scholarly journals The Brabant study: design of a large prospective perinatal cohort study among pregnant women investigating obstetric outcome from a biopsychosocial perspective

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e038891
Author(s):  
Margreet Meems ◽  
Lianne Hulsbosch ◽  
Madelon Riem ◽  
Christina Meyers ◽  
Tila Pronk ◽  
...  
Keyword(s):  
Cohort Study ◽  
Pregnant Women ◽  
Thyroid Function ◽  
Maternal Distress ◽  
Obstetric Outcomes ◽  
Social Changes ◽  
Obstetric Outcome ◽  
Partner Relationship ◽  
Pregnancy Distress

BackgroundPregnancy is characterised by many biological and psychosocial changes. Adequate maternal thyroid function is important for the developing fetus throughout gestation. Latent class analyses recently showed three different patterns of change in thyroid function throughout pregnancy with different associations with obstetric outcome. Maternal distress during the pregnancy (anxiety and depression) negatively affects obstetric outcome. Pregnancy distress in turn may be affected by personality traits and attachment styles. Moreover, during the pregnancy, substantial social changes occur in the partner relationship and work experience. The aim of the Brabant study is to investigate the association between thyroid function trajectories and obstetric outcomes. Moreover, within the Brabant study, we will investigate how different trajectories of pregnancy distress are related to obstetric outcome, and the role of personality in this association. We will evaluate the possible role of maternal distress and attachment style on maternal–fetal bonding. Finally, we will study social changes in the perinatal period regarding partner relationship and well-being and performance at work.Methods and analysisThe Brabant study is a longitudinal, prospective cohort study of an anticipated 4000 pregnant women. Women will be recruited at 8–10 weeks gestation among community midwife practices in South-East Brabant in the Netherlands. Thyroid function parameters (TSH and fT4), thyroid peroxidase antibody and human chorionic gonadotrophin will be assessed at 12, 20 and 28 weeks gestation. Moreover, at these three time points women will fill out questionnaires assessing demographic and obstetric features, life style habits and psychological and social variables, such as depressive symptoms, personality, partner relationship quality and burnout. Data from the obstetric records will also be collected.Ethics and disseminationThe study has been approved by the Medical Ethical Committee of the Máxima Medical Center Veldhoven. Results will be submitted to peer-reviewed journals in the relevant fields and presented on national and international conferences.

scholarly journals The Brabant Study: design of a large prospective perinatal cohort study among pregnant women investigating obstetric outcome from a biopsychosocial perspective

2020 ◽  
Author(s):  
Margreet Meems ◽  
Lianne Hulsbosch ◽  
Madelon Hendricx-Riem ◽  
Christina Meyers ◽  
Tila M. Pronk ◽  
...  
Keyword(s):  
Cohort Study ◽  
Pregnant Women ◽  
Thyroid Function ◽  
Latent Class ◽  
Maternal Distress ◽  
Social Changes ◽  
Obstetric Outcome ◽  
Partner Relationship ◽  
Pregnancy Distress

Background: Pregnancy is characterized by many biological and psychosocial changes. Adequate maternal thyroid function is important for the developing fetus throughout gestation. Latent class analyses (LCA) (including three consecutive trimester assessments) recently showed new insights into changes of thyroid function in relation to obstetric outcome. Furthermore, maternal distress during pregnancy (anxiety and depression) negatively affects obstetric outcome. Pregnancy distress in turn may be affected by personality traits and attachment styles. Moreover, during pregnancy, substantial social changes occur in the partner relationship and work experience. The aim of the Brabant Study is to investigate the association between thyroid function trajectories and obstetric outcomes. Moreover, within the Brabant Study, we will investigate how different trajectories of pregnancy distress are related to obstetric outcome, and the role of personality in this association. We will evaluate the possible role of maternal distress and attachment style on maternal-fetal bonding. Finally, we will study social changes in the perinatal period regarding partner relationship and well-being and performance at work. Methods and analysis: The Brabant Study is a longitudinal, prospective cohort study of an anticipated 4000 pregnant women. Women will be recruited at 8-10 weeks gestation among community midwife practices in South-East Brabant in the Netherlands. Thyroid hormone levels (TSH and fT4), TPO-Ab and hCG will be assessed at 12, 20 and 28 weeks gestation. Moreover, at these three time points women will fill out questionnaires assessing demographic and obstetric features, life style habits and psychological and social variables, such as depressive symptoms, personality, partner relationship quality and burnout. Data from the obstetric records will also be collected. Ethics and dissemination: The study has been approved by the Medical Ethical Committee of the Máxima Medical Center Veldhoven. Results will be submitted to peer reviewed journals in the relevant fields and presented on national and international conferences. Strengths and limitations of this study•Prospective design with three measurements of both biological and psychological variables during pregnancy which enables the use of Latent Class Analysis;•A multi-factorial approach;•A large sample size;•Use of self-report with validated questionnaires instead of interviews.

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.

scholarly journals Effect of perchlorate and thiocyanate exposure on thyroid function of pregnant women from South-West England: a cohort study

2018 ◽  
Vol 11 (1) ◽  
Author(s):  
Bridget A. Knight ◽  
Beverley M. Shields ◽  
Xuemei He ◽  
Elizabeth N. Pearce ◽  
Lewis E. Braverman ◽  
...  
Keyword(s):  
Cohort Study ◽  
Pregnant Women ◽  
Thyroid Function ◽  
South West ◽  
South West England

scholarly journals Role of low dose ecosprin and heparin in achieving live births in pregnancy with thrombophilia

2017 ◽  
Vol 6 (12) ◽  
pp. 5261
Author(s):  
Shilpa Asthana ◽  
Bandana Sodhi ◽  
Satish Kumar
Keyword(s):  
Low Dose ◽  
Previous History ◽  
Fetal Loss ◽  
Obstetric Outcomes ◽  
Obstetric Outcome ◽  
Live Births ◽  
History Of ◽  
Chi Square Analysis ◽  
In Pregnancy

Background: Thrombophilia is a disorder of haemostatic system that results in increased tendency of thrombus formation in both venous and arterial vascular system. The thrombotic events are not only restricted to venous thromboembolism but also can cause fetal loss (abortions or recurrent abortions and fetal demise), placental abruption, intrauterine growth restriction and severe pre-eclampsia. This study evaluates the role of administering thromboprophylaxis with heparin and ecosprin to patients with thrombophilia in pregnancy with previous history of adverse obstetric outcomes.Methods: This prospective study was conducted in 60 patients diagnosed with thrombophilia during pregnancy. The objective of the study was to determine the role of administering low dose ecosprin and heparin as thromboprophylaxis in achieving live births in these patients with thrombophilia. All patients included in this study were prophylactically administered low dose ecosprin with either unfractionated heparin (5000 IU s.c, BD) or low molecular weight heparin (40 mg s.c, OD) during pregnancy. Patients were followed up in the antenatal period and the obstetric outcome noted. Comparisons were made between the obstetric outcomes of these patients receiving the aforesaid thromboprophylaxis with those of previous untreated pregnancies during which no ecosprin or heparin had been administered. The data obtained were subjected to statistical analysis using Students ‘t’ test and Chi square analysis. P value <0.05 was considered statistically significant.Results: Fifty nine of the sixty patients with thrombophilia and previous adverse pregnancy outcome who received prophylaxis with ecosprin and heparin during the present pregnancy had live births (98.33%; p <0.0001). Fifty-eight (96.66%) of these patients progressed to term delivery and one (1.67%) pregnancy resulted in a pre-term birth.Conclusions: Present study reveals that prophylaxis with low dose ecosprin and heparin administered to patients with thrombophilia (acquired or inherited) with history of previous adverse obstetric outcome resulted in a positive outcome in terms of a significantly higher number of live births. However, larger studies are needed to further elaborate on the role of thromboprophylaxis in pregnancies with inherited thrombophilia.

scholarly journals Ambient and Indoor Air Pollution in Pregnancy and the risk of Low birth weight and Ensuing Effects in Infants (APPLE): A cohort study in Bangalore, South India

2019 ◽  
Vol 3 ◽  
pp. 133
Author(s):  
Prafulla Shriyan ◽  
Giridhara R Babu ◽  
Deepa Ravi ◽  
Yamuna Ana ◽  
Onno CP van Schayck ◽  
...  
Keyword(s):  
Air Pollution ◽  
Cohort Study ◽  
Particulate Matter ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Pregnant Women ◽  
Indoor Air ◽  
Indoor Air Pollution ◽  
In Pregnancy

Background: Exposure to air pollution (IAP) from the combustion of solid fuels is a significant cause of morbidity and mortality in developing countries. Pregnant women exposed to higher pollutant levels are at higher risk of delivering a low-birth-weight (LBW) baby. There is a lack of standardized data regarding the levels and types of specific pollutants and how they impact LBW. We aim to prospectively assess the association between ambient and indoor air pollution levels in pregnancy and low birth weight and understand the subsequent risk of adiposity in these infants. Methods: We will conduct a prospective cohort study of 516 pregnant women recruited before 18 weeks of gestation in the urban slums of Bangalore, who have voluntarily consented to participate. We will estimate the level of air pollutants including coarse particulate matter 10 ug/m3 (PM10 ), fine particulate matter 2.5 ug/m3(PM2.5) and carbon monoxide (CO) parts per million (ppm) levels in both indoor and ambient environment. The follow-up of the delivered children will be done at delivery until the infant is two years old. The association between pollutants and LBW will be evaluated using logistic regression adjusting for potential confounders.Further, we will explore the mediation role of LBW in the hypothesized causal chain of air pollution and adiposity. Nested within a larger Maternal Antecedents of Adiposity and Studying the Transgenerational role of Hyperglycemia and Insulin (MAASTHI) cohort, we can estimate the absolute risk of having low birth weight caused by air pollution and other variables. Discussion: Understanding the association between exposures to ambient and indoor air pollution and low birth weight is essential in India. LBW babies have a higher risk of developing obesity and Non-Communicable Diseases (NCDs) during adulthood. The results from this study can inform the efforts for controlling the air pollution-related chronic diseases in India.

scholarly journals Thyroid function and autoimmunity in Danish pregnant women after an iodine fortification program and associations with obstetric outcomes

2015 ◽  
Vol 173 (6) ◽  
pp. 709-718 ◽  
Author(s):  
Sofie Bliddal ◽  
Malene Boas ◽  
Linda Hilsted ◽  
Lennart Friis-Hansen ◽  
Ann Tabor ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Preterm Delivery ◽  
Thyroid Function ◽  
Gestational Age ◽  
Thyroid Dysfunction ◽  
Reference Intervals ◽  
Obstetric Outcome ◽  
Thyroid Status ◽  
Antibody Positivity ◽  
Maternal Thyroid

ObjectiveAberrations in maternal thyroid function and autoimmunity during pregnancy have been associated with negative obstetric outcome. In Denmark, a national iodine fortification program was implemented in the year 2000 with the aim to alleviate the mild-moderate iodine deficiency. Following the iodine implementation, there has been an increase in thyroid autoimmunity in the background population. This study investigates the thyroid status of pregnant Danish women following the iodine fortification program, and a possible association with preterm delivery.DesignHistorical cohort study of 1278 randomly selected pregnant Danish women attending the national Down's syndrome screening program.MethodsThe main outcome measures were thyroid status according to laboratory- and gestational-age-specific reference intervals, and association with risk of abnormal obstetric outcome. Antibody-positivity was defined as an antibody-level (thyroid peroxidase and/or thyroglobulin antibodies) above 60 U/ml.ResultsEstablishing laboratory-specific gestational-age-dependent reference intervals, we found a prevalence of maternal thyroid dysfunction of 10%–15.8% by use of the cut-off suggested by the American Thyroid Association. Thyroid dysfunction was significantly associated with antibody-positivity (P<0.05). No associations were found between preterm delivery and thyroid dysfunction (adjusted OR 0.6, 95% CI: 0.1–2.3) or autoimmunity (adjusted OR 1.1, 95% CI: 0.4–2.7).ConclusionsAfter the implementation of the Danish iodine fortification program, the prevalence of thyroid dysfunction and autoimmunity in Danish pregnant women is high – even higher by use of pre-established reference intervals from international consensus guidelines. However, no associations were found with abnormal obstetric outcome. Large randomized controlled trials are needed to clarify the benefit of treating slight aberrations in pregnant women's thyroid function.

scholarly journals Ambient and Indoor Air Pollution in Pregnancy and the risk of Low birth weight and Ensuing Effects in Infants (APPLE): A cohort study in Bangalore, South India

2018 ◽  
Vol 3 ◽  
pp. 133
Author(s):  
Prafulla Shriyan ◽  
Giridhara R Babu ◽  
Deepa Ravi ◽  
Yamuna Ana ◽  
Onno CP van Schayck ◽  
...  
Keyword(s):  
Air Pollution ◽  
Cohort Study ◽  
Particulate Matter ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Pregnant Women ◽  
Indoor Air ◽  
Indoor Air Pollution ◽  
In Pregnancy

Background: Exposure to air pollution (IAP) from the combustion of solid fuels is a significant cause of morbidity and mortality in developing countries. Pregnant women exposed to higher pollutant levels are at higher risk of delivering a low-birth-weight (LBW) baby. There is a lack of standardized data regarding the levels and types of specific pollutants and how they impact LBW. We aim to prospectively assess the association between ambient and indoor air pollution levels in pregnancy and low birth weight and understand the subsequent risk of adiposity in these infants. Methods: We will conduct a prospective cohort study of 516 pregnant women recruited before 18 weeks of gestation in the urban slums of Bangalore, who have voluntarily consented to participate. We will estimate the level of air pollutants including coarse particulate matter 10 ug/m3 (PM10 ), fine particulate matter 2.5 ug/m3(PM2.5) and carbon monoxide (CO) parts per million (ppm) levels in both indoor and ambient environment. The follow-up of the delivered children will be done at delivery until the infant is two years old. The association between pollutants and LBW will be evaluated using logistic regression adjusting for potential confounders.Further, we will explore the mediation role of LBW in the hypothesized causal chain of air pollution and adiposity. Nested within a larger Maternal Antecedents of Adiposity and Studying the Transgenerational role of Hyperglycemia and Insulin (MAASTHI) cohort, we can estimate the absolute risk of having low birth weight caused by air pollution and other variables. Discussion: Understanding the association between exposures to ambient and indoor air pollution and low birth weight is essential in India. LBW babies have a higher risk of developing obesity and Non-Communicable Diseases (NCDs) during adulthood. The results from this study can inform the efforts for controlling the air pollution-related chronic diseases in India.

scholarly journals Variation between Initial and Final Diagnosis as A Predictor of Adverse Obstetric Outcome among Post-Natal Women at Bungoma Hospitals, Kenya

2022 ◽  
Vol 4 (1) ◽  
pp. 5-10
Author(s):  
David Nandebe Wafula ◽  
Bernard Wesonga ◽  
Maximilla Wanzala ◽  
Nathan Shaviya ◽  
Rose A. M. Nyang’au
Keyword(s):  
Pregnant Women ◽  
Odds Ratio ◽  
Diagnostic Errors ◽  
Final Diagnosis ◽  
Initial Diagnosis ◽  
Sub Saharan Africa ◽  
Systematic Sampling ◽  
Obstetric Outcomes ◽  
P Value ◽  
Obstetric Outcome

Despite diagnosis being an important part of clinical or medical consultations, the diagnosis might fail leading to adverse effects. This is a global problem, where developed and developing countries go through. In sub-Saharan Africa, variations between initial diagnosis and final diagnosis lead to diagnostic errors with high maternal mortalities. In Kenya, a lot of measures have been put in place but still, variation in diagnosis appear to have become rampant. Bungoma county is one of the counties with a high mortality ratio, especially for pregnant women attributed to the variation between initial and final diagnosis. Therefore, it was crucial to investigate the variation between initial and final diagnosis in relation to obstetric outcomes at hospitals in Bungoma County. The cross-sectional research design was used (Bungoma and Webuye hospitals). Systematic sampling was used to obtain 384 respondents after proportionate allocation to each hospital, and purposive sampling to select 8 health care workers as key informants. Data was collected using a structured questionnaire and an interview guide. The pre-test was done with validity established through crosschecking and reliability calculated using the Cronbach method (0.89). Using a statistical package for social sciences version 25, descriptive and inferential statistics was run where chi-square and odds ratio was used to determine the influence between variables, significance and prediction. The study revealed a variation between initial diagnosis and the final diagnosis was 20.8% while diagnostic errors were significant predictors of obstetric outcomes among post-natal mothers at level five with a p-value of 0.045 at a significance of 5%(P=0.045). Demographic characteristics showed no relationship with obstetric outcomes (P=0.54>0.05). Matched diagnostic had no variations (N=327, M=1.00, SD=0.000); while unmatched diagnostic had variations (N=327, M=1.82, SD=.384). There was a relationship between diagnostic errors and obstetric outcome (ꭓ2 (1) = 251.86, p< .001). An association between diagnostic error with unsafe obstetric outcomes was significant at the odds ratio of 2.03(OR 2.03, 95% CI 1.31–2.16). The study demonstrates that a correct diagnosis is a viable strategy in preventing unsafe obstetric outcomes and by extension minimizing morbidity and mortality among pregnant women. The study concluded that there was a variation between initial diagnosis and final diagnosis which had an adverse obstetric outcome. it was recommended to build capacities for the health workers in order to address increased diagnostic errors.

scholarly journals Ambient and Indoor Air Pollution in Pregnancy and the risk of Low birth weight and Ensuing Effects in Infants (APPLE): A cohort study in Bangalore, South India

2020 ◽  
Vol 3 ◽  
pp. 133
Author(s):  
Prafulla Shriyan ◽  
Giridhara R Babu ◽  
Deepa Ravi ◽  
Yamuna Ana ◽  
Onno CP van Schayck ◽  
...  
Keyword(s):  
Air Pollution ◽  
Cohort Study ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Pregnant Women ◽  
Indoor Air ◽  
Indoor Air Pollution ◽  
Absolute Risk ◽  
In Pregnancy

Background: Exposure to air pollution (IAP) from the combustion of solid fuels is a significant cause of morbidity and mortality in developing countries. Pregnant women exposed to higher pollutant levels are at higher risk of delivering a low-birth-weight (LBW) baby. There is a lack of standardized data regarding the levels and types of specific pollutants and how they impact LBW. We aim to prospectively assess the association between ambient and indoor air pollution levels in pregnancy and low birth weight and understand the subsequent risk of adiposity in these infants. Methods: We will conduct a prospective cohort study of 516 pregnant women recruited before 18 weeks of gestation in the urban slums of Bangalore, who have voluntarily consented to participate. We will estimate the level of air pollutants including particulate matter (<10 μm, <2.5 μm) and carbon monoxide (CO) parts per million (ppm) levels in both indoor and ambient environment. The follow-up of the delivered children will be done at delivery until the infant is one year old. The association between pollutants and LBW will be evaluated using logistic regression adjusting for potential confounders.Further, we will explore the mediation role of LBW in the hypothesized causal chain of air pollution and adiposity. Nested within a large cohort titled "Maternal Antecedents of Adiposity and Studying the Transgenerational role of Hyperglycemia and Insulin (MAASTHI)", we can estimate the absolute risk of having low birth weight caused by air pollution and other variables. Discussion: Understanding the association between exposures to ambient and indoor air pollution and low birth weight is essential in India. LBW babies have a higher risk of developing obesity and Non-Communicable Diseases (NCDs) during adulthood. The results from this study can inform the efforts for controlling the air pollution-related chronic diseases in India.

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