Association between two common environmental toxicants (phthalates and melamine) and urinary markers of renal injury in the third trimester of pregnant women: The Taiwan Maternal and Infant Cohort Study (TMICS)

Abstract Objectives An elevated sFlt-1/PlGF-ratio has been validated as a significant predictor of preeclampsia, but has not been established in women with rheumatoid arthritis (RA). We explored whether the sFlt-1/PlGF-ratio could be altered due to disease activity in RA, and could be applied in this population to predict preeclampsia. Since sulfasalazine has been suggested to improve the angiogenic imbalance in preeclampsia, we also aimed to examine whether sulfasalazine could affect sFlt-1 or PlGF levels. Methods Making use of a nationwide, observational, prospective cohort study on pregnant women with RA, sFlt-1 and PlGF were measured in the third trimester. A total of 221 women, aged 21–42 years, were included, with a median gestational age of 30 + 3 weeks. Results No differences in sFlt-1 or PlGF were observed between women with high, intermediate or low disease activity (p= 0.07 and p= 0.41), whereas sFlt-1 and PlGF did not correlate with DAS28-CRP score (r=-0.01 and r=-0.05, respectively). Four (2%) women with a sFlt-1/PlGF-ratio ≤38 developed preeclampsia in comparison to three (43%) women with a ratio > 38, corresponding to a negative predictive value of 98.1%. Sulfasalazine users (n = 57) did not show altered levels of sFlt-1 or PlGF in comparison to non-sulfasalazine users (n = 164, p= 0.91 and p= 0.11). Conclusion Our study shows that in pregnant women with RA, the sFlt-1/PlGF-ratio is not altered due to disease activity and a cut-off ≤38 can be used to exclude preeclampsia. Additionally, sulfasalazine use did not affect sFlt-1 or PlGF levels in this population.

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Relationship between anaemia, coagulation parameters during pregnancy and postpartum haemorrhage at childbirth: a prospective cohort study

BMJ Open ◽

10.1136/bmjopen-2021-050815 ◽

2021 ◽

Vol 11 (10) ◽

pp. e050815

Author(s):

Manisha Nair ◽

Shakuntala Chhabra ◽

Saswati Sanyal Choudhury ◽

Dipika Deka ◽

Gitanjali Deka ◽

...

Keyword(s):

Cohort Study ◽

Pregnant Women ◽

Postpartum Haemorrhage ◽

Severe Anaemia ◽

Third Trimester ◽

Coagulation Parameters ◽

The Third ◽

Mild Anaemia ◽

Moderate Anaemia ◽

D Dimer

ObjectivesTo investigate the association between coagulation parameters and severity of anaemia (moderate anaemia: haemoglobin (Hb) 7–9.9 g/dL and severe anaemia: Hb <7 g/dL) during pregnancy and relate these to postpartum haemorrhage (PPH) at childbirth.DesignA prospective cohort study of pregnant women recruited in the third trimester and followed-up after childbirth.SettingTen hospitals across four states in India.Participants1342 pregnant women.InterventionNot applicable.MethodsHb and coagulation parameters: fibrinogen, D-dimer, D-dimer/fibrinogen ratio, platelets and international normalised ratio (INR) were measured at baseline. Participants were followed-up to measure blood loss within 2 hours after childbirth and PPH was defined based on blood loss and clinical assessment. Associations between coagulation parameters, Hb, anaemia and PPH were examined using multivariable logistic regression models.Outcomes measuresAdjusted OR with 95% CI.ResultsIn women with severe anaemia during the third trimester, the D-dimer was 27% higher, mean fibrinogen 117 mg/dL lower, D-dimer/fibrinogen ratio 69% higher and INR 12% higher compared with women with no/mild anaemia. Mean platelets in severe anaemia was 37.8×109/L lower compared with women with moderate anaemia. Similar relationships with smaller effect sizes were identified for women with moderate anaemia compared with women with no/mild anaemia. Low Hb and high INR at third trimester of pregnancy independently increased the odds of PPH at childbirth, but the other coagulation parameters were not found to be significantly associated with PPH.ConclusionAltered blood coagulation profile in pregnant women with severe anaemia could be a risk factor for PPH and requires further evaluation.

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Effects of Maternal Weight Gain and Macronutrients Intakes During the Third Trimester of Pregnancy on Birth Weight: A Prospective Cohort Study in Pregnant Women in Sleman, Indonesia

Indian Journal of Public Health Research & Development ◽

10.37506/ijphrd.v11i4.7592 ◽

2020 ◽

Keyword(s):

Cohort Study ◽

Weight Gain ◽

Birth Weight ◽

Pregnant Women ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Maternal Weight Gain ◽

Maternal Weight ◽

Third Trimester ◽

The Third

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Prevalence of anemia and factors associated with pregnant women in West Sumatra, Indonesia: Findings from VDPM Cohort Study

Jurnal Gizi dan Dietetik Indonesia (Indonesian Journal of Nutrition and Dietetics) ◽

10.21927/ijnd.2019.7(3).97-106 ◽

2020 ◽

Vol 7 (3) ◽

pp. 97

Author(s):

Arif Sabta Aji ◽

Yusrawati Yusrawati ◽

Safarina G Malik ◽

Nur Indrawaty Lipoeto

Keyword(s):

Public Health ◽

Risk Factors ◽

Vitamin D ◽

Cohort Study ◽

Pregnant Women ◽

Pregnant Mother ◽

Third Trimester ◽

The Third ◽

West Sumatra ◽

Prevalence Of Anemia

ABSTRAK Latar belakang: Anemia kehamilan masih menjadi masalah kesehatan masyarakat di negara berkembang yang berkontribusi terhadap risiko tinggi komplikasi kehamilan. Indonesia sebagai negara berkembang memiliki risiko anemia yang lebih tinggi yang bisa disebabkan oleh kekurangan asupan zat gizi mikro, infeksi, atau faktor sosial-demografis lainnya. Tujuan: Identifikasi prevalensi dan faktor risiko anemia pada ibu hamil yang tinggal di Sumatera Barat, Indonesia. Metode: Penelitian ini adalah analisis data sekunder dari studi kohort prospektif yaitu "“Vitamin D Pregnant Mother (VDPM) di Sumatera Barat". Subyek ibu hamil trimester diperoleh dari Puskesmas di Provinsi Sumatera Barat. Waktu penelitian dilakukan pada Januari-Maret 2017. Data demografi, sosial ekonomi, antropometri, dan Riwayat kesehatan ibu diteliti. Regresi logistik biner multivariatdigunakan untuk menentukan faktor-faktor terkait anemia. Dalam semua kasus, nilai p kurang dari 0,05 dianggap signifikan secara statistik. Hasil: 176 ibu hamil yang memenuhi kriteria inklusi diambil dalam penelitian ini. Prevalensi anemia ditemukan sebesar 61,90%. Rerata konsentrasi hemoglobin adalah 10,56 ± 1,41 g / dL. Prevalensi anemia sedang dan ringan masing-masing adalah 34% dan 27%. Status anemia ibu hamil trimester ketiga berhubungan dengan wanita yang memiliki <upah minimum/bulan (AOR: 5.15; 95% CI: 1.30-20.47), pengetahuan gizi ibu yang rendah (AOR: 15.88; 95% CI: 3.82- 66.02), IMT sebelum kehamilan <25 kg/m2 (AOR: 11.82; 95% CI: 2.70-51.69), dan tidak patuh konsumsi suplemen zat besi (AOR: 29.69; 95% CI: 6.58-133.91). Kesimpulan: Terdapat masih tingginya prevalensi anemia pada wanita hamil di Sumatera Barat. Oleh karena itu, meningkatkan kesadaran akan suplementasi zat besi dan kesehatan yang berkaitan dengan nutrisi selama kehamilan perlu dipertimbangkan untuk meningkatkan status kesehatan ibu untuk mengurangi anemia. Namun, penelitian lebih lanjut diperlukan dengan ukuran sampel yang besar untuk mengkonfirmasi temuan ini.KATA KUNCI: anemia; faktor risiko; kehamilan; trimester ketiga; Sumatra Barat ABSTRACT Background: Anemia during pregnancy remain to be a public health problem in developing countries which contributes to the high risk of adverse pregnancy outcomes. Indonesia as developing country has a higher risk of anemia that could be due to high of deficiencies of micronutrients intake, infection, or other socio-demographic factors. Objectives: The aim of this study was to determine the prevalence and risk factors anemia among pregnant women living in West Sumatra, Indonesia. Methods: The study is a secondary data analysis of prospective cohort study named “Vitamin D Pregnant Mother (VDPM) study in West Sumatra”. The third trimester pregnant women were enrolled from the public health centers in West Sumatra Province from January to March 2017. Structured questionnaires were used to collect data of demographic, socio-economic, anthropometry, and maternal health from all the study subjects. A multivariate binary logistic regression had been used to determine the associated factors of anemia. In all cases, P value less than 0.05 was considered statistically significant. Results: 176 pregnant women who fulfilled the inclusion criteria were enrolled this study. The prevalence of anemia was 61.90%. The mean of hemoglobin concentration was 10.56±1.41 g/dL. Moderate and mild anemia prevalence were 34% and 27%, respectively. The third trimester of pregnant women anemia status were associated with women who had <minimum wage/month (AOR: 5.15; 95%CI: 1.30-20.47), low-moderate maternal nutrition knowledge (AOR: 15.88; 95%CI: 3.82-66.02), pre-pregnancy BMI <25 kg/m2 (AOR: 11.82; 95%CI: 2.70-51.69), and no adherence iron supplement intake status (AOR: 29.69; 95%CI: 6.58-133.91). Conclusions: There was a high prevalence of anemia status in the third pregnant women in West Sumatra. Therefore, raise awareness of iron supplementation and health related to nutrition during pregnancy need to be considered to improve maternal health status to reduce anemia. However, further studies required with large sample size to confirm this finding.KEYWORDS: anemia; risk factors; third trimester; pregnancy; West Sumatra

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Multi-micronutrient supplementation during pregnancy for prevention of maternal anaemia and adverse birth outcomes in a high-altitude area: a prospective cohort study in rural Tibet of China

British Journal Of Nutrition ◽

10.1017/s000711451700229x ◽

2017 ◽

Vol 118 (6) ◽

pp. 431-440 ◽

Cited By ~ 3

Author(s):

Yijun Kang ◽

Shaonong Dang ◽

Lingxia Zeng ◽

Duolao Wang ◽

Qiang Li ◽

...

Keyword(s):

Cohort Study ◽

Birth Weight ◽

Pregnant Women ◽

High Altitude ◽

Preterm Delivery ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Third Trimester ◽

The Third ◽

High Altitude Area

AbstractAnaemia during pregnancy, characterised by Hb <110 g/l, is a specific risk factor for adverse maternal and perinatal outcomes in developing countries. The objective of this study was to determine the effectiveness of daily antenatal supplementation with multiple micronutrients (MMN) compared with folic acid (FA) on the occurrence of anaemia among pregnant women and their infants’ health in a high-altitude area. A prospective cohort study was carried out in two rural counties in Tibet from 2007 to 2012. A total of 1149 eligible pregnant women were allocated daily supplementation with FA in one county and MMN containing a recommended allowance of twenty-three vitamins and minerals in another county starting ≤24 weeks of gestation and continuing until delivery. Compared with the FA group, prenatal supplementation with MMN was significantly associated with reduced odds of anaemia in the third trimester. This was demonstrated in the primary outcome, with an adjusted OR (AOR) of 0·63; 95 % CI 0·45, 0·88 and P=0·007 and also reduced odds of preterm delivery (AOR: 0·31; 95 % CI 0·15, 0·61; P=0·001). There was no difference between MMN and FA groups in mean birth weight (adjusted mean difference: 36·78; 95 % CI −19·42, 92·98 g; P=0·200), whereas MMN supplementation significantly reduced the odds of low-birth weight (LBW) babies (AOR: 0·58; 95 % CI 0·36, 0·91; P=0·019). In conclusion, the antenatal MMN supplementation in rural Tibet is associated with a reduction of maternal anaemia in the third trimester, and may potentially decrease the risk of preterm delivery and LBW babies.

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Features of the course and treatment of glaucoma during pregnancy

Clinical Medicine (Russian Journal) ◽

10.30629/0023-2149-2020-98-3-178-184 ◽

2020 ◽

Vol 98 (3) ◽

pp. 178-184

Author(s):

T. V. Chernyakova ◽

A. Yu. Brezhnev ◽

I. R. Gazizova ◽

A. V. Kuroyedov ◽

A. V. Seleznev

Keyword(s):

Pregnant Women ◽

Laser Treatment ◽

Progressive Disease ◽

Clinical Course ◽

The Other ◽

Third Trimester ◽

The Third ◽

Chronic Progressive Disease ◽

Hypotensive Therapy ◽

Eye Pressure

In the review we have integrated all up-to-date knowledge concerning clinical course and treatment of glaucoma among pregnant women to help specialists choose a proper policy of treatment for such a complicated group of patients. Glaucoma is a chronic progressive disease. It rarely occurs among childbearing aged women. Nevertheless the probability to manage pregnant patients having glaucoma has been recently increasing. The situation is complicated by the fact that there are no recommendations on how to treat glaucoma among pregnant women. As we know, eye pressure is progressively going down from the first to the third trimester, so we often have to correct hypotensive therapy. Besides, it is necessary to take into account the effect of applied medicines on mother health and evaluate possible teratogenic complications for a fetus. The only medicine against glaucoma which belongs to category B according to FDA classification is brimonidine. Medicines of the other groups should be prescribed with care. Laser treatment or surgery may also be a relevant decision when monitoring patients who are planning pregnancy or just bearing a child. Such treatment should be also accompanied by medicines.

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A systematic review and meta-analysis of prevalence of insomnia in the third trimester of pregnancy

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-03755-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Nader Salari ◽

Niloofar Darvishi ◽

Behnam Khaledi-Paveh ◽

Aliakbar Vaisi-Raygani ◽

Rostam Jalali ◽

...

Keyword(s):

Pregnant Women ◽

Sleep Disorders ◽

Sleep Disturbances ◽

Meta Analysis ◽

Physical And Mental Health ◽

Third Trimester ◽

Cross Sectional ◽

The Third ◽

Physical Problems ◽

Meta Regression Analysis

Abstract Background Sleep disorders, which are among the foremost important medical care issues, are prevalent in pregnancy. The present study is a meta-analysis of the prevalence of insomnia in the third trimester of pregnancy. This study aims to systematically review the overall prevalence of insomnia in the third trimester of pregnancy through conducting a meta-analysis. Method The literature used in this meta-analysis for the topic discussed above were obtained through searching several databases, including SID, MagIran, IranDoc, Scopus, Embase, Web of Science (WoS), PubMed Science Direct and Google Scholar databases without time limitation until December 2020. Articles developed based on cross-sectional studies were included in the study. The heterogeneity of studies was investigated using the I2 index. Also, the possible effects of heterogeneity in the studied studies are investigated using meta-regression analysis. Result In 10 articles and 8798 participants aged between11–40, the overall prevalence of insomnia in the third trimester of pregnancy based on meta-analysis was 42.4% (95% CI: 32.9–52.5%). It was reported that as the sample size increases, the prevalence of insomnia in the third trimester of pregnancy increases. Conversely, as the year of research increases, the prevalence of insomnia in the third trimester of pregnancy decreases. Both of these differences were statistically significant (P < 0.05). Conclusion Insomnia was highly prevalent in the last trimester of pregnancy. Sleep disorders are neglected among pregnant women, and they are considered natural. While sleep disturbances can cause mental and physical problems in pregnant women, they can consequently cause problems for the fetus. As a result, maintaining the physical and mental health of pregnant mothers is very important. It is thus recommended that in addition to having regular visits during pregnancy, pregnant women should also be continuously monitored for sleep-related disorders.

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Health anxiety and related factors among pregnant women during the COVID-19 pandemic: a cross-sectional study from Iran

BMC Psychiatry ◽

10.1186/s12888-021-03092-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Najmieh Saadati ◽

Poorandokht Afshari ◽

Hatam Boostani ◽

Maryam Beheshtinasab ◽

Parvin Abedi ◽

...

Keyword(s):

Pregnant Women ◽

Health Care Providers ◽

Health Anxiety ◽

Cross Sectional Study ◽

Care Providers ◽

Sectional Study ◽

Third Trimester ◽

Related Factors ◽

Cross Sectional ◽

The Third

Abstract Background The COVID-19 pandemic has affected many countries around the world and Iran was no exception. The aim of this study was to evaluate health anxiety of Iranian pregnant women during the COVID-19 pandemic. Methods In this cross-sectional study, 300 pregnant women in different trimesters (n = 100 in each trimester) were recruited. A demographic questionnaire and the Health Anxiety Questionnaire were used to collect data. Scores of < 27, 27–34 and more than 35 were defined as low, moderate and high health anxiety, respectively. Due to nationwide restrictions, data were collected through social media groups. Chi-square tests, ANOVA and multiple linear regression were used to analyze the data. Results Mean (SD) total anxiety scores were 22.3 ± 9.5, 24.6 ± 9.3 and 25.4 ± 10.6 in the first, second and third trimesters of pregnancy, respectively. 9, 13 and 21% of women had severe anxiety in the first, second and third trimesters of pregnancy, respectively. Women in the third trimester had significantly higher health anxiety scores than those in the first trimester (p = 0.045). Conclusion At the time of the COVID-19 pandemic, women in the second and third trimesters of pregnancy were more worried about consequences of disease, but total health anxiety scores were significantly higher among women in the third trimester of pregnancy. Health care providers should pay more attention to the mental health of pregnant women in times of crises such as the COVID-19 pandemic.

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EFFECT OF ZINK TABLETS INTERVENTION IN ZINC DEFICIENCY OF TRIMESTER III PREGNANT WOMEN TOWARD WEIGHT AND BODY LENGTH OF NEWBORN

Nurse and Health: Jurnal Keperawatan ◽

10.36720/nhjk.v10i2.295 ◽

2021 ◽

Vol 10 (2) ◽

pp. 304-312

Author(s):

Nurfadillah S ◽

Wardihan Sinrang ◽

Suryani As'ad ◽

Muh. Nasrum Massi ◽

Mardiana Ahmad ◽

...

Keyword(s):

Birth Weight ◽

Pregnant Women ◽

Zinc Deficiency ◽

Birth Length ◽

World Health ◽

Third Trimester ◽

Average Value ◽

The Third ◽

A Value ◽

Zinc Levels

Background: According to 2018 World Health Organization (WHO) data globally, an estimated 17.3% of the population has inadequate zinc intake, with estimates ranging from 5.7% in Oceania to 7.6% in Europe, 9.6% in America and the Caribbean, highest in Africa (23.9%) and Asia (19.6%). Zinc is important for the function of a number of enzymes and growth hormones during pregnancy. In pregnant women, the relative zinc concentration decreases up to 35% due to the influence of hormonal changes and the transport of nutrients from mother to baby. Objectives: The purpose of this study was to identify the effect of giving zinc tablets to pregnant women with zinc deficiency in the third trimester on body weight and length of babies born at the Makassar City Health Center. Methods: This type of research is True Experimental with a pretest-posttest design with a control group. The sample in this study was 62 samples of third trimester pregnant women, and the sampling technique used was purposive sampling. Measurement of zinc levels in third trimester pregnant women using the Elisa reader kit at the Research Laboratory of the Hasanuddin University Teaching Hospital. The research instruments were in the form of a research explanation sheet, respondent's consent sheet, respondent's checklist sheet, and the mother's zinc tablet consumption control sheet for 14 days. Results: Judging from the average value of newborns in pregnant women who did not have zinc deficiency, the average value of birth weight in pregnant women with zinc deficiency was 15.70 g/dL and 18.95 g/dL. zinc deficiency with a value (p < 0.05), while pregnant women with zinc deficiency have an average birth length of 10.00 g/dL and mothers who do not have a deficiency of 19.87 g/dL with a value (p < 0.05). So, it can be concluded that giving zinc tablets to pregnant women in the third trimester has an effect on Birth Weight (BBL) and Birth Length (PBL). Conclusion: Giving zinc tablets has an effect on increasing zinc levels in third trimester zinc deficiency pregnant women and increasing birth weight and length of the baby.

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MENGURANGI KECEMASAN PADA MASA KEHAMILAN TM III DENGAN METODE ACCUPRESSURE DEPRESSION POINTS

Jurnal Kebidanan ◽

10.35872/jurkeb.v13i02.465 ◽

2021 ◽

Vol 13 (02) ◽

pp. 172

Author(s):

Dyah Ayu Wulandari ◽

Meika Jaya Rockhmana ◽

Adelina Cahyaningrum

Keyword(s):

Sleep Quality ◽

Pregnant Women ◽

Psychological Adaptation ◽

The Body ◽

Wilcoxon Test ◽

P Value ◽

Third Trimester ◽

Purposive Sampling ◽

The Third

ABSTRAKAdaptasi fisik dan psikis kehamilan trimester III secara fisiologis dapat menimbulkan kecemasan ibu hamil. Adanya kecemasan pada ibu hamil trimester III dapat menyebabkan komplikasi ibu dan janin saat kehamilan, persalinan bahkan nifas. Terapi acupressure merupakan natural terapi dengan cara menekan acupoint untuk merelaksasi tubuh, melancarkan sirkulasi darah serta memberikan rasa tenang dan nyaman. Acupoint KID 27 dan CV 17 adalah titik yang berhubungan dengan kecemasan, agitasi, penyimpangan kelenjar tiroid, keseimbangan tubuh dan pusat jantung. Penekanan pada titik ini menyeimbangkan kadar hormon tiroid dan mengatasi gangguan kecemasan. Tujuan penelitian mengetahui pengaruh acupressure depression points terhadap kecemasan ibu hamil trimester III. Metode: Jenis penelitian kuantitatif dengan metode penelitian pre-experimental One Group Pretest-Posttest Design. Penelitian dilakukan Bulan Februari-Agustus 2021. Populasi penelitian ibu hamil trimester III yang melakukan ANC bulan Juni 2021 dengan keluhan kecemasan. Sampel penelitian 22 ibu hamil trimester III dengan teknik purposive sampling. Instrumen penelitian menggunakan kuesioner PRAQ-R2. Analisa data univariat dan bivariat (Uji Wilcoxon) Hasil: Hasil analisa statistik dengan uji Wilcoxon diperoleh nilai P-value 0,000 pada tingkat kecemasan. Kesimpulan: Acupressure depression points berpengaruh terhadap tingkat kecemasan ibu hamil trimester III di Semarang.Kata kunci: kecemasan, ibu hamil trimester IIIREDUCE ANXIETY IN PREGNANT MOTHER TRIMESTER III WITH ACCUPRESSURE DEPRESSION POINTS METHODABSTRACTPhysical and psychological adaptation of the third trimester of pregnancy can physiologically cause anxiety for pregnant women. The existence of anxiety in third trimester pregnant women can affect the quality of sleep which causes maternal and fetal complications during pregnancy, delivery and even postpartum. Acupressure therapy is a natural therapy by pressing the acupoints to relax the body, improve blood circulation and provide a sense of calm and comfort. Acupoints KID 27 and CV 17 are points associated with anxiety, agitation, thyroid disorders, body balance and heart centers. Emphasis on this point balances thyroid hormone levels and treats anxiety disorders thereby improving sleep quality. Objective: to determine the effect of acupressure depression points on the level of anxiety and sleep quality of pregnant women in the third trimester. Methods: This type of research is quantitative with pre-experimental research method One Group Pretest-Posttest Design. The study was conducted in February-August 2021. The study population was pregnant women in the third trimester who performed ANC in June 2021 with complaints of anxiety. The study sample was 22 pregnant women in the third trimester with purposive sampling technique. The research instrument used the PRAQ-R2. Analysis of univariate and bivariate data (Wilcoxon test) Results: The results of statistical analysis using the Wilcoxon test obtained a P-value of 0.000 on anxiety levels. Conclusion: Acupressure depression points have an effect on the level of anxiety of pregnant women in the third trimester at Semarang.Keyword: Anxiety, Pregnant Women In The Third Trimester

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