deliveries complicated by frank or gestational diabetes occurred in our Department in the period of 1988-1999. Perinatal mortality and morbidity, prevalence of premature deliveries, methods of fetal surveillance, options for respiratory distress syndrome (RDS) profilaxis, cesarean section rate, timing of delivery and its indications and occurrence of malformations have been analyzed. It was found that malformation rate and perinatal mortality may be reduced to even lower level than that of in healthy pregnant women by appropriate glucose control and by using the latest methods of intrauterine fetal surveillance including cardiotocography (non stress test and oxytocin challenge test), doppler fetal artery velocimetry and fetal pulse oximetry. Timing of delivery was needed in 35% of the cases with IDDM and 15% of gestational diabetes due to chronic placental insufficiency. If labour induction was needed before the 38 weeks, amniocentesis was performed to test fetal lung maturity. Direct fetal glucocorticoid administration was used to enhance fetal lung maturation in 14 cases. C-section rate was slightly higher than that of in non diabetic pregnant women. Our perinatal morbidity data (macrosomia, hyperbilirubinemia, hypoglycemia, injuries, infections) are comparable with the data from the literature. Although perinatal mortality with the help of thorough fetal surveillance is even better in diabetic pregnant women than in non diabetic patients, future eye should be focused on factors affecting perinatal morbidity, because it is still higher than in newborns of healthy mothers.
Velkoska Nakova, V; Krstevska, B; Dimitrovski, Ch; Simeonova, S; Hadzi-Lega, M; Serafimoski, V
The aim of the present study was to determine the prevalence of abnormal thyroid function and antithyroid antibodies during pregnancy in women with diabetes type 1 and gestational diabetes mellitus (GDM). The study group included 83 pregnant women who attended the Outpatient Department of the Endocrinology, Diabetes and Metabolic Disorders Clinic in the period from 05.2009 to 11.2009. The one hundred-g. oral glucose tolerance test (OGTT) was conducted on the pregnant women except for women with diabetes type 1. Thyroid functions were evaluated in all the pregnant women. After routine screening for GDM, thirty of the pregnant women were healthy and GDM was diagnosed in forty of them. The rest, thirteen women, had diabetes type 1. The women who developed GDM showed a mean free thyroxin concentration (fT4) significantly lower than that observed in the healthy pregnant women and women with diabetes type 1. Among the pregnant women with GDM, 10 women or 25% had fT4 concentrations below the lower cut-off with normal thyroid-stimulating hormone concentrations (TSH). A statistically significant difference was found in the prevalence of antithyroid antibodies (anti-TPO) between the (30%) women with diabetes type 1 and (10%) healthy pregnant women (p<0.05). In the women positive for anti-TPO, TSH was significantly higher (p<0.05). The significantly higher prevalence of hypothyroxinemia in GDM pregnancies and anti-TPO titres in pregnancies with diabetes type 1, than in healthy pregnant women warrants routine screening for thyroid abnormalities in these groups of pregnant women.
Anwar, N; Zaman, N; Nimmi, N; Chowdhury, T A; Khan, M H
There have been an association between systemic diseases and hormonal changes particularly diabetes which has been cited as a risk factor in the progression of periodontitis in pregnant women. The incidence and severity of periodontal diseases are increasing at a higher rate and a common condition in pregnant diabetic women among Bangladeshi population. This cross sectional study included 200 pregnant women who were selected from gynecological department and examined at the dental unit. The clinical parameters used were the Silness and Loe plaque index (PI), gingival scores and periodontal status and any relationship to socio demographic variables (age, occupation, level of education and urban or rural residence) and clinical variables (gestation period, previous pregnancy, type of diabetes and periodontal maintenance) were evaluated. The results showed that these clinical parameters increased concomitantly with an increase in the stage of pregnancy and in women with multiple pregnancies. Increased age, lower level of education, unemployment and patients residing in rural areas were associated with significantly higher gingival scores and periodontal measures. Women with increased age and multiple pregnancies usually have less interest to frequent periodontal maintenance showing a significant statistical relation between an increased age and changes in gingival and periodontal status; however no significant association was found between increased age and plaque index. It is concluded that gingival inflammatory symptoms are aggravated during pregnancy in diabetic women and are related to different clinical and demographic variables.
Fitch, W.L.; King, J.C.
Protein turnover was studied in nine non-pregnant (NP) women, eight pregnant (P) and two gestational diabetic (GDM) women. Whole body protein turnover, synthesis and catabolism rates were measured using a single oral dose of 15 N-glycine followed by measurement of enrichment of urinary ammonia. Urinary 3-methylhistidine (3MH) excretion was measured for three consecutive days, including the day of the protein turnover study. Whole body protein turnover and synthesis rates did not differ between the P and NP women, although the synthesis rates tended to be higher in the P group. Gestational diabetic women appeared to have considerably higher rates of both turnover and synthesis. Pregnant women excreted significantly more urinary 3MH than did non-pregnant women. GDM women appeared to have lower 3MH excretion than the P women. Correlation between 3MH excretion and protein turnover rates was nearly significant (p = .06) in the NP women, but was poorly correlated (p = .43) in the P women, suggesting that muscles may be a less important site of whole body protein turnover in pregnancy than in the non-pregnant state
Law, Graham R; Ellison, George T H; Secher, Anna L
with diabetes. RESEARCH DESIGN AND METHODS: Functional data analysis (FDA) was applied to 1.68 million glucose measurements from 759 measurement episodes, obtained from two previously published randomized controlled trials of CGM in pregnant women with diabetes. A total of 117 women with type 1 diabetes (n = 89...... developed LGA. LGA was associated with lower mean glucose (7.0 vs. 7.1 mmol/L; P FDA showed that glucose was significantly lower midmorning (0900-1100 h) and early...... evening (1900-2130 h) in trimester 1, significantly higher early morning (0330-0630 h) and throughout the afternoon (1130-1700 h) in trimester 2, and significantly higher during the evening (2030-2330 h) in trimester 3 in women whose infants were LGA. CONCLUSIONS: FDA of CGM data identified specific times...
Begum, S; Huda, S N; Musarrat, N; Ahmed, S; Banu, L A; Ali, S M Keramat
This cross sectional study compares the nutritional status and birth outcomes of 357 diabetic and non-diabetic pregnant women (203 DM and 154 NDM as control). Uncomplicated diabetic and non-diabetic pregnant women of singleton pregnancies with age range of 19-35 years were enrolled at term in BIRDEM hospital. Maternal anthropometry and neonatal anthropometric measurements were taken following standard techniques. Educational level was significantly different between the groups. The diabetic mothers were found significantly less educated (phemoglobin concentration (p values for all: 29.0), on the other hand most of the NDM pregnant mothers were within normal range (BMI: 19.8-26.0). DM pregnant mothers were found more anemic (45.8% vs. 23.4%; pnutritional status. The DM group experienced more anemia and preterm deliveries and macrosomic babies were born only in them.
Syngelaki, Argyro; Nicolaides, Kypros H; Balani, Jyoti; Hyer, Steve; Akolekar, Ranjit; Kotecha, Reena; Pastides, Alice; Shehata, Hassan
Obesity is associated with an increased risk of adverse pregnancy outcomes. Lifestyle-intervention studies have not shown improved outcomes. Metformin improves insulin sensitivity and in pregnant patients with gestational diabetes it leads to less weight gain than occurs in those who do not take metformin. In this double-blind, placebo-controlled trial, we randomly assigned pregnant women without diabetes who had a body-mass index (BMI; the weight in kilograms divided by the square of the height in meters) of more than 35 to receive metformin, at a dose of 3.0 g per day, or placebo (225 women in each group) from 12 to 18 weeks of gestation until delivery. The BMI was calculated at the time of study entry (12 to 18 weeks of gestation). The primary outcome was a reduction in the median neonatal birth-weight z score by 0.3 SD (equivalent to a 50% reduction, from 20% to 10%, in the incidence of large-for-gestational-age neonates). Secondary outcomes included maternal gestational weight gain and the incidence of gestational diabetes and of preeclampsia, as well as the incidence of adverse neonatal outcomes. Randomization was performed with the use of computer-generated random numbers. The analysis was performed according to the intention-to-treat principle. A total of 50 women withdrew consent during the trial, which left 202 women in the metformin group and 198 in the placebo group. There was no significant between-group difference in the median neonatal birth-weight z score (0.05 in the metformin group [interquartile range, -0.71 to 0.92] and 0.17 in the placebo group [interquartile range, -0.62 to 0.89], P=0.66). The median maternal gestational weight gain was lower in the metformin group than in the placebo group (4.6 kg [interquartile range, 1.3 to 7.2] vs. 6.3 kg [interquartile range, 2.9 to 9.2], Pmetformin group than in the placebo group. There were no significant between-group differences in the incidence of gestational diabetes, large
Christiansen, MS; Hesse, D; Ekbom, P
We evaluated the urinary orosomucoid excretion (UOE) as a biomarker of preeclampsia and preterm delivery in pregnant women with type 1 diabetes.......We evaluated the urinary orosomucoid excretion (UOE) as a biomarker of preeclampsia and preterm delivery in pregnant women with type 1 diabetes....
Schneeberger, Caroline; Erwich, Jan Jaap H. M.; van den Heuvel, Edwin R.; Mol, Ben W. J.; Ott, Alewijn; Geerlings, Suzanne E.
To compare the prevalence of asymptomatic bacteriuria (ASB) and the incidence of urinary tract infection (UTI) in pregnant women with and without diabetes mellitus (DM) or gestational DM (GDM). We performed a cohort study in five hospitals and two midwifery clinics in the Netherlands. Pregnant women
Zulfiya Raisovna Alimetova
Full Text Available Aim. To study excretion of amine nitrogen and ammonia in urine of pregnant women with type 1 diabetes mellitus depending on gestational ageand albuminuria level. Materials and methods. A total of 60 pregnant women with type 1 diabetes mellitus were examined. Proximal and distal tubular function was estimatedfrom daily excretion of amine nitrogen and ammonia respectively. Results. Daily excretion of amine nitrogen and ammonia in urine of pregnant women with type 1 diabetes mellitus was lower than in healthycontrols in the 2nd trimester regardless of albuminuria and in the 3rd trimester in patients with microalbuminuria (MAU and proteinuria (PU.Ammonia excretion was twice lower than normal in the 2nd trimester in women with MAU and PU, and in the 3rd trimester in patients with PU.Healthy pregnant women showed significant correlation between ammonia and amine nitrogen excretion throughout pregnancy (r?0.833,p
Knox, Caitlin A; Delaney, Joseph A C; Winterstein, Almut G
With the increasing prevalence of type 2 diabetes in young adulthood, treatment of diabetes in pregnancy faces new challenges. Anti-diabetic drug utilization patterns of pregnant women with pre-existing diabetes are poorly described. We aim to describe anti-diabetic (AD) agent utilization among diabetic pregnant women. We utilized IMS LifeLink, including administrative claims data of patients in US managed care plans, to establish a retrospective cohort of women, age 18-46 years (N = 96,740) with billed procedures for a live birth, and a 12 month eligibility period before and 3 month after delivery. Diabetes mellitus was identified from ≥2 in- or outpatient claims with diagnoses (ICD-9-CM 250.XX) before pregnancy. We estimated the prevalence of AD drugs before, during and after pregnancy, and secular trends across the study period (1999-2009), using linear regression. A sensitivity analysis was conducted to identify the extent of misclassification of trimesters. Almost six percent (n = 5,581) of the live birth cohort had diabetes mellitus. Throughout the study, 48% (1999) and 78% (2009) (p metformin, sulfonylureas, thiazolidinediones (TZD), and combination AD. The annual prevalence of insulin use increased by only 1% from 39% (1999) to 40% (2009) (p = 0.589) during pregnancy, while use of sulfonylureas and metformin increased from 2.5% and 4.2% (1999) to 17.3% and 15.3% (2009) (p use steadily increased in prevalence from the 1st to 3rd trimester (16.5% and 3.3% to 33.0% and 7.5%), while metformin and TZD use decreased (11.4% and 1.6% to 3.8% and 0.2%). AD use during pregnancy demonstrates the need for additional investigation regarding safety and efficacy of AD drugs on maternal outcomes.
Roskjær, Ann B; Andersen, Jens Rikardt; Ronneby, Helle
of Medicine (IOM) is generally recommended. A low-glycaemic index diet is considered safe, and has shown, positive effects on the glycaemic control and pregnancy outcomes for both healthy women, those with type 2 diabetic and gestational diabetes (GDM). In general, carbohydrate counting does improve glycaemic...... control in type 1 diabetes. A moderately low carbohydrate diet with a carbohydrate content of 40% of the calories results in better glycaemic control and comparable obstetric outcomes in type 2 diabetes and GDM when compared to a diet with a higher carbohydrate content, and is regarded safe in diabetic...... carbohydrate counting can be recommended for pregnant women with type 1 diabetes....
Damm, P.; Handberg, A.; Kühl, C.
OBJECTIVE: To ascertain whether the decreased glucose tolerance and insulin resistance found in normal and gestational diabetic pregnancy might be associated with changes in insulin receptor function. METHODS: Eight nonpregnant healthy women (nonpregnant controls), eight healthy pregnant women...... (pregnant controls), and eight women with gestational diabetes were investigated. All were non-obese. Muscle biopsies were obtained from the vastus lateralis muscle, and insulin binding and tyrosine kinase activities in partially purified skeletal muscle insulin receptors were studied. The pregnant controls...... with gestational diabetes compared to nonpregnant controls (P pregnant women did not differ from the other two groups. Postpartum, no differences in insulin binding were found between the groups. Basal and maximal tyrosine kinase activities toward the exogenous substrate poly(Glu4Tyr1) were...
Shrestha, S; Thapa, P; Saleh, F; Thapa, N; Stray, B Pedersen; Khanom, K
Diabetes mellitus is an emerging health problem in developing world with the consumption of energy dense diet and inactive lifestyle. The problem of diabetes is further expanded due to ignorance and lack of knowledge. The aim of the study was to assess the knowledge of diabetes among pregnant women in three districts of Nepal. A community based cross-sectional study was conducted in three districts in mountain, hilly and plain areas of Nepal. A total of 590 pregnant women were interviewed during the period of July 2009 to June 2010. A knowledge score system was applied. Poor score was 60%) of the total score. Statistical software SPSS 11.5 was used for data entry, data management and analysis. Out of 590 pregnant women, only 41% had heard about diabetes mellitus. Majority of the participants (75%) from age group >30 years had not heard about diabetes. Among the 241 with some knowledge, the knowledge score median percent(range) on the meaning, symptoms, risk factors, treatment, prevention, complications and overall knowledge were 50%(0-100), 25% (0-75), 20% (0-60), 20% (0-100), 25% (0-100), 20% (0-60) and 26% (0- 58) respectively. According to defined category, majority of those who ever heard about diabetes had poor knowledge (95%). Knowledge among literate women (p=.001), women residing in Kailali district (plain region) (p=.003) and those with positive family history of diabetes (p=.003) was found to be significant. As large proportions of Nepalese pregnant women do not have any knowledge or have poor knowledge regarding diabetes, extensive health education and health promotion programs are urgently recommended to prevent diabetes in Nepal.
Vestgaard, Marianne; Nielsen, Lene Ringholm; Rasmussen, Åse Krogh
In pregnant women with type 1 diabetes, we evaluated whether the presence of thyroid peroxidase autoantibodies (anti-TPO) was associated with changes in thyroid function, metabolic control and pregnancy outcome.......In pregnant women with type 1 diabetes, we evaluated whether the presence of thyroid peroxidase autoantibodies (anti-TPO) was associated with changes in thyroid function, metabolic control and pregnancy outcome....
Carral, Florentino; Ayala, María del Carmen; Fernández, Juan Jesús; González, Carmen; Piñero, Antonia; García, Gloria; Cañavate, Concepción; Jiménez, Ana Isabel; García, Concepción
The aim of this study was to examine the impact of a Web-based telemedicine system for monitoring glucose control in pregnant women with diabetes on healthcare visits, metabolic control, and pregnancy outcomes. A prospective, single-center, interventional study with two parallel groups was performed in Puerto Real University Hospital (Cadiz, Spain). Women were assigned to two different glucose monitoring groups: the control group (CG), which was managed only by follow-ups with the Gestational Diabetes Unit (GDU), and the telemedicine group (TMG), which was monitored by both more spaced GDU visits and a Web-based telemedicine system. The number of healthcare visits, degree of metabolic control, and maternal and neonatal outcomes were evaluated. One hundred four pregnant women with diabetes (77 with gestational diabetes, 16 with type 1 diabetes, and 11 with type 2 diabetes) were included in the TMG (n=40) or in the CG (n=64). There were no significant differences in mean glycated hemoglobin level during pregnancy or after delivery, despite a significantly lower number of visits to the GDU (3.2±2.3 vs. 5.9±2.3 visits; P3.0±1.7 visits; PWeb-based telemedicine system can be a useful tool facilitating the management of pregnant diabetes patients, as a complement to conventional outpatient clinic visits.
Schneeberger, C.; Erwich, J.J.H.M.; van den Heuvel, E.R.; Mol, B.W.J.; Ott, A.; Geerlings, S.E.
Objective: To compare the prevalence of asymptomatic bacteriuria (ASB) and the incidence of urinary tract infection (UTI) in pregnant women with and without diabetes mellitus (DM) or gestational DM (GDM). Study design: We performed a cohort study in five hospitals and two midwifery clinics in the
Full Text Available Objective: To explore the application value of Tei index in determination of fetal cardiac function in pregnant women with gestational diabetes mellitus (GDM. Methods: A total of 60 gestational diabetes mellitus pregnant women with single birth were included in the study and served as GDM group, while 60 healthy pregnant women with single birth were served as the control group. The fetal echocardiography was performed. The cardiac structure, function, and other related indicators were detected and compared. Results: IVSs, LVWT, RVWT, LVEF, LVFS, and RVFS in GDM group were significantly greater than those in the control group (P<0.05. E/A MV and E/A TV in GDM group were significantly lower than those in the control group (P<0.05. The left and right ventricular Tei index in GDM group was significantly higher than that in the control group (P<0.05. Conclusions: The fetal cardiac structure and function in GDM pregnant women can cause damage to a different degree. Tei index is an important indicator to evaluate the fetal cardiac function in GDM pregnant women, and can be applied in the early diagnosis and treatment; therefore, it deserved to be widely recommended in the clinic.
Doddabelavangala Mruthyunjaya, Mahesh; Chapla, Aaron; Hesarghatta Shyamasunder, Asha; Varghese, Deny; Varshney, Manika; Paul, Johan; Inbakumari, Mercy; Christina, Flory; Varghese, Ron Thomas; Kuruvilla, Kurien Anil; V Paul, Thomas; Jose, Ruby; Regi, Annie; Lionel, Jessie; Jeyaseelan, L; Mathew, Jiji; Thomas, Nihal
Pregnant women with diabetes may have underlying beta cell dysfunction due to mutations/rare variants in genes associated with Maturity Onset Diabetes of the Young (MODY). MODY gene screening would reveal those women genetically predisposed and previously unrecognized with a monogenic form of diabetes for further clinical management, family screening and genetic counselling. However, there are minimal data available on MODY gene variants in pregnant women with diabetes from India. In this study, utilizing the Next generation sequencing (NGS) based protocol fifty subjects were screened for variants in a panel of thirteen MODY genes. Of these subjects 18% (9/50) were positive for definite or likely pathogenic or uncertain MODY variants. The majority of these variants was identified in subjects with autosomal dominant family history, of whom five were in women with pre-GDM and four with overt-GDM. The identified variants included one patient with HNF1A Ser3Cys, two PDX1 Glu224Lys, His94Gln, two NEUROD1 Glu59Gln, Phe318Ser, one INS Gly44Arg, one GCK, one ABCC8 Arg620Cys and one BLK Val418Met variants. In addition, three of the seven offspring screened were positive for the identified variant. These identified variants were further confirmed by Sanger sequencing. In conclusion, these findings in pregnant women with diabetes, imply that a proportion of GDM patients with autosomal dominant family history may have MODY. Further NGS based comprehensive studies with larger samples are required to confirm these finding.
Sreedevi, E.; Vijaya Lakshmi, K.; Chaitanya Krishna, E.; Padmavathamma, M.
Diabetes is a chronic illness that requires continuous medical care and patient self-management education to prevent acute complications and to reduce the risk of long-term complications. This paper deals with study and development of algorithm to develop an initial stage expert system to provide diagnosis to the pregnant women who are suffering from Gestational Diabetes Mellitus (GDM) by means of Oral Glucose Tolerance Test (OGTT).
Egan, Aoife M.; Vellinga, Akke; Harreiter, Jürgen; Simmons, David; Desoye, Gernot; Corcoy, Rosa; Adelantado, Juan M.; Devlieger, Roland; van Assche, Andre; Galjaard, Sander; Damm, Peter; Mathiesen, Elisabeth R.; Jensen, Dorte M.; Andersen, Liselotte; Lapolla, Annuziata; Dalfrà, Maria G.; Bertolotto, Alessandra; Mantaj, Urszula; Wender-Ozegowska, Ewa; Zawiejska, Agnieszka; Hill, David; Jelsma, Judith G. M.; Snoek, Frank J.; Worda, Christof; Bancher-Todesca, Dagmar; van Poppel, Mireille N. M.; Kautzky-Willer, Alexandra; Dunne, Fidelma P.
Aims/hypothesis Accurate prevalence estimates for gestational diabetes mellitus (GDM) among pregnant women in Europe are lacking owing to the use of a multitude of diagnostic criteria and screening strategies in both high-risk women and the general pregnant population. Our aims were to report
Full Text Available ... diabetes for the first time when they become pregnant. This is called gestational (jes-Tay-shun-ul) diabetes. Other women have diabetes before they get pregnant. Use these resources to help you talk to ...
Full Text Available Annsofie Adolfsson,1,2 Malin Jansson1,21School of Life Sciences, University of Skovde, Skovde, Sweden; 2Department of Obstetrics and Gynaecology, Skaraborg Hospital, Skovde, SwedenBackground: The aim of this study was to pilot test a prototype website called MODIAB-web designed to support pregnant women and mothers with type 1 diabetes.Method: A focus group was undertaken and the results were analyzed using qualitative content analysis.Results: Eight subthemes were identified, comprising "blood glucose versus insulin," "application for smart phones," "the time aspect," "interface and technology," "forum," "direct link to the diabetes midwife," "ask the expert," and "lack of contact information." These subthemes were condensed into two main themes. The first theme was "easily understood interface, but in need of a more blood-glucose focused orientation" and the second theme was "forum for interaction with both equals and experts." Conclusion: The women in this study had positive impressions of several of the MODIAB-web functions, including a forum for pregnant mothers with type 1 diabetes and the possibility of being able to put their blood glucose levels into a diagram which could be sent directly to the diabetes midwife. Access to articles and information via the "fact" tab and the ability to ask questions of experts were also significantly helpful to women in the focus group. Pregnant women and mothers with type 1 diabetes can gain support from such a Web-based self-help system.Keywords: type 1 diabetes, web support, pregnancy, focus group interview
Vestgaard, Marianne; Nielsen, Lene Ringholm; Rasmussen, Åse Krogh
In pregnant women with type 1 diabetes, we evaluated whether the presence of thyroid peroxidase autoantibodies (anti-TPO) was associated with changes in thyroid function, metabolic control and pregnancy outcome....
Rubio, José Antonio; Ontañón, Marta; Perea, Verónica; Megia, Ana
To ascertain how health care for pregnant women with gestational diabetes (GD) and pregestational diabetes (PGD) is organized, and to estimate the number of Pregnancy and Diabetes Units (PDUs) in Spain in 2013. The Spanish Group of Diabetes and Pregnancy (GEDE) developed and agreed on a questionnaire based on the recommendations of the group. The questionnaire was sent to members of the Spanish Society of Diabetes and the Spanish Society of Endocrinology and Nutrition. Eighty-seven questionnaires were received from 81 hospitals, 4 outpatient specialty centers, and 2 primary healthcare centers, which accounted for 51% of the Spanish population and for 39% of births in 2013. GD was mainly diagnosed based on GEDE recommendations (98%), and less than 50% of women were reevaluated after delivery in primary care. Fourteen (26%) of the 53 centers identified as PDUs corresponded to a minimal model. Continuous subcutaneous insulin infusion (CSII) therapy was not available in 30% of centers, and 13% of hospitals had no preconceptional clinics. No nurse support was available in 20% of centers. Care of women with PGD has a fair coverage with PDU, but significant deficits still exist, for instance, in preconception clinic and CSII. However, organization of care for women with GD appears to be adequate. There are aspects in need of improvement such as integration of diabetes educators and coordination with primary care for postpartum reclassification. Copyright © 2015 SEEN. Published by Elsevier España, S.L.U. All rights reserved.
Surdacka, Anna; Ciężka, Edyta; Pioruńska-Stolzmann, Maria; Wender-Ożegowska, Ewa; Korybalska, Katarzyna; Kawka, Edyta; Kaczmarek, Elżbieta; Witowski, Janusz
Both pregnancy and diabetes are thought to predispose to the impairment of oral health. As saliva contributes to oral homeostasis, we have characterised its properties and flow rate in pregnant women with or without diabetes. Unstimulated whole mixed saliva was collected from 63 women in the first trimester of pregnancy and analysed for the concentration of selected antioxidants, cytokines, and growth factors. Pregnant women with diabetes were found to have markedly increased indexes of caries activity, plaque formation, gingival and periodontal status, as well as increased salivary antioxidant capacity and pro-inflammatory cytokine levels. These changes were more pronounced in patients with long-term disease and systemic diabetic complications, but only partly correlated with the level of blood glycated haemoglobin. Of the cytokines examined, salivary VEGF and HGF concentrations in diabetic pregnant women correlated in a positive and negative manner, respectively, with the prevalence of caries. Moreover, VEGF levels in this group correlated inversely with the probing depth and clinical attachment levels. All such associations did not occur in healthy individuals. In contrast, the salivary pH and flow rate correlated inversely with several parameters of caries and plaque formation irrespectively of whether the pregnant women were diabetic or not. Diabetes in pregnant women significantly changes saliva properties, which may contribute to accelerated deterioration of the oral status in this population. Copyright © 2010 Elsevier Ltd. All rights reserved.
Ibrahim, Moustafa Ibrahim; Hamdy, Ahmed; Shafik, Adel; Taha, Salah; Anwar, Mohammed; Faris, Mohammed
The aim of the present study is to assess the impact of adding oral metformin to insulin therapy in pregnant women with insulin-resistant diabetes mellitus. The current non-inferiority randomized controlled trial was conducted at Ain Shams University Maternity Hospital. The study included pregnant women with gestational or pre-existing diabetes mellitus at gestations between 20 and 34 weeks, who showed insulin resistance (defined as poor glycemic control at a daily dose of ≥1.12 units/kg). Recruited women were randomized into one of two groups: group I, including women who received oral metformin without increasing the insulin dose; and group II, including women who had their insulin dose increased. The primary outcome was maternal glycemic control. Secondary outcomes included maternal bouts of hypoglycemia, need for another hospital admission for uncontrolled diabetes during pregnancy, gestational age at delivery, mode of delivery, birth weight, birth trauma, congenital anomalies, 1- and 5-min Apgar score, neonatal hypoglycemia, need for neonatal intensive care unit (NICU) admission and adverse neonatal outcomes. A total number of 154 women with diabetes mellitus with pregnancy were approached; of them 90 women were eligible and were randomly allocated and included in the final analysis. The recruited 90 women were randomized into one of two groups: group I (metformin group) (n = 46), including women who received oral metformin in addition to the same initial insulin dose; and group II (control group) (n = 44), including women who had their insulin dose increased according to the standard protocol. The mean age of included women was 29.84 ± 5.37 years (range 20-42 years). The mean gestational age at recruitment was 28.7 ± 3.71 weeks (range 21-34 weeks). Among the 46 women of group I, 17 (36.9 %) women reached proper glycemic control at a daily metformin dose of 1,500 mg, 18 (39.2 %) at a daily dose of 2,000 mg, while 11 (23.9 %) received metformin at a daily
Schneeberger, Caroline; Erwich, Jan Jaap H M; van den Heuvel, Edwin R; Mol, Ben W J; Ott, Alewijn; Geerlings, Suzanne E
To compare the prevalence of asymptomatic bacteriuria (ASB) and the incidence of urinary tract infection (UTI) in pregnant women with and without diabetes mellitus (DM) or gestational DM (GDM). We performed a cohort study in five hospitals and two midwifery clinics in the Netherlands. Pregnant women with and without DM or GDM were screened for the presence of ASB around 12 and 32 weeks' gestation. Characteristics of participants as well as outcome data were collected from questionnaires and medical records. ASB was defined as the growth of at least 10e5 cfu/ml isolated from the urine of a woman without UTI complaints. UTI was considered to be present when a treating physician had diagnosed UTI and prescribed antibiotics. We studied 202 women with and 272 women without DM or GDM. Of all women 31.7% with and 94.9% without DM or GDM provided a week 12 sample. The prevalence of ASB was comparable in women with and without DM or GDM (12 weeks' n = 322; 4.7% and 2.3%; relative risk (RR) 2.02; 95% confidence interval (CI) 0.52-7.84; 32 weeks' n = 422; 3.2% and 3.0%; RR 1.06; 95% CI 0.36-3.09), as was the incidence of UTI (16.8% and 12.9%; RR 1.31; 95% CI 0.85-2.02). Neither ASB nor UTI were associated with preterm birth or babies being small for gestational age. In pregnant women with and women without DM or GDM, the overall prevalence of ASB was low. Neither ASB nor UTI did differ significantly between the groups. Our data discourage a routine ASB screen and treat policy in pregnant women with DM or GDM. Copyright © 2017. Published by Elsevier B.V.
Full Text Available The paper contains an analysis of the factors affecting the quality of life (QoL and the illness acceptance of diabetic pregnant women. The study was performed between January and April, 2013. It included 114 pregnant women with diabetes, hospitalized in the High Risk Pregnancy Wards of several hospitals in Lublin, Poland. The study used a diagnostic survey with questionnaires. The research instruments used were: The WHOQOL-Bref questionnaire and the Acceptance of Illness Scale (AIS. The women’s general quality of life was slightly higher than their perceived general health. A higher quality of life was reported by women with a very good financial standing, very good perceived health, moderate self-reported knowledge of diabetes, and also by those only treated with diet and stating that the illness did not interfere with their lives (p < 0.05. Women with a very good financial standing (p < 0.009, high self-reported health (p < 0.002, and those treated with by means of a diet (p < 0.04 had a higher acceptance of illness. A higher acceptance of illness contributes to a higher general quality of life and a better perception of one’s health.
Mahesh Doddabelavangala Mruthyunjaya
Full Text Available Pregnant women with diabetes may have underlying beta cell dysfunction due to mutations/rare variants in genes associated with Maturity Onset Diabetes of the Young (MODY. MODY gene screening would reveal those women genetically predisposed and previously unrecognized with a monogenic form of diabetes for further clinical management, family screening and genetic counselling. However, there are minimal data available on MODY gene variants in pregnant women with diabetes from India. In this study, utilizing the Next generation sequencing (NGS based protocol fifty subjects were screened for variants in a panel of thirteen MODY genes. Of these subjects 18% (9/50 were positive for definite or likely pathogenic or uncertain MODY variants. The majority of these variants was identified in subjects with autosomal dominant family history, of whom five were in women with pre-GDM and four with overt-GDM. The identified variants included one patient with HNF1A Ser3Cys, two PDX1 Glu224Lys, His94Gln, two NEUROD1 Glu59Gln, Phe318Ser, one INS Gly44Arg, one GCK, one ABCC8 Arg620Cys and one BLK Val418Met variants. In addition, three of the seven offspring screened were positive for the identified variant. These identified variants were further confirmed by Sanger sequencing. In conclusion, these findings in pregnant women with diabetes, imply that a proportion of GDM patients with autosomal dominant family history may have MODY. Further NGS based comprehensive studies with larger samples are required to confirm these finding.
Hesarghatta Shyamasunder, Asha; Varghese, Deny; Varshney, Manika; Paul, Johan; Inbakumari, Mercy; Christina, Flory; Varghese, Ron Thomas; Kuruvilla, Kurien Anil; V. Paul, Thomas; Jose, Ruby; Regi, Annie; Lionel, Jessie; Jeyaseelan, L.; Mathew, Jiji; Thomas, Nihal
Pregnant women with diabetes may have underlying beta cell dysfunction due to mutations/rare variants in genes associated with Maturity Onset Diabetes of the Young (MODY). MODY gene screening would reveal those women genetically predisposed and previously unrecognized with a monogenic form of diabetes for further clinical management, family screening and genetic counselling. However, there are minimal data available on MODY gene variants in pregnant women with diabetes from India. In this study, utilizing the Next generation sequencing (NGS) based protocol fifty subjects were screened for variants in a panel of thirteen MODY genes. Of these subjects 18% (9/50) were positive for definite or likely pathogenic or uncertain MODY variants. The majority of these variants was identified in subjects with autosomal dominant family history, of whom five were in women with pre-GDM and four with overt-GDM. The identified variants included one patient with HNF1A Ser3Cys, two PDX1 Glu224Lys, His94Gln, two NEUROD1 Glu59Gln, Phe318Ser, one INS Gly44Arg, one GCK, one ABCC8 Arg620Cys and one BLK Val418Met variants. In addition, three of the seven offspring screened were positive for the identified variant. These identified variants were further confirmed by Sanger sequencing. In conclusion, these findings in pregnant women with diabetes, imply that a proportion of GDM patients with autosomal dominant family history may have MODY. Further NGS based comprehensive studies with larger samples are required to confirm these finding PMID:28095440
Skajaa, Gitte Ø; Fuglsang, Jens; Kampmann, Ulla; Ovesen, Per G
Tight glycemic control throughout pregnancy in women with type 1 diabetes is crucial, and knowledge about which factors that affect insulin sensitivity could improve the outcome for both mother and offspring. To evaluate insulin requirements in women with type 1 diabetes during pregnancy and test whether parity affects insulin requirements. Observational cohort study consisting of women with type 1 diabetes who gave birth at Aarhus University Hospital, Denmark, from 2004 to 2014. Daily insulin requirement (the hypothesis that parity could affect insulin resistance was formulated before data collection). A total of 380 women with a total of 536 pregnancies were included in the study. Mean age was 31.1 years, and prepregnancy hemoglobin A1c was 60 mmol/mol. Parity was as follows: P0, 43%; P1, 40%; P2, 14%; and P3+4, 3%. Insulin requirements from weeks 11 to 16 decreased significantly by 4% (P = 0.0004) and rose from week 19 to delivery with a peak of 70% (P insulin requirements increased significantly with parity. The unadjusted differences between P0 and P1, P2, and P3+4 were 9% (P insulin requirements from week to week in pregnancy and indicate that insulin requirements increase with parity. This suggests that the patient's parity probably should be considered in choosing insulin dosages for pregnant women with type 1 diabetes.
Nielsen, L.R.; Johansen, M.; Pedersen-Bjergaard, U.
OBJECTIVE- In pregnancy with type 1 diabetes, we evaluated occurrence of mild and severe hypoglycemia and analyzed the influence of strict metabolic control, nausea, Vomiting, and other potential predictors of occurrence of severe hypoglycemia. RESEARCH DESIGN AND METHODS- A prospective...... awareness or unawareness (3.2 [1.2-8.2]) as independent predictors for severe hypoglycemia. CONCLUSIONS - In pregnancy with type 1 diabetes, the incidence of mild and severe hypoglycemia was highest in early pregnancy, although metabolic control was tighter in the last part of pregnancy. Predictors...... observational study of 108 consecutive pregnant women with type 1 diabetes was conducted. At 8, 14, 21, 27, and 33 weeks of gestation, patients performed self-monitored plasma glucose (SMPG) (eight/day) for 3 days and completed a questionnaire on nausea, vomiting, hypoglycemia awareness, and history of mild...
Egan, Aoife M; Vellinga, Akke; Harreiter, Jurgen
at enrolment and throughout pregnancy. GDM was diagnosed using IADPSG/WHO 2013 criteria. GDM treatment followed local policies. RESULTS: The number of women recruited per country ranged from 80 to 217, and the dropout rate was 7.1%. Overall, 39% of women developed GDM during pregnancy, with no significant......AIMS/HYPOTHESIS: Accurate prevalence estimates for gestational diabetes mellitus (GDM) among pregnant women in Europe are lacking owing to the use of a multitude of diagnostic criteria and screening strategies in both high-risk women and the general pregnant population. Our aims were to report...... important risk factors for GDM development and calculate the prevalence of GDM in a cohort of women with BMI ≥29 kg/m(2) across 11 centres in Europe using the International Association of the Diabetes and Pregnancy Study Groups (IADPSG)/WHO 2013 diagnostic criteria. METHODS: Pregnant women (n = 1023, 86...
Full Text Available This paper explores well-being and diabetes management in women with type 1 diabetes mellitus (DM in early pregnancy and investigates associations among perceived well-being, diabetes management, and maternal characteristics. Questionnaires were answered by 168 Swedish women. Correlation analyses were conducted with Spearman’s correlation coefficient (rs. The women reported relatively high scores of self-efficacy in diabetes management (SWE-DES-10: 3.91 (0.51 and self-perceived health (excellent (6.5%, very good (42.3%, good (38.7%, fair (11.3% and poor (1.2%. Moderate scores were reported for general well-being (WBQ-12: 22.6 (5.7 and sense of coherence (SOC-13: 68.9 (9.7, moderate/low scores for hypoglycemia fear (SWE-HFS 26.6 (11.8 and low scores of diabetes-distress (SWE-PAID-20 27.1 (15.9. A higher capability of self-efficacy in diabetes management showed positive correlations with self-perceived health (rs = −0.41, p < 0.0001 and well-being (rs = 0.34, p < 0.0001 as well as negative correlations with diabetes distress (rs = −0.51, p < 0.0001 and hypoglycemia worries (rs = −0.27, p = 0.0009. Women with HbA1c levels of ≤48 mmL/mol scored higher in the subscales “goal achievement” in SWE-DES (p = 0.0028 and “comprehensibility” in SOC (p = 0.016. Well-being and diabetes management could be supported by strengthening the women’s capability to achieve glycemic goals and their comprehensibility in relation to the treatment. Further studies are needed to test this.
Rhoads-Baeza, Maria Elena; Reis, Janet
Objective: To describe and assess low income, healthy, pregnant Hispanic women's understanding of gestational diabetes (GDM) and willingness to change aspects of their diet. Design: One-on-one, in-person interviews conducted in Spanish with 94 women (primarily Mexican). Setting: Federal Qualified Community Health Center's prenatal clinic. Method:…
Zheng, N-N; Guo, X-C; Lv, W; Chen, X-X; Feng, G-F
Pregnancy and diabetes are regarded as individual risk factors for vaginal candidiasis. The high prevalence of vaginal candidiasis in pregnant diabetic women can be explained by disruption of the balance of the vaginal normal flora. However, little is known about the overall structure and composition of the vaginal fungal flora in pregnant diabetic women. In the present study, the diversity and richness of the vaginal fungal flora in healthy non-pregnant women (group HN), healthy pregnant women (group HP), women with gestational diabetes mellitus (group GDM), and pregnant women with diabetes mellitus type I (group T1DM) were investigated using an 18S rRNA gene clone library method. Our data demonstrated that the composition of the vaginal fungal flora in the four groups could be divided into two phyla (Ascomycetes, 20/26, and Basidiomycetes, 6/26). The most predominant vaginal fungal species belonged to the Candida and Saccharomyces genera, uncultured fungi, and a large number of low-abundance taxa that were unrecorded or underrepresented in previous studies using cultivation-dependent methods. Variation in operational taxonomic units (OTUs) between the study cohorts was generally high in the clone libraries, as 9, 13, 17, and 20 phylotypes were identified in groups HN, HP, GDM, and T1DM, respectively. The Shannon indices of groups GDM and T1DM (with poorer glycemic control) were significantly higher compared to groups HN and HP (p flora in pregnant diabetic women and demonstrated that poor glycemic control might be associated with disturbances in the vaginal fungal flora.
Schneeberger, Caroline; Kazemier, Brenda M; Geerlings, Suzanne E
Asymptomatic bacteriuria (ASB) and urinary tract infections (UTIs) in women with diabetes mellitus and during pregnancy are common and can have far-reaching consequences for the woman and neonate. This review describes epidemiology, risk factors, complications and treatment of UTI and ASB according to recent developments in these two groups. Most articles addressing the epidemiology and risk factors of ASB and UTI in diabetic and pregnant women confirmed existing knowledge. New insights were obtained in the association between sodium-glucose cotransporter-2 (SGLT2) inhibitors, as medication for diabetes mellitus type 2, and a small increased risk for UTI due to glucosuria and the possible negative effects of UTI, including urosepsis,on bladder and kidney function in diabetic women. Predominantly, potential long-term effects of antibiotic treatment of ASB or UTI during pregnancy on the neonate have received attention, including antibiotic resistance and epilepsy. SGLT2 inhibitors were associated with a small increased risk for UTI, UTI in diabetic women may lead to bladder and kidney dysfunction, and antibiotic treatment of ASB and UTI during pregnancy was associated with long-term effects on the neonate. Up-to-date research on the effectiveness and long-term effects of ASB screening and treatment policies, including group B Streptococcus bacteriuria in pregnancy, is warranted to inform clinical practice.
Jeon, Eon Ju; Hong, Seong Yeon; Lee, Ji Hyun
The aim of this study was to evaluate adipokines concentration and insulin resistance according to maternal age or obesity at pregnancy and weight change at diagnosed gestational diabetes mellitus (GDM) in pregnant women with GDM. This study included 57 pregnant women who were diagnosed with GDM at 24 to 28 weeks of gestation. The subjects were classified into two or three groups according to pre-pregnancy body mass index (BMI, insulin resistance (HOMA-IR), and HOMA2-%B were increased in the group with pre-pregnancy BMI ≥25 kg/m². Leptin and HOMA-IR were positively correlated with BMI both before pregnancy and at screening for GDM. There were no significant correlations between HOMA-IR and adipokines. HOMA-IR showed positive correlation with HOMA2-%B and negative correlation with HOMA2-%S. Leptin and HOMA-IR at diagnosed GDM were increased in the GDM patients with obesity before pregnancy. They were positively correlated with BMI both before pregnancy and at screening for GDM. The effect of maternal age at pregnancy and weight change during pregnancy at GDM screening on adipokines and insulin resistance might be less pronounced than the effect of maternal obesity. Copyright © 2017 Korean Diabetes Association
Shalayel, Mohammed Helmy Faris
To detect the effect of some maternal risk factors such as age, parity, previous heavy babies and family history of diabetes, in glucose tolerance impairment and to stand on the state of insulin resistance which occurs in pregnancy and the possible role of cortisol, human placental lactogen and prolactin in augmentation of this state of insulin resistance as well as to show the effect of glucose tolerance deterioration on lipid metabolism, a study was carried out on Sudanese pregnant women. The study included thirty gestational diabetes mellitus (GDM) pregnant women, thirty impaired glucose tolerance (IGT) and thirty women with normal glucose tolerance as a control group. The GDM, IGT and the control group were screened from about 2000 Sudanese pregnant women in the different gestational weeks. The GDM and IGT women were all discovered in the third trimester of pregnancy, they found to be significantly older than the control group. The IGT group was found to have a first degree family history of diabetes incidence significantly more than that of the control group while the GDM group has significantly much higher results when compared with the normal control group. The incidence of previous heavy babies was significantly higher in the IGT group when compared with the control while that of GDM was significantly much higher. The GDM group was found to have significantly higher mean levels of fasting blood plasma glucose sugar than that of the IGT and the control groups. It was found that the serum cholestrol mean level and the serum triglycerides mean level of the IGT and that of the GDM were significantly higher than that of the control group. Also, there were no significant differences among serum fasting insulin mean levels of the three studied groups. Results of serum anti-insulin antibodies of the three studied groups were significantly different. Results of serum cortisol of the control group in the first, second and third trimesters revealed that cortisol
Egan, Aoife M; Vellinga, Akke; Harreiter, Jürgen
AIMS/HYPOTHESIS: Accurate prevalence estimates for gestational diabetes mellitus (GDM) among pregnant women in Europe are lacking owing to the use of a multitude of diagnostic criteria and screening strategies in both high-risk women and the general pregnant population. Our aims were to report...... important risk factors for GDM development and calculate the prevalence of GDM in a cohort of women with BMI ≥29 kg/m(2) across 11 centres in Europe using the International Association of the Diabetes and Pregnancy Study Groups (IADPSG)/WHO 2013 diagnostic criteria. METHODS: Pregnant women (n = 1023, 86...... differences in prevalence across countries. The prevalence of GDM was high (24%; 242/1023) in early pregnancy. Despite interventions used in the DALI study, a further 14% (94/672) had developed GDM when tested at mid gestation (24-28 weeks) and 13% (59/476) of the remaining cohort at late gestation (35...
Youngwanichsetha, Sununta; Phumdoung, Sasitorn
To explore and describe lived experience of blood glucose self-monitoring among pregnant Thai women with gestational diabetes mellitus. Self-monitoring of blood glucose is an essential practice among pregnant women with diabetes to prevent complications in pregnancy and the newborn infant. Phenomenological research was employed to understand lived experiences in glycemic control. Thirty participants were approached and interviewed using a semistructured interview guides. Qualitative data were analysed following Colaizzi's method. The findings revealed three themes: being worried about diabetes and blood testing, trying to control it and being patient for the child. Their worry comprised three dimensions: (1) wondering about the impacts of diabetes on the child, (2) concern about maternal health and (3) being worried about doing blood test. Trying to control diabetes was composed of three dimensions: (1) learning to test blood glucose, (2) being afraid of elevated blood sugar and (3) being aware of what to eat. Being patient for the child was composed of three dimensions: (1) overcoming food desires, (2) tolerating the fingerprick pain and (3) satisfaction with the outcomes. Women with gestational diabetes experienced being worried and afraid regarding blood glucose self-monitoring; however, they could overcome and tolerate this with some difficulties. These findings can be used to guide nursing practice in assessment of perception and response towards blood glucose self-monitoring in order to improve achievement of a good glycaemic control among pregnant women with gestational diabetes mellitus. © 2016 John Wiley & Sons Ltd.
Gutiérrez Gutiérrez, Héctor Israel; Carrillo Iñiguez, Mayra Judith; Pestaña Mendoza, Silvia; Santamaría Ferreira, Mauricio
Diabetes mellitus complicates 3-5% of all pregnancies and is a major cause of perinatal morbidity and mortality. The diet and insulin have revolutionized the care related with pregnancy complicated by diabetes mellitus. To report the management experience in patients with diabetes and pregnancy at the Instituto Materno Infantil, Estado de Mexico. A descriptive, retrospective, observational and cross-sectional study of pregnant women with diabetes and pregnancy was conducted from 2003 to 2004. We included 55 pregnant women who had: gestational diabetes 30 (54.4%), pregestational diabetes 24 (43.6%), and carbohydrate intolerance 1 (1.8%); every one of them were controlled either with diet, insulin or both. The mean age was 30.6, 80% with family history of type 2 diabetes mellitus, 9% gestational diabetes. Gestational diabetes was diagnosed in 33.3% by abnormal 50 g glucose screening and 46.6% with oral glucose tolerance test (OGTT). The main complications among the patients were urinary disease (61.3%) and the major fetal malformation were those related with cardiovascular disease (9.09%). The most frequent mode of delivery was cesarean section (58%) and birth weight was of 3,146 g. The main risk factors identified among women in the study group were as follow: More than 25 years of age and family history of diabetes mellitus. We observed a progressive increase in the insulin dosage. The most consistent complications among the patients were urinary infection and the major fetal malformation was cardiovascular disease.
Fleisch, Abby F; Kloog, Itai; Luttmann-Gibson, Heike; Gold, Diane R; Oken, Emily; Schwartz, Joel D
Rodent and human studies suggest an association between air pollution exposure and type 2 diabetes mellitus, but the extent to which air pollution is associated with gestational diabetes mellitus (GDM) is less clear. We used the Massachusetts Registry of Vital Records to study primiparous women pregnant from 2003-2008 without pre-existing diabetes. We used satellite-based spatiotemporal models to estimate first and second trimester residential particulate (PM2.5) exposure and geographic information systems to estimate neighborhood traffic density. We obtained GDM status from birth records. We performed logistic regression analyses adjusted for sociodemographics on the full cohort and after stratification by maternal age and smoking habits. Of 159,373 women, 5,381 (3.4 %) developed GDM. Residential PM2.5 exposure ranged 1.3-19.3 μg/m(3) over the second trimester. None of the exposures were associated with GDM in the full cohort [e.g. OR 0.99 (95 % CI: 0.95, 1.03) for each interquartile range (IQR) increment in second trimester PM2.5]. There were also no consistent associations after stratification by smoking habits. When the cohort was stratified by maternal age, women less than 20 years had 1.36 higher odds of GDM (95 % CI: 1.08, 1.70) for each IQR increment in second trimester PM2.5 exposure. Although we found no evidence of an association between air pollution exposure and GDM among all women in our study, greater exposure to PM2.5 during the second trimester was associated with GDM in the youngest age stratum.
Bishwajit, Ghose; Yaya, Sanni; Seydou, Ide
To investigate the association between overweight and obesity (in terms of BMI) and diabetes, HBP and diabetes-HBP comorbidity among adult women non-pregnant in Bangladesh. Information about demographics, socioeconomic, blood pressure and blood glucose levels were collected for 2022 women ageing above 35 years were collected from Bangladesh Demographic and Health Survey (BDHS 2011). The primary outcome variables were diabetes and high blood pressure. Diabetes was defined as fasting plasma glucose value ≥7.0mmol/L and HBP as systolic blood pressure ≥140mmHg or diastolic blood pressure ≥90mmHg. Blood pressure and plasma glucose measurement were performed by standard clinical procedures. Data were analysed using cross-tabulation, chi-square tests and logistic regression methods. Mean age of the participants was 41.42 (SD=4.37). 38.7% of the women had BMI values ≥25. The prevalence of HBP, diabetes, and diabetes-HBP comorbidity was respectively 18% and 5.1%, and 2%. The adjusted odds of having diabetes, HBP and Diabetes-HBP comorbidity were respectively 2.14 (p=0.002; 95%CI=1.31-3.48), 2.3 (p=<0.0001; 95%CI=1.70-2.98), and 3.4 (p=0.004; 95%CI=1.47-7.81) times higher among overweight/obese women compared to those with normal weight. Overweight and obesity account for a major proportion of diabetes, HBP and the comorbidity of these two among non-pregnant women. There remains a considerable risk for future expansion of diabetes and HBP as the prevalence of overweight/obesity is rising constantly. Maintaining a healthy BMI needs to be regarded as among the most important diabetes and HBP preventive strategies among Bangladeshi women. Copyright © 2016 Diabetes India. Published by Elsevier Ltd. All rights reserved.
Law, Graham R; Gilthorpe, Mark S; Secher, Anna L
AIMS/HYPOTHESIS: This study aimed to examine the relationship between average glucose levels, assessed by continuous glucose monitoring (CGM), and HbA1c levels in pregnant women with diabetes to determine whether calculations of standard estimated average glucose (eAG) levels from HbA1c measureme...
Farrar, Diane; Tuffnell, Derek J; West, Jane; West, Helen M
Diabetes results in a rise in blood glucose above normal physiological levels; if untreated this may cause damage to many systems including the cardiovascular and renal systems. Pregnancy increases resistance to insulin action; for those women who have pre-gestational diabetes, this results in an increasing insulin requirement. There are several methods of administering insulin. Conventionally, insulin has been administered subcutaneously, formally referred to as intensive conventional treatment, but now more usually referred to as multiple daily injections (MDI). An alternative method of insulin administration is the continuous subcutaneous insulin infusion pump (CSII). To compare CSII with MDI of insulin for pregnant women with pre-existing and gestational diabetes. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 March 2016) and reference lists of retrieved studies. Randomised trials comparing CSII with MDI for pregnant women with diabetes. Three review authors independently assessed studies and two review authors extracted data. Disagreements were resolved through discussion with the third author. We assessed the quality of the evidence using the GRADE approach. We included five single-centre trials (undertaken in Italy) with 153 women and 154 pregnancies in this review.There were no clear differences in the primary outcomes reported between CSII and MDI in the included trials: caesarean section (risk ratio (RR) 1.09, 95% confidence interval (CI) 0.66 to 1.77; three trials, 71 women, evidence graded very low), large-for-gestational age (RR 4.15, 95% CI 0.49 to 34.95; three trials, 73 infants; evidence graded very low), and perinatal mortality (RR 2.33, 95% CI 0.38 to 14.32; four trials, 83 infants, evidence graded very low). Other primary outcomes were not reported in these trials (hypertensive disorders of pregnancy, development of type 2 diabetes, composite outcome of serious neonatal outcomes, and neurosensory disability
Juhl, B.; Lauszus, Finn; Lykkesfeldt, Jens
Abstract.Few studies have examined how vitamin C status is affected in diabetic pregnancy and no comparison between normal and diabetic pregnancies has been found. This study evaluated vitamin C status prospectively during pregnancy in women with type 1 diabetes mellitus (n=76), in non......-diabetic women (n=60), and in their respective neonates. Vitamin C was lower in diabetic women throughout all trimesters compared to controls (p...-diabetic women, vitamin C levels were lower in 3rd trimester compared to 1st and 2nd trimester (both pvitamin C status - defined as a plasma concentration vitamin C...
Pedersen, Berit Woetmann; Ringholm, Lene; Damm, Peter
AIM: To evaluate whether initiation of anti-hypertensive treatment with methyldopa affects fetal hemodynamics in women with pregestational diabetes. METHODS: Prospective study of unselected singleton pregnant women with diabetes (seven type 1 and two type 2 diabetes), normal blood pressure and ki...
Ngala, Robert Amadu; Fondjo, Linda Ahenkorah; Gmagna, Peter; Ghartey, Frank Naku; Awe, Martin Akilla
Gestational diabetes is a risk factor for perinatal complications; include shoulder dystocia, birth injuries such as bone fractures and nerve palsies. It is associated with later development of type 2 diabetes, the risk of macrosomia and other long-term health effects of infants born to diabetic mothers. The study assesses placental peptides and maternal factors as potential predictors of gestational diabetes among pregnant women. A total of 200 pregnant women were recruited for the study, 150 pregnant women without pre gestational diabetes including 50 women with low risk factors of diabetes as controls and 50 other pregnant women with pregestational diabetes as control. Fasting blood glucose and the lipid profile were determined by enzymatic methods using Envoy® 500 reagents (Vital Diagnostics, USA). Glycated haemoglobin was assessed using the Cation Exchange resin method. Leptin and the Human Placenta Lactogen were assayed using the Sandwich-ELISA technique. Beta chorionic gonadotrophin, insulin, progesterone and estradiol were determined using chemilumiscence imunoassay technique on MAGLUMI 600 analyzer. Anthropometry, including BMI and blood pressure were also measured. Fasting plasma glucose (FBG), insulin, insulin resistance, glycated haemoglobin and Human Placenta Lactogen(HPL)were significantly (p0.05) in estradiol, insulin, insulin resistance and HPL between the pregnant women who developed gestational diabetes and those who did not. Leptin, progesterone and FBG were significantly increased in those who developed GDM. The risk of developing gestational diabetes increased with overweight (OR = 1.76, P = 0.370) and family history of diabetes (OR = 2.18, P = 0.282). Leptin, progesterone, estradiol estimated in this study were increased in the gestational diabetes mellitus women and fairly predicted gestational diabetes in the non-diabetics pregnant women. Obesity, aging and family history of diabetes were strongly predictive of gestational diabetes.
Fei, Bei-bei; Ling, Li; Hua, Chen; Ren, Shu-yan
The effects of soybean oligosaccharides (SBOS) on antioxidant enzyme activities and insulin resistance in pregnant women with gestational diabetes mellitus (GDM) were investigated. Ninety-seven pregnant women with GDM were randomly divided into two groups, the control group (51 cases) and the SBOS group (46 cases). Before the group separation, the blood sugar level in patients was maintained stable by regular diet and insulin treatment. The control group was continued with the insulin treatment, while the SBOS group was treated with the combination of insulin and SBOS. Results showed that SBOS were able to reduce oxidative stress and alleviate insulin resistance in pregnant women with GDM, which indicates that SBOS may play an important role in the control of GDM complications. Copyright © 2014 Elsevier Ltd. All rights reserved.
Embaby, Heba; Elsayed, Enas; Fawzy, Mohamed
Gestational diabetes mellitus (GDM) is one of the common complications that occur during pregnancy. Early intervention is essential to prevent the development of the disease in the non-pregnant state but also helpful in preventing the occurrence of GDM. The aim of the study was to assess the effect of aerobic exercises on insulin sensitivity and fasting plasma glucose level in pregnant women with risk for gestational diabetes mellitus. Forty multigravidae women between 20-24 weeks of gestation with risk for GDM were randomly selected (age range was 25-35 years), body mass index ranged from 30-35 kg/m 2 . Women were divided into two equal groups: intervention group (A), which followed an aerobic exercise program in the form of walking on treadmill, three times weekly until the end of 37 weeks of gestation in addition to diet control. Control group (B) which received diet control with usual care given by obstetricians and midwives. Evaluation of the women in both groups was carried out before and after treatment program through assessment of fasting blood glucose and insulin levels. There was a highly statistically significance decrease in fasting blood glucose level, fasting insulin level in both groups where the p value was 0.0001 favoring group (A). Moderate intensity of aerobic exercises were effective in reducing fasting blood glucose level and fasting insulin level in pregnant women with risk for gestational diabetes mellitus.
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CONCLUSION: Thiol- disulphide balance has shifted to the oxidative side in pregnant women with GDM. So blood glucose regulation is extremely crucial for reducing the oxidative stress which may lead to damages to vital organs of a mother or possibly to development of a fetus in women with GDM.
Wang, Qiuwei; Huang, Ruiping; Yu, Bin; Cao, Fang; Wang, Huiyan; Zhang, Ming; Wang, Xinhong; Zhang, Bin; Zhou, Hong; Zhu, Ziqiang
OBJECTIVE: The aim of this study was to determine the effect of gestational diabetes mellitus (GDM) on fetal insulin resistance or β-cell function in Chinese pregnant women with GDM. MEASUREMENTS: Maternal fasting blood and venous cord blood samples (reflecting fetal condition) were collected in 65 well-controlled Chinese GDM mothers (only given dietary intervention) and 83 control subjects. The insulin, glucose and proinsulin concentrations of both maternal and cord blood samples were measur...
May 1, 2018 ... sample was collected from 139 pregnant and 139 age matched ... have major consequences for fetal growth. ... metabolic disorder in pregnancy is gestational ... expected to be 23.4 %, and the child mortality rate ... diabetic pregnant women and her unborn infant ... hemorrhage, fetal obesity, miscarriage,.
Fagundes, Danny L G; França, Eduardo L; Gonzatti, Michelangelo B; Rugde, Marilza V C; Calderon, Iracema M P; Honorio-França, Adenilda C
The study investigated the role of cytokines IL-4 and IL-17 in the modulation of the functional activity of mononuclear phagocytes in diabetic pregnant women with hyperglycemia. Sixty pregnant women were assigned to the following groups: nondiabetic (ND), mild gestational hyperglycemia (MGH), gestational diabetes mellitus (GDM), or type 2 diabetes mellitus (DM2). The functional activity of phagocytes from maternal blood, cord blood, and colostrum was assessed by determining their superoxide release, phagocytosis, microbicidal activity, and intracellular Ca 2+ release. Irrespective of glycemic status, colostrum and blood cells treated with IL-4 and IL-17 increased superoxide release in the presence of enteropathogenic Escherichia coli (EPEC). The highest phagocytosis rate was observed in cells from the DM2 group treated with IL-4. In all the groups, phagocytes from colostrum, maternal blood, and cord blood exhibited higher microbicidal activity against EPEC when treated with cytokines. IL-17 increased intracellular Ca 2+ release by colostrum phagocytes in diabetic groups. The results indicate that the IL-4 and IL-17 modulate the functional activity of phagocytes in the maternal blood, cord blood, and colostrum of diabetic mother. The natural immunity resulting from the interaction between the cells and cytokines tested may be an alternative procedure to improve the prognosis of maternal and newborn infections. © 2017 APMIS. Published by John Wiley & Sons Ltd.
Bartáková, Vendula; Kuricová, Katarína; Zlámal, Filip; Bělobrádková, Jana; Kaňková, Katetřina
Gestational diabetes mellitus (GDM) represents the most frequent metabolic disorder in pregnancy. Since dietary intake plays an important role in obesity and type 2 diabetes development, it is likely to be for the susceptibility to GDM too. Food preferences, driving partly the diet composition, are changing during pregnancy. Taste and genetic variability in taste receptors is an important factor in determining food preferences. Aims of our study were (1) to characterize dietary habits of pregnant women and to find possible differences in food preferences between healthy pregnant women and those with GDM and (2) to ascertain possible association of several single nucleotide polymorphisms (SNPs) in taste receptor (TR) genes with GDM. A total of 363 pregnant women (293 with GDM and 70 with physiologic pregnancy) were included in the study. Dietary pattern spanning the period of approx. 6 months preceding the time of GDM screening was assessed using a semi-quantitative food frequency questionnaire. A total of five SNPs in TR genes were selected for genotyping based on their functionality or previous associations. Women with GDM exhibited significantly more frequent meat consumption (esp. poultry, pork and smoked meat), dairy products and sweet beverages consumption. The legumes consumption was found to be inversely correlated with fasting glycaemia (P = 0.007, Spearman). CC genotype in TAS2R9 gene (SNP rs3741845) was significantly associated with GDM (P = 0.0087, Chi-square test). Our study showed differences in dietary intake of selected food items between healthy pregnant women and those with GDM and genetic association of bitter taste receptor allele with GDM.
Full Text Available Background: Metformin reduces maternal and neonatal weight gain in gestational diabetes mellitus; however, this effect is poorly investigated in non-diabetic women. Objective: We performed this meta-analysis to investigate the effect of metformin intake during pregnancy on maternal and neonatal outcomes in obese non-diabetic women. Materials and Methods: We searched Medline, EMBASE, and Cochrane CENTRAL for eligible randomized controlled trials addressing the efficacy of metformin in pregnant obese non-diabetic women. Data were extracted and analyzed using RevMan software (Version 5.3. Neonatal birth weight was the key outcome. Secondary outcomes included maternal weight gain, the incidence of preeclampsia, and neonatal adverse effects (miscarriage, stillbirth and congenital anomalies. Results: Pooled data from two RCTs (n=843 showed that metformin caused a significant reduction in maternal gestational weight gain (MD-1.35, 95% CI: [2.08, -0.630], compared to placebo. The summary effect-estimate did not favor either of the two groups in terms of reduction of neonatal birth weight Z score (MD-0.09, 95% CI: [0.23, 0.06]. Metformin was associated with 41% reduction in the risk of preeclampsia; however, this reduction was not statistically significant [RR 0.59, 95% CI: [0.03, 11.46]. None of the neonatal adverse events including stillbirth [RR 1.14, 95% CI: 0.42, 3.10] and congenital anomalies (RR= 1.36, 95% CI: [0.58, 3.21] differed significantly between the two groups. Conclusion: For obese pregnant women, metformin could decrease gestational weight gain with no significant reduction in neonatal birth weight. In light of the current evidence, metformin should not be used to prevent poor pregnancy outcomes in obese non-diabetic women.
Law, Graham R; Gilthorpe, Mark S; Secher, Anna L; Temple, Rosemary; Bilous, Rudolf; Mathiesen, Elisabeth R; Murphy, Helen R; Scott, Eleanor M
This study aimed to examine the relationship between average glucose levels, assessed by continuous glucose monitoring (CGM), and HbA 1c levels in pregnant women with diabetes to determine whether calculations of standard estimated average glucose (eAG) levels from HbA 1c measurements are applicable to pregnant women with diabetes. CGM data from 117 pregnant women (89 women with type 1 diabetes; 28 women with type 2 diabetes) were analysed. Average glucose levels were calculated from 5-7 day CGM profiles (mean 1275 glucose values per profile) and paired with a corresponding (±1 week) HbA 1c measure. In total, 688 average glucose-HbA 1c pairs were obtained across pregnancy (mean six pairs per participant). Average glucose level was used as the dependent variable in a regression model. Covariates were gestational week, study centre and HbA 1c . There was a strong association between HbA 1c and average glucose values in pregnancy (coefficient 0.67 [95% CI 0.57, 0.78]), i.e. a 1% (11 mmol/mol) difference in HbA 1c corresponded to a 0.67 mmol/l difference in average glucose. The random effects model that included gestational week as a curvilinear (quadratic) covariate fitted best, allowing calculation of a pregnancy-specific eAG (PeAG). This showed that an HbA 1c of 8.0% (64 mmol/mol) gave a PeAG of 7.4-7.7 mmol/l (depending on gestational week), compared with a standard eAG of 10.2 mmol/l. The PeAG associated with maintaining an HbA 1c level of 6.0% (42 mmol/mol) during pregnancy was between 6.4 and 6.7 mmol/l, depending on gestational week. The HbA 1c -average glucose relationship is altered by pregnancy. Routinely generated standard eAG values do not account for this difference between pregnant and non-pregnant individuals and, thus, should not be used during pregnancy. Instead, the PeAG values deduced in the current study are recommended for antenatal clinical care.
Eriksen, Nina Bonne; Damm, Peter; Mathiesen, Elisabeth R; Ringholm, Lene
We assessed the association between congenital malformations and maternal hyperglycemia in pregnant women with pregestational (type 1 or type 2) diabetes and investigated if the rate of congenital malformations was similar in women with near-normal glycemic control compared to the background population. We also assessed the association between congenital malformations and maternal hyperglycemia in pregnant women with pregestational diabetes with special focus on women with near-normal HbA1c in early pregnancy. This is a literature review based on an electronic literature search of the databases PubMed, Cochrane, Embase and Web of Science conducted in July 2017 using the search terms diabetes, pregnancy, HbA1c or glycemic control and congenital anomaly or congenital anomaly. We included original papers in English published after 1997 with data on congenital malformations and HbA1c in at least 250 women with pregestational diabetes. Nine papers with in total 6225 women with type 1 diabetes and 2334 women with type 2 diabetes were included. The prevalence of congenital malformations was 6.4% in women with type 1 diabetes and 4.3% in women with type 2 diabetes and for the combined group of women with pregestational diabetes, the relative risk compared to the background population was 3.2. In women with HbA1c congenital malformations was 4.3 and 3.7%, respectively, with a relative risk of 2.2 and 1.9, respectively. In pregnant women with pregestational diabetes the prevalence of congenital abnormalities was threefold higher in women with pregestational diabetes compared to the background population. However, HbA1c below 53 mmol/mol (7.0%) in early pregnancy was also associated with a two times increased risk of congenital malformations compared to the background population.
Zaman, Ferdos; Nouhjah, Sedigheh; Shahbazian, Hajieh; Shahbazian, Nahid; Latifi, Seyed Mahmoud; Jahanshahi, Alireza
Early identification of at-risk groups is an important step in preventing gestational diabetes and its subsequent side effects. This study aimed to evaluate the risk factors of gestational diabetes based on the International Association of Diabetes and Pregnancy Study Groups criteria in Ahvaz. In a cross-sectional case control study, 520 pregnant women involving life after gestational diabetes Ahvaz cohort study (LAGAs) were investigated for risk factors of gestational diabetes mellitus. The prevalence of overweight and obesity were 40% and25.8% in the GMD group and in 35.8% and 16.2% in the control group respectively (p = 0.002). According to NCEP-ATP III criteria, 16.9% of women with GDM and 6.9% of mothers in the control group had metabolic syndrome in first visit of pregnancy (p diabetes[OR = 1.86(95% CI, 1.19-2.94)] (p = 0.006), pre-pregnancy BMI [OR = 1.05(95% CI, 1.007-1.11)] (p = 0.04) and metabolic syndrome in first visit of pregnancy[OR = 2.34 (95% CI, 1.038-5.30)] (p = 0.04) with GDM. Factors including maternal age, previous GDM, family history of diabetes, pre-pregnancy BMI reported in previous studies around the world. A significant association between metabolic syndrome in the first visit of pregnancy and GDM is novel finding of this study. Therefore screening of pre-pregnancy metabolic syndrome in women at risk of gestational diabetes is recommended. Copyright © 2018 Diabetes India. Published by Elsevier Ltd. All rights reserved.
Full Text Available The present study aimed to investigate visceral adipose tissue-specific serpin (vaspin concentrations in serum and term placentas and relate these values to insulin resistance and lipid parameters in women with gestational diabetes mellitus (GDM. A total of 30 GDM subjects and 27 age-matched pregnant women with normal glucose tolerance (NGT, control were included. Serum glucose, glycated hemoglobin (HbA1c, lipid profile, insulin, and vaspin were measured at the end of pregnancy, and homeostasis model of assessment-insulin resistance (HOMA-IR values were calculated. Vaspin mRNA and protein levels in placentas were measured by real-time fluorescence quantitative reverse transcription polymerase chain reaction (RT-qPCR and Western blotting, respectively. Serum vaspin levels were significantly lower in the GDM group than in controls (0.49±0.24 vs 0.83±0.27 ng/mL, respectively; P<0.01. Three days after delivery, serum vaspin levels were significantly decreased in subjects with GDM (0.36±0.13 vs 0.49±0.24 ng/mL, P<0.01. However, in the GDM group, serum vaspin levels were not correlated with the parameters evaluated. In contrast, in the control group, serum vaspin levels were positively correlated with triglycerides (TG; r=0.45, P=0.02 and very low-density lipoprotein cholesterol (VLDL-C; r=0.42, P=0.03. Placental mRNA vaspin (0.60±0.32 vs 0.68±0.32, P=0.46 and protein (0.30±0.08 vs 0.39±0.26; P=0.33 levels in the GDM group did not differ significantly from those in the control group, but were negatively correlated with neonatal birth weight in the GDM group (r=-0.48, P=0.03; r=-0.88; P<0.01. Our findings indicated that vaspin may be an important adipokine involved in carbohydrate and lipid metabolism and may also play a role in fetal development.
Lauszus, F.F.; Schmitz, O.; Vestergaard, H.
BACKGROUND: Leptin is an important weight regulator and during pregnancy leptin is not only synthesized in adipose tissue but also in the placenta. AIM: To examine changes in serum leptin levels in women with type 1 diabetes mellitus during pregnancy and post delivery in relation to concomitant...... changes in maternal body weight, birth weight, glycemic control, and blood pressure. METHODS: Non-fasting serum leptin from 45 women with type 1 diabetes mellitus were studied consecutively throughout pregnancy and 3 months post partum. RESULTS: Serum leptin was positively associated with HbA1c in week 18...... of serum leptin throughout pregnancy and it changed significantly differently from the women with higher blood pressure (ptype 1 diabetes mellitus were associated with parallel changes in maternal body weight and glycemic control...
Lauszus, F F; Schmitz, O; Vestergaard, H
BACKGROUND: Leptin is an important weight regulator and during pregnancy leptin is not only synthesized in adipose tissue but also in the placenta. AIM: To examine changes in serum leptin levels in women with type 1 diabetes mellitus during pregnancy and post delivery in relation to concomitant...... changes in maternal body weight, birth weight, glycemic control, and blood pressure. METHODS: Non-fasting serum leptin from 45 women with type 1 diabetes mellitus were studied consecutively throughout pregnancy and 3 months post partum. RESULTS: Serum leptin was positively associated with HbA1c in week 18...... of serum leptin throughout pregnancy and it changed significantly differently from the women with higher blood pressure (p1 diabetes mellitus were associated with parallel changes in maternal body weight and glycemic control...
Wang, Qiuwei; Huang, Ruiping; Yu, Bin; Cao, Fang; Wang, Huiyan; Zhang, Ming; Wang, Xinhong; Zhang, Bin; Zhou, Hong; Zhu, Ziqiang
The aim of this study was to determine the effect of gestational diabetes mellitus (GDM) on fetal insulin resistance or β-cell function in Chinese pregnant women with GDM. Maternal fasting blood and venous cord blood samples (reflecting fetal condition) were collected in 65 well-controlled Chinese GDM mothers (only given dietary intervention) and 83 control subjects. The insulin, glucose and proinsulin concentrations of both maternal and cord blood samples were measured, and the homeostasis model assessment of insulin resistance (HOMA-IR) and the proinsulin-to-insulin ratios (an indicator of fetal β-cell function) were calculated in maternal and cord blood respectively. Both maternal and fetal levels of insulin, proinsulin and HOMA-IR but not proinsulin-to-insulin ratios were significantly higher in the GDM group than in the control group (maternal insulin, 24.8 vs. 15.4 µU/mL, P = 0.004, proinsulin, 23.3 vs. 16.2 pmol/L, P = 0.005, and HOMA-IR, 5.5 vs. 3.5, P = 0.041, respectively; fetal: insulin, 15.1 vs. 7.9 µU/mL, Pinsulin ratios was significantly correlated to maternal HOMA-IR (r = 0.307, P = 0.019), in the pregnant women with GDM. Fetal insulin resistance was higher in Chinese pregnant women with GDM than control subjects, and correlated with maternal insulin resistance.
Khan, Imran A; Jahan, Parveen; Hasan, Qurratulain; Rao, Pragna
Gestational diabetes mellitus (GDM) is defined as glucose intolerance first recognized during pregnancy. Insertion/deletion (I/D) polymorphism of a 287 bp Alu repetitive sequence in intron 16 of the angiotensin-converting enzyme (ACE) gene has been widely investigated in Asian Indian populations with different ethnic origins. The present study examined possible association between I/D polymorphism of the ACE gene and GDM in Asian Indian pregnant women. A total of 200 pregnant women (100 GDM and 100 non-GDM) were recruited in this study and I/D polymorphism of a 287 bp Alu1 element inside intron 16 of the ACE gene was examined by polymerase chain reaction (PCR)-based gel electrophoresis. The distribution of the variants like II, ID, and DD genotypes of ACE gene showed differences between normal GDM versus non-GDM subjects, and the frequency of the ID+ DD Vs II genotype was significant (p=0.0002) in the GDM group. ACE gene polymorphism was associated with GDM in Asian Indian pregnant women. © The Author(s) 2013.
Habiba I Ali
Full Text Available Diet therapy is the cornerstone for the management of gestational diabetes mellitus (GDM. Carbohydrate is the primary nutrient affecting postprandial blood glucose levels. Hence, knowledge of food containing carbohydrates can assist women with GDM optimize glycemic control. Despite that, there is a paucity of research on carbohydrate-related knowledge of women with GDM. The United Arab Emirates (UAE has one of the highest prevalence of diabetes (19.2% in the world. This study compared diet and knowledge of carbohydrate-containing foods among pregnant women with and without GDM in the UAE.The sample consisted of multi-ethnic women with GDM (n = 94 and a control group of healthy pregnant women (n = 90 attending prenatal clinics in three hospitals in Al Ain, UAE. Data were collected using a questionnaire and a 24-hour recall. Knowledge of food sources of carbohydrate, dietary patterns, and nutrient intakes of the two groups were compared.There were no significant differences in the mean knowledge score of food sources of carbohydrate between women with GDM and that of pregnant women without GDM. Similarly, there were no significant differences in energy and nutrient intakes between the two groups with the exception of percent energy from protein. Women with GDM reported significantly lower intake of fruits and fruit juices (P = 0.012 and higher consumption of milk and yogurt (P = 0.004 compared to that of women without GDM. Twenty-two percent of women with GDM indicated they never visited a dietitian for counseling while 65% reported they visited a dietitian only once or twice during the pregnancy. Predictors of carbohydrate knowledge score were perceived knowledge of diet and GDM and parity among women with GDM and parity and educational level among those without GDM.The results of the study highlight the urgent need to provide nutrition education for women with GDM in the UAE.
Wang, Yun-Hui; Wu, Hui-Hua; Ding, Hong; Li, Yan; Wang, Zhen-Hua; Li, Feng; Zhang, Jian-Ping
The aim of this study was to observe insulin resistance and β-cell function changes among women diagnosed with gestational impaired glucose tolerance or gestational diabetes mellitus (GDM) in mid-pregnancy. Sixty-four pregnant women receiving prenatal care underwent an oral glucose tolerance test at 20-24 weeks of gestation and an insulin release test. The GDM group included 34 pregnant women diagnosed with gestational impaired glucose tolerance or GDM, and the subjects with normal blood glucose were the control group. Insulin resistance and islet β-cell function changes were observed with the oral glucose tolerance test and insulin release test. The homeostatic model assessment-β levels in late pregnancy were higher than those in mid-pregnancy for both groups, and the primary time effect was statistically significant. The early insulin secretion index (ΔI(30)/ΔG(30)) values in mid- and late pregnancy were lower in the GDM group. The values of the area under the curve of blood glucose in mid- and late pregnancy were higher in the GDM group than those in the control group. Insulin resistance was higher in GDM patients than in normal pregnant women. Insulin resistance was aggravated, and β-cell's ability to compensate for the increased insulin resistance by modulating insulin secretion was aggravated, as gestational week increased in women with gestational diabetes and normal pregnant women. Insulin resistance in women with GDM is higher than in pregnant women with normal metabolism of glucose. © 2012 The Authors. Journal of Obstetrics and Gynaecology Research © 2012 Japan Society of Obstetrics and Gynecology.
Kramek, J; Grzymała-Krzyzostaniak, A; Celewicz, Z; Ronin-Walknowska, E
The aim of this work was the evaluation of the scale of violence towards pregnant women in the westpomeranian province, the definition of the social-biological profile of women exposed to violence and social-biological profile of their partners. The evaluation of the influence of violence on pregnant women's ending term and the weight of the newborns. 481 women were enrolled and an anonymous study was used in the form of questionnaires. A questionnaire was a modified form of a query-sheet proposed by WHO. 25% of the enrolled women were exposed to physical and psychological (emotional) abuse, 7.1% to psychical violence, women and men exposed to violence in their childhood more often become violent in their adult life. Men that physically abuse pregnant women are often of primary school education, are unemployed, drink alcohol and smoke. Physical abuse by a partner during pregnancy usually experience women with primary school education, who drink and smoke. Violence during pregnancy is usually associated with premature delivery as well as low birth weight of the newborns.
Eriksen, Nina Bonne; Damm, Peter; Mathiesen, Elisabeth R.
Aims/hypothesis: We assessed the association between congenital malformations and maternal hyperglycemia in pregnant women with pregestational (type 1 or type 2) diabetes and investigated if the rate of congenital malformations was similar in women with near-normal glycemic control compared to th...
Pertyńska-Marczewska, Magdalena; Głowacka, Ewa; Grodzicka, Alicja; Sobczak, Małgorzata; Cypryk, Katarzyna; Wilczyński, Jacek R; Wilczyński, Jan
Interleukin (IL)-12, IL-10, tumor necrosis factor-alpha (TNF-alpha), IL-6 and IL-8 alter as pregnancy progresses, implying continuous immune regulation associated with the maintenance of pregnancy. We aimed to evaluate the peripheral blood neutrophil-derived production of these cytokines in the course of pregnancy complicated by type 1 diabetes. of study These parameters were measured in samples from healthy non-pregnant (C), diabetic non-pregnant (D), healthy pregnant (P) and pregnant diabetic (PD) women. Neutrophil-derived secretion of TNF-alpha and IL-12 increased along with progression of pregnancy in PD and P groups. The concentration of IL-10 from lipopolysaccharide (LPS)-stimulated neutrophils increased during the course of uncomplicated pregnancy but decreased in diabetic pregnancy. Concentration of IL-8 decreased with the advancing gestational age in P and PD groups. LPS-stimulated neutrophil-derived IL-6 concentration increased only in PD patients. Our results show that diabetes creates pro-inflammatory environment thus potentially influencing the outcome of pregnancy. We conclude that neutrophil-derived cytokine production could contribute to the complications seen in pregnant women with type 1 diabetes.
Vestgaard, Marianne; Nielsen, Lene Ringholm; Laugesen, C.S.
To determine the progression of diabetic retinopathy in pregnant women with diabetes offered tight glycaemic and blood pressure control.......To determine the progression of diabetic retinopathy in pregnant women with diabetes offered tight glycaemic and blood pressure control....
Skar, Jeanette B; Garnweidner-Holme, Lisa M; Lukasse, Mirjam; Terragni, Laura
The purpose of this study was to explore the experiences of women with gestational diabetes mellitus (GDM) with controlling their blood glucose values and receiving health and nutrition information using a smartphone app (the Pregnant+ app). The study utilised the interpretative phenomenological analysis method. Semi-structured interviews were conducted with 17 participants among those participating to the randomised controlled trial. The women experienced sorrow and disappointment when they were diagnosed with GDM, but they all went through a process of learning to self-manage their condition that was strongly motivated by theirdesire to care for their unborn babies. The women found that the app increased their confidence in their self management of GDM and their motivation for behavioural change. For some women, the app contributed to feelings offrustration or obsession. In addition, some technological problems and a lack of support from health-care professionals limited several women from using the app. The findings suggest that asmartphone app may have potential for supporting women with GDM, particularly in their blood glucose management. However, it also highlights some of the potential challenges of using mHealth technologies. The findings indicate that a closer collaboration between health-care professionals and patients is of great importance in the implementation of apps for women with GDM. Copyright © 2018 Elsevier Ltd. All rights reserved.
Saadati, Fatemeh; Sehhatiei Shafaei, Fahimeh; Mirghafourvand, Mozhgan
Sleep is one of the most basic human requirements. This research aims at determining the status of sleep quality and its relationship with quality of life among high-risk pregnant women in Tabriz, Iran, in 2015. This research was a sectional study done on 364 qualified women in 28-36 weeks of pregnancy suffering from mild preeclampsia and gestational diabetes. The sampling was done as convenience. Personal-social-midwifery questionnaire, Pittsburg sleep quality, and quality of life in pregnancy (QOL-ORAV) were used for gathering data. Multivariate linear regression model was used for determining the relationship between sleep quality and its subsets with quality of life and controlling confounders. In the current study, the prevalence of sleep disturbance was 96.4%. Mean (SD) of the total score of sleep quality was 10.1 (4.1) and the total score of quality of life was 61.7 (17.3). According to Pearson's correlation test, there was statistically significant relationship between quality of life and sleep quality and all its subsets except sleep duration and use of sleep medication (p quality of life. The findings of current research show that sleep quality is low among high-risk pregnant women and quality of life is medium. So, it is necessary that required training is given by health cares for improving sleep quality and quality of life to mothers.
Nørgaard, Sidse Kjærhus; Nichum, Vibeke Ladefoged; Barfred, Charlotte
-hospitalet, to develop the app "Pregnant with Diabetes". The app communicates clinically important antenatal health information to women with diabetes, based on recommendations from our centre. Women with pre-existing diabetes (Type 1 and Type 2 diabetes) completed an anonymous, structured questionnaire at their first...... antenatal visit in early pregnancy at our centre. National and international data on numbers of downloads were obtained from Google Play, from the App Store and from Google Analytics. RESULTS: Among 139 pregnant women with diabetes (96 with Type 1 diabetes and 43 with Type 2 diabetes), 99% had a smartphone...
Full Text Available OBJECTIVE: The aim of this study was to determine the effect of gestational diabetes mellitus (GDM on fetal insulin resistance or β-cell function in Chinese pregnant women with GDM. MEASUREMENTS: Maternal fasting blood and venous cord blood samples (reflecting fetal condition were collected in 65 well-controlled Chinese GDM mothers (only given dietary intervention and 83 control subjects. The insulin, glucose and proinsulin concentrations of both maternal and cord blood samples were measured, and the homeostasis model assessment of insulin resistance (HOMA-IR and the proinsulin-to-insulin ratios (an indicator of fetal β-cell function were calculated in maternal and cord blood respectively. RESULTS: Both maternal and fetal levels of insulin, proinsulin and HOMA-IR but not proinsulin-to-insulin ratios were significantly higher in the GDM group than in the control group (maternal insulin, 24.8 vs. 15.4 µU/mL, P = 0.004, proinsulin, 23.3 vs. 16.2 pmol/L, P = 0.005, and HOMA-IR, 5.5 vs. 3.5, P = 0.041, respectively; fetal: insulin, 15.1 vs. 7.9 µU/mL, P<0.001, proinsulin, 25.8 vs. 15.1 pmol/L, P = 0.015, and HOMA-IR, 2.8 vs. 1.4, P = 0.017, respectively. Fetal HOMA-IR but not proinsulin-to-insulin ratios was significantly correlated to maternal HOMA-IR (r = 0.307, P = 0.019, in the pregnant women with GDM. CONCLUSIONS: Fetal insulin resistance was higher in Chinese pregnant women with GDM than control subjects, and correlated with maternal insulin resistance.
A. V. Dreval'
Full Text Available Background: Pregnancy is one of the indications for continuous glucose monitoring (CGM. The data on its efficiency in pregnant women are contradictory.Aim: To compare the results of blood glucose self-monitoring (SMBG and CGM in pregnant women with previous diabetes mellitus.Materials and methods: We performed a cross-sectional comparative study of glycemia in 18 pregnant women with previous type 1 (87.8% of patients and type 2 diabetes (22.2% of patients with various degrees of glycemic control. Their age was 27.7 ± 4.9 year. At study entry, the patients were at 17.2 ± 6.1 weeks of gestation. CGM and SMBG were performed in and by all patients for the duration of 5.4 ± 1.5 days. Depending on their HbA1c levels, all patients were divided into two groups: group 1 – 12 women with the HbA1c above the target (8.5 ± 1%, and group 2 – 6 women with the HbA1c levels within the target (5.6 ± 0.3%.Results: According to SMBG results, women from group 2 had above-the-target glycemia levels before breakfast, at 1 hour after breakfast and at bedtime: 6.2 ± 1.6, 8.7 ± 2.1, and 5.7 ± 1.9 mmol/L, respectively. According to CGM, patients from group 1 had higher postprandial glycemia than those from group 2 (8.0 ± 2.1 and 6.9 ± 1.8 mmol/L, respectively, p = 0.03. The analysis of glycemia during the day time revealed significant difference between the groups only at 1 hour after dinner (7.1 ± 1.4 mmol/L in group 1 and 5.8 ± 0.9 mmol/L in group 2, р = 0.041 and the difference was close to significant before lunch (6.0 ± 2.2 mmol/L in group 1 and 4.8 ± 1.0 mmol/L in group 2, р = 0.053. Comparison of SMBG and CGM results demonstrated significant difference only at one timepoint (at 1 hour after lunch and only in group 1: median glycemia was 7.4 [6.9; 8.1] mmol/L by SMBG and 6 [5.4; 6.6] mmol/L by CGM measurement (р = 0.001. Lower median values by CGM measurement could be explained by averaging of three successive measurements carried out in the
Zhu, Chunyan; Yang, Hongling; Geng, Qingshan; Ma, Qingling; Long, Yan; Zhou, Cheng; Chen, Ming
Objective The relationship between gestational diabetes mellitus (GDM) and oxidative stress has not been fully elucidated. This study examined the association between biomarkers of oxidative stress and GDM. Methods We conducted a case-control study which included 36 women presenting with GDM and 36 asymptomatic matched control subjects who visited Guangzhou Women and Children’s Medical Centre, China, from June 2012 to December 2012. Pregnant women were prospectively recruited to the study, and blood samples were collected at the time of a routine oral glucose tolerance test. These samples were then analyzed for levels of endocrine and surrogate markers of oxidative stress. Results Compared to control subjects, women with GDM exhibited elevated values for plasma glucose, insulin, and insulin resistance (IR), and showed reduced HOMA pancreatic β-cell function (HOMA-B), insulin sensitivity index (ISI), insulinogenic index, and corrected insulin response at 24–28 weeks gestation. A bivariate logistic regression analysis showed that levels of high-sensitivity C reactive protein (hs-CRP) and high fluorescence reticulocytes at fasting, and hs-CRP in a 1-h OGTT, were significantly associated with GDM. A linear regression analysis showed that levels of hs-CRP (P = 0.003) and reticulocytes (P = 0.029) at fasting were associated with IR, and levels of hs-CRP (P = 0.002) and monocytes (P = 0.006) in a 1-h OGTT were associated with ISI. Conclusions Pregnant women with GDM developed a pathological IR and exhibited β-cell dysfunction. Their decreased ability to compensate for oxidative stress was associated with increased IR and a reduced ISI, which might be important factors in GDM. PMID:25915047
Full Text Available The relationship between gestational diabetes mellitus (GDM and oxidative stress has not been fully elucidated. This study examined the association between biomarkers of oxidative stress and GDM.We conducted a case-control study which included 36 women presenting with GDM and 36 asymptomatic matched control subjects who visited Guangzhou Women and Children's Medical Centre, China, from June 2012 to December 2012. Pregnant women were prospectively recruited to the study, and blood samples were collected at the time of a routine oral glucose tolerance test. These samples were then analyzed for levels of endocrine and surrogate markers of oxidative stress.Compared to control subjects, women with GDM exhibited elevated values for plasma glucose, insulin, and insulin resistance (IR, and showed reduced HOMA pancreatic β-cell function (HOMA-B, insulin sensitivity index (ISI, insulinogenic index, and corrected insulin response at 24-28 weeks gestation. A bivariate logistic regression analysis showed that levels of high-sensitivity C reactive protein (hs-CRP and high fluorescence reticulocytes at fasting, and hs-CRP in a 1-h OGTT, were significantly associated with GDM. A linear regression analysis showed that levels of hs-CRP (P = 0.003 and reticulocytes (P = 0.029 at fasting were associated with IR, and levels of hs-CRP (P = 0.002 and monocytes (P = 0.006 in a 1-h OGTT were associated with ISI.Pregnant women with GDM developed a pathological IR and exhibited β-cell dysfunction. Their decreased ability to compensate for oxidative stress was associated with increased IR and a reduced ISI, which might be important factors in GDM.
Mathiesen, Elisabeth R; Hod, Moshe; Ivanisevic, Marina
OBJECTIVE This randomized, controlled noninferiority trial aimed to compare the efficacy and safety of insulin detemir (IDet) versus neutral protamine Hagedorn (NPH) (both with prandial insulin aspart) in pregnant women with type 1 diabetes. RESEARCH DESIGN AND METHODS Patients were randomized an...
Schneeberger, Caroline; Kazemier, Brenda M.; Geerlings, Suzanne E.
Purpose of reviewAsymptomatic bacteriuria (ASB) and urinary tract infections (UTIs) in women with diabetes mellitus and during pregnancy are common and can have far-reaching consequences for the woman and neonate. This review describes epidemiology, risk factors, complications and treatment of UTI
Schneeberger, Caroline; Kazemier, Brenda M.; Geerlings, Suzanne E.
Asymptomatic bacteriuria (ASB) and urinary tract infections (UTIs) in women with diabetes mellitus and during pregnancy are common and can have far-reaching consequences for the woman and neonate. This review describes epidemiology, risk factors, complications and treatment of UTI and ASB according
Nørgaard, Sidse Kjærhus; Nichum, Vibeke Ladefoged; Barfred, Charlotte
INTRODUCTION: The aim of this article was to evaluate the awareness and use of the smartphone application (app) "Pregnant with Diabetes" locally, nationally and internationally. METHODS: In 2013, a patient initiated collaboration with the staff at Centre for Pregnant Women with Diabetes, Rigs...... antenatal visit in early pregnancy at our centre. National and international data on numbers of downloads were obtained from Google Play, from the App Store and from Google Analytics. RESULTS: Among 139 pregnant women with diabetes (96 with Type 1 diabetes and 43 with Type 2 diabetes), 99% had a smartphone...
Berry, Diane C; Boggess, Kim; Johnson, Quinetta B
The obesity epidemic has fueled an epidemic of prediabetes and type 2 diabetes mellitus in women of childbearing age. This paper examines the state of the science on preconception and pregnancy management of women with type 2 diabetes to optimize outcomes for the women and their infants. In addition, the consequence of fetal programming as a result of suboptimal maternal glycemic control is discussed. The paper focuses on type 2 diabetes, not type 1 diabetes or gestational diabetes. Management of women with type 2 diabetes includes preconception counseling, preconception weight management and weight loss, proper weight gain during pregnancy, self-monitoring of blood glucose levels, medication, medical nutrition therapy, and exercise.
Cavassini, Ana Claudia Molina; Lima, Silvana Andréa Molina; Calderon, Iracema Mattos Paranhos; Rudge, Marilza Vieira Cunha
Pregnancies complicated by diabetes are associated with increased numbers of maternal and neonatal complications. Hospital costs increase according to the type of care provided. This study aimed to estimate the cost-benefit relationship and social profitability ratio of hospitalization, compared with outpatient care, for pregnant women with diabetes or mild hyperglycemia. This was a prospective observational quantitative study conducted at a university hospital. It included all pregnant women with pregestational or gestational diabetes, or mild hyperglycemia, who did not develop clinical intercurrences during pregnancy and who delivered at the Botucatu Medical School Hospital (Hospital das Clínicas, Faculdade de Medicina de Botucatu, HC-FMB) of Universidade Estadual de São Paulo (Unesp). Thirty pregnant women treated with diet were followed as outpatients, and twenty treated with diet plus insulin were managed through frequent short hospitalizations. Direct costs (personnel, materials and tests) and indirect costs (general expenses) were ascertained from data in the patients' records and the hospital's absorption costing system. The cost-benefit was then calculated. Successful treatment of pregnant women with diabetes avoided expenditure of US$ 1,517.97 and US$ 1,127.43 for patients treated with inpatient and outpatient care, respectively. The cost-benefit of inpatient care was US$ 143,719.16, and outpatient care, US$ 253,267.22, with social profitability of 1.87 and 5.35, respectively. Decision-tree analysis confirmed that successful treatment avoided costs at the hospital. Cost-benefit analysis showed that outpatient management was economically more advantageous than hospitalization. The social profitability of both treatments was greater than one, thus demonstrating that both types of care for diabetic pregnant women had positive benefits.
Full Text Available Objective To investigate the influence of glucose transporter 4 (GLUT-4 and protein kinase B (Akt on gestational diabetes mellitus (GDM by determining their expressions in adipose tissues from women with GDM, excessive weight gain pregnant women, and normal pregnant women. Methods Adipose tissues were obtained by biopsy during cesarean section from 15 pregnant women with normal glucose tolerance while their body mass index (BMI increased in about 4kg/m2 (NGT1 group, and 15 pregnant women with normal glucose tolerance with BMI increased by 8kg/m2 (NGT2 group, and 15 cases of GDM (GDM group. Adipose tissue were divided into two sections and incubated in the culture medium with or without insulin (1×10-7 mol/L for 30 minutes. Fasting blood glucose (FBG and fasting insulin (FINS levels were determined with glucose oxidase and radioimmunoassay. Homeostatic model assessment of insulin resistance (HOMA-IR, and homeostatic model assessment of insulin secretions index (HOMA-IS were calculated from the data. Phosphorylation of Akt (P-Akt and GLUT-4 levels of cultured adipose tissue were examined by Western blotting. Results The FBG levels were similar in 3 groups. FINS, HOMA-IR and HOMA-IS were significantly different among the 3 groups (P0.05 in basal state. Compared with the basal state, however, the phosphorylation of Akt increased significantly in NGT1 group (P0.05 after insulin stimulation. The expression of GLUT-4 was significantly lower in GDM group and NGT2 group than in NGT1 group (P<0.05 in basal state. The expression of GLUT-4 increased much more in NGT1 group than in NGT2 group or GDM group (P<0.05 after insulin stimulation. Conclusion The excessive weight gain and normal glucose tolerance pregnant women almost share a similar expression with GDM women in the insulin signaling and glucose transporter proteins, Akt and GLUT-4, and their abnormal expression and function might play an important role in insulin resistance and GDM
Cynthia, Porter; Timothy, Skinner; Isabelle, Ellis
The impact differential of diabetes for Aboriginal maternal and infant health outcomes is different to Caucasian outcomes. With maternal diabetes, Aboriginal infant's birth weight increases and stillbirth rate is 22/1000 for gestational diabetes mellitus (GDM) and 53/1000 for pre-existing diabete...
Bongiovanni, Marzia; Fresa, Raffaella; Visalli, Natalia; Bitterman, Olimpia; Suraci, Concetta; Napoli, Angela
The aim of this study was to assess carbohydrate (CHO)-to-insulin ratio (CHO/IR) values in pregnant women with type 1 diabetes and to describe differences in CHO/IR across each week of pregnancy. This was a multicenter, retrospective, observational study (2006-2012) of 101 white pregnant women with a mean age of 32 (range, 18-43) years who had type 1 diabetes and were under continuous subcutaneous insulin infusion (CSII) therapy. These patients had the following characteristics: type 1 diabetes duration was 1 year (range, 1-31 years), the pregestational glycosylated hemoglobin level was 6.9% (range, 6.8-12.1%), the median weight gain during pregnancy was 14 kg (-3; 25 kg), with delivery at 37 weeks (range, 30-40 weeks), and the child had a birth weight of 3.530 kg (range, 1.480-5.250 kg). The CHO/IR was measured by dividing the CHO (in g) of each meal by insulin unit injected to acquire and maintain the following glycemic targets: fasting insulin and 300/total daily doses of insulin. Education and management before and during pregnancy were in agreement with Italian Association of Dietitians, Association of Medical Diabetologists, and Italian Society of Diabetology recommendations. Data were analyzed using SPSS software (version 20.0; SPSS, Inc., Chicago, IL). The CHO/IR decreased on average from 9.6 (5-18) to 5.4 (2.3-8) at breakfast, from 10 (3.5-16) to 8.4 (3.0-17.8) at lunch, and from 12.5 (8-20) to 6.1 (4.2-12) at dinner. The CHO/IR calculated using the "500 rule" decreased from 14.3 (10-20.3) to 8.6 (4.1-15.9). Using the "300 rule," the ratios decreased from 8.5 (6-12.1) to 5.2 (2.4-9.5). The bivariate correlation between the values calculated more appropriate values using the "300 rule" for breakfast and the "500 rule" for lunch and dinner across all weeks of pregnancy. CHO/IR reduction in pregnancy is likely due to an increase in insulin resistance.
No effect of the FitFor2 exercise programme on blood glucose, insulin sensitivity, and birthweight in pregnant women who were overweight and at risk for gestational diabetes: Results of a randomised controlled trial
Oostdam, N.; Poppel, M.N.M. van; Wouters, M.G.A.J.; Eekhoff, E.M.W.; Bekedam, D.J.; Kuchenbecker, W.K.H.; Quartero, H.W.P.; Heres, M.H.B.; Mechelen, W. van
Objective To evaluate the effectiveness of an exercise programme for pregnant women who were overweight or obese and at risk for gestational diabetes mellitus (GDM). Design Randomised controlled trial. Setting Hospitals and midwifery practices in the Netherlands. Population Pregnant women who were
Urinary tract infection (UTI) constitutes a major health problem in pregnant women due to their relatively short urethra, which ... the urine samples of pregnant women prior to treatment. ... Of 500 asymptomatic pregnant women screened, 433.
Tramontana, Allessandra; Dieplinger, Benjamin; Stangl, Gerhard; Hafner, Erich; Dieplinger, Hans
Aim of this study was to assess the prognostic capability of afamin to predict pregnancy complications. First-trimester screening was consecutively performed in 4948 pregnant women, of whom 474 women developed pregnancy complications [gestational hypertension (n=84), pre-eclampsia (n=30), intrauterine growth restriction (n=107), preterm birth (n=44), and gestational diabetes mellitus (n=209)]. To each woman with pregnancy complications an uncomplicated pregnancy was matched for body mass index. Afamin serum concentrations were measured in 948 pregnant women at the first-trimester screening. Median afamin concentrations were significantly higher in women developing pre-eclampsia or gestational diabetes mellitus when compared to women with uncomplicated pregnancies (76mg/L vs. 65mg/L, p=0.001 and 80mg/L vs. 69mg/L, p65mg/L) was a strong and independent predictor for the development of pre-eclampsia (risk ratio, 24.58; 95%CI, 2.82-214.12; p=0.004) as well as gestational diabetes mellitus (risk ratio, 2.07; 95%CI, 1.33-3.22; p=0.001). In this large nested case-control study increased afamin concentrations were a strong and independent predictor for pre-eclampsia and gestational diabetes mellitus, suggesting a potential role of afamin as predictive marker for pregnancy-related metabolic disorders. Copyright © 2017. Published by Elsevier B.V.
Pregnancy in women with type 1 diabetes mellitus is associated with neonatal morbidity. It is commonly agreed that the morbidity decreases when diabetic control is tightened. The most common methods for the determination of diabetic control are the self-monitoring of blood glucose levels (SMBG) and
Ringholm, Lene; Secher, A L; Pedersen-Bjergaard, U
To investigate whether the incidence of severe hypoglycaemia in pregnant women with type 1 diabetes can be reduced without deteriorating HbA1c levels or pregnancy outcomes in a routine care setting....
Nørgaard, Sidse Kjærhus; Nichum, Vibeke Ladefoged; Barfred, Charlotte
INTRODUCTION: The aim of this article was to evaluate the awareness and use of the smartphone application (app) "Pregnant with Diabetes" locally, nationally and internationally. METHODS: In 2013, a patient initiated collaboration with the staff at Centre for Pregnant Women with Diabetes, Rigs-hos...... by Novo Nordisk, Bayer A/S, Diabetes Care, Abbott, MSD Denmark, A.D.I.P.S and Rigshospitalet. TRIAL REGISTRATION: not relevant....
Han, Qian; Shao, Ping; Leng, Junhong; Zhang, Cuiping; Li, Wei; Liu, Guifeng; Zhang, Yuanyuan; Li, Yi; Li, Zhe; Ren, Yanfeng; Chan, Juliana C N; Yang, Xilin
The aim of the present study was to define cut-off points of body mass index (BMI) and waist circumference (WC) for gestational diabetes mellitus (GDM) and to investigate any interactions between high BMI and high WC on the risk of GDM in pregnant Chinese women. From 2010 to 2012, 17 803 women in Tianjin, China, who were at 4-12 weeks gestation were recruited to the study. Gestational diabetes mellitus was diagnosed according to the criteria of the International Association of Diabetes and Pregnancy Study Group at 24-28 weeks gestation. Binary logistic regression was used to obtain odds ratios (ORs) and 95% confidence intervals (CIs) while controlling for the confounding effects of traditional risk factors. Restricted cubic spline was used to identify cut-off points of WC and BMI, if any, for GDM. Gestational diabetes mellitus developed in 1383 (7.8%) women. The risk of GDM increased steeply with increasing WC from ≥78.5 cm and BMI ≥22.5 kg/m 2 . If BMI gestation were independently and synergistically associated with increased risks of GDM in Chinese pregnant women. © 2017 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.
Balas-Nakash, Margie; Rodríguez-Cano, Ameyalli; Muñoz-Manrique, Cinthya; Vásquez-Peña, Paulina; Perichart-Perera, Otilia
The measurement of adherence to nutrition therapy is essential to evaluate if the outcomes are related to given recommendations. The aim of this study was to describe adherence to a Medical Nutrition Therapy Program in Mexican pregnant women with diabetes, using three different methods; and evaluate its association with glycemic control. Adherence was measured with a questionnaire (0-100%), women's self-perception (0-100%) and energy intake adequacy by multiple pass 24 hour recall (85-115% of recommendation). Women were randomly assigned to two different dietary strategies. Glycemic control was determined by capillary glucose self-monitoring. Women analyzed in this study (n=69) had an age range of 22-42 years; 47.8% had type 2 diabetes (DM2) and 52.2% had gestational diabetes (GDM). Energy intake adequacy was higher in women with GDM (41.9% vs. 37.7%, p = 0.001). Average adherence measured with the questionnaire was 55%; no differences were found by type of diabetes. Self-perception was higher in women with DM2 (84%) when compared to women with GDM (70%) (p = 0.039). No differences were found in the three methods by study group. Optimal glycemic control was observed in 50% of women; no association was found with adherence measured with any of the three methods studied. The observed differences in adherences suggest that it may be recommendable to combine different measurement methods and include social and psychological factors that affect behavioral change.
Tang, Yuping; Qiao, Ping; Qu, Xiaoxian; Bao, Yirong; Li, Yuhong; Liao, Yini; Ying, Hao
Vaspin is associated with metabolic parameters and insulin resistance. However, the expression of vaspin in visceral adipose tissue (VAT) in pregnant women with gestational diabetes mellitus (GDM) has not been fully explored, and the contribution of vaspin to the biological mechanisms underlying GDM remains unclear. This study aimed to compare circulating vaspin levels and its expression in different insulin target tissues including subcutaneous adipose tissue (SAT), VAT and smooth muscle tissue (SMT) in pregnant women with and without GDM. A total of 37 women with GDM (GDM group) and 37 normal pregnant women (control group) were selected. Fasting plasma glucose (FPG), fasting insulin (FINS) and serum vaspin levels were quantified at term, and homeostasis model of assessment2-insulin resistance (HOMA2-IR) values were calculated. RT-qPCR and Western blotting were used to measure mRNA and protein levels of vaspin in VAT, SAT and SMT of 15 GDM women and normal pregnant women. In the GDM group, serum vaspin concentrations were significantly higher than in the control group. Serum vaspin levels were positively correlated with HOMA2-IR in the GDM group but not in the control group. In the GDM group, vaspin mRNA and protein expression levels in SAT and VAT were both significantly higher than in controls, but no difference was found in SMT. Moreover, relative mRNA but not protein expression levels of vaspin in SAT were highest among the three tissues in both groups. Circulating vaspin levels and expression of vaspin in SAT and VAT were higher in GDM women than in normal pregnant women. However, the specific role of vaspin from SAT and VAT in the pathogenesis of GDM needs further study. © 2017 John Wiley & Sons Ltd.
... Audience For Women Women's Health Topics Women and Diabetes - Diabetes Medicines Share Tweet Linkedin Pin it More sharing ... 1-800-332-1088 to request a form. Diabetes Medicines The different kinds of diabetes medicines are ...
Secher, A L; Stage, E; Ringholm, Lene
AIMS: Among women with Type 1 diabetes who have had severe hypoglycaemia the year before pregnancy, 70% also experience this complication in pregnancy, and particularly in the first half of pregnancy. We evaluated whether routine use of real-time continuous glucose monitoring from early pregnancy...... onwards could prevent severe hypoglycaemia in these women. METHODS: All 136 consecutive pregnant women with Type 1 diabetes referred to our centre were asked about severe hypoglycaemic events in the year before pregnancy and early in pregnancy at their first antenatal visit. Women with a relevant recent...... history were informed about their additional high risk of severe hypoglycaemia, their treatment was focused on restricted insulin doses during the first 16 gestational weeks, and they were offered real-time continuous glucose monitoring on top of self-monitored plasma glucose measurements. RESULTS: Among...
... risk of serious flu complications, such as pregnant women. Treatment should begin as soon as possible because antiviral drugs work best when started early (within 48 hours after symptoms start). Antiviral drugs can make your ...
Youngwanichsetha, Sununta; Phumdoung, Sasitorn; Ingkathawornwong, Thitiporn
This randomized controlled trial was carried out to investigate the effect of mindfulness eating and yoga exercise on blood sugar levels among pregnant Thai women with GDM. Interventions promoting achievement of good glycemic control result in desired pregnancy outcomes. Little is known about the health benefits of mindfulness eating and yoga exercise on blood sugar levels among pregnant with GDM. A randomized controlled trial was carried out. Main outcome measures were capillary fasting plasma glucose, 2-h postprandial blood glucose, and hemoglobin A1c. The intervention group showed significantly reduced fasting plasma glucose, 2-h postprandial blood glucose, and glycosylated hemoglobin (HbA1c) in the intervention group (pMindfulness eating and yoga exercise had health benefits on glycemic control in pregnant women with GDM. It should be recommended in clinical and community health services. Copyright © 2014 Elsevier Inc. All rights reserved.
Justyna Magdalena Skolarczyk
Full Text Available A vaccine is a formulation of biological origin that contains substances capable of inducing immune processes without the ability to cause a disease. Vaccination is considered the best mean to prevent infectious diseases and their serious complications. Vaccination of a pregnant women can provide protection against severe infectious diseases of both pregnant women and their children. The aim of the study is to present currently available types of vaccines recommended for pregnant women and indications for their use by analyzing the data available in the PubMed, and Medline electronic databases. In the United States, vaccination recommendations for pregnant women include inactivated influenza vaccine and tetanus and diphtheria toxoid vaccine (Tdap. In some countries, pregnant women also receive a vaccine against hepatitis B as well as anti hepatitis A and E. There are also studies on vaccines against the RSV virus and pneumococci. Vaccination is the most effective form of prevention of infectious diseases and their use during pregnancy does not entail any additional risk to the mother or her baby. The benefits of vaccination are huge, so pregnant women should take recommended vaccination and shouldn’t be afraid of using them.
Khattab, S.; Mohsen, I. A.; Aboul Foutouh, I.; Ashmawi, H. S.; Mohsen, M. N.; van Wely, M.; van der Veen, F.; Youssef, M. A. F. M.
Women with polycystic ovary syndrome (PCOS) are at a high risk to develop Gestational Diabetes mellitus (GDM). We hypothesized that metformin due to its metabolic, endocrine, vascular, and anti-inflammatory effects may reduce the incidence of GDM in PCOS women. We carried out a prospective cohort
Full Text Available The term “Maturity-Onset Diabetes of the Young” (MODY was first described in 1976 and is currently referred to as monogenic diabetes. There are 14 known entities accounting for 1-2% of diabetes and they are frequently misdiagnosed as either type 1 or type 2 diabetes. MODY-5 is an entity of monogenic diabetes that is associated with genitourinary malformations and should be considered by obstetricians in pregnant women with a screen positive for diabetes, genitourinary malformations, and fetal renal anomalies. Correct diagnosis of monogenic diabetes has implications on managing patients and their families. We are reporting a case of a 21-year-old pregnant woman with a bicornuate uterus, fetal renal anomalies, and a family history of diabetes that were suggestive of a MODY-5 diabetes.
May 1, 2018 ... RESULT: Pregnant women as compared to non-pregnant had significantly increased .... addition, study participants who were smokers, drinkers and chewers of ..... physiology. a clinical perspective 4th ed. Maryland Heights ...
Sklempe Kokic, Iva; Ivanisevic, Marina; Biolo, Gianni; Simunic, Bostjan; Kokic, Tomislav; Pisot, Rado
Gestational diabetes mellitus, defined as any carbohydrate intolerance first diagnosed during pregnancy, is associated with a variety of adverse outcomes, both for the mother and her child. To investigate the impact of a structured exercise programme which consisted of aerobic and resistance exercises on the parameters of glycaemic control and other health-related outcomes in pregnant women diagnosed with gestational diabetes mellitus. Thirty-eight pregnant women diagnosed with gestational diabetes mellitus were randomised to two groups. Experimental group was treated with standard antenatal care for gestational diabetes mellitus, and regular supervised exercise programme plus daily brisk walks of at least 30min. Control group received only standard antenatal care for gestational diabetes mellitus. The exercise programme was started from the time of diagnosis of diabetes until birth. It was performed two times per week and sessions lasted 50-55min. The experimental group had lower postprandial glucose levels at the end of pregnancy (P<0.001). There was no significant difference between groups in the level of fasting glucose at the end of pregnancy. Also, there were no significant differences in the rate of complications during pregnancy and birth, need for pharmacological therapy, maternal body mass and body fat percentage gains during pregnancy, and neonatal Apgar scores, body mass and ponderal index. Neonatal body mass index was higher in the experimental group (P=0.035). The structured exercise programme had a beneficial effect on postprandial glucose levels at the end of pregnancy. Copyright © 2017 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.
... Audience For Women Women's Health Topics Women and Diabetes Share Tweet Linkedin Pin it More sharing options ... Diabetes How to Report Problems with Glucose Meters Diabetes Treatments Some people with diabetes need to take ...
Full Text Available ... women with diabetes can make a difference. Other Resources from the FDA FDA Information on Diabetes Treatment ... for Women Pregnancy Menopause More Women's Health Topics Resources for You YourDiabetesInfo.org American Diabetes Association Get ...
Full Text Available ... from Other Government Agencies and Offices National Diabetes Education Program Diabetes Information on MedlinePlus Diabetes and Depression in Older Women More in Women's Health Topics Mammography Women and Diabetes HPV, HIV, Birth ...
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Pan, Jiemin; Zhang, Feng; Zhang, Lei; Bao, Yuqian; Tao, Minfang; Jia, Weiping
To examine the differential effects of insulin sensitivity and secretion on hemoglobin A1c (HbA1c) and glycated albumin (GA) at 24-32weeks of pregnancy in women with gestational diabetes mellitus (GDM). A cross-sectional, sequential case series study was performed in pregnant women with an abnormal 50-g oral glucose-screening test. Hemoglobin A1c and GA measurements were taken during oral glucose tolerance test (OGTT). The homeostasis model assessment of insulin resistance (HOMA-IR) and beta-cell function (HOMA-%β), insulin sensitivity index (ISOGTT), and modified insulinogenic index were calculated to assess insulin sensitivity and secretory function. A total of 713 pregnant women were enrolled. The GDM group had lower ISOGTT and insulinogenic index scores, and a higher HOMA-IR score. Hemoglobin A1c was positively correlated with HOMA-IR. Glycated albumin was negatively correlated with insulinogenic index and HOMA-%β. Multiple regression analysis revealed that HbA1c was independently associated with diastolic pressure, 0- and 120-minute glucose, and HOMA-IR; GA was independently associated with 0- and 120-minute glucose. Compared with HbA1c, GA is more closely correlated with fasting and postprandial glucose, regardless of insulin resistance and blood pressure, and might be a better monitoring index in women with GDM. Copyright © 2013 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
Full Text Available ... Diabetes How to Report Problems with Glucose Meters Diabetes Treatments Some people with diabetes need to take diabetes ... talk with your health care provider about your diabetes treatment. Diabetes Medicines - easy-to-read booklet for women ...
Habib, Sadia; Abbasi, Nasreen; Khan, Bushra; Danish, Nargis; Nazir, Quratulain
Domestic violence during pregnancy is an important social & health issue in all societies. In Muslim world and particularly underdeveloped countries, domestic violence is often under reported. It is the need of hour to encourage reporting of such events & implementation of research-based policies for prevention of women abuse & support of the victims of domestic violence (DV). The objective of this study was to highlight this neglected social problem of our society & to identify at risk population. This is a cross sectional study conducted at Ayub Teaching Hospital & Benazir Bhutto Shaheed Teaching Hospital, Abbottabad (January 2014 to December. 2016). Pregnant women were inquired regarding history of abuse by husband and sociodemographic characteristics were noted in a Performa to analyse the risk factors for domestic violence. The overall prevalence was found to be 35%. Out of 1000 pregnant women, 270 (27%) suffered from simple violence and 60 (6%) were victims of grievous assault. Violence among pregnant women is found to be more prevalent among residents of urban areas, women of older age being uneducated & belonging to poor socioeconomic status. Domestic violence during pregnancy is a common & often neglected psychosocial health problem. High risk population needs to be identified so that preventive strategies can be planned & implemented.
Full Text Available Abstract Background This paper describes the process of developing specifically designed web-based maternity information for women with type 1 diabetes. Methods A participatory design was used and the information was evaluated in seven stages by researchers, professional experts and users. All steps of the development process were noted in an online logbook. Results The information developed gradually and its contents were reviewed by nurse-midwives, nurses and physicians specializing in different key areas including diabetes care, paediatrics, obstetrics and breastfeeding, a clinical dietician and mothers with type 1 diabetes. The draft was reviewed in regard to its cultural suitability and the information material was adjusted to meet quality criterions. Finally, the text was adapted for a lay audience. Conclusions Using participatory design required time and resources, however; it proved a functional way of producing appropriate information for the target group.
Mahalakshmi, Manni Mohanraj; Bhavadharini, Balaji; Maheswari, Kumar; Kalaiyarasi, Gunasekaran; Anjana, Ranjit Mohan; Ranjit, Unnikrishnan; Mohan, Viswanathan; Joseph, Kurian; Rekha, Kurian; Nallaperumal, Sivagnanam; Malanda, Belma; Kayal, Arivudainambi; Belton, Anne; Uma, Ram
To compare the existing maternal and fetal outcomes in Asian Indian women with or without gestational diabetes mellitus (GDM) before the development of the Women in India with GDM Strategy (WINGS) GDM model of care (MOC). Records of pregnant women were extracted retrospectively from three maternity centers in Chennai. GDM was diagnosed using the International Association for Pregnancy Study Groups criteria or the Carpenter and Coustan criteria. Demographic details, obstetric history, antenatal follow-up, treatment for GDM, and outcomes of delivery were collected from the electronic medical records. Of the 3642 records analyzed, 799 (21.9%) had GDM, of whom 456 (57.1%) were treated with insulin and medical nutrition therapy (MNT), 339 (42.4%) with MNT alone, and 4 (0.5%) with metformin. Women with GDM were older than those without (28.5 ± 4.5 vs. 27.1 ± 4.5 years; P women with GDM. In women with GDM treated with insulin and MNT, emergency cesarean section (16.2% vs. 36.6%; P women. Treatment with insulin was associated with a significantly lower risk of complications. However, in countries with limited access to insulin and other medicines may lead to poor follow-up and management of GDM. Data from this retrospective study will form the basis for the development of the WINGS GDM MOC, which will address these gaps in GDM care in low-resource settings.
Full Text Available The effects of pregnancy on the Oral Mucosa Disorder (OMD have been sporadically documented in some developed countries. Less known is the status of OMD during pregnancy in less developed/developing countries. Iran is no exception. This study assesses the prevalence of OMD in 200 pregnant women and compares the findings with the findings from a 200 non-pregnant woman of similar age distribution in Iran. The participants had been referred to a clinic to receive reproductive age-related services. Participants suffering from systemic chronic diseases, those on medications/drugs, smokers, needing biopsies, and those with urgent Oral Mucosal Lesion (OML treatments were excluded from the study. Oral mucosal of all 400 participants were examined. The participants’ age ranges were from 17 to 47; with the average age of 33.14 for one group; and 30.23 for the other group. Both groups had the same level of formal education. Out of 400 examined women; 62 had lesions, including 47 pregnant (23.5%; and 15 non-pregnant (7.5% women. This result shows that the OMD rate of occurrence was significantly higher among the pregnant women. Higher OML prevalence in pregnant women, as compared to the non-pregnant women, indicates the importance of timely oral examination of pregnant women and subsequent treatment plans for them.
Full Text Available ... Medicines and Devices Beware of Illegally Sold Diabetes Treatments Diabetes and Pregnancy Some women develop diabetes for the ... Clinical trials can help doctors learn more about treatments for diabetes. The FDA Office of Women's Health is partnering ...
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Methos: Glucose, insulin and lipids (total cholesterol, triglyceride, high density lipoprotein and low density lipoproteins) were measured at 26 to 32 weeks of pregnancy in fasting blood samples obtained from 75 pregnant non diabetic women (Twenty five with a history of first degree relative with DM and fifty women without ...
Full Text Available ... How to Report Problems with Glucose Meters Diabetes Treatments Some people with diabetes need to take diabetes ... with your health care provider about your diabetes treatment. Diabetes Medicines - easy-to-read booklet for women ...
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Int J Med Biomed Res 2012;1(1):79-84. 79. Risk factors for gestational diabetes mellitus in Sudanese pregnant women. Mardi T.G1, Lutfi M.F2*. 1Department of Physiology, Faculty of Medicine and Health Sciences, Omdurman Islamic University,. Sudan. 2Department of Physiology, Faculty of Medicine and Health Sciences, ...
Background: The prevalence of gestational diabetes mellitus (GDM) in Sudan is less compared with international reports. Whether there is concomitant difference in the risk factors for GDM among Sudanese women is uncertain. Aim: This study investigated the common risk factors for GDM among Sudanese pregnant ...
Acosta, I; Aponte, Z; de-Jesús, Z; de-León, A; González, M C; Hernández, J; Martínez, P; Santos, E R; Pérez-Perdomo, R
To estimate the prevalence and to describe the clinical characteristics of gestational diabetes mellitus (GDM) in pregnant women receiving health care services at the Puerto Rico University Hospital from 1997 to 1998. The study design was cross-sectional. All medical records available of pregnant women diagnosed with GDM were retrospectively reviewed. Descriptive statistics such as frequency distributions and summary measures (mean and standard deviation) were used. Annual and 18-month period prevalences of GDM were calculated. Fisher's exact test was used to compare proportions. A total of 78 medical records were available during the 18-month study period (June 1997 to December 1998). The estimated prevalence of GDM was 2% for the total study period (18-month) as well as for the year 1998. The highest proportion (52.3%) of GDM cases was found in the 30 years or less age group. Forty-eight percent had a body mass index (BMI) > or = 30 m/kg2 (obese) before pregnancy; however, the weight gained during the last pregnancy was higher than 15 pounds (57%). Sixty-four percent of the cases had a family history of diabetes, meanwhile, 34.7% reported a history of GDM during previous pregnancies. During the first prenatal visit, 80.5% reflected glucose levels higher than 110 mg/ml. Preeclampsia (6.4%) and macrosomia (14%) were the most frequent complications for the mother and the fetus, respectively. More epidemiological studies about GMD in Puerto Rico need to be performed to better describe the prevalence of the condition in the island.
Full Text Available Sedentary behavior has been associated with adverse health outcomes among pregnant women; however, few studies have characterized sedentary behavior patterns in this population. We described patterns of accelerometer-determined indicators of sedentary behavior among a national sample of US pregnant (n = 234 women and non-pregnant (n = 1146 women participating in the NHANES 2003-06 cycles. We included women with ≥4 days of accelerometer wear of ≥10 h/day. A count threshold of <100 cpm was used to describe sedentary behavior as: 1 total accumulated sedentary time by bout length categories; 2 accumulated sedentary time within discrete bout length categories; 3 mean, median, and usual bout length; and 4 and bout frequency. Both non-pregnant and pregnant women spent up to 60% of their accelerometer wear time in sedentary behavior depending on the minimum bout threshold applied. Sedentary time was higher among pregnant women compared to non-pregnant women when lower bout thresholds (i.e. 10 min or less were applied. The majority of total sedentary time was accumulated in bouts lasting <10 min. The women averaged less than two prolonged sedentary bouts (i.e., ≥30 min per day, which accounted for nearly 20% of total accumulated sedentary time. When applying a minimum threshold of at least 15 min, sedentary time increased across pregnancy trimesters, while sedentary time was similar across trimesters when using lower thresholds. These findings provide the first characterization of accelerometer-determined indicators of sedentary behavior in pregnant women. The minimum bout threshold applied influenced estimates of sedentary time and patterns sedentary time accumulation across pregnancy trimesters.
Skolarczyk, Justyna; Łabądź, Dawid; Pekar, Joanna; Nieradko-Iwanicka, Barbara
Skolarczyk Justyna, Łabądź Dawid, Pekar Joanna, Nieradko-Iwanicka Barbara. Vaccination recommended for pregnant women. Journal of Education, Health and Sport. 2017;7(4):682-688. eISSN 2391-8306. DOI http://dx.doi.org/10.5281/zenodo.569050 http://ojs.ukw.edu.pl/index.php/johs/article/view/4423 The journal has had 7 points in Ministry of Science and Higher Education parametric evaluation. Part B item 1223 (26.01.2017). 1223 Journal of Education, Health and Sport eI...
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Full Text Available Introduction: Prolongation of QT interval might result in dangerous cardiac arrhythmias, including Torsades de Pointes (TdP, consequently leading to syncope or death. A limited number of studies carried out in this respect to date have shown that QT interval might increase during pregnancy. On the other hand, it has been shown that each pregnancy might result in an increase in the risk of cardiac accidents in patients with long QT interval. Therefore, the present study was undertaken to compare QT intervals in pregnant and non-pregnant women. Methods: Pregnant women group consisted of 40 women in the second and third trimesters of pregnancy and the non-pregnant control group consisted of healthy women 18-35 years of age. All the patients underwent standard 12-lead electrocardiogram (ECG. The QT interval was measured for each patient at lead II. The mean corrected QT interval (QTc and QT dispersions (QTd were compared between the two groups. Results: Mean heart rates in the pregnant and non-pregnant groups were 98.55±14.09 and 72.53±13.17 beats/minutes (P<0.001. QTd and QTc means were in the normal range in both groups; however, these variables were 49.50±12.80 and 43.03±18.47 milliseconds in the pregnant group and 39.5±9.59 and 40.38±17.20 milliseconds in the control group, respectively (P<0.001. Conclusion: The QT interval was longer in pregnant women compared to non-pregnant women; however, it was in the normal range in both groups. Therefore, it is important to monitor and manage risk factors involved in prolongation of QT interval and prevent concurrence of these factors with pregnancy.
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Bruno, Raffaele; Petrella, Elisabetta; Bertarini, Valentina; Pedrielli, Giulia; Neri, Isabella; Facchinetti, Fabio
This study aims to determine whether the prescription of a detailed lifestyle programme in overweight/obese pregnant women influences the occurrence of gestational diabetes (GDM), and if this kind of prescription increases the adherence to a healthier lifestyle in comparison to standard care. The study was designed as a randomized controlled trial, with open allocation, enrolling women at 9-12 weeks of pregnancy with a BMI ≥ 25 kg/m 2 . The women assigned to the Intervention group (I = 96) received a hypocaloric, low-glycaemic, low-saturated fat diet and physical activity recommendations. Those assigned to the Standard Care group (SC = 95) received lifestyle advices regarding healthy nutrition and exercise. Follow-up was planned at the 16 th , 20 th , 28 th and 36 th weeks. A total of 131 women completed the study (I = 69, SC = 62). The diet adherence was higher in the I (57.9%) than in the SC (38.7%) group. GDM occurred less frequently in the I (18.8%) than in the SC (37.1%, P = 0.019) group. The adherent women from either groups showed a lower GDM rate (12.5% vs. 41.8%, P 4000 g were significantly lower in I group. The incidence of small for gestational age babies was not different. These findings demonstrate that the adherence to a personalized, hypocaloric, low-glycaemic, low-saturated fat diet started early in pregnancy prevents GDM occurrence, in women with BMI ≥ 25 kg/m 2 . © 2016 John Wiley & Sons Ltd.
Aydin, Y; Atis, A; Tutuman, T; Goker, N
We aimed to find a prevalence of human papilloma virus (HPV) in order to define the 100 genotypes and subset of 14 oncogenic genotypes in pregnant Turkish women and to compare these with non-pregnant women. Cervical thin-prep specimens were obtained from 164 women in the first trimester pregnancy and 153 non pregnant women. 29.2% of pregnant versus 19.6% of non-pregnant Turkish women had at least one of the 100 types of HPV infection--a statistically significant difference. The rate of 14 high-risk HPV genotype infections was significantly higher in pregnant (14.6) compared to non-pregnant Turkish women (9.6%). Pregnant Turkish women are at higher risk for all HPV infections including high-risk cervical cancer genotypes.
Karaduman, Mevlüt; Sarı, Oktay; Aydoğan, Umit; Akpak, Yaşam Kemal; Semiz, Altuğ; Yılanlıoğlu, Necip Cihangir; Keskin, Uğur
Obstructive sleep apnea syndrome (OSAS) is a disease which is estimated to be undiagnosed to a large extent. Hence, the prevalence of OSAS in pregnant women is unknown. We aimed to evaluate the symptoms of obstructive sleep apnea in pregnant women with chronic diseases. In the study, 97 pregnant women with chronic diseases and 160 healthy pregnant women were included. A form questioning socio-demographic characteristics and pregnancy characteristics, Epworth scale and the Berlin questionnaire to evaluate the risk of OSAS were applied to participants. It has been determined that 10-12.5% of healthy pregnant women, 34-45.4% of pregnants with chronic diseases and 20.6-23.3% of all pregnant women had a high risk of OSAS, the pregnants with chronic disease compared to healthy pregnant women had statistically significant higher risk of OSAS. The risk of OSAS was found to be significantly higher especially in pregnant women with hypertension and diabetes. OSAS can lead to the adverse consequences in pregnancy, should be questioned for all pregnants especially those with chronic diseases. Pregnant women with OSAS should be monitored more carefully in terms of diabetes and hypertension in antenatal care.
Improving working conditions for pregnant women can boost their feeling of wellbeing in their job. As a result of its innovative work in this area, Seclin general hospital, in the north of France, has received special recognition for its policy in supporting pregnant women. Copyright © 2015 Elsevier Masson SAS. All rights reserved.
The study's population encompassed of 1900 pregnant women in selected hospitals. Proportional ... Internet, friends/relatives, persons at the workplace or professional advisors. Despite the ... city is an important trade and educational centre. It also houses one of .... This study was restricted to pregnant women registered for ...
The apparent decline in immunity of pregnant women appears to promote the growth of both com-mensal and non-commensal microorganisms. The objective of the study was to determine the prevalence of asymptomatic bacteriuria in pregnant women visiting the University hospital, Ku-masi. This prospective ...
Full Text Available Dysregulation of NO production is implicated in pregnancy-related diseases, including gestational diabetes mellitus (GDM. The role of NO and its placental targets in GDM pregnancies has yet to be determined. S-Nitrosylation is the NO-derived posttranslational protein modification that can modulate biological functions by forming NO-derived complexes with longer half-life, termed S-nitrosothiol (SNO. Our aim was to examine the presence of endogenous S-nitrosylated proteins in cysteine residues in relation to antioxidant defense, apoptosis, and cellular signal transduction in placental tissue from control (n=8 and GDM (n=8 pregnancies. S-Nitrosylation was measured using the biotin-switch assay, while the expression and protein activity were assessed by immunoblotting and colorimetric methods, respectively. Results indicated that catalase and peroxiredoxin nitrosylation levels were greater in GDM placentas, and that was accompanied by reduced catalase activity. S-Nitrosylation of ERK1/2 and AKT was increased in GDM placentas, and their activities were inhibited. Activities of caspase-3 and caspase-9 were increased, with the latter also showing diminished nitrosylation levels. These findings suggest that S-nitrosylation is a little-known, but critical, mechanism by which NO directly modulates key placental proteins in women with GDM and, as a consequence, maternal and fetal anomalies during pregnancy can occur.
The present report clearly states that radiosensitivity is highest during intrauterine development and that the possibility of different types of effects depends on the state of pregnancy and on the dose. The decision whether an examination of the abdomen or pelvis of pregnant or potentiably pregnant women should be carried out is made clear that a delay of examinations due to dose reduction is only warranted if no danger to the patient and/or the unborn child is involved. (orig.) [de
Mikkelsen, A L; Schütten, G; Asping, U
Plasma concentration of atrial natriuretic peptide (ANP) was determined in pregnant women with preeclampsia, in normal pregnant and in nonpregnant women by a specific radioimmunoassay. Results did not show important differences between nonpregnant controls and normal pregnant women, but a signifi......Plasma concentration of atrial natriuretic peptide (ANP) was determined in pregnant women with preeclampsia, in normal pregnant and in nonpregnant women by a specific radioimmunoassay. Results did not show important differences between nonpregnant controls and normal pregnant women......, but a significant rise was seen in women with preeclampsia compared to nonpregnant controls. Marked interindividual variation was found in all three groups. The mechanism of ANP release may differ between those women with normal pregnancy and those with preeclampsia. It is unclear whether the increased level of ANP...... in preeclampsia is an effect or a cause of the disease....
Gizeli de Fátima Ribeiro dos Anjos
.PURPOSES: To evaluate the hemodynamic patterns of the ophthalmic artery by Doppler analysis in women with gestational diabetes mellitus (GDM, comparing them to normal pregnant women. METHODS: A prospective case-control study that analyzed the ophthalmic artery Doppler indices in two groups: one consisting of 40 women diagnosed with GDM and the other of 40 normal pregnant women. Included were pregnant women with GDM criteria of the American Diabetes Association - 2012, with 27 weeks of pregnancy to term, and excluded were women with hypertension, use of vasoactive drugs on or previous diagnosis of diabetes. Doppler analysis was performed in one eye with a 10 MHz linear transducer and the Sonoace 8000 Live Medison® equipment . The following variables were analyzed: pulsatility index (PI, resistance index (RI, peak velocity ratio (PVR, peak systolic velocity (PSV and end diastolic velocity (EDV. To analyze the normality of the samples we used the Lillefors test, and to compare means and medians we used the Student's t-test and Mann-Whitney test according to data normality, with the level of significance set at 95%. RESULTS: The median and mean values with standard deviation of the variables of the ophthalmic artery Dopplervelocimetry group GDM and normal pregnant women were: IP=1.7±0.6 and 1.6±0.4 (p=0.7; IR=0.7 and 0.7 (p=0.9; RPV=0.5±0.1 and 0.5±0.1 (p=0.1, PSV=33.6 and 31.9 cm/sec (p=0.7; VDF=6.3 and 7.9 cm/sec (p=0.4. There was no significant difference in the means and medians of these variables between the two groups of pregnant women. CONCLUSIONS: The ophthalmic artery hemodynamic patterns, analyzed by means of a Doppler technique remained unchanged in the group of pregnant women with GDM compared to the group of normal pregnant women, suggesting that the time of exposure to the disease during pregnancy was too short to cause significant vascular disorders in the central territory.
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Manni Mohanraj Mahalakshmi
Full Text Available Aim: To compare the existing maternal and fetal outcomes in Asian Indian women with or without gestational diabetes mellitus (GDM before the development of the Women in India with GDM Strategy (WINGS GDM model of care (MOC. Materials and Methods: Records of pregnant women were extracted retrospectively from three maternity centers in Chennai. GDM was diagnosed using the International Association for Pregnancy Study Groups criteria or the Carpenter and Coustan criteria. Demographic details, obstetric history, antenatal follow-up, treatment for GDM, and outcomes of delivery were collected from the electronic medical records. Results: Of the 3642 records analyzed, 799 (21.9% had GDM, of whom 456 (57.1% were treated with insulin and medical nutrition therapy (MNT, 339 (42.4% with MNT alone, and 4 (0.5% with metformin. Women with GDM were older than those without (28.5 ± 4.5 vs. 27.1 ± 4.5 years; P < 0.001 and had higher mean body mass index at first booking (26.4 ± 5.2 kg/m2 vs. 25.2 ± 5.1 kg/m2; P < 0.001. Rates of cesarean section (26.2% vs. 18.7%; P < 0.001, preeclampsia (1.8% vs. 0.8%; P = 0.04, and macrosomia (13.9% vs. 10.8%; P = 0.02 were significantly higher among women with GDM. In women with GDM treated with insulin and MNT, emergency cesarean section (16.2% vs. 36.6%; P < 0.0001, preeclampsia (0.7% vs. 3.2%; P = 0.015, and macrosomia (9.9% vs. 18.6%; P = 0.0006 were significantly lesser compared to those treated with MNT alone. Conclusion: Pregnancy outcomes were in general worse in GDM women. Treatment with insulin was associated with a significantly lower risk of complications. However, in countries with limited access to insulin and other medicines may lead to poor follow-up and management of GDM. Data from this retrospective study will form the basis for the development of the WINGS GDM MOC, which will address these gaps in GDM care in low-resource settings.
Full Text Available Background: Our understanding of pathogenesis of periodontal disease has changed remarkably over a few decades. Rather than being confined to periodontium, periodontal disease may have a wide ranging systemic effects. It is now recognized that it shares most of the common risk factors for diabetes, coronary heart disease preterm low birth weight, miscarriage or early pregnancy loss and preeclampsia. Materials and Methods: The study group comprised of 400 women (200 pregnant women and 200 non-pregnant with an age range of 18-40 years. Maternal demographic and medical data were collected. Periodontal examinations included: Oral hygiene index (OHI-S, gingival index (GI, pocket probing depth and clinical attachment loss (CAL. Results: The results were analyzed using test of proportion when OHI-S was compared in pregnant women with that of non-pregnant individuals, there was no significant difference in good oral hygiene group (P = 0.187, Z = 1.32. When the GI index was evaluated, a definite statistical difference was noted in mild, moderate and severe gingivitis (P - 0.000, Z = 0.365; P - 0.00, Z = 4.17; P - 0.000, Z = 0.75. CAL index revealed a statistical difference was observed healthy periodontium, mild, moderate and severe periodontitis in both pregnant and non-pregnant women (P = −0.000, Z = 3.65; P - 0.000, Z = 5.83; P - 0.001, Z - 3.24; P - 0.000, Z - 6.47. Conclusion: The present study conducted supports the hypothesis that there is a definite correlation between the pregnant women and poor oral hygiene (gingivitis and periodontitis as compared with the non-pregnant controls.
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Liao, Shunyao; Liu, Yunqiang; Chen, Xiaojuan; Tan, Yuande; Mei, Jie; Song, Wenzhong; Gan, Lu; Wang, Hailian; Yin, Shi; Dong, Xianjue; Chi, Shu; Deng, Shaoping
We investigate the impact of genetic variants on transiently upregulated gestational insulin signaling. We recruited 1152 unrelated nondiabetic pregnant Han Chinese women (age 28.5 ± 4.1 years; body mass index [BMI] 21.4 ± 2.6 kg/m(2)) and gave them oral glucose tolerance tests. Matsuda index of insulin sensitivity, homeostatic model assessment of insulin resistance, indices of insulin disposition, early-phase insulin release, fasting state, and 0 to 120 minute's proinsulin to insulin conversion were used to dissect insulin physiological characterization. Several variants related to β-cell function were genotyped. The genetic impacts were analyzed using logistic regression under an additive model. By adjusting for maternal age, BMI, and the related interactions, the genetic variants in ABCC8, CDKAL1, CDKN2A, HNF1B, KCNJ11, and MTNR1B were detected to impact gestational insulin signaling through heterogeneous mechanisms; however, compared with that in nonpregnant metabolism, the genetic effects seem to be eminently and heavily influenced by maternal age and BMI, indicating possible particular mechanisms underlying gestational metabolism and diabetic pathogenesis. © The Author(s) 2015.
Pringle, Kirsty G; de Meaultsart, Celine Corbisier; Sykes, Shane D; Weatherall, Loretta J; Keogh, Lyniece; Clausen, Don C; Dekker, Gus A; Smith, Roger; Roberts, Claire T; Rae, Kym M; Lumbers, Eugenie R
The intrarenal renin-angiotensin system (iRAS) is implicated in the pathogenesis of hypertension, chronic kidney disease and diabetic nephropathy. Urinary angiotensinogen (uAGT) levels reflect the activity of the iRAS and are altered in women with preeclampsia. Since Indigenous Australians suffer high rates and early onset of renal disease, we hypothesised that Indigenous Australian pregnant women, like non-Indigenous women with pregnancy complications, would have altered uAGT levels. The excretion of RAS proteins was measured in non-Indigenous and Indigenous Australian women with uncomplicated or complicated pregnancies (preeclampsia, diabetes/gestational diabetes, proteinuria/albuminuria, hypertension, small/large for gestational age, preterm birth), and in non-pregnant non-Indigenous women. Non-Indigenous pregnant women with uncomplicated pregnancies, had higher uAGT/creatinine levels than non-Indigenous non-pregnant women (P pregnant women with pregnancy complications, uAGT/creatinine was suppressed in the third trimester (P pregnant women with uncomplicated pregnancies, there was no change in uAGT/creatinine with gestational age and uAGT/creatinine was lower in the 2nd and 3rd trimesters than in non-Indigenous pregnant women with uncomplicated pregnancies (P pregnant women may reflect subclinical renal dysfunction which limits the ability of the kidney to maintain sodium balance and could indicate an increased risk of pregnancy complications and/or future renal disease. Copyright © 2018. Published by Elsevier B.V.
Qian, Yuan; Sun, Hao; Xiao, Hongli; Ma, Meirun; Xiao, Xue; Qu, Qinzai
Increasing evidence has shown that insulin resistance in omental visceral adipose tissue (OVAT) is a characteristic of gestational diabetes mellitus (GDM). The present study aimed to identify differentially expressed genes (DEGs) and their associated functions and pathways involved in the pathogenesis of GDM by comparing the expression profiles of OVATs obtained from pregnant Chinese women with and without GDM during caesarian section. A total of 935 DEGs were identified, including 450 downregulated and 485 upregulated genes. In the gene ontology category cellular components, the DEGs were predominantly associated with functions of the extracellular region, while receptor binding was predominant in the molecular function category and biological process terms included antigen processing and presentation, extracellular matrix organization, positive regulation of cell-substrate adhesion, response to nutrients and response to dietary excess. Functional enrichment and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment were performed and a functional interaction network was constructed. Functions of downregulated genes included antigen processing and presentation as well as cell adhesion molecules, while those of upregulated genes included transforming growth factor (TGF)-β-signaling, focal adhesion, phosphoinositide-3 kinase-Akt-signaling, P53 signaling, extracellular matrix-receptor interaction and regulation of actin cytoskeleton pathway. The five main pathways associated with GDM were antigen processing and presentation, cell adhesion molecules, Type 1 diabetes mellitus, natural killer cell-mediated cytotoxicity and TGF-β signaling. These pathways were included in the KEGG pathway categories of ‘signaling molecules and interaction’, ‘immune system’ and ‘inflammatory response’, suggesting that these processes are involved in GDM. The results of the present study enhanced the present understanding of the mechanisms associated with insulin
Broekhuizen, Karen; Simmons, David; Devlieger, Roland
for pregnant women at increased risk for GDM. The purpose of this study was to evaluate the cost-effectiveness of the healthy eating and/or physical activity promotion intervention compared to usual care among pregnant women at increased risk of GDM from a societal perspective. Methods: An economic evaluation...... was performed alongside a European multicenter-randomized controlled trial. A total of 435 pregnant women at increased risk of GDM in primary and secondary care settings in nine European countries, were recruited and randomly allocated to a healthy eating and physical activity promotion intervention (HE + PA...... intervention), a healthy eating promotion intervention (HE intervention), or a physical activity promotion intervention (PA intervention). Main outcome measures were gestational weight gain, fasting glucose, insulin resistance (HOMA-IR), quality adjusted life years (QALYs), and societal costs. Results: Between...
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Vinter, Christina Anne; Tanvig, Mette Honnens; Damm, Peter
One third of the pregnant Danish women are overweight or obese. Maternal obesity is an independent risk factor for adverse maternal and foetal outcomes including infertility, miscarriage, congenital malformations, preeclampsia, gestational diabetes, complicated deliveries, caesarean section, macr...
Full Text Available Properly selected and prescribed physical activity during pregnancy has a favorable effects on the health of pregnant women and the fetus, and is excellent preparation for childbirth. Absolute and relative contraindications to exercise during pregnancy are well defined, as well as the warning signs to terminate exercise while pregnant. Knowledge of these is essential for physically active pregnant women and exercise professionals that work with pregnant women. Pregnant women should be moderately physically active every day of the week for at least 30 minutes. The term moderate is thoroughly and clearly defined in the guidelines. Resistance exercises during pregnancy are safe but it is advised to use light loads and a large number of repetitions (e.g. 15-20 repetitions. Strength exercises for the pelvic floor muscles deserves a special place during pregnancy. Appropriate forms of physical activity for pregnant women are walking and jogging, swimming and aquatic exercise, cycling, Pilates and yoga, aerobics, fitness and cross-country skiing. Certain forms of physical activity need special adjustments (alpine skiing, ice skating and rollerblading, racket sports, team ball games, horseback riding and scuba diving.
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Conclusions. In patients with diabetes mellitus type 1 and concomitant diabetic nephropathy without hypertension, we can recommend to study these polymorphic variants of genes to determine the risk of preeclampsia.
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Many women suffer psychological symptoms during pregnancy but few studies have examined anxiety among pregnant ladies in relation to the level of education, previous bad obstetrical history and female circumcision. Aims: To determine frequency of anxiety among Sudanese women as related to pregnancy and ...
Blood was collected by venipuncture from 180 women attending the antenatal clinic in Murtala Mohammed Specialist Hospital Kano, Kano State, Nigeria. Sera samples were screened in a qualitative study using CMV IgG ELISA kit (Dialab, Austria). Results: Out of 180 pregnant women, 164 (91.1%) were seropositive.
2016 Annals of Medical and Health Sciences Research | Published by Wolters Kluwer - ... Background: Food taboos among rural women have been identified as one of the factors .... items and incorrect knowledge regarding their benefits can ..... 2003;28:183‑9. 33. Ngozi PO. Pica practices of pregnant women in Nairobi,.
Zołnierczuk-Kieliszek, Dorota; Chemperek, Ewa; Koza, Matylda
The aim of the paper was to determine the frequency and intensity of tobacco smoking by pregnant women as well as to find out the relationship between tobacco smoking during pregnancy and socioeconomic variables (education, marital status, professional career, smoking partner, number of children) as well as health variables (severe ailments during pregnancy period, taking medicines, using medical care). The research was carried out at the department of gynecology and obstetrics of the Specialist Hospital in Jasło as well as at the Women's Outpatient Clinic of the Public Independent Health Service Institution in Skołyszyn (Podkarpackie Voivodship). The research was conducted by means of the questionnaire distributed from July to September 2002 among 100 pregnant women. The results of the analysis indicate that 18% of the women under survey smoked cigarettes during pregnancy, including 6% daily smokers and 12% occasional smokers. 18% of women quitted smoking when they found out that they were pregnant, and 18% of them limited smoking. Exposure to passive smoking at their family home was declared by more than a half of the pregnant women, while 14% of the surveyed women mentioned passive exposure to smoke at their workplace. The socioeconomic variables that most clearly showed positive correlation with active smoking by pregnant women were: smoking tobacco by a husband or steady partner, smoking tobacco in the presence of a pregnant woman in her workplace and at home, as well as taking advantage of a family doctor's advice. Smoking tobacco during pregnancy was also enhanced by: the lower level of education, extramarital pregnancy, permanent residence in a town or a city, poor living conditions, not working professionally during pregnancy, having two or more children, abnormal course of pregnancy, suffering from such ailments as: weepiness, problems with relaxation, lack of appetite and taking no medicines during pregnancy.
Tayyari Dehbarez, Nasrin; Lou, Stina; Uldbjerg, Niels
design was used and women were recruited during their first pregnancy-related visit to a general practitioner. The interviews were conducted using a semi-structured interview guide, and a thematic analysis of the data was carried out. RESULTS: Women made their hospital choice decision independently......OBJECTIVE: To investigate pregnant women's decision making in relation to their choice of birthing hospital and, in particular, their priorities regarding hospital characteristics. METHODS: The focus of this study was the choice of birthing hospital among pregnant women. A qualitative interview...... and they relied extensively on their own or peers' experiences. Travel distance played a role, but some women were willing to incur longer travel times to give birth at a specialized hospital in order to try to reduce the risks (in case of unexpected events). The women associated the presence of specialized...
Jayasvasti, Kanthika; Kanchanatawan, Buranee
Pregnancy is a crisis in the human life cycle as an important turning point in aspects of anatomical, physiological and psychosocial changes. An unhappy pregnanus could influence the fetal growth and development and sense of maternal competence as well as bonding with the fetus which profoundly affect the nurture of the infant after delivery. The authors'purposes were to study happiness and related factors in pregnant women having antenatal care at King Chulalongkorn Memorial Hospital. Four hundred and thirty-eight pregnant women from the antenatal clinic at King Chulalongkorn Memorial Hospital were randomly selected to complete a set of questionnaires that consisted of personal information, pregnant information, The Oxford Happiness Questionnaire (OHQ), The Maudsley Personality Inventory (MPI) and The Marital Satisfaction Scale (MSS). Prevalence of happiness level was classified by descriptive analysis. Unpaired t-test, ANOVA and Pearson's Product Moment Correlation analyzed related factors to happiness in pregnant woman. Also Stepwise Multiple Regression Analysis was used to define predictive factors for happiness in pregnant women. The sample had a high level of happiness of 57.3%. Significant related factors to happiness were age between 31-35 years, high education level, high individual and family income, having saving deposition, no drug abuse, improved marital relationship, no conflict with relatives, extrovert and stable personality types and no concerns about post-partum body image. Four predictive factors for happiness in pregnant women were extrovert personality, stable personality, high family income and improved marital relationship. Level of happiness in pregnant women could be predicted by type of personality, family income and marital relationship.
Full Text Available Pregnancy is a very important period in a woman's life, but it is often associated not only with positive emotions, but also with negative emotions such as anxiety, stress or depression. Women most often fear birth and various medical complications during pregnancy. Very often their unpleasant experiences at the beginning such as nausea, fatigue and strong anxiety cause them to give up their physical activity. Numerous studies show that the physical activity of pregnant women has a positive impact on mother and child health. First and foremost, it is a powerful preventive agent in cardiovascular disease, diabetes mellitus, but also has a beneficial effect on the well-being of future mothers, including lowering anxiety and lowering the incidence of postpartum depression. That is why it is so important to educate pregnant women what exercises are most beneficial for them.
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This women's health podcast focuses on gestational diabetes (GDM) to help educate women who may have been diagnosed with GDM now or in the past. GDM is a condition that can lead to pregnancy complications.
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Nybo, Mads; Friis-Hansen, Lennart; Felding, Peter
The aim of the study was to investigate whether the well-known high anemia prevalence in pregnant women from the eastern Mediterranean and Asian regions decreased when the women immigrated to a low-frequency region (Denmark). During 70 months, 1,741 pregnant immigrant women referred from primary...... status parameters were examined in the two groups. The prevalence of anemia was higher in the immigrant group (20.0%) compared to the Danish women (4.9%) (P ... indicated iron deficiency. Conclusively, the pregnant immigrant women had significantly higher prevalence of anemia compared to pregnant women of Danish origin. It indicates the need for an alternative routine screening procedure for this population group, which should also include nutritional counselling....
Results: In this study, 600pregnant women were evaluated.Mean BMI befor pregnancy in the women with GDM was significantly higher than in the women without the above-mentioned problems(P=0.0001. The mean weight gained during pregnancy in the women with these symptoms was significantly higher than that in the women without the above –mentioned problems(P=0.039(P=0.0001. Compared to pre-pregnancy BMI, weight gain during pregnancy had a higher with GDM(0.278 vs 0.077. Conclusion: Pre-pregnancy BMI in comparison with weight gain during pregnancy, had a higher correlation with GDM and macrosomia
Nucci Luciana Bertoldi
Full Text Available INTRODUCTION: Although obesity is well recognized as a current public health problem, its prevalence and impact among pregnant women have been less investigated in Brazil. The objective of the study was to evaluate the impact of pre-obesity and obesity among pregnant women, describing its prevalence and risk factors, and their association with adverse pregnancy outcomes. METHODS: A cohort of 5,564 pregnant women, aged 20 years or more, enrolled at aproximately 20 to 28 weeks of pregnancy, seen in prenatal public clinics of six state capitals in Brazil were followed up, between 1991 and 1995. Prepregnancy weight, age, educational level and parity were obtained from a standard questionnaire. Height was measured in duplicate and the interviewer assigned the skin color. Nutritional status was defined using body mass index (BMI, according to World Health Organization (WHO criteria. Odds ratios and 95% confidence interval were calculated using logistic regression. RESULTS: Age-adjusted prevalences (and 95% CI based on prepregnancy weight were: underweight 5.7% (5.1%-6.3%, overweight 19.2% (18.1%-20.3%, and obesity 5.5% (4.9%-6.2%. Obesity was more frequently observed in older black women, with a lower educational level and multiparous. Obese women had higher frequencies of gestational diabetes, macrosomia, hypertensive disorders, and lower risk of microsomia. CONCLUSIONS: Overweight nutritional status (obesity and pre-obesity was seen in 25% of adult pregnant women and it was associated with increased risk for several adverse pregnancy outcomes, such as gestational diabetes and pre-eclampsia.
A study was carried out on the prevalence of malaria among pregnant women in Owerri Municipal council area in Imo State, Nigeria between December 2001 and October 2002. Of 250 women examined, 200 women were pregnant. Of the 200 pregnant women examined, 22 (11.0%) had malaria parasitaemia. Prevalence ...
Full Text Available This cross-sectional study investigated the impact of pregestational overweight and obesity on periodontal status of patients with gestational diabetes mellitus (GDM. Sixty pregnant women with gestational diabetes mellitus (GDM were recruited for the study. According to the pregestational body mass index (BMI, patients were classified into 3 groups: normal, overweight or obese. The periodontal assessment parameters were the presence of gingival bleeding (GB and bleeding on probing (BOP per tooth. Clinical attachment loss (CAL was assessed per tooth and classified according to following values: 1 absence of attachment loss; 2 between 1 and 2 mm, 3 between 3 and 5 mm; and 4 CAL > 6 mm. The means of individual percentage of teeth with GB and BOP and the means of the individual classified values of CAL were compared through ANOVA. Differences between the groups were established through post hoc Bonferroni test for multiple comparisons (p O objetivo do presente estudo foi examinar o efeito da massa corporal prévia à gestação (IMC - índice de massa corpórea sobre o periodonto de pacientes com diabete mellitus gestacional (DMG. A amostra constituiu-se de 60 gestantes classificadas em 3 grupos segundo o IMC: normal, sobrepeso ou obeso. Os parâmetros de avaliação periodontal foram sangramento gengival (SG, sangramento à sondagem (SS e perda de inserção clínica periodontal (PI categorizada de acordo com os seguintes valores: 1 correspondente à ausência de perda de inserção; 2 PI entre 1 e 2 mm, 3 PI entre 3 e 5 mm; e 4 PI > 6 mm. Médias das porcentagens dos dentes com SG e SS e as médias dos valores categorizados, por dente, da perda de inserção foram comparadas por meio do teste ANOVA e as diferenças entre os grupos foram estabelecidas por meio do teste post hoc de Bonferroni para comparações múltiplas (p < 0,05. Diferenças estatisticamente significantes foram identificadas entre o grupo normal e obeso com relação às m
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Adolfsson, Annsofie; Linden, Karolina; Sparud-Lundin, Carina; Larsson, Per-Göran; Berg, Marie
Women with type 1 diabetes face particular demands in their lives in relation to childbearing. During pregnancy, in order to optimize the probability of giving birth to a healthy child, their blood glucose levels need to be as normal as possible. After childbirth, they experience a 'double stress': in addition to the ordinary challenges they face as new mothers, they also need to focus on getting their blood glucose levels normal. To improve self-management of diabetes and overall well-being in women with type 1 diabetes, a person-centered web-based support was designed to be tested in a randomized controlled trial (RCT) to be used during pregnancy and early motherhood. This protocol outlines the design of this RCT, which will evaluate the effectiveness of the specially designed web-based support for mothers with type 1 diabetes in Sweden. The study is designed as an RCT. The web support consists of three parts: 1) evidence-based information, 2) a self-care diary, and 3) communication with peers. The primary outcome is general well-being evaluated with the Well-Being Questionnaire short version (W-BQ12) and diabetes management evaluated with the Diabetes Empowerment Scale, short version (SWE-DES). Women attending six hospital-based antenatal care centers in Sweden are invited to participate. The inclusion period is November 2011 to late 2014. The allocation of participants to web support (intervention group) and to usual care (control group) is equal (1:1). In total, 68 participants in each group will be needed to reach a statistical power of 80% with significance level 0.05. The web support is expected to strengthen the women's personal capacity and autonomy during pregnancy, breastfeeding, and early motherhood, leading to optimal well-being and diabetes management. ClinicalTrials.gov: NCT01565824 (registration date March 27th 2012).
Ergönen, Akça Toprak; Ozdemir, M Hakan; Can, Ismail Ozgür; Sönmez, Ersel; Salaçin, Serpil; Berberoğlu, Evrim; Demir, Namik
Domestic violence is accepted worldwide as an important health problem. Besides diagnosis and treatment process, there are difficulties when considering of medico-legal evaluation of pregnant women subjected to domestic violence. As a signatory of the ''Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW)'' Turkey has certain commitments regarding domestic violence and made regulations on national law. The purpose of the present study is to demonstrate the prevalence of domestic violence during pregnancy among the women who applied to obstetrics clinics and evaluating of the participants' knowledge level about the legal legislation concerning domestic violence. Pregnant women attending for antenatal care to department of Gynecology and Obstetrics were interviewed using an anonymous and confidential questionnaire. The questionnaire used was a version of Abuse Assessment Screen with guidance of references. 28 (13.4%) women stated that they had been subjected to violence before pregnancy. Only 10 (4.67%) women had stated experience of violence during pregnancy. 148 (69.2%) of them had stated that they had no knowledge about any legislation concerning domestic violence in our country. We believe that society awareness should be increased and the health workers should be informed about their ethical and legal responsibilities concerning domestic violence during pregnancy. The knowledge and sensitivity of health care personnel in Prenatal Clinics and Family Planning Services should be increased and examination protocols should be provided about domestic violence against pregnant women.
Kinnunen, Tarja I; Puhkala, Jatta; Raitanen, Jani; Ahonen, Suvi; Aittasalo, Minna; Virtanen, Suvi M; Luoto, Riitta
The incidence of gestational diabetes mellitus (GDM) is increasing and GDM might be prevented by improving diet. Few interventions have assessed the effects of dietary counselling on dietary intake of pregnant women. This study examined the effects of dietary counselling on food habits and dietary intake of Finnish pregnant women as secondary outcomes of a trial primarily aiming at preventing GDM. A cluster-randomized controlled trial was conducted in 14 municipalities in Finland, including 399 pregnant women at increased risk for developing GDM. The intervention consisted of dietary counselling focusing on dietary fat, fibre and saccharose intake at four routine maternity clinic visits. Usual counselling practices were continued in the usual care municipalities. A validated 181-item food frequency questionnaire was used to assess changes in diet from baseline to 26-28 and 36-37 weeks gestation. The data were analysed using multilevel mixed-effects linear regression models. By 36-37 weeks gestation, the intervention had beneficial effects on total intake of vegetables, fruits and berries (coefficient for between-group difference in change 61.6 g day(-1), 95% confidence interval 25.7-97.6), the proportions of high-fibre bread of all bread (7.2% units, 2.5-11.9), low-fat cheeses of all cheeses (10.7% units, 2.6-18.9) and vegetable fats of all dietary fats (6.1% -units, 2.0-10.3), and the intake of saturated fatty acids (-0.67 energy-%-units, -1.16 to -0.19), polyunsaturated fatty acids (0.38 energy-%-units, 0.18-0.58), linoleic acid (764 mg day(-1), 173-1354) and fibre (2.07 g day(-1) , 0.39-3.75). The intervention improved diet towards the recommendations in pregnant women at increased risk for GDM suggesting the counselling methods could be implemented in maternity care. © 2012 John Wiley & Sons Ltd.
Background: A good proportion of pregnant women patronize traditional birth homes in Nigeria for ante-natal care. This study aimed at determining the prevalence, risk factors, and susceptibility profile of etiologic agents of urinary tract infection among ante-natal attendees in a traditional birth home in Benin City, Nigeria.
... Ante-Natal Clinic at Military Hospital Port Harcourt, Rivers State, Nigeria using the Standard parasitological technique. Venous blood was collected from 200 pregnant women, both thick and thin blood films were made on clean greese-free glass slide and stained with 10% Giemsa stains diluted with 7.2 buffered water for ...
Objectives: To investigate the prevalence and intensity of intestinal helminth infections in pregnant Cameroonian women and assess their anaemic status. Design: Longitudinal study. Setting: Buea Integrated Health Centre, Muea Health Centre, Mutengene Integrated Health Centre and the University of Buea Life Sciences ...
A cross-sectional study to determine malaria parasitemia amongst 300 randomly selected pregnant women attending government and private healthcare facilities in Rivers State was carried out. Blood samples were obtained through venous procedure and the presence or absence of Plasmodium was determined ...
Introduction: iron deficiency anemia is the leading cause of anemia worldwide. It may also be the leading cause of anemia in pregnancy, although this has not yet been demonstrated in our country. The aim of the study was to describe hematologic features of Cameroonian anemic pregnant women. Methods: this cross ...
Wang, Chen; Wei, Yumei; Zhang, Xiaoming; Zhang, Yue; Xu, Qianqian; Sun, Yiying; Su, Shiping; Zhang, Li; Liu, Chunhong; Feng, Yaru; Shou, Chong; Guelfi, Kym J; Newnham, John P; Yang, Huixia
Obesity and being overweight are becoming epidemic, and indeed, the proportion of such women of reproductive age has increased in recent times. Being overweight or obese prior to pregnancy is a risk factor for gestational diabetes mellitus, and increases the risk of adverse pregnancy outcome for both mothers and their offspring. Furthermore, the combination of gestational diabetes mellitus with obesity/overweight status may increase the risk of adverse pregnancy outcome attributable to either factor alone. Regular exercise has the potential to reduce the risk of developing gestational diabetes mellitus and can be used during pregnancy; however, its efficacy remain controversial. At present, most exercise training interventions are implemented on Caucasian women and in the second trimester, and there is a paucity of studies focusing on overweight/obese pregnant women. We sought to test the efficacy of regular exercise in early pregnancy to prevent gestational diabetes mellitus in Chinese overweight/obese pregnant women. This was a prospective randomized clinical trial in which nonsmoking women age >18 years with a singleton pregnancy who met the criteria for overweight/obese status (body mass index 24≤28 kg/m 2 ) and had an uncomplicated pregnancy at exercise or a control group. Patients did not have contraindications to physical activity. Patients allocated to the exercise group were assigned to exercise 3 times per week (at least 30 min/session with a rating of perceived exertion between 12-14) via a cycling program begun within 3 days of randomization until 37 weeks of gestation. Those in the control group continued their usual daily activities. Both groups received standard prenatal care, albeit without special dietary recommendations. The primary outcome was incidence of gestational diabetes mellitus. From December 2014 through July 2016, 300 singleton women at 10 weeks' gestational age and with a mean prepregnancy body mass index of 26.78 ± 2.75 kg/m 2 were
Beliefs, perceptions, and views of pregnant women about Caesarean section and ... decision‑making in a specialist health facility in Enugu, southeast Nigeria. ... was administered to 200 pregnant women, following an oral informed consent.
Carmona-Fonseca, Jaime; Agudelo, Olga M; Arango, Eliana M
Information about asymptomatic plasmodial infection is scarce in the world, and the current antimalarial program goals (control, elimination, and eradication) demand this evidence to be well documented in different populations and malaria transmission settings. This study aimed to measure the prevalence of API in Colombian pregnant women at delivery. A retrospective prevalence survey was used. Women were recruited at hospital obstetric facility in each of the municipalities of Turbo, Necoclí in Antioquia department, and Puerto Libertador in Córdoba department. Malaria infection was tested by thick blood smear (TBS) and real-time quantitative PCR (qPCR). Ninety-six pregnant women at delivery were studied: 95% were asymptomatic (91/96), 45% had asymptomatic plasmodial infection (API) by qPCR (41/91), and only 8% (7/91) had API by microscopy. The prevalence of submicroscopic infections (TBS negative and qPCR positive) was very high, 37% (34/91) in asymptomatic women and 41% (39/96) in total women studied (91 asymptomatic and 5 symptomatic). The prevalence of API in Colombian pregnant women is much higher than which is expected for a country that does not have the level of malaria transmission as Sub-Saharan African countries. Copyright © 2017 Elsevier B.V. All rights reserved.
Eekhoff Elisabeth MW
Full Text Available Abstract Background Pregnancy is a period in the life of women that is often associated with decreased daily physical activity and/or exercise. However, maintaining adequate levels of daily physical activity during pregnancy is important for mother and child. Studies suggest that moderate daily physical activity and exercise during pregnancy are associated with reductions in the risk of gestational diabetes mellitus (GDM. However, at present, physical activity is not routinely advised to pregnant women at risk for gestational diabetes in the Netherlands. In FitFor2-study we aim to assess whether an exercise program can improve insulin sensitivity and fasting plasma glucose levels of women at high risk for gestational diabetes, assuming that this will lower their risk of gestational diabetes. Methods The FitFor2-study is a randomised controlled trial. Women who visit one of the participating hospitals or midwifery practices and who are at risk for gestational diabetes are eligible to participate. After baseline measurement they are randomly allocated to in the intervention or control group. The intervention group receives an exercise program twice a week in addition to usual care. The exercise program consist of aerobic and strength exercises and takes place under close supervision of a physiotherapist. Data are collected at 15, 24 and 32 weeks of pregnancy and 12 weeks after delivery. Primary maternal outcome measures are fasting plasma glucose and relative increase in insulin resistance. Primary neonatal outcome is birth weight. Secondary outcome measures are: maternal serum triglycerides, HDL, cholesterol, HbA1c, maternal weight gain during pregnancy, maternal physical activity level, foetal growth. Discussion If the FitFor2 intervention program proves to be effective, obstetricians and midwives should refer women at risk for GDM to a special exercise program. Exercise programs for pregnant women under supervision of an experienced trainer are
N. B. Gordovskaya; I. V. Korotchaeva
In this article, the questions of screening, diagnostics and treatment of asymptomatic bacteriuria in pregnant women are considered. AB is found in 2-13% of pregnant women and it is a risk factor of gestational pyelonephritis development in 30-40% of pregnant women. Timely antibacterial therapy of AB prevents development of pyelonephritis in 70-80% of cases.
N. B. Gordovskaya
Full Text Available In this article, the questions of screening, diagnostics and treatment of asymptomatic bacteriuria in pregnant women are considered. AB is found in 2-13% of pregnant women and it is a risk factor of gestational pyelonephritis development in 30-40% of pregnant women. Timely antibacterial therapy of AB prevents development of pyelonephritis in 70-80% of cases.
tobacco use during their pregnancy. Of the pregnant women, 70% lived with at least one smoker in the house. Conclusions. Few black and Indian pregnant women in. South Africa smoke, while coloured pregnant women smoke heavily. QUitting programmes should be targeted at them when they attend antenatal services.
Full Text Available ... raise awareness about diverse women of different ages, races, ethnic backgrounds, and health conditions participating in clinical trials. Visit the Women in Clinical Trials webpage to learn how women with diabetes can make a difference. Other Resources from the FDA FDA Information on ...
Full Text Available ... Pregnancy (CDC) Diverse Women in Clinical Trials Campaign Clinical trials can help doctors learn more about treatments for diabetes. The FDA Office of Women's Health is partnering with the NIH Office of Research on Women's Health to raise awareness about diverse ...
Full Text Available ... Skip to common links HHS U.S. Department of Health and Human Services U.S. Food and Drug Administration ... Consumers Consumer Information by Audience For Women Women's Health Topics Women and Diabetes Share Tweet Linkedin Pin ...
Clausen, Tine D; Mathiesen, Elisabeth; Ekbom, Pia
. Pregnancy outcome was compared with that of pregnant women with type 1 diabetes during 1996-2000, the background population, and pregnant women with type 2 diabetes during 1980-1992 from the same department. RESULTS: The perinatal mortality in pregnancies complicated by type 2 diabetes (4/61, 6.......6%) was increased four- and ninefold, respectively, and the rate of major congenital malformations (4/60, 6.7%) was more than doubled, although not statistically significant, compared with type 1 diabetic pregnancies and the background population. The glycemic control was similar or better in women with type 2...... diabetes compared with women with type 1 diabetes. Multivariate logistic regression analysis in the pooled group of pregnancies with pregestational diabetes from 1996 to 2001 showed that high HbA(1c) at admission and type 2 diabetes were independently associated with a serious adverse fetal outcome...
Metabolic complications including diabetes mellitus have been increasingly recognised in HIV-infected individuals since the introduction of antiretroviral therapy, particularly protease inhibitors (PIs). Pregnancy is also a risk factor for impaired glucose metabolism, and previous studies have given conflicting results regarding the contribution of PIs to impaired glucose tolerance (IGT) and gestational diabetes mellitus (GDM) in pregnant HIV-infected women.
Andersen, Stine Linding
Iodine is required for the synthesis of thyroid hormones, which are crucial regulator of early brain development. The source of iodine in the fetus and the breastfed infant is maternal iodine, and adequate iodine intake in pregnant and breastfeeding is of major concern. Severe iodine deficiency can...... cause irreversible brain damage, whereas the consequences of mild to moderate iodine deficiency are less clear. Denmark was previously iodine deficient with regional differences (mild iodine deficiency in East Denmark and moderate iodine deficiency in West Denmark), and also pregnant and breastfeeding...... women suffered from iodine deficiency. A mandatory iodine fortification of household salt and salt used for commercial production of bread was introduced in Denmark in the year 2000. The PhD thesis investigates intake of iodine supplements and urinary iodine status in Danish pregnant and breastfeeding...
Full Text Available ... in Clinical Trials Campaign Clinical trials can help doctors learn more about treatments for diabetes. The FDA Office of Women's Health is partnering with the NIH Office of Research ...
H. Ben Nasr
Full Text Available Scorpion envenomation is common in many countries; however, its effects on pregnancy are still unclear. In the present paper, we described the effects of scorpion envenomation on pregnant patients. A retrospective study was carried out considering the clinical and laboratory exams of patients admitted to the emergency room of Habib Bourguiba Hospital, Sfax, Tunisia, from 1990 to 2004. Variability of these clinical and laboratory profiles according to maternal age, gestational age and number of previous parities was also discussed. Among 167 scorpion-envenomed women, age ranged from 17 to 42 years, 7.18% were pregnant. These presented symptoms similar to those of non-pregnant women envenomed by scorpions. Two pregnant patients developed intense pelvic pain and one manifested vaginal bleeding. Although the studied parameters showed non-significant differences, we could conclude that scorpion envenomation may lead to abnormal uterine contraction probably causing preterm delivery. Maternal disturbances induced by scorpion envenomation may influence the fetus development. The effects were more severe in the second trimester of pregnancy.
Hotelling, Barbara A.
Pregnant prisoners have health-care needs that are minimally met by prison systems. Many of these mothers have high-risk pregnancies due to the economic and social problems that led them to be incarcerated: poverty, lack of education, inadequate health care, and substance abuse. Lamaze educators and doulas have the opportunity to replicate model programs that provide these women and their children with support, information, and empowering affirmation that improve parenting outcomes and decrease recidivism. PMID:19252687
Full Text Available We compared the increases in the prevalence of gestational diabetes mellitus (GDM based on the 1999 World Health Organization (WHO criteria and its risk factors in Tianjin, China, over a 12-year period. We also examined the changes in the prevalence using the criteria of International Association of Diabetes and Pregnancy Study Group (IADPSG.In 2010-2012, 18589 women who registered within 12 weeks of gestation underwent a glucose challenge test (GCT at 24-28 gestational weeks. Amongst them, 2953 women with 1-hour plasma glucose ≥ 7.8 mmol/L underwent a 75-gram 2-hour oral glucose tolerance test (OGTT and 781 women had a positive GCT but absented from the standard OGTT. An adjusted prevalence of GDM was calculated for the whole cohort of women by including an estimate of the proportion of women with positive GCTs who did not have OGTTs but would have been expected to have GDM. Logistic regression was used to obtain odds ratios and 95% confidence intervals using the IADPSG criteria. The prevalence of GDM risk factors was compared to the 1999 survey.The adjusted prevalence of GDM by the 1999 WHO criteria was 8.1%, a 3.5-fold increase as in 1999. Using the IADPSG criteria increased the adjusted prevalence further to 9.3%. Advanced age, higher pre-pregnancy body mass index, Han-nationality, higher systolic blood pressure (BP, a family history of diabetes, weight gain during pregnancy and habitual smoking were risk factors for GDM. Compared to the 1999 survey, the prevalence of overweight plus obesity had increased by 1.8 folds, age ≥ 30 years by 2.3 folds, systolic BP by 2.3 mmHg over the 12-year period.Increasing prevalence of overweight/obesity and older age at pregnancy were accompanied by increasing prevalence of GDM, further increased by change in diagnostic criteria.
Bombard, Jennifer M.; Farr, Sherry L.; Dietz, Patricia M.; Tong, Van T.; Zhang, Lei; Rabius, Vance
To describe characteristics, referrals, service utilization, and self-reported quit rates among pregnant and non-pregnant women enrolled in a smoking cessation quitline. This information can be used to improve strategies to increase pregnant and non-pregnant smokers’ use of quitlines. We examined tobacco use characteristics, referral sources, and use of services among 1,718 pregnant and 24,321 non-pregnant women aged 18–44 years enrolled in quitline services in 10 states during 2006–2008. We ...
... Substance Abuse Prevention and Treatment Block Grant § 96.131 Treatment services for pregnant women. (a) The State is required to, in accordance with this section, ensure that each pregnant woman in the State who... 45 Public Welfare 1 2010-10-01 2010-10-01 false Treatment services for pregnant women. 96.131...
Bertuit, Jeanne; Leyh, Clara; Rooze, Marcel; Feipel, Véronique
During pregnancy, physical and hormonal modifications occur. Morphologic alterations of the feet are found. These observations can induce alterations in plantar pressure. This study sought to investigate plantar pressures during gait in the last 4 months of pregnancy and in the postpartum period. A comparison with nulliparous women was conducted to investigate plantar pressure modifications during pregnancy. Fifty-eight women in the last 4 months of pregnancy, nine postpartum women, and 23 healthy nonpregnant women (control group) performed gait trials on an electronic walkway at preferred speeds. The results for the three groups were compared using analysis of variance. During pregnancy, peak pressure and contact area decreased for the forefoot and rearfoot. These parameters increased significantly for the midfoot. The gait strategy seemed to be lateralization of gait with an increased contact area of the lateral midfoot and both reduced pressure and a later peak time on the medial forefoot. In the postpartum group, footprint parameters were modified compared with the pregnant group, indicating a trend toward partial return to control values, although differences persisted between the postpartum and control groups. Pregnant women had altered plantar pressures during gait. These findings could define a specific pattern of gait footprints in late pregnancy because plantar pressures had characteristics that could maintain a stable and safe gait.
Full Text Available Background: Sexuality is an important part of women’s health, quality of life, and general well-being. There are many factors influencing the female sexual function, including psychological, physiological, couple relationship, and socio-cultural factors. Pregnancy plays an important role in the sexual function and behavior of women. Objective: This study aims to evaluate the sexual function and determine the prevalence of sexual dysfunction among women during pregnancy. Materials and Methods: The present cross-sectional study was conducted on 257 healthy pregnant women aging between18-40 years who had attended the antenatal clinic, Paymaneh Hospital, Jahrom, Iran between April and October 2011 Female Sexual Function Index (FSFI questionnaire was used for assessing the sexual function Results: The mean age of the participants was reported as 26.45±4.49 years. In addition, 143, 69, and 45 subjects were in their 1st, 2nd, and 3rd trimesters, respectively. Comparison of the second and the third trimesters revealed a significant difference in the scores of all FSFI domains and the mean total FSFI score was reported as 19.9±22.45. Among the study subjects, 197 ones (79.1% had sexual dysfunction (FSFI score <26.5, while only 52 (20.9% had normal sexual function (FSFI score ≥26.5. The sexual dysfunction among pregnant women was rated as 23.4%, 30.5%, and 46.2% in the 1st, 2nd, and 3rd trimesters, respectively. Conclusion: The prevalence of sexual dysfunction is high during pregnancy and reaches higher levels in the third trimester. Therefore, pregnant women and their partners need counseling about physical and psychological changes in pregnancy
Broekhuizen, Karen; Simmons, David; Devlieger, Roland
was performed alongside a European multicenter-randomized controlled trial. A total of 435 pregnant women at increased risk of GDM in primary and secondary care settings in nine European countries, were recruited and randomly allocated to a healthy eating and physical activity promotion intervention (HE + PA...... intervention), a healthy eating promotion intervention (HE intervention), or a physical activity promotion intervention (PA intervention). Main outcome measures were gestational weight gain, fasting glucose, insulin resistance (HOMA-IR), quality adjusted life years (QALYs), and societal costs. Results: Between...... intervention strategy. At 35-37 weeks, it depends on the decision-makers' willingness to pay per kilogram reduction in gestational weight gain whether the HE + PA intervention is cost-effective for gestational weight gain, whereas it was not cost-effective for fasting glucose and HOMA-IR. After delivery...
This women's health podcast focuses on gestational diabetes (GDM) to help educate women who may have been diagnosed with GDM now or in the past. GDM is a condition that can lead to pregnancy complications. Created: 5/12/2009 by Office of Womenâs Health (OWH) and National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP). Date Released: 5/12/2009.
Salih Joelsson, L; Tydén, T; Wanggren, K; Georgakis, M K; Stern, J; Berglund, A; Skalkidou, A
Infertility has been associated with psychological distress, but whether these symptoms persist after achieving pregnancy via assisted reproductive technology (ART) remains unclear. We compared the prevalence of anxiety and depressive symptoms between women seeking for infertility treatment and women who conceived after ART or naturally. Four hundred and sixty-eight sub-fertile non-pregnant women, 2972 naturally pregnant women and 143 women pregnant after ART completed a questionnaire in this cross-sectional study. The Anxiety subscale of the Hospital Anxiety and Depression Scale (HADS-A≥8) and Edinburgh Postnatal Depression Scale (EPDS≥12) were used for assessing anxiety and depressive symptoms, respectively. Multivariate Poisson regression models with robust variance were applied to explore associations with anxiety and depressive symptoms. The prevalence of anxiety and depressive symptoms among sub-fertile, non-pregnant women (57.6% and 15.7%, respectively) were significantly higher compared to women pregnant after ART (21.1% and 8.5%, respectively) and naturally pregnant women (18.8% and 10.3%, respectively). History of psychiatric diagnosis was identified as an independent risk factor for both anxiety and depressive symptoms. The presence of at least one unhealthy lifestyle behavior (daily tobacco smoking, weekly alcohol consumption, BMI≥25, and regular physical exercise<2h/week) was also associated with anxiety (Prevalence Ratio, PR: 1.24; 95%CI: 1.09-1.40) and depressive symptoms (PR: 1.25; 95%CI: 1.04-1.49). Women pregnant after ART showed no difference in anxiety and depressive symptoms compared to naturally pregnant women. However, early psychological counseling and management of unhealthy lifestyle behaviors for sub-fertile women may be advisable, particularly for women with a previous history of psychiatric diagnosis. Copyright © 2017. Published by Elsevier Masson SAS.
Farmakidis, Constantine; Dayal, Ashlesha K.; Lipton, Richard B.
Objective: To characterize demographic and clinical features in pregnant women presenting with acute headache, and to identify clinical features associated with secondary headache. Methods: We conducted a 5-year, single-center, retrospective study of consecutive pregnant women presenting to acute care with headache receiving neurologic consultation. Results: The 140 women had a mean age of 29 ± 6.4 years and often presented in the third trimester (56.4%). Diagnoses were divided into primary (65.0%) and secondary (35.0%) disorders. The most common primary headache disorder was migraine (91.2%) and secondary headache disorders were hypertensive disorders (51.0%). The groups were similar in demographics, gestational ages, and most headache features. In univariate analysis, secondary headaches were associated with a lack of headache history (36.7% vs 13.2%, p = 0.0012), seizures (12.2% vs 0.0%, p = 0.0015), elevated blood pressure (55.1% vs 8.8%, p headache history (OR 4.9, 95% CI 1.7–14.5) had an increased association with secondary headache, while psychiatric comorbidity (OR 0.13, 95% CI 0.021–0.78) and phonophobia (OR 0.29, 95% CI 0.09–0.91) had a reduced association with secondary headache. Conclusions: Among pregnant women receiving inpatient neurologic consultation, more than one-third have secondary headache. Diagnostic vigilance should be heightened in the absence of a headache history and if seizures, hypertension, or fever are present. Attack features may not adequately distinguish primary vs secondary disorders, and low thresholds for neuroimaging and monitoring for preeclampsia are justified. PMID:26291282
Szczesniak, Rhonda D; Li, Dan; Duan, Leo L; Altaye, Mekibib; Miodovnik, Menachem; Khoury, Jane C
Objective To identify phenotypes of type 1 diabetes control and associations with maternal/neonatal characteristics based on blood pressure (BP), glucose, and insulin curves during gestation, using a novel functional data analysis approach that accounts for sparse longitudinal patterns of medical monitoring during pregnancy. Methods We performed a retrospective longitudinal cohort study of women with type 1 diabetes whose BP, glucose, and insulin requirements were monitored throughout gestation as part of a program-project grant. Scores from sparse functional principal component analysis (fPCA) were used to classify gestational profiles according to the degree of control for each monitored measure. Phenotypes created using fPCA were compared with respect to maternal and neonatal characteristics and outcome. Results Most of the gestational profile variation in the monitored measures was explained by the first principal component (82-94%). Profiles clustered into three subgroups of high, moderate, or low heterogeneity, relative to the overall mean response. Phenotypes were associated with baseline characteristics, longitudinal changes in glycohemoglobin A1 and weight, and to pregnancy-related outcomes. Conclusion Three distinct longitudinal patterns of glucose, insulin, and BP control were found. By identifying these phenotypes, interventions can be targeted for subgroups at highest risk for compromised outcome, to optimize diabetes management during pregnancy. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Azar, Madona; Stoner, Julie A; Dao, Hanh Dung; Stephens, Lancer; Goodman, Jean R; Maynard, John; Lyons, Timothy J
Minority communities are disproportionately affected by diabetes, and minority women are at an increased risk for glucose intolerance (dysglycemia) during pregnancy. In pregnant American Indian women, the objectives of the study were to use current criteria to estimate the prevalence of first-trimester (Tr1) dysglycemia and second-trimester (Tr2) incidence of gestational diabetes mellitus (GDM) and to explore new candidate measures and identify associated clinical factors. This was a prospective cohort study. In Tr1 we performed a 75-g, 2-hour oral glucose tolerance test (OGTT) and glycated hemoglobin (HbA1c) to determine the following: fasting insulin; homeostasis model assessment of insulin resistance; serum 1,5-anhydroglucitol; noninvasive skin autofluorescence (SCOUT). We defined dysglycemia by American Diabetes Association and Endocrine Society criteria and as HbA1c of 5.7% or greater. In Tr2 in an available subset, we performed a repeat OGTT and SCOUT. Pregnant American Indian women (n = 244 at Tr1; n = 114 at Tr2) participated in the study. The prevalence of dysglycemia at Tr1 and incidence of GDM at Tr2 were measured. At Tr1, one woman had overt diabetes; 36 (15%) had impaired glucose tolerance (American Diabetes Association criteria and/or abnormal HbA1c) and 59 (24%) had GDM-Tr1 (Endocrine Society criteria). Overall, 74 (30%) had some form of dysglycemia. Associated factors were body mass index, hypertension, waist/hip circumferences, SCOUT score, fasting insulin, and homeostasis model assessment of insulin resistance. At Tr2, 114 of the Tr1 cohort underwent a repeat OGTT and SCOUT, and 26 (23%) had GDM. GDM-Tr2 was associated with increased SCOUT scores (P = .029) and Tr1 body mass index, waist/hip circumferences, diastolic blood pressure, fasting insulin, and triglyceride levels. Overall, dysglycemia at Tr1 and/or Tr2 affected 38% of the women. Dysglycemia at some point during pregnancy was common among American Indian women. It was associated with
Full Text Available This study was aimed at investigating the knowledge of pregnant women on food safety with particular attention to the effectiveness of the informative material (pamphlet and poster prepared in a previous study. To this scope, a questionnaire composed by 8 questions (Likert scaled was used except for one which was a Y/N question. Themes of the questionnaire were: level of concerns on food safety, and knowledge on foodborne diseases (salomonellosis, toxoplasmosis and listeriosis, risk factors and preventive measures. Results indicate that knowledge increased in respect to that of the previous study, but in relation to informative material previously distributed.
Melo, D.R.; Lipsztein, J.L.; Oliveira, C.A.N.; Bertelli, L.
Data from two pregnant women contaminated with 137 Cs, body burdens of 0.2 and 300 MBq, respectively at the time of the Goiania accident, were compared. The first one, with lower body burden was exposed during the fourth month of pregnancy, while the second became pregnant three years and eight months after 137 Cs intake. For the first woman 137 Cs concentrations were equal for the mother, infant and placenta, indicating an easy and homogeneous transport of 137 Cs from mother to foetus. The whole body monitoring data from the second woman, who became pregnant four years after intake, did not show a reduction in biological half-life during the pregnancy. Cs concentration in the mother was found to be 13 times higher than in the infant. One possible reason for this result is that four years after intake, Cs is supposed to be concentrated mainly in skeletal muscle tissue. During the pregnancy the blood flux becomes higher in most of the organs and tissues except brain, liver and skeletal muscle tissue. (author)
Full Text Available Background: Women’s empowerment programs during pregnancy focus primarily on increasing women’s health goals and psychological empowerment has been considered important in most issues related to pregnant mothers’ mental health. Using path analysis, this study aims to examine the direct and indirect components of psychological empowerment of pregnant mothers. Methods: This model-testing study was conducted in Gorgan, northwest of Iran during three months in spring of 2015. Through random cluster sampling, a total number of 160 pregnant women were selected from 10 urban medical centers and clinics as primary centers. We used Spritzer’s Psychological empowerment scale. Suitable sampling based on Nunally and Bernstein was followed in the model. The relationships between the dependent variables were then examined by means of path analysis using Amos 18. Results: The psychological empowerment of pregnant mothers (PEPW model is impacted by individual factors, such as marriage age and employment, including some subjectively rated factors such as marital satisfaction and experience of violence. The PEPW model was deemed appropriate as optimum conditions indicators of goodness of fit; low index of χ2/df shows little difference between the conceptual model and observed data, while RMSEA value indicated the goodness of fit. Other indicators such as CMIN=0.957, CMIN/DF=0.957, P-CLOSE=0.418, χ2=0.957 and probability level=0.328 the fact that the model is ideal. The mothers’ employment had the highest coefficient in the PEPW path model .731 (0.443, 0.965 bootstrap confidence intervals by 95%, and with a p-value of less than 0.05. Conclusions: The mothers’ employment is the most important factor in psychological empowerment, but it cannot be addressed quickly. Programming to increase marital satisfaction followed by a decrease in family violence and prevention of early marriage are necessary for promotion of psychological empowerment during
Diabetes gestacional na perspectiva de mulheres grávidas hospitalizadas Diabetes gestacional desde la perspectiva de mujeres embarazadas hospitalizadas Gestational diabetes from the perspective of hospitalized pregnant women
Márcio Flávio Moura Araújo
experiences lived by women with gestational diabetes mellitus. The sample consisted of 12 patients hospitalized at a maternity hospital in the city of Fortaleza, state of Ceará, Brazil, which expressed their feelings and perceptions through open interviews and drawings. The empirical material was fully transcribed and then organized and analyzed by the phenomenological method. The results revealed two themes: (1 Living experiences that bring happiness and well-being, and (2 Living experiences that cause suffering. This phenomenological study showed the experience of women with gestational diabetes mellitus, thus enabling to plan and to implement intervention programs based on a participatory model of health in order to prioritize the subjective aspects involved in high-risk pregnancy.
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Full Text Available Abstract Background Physical activity may reduce the risk of adverse maternal outcomes, yet there are very few studies that have examined the correlates of exercise amongst obese women during pregnancy. We examined which relevant sociodemographic, obstetric, and health behaviour variables and pregnancy symptoms were associated with exercise in a small sample of obese pregnant women. Methods This was a secondary analysis using data from an exercise intervention for the prevention of gestational diabetes in obese pregnant women. Using the Pregnancy Physical Activity Questionnaire (PPAQ, 50 obese pregnant women were classified as "Exercisers" if they achieved ≥900 kcal/wk of exercise and "Non-Exercisers" if they did not meet this criterion. Analyses examined which relevant variables were associated with exercise status at 12, 20, 28 and 36 weeks gestation. Results Obese pregnant women with a history of miscarriage; who had children living at home; who had a lower pre-pregnancy weight; reported no nausea and vomiting; and who had no lower back pain, were those women who were most likely to have exercised in early pregnancy. Exercise in late pregnancy was most common among tertiary educated women. Conclusions Offering greater support to women from disadvantaged backgrounds and closely monitoring women who report persistent nausea and vomiting or lower back pain in early pregnancy may be important. The findings may be particularly useful for other interventions aimed at reducing or controlling weight gain in obese pregnant women.
Nnaji, G A; Ikechebelu, J I; Okafor, C I
To compare the prevalence of malaria parasitaemia and the mean parasite density in pregnant women at first antenatal visit with those of the control subjects at Nnamdi Azikiwe University Teaching Hospital, Nnewi. A case control prospective survey using a structured questionnaire to collect data from pregnant women attending antenatal clinic between 1 April and 30 September 2001 and matched controls at the GOPD during the same period. Peripheral blood smears were examined in 420 pregnant women at their first antenatal visit and 200 control subjects to compare the prevalence of malaria parasitaemia and mean parasite density in pregnant women and controls. The prevalence of parasitaemia was 79.3 percent (i.e. 333 of 420) for pregnant women and 31.5 percent (or 63 of 200) for the control. For both pregnant women and controls, an overall prevalence of 63.1 percent was observed. The study found the mean parasite density for the pregnant women to be 1978 +/- 1531 (Mean +/- SD), while that of the controls was 766 +/- 1923. This study demonstrates the higher prevalence of malaria parasitaemia and mean parasite density in pregnant women when compared with the matched controls.
Shields, Kristine E; Lyerly, Anne Drapkin
The lack of human data available to inform evidence-based treatment for illness during pregnancy has led to calls for greater inclusion of pregnant women in research, but the extent of their current representation is poorly characterized. Our objective was to measure the current exclusion of pregnant women from industry-sponsored clinical trials as a baseline for future comparison. We compiled data from studies enrolling women of childbearing potential posted on www.ClinicalTrials.gov between 1 October 2011 and 31 January 2012. The review was limited to open United States-based phase IV interventional studies sponsored by the pharmaceutical industry evaluating treatment of conditions that may be experienced by but are not limited to pregnant women and did not involve a medication classified as potentially teratogenic. If there was no mention of pregnancy in the inclusion or exclusion criteria, we contacted a study representative to confirm that pregnant women could be enrolled. Of 558 qualifying industry-sponsored studies, five (1%) were designed specifically for pregnant women. Of 367 phase IV clinical trials with verified inclusion and exclusion criteria, 348 (95%) excluded pregnant women and 19 (5%) did not. We found the exclusion of pregnant women from industry-sponsored clinical trials to be common practice. Moving beyond reflexive exclusion and developing thoughtful criteria for inclusion of pregnant women in clinical research would likely advance the evidence base to inform treatment decisions during pregnancy and lead to better health outcomes for women and children.
Full Text Available Introduction: One of the basic elements of a healthy lifestyle is regular physical activity. Nowadays, more and more women during pregnancy take up the topic of the impact of physical activity and diet on the child developing in the womb. The existence of birth schools allows you to prepare for delivery, obtain information on acceptable safe activity adapted to the health of the future mother and ways of rational nutrition. The silhouette of women during pregnancyis constantly changing. Literature often shows the subject of a decrease in self-esteem during this period, associated with hormonal changes, appearance, fatigue and limitation of time for self-development. In the literature, we find two different positions of women about the subject of physical activity during pregnancy. The first position speaks of virtually complete limitation of activity, the second is about taking minimal activity such as before pregnancy. The aim of the study: 1 What impact on physical well-being in pregnant women and postpartum is having, 2 Is there a relationship between physical activity and pregnancy? 3 Is there a relationship between physical activity and postpartum period?, 4 What is the most common motivation to undertake physical activity after delivery? Material and methods:57 women aged 18 to 47 participated in the study. The study used an original anonymous survey of 28 questions. The questions concerned, among others: pregnancy, postnatal period, physical activity during pregnancy and after delivery. Conclusions: Taking physical activity during pregnancy and after childbirth influences the increase of self-esteem and well-being of women. About 25% of women surveyed did not return to physical activity a year after delivery. The basic factors influencing the activity after childbirth are the desire to improve the appearance, well-being and return to fitness which they presented before delivery.
N. V. Shperling
Full Text Available Goal. To assess the efficacy and safety of Azelic (15% gel of azelaic acid for topical administration for the treatment of chloasma in pregnant women. Materials and methods. The study involved 28 pregnant women aged 18-36 (mean age: 24.7 with a normal course of pregnancy. The patients consulted a doctor in the spring, summer or fall complaining of focal skin hyperpigmentation on the face, chin and chest area. Ten patients (35.7% developed hyperpigmentation prior to their pregnancy and 18 women (64.3% - during the pregnancy. As of the consultation date, the pregnancy terms in all of the patients were 18-20 weeks. Chloasma was diagnosed by using dermatoscopy and skin examination with the Wood’s lamp. The patients were informed about the content and procedure of the study and gave their consent to take part in the study. Thin layers of Azelic (15% gel of azelaic acid for topical administration were applied to the hyperpigmented skin of the patients and gently rubbed twice a day (in the morning and evening as topical treatment for four months. The treatment results were assessed taking into consideration the patient’s subjective assessment, study group structure depending on the clinical efficacy, percentage of adverse events, and survey results based on the Dermatology Life Quality Index questionnaire. To reveal any potential general toxicological effects of the treatment, hepatic samples, total blood count and coagulogram results were analyzed as a part of obstetrical and gynecologic care for pregnant women. Key findings. Positive dynamics of the following characteristics was revealed: subjective assessment of treatment results by the patients, clinical efficacy of treatment and life quality index. Therapeutic results were observed as early as after one month but not later than three months after the treatment began. The therapeutic efficacy was recorded in 92.9-96.4% of all cases after four months of treatment: pigment spots disappeared or
Shimada, Mieko; Seki, Hiroyuki; Samejima, Michikazu; Hayase, Mako; Shirai, Fumie
In preeclampsia and gestational diabetes, the sympathetic nerves are activated, leading to disrupted sleep. Melatonin, which transmits information to regulate the sleep-wake rhythm and other such biorhythms, has been implicated in insulin resistance, antioxidant behaviors, and metabolic syndrome. In addition, its reduced secretion increases the risk of hypertension and diabetes. The aim of this study was to elucidate the features of melatonin secretion, sleep quality, and sleep-wake rhythms in pregnant women with complications. Fifty-eight pregnant women with pregnancy complications (hypertensive or glucose metabolic disorders) and 40 healthy pregnant women completed questionnaires, including sleep logs and the Pittsburgh Sleep Quality Index (PSQI), during the second to third trimesters. Their salivary melatonin levels were also measured. Pregnant women with complications had significantly lower morning (p melatonin values than healthy pregnant women. Pregnant women with complications also had significantly smaller melatonin amplitudes than healthy pregnant women (p melatonin secretion, and their values were lower throughout the day than healthy pregnant women.
Karanci, Gülsah; Yenal, Kerziban
The purpose of this study was to examine the breastfeeding knowledge of pregnant working women and explore factors that affected their knowledge. This Turkish study included 260 healthy, working women in the last trimester of pregnancy. Two separate questionnaires developed by the researcher were used to collect data. The average knowledge score of pregnant women respondents for all questions were 6.03 ± 2.99 (range: 0 to 14). Pregnant women had the least knowledge about duration of expressing breast milk (21.9%) and safe storage conditions for breast milk (27.2%). They knew the most about methods to express breast milk (87.3%) and features of containers used to store expressed milk (80%). Study results indicated that working pregnant women need better prenatal education to continue safe breastfeeding after returning to work. Occupational health nurses should inform working pregnant women about expression and storage of breast milk during prenatal education. Copyright 2014, SLACK Incorporated.
Hare, K J; Bonde, L; Svare, J A
circulating chemerin levels, which may act to reduce pregnancy-induced insulin resistance and prevent glucose intolerance. Women with gestational diabetes, however, have severely reduced chemerin levels that remain low after delivery, which may contribute to the insulin resistance, glucose intolerance......AIMS: To evaluate fasting and post-prandial serum chemerin levels in pregnant women with and without gestational diabetes, and again following delivery when normal glucose homeostasis is re-established. METHODS: Chemerin levels were measured in serum from nine women with gestational diabetes......, and from eight age- and BMI-matched pregnant women with normal glucose tolerance during two meal tests: in the third trimester and 3-4 months post partum. All women with gestational diabetes re-established normal glucose tolerance after delivery. RESULTS: Meal intake did not affect serum chemerin levels...
Jessica R. Gorman
Conclusions: Pregnant women and postpartum women who are breastfeeding could benefit from receiving information and recommendations specific to vaccination from their healthcare providers, with a focus on discussing known risks and benefits to the baby's health.
The primary aim of this study was to explore pregnant women`s knowledge ... A qualitative, exploratory approach was used. ... Trustworthiness was ensured by considering the criteria of credibility, dependability, applicability and transferability.
Vinter, Christina Anne; Tanvig, Mette Honnens; Damm, Peter
One third of the pregnant Danish women are overweight or obese. Maternal obesity is an independent risk factor for adverse maternal and foetal outcomes including infertility, miscarriage, congenital malformations, preeclampsia, gestational diabetes, complicated deliveries, caesarean section......, macrosomia and childhood obesity. This article reviews the effect of maternal obesity on obstetric and neonatal outcomes and provides recommendations for management of obesity in pregnancy....
Aim: The present study was carried out to assess the level of oral health knowledge, behavior, experience and sources of oral health knowledge among pregnant women attending Kyela district hospital. Study participants and Methods: This was a hospital based Cross-sectional study among 380 pregnant women attending ...
Objective: This study evaluates the oral health knowledge and practise among pregnant women in a Nigerian population. Consecutive pregnant women attending three tertiary level of care were recruited. An interviewer administered questionnaire was used to assessing socio-demographic variables, dental visiting habits, ...
for overweight pregnant women. Methods: The theory of social construction and the concept of governmentality are applied in a discourse analysis on the prevention of overweight among pregnant women in Denmark. This study draws on a documentary analysis of the discourse in central governmental documents...
Aim. To estimate the exposure to active and passive smoking of pregnant women in South Africa and to determine their knowledge and behaviour with regard to smoking during pregnancy. Methods. A questionnaire was completed by pregnant women attending antenatal services in four South African cities. Questions were ...
Objectives: To investigate Toxoplasma infection among pregnant women in relation to exposure to infection risk, age and pregnancy-related risk factors. Design and Methods: This cross-sectional study involved 294 pregnant women attending ante-natal clinic in Accra who consented to participate. Personal and Toxoplasma ...
Introduction: vitamin D insufficiency to pregnant women has been associated with a number of adverse consequences, and has been recognized as a public health concern. The aim of this study was to evaluate vitamin D status of Morrocan pregnant women and their newborns. Our study is being the first of its kind in ...
Abstract. Background and objectives: The need to attain and maintain good oral hygiene among pregnant women cannot be over emphasized as periodontal diseases in pregnancy have been linked with poor pregnancy outcomes. This study assessed the variables that affect oral hygiene status among pregnant women in ...
van der Zande, I.S.E.
Background: There has always been a reluctance to include pregnant women in clinical research, due to a fear of harm to the foetus. At the same time, there is a need for evidence-based information on medications and treatments for pregnant women who are or become ill during their pregnancy, which
Syphilis and HIV infections among pregnant women attending antenatal clinics in Republic of Congo. ... Introduction: HIV and syphilis during pregnancy remain a public health concern especially in developing countries. Pregnant women ... Marital status and sentinel site location were a risk factor associated with. HIV and ...
Urinary tract infections are the first infections in pregnant women and can cause serious complications during pregnancy. In order to improve its management in low income country like Burkina Faso, we conducted a prospect cross-sectional study, to describe its epidemiological and biological aspects in pregnant women at ...
Krishna Bahadur Raut
Conclusions: Aanaemia is prevalent in pregnant women of PHCRC, chapagaun and there was a significant correlation between anaemia and worm infestation. However, the relation among the haemoglobin level, iron, folic acid and albendazole was not significant. Keywords: anaemia; infestation; pregnant women; worm. | PubMed
Schirm, Eric; Meijer, W.M.; Tobi, H; de Jong-van den Berg, Lolkje Theodora Wilhelmina
Objective: To describe drug use in pregnancy, and compare drug use of pregnant women with non-pregnant women with respect to possible teratogenicity. Study design: A cross-sectional study based on pharmacy records from 1997 to 2001 was performed. Pregnant women and matched non-pregnant women (same
Minkoff, Howard; Paltrow, Lynn M
At times, obstetricians are called upon to assist pregnant women in making clinical choices between options that may selectively disadvantage either the mother or the fetus. If a mother chooses a therapeutic course that disadvantages the fetus the physician may feel distressed. In this paper we argue that the choices made by mothers are almost always in the interests of the fetus, and supported by physicians. When there is disagreement it is often due to poor communication. While acknowledging that the rare circumstances in which the physician and patient wish to pursue different clinical paths can be stressful for the provider, we explain why obstetricians should accept the judgment of their patient in all instances. Finally, we will maintain that positing a choice between maternal and fetal interests is, in fact, creating a false choice, in as much as options are presented as being exclusive, when in fact that is not the case.
González, Raquel; Pons-Duran, Clara; Piqueras, Mireia; Aponte, John J; Ter Kuile, Feiko O; Menéndez, Clara
The World Health Organization recommends intermittent preventive treatment in pregnancy (IPTp) with sulfadoxine-pyrimethamine for malaria for all women who live in moderate to high malaria transmission areas in Africa. However, parasite resistance to sulfadoxine-pyrimethamine has been increasing steadily in some areas of the region. Moreover, HIV-infected women on cotrimoxazole prophylaxis cannot receive sulfadoxine-pyrimethamine because of potential drug interactions. Thus, there is an urgent need to identify alternative drugs for prevention of malaria in pregnancy. One such candidate is mefloquine. To assess the effects of mefloquine for preventing malaria in pregnant women, specifically, to evaluate:• the efficacy, safety, and tolerability of mefloquine for preventing malaria in pregnant women; and• the impact of HIV status, gravidity, and use of insecticide-treated nets on the effects of mefloquine. We searched the Cochrane Infectious Diseases Group Specialized Register, the Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library, MEDLINE, Embase, Latin American Caribbean Health Sciences Literature (LILACS), the Malaria in Pregnancy Library, and two trial registers up to 31 January 2018. In addition, we checked references and contacted study authors to identify additional studies, unpublished data, confidential reports, and raw data from published trials. Randomized and quasi-randomized controlled trials comparing mefloquine IPT or mefloquine prophylaxis against placebo, no treatment, or an alternative drug regimen. Two review authors independently screened all records identified by the search strategy, applied inclusion criteria, assessed risk of bias, and extracted data. We contacted trial authors to ask for additional information when required. Dichotomous outcomes were compared using risk ratios (RRs), count outcomes as incidence rate ratios (IRRs), and continuous outcomes using mean differences (MDs). We have presented all
Discussion of women, gender equality, and diabetes should be placed in the context of United Nations mandates on women's health which highlight the need for equal access to information, prevention activities, services, and care across the life cycle. Gender differences and inequalities have been identified in relation to causes and consequences of diabetes and access to services and support between women and men, and among different groups of women. Appropriate gender-sensitive policy responses, including research and data collection, need to be developed. The recent United Nations resolution on diabetes provides an opportunity to strengthen the focus on women and diabetes.
Dong, C X; Yin, S A
Improvement of the nutrition and health status of pregnant women should be one of the top priority strategies of improving the physical fitness of next generation and reserve of talented person for national sustainable development. This paper reviews the nutrition and health status of pregnant women in China over the recent ten years and discusses the underlying factors and changing trends. The most popular nutrition-related problem is dietary imbalance, and many micronutrient intakes are lower than the recommended dietary intakes or adequate intakes, and some of nutrient intakes are still at a very low level for a long time such as vitamin D and calcium. The nutrition-related health problems are mainly anemia, vitamin D and vitamin A deficiencies; iodine intake is not in optimal state with a large proportion of inadequate and individual cases facing excessive intake risk. Overweight and obesity, pregnancy complications such as gastrocnemius muscle spasms, pregnancy hypertensive disorders and gestational diabetes were prevalent among pregnant women. We should address both malnutrition and nutrition imbalance in the same time in order to improve the nutrition and health status of pregnant women, by developing and implementing relevant laws and regulations, giving higher attention to pregnant women with advanced age, which in turns prevent a variety of micronutrient deficiencies, reduce adverse pregnant outcomes, and improve nutrition and health status of maternal and child.
Willcox, Jane C.; Campbell, Karen J.; McCarthy, Elizabeth A.; Lappas, Martha; Ball, Kylie; Crawford, David; Shub, Alexis; Wilkinson, Shelley A.
Background Promoting healthy gestational weight gain (GWG) is important for preventing obstetric and perinatal morbidity, along with obesity in both mother and child. Provision of GWG guidelines by health professionals predicts women meeting GWG guidelines. Research concerning women?s GWG information sources is limited. This study assessed pregnant women?s sources of GWG information and how, where and which women seek GWG information. Methods Consecutive women (n?=?1032) received a mailed que...
Frederick Olusegun Akinbo
Full Text Available Background: Trichomonas vaginalis has been recognized as a cosmopolitan parasite of male and female genital tract. This study was conducted to determine the prevalence of asymptomatic trichomoniasis among pregnant women in Benin City, Edo State. Materials and Methods: A total of 300 patients and subjects consisting of 250 pregnant women attending antenatal clinics and 50 non-pregnant apparently healthy subjects who served as controls were recruited in this study. The age ranged from 20 to 40 years. High vaginal swab was collected from each participant and T. vaginalis was diagnosed by microscopy. Results: An overall prevalence of 2.8% of trichomoniasis was observed among pregnant women. Gestational age and educational status of pregnant women were significantly associated with the prevalence of trichomoniasis. Conclusion: Asymptomatic T. vaginalis infection is common in pregnancy. We recommend routine screening for this infection in order to reduce the potential adverse pregnancy outcomes.
Kuizon, M D; Natera, M G; Ancheta, L P; Platon, T P; Reyes, G D; Macapinlac, M P
The hemoglobin concentrations during pregnancy in Filipinos belonging to the upper income group, who were prescribed 105 mg elemental iron daily, and who had acceptable levels of transferrin saturation, were examined in an attempt to define normal levels. The hemoglobin concentrations for each trimester followed a Gaussian distribution. The hemoglobin values equal to the mean minus one standard deviation were 11.4 gm/dl for the first trimester and 10.4 gm/dl for the second and third trimesters. Using these values as the lower limits of normal, in one group of pregnant women the prevalence of anemia during the last two trimesters was found lower than that obtained when WHO levels for normal were used. Groups of women with hemoglobin of 10.4 to 10.9 gm/dl (classified anemic by WHO criteria but normal in the present study) and those with 11.0 gm/dl and above could not be distinguished on the basis of their serum ferritin levels nor on the degree of decrease in their hemoglobin concentration during pregnancy. Many subjects in both groups, however, had serum ferritin levels less than 12 ng/ml which indicate poor iron stores. It might be desirable in future studies to determine the hemoglobin cut-off point that will delineate subjects who are both non-anemic and adequate in iron stores using serum ferritin levels as criterion for the latter.
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Krubiner, Carleigh B; Faden, Ruth R; Cadigan, R Jean; Gilbert, Sappho Z; Henry, Leslie M; Little, Margaret O; Mastroianni, Anna C; Namey, Emily E; Sullivan, Kristen A; Lyerly, Anne D
Concerns about including pregnant women in research have led to a dearth of evidence to guide safe and effective treatment and prevention of HIV in pregnancy. To better understand why these evidence gaps persist and inform guidance for responsible inclusion of pregnant women in the HIV research agenda, we aimed to learn what HIV experts perceive as barriers and constraints to conducting this research. We conducted a series of group and one-on-one consultations with 62 HIV investigators and clinicians to elicit their views and experiences conducting HIV research involving pregnant women. Thematic analysis was used to identify priorities and perceived barriers to HIV research with pregnant women. Experts discussed a breadth of needed research, including safety, efficacy, and appropriate dosing of: newer antiretrovirals for pregnant women, emerging preventive strategies, and treatment for coinfections. Challenges to conducting research on pregnancy and HIV included ethical concerns, such as how to weigh risks and benefits in pregnancy; legal concerns, such as restrictive interpretations of current regulations and liability issues; financial and professional disincentives, including misaligned funder priorities and fear of reputational damage; and analytical and logistical complexities, such as challenges recruiting and retaining pregnant women to sufficiently power analyses. Investigators face numerous challenges to conducting needed HIV research with pregnant women. Advancing such research will require clearer guidance regarding ethical and legal uncertainties; incentives that encourage rather than discourage investigators to undertake such research; and a commitment to earlier development of safety and efficacy data through creative trial designs.
Reynaud, Quitterie; Poupon-Bourdy, Stéphanie; Rabilloud, Muriel; Al Mufti, Lina; Rousset Jablonski, Christine; Lemonnier, Lydie; Nove-Josserand, Raphaële; Touzet, Sandrine; Durieu, Isabelle
With increasing life expectancy, more women with cystic fibrosis and diabetes mellitus become pregnant. We investigated how pre-gestational diabetes (cystic fibrosis-related diabetes) influenced pregnancy outcome and the clinical status of these women. We analyzed all pregnancies reported to the French cystic fibrosis registry between 2001 and 2012, and compared forced expiratory volume (FEV 1 ) and body mass index before and after pregnancy in women with and without pre-gestational diabetes having a first delivery. A total 249 women delivered 314 infants. Among these, 189 women had a first delivery and 29 of these had pre-gestational diabetes. There was a trend towards a higher rate of assisted conception among diabetic women (53.8%) than non-diabetic women (34.5%, p = 0.06), and the rate of cesarean section was significantly higher in diabetic women (48% vs. 21.4%, p = 0.005). The rate of preterm birth and mean infant birthweight did not differ significantly between diabetic and non-diabetic women. Forced expiratory volume before pregnancy was significantly lower in the diabetic group. The decline in forced expiratory volume and body mass index following pregnancy did not differ between the women with and those without pre-gestational diabetes. Pre-gestational diabetes in women with cystic fibrosis is associated with a higher rate of cesarean section but does not seem to have a clinically significant impact on fetal growth or preterm delivery. The changes in maternal pulmonary and nutritional status following pregnancy in women with cystic fibrosis were not influenced by pre-gestational diabetes. © 2017 Nordic Federation of Societies of Obstetrics and Gynecology.
Hiro M. Obaid
Cytomegalovirus, Rubella and Toxoplasma are prevalent among pregnant women in Kirkuk city and probably they are the causative agents of abortion and infertility found among them, therefore it's better for pregnant woman or those planning to become pregnant to be tested for TORCH infections, and vaccinated against Rubella, Cytomegalovirus, Herpes simplex virus and Toxoplasma to grantee her health as well as her baby.
Nasri, Khadijeh; Razavi, Maryamsadat; Rezvanfar, Mohammad Reza; Mashhadi, Esmat; Chehrei, Ali; Mohammadbeigi, Abolfazl
Objective To investigate the relationship between mid-gestational serum uric acid and birth weight in diabetic pregnant women with or without insulin resistance. Methods: In a prospective cohort study, fasting uric acid, blood glucose, and serum insulin were measured in 247 pregnant women between 20-22 weeks of gestational period. Insulin resistance was estimated using the homeostasis model assessment-insulin resistance (HOMA-IR). Stratification analysis and independent t-test was used to ass...
Renault, Kristina M; Nørgaard, Kirsten; Nilas, Lisbeth
OBJECTIVE: The objective of the study was to assess physical activity intervention assessed by a pedometer with or without dietary intervention on gestational weight gain (GWG) in obese pregnant women by comparing with a control group. STUDY DESIGN: This study was a randomized controlled trial...... of 425 obese pregnant women comparing 3 groups: (1) PA plus D, physical activity and dietary intervention (n = 142); (2) PA, physical activity intervention (n = 142); and (3) C, a control group receiving standard care (n = 141). All participants routinely in gestational weeks 11-14 had an initial dietary......-up reduced GWG compared with controls in obese pregnant women....
Dufloth, Rozany Mucha; Vieira, Luiz Fernando Fonseca; Xavier Júnior, José Candido Caldeira; Vale, Diama Bhadra; Zeferino, Luiz Carlos
To compare the frequency of an ASCUS Pap Smear result in pregnant and non-pregnant women, stratified by age group. We analyzed the results of 1,336,180 cytopathologyc exams of Pap smears performed between 2000 and 2009 (ten years) with the purpose of screening for cervical carcinoma. Comparisons were made between pregnant and non-pregnant women, and the sample was stratified into three age groups (20-24, 25-29 and 30-34 years). The χ2 test was used and the magnitude of association was determined by the by Odds Ratio (OR) with the 95% confidence interval (95%CI). A Total of 447,489 samples were excluded on the basis of the criteria adopted, for a total final sample of 37,137 pregnant women and 851,554 non-pregnant women. An ASCUS result was detected in 1.2% of cases, with a significant difference between pregnant and non-pregnant women in the age groups of 20-24 years (OR=0.85; 95%CI 0.75-0.97) and 25-29 years (OR=0.78; 95%CI 0.63-0.96). There was no difference in the group between 30-34 years (OR=0.76; 95%CI 0.57-1.03). This study suggested that non-pregnant women have a higher frequency of ASCUS, most evident in the age group of 20 to 29 years. The collection of cervical cancer screening should not be a compulsory part of the prenatal routine.
whereas a control group of patients treated with insulin and/or diet had a perinatal mortality rate of 20%, the foetal loss in the sulphonylurea-treated patients was 50%. TABLE 1. RETROSPECTIVE ANALYSIS OF PERINATAL MORTALITY. IN 40 PREGNANT DIABETICS TREATED WITH SULPHONYLUREAS'. Durban series ...
María José Aguilar-Cordero
Full Text Available Introduction: The oral health of pregnant women depends on the knowledge, attitudes and behaviors learned prior to pregnancy. Research shows that the most frequent and specific problem encountered during this period, which continues during lactation, is gestational gingivitis, that is, inflammation of the gums. Therefore, the knowledge that the pregnant woman has about these alterations is essential, not only to prevent them, but for the consequences that can have during pregnancy, childbirth and postpartum. Aim: To analyze the main studies on the level of oral health knowledge of pregnant women. Method: The systematic review was performed according to the PRISMA guidelines. We have selected 18 studies that analyze the subject matter. Results: The studies reviewed did not present similar samples at the time of assessing the level of knowledge of the oral health of pregnant women. This can create problems comparing studies with each other. The issue addressed to measure the knowledge of pregnant women served to determine this discernment, and thus orient the research towards those aspects that presented difficulties. Conclusions: All of the studies reviewed show that the level of knowledge of pregnant women about their oral health is regular. This result that the surveys show, is not validated by a unified protocol, this means that there is no unanimity when verifying the knowledge of pregnant women, in relation to their oral health, as a health problem in general.
Full Text Available Introduction. Monitoring of the environmental differences in the mode of nutrition is especially important in pregnant women, for whom normal body weight gain is especially important for both the course of pregnancy and the normal development of the foetus, and is inseparably associated with rational nutrition. Objective. The objective of the study was evaluation of the mode of nutrition of pregnant women according to the place of residence. Materials and methods. The investigation comprised 704 women. Information was collected by means of an anonymous survey concerning place of residence, consumption of selected products and beverages, and taking folic acid and other vitamin and/or mineral dietary supplements. Results. In the urban environment, pregnant women more frequently consumed vegetables, milk and dairy products, sea fish and wholemeal cereal products, drank more liquids, as well as more fruit and/or vegetable juices, and more often used the supplementation with folic acid, even before becoming pregnant. No significant differences were found in the consumption of fruits, pulses, products which are the source of complete proteins, confectionery products and sweets, according to the place of residence. Conclusions. The diet of pregnant women from the rural environment compared to that of women from urban areas, was characterized by worse quality. It is necessary to carry out health education in the area of adequate nutrition among pregnant women, and those who plan pregnancy, directed primarily to all women from the rural environment.
As a pregnant woman, you may have questions about Zika. Learn more about what Zika is, what it means for pregnant women, and how you can protect your pregnancy. Created: 6/13/2016 by National Center on Birth Defects and Developmental Disabilities (NCBDDD). Date Released: 6/13/2016.
Objective: To assess the knowledge and use of herbal medicines among pregnant women attending the antenatal clinic at Kiryandongo general hospital. Design: A descriptive cross-sectional study. Setting: Kiryandongo general hospital in Masindi District, mid-western Uganda. Subjects: Four hundred (400) pregnant ...
Full Text Available Sleep problems are common complaints among pregnant women. This study was designed to compare subjective sleep problems in non-pregnancy condition, healthy and preeclamptic pregnancy as a major complication of pregnancy. We hypothesized that some sleep problems are more prevalent in females with preeclampsia.In this cross-sectional study, 102 women with preeclampsia, 106 healthy pregnant women in the third trimester and 103 healthy non-pregnant women were selected through random sampling. Age and parity were matched in the three groups. We used Global sleep assessment questionnaire (GSAQ to check the subjective sleep problems, and then we performed statistical analysis using Analysis of variance (ANOVA and Pearson Chi-square tests.Our findings revealed significant differences in initial insomnia (p = 0.034, fragmented sleep (p = 0.022, snoring (p<0.001, non-idiopathic insomnia (p = 0.045 and sadness and anxiety (p = 0.001 between the three groups. Some sleep problems were more common in preeclampctic compared to healthy pregnant women including initial insomnia, fragmented sleep, snoring, sleep apnea and non-idiopathic insomnia. Moreover, the subjects with preeclampsia revealed more fragmented sleep, snoring, sadness and anxiety and lack of getting enough sleep due to other activities compared to non-pregnant women.Different kinds of sleep problems can occur in subjects with preeclampsia in comparison with the non-pregnant and healthy pregnant subjects. Sleep problems should be evaluated during pregnancy, particularly in pregnant women with preeclampsia, and suitable treatment should be provided for any specific sleep problem.
Full Text Available The research goal is to study clinical and immunological features of parodentium and cytokine profile in oral cavity of pregnant women. The condition of parodentium tissues was studied at 200 women with physiological pregnancy and 300 women with pregnancy complicated by gestosis. According to the results of examination 50 women with gestosis and 50 women with physiological pregnancy had inflammatory periodontal diseases. Phenotyping of lymphocytes by immunofluorescence method, investigation of necrosis containing factor of tumour-a, interleukin-8, interleukin-4 and transforming growth factor beta-1 in oral cavity by immunofermental analysis were performed. Frequency and character of inflammatory periodontal diseases at pregnancy were defined. Correlation of gingivitis and periodontitis at pregnancy with extragenital pathology was demonstrated. Immune and cytokine disbalance contributed greatly to pathogenesis of inflammatory periodontal diseases at pregnant women. Thus pathogenesis of oral hygiene, smoking, gestosis, immunosuppression and cytokine disbalance affects inflammatory periodontal diseases at pregnant women
Renan Magalhães Montenegro Junior
Full Text Available Objetivo: avaliar a relação entre o uso de sulfoniluréias (SF por gestantes diabéticas seguidas na nossa clínica e as malformações (MF fetais detectadas. Métodos: estudamos, retrospectivamente, 35 gestantes diabéticas tipo 2, seguidas no Ambulatório de Pré-Natal Patológico do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, USP, no período de 1993-1995, das quais 22 encontravam-se em uso inadvertido de SF no 1º trimestre da gestação (grupo SF. Avaliamos a prevalência de MF e comparamos com as gestantes diabéticas que nesse período encontravam-se em uso de insulina ou apenas dieta (grupo C. Foram também analisadas outras variáveis: tempo de doença, idade, controle metabólico e seguimento pré-natal. Resultados: não houve diferença estatisticamente significativa entre os 2 grupos quanto a faixa etária, tempo de evolução do diabetes, controle metabólico ou precocidade do início do pré-natal, sendo a freqüência de MF semelhante nos 2 grupos (8,3% no grupo C e 13,6% no grupo SF. As malformações encontradas foram: no grupo SF - agenesia renal, hipoplasia pulmonar e gônadas em fita (paciente 1; membros curtos e pododáctilos de implantação anormal (paciente 2; fenda palatina, implantação baixa de orelhas, pescoço alado, prega palmar única e nariz em sela (paciente 3, e no grupo C - micrognatia, orelha displásica, polidactilia, imperfuração anal, hipospadia, comunicação inter-atrial e comunicação interventricular (paciente 4. Conclusões: esses dados não nos permitem atribuir as malformações encontradas no grupo SF ao uso de sulfoniluréias, embora nesse grupo tenham ocorrido alterações não usualmente descritas na embriopatia diabética.Purpose: to evaluate a possible relationship between fetal malformations (FM and the use of sulfonylureas (SF by diabetic pregnant women. Methods: we retrospectively studied 35 type 2 diabetic pregnant women followed at the Pathological Prenatal
Jacobsen, Jytte Lindskov; Jørgensen, Marit Eika
OBJECTIVES: To estimate the prevalence of gestational diabetes mellitus (GDM) among Greenlanders and to evaluate the quality of the current screening procedure for gestational diabetes. STUDY DESIGN: Observational retrospective study of consecutive birth-log data and medical records on pregnant....... However, only 54% of those women were screened. The prevalence of gestational diabetes was calculated to be 4.3% among high-risk Greenlandic pregnant women (2/46) (95% CI 0-10.0%). CONCLUSIONS: Despite a suboptimal screening rate, the prevalence of GDM among Greenlanders seems to be relatively low...... women who had given birth in Nuuk during 2008. METHODS: Information about maternal weight, weight gain in pregnancy, height, blood pressure, result of oral glucose tolerance test, family history of diabetes, smoking and alcohol habits, ethnicity, delivery and birth weight and length was collected...
Full Text Available Objectives: The level of dental awareness of a pregnant woman affects the sanitary condition of her own teeth and the health of the child to be born. Poor oral health is considered to be a probable risk factor for the pre-term birth or low birth weight. The aim of this work was to assess the level of oral health knowledge that determines oral health condition of pregnant women in Poland. Material and Methods: Empirical data were obtained from the National Monitoring of Oral Health and Its Determinants, financed by the Ministry of Health. This socio-epidemiological study assessed oral health status and dental health awareness, which affects that status. Study subjects included 1380 pregnant women at the age ranging from 15 to 44, randomly-selected from urban and rural environments. Dental health status was recorded in the clinical examination sheets supplied by the World Health Organization, and the socio-medical data were recorded in the questionnaire interview sheets. Results: Almost 3/4 of the pregnant women evaluated their dental health as unsatisfactory or poor. Over 60% of the pregnant women rated their knowledge and practical skills concerning care of their own teeth and of the child to be born as limited, inadequate or none. Only 40% of the pregnant women provided right answers to the questions about dental issues. Conclusions: Low oral health awareness results in poor oral health status of the study subjects. A statistical pregnant woman has a total of 13 teeth showing the symptoms of tooth decay or caries. Over 70% of the pregnant women developed gingivitis or periodontitis. There is an urgent need in Poland to make the European principle of treating pregnant women as a dentally vulnerable group obligatory.
Gaszyńska, Ewelina; Klepacz-Szewczyk, Justyna; Trafalska, Elżbieta; Garus-Pakowska, Anna; Szatko, Franciszek
The level of dental awareness of a pregnant woman affects the sanitary condition of her own teeth and the health of the child to be born. Poor oral health is considered to be a probable risk factor for the pre-term birth or low birth weight. The aim of this work was to assess the level of oral health knowledge that determines oral health condition of pregnant women in Poland. Empirical data were obtained from the National Monitoring of Oral Health and Its Determinants, financed by the Ministry of Health. This socio-epidemiological study assessed oral health status and dental health awareness, which affects that status. Study subjects included 1380 pregnant women at the age ranging from 15 to 44, randomly-selected from urban and rural environments. Dental health status was recorded in the clinical examination sheets supplied by the World Health Organization, and the socio-medical data were recorded in the questionnaire interview sheets. Almost 3/4 of the pregnant women evaluated their dental health as unsatisfactory or poor. Over 60% of the pregnant women rated their knowledge and practical skills concerning care of their own teeth and of the child to be born as limited, inadequate or none. Only 40% of the pregnant women provided right answers to the questions about dental issues. Low oral health awareness results in poor oral health status of the study subjects. A statistical pregnant woman has a total of 13 teeth showing the symptoms of tooth decay or caries. Over 70% of the pregnant women developed gingivitis or periodontitis. There is an urgent need in Poland to make the European principle of treating pregnant women as a dentally vulnerable group obligatory. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.
Full Text Available Introduction/Objective. “Cariogram” takes into account interactions between caries-related factors and expresses a graphic assessment of the caries risk. The aim of this study was to evaluate the relationship between caries risk and different variables of Cariogram in pregnant women. Methods. This study included 96 pregnant women. At baseline, data on general health, diet, oral hygiene, and fluoride exposure were obtained. DMFT (decayed, missing, and filled teeth index was calculated by clinical examination. Saliva analyses included mutans streptococci and lactobacilli counts, buffer capacity, and secretion rate. Scores were entered and caries risk was assessed. The women were divided into five groups according to their Cariogram caries risk. Results. The results of the study showed that 29.17% (28 of the pregnant women had high caries risk, 21.88% (21 – medium, 17.71% (17 – low, 16.67% (16 – very high, and 14.58% (14 – very low caries risk. In an average caries risk profile of pregnant women, the dominant sector was “Bacteria” (18.85% of the risk structure profile, followed by “Diet” (17.97%, “Circumstances” (15.68%, and “Susceptibility” sector (14.65%. Conclusion. Cariogram shows that pregnant women in Banja Luka, Bosnia and Herzegovina, had 46.14% chance of avoiding caries in the future. The Cariogram model can successfully determine caries risk profiles for pregnant women.
Cüneyt Eftal Taner; Seçil Kurtulmuş; Ümit Nayki; Ayşen Kızılyar; Yasemin Baskın
OBJECTIVE: To determine the effect of maternal body composition and triglyceride levels on newborn weight in nondiabetic women with positive diabetic screening. STUDY DESIGN : 40 pregnant women with positive diabetic screenings and negative glucose tolerance tests were enrolled as the study group. 72 pregnant women with negative diabetic screenings were enrolled as the control group. 50-gram glucose challenge tests were performed at 24-32 weeks of gestations and serum lipid levels were mea...
Parveen, N.; Munir, A.A.; Majeed, R.
To determine the frequency of vaginal candidiasis in clinically symptomatic and asymptomatic cases of pregnant women attending routine antenatal clinic. A total of 110 pregnant women were nonrandomly recruited by convenient sampling. The studied variables included the demographic data information on parity, trimester of pregnancy, presence of vaginal discharge and the presence or absence of diabetes. Vulva and vagina were inspected for signs of inflammation and discharge with sterile speculum and vaginal specimens were collected with sterile cotton tipped swabs. Swabs were subjected to Gram staining and examined microscopically for the diagnosis of candidiasis. The frequency of vaginal candidiasis during pregnancy was found to be 38%, in which 27% were symptomatic and 11% were asymptomatic group. Increased ratio of infection was observed in multigravida and diabetic women. There was no marked differences in results with respect to age and trimester of pregnancy. Although there is generally a high frequency of vaginal candidiasis, an increased ratio of vaginal candidiasis in multigravida and diabetic pregnant women requires these women to be routinely screened for vaginal candidiasis regardless of symptomatic status. (author)
Full Text Available All pregnant women need easy access to pregnancy-related personalized information, on-time quality healthcare services and effective communication links with healthcare providers. Smartphone-based devices, communication systems and eHealth applications can play an important role in facilitating some of these services to pregnant women in a fast and efficient way and can thus prevent most of the pregnancy-related complications. The objective of this work is to propose and design a pregnancy care network for pregnant women and healthcare providers. The network model, an eHealth application based on smartphone-based devices and communication systems, is designed to strengthen communication links between health professionals and pregnant women and increase education, awareness and quality of care during pregnancy and childbirth.
I. R. Gaisin
Full Text Available Aim. To assess the efficacy of specialized management of pregnant women with cardiovascular diseases (CVD in the Udmurt Republic (UR of Russia.Material and methods. In prospective and retrospective study we investigated pregnancy outcomes in all 17948 women in management system created for pregnant patients with CVD in the UR from 2000 to 2007. The system comprises specialized outpatient and inpatient departments and an obstetric hospital within the regional cardiological centre. Pregnant women had different CVD including hypertension, congenital and rheumatic heart disease, cardiac arrhythmias, noncoronary myocardial disease, disorders and autoimmune diseases of connective tissue, etc.Results. Perinatal mortality decreased by 41,1% from 11,2‰ in 2000 to 6,6‰ in 2007. During 8 years, no one woman died.Conclusion. The management system for pregnant women with CVD within the regional cardiological clinic makes it possible to reduce of maternal and perinatal mortality rates significantly.
Keyword: Prevalence, Malarial Parasite, Pregnant Women, Kano. INTRODUCTION ... protective semi-immunity against plasmodium falciparum is acquired during the first 10-. 15 years of life and .... hiding place for the mosquito? It is therefore ...
Dec 2, 2012 ... of pregnant women in General Hospital Kiru, Kiru. Local Government .... AACC, American Association for Clinical Chemistry,. 2012. ... Animal. Reproductive Science. 72: pp. 235. Das, S. C. and Isechei, U. P. (1996). Serum ...
Malaria is still a major health problem during pregnancy in Ihiala Local Government Area ... Knowledge, attitude and practices (KAP) of pregnant women on malaria, ... Oral interviews and observations were used to retrieve information from the ...
making, and practices among HIV-positive pregnant women attending antenatal clinic at ... HIV/AIDS continues to be a major public health challenge, as it directly and ..... Community groups conduct nutrition education for HIV- positive people.
Oct 4, 2013 ... Key words: Enugu, falls, Nigeria, pregnant women, prevalence, risk factors .... in which someone is paid some wages (salary) at specific intervals, for example .... initiated the process of filling the existing gap on falls during.
Prevalence of Hepatitis B surface antigen among pregnant women attending antenatal ... Majigo Mtebe, Nyambura Moremi, Jeremiah Seni, Stephen E. Mshana. Abstract. In developing countries there is no routine screening of hepatitis B virus ...
Sep 1, 2014 ... Subjects: Four hundred and seventeen (417) pregnant women attending antenatal care ... convenience of opening hours at ANC facility, commuting distance from home to ... identifying maternal education, employment, age,.
Perceived stress and anxiety among Ghanaian pregnant women. ... Abstract. The aim of the study was to assess the prevalence of stress and anxiety, as well as the association that exists between stress/anxiety and ... from 32 Countries:.
bacterial infections in the elderly but also the most common and ... For pregnant women, urinary tract infection is the most common ... causing arthropathy in children. Urinary tract ... resistance in our environment, resistance such as β-. Urinary ...
Decline in the prevalence HIV among pregnant women attending antenatal clinics in Tanzania, 2001-2011. ... Journal Home > Vol 19, No 2 (2017) > ... as age, marital status, parity, education level and duration of stay at present residence.
Perinatal outcomes in pregnant women presenting with preterm premature rupture of membranes at a ... Journal Home > Vol 23, No 2 (2017) > ... in sepsis rates, the need for ventilation and the duration of hospital stay between the two groups.
Buchanan House, Glasgow Caledonian University Email: Caroline. ... exploratory qualitative study was carried out to identify pregnant women in a rural Niger Delta community's perceptions of ..... sometimes you stay for the whole day.
used to manage anaemia and for child development and good health among the pregnant women. ... Keywords: Medicinal Plants, Antenatal, Traditional Birth Attendants, Uganda. Résumé ..... phenomenon, possibly due to their availability and.
Goñi, L; Cuervo, M; Santiago, S; Zazpe, I; Martínez, J A
Maintaining an adequate health status and appropriate lifestyles during pregnancy is of great importance to prevent adverse outcomes for both mother and baby. The present study aimed to assess the nutritional status, socio-demographic features, lifestyle behaviors and dietary habits of pregnant women in Spain, and to identify the influence of parity on these profiles. This cross-sectional study included pregnant women from regions all over Spain. The information was collected through a 40 item questionnaire, previously validated by community health professionals. The 5,087 pregnant women analyzed had an average age of 31.9 years with an adequate nutritional status. The distribution of the sample was 56% nulliparous and 44% multiparous. The nulliparous reported a better self-perceived health status and nutritional balance, and a lower incidence of gestational diabetes mellitus. However, the multiparous showed healthier lifestyle habits (lower rates of smoking and alcohol consumption) and more physically active patterns. Regarding diet, nulliparous pregnant women consumed more dairy products, fresh fruit and nuts, and less bread, rice/pasta/potatoes, meat, sausage and buns/pastries than multiparous pregnant women. Differences between analyzed patterns were observed in anthropometrical variables, lifestyle behaviors and dietary habits, which may require different nutritional messages to nulliparous as compared to multiparous from a public health point of view.
Chad A Grotegut
Full Text Available The number of women aged 45 and older who become pregnant is increasing. The objective of this study was to estimate the risk of medical and obstetric complications among women aged 45 and older.The Nationwide Inpatient Sample was used to identify pregnant woman during admission for delivery. Deliveries were identified using International Classification of Diseases, Ninth Revision (ICD-9-CM codes. Using ICD-9-CM codes, pre-existing medical conditions and medical and obstetric complications were identified in women at the time of delivery and were compared for women aged 45 years and older to women under age 35. Outcomes among women aged 35-44 were also compared to women under age 35 to determine if women in this group demonstrated intermediate risk between the older and younger groups. Logistic regression analyses were used to calculate odds ratios with 95% confidence intervals for pre-existing medical conditions and medical and obstetric complications for both older groups relative to women under 35. Multivariable logistic regression analyses were also developed for outcomes at delivery among older women, while controlling for pre-existing medical conditions, multiple gestation, and insurance status, to determine the effect of age on the studied outcomes.Women aged 45 and older had higher adjusted odds for death, transfusion, myocardial infarction/ischemia, cardiac arrest, acute heart failure, pulmonary embolism, deep vein thrombosis, acute renal failure, cesarean delivery, gestational diabetes, fetal demise, fetal chromosomal anomaly, and placenta previa compared to women under 35.Pregnant women aged 45 and older experience significantly more medical and obstetric complications and are more likely to die at the time of a delivery than women under age 35, though the absolute risks are low and these events are rare. Further research is needed to determine what associated factors among pregnant women aged 45 and older may contribute to these
Giurgescu, Carmen; Zenk, Shannon N; Engeland, Christopher G; Garfield, Lindsey; Templin, Thomas N
African American women are more likely to be exposed to racial discrimination and to experience psychological distress compared with white women. Although studies have shown that social support is positively related to psychological wellbeing, little is known about the potential buffering effect of social support on the relationship between racial discrimination and psychological wellbeing of pregnant women. The purpose of this study was to determine if social support moderates effects of racial discrimination on psychological wellbeing among pregnant African American women. Using a cross-sectional design, 107 African American women between 15 and 26 weeks gestation from an urban university-based midwifery practice completed questionnaires. Women who reported more experiences of racial discrimination also reported lower levels of social support and psychological wellbeing (p discrimination have negative effects on psychological wellbeing of pregnant African American women regardless of their levels of social support. However, social support can reduce psychological distress and improve wellbeing of pregnant women. Therefore, nurses need to provide pregnant women with positive and supportive experiences that may improve their psychological wellbeing.
Occupational health physicians often face the problem of whether to keep pregnant women at work in hospitals where they risk exposure to ionizing radiation. Current legislation requires that doctors ensure a certain level of safety for the embryo and the fetus. The current rules are unsatisfactory, however, because women are not obliged to declare that they are pregnant until the third month, which is one month past the period when he fetus is most sensitive to ionizing radiation. (author). 15 refs
Flynn, Angela C; Dalrymple, Kathryn; Barr, Suzanne
: A systematic review of the literature, consistent with PRISMA guidelines, was performed as part of the International Weight Management in Pregnancy collaboration. STUDY SELECTION: Thirteen randomized controlled trials, which aimed to modify diet and physical activity in overweight and obese pregnant women...... gestational weight gain. CONCLUSION: This review reveals large methodological variability in dietary interventions to control gestational weight gain and improve clinical outcomes in overweight and obese pregnant women. This lack of consensus limits the ability to develop clinical guidelines and apply...
Shah, Megha K.; Kieffer, Edith C.; Choi, Hwajung; Schumann, Christina; Heisler, Michele
Background. Pregnancy is an opportune time to initiate diabetes prevention strategies for minority and underserved women, using culturally tailored interventions delivered by community health workers. A community-partnered randomized controlled trial (RCT) with pregnant Latino women resulted in significantly improved vegetable, fiber, added sugar,…
Nasir, J.A.; Zaidi, S.A.A.
Vitamin D deficiency is an emerging health concern around the world, highly prevalent in south Asian population, despite abundant sunlight. In Pakistan, all age groups are vulnerable to Vitamin D deficiency including pregnant women. This systematic review aimed to determine the pattern of Vitamin D deficiency among Pakistani pregnant women as well as exploring the causes and possible interventions that have had a substantial effect on improving the vitamin D level. Three databases (PubMed, Pub Get and Google Scholar), for the present review up to 2016, were used for the identification of published peer reviewed original relevant studies regarding Vitamin D deficiency among Pakistani pregnant women with the keywords Vitamin D or 25-hydroxyvitamin D or 25(OH)D in combination with pregnant women. Five studies were included for the final analysis. Vitamin D deficiency was common and highly prevalent among Pakistani pregnant women and their neonates. The main reasons for this were found to be avoiding sun exposure, quality of diet, and lower intake of calcium. Maternal vitamin D supplementation was found to be a key intervention to improve the maternal and neonatal vitamin D status. These review findings can be emerging in ensuring the adequate vitamin D level for Pakistani pregnant women during pregnancy, ultimately to achieve positive maternal and neonate's health outcomes. (author)
Fazzi, Caterina; Mohd-Shukri, Nor; Denison, Fiona C; Saunders, David H; Norman, Jane E; Reynolds, Rebecca M
Interventions to increase physical activity in pregnancy are challenging for morbidly obese women. Targeting sedentary behaviours may be a suitable alternative to increase energy expenditure. We aimed to determine total energy expenditure, and energy expended in sedentary activities in morbidly obese and lean pregnant women. We administered the Pregnancy Physical Activity Questionnaire PPAQ (non-objective) and the Actical accelerometer (objective) to morbidly obese (BMI≥40kg/m²) and lean (BMI≤25Kg/M²) pregnant women recruited in early (lean pregnant women. No differences were observed in the proportion of energy expended sedentary between lean and morbidly obese pregnant women. The greater total energy expenditure in morbidly obese pregnant women was corroborated by Actical accelerometer in early (n=14 per group, obese 1167.7 (313.6) Kcal; lean 781.1 (210.1) Kcal, plean 893.7 (175.9) Kcal, plean pregnant. Further studies are needed to determine whether sedentary behaviours are a suitable target for intervention in morbidly obese pregnancy. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
Y. Y. Nikulina
Full Text Available The biological properties of the vaginosis pathogens isolated from 255 pregnant patients of the Pregnancy Pathology Department of the Mechnikov Dnipropetrovsk Region Clinical Hospital were studied. It was found that all investigated microflora was represented by the Candida yeasts, Trichomonas vaginalis, Toxoplasma gondii, Chlamidia trachomatis, Gardnerella vaginalis and Leptotrix vaginalis. The yeasts of genus Candida were the most common isolated pathogens of the vaginosis in pregnant women. The presence of Candida sp., Trichomonas vaginalis, Chlamidia trachomatis and Toxoplasma gondii in the vaginal smears taken from pregnant women was accompanied by changes of the immunity cell parameters and concentration of circulating immune complexes.
Clerico, A.; Del Chicca, M.G.; Balzan, S.; Strigini, F.; Melis, G.B.; Fruzzetti, F.; Bernardini, G.; Fioretti, P.
Elevated plasma levels of an endogenous factor with digoxin-like immunoreactivity (DLIS) was recently found in pregnant women, and it has been postulated to play a role in the regulation of fluids and electrolytes, as well as in the pathogenesis of hypertensive disorders in pregnancy. The authors have studied the plasma levels of DLIS in normal women (before and after treatment with contraceptive pills) and in pregnant women (either normotensive or hypertensive), during the gestional and the post-partum period using a sensitive RIA method. In addition, the authors have measured the inhibition of binding activity of 3 H-ouabain to intact erythrocytes in 7 plasma samples collected from healthy adults and in 5 plasma samples of women in the second or third trimester of pregnancy. In 8 normal cycling women DLIS levels were similar during the follicular phase (24.9±6.2 pg/ml d.e.) and the luteal phase (22.6±4.7 pg/ml d.e.9. Six months treatment with different preparations of contraceptive pills did not affect the concentrations of DLIS. In a cross-sectional study performed on 171 healthy pregnant women a significant increase (p 3 Houbain extracts of pregnant women as compared to normal adults, with a significant correlation between the data obtained with RIA and RRA method. On the other hand, no significant differences in DLIS levels were found between singleton and 9 twin pregnancies, and also between non-hypertensive and 8 hypertensive pregnant women. This data confirm that the plasma concentration of an endogenous factor (or a group of substances) with cardiac glycoside-like activity is significantly increased in pregnant women. However, further studies are necessary to well charcterize the possible role of DLIS in the pathphysiology of hypertension in pregnancy
Meng, Qinghong; Luo, Jie; Li, Lijun; Shi, Wei; Yu, Jinqian; Shen, Yingjie; Li, Li; Wang, Yajuan; Yao, Kaihu
Rubella infection in pregnant women can result in serious effects, such as miscarriages, stillbirths, and congenital rubella syndrome (CRS). However, very little is known about the rubella seroprevalence among pregnant women in China. This is a cross-sectional and hospital-based study. From June 2016 through March 2017, a total of 324 serum samples from healthy pregnant women were collected in the Shunyi Women and Children's Hospital of Beijing Children's Hospital. Rubella-specific IgG antibody was determined by ELISA (Euroimmun, Lübeck, Germany) kits. International assigned cut-off values of ≥10 IU/ml were used to assess the percentage of pregnant women with protective IgG concentrations. The total rate of protected individuals was 83.3% (95% CI: 78.9%-87.0%). The protective rates of pregnant women in 17-26 years group, 27-36 years group and 37-46 years group were 84.0% (95% CI: 75.3%-90.1%), 81.9% (95% CI: 74.9%-87.4%) and 84.9% (95% CI: 75.8%-90.9%) respectively. No significant difference in protective rates among the three age groups was found (P = 0.83). There were also no statistically significant correlations between protective rates and gravidity (P = 0.84), parity (P = 0.84), birth place (P = 0.16), residence area (P = 0.58), education (P = 0.40) or occupation (P = 0.65). Despite the generally low vaccination coverage for rubella, most of Chinese pregnant women had potent rubella immunity. However, at least 16.7% of pregnant women were susceptible to rubella, which suggested rubella immunization in Chinese women at or before child-bearing age.
M. P. Kostinov
Full Text Available Recent epidemiological events showed that pregnant women are the most vulnerable part of population if there is the flu in the country and they die much more often than the rest part of people. That is why influenza vaccination of population including pregnant women is one of the priorities of public health service in our state. Worldwide experience of influenza vaccination of either adults or children by new adjuvant vaccine has caused our research of its efficiency among pregnant women. The aim of the study was to investigate the level of antibodies to influenza virus strain A/H1N1/v, A/H3N2 and B in pregnant women vaccinated adjuvant trivalent subunit vaccine. Our research is randomized and comparative on parallel groups. It was carried out within the demands of Russian Federation and International ethic norms adapted to such kind of researches. Evaluation of the immunogenicity of the vaccine was conducted in 27 pregnant women in the II trimester of gestation, and in 23 pregnant women in the III trimester of gestation, 19 non-pregnant women was in the control group. The level of antibodies in the serum was determined using a reaction of hemagglutination inhibition before and 1, 3, 6, 9 and 12 months after the vaccination. Revealed that influenza vaccination of pregnant women in the II and III trimester, causes the increase in titers of antibodies to vaccine influenza strains A and B, to fully meet the required criteria CPMP, and does not differ from the nonpregnant group. In a month after vaccination the level of seroprotective against A/H1N1/v was 77.0%, A/H3N2 — 88.9%, B — 85.2% after vaccination in II trimester, and 87.0; 87.0; 91.35% in III trimester of gestation. The factor of seroconversion after vaccination in II trimester for A/H1N1/v was equal to 6.5, A/H3N2 — 7.2, B — 6.5, after vaccination in III trimester of pregnancy: 7.1, 6.5 and 5.1 correspondingly. At the same time revealed accelerated decline in antibody titer against
V. N. Trubilin
Full Text Available Ophthalmologist consultation has an important role in the examination of pregnant women. In some cases, his conclusion can play a decisive role in choice of delivery method. Obstetricians-gynecologists rely on ophthalmologist opinion for determining the severity of preeclampsia; it affects the treatment tactics and the life of mother and child. Examination of a pregnant woman has a number of characteristics, with regard to them, 3 groups of patients, which can be identified: the first group — Physiological pregnancywithout ophthalmological pathology. The second group: Physiological pregnancy with eye pathology in the anamnesis: myopia, peripheral choriovitreoretinal dystrophy; retinal detachment, vitreous body, vascular membrane, etc. Third group — Pathologically flowing pregnancy with pathology resulting from pregnancy: pre-eclampsia, anemia, diabetes and others pregnant. In physiological pregnancy without ophthalmological pathology, the most common physiological changes are increased pigmentation around the eyes, ptosis, a decrease of conjunctival capillaries, changes of cornea sensitivity and thickness, and, consequently, a change in refraction with a myopic shift, a decrease of tolerance to contact lenses, a decrease intraocular pressure, hemeralopia. It is necessary to differentiate the physiological feature of pregnancy, which include, in particular, the shift of refraction to the myopia, from pathological manifestations such as retinal angiopathy, macular edema, central serous chorioretinopathy and others. An important aspect is the identification of potentially dangerous conditions of laser retina coagulation no later than 34 weeks of gestation with considering thepossibility of rheumatogenic retinal detachment and dystrophic changes in the delivery. This procedure can allow avoiding operativedelivery in the second group of patients. Timely detection of angiospasm on fundus in patients with pre-eclampsia from the third
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Nielsen, Lene Ringholm; Pedersen-Bjergaard, U; Thorsteinsson, B
Diabet. Med. 29, 558-566 (2012) ABSTRACT: Aims To explore incidence, risk factors, possible pathophysiological factors and clinical management of hypoglycaemia during pregnancy in women with Type 1 diabetes. Methods Literature review. Results In women with Type 1 diabetes, severe hypoglycaemia......% of the pregnant women account for 60% of all recorded events. Risk factors for severe hypoglycaemia during pregnancy include a history with severe hypoglycaemia in the year preceding pregnancy, impaired hypoglycaemia awareness, long duration of diabetes, low HbA(1c) in early pregnancy, fluctuating plasma glucose...... should have high priority among clinicians with the persistent aim of improving pregnancy outcome among women with Type 1 diabetes. Pre-conception counselling, carbohydrate counting, use of insulin analogues, continuous subcutaneous insulin infusion (insulin pump) therapy and real-time continuous glucose...
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Emília de Carvalho Coutinho
Full Text Available This study aimed to assess the care received and the barriers faced by immigrants and Portuguese pregnant women in Portugal. This is an exploratory qualitative study, resorting to applying semi-structured interviews to 60 immigrant and 22 Portuguese women. Content analysis supported by QSR Nvivo10 program was used. The study was approved by an Ethics Committee. The results showed four categories related to affective dimensions-relational, cognitive, technical-instrumental and health care policy for pregnant women. As for the barriers in health care, these were mentioned by some of the expectant mothers, especially immigrant women. Almost all, both immigrant and Portuguese, pregnant women were satisfied with the health care.
Full Text Available Background/aim: Ureaplasma urealyticum, a common commensal of the female lower genital tract, has been observed as an important opportunistic pathogen during pregnancy. The aims of this study were to determine the degree of cervical colonization with U. urealyticum in pregnant women with risk pregnancy and in pregnant women with normal term delivery and to evaluate the correlation between high-density cervical U. urealyticum colonization and premature rupture of membranes (PROM as well. Methods. This research was conducted on the samples comprising 130 hospitalized pregnant women with threatening preterm delivery and premature rupture of membranes. The control group consisted of 39 pregnant women with term delivery without PROM. In addition to standard bacteriological examination and performing direct immunofluorescence test to detect Chlamydia trachomatis, cervical swabs were also examined for the presence of U. urealyticum and Mycoplasma hominis by commercially available Mycofast Evolution 2 test (International Microbio, France. Results. The number of findings with isolated high-density U. urealyticum in the target group was 69 (53.08%, while in the control group was 14 (35.90%. Premature rupture of membranes (PROM occurred in 43 (33.08% examinees: 29 were pPROM, and 14 were PROM. The finding of U.urealyticum ≥104 was determined in 25 (58.14% pregnant women with rupture, 17 were pPROM, and 8 were PROM. There was statistically significant difference in the finding of high-density U. urealyticum between the pregnant women with PROM and the control group (χ² = 4.06, p < 0.05. U. urealyticum was predominant bacterial species found in 62.79% of isolates in the PROM cases, while in 32.56% it was isolated alone. Among the 49 pregnant women with preterm delivery, pPROM occurred in 29 (59.18% examinees, and in 70.83% of pregnant women with findings of high-density U. urealyticum pPROM was observed. Conclusion. Cervical colonization with U
Gardella, Barbara; Roccio, Marianna; Maccabruni, Anna; Mariani, Bianca; Panzeri, Lucia; Zara, Francesca; Spinillo, Arsenio
The purpose of this study was to evaluate the presence of HIV-1 in cervico-vaginal secretions of pregnant as compared to non-pregnant HIV-seropositive women. We compared 43 known HIV seropositive pregnant patients versus 241 age-matched (± 2 years) control non-pregnant HIV-seropositive subjects. In pregnant patients blood and cervico-vaginal samples were obtained during each trimester of pregnancy. In control subjects the same samples were obtained at enrolment. HIV-1 RNA was measured in plasma; proviral HIV-1 DNA, cell-associated and cell-free HIV-1 RNA in cervico-vaginal secretion by competitive polymerase chain reaction (cRT-PCR) and reverse transcriptase PCR. The genital shedding of HIV-DNA (22/43 as compared to 79/241, p = 0.02), and cell-free HIV-RNA detection (26/43 as compared to 72/241, p pregnant than in non pregnant women. Pregnancy correlated with a significant positive trend in the cervico-vaginal load of HIV-DNA (Spearman Rho= 0.149, p= 0.012), and cell-free HIV-RNA (Spearman Rho= 0.253, p HIV-RNA transcripts (Spearman Rho = 0.06, p= 0.31). After correction for potential confounders, first trimester pregnant women had increased rates of genital HIV- DNA (odds ratio = 1.94, 95% confidence interval = 1.01 3.78) and cell-free HIV-RNA (odds ratio = 4.07, 95% confidence interval = 1.97 8.41) detection compared to nonpregnant controls. The shedding of genital HIV was increased in pregnant compared to non pregnant subjects, even in patients with undetectable viremia. In this low-risk HIV-positive population the risks of vertical or horizontal transmissions should not be underestimated.
Diabetes gestacional na perspectiva de mulheres grávidas hospitalizadas Diabetes gestacional desde la perspectiva de mujeres embarazadas hospitalizadas Gestational diabetes from the perspective of hospitalized pregnant women
Márcio Flávio Moura Araújo; Sarah Maria Fraxe Pessoa; Marta Maria Coelho Damasceno; Maria Lúcia Zanetti
Estudo qualitativo fenomenológico, que teve como objetivo compreender o significado das experiências vivenciadas por mulheres com diabetes mellitus gestacional. Participaram 12 pacientes internadas em uma maternidade de Fortaleza-CE, Brasil, que manifestaram seus sentimentos e percepções por meio de entrevista aberta e desenhos. O material empírico foi transcrito na íntegra e, posteriormente, organizado e analisado pelo método fenomenológico. Os resultados evidenciaram dois temas: (1) Vivenci...
Nguyen, Hang Thanh; Pandolfini, Chiara; Chiodini, Peter; Bonati, Maurizio
Tuberculosis (TB) during pregnancy may lead to severe consequences affecting both mother and child. Prenatal care could be a very good opportunity for TB care, especially for women who have limited access to health services. The aim of this review was to gather and evaluate studies on TB care for pregnant women. We used a combination of the terms "tuberculosis" and "pregnancy", limited to human, to search for published articles. Studies reflecting original data and focusing on TB care for pregnant women were included. All references retrieved were collected using the Reference Manager software (Version 11). Thirty five studies were selected for review and their data showed that diagnosis was often delayed because TB symptoms during pregnancy were not typical. TB prophylaxis and anti-TB therapy appeared to be safe and effective for pregnant women and their babies when suitable follow up and early initiation were present, but the compliance rate to TB prophylaxis is still low due to lack of follow up and referral services. TB care practices in the reviewed studies were in line in principle with the WHO International Standards for Tuberculosis Care (ISTC). Integration of TB care within prenatal care would improve TB diagnosis and treatment for pregnant women. To improve the quality of TB care, it is necessary to develop national level guidelines based on the ISTC with detailed guidelines for pregnant women.
Vanessa Marcon de Oliveira
Full Text Available Abstract Objectives: to determine the frequency of serum markers for hereditary and acquired thrombophilia and their association with pregnancy in women with Systemic Lupus Erythematosus (SLE. Methods: a case-control study was conducted among 25 pregnant women with SLE (study group and 32 pregnant women without known disease and with at least one previous pregnancy (control group. The presence of antiphospholipid antibodies and hereditary thrombophilia were examined in both groups. We used the y2 Test with Yates correction or Fisher's Exact Test to verify the associations and calculate the relative risk. Results: thrombophilia was present in 72.0% of pregnant women with SLE and in 6.0% of patients in the control group. A significant association was found between the presence of SLE and serum markers for hereditary thrombophilia / antiphospholipid antibodies (p<0.05. The relative risks for antiphospholipid antibodies were 13.20 (ICR95%= 1.81 - 96.46 in pregnant women with SLE, 7.26 (CI95%= 1.77 - 29.86 for the presence of serum markers of hereditary thrombophilia and 7.92 (CI95%= 2.62 - 3.94 for the presence of hereditary thrombophilia and/or antiphospholipid antibodies. Conclusions: the identification of markers for hereditary and/or acquired thrombophilia in pregnant women with lupus may be clinically useful to determine which patients have a higher risk of obstetric complications.
A. A. Volynkin
Full Text Available Objective: to investigate emotional disturbances in pregnant women with sequels of brain injury (BI.Patients and methods. A total of 47 pregnant women with a history of BI, who had been admitted to the Department of Obstetric Physiology, Moscow Regional Research Institute of Obstetrics and Gynecology, in 2013-2015, were examined. All the patients underwent a comprehensive neurological and neuropsychological examination using the Miltidimensional Fatigue Inventory-20 (MFI-20, the Hospital Anxiety and Depression Scale (HADS, and the Spielberg-Hanin Situational and Personal Anxiety Scale.Results. The pregnant women with BI sequels were found to have emotional changes involving asthenic, anxiety, and depressive components. In these women, anxiety symptoms were most common (53.3%; psychoemotional disturbance and asthenic and depressive manifestations were identified in 23.4 and 14.9% of cases. This investigation first verified the structural (situational and personal components of post-traumatic anxiety syndrome in the pregnant women. It revealed that an increased level of situational anxiety and physical symptoms of fatigue was observed in brain concussion sequels; and after brain contusion (BC, alarm acquired personality traits, asthenia was of a mental nature. In the pregnant women with BI sequels, depression was diagnosed only at the subclinical level and more often noted after BC (p=0.0473.
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Butchon, Rukmanee; Liabsuetrakul, Tippawan; McNeil, Edward; Suchonwanich, Yolsilp
To determine the rates of births in adolescent pregnant women in diferent regions of Thailand and assess the rates of complications occurring at pregnancy, childbirth, and postpartum in women admitted in the hospitals ofThailand. The secondary analysis of data from pregnant women aged 10 to 49 years, who were admitted to hospitals and recorded in the National Health Security Office database between October 2010 and September 2011 was carried out. Adolescent birth rate by the regions and rate of complications ofpregnancy, delivery, and postpartum by age groups were analyzed. Highest birth rate was found among women aged 19 years (58.3 per 1, 000 population). The distribution of adolescent births varied across regions of Thailand, which was high in central region. Rate of preterm delivery was highest (10%) in adolescent aged 10 to 14 years. Rate of diabetes mellitus (6%), preeclampsia (4%), and postpartum hemorrhage (3%) among women aged 35 to 49 years were substantially higher than those among women aged 34 years or less. Adolescent birth rate varied across regions of Thailand. Complications occurred differently by ages of women. Holistic policy and planning strategies for proper prevention and management among pregnant women in different age groups are needed
Background and aims: Diabetes in pregnancy increases the risk of maternal and perinatal morbidity and mortality. The experience of diabetes during pregnancy may be a significant source of stress, both because of the impact of the illness and associated treatments on the expectant mother and because of concern about the impact on the unborn child. In order to examine stress associated with diabetes during pregnancy, we carried out a prospective study in women with pre-existing (Type 1 or Type 2) Diabetes (PDM), Gestational Diabetes Mellitus (GDM), and non-diabetic pregnant controls (NDM).\\r\
Objective: To determine the prevalence of hepatitis B virus (HBV) carrier and infectivity status among women delivering at Harare Maternity Hospital. Design: A serological survey study of pregnant women admitted for labour and delivery. Setting: Harare Maternity Hospital, Harare, Zimbabwe between June 1996 and June ...
A survey of pregnant and postnatal women, clinic attendees and maternity staff regarding the presence of birth companions during labour and delivery. ... Conclusion: The involvement of birth companions supporting women during childbirth could be promoted as a low cost preventive intervention to improve maternal and ...
98) and gentamicin 100% (98/98) for HbAS and HbAA women respectively. Conclusions: The prevalence of ASB in pregnant women with HbAS in Enugu, Nigeria was high and did not vary significantly from that of woman with HbAA.
Background: Anaemia in pregnancy remains a common problem affecting women in northern Nigeria. It is associated with several adverse consequences. Objective: The aim of this study was to determine the prevalence of anaemia and its associated factors among pregnant women in Koko/Besse local government area of ...
HIV infected women commenced on nevirapine-based regimen in the current pregnancy with CD4 counts up to. 3. 350 cells/mm at the University Teaching Hospital,. Lusaka, Zambia. Design: Longitudinal observational study with 2 arms. Group 1 (low CD4 count arm): HIV infected pregnant. 3 women with CD4 counts less ...
Full Text Available Introduction. Intestinal parasitic infections, especially due to helminths, increase anemia in pregnant women. The results of this are low pregnancy weight gain and IUGR, followed by LBW, with its associated greater risks of infection and higher perinatal mortality rates. For these reasons, in the setting of no large previous studies in Venezuela about this problem, a national multicentric study was conducted. Methods. Pregnant women from nine states were studied, a prenatal evaluation with a coproparasitological study. Univariated and multivariated analyses were made to determine risk factors for intestinal parasitosis and related anemia. Results. During 19 months, 1038 pregnant women were included and evaluated. Intestinal parasitosis was evidenced in 73.9%: A lumbricoides 57.0%, T trichiura 36.0%, G lamblia 14.1%, E hystolitica 12.0%, N americanus 8.1%, E vermicularis 6.3%, S stercoralis 3.3%. Relative risk for anemia in those women with intestinal parasitosis was 2.56 ( P<.01 . Discussion. Intestinal parasitoses could be associated with conditions for development of anemia at pregnancy. These features reflect the need of routine coproparasitological study among pregnant women in rural and endemic zones for intestinal parasites. Further therapeutic and prophylactic protocols are needed. Additional research on pregnant intestinal parasitic infection impact on newborn health is also considered.
Full Text Available To understand the prevalence of functional constipation in pregnant women and to analyze the impact of its risk factors.We searched hospital databases for women who were 37-41 weeks pregnant (1698 cases from July 2012 to January 2014 in four hospitals in Shanghai. We reviewed factors including general data, living and eating habits, psychological history, past history of defecation in the 6 months before pregnancy and defecation after pregnancy. Data were analyzed using SPSS software.Pregnant women who were more than 35 years old, with a pre-pregnancy body mass index >24, who were highly educated and employed in a sedentary occupation, showed a higher prevalence of functional constipation. Multivariate logistic regression analysis indicated that the prevalence of functional constipation among pregnant women was related to age, pre-pregnancy body mass index, diet, exercise, occupation, psychological factors, threatened abortion in early pregnancy and constipation history.The prevalence rate of functional constipation in pregnant women was significantly higher than in the general population.
Lívia de Castro Crivellenti
Full Text Available OBJECTIVE: To estimate food and dietary folate inadequacies in the diets of adult pregnant women. METHODS: A prospective study was conducted with 103 healthy pregnant adult users of the Public Health Care System of Ribeirão Preto, São Paulo, Brazil. The present study included the 82 women with complete food intake data during pregnancy, which were collected by three 24-hour dietary recalls. Food folate (folate naturally present in foods and dietary folate (food folate plus folate from fortified wheat flour and cornmeal inadequacies were determined, using the Estimated Average Requirement as cutoff. RESULTS: The diets of 100% and 94% of the pregnant women were inadequate in food folate and dietary folate, respectively. However, fortified foods increased the medium availability of the nutrient by 87%. CONCLUSION: The large number of pregnant women consuming low-folate diets was alarming. Nationwide population studies are needed to confirm the hypothesized high prevalence of low-folate diets among pregnant women.
Rodríguez-Morales, Alfonso J.; Barbella, Rosa A.; Case, Cynthia; Arria, Melissa; Ravelo, Marisela; Perez, Henry; Urdaneta, Oscar; Gervasio, Gloria; Rubio, Nestor; Maldonado, Andrea; Aguilera, Ymora; Viloria, Anna; Blanco, Juan J.; Colina, Magdary; Hernández, Elizabeth; Araujo, Elianet; Cabaniel, Gilberto; Benitez, Jesús; Rifakis, Pedro
Introduction. Intestinal parasitic infections, especially due to helminths, increase anemia in pregnant women. The results of this are low pregnancy weight gain and IUGR, followed by LBW, with its associated greater risks of infection and higher perinatal mortality rates. For these reasons, in the setting of no large previous studies in Venezuela about this problem, a national multicentric study was conducted. Methods. Pregnant women from nine states were studied, a prenatal evaluation with a coproparasitological study. Univariated and multivariated analyses were made to determine risk factors for intestinal parasitosis and related anemia. Results. During 19 months, 1038 pregnant women were included and evaluated. Intestinal parasitosis was evidenced in 73.9%: A lumbricoides 57.0%, T trichiura 36.0%, G lamblia 14.1%, E hystolitica 12.0%, N americanus 8.1%, E vermicularis 6.3%, S stercoralis 3.3%. Relative risk for anemia in those women with intestinal parasitosis was 2.56 (P Intestinal parasitoses could be associated with conditions for development of anemia at pregnancy. These features reflect the need of routine coproparasitological study among pregnant women in rural and endemic zones for intestinal parasites. Further therapeutic and prophylactic protocols are needed. Additional research on pregnant intestinal parasitic infection impact on newborn health is also considered. PMID:17093349
María José Aguilar-Cordero; Tania Rivero-Blanco; Norma Mur-Villar; Raquel Rodríguez-Blanque; María Dolores Moraleda-Hurtado; Luis Emilio Fernández-Curbero; Antonio Manuel Sánchez-López
Introduction: The oral health of pregnant women depends on the knowledge, attitudes and behaviors learned prior to pregnancy. Research shows that the most frequent and specific problem encountered during this period, which continues during lactation, is gestational gingivitis, that is, inflammation of the gums. Therefore, the knowledge that the pregnant woman has about these alterations is essential, not only to prevent them, but for the consequences that can have during pregnancy, childbirth...
Full Text Available Urinary system stones can be classified according to size, location, X-ray characteristics, aetiology of formation, composition, and risk of recurrence. Especially urolithiasis during pregnancy is a diagnostic and therapeutic challenge. In most cases, it becomes symptomatic in the second or third trimester. Diagnostic options in pregnant women are limited due to the possible teratogenic, carcinogenic, and mutagenic risk of foetal radiation exposure. Clinical management of a pregnant urolithiasis patient is complex and demands close collaboration between patient, obstetrician and urologist. We would like to review current diagnosis and treatment modalities of stone disease of pregnant woman.
M. L. Drewery
Full Text Available Background. The 2015–2020 Dietary Guidelines for Americans recommend that pregnant women and women of childbearing ages consume 8–12 oz. of seafood per week. Fish are the major dietary source of omega-3 long chain polyunsaturated fatty acids, which have benefits for the mother and fetus. Methods. In this observational study, we investigated dietary habits of pregnant women in Baton Rouge, Louisiana, USA, to determine if they achieve recommended seafood intake. A print survey, which included commonly consumed foods from protein sources (beef, chicken, pork, and fish, was completed by pregnant women at a single-day hospital convention for expecting families in October 2015. Women (n=221 chose from six predefined responses to answer how frequently they were consuming each food. Results. Chicken was consumed most frequently (75% of women, followed by beef (71%, pork (65%, and fish (22%, respectively. Consumption frequency for the most consumed fish (catfish, once per month was similar to or lower than that of the least consumed beef, chicken, and pork foods. Consumption frequency for the most consumed chicken and beef foods was at least once per week. Conclusion. Our data indicate that pregnant women in Louisiana often consume protein sources other than fish and likely fail to meet dietary seafood recommendations.
Mbule, Marjorie A; Byaruhanga, Yusuf B; Kabahenda, Magaret; Lubowa, Abdulrahman
In spite of intervention efforts, in Uganda, as in other developing countries, high levels of anaemia among pregnant women continue. Anaemia among women of reproductive age (15-49 years) is a matter of national concern. This study was carried out to assess determinants of anaemia in Kiboga district. This was a single cross-sectional, descriptive survey. The anaemia status of the pregnant women was determined by measuring their haemoglobin levels. Possible determinant factors including socio-economic characteristics, knowledge, attitudes, practices and food intake were assessed using a structured questionnaire. Results showed that the prevalence of anaemia among pregnant women in Kiboga district was high enough (63.1%) to be described as a severe public health problem. The uptake and utilisation of the public-health intervention package to combat anaemia in pregnancy was low, with iron/folic acid supplementation at 13.2%, use of intermittent preventive treatment of malaria 45.4%, and use of de-worming medicines 14.5%. Women from households without a functional radio were 2.07 times more likely be anaemic (95%CI, 1.08-3.00) compared with women from households where there was a functional radio. There was little awareness and functional knowledge about anaemia among pregnant women. The high prevalence of anaemia observed in Kiboga district can be attributed to poverty and limited access to nutrition and health education information which lead to low uptake and utilization of the public-health intervention package to combat anaemia in pregnancy.
Z Rostamzadeh Khameneh
Full Text Available Introduction: Although the hepatitis E virus mostly causes a self-limited disease in general population, but the disease is more severe in pregnant women. Hepatitis E accounts for about 10% of pregnancy associated deaths in southern Asia. But the prevalence in Iran is almost unclear, so this study is aimed to investigate the seroprevalence of anti-HEV IgG among a population of pregnant women in West Azerbaijan of Iran. Materials and Methods: 136 pregnant women who referred to an urban health centers of Urmia for pursuing pregnancy-related health services were selected randomly and enrolled in a descriptive, cross-sectional study. Each subject was tested for the presence of anti-HEV IgG antibody using an enzyme-linked immunosorbent assay (ELISA, Dia.Pro; Diagnostic Bioprobes, Italy. Results: The mean age among 136 pregnant women was 25.12±4.91 years old (range of 14-39 years. Only five cases (3.6% among all 136 subjects were demonstrated to be seropositive for anti-HEV IgG using ELISA method. There was no significant difference between age (P=0.88, income level (P=0.19 of two seropositive and seronegative groups. All seropositive cases were from urban areas. Conclusion: The seroprevalence of anti-HEV IgG is low in the population of pregnant women in Urmia, Iran. Because of limited sample size in this study, we recommend to perform further studies with larger sample size in other regions of Iran in order to be able to systematically generalize the findings of studies to the population of Iranian pregnant women. Keywords: Pregnancy, Hepatitis E, women ELISA
Nielsen, Tore; Paquette, Tyna
Study objectives: Evaluate the prevalence and phenomenology of dream-associated behaviors affecting pregnant and postpartum mothers. Episodes consist of anxious dreams and nightmares about the new infant that are accompanied by complex behaviors (motor activity, speaking, expressing emotion). Design: Three-group design (postpartum, pregnant, null gravida), self-report, and repeated measures. Setting: Pregnancy and postpartum groups: completion of questionnaires in hospital room within 48 hours of giving birth and home telephone interviews; null gravida group: completion of questionnaires and interview in person or by telephone. Participants: Two hundred seventy-three women in 3 groups: postpartum: n = 202 (mean age = 29.7 ± 4.94 years; 95 primiparas, 107 multiparas); pregnant: n = 50 (mean age = 31.1 ± 5.44 years); null gravida: n = 21 (mean age = 28.5 ± 6.34 years). Interventions: Subjects completed questionnaires about pregnancy and birth factors, personality, and sleep and participated in interviews concerning the prevalence of recent infant dreams and nightmares, associated behaviors, anxiety, depression, and other psychopathologic factors. Measurements and Results: Most women in all groups recalled dreams (88%-91%). Postpartum and pregnant women recalled infant dreams and nightmares with equal prevalence, but more postpartum women reported they contained anxiety (75%) and the infant in peril (73%) than did pregnant women (59%, P dream-associated behaviors (P dream anxiety and, among postpartum women, post-awakening anxiety (41%), confusion (51%), and a need to check on the infant (60%). Primiparas and multiparas differed in dream and nightmare recall but not in prevalence of dream-associated behaviors. Conclusion: The prevalent occurrence of pregnancy and postpartum infant dreams and associated behaviors may reflect the pervasive emotional influence of maternal concerns or changes instigated by severe sleep disruption, rapid eye movement sleep deprivation
Sharif, S.; Farasat, T.; Fazal, S.
Objective: To assess the serum level of vitamin D in pregnant and lactating women. Study Design: Case-control study. Place and Duration of Study: Gynaecological Unit 1 of Jinnah Hospital, Lahore, from December 2010 to May 2011. Methodology: A total of 100 women comprised of three groups: pregnant (n = 40), lactating (n = 40) and control (n = 20) groups. The information regarding age, educational level, socioeconomic status, exposure to sunlight and dietary vitamin D intake were collected through self-structured questionnaire. Serum concentration of vitamin D was measured by ELISA and serum calcium and phosphate levels were measured by chemistry analyzer. Statistical analysis was done using SPSS (version 13). The values were considered significant at 0.05 level of significance. Results: The mean serum vitamin D level in the pregnant and lactating mothers was 26.5 +- 17.1 nmol/L and 21.4 +- 16.3 nmol/L respectively and in control group was 33.8 +- 21.1 nmol/L. The mean calcium level in the pregnant, lactating and control group was 10.3 +- 1.2 mg/dL, 9.7 +- 1.3 mg/dL and 9.7 +- 1.3 mg/dL respectively. The mean phosphate in pregnant was 3.2 +- 0.76 mg/dl, in lactating was 3.3 +- 0.76 mg/dl and in control was 3.5 +- 0.92 mg/dl. Significant difference (p = 0.041 and p = 0.037 respectively) in the serum levels of vitamin D and calcium was observed among the pregnant and lactating women as compared to control group. Conclusion: Low serum vitamin D concentration was observed in lactating women and pregnant women as compared to control group. (author)
Sharif, Saima; Farasat, Tasnim; Shoaib, Hamna; Saqib, Muhammad; Fazal, Sabiha
To assess the serum level of vitamin D in pregnant and lactating women. Case-control study. Gynaecological Unit 1 of Jinnah Hospital, Lahore, from December 2010 to May 2011. A total of 100 women comprised of three groups: pregnant (n = 40), lactating (n = 40) and control (n = 20) groups. The information regarding age, educational level, socioeconomic status, exposure to sunlight and dietary vitamin D intake were collected through self-structured questionnaire. Serum concentration of vitamin D was measured by ELISA and serum calcium and phosphate levels were measured by chemistry analyzer. Statistical analysis was done using SPSS (version 13). The values were considered significant at 0.05 level of significance. The mean serum vitamin D level in the pregnant and lactating mothers was 26.5 ± 17.1 nmol/L and 21.4 ± 16.3 nmol/L respectively and in control group was 33.8 ± 21.1 nmol/L. The mean calcium level in the pregnant, lactating and control group was 10.3 ± 1.2 mg/dL, 9.7 ± 1.3 mg/dL and 9.7 ± 1.3 mg/dL respectively. The mean phosphate in pregnant was 3.2 ± 0.76 mg/dl, in lactating was 3.3 ± 0.76 mg/dl and in control was 3.5 ± 0.92 mg/dl. Significant difference (p = 0.041 and p = 0.037 respectively) in the serum levels of vitamin D and calcium was observed among the pregnant and lactating women as compared to control group. Low serum vitamin D concentration was observed in lactating women and pregnant women as compared to control group.
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Colstrup, Miriam; Mathiesen, Elisabeth; Damm, Peter
Abstract Objective: In 1989 the St. Vincent declaration set a five-year target for approximating outcomes of pregnancies in women with diabetes to those of the background population. We investigated and quantified the risk of adverse pregnancy outcomes in pregnant women with type 1 diabetes (T1DM......) to evaluate if the goals of the 1989 St. Vincent Declaration have been obtained concerning foetal and neonatal complications. Methods: Twelve population-based studies published within the last 10 years with in total 14 099 women with T1DM and 4 035 373 women from the background population were identified....... The prevalence of four foetal and neonatal complications was compared. Results: In women with T1DM versus the background population, congenital malformations occurred in 5.0% (2.2-9.0) (weighted mean and range) versus 2.1% (1.5-2.9), relative risk (RR) = 2.4, perinatal mortality in 2.7% (2.0-6.6) versus 0.72% (0...
Vestgaard, Marianne; Secher, Anna L; Ringholm, Lene
INTRODUCTION: The aim of this study was to evaluate whether vitamin D insufficiency is associated with preterm delivery and preeclampsia in women with type 1 diabetes. MATERIAL AND METHODS: An observational study of 198 pregnant women with type 1 diabetes. 25-Hydroxy-Vitamin D and HbA1c were meas...
Shahbazian, Hajieh; Nouhjah, Sedigheh; Shahbazian, Nahid; Jahanfar, Shayesteh; Latifi, Seyed Mahmoud; Aleali, Armaghan; Shahbazian, Nasrin; Saadati, Najmieh
Different approaches for screening and diagnosis of gestational diabetes mellitus(GDM) have great impact on all process of management of gestational diabetes and its future complications. The aims of this study were to evaluate rate, risk factors and outcomes of GDM based on International Association of Diabetes and Pregnancy Study Groups diagnostic criteria. In a prospective study pregnant women attended 5 clinics in Ahvaz, screened for gestational diabetes mellitus using IADPSG criteria and followed up delivery from August 2014 to February 2015. At the first prenatal visit women underwent the fasting blood sugar test. A 75-g oral glucose tolerance test (OGTT) was performed for 750 mothers between 24 and 32 weeks of gestation. Logistic regression test for calculating the odds ratios and 95% confidence intervals was used. The mean age of participants was 28.43±5.52years. The overall rate of GDM in our study was 29.9% (224/750). Incidence of gestational diabetes was associated with age group≥35years [OR=1.92(95% CI, 1.19-3.09)], family history of diabetes [OR=2.47(95% CI, 1.33-4.59)], previous GDM [OR=3.12(1.35-7.19)], BMI≥25 [OR=1, 71(1.10-2.67)] Using logistic regression. The most common maternal complication in studied women was cesarean section followed by hypertension and preeclampsia. About one third of studied women diagnosed as GDM according to the IADPSG criteria. Risk factors of GDM were maternal age, family history of diabetes, Previous GDM, overweight and obesity before pregnancy, the same reported factors with 2 steps approach. Higher rate of GDM using this criterion may increase concern about healthcare costs and workloads. Copyright © 2016 Diabetes India. Published by Elsevier Ltd. All rights reserved.
Full Text Available ... Treatments Some people with diabetes need to take diabetes medicines or insulin to help keep their blood sugar at a healthy level. What you need depends on your health and the type of diabetes you have. Use these resources to ...
This study aims to evaluate the effects of Pilates exercises for a decreasing pain in pregnant women. A total of 40 pregnant women were divided into two groups, a control group (followed a standard pregnancy exercise regimen) and a Pilates group (completed a Pilates exercise regimen). A pain assessment was carried out after exercise, using a visual analog scale. The Pilates group workout program lasted 70-80 min per day, once a week, for 8 weeks. The reduction in the level of pain was found to be significantly greater in the group of pregnant women who completed the Pilates workout (p Pilates is an effective, healthy, and feasible method of reducing pain in pregnancy, and is therefore a beneficial alternative workout for the suppression of pain in the third trimester of pregnancy. Copyright © 2017 Elsevier Ltd. All rights reserved.
Agnieszka Maria Bień
Full Text Available Introduction. The healthy and unhealthy behaviors of a pregnant woman influence both her own health and that of her unborn child, affecting its future development. The purpose of the study was to evaluate the health-related behaviors of pregnant women with hypertension. Material i method. The study was performed between November 2011 and February 2012 and included 80 hypertensive pregnant women hospitalized in a high risk pregnancy ward. The study used a diagnostic survey with questionnaires. Results. Statistical analyses showed a correlation between the respondents’ health-related behaviors and their socio-demographic characteristics: exercise was correlated with age (p=0.01, and rest during the day was correlated with support in everyday responsibilities (p<0.00001, and with the respondents’ socio-economic standing (p=0.03. Correlations were also found between healthy eating habits and residence (0.006, education (p=0.05, and sodium intake (p=0.0003, as well as between education and substance use (p=0.0003. Conclusion. Health-related behaviors of pregnant women with hypertension are influenced by their education, support they receive in daily responsibilities, and their socio-economic standing. The diagnosis of hypertension in pregnant women does not necessarily prompt them to discontinue all unhealthy behaviors.
Full Text Available Hookworm infection is among the major causes of anaemia in poor communities, but its importance in causing maternal anaemia is poorly understood, and this has hampered effective lobbying for the inclusion of anthelmintic treatment in maternal health packages. We sought to review existing evidence on the role of hookworm as a risk factor for anaemia among pregnant women. We also estimate the number of hookworm infections in pregnant women in sub-Saharan Africa (SSA.Structured searches using MEDLINE and EMBASE as well as manual searches of reference lists were conducted, and unpublished data were obtained by contacting authors. Papers were independently reviewed by two authors, and relevant data were extracted. We compared haemoglobin concentration (Hb according to intensity of hookworm infection and calculated standardised mean differences and 95% confidence intervals. To estimate the number of pregnant women, we used population surfaces and a spatial model of hookworm prevalence.One hundred and five reports were screened and 19 were eligible for inclusion: 13 cross-sectional studies, 2 randomised controlled trials, 2 non-randomised treatment trials and 2 observational studies. Comparing uninfected women and women lightly (1-1,999 eggs/gram [epg] infected with hookworm, the standardised mean difference (SMD was -0.24 (95% CI: -0.36 to -0.13. The SMD between women heavily (4000+ epg infected and those lightly infected was -0.57 (95% CI: -0.87 to -0.26. All identified intervention studies showed a benefit of deworming for maternal or child health, but since a variety of outcomes measures were employed, quantitative evaluation was not possible. We estimate that 37.7 million women of reproductive age in SSA are infected with hookworm in 2005 and that approximately 6.9 million pregnant women are infected.Evidence indicates that increasing hookworm infection intensity is associated with lower haemoglobin levels in pregnant women in poor countries
Rasch, V; Knudsen, L B; Wielandt, H
OBJECTIVE: To study how living conditions influence pregnancy planning and acceptance among Danish women. METHOD: A cross-sectional questionnaire study performed among 3516 pregnant women attending Odense University Hospital, Denmark. The study population consisted of women with spontaneous...... abortion, women with ectopic pregnancies, women attending antenatal care and women with induced abortion. They were divided into four groups: women with planned and accepted pregnancies (accepting planners, n=2137), women who accepted an initially unplanned pregnancy (accepting non-planners, n=1006), women...... who rejected an initially planned pregnancy (rejecting planners, n=31), and women with unplanned and rejected pregnancies (rejecting non-planners, n=342). The association between socio-economic characteristics and pregnancy planning and acceptance was evaluated by comparing accepting non...
Okanishi, Natsuko; Kito, Nobuhiro; Akiyama, Mitoshi; Yamamoto, Masako
Pregnant women often report complaints due to physiological and postural changes. Postural changes during pregnancy may cause low back pain and pelvic girdle pain. This study aimed to compare the characteristics of postural changes in pregnant compared with non-pregnant women. Prospective case-control study. Pregnancy care center. Fifteen women at 17-34 weeks pregnancy comprised the study group, while 10 non-pregnant female volunteers comprised the control group. Standing posture was evaluated in the sagittal plane with static digital pictures. Two angles were measured by image analysis software: (1) between the trunk and pelvis; and (2) between the trunk and lower extremity. Spinal curvature was measured with Spinal Mouse® to calculate the means of sacral inclination, thoracic and lumbar curvature and inclination. The principal components were calculated until eigenvalues surpassed 1. Three distinct factors with eigenvalues of 1.00-2.49 were identified, consistent with lumbosacral spinal curvature and inclination, thoracic spine curvature, and inclination of the body. These factors accounted for 77.2% of the total variance in posture variables. Eleven pregnant women showed postural characteristics of lumbar kyphosis and sacral posterior inclination. Body inclination showed a variety of patterns compared with those in healthy women. Spinal curvature demonstrated a tendency for lumbar kyphosis in pregnant women. Pregnancy may cause changes in spinal curvature and posture, which may in turn lead to relevant symptoms. Our data provide a basis for investigating the effects of spinal curvature and postural changes on symptoms during pregnancy. © 2012 The Authors Acta Obstetricia et Gynecologica Scandinavica© 2012 Nordic Federation of Societies of Obstetrics and Gynecology.
Gomes, Caroline de Barros; Malta, Maíra Barreto; Martiniano, Ana Carolina de Almeida; Di Bonifácio, Luiza Pereira; Carvalhaes, Maria Antonieta de Barros Leite
To determine the eating behavior of pregnant women assisted by primary health care and to compare it with women at childbearing age in Brazilian capitals. A cross-sectional study conducted on 256 pregnant women in the second trimester of gestation, selected by drawing lots from those assisted by primary health care units of a municipality in the state of São Paulo in 2009/2010. Eating habits were investigated via a questionnaire adapted from the VIGITEL system, consisting of questions about eating habits in general and the frequency and consumption characteristics of food groups/specific foods. For tis comparison, we used the indicators reported by the VIGITEL system for women at childbearing age in Brazilian capitals in 2010. The analyses involved the presentation of frequency distribution and descriptive statistics with comparisons according to the age group. Most patients had breakfast every day (86.7%) and 45.7% habitually exchanged a main meal for a snack once or twice a week. A daily consumption of fruit, raw salad and vegetables was not reported by 48.8%, 41.8% and 55.1% of the women, respectively. Fish was reported to never or almost never be consumed by 64.4% of the pregnant women. At least once a week, 69.9% of them reported the consumption of soda, and 86.4% of wafers/cookies. The comparison between the pregnant women and women at childbearing age in capitals showed a close similar prevalence of overweight, and no difference in the regular consumption of fruit and vegetables. Meat containing excess of fat and whole milk were more consumed by pregnant women, with differences reported in all the age groups analyzed. On the other hand, the pregnant women reported a less regular intake of soft drinks. The actions that need to be performed in prenatal care are various and very important, promoting the consumption of specific foods and providing guidelines about eating behavior, while reinforcing healthy eating habits already present.
Michalowicz, Bryan S; DiAngelis, Anthony J; Novak, M John; Buchanan, William; Papapanou, Panos N; Mitchell, Dennis A; Curran, Alice E; Lupo, Virginia R; Ferguson, James E; Bofill, James; Matseoane, Stephen; Deinard, Amos S; Rogers, Tyson B
Although clinicians generally consider it safe to provide dental care for pregnant women, supporting clinical trial evidence is lacking. This study compares safety outcomes from a trial in which pregnant women received scaling and root planing and other dental treatments. The authors randomly assigned 823 women with periodontitis to receive scaling and root planing, either at 13 to 21 weeks' gestation or up to three months after delivery. They evaluated all subjects for essential dental treatment (EDT) needs, defined as the presence of moderate-to-severe caries or fractured or abscessed teeth; 351 women received complete EDT at 13 to 21 weeks' gestation. The authors used Fisher exact test and a propensity-score adjustment to compare rates of serious adverse events, spontaneous abortions/stillbirths, fetal/congenital anomalies and preterm deliveries ( .05) between women who received EDT and those who did not require this treatment, or between groups that received both EDT and periodontal treatment, either EDT or periodontal treatment alone, or no treatment. Use of topical or local anesthetics during root planing also was not associated with an increased risk of experiencing adverse outcomes. EDT in pregnant women at 13 to 21 weeks' gestation was not associated with an increased risk of experiencing serious medical adverse events or adverse pregnancy outcomes. Data from larger studies and from groups with other treatment needs are needed to confirm the safety of dental care in pregnant women. This study provides evidence that EDT and use of topical and local anesthetics are safe in pregnant women at 13 to 21 weeks' gestation.
Full Text Available Objective — to study the effectiveness and safety of the use of Ursonost preparation of Organosin Company, produced by Francia Farmaceutici Industria Farmaco Biologica S.r.l. (Italy in pregnant women with cholestatic hepatosis. Patients and methods. A total of 42 pregnant women, who were under outpatient and inpatient treatment in the department of obstetric problems of extragenital pathology for the period of 2013–2015 years were comprehensively examined. All pregnant at the time of observation were at the end of the II and III trimester of pregnancy. All 42 pregnant were divided into three groups. Results. For the end of the treatment by Ursonost preparation in the first and second group of pregnant was marked a general improvement of well-being such as reduction of fatigue, weakness, dyspepsia and pruritus. Also, was noted a normalization of blood biochemical parameters. Conclusions. As a result of the inclusion of Ursonost preparation of Organosin Company, produced by Francia Farmaceutici Industria Farmaco Biologica S.r.l. (Italy was observed a significant improvement in overall well-being and normalization of blood biochemical parameters in women of the first and second test groups. Application of the proposed medical complex in the present groups of pregnant women allowed to seize the results of the pregnancy outcomes and almost avoiding premature delivery. Effectiveness and safety of the use of preparation during the pregnancy allow recommend inclusion of Ursonost preparation of Organosin Company, produced by Francia Farmaceutici Industria Farmaco Biologica S.r.l. (Italy to the treatment regimen of cholestatic hepatosis in pregnant.
Husak, V.; Ryznar, V.; Klener, V.
Based on a critical analysis of a large amount of data from the literature, a table was prepared of radiation loads of the fetus after administration of radiopharmaceuticals to pregnant women. Briefly mentioned are recent findings on the biological effects of ionizing radiation on the fetus and the radiation risk was evaluated of radiopharmaceuticals administered during the third trimester of pregnancy. The possibility is discussed to evaluate the benefit of radionuclide examinations of pregnant women in relation to the radiation risk. (author). 4 figs., 4 tabs., 31 refs
Maral G. Nogayeva
Full Text Available Urinary tract morbidity has increased by 7% in Kazakhstan between 2007 to 2011. Pregnant women with extragenital pathologies or kidney diseases had the greatest prevalence of morbidity. Asymptomatic bacteriuria (AB is one of the most important risk factors of pyelonephritis development in pregnant women, and it can affect the course and outcome of pregnancy, delivery, and postnatal period. AB prevention requires prevention of pregnancy complications including early diagnostic of urinary tract infections, timely optimization of therapy at outpatient facilities, and dynamic follow-up.
Benjamin A I
Full Text Available The role of immunization in reducing childhood mortality cannot be over-emphasised, yet many opportunities for immunization are missed when children and pregnant women visit a health facility. Reducing missed opportunities is the cheapest way to increase immunization coverage. The present study discusses the extent of the problem of missed opportunities for immunization in children and pregnant women and the factors contributing to the problem, in spatiality and community outreach clinics of Christian Medical College & Hospital, Ludhiana. Recommendations are made regarding ways and means of reducing missed opportunities.
Dahl, Katja; Hvidman, Lone; Jørgensen, Finn Stener
OBJECTIVES: The primary aim of this study was to assess pregnant women's knowledge of first trimester combined Down's syndrome screening in a setting of required informed consent. Secondary, we wanted to identify relevant differences in knowledge level among subgroups of pregnant women, including...... of adverse findings other than Down's syndrome. Knowledge level was positively associated with length of education (adjusted ORs 1.0 (0.8-1.4) to 3.9 (2.4-6.4)) and participation in the screening programme (adjusted OR 0.9 (0.6-1.3) to 5.9 (3.9-8.8)). Participation in an individual information session...
Dahl, Katja; Hvidman, Lone; Jørgensen, Finn Stener
OBJECTIVES: The primary aim of this study was to assess pregnant women's knowledge of first trimester combined Down's syndrome screening in a setting of required informed consent. Secondary, we wanted to identify relevant differences in knowledge level among subgroups of pregnant women, including...... of adverse findings other than Down's syndrome. Knowledge level was positively associated with length of education (adjusted ORs 1.0 (0.8-1.4) to 3.9 (2.4-6.4)) and participation in the screening programme (adjusted OR 0.9 (0.6-1.3) to 5.9 (3.9-8.8)). Participation in an individual information session...
Because of the rapid proliferation of the use of video display units for data processing, we have investigated the levels of the personnel exposure to parasit X-rays emission from these devices. The case of pregnant women was investigated because the greater part of the staff involved is female. In the worst case, the dose equivalent received by the foetus at the most exposed point is estimated at 0,01 μSv. This level is too low to cause any pathology. There is, therefore, no reason to discard pregnant women from the use of video display units [fr
Full Text Available Abstract Background The World Health Organization endorses the use of artemisinin-based combination therapy for treatment of acute uncomplicated falciparum malaria in the second and third trimesters of pregnancy. However, the effects of pregnancy on the pharmacokinetics of artemisinin derivatives, such as artesunate (AS, are poorly understood. In this analysis, the population pharmacokinetics of oral AS, and its active metabolite dihydroartemisinin (DHA, were studied in pregnant and non-pregnant women at the Kingasani Maternity Clinic in the DRC. Methods Data were obtained from 26 pregnant women in the second (22 - 26 weeks or the third (32 - 36 weeks trimester of pregnancy and from 25 non-pregnant female controls. All subjects received 200 mg AS. Plasma AS and DHA were measured using a validated LC-MS method. Estimates for pharmacokinetic and variability parameters were obtained through nonlinear mixed effects modelling. Results A simultaneous parent-metabolite model was developed consisting of mixed zero-order, lagged first-order absorption of AS, a one-compartment model for AS, and a one-compartment model for DHA. Complete conversion of AS to DHA was assumed. The model displayed satisfactory goodness-of-fit, stability, and predictive ability. Apparent clearance (CL/F and volume of distribution (V/F estimates, with 95% bootstrap confidence intervals, were as follows: 195 L (139-285 L for AS V/F, 895 L/h (788-1045 L/h for AS CL/F, 91.4 L (78.5-109 L for DHA V/F, and 64.0 L/h (55.1-75.2 L/h for DHA CL/F. The effect of pregnancy on DHA CL/F was determined to be significant, with a pregnancy-associated increase in DHA CL/F of 42.3% (19.7 - 72.3%. Conclusions In this analysis, pharmacokinetic modelling suggests that pregnant women have accelerated DHA clearance compared to non-pregnant women receiving orally administered AS. These findings, in conjunction with a previous non-compartmental analysis of the modelled data, provide further evidence that
Luewan, Suchaya; Bootchaingam, Phenphan; Tongsong, Theera
To compare the prevalence and pregnancy outcomes of GDM between those screened by the "one-step" (75 gm GTT) and "two-step" (100 gm GTT) methods. A prospective study was conducted on singleton pregnancies at low or average risk of GDM. All were screened between 24 and 28 weeks, using the one-step or two-step method based on patients' preference. The primary outcome was prevalence of GDM, and secondary outcomes included birthweight, gestational age, rates of preterm birth, small/large-for-gestational age, low Apgar scores, cesarean section, and pregnancy-induced hypertension. A total of 648 women were screened: 278 in the one-step group and 370 in the two-step group. The prevalence of GDM was significantly higher in the one-step group; 32.0% versus 10.3%. Baseline characteristics and pregnancy outcomes in both groups were comparable. However, mean birthweight was significantly higher among pregnancies with GDM diagnosed by the two-step approach (3204 ± 555 versus 3009 ± 666 g; p =0.022). Likewise, the rate of large-for-date tended to be higher in the two-step group, but was not significant. The one-step approach is associated with very high prevalence of GDM among Thai population, without clear evidence of better outcomes. Thus, this approach may not be appropriate for screening in a busy antenatal care clinic like our setting or other centers in developing countries.
Meshaka, Riwa; Jeffares, Stephen; Sadrudin, Farah; Huisman, Nicole; Saravanan, Ponnusamy
Patient participation in study design is paramount to design studies that are acceptable to patients. Despite an increase in research involving pregnant women, relatively little is known about the motivational factors that govern their decision to be involved in a clinical trial, compared to other patient groups. To better understand the viewpoints of pregnant women who take part in clinical trials. We chose to use Q-Methodology, a method of exploring the structure of opinions surrounding a topic. We developed a set of 40 statements that encompassed the reasons why pregnant women might want to take part in research and 30 research participants from the PRiDE study (an observational trial investigating the role of micronutrients in gestational diabetes) were asked to rank them in order of agreement. The finished matrices from each participant were compared and analysed to produce capturing viewpoints. About 30 women aged 19-40 involved in the PRiDE study completed the questionnaire. There were two overarching motivators that emerged: a willingness to help medical research and improve our knowledge of medical science, and having a personal connection to the disease, therefore a potential fear of being affected by it. A third, less significant viewpoint, was that of a lack of inconvenience being a motivating factor. Understanding what motivates pregnant women to decide to take part in a research study is valuable and helps researchers maximize their uptake and retention rates when designing a trial involving pregnant women. © 2016 The Authors. Health Expectations Published by John Wiley & Sons Ltd.
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Research Goal was to study features of psychoemotional status of pregnant women with chronic fetoplacental insuffciency. Materials. 112 pregnant women with chronic fetoplacental insuffciency; 73 women with physiological course of pregnancy and delivery. Research of personal psychological characteristics was carried out by Minnesota multidimensional personal index (MMPI, adapted by F. B. Berezina and V. P Miroshnikova (1989. Personal and reactive anxiety was defned by method of self-appraisal according to D. Spilberger and Yu. L. Khalin. Results. Psychoveg-etative changes lead to unequal mobilization of various visceral systems, which can promote development of different complications of pregnancy course along with other factors, including fetoplacental insuffciency. Pregnant women with increased level of reactive anxiety more often have isolated decrease of uteroplacental blood fow; at hyperdepression combined disturbance of uteroplacental and fetoplacental blood fow was revealed; at hypochondria disturbance of uteroplacental and fetoplacental blood fow was also marked. Conclusion. Pregnant women with fetoplacental insuf-fciency demonstrated increase of anxiety and psychasthenia. As gestation period extended, patients with fetoplacental insuffciency marked high level of lability and reactivity of vegetative nervous system in combination with increased anxiety and presence of depression. Taking into consideration psychovegetative basis of occurrence of functional disturbances in the system mother-placenta-fetus, determination of personal psychoemotional features and state of vegetative nervous system, with future correction of reveled disturbances, should be obligatory.
Nana Philip N
Full Text Available Abstract Objective To compare the prevalence of gynaecological conditions among HIV infected and non-infected pregnant women. Methods Two thousand and eight (2008 pregnant women were screened for HIV, lower genital tract infections and lower genital tract neoplasia at booking antenatal visit. Results About 10% (198/2008 were HIV positive. All lower genital tract infections except candidiasis were more prevalent among HIV positive compared to HIV negative women: vaginal candidiasis (36.9% vs 35.4%; p = 0.678, Trichomoniasis (21.2% vs 10.6%; p p p = 0.026, syphilis (35.9% vs 10.6%; p Chlamydia trachomatis (38.4% vs 7.1%; p p p Conclusion We conclude that (i sexually transmitted infections (STIs are common in both HIV positive and HIV negative pregnant women in Cameroon, and (ii STIs and preinvasive cervical lesions are more prevalent in HIV-infected pregnant women compared to their non-infected compatriots. We recommend routine screening and treatment of STIs during antenatal care in Cameroon and other countries with similar social profiles.
Brown, Qiana L; Hasin, Deborah S; Keyes, Katherine M; Fink, David S; Ravenell, Orson; Martins, Silvia S
Understanding the relationship between health insurance coverage and tobacco and alcohol use among reproductive age women can provide important insight into the role of access to care in preventing tobacco and alcohol use among pregnant women and women planning to become pregnant. We examined the association between health insurance coverage and both past month alcohol use and past month tobacco use in a nationally representative sample of women age 12-44 years old, by pregnancy status. The women (n=97,788) were participants in the National Survey of Drug Use and Health (NSDUH) in 2010-2013. Logistic regression models assessed the association between health insurance (insured versus uninsured), past month tobacco and alcohol use, and whether this was modified by pregnancy status. Pregnancy status significantly moderated the relationship between health insurance and tobacco use (p-value≤0.01) and alcohol use (p-value≤0.01). Among pregnant women, being insured was associated with lower odds of alcohol use (adjusted odds ratio [AOR]=0.47; 95% confidence interval [CI]=0.27-0.82), but not associated with tobacco use (AOR=1.14; 95% CI=0.73-1.76). Among non-pregnant women, being insured was associated with lower odds of tobacco use (AOR=0.67; 95% CI=0.63-0.72), but higher odds of alcohol use (AOR=1.23; 95% CI=1.15-1.32). Access to health care, via health insurance coverage is a promising method to help reduce alcohol use during pregnancy. However, despite health insurance coverage, tobacco use persists during pregnancy, suggesting missed opportunities for prevention during prenatal visits. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Orchard, Elizabeth; Dix, Sarah; Wilson, Neil; Mackillop, Lucy; Ormerod, Oliver
There is concern over ionizing radiation exposure in women who are pregnant or of child-bearing age. Due to the increasing prevalence of congenital and acquired heart disease, the number of women who require cardiac interventions during pregnancy has increased. We have developed protocols for cardiac interventions in pregnant women and women of child-bearing age, aimed at substantially reducing both fluoroscopy duration and radiation doses. Over five years, we performed cardiac interventions on 15 pregnant women, nine postpartum women and four as part of prepregnancy assessment. Fluoroscopy times were minimized by simultaneous use of intracardiac echocardiography, and by using very low frame rates (2/second) during fluoroscopy. The procedures most commonly undertaken were closure of atrial septal defect (ASD) or patent foramen ovale (PFO) in 16 women, coronary angiograms in seven, right and left heart catheters in three and two stent placements. The mean screening time for all patients was 2.38 minutes (range 0.48-13.7), the median radiation dose was 66 (8.9-1501) Gy/cm(2). The median radiation dose to uterus was 1.92 (0.59-5.47) μGy, and the patient estimated dose was 0.24 (0.095-0.80) mSv. Ionizing radiation can be used safely in the management of severe cardiac structural disease in pregnancy, with very low ionizing radiation dose to the mother and extremely low exposure to the fetus. With experience, ionizing radiation doses at our institution have been reduced.
Blood concentration profiles for follicle-stimulating hormone, luteinizing hormone, chorionic gonadotropin, testosterone, estradiol, estriol, progesterone, cortisol and sex hormonebinding globulin throughout a menstrual cycle were derived from measurements by radioimmunoassay and related procedures on serial blood samples from 16 normal women as controls. Similar studies were then performed on 9 normal women receiving a low-dose oral contraceptive combination of D-norgestrel and ethynlestradiol. Further studies were performed on 9 out of 16 normal women in whom progestational contraception was carried out with orally administered lynestrenol or intramuscularly administered norethindrone enathate and on 12 normal pregnant women from the 28th to the 38th week of pregnancy. Additional studies embracing chorionic gonadotropin progesterone and 17-hydroxyprogesterone were performed on 10 normal pregnant women from the 6th to the 12th week of pregnancy. Detailed results are presented and their significance discussed
Jun, I J; Jun, J; Kim, E M; Lee, K Y; Kim, N; Chung, M H; Choi, Y R; Choi, E M
This study set out to compare the onset and duration of rocuronium-induced neuromuscular blockade in second trimester pregnant women and non-pregnant women receiving general anesthesia. Forty-seven pregnant (Group P) and forty-seven non-pregnant (Group C) women were enrolled. Anesthesia was induced with propofol 2.0 mg/kg and rocuronium 0.6 mg/kg, and neuromuscular blockade was assessed with an accelerometric sensor using train-of-four stimulation (TOF-Watch® SX). Tracheal intubation was performed at maximum depression of the first twitch (T1) and anesthesia was maintained with sevoflurane 1.5-2.5% and 50% oxygen in air. We recorded the times to maximum T1 depression and 5% and 25% T1 recovery, as well as the mean arterial pressure and heart rate at baseline, injection of rocuronium, intubation, and 5% and 25% T1 recovery. The onset of rocuronium-induced neuromuscular blockade (time to maximum T1 depression) did not differ significantly between the groups. The duration (time to 25% T1 recovery) was significantly longer in Group P than in Group C (45.7 ± 12.9 min vs 40.6 ± 10.4 min, P rocuronium-induced neuromuscular blockade did not significantly differ in onset but lasted significantly longer in second trimester pregnant women compared with non-pregnant women. Copyright © 2018 Elsevier Ltd. All rights reserved.
Nora A. Al-Faris
Full Text Available Vitamin D deficiency has emerged as a public health problem worldwide due to its important role in health and disease. The present work is intended to examine prevalence of vitamin D deficiency among pregnant Saudi women and related risk factors. A cross-sectional study was carried out at King Fahad Medical City in Riyadh, Saudi Arabia. Serum 25-hydroxy vitamin D (25(OHD was measured by enzyme-linked immunosorbent assay in 160 pregnant women during the first trimester of pregnancy. Socio-demographic, lifestyle and maternal characteristics were collected and vitamin D intake was assessed using a 24-h dietary recall. Weight and height were measured using standardized methods. Vitamin D deficiency (25(OHD < 50 nmol/L and insufficiency (25(OHD = 50–74 nmol/L were reported in 50% and 43.8% of the study sample, respectively. Median serum 25(OHD concentration was 49.9 nmol/L. Adequate vitamin D intake (≥600 IU/day was reported among only 8.1% of pregnant women. Age group, educational level, sun exposure frequency and daytime and daily practice of exercise were significantly associated with vitamin D status. Overall, vitamin D deficiency was common among pregnant Saudi women in Riyadh. Steps should be taken to address the current situation, including increased sunlight exposure, consumption of fatty fish, and vitamin D supplements.
Adriella Silva Oliveira
Full Text Available This study aimed to perform an integrative review of the epidemiology and the main risk factors for infection with human T lymphotropic to cells (HTLV in pregnant women from the Brazilian scientific production. The articles were extracted from databases: Literature Latin American and Caribbean Health Sciences (LILACS, Medical Literature Analysis and Retrieval System Online (MEDLINE and Scientific Electronic Library Online (SCIELO, with nine selected articles published between the years 2000-2012. Upon review of the studies it was observed that Brazil has significant prevalence of HTLV in pregnant women, demonstrating the need for adequate attention to this indicator. Some risk factors indicated by the studies analyzed were: low education, criterion race/color (infected pregnant women were mostly black, brown or indigenous majority, vertical transmission, sexual transmission, multiple pregnancies and premature sexual activity. Therefore, it is important serologic screening to prevent congenital infections, as well as the introduction of new studies on the infection in Brazil. Thus, it becomes evident the need for planning and implementation of prevention and control of HTLV in the prenatal for structuring measures that minimize the appearance of new infections in pregnant women and children due to vertical transmission, the main route of transmission.
Adriella Silva Oliveira
Full Text Available This study aimed to perform an integrative review of the epidemiology and the main risk factors for infection with human T lymphotropic to cells (HTLV in pregnant women from the Brazilian scientific production. The articles were extracted from databases: Literature Latin American and Caribbean Health Sciences (LILACS, Medical Literature Analysis and Retrieval System Online (MEDLINE and Scientific Electronic Library Online (SCIELO, with nine selected articles published between the years 2000-2012. Upon review of the studies it was observed that Brazil has significant prevalence of HTLV in pregnant women, demonstrating the need for adequate attention to this indicator. Some risk factors indicated by the studies analyzed were: low education, criterion race/color (infected pregnant women were mostly black, brown or indigenous majority, vertical transmission, sexual transmission, multiple pregnancies and premature sexual activity. Therefore, it is Epidemiologia e fatores de risco da infecção do vírus HTLV em gestantes important serologic screening to prevent congenital infections, as well as the introduction of new studies on the infection in Brazil. Thus, it becomes evident the need for planning and implementation of prevention and control of HTLV in the prenatal for structuring measures that minimize the appearance of new infections in pregnant women and children due to vertical transmission, the main route of transmission.
Sato, Ana Paula Sayuri; Fujimori, Elizabeth
This study described the nutritional status of 228 pregnant women and the influence of this on birth weight. This is a retrospective study, developed in a health center in the municipality of São Paulo, with data obtained from medical records. Linear regression analysis was carried out. An association was verified between the initial and final nutritional status (ppregnancy underweight was higher compared those who started overweight/obese (p=0.005). Weight gain was insufficient for 43.4% of the pregnant women with adequate initial weight and for 36.4% of all the pregnant women studied. However, 37.1% of those who began the pregnancy overweight/obese finished with excessive weight gain, a condition that ultimately affected almost a quarter of the pregnant women. Anemia and low birth weight were uncommon, however, in the linear regression analysis, birth weight was associated with weight gain (pimportance of nutritional care before and during pregnancy to promote maternal-infant health.
Background: The objective of this study was to determine the sero-prevalence of Toxoplasma gondii infection and ... Conclusion: A significant proportion of pregnant women have been exposed to Toxoplasma gondii, with the ..... observation that food-borne transmission of T. gondii is increasingly recognized as a potentially.
Quiroga-Feuchter, Germán; Robles-Torres, Rosa Evangelina; Ruelas-Morán, Andrés; Gómez-Alcalá, Alejandro V
Urinary tract infection is a common pregnancy complication. Asymptomatic bacteriuria (AB) can trigger the development of serious complications affecting both the mother and the fetus. Determine the frequency of AB among pregnant women attending to antenatal care at the family medicine clinic number 1 of the Instituto Mexicano del Seguro Social, located in Ciudad Obregón, Sonora. A longitudinal study was carried out from September to December 2004. Seventy-two 72 pregnant women with gestational age of 24 weeks or less were followed up during four months. All pregnant women were selected by a non-probabilistic method. Every patient had a monthly urine culture during the follow up period. Among the 72 pregnant women, 16.7% developed symptomatic urinary infections during the follow-up and 25% had at least one positive urine culture without urinary symptoms, being classified as AB, thus receiving treatment. Frequency of positive urine cultures was common at first and fourth months of follow-up. Urine culture is an important component of prenatal care, and helps in identifying a significant number of urinary tract infections that would go otherwise undetected.
the frequency of periodontitis among pregnant women, ranging from 35% to ... Department of Preventive Dentistry, Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria. Abstract .... by the stress and anxiety during pregnancy, which may lead to a neglect of .... Khader YA, Al‑shishani L, Obeidat B, Khassawneh M,.
Knudsen, Ane-Kersti Skaarup; Long, Manhai; Pedersen, Henning S
in Disko Bay had the lowest intake of terrestrial species. No significant geographical differences were found for intake of marine mammals or seabirds. CONCLUSIONS: The present study found relatively high BMI level and high smoking frequency in Greenlandic pregnant women. Age and region differences were...
Results: 35% of pregnant women (95% CI 31% - 38%) had utilised ITNs. Factors that promoted ... 0.050) and being single/widow/divorced (AOR 0.22, p-value 0.000). Conclusion: .... being engaged in business (OR = 1.56, 95% CI 1.08. - 2.26 ...
Dr S.B. OLALEYE
Back pain is (BP) is recognized as an important problem in pregnancy. The objectives of this study were to examine the prevalence and pattern of back pain. (BP) in pregnancy. A survey of 2,187 pregnant women attending ante-natal clinics in selected Medical facilities in Ibadan and Ogbomoso, Nigeria was carried out ...
Having not being informed and helped adequately, a significant percentage of pregnant women continued to smoke throughout their pregnancy. The failure in imposing the clean indoor air law in public places in Greece has also contributed to the increased passive smoking exposure.
Positive findings on ultrasound were significantly greater in the group with specific indications for scanning, P< 0.001. Conclusion: Our suggestion is that ultrasound examination in pregnant women should be performed only when there are clear obstetric reasons, established clinically. Key Words: obstetric ultrasound scan, ...
Toxoplasmosis is a neglected tropical protozoan disease of public health importance. This study estimated the seroprevalence of toxoplasmosis and the associated risk factors among pregnant women attending the antenatal clinic in the University of Port Harcourt Teaching Hospital, Rivers State, Nigeria. Two hundred and ...
The patterns and predictors of physical activity (PA) in pregnant women is poorly understood. This study described the patterns of physical activity (PA) in specific domains (home, occupation, transport and exercise/sport) and intensities (light, moderate and vigorous), and determined the factors associated with achieving ...
Background: Geophagy, a regular and deliberate habit of eating non-food substances is practiced worldwide and in sub-Saharan Africa. ... was not associated with parasitic infections in pregnant women, geophagy was found to have a significant association with education, history of geophagy and the feeding problems.
This podcast is targeted to pregnant women and explains 1) the signs and symptoms of the flu, and 2) what to do if you experience and signs and symptoms. This podcast is NOT a substitute for the advice of your doctor or health care provider. It is intended for educational purposes only.
Three hundred pregnant women between ages 15-60 years and attending antenatal clinics in Lagos State, Nigeria were screened for trichomoniasis in 2015. High vaginal swab samples obtained from the participants were examined by direct wet mount microscopy to determine prevalence of infection. Questionnaires were ...
Apr 2, 2014 ... Ordinioha and Brisibe: Alcohol consumption by pregnant women in South‑South Nigeria. 14. Nigerian Journal ... that they may have, and social and family supports for .... through the mass media, 21 (18.42%) read it in the internet, while 13 .... while all the Muslim respondents and Christians of the. 7th Day ...
In a survey of 200 pregnant women (mean age 24 years) attending a traditional birth home (TBH) in Abeokuta, Nigeria, 19 (9.5%) were found to be rhesus negative, 8 (42.1%) of which were primigravidae while 11 (57.9%) were multigravidae. 87.5% of the Rhesus negative primigravidae delivered at the TBH without being ...
Malaria is a chronic parasitic disease that affects everybody but with pregnant women and children under the age of 5 years as its main target. The adverse complications of malaria in pregnancy makes it of immense public health importance. This study was designed to evaluate the prevalence of malaria among antenatal ...
Toxic metals are part of the most important groups of environmental pollutants that can bind to vital cellular components and interfere with their functions via inhalation, foods, water etc. The serum levels of toxic metals (lead, mercury, cadmium and arsenic) in pregnant women with history of pregnancy complications, ...
Malaria during pregnancy poses a substantial risk to mother and foetus especially an infection with Plasmodium falciparum. This study was undertaken to assess the prevalence of falciparum malaria among pregnant women in Aba South Local Government Area, Abia State, south-east Nigeria. Blood samples from 432 ...
Al-Faris, Nora A
Vitamin D deficiency has emerged as a public health problem worldwide due to its important role in health and disease. The present work is intended to examine prevalence of vitamin D deficiency among pregnant Saudi women and related risk factors. A cross-sectional study was carried out at King Fahad Medical City in Riyadh, Saudi Arabia. Serum 25-hydroxy vitamin D (25(OH)D) was measured by enzyme-linked immunosorbent assay in 160 pregnant women during the first trimester of pregnancy. Socio-demographic, lifestyle and maternal characteristics were collected and vitamin D intake was assessed using a 24-h dietary recall. Weight and height were measured using standardized methods. Vitamin D deficiency (25(OH)D L) and insufficiency (25(OH)D = 50-74 nmol/L) were reported in 50% and 43.8% of the study sample, respectively. Median serum 25(OH)D concentration was 49.9 nmol/L. Adequate vitamin D intake (≥600 IU/day) was reported among only 8.1% of pregnant women. Age group, educational level, sun exposure frequency and daytime and daily practice of exercise were significantly associated with vitamin D status. Overall, vitamin D deficiency was common among pregnant Saudi women in Riyadh. Steps should be taken to address the current situation, including increased sunlight exposure, consumption of fatty fish, and vitamin D supplements.
A study on the prevalence of malaria parasitaemia and anaemia among pregnant women attending Federal Medical Centre (FMC), Umuahia and Nwachinemere Maternity and Child-Care (NMCCD) Ihie in Umuahia metropolis in Abia State Nigeria was carried out between April and October 2010. Blood samples were ...
... prophylaxis against pregnancy loss in 58 pregnant Sudanese women with recurrent (>3) miscarriages associated with antiphospholipid syndrome (APS). Three (5.1%) patients had early miscarriages, three (5.1%) patients developed pre-eclamptic toxaemia and forty-seven (81%) of the 58 patients had cesarean delivery.
HIV prevalence and trends among pregnant women in Abuja, Nigeria: a 5-year ... trends in HIV prevalence to ascertain the current course of the HIV epidemic in ... Objective: The aim of this study was to determine the prevalence of HIV and its ...
Objective: This study determined the prevalence and socio‑demographic characteristics of bacterial vaginosis (BV) among pregnant women with abnormal vaginal discharge. Study Design: Descriptive cross‑sectional study. Setting: University of Maiduguri Teaching Hospital. Materials and Methods: Vaginal swab samples ...
60.4%) were asymptomatic. There were 92 out of 250 pregnant women (36.8%) that had three or more of the Amsel's criteria for the diagnosis of bacterial vaginosis. The associated risk factors for developing bacterial vaginosis in the study ...
BACKGROUND: Pregnancy represents a risk factor in the occurrence of vaginal candidiasis. OBJECTIVES: To determine the prevalence and clinical features associated with abnormal vaginal discharge and C. albicans infection in pregnant women. METHODS: High vaginal swab samples and data on epidemiological ...
This study reports the incidence of urinary tract infections (UTIs) among 80 pregnant women attending antenatal clinics at Oluyoro Catholic Hospital (OCH), Ibadan, Nigeria, as well as the isolation and identification of the pathogens responsible for the infection. A total of 80 clean voided mid-stream urine samples were ...
Urinary tract infections (UTI) are the most common bacterial infections during pregnancy and these infections. Untreated UTI can be associated with serious obstetric complications. This cross-sectional study was carried out to determine the prevalence of UTI among symptomatic and asymptomatic pregnant women ...
Molatelo Elisa Shikwane
Jan 3, 2014 ... To cite this article: Molatelo Elisa Shikwane, Olga M. Villar-Loubet, Stephen M. Weiss, Karl Peltzer & Deborah L. Jones. (2013) HIV knowledge, disclosure and sexual risk among pregnant women and their partners in rural South Africa, SAHARA-. J: Journal of Social Aspects of HIV/AIDS: An Open Access ...
To date, studies have sought cause and effect and have neglected the opinion of the people about what they perceive to be problematic and what they believe constitutes satisfactory maternity service provision. An exploratory qualitative study was carried out to identify pregnant women in a rural Niger Delta community's ...
The prevalence of malaria parasitaemia in 200 pregnant women attending the antenatal clinic (ANC) of Jos University Teaching Hospital (JUTH) between April and June 2003 was determined. Geimsa-stained thick and thin blood films were examined microscopically for malaria parasites; the parasite densities were ...
Malaria parasitaemia among pregnant women in a rural community of ... ours, it is a common cause of anaemia in pregnancy in both immune and non-immune ... Apart from the use of nets, drugs and vector control, the prevention of malaria in ...
Boggess, Kim A; Urlaub, Diana M; Massey, Katie E; Moos, Merry-K; Matheson, Matthew B; Lorenz, Carol
Daily oral hygiene and regular dental visits are important components of oral health care. The authors' objective in this study was to examine women's oral hygiene practices and use of dental services during pregnancy. The authors developed a written oral health questionnaire and administered it to 599 pregnant women. They collected demographic information, as well as data on oral hygiene practices and use of dental services during pregnancy. They used chi2 and multivariable logistic regression models to assess associations between oral hygiene practice and dental service use during pregnancy and to identify maternal predictor variables. Of the 599 participants, 83 percent (n=497) reported brushing once or twice per day. Twenty-four percent (n=141) reported flossing at least once daily; Hispanic women were more likely to floss than were white or African American women (28 percent [52 of 183] versus 22 percent [54 of 248] versus 19 percent [23 of 121], respectively, Pdental care during pregnancy. Hispanic women were significantly less likely than were black or white women to receive routine dental care during pregnancy (13 percent versus 21 percent versus 36 percent, respectively, Pdental care when not pregnant were significantly associated with lack of routine dental care during pregnancy (adjusted odds ratios, 95 percent confidence intervals: 2.56 [1.33-4.92]; 2.19 [1.11-4.29]; 2.02 [1.12-3.65]; 1.86 [1.13-3.07]; and 4.35 [2.5-7.69], respectively). A woman's lack of receiving routine dental care when not pregnant was the most significant predictor of lack of receiving dental care during pregnancy. Racial, ethnic and economic disparities related to oral hygiene practices and dental service utilization during pregnancy exist. Medical and dental care providers who treat women of reproductive age and pregnant women need to develop policy strategies to address this population's access barriers to, and use of, dental care services.
Full Text Available Background: Listeriosis is a food-borne disease often associated with ready-to-eat foods. It usually causes mild febrile gastrointestinal illness in immunocompetent persons. In pregnant women, it may cause more severe infection and often crosses the placenta to infect the fetus, resulting in miscarriage, fetal death or neonatal morbidity. Simple precautions during pregnancy can prevent listeriosis. However, many women are unaware of these precautions and listeriosis education is often omitted from prenatal care.
Desjardins, Michaël; Boucoiran, Isabelle; Paquet, Caroline; Laferrière, Céline; Gosselin-Brisson, Anne; Labbé, Annie-Claude; Martel-Laferrière, Valérie
Serological testing guidelines for vaccine-preventable infectious diseases in pregnant women are heterogeneous. It is unclear how vaccination history influences health care workers' (HCWs) attitudes about testing. The aim of this study was to describe current practices in screening for rubella, hepatitis B, and varicella-zoster virus (VZV) in pregnant women in the province of Québec. In 2015, an electronic survey was distributed to HCWs who followed the case of at least one pregnant woman in the previous year and who could be contacted by email by their professional association. A total of 363 of 1084 (33%) participants were included in the analysis: general practitioners (57%), obstetrician-gynaecologists (20%), midwives (41%), and nurse practitioners (31%). For rubella, 48% of participants inquired about vaccination status, and of these, 98% offered serological testing for unvaccinated women versus 44% for vaccinated women. Similarly, of the 48% of participants who asked about hepatitis B vaccination status before offering testing, 96% ordered testing for hepatitis B surface antigen, 28% ordered testing for hepatitis B surface antibody, and 1% ordered no serological testing to unvaccinated women versus 72%, 46%, and 8%, respectively, for vaccinated women. Among the 81% of respondents who discussed VZV during prenatal care, 13% ordered serological testing if patients had a history of VZV infection, 87% if the VZV history was uncertain, and 19% if patients had a positive history of vaccination. Asking about vaccination status influences HCWs' attitudes about serological testing for rubella, hepatitis B, and VZV. In the context of increasing vaccination coverage in women of child-bearing age, it is important to clarify the impact of vaccination status in serological screening guidelines in pregnant women. Copyright © 2018 Society of Obstetricians and Gynaecologists of Canada. Published by Elsevier Inc. All rights reserved.
Alina Coutinho Rodrigues Feitosa
Full Text Available Abstract Background: There is a physiologic elevation of total cholesterol (TC and triglycerides (TG during pregnancy. Some authors define dyslipidemia (DLP in pregnant women when TC, LDL and TG concentrations are above the 95th percentile (p95% and HDL concentration is below the 5th percentile (P5% for gestational age (GA. Objective: To compare the prevalence of DLP in pregnant women using percentiles criteria with the V Brazilian Guidelines on Dyslipidemia and the association with maternal and fetal outcomes. Results: Pregnant women with high-risk conditions, aged 18-50 years, and at least one lipid profile during pregnancy was classified as the presence of DLP by two diagnostic criteria. Clinical and laboratorial data of mothers and newborns were evaluated. Conclusion: 433 pregnant women aged 32.9 ± 6.5 years were studied. Most (54.6% had lipid profile collected during third trimester. The prevalence of any lipid abnormalities according to the criteria of the National Guidelines was 83.8%: TC ≥ 200 mg/dL was found in 49.9%; LDL ≥ 160 mg/dL, in 14.3%, HDL ≤ 50 mg/dL in 44.4% and TG ≥ 150 mg/dL in 65.3%. Any changes of lipid according to percentiles criteria was found in 19.6%: elevation above the P95% for TC was found in 0.7%; for LDL, 1.7%; for TG 6.4% and HDL lower than the P5% in 13%. The frequency of comorbidity: hypertension, diabetes, smoking, obesity and preeclampsia was similar among pregnant women when DLP was compared by both criteria. Conclusion: The prevalence of DLP during pregnancy varies significantly depending on the criteria used, however none demonstrated superiority in association with comorbidities.
Feitosa, Alina Coutinho Rodrigues; Barreto, Luciana Tedgue; da Silva, Isabela Matos; da Silva, Felipe Freire; Feitosa Filho, Gilson Soares
Background There is a physiologic elevation of total cholesterol (TC) and triglycerides (TG) during pregnancy. Some authors define dyslipidemia (DLP) in pregnant women when TC, LDL and TG concentrations are above the 95th percentile (p95%) and HDL concentration is below the 5th percentile (P5%) for gestational age (GA). Objective To compare the prevalence of DLP in pregnant women using percentiles criteria with the V Brazilian Guidelines on Dyslipidemia and the association with maternal and fetal outcomes. Results Pregnant women with high-risk conditions, aged 18-50 years, and at least one lipid profile during pregnancy was classified as the presence of DLP by two diagnostic criteria. Clinical and laboratorial data of mothers and newborns were evaluated. Conclusion 433 pregnant women aged 32.9 ± 6.5 years were studied. Most (54.6%) had lipid profile collected during third trimester. The prevalence of any lipid abnormalities according to the criteria of the National Guidelines was 83.8%: TC ≥ 200 mg/dL was found in 49.9%; LDL ≥ 160 mg/dL, in 14.3%, HDL ≤ 50 mg/dL in 44.4% and TG ≥ 150 mg/dL in 65.3%. Any changes of lipid according to percentiles criteria was found in 19.6%: elevation above the P95% for TC was found in 0.7%; for LDL, 1.7%; for TG 6.4% and HDL lower than the P5% in 13%. The frequency of comorbidity: hypertension, diabetes, smoking, obesity and preeclampsia was similar among pregnant women when DLP was compared by both criteria. Conclusion The prevalence of DLP during pregnancy varies significantly depending on the criteria used, however none demonstrated superiority in association with comorbidities. PMID:28591252
van der Graaf, Rieke; van der Zande, Indira S E; den Ruijter, Hester M; Oudijk, Martijn A; van Delden, Johannes J M; Oude Rengerink, Katrien; Groenwold, Rolf H H
Since pregnant women are severely underrepresented in clinical research, many take the position that the exclusion of pregnant women from research must be justified unless there are compelling "scientific reasons" for their exclusion. However, it is questionable whether this approach renders research with pregnant women fair. This paper analyzes and evaluates when research with pregnant women can be considered as fair and what constitutes scientific reasons for exclusion. Conceptual ethical and methodological analysis and evaluation of fair inclusion. Fair inclusion of pregnant women means (1) that pregnant women who are eligible are not excluded solely for being pregnant and (2) that the research interests of pregnant women are prioritized, meaning that they ought to receive substantially more attention. Fairness does not imply that pregnant women should be included in virtually every research project, as including only a few pregnant women in a population consisting only of women will not help to determine the effectiveness and safety of a treatment in pregnant women. Separate trials in pregnant women may be preferable once we assume, or know, that effects of interventions in pregnant women differ from the effects in other subpopulations, or when we assume, or know, that there are no differences. In the latter case, it may be preferable to conduct post-marketing studies or establish registries. If there is no conclusive evidence indicating either differences or equivalence of effects between pregnant and non-pregnant women, yet it seems unlikely that major differences or exact equivalence exist, the inclusion of pregnant women should be sufficient. Depending on the research question, this boils down to representativeness in terms of the proportion of pregnant and non-pregnant women, or to oversampling pregnant women. Fair inclusion of pregnant women in research implies that separate trials in pregnant women should be promoted. Inclusion of pregnant women has to
Identifying pregnant women who would adhere to food taboos in a rural ... Poor maternal nutrition, especially in rural settings, adversely affects pregnancy and ... Data was collected from 405 pregnant women that attended antenatal care at ...
pregnant blackAfrican women. Uric acid levels for the pregnant women were significantly raised, and the relationship between uric acid elevation and gestational proteinuric hypertensionwas discussed. In conclusion, we recommend that uric acid ...
... contaminate. For example, after cutting meat, wash the knife before using it to cut vegetables. COOK: Cook ... Adults Men and Women Moms/ Moms-to-Be Making Healthy Choices in Each Food Group MyPlate Plan ...
Deren, Sherry; And Others
Compared high-risk pregnant (n=55) and nonpregnant (n=598) women from Harlem on human immunodeficiency virus-related drug and sexual risk behaviors. Found higher percentage of intravenous drug users (IVDUs) among nonpregnant women and no significant differences between pregnant and nonpregnant IVDUs in terms of needle risk behaviors. Pregnant…
Ringholm, Lene; Damm, Julie Agner; Vestgaard, Marianne
In women with preexisting diabetes and nephropathy or microalbuminuria, it is important to deliver careful preconception counselling to assess the risk for the mother and the foetus, for optimizing glycaemic status and to adjust medical treatment. If serum creatinine is normal in early pregnancy,....... Supplementation with folic acid in early pregnancy and low-dose aspirin from 10 to 12 weeks reduces the risk of adverse pregnancy outcomes. During breastfeeding, several ACE inhibitors are considered safe.......In women with preexisting diabetes and nephropathy or microalbuminuria, it is important to deliver careful preconception counselling to assess the risk for the mother and the foetus, for optimizing glycaemic status and to adjust medical treatment. If serum creatinine is normal in early pregnancy......, kidney function is often preserved during pregnancy, but complications such as severe preeclampsia and preterm delivery are still common. Perinatal mortality is now comparable with that in women with diabetes and normal kidney function. Besides strict glycaemic control before and during pregnancy, early...
Bertuit, Jeanne; Leyh, Clara; Rooze, Marcel; Feipel, Véronique
Background: During pregnancy, physical and hormonal modifications occur. Morphologic alterations of the feet are found. These observations can induce alterations in plantar pressure. This study sought to investigate plantar pressures during gait in the last 4 months of pregnancy and in the postpartum period. A comparison with nulliparous women was conducted to investigate plantar pressure modifications during pregnancy. Methods: Fifty-eight women in the last 4 months of pregnancy, nine postpa...
Bhavadharini, Balaji; Mahalakshmi, Manni Mohanraj; Deepa, Mohan; Harish, Ranjani; Malanda, Belma; Kayal, Arivudainambi; Belton, Anne; Saravanan, Ponnusamy; Ranjit, Unnikrishnan; Uma, Ram; Anjana, Ranjit Mohan; Mohan, Viswanathan
The aim of this study was to determine the optimal glycated hemoglobin (HbA1c) cut point for diagnosis of gestational diabetes mellitus (GDM) and to evaluate the usefulness of HbA1c as a prognostic indicator for adverse pregnancy outcomes. HbA1c estimations were carried out in 1459 pregnant women attending antenatal care centers in urban and rural Tamil Nadu in South India. An oral glucose tolerance test was carried out using 75 g anhydrous glucose, and GDM was diagnosed using the International Association of the Diabetes and Pregnancy Study Groups criteria. GDM was diagnosed in 195 women. Receiver operating curves showed a HbA1c cut point of ≥ 5.0% (≥31 mmol/mol) have a sensitivity of 66.2% and specificity of 56.2% for identifying GDM (area under the curve 0.679, confidence interval [CI]: 0.655-0.703). Women with HbA1c ≥ 5.0% (≥31 mmol/mol) were significantly older and had higher body mass index, greater history of previous GDM, and a higher prevalence of macrosomia compared to women with HbA1c Indian pregnant women, a HbA1c of 5.0% (31 mmol/mol) or greater is associated with increased risk of macrosomia.
Full Text Available ... and learn helpful tips about managing your diabetes medicines. Veal el video en espanol . Get tips on ... a healthy diet, exercising, and using FDA-approved medicines, insulin, and devices every day. FDA has lots ...
Full Text Available ... Biologics Animal & Veterinary Cosmetics Tobacco Products For Consumers ... Diabetes is a serious illness that affects over 29 million people in the United States. Watch and learn helpful tips about managing your ...
Full Text Available ... Medical Devices Radiation-Emitting Products Vaccines, Blood & Biologics Animal & Veterinary Cosmetics Tobacco ... Diabetes is a serious illness that affects over 29 million people in the United States. Watch and learn helpful ...
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Willcox, Jane Catherine; Ball, Kylie; Campbell, Karen Jane; Crawford, David Andrew; Wilkinson, Shelley Ann
to investigate correlates of pregnant women's gestational weight gain (GWG) knowledge commensurate with GWG guidelines. cross sectional quantitative study. an Australian tertiary level maternity hospital. pregnant women (n=1032) following their first antenatal visit. survey to assess GWG knowledge and a range of potential correlates of knowledge including socio-economic characteristics, pregnancy characteristics (parity, gestation, pre-pregnancy BMI) and GWG information procurement and GWG attitudinal variables. participants (n=366; 35.4% response) averaged 32.5 years of age with 33% speaking a language other than English. One third of women reported GWG knowledge consistent with guidelines. Women overweight prior to pregnancy were less likely to underestimate appropriate GWG (RRR 0.23, 95% CI=0.09-0.59). Conversely, women in the overweight (RRR 8.80, 95% CI=4.02-19.25) and obese (RRR 19.62, 95% CI=8.03-48.00) categories were more likely to overestimate GWG recommendations, while tertiary educated women were less likely to overestimate GWG (RRR 0.28, 95% CI=0.10-0.79). No associations were found between GWG knowledge and pregnancy, GWG information source or attitudinal variables. the findings highlight women's lack of GWG knowledge and the role of pre-pregnancy body mass index and women's education as correlates of GWG knowledge. Women susceptible to poor GWG knowledge should be a priority target for individual and community-based education. Copyright © 2016 Elsevier Ltd. All rights reserved.
Ewelina Gaszyńska; Justyna Klepacz-Szewczyk; Elżbieta Trafalska; Anna Garus-Pakowska; Franciszek Szatko
Objectives: The level of dental awareness of a pregnant woman affects the sanitary condition of her own teeth and the health of the child to be born. Poor oral health is considered to be a probable risk factor for the pre-term birth or low birth weight. The aim of this work was to assess the level of oral health knowledge that determines oral health condition of pregnant women in Poland. Material and Methods: Empirical data were obtained from the National Monitoring of Oral Health and Its Det...
Kesmodel, Ulrik; Olsen, Sjurdur Frodi
STUDY OBJECTIVE: To compare recall of smoking habits during pregnancy 0.5-3 years after delivery across groups defined by recall time (5 six month periods) and pregnancy outcome (pre-eclampsia, pregnancy induced hypertension, intrauterine growth retardation, preterm or post-term delivery compared......, particularly among women smoking > or = 10 cigarettes/day. CONCLUSIONS: Information on smoking habits could be accurately obtained retrospectively independent of recall time and the pregnancy outcomes studied here. Accuracy diminished with increasing alcohol intake, particularly among heavy smokers....... with controls). DESIGN: Case-control nested in cohort study. SETTING AND PARTICIPANTS: A subsample of 503 women from a cohort of 6347 women established between 1989 and 1991 in Aarhus University Hospital. MAIN RESULTS: Measures of agreement between concurrent and retrospective data on smoking status varied...
Oude Rengerink, Katrien; Logtenberg, Sabine; Hooft, Lotty; Bossuyt, Patrick M.; Mol, Ben Willem
Pregnant women were excluded from clinical trials until the 1990s, but the Food and Drug Administration nowadays allows--and even encourages--responsible inclusion of pregnant women in trials with adequate safety monitoring. Still, randomized trials in pregnant women face specific enrolment
Conclusions: As observed in this study, most pregnant women with previous caesarean delivery prefer repeated caesarean delivery rather than VD in their subsequent pregnancy and educational level of pregnant women and doctor′s advice were important factors that influenced this preference. This subject suggests the need to counsel pregnant women with an obstetrician before select delivery type.
Oude Rengerink, Katrien; Logtenberg, Sabine; Hooft, Lotty; Bossuyt, Patrick M; Mol, Ben Willem; Oude Rengerink, K
BACKGROUND: Pregnant women were excluded from clinical trials until the 1990s, but the Food and Drug Administration nowadays allows--and even encourages--responsible inclusion of pregnant women in trials with adequate safety monitoring. Still, randomized trials in pregnant women face specific
Olesen, Charlotte; Søndergaard, Charlotte; Thrane, Nana
Surveillance of drug safety in pregnancy often draws on administrative prescription registries. Noncompliance in the use of prescribed medication may be frequent among pregnant women owing to their fear of fetotoxic side effects. To estimate compliance in the use of prescription drugs dispensed...... during pregnancy, we compared prescription data from the North Jutland Prescription Database with information on drug use provided by pregnant women to the Danish National Birth Cohort (DNBC), which is a health interview survey. We used the North Jutland Prescription Database to identify all prescription...... drugs dispensed during pregnancy for the 2,041 women who were enrolled in the DNBC in the County of North Jutland, Denmark. Compliance was defined as the probability of reporting drug use in DNBC after purchasing a dispensed prescription drug. The overall compliance to drugs purchased within 120 days...
Sommer, Janine; Daus, Mariana; Smith, María; Luna, Daniel
Today, health information technologies are constantly expanding and changing, allowing more and more people to use different mobile applications to receive information and control their health condition. Based on the need to implement an application for pregnant women in the Personal Health Record (PHR) of Hospital Italiano de Buenos Aires (HIBA), an Australian survey was carried out to measure the use and utility of a pregnancy application (pregnancy app). Our results were broadly in agreement with the reference values. The survey was distributed through social networks (Facebook and Twitter) during September 2016. We obtained 235 responses from Spanish-speaking women, mostly Argentinian. In conclusion, it could be observed that a pregnancy app offers the possibility of a greater follow-up and provides reassurance to the pregnant women who use it.
Kocaöz, Semra; Talas, Melek S; Atabekoğlu, Cem S
The aim was to investigate the prevalence of urinary incontinence during pregnancy and the related risk factors as well as to assess its influence on the quality of life. Although urinary incontinence is common during pregnancy and can have a substantial impact on quality of life, women rarely seek help for this symptom. This study was designed as a cross-sectional and descriptive survey. A total of 393 pregnant women participated in the study between March and June 2007. The data was collected using the International Consultation on Incontinence Questionnaire Short Form and Wagner's quality of life scale. Potential risk factors were investigated through logistic regression analysis. The prevalence of urinary incontinence was 27% (106/393). Factors significantly associated with urinary incontinence included age group, parity, previous urinary incontinence, constipation, urinary incontinence in mother and sister, previous urinary incontinence during pregnancy and postpartum. According to the results of our study, urinary incontinence is common in women during pregnancy. The quality of life of pregnant women was found to be either unaffected or affected very little by urinary incontinence. This study reveals that the prevalence of urinary incontinence during pregnancy is very high. The findings will help increase the awareness of health care workers involved in the care of pregnant women about urinary incontinence and aid the design of more intensive education programmes directed towards the prevention of urinary incontinence during pregnancy. © 2010 Blackwell Publishing Ltd.
Boggess, Kim A; Espinola, Janice A; Moss, Kevin; Beck, Jim; Offenbacher, Steven; Camargo, Carlos A
Maternal periodontal disease is found in pregnancy outcomes. Vitamin D deficiency may play a role in periodontal disease and tooth loss, and insufficient vitamin D status is common among pregnant women. The objective of this study is to examine the relationship between maternal vitamin D status and periodontal disease. A case-control study was conducted. Cases were defined as pregnant women with clinical moderate to severe periodontal disease; controls were pregnant women who were periodontally healthy. Maternal data were chart abstracted and serum was collected between 14 and 26 weeks of gestation. Serum 25-hydroxyvitamin D (25[OH]D) levels were measured using liquid chromatography-tandem mass spectrometry. Median serum 25(OH)D levels and prevalence of vitamin D insufficiency (defined as periodontal disease among women with vitamin D insufficiency was calculated using multivariable logistic regression, adjusting for maternal race, season of blood draw, and other potential confounders. A total of 117 cases were compared to 118 controls. Cases had lower median 25(OH)D levels than controls (59 versus 100 nmol/l; P periodontal disease among women with vitamin D insufficiency was 2.1 (0.99 to 4.5). Vitamin D insufficiency (serum 25[OH]D periodontal disease during pregnancy. Vitamin D supplementation represents a potential therapeutic strategy to improve maternal oral health.
Valladares, Guillermo; Chacaltana, Alfonso; Sjogren, Maria H
Hepatitis C is, at present, a worldwide health problem and is the most common cause of liver transplantation. Its prevalence in pregnant women is similar to that of the general population. In the absence of cirrhosis and portal hypertension, most HCV-infected pregnant women do not have obstetric complications. Screening of pregnant women that are asymptomatic and do not have risk factors is not cost effective. A high hepatitis C viral load reportedly increases vertical transmission and is higher in women who are coinfected with HIV or who are intravenous drug users. Prolonged rupture of the membrane for more than 6 h, amniocentesis, and perineal lacerations increase the potential risk of perinatal transmission. Although the hepatitis C virus can be transmitted intrapartum, prevention by caesarean delivery is not generally indicated. The HCV virus can be found in maternal milk; however, breast feeding is not contraindicated. In conclusion, there are no antiviral treatment recommendations for HCV-infected women during pregnancy, or guidelines for the prevention of vertical transmission.
Anna L. Njunda
Full Text Available Toxoplasmosis is caused by an intracellular protozoan, Toxoplasma gondii, which has a wide geographical distribution. The congenital form results in a gestational form that can present a temporary parasiteamia that will infect the fetus. For this reason early diagnosis in pregnancy is highly desirable, allowing prompt intervention in cases of infection. The aim of this study was to determine the seroprevalence of Toxoplasma gondii antibodies among pregnant women attending the Douala General Hospital. The study was carried out between March and July 2009, whereby 110 pregnant women were tested for IgG and IgM antibodies and information about eating habits and hygienic conditions was collected using a questionnaire. These women’s ages ranged from 20-44 years old with an average of 29.9 years; the overall IgG and IgM seroprevalence was 70% and 2.73 % respectively. Seroprevalence was significantly high amongst women who ate raw vegetables (76.39%, P<0.05 and there was a significant trend towards a higher seroprevalence in women who did not have a good source of water (75.58%, P<0.05. This research showed that consumption raw vegetables and poor quality drinking water are two risk factors associated with Toxoplasma gondii infection amongst pregnant women attending the Douala General Hospital in Cameroon.
Full Text Available The cause of neural tube defects (NTDs is multifactorial and in this case folic acid has an important role. Since the neural tube is closed during 21-28 days of pregnancy, most of women are not informed about their pregnancy at this time, and as a result the golden time of folic acid consumption is missed. The aim of this study was evaluating the performance of pregnant women attending to Tehran Women's Hospital in regard to folic acid intake during pre-conceptional period between 2011 and 2012. This cross-sectional study was conducted in 370 pregnant women attending the prenatal clinic of a hospital affiliate to Tehran University of Medical Sciences between 2011 and 2012. Data were collected through interview using a questionnaire. Although 70% of the pregnancies were planned, but 70.5% of pregnant women had not taken folic acid before conception or in necessary time. There was found a significant relationship between level of education, history of abnormalities in children and the number of abortions and taking folic acid before pregnancy (P=0.005, P=0.000 and P=0.000, respectively.
Full Text Available Background: Toxoplasma gondii is an obligate intracellular protozoan parasite which can infect human and animals. Acquired toxoplasmosis during pregnancy can lead to fetal infection, which may ultimately result in loss of fetus or lesion in brain and eyes. This study was performed to evaluate the seroepidemiological status of toxoplasmosis in pregnant women in Ilam City, western Iran. Methods: In this cross-sectional study, 553 blood samples were collected from pregnant women. Sera were separated by blood centrifugation at 3000 rpm for 5 min and frozen at -20 °C until use. The samples were tested for IgG antibody by Indirect Immunoflourecence antibody test (IFA. Results: Out of the 553 pregnant women, 247 were positive for T. gondii IgG antibodies and 306 were negative. The mean age of women was 21 and the seropositive rate of latent T. gondii infection was 44.8%. Conclusion: About half of the married women in the present study were at risk of infection with T.gondii, so preventive method should be considered. Keywords: Seroepidemiology, Toxoplasmosis, IFA, Iran.
Full Text Available Background &Objective: Adiponectin is an adipose tissue adipokin that may contribute to obesity and insulin resistantance. The aim of this study was to evaluate the associations between serum concentrations of adiponectin and insulin resistance in gestational diabetes (GDM.Materials & Methods: Serum adiponectin levels, fasting blood sugar (FBS, glycated hemoglobin (HbA1C, insulin levels and blood lipids were measured in 66 women with GDM and 70 pregnant women without GDM. The associations between serum concentrations of adiponectin and insulin resistance were evaluated using the homeostasis model assessment of insulin resistance (HOMA–IR and quantitative insulin sensitivity check index (QUICKI.Results: There were statistically significant between-group differences in FBS, HbA1C and HOMA–IR. Adiponectin concentrations were not significantly different in GDM women in comparison with the control group. However, GDM women above the age of 30 have significantly lower adiponectin concentrations than those without GDM. Adiponectin was positively associated with QUICKI (r = 0.268, P < 0.03 and inversely related to HOMA–IR (r = 0.238, P < 0.05.Conclusion: Adiponectin is significantly decreased in older women with GDM. Deficiency of adiponectin may correlate with insulin resistance in GDM.
Leila Graziele Dias de Almeida
Full Text Available This research had how his objectives to investigate if there is difference between the insp. and exp. pressure maxim of pregnant women and no-pregnant women of period different of pregnancy. To get the informations necessary, we use the machine manuvacuômetro MVD 500 Mycrohard Globalmed , how the instrument to have the insp. and exp. pressure maxim of pregnant and no- pregnant women that have similar age. We use how criterion to select the informer this research to be pregnant in one group and not to be pregnant in another group. The women that participate of this research were choose aleatorialy through of the indications of the another persons. We went to their houses to collect data of the insp. and exp. maxim pressure and afterward, we organize, understand, pass to the category and, finely, to find the medium of the value. The value of the insp. and exp. maxim pressures that were found in the pregnant group was the follow: PE Max= 51,3 cm H20 and PIMax= 48,3 cm H20; the averages found in the not- pregnant were: PEMax= 73 cm H20, PIMax = 69,2 cm H20. The pregnants that were in the subgroup of the 1o to 5o month had a average of PE= 56 cm H20 and PI= 60 cm H20, while the pregnant of subgroup above the 6o month had the averages of PE and PI = 56 cm H20 and 43 cm H20, respective. Based in the results we conclude that have difference between the insp. and exp. pressures between pregnant and no-pregnant women, as well as in the pregnant of different period of pregnance.
Yadav R. J
Full Text Available Research Question: What is the coverage level of immunization and other maternal services by a modified technique developed by IRMS (ICMR Delhi in comparison to standard WHO technique. Objectives: To study the â€"Coverage level for immunization, antenatal care and IFA tablets â€"Relationship of caste and education with the coverage levels. â€"Place and persons conducting deliveries. Study design: Cross-sectional. Setting: Both in rural and urban areas of Bihar. Participants: 375 mothers having children up to one year of age selected by a stratified random sampling technique developed by IRMS Delhi. Study variables: Immunisation status, antenatal care, Use of IFA tabs, Education of the female, Education of husband, place and person conducting the delivery. Statistical analysis: Proportions. Results: Overall immunization coverage was 42% for pregnant females. Coverage was high (60% in urban areas compared to rural areas (40%. Coverage was low among females from SC/ST category, also when females and their husbands were illiterates. Similar trend was observed for antenatal care and IFA tabs. 90% deliveries took place at home and were mainly attended by village dais. Majority of mothers received immunization from some. Govt. agency lack of, awareness and lack of motivation were more commonly found as reasons for non-immunisation among SC/ST as compared to others. Lack of awareness was also found as a common reason for non-immunisation among illiterate females.
Relação entre a Classificação Clínica de White e a Histopatologia das Placentas de Gestantes Diabéticas The Relationship between White's Classification and the Histopathological Changes in the Placentas of Diabetic Pregnant Women
Iracema de Mattos Paranhos Calderon
as alterações histopatológicas e a elevada proporção de recém-nascidos pré-termo nas diabéticas clínicas, classes D a FRH, sugerem amadurecimento placentário precoce nas diabéticas clínicas com vasculopatia.Purpose: to analyze the relationship between White's classification and the histopathological, changes occurring in the placentas of diabetic pregnant women, performing a qualitative comparison of histopathological changes in the placentas of nondiabetic pregnant women with those in diabetic ones (classes A and A/B, clinical, short duration (classes B and C, and clinical with vasculopathy (classes D to FRH, studying the influence of the quality of glycemic control and of gestational age on placental changes in the three groups of diabetic pregnant women. Patients and methods: specimens of placentas were collected from all diabetic pregnant women seen between 1991 and 1996 in the Maternity Section of the Hospital das Clínicas, Faculdade de Medicina de Botucatu, stained using the hematoxylin-eosin technique, and submitted to a histopathological examination. The quality of glycemic control was analyzed by the glycemia average of gestation and classified as adequate or inadequate, with a limit of 120 mg/dl. Gestational age was individualized as term and preterm. Results: forty-two newborns (43.3% were born at term and the remaining were preterm (56.7%. The prematurity rate was higher for women with clinical diabetes (classes B and C; D to FRH. Some histopathological alterations were observed only in placentas from diabetic pregnant women: cystoid degeneration, chorial edema, intima edema, dysmaturity, Hofbauer cell hyperplasia, villitis, ghost cells, two vessels in the umbilical cord, and endarteritis. Conclusions: histopathological changes in the placentas of pregnant women with gestational diabetes (classes A and A/B, clinical, short duration (classes B and C, and clinical with vasculopathy (classes D to FRH were similar to those in the nondiabetic ones
Mar 3, 2014 ... and 106/114(93.0%) were seropositive among women in the first, second and third trimesters respectively. .... transient depression of CMV- specific cellular immu- nity can be .... Malaysian Journal of Microbiology. 2007;3:23–8 ...
Cook, Rebecca J; Dickens, Bernard M
Recent decisions of the Committee on the Elimination of Discrimination against Women (CEDAW), the Inter-American Court of Human Rights, and the High Court of Delhi have shown how the pregnancy-related deaths of individual women have been bases on which these authoritative tribunals have held Brazil, Paraguay, and India respectively accountable for avoidable maternal mortality not only in these cases, but also among their populations more generally. The right to life is the most fundamental of women's human rights, recognized in international human rights treaties and national laws. Failure of governments to apply their resources adequately to address, respect, and protect this right violates the law of human rights. These cases show, however, that governments may fail to allocate adequate resources to women's survival of pregnancy. Tribunals can build on the failures in individual cases to set standards of performance to which governments will legally be held to achieve safe motherhood. Copyright Â© 2012 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
Full Text Available Abstract Background Intimate partner violence (IPV, defined as actual or threatened physical, sexual, psychological, and emotional abuse by current or former partners is a global public health concern. The prevalence and determinants of intimate partner violence (IPV against pregnant women has not been described in Rwanda. A study was conducted to identify variables associated with IPV among Rwandan pregnant women. Methods A convenient sample of 600 pregnant women attending antenatal clinics were administered a questionnaire which included items on demographics, HIV status, IPV, and alcohol use by the male partner. Mean age and proportions of IPV in different groups were assessed. Odds of IPV were estimated using logistic regression analysis. Results Of the 600 respondents, 35.1% reported IPV in the last 12 months. HIV+ pregnant women had higher rates of all forms of IVP violence than HIV- pregnant women: pulling hair (44.3% vs. 20.3%, slapping (32.0% vs. 15.3%, kicking with fists (36.3% vs. 19.7%, throwing to the ground and kicking with feet (23.3% vs. 12.7%, and burning with hot liquid (4.1% vs. 3.5%. HIV positive participants were more than twice likely to report physical IPV than those who were HIV negative (OR = 2.38; 95% CI [1.59, 3.57]. Other factors positively associated with physical IPV included sexual abuse before the age of 14 years (OR = 2.69; 95% CI [1.69, 4.29], having an alcohol drinking male partner (OR = 4.10; 95% CI [2.48, 6.77] for occasional drinkers and OR = 3.37; 95% CI [2.05, 5.54] for heavy drinkers, and having a male partner with other sexual partners (OR = 1.53; 95% CI [1.15, 2.20]. Education was negatively associated with lifetime IPV. Conclusion We have reported on prevalence of IPV violence among pregnant women attending antenatal care in Rwanda, Central Africa. We advocate that screening for IPV be an integral part of HIV and AIDS care, as well as routine antenatal care. Services for battered women should also be
Diabetes is a disease in which your blood glucose, or blood sugar, levels are too high. When ... pregnant women in the United States get gestational diabetes. Gestational diabetes is diabetes that happens for the ...
Romero, Roberto; Hassan, Sonia S; Gajer, Pawel
was higher than that of non-pregnant women; however, during normal pregnancy, bacterial communities shift almost exclusively from one CST dominated by Lactobacillus spp. to another CST dominated by Lactobacillus spp. CONCLUSION: We report the first longitudinal study of the vaginal microbiota in normal......BACKGROUND: This study was undertaken to characterize the vaginal microbiota throughout normal human pregnancy using sequence-based techniques. We compared the vaginal microbial composition of non-pregnant patients with a group of pregnant women who delivered at term. RESULTS: A retrospective case......-control longitudinal study was designed and included non-pregnant women (n = 32) and pregnant women who delivered at term (38 to 42 weeks) without complications (n = 22). Serial samples of vaginal fluid were collected from both non-pregnant and pregnant patients. A 16S rRNA gene sequence-based survey was conducted...
Xie, Huan Yu; Feng, Dan; Wei, Dong Mei; Mei, Ling; Chen, Hui; Wang, Xun; Fang, Fang
Vulvovaginal candidiasis (VVC) is estimated to be the second most common form of infection after bacterial vaginosis. The ability of probiotics in maintaining and recovering the normal vaginal microbiota, and their potential ability to resist Candidas give rise to the concept of using probiotics for the treatment of VVC. To assess the effectiveness and safety of probiotics for the treatment of vulvovaginal candidiasis in non-pregnant women. We searched the following databases to October 2017: Sexually Transmitted Infections Cochrane Review Group's Specialized Register, CENTRAL, MEDLINE, Embase and eight other databases. We searched in following international resources: World Health Organization International Clinical Trials Registry Platform, ClinicalTrials.gov, Web of Science and OpenGrey. We checked specialty journals, reference lists of published articles and conference proceedings. We collected information from pharmaceutical companies and experts in the field. Randomized controlled trials (RCT) using probiotics, alone or as adjuvants to conventional antifungal drugs, to treat VVC in non-pregnant women. Trials recruiting women with recurrent VVC, coinfection with other vulvovaginal infections, diabetes mellitus, immunosuppressive disorders or taking immunosuppressant medication were ineligible for inclusion. Probiotics were included if they were made from single or multiple species and in any preparation type/dosage/route of administration. Two review authors independently assessed trials for eligibility and quality and extracted data. We resolved any disagreements through consensus. The quality of the evidence was assessed using the GRADE approach. Ten RCTs (1656 participants) met our inclusion criteria, and pharmaceutical industry funded none of these trials. All trials used probiotics as adjuvant therapy to antifungal drugs. Probiotics increased the rate of short-term clinical cure (risk ratio (RR) 1.14, 95% confidence interval (CI) 1.05 to 1.24, 695
Chantacha Sitticharoon, M.D., Ph.D.
Full Text Available Objective: This study aimed to compare serum adiponectin, visfatin, and omentin between non-pregnant and pregnant women in overall, non-obese, and obese subjects. Methods: There were 40 pregnant and 33 non-pregnant women classified by body mass index (BMI into non-obese or obese subjects. Fasting blood samples were collected in the morning for the non-pregnant group and before delivery for the pregnant group. Results: Plasma glucose levels were significantly lower, but plasma insulin levels were significantly higher in pregnant when compared to non-pregnant women in overall, non-obese, and obese women (p<0.05 all. The homeostasis model assessment of insulin resistance (HOMA-IR was significantly higher, but the quantitative insulin sensitivity check index (QUICKI was significantly lower only in obese pregnant when compared to obese non-pregnant women (p<0.01 all. However, in non-obese women, HOMA-IR and QUICKI were comparable between pregnant and non-pregnant women. Serum adiponectin, visfatin, and omentin were significantly lower in pregnant compared to non-pregnant women in overall, non-obese, and obese groups (p<0.05 all. In pregnant women, serum adiponectin and omentin levels were significantly lower in obese compared to non-obese pregnant women while serum visfatin levels were comparable in both groups. Serum adiponectin levels were highest followed by omentin and visfatin, respectively in both non-obese and obese pregnant groups. These results indicated that lower serum adiponectin, visfatin, and omentin in pregnant women might contribute to higher insulin resistance in pregnancy. Furthermore, serum adiponectin and omentin were reduced in increasing adiposity similarly to non-pregnant women. Conclusion: Lower serum adiponectin, visfatin, and omentin in pregnant women might lead to decreased insulin sensitivity in these women.
Petersen, Kathrine Birch; Johansen, Helle Krogh; Rosthoj, Susanne
the Clinical Microbiology Database. Maternal data were obtained from a local database at the RH. RESULTS: In our cohort, a total of 638 (3.8%) women were diagnosed with GBS, 517 (81%) from urine, 92 (14%) from vaginal swabs and 29 (5%) from both. The overall rate of women colonised with GBS rose from 3......INTRODUCTION: Group B streptococci (GBS) can cause preterm delivery for women and sepsis and meningitis in infants younger than 90 days of age. The present retrospective cohort study determines the trend over time in the rates of GBS and in demographic risk factors for GBS among pregnant women...... delivering at Rigshospitalet (RH). MATERIAL AND METHODS: In the period from 2002 to 2010, a total of 33,616 women gave birth at the RH. Our cohort was defined as 16,587 (49%) women examined by 24,724 cultures. All microbiological requisitions from the Department of Obstetrics at RH were extracted from...
Geiker, Nina Rica Wium; Thomsen, Henrik Segelcke; Astrup, Arne
therefore undertook a study of the willingness of obese women to undergo MRI during pregnancy. Method: Obese pregnant women, body mass index (BMI) 30-45 kg/m2, participating in a weight management intervention study, were offered three MRI scans to be performed during pregnancy. One hundred and one women......Background/Aim: Magnetic resonance imaging (MRI) is considered safe to perform during pregnancy. In spite of this many women are reluctant to undergo the examination. Weight gain is to be expected during pregnancy, but little is known about changes in the compartmentalization of abdominal fat. We...... were offered MRI scanning in gestational week (GW) 15, 64 in GW 32, and 45 in GW 40. Results: Of 106 women offered MRI scans 102 completed (96%) at least one scan. In total 177 out of 210 possible scans were completed. The proportion of women who completed first, second and third MRI scans were 96%, 83...
McGowan, C A
Vitamin D has an important role in pregnancy in promoting fetal skeletal health. Maternal dietary intake is a key factor influencing both maternal and fetal status. There are limited data available on food groups contributing to vitamin D intake in pregnancy. The aim of this study was to determine dietary intakes of vitamin D throughout pregnancy in 64 women and to determine the main food groups contributing to vitamin D intake. Results showed that median dietary intakes of vitamin D ranged from 1.9-2.1 μg\\/d during pregnancy, and were 80% below the current recommendation. The principal food groups contributing to vitamin D intake were meat, egg and breakfast cereal groups. Oily fish, the best dietary source of vitamin D, was consumed by <25% of women. These data call for more education; they question the role of vitamin D supplementation and highlight the contribution of other food groups more frequently consumed, namely, breakfast cereals, meat and eggs.
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Duffy, Emeir M; Bonham, Maxine P; Wallace, Julie M W; Chang, Chin-Kuo; Robson, Paula J; Myers, Gary J; Davidson, Philip W; Clarkson, Thomas W; Shamlaye, Conrad F; Strain, J J
To establish the Fe status of pregnant women and their neonates in the Republic of Seychelles. A prospective study. Republic of Seychelles. Pregnant women were recruited and blood samples taken at enrolment and post-delivery along with cord blood samples. Ferritin and soluble transferrin receptor (sTfR) were measured in maternal (n 220) and cord blood (n 123) samples. Maternal Fe deficiency (ferritin 28 nmol/l) was present in 6 % of subjects at enrolment and in 20 % at delivery. There was no significant decrease in maternal ferritin. A significant increase in sTfR was observed between enrolment and delivery (P < 0.001). Maternal BMI and use of Fe supplements at 28 weeks' gestation were associated with improved maternal Fe status at delivery, whereas parity had a negative effect on sTfR and ferritin at delivery. Fe status of pregnant Seychellois women was, on average, within normal ranges. The incidence of Fe deficiency throughout pregnancy in this population was similar to that in a Westernised population. Increased awareness of the importance of adequate Fe intake during pregnancy, particularly in multiparous women, is warranted.
Rodrigo Batista Souza
Full Text Available The aim this study was to determine the in vitro susceptibility to fosfomycin of bacteria isolated from urine samples of pregnant women with urinary tract infection. Samples of urine culture with bacterial growth of pregnant women were collected from clinical laboratories in Tubarão, state of Santa Catarina, Brazil, between September 2012 and May 2013. In the experimental stage, the colonies were tested for sensitivity to fosfomycin by using the Kirby–Bauer method. The following information relating to the samples was also collected: patients’ age, colony count, type(s of identified bacterial(s and result of the antimicrobial sensitivity test. Student's t-test was used for mean comparison. A total of 134 samples were selected for the study. The age of the subjects ranged from 15 to 40 years (mean 26.7. Escherichia coli (Gram-negative and Staphylococcus aureus (Gram-positive were the most commonly identified species. In 89% of cases, the microorganisms were sensitive to fosfomycin. E. coli and S. aureus were the main species of bacteria responsible for urinary tract infections in women in the study area. The most prevalent microorganisms in pregnant women with urinary tract infection were susceptible to fosfomycin.
To determine the frequency pattern of presentation and causative agents of lower urinary tract symptoms in pregnant females. One thousand consecutive pregnant women, attending the antenatal clinics of Fatima Memorial Hospital, were included in the study. Women with renal pathology, postrenal transplant and those on immunosuppressive agents were excluded. All women underwent complete examination of urine. Those who had one or more urinary complaints had culture and sensitivity test of urine. Other variables studied were the symptomatology. Out of one thousand pregnant women, 426 (42.6%) complained of one or more urinary symptoms. Diurnal and nocturnal frequency was the most commonly encountered symptom (87.32%), followed by irritative symptoms and voiding difficulties. Complete urine examination of symptomatic patients revealed < 5 pus cells /HPF (high power field) in 322 cases and 6-20 pus cell/HPF in the remaining 104 cases. The urine culture of the symptomatic patients (426 cases) showed growth in only 37 cases (8.69%). Escherichia (E.) coli was the commonest organism (89.1%) followed by Staphylococcus (S.) aureus (8.1%) and candidiasis (2.7%). (author)
Duria Abdulwhab Rayis
Full Text Available Objective: To determine the epidemiology of malaria [especially Plasmodium vivax (P. vivax] among pregnant women in Eastern Sudan. Methods: A cross sectional study was conducted in the antenatal care of New Halfa hospital, Eastern Sudan to investigate the prevalence, manifestations and determinants of malaria (especially P. vivax among pregnant women. Results: Out of 2 378 pregnant women, there were 48 (2.0% and 36 (1.5% Plasmodium falciparum (P. falciparum and P. vivax infection, respectively. There was no significant difference in the age, parity, gestational age between women with malaria and healthy controls. The mean ± SD of the temperature was significantly higher in patients with P. vivax than in patient with P. falciparum malaria [(38.6 ± 0.7 °C vs. (38.1 ± 0.6 °C, P = 0.001]. Patients with P. vivax malaria had slightly (not reach statistical significance lower hemoglobin level compared with P. falciparum malaria and healthy controls. The geometric parasite count showed no significant difference between patients with P. vivax and P. falciparum malaria infections (12 189.9 vs. 9 755.1 trophozoite/µL, P = 0.356. Conclusions: P. vivax malaria is an existing health problem in Eastern Sudan. Further research is also needed.
Brantsæter, Anne Lise; Abel, Marianne Hope; Haugen, Margaretha; Meltzer, Helle Margrete
Pregnant women and infants are exceptionally vulnerable to iodine deficiency. The aims of the present study were to estimate iodine intake, to investigate sources of iodine, to identify predictors of low or suboptimal iodine intake (defined as intakes below 100 μg/day and 150 μg/day) in a large population of pregnant Norwegian women and to evaluate iodine status in a sub-population. Iodine intake was calculated based on a validated Food Frequency Questionnaire in the Norwegian Mother and Child Cohort. The median iodine intake was 141 μg/day from food and 166 μg/day from food and supplements. Use of iodine-containing supplements was reported by 31.6%. The main source of iodine from food was dairy products, contributing 67% and 43% in non-supplement and iodine-supplement users, respectively. Of 61,904 women, 16.1% had iodine intake below 100 μg/day, 42.0% had iodine intake below 150 μg/day and only 21.7% reached the WHO/UNICEF/ICCIDD recommendation of 250 μg/day. Dietary behaviors associated with increased risk of low and suboptimal iodine intake were: no use of iodine-containing supplements and low intake of milk/yogurt, seafood and eggs. The median urinary iodine concentration measured in 119 participants (69 μg/L) confirmed insufficient iodine intake. Public health strategies are needed to improve and secure the iodine status of pregnant women in Norway.
I. A. Lyoshenko
Abstract Purpose. To determine the state of various stages of hemostasis in pregnant women with hydramnion as a risk factor for premature detachment of the placenta. Results. There was investigated the state of hemostasis in pregnant women with hydramnion by low piezoelectric thromboelastography (LPTEG and standard coagulogram. According to the LPTEG results this group of women was found to have increased plasma coagulation potential manifested in elevated constant thrombin activity (TAC by 76.8%, the intensity of coagulation drive (ICD by 74.9%, maximum clot density (MA by 16.8%, shortening of coagulation time (T3 by 7.8% and inhibition of fibrinolysis manifested by decrease in retraction intensity and clot lysis (RICL by 67.7% (p<0.05. Conclusions. The state of hemostasis in pregnant women with hydramnion is characterized by increased plasma coagulation and inhibition of fibrinolysis potential that are factors of preparing the woman’s body for the upcoming birth to control and minimize blood loss. Keywords: pregnancy, hydramnion, hemostasis, thromboelastography.
Ewing, Alexander C; Datwani, Hema M; Flowers, Lisa M; Ellington, Sascha R; Jamieson, Denise J; Kourtis, Athena P
With the development and widespread use of combination antiretroviral therapy, HIV-infected women live longer, healthier lives. Previous research has shown that, since the adoption of combination antiretroviral therapy in the United States, rates of morbidity and adverse obstetric outcomes remained higher for HIV-infected pregnant women compared with HIV-uninfected pregnant women. Monitoring trends in the outcomes these women experience is essential, as recommendations for this special population continue to evolve with the progress of HIV treatment and prevention options. We conducted an analysis comparing rates of hospitalizations and associated outcomes among HIV-infected and HIV-uninfected pregnant women in the United States from 2004 through 2011. We used cross-sectional hospital discharge data for girls and women age 15-49 from the 2004, 2007, and 2011 Nationwide Inpatient Sample, a nationally representative sample of US hospital discharges. Demographic characteristics, morbidity outcomes, and time trends were compared using χ(2) tests and multivariate logistic regression. Analyses were weighted to produce national estimates. In 2011, there were 4751 estimated pregnancy hospitalizations and 3855 delivery hospitalizations for HIV-infected pregnant women; neither increased since 2004. Compared with those of HIV-uninfected women, pregnancy hospitalizations of HIV-infected women were more likely to be longer, be in the South and Northeast, be covered by public insurance, and incur higher charges (all P pregnant women with HIV infection had higher rates for many adverse outcomes. Compared to 2004, hospitalizations of HIV-infected pregnant women in 2011 had higher odds of gestational diabetes (adjusted odds ratio, 1.81; 95% confidence interval, 1.16-2.84), preeclampsia/hypertensive disorders of pregnancy (adjusted odds ratio, 1.58; 95% confidence interval, 1.12-2.24), viral/mycotic/parasitic infections (adjusted odds ratio, 1.90; 95% confidence interval, 1
This outline review concludes that pregnancy is a major contra-indication for any diagnostic procedures. The only exception is a perfusion scintigraphy of the lungs, when a pulmonary embolism is suspected. Accidental exposures of the embryo should be guarded against by implementing the ten day rule for diagnostic examinations of fertile women at risk of pregnancy. In the event of clinical emergencies resulting in radiation of an early developing embryo, reconstruction of the received dose is essential. A foetal dose of 10 rads or more is usually considered as an indication of a therapeutic abortion, while doses below 1 rad can probably be neglected. (U.K.)
Olén, Ola; Montgomery, Scott M; Ekbom, Anders; Bollgren, Ingela; Ludvigsson, Jonas F
Previous research has indicated a link between coeliac disease (CD) and urinary tract infection (UTI). The objective of this study was to assess the risk of UTI and repeated episodes of UTI before the current pregnancy in women with diagnosed or undiagnosed CD. A national registry-based cohort study restricted to pregnant women was used in this investigation, with linkage between the Swedish National Medical Birth Registry and the National Inpatient Registry. We analysed the risk of UTI during pregnancy from 1973 to 1989 in 212 pregnancies to women who had received a diagnosis of CD prior to giving birth and in 786 pregnancies to women diagnosed after giving birth. We also assessed the risk of repeated episodes of UTI before the current pregnancy according to data in the national birth records of 1990-2001 in 617 women with CD diagnosed prior to giving birth and 109 women diagnosed after giving birth. UTI during pregnancy: UTI occurred during 19,139/1,678,304 pregnancies to women who had never had a diagnosis of CD, compared with in 12/786 pregnancies to women with undiagnosed CD (adjusted odds ratio (AOR)=1.37; 95% CI=0.78-2.43; p=0.276) and in 0/212 pregnancies to women with diagnosed CD (AOR=0.06; 95% CI=0.00-8.94; p=0.277) (ORs adjusted for maternal age, parity, nationality and calendar period). Repeated episodes of UTI before the current pregnancy: among 692,991 women who had never had a diagnosis of CD, 74,776 reported repeated episodes of UTI, compared with 14/101 women with undiagnosed CD (AOR=1.39; 95% CI=0.79-2.45; p=0.255) and 69/566 women with diagnosed CD (AOR=1.02; 95% CI=0.79-1.32; p=0.864) (ORs adjusted for maternal age, parity, nationality, calendar period and civil status). Adjustment for smoking in a subset of patients with available data did not change the risk estimates. It cannot be ruled out that undiagnosed CD in pregnant women is associated with a small, increased risk of UTI. In pregnant women with diagnosed CD, there seems to be no
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Mukerji, G; Kainth, S; Pendrith, C; Lowe, J; Feig, D S; Banerjee, A T; Wu, W; Lipscombe, L L
To determine what proportion of women with gestational diabetes underestimate their diabetes risk and identify factors associated with low diabetes risk perception. Participants included pregnant adult women with gestational diabetes between 2009 and 2012 across seven diabetes clinics in Ontario, Canada. Data were collected through chart review and a survey that included a diabetes risk perception question. Of the 614 of 902 women (68% response rate) with gestational diabetes, 89% correctly responded that gestational diabetes increases the risk for developing diabetes. However, 47.1% of women perceived themselves to be at low risk for developing diabetes within 10 years. On multivariable analysis, BMI gestational diabetes history, absent diabetes family history and absent insulin use were appropriately associated with low diabetes risk perception. However, compared with Caucasian ethnicity, high-risk ethnicity (Aboriginal, Latin American, West Indian, South Asian, Middle Eastern, Filipino, Black, Pacific Islander) [odds ratio (OR) 2.07; 95% CI 1.30-3.31] and East and South East Asian ethnicity (OR 2.01; 1.10-3.67) were associated with low diabetes risk perception. After further adjustment for immigration, only high-risk ethnicity remained a predictor of low diabetes risk perception (OR 1.86; 1.09-3.19), whereas East and South East Asian ethnicity did not (OR 1.67; 0.86-3.22). Although the majority of women recognized gestational diabetes as a risk factor for diabetes, almost half underestimated their personal high diabetes risk despite prenatal care. Furthermore, women from high-risk ethnic groups were more likely to underestimate their risk, even after adjusting for immigration. Interventions tailored to these groups are necessary to enhance perceived diabetes risk. © 2015 Diabetes UK.
Full Text Available Pregnancy causes significant haemodynamic changes and imposes stress on the cardiovascular system. Many healthy women develop signs and symptoms of cardiovascular overload during pregnancy. Knowledge of established normal changes in EKG during normal pregnancy is important. The aim of our study was to detect any early damage to myocardium during pregnancy with the help of electrocardiography. Total of 20 pregnant and 20 non pregnant women were studied. The most significant change observed in ECG was T wave inversion with odds ratio 7.43 (95%. Cl = 1.49 to 41.00. P= 0.005. Stratified analysis showed that there was no confounding role of age in the relationship of T wave inversion and ECG findings. Moreover, a significant relationship between anaemia and T wave inversion was also observed. (0=1.74 ■ 1101.06; P= 0.007.
de Aguiar, M M; da Silva, H J; Rizzo, J Â; Leite, D F B; Silva Lima, M E P L; Sarinho, E S C
The aim of this study was to systematically review the safety and efficacy of inhaled beclomethasone for asthma treatment in pregnant women. We performed a systematic review in Medline, LILACS and SciELO electronic databases in December 2012. A total of 3433 articles were found by using the keywords asthma, pregnancy and beclomethasone. Among these, 1666 were from Medline, via PubMed, and 1767 were from LILACS and SciELO. Nine of these articles were selected. Only one paper suggested an increased foetal risk for congenital malformations, and one other for offspring endocrine and metabolic disturbances. Data are mostly reassuring, supporting the use of glucocorticoid inhalants during pregnancy, and we found no evidence of inferiority in relation to efficacy and safety of beclomethasone compared to other drugs used in pregnant asthmatic women. Copyright © 2013 SEICAP. Published by Elsevier Espana. All rights reserved.
Full Text Available Although pregnancy was once thought to protect against psychiatric disorders, gravid and non gravid women have similar risks for major depression, at 10% to 15%. Both depression and antidepressant treatment during pregnancy have been associated with risks. Few medications have been proved unequivocally safe during pregnancy. Although certain antidepressants have not been linked with an increased risk of birth defects or impaired development including bupropion, citalopram, escitalopram and venlafaxine, the latest studies aren't necessarily reassuring. As researchers continue to learn more about antidepressants, the risks and benefits of taking the drugs during pregnancy must be weighed carefully on a case-by-case basis. This review discusses about the use of new generation of antidepressants in pregnancy
Damm, P.; Mathiesen, E.; Clausen, T.D.
Planned pregnancy is mandatory in women with diabetes, and their need for contraception is essential. Basically, the same methods can be used as in women without diabetes, but a number of specific conditions have to be considered when guiding these women, as we discuss in this review. Unfortunately......, the field is limited in studies in certain areas, especially considering contraception for women with type 1 diabetes and late diabetic complications and women with type 2 diabetes. Thus, in the real clinical world, the choice of contraceptive often will be a kind of compromise, balancing pro and cons...
Damm, Peter; Mathiesen, Elisabeth; Clausen, Tine Dalsgaard
Planned pregnancy is mandatory in women with diabetes, and their need for contraception is essential. Basically, the same methods can be used as in women without diabetes, but a number of specific conditions have to be considered when guiding these women, as we discuss in this review. Unfortunately......, the field is limited in studies in certain areas, especially considering contraception for women with type 1 diabetes and late diabetic complications and women with type 2 diabetes. Thus, in the real clinical world, the choice of contraceptive often will be a kind of compromise, balancing pro and cons...
Parsons, Judith; Ismail, Khalida; Amiel, Stephanie; Forbes, Angus
Women with gestational diabetes are at high risk of developing type 2 diabetes, which could be prevented or delayed by lifestyle modification. Lifestyle interventions need to take into account the specific situation of women with gestational diabetes. We aimed to gain a deeper understanding of women's experiences of gestational diabetes, their diabetes risk perceptions, and their views on type 2 diabetes prevention, to inform future lifestyle interventions. We conducted a metasynthesis that included 16 qualitative studies and identified 11 themes. Factors that require consideration when developing a type 2 diabetes prevention intervention in this population include addressing the emotional impact of gestational diabetes; providing women with clear and timely information about future diabetes risk; and offering an intervention that fits with women's multiple roles as caregivers, workers, and patients, and focuses on the health of the whole family.
Auriault, F; Thollon, L; Peres, J; Delotte, J; Kayvantash, K; Brunet, C; Behr, M
This study report documents the development of a finite element (FE) model for analyzing trauma in pregnant women involved in road accidents and help the design of a specific safety device. The model is representative of a 50th percentile pregnant woman at 26 weeks of pregnancy in sitting position. To achieve this, the HUMOS 2 model, which has been validated in a wide range of dynamic tests, was scaled to the morphology of a woman in the 50th percentile and coupled with a model of gravid uterus. During scaling, special attention was paid to the pelvic region which is known to differ considerably in morphological terms between men and women. The gravid uterus model includes a placenta, a fetus, uterosacral ligaments and the amniotic fluid by means of fluid structure interaction formulation. The uterus and the female model were coupled using an original method whereby the growth of an uterus was simulated to compress the abdominal organs in a realistic manner. The model was validated based on experimental tests described in the literature. Additional tests based on abdominal loadings with a seatbelt on Post Mortem Human Surrogates (PMHS) coupled to silicone uterus were also performed. Results highlighted the role of the possible interaction of the fetus in the pregnant woman abdominal response. Experimental corridors taking into account the presence of this fetus could therefore be proposed. © 2013 Elsevier Ltd. All rights reserved.
This podcast is targeted to pregnant women and explains 1) the signs and symptoms of the flu, and 2) what to do if you experience and signs and symptoms. This podcast is NOT a substitute for the advice of your doctor or health care provider. It is intended for educational purposes only. Created: 11/17/2010 by National Center for Immunization and Respiratory Diseases (NCIRD), Office of the Director (OD). Date Released: 11/17/2010.
Fan, Ling; Zou, Li-ying; Wu, Yu-mei; Zhang, Wei-yuan
To investigate the risk factors associated with abnormal cervical cytology findings in pregnant women. From Sep. 2007 to Sep. 2008, 12,112 pregnant women who underwent their antenatal examinations at 12-36 gestational weeks in Beijing Obstetrics and Gynecology Hospital were enrolled in this study. They were all excluded from the following pathologic obstetrics factors including threatened abortion, premature rupture of membranes or placental previa. Thinprep cytology test (TCT) were given at their first examination, meanwhile, a personal clinic file was established to record her occupation, education, address, family income, nationality, age of first intercourse, number of sex partners, contraception, marriage and pregnancy, current gynecologic diseases, family history of gynecologic tumors, history of gynecologic diseases and smoking and result of pelvic examination. Those risk factors leading to abnormal cervical cytology were analyzed. The complete clinical data were collected from 11 906 cases (98.30%, 11,906/12,112). It was found that 10,354 women were shown with normal TCT result, however, 1134 women (9.52%, 1134/11,906) with atypical squamous cells of undetermined significance (ASCUS), 112 women (0.94%, 112/11,906) with atypical glandular cells of undetermined significance (AGUS), 229 women (1.92%, 229/11,906) with low grade squamous intraepithelial (LSIL), 74 women (0.62%, 74/11,906) with high grade squamous intraepithelial (HSIL). Multiple factorial non-conditioned logistic regression analysis showed that age of first sexual intercourse (OR(ASCUS) = 2.90, OR(AGUS) = 7.32), number of sex partners (OR(ASCUS) = 1.49, OR(AGUS) = 2.02), number of abortion (OR(ASCUS) = 1.68, OR(AGUS) = 3.50) were correlated with ASCUS and AGUS. In LSIL group and HSIL group, age of first sexual intercourse (OR(LSIL) = 6.34, OR(HSIL) = 9.26), number of sex partners (OR(LSIL) = 1.69, OR(HSIL) = 1.65), number of abortion (OR(LSIL) = 1.53, OR(HSIL) = 5.33), smoking (OR(LSIL) = 1
Adhikari, A.; Biswas, S.; Chattopadhyay, J.C.
Objective: To evaluate the drug use habit of pregnant women in villages of central India. Methods: An observational, cross sectional study was conducted among six hundred fifty pregnant women from different randomly selected villages of Wardha district of central India through interviews on medicine use behaviour and evaluation of prescriptions. Results: Pregnant women of younger age group from lower socio economic status constituted the majority of the study population. Major portion (97.7) of this socio economically backward population followed the doctor's advice as far as dose, frequency and duration of the drug was concerned. The antenatal mothers were of the opinion that, if the instructions on the drug envelop or foil was in written in the local language, it could be more helpful for them. Conclusion: Majority of the study population used drugs or medicines regularly but some mothers were reluctant. This indicated that even in this age of advancement of scientific knowledge, all antenatal mothers were not conversant with the advantages of drug use. (author)
Full Text Available BACKGROUND A prospective clinical study to know the various types of congenital Neuroectodermal Anomalies on obstetric Ultrasound, in rural pregnant women. To reduce the maternal morbidity and mortality by early detection of these Congenital Neuroectodermal Anomalies. To calculate the incidence and prevalence of different types of Congenital Neuroectodermal Anomalies, in these rural pregnant women. To assist the obstetrician in taking decisions regarding the termination or continuation of the pregnancy in relation to the type of malformation and its prognosis. METHODS A prospective clinical study of Congenital Neuroectodermal Anomalies in 22,000 rural pregnant women coming to the Santhiram Medical College, Radiology Department for a routine obstetric scan. 44 cases of neuroectodermal anomalies were detected out of the 22000 cases, within an incidence of 2 per 1000 cases. Approximately 1 in every 500 cases showed an anomaly. RESULTS The most common lesions detected were hydrocephalus, and spina bifida followed by anencephaly. Association of these lesions with consanguinity, previous history of similar anomaly and intake of iron and folic acid tablets was noted. CONCLUSION Ultrasound is an excellent modality for the diagnosis and characterisation of the neuroectodermal anomalies. Its multiplanar imaging property along with real time image visualisation make it an excellent tool for the diagnosis and characterisation of these anomalies
Ali, Shahzad; Akhter, Shamim; Neubauer, Heinrich; Scherag, André; Kesselmeier, Miriam; Melzer, Falk; Khan, Iahtasham; El-Adawy, Hosny; Azam, Asima; Qadeer, Saima; Ali, Qurban
Brucella species occasionally cause spontaneous human abortion. Brucella can be transmitted commonly through the ingestion of raw milk or milk products. The objective of this study was to determine the sero-prevalence of and to identify potential risk factors for brucellosis in pregnant women from Rawalpindi, Pakistan. We conducted a cross-sectional study at the Gynecology Outdoor Patient department of the Benazir Bhutto Hospital, Rawalpindi, Pakistan from March to June 2013. Data related to potential risk factors and clinical history was collected by individual interviews on the blood sampling day. The 429 serum samples collected were initially screened by Rose Bengal Plate Agglutination test for the detection of Brucella antibodies. We applied standard descriptive statistics and logistic regression analyses. Twenty five (5.8 %; 95 % confidence interval (CI): 3.8 % -8.5 %) serum samples were found to be seropositive. Brucellosis-related clinical symptoms were recorded in various seropositive cases. Animal contact, raw milk consumption, having an abortion history and the experience of an intrauterine fetal death were associated with seropositivity for brucellosis in univariate analyses (all p Brucellosis is a serious threat for pregnant women and their unborn children in Pakistan. Pregnant women having brucellosis-related symptoms or previous history of abortions, miscarriages, intrauterine fetal death and other brucellosis-related manifestations should be screened for brucellosis - especially those exposed to animals given the increased risk - and medication should be administered according to state of the art.
Vera A. Yakupova
Full Text Available Nowadays in vitro fertilization procedure is widespread. Due to improvements in medical technology parenting has become possible for couples who were doomed to childlessness. Practical request for psychological support couples who have decided to take part in the IVF program has been raised. Shaping the internal position of the IVF parent takes place in special psychological conditions. The IVF procedure is preceded by a period of infertility, the procedure is often the last chance to have a baby alone. Participation in the IVF program involves regular contact with doctors, medical personnel access to the intimate sphere of life couples. The paper analyzes the attitude of women participating in the IVF pregnancy program, the unborn baby and parenting - the elements constituting the parent position. The study which was attended by 224 pregnant women, 62 participants of IVF program and 162 women with physiological pregnancy was carried out on the basis of Kulakov Scientific Centre for Obstetrics, Gynecology and Perinatology. When analyzing the data obtained we were able to identify features of the internal position of women who became pregnant using IVF. In comparison with a group of women with physiological pregnancy, the IVF program participants tend to romanticize the role of parent and child. IVF program participants demonstrate unwillingness to take on the role of parent. The main motivation of mothers in the IVF group concentrated on the very fact of pregnancy and childbirth, proper parenting, while care and support for children is not appealing to women who became pregnant using IVF. Important conditions for becoming a parent are the experience of motherhood and the time of pregnancy expectation.
Full Text Available Abstract Background In areas where malaria is endemic, pregnancy is associated with increased susceptibility to malaria. It is generally agreed that this risk ends with delivery and decreases with the number of pregnancies. Our study aimed to demonstrate relationships between malarial parasitaemia and age, gravidity and anaemia in pregnant women in Libreville, the capital city of Gabon. Methods Peripheral blood was collected from 311 primigravidae and women in their second pregnancy. Thick blood smears were checked, as were the results of haemoglobin electrophoresis. We also looked for the presence of anaemia, fever, and checked whether the volunteers had had chemoprophylaxis. The study was performed in Gabon where malaria transmission is intense and perennial. Results A total of 177 women (57% had microscopic parasitaemia; 139 (64%of them were primigravidae, 38 (40% in their second pregnancy and 180 (64% were teenagers. The parasites densities were also higher in primigravidae and teenagers. The prevalence of anaemia was 71% and was associated with microscopic Plasmodium falciparum parasitaemia: women with moderate or severe anaemia had higher parasite prevalences and densities. However, the sickle cell trait, fever and the use of chemoprophylaxis did not have a significant association with the presence of P. falciparum. Conclusions These results suggest that the prevalence of malaria and the prevalence of anaemia, whether associated with malaria or not, are higher in pregnant women in Gabon. Primigravidae and young pregnant women are the most susceptible to infection. It is, therefore, urgent to design an effective regimen of malaria prophylaxis for this high risk population.
Haq, A.N.; Ahsan, S.; Sher, Z.
Objective: To differentiate the effect of gestation on the mode of delivery by analysing the difference in the mode of induction, length of labour and the difference in parity or Bishop score and their effect on the mode of delivery of postdates women. Study Design: A cross-sectional observational study. Place and Duration of Study: PAEC General Hospital, Islamabad, from July 2006 to July 2008. Methodology:Patients were induced at 41 weeks (Group B) and > 40 weeks (Group A) of gestation. Tab misoprostol and PGE2 tablets were administered according to amniotic fluid index (AFI) and parity . Study variables included duration of gestation, mode of induction, length of labour, difference in parity and Bishop score assessed before induction in each group. The outcome was assessed by applying Chi-square test by comparing mode of delivery with the study variables in both groups. Results: A total of 78 patients were inducted in the study. They were divided in group B (n = 39) induced 41 weeks and group A (n = 39) induced at 40 weeks. Eighty four percent (n = 35) patients in group B delivered vaginally as compared to 71% (n = 28) in the 40 weeks group (p < 0.0001). The higher number of vaginal deliveries in 41 weeks group was independent of association between the induction agent, parity and mode of delivery. Conclusion: The mean length of gestation was the single most important factor among the studied variables in predicting a vaginal delivery. (author)
T. S. Krivonogova
Full Text Available Our research is aimed to investigate the influence of breathing exercises and aqua-gymnastics on the adaptive capabilities of pregnant women in different trimesters of gestation.The estimation of adaptive capabilities of the pregnant women organism was carried out on the basis of functional tests on breath-holding duration – Stange’s test (for inhalation and Ghencea’s test (for exhalation in the initial period, 11–19, 21–29 and 31–39 weeks periods of pregnancy.To identify the adaptation strategies for pregnant women the method proposed by Ya.S. Pekker and A. Rotov was used, namely, the consideration of information measure as a measure of biological object preference behavior. Analysis of the results with information criterion of curve types using cluster analysis allowed to identify 4 standard types of adaptation strategies for pregnant women: adaptive, compensatory, compensatory-adaptive and maladaptive compensatory type of response. To estimate the adaptive capabilities of the respiratory system the ratio between the level of respiratory system functioning, its functional reserve and the degree of stress regulation mechanisms was considered.The intensity of lipid peroxidation processes (LPO in the blood serum of pregnant women was assessed by determining malondialdehyde (MDA in the reaction with 2-thiobarbituric acid. Determination of vitamin D content in blood serum was estimated by fluorimetric method using spectrophotometer «Hitachi-85» (Japan at an excitation wavelength of 295 nm and 320 nm fluorescence. Determination of the level of stress hormones (cortisol, insulin in the blood serum of pregnant women was performed by radio ligand assay.The following somatic diseases were registered among pregnant women applying to hospital: chronic tonsillitis, sinusitis, vasomotor rhinitis, bronchitis, bronchial asthma, hay fever, chronic pyelonephritis, atopic dermatitis. The next prenatal risks were revealed: morning sickness in I
Yu Suqing; Li Yusheng; Wang Lin; Chu Kaiqiu
Objective: To investigate the changes of serum leptin, insulin levels and blood sugar contents in pregnant women with gestational glucose metabolism disturbances. Methods: Fasting and 3h after oral 50g glucose serum levels of leptin were measured with RIA in 36 pregnant women with glucose metabolism disturbances (gestational diabetes mellitus or gestational impaired glucose tolerance) and 34 controls. Also, fasting serum insulin levels (with CLIA) and blood sugar contents 1h after oral 50 glucose (with glucose oxidase method) were determined in all these subjects. Results: 1. Serum levels of leptin in pregnant women with glucose metabolism disturbances were 14.9 ± 4.3 μg/L (vs controls 9.8 ± 1.7 μg/L, P<0.01). 2. The serum levels of insulin and 1 h post - 50g glucose blood sugar contents in pregnant women with glucose metabolism disturbances were 12.9±4.3mU/L and 11.0±1.4mmol/L respectively, which were both significantly positively correlated with the serum leptin levels (r=0.835, r=0.758 respectively) (vs levels in controls: 8.45±3.0mU/L and 7.84±1.3mmol/L). Conclusion: Elevation of fasting serum levels of leptin was demonstrated in pregnant women with glucose metabolism disturbances and the level of leptin was positively correlated with that of insulin and blood sugar. (authors)
Full Text Available The structural integrity of the cervix in pregnancy is necessary for carrying a pregnancy until term, and the organization of human cervical tissue collagen likely plays an important role in the tissue's structural function. Collagen fibers in the cervical extracellular matrix exhibit preferential directionality, and this collagen network ultrastructure is hypothesized to reorient and remodel during cervical softening and dilation at time of parturition. Within the cervix, the upper half is substantially loaded during pregnancy and is where the premature funneling starts to happen. To characterize the cervical collagen ultrastructure for the upper half of the human cervix, we imaged whole axial tissue slices from non-pregnant and pregnant women undergoing hysterectomy or cesarean hysterectomy respectively using optical coherence tomography (OCT and implemented a pixel-wise fiber orientation tracking method to measure the distribution of fiber orientation. The collagen fiber orientation maps show that there are two radial zones and the preferential fiber direction is circumferential in a dominant outer radial zone. The OCT data also reveal that there are two anatomic regions with distinct fiber orientation and dispersion properties. These regions are labeled: Region 1-the posterior and anterior quadrants in the outer radial zone and Region 2-the left and right quadrants in the outer radial zone and all quadrants in the inner radial zone. When comparing samples from nulliparous vs multiparous women, no differences in these fiber properties were noted. Pregnant tissue samples exhibit an overall higher fiber dispersion and more heterogeneous fiber properties within the sample than non-pregnant tissue. Collectively, these OCT data suggest that collagen fiber dispersion and directionality may play a role in cervical remodeling during pregnancy, where distinct remodeling properties exist according to anatomical quadrant.
Yao, Wang; Gan, Yu; Myers, Kristin M; Vink, Joy Y; Wapner, Ronald J; Hendon, Christine P
The structural integrity of the cervix in pregnancy is necessary for carrying a pregnancy until term, and the organization of human cervical tissue collagen likely plays an important role in the tissue's structural function. Collagen fibers in the cervical extracellular matrix exhibit preferential directionality, and this collagen network ultrastructure is hypothesized to reorient and remodel during cervical softening and dilation at time of parturition. Within the cervix, the upper half is substantially loaded during pregnancy and is where the premature funneling starts to happen. To characterize the cervical collagen ultrastructure for the upper half of the human cervix, we imaged whole axial tissue slices from non-pregnant and pregnant women undergoing hysterectomy or cesarean hysterectomy respectively using optical coherence tomography (OCT) and implemented a pixel-wise fiber orientation tracking method to measure the distribution of fiber orientation. The collagen fiber orientation maps show that there are two radial zones and the preferential fiber direction is circumferential in a dominant outer radial zone. The OCT data also reveal that there are two anatomic regions with distinct fiber orientation and dispersion properties. These regions are labeled: Region 1-the posterior and anterior quadrants in the outer radial zone and Region 2-the left and right quadrants in the outer radial zone and all quadrants in the inner radial zone. When comparing samples from nulliparous vs multiparous women, no differences in these fiber properties were noted. Pregnant tissue samples exhibit an overall higher fiber dispersion and more heterogeneous fiber properties within the sample than non-pregnant tissue. Collectively, these OCT data suggest that collagen fiber dispersion and directionality may play a role in cervical remodeling during pregnancy, where distinct remodeling properties exist according to anatomical quadrant.
Leal, Claudio A M; Schetinger, Maria R C; Leal, Daniela B R; Morsch, Vera M; da Silva, Aleksandro Schafer; Rezer, João F P; de Bairros, André Valle; Jaques, Jeandre Augusto Dos Santos
Oxidative stress (OS) is defined as an imbalance in the production of reactive oxygen species and the capacity of antioxidant defenses. The objective of this work was to investigate OS and antioxidant capacity in pregnant women. Parameters of the oxidative status and antioxidant capacity in serum and whole blood were evaluated in thirty-nine women with normal pregnancy. The assessment of antioxidants indicated an increase in superoxide dismutase and catalase activities (P0.05) in protein carbonylation. This study demonstrates that there is a change in the pro-oxidant and antioxidant defenses associated with body and circulation changes that are inherent to the pregnancy process.
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Sugarman, J; Kaplan, L; Cogswell, B; Olson, J
Promising clinical results suggest that umbilical cord blood (UCB) collected after delivery of a child may have many advantages over bone marrow for transplantation. As there are an increasing number of options regarding the collection of UCB, including private and public banking, more pregnant women are likely to be asked to make decisions about UCB collection. We conducted three focus groups with pregnant women to learn about their perspectives on this emerging technology. All the women in these focus groups indicated that they would choose to have UCB collected. Reasons leading to this choice were that the UCB would otherwise be discarded and altruism. Participants indicated that possible reasons to decide not to have UCB collected include concerns about the safety of the mother and neonate, beliefs about the placenta, threats against confidentiality, rejection of UCB, and the influence of fathers. While feeling confident in making an anticipatory decision about UCB collection, women expressed a clear desire to learn much more about the collection, storage (including distinctions between public and private banking), and use of UCB. In addition, they believed that recruitment for UCB collection should occur after sufficient education about UCB and certainly not after delivery and collection. These data will be useful in guiding efforts to help women make decisions about having UCB collected and in developing an appropriate recruitment and informed consent process for donating UCB to a public bank.
Azizeh Farshbaf Khalili
Full Text Available Introduction: Down syndrome is one of the most prevalent genetic diseases. Screening methods for this syndrome are easy and safe and are recommended to all pregnant wom-en particularly mothers over 35 years of age. This study aimed to review the status of Down syndrome screening and related factors in Iranian pregnant women. Methods: This descriptive analytical study was carried out in 2011. It included 400 women who were randomly selected from those referring to Alzahra Hospital (Tabriz, Iran during their third trimester of pregnancy. Data was collected through a question-naire whose reliability and validity have been approved. The data was analyzed by chi-square test in SPSS13. Results: The results showed that while 28 and 26 women imple-mented screening tests during the first and second trimesters, respectively, only 5 sub-jects benefited from both (integrated test. Chi-square test showed significant correla-tions between the implementation of screening methods and age, education level, in-come, and the location of prenatal care (p < 0.05. Conclusion: The findings of the present study showed women to poorly implement Down syndrome screening methods. Therefore, the necessity of providing appropriate educational programs for health staff and mothers seems undeniable. Moreover, paying attention to the related factors such as income, educational level, and adequate training of mothers during pregnancy is essential.
R. N. Bogdanovich
Full Text Available Abstract. The level of trophoblastic β1 – glycoprotein (SP–1 was determined in the blood sera of 200 healthy pregnant women and 184 women with threatened abortions in term till 20 weeks of pregnancy. In group of women experiencing recurrent abortions in 38 % cases antibodies to chorionic gonadotropin, in 39,5 % cases antibodies to phospholipids, in 25,5 % – antibodies to tireoglobulin were revealed in significant amounts. In 20,65 % lupus anticoagulant was found. The majority of women in this group had changes in homeostasis. The presence of autoantibodies during pregnancy is the unfavourable factor in the development of placental insufficiency. This is proved by the decreased secretion of trophoblastic β1 – glycoprotein – a marker of the fetal part of placenta. (Med. Immunol., 2005, vol.7, № 1, pp. 85588
Full Text Available Sub-Saharan Africa records each year about thirty-two million pregnant women living in areas of high transmission of Plasmodium falciparum causing malaria. The aim of this study was to carve out the prevalence of asymptomatic malaria among pregnant women and to emphasize its influence on haematological markers. The prevalence of Plasmodium falciparum asymptomatic infection among pregnant women was 30% and 24% with rapid detection test (RDT and microscopy, respectively. The prevalence of P. falciparum asymptomatic malaria was reduced among pregnant women using sulfadoxine-pyrimethamine's intermittent preventive treatment and 61% of them were anaemic. Anaemia was significantly more common in women infected with P. falciparum compared with the uninfected pregnant women. Most of the women had normal levels of homocysteine and low levels of folate, respectively. Therefore, the systematic diagnosis of malaria should be introduced to pregnant women as a part of the antenatal care.
Rosebrock, Laina; Hoxha, Denada; Gollan, Jackie
Reactions to emotional cues, termed affective reactivity, promote adaptation and survival. Shifts in affective reactivity during pregnancy and postpartum may invoke altered responses to environmental and biological changes. The development and testing of affective reactivity tasks, with published normative ratings for use in studies of affective reactivity, has been based on responses provided by healthy college students. A comparison of the healthy norms with ratings provided by peripartum women has yet to be conducted, despite its value in highlighting critical differences in affective reactivity during peripartum phases. This study compared arousal ratings of unpleasant, neutral, pleasant, and threat stimuli from the International Affective Picture System (IAPS; Lang, P.J., Bradley, M.M., Cuthbert, B.N. 2008. International Affective Picture System (IAPS): Affective Ratings of Pictures and Instruction Manual (Technical Report A-8). University of Florida, Gainseville, FL.) between three samples: (a) women measured during pregnancy and again at postpartum, (b) age-matched nonpregnant women, and (c) college-aged women from the normative sample used to test the stimuli. Using mixed-design GLMs, results showed that the pregnant and postpartum women and the age-matched women showed suppressed arousal relative to the college-age women. Additionally, postpartum women showed increased arousal to unpleasant/threat images compared to other types of images. The data suggest that future research on peripartum women should include affective reactivity tasks based on norms reflective of this specific population. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Full Text Available Abstract Background Pregnant women are at an increased risk for HIV infection due to unknown biological causes. Given the strong effect of sex-hormones on the expression of immunomuodulatory factors, the central role of mucosal immunity in HIV pathogenesis and the lack of previous studies, we here tested for differences in immunomuodulatory factors in cervico-vaginal secretions between pregnant and non-pregnant women. Methods We compared concentrations of 39 immunomodulatory factors in cervicovaginal lavages (CVL from 21 pregnant women to those of 24 non-pregnant healthy women from the US. We used Bonferroni correction to correct for multiple testing and linear regression modeling to adjust for possible confounding by plasma cytokine concentration, cervical ectopy, total protein concentration, and other possible confounders. Cervical ectopy was determined by planimetry. Concentration of immunomodulatory factors were measured by a multiplex assay, protein concentration by the Bradford Method. Results Twenty six (66% of the 39 measured immunomodulatory factors were detectable in at least half of the CVL samples included in the study. Pregnant women had threefold lower CVL concentration of CCL22 (geometric mean: 29.6 pg/ml versus 89.7 pg/ml, p = 0.0011 than non-pregnant women. CVL CCL22 concentration additionally correlated negatively with gestational age (Spearman correlation coefficient [RS]: -0.49, p = 0.0006. These associations remained significant when corrected for multiple testing. CCL22 concentration in CVL was positively correlated with age and negatively correlated with time since last coitus and the size of cervical ectopy. However, none of these associations could explain the difference of CCL22 concentration between pregnant and non-pregnant women in this study, which remained significant in adjusted analysis. Conclusions In this study population, pregnancy is associated with reduced concentrations of CCL22 in cervicovaginal secretions
Fatores relacionados à presença de recém-nascidos grandes para a idade gestacional em gestantes com diabetes mellitus gestacional Factors related to the presence of large for gestational age newborns in pregnant women with gestational diabetes mellitus
Jean Carl Silva
Full Text Available OBJETIVO: avaliar os fatores relacionados à presença de recém-nascidos grandes para a idade gestacional nas gestantes com diabetes mellitus gestacional. MÉTODOS: no período de janeiro de 2004 a julho de 2006, foram selecionadas, retrospectivamente, 157 gestantes que apresentavam diabete mellitus gestacional e estavam em acompanhamento. Esse grupo foi dividido em dois subgrupos: um com recém-nascidos de peso adequado para a idade gestacional (n=136 e outro com recém-nascidos grandes para a idade gestacional (n=21. Foram comparadas as características maternas nos dois grupos. Para a análise da hipótese de igualdade entre a média dos dois grupos, utilizou-se o teste t de Student. E para que se testasse a homogeneidade dos grupos em relação às proporções, foi utilizado o teste do χ2. RESULTADOS: os grupos não apresentaram diferença significativa quanto à idade materna, índice de massa corporal, ganho de peso durante a gestação, número de gestações anteriores, glicemia de jejum no teste oral de tolerância à glicose após a ingestão de 75 g (TOTG 75 g, idade gestacional no momento do parto, valores glicêmicos durante o tratamento e o tipo de tratamento utilizado (p>0,05. No grupo com recém-nascidos grandes para a idade gestacional, observou-se valor de glicemia de duas horas no TOTG 75 g maior (p=0,02, a idade gestacional de início de tratamento maior (p=0,02, e um número menor de consultas realizadas no serviço (pPURPOSE: to evaluate factors related to the presence of neonatal macrosomia in pregnant women with gestational diabetes mellitus. METHODS: 157 pregnant women presenting gestational diabetes mellitus in follow-up were retrospectively selected from January 2004 to July 2006. This group has been divided into two subgroups: one with newborns with weight in accordance with the gestational age (n=136 and another with macrosomic newborns (n=21. Maternal characteristics have been compared between the groups. The t
Ohagwu, Cc; Eze, Cu; Eze, Jc; Odo, Mc; Abu, Po; Ohagwu, Ci
Male gender preference is a dominant feature of Igbo culture and could be the reason behind women seeking fetal gender at ultrasound. The aim of this study is to investigate the perception of prenatal ultrasound patients of male gender preference in a patriarchal and gender sensitive society. The study was a cross-sectional survey, which targeted pregnant women who presented for prenatal ultrasound at four selected hospitals in Anambra State. A convenience sample size of 790 pregnant women constituted the respondents. The data collection instrument was a 13-item semi-structured self-completion questionnaire designed in line with the purpose of the study. Descriptive and inferential statistical analyses were carried out with statistical significance being considered at P < 0.05. Most of the women (88.4%, 698/790) were aware that fetal gender can be determined during the prenatal ultrasound while just over half of them (61.0%, 482/790) wanted fetal gender disclosed to them during prenatal ultrasound. More than half (58.6%, 463/790) of the women desired to have male babies in their present pregnancies while 20.1% (159/790) desired female babies and 21.3% (168/790) did not care if the baby was male or female. Some of the women (22.2%, 175/790) wanted to have male babies in their present pregnancies for various reasons predominant of which was protecting their marriages and cementing their places in their husbands' hearts. Male gender preference was strongly perceived. There was considerable anxiety associated with prenatal gender determination and moderate loss of interest in the pregnancy associated with disclosure of undesired fetal gender. Socio-demographic factors had significant influence on perception of male gender preference. Male gender preference is strongly perceived among Igbo women and its perception is significantly influenced by socio-demographic factors. Male gender preference may be responsible for Igbo women seeking fetal gender at ultrasound.
Khan, S.; Butt, R.W.; Masoud, R; Umar, M.; Shakil, U.
To investigate whether normal pregnancy has a significant effect on intrarenal venous blood flow and to assess whether the physiological maternal pyelocaliectasis causes a measurable change in venous impedance indices in pregnant women. Study Design: Cross sectional comparative study. Place and duration of study: Radiology Departments, KRL Hospital Islamabad and Combined Military Hospital Lahore from Jan 2010 to Jul 2010 Patients and Methods: A total of 50 normal pregnant women in their second and third trimester and 50 controls, i.e. normal non-pregnant married healthy women of childbearing age were included in the study. Confounding variables were controlled by excluding subjects having recent or previous renal calculi, pathological renal conditions or congenital renal anomalies or generalized disorders affecting haemodynamics ruled out by history, clinical examination and ultrasound examination in both pregnant and non-pregnant women. Results: After grading the degree of hydronephrosis, venous impedance index was obtained from the interlobar veins. Overall the collecting system dilatation was present in 60 % of 50 right kidneys and 42 % of 50 left kidneys in the pregnant women. The venous impedance indices were significantly lower in 50 pregnant women than the values in non-pregnant subjects (p< 0.001 for the right and the left kidney). The overall difference in venous impedance indices between right and left kidneys was not significant in pregnant women (p = 0.11). There was an inverse correlation between the grade of pelvicalyceal dilatation and the venous impedance indices in both kidneys in 50 pregnant women. Conclusion: Normal pregnancy causes dilatation of the pelvicalyceal system and significant reduction in renal venous impedance index values in second and third trimesters. Therefore one should be careful in interpretation of an abnormally reduced venous impedance index and hydronephrosis as a sign of pathological ureteral obstruction in pregnant women
Coyne, Sarah M; Liechty, Toni; Collier, Kevin M; Sharp, Aubrey D; Davis, Emilie J; Kroff, Savannah L
Much research has found that exposure to certain types of media portrayals of women can be related to body image concerns among women. The current paper focuses on the impact of certain messages on pregnant and postpartum women. These women are rarely examined in a media research context but are particularly vulnerable to body image concerns. This experimental study involved 192 pregnant or postpartum women who read a magazine containing glamorized media portrayals of pregnant/postpartum women or a control magazine. Pregnant women reported lower body image after only five minutes of exposure to the magazine with pregnant/postpartum women compared to the control group. There was no immediate effect on postpartum women. Implications for the media industry, health professionals, and women are discussed.
Sadeh, Maryam; Firouzi, Roya; Derakhshandeh, Abdollah; Bagher Khalili, Mohammad; Kong, Fanrong; Kudinha, Timothy
Background: Streptococcus agalactiae (Group B streptococcus, GBS) that colonize the vaginas of pregnant women may occasionally cause neonatal infections. It is one of the most common causes of sepsis and meningitis in neonates and of invasive diseases in pregnant women. It can also cause infectious disease among immunocompromised individuals. The distribution of capsular serotypes and genotypes varies over time and by geographic era. The serotyping and genotyping data of GBS in Iranian pregna...
Mathiesen, Jonathan M; Secher, Anna L; Ringholm, Lene
OBJECTIVE: To explore insulin pump settings in a cohort of pregnant women with type 1 diabetes on insulin pump therapy with a bolus calculator. METHODS: Twenty-seven women with type 1 diabetes on insulin pump therapy were included in this study. At 8, 12, 21, 27 and 33 weeks, insulin pump setting...
Ringholm Nielsen, L; Juul, A; Pedersen-Bjergaard, U
Severe hypoglycaemia is a significant problem in pregnant women with Type 1 diabetes. We explored whether frequent severe hypoglycaemia during pregnancy in women with Type 1 diabetes is related to placental growth hormone (GH) and insulin-like growth factor I (IGF-I) levels....
Okeke, T C; Ugwu, E O; Ikeako, L C; Adiri, C O; Ezenyeaku, C C T; Ekwuazi, K E; Okoro, O S
Falls during pregnancy are major public health issues and a common cause of maternal injury during pregnancy. There is paucity of data on prevalence and risk factors of falls during pregnancy in African population including Nigeria. To determine the prevalence and risk factors associated with falls during pregnancy in Enugu, Nigeria. This was a cross-sectional study of 332 consecutive pregnant women presenting in labor for delivery at the University of Nigeria Teaching Hospital Enugu, Nigeria between 1(st) May and 31(st) December, 2012. The mean age of the women was 32.2 ± 2.7 (range: 20-42) years. One hundred and eight women (32.5%) reported falling at least once during the index pregnancy. Women aged ≤ 30 years had twofold risk of falling during pregnancy than women aged > 30 years [41.1% (69/168) vs. 23.8% (39/164); odds ratio (OR): 2.23; 95% confidence interval (CI): 1.39-3.58; P women ≥ 160 cm in height had significantly higher risk of falling during pregnancy than women risk of falling during pregnancy than multigravidae [45.3% (63/139) vs. 23.3% (45/193); OR: 2.73; 95% CI: 1.70-4.37; P Falls during pregnancy is common in Enugu, Nigeria. It is, therefore, recommended that women should be counseled during pregnancy on this public health problem and the above-identified risk factors emphasized in order to reduce the prevalence and morbidity.