Glycaemic profile in the second and third trimesters of normal pregnancy compared to non-pregnant adult females

Aim To assess the glycaemic profile and glycaemic variation in the second and third trimesters of normal pregnancies. Methodology Healthy pregnant women aged 19–35 years between 24 and 36 weeks of gestation were recruited for ambulatory glucose profile monitoring. A total of 18 women in the second trimester, 15 women in the third trimester and 9 healthy non-pregnant women were recruited providing, respectively, 205 days (19,680 data points), 147 days (14,112 data points) and 100 days (9,600 data points) for analysis. Results Mean blood glucose level was 20.2% lower in the second trimester and 10.6% lower in the third trimester than non-pregnant women (p < 0.001). In pregnancy, it took 15 to 20 minutes more to reach peak postprandial blood glucose levels compared to non-pregnant women (p = 0.003). Glycaemic variability was more in the third trimester (p < 0.001). Conclusion There is tight blood sugar control along with lower mean blood glucose in healthy pregnant women compared to non-pregnant women. Despite this tight glycaemic control, glycaemic variability is higher during pregnancy.

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Trends in Heart Rate and Heart Rate Variability during Pregnancy and Three Months Postpartum: Continuous Monitoring in a Free-Living Context (Preprint)

10.2196/preprints.33458 ◽

2021 ◽

Author(s):

Fatemeh Sarhaddi ◽

Iman Azimi ◽

Anna Axelin ◽

Hannakaisa Niela-Vilen ◽

Pasi Liljeberg ◽

...

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

Pregnant Women ◽

Time Domain ◽

Second Trimester ◽

Third Trimester ◽

Non Invasive ◽

The Third ◽

Invasive Method ◽

Frequency Power

BACKGROUND Heart rate variability (HRV) is a non-invasive method reflecting autonomic nervous system (ANS) regulations. Altered HRV is associated with adverse mental or physical health complications. ANS also has a central role in physiological adaption during pregnancy causing normal changes in HRV. OBJECTIVE Assessing trends in heart rate (HR) and HRV parameters as a non-invasive method for remote maternal health monitoring during pregnancy and three months postpartum. METHODS Fifty-eight pregnant women were monitored using an Internet-of-Things (IoT)-based remote monitoring system during pregnancy and 3-months postpartum. Pregnant women were asked to continuously wear Gear sport smartwatch to monitor their HR and HRV. In addition, a cross-platform mobile application was utilized for collecting pregnancy-related information. The trends of HR and HRV parameters were extracted using reliable data. We also analyzed the trends of normalized HRV parameters based on HR to remove the effect of HR changes on HRV trends. Finally, we exploited hierarchical linear mixed models to analyze the trends of HR, HRV, and normalized HRV parameters. RESULTS HR increased significantly during the second trimester (P<.001) and decreased significantly during the third trimester (P<.01). Time-domain HRV parameters, average normal interbeat intervals (AVNN), standard deviation of normal interbeat intervals (SDNN), root mean square of the successive difference of normal interbeat intervals (RMSSD), normalized SDNN (nSDNN), and normalized RMSSD (nRMSSD) decreased significantly during the second trimester (P<.001) then increased significantly during the third trimester (P<.01). Some of the frequency domain parameters, low-frequency power (LF), high-frequency power (HF), and normalized HF (nHF) decreased significantly during the second trimester (P<.01), and HF increased significantly during the third trimester (P<.01). In the postpartum period, nRMSSD decreased (P<.05), and the LF to HF ratio (LF/HF) increased significantly (P<.01). CONCLUSIONS Our study showed that HR increased and HRV parameters decreased as the pregnancy proceeded, and the values returned to normal after the delivery. Moreover, our results show that HR started to decrease while time-domain HRV parameters and HF started to increase during the third trimester. Our results also demonstrate the possibility of continuous HRV monitoring in everyday life settings.

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Discovery of metabolic biomarkers for gestational diabetes mellitus in a Chinese population

10.21203/rs.3.rs-109665/v2 ◽

2021 ◽

Author(s):

Wenqian Lu ◽

Mingjuan Luo ◽

Xiangnan Fang ◽

Rong Zhang ◽

Mengyang Tang ◽

...

Keyword(s):

Diabetes Mellitus ◽

Logistic Regression ◽

Gestational Diabetes ◽

Pregnant Women ◽

Regression Models ◽

Second Trimester ◽

Third Trimester ◽

Logistic Regression Models ◽

The Third ◽

Clinical Indices

Abstract Background: Gestational diabetes mellitus (GDM), one of the most common pregnancy complications, can lead to morbidity and mortality in both the mother and the infant. Metabolomics has provided new insights into the pathology of GDM and systemic analysis of GDM with metabolites is required for providing more clues for GDM diagnosis and mechanism research. This study aims to reveal metabolic differences between normal pregnant women and GDM patients in the second- and third-trimester stages and to confirm the clinical relevance of these new findings.Methods: Metabolites were quantitated with the serum samples of 200 healthy pregnant women and 200 GDM women in the second trimester, 199 normal controls, and 199 GDM patients in the third trimester. Both function and pathway analyses were applied to explore biological roles involved in the two sets of metabolites. Then the trimester stage-specific GDM metabolite biomarkers were identified by combining machine learning approaches, and the logistic regression models were constructed to evaluate predictive efficiency. Finally, the weighted gene co-expression network analysis method was used to further capture the associations between metabolite modules with biomarkers and clinical indices. Results: This study revealed that 57 differentially expressed metabolites (DEMs) were discovered in the second-trimester group, among which the most significant one was 3-methyl-2-oxovaleric acid. Similarly, 72 DEMs were found in the third-trimester group, and the most significant metabolites were ketoleucine and alpha-ketoisovaleric acid. These DEMs were mainly involved in the metabolism pathway of amino acids, fatty acids and bile acids. The logistic regression models for selected metabolite biomarkers achieved the area under the curve values of 0.807 and 0.81 for the second- and third-trimester groups. Furthermore, significant associations were found between DEMs/biomarkers and GDM-related indices. Conclusions: Metabolic differences between healthy pregnant women and GDM patients were found. Associations between biomarkers and clinical indices were also investigated, which may provide insights into pathology of GDM.

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Thrombin Generation in Chinese Pregnant Women and the Effect of Insulin Use on Thrombin Generation in Patients with GDM

Clinical and Applied Thrombosis/Hemostasis ◽

10.1177/1076029619863492 ◽

2019 ◽

Vol 25 ◽

pp. 107602961986349

Author(s):

Feng Dong ◽

Longhao Wang ◽

Chengbin Wang

Keyword(s):

Blood Glucose ◽

Pregnant Women ◽

Thrombin Generation ◽

First Trimester ◽

Normal Pregnancy ◽

Third Trimester ◽

Control Blood Glucose ◽

Normal Ranges ◽

Increased Risk ◽

Significant Difference

Pregnancy is a hypercoagulable state associated with an increased risk of venous thrombosis. Calibrated automated thrombogram (CAT) is a test to monitor the thrombin generation (TG), a laboratory marker of thrombosis risk, and increases during normal pregnancy, but it is still unclear whether TG is related to the use of insulin in pregnant women with gestational diabetes mellitus (GDM). We performed thrombin generation by CAT on 135 normal pregnant women, including 43 in first trimester, 32 in second trimester, 60 in third trimester, respectively; 68 pregnant women with GDM were also enrolled, 19 patients with GDM using insulin to control blood glucose and 49 patients control their blood glucose through diet and exercise with noninsulin treatment. The overall CAT parameters were calculated using descriptive statistics method with mean ± standard deviation. Mean endogenous thrombin potential, peak thrombin generation, and StartTail time increased significantly with the pregnancy. There was no significant difference in TG test parameters except StartTail time( P = .003) in insulin-treated GDM group when compared to those without insulin in the GDM group. The normal ranges for CAT parameters in pregnant women were determined. Thrombin generation increased significantly in first trimester and remains stable in second and third trimester. The use of insulin in patient with GDM did not affect thrombin generation test. Our study helps to establish the reference range of thrombin generation in Chinese normal pregnant population and provide more basis to predict the risk of thrombus complicating during pregnancy.

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Alterations of serum resistin in normal pregnancy and pre-eclampsia

Clinical Science ◽

10.1042/cs20040225 ◽

2004 ◽

Vol 108 (1) ◽

pp. 81-84 ◽

Cited By ~ 59

Author(s):

Danqing CHEN ◽

Minyue DONG ◽

Qin FANG ◽

Jing HE ◽

Zhengping WANG ◽

...

Keyword(s):

Pregnant Women ◽

Normal Pregnancy ◽

Third Trimester ◽

Resistin Level ◽

Blood Samples ◽

The Third ◽

Maternal Adaptation ◽

Serum Resistin Level ◽

One Way Anova ◽

Insight Into

Resistin is expressed in human placenta and has been postulated to play a role in regulating energy metabolism in pregnancy. However, changes in serum resistin levels in normal pregnancy and in the setting of pre-eclampsia are far from understood. The purpose of the present study was to clarify the alterations in serum resistin level in normal pregnancy and pre-eclampsia. Blood samples were taken from 28 healthy non-pregnant women, 27 women in the first, 26 in the second and 26 in the third trimesters of normal pregnancy and 25 women with pre-eclampsia. Serum resistin concentrations were determined by using an ELISA, and mean serum resistin levels were compared with one-way ANOVA. Serum resistin levels were not significantly different among non-pregnant women and women in the first and second trimesters of pregnancy (P>0.05 for all). Serum resistin was significantly elevated in the third trimester of normal pregnancy compared with non-pregnant women (P<0.01) and women in the first (P<0.001) and second (P<0.001) trimesters of pregnancy. Serum resistin level was significantly lower in women with pre-eclampsia than women in the third trimester of normal pregnancy (P<0.001), but was comparable with those of non-pregnant women and women in the first and second trimesters of pregnancy (P>0.05 for all). In conclusion, we found an increase in serum resistin in the third trimester of normal pregnancy, but this increase was not present in pre-eclampsia. We postulate that these associations may offer insight into the mechanisms of maternal adaptation to pregnancy and the pathogenesis of pre-eclampsia.

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Stroke Volume Recruitability during the Third Trimester of Pregnancy

American Journal of Perinatology ◽

10.1055/s-0037-1615788 ◽

2017 ◽

Vol 35 (08) ◽

pp. 737-740 ◽

Cited By ~ 1

Author(s):

Sandra Herrera ◽

Maggie Kuhlmann-Capek ◽

Sarah Rogan ◽

Antonio Saad ◽

George Saade ◽

...

Keyword(s):

Stroke Volume ◽

Pregnant Women ◽

Vena Cava ◽

Normal Pregnancy ◽

Gravid Uterus ◽

Third Trimester ◽

Fluid Bolus ◽

The Third ◽

Hemodynamic Variables ◽

Flat Portion

Objective It is unknown whether the heart operates in the ascending or flat portion of the Starling curve during normal pregnancy. Pregnant women do not respond to the passive leg-raising maneuver secondary to mechanical obstruction of the inferior vena cava by the gravid uterus. Our objective was to evaluate if administration of a fluid bolus increases baseline stroke volume (SV) among healthy pregnant patients during the third trimester. Study Design Healthy pregnant women who underwent elective term cesarean sections were included. A noninvasive cardiac output monitor was used to measure hemodynamic variables at baseline and after administration of a 500-mL crystalloid bolus. Results Forty-five women were included in the study. Fluid administration was associated with a statistically significant increase in SV from a baseline value of 71 ± 11 to 90 ± 19 mL (95% confidence interval [CI]: 13.67–21.49; p < 0.01) and a significant decrease in maternal heart rate from a baseline of 87 ± 9 beats per minute to 83 ± 8 after the fluid bolus (95% CI: −6.81 to −2.78; p = 0.03). No changes in peripheral vascular resistances or any other measured hemodynamic parameters were noted with volume expansion. Conclusion In healthy term pregnancy, the heart operates in the ascending portion of the Starling's curve, rendering it fluid responsive.

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Gestation specific reference intervals for thyroid function tests in pregnancy

Clinical Chemistry and Laboratory Medicine (CCLM) ◽

10.1515/cclm-2015-0569 ◽

2016 ◽

Vol 54 (8) ◽

Cited By ~ 6

Author(s):

Süleyman Akarsu ◽

Filiz Akbiyik ◽

Eda Karaismailoglu ◽

Zeliha Gunnur Dikmen

Keyword(s):

Pregnant Women ◽

Thyroid Function ◽

First Trimester ◽

Reference Intervals ◽

Specific Reference ◽

Thyroid Function Tests ◽

Second Trimester ◽

Third Trimester ◽

The Third ◽

Function Tests

AbstractThyroid function tests are frequently assessed during pregnancy to evaluate thyroid dysfunction or to monitor pre-existing thyroid disease. However, using non-pregnant reference intervals can lead to misclassification. International guidelines recommended that institutions should calculate their own pregnancy-specific reference intervals for free thyroxine (FT4), free triiodothyronine (FT3) and thyroid-stimulating hormone (TSH). The objective of this study is to establish gestation-specific reference intervals (GRIs) for thyroid function tests in pregnant Turkish women and to compare these with the age-matched non-pregnant women.Serum samples were collected from 220 non-pregnant women (age: 18–48), and 2460 pregnant women (age: 18–45) with 945 (39%) in the first trimester, 1120 (45%) in the second trimester, and 395 (16%) in the third trimester. TSH, FT4 and FT3 were measured using the Abbott Architect i2000SR analyzer.GRIs of TSH, FT4 and FT3 for first trimester pregnancies were 0.49–2.33 mIU/L, 10.30–18.11 pmol/L and 3.80–5.81 pmol/L, respectively. GRIs for second trimester pregnancies were 0.51–3.44 mIU/L, 10.30–18.15 pmol/L and 3.69–5.90 pmol/L. GRIs for third trimester pregnancies were 0.58–4.31 mIU/L, 10.30–17.89 pmol/L and 3.67–5.81 pmol/L. GRIs for TSH, FT4 and FT3 were different from non-pregnant normal reference intervals.TSH levels showed an increasing trend from the first trimester to the third trimester, whereas both FT4 and FT3 levels were uniform throughout gestation. GRIs may help in the diagnosis and appropriate management of thyroid dysfunction during pregnancy which will prevent both maternal and fetal complications.

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Discovery of metabolic biomarkers for gestational diabetes mellitus in a Chinese population

Nutrition & Metabolism ◽

10.1186/s12986-021-00606-8 ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Wenqian Lu ◽

Mingjuan Luo ◽

Xiangnan Fang ◽

Rong Zhang ◽

Shanshan Li ◽

...

Keyword(s):

Diabetes Mellitus ◽

Logistic Regression ◽

Gestational Diabetes ◽

Pregnant Women ◽

Regression Models ◽

Second Trimester ◽

Third Trimester ◽

Logistic Regression Models ◽

The Third ◽

Clinical Indices

Abstract Background Gestational diabetes mellitus (GDM), one of the most common pregnancy complications, can lead to morbidity and mortality in both the mother and the infant. Metabolomics has provided new insights into the pathology of GDM and systemic analysis of GDM with metabolites is required for providing more clues for GDM diagnosis and mechanism research. This study aims to reveal metabolic differences between normal pregnant women and GDM patients in the second- and third-trimester stages and to confirm the clinical relevance of these new findings. Methods Metabolites were quantitated with the serum samples of 200 healthy pregnant women and 200 GDM women in the second trimester, 199 normal controls, and 199 GDM patients in the third trimester. Both function and pathway analyses were applied to explore biological roles involved in the two sets of metabolites. Then the trimester stage-specific GDM metabolite biomarkers were identified by combining machine learning approaches, and the logistic regression models were constructed to evaluate predictive efficiency. Finally, the weighted gene co-expression network analysis method was used to further capture the associations between metabolite modules with biomarkers and clinical indices. Results This study revealed that 57 differentially expressed metabolites (DEMs) were discovered in the second-trimester group, among which the most significant one was 3-methyl-2-oxovaleric acid. Similarly, 72 DEMs were found in the third-trimester group, and the most significant metabolites were ketoleucine and alpha-ketoisovaleric acid. These DEMs were mainly involved in the metabolism pathway of amino acids, fatty acids and bile acids. The logistic regression models for selected metabolite biomarkers achieved the area under the curve values of 0.807 and 0.81 for the second- and third-trimester groups. Furthermore, significant associations were found between DEMs/biomarkers and GDM-related indices. Conclusions Metabolic differences between healthy pregnant women and GDM patients were found. Associations between biomarkers and clinical indices were also investigated, which may provide insights into pathology of GDM.

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Plasma endothelin-1 and big endothelin-1 levels in women with pre-eclampsia

Acta Endocrinologica ◽

10.1530/acta.0.1290114 ◽

1993 ◽

Vol 129 (2) ◽

pp. 114-120 ◽

Cited By ~ 31

Author(s):

Norihito Sudo ◽

Kyuzi Kamoi ◽

Miyuki Ishibashi ◽

Tohru Yamaji

Keyword(s):

Pregnant Women ◽

Vascular Endothelial Cells ◽

Plasma Concentrations ◽

Regulatory System ◽

Normal Pregnancy ◽

Molar Ratio ◽

Chronic Hypertension ◽

Third Trimester ◽

Endothelin 1 ◽

The Third

To examine a possible role for endothelin-1 (ET-1) and conversion of big ET-1 to ET-1 in the pathophysiology of pre-eclampsia, we measured plasma levels of ET-1 and big ET-1 in 16 women with pre-eclampsia in the third trimester and compared them with those in 11 age-matched normotensive pregnant women and in 10 age-matched pregnant women with chronic hypertension in the third trimester. The plasma concentrations of ET-1 and big ET-1 in the normotensive pregnant women were significantly lower than those in 16 non-pregnant women with a higher molar ratio of big ET-1 to ET-1 in the former group. The plasma concentrations of ET-1 and big ET-1 in the women with pre-eclampsia, on the other hand, were significantly higher than those in the normotensive pregnant women and the molar ratio of big ET-1 to ET-1 in the former group was less than that in the latter group. In sharp contrast, plasma ET-1 and big ET-1 levels in the pregnant women with chronic hypertension were not significantly different from those in the normotensive pregnant women. When examined after delivery, elevated plasma ET-1 and big ET-1 in the women with pre-eclampsia declined, with restoration of normal blood pressure, to the levels in the normotensive women after parturition. There were no significant differences of the levels of ET-1 and big ET-1 in umbilical venous plasma and simultaneously drawn maternal plasma at cesarean section between normotensive pregnant women and women with pre-eclampsia, respectively. These results suggest that normal pregnancy is associated with decreased plasma concentrations of ET-1 with reduced conversion of big ET-1 to ET-1 in maternal vascular endothelial cells, and the derangement of this regulatory system plays an important role in the pathophysiology of pre-eclampsia.

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Midwifery Care with Frequent Urination on Pregnant Women at BPM Nuril Masrukah Candi Sidoarjo

Academia Open ◽

10.21070/acopen.5.2021.1908 ◽

2021 ◽

Vol 5 ◽

Author(s):

Okky Elvira Novianti ◽

Evi Rinata ◽

Rafhani Rosyidah

Keyword(s):

Data Collection ◽

Pregnant Women ◽

Continuity Of Care ◽

Normal Pregnancy ◽

Case Study Method ◽

Third Trimester ◽

Midwifery Care ◽

Psychological Condition ◽

The Third

Pregnancy is the fertilization or fusion of spermatozoa and ovum which is followed by bullying. Normal pregnancy lasts in 9 to 10 months. Complaints and discomfort can arise from the beginning of pregnancy to the end of pregnancy which can affect the physical and psychological condition of the mother. Pregnant women often complain in the third trimester and 96.7% experience complaints of frequent urination. The case study method used is observational (COC) Continuity of Care. From data collection and inspection there were no gaps and problem found, so no further special handling was needed.

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Is normal pregnancy atherogenic?

Clinical Science ◽

10.1042/cs0960421 ◽

1999 ◽

Vol 96 (4) ◽

pp. 421-425 ◽

Cited By ~ 47

Author(s):

U. MARTIN ◽

C. DAVIES ◽

S. HAYAVI ◽

A. HARTLAND ◽

F. DUNNE

Keyword(s):

Serum Cholesterol ◽

First Trimester ◽

Normal Pregnancy ◽

Cholesterol Concentration ◽

Second Trimester ◽

Third Trimester ◽

The Third ◽

Serum Cholesterol Concentration ◽

Ldl Subfractions ◽

Normal Gestation

Serum cholesterol, triacylglycerols and low-density lipoprotein (LDL) subfractions were determined in 120 primagravid women during normal gestation (40 in each trimester) and in 20 non-pregnant age-matched controls. LDL subfractions were determined by PAGE, and an LDL score was calculated. The higher the score, the smaller the subfractions. The objective of the study was to determine the effects of the hyperlipidaemia, high oestrogen concentrations and insulin resistance known to exist in normal pregnancy on LDL subfraction formation. Pregnant women had an increased mean serum cholesterol concentration [5.78 (S.D. 1.09) mmol/l] in the first trimester compared with the non-pregnant controls [5.11 (0.77) mmol/l; P< 0.01]. The serum cholesterol concentration increased progressively throughout gestation to a mean of 8.14 (1.39) mmol/l in the third trimester (P< 0.001 compared with the second trimester). Triacylglycerol concentrations in the first trimester were similar to those of controls, and there was a non-significant increase by the second trimester to 1.32 (0.44) mmol/l. However, by the third trimester the mean triacylglycerol concentration had doubled [2.58 (0.98) mmol/l; P< 0.001 compared with the first and second trimester]. During gestation the LDL score increased dramatically, from 1.17 (0.39) during the first trimester to 2.01 (0.37) in the second trimester (P< 0.001) to 2.73 (0.48) in the third trimester (P< 0.001 compared with the second trimester). Thus an atherogenic lipid profile develops during normal gestation. The significance of these changes remains unclear, but thay may have important implications for mother and foetus.

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