scholarly journals Iodine supplementation: compliance and association with adverse obstetric and neonatal outcomes

2022 ◽  
Vol 11 (1) ◽  
Author(s):  
Maria Lopes-Pereira ◽  
Anna Quialheiro ◽  
Patrício Costa ◽  
Susana Roque ◽  
Nadine Correia Santos ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Fetal Loss ◽  
Family Health ◽  
Neonatal Outcomes ◽  
Vulnerable Groups ◽  
Psychomotor Development ◽  
Obstetric Outcomes ◽  
Childbearing Age ◽  
Iodine Supplementation ◽  
The Impact

Objectives Over 1.9 billion people worldwide are living in areas estimated to be iodine insufficient. Strategies for iodine supplementation include campaigns targeting vulnerable groups, such as women in pre-conception, pregnancy and lactation. Portuguese women of childbearing age and pregnant women were shown to be mildly-to-moderately iodine deficient. As a response, in 2013, the National Health Authority (NHA) issued a recommendation that all women considering pregnancy, pregnant or breastfeeding, take a daily supplement of 150–200 μg iodine. This study explored how the iodine supplementation recommendation has been fulfilled among pregnant and lactating women in Portugal, and whether the reported iodine supplements intake impacted on adverse obstetric and neonatal outcomes. Design and methods Observational retrospective study on pregnant women who delivered or had a fetal loss in the Braga Hospital and had their pregnancies followed in Family Health Units. Results The use of iodine supplements increased from 25% before the recommendation to 81% after the recommendation. This was mostly due to an increase in the use of supplements containing iodine only. Iodine supplementation was protective for the number of adverse obstetric outcomes (odds ratio (OR) = 0.791, P = 0.018) and for neonatal morbidities (OR = 0.528, P = 0.024) after controlling for relevant confounding variables. Conclusion The recommendation seems to have succeeded in implementing iodine supplementation during pregnancy. National prospective studies are now needed to evaluate the impact of iodine supplementation on maternal thyroid homeostasis and offspring psychomotor development and on whether the time of the beginning of iodine supplementation (how early during preconception or pregnancy) is relevant to consider.

scholarly journals Impact of iodine supplementation during preconception, pregnancy and lactation on maternal thyroid homeostasis and offspring psychomotor development: protocol of the IodineMinho prospective study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Maria Lopes-Pereira ◽  
Susana Roque ◽  
Patrício Costa ◽  
Anna Quialheiro ◽  
Nadine Correia Santos ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Iodine Deficiency ◽  
Energy Content ◽  
Thyroid Volume ◽  
Endocrine Function ◽  
Psychomotor Development ◽  
Childbearing Age ◽  
Iodine Supplementation ◽  
Pregnancy And Lactation ◽  
Maternal Thyroid

Abstract Background Iodine deficiency is the most common cause of preventable brain harm and cognitive impairment in children. Portuguese women of childbearing age, pregnant women and their progeny were shown to have inadequate iodine intake. Consequently, the Portuguese Health Authorities have recommended a daily supplementation with 150–200 µg iodine in preconception, pregnancy, and lactation. The IodineMinho study intends to evaluate whether (i) this recommendation impacted on the prevalence of iodine deficiency in pregnant women from the Minho region of Portugal, (ii) the time of initiation of iodine supplementation (if any) influences the serum levels of thyroid hormones at several intervals during pregnancy and (iii) there are serum thyroid-hormone parameters in the 1st trimester of pregnancy that predict psychomotor development of the child at 18 months of age. Methods Most Portuguese women are followed throughout pregnancy in community Family Health Units, where family physicians may choose to follow the National recommendation or other, concerning iodine sufficiency. This study will recruit women (N = 304) who intend to become pregnant or are already pregnant from 10 representative Units. Physician’s approach and prescriptions, sociodemographic, nutrition and clinical information will be obtained at baseline and throughout pregnancy. To evaluate endocrine function, blood and urine samples will be collected at recruitment, once in each trimester of pregnancy, at delivery and 3 months after delivery. Breastmilk samples will be collected for iodine and energy content analysis. Children will be evaluated for psychomotor development at 18 months. Maternal thyroid volume will be evaluated by ultrasound scan at baseline, in the 3rd trimester and at 3 months after delivery. Discussion Iodine deficiency early during development precludes children from achieving full intellectual capabilities. This protocol describes a study that is innovative and unique in its detailed and comprehensive evaluation of maternal and child endocrine and psychomotor parameters. By evaluating the effectiveness of the iodine supplementation recommendation, it will contribute to the public health systems’ efforts to provide excellence in maternal and infant care. Trial registration ClinicalTrials.gov, NCT04288531. Registered 28 February 2020-Retrospectively registered.

scholarly journals COVID-19: Uncertainties from Conception to Birth

2021 ◽  
Vol 43 (01) ◽  
pp. 054-060
Author(s):  
Bruno Ramalho de Carvalho ◽  
Karina de Sá Adami ◽  
Walusa Assad Gonçalves-Ferri ◽  
Marise Samama ◽  
Rui Alberto Ferriani ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Present Article ◽  
Vertical Transmission ◽  
Scientific Information ◽  
Obstetric Outcomes ◽  
Reproductive Events ◽  
The Impact ◽  
Initial Impressions ◽  
Quality Evidence

AbstractScientific information on the impact of the new coronavirus (SARS-CoV-2) on the health of pregnant women, fetuses and newborns is considered of limited confidence, lacking good-quality evidence, and drawing biased conclusions. As a matter of fact, the initial impressions that the evolution of COVID-19 was no different between pregnant and non-pregnant women, and that SARS-CoV-2 was not vertically transmitted, are confronted by the documentation of worsening of the disease during pregnancy, poor obstetric outcomes, and the possibility of vertical transmission. The present article aims to compile the data available on the association of COVID-19 and reproductive events, from conception to birth.

Evaluation of Thyroid Function in Pregnant Women Using Automated Immunoassays

2021 ◽  
Author(s):  
K Aaron Geno ◽  
Matthew S Reed ◽  
Mark A Cervinski ◽  
Robert D Nerenz
Keyword(s):  
Pregnant Women ◽  
Equilibrium Dialysis ◽  
Reference Interval ◽  
First Trimester ◽  
Reference Intervals ◽  
Free Thyroxine ◽  
Specific Reference ◽  
Childbearing Age ◽  
Thyroid Autoantibody ◽  
The Impact

Abstract Introduction Automated free thyroxine (FT4) immunoassays are widely available, but professional guidelines discourage their use in pregnant women due to theoretical under-recoveries attributed to increased thyroid hormone binding capacity and instead advocate the use of total T4 (TT4) or free thyroxine index (FTI). The impact of this recommendation on the classification of thyroid status in apparently euthyroid pregnant patients was evaluated. Methods After excluding specimens with thyroid autoantibody concentrations above reference limits, thyroid-stimulating hormone (TSH), FT4, TT4, and T-uptake were measured on the Roche Cobas® platform in remnant clinical specimens from at least 147 nonpregnant women of childbearing age and pregnant women at each trimester. Split-sample comparisons of FT4 as measured by the Cobas and equilibrium dialysis were performed. Results FT4 decreased with advancing gestational age by both immunoassay and equilibrium dialysis. TSH declined during the first trimester, remained constant in the second, and increased throughout the third, peaking just before delivery. Interpretation of TT4 concentrations using 1.5-times the nonpregnant reference interval classified 13.6% of first trimester specimens below the lower reference limit despite TSH concentrations within trimester-specific reference intervals. Five FTI results from 480 pregnant individuals (about 1.0%) fell outside the manufacturer’s reference interval. Conclusions Indirect FT4 immunoassay results interpreted in the context of trimester-specific reference intervals provide a practical and viable alternative to TT4 or FTI. Declining FT4 and increasing TSH concentrations near term suggest that declining FT4 is not an analytical artifact but represents a true physiological change in preparation for labor and delivery.

“Less Feminine and Less a Woman”:The Impact of Unplanned Postpartum Hysterectomy on Women

2012 ◽  
Vol 2 (1) ◽  
pp. 51-60 ◽  
Author(s):  
Rakime Elmir ◽  
Debra Jackson ◽  
Virginia Schmied ◽  
Lesley Wilkes
Keyword(s):  
Interpersonal Relationships ◽  
Qualitative Interviews ◽  
Family Health ◽  
Major Theme ◽  
Childbearing Age ◽  
Number Of Children ◽  
Emergency Hysterectomy ◽  
The Impact ◽  
Experiences Of Women

AIM: This article is a report of the women’s experiences of unplanned emergency hysterectomy following severe postpartum hemorrhage (PPH).BACKGROUND: Every year, thousands of women worldwide undergo hysterectomies for either gynecological issues or following childbirth to save their life from severe PPH. Little attention has been given to the experiences of women with secondary infertility, despite many of these women being of childbearing age. Some of the issues concerning this group of women are related to their feminine identity, sexuality, sense of being, and womanhood.METHOD: Qualitative interviews were conducted with 21 Australian women between the ages of 24 and 57 years. The data were collected between May and October 2009. Data were analyzed using inductive thematic analysis.FINDINGS: One major theme; loss of normality, and four subthemes emerged, “being incomplete: half a woman,” “not myself: a changed body,” “being alone: isolation and disconnectedness,” and “fearing intimacy: insecure and wary.”CONCLUSIONS: This study shows that irrespective of the number of children women have, they may continue to experience significant emotional distress following their hysterectomy after childbirth. The distress these women experience is not only during the immediate postsurgical period but continues long term, and affects social, familial, and interpersonal relationships. Health professionals, particularly those providing community-based child and family health services, are in a position to provide ongoing professional support to women who experience an emergency hysterectomy following childbirth.

scholarly journals Bacterial Vaginosis and Risk Factors in Pregnant Women in Senegal

2021 ◽  
Author(s):  
Marion Bonneton ◽  
Bich-Tram Huynh ◽  
Abdoulaye Seck ◽  
Raymond Bercion ◽  
Fatoumata Diene Sarr ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Bacterial Vaginosis ◽  
Pregnant Women ◽  
Rural Areas ◽  
Vaginal Flora ◽  
Obstetric Outcomes ◽  
Vaginal Smear ◽  
Sub Saharan ◽  
The Impact

Abstract Background Bacterial vaginosis (BV) is associated with a higher risk of preterm delivery and spontaneous abortion. Yet little data on BV prevalence exist for sub-Saharan countries. The aim of this study was to estimate the prevalence of bacterial vaginosis and associated risk factors among pregnant women in Senegal.MethodsFrom October 2013 to December 2018, pregnant women in their third trimester were recruited in two primary health centers (one suburban, one rural) in Senegal. Healthcare workers interviewed women and collected a lower vaginal swab and a blood sample. Vaginal flora were classified into four categories using vaginal smear microscopic examination and Gram’s coloration. In our study, BV was defined as vaginal flora with no Lactobacillus spp. Variables associated with BV were analyzed using STATA® through univariate and multivariate analysis.Results A total of 457 women provided a vaginal sample for analysis. Overall, BV prevalence was 18.6% (85/457) [95% CI: 15.4-22.6]) and was similar in suburban and rural areas (18.9 % versus 18.1%, p=0.843). Multivariate analysis showed that primigravidity was the only factor independently associated with a lower risk of BV (aOR=0.35 [95% CI 0.17-0.72]).Conclusions Our study showed significant BV prevalence among pregnant women in Senegal. Although the literature has underscored the potential consequences of BV for obstetric outcomes, data are scarce on BV prevalence in sub-Saharan African countries. Before authorities consider systematic BV screening for pregnant women, a larger study would be useful in documenting prevalence, risk factors and the impact of BV on pregnancy outcomes.

scholarly journals The burden of premature ventricular contractions predicts adverse fetal and neonatal outcomes among pregnant women without structural heart disease

2020 ◽  
Author(s):  
Jing Lin ◽  
Yanxia Qian ◽  
Xin Wu ◽  
Qiushi Chen ◽  
Qiang Ding ◽  
...  
Keyword(s):  
Cohort Study ◽  
Adverse Events ◽  
Pregnant Women ◽  
Multivariate Logistic Regression Analysis ◽  
Structural Heart Disease ◽  
Adverse Outcomes ◽  
Neonatal Outcomes ◽  
Multivariate Logistic Regression ◽  
Premature Ventricular Contractions ◽  
The Impact

Abstract Objective: To investigate the outcomes of fetuses or neonates of pregnant women with premature ventricular contractions (PVCs). Study design: 6, 148 pregnant women were prospectively enrolled in the study. Of these women, 103 with a PVC burden >0.5% were divided into two groups based on the presence or absence of adverse fetal or neonatal events. The adverse outcomes were compared between the groups to assess the impact of PVCs on pregnancy. Results: A total of 17 adverse events (12 cases) occurred among 103 pregnant women with PVCs, which was significantly higher than that among women without PVCs (11.65% vs. 2.93%, p<0.01). The median PVC burden among pregnant women with PVCs was 2.84% (1.02% to 6.1%). Furthermore, compared with that of the women without adverse events, the median PVC burden of women with adverse fetal or neonatal outcomes was significantly higher (9.02% vs. 2.30%, p<0.01). Multivariate logistic regression analysis demonstrated that PVC burden was associated with adverse fetal or neonatal outcomes among pregnant women with PVCs (OR: 1.34, 95% CI (1.11-1.61), p<0.01). Conclusions: Frequent PVCs have adverse effects on pregnancy, and the PVC burden might be an important factor associated with adverse fetal and neonatal outcomes among pregnant women with PVCs. Our cohort study indicated that the higher the PVC burden is, the higher the likelihood of adverse events would be.

scholarly journals Frequency of Fits in Pregnant Women with Previously Controlled Epilepsy

2021 ◽  
Vol 15 (7) ◽  
pp. 1843-1846
Author(s):  
Jawad Hussain ◽  
Muhammad Saqib ◽  
Nadia Khan ◽  
Sohail Khan ◽  
Fawad Jan ◽  
...  
Keyword(s):  
Sleep Deprivation ◽  
Pregnant Women ◽  
Statistical Significance ◽  
Drug Regimen ◽  
Cross Sectional Study ◽  
Childbearing Age ◽  
Keywords Epilepsy ◽  
Cross Sectional ◽  
The Impact ◽  
Epileptic Women

Background: Epilepsy drug therapy advancements have resulted in an increasing number of childbearing age well-controlled epileptic women. It is not surprising then, that the impact of pregnancy on the progression of epilepsy has sparked renewed interest. Aim: The aim of current study was to evaluate the frequency of fits or seizure in pregnant women with previously controlled epilepsy. Materials and Methods: This cross-sectional study was carried out on 98 pregnancies of 84 epileptic women during the period between August 2019 and August 2021in the department of neurology and gynaecology of Ayub Teaching Hospital, Abbottabad. All the pregnant women with less than three verified epileptic fits, pregnancy ended with abortion and incomplete seizure or fit frequency were excluded. All the patients were referred to Gynaecology and Neurology department for early pregnancy and planning by a neurologist and gynaecologist. Data analysis was done with SPSS version 23 with p<0.05 as statistical significance. Results: The association of fits frequency on pregnancy was studied and monitored in 84 epileptic women out of 98pregnancies. About 49 (50%) pregnancies were not affected by fits frequency. The fits frequency was increased in 36 (37%) pregnancies or puerperium while decreased in 13 (13%) pregnancies. Sleep deprivation or drug regimen on-compliances associated was increased in 30 (30.6%) pregnancies. Out of 19pregnancies, eight (42%) had improvement with sleep deprivation correction during none months pre-gestation. Antiepileptic drugs with low plasma concentration of uncontrolled epilepsy during pregnancy were found in 47%. Conclusion: Sleep deprivation, Non-compliance during pregnancy, and before and after pregnancy inadequate therapy all have a significant impact on the course of epilepsy during pregnancy. With proper medical care, pregnancy appears to have only a minor impact on the course of epilepsy. Keywords: Epilepsy, Frequency fits, Sleep Deprivation.

scholarly journals The Impact of Response to Iron Therapy on Maternal and Neonatal Outcomes among Pregnant Women with Anemia

2022 ◽  
pp. 100569
Author(s):  
Sarah E. Detlefs ◽  
Michael D. Jochum ◽  
Bahram Salmanian ◽  
Jennifer R McKinney ◽  
Kjersti M. Aagaard
Keyword(s):  
Pregnant Women ◽  
Neonatal Outcomes ◽  
Iron Therapy ◽  
Maternal And Neonatal Outcomes ◽  
The Impact

scholarly journals Low Bioactive Vitamin D Is Associated with Pregnancy-Induced Hypertension in a Cohort of Pregnant HIV-Infected Women Sampled Over a 23-Year Period

2019 ◽  
Vol 37 (14) ◽  
pp. 1446-1454 ◽  
Author(s):  
Kristi R. Van Winden ◽  
Allison Bearden ◽  
Naoko Kono ◽  
Toni Frederick ◽  
Eva Operskalski ◽  
...  
Keyword(s):  
Vitamin D ◽  
Pregnant Women ◽  
Group B Streptococcus ◽  
Perinatal Outcomes ◽  
Obstetric Outcomes ◽  
Pregnancy Induced Hypertension ◽  
Vitamin D Metabolism ◽  
Vitamin D Levels ◽  
Induced Hypertension ◽  
The Impact

Objective To examine the association of vitamin D insufficiency and risk of pregnancy-induced hypertension (PIH) among human immunodeficiency virus (HIV)-infected pregnant women. Study Design This is a retrospective cohort study evaluating the impact of low maternal vitamin D levels on PIH and perinatal outcomes among HIV-infected pregnant women receiving care at an urban HIV center from 1991 to 2014. Results A total of 366 pregnant women were included, of which 11% developed PIH. Lower levels of 25-hydroxyvitamin D (25(OH)D) and bioactive 1,25-dihydroxyvitamin D (1,25(OH)2D) were associated with increased HIV disease activity. 25(OH)D levels were not significantly associated with the incidence of PIH. Higher 1,25(OH)2D levels were associated with reduced incidence of PIH in univariate (odds ratio, OR: 0.87 [95% confidence interval, CI: 0.79–0.95], p = 0.004) and multivariate (OR: 0.88 [95% CI: 0.80–0.97], p = 0.010) analyses. No association was found between 25(OH)D levels and other obstetric outcomes. Lower 1,25(OH)2D levels were associated with group B Streptococcus colonization (OR: 0.92 [95% CI: 0.86–0.99]) and low birth weight (LBW) (OR: 0.90 [95% CI: 0.83–0.98]) on multivariate analysis. Mean 1,25(OH)2D levels were significantly lower in women with preterm delivery and LBW infants. Conclusion Lower bioactive vitamin D levels are related to PIH in HIV-infected women. This association may be related to the coexistence of abnormal placental vitamin D metabolism and abnormal placental implantation.

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