scholarly journals Increased risk of preeclampsia after use of paracetamol during pregnancy – causal or coincidence?

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hetti von Hellens ◽  
Leea Keski-Nisula ◽  
Heidi Sahlman

Abstract Background The maternal use of paracetamol during pregnancy has been associated with the development of preeclampsia. This study aims to clarify whether the connection is causal or whether it is due to reverse causation. Methods This study is a continuation of the retrospective case cohort study examining 2,508 pregnant women using a variety of drugs and the development of preeclampsia (1,252 women with preeclampsia and 1,256 controls). For the purposes of this study, more precise data was collected from several hospital databases of the women among this cohort who had reported taking paracetamol during pregnancy (indications, gestational period etc.); this was evaluated in association with the development of preeclampsia. Results 5.5% (100 cases and 37 controls) of all the study population (2,508) had clearly reported paracetamol use. Women with preeclampsia had used significantly more often paracetamol during pregnancy compared to controls (cases 8.0%, controls 2.9%, p < 0.001). The difference was most evident in the third trimester (after the 29th GW) and the use of paracetamol was associated with both mild and severe preeclampsia. Headache and “general pain” were the most common indications for medication among all paracetamol users. Conclusions The use of paracetamol in the third trimester of pregnancy was associated with preeclampsia. This observation indicates that association between paracetamol use and preeclampsia is probably due to reverse causation, i.e. women with preeclampsia experience more headaches due to preeclampsia symptoms since this association was not detected with the use of paracetamol in earlier stages of pregnancy.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chenchen Liu ◽  
Puying Wei ◽  
Jun Li

Abstract Objectives To observe and compare the difference in retinal thickness using optical coherence tomography (OCT) between patients with high myopia (HM) during the third trimester of pregnancy and age-matched HM non-pregnant women. Methods A case-control study. A total of 39 eyes from 39 HM women in the third trimester (study group) and 50 eyes of 50 age-matched non-pregnant women with HM (control group) were included. All subjects underwent SD-OCT examination. The built-in software was used to measure the retinal thickness in macular region. The data from two groups were compared using independent-samples t test. Results Among the 89 subjects in this study, the mean gestational age of the study group was 35.09 ± 2.44 weeks, and the average age was 32.24 ± 3.75 years. The average age of the control group was 34.04 ± 7.19 years old. Compared with the control group, the average thickness of parafoveal area, and the average thickness of parafoveal superior, inferior, temporal quadrants of the superficial retina and the average thickness of the foveal and parafoveal of the superficial retina were significantly decreased in the study group (P < 0.05). Compared with the control group, the average thickness of all quadrants of the retina in the parafoveal area except the nasal quadrant were significantly decreased in the study group (P < 0.05). Conclusions In this observational study, the retinal thickness of patients with high myopia during the third trimester of pregnancy was thinner than that of non-pregnant women with age-matched high myopia.


Author(s):  
Teun van Erp ◽  
Taco van der Hoorn ◽  
Marco J.M. Hoozemans ◽  
Carl Foster ◽  
Jos J. de Koning

Purpose: To determine if workload and seasonal periods (preseason vs in season) are associated with the incidence of injuries and illnesses in female professional cyclists. Methods: Session rating of perceived exertion was used to quantify internal workload and was collected from 15 professional female cyclists, from 33 athlete seasons. One week (acute) workload, 4 weeks (chronic) workload, and 3 acute:chronic workload models were analyzed. Two workload models are based on moving averages of the ratios, the acute:chronic workload ratio (ACWR), and the ACWR uncoupled (ACWRuncoup). The difference between both is the chronic load; in ACWR, the acute load is part of the chronic load, and in ACWRuncoup, the acute and chronic load are uncoupled. The third workload model is based on exponentially weighted moving averages of the ratios. In addition, the athlete season is divided into the preseason and in season. Results: Generalized estimating equations analysis was used to assess the associations between the workload ratios and the occurrence of injuries and illnesses. High values of acute workload (P = .048), ACWR (P = .02), ACWRuncoup (P = .02), exponentially weighted moving averages of the ratios (P = .01), and the in season (P = .0001) are significantly associated with the occurrence of injury. No significant associations were found between the workload models, the seasonal periods, and the occurrence of illnesses. Conclusions: These findings suggest the importance of monitoring workload and workload ratios in female professional cyclists to lower the risk of injuries and therefore improve their performances. Furthermore, these results indicate that, in the preseason, additional stressors occur, which could lead to an increased risk of injuries.


2019 ◽  
pp. 1-9 ◽  
Author(s):  
Carolina Martins Corcino ◽  
Tatiana Martins Benvenuto Louro Berbara ◽  
Débora Ayres Saraiva ◽  
Nathalie Anne de Oliveira e Silva de Morais ◽  
Annie Schtscherbyna ◽  
...  

AbstractObjectiveTo assess iodine status and its effects on maternal thyroid function throughout pregnancy.DesignIn the present prospective cohort study, three urinary samples were requested for urinary iodine concentration (UIC) determinations in both the first and third gestational trimesters. Serum thyrotropin (TSH) and free thyroxine (FT4) were analysed in both trimesters and thyroid antibodies were assessed once.SettingRio de Janeiro, Brazil.ParticipantsFirst-trimester pregnant women (n243), of whom 100 were re-evaluated during the third trimester.ResultsIodine sufficiency was found in the studied population (median UIC=216·7 µg/l). The first- and third-trimester median UIC was 221·0 and 208·0 µg/l, respectively. TSH levels (mean (sd)) were higher in the third trimester (1·08 (0·67)v. 1·67 (0·86) mIU/l;P<0·001), while FT4levels decreased significantly (1·18 (0·16)v. 0·88 (0·12) ng/dl;P<0·001), regardless the presence of iodine deficiency (UIC<150 µg/l) or circulating thyroid antibodies. UIC correlated (β; 95% CI) independently and negatively with age (–0·43; –0·71, –0·17) and positively with multiparity (0·15; 0·02, 0·28) and BMI (0·25; 0·00, 0·50). Furthermore, median UIC per pregnant woman tended to correlate positively with TSH (0·07; –0·01, 0·14). Women with median UIC≥250 µg/l and at least one sample ≥500 µg/l throughout pregnancy had a higher risk of subclinical hypothyroidism (OR=6·6; 95% CI 1·2, 37·4).ConclusionsIn this cohort with adequate iodine status during pregnancy, excessive UIC was associated with an increased risk of subclinical hypothyroidism.


2018 ◽  
Vol 6 (2) ◽  
pp. 16
Author(s):  
Mezzi Wulandari Arenza ◽  
Ni Wayan Tianing ◽  
I Putu Adiartha Griadhi

ABSTRACTSleep disturbance in the third trimester pregnant women is caused by discomfort, an increasingly largeabdominal condition, back pain, frequent urination, fetal movement, heartburn, cramps in the legs, tiredness, difficultygetting started, and physiological changes. Sleep disorders result in decreased quality of sleep. Pregnant women whohave poor sleep quality are at risk of longer labor, cesarean delivery, premature birth, and even infant mortality. The aimof this research is to know the difference of pregnant exercise combination and back massage in improving the sleepquality of third trimester pregnant women. This research use experiment method with quasi experiment approach andresearch design is pre and post test with control design. Sample are 18 people, divided into 2 groups, 9 people intreatment groups given pregnancy exercise and back massage and 9 people in control group is given only pregnantexercise. Intervention is given 8 times. Pittsburgh Sleep Quality Index (PSQI) questionnaire used for measured of sleepquality. The result of different test of unpaired group, in the treatment group got difference of average 4,556 and controlgroup got difference mean 2,333 with p=0,004 (p<0,05). These results showed that there was a significant differencebetween the treatment group and the control group in improving the sleep quality of the third trimester pregnant women.In conclusion, there are differences in the addition of back massage combination in pregnancy exercise intervention inimproving sleep quality of third trimester pregnant women.Keyword : Pregnancy Exercise, Back Massage, Sleep Quality, Third Trimester.


2018 ◽  
Vol 5 (2) ◽  
pp. 82
Author(s):  
Sri Wahyuni ◽  
Anies Anies ◽  
Ariawan Soejoenoes ◽  
Suhartono Taat Putra

Background: Unstable emotions that are common during the perinatal period affect hormonal regulation and affect immunity. Research of psychoeducation dhikr be important was done to reduce perceived stress so that cortisol levels can be controlled hence IgG increases.Purposes: to prove additional psychoeducation of dhikr in routine midwifery care more influential on decreasing cortisol and increasing IgG among primiparous women.Methods: This study was an experimental study. A number of 24 participants as intervention group and a number of 23 participants as control group. Cortisol and IgG levels measured using ELIZA kits in the third trimester of pregnancy, the three days and tenth days after birth. Statistical test using General Linear Model and independent t test to compare Δ score.Results: The result showed mean difference between groups on the end of interventions, cortisol 18.95, CI 95% (-13.42 – 51.33) and p value is 0.245. The difference of the IgG between groups 482.72, CI 95% (55,51 - 909,93) and p value is 0.028.Conclusions: Additional psychoeducation of dhikr in routine midwifery care has more decrease Cortisol and increase IgG levels in primiparous women. Keywords: Cortisol, Psychoeducation Dzikr, IgG, Primiparous


2018 ◽  
Vol 33 (3) ◽  
pp. 247-264 ◽  
Author(s):  
Alexandra Grippo ◽  
Jun Zhang ◽  
Li Chu ◽  
Yanjun Guo ◽  
Lihua Qiao ◽  
...  

Abstract The developing fetus is particularly susceptible to environmental pollutants, and evidence has shown adverse effects of air pollutants on pregnancy and birth outcomes. Pregnancy loss, including spontaneous abortion (miscarriage) and stillbirth, is the most severe adverse pregnancy outcome. This review focuses on air pollution exposure during pregnancy in relation to spontaneous abortion and stillbirth. A total of 43 studies are included in this review, including 35 human studies and eight animal studies. Overall, these studies suggest that exposure to air pollutants such as particulate matter (PM), carbon monoxide (CO) and cooking smoke may be associated with higher risk for stillbirth and spontaneous abortion. PM10 exposure during an entire pregnancy was associated with increased risk of spontaneous abortion, and exposure to PM2.5 and PM10 in the third trimester might increase the risk of stillbirth. CO exposure during the first trimester of pregnancy was associated with an increased risk of spontaneous abortion and exposure during the third trimester was associated with an increased risk of stillbirth. Cooking smoke was found to increase the risk of stillbirths, and the evidence was consistent. Insufficient and conflicting evidence was found for various other pollutants, such as NO2 and SO2. Studies did not show clear evidence for associations between pregnancy loss and others pollutants such as heavy metals, organochlorine compounds, PAH and total dust count. Further research is warranted to better understand the relationship between air pollution exposure and pregnancy loss.


2019 ◽  
pp. 395-408 ◽  
Author(s):  
P. ŽÁK ◽  
M. SOUČEK

Several pathophysiological mechanisms have been proposed in the development of pregnancy complications, including endothelial dysfunction, an inflammatory pathway and oxidative stress. The aim of the present study was to evaluate the correlation between proinflammatory cytokines TNF-α, IL-6 and dual cytokine IL-10 in the mother’s peripheral blood and systolic blood pressure, risk of preeclampsia and low birth weight in gestational diabetes (GDM). We observed 40 women with GDM divided into a gestational hypertension group (n=20) and comparison group (n=20) with normal blood pressure. We found a significant positive correlation between TNF-α; IL-6; IL-10 levels and systolic blood pressure (SBP) in the second trimester (p<0.001; p<0.001; p<0.001); the third trimester (p<0.001; p<0.001; p<0.05). We also proved correlations for diastolic blood pressure (DBP) during the second; third trimester (p<0.001; p<0.001; p<0.001); (p<0.001; p<0.001; p<0.0015). We demonstrated a statistically significant positive association between high TNF-α group and preeclampsia risk in the third trimester (p=0.04). We also determined the negative correlation in the second trimester between birth weight and TNF-α; IL-6, IL-10 levels (p<0.05; p<0.001; p<0.001). To conclude, our data highlight the importance of cytokines TNF-α, IL-6 and IL-10 in blood pressure regulation. In addition, high levels of TNF-α have been associated with increased risk of preeclampsia. We found a significant negative correlation between levels of TNF-α, IL-6, IL-10 and birth weight.


2019 ◽  
Vol 2019 ◽  
pp. 1-3
Author(s):  
Lily Criscione ◽  
Kristen Elmezzi ◽  
Saioa Torrealday ◽  
Barton C. Staat ◽  
Kimberly Hickey

Vaginal bleeding during pregnancy places women at increased risk of spontaneous abortion. Etiologies for threatened and spontaneous abortions have been well studied, but there is little information on intertwin membrane hemorrhage. We present a patient with a multiple gestation pregnancy who experienced first trimester vaginal bleeding with visualization and subsequent rapid resolution of an intertwin membrane hemorrhage. The patient had an otherwise normal pregnancy until the third trimester when she developed preeclampsia with severe features and elected for a primary cesarean section at 35 + 5 weeks. The implications of an intertwin membrane hemorrhage are not well understood, although there could be a possible correlation between the hemorrhage and the ultimate progression to preeclampsia with severe features. Despite the final diagnosis, the patient did not have any noticeable complications due to the hemorrhage both when it was discovered and in the weeks following its discovery.


Sign in / Sign up

Export Citation Format

Share Document