Hypocalcaemia and its contributing factors among first trimester pregnant women in an urban area in Malaysia

Purpose The aim of this study is to determine the prevalence of hypocalcaemia among first-trimester pregnant women and its contributing factors. Design/methodology/approach A cross-sectional study was carried out among first-trimester pregnant women who were recruited during their first antenatal visit. A total of 396 respondents of age 18-40 years completed the self-administered questionnaire (socio-demographic, socio-economic, obstetric information), validated semi-quantitative food frequency questionnaire for calcium (FFQ-calcium), anthropometric measurements (weight and height) and blood test for serum calcium during their first trimester. Findings The prevalence of hypocalcaemia based on serum calcium level of less than 2.11 mmol/L was 26.0 per cent (n = 103). The median serum calcium level was 2.2 mmol/L (IQR, 25th and 75th percentile – 2.1 and 2.3, respectively). Milk intake of less than two glasses per day during pregnancy showed a twofold increase in developing hypocalcaemia (OR, 2.231; 95 per cent CI, 1.399, 3.588). Other than that, underweight (aOR, 2.038; 95 per cent SK, 1.088, 3.820) and obese before pregnancy (aOR, 1.954; 95 per cent SK, 1.007, 3.790) are also predictors of hypocalcaemia. Originality/value The prevalence of hypocalcaemia among first-trimester pregnant women in this study was 26.0 per cent. Intake of two or more glasses of milk per day can help prevent hypocalcaemia at this stage of pregnancy.

Download Full-text

A cross sectional study to evaluate serum calcium levels among pregnant women and it's association with preeclampsia and delivery outcomes at tertiary care Hospital Bikaner, Rajasthan

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20211532 ◽

2021 ◽

Vol 10 (5) ◽

pp. 2026

Author(s):

Laxmi Poonia ◽

Swati Kochar ◽

Shweta Chaudhary ◽

Priyanka Gaur ◽

Kirti Solanki

Keyword(s):

Pregnant Women ◽

Serum Calcium ◽

Calcium Level ◽

Serum Calcium Level ◽

Tertiary Care ◽

Cross Sectional Study ◽

Control Group ◽

Care Hospital ◽

Sectional Study ◽

Cross Sectional

Background: Hypertensive disorders of pregnancy, including preeclampsia complicates about 10% of pregnancies worldwide. Preeclampsia is one of the major cause of maternal and perinatal morbidity and mortality worldwide. According to the National Health Portal of India, the incidence of preeclampsia is reported to be about 8-10% among pregnant women. The present study was aimed to compare mean serum calcium levels in preeclamptic and normotensive pregnant women at third trimester of gestation and assess relationship between maternal serum calcium levels, severity of disease and overall maternal and perinatal outcome.Methods: This was a cross sectional study conducted on 200 females divided into two groups (i.e. Study and Control Group) from 1st November 2019 to 31st October 2020. Informed consent was obtained for subjecting. Detailed history and clinical examination were performed. Serum calcium level was measured in both groups by spectrophotometric method.Results: Mean serum calcium level in study group (preeclamptic) was 7.84+0.74mg/dl while in control group (normotensive) mean serum calcium level was 9.68+0.97mg/dl. Serum calcium level was significantly lower in preeclamptic women than normotensive pregnant women (p<0.001).Serum calcium showed significant negative correlation with systolic and diastolic blood pressure.Conclusions: This study concludes that hypocalcaemia may have a role in aetiology of preeclampsia and adverse maternal and perinatal outcome. Thus intake of calcium supplements may help in reduction of incidence of preeclampsia especially in a population of a developing country.

Download Full-text

Phototherapy Induced Hypocalcemia in Neonates with Unconjugated Hyperbilirubinemia

Journal of Bahria University Medical and Dental College ◽

10.51985/gubk9588 ◽

2021 ◽

Vol 11 (1) ◽

pp. 4-8

Author(s):

Amna Khan ◽

Anila Farhat ◽

Hamayun Anwar ◽

Sajid Shamim ◽

Mujeeb Ur Rehman ◽

...

Keyword(s):

Serum Calcium ◽

Calcium Level ◽

Serum Calcium Level ◽

Neonatal Intensive Care ◽

Cross Sectional Study ◽

Categorical Variables ◽

P Value ◽

Cross Sectional ◽

Unconjugated Hyperbilirubinemia ◽

Before And After

Objective: To determine the frequency of hypocalcemia in neonates with unconjugated hyperbilirubinemia receivingphototherapy.Study design and setting: Cross sectional study conducted at neonatal intensive care unit, King Abdullah Teaching Hospital,Mansehra for one year from December 2017 to November 2018.Methodology: Total 213 full term stable neonates of either gender with jaundice were studied in this study. Out of which,143 with unconjugated hyperbilirubinemia were exposed to phototherapy while 70 neonates with exaggerated physiologicalhyperbilirubinemia taken as control were not exposed to phototherapy. Serum calcium level was determined through bloodtest before and after 24 hours of phototherapy. SPSS version 22 was used to analyze the data. Frequency and percentageswere used to describe categorical variables like gender and hypocalcemia. Hypocalcemia was stratified by age and genderto see effect modifiers. Post stratified chi-square test was applied in which p value = 0.05 was considered as significancevalue.Results: In study group, 143 neonates who received phototherapy had mean age of 7 days ± 2.62 SD. Total 65% neonateswere male and 35% neonates were female. Mean serum calcium level of neonates before and after provision of phototherapywas 9.28 mg/dl ± 0.23 and 8.54 mg/dl ± 0.68 respectively, which is statistically significant. The frequency of hypocalcemiawas 40% in neonates with unconjugated hyperbilirubinemia after 24 hours of phototherapy.Conclusion: Hypocalcemia is an important complication in neonates with unconjugated hyperbilirubinemia after continuousphototherapy. Hypocalcemia has clinical impact and adds to morbidity, and if left untreated, can lead to mortality.

Download Full-text

Evaluation of Serum Calcium Levels in Pre-eclampsia

Medicine Today ◽

10.3329/medtoday.v30i2.37810 ◽

2018 ◽

Vol 30 (2) ◽

pp. 57-60

Author(s):

Heera Lal Roy ◽

Susmita Nargis ◽

Md Mahbubur Rahman ◽

Mohammad Shahadat Hossain ◽

Md Ruhul Amin ◽

...

Keyword(s):

Pregnant Women ◽

Serum Calcium ◽

Gestational Age ◽

Calcium Level ◽

Serum Calcium Level ◽

Colorimetric Method ◽

Medical Complication ◽

Cross Sectional ◽

Mortality And Morbidity ◽

The Mean

Pre-eclampsia is the most common medical complication of pregnancy associated with increased maternal and infant mortality and morbidity. Reduced serum calcium level are found associated with elevated blood pressure in preeclampsia. To evaluate serum calcium level in pre-eclamptic women. This cross sectional study was carried out in among 50 preeclamptic patients, aged 20 to 40 years, and gestational age ranges from 20 to 40 weeks and 50 age and gestational age matched normotensive pregnant women having no proteinuria. Serum calcium was measured by Colorimetric method. The mean age and mean gestational age of pre-eclampsia was not significantly different from those of normotensive pregnant women (p=0.203 and p=0.251 respectively). The mean body mass indexes of the test patients were significantly different from those of normotensive pregnant women (p<0.001). The mean serum calcium level was 7.27 ± 3.01 mg/dl in pre-eclampsia and 7.25 ± 2.59 mg/dl in normal pregnant women; did not differ significantly between the subjects of pre-eclampsia and normal pregnant women (p=0.963). Serum calcium has no association in occurrence of preeclampsia.Medicine Today 2018 Vol.30(2): 57-60

Download Full-text

Phototherapy Induced Hypocalcemia in Neonates with Unconjugated Hyperbilirubinemia

Journal of Bahria University Medical and Dental College ◽

10.51985/bhrtu3452 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Amna Khan ◽

Anila Farhat ◽

Hamayun Anwar ◽

Sajid Shamim ◽

Mujeeb Ur Rehman ◽

...

Keyword(s):

Serum Calcium ◽

Calcium Level ◽

Serum Calcium Level ◽

Neonatal Intensive Care ◽

Cross Sectional Study ◽

Categorical Variables ◽

P Value ◽

Cross Sectional ◽

Unconjugated Hyperbilirubinemia ◽

Before And After

Download Full-text

The Correlation of Serum Calcium Level and Obesity; Is There Any Explanation?

Galen Medical Journal ◽

10.31661/gmj.v2i1.28 ◽

2013 ◽

Vol 2 (1) ◽

pp. 26-31

Author(s):

Omid Dalfardi ◽

Dariush Jahandideh ◽

Gholam Hossein Ranjbar Omrani

Keyword(s):

Serum Calcium ◽

Calcium Level ◽

Serum Calcium Level ◽

Serum Levels ◽

Cross Sectional Study ◽

Albumin Level ◽

Obese People ◽

High Calcium Intake ◽

Cross Sectional ◽

High Calcium

Background: Obesity is caused by several factors while sedentary lifestyle and excessive energy intake are the most important ones. Obesity could be due to abnormal calcium metabolism, and a high calcium intake may prevent obesity. Studying serum calcium level, albumin, and triglyceride concentrations, we searched for probable correlation between serum calcium level and anthropometric data of the participants.Materials and Methods: This cross-sectional study was performed in 2011 in Shiraz Endocrine and Metabolism Research Center on 468 participants. Anthropometrics and serum levels of calcium, albumin, and triglyceride levels were measured, recorded, and analyzed by SPSS statistical software.Results: 329 participants were female (70.3%) and the remaining were male (29.7%) with mean age of 46.08 ±15.22 years old. Corrected plasma concentration of calcium based on albumin level had a significant relation with weight, BMI, and triglyceride levels.Conclusion: It is assumed that obesity induces the production of inflammatory cytokines which stimulates bone absorption by osteoclasts that might subsequently lead to a higher serum calcium level in obese people who have a high level of triglyceride at the same time.

Download Full-text

Knowledge about Anemia among Pregnant Women in Tertiary Hospital

Medicine Today ◽

10.3329/medtoday.v31i2.41962 ◽

2019 ◽

Vol 31 (2) ◽

pp. 105-110 ◽

Cited By ~ 1

Author(s):

Fahmida Sultana ◽

Gulshan Ara ◽

Tania Akbar ◽

Rayhana Sultana

Keyword(s):

Pregnant Women ◽

First Trimester ◽

Tertiary Hospital ◽

Cross Sectional Study ◽

Antenatal Visit ◽

Age Group ◽

Sectional Study ◽

Cross Sectional ◽

Gynecology And Obstetrics ◽

Medicine Today

Introduction: To evaluate knowledge about anemia among pregnant women visiting in OPD for antenatal care. Materials and Methods: A cross sectional study was conducted in tertiary hospital Dhaka, from outdoor patient department of gynecology and obstetrics, to assess the knowledge about anemia among pregnant women and also to find out the percentage and type of anemia. A total 396 pregnant women were interviewed and information were collected by pre designed data collection sheet using various parameters. Interviews conducted by direct questionnaire, blood samples were collected at same setting. Results: The mean age was 25.92±5.05, highest number 39.65% were age group 21-25 years, 28.79% were age group -30 years, 15.91% were age group 31-35 years, 11.36% were found age group <20 years. Regarding antenatal visit during pregnancy, 25.8% pregnant women visited in 1st trimester, 46.7% pregnant women visited in second trimester, and 27.5% in 3rd trimester. Also 11.11% patients had anemia in first trimester, 39.39% anemic in 2nd trimester, 14.39% pregnant women anemic in third trimester and 35.10% had normal findings. And 67% pregnant woman’s had knowledge about ANC 32% had no knowledge. Conclusion: In this cross sectional study it was found that poor knowledge about anemia and less iron intake is the main cause for anemia during pregnancy. Medicine Today 2019 Vol.31(2): 105-110

Download Full-text

The effect of phototherapy on serum calcium level in neonates with hyperbilirubinemia: a cross sectional study

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20203174 ◽

2020 ◽

Vol 7 (8) ◽

pp. 1772

Author(s):

Anjali Vasant Kale ◽

Pranoti Uttam Jadhao ◽

Aashna Valecha ◽

Sreelekha Kethepalli

Keyword(s):

Standard Deviation ◽

Serum Calcium ◽

Calcium Level ◽

Serum Calcium Level ◽

Cross Sectional Study ◽

Water Soluble ◽

Neonatal Hyperbilirubinemia ◽

Cross Sectional ◽

Mortality And Morbidity ◽

Before And After

Background: Neonatal Hyperbilirubinemia is one of the leading causes for admission in NICU in the first week of life. This condition if left untreated may lead to irreversible neurological damage hence increasing mortality and morbidity in newborns. Neonatal Hyperbilirubinemia is treated with phototherapy which employs blue wavelengths of light to change unconjugated bilirubin in the skin. The bilirubin is then converted to less toxic water-soluble photo-isomers that are excreted in the bile and urine. There are several toxic effects to the use of this treatment, one of them being hypocalcemia.Methods: This study has been done at Mahatma Gandhi Institute of Medical Sciences in 2016-2018 on 100 new-borns to prove the effect of phototherapy on serum calcium levels in neonates with hyperbilirubinemia. New-born who were admitted in NICU for Hyperbilirubinemia were screened according to inclusion and exclusion criteria, their sample for serum calcium and serum bilirubin levels were taken as pre and post phototherapy samples.Results: It was observed that the mean Serum calcium level before phototherapy in neonates was 9.31 mg/dl with standard deviation of 0.69 mg/dl. Whereas after phototherapy mean serum calcium level in neonates was 8.88 mg/dl with standard deviation of 0.73 mg/dl. There was statistically significant mean difference in serum calcium level at before and after phototherapy in neonates (p<0.0001).Conclusions: This study proves the hypothesis that phototherapy can cause hypocalcemia in neonates with hyperbilirubinemia.

Download Full-text

Association Between Serum Calcium and the Prevalence of Hypertension Among US Adults

Frontiers in Cardiovascular Medicine ◽

10.3389/fcvm.2021.719165 ◽

2021 ◽

Vol 8 ◽

Author(s):

Yang Hua ◽

Heng-li Liu ◽

Jin-Yu Sun ◽

Xiang-Qing Kong ◽

Wei Sun ◽

...

Keyword(s):

Serum Calcium ◽

Calcium Level ◽

Serum Calcium Level ◽

Significant Risk ◽

Positive Association ◽

Significant Risk Factor ◽

Cross Sectional Study ◽

Cubic Spline ◽

Multivariable Logistic Regression Analysis ◽

Cross Sectional

Background: Hypertension is a significant risk factor of cardiovascular diseases, posing a serious threat to global health. Calcium plays an important role in regulating body homeostasis. The association of calcium with hypertension remains uncertain in the general population.Methods and Results: Cross-sectional data from the 2007–2018 National Health and Nutrition Examination Survey (NHANES) were analyzed. Adjusted multivariable logistic regression analysis and restricted cubic spline were used to investigate the association of serum calcium with the prevalence of hypertension. A total of 26,778 participants were included. The increase in calcium levels showed a positive association with the prevalence of hypertension in all three models with ORs of 1.347 (1.249–1.454), 1.522 (1.401–1.654), and 1.438 (1.306–1.583). The further subgroup analysis demonstrated a robust trend across all categories by sex, age, race, BMI, and eGFR. The restricted cubic spline plot exhibited an S-curve relationship between calcium and hypertension.Conclusion: Our cross-sectional study demonstrated a positive association between higher serum calcium level and the prevalence of hypertension. Our findings highlighted serum calcium level in hypertensive patients.

Download Full-text

Antibiotic Prescriptions among China Ambulatory Care Visits of Pregnant Women: A Nationwide Cross-Sectional Study

Antibiotics ◽

10.3390/antibiotics10050601 ◽

2021 ◽

Vol 10 (5) ◽

pp. 601

Author(s):

Houyu Zhao ◽

Mei Zhang ◽

Jiaming Bian ◽

Siyan Zhan

Keyword(s):

Pregnant Women ◽

Ambulatory Care ◽

National Level ◽

Mainland China ◽

Antibiotic Use ◽

First Trimester ◽

Cross Sectional Study ◽

Cross Sectional ◽

Fetal Safety ◽

First Trimester Of Pregnancy

Background: Antibiotic use in pregnant women at the national level has rarely been reported in China. Objectives: We aimed to investigate antibiotic prescriptions during pregnancy in ambulatory care settings in China. Methods: Data of 4,574,961 ambulatory care visits of pregnant women from October 2014 to April 2018 were analyzed. Percentages of Antibiotic prescriptions by different subgroups and various diagnosis categories and proportions of inappropriate antibiotic prescriptions for different subgroups were estimated. Food and Drug Administration (FDA) pregnancy categories were used to describe the antibiotic prescription patterns. The 95% confidence intervals (CIs) were estimated using the Clopper––Pearson method or Goodman method. Results: Among the 4,574,961 outpatient visits during pregnancy, 2.0% (92,514 visits; 95% CI, 2.0–2.0%) were prescribed at least one antibiotic. The percentage of antibiotic prescriptions for pregnant women aged >40 years was 4.9% (95% CI, 4.7–5.0%), whereas that for pregnant women aged 26–30 years was 1.5% (95% CI, 1.4–1.5%). In addition, percentages of antibiotic prescriptions varied among different trimesters of pregnancy, which were 5.4% (95% CI, 5.3–5.4%) for the visits in the first trimester of pregnancy and 0.5% (95% CI, 0.4–0.5%) in the third trimester of pregnancy. Furthermore, the percentages of antibiotic prescriptions substantially varied among different diagnosis categories and nearly three-quarters of antibiotic prescriptions had no clear indications and thus might be inappropriate. In total, 130,308 individual antibiotics were prescribed; among these, 60.4% (95% CI, 60.0–60.8%) belonged to FDA category B, 2.7% (95% CI, 2.1–3.5%) were classified as FDA category D and 16.8% (95% CI, 16.2–17.4%) were not assigned any FDA pregnancy category. Conclusions: Antibiotic prescriptions in ambulatory care during pregnancy were not highly prevalent in mainland China. However, a substantial proportion of antibiotics might have been prescribed without adequate indications. Antibiotics whose fetal safety has not been sufficiently illustrated were widely used in pregnant women.

Download Full-text

Cross-sectional study to assess etiology and associated factors for anaemia during first trimester of pregnancy in Anuradhapura District, Sri Lanka: a protocol

F1000Research ◽

10.12688/f1000research.28226.1 ◽

2021 ◽

Vol 10 ◽

pp. 223

Author(s):

Gayani Amarasinghe ◽

Vasana Mendis ◽

Thilini Agampodi

Keyword(s):

Sri Lanka ◽

Data Collection ◽

Pregnant Women ◽

Associated Factors ◽

First Trimester ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Anaemia In Pregnancy ◽

In Pregnancy

Background: Anaemia in pregnancy, which can lead to adverse maternal and fetal outcomes, is a significant global health problem. Despite Sri Lanka’s strong public health system and commitment towards prevention, maternal anaemia remains a major problem in the country. While prevention is focused on iron deficiency, detailed etiological studies on this topic are scarce. Moreover, estimates of socio demographic and economic factors associated with anaemia in pregnancy, which can provide important clues for anaemia control, are also lacking. This study aims to evaluate the hemoglobin distribution, spatial distribution, etiology and associated factors for anaemia in pregnant women in Anuradhapura, Sri Lanka. Methods: This is a cross sectional study of pregnant women in their first trimester registered for antenatal care from July to September 2019 in the Anuradhapura district. The minimal sample size was calculated to be 1866. Initial data collection has already been carried out in special field clinics for pregnant women between June to October 2019. An interviewer-administered questionnaire, a self-completed dietary questionnaire and an examination checklist were used for data collection. In addition, all participants underwent complete blood count testing. Further investigations are being conducted for predicting the etiology of anaemia based on a developed algorithm (such as high-performance liquid chromatography [HPLC] and peripheral blood film analysis). Discussion: Being the largest study on anaemia during pregnancy in a single geographical area in Sri Lanka, this study will provide important clues about geographical clustering of anaemia cases with similar etiology, associated factors and etiologies which would help to develop interventions to improve the health of pregnant women in the area. The possibility of selection bias is a potential limitation associated with the study design.

Download Full-text