scholarly journals Polybrominated diphenyl ether serum concentrations and depressive symptomatology in pregnant African American women

2020 ◽  
Author(s):  
A. Mutic ◽  
D. Barr ◽  
V. Hertzberg ◽  
A. Dunlop ◽  
P. Brennan ◽  
...  
Keyword(s):  
African American ◽  
Depressive Symptoms ◽  
High Risk ◽  
Pregnant Women ◽  
Depressive Symptomatology ◽  
The United States ◽  
The Body ◽  
Chemical Degradation ◽  
Weighted Estimate ◽  
Environmental Toxicants

ABSTRACTBackgroundPolybrominated diphenyl ethers (PBDEs) are lipophilic, persistent endocrine disrupting chemicals often used as flame retardants in products that were widely produced in the United States until 2004. The potential for environmental toxicants such as PBDEs to disrupt normal neuroendocrine pathways resulting in depression and other neurological symptoms has been largely understudied. This study examined whether PBDE exposure in pregnant women was associated with antenatal depressive symptomatology.MethodsThis study is part of a larger longitudinal pregnancy and birth cohort study. Data were collected from 193 African American pregnant women at 8-14 weeks gestation. Serum PBDEs were analyzed using gas chromatography-tandem mass spectrometry. The Edinburgh Depression Scale (EDS) was used to identify depressive symptoms experienced in the last seven days prior to biosampling. The dichotomous depression variable was used to explore varying high-risk EDS cutoffs and illustrated with receiver operating characteristic curves. Logistic regression models were constructed to investigate associations with antenatal depression and a weighted quantile sum (WQS) index was calculated to account for the mixture of PBDE congeners.ResultsOf the total sample, 52 women (26.9%) were categorized as having a high risk of depression. PBDE congeners −47, −99, and −100 were detected in 50% or more of the samples tested. BDE-47 was positively associated with depressive symptoms (β =2.36, p=0.05). The risk of being mild to moderately depressed increased by a factor of 4.52 for BDE-47 (CI 1.50, 13.60) and 1.58 for BDE-99 (CI 1.08, 2.29). The WQS index, a weighted estimate of the body burden of the congener mixture was positively associated with a higher risk of mild to moderate depression using an EDS cutoff ≥10 (OR=2.93; CI 1.18, 7.82).ConclusionBDE-47 and −99 exposures are significantly associated with depressive symptomatology in a pregnant cohort. These exposures will likely continue for years due to slow chemical degradation. Interventions should focus on PBDE mitigation to reduce toxic neuroendocrine effects on vulnerable pregnant women.

scholarly journals Polybrominated Diphenyl Ether Serum Concentrations and Depressive Symptomatology in Pregnant African American Women

2021 ◽  
Vol 18 (7) ◽  
pp. 3614
Author(s):  
Abby D. Mutic ◽  
Dana Boyd Barr ◽  
Vicki S. Hertzberg ◽  
Patricia A. Brennan ◽  
Anne L. Dunlop ◽  
...  
Keyword(s):  
United States ◽  
African American ◽  
Pregnant Women ◽  
African American Women ◽  
Polybrominated Diphenyl Ethers ◽  
Depressive Symptomatology ◽  
Depression Scale ◽  
The United States ◽  
Cutoff Score ◽  
American Women

(1) Polybrominated diphenyl ethers (PBDEs) were widely produced in the United States until 2004 but remain highly persistent in the environment. The potential for PBDEs to disrupt normal neuroendocrine pathways resulting in depression and other neurological symptoms is largely understudied. This study examined whether PBDE exposure in pregnant women was associated with antenatal depressive symptomatology. (2) Data were collected from 193 African American pregnant women at 8–14 weeks gestation. Serum PBDEs and depressive symptoms were analyzed and a mixture effect was calculated. (3) Urban pregnant African American women in the Southeastern United States had a high risk of depression (27%) compared to the National average. Increased levels of PBDEs were found. BDE-47 and -99 exposures are significantly associated with depressive symptomatology in the pregnant cohort. The weighted body burden estimate of the PBDE mixture was associated with a higher risk of mild to moderate depression using an Edinburgh Depression Scale cutoff score of ≥10 (OR = 2.93; CI 1.18, 7.82). (4) Since antenatal depression may worsen in postpartum, reducing PBDE exposure may have significant clinical implications.

Abstract P326: Impact of Cardiac Rehabilitation on Depressive Symptomatology in Female Cardiac Patients

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Bharathi Reddy ◽  
Kiseok Lee ◽  
Nancy Rullo ◽  
Donna Cheslik Candy ◽  
John P Nicholson
Keyword(s):  
New York ◽  
Depressive Symptoms ◽  
Cardiac Rehabilitation ◽  
Depressive Symptomatology ◽  
The United States ◽  
Cardiac Patients ◽  
Female Patients ◽  
Enrollment Rates ◽  
Male Patients ◽  
Artery Disease

BACKGROUND: Coronary artery disease (CAD) is the leading cause of mortality in women and is responsible for more than 500,000 lives each year in the United States. Depression and depressive symptomatology in healthy subjects increases cardiovascular mortality in both men and women and its prevalence is exponentially rising in women. Research suggests that participation in a cardiac rehabilitation (CR) program reduces depression. Unfortunately studies have shown that CR is widely underutilized, particularly with significantly lower CR enrollment rates among women. HYPOTHESIS: The aim of this study was to demonstrate the effect of CR in the improvement of depressive symptoms in female cardiac patients after a cardiovascular event enrolled at the Cardiac Health Center (CHC) New York Hospital Queens (NYHQ). METHODS: The study sample comprised of 295 patients who completed 36 visits of CR at CHC NYHQ from 2007-2009. Out of 295 patients (age 66.85 ±10.64), 214 are males (71%) and 81 are females (29%). Mood scores were assessed using the PHQ-9 at the initial visit and again upon completion of the CR program. Of the 81 female patients enrolled, 31 female patients had documented pre and post CR-PHQ scores and of the 214 male patients enrolled, 81male patients had documented pre and post CR-PHQ scores. Using paired t test average mean difference in mood scores was tested. RESULTS: There was a significant decrease in mood scores in female patients (7.57 ± 5.18 to 3.11 ± 4.00, Δ 4.45 p= 0.00) compared to male patients (5.72 ± 5.19 to 2.37 ± 3.95 Δ 3.34 p = 0.00) after the completion of CR. CONCLUSION: The result of this study confirms that both male and female cardiac patients demonstrated significant reduction in depressive symptoms upon completion of CR. Female cardiac patients reported higher levels of depressive symptoms than male cardiac patients at the beginning of CR and exhibited a significant decrease in mood scores at the end of CR. This evidence supports that CR is an effective treatment in the reduction of depressive symptoms among female cardiac patients. Future studies are needed to establish the relationship among gender, CR, and depression. Clearly this is a complex issue and further efforts are needed to institute strategies to increase participation rates among female cardiac patients.

scholarly journals Chronic Stress and Unhealthy Dietary Behaviors among Low-Income African-American Female Caregivers

2020 ◽  
Vol 4 (3) ◽  
Author(s):  
Sungwoo Lim ◽  
Marisol Tellez ◽  
Amid I Ismail
Keyword(s):  
African American ◽  
Depressive Symptoms ◽  
Chronic Stress ◽  
Low Income ◽  
The United States ◽  
Dietary Behaviors ◽  
African American Female ◽  
Current Smoking ◽  
Residential Movement ◽  
African American Caregivers

ABSTRACT Background Chronic stress increases the risk of excess intake of calorie-dense foods. Low-income minority caregivers in the United States are cumulatively exposed to stressors and unhealthy foods, but evidence of this association is limited in this population group. The objective of the current study was to assess the association between chronic stress and unhealthy dietary behaviors among low-income African-American caregivers in Detroit, Michigan. Methods Data came from Detroit Dental Health Project, a longitudinal study of pairs of African-American caregivers and children during 2002–2007. A sample of 912 female caregivers were included and their baseline (2002–2003) survey responses were analyzed to identify those with chronic stress and patterns of dietary behaviors. The likelihood of having unhealthy dietary behaviors was compared between chronically stressed caregivers and others, and the mediator role of depressive symptoms or current smoking was tested. Results Approximately 10% of caregivers experienced chronic stress as they all reported discrimination, residential movement, and lack of social support. Twenty-five percent of the caregivers were found to have an unhealthy dietary pattern characterized by excess intake of high fatty foods and soda. Chronically stressed caregivers were more likely to exhibit unhealthy dietary behaviors (prevalence ratio: 1.39; 95% CI: 1.05, 1.84), and this relation was significantly mediated by depressive symptoms, not current smoking. Conclusions These findings suggest that chronic stress played a role in negatively influencing dietary behaviors. As this association might be mediated by depressive symptoms, an intervention to reduce depressive symptoms can be considered as an effective strategy to promote healthy dietary behaviors among chronically stressed minority caregivers.

scholarly journals Development and Implementation of a Mobile Tool for High-Risk Pregnant Women to Deliver Effective Caregiving for Neonatal Abstinence Syndrome: Protocol for a Mixed Methods Study (Preprint)

2021 ◽  
Author(s):  
Ekaterina Burduli ◽  
Hendrée E Jones ◽  
Olivia Brooks ◽  
Celestina Barbosa-Leiker ◽  
Ron Kim Johnson ◽  
...  
Keyword(s):  
Mixed Methods ◽  
High Risk ◽  
Data Collection ◽  
Pregnant Women ◽  
The United States ◽  
Neonatal Abstinence Syndrome ◽  
Abstinence Syndrome ◽  
Semistructured Interviews ◽  
Stage 1 ◽  
Perinatal Women

BACKGROUND The United States continues to experience an alarming rise in opioid use that includes women who become pregnant and related neonatal abstinence syndrome (NAS) in newborns. Most newborns experiencing NAS require nonpharmacological care, which entails, most importantly, maternal involvement with the newborn. To facilitate positive maternal-newborn interactions, mothers need to learn effective caregiving NAS strategies when they are pregnant; however, an enormous gap exists in the early education of mothers on the symptoms and progression of NAS, partly because no education, training, or other interventions exist to prepare future mothers for the challenges of caring for their newborns at risk for NAS. OBJECTIVE In this paper, we describe a mixed methods, multistage study to adapt an existing mobile NAS tool for high-risk pregnant women and assess its usability, acceptability, and feasibility in a small randomized controlled trial. METHODS Stage 1 will include 20 semistructured interviews with a panel of neonatology experts, NAS care providers, and mothers with experience caring for NAS-affected newborns to gather their recommendations on the management of NAS and explore their perspectives on the care of these newborns. The findings will guide the adaptation of existing mobile NAS tools for high-risk pregnant women. In stage 2, we will test the usability, acceptability, and feasibility of the adapted mobile tool via surveys with 10 pregnant women receiving opioid agonist therapy (OAT). Finally, in stage 3, we will randomize 30 high-risk pregnant women receiving OAT to either receive the adapted mobile NAS caregiving tool or usual care. We will compare these women on primary outcomes—maternal drug relapse and OAT continuation—and secondary outcomes—maternal-newborn bonding; length of newborn hospital stays; readmission rates; breastfeeding initiation and duration; and postpartum depression and anxiety at 4, 8, and 12 weeks postpartum. RESULTS This project was funded in July 2020 and approved by the institutional review board in April 2020. Data collection for stage 1 began in December 2020, and as of January 2021, we completed 18 semistructured interviews (10 with NAS providers and 8 with perinatal women receiving OAT). Common themes from all interviews will be analyzed in spring 2021 to inform the adaptation of the NAS caregiving tool. The results from stage 1 are expected to be published in summer 2021. Stage 2 data collection will commence in fall 2021. CONCLUSIONS The findings of this study have the potential to improve NAS care and maternal-newborn outcomes and lead to commercialized product development. If effective, our new tool will be well suited to tailoring for other high-risk perinatal women with substance use disorders. CLINICALTRIAL ClinicalTrials.gov NCT04783558; https://clinicaltrials.gov/ct2/show/NCT04783558 INTERNATIONAL REGISTERED REPORT DERR1-10.2196/27382

scholarly journals Treating Insomnia with High Risk of Depression Using Therapist-Guided Digital Cognitive, Behavioral, and Circadian Rhythm Support Interventions to Prevent Worsening of Depressive Symptoms: A Randomized Controlled Trial

2021 ◽  
pp. 1-12
Author(s):  
Jeanne Leerssen ◽  
Oti Lakbila-Kamal ◽  
Laura M.S. Dekkers ◽  
Savannah L.C. Ikelaar ◽  
Anne C.W. Albers ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Circadian Rhythm ◽  
Depressive Symptoms ◽  
High Risk ◽  
Depressive Symptomatology ◽  
Controlled Trial ◽  
Self Report ◽  
Cognitive Behavioral ◽  
Randomized Controlled ◽  
Increased Risk

<b><i>Introduction:</i></b> The global disease burden of major depressive disorder urgently requires prevention in high-risk individuals, such as recently discovered insomnia subtypes. Previous studies targeting insomnia with fully automated eHealth interventions to prevent depression are inconclusive: dropout was high and likely biased, and depressive symptoms in untreated participants on average improved rather than worsened. <b><i>Objective:</i></b> This randomized controlled trial aimed to efficiently prevent the worsening of depressive symptoms by selecting insomnia subtypes at high risk of depression for internet-based circadian rhythm support (CRS), cognitive behavioral therapy for insomnia (CBT-I), or their combination (CBT-I+CRS), with online therapist guidance to promote adherence. <b><i>Methods:</i></b> Participants with an insomnia disorder subtype conveying an increased risk of depression (<i>n</i> = 132) were randomized to no treatment (NT), CRS, CBT-I, or CBT-I+CRS. The Inventory of Depressive Symptomatology – Self Report (IDS-SR) was self-administered at baseline and at four follow-ups spanning 1 year. <b><i>Results:</i></b> Without treatment, depressive symptoms indeed worsened (<i>d</i> = 0.28, <i>p</i> = 0.041) in high-risk insomnia, but not in a reference group with low-risk insomnia. Therapist-guided CBT-I and CBT-I+CRS reduced IDS-SR ratings across all follow-up assessments (respectively, <i>d</i> = –0.80, <i>p</i> = 0.001; <i>d</i> = –0.95, <i>p</i> &#x3c; 0.001). Only CBT-I+CRS reduced the 1-year incidence of clinically meaningful worsening (<i>p</i> = 0.002). Dropout during therapist-guided interventions was very low (8%) compared to previous automated interventions (57–62%). <b><i>Conclusions:</i></b> The findings tentatively suggest that the efficiency of population-wide preventive strategies could benefit from the possibility to select insomnia subtypes at high risk of developing depression for therapist-guided digital CBT-I+CRS. This treatment may provide effective long-term prevention of worsening of depressive symptoms. <b><i>Trial registration:</i></b> the Netherlands Trial Register (NL7359).

scholarly journals Lipidome Profiles Are Related to Depressive Symptoms and Preterm Birth Among African American Women

2020 ◽  
Vol 22 (3) ◽  
pp. 354-361 ◽  
Author(s):  
Nadia Saadat ◽  
Todd A. Lydic ◽  
Dawn P. Misra ◽  
Rhonda Dailey ◽  
Deborah S. Walker ◽  
...  
Keyword(s):  
African American ◽  
Depressive Symptoms ◽  
Preterm Birth ◽  
African American Women ◽  
Depression Scale ◽  
The United States ◽  
Mass Spectrometry Data ◽  
Orthogonal Projections ◽  
Clear Separation ◽  
American Women

African American women have the highest rate of preterm birth (PTB; <37 completed weeks’ gestation) of any racial and ethnic group in the United States (14.1%). Depressive symptoms (DS) have been linked to PTB risk of African American women. We hypothesized that maternal lipidomic profiles are related to prenatal DS and gestational age at birth among African American women. Women were enrolled at 9–25 weeks’ gestation, completed questionnaires, and provided plasma samples. Lipidomic profiles were determined by “shotgun” Orbitrap high-resolution/accurate mass spectrometry. Data were analyzed using SIMCA P+ software. There was a clear separation in the orthogonal projections to latent structures discriminant analysis score plot between women with Center for Epidemiologic Studies Depression Scale (CES-D) scores ≥23 and women with CES-D scores ≤22. Similarly, a clear separation was observed in the model between PTB and full-term birth. Corresponding S-plot, loading plot, and variable importance in projection plot/list were used to identify the lipids responsible for the groupings. Higher levels of specific triglyceride (TG) species and lower levels of specific phosphatidylcholines (PCs) PC(37:1), PC(41:6), and PC(39:3) were associated with PTB. PC PC(37:1) levels were also lower among women with CES-D scores ≥23, pointing toward a possible connection between DS and PTB. Although overweight pregnant women showed higher levels of TGs, the PTB model showed specific TGs unique to PTB. Lipidomic profiles in pregnant African American women are related to DS, and our data suggest a role for specific TGs and PCs in PTB.

Complex pharmaco-ozone therapy in the prevention of placental insufficiency in high-risk pregnancy

2020 ◽  
pp. 19-27
Author(s):  
L. V. Tsallagova ◽  
L. V. Maisuradze ◽  
S. V. Sagkaeva ◽  
T. I. Tsidaeva
Keyword(s):  
High Risk ◽  
Pregnant Women ◽  
The Body ◽  
High Risk Pregnancy ◽  
Placental Lactogen ◽  
Control Group ◽  
Ozone Therapy ◽  
Morphological Examination ◽  
Adaptive Capabilities ◽  
Risk Pregnancy

Summary. Purpose of research. Development of a method for prevention of placental insuffi ciency (PN) in high-risk pregnancy in women of the Republic of North Ossetia-Alania (RSO-A) with the complex use of antihypoxant limontar and ozone therapy (OT). Material and methods. Observations were made of 75 pregnant residents of RSO-A with diagnosed PN, whose average age was 32,6 ± 8,14 years. Using a simple randomization method, 3 groups were formed: in the main group (OG), patients received prevention of PN by using OT and antihypoxant limontar; in the comparison group (GS), only limontar; in the control group (KG), pregnant women did not receive prevention of PN. All patients observed before and after PN prevention were examined for placental lactogen and estriol, ultrasound of the fetoplacental complex (FPC), Doppler examination of the uterine blood fl ow and ultrasound examination of the placenta structure, and morphological examination of the placenta. Results. Based on identifi ed pathogenetic mechanisms of the disorders in the system “mother — placenta — fetus” are defined by a high clinical effi cacy of combined pharmaco-ozone therapy (CT) in the prevention of PN in pregnant women at risk, which was manifested by the lack of progression of PN, whereas in GS, where patients received only pharmacotherapy with limontar, progression was noted in 31,8 % of cases, in KG, where there was no prevention, is 56 %. Conclusion. In the present study, the positive effect of OT and antihypoxant limontar on the processes of microcirculation, metabolism, and adaptation of the body, which provides a signifi cant reduction in the frequency of pregnancy complications, increasing the adaptive capabilities of the fetus and improving perinatal outcomes.

Early glucose intolerance postpartum of gestational diabetes associated with overload test with 50 grams of glucose

2016 ◽  
Vol 62 (5) ◽  
pp. 30-31
Author(s):  
Dora Varillas ◽  
VF Varillas
Keyword(s):  
Blood Glucose ◽  
High Risk ◽  
Gestational Diabetes ◽  
Glucose Tolerance ◽  
Pregnant Women ◽  
Glucose Intolerance ◽  
The United States ◽  
Normal Vaginal Delivery ◽  
Loading Test ◽  
History Of

Introduction. The glucose intolerance later gestational diabetes is a very important indicator that helps establish the prognosis of diabetes in pregnant women who have had gestational diabetes (1). In this study we followed for one year to all gestational diabetes who were treated at the Hospital of Fuerteventura in endocrinology consultation,Canary Island, Spain. The aim was to study what factors might be related to glucose intolerance in the immediate postpartum.Materials and methods. All pregnant women served with the diagnosis of gestational diabetes during April 2012 to May 2013, diagnosed according to the criteria of the ADA (2), were subjected to routine procedure of specialized gynecology and endocrinology unit, first: test loading test with 50 grams of glucose, and if blood glucose was greater whom 140 mgdl,SOG was performed with 100 grams glucose three hours. All these patients were followed up with a minimum of a monthly review by both gynecology and endocrinology as was given a standard diet and as controls if necessary insulin treatment. In addition glycemia in the first quarter, glycated hemoglobin in the second and third quarter was measured, if there was family history of diabetes, as well as history of previous gestational diabetes, presence of other diseases, hypertension in pregnancy, if they had done treatment with diet or insulin. Finally, it determines if the birth was eutocic or dystocia. All the analyzes were performed in the Hospital Fuerteventura laboratory by standard autoanalyzer. SPSS v.24 program for frequency valuations and statistical analyzes. Was measured frequencies, all dependent and independent variables and logistic regression analysis, ANOVA and linear correlation with statistical significance of ≤0.05 was performed.Results. Of the 60 diabetic gestational included in the study, 49 completed the assessment of oral glucose tolerance test at 0 and 120 minutes, 81'7%, of these 57.1% were normal, 41.8% had glucose intolerance which were 26.5% impaired fasting glucose and 14’3 were intolerant, 2.5 were diabetic. In these patients: 57.6 percent had a normal vaginal delivery and 39.0% were dystocia. When we analyze all the variables according to the diagnosis of glucose intolerance, just correlated test 50 grams of glucose, ANOVA (p <0.033) with degrees of impaired glucose tolerance and there was a correlation positive linear between higher blood glucose value post 50 grams of glucose and glucose intolerance in the immediate postpartum. When we analyze dystocia, there was no correlation with any of the studied variables.Discussion. Interestingly in this study it is among correlation values loading test with 50g glucose and the presence of glucose intolerance and diabetes immediately after birth of gestational diabetes. It is known that after 50 grams of glucose greater than 200 glucose has an almost certain chance of having gestational diabetes (2) and according to some centers especially in the United States is not necessary to make a confirmatory SOG (2), however, their relationship to the immediate postpartum, it has not been seen in another study that we know until now and therefore part of their predictive value for gestational diabetes, could already give us an indication of glycemic alteration itself will happen in the immediate postpartum (3). Compared with other studies, the prevalence of glucose intolerance is similar to other high-risk populations, such as the Indian population (4), which gives the Canarian population at high risk of developing diabetes in the future. This study shows that the overload test with 50 grams of glucose is not only indicative of a very high suspicion of gestational diabetes, but can also help establish the prognosis of a future change in glucose metabolism in gestational diabetes.

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