Routine first trimester combined screening for preterm preeclampsia in Australia: a multicenter clinical implementation cohort study

2021 ◽  
Author(s):  
Daniel L. Rolnik ◽  
Roshan J. Selvaratnam ◽  
Dagmar Wertaschnigg ◽  
Simon Meagher ◽  
Euan Wallace ◽  
...  
Keyword(s):  
Cohort Study ◽  
First Trimester ◽  
Clinical Implementation

scholarly journals Cohort profile: the Chinese Pregnant Women Cohort Study and Offspring Follow-up (CPWCSaOF)

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e044933
Author(s):  
Tianchen Lyu ◽  
Yunli Chen ◽  
Yongle Zhan ◽  
Yingjie Shi ◽  
Hexin Yue ◽  
...  
Keyword(s):  
Cohort Study ◽  
Pregnant Women ◽  
First Trimester ◽  
Health Problems ◽  
Environmental Data ◽  
Geographical Information ◽  
Obstetric Outcomes ◽  
Factors Affecting ◽  
Link Type

PurposeA multicentre prospective cohort study, known as the Chinese Pregnant Women Cohort Study (CPWCS), was established in 2017 to collect exposure data during pregnancy (except environmental exposure) and analyse the relationship between lifestyle during pregnancy and obstetric outcomes. Data about mothers and their children’s life and health as well as children’s laboratory testing will be collected during the offspring follow-up of CPWCS, which will enable us to further investigate the longitudinal relationship between exposure in different periods (during pregnancy and childhood) and children’s development.Participants9193 pregnant women in 24 hospitals in China who were in their first trimester (5–13 weeks gestational age) from 25 July 2017 to 26 November 2018 were included in CPWCS by convenience sampling. Five hospitals in China which participated in CPWCS with good cooperation will be selected as the sample source for the Chinese Pregnant Women Cohort Study (Offspring Follow-up) (CPWCS-OF).Findings to dateSome factors affecting pregnancy outcomes and health problems during pregnancy have been discovered through data analysis. The details are discussed in the ‘Findings to date’ section.Future plansInfants and children and their mothers who meet the criteria will be enrolled in the study and will be followed up every 2 years. The longitudinal relationship between exposure (questionnaire data, physical examination and biospecimens, medical records, and objective environmental data collected through geographical information system and remote sensing technology) in different periods (during pregnancy and childhood) and children’s health (such as sleeping problem, oral health, bowel health and allergy-related health problems) will be analysed.Trail registration numberCPWCS was registered with ClinicalTrials.gov on 18 January 2018: NCT03403543. CPWCS-OF was registered with ClinicalTrials.gov on 24 June 2020: NCT04444791.

SARS-CoV-2 in First Trimester Pregnancy: A Cohort Study

2021 ◽  
Vol 76 (4) ◽  
pp. 205-207
Author(s):  
N. la Cour Freiesleben ◽  
P. Egerup ◽  
K. V. R. Hviid ◽  
E. R. Severinsen ◽  
A. M. Kolte ◽  
...  
Keyword(s):  
Cohort Study ◽  
First Trimester ◽  
First Trimester Pregnancy ◽  
Trimester Pregnancy

Decreased Monocyte Count is Associated with Gestational Diabetes Mellitus Development, Macrosomia and Inflammation

2021 ◽  
Author(s):  
Xinmei Huang ◽  
Bingbing Zha ◽  
Manna Zhang ◽  
Yue Li ◽  
Yueyue Wu ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Cohort Study ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Glucose Level ◽  
First Trimester ◽  
Case Control ◽  
Monocyte Count ◽  
Tnf Α ◽  
Newborn Weight

Abstract Objective The immune system plays a central role in the pathophysiology of gestational diabetes mellitus (GDM). Monocytes, the main innate immune cells, are especially important in the maintenance of a normal pregnancy. Here, we investigated the potential effect of monocytes in GDM. Materials and Methods: Monocyte count was monitored throughout pregnancy in 214 women with GDM and 926 women without in a case-control and cohort study. Circulating levels of inflammatory cytokines, placenta-derived macrophages and their products were measured. Results Throughout pregnancy, monocyte count was significantly decreased in women with GDM, and closely associated with glucose level, insulin resistance and newborn weight. First-trimester monocyte count outperformed that of the second and third trimester as a risk factor and diagnostic predictor of GDM and macrosomia in both the case-control and cohort study. In addition, our cohort study showed that as first-trimester monocyte count decreased, GDM and macrosomia incidence, glucose level and newborn weight increased in a stepwise manner. Risk of GDM started to decrease rapidly when first-trimester monocyte count exceeded 0.48 × 10 9/L. Notably, CD206 and IL-10 were significantly lower, while CD80, CD86, TNF-α and IL-6 were higher in both GDM placental tissue and peripheral blood. First-trimester monocyte count was positively related to IL-10 and CD206, but negatively related to CD80, CD86, TNF-α and IL-6. Conclusions Decreased monocyte count throughout pregnancy was closely-associated with the development of GDM, macrosomia and the chronic inflammatory state of GDM. First-trimester monocyte count has great potential as an early diagnostic marker of GDM.

Maternal Serum EG-VEGF as A First Trimester Predictor of Hypertensive Disorders of Pregnancy: A Prospective Cohort Study

2021 ◽  
Author(s):  
Shiyu Zeng ◽  
Ling Yu ◽  
Yiling Ding ◽  
Mengyuan Yang
Keyword(s):  
Cohort Study ◽  
Growth Factor ◽  
Prediction Model ◽  
Pregnant Women ◽  
Predictive Value ◽  
Prospective Cohort ◽  
First Trimester ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders ◽  
Sensitivity Specificity

Abstract Background This study aims to explore whether plasma endocrine gland-derived vascular endothelial growth factor (EG-VEGF) in the first trimester can be used as a predictor of hypertensive disorders of pregnancy (HDP), and compare it with placental growth factor (PlGF) and soluble fms-like tyrosine kinase-1 (sFlt-1) to evaluate its prediction of HDP value. Methods This is a prospective cohort study that records the medical history of the pregnant women included in the study at 11–13 weeks’ gestation, and analyzes serum biochemical markers including EG-VEGF, PIGF, sFlt-1 and sFlt-1/PIGF. The predictive values of these tests were determined. We used the receiver operating characteristic (ROC) curve to find the optimal cut-off value for each biomarker and compare the operating characteristics (sensitivity, specificity). Logistic regression analysis was used to create a prediction model for HDP based on maternal characteristics and maternal biochemistry. Results Data were obtained from 205 pregnant women. 17 cases were diagnosed with HDP, the incidence rate was 8.2% (17/205). Women who developed HDP had a significantly higher body mass index (BMI) and mean arterial pressure (MAP). Serum EG-VEGF levels in the first trimester are significantly higher in pregnant women with HDP. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value(NPV) of serum EG-VEGF levels more than 227.83 pg/ml for predicting HDP were 43%, 93%, 86% and 62%, respectively. We established a prediction model in the first trimester include maternal BMI, MAP, and EG-VEGF, with an AUC of 0.8861 (95%CI: 0.7905–0.9818), which is better than using EG-VEGF alone (AUC: 0.66). Conclusion This study demonstrated that serum EG-VEGF is a promising biomarker for predicting HDP in the first trimester. It has better predictive performance compared with the currently used biomarkers like PIGF and sFlt-1. Combining maternal clinical characteristics and biochemical tests at 11–13 weeks can effectively identify women at high risk of HDP.

Metamizole use during first trimester-A prospective observational cohort study on pregnancy outcome

2017 ◽  
Vol 26 (10) ◽  
pp. 1197-1204 ◽  
Author(s):  
Katarina Dathe ◽  
Stephanie Padberg ◽  
Stefanie Hultzsch ◽  
Katja Meixner ◽  
Tatjana Tissen-Diabaté ◽  
...  
Keyword(s):  
Cohort Study ◽  
Pregnancy Outcome ◽  
First Trimester ◽  
Observational Cohort Study ◽  
Prospective Observational Cohort Study ◽  
Observational Cohort

scholarly journals Association between neighbourhood deprivation, fetal growth, small-for-gestational age and preterm birth: a population-based prospective cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e049075
Author(s):  
Dionne V Gootjes ◽  
Anke G Posthumus ◽  
Vincent W V Jaddoe ◽  
Eric A P Steegers
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Preterm Birth ◽  
Fetal Growth ◽  
Gestational Age ◽  
Pregnancy Outcomes ◽  
First Trimester ◽  
Adverse Pregnancy Outcomes ◽  
Neighbourhood Deprivation ◽  
Adverse Pregnancy

ObjectiveTo study the associations between neighbourhood deprivation and fetal growth, including growth in the first trimester, and adverse pregnancy outcomes.DesignProspective cohort study.SettingThe Netherlands, Rotterdam.Participants8617 live singleton births from the Generation R cohort study.ExpositionLiving in a deprived neighbourhood.Main outcome measuresFetal growth trajectories of head circumference, weight and length.Secondary outcomes measuresSmall-for-gestational age (SGA) and preterm birth (PTB).ResultsNeighbourhood deprivation was not associated with first trimester growth. However, a higher neighbourhood status score (less deprivation) was associated with increased fetal growth in the second and third trimesters (eg, estimated fetal weight; adjusted regression coefficient 0.04, 95% CI 0.02 to 0.06). Less deprivation was also associated with decreased odds of SGA (adjusted OR 0.91, 95% CI 0.86 to 0.97, p=0.01) and PTB (adjusted OR 0.89, 95% CI 0.82 to 0.96, p=0.01).ConclusionsWe found an association between neighbourhood deprivation and fetal growth in the second and third trimester pregnancy, but not with first trimester growth. Less neighbourhood deprivation is associated with lower odds of adverse pregnancy outcomes. The associations remained after adjustment for individual-level risk factors. This supports the hypothesis that living in a deprived neighbourhood acts as an independent risk factor for fetal growth and adverse pregnancy outcomes, above and beyond individual risk factors.

scholarly journals The role of triiodothyronine (T3) and T3/free thyroxine (fT4) on glucose metabolism during pregnancy: the Ma’anshan Birth Cohort Study

2021 ◽  
Author(s):  
Beibei Zhu ◽  
Yan Han ◽  
Fen Deng ◽  
Kun Huang ◽  
Shuangqin Yan ◽  
...  
Keyword(s):  
Cohort Study ◽  
Glucose Metabolism ◽  
Birth Cohort ◽  
Goodness Of Fit ◽  
Prediction Models ◽  
First Trimester ◽  
Repeated Measurements ◽  
Free Thyroxine ◽  
Birth Cohort Study ◽  
Goodness Of Fit Test

Objectives: Compared with other thyroid markers, fewer studies explored the associations between triiodothyronine (T3) and T3/free thyroxine (fT4) and glucose abnormality during pregnancy. Thus, we aimed to: (1) examine the associations of T3 and T3/fT4 with glucose metabolism indicators; and (2) evaluate, in the first trimester, the performance of the two markers as predictors of gestational diabetes mellitus (GDM) risk. Methods: Longitudinal data from 2723 individuals, consisting of three repeated measurements of T3 and fT4, from the Man’anshan birth cohort study (MABC), China, were analyzed using a time-specific generalized estimating equation (GEE). The receiver operating characteristic curve (ROC) - area under the curve (AUC) and Hosmer-Lemeshow goodness of fit test were used to assess the discrimination and calibration of prediction models. Results: T3 and T3/fT4 presented stable associations with the level of fasting glucose, glucose at 1h/2h across pregnancy. T3 and T3/fT4 in both the first and second trimesters were positively associated with the risk of GDM, with the larger magnitude of association observed in the second trimester (Odds ratio (OR) = 2.50, 95%CI = 1.95, 3.21 for T3; OR = 1.09, 95%CI = 1.07, 1.12 for T3/fT4). T3 ((AUC) = 0.726, 95%CI = 0.698, 0.754) and T3/fT4 (AUC = 0.724, 95%CI = 0.696, 0.753) in the first trimester could improve the performance of the predicting model; however, the overall performance is not good. Conclusion: Significant and stable associations of T3, T3/fT4 and glucose metabolism indicators were documented. Both T3 and T3/fT4 improve the performance of the GDM predictive model.

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